Kazakhstan: Monitoring the situation of children and women: Multiple Indicator Cluster Survey (2006)

Publication date: 2006

KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 I KAZAKHSTAN Multiple Indicator Cluster Survey 2006 Monitoring the situation of children and women United Nations Children’s Fund Agency of the Republic of Kazakhstan on Statistics United States Agency for International Development United Nations Population Fund United Nations Resident Coordinator International Labour Organization Contributor’s to the Report: Erbolat Mussabek Gyulnar Kukanova Gaziza Moldakulova Kazakhstan Multiple Indicator Cluster Survey (MICS) first conducted in Kazakhstan in 2006 by the Agency of the Republic of Kazakhstan on Statistic in collaboration with the Republican State Enterprise “Data Computing Centre”. Financial, methodological and technical support was provided by the United Nations Children’s Fund (UNICEF) and with financial support of United States Agency for International Development (USAID), United Nations Population Fund (UNFPA), UN Resident Coordinator Fund (UN ResCor) and International Labour Organization (ILO). The survey has been conducted as part of the third round of MICS surveys (MICS3), carried out around the world in more than 50 countries, in 2005-2006, following the first two rounds of MICS surveys that were conducted in 1995 and the year 2000. Survey tools are based on the models and standards developed by the global MICS project, designed to collect information on the situation of children and women in countries around the world. Additional information on the global MICS project may be obtained from www.childinfo.org. Suggested citation: United Nations Children’s Fund (UNICEF), Agency of the Republic of Kazakhstan on Statistic © Agency of the Republic of Kazakhstan on Statistics, 2007 © UNICEF, Kazakhstan 2007 Any information from this publication may be freely reproduced, but proper acknowledgement of the source must be provided. The publication is not for sale Agency of the Republic of Kazakhstan on Statistics 010000, Astana City, Left Bank of Ishim River The House of Ministries, 35th Street, 4th Gate Fax: (7172) 74-94-94 E-Mail: stat@mail.online.kz United Nations Children’s Fund (UNICEF) in the Republic of Kazakhstan 010000, Astana City, 10A, Beibitshilik str., Block 1 Tel: (+7 7172) 32-17-97, 32-29-69 Fax: (+7 7172) 32-18-03 Web: www.unicef.org KAZAKHSTAN Multiple Indicator Cluster Survey 2006 Final Report Astana, 2007 MONITORING THE SITUATION OF CHILDREN AND WOMENii Summary Table of Findings Multiple Indicator Cluster Surveys (MICS) and Millennium Development Goals (MDG) Indicators, Kazakhstan, 2006 Topic MICS Indicator Number MDG Indicator Number Indicator Value CHILD MORTALITY Child mortality 1 13 Under-five mortality rate 36.3 per thousand 2 14 Infant mortality rate 31.8 per thousand NUTRITION Nutritional status 6 4 Underweight prevalence 4.0 percent 7 Stunting prevalence 12.8 percent 8 Wasting prevalence 3.8 percent Breastfeeding 45 Timely initiation of breastfeeding 64.2 percent 15 Exclusive breastfeeding rate 16.8 Percent 16 Continued breastfeeding rate at 12-15 months at 20-23 months 57.1 16.2 percent percent 17 Timely complementary feeding rate 39.1 percent 18 Frequency of complementary feeding 24.0 percent 19 Adequately fed infants 20.7 percent Salt iodization 41 Iodized salt consumption 92.0 percent Low birth weight 9 Low birth weight infants 5.8 percent 10 Infants weighed at birth 99.4 percent CHILD HEALTH Immunization 25 Tuberculosis immunization coverage 97.9 percent 26 Polio immunization coverage 93.9 percent 27 DPT immunization coverage 91.7 percent 28 15 Measles immunization coverage 94.7 percent 31 Fully immunized children 81.0 percent 29 Hepatitis B immunization coverage 92.3 percent KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 iii Care of illness 33 Use of oral rehydration therapy (ORT) 74.0 percent 34 Home management of diarrhoea 21.8 percent 35 Received ORT or increased fluids, and continued feeding 48.0 percent 23 Care seeking for suspected pneumonia 70.5 percent 22 Antibiotic treatment of suspected pneumonia 31.7 percent Solid fuel use 24 29 Solid fuels 19.0 percent ENVIRONMENT Water and Sanitation 11 30 Use of improved drinking water sources 93.7 percent 13 Water treatment 70.8 percent 12 31 Use of improved sanitation facilities 99.2 percent 14 Disposal of child’s faeces 31.4 percent REPRODUCTIVE HEALTH Contraception 21 19c Contraceptive prevalence 50.7 percent Maternal and newborn health 20 Antenatal care 99.9 percent 44 Content of antenatal care Weight measured Blood pressure measured Urine specimen taken Blood test taken 99.5 99.5 99.5 99.5 percent percent percent percent 4 17 Skilled attendant at delivery 99.8 percent 5 Institutional deliveries 99.8 percent Maternal mortality 3 16 Maternal mortality ratio 70 per 100 000 CHILD DEVELOPMENT Child development 46 Support for learning 81.0 percent 47 Father’s support for learning 46.9 percent 48 Support for learning: children’s books 66.4 percent 49 Support for learning: non-children’s books 89.1 percent 50 Support for learning: materials for play 19.8 percent 51 Non-adult care 9.8 percent MONITORING THE SITUATION OF CHILDREN AND WOMENiv EDUCATION Education 52 Pre-school attendance 16.0 percent 53 School readiness 39.5 percent 54 Net intake rate in primary education 92.9 percent 55 6 Net primary school attendance rate 98.0 percent 56 Net secondary school attendance rate 95.3 percent 57 7 Children reaching grade five 99.7 percent 58 Transition rate to secondary school 99.7 percent 59 7b Primary completion rate 88.4 percent 60 8 Adult literacy rate 99.8 percent 61 9 Gender parity index primary school secondary school 0.99 1.00 ratio ratio CHILD PROTECTION Birth registration 62 Birth registration 99.2 percent Child labor 71 Child labor 2.2 percent 72 Laborer students 94.3 percent 73 Student laborers 2.3 percent Child discipline 74 Child discipline Any psychological/physical punishment 52.2 percent Early marriage 67 Marriage before age 15 Marriage before age 18 0.4 8.5 percent percent 68 Young women aged 15-19 currently married/in union 4.9 percent 69 Spousal age difference (>10 years) Women aged 20-24 7.4 percent Domestic violence 100 Attitudes towards domestic violence 10.4 percent KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 v HIV/AIDS HIV/AIDS knowl- edge and attitudes 83 19b Comprehensive knowledge about HIV prevention among young people 22.4 percent 89 Knowledge of mother- to-child trans- mission of HIV 54.5 percent 86 Attitude towards people with HIV/AIDS 3.8 percent 87 Women who know where to be tested for HIV 83.5 percent 88 Women who have been tested for HIV 61.7 percent 90 Counselling coverage for the preven- tion of mother-to-child transmission of HIV 82.4 percent 91 Testing coverage for the prevention of mother-to-child transmission of HIV 78.8 percent TUBERCULOSIS Tuberculosis knowledge Awareness of tuberculosis 99.4 percent Knowledge of TB transmission by air 94.9 percent Knowledge of recovery after tuberculo- sis at proper treatment 79.0 percent Women who were sick or have a family member with TB 5.0 percent Women who communicate with neighbours, colleagues or close friends suffering from TB 7.5 percent INFORMATION SOURCES Sources of main information for households Households receiving information from TV 97.7 percent Households receiving information from newspapers 66.4 percent Households receiving information from friends, relatives, neighbours and col- leagues 54.1 percent MONITORING THE SITUATION OF CHILDREN AND WOMENvi Summary Table of Findings . . . . . . . . . . . . . . . . . . . . .ii List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii List of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .x List of Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Foreword and Acknowledgments . . . . . . . . . . . . xii Executive Summary . . . . . . . . . . . . . . . . . . . . . 1 I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . 7 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 Survey objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9 II. Sample and Survey Methodology . . . .10 Sample design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Questionnaires . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Training and fieldwork . . . . . . . . . . . . . . . . . . . . 14 Data Processing . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 III. Sample Coverage and the Characteristics of Households and Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 Sample Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Characteristics of Households . . . . . . . . . . . . 17 Characteristics of Respondents . . . . . . . . . . . 19 Sources of information for the family . . . . 20 IV. Child mortality . . . . . . . . . . . . . . . . . . . . . .21 V. Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 Nutritional Status . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Salt iodization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Low Birth Weight . . . . . . . . . . . . . . . . . . . . . . . . . . 30 VI. Child Health . . . . . . . . . . . . . . . . . . . . . . . . .32 Immunization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Oral Rehydration Treatment . . . . . . . . . . . . . . 35 Care Seeking and Antibiotic Treatment of Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Solid Fuel Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 VII. Environment . . . . . . . . . . . . . . . . . . . . . . .39 Water and Sanitation . . . . . . . . . . . . . . . . . . . . . . 40 VIII. Reproductive Health . . . . . . . . . . . . . .43 Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Reproductive Behavior . . . . . . . . . . . . . . . . . . . . 44 Antenatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Assistance at Delivery . . . . . . . . . . . . . . . . . . . . . . 46 Maternal Mortality . . . . . . . . . . . . . . . . . . . . . . . . . 47 IX. Child Development . . . . . . . . . . . . . . . . .48 X. Education . . . . . . . . . . . . . . . . . . . . . . . . . . . .51 Pre-School Attendance and School Readiness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Primary and Secondary School Participation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Adult Literacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 XI. Child Protection . . . . . . . . . . . . . . . . . . . . .55 Birth Registration . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Child Labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Child Discipline . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Early Marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Domestic Violence . . . . . . . . . . . . . . . . . . . . . . . . 60 XII. HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . .61 Knowledge of HIV Transmission . . . . . . . . . . 61 XIII. Tuberculosis . . . . . . . . . . . . . . . . . . . . . .64 Knowledge of Tuberculosis . . . . . . . . . . . . . . . . 64 List of References . . . . . . . . . . . . . . . . . . . . . . .66 Appendix A. Sample design . . . . . . . . . . . . . . . . .154 Appendix B. List of Personnel Involved in the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158 Appendix C. Estimates of Sampling Errors . .162 Appendix D. Data Quality Tables . . . . . . . . . . .183 Appendix E. MICS indicators: Numerators and Denominators . . . . . . . . . . . . . . . . . . . . . . . . . . .190 Appendix F. Questionnaires . . . . . . . . . . . . . . . .194 Table of Contents KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 vii List of Tables Table HH.1: Results of household and individual interviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Table HH.2: Household age distribution by sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Table HH.3: Household composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Table HH.4: Women’s background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Table HH.5: Children’s background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Table НН. 6: Resources of the main information for households . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Table CM.1: Early child mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Table CM.2: Children ever born and proportion dead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Table NU.1: Child malnourishment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Table NU.2: Initial breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Table NU.3: Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Table NU.4: Adequately fed infants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Table NU.5: Iodized salt consumption . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Table NU.8: Low birth weight infants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Table CH.1: Vaccinations in first year of life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Table CH.1C: Vaccinations in first year of life (continued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Table CH.2: Vaccinations by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Table CH.2C: Vaccinations by background characteristics (continued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Table CH.4: Oral rehydration treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Table CH.5: Home management of diarrhoea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 Table CH.6: Care seeking for suspected pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Table CH.7: Antibiotic treatment of pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Table CH.7A: Knowledge of the two danger signs of pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Table CH.8: Solid fuel use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 Table CH.9: Solid fuel use by type of stove or fire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Table EN.1: Use of improved water sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Table EN.2: Household water treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Table EN.3: Time to source of water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 Table EN.4: Person collecting water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Table EN.5: Use of sanitary means of excreta disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Table EN.5W: Number of households using improved sanitation facilities (worksheet) . . . . . . . . . . . . . .100 Table EN.6: Disposal of child’s faeces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102 Table EN.7: Use of improved water sources and improved sanitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 MONITORING THE SITUATION OF CHILDREN AND WOMENviii Table RH.1: Use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .104 Table RH.2A: Reproductive behavior of women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106 Table RH.2B: Factors limiting birth rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108 Table RH.2C: Factors stimulating birth rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110 Table RH.3: Antenatal care provider. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112 Table RH.4: Antenatal care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .114 Table RH.5: Assistance during delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116 Table RH.6: Maternal mortality ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118 Table CD.1: Family support for learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119 Table CD.2: Learning materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121 Table CD.3: Children left alone or with other children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123 Table ED.1: Early childhood education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124 Table ED.2: Primary school entry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125 Table ED.3: Primary school net attendance ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .126 Table ED.4: Secondary school net attendance ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127 Table ED.4W: Secondary school age children attending primary school . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .128 Table ED.5: Children reaching grade 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .129 Table ED.6: Primary school completion and transition to secondary education . . . . . . . . . . . . . . . . . . . .130 Table ED.7: Education gender parity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131 Table ED.8: Adult literacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .132 Table CP.1: Birth registration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .133 Table CP.2: Child labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134 Table CP.3: Laborer students and student laborers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135 Table CP.4: Child discipline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .136 Table CP.5: Early marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .137 Table CP.6: Spousal age difference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .138 Table CP.9: Attitudes toward domestic violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .139 Table HA.1: Knowledge of preventing HIV transmission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .140 Table HA.2: Identifying misconceptions about HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141 Table HA.3: Comprehensive knowledge of HIV/AIDS transmission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142 Table HA.4: Knowledge of mother-to-child HIV transmission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143 Table HA.5: Attitudes toward people living with HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .144 Table HA.6: Knowledge of a facility for HIV testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .145 Table HA.7: HIV testing and counseling coverage during antenatal care . . . . . . . . . . . . . . . . . . . . . . . . . . . . .146 Table TB.1: Knowledge about tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 ix Table TB.2: Symptoms of suspected tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149 Table TB.3: TB symptoms, which require seeing a doctor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151 Table TB.4: Attitudes towards people with TB. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153 Table SD.1. Allocation of sample clusters (primary sampling units) to Sampling Domains . . . . . . . . .155 Table SE.1. Indicators selected for sampling error calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163 Table SE.2. Sampling errors: total sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164 Table SE.3. Sampling errors: urban areas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165 Table SE.4. Sampling errors: rural areas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166 Table SE.5. Sampling errors: Akmola Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167 Table SE.6. Sampling errors: Aktobe Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168 Table SE.7. Sampling errors: Almaty Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169 Table SE.8. Sampling errors: Atyrau Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170 Table SE.9. Sampling errors: West Kazakhstan Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171 Table SE.10. Sampling errors: Zhambyl Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172 Table SE.11. Sampling errors: Karagandy Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173 Table SE.12. Sampling errors: Kostanai Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174 Table SE.13. Sampling errors: Kyzylorda Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175 Table SE.14. Sampling errors: Mangistau Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176 Table SE.15. Sampling errors: South Kazakhstan Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177 Table SE.16. Sampling errors: Pavlodar Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .178 Table SE.17. Sampling errors: North Kazakhstan Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179 Table SE.18. Sampling errors: East Kazakhstan Oblast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Table SE.19. Sampling errors: Astana City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181 Table SE.20. Sample errors: Almaty City . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .182 Table DQ.1. Age distribution of household members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183 Table DQ.2. Age distribution of eligible and interviewed women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184 Table DQ.3. Age distribution of eligible and interviewed under-5s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184 Table DQ.4. Age distribution of under 5 children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185 Table DQ.5. Heaping on ages and periods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .186 Table DQ.6. Completeness of reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187 Table DQ.7. Presence of mother in the household and the person interviewed for the under-5 questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188 Table DQ.8. School attendance by single age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188 Table DQ.9. Sex ratio at birth among children ever born and living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .189 Table DQ.10. Distribution of women by time since last birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .189 MONITORING THE SITUATION OF CHILDREN AND WOMENx List of Figures Figure HH.2. Age and sex distribution of household population, %, Kazakhstan, 2006 . . . . . . . . 18 Figure CM.1. Infant Mortality by Sources, Kazakhstan, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Figure CM.1А. Under Five Mortality Rate, Kazakhstan, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Figure CM.1В. Under Five Mortality Tendency, Kazakhstan, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Figure NU.1. Percentage of children under 5 who are undernourished, Kazakhstan, 2006 . . . . 26 Figure NU.2. Percentage of mothers who started breastfeeding within one hour and within one day of birth, Kazakhstan, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Figure NU.3. Infant feeding patterns by age: Percent distribution of children aged under 3 years by feeding pattern by age group, Kazakhstan, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . .29 Figure NU.5. Percentage of households consuming adequately iodized salt, Kazakhstan, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Figure NU.8. Percentage of Infants Weighing Less Than 2500 Grams at Birth, Kazakhstan, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Figure CH.1. Percentage of children aged 15-26 months who received the recommended vaccinations by 12 months, Kazakhstan, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Figure CH.5. Percentage of children aged 0-59 with diarrhoea who received ORT or increased fluids, AND continued feeding, Kazakhstan, 2006, % . . . . . . . . . . . . . . . . 36 Figure EN.1. Percentage distribution of population by source of drinking water, Kazakhstan, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Figure HA.1. Percent of women who have comprehensive knowledge of HIV/AIDS transmission, Kazakhstan, 2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 xi ADB Asian Development Bank AIDS Acquired Immune Deficiency Syndrome BCG Bacillis-Cereus-Geuerin (Tuberculosis) DHS Demography and Health Survey DPT Diphtheria Pertussis Tetanus vaccine EPI Expanded Programme on Immunization GCR Gender Correlation Rate GPI Gender Parity Index HIV Human Immunodeficiency Virus HMRS Home-made Rehydration Solution IDD Iodine Deficiency Disorders ILO International Labour Organization IQ Intelligence Quotient IMR Infant Mortality Rate IUD Intrauterine Device MDG Millennium Development Goals MICS Multiple Indicator Cluster Survey MMR Mumps, Measles, Rubella MoH Ministry of Health NAR Net Attendance Rate ORT Oral Rehydration Therapy ORS Oral Rehydration Salt PLWHA People Living with HIV/AIDS PPS Packed Powder Solution ppm Parts Per Million PSU Primary Sampling Units ResCor UN Resident Coordinator Fund RSE DCC AS Republican State Enterprise, Data Computing Centre of the Agency RK on Statistics AS RK Agency of the Republic of Kazakhstan on Statistic SPSS Statistical Package for Social Sciences STI Sexually Transmitted Infections UNAIDS United Nations Programme on HIV/AIDS UNDAF United Nations Development Assistance Framework UNDP United Nations Development Programme UNFPA United Nations Population Fund UNGASS United Nations General Assembly Special Session on HIV/AIDS UNICEF United Nations Children’s Fund U5MR Under-Five Mortality Rate WFFC World Fit for Children WHO World Health Organization List of Abbreviations MONITORING THE SITUATION OF CHILDREN AND WOMENxii Foreword and Acknowledgments The Kazakhstan Multiple Indicator Cluster Survey (MICS) was first conducted in 2006 with the pur- pose of obtaining information to assess progress towards the situation of children and women in Kazakhstan required for monitoring the Millennium Development Goals (MDGs) and objectives of the World Fit for Children document (WFFC) and other documents agreed at international level. Because of significant discrepancies in social and economic development of the regions of the coun- try, the Kazakhstan MICS was conducted at sub-national level as well, which makes it unique. I hope the survey findings will be useful for the Government and civil society institutes in planning and de- veloping social programs that meet the requirements of the real situations and needs of women and children both at national level and at the level of each region and oblast. The success of MICS and publication of the current Report is the work of many experts at different levels. We would like to mention the following international organizations working in Kazakhstan: United Nations Children’s Fund (UNICEF) for methodological, technical and financial support as well as the US Agency for International Development (USAID), the United Nations Population Fund (UNFPA), the UN Resident Coordinator’s Fund (ResCor) and the UN International Labor Organization (ILO) for their significant financial support. I also express thanks to the staff of the UNICEF Office in Kazakhstan in the person of Mr. Alexander Zouev, UNICEF Representative in Kazakhstan and Mr. Raimbek Sissemaliev, Head of Almaty Zone Office, UNICEF Project Coordinator, Kazakhstan, for technical, methodical and financial sup- port during training of staff from the Agency RK on Statistics and permanent support in preparation and implementation of the current survey; great thanks to Ms. Gaziza Moldakulova, MICS Project Coordinator, UNFPA Kazakhstan, for coordination of UN agencies involved in the MICS Project as well as for collaboration in preparation of financial reports and the current MICS report. I express thanks to UNICEF staff members, who conducted training workshops, developed question- naires and programs for data entry and calculation of indicators, accomplished general manage- ment as well as provided consultations during preparation, implementation and processing the out- comes of current global survey, in particular: MICS-3 Project Coordinator from UNICEF Regional Office Mr. George Sakvarelidze (Geneva, Switzerland) for his maximal assistance to the staff of the Agency in preparation and carrying out this survey in Kazakhstan. We express special gratitude to Mr. Anthony Turner, International Consultant on Sampling (USA) for his expert assistance in Kazakhstan MICS sampling and Mr. Muktar Minbayev, Project Coordinator on Monitoring and Evaluation, UNICEF, Kyrgyzstan, who provided invaluable assist- ance during sampling. Moreover, I would like to highlight local authorities of all levels who provided support during the im- plementation of the project, who provided valuable assistant to MICS field teams during the survey and data collection. In addition, I would like to express high appreciation to members of Coordination Committee on MICS preparation and implementation in Kazakhstan, ministries and agencies of the Republic, the non-governmental sector and international institutions concerned with MICS findings, which ex- pressed their comments and proposals to the current report. Chair Anar Meshimbayeva Agency of the Republic of Kazakhstan KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 xiii 1 Project participants occupied these positions the years MICS was prepared and implemented (2005-2007). Foreword and Acknowledgments I have great pleasure in presenting the Final Report on findings of Multiple Indicator Cluster Survey first held in Kazakhstan in 2006. This is a unique survey based on methodology developed and used by UNICEF in many countries in the world but has an essential feature, since it was conducted not only at the national scale. Unlike in many other countries focusing mainly on the national level, MICS in Kazakhstan was conducted at the sub-national level, which allowed obtaining more complete and reliable picture on social status of children, women and families in the entire country as well as in every region. The survey was based, in large part, on the need to monitor progress towards goals and targets emanat- ing from recent international agreements – the Millennium Declaration, adopted by all United Nations Member States in September 2000, and the Plan of Action of a “World Fit For Children”, adopted by 189 Member States at the United Nations Special Session on Children in May 2002. The success of MICS is the work of many experts from the Agency RK on Statistic and its territorial divi- sions as well as structural subdivision of RSE Data Computing Center. In this regard I sincerely appreciate the assistance of Mr. Kali Abdiyev, the Chair of the Agency RK on Statistics, who launched this Project, made all the necessary arrangements and established an environ- ment for successful Project implementation, Mr. Bakhyt Sultanov and Ms. Anar Meshimbayeva, who provided support to the MICS as Chairs of the Agency RK on Statistics, and express particular ap- preciation and gratitude to Mr. Yuri Shokamanov, Deputy Chair for their ongoing support in further MICS implementation.1 I would like to specially thank Mr. Yerbolat Mussabek, Deputy Director of Social and Demography Statistics Department of the Agency RK on Statistics, National MICS Coordinator, for coordination of all structures involved in the Project as well as planning of MICS preparation and implementation, formation of field teams for data collection, development of training techniques and arrangement of training workshops and Ms. Gulnar Kukanova, Head of the Population Statistics Division of the Social and Demography Statistics Department of the Agency RK on Statistics for training of field teams staff at regional training workshops and assistance in development and adaptation of MICS tools, and also Ms. Zinagul Dzhumanbayeva, Director of the Republican State Enterprise «Data Computing Centre» of the Agency RK on Statistics (RSE DCC AS) and her team for leading arrangements and work- ing with the financial reports of the executive partner of the Project; Ms. Aigul Kapisheva, Head of the Department on Databases Processing (RSE DCC AS) for adaptation of MICS software to the condi- tions of Kazakhstan and its accommodation; Ms. Saule Dauylbayeva, Head of Population Register Dataware Division (RSE DCC AS) and her team for the high quality entering of primary data and for- mation of the MICS database. In addition to the main activities of the Agency RK on Statistics within the current survey, the staff of the Kazakh Academy of Nutrition, our long standing and reliable partner, conducted study on food con- sumption frequency, prevalence of IDD and IDA among women and prevalence of Vitamin A Deficiency among children under 5. Findings of this study will be presented in second volume of the MICS Report due in the beginning 2008. Having this opportunity I would like to thank personally Professor Toregeldy Sharmanov, the President of the Kazakh Academy of Nutrition, and his staff, particularly Professor Shamil Tajibayev for successful completion of this work. I highly appreciate the assistance of the Heads of Oblast/City Departments on Statistics of the Republic of Kazakhstan for provision of human resources – state servants – for fieldwork and their invalu- able contribution to arranging the survey as well as work of the staff of the Regional Departments on Statistics, involved in fieldwork on data collection in the severe winter conditions in 2006. I would like to specially acknowledge the work of field team supervisors for due level of fieldwork arrangement and implementation, development of optimal routes for the teams; interviewers for high-quality and MONITORING THE SITUATION OF CHILDREN AND WOMENxiv timely fieldwork on data collection in compliance with MICS requirements, editors – for quality ques- tionnaires editing, anthropometric measurements and timely delivery of questionnaires to the central office, drivers for timely and safe delivery of teams to remote settlements as per tight schedule. I have to emphasize that implementation of the MICS project became possible in Kazakhstan not only due to financial and overall support of UNICEF but also due to substantial contribution of our reliable UN family partners into the process, primarily United Nations Population Fund (UNFPA) and also UN Resident Coordinator Fund, International Labor Organization (ILO), and certainly our main donor partner the United States Agency for International Development (USAID). Implementation of MICS allowed to train many relevant professionals and technical staff in the coun- try. I believe that state agencies would continue use their capacity and the methodology in other similar surveys concerning social and economical issues of the country as well as to measure their progress. The report contains a lot of interesting information about the status of women and children in Kazakhstan and will be of use for state bodies, non-governmental organizations, international insti- tutes, professors and students as well as the general public. UNICEF Representative in the Republic of Kazakhstan Alexandre Zouev KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 1 EXECUTIVE SUMMARY MONITORING THE SITUATION OF CHILDREN AND WOMEN2 Characteristics of households In 14,564 surveyed households resided 51,261 people. Of them 48.2 percent were males and 51.8 percent females. The average household size was 3.5 people. The major number of households con- sisted of 2-3 people (41 percent) and 4-5 people (32.4 percent). The proportion of households with at least one child under 18 was 56.7 percent; in 21.8 percent of households lived children under 5, the proportion of households with at least one woman aged 15-49 was 70.6 percent. The proportion of children under 15 years made 24.1 percent, persons aged 15-64 – 67.2 percent, people over 65 – 8.7 percent and the number of children aged 0-17 years made 30.3 percent of the total number of surveyed household members. In total, the number of reproductive age women (15-49 years) made 54.9 percent. At the time of the sur- vey, 57.4 percent of interviewed women were married or in union, 14.1 percent – divorced/separated/ widowers and 28.6 percent – never married. According to maternal status – 66.8 percent women had given birth. 13.4 percent of reproductive age women have primary or incomplete secondary education, 33.6 percent have completed secondary education, 27.1 percent have specialized secondary and 25.9 percent – higher education. As for wealth levels the poorest and poor quintiles are represented approxi- mately by the same indicator 18.5-18.7 percent, middle – 19.4 percent, rich – 20 percent and richest 23.4 percent, where reproductive age women resided. Among interviewed women 59.1 percent were Kazakhs, and 30.8 percent Russians. The number of children under 5 was 7.8 percent. 51 percent of children lived in urban areas and 49 percent – in rural areas. Age of children: under 6 months – 8.7 percent, 6-11 months – 10.5 percent, 12-23 months – 21.9 percent, 24-35 months –21.5 percent, 36-47 months – 19.4 percent and 48-59 months – 18 percent. Sources of Information for Family Almost all residents (over 97 percent) of Kazakhstan obtain information for the family, mainly from TV. The second source of information for 66 percent of the population is newspapers. The third prevalent source of information for Kazakhstan citizens are friends, siblings, neighbors and col- leagues. The next source of information reported by over one quarter (25.4 percent) of population was radio. Over 18 percent of Kazakhstan people get information from magazines. Outdoor adver- tisement and posters (9.4 percent), as well as the Internet (4.7 percent) are not very popular among respondents. The popularity of some information sources mainly depends on education level and wealth of population as well as regions and area of residence, and of course, access to some sources, for instance, the Internet. Infant and child mortality The infant mortality rate (IMR) is estimated at 31.8 per thousand life births, while the probability of dying before the age 5 is around 36.3 per thousand live births. Boys’ mortality significantly exceeds girls’ and makes 36.6 and 26.6 per thousand respectively for IMR, and 41.7 and 30.3 per thousand livebirths respectively for under 5 mortality. Nutrition Status In Kazakhstan 4 percent of children under 5 are moderately underweight (weight for age) and 0.8 percent are classified as severely underweight, at that, 3.8 percent of children are wasted (weight for height) and 1 percent severely wasted. At the same time, 12.8 percent of children in the country are stunted for their age and the height of 4 percent is too short for their age. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 3 Breastfeeding 64.2 percent started breastfeeding within one hour of birth; the urban-rural difference was 4.4 per- cent – urban women 66.3 percent and 61.9 of rural women. 87.8 percent started breastfeeding with- in one day of birth (which includes those who started within one hour), the percentage of such women in urban and rural settlements is almost the same (87.7 and 88 percent respectively). 16.8 percent of children aged less than six months are exclusively breastfed, a level considerably lower than recommended. At aged 6-9 months, 39.1 percent of children are receiving breast milk and solid or semi-solid foods. By age 12-15 months, 57.1 percent of children are still being breastfed and by age 20-23 months, 16.2 percent are still breastfed. Girls were more likely to be exclusively breastfed than boys were, while boys had higher levels than girls for timely complementary feeding. Salt Iodization In 98.8 percent of households, salt used for cooking was tested for iodine content by using salt test kits and testing for the presence of potassium iodate. In 92 percent of households, salt was found to contain 15 ppm or more of iodine. The above data proves that Kazakhstan is ready for certification as a country that has achieved universal salt iodization. Low Birth Weight Overall, 99.4 percent of babies were weighed at birth and approximately 5.8 percent of infants are estimated to weigh less than 2,500 grams at birth. Immunization 97.9 percent of children in Kazakhstan aged 15-26 months received a BCG vaccination and the first dose of DPT by the age of 12 months. The percentage declines for subsequent doses of DPT to 96.7 percent for the second dose, and 91.7 percent for the third dose. Similarly, 99 percent of children received Polio 1 (OPV) by age 12 months and this declines to 93.9 percent by the third dose. The coverage for measles vaccine by 15 months is a bit lower than for the other vaccines at 94.7 percent. This is primarily because, although 99.4 percent of children received the vaccine, only 94.7 percent received it by their first birthday. Despite the fact that by the age of 12 months coverage with some vaccines exceeds 94 percent, the percentage of children who had all the recommended vaccina- tions by their first birthday (by 15 months for measles) is low at only 81 percent. Solid Fuels Overall, 19 percent of all households in Kazakhstan are using solid fuels for cooking. Use of solid fu- els is very high in rural areas, where 40.8 percent of households are using solid fuels and very low in urban areas – 6.8 percent. The highest percent of households using solid fuels for cooking was found in South Kazakhstan (40.7 percent) and Kyzylorda (39.8 percent) Oblasts. The total percentage of solid fuels is too high due to high use of coal for cooking. Use of improved sources of drinking water and water treatment Overall, 93.7 percent of the population in Kazakhstan is using an improved source of drinking wa- ter – 98.1 percent in urban areas and 87.7 percent in rural areas. The situation with drinking water received from improved sources is worse in North Kazakhstan Oblast (81.7 percent), Kostanai (83.2 percent), South Kazakhstan (85.7 percent) and Atyrau (89.3 percent) Oblasts. In Atyrau and South Kazakhstan Oblasts 8.1 and 6.8 percent of population respectively use surface water. MONITORING THE SITUATION OF CHILDREN AND WOMEN4 70.8 percent of the population uses any way to treat drinking water obtained from all sources. The main method of water treatment used almost by 70 percent of the population is boiling; 24.7 per- cent of the population let the water to settle before consuming it. The urban population more often uses water treatment methods than the rural one. Use of improved sanitation Almost all the population of Kazakhstan (99.2 percent) are living in households with improved sani- tation facilities. In urban areas modern lavatory pans are more popular – over 60 percent of house- holds use them – as well as pit latrines with slab (35.5 percent). In rural areas about 95 percent of households use latrines with slab. The proportion of children aged 0-2 years whose last faeces was safely disposed of was 31.4 percent, at that, this indicator in urban area made 54.3 percent against 8.7 percent of rural area. Contraception Current use of contraception was reported by 50.7 percent of women currently married or in union. The most popular method is IUD (intrauterine device) which is used by one in three married women (36.2 percent of married women) in Kazakhstan. The next most popular but of limited occurrence method is pills, which accounts for 6.6 percent. 4.8 percent of women reported use of the condom. Reproductive Behavior Over one-third (37.7 percent) of women wanted to have 2 children, almost one in three (28.7 per- cent) women – three children and 17.0 percent – four children. Less than 9 percent (8.7 percent) of women in the survey wanted to have 5 to 9 children and only 0.5 percent of women – 10 or more. Factors limiting the birth of another child reported by women were low salary (25 percent) and health status (19.7 percent). The factors encouraging the birth of another baby reported by women were ma- ternity leave with sufficient pay (21.4 percent) and reduced age of retirement (19.8 percent). Antenatal Care Coverage of antenatal care (by a doctor, nurse, or midwife) is relatively high in Kazakhstan with 99.9 percent of women receiving antenatal care at least once during the pregnancy. All interviewed women had blood testing, blood pressure measurement; urine testing and were weighted (by 99.5 percent). Assistance at Delivery Almost all births in Kazakhstan (99.8 percent) were delivered by skilled personnel in health facilities. 80.9 percent of births were delivered by doctors, 18.2 percent – by nurses/obstetricians. Maternal Mortality In MICS, the maternal mortality ratio in Kazakhstan over the past 10-14 years was 70 cases per 100,000 of life births. School Readiness and Pre-School Attendance At the time of the survey, only 16 percent of children aged 36-59 months were attending pre-school institutions. Overall, 39.5 percent of children attending the first grade of primary school were at- tending pre-school the previous year. The proportion of males and females was almost the same, while 46.4 percent of children in urban areas had attended pre-school the previous year compared KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 5 to 33 percent among children living in rural areas. Urban-rural differentials are very significant as well as mother’s educational level. Socioeconomic status appears to have a significant impact on school readiness. Primary and Secondary School Participation Of children who are of primary school entry age (age 7) in Kazakhstan, 92.9 percent are attending the first grade of primary school. By gender indicator boys (95.1 percent) prevail over girls (90.4 per- cent). Gender Parity Index for primary school is 0.99, indicating no difference in the attendance of girls and boys to primary school. This indicator is kept for secondary education (1.00). Birth Registration The birth of 99.2 percent of sampled children aged under 5 in Kazakhstan was registered. There are no significant variations in birth registration across sex, age, or education categories. Child Labor In Kazakhstan, 2.2 percent of children aged 5-14 years are involved in child labor of different types, such as work in a household, family business or outside of the household. Child Discipline In Kazakhstan, 52.2 percent of children aged 2-14 years were subjected to at least one form of psy- chological or physical punishment by their mothers/caretakers or other household members. Less than one percent of children were subjected to severe physical punishment; in urban area percent- age of such children is twice as much as in rural. Only 7.4 percent of mothers/caretakers believed that children should be physically punished, when in practice over 20 percent indicated the opposite. Early Marriage In Kazakhstan 57.4 percent of women aged 15-49 years sampled for MICS, are married/in union. It is necessary to note that around 5 percent of young women aged 15-19 years are married. Only 0.4 percents of women aged 15-49 were married or lived with man before they turned 15 years of age and 8.5 percents of women aged 20-49 years got married before they turned 18 years of age. Domestic Violence 10.4 percent of women aged 15-49 years said that a partner might beat his wife for the following reasons: • Goes out for long without telling her husband; • Neglects her children; • Contradicts her husband; • Refuses sex with him; • Burns food. The highest percentage of women (7.1 percent) recognized that partner can beat his wife if she neglects their children or does not care for them; at the same time, the percentage of women cur- rently and previously married was 8.3 and 7.7 percents respectively against 4.6 percent of women MONITORING THE SITUATION OF CHILDREN AND WOMEN6 never married/in union. Least percentage of women (1.5 percent) accepts this situation in case if wife refuses sex with her partner. Distribution of causes justifying, according to interviewed women, domestic violence from the partner and the number of women who accept such situation is almost the same in urban and rural areas. Knowledge of HIV transmission In Kazakhstan, almost all interviewed women (98.7 percent) have heard of AIDS. However, the per- centage of women who know all three main ways of preventing HIV transmission is only 30 per- cent. Almost 66 percent of women know of having one faithful uninfected sex partner, 62.9 percent know of using a condom every time, and 42.7 percent know of abstaining from sex as the main ways of preventing HIV transmission. While 80 percent of women know at least one way, a high propor- tion of women (20 percent) do not know any of the three ways. Misconceptions about HIV/AIDS Of the interviewed women, 36.3 percent reject the two most common misconceptions and know that a healthy-looking person can be infected. 68.7 percent of women know that HIV cannot be transmitted by sharing food, and 60.6 percent of women know that HIV cannot be transmitted by mosquito bites, while 67.5 percent of women know that a healthy-looking person can be infected. 79.8 percent of women know that HIV cannot be transmitted by supernatural means, and 96.2 per- cent of women know that HIV can be transmitted by multiple uses of needles. Attitudes toward people living with HIV 96.2 percent of women in survey agree with at least one discriminatory statement concerning peo- ple with HIV; urban as well as rural population, irrespective of education level, wealth of household, and age were unanimous. 82.7 percent of people would not buy foodstuffs from HIV-positive ven- dor, 65.9 percent of respondents would want to keep HIV status of a family member a secret, 60.1 percent of population of Kazakhstan believes that HIV positive teacher should not be allowed to teach in school. Interviewing revealed that 9.4 percent of population in general would not take care of family member with HIV (AIDS), there were found no significant urban-rural differences. Knowledge of Tuberculosis 99.4 percent of population of the country is aware of tuberculosis, equally in urban and rural areas. 79 percent of women know about tuberculosis patients’ recovery if it is properly treated. 83.2 per- cent of interviewed females reported that TB should be treated in the hospital. Almost all respond- ents regardless of the place of residence, education level and wealth knew about TB transmission by air during coughing. About 42 percent of parents in urban and rural areas responded that they will seek medical care in TB dispensary with suspected TB in children. About 39 percent parents in rural area and 25.5 percents of parents in urban area will seek hospital care. The latter prefer to apply to the clinic (32 percent). Almost 53 percent of interviewed women correctly named ‘coughing for more than three weeks’ as a TB symptom and 58.5 percent of women reported seeking the medical care if this sign appears. Among other symptoms almost 43 percent of women named blood with phlegm, 38 percent – fever and 37 percent – night sweating. Overall in the country over 12 percent of respondents were sick or have family members suffering from TB and communicated with people with TB outside of the family. This shows quite high disease prevalence within the Republic. At the same time the population is well informed on the ways of disease transmission and symptoms. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 7 I. Introduction MONITORING THE SITUATION OF CHILDREN AND WOMEN8 Background This report is based on the Kazakhstan Multiple Indicator Cluster Survey (hereinafter MICS), first conducted in Kazakhstan in 2006 by the Agency of Kazakhstan on Statistics. The survey provides valu- able information on the situation of children and women in Kazakhstan and was based, in large part, on the need to monitor progress towards goals and targets emanating from recent international agree- ments: the Millennium Declaration, adopted by all 191 United Nations Member States in September 2000, and the Plan of Action of a “World Fit For Children”, adopted by 189 Member States at the United Nations Special Session on Children in May 2002. Both of these commitments build upon promises made by the international community at the 1990 World Summit for Children. By signing these international agreements, govern- ments committed themselves to improving condi- tions for their children and to monitor progress towards that end. UNICEF was assigned a support- ing role in this task (see below). After the President of the Republic of Kazakhstan (RK) signed the Declaration, the Government of RK committed itself to monitor progress towards the Millennium Development Goals (MDGs) to 2015. Assessment of follow-up indicators is essen- tial in view of information provision for further ac- tion and assessment of changes. The long-term strategic development of Kazakhstan associates with the Millennium Development Goals. State and sectoral programs as well as development strategies of the Republic reflect all MDG goals and objectives. The long- term National Strategy ‘Kazakhstan-2030’ and the Mid-Term Development Plan ‘Kazakhstan-2010’ also reflect the strategic development priorities of Kazakhstan focused on reducing gaps between rich and poor people, strengthening human se- curity through a decrease in social vulnerability, improvement of social services quality, environ- mental sanitation, civil society participation in development and strengthening the institutional potential of state bodies. During the last years Kazakhstan made certain progress towards the MDGs achievement. The Republic has developed a number of strategies and state programs for achieving national goals and priorities, such as: • Program on Combating Poverty and Unemployment in the Republic of Kazakhstan for 2000-2002; A Commitment to Action: National and International Reporting Responsibilities The governments that signed the Millennium Declaration and the World Fit for Children Declaration and Plan of Action World Fit for Children also committed themselves to moni- toring progress towards the goals and objec- tives they contained: “We will monitor regularly at the national lev- el and, where appropriate, at the regional lev- el and assess progress towards the goals and targets of the present Plan of Action at the na- tional, regional and global levels. Accordingly, we will strengthen our national statistical capacity to collect, analyse and disaggregate data, including by sex, age and other relevant factors that may lead to disparities, and sup- port a wide range of child-focused research. We will enhance international cooperation to support statistical capacity-building efforts and build community capacity for monitor- ing, assessment and planning.” (A World Fit for Children, paragraph 60) “…We will conduct periodic reviews at the na- tional and subnational levels of progress in order to address obstacles more effectively and accelerate actions.…” (A World Fit for Children, paragraph 61) The Plan of Action (paragraph 61) also calls for the specific involvement of UNICEF in the preparation of periodic progress reports: “… As the world’s lead agency for children, the United Nations Children’s Fund is requested to continue to prepare and disseminate, in close collaboration with Governments, relevant funds, programmes and the specialized agen- cies of the United Nations system, and all other relevant actors, as appropriate, information on the progress made in the implementation of the Declaration and the Plan of Action.” Similarly, the Millennium Declaration (paragraph 31) calls for periodic reporting on progress: “…We request the General Assembly to review on a regular basis the progress made in im- plementing the provisions of this Declaration, and ask the Secretary-General to issue peri- odic reports for consideration by the General Assembly and as a basis for further action.” KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 9 • State Program on Poverty Reduction for 2003- 2005; • State Program on Reforming and Development of Public Health RK for 2005-2010; • State Education Program in Kazakhstan for 2005-2010; • Gender Equality Strategy of the Republic of Kazakhstan for 2005-2015; • Program on Development of Rural Areas for 2004-2010; • Branch Program «Drinking waters» for 2002- 2010; • Program on Counteracting AIDS Epidemics in the Republic of Kazakhstan for 2001-2005. In frames of assistance to the Government of Kazakhstan in achievement of the global goals and national priorities, UN System coordinates and consolidates efforts of individual UN agen- cies at country level through a strategic tool called the United Nations Development Assistance Framework for 2005-2009 (UNDAF). Better access to quality basic social services, in particular, reduction of child mortality, improve- ment of maternal health and reduction of HIV/ AIDS, tuberculosis and other dangerous diseases in Kazakhstan is directly linked to expected UNDAF outcome. UN assistance in achieving these goals focuses on: • Strengthening of legislative base for better public health and education services; • Improvement of public health management; • Improvement and expansion of key health services: MCH, reproductive health and HIV/ AIDS especially to vulnerable groups; • Dissemination and improvement of knowl- edge, behavior skills and practices in the area of MCH, reproductive health, HIV/AIDS and child care to the community and family levels; • Capacity building of education management at the republican and regional level; • Establishment of child and youth-friendly edu- cation environment focused at development of vital skills and HIV/AIDS prevention in pilot regions. Based on the Situation Analysis of Status of Chilren and its own experience UNICEF identified in 2001 five priority areas, where the most impact on chil- dren’s life could be achieved: girl’s education; in- tegrated development in childhood and adolec- sence; immunization «plus»; combating HIV/AIDS; and enforced protection of children against do- mestic violence, exploitation and discrimination. For the first time, the 2006 Kazakhstan Multiple Indicator Cluster Survey (MICS) was conducted in order to analyze and assess progress in the area of mother and child situation in Kazakhstan as well as progress towards Millennium Development Goals. Agency of the Republic of Kazakhstan on Statistics represented the Government RK in the survey conducted under methodological, technical and financial support of UNICEF and financial sup- port of US Agency for International Development (USAID), UN Population Fund (UNFPA), UN Resident Coordinator Fund and International Labor Organization (ILO). Because of significant discrepancies in social and economical development of the regions of the country, Kazakhstan MICS was conducted at sub-national level, which makes it unique; thus, the results of the survey might encourage the Government and civil society institutes to plan and develop social programs that will meet de- mands of real situation and needs of women and children both at national level and at the level of each region. In addition, MICS improves the quality of statisti- cal information and monitoring of situation of children and mothers in Kazakhstan and progress towards Millennium Development Goals as well as strengthens technical and qualification potential of the Agency RK on Statistic staff on such surveys. This final report presents the results of the indica- tors and topics covered in the survey. Survey objectives 2006 Kazakhstan Multiple Indicator Cluster Survey has as its primary objectives: • To provide up-to-date information for assess- ing the situation of children and women in Kazakhstan; • To furnish data needed for monitoring progress toward goals established by the Millennium Development Goals in the Millennium Declaration, the goals of A World Fit For Children (WFFC), and other internationally agreed upon goals, as a basis for future action; • To contribute to the improvement of data and monitoring systems in Kazakhstan and to strengthen technical expertise in the design, implementation, and analysis of such systems. MONITORING THE SITUATION OF CHILDREN AND WOMEN10 II. Sample and Survey Methodology KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 11 Sample design The sample for the Kazakhstan Multiple Indicator Cluster Survey (MICS) was designed to provide es- timates on a large number of indicators on the situation of children and women at the national level, for urban and rural areas, as well as at sub-national level for 16 regions – 14 Oblasts and 2 cities: Akmola Oblast Aktobe Oblast Almaty Oblast Atyrau Oblast West Kazakhstan Oblast Zhambyl Oblast Karaganda Oblast Kostanai Oblast Kyzylorda Oblast Mangistau Oblast South Kazakhstan Oblast Pavlodar Oblast North Kazakhstan Oblast East Kazakhstan Oblast Astana City Almaty City Regions were identified as the main sampling domains and the sample was selected in two stages. The sample was stratified by urban and rural areas (which represent second level territorial and ad- ministrative units). 1999 Population Census enumeration areas were selected as Primary Sampling Units (PSUs). The number of primary sampling units (PSUs) for oblast and main cities depended on the total population at the beginning of 2005. At the first stage, mentioned number of PSUs was randomly selected for each stratum. In general, 625 PSUs were selected within the country. At the second stage, 24 households were systematically se- lected in each sampled primary sampling unit. Thus, the total number of sampled households made 15,000. The sample was stratified by region and is not self-weighting. For reporting national level re- sults, sample weights are used. A more detailed description of the sample design can be found in Appendix A. MONITORING THE SITUATION OF CHILDREN AND WOMEN12 2 Children under-5 and children aged 0–4 years and children aged 0–59 months are used as interchangeable in this report. In addition to the main activities of the Agency RK on Statistics within the current survey, the staff of the Kazakh Academy of Nutrition conducted study on micronutrients. To do so a sub-sample of 5,000 households was made based upon main sample. This study envisaged interviewing of 5,000 women aged 15-49 on food consumption frequency, blood pressure measurement, taking blood samples for haemoglobin, and collection of urine for iodine excretion measurement. Moreover, within the 5,000 households a sub-sample of 1,000 households with children under 5 was identified to measure the contents of Vitamin A in their blood and to collect edible salt for iodine level meas- urement in laboratory. The findings of this study will be presented in the second volume of the MICS report due early 2008. Questionnaires Three sets of questionnaires were used in the survey: 1) a household questionnaire which was used to collect information on all de jure household members, the household, and the dwelling; 2) a women’s questionnaire administered in each household to all women aged 15-49 years; and 3) an under-5 questionnaire2 administered to mothers or caretakers of all children under 5 living in the household. The questionnaires included the following modules: • The Household Questionnaire included the following modules • Household Listing • Education • Water and Sanitation • Household Characteristics • Child Labor • Child Discipline • Maternal Mortality • Consumption of Iodized Salt • The Questionnaire for Individual Woman included the following modules • Child Mortality • Maternal and Newborn Health • Marriage and Union • Contraception • Attitudes Towards Domestic Violence • HIV/AIDS • The Questionnaire for Children Under Five included the following modules • Birth Registration and Early Learning • Child Development • Breastfeeding • Care of Illness KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 13 • Immunization • Anthropometry Moreover, household questionnaires were supplemented with following modules: • UNICEF Module (knowledge about UNICEF, Convention on the Rights of the Child, sources of information for families); • Health Care System Information Module; • Primary Health Care Accessibility Module; • Accessibility of In-patient and Specialized Care Module Individual questionnaire for women was added with specially developed modules on: • Reproductive Behavior • Tuberculosis Also the Mother and Newborn Health Module was supplemented by a number of questions on smok- ing and alcohol consumption by women in general and those pregnant in particular. Out of the 3 questions of UNICEF Module this report only provides findings on sources of informa- tion for family as ones having substantial significance for the public. Unfortunately, it was not possible to process data from the modules on health care system, accessibility of primary health care and in-pa- tient and specialized care within the framework of this exercise. In this regard it was decided to leave the collected data for further research. Due to very low response on ques- tions about tobacco and alcohol consumption the findings are not presented. The questionnaires are based on the MICS3 model questionnaire3; how- ever, some Modules were adapt- ed to Kazakhstan (in particular, Education Module, which was con- siderably changed). English ques- tionnaires were translated into Russian and Kazakh. Questionnaires were pre-tested in Fabrichnyi (Almaty Oblast) and Kordai (Zhambyl Oblast) settlements in November 2005. Based on the results of the pre-test, modifications were made to the wording and translation of the questionnaires. MICS Questionnaires for Kazakhstan are presented in Appendix F. In addition to the administration of questionnaires, fieldwork teams tested the salt used for cooking in the households for iodine content, and measured the weight and height of children age under 5 years. Details and findings of these measurements are provided in the respective sections of the report. 3 The model MICS3 questionnaire can be found at www.childinfo.org, or in UNICEF, 2006. MONITORING THE SITUATION OF CHILDREN AND WOMEN14 received a certificate upon completion of the workshop. Prior to fieldwork, supervisors developed spe- cial routes and schedules for teams moving by clusters. Before fieldwork mass media (newspa- pers, TV and radio) in the fields elucidated MICS targets and terms to population. The data were collected by 16 teams; each com- prised of six female interviewers, two drivers, one editor and one supervisor – head of team. Qualitative composition of fieldworkers was very high; each team comprised of state serv- ants, supervisors were deputy heads of Oblast/ City Statistics Departments, editors – director or deputy director FSE DCC AS RK, interview- ers – senior specialists and heads of depart- ments. Special badge with colored photo, full name, MICS and AS RK logos was prepared for each team member. Fieldwork began in January and concluded in March 2006. Preparatory work and coordination of all struc- tures involved in the Project was agreed with MICS coordinators from the Agency RK on Statistics with close cooperation of UNICEF and UNFPA MICS coordinators. Central office of RSE DCC of the Agency RK on Statistics dispatched all necessary tools and equipment required for MICS fieldwork ahead of time. During the fieldwork, Project Coordinators had Training and fieldwork The list of team members for 16 domains was composed from Oblast/City Statistics Departments staff. Training on data collec- tion techniques in the fields was conducted in November-December 2005. Four regional train- ing workshops 6 days long each were conduct- ed in Petropavlovsk City (21-26 November), Shymkent City (28 November – 3 December), Semipalatinsk City (5-10 December) and Aktobe City (20-25 December) for the staff of regional departments involved in fieldwork. In total, 129 Statistic Division’s staff members were trained. Four teams of eight people from each Oblast par- ticipated in each workshop, in total 32 people. Training included lectures on interviewing tech- niques, contents of the questionnaires and mock interviews between trainees in practice inter- viewing. By the end of the training participants spent two days in practicing interviewing at the venue of training workshops. With the purpose of practical training, teams of interviewers and respondents were established that had mock in- terviews and answered each questionnaire fol- lowed with discussion of completed question- naires, correction of mistakes and amendment of some questions for better comprehension. In addition, training on anthropometric measure- ments of children under 5 and testing of iodine in salt by testers was conducted in small groups. In the frames of the same workshops, special 2- day training workshops were conducted for su- pervisors and editors on monitoring in the fields and editing of questionnaires. Each participant KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 15 a few monitoring visits to the following Oblasts in accordance with schedule for field teams: Akmola, Karaganda, Mangistau, Atyrau, Almaty, Zhambyl, Kyzylorda and South Kazakhstan. Representative from UNICEF Regional Office (Geneva, Switzerland) took part in monitoring in the first two Oblasts. Heads of Oblast, city (rayon and rural) Akimates, health workers as well as statisticians provided efficient assistance to MICS teams in the fields. After completion of fieldwork teams presented reports, photo/video materials, comments and suggestions for MICS to the Central Office of AS RK. Data Processing ing entered data. Data were entered on twelve personal computers by 24 operators in two shifts. Four editors, four controllers (operators) and two supervisors monitored the question- naires quality and data entry. In order to ensure quality control, all questionnaires were double entered and internal consistency checks were performed. Procedures and standard programs developed under the global MICS-3 project and adapted to the Kazakhstan questionnaires were used throughout. Data processing began simul- taneously with data collection in January 2006 and finished at the beginning of April 2006. Data were analysed using the Statistical Package for Social Sciences (SPSS) software program, ver- sion 14, and the model syntax and tabulation plans developed by UNICEF for this purpose. Data were centrally processed in Data Computing Center of the Agency RK on Statistics (DCC AS RK). Editors responsible for checking complete- ness and correctness of completed question- naires as well as controllers responsible for data verification and operators entering data passed special training. Field editors checked complet- ed questionnaires for completeness and quality, composed questionnaires for households with- in clusters and sent them to the Central Office AS RK for data entry and establishment of data- base. Fourteen computers were installed in the ap- propriate premises in DCC AS RK, 12 of these computers had CSPro software for data entry and 2 – CSPro software for controllers verify- MONITORING THE SITUATION OF CHILDREN AND WOMEN16 III. Sample Coverage and the Characteristics of Households and Respondents KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 17 Sample Coverage Of the 15,000 households selected for the sample, 14,984 were found to be occupied. Of these 14,564 were successfully interviewed for a household response rate of 97.2 percent. In the inter- viewed households, 14,719 women (age 15-49) were identified. Of these, 14,570 were successfully interviewed, yielding a response rate of 99.0 percent. In addition, 4,424 children under age five were listed in the household questionnaire. Of these, questionnaires were completed for 4,416, which correspond to a response rate of 99.8 percent. Overall response rates calculated for the interviews of women 15-49 years of age and children under-5 were 96.2 and 97.0 percent respectively (Table HH.1). Household response rates in rural areas were higher than in urban – 99.4 percent and 95.6 percent respectively. The overall household response rate throughout the country was high and varied from 91.6 percent in Almaty City up to 99 percent in Zhambyl Oblast. Characteristics of Households The age and sex distribution of survey population is provided in HH.2. The distribution is also used to produce the population pyramid by sex and age in Figure HH.2. In 14,564 households successfully interviewed in the survey 51,261 household members were listed. Of these 24,724 (48.2 percent) were males and 26,537 (51.8 percent) were females. These data also indicate that the survey esti- mated the average household size at 3.5 people. Population aged 0-14 years made up 12,344 people or 24.1 percent, of these 6,405 were males (25.9 percent of all males), 5,939 were females (22.4 percent of all females). Population aged 15-64 years made 34,428 people or 67.2 percent, of these 16,621 were males (67.2 percent of all males) and 17,807 were females (67.1 percent of all females). People older 65 were 4,488 or 8.7 percent, of these 1,698 were males (6.9 percent of all males) and 2,790 were females (10.5 percent of all females). Children aged 0-17 years were 15,538 or 30.3 percent of total number of survey household mem- bers, of these 8,090 were males (32.7 percent of all males) and 7,448 were females (28.1 percent of all females). According to official statistics , as of 1 January 2006, the distribution of the population of the Republic of Kazakhstan by sex and age was as follows: percentage of males was 48.1 and females – 51,9 per- MONITORING THE SITUATION OF CHILDREN AND WOMEN18 Figure HH.2. Age and sex distribution of household population, %, Kazakhstan, 2006 vey and official statistics of Kazakhstan as of 1 January 2006, deviation makes 0.1 percent to 1.1 percent. Table HH.3 provides basic background infor- mation on the households. Within households, the sex of the household head, region, urban/ rural status, number of household members, and ethnicity4 group of the household head are shown in the table. These background charac- teristics are also used in subsequent tables in this report; the figures in the table are also in- tended to show the numbers of observations by major categories of analysis in the report. The weighted and unweighted numbers of households are equal, since sample weights were normalized (See Appendix A). The ta- ble also shows the proportions of households where at least one child under 18, at least one child under 5, and at least one eligible woman age 15-49 were found. The proportion of house- hold with at least one child under 18 made 56.7 percent, in 21.8 percent of households were children under 5, proportion of households with at least one woman aged 15-49 made 70.6 percent. 13 percent of households had one member, 41 percent had 2-3 members, 32.4 percent had 4- 5 members, 10.5 percent had 6-7 members, 2.4 percent had 8-9 members and 0.8 percent had 10 and more household members. cent. Population aged 0-14 years made 24.2 per- cent, of this age group 25.7 percent were males and 22.8 percent females. Population aged 15- 64 years of age made 68 percent, of this age group 68.5 percent were males and 67.5 percent were females. The age group of people older than 65 made 7.8 percent, of these 5.8 percent were males and 9.7 percent females. Percentage of children aged 0-17 years made 30.3 percent; of these 32.2 percent were males, 28.6 percent were females of total number of males and fe- males respectively. This data proves there is an insignificant diver- gence in distribution of population by sex and age (wide age group) between the current sur- 4 This was determined by asking about native language of household head Males Females KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 19 Tables HH.4 and HH.5 provide information on the background characteristics of female re- spondents 15-49 years of age and of children under age 5. In both tables, the total numbers of weighted and unweighted observations are equal, since sample weights have been normal- ized (standardized). In addition to providing useful information on the background charac- teristics of women and children, the tables are also intended to show the numbers of observa- tions in each background category. These cat- egories are used in the subsequent tabulations of this report. Table HH.4 provides background characteris- tics of female respondents 15-49 years of age. The table includes information on the distri- bution of women according to region, urban- rural areas, age, marital status, motherhood status, education5, wealth index quintiles6, and ethnicity. According to the weighted sample 8,655 peo- ple or 59.5 percent of the total women at the age of 15-49 lived in urban area, and 5,903 people (40.5 percent) lived in rural area (inci- dentally, the unweighted sample provided the urban-rural distribution of women at the age of 15-49 as 7,608 and 6,952 showing the re- spective difference of 1,047 and minus 1,049). At the moment of survey, 8,349 women (57.4 percent) were married or in union, 2,049 wom- en (14.1 percent) divorced/separated/widows and 4,160 women (28.6 percent) were never married. As for motherhood status – 66.8 per- cent of women had given birth. By education 1,948 women or 13.4 percent have primary or incomplete secondary education, 4,893 wom- en or 33.6 percent have secondary education, 3,949 women or 27.1 percent have specialized secondary and 3,768 women or 25.9 percent – higher education. As for wealth level the poor and poorest are rep- resented approximately by the same number 18.5 – 18.7 percent, middle – 19.4 percent, rich – 20 percent and richest 23.4 percent. Ethnicity: 8,609 women (59.1 percent) – Kazakhs, 4,481 women (30.8 percent) – Russians and 1,468 women (10.1 percent) – other nationalities. Some background characteristics of children under 5 are presented in Table HH.5. These include distribution of children by several at- tributes: sex, region and area of residence, age in months, mother’s or caretaker’s education, wealth, and ethnicity. In total, 4,415 children under 5 were surveyed; of these 2,327 or 52.7 percent were males and 2,088 or 47.3 percent were girls. 2,251 children or 51 percent lived in urban area and 2,164 children or 49 percent – in rural area. Age of children: under 6 months – 382 children or 8.7 percent, 6-11 months – 462 children or 10.5 percent, 12-23 months – 969 children or 21.9 percent, 24-35 months – 948 children or 21.5 5 Unless otherwise stated, “education” refers to educational level attended by the respondent throughout this report when it is used as a background variable. 6 Principal components analysis was performed by using information on the ownership of household goods and amenities (assets) to assign weights to each household asset, and obtain wealth scores for each household in the sample (The tools (devises) used in these calculations were as follows: electricity, radio, TV set, mobile phone, stationary (non-mobile) telephone, refrigerator, PC, washing-machine, sewing machine, vacuum cleaner as well as personal belongings of each household member such as watches, bicycle, motorbike, horse cart, vehicle, motor boat). Each household was then weighted by the number of household members, and the household population was divided into five groups of equal size, from the poorest quintile to the richest quintile, based on the wealth scores of households they were living in. The wealth index is assumed to capture the underlying long-term wealth through information on the household assets, and is intended to produce a ranking of households by wealth, from poorest to richest. The wealth index does not provide information on absolute poverty, current income or expenditure levels, and the wealth scores calculated are applicable for only the particular data set they are based on. Further information on the construction of the wealth index can be found in Rutstein and Johnson, 2004, and Filmer and Pritchett, 2001 Characteristics of Respondents MONITORING THE SITUATION OF CHILDREN AND WOMEN20 percent, 36-47 months – 858 children or 19.4 percent and 48-59 months – 796 children or 18 percent. Mothers with children under 5 had the following educational level: primary and incomplete secondary 7 percent or 309 moth- ers, 45.3 percent or 2,000 mothers had second- ary education, 23.3 percent or 1,030 mothers had specialized secondary and 24.4 percent or 1,076 mothers had higher education. Households with children under 5 were distrib- uted by wealth quintiles as the following: poor- est – 26.9 percent, poor – 20.9 percent, mid- dle 19.7 percent, rich – 16 percent and richest – 16.4 percent. tively, while in Aktobe, Mangistau and Atyrau Oblasts – from 82 to 89 percent of population. The next popular source of information report- ed by over one fourth (25.4 percent) of popula- tion was radio, at that, the proportion of urban population is twice as much as rural one. The popularity of radio also varies by region: 62 percent of the population of Almaty City and over 40 percent of the population in Aktobe and Atyrau Oblasts reported radio as one of the source of information for family, while in 8 regions of the Republic proportion of such respondents is below 20 percent. Over 18 per- cent of Kazakhstan’s population gets informa- tion from magazines, with a higher proportion among the urban population. Outdoor adver- tisement and posters (9.4 percent) as well as Internet (4.7 percent) are not very popular among respondents. Internet was mentioned by 7 percent of the urban population and 13.7 percent of respondents with higher education, at that, the largest proportion of respondents live in the cities of Astana (21.9 percent) and Almaty (13.5 percent). Overall, the popular- ity of some sources of information depends mainly on the level of education and wealth of the population as well as regions and place of residence, and, of course, access to some sources, for instance, to Internet. During the survey, household members were asked about the main sources of information for the family. Respondents proposed the fol- lowing sources: newspaper, TV, radio, maga- zines, Internet, outdoor advertisement and posters, siblings, friends, neighbors, colleagues. Almost all the population (over 97 percent) of Kazakhstan was found to be receiving infor- mation for the family, mainly, from TV, with no large difference by the place of residence, level of education, wealth, ethnicity and region. The second source of information for the popula- tion is newspapers (66 percent), with a higher proportion of the urban population; propor- tion of respondents with higher education lev- els prevails over those with lower education levels. Less than half of the population gets in- formation from the newspapers in Kyzylorda (44.1 percent) and South Kazakhstan (49.1 per- cent) Oblasts. The third predominant source of information for over half of Kazakhstan’s population (54.3 percent) are friends, relatives, neighbors and colleagues – equally used by ur- ban and rural population irrespective of edu- cational level, wealth and ethnicity. Popularity of this source varies significantly by region: in Kostanai and North Kazakhstan Oblasts only 38 and 41 percent of population gets information from friends, relatives, and colleagues respec- Sources of information for the family KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 21 IV. Child mortality MONITORING THE SITUATION OF CHILDREN AND WOMEN22 1990b). The data used in the estimation are: the mean number of children ever born for five-year age groups of women from age 15 to 49, and the proportion of these children who are dead, also for five-year age groups of wom- en. The technique converts these data into probabilities of dying by taking into account both the mortality risks to which children are exposed and their length of exposure to the risk of dying, assuming a particular model age pattern of mortality. Based on previous infor- mation on mortality in Kazakhstan the stand- ard East model life table was selected as most appropriate and more accurately reflecting mortality in age groups 20-24, 25-29 and 30- 34 years. Table CM.1 provides estimates of child mortal- ity by various background characteristics, while Table CM.2 provides the basic data used in the calculation of the mortality rates for the na- tional total. IMR and U5MR estimates provided for the national level by sex, place of residence and ethnicity. The infant mortality rate is estimated at 32 per thousand, while the probability of dying under-5 mortality rate (U5MR) is around 36 per thousand livebirths. These estimates have been calculated by averaging mortality esti- mates obtained from women aged 20-24, 25- 29 and 30-34. There is a difference between the probabilities of dying among males and females. Boy’s mortality significantly exceeds One of the overarching goals of the Millennium Development Goals (MDGs) and the World Fit for Children (WFFC) is to reduce in- fant and under-five mortality. Specifically, the MDGs call for the reduction in under-five mor- tality by two-thirds between 1990 and 2015. Monitoring progress towards this goal is an important but difficult objective. Measuring childhood mortality may seem easy, but at- tempts using direct questions, such as “Has an- yone in this household died in the last year?” give inaccurate results. Using direct measures of child mortality from birth histories is time consuming, more expensive, and requires greater attention to training and supervision. Alternatively, indirect methods developed to measure child mortality produce robust esti- mates that are comparable with the ones ob- tained from other sources. Indirect methods minimize the pitfalls of memory lapses, inex- act or misinterpreted definitions, and poor in- terviewing technique. The infant mortality rate is the probability of dying before the first birthday (during the first year of life). The under-five mortality rate (U5MR – under 5 mortality rate) is the prob- ability of dying before the fifth birthday (aged 0-4 years). In MICS surveys, infant and under five mortality rates are calculated based on an indirect estimation technique known as the Brass method (United Nations, 1983; 1990a; Figure CM.1. Infant Mortality by Sources, Kazakhstan, 2006 DHS(1995, 1999), MICS(2006) AS RK Linear (DHS(1995, 1999), MICS(2006)) KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 23 Figure CM.1А. Under Five Mortality Rate, Kazakhstan, 2006 Figure CM.1В. Under Five Mortality Tendency, Kazakhstan, 2006 7 Nutrition Institute MoH-SA RK, Academy of Preventive Medicine, Demography and Health Survey Department, Macro International Inc. Kazakhstan Demography and Health Survey, 1995. Almaty, 1996. 8 Academy of Preventive Medicine, and Macro International Inc., 2000. Kazakhstan Demography and Health Survey, 1999. Almaty, 2000. girl’s and makes 36.6 and 26.6 per thousand respectively. In rural area infant mortality rates are almost 1.5 times higher than in ur- ban areas. Figure CM.1 reflects infant mortality rates by different sources – there are obvious significant differences between official data and data ob- tained from surveys7 conducted in Kazakhstan. According to official statistics, in 1985-1994 infant mortality was on average approximately 27 per 1,000 live births, gradually declining in 1996-2005 reaching over 19 cases per 1,000 of births. Under-5 mortality rates are provided in Figure CM.1A. U5MR is a bit higher in rural than in urban areas and mortality among boys is sig- nificantly higher than among girls. Moreover, U5MR is higher among Kazakh population. Figure CM.1B shows the series of U5MR es- timates of the survey, based on responses of women in different age groups, and referring to various points in time, thus showing the esti- mated trend in U5MR based on DHS-1995 and MICS-2006 as well as country’s official statis- tics8. The MICS estimates indicate a decline in mortality during the last 15 years. Area Urban Rural Sex Boys Girls Ethnicity Kazakhs Russians Kazakhstan Per 1,000 livebirths DHS 1995 AS RK MICS 2006 Linear (DHS 1995) Linear (MICS 2006) Different approaches to life birth definitions and child’s mortality assessment techniques cause discrepancies between different sources. Further qualification of these apparent declines and differences as well as its determinants should be taken up in a more detailed and sep- arate analysis. 30.2 42.6 41.7 30.3 36.2 31.0 36.3 MONITORING THE SITUATION OF CHILDREN AND WOMEN24 V. Nutrition KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 25 Nutritional Status Children’s nutritional status is a reflection of their overall health. When children have access to an adequate food supply, are not exposed to repeated illness, and are well cared for, they reach their growth potential and are considered well nourished. Malnutrition is associated with more than half of all children deaths worldwide. Undernourished children are more likely to die from common childhood ailments, and for those who survive, have recurring sicknesses and faltering growth. Three-quarters of the children who die from causes re- lated to malnutrition were only mildly or moderately malnourished – showing no outward sign of their vulnerability. The Millennium Development target is to reduce by half the proportion of people who suffer from hunger between 1990 and 2015. The World Fit for Children goal is to re- duce the prevalence of malnutrition among children under five years of age by at least one-third (between 2000 and 2010), with special attention to children under 2 years of age. A reduction in the prevalence of malnutrition will assist in the goal of reducing child mortality. In a well-nourished population, there is a reference distribution of height and weight for children under five. Under-nourishment in a population can be gauged by comparing children to a refer- ence population. The reference population used in this report is the WHO/CDC/NCHS reference, which was recommended for use by UNICEF and the World Health Organization (WHO) at the time the survey was implemented. Each of the three nutritional status indicators can be expressed in standard deviation units (z-scores) from the median of the reference population. Weight-for-age is a measure of both acute and chronic malnutrition. Children whose weight-for- age is more than two standard deviations below the median of the reference population are con- sidered moderately or severely underweight while those whose weight-for-age is more than three standard deviations below the median are classified as severely underweight. Height-for-age is a measure of linear height of children. Children whose height-for-age is more than two standard deviations below the median of the reference population are considered short for their age and are classified as moderately or severely stunted. Those whose height-for-age is more than three standard deviations below the median are classified as severely stunted. Stunting is a reflection of chronic malnutrition as a result of failure to receive adequate nutrition over a long period and recurrent or chronic illness. Finally, children whose weight-for-height is more than two standard deviations below the median of the reference population are classified as moderately or severely wasted, while those who fall more than three standard deviations below the median are severely wasted. Wasting is usually the result of a recent nutritional deficiency. The indicator may exhibit lack of foodstuffs in popula- tion or might be related to the high prevalence of illnesses among children from that particular MONITORING THE SITUATION OF CHILDREN AND WOMEN26 children are stunted for their age and 4 percent are too short (Table NU.1). Children in the West Kazakhstan (8.8 percent) and Almaty Oblasts (8.1 percent) are more likely to be underweight for their age than other chil- dren; as for height to age – Aktobe Oblast (23.5 percent), Kyzylorda Oblast (23.3 percent) and Almaty Oblast (22.1 percent). The highest propor- tion of moderately stunted children for their age was found in West Kazakhstan (12.5 percent) and Mangistau Oblasts (9.3 percent). Those children whose mothers have higher levels of education are the least likely to be underweight and stunted compared to children of mothers with primary/ incomplete secondary education. Boys appear more likely to be underweight and stunted. A higher percentage of stunted and under- weight for their age children are found in the age group 12-23 months (Figure NU.1). This pattern may well be expected as it relates to the age at which many children cease to be breast- fed, which coupled with inadequate comple- mentary feeding, lead to high risk of disease development due to exposure to contaminated water, food and other environmental factors. The worst underweight for age was found in age group below 6 months. In addition, 11.3 percent of children are over- weighed; percentage of boys and girls as well as children in urban and rural areas is almost the same. Figure NU.1. Percentage of children under 5 who are undernourished, Kazakhstan, 2006 age group (for example, diarrhoea, HIV/AIDS, etc.). An increase in this indicator by 5 percent requires certain measures as growth of infant mortality could be expected afterwards. In MICS, weights and heights of all children un- der 5 years of age were measured using anthro- pometric equipment recommended by UNICEF (UNICEF, 2006). Findings in this section are based on the results of these measurements. Table NU.1 shows percentages of children clas- sified into each of these categories, based on the anthropometric measurements that were taken during fieldwork. Additionally, the table includes the percentage of children who are overweight, which takes into account those children whose weight for height is above 2 standard deviations from the median of the reference population. In Table NU.1, children who were not weighed and measured (about 2.6 percent of children) and those whose measurements are outside a plausible range are excluded. In addition, a small number of children whose birth dates are not known are excluded. In Kazakhstan 4 percent of children under 5 are moderately underweight (weight for age) and 0.8 percent are classified as severely un- derweight, at that, 3.8 percent of children are wasted (weight for height) and 1 percent – se- vere wasted. At the same time, 12.8 percent of Underweight Stunted Wasted Age (months) % KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 27 Breastfeeding for the first few years of life pro- tects children from infection, provides an ide- al source of nutrients, and is economical and safe. However, many mothers stop breastfeed- ing too soon and there are often pressures to switch to infant formula, which can contribute to growth faltering and micronutrient malnu- trition and is unsafe if clean water is not readily available. The World Fit for Children goal states that children should be exclusively breastfed for 6 months and continue to be breastfed in addition to nutritious, safe and adequate com- plementary feeding for up to 2 years of age and beyond. WHO/UNICEF have the following feeding recommendations: • Exclusive breastfeeding for first six months • Continued breastfeeding for two years or more • Timely introduction of nutritious and safe complementary foods beginning at 6 months • Frequency of complementary feeding should be: 2 times per day for 6-8 month olds; 3 times per day for 9-11 month old children It is also recommended that breastfeeding be ini- tiated within one hour of birth. Quality of child feeding is evaluated by the following indicators: • Exclusive breastfeeding rate (< 6 months & < 4 months) • Timely complementary feeding rate (6-9 months) • Continued breastfeeding rate (12-15 & 20- 23 months) • Timely initiation of breastfeeding (within 1 hour of birth) • Frequency of complementary feeding (6-11 months) • Proportion of adequately fed infants (0-11 months) Table NU.2 provides the proportion of women who started breastfeeding their infants with- in one hour of birth, and women who started Breastfeeding The percentage of women with higher educa- tion who timely started breastfeeding (within 1 hour after birth) almost by 10 percent exceeded the percentage of women with lower education level. The highest proportion of women who started breastfeeding within one hour of birth was in Kyzylorda (95.5 percent) and Karaganda (91.6 percent) Oblasts, the lowest proportion were found in Aktobe Oblast (31.5 percent) and North Kazakhstan (36.6 percent) Oblasts. 87.8 percent started breastfeeding within one day of birth (which includes those who started within one hour), percentage of such women in urban and rural settlements is almost the same – 87.7 and 88 percent respectively (Figures NU.2). In almost all regions of Kazakhstan over 90 percent of wom- en started breastfeeding their infants within one day of birth, with the exception of women from Pavlodar, Akmola and East Kazakhstan Oblasts (68.6, 77.3 and 80.6 percent respectively). In Table NU.3, breastfeeding status is based on the reports of mothers/caretakers of children’s consumption of food and fluids in the 24 hours prior to the interview. Exclusively breastfed re- fers to infants who received only breast milk (and vitamins, mineral supplements, or medi- cine). The table shows exclusive breastfeed- breastfeeding within one day of birth (which in- cludes those who started within one hour). In total 1,719 women who gave birth to a live baby during two years before the survey were interviewed about breastfeeding. Of them 64.2 percent started breastfeeding within one hour of birth, the difference between urban and ru- ral women was 4.4 percent – urban women 66.3 percent and 61.9 of rural women respectively. MONITORING THE SITUATION OF CHILDREN AND WOMEN28 Figure NU.2. Percentage of mothers who started breastfeeding within one hour and within one day of birth, Kazakhstan, 2006 Re gi on s A km ol a A kt ob e A lm at y A ty ra u W es t K az ak hs ta n Zh am by l Ka ra ga nd a Ko st an ai Ky zy lo rd a So ut h Ka za kh st an Pa vl od ar N or th K az ak hs ta n Ea st K az ak hs ta n A lm at y Ci ty U rb an Ru ra l K az ak hs ta n Within one hour Within one day are receiving liquids or foods other than breast milk. By the end of the sixth month, the percent- age of children exclusively breastfed is below 10 percent. Only over 16 percent of children are re- ceiving breast milk after 2 years. The adequacy of infant feeding in children less than 12 months is provided in Table NU.4. Different criteria of adequate feeding are used depending on the age of the child. For infants aged 0-5 months, exclusive breastfeeding is considered as adequate practice. Infants aged 6- 8 months and 9-11 months are considered to be adequately fed if they are receiving breastmilk at least two-three times a day (excluding night feeding) in addition to adequate quality and quantity feeding. 16.8 children aged below 6 month are adequately fed, girls more often than boys. Percentage of exclusively breastfed chil- dren aged 0-5 months in urban and rural areas and by mother’s education is almost the same. 28.8 percent of babies aged 6-8 months receive adequate feeding; boys were slightly more likely to be adequately fed than girls were. The propor- tion of such children in urban and rural areas is 30.3 and 27.1 percent respectively. By age 9-11 months 19.7 percent of children are adequately fed, there is almost no difference between boys and girls. However, the proportion of such chil- dren in rural area is higher than in urban. ing of infants during the first six months of life (separately for 0-3 months and 0-5 months), as well as complementary feeding of children 6-9 months and continued breastfeeding of chil- dren at 12-15 and 20-23 months of age. 16.8 percent of children aged less than six months are exclusively breastfed, which is an extremely low figure. Timely introduction of complemen- tary feeding at age 6-9 months was found in 39.1 percent of children (receive breast milk and solid or semi-solid foods). By age 12-15 months, 57.1 percent of children are still being breastfed and by age 20-23 months, 16.2 percent are still breastfed. Girls were more likely to be exclusively breastfed than boys, while boys had higher levels than girls for timely complementary feeding. In rural area, the percentage of exclusively breast- fed children aged below six months is higher than in urban areas, the same trend is found in children aged 12-15 months and 20-23 months who still receive breast milk. Percentage of chil- dren receiving timely complementary feeding aged 6-9 months is higher than in urban areas and less wealthy households. Figure NU.3 shows the detailed pattern of breast- feeding by the child’s age in months. [This figure is obtained by using data from Table NU.3W]. Even at the earliest ages, the majority of children KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 29 As a result of these feeding patterns, only 24 percent of children aged 6-11 months are be- ing adequately fed: 23.1 percent of urban and 25 percent of rural children, boys were more likely to be adequately fed than girls were. Proportion of children aged 6-11 months in poor house- holds who receive recommended feeding is by 7 percent points higher than in households with middle income. Proportion of children aged 6- Figure NU.3. Infant feeding patterns by age: Percent distribution of children aged under 3 years by feeding pattern by age group, Kazakhstan, 2006 Weaned (not breastfed) Breastfed and comple- mentary foods Breastfed and other milk/ formula Breastfed and non-milk liquids Breastfed and plain water only Exclusively breastfed Age group in months % 11 months who receive adequate feeding is al- most the same in Kazakh and Russian families and varies between 22.1-23.3 percent. There are minor differences by mothers’ education. Only 20.7 percent infants aged 0–11 months were adequately fed, of these 20.3 percent live in ur- ban areas and 21.2 percent in rural areas. There were no significant differences by children’s sex, the mother’s education or ethnicity. It is well known that health and intellectual capital is the most important precondition for the progress of some countries and the world in general. However, preventable deficiency of es- sential foodstuff causes harm for entire genera- tions, and reduces the intelligence quotient (IQ) in a hundred million people. Iodine Deficiency Disorders (IDD) are the world’s leading cause of preventable mental retardation and impaired psychomotor development in young children. In its most extreme form, iodine deficiency causes cretinism. It also increases the risks of stillbirth and miscarriage in pregnant women. Iodine de- ficiency is most commonly and visibly associated with goitre. Iodine deficiency takes its greatest toll in impaired mental growth and development, contributing in turn to poor school performance, reduced intellectual ability, and impaired work performance. The international goal is to achieve sustainable elimination of iodine deficiency by 2005. The indicator is the percentage of house- holds consuming ad- equately iodized salt (>15 parts per million). Following global politi- cal recommendations, the Government of Kazakhstan commit- ted itself to eliminate iodine deficiency in the country through uni- versal salt iodization with potassium iodate during salt production at 40±15 ррм both for home consumption, for the food industry and for animals. Two local salt pro- ducers ‘Araltuz’ (Kyzylorda Oblast) and Salt iodization MONITORING THE SITUATION OF CHILDREN AND WOMEN30 ‘Pavlodarsol’ (Pavlodar Oblast) have the techni- cal capacity to supply the internal market with adequately iodized salt in sufficient quantity. Sanitary-epidemiological services of the Ministry of Healthcare of the Republic of Kazakhstan bear the responsibility for inspection and monitoring of foodstuffs. Success of the Republic of Kazakhstan recent years was based on effective cooperation between the government, salt producers, non- governmental sector and international organiza- tions (UNICEF and ADB). Today, the children of Kazakhstan are better protected against mental retardation due to increased access to iodized salt. Today Kazakhstan joins the elite nations that have achieved comprehensive salt iodization9. In 98.8 percent of households, salt used for cook- ing was tested for iodine content by using salt test ished, with reduced muscle strength, through- out their lives, and suffer a higher incidence of diabetes and heart disease in later life. Children born underweight also tend to have a lower IQ and cognitive disabilities, affecting their per- formance in school and their job opportunities as adults. In the developing world, low birth weight stems primarily from the mother’s poor health and nutrition. Three factors have most impact: the Figure NU.5. Percentage of households consuming adequately iodized salt, Kazakhstan, 2006 Weight at birth is an obvious indicator not only of a mother’s health and nutritional status but also the newborn’s chances for survival, growth, long-term health and psychosocial develop- ment. Low birth weight (less than 2,500 grams) carries a range of grave health risks for children. Babies who were undernourished in the womb face a greatly increased risk of dying during their early months and years. Those who survive have impaired immune function and increased risk of disease; they are likely to remain undernour- 9 UNICEF, Kazakhstan. Assessment of Salt Iodization Adequacy and Its Consumption in Kazakhstan, Almaty, 2005. Low Birth Weight kits and testing for the presence of potassium io- date. Table NU.5 shows that in a very small pro- portion of households (0.3 percent), there was no salt available. In 92 percent of households, salt was found to contain 15 ppm or more of iodine. Use of iodized salt was lowest in Pavlodar Obast (only 68.3 percent) and highest in Almaty (99.7 percent) and Mangistau (99.5 percent) Oblasts. The difference between urban and rural house- holds in terms of iodized salt consumption is much less than expected (Figure NU.5). The above data proves that Kazakhstan should be ready for certification as a country that has achieved universal salt iodization. In addi- tion, monitoring of iodized salt quality as well as monitoring of iodine deficiency prevalence among population should be enforced. Re gi on s A km ol a A kt ob e A lm at y A ty ra u W es t K az ak hs ta n Zh am by l Ka ra ga nd a Ko st an ai Ky zy lo rd a M an gi st au So ut h Ka za kh st an Pa vl od ar N or th K az ak hs ta n Ea st K az ak hs ta n A st an a Ci ty A lm at y Ci ty U rb an Ru ra l K az ak hs ta n KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 31 10 For a detailed description of the methodology, see Boerma, Weinstein, Rutstein and Sommerfelt, 1996. U rb an Ru ra l Pr im ar y/ in co m - pl et e se co nd ar y Se co nd ar y Sp ec ia liz ed se co nd ar y H ig he r Po or es t Se co nd M id dl e Fo ur th Ri ch es t K az ak hs ta n Figure NU.8. Percentage of Infants Weighing Less Than 2500 Grams at Birth, Kazakhstan, 2006 mother’s poor nutritional status before concep- tion, short stature (due mostly to undernourish- ment and infections during her childhood), and poor nutrition during the pregnancy. Inadequate weight gain during pregnancy is particularly im- portant since it accounts for a large proportion of foetal growth retardation. Moreover, diseases such as diarrhoea and malaria, which are com- mon in many developing countries, can signifi- cantly impair foetal growth if the mother be- comes infected while pregnant. In the industrialized world, cigarette smok- ing during pregnancy is the leading cause of low birth weight. In developed and developing countries alike, teenagers who give birth when their own bodies have yet to finish growing run the risk of bearing underweight babies. Because many infants are not weighed at birth and those who are weighed may be a biased sam- ple of all births, the reported birth weights usu- ally cannot be used to estimate the prevalence of low birth weight among all children. Therefore, the percentage of births weighing below 2,500 grams is estimated from two items in the ques- tionnaire: the mother’s assessment of the child’s size at birth (i.e., very small, smaller than aver- age, average, larger than average, very large) and the mother’s recall of the child’s weight or the weight as recorded on a health card if the child was weighed at birth10. In Kazakhstan almost all babies were weighed at birth (99.4 percent) and 5.8 percent of infants are estimated to weigh less than 2500 grams at birth (Table NU.8 and Figure NU.8). There was significant variation by region: the highest pro- portion of children with low weight was found in Pavlodar Oblast (19.4 percent), and in 9 Oblasts number of such children was between 4.1 – 4.8 percents. The percentage of low birth weight does not vary much by urban and rural areas, but the percentage of children with low weight was higher if mothers had primary/in- complete secondary education comparing to women with higher levels of education. MONITORING THE SITUATION OF CHILDREN AND WOMEN32 VI. Child Health KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 33 Immunization Millennium Development Goal (MDG) 4 aims to reduce child mortality by two thirds between 1990 and 2015. Immunization plays a key part in this goal. Immunization has saved the lives of millions of children in the three decades since the launch of the Expanded Programme on Immunization (EPI) in 1974. Worldwide there are still 27 million children overlooked by routine immunization and as a result, vaccine-preventable diseases cause more than 2 million deaths every year. A World Fit for Children goal is to ensure full immunization of children under one year of age at 90 percent nationally, with at least 80 percent coverage in every district or equivalent administrative unit. One of the major achievements of Kazakhstan is acquiring of status of Vaccine Independent Country as well as Country Free from Poliomyelitis. Below is Extraction from Schedule for Preventive Vaccination of children under age of 24 months in Kazakhstan. Terms of Vaccination (children under 2 years old) Age Vaccination against: Tuberculosis (BCG) Hepatitis “В” Poliomyelitis (OPV) Pertussis, diphtheria, tetanus (DPT) Measles 1-4 weeks + + + 2 months + + + 3 months + + 4 months + + + 12-15 months + 18 months + Extraction from Annex to the Rules for Vaccination, approved by the Decree of the Government of the Republic of Kazakhstan as of 23 May 2003 N 488 MONITORING THE SITUATION OF CHILDREN AND WOMEN34 of main questionnaire for children under-5 (Immunization Module) – was prepared, which included home address of child in survey, his/ her personalized data and address of health fa- cility indicating number of district. Interviewers copied vaccination data into these forms from vaccination cards available in health facilities. Overall, 95.1 percent of surveyed children in Kazakhstan had immunization cards (Table CH.2). The percentage of children aged 15 to 26 months who received all recommended vacci- nations is shown in Table CH.1. The denomina- tor for the table is comprised of children aged 15-26 months so that only children who are old enough to be fully vaccinated are counted. In the top panel, the numerator includes all chil- dren who were vaccinated at any time before the survey according to the vaccination card or the mother’s report. In the bottom panel, only those who were vaccinated before their first birthday, as recommended, are included (by 15 months for measles). For children without vaccination cards, the proportion of vaccina- tions given before the first birthday is assumed to be the same as for children with vaccination cards. 97.9 percent of children aged 15-26 months re- ceived a BCG vaccination and the first dose of DPT by the age of 12 months. The percentage declines for subsequent doses of DPT to 96.7 percent for the second dose, and 91.7 percent for the third dose (Figure CH.1). Similarly, 99 percent of children received Polio 1 (OPV) and this declines to 93.9 percent by the third dose by age 12 months. The coverage for measles vaccine by 15 months is a bit lower than for the other vaccines at 94.7 percent. This is primarily because, although 99.4 percent of children re- ceived the vaccine, only 94.7 percent received it by their first birthday. Despite the fact that by the age of 12 months coverage with some vaccines exceeds 94 percent, the percentage of children who had all the recommended vacci- nations by their first birthday is low at only 81 percent. In Kazakhstan, Hepatitis B vaccination is also recommended as part of the immunization schedule. The first HepB vaccine is introduced at age of 1-4 days of birth, the second one at age of 2 months and the third one at age of 4 Figure CH.1. Percentage of children aged 15-26 months who received the recommended vaccinations by 12 months, Kazakhstan, 2006 In Kazakhstan since 1 October 2005, children 1 year old and above receive complex vac- cination against measles, mumps and rubella (MMR). The schedule of vaccination against communicable diseases complies with interna- tional standards. According to UNICEF and WHO guidelines, a child should receive a BCG vaccination to pro- tect against tuberculosis, three doses of DPT to protect against diphtheria, pertussis, and teta- nus, three doses of polio vaccine by the age of 12 months, and a measles vaccination by the age of 15 months. Mothers were asked to pro- vide vaccination cards for children (f. 063-у) under the age of five. If the card was available in the household, interviewers copied vaccina- tion information from the cards onto the MICS questionnaire. If the child did not have a card, the mother was asked to recall whether or not the child had received each of the vaccinations and, for DPT and Polio, how many times. In Kazakhstan, health cards of children includ- ing vaccination cards are usually kept in health facilities. Therefore, interviewers visited health facilities to fill in an Immunization Module for each child irrespective of immunization card availability in the household or the mother’s re- port. With this purpose, a special form – copy Total Measles Polio-3 Polio-2 Polio-1 DPT-3 DPT-2 DPT-1 BCG KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 35 months. By the age of 12 month 94.3 percent of children in survey received first dose of HepB vaccine. Percentage of coverage with the sec- ond dose was 94.4 percent and 92.3 percent with the third one (Tables CH.1.C and CH.2.C). Tables CH.2 and CH.2C show vaccination cov- erage rates among children 15-26 months by background characteristics. Data indicate chil- dren receiving the vaccinations at any time up to the date of the survey, and are based on in- formation from both the vaccination cards and mothers’/caretakers’ reports. In Kazakhstan, 96.2 percent of children had all recommended vaccinations by age of 2 years. There are almost no differences by sex; the per- centage of vaccinated children in urban areas is a bit higher than in rural area. Low immuniza- tion coverage was found in Almaty Oblast (82 percent). There was no difference in coverage with BCG vaccination by sex, place of resi- dence, mother’s education, household wealth and almost all children aged 15-26 months were vaccinated with BCG (99.6 percent). By the age of 26 months, 99.4 percent of chil- dren received first dose of DPT. The percentage declines for subsequent doses of DPT to 99.3 percent for the second dose, and 98 percent for the third dose; boys were slightly more likely to be vaccinated with DPT than girls were. By third dose of DPT, percentage of vaccinated children in rural area was by 2 percent points lower than in urban area. Similarly, over 99 percent of children received Polio 1 and this declines to 95.5 percent of vaccinated rural children by the third dose, which is by 2.4 percent points lower than urban children. The coverage for measles vaccine was found to be almost 100 percent in each Oblast of Kazakhstan, except Karaganda (97.7 percent) and Almaty (97.9 percent) Oblasts. 95 percent of children received HepB vaccine by the age of 26 months; at that, percentage of urban children was a bit higher than rural chil- dren (97.1 and 93.0 percent respectively). Low immunization with Hep. B vaccine was found in Almaty Oblast (75.1 percent). The highest percentage of children who re- ceived no vaccination by 26 months was found in Karaganda Oblast (2.3 percent). The per- centage of girls who are not vaccinated is high- er than the boys. The goals are to: 1) reduce by one half death due to diarrhoea among children under five by 2010 compared to 2000 (A World Fit for Children); and 2) reduce by two thirds the mor- tality rate among children under five by 2015 compared to 1990 (Millennium Development Goals). In addition, the World Fit for Children calls for a reduction in the incidence of diar- rhoea by 25 percent. The indicators are: • Prevalence of diarrhoea • Oral rehydration therapy (ORT) Oral Rehydration Treatment Diarrhoea is the second leading cause of death among children under five worldwide. Most diarrhoea-related deaths in children are due to dehydration from loss of large quantities of water and electrolytes from the body in liq- uid stools. Management of diarrhoea – either through oral rehydration salts (ORS) or a rec- ommended home fluid (RHF) – can prevent many of these deaths. Preventing dehydration and malnutrition by increasing fluid intake and continuing to feed the child are also important strategies for managing diarrhoea. MONITORING THE SITUATION OF CHILDREN AND WOMEN36 • Home management of diarrhoea • (ORT or increased fluids) AND continued feeding In the MICS questionnaire, mothers (or care- takers) were asked to report whether their child had had diarrhoea in the two weeks prior to the survey. If so, the mother was asked a se- ries of questions about what the child had to drink and eat during the episode and whether this was more or less than the child usually ate and drank. Overall, only 1.8 percent or 80 of under five children had diarrhoea in the two weeks pre- ceding the survey (Table CH.4). Due to small number of cases, data is distributed by resi- dence and sex of children. Diarrhoea preva- lence was a bit different in rural and urban areas as well as between girls and boys. The peak of diarrhoea among children aged 6-23 months observed during a period when moth- ers stop breastfeeding. Table CH.4 also shows the percentage of chil- dren receiving various types of recommended liquids during the episode of diarrhoea. In Kazakhstan, the most popular medicine for home treatment of diarrhoea is packed pow- der Smekta and Regidron, which should be dissolved with water. In addition, herbal teas and extracts are widely used. Since mothers were able to name more than one type of liq- uid, the percentages do not necessarily add to 100. 73.3 percent of mothers used fluids from ORS packets for diarrhoea treatment in their chil- dren; 16.4 percent used pre-packaged ORS fluids, and 17.9 percent used recommended homemade fluids. Twenty six percent of chil- dren who had diarrhoea received no treat- ment. The rate of ORT use overall in the country was 74 percent. 21.8 percent of children with di- arrhoea received one or more of the recom- mended home treatments. Less than one half (45.3 percent) of under five children with diarrhoea drank more than usual while 53 percent drank the same or less (Table CH.5). About 59 percent ate somewhat less, same or more (continued feeding), but 41 percent ate much less or ate almost none. Given these figures, 48 percent of children received ORT and increased fluids and at the same time continued feeding as recommend- ed. There are significant differences in the home management of diarrhoea by background characteristics: 55.5 percent of rural children received ORT or increased fluids and contin- ued feeding, while urban children – only 42.2 percent, boys a bit less than girls received such diarrhoea treatment (Figure CH.5). Figure CH.5. Percentage of children aged 0-59 with diarrhoea who received ORT or increased fluids, AND continued feeding, Kazakhstan, 2006, % Sex Male Female Residence Urban Rural Kazakhstan KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 37 Pneumonia is the leading cause of death in children and the use of antibiotics for under-5s with suspected pneumonia is a key interven- tion. A World Fit for Children goal is to reduce by one-third deaths due to acute respiratory in- fections. Children with suspected pneumonia are those who had an illness with a cough accompanied by rapid or difficult breathing and whose symp- toms were not due to a problem in the chest and a blocked nose. The indicators are: • Prevalence of suspected pneumonia • Care seeking for suspected pneumonia • Antibiotic treatment for suspected pneu- monia • Knowledge of the danger signs of pneumo- nia Table CH.6 presents the prevalence of suspect- ed pneumonia and, if care was sought outside the home, the site of care. Only 1.5 percent of children 0-59 months were reported to have had symptoms of pneumo- nia (acute respiratory infection) during the two weeks preceding the survey. Due to small number of cases data is distributed by sex and residence only. Approximately 70 percent of ill children were admitted to different health institutions, of them over 40 percent to pub- lic policlinic facilities and 18 percent to public hospitals. Table CH.7 presents the use of antibiotics for the treatment of suspected pneumonia in un- der-5s by sex and residence. In Kazakhstan, 31.7 percent of under-5 children with sus- pected pneumonia had received an antibiotic during the two weeks prior to the survey with urban population more often than the rural one. Issues related to knowledge of danger signs of pneumonia are presented in Table CH.7A. Obviously, mothers’ knowledge of the danger signs is an important determinant of care-seek- ing behaviour. Overall, 31.7 percent of women know of the two danger signs of pneumonia – fast and difficult breathing. The most com- monly identified symptom for taking a child to a health facility is high fever (89.2 percent). 44.7 percent of mothers identified fast breath- ing and 56.2 percent of mothers identified diffi- cult breathing as symptoms for taking children immediately to a health care provider. For over 55.5 percent of mothers danger sign for seek- ing care is if the child becomes weaker, for 45.8 percent of mothers danger signs is blood in stool, for 25.2 percent of mothers – if a child is not able to drink or breastfeed. Only 11.3 per- cent of mothers will seek care if a child drinks poorly. The highest percentage of mothers aware of two danger signs of pneumonia was found in Mangistau (93.4 percent), followed by Pavlodar (71.4 percent) and North Kazakhstan (52.6 percent) Oblasts, the least was in Kyzylorda (8.7 percent) and Almaty (10.6 percent) Oblasts. 36.3 percent of mothers in urban and 26.9 per- cent in rural area are aware of main pneumonia symptoms. Women with higher education are slightly bet- ter aware of two symptoms of pneumonia, their percentage increase depending on wealth of household (from 22 percent – in poorest to 43.4 percent – in richest). Mothers in Russian families are somewhat better informed about two symptoms of pneumonia than in Kazakh families and make 39.5 percent vs. 30.9 per- cent. Care Seeking and Antibiotic Treatment of Pneumonia MONITORING THE SITUATION OF CHILDREN AND WOMEN38 More than 3 billion people around the world rely on solid fuels (biomass and coal) for their basic energy needs, including cooking and heating. Cooking and heating with solid fuels leads to high levels of indoor smoke, a complex mix of health-damaging pollutants. The main problem with the use of solid fuels is the prod- ucts of incomplete combustion, including CO (single-oxide carbon), polyaromatic hydrocar- bons, SO2, (sulphur oxide) and other toxic ele- ments. Use of solid fuels increases the risks of acute respiratory illness, pneumonia, chronic obstructive lung disease, cancer, and possibly tuberculosis, low birth weight, cataracts, and asthma. The primary indicator is the propor- tion of the population using solid fuels as the primary source of domestic energy for cook- ing. Approximately 19 percent of all households in Kazakhstan are using solid fuels for cook- ing. Use of solid fuels is very high in rural ar- eas, where 40.8 percent of households are us- ing solid fuels, but very low in urban areas (6.8 percent). Differentials with respect to house- hold wealth and the educational level of the household head are also significant. The find- ings show that there is no use of solid fuels among households in Almaty and Astana cities and Mangistau Oblast as well as among richest households. The highest percentage of house- holds using solid fuels for cooking was found in South Kazakhstan (40.7 percent) and Kyzylorda (39.8 percent) Oblasts (Table CH.8). The table also clearly shows that the overall percentage is high due to excessive level of coal use for cook- ing purposes (14.7 percent). Solid fuel use alone is a poor proxy for indoor air pollution, since the concentration of the pollutants is different when the same fuel is burnt in different stoves or fires. Use of closed stoves with chimneys minimizes indoor pol- lution, while open stove or fire with no chim- ney or hood means that there is no protection from the harmful effects of solid fuels. The type of stove used to burn solid fuel is depicted in Table CH.9. 83.7 percent of abovementioned households use closed stoves with a chimney – 79.5 per- cent in urban area and – 85 percent in rural. 15.8 percent of households use open stoves with chimney (hook), their percent is higher in urban areas than in rural. The highest percent of closed stove systems was found in poorest (89.7 percent) and poor (81.6 percent) house- holds; only 51.9 percent of rich households use such devices while there is no use among the richest households. Closed stoves with chimney are least spread in Karaganda Oblast (3.4 per- cent) and only one third households of Aktobe Oblast (30.2 percent) use such stoves. Only 0.4 percent of households in the country use open stove (without chimney or hook). These stoves are not widely spread, they could be considered as seasonal devices for cooking in some house- holds. Solid Fuel Use KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 39 VII. Environment MONITORING THE SITUATION OF CHILDREN AND WOMEN40 Water and Sanitation Safe drinking water is a basic necessity for good health. Unsafe drinking water can be a signifi- cant carrier of diseases such as trachoma, chol- era, typhoid, and schistosomiasis. Drinking wa- ter can also be tainted with chemical, physical and radiological contaminants with harmful effects on human health. In addition to its as- sociation with disease, access to drinking water may be particularly important for women and children, especially in rural areas, who bear the primary responsibility for carrying water, often over long distances. The MDG goal is to reduce by half, between 1990 and 2015, the proportion of people without sus- tainable access to safe drinking water and basic sanitation. The World Fit for Children goal calls for a reduction in the proportion of households without access to hygienic sanitation facilities and affordable and safe drinking water by at least one-third. The list of indicators used in MICS are as follows: Water • Use of improved drinking water sources • Use of adequate water treatment method • Time to source of drinking water • Person collecting drinking water Sanitation • Use of improved sanitation facilities • Sanitary disposal of child’s faeces The distribution of the population by source of drinking water is shown in Table EN.1 and Figure EN.1. The population using improved sources of drinking water are those using any of the follow- ing types of supply: piped water (into dwelling, yard or plot), public tap/standpipe, tubewell/ borehole, protected well, protected spring, rain- water collection. Bottled water is considered as an improved water source only if the household is using an improved water source for other pur- poses, such as hand washing and cooking. Overall, 93.7 percent of the population in Kazakhstan is using an improved source of drinking water – 98.1 percent in urban areas and 87.7 percent in rural areas. The situation in North Kazakhstan (81.7 percent), Kostanai (83.2 percent), South Kazakhstan (85.7 per- cent) and Atyrau (89.3 percent) Oblasts is a bit worse. The population of capital city Astana and Almaty gets water only from improved sources. Population with higher education level more of- ten uses improved sources of drinking water. The source of drinking water for the popula- tion varies strongly by region (Table EN.1). In Karaganda, Almaty, Mangistau and East Kazakhstan Oblasts (75.7, 64.9, 64.4 and 62.7 percents respectively) and in Almaty and Astana cities (98.5 and 84.8 percent respectively) use drinking water piped into dwelling, yard or plot. In contrast, only about 27.5 percent of house- holds in North Kazakhstan, 32.3 percent in Akmola and 32.8 percent in West Kazakhstan Oblasts have water piped into dwelling or yard. Almost half (48 percent) of the households in Zhambyl Oblast obtains drinking water from tube-well/borehole, about 35-38 percent of households in Mangystau, West-Kazakhstan and Atyrau Oblasts use water from protected wells, and 33.4 percent of households in Kyzylorda and 38.2 percent – in Akmola Oblasts use public taps/standpipes. Six percent of households use carried water in the North Kazakhstan Oblast. In Atyrau and South Kazakhstan Oblasts 8.1 and 6.8 percent of population respectively use sur- face water sources. Use of in-house water treatment is presented in Table EN.2. Households were asked about ways they may be treating water at home to make it safer to drink – boiling, adding bleach or chlo- rine, using a water filter, and using solar disin- fection were considered as proper treatment of drinking water. The table shows the percentages of household members using appropriate water treatment methods, separately for all house- holds, for households using improved and un- improved drinking water sources. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 41 In Kazakhstan, 70.8 percent of the population uses an appropriate way to treat drinking wa- ter obtained from all sources, including 70.2 percent of those who appropriately treat drink- ing water obtained from improved sources and 80.7 percent of those who obtains water from unimproved sources use an appropriate wa- ter treatment method. The urban population and population with higher levels of education use treatment methods more often. Wealthier households more often treat drinking water compared to less wealthy households. Overall, 69 percent of population boils water as the main method of water treatment, 24.7 percent of population let the water stay and settle. Other methods of water treatment are not very much popular. 23.7 percent of population use no treat- ment of drinking water, 0.1 percent of popula- tion knows neither method of water treatment. The percentage of households using appropri- ate method of water treatment from improved and unimproved drinking water sources is high in Mangistau (98.5 percent), South Kazakhstan (93.4 percent), Atyrau (93.1 percent) Oblasts and Almaty City (95.9 percent). Low percentage of water treatment was found in households of Zhambyl (24.9 percent), East Kazakhstan (53.2 percent) and Almaty (54.3 percent) Oblasts. Water treatment from unimproved sources for drinking purpose was found very high in Atyrau (100 percent), South Kazakhstan (96 percent) and West Kazakhstan (83.6 percent) Oblasts. Notable is the fact that the urban and the poor households used water treatment more often than those in rural areas and regardless of their education levels. Moreover, Kazakh households resort to water treatment more often than Russian households (84.9 percent and 66.1 per- cent respectively). Water treatment from improved sources for drink- ing purpose was reported by respectively 74 and 65 percent of urban and rural households. Water treatment practice shows direct correlation with education and welfare levels i.e. the higher edu- cation and welfare the higher use of water treat- ment. Almaty city reported the highest utilization of water treatment followed by Mangistau, South Kazakhstan, and Atyrau Oblasts, and the least wa- ter treatment practice was reported by Zhambyl, Almaty and East Kazakhstan Oblasts. The amount of time it takes to obtain water is presented in Table EN.3 and the person who usually collected the water in Table EN.4. Note that these results refer to one roundtrip from home to the drinking water source. Information on the number of trips made in one day was not collected. Figure EN.1. Percentage distribution of population by source of drinking water, Kazakhstan, 2006 Piped into dwelling, yard or plot 56,6% Public tap/stand pipe 15,6% Tube-well/bore-hole 9,2% Protected spring 12,1% Unprotectd spring 1,2% Surface water 1,6% Other unimproved sources 3,7% MONITORING THE SITUATION OF CHILDREN AND WOMEN42 Table EN.3 shows that for 73.4 percent of house- holds, the drinking water source is on the premises. For 20.3 percent of households, it takes less than 30 minutes to get to the water source and bring water, while 4.7 percent of households spend from 30 minutes to one hour and 1.4 percent spend over one hour for this purpose. Excluding those households with water on the premises, the average time to the source of drinking water is 19 minutes. The time spent in rural areas in collect- ing water is slightly higher than in urban areas. The high average time spent in Kostanai and Kyzylorda Oblasts in collecting water is over 25 minutes. Table EN.4 shows that for the majority of house- holds, an adult male is usually the person collect- ing the water, when the source of drinking water is not on the premises. Adult men collect water almost in 65 percent of cases, while for the rest of the households, about 30 percent of adult females and 5.5 percent of female or male children under age 15 collect water. In poor households male children under 15 years more often collect water than in middle income and rich households. Inadequate disposal of human excreta and poor personal hygiene is associated with a range of diseases including diarrhoeal diseases and polio. Improved sanitation facilities for excreta disposal include: flush or pour flush to a piped sewer system, septic tank, or latrine; ventilated improved pit la- trine, pit latrine with slab, and composting toilet. 99.2 percent of the population of Kazakhstan is living in households using improved sanitation facilities (Table EN.5). This percentage is 99.5 in urban areas and 98.9 percent in rural areas. A high proportion of the population almost in all regions of the country uses improved sanitation facilities – 98.3 percent or higher, the lowest is in Aktobe Oblast with 93.6 percent. The table indicates that use of improved sanitation facili- ties is strongly correlated with wealth and is pro- foundly different between urban and rural areas. In rural areas, the population is mostly using pit latrines with slabs, while for urban population, on the contrary, the most common facilities are flush toilets connected to a sewage system or septic tank. Residents of urban areas are much more likely than in rural areas to use modern flush toilets (60 percent of households) and pit latrine with slab (35.5 percent of household); in rural areas about 95 percent of households use pit latrine with slab. By wealth level, 73.3 percent of rich and 99.8 percent of richest households use modern flush toilets, while over 98 percent of poorest and poor households use pit latrines with slab. Use of modern sanitation facilities at large depends on the level of education; popula- tion with lower levels of education uses simpli- fied types of facilities (pit latrines with slab). Residents of Almaty and South Kazakhstan Oblasts are less likely than others to use flush toilets and more pit latrines with slab, which is related mainly to the rural type of dwelling. It could be noted that only 2 percent of im- proved sanitation facilities are used jointly by several households (Table EN.5W). Safe disposal of a child’s faeces is the last stool by the child was disposed of by use of a toilet or rinsed into toilet or latrine. Disposal of faeces of children 0-2 years of age is presented in Table EN.6. Mothers reported only 3.1 percent of children aged 0-2 years visiting toilet, in 28.3 percent of cases faeces were disposed/flushed to the toilet, in 38.2 percent – disposed or flushed to sewer- age, 25.3 percent thrown to garbage, and in 0.5 percent – buried. Percentage of children whose latest faeces were safely disposed made 31.4 per- cent; this indicator in urban area was 54.3 per- cent against 8.7 percent in rural area. Proportion of proper disposal of children’s faeces is higher in rich and richest households (65.7-89.4 percents respectively), while in the less wealthy house- holds this indicator made 5.2 to 15.9 percent. Percentage of children whose faeces were prop- erly disposed is higher if mother has higher level of education – 46.6 percent against 19.2 percent of mothers with primary/incomplete secondary education. There also was significant difference by regions, for instance, very low level of safe fae- ces disposal was found in Almaty (6.1 percent), South Kazakhstan (11.2 percent) Oblasts, as ru- ral population prevails in these regions (as men- tioned above only 8.7 percent of children’s faeces are disposed safely in rural area). High level of safe children’s faeces disposal was found in Astana (77.7 percent) and Almaty (83.3 percent) Cities as well as in Pavlodar Oblast (61.9 percent). As summarized in Table EN.7, 93.7 percent of population of Kazakhstan use improved sources of drinking water. And 99.2 percent use sanitary means of excreta disposal. Overall, 93 percent of population of Kazakhstan use improved sources of drinking water and improved sanitation facil- ities for faeces disposal. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 43 VIII. Reproductive Health MONITORING THE SITUATION OF CHILDREN AND WOMEN44 Appropriate family planning is important to the health of women and children for: 1) preventing pregnancies that are too early or too late; 2) ex- tending the period between births; and 3) limiting the number of children. A World Fit for Children goal is access by all couples to information and services to prevent pregnancies that are too early, too closely spaced, too late or too frequent. Current use of contraception was reported by 50.7 percent of women currently married or in union (Table RH.1). The most popular method is IUD (intrauterine device) which is used by one in three married women (36.2 percent) in Kazakhstan. The next most popular but of lim- ited occurrence method is pills, which accounts for 6.7 percent. 4.8 percent of women reported use of the condom. Less than one percent use periodic abstinence, withdrawal, female sterili- zation, vaginal methods, or the lactation amen- orrhea method (LAM). Prevalence of contraception is highest in West Kazakhstan, North Kazakhstan, Pavlodar, Kostanai, Akmola and East Kazakhstan Oblasts and Astana City at over 60 percent. The high- est prevalence of pills was found in urban areas where women use them about three times more often than in rural area. In large cities of Astana and Almaty, almost each seventh married wom- an uses contraception pills. Younger women use less contraception than adult women do. Current use of contraception was reported by only 31.7 percent of women aged 15-19 currently married or in union com- paring to 53.7 percent of women aged 25–29 years and 61.5 percent of women aged 30-34. Women’s education level is strongly associated with contraceptive prevalence. The percentage of women using any method of contraception rises from 43 percent among those with pri- mary/incomplete secondary education to 53.3 percent among women with higher education. Education level also corresponds with method of contraception. 48.7 percent of women use modern methods of contraception, while only 2 percent of inter- viewed women used traditional methods. Over 60 percent of women use modern contracep- tion in Astana city and East Kazakhstan Oblast. The percentage of women using contraception is higher among women with two (61.2 percent) and three (51.6 percent) children. Percentage of women without children using contraception was 11.7 percent. Contraception Reproductive behavior is a component of Reproductive Health Program. Family planning as a reserve for the health of woman and com- ponent of Reproductive Health Program is es- sential for birth of wanted children. Based on this thesis WHO Alma-Ata Declaration (1978) considers protection of mother and child health as essential part of primary healthcare needed to ensure health of family. Major provisions related to reproductive health rising from reproductive rights and reproductive behavior were approved by Platform for Action of IV World Conference on Status of Women (Beijing, 1995). Reproductive Behavior Reproductive behavior is the system of human actions and attitudes stipulating birth or refuse birth. The conceive age for woman is considered 15–49 years, called reproductive (fertile) age. This age limitation is conditional; therefore, re- productive period is a part of woman’s life when she is able to give birth. Essential component of Reproductive Health Program is family plannng, which helps to en- sure wanted number of children in the family, safe them and select the best time for birth taking into account age of parents and social- economic conditions, avoid unwanted preg- nancy, plan birth, it reduces maternal and in- KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 45 fant mortality, improves health of mother and child. Over one-third (37.7 percent) women wanted to have 2 children, almost one in three (28.7 percent) women – three children and 17.0 per- cent – four children (Table RH.2A). Less than 9 percent of women in the survey wanted to have 5 to 9 children and only 0.5 percent of women wanted 10 and more children. More ur- ban women prefer having two (44.1 percent) and three (28.4 percent) children. Less than one-third of rural women wanted to have two children (28.5 percent) and approximately the same percentage wanted to have three chil- dren (29.2 percent). Only 13.3 percent of urban women wanted to have four children, while 22.5 percent of rural women wanted to have the same number of children. The largest differ- ence was found among women willing to have 5-9 children: their percentage in rural areas is almost three times greater than the percentage of urban women – 14.0 percent and 5.0 percent respectively. Major number of women regulates the number of children and time for birth of the next baby, i.e. follow certain birth interval. Thus, almost 37.3 percent of interviewed women would pre- fer to have a three-year birth space, 32.6 percent – two years, about 11 percent believe birth space should be 4 – 5 and more years. Least number of women (7.4 percent) wanted to wait for one year before the next birth. Almost half of women in survey (49.3 percent) in Kyzylorda Oblast prefer to have two-year birth space and over half (50.7 percent) women in South Kazakhstan Oblast – three-year. The best birth interval both for urban and rural women is three years (36 percent of urban and 39.3 per- cent of rural women). Reproductive aims of women aged 15 – 49 years differ by Oblasts. Thus, 39.1 percent of women in South Kazakhstan Oblast wish to have four chil- dren and 22.5 percent want to have 5 to 9 chil- dren, while in North Kazakhstan Oblast more women want to have two children (more than half – 50.4 percent), and one-fourth of women (25.3 percent) wanted to have three children (Table RH.2A). Reproductive aims of women slightly differ (by few percent) in Kostanai, Karaganda, East Kazakhstan Oblasts and Astana and Almaty Cities. Percentage of women will- ing to have 5 to 9 children prevails in South Kazakhstan (22.5 percent), Kyzylorda (17.4 per- cent), Zhambyl (14.1 percent) Oblasts and by 10 percents in Atyrau and Mangistau Oblasts. Wealth level is not much associated with per- centage of women willing to have three children and makes around 30 percent in each group sampled by wealth level, while percentage of women planning to have four children declines from 27.2 percent in poorest families to 9.2 per- cent in richer families. The highest percentage of women willing to have 5 to 9 children was found in poorest families – 18.4 percent, the least percentage (2.6 percent) in richer families. As shown in Table RH.2B, women reported on the following factors limiting the number of children: • Low salary – 25 percent. The highest per- centage of women who mentioned this fac- tor was found in South Kazakhstan (48.1 per- cent) and Karaganda (36.8 percent) Oblasts. • Health status – 19.7 percent – almost half of respondents mentioned this factor (46 per- cent) in Almaty Oblast. • Uncertainty about future of children – 14.4 percent; • No job – 9.8 percent. Almost every fifth wom- an (by 21.8 percent) mentioned this factor in Kyzylorda and South Kazakhstan Oblast. The percentage of a restricting factor such as absence of housing and regular work made 6.2 percent and 5.3 percent respectively all over the country. Similarly, the following factors were mentioned as stimuli for birth of another baby (Table RH.2C): • maternity leave with sufficient pay– 21.4 percent; • reducing age of retirement – 19.8 percent. • sufficient family allowance – 16.2 percent; • mortgage and credits – 12.1 percent; About 8 percent of women would give birth to another baby in case of shortened working day for breastfeeding mothers. Maternity leave with sufficient pay and reduction of retirement age are the most popular birth stimulus mentioned by 26 to 38 percent of women. MONITORING THE SITUATION OF CHILDREN AND WOMEN46 The antenatal period presents important op- portunities for reaching pregnant women with a number of interventions that may be vital to their health and well-being and that of their in- fants. Better understanding of foetal growth and development and its relationship to the mother’s health has resulted in increased attention to the potential of antenatal care as an intervention to improve both maternal and newborn health. For example, if the antenatal period is used to inform women and families about the danger signs and symptoms and about the risks of labour and de- livery, it may provide the route for ensuring that pregnant women do, in practice, deliver with the assistance of a skilled health care provider. The antenatal period also provides an opportunity to provide information on birth control, which is recognized as an important factor in improving infant survival. The prevention and treatment of malaria among pregnant women, management anaemia during pregnancy and treatment of STIs can significantly improve foetal outcomes and improve maternal health. Adverse outcomes such as low birth weight can be reduced through a combination of interventions to improve wom- en’s nutritional status and prevent infections (e.g., malaria and STIs) during pregnancy. More recently, the potential of the antenatal period as an entry point for HIV prevention and care, in particular for the prevention of HIV transmission from mother to child, has led to renewed interest in access to and use of antenatal services. WHO recommends a minimum of four antena- tal visits based on a review of the effectiveness of different models of antenatal care. WHO guide- lines are specific on the content of antenatal care visits, which include: • Blood pressure measurement • Urine testing for bacteriuria and proteinuria • Blood testing to detect syphilis and severe anaemia • Weight/height measurement (optional) Coverage of antenatal care (by a doctor, nurse, or midwife) is high in Kazakhstan with 99.9 percent of women receiving antenatal care at least once during the pregnancy (Table RH.3). Antenatal care in all regions of Kazakhstan is 100 percent. Coverage of antenatal care in ur- ban area is 100 percent, while in rural areas this indicator is lower by only 0.3 percent points. The type of personnel providing antenatal care to women aged 15-49 years who gave birth in the two years preceding is also presented in Table RH.3. Mainly doctors provide antenatal care in Kazakhstan (88.9 percent); in 9.1 percent nurses/ midwives, 0.2 percent – auxiliary midwives and 1.7 percent – feldshers provide antenatal care. The types of services pregnant women received are shown in table RH.4. As mentioned above, 99.9 percent of pregnant women in Kazakhstan re- ceived antenatal care. In fact, all women had blood testing, blood pressure measurement; urine test- ing and weight measurement (by 99.5 percent). Antenatal care content varies across the Oblasts. Three quarters of all maternal deaths occur dur- ing delivery and the immediate post-partum period. The single most critical intervention for safe motherhood is to ensure a competent health worker with midwifery skills is present at every birth, and transport is available to a referral facili- ty for obstetric care in case of emergency. A World Fit for Children goal is to ensure that women have ready and affordable access to skilled attendance at delivery. The indicators are the proportion of births with a skilled attendant and proportion of institutional deliveries. The skilled attendant at delivery indicator is also used to track progress toward the Millennium Development target of reducing the maternal mortality ratio by three quarters between 1990 and 2015. The MICS included a number of questions to Antenatal Care Assistance at Delivery KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 47 number of maternal deaths per 100,000 live births. In MICS, the maternal mortality ratio is estimated by using indirect sisterhood method, which allows obtaining maternal mortality es- timates for past 10-14 years before the survey. To collect the information needed for the use of this estimation method in Kazakhstan, adult household members were asked a few questions regarding the survival of their sisters and the timing of death relative to pregnancy, childbirth and the postpartum period for deceased sisters. The information collected is then converted to lifetime risks of maternal death and maternal mortality ratios11. MICS results on maternal mortality are shown in Table RH.6. The results are also presented only for the national total, since maternal mortality ratios generally have very large sampling errors. In total, 38,818 respondents were interviewed, they had 62,823 sisters aged 15 years and older. In survey, in Kazakhstan mortality rate within past 10-14 years was 70 cases per 100,000 of life birth in average. As per official data of the Ministry of Health of the Republic of Kazakhstan, maternal mortality in Kazakhstan was 36.9 in 2004 and 40.5 per 100,000 life births in 2005. In the 1995 and 1999 Demography and Health Surveys (DHS), the level of maternal mortality was 77 and 62.5 per 100,000 life births respec- tively12. Maternal Mortality The complications of pregnancy and child- birth are a leading cause of death and disability among women of reproductive age in devel- oping countries. It is estimated worldwide that around 529,000 women die each year from ma- ternal causes. And for every woman who dies, approximately 20 more suffer injuries, infection and disabilities in pregnancy or childbirth. This means that at least 10 million women a year suf- fer from these type of injuries. The most common fatal complication is post- partum haemorrhage. Sepsis, complications of unsafe abortion, prolonged or obstructed labour and the hypertensive disorders of preg- nancy, especially eclampsia, claim further lives. These complications, which can occur at any time during pregnancy and childbirth without forewarning, require prompt access to quality obstetric services equipped to provide lifesav- ing drugs, antibiotics and transfusions and to perform the caesarean sections and other surgi- cal interventions that prevent deaths from ob- structed labour, eclampsia and haemorrhage. One MDG target is to reduce by three quarters, between 1990 and 2015, the maternal mortality ratio. Maternal mortality is defined as the death of a woman from pregnancy-related causes, when pregnant or within 42 days of termination of pregnancy. The maternal mortality ratio is the 11 For more information on the indirect sisterhood method, see WHO and UNICEF, 1997. 12 Nutrition Institute MoH-SA RK, Academy of Preventive Medicine, Demography and Health Survey Department, Macro International Inc. Kazakhstan Demography and Health Survey, 1995. Almaty, 1996. Academy of Preventive Medicine, and Macro International Inc., 2000. Kazakhstan Demography and Health Survey, 1999. Almaty, 2000 assess the proportion of births attended by a skilled attendant. A skilled attendant includes a doctor, nurse, midwife or auxiliary midwife. In Kazakhstan, almost all births (99.8 percent) were delivered by skilled personnel (Table RH.5). This percentage is 100 percent almost in each Oblast of the country, except in North Kazakhstan Oblast (96.4 percent) and in Astana City (98.8 percent). No significant differences between women delivered with the assistance of skilled attendant was found by education lev- el of woman, wealth and ethnicity. 80.9 percent of deliveries were attended by doctors, while 18.2 percent of deliveries attended nurses/ob- stetricians. MONITORING THE SITUATION OF CHILDREN AND WOMEN48 IX. Child Development KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 49 It is well recognized that a period of rapid brain development occurs in the first 3-4 years of life, and the quality of home care is the major determinant of the child’s development during this period. In this con- text, adult activities with children, presence of books in the home, for the child, and the conditions of care are important indicators of quality of home care. A World Fit for Children goal is that “children should be physically healthy, mentally alert, emotionally secure, so- cially competent and ready to learn.” Information on a number of activities that sup- port early learning was collected in the survey. These included the involvement of adults with children in the following activities: reading books or looking at picture books, telling sto- ries, singing songs, taking children outside the home, compound or yard, playing with chil- dren, and spending time with children nam- ing, counting, or drawing things. For 81 percent of under-five children, an adult engaged in more than four activities that pro- mote learning and school readiness during the 3 days preceding the survey (Table CD.1). The average number of activities that adults engaged with children was 4.9. Father’s and mother’s involvement in such activities are almost the same (81.1 and 80.9 percent re- spectively). Father’s involvement with one or more activities was 46.9 percent. 13.6 percent of total number of children in households had no father. Average number of activities that fa- thers are engaged with their children was 1.2. There are no gender differentials in terms of adult activities with children; however, a larg- er proportion of fathers engaged in activities with male children (47.7 percent) than with female children (46 percent). Larger propor- tions of adults engaged in learning and school readiness activities with children in urban areas (82.9 percent) than in rural areas (79.1 percent). Strong differentials by region and socio-economic status are also observed: adult engagement in activities with children was greatest in South Kazakhstan Oblast (94.3 per- cent) and lowest in Almaty Oblast (60.4 per- cent), while the proportion was 86.9 percent for children living in the richest households, as opposed to almost 80 percent among those living in the poorer households. Father’s in- volvement showed a similar pattern in terms of adults’ engagement in such activities. More educated mothers and fathers engaged more in such activities with children than those with less education. Exposure to books in the early years not only provides the child with greater understanding of the nature of print, but may also give the child opportunities to see others reading, such as older siblings doing school work. Presence of books is important for later school perform- ance and IQ scores. In Kazakhstan, 89.1 percent of children are living in households where at least 3 non-chil- dren’s books are available (Table CD.2). 66.4 percent of children aged 0-59 months have children’s books. Median number of non-chil- dren’s books is twice as many as children’s books (10 and 5 books respectively). While no gender differentials are observed, urban chil- dren appear to have more access to all types of books than those living in rural households. Ninety one percent of under-5 children living in urban areas live in households with more than 3 non-children’s books, while the figure is 87.1 percent in rural households. The pro- portion of under 5 children who have 3 or more children’s books is 76.9 percent in urban areas, compared to 55.5 percent in rural areas. The presence of children’s books is positively correlated with the child’s age: in the homes of 71.2 of children aged 24-59 months there are 3 and more children’s book, while the figure is only 59.6 for children aged 0-23 months. Table CD.2 also shows that 19.8 percent of chil- dren aged 0-59 months had 3 or more playthings to play with in their homes, while 4.5 percent MONITORING THE SITUATION OF CHILDREN AND WOMEN50 had none of the playthings asked to the moth- ers/caretakers (Table CD.2). The playthings in MICS included household objects, homemade toys, toys that came from a store, and objects and materials found outside the home. It is in- teresting to note that 93.5 percent of children play with toys that come from a store; however, the percentages for other types of toys is be- low 7 percent. The proportion of children who have 3 or more playthings to play with is 19.4 percent among male children and 20.2 percent among female children. No urban-rural differ- entials are observed in this respect; some differ- ences are observed in terms of mother’s educa- tion: approximately 20-24 percent of children whose mother’s have primary/incomplete secondary and secondary education have 3 or more playthings, while the proportion is 16.8 and 19.7 percent for children whose mother’s have specialized secondary and higher educa- tion. Differentials are small by socioeconomic status of the households, and regions. The only background variable which appears to have a strong correlation with the number of play- things children have is the age of the child, a somewhat expected result, for instance, only 11.2 percent of children aged 0-23 months and 25.7 percent of children aged 24-59 have 3 and more playthings. Leaving children alone or in the presence of other young children is known to increase the risk of accidents. In MICS, two questions were asked to find out whether children aged 0-59 months had been left alone during the week preceding the interview, and whether children were left in the care of other children under 10 years of age. Table CD.3 shows that 9 percent of children aged 0-59 months were left in the care of oth- er children, while 2.3 percent were left alone during the week preceding the interview. Combining the two care indicators, it is cal- culated that 9.8 percent of children were left with inadequate care during the week preced- ing the survey. No differences were observed by the sex of the child (9.9 and 9.6 percent re- spectively), while there were some difference between urban and rural areas: in urban area 10.4 percent of children were left alone and 9.2 percent in rural area. On the other hand, inadequate care was more prevalent among children whose mothers had primary/ incom- plete secondary education (10 percent) and secondary completed education (11.4 per- cent), as opposed to children whose mothers had higher education (8.3 percent). Children aged 24-59 months were left with inadequate care more (12.7 percent) than those who were aged 0-23 months (5.6 percent). No differenc- es are observed in regard to socioeconomic status and ethnicity of the household (except poorest households – 7.6 percent). In Aktobe (27.3 percent) and Akmola (24.9 percent) Oblasts children were left with in- adequate care more than in other oblasts and this indicator was the lowest in Almaty city (1.9 percent), Almaty (2 percent) and South Kazakhstan (3.7 percent) Oblasts. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 51 X. Education MONITORING THE SITUATION OF CHILDREN AND WOMEN52 Attendance to pre-school education in an or- ganized learning or child education program is important for the readiness of children to school. One of the World Fit for Children goals is the promotion of early childhood education. Only 16 percent of children aged 36-59 months are attending pre-school institutions (Table ED.1). Urban-rural and regional differentials are significant – the figure is as high as 24.1 per- cent in urban areas, compared to 7 percent in rural areas. Proportion of children attending pre-school facilities at age of 36-47 months and 48-59 months is almost the same (15.4-16.7 percent). Among children aged 36-59 months, attendance to pre-school is more prevalent in Karaganda (33.4 percent) Oblast compared to Almaty (7.1 percent), Kyzylorda (8.2 percent) and South Kazakhstan (8.1 percent) Oblasts. Boys more often than girls attend pre-school institutions (17.8 percent vs. 14.1 percent re- spectively); also differentials by socioeconomic status are significant. 44.8 and 22.5 percent of children living in the richest and rich house- holds respectively attend pre-school facilities, while the figure drops to 8.6 and 2.8 percent in poor and poorest households. Early education of children at large depends on the level of mother’s education. In the survey, proportion of children attending pre-school institutions, whose mothers had specialized secondary or higher education was 20 and 32.5 percent respectively comparing to children of mothers with primary of secondary education (3.2 and 7.5 percent respectively). The table also shows the proportion of children in the first grade of primary school who attend- ed pre-school the previous year (Table ED.1), an important indicator of school readiness. Overall, 39.5 percent of children who currently attend the first grade of primary school were attending pre-school the previous year. This indicator is al- most the same for boys and girls, 46.4 percent of children in urban areas had attended pre-school the previous year compared to 33 percent of in rural areas. Regional differentials are also very significant. Socioeconomic status appears to have a positive correlation with school readi- ness – while the indicator is only 19.2 percent among the poorest households, it increases to 59.2 percent among those children living in the richest households. Pre-School Attendance and School Readiness Universal access to basic education and the achievement of primary education by the world’s children is one of the most important goals of the Millennium Development Goals and A World Fit for Children. Education is a vital prerequisite for combating poverty, empowering women, pro- tecting children from hazardous and exploita- tive labour and sexual exploitation, promoting human rights and democracy, protecting the en- vironment, and influencing population growth. The indicators for primary and secondary school attendance include: • Net intake rate in primary education Primary and Secondary School Participation • Net primary school attendance rate • Net secondary school attendance rate • Net primary school attendance rate of chil- dren of secondary school age • Female to male education ratio (gender par- ity index – GPI) The indicators of school progression in- clude: • Survival rate to grade five • Transition rate to secondary school • Net primary completion rate KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 53 Of children who are of primary school entry age (age 7) in Kazakhstan, 92.9 percent are at- tending the first grade of primary school (Table ED.2). By gender indicator boys (95.1 percent) prevail over girls (90.4 percent); significant dif- ferentials are present by region, but there are no much differences between urban-rural areas. In South Kazakhstan, for instance, all children at- tended primary school, while in East Kazakhstan the value of the indicator reaches only 80.4 per- cent. Children’s participation to primary school is higher in urban areas (93.5 percent) than in rural areas (92.2 percent). A positive correlation with mother’s education and socioeconomic status is observed; for children aged 7 whose mothers have high level of education, 93.9 per- cent were attending the first grade. Table ED.3 provides the percentage of children of primary school age attending primary or second- ary school. The majority of children of primary school age are attending school (98 percent). However, 2 percent of the children are out of school when they are expected to be participating in school. The primary school net attendance ra- tio is almost the same in urban and rural area (98 percent); however, there are small differentials be- tween school attendance by boys and girls (98.5 and 97.5 percent respectively). Some correlation with mother’s education is found – 98.4 percent of children whose mothers have higher level of edu- cation attended primary school, opposed to 94.8 percent of children whose mothers have lower level of education. The primary school net attend- ance increases depending on the age of children – from 93.6 percent at age 7 years to 99.7 percent – at age 8-10 years. The primary school net attend- ance of children from Kazakh families (98.9 per- cent) is higher than children from Russian families (95.4 percent), especially among girls (difference in 5.5 percent). Wealth differentials almost are not present; the indicator varies from 97.6-98.5 percent. There are some differences by regions, for instance, the primary school net attendance is below than in any regions of the Republic only in East Kazakhstan Oblast – 93.6 percent (boys – 97.7, girls – 90.1 percent). The secondary school net attendance ratio is presented in Table ED.4. 95.3 percent of secondary school age children at- tend secondary school. There were no large differ- ences found by sex of children. Attendance ratio is slightly higher among urban children; attend- ance ratio among girls in rural area is higher than among boys. There are significant differences by age of children: 87.4 percent of 11-year-olds and 85.6 percent of 17-year-old children attend sec- ondary school as opposed to 99 percent of chil- dren aged 12-16 years. 90.9 percent of children, whose mothers were missing in the households, attend secondary school. Attendance rate among children, whose mothers have higher level of education, is higher than among those children, whose mothers have primary or incomplete sec- ondary education. The same trend was found by household wealth. The highest attendance rate was found in Mangistau (98.7 percent) and East Kazakhstan (97.9 percent) Oblasts and Astana (97.5 percent) and Almaty (96.2 percent) Cities and lower in Almaty Oblast (93.3 percent). The primary school net attendance ratio of chil- dren of secondary school age is presented in Table ED.4W. 1.6 percent of the children of secondary school age are attending primary school when they should be attending secondary school. The remaining 3.1 percent are not attending school at all; they are children out of school since we already indicated that 95.3 percent of children were attending secondary school. Secondary school age includes children aged 11 years, al- most no children attending primary school were found by other age groups, except 12 years – 0.2 percent of them, by 0.2 percent of boys and girls of secondary school age attend primary school. Percentage of rural boys is higher than urban ones opposed to girls; overall, the percentage of rural children is higher than percentage of ur- ban children (1.7 and 1.4 percent respectively). Percentage of these children is higher at moth- MONITORING THE SITUATION OF CHILDREN AND WOMEN54 ers having primary education and in households with low wealth level. The highest percent of children of secondary school age, who attended primary school at the moment of survey, was found in Pavlodar Oblast (3.1 percent) and the lowest in Atyrau and Mangistau Oblasts, where their percentage made only by 0.3 percent. The percentage of children entering first grade who eventually reach grade 5 is presented in Table ED.5. Of all children starting grade one, almost all of them (99.7 percent) will eventu- ally reach grade five. Notice that this number includes children that repeat grades and that eventually move up to reach grade five. Boys and girls almost with the same probability reach grade five, with slight difference in favor of girls and urban schoolchildren. Almost 100 percent of children, whose mothers have primary and secondary education, reach grade five, while for mothers with specialized secondary and higher education only 98.9—99.7 percent of children reach grade five. Percentage of children entered the first grade and reached grade five in poorest households is slightly lower than in households with higher wealth levels. The lowest indicator was found in Astana City (97.1 percent) and in Almaty Oblast (97.6 percent), in all other re- gions 100 percent of children reach grade five, both boys and girls. The net primary school completion rate and transition rate to secondary education is pre- sented in Table ED.6. At the moment of the sur- vey, 88.4 percent of the children of primary com- pletion age (11 years) were attending the fourth grade of primary education. This value should be distinguished from the gross primary com- pletion ratio, which includes children of any age attending the last grade of primary school. The net primary school completion rate in urban and rural area is almost the same (88 percent) and increasing depending on the level of their mothers’ education from 87 percent for moth- ers with secondary education to 92.8 percent for mothers with higher education. The net pri- mary school completion rate is lower in poorest household (86.6 percent). 99.7 percent of children who successfully com- pleted the last grade of primary school (4th grade), at the moment of survey attended grade 5 of secondary school. Transition rate to second- ary education is 99.7 percent all over Kazakhstan, by 100 percent in 8 regions of the country. There were found no significant differences by child’s sex and residence, mother’s education level, eth- nicity and household wealth level. The ratio of girls to boys attending primary and secondary education is provided in Table ED.7. These ratios are better known as the Gender Parity Index (GPI). Notice that the ratios includ- ed here are obtained from net attendance ratios rather than gross attendance ratios. The last ra- tios provide an erroneous description of the GPI mainly because in most of the cases the majority of over-aged children attending primary educa- tion tend to be boys. The table shows that gen- der parity for secondary school is 1.0, indicating no difference in the attendance of girls and boys to secondary school. This indicator value is kept almost the same for primary education (0.99). There were no significant differentials found at the primary/secondary school attendance level and between boys and girls by residence, moth- er’s education and wealth of household. Adult Literacy One of the World Fit for Children goals is to as- sure adult literacy. Adult literacy is also an MDG indicator, relating to both men and women. In MICS, since only a women’s questionnaire was administered, the results are based only on fe- males age 15-24. Woman’s literacy was assessed on the attendance of any education institutions and made 99.8 percent. In Kazakhstan, literacy is comprehensive, thus, no significant differences by residence, region, level of education, wealth and ethnicity of women were found (Table ED.8). KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 55 XI. Child Protection MONITORING THE SITUATION OF CHILDREN AND WOMEN56 The Convention on the Rights of the Child states that every child has the right to a name and a na- tionality and the right to protection from being deprived of his or her identity. Birth registration is a fundamental means of securing these rights for children. The World Fit for Children states the goal to develop systems to ensure the reg- istration of every child at or shortly after birth, and fulfil his or her right to acquire a name and a nationality, in accordance with national laws and relevant international instruments. The in- dicator is the percentage of children under 5 years of age whose birth is registered. In Kazakhstan, the Law About Marriage and Family regulates order and terms of birth regis- tration. According to the Law, parents or caretak- ers should register the birth within two months. There are no governmental charges for birth registration. Indirect stimulus for birth timely registration is one time birth allowance as well as monthly childcare allowances to mothers/care- takers paid until 1 year of age. Birth of 99.2 per- cent of children aged under 5 in Kazakhstan was registered (Table CP.1). There are no variations in birth registration across sex, age, or educa- tion categories. Children in Kostanai, Zhambyl, Akmola, Almaty and Karaganda Oblasts (98.5- 98.9 percent) are somewhat less likely to have their births registered than other children but this appears to be due primarily to the long jour- ney to the registration office. Birth Registration Article 32 of the Convention on the Rights of the Child states: “States Parties recognize the right of the child to be protected from economic ex- ploitation and from performing any work that is likely to be hazardous or to interfere with the child’s education, or to be harmful to the child’s health or physical, mental, spiritual, moral or so- cial development.” The World Fit for Children mentions nine strategies to combat child labor and the MDGs call for the protection of children Child Labor against exploitation. In the MICS questionnaire, a number of questions addressed the issue of child labor, that is, children 5-14 years of age in- volved in labour activities. A child is considered to be involved in child labor activities at the time of the survey if during the week preceding the survey: • Ages 5-11: at least one hour of economic work or 28 hours of domestic work per week. • Ages 12-14: at least 14 hours of economic work or 28 hours of domestic work per week. This definition allows us to differentiate be- tween child labor and child work to identify the type of work that should be eliminated. As such, the estimate provided here is a minimum of the prevalence of child labor since some children may be involved in hazardous labor activities for a number of hours that could be less than the numbers specified in the criteria explained before. Table CP.2 presents the results of child labor by the type of work. In Kazakhstan 2.2 percent of children aged 5- 14 years are involved in child labor of different type, such as work in household, family busi- ness or outside of household (Table CP.2). 0.5 percent of children in this age group helped to perform domestic work during 4 and more hours per day (28 hours a week). One percent of KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 57 children helped during a week with family busi- ness. One percent of children were involved in unpaid labor outside of the household. In gen- eral, boys were more often involved in labor activity than the girls were (2.4 and 2.1 percent respectively). While boys were more often busy with family business and with unpaid work out- side the household, the girls helped more in do- mestic work. Urban children were more loaded with work than rural children (2.5 and 1.9 per- cent respectively). A higher workload for chil- dren was found in Kyzylorda (7.2 percent) and Pavlodar (5.9 percent) Oblasts, the lowest – in Atyrau (0.2 percent), Karaganda (0.5 percent) and Almaty (0.9 percent) Oblasts. 0.1 percent of children were involved in economic work out- side the household. No significant differences were found by regions, sex of child and educa- tion of mother. Table CP.3 presents the percentage of children classified as student laborers or as laborer stu- dents. Student laborers are categorized as chil- dren attending school that were involved in child labor activities at the moment of the sur- veys. More specifically, of the 90.7 percent of the children 5-14 years of age attending school, 2.3 percent are also involved in child labor activities. On the other hand, out of the 2.2 percent of the children classified as child laborers, almost all of them attend school (94.3 percent). The percent- age of student laborers is lower in urban area than in rural area (90.3 and 99.5 percent respectively). There are differences depending on the level of the mother’s education: 100 percent of working children of mothers with primary/incomplete secondary education attend school compared to 93.8 percent of children whose mothers have higher and specialized secondary education. which implies an interesting contrast with the actual prevalence of physical discipline. The largest number of children age 2-14 years (47.8 percent) in Kazakhstan are exposed to psycho- logical pressure. 30.5 percent of children are subjected only to nonviolent punishment and 22.9 percent of children – to minor physical punishment. In turn, almost every fifth child (17.3 percent) experiences neither discipline methods nor pun- ishment; the percentage of children, who expe- rienced neither form of disciplining, is higher in rural area. Male children were subjected more to both minor and severe physical discipline (25.3 and 1.1 percent) than female children (20.3 and 0.4 percent respectively). Girls are more exposed to non-violent methods of discipline. More children were subjected to severe physical punishment in Kyzylorda Oblast (5.6 percent), where the largest number of mothers/caretakers (14.4 percent) believes that the child should be physically punished. In Almaty City and Almaty Oblast no cases of severe physical punishment of children were found. The number of children who experience non- violent methods, psychological punishment and minor physical punishment as well as se- vere physical punishment is higher in urban area than in rural one. Child Discipline As stated in A World Fit for Children, “children must be protected against any acts of violence…” and the Millennium Declaration calls for the pro- tection of children against abuse, exploitation and violence. In the Kazakhstan MICS survey, mothers/ caretakers of children age 2-14 years were asked a series of questions on the ways parents tend to use to discipline their children when they misbe- have. Note that for the child discipline module, one child aged 2-14 per household was selected randomly during fieldwork. Out of these ques- tions, three indicators used to describe aspects of child discipline are: 1) the number of children 2- 14 years that experience psychological aggression as punishment or minor physical punishment or severe physical punishment; and 2) the number of parents/caretakers of children 2-14 years of age that believe that in order to raise their children properly, they need to physically punish them. In Kazakhstan, over 52 percent of children aged 2-14 years were subjected to at least one form of psychological or physical punishment by their mothers/caretakers or other household mem- bers (Table CP.4). Less than one percent of chil- dren were subjected to severe physical punish- ment; in urban area percentage of such children is almost twice as much as in rural (0.9 and 0.5 percent respectively). On the other hand, 7.4 percent of mothers/caretakers who believed that children should be physically punished, MONITORING THE SITUATION OF CHILDREN AND WOMEN58 It is very interesting to note that differentials with respect to many of the background vari- ables were relatively small. Despite the fact that over 50 percent of elder children (5-9 and 10- 14 years), and those living in urban areas, were subjected to at least one psychological or physi- cal punishment, the differentials in terms of severe physical punishment were high only in rich households – 1 percent. In addition, pun- ishment of children (any) is more prevalent if mothers have primary education (60.7 percent). It is of importance also to indicate that far fewer parents/caretakers believe that in order to raise their children properly, they need to physically punish them (7.4 percent), in practice over 20 percent indicated the opposite. legislation, shall be taken to specify a minimum age for marriage.” While marriage is not consid- ered directly in the Convention on the Rights of the Child, child marriage is linked to other rights – such as the right to express their views freely, the right to protection from all forms of abuse, and the right to be protected from harmful tradi- tional practices – and is frequently addressed by the Committee on the Rights of the Child. Other international agreements related to child mar- riage are the Convention on Consent to Marriage, Minimum Age for Marriage and Registration of Marriages and the African Charter on the Rights and Welfare of the Child and the Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa. Child marriage was also identified by the Pan-African Forum against the Sexual Exploitation of Children as a type of commercial sexual exploitation of chil- dren. Young married girls are a unique, though often invisible, group. They are often required to per- form heavy amounts of domestic work, under pressure to demonstrate fertility, and respon- sible for raising children while still children themselves, married girls and child mothers face constrained decision-making and reduced life choices. Boys are also affected by child marriage but the issue impacts on girls in far larger num- bers and with more intensity. Cohabitation – when a couple lives together as if married – raises the same human rights con- cerns as marriage. Where a girl lives with a man Marriage before the age of 18 is a reality for many young girls. According to UNICEF’s world- wide estimates, over 60 million women aged 20-24 were married/in union before the age of 18. Factors that influence child marriage rates include: the state of the country’s civil registra- tion system, which provides proof of age for children; the existence of an adequate legislative framework with an accompanying enforcement mechanism to address cases of child marriage; and the existence of customary or religious laws that condone the practice. In many parts of the world parents encourage the marriage of their daughters while they are still children in the hope that the marriage will benefit them both financially and socially, while also relieving financial burdens on the family. In actual fact, child marriage is a violation of hu- man rights, compromising the development of girls and often resulting in early pregnancy and social isolation, with little education and poor vocational training reinforcing the gendered nature of poverty. The right to ‘free and full’ con- sent to a marriage is recognized in the Universal Declaration of Human Rights – with the recogni- tion that consent cannot be ‘free and full’ when one of the parties involved is not sufficiently mature to make an informed decision about a life partner. The Convention on the Elimination of all Forms of Discrimination against Women (CEDAW) mentions the right to protection from child marriage in article 16, which states: “The betrothal and the marriage of a child shall have no legal effect, and all necessary action, including Early Marriage KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 59 and takes on the role of caregiver for him, the as- sumption is often that she has become an adult woman, even if she has not yet reached the age of 18. Additional concerns due to the informal- ity of the relationship – for example, inherit- ance, citizenship and social recognition – might make girls in informal unions vulnerable in dif- ferent ways than those who are in formally rec- ognized marriages. Research suggests that many factors interact to place a child at risk of marriage. Poverty, pro- tection of girls, family honor and the provision of stability during unstable social periods are considered as significant factors in determin- ing a girl’s risk of becoming married while still a child. Women who married at younger ages were more likely to believe that it is sometimes acceptable for a husband to beat his wife and were more likely to experience domestic vio- lence themselves. The age gap between partners is thought to contribute to these abusive power dynamics and to increase the risk of untimely widowhood. Closely related to the issue of child marriage is the age at which girls become sexually active. Women who are married before the age of 18 tend to have more children than those who marry later in life. Pregnancy related deaths are known to be a leading cause of mortality for both married and unmarried girls between the ages of 15 and 19, particularly among the youngest of this cohort. Two of the indictors are to estimate the percent- age of women married before 15 years of age and percentage married before 18 years of age. The percentage of women married at various ages is provided in Table CP.5 In Kazakhstan the Law “On Marriage and Family” determines the age of 18 as legal for marriage for both men and women. In exceptional cases the state registrar’s offices have the authority to reg- ister marriage at the earlier age of spouses but not younger than 16. In Kazakhstan 57.4 percent of women at the age of 15-49 years selected in the sample for MICS, are either married or live in union. Noteworthy is the fact that among young women in the age group of 15-19 only 5 percent reported of being married. The proportion of women at the age of 15-49 who had got married or lived in union with men before they turned 15 was 0.4 percent, and 8.5 percent of the 20-49 age group had got married before the age of 18. The results show that early marriages at the age below 15 years are not widely spread in Kazakhstan. In Aktobe, West Kazakhstan and Mangistau Oblasts there were found no such marriages. In the remaining Oblasts, number of marriages below 15 years of age does not exceed 0.5 percent. Only in East Kazakhstan Oblast, the number of such marriages was one percent. This indicator does not differ by urban and rural are- as, making 0.3-0.4 percent. There is small differ- ence by the level of education – this indicator is higher among women with primary education (0.7 percent). More often young women marry at the age below 18 in Zhambyl (12 percent), North Kazakhstan (11.3 percent) and Karaganda (11.1 percent) Oblasts. The least percentage of such marriages was found in Atyrau (4.2 percent) and Mangistau (4.6 percent) Oblasts. Below full 18 years, Russian women, women in rural area and with primary education married more often. A lower percent- age of women from the richest households got married at young age (6 percent). Another component is the spousal age differ- ence with an indicator being the percentage of married/in union women with a difference of 10 or more years of age compared to their current spouse. Table CP.6 presents the results of the age difference between husbands and wives. In Kazakhstan the major proportion of marriages have the age difference between spouses at 0 to 9 years. For instance, the proportion of women MONITORING THE SITUATION OF CHILDREN AND WOMEN60 at the age of 20-24 years with a husband/part- ner’s age of 0-4 years older made 56.5 percent and those of 5-9 years older were 29.7 percent. Only 7.4 percent of young women of this age group married to men of 10 and/or more years older, at the same time, 5.7 percent of women were married to younger men. The percentage of marriages, when husband is by 5-9 years and 10 and more years older than his wife is more prevalent in rural area and among poorest households. Marriages, when husband is by 0-4 years older are more prevalent among women with higher levels of education and in rich households, it is also more often among Russian women than among Kazakh women. this regard, where 47.6 percent of women rec- ognized this fact (of these 28.6 percent believe husband can beat his wife if she argues with him). Negative attitudes to domestic violence (below 5 percent) expressed women of Almaty, Mangistau and South Kazakhstan Oblasts and Astana city. 12.3 percent of women married at the time of the survey and 10.4 percent of previously mar- ried/in union women believe that husband can sometimes beat his wife, 6.5 percent of never married women expressed negative attitudes to beating by partner/husband. Women aged 15- 19 years (6.8 percent) expressed less negative attitude towards domestic violence, in other age groups percentage of women was distributed al- most the same (by 10-12 percent). Interestingly, women with secondary education have more positive attitudes to beating by husband (12.9 percents), than women with primary and higher education (8.4 -9.8 percent). The highest percentage of women (7.1 percent) recognized that partner can beat his wife if she neglects their children and under-cares of them. The percentage for women currently and previ- ously married was 8.3 and 7.7 percents respec- tively while it is 4.6 percent for women never married/in union. Least percentage of women (1.5 percent) accepts this situation in case if wife refuses sex with her partner. Distribution of causes justifying, according to interviewed wom- en, domestic violence from the partner and the number of women who accept such situation is almost the same in urban and rural areas. A number of questions were asked of women age 15-49 years to assess their attitudes towards whether husbands are justified to hit or beat their wives/partners for a variety of reasons. These questions were asked to get an indication of cul- tural beliefs that tend to be associated with the prevalence of violence against women by their husbands/partners. The main assumption here is that women that agree with the statements in- dicating that husbands/partners are justified to beat their wives/partners under the situations described in reality tend to be abused by their own husbands/partners. The responses to these questions can be found in Table CP.9. To study attitudes of women aged 15-49 years towards domestic violence within MICS this group of women were presented with the fol- lowing situations that might cause her husband/ partner beating his wife/partner and they were asked proposed to specify in which of the below she presumed this outcome: • Goes out for long without telling her hus- band; • Neglects her children; • Contradicts her husband; • Refuses sex with him; • Burns food. 10.4 percent of women aged 15-49 years rec- ognized that partner might beat his wife due to one of the above causes (Table CP.9). Kyzylorda Oblast was the most unfavorable in Domestic Violence KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 61 XII. HIV/AIDS Knowledge of HIV Transmission One of the most important prerequisites for reducing the rate of HIV infection is accurate knowl- edge of how HIV is transmitted and strategies for preventing transmission. Correct information is the first step toward raising awareness and giving young people the tools to protect themselves from infection. Misconceptions about HIV are common and can confuse young people and hinder pre- vention efforts. Different regions are likely to have variations in misconceptions although some ap- pear to be universal (for example that sharing food can transmit HIV or mosquito bites can transmit HIV). The UN General Assembly Special Session on HIV/AIDS (UNGASS) called on governments to improve the knowledge and skills of young people to protect themselves from HIV. The indicators to measure this goal as well as the MDG of reducing HIV infections by half include improving the level of knowledge of HIV and its prevention, and changing behaviours to prevent further spread of the disease. The HIV module was administered to women 15-49 years of age. One indicator which is both an MDG and UNGASS indicator is the percent of young women who have comprehensive and correct knowledge of HIV prevention and transmission. Women were asked whether they knew of the three main ways of HIV transmission – having only one faithful uninfected partner, using a condom every time, and abstaining from sex. The results are presented in Table HA.1. In Kazakhstan, almost all interviewed women (98.7 percent) have heard of AIDS. However, the per- centage of women who know of all three main ways of preventing HIV transmission is only 30 per- cent. Almost 66 percent of women know of having one faithful uninfected sex partner, 62.9 percent know of using a condom every time, and 42.7 percent know of abstaining from sex as main ways of preventing HIV transmission. While almost 80 percent of women know at least one way, a high proportion of women (20.1 percent) do not know any of the three ways. Knowledge of HIV and HIV transmission is higher in urban area and associates with education – the higher education level of woman, the higher knowledge of HIV. Percentage of women aware of three ways of HIV prevention is higher in 35-39 and 40-44 age groups (about 32 percent), and lower in 15-19 age group (27.6 percent). The percentage of women who do not know any way of HIV pre- vention is high in 15 - 19 age group (28.2 percent). Half of interviewed women in Mangistau and 42 percent in Kyzylorda Oblasts know neither way of HIV transmission. Table HA.2 presents the percentage of women who can correctly identify misconceptions concerning HIV. The indicator is based on the two most common and relevant misconceptions in Kazakhstan, that HIV can be transmitted by sharing food and mosquito bites. The table also provides information on whether women know that HIV cannot be transmitted by supernatural means, and that HIV can be transmitted by sharing needles. Of the interviewed women, 36.3 percent reject the two most common misconceptions and know that a healthy-looking person can be infected. 68.7 percent of women know that HIV cannot be transmitted by sharing food, and 60.6 percent of women know that HIV cannot be transmitted by mosquito bites, while 67.5 percent of women know that a healthy-looking person can be infected. 79.8 percent of women know that HIV cannot be transmitted by supernatural means, MONITORING THE SITUATION OF CHILDREN AND WOMEN62 and 96.2 percent of women know that HIV can be transmitted by multiple uses of needles. Table HA.3 summarizes information from Tables HA.1 and HA.2 and presents the percentage of women who know 2 ways of preventing HIV transmission and reject three common miscon- ceptions. Comprehensive knowledge of HIV pre- vention methods and transmission is still fairly low although there are differences by area of residence. Overall, 22.3 percent of women were found to have comprehensive knowledge, which was slightly higher in urban areas (23.8 percent). As expected, the percent of women with com- prehensive knowledge increases with the wom- an’s education level (Figure HA.1). Overall, 53.1 percent of women said they knew of two ways of HIV prevention. Knowledge of two ways of HIV transmission slightly differs by urban and rural area, thus in urban area 53.7 women knew these ways, in rural area – 52.2 percent of women. As expected, the percentage of women, who know two ways of HIV prevention, increases with edu- cation level. 36.3 percent of women may correctly identify 3 misconceptions concerning HIV trans- mission, of these 39 percent of urban and 32.5 percent of rural women. Percentage of women aware of HIV transmission is higher in the house- holds with high wealth level and among women with higher levels of education. Percentage of women having comprehensive knowledge about HIV is almost the same in all age groups and makes approximately 22. Percentage of women having sufficient knowledge of HIV prevention (can identify 2 ways of preven- tion and 3 misconceptions) is high in Astana City (45.8 percent), lower percentage was found in Mangistau (10.7 percent), Zhambyl (11.5 percent) Oblasts and Almaty city (11 percent). Knowledge of mother-to-child transmission of HIV is also an important first step for wom- en to seek HIV testing when they are pregnant to avoid infecting in the baby. Women should know that HIV can be transmitted during preg- nancy, delivery, and through breastfeeding. The level of knowledge among women age 15-49 years concerning mother-to-child transmission is presented in Table HA.4. Overall, 92.2 percent of women know that HIV can be transmitted from mother to child. The percentage of wom- en who know all three ways of mother-to-child transmission is 54.5 percent, while 6.5 percent of women did not know of any specific way. The percentage of women in urban areas who know all three ways of mother-to-child transmis- sion is higher than in rural area. Age of respondents associates with knowledge of these three ways: for instance, in age group 15-19 only 47.4 percent know all three ways of mother-to-child HIV trans- mission, in age group 40-44 – 57.8 percent. The indicators on attitudes toward people living with HIV measure stigma and discrimination in the community. Stigma and discrimination are low if respondents report an accepting attitude on the following four questions: 1) would care for family member sick with AIDS; 2) would buy fresh vegetables from a vendor who was HIV positive; 3) thinks that a teacher who is HIV positive should be allowed to teach in school; and 4) would not Figure HA.1. Percent of women who have comprehensive knowledge of HIV/AIDS transmission, Kazakhstan, 2006 Know 2 ways to prevent HIV Identify 3 miscon- ceptions Comprehensive knowledge Primary and incom- plete secondary Secondary Specialized secondary Higher Kazakhstan KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 63 want to keep HIV status of a family member a se- cret. Table HA.5 presents the attitudes of women towards people living with HIV/AIDS. Interviewing revealed that 9.4 percent of the pop- ulation in general would not care of family mem- ber sick with HIV (AIDS); there were found no sig- nificant differences by urban and rural areas (9.3 and 9.5 percent respectively). However, the high- est proportion of such population was found in Aktobe (28.7 percent), Kyzylorda (27.5 percent) and Atyrau (23.8 percent) Oblasts, the least pro- portion – in Almaty (1.9 percent), Kostanai (2.4 percent), Zhambyl (3.6 percent), Karaganda (4.2 percent) Oblasts and Almaty city (3 percent). 65.9 percent of respondents would want to keep the HIV status of a family member a secret, the percentage of such respondents is almost by 10 percent higher in urban area than in rural area. 60.1 percent of population of Kazakhstan believe that HIV positive teacher should not be allowed to teach in school; rural people are more cate- gorical than urban (65 and 56.8 percent respec- tively), the highest percentage of such answers was found in 30-34 age group of respondents, people with primary, secondary and specialized secondary education, in poorest households and among Kazakh women. 82.7 percent of people would not buy foodstuffs from HIV-positive ven- dor; again the percentage of such respondents is higher among rural population than among ur- ban population (84.9 and 81.2 percent respec- tively) and in poorest households (86.3 percent). 96.2 percent of women in survey agreed with one of the proposed discriminatory statements re- garding people living with HIV/AIDS (PLWHA); women of urban as well as rural areas, irrespec- tively to their education level, age and wealth of their households were unanimous in their an- swers. The lowest number of women who agreed with a proposed discriminatory statement were noted in Atyrau (92.4 percent), Akmola (92.7 percent) Oblasts and Almaty City (92.6 percent). Only 3.8 percent of women agreed with none of the discriminatory statements regarding PLWHA and the majority of those women were with pri- mary and/or incomplete secondary education (4.7 percent) and from Akmola Oblast (7.3 per- cent) and Almaty City (7.4 percent). Another important indicator is the knowledge of where to be tested for HIV and use of such servic- es. Questions related to knowledge among wom- en of a facility for HIV testing and whether they have ever been tested is presented in Table HA.6. In Kazakhstan, 83.5 percent of women know where to be tested; percentage of such women is higher in urban area and among respondents with higher levels of education. Moreover, a high- er percentage of knowledge of where to be tested for HIV was found in more wealthy households (88-89 percent) and and among Russian women (89.7 percent), the lower percentage was preva- lent in age group 15-19 (64.9 percent) compared to 25-29 age group (88.9 percent) and 30-34 age group (89.6 percent). The lowest percent was found in Zhambyl Oblast (61.4 percent), the highest – in Pavlodar Oblast (96.5 percent). Of 83.5 percent of women knowing where to be tested, 61.7 percent were actually tested. Of these, significant part (87.2 percent) received the test results. The percentage of those who have been tested for HIV and received the results is higher in urban area (89.8 percent) than in rural area (83 percent). In Mangistau Oblast only 49 percent of women had been told the test results, which is the lowest indicator among all regions. Among women who had given birth within the two years preceding the survey, the percentage who received counselling and HIV testing dur- ing antenatal care is presented in Table HA.7. 98.1 percent of women in Kazakhstan received antenatal care during last pregnancy, of them 82.4 percent in any way obtained information about HIV prevention during antenatal care. There were found no significant differences between urban and rural women (82.7 and 82.1 percent respec- tively), however, this indicator was associated with education level of women and wealth of house- holds. Only 71.5 percent of women with primary and incomplete secondary education received in- formation about HIV opposed to over 84 percent of women with higher education and 79 percent of women from poorest households against 88 percent of women from richest households. 92.9 percent of interviewed women were tested for HIV during antenatal care, 78.8 percent of them received their test results. This percentage was higher among urban women (82.3 percent) com- pared to rural (75 percent). The largest proportion of women received results of HIV test is higher in 15-19 age group (93 percent), among women with higher level of education and in households with higher wealth level. In Almaty City all women received HIV test results, the lowest indicator val- ue was found in Aktobe Oblast (49 percent). MONITORING THE SITUATION OF CHILDREN AND WOMEN64 XIII. Tuberculosis Knowledge of Tuberculosis Task 8 of Sixth Millennium Development Goal (MDG) is to reduce TB incidence by 2015 and initiate a trend to TB reduction. Tuberculosis seriously threatens the health of the population. In 1993, World Health Organization (WHO) announced tuberculosis the global world problem and it is still a serious healthcare problem in Kazakhstan. Prevalence of TB multi-resistant forms caused by strains resistant to the majority of TB medicines is of great danger to the population. These TB forms result from inadequate and in- complete treatment or irregularly taking medicines by patients. The high growth in disease may become a factor threatening social and economic development of the country, which in turn establishes environment for tuberculosis prevalence. Domestic and social levels of population are the major factors influencing tuberculosis prevalence. Volume of public expenditures in health care, provision with TB health personnel and equipment of health facilities with diagnostic equipment and medicines is essential. Fight against TB is closely linked to literacy of population, awareness of symptoms, ways of TB trans- mission and access to qualified health assistance, which promotes TB prevention, seeking timely care in health facility and following doctor’s recommendations. In 2006 MICS women aged 15-49 were asked about their knowledge of TB symptoms, ways of trans- mission and possibility to treat TB. Thus, respondents were asked if they knew such disease as tu- berculosis, if they knew that TB could be treated if proper treatment selected, the main ways of treatment, ways of infection transmission and the site where the parent would take the child with suspected TB. 99.4 percent of country’s population is aware of tuberculosis with no difference by urban and rural areas (Table TB.1). 79 percent of women know about tuberculosis patients’ recovery if it is properly treated. The highest percent of women knowing about this were found in Pavlodar (89.1 percent) fol- lowed by Kostanai (88.5 percent) and East Kazakhstan (88.4 percent) Oblasts. The lowest percentage was seen in Karaganda, Mangistau, South Kazakhstan Oblasts and Almaty City (around 72 percent). 83.2 percent of women noted that TB should be treated in hospital. In general, ranging from 70 percent of women in Pavlodar Oblast to 99.7 percent in Mangistau Oblast agreed with this opin- ion. Almost each third woman (about 28 percent) in Pavlodar and Zhambyl Oblasts and each fifth (about 20 percent) in Karaganda and West Kazakhstan Oblasts believe that TB requires hospitaliza- tion at initial stage with following treatment at home. In Mangistau and Atyrau Oblasts almost all interviewed women accepted only hospital treatment. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 65 Lower percentages of respondents knew nei- ther ways of TB treatment – from 0.1 percent in Karaganda and Atyrau Oblasts to 1.2 percent and 1.6 percent respectively in North Kazakhstan and Akmola Oblasts. Almost all respondents irrespectively to their place of residence, level of education and wealth knew about TB transmission by air during coughing. The largest number of parents who reported on taking child with suspected TB to TB dis- pensary was found in Atyrau (80 percent), West Kazakhstan (64.3 percent) and South Kazakhstan (61 percent) Oblasts. About 50 percent of par- ents in Akmola Oblast and Almaty City and 56.3 percent of respondents in Almaty Oblast would refer to the hospital (in-patient) in this situation, and 64.5 percent of parents in Karaganda Oblast would seek care in polyclinic (out-patient). About 42 percent of parents in urban and rural areas responded they would refer to a TB dispen- sary with suspected TB in children. Respondents with higher education more often mentioned TB dispensary as the place of seeking care. These facilities provide diagnostics and medical treat- ment to the patients directly referred for first medical aid and those who were referred there with suspected TB after medical examination in other health facilities. About 39 percent of parents in rural area and 25.5 percent of urban population would refer to hospi- tal. The latter would refer to a Polyclinic (32 pere- cent). It could be explained by high coverage of ur- ban population with polyclinic care, while due to lack of polyclinics in rural areas the rural popula- tion is forced to seek care in the nearest hospital. In order to identify the level of population awareness of disease symptoms respondents were asked about symptoms of suspected TB that would make them seeking medical care. Thus, almost 53 percent of interviewed women correctly named “coughing over three weeks” as a TB sign (Table ТВ.2). At the same time the high- est awareness level was found in Kostanai (78.3 percent), Pavlodar (75.7 percent), Mangistau and Aktobe Oblasts as well as in Almaty city (around 70 percent). Among other symptoms almost 43 percent of women listed blood with phlegm, 38 percent – fever and 37 percent – night sweating. Overall, the urban population is more aware of TB signs than the rural population. Similarly, the level of awareness by each TB symptom grows along with respondents’ level of education and wealth. Table ТВ.3 provides information on what TB symptoms would require women to see a doc- tor. Over 58.5 percent of women reported that they would be forced to see a doctor if they would have cough over three weeks, 43.9 per- cent if they would lose weight; 41.3 percent – fe- ver, 39.0 percent – blood with phlegm and 39.8 percent women – pain in the chest. In the survey women were asked about their con- tacts with people who had TB (family members or anybody who suffers from TB, such as neigh- bors, colleagues or close friends) and whether they would take care of a family member after TB treatment. Five percent of interviewed women informed that they were sick or have family members with TB and 7.5 percent often communicate with neighbors, colleagues or close friends suffering from TB (Table TB.4). The largest percent of peo- ple contacting with persons suffering from TB (including siblings, colleagues and friends) live in Pavlodar (25 percent), Akmola (21.2 percent), North Kazakhstan (19.3 percent), Kyzylorda (18.6 percent), West Kazakhstan (17.8 percent), Kostanai (17.7 percent), Karaganda (19.4 per- cent) Oblasts and Astana city (21.6 percent). The proportion of respondents who denied care to family member who had TB treatment increas- es with growth of family wealth from 3.4 percent in poorest households to 5.4 percent in the richer ones. Proportion of such respondents increases with education level from 3.5 percent in women with primary/incomplete secondary education to 4.5 percent in women with higher education. Overall about 4 percent of interviewed women reported that they would not take care of family member who had TB treatment. Overall 12.5 percent of the population in the country had TB or had family members suffer- ing from tuberculosis and/or have frequent con- tacts with people who have TB outside of their families. The population is well informed about ways of TB transmission and the disease’s symp- toms. Better knowledge about proper treatment of tuberculosis would allow improvement of references to health facilities at earlier stages. This would promote more effective treatment and better TB prevention. MONITORING THE SITUATION OF CHILDREN AND WOMEN66 List of References Boerma, J. T., Weinstein, K. I., Rutstein, S.O., and Sommerfelt, A. E. , 1996. Data on Birth Weight in Developing Countries: Can Surveys Help? Bulletin of the World Health Organization, 74(2), 209-16. Rutstein, S.O. and Johnson, K., 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, Maryland: ORC Macro. Filmer, D. and Pritchett, L., 2001. 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KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 67 T ab le H H .1 : R es ul ts o f h o us eh o ld a n d in d iv id ua l i n te rv ie w s N um b er o f h o us eh o ld s, w o m en , a n d c h ild re n u n d er 5 b y re su lt s o f t h e h o us eh o ld , w o m en ’s a n d u n d er -fi ve ’s in te rv ie w s, a n d h o us eh o ld , w o m en ’s a n d u n d er - fiv e’ s re sp o n se r at es , K az ak h st an , 2 00 6 RE SI D EN CE TO TA L IN CL U D IN G O BL A ST S Urban Rural Akmola Aktobe Almaty Atyrau West Kazakhstan Zhambyl Karagandy Kostanai Kyzylorda Mangistau South Kazakhstan Pavlodar North Kazakhstan East Kazakhstan Astana City Almaty City N um be r o f h ou se ho ld s Sa m pl ed 8 64 0 6 36 0 15 0 00 88 8 86 4 1 12 8 79 2 84 0 98 4 1 08 0 93 6 84 0 76 8 1 15 2 88 8 86 4 1 10 4 81 6 1 05 6 O cc up ie d 8 63 0 6 35 4 14 9 84 88 5 86 4 1 12 3 79 1 84 0 98 4 1 07 8 93 4 84 0 76 7 1 15 2 88 8 86 3 1 10 4 81 6 1 05 5 In te rv ie w ed 8 24 6 6 31 8 14 5 64 84 6 83 7 1 09 6 78 2 82 0 97 4 1 05 2 92 1 83 0 75 8 1 12 5 87 3 84 7 1 08 2 75 5 96 6 Re sp on se ra te 95 .6 99 .4 97 .2 95 .6 96 .9 97 .6 98 .9 97 .6 99 .0 97 .6 98 .6 98 .8 98 .8 97 .7 98 .3 98 .1 98 .0 92 .5 91 .6 N um be r o f w om en El ig ib le 7 68 1 7 03 8 14 7 19 73 4 88 7 1 16 2 1 03 6 92 5 1 00 2 92 5 78 3 1 02 5 93 8 1 35 8 75 9 68 2 94 1 79 3 76 9 In te rv ie w ed 7 61 1 6 95 9 14 5 70 66 6 88 7 1 15 9 1 02 6 90 5 99 9 92 4 78 2 1 02 2 93 8 1 35 5 75 6 68 1 94 0 76 6 76 4 Re sp on se ra te 99 .1 98 .9 99 .0 90 .7 10 0. 0 99 .7 99 .0 97 .8 99 .7 99 .9 99 .9 99 .7 10 0. 0 99 .8 99 .6 99 .9 99 .9 96 .6 99 .3 O ve ra ll re sp on se ra te 94 .7 98 .3 96 .2 86 .7 96 .9 97 .3 97 .9 95 .5 98 .7 97 .5 98 .5 98 .5 98 .8 97 .4 97 .9 98 .0 97 .9 89 .4 91 .0 N um be r o f c hi ld re n un de r 5 El ig ib le 1 94 4 2 48 0 4 42 4 21 6 23 4 41 5 31 4 20 3 38 8 19 1 20 1 39 8 31 9 61 9 17 4 16 1 19 5 18 5 21 1 M ot he r/ Ca re ta ke r in te rv ie w ed 1 94 2 2 47 4 4 41 6 21 3 23 4 41 3 31 4 20 3 38 7 19 1 20 1 39 7 31 9 61 9 17 3 16 1 19 5 18 5 21 1 Re sp on se ra te 99 .9 99 .8 99 .8 98 .6 10 0. 0 99 .5 10 0. 0 10 0. 0 99 .7 10 0. 0 10 0. 0 99 .7 10 0. 0 10 0. 0 99 .4 10 0. 0 10 0. 0 10 0. 0 10 0. 0 O ve ra ll re sp on se ra te 95 .5 99 .2 97 .0 94 .3 96 .9 97 .1 98 .9 97 .6 98 .7 97 .6 98 .6 98 .6 98 .8 97 .7 97 .7 98 .1 98 .0 92 .5 91 .6 D en o m in at o r fo r h o us eh o ld r es p o n se r at e – i s th e n um b er o f h o us eh o ld s id en ti fie d a s o cc up ie d d ur in g th e fie ld w o rk ( H H 9 = 1, 2 , 3 ); n um er at o r – i s th e n um b er o f h o us eh o ld s en te re d in to t h e h o us eh o ld q ue st io n n ai re s (H H 9 = 1) . D en o m in at o r fo r w o m en ’s r es p o n se r at e – is t h e n um b er o f el ig ib le w o m en in th e h o us eh o ld li st in g (i .e . w o m en 1 5– 49 y ea rs o ld , H H 12 ); n um er at o r – is t h e n um b er o f su cc es sf ul ly in te rv ie w ed w o m en ( H H 13 ). D en o m in at o r fo r un d er fiv e ch ild re n r es p o n se – is t h e n um b er o f c h ild re n u n d er fi ve in t h e h o us eh o ld li st in g (H H 14 ); n um er at o r – is t h e n um b er o f fi lle d q ue st io n n ai re s fo r ch ild re n un d er fi ve ( H H 15 ). O ve ra ll re sp o n se r at es in te rv ie w s ar e o bt ai n ed th ro ug h m ul ti p ly in g th e h o us eh o ld r es p o n se s ra te s by w o m en a n d c h ild re n u n d er fi ve r es p o n se r at es a cc o rd in gl y. MONITORING THE SITUATION OF CHILDREN AND WOMEN68 Table HH.2: Household age distribution by sex Percent distribution of the household population by five-year age groups and interdependent age groups, and number of children aged 0-17 years, by sex, Kazakhstan, 2006 MALES FEMALES TOTAL Number Percent Number Number Percent Number Age 0-4 2 125 8.6 1 898 7.1 4 023 7.8 5-9 1 863 7.5 1 686 6.4 3 549 6.9 10-14 2 417 9.8 2 355 8.9 4 772 9.3 15-19 2 665 10.8 2 360 8.9 5 025 9.8 20-24 2 104 8.5 2 022 7.6 4 126 8.0 25-29 1 981 8.0 1 809 6.8 3 790 7.4 30-34 1 685 6.8 1 814 6.8 3 499 6.8 35-39 1 660 6.7 1 956 7.4 3 616 7.1 40-44 1 845 7.5 1 978 7.5 3 823 7.5 45-49 1 711 6.9 1 968 7.4 3 679 7.2 50-54 1 349 5.5 1 805 6.8 3 154 6.1 55-59 1 073 4.3 1 327 5.0 2 400 4.7 60-64 548 2.2 768 2.9 1 316 2.6 65-69 773 3.1 1 173 4.4 1 946 3.8 70+ 925 3.8 1 617 6.1 2 542 5.0 Interdependent age groups < 15 6 405 25.9 5 939 22.4 12 344 24.1 15-64 16 621 67.2 17 807 67.1 34 428 67.2 65 + 1 698 6.9 2 790 10.5 4 488 8.7 Missing/DK 0 0.0 1 0.0 1 0.0 Children aged 0-17 8 090 32.7 7 448 28.1 15 538 30.3 Adults 18+/Missing/ DK 16 634 67.3 19 089 71.9 35 723 69.7 Total 24 724 100.0 26 537 100.0 51 261 100.0 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 69 Table HH.3: Household composition Percent distribution of households by selected characteristics. Kazakhstan, 2006 WEIGHTED PERCENT NUMBER OF HOUSEHOLDS Weighted Unweighted Sex of household head Male 64.5 9 396 9 703 Female 35.5 5 168 4 861 Oblast Akmola 6.0 879 846 Aktobe 4.3 629 837 Almaty 9.3 1 352 1 096 Atyrau 2.3 334 782 West Kazakhstan 4.1 600 820 Zhambyl 5.7 834 974 Karagandy 11.1 1 614 1 052 Kostanai 8.0 1 170 921 Kyzylorda 2.8 409 830 Mangistau 1.9 273 758 South Kazakhstan 9.7 1 415 1 125 Pavlodar 6.3 911 873 North Kazakhstan 5.5 805 847 East Kazakhstan 11.4 1 652 1 082 Astana City 2.3 334 755 Almaty City 9.3 1 353 966 Residence Urban 64.1 9 339 8 246 Rural 35.9 5 225 6 318 Number of household members 1 13.0 1 894 1 675 2-3 41.0 5 965 5 560 4-5 32.4 4 723 4 935 6-7 10.4 1 522 1 799 8-9 2.4 349 447 10+ 0.8 111 148 Ethnicity/language Kazakh 49.1 7 145 8 071 Russian 41.2 6 007 5 242 Other 9.7 1 412 1 251 Total 100.0 14 564 14 564 At least one child aged < 18 years 56.7 14 564 14 564 At least one child aged < 5 years 21.8 14 564 14 564 At least one woman aged 15-49 years 70.6 14 564 14 564 MONITORING THE SITUATION OF CHILDREN AND WOMEN70 Table HH.4: Women’s background characteristics Percent distribution of women aged 15-49 years by background characteristics, Kazakhstan, 2006 WEIGHTED PERCENT NUMBER OF WOMEN Weighted Weighted Oblast Akmola 5.5 797 666 Aktobe 4.6 675 887 Almaty 10.1 1 475 1 155 Atyrau 3.2 458 1 026 West Kazakhstan 4.8 699 905 Zhambyl 6.0 877 998 Karagandy 10.2 1 476 924 Kostanai 7.0 1 016 782 Kyzylorda 3.6 528 1 022 Mangistau 2.3 335 938 South Kazakhstan 12.2 1 767 1 352 Pavlodar 5.6 820 756 North Kazakhstan 4.6 674 681 East Kazakhstan 10.1 1 467 940 Astana City 2.5 368 766 Almaty City 7.7 1 126 762 Residence Urban 59.5 8 655 7 608 Rural 40.5 5 903 6 952 Age 15–19 17.0 2 469 2 528 20–24 14.5 2 108 2 169 25–29 13.0 1 894 1 924 30–34 13.1 1 900 1 877 35–39 14.1 2 055 2 021 40–44 14.2 2 076 2 066 45–49 14.1 2 056 1 975 Marital/Union status Currently married/in union 57.4 8 349 8 370 Formerly married/in union 14.1 2 049 1 857 Never married/in union 28.6 4 160 4 333 Motherhood status Ever gave birth 66.8 9 727 9 595 Never gave birth 33.2 4 831 4 965 Education Primary/incomplete secondary 13.4 1 948 1 955 Secondary 33.6 4 893 5 004 Specialized secondary 27.1 3 949 3 919 Higher 25.9 3 768 3 682 Wealth index quintiles Poorest 18.5 2 689 3 041 Poor 18.7 2 728 2 977 Middle 19.4 2 824 2 840 Rich 20.0 2 915 2 513 Richest 23.4 3 402 3 189 Ethnicity/language Kazakh 59.1 8 609 9 553 Russian 30.8 4 481 3 761 Other 10.1 1 468 1 246 Total 100.0 14 558 14 558 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 71 Table HH.5: Children’s background characteristics Percent distribution of children under five years of age by background characteristics, Kazakhstan, 2006 WEIGHTED PERCENT NUMBER OF UNDER-5 CHILDREN Weighted Unweighted Sex Male 52.7 2 327 2 323 Female 47.3 2 088 2 092 Oblast Akmola 5.5 243 213 Aktobe 4.1 181 234 Almaty 12.3 545 412 Atyrau 3.3 143 314 West Kazakhstan 3.4 152 203 Zhambyl 7.8 345 387 Karagandy 7.2 316 191 Kostanai 6.1 267 201 Kyzylorda 4.7 209 397 Mangistau 2.5 109 319 South Kazakhstan 18.7 827 619 Pavlodar 4.5 197 173 North Kazakhstan 3.7 163 161 East Kazakhstan 6.9 304 195 Astana City 2.0 90 185 Almaty City 7.3 324 211 Residence Urban 51.0 2 251 1 942 Rural 49.0 2 164 2 473 Age < 6 months 8.7 382 387 6-11 months 10.5 462 477 12-23 months 21.9 969 960 24-35 months 21.5 948 936 36-47 months 19.4 858 861 48-59 months 18.0 796 794 Mother’s education Primary/incomplete secondary 7.0 309 272 Secondary 45.3 2 000 2 047 Specialized secondary 23.3 1 030 1 052 Higher 24.4 1 076 1 044 Wealth index quintiles Poorest 27.0 1 189 1 266 Poor 20.9 924 998 Middle 19.7 868 875 Rich 16.0 707 598 Richest 16.4 725 678 Ethnicity/language Kazakh 66.2 2 924 3 193 Russian 21.1 931 771 Other 12.7 560 451 Total 100.0 4 415 4 415 MONITORING THE SITUATION OF CHILDREN AND WOMEN72 Table НН. 6: Resources of the main information for households Percent distribution of households using any sources (mean) of information, Kazakhstan, 2006 SOURCE OF INFORMATION FOR FAMILY N U M BE R O F H O U SE H O LD S N ew sp ap er TV Ra di o M ag az in es In te rn et O ut do or ad ve rt is in g an d po st er s Si bl in gs , fr ie nd s an d co lle ag ue s O th er Oblast Akmola 69.8 97.0 22.3 21.8 4.0 10.0 56.5 1.2 879 Aktobe 81.6 97.5 40.8 41.8 6.2 24.1 82.4 3.4 629 Almaty 59.8 98.5 14.4 4.6 1.5 9.6 60.0 0.4 1 352 Atyrau 91.0 98.4 45.7 16.4 5.1 11.7 88.9 0.8 334 West Kazakhstan 64.9 97.3 29.5 23.1 2.7 3.1 51.6 0.3 600 Zhambyl 52.0 95.2 8.8 8.5 0.9 2.1 23.9 0.4 834 Karagandy 67.1 97.4 17.1 18.2 6.1 7.1 52.2 0.5 1 614 Kostanai 71.1 97.8 26.1 15.4 5.6 6.0 38.0 0.2 1 170 Kyzylorda 44.1 97.0 18.4 7.1 1.3 5.8 55.4 2.9 409 Mangistau 89.5 99.5 33.9 38.1 8.1 23.4 84.4 4.1 273 South Kazakhstan 49.1 98.3 19.8 4.7 1.5 11.3 54.6 0.2 1 415 Pavlodar 69.7 98.3 34.8 18.4 3.8 2.3 50.0 0.2 911 North Kazakhstan 69.9 96.6 17.3 9.6 2.2 3.8 41.1 0.1 805 East Kazakhstan 62.7 97.9 12.1 11.1 1.8 5.5 50.8 5.1 1 652 Astana City 84.0 96.7 36.3 42.3 21.9 17.0 40.1 (*) 334 Almaty City 78.7 98.7 62.4 48.1 13.5 21.8 71.2 0.5 1 353 Residence Urban 70.7 97.7 30.8 23.2 7.0 12.2 54.3 1.0 9 339 Rural 58.8 97.6 15.7 9.6 (0.6) 4.5 53.7 1.6 5 225 Education of household head Primary/incomplete secondary 51.1 95.6 17.2 6.2 (*) 4.6 48.1 (1.4) 2 407 Secondary 61.6 97.8 21.1 12.9 2.0 7.3 54.8 1.2 5 224 Specialized secondary 73.2 98.4 27.4 21.0 4.0 10.2 52.7 (1.1) 3 744 Higher 80.3 98.5 37.6 34.9 13.7 16.2 59.4 (1.2) 3 048 Missing/ DK (*) (*) (*) (*) (*) (*) (*) (*) 2 Wealth index quintiles Poorest 43.2 94.5 10.0 4.0 (*) 3.9 52.9 (1.5) 2 208 Poor 60.4 98.1 15.6 8.8 (*) 5.9 53.4 (1.4) 2 554 Middle 67.2 98.1 22.3 12.8 (1.3) 5.1 51.4 (1.3) 2 751 Rich 70.6 97.8 30.2 21.9 3.8 9.7 52.9 (*) 3 560 Richest 80.6 98.9 39.9 35.3 14.5 18.7 58.5 1.3 3 491 Ethnicity/language Kazakh 66.3 98.0 24.7 18.6 4.2 9.6 58.1 1.4 7 145 Russian 68.2 97.4 26.6 19.3 5.7 8.9 49.1 1.1 6 007 Other 60.0 97.1 23.9 13.1 3.0 10.8 54.4 0.7 1 412 Total 66.4 97.7 25.4 18.4 4.7 9.4 54.1 1.2 14 564 Note: ( ) – indicators are based on 25 – 49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 73 Table CM.1: Early child mortality Distribution of infant mortality and under fife mortality rates by key characteristics, Kazakhstan, 2006 INFANT MORTALITY RATE* UNDER-FIVE MORTALITY RATE** Sex Male 36.6 41.7 Female 26.6 30.3 Residence Urban 26.8 30.2 Rural 37.0 42.6 Ethnicity/language Kazakh 31.8 36.2 Russian 27.3 31.0 Total 31.8 36.3 * MICS indicator 2; MDG indicator 14 ** MICS indicator 1; MDG indicator 13 Table CM.2: Children ever born and proportion dead Mean number of children ever born, survived and proportion dead by age of women, Kazakhstan, 2006 MEAN NUMBER OF CHILDREN EVER BORN PROPORTION DEAD RATIO OF SURVIVED AND DEAD NUMBER OF WOMEN Age 15–19 0.031 0.030 0.039 2 469 20–24 0.507 0.497 0.020 2 108 25–29 1.309 1.258 0.038 1 894 30–34 1.895 1.811 0.044 1 900 35–39 2.230 2.132 0.044 2 055 40–44 2.562 2.425 0.053 2 076 45–49 2.737 2.544 0.071 2 056 Total 1.563 1.483 0.051 14 558 MONITORING THE SITUATION OF CHILDREN AND WOMEN74 T ab le N U .1 : C h ild m al n o ur is h m en t Pe rc en ta ge o f c h ild re n a ge d 0 -5 9 m o n th s w h o a re s ev er el y o r m o d er at el y m al n o ur is h ed , K az ak h st an , 2 00 6 W EI G H T FO R A G E H EI G H T FO R A G E W EI G H T FO R H EI G H T N um be r o f c hi ld re n ag ed 0 – 59 m on th s Pe rc en t b el ow Pe rc en t b el ow Pe rc en t b el ow Pe rc en t b el ow Pe rc en t b el ow Pe rc en t b el ow Pe rc en t a bo ve – 2 S D * – 3 S D – 2 S D ** – 3 S D – 2 S D ** * – 3 S D + 2 S D Se x M al e 4. 3 0. 8 13 .4 4. 5 4. 4 1. 3 11 .1 2 20 0 Fe m al e 3. 6 0. 7 12 .1 3. 5 3. 2 0. 6 11 .6 1 99 0 O bl as t A km ol a 3. 7 0. 4 4. 6 0. 4 1. 4 1. 4 8. 8 24 2 A kt ob e 5. 7 1. 0 23 .5 8. 6 1. 7 0. 6 15 .6 17 1 A lm at y 8. 1 2. 0 22 .1 6. 2 5. 0 1. 4 13 .9 50 6 A ty ra u 2. 2 0. 0 14 .2 3. 9 4. 4 0. 4 10 .7 13 4 W es t K az ak hs ta n 8. 8 0. 9 9. 8 4. 1 12 .5 3. 3 11 .9 14 9 Zh am by l 2. 1 0. 0 9. 5 1. 5 1. 3 0. 2 7. 6 33 7 Ka ra ga nd y 3. 2 1. 4 13 .3 2. 8 5. 8 1. 8 11 .3 29 6 Ko st an ai 3. 9 0. 5 10 .8 2. 8 3. 4 0. 5 10 .8 25 4 Ky zy lo rd a 3. 9 1. 0 23 .3 11 .4 3. 7 0. 9 15 .6 18 7 M an gi st au 2. 7 0. 5 14 .4 4. 1 9. 3 2. 0 11 .0 10 2 So ut h Ka za kh st an 2. 8 0. 3 10 .0 2. 5 2. 6 0. 7 10 .9 80 7 Pa vl od ar 2. 1 0. 0 8. 8 3. 2 1. 4 0. 0 10 .9 19 0 N or th K az ak hs ta n 2. 8 0. 0 6. 6 1. 7 0. 0 0. 0 8. 2 15 8 Ea st K az ak hs ta n 5. 6 1. 2 18 .4 9. 2 4. 9 0. 7 10 .5 28 2 A st an a Ci ty 3. 5 0. 6 11 .6 4. 1 4. 7 0. 6 14 .0 84 A lm at y Ci ty 2. 1 1. 6 4. 2 2. 1 5. 3 1. 6 11 .6 29 1 Re si de nc e U rb an 3. 0 0. 6 10 .7 3. 5 4. 4 1. 3 11 .0 2 12 6 Ru ra l 5. 1 1. 0 14 .9 4. 6 3. 2 0. 6 11 .7 2 06 4 * M IC S in di ca to r 6 ; M D G in di ca to r 4 ** M IC S in di ca to r 7 ** * M IC S in di ca to r 8 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 75 T ab le N U .1 : C h ild m al n o ur is h m en t ( co n ti n ue d ) W EI G H T FO R A G E H EI G H T FO R A G E W EI G H T FO R H EI G H T N um be r o f c hi ld re n ag ed 0 – 59 m on th s Pe rc en t b el ow Pe rc en t b el ow Pe rc en t b el ow Pe rc en t b el ow Pe rc en t b el ow Pe rc en t b el ow Pe rc en t a bo ve – 2 S D * – 3 S D – 2 S D ** – 3 S D – 2 S D ** * – 3 S D + 2 S D A ge < 6 m on th s 3. 3 1. 2 5. 8 2. 1 6. 7 2. 5 12 .7 36 1 6- 11 m on th s 3. 5 0. 7 8. 2 3. 4 5. 1 0. 6 16 .5 43 3 12 -2 3 m on th s 4. 9 0. 7 16 .6 4. 7 3. 1 0. 7 16 .6 90 1 24 -3 5 m on th s 4. 4 0. 8 12 .5 4. 2 2. 7 0. 6 8. 9 89 1 36 -4 7 m on th s 2. 7 0. 4 13 .9 4. 3 3. 2 0. 9 8. 8 83 3 48 -5 9 m on th s 4. 5 1. 1 13 .4 3. 9 4. 4 1. 2 7. 2 77 1 M ot he r’ s ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 5. 1 0. 8 15 .4 3. 0 3. 5 1. 3 9. 3 29 3 Se co nd ar y 4. 8 1. 0 14 .8 5. 0 3. 8 0. 7 10 .7 1 89 3 Sp ec ia liz ed s ec on da ry 3. 9 0. 4 11 .8 3. 5 3. 2 1. 1 11 .5 98 8 H ig he r 2. 4 0. 8 9. 3 3. 0 4. 5 1. 3 12 .8 1 01 6 W ea lt h in de x qu in ti le s Po or es t 4. 7 1. 0 15 .7 4. 9 3. 3 0. 8 12 .5 1 14 6 Po or 5. 0 0. 8 13 .7 4. 4 3. 3 1. 0 10 .6 87 9 M id dl e 4. 5 0. 5 13 .8 4. 5 4. 1 0. 8 11 .0 82 1 Ri ch 4. 1 1. 4 9. 9 3. 2 4. 9 1. 4 12 .0 66 8 Ri ch es t 0. 8 0. 1 8. 4 2. 2 4. 0 1. 2 9. 9 67 6 Et hn ic it y/ la ng ua ge Ka za kh 4. 4 0. 9 14 .5 4. 9 4. 2 0. 9 12 .1 2 78 1 Ru ss ia n 2. 8 0. 7 7. 9 1. 7 3. 6 1. 1 8. 5 87 8 O th er 4. 0 0. 5 11 .7 3. 6 1. 8 1. 0 11 .9 53 1 To ta l 4. 0 0. 8 12 .8 4. 0 3. 8 1. 0 11 .3 4 19 0 * M IC S in di ca to r 6 ; M D G in di ca to r 4 ** M IC S in di ca to r 7 ** * M IC S in di ca to r 8 MONITORING THE SITUATION OF CHILDREN AND WOMEN76 Table NU.2: Initial breastfeeding Percentage of women aged 15-49 years with a birth in the two years preceding the survey who attached their baby to the breast within one hour of birth and within one day of birth, Kazakhstan, 2006 Percentage who started breastfeeding within one hour of birth* Percentage who started breastfeeding within one day of birth Number of women with a life birth in the two years preced- ing the survey Oblast Akmola 49.3 77.3 80 Aktobe 31.5 92.3 68 Almaty 50.5 91.3 225 Atyrau 76.7 94.8 53 West Kazakhstan 65.7 91.0 58 Zhambyl 66.7 91.6 139 Karagandy 91.6 91.6 129 Kostanai 58.7 88.7 84 Kyzylorda 95.5 98.5 80 Mangistau (85.6) (93.1) 45 South Kazakhstan 75.4 84.2 309 Pavlodar 47.6 68.6 83 North Kazakhstan 36.6 85.6 61 East Kazakhstan 49.6 80.6 141 Astana City (82.1) (91.7) 40 Almaty City 63.1 94.0 124 Residence Urban 66.3 87.7 890 Rural 61.9 88.0 829 Months since birth < 6 months 62.6 87.3 379 6-11 months 67.5 87.5 449 12-23 months 63.3 88.3 891 Mother’s education Primary/incomplete secondary 56.1 84.3 112 Secondary 65.4 88.2 734 Specialized secondary 61.5 85.0 416 Higher 66.7 90.8 457 Wealth index quintiles Poorest 66.5 86.6 458 Poor 59.6 88.4 348 Middle 62.5 88.7 330 Rich 66.9 91.7 280 Richest 65.5 84.7 303 Ethnicity/language Kazakh 65.9 89.1 1 163 Russian 56.2 84.8 343 Other 68.0 85.7 213 Total 64.2 87.8 1 719 * MICS indicator 45 ( ) – indicators are based on 25-49 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 77 Table NU.3: Breastfeeding Percentage of living children according to breastfeeding status at each age group, Kazakhstan, 2006 Children 0–3 months Children 0–5 months Children 6–9 months Children 12–15 months Children 20–23 months Pe rc en t e xc lu si ve ly br ea st fe d N um be r o f c hi ld re n Pe rc en t e xc lu si ve ly br ea st fe d* N um be r o f c hi ld re n Pe rc en t r ec ei vi ng br ea st m ilk & s ol id / m us hy fo od ** N um be r o f c hi ld re n Pe rc en t b re as t- fe d* ** N um be r o f c hi ld re n Pe rc en t b re as t- fe d* ** N um be r o f c hi ld re n Sex Male 21.9 121 15.3 206 42.8 159 53.0 175 15.7 171 Female 28.2 108 18.5 176 35.0 147 61.9 151 16.7 150 Residence Urban 25.1 105 16.5 184 41.1 167 50.3 167 14.6 174 Rural 24.7 124 17.0 198 36.7 139 64.2 159 18.0 147 Mother’s education Primary/incomplete secondary (*) 11 (*) 25 (*) 17 (*) 18 (*) 22 Secondary 26.9 91 16.5 169 36.2 119 58.1 145 15.3 135 Specialized secondary 18.6 56 15.9 88 43.9 81 52.4 83 9.0 85 Higher 24.3 71 17.4 100 37.9 89 60.9 80 25.1 79 Wealth index quintiles Poorest 21.3 60 13.4 101 31.3 77 58.9 86 19.9 90 Poor 24.9 46 15.7 82 51.5 66 60.2 71 13.2 60 Middle 31.8 50 20.6 82 35.3 51 63.3 68 13.3 55 Rich (19.4) 30 (13.4) 55 (45.0) 58 (58.2) 51 (9.3) 54 Richest (25.6) 43 21.8 62 (32.4) 54 (40.1) 50 (22.1) 62 Ethnicity/language Kazakh 22.2 156 15.1 256 37.7 204 60.6 219 18.3 212 Russian (27.7) 43 18.2 74 43.7 67 40.9 64 7.1 71 Other (34.7) 30 (22.8) 52 (38.5) 35 (63.3) 43 (21.4) 38 Total 24.9 229 16.8 382 39.1 306 57.1 326 16.2 321 * MICS indicator 15 ** MICS indicator 17 *** MICS indicator 16 ( ) – indicators are based on 25 – 49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations MONITORING THE SITUATION OF CHILDREN AND WOMEN78 Table NU.4: Adequately fed infants Percentage of infants under 6 months of age exclusively breastfed, percentage of infants 6-11 months who are breast- fed and who ate solid/semi-solid food at least the minimum recommended number of times yesterday and percent- age of infants adequately fed, Kazakhstan, 2006 PERCENT OF INFANTS NUMBER OF INFANTS 0–11 MONTHS 0-5 months exclusively breastfed 6-8 months who received breast milk and comple- mentary food at least 2 times in prior 24 hours 9-11 months who received breast milk and comple- mentary food at least 3 times in prior 24 hours 6-11 months who received breast milk and complementary food at least the minimum recom- mended number of times per day* 0-11 months who were appropri- ately fed** Sex Male 15.3 30.7 19.9 25.0 20.6 451 Female 18.5 26.6 19.4 22.9 20.9 392 Residence Urban 16.5 30.3 16.7 23.1 20.3 427 Rural 17.0 27.1 23.0 25.0 21.2 416 Mother’s education Primary/incomplete secondary (19.4) (44.4) (25.3) (35.8) (27.2) 48 Secondary 16.5 25.6 22.4 23.8 20.3 356 Specialized secondary 15.9 29.2 17.7 23.8 20.3 198 Higher 17.4 29.4 16.4 22.6 20.4 241 Wealth index quintiles Poorest 13.4 24.8 23.4 24.0 19.3 229 Poor 15.7 34.8 20.2 27.0 21.9 180 Middle 20.6 22.6 17.2 19.9 20.3 160 Rich 13.4 28.4 15.3 22.5 18.6 129 Richest 21.8 34.3 18.6 25.7 24.0 145 Ethnicity/language Kazakh 15.1 29.3 18.3 23.3 19.7 582 Russian 18.2 23.1 20.8 22.1 20.3 162 Other 22.8 36.5 28.8 33.0 27.6 99 Total 16.8 28.8 19.7 24.0 20.7 843 * MICS indicator 18 ** MICS indicator 19 ( ) – indicators are based on 25-49 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 79 Table NU.5: Iodized salt consumption Percentage of households consuming adequately iodized salt, Kazakhstan, 2006 Percent of households in which salt was tested Number of households interviewed PERCENT OF HOUSEHOLDS WITH TOTAL Number of house- holds in which salt was tested or with no (iodized) salt No salt Salt test result < 15 PPM 15 and + PPM* Oblast Akmola 99.8 879 0.2 15.9 83.9 100.0 879 Aktobe 99.2 629 0.2 8.6 91.2 100.0 626 Almaty 98.4 1 352 0.1 0.2 99.7 100.0 1 332 Atyrau 100.0 334 0.0 13.0 87.0 100.0 334 West Kazakhstan 100.0 600 0.0 9.5 90.5 100.0 600 Zhambyl 97.9 834 0.6 8.2 91.2 100.0 821 Karagandy 99.4 1 614 0.6 9.9 89.5 100.0 1 614 Kostanai 99.7 1 170 0.2 1.5 98.3 100.0 1 168 Kyzylorda 100.0 409 0.0 5.4 94.6 100.0 409 Mangistau 99.8 273 0.1 0.4 99.5 100.0 273 South Kazakhstan 99.9 1 415 0.0 5.4 94.6 100.0 1 414 Pavlodar 99.7 911 0.1 31.6 68.3 100.0 909 North Kazakhstan 100.0 805 0.0 3.3 96.7 100.0 805 East Kazakhstan 100.0 1 652 0.0 7.2 92.8 100.0 1 652 Astana City 98.8 334 1.1 4.6 94.3 100.0 333 Almaty City 91.6 1 353 1.3 2.0 96.7 100.0 1 257 Residence Urban 98.2 9 339 0.4 7.5 92.1 100.0 9 211 Rural 99.7 5 225 0.1 8.1 91.8 100.0 5 215 Wealth index quintiles Poorest 99.6 2 208 0.2 9.1 90.7 100.0 2 204 Poor 99.5 2 554 0.2 7.7 92.1 100.0 2 545 Middle 99.2 2 751 0.2 6.5 93.3 100.0 2 735 Rich 98.3 3 560 0.3 7.2 92.5 100.0 3 510 Richest 97.8 3 491 0.5 8.4 91.1 100.0 3 432 Total 98.8 14 564 0.3 7.7 92.0 100.0 14 426 * MICS indicator 41 MONITORING THE SITUATION OF CHILDREN AND WOMEN80 Table NU.8: Low birth weight infants Percentage of live births in the 2 years preceding the survey that weighed below 2500 grams at birth, Kazakhstan, 2006 PERCENT OF LIVE BIRTH: NUMBER OF LIVE BIRTH Below 2500 grams* Weighted at birth** Oblast Akmola 4.8 100.0 80 Aktobe 4.4 96.8 68 Almaty 4.5 99.5 225 Atyrau 4.2 100.0 53 West Kazakhstan 4.6 100.0 58 Zhambyl 6.3 100.0 139 Karagandy 4.4 99.1 129 Kostanai 4.1 98.7 84 Kyzylorda 4.4 100.0 80 Mangistau (4.0) (98.0) 45 South Kazakhstan 4.6 99.6 309 Pavlodar 19.4 100.0 83 North Kazakhstan 7.7 98.6 61 East Kazakhstan 6.9 99.1 141 Astana City (6.4) (100.0) 40 Almaty City 5.8 98.8 124 Residence Urban 6.2 99.6 890 Rural 5.4 99.1 829 Mother’s education Primary/incomplete secondary 7.2 98.0 112 Secondary 5.4 99.2 734 Specialized secondary 6.9 99.5 416 Higher 5.1 99.9 457 Wealth index quintiles Poorest 5.0 99.3 458 Poor 6.0 99.3 348 Middle 5.4 99.4 330 Rich 7.4 99.0 280 Richest 5.8 99.9 303 Ethnicity/language Kazakh 5.7 99.5 1 163 Russian 5.2 99.4 343 Other 7.0 98.2 213 Total 5.8 99.4 1 719 * MICS indicator 9 ** MICS indicator 10 ( ) – indicators are based on 25-49 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 81 Table CH.1: Vaccinations in first year of life Percentage of children aged 15-26 months immunized against childhood diseases at any time before the survey and before the first birthday (15 months for Measles), Kazakhstan, 2006 PERCENTAGE OF CHILDREN WHO RECEIVED N um be r o f ch ild re n1 5- 26 m on th s BC G * D PT 1 D PT 2 D PT 3* * Po lio 0 Po lio 1 Po lio 2 Po lio 3* ** M ea sl es ** ** A ll* ** ** N on e Vaccinated at any time before the survey According to: Vaccination card 95.1 95.5 95.7 95.7 95.2 95.2 95.3 95.3 95.6 95.4 0.0 991 Mother’s report 4.5 4.0 3.7 2.4 3.0 4.3 3.3 1.4 3.8 0.8 0.4 991 Either 99.6 99.4 99.3 98.0 98.2 99.5 98.6 96.7 99.4 96.2 0.4 991 Vaccinated by 12 months of age 97.9 97.9 96.7 91.7 97.6 99.0 96.9 93.9 94.7 81.0 0.4 991 * MICS Indicator 25 ** MICS Indicator 27 *** MICS Indicator 26 **** MICS Indicator 28; MTG Indicator 15 ***** MICS Indicator 31 Table CH.1C: Vaccinations in first year of life (continued) Percentage of children aged 15-26 months immunized against childhood diseases at any time before the survey and before the first birthday, Kazakhstan, 2006 PERCENTAGE OF CHILDREN WHO RECEIVED: Number of children aged 15-26 monthsHep В1 Hep В2 Hep В3* Vaccinated at any time before the survey According to: Vaccination card 95.1 95.1 95.1 991 Mother’s report 0.0 0.0 0.0 991 Either 95.1 95.1 95.1 991 Vaccinated by 12 months of age 94.3 94.4 92.3 991 * MICS indicator 29 MONITORING THE SITUATION OF CHILDREN AND WOMEN82 T ab le C H .2 : V ac ci n at io n s b y b ac kg ro un d c h ar ac te ri st ic s Pe rc en ta ge o f c h ild re n a ge d 1 5- 26 m o n th s cu rr en tl y va cc in at ed a ga in st c h ild h o o d d is ea se s, K az ak h st an , 2 00 6 PE RC EN TA G E O F CH IL D RE N W H O R EC EI V ED Pe rc en t w ith v ac - ci na tio n ca rd N um be r of c hi l- dr en a ge d 15 -2 6 m on th s BC G D PT 1 D PT 2 D PT 3 Po lio 0 Po lio 1 Po lio 2 Po lio 3 M ea sl es A ll N on e Se x M al e 99 .8 99 .8 99 .8 98 .8 98 .6 99 .8 98 .5 97 .2 99 .6 96 .4 0. 2 95 .5 52 3 Fe m al e 99 .5 99 .1 98 .8 97 .2 97 .8 99 .2 98 .7 96 .2 99 .2 96 .0 0. 5 94 .7 46 8 O bl as t A km ol a (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (9 6. 7) (9 6. 7) (1 00 .0 ) (9 6. 7) (0 .0 ) (9 6. 7) 38 A kt ob e (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (0 .0 ) (1 00 .0 ) 43 A lm at y 99 .0 98 .9 97 .9 88 .2 91 .6 97 .9 91 .6 84 .3 97 .9 82 .0 1. 0 75 .1 11 9 A ty ra u (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (0 .0 ) (1 00 .0 ) 26 W es t K az ak hs ta n (9 7. 8) (9 7. 8) (9 7. 8) (9 7. 8) (9 2. 5) (9 7. 8) (9 7. 8) (9 7. 8) (9 4. 7) (9 4. 6) (2 .2 ) (9 2. 5) 31 Zh am by l 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 0. 0 10 0. 0 78 Ka ra ga nd y 97 .7 97 .7 97 .7 97 .7 97 .7 97 .7 97 .7 97 .7 97 .7 97 .7 2. 3 97 .7 79 Ko st an ai 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 0. 0 10 0. 0 54 Ky zy lo rd a (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (0 .0 ) (1 00 .0 ) 44 M an gi st au (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (0 .0 ) (1 00 .0 ) 26 So ut h Ka za kh st an 10 0. 0 99 .0 99 .0 99 .0 98 .1 10 0. 0 10 0. 0 99 .0 10 0. 0 99 .0 0. 0 98 .1 18 4 Pa vl od ar (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (0 .0 ) (1 00 .0 ) 47 N or th K az ak hs ta n (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (0 .0 ) (1 00 .0 ) 28 Ea st K az ak hs ta n 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 94 .8 10 0. 0 94 .8 0. 0 94 .8 87 A st an a Ci ty (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 19 A lm at y Ci ty 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 0. 0 10 0. 0 88 ( ) – in di ca to rs a re b as ed o n 25 - 49 c as es o f u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 83 T ab le C H .2 : V ac ci n at io n s b y b ac kg ro un d c h ar ac te ri st ic s (c o n ti n ue d ) PE RC EN TA G E O F CH IL D RE N W H O R EC EI V ED Pe rc en t w ith v ac - ci na tio n ca rd N um be r of c hi ld re n ag ed 15 -2 6 m on th s BC G D PT 1 D PT 2 D PT 3 Po lio 0 Po lio 1 Po lio 2 Po lio 3 M ea sl es A ll N on e Re si de nc e U rb an 99 .6 99 .3 99 .3 99 .0 98 .8 99 .6 99 .3 97 .9 99 .5 97 .4 0. 4 97 .1 50 9 Ru ra l 99 .6 99 .6 99 .3 97 .0 97 .7 99 .3 97 .8 95 .5 99 .3 94 .9 0. 4 93 .0 48 2 M ot he r’ s ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 98 .2 94 .5 10 0. 0 94 .5 0. 0 92 .8 69 Se co nd ar y 99 .4 99 .4 99 .1 97 .4 97 .3 99 .1 98 .5 96 .9 99 .1 96 .3 0. 6 94 .8 42 7 Sp ec ia liz ed s ec on da ry 99 .5 99 .5 99 .5 98 .5 98 .7 99 .5 98 .0 95 .9 99 .5 95 .9 0. 5 95 .1 24 8 H ig he r 10 0. 0 99 .3 99 .3 98 .2 98 .9 10 0. 0 99 .3 97 .8 99 .6 96 .8 0. 0 96 .3 24 7 W ea lt h in de x qu in ti le s Po or es t 10 0. 0 10 0. 0 99 .5 98 .6 98 .4 99 .5 99 .1 97 .7 10 0. 0 97 .7 0. 0 95 .7 27 0 Po or 99 .6 99 .6 99 .6 97 .6 98 .6 99 .6 97 .6 96 .2 99 .6 95 .5 0. 4 95 .2 18 2 M id dl e 99 .4 99 .4 99 .4 97 .2 96 .9 99 .4 98 .1 96 .3 98 .7 95 .4 0. 6 92 .9 19 8 Ri ch 10 0. 0 98 .9 98 .9 98 .2 98 .3 10 0. 0 10 0. 0 96 .3 99 .4 95 .7 0. 0 95 .7 16 3 Ri ch es t 99 .0 99 .0 99 .0 98 .4 99 .0 99 .0 98 .0 96 .7 99 .0 96 .1 1. 0 96 .1 17 8 Et hn ic it y/ la ng ua ge Ka za kh 99 .7 99 .5 99 .3 98 .1 98 .4 99 .5 98 .4 96 .8 99 .5 96 .3 0. 3 95 .5 67 6 Ru ss ia n 99 .1 99 .1 99 .1 98 .6 99 .1 99 .1 99 .1 97 .7 99 .1 97 .3 0. 9 97 .3 20 1 O th er 10 0. 0 10 0. 0 10 0. 0 96 .8 95 .5 10 0. 0 98 .9 94 .6 99 .2 93 .8 0. 0 89 .0 11 4 To ta l 99 .6 99 .4 99 .3 98 .0 98 .2 99 .5 98 .6 96 .7 99 .4 96 .2 0. 4 95 .1 99 1 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN84 Table CH.2C: Vaccinations by background characteristics (continued) Percentage of children aged 15-26 months currently vaccinated against childhood diseases, Kazakhstan, 2006 PERCENTAGE OF CHILDREN WHO RECEIVED: Percent with vac- cination card Number of chil- dren aged 15-26 monthsHep В1 Hep В2 Hep В3 Sex Male 95.5 95.5 95.5 95.5 523 Female 94.7 94.7 94.7 94.7 468 Oblast Akmola (96.7) (96.7) (96.7) (96.7) 38 Aktobe (100.0) (100.0) (100.0) (100.0) 43 Almaty 75.1 75.1 75.1 75.1 119 Atyrau (100.0) (100.0) (100.0) (100.0) 26 West Kazakhstan (92.5) (92.5) (92.5) (92.5) 31 Zhambyl 100.0 100.0 100.0 100.0 78 Karagandy 97.7 97.7 97.7 97.7 79 Kostanai 100.0 100.0 100.0 100.0 54 Kyzylorda (100.0) (100.0) (100.0) (100.0) 44 Mangistau (100.0) (100.0) (100.0) (100.0) 26 South Kazakhstan 98.1 98.1 98.1 98.1 184 Pavlodar (100.0) (100.0) (100.0) (100.0) 47 North Kazakhstan (100.0) (100.0) (100.0) (100.0) 28 East Kazakhstan 94.8 94.8 94.8 94.8 87 Astana City (*) (*) (*) (*) 19 Almaty City 100.0 100.0 100.0 100.0 88 Residence Urban 97.1 97.1 97.1 97.1 509 Rural 93.0 93.0 93.0 93.0 482 Mother’s education Primary/incomplete secondary 92.8 92.8 92.8 92.8 69 Secondary 94.8 94.8 94.8 94.8 427 Specialized secondary 95.1 95.1 95.1 95.1 248 Higher 96.3 96.3 96.3 96.3 247 Wealth index quintiles Poorest 95.7 95.7 95.7 95.7 270 Poor 95.2 95.2 95.2 95.2 182 Middle 92.9 92.9 92.9 92.9 198 Rich 95.7 95.7 95.7 95.7 163 Richest 96.1 96.1 96.1 96.1 178 Ethnicity/language Kazakh 95.5 95.5 95.5 95.5 676 Russian 97.3 97.3 97.3 97.3 201 Other 89.0 89.0 89.0 89.0 114 Total 95.1 95.1 95.1 95.1 991 ( ) – indicators are based on 25 – 49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 85 Table CH.4: Oral rehydration treatment Percentage of children aged 0-59 months with diarrhoea in the last two weeks and treatment with oral rehydration solution (ORS) or other oral rehydration treatment (ORT), Kazakhstan, 2006 H ad d ia rr ho ea in la st tw o w ee ks N um be r o f c hi l- dr en a ge d 0- 59 m on th s Children with diarrhoea who received: O rt u se ra te * N um be r o f c hi l- dr en a ge d 0– 59 m on th s w ith d ia r- rh oe a Fl ui d fr om O RS pa ck et Re co m m en de d ho m em ad e flu id Pr e- pa ck ag ed O RS fl ui d N o tr ea tm en t Sex Male 2.1 2 327 (73.1) (23.9) (21.3) (25.6) (74.4) 49 Female 1.5 2 088 (73.5) (8.6) (8.6) (26.5) (73.5) 31 Residence Urban 2.0 2 251 (67.7) (12.3) (13.7) (30.9) (69.1) 45 Rural 1.6 2 164 (80.4) (25.1) (19.8) (19.6) (80.4) 35 Age < 6 months 2.5 382 (*) (*) (*) (*) (*) 10 6–11 months 2.5 462 (*) (*) (*) (*) (*) 11 12–23 months 3.0 969 (78.0) (12.7) (14.2) (19.8) (80.2) 29 24–35 months 1.1 948 (*) (*) (*) (*) (*) 11 36–47 months 0.4 858 (*) (*) (*) (*) (*) 3 48–59 months 2.0 796 (*) (*) (*) (*) (*) 16 Mother’s education Primary/incomplete secondary 3.5 309 (*) (*) (*) (*) (*) 11 Secondary 1.6 2 000 (70.5) (19.9) (19.0) (27.5) (72.5) 32 Specialized secondary 1.8 1 030 (*) (*) (*) (*) (*) 19 Higher 1.7 1 076 (*) (*) (*) (*) (*) 18 Wealth index quintiles Poorest 1.1 1 189 (*) (*) (*) (*) (*) 13 Poor 2.2 924 (*) (*) (*) (*) (*) 20 Middle 1.3 869 (*) (*) (*) (*) (*) 11 Rich 2.8 708 (*) (*) (*) (*) (*) 20 Richest 2.2 725 (*) (*) (*) (*) (*) 16 Ethnicity/language Kazakh 1.5 2 924 (79.6) (18.7) (20.0) (18.9) (81.1) 44 Russian 3.3 931 (*) (*) (*) (*) (*) 30 Other 1.0 560 (*) (*) (*) (*) (*) 6 Total 1.8 4 415 73.3 17.9 16.4 26.0 74.0 80 * MICS indicator 33 ( ) – indicators are based on 25-49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations MONITORING THE SITUATION OF CHILDREN AND WOMEN86 Table CH.5: Home management of diarrhoea Percentage of children aged 0-59 months with diarrhoea in the last two weeks who took increased fluids and contin- ued to feed during the episode, Kazakhstan, 2006 H ad d ia rr ho ea in la st tw o w ee ks N um be r o f c hi ld re n ag ed 0 -5 9 m on th s Children with diarrhoea who received: H om e m an ag em en t of d ia rr ho ea * Re ce iv ed o rt o r in cr ea se d flu id s an d co nt in ue d fe ed in g* * N um be r o f c hi ld re n ag ed 0 -5 9 m on th s w ith d ia rr ho ea D ra nk m or e D ra nk th e sa m e or le ss A te s om ew ha t le ss , s am e or m or e A te m uc h le ss o r no ne Sex Male 2.1 2 327 (49.2) (50.8) (57.5) (42.5) (20.0) (47.8) 49 Female 1.5 2 088 (39.2) (56.3) (61.2) (38.8) (24.6) (48.4) 31 Residence Urban 2.0 2 251 (46.0) (50.8) (51.4) (48.6) (19.8) (42.2) 45 Rural 1.6 2 164 (44.3) (55.7) (68.6) (31.4) (24.3) (55.5) 35 Age 0–11 months 2.5 843 (*) (*) (*) (*) (*) (*) 21 12–23 months 3.0 969 (39.5) (60.5) (57.1) (42.9) (27.5) (48.3) 29 24–35 months 1.1 948 (*) (*) (*) (*) (*) (*) 11 36–47 months 0.4 858 (*) (*) (*) (*) (*) (*) 3 48–59 months 2.0 796 (*) (*) (*) (*) (*) (*) 16 Mother’s education Primary/incomplete secondary 3.5 309 (*) (*) (*) (*) (*) (*) 11 Secondary 1.6 2 000 (44.6) (51.1) (58.6) (41.4) (18.8) (52.3) 32 Specialized secondary 1.8 1 030 (*) (*) (*) (*) (*) (*) 19 Higher 1.7 1 076 (*) (*) (*) (*) (*) (*) 18 Wealth index quintiles Poorest 1.1 1 189 (*) (*) (*) (*) (*) (*) 13 Poor 2.2 924 (*) (*) (*) (*) (*) (*) 20 Middle 1.3 869 (*) (*) (*) (*) (*) (*) 11 Rich 2.8 708 (*) (*) (*) (*) (*) (*) 20 Richest 2.2 725 (*) (*) (*) (*) (*) (*) 16 Ethnicity/language Kazakh 1.5 2 924 (47.3) (52.7) (58.9) (41.1) (23.5) (46.9) 44 Russian 3.3 931 (*) (*) (*) (*) (*) (*) 30 Other 1.0 560 (*) (*) (*) (*) (*) (*) 6 Total 1.8 4 415 45.3 53.0 58.9 41.1 21.8 48.0 80 * MICS indicator 34 ** MICS indicator 35 ( ) – indicators are based on 25-49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 87 Table CH.6: Care seeking for suspected pneumonia Percentage of children aged 0-59 months with suspected pneumonia in the last two weeks taken to a health pro- vider, Kazakhstan, 2006 H ad a cu te re sp ira to ry in fe ct io n N um be r o f c hi ld re n ag ed 0 – 59 m on th s CHILDREN WITH SUSPECTED PNEUMONIA WHO WERE TAKEN TO: Public health facilities Private health facilities Other A ny a pp ro pr ia te pr ov id er * N um be r o f c hi ld re n ag ed 0 – 59 m on th s w ith s us pe ct ed pn eu m on ia G ov t. H os pi ta l G ov t. he al th ce nt re G ov t. he al th po st Vi lla ge h ea lth w or ke r M ob ile / ou t- re ac h cl in ic Other private health facilities Relative or friend Sex Male 1.8 2 327 (23.7) (5.9) (37.7) (3.2) (4.9) (0.0) (1.5) (73.3) 42 Female 1.2 2 088 (9.4) (0.0) (49.4) (0.0) (1.4) (7.2) (0.0) (65.9) 25 Residence Urban 1.8 2 251 (18.2) (0.0) (49.0) (0.0) (0.0) (4.5) (0.0) (71.7) 40 Rural 1.2 2 164 (18.5) (9.2) (31.9) (4.9) (8.9) (0.0) (2.3) (68.8) 27 Age 0–11 months 1.8 844 (*) (*) (*) (*) (*) (*) (*) (*) 15 12–23 months 1.2 969 (*) (*) (*) (*) (*) (*) (*) (*) 12 24–35 months 1.1 948 (*) (*) (*) (*) (*) (*) (*) (*) 11 36–47 months 2.1 858 (*) (*) (*) (*) (*) (*) (*) (*) 18 48–59 months 1.4 796 (*) (*) (*) (*) (*) (*) (*) (*) 11 Mother’s education Primary/incomplete secondary 2.9 309 (*) (*) (*) (*) (*) (*) (*) (*) 9 Secondary 1.2 2 000 (11.8) (5.5) (52.5) (2.7) (6.4) (0.0) (2.6) (73.7) 24 Specialized secondary 2.1 1 030 (*) (*) (*) (*) (*) (*) (*) (*) 22 Higher 1.1 1 076 (*) (*) (*) (*) (*) (*) (*) (*) 12 Wealth index quintiles Poorest 0.8 1 189 (*) (*) (*) (*) (*) (*) (*) (*) 9 Poor 1.6 924 (*) (*) (*) (*) (*) (*) (*) (*) 15 Middle 1.4 869 (*) (*) (*) (*) (*) (*) (*) (*) 12 Rich 2.0 708 (*) (*) (*) (*) (*) (*) (*) (*) 14 Richest 2.3 725 (*) (*) (*) (*) (*) (*) (*) (*) 17 Ethnicity/language Kazakh 1.3 2 924 (16.5) (6.4) (51.8) (1.6) (0.9) (0.0) (1.6) (74.0) 39 Russian 2.4 931 (*) (*) (*) (*) (*) (*) (*) (*) 22 Other 1.1 560 (*) (*) (*) (*) (*) (*) (*) (*) 6 Total 1.5 4 415 18.3 3.7 42.1 2.0 3.6 2.7 0.9 70.5 67 * MICS indicator 23 ( ) – indicators are based on 25 – 49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations MONITORING THE SITUATION OF CHILDREN AND WOMEN88 Table CH.7: Antibiotic treatment of pneumonia Percentage of children aged 0-59 months with suspected pneumonia who received antibiotic treatment, Kazakhstan, 2006 PERCENTAGE OF UNDER FIVES WITH SUSPECTED PNEUMONIA WHO RECEIVED ANTIBIOTICS IN THE LAST TWO WEEKS* NUMBER OF CHILDREN AGED 0- 59 MONTHS WITH SUSPECTED PNEUMONIA IN THE TWO WEEKS PRIOR TO THE SURVEY Sex Male (25.5) 42 Female (41.9) 25 Residence Urban (32.3) 40 Rural (30.8) 27 Age 0–11 months (*) 15 12–23 months (*) 12 24–35 months (*) 11 36–47 months (*) 18 48–59 months (*) 11 Mother’s education Primary/incomplete secondary (*) 9 Secondary (41.8) 24 Specialized secondary (*) 22 Higher (*) 12 Wealth index quintiles Poorest (*) 9 Poor (*) 15 Middle (*) 12 Rich (*) 14 Richest (*) 17 Ethnicity/language Kazakh (30.8) 39 Russian (*) 22 Other (*) 6 Total 31.7 67 * MICS indicator 22 ( ) – indicators are based on 25 – 49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 89 Table CH.7A: Knowledge of the two danger signs of pneumonia Percentage of mothers/caretakers of children aged 0-59 months by knowledge of types of symptoms for taking a child immediately to a health facility, and percentage of mothers/caretakers who recognize fast and difficult breath- ing as signs for seeking care immediately, Kazakhstan, 2006 Percentage of mothers/caretakers of children aged 0-59 months who think that a child should be taken immediately to a health facil- ity if the child: M ot he rs /c ar et ak er s w ho re co gn iz e th e tw o da ng er s ig ns o f pn eu m on ia N um be r o f m ot he rs / ca re ta ke rs o f c hi ld re n ag ed 0 -5 9 m on th s Is n ot a bl e to d rin k or br ea st fe ed Be co m es si ck er D ev el op s a fe ve r H as fa st br ea th in g H as d iffi cu lt br ea th in g H as b lo od in st oo l Is d rin ki ng po or ly H as o th er sy m pt om s Oblast Akmola 23.6 51.1 92.0 45.9 50.7 47.5 11.2 14.5 40.3 243 Aktobe 36.7 63.5 73.6 77.4 74.5 72.6 8.7 5.3 60.0 181 Almaty 16.1 42.0 93.4 18.0 32.7 21.4 2.5 0.3 10.6 545 Atyrau 54.4 57.6 93.3 52.2 70.0 75.8 33.8 8.7 44.8 143 West Kazakhstan 35.6 42.2 80.7 39.6 51.3 50.8 3.3 23.2 24.9 152 Zhambyl 17.5 46.9 93.0 37.7 47.6 30.4 6.8 15.0 27.1 345 Karagandy 40.3 52.0 92.8 59.5 61.4 58.2 19.7 26.5 45.6 316 Kostanai 28.1 41.6 86.9 41.4 65.9 57.2 7.1 0.0 30.5 267 Kyzylorda 35.7 55.1 69.4 19.7 36.2 28.4 3.9 2.2 8.7 209 Mangistau 54.9 68.2 93.3 96.7 95.0 93.9 77.4 0.0 93.4 109 South Kazakhstan 5.6 66.5 91.4 41.6 56.7 32.9 1.6 7.8 17.6 827 Pavlodar 55.4 74.5 87.8 75.7 84.4 84.7 34.6 28.1 71.4 197 North Kazakhstan 43.0 58.4 78.7 60.6 77.8 72.1 16.4 25.5 52.6 163 East Kazakhstan 20.0 45.4 91.8 46.5 51.3 41.8 2.6 5.3 28.1 304 Astana City 35.7 48.1 81.6 54.6 47.0 52.4 18.4 24.9 38.9 90 Almaty City 17.1 72.5 96.7 40.3 60.2 43.1 18.5 1.9 31.3 324 Residence Urban 27.3 56.8 89.0 47.7 61.0 52.6 16.3 11.5 36.3 2 251 Rural 23.1 54.1 89.5 41.6 51.3 38.8 6.2 8.4 26.9 2 164 Mother’s education Primary/incomplete secondary 20.1 47.6 89.2 49.6 59.3 44.4 10.7 11.7 31.1 309 Secondary 23.2 56.9 88.2 42.7 53.9 43.0 8.9 8.8 29.1 2 000 Specialized secondary 28.9 54.6 90.8 44.3 55.5 48.8 13.1 11.1 33.9 1 030 Higher 27.1 55.8 89.5 47.4 60.4 48.7 14.3 10.6 34.5 1 076 Wealth index quintiles Poorest 19.2 59.3 88.8 37.3 51.1 36.3 4.1 7.7 22.0 1 189 Poor 23.3 49.5 88.2 42.6 48.6 39.3 8.6 7.7 27.1 924 Middle 27.8 53.3 90.3 46.1 57.7 46.1 13.1 9.8 33.7 869 Rich 28.5 56.4 89.8 50.5 62.0 53.3 12.8 15.5 39.5 708 Richest 31.5 58.5 89.3 52.2 67.0 62.3 23.0 11.3 43.4 725 Ethnicity/language Kazakh 25.8 55.6 89.0 44.2 55.2 44.2 11.4 9.3 30.9 2 924 Russian 29.3 55.3 89.2 49.7 62.5 57.6 13.2 14.3 39.5 931 Other 15.4 55.3 90.1 38.6 51.5 35.0 7.8 6.1 22.7 560 Total 25.2 55.5 89.2 44.7 56.2 45.8 11.3 10.0 31.7 4 415 MONITORING THE SITUATION OF CHILDREN AND WOMEN90 Table CH.8: Solid fuel use Percent distribution of households according to type of cooking fuel and percentage of households using solid fuels for cooking, Kazakhstan, 2006 PERCENTAGE OF HOUSEHOLDS USING: So lid fu el s fo r c oo ki ng * N um be r o f ho us eh ol ds El ec tr ic ity Li qu ifi ed ga z/ pr o- pa ne N at ur al ga s Ke ro se ne Co al Ch ar co al W oo d A ni m al du ng To ta l Oblast Akmola 5.2 76.0 0.1 0.0 14.6 0.5 3.4 0.2 100.0 18.7 879 Aktobe 0.4 7.4 65.6 0.1 17.1 0.0 2.4 7.0 100.0 26.5 629 Almaty 0.5 74.8 7.2 0.3 14.7 0.2 2.3 0.0 100.0 17.2 1 352 Atyrau 0.0 19.9 73.0 0.1 0.5 0.0 0.0 6.5 100.0 7.0 334 West Kazakhstan 0.3 11.7 61.3 0.0 1.8 0.1 10.2 14.7 100.0 26.7 600 Zhambyl 1.1 18.5 50.2 0.0 24.7 0.3 4.9 0.4 100.0 30.3 834 Karagandy 40.6 42.6 0.0 0.0 16.7 0.1 0.0 0.0 100.0 16.8 1 614 Kostanai 3.9 38.9 43.6 0.0 11.8 0.3 1.2 0.3 100.0 13.6 1 170 Kyzylorda 0.9 44.0 15.3 0.0 14.1 1.6 24.1 0.0 100.0 39.8 409 Mangistau 0.2 6.5 93.3 0.0 0.0 0.0 0.0 0.0 100.0 0.0 273 South Kazakhstan 0.1 22.5 36.7 0.1 36.6 0.4 3.0 0.6 100.0 40.7 1 415 Pavlodar 64.1 27.8 0.0 0.0 7.2 0.3 0.6 0.0 100.0 8.2 911 North Kazakhstan 4.5 90.9 0.1 0.0 1.9 0.0 2.4 0.0 100.0 4.4 805 East Kazakhstan 33.6 35.9 0.7 0.0 25.2 0.1 3.5 1.0 100.0 29.8 1 652 Astana City 8.4 91.5 0.1 0.0 0.0 0.0 0.0 0.0 100.0 0.0 334 Almaty City 4.1 23.5 72.4 0.0 0.0 0.0 0.0 0.0 100.0 0.0 1 353 Residence Urban 20.5 36.5 36.1 0.0 6.2 0.1 0.6 0.0 100.0 6.8 9 339 Rural 2.2 47.2 9.8 0.0 29.8 0.4 7.0 3.6 100.0 40.8 5 225 Education of household head Primary/incomplete secondary 13.1 42.8 17.6 0.1 20.6 0.3 4.1 1.4 100.0 26.4 2 407 Secondary 11.0 41.5 20.9 0.1 19.5 0.3 4.4 2.3 100.0 26.5 5 224 Specialized secondary 16.8 41.7 29.4 0.0 9.8 0.1 1.5 0.7 100.0 12.1 3 744 Higher 16.4 35.0 40.8 0.0 6.7 0.1 0.7 0.3 100.0 7.8 3 048 Wealth index quintiles Poorest 0.2 27.0 3.2 0.2 48.2 0.9 13.3 7.0 100.0 69.4 2 208 Poor 1.8 56.0 11.4 0.1 25.5 0.4 3.8 1.0 100.0 30.8 2 554 Middle 4.8 59.2 21.6 0.1 13.2 0.1 0.8 0.2 100.0 14.4 2 751 Rich 21.0 42.5 34.9 0.0 1.5 0.0 0.1 0.0 100.0 1.6 3 560 Richest 31.5 20.3 48.2 0.0 0.0 0.0 0.0 0.0 100.0 0.0 3 491 Ethnicity/language Kazakh 10.2 35.9 26.4 0.0 20.2 0.4 4.3 2.6 100.0 27.4 7 145 Russian 19.9 44.3 26.4 0.0 8.0 0.0 1.4 0.0 100.0 9.4 6 007 Other 7.6 46.0 28.9 0.1 15.3 0.1 1.8 0.2 100.0 17.4 1 412 Total 14.0 40.3 26.6 0.0 14.7 0.2 2.9 1.3 100.0 19.0 14 564 * MICS indicator 24; MDG indicator 29 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 91 Table CH.9: Solid fuel use by type of stove or fire Percentage of households using solid fuels for cooking by type of stove or fire, Kazakhstan, 2006 Percentage of households using solid fuels for cooking: Total Number of house- holds using solid fuels for cooking Closed stove with chim- ney Open stove or fire with chimney or hood Open stove or fire with no chimney or hood Other stove Oblast Akmola 99.3 0.7 0.0 0.0 100.0 164 Aktobe 30.2 69.8 0.0 0.0 100.0 167 Almaty 84.6 14.4 1.0 0.0 100.0 233 Atyrau (*) (*) (*) (*) 100.0 23 West Kazakhstan 98.0 2.0 0.0 0.0 100.0 160 Zhambyl 99.5 0.5 0.0 0.0 100.0 253 Karagandy 3.4 94.2 2.4 0.0 100.0 271 Kostanai 98.6 0.7 0.0 0.7 100.0 159 Kyzylorda 99.8 0.0 0.0 0.2 100.0 163 South Kazakhstan 96.9 3.1 0.0 0.0 100.0 575 Pavlodar 98.9 1.1 0.0 0.0 100.0 74 North Kazakhstan (100.0) (0.0) (0.0) (0.0) (100.0) 35 East Kazakhstan 98.0 1.4 0.6 0.0 100.0 492 Residence Urban 79.5 19.7 0.8 0.0 100.0 638 Rural 85.0 14.6 0.3 0.1 100.0 2 131 Education of household head Primary/incomplete secondary 85.2 14.8 0.0 0.0 100.0 635 Secondary 83.3 16.2 0.4 0.1 100.0 1 382 Specialized secondary 82.7 16.0 1.3 0.0 100.0 454 Higher 84.5 15.0 0.5 0.0 100.0 239 None/DK (*) (*) (*) (*) 100.0 1 Wealth index quintiles Poorest 89.7 10.1 0.1 0.1 100.0 1 532 Poor 81.6 17.8 0.6 0.0 100.0 786 Middle 69.3 29.8 0.9 0.0 100.0 395 Rich 51.9 46.2 1.9 0.0 100.0 56 Ethnicity/language Kazakh 84.0 15.6 0.3 0.1 100.0 1 959 Russian 80.8 18.2 1.0 0.0 100.0 564 Other 88.2 11.8 0.0 0.0 100.0 246 Total 83.7 15.8 0.4 0.1 100.0 2 769 ( ) – indicators are based on 25 – 49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations MONITORING THE SITUATION OF CHILDREN AND WOMEN92 T ab le E N .1 : U se o f i m p ro ve d w at er s o ur ce s Pe rc en t d is tr ib ut io n o f h o us eh o ld m em b er s a cc o rd in g to m ai n so ur ce o f d ri n ki n g w at er a n d p er ce n ta ge o f h o us eh o ld m em b er s u si n g im p ro ve d d ri n ki n g w at er so ur ce s, K az ak h st an , 2 00 6 M A IN S O U RC E O F D RI N KI N G W AT ER Total Improved source of drinking water * Number of household members IM PR O V ED S O U RC ES U N IM PR O V ED S O U RC ES Piped into dwelling Piped into yard/ plot Public tap/ stand-pipe Tube-well/ bore-hole Protected well Protected spring Bottled water Unprotected well Unprotected spring Tanker truck Cart with tank/ drum Surface water (river, spring, dam, lake, pool) Bottled water Other O bl as t A km ol a 30 .3 2. 0 38 .2 18 .4 9. 1 0. 2 0. 2 0. 0 0. 3 0. 4 0. 2 0. 0 0. 0 0. 7 10 0. 0 98 .4 2 92 4 A kt ob e 42 .7 3. 3 18 .1 6. 9 22 .7 0. 0 1. 3 0. 7 1. 6 0. 0 0. 7 0. 0 0. 0 2. 0 10 0. 0 95 .0 2 29 2 A lm at y 28 .1 36 .8 27 .8 2. 6 2. 1 0. 2 0. 0 0. 4 0. 4 0. 5 0. 2 0. 5 0. 0 0. 4 10 0. 0 97 .6 5 47 4 A ty ra u 39 .4 9. 1 2. 0 0. 7 37 .8 0. 3 0. 0 0. 3 0. 0 0. 5 0. 0 8. 1 0. 0 1. 8 10 0. 0 89 .3 1 51 1 W es t K az ak hs ta n 31 .8 1. 1 22 .1 0. 3 34 .5 0. 1 0. 6 4. 2 0. 1 4. 8 0. 2 0. 2 0. 0 0. 0 10 0. 0 90 .5 2 26 4 Zh am by l 30 .5 8. 0 9. 6 48 .4 2. 8 0. 3 0. 0 0. 1 0. 0 0. 0 0. 1 0. 2 0. 0 0. 0 10 0. 0 99 .6 3 19 0 Ka ra ga nd y 74 .9 0. 8 5. 5 9. 4 5. 5 0. 0 0. 0 0. 0 0. 0 3. 3 0. 2 0. 0 0. 2 0. 2 10 0. 0 96 .1 4 95 8 Ko st an ai 38 .6 0. 5 16 .1 12 .2 15 .1 0. 4 0. 2 4. 1 0. 2 2. 4 0. 1 2. 1 0. 0 8. 0 10 0. 0 83 .2 3 61 7 Ky zy lo rd a 29 .2 7. 2 33 .4 0. 2 26 .4 0. 3 0. 0 0. 5 0. 0 2. 8 0. 0 0. 0 0. 0 0. 0 10 0. 0 96 .7 1 92 1 M an gi st au 64 .1 0. 3 0. 4 0. 0 34 .8 0. 2 0. 0 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .8 1 12 7 So ut h Ka za kh st an 22 .7 34 .7 6. 3 10 .3 11 .3 0. 3 0. 1 0. 0 2. 4 3. 2 1. 9 6. 8 0. 0 0. 0 10 0. 0 85 .7 6 79 1 Pa vl od ar 60 .6 0. 7 10 .0 11 .4 13 .6 0. 0 0. 0 0. 1 0. 0 0. 0 0. 1 0. 3 0. 0 3. 2 10 0. 0 96 .3 2 75 4 N or th K az ak hs ta n 26 .9 0. 6 23 .4 9. 4 19 .6 1. 1 0. 7 1. 2 0. 5 6. 0 0. 1 1. 0 0. 0 9. 5 10 0. 0 81 .7 2 43 9 Ea st K az ak hs ta n 46 .7 16 .0 21 .8 3. 3 8. 3 0. 3 0. 0 0. 1 0. 3 0. 0 0. 0 1. 7 0. 0 1. 5 10 0. 0 96 .4 5 09 7 A st an a Ci ty 84 .3 0. 5 15 .2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 1 06 3 A lm at y Ci ty 92 .8 5. 7 1. 5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 3 83 9 * M IC S in di ca to r 1 1; M D G in di ca to r 3 0 (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 93 T ab le E N .1 : U se o f i m p ro ve d w at er s o ur ce s (c o n ti n ue d ) M A IN S O U RC E O F D RI N KI N G W AT ER Total Improved source of drinking water * Number of household members IM PR O V ED S O U RC ES U N IM PR O V ED S O U RC ES Piped into dwelling Piped into yard/ plot Public tap/ stand-pipe Tube-well/ bore-hole Protected well Protected spring Bottled water Unprotected well Unprotected spring Tanker truck Cart with tank/ drum Surface water (river, spring, dam, lake, pool) Bottled water Other Re si de nc e U rb an 71 .9 7. 7 10 .4 4. 0 3. 8 0. 1 0. 2 0. 1 0. 1 1. 0 0. 2 0. 3 0. 0 0. 2 10 0. 0 98 .1 29 1 72 Ru ra l 8. 3 17 .9 22 .4 16 .1 22 .6 0. 4 0. 0 1. 5 1. 1 2. 4 0. 6 3. 4 0. 0 3. 3 10 0. 0 87 .7 22 0 89 Ed uc at io n of h ou se ho ld h ea d Pr im ar y/ in co m pl et e se co nd ar y 30 .0 15 .8 17 .1 13 .6 14 .0 0. 3 0. 0 0. 6 0. 9 2. 5 0. 3 3. 1 0. 0 1. 8 10 0. 0 90 .9 7 87 4 Se co nd ar y 32 .6 14 .8 19 .9 10 .1 15 .0 0. 3 0. 1 0. 9 0. 8 1. 5 0. 5 1. 6 0. 0 1. 9 10 0. 0 92 .8 20 6 07 Sp ec ia liz ed s ec on da ry 55 .1 8. 8 12 .9 7. 6 10 .1 0. 2 0. 2 0. 7 0. 2 1. 5 0. 3 0. 9 0. 0 1. 5 10 0. 0 94 .9 12 2 96 H ig he r 69 .2 6. 7 8. 0 5. 8 5. 8 0. 1 0. 5 0. 1 0. 2 1. 3 0. 2 1. 2 0. 0 0. 9 10 0. 0 96 .0 9 85 7 N on e/ D K (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 10 0. 0 10 W ea lt h in de x qu in ti le s Po or es t 0. 3 22 .2 24 .9 15 .8 24 .7 0. 4 0. 0 1. 7 1. 5 2. 6 0. 9 3. 9 0. 0 1. 1 10 0. 0 88 .4 10 2 53 Po or 4. 2 21 .2 29 .4 15 .1 19 .8 0. 1 0. 0 1. 1 0. 8 2. 4 0. 4 2. 8 0. 0 2. 7 10 0. 0 89 .8 10 2 53 M id dl e 28 .3 15 .5 21 .1 12 .4 13 .1 0. 5 0. 0 0. 6 0. 3 2. 6 0. 5 1. 1 0. 1 3. 9 10 0. 0 90 .9 10 2 51 Ri ch 90 .0 1. 6 2. 5 2. 8 1. 9 0. 2 0. 2 0. 0 0. 1 0. 4 0. 0 0. 1 0. 0 0. 2 10 0. 0 99 .1 10 2 52 Ri ch es t 99 .5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 10 2 52 Et hn ic it y/ la ng ua ge Ka za kh 34 .6 14 .3 18 .6 9. 6 15 .4 0. 2 0. 1 0. 6 0. 6 2. 0 0. 5 2. 0 0. 0 1. 5 10 0. 0 92 .8 29 3 41 Ru ss ia n 64 .0 4. 5 11 .6 7. 7 7. 1 0. 3 0. 2 0. 8 0. 1 1. 2 0. 1 0. 3 0. 0 2. 1 10 0. 0 95 .3 16 3 89 O th er 38 .8 23 .0 11 .5 12 .0 7. 5 0. 1 0. 1 0. 5 1. 1 0. 8 0. 5 3. 4 0. 0 0. 7 10 0. 0 93 .1 5 53 1 To ta l 44 .5 12 .1 15 .6 9. 2 11 .9 0. 2 0. 1 0. 7 0. 5 1. 6 0. 4 1. 6 0. 0 1. 6 10 0. 0 93 .7 51 2 61 * M IC S in di ca to r 1 1; M D G in di ca to r 3 0 (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN94 T ab le E N .2 : H o us eh o ld w at er tr ea tm en t Pe rc en t d is tr ib ut io n o f h o us eh o ld p o p ul at io n a cc o rd in g to d ri n ki n g w at er tr ea tm en t m et h o d u se d in th e h o us eh o ld , a n d p er ce n ta ge o f h o us eh o ld p o p ul at io n th at a p p lie d a n a p p ro p ri at e w at er tr ea tm en t m et h o d , K az ak h st an , 2 00 6 W at er tr ea tm en t m et ho d us ed in th e ho us eh ol d A ll dr in ki ng w at er so ur ce s Im pr ov ed d rin ki ng w at er s ou rc es U ni m pr ov ed d rin k- in g w at er s ou rc es None Boil Add bleach/ chlorine Strain through a cloth Use water filter Solar dis-infec- tion Let it stand and settle Other Don’t know Appropriate water treat- ment method* Number of household members Appropriate water treat- ment method Number of household members Appropriate water treat- ment method Number of household members O bl as t A km ol a 28 .7 66 .5 0. 2 0. 6 3. 6 0. 3 12 .6 0. 0 0. 1 69 .0 2 92 4 68 .8 2 87 6 (* ) 48 A kt ob e 18 .3 65 .5 0. 0 0. 1 1. 3 0. 0 42 .9 0. 1 0. 0 66 .3 2 29 2 67 .4 2 17 7 (4 6. 3) 11 5 A lm at y 43 .6 54 .2 0. 0 0. 3 0. 3 0. 1 10 .3 0. 0 0. 2 54 .3 5 47 4 53 .7 5 34 4 (* ) 13 0 A ty ra u 2. 7 92 .9 0. 0 0. 1 0. 2 0. 0 83 .8 0. 3 0. 0 93 .1 1 51 1 92 .3 1 34 9 10 0. 0 16 2 W es t K az ak hs ta n 19 .7 67 .2 1. 1 0. 0 2. 9 0. 0 47 .0 0. 0 0. 0 68 .7 2 26 4 67 .1 2 04 8 83 .8 21 5 Zh am by l 73 .9 24 .6 0. 0 0. 2 0. 3 0. 0 5. 9 0. 1 0. 0 24 .9 3 19 0 24 .9 3 17 7 (* ) 13 Ka ra ga nd y 16 .6 75 .7 0. 1 0. 4 5. 9 0. 0 24 .4 3. 3 0. 1 78 .7 4 95 8 79 .2 4 76 5 (6 6. 2) 19 3 Ko st an ai 22 .0 66 .5 0. 5 0. 3 4. 6 0. 0 26 .7 0. 2 0. 2 70 .5 3 61 7 70 .7 3 00 9 69 .3 60 9 Ky zy lo rd a 25 .3 65 .1 0. 0 0. 0 0. 5 0. 9 30 .3 0. 0 0. 0 65 .6 1 92 1 66 .0 1 85 9 (5 5. 0) 63 M an gi st au 0. 7 98 .5 0. 3 11 .7 26 .4 0. 2 69 .3 0. 3 0. 0 98 .5 1 12 7 98 .5 1 12 4 (* ) 3 So ut h Ka za kh st an 3. 7 93 .1 0. 0 0. 0 0. 4 0. 0 10 .8 0. 0 0. 0 93 .4 6 79 0 92 .9 5 82 1 96 .0 96 9 Pa vl od ar 23 .5 68 .1 0. 0 0. 0 4. 3 0. 3 32 .1 0. 1 0. 1 71 .3 2 75 4 71 .4 2 65 2 (6 6. 8) 10 2 N or th K az ak hs ta n 20 .5 67 .7 0. 7 0. 1 6. 9 0. 0 15 .2 0. 5 0. 0 73 .3 2 43 9 72 .5 1 99 2 76 .9 44 7 Ea st K az ak hs ta n 36 .9 50 .6 0. 2 0. 0 2. 5 0. 0 13 .3 0. 1 0. 0 53 .2 5 09 7 52 .2 4 91 3 (8 0. 8) 18 4 A st an a Ci ty 11 .4 58 .7 0. 0 0. 0 17 .9 0. 2 46 .0 10 .7 0. 4 68 .6 1 06 3 68 .6 1 06 3 na 0 A lm at y Ci ty 3. 8 95 .7 0. 0 0. 0 12 .8 0. 9 39 .3 1. 9 0. 0 95 .9 3 83 9 95 .9 3 83 9 na 0 * M IC S in di ca to r 1 3 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns na : n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 95 T ab le E N .2 : H o us eh o ld w at er tr ea tm en t ( co n ti n ue d ) W at er tr ea tm en t m et ho d us ed in th e ho us eh ol d A ll dr in ki ng w at er so ur ce s Im pr ov ed d rin ki ng w at er s ou rc es U ni m pr ov ed d rin k- in g w at er s ou rc es None Boil Add bleach/ chlorine Strain through a cloth Use water filter Solar dis-infec- tion Let it stand and settle Other Don’t know Appropriate water treat- ment method* Number of household members Appropriate water treat- ment method Number of household members Appropriate water treat- ment method Number of household members Re si de nc e U rb an 19 .5 71 .0 0. 1 0. 6 7. 1 0. 2 28 .6 1. 4 0. 0 74 .0 29 1 72 73 .9 28 6 32 82 .1 54 0 Ru ra l 29 .3 66 .3 0. 3 0. 2 0. 2 0. 1 19 .4 0. 0 0. 1 66 .6 22 0 89 64 .6 19 3 76 80 .4 2 71 3 Ed uc at io n of h ou se ho ld h ea d Pr im ar y/ in co m pl et e se co nd ar y 27 .4 66 .0 0. 3 0. 3 0. 9 0. 0 21 .2 0. 3 0. 1 66 .8 7 87 4 65 .1 7 15 4 84 .5 71 9 Se co nd ar y 25 .7 68 .2 0. 1 0. 2 1. 8 0. 1 22 .9 0. 4 0. 0 69 .1 20 6 07 68 .5 19 1 22 78 .0 1 48 5 Sp ec ia liz ed s ec on da ry 22 .1 69 .7 0. 1 0. 7 5. 4 0. 3 28 .2 0. 8 0. 1 72 .3 12 2 96 71 .9 11 6 73 79 .7 62 3 H ig he r 17 .5 73 .1 0. 2 0. 7 10 .4 0. 2 27 .3 1. 9 0. 1 76 .9 9 85 7 76 .5 9 46 6 84 .6 39 1 N on e/ D K (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 (* ) 10 (* ) 0 W ea lt h in de x qu in ti le s Po or es t 27 .1 69 .4 0. 3 0. 2 0. 0 0. 1 17 .9 0. 0 0. 1 69 .6 10 2 53 67 .7 9 06 6 84 .0 1 18 7 Po or 28 .6 66 .0 0. 0 0. 2 0. 2 0. 1 21 .2 0. 1 0. 1 66 .1 10 2 53 64 .5 9 21 0 80 .5 1 04 3 M id dl e 30 .0 62 .8 0. 3 0. 0 0. 7 0. 1 22 .5 0. 2 0. 0 63 .5 10 2 51 62 .0 9 32 2 78 .2 92 9 Ri ch 19 .7 72 .2 0. 1 0. 1 5. 8 0. 2 26 .4 1. 4 0. 0 74 .6 10 2 52 74 .7 10 1 63 (* ) 89 Ri ch es t 13 .2 74 .6 0. 0 1. 5 13 .9 0. 2 35 .2 2. 3 0. 1 80 .3 10 2 52 80 .3 10 2 47 (* ) 5 Et hn ic it y/ la ng ua ge Ka za kh 22 .6 71 .4 0. 2 0. 5 3. 0 0. 2 25 .7 0. 5 0. 0 72 .4 29 3 40 71 .4 27 2 35 84 .9 2 10 5 Ru ss ia n 25 .6 64 .5 0. 1 0. 2 6. 4 0. 2 24 .5 1. 3 0. 1 68 .0 16 3 89 68 .1 15 6 24 66 .1 76 5 O th er 23 .8 69 .7 0. 0 0. 7 3. 2 0. 0 19 .4 0. 5 0. 1 70 .9 5 53 1 69 .7 5 14 9 86 .5 38 3 To ta l 23 .7 69 .0 0. 2 0. 4 4. 1 0. 2 24 .7 0. 8 0. 1 70 .8 51 2 61 70 .2 48 0 08 80 .7 3 25 3 * M IC S in di ca to r 1 3 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns na : n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN96 Table EN.3: Time to source of water Percent distribution of households according to time to go to source of drinking water, get water and return, and mean time to source of drinking water, Kazakhstan, 2006 TIME TO SOURCE OF DRINKING WATER M ea n tim e to so ur ce o f d rin k- in g w at er * N um be r o f ho us eh ol ds Water on premises Less than 15 minutes 15 min- utes to less than 30 minutes 30 min- utes to less than 1 hour 1 hour or more Don’t know Total Oblast Akmola 51.5 22.9 14.4 7.5 3.1 0.6 100.0 18.0 879 Aktobe 68.4 13.2 12.0 5.5 0.9 0.0 100.0 17.7 629 Almaty 70.4 13.4 9.2 5.8 0.9 0.3 100.0 18.1 1 352 Atyrau 66.6 15.3 15.1 2.9 0.1 0.0 100.0 14.7 334 West Kazakhstan 55.1 12.8 18.2 11.1 2.7 0.1 100.0 22.2 600 Zhambyl 83.0 7.7 5.9 2.6 0.5 0.3 100.0 16.7 834 Karagandy 91.1 3.4 3.8 1.2 0.5 0.0 100.0 19.5 1 614 Kostanai 65.7 10.5 10.0 8.5 4.4 0.9 100.0 25.8 1 170 Kyzylorda 58.3 11.8 14.9 10.1 4.9 0.0 100.0 25.6 409 Mangistau 99.4 0.5 0.1 0.0 0.0 0.0 100.0 10.6 273 South Kazakhstan 66.7 15.9 15.0 2.1 0.3 0.0 100.0 14.2 1 415 Pavlodar 76.6 10.7 8.0 4.4 0.3 0.0 100.0 16.5 911 North Kazakhstan 43.7 22.3 14.9 13.0 5.7 0.4 100.0 22.0 805 East Kazakhstan 74.8 12.4 8.0 4.0 0.7 0.1 100.0 16.9 1 652 Astana City 87.5 8.1 4.1 0.3 0.0 0.0 100.0 12.1 334 Almaty City 98.7 1.1 0.0 0.2 0.0 0.0 100.0 15.4 1 353 Residence Urban 87.4 5.7 4.3 2.0 0.5 0.1 100.0 17.9 9 339 Rural 48.5 21.1 17.5 9.5 3.0 0.4 100.0 19.5 5 225 Education of household head Primary/incomplete secondary 65.4 14.8 11.5 6.3 1.6 0.4 100.0 18.7 2 407 Secondary 65.1 14.3 12.3 6.1 2.0 0.2 100.0 19.3 5 224 Specialized secondary 79.6 8.4 6.8 3.9 1.2 0.1 100.0 19.7 3 744 Higher 87.0 6.4 4.2 1.8 0.6 0.0 100.0 17.4 3 048 None/DK (*) (*) (*) (*) (*) (*) 100.0 (*) 2 Wealth index quintiles Poorest 40.0 22.3 23.2 11.0 3.3 0.2 100.0 19.7 2 208 Poor 45.1 24.7 17.6 9.4 2.8 0.4 100.0 18.7 2 554 Middle 63.3 16.9 11.4 6.1 2.0 0.3 100.0 18.4 2 751 Rich 96.4 1.2 1.3 0.7 0.3 0.1 100.0 21.4 3 560 Richest 100.0 0.0 0.0 0.0 0.0 0.0 100.0 na 3 491 Ethnicity/language Kazakh 66.6 13.6 12.0 5.9 1.8 0.1 100.0 19.2 7 145 Russian 80.9 8.6 5.7 3.4 1.1 0.3 100.0 18.9 6 007 Other 75.7 10.4 8.6 4.0 1.0 0.3 100.0 18.0 1 412 Total 73.4 11.2 9.1 4.7 1.4 0.2 100.0 19.0 14 564 * The mean time to source of drinking water is calculated based on those households that do not have water on the premises (*) – indicators are based on less than 25 cases of unweighted observations na: not applicable KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 97 Table EN.4: Person collecting water Percent distribution of households according to the person collecting drinking water used in the household, Kazakhstan, 2006 PERSON COLLECTING DRINKING WATER Total Number of householdsAdult woman Adult man Female child under age 15 Male child under age 15 Don’t know Oblast Akmola 25.1 69.2 1.6 4.1 0.0 100.0 425 Aktobe 17.0 77.7 0.6 4.7 0.0 100.0 195 Almaty 32.0 65.2 0.6 2.2 0.0 100.0 400 Atyrau 33.3 57.4 0.7 8.6 0.0 100.0 112 West Kazakhstan 26.8 67.6 0.7 4.9 0.0 100.0 267 Zhambyl 33.6 56.6 2.2 7.6 0.0 100.0 142 Karagandy 19.2 78.6 0.0 2.2 0.0 100.0 144 Kostanai 22.7 74.7 0.3 2.3 0.0 100.0 401 Kyzylorda 35.6 51.5 4.1 8.8 0.0 100.0 171 Mangistau (*) (*) (*) (*) (*) 100.0 2 South Kazakhstan 50.2 39.0 4.2 6.6 0.0 100.0 471 Pavlodar 33.9 61.3 0.0 4.4 0.4 100.0 213 North Kazakhstan 24.8 72.7 0.2 2.3 0.0 100.0 449 East Kazakhstan 25.9 69.3 0.0 4.8 0.0 100.0 416 Astana City (20.2) (76.6) (0.0) (3.2) (0.0) 100.0 42 Almaty City (*) (*) (*) (*) (*) 100.0 18 Residence Urban 29.1 66.4 0.6 3.9 0.0 100.0 1 176 Rural 30.2 63.8 1.4 4.6 0.0 100.0 2 692 Education of household head Primary/incomplete secondary 34.6 62.1 0.6 2.6 0.1 100.0 834 Secondary 28.1 65.3 1.5 5.1 0.0 100.0 1 821 Specialized secondary 31.1 63.8 0.7 4.4 0.0 100.0 764 Higher 25.0 68.3 1.8 4.9 0.0 100.0 394 Wealth index quintiles Poorest 34.0 58.7 1.5 5.8 0.0 100.0 1 326 Poor 31.1 63.6 1.4 3.9 0.0 100.0 1 402 Middle 24.2 71.9 0.6 3.3 0.0 100.0 1 010 Rich 18.3 78.9 0.0 2.8 0.0 100.0 129 Richest (*) (*) (*) (*) (*) 100.0 1 Ethnicity/language Kazakh 27.2 65.6 1.6 5.6 0.0 100.0 2 382 Russian 31.2 66.4 0.2 2.1 0.1 100.0 1 143 Other 43.8 51.7 1.3 3.2 0.0 100.0 343 Total 29.9 64.6 1.1 4.4 0.0 100.0 3 868 ( ) – indicators are based on 25-49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations MONITORING THE SITUATION OF CHILDREN AND WOMEN98 T ab le E N .5 : U se o f s an it ar y m ea n s o f e xc re ta d is p o sa l Pe rc en t d is tr ib ut io n o f h o us eh o ld m em b er s ac co rd in g to ty p e o f t o ile t f ac ili ty u se d b y th e h o us eh o ld , a n d th e p er ce n ta ge o f h o us eh o ld m em b er s us in g sa n it ar y m ea n s o f e xc re ta d is p o sa l, K az ak h st an , 2 00 6 TY PE O F TO IL ET F A CI LI TY U SE D B Y H O U SE H O LD Total Percentage of popula- tion using sanitary means of excreta disposal* Number of household members IM PR O V ED S A N IT AT IO N F A CI LI TY U N IM PR O V ED S A N IT AT IO N F A CI LI TY Fl us h/ po ur fl us h to : Ventilated improved pit latrine Pit latrine with slab Compos- ting toilet Pit latrine without slab/ open pit Bucket Hanging toi- let/ hanging latrine No facilities/ bush/field Other Pi pe d se w er sy st em Se pt ic ta nk Pi t la tr in e O bl as t A km ol a 23 .0 3. 4 0. 0 1. 0 71 .5 0. 0 0. 1 0. 2 0. 0 0. 1 0. 7 10 0. 0 98 .9 2 92 4 A kt ob e 39 .7 0. 0 1. 6 0. 0 52 .2 0. 0 0. 4 0. 0 6. 1 0. 0 0. 0 10 0. 0 93 .6 2 29 2 A lm at y 10 .5 0. 7 0. 1 0. 2 87 .7 0. 2 0. 2 0. 0 0. 4 0. 0 0. 0 10 0. 0 99 .4 5 47 4 A ty ra u 32 .9 0. 0 0. 0 0. 0 67 .1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 1 51 1 W es t K az ak hs ta n 29 .1 0. 7 0. 0 0. 0 69 .6 0. 3 0. 3 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .8 2 26 4 Zh am by l 23 .5 0. 0 0. 0 0. 0 75 .3 0. 0 1. 1 0. 0 0. 1 0. 0 0. 0 10 0. 0 98 .8 3 19 0 Ka ra ga nd y 64 .0 5. 1 0. 3 0. 0 29 .8 0. 1 0. 0 0. 1 0. 1 0. 2 0. 3 10 0. 0 99 .3 4 95 8 Ko st an ai 35 .3 6. 5 0. 0 0. 0 58 .2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 3 61 7 Ky zy lo rd a 21 .3 0. 0 0. 0 0. 0 78 .6 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 1 92 1 M an gi st au 64 .1 0. 0 0. 0 0. 0 35 .8 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .9 1 12 7 So ut h Ka za kh st an 12 .8 0. 3 4. 0 0. 1 82 .7 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .9 6 79 1 Pa vl od ar 60 .2 0. 4 0. 7 0. 0 38 .3 0. 4 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 2 75 4 N or th K az ak hs ta n 26 .3 4. 5 0. 2 0. 2 68 .0 0. 0 0. 1 0. 6 0. 0 0. 1 0. 0 10 0. 0 99 .2 2 43 9 Ea st K az ak hs ta n 28 .0 0. 2 1. 1 0. 1 70 .6 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 5 09 7 A st an a Ci ty 82 .6 0. 0 0. 0 0. 2 17 .2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 1 06 3 A lm at y Ci ty 79 .4 0. 0 0. 5 2. 1 16 .2 0. 1 0. 1 0. 0 1. 6 0. 0 0. 0 10 0. 0 98 .3 3 83 9 *M IC S in di ca to r 1 2; M D G in di ca to r 3 1 (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 99 T ab le E N .5 : U se o f s an it ar y m ea n s o f e xc re ta d is p o sa l ( co n ti n ue d ) TY PE O F TO IL ET F A CI LI TY U SE D B Y H O U SE H O LD Total Percentage of popula- tion using sanitary means of excreta disposal* Number of household members IM PR O V ED S A N IT AT IO N F A CI LI TY U N IM PR O V ED S A N IT AT IO N F A CI LI TY Fl us h/ po ur fl us h to : Ventilated improved pit latrine Pit latrine with slab Compos- ting toilet Pit latrine without slab/ open pit Bucket Hanging toi- let/ hanging latrine No facilities/ bush/field Other Pi pe d se w er sy st em Se pt ic ta nk Pi t la tr in e Re si de nc e U rb an 60 .7 1. 6 1. 3 0. 4 35 .5 0. 0 0. 0 0. 1 0. 4 0. 0 0. 0 10 0. 0 99 .5 29 1 72 Ru ra l 2. 1 1. 5 0. 2 0. 1 94 .8 0. 1 0. 3 0. 1 0. 5 0. 1 0. 2 10 0. 0 98 .9 22 0 89 Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 20 .1 1. 0 1. 1 0. 3 76 .8 0. 1 0. 1 0. 2 0. 2 0. 0 0. 1 10 0. 0 99 .3 7 87 4 Se co nd ar y 24 .1 1. 6 0. 8 0. 2 72 .4 0. 0 0. 1 0. 0 0. 6 0. 1 0. 1 10 0. 0 99 .1 20 6 07 Sp ec ia liz ed s ec on da ry 45 .5 1. 7 0. 7 0. 2 51 .1 0. 1 0. 2 0. 1 0. 4 0. 0 0. 0 10 0. 0 99 .3 12 2 96 H ig he r 60 .4 1. 8 1. 0 0. 5 35 .7 0. 1 0. 3 0. 0 0. 2 0. 0 0. 0 10 0. 0 99 .5 9 85 7 N on e/ D K (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 W ea lt h in de x qu in ti le s Po or es t 0. 0 0. 0 0. 1 0. 0 99 .1 0. 1 0. 0 0. 0 0. 6 0. 1 0. 0 10 0. 0 99 .2 10 2 53 Po or 0. 2 0. 1 0. 4 0. 0 98 .1 0. 1 0. 4 0. 2 0. 4 0. 0 0. 1 10 0. 0 98 .9 10 2 53 M id dl e 4. 0 2. 8 1. 7 0. 7 89 .8 0. 1 0. 2 0. 1 0. 5 0. 0 0. 1 10 0. 0 99 .1 10 2 51 Ri ch 73 .2 4. 6 2. 0 0. 7 18 .4 0. 1 0. 1 0. 0 0. 8 0. 0 0. 1 10 0. 0 99 .0 10 2 52 Ri ch es t 99 .8 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 10 2 52 Et hn ic it y/ la ng ua ge Ka za kh 28 .1 0. 6 0. 3 0. 2 69 .9 0. 1 0. 2 0. 0 0. 5 0. 0 0. 1 10 0. 0 99 .2 29 3 41 Ru ss ia n 52 .1 3. 4 1. 4 0. 4 42 .0 0. 1 0. 0 0. 1 0. 4 0. 0 0. 1 10 0. 0 99 .3 16 3 89 O th er 25 .0 1. 0 1. 8 0. 3 70 .9 0. 2 0. 2 0. 1 0. 4 0. 0 0. 1 10 0. 0 99 .2 5 53 1 To ta l 35 .4 1. 5 0. 8 0. 3 61 .1 0. 1 0. 1 0. 1 0. 5 0. 0 0. 1 10 0. 0 99 .2 51 2 61 *M IC S in di ca to r 1 2; M D G in di ca to r 3 1 (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN100 T ab le E N .5 W : N um b er o f h o us eh o ld s us in g im p ro ve d s an it at io n fa ci lit ie s (w o rk sh ee t) Pe rc en t d is tr ib ut io n o f h o us eh o ld s us in g im p ro ve d s an it ar y m ea n s (p ilo t a re a) a cc o rd in g to th e n um be r o f h o us eh o ld s us in g m ea n s (o bj ec t) , K az ak h st an , 2 00 6 N U M BE R O F H O U SE H O LD S U SI N G IM PR O V ED S A N IT A RY M EA N S TO TA L N um be r o f ho us eh ol d m em be rs O ne Tw o Th re e Fo ur Fi ve Si x Se ve n Ei gh t N in e 10 O r M or e D oe s no t Kn ow Ty pe o f t oi le t La va to ry p an /s ew er ag e 98 .2 0. 4 0. 3 0. 3 0. 1 0. 1 0. 1 0. 2 0. 0 0. 3 0. 0 10 0. 0 18 1 63 Se pt ic ta nk 98 .3 0. 7 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1. 0 10 0. 0 79 5 Pi t l at rin e 95 .7 0. 0 0. 0 0. 5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 6 3. 2 10 0. 0 42 4 Ve nt ila te d im pr ov ed p it la tr in e 88 .5 3. 6 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1. 0 6. 9 10 0. 0 14 2 Pi t l at rin e w ith s la b 97 .9 1. 1 0. 2 0. 1 0. 1 0. 1 0. 0 0. 2 0. 0 0. 2 0. 1 10 0. 0 31 3 13 Co m po s- tin g to ile t (7 9. 6) (1 4. 3) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (6 .1 ) 10 0. 0 41 O bl as t A km ol a 98 .1 0. 7 0. 2 0. 2 0. 0 0. 0 0. 0 0. 2 0. 0 0. 4 0. 2 10 0. 0 2 89 2 A kt ob e 99 .7 0. 0 0. 0 0. 1 0. 0 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 2 14 5 A lm at y 99 .4 0. 2 0. 2 0. 0 0. 1 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 10 0. 0 5 44 0 A ty ra u 98 .2 0. 6 0. 2 0. 4 0. 0 0. 3 0. 0 0. 2 0. 0 0. 0 0. 1 10 0. 0 1 51 1 W es t K az ak hs ta n 95 .7 2. 2 0. 3 0. 5 0. 1 0. 0 0. 0 0. 6 0. 0 0. 5 0. 1 10 0. 0 2 25 8 Zh am by l 98 .0 0. 7 0. 3 0. 0 0. 0 0. 1 0. 0 0. 1 0. 0 0. 7 0. 1 10 0. 0 3 15 1 Ka ra ga nd y 99 .7 0. 1 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 10 0. 0 4 92 3 Ko st an ai 99 .5 0. 2 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 2 10 0. 0 3 61 7 Ky zy lo rd a 96 .6 0. 7 0. 4 1. 1 0. 4 0. 0 0. 0 0. 7 0. 0 0. 1 0. 0 10 0. 0 1 92 1 M an gi st au 97 .0 2. 6 0. 2 0. 1 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 1 12 6 So ut h Ka za kh st an 97 .9 1. 2 0. 2 0. 1 0. 0 0. 0 0. 0 0. 1 0. 0 0. 4 0. 1 10 0. 0 6 78 6 Pa vl od ar 97 .5 0. 4 0. 6 0. 1 0. 1 0. 1 0. 0 0. 5 0. 0 0. 4 0. 3 10 0. 0 2 75 4 N or th K az ak hs ta n 95 .3 1. 3 1. 0 0. 4 0. 2 0. 9 0. 2 0. 1 0. 2 0. 3 0. 1 10 0. 0 2 42 0 Ea st K az ak hs ta n 96 .8 2. 5 0. 2 0. 2 0. 1 0. 0 0. 0 0. 2 0. 0 0. 0 0. 0 10 0. 0 5 09 7 A st an a Ci ty 93 .0 0. 3 0. 6 1. 7 1. 0 0. 3 0. 4 1. 3 0. 1 1. 3 0. 0 10 0. 0 1 06 3 A lm at y Ci ty 98 .5 0. 6 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 4 0. 4 10 0. 0 3 77 3 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 101 T ab le E N .5 w : N um b er o f h o us eh o ld s us in g im p ro ve d s an it at io n fa ci lit ie s (w o rk sh ee t) ( co n ti n ue d ) N U M BE R O F H O U SE H O LD S U SI N G IM PR O V ED S A N IT A RY M EA N S TO TA L N um be r o f ho us eh ol d m em be rs O ne Tw o Th re e Fo ur Fi ve Si x Se ve n Ei gh t N in e 10 O r M or e D oe s no t Kn ow Re si de nc e U rb an 97 .3 1. 1 0. 3 0. 3 0. 1 0. 1 0. 1 0. 2 0. 0 0. 4 0. 1 10 0. 0 29 0 26 Ru ra l 98 .9 0. 6 0. 2 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 1 0. 1 10 0. 0 21 8 51 Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 98 .2 0. 9 0. 2 0. 1 0. 1 0. 0 0. 0 0. 1 0. 0 0. 2 0. 2 10 0. 0 7 81 9 Se co nd ar y 97 .8 1. 1 0. 2 0. 2 0. 1 0. 1 0. 0 0. 2 0. 0 0. 2 0. 1 10 0. 0 20 4 17 Sp ec ia liz ed s ec on da ry 97 .5 0. 8 0. 3 0. 3 0. 1 0. 2 0. 1 0. 2 0. 1 0. 4 0. 0 10 0. 0 12 2 09 H ig he r 98 .7 0. 5 0. 2 0. 1 0. 0 0. 0 0. 0 0. 1 0. 0 0. 2 0. 2 10 0. 0 9 80 7 N on e/ D K (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 W ea lt h in de x qu in ti le s Po or es t 98 .0 1. 1 0. 2 0. 0 0. 1 0. 1 0. 0 0. 2 0. 0 0. 2 0. 1 10 0. 0 10 1 75 Po or 97 .3 1. 6 0. 2 0. 3 0. 0 0. 0 0. 0 0. 3 0. 0 0. 2 0. 1 10 0. 0 10 1 40 M id dl e 97 .6 1. 0 0. 2 0. 2 0. 1 0. 1 0. 0 0. 1 0. 1 0. 5 0. 1 10 0. 0 10 1 61 Ri ch 97 .5 0. 6 0. 5 0. 4 0. 1 0. 2 0. 0 0. 3 0. 0 0. 3 0. 1 10 0. 0 10 1 49 Ri ch es t 99 .5 0. 1 0. 1 0. 1 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 1 10 0. 0 10 2 52 Et hn ic it y/ la ng ua ge Ka za kh 97 .5 1. 2 0. 3 0. 2 0. 1 0. 1 0. 0 0. 2 0. 0 0. 3 0. 1 10 0. 0 29 1 06 Ru ss ia n 98 .3 0. 6 0. 2 0. 1 0. 0 0. 2 0. 0 0. 2 0. 1 0. 1 0. 2 10 0. 0 16 2 82 O th er 99 .4 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 3 0. 1 10 0. 0 5 48 9 To ta l 98 .0 0. 9 0. 2 0. 2 0. 1 0. 1 0. 0 0. 2 0. 0 0. 2 0. 1 10 0. 0 50 8 77 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN102 Table EN.6: Disposal of child’s faeces Percent distribution of children aged 0-2 years according to place of disposal of child’s faeces, and the percentage of children aged 0-2 years whose stools are disposed of safely, Kazakhstan, 2006 PLACE OF DISPOSAL OF CHILD’S FAECES Pr op or tio n of ch ild re n w ho se la te st st oo ls w er e di sp os ed o f s af el y* N um be r o f c hi l- dr en a ge d 0– 2 ye ar s Ch ild u se d to ile t Pu t/ rin se d in to to ile t o r l at rin e Pu t/ rin se d in to dr ai n or d itc h Th ro w n in to ga rb ag e Bu rie d Le ft in th e op en O th er D K To ta l Oblast Akmola 9.5 24.7 33.7 16.0 0.8 0.0 12.0 3.3 100.0 34.2 134 Aktobe 4.7 31.0 29.3 32.0 0.6 0.0 1.5 0.9 100.0 35.7 110 Almaty 0.3 5.8 16.7 70.7 1.0 0.0 1.5 4.0 100.0 6.1 373 Atyrau 0.0 20.7 8.1 68.0 0.7 0.4 1.3 0.8 100.0 20.7 85 West Kazakhstan 13.8 12.2 38.6 31.8 0.0 0.0 2.9 0.7 100.0 26.0 95 Zhambyl 1.7 30.1 42.0 12.5 2.5 0.0 4.9 6.3 100.0 31.8 225 Karagandy 4.6 50.1 24.3 21.0 0.0 0.0 0.0 0.0 100.0 54.6 196 Kostanai 1.0 28.8 26.0 39.8 1.7 0.0 2.7 0.0 100.0 29.8 160 Kyzylorda 0.0 19.1 70.2 9.2 0.0 0.0 0.0 1.5 100.0 19.1 130 Mangistau 12.8 25.3 0.0 61.9 0.0 0.0 0.0 0.0 100.0 38.1 70 South Kazakhstan 2.8 8.4 82.6 1.2 0.0 0.0 4.0 1.0 100.0 11.2 524 Pavlodar 1.0 61.0 27.4 7.8 0.0 0.0 2.1 0.7 100.0 61.9 131 North Kazakhstan 0.0 28.9 34.6 27.3 0.0 0.0 8.3 0.9 100.0 28.8 95 East Kazakhstan 6.2 25.1 39.6 26.3 0.0 0.0 0.0 2.8 100.0 31.4 191 Astana City 5.0 72.7 0.0 19.8 0.0 0.0 1.7 0.8 100.0 77.7 59 Almaty City 0.7 82.6 13.8 2.2 0.0 0.0 0.0 0.7 100.0 83.3 212 Residence Urban 4.4 49.9 23.3 17.5 0.2 0.0 3.2 1.5 100.0 54.3 1 394 Rural 1.9 6.7 53.0 33.1 0.8 0.0 2.2 2.3 100.0 8.7 1 396 Mother’s education Primary/incomplete secondary 3.1 16.1 47.4 29.6 0.0 0.0 3.2 0.6 100.0 19.2 195 Secondary 2.7 18.8 46.4 26.8 0.8 0.0 2.6 1.9 100.0 21.5 1 245 Specialized secondary 3.2 34.8 30.1 25.9 0.5 0.1 3.2 2.2 100.0 38.0 658 Higher 3.9 42.6 28.4 20.7 0.2 0.0 2.3 1.9 100.0 46.6 692 Wealth index quintiles Poorest 2.3 2.9 65.0 26.1 1.1 0.0 1.0 1.6 100.0 5.2 759 Poor 2.0 6.4 47.7 37.7 0.9 0.0 2.6 2.7 100.0 8.4 579 Middle 3.4 12.5 43.1 34.9 0.2 0.1 4.2 1.6 100.0 15.9 551 Rich 4.3 61.4 12.3 14.1 0.0 0.0 5.6 2.3 100.0 65.7 438 Richest 4.7 84.7 0.8 7.6 0.0 0.0 1.1 1.1 100.0 89.4 463 Ethnicity/language Kazakh 2.9 24.2 41.1 27.8 0.5 0.0 1.8 1.7 100.0 27.1 1 873 Russian 3.5 46.0 21.2 21.0 0.2 0.0 5.9 2.2 100.0 49.5 557 Other 3.6 22.4 49.1 19.2 1.0 0.0 2.5 2.2 100.0 26.0 360 Total 3.1 28.3 38.2 25.3 0.5 0.0 2.7 1.9 100.0 31.4 2 790 * MICS indicator 14 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 103 Table EN.7: Use of improved water sources and improved sanitation Percentage of household population using both improved drinking water sources and sanitary means of excreta disposal, Kazakhstan, 2006 Percentage of household population: Number of house- hold members Using improved sources of drinking water * Using sanitary means of excreta disposal ** Using improved sources of drinking water and using sanitary means of excreta disposal Oblast Akmola 98.4 98.9 97.3 2 924 Aktobe 95.0 93.6 89.4 2 292 Almaty 97.6 99.4 97.0 5 474 Atyrau 89.3 100.0 89.3 1 511 West Kazakhstan 90.5 99.8 90.2 2 264 Zhambyl 99.6 98.8 98.3 3 190 Karagandy 96.1 99.3 95.6 4 958 Kostanai 83.2 100.0 83.2 3 617 Kyzylorda 96.7 100.0 96.7 1 922 Mangistau 99.8 99.9 99.7 1 127 South Kazakhstan 85.7 99.9 85.7 6 790 Pavlodar 96.3 100.0 96.3 2 754 North Kazakhstan 81.7 99.2 81.1 2 439 East Kazakhstan 96.4 100.0 96.4 5 097 Astana City 100.0 100.0 100.0 1 063 Almaty City 100.0 98.3 98.3 3 839 Residence Urban 98.1 99.5 97.7 29 172 Rural 87.7 98.9 86.8 22 089 Education of household head Primary/incomplete secondary 90.9 99.3 90.2 7 874 Secondary 92.8 99.1 92.0 20 607 Specialized secondary 94.9 99.3 94.3 12 296 Higher 96.0 99.5 95.5 9 857 None/DK (*) (*) (*) 10 Wealth index quintiles Poorest 88.4 99.2 87.8 10 253 Poor 89.8 98.9 88.8 10 253 Middle 90.9 99.1 90.2 10 251 Rich 99.1 99.0 98.2 10 252 Richest 100.0 100.0 100.0 10 252 Ethnicity/language Kazakh 92.8 99.2 92.1 29 340 Russian 95.3 99.3 94.7 16 389 Other 93.1 99.2 92.4 5 532 Total 93.7 99.2 93.0 51 261 * MICS indicator 11; MDG indicator 30 ** MICS indicator 12; MDC indicator 31 (*) – indicators are based on less than 25 cases of unweighted observations MONITORING THE SITUATION OF CHILDREN AND WOMEN104 T ab le R H .1 : U se o f c o n tr ac ep ti o n Pe rc en ta ge o f m ar ri ed o r in u n io n w o m en a ge d 1 5- 49 w h o a re u si n g (o r w h o se p ar tn er is u si n g) a c o n tr ac ep ti ve m et h o d , K az ak h st an , 2 00 6 Not using any method PE RC EN T O F W O M EN ( CU RR EN TL Y M A RR IE D O R IN U N IO N ) W H O A RE U SI N G : TOTAL Any modern method Any tradi-tional method Any method* Number of women currently married or in union Female steri- lization Male sterili- zation Pills IUD Injections Implants Condom Female con- dom Diaphragm/ foam/ jelly LAM Periodic abstinence With-drawal Other O bl as t A km ol a 39 .4 1. 5 0. 3 7. 2 41 .1 0. 0 0. 0 7. 3 0. 2 0. 0 0. 0 0. 9 0. 9 1. 2 10 0. 0 57 .6 2. 9 60 .6 52 9 A kt ob e 52 .1 0. 6 0. 0 3. 5 38 .0 2. 2 0. 0 1. 3 0. 0 0. 2 0. 7 0. 8 0. 3 0. 3 10 0. 0 45 .8 2. 1 47 .9 34 8 A lm at y 59 .8 0. 1 0. 0 6. 8 26 .9 0. 0 0. 0 2. 2 0. 0 0. 2 2. 6 0. 8 0. 5 0. 1 10 0. 0 36 .1 4. 1 40 .2 87 5 A ty ra u 47 .6 0. 0 0. 0 2. 8 47 .4 0. 5 0. 0 1. 1 0. 0 0. 0 0. 4 0. 0 0. 0 0. 2 10 0. 0 51 .7 0. 7 52 .4 23 6 W es t K az ak hs ta n 37 .7 0. 4 0. 0 7. 6 49 .2 0. 0 0. 0 2. 1 0. 0 0. 0 1. 5 0. 0 1. 0 0. 5 10 0. 0 59 .2 3. 0 62 .3 38 8 Zh am by l 57 .2 0. 0 0. 0 1. 8 39 .2 0. 2 0. 0 1. 2 0. 0 0. 0 0. 0 0. 2 0. 2 0. 0 10 0. 0 42 .4 0. 4 42 .8 51 0 Ka ra ga nd y 45 .0 1. 0 0. 0 5. 8 37 .2 0. 5 0. 2 7. 5 0. 0 0. 0 1. 1 0. 8 0. 3 0. 6 10 0. 0 52 .2 2. 9 55 .0 79 9 Ko st an ai 39 .6 1. 0 0. 0 9. 6 39 .9 0. 2 0. 0 5. 6 0. 0 0. 3 0. 7 0. 7 0. 7 1. 7 10 0. 0 56 .6 3. 8 60 .4 58 4 Ky zy lo rd a 42 .8 0. 0 0. 0 1. 7 52 .2 2. 1 0. 0 0. 5 0. 0 0. 0 0. 0 0. 0 0. 7 0. 0 10 0. 0 56 .5 0. 7 57 .1 30 1 M an gi st au 46 .6 0. 0 0. 0 5. 8 44 .1 0. 0 0. 0 3. 2 0. 0 0. 0 0. 2 0. 0 0. 0 0. 1 10 0. 0 53 .1 0. 4 53 .4 18 3 So ut h Ka za kh st an 73 .4 0. 3 0. 0 2. 6 21 .5 0. 2 0. 0 1. 4 0. 0 0. 1 0. 2 0. 1 0. 2 0. 0 10 0. 0 26 .1 0. 5 26 .6 1 15 5 Pa vl od ar 39 .0 0. 7 0. 0 5. 7 41 .9 0. 3 0. 0 9. 5 0. 0 0. 5 0. 5 0. 7 0. 6 0. 6 10 0. 0 58 .6 2. 4 61 .0 46 3 N or th K az ak hs ta n 44 .5 0. 6 0. 0 8. 0 36 .8 0. 3 0. 3 6. 6 0. 0 0. 3 0. 0 0. 7 0. 6 1. 3 10 0. 0 53 .0 2. 6 55 .5 41 8 Ea st K az ak hs ta n 38 .9 0. 5 0. 0 9. 4 41 .5 0. 0 0. 0 8. 5 0. 0 0. 2 0. 6 0. 2 0. 2 0. 0 10 0. 0 60 .1 1. 0 61 .1 80 9 A st an a Ci ty 38 .3 0. 0 0. 0 16 .4 37 .3 0. 3 0. 0 6. 3 0. 0 0. 0 0. 0 0. 2 0. 0 1. 2 10 0. 0 60 .3 1. 4 61 .7 20 4 A lm at y Ci ty 44 .0 0. 8 0. 3 15 .1 29 .2 0. 0 0. 0 9. 7 0. 0 0. 3 0. 0 0. 3 0. 0 0. 3 10 0. 0 55 .4 0. 5 55 .9 54 7 Re si de nc e U rb an 46 .0 0. 5 0. 1 9. 2 35 .7 0. 4 0. 1 6. 0 0. 0 0. 2 0. 5 0. 4 0. 3 0. 6 10 0. 0 52 .2 1. 8 54 .0 4 65 2 Ru ra l 53 .5 0. 6 0. 0 3. 5 36 .8 0. 2 0. 0 3. 3 0. 0 0. 0 0. 9 0. 4 0. 5 0. 3 10 0. 0 44 .4 2. 1 46 .5 3 69 7 * M IC S in di ca to r 2 1; M D G in di ca to r 1 9C KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 105 T ab le R H .1 : U se o f c o n tr ac ep ti o n ( co n ti n ue d ) Not using any method PE RC EN T O F W O M EN ( CU RR EN TL Y M A RR IE D O R IN U N IO N ) W H O A RE U SI N G : TOTAL Any modern method Any tradi-tional method Any method* Number of women cur- rently married or in union Female steri- lization Male sterili- zation Pills IUD Injections Implants Condom Female condom Diaphragm/ foam/ jelly LAM Periodic abstinence With-drawal Other A ge 15 – 19 68 .3 0. 0 0. 0 4. 3 13 .1 0. 0 0. 0 11 .1 0. 0 0. 0 2. 3 0. 0 0. 0 0. 9 10 0. 0 28 .5 3. 3 31 .7 12 1 20 – 24 60 .1 0. 0 0. 0 8. 5 21 .4 0. 1 0. 0 8. 0 0. 0 0. 0 1. 5 0. 0 0. 3 0. 1 10 0. 0 38 .0 1. 9 39 .9 92 1 25 – 29 46 .3 0. 4 0. 0 9. 3 35 .4 0. 4 0. 1 5. 4 0. 0 0. 2 1. 7 0. 2 0. 4 0. 2 10 0. 0 51 .2 2. 5 53 .7 1 29 8 30 – 34 38 .5 0. 7 0. 1 8. 2 44 .7 0. 4 0. 0 4. 7 0. 1 0. 0 0. 8 0. 6 0. 6 0. 6 10 0. 0 58 .9 2. 5 61 .5 1 39 9 35 – 39 40 .9 0. 7 0. 1 7. 9 42 .3 0. 4 0. 1 5. 0 0. 0 0. 4 0. 3 0. 8 0. 4 0. 7 10 0. 0 56 .9 2. 2 59 .1 1 56 3 40 – 44 45 .4 0. 8 0. 0 4. 6 43 .2 0. 4 0. 0 4. 2 0. 0 0. 1 0. 1 0. 4 0. 4 0. 4 10 0. 0 53 .2 1. 3 54 .6 1 57 6 45 – 49 66 .9 0. 4 0. 0 2. 6 26 .1 0. 1 0. 0 2. 5 0. 0 0. 2 0. 0 0. 6 0. 2 0. 4 10 0. 0 31 .9 1. 3 33 .1 1 47 1 N um be r o f l iv in g ch ild re n N o ch ild re n 88 .3 0. 3 0. 0 5. 1 1. 9 0. 0 0. 0 4. 0 0. 0 0. 0 0. 0 0. 1 0. 2 0. 1 10 0. 0 11 .3 0. 4 11 .7 61 0 1 ch ild 50 .5 0. 0 0. 0 10 .8 28 .5 0. 5 0. 0 7. 1 0. 1 0. 2 0. 9 0. 5 0. 4 0. 5 10 0. 0 47 .2 2. 3 49 .5 1 93 6 2 ch ild re n 38 .8 0. 8 0. 1 8. 0 44 .2 0. 3 0. 0 5. 5 0. 0 0. 2 0. 8 0. 4 0. 3 0. 6 10 0. 0 59 .1 2. 1 61 .2 3 01 1 3 ch ild re n 48 .4 0. 6 0. 0 3. 6 41 .3 0. 5 0. 2 3. 3 0. 0 0. 1 0. 5 0. 8 0. 5 0. 2 10 0. 0 49 .5 2. 1 51 .6 1 60 9 4 an d m or e ch ild re n 55 .2 0. 7 0. 0 1. 5 39 .1 0. 1 0. 0 1. 8 0. 0 0. 0 0. 6 0. 2 0. 3 0. 5 10 0. 0 43 .1 1. 7 44 .8 1 18 3 Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 57 .0 0. 4 0. 0 4. 9 30 .8 0. 6 0. 3 4. 4 0. 0 0. 0 0. 8 0. 0 0. 5 0. 3 10 0. 0 41 .4 1. 6 43 .0 40 2 Se co nd ar y 52 .0 0. 5 0. 0 4. 5 37 .5 0. 1 0. 1 3. 3 0. 0 0. 1 0. 7 0. 5 0. 4 0. 3 10 0. 0 46 .1 1. 9 48 .0 3 44 1 Sp ec ia liz ed s ec on da ry 46 .4 0. 8 0. 1 6. 4 38 .1 0. 6 0. 0 5. 6 0. 0 0. 2 0. 5 0. 4 0. 4 0. 5 10 0. 0 51 .7 1. 9 53 .6 2 44 9 H ig he r 46 .7 0. 3 0. 0 10 .8 32 .9 0. 3 0. 0 6. 5 0. 1 0. 2 0. 7 0. 4 0. 3 0. 8 10 0. 0 51 .1 2. 2 53 .3 2 05 7 W ea lt h in de x qu in ti le s Po or es t 58 .0 0. 3 0. 0 1. 8 36 .1 0. 1 0. 0 1. 8 0. 0 0. 0 1. 0 0. 3 0. 4 0. 2 10 0. 0 40 .1 1. 9 42 .0 1 62 3 Po or 52 .7 0. 4 0. 0 3. 1 38 .0 0. 3 0. 1 3. 5 0. 0 0. 0 0. 7 0. 6 0. 3 0. 3 10 0. 0 45 .4 1. 9 47 .3 1 66 9 M id dl e 48 .5 0. 5 0. 2 7. 2 35 .7 0. 4 0. 1 5. 0 0. 1 0. 1 0. 8 0. 3 0. 6 0. 5 10 0. 0 49 .2 2. 3 51 .5 1 70 9 Ri ch 47 .1 0. 7 0. 0 8. 8 36 .2 0. 3 0. 0 5. 2 0. 0 0. 2 0. 4 0. 5 0. 3 0. 3 10 0. 0 51 .4 1. 5 52 .9 1 60 5 Ri ch es t 40 .7 0. 8 0. 0 12 .0 35 .1 0. 5 0. 0 8. 4 0. 0 0. 4 0. 4 0. 6 0. 3 0. 8 10 0. 0 57 .2 2. 1 59 .3 1 74 3 Et hn ic it y/ la ng ua ge Ka za kh 51 .6 0. 6 0. 0 4. 3 38 .0 0. 3 0. 0 3. 3 0. 0 0. 1 0. 9 0. 4 0. 3 0. 2 10 0. 0 46 .7 1. 7 48 .4 5 01 7 Ru ss ia n 41 .6 0. 7 0. 1 11 .3 34 .8 0. 4 0. 0 8. 3 0. 0 0. 4 0. 2 0. 6 0. 7 0. 9 10 0. 0 56 .0 2. 4 58 .4 2 46 6 O th er 57 .7 0. 0 0. 0 6. 7 29 .7 0. 0 0. 0 3. 8 0. 0 0. 0 0. 7 0. 5 0. 4 0. 5 10 0. 0 40 .2 2. 0 42 .3 86 6 To ta l 49 .3 0. 5 0. 0 6. 7 36 .2 0. 3 0. 0 4. 8 0. 0 0. 1 0. 7 0. 5 0. 4 0. 5 10 0. 0 48 .7 2. 0 50 .7 8 34 9 * M IC S in di ca to r 2 1; M D G in di ca to r 1 9C MONITORING THE SITUATION OF CHILDREN AND WOMEN106 T ab le R H .2 A : R ep ro d uc ti ve b eh av io r o f w o m en Pe rc en ta ge o f w o m en a ge d 1 5– 49 e xp re ss ed w ill in gn es s to g iv e (o n e m o re ) b ir th a n d a b o ut d es ir ab le b ir th s p ac e, K az ak h st an , 2 00 6 Pe rc en t o f w om en a ge d 15 -4 9 w ill in g to g iv e bi rt h Pr ef er ab le b irt h sp ac e N um be r of w om en ag ed 15 -4 9 1 ch ild 2 ch il- dr en 3 ch il- dr en 4 ch il- dr en 5- 9 ch ild re n 10 a nd m or e ch ild re n N o ch il- dr en 1 ye ar 2 ye ar s 3 ye ar s 4 ye ar s 5 an d m or e ye ar s O bl as t A km ol a (3 .9 ) 41 .2 33 .2 12 .7 8. 1 (* ) (* ) (9 .1 ) 28 .5 29 .1 (9 .1 ) 24 .1 79 7 A kt ob e 6. 1 39 .1 29 .1 17 .2 7. 7 (* ) (* ) (4 .1 ) 31 .8 36 .3 13 .3 14 .5 67 5 A lm at y 5. 3 37 .1 33 .0 14 .8 6. 8 (* ) (2 .7 ) (5 .2 ) 29 .5 46 .9 13 .2 (5 .2 ) 1 47 5 A ty ra u (* ) 19 .8 37 .8 27 .3 10 .1 (* ) (* ) (* ) 32 .1 38 .7 15 .3 12 .3 45 8 W es t K az ak hs ta n (3 .6 ) 41 .6 34 .5 14 .7 (4 .5 ) (* ) (* ) (5 .0 ) 33 .5 42 .7 10 .5 8. 2 69 9 Zh am by l (* ) 25 .2 29 .2 27 .2 14 .1 (* ) (* ) 8. 4 41 .0 35 .2 7. 7 7. 6 87 7 Ka ra ga nd y 7. 9 46 .3 30 .7 8. 8 (5 .0 ) (* ) (* ) (5 .4 ) 32 .2 41 .8 10 .8 9. 8 1 47 6 Ko st an ai 9. 2 47 .6 25 .7 8. 1 7. 1 (* ) (* ) (7 .2 ) 34 .4 32 .2 11 .4 14 .8 1 01 6 Ky zy lo rd a (3 .3 ) 21 .8 21 .1 34 .1 17 .4 (* ) (* ) 14 .3 49 .3 27 .5 (3 .7 ) (5 .1 ) 52 8 M an gi st au (* ) 16 .1 36 .9 34 .8 10 .2 (* ) (* ) (5 .1 ) 29 .0 41 .7 15 .6 8. 6 33 5 So ut h Ka za kh st an (* ) 12 .3 23 .3 39 .1 22 .5 (* ) (* ) (3 .6 ) 32 .3 50 .7 8. 6 (4 .9 ) 1 76 7 Pa vl od ar 6. 9 44 .3 31 .4 10 .7 (5 .0 ) (* ) (* ) 9. 7 32 .4 32 .9 13 .0 12 .0 82 0 N or th K az ak hs ta n 10 .8 50 .4 25 .3 8. 0 (4 .4 ) (* ) (* ) (1 2. 9) 27 .8 25 .3 (1 2. 0) 21 .9 67 4 Ea st K az ak hs ta n 9. 5 47 .7 26 .3 8. 5 (4 .5 ) (* ) (3 .5 ) 10 .4 25 .3 25 .5 15 .1 23 .8 1 46 7 A st an a Ci ty 10 .4 52 .1 26 .0 8. 6 (* ) (* ) (* ) 17 .6 29 .9 24 .4 12 .2 15 .8 36 8 A lm at y Ci ty 8. 3 53 .8 26 .1 7. 1 (* ) (* ) (* ) 11 .5 35 .0 31 .2 (9 .4 ) 12 .8 1 12 6 Re si de nc e U rb an 7. 4 44 .1 28 .4 13 .3 5. 0 (0 .4 ) 1. 3 7. 7 32 .0 36 .0 11 .4 12 .9 8 65 5 Ru ra l 3. 7 28 .5 29 .2 22 .5 14 .0 (0 .6 ) 1. 5 6. 9 33 .4 39 .3 10 .5 9. 9 5 90 3 ( ) – in di ca to rs a re b as ed o n 25 -4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 107 T ab le R H .2 A : R ep ro d uc ti ve b eh av io r o f w o m en ( co n ti n ue d ) Pe rc en t o f w om en a ge d 15 -4 9 w ill in g to g iv e bi rt h Pr ef er ab le b irt h sp ac e N um be r of w om en ag ed 15 -4 9 1 ch ild 2 ch il- dr en 3 ch il- dr en 4 ch il- dr en 5- 9 ch ild re n 10 a nd m or e ch ild re n N o ch il- dr en 1 ye ar 2 ye ar s 3 ye ar s 4 ye ar s 5 an d m or e ye ar s Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 7. 1 45 .1 26 .3 12 .4 5. 1 1. 0 3. 0 5. 4 29 .8 35 .1 9. 4 20 .2 1 94 8 Se co nd ar y 4. 4 29 .1 29 .4 21 .9 13 .4 (0 .7 ) 1. 2 8. 2 33 .5 37 .8 11 .6 8. 9 4 89 3 Sp ec ia liz ed s ec on da ry 6. 8 39 .9 28 .9 15 .5 7. 5 (* ) (1 .1 ) 7. 3 34 .2 36 .7 11 .0 10 .8 3 94 9 H ig he r 6. 4 42 .9 29 .1 14 .8 5. 5 (* ) (1 .1 ) 7. 6 31 .7 38 .7 11 .4 10 .5 3 76 8 A ge 15 -1 9 6. 6 52 .5 26 .5 10 .1 2. 2 (* ) 2. 0 4. 0 29 .9 36 .2 11 .3 18 .7 2 46 9 20 -2 4 6. 6 42 .9 30 .4 15 .0 3. 6 (* ) 1. 1 6. 5 32 .7 39 .1 12 .6 9. 1 2 10 8 25 -2 9 6. 6 38 .5 30 .9 17 .3 5. 5 (* ) 1. 0 8. 7 33 .2 34 .3 10 .3 13 .5 1 89 4 30 -3 4 5. 2 33 .8 30 .1 19 .8 9. 4 (* ) 1. 2 9. 1 31 .8 36 .7 10 .6 11 .8 1 90 0 35 -3 9 5. 9 31 .2 28 .7 20 .8 11 .5 (* ) 1. 3 12 .0 31 .5 36 .5 11 .9 8. 1 2 05 5 40 -4 4 5. 2 29 .3 29 .5 20 .3 13 .3 (* ) 1. 8 7. 4 37 .8 40 .4 9. 7 (4 .7 ) 2 07 6 45 -4 9 5. 2 32 .6 25 .8 17 .5 16 .3 (1 .3 ) 1. 3 6. 0 36 .1 41 .7 9. 2 7. 1 2 05 6 W ea lt h in de x qu in ti le s Po or es t 2. 9 22 .0 27 .0 27 .2 18 .4 (0 .7 ) (1 .8 ) 6. 5 35 .8 40 .6 9. 7 7. 4 2 68 9 Po or 4. 7 28 .0 30 .2 22 .2 12 .4 (* ) (1 .7 ) 7. 4 33 .7 37 .6 11 .1 10 .1 2 72 8 M id dl e 4. 8 37 .7 31 .3 17 .1 7. 2 (* ) (1 .4 ) 6. 5 32 .0 37 .1 12 .2 12 .3 2 82 4 Ri ch 7. 2 46 .5 27 .7 12 .0 4. 7 (* ) (1 .3 ) 8. 1 32 .9 36 .0 9. 9 13 .1 2 91 5 Ri ch es t 9. 1 50 .5 27 .7 9. 2 2. 6 (* ) (* ) 8. 1 29 .3 35 .8 12 .2 14 .7 3 40 2 Et hn ic it y/ la ng ua ge Ka za kh 3. 2 28 .8 31 .6 22 .7 11 .8 0. 6 1. 2 7. 0 34 .8 38 .5 10 .1 9. 7 8 60 9 Ru ss ia n 11 .4 57 .1 23 .2 4. 3 2. 4 0. 2 1. 4 8. 3 27 .6 33 .3 13 .2 17 .6 4 48 1 O th er 5. 0 31 .2 29 .1 22 .5 9. 3 0. 6 2. 4 7. 1 33 .0 41 .4 10 .8 7. 7 1 46 8 To ta l 5. 9 37 .7 28 .7 17 .0 8. 7 0. 5 1. 4 7. 4 32 .6 37 .3 11 .1 11 .7 14 55 8 ( ) – in di ca to rs a re b as ed o n 25 -4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN108 T ab le R H .2 B : F ac to rs li m it in g b ir th r at e Pe rc en ta ge o f w o m en a ge d 1 5- 49 , w h o r ep o rt ed th e fa ct o rs in flu en ci n g th ei r d ec is io n to g iv e (a n o th er ) b ir th , K az ak h st an , 2 00 6 Fa ct or s in flu en ci ng th e de ci si on to g iv e bi rt h or re st ric t t he n um be r o f c hi ld re n To ta l N um be r of w om - en a ge d 15 -4 9 Health Status Fear to lose job Uncertainty in the future of children Low level of health services Lack of pre-school institutions No housing No utilities in the house/ apartment No regular job Low wages No job at all Other O bl as t A km ol a 17 .3 (* ) 18 .6 (* ) (* ) (4 .1 ) (* ) (5 .8 ) 17 .4 9. 7 21 .3 10 0. 0 79 7 A kt ob e 20 .5 (* ) 11 .9 (3 .9 ) (* ) 6. 4 (3 .7 ) 7. 7 32 .5 7. 9 (* ) 10 0. 0 67 5 A lm at y 46 .1 (* ) (3 .7 ) (* ) (* ) 5. 2 (* ) (2 .7 ) (4 .0 ) (* ) 34 .3 10 0. 0 1 47 5 A ty ra u 16 .2 7. 0 21 .5 (* ) (* ) 10 .3 6. 0 8. 0 21 .4 5. 0 (* ) 10 0. 0 45 8 W es t K az ak hs ta n 22 .3 (* ) 13 .3 (3 .5 ) (3 .8 ) 11 .8 6. 0 9. 0 10 .6 10 .4 7. 3 10 0. 0 69 9 Zh am by l 23 .6 (3 .6 ) 16 .4 (* ) (4 .4 ) (4 .2 ) (3 .5 ) 7. 4 17 .8 15 .3 (* ) 10 0. 0 87 7 Ka ra ga nd y 17 .7 (* ) 9. 6 (* ) (* ) (2 .7 ) (* ) (2 .9 ) 36 .8 5. 0 20 .1 10 0. 0 1 47 6 Ko st an ai 19 .3 (* ) 26 .8 (* ) (3 .4 ) (3 .5 ) (3 .2 ) (5 .3 ) 25 .7 5. 9 (4 .8 ) 10 0. 0 1 01 6 Ky zy lo rd a 10 .9 (* ) 8. 6 (3 .6 ) (* ) (4 .3 ) (3 .0 ) 12 .4 28 .6 21 .8 (4 .0 ) 10 0. 0 52 8 M an gi st au 5. 6 (* ) 10 .5 (* ) 5. 6 20 .1 (* ) 7. 3 28 .3 17 .5 0. 1 10 0. 0 33 5 So ut h Ka za kh st an 9. 8 (2 .3 6. 5 (* ) (* ) (2 .6 ) (* ) 4. 9 48 .1 21 .8 1. 2 10 0. 0 1 76 7 Pa vl od ar 22 .8 (* ) 19 .6 (* ) (* ) (* ) (* ) (* ) 31 .2 6. 4 9. 3 10 0. 0 82 0 N or th K az ak hs ta n 14 .2 (* ) 16 .8 (* ) (* ) (* ) (* ) (5 .0 ) 17 .8 10 .9 27 .1 10 0. 0 67 4 Ea st K az ak hs ta n 17 .3 (3 .1 ) 21 .3 (* ) (* ) (5 .1 ) (* ) 5. 5 20 .7 10 .5 13 .7 10 0. 0 1 46 7 A st an a Ci ty 14 .9 18 .0 9. 5 (* ) (* ) 8. 7 (* ) (* ) 17 .2 11 .2 12 .9 10 0. 0 36 8 A lm at y Ci ty 16 .0 (* ) 22 .2 (* ) (* ) 19 .3 (* ) (3 .7 ) 22 .8 (* ) (4 .2 ) 10 0. 0 1 12 6 Re si de nc e U rb an 17 .5 3. 2 16 .0 1. 8 1. 5 7. 5 2. 0 4. 9 28 .0 7. 4 10 .4 10 0. 0 8 65 5 Ru ra l 23 .0 1. 7 12 .1 1. 3 1. 6 4. 2 2. 5 5. 9 20 .8 13 .3 13 .7 10 0. 0 5 90 3 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 109 T ab le R H .2 B : F ac to rs li m it in g b ir th r at e (c o n ti n ue d ) Fa ct or s in flu en ci ng th e de ci si on to g iv e bi rt h or re st ric t t he n um be r o f c hi ld re n To ta l N um be r of w om - en a ge d 15 -4 9 Health Status Fear to lose job Uncertainty in the future of children Low level of health services Lack of pre-school institutions No housing No utilities in the house/ apartment No regular job Low wages No job at all Other Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 15 .0 (1 .2 ) 16 .8 (1 .8 ) (1 .6 ) 6. 2 2. 2 5. 7 23 .0 12 .7 13 .7 10 0. 0 1 94 8 Se co nd ar y 21 .7 1. 6 12 .1 1. 1 1. 2 5. 2 2. 1 6. 6 23 .9 12 .4 12 .3 10 0. 0 4 89 3 Sp ec ia liz ed s ec on da ry 20 .2 3. 3 14 .4 1. 2 1. 1 5. 6 2. 2 4. 8 27 .1 8. 2 11 .9 10 0. 0 3 94 9 H ig he r 19 .1 3. 9 16 .2 2. 5 2. 4 8. 0 2. 1 3. 9 25 .4 6. 6 10 .0 10 0. 0 3 76 8 A ge 15 -1 9 11 .8 2. 2 19 .6 (1 .8 ) (1 .4 ) 7. 9 2. 6 5. 3 22 .9 11 .0 13 .5 10 0. 0 2 46 9 20 -2 4 12 .8 2. 6 14 .0 (2 .0 ) (1 .7 ) 8. 7 1. 9 7. 4 25 .8 13 .6 9. 3 10 0. 0 2 10 8 25 -2 9 15 .4 2. 6 12 .3 (2 .0 ) 2. 4 7. 8 (2 .0 ) 5. 8 27 .2 12 .2 10 .2 10 0. 0 1 89 4 30 -3 4 19 .6 (2 .2 ) 13 .7 (1 .4 ) (1 .8 ) 6. 2 2. 8 5. 8 25 .9 10 .8 10 .0 10 0. 0 1 90 0 35 -3 9 24 .8 2. 6 12 .9 (1 .3 ) (1 .4 ) 4. 3 2. 8 4. 9 26 .4 7. 9 10 .6 10 0. 0 2 05 5 40 -4 4 26 .4 2. 9 14 .1 (1 .1 ) (1 .4 ) 4. 6 (1 .3 ) 4. 1 24 .7 6. 7 12 .8 10 0. 0 2 07 6 45 -4 9 28 .6 2. 9 12 .9 (1 .5 ) (0 .9 ) 3. 4 (1 .7 ) 3. 6 23 .0 6. 0 15 .4 10 0. 0 2 05 6 W ea lt h in de x qu in ti le s Po or es t 20 .9 (1 .2 ) 9. 3 (1 .0 ) (1 .3 ) 3. 8 2. 4 6. 9 23 .7 18 .9 10 .7 10 0. 0 2 68 9 Po or 21 .4 2. 6 13 .0 (1 .1 ) 1. 7 5. 0 2. 9 7. 2 20 .4 11 .7 13 .0 10 0. 0 2 72 8 M id dl e 21 .6 2. 5 14 .9 1. 5 1. 8 5. 3 2. 4 4. 8 22 .8 7. 9 14 .4 10 0. 0 2 82 4 Ri ch 17 .3 2. 5 16 .3 2. 1 (1 .6 ) 8. 5 2. 2 3. 5 27 .4 6. 1 12 .5 10 0. 0 2 91 5 Ri ch es t 17 .9 3. 8 17 .5 2. 1 (1 .4 ) 7. 7 (1 .1 ) 4. 3 29 .7 5. 7 8. 7 10 0. 0 3 40 2 Et hn ic it y/ la ng ua ge Ka za kh 20 .5 2. 9 12 .4 1. 6 1. 6 6. 7 2. 4 5. 7 24 .0 10 .9 11 .1 10 0. 0 8 60 9 Ru ss ia n 16 .8 2. 2 19 .1 1. 6 1. 3 5. 3 1. 8 4. 7 26 .8 7. 5 12 .9 10 0. 0 4 48 1 O th er 24 .0 (1 .7 ) 11 .7 (1 .4 ) (2 .0 ) 5. 9 (1 .7 ) 4. 3 25 .6 9. 8 12 .0 10 0. 0 1 46 8 To ta l 19 .7 2. 6 14 .4 1. 6 1. 6 6. 2 2. 2 5. 3 25 .0 9. 8 11 .8 10 0. 0 14 5 58 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN110 T ab le R H .2 C : F ac to rs s ti m ul at in g b ir th r at e Pe rc en ta ge o f w o m en a ge d 1 5– 49 , w h o r ep o rt ed th e fa ct o rs in flu en ci n g th ei r d ec is io n to g iv e (a n o th er ) b ir th , K az ak h st an , 2 00 6 M ea su re s in flu en ci ng th e de ci si on to g iv e (a no th er ) bi rt h To ta l N um be r o f w om en a ge d 15 -4 9 Su ffi ci en t f am - ily a llo w an ce s Su ffi ci en t p ai d m at er ni ty le av e G ra nt in g cr ed - its a nd lo an s Sh or te ne d w or ki ng d ay fo r br ea st fe ed in g m ot he rs Re du si ng o f re tir em en t a ge fo r m ot he rs O th er O bl as t A km ol a 19 .1 13 .8 (7 .6 ) (* ) 12 .4 46 .2 10 0. 0 79 7 A kt ob e 13 .5 26 .8 12 .6 14 .5 20 .2 12 .3 10 0. 0 67 5 A lm at y 19 .4 18 .6 5. 7 (* ) (2 .5 ) 52 .1 10 0. 0 1 47 5 A ty ra u 9. 3 32 .1 11 .9 6. 8 23 .2 16 .7 10 0. 0 45 8 W es t K az ak hs ta n 16 .4 29 .7 21 .6 5. 8 13 .4 13 .1 10 0. 0 69 9 Zh am by l 26 .3 36 .9 13 .4 5. 2 13 .2 4. 9 10 0. 0 87 7 Ka ra ga nd y 11 .8 31 .2 6. 9 9. 8 28 .2 12 .1 10 0. 0 1 47 6 Ko st an ai 33 .7 30 .2 6. 8 (3 .1 ) 17 .3 8. 9 10 0. 0 1 01 6 Ky zy lo rd a 19 .6 31 .7 6. 6 10 .2 22 .7 9. 3 10 0. 0 52 8 M an gi st au (* ) (3 .4 ) 18 .8 30 .9 38 .3 6. 1 10 0. 0 33 5 So ut h Ka za kh st an 14 .5 18 .3 22 .0 4. 1 36 .2 4. 9 10 0. 0 1 76 7 Pa vl od ar (5 .0 ) 10 .4 13 .2 17 .4 22 .9 31 .0 10 0. 0 82 0 N or th K az ak hs ta n 11 .7 12 .6 (6 .8 ) (* ) 10 .5 56 .6 10 0. 0 67 4 Ea st K az ak hs ta n 23 .2 13 .0 (4 .6 ) (* ) 16 .6 41 .6 10 0. 0 1 46 7 A st an a Ci ty 10 .1 23 .0 16 .6 (5 .2 ) 30 .2 15 .0 10 0. 0 36 8 A lm at y Ci ty (5 .4 ) 14 .3 24 .4 30 .4 18 .1 7. 3 10 0. 0 1 12 6 Re si de nc e U rb an 13 .8 21 .9 13 .5 10 .7 20 .9 19 .2 10 0. 0 8 65 5 Ru ra l 19 .7 20 .7 10 .2 4. 4 18 .3 26 .7 10 0. 0 5 90 3 ( ) – in di ca to rs a re b as ed o n 25 -4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 111 T ab le R H .2 C : F ac to rs s ti m ul at in g b ir th r at e (c o n ti n ue d ) M ea su re s in flu en ci ng th e de ci si on to g iv e (a no th er ) bi rt h To ta l N um be r o f w om en a ge d 15 -4 9 Su ffi ci en t f am - ily a llo w an ce s Su ffi ci en t p ai d m at er ni ty le av e G ra nt in g cr ed - its a nd lo an s Sh or te ne d w or ki ng d ay fo r br ea st fe ed in g m ot he rs Re du si ng o f re tir em en t a ge fo r m ot he rs O th er Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 21 .2 22 .2 12 .4 6. 6 14 .8 22 .7 10 0. 0 1 94 8 Se co nd ar y 17 .8 20 .3 11 .9 6. 1 20 .5 23 .3 10 0. 0 4 89 3 Sp ec ia liz ed s ec on da ry 15 .0 21 .1 11 .5 7. 8 20 .4 24 .1 10 0. 0 3 94 9 H ig he r 12 .8 22 .8 12 .9 11 .9 20 .8 18 .7 10 0. 0 3 76 8 A ge 15 -1 9 18 .8 25 .1 15 .6 8. 3 13 .1 19 .0 10 0. 0 2 46 9 20 -2 4 17 .6 22 .8 16 .4 10 .9 17 .5 14 .8 10 0. 0 2 10 8 25 -2 9 17 .3 25 .3 13 .9 8. 7 18 .4 16 .4 10 0. 0 1 89 4 30 -3 4 17 .8 21 .6 11 .8 8. 3 20 .0 20 .5 10 0. 0 1 90 0 35 -3 9 15 .9 20 .0 10 .6 7. 6 21 .6 24 .3 10 0. 0 2 05 5 40 -4 4 13 .7 19 .2 7. 9 6. 5 25 .3 27 .4 10 0. 0 2 07 6 45 -4 9 12 .1 15 .5 8. 2 6. 6 24 .0 33 .6 10 0. 0 2 05 6 W ea lt h in de x qu in ti le s Po or es t 19 .9 20 .0 14 .0 4. 0 21 .5 20 .6 10 0. 0 2 68 9 Po or 20 .6 22 .3 9. 0 4. 6 18 .2 25 .4 10 0. 0 2 72 8 M id dl e 16 .2 21 .1 9. 9 7. 2 18 .1 27 .6 10 0. 0 2 82 4 Ri ch 14 .0 21 .0 13 .6 9. 7 20 .6 21 .1 10 0. 0 2 91 5 Ri ch es t 11 .6 22 .6 13 .9 13 .7 20 .6 17 .7 10 0. 0 3 40 2 Et hn ic it y/ la ng ua ge Ka za kh 15 .8 21 .8 12 .7 8. 0 21 .4 20 .2 10 0. 0 8 60 9 Ru ss ia n 16 .4 20 .9 10 .9 8. 6 16 .2 26 .9 10 0. 0 4 48 1 O th er 17 .8 20 .8 12 .5 7. 6 21 .5 19 .8 10 0. 0 1 46 8 To ta l 16 .2 21 .4 12 .1 8. 1 19 .8 22 .3 10 0. 0 14 5 58 ( ) – in di ca to rs a re b as ed o n 25 -4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN112 T ab le R H .3 : A n te n at al c ar e p ro vi d er Pe rc en t d is tr ib ut io n o f w om en a ge d 15 -4 9 w h o ga ve b ir th in th e tw o ye ar s p re ce di n g th e su rv ey b y ty p e of p er so n n el p ro vi di n g an te n at al c ar e, K az ak h st an , 2 00 6 Pe rs on p ro vi di ng a nt en at al c ar e N o an te - na ta l c ar e re ce iv ed To ta l A ny s ki lle d pe rs on ne l* N um be r o f w om en w ho g av e bi rt h in th e pr ec ed in g tw o ye ar s M ed ic al do ct or N ur se / m id w ife A ux ili ar y m id w ife Tr ad iti on al bi rt h at te nd an t O th er O bl as t A km ol a 79 .9 17 .3 0. 0 2. 8 0. 0 0. 0 10 0. 0 10 0. 0 80 A kt ob e 88 .3 10 .0 0. 0 1. 7 0. 0 0. 0 10 0. 0 10 0. 0 68 A lm at y 83 .8 14 .1 0. 0 1. 6 0. 5 0. 0 10 0. 0 99 .5 22 5 A ty ra u 88 .0 12 .0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 53 W es t K az ak hs ta n 89 .5 4. 7 1. 1 4. 7 0. 0 0. 0 10 0. 0 10 0. 0 58 Zh am by l 84 .2 12 .6 1. 6 1. 6 0. 0 0. 0 10 0. 0 10 0. 0 13 9 Ka ra ga nd y 95 .1 4. 0 0. 0 0. 9 0. 0 0. 0 10 0. 0 10 0. 0 12 9 Ko st an ai 79 .5 12 .5 0. 0 8. 0 0. 0 0. 0 10 0. 0 10 0. 0 84 Ky zy lo rd a 86 .5 10 .9 0. 0 2. 6 0. 0 0. 0 10 0. 0 10 0. 0 80 M an gi st au (9 5. 3) (4 .7 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) 10 0. 0 10 0. 0 45 So ut h Ka za kh st an 94 .2 5. 8 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 30 9 Pa vl od ar 88 .9 10 .1 0. 0 1. 0 0. 0 0. 0 10 0. 0 10 0. 0 83 N or th K az ak hs ta n 98 .6 0. 0 0. 0 1. 4 0. 0 0. 0 10 0. 0 10 0. 0 61 Ea st K az ak hs ta n 83 .8 11 .0 0. 0 4. 3 0. 0 0. 9 10 0. 0 99 .1 14 1 A st an a Ci ty (9 2. 9) (7 .1 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) 10 0. 0 10 0. 0 40 A lm at y Ci ty 95 .2 4. 8 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 12 4 Re si de nc e U rb an 95 .2 4. 8 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 89 0 Ru ra l 82 .1 13 .7 0. 3 3. 6 0. 1 0. 2 10 0. 0 99 .7 82 9 * M IC S in di ca to r 2 0 ( ) – in di ca to rs a re b as ed o n 25 -4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 113 T ab le R H .3 : A n te n at al c ar e p ro vi d er ( co n ti n ue d ) Pe rs on p ro vi di ng a nt en at al c ar e N o an te - na ta l c ar e re ce iv ed To ta l A ny s ki lle d pe rs on ne l* N um be r o f w om en w ho g av e bi rt h in th e pr ec ed in g tw o ye ar s M ed ic al do ct or N ur se / m id w ife A ux ili ar y m id w ife Tr ad iti on al bi rt h at te nd an t O th er A ge 15 – 19 85 .7 8. 8 0. 0 5. 5 0. 0 0. 0 10 0. 0 10 0. 0 64 20 – 24 88 .2 9. 9 0. 3 1. 4 0. 2 0. 0 10 0. 0 99 .8 50 7 25 – 29 91 .3 7. 4 0. 3 0. 7 0. 0 0. 3 10 0. 0 99 .8 50 1 30 – 34 88 .5 8. 8 0. 0 2. 7 0. 0 0. 0 10 0. 0 10 0. 0 36 9 35 – 39 85 .4 12 .7 0. 0 1. 9 0. 0 0. 0 10 0. 0 10 0. 0 20 8 40 – 44 92 .1 5. 9 0. 0 2. 0 0. 0 0. 0 10 0. 0 10 0. 0 61 45 – 49 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 10 0. 0 9 Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 79 .6 14 .2 0. 0 5. 1 0. 0 1. 1 10 0. 0 98 .9 11 2 Se co nd ar y 87 .1 10 .8 0. 3 1. 7 0. 1 0. 0 10 0. 0 99 .8 73 4 Sp ec ia liz ed s ec on da ry 91 .0 7. 3 0. 0 1. 7 0. 0 0. 0 10 0. 0 10 0. 0 41 6 H ig he r 92 .2 6. 7 0. 1 1. 0 0. 0 0. 0 10 0. 0 10 0. 0 45 7 W ea lt h in de x qu in ti le s Po or es t 80 .9 15 .3 0. 2 3. 3 0. 3 0. 0 10 0. 0 99 .7 45 8 Po or 88 .1 8. 1 0. 6 2. 9 0. 0 0. 3 10 0. 0 99 .6 34 8 M id dl e 90 .0 9. 1 0. 0 0. 9 0. 0 0. 0 10 0. 0 10 0. 0 33 0 Ri ch 95 .6 4. 0 0. 0 0. 4 0. 0 0. 0 10 0. 0 10 0. 0 28 0 Ri ch es t 94 .5 5. 5 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 30 3 Et hn ic it y/ la ng ua ge Ka za kh 88 .7 9. 8 0. 2 1. 2 0. 1 0. 0 10 0. 0 99 .9 1 16 3 Ru ss ia n 89 .3 6. 7 0. 0 3. 7 0. 0 0. 3 10 0. 0 99 .6 34 3 O th er 89 .3 9. 3 0. 0 1. 4 0. 0 0. 0 10 0. 0 10 0. 0 21 3 To ta l 88 .9 9. 1 0. 1 1. 7 0. 1 0. 1 10 0. 0 99 .9 1 71 9 * M IC S in di ca to r 2 0 ( ) – in di ca to rs a re b as ed o n 25 -4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN114 T ab le R H .4 : A n te n at al c ar e Pe rc en ta ge o f p re gn an t w o m en r ec ei vi n g an te n at al c ar e am o n g w o m en a ge d 1 5- 49 y ea rs w h o g av e b ir th in tw o y ea rs p re ce d in g th e su rv ey a n d p er ce n ta ge o f p re gn an t w o m en r ec ei vi n g sp ec ifi c ca re a s p ar t o f t h e an te n at al c ar e re ce iv ed , K az ak h st an , 2 00 6 Pe rc en t o f w om en re ce iv in g an c on e or m or e tim es d ur in g pr eg na nc y PE RC EN TA G E O F PR EG N A N T W O M EN R EC EI V IN G A N TE N AT A L CA RE N um be r o f w om en w ho g av e bi rt h in tw o ye ar s pr ec ed in g su rv ey Bl oo d te st ta ke n* Bl oo d pr es su re m ea su re d* U rin e sp ec im en ta ke n* W ei gh t m ea su re d* O bl as t A km ol a 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 80 A kt ob e 10 0. 0 10 0. 0 10 0. 0 10 0. 0 97 .7 68 A lm at y 10 0. 0 98 .3 98 .3 98 .3 98 .3 22 5 A ty ra u 10 0. 0 97 .4 10 0. 0 97 .4 10 0. 0 53 W es t K az ak hs ta n 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 58 Zh am by l 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 13 9 Ka ra ga nd y 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 12 9 Ko st an ai 10 0. 0 10 0. 0 10 0. 0 10 0. 0 98 .7 84 Ky zy lo rd a 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 80 M an gi st au 10 0. 0 (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) (1 00 .0 ) 45 So ut h Ka za kh st an 10 0. 0 99 .6 99 .6 99 .6 99 .6 30 9 Pa vl od ar 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 83 N or th K az ak hs ta n 10 0. 0 10 0. 0 96 .4 10 0. 0 10 0. 0 61 Ea st K az ak hs ta n 99 .1 99 .1 99 .1 99 .1 99 .1 14 1 A st an a Ci ty 10 0. 0 (9 8. 8) (9 8. 8) (9 8. 8) (9 8. 8) 40 A lm at y Ci ty 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 12 4 Re si de nc e U rb an 10 0. 0 99 .8 99 .6 99 .8 99 .7 89 0 Ru ra l 99 .9 99 .3 99 .3 99 .3 99 .2 82 9 * M IC S in di ca to r 4 4 ( ) – in di ca to rs a re b as ed o n 25 -4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 115 T ab le R H .4 : A n te n at al c ar e (c o n ti n ue d ) Pe rc en t o f w om en re ce iv in g an c on e or m or e tim es d ur in g pr eg na nc y Pe rc en ta ge o f p re gn an t w om en re ce iv in g an te na ta l c ar e N um be r o f w om en w ho g av e bi rt h in tw o ye ar s pr ec ed in g su rv ey Bl oo d te st ta ke n* Bl oo d pr es su re m ea su re d* U rin e sp ec im en ta ke n* W ei gh t m ea su re d* A ge 15 – 19 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 64 20 – 24 10 0. 0 10 0. 0 99 .8 10 0. 0 10 0. 0 50 7 25 – 29 99 .8 99 .1 99 .2 99 .1 98 .9 50 1 30 – 34 10 0. 0 99 .5 99 .7 99 .5 99 .7 36 9 35 – 39 10 0. 0 99 .2 98 .6 99 .2 99 .2 20 8 40 – 44 10 0. 0 10 0. 0 10 0. 0 10 0. 0 98 .2 61 45 – 49 (* ) (* ) (* ) (* ) (* ) 9 Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 98 .9 97 .9 96 .7 97 .9 97 .9 11 2 Se co nd ar y 10 0. 0 99 .3 99 .4 99 .3 99 .3 73 4 Sp ec ia liz ed s ec on da ry 10 0. 0 99 .9 99 .9 99 .9 99 .9 41 6 H ig he r 10 0. 0 10 0. 0 10 0. 0 10 0. 0 99 .7 45 7 W ea lt h in de x qu in ti le s Po or es t 10 0. 0 98 .9 98 .9 98 .9 98 .8 45 8 Po or 99 .6 99 .5 99 .3 99 .5 99 .3 34 8 M id dl e 10 0. 0 99 .5 99 .6 99 .5 99 .9 33 0 Ri ch 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 28 0 Ri ch es t 10 0. 0 10 0. 0 10 0. 0 10 0. 0 99 .7 30 3 Et hn ic it y/ la ng ua ge Ka za kh 10 0. 0 99 .5 99 .5 99 .5 99 .6 1 16 3 Ru ss ia n 99 .6 99 .6 99 .3 99 .6 99 .3 34 3 O th er 10 0. 0 99 .5 99 .5 99 .5 99 .0 21 3 To ta l 99 .9 99 .5 99 .5 99 .5 99 .5 1 71 9 * M IC S in di ca to r 4 4 ( ) – in di ca to rs a re b as ed o n 25 -4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN116 T ab le R H .5 : A ss is ta n ce d ur in g d el iv er y Pe rc en t d is tr ib ut io n o f w o m en a ge d 1 5- 49 w it h a b ir th in tw o y ea rs p re ce d in g th e su rv ey b y ty p e o f p er so n n el a ss is ti n g at d el iv er y, K az ak h st an , 2 00 6 Pe rs on a ss ist in g at d el iv er y To ta l A ny s ki lle d pe rs on ne l* D el iv er ed in he al th fa ci l- ity ** N um be r o f w om en w ho g av e bi rt h in pr ec ed in g tw o ye ar s M ed ic al do ct or N ur se / m id w ife A ux ili ar y m id w ife Tr ad iti on al bi rt h at te nd an t O th er O bl as t A km ol a 82 .6 17 .4 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 98 .6 80 A kt ob e 56 .7 41 .9 1. 4 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 68 A lm at y 58 .1 38 .8 3. 1 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 22 5 A ty ra u 86 .4 13 .0 0. 6 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 53 W es t K az ak hs ta n 98 .8 1. 2 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 58 Zh am by l 80 .8 17 .1 2. 1 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 13 9 Ka ra ga nd y 95 .6 4. 4 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 12 9 Ko st an ai 92 .4 7. 6 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 84 Ky zy lo rd a 50 .8 49 .2 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 80 M an gi st au (9 9. 0) (1 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (1 00 .0 ) (1 00 .0 ) (9 9. 6) 45 So ut h Ka za kh st an 81 .9 17 .2 0. 9 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 30 9 Pa vl od ar 94 .4 5. 6 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 83 N or th K az ak hs ta n 87 .9 8. 5 0. 0 0. 0 3. 6 10 0. 0 96 .4 98 .6 61 Ea st K az ak hs ta n 84 .9 15 .1 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 14 1 A st an a Ci ty (6 1. 9) (3 6. 9) (0 .0 ) (1 .2 ) (0 .0 ) (1 00 .0 ) (9 8. 8) (9 8. 8) 40 A lm at y Ci ty 10 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 98 .8 12 4 Re si de nc e U rb an 88 .7 10 .8 0. 3 0. 1 0. 1 10 0. 0 99 .8 99 .8 89 0 Ru ra l 72 .5 26 .0 1. 4 0. 0 0. 1 10 0. 0 99 .9 99 .7 82 9 * M IC S in di ca to r 4 ; M D G in di ca to r 1 7 ** M IC S in di ca to r 5 ( ) – in di ca to rs a re b as ed o n 25 -4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 117 T ab le R H .5 : A ss is ta n ce d ur in g d el iv er y (c o n ti n ue d ) Pe rs on a ss ist in g at d el iv er y To ta l A ny s ki lle d pe rs on ne l* D el iv er ed in he al th fa ci l- ity ** N um be r o f w om en w ho g av e bi rt h in pr ec ed in g tw o ye ar s M ed ic al do ct or N ur se / m id w ife A ux ili ar y m id w ife Tr ad iti on al bi rt h at te nd an t O th er A ge 15 – 19 75 .3 22 .9 1. 8 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 64 20 – 24 80 .7 18 .4 0. 8 0. 0 0. 1 10 0. 0 99 .8 99 .8 50 7 25 – 29 79 .9 19 .1 1. 0 0. 0 0. 0 10 0. 0 10 0. 0 99 .4 50 1 30 – 34 80 .1 19 .0 0. 8 0. 1 0. 0 10 0. 0 99 .9 10 0. 0 36 9 35 – 39 84 .4 15 .0 0. 0 0. 0 0. 6 10 0. 0 99 .4 99 .9 20 8 40 – 44 86 .2 11 .9 1. 9 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 61 45 – 49 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 9 Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 81 .1 17 .2 1. 7 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 11 2 Se co nd ar y 77 .6 21 .6 0. 7 0. 0 0. 1 10 0. 0 99 .9 99 .7 73 4 Sp ec ia liz ed s ec on da ry 84 .7 14 .7 0. 6 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 41 6 H ig he r 82 .6 16 .0 1. 0 0. 1 0. 3 10 0. 0 99 .6 99 .6 45 7 W ea lt h in de x qu in ti le s Po or es t 73 .0 26 .2 0. 8 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 45 8 Po or 76 .7 21 .9 1. 4 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 34 8 M id dl e 80 .5 18 .2 1. 3 0. 0 0. 0 10 0. 0 10 0. 0 99 .6 33 0 Ri ch 90 .0 9. 2 0. 0 0. 0 0. 8 10 0. 0 99 .2 99 .7 28 0 Ri ch es t 89 .5 10 .0 0. 3 0. 2 0. 0 10 0. 0 99 .8 99 .4 30 3 Et hn ic it y/ la ng ua ge Ka za kh 78 .8 20 .4 0. 7 0. 0 0. 1 10 0. 0 99 .9 99 .8 1 16 3 Ru ss ia n 87 .8 11 .8 0. 0 0. 1 0. 3 10 0. 0 99 .6 99 .3 34 3 O th er 81 .1 16 .3 2. 6 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 21 3 To ta l 80 .9 18 .2 0. 8 0. 0 0. 1 10 0. 0 99 .8 99 .8 1 71 9 * M IC S in di ca to r 4 ; M D G in di ca to r 1 7 ** M IC S in di ca to r 5 ( ) – in di ca to rs a re b as ed o n 25 -4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN118 Table RH.6: Maternal mortality ratio Lifetime risk of maternal death and proportion of dead sisters dying of maternal causes, Kazakhstan, 2006 Number of adult household respond- ents Sisters who reached age 15 Sisters who reached age 15 (adjusted) Sisters who reached aged 15 and who died Maternal deaths Adjustment factor Sister units of risk exposure Lifetime risk of maternal death Proportion of dead sisters dying of maternal causes Respondent age 15–19 5 024 4 346 8 013 46 4 0.107 857 0.005 8.5 20–24 4 123 5 003 9 223 56 0 0.206 1 900 0.000 0.3 25–29 3 789 5 761 10 621 67 2 0.343 3 643 0.000 2.6 30–34 3 499 6 357 6 357 132 9 0.503 3 198 0.003 7.1 35–39 3 612 7 734 7 734 198 17 0.664 5 135 0.003 8.5 40–44 3 818 8 161 8 161 277 12 0.802 6 546 0.002 4.4 45–49 3 676 7 423 7 423 358 14 0.900 6 681 0.002 3.8 50–54 3 148 5 544 5 544 392 6 0.958 5 311 0.001 1.5 55–59 2 395 4 031 4 031 400 5 0.986 3 974 0.001 1.2 60 + 5 734 8 463 8 463 2 756 18 1.000 8 463 0.002 0.7 Total 38 818 62 823 75 570 4 682 87 . 45 708 0.002 1.9 Total fertility rate for the last 10 to 14 years 2.72 Maternal Mortality Ratio* 70 * MICS indicator 3; MDG indicator 16 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 119 T ab le C D .1 : F am ily s up p o rt fo r le ar n in g Pe rc en ta ge o f c h ild re n a ge d 0- 59 m on th s fo r w h om h ou se h ol d m em be rs a re e n ga ge d in a ct iv it ie s th at p ro m ot e le ar n in g an d sc h oo l r ea di n es s, K az ak h st an , 2 00 6 PE RC EN TA G E O F CH IL D RE N A G ED 0 – 59 M O N TH S N um be r o f ch ild re n ag ed 0– 59 m on th s Fo r w ho m h ou se ho ld m em - be rs e ng ag ed in fo ur o r m or e ac tiv iti es th at p ro m ot e le ar n- in g an d sc ho ol re ad in es s* M ea n nu m be r o f ac tiv iti es h ou se ho ld m em be rs e ng ag e in w ith th e ch ild Fo r w ho m th e fa th er e n- ga ge d in o ne o r m or e ac tiv i- tie s th at p ro m ot e le ar ni ng an d sc ho ol re ad in es s* * M ea n nu m be r o f ac tiv iti es th e fa th er en ga ge d in w ith th e ch ild Li vi ng in a ho us eh ol d w ith ou t t he ir na tu ra l f at he r Se x M al e 81 .1 4. 8 47 .7 1. 2 13 .3 2 32 7 Fe m al e 80 .9 4. 9 46 .0 1. 1 14 .0 2 08 8 O bl as t A km ol a 80 .1 4. 8 51 .6 1. 1 15 .7 24 3 A kt ob e 78 .7 4. 8 59 .6 1. 1 9. 5 18 1 A lm at y 60 .4 4. 0 28 .3 0. 5 16 .4 54 5 A ty ra u 79 .4 4. 7 54 .6 1. 0 8. 9 14 3 W es t K az ak hs ta n 87 .3 5. 3 59 .0 1. 3 14 .9 15 2 Zh am by l 69 .7 4. 4 32 .8 0. 8 15 .1 34 5 Ka ra ga nd y 85 .3 5. 0 68 .8 2. 1 19 .5 31 6 Ko st an ai 87 .9 5. 3 66 .6 1. 9 15 .6 26 7 Ky zy lo rd a 71 .7 4. 3 63 .2 1. 2 8. 5 20 9 M an gi st au 84 .3 4. 9 83 .0 2. 0 5. 1 10 9 So ut h Ka za kh st an 94 .3 5. 4 11 .7 0. 2 5. 5 82 7 Pa vl od ar 86 .1 5. 1 72 .5 2. 4 17 .1 19 7 N or th K az ak hs ta n 77 .9 4. 7 64 .3 1. 6 20 .8 16 3 Ea st K az ak hs ta n 76 .3 4. 7 37 .6 0. 8 20 .5 30 4 A st an a Ci ty 88 .1 5. 2 75 .1 2. 4 13 .5 90 A lm at y Ci ty 89 .6 5. 1 79 .6 2. 4 16 .6 32 4 Re si de nc e U rb an 82 .9 4. 9 56 .1 1. 5 15 .0 2 25 1 Ru ra l 79 .1 4. 8 37 .3 0. 8 12 .2 2 16 4 * M IC S in di ca to r 4 6 * * M IC S in di ca to r 4 7 MONITORING THE SITUATION OF CHILDREN AND WOMEN120 T ab le C D .1 : F am ily s up p o rt fo r le ar n in g (c o n ti n ue d ) PE RC EN TA G E O F CH IL D RE N A G ED 0 – 59 M O N TH S N um be r o f ch ild re n ag ed 0– 59 m on th s Fo r w ho m h ou se ho ld m em - be rs e ng ag ed in fo ur o r m or e ac tiv iti es th at p ro m ot e le ar n- in g an d sc ho ol re ad in es s* M ea n nu m be r o f ac tiv iti es h ou se ho ld m em be rs e ng ag e in w ith th e ch ild Fo r w ho m th e fa th er e n- ga ge d in o ne o r m or e ac tiv i- tie s th at p ro m ot e le ar ni ng an d sc ho ol re ad in es s* * M ea n nu m be r o f ac tiv iti es th e fa th er en ga ge d in w ith th e ch ild Li vi ng in a ho us eh ol d w ith ou t t he ir na tu ra l f at he r A ge 0– 23 m on th 63 .1 4. 0 45 .1 1. 0 11 .4 1 81 3 24 – 59 m on th s 93 .5 5. 4 48 .1 1. 3 15 .1 2 60 2 M ot he r’ s ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 81 .6 4. 9 30 .5 0. 7 21 .7 30 9 Se co nd ar y 81 .0 4. 8 42 .6 1. 0 13 .0 2 00 0 Sp ec ia liz ed s ec on da ry 79 .3 4. 8 51 .8 1. 3 13 .8 1 03 0 H ig he r 82 .5 5. 0 55 .0 1. 5 12 .2 1 07 6 Fa th er ’s e du ca ti on Pr im ar y/ in co m pl et e se co nd ar y 78 .3 4. 8 42 .9 1. 0 0. 0 28 0 Se co nd ar y 81 .0 4. 8 46 .7 1. 1 0. 0 1 91 2 Sp ec ia liz ed s ec on da ry 78 .3 4. 8 61 .9 1. 6 0. 0 76 5 H ig he r 81 .9 4. 9 65 .1 1. 8 0. 0 84 5 Fa th er n ot in H H 85 .2 5. 0 5. 3 0. 1 10 0. 0 60 0 W ea lt h in de x qu in ti le s Po or es t 79 .7 4. 8 30 .0 0. 6 11 .6 1 18 9 Po or 79 .2 4. 8 40 .9 0. 9 13 .2 92 4 M id dl e 78 .5 4. 8 46 .9 1. 1 13 .4 86 9 Ri ch 82 .7 5. 0 60 .7 1. 7 15 .1 70 8 Ri ch es t 86 .9 5. 1 68 .8 2. 0 16 .2 72 5 Et hn ic it y/ la ng ua ge Ka za kh 79 .5 4. 8 46 .6 1. 1 10 .0 2 92 4 Ru ss ia n 84 .6 5. 1 57 .7 1. 7 25 .1 93 1 O th er 83 .1 4. 9 30 .6 0. 7 13 .2 56 0 To ta l 81 .0 4. 9 46 .9 1. 2 13 .6 4 41 5 * M IC S in di ca to r 4 6 * * M IC S in di ca to r 4 7 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 121 T ab le C D .2 : L ea rn in g m at er ia ls Pe rc en ta ge o f c h ild re n a ge d 0 -5 9 m o n th s liv in g in h o us eh o ld s co n ta in in g le ar n in g m at er ia ls , K az ak h st an , 2 00 6 CH IL D RE N L IV IN G IN H O U SE H O LD S W IT H : CH IL D H A S: CH IL D P LA YS W IT H : 3 or m or e ty pe s of pl ay - th in gs ** * N um be r of c hi l- dr en a ge d 0– 59 m on th s 3 or m or e no n- ch il- dr en ’s bo ok s* M ed ia n nu m be r of n on - ch ild re n’ s bo ok s 3 or m or e ch ild re n’ s bo ok s* * M ed ia n nu m be r o f ch ild re n’ s bo ok s H ou se - ho ld ob je ct s O bj ec ts an d m at er i- al s fo un d ou ts id e th e ho m e H om e- m ad e to ys To ys th at ca m e fr om a st or e N o pl ay - th in gs m en - tio ne d Se x M al e 89 .3 10 66 .1 5 30 .4 27 .1 18 .0 93 .9 4. 1 19 .4 2 32 7 Fe m al e 88 .9 10 66 .8 5 38 .1 23 .8 16 .3 92 .9 5. 0 20 .2 2 08 8 O bl as t A km ol a 85 .5 10 71 .3 5 44 .8 37 .8 16 .5 97 .3 2. 3 24 .0 24 3 A kt ob e 89 .9 10 60 .2 3 23 .7 10 .3 16 .9 96 .3 2. 3 9. 4 18 1 A lm at y 86 .8 10 55 .4 3 8. 0 0. 7 6. 4 90 .2 7. 7 0. 5 54 5 A ty ra u 87 .3 10 63 .2 4 28 .5 14 .7 5. 5 92 .3 5. 5 3. 8 14 3 W es t K az ak hs ta n 91 .6 10 76 .9 10 41 .4 27 .1 19 .8 90 .8 4. 4 24 .5 15 2 Zh am by l 78 .7 10 50 .2 3 25 .9 28 .3 31 .3 90 .2 5. 4 24 .0 34 5 Ka ra ga nd y 80 .5 10 79 .2 10 48 .2 20 .0 7. 4 93 .6 5. 5 14 .2 31 6 Ko st an ai 93 .4 10 87 .1 10 32 .9 13 .1 5. 9 96 .9 2. 7 13 .3 26 7 Ky zy lo rd a 94 .1 10 52 .6 3 42 .4 26 .0 21 .8 87 .5 4. 7 22 .6 20 9 M an gi st au 97 .5 10 86 .5 10 56 .7 24 .8 13 .6 95 .7 4. 0 23 .4 10 9 So ut h Ka za kh st an 90 .7 10 49 .1 2 36 .9 44 .2 35 .8 93 .3 4. 3 34 .8 82 7 Pa vl od ar 94 .6 10 81 .0 10 41 .4 31 .4 15 .6 95 .7 3. 4 27 .3 19 7 N or th K az ak hs ta n 85 .3 10 72 .4 7 51 .9 34 .8 20 .4 95 .4 3. 7 31 .1 16 3 Ea st K az ak hs ta n 91 .9 10 72 .1 6 41 .0 20 .7 9. 8 93 .6 4. 7 16 .0 30 4 A st an a Ci ty 98 .4 10 95 .7 10 38 .4 20 .0 12 .4 93 .5 5. 4 17 .3 90 A lm at y Ci ty 93 .8 10 90 .0 10 28 .4 33 .2 1. 9 97 .6 2. 4 18 .5 32 4 * M IC S in di ca to r 4 9 ** M IC S in di ca to r 4 8 ** * M IC S in di ca to r 5 0 MONITORING THE SITUATION OF CHILDREN AND WOMEN122 T ab le C D .2 : L ea rn in g m at er ia ls ( co n ti n ue d ) CH IL D RE N L IV IN G IN H O U SE H O LD S W IT H : CH IL D H A S: CH IL D P LA YS W IT H : 3 or m or e ty pe s of pl ay - th in gs ** * N um be r of c hi l- dr en a ge d 0– 59 m on th s 3 or m or e no n- ch il- dr en ’s bo ok s* M ed ia n nu m be r of n on - ch ild re n’ s bo ok s 3 or m or e ch ild re n’ s bo ok s* * M ed ia n nu m be r o f ch ild re n’ s bo ok s H ou se - ho ld ob je ct s O bj ec ts an d m at er i- al s fo un d ou ts id e th e ho m e H om e- m ad e to ys To ys th at ca m e fr om a st or e N o pl ay - th in gs m en - tio ne d Re si de nc e U rb an 91 .0 10 76 .9 10 36 .8 26 .4 15 .3 95 .1 3. 8 19 .9 2 25 1 Ru ra l 87 .1 10 55 .5 3 31 .2 24 .6 19 .1 91 .7 5. 2 19 .6 2 16 4 A ge 0– 23 m on th s 88 .0 10 59 .6 4 30 .7 11 .8 10 .6 88 .9 9. 7 11 .2 1 81 3 24 – 59 m on th s 89 .9 10 71 .2 6 36 .4 35 .1 21 .7 96 .6 0. 9 25 .7 2 60 2 M ot he r’ s ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 76 .0 10 51 .0 3 37 .7 29 .3 23 .6 89 .7 5. 9 24 .1 30 9 Se co nd ar y 86 .1 10 57 .8 3 31 .8 27 .4 18 .0 92 .8 5. 0 20 .7 2 00 0 Sp ec ia liz ed s ec on da ry 92 .1 10 72 .9 6 34 .9 22 .3 15 .6 94 .1 3. 8 16 .8 1 03 0 H ig he r 95 .7 10 80 .5 10 36 .3 24 .1 15 .2 95 .1 3. 8 19 .7 1 07 6 W ea lt h in de x qu in ti le s Po or es t 84 .2 10 43 .8 2 29 .8 27 .8 20 .8 89 .5 6. 0 20 .6 1 18 9 Po or 88 .1 10 61 .3 4 31 .6 26 .2 20 .7 94 .6 4. 1 20 .5 92 4 M id dl e 90 .7 10 75 .5 6 36 .1 24 .5 16 .9 94 .3 4. 7 19 .8 86 9 Ri ch 91 .4 10 77 .0 10 35 .6 24 .0 15 .4 95 .2 3. 6 19 .1 70 8 Ri ch es t 94 .2 10 88 .7 10 39 .9 23 .6 8. 7 95 .9 3. 5 18 .1 72 5 Et hn ic it y/ la ng ua ge Ka za kh 88 .9 10 61 .7 4 34 .2 24 .4 17 .9 92 .7 4. 8 19 .4 2 92 4 Ru ss ia n 92 .3 10 86 .1 10 35 .3 26 .1 12 .2 96 .4 3. 3 18 .5 93 1 O th er 84 .6 10 58 .4 3 31 .2 30 .4 21 .7 92 .8 5. 1 23 .9 56 0 To ta l 89 .1 10 66 .4 5 34 .0 25 .5 17 .2 93 .5 4. 5 19 .8 4 41 5 * M IC S in di ca to r 4 9 ** M IC S in di ca to r 4 8 ** * M IC S in di ca to r 5 0 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 123 Table CD.3: Children left alone or with other children Percentage of children aged 0-59 months left in the care of other children under the age of 10 years or left alone in the past week, Kazakhstan, 2006 PERCENTAGE OF CHILDREN AGED 0–59 MONTHS WHO Number of children aged 0–59 months Left in the care of chil- dren under the age of 10 years in past week Left alone in the past week Left with inadequate care in past week* Sex Male 9.0 2.7 9.9 2 327 Female 9.0 1.9 9.6 2 088 Oblast Akmola 23.0 3.4 24.9 243 Aktobe 25.8 10.5 27.3 181 Almaty 1.8 0.2 2.0 545 Atyrau 17.2 3.0 17.5 143 West Kazakhstan 8.3 1.8 8.8 152 Zhambyl 6.3 1.7 6.5 345 Karagandy 10.8 4.2 12.3 316 Kostanai 8.7 2.3 10.0 267 Kyzylorda 11.7 0.6 11.7 209 Mangistau 19.7 0.2 19.9 109 South Kazakhstan 3.7 1.4 3.7 827 Pavlodar 10.4 2.3 11.8 197 North Kazakhstan 13.4 3.9 15.8 163 East Kazakhstan 12.0 5.3 13.9 304 Astana City 9.2 2.2 10.3 90 Almaty City 1.9 0.0 1.9 324 Residence Urban 9.8 2.6 10.4 2 251 Rural 8.2 2.1 9.2 2 164 Age 0-23 months 5.3 0.7 5.6 1 813 24-59 months 11.6 3.5 12.7 2 602 Mother’s education Primary/incomplete secondary 7.6 2.4 10.0 309 Secondary 9.1 2.5 9.7 2 000 Specialized secondary 10.4 2.6 11.4 1 030 Higher 8.0 1.6 8.3 1 076 Wealth index quintiles Poorest 7.3 1.7 7.6 1 189 Poor 9.5 2.6 10.7 924 Middle 10.6 3.2 11.8 869 Rich 9.0 2.4 9.4 708 Richest 9.4 2.0 10.0 725 Ethnicity/language Kazakh 9.6 2.3 10.1 2 924 Russian 9.8 3.2 11.3 931 Other 5.0 0.9 5.3 560 Total 9.0 2.3 9.8 4 415 * MICS indicator 51 MONITORING THE SITUATION OF CHILDREN AND WOMEN124 Table ED.1: Early childhood education Percentage of children aged 36-59 months who are attending some form of organized early childhood education programme and percentage of first graders who attended pre-school, Kazakhstan, 2006 Percentage of children aged 36-59 months currently attending early childhood education * Number of chil- dren aged 36-59 months Percentage of children attending first grade who attended preschool pro- gram in previous year ** Number of chil- dren attending first grade Sex Male 17.8 860 39.8 363 Female 14.1 794 39.2 324 Oblast Akmola 8.8 110 (56.8) 38 Aktobe 12.0 75 (29.0) 46 Almaty 7.1 175 22.9 82 Atyrau 11.1 60 (39.2) 31 West Kazakhstan 23.2 57 (40.1) 30 Zhambyl 15.7 121 (35.2) 45 Karagandy 33.4 122 (63.2) 47 Kostanai 16.2 107 (76.8) 44 Kyzylorda 8.2 80 (9.1) 40 Mangistau (17.4) 40 (*) 16 South Kazakhstan 8.1 311 14.5 125 Pavlodar 26.8 66 (76.0) 27 North Kazakhstan 20.2 70 (77.3) 34 East Kazakhstan 15.6 114 (47.9) 37 Astana City (47.0) 32 (*) 9 Almaty City 29.7 114 (57.7) 36 Residence Urban 24.1 873 46.4 335 Rural 7.0 781 33.0 352 Age of child 36–47 months 15.4 858 na Na 48–59 months 16.7 796 na Na 6 years na na 23.7 235 7 years na na 47.8 452 Mother’s education Primary/incomplete secondary 3.2 112 43.8 50 Secondary 7.5 770 31.3 320 Specialized secondary 20.0 376 45.6 174 Higher 32.5 394 50.0 140 Wealth index quintiles Poorest 2.8 438 19.2 185 Poor 8.6 355 37.3 146 Middle 12.5 318 44.6 130 Rich 22.5 273 49.7 108 Richest 44.8 270 59.2 118 Ethnicity/language Kazakh 12.4 1 072 32.0 460 Russian 29.4 377 70.3 145 Other 10.1 205 27.5 82 Total 16.0 1 654 39.5 687 * MICS indicator 52, ** MICS indicator 53 ( ) – indicators are based on 25 – 49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations na: not applicable KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 125 Table ED.2: Primary school entry Percentage of children of primary school entry age attending grade 1, Kazakhstan, 2006 Percentage of children of primary school entry age currently attending grade 1* Number of children of primary school entry age Sex Male 95.1 361 Female 90.4 340 Oblast Akmola (90.1) 42 Aktobe (95.7) 35 Almaty 91.9 83 Atyrau (97.9) 25 West Kazakhstan (97.2) 31 Zhambyl 89.3 50 Karagandy 94.0 54 Kostanai (90.3) 44 Kyzylorda (97.0) 39 Mangistau (*) 21 South Kazakhstan 100.0 116 Pavlodar (83.2) 28 North Kazakhstan (90.9) 32 East Kazakhstan 80.4 51 Astana City (*) 14 Almaty City (96.2) 36 Residence Urban 92.2 362 Rural 93.5 339 Age of child 7 years 92.9 701 Mother’s education Primary/incomplete secondary 88.4 51 Secondary 93.2 335 Specialized secondary 92.6 164 Higher 93.9 148 Wealth index quintiles Poorest 97.3 166 Poor 92.1 157 Middle 90.6 144 Rich 92.0 117 Richest 91.1 117 Ethnicity/language Kazakh 96.4 445 Russian 83.5 165 Other 92.3 91 Total 92.9 701 * MICS indicator 54 ( ) – indicators are based on 25-49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations MONITORING THE SITUATION OF CHILDREN AND WOMEN126 Table ED.3: Primary school net attendance ratio Percentage of children of primary school age attending primary or secondary school (NAR), Kazakhstan, 2006 MALE FEMALE TOTAL Net attend- ance ratio Number of children Net attend- ance ratio Number of children Net attend- ance ratio* Number of children Oblast Akmola 100.0 91 94.2 91 97.1 181 Aktobe 98.3 86 99.1 66 98.7 152 Almaty 97.8 203 99.3 166 98.5 368 Atyrau 98.5 55 (99.3) 46 98.9 101 West Kazakhstan 100.0 51 99.0 63 99.4 113 Zhambyl 98.3 106 96.0 106 97.2 212 Karagandy 98.8 142 98.7 129 98.8 271 Kostanai 98.2 118 97.3 80 97.9 198 Kyzylorda 97.2 75 100.0 67 98.5 143 Mangistau (99.0) 43 (99.5) 41 99.3 84 South Kazakhstan 99.3 315 99.6 257 99.4 572 Pavlodar 96.8 73 96.5 67 96.6 140 North Kazakhstan 98.7 61 96.3 57 97.6 117 East Kazakhstan 97.7 100 90.1 113 93.6 213 Astana City (95.2) 28 (91.5) 26 93.4 54 Almaty City 100.0 87 97.9 67 99.1 154 Residence Urban 98.8 837 97.3 721 98.1 1 558 Rural 98.3 797 97.7 721 98.0 1 518 Age 7 95.8 361 91.3 340 93.6 700 8 99.3 372 98.7 351 99.0 723 9 99.5 448 100.0 357 99.7 805 10 99.2 452 99.4 394 99.3 847 Mother’s education Primary/incomplete secondary 96.4 108 93.0 94 94.8 202 Secondary 98.5 765 98.1 687 98.3 1 453 Specialized secondary 98.7 430 97.3 378 98.1 809 Higher 99.1 320 97.6 278 98.4 598 Wealth index quintiles Poorest 98.1 429 99.0 382 98.5 811 Poor 98.7 358 97.2 308 98.0 666 Middle 98.7 311 96.5 275 97.6 586 Rich 98.3 292 97.8 248 98.1 539 Richest 99.1 244 96.2 230 97.7 473 Ethnicity/language Kazakh 99.2 1 080 98.6 977 98.9 2 058 Russian 97.5 348 93.1 313 95.4 661 Other 97.0 206 99.4 151 98.0 357 Total 98.5 1 634 97.5 1 442 98.0 3 076 * MICS indicator 55; MDG indicator 6 ( ) – indicators are based on 25-49 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 127 Table ED.4: Secondary school net attendance ratio Percentage of children of secondary school age attending secondary school or higher (NAR), Kazakhstan, 2006 MALE FEMALE TOTAL Net attend- ance ratio Number of children Net attend- ance ratio Number of children Net attend- ance ratio* Number of children Oblast Akmola 92.9 204 95.8 188 94.3 392 Aktobe 94.9 168 95.0 153 94.9 321 Almaty 92.4 367 94.1 383 93.3 750 Atyrau 97.0 123 94.8 122 95.9 245 West Kazakhstan 93.8 169 95.3 166 94.5 335 Zhambyl 96.5 239 94.6 239 95.5 478 Karagandy 96.6 337 95.2 321 95.9 658 Kostanai 94.4 258 97.3 208 95.7 466 Kyzylorda 94.6 171 96.6 162 95.6 333 Mangistau 99.3 86 98.1 78 98.7 164 South Kazakhstan 93.7 578 94.3 538 94.0 1 116 Pavlodar 94.0 193 95.3 171 94.6 364 North Kazakhstan 95.5 162 94.6 153 95.0 315 East Kazakhstan 97.9 316 97.8 331 97.9 647 Astana City 96.6 64 98.5 60 97.5 124 Almaty City 97.4 216 95.0 195 96.2 411 Residence Urban 95.7 1 884 95.6 1 789 95.6 3 673 Rural 94.4 1 767 95.3 1 679 94.9 3 446 Age 11 86.2 412 88.4 469 87.4 881 12 99.3 518 99.5 502 99.4 1 020 13 99.2 515 99.3 489 99.3 1 004 14 99.2 520 99.2 499 99.2 1 019 15 98.6 543 98.6 486 98.6 1 029 16 96.5 574 97.2 519 96.8 1 093 17 85.5 569 85.6 504 85.6 1 073 Mother’s education Primary/incomplete secondary 90.7 161 95.1 186 93.1 347 Secondary 93.5 1 519 95.2 1 488 94.4 3 007 Specialized secondary 96.1 1 115 96.2 1 003 96.1 2 118 Higher 97.7 718 96.8 649 97.3 1 367 Mother is not in HH 95.8 126 86.2 130 90.9 256 Wealth index quintiles Poorest 93.6 884 94.5 820 94.0 1 704 Poor 94.3 775 95.6 793 94.9 1 568 Middle 95.5 745 96.1 679 95.8 1 424 Rich 96.0 584 94.7 581 95.4 1 165 Richest 96.9 663 96.5 595 96.7 1 258 Ethnicity/language Kazakh 95.7 2 441 96.3 2 270 96.0 4 711 Russian 94.5 842 95.6 865 95.1 1 707 Other 92.3 368 89.1 333 90.8 701 Total 95.1 3 651 95.4 3 468 95.3 7 119 * MICS indicator 56 MONITORING THE SITUATION OF CHILDREN AND WOMEN128 Table ED.4W: Secondary school age children attending primary school Percentage of children of secondary school age attending primary school, Kazakhstan, 2006 MALE FEMALE TOTAL Percent at- tending pri- mary school Number of children Percent at- tending pri- mary school Percent at- tending pri- mary school Number of children Percent at- tending pri- mary school Oblast Akmola 3.1 204 1.5 188 2.3 392 Aktobe 1.6 168 0.6 153 1.1 321 Almaty 3.0 367 1.6 383 2.2 750 Atyrau 0.3 123 0.4 122 0.3 245 West Kazakhstan 2.4 169 2.0 166 2.2 335 Zhambyl 1.3 239 2.8 239 2.1 478 Karagandy 0.8 337 1.4 321 1.1 658 Kostanai 1.7 258 1.0 208 1.4 466 Kyzylorda 1.1 171 0.4 162 0.7 333 Mangistau 0.0 86 0.5 78 0.3 164 South Kazakhstan 1.1 578 2.5 538 1.8 1 116 Pavlodar 4.1 193 2.1 171 3.1 364 North Kazakhstan 1.5 162 2.7 153 2.1 315 East Kazakhstan 0.6 316 0.4 331 0.5 647 Astana City 1.4 64 1.5 60 1.4 124 Almaty City 0.6 216 1.4 195 1.0 411 Residence Urban 1.2 1 884 1.6 1 789 1.4 3 673 Rural 1.9 1 767 1.5 1 679 1.7 3 446 Age 11 13.5 412 11.2 469 12.3 881 12 0.2 518 0.2 502 0.2 1 020 13 0.0 515 0.0 489 0.0 1 004 14 0.0 520 0.0 499 0.0 1 019 15 0.0 543 0.0 486 0.0 1 029 16 0.0 574 0.0 519 0.0 1 093 17 0.0 569 0.0 504 0.0 1 073 Mother’s education Primary/incomplete secondary 4.1 161 2.4 186 3.2 347 Secondary 1.7 1 519 1.3 1 488 1.5 3 007 Specialized secondary 1.4 1 115 1.6 1 003 1.5 2 118 Higher 1.3 718 2.1 649 1.7 1 367 Mother in not in HH 0.0 126 0.0 130 0.0 256 None/DK 0.0 0 0.0 1 0.0 1 Wealth index quintiles Poorest 1.9 884 1.8 820 1.9 1 704 Poor 1.7 775 0.9 793 1.3 1 568 Middle 1.7 745 1.3 679 1.5 1 424 Rich 0.9 584 2.3 581 1.6 1 165 Richest 1.4 663 1.6 595 1.5 1 258 Ethnicity/language Kazakh 1.4 2 441 1.4 2 270 1.4 4 711 Russian 1.9 842 1.7 865 1.8 1 707 Other 1.6 368 2.3 333 2.0 701 Total 1.6 3 651 1.5 3 468 1.6 7 119 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 129 Table ED.5: Children reaching grade 5 Percentage of children entering first grade of primary school who eventually reach grade 5, Kazakhstan, 2006 Percent attend- ing 2nd grade who were in 1st grade last year Percent attend- ing 3rd grade who were in 2nd grade last year Percent attend- ing 4th grade who were in 3rd grade last year Percent attend- ing 5th grade who were in 4th grade last year Percent who reach grade 5 of those who enter 1st grade* Sex Male 99.7 99.7 100.0 100.0 99.5 Female 100.0 100.0 99.9 100.0 99.9 Oblast Akmola 100.0 100.0 100.0 100.0 100.0 Aktobe 100.0 100.0 100.0 100.0 100.0 Almaty 98.9 98.8 100.0 100.0 97.6 Atyrau 100.0 100.0 100.0 100.0 100.0 West Kazakhstan 100.0 100.0 100.0 100.0 100.0 Zhambyl 100.0 100.0 100.0 100.0 100.0 Karagandy 100.0 100.0 100.0 100.0 100.0 Kostanai 100.0 100.0 100.0 100.0 100.0 Kyzylorda 100.0 100.0 100.0 100.0 100.0 Mangistau 100.0 100.0 100.0 100.0 100.0 South Kazakhstan 100.0 100.0 100.0 100.0 100.0 Pavlodar 100.0 100.0 100.0 100.0 100.0 North Kazakhstan 100.0 100.0 100.0 100.0 100.0 East Kazakhstan 100.0 100.0 100.0 100.0 100.0 Astana City 100.0 100.0 97.1 100.0 97.1 Almaty City 100.0 100.0 100.0 100.0 100.0 Residence Urban 100.0 100.0 99.9 100.0 99.9 Rural 99.7 99.7 100.0 100.0 99.4 Mother’s education Primary/incomplete secondary 100.0 100.0 100.0 100.0 100.0 Secondary 100.0 100.0 100.0 100.0 100.0 Specialized secondary 99.4 99.5 100.0 100.0 98.9 Higher 100.0 100.0 99.7 100.0 99.7 Wealth index quintiles Poorest 99.4 99.5 100.0 100.0 98.9 Poor 100.0 100.0 100.0 100.0 100.0 Middle 100.0 100.0 100.0 100.0 100.0 Rich 100.0 100.0 100.0 100.0 100.0 Richest 100.0 100.0 99.7 100.0 99.7 Ethnicity/language Kazakh 100.0 100.0 99.9 100.0 99.9 Russian 100.0 100.0 100.0 100.0 100.0 Other 98.9 98.6 100.0 100.0 97.6 Total 99.9 99.9 99.9 100.0 99.7 * MICS indicator 57; MDG indicator 7 MONITORING THE SITUATION OF CHILDREN AND WOMEN130 Table ED.6: Primary school completion and transition to secondary education Primary school completion rate and transition rate to secondary education, Kazakhstan, 2006 Net primary school completion rate* Number of children of primary school completion age Transition rate to secondary educa- tion** Number of children who were in the last grade of primary school the previous year Sex Male 87.9 452 99.5 458 Female 88.9 394 99.9 501 Oblast Akmola (85.7) 42 (97.7) 43 Aktobe 88.5 41 98.5 38 Almaty 79.7 105 100.0 98 Atyrau 90.4 28 100.0 33 West Kazakhstan (95.6) 28 (98.6) 45 Zhambyl 89.5 63 100.0 78 Karagandy (90.2) 67 100.0 82 Kostanai 88.0 66 100.0 70 Kyzylorda 95.2 40 99.2 51 Mangistau 91.1 21 100.0 23 South Kazakhstan 95.3 169 100.0 166 Pavlodar (81.5) 34 (100.0) 48 North Kazakhstan (*) 22 (100.0) 39 East Kazakhstan (79.3) 63 100.0 74 Astana City (88.2) 15 (97.2) 16 Almaty City (90.0) 42 (100.0) 55 Residence Urban 88.6 419 99.9 471 Rural 88.2 427 99.5 488 Mother’s education Primary/incomplete secondary (80.8) 47 (100.0) 42 Secondary 87.0 405 99.7 442 Specialized secondary 90.1 236 99.7 278 Higher 92.8 154 99.7 192 Wealth index quintiles Poorest 86.6 238 99.4 250 Poor 88.2 188 99.7 214 Middle 89.1 152 100.0 187 Rich 89.6 148 99.5 157 Richest 90.1 120 100.0 151 Ethnicity/language Kazakh 89.4 582 99.6 648 Russian 82.8 169 100.0 204 Other 92.2 95 99.6 107 Total 88.4 846 99.7 959 * MICS indicator 59; MDG indicator 7b ** MICS indicator 58 ( ) – indicators are based on 25-49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 131 Table ED.7: Education gender parity Ratio of girls to boys attending primary education and ratio of girls to boys attending secondary education, Kazakhstan, 2006 Primary school net attend- ance ratio (NAR), girls Primary school net attend- ance ratio (NAR), boys Gender parity index (GPI) for primary school NAR* Secondary school net at- tendance ratio (NAR), girls Secondary school net at- tendance ratio (NAR), boys Gender parity index (GPI) for secondary school NAR* Oblast Akmola 94.2 100.0 0.94 95.8 92.9 1.03 Aktobe 99.1 98.3 1.01 95.0 94.9 1.00 Almaty 99.3 97.8 1.02 94.1 92.4 1.02 Atyrau 99.3 98.5 1.01 94.8 97.0 0.98 West Kazakhstan 99.0 100.0 0.99 95.3 93.8 1.02 Zhambyl 96.0 98.3 0.98 94.6 96.5 0.98 Karagandy 98.7 98.8 1.00 95.2 96.6 0.99 Kostanai 97.3 98.2 0.99 97.3 94.4 1.03 Kyzylorda 100.0 97.2 1.03 96.6 94.6 1.02 Mangistau 99.5 99.0 1.01 98.1 99.3 0.99 South Kazakhstan 99.6 99.3 1.00 94.3 93.7 1.01 Pavlodar 96.5 96.8 1.00 95.3 94.0 1.01 North Kazakhstan 96.3 98.7 0.98 94.6 95.5 0.99 East Kazakhstan 90.1 97.7 0.92 97.8 97.9 1.00 Astana City 91.5 95.2 0.96 98.5 96.6 1.02 Almaty City 97.9 100.0 0.98 95.0 97.4 0.97 Residence Urban 97.3 98.8 0.98 95.6 95.7 1.00 Rural 97.7 98.3 0.99 95.3 94.4 1.01 Mother’s education Primary/incomplete secondary 93.0 96.4 0.96 95.1 90.7 1.05 Secondary 98.1 98.5 1.00 95.2 93.5 1.02 Specialized secondary 97.3 98.7 0.99 96.2 96.1 1.00 Higher 97.6 99.1 0.98 96.8 97.7 0.99 Mother in not in HH na na na 86.2 95.8 0.90 Absent/DK na na na 100.0 na na Wealth index quintiles Poorest 99.0 98.1 1.01 94.5 93.6 1.01 Poor 97.2 98.7 0.98 95.6 94.3 1.01 Middle 96.5 98.7 0.98 96.1 95.5 1.01 Rich 97.8 98.3 0.99 94.7 96.0 0.99 Richest 96.2 99.1 0.97 96.5 96.9 1.00 Ethnicity/language Kazakh 98.6 99.2 0.99 96.3 95.7 1.01 Russian 93.1 97.5 0.95 95.6 94.5 1.01 Other 99.4 97.0 1.02 89.1 92.3 0.97 Total 97.5 98.5 0.99 95.4 95.1 1.00 * MICS indicator 61; MDG indicator 9 na: not applicable MONITORING THE SITUATION OF CHILDREN AND WOMEN132 Table ED.8: Adult literacy Percentage of women aged 15-24 years that are literate, Kazakhstan, 2006 Percentage literate* Number of women aged 15-24 years Oblast Akmola 100.0 221 Aktobe 99.7 217 Almaty 99.7 451 Atyrau 100.0 175 West Kazakhstan 99.3 239 Zhambyl 99.7 276 Karagandy 100.0 486 Kostanai 99.5 296 Kyzylorda 99.4 177 Mangistau 100.0 117 South Kazakhstan 99.8 602 Pavlodar 99.5 255 North Kazakhstan 100.0 175 East Kazakhstan 99.6 469 Astana City 99.6 109 Almaty City 100.0 312 Residence Urban 99.7 2 627 Rural 99.8 1 950 Education Primary/incomplete secondary 99.2 1 502 Secondary 100.0 1 034 Specialized secondary 100.0 844 Higher 100.0 1 197 Age 15–19 99.7 2 469 20–24 99.8 2 108 Wealth index quintiles Poorest 99.8 964 Poor 99.7 878 Middle 99.7 870 Rich 99.5 846 Richest 100.0 1 019 Ethnicity/language Kazakh 99.8 2 752 Russian 99.9 1 304 Other 99.5 521 Total 99.8 4 577 * MICS indicator 60; MDG indicator 8 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 133 Table CP.1: Birth registration Percent distribution of children aged 0-59 months by whether birth is registered and reasons for non-registration, Kazakhstan, 2006 Birth is registered* Number of children aged 0-59 months Sex Male 99.3 2 327 Female 99.2 2 088 Oblast Akmola 98.7 243 Aktobe 99.7 181 Almaty 98.8 545 Atyrau 100.0 143 West Kazakhstan 99.5 152 Zhambyl 98.6 345 Karagandy 98.9 316 Kostanai 98.5 267 Kyzylorda 99.7 209 Mangistau 99.4 109 South Kazakhstan 99.2 827 Pavlodar 99.3 197 North Kazakhstan 99.1 163 East Kazakhstan 100.0 304 Astana City 100.0 90 Almaty City 100.0 324 Residence Urban 99.2 2 251 Rural 99.2 2 164 Age 0–11 months 98.4 844 12–23 months 99.7 969 24–35 months 99.4 948 36–47 months 99.4 858 48–59 months 99.2 796 Mother’s education Primary/incomplete secondary 98.6 309 Secondary 99.0 2 000 Specialized secondary 99.2 1 030 Higher 99.8 1 076 Wealth index quintiles Poorest 99.0 1 189 Poor 99.3 924 Middle 99.3 869 Rich 99.1 708 Richest 99.6 725 Ethnicity/language Kazakh 99.3 2 924 Russian 99.4 931 Other 98.6 560 Total 99.2 4 415 * MICS indicator 62 MONITORING THE SITUATION OF CHILDREN AND WOMEN134 Table CP.2: Child labor Percentage of children aged 5-14 years who are involved in child labor activities by type of work, Kazakhstan, 2006 Working outside household Household chores for 28+ hours/ week Working for family busi- ness Total child labor* Number of children aged 5-14 yearsPaid work Unpaid work Sex Male 0.1 1.1 0.4 1.2 2.4 4 280 Female 0.1 0.9 0.6 0.9 2.1 4 041 Oblast Akmola 0.0 0.9 0.2 0.9 1.1 471 Aktobe 0.0 2.4 0.1 0.7 2.6 390 Almaty 0.0 0.2 0.6 0.1 0.9 954 Atyrau 0.0 0.0 0.0 0.2 0.2 274 West Kazakhstan 0.0 1.0 0.0 2.1 2.4 344 Zhambyl 0.0 0.8 0.0 0.3 1.0 604 Karagandy 0.2 0.2 0.0 0.0 0.5 718 Kostanai 0.0 2.9 0.6 1.9 4.8 514 Kyzylorda 0.2 1.6 2.6 4.0 7.2 403 Mangistau 0.0 1.2 0.0 1.0 1.8 207 South Kazakhstan 0.2 0.5 0.3 1.1 1.6 1 481 Pavlodar 0.3 4.6 0.0 3.1 5.9 382 North Kazakhstan 0.2 0.7 0.4 3.0 4.2 345 East Kazakhstan 0.0 0.2 0.4 0.4 1.0 611 Astana City 0.0 1.1 3.4 0.6 4.6 155 Almaty City 0.0 0.9 1.5 0.0 2.4 468 Residence Urban 0.1 1.2 0.7 1.1 2.5 4 203 Rural 0.1 0.8 0.3 1.0 1.9 4 118 Age 5–11years 0.0 1.5 0.4 1.4 2.7 5 277 12–14 years 0.2 0.1 0.7 0.5 1.4 3 044 School participation Yes 0.1 1.0 0.5 1.1 2.3 7 545 No 0.2 0.9 0.3 0.2 1.4 776 Mother’s education Primary/incomplete secondary 0.2 0.2 0.3 1.3 1.9 498 Secondary 0.1 0.9 0.4 1.3 2.3 3 794 Specialized secondary 0.1 1.0 0.6 0.7 2.0 2 319 Higher 0.1 1.5 0.7 1.0 2.6 1 677 Wealth index quintiles Poorest 0.1 0.4 0.5 0.9 1.8 2 139 Poor 0.0 0.8 0.5 1.1 2.1 1 860 Middle 0.0 1.3 0.3 1.7 2.8 1 589 Rich 0.2 1.7 0.2 1.0 2.4 1 401 Richest 0.1 1.1 1.0 0.4 2.2 1 332 Ethnicity/language Kazakh 0.1 1.0 0.5 1.0 2.1 5 583 Russian 0.0 1.3 0.5 1.1 2.5 1 812 Other 0.3 0.4 0.7 1.2 2.4 926 Total 0.1 1.0 0.5 1.0 2.2 8 321 * MICS indicator 71 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 135 Table CP.3: Laborer students and student laborers Percentage of children aged 5-14 years who are laborer students and student laborers, Kazakhstan, 2006 Percentage of children in child labor Percentage of children attending school Number of children 5-14 years of age Percentage of child laborers who are also attending school* Number of child lab- orers aged 5-14 Percentage of students who are also involved in child labor** Number of stu- dents aged 5-14 Sex Male 2.4 90.4 4 281 97.7 101 2.5 3 871 Female 2.1 90.9 4 040 90.1 84 2.1 3 674 Oblast Akmola 1.1 92.7 471 100.0 5 1.2 436 Aktobe 2.6 92.6 390 100.0 10 2.8 362 Almaty 0.9 87.8 954 100.0 9 1.0 838 Atyrau 0.2 92.5 274 100.0 1 0.2 254 West Kazakhstan 2.4 92.5 344 89.5 8 2.4 318 Zhambyl 1.0 91.2 604 100.0 6 1.1 550 Karagandy 0.5 92.7 718 50.0 3 0.2 666 Kostanai 4.8 92.8 514 94.1 25 4.9 477 Kyzylorda 7.2 88.3 403 94.7 29 7.7 356 Mangistau 1.8 90.6 207 100.0 4 2.0 187 South Kazakhstan 1.6 89.0 1 481 100.0 24 1.8 1 317 Pavlodar 5.9 92.3 382 100.0 22 6.3 353 North Kazakhstan 4.2 95.6 345 100.0 15 4.4 330 East Kazakhstan 1.0 88.8 611 100.0 6 1.1 543 Astana City 4.6 92.0 155 87.5 7 4.4 142 Almaty City 2.4 88.9 468 62.5 11 1.7 416 Residence Urban 2.5 90.9 4 203 90.3 106 2.5 3 821 Rural 1.9 90.5 4 118 99.5 79 2.1 3 724 Age 5–9 years 2.7 85.7 5 277 94.1 142 3.0 4 520 10–14 years 1.4 99.4 3 044 94.8 43 1.3 3 025 Mother’s education Primary/incomplete secondary 1.9 89.4 498 100.0 10 2.1 445 Secondary 2.3 89.6 3 794 93.1 86 2.4 3 400 Specialized secondary 2.0 91.4 2 319 95.7 46 2.1 2 218 Higher 2.6 92.6 1 677 93.8 43 2.6 1 552 Wealth index quintiles Poorest 1.8 89.0 2 139 99.0 38 2.0 1 905 Poor 2.1 90.0 1 860 96.3 40 2.3 1 673 Middle 2.8 91.2 1 589 96.9 45 3.0 1 449 Rich 2.4 92.3 1 401 86.5 33 2.2 1 292 Richest 2.2 92.0 1 332 90.2 29 2.1 1 226 Ethnicity/language Kazakh 2.1 91.1 5 583 92.8 118 2.1 5 089 Russian 2.5 91.4 1 812 99.0 45 2.7 1 656 Other 2.4 86.5 926 92.7 22 2.6 800 Total 2.2 90.7 8 321 94.3 185 2.3 7 545 * MICS indicator 72 ** MICS indicator 73 MONITORING THE SITUATION OF CHILDREN AND WOMEN136 Table CP.4: Child discipline Percentage of children aged 2-14 years according to method of disciplining the child, Kazakhstan, 2006 Percentage of children 2-14 years of age who experience: M ot he r/ ca re ta ke r b el ie ve s th at th e ch ild ne ed s to b e ph ys ic al ly p un - is he d N um be r o f c hi l- dr en a ge d 2- 14 ye ar s O nl y no n- vi ol en t di sc ip lin e Ps yc ho lo gi ca l pu ni sh m en t M in or p hy si - ca l p un is h- m en t Se ve re p hy si - ca l p un is h- m en t A ny p sy - ch ol og ic al or p hy si ca l pu ni sh m en t* N o di sc ip lin e or p un is h- m en t Sex Male 8.5 3 376 25.3 1.1 55.1 16.8 8.5 3 376 Female 6.3 3 034 20.3 0.4 48.9 17.9 6.3 3 035 Oblast Akmola 4.1 298 23.8 0.8 54.0 23.8 11.1 382 Aktobe 5.7 705 11.5 0.8 39.5 9.6 4.1 298 Almaty 0.0 184 7.3 0.0 24.6 32.6 5.7 705 Atyrau 7.0 276 25.8 0.6 55.4 25.5 0.0 184 West Kazakhstan 7.4 441 20.9 0.3 57.0 12.7 7.0 276 Zhambyl 10.6 614 39.9 1.0 62.5 11.5 7.4 441 Karagandy 8.7 452 32.9 0.5 68.8 0.9 10.6 614 Kostanai 14.4 265 18.5 0.2 44.9 35.2 8.7 452 Kyzylorda 0.6 142 32.1 5.6 58.7 17.4 14.4 265 Mangistau 3.6 899 20.2 0.4 40.9 19.7 0.6 141 South Kazakhstan 7.2 332 18.5 0.2 55.7 23.6 3.6 899 Pavlodar 12.7 298 40.3 1.0 71.5 1.0 7.2 332 North Kazakhstan 12.5 558 29.6 2.0 65.9 12.4 12.7 298 East Kazakhstan 8.7 142 24.2 0.4 52.9 10.1 12.5 558 Astana City 2.3 424 37.4 1.6 61.1 21.2 8.7 142 Almaty City 50.2 35.3 8.9 0.0 37.3 12.5 2.3 424 Residence Urban 31.2 49.6 25.9 0.9 54.7 14.0 7.5 3 525 Rural 29.5 45.7 19.3 0.5 49.1 21.4 7.3 2 886 Age of child 2-4 years 31.0 37.3 29.8 0.5 46.4 22.7 6.8 1 398 5-9 years 28.0 52.4 27.2 1.0 56.3 15.7 8.2 2 082 10-14 years 32.0 49.6 16.6 0.6 52.1 16.0 7.2 2 931 Mother’s education Primary/incomplete secondary 22.7 54.6 30.7 0.8 60.7 16.6 10.8 397 Secondary 29.9 48.7 22.5 0.8 52.9 17.2 7.7 2 717 Specialized secondary 30.7 48.5 23.8 0.6 52.7 16.6 7.6 1 831 Higher 33.4 43.4 20.6 0.7 47.7 18.9 5.8 1 452 Wealth index quintiles Poorest 29.2 47.6 21.0 0.7 51.0 19.8 5.6 1 385 Poor 28.3 45.1 21.0 0.8 49.1 22.6 8.1 1 323 Middle 28.5 49.9 23.8 0.7 54.5 17.0 8.1 1 264 Rich 34.7 47.1 22.5 1.0 52.6 12.7 8.8 1 197 Richest 32.0 49.6 26.6 0.4 54.2 13.8 6.7 1 242 Ethnicity/language Kazakh 32.5 44.9 21.7 0.8 49.1 18.4 6.5 4 012 Russian 26.1 54.9 26.9 0.6 59.9 14.0 10.6 1 725 Other 29.2 47.2 20.1 0.6 51.1 19.7 5.0 674 Total 30.5 47.8 22.9 0.7 52.2 17.3 7.4 6 411 * MICS indicator 74 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 137 Table CP.5: Early marriage Percentage of women aged 15-49 years in marriage or union before their 15th birthday, percentage of women aged 20-49 years in marriage or union before their 18th birthday, percentage of women aged 15-19 years currently mar- ried or in union, Kazakhstan, 2006 Percentage married before age 15* Number of women aged 15-49 years Percentage married before age 18* Number of women aged 20-49 years Percentage of women 15-19 married/in union** Number of women aged 15-19 years Number of women aged 15-49 years currently mar- ried/in union Oblast Akmola 0.4 797 9.6 668 3.8 129 529 Aktobe 0.0 675 5.8 560 2.0 115 348 Almaty 0.3 1 475 9.0 1 225 5.8 250 875 Atyrau 0.2 458 4.2 356 3.3 102 236 West Kazakhstan 0.0 699 5.4 565 4.4 134 388 Zhambyl 0.3 877 12.0 725 6.0 152 510 Karagandy 0.4 1 476 11.1 1 207 7.0 269 799 Kostanai 0.3 1 015 10.1 851 7.4 164 584 Kyzylorda 0.2 528 6.9 430 2.3 98 301 Mangistau 0.0 335 4.6 279 3.5 56 183 South Kazakhstan 0.2 1 768 7.8 1 459 6.0 309 1 155 Pavlodar 0.3 820 9.0 686 5.0 134 463 North Kazakhstan 0.4 674 11.3 573 2.7 101 418 East Kazakhstan 1.0 1 467 9.3 1 217 3.0 250 809 Astana City 0.7 368 5.6 319 (2.0) 49 204 Almaty City 0.5 1 126 5.8 969 5.7 157 547 Residence Urban 0.4 8 655 7.8 7 271 4.7 1 384 4 652 Rural 0.3 5 903 9.5 4 818 5.1 1 085 3 697 Age 15–19 0.2 2 469 Na Na 4.9 2 469 121 20–24 0.5 2 108 7.3 2 108 Na Na 921 25–29 0.3 1 894 13.4 1 894 Na Na 1 298 30–34 0.4 1 900 11.0 1 900 Na Na 1 399 35–39 0.5 2 055 7.4 2 055 Na Na 1 563 40–44 0.3 2 076 6.5 2 076 Na Na 1 576 45–49 0.5 2 056 6.1 2 056 Na Na 1 471 Education Primary/incomplete secondary 0.7 1 948 24.8 582 1.7 1 366 402 Secondary 0.4 4 892 12.4 4 555 20.6 337 3 441 Specialized secondary 0.3 3 950 5.9 3 533 5.2 417 2 449 Higher 0.2 3 768 3.2 3 419 1.6 349 2 057 Wealth index quintiles Poorest 0.3 2 689 9.7 2 162 4.5 527 1 623 Poor 0.4 2 728 9.1 2 237 4.7 491 1 669 Middle 0.4 2 824 9.1 2 348 4.9 476 1 709 Rich 0.3 2 915 9.0 2 484 6.1 431 1 605 Richest 0.3 3 402 6.3 2 858 4.4 544 1 743 Ethnicity/language Kazakh 0.2 8 608 5.8 7 081 3.7 1 527 5 017 Russian 0.7 4 481 11.9 3 801 5.8 680 2 466 Other 0.4 1 469 13.6 1 207 9.4 262 866 Total 0.4 14 558 8.5 12 089 4.9 2 469 8 349 * MICS indicator 67 ** MICS indicator 68 ( ) – indicators are based on 25 – 49 cases of unweighted observations na: not applicable MONITORING THE SITUATION OF CHILDREN AND WOMEN138 Table CP.6: Spousal age difference Percent distribution of currently married/in union women aged 20-24 years according to the age difference with their husband or partner, Kazakhstan, 2006 PERCENTAGE OF CURRENTLY MARRIED/IN UNION WOMEN AGED 20-24 YEARS WHOSE HUSBAND OR PARTNER IS: Total Number of women aged 20-24 years currently mar- ried/ in union Younger 0-4 years older 5-9 years older 10+ years older* Husband/ partner’s age unknown Oblast Akmola (10.7) (48.9) (33.1) (7.4) (0.0) 100.0 46 Aktobe (3.7) (60.8) (30.0) (5.5) (0.0) 100.0 42 Almaty 4.5 50.2 32.2 10.2 2.9 100.0 96 Atyrau (8.4) (63.5) (24.5) (3.5) (0.0) 100.0 25 West Kazakhstan (14.0) (55.4) (24.6) (5.9) (0.0) 100.0 34 Zhambyl 5.5 40.9 41.4 12.1 0.0 100.0 67 Karagandy 7.4 62.0 22.1 8.6 0.0 100.0 93 Kostanai 5.4 55.9 32.7 5.9 0.0 100.0 56 Kyzylorda (2.1) (64.1) (27.4) (6.4) (0.0) 100.0 29 Mangistau (*) (*) (*) (*) (*) 100.0 21 South Kazakhstan 1.6 59.0 34.6 4.2 0.6 100.0 175 Pavlodar 4.8 58.8 30.2 6.2 0.0 100.0 54 North Kazakhstan (14.5) (53.3) (21.5) (10.7) (0.0) 100.0 36 East Kazakhstan 9.6 57.0 27.4 6.0 0.0 100.0 73 Astana City (5.8) (53.8) (26.9) (11.5) (1.9) 100.0 25 Almaty City (3.0) (63.6) (18.2) (12.1) (3.0) 100.0 49 Residence Urban 7.5 60.5 25.1 6.1 0.8 100.0 472 Rural 3.9 52.4 34.4 8.8 0.5 100.0 449 Education Primary/incomplete secondary 4.4 44.4 42.1 9.1 0.0 100.0 73 Secondary 3.7 52.2 31.3 11.7 1.1 100.0 382 Specialized secondary 7.4 67.4 20.5 4.0 0.7 100.0 171 Higher 7.7 58.9 29.8 3.5 0.2 100.0 295 Wealth index quintiles Poorest 3.1 47.7 39.1 9.0 1.1 100.0 213 Poor 5.3 56.8 28.8 9.1 0.0 100.0 197 Middle 3.3 55.2 30.4 9.0 2.0 100.0 177 Rich 9.5 61.7 24.6 4.2 0.0 100.0 178 Richest 8.2 63.8 22.8 5.1 0.0 100.0 156 Ethnicity/language Kazakh 4.2 55.9 32.8 6.3 0.8 100.0 527 Russian 11.5 58.0 22.0 8.5 0.0 100.0 255 Other 0.9 56.3 31.9 9.7 1.1 100.0 139 Total 5.7 56.5 29.7 7.4 0.6 100.0 921 * MICS indicator 69 ( ) – indicators are based on 25 – 49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 139 Table CP.9: Attitudes toward domestic violence Percentage of women aged 15-49 years who believe a husband is justified in beating his wife/partner in various cir- cumstances, Kazakhstan, 2006 PERCENTAGE OF WOMEN AGED 15-49 YEARS WHO BELIEVE A HUSBAND IS JUSTIFIED IN BEATING HIS WIFE/PARTNER: Number of women aged 15-49 years When she goes out without telling him When she neglects the children When she argues with him When she refuses sex with him When she burns the food For any of these reasons* Oblast Akmola 3.2 17.8 7.2 2.2 3.3 22.2 797 Aktobe 1.7 6.3 4.4 2.1 1.3 9.2 675 Almaty 0.2 2.1 0.6 0.3 0.0 2.2 1 475 Atyrau 7.9 10.0 12.5 1.4 2.2 16.5 458 West Kazakhstan 0.6 5.1 1.3 2.2 0.4 7.1 699 Zhambyl 2.0 5.6 4.9 1.8 1.8 9.9 877 Karagandy 2.2 10.0 4.6 2.2 4.6 13.2 1 476 Kostanai 0.6 4.2 1.7 0.8 0.3 5.2 1 015 Kyzylorda 24.1 17.6 28.6 9.4 13.1 47.6 528 Mangistau 1.5 1.9 2.3 0.6 0.7 3.6 335 South Kazakhstan 1.7 1.5 2.1 0.9 0.3 3.9 1 768 Pavlodar 2.2 11.2 4.5 1.7 1.3 14.4 820 North Kazakhstan 1.5 7.4 2.7 1.2 1.9 8.7 674 East Kazakhstan 1.4 8.6 2.7 0.9 1.4 10.1 1 467 Astana City 0.5 2.3 1.0 0.1 0.3 3.3 368 Almaty City 0.8 8.8 3.1 0.4 0.4 10.0 1 126 Residence Urban 2.5 7.0 4.2 1.5 1.9 10.3 8 655 Rural 2.4 7.3 4.4 1.7 1.7 10.4 5 903 Age 15–19 1.1 4.8 2.3 0.6 1.2 6.8 2 469 20–24 1.7 6.8 3.2 1.4 1.6 9.3 2 108 25–29 3.1 7.2 4.4 2.3 2.5 11.2 1 894 30–34 3.4 8.0 5.5 1.7 1.6 12.0 1 900 35–39 3.2 8.1 5.9 1.9 2.1 12.0 2 055 40–44 2.6 7.8 4.8 1.8 1.8 11.5 2 076 45–49 2.6 7.7 4.3 1.3 1.9 10.7 2 056 Marital/Union status Currently married/in union 3.2 8.3 5.3 1.8 2.1 12.3 8 349 Formerly married/in union 2.5 7.7 4.2 2.1 2.0 10.4 2 049 Never married/in union 1.1 4.6 2.3 0.7 1.1 6.5 4 160 Education Primary/incomplete secondary 1.8 6.0 3.2 1.1 1.6 8.4 1 948 Secondary 3.5 9.2 5.2 2.0 2.5 12.9 4 892 Specialized secondary 2.3 6.2 4.1 1.8 1.7 9.8 3 950 Higher 1.7 6.0 3.7 0.9 1.1 8.7 3 768 Wealth index quintiles Poorest 3.4 6.8 5.0 2.2 2.2 10.7 2 689 Poor 3.1 7.8 5.0 2.1 2.4 11.6 2 728 Middle 3.0 8.1 4.6 1.5 1.6 12.1 2 824 Rich 2.0 7.7 3.9 1.3 1.6 10.3 2 915 Richest 1.2 5.5 3.0 0.9 1.3 7.8 3 402 Ethnicity/language Kazakh 3.3 7.4 5.6 1.9 2.1 11.6 8 608 Russian 1.1 7.0 2.1 1.0 1.2 8.7 4 481 Other 2.2 5.9 3.3 1.3 1.6 8.3 1 469 Total 2.5 7.1 4.3 1.5 1.8 10.4 14 558 * MICS indicator 100 MONITORING THE SITUATION OF CHILDREN AND WOMEN140 Table HA.1: Knowledge of preventing HIV transmission Percentage of women aged 15-49 years who know the main ways of preventing HIV transmission, Kazakhstan, 2006 Heard of HIV/ AIDS Percentage who know HIV transmis- sion can be prevented by: Knows all three ways Knows at least one way Doesn’t know any way Number of women aged 15- 49 years Having only one faithful uninfected sex partner Using a condom every time Abstaining from sex Oblast Akmola 98.5 78.4 73.0 51.6 35.8 91.4 8.6 797 Aktobe 97.6 74.1 59.9 41.1 28.3 84.4 15.6 675 Almaty 97.3 79.7 76.4 52.8 45.4 87.9 12.1 1 475 Atyrau 98.0 53.5 67.1 53.6 36.9 77.8 22.2 458 West Kazakhstan 99.3 71.0 70.1 42.6 34.9 81.4 18.6 699 Zhambyl 97.4 51.9 48.9 35.8 22.0 67.1 32.9 877 Karagandy 99.8 78.4 73.1 45.6 34.3 88.3 11.7 1 476 Kostanai 98.6 59.5 53.8 32.2 22.6 71.9 28.1 1 015 Kyzylorda 94.1 43.8 34.6 31.4 16.2 58.0 42.0 528 Mangistau 99.1 36.8 31.6 38.7 20.5 50.0 50.0 335 South Kazakhstan 99.4 52.4 50.5 40.8 30.8 65.3 34.7 1 768 Pavlodar 99.2 80.8 72.8 30.4 20.4 90.4 9.6 820 North Kazakhstan 99.6 79.4 77.7 44.9 32.8 93.5 6.5 674 East Kazakhstan 99.1 75.1 69.1 40.8 27.7 89.1 10.9 1 467 Astana City 98.8 78.5 76.2 54.4 43.2 90.5 9.5 368 Almaty City 99.9 41.5 52.5 47.1 22.4 76.0 24.0 1 126 Residence Urban 99.2 66.5 63.7 43.1 29.6 81.7 18.3 8 655 Rural 97.8 65.0 61.6 42.3 31.0 77.4 22.6 5 903 Age 15–19 97.3 58.4 56.0 39.8 27.6 71.8 28.2 2 469 20–24 99.4 65.9 63.6 42.0 29.9 80.6 19.4 2 108 25–29 98.9 65.7 63.5 43.0 30.5 80.4 19.6 1 894 30–34 98.9 69.1 64.5 42.6 30.2 82.4 17.6 1 900 35–39 99.1 69.2 65.9 44.0 31.9 82.6 17.4 2 055 40–44 98.9 67.1 64.8 44.6 31.5 81.8 18.2 2 076 45–49 98.4 67.6 63.3 43.7 30.2 81.8 18.2 2 056 Education Primary/incomplete secondary 95.7 56.7 54.1 36.9 25.9 69.7 30.3 1 948 Secondary 98.4 65.9 62.7 43.4 31.0 79.7 20.3 4 892 Specialized secondary 99.5 69.8 66.8 43.4 30.6 83.6 16.4 3 950 Higher 99.7 66.6 63.4 44.2 30.8 81.7 18.3 3 768 Wealth index quintiles Poorest 96.7 57.3 55.4 39.4 27.9 70.8 29.2 2 689 Poor 98.1 67.5 62.3 43.9 32.0 80.5 19.5 2 728 Middle 99.1 69.6 66.1 43.7 32.3 82.0 18.0 2 824 Rich 99.3 67.7 63.9 43.8 30.6 81.9 18.1 2 915 Richest 99.7 66.8 65.6 42.7 28.5 83.3 16.7 3 402 Ethnicity/language Kazakh 98.2 63.9 59.9 43.2 30.2 77.4 22.6 8 608 Russian 99.7 70.9 69.9 42.0 30.0 85.8 14.2 4 481 Other 98.4 62.6 58.8 42.3 31.0 76.8 23.2 1 469 Total 98.7 65.9 62.9 42.7 30.2 79.9 20.1 14 558 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 141 Table HA.2: Identifying misconceptions about HIV/AIDS Percentage of women aged 15-49 years who correctly identify misconceptions about HIV/AIDS, Kazakhstan, 2006 Percent who know that: Reject two most common mis- conceptions and know a healthy- looking person can be infected Percent who know that: Number of women aged 15- 49 years HIV cannot be trans- mitted by: A healthy looking person can be infected Option 3: HIV cannot be transmitted by supernat- ural means Option 4: HIV can be transmitted by sharing needles Option 1: Sharing food Option 2: Mosquito bites Oblast Akmola 64.2 47.0 79.4 34.6 78.7 96.1 797 Aktobe 62.2 64.4 59.1 30.7 80.1 92.3 675 Almaty 80.4 66.0 54.7 38.6 79.8 95.2 1 475 Atyrau 68.5 70.8 54.3 35.8 75.3 90.5 458 West Kazakhstan 76.4 80.7 69.7 48.0 90.3 98.3 699 Zhambyl 59.2 63.8 52.0 29.2 78.3 93.2 877 Karagandy 69.1 64.1 61.0 32.4 78.1 97.5 1 476 Kostanai 79.1 75.9 81.5 55.6 92.8 97.4 1 015 Kyzylorda 40.1 71.6 43.5 24.6 74.7 84.2 528 Mangistau 61.7 80.3 71.0 41.5 91.2 97.4 335 South Kazakhstan 59.2 43.1 64.6 25.8 65.7 97.7 1 768 Pavlodar 78.4 66.5 84.9 49.8 77.9 98.2 820 North Kazakhstan 70.0 56.6 81.3 40.0 73.7 96.6 674 East Kazakhstan 77.0 55.3 66.9 36.0 90.2 97.3 1 467 Astana City 84.1 74.5 86.0 62.5 89.8 98.0 368 Almaty City 59.6 40.6 81.0 24.7 76.9 99.9 1 126 Residence Urban 70.7 62.3 71.1 39.0 82.4 97.2 8 655 Rural 65.7 58.2 62.2 32.5 76.1 94.8 5 903 Age 15–19 67.1 60.8 63.6 36.2 77.5 93.6 2 469 20–24 68.4 62.3 67.3 37.2 82.3 97.1 2 108 25–29 69.1 62.5 69.0 37.4 81.2 96.6 1 894 30–34 69.4 61.2 67.1 35.9 80.1 96.8 1 900 35–39 70.3 61.4 68.7 37.5 79.4 97.0 2 055 40–44 68.0 59.5 69.4 35.3 80.1 97.3 2 076 45–49 68.9 56.7 68.2 34.9 78.7 95.7 2 056 Education Primary/incomplete secondary 61.8 53.7 59.9 30.3 71.1 91.7 1 948 Secondary 64.1 57.0 60.9 29.8 76.4 95.8 4 892 Specialized secondary 72.3 63.4 71.8 40.1 82.9 97.4 3 950 Higher 74.3 66.0 75.4 44.0 85.5 98.0 3 768 Wealth index quintiles Poorest 57.8 53.5 55.9 27.2 71.3 93.3 2 689 Poor 66.8 61.8 62.0 32.4 77.5 94.9 2 728 Middle 71.1 59.8 67.1 36.4 81.5 96.8 2 824 Rich 69.8 62.1 71.8 38.9 81.2 97.1 2 915 Richest 75.8 64.7 77.6 44.5 85.7 98.4 3 402 Ethnicity/language Kazakh 65.6 60.8 63.7 34.1 78.1 95.2 8 608 Russian 75.7 62.7 76.2 42.9 85.2 98.3 4 481 Other 65.2 53.4 62.8 29.6 73.5 95.8 1 469 Total 68.7 60.6 67.5 36.3 79.8 96.2 14 558 MONITORING THE SITUATION OF CHILDREN AND WOMEN142 Table HA.3: Comprehensive knowledge of HIV/AIDS transmission Percentage of women aged 15-49 years who have comprehensive knowledge of HIV/AIDS transmission, Kazakhstan, 2006 Know 2 ways to prevent hiv trans- mission Correctly identify 3 misconceptions about hiv transmission Have comprehensive knowledge (identify 2 prevention methods and 3 misconceptions)* Number of women aged 15-49 years Oblast Akmola 62.8 34.6 24.8 797 Aktobe 53.7 30.7 21.5 675 Almaty 70.7 38.6 31.1 1 475 Atyrau 44.7 35.8 19.0 458 West Kazakhstan 62.3 48.0 32.4 699 Zhambyl 38.8 29.2 11.5 877 Karagandy 64.9 32.4 25.0 1 476 Kostanai 44.6 55.6 21.8 1 015 Kyzylorda 26.8 24.6 12.9 528 Mangistau 26.3 41.5 10.7 335 South Kazakhstan 40.5 25.8 12.4 1 768 Pavlodar 65.6 49.8 34.8 820 North Kazakhstan 65.2 40.0 28.1 674 East Kazakhstan 58.5 36.0 23.4 1 467 Astana City 70.8 62.5 45.8 368 Almaty City 35.2 24.7 11.0 1 126 Residence Urban 53.7 39.0 23.8 8 655 Rural 52.2 32.5 20.0 5 903 Age 15–19 47.4 36.2 22.2 2 469 20–24 53.4 37.2 22.7 2 108 15–24 50.1 36.7 22.4 4 577 25–29 53.4 37.4 22.6 1 894 30–34 54.9 35.9 22.3 1 900 35–39 55.7 37.5 22.2 2 055 40–44 54.7 35.3 22.4 2 076 45–49 53.8 34.9 21.3 2 056 Education Primary/incomplete secondary 45.0 30.3 17.5 1 948 Secondary 52.7 29.8 18.3 4 892 Specialized secondary 56.9 40.1 25.3 3 950 Higher 54.0 44.0 26.7 3 768 Wealth index quintiles Poorest 45.4 27.2 15.6 2 689 Poor 52.8 32.4 19.2 2 728 Middle 57.0 36.4 24.2 2 824 Rich 54.1 38.9 23.2 2 915 Richest 55.6 44.5 27.5 3 402 Ethnicity/language Kazakh 50.8 34.1 20.5 8 608 Russian 59.1 42.9 27.3 4 481 Other 48.7 29.6 17.1 1 469 Total 53.1 36.3 22.3 14 558 * MICS indicator 82; MDG indicator 19b KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 143 Table HA.4: Knowledge of mother-to-child HIV transmission Percentage of women aged 15-49 years who correctly identify means of HIV transmission from mother to child, Kazakhstan, 2006 Know aids can be transmitted from mother to child Percent who know aids can be transmitted: Did not know any specific way Number of women aged 15- 49 years During pregnancy At deliv- ery Through breast milk All three ways* Oblast Akmola 92.3 87.7 72.3 56.6 47.0 6.2 797 Aktobe 87.3 82.9 72.0 52.9 48.9 10.3 675 Almaty 81.3 78.4 67.5 47.8 46.1 16.0 1 475 Atyrau 81.9 81.0 58.1 52.6 39.8 16.1 458 West Kazakhstan 98.0 84.7 93.1 62.4 56.0 1.3 699 Zhambyl 87.5 86.0 77.5 67.4 64.7 9.9 877 Karagandy 92.9 90.9 79.0 59.6 53.5 6.9 1 476 Kostanai 96.3 91.7 92.1 58.1 55.7 2.3 1 015 Kyzylorda 80.1 73.7 68.3 69.7 60.7 13.9 528 Mangistau 98.3 96.6 89.9 65.2 61.2 0.8 335 South Kazakhstan 96.0 95.7 88.9 61.6 60.6 3.4 1 768 Pavlodar 95.8 92.7 85.0 71.5 65.0 3.4 820 North Kazakhstan 95.2 91.6 73.0 52.7 41.4 4.4 674 East Kazakhstan 93.5 88.3 87.0 52.7 49.5 5.6 1 467 Astana City 96.6 95.3 94.8 60.2 59.4 2.2 368 Almaty City 99.3 98.7 92.9 63.1 62.5 0.5 1 126 Residence Urban 93.5 90.1 83.7 60.0 55.8 5.8 8 655 Rural 90.4 87.2 78.0 57.3 52.7 7.4 5 903 Age 15–19 85.6 81.7 72.3 52.4 47.4 11.8 2 469 20–24 92.2 88.8 81.3 58.3 53.8 7.1 2 108 25–29 94.2 91.4 83.1 60.1 56.1 4.7 1 894 30–34 94.1 90.8 83.2 60.7 56.4 4.8 1 900 35–39 94.0 91.1 84.0 60.4 56.4 5.1 2 055 40–44 94.4 91.7 85.1 61.9 57.8 4.5 2 076 45–49 92.5 88.8 82.7 59.9 55.5 5.9 2 056 Education Primary/incomplete secondary 83.8 80.6 69.9 51.5 46.3 11.9 1 948 Secondary 92.2 89.3 80.8 59.6 55.3 6.2 4 892 Specialized secondary 94.0 90.9 83.7 59.9 55.4 5.6 3 950 Higher 94.7 90.7 85.6 60.8 56.8 5.0 3 768 Wealth index quintiles Poorest 87.7 84.6 76.7 56.7 53.1 9.0 2 689 Poor 90.7 87.6 77.5 58.9 53.5 7.4 2 728 Middle 92.0 88.6 80.7 58.8 53.6 7.1 2 824 Rich 94.5 90.9 84.6 59.3 55.1 4.8 2 915 Richest 95.1 92.0 86.0 60.3 56.8 4.6 3 402 Ethnicity/language Kazakh 90.6 87.2 79.2 59.1 54.3 7.5 8 608 Russian 95.5 92.0 85.4 58.1 53.8 4.2 4 481 Other 91.3 89.7 82.1 59.9 58.0 7.1 1 469 Total 92.2 88.9 81.4 58.9 54.5 6.5 14 558 * MICS indicator 89 MONITORING THE SITUATION OF CHILDREN AND WOMEN144 Table HA.5: Attitudes toward people living with HIV/AIDS Percentage of women aged 15-49 years who have heard of AIDS who express a discriminatory attitude towards peo- ple living with HIV/AIDS, Kazakhstan, 2006 PERCENT OF WOMEN WHO: Number of women who have heard of aids Would not care for a family mem- ber who was sick with AIDS If a family member had HIV would want to keep it a secret Believe that a teacher with HIV should not be allowed to work Would not buy food from a person with HIV/ AIDS Agree with at least one discrimi- natory statement Agree with none of the dis- crimina- tory state- ments* Oblast Akmola 12.9 58.6 54.7 78.7 92.7 7.3 797 Aktobe 28.7 63.5 68.9 84.8 93.9 6.1 675 Almaty 1.9 59.7 51.7 87.0 96.1 3.9 1 475 Atyrau 23.8 75.7 54.2 70.6 92.4 7.6 458 West Kazakhstan 12.0 52.4 67.0 93.2 97.2 2.8 699 Zhambyl 3.6 63.4 69.2 77.7 98.1 1.9 877 Karagandy 4.2 83.1 56.3 82.7 98.3 1.7 1 476 Kostanai 2.4 77.5 48.4 79.7 96.7 3.3 1 015 Kyzylorda 27.5 50.2 73.0 90.4 97.0 3.0 528 Mangistau 10.0 79.8 79.9 93.1 98.5 1.5 335 South Kazakhstan 13.8 58.3 77.6 86.1 98.0 2.0 1 768 Pavlodar 7.1 60.6 46.5 78.1 94.8 5.2 820 North Kazakhstan 11.6 62.4 55.7 80.2 94.7 5.3 674 East Kazakhstan 5.1 72.5 64.5 89.0 97.6 2.4 1 467 Astana City 18.9 87.7 52.3 76.0 97.4 2.6 368 Almaty City 3.0 58.3 46.8 70.6 92.6 7.4 1 126 Residence Urban 9.3 69.4 56.8 81.2 96.2 3.8 8 655 Rural 9.5 60.6 65.0 84.9 96.3 3.7 5 903 Age 15–19 9.8 63.2 58.3 81.3 94.8 5.2 2 469 20–24 9.5 68.4 60.3 82.0 96.3 3.7 2 108 25–29 9.9 64.6 60.5 82.3 95.5 4.5 1 894 30–34 10.1 66.5 63.8 83.8 97.6 2.4 1 900 35–39 10.0 64.5 59.8 83.2 96.6 3.4 2 055 40–44 9.0 67.2 60.2 82.9 96.6 3.4 2 076 45–49 7.4 66.9 58.8 83.7 96.4 3.6 2 056 Education Primary/incomplete secondary 9.6 62.8 61.5 82.3 95.3 4.7 1 948 Secondary 10.1 62.8 65.0 84.7 96.5 3.5 4 892 Specialized secondary 9.2 68.3 58.4 82.4 96.4 3.6 3 950 Higher 8.6 68.7 55.1 80.5 96.1 3.9 3 768 Wealth index quintiles Poorest 10.8 56.6 69.2 86.3 96.3 3.7 2 689 Poor 9.5 62.7 64.2 84.2 96.4 3.6 2 728 Middle 9.2 65.7 61.3 83.9 96.3 3.7 2 824 Rich 9.5 69.0 56.5 81.4 96.4 3.6 2 915 Richest 8.3 72.9 52.1 78.7 95.8 4.2 3 402 Ethnicity/language Kazakh 11.3 62.6 64.6 84.4 96.2 3.8 8 608 Russian 6.4 71.5 51.1 79.4 96.3 3.7 4 481 Other 7.3 67.6 62.0 82.6 96.3 3.7 1 469 Total 9.4 65.9 60.1 82.7 96.2 3.8 14 362 * MICS indicator 86 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 145 Table HA.6: Knowledge of a facility for HIV testing Percentage of women aged 15-49 years who know where to get an HIV test, percentage of women who have been tested and, of those tested the percentage who have been told the result, Kazakhstan, 2006 Know a place to get tested* Have been tested** Number of women If tested, have been told result Number of women who have been tested for HIV Oblast Akmola 87.5 66.6 797 83.0 531 Aktobe 82.6 58.7 675 71.3 396 Almaty 73.3 42.7 1 475 83.6 630 Atyrau 78.6 45.8 458 94.5 210 West Kazakhstan 93.9 83.6 699 95.6 584 Zhambyl 61.4 42.0 877 93.6 368 Karagandy 82.0 71.1 1 476 88.4 1 049 Kostanai 91.5 69.4 1 015 97.8 705 Kyzylorda 81.6 53.3 528 73.1 281 Mangistau 87.5 52.8 335 49.0 177 South Kazakhstan 82.4 56.1 1 768 78.2 992 Pavlodar 96.5 90.3 820 84.6 740 North Kazakhstan 92.5 75.3 674 92.4 508 East Kazakhstan 82.3 50.0 1 467 87.6 733 Astana City 90.7 70.9 368 94.8 261 Almaty City 87.4 73.0 1 126 99.1 821 Residence Urban 86.4 63.8 8 655 89.8 5 524 Rural 79.2 58.6 5 903 83.0 3 462 Age 15–19 64.9 29.5 2 469 87.7 729 20–24 84.1 61.9 2 108 85.4 1 305 25–29 88.9 74.5 1 894 85.9 1 411 30–34 89.6 73.1 1 900 87.3 1 388 35–39 88.6 71.0 2 055 88.0 1 458 40–44 87.4 68.9 2 076 87.4 1 429 45–49 85.2 61.6 2 056 88.8 1 266 Education Primary/incomplete secondary 63.6 34.3 1 948 89.5 668 Secondary 83.4 64.3 4 892 84.5 3 144 Specialized secondary 87.7 67.9 3 950 88.2 2 682 Higher 89.4 66.1 3 768 88.8 2 492 Wealth index quintiles Poorest 74.8 55.1 2 689 81.2 1 482 Poor 81.2 57.3 2 728 84.6 1 563 Middle 82.1 60.8 2 824 85.5 1 716 Rich 88.1 66.0 2 915 88.7 1 925 Richest 89.3 67.6 3 402 92.8 2 300 Ethnicity/language Kazakh 80.9 58.4 8 608 84.5 5 024 Russian 89.7 69.5 4 481 91.2 3 116 Other 79.3 57.6 1 469 88.3 846 Total 83.5 61.7 14 558 87.2 8 986 * MICS indicator 87 ** MICS indicator 88 MONITORING THE SITUATION OF CHILDREN AND WOMEN146 Table HA.7: HIV testing and counseling coverage during antenatal care Percentage of women aged 15-49 years who gave birth in the two years preceding the survey who were offered HIV testing and counseling with their antenatal care, Kazakhstan, 2006 PERCENT OF WOMEN WHO: Number of women who gave birth in the 2 years preced- ing the survey Received antenatal care from a health care professional for last pregnancy Were provided information about HIV prevention during ANC visit* Were tested for HIV at ANC visit Received results of HIV test at ANC visit** Oblast Akmola 97.1 70.2 94.0 78.1 80 Aktobe 98.3 84.5 71.1 49.0 68 Almaty 97.9 78.0 83.3 70.2 225 Atyrau 100.0 98.3 89.3 84.3 53 West Kazakhstan 95.3 96.5 97.7 93.0 58 Zhambyl 98.4 78.9 89.2 82.3 139 Karagandy 99.1 75.6 98.7 74.8 129 Kostanai 92.0 81.6 97.3 93.3 84 Kyzylorda 97.4 86.8 90.6 69.3 80 Mangistau (100.0) (99.0) (98.6) (39.8) 45 South Kazakhstan 100.0 80.3 95.5 76.4 309 Pavlodar 99.0 86.1 99.0 81.5 83 North Kazakhstan 98.6 54.5 95.0 87.9 61 East Kazakhstan 94.8 82.7 95.2 84.6 141 Astana City (100.0) (94.0) (98.8) (96.4) 40 Almaty City 100.0 98.8 100.0 100.0 124 Residence Urban 100.0 82.7 95.8 82.3 890 Rural 96.1 82.1 89.8 75.0 829 Age 15–19 94.5 87.6 100.0 93.0 64 20–24 98.4 78.8 93.9 76.5 507 25–29 99.0 82.3 92.3 77.9 501 30–34 97.3 82.7 90.9 75.7 369 35–49 98.0 87.5 93.3 85.4 278 Education Primary/incomplete secondary 93.8 71.5 87.4 77.5 112 Secondary 98.2 81.7 91.4 74.5 734 Specialized secondary 98.3 84.7 94.2 83.3 416 Higher 99.0 84.1 95.6 81.9 457 Wealth index quintiles Poorest 96.4 79.0 87.8 71.5 458 Poor 96.8 81.9 92.7 78.7 348 Middle 99.1 83.7 94.0 77.7 330 Rich 99.6 80.7 96.4 82.4 280 Richest 100.0 88.2 96.6 87.7 303 Ethnicity/language Kazakh 98.7 84.9 92.7 77.0 1 163 Russian 96.0 79.1 95.9 85.8 343 Other 98.6 73.9 89.2 77.5 213 Total 98.1 82.4 92.9 78.8 1 719 * MICS indicator 90 ** MICS indicator 91 ( ) – indicators are based on 25 – 49 cases of unweighted observations KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 147 T ab le T B .1 : K n o w le d ge a b o ut tu b er cu lo si s Pe rc en t o f w o m en a ge d 1 5- 49 w h o h av e ge n er al k n o w le d ge o f t ub er cu lo si s, K az ak h st an , 2 00 6 Heard of tubercu- losis Know about recov- ery after tuber- culosis at proper treatment Kn ow le dg e of m aj or tr ea tm en t Kn ow le dg e of tu be r- cu lo si s tr an sm iss io n Pa re nt s w ou ld ta ke a c hi ld w ith su sp ec te d tu be rc ul os is to : Total Number of women aged 15-49 years In hospital At home In hospital at initial stage with further treatment at home Other By air when coughing Other DK Hospital Polyclinic Feldsher TB dispen- sary O bl as t A km ol a 99 .3 84 .0 83 .2 1. 4 13 .8 (* ) 83 .9 (7 .2 ) 8. 9 49 .1 21 .6 (7 .1 ) 21 .4 10 0. 0 79 7 A kt ob e 99 .8 84 .5 88 .9 0. 3 10 .8 na 95 .9 (* ) (3 .4 ) 33 .2 16 .8 (* ) 48 .3 10 0. 0 67 5 A lm at y 98 .3 74 .1 88 .8 0. 1 10 .8 (* ) 96 .8 (* ) (* ) 56 .3 12 .3 4. 5 26 .7 10 0. 0 1 47 5 A ty ra u 99 .9 83 .1 91 .1 8. 8 (* ) 97 .2 (* ) (2 .7 ) 11 .1 7. 9 (* ) 79 .8 10 0. 0 45 8 W es t K az ak hs ta n 99 .5 83 .9 79 .2 0. 1 20 .6 na 98 .4 (* ) (* ) 15 .7 14 .3 5. 7 64 .3 10 0. 0 69 9 Zh am by l 99 .1 73 .6 70 .8 0. 3 27 .6 (* ) 89 .4 5. 7 5. 0 25 .7 19 .5 (* ) 54 .0 10 0. 0 87 7 Ka ra ga nd y 99 .9 72 .0 78 .3 1. 2 20 .3 (* ) 94 .2 (2 .6 ) (3 .3 ) 11 .0 64 .5 (* ) 24 .1 10 0. 0 1 47 6 Ko st an ai 99 .1 88 .5 81 .0 0. 3 17 .5 (* ) 97 .7 (* ) (* ) 21 .9 19 .8 (4 .6 ) 53 .5 10 0. 0 1 01 6 Ky zy lo rd a 99 .2 76 .5 75 .0 0. 3 24 .4 (* ) 93 .2 (3 .1 ) (3 .8 ) 27 .9 15 .1 (* ) 56 .1 10 0. 0 52 8 M an gi st au 99 .7 72 .4 99 .7 0. 3 (* ) na 10 0. 0 na na 25 .7 27 .4 (* ) 45 .2 10 0. 0 33 5 So ut h Ka za kh st an 99 .8 72 .6 88 .2 0. 5 11 .2 (* ) 98 .2 (* ) (* ) 19 .0 17 .9 (1 .7 ) 61 .2 10 0. 0 1 76 7 Pa vl od ar 99 .8 89 .1 69 .9 1. 8 27 .7 (* ) 93 .6 (* ) (3 .8 ) 31 .5 28 .0 (* ) 39 .1 10 0. 0 82 0 N or th K az ak hs ta n 99 .8 76 .8 86 .0 1. 0 11 .7 (* ) 88 .8 (5 .8 ) (5 .4 ) 48 .5 23 .1 (3 .7 ) 24 .5 10 0. 0 67 4 Ea st K az ak hs ta n 99 .6 88 .4 87 .6 0. 4 11 .6 (* ) 94 .9 (* ) (3 .0 ) 36 .2 23 .4 (2 .1 ) 38 .0 10 0. 0 1 46 7 A st an a Ci ty 99 .7 85 .5 83 .1 0. 1 15 .7 (* ) 98 .3 (* ) (* ) 11 .5 41 .0 na 47 .4 10 0. 0 36 8 A lm at y Ci ty 98 .6 71 .8 83 .1 0. 3 15 .8 (* ) 97 .5 (* ) (* ) 49 .8 28 .2 na 21 .8 10 0. 0 1 12 6 Re si de nc e U rb an 99 .4 79 .2 82 .0 (0 .6 ) 16 .9 (0 .5 ) 95 .7 1. 9 2. 4 25 .5 31 .9 (* ) 42 .1 10 0. 0 8 65 5 Ru ra l 99 .3 78 .8 85 .0 (0 .5 ) 14 .0 (0 .5 ) 93 .8 2. 8 3. 4 38 .8 14 .5 5. 3 41 .2 10 0. 0 5 90 3 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns na : n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN148 T ab le T B .1 : K n o w le d ge a b o ut tu b er cu lo si s (c o n ti n ue d ) Heard of tubercu- losis Know about recov- ery after tuber- culosis at proper treatment Kn ow le dg e of m aj or tr ea tm en t Kn ow le dg e of tu be r- cu lo si s tr an sm iss io n Pa re nt s w ou ld ta ke a c hi ld w ith su sp ec te d tu be rc ul os is to : Total Number of women aged 15-49 years In hospital At home In hospital at initial stage with further treatment at home Other By air when coughing Other DK Hospital Polyclinic Feldsher TB dispen- sary Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 97 .9 73 .0 83 .5 (* ) 14 .4 (1 .6 ) 91 .2 3. 3 5. 4 36 .3 22 .0 3. 0 38 .2 10 0. 0 1 94 8 Se co nd ar y 99 .3 77 .0 84 .7 (* ) 14 .5 (* ) 94 .4 2. 6 3. 0 35 .3 21 .8 3. 0 39 .8 10 0. 0 4 89 3 Sp ec ia liz ed s ec on da ry 99 .9 81 .0 83 .8 (0 .7 ) 15 .1 (* ) 95 .4 2. 0 2. 6 27 .3 27 .3 2. 2 42 .9 10 0. 0 3 94 9 H ig he r 99 .8 82 .7 80 .5 (* ) 18 .6 (* ) 97 .1 (1 .5 ) 1. 5 26 .2 27 .7 (1 .2 ) 44 .8 10 0. 0 3 76 8 A ge 15 -1 9 98 .3 74 .5 83 .5 (* ) 15 .1 (* ) 94 .5 2. 1 3. 4 33 .3 23 .5 2. 1 40 .7 10 0. 0 2 46 9 20 -2 4 99 .8 78 .1 83 .7 (* ) 15 .8 (* ) 95 .9 (2 .0 ) 2. 1 30 .7 22 .8 2. 5 43 .9 10 0. 0 2 10 8 25 -2 9 99 .5 77 .2 80 .8 (* ) 17 .7 (* ) 94 .3 (2 .7 ) 3. 0 31 .7 24 .5 (2 .2 ) 41 .3 10 0. 0 1 89 4 30 -3 4 99 .2 79 .8 84 .4 (* ) 14 .5 (* ) 94 .9 (2 .1 ) 3. 0 31 .3 25 .1 (2 .2 ) 41 .1 10 0. 0 1 90 0 35 -3 9 99 .7 81 .7 84 .9 (* ) 14 .2 (* ) 94 .4 2. 9 2. 7 29 .5 27 .2 (1 .7 ) 41 .5 10 0. 0 2 05 5 40 -4 4 99 .8 81 .1 82 .5 (* ) 16 .3 (* ) 95 .8 (1 .8 ) 2. 4 29 .6 25 .8 3. 0 41 .4 10 0. 0 2 07 6 45 -4 9 99 .6 81 .7 82 .4 (* ) 16 .5 (* ) 94 .7 (2 .2 ) 3. 0 29 .9 25 .2 (2 .3 42 .3 10 0. 0 2 05 6 W ea lt h in de x qu in ti le s Po or es t 99 .1 74 .7 84 .1 (* ) 14 .8 (* ) 93 .6 2. 5 3. 9 37 .3 13 .7 3. 8 45 .0 10 0. 0 2 68 9 Po or 99 .4 81 .1 85 .7 (* ) 13 .4 (* ) 94 .6 2. 1 3. 2 39 .0 15 .9 4. 5 40 .5 10 0. 0 2 72 8 M id dl e 99 .2 78 .8 85 .8 (* ) 13 .1 (* ) 94 .2 2. 5 3. 3 33 .2 23 .1 2. 9 40 .5 10 0. 0 2 82 4 Ri ch 99 .4 79 .0 82 .9 (* ) 16 .2 (* ) 94 .7 2. 9 2. 4 26 .7 31 .4 (* ) 40 .9 10 0. 0 2 91 6 Ri ch es t 99 .7 81 .0 78 .5 (* ) 20 .0 (* ) 97 .0 (1 .4 ) (1 .5 ) 21 .0 36 .6 (* ) 42 .0 10 0. 0 3 40 2 Et hn ic it y/ la ng ua ge Ka za kh 99 .3 78 .9 83 .5 (0 .5 ) 15 .6 (0 .4 ) 95 .5 1. 9 31 .1 22 .4 2. 7 43 .6 43 .5 10 0. 0 8 60 9 Ru ss ia n 99 .8 80 .9 81 .6 (0 .7 ) 16 .9 (* ) 93 .9 2. 7 29 .7 29 .4 1. 6 39 .0 39 .8 10 0. 0 4 48 1 O th er 98 .3 74 .2 86 .2 (* ) 12 .7 (* ) 94 .9 2. 8 33 .2 25 .2 2. 1 (3 9. 1) 37 .9 10 0. 0 1 46 8 To ta l 99 .4 79 .0 83 .2 0. 6 15 .7 0. 5 94 .9 2. 3 2. 8 30 .9 24 .8 2. 3 41 .7 10 0. 0 14 5 58 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns na : n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 149 T ab le T B .2 : S ym p to m s o f s us p ec te d tu b er cu lo si s Pe rc en t o f w o m en a ge d 1 5– 49 w h o k n o w m aj o r sy m p to m s o f s us p ec te d tu b er cu lo si s, K az ak h st an , 2 00 6 SY M PT O M S O F SU SP EC TE D T U BE RC U LO SI S TOTAL Number of women aged 15-49 years Cough Cough with phlegm Cough over three weeks Fever Blood with phlegm Appetite loss Night sweating Chest pain Fatigue, tiredness Weight loss Inertia, apathy Other Do not know O bl as t A km ol a 29 .7 40 .5 44 .6 23 .8 18 .9 22 .7 32 .2 16 .0 25 .4 36 .9 21 .0 (5 .4 ) (5 .8 ) 10 0. 0 79 7 A kt ob e 31 .0 54 .2 69 .9 29 .6 58 .4 22 .1 34 .2 55 .1 27 .9 56 .7 18 .0 (* ) (* ) 10 0. 0 67 5 A lm at y 32 .9 34 .4 27 .8 19 .2 24 .5 18 .5 12 .1 43 .5 16 .6 30 .2 19 .9 na (* ) 10 0. 0 1 47 5 A ty ra u 33 .3 16 .9 40 .8 49 .4 52 .8 43 .7 43 .1 45 .9 30 .9 50 .8 13 .1 (* ) (* ) 10 0. 0 45 8 W es t K az ak hs ta n 6. 2 43 .2 49 .1 35 .1 47 .9 17 .3 47 .2 40 .4 19 .7 43 .9 8. 9 na (* ) 10 0. 0 69 9 Zh am by l 31 .8 37 .0 46 .3 42 .7 31 .5 19 .2 29 .8 18 .7 24 .5 35 .1 17 .5 (* ) (* ) 10 0. 0 87 7 Ka ra ga nd y 24 .3 30 .9 58 .8 27 .8 39 .5 19 .9 30 .9 20 .0 23 .3 49 .5 21 .0 (* ) (* ) 10 0. 0 1 47 6 Ko st an ai 5. 8 36 .0 78 .3 49 .2 46 .2 24 .8 38 .7 49 .2 32 .1 45 .8 20 .4 na (* ) 10 0. 0 1 01 6 Ky zy lo rd a 27 .6 35 .1 36 .4 16 .1 16 .2 35 .1 35 .3 44 .4 28 .7 41 .1 8. 4 (* ) (* ) 10 0. 0 52 8 M an gi st au 14 .3 66 .9 71 .7 59 .9 98 .2 61 .8 54 .4 78 .7 52 .1 60 .5 15 .1 na na 10 0. 0 33 5 So ut h Ka za kh st an 24 .0 43 .2 39 .8 34 .2 35 .8 40 .5 42 .9 36 .1 22 .4 54 .4 13 .0 (* ) (* ) 10 0. 0 1 76 7 Pa vl od ar 7. 4 42 .2 75 .7 51 .9 55 .4 38 .1 51 .5 41 .5 39 .0 60 .5 24 .5 na (* ) 10 0. 0 82 0 N or th K az ak hs ta n 18 .4 45 .6 43 .7 31 .8 35 .3 24 .0 41 .0 24 .7 27 .4 42 .9 22 .9 (* ) (* ) 10 0. 0 67 4 Ea st K az ak hs ta n 27 .9 43 .8 56 .2 51 .1 34 .4 22 .4 34 .0 26 .2 23 .0 41 .6 11 .8 na (* ) 10 0. 0 1 46 7 A st an a Ci ty 16 .0 62 .6 61 .4 55 .0 60 .3 23 .0 37 .6 41 .4 31 .4 42 .5 19 .1 (* ) (* ) 10 0. 0 36 8 A lm at y Ci ty 29 .2 50 .9 68 .3 38 .1 34 .2 22 .0 38 .5 39 .1 20 .8 57 .4 18 .0 (* ) (* ) 10 0. 0 1 12 6 Re si de nc e U rb an 23 .1 43 .7 54 .7 39 .6 46 .5 30 .4 39 .5 40 .9 29 .0 49 .0 17 .7 (0 .5 ) 1. 2 10 0. 0 8 65 5 Ru ra l 23 .1 40 .4 50 .8 36 .1 38 .7 27 .6 35 .0 37 .5 25 .8 44 .3 15 .3 (0 .4 ) 1. 6 10 0. 0 5 90 3 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns na : n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN150 T ab le T B .2 : S ym p to m s o f s us p ec te d tu b er cu lo si s (c o n ti n ue d ) SY M PT O M S O F SU SP EC TE D T U BE RC U LO SI S TOTAL Number of women aged 15-49 years Cough Cough with phlegm Cough over three weeks Fever Blood with phlegm Appetite loss Night sweating Chest pain Fatigue, tiredness Weight loss Inertia, apathy Other Do not know Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 25 .7 40 .6 50 .3 36 .0 37 .9 24 .4 32 .1 35 .6 24 .8 42 .4 13 .1 (* ) 2. 8 10 0. 0 1 94 8 Se co nd ar y 23 .4 41 .3 51 .0 36 .4 39 .3 28 .0 35 .7 37 .4 24 .5 43 .9 15 .6 (0 .5 ) 1. 4 10 0. 0 4 89 3 Sp ec ia liz ed s ec on da ry 22 .4 42 .5 54 .4 39 .8 45 .4 30 .3 39 .4 41 .1 30 .4 49 .2 18 .3 (* ) (0 .8 ) 10 0. 0 3 94 9 H ig he r 22 .1 43 .5 55 .0 39 .2 47 .2 31 .7 40 .1 41 .8 29 .7 50 .4 17 .8 (* ) (1 .0 ) 10 0. 0 3 76 8 A ge 15 -1 9 24 .2 39 .9 51 .8 38 .4 41 .7 27 .5 32 .9 39 .3 24 .9 44 .9 14 .4 (* ) (1 .9 ) 10 0. 0 2 46 9 20 -2 4 22 .7 40 .2 53 .4 38 .5 44 .4 29 .6 35 .6 40 .7 25 .7 45 .9 13 .7 (* ) (* ) 10 0. 0 2 10 8 25 -2 9 23 .1 44 .1 52 .7 38 .4 43 .8 29 .0 36 .9 40 .6 27 .1 44 .3 17 .3 (* ) (* ) 10 0. 0 1 89 4 30 -3 4 23 .5 43 .2 54 .4 36 .8 42 .6 29 .8 38 .9 39 .2 28 .5 47 .6 16 .1 (* ) (* ) 10 0. 0 1 90 0 35 -3 9 23 .4 44 .2 52 .8 38 .0 41 .7 29 .1 39 .7 38 .3 28 .8 47 .5 18 .2 (* ) (1 .3 ) 10 0. 0 2 05 5 40 -4 4 21 .9 42 .4 53 .3 38 .7 41 .1 29 .3 39 .3 38 .0 28 .4 48 .6 18 .5 (* ) (1 .4 ) 10 0. 0 2 07 6 45 -4 9 22 .8 41 .5 51 .9 36 .7 44 .1 29 .5 39 .3 38 .7 29 .8 49 .1 18 .4 (* ) (1 .2 ) 10 0. 0 2 05 6 W ea lt h in de x qu in ti le s Po or es t 24 .8 41 .2 46 .4 33 .6 35 .6 28 .1 36 .4 38 .6 23 .2 42 .3 13 .1 (* ) (1 .4 ) 10 0. 0 2 68 9 Po or 22 .6 39 .2 52 .3 36 .1 37 .6 27 .3 35 .1 35 .6 26 .6 43 .9 15 .4 (* ) (1 .6 ) 10 0. 0 2 72 8 M id dl e 24 .3 39 .4 52 .7 40 .9 41 .9 30 .2 36 .1 37 .4 28 .2 46 .7 17 .0 (* ) (1 .3 ) 10 0. 0 2 82 4 Ri ch 22 .9 43 .2 54 .9 37 .8 44 .8 27 .4 39 .3 40 .0 26 .1 50 .3 18 .2 (* ) (1 .4 ) 10 0. 0 2 91 6 Ri ch es t 21 .1 47 .2 58 .0 41 .3 53 .5 31 .9 39 .9 44 .4 32 .7 51 .0 19 .1 (* ) (1 .0 ) 10 0. 0 3 40 2 Et hn ic it y/ la ng ua ge Ka za kh 24 .2 41 .1 52 .1 37 .3 39 .3 28 .5 36 .0 38 .0 25 .4 46 .4 16 .1 0. 3 1. 2 10 0. 0 8 60 9 Ru ss ia n 22 .1 41 .6 56 .7 37 .1 41 .4 24 .1 38 .6 33 .3 27 .9 47 .5 20 .5 1. 2 1. 5 10 0. 0 4 48 1 O th er 23 .8 40 .9 43 .9 31 .5 32 .5 25 .7 27 .5 31 .8 20 .5 44 .1 14 .9 0. 6 1. 3 10 0. 0 1 46 8 To ta l 23 .1 42 .1 52 .8 38 .0 42 .8 29 .1 37 .3 39 .3 27 .5 46 .8 16 .6 0. 5 1. 3 10 0. 0 14 5 58 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns na : n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 151 T ab le T B .3 : T B s ym p to m s, w h ic h r eq ui re s ee in g a d o ct o r Pe rc en t o f w o m en a ge d 1 5– 49 w h o w ill s ee a d o ct o r if s o m e T B s ym p to m s ap p ea r, K az ak h st an , 2 00 6 SY M PT O M S O F TU BE RC U LO SI S RE Q U IR IN G S EE IN G A D O CT O R TO TA L Number of women aged 15-49 years Cough Cough with phlegm Cough over three weeks Fever Blood with phlegm Appetite loss Night sweating Chest pain Fatigue, tiredness Weight loss Inertia, apathy Other DK O bl as t A km ol a 25 .6 37 .6 50 .7 30 .3 21 .9 22 .6 31 .0 19 .4 24 .8 35 .0 19 .1 (* ) (5 .4 ) 10 0. 0 79 7 A kt ob e 32 .6 50 .8 75 .2 37 .6 58 .5 18 .4 35 .8 54 .3 21 .8 49 .3 18 .2 (* ) (* ) 10 0. 0 67 5 A lm at y 31 .1 29 .6 30 .7 30 .8 23 .9 21 .6 14 .8 43 .2 17 .0 31 .2 20 .8 (* ) (* ) 10 0. 0 1 47 5 A ty ra u 34 .1 17 .3 39 .2 50 .5 52 .0 44 .2 43 .4 46 .7 31 .5 50 .6 13 .7 (* ) (* ) 10 0. 0 45 8 W es t K az ak hs ta n 7. 2 39 .8 55 .7 38 .2 49 .1 16 .3 59 .1 43 .8 19 .1 40 .9 6. 5 (* ) (* ) 10 0. 0 69 9 Zh am by l 27 .8 31 .3 47 .0 39 .9 27 .5 14 .0 22 .7 14 .8 16 .7 28 .9 15 .1 (* ) (* ) 10 0. 0 87 7 Ka ra ga nd y 13 .2 24 .6 80 .7 49 .2 52 .3 23 .2 45 .9 42 .5 23 .9 50 .1 21 .6 (* ) (* ) 10 0. 0 1 47 6 Ko st an ai 5. 6 37 .2 78 .3 49 .4 47 .6 24 .8 38 .7 50 .2 31 .4 46 .5 19 .4 (* ) (* ) 10 0. 0 1 01 6 Ky zy lo rd a 25 .9 33 .0 40 .4 18 .2 21 .1 34 .8 37 .7 51 .1 30 .7 51 .1 9. 4 (* ) (* ) 10 0. 0 52 8 M an gi st au 9. 6 53 .3 62 .0 52 .0 97 .0 48 .2 43 .5 81 .2 38 .9 61 .6 10 .4 (* ) (* ) 10 0. 0 33 5 So ut h Ka za kh st an 23 .9 43 .7 38 .9 34 .0 35 .6 40 .4 41 .5 35 .5 23 .3 54 .9 13 .1 (* ) (* ) 10 0. 0 1 76 7 Pa vl od ar 10 .2 35 .3 78 .0 49 .8 47 .6 29 .3 43 .4 37 .2 32 .2 44 .2 17 .5 (* ) (* ) 10 0. 0 82 0 N or th K az ak hs ta n 14 .2 33 .4 57 .5 44 .0 35 .8 17 .2 34 .3 30 .2 21 .7 30 .4 18 .3 (* ) (* ) 10 0. 0 67 4 Ea st K az ak hs ta n 19 .7 30 .2 64 .3 53 .3 24 .5 12 .8 26 .6 37 .6 18 .9 33 .6 12 .7 (* ) (* ) 10 0. 0 1 46 7 A st an a Ci ty 14 .3 53 .5 72 .3 50 .7 64 .0 20 .4 33 .1 41 .8 28 .5 51 .3 22 .9 (* ) (* ) 10 0. 0 36 8 A lm at y Ci ty 29 .6 49 .8 74 .0 38 .7 33 .6 22 .5 38 .5 41 .4 20 .0 57 .1 19 .2 (* ) (* ) 10 0. 0 1 12 6 Re si de nc e U rb an 20 .9 37 .6 61 .6 42 .5 42 .6 25 .2 37 .9 41 .3 24 .5 46 .3 17 .4 (0 .4 ) 0. 8 10 0. 0 8 65 5 Ru ra l 20 .6 34 .5 54 .0 39 .5 33 .7 23 .9 32 .6 37 .6 22 .0 40 .4 15 .2 (* ) 1. 4 10 0. 0 5 90 3 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns MONITORING THE SITUATION OF CHILDREN AND WOMEN152 T ab le T B .3 : T B s ym p to m s, w h ic h r eq ui re s ee in g a d o ct o r (c o n ti n ue d ) SY M PT O M S O F TU BE RC U LO SI S RE Q U IR IN G S EE IN G A D O CT O R TO TA L Number of women aged 15-49 years Cough Cough with phlegm Cough over three weeks Fever Blood with phlegm Appetite loss Night sweating Chest pain Fatigue, tiredness Weight loss Inertia, apathy Other DK Ed uc at io n Pr im ar y/ in co m pl et e se co nd ar y 22 .5 36 .4 54 .3 40 .5 36 .6 21 .6 31 .0 36 .8 20 .3 39 .9 12 .5 (* ) (2 .4 ) 10 0. 0 1 94 8 Se co nd ar y 21 .0 35 .9 56 .1 41 .0 36 .3 24 .3 34 .3 37 .7 21 .8 41 .1 15 .7 (* ) 1. 0 10 0. 0 4 89 3 Sp ec ia liz ed s ec on da ry 19 .2 35 .8 61 .1 42 .9 40 .9 24 .9 37 .6 41 .0 24 .9 44 .9 18 .0 (* ) (0 .8 ) 10 0. 0 3 94 9 H ig he r 21 .3 37 .5 61 .1 40 .4 41 .8 26 .6 38 .1 42 .9 25 .6 48 .6 18 .1 (* ) (* ) 10 0. 0 3 76 8 A ge 15 -1 9 21 .1 36 .6 55 .3 42 .6 38 .6 22 .6 32 .8 39 .4 20 .2 41 .8 14 .1 (* ) (1 .8 ) 10 0. 0 2 46 9 20 -2 4 20 .6 34 .2 59 .7 39 .9 39 .0 25 .4 33 .3 40 .5 21 .6 42 .3 14 .1 (* ) (* ) 10 0. 0 2 10 8 25 -2 9 21 .1 38 .3 58 .5 41 .3 39 .8 24 .5 34 .9 41 .5 23 .0 42 .5 17 .3 (* ) (* ) 10 0. 0 1 89 4 30 -3 4 22 .2 36 .3 59 .7 39 .4 39 .1 25 .5 38 .0 39 .8 24 .8 43 .9 16 .0 (* ) (* ) 10 0. 0 1 90 0 35 -3 9 19 .9 37 .2 59 .2 40 .7 37 .8 25 .5 38 .1 38 .7 25 .0 45 .0 18 .0 (* ) (* ) 10 0. 0 2 05 5 40 -4 4 20 .6 37 .1 58 .9 42 .5 38 .4 25 .4 35 .9 39 .4 24 .8 45 .3 18 .5 (* ) (* ) 10 0. 0 2 07 6 45 -4 9 20 .2 35 .0 58 .8 42 .3 40 .5 24 .2 38 .1 39 .5 25 .5 47 .0 18 .3 (* ) (* ) 10 0. 0 2 05 6 W ea lt h in de x qu in ti le s Po or es t 23 .4 37 .4 49 .1 38 .1 32 .8 28 .2 36 .0 39 .9 20 .7 41 .2 13 .6 (* ) (1 .3 ) 10 0. 0 2 68 9 Po or 20 .0 34 .5 55 .0 39 .6 33 .5 23 .0 32 .1 36 .1 23 .0 40 .0 15 .5 (* ) (1 .1 ) 10 0. 0 2 72 8 M id dl e 21 .0 34 .7 56 .5 43 .4 37 .1 23 .1 32 .3 36 .6 22 .8 41 .4 15 .6 (* ) (1 .2 ) 10 0. 0 2 82 4 Ri ch 19 .8 35 .8 61 .2 40 .9 40 .3 23 .5 36 .8 41 .5 21 .7 46 .9 17 .3 (* ) (* ) 10 0. 0 2 91 6 Ri ch es t 20 .1 38 .8 67 .9 43 .6 48 .7 25 .5 40 .3 43 .9 27 .9 48 .8 19 .7 (* ) (* ) 10 0. 0 3 40 2 Et hn ic it y/ la ng ua ge Ka za kh 22 .0 36 .7 56 .6 41 .0 38 .7 25 .8 36 .2 41 .6 23 .2 44 .6 15 .6 0. 2 1. 0 10 0. 0 8 60 9 Ru ss ia n 18 .8 35 .1 64 .8 43 .3 41 .9 21 .7 36 .8 37 .9 25 .0 41 .9 18 .7 0. 4 1. 1 10 0. 0 4 48 1 O th er 19 .7 38 .3 50 .2 36 .5 32 .1 27 .3 29 .9 34 .9 20 .1 45 .9 15 .2 0. 3 0. 9 10 0. 0 1 46 8 To ta l 20 .8 36 .4 58 .5 41 .3 39 .0 24 .7 35 .8 39 .8 23 .5 43 .9 16 .5 (0 .3 ) 1. 0 10 0. 0 14 5 58 ( ) – in di ca to rs a re b as ed o n 25 – 4 9 ca se s of u nw ei gh te d ob se rv at io ns (* ) – in di ca to rs a re b as ed o n le ss th an 2 5 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 153 Table TB.4: Attitudes towards people with TB. Percent of women aged 15–49 who express a discriminatory attitude towards people with TB, Kazakhstan, 2006 RESPONDENTS WHO: Percentage of women aged 15-49 Number of women aged 15-49 years Had TB or have family members with TB Communicate with neighbors, colleagues or close friends with TB Would not care for a family member who was treated against TB Oblast Akmola 8.1 13.1 (4.3) 5.5 797 Aktobe (3.1) 6.6 14.4 4.6 675 Almaty (2.9) (2.5) (2.4) 10.1 1 475 Atyrau (3.3) 12.8 8.9 3.1 458 West Kazakhstan 6.9 10.9 11.4 4.8 699 Zhambyl 5.3 (4.8) (*) 6.0 877 Karagandy (4.8) 7.1 (2.8) 10.1 1 476 Kostanai 7.8 9.9 (*) 7.0 1 016 Kyzylorda 7.1 11.5 (4.2) 3.6 528 Mangistau (3.1) (4.5) 6.7 2.3 335 South Kazakhstan 3.1 (2.7) (2.7) 12.1 1 767 Pavlodar 12.4 12.6 (*) 5.6 820 North Kazakhstan 5.3 14.0 (*) 4.6 674 East Kazakhstan 4.4 7.0 (*) 10.1 1 467 Astana City 5.5 16.1 14.4 2.5 368 Almaty City 1.3 (3.0) (*) 7.7 1 126 Residence Urban 4.7 7.5 4.6 59.5 8 655 Rural 5.5 7.5 2.9 40.5 5 903 Education Primary/incomplete secondary 6.4 5.4 3.5 13.4 1 948 Secondary 5.3 7.1 3.5 33.6 4 893 Specialized secondary 5.2 9.0 3.9 27.1 3 949 Higher 3.6 7.3 4.5 25.9 3 768 Age 15-19 4.5 4.5 3.7 17.0 2 469 20-24 4.9 5.4 4.7 14.5 2 108 25-29 4.7 8.5 4.7 13.0 1 894 30-34 4.7 7.8 4.5 13.0 1 900 35-39 4.9 8.1 3.3 14.1 2 055 40-44 5.0 9.3 3.6 14.3 2 076 45-49 6.1 9.5 2.7 14.1 2 056 Wealth index quintiles Poorest 5.6 5.9 3.4 18.5 2 689 Poor 5.3 7.3 2.7 18.7 2 728 Middle 5.1 7.8 3.2 19.4 2 824 Rich 4.5 7.6 4.2 20.0 2 916 Richest 4.6 8.4 5.4 23.4 3 402 Ethnicity/language Kazakh 5.0 7.1 4.1 59.1 8 609 Russian 5.1 8.5 3.8 30.8 4 481 Other 4.5 6.1 2.7 10.1 1 468 Total 5.0 7.5 3.9 100.0 14 558 ( ) – indicators are based on 25-49 cases of unweighted observations (*) – indicators are based on less than 25 cases of unweighted observations MONITORING THE SITUATION OF CHILDREN AND WOMEN154 Appendix A Sample design The sample for the Kazakhstan Multiple Indicator Cluster Survey (MICS) was designed to provide estimates of a large number of indicators on the situation of children and women at national level, for urban and rural areas, as well as at sub-national level for 16 regions – 14 Oblasts and 2 cities. Akmola Oblast Aktobe Oblast Almaty Oblast Atyrau Oblast West Kazakhstan Oblast Zhambyl Oblast Karaganda Oblast Kostanai Oblast Kyzylorda Oblast Mangistau Oblast South Kazakhstan Oblast Pavlodar Oblast North Kazakhstan Oblast East Kazakhstan Oblast Astana City Almaty City The major features of sample design are described in this appendix. Sample design features include target sample size, sample allocation, sample frame and listing, choice of domains, sampling stages, stratification, and the calculation of sample weights. The primary objective of the sample design for the Kazakhstan Multiple Indicator Cluster Survey (MICS) was to produce statistically reliable estimates of most indicators, at the national level, for urban and rural areas, and for the above 16 regions of the country. A multi-stage, stratified cluster sampling approach was used for the selection of the survey sample. Sample Size and Sample Allocation The target sample size for the Kazakhstan MICS was calculated as 15,000 households. For the calcu- lation of the sample size, the key indicator used was immunization prevalence among children aged 0-4 years. The following formula was used to estimate the required sample size for these indicators: where n is the required sample size, expressed as number of households 4 is a factor to achieve the 95 percent level of confidence r is the predicted or anticipated prevalence (coverage rate) of the indicator 1.1 is the factor necessary to raise the sample size by 10 percent for non-response f is the shortened symbol for deff (design effect) 0.12r is the margin of error to be tolerated at the 95 percent level of confidence, defined as 12 per- cent of r (relative sampling error of r) p is the proportion of the total population upon which the indicator, r, is based nh is the average household size. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 155 In this case, the sample size provides 12 percent error for identifying the indicator (at 95 percent of the level of confidence). Identification of sample size based on indicators related to the smallest groups of population guarantees sampling representation for other indicators related to the larger groups of population. For the calculation, r (immunization prevalence) was assumed to be 25 percent (0.25). The value of deff (design effect) was taken as 1.5, based on estimates from previous surveys, p (percentage of children aged 0-4 years in the total population) was taken as 8 percent, and nh (average household size) was taken as 3.6 people. The resulting number of households from this exercise was 4,775. This number of households is sufficient for producing estimates of indicators at national level; however, sample volume should be tripled in order to provide representation of sample for urban and rural area. At the same time, some indicators will be obtained with good accuracy and at regional level. In order to increase the number of these indicators, a compromise decision was taken to increase the sample size up to 15,000 households considering financial and human resources. The average cluster size in the Kazakhstan MICS was determined as 24 households, based on a number of considerations, including the budget available, and the time that would be needed per team to complete one cluster. Dividing the total number of households by the number of households per cluster, we have 625 clusters to be surveyed. In each region, the clusters (primary sampling units – PSU) were distributed to urban and rural areas, proportional to the size of urban and rural popula- tions in that region. The table below shows the allocation of clusters to the sampling domains. Table SD.1. Allocation of sample clusters (primary sampling units) to Sampling Domains Oblast Population (2005 estimates) Number of Clusters Total Urban Rural Total Urban Rural KAZAKHSTAN 15,074,767 8,614,651 6,460,116 625 360 265 Akmola 747,185 352,204 394,981 37 18 19 Aktobe 678,607 374,775 303,832 36 19 17 Almaty 1,589,751 473,978 1,115,773 47 14 33 Atyrau 463,466 261,702 201,764 33 18 15 West Kazakhstan 606,534 262,518 344,016 35 15 20 Zhambyl 992,089 447,406 544,683 41 18 23 Karaganda 1,331,702 1,116,456 215,246 45 37 8 Kostanai 907,396 498,630 408,766 39 21 18 Kyzylorda 612,048 364,248 247,800 35 20 15 Mangistau 361,754 274,628 87,126 32 23 9 South Kazakhstan 2,193,556 880,663 1,312,893 48 18 30 Pavlodar 743,826 487,817 256,009 37 23 14 North Kazakhstan 665,936 227,440 438,496 36 12 24 East Kazakhstan 1442,097 853,366 588,731 46 26 20 Astana City 529,335 529,335 0 34 34 0 Almaty City 1,209,485 1,209,485 0 44 44 0 MONITORING THE SITUATION OF CHILDREN AND WOMEN156 Sampling Frame and Selection of Clusters The 1999 census frame was used for the selection of clusters. Census enumeration areas were defined as primary sampling units (PSUs). 14 Oblasts were divided up in accordance with existing territorial and administrative divisions and 625 clusters were distributed between the districts and Almaty and Astana cities based on the population density as of the beginning of 2005. Then, the given number of PSUs in each region was randomly selected with equal probability. Listing activities and selection of households Since the sample frame (the 1999 Population Census) was not up to date, household lists in all se- lected enumeration areas were updated prior to the selection of households. For this purpose, listing teams were formed, who visited each enumeration area, and listed the occupied households. The staff of territorial statistical bodies listed the households in their territories; rural statisticians, staff of rayon, city and Oblast Statistic Departments visited each sampled census area and listed all inhabited households. Listing was based on the list of sampled households in accordance with the 1999 Population Census, prepared by the DCC AS RK, from 10 November to 25 December 2005. As a result, the real addresses and the number of inhabitants in each cluster was established. For each PSU, 24 households were selected out of a general list of households using systematic selection pro- cedures. Calculation of Sample Weights The Kazakhstan Multiple Indicator Cluster Survey sample is not self-weighted. In general, by allocat- ing equal numbers of households to each of the regions, different sampling fractions were used in each region since the size of the regions varied. For this reason, sample weights were calculated and these were used in the subsequent analyses of the survey data. The major component of the weight is the reciprocation of the sampling fraction employed in se- lecting the number of sample households in that particular sampling domain: Wh = 1 / fh where fh, the sampling fraction at the h-th stratum, is the product of probabilities of selection at every stage in each sampling domain: fh = Pih * P2h * P3h, where Pih is the probability of selection of the sampling unit in the i-th stage for the h-th sampling domain. Since the estimated numbers of households per enumeration area prior to the first stage selection (selection of primary sampling units) and the updated number of households per enumeration area were different, individual sampling fractions for households in each enumeration area (cluster) were calculated. The sampling fractions for households in each cluster therefore included the probability of selection of the enumeration area in that particular sampling domain and the probability of selec- tion of a household in the sample enumeration area (cluster). A second component which has to be taken into account in the calculation of sample weights is the level of non-response for the household and individual interviews. The adjustment for household non-response is equal to the inverse value of: RR = Number of interviewed households / Number of occupied households listed After the completion of fieldwork, response rates were calculated for each area. These were used to adjust the sample weights calculated for each cluster. Response rates in Kazakhstan Multiple Indicator Cluster Survey are shown in Table HH.1 in this report. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 157 Similarly, the adjustment for non-response at the individual level (women and children under 5) is equal to the inverse value of: RR = Completed women’s (or under-5’s) questionnaires / Eligible women (or under-5s) Numbers of eligible women and under-5 children were obtained from the household listing in the Household Questionnaire in households where interviews were completed. The unadjusted weights for the households were calculated by multiplying the above factors for each enumeration area. These weights were then standardized (or normalized), one purpose of which is to make the sum of the interviewed sample units equal the total sample size at the national level. Normalization is performed by multiplying the aforementioned unadjusted weights by the ratio of the number of completed households to the total unadjusted weighted number of households. A similar standardization procedure was followed in obtaining standardized weights for the women’s and under-5’s questionnaires. Corrected (standardized) weights of households varied in 625 clusters from 0.187 to 1.814. Sample weights were appended to all data sets and analyses were performed by weighting each household, woman or under-5 with these sample weights. Number of population at the begin- ning of 2005 Number of households Number of clusters MONITORING THE SITUATION OF CHILDREN AND WOMEN158 Appendix B List of Personnel Involved in the Survey Supervisory personnel14 Mr. Kali Abdiyev – Chair of the Agency RK on Statistics (2006, February), Director of RSE «Data Computing Centre» of the Statistic Agency of the Republic of Kazakhstan (2006, February-2007, July) Mr. Bakhyt Sultanov – Chair of the Agency RK on Statistics (2006, February – 2007, February) Ms. Anar Meshimbayeva – Chair of the Agency RK on Statistics (2007, February) Mr. Yury Shokamanov – Deputy Chair of the Agency RK on Statistic Mr. Yerbolat Mussabek – MICS National Project Coordinator, from the Agency RK on Statistic, Deputy Director of Social and Demography Statistics Department Ms. Gulnara Kukanova – MICS Technical Coordinator, Head of Population Statistics Department, Agency RK on Statistics Mr. Asankhan Mamedaliyev – specialist on MISC sampling, Head of Registers Division, Coordination Department, AS RK International Organizations Mr. Alexandre Zouev –UNICEF Representative in Kazakhstan Mr. Raimbek Sissemaliev – Head of UNICEF Almaty Zone Office, Programme Officer Ms. Gaziza Moldakulova – MICS Project Coordinator, UNFPA Office in Kazakhstan Consultants Mr. Trevor Croft – International expert on data processing (USA) Mr. George Sakvarelidze – UNICEF Regional Office (Switzerland) Mr. Turgay Unalan – UNICEF International Consultant (Turkey) Mr. Anthony Turner – UNICEF International Sampling Expert (USA) Mr. Mukhtar Minbayev – Project Coordinator on Monitoring and Evaluation, UNICEF Office in the Kyrgyz Republic RSE DCC staff Ms. Zinagul Dzhumanbayeva – Director, RSE DCC AS (2005 – 2006, February), Deputy Director, RSE DCC AS (2006, February till present) Mr. Bakhytbek Kulekeyev – Deputy Director, RSE DCC AS Ms. Aigul Kapisheva – Head of Division for Processing Databases Ms. Gulnara Nurunova – Head of Personnel Department Ms. Aigerim Kaliakbarova – Head of Financial and Accounting Division Mr. Orynbassar Dzhunisbayev – Head of Transport Service Ms. Hamia Iskakova – Head of General Service Division 14 All positions are indicated at the moment of MICS (2005-2007) KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 159 Staff processing and entering the data Ms. Saule Dauylbayeva – Supervisor of data control and entry and formation of MICS database, Head of Dataware Division of the Department of Population Register and Survey Editors Controllers Beibit Ibraimov Gulzat Nusipzhanova Olga Bikmeyeva Arman Zhantileuov Mukhamed Shakhzadayev Zhanat Ordakhanov Madiar Ordakhanov Nurgul Moldakhmetova Data Entry Operators Gulmira Zhumanbayeva Sanzhar Zhumanbayev Sanzhar Dauylbayev Takhir Nuritdinov Nikolay Stepin Azamat Marat Yerlan Aidynbayev Azhar Beibit Marzhan Parmenova Ayauzhan Bazgalamova Assem Abikeyeva Timur Kanlybayev Lyazzat Aimukhanova Bayan Dautaliyeva Assel Beissenova Zhanna Kanlybayeva Assem Alchikanova Yekaterina Konstantinova Arailym Imanbayeva Elmira Umarkodzhayeva Marina Novikova Ainur Zhambylbayeva Kanat Imanaliyev Azhar Bapysheva Oblast teams for fieldwork Akmola Oblast Altyn Kassymova – supervisor Altynai Kazybayeva – editor Interviewers: Zhanna Sagindykova Anargul Makizhanova Roza Ordabayeva Gulim Kozhanova Aizhan Aissabayeva Bakytgul Nurusheva Aktobe Oblast Kairat Zhekeyev – supervisor Zholdaskali Beissov – editor Interviewers: Kunbibi Kazmukhanbetova Laura Suyundukova Aisaule Adbenova Klara Kurganbayeva Gulmira Yeralina Kadisha Tulegenova Almaty Oblast Lyudmila Saveko – supervisor Bolatkan Nukezhanov – editor Interviewers: Vera Tobolich Svetlana Malogolovaya Svetlana Imirova Lyudmila Ivanova Shargul Tokhtarbekova Marzhan Issayeva Atyrau Oblast Galya Mukhangaliyeva – supervisor Amankos Tuleuov – editor Interviewers: Maira Shershekbayeva Kunsulu Iskaliyeva Lazgul Kuzembayeva Bayan Kurmangaliyeva Zhanar Mukusheva Marzhan Anessova MONITORING THE SITUATION OF CHILDREN AND WOMEN160 West Kazakhstan Oblast Amanzhan Zhumanov – supervisor Margulan Hugmanov – editor Interviewers: Dzhamilya Hussainova Zoya Klimenko Gulnara Shukalova Maria Sagitova Roza Kozhbayeva Assiya Yesekenova Zhambyl Oblast Inga Shevtsova – supervisor Mubara Rakhimova – editor Interviewers: Natalia Pak Zhanyl Kurmanbekova Zhanat Ustabayeva Galina Shestakova Marianna Tigai Karaganda Oblast Galia Kaskirbayeva – supervisor Sayagul Konakbayeva – editor Interviewers: Tatiana Zeinollina Bayan Bekpayeva Alla Lysenko Aisha Belgibayeva Natalia Nechet Nina Balakina Kostanai Oblast Altyn Nuralenova – supervisor Aibek Galymzhanov – editor Interviewers: Dina Kurganbekova Svetlana Levitskaya Lilia Lodyanaya Tatiana Zhartayeva Anar Kassenova Tatiana Matushevich Kyzylorda Oblast Lidiya Kim – supervisor Ondash Mashenbayev – editor Interviewers: Galina Yermekova Assel Doszhanova Bakhyt Mulikova Roza Abshakirova Zaida Abdrakhmanova Zhuldyz Tokanova Mangistau Oblast Sholpan Shakabayeva – supervisor Akdary Narinbayeva – editor Interviewers: Shyrailym Ketebayeva Akmaral Bekkaliyeva Natalia Chetyrina Gulna Ayupova Assel Bekzhanova Fatima Kanatova KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 161 Almaty City Gulnara Kerimkhanova – supervisor Aikhan Bokhanov – editor Interviewers: Aigul Turganbayeva Gulbanu Eshzhanova Gulmira Saitova Lyazzat Nysanbayeva Indira Kassymkhanova Nurgul Abdiyeva South Kazakhstan Oblast Yernazar Kultayev – supervisor Mirakhmet Tasbolatov – editor Interviewers: Lyudmila Karbysheva Bagila Shaulenova Bakhyt Tuyebalova Zhanat Buribekova Aurika Khan Gulmira Syzdykova North Kazakhstan Oblast Gulziyan Izbassova – supervisor Lyubov Zelevova – editor Interviewers: Guzalia Permyakova Lyazzat Zhetpissova Irina Vdovina Natalia Solopova Ermek Kairzhanova Assel Kermbayeva Pavlodar Oblast Kumar Alseitov – supervisor Kulzhan Issenova– editor Interviewers: Aigul Nurgaliyeva Zhanar Abisheva Larissa Shalukho Lyudmila Berezhnaya Marina Nosko Irina Penko Astana City Kenzhebulat Bekpenbet – supervisor Sara Aubakirova– editor Interviewers Svetlana Orezkhova Roza Tazhikenova Roza Taibasarova Lyubov Akinshina Almagul Zhumagulova Lyazzat Boldurukova East Kazakhstan Oblast Bogdan Grinishin – supervisor Yury Komarov – editor Interviewers: Zinazaip Dzhabossinova Svetlana Dolgikh Nazgul Orazayeva Gulyaim Kassenova Ardak Akhmadieva Laura Uskabayeva MONITORING THE SITUATION OF CHILDREN AND WOMEN162 Appendix C Estimates of Sampling Errors The sample of respondents selected in the Kazakhstan Multiple Indicator Cluster Survey is only one of the samples that could have been selected from the same population, using the same design and size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. The extent of variability is not known exactly, but can be estimated statistically from the survey results. The following sampling error measures are presented in this appendix for each of the selected indi- cators:  Standard error (se): Sampling errors are usually measured in terms of standard errors for par- ticular indicators (means, proportions etc). Standard error is the square root of the variance. The Taylor linearization method is used for the estimation of standard errors.  Coefficient of variation (se/r) is the ratio of the standard error to the value of the indicator.  Design effect (deff) is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption of simple random sampling. The square root of the design effect (deft) is used to show the efficiency of the sample design. A deft value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a deft value above 1.0 indicates the increase in the standard error due to the use of a more complex sample design.  Confidence limits are calculated to show the interval within which the true value for the popu- lation can be reasonably assumed to fall. For any given statistic calculated from the survey, the value of that statistics will fall within a range of plus or minus two times the standard error (p + 2.se or p – 2.se) of the statistic in 95 percent of all possible samples of identical size and design. For the calculation of sampling errors from MICS data, SPSS Version 14 Complex Samples module has been used. The results are shown in the tables that follow. In addition to the sampling error measures described above, the tables also include weighted and unweighted counts of denomina- tors for each indicator. Sampling errors are calculated for indicators of primary interest, for the national total, for the re- gions, and for urban and rural areas. Two of the selected indicators are based on households, 6 are based on household members, 9 are based on women, and 12 are based on children under 5. All indicators presented here are in the form of proportions. Table SE.1 shows the list of indicators for which sampling errors are calculated, including the base population (denominator) for each indica- tor. Tables SE.2 to SE.9 show the calculated sampling errors. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 163 Table SE.1. Indicators selected for sampling error calculations List of indicators selected for sampling error calculations, and base populations (denominators) for each indicator, Kazakhstan, 2006 MICS Indicator Base Population HOUSEHOLDS 41 Iodized salt consumption All households 74 Child discipline Children aged 2-14 years selected HOUSEHOLD MEMBERS 11 Use of improved drinking water sources All household members 12 Use of improved sanitation facilities All household members 55 Net primary school attendance rate Children of primary school age 56 Net secondary school attendance rate Children of secondary school age 59 Primary completion rate Children of primary school completion age 71 Child labor Children aged 5-14 years WOMEN 4 Skilled attendant at delivery Women aged 15-49 years with a live birth in the last 2 years 20 Antenatal care Women aged 15-49 years with a live birth in the last 2 years 21 Contraceptive prevalence Women aged 15-49 currently married/in union 60 Adult literacy Women aged 15-24 years 67 Marriage before age 18 Women aged 20-49 years 82 Comprehensive knowledge about HIV pre- vention among young people Women aged 15-24 years 86 Attitude towards people with HIV/AIDS Women aged 15-49 years 88 Women who have been tested for HIV Women aged 15-49 years 89 Knowledge of mother- to-child transmission of HIV Women aged 15-49 years UNDER-5s 6 Underweight prevalence Children under age 5 25 Tuberculosis immunization coverage Children aged 12-23 months 26 Polio immunization coverage Children aged 12-23 months 27 Immunization coverage for DPT Children aged 12-23 months 28 Measles immunization coverage Children aged 12-23 months 31 Fully immunized children Children aged 12-23 months - Acute respiratory infection in last two weeks Children under age 5 22 Antibiotic treatment of suspected pneumo- nia Children under age 5 with suspected pneu- monia in the last 2 weeks - Diarrhoea in last two weeks Children under age 5 35 Received ORT or increased fluids and contin- ued feeding Children under age 5 with diarrhoea in the last 2 weeks 46 Support for learning Children under age 5 62 Birth registration Children under age 5 MONITORING THE SITUATION OF CHILDREN AND WOMEN164 T ab le S E .2 . S am p lin g er ro rs : t o ta l s am p le St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 92 0 0. 00 3 0. 00 4 2. 35 6 1. 53 5 14 42 6 14 45 8 0. 91 3 0. 92 7 Ch ild d is ci pl in e CP .4 0. 52 2 0. 00 8 0. 01 5 1. 64 9 1. 28 4 64 11 68 64 0. 50 6 0. 53 7 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 93 7 0. 00 6 0. 00 6 8. 13 7 2. 85 3 51 26 1 14 56 4 0. 92 5 0. 94 8 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 99 2 0. 00 2 0. 00 2 7. 34 8 2. 71 1 51 26 1 14 56 4 0. 98 9 0. 99 6 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 98 0 0. 00 3 0. 00 3 1. 25 2 1. 11 9 30 76 33 87 0. 97 5 0. 98 6 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 95 3 0. 00 3 0. 00 3 1. 38 3 1. 17 6 71 19 78 04 0. 94 7 0. 95 8 Pr im ar y co m pl et io n ra te ED .6 0. 88 4 0. 01 0 0. 01 1 0. 83 1 0. 91 1 84 7 92 8 0. 86 5 0. 90 3 Ch ild la bo r CP .2 0. 02 2 0. 00 2 0. 08 5 1. 52 3 1. 23 4 83 21 91 92 0. 01 8 0. 02 6 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 0. 99 8 0. 00 1 0. 00 1 0. 80 1 0. 89 5 17 19 17 84 0. 99 7 1. 00 0 A nt en at al c ar e RH .3 0. 99 9 0. 00 1 0. 00 1 0. 59 2 0. 77 0 17 19 17 84 0. 99 7 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 50 7 0. 00 7 0. 01 3 1. 54 2 1. 24 2 83 49 83 70 0. 49 3 0. 52 1 A du lt lit er ac y ED .8 0. 99 8 0. 00 1 0. 00 1 1. 18 1 1. 08 7 45 77 46 97 0. 99 6 0. 99 9 M ar ria ge b ef or e ag e 18 CP .5 0. 08 5 0. 00 3 0. 03 7 1. 56 1 1. 24 9 12 08 9 12 03 2 0. 07 9 0. 09 2 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 22 3 0. 00 6 0. 02 5 2. 67 5 1. 63 5 14 55 8 14 56 0 0. 21 1 0. 23 4 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 03 8 0. 00 3 0. 07 0 2. 73 3 1. 65 3 14 36 2 14 31 0 0. 03 2 0. 04 3 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 61 7 0. 00 7 0. 01 1 2. 78 8 1. 67 0 14 55 8 14 56 0 0. 60 4 0. 63 1 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 54 5 0. 00 7 0. 01 3 2. 86 9 1. 69 4 14 55 8 14 56 0 0. 53 1 0. 55 9 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 04 0 0. 00 3 0. 08 5 1. 26 9 1. 12 7 41 90 41 81 0. 03 3 0. 04 7 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 0. 99 6 0. 00 2 0. 00 2 1. 37 6 1. 17 3 99 1 97 6 0. 99 2 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 0. 96 7 0. 00 8 0. 00 8 1. 77 4 1. 33 2 98 9 97 4 0. 95 2 0. 98 2 Im m un iz at io n co ve ra ge fo r D PT CH .2 0. 98 0 0. 00 6 0. 00 6 1. 63 4 1. 27 8 98 6 97 1 0. 96 9 0. 99 2 M ea sl es im m un iz at io n co ve ra ge CH .2 0. 99 4 0. 00 3 0. 00 3 1. 11 0 1. 05 4 98 6 97 2 0. 98 9 0. 99 9 Fu lly im m un iz ed c hi ld re n CH .2 0. 96 2 0. 00 8 0. 00 8 1. 64 4 1. 28 2 98 8 97 3 0. 94 7 0. 97 8 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 01 5 0. 00 2 0. 14 6 1. 45 5 1. 20 6 44 15 44 15 0. 01 1 0. 02 0 A nt ib io tic tr ea tm en t o f s us pe ct ed p ne um on ia CH .7 0. 31 7 0. 01 0 0. 03 2 0. 03 2 0. 17 8 67 66 0. 29 6 0. 33 7 D ia rr ho ea in la st tw o w ee ks CH .4 0. 01 8 0. 00 2 0. 12 5 1. 26 7 1. 12 6 44 15 44 15 0. 01 4 0. 02 3 Re ce iv ed O RT o r i nc re as ed fl ui ds a nd C on tin ue d fe ed in g CH .5 0. 48 0 0. 01 2 0. 02 5 0. 04 1 0. 20 3 80 75 0. 45 6 0. 50 4 Su pp or t f or le ar ni ng CD .1 0. 81 0 0. 00 7 0. 00 8 1. 26 4 1. 12 4 44 15 44 15 0. 79 7 0. 82 3 Bi rt h re gi st ra tio n CP .1 0. 99 2 0. 00 1 0. 00 1 1. 15 3 1. 07 4 44 15 44 15 0. 98 9 0. 99 5 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 165 T ab le S E .3 . S am p lin g er ro rs : u rb an a re as St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 92 1 0. 00 4 0. 00 5 2. 19 5 1. 48 1 92 11 81 51 0. 91 2 0. 92 9 Ch ild d is ci pl in e CP .4 0. 54 7 0. 01 1 0. 02 0 1. 64 0 1. 28 1 35 25 32 76 0. 52 5 0. 57 0 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 98 1 0. 00 4 0. 00 4 8. 56 6 2. 92 7 29 17 2 82 46 0. 97 3 0. 99 0 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 99 5 0. 00 2 0. 00 2 9. 83 5 3. 13 6 29 17 2 82 46 0. 99 0 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 98 1 0. 00 4 0. 00 4 1. 18 8 1. 09 0 15 58 14 82 0. 97 3 0. 98 9 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 95 6 0. 00 4 0. 00 4 1. 36 7 1. 16 9 36 73 34 31 0. 94 8 0. 96 5 Pr im ar y co m pl et io n ra te ED .6 0. 88 6 0. 01 4 0. 01 6 0. 75 8 0. 87 0 41 9 39 7 0. 85 8 0. 91 4 Ch ild la bo r CP .2 0. 02 5 0. 00 3 0. 11 7 1. 41 5 1. 19 0 42 03 39 82 0. 01 9 0. 03 1 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 0. 99 8 0. 00 2 0. 00 2 1. 01 2 1. 00 6 89 0 80 2 0. 99 5 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 89 0 80 2 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 54 0 0. 01 0 0. 01 9 1. 68 7 1. 29 9 46 52 40 80 0. 52 0 0. 56 1 A du lt lit er ac y ED .8 0. 99 7 0. 00 1 0. 00 1 1. 20 7 1. 09 9 26 27 23 55 0. 99 5 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 07 8 0. 00 4 0. 05 3 1. 55 1 1. 24 6 72 71 63 72 0. 07 0 0. 08 7 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 23 8 0. 00 8 0. 03 4 2. 73 5 1. 65 4 86 55 76 08 0. 22 2 0. 25 4 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 03 8 0. 00 4 0. 10 3 3. 18 2 1. 78 4 85 90 75 34 0. 03 0 0. 04 6 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 63 8 0. 01 0 0. 01 5 3. 02 0 1. 73 8 86 55 76 08 0. 61 9 0. 65 7 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 55 8 0. 01 0 0. 01 8 3. 19 1 1. 78 6 86 55 76 08 0. 53 8 0. 57 8 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 03 0 0. 00 4 0. 14 7 1. 20 9 1. 10 0 21 26 18 23 0. 02 1 0. 03 9 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 0. 99 6 0. 00 4 0. 00 4 1. 50 3 1. 22 6 50 9 42 8 0. 98 9 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 0. 97 9 0. 00 8 0. 00 8 1. 20 0 1. 09 5 50 9 42 8 0. 96 4 0. 99 4 Im m un iz at io n co ve ra ge fo r D PT CH .2 0. 99 0 0. 00 5 0. 00 5 1. 23 6 1. 11 2 50 7 42 7 0. 97 9 1. 00 0 M ea sl es im m un iz at io n co ve ra ge CH .2 0. 99 5 0. 00 4 0. 00 4 0. 97 7 0. 98 8 50 7 42 7 0. 98 8 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 0. 97 4 0. 00 8 0. 00 8 1. 02 9 1. 01 5 50 9 42 8 0. 95 9 0. 99 0 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 01 8 0. 00 4 0. 21 7 1. 65 2 1. 28 5 22 51 19 42 0. 01 0 0. 02 5 A nt ib io tic tr ea tm en t o f s us pe ct ed p ne um on ia CH .7 (0 .3 23 ) (* ) (* ) (* ) (* ) 40 29 (* ) (* ) D ia rr ho ea in la st tw o w ee ks CH .4 0. 02 0 0. 00 4 0. 18 8 1. 39 6 1. 18 2 22 51 19 42 0. 01 2 0. 02 7 Re ce iv ed O RT o r i nc re as ed fl ui ds a nd C on tin ue d fe ed in g CH .5 (0 .4 22 ) (* ) (* ) (* ) (* ) 45 33 (* ) (* ) Su pp or t f or le ar ni ng CD .1 0. 82 9 0. 01 0 0. 01 2 1. 26 6 1. 12 5 22 51 19 42 0. 80 9 0. 84 8 Bi rt h re gi st ra tio n CP .1 0. 99 2 0. 00 2 0. 00 2 1. 05 5 1. 02 7 22 51 19 42 0. 98 8 0. 99 6 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN166 T ab le S E .4 . S am p lin g er ro rs : r ur al a re as St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 91 8 0. 00 6 0. 00 6 2. 57 3 1. 60 4 52 15 63 07 0. 90 7 0. 92 9 Ch ild d is ci pl in e CP .4 0. 49 1 0. 01 1 0. 02 1 1. 58 3 1. 25 8 28 86 35 88 0. 47 0 0. 51 2 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 87 7 0. 01 2 0. 01 4 8. 33 7 2. 88 7 22 08 9 63 18 0. 85 3 0. 90 1 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 98 9 0. 00 3 0. 00 3 5. 84 4 2. 41 7 22 08 9 63 18 0. 98 3 0. 99 6 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 98 0 0. 00 4 0. 00 4 1. 28 9 1. 13 6 15 18 19 05 0. 97 3 0. 98 7 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 94 9 0. 00 4 0. 00 4 1. 35 8 1. 16 5 34 46 43 73 0. 94 1 0. 95 6 Pr im ar y co m pl et io n ra te ED .6 0. 88 2 0. 01 3 0. 01 5 0. 88 9 0. 94 3 42 7 53 1 0. 85 6 0. 90 8 Ch ild la bo r CP .2 0. 01 9 0. 00 2 0. 12 4 1. 55 5 1. 24 7 41 18 52 10 0. 01 4 0. 02 4 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 0. 99 9 0. 00 0 0. 00 0 0. 00 1 0. 03 3 82 9 98 2 0. 99 9 0. 99 9 A nt en at al c ar e RH .3 0. 99 7 0. 00 1 0. 00 1 0. 67 0 0. 81 9 82 9 98 2 0. 99 4 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 46 5 0. 00 8 0. 01 8 1. 22 6 1. 10 7 36 97 42 90 0. 44 8 0. 48 2 A du lt lit er ac y ED .8 0. 99 8 0. 00 1 0. 00 1 1. 04 9 1. 02 4 19 51 23 42 0. 99 6 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 09 5 0. 00 5 0. 05 1 1. 53 3 1. 23 8 48 18 56 60 0. 08 6 0. 10 5 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 20 0 0. 00 7 0. 03 6 2. 31 7 1. 52 2 59 03 69 52 0. 18 6 0. 21 5 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 03 7 0. 00 3 0. 07 9 1. 64 7 1. 28 3 57 73 67 76 0. 03 1 0. 04 3 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 58 6 0. 00 9 0. 01 5 2. 30 5 1. 51 8 59 03 69 52 0. 56 9 0. 60 4 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 52 7 0. 00 9 0. 01 6 2. 10 0 1. 44 9 59 03 69 52 0. 50 9 0. 54 4 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 05 1 0. 00 5 0. 10 4 1. 35 8 1. 16 5 20 64 23 58 0. 04 0 0. 06 1 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 0. 99 6 0. 00 3 0. 00 3 1. 17 0 1. 08 2 48 3 54 8 0. 99 0 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 0. 95 5 0. 01 3 0. 01 4 2. 23 4 1. 49 5 48 1 54 6 0. 92 8 0. 98 1 Im m un iz at io n co ve ra ge fo r D PT CH .2 0. 97 0 0. 01 0 0. 01 1 1. 96 6 1. 40 2 47 8 54 4 0. 95 0 0. 99 1 M ea sl es im m un iz at io n co ve ra ge CH .2 0. 99 3 0. 00 4 0. 00 4 1. 24 4 1. 11 5 47 9 54 5 0. 98 6 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 0. 94 9 0. 01 4 0. 01 5 2. 15 1 1. 46 7 47 9 54 5 0. 92 2 0. 97 7 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 01 2 0. 00 2 0. 16 9 0. 88 7 0. 94 2 21 64 24 73 0. 00 8 0. 01 7 A nt ib io tic tr ea tm en t o f s us pe ct ed p ne um on ia CH .7 (0 .3 08 ) (* ) (* ) (* ) (* ) 27 37 (* ) (* ) D ia rr ho ea in la st tw o w ee ks CH .4 0. 01 6 0. 00 2 0. 15 2 0. 94 1 0. 97 0 21 64 24 73 0. 01 1 0. 02 1 Re ce iv ed O RT o r i nc re as ed fl ui ds a nd Co nt in ue d fe ed in g CH .5 (0 .5 55 ) (* ) (* ) (* ) (* ) 35 42 (* ) (* ) Su pp or t f or le ar ni ng CD .1 0. 79 1 0. 00 9 0. 01 1 1. 21 9 1. 10 4 21 64 24 73 0. 77 3 0. 80 9 Bi rt h re gi st ra tio n CP .1 0. 99 2 0. 00 2 0. 00 2 1. 23 5 1. 11 1 21 64 24 73 0. 98 8 0. 99 6 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 167 T ab le S E .5 . S am p lin g er ro rs : A km o la O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 83 9 0. 01 7 0. 02 0 1. 81 1 1. 34 6 87 9 84 6 0. 80 5 0. 87 3 Ch ild d is ci pl in e CP .4 0. 54 0 0. 03 4 0. 06 2 1. 68 8 1. 29 9 38 2 37 3 0. 47 3 0. 60 8 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 98 4 0. 00 7 0. 00 7 2. 67 0 1. 63 4 29 24 84 6 0. 96 9 0. 99 8 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 98 9 0. 00 6 0. 00 6 2. 49 8 1. 58 1 29 24 84 6 0. 97 7 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 97 1 0. 01 6 0. 01 6 1. 51 4 1. 23 0 18 1 17 8 0. 94 0 1. 00 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 94 3 0. 01 2 0. 01 3 1. 09 6 1. 04 7 39 2 38 2 0. 91 8 0. 96 8 Pr im ar y co m pl et io n ra te ED .6 (0 .8 57 ) (* ) (* ) (* ) (* ) 42 41 (* ) (* ) Ch ild la bo r CP .2 0. 01 1 0. 00 5 0. 43 3 0. 95 1 0. 97 5 47 1 46 1 0. 00 1 0. 02 0 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 80 67 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 80 67 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 60 6 0. 02 2 0. 03 6 0. 89 5 0. 94 6 52 9 44 3 0. 56 2 0. 65 0 A du lt lit er ac y ED .8 1. 00 0 0. 00 0 0. 00 0 na na 22 1 18 4 1. 00 0 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 09 6 0. 01 3 0. 13 7 1. 11 0 1. 05 4 66 8 55 8 0. 07 0 0. 12 2 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 24 8 0. 01 8 0. 07 4 1. 21 1 1. 10 0 79 7 66 6 0. 21 1 0. 28 5 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 07 3 0. 01 0 0. 13 5 0. 94 7 0. 97 3 78 5 65 6 0. 05 3 0. 09 3 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 66 6 0. 02 7 0. 04 0 2. 13 3 1. 46 1 79 7 66 6 0. 61 3 0. 71 9 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 47 0 0. 02 8 0. 06 0 2. 09 8 1. 44 9 79 7 66 6 0. 41 4 0. 52 6 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 03 7 0. 01 4 0. 38 0 1. 17 3 1. 08 3 24 2 21 2 0. 00 9 0. 06 5 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 38 33 (* ) (* ) Po lio im m un iz at io n co ve ra ge CH .2 (0 .9 67 ) (* ) (* ) (* ) (* ) 38 33 (* ) (* ) Im m un iz at io n co ve ra ge fo r D PT CH .2 (1 .0 00 ) (* ) (* ) na na 36 32 (* ) (* ) M ea sl es im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 38 33 (* ) (* ) Fu lly im m un iz ed c hi ld re n CH .2 (0 .9 67 ) (* ) (* ) (* ) (* ) 38 33 (* ) (* ) A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 00 9 0. 00 6 0. 69 8 0. 92 7 0. 96 3 24 3 21 3 0. 00 0 0. 02 1 D ia rr ho ea in la st tw o w ee ks CH .4 0. 00 9 0. 00 6 0. 67 9 0. 87 7 0. 93 6 24 3 21 3 0. 00 0 0. 02 1 Su pp or t f or le ar ni ng CD .1 0. 80 1 0. 02 6 0. 03 2 0. 88 6 0. 94 1 24 3 21 3 0. 74 9 0. 85 2 Bi rt h re gi st ra tio n CP .1 0. 98 7 0. 01 0 0. 01 0 1. 52 7 1. 23 6 24 3 21 3 0. 96 7 1. 00 0 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN168 T ab le S E .6 . S am p lin g er ro rs : A kt o b e O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 91 2 0. 02 0 0. 02 2 4. 19 5 2. 04 8 62 6 83 3 0. 87 1 0. 95 2 Ch ild d is ci pl in e CP .4 0. 39 5 0. 04 5 0. 11 5 3. 56 7 1. 88 9 29 8 41 6 0. 30 4 0. 48 5 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 95 0 0. 02 6 0. 02 7 11 .9 67 3. 45 9 22 92 83 7 0. 89 8 1. 00 0 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 93 6 0. 03 1 0. 03 3 12 .9 08 3. 59 3 22 92 83 7 0. 87 5 0. 99 7 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 98 7 0. 00 8 0. 00 8 1. 01 0 1. 00 5 15 2 21 6 0. 97 1 1. 00 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 94 9 0. 00 9 0. 00 9 0. 76 1 0. 87 2 32 1 46 1 0. 93 2 0. 96 7 Pr im ar y co m pl et io n ra te ED .6 0. 88 5 0. 03 1 0. 03 5 0. 56 0 0. 74 9 41 60 0. 82 3 0. 94 7 Ch ild la bo r CP .2 0. 02 6 0. 01 0 0. 39 1 2. 24 8 1. 49 9 39 0 55 7 0. 00 6 0. 04 6 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 68 93 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 68 93 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 47 9 0. 04 0 0. 08 4 2. 99 8 1. 73 1 34 8 46 1 0. 39 8 0. 56 0 A du lt lit er ac y ED .8 0. 99 7 0. 00 3 0. 00 3 0. 83 7 0. 91 5 21 7 29 6 0. 99 2 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 05 8 0. 01 2 0. 20 2 1. 82 9 1. 35 3 56 0 72 9 0. 03 4 0. 08 1 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 21 5 0. 04 4 0. 20 7 10 .3 82 3. 22 2 67 5 88 7 0. 12 6 0. 30 3 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 06 1 0. 01 8 0. 29 1 4. 70 7 2. 17 0 65 9 86 1 0. 02 5 0. 09 6 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 58 7 0. 02 9 0. 05 0 3. 10 0 1. 76 1 67 5 88 7 0. 52 9 0. 64 6 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 48 9 0. 04 4 0. 08 9 6. 76 6 2. 60 1 67 5 88 7 0. 40 1 0. 57 6 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 05 7 0. 02 3 0. 40 4 2. 18 5 1. 47 8 17 1 22 1 0. 01 1 0. 10 4 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 43 56 1. 00 0 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 43 56 1. 00 0 1. 00 0 Im m un iz at io n co ve ra ge fo r D PT CH .2 1. 00 0 0. 00 0 0. 00 0 na na 43 56 1. 00 0 1. 00 0 M ea sl es im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 43 56 1. 00 0 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 1. 00 0 0. 00 0 0. 00 0 na na 43 56 1. 00 0 1. 00 0 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 01 0 0. 00 6 0. 57 6 0. 79 6 0. 89 2 18 1 23 4 0. 00 0 0. 02 2 D ia rr ho ea in la st tw o w ee ks CH .4 0. 02 3 0. 01 0 0. 45 3 1. 11 2 1. 05 4 18 1 23 4 0. 00 2 0. 04 3 Su pp or t f or le ar ni ng CD .1 0. 78 7 0. 02 9 0. 03 7 1. 20 0 1. 09 5 18 1 23 4 0. 72 8 0. 84 6 Bi rt h re gi st ra tio n CP .1 0. 99 7 0. 00 3 0. 00 3 0. 81 4 0. 90 2 18 1 23 4 0. 99 0 1. 00 0 na – n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 169 T ab le S E .7 . S am p lin g er ro rs : A lm at y O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 99 7 0. 00 2 0. 00 2 2. 05 2 1. 43 3 13 32 10 81 0. 99 2 1. 00 0 Ch ild d is ci pl in e CP .4 0. 24 6 0. 02 2 0. 09 1 1. 57 5 1. 25 5 70 5 58 2 0. 20 1 0. 29 1 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 97 6 0. 00 7 0. 00 7 2. 13 0 1. 45 9 54 74 10 96 0. 96 3 0. 99 0 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 99 4 0. 00 4 0. 00 4 3. 05 5 1. 74 8 54 74 10 96 0. 98 6 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 98 5 0. 00 8 0. 00 8 1. 27 0 1. 12 7 36 8 30 4 0. 96 9 1. 00 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 93 3 0. 00 9 0. 01 0 0. 84 7 0. 92 1 75 0 62 4 0. 91 4 0. 95 1 Pr im ar y co m pl et io n ra te ED .6 0. 79 7 0. 03 9 0. 04 9 0. 81 1 0. 90 1 10 5 87 0. 71 8 0. 87 5 Ch ild la bo r CP .2 0. 00 9 0. 00 4 0. 42 0 1. 27 0 1. 12 7 95 4 79 0 0. 00 1 0. 01 7 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 22 5 17 9 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 0. 99 5 0. 00 5 0. 00 5 0. 89 7 0. 94 7 22 5 17 9 0. 98 5 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 40 2 0. 02 0 0. 05 1 1. 18 1 1. 08 7 87 5 68 6 0. 36 2 0. 44 3 A du lt lit er ac y ED .8 0. 99 7 0. 00 3 0. 00 3 0. 92 4 0. 96 1 45 1 35 7 0. 99 2 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 09 0 0. 00 9 0. 10 5 1. 03 5 1. 01 7 12 25 95 6 0. 07 1 0. 10 9 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 31 1 0. 02 0 0. 06 6 2. 24 4 1. 49 8 14 75 11 55 0. 27 0 0. 35 1 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 03 9 0. 00 7 0. 18 6 1. 58 7 1. 26 0 14 35 11 23 0. 02 5 0. 05 4 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 42 7 0. 01 6 0. 03 7 1. 20 7 1. 09 9 14 75 11 55 0. 39 5 0. 45 9 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 46 1 0. 02 0 0. 04 3 1. 83 3 1. 35 4 14 75 11 55 0. 42 2 0. 50 1 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 08 1 0. 01 3 0. 16 5 0. 92 3 0. 96 1 50 6 38 3 0. 05 4 0. 10 8 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 0. 99 0 0. 01 0 0. 01 0 0. 90 7 0. 95 3 11 9 91 0. 96 9 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 0. 84 3 0. 04 5 0. 05 4 1. 39 0 1. 17 9 11 8 90 0. 75 2 0. 93 4 Im m un iz at io n co ve ra ge fo r D PT CH .2 0. 88 2 0. 03 9 0. 04 5 1. 29 4 1. 13 7 11 5 88 0. 80 4 0. 96 1 M ea sl es im m un iz at io n co ve ra ge CH .2 0. 97 9 0. 01 4 0. 01 5 0. 85 8 0. 92 6 11 5 88 0. 95 0 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 0. 82 0 0. 04 7 0. 05 8 1. 33 0 1. 15 3 11 7 89 0. 72 6 0. 91 5 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 00 0 0. 00 0 0. 00 0 na na 54 5 41 2 0. 00 0 0. 00 0 D ia rr ho ea in la st tw o w ee ks CH .4 0. 00 2 0. 00 2 0. 98 8 0. 91 1 0. 95 4 54 5 41 2 0. 00 0 0. 00 7 Su pp or t f or le ar ni ng CD .1 0. 60 4 0. 02 8 0. 04 6 1. 31 3 1. 14 6 54 5 41 2 0. 54 9 0. 65 9 Bi rt h re gi st ra tio n CP .1 0. 98 8 0. 00 4 0. 00 4 0. 63 9 0. 80 0 54 5 41 2 0. 97 9 0. 99 7 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN170 T ab le S E .8 . S am p lin g er ro rs : A ty ra u O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 87 0 0. 01 0 0. 01 2 0. 75 0 0. 86 6 33 4 78 2 0. 84 9 0. 89 1 Ch ild d is ci pl in e CP .4 0. 55 4 0. 02 3 0. 04 1 0. 91 6 0. 95 7 18 4 44 4 0. 50 8 0. 59 9 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 89 3 0. 03 5 0. 03 9 9. 80 1 3. 13 1 15 11 78 2 0. 82 3 0. 96 2 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 1. 00 0 0. 00 0 0. 00 0 na na 15 11 78 2 1. 00 0 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 98 9 0. 00 7 0. 00 7 0. 92 2 0. 96 0 10 1 24 7 0. 97 6 1. 00 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 95 9 0. 01 3 0. 01 3 2. 48 3 1. 57 6 24 5 61 0 0. 93 4 0. 98 4 Pr im ar y co m pl et io n ra te ED .6 0. 90 4 0. 03 2 0. 03 6 0. 80 9 0. 89 9 28 69 0. 84 0 0. 96 8 Ch ild la bo r CP .2 0. 00 2 0. 00 2 1. 02 3 1. 34 4 1. 15 9 27 4 68 1 0. 00 0 0. 00 6 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 53 12 4 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 53 12 4 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 52 4 0. 02 8 0. 05 4 1. 69 8 1. 30 3 23 6 53 2 0. 46 7 0. 58 0 A du lt lit er ac y ED .8 1. 00 0 0. 00 0 0. 00 0 na na 17 5 39 6 1. 00 0 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 04 2 0. 00 5 0. 12 9 0. 57 9 0. 76 1 35 6 79 8 0. 03 1 0. 05 3 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 19 0. 02 3 0. 12 2 3. 55 5 1. 88 6 45 8 10 26 0. 14 4 0. 23 6 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 07 6 0. 02 3 0. 30 0 7. 48 7 2. 73 6 45 0 10 04 0. 03 0 0. 12 2 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 45 8 0. 02 9 0. 06 4 3. 49 0 1. 86 8 45 8 10 26 0. 39 9 0. 51 6 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 39 8 0. 03 2 0. 08 1 4. 45 4 2. 11 0 45 8 10 26 0. 33 4 0. 46 3 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 02 2 0. 00 9 0. 43 5 1. 22 3 1. 10 6 13 4 29 2 0. 00 3 0. 04 1 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 26 59 1. 00 0 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 26 59 1. 00 0 1. 00 0 Im m un iz at io n co ve ra ge fo r D PT CH .2 1. 00 0 0. 00 0 0. 00 0 na na 26 59 1. 00 0 1. 00 0 M ea sl es im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 26 59 1. 00 0 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 1. 00 0 0. 00 0 0. 00 0 na na 26 59 1. 00 0 1. 00 0 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 01 4 0. 00 6 0. 43 7 0. 84 0 0. 91 7 14 3 31 4 0. 00 2 0. 02 6 D ia rr ho ea in la st tw o w ee ks CH .4 0. 00 9 0. 00 5 0. 60 4 1. 02 8 1. 01 4 14 3 31 4 0. 00 0 0. 02 0 Su pp or t f or le ar ni ng CD .1 0. 79 4 0. 02 5 0. 03 2 1. 24 2 1. 11 4 14 3 31 4 0. 74 3 0. 84 5 Bi rt h re gi st ra tio n CP .1 1. 00 0 0. 00 0 0. 00 0 na na 14 3 31 4 1. 00 0 1. 00 0 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 171 T ab le S E .9 . S am p lin g er ro rs : W es t K az ak h st an O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 90 5 0. 02 8 0. 03 1 7. 57 5 2. 75 2 60 0 82 0 0. 84 8 0. 96 1 Ch ild d is ci pl in e CP .4 0. 57 0 0. 03 2 0. 05 6 1. 64 9 1. 28 4 27 6 39 5 0. 50 6 0. 63 4 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 90 5 0. 04 4 0. 04 9 18 .4 04 4. 29 0 22 64 82 0 0. 81 7 0. 99 3 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 99 8 0. 00 1 0. 00 1 0. 21 0 0. 45 8 22 64 82 0 0. 99 6 0. 99 9 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 99 4 0. 00 6 0. 00 6 0. 91 3 0. 95 5 11 3 16 3 0. 98 3 1. 00 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 94 5 0. 00 8 0. 00 8 0. 54 7 0. 74 0 33 5 48 5 0. 93 0 0. 96 1 Pr im ar y co m pl et io n ra te ED .6 (0 .9 56 ) (* ) (* ) (* ) (* ) 28 40 (* ) (* ) Ch ild la bo r CP .2 0. 02 4 0. 00 9 0. 38 6 1. 86 1 1. 36 4 34 4 50 1 0. 00 6 0. 04 3 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 58 79 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 58 79 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 62 3 0. 02 4 0. 03 9 1. 25 6 1. 12 1 38 8 50 9 0. 57 5 0. 67 1 A du lt lit er ac y ED .8 0. 99 3 0. 00 5 0. 00 5 0. 99 5 0. 99 8 23 9 30 7 0. 98 4 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 05 4 0. 00 8 0. 15 1 0. 93 9 0. 96 9 56 5 73 1 0. 03 8 0. 07 0 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 32 4 0. 02 9 0. 09 0 3. 52 9 1. 87 8 69 9 90 5 0. 26 5 0. 38 2 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 02 8 0. 00 6 0. 21 8 1. 21 4 1. 10 2 69 4 89 8 0. 01 6 0. 04 0 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 83 6 0. 01 5 0. 01 8 1. 50 3 1. 22 6 69 9 90 5 0. 80 6 0. 86 6 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 56 0 0. 02 6 0. 04 6 2. 44 4 1. 56 3 69 9 90 5 0. 50 9 0. 61 2 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 08 8 0. 01 9 0. 21 7 0. 90 2 0. 95 0 14 9 20 0 0. 04 9 0. 12 6 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 (0 .9 78 ) (* ) (* ) (* ) (* ) 31 42 (* ) (* ) Po lio im m un iz at io n co ve ra ge CH .2 (0 .9 78 ) (* ) (* ) (* ) (* ) 31 41 (* ) (* ) Im m un iz at io n co ve ra ge fo r D PT CH .2 (0 .9 78 ) (* ) (* ) (* ) (* ) 31 41 (* ) (* ) M ea sl es im m un iz at io n co ve ra ge CH .2 (0 .9 47 ) (* ) (* ) (* ) (* ) 31 42 (* ) (* ) Fu lly im m un iz ed c hi ld re n CH .2 (0 .9 46 ) (* ) (* ) (* ) (* ) 31 41 (* ) (* ) A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 04 7 0. 01 0 0. 21 2 0. 44 8 0. 66 9 15 2 20 3 0. 02 7 0. 06 7 D ia rr ho ea in la st tw o w ee ks CH .4 0. 03 8 0. 01 2 0. 32 3 0. 83 2 0. 91 2 15 2 20 3 0. 01 3 0. 06 3 Su pp or t f or le ar ni ng CD .1 0. 87 3 0. 02 3 0. 02 6 0. 92 7 0. 96 3 15 2 20 3 0. 82 8 0. 91 8 Bi rt h re gi st ra tio n CP .1 0. 99 5 0. 00 5 0. 00 5 0. 92 5 0. 96 2 15 2 20 3 0. 98 6 1. 00 0 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN172 T ab le S E .1 0. S am p lin g er ro rs : Z h am b yl O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 91 2 0. 01 5 0. 01 6 2. 57 5 1. 60 5 82 1 96 1 0. 88 3 0. 94 1 Ch ild d is ci pl in e CP .4 0. 62 5 0. 02 5 0. 04 0 1. 42 6 1. 19 4 44 1 52 7 0. 57 5 0. 67 6 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 99 6 0. 00 3 0. 00 3 1. 60 2 1. 26 6 31 90 97 4 0. 99 1 1. 00 0 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 98 8 0. 00 4 0. 00 5 1. 58 7 1. 26 0 31 90 97 4 0. 97 9 0. 99 7 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 97 2 0. 01 3 0. 01 4 1. 68 1 1. 29 6 21 2 25 7 0. 94 5 0. 99 9 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 95 5 0. 00 9 0. 00 9 1. 09 0 1. 04 4 47 8 57 7 0. 93 7 0. 97 3 Pr im ar y co m pl et io n ra te ED .6 0. 89 5 0. 02 6 0. 03 0 0. 56 3 0. 75 0 63 77 0. 84 2 0. 94 8 Ch ild la bo r CP .2 0. 01 0 0. 00 5 0. 55 7 2. 25 4 1. 50 1 60 3 73 4 0. 00 0 0. 02 1 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 13 9 16 5 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 13 9 16 5 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 42 8 0. 02 3 0. 05 3 1. 25 5 1. 12 0 51 0 59 2 0. 38 2 0. 47 4 A du lt lit er ac y ED .8 0. 99 7 0. 00 3 0. 00 3 0. 82 4 0. 90 7 27 6 31 6 0. 99 2 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 12 0 0. 01 2 0. 10 2 1. 17 7 1. 08 5 72 5 82 6 0. 09 6 0. 14 5 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 11 5 0. 01 7 0. 15 1 2. 97 4 1. 72 4 87 7 99 8 0. 08 0 0. 15 0 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 01 9 0. 00 6 0. 31 1 1. 77 3 1. 33 2 85 4 96 8 0. 00 7 0. 03 0 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 42 0 0. 02 1 0. 05 0 1. 83 5 1. 35 5 87 7 99 8 0. 37 7 0. 46 2 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 64 7 0. 03 0 0. 04 6 3. 87 0 1. 96 7 87 7 99 8 0. 58 7 0. 70 6 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 02 1 0. 00 7 0. 33 3 0. 88 6 0. 94 2 33 7 37 9 0. 00 7 0. 03 5 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 78 89 1. 00 0 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 78 89 1. 00 0 1. 00 0 Im m un iz at io n co ve ra ge fo r D PT CH .2 1. 00 0 0. 00 0 0. 00 0 na na 78 89 1. 00 0 1. 00 0 M ea sl es im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 78 89 1. 00 0 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 1. 00 0 0. 00 0 0. 00 0 na na 78 89 1. 00 0 1. 00 0 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 01 3 0. 00 6 0. 47 5 1. 18 9 1. 09 0 34 5 38 7 0. 00 1 0. 02 6 D ia rr ho ea in la st tw o w ee ks CH .4 0. 02 5 0. 00 8 0. 30 7 0. 91 4 0. 95 6 34 5 38 7 0. 00 9 0. 04 0 Su pp or t f or le ar ni ng CD .1 0. 69 7 0. 03 1 0. 04 5 1. 80 9 1. 34 5 34 5 38 7 0. 63 4 0. 76 0 Bi rt h re gi st ra tio n CP .1 0. 98 6 0. 00 7 0. 00 7 1. 46 0 1. 20 8 34 5 38 7 0. 97 1 1. 00 0 na – n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 173 T ab le S E .1 1. S am p lin g er ro rs : K ar ag an d y O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 89 5 0. 01 2 0. 01 3 1. 62 8 1. 27 6 16 14 10 52 0. 87 1 0. 91 9 Ch ild d is ci pl in e CP .4 0. 68 8 0. 02 2 0. 03 1 0. 87 4 0. 93 5 61 4 40 4 0. 64 5 0. 73 1 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 96 1 0. 01 9 0. 02 0 10 .6 16 3. 25 8 49 58 10 52 0. 92 2 1. 00 0 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 99 3 0. 00 2 0. 00 2 0. 55 1 0. 74 2 49 58 10 52 0. 98 9 0. 99 7 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 98 8 0. 00 8 0. 00 8 1. 04 0 1. 02 0 27 1 18 0 0. 97 1 1. 00 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 95 9 0. 01 1 0. 01 1 1. 35 4 1. 16 3 65 7 44 0 0. 93 8 0. 98 1 Pr im ar y co m pl et io n ra te ED .6 (0 .9 02 ) (* ) (* ) (* ) (* ) 67 44 (* ) (* ) Ch ild la bo r CP .2 0. 00 5 0. 00 3 0. 69 8 1. 06 4 1. 03 2 71 8 47 8 0. 00 0 0. 01 1 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 12 9 81 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 12 9 81 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 55 0 0. 02 1 0. 03 8 0. 90 9 0. 95 4 79 9 50 5 0. 50 8 0. 59 3 A du lt lit er ac y ED .8 1. 00 0 0. 00 0 0. 00 0 na na 48 6 30 5 1. 00 0 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 11 1 0. 01 3 0. 11 8 1. 31 2 1. 14 5 12 07 75 7 0. 08 5 0. 13 7 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 25 0 0. 02 0 0. 08 1 2. 00 9 1. 41 7 14 76 92 4 0. 21 0 0. 29 1 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 01 7 0. 00 5 0. 28 3 1. 31 4 1. 14 6 14 73 92 2 0. 00 8 0. 02 7 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 71 1 0. 02 0 0. 02 8 1. 77 1 1. 33 1 14 76 92 4 0. 67 1 0. 75 0 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 53 5 0. 02 5 0. 04 7 2. 34 3 1. 53 1 14 76 92 4 0. 48 5 0. 58 6 W O M EN U nd er w ei gh t p re va le nc e N U .1 0. 03 2 0. 01 6 0. 49 6 1. 45 6 1. 20 7 29 6 17 9 0. 00 0 0. 06 4 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 (0 .9 77 ) (* ) (* ) (* ) (* ) 79 46 (* ) (* ) Po lio im m un iz at io n co ve ra ge CH .2 (0 .9 77 ) (* ) (* ) (* ) (* ) 79 46 (* ) (* ) Im m un iz at io n co ve ra ge fo r D PT CH .2 (0 .9 77 ) (* ) (* ) (* ) (* ) 79 46 (* ) (* ) M ea sl es im m un iz at io n co ve ra ge CH .2 (0 .9 77 ) (* ) (* ) (* ) (* ) 79 46 (* ) (* ) Fu lly im m un iz ed c hi ld re n CH .2 (0 .9 77 ) (* ) (* ) (* ) (* ) 79 46 (* ) (* ) A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 05 3 0. 01 9 0. 35 3 1. 32 2 1. 15 0 31 6 19 1 0. 01 6 0. 09 0 D ia rr ho ea in la st tw o w ee ks CH .4 0. 04 0 0. 01 6 0. 39 8 1. 24 5 1. 11 6 31 6 19 1 0. 00 8 0. 07 1 Su pp or t f or le ar ni ng CD .1 0. 85 3 0. 02 4 0. 02 8 0. 85 2 0. 92 3 31 6 19 1 0. 80 5 0. 90 0 Bi rt h re gi st ra tio n CP .1 0. 98 9 0. 00 8 0. 00 8 1. 12 1 1. 05 9 31 6 19 1 0. 97 2 1. 00 0 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN174 T ab le S E .1 2. S am p lin g er ro rs : K o st an ai O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 98 3 0. 00 6 0. 00 6 1. 72 5 1. 31 3 11 68 92 0 0. 97 2 0. 99 4 Ch ild d is ci pl in e CP .4 0. 44 9 0. 02 9 0. 06 4 1. 24 1 1. 11 4 45 2 37 1 0. 39 1 0. 50 6 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 83 2 0. 03 9 0. 04 7 10 .1 57 3. 18 7 36 17 92 1 0. 75 3 0. 91 0 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 1. 00 0 0. 00 0 0. 00 0 na na 36 17 92 1 1. 00 0 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 97 9 0. 00 8 0. 00 8 0. 44 7 0. 66 9 19 8 16 5 0. 96 3 0. 99 4 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 95 7 0. 01 3 0. 01 4 1. 59 1 1. 26 1 46 6 38 7 0. 93 1 0. 98 3 Pr im ar y co m pl et io n ra te ED .6 0. 88 0 0. 04 5 0. 05 1 1. 00 0 1. 00 0 66 54 0. 79 1 0. 96 9 Ch ild la bo r CP .2 0. 04 8 0. 01 2 0. 25 0 1. 35 9 1. 16 6 51 4 43 0 0. 02 4 0. 07 2 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 84 67 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 84 67 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 60 4 0. 03 2 0. 05 2 1. 90 2 1. 37 9 58 4 45 6 0. 54 1 0. 66 8 A du lt lit er ac y ED .8 0. 99 5 0. 00 5 0. 00 5 1. 20 2 1. 09 6 29 6 22 8 0. 98 4 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 10 1 0. 01 3 0. 13 3 1. 30 4 1. 14 2 85 1 65 3 0. 07 4 0. 12 8 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 21 8 0. 01 9 0. 08 7 1. 65 8 1. 28 8 10 16 78 2 0. 18 0 0. 25 6 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 03 3 0. 01 0 0. 30 4 2. 40 9 1. 55 2 10 02 77 1 0. 01 3 0. 05 3 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 69 4 0. 02 0 0. 02 8 1. 41 9 1. 19 1 10 16 78 2 0. 65 5 0. 73 4 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 55 7 0. 02 5 0. 04 5 1. 99 1 1. 41 1 10 16 78 2 0. 50 6 0. 60 7 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 03 9 0. 01 3 0. 33 1 0. 83 6 0. 91 4 25 4 19 1 0. 01 3 0. 06 4 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 54 42 (* ) (* ) Po lio im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 54 42 (* ) (* ) Im m un iz at io n co ve ra ge fo r D PT CH .2 (1 .0 00 ) (* ) (* ) na na 54 42 (* ) (* ) M ea sl es im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 54 42 (* ) (* ) Fu lly im m un iz ed c hi ld re n CH .2 (1 .0 00 ) (* ) (* ) na na 54 42 (* ) (* ) A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 02 2 0. 01 1 0. 50 0 1. 13 7 1. 06 6 26 7 20 1 0. 00 0 0. 04 4 D ia rr ho ea in la st tw o w ee ks CH .4 0. 02 9 0. 01 3 0. 45 3 1. 24 5 1. 11 6 26 7 20 1 0. 00 3 0. 05 6 Su pp or t f or le ar ni ng CD .1 0. 87 9 0. 01 7 0. 01 9 0. 53 8 0. 73 4 26 7 20 1 0. 84 5 0. 91 3 Bi rt h re gi st ra tio n CP .1 0. 98 5 0. 00 8 0. 00 8 0. 95 1 0. 97 5 26 7 20 1 0. 96 9 1. 00 0 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 175 T ab le S E .1 3. S am p lin g er ro rs : K yz yl o rd a O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 94 6 0. 01 3 0. 01 3 2. 52 0 1. 58 7 40 9 83 0 0. 92 1 0. 97 1 Ch ild d is ci pl in e CP .4 0. 58 7 0. 02 1 0. 03 5 0. 96 0 0. 98 0 26 5 54 7 0. 54 6 0. 62 8 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 96 7 0. 02 6 0. 02 7 17 .6 43 4. 20 0 19 21 83 0 0. 91 5 1. 00 0 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 1. 00 0 0. 00 0 0. 00 0 na na 19 21 83 0 1. 00 0 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 98 5 0. 00 5 0. 00 5 0. 54 9 0. 74 1 14 3 29 7 0. 97 5 0. 99 6 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 95 6 0. 00 8 0. 00 8 1. 02 6 1. 01 3 33 3 69 5 0. 94 0 0. 97 1 Pr im ar y co m pl et io n ra te ED .6 0. 95 2 0. 02 4 0. 02 5 1. 06 6 1. 03 3 40 84 0. 90 4 1. 00 0 Ch ild la bo r CP .2 0. 07 2 0. 01 3 0. 17 5 1. 99 7 1. 41 3 40 3 84 2 0. 04 7 0. 09 7 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 80 15 6 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 80 15 6 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 57 1 0. 02 2 0. 03 9 1. 21 5 1. 10 2 30 1 59 2 0. 52 7 0. 61 6 A du lt lit er ac y ED .8 0. 99 4 0. 00 4 0. 00 4 0. 96 8 0. 98 4 17 7 34 1 0. 98 6 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 06 9 0. 01 0 0. 13 8 1. 17 4 1. 08 3 42 9 83 2 0. 05 0 0. 08 8 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 12 85 0. 01 3 0. 10 1 1. 53 3 1. 23 8 52 8 10 22 0. 10 3 0. 15 4 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 03 0 0. 00 5 0. 17 4 0. 89 6 0. 94 7 49 7 95 7 0. 02 0 0. 04 1 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 53 3 0. 01 9 0. 03 6 1. 50 0 1. 22 5 52 8 10 22 0. 49 5 0. 57 1 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 60 7 0. 02 5 0. 04 2 2. 72 3 1. 65 0 52 8 10 22 0. 55 7 0. 65 8 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 03 9 0. 01 0 0. 25 7 0. 94 6 0. 97 3 18 8 35 9 0. 01 9 0. 05 8 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 44 82 1. 00 0 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 44 82 1. 00 0 1. 00 0 Im m un iz at io n co ve ra ge fo r D PT CH .2 1. 00 0 0. 00 0 0. 00 0 na na 44 82 1. 00 0 1. 00 0 M ea sl es im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 44 82 1. 00 0 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 1. 00 0 0. 00 0 0. 00 0 na na 44 82 1. 00 0 1. 00 0 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 01 0 0. 00 5 0. 50 2 1. 01 9 1. 00 9 20 9 39 7 0. 00 0 0. 02 0 D ia rr ho ea in la st tw o w ee ks CH .4 0. 00 5 0. 00 3 0. 68 8 0. 95 4 0. 97 7 20 9 39 7 0. 00 0 0. 01 2 Su pp or t f or le ar ni ng CD .1 0. 71 7 0. 02 4 0. 03 3 1. 10 3 1. 05 0 20 9 39 7 0. 66 9 0. 76 4 Bi rt h re gi st ra tio n CP .1 0. 99 7 0. 00 3 0. 00 3 1. 18 6 1. 08 9 20 9 39 7 0. 99 1 1. 00 0 na – n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN176 T ab le S E .1 4. S am p lin g er ro rs : M an gi st au O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 99 5 0. 00 2 0. 00 2 0. 41 1 0. 64 1 27 3 75 8 0. 99 1 0. 99 8 Ch ild d is ci pl in e CP .4 0. 40 9 0. 02 7 0. 06 6 1. 28 3 1. 13 3 14 2 42 1 0. 35 5 0. 46 4 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 99 8 0. 00 2 0. 00 2 1. 74 8 1. 32 2 11 27 75 8 0. 99 3 1. 00 0 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 99 9 0. 00 1 0. 00 1 0. 63 5 0. 79 7 11 27 75 8 0. 99 8 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 99 3 0. 00 5 0. 00 5 1. 01 4 1. 00 7 84 25 9 0. 98 2 1. 00 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 98 7 0. 00 5 0. 00 5 1. 13 3 1. 06 4 16 4 49 7 0. 97 7 0. 99 8 Pr im ar y co m pl et io n ra te ED .6 0. 91 1 0. 04 5 0. 05 0 1. 62 1 1. 27 3 21 65 0. 82 0 1. 00 0 Ch ild la bo r CP .2 0. 01 8 0. 01 2 0. 63 9 4. 83 1 2. 19 8 20 7 63 2 0. 00 0 0. 04 2 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 45 13 3 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 45 13 3 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 53 4 0. 02 0 0. 03 7 0. 83 5 0. 91 4 18 3 51 9 0. 49 4 0. 57 4 A du lt lit er ac y ED .8 1. 00 0 0. 00 0 0. 00 0 na na 11 7 33 9 1. 00 0 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 04 6 0. 01 0 0. 21 3 1. 67 8 1. 29 6 27 9 77 8 0. 02 6 0. 06 5 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 10 7 0. 02 9 0. 27 0 8. 16 4 2. 85 7 33 5 93 8 0. 04 9 0. 16 5 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 01 5 0. 00 2 0. 10 4 0. 15 3 0. 39 1 33 2 93 1 0. 01 2 0. 01 8 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 52 8 0. 02 8 0. 05 3 2. 96 1 1. 72 1 33 5 93 8 0. 47 2 0. 58 5 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 61 2 0. 04 5 0. 07 3 7. 92 6 2. 81 5 33 5 93 8 0. 52 3 0. 70 2 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 02 7 0. 01 3 0. 46 8 1. 81 7 1. 34 8 10 2 29 8 0. 00 2 0. 05 3 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 26 76 1. 00 0 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 26 76 1. 00 0 1. 00 0 Im m un iz at io n co ve ra ge fo r D PT CH .2 1. 00 0 0. 00 0 0. 00 0 na na 26 76 1. 00 0 1. 00 0 M ea sl es im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 26 76 1. 00 0 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 1. 00 0 0. 00 0 0. 00 0 na na 26 76 1. 00 0 1. 00 0 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 01 9 0. 00 9 0. 48 0 1. 38 3 1. 17 6 10 9 31 9 0. 00 1 0. 03 6 D ia rr ho ea in la st tw o w ee ks CH .4 0. 00 4 0. 00 4 0. 94 6 1. 23 0 1. 10 9 10 9 31 9 0. 00 0 0. 01 2 Su pp or t f or le ar ni ng CD .1 0. 84 3 0. 02 4 0. 02 8 1. 34 0 1. 15 8 10 9 31 9 0. 79 6 0. 89 0 Bi rt h re gi st ra tio n CP .1 0. 99 4 0. 00 5 0. 00 5 1. 12 9 1. 06 3 10 9 31 9 0. 98 4 1. 00 0 na – n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 177 T ab le S E .1 5. S am p lin g er ro rs : S o ut h K az ak h st an O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 94 6 0. 00 7 0. 00 7 1. 08 4 1. 04 1 14 14 11 24 0. 93 2 0. 96 0 Ch ild d is ci pl in e CP .4 0. 55 7 0. 02 3 0. 04 1 1. 56 0 1. 24 9 89 9 72 6 0. 51 1 0. 60 3 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 85 7 0. 02 0 0. 02 4 3. 80 7 1. 95 1 67 90 11 25 0. 81 7 0. 89 8 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 99 9 0. 00 1 0. 00 1 0. 70 5 0. 84 0 67 90 11 25 0. 99 8 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 99 4 0. 00 3 0. 00 3 0. 85 7 0. 92 6 57 2 46 8 0. 98 8 1. 00 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 94 0 0. 00 9 0. 01 0 1. 33 7 1. 15 6 11 16 91 3 0. 92 2 0. 95 8 Pr im ar y co m pl et io n ra te ED .6 0. 95 3 0. 01 9 0. 02 0 1. 12 3 1. 06 0 16 9 14 1 0. 91 5 0. 99 1 Ch ild la bo r CP .2 0. 01 6 0. 00 5 0. 30 6 1. 86 6 1. 36 6 14 81 12 10 0. 00 6 0. 02 6 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 30 9 24 3 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 30 9 24 3 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 26 6 0. 01 6 0. 06 1 1. 21 4 1. 10 2 11 56 89 5 0. 23 3 0. 29 8 A du lt lit er ac y ED .8 0. 99 8 0. 00 2 0. 00 2 0. 86 6 0. 93 1 60 2 47 3 0. 99 4 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 07 8 0. 01 0 0. 13 0 1. 58 4 1. 25 9 14 59 11 11 0. 05 8 0. 09 9 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 12 4 0. 01 0 0. 07 8 1. 15 2 1. 07 3 17 68 13 52 0. 10 5 0. 14 3 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 02 0 0. 00 4 0. 21 9 1. 34 0 1. 15 8 17 56 13 44 0. 01 1 0. 02 9 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 56 1 0. 03 1 0. 05 5 5. 15 6 2. 27 1 17 68 13 52 0. 50 0 0. 62 2 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 60 6 0. 01 5 0. 02 5 1. 30 3 1. 14 1 17 68 13 52 0. 57 6 0. 63 7 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 02 8 0. 00 7 0. 23 4 0. 96 0 0. 98 0 80 7 60 3 0. 01 5 0. 04 1 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 18 4 13 9 1. 00 0 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 0. 99 0 0. 00 9 0. 00 9 1. 28 2 1. 13 2 18 4 13 9 0. 97 2 1. 00 0 Im m un iz at io n co ve ra ge fo r D PT CH .2 0. 99 0 0. 00 9 0. 00 9 1. 28 2 1. 13 2 18 4 13 9 0. 97 2 1. 00 0 M ea sl es im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 18 3 13 8 1. 00 0 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 0. 99 0 0. 00 9 0. 00 9 1. 28 2 1. 13 2 18 4 13 9 0. 97 2 1. 00 0 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 01 1 0. 00 5 0. 51 5 1. 75 4 1. 32 4 82 7 61 9 0. 00 0 0. 02 2 D ia rr ho ea in la st tw o w ee ks CH .4 0. 00 6 0. 00 4 0. 56 9 1. 27 8 1. 13 1 82 7 61 9 0. 00 0 0. 01 4 Su pp or t f or le ar ni ng CD .1 0. 94 3 0. 00 7 0. 00 8 0. 59 3 0. 77 0 82 7 61 9 0. 92 9 0. 95 8 Bi rt h re gi st ra tio n CP .1 0. 99 2 0. 00 3 0. 00 3 0. 50 6 0. 71 2 82 7 61 9 0. 98 7 0. 99 7 na – n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN178 T ab le S E .1 6. S am p lin g er ro rs : P av lo d ar O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 68 3 0. 02 0 0. 02 9 1. 55 4 1. 24 7 90 9 87 1 0. 64 3 0. 72 2 Ch ild d is ci pl in e CP .4 0. 71 5 0. 02 3 0. 03 2 0. 81 5 0. 90 3 33 2 32 8 0. 67 0 0. 76 0 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 96 3 0. 01 2 0. 01 2 3. 33 0 1. 82 5 27 54 87 3 0. 94 0 0. 98 6 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 1. 00 0 0. 00 0 0. 00 0 na na 27 54 87 3 1. 00 0 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 96 6 0. 01 2 0. 01 2 0. 62 0 0. 78 7 14 0 14 0 0. 94 2 0. 99 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 94 6 0. 01 2 0. 01 3 1. 01 8 1. 00 9 36 4 36 6 0. 92 3 0. 97 0 Pr im ar y co m pl et io n ra te ED .6 (0 .8 15 ) (* ) (* ) (* ) (* ) 34 36 (* ) (* ) Ch ild la bo r CP .2 0. 05 9 0. 01 2 0. 21 1 1. 06 3 1. 03 1 38 2 38 4 0. 03 4 0. 08 3 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 84 75 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 84 75 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 61 0 0. 02 3 0. 03 8 0. 97 4 0. 98 7 46 3 43 3 0. 56 4 0. 65 6 A du lt lit er ac y ED .8 0. 99 5 0. 00 5 0. 00 5 1. 15 9 1. 07 7 25 5 23 4 0. 98 5 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 09 0 0. 01 0 0. 10 8 0. 72 3 0. 85 0 68 6 63 0 0. 07 1 0. 11 0 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 34 8 0. 01 5 0. 04 2 0. 72 7 0. 85 2 82 0 75 6 0. 31 9 0. 37 8 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 05 2 0. 00 7 0. 13 8 0. 77 5 0. 88 0 81 3 74 9 0. 03 7 0. 06 6 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 90 3 0. 01 0 0. 01 2 0. 94 3 0. 97 1 82 0 75 6 0. 88 2 0. 92 4 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 65 0 0. 01 8 0. 02 7 1. 02 7 1. 01 4 82 0 75 6 0. 61 5 0. 68 5 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 02 1 0. 01 1 0. 49 6 0. 88 9 0. 94 3 19 0 16 8 0. 00 0 0. 04 2 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 47 41 (* ) (* ) Po lio im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 47 41 (* ) (* ) Im m un iz at io n co ve ra ge fo r D PT CH .2 (1 .0 00 ) (* ) (* ) na na 47 41 (* ) (* ) M ea sl es im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 47 41 (* ) (* ) Fu lly im m un iz ed c hi ld re n CH .2 (1 .0 00 ) (* ) (* ) na na 47 41 (* ) (* ) A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 02 7 0. 01 2 0. 44 6 0. 95 3 0. 97 6 19 7 17 3 0. 00 3 0. 05 1 D ia rr ho ea in la st tw o w ee ks CH .4 0. 03 6 0. 01 6 0. 44 1 1. 23 9 1. 11 3 19 7 17 3 0. 00 4 0. 06 7 Su pp or t f or le ar ni ng CD .1 0. 86 1 0. 02 5 0. 03 0 0. 93 2 0. 96 6 19 7 17 3 0. 81 0 0. 91 2 Bi rt h re gi st ra tio n CP .1 0. 99 3 0. 00 7 0. 00 7 1. 20 7 1. 09 9 19 7 17 3 0. 98 0 1. 00 0 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 179 T ab le S E .1 7. S am p lin g er ro rs : N o rt h K az ak h st an O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0, 96 7 0, 00 5 0, 00 6 0, 75 6 0, 87 0 80 5 84 7 0, 95 6 0, 97 7 Ch ild d is ci pl in e CP .4 0, 65 9 0, 03 5 0, 05 3 1, 71 4 1, 30 9 29 8 32 1 0, 59 0 0, 72 9 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0, 81 7 0, 04 6 0, 05 6 11 ,9 10 3, 45 1 24 39 84 7 0, 72 5 0, 90 9 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0, 99 2 0, 00 4 0, 00 4 2, 02 6 1, 42 3 24 39 84 7 0, 98 3 1, 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0, 97 6 0, 01 5 0, 01 5 1, 15 2 1, 07 3 11 7 13 0 0, 94 6 1, 00 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0, 95 0 0, 01 4 0, 01 5 1, 49 5 1, 22 3 31 5 34 3 0, 92 2 0, 97 9 Pr im ar y co m pl et io n ra te ED .6 (* ) (* ) (* ) (* ) (* ) 22 23 (* ) (* ) Ch ild la bo r CP .2 0, 04 2 0, 00 8 0, 18 3 0, 55 5 0, 74 5 34 5 37 6 0, 02 7 0, 05 8 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 0, 96 4 0, 02 2 0, 02 3 0, 85 7 0, 92 6 61 60 0, 91 9 1, 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 61 60 1, 00 0 1, 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0, 55 5 0, 02 7 0, 04 9 1, 26 1 1, 12 3 41 8 42 7 0, 50 1 0, 60 9 A du lt lit er ac y ED .8 1. 00 0 0. 00 0 0. 00 0 na na 17 5 17 7 1, 00 0 1, 00 0 M ar ria ge b ef or e ag e 18 CP .5 0, 11 3 0, 01 6 0, 14 3 1, 50 0 1, 22 5 57 3 57 6 0, 08 1 0, 14 6 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0, 28 1 0, 02 6 0, 09 4 2, 36 2 1, 53 7 67 4 68 1 0, 22 8 0, 33 4 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0, 05 3 0, 01 2 0, 21 8 1, 80 2 1, 34 2 67 2 67 8 0, 03 0 0, 07 6 W om en w ho h av e be en te st ed fo r H IV H A .6 0, 75 3 0, 01 5 0, 01 9 0, 78 8 0, 88 7 67 4 68 1 0, 72 4 0, 78 3 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0, 41 4 0, 01 5 0, 03 6 0, 61 6 0, 78 5 67 4 68 1 0, 38 4 0, 44 3 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 02 8 0. 01 4 0. 51 4 1. 16 1 1. 07 7 15 8 15 6 0. 00 0 0. 05 6 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 28 28 (* ) (* ) Po lio im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 28 28 (* ) (* ) Im m un iz at io n co ve ra ge fo r D PT CH .2 (1 .0 00 ) (* ) (* ) na na 28 28 (* ) (* ) M ea sl es im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 28 28 (* ) (* ) Fu lly im m un iz ed c hi ld re n CH .2 (1 .0 00 ) (* ) (* ) na na 28 28 (* ) (* ) A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 02 8 0. 01 4 0. 51 7 1. 22 9 1. 10 8 16 3 16 1 0. 00 0 0. 05 7 D ia rr ho ea in la st tw o w ee ks CH .4 0. 06 3 0. 01 7 0. 26 4 0. 75 3 0. 86 8 16 3 16 1 0. 03 0 0. 09 7 Su pp or t f or le ar ni ng CD .1 0. 77 9 0. 03 0 0. 03 8 0. 83 2 0. 91 2 16 3 16 1 0. 71 9 0. 83 9 Bi rt h re gi st ra tio n CP .1 0. 99 1 0. 00 9 0. 00 9 1. 38 0 1. 17 5 16 3 16 1 0. 97 4 1. 00 0 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN180 T ab le S E .1 8. S am p lin g er ro rs : E as t K az ak h st an O b la st St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 92 8 0. 01 6 0. 01 7 3. 96 7 1. 99 2 16 52 10 82 0. 89 6 0. 95 9 Ch ild d is ci pl in e CP .4 0. 52 9 0. 03 1 0. 05 9 1. 51 1 1. 22 9 55 8 38 5 0. 46 7 0. 59 2 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 0. 96 4 0. 01 2 0. 01 3 4. 55 6 2. 13 5 50 97 10 82 0. 94 0 0. 98 8 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 1. 00 0 0. 00 0 0. 00 0 na na 50 97 10 82 1. 00 0 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 93 6 0. 02 1 0. 02 2 1. 09 8 1. 04 8 21 3 15 1 0. 89 4 0. 97 8 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 97 9 0. 00 8 0. 00 8 1. 33 8 1. 15 7 64 7 45 0 0. 96 3 0. 99 5 Pr im ar y co m pl et io n ra te ED .6 (0 .7 93 ) (* ) (* ) (* ) (* ) 63 43 (* ) (* ) Ch ild la bo r CP .2 0. 01 0 0. 00 3 0. 34 2 0. 48 7 0. 69 8 61 1 43 3 0. 00 3 0. 01 6 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 14 1 94 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 0. 99 1 0. 00 1 0. 00 1 0. 00 4 0. 06 5 14 1 94 0. 99 0 0. 99 3 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 61 1 0. 03 0 0. 04 8 1. 92 1 1. 38 6 80 9 52 4 0. 55 2 0. 67 0 A du lt lit er ac y ED .8 0. 99 6 0. 00 4 0. 00 4 1. 24 6 1. 11 6 46 9 30 5 0. 98 8 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 09 3 0. 01 3 0. 13 6 1. 47 0 1. 21 2 12 16 77 7 0. 06 7 0. 11 8 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 23 4 0. 02 3 0. 10 0 2. 85 4 1. 68 9 14 67 94 0 0. 18 7 0. 28 0 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 02 4 0. 00 6 0. 25 7 1. 50 7 1. 22 7 14 53 93 0 0. 01 2 0. 03 6 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 50 0 0. 02 4 0. 04 7 2. 08 5 1. 44 4 14 67 94 0 0. 45 2 0. 54 7 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 49 5 0. 03 2 0. 06 4 3. 79 8 1. 94 9 14 67 94 0 0. 43 1 0. 55 8 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 05 6 0. 01 7 0. 30 6 0. 98 0 0. 99 0 28 2 17 9 0. 02 2 0. 09 0 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 87 56 1. 00 0 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 0. 94 8 0. 03 8 0. 04 0 1. 58 1 1. 25 7 87 56 0. 87 3 1. 00 0 Im m un iz at io n co ve ra ge fo r D PT CH .2 1. 00 0 0. 00 0 0. 00 0 na na 87 56 1. 00 0 1. 00 0 M ea sl es im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 87 56 1. 00 0 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 0. 94 8 0. 03 8 0. 04 0 1. 58 1 1. 25 7 87 56 0. 87 3 1. 00 0 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 00 7 0. 00 7 1. 00 9 1. 30 0 1. 14 0 30 4 19 5 0. 00 0 0. 02 0 D ia rr ho ea in la st tw o w ee ks CH .4 0. 02 6 0. 01 1 0. 44 2 0. 99 9 1. 00 0 30 4 19 5 0. 00 3 0. 04 8 Su pp or t f or le ar ni ng CD .1 0. 76 3 0. 03 1 0. 04 0 1. 02 0 1. 01 0 30 4 19 5 0. 70 1 0. 82 4 Bi rt h re gi st ra tio n CP .1 1. 00 0 0. 00 0 0. 00 0 na na 30 4 19 5 1. 00 0 1. 00 0 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 181 T ab le S E .1 9. S am p lin g er ro rs : A st an a C it y St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 94 3 0. 00 8 0. 00 9 0. 97 2 0. 98 6 33 4 75 4 0. 92 6 0. 96 0 Ch ild d is ci pl in e CP .4 0. 61 1 0. 03 5 0. 05 8 1. 66 4 1. 29 0 14 2 32 1 0. 54 0 0. 68 1 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 1. 00 0 0. 00 0 0. 00 0 na na 10 63 75 5 1. 00 0 1. 00 0 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 1. 00 0 0. 00 0 0. 00 0 na na 10 63 75 5 1. 00 0 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 93 4 0. 02 3 0. 02 5 1. 06 9 1. 03 4 54 12 2 0. 88 8 0. 98 1 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 97 5 0. 01 0 0. 01 0 1. 19 0 1. 09 1 12 4 28 1 0. 95 5 0. 99 5 Pr im ar y co m pl et io n ra te ED .6 (0 .8 82 ) (* ) (* ) (* ) (* ) 15 34 (* ) (* ) Ch ild la bo r CP .2 0. 04 6 0. 02 2 0. 47 0 3. 70 0 1. 92 3 15 4 34 9 0. 00 3 0. 08 9 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 0. 98 8 0. 01 2 0. 01 2 0. 99 0 0. 99 5 40 84 0. 96 4 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 40 84 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 61 7 0. 03 5 0. 05 7 2. 20 0 1. 48 3 20 4 42 6 0. 54 7 0. 68 7 A du lt lit er ac y ED .8 0. 99 6 0. 00 4 0. 00 4 1. 03 7 1. 01 9 10 9 22 8 0. 98 7 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 05 6 0. 01 4 0. 24 5 2. 34 1 1. 53 0 31 9 66 4 0. 02 8 0. 08 3 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 45 8 0. 03 9 0. 08 4 4. 60 4 2. 14 6 36 8 76 6 0. 38 1 0. 53 6 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 02 6 0. 00 8 0. 31 1 1. 99 0 1. 41 1 36 3 75 7 0. 01 0 0. 04 3 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 70 9 0. 03 7 0. 05 2 5. 00 7 2. 23 8 36 8 76 6 0. 63 5 0. 78 2 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 59 4 0. 04 9 0. 08 3 7. 63 0 2. 76 2 36 8 76 6 0. 49 6 0. 69 2 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 03 5 0. 01 5 0. 43 5 1. 16 9 1. 08 1 84 17 2 0. 00 5 0. 06 5 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 19 39 (* ) (* ) Po lio im m un iz at io n co ve ra ge CH .2 (0 .7 95 ) (* ) (* ) (* ) (* ) 19 39 (* ) (* ) Im m un iz at io n co ve ra ge fo r D PT CH .2 (0 .9 23 ) (* ) (* ) (* ) (* ) 19 39 (* ) (* ) M ea sl es im m un iz at io n co ve ra ge CH .2 (1 .0 00 ) (* ) (* ) na na 19 39 (* ) (* ) Fu lly im m un iz ed c hi ld re n CH .2 (0 .7 18 ) (* ) (* ) (* ) (* ) 19 39 (* ) (* ) A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 00 0 0. 00 0 0. 00 0 na na 90 18 5 0. 00 0 0. 00 0 D ia rr ho ea in la st tw o w ee ks CH .4 0. 01 6 0. 00 9 0. 57 9 1. 01 8 1. 00 9 90 18 5 0. 00 0 0. 03 5 Su pp or t f or le ar ni ng CD .1 0. 88 1 0. 02 4 0. 02 8 1. 03 3 1. 01 6 90 18 5 0. 83 3 0. 93 0 Bi rt h re gi st ra tio n CP .1 1. 00 0 0. 00 0 0. 00 0 na na 90 18 5 1. 00 0 1. 00 0 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le MONITORING THE SITUATION OF CHILDREN AND WOMEN182 T ab le S E .2 0. S am p le e rr o rs : A lm at y C it y St an da rd e rr or s, co ef fic ie n ts o f v ar ia ti on , d es ig n e ff ec ts ( de ff ), s qu ar e ro ot o f d es ig n e ff ec ts ( de ft ) an d co n fid en ce in te rv al s fo r s el ec te d in di ca to rs , K az ak h st an , 2 00 6 Ta bl e Va lu e ® St an da rd er ro r ( se ) Co ef fic ie nt of v ar ia - tio n (s e/ r) D es ig n ef - fe ct ( de ff) Sq ua re ro ot of d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t Co nfi de nc e lim its r – 2 s e r+ 2 s e H O U SE H O LD S Io di ze d sa lt co ns um pt io n N U .5 0. 96 7 0. 00 8 0. 00 8 1. 68 6 1. 29 8 12 57 89 7 0. 95 1 0. 98 2 Ch ild d is ci pl in e CP .4 0. 37 3 0. 03 8 0. 10 2 1. 85 7 1. 36 3 42 4 30 3 0. 29 7 0. 44 9 H O U SE H O LD M EM BE RS U se o f i m pr ov ed d rin ki ng w at er s ou rc es EN .1 1. 00 0 0. 00 0 0. 00 0 na na 38 39 96 6 1. 00 0 1. 00 0 U se o f i m pr ov ed s an ita tio n fa ci lit ie s EN .5 0. 98 3 0. 01 6 0. 01 6 14 .3 30 3. 78 6 38 39 96 6 0. 95 1 1. 00 0 N et p rim ar y sc ho ol a tte nd an ce ra te ED .3 0. 99 1 0. 00 9 0. 00 9 1. 03 2 1. 01 6 15 4 11 0 0. 97 2 1. 00 0 N et s ec on da ry s ch oo l a tte nd an ce ra te ED .4 0. 96 2 0. 01 2 0. 01 2 1. 11 9 1. 05 8 41 0 29 3 0. 93 9 0. 98 6 Pr im ar y co m pl et io n ra te ED .6 (0 .9 00 ) (* ) (* ) (* ) (* ) 42 30 (* ) (* ) Ch ild la bo r CP .2 0. 02 4 0. 00 6 0. 26 8 0. 58 6 0. 76 5 46 8 33 4 0. 01 1 0. 03 7 W O M EN Sk ill ed a tte nd an t a t d el iv er y RH .5 1. 00 0 0. 00 0 0. 00 0 na na 12 4 84 1. 00 0 1. 00 0 A nt en at al c ar e RH .3 1. 00 0 0. 00 0 0. 00 0 na na 12 4 84 1. 00 0 1. 00 0 Co nt ra ce pt iv e pr ev al en ce RH .1 0. 55 9 0. 03 7 0. 06 6 2. 06 8 1. 43 8 54 7 37 0 0. 48 5 0. 63 4 A du lt lit er ac y ED .8 1. 00 0 0. 00 0 0. 00 0 na na 31 2 21 1 1. 00 0 1. 00 0 M ar ria ge b ef or e ag e 18 CP .5 0. 05 8 0. 01 1 0. 18 6 1. 40 1 1. 18 4 96 9 65 6 0. 03 6 0. 08 0 Co m pr eh en si ve k no w le dg e ab ou t H IV p re ve nt io n am on g yo un g pe op le H A .3 0. 11 0 0. 01 9 0. 17 5 2. 90 4 1. 70 4 11 26 76 2 0. 07 2 0. 14 9 A tti tu de to w ar ds p eo pl e w ith H IV /A ID S H A .5 0. 07 4 0. 02 1 0. 28 9 5. 05 2 2. 24 8 11 24 76 1 0. 03 1 0. 11 6 W om en w ho h av e be en te st ed fo r H IV H A .6 0. 73 0 0. 03 2 0. 04 4 3. 89 6 1. 97 4 11 26 76 2 0. 66 6 0. 79 3 Kn ow le dg e of m ot he r- to -c hi ld tr an sm iss io n of H IV H A .4 0. 62 5 0. 02 9 0. 04 7 2. 74 8 1. 65 8 11 26 76 2 0. 56 6 0. 68 3 U N D ER -5 s U nd er w ei gh t p re va le nc e N U .1 0. 02 1 0. 01 4 0. 68 4 1. 90 2 1. 37 9 29 1 18 9 0. 00 0 0. 05 0 Tu be rc ul os is im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 88 57 1. 00 0 1. 00 0 Po lio im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 88 57 1. 00 0 1. 00 0 Im m un iz at io n co ve ra ge fo r D PT CH .2 1. 00 0 0. 00 0 0. 00 0 na na 88 57 1. 00 0 1. 00 0 M ea sl es im m un iz at io n co ve ra ge CH .2 1. 00 0 0. 00 0 0. 00 0 na na 88 57 1. 00 0 1. 00 0 Fu lly im m un iz ed c hi ld re n CH .2 1. 00 0 0. 00 0 0. 00 0 na na 88 57 1. 00 0 1. 00 0 A cu te re sp ira to ry in fe ct io n in la st tw o w ee ks CH .6 0. 00 5 0. 00 5 1. 00 3 1. 00 7 1. 00 3 32 4 21 1 0. 00 0 0. 01 4 D ia rr ho ea in la st tw o w ee ks CH .4 0. 00 9 0. 00 7 0. 71 2 1. 01 8 1. 00 9 32 4 21 1 0. 00 0 0. 02 3 Su pp or t f or le ar ni ng CD .1 0. 89 6 0. 02 9 0. 03 3 1. 92 4 1. 38 7 32 4 21 1 0. 83 7 0. 95 4 Bi rt h re gi st ra tio n CP .1 1. 00 0 0. 00 0 0. 00 0 na na 32 4 21 1 1. 00 0 1. 00 0 (* ) – in di ca to rs a re b as ed o n le ss th an 5 0 ca se s of u nw ei gh te d ob se rv at io ns na – n ot a pp lic ab le KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 183 Appendix D Data Quality Tables Table DQ.1. Age distribution of household members Single-year age distribution of household population by sex (weighted), Kazakhstan, 2006 age Males Females age Males Females Number Percent Number Percent Number Percent Number Percent 0 427 1.7 377 1.4 42 377 1.5 419 1.6 1 470 1.9 411 1.6 43 395 1.6 408 1.5 2 460 1.9 398 1.5 44 378 1.5 424 1.6 3 408 1.7 375 1.4 45 426 1.7 465 1.8 4 360 1.5 337 1.3 46 320 1.3 402 1.5 5 338 1.4 318 1.2 47 295 1.2 410 1.5 6 344 1.4 320 1.2 48 340 1.4 374 1.4 7 361 1.5 340 1.3 49 330 1.3 317 1.2 8 372 1.5 351 1.3 50 331 1.3 471 1.8 9 448 1.8 357 1.3 51 247 1.0 299 1.1 10 452 1.8 395 1.5 52 272 1.1 348 1.3 11 412 1.7 469 1.8 53 271 1.1 347 1.3 12 518 2.1 502 1.9 54 228 0.9 340 1.3 13 515 2.1 489 1.8 55 251 1.0 322 1.2 14 520 2.1 500 1.9 56 235 1.0 280 1.1 15 543 2.2 486 1.8 57 207 0.8 260 1.0 16 573 2.3 519 2.0 58 201 0.8 267 1.0 17 569 2.3 504 1.9 59 179 0.7 198 0.7 18 521 2.1 425 1.6 60 117 0.5 161 0.6 19 459 1.9 426 1.6 61 51 0.2 96 0.4 20 431 1.7 417 1.6 62 97 0.4 138 0.5 21 456 1.8 399 1.5 63 139 0.6 169 0.6 22 414 1.7 395 1.5 64 144 0.6 204 0.8 23 390 1.6 458 1.7 65 162 0.7 303 1.1 24 413 1.7 353 1.3 66 140 0.6 195 0.7 25 432 1.7 395 1.5 67 149 0.6 263 1.0 26 398 1.6 365 1.4 68 162 0.7 198 0.8 27 408 1.7 354 1.3 69 160 0.6 214 0.8 28 392 1.6 365 1.4 70 138 0.6 218 0.8 29 351 1.4 330 1.2 71 86 0.3 96 0.4 30 382 1.5 436 1.6 72 57 0.2 116 0.4 31 330 1.3 340 1.3 73 69 0.3 134 0.5 32 328 1.3 368 1.4 74 60 0.2 94 0.4 33 336 1.4 337 1.3 75 88 0.4 134 0.5 34 309 1.2 333 1.3 76 90 0.4 89 0.3 35 367 1.5 403 1.5 77 56 0.2 94 0.4 36 332 1.3 388 1.5 78 60 0.2 112 0.4 37 316 1.3 366 1.4 79 41 0.2 98 0.4 38 338 1.4 404 1.5 80 + 180 0.7 432 1.6 39 307 1.2 395 1.5 DK/ Missing 0 0.0 1 0.040 355 1.4 373 1.4 41 340 1.4 354 1.3 Total 24 724 100.0 26 537 100.0 MONITORING THE SITUATION OF CHILDREN AND WOMEN184 Table DQ.2. Age distribution of eligible and interviewed women Household population of women age 10-54, interviewed women age 15-49, and percentage of eligi- ble women who were interviewed (weighted), by five-year age group, Kazakhstan, 2006 Age Household population of women age 10-54 Interviewed women age 15-49 Percentage of eligible women interviewed Number Number Percent 10–14 2 353 na na na 15–19 2 360 2 336 17.0 99.0 20–24 2 022 1 996 14.5 98.7 25–29 1 809 1 791 13.0 99.0 30–34 1 814 1 797 13.1 99.1 35–39 1 956 1 944 14.1 99.4 40–44 1 978 1 962 14.2 99.2 45–49 1 968 1 944 14.1 98.8 50–54 1 805 na na na 15–49 13 907 13 770 100,0 99,0 na: not applicable Note. Weights for both household population of women and interviewed women are household weights. Age is based on the household schedule. Table DQ.3. Age distribution of eligible and interviewed under-5s Household population of children age 0-4, children whose mothers/caretakers were interviewed, and percentage of under-5 children whose mothers/caretakers were interviewed (weighted), by five-year age group, Kazakhstan, 2006 Age Household population of children age 0-7 Interviewed children age 0-4 Percentage of eligible children interviewed Number Number Percent 0 804 803 20.0 99.9 1 881 877 21.8 99.5 2 858 857 21.3 99.9 3 783 781 19.5 99.7 4 697 697 17.4 100.0 5 656 na na na 6 664 na na na 7 701 na na na 0–4 4 023 4 015 100,0 99,8 na: not applicable Note: Weights for both household population of children and interviewed children are household weights. Age is based on the household schedule. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 185 Table DQ.4. Age distribution of under 5 children Age distribution of under-5 children by 3-month groups (weighted), Kazakhstan, 2006 Age in months Males Females Total Number Percent Number Percent Number Percent 0–2 77 3.3 73 3.5 150 3.4 3–5 129 5.6 103 4.9 232 5.3 6–8 115 4.9 105 5.0 220 5.0 9–11 131 5.6 111 5.3 242 5.5 12–14 120 5.2 116 5.6 236 5.3 15–17 138 5.9 112 5.4 250 5.7 18–20 117 5.0 119 5.7 236 5.3 21–23 135 5.8 111 5.3 246 5.6 24–26 133 5.7 125 6.0 258 5.8 27–29 130 5.6 119 5.7 249 5.6 30–32 122 5.3 84 4.0 206 4.7 33–35 119 5.1 115 5.5 234 5.3 36–38 111 4.8 97 4.7 208 4.7 39–41 108 4.6 115 5.5 223 5.1 42–44 117 5.0 113 5.4 230 5.2 45–47 113 4.9 85 4.1 198 4.5 48–50 93 4.0 86 4.1 179 4.1 51–53 90 3.9 91 4.4 181 4.1 54–56 107 4.6 107 5.1 214 4.8 57–59 122 5.2 101 4.8 223 5.0 Total 2 327 100.0 2 088 100.0 4 415 100.0 MONITORING THE SITUATION OF CHILDREN AND WOMEN186 Table DQ.5. Heaping on ages and periods Age and period ratios at boundaries of eligibility by type of information collected (weighted), Kazakhstan, 2006 Age in household questionnaire Age and period ratios * Eligibility boundary (lower-upper) Module or questionnaireMales Females Total 1 1.04 1.04 1.04 2 1.03 1.01 1.02 Lower Child discipline and child disability 3 1.00 1.01 1.00 4 0.98 0.98 0.98 Upper Under-5 questionnaire 5 0.97 0.98 0.98 Lower Child labour and education 6 0.99 0.98 0.99 8 0.95 1.01 0.97 10 1.03 0.97 1.00 13 1.00 0.98 0.99 14 0.99 1.02 1.00 Upper Child labour and child discipline 15 1.00 0.97 0.98 Lower Women’s questionnaire 16 1.02 1.03 1.03 18 1.10 1.12 1.11 23 0.96 1.14 1.05 24 1.00 0.88 0.94 Upper Education 25 1.04 1.06 1.05 48 1.06 1.02 1.04 49 0.99 0.82 0.90 Upper Women’s questionnaire 50 1.10 1.30 1.21 Age in women’s questionnaire 23 na 1.14 na 25 na 1.06 na Months since last birth in women’s questionnaire 6–11 na 1.06 na 12–17 na 1.02 na 18–23 24–29 na 1.04 na 30–35 na 0.94 na na: not applicable Age or period ratios are calculated as x / ((xn-1 + xn + xn+1) / 3), where x – is age or period. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 187 Table DQ.6. Completeness of reporting Percentage of observations missing information for selected questions and indicators (weighted), Kazakhstan, 2006 Questionnaire and Subject Reference group Percent with missing information* Number of cases Household Salt testing All households surveyed 0.0 14 564 Women Date of Birth All women age 15-49 Month only 0.0 14 558 Month and year missing 0.0 14 558 Date of first birth All women age 15-49 with at least one live birth Month only 0.1 9 726 Month and year missing 0.1 9 726 Completed years since first birth All women age 15-49 with at least one live birth 0.0 9 Date of last birth All women age 15-49 with at least one live birth Month only 0.1 9 726 Month and year missing 0.0 9 726 Date of first marriage/union All ever married women age 15-49 Month only 0.8 10 398 Month and year missing 3.2 10 398 Age at first marriage/union All ever married women age 15-49 0.3 10 398 Under-5 Date of Birth All under five children surveyed Month only 0.0 4 415 Month and year missing 0.0 4 415 Anthropometry All under five children surveyed Height 0.1 4 415 Weight 0.1 4 415 Height or Weight 0.1 4 415 * Includes “Don’t know” responses MONITORING THE SITUATION OF CHILDREN AND WOMEN188 Table DQ.7. Presence of mother in the household and the person interviewed for the under-5 questionnaire Distribution of children under five by whether the mother lives in the same household, and the per- son interviewed for the under-5 questionnaire (weighted), Kazakhstan, 2006 Age Mother in the household Mother not in the household Total Number of children aged 0-4 years Mother inter- viewed Father in- terviewed Other adult female interview ed Other adult male inter- viewed Father in- terviewed Other adult female in- terviewed Other adult male inter- viewed 0 98.9 0.0 0.9 0.2 100.0 804 1 98.0 0.0 2.0 0.0 100.0 881 2 96.8 0.2 3.0 0.0 100.0 858 3 97.0 0.4 2.6 0.0 100.0 783 4 97.5 0.0 2.4 0.1 100.0 697 Total 97.6 0.1 2.2 0.1 100.0 4 023 Table DQ.8. School attendance by single age Distribution of household population age 5-24 by educational level and grade attended in the cur- rent year (weighted), Kazakhstan, 2006 A ge Pr es ch oo l Primary school Secondary school Sp ec ia liz ed se co nd ar y H ig he r N ot a tte nd - in g sc ho ol To ta l N um be r Grade Grade 0 1 2 3 4 5 6 7 8 9 10 11 5 18.7 2.4 1.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 77.6 100.0 656 6 27.5 5.5 35.3 0.7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 31.0 100.0 664 7 2.9 0.4 64.6 28.3 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.5 100.0 700 8 0.2 0.2 5.8 70.2 22.4 0.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.8 100.0 724 9 0.0 0.0 0.2 11.3 65.4 22.3 0.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 100.0 805 10 0.0 0.0 0.1 0.0 10.6 64.7 23.7 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.7 100.0 847 11 0.0 0.0 0.0 0.0 0.1 12.2 69.1 17.9 0.3 0.0 0.0 0.0 0.0 0.0 0.0 0.4 100.0 881 12 0.0 0.0 0.0 0.1 0.0 0.1 13.6 71.2 14.6 0.0 0.0 0.0 0.0 0.0 0.0 0.4 100.0 1 020 13 0.0 0.0 0.0 0.0 0.0 0.0 0.0 14.6 68.8 15.4 0.5 0.0 0.0 0.0 0.0 0.7 100.0 1 004 14 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.2 13.2 66.8 17.0 1.0 0.0 0.0 0.0 0.8 100.0 1 019 15 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.3 12.9 64.3 17.7 0.7 2.7 0.0 1.4 100.0 1 029 16 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 12.8 48.5 18.0 17.1 0.4 3.2 100.0 1 093 17 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 7.9 51.0 20.5 6.2 14.4 100.0 1 073 18 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.1 8.3 24.2 28.7 37.7 100.0 946 19 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.4 16.0 31.6 52.0 100.0 885 20 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 7.1 30.7 62.2 100.0 848 21 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 2.4 21.8 75.7 100.0 855 22 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.2 11.7 87.1 100.0 809 23 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.4 7.0 91.6 100.0 847 24 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.6 5.0 94.4 100.0 766 Total 1.9 0.3 4.2 4.6 4.5 4.8 5.5 6.0 5.6 5.5 5.6 4.7 4.8 5.2 7.2 29.6 100.0 17 471 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 189 Table DQ.9. Sex ratio at birth among children ever born and living Sex ratio at birth among children ever born, children living, and deceased children, by age of women (weighted), Kazakhstan, 2006 Age Children Ever Born Children Living Children deceased Number of women Number of sons ever born Number of daugh- ters ever born Sex ratio Number of sons living Number of daugh- ters living Sex ratio Number of de- ceased sons Number of de- ceased daugh- ters Sex ratio 15–19 43 34 1.26 42 32 1.31 1 2 0.50 2 469 20–24 570 499 1.14 559 489 1.14 11 10 1.10 2 108 25–29 1 288 1 191 1.08 1 239 1 144 1.08 49 46 1.07 1 894 30–34 1 878 1 721 1.09 1 764 1 677 1.05 114 44 2.59 1 900 35–39 2 367 2 216 1.07 2 250 2 133 1.05 117 84 1.39 2 055 40–44 2 785 2 532 1.10 2 614 2 419 1.08 172 113 1.52 2 076 45–49 2 895 2 733 1.06 2 664 2 566 1.04 231 167 1.38 2 056 Total 11 826 10 926 1.08 11 132 10 460 1.06 695 466 1.49 14 558 Note: Sex ratios are calculated as number of males/ number of females. Table DQ.10. Distribution of women by time since last birth Distribution of women aged 15-49 with at least one live birth, by months since last birth (weighted), Kazakhstan, 2006 Age Months since last birth Age (continued) Months since last birth Number Percent Number Percent 0 18 0.8 19 77 3.2 1 64 2.7 20 62 2.6 2 68 2.8 21 82 3.4 3 80 3.4 22 59 2.5 4 83 3.5 23 67 2.8 5 66 2.8 24 69 2.9 6 84 3.5 25 79 3.3 7 64 2.7 26 56 2.3 8 64 2.7 27 58 2.4 9 83 3.5 28 56 2.3 10 81 3.4 29 68 2.8 11 74 3.1 30 47 2.0 12 66 2.8 31 50 2.1 13 83 3.5 32 57 2.4 14 63 2.6 33 45 1.9 15 81 3.4 34 56 2.3 16 80 3.3 35 55 2.3 17 74 3.1 18 70 2.9 Total 2 389 100.0 MONITORING THE SITUATION OF CHILDREN AND WOMEN190 Appendix E MICS indicators: Numerators and Denominators INDICATOR NUMERATOR DENOMINATOR 1 Under-five mortality rate Probability of dying by exact age 5 years 2 Infant mortality rate Probability of dying by exact age 1 year 3 Maternal mortality ratio Number of deaths of women from pregnancy-related causes in a given year Number of live births in the year (ex- pressed per 100,000 births) 4 Skilled attendant at delivery Number of women aged 15-49 years with a birth in the 2 years preceding the survey that were attended during childbirth by skilled health personnel Total number of women surveyed aged 15-49 years with a birth in the 2 years preceding the survey 5 Institutional deliveries Number of women aged 15-49 years with a birth in the 2 years preceding the survey that delivered in a health facility Total number of women surveyed aged 15-49 years with a birth in 2 years preceding the survey 6 Underweight prevalence Number of children under age five that fall below mi- nus two standard deviations from the median weight for age of the NCHS/WHO standard (moderate and severe); number that fall below minus three standard deviations (severe) Total number of children under age five that were weighed 7 Stunting prevalence Number of children under age five that fall below mi- nus two standard deviations from the median height for age of the NCHS/WHO standard (moderate and severe); number that fall below minus three standard deviations (severe) Total number of children under age five measured 8 Wasting prevalence Number of children under age five that fall below mi- nus two standard deviations from the median weight for height of the NCHS/WHO standard (moderate and severe); number that fall below minus three standard deviations (severe) Total number of children under age five weighed and measured 9 Low-birthweight infants Number of last live births in the 2 years preceding the survey weighing below 2,500 grams Total number of last live births in the 2 years preceding the survey 10 Infants weighed at birth Number of last live births in the 2 years preceding the survey that were weighed at birth Total number of last live births in the 2 years preceding the survey 11 Use of improved drink- ing water sources Number of household members living in households using improved sources of drinking water Total number of household members in households surveyed 12 Use of improved sanita- tion facilities Number of household members using improved sani- tation facilities Total number of household members in households surveyed 13 Water treatment Number of household members using water that has been treated Total number of household members in households surveyed 14 Disposal of child’s faeces Number of children under age three whose (last) stools were disposed of safely Total number of children under age three surveyed 15 Exclusive breastfeeding rate Number of infants aged 0-5 months that are exclu- sively breastfed Total number of infants aged 0-5 months surveyed 16 Continued breastfeed- ing rate Number of infants aged 12-15 months, and 20-23 months, that are currently breastfeeding Total number of children aged 12-15 months and 20-23 months surveyed KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 191 17 Timely complementary feeding rate Number of infants aged 6-9 months that are receiv- ing breastmilk and complementary foods Total number of infants aged 6-9 months surveyed 18 Frequency of comple- mentary feeding Number of infants aged 6-11 months that receive breastmilk and complementary food at least the mini- mum recommended number of times per day (two times per day for infants aged 6-8 months, three times per day for infants aged 9-11 months) Total number of infants aged 6-11 months surveyed 19 Adequately fed infants Number of infants aged 0-11 months that are appro- priately fed: infants aged 0-5 months that are exclu- sively breastfed and infants aged 6-11 months that are breastfed and ate solid or semi-solid foods the ap- propriate number of times (see above) yesterday Total number of infants aged 0-11 months surveyed 20 Antenatal care Number of women aged 15-49 years that were at- tended at least once during pregnancy in the 2 years preceding the survey by skilled health personnel Total number of women surveyed aged 15-49 years with a birth in the 2 years preceding the survey 21 Contraceptive preva- lence Number of women currently married or in union aged 15-49 years that are using (or whose partner is using) a contraceptive method (either modern or traditional) Total number of women aged 15-49 years that are currently married or in union 22 Antibiotic treatment of suspected pneumonia Number of children aged 0-59 months with sus- pected pneumonia in the previous 2 weeks receiving antibiotics Total number of children aged 0-59 months with suspected pneumonia in the previous 2 weeks 23 Care-seeking for sus- pected pneumonia Number of children aged 0-59 months with suspect- ed pneumonia in the previous 2 weeks that are taken to an appropriate health provider Total number of children aged 0-59 months with suspected pneumonia in the previous 2 weeks 24 Solid fuels Number of residents in households that use solid fuels (wood, charcoal, crop residues and dung) as the pri- mary source of domestic energy to cook Total number of residents in house- holds surveyed 25 Tuberculosis immuniza- tion coverage Number of children aged 12-23 months receiving BCG vaccine before their first birthday Total number of children aged 12-23 months surveyed 26 Polio immunization coverage Number of children aged 12-23 months receiving OPV3 vaccine before their first birthday Total number of children aged 12-23 months surveyed 27 Immunization coverage for diphtheria, pertussis and tetanus (DPT) Number of children aged 12-23 months receiving DPT3 vaccine before their first birthday Total number of children aged 12-23 months surveyed 28 Measles immunization coverage Number of children aged 12-23 months receiving measles vaccine before their first birthday Total number of children aged 12-23 months surveyed 29 Hepatitis B immuniza- tion coverage Number of children aged 12-23 months immunized against hepatitis before their first birthday Total number of children aged 12-23 months surveyed 31 Fully immunized children Number of children aged 12-23 months receiving DPT1-3, OPV-1-3, BCG and measles vaccines before their first birthday Total number of children aged 12-23 months surveyed 33 Use of oral rehydration therapy (ORT) Number of children aged 0-59 months with diarrhoea in the previous 2 weeks that received oral rehydration salts and/or an appropriate household solution Total number of children aged 0-59 months with diarrhoea in the previ- ous 2 weeks 34 Home management of diarrhoea Number of children aged 0-59 months with diar- rhoea in the previous 2 weeks that received more flu- ids AND continued eating somewhat less, the same or more food Total number of children aged 0-59 months with diarrhoea in the previ- ous 2 weeks 35 Received ORT or increased fluids and con- tinued feeding Number of children aged 0-59 months with diarrhoea that received ORT (oral rehydration salts or an appro- priate household solution) or received more fluids AND continued eating somewhat less, the same or more food Total number of children aged 0-59 months with diarrhoea in the previ- ous 2 weeks MONITORING THE SITUATION OF CHILDREN AND WOMEN192 41 Iodized salt consump- tion Number of households with salt testing 15 parts per million or more of iodine/iodate Total number of households surveyed 44 Content of antenatal care Number of women with a live birth in the 2 years pre- ceding the survey that received antenatal care during the last pregnancy Total number of women with a live birth in the 2 years preceding the sur- vey 45 Timely initiation of breastfeeding Number of women with a live birth in the 2 years pre- ceding the survey that put the newborn infant to the breast within 1 hour of birth Total number of women with a live birth in the 2 years preceding the sur- vey 46 Support for learning Number of children aged 0-59 months living in households in which an adult has engaged in four or more activities to promote learning and school readi- ness in the past 3 days Total number of children aged 0-59 months surveyed 47 Father’s support for learning Number of children aged 0-59 months whose father has engaged in one or more activities to promote learning and school readiness in the past 3 days Total number of children aged 0-59 months 48 Support for learning: children’s books Number of households with three or more children’s books Total number of households surveyed 49 Support for learning: non-children’s books Number of households with three or more non-chil- dren’s books Total number of households surveyed 50 Support for learning: materials for play Number of households with three or more materials intended for play Total number of households surveyed 51 Non-adult care Number of children aged 0-59 months left alone or in the care of another child younger than 10 years of age in the past week Total number of children aged 0-59 months surveyed 52 Pre-school attendance Number of children aged 36-59 months that attend some form of early childhood education programme Total number of children aged 36-59 months surveyed 53 School readiness Number of children in first grade that attended some form of pre-school the previous year Total number of children in the first grade surveyed 54 Net intake rate in pri- mary education Number of children of school-entry age that are cur- rently attending first grade Total number of children of primary- school entry age surveyed 55 Net primary school at- tendance rate Number of children of primary-school age currently attending primary or secondary school Total number of children of primary- school age surveyed 56 Net secondary school attendance rate Number of children of secondary-school age current- ly attending secondary school or higher Total number of children of second- ary-school age surveyed 57 Children reaching grade five Proportion of children entering the first grade of pri- mary school that eventually reach grade five 58 Transition rate to sec- ondary school Number of children that were in the last grade of pri- mary school during the previous school year that at- tend secondary school Total number of children that were in the last grade of primary school dur- ing the previous school year surveyed 59 Primary completion rate Number of children (of any age) attending the last grade of primary school (excluding repeaters) Total number of children of primary school completion age (age appropri- ate to final grade of primary school) surveyed 60 Adult literacy rate Number of women aged 15-24 years that are able to read a short simple statement about everyday life Total number of women aged 15-24 years surveyed 61 Gender parity index Proportion of girls in primary and secondary educa- tion Proportion of boys in primary and secondary education 62 Birth registration Number of children aged 0-59 months whose births are reported registered Total number of children aged 0-59 months surveyed KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 193 67 Marriage before age 15 and age 18 Number of women that were first married or in union by the exact age of 15 and the exact age of 18, by age groups Total number of women aged 15-49 years and 20-49 years surveyed, by age groups 68 Young women aged 15-19 years currently married or in union Number of women aged 15-19 years currently mar- ried or in union Total number of women aged 15-19 years surveyed 69 Spousal age difference Number of women married/in union aged 20-24 years with a difference in age of 10 or more years be- tween them and their current spouse Total number of women aged 20-24 years surveyed that are currently mar- ried or in union 71 Child labour Number of children aged 5-14 years that are involved in child labour Total number of children aged 5-14 years surveyed 72 Labourer students Number of children aged 5-14 years involved in child labour activities that attend school Total number of children aged 5-14 years involved in child labour activi- ties 73 Student labourers Number of children aged 5-14 years attending school that are involved in child labour activities Total number of children aged 5-14 years attending school 74 Child discipline Number of children aged 2-14 years that (1) expe- rience only non-violent aggression, (2) experience psychological aggression as punishment, (3) experi- ence minor physical punishment, (4) experience se- vere physical punishment Total number of children aged 2-14 years selected and surveyed 82 Comprehensive knowl- edge about HIV preven- tion among young people Number of women aged 15-24 years that correctly identify two ways of avoiding HIV infection and reject three common misconceptions about HIV transmis- sion Total number of women aged 15-24 years surveyed 86 Attitude towards people with HIV/AIDS Number of women expressing acceptance on all four questions about people with HIV or AIDS Total number of women surveyed 87 Women who know where to be tested for HIV Number of women that state knowledge of a place to be tested for HIV Total number of women surveyed 88 Women who have been tested for HIV Number of women that report being tested for HIV Total number of women surveyed 89 Knowledge of mother- to-child transmission of HIV Number of women that correctly identify all three means of vertical transmission Total number of women surveyed 90 Counselling coverage for the prevention of mother-to-child trans- mission of HIV Number of women that gave birth in the previous 24 months and received antenatal care reporting that they received counselling on HIV/AIDS during this care Total number of women that gave birth in the previous 24 months sur- veyed 91 Testing coverage for the prevention of mother- to-child transmission of HIV Number of women that gave birth in the previous 24 months and received antenatal care reporting that they received the results of an HIV test during this care Total number of women that gave birth in the previous 24 months sur- veyed 100 Attitudes towards do- mestic violence Number of women that consider that a husband/ partner is justified in hitting or beating his wife in at least one of the following circumstances: (1) she goes out without telling him, (2) she neglects the children, (3) she argues with him, (4) she refuses sex with him, (5) she burns the food Total number of women surveyed MONITORING THE SITUATION OF CHILDREN AND WOMEN194 Appendix F. Questionnaires HOUSEHOLD QUESTIONNAIRE BEGIN WITH WELCOMING: WE ARE FROM THE AGENCY OF THE REPUBLIC OF KAZAKHSTAN ON STATISTIC. WE WORK ON THE FAMILY HEALTH AND EDUCATION PROJECT. I WANT TO DISCUSS THIS WITH YOU. ALL RECEIVED INFORMATION IS STRICTLY CONFIDENTIAL; NO ONE WILL LEARN BELOW ANSWERS ARE YOURS. I WANT TO SPEAK WITH THE HOUSEHOLD HEAD AND EVERY MOTHER OR CHILD CARETAKER IN THE HOUSEHOLD. SHALL I START? If Yes, begin the interview. HOUSEHOLD INFORMATION HH HH1. Cluster number: HH2. Household number: ___ ___ ___ ___ ___ HH3. Interviewer’s name and number: HH4. Supervisor’s name and number: Name _________________________________ Name _________________________________ HH5. Interview day/month/year: ___ ___ / ___ ___ / ___ ___ ___ ___ HH6. Location Cities and villages 1 Rural settlements 2 HH7. Oblast Akmola 01 Aktobe 02 Almaty 03 Atyrau 04 West Kazakhstan 05 Zambylskaya 06 Karaganda 07 Kostanai 08 Kyzylorda 09 Mangistau 10 South Kazakhstan 11 Pavlodar 12 North Kazakhstan 13 East Kazakhstan 14 Astana City 15 Almaty City 16 HH 8. Name of household head: ________________________________________________________ After completing all household questionnaires enter the following: HH9. HH interview outcomes: Interviewed 1 Absent 2 Refused 3 HH not found/demolished 4 Other (specify)___________________________ 6 HH10. HH questionnaire respondent: Name: Line number: __ ___ HH11. Number of household members: ___ ___ HH12. Number of eligible women: HH13. Number of completed women’s questionnaires: ___ ___ ___ ___ HH14. Number of under-5s: HH15. Number of completed under-5 questionnaires: ___ ___ ___ ___ Interviewer/supervisor’s note: Use this field for notes on household members interviews, such as: additional telephone calls, individual incomplete interview forms, number of visits for interview etc. HH 16. Data entry operator: ___ __________________________________ KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 195 HOUSEHOLD LISTING HL PLEASE, NAME ALL PEOPLE WHO USUALLY RESIDE HERE. START FROM THE HOUSEHOLD HEAD. Write down the name of household head at line 01. List all household members (HL2), their relationship to the household head (HL3) and their sex (HL4). Question: DO ANY OTHER PEOPLE, WHO ARE CURRENTLY OUT, RESIDE HERE? (These could be children or adults at school or work). If there are any, include them into the Questionnaire. Then, interview every person by turn, starting from HL5. Eligible members For household members ages 0-17 years women child labor child health HL1 HL2. HL3. HL4. HL5. HL6. HL7. HL8. HL9. HL10. HL11. HL12. № N am e RE LA TI O N SH IP T O H H H EA D Se e co de s be lo w SE X 1 -M A LE 2 – F EM A LE A G E: F U LL Y EA RS If 97 * + , w rit e «9 7» Ci rc le a pp ro pr ia te n um be r fo r w om en a ge d 15 -4 9 ye ar s For each child aged 5- 14 year: For each under-5 child: IS M O TH ER A LI V E? 1 YE S 2 N O  H L1 1 8 D K H L1 1 If al iv e: D O ES M O TH ER RE SI D E IN T H IS H H ? YE S- lin e № o f m ot he r, N O - 00 IS F AT H ER A LI V E? 1 YE S 2 N O  N EX T LI N E 8 D K N EX T LI N E If al iv e: D O ES F AT H ER RE SI D E IN T H IS H H ? YE S- lin e № o f f at he r, N O - 00 CHILD’S MOTHER OR CARE-TAKER write line number of mother/caretaker LINE NAME RELAT. M F YEARS 15-49 MOTHER MOTHER Y N DK MOTHER Y N DK FATHER 01 0 1 1 2 __ __ 01 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 02 __ __ 1 2 __ __ 02 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 03 __ __ 1 2 __ __ 03 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 04 __ __ 1 2 __ __ 04 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 05 __ __ 1 2 __ __ 05 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 06 __ __ 1 2 __ __ 06 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 07 __ __ 1 2 __ __ 07 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 08 __ __ 1 2 __ __ 08 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 09 __ __ 1 2 __ __ 09 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 10 __ __ 1 2 __ __ 10 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 11 __ __ 1 2 __ __ 11 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 12 __ __ 1 2 __ __ 12 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 13 __ __ 1 2 __ __ 13 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 14 __ __ 1 2 __ __ 14 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 15 __ __ 1 2 __ __ 15 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ 16 __ __ 1 2 __ __ 16 __ __ __ __ 1 2 8 __ __ 1 2 8 __ __ Question: DO ANY OTHER CHILDREN RESIDE IN YOUR HOUSEHOLD, EVEN IF THEY ARE NOT YOUR FAMILY MEMBERS OR ORPHANED (INCLUDING THOSE IN SCHOOL OR AT WORK)? If ‘Yes’, write down child’s name and complete listing. Then enter total number. Total: Women aged 15-49 years Children aged 5-14 years Under-5s __ __ __ __ __ __ CODES to question HL3 01 = HEAD 09 = BROTHER/SISTER IN LAW 02 = SPOUSE 10 = UNCLE/AUNT 03 = SON/DAUGHTER 11 = BLOOD NEPHEW/NIECE 04 = SON/DAUGHTER IN LAW 12 = NEPHEW/NIECE IN LAW 05 = GRANDSON/GRANDDAUGHTER 13 = OTHER RELATIVE 06 = MOTHER/FATHER 14 = ADOPTED CHILD, STEPSON/STEPDAUGHTER 07 = FATHER/MOTHER IN LAW 15 = NON RELATIVE 08 = BROTHER/SISTER 98 = DO NOT KNOW (dk) *) 97 – Only for aged household members. MONITORING THE SITUATION OF CHILDREN AND WOMEN196 EDUCATION ED For household members aged 5 years + For household members aged 5-24 years ED1 ED1A ED2 ED3 ED4 ED5 ED6 ED7 ED8 № N am e H AV E (N A M E) A TT EN D ED PR ES CH O O L IN ST IT U TI O N , SC H O O L A N D O TH ER ED U CA TI O N A L IN ST IT U TI O N ? 1 YE S 2 N O  N EX T LI N E TH E H IG H ES T LE V EL ( N A M E) AT TE N D ED G RA D E/ CO U RS E (S )H E CO M PL ET ED A T TH IS LE V EL L EV EL :  S ee c od es be lo w : G RA D E/ CO U RS E 98 = D K H A S (S )H E AT TE N D ED ED U CA TI O N A L O R PR E- SC H O O L IN ST IT U TI O N D U RI N G ( 20 05 /2 00 6) ? 1 – Y ES 2 – N O  E D 7 N U M BE R O F D AY S (N A M E) AT TE N D ED E D U CA TI O N FA CI LI TY S IN CE L A ST D AY O F SC H O O L W EE K (D O W ) (D AY S) LE V EL A N D G RA D E (N A M E) AT TE N D ED D U RI N G T H IS SC H O O L YE A R (2 00 5/ 20 06 ) LE V EL :  S ee c od es b el ow G RA D E/ CO U RS E: 9 8 = D K H A S (N A M E) A TT EN D ED ED U CA TI O N A L IN ST IT U TI O N PR EV IO U S SC H O O L YE A R – 2 00 4/ 20 05 ? 1 – Y ES 2 – N O  N EX T LI N E 8 D K  N ex t l in e W H AT L EV EL A N D G RA D E/ CO U RS E AT TE N D ED ( N A M E) PR EV IO U S SC H O O L YE A R (2 00 4/ 20 05 )? L EV EL :  S ee co de s be lo w К Л А СС /К УР С 98 = D K line name yes no level grade yes no days level grade y no dk level grade 01 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 02 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 03 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 04 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 05 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 06 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 07 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 08 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 09 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 10 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 11 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 12 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 13 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 14 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 15 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ 16 1 2 012348 __ 1 2 __ 012348 __ 1 2 8 012348 __ For questions ED3, ED6, ED8 Education level Code of education level grade/course (for interviewer) Schooling years (for operator) PRESCHOOL/KINDERGARTEN 0 0 – 4 0 – 4 PRIMARY 1 0 – 4 0 – 4 SECONDARY 2 5 – 11 0 – 7 SPECIALIZED SECONDARY 3 0 – 3 0 – 3 HIGHER 4 0 – 6 0 – 6 DK (DOES NOT KNOW) 8 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 197 WATER AND SANITATION WS WS1. WHAT MAIN SOURCE OF DRINKING WATER DO YOUR HOUSEHOLD MEMBERS USE? Piped water Piped into dwelling …11 11 WS5 Piped into yard/plot 12 12 WS5 Public tap 13  WS3 Tube well/bore-hole 21 Dug well Protected (fenced) well 31 Unprotected (no fence) well 32 Spring water Protected (fenced) spring 41 Unprotected (no fence) spring 42 Rain water 51 Tank 61 Cart with tank 71 Surface water (river, stream, dam, lake, pool, canal) 81 Bottled water 91 91 WS2 Other (specify) 96 96 WS3 WS2. WHAT MAIN SOURCE OF WATER DO YOUR HOUSEHOLD MEMBERS USE FOR COOKING AND HAND WASHING? Piped water Piped into dwelling 11 11 WS5 Piped into yard/plot 12 12 WS5 Public tap 13 Tube well/bore-hole 21 Dug well Protected (fenced) well 31 Unprotected (no fence) well 32 Spring water Protected (fenced) spring 41 Unprotected (no fence) spring 42 Rain water 51 Tank 61 Cart with tank 71 Surface water (river, stream, dam, lake, pool, canal) 81 Bottled water 91 Other (specify) 96 WS3. HOW MUCH TIME IS NEEDED TO GO TO SOURCE OF DRINKING WATER, GET WATER AND RETURN? Minutes __ __ __ Piped to dwelling, yard 995 995 WS5 DK 998 MONITORING THE SITUATION OF CHILDREN AND WOMEN198 WS4. WHO USUALLY GOES TO THIS SOURCE OF WATER FOR YOUR HH MEMBERS? Ask: whether THIS PERSON IS UNDER AGE 15 AND WHAT SEX? Circle code describing this person. Adult woman 1 Adult man 2 Female childe (under age 15) 3 Male child (under age 15) 4 DK 8 WS5. DO YOU USE ANY METHOD FOR TREATMENT OF DRINKING WATER? Yes 1 No. 2 2 WS7 DK 8 8 WS7 WS6. WHAT METHOD DO YOU USE FOR TREATMENT OF DRINKING WATER? OTHER Write down all mentioned. Boil A Add bleach/chlorine B Strain through a cloth C Use water filter (ceramic, sand, composite etc.) D Solar disinfection E Let it stand and settle F Other (specify) X DK Z WS7. WHAT TYPE OF TOILET FACILITY DO YOUR HH MEMBERS USUALLY USE? If “LAVATORY PAN” OR “FLUSH”, ask: WHERE IT FLUSHES? If necessary, ask to see the facilities. Flush toilet Lavatory pan/piped sewerage 11 Connected to septic tank 12 Connected to pit latrine 13 Connected to other 14 Connected to unknown/not sure/DK 15 Pit latrine Improved ventilated 21 Pit latrine with slab 22 Pit latrine without slab/ open pit 23 Composting toilet 31 Bucket 41 Hanging toilet 51 No toilets, bushes/field 95 95 NEXT MODULE Other (specify) 96 WS8. DO OTHER HOUSEHOLDS USE THIS TOILET AS WELL? Yes 1 No. 2 2 NEXT MODULE WS9. IN TOTAL, HOW MANY HOUSEHOLDS USE THIS TOILET FACILITY? Number of households (if < 10)…. 0 _ 10 + households 10 DK 98 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 199 HOUSEHOLD CHARACTERISTICS HC HC1B. NATIVE LANGUAGE OF THE HOUSEHOLD HEAD Kazakh 1 Russian 2 Other (specify) 6 HC1C. NATIONALITY OF THE HOUSEHOLD HEAD Kazakh 1 Russian 2 Other (specify) 6 HC2. HOW MANY ROOMS ARE USED AS BEDROOMS IN THE HOUSEHOLD? Number of rooms __ __ HC3. FLOOR MATERIAL Write down your observations. Regular floor Floor boards 21 Finished floor Parquet or polished wood 31 Vinyl or asphalt strips 32 Ceramic tiles 33 Cement 34 Carpet 35 Laminate 36 Carpet type 37 Linoleum 38 Other (specify) 96 HC4 ROOF MATERIAL Write down your observations. Regular roof Roof boards 23 Finished roof Metal 31 Wood 32 Calamine/cement fiber 33 Ceramic tile 34 Cement 35 Shingles 36 Roofing slate 37 Tiling 38 Ruberoid/Tar 39 Other (specify) 96 HC5. WALLS MATERIAL Write down your observations. Regular walls Stone with clay 22 Crude clay 23 Processed wood 26 Reed-fiber 27 Finished walls Cement, concrete, slag 31 Stone with lime/cement 32 Bricks 33 Cement modules 34 Processed clay 35 Boards/lath 36 Monolith 37 Other (specify) 96 MONITORING THE SITUATION OF CHILDREN AND WOMEN200 HC6. POWER (FUEL) SOURCE HOUSEHOLD MEMBERS USUALLY USE FOR COOKING Electricity 01 01 HC8 Liquified gas/propane 02 02 HC8 Natural gas 03 03 HC8 Kerosene 05 Coal 06 Charcoal 07 Woods 08 Animal dung 10 Other (specify) 96 HC7. COOKING IN THIS HOUSEHOLD BY TYPE OF STOVE OR FIRE Identify type Open stove 1 Open fire 2 Closed stove 3 Other (specify) 6 HC7A. AVAILABILITY OF CHIMNEY OR HOOD FOR FIRE/ STOVE Yes 1 No 2 HC8. TYPE OF COOKING: INSIDE THE HOUSE, IN SEPARATE PREMISES OR OUTSIDE Inside 1 In separate premises 2 Outside 3 Other (specify) 6 HC9. IS THERE IN YOUR HOUSEHOLD: Yes No Electricity 1 2 Radio 1 2 TV set 1 2 Cellular phone 1 2 Stationery telephone 1 2 Refrigerator 1 2 Personal computer 1 2 Washing machine 1 2 Sewing machine 1 2 Vacuum cleaner 1 2 HC10. DOES ANY MEMBER OF YOUR HOUSEHOLD OWN: Yes No Watches 1 2 Bicycle 1 2 Motorbike 1 2 Horse-cart 1 2 Vehicle 1 2 Motor boat 1 2 HC11. WHERE DO YOU GET THE MAIN INFORMATION FOR YOUR FAMILY FROM? Newspapers A TV B Radion C Magazines D Internet E Outdoor advertising and posters F Siblings, friends and colleagues G Other (specify) H KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 201 CHILD LABOR CL Questions to caretakers of children aged 5–14 years residing in the household. Copy the line number of each eligible child from the Household Listing. Now I shall inquire about the labor activity children might be involved in this household. CL1. CL2. CL3. CL4. CL5. CL6. CL7. CL8. CL9. № N A M E JOB FOR NON-MEMBER OF THIS HOUSEHOLD HOUSEHOLD CHORES IN THE FAMILY W A S TH E CH IL D IN VO LV ED IN L A BO R A CT IV IT Y D U RI N G P A ST W EE K? If ‘Y es : W A S IT P A ID ? 1 – Y ES , ( CA SH O R IN KI N D ) 2 – Y ES , U N PA ID 3 – N O  CL 5 A PP RO X IM AT E N U M BE R O F H O U RS W O RK ED D U RI N G P A ST W EE K IF M O RE TH A N O N E W O RK D O N E, S PE CI FY T O TA L H O U RS W O RK ED A T A LL JO BS  CL 6 W A S (S )H E IN VO LV ED IN A N Y LA BO R A CT IV IT Y D U RI N G P RE V IO U S YE A R? If ‘Y es : W A S IT P A ID ? 1 – Y ES , ( CA SH O R IN KI N D ) 2 – Y ES , U N PA ID 3 – N O D U RI N G P A ST W EE K W A S (S )H E IN VO LV ED IN H O U SE H O LD C H O RE S, SU CH A S SH O PP IN G , C O LL EC TI O N O F FI RE W O O D , C LE A N IN G , C A RR YI N G W AT ER O R CH IL D C A RE ? 1 – Y ES 2 – N O  CL 8 A PP RO X IM AT E N U M BE R O F H O U RS IN VO LV ED IN T H IS H O U SE H O LD C H O RE S D U RI N G P A ST W EE K D U RI N G P A ST W EE K W A S (S )H E IN VO LV ED IN A N Y O TH ER L A BO R A CT IV IT Y IN T H E FA M ILY ( FA RM , F A M ILY BU SI N ES S) ? 1 – Y ES 2 – N O  N EX T LI N E A PP RO X IM AT E N U M BE R O F H O U RS IN VO LV ED IN T H IS A CT IV IT Y D U RI N G PA ST W EE K? line name paid un-paid no number of hours paid un- paid no yes no number of hours yes no number of hours 01 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 02 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 03 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 04 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 05 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 06 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 07 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 08 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 09 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 10 1 2 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 11 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 12 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 13 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 14 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 15 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ 16 1 2 3 ___ ___ 1 2 3 1 2 ___ ___ 1 2 ___ ___ MONITORING THE SITUATION OF CHILDREN AND WOMEN202 TABLES FOR IDENTIFYING CHILDREN AGED 2-14 FOR CHILD DISCIPLINE MODULE Table 1: Eligible children aged 2-14 years List below all children aged 2-14 years out of the Household Listing in accordance with the line number (HL1). Exclude other household members who are not aged 2-14 years. Write down line number, name, sex, age and line number for mother or each child caretaker. Then write down total number of children aged 2-14 years in the table below (CD7). CD1. CD2. CD3. CD4. CD5. CD6. № Line number (from HL1) Name (from HL2) Sex (from HL4) Age (from HL5) Line number of mother/care- taker (from HL7 or HL8) LINE LINE NAME M F AGE MOTHER/CARETAKER 01 __ __ 1 2 __ __ __ __ 02 __ __ 1 2 __ __ __ __ 03 __ __ 1 2 __ __ __ __ 04 __ __ 1 2 __ __ __ __ 05 __ __ 1 2 __ __ __ __ 06 __ __ 1 2 __ __ __ __ 07 __ __ 1 2 __ __ __ __ 08 __ __ 1 2 __ __ __ __ CD7. TOTAL NUMBER OF CHILDREN AGED 2-14 YEARS __ __ If there is only one child aged 2-14 years in the household, go to CD9 and CD11, if more than one child – continue with CD8. Table 2: random selection of child for discipline interview This table should be used to select one child aged 2-14 years, if there is more than one child of current age group in the household. See the last figure of the household number on the cover page. This is the line number to which you should go in the below table. Check the total number of eligible children in CD7(above). This is the column number from the table to which you should go. Find the cell, in which line and column cross and circle the figure in the cell. This is the serial number of child you will question about. Write down serial number in CD9 below. Finally, write down line number and name of selected child in CD11 next page. Then find mother/care-taker and start interview from CD12. CD8. Total number of eligible children in household (from cd7) Last figure of questionnaire 1 2 3 4 5 6 7 8+ 0 1 2 2 4 3 6 5 4 1 1 1 3 1 4 1 6 5 2 1 2 1 2 5 2 7 6 3 1 1 2 3 1 3 1 7 4 1 2 3 4 2 4 2 8 5 1 1 1 1 3 5 3 1 6 1 2 2 2 4 6 4 2 7 1 1 3 3 5 1 5 3 8 1 2 1 4 1 2 6 4 9 1 1 2 1 2 3 7 5 CD9. Write down serial number of selected child from Table 2 Serial number of child __ __ CD10. Identify eligible child in the household aged 2-14 years using tables in the previous page in accordance with instruc- tions. Ask mother/caretaker about interview (identified by the line number CD6). CD11. Write down name and line number of a child selected for module from CD3 and CD2, on the basis of serial number in CD9. Name LINE NUMBER __ __ KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 203 CHILD DISCIPLINE CD CD12. ADULTS USE DIFFERENT METHODS OF DISCIPLINING THE CHILD. I AM GOING TO LIST DIFFERENT METHODS AND ASK YOU IF YOU OR ANY MEMBER OF YOUR HOUSEHOLD USED THESE METHODS DURING PAST MONTH. Yes No CD12A. DEPRIVED (NAME) PRIVILEGES, PLEASURES, BANNED ANYTHING OR GOING OUT 1 2 CD12B. EXPLAINED TO (NAME) INCORRECTNESS OF SUCH (ACTION) BEHAVIOR 1 2 CD12C. SHAKE HIM/HER 1 2 CD12D. SCREAM AT HIM/HER 1 2 CD12E. FORCED HIM/HER ACTING AGAINST HIS/HER WILL 1 2 CD12F. SLAPPED, BEAT OT HIT HIS BACK WITH YOUR HAND 1 2 CD12G. BEAT HIS/HER BACK OR OTHER PARTS OF THE BODY WITH ANY HARD THINGS SUCH AS BELT 1 2 CD12H. CALLED HIM/HER SILLY, LAZY OR OTHER SIMILAR WORDS 1 2 CD12I. BEAT HIS/HER FACE, HEAD OR EARS 1 2 CD12J. BEAT HIS HANDS, SHOULDERS, LEGS 1 2 CD12K. BEAT HIM/HER WITH ANY STUFF (AGAIN AND AGAIN STRONGER) 1 2 CD13. DO YOU BELIEVE THAT THE CHILD NEEDS TO BE PHYSICALLY PUNISHED FOR PROPER DISCIPLINE? Yes 1 No 2 DK/no opinion 8 MATERNAL MORTALITY MM Applicable to each adult member of household aged 15 years +. Copy the name and the line number of each adult (15 +) member of household. Any adult member might give answers for missing adult member. In this case, put ‘1’ in MM3, and specify line number of authorized respondent in MM4. Leave blank lines for members of household aged < 15 years. MM1. MM2. MM3. MM4. MM5. MM6. MM7. MM8. MM9. LINE № NAME IS IT «AUTHORI- ZED» REPORT? 1. YES  MM4 2. NO  MM5 LINE NUMBER OF AUTHORIZED RESPONDENT (FROM THE HH LISTING HL1) NUMBER OF SISTERS (FROM THE SAME MOTHER) YOU EVER HAD 98= DON’T KNOW SISTERS WHO REACHED AGE 15 YEARS 98= DON’T KNOW SISTERS (AT THE AGE AT LEAST 15 YEARS) STILL ALIVE 98= DON’T KNOW SISTERS WHO REACHED AGE 15 + AND WHO DIED 98= DON’T KNOW NUMBER OF DEAD SISTERS DYING DURING PREGNANCY OR DELIVERY OR WITHIN 6 WEEKS AFTER PREGNANCY FINISHED 98= DON’T KNOW LINE NAME YES NO LINE 01 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 02 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 03 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 04 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 05 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 06 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 07 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 08 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 09 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 10 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 11 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 12 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 13 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 14 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 15 1 2 __ __ __ __ __ __ __ __ __ __ __ __ 16 1 2 __ __ __ __ __ __ __ __ __ __ __ __ MONITORING THE SITUATION OF CHILDREN AND WOMEN204 CONSUMPTION OF IODIZED SALT SI SI1. WE WANT TO SEE IF MEMBERS OF YOUR HOUSEHOLD USE IODIZED SALT. MAY I SEE SALT THE MEMBERS OF YOUR HOUSEHOLD USED FOR COOKING AND CONSUMED LAST NIGHT? After testing salt, circle the number, which corresponds to the test result. Not iodized 0 РРМ 1 < 15 РРМ 2 15 PPM + 3 No salt 6 Not tested 7 SI2. IS THERE ELIGIBLE WOMAN AGED 15-49 YEARS IN THE HOUSEHOLD? Check the HL6 column in the Household Listing. You must have question- naire containing Informational Module completed for each eligible woman.  Yes.  Go to WOMEN’S QUESTIONNAIRE for interviewing the first eligible woman.  No.  Continue. SI3. ARE THERE UNDER-5 CHILDREN IN THE HOUSEHOLD? Check the HL8 column in the Household Listing. You must have question- naire containing Informational Module completed for each eligible child.  Yes.  Go to UNDER-5 QUESTIONNAIRE for interviewing caretaker of the first eligible child.  No.  Finish the interview, thank respondent for cooperation. Collect all questionnaires for current household and write down the total number of completed interviews on the cover page. KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 205 QUESTIONNAIRE FOR INDIVIDUAL WOMEN WOMAN’S INFORMATION WM This module should be completed for each woman aged 15 – 49 years (see column HL6 of the Household Listing). Complete separate Questionnaire for each eligible woman. Write down cluster number, household number, name and line number of woman in correspondent cell. Write down your name, number and date of interview WM1. Cluster number: WM2. Household number: ___ ___ ___ ___ ___ WM3. Name woman: WM4. Line number of woman: _________ ___ ___ WM5. Name and number of interviewer: WM6. Interview day/month /year: __ ___ ___ ___ ___ / ___ ___ / ___ ___ ___ ___ WM7. Outcome of interview with woman: Interviewed 1 Missing 2 Refused 3 Partially interviewed 4 Recognized not eligible 5 Other (Specify) 6 Repeat welcoming if not read for woman earlier: WE ARE FROM THE STATISTIC AGENCY OF THE REPUBLIC OF KAZAKHSTAN. WE WORK WITHIN THE FAMILY HEALTH AND EDUCATION PROJECT. I WANT TO DISCUSS THIS WITH YOU. ALL RECEIVED INFORMATION IS STRICTLY CONFIDENTIAL; NO ONE WILL LEARN BELOW ANSWERS ARE YOURS. SHALL I START? If agreed start interview. If woman disagrees with interview, thank her, finish with WM7, and go to the next interview. Discuss the result with your su- pervisor for further additional visit to household for interviewing the woman. WM8. WHAT MONTH WERE YOU BORN? Date of Birth: __________________ month __ __ DK months 98 year __ __ __ ___________ DK year 9998 WM9. HOW OLD WERE YOU AT YOUR PREVIOUS BIRTHDAY? Age (full years) __ __ WM10. HAVE YOU EVER STUDIED IN ANY EDUCATIONAL INSTITUTION? Yes 1 No 2 WM11. WHAT HIGHEST LEVEL DID YOU ATTEND: PRIMARY, SECONDARY, SPECIALIZED SECONDARY OR HIGHER? Primary 1 Secondary 2 Specialized secondary 3 Higher 4 DK 8 WM12. WHAT HIGHEST GRADE/COURSE HAVE YOU COMPLETED AT THIS LEVEL? Grade/course __ __ MONITORING THE SITUATION OF CHILDREN AND WOMEN206 CHILD MORTALITY CM This module should be completed for each woman aged 15-49 years. All questions should be asked only about LIVE BIRTHS. CM1. NOW I WILL ASK YOU ABOUT BIRTHS YOU GAVE DURING YOUR LIFE. DID YOU EVER GIVE BIRTH? If “NO”, try to clarify: I MEAN BABY WHO WAS BREATHING, CRYING OR HAVING OTHER SIGNS OF LIFE, EVEN THOUGH (S)HE LIVED FOR SEVERAL MINUTES OR HOURS? Yes 1 No 2 2  MODULE MA CM2A. WHEN DID YOU GIVE BIRTH FOR THE FIRST TIME? I MEAN THE VERY FIRST BIRTH, EVEN IF THE BABY DIED LATER OR WAS BORN TO A MAN WHO DOES NOT LIVE WITH YOU ANYMORE. Go to CM3 only if the year of first birth is specified. Otherwise, continue with CM2B. Date of first delivery Day __ __ DK day 98 Month __ __ DK month 98 Year __ __  CM3 DK year 9998  CM2B CM2B. HOW MANY YEARS AGO DID YOU GIVE BIRTH FIRST TIME? Full years after first birth __ __ CM3. DO ANY OF YOUR OWN SONS OR DAUGHTERS RESIDE WITH YOU CURRENTLY? Yes 1 No 2 2 CM5 CM4. HOW MANY OF YOUR OWN SONS RESIDE WITH YOU? HOW MANY OF YOUR OWN DAUGHTERS RESIDE WITH YOU? Sons residing with mother __ __ Daughters residing with mother __ __ CM5. ARE THERE ANY OF YOUR LIVING SONS AND DAUGHTER WHO DO NOT RESIDE WITH YOU? Yes 1 No 2 2 CM7 CM6. HOW MANY OF YOUR LIVING SONS DO NOT RESIDE WITH YOU? HOW MANY OF YOUR LIVING DAUGHTERS DO NOT RESIDE WITH YOU? Sons residing separately __ __ Daughters residing separately __ __ CM7. HAVE YOU EVER GIVEN BIRTH TO A LIVE BOY OR GIRL WHO DIED LATER? Yes 1 No 2 2 CM9 CM8. HOW MANY BOYS HAVE DIED? HOW MANY GIRLS HAVE DIED? Number of dead boys __ __ Number of dead girls __ __ CM9. SUM UP ANSWERS FOR CM4, CM6, CM8. Total __ __ CM10. TO CHECK MY NOTES, DURING YOUR LIFE YOU GAVE BIRTH (total number) OF TIMES. IS IT TRUE?  Yes.  Go to CM11  No.  Check answers and make corrections before going to CM11 CM11. WHEN DID YOU GIVE LAST BIRTH OUT OF (total number) BIRTHS (EVEN IF THIS BABY DIED LATER)? If day is unknown, enter ‘98’ for the date. Date of last birth Day/Month/Year __ __/__ __/__ __ __ __ CM12. Check CM11: Did you give last birth during past 2 years, namely from «_____» ____________ 2004 and later? If the child died, pay special attention to the questions about this child in the next module.  No births during 2 years preceding interview.  Go to MARITAL/UNION STATUS MODULE.  Yes, birth during 2 years preceding interview.  Continue with CM13 Name of the child____________________________________________ CM13. WHEN YOU BECOME PREGNANT WITH (NAME), WAS IT WANTED PREGNANCY, YOU WANTED IT COME LATER OR YOU WANTED NO (MORE) CHILDREN? Wanted pregnancy 1 Wanted later 2 Unwanted pregnancy 3 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 207 MATERNAL AND NEWBORN HEALTH MN This module should be completed for each woman who gave live birth during two years preceding the interview. Check the Child Mortality Module CM12 and write down the name of the last child _______________________ Use the name of this child in the following questions MN2. DID YOU SEEK ANTENATAL CARE DURING THIS PREGNANCY? If yes: WHO PROVIDED ANTENATAL CARE TO YOU? ANY OTHER STAFF? Ask additional questions to clarify personnel providing an- tenatal care and circle all mentioned persons. Health staff: Medical doctor A Nurse/midwife B Auxiliary midwife C Feldsher D Other Traditional birth attendant F Public health worker G Relative/friend H Other (specify) X No one Y Y MN7 MN2А. HOW MANY TIMES DID YOU SEEK ANTENATAL CARE DURING THIS PREGNANCY? Regularly 1 1 time 2 2-3 times 3 Did not seek 4 4 MN7 MN3. AS A PART OF YOUR ANTENATAL CARE, HAVE YOU RECEIVED ONE OF THE FOLLOWING SPECIFIC CARE, AT LEAST, ONCE? Yes No MN3A. WEIGHT MEASURED Weight 1 2 MN3B. BLOOD PRESSURE MEASURED Blood pressure 1 2 MN3C. URINE TESTED Urine test 1 2 MN3D. BLOOD TESTED Blood test 1 2 MN4. DURING ANTENATAL VISITS, DID ANYBODY SPEAK WITH ABOUT AIDS AND HIV? Yes 1 No 2 DK 8 MN5. I DO NOT WANT TO KNOW THE RESULTS, BUT WERE YOU TESTED FOR AIDS AS A PART OF ANTENATAL CARE? Yes 1 No 2 2 MN7 DK 8 8 MN7 MN6. I DO NOT WANT TO KNOW THE RESULTS, BUT DID YOU GET THE RESULTS OF THE TEST? Yes 1 No 2 DK 8 MN7. WHO ASSISTED YOU DURING DELIVERY OF YOUR LAST CHILD (name)? ANYBODY ELSE? Ask additional questions to clarify the person assisted dur- ing delivery and circle all mentioned persons. Health staff: Medical doctor A Nurse/midwife B Auxiliary midwife C Feldsher D Other Traditional birth attendant F Public health worker G Relative/friend H Other (specify) X No one Y MONITORING THE SITUATION OF CHILDREN AND WOMEN208 MN8. WHERE DID YOU GIVE BIRTH TO (NAME)? If the source is hospital, health center or clinic, write down the name of institution on below line. Ask type of institu- tion and circle correspondent code. __________________________________ ________ (name of institution) Home At her home 11 Not at her home 12 Public sector Public hospital/maternity 21 Public clinic/Health center 22 Other health facility (specify) 26 Private health sector Private hospital 31 Private clinic 32 Private maternity 33 Other health facility (specify) 36 Other (specify) 96 MN9. WHEN YOU GAVE BIRTH TO YOUR LAST BABY (NAME), WAS HE LARGE, MORE THAN AVERAGE, AVERAGE, BELOW AVERAGE OR VERY LITTLE? Large 1 More than average 2 Average 3 Below average 4 Very little 5 DK 8 MN10. WAS (name) WEIGHTED IMMEDIATELY AFTER BIRTH? Yes 1 No 2 2 MN12 DK 8 8 MN12 MN11. WHAT WAS (name) WEIGHT? Copy weight from child development card if available. Card (grams) 1 __ __ From memory (grams) 2 __ __ DK 8 99998 MN12. HAVE YOU EVER BREASTFED (name)? Yes 1 No 2 2 next module MN13. HOW MUCH TIME AFTER BIRTH YOU BREASTFED (NAME) FOR THE FIRST TIME? If < 1 hour, write down ‘00’ hours. If < 24 hours, write down number of hours. If other write down days. Immediately 000 Hours 1 __ __ or Days 2 __ __ DK/does not remember 998 MN14. DO YOU SMOKE? Yes 1 No 2 2 MN16 MN14A. WERE YOU SMOKING DURING THE PREGNANCY? Yes 1 No 2 MN15. HOW MANY TIMES DID YOU SMOKE DURING LAST 24 HOUR? 1-2 times 1 3-5 times 2 5 + 3 MN16. HAVE YOU EVER CONSUMED ALCOHOL BEVERAGES? Yes 1 No 2 2 next module MN17. HAVE YOU EVER BECOME DRUNK WHEN CONSUMING ALCOHOL BEVERAGES? Yes 1 No 2 MN18. HOW MANY DAYS HAVE YOU CONSUMED ALCOHOL BEVERAGES DURING LAST 3 MONTHS Days __ __ No/never 0_0 MN19. HOW MANY TIMES WERE YOU DRUNK DURING LAST 3 MONTHS? Days __ __ No/never 0_0 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 209 MARRIAGE AND UNION MA MA1. ARE YOU CURRENTLY MARRIED/IN UNION? Yes, married 1 Yes, in union 2 Not in union 3 3 MA3 MA2. HOW OLD WAS YOUR HUSBAND/PARTNER AT HIS LAST BIRTHDAY? Age in years  MA5 DK 98  MA5 MA3. HAVE YOU EVER BEEN MARRIED/IN UNION? Yes, was married 1 Yes, was in union 2 No. 3 3 next module MA4. WHAT IS YOUR MARITAL STATUS AT PRESENT: WIDOW, DIVORCED OR SEPARATED? Widow 1 Divorced 2 Separated 3 MA5. HAVE YOU BEEN MARRIED/IN UNION ONLY ONCE OR MORE THAN ONCE? Only once 1 More than once 2 MA6. WHAT MONTH AND YEAR YOU MARRIED OR STARTED LIVING IN UNION FIRST TIME? Month __ __ DK month 98 Year __ __ DK year 9998 MA7. Check MA6:  Month and year of marriage/union is known?  go to the next Module.  Or month and year of marriage/union is not known?  continue with MA8 MA8. AT WHAT AGE HAVE YOU STARTED LIVING WITH YOUR FIRST HUSBAND/PARTNER? Age in years __ __ REPRODUCTIVE BEHAVIOR RP RP1. I WANT TO DISCUSS YOUR REPRODUCTIVE BEHAVIOR. IF YOU HAVE CHOICE, HOW MANY CHILDREN WOULD YOU HAVE DURING YOUR LIFE? One A Two B Three C Four D Five-nine E Ten + F None G RP2. YOUR DECISION TO HAVE NO CHILDREN OR RESTRICT THEIR NUMBER WOULD DEPEND ON: Health status A Fear to lose job B Uncertainty in children’s future C Low level of health service D Lack of preschool institutions E No housing F No utilities in dwelling G No regular job H Low salary I No job in general J Other (specify) K RP3. YOUR DECISION TO HAVE (MORE) CHILDREN WOULD DEPEND ON: Sufficient family allowances A Sufficient maternity leave B Availability of mortgage and credits C Short working day for breastfeeding mothers D Younger retirement age for mothers (of how many children?) E Other (specify) F RP4. WHAT IS PREFERABLE BIRTH INTERVAL BEFORE YOU WOULD HAVE (ANOTHER) BABY? One year A Two years B Three years C Four years D Five + E No more kids F MONITORING THE SITUATION OF CHILDREN AND WOMEN210 CONTRACEPTION CP CP1. I WANT TO CHANGE SUBJECT. I WANT TO DISCUSS WITH YOU FAMILY PLANNING AND YOUR REPRODUCTIVE HEALTH. ARE YOU PREGNANT NOW? Yes, pregnant 1 1 NEXT MODULE No 2 No sure/DK 8 CP2. SOME PEOPLE USE DIFFERENT METHODS TO DELAY OR AVOID PREGNANCY. ARE YOU DOING ANYTHING OR DO YOU USE ANY METHOD TO DELAY OR AVOID PREGNANCY? Да 1 Нет 2 2 NEXT MODULE CP3. WHAT METHOD DO YOU USE? DO NOT SUGGEST ANSWERS TO RESPONDENT. If several methods are mentioned, circle each. Female sterilization A Male sterilization B Pills C Intrauterine device D Injections E Implants F Condoms G Female condom H Diaphragm I Foam/jelly J Lactation amenorrhea K Periodic abstinence L Withdrawal M Other (specify) X A TTITUDES TOWARDS DOMESTIC VIOLENCE DV DV1. SOMETIMES HUSBAND IS ANGRY WITH HIS WIFE. DO YOU BELIEVE HE CAN HIT HIS WIFE IN THE FOLLOWING SITUATIONS: Yes No DK DV1A. WHEN SHE GOES OUT WITHOUT TELLING HIM? Goes out without telling him 1 2 8 DV1B. WHEN SHE NEGLECTS THE CHILDREN? Neglects the children 1 2 8 DV1C. WHEN SHE ARGUES WITH HIM? Argues with him 1 2 8 DV1D. WHEN SHE REFUSES SEX WITH HIM? Refuses sex with him 1 2 8 DV1E. WHEN SHE BURNS THE FOOD? Burns food 1 2 8 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 211 TUBERCULOSIS HT HT1. HAVE YOU EVER HEARD ABOUT TUBERCULOSIS? Yes 1 No 2 2  NEXT MODULE HT2. DO YOU KNOW ABOUT FULL RECOVERY AFTER TUBERCULOSIS IF PROPER TREATMENTS RECEIVED? Yes 1 No 2 DK 8 HT3. HAVE YOU OR ANY MEMBER OF YOUR FAMILY EVER HAD TUBERCULOSIS? Yes 1 No 2 DK 8 HT4. IN ADDITION TO YOUR FAMILY MEMBERS DO YOU OFTEN COMMUNICATE TO ANYBODY (NEIGHBORS, COLLEAGUES OR CLOSE FRIENDS) SUFFERING FROM TUBERCULOSIS? Yes 1 No 2 DK 8 HT5. WHAT SYMPTOMS HELP TO IDENTIFY TUBERCULOSIS? Cough 1 Cough with phlegm 2 Cough over 3 weeks 3 Fever 4 Blood with phlegm 5 Appetite loss 6 Sweating at night 7 Chest pain 8 Fatigue, tirelessness 9 Weight loss 10 Apathy, inertia 11 Other (specify) 96 DK 98 HT6. WHICH TB SYMPTOMS REQUIRE SEEING A DOCTOR? Cough 1 Cough with phlegm 2 Cough over 3 weeks 3 Fever 4 Blood with phlegm 5 Appetite loss .6 Sweating at night 7 Chest pain 8 Fatigue, tirelessness 9 Weight loss 10 Apathy, inertia 11 Other (specify) 96 DK 98 HT7. WHAT TREATMENT SHOULD HAVE THE PERSON WITH TB DIAGNOSED FIST TIME? Hospital 1 Home 2 Initially in the hospital, later at home 3 Other (specify) 6 DK 8 HT8. HOW IS TB TRANSMITTED BETWEEN PEOPLE? By air when coughing 1 Other (specify) 6 DK 8 HT9. WHERE WOULD YOU TAKE YOUR CHILD WITH SUSPECTED TB? Hospital 1 Policlinic 2 Feldsher 3 NB dispensary 4 Other (specify) 6 DK 8 HT10. WOULD YOU TAKE CARE OF YOUR FAMILY MEMBER, WHO, LET US ASSUME, HAD TB TREATMENT IN THE HOSPITAL, DURING FURTHER TREATMENT AT HOME? Yes 1 No 2 DK/not sure 8 MONITORING THE SITUATION OF CHILDREN AND WOMEN212 HIV/AIDS HA HA1. LET US DISCUSS DIFFERENT STUFF. Yes 1 HAVE YOU EVER HEARD OF HUMAN IMMUNODEFICIENCY VIRUS OR THE DISEASE CALLED AIDS? No 2 2 next quest-re HA2. CAN YOU PREVENT THIS DISEASE IF YOU HAVE ONLY ONE UNINFECTED SEX PARTNER, WHO HAS NO OTHER PARTNERS? Yes 1 No 2 DK 8 HA3. DO YOU BELIEVE THAT AIDS CAN BE TRANSMITTED BY SUPERNATURAL MEANS? Yes 1 No 2 DK 8 HA4. CAN YOU PREVENT AIDS BY PROPERLY USING CONDOMS AT EACH INTERCOURSE? Yes 1 No 2 DK 8 HA5. CAN AIDS BE TRANSMITTED THROUGH MOSQUITO BITES? Yes 1 No 2 DK 8 HA6. IS IT POSSIBLE TO PROTECT AGAINST AIDS ABSTAINING FROM SEX? Yes 1 No 2 DK 8 HA7. CAN PERSON GET AIDS THROUGH SHARING FOOD WITH AIDS-INFECTED PERSON? Yes 1 No 2 DK 8 HA7A. CAN PERSON GET AIDS THROUGH NEEDLE USED BY SOMEBODY ELSE? Yes 1 No 2 DK 8 HA8. CAN A HEALTHY LOOKING PERSON BE INFECTED WITH AIDS? Yes 1 No 2 DK 8 HA9. CAN AIDS BE TRANSMITTED FROM MOTHER TO CHILD? Yes 1 No 2 DK 8 Yes No DK HA9A. DURING PREGNANCY? During pregnancy 1 2 8 HA9B. DURING DELIVERY? During delivery 1 2 8 HA9C. DURING BREASTFEEDING? Through breastmilk 1 2 8 HA10. CAN THE TEACHER INFECTED BUT NOT SICK WITH THIS VIRUS CONTINUE WORKING IN THE SCHOOL? Yes 1 No 2 DK 8 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 213 HA11. WOULD YOU BUY FRESH VEGETABLES FROM THE SELLER KNOWING (S)HE IS SICK OR INFECTED WITH VIRUS? Yes 1 No 2 DK 8 HA12. WOULD YOU KEEP IN A SECRET IF ONE OF YOUR FAMILY MEMBERS WOULD BE INFECTED WITH AIDS? Yes 1 No 2 DK 8 HA13. WOULD YOU TAKE CARE OF YOUR FAMILY MEMBER AT HOME KNOWING (S)HE IS SICK WITH AIDS? Yes 1 No 2 DK 8 HA14. Check MN5: WAS THE WOMAN TESTED FOR AIDS AS A PART OF ANTENATAL CARE?  Yes.  Go to HA18А  No.  Continue with HA15 HA15. I DO NOT WANT TO KNOW A RESULT, BUT HAVE YOU EVER BEEN TESTED FOR AIDS? Yes 1 No 2 2 HA18 DK 8 8 HA18 HA16. I DO NOT WANT TO KNOW A RESULT, BUT WERE YOU INFORMED ON THE RESULTS OF YOUR TEST? Yes 1 No 2 HA17. DID YOU REQUEST TEST OR IT WAS PROPOSED TO YOU AND AGREED OR IT WAS OBLIGATORY? Requested test 1 1 next quest-re Proposed and agreed 2 2 next quest-re Obligatory 3 3 next quest-re HA18. AT PRESENT TIME, ARE YOU AWARE OF PLACE WHERE YOU CAN GET TESTED FOR AIDS? Yes 1 No 2 HA18А. If was tested for AIDS virus as a part of antenatal care: DO YOU KNOW ABOUT ANY PLACE IN ADDITION TO ANC PLACE WHERE YOU CAN BE TESTED FOR AIDS? Yes 1 No 2 MONITORING THE SITUATION OF WOMEN AND CHILDREN214 QUESTIONNAIRE FOR CHILDREN UNDER-5 UNDER-5 INFORMATION UF This questionnaire should be filled for all women (see household listing, column HL8), who takes care of children aged under-5 living with them (see household listing, column HL5). Separate Questionnaire should be filled for each child. Write down cluster and household number, name and line number of the child and his/her mother or caretaker. Write down your name, number and day of interview UF1. Cluster number: UF2. Household number: _____________________________________ _____________________________________ UF3. Name of child: UF4. Line number of child: _____________________________________ _____________________________________ UF5. Name of mother/caretaker: UF6. Line number of mother/caretaker: _____________________________________ _____________________________________ UF7. Name and number of interviewer: UF8. Day/month /year of interview: _____________________________________ ___ ___ / ___ ___ / ___ ___ ___ ___ UF9. Outcome of Under-5 interview (Codes relate mothers/ caretaker) Interviewed 1 Missing 2 Refused 3 Partially interviewed 4 Recognized unfit 5 Other (Specify) 6 Repeat welcome if not read for woman earlier: WE ARE FROM THE STATISTIC AGENCY OF THE REPUBLIC OF KAZAKHSTAN. WE WORK WITHIN THE FAMILY HEALTH AND EDUCATION PROJECT. I WANT TO DISCUSS THIS WITH YOU. ALL RECEIVED INFORMATION IS STRICTLY CONFIDENTIAL; NO ONE WILL LEARN BELOW ANSWERS ARE YOURS. SHALL I START? If agreed start interview. If respondent disagrees with interview, thank him/her, and go to the next interview. Discuss the result with your supervisor for further additional visit to household for getting information about the child. UF10. NOW I WILL INQUIRE YOU ABOUT HEALTH OF EACH UNDER-5 CHILD WHO YOU TAKE CARE OF AND WHO LIVES WITH YOU. PLEASE, TELL HIS/HER (name). WHAT IS HIS/HER MONTHS AND YEAR OF BIRTH (NAME)? Continue: WHAT IS HIS/HER BIRTHDAY? If mother/caretaker knows exact date of birth, write it down; otherwise circle number 98 for birthday. Birthday: Day __ __ DK day 98 Month __ __ Year __ __ __ __ UF11. HOW OLD BECAME (name) AT HER/HIS LAST BIRTHDAY? Write down age in full years. Age in full years __ KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 215 BIRTH REGISTRATION AND EARLY LEARNING BR BR1. HAS (name) BIRTH CERTIFICATE? MAY I SEE IT? Yes, certificate was shown 1 1 BR5 Yes, no certificate shown 2 No…. 3 DK 8 BR2. WAS BIRTH OF (name) REGISTERED IN THE REGISTRY OFFICE? Yes 1 1 BR5 No 2 2 BR3 DK 8 8 BR4 BR3. WHY BIRTH OF (name) WAS NOT REGISTERED? Too expensive 1 Too far to go 2 Did not know 3 Did not want to pay fine 4 Did not know where to go 5 Other (specify) 6 DK 8 BR4. DO YOU KNOW HOW TO REGISTER BIRTH? Yes 1 No 2 BR5. Check age of the child in UF11: IS CHILD 3 – 4 YEARS?  Yes.  Continue with BR6  No.  Go to BR8 BR6. DOES (name) ATTEND ANY FORM OF EARLY CHILDHOOD EDUCATION PROGRAM IN PRIVATE OR PUBLIC INSTITUTION, SUCH AS KINDERGARTEN OR OTHER CHILD CARE GROUP? Yes 1 No 2 2 BR8 DK 8 8 BR8 BR7. HOW MANY HOURS (APPROXIMATELY) OF THIS PROGRAM HAS (name) ATTENDED IN THE PAST WEEK? Number of hours __ __ BR8. WERE YOU OR ANY HOUSEHOLD MEMBER OLDER 15 YEAS ENGAGED IN THE FOLLOWING ACTIVITIES WITH (name) DURING LAST 3 DAYS: If Yes, ask: WHO WAS ENGAGED IN THESE ACTIVITIES – MOTHER, FATHER OR OTHER ADULT HOUSEHOLD MEMBER (INCLUDING ADULT CARETAKER/RESPONDENT)? Circle appropriate. Mother Father Other HH mem- ber Nobody BR8A. READ BOOKS OR WATCHED PICTURES IN THE BOOKS WITH (name) Read books A B X Y BR8B. TOLD STORIES TO (name) Told stories A B X Y BR8C. SANG SONGS WITH (NAME) Sang sons A B X Y BR8D WENT OUT WITH (name) Went out A B X Y BR8E. PLAYED С (имя) Played A B X Y BR8F. SPENT TIME WITH (name) NAMING WORDS, COUNTING AND/OR DRAWING Spent time A B X Y MONITORING THE SITUATION OF WOMEN AND CHILDREN216 CHILD DEVELOPMENT CE Ask question CE1 to each caretaker only once CE1. HOW MANY BOOKS ARE THERE IN YOUR HOUSEHOLD? PLEASE INCLUDE SCHOOLBOOKS, BUT NOT OTHER, FOR INSTANCE, ILLUSTRATED CHILDREN’S BOOKS. If no, write down 00 Number on non-children’s books (< 10) 0_ 10 + non-children’s books 10 CE2. HOW MANY CHILDREN’S BOOKS OR ILLUSTRATED BOOKS DO YOU HAVE FOR (имя)? If no, write down 00 Number on non-children’s books (< 10) 0__ 10 + non-children’s books 10 CE3. I AM INTERESTED TO LEARN WITH WHAT (name) PLAYS WHEN (S)HE IS AT HOME. WITH WHAT DOES (name) PLAY? DOES (S)HE PLAY WITH HOUSEHOLD OBJECTS, SUCH AS BOWLS, DISHES, CUPS AND PANS OBJECTS AND MATERIALS FOUND OUTSIDE THE HOME, SUCH AS STICKS, STONES, SEASHELLS OR LEAVES HOMEMADE TOYS, SUCH AS DOLLS, CARS AND OTHER TOYS THAT COME FROM STORE DOMESTIC ANIMALS If respondent answers ‘YES’ to mentioned category, try to specify the object with that the child plays. Circle Y, if child plays with neither listed item. Household objects (bowls, dishes, cups, pots A Objects and materials found outside the home (sticks, stones, sea-shells, leaves) B Homemade toys (dolls, cars and other toys) C Toys that come from store D Domestic animals E No toys listed Y CE4. SOMETIMES ADULT CARETAKERS SHOULD GO SHOPPING, FOR LAUNDRY OR SOME OTHER BUSINESS LEAVING LITTLE CHILDREN IN CARE OF OTHERS. HOW MANY TIMES IN THE PAST WEEK (name) WAS LEFT IN CARE OF ANOTHER CHILD (BELOW 10 YEARS)? If ‘no’, write down 00 Number of times __ CE5. HOW MANY TIMES (name) WAS LEFT ALONE IN THE PAST WEEK? If ‘no’, write down 00 Number of times __ BREASTFEEDING BF BF1. WAS (name) EVER BREASTFED? Yes 1 No 2 2  BF3 DK 8 8  BF3 BF2. IS THE BABY STILL BREASTFED? Yes 1 No 2 DK 8 BF3. WAS ANY OF THE BELOW GIVEN TO THE CHILD SINCE THE SAME HOUR YESTERDAY: Name loudly each product and write down the answer be- fore going to the next item. Yes No DK BF3A. VITAMINS, MINERAL SUPPLEMENTS OR MEDICINES? A. Vitamins, mineral supple- ments or medicines 1 2 8 BF3B. PLAIN WATER? B. Plain water 1 2 8 BF3C. SWEETENED, AROMATIZED WATER OR FRUIT JUICE, TEA OR EXTRACT? C. Sweetened water, tea or juice 1 2 8 BF3D. ORAL REHYDRATION SOLUTION (ORS)? D. ORS (oral rehydration solution) 1 2 8 BF3E. INFANT FORMULA? E. Infant formula 1 2 8 BF3F. TINNED, POWDER OR FRESH MILK? F. Milk and diary products 1 2 8 BF3G. OTHER FLUIDS? G. Other fluids (soup, broth) 1 2 8 BF3H. SOLID/SEMI-SOLID (SHABBY) FOOD? H. Solid/semi-solid (shabby) food 1 2 8 BF4. Check BF3H: WAS THE CHILD RECEIVING SOLID/SEMI-SOLID (SHABBY) FOOD?  Yes.  Go to BF5  No or DK.  Go to the next Module BF5. SINCE THE SAME HOUR YESTERDAY, HOW MANY TIMES (name) RECEIVED SOLID/SEMI-SOLID (SHABBY) FOOD, EXCLUDING FLUIDS? If 7 or more times, write own ‘7’. Number of times ___ DK 8 KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 217 CARE OF ILLNESS CA CA1. DID (name) HAD DIARRHOEA LAST TWO WEEKS, I.E. STARTING FROM (DAY OF WEEK) BEFORE LAST WEEK? Diarrhoea is identified in a way mother/caretaker under- stands it, or if a child had three watery stools per day or blood in stool. Yes 1 No 2 2 CA5 DK 8 8 CA5 CA2. DID (name) DRINK THE FOLLOWING DURING THE LAST EPISODE OF DIARRHOEA: Read out loudly and write down answer before going to next. Yes No DK CA2A. FLUID FROM ORS PACKET, CALLED REGIDRON, SMEKTA? A. Fluid from ORS packet (Regidron, Smekta) 1 2 8 CA2B. RECOMMENDED BY MOH HOMEMADE FLUID? B. Recommended by MoH fluid 1 2 8 CA2C. PRE-PACKED ORS FLUID? C. Pre-packed ORS fluid 1 2 8 CA3. DURING LAST EPISODE DID (name) DRINK LESS, THE SAME OR MORE? Much less or nothing 1 The same (or somewhat less) 2 More 3 DK 8 CA4. DURING LAST EPISODE DID (name) EAT LESS, THE SAME OR MORE? If “LESS”, specify: MUCH LESS OR SOMEWHAT LESS? Not at all 1 Much less 2 Somewhat less 3 Same 4 More 5 DK 8 CA5. DID (name) HAD ILLNESS WITH COUGH IN THE PAST TWO WEEKS, I.E. STARTING FROM (DAY OF WEEK) OF PRE PAST WEEK? Yes 1 No 2 2  CA12 DK 8 8  CA12 CA6. DURING LAST EPISODE WAS BREATHING FASTER THAN USUAL, WITH SHORT FAST DEEP BREATHS, OR WAS IT DIFFICULT? Yes 1 No 2 2  CA12 DK 8 8  CA12 CA7. WERE THESE SYMPTOMS RELATED TO CHEST OF STUFFY NOSE? Stuffy nose 1 1  CA12 Chest 2 Other (specify) 6 6  CA12 DK 8 CA8. DID YOU SEEK HEALTH ASSISTANCE OR ADVICE OUTSIDE FOR ILLNESS MANAGEMENT? Yes 1 No 2 2  CA10 DK 8 8  CA10 CA9. WHERE DID YOU GET ASSISTANCE? HAVE ANYBODY ELSE ASSISTED YOU? Circle all mentioned, but do NOT suggest answers If the source is hospital, health center or clinic, write down the name of institution on below line. Ask the type of in- stitution and circle correspondent code. _________________________________ (name of institution) Public sector Hospital A Health point B Policlinic/RDA C Feldsher D Mobile/field team (Ambulance) E Other public health institutions (specify) H MONITORING THE SITUATION OF WOMEN AND CHILDREN218 Private health sector Private hospital/ambulance I Private doctor J Private drug store K Mobile team L Other private health institutions (specify) O Another source Relatives or friends P Traditional healer R Other (specify) X CA10. DID (name) RECEIVE ANY MEDICINE FOR THIS ILLNESS? Yes 1 No 2 2  CA12 DK 8 8  CA12 CA11. WHAT MEDICINE DID (name) RECEIVE? Circle all mentioned medicines. Ampicillini A Paracetamol//Panadol P Aspirin Q Ibuprofen R Other (specify) X DK Z CA12. Check UF11: IS CHILD AGED BELOW 3 YEARS?  Yes.  Continue with CA13  No.  Go to CA14 CA13. WHEN (name) HAD WATERY STOOL LAST TIME HOW WAS EXCRETA DISPOSED? Child used toilet 01 Flush toilet 02 Flushed to pit/ditch 03 Thrown in garbage 04 Buried 05 Left open 06 Other (specify) 96 DK 98 Ask this question (CA14) only once to each caretaker. CA14. SOMETIMES YOU SHOULD TAKE THE CHILD WHO IS SERIOUSLY SICK TO HEALTH FACILITY IMMEDIATELY. WHAT SYMPTOMS WILL MAKE YOU TAKING THE CHILD TO SUCH FACILITY? Continue asking about other symptoms until all additional symptoms mentioned. Circle all mentioned symptoms, DO NOT SUGGEST ANSWERS. Child in to able to eat or breastfeed A Becomes sicker B Developed fever C Has fast breathing D Has difficult breathing E Has blood in stool F Is drinking poorly G Other (specify) X Other (specify) Y Other (specify) Z KAZAKHSTAN MULTIPLE INDICATOR CLUSTER SURVEY (MICS), 2006 219 IMMUNIZATION IM If the child has immunization card, copy from IM2- IM6 dates of immunization given in the card. IM10- IM17 cover vaccination not in the card. IM10- IM17 should be asked if child has no immunization card. IM1. DO YOU HAVE IMMUNIZATION CARD FOR (name)? Yes, presented 1 No, not presented 2 2  IM10 No 3 3  IM10 A. Copy dates of every vaccination from card. B. Put ‘44’ in the ‘Day” column if date of vaccination is not avail- able, but there is note about vaccination. Date of immunization DAY MONTH YEAR IM2. BCG (TUBERCULOSIS) BCG IM3A. POLIO О (POLIOMYELITIS) POLIO О IM3B. POLIO 1 ((POLIOMYELITIS) POLIO 1 IM3C. POLIO 2 ((POLIOMYELITIS) POLIO 2 IM3D. POLIO 3 ((POLIOMYELITIS) POLIO 3 IM4A. DPT1 (PERTUSIS, DIPHTHERIA, TETANUS) DPT 1 IM4B. DPT2 (PERTUSIS, DIPHTHERIA, TETANUS) DPT 2 IM4C. DPT3 (PERTUSIS, DIPHTHERIA, TETANUS) DPT 3 IM5A. HEP B1 (OR DPTHEPB 1) (DPT)H1 IM5B. HEP B2 (OR DPTHEPB 2) (DPT)H 2 IM5C. HEP (OR DPTHEPB 3) (DPT)H 3 IM6. MEASLES (OR MUMPS) MEASLES IM6.1. MMR (MEASLES, MUMPS, RUBELLA) MMR IM9. IN ADDITION TO VACCINES MENTIONED IN THE CARD, DID (name) RECEIVE ANY OTHER VACCINATION INCLUDING THOSE DURING NATIONAL DAYS OF IMMUNIZATION? Write down ‘Yes’ only if respondent names BCG, Polio 0-3, DPT 1-3, and/or Hep B 1-3, Measles Yes (Continue asking about vac- cines and put ’66’ in correspond- ent column ‘Day’ in IM2 – IM6B.) 1 1  IM20 No 2 2  IM20 DK 8 8  IM20 IM10. WAS (name) VACCINATED AGAINST DISEASES, INCLUDING VACCINATION DURING NATIONAL IMMUNIZATION DAYS? Yes 1 No 2 2  IM20 DK 8 8  IM20 IM11. HAS (name) EVER RECEIVED BCG AGAINST TUBERCULOSIS, WHICH IS INJECTED INTO THE LEFT SHOULDER LEAVING SCAR? Yes 1 No 2 DK 8 IM12. HAS (name) EVER RECEIVED “VACCINE IN A FORM OF DROPS” TO PREVENT POLIOMYELITIS? Yes 1 No 2 2  IM15 DK 8 8  IM15 MONITORING THE SITUATION OF WOMEN AND CHILDREN220 IM13. DID THE BABY RECEIVE THESE DROPS IMMEDIATELY AFTER BIRTH (WITHIN 2 WEEKS) OR LATER? Immediately after birth (within 2 weeks) 1 Later 2 DK 8 8  IM15 IM14. HOW MANY TIMES DID (S)HE RECEIVE DROPS? Number of times __ DK 8 IM15. DID (name) RECEIVE DPT VACCINE INJECTION INTO HIP OR BUTTOCK TO PREVENT TETANUS, PERTUSIS AND DIPHTHERIA? (SOMETIMES THESE VACCINES ARE ADMINISTERED ALONG WITH POLIO VACCINE) Yes 1 No 2 2  IM17 DK 8 8  IM17 IM16. HOW MANY TIMES? Number of times __ __ DK 8 IM17. DID (name) EVER RECEIVE “INJECTION OF MEASLES VACCINE”, MEANS, INJECTION INTO ARM AT THE AGE OF 9 MONTHS AND OLDER TO PREVENT MEASLES? Yes 1 No 2 DK 8 IM20. IS THERE ANY OTHER CHILD LIVING IN THE HOUSEHOLD UNDER CARE OF RESPONDENT? Check Household Listing, column HL8.  Yes.  Complete this questionnaire, then Go to UNDER-5 QUESTIONNAIRE for another child.  No.  Complete interview with respondent thanking for help. If this is the last child in interviewed household go to ANTHROPOMETRY MODULE. ANTHROPOMETRY AN After competing questionnaires for all children, weight and measure each child. Write down weight and height, check accuracy of notes. Check name and serial number with the Household Listing before recording measures. AN1. Weight of child Kilograms (kg) AN2. HEIGHT OF CHILD Check age of child in UF11:  Child < 2 years.  Measure height (when lying).  Child 2 years +.  Measure height (standing). Height (cm) Lying 1 Height (cm) Standing 2 AN3. Identification code of person taken measures. Code __ __ AN4. RESULT. Measured 1 Missing 2 Refused 3 Other (specify) 6 AN5. IS THERE ANOTHER ELIGIBLE CHILD IN THE FAMILY?  Yes.  Write down measures for the next child.  No.  Finish interview with household. Thank all participants for their assistance. Collect all questionnaires of this household and make sure identification numbers are available on the top of each page Write down the number of completed interviews in the Household Characteristics Module.

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