Lao - Multiple Indicator Cluster Survey - 2011

Publication date: 2011

Lao PDR Lao Social Indicator Survey (LSIS) 2011 - 12 (MULTIPLE INDICATOR CLUSTER SURVEY / DEMOGRAPHIC AND HEALTH SURVEY) December 2012 The Lao Social Indicator Survey LSIS (MICS/DHS) was carried out in 2011-12 by the Ministry of Health (MoH) and Lao Statistics Bureau (LSB) in collaboration with line ministries. Financial and technical support was provided by the United Nations Children’s Fund (UNICEF), United Nations Population Fund (UNFPA), Luxembourg Government (LuxGov), United States Agency for International Development (USAID), The Australian Agency for International Development (AusAID), Swiss Development Cooperation (SDC), United Nations Development Programme (UNDP), World Health Organization (WHO), Japan International Cooperation Agency (JICA), Joint United Nations Programme on HIV/AIDS (UNAIDS), and World Food Programme (WFP). LSIS is a household-based survey that applied the technical frameworks of the Multiple Indicator Cluster Survey (MICS) and Demographic and Health Survey (DHS). It is the first of its kind in Lao PDR. The LSIS was conducted to collect baseline data for the 7th National Social Economic Development Plan (NSEDP) and continued monitoring of progress towards the MDGs. LSIS provides up-to-date information on the social situation of children, women and men covering health, nutrition, education, water and sanitation, marriage and sexual activity, fertility and mortality, contraception, HIV/AIDS, child protection, and use of mass media and information technology. Ministry of Health and Lao Statistics Bureau 2012 Lao Social Indicator Survey 2011-12 Vientiane, Lao PDR Lao PDR Lao Social Indicator Survey 2011-12 (Multiple Indicator Cluster Survey/Demographic and Health Survey) Implementing Agencies MoH, LSB/MPI and MoES Partner Agencies UNICEF, UNFPA, LuxGov, USAID, AusAID, SDC, UNDP, WHO, JICA, UNAIDS, WFP Technical Assistance December 2012 III Topic MICS4 Indicator Number MDG Indicator Number Indicator Value CHILD MORTALITY Child mortality 1.1 4.1 Under-five mortality rate 79 per 1,000 1.2 4.2 Infant mortality rate 68 per 1,000 1.3 Neonatal mortality rate 32 per 1,000 1.4 Post-neonatal mortality rate 36 per 1,000 1.5 Child mortality rate 11 per 1,000 NUTRITION Nutritional status 2.1a 2.1b 1.8 Underweight prevalence Moderate and Severe (- 2 SD) Severe (- 3 SD) 26.6 7.2 per cent per cent 2.2a 2.2b Stunting prevalence Moderate and Severe (- 2 SD) Severe (- 3 SD) 44.2 18.8 per cent per cent 2.3a 2.3b Wasting prevalence Moderate and Severe (- 2 SD) Severe (- 3 SD) 5.9 1.4 per cent per cent Breastfeeding and infant feeding 2.4 Children ever breastfed 95.6 per cent 2.5 Early initiation of breastfeeding 39.1 per cent 2.6 Exclusive breastfeeding under 6 months 40.4 per cent 2.7 Continued breastfeeding at 1 year 73.0 per cent 2.8 Continued breastfeeding at 2 years 40.0 per cent 2.9 Predominant breastfeeding under 6 months 68.3 per cent 2.10 Duration of breastfeeding 19.5 months 2.11 Bottle feeding 17.5 per cent 2.12 Introduction of solid, semi-solid or soft foods 52.3 per cent 2.13 Minimum meal frequency 43.0 per cent 2.14 Age-appropriate breastfeeding 36.7 per cent 2.15 Milk feeding frequency for non-breastfed children 51.2 per cent Vitamin A 2.17 Vitamin A supplementation (children under age 5) 59.1 per cent Low birth weight 2.18 Low-birth weight infants 14.8 per cent 2.19 Infants weighed at birth 42.5 per cent CHILD HEALTH Vaccinations 3.1 Tuberculosis immunization coverage 77.1 per cent 3.2 Polio immunization coverage 49.1 per cent 3.3 Immunization coverage for diphtheria, pertussis and tetanus (DPT) 51.5 per cent 3.4 4.3 Measles immunization coverage 55.3 per cent 3.5 Hepatitis B immunization coverage 51.5 per cent Tetanus toxoid 3.7 Neonatal tetanus protection 65.8 per cent Care of illness 3.8 Oral rehydration therapy with continued feeding 57.4 per cent 3.9 Care seeking for suspected pneumonia 54.4 per cent 3.10 Antibiotic treatment of suspected pneumonia 57.4 per cent Solid fuel use 3.11 Solid fuels 96.5 per cent Summary Table of Findings Lao Social Indicator Survey (LSIS) and Millennium Development Goals (MDG) Indicators, Lao PDR 2011-12 IV Topic MICS4 Indicator Number MDG Indicator Number Indicator Value Malaria 3.12 Household availability of insecticide-treated nets (ITNs) 50.2 per cent 3.14 Children under age 5 sleeping under any type of mosquito net 87.4 per cent 3.15 6.7 Children under age 5 sleeping under insecticide-treated nets (ITNs) 43.2 per cent 3.16 Malaria diagnostics usage 9.1 per cent 3.17 Anti-malarial treatment of children under age 5 the same or next day 1.2 per cent 3.18 6.8 Anti-malarial treatment of children under age 5 1.9 per cent 3.19 Pregnant women sleeping under insecticide-treated nets (ITNs) 43.2 per cent WATER AND SANITATION Water and sanitation 4.1 7.8 Use of improved drinking water sources 69.9 per cent 4.2 Water treatment 53.2 per cent 4.3 7.9 Use of improved sanitation 56.9 per cent 4.4 Safe disposal of child's faeces 18.6 per cent REPRODUCTIVE HEALTH Contraception and unmet need 5.1 5.4 Adolescent birth rate 94 per 1,000 5.2 Early childbearing 18.2 per cent 5.3 5.3 Contraceptive prevalence rate 49.8 per cent 5.4 5.6 Unmet need 19.9 per cent Maternal and newborn health 5.5a 5.5b 5.5 Antenatal care coverage At least once by skilled personnel At least four times by any provider 54.2 36.9 per cent per cent 5.6 Content of antenatal care 18.3 per cent 5.7 5.2 Skilled attendant at delivery 41.5 per cent 5.8 Institutional deliveries 37.5 per cent 5.9 Caesarean section 3.7 per cent Post-natal health checks 5.10 Post-partum stay in health facility 64.9 per cent 5.11 Post-natal health check for the newborn 40.6 per cent 5.12 Post-natal health check for the mother 39.5 per cent Maternal mortality 5.13 5.1 Maternal mortality ratio 357 per 100,000 CHILD DEVELOPMENT Child development 6.1 Support for learning 57.4 per cent 6.2 Father's support for learning 51.5 per cent 6.3 Learning materials: children’s books 5.0 per cent 6.4 Learning materials: playthings 40.9 per cent 6.5 Inadequate care 14.0 per cent 6.6 Early child development index 81.3 per cent 6.7 Attendance to early childhood education 23.0 per cent V Topic MICS4 Indicator Number MDG Indicator Number Indicator Value EDUCATION Literacy and education 7.1 2.3 Literacy rate among young people women age 15-24 years men age 15-24 years 68.7 77.4 per cent per cent 7.2 School readiness 23.7 per cent 7.3 Net intake rate in primary education 63.9 per cent 7.4 2.1 Primary school net attendance ratio (adjusted) 84.9 per cent 7.5 Secondary school net attendance ratio (adjusted) 44.6 per cent 7.6 2.2 Children reaching last grade of primary 65.3 per cent 7.7 Primary completion rate 94.2 per cent 7.8 Transition rate to secondary school 90.9 per cent 7.9 Gender parity index (primary school) 0.99 ratio 7.10 Gender parity index (secondary school) 1.00 ratio CHILD PROTECTION Birth registration 8.1 Birth registration 74.8 per cent Child discipline 8.5 Violent discipline 75.7 per cent Early marriage 8.6 Marriage before age 15 women age 15-49 years men age 15-49 years 9.3 3.0 per cent per cent 8.7 Marriage before age 18 women age 20-49 years men age 20-49 years 37.0 14.6 per cent per cent 8.8 Young women age 15-19 years currently married or in union Young men age 15-19 years currently married or in union 24.7 9.0 per cent per cent 8.10a 8.10b Spousal age difference women age 15-19 years women age 20-24 years 11.4 9.0 per cent per cent Domestic violence 8.14 Attitudes towards domestic violence women age 15-49 years men age 15-49 years 58.2 49.1 per cent per cent VI Topic MICS4 Indicator Number MDG Indicator Number Indicator Value HIV/AIDS, SEXUAL BEHAVIOUR, AND ORPHANED AND VULNERABLE CHILDREN HIV/AIDS knowledge and attitudes 9.1 Comprehensive knowledge about HIV prevention women age 15-49 years men age 15-49 years 22.7 29.9 per cent per cent 9.2 6.3 Comprehensive knowledge about HIV prevention among young people women age 15-24 years men age 15-24 years 24.0 27.6 per cent per cent 9.3 Knowledge of mother-to-child transmission of HIV women age 15-49 years men age 15-49 years 55.4 57.0 per cent per cent 9.4 Accepting attitudes towards people living with HIV women age 15-49 years men age 15-49 years 17.0 14.2 per cent per cent 9.5 Women who know where to be tested for HIV Men who know where to be tested for HIV 37.3 46.5 per cent per cent 9.6 Women who have been tested for HIV and know the results Men who have been tested for HIV and know the results 2.3 2.2 per cent per cent 9.7 Sexually active young women who have been tested for HIV and know the results Sexually active young men who have been tested for HIV and know the results 3.8 2.6 per cent per cent 9.8 HIV counselling during antenatal care 12.1 per cent 9.9 HIV testing during antenatal care 6.2 per cent Sexual behaviour 9.10 Young women who have never had sex Young men who have never had sex 96.5 74.6 per cent per cent 9.11 9.12 Sex before age 15 among young people women age 15-24 years men age 15-24 years Age –mixing among sexual partner Women age 15-24 years 6.4 2.7 10.9 per cent per cent per cent Orphaned children 9.17 Children’s living arrangements 6.3 per cent 9.18 Prevalence of children with one or both parents dead 5.3 per cent 9.19 6.4 School attendance of orphans 66.8 per cent 9.20 6.4 School attendance of non-orphans 83.8 per cent ACCESS TO MASS MEDIA AND USE OF INFORMATION/COMMUNICATION TECHNOLOGY Access to mass media MT.1 Exposure to mass media women age 15-49 years men age 15-49 years 6.8 9.9 per cent per cent Use of information/ communication technology MT.2 Use of computers women age 15-24 years men age 15-24 years 13.9 15.9 per cent per cent MT.3 Use of internet women age 15-24 years men age 15-24 years 7.5 9.4 per cent per cent VII Table of Contents Summary Table of Findings .III Table of Contents . VII List of Tables .X List of Figures . XIV List of Abbreviations . XV Acknowledgements . XVI Executive Summary . XVIII I. Introduction.1 Background .1 Survey Objectives .2 II. Sample and Survey Methodology .4 Sample Design .4 Questionnaires .4 Training and Fieldwork .5 Data Processing .6 III. Sample Coverage and the Characteristics of Households and Respondents .8 Sample Coverage .8 Characteristics of Households .10 Characteristics of Female and Male Respondents Age 15-49 and Children Age Under 5 .14 IV. Water and Sanitation .21 Use of Improved Water Sources .21 Use of Improved Sanitation Facilities .31 V. Marriage and Sexual Activity .43 Current Marital Status .43 Age at First Marriage .44 Early Marriage .48 Spousal Age Difference .52 Attitudes toward Domestic Violence .55 Age at First Sexual Intercourse .58 Recent Sexual Activity .61 VI. Fertility Levels, Trends, Differentials and Preferences .66 Current Fertility .66 Fertility Differentials .67 Fertility Trends .70 Children Ever Born and Living .70 Birth Intervals.72 Age at First Birth .74 Early Childbearing .76 Desire For More Children .80 Desire To Limit Childbearing .81 Fertility Planning Status .83 VIII VII. Reproductive Health .85 Contraception .85 Unmet Need .90 Antenatal Care .94 Use of Iron Pills .101 Assistance at Delivery .103 Place of Delivery .106 Post-natal Health Checks .108 VIII. Adult and Maternal Mortality .122 Assessment of Data Quality .122 Estimates of Adult Mortality .123 Estimates of Maternal Mortality .124 IX. Child Health .127 Vaccinations .127 Neonatal Tetanus Protection .131 Oral Rehydration Treatment .134 Care Seeking and Antibiotic Treatment of Pneumonia .142 Solid Fuel Use .148 Malaria .153 X. Nutrition .167 Nutritional Status .167 Breastfeeding and Infant and Young Child Feeding .171 Salt Iodization .183 Children’s Vitamin A Supplementation .185 Low Birth Weight .188 XI. Child Mortality .194 Trends in Early Childhood Mortality .194 Early Childhood Mortality Rates by Socioeconomic and Demographic Characteristics .195 Comparison of Early Childhood Mortality Rates with Estimates from Other Sources .198 Data Quality Observations .199 XII. Child Development .202 Early Childhood Education and Learning .202 Early Childhood Development .211 XIII. Literacy and Education .215 Literacy among Young People .215 School Readiness .218 Primary and Secondary School Participation .220 XIV. Child Protection .236 Birth Registration .236 Child Discipline .238 Orphans .241 IX XV. HIV/AIDS and Sexual Behaviour .246 Knowledge about HIV Transmission and Misconceptions about HIV/AIDS .246 Accepting Attitudes towards People Living with HIV/AIDS .260 Knowledge of a Place for HIV Testing, Counselling and Testing during Antenatal Care .265 Sexual Behaviour Related to HIV Transmission .274 Self-reporting of Sexually Transmitted Infections .277 XVI. Access to Mass Media and Use of Information/Communication Technology .283 Access to Mass Media .283 Use of Information/Communication Technology .287 References .291 Appendix A. Sample Design .292 Appendix B. List of Personnel Involved in the Survey .298 Appendix C. Estimates of Sampling Errors .312 Appendix D. Data Quality Tables .366 Appendix E. MICS Indicators: Numerators and Denominators .384 Appendix F. Questionnaires .393 X List of Tables Table HH.1: Results of household, women's, men's and under-5 interviews.9 Table HH.2: Household age distribution by sex .10 Table HH.3: Household composition .12 Table HH.4.1: Women’s background characteristics .14 Table HH.4.2: Men’s background characteristics .17 Table HH.4.3: Under-5’s background characteristics.19 Table WS.1: Use of improved water sources .22 Table WS.2: Household water treatment .26 Table WS.3: Time to source of drinking water .28 Table WS.4: Person collecting water .30 Table WS.5: Types of sanitation facilities .32 Table WS.6: Use and sharing of sanitation facilities .35 Table WS.7: Disposal of child’s faeces .38 Table WS.8: Drinking water and sanitation ladders .40 Table MS.1.1: Current marital status: women .43 Table MS.1.2: Current marital status: men .44 Table MS.2.1: Age at first marriage: women .45 Table MS.2.2: Age at first marriage: men .46 Table MS.3: Median age at first marriage .47 Table MS.4.1: Early marriage: women .49 Table MS.4.2: Early marriage: men .51 Table MS.5: Spousal age difference .53 Table MS.6.1: Attitudes toward domestic violence: women .56 Table MS.6.2: Attitudes toward domestic violence: men .57 Table MS.7.1: Age at first sexual intercourse: women .58 Table MS.7.2: Age at first sexual intercourse: men .59 Table MS.8: Median age at first sexual intercourse .60 Table MS.9.1: Recent sexual activity: women.62 Table MS.9.2: Recent sexual activity: men .64 Table FE.1: Current fertility .66 Table FE.2: Fertility by background characteristics .68 Table FE.3: Trends in age-specific fertility rates and total fertility rate .70 Table FE.4: Children ever born and living .71 Table FE.5: Birth intervals .73 Table FE.6: Age at first birth .74 Table FE.7: Median age at first birth .75 Table FE.8: Fertility preferences by number of living children .80 Table FE.9: Desire to limit childbearing .82 Table FE.10: Fertility planning status .83 Table FE.11: Early childbearing .77 Table FE.12: Trends in early childbearing .79 Table RH.1: Knowledge of contraceptive methods .86 Table RH.2: Use of contraception .87 Table RH.3: Source of modern contraceptive methods .89 Table RH.4: Unmet need for contraception .92 Table RH.5: Antenatal care coverage .96 Table RH.6: Number of antenatal care visits .98 XI Table RH.7: Content of antenatal care .100 Table RH.8: Iron pills taken during pregnancy .102 Table RH.9: Assistance during delivery .104 Table RH.10: Place of delivery .107 Table RH.11: Post-partum stay in health facility .109 Table RH.12: Post-natal health checks for newborns .111 Table RH.13: Post-natal care (PNC) visits for newborns .114 Table RH.14: Post-natal health checks for mothers .116 Table RH.15: Post-natal care (PNC) visits for mothers .118 Table RH.16: Post-natal health checks for mothers and newborns .120 Table MM.1: Adult mortality rates .123 Table MM.2: Adult mortality probabilities .124 Table MM.3: Maternal mortality .124 Table CH.1: Vaccinations in first year of life .128 Table CH.2: Vaccinations by background characteristics .130 Table CH.3: Neonatal tetanus protection .132 Table CH.4: Oral rehydration solutions and recommended homemade fluids .135 Table CH.5: Feeding practices during diarrhoea .137 Table CH.6: Oral rehydration therapy with continued feeding and other treatments .140 Table CH.7: Care seeking for suspected pneumonia and antibiotic use during suspected pneumonia .143 Table CH.8: Knowledge of the two danger signs of pneumonia .146 Table CH.9: Solid fuel use .149 Table CH.10: Solid fuel use by place of cooking .152 Table CH.11: Household availability of insecticide treated nets .154 Table CH.12: Children sleeping under mosquito nets .156 Table CH.13: Pregnant women sleeping under mosquito nets .159 Table CH.14: Anti-malarial treatment of children with anti-malarial drugs .162 Table CH.15: Malaria diagnostics usage .165 Table NU.1: Nutritional status of children .168 Table NU.2: Initial breastfeeding .172 Table NU.3: Breastfeeding .175 Table NU.4: Duration of breastfeeding .177 Table NU.5: Age-appropriate breastfeeding .179 Table NU.6: Introduction of solid, semi-solid or soft foods .180 Table NU.7: Minimum meal frequency .181 Table NU.8: Bottle feeding .182 Table NU.9: Iodized salt consumption .184 Table NU.10: Children’s vitamin A supplementation .187 Table NU.11: Low birth weight infants .189 Table NU.A1: Nutritional status of children based on the former NCHS/CDC/WHO International Reference Population .191 Table CM.1: Early childhood mortality rates .195 Table CM.2: Early childhood mortality rates by socioeconomic characteristics .196 Table CM.3: Early childhood mortality rates by demographic characteristics .197 Table CD.1: Early childhood education.203 Table CD.2: Support for learning .205 Table CD.3: Learning materials .208 Table CD.4: Inadequate care .210 Table CD.5: Early child development index .212 XII Table ED.1.1: Literacy among young women .216 Table ED.1.2: Literacy among young men .217 Table ED.2: School readiness .219 Table ED.3: Primary school entry .221 Table ED.4: Primary school attendance .223 Table ED.5: Secondary school attendance .225 Table ED.6: Children reaching last grade of primary school .228 Table ED.6A: Children reaching last grade of primary school .230 Table ED.7: Primary school completion and transition to secondary school .232 Table ED.8: Education gender parity .234 Table CP.1: Birth registration .237 Table CP.2: Child discipline .240 Table CP.3: Children’s living arrangements and orphanhood .242 Table CP.4: School attendance of orphans and non-orphans .244 Table HA.1.1: Knowledge about HIV transmission, misconceptions about HIV/AIDS, and comprehensive knowledge about HIV transmission: women .248 Table HA.1.2: Knowledge about HIV transmission, misconceptions about HIV/AIDS, and comprehensive knowledge about HIV transmission: men .250 Table HA.2.1: Knowledge about HIV transmission, misconceptions about HIV/AIDS, and comprehensive knowledge about HIV transmission among young women .253 Table HA.2.2: Knowledge about HIV transmission, misconceptions about HIV/AIDS, and comprehensive knowledge about HIV transmission among young men .255 Table HA.3.1: Knowledge of mother-to-child HIV transmission: women .258 Table HA.3.2: Knowledge of mother-to-child HIV transmission: men .259 Table HA.4.1: Accepting attitudes toward people living with HIV/AIDS: women .261 Table HA.4.2: Accepting attitudes toward people living with HIV/AIDS: men .263 Table HA.5.1: Knowledge of a place for HIV testing .266 Table HA.5.2: Knowledge of a place for HIV testing .267 Table HA.6.1: Knowledge of a place for HIV testing among sexually active young women .269 Table HA.6.2: Knowledge of a place for HIV testing among sexually active young men .270 Table HA.7: HIV counselling and testing during antenatal care .272 Table HA.8.1: Sexual behaviour that increases the risk of HIV infection: women.275 Table HA.8.2: Sexual behaviour that increases the risk of HIV infection: men .276 Table HA.9.1: Self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms women .279 Table HA.9.2: Self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms men .280 Table MT.1.1: Exposure to mass media: women .284 Table MT.1.2: Exposure to mass media: men .286 Table MT.2.1: Use of computers and internet: women .288 Table MT.2.2: Use of computers and internet: men .290 Table SD.1: Villages and households in Lao PDR, by province and locality .292 Table SD.2: Estimating the required sample size, using contraceptive prevalence rate as the key indicator .294 Table SD.3: Allocation of villages (primary sampling units) to sampling strata .294 Table SE.1: Indicators selected for sampling error calculations .313 Table SE.2: Sampling errors: Total sample .315 Table SE.3: Sampling errors: Urban areas .317 Table SE.4: Sampling errors: Rural areas .319 XIII Table SE.5: Sampling errors: Rural areas with roads .321 Table SE.6: Sampling errors: Rural areas without roads .323 Table SE.7: Sampling errors: North region .325 Table SE.8: Sampling errors: Central region .327 Table SE.9: Sampling errors: South region .329 Table SE.10: Sampling errors: Vientiane Capital .331 Table SE.11: Sampling errors: Phongsaly .333 Table SE.12: Sampling errors: Luangnamtha .335 Table SE.13: Sampling errors: Oudomxay .337 Table SE.14: Sampling errors: Bokeo .339 Table SE.15: Sampling errors: Luangprabang .341 Table SE.16: Sampling errors: Huaphanh .343 Table SE.17: Sampling errors: Xayabury .345 Table SE.18: Sampling errors: Xiengkhuang .347 Table SE.19: Sampling errors: Vientiane .349 Table SE.20: Sampling errors: Borikhamxay .351 Table SE.21: Sampling errors: Khammuane .353 Table SE.22: Sampling errors: Savannakhet .355 Table SE.23: Sampling errors: Saravane .357 Table SE.24: Sampling errors: Sekong .359 Table SE.25: Sampling errors: Champasack .361 Table SE.26: Sampling errors: Attapeu .363 Table SE.27: Sampling errors: Adult and maternal mortality rates .365 Table DQ.1: Age distribution of household population .366 Table DQ.2.1: Age distribution of eligible and interviewed women .367 Table DQ.2.2: Age distribution of eligible and interviewed men .368 Table DQ.3: Age distribution of under-5s in household and under-5 questionnaires .368 Table DQ.4.1: Women’s completion rates by socioeconomic characteristics of households .369 Table DQ.4.2: Men’s completion rates by socioeconomic characteristics of households .370 Table DQ.5: Completion rates for under-5 questionnaires by socioeconomic characteristics of households .371 Table DQ.6: Completeness of reporting .372 Table DQ.7: Completeness of information for anthropometric indicators .373 Table DQ.8: Heaping in anthropometric measurements .374 Table DQ.9: Observation of bednets .374 Table DQ.10: Observation of women’s health cards .375 Table DQ.11: Observation of under-5s birth certificates .376 Table DQ.12: Observation of vaccination cards .377 Table DQ.13: Presence of mother in the household and the person interviewed for the under-5 questionnaire .378 Table DQ.14: Selection of children age 2-14 years for the child discipline module .378 Table DQ.15: School attendance by single age .379 Table DQ.16: Sex ratio at birth among children ever born and living .380 Table DQ.17: Births by calendar years .381 Table DQ.18: Reporting of age at death in days .382 Table DQ.19: Reporting of age at death in months .382 Table DQ.20: Completeness of information on siblings.383 Table DQ.21: Sibship size and sex ratio of siblings .383 XIV List of Figures Figure HH.1: Age and sex distribution of household population .11 Figure WS.1: Percent distribution of household members by source of drinking water .24 Figure FE.1: Age-Specific Fertility Rates by Urban-Rural Residence .67 Figure FE.2: Desire for more children among currently married women .81 Figure MM.1: Trend in maternal mortality ratios .125 Figure CH.1: Percentage of children age 12-23 months who received the recommended vaccinations by 12 months of age .129 Figure CH.2: Percentage of women with a live birth in the last 2 years who are protected against neonatal tetanus .133 Figure CH.3: Percentage of children under age 5 with diarrhoea who received oral rehydration treatment .136 Figure CH.4: Percentage of children under age 5 with diarrhoea who received ORT or increased fluids, AND continued feeding .142 Figure NU.1: Percentage of children under age 5 who are underweight, stunted and wasted .170 Figure NU.2: Percentage of mothers who started breastfeeding within one hour and within one day of birth .173 Figure NU.3: Infant feeding patterns by age .176 Figure NU.4: Percentage of households consuming iodized salt .185 Figure NU.5: Percentage of infants weighing less than 2500 grams at birth .190 Figure CM.1: Under-5 mortality rates by background characteristics .198 Figure CM.2: Trend in under-5 mortality rates .199 Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission .252 Figure HA.2: Sexual behaviour that increases risk of HIV infection .277 Figure HA.3: Percentage of women and men age 15-49 reporting an STI or symptoms of an STI in the past 12 months who sought advice or treatment.281 Figure DQ.1: Number of household population by single ages.367 XV List of Abbreviations AIDS Acquired Immune Deficiency Syndrome ANC Antenatal Care ASFR Age-specific Fertility Rate AusAID The Australian Agency for International Development BCG Bacille-Calmette-Guerin (Tuberculosis) CBR Crude Birth Rate CSPro Census and Survey Processing System DHS Demographic and Health Survey DPIC Department of Planning and International Cooperation DPT Diphteria Pertussis Tetanus EPI Expanded Programme on Immunization GFR General Fertility Rate GPI Gender Parity Index HIV Human Immunodeficiency Virus HiB Haemophilus Influenzae Type B HepB Hepatitis B IDD Iodine Deficiency Disorders ITN Insecticide-Treated Net IUD Intrauterine Device IYCF Infant and Young Child Feeding JICA Japan International Cooperation Agency Lao PDR Lao People’s Democratic Republic LRHS Lao Reproductive Health Survey LSB Lao Statistics Bureau LuxGov Luxembourg Government MDG Millennium Development Goals MICS Multiple Indicator Cluster Survey MoH Ministry of Health MPI Ministry of Planning and Investment MoES Ministry of Education and Sports NAR Net Attendance Rate NCHS U.S. National Centers for Health Statistics NIOPH National Institute of Public Health NSEDP National Socio-Economic Development Plan ORT Oral Rehydration Therapy PASW Predictive Analytics SoftWare PNC Post-natal Care SDC Swiss Development Cooperation SPSS Statistical Package for Social Sciences TFR Total Fertility Rate UHS University of Health Science UNAIDS United Nations Programme on HIV/AIDS UNDP United Nations Development Programme UNFPA United Nations Population Fund UNGASS United Nations General Assembly Special Session on HIV/AIDS UNICEF United Nations Children’s Fund USAID United States Agency for International Development WFFC World Fit For Children WFP World Food Programme WHO World Health Organization XVI Acknowledgements The Lao Social Indicator Survey 2011-12 (LSIS 2011-12) is a nation-wide household-based survey of social development indicators. It combines the Multiple Indicator Cluster Survey (MICS) and Lao Reproductive Health Survey (LRHS) where the LRHS applied technical platform of Demographic and Health Survey (DHS). The LSIS is based on MICS4 platform and add-on DHS modules, for example, live birth history and the maternal mortality module. The LSIS 2011-12 was undertaken by the Ministry of Health and Ministry of Planning and Investment (Lao Statistics Bureau) in collaboration with other line ministries. UNICEF and UNFPA were the primary agencies giving financial and technical assistance to support the survey. In addition, USAID, AusAID, LuxGov, WHO, UNDP, SDC, JICA and WFP provided financial and technical input to the implementation of the LSIS. The main purposes of LSIS are to allow continued monitoring of progress towards the Millennium Development Goals (MDGs) and to serve as a baseline for the 7th National Socio-Economic Development Plan (7th NSEDP). The survey results can also be used by the Government and development partners to prepare policies, strategies and planning to improve the social environment of people in Lao PDR, especially women and men of reproductive age (15 to 49 years) and children age under five. In addition, the survey provides key sources and references for researchers and academics to conduct further analysis and research studies in specific areas using LSIS data. We would like to extend our sincere thanks to all organizations and individuals who have contributed to making this survey a success, especially all concerned departments in the Ministry of Health and the Lao Statistics Bureau, Ministry of Planning and Investment, for leading the entire survey, and the Ministry of Education and Sports for actively participating in the planning and implementing the survey. We would also like to express our special thanks to the LSIS Steering Committee for their leadership and guidance of the survey, the Technical Task Force for advising and supporting the survey, and the Secretariat Group for organizing and dealing with day-to-day work. We acknowledge the great contribution of the Review Team for its valuable input to the LSIS findings, and the Report Writing Team for its dedication and commitment in conducting analysis and writing the report. Special thanks are extended to the Provincial Health Offices and Statistics Units of the Department of Planning and Investment in each province for being intensively involved in field data collection and monitoring. All Committees at all levels have played a very critical role in the successful achievement of the survey, and its high standard of quality. We would like to also extend our sincere appreciation to UNICEF and UNFPA for their initial support that made the survey possible. Thanks to UNDP, WHO and WFP for their financial and technical contribution. Special thanks to USAID, AusAID, LuxGov, JICA and SDC for their generous contributions to support the survey. Special thanks to the ICF International and MICS specialists for their technical contribution and support. XVII Prof. Dr. Eksavang Vongvichit Samaychanh Boupha Minister Vice Minister, Head of Lao Statistics Bureau Ministry of Health Ministry of Planning and Investment Mr. Timothy Schaffter Dr. Esther Muia Representative Representative UNICEF Lao PDR UNFPA Lao PDR XVIII Executive Summary The Lao Social Indicator Survey (LSIS) is a nationally representative sample survey. Its field data collection was conducted from October 2011 to February 2012. Among the 18,843 successfully interviewed nationally in the survey, 97,421 household members were listed. Of these, 47,820 were male and 49,601 were female. The average household size found in the survey was 5.2. Water and Sanitation • 70 per cent of the population is using an improved source of drinking water - 88 per cent in urban areas and 64 per cent in rural areas • Use of an improved source of drinking water is more common in the Northern region (79 per cent) than in the Central and Southern regions, where only two-thirds of the population get their drinking water from an improved source • Across the country, the proportion of the population using an improved source for drinking water varies from a low of 48 per cent in Savannakhet to a high of 98 per cent in Luangnamtha • For 31 per cent of households, it takes less than 30 minutes to collect water and return home, while 6 per cent of households spend 30 minutes or more • In 71 per cent of households, an adult female is usually the person who collects the drinking water when the source is not on the premises, while children age under 15 are water collectors in 12 per cent of the households without a source on the premises • 59 per cent of the population is living in households using an improved type of sanitation facility, while 38 per cent of the population has no sanitation facilities at all • 9 in 10 people in urban areas are using an improved type of sanitation facility, while only 5 in 10 rural people are doing so • Under 2 year-old children’s stools are disposed of safely in only 19 per cent of cases. Overall, the most common way to address stool disposal is to leave them in the open (43 per cent), followed by 19 per cent being buried Marriage and Sexual Activity • 22 per cent of women age 15-49 have never married, 71 per cent are currently married, 2 per cent are living together with a man, and 5 per cent are divorced, separated, or widowed • Among women age 25-49, 37 per cent married by the age of 18, and 58 per cent married by the age of 20 • The median age at first marriage among women age 25-49 is 19.2 years and has been relatively unchanged over the past two decades • Among men age 25-49, only 15 per cent were married by the age of 18 and 30 per cent by the age of 20. The median age at marriage for men age 25-49 is 22.5 years • One in four young women and nearly 1 in 10 men age 15-19 years is currently married • The median age at first sexual intercourse among men age 25-49 is 19.6 years; about a year older than women • Three in 10 men had sexual intercourse before age 18 compared with 4 in 10 women • 63 per cent of all women age 15-49 were sexually active in the four weeks before the survey, compared to 64 per cent of men in the same age group XIX Fertility • The total fertility rate (TFR) for Lao PDR for the three-year period preceding the survey (2009- 2011) is 3.2 children per woman, and 3.6 and 2.2 in rural and urban areas, respectively • With regard to TFR among women age 15-49, women living in the South have a higher fertility rate (3.9 births) than those living in the Northern and the Central regions (3.2 and 2.9 births, respectively) • Adolescent fertility for every 1,000 girls age 15-19 is 94; a big difference between rural and urban areas (114 and 44 births per 1,000 adolescents, respectively) • Based on the trends of the ASFRs and the TFR from 15 years before the survey to the three years prior to the survey (2009-11), there is evidence that the TFR has declined. For example, the TFR has declined from 5.0 births per woman around 1997-99 to 4.7 births in 2000-02, to 4.1 and 3.6 in 2003-05 and 2006-08, and continued to decline to 3.2 in the three-year period prior to the survey • The median birth interval is 34 months, the median birth interval of urban women is longer than that of rural women (46.3 and 32.2 months, respectively) • 4 per cent of women age 25-49 have given birth by the age of 15, 19 per cent have given birth by the age of 18, and 39 per cent have become mothers by the age of 20 • The median age at first birth for women age 25-49 is 21.1 years Reproductive Health • Over 90 per cent of women and men have heard of a modern contraception method. Both women and men are more familiar with modern methods of contraception (94 per cent and 95 per cent, respectively) than with traditional methods (68 and 69 per cent, respectively) • 50 per cent of currently married women are using a method of contraception. The most popular method is the pill, used by 2 in 10 married women in Lao PDR. Injectables are the next most popular method, used by 14 per cent of currently married women • 42 per cent of married women are using a modern method of family planning • 35 per cent of users obtained their contraceptive method from a government hospital, and 30 per cent from a government health centre • Overall, 1 in 5 married women have an unmet need for contraception, with 12 per cent of married women having an unmet need for limiting and 8 per cent having an unmet need for birth spacing • Unmet need is highest in the Southern region (24 per cent) and lower in the Central (21 per cent) and Northern (17 per cent) regions • 54 per cent of women age 15-49 years who gave birth in the two years preceding the survey received antenatal care from a health professional • Nearly half of women (48 per cent) did not take any iron pills during their pregnancy • 42 per cent of women who gave birth in the previous two years were assisted at the time of delivery by a health professional • Fewer deliveries in the Northern region were assisted by a health professional (31 per cent) than in the Southern (33 per cent) and Central regions (53 per cent) • 38 per cent of births in Lao PDR are delivered in a health facility, the majority in public sector facilities • Only 41 per cent of newborns in the last two years received either a health check or post-natal care (PNC) visit within two days of delivery • Only 40 per cent of mothers received either a health check after delivery or a PNC visit within two days of delivery XX Adult and Maternal Mortality • Age-specific mortality rates for women and men age 15-49 for the seven-year period preceding the survey (2005-2011) indicate that the level of adult mortality was slightly higher among men (3.1 deaths per 1,000 population) than among women (2.3 deaths per 1,000 population) • The risk of dying between the ages of 15 and 50 for women and men in the seven years preceding the survey (2005-2011) was 8.4 per cent of women and 11.7 per cent of men, respectively. Therefore, more men than women are likely to die between the ages of 15 and age 50 • The Maternal Mortality Ratio (MMR) was 357 deaths per 100,000 live births during the seven- year period preceding the survey. The 95 per cent confidence interval of the MMR is between 269 and 446 Child Health • By the age of 12 months, the proportions of children age 12-23 months receiving vaccinations were: BCG - 77 per cent; Polio 3 – 49 per cent; DPT-HepB – HiB 3 – 52 per cent; Measles – 55 per cent; all vaccinations (BCG, DPT, HepB, HiB 1 – 3, Polio 1 – 3, and Measles) – 34 per cent. • 66 per cent of women with a live birth in the previous two years were protected against tetanus • 74 per cent of women residing in urban areas were protected against tetanus, while only 63 per cent of women residing in rural areas were protected • Nearly half (48 per cent) of children with diarrhoea received ORS or a recommended home fluid during an episode of diarrhoea • The vast majority of households (97 per cent) use solid fuels for cooking. Use of solid fuels is 97 per cent or higher in every province of the country, with the exception of Vientiane Capital, where 19 per cent of households use gas or electricity for cooking • 81 per cent of household members live where cooking is done inside the house • 50 per cent of households have at least one insecticide treated net (ITN) and 94 per cent of households have at least one mosquito net • 87 per cent of children under the age of five slept under a mosquito net on the night prior to the survey and 43 per cent slept under an ITN • 91 per cent of pregnant women slept under a mosquito net and 43 per cent of pregnant women slept under an ITN on the night prior to the survey Nutrition • One in four children under the age of five years is moderately underweight (27 per cent) and 7 per cent are severely underweight • Nearly half of children (44 per cent) are moderately stunted (too short for their age) and 19 per cent are severely stunted • 6 per cent of children are moderately wasted (too thin for their height), and 1 per cent are severely wasted • 39 per cent of babies are breastfed for the first time within one hour of birth, while 71 per cent start breastfeeding within one day of birth • 40 per cent of children age less than six months are exclusively breastfed. While this level is considerably lower than recommended, it indicates a wider practice of exclusive breastfeeding than in the recent past (The percentage of infants being exclusively breastfed is twice as high in the Northern (61 per cent) than in the Central and Southern regions. Prevalence of exclusive breastfeeding does not vary greatly by urban / rural residence or by mother’s education or wealth quintile. The median duration of exclusive breastfeeding is only 2.7 months • Iodized salt was being used in 80 per cent of households • 59 per cent of children were reported to have received a vitamin A supplement. Vitamin A supplementation coverage is lower in the Central region (51 per cent) than in the Northern and Southern regions (66/67 per cent), while urban and rural respondents reported equal coverage • Overall, 43 per cent of births were weighed at birth and 15 per cent of infants were estimated to weigh less than 2,500 grams at birth • 20 per cent of babies in the South were low birth weight, compared with 13 and 14 per cent in the Northern and Central regions XXI Child Mortality • For the two-year period preceding the survey (2010-2011), infant mortality was 68 deaths per 1,000 live births, and under-five mortality was 79 deaths per 1,000 live births • The under 5 mortality rate in the Central region is 73 deaths per 1,000 live births, and over 100 in the Northern and Southern regions • The under-5 mortality rates in rural areas are those in urban areas. For example, the under-5 mortality rate for the five years preceding the survey was 100 deaths per 1,000 live births in rural areas compared with 45 in urban areas Child Development • 23 per cent of children age 36-59 months are attending an organised early childhood education programme • Only 5 per cent of children under the age of five years live in households where there are at least three children’s books • 41 per cent of children under five years had two or more play things in their homes • 12 per cent of children under five years of age were left in the care of other children who are under 10 years of age • 6 per cent of children under five years of age were left completely alone (under the care of no one) during the week preceding the interview Literacy and Education • 69 per cent of young women (age 15 – 24) and 77 per cent of young men are literate in Lao PDR • Among both women and men (age 15 – 24), the literacy is highest in the Central region at 76 per cent among young women and 79 per cent among young men, and lowest in the South at 55 per cent among women and 70 per cent among men • 24 per cent of children who are currently attending the first grade of primary school attended pre-school the previous year • Of all children of the primary school entry age of 6 years, 64 per cent are attending the first grade of primary school • The majority of children of primary school age are attending school (85 per cent) • Only about half (45 per cent) of children of secondary school age are attending secondary school. Of the remaining half, some are attending primary school, while others are not attending school at all • 30 per cent of children of secondary school age in the North and South are attending primary school, compared with 20 per cent of children in the Central region • The survival rate of primary education in Lao PDR is 65 per cent, if it is assumed that repeaters do not progress to the next grade • The primary school completion rate for all of Lao PDR is 94 per cent. The completion rate among boys (101 per cent) is higher than that of girls (88 per cent) • The transition rate to secondary school is 91 per cent • The Gender Parity Index (GPI) for both primary and secondary school is close to 1.00, indicating no difference in the attendance of girls and boys at primary and secondary schools XXII Child Protection • The births of 75 per cent of all children under the age of five are registered, and 33 per cent have a birth certificate • Nearly 9 in 10 children in urban areas (88 per cent) are registered, while only 7 in 10 rural children are officially registered • 76 per cent of all Lao children age 2-14 are subject to at least one form of psychological aggression or physical punishment from an adult in their household • Four in ten Lao adults believe physical punishment is necessary to properly raise a child • 84 per cent of children age 0-17 years live with both their parents; 6 per cent of children live with neither parent HIV/AIDS and Sexual Behaviour • In Lao PDR, 84 per cent of women and 92 per cent of men have heard of AIDS • 44 per cent of women with no education or in the poorest households have never heard of AIDS • 67 per cent of women and 82 per cent of men know both of the main ways of preventing HIV transmission • Comprehensive knowledge of AIDS is not common. Only 2 in 10 women and 3 in 10 men have comprehensive knowledge of AIDS • 8 in 10 adults know that HIV can be transmitted from a mother to her child (77 per cent of women and 82 per cent of men) • Only 4 in 10 women said they would be willing to care for a family member with AIDS in their household • 37 per cent of women and 47 per cent of men know where they can go to be tested for HIV • Nationally, 3 per cent of both women and men were tested for HIV within the 12 months prior to the survey • Overall, 46 per cent of young women and 42 per cent of young men have had sexual intercourse in the 12 months prior to the survey • Among the never-married, 3 per cent of young women and 22 per cent of young men report having had intercourse in the previous 12 months • 54 per cent of women received antenatal care from a health care professional for their last pregnancy. Only 12 per cent received HIV information during antenatal care, and only 6 per cent were offered an HIV test during antenatal care, tested, and told the result • 6 per cent of women and 3 per cent of men age 15-24 have had sex before the age of 15 • 7 per cent of women who have had sexual intercourse reported having either an STI, bad- smelling or abnormal genital discharge, or a genital sore or ulcer in the last 12 months. 2 per cent of men reported having either an STI, abnormal discharge, genital sore, or genital ulcer in the last 12 months • 54 per cent of women and 45 per cent of men sought advice or treatment from a clinic, hospital, private doctor or other health professional XXIII Access to Mass Media and Use of ICT • Only 13 per cent of women age 15-49 read a newspaper at least once a week. One in three women listens to the radio at least once a week, while as many as three in four women watch television at least once a week • 18 per cent of men age 15-49 read a newspaper or magazine and 42 per cent listen to the radio at least once a week • 14 per cent of women age 15-24 have used a computer within the last year and 11 per cent have used a computer at least once a week during the last month • 9 per cent of women age 15-24 have ever used the Internet, while 8 per cent used the Internet within the last year. Only 6 per cent of young women used the Internet once a week or more during the last month • 16 per cent of 15-24 year old men used a computer and 9 per cent used the internet during the last year 1 1 I. Introduction Background Prior to the Lao Social Indicator Survey (LSIS), conducted in 2011 and 2012, there were two series of national surveys that collected data surrounding key social development indicators in Lao PDR: • The Multiple Indicator Cluster Surveys (MICS) (1996, 2000, 2006), focusing on child-related indicators such as education, health, nutrition, water and sanitation, child development, child protection and HIV/AIDS. • The Lao Reproductive Health Surveys (LRHS) (1995, 2000, 2005) focusing on reproductive health, contraception and sexual behavior. The MICS and LRHS were conducted at similar times, and produced different national figures for social indicators. In order to maximize government resources and achieve a set of single national figures for social indicators both surveys were combined to create the LSIS. LSIS is a household-based survey that applies the technical frameworks of the MICS and DHS. It aims to produce statistically sound and internationally comparable estimates of a range of indicators. Therefore, LSIS includes water and sanitation, marriage and sexual, fertility, reproductive health, maternal mortality, child health, nutrition, education, child mortality, child development, child protection, HIV/AIDS, and mass media. According to the Vientiane declaration on Aid effectiveness, UNICEF and UNFPA, who are the main supporters of the surveys mentioned above, agreed to jointly provide the Lao Government with budget and technical support in order to conduct LSIS as a way to maximize resources. At the later stages, as the importance of LSIS in generating social indicators, more donors and development partners also contributed to the survey. At the later stages, support for the LSIS was provided by other development partners and donors. In April 2010, the Prime Minister Office issued the Letter of Approval to Ministry of Health (MoH) No. 730 to conduct LSIS. The MoH then released Decree No. 720, dated 18 May 2010, to set up a Steering Committee, Technical Task Force and Secretariat Group to ensure smooth planning, coordination and implementation of the Survey. Members of the Committee and Task Force came from various offices of MoH, the Lao Statistics Bureau (LSB) and the Ministry of Education and Sports (MoES). In early 2012, during the data analysis and report writing process, a Review Team was set up that was composed of government officials from line ministries and development partners. A Report Writing Team was also formed to ensure comprehensive data analysis and a final survey report. This report is based on the LSIS results for Lao PDR, conducted by the MoH and LSB in collaboration with other line ministries. The survey provides valuable information on the situation of children, women and men in Lao PDR, and was based, in large part, on the need to monitor progress towards the goals and targets emanating from recent international agreements, principally the Millennium Declaration, adopted by all 191 United Nations Member States in September 2000. It can also be used as baseline data for the 7th National Socio Economic Development Plan. 2 1 Survey Objectives The LSIS had the following primary objectives: • To provide a comprehensive selection of data on key social development indicators in order to support the monitoring of Millennium Development Goals (MDGs) and to establish a baseline for the 7th National Socio-Economic Development Plan (NSEDP). • To measure the achievement of national and provincial targets in different development sectors. • To produce a range of indicators that are statistically sound and internationally comparable based on methodology that follows the international survey standards of the Multiple Indicator Cluster Survey (MICS) and the Demographic and Health Surveys (DHS). • To strengthen government capacity to conduct a nationwide survey, and to analyze social data, making use of its findings to formulate and advocate for policy making. • To reinforce coordination mechanisms on supporting and strengthening social statistics in Lao PDR. 4 2 II. Sample and Survey Methodology Sample Design The sample for the Lao Social Indicator Survey (LSIS) was designed to provide estimates for a large number of indicators on the situation of children, women and men at the national level, for urban and rural areas, and for 17 provinces including the Vientiane Capital. Urban areas, rural areas with road access and rural areas without road access within each province were identified as the main sampling strata and the sample was selected in two stages. Within each province, a specified number of census enumeration areas were selected systematically using a square root allocation method. However, to be able to adequately represent each province, the allocation was adjusted so that there was a minimum of 50 enumeration areas in each province and up to a maximum of 75 enumeration areas in the largest provinces. After a household listing was carried out within the selected enumeration areas, a systematic sample of 20 households was drawn in each sample enumeration area. Two of the selected enumeration areas were not visited because they were merged into nearby villages during the period between the household listing operation and the fieldwork. These two selected enumeration areas could not be identified separately in the new villages. The sample was stratified by province, urban areas, rural areas with road access and rural areas without road access within each province, and was not self- weighting. For reporting national level results, sample weights were used. A more detailed description of the sample design can be found in Appendix A. Questionnaires Four sets of questionnaires were used in the survey: 1) a household questionnaire which was used to collect information on all de jure household members (usual residents), the household, and the dwelling; 2) a women’s questionnaire administered in every second household in each cluster visited to all men age 15-49 years; 3) a men’s questionnaire administered in each household to all men age 15-49 years; and 4) an under-5 questionnaire, administered to mothers or caretakers for all children under 5 years of age living in the household. The questionnaires included the following modules: The Household Questionnaire included the following modules: o Household Listing Form o Education o Water and Sanitation o Household Characteristics o Insecticide Treated Nets o Child Discipline o Salt Iodization The Questionnaire for Individual Women was administered to all women age 15-49 years living in the households, and included the following modules: o Women’s Background o Access to Mass Media and Use of Information/Communication Technology o Child Mortality with Birth History o Desire for Last Birth o Maternal and Newborn Health o Post-natal Health Checks o Illness Symptoms o Contraception 5 2 o Unmet Need o Attitudes Towards Domestic Violence o Marriage/Union o Sexual Behaviour o HIV/AIDS o Maternal Mortality The Questionnaire for Individual Men was administered to all men age 15-49 years living in the households, and included the following modules: o Men’s Background o Access to Mass Media and Use of Information/Communication Technology o Contraception o Attitudes Towards Domestic Violence o Marriage and Sexual Activity o HIV/AIDS The Questionnaire for Children Under Five was administered to mothers or caretakers of children under 5 years of age1 living in the households. Normally, the questionnaire was administered to mothers of under-5 children; in cases when the mother was not listed in the household roster, a primary caretaker for the child was identified and interviewed. The questionnaire included the following modules: o Age o Birth Registration o Early Childhood Development o Breastfeeding o Care of Illness o Malaria o Immunization o Anthropometry The LSIS questionnaires are based on the UNICEF MICS4 model questionnaires with components added from the Demographic and Health Surveys (DHS), for example, the components the full birth history and the maternal mortality module and interviewing a subsample of men. The original questionnaires were designed in English, then translated into the Lao language and were pre-tested in three villages in Luangprabang in January 2011. Based on the results of the pre-test, modifications were made to the wording and translation of the questionnaires. A copy of the LSIS questionnaires is provided in Appendix F. In addition to the administration of questionnaires, fieldwork teams tested the salt used for cooking in the households for inclusion of iodine, and measured the weight and height of children age under 5 years. The details of these measurements are provided in the respective sections of the report. Training and Fieldwork Training for the fieldwork was conducted for 17 working days from 5 to 23 September 2011. Training included lectures on interviewing techniques and the contents of the questionnaires, and mock interviews between trainees to gain practice in asking questions. Towards the end of the training period, trainees spent two days in practice interviewing in 20 villages in Vientiane Province. The training was mainly implemented by seven LSIS trainers from MoH and LSB central offices who had been trained earlier in the LSIS Training of Trainers/Pretest. Furthermore, the training was technically supported by a Regional MICS Coordinator from UNICEF and a survey expert from ICF International on the Demographic and Health Surveys project. 1 The terms “children under 5”, “children age 0-4 years”, and “children age 0-59 months” are used interchange- ably in this report. 6 2 The data were collected by 20 teams; each was comprised of four interviewers, one editor, one measurer and a supervisor. All field staff are from central and provincial offices of the MoH and the Ministry of Planning and Investment (MPI). Fieldwork was conducted in two phases. In the first phase, all 20 teams, consisting of 140 enumerators, kicked off the field data collection at 75 selected enumeration areas in Vientiane Capital on 27 September 2011. Field data collection in the capital lasted nine days on average. During the first phase of data collection, all teams were monitored by the seven LSIS trainers as well as the expert from ICF International and LSIS Survey Coordinator. Towards the end of the first phase, the LSIS trainers conducted feedback sessions with all 20 teams individually. After the first phase of field data collection, the enumerators from provincial offices went back to their provinces and contacted the district level authorities and heads of villages concerned. The enumerators from central offices collected all survey materials, equipment and necessary official documents from MoH and MPI. Each survey team was provided with two vehicles for field data collection in the provinces. The field data collection in the provinces began on 15 October 2011 and concluded at the end of February 2012. Data Processing Data processing began simultaneously with data collection in October 2011 and was completed on 15 March 2012. Data were entered using CSPro software. The data were entered on 14 microcomputers and carried out by 14 data entry operators temporarily recruited and trained by four data entry supervisors from the Lao Statistics Bureau (LSB). In order to ensure quality control, all questionnaires were double entered and internal consistency checks were performed. Procedures and standard programmes developed under the global MICS4 programme and adapted to the LSIS questionnaire by the LSB in collaboration with a data processing expert from ICF International were used throughout. Data were analysed using the Statistical Package for the Social Sciences (SPSS), Version 19, and the model syntax and tabulation plans developed by UNICEF and ICF International were used for this purpose. 8 III. Sample Coverage and the Characteristics of Households and Respondents Sample Coverage Of the 19,960 households selected for inclusion in the LSIS, 19,018 were found to be occupied. Of these, 18,843 were successfully interviewed, yielding a household response rate of 99 per cent. In the interviewed households, 23,937 women age 15-49 years were identified. Of these, 22,476 were successfully interviewed, yielding a response rate of 94 per cent within interviewed households. In addition, 11,166 men age 15-49 years were listed in the household questionnaire and eligible for individual interview. Questionnaires were completed for 9,951 men, which corresponds to a response rate of 89 per cent within interviewed households. There were 11,258 children age fewer than five listed in the household questionnaire. Questionnaires were completed for 11,067 of these children, which corresponds to a response rate of 98 per cent within interviewed households. Overall response rates of 93, 88, and 97 per cent were calculated for the women, men and under-five interviewed, respectively (Table HH.1). 3 9 S am pl ed O cc up ie d In te rv ie w ed H ou se ho ld re sp on se ra te E lig ib le In te rv ie w ed W om en 's re sp on se ra te W om en 's ov er al l re sp on se ra te E lig ib le In te rv ie w ed M en 's re sp on se ra te M en 's o ve ra ll re sp on se ra te E lig ib le M ot he rs / ca re ta ke rs in te rv ie w ed U nd er -5 's re sp on se ra te U nd er -5 's ov er al l re sp on se ra te R es id en ce U rb an 5, 08 0 4, 78 4 4, 73 0 98 .9 6, 37 5 5, 97 0 93 .6 92 .6 2, 85 2 2, 51 7 88 .3 87 .3 2, 12 5 2, 08 1 97 .9 96 .8 R ur al 14 ,8 80 14 ,2 34 14 ,1 13 99 .1 17 ,5 62 16 ,5 06 94 .0 93 .2 8, 31 4 7, 43 4 89 .4 88 .7 9, 13 3 8, 98 6 98 .4 97 .6 .R ur al w ith ro ad 13 ,2 20 12 ,6 73 12 ,5 66 99 .2 15 ,6 38 14 ,7 23 94 .1 93 .4 7, 43 6 6, 67 4 89 .8 89 .0 7, 87 1 7, 74 9 98 .5 97 .6 .R ur al w ith ou t r oa d 1, 66 0 1, 56 1 1, 54 7 99 .1 1, 92 4 1, 78 3 92 .7 91 .8 87 8 76 0 86 .6 85 .8 1, 26 2 1, 23 7 98 .0 97 .1 R eg io n N or th 7, 78 0 7, 47 5 7, 40 8 99 .1 9, 29 6 8, 79 3 94 .6 93 .7 4, 40 3 4, 05 5 92 .1 91 .3 4, 29 2 4, 22 6 98 .5 97 .6 C en tra l 7, 56 0 7, 16 7 7, 08 2 98 .8 9, 03 7 8, 39 3 92 .9 91 .8 4, 24 4 3, 71 1 87 .4 86 .4 3, 91 4 3, 83 3 97 .9 96 .8 S ou th 4, 62 0 4, 37 6 4, 35 3 99 .5 5, 60 4 5, 29 0 94 .4 93 .9 2, 51 9 2, 18 5 86 .7 86 .3 3, 05 2 3, 00 8 98 .6 98 .0 P ro vi nc e V ie nt ia ne C ap ita l 1, 50 0 1, 38 7 1, 36 6 98 .5 1, 92 4 1, 74 0 90 .4 89 .1 85 9 73 4 85 .4 84 .2 57 4 55 6 96 .9 95 .4 P ho ng sa ly 1, 00 0 96 6 95 6 99 .0 1, 16 4 1, 08 0 92 .8 91 .8 59 3 52 2 88 .0 87 .1 58 9 56 9 96 .6 95 .6 Lu an gn am th a 1, 00 0 97 5 97 0 99 .5 1, 21 0 1, 15 7 95 .6 95 .1 53 7 49 7 92 .6 92 .1 50 2 50 2 10 0. 0 99 .5 O ud om xa y 1, 08 0 1, 05 8 1, 05 3 99 .5 1, 45 7 1, 43 0 98 .1 97 .7 69 2 67 4 97 .4 96 .9 76 4 75 7 99 .1 98 .6 B ok eo 1, 00 0 96 8 96 0 99 .2 1, 22 3 1, 12 0 91 .6 90 .8 55 8 50 9 91 .2 90 .5 60 4 60 0 99 .3 98 .5 Lu an gp ra ba ng 1, 34 0 1, 26 5 1, 24 9 98 .7 1, 44 9 1, 35 0 93 .2 92 .0 67 0 61 3 91 .5 90 .3 68 0 66 4 97 .6 96 .4 H ua ph an h 1, 08 0 1, 03 2 1, 01 4 98 .3 1, 36 1 1, 27 3 93 .5 91 .9 67 6 61 4 90 .8 89 .2 69 9 68 5 98 .0 96 .3 X ay ab ur y 1, 28 0 1, 21 1 1, 20 6 99 .6 1, 43 2 1, 38 3 96 .6 96 .2 67 7 62 6 92 .5 92 .1 45 4 44 9 98 .9 98 .5 X ie ng kh ua ng 1, 00 0 95 0 94 1 99 .1 1, 23 1 1, 13 4 92 .1 91 .2 61 3 51 3 83 .7 82 .9 65 1 61 9 95 .1 94 .2 V ie nt ia ne 1, 32 0 1, 24 9 1, 22 7 98 .2 1, 51 8 1, 42 8 94 .1 92 .4 69 2 63 3 91 .5 89 .9 63 3 62 9 99 .4 97 .6 B or ik ha m xa y 1, 02 0 95 7 94 6 98 .9 1, 14 4 1, 10 9 96 .9 95 .8 52 1 48 8 93 .7 92 .6 47 8 47 4 99 .2 98 .0 K ha m m ua ne 1, 24 0 1, 21 2 1, 19 9 98 .9 1, 30 4 1, 27 9 98 .1 97 .0 63 2 58 9 93 .2 92 .2 65 2 65 0 99 .7 98 .6 S av an na kh et 1, 48 0 1, 41 2 1, 40 3 99 .4 1, 91 6 1, 70 3 88 .9 88 .3 92 7 75 4 81 .3 80 .8 92 6 90 5 97 .7 97 .1 S ar av an e 1, 22 0 1, 17 5 1, 17 3 99 .8 1, 56 6 1, 50 1 95 .8 95 .7 71 1 64 8 91 .1 91 .0 85 6 84 5 98 .7 98 .5 S ek on g 1, 00 0 97 1 96 5 99 .4 1, 42 7 1, 31 6 92 .2 91 .7 62 5 54 3 86 .9 86 .3 90 3 88 1 97 .6 97 .0 C ha m pa sa ck 1, 40 0 1, 31 7 1, 31 5 99 .8 1, 52 8 1, 44 0 94 .2 94 .1 70 4 62 7 89 .1 88 .9 72 5 71 7 98 .9 98 .7 A tta pe u 1, 00 0 91 3 90 0 98 .6 1, 08 3 1, 03 3 95 .4 94 .0 47 9 36 7 76 .6 75 .5 56 8 56 5 99 .5 98 .1 To ta l 19 ,9 60 19 ,0 18 18 ,8 43 99 .1 23 ,9 37 22 ,4 76 93 .9 93 .0 11 ,1 66 9, 95 1 89 .1 88 .3 11 ,2 58 11 ,0 67 98 .3 97 .4 Ta bl e H H .1 : R es ul ts o f h ou se ho ld , w om en 's , m en 's a nd u nd er -5 in te rv ie w s H ou se ho ld s W om en M en C hi ld re n un de r 5 N um be r o f h ou se ho ld s, w om en , m en , a nd c hi ld re n un de r 5 b y re su lts o f t he h ou se ho ld , w om en 's , m en 's a nd u nd er -5 's in te rv ie w s, a nd h ou se ho ld , w om en 's , m en 's a nd u nd er -5 's re sp on se ra te s, L ao P D R 2 01 1- 12 3 10 Household response rates are similar across provinces and areas of residence (urban, rural areas with road access and rural areas without road access). Women’s response rates are also similar across areas of residence. However, the women’s response rate is lower in Vientiane Capital and Savannakhet than in other provinces. Likewise, it is found out that the response rates of men in Savannakhet and Attapeu are lower than others. The main reason for non-response of these individuals is the failure to find these women and men despite several visits to the households. It is observed that, especially in the case of men, most go to neighbouring countries or other provinces in Lao PDR for work and for further education. Characteristics of Households The weighted age and sex distribution of the survey population is provided in Table HH.2. The distribution is also used to produce the population pyramid in Figure HH.1. In the 18,843 households successfully interviewed in the survey, 97,421 household members were listed. Of these, 47,820 were male, and 49,601 were female. Number Percent Number Percent Number Percent Age 0-4 5,527 11.6 5,423 10.9 10,949 11.2 5-9 6,079 12.7 6,087 12.3 12,166 12.5 10-14 6,275 13.1 6,366 12.8 12,641 13.0 15-19 4,862 10.2 4,872 9.8 9,733 10.0 20-24 3,575 7.5 3,926 7.9 7,501 7.7 25-29 3,635 7.6 3,883 7.8 7,517 7.7 30-34 3,128 6.5 3,188 6.4 6,316 6.5 35-39 3,157 6.6 3,218 6.5 6,374 6.5 40-44 2,406 5.0 2,652 5.3 5,058 5.2 45-49 2,318 4.8 2,332 4.7 4,650 4.8 50-54 2,111 4.4 2,458 5.0 4,569 4.7 55-59 1,592 3.3 1,555 3.1 3,147 3.2 60-64 1,040 2.2 1,102 2.2 2,141 2.2 65-69 876 1.8 886 1.8 1,761 1.8 70-74 511 1.1 672 1.4 1,183 1.2 75-79 372 0.8 423 0.9 795 0.8 80-84 185 0.4 294 0.6 479 0.5 85+ 172 0.4 247 0.5 419 0.4 Missing/DK 1 0.0 19 0.0 20 0.0 Dependency age groups 0-14 17,881 37.4 17,876 36.0 35,757 36.7 15-64 27,823 58.2 29,184 58.8 57,007 58.5 65+ 2,115 4.4 2,522 5.1 4,637 4.8 Missing/DK 1 0.0 19 0.0 20 0.0 Child and adult populations Children age 0-17 years 20,980 43.9 20,859 42.1 41,840 42.9 Adults age 18+ years 26,838 56.1 28,723 57.9 55,561 57.0 Missing/DK 1 0.0 19 0.0 20 0.0 Total 47,820 100.0 49,601 100.0 97,421 100.0 Table HH.2: Household age distribution by sex Percent and frequency distribution of the household population by five-year age groups, dependency age groups, and by child (age 0-17 years) and adult populations (age 18 or more), by sex, Lao PDR 2011-12 Males Females Total 3 11 According to the LSIS, children under 15 years of age make up 37 per cent of the total household population – 37 per cent of the male population, and 36 per cent of the female population. The household population age 15-64 make up 59 per cent of the total household population – 58 per cent of the male population, and 59 per cent of the female population. These figures are very close to and are within the acceptable range of the relevant figures found in the Lao Population and Housing Census of 2005. However, some minor differences are observed. The percentage of 15-19 year-olds is three percentage points lower than the percentage of 10-14 year-olds in the LSIS, while the Census found a 1.8 percentage point difference. This suggests slight possible bias among the interviewers when determining women and men’s ages around the cut off point for inclusion for further interviews. The population pyramid of the LSIS looks slightly different from the pyramid of the Census, primarily for ages 20 and older. In the Census, the proportion of women dropped from 4 per cent in age group 45-49 to 3.2 per cent in age group 50-54. The structure of the population pyramid of the 2006 MICS and the LSIS is similar for all age groups, but in both the 2006 MICS and LSIS, the percentage of women increased from age group 45-49 to 50-54. A possible reason is that females age around 50 did not report their exact completed age, but rather preferred to round their response to 50. Figure HH.1: Age and sex distribution of household Figure HH.1: Age and sex distribution of household population, Lao PDR 2011-12 85+ Figure HH.1: Age and sex distribution of household population, Lao PDR 2011-12 80-84 85+ 65 69 70-74 75-79 80-84 85+ 60-64 65-69 70-74 75-79 50-54 55-59 60-64 65-69 70-74 35 39 40-44 45-49 50-54 55-59 60-64 30-34 35-39 40-44 45-49 20-24 25-29 30-34 35-39 40-44 15-19 20-24 25-29 30-34 0-4 5-9 10-14 15-19 20-24 25 29 8 6 4 2 0 2 4 6 8 0-4 5-9 10-14 8 6 4 2 0 2 4 6 8 0-4 5-9 Percent 8 6 4 2 0 2 4 6 8 PercentPercent Males FemalesMales Females 3 12 Tables HH.3, HH.4.1, HH.4.2 and HH.4.3 provide basic information on the households, female respondents age 15-49, male respondents age 15-49, and children age under 5 by presenting the unweighted, as well as the weighted numbers. Information on the basic characteristics of households, women, men and children age under 5 interviewed in the survey is essential for the interpretation of findings presented later in the report, and also can provide an indication of the representativeness of the survey. The remaining tables in this report are presented only with weighted numbers. See Appendix A for more details about weighting. Table HH.3 provides basic background information on the households. Within households, the sex of the household head, region, province, residence, number of household members, education of household head and ethno-linguistic group of the household head are shown. These background characteristics are used in subsequent tables in this report; the figures in the table are intended to show the number of observations by major categories of analysis used in this report. 3 Weighted Unweighted Sex of household head Male 87.9 16,561 16,812 Female 12.1 2,282 2,031 Region North 32.2 6,065 7,408 Central 49.1 9,247 7,082 South 18.7 3,531 4,353 Province Vientiane Capital 13.3 2,497 1,366 Phongsaly 3.1 578 956 Luangnamtha 2.9 544 970 Oudomxay 4.8 913 1,053 Bokeo 2.8 520 960 Luangprabang 7.3 1,371 1,249 Huaphanh 4.6 869 1,014 Xayabury 6.7 1,269 1,206 Xiengkhuang 4.0 762 941 Vientiane 7.7 1,447 1,227 Borikhamxay 4.3 804 946 Khammuane 5.7 1,078 1,199 Savannakhet 14.1 2,659 1,403 Saravane 6.0 1,123 1,173 Sekong 1.5 283 965 Champasack 9.5 1,789 1,315 Attapeu 1.8 336 900 Residence Urban 27.5 5,177 4,730 Rural 72.5 13,666 14,113 .Rural with road 89.9 12,285 12,566 .Rural without road 10.1 1,380 1,547 Percent and frequency distribution of households by selected characteristics, Lao PDR 2011-12 Number of households Table HH.3: Household composition Weighted percent 13 3 Weighted Unweighted Number of household members 1 2.1 393 353 2 6.3 1,196 1,168 3 14.0 2,635 2,574 4 21.1 3,976 3,896 5 18.9 3,562 3,564 6 14.5 2,733 2,817 7 9.2 1,739 1,771 8 5.9 1,115 1,155 9 3.4 648 667 10+ 4.5 846 878 Education of household head None 20.3 3,833 4,049 Primary 45.3 8,542 8,688 Lower secondary 15.5 2,925 2,842 Upper secondary 6.1 1,147 999 Post secondary non tertiary 7.5 1,413 1,376 Higher 5.1 958 872 Missing/DK 0.1 25 17 Wealth index quintile Poorest 19.0 3,585 4,165 Second 18.8 3,533 3,832 Middle 19.9 3,743 3,881 Fourth 21.0 3,962 3,686 Richest 21.3 4,019 3,279 Ethno-linguistic group of household head Lao-Tai 67.5 12,721 11,337 Mon-Khmer 22.0 4,140 5,014 Hmong-Mien 6.8 1,287 1,419 Chinese-Tibetan 3.1 579 964 Other, Missing, DK 0.6 117 109 Total 100.0 18,843 18,843 Households with at least One child age 0-4 years 42.6 - - One child age 0-17 years 85.9 - - One woman age 15-49 years 89.0 - - One man age 15-49 years 84.7 - - Mean household size 5.2 - - Weighted percent Number of households Table HH.3: Household composition Percent and frequency distribution of households by selected characteristics, Lao PDR 2011-12 14 The total weighted and unweighted numbers of households are equal, since sample weights were normalized (See Appendix A). The table also shows the proportions of households with at least one child under 18, at least one child under 5, at least one eligible woman age 15-49 and at least one man age 15-49. Eighty-eight per cent of household heads are male. Twenty-eight per cent of households are urban, 73 per cent are rural. Sixty-eight per cent of households are Lao-Tai-headed, while 22 per cent are Mon-Khmer-headed households. Forty per cent of all households have four to five members, 24 per cent have six to seven members. The average household size is 5.2 people. Characteristics of Female and Male Respondents Age 15-49 and Children Age Under 5 Tables HH.4.1, HH.4.2 and HH.4.3 provide information on the background characteristics of female respondents, male respondents, and children age under 5 years. In all three tables, the total numbers of weighted and unweighted observations are equal, since sample weights have been normalized. In addition to providing useful information on the background characteristics of women, men and children, the tables are intended to show the number of observations in each background category. These categories are used in the subsequent tabulations of this report. 3 Weighted Unweighted Region North 31.4 7,057 8,793 Central 50.1 11,255 8,393 South 18.5 4,164 5,290 Province Vientiane Capital 14.6 3,288 1,740 Phongsaly 3.0 666 1,080 Luangnamtha 2.8 627 1,157 Oudomxay 5.3 1,182 1,430 Bokeo 2.8 620 1,120 Luangprabang 6.6 1,473 1,350 Huaphanh 4.8 1,086 1,273 Xayabury 6.2 1,402 1,383 Xiengkhuang 4.1 930 1,134 Vientiane 7.5 1,677 1,428 Borikhamxay 4.0 901 1,109 Khammuane 4.8 1,082 1,279 Savannakhet 15.0 3,376 1,703 Saravane 6.5 1,456 1,501 Sekong 1.7 388 1,316 Champasack 8.6 1,943 1,440 Attapeu 1.7 376 1,033 Residence Urban 29.6 6,649 5,970 Rural 70.4 15,827 16,506 .Rural with road 90.1 14,268 14,723 .Rural without road 9.9 1,559 1,783 Number of women Table HH.4.1: Women's background characteristics Percent and frequency distribution of women age 15-49 years by selected background characteristics, Lao PDR 2011-12 Weighted percent 15 3 Age 15-19 19.6 4,415 4,558 20-24 16.1 3,617 3,598 25-29 16.2 3,642 3,668 30-34 13.4 3,015 2,972 35-39 13.6 3,065 3,058 40-44 11.2 2,507 2,463 45-49 9.9 2,215 2,159 Marital/Union status Currently married/in union 72.8 16,368 16,550 Widowed 1.8 397 398 Divorced 2.5 562 545 Separated 0.5 119 119 Never married/in union 22.4 5,031 4,864 Motherhood status Ever gave birth 70.8 15,916 16,119 Never gave birth 29.2 6,560 6,357 Births in last two years Had a birth in last two years 19.2 4,306 4,444 Had no birth in last two years 80.8 18,170 18,032 Education None 20.7 4,660 5,275 Primary 39.8 8,955 9,174 Lower secondary 18.3 4,111 3,905 Upper secondary 11.1 2,496 2,191 Post secondary non tertiary 4.6 1,030 961 Higher 5.4 1,224 970 Wealth index quintile Poorest 16.9 3,809 4,531 Second 18.2 4,088 4,472 Middle 19.2 4,309 4,566 Fourth 20.9 4,694 4,416 Richest 24.8 5,577 4,491 Ethno-linguistic group of household head Lao-Tai 67.4 15,151 13,355 Mon-Khmer 21.9 4,913 6,083 Hmong-Mien 7.1 1,606 1,786 Chinese-Tibetan 3.0 685 1,137 Other, Missing, DK 0.5 121 115 Total 100.0 22,476 22,476 Percent and frequency distribution of women age 15-49 years by selected background characteristics, Lao PDR 2011-12 Table HH.4.1: Women's background characteristics 16 Table HH.4.1 provides the background characteristics of female respondents 15-49 years of age. The table includes information on the distribution of women according to region, province, residence, age, marital status, motherhood status, births in last two years, education,1 wealth index quintiles,2 and ethno-linguistic group of the household head. Seventy-three per cent of women age 15-49 are married or in union with a man, nearly 3 per cent are divorced or separated, and another 2 per cent are widowed. Seventy-one per cent of women age 15- 49 have ever given birth. The education variable refers to the highest level of schooling a person has attended (they may or may not have completed the level). Forty per cent of women age 15-49 have attended primary school without advancing beyond the primary school level. Thirty-four per cent of women have attended secondary school. Only about 5 per cent of women age 15-49 have any higher education. Seventy-three per cent of women are currently married or living with a partner, while 71 per cent had ever given birth and 19 per cent had given birth in the previous two years. Twenty-five per cent of women belong to the richest wealth index quintile households, and about 17 per cent are members of households from the poorest. 1 Unless otherwise stated, “education” refers to educational level attended by the respondent throughout this report when it is used as a background variable. 2 Principal component analysis was performed by using information on the ownership of consumer goods, dwell- ing characteristics, water and sanitation, and other characteristics that are related to the household’s wealth to assign weights (factor scores) to each of the household assets. Each household was then assigned a wealth score based on these weights and the assets owned by that household. The survey household population was then ranked according to the wealth score of the household they are living in, and was finally divided into five equal parts (quintiles) from lowest (poorest) to highest (richest). The assets used in these calculations were: electricity; radio; television; non-mobile telephone; refrigerator; clock; fan; sofa/wooden settee; water pump; air conditioner; washing machine; CD/DVD player; watch; mobile telephone; bicycle; motor cycle/scooter; animal drawn-cart; car/truck; boat with motor; tuk tuk; tak tak; camera; computer; type of sanitation facility; type of cooking fuel; type of material used for floor, roof and wall; ownership of dwelling; ownership of agricultural land; ownership of livestock; and having a bank account. The wealth index is assumed to capture underlying long-term wealth through information on household assets, and is intended to produce a ranking of households by wealth, from poorest to richest. The wealth index does not provide information on absolute poverty, current income or expenditure levels. The wealth scores calculated are applicable to only the particular data set they are based on. Further information on the construction of the wealth index can be found in Filmer, D. and Pritchett, L., 2001. “Estimating wealth effects without expenditure data – or tears: An application to educational enrolments in states of India”. Demography 38(1): 115-132. Gwatkin, D.R., Rutstein, S., Johnson, K. ,Pande, R. and Wagstaff. A., 2000. Socio-Economic Differences in Health, Nutrition, and Population. HNP/Poverty Thematic Group, Washing- ton, DC: World Bank. Rutstein, S.O. and Johnson, K., 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, Maryland: ORC Macro. 3 17 Weighted Unweighted Region North 31.9 3,172 4,055 Central 50.1 4,990 3,711 South 18.0 1,789 2,185 Province Vientiane Capital 13.9 1,379 734 Phongsaly 3.2 318 522 Luangnamtha 2.7 266 497 Oudomxay 5.3 530 674 Bokeo 2.7 267 509 Luangprabang 6.5 644 613 Huaphanh 5.1 511 614 Xayabury 6.4 635 626 Xiengkhuang 4.4 442 513 Vientiane 7.2 721 633 Borikhamxay 3.9 390 488 Khammuane 5.1 503 589 Savannakhet 15.6 1,556 754 Saravane 6.0 597 648 Sekong 1.6 162 543 Champasack 8.8 873 627 Attapeu 1.6 157 367 Residence Urban 28.1 2,800 2,517 Rural 71.9 7,151 7,434 .Rural with road 90.3 6,457 6,674 .Rural without road 9.7 694 760 Age 15-19 21.3 2,119 2,151 20-24 15.7 1,557 1,531 25-29 15.1 1,500 1,513 30-34 12.7 1,264 1,290 35-39 14.5 1,445 1,449 40-44 10.5 1,043 1,021 45-49 10.3 1,023 996 Marital/Union status Currently married/in union 66.4 6,611 6,721 Widowed 0.4 41 37 Divorced 0.9 90 84 Separated 0.5 46 36 Never married/in union 31.8 3,163 3,073 Education None 9.3 923 1,007 Primary 38.9 3,872 4,031 Lower secondary 23.6 2,351 2,342 Upper secondary 14.6 1,450 1,337 Post secondary non tertiary 6.1 608 597 Higher 7.5 747 637 Wealth index quintile Poorest 17.0 1,692 2,005 Second 19.2 1,911 2,054 Middle 20.5 2,039 2,164 Fourth 21.0 2,092 1,939 Richest 22.3 2,217 1,789 Ethno-linguistic group of household head Lao-Tai 66.7 6,635 5,845 Mon-Khmer 22.0 2,191 2,665 Hmong-Mien 7.3 728 816 Chinese-Tibetan 3.4 335 568 Other, Missing, DK 0.6 62 57 Total 100.0 9,951 9,951 Table HH.4.2: Men's background characteristics Percent and frequency distribution of men age 15-49 years by selected background characteristics, Lao PDR 2011-12 Weighted percent Number of men 3 18 Similarly, Table HH.4.2 provides background characteristics of male respondents age 15-49. The table shows information about the distribution of men according to region, province, residence, age, marital status, education, wealth index quintile, and ethno-linguistic group of the household head. Seventy-two per cent of men age 15-49 live in rural areas. Sixty-six per cent of men age 15-49 are married or union with a woman and 32 per cent have never married. Thirty-nine per cent of men age 15-49 have attended primary school without going any further, 44 per cent have attended secondary school, and another 7.5 per cent have pursued higher education. Only 9 per cent have no education, while 8 per cent have higher education. Twenty-two per cent are members of households from the richest wealth index quintile, while about 17 per cent are members of households in the poorest. Some background characteristics of children age under 5 are presented in Table HH.4.3. These include the distribution of children by several attributes: sex; region; province and residence; age; mother’s or caretaker’s education; wealth index quintile; and ethno-linguistic group of the household head. Seventy-nine per cent of children age under 5 live in rural areas. One-third have mothers who have no education, and another 41 per cent have mothers who have attended primary school without going on to secondary school. Twenty-nine per cent of children are members of households in the poorest wealth quintile, while 15 per cent are members of households in the richest quintile. This indicates that the richest households have fewer children than the poorest households. 3 19 Weighted Unweighted Sex Male 50.5 5,593 5,612 Female 49.5 5,474 5,455 Region North 31.6 3,502 4,226 Central 46.6 5,154 3,833 South 21.8 2,411 3,008 Province Vientiane Capital 9.6 1,058 556 Phongsaly 3.3 368 569 Luangnamtha 2.5 280 502 Oudomxay 6.1 676 757 Bokeo 3.0 335 600 Luangprabang 6.8 752 664 Huaphanh 5.5 606 685 Xayabury 4.4 486 449 Xiengkhuang 4.9 540 619 Vientiane 6.9 767 629 Borikhamxay 3.6 402 474 Khammuane 5.5 603 650 Savannakhet 16.1 1,784 905 Saravane 8.3 923 845 Sekong 2.4 269 881 Champasack 9.1 1,003 717 Attapeu 1.9 216 565 Residence Urban 21.0 2,319 2,081 Rural 79.0 8,748 8,986 .Rural with road 87.6 7,661 7,749 .Rural without road 12.4 1,086 1,237 Age 0-5 months 10.7 1,182 1,168 6-11 months 10.2 1,125 1,092 12-23 months 19.3 2,141 2,173 24-35 months 19.8 2,193 2,158 36-47 months 20.8 2,302 2,332 48-59 months 19.2 2,124 2,144 Mother’s education* None 32.3 3,580 3,805 Primary 41.2 4,556 4,610 Lower secondary 14.6 1,613 1,503 Upper secondary 6.3 695 585 Post secondary non tertiary 3.3 368 341 Higher 2.3 255 223 Wealth index quintile Poorest 29.2 3,233 3,640 Second 21.2 2,346 2,485 Middle 18.2 2,019 2,011 Fourth 16.3 1,807 1,629 Richest 15.0 1,663 1,302 Ethno-linguistic group of household head Lao-Tai 54.5 6,030 5,116 Mon-Khmer 28.8 3,189 3,757 Hmong-Mien 13.0 1,439 1,552 Chinese-Tibetan 3.2 357 589 Other, Missing, DK 0.5 52 53 Total 100.0 11,067 11,067 Percent and frequency distribution of children under five years of age by selected characteristics, Lao PDR 2011-12 Number of under-5 children Table HH.4.3: Under-5's background characteristics * Mother's education refers to educational attainment of mothers and caretakers of children under 5. Weighted percent 3 © UNICEF Lao PDR / 2012 / Noorani 21 IV. Water and Sanitation Safe drinking water is a basic necessity for good health. Unsafe water can be a significant carrier of diseases such as trachoma, cholera, typhoid and schistosomiasis. Drinking water can also be tainted with chemical, physical and radiological contaminants with harmful effects on human health. MDG Goal 7c is to half the proportion of people without sustainable access to safe drinking water and basic sanitation between 1990 and 2015. The World Fit for Children goal is to reduce by one third the proportion of households without access to affordable and safe drinking water and hygienic sanitation facilities. The MICS indicators pertaining to water and sanitation include these issues: 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 Use of Improved Water Sources The distribution of the population by main source of drinking water is shown in Table WS.1 and Figure WS.1. The population using improved sources of drinking water are those using any of the following types of supply: piped water (piped into the dwelling, compound, yard or plot, or to a neighbour, or public tap/standpipe); tubewell/borehole; protected well; protected spring; or rainwater collection. Bottled water is considered as an improved water source only if the household is using an improved water source for handwashing and cooking. 4 22 4 In to dw el lin g In to ya rd /p lo t To n ei gh - bo ur P ub lic ta p/ st an dp ip e R eg io n N or th 5. 8 8. 4 0. 7 34 .6 0. 7 2. 5 15 .9 0. 5 10 .5 4. 1 2. 0 0. 0 0. 3 11 .1 2. 0 1. 0 0. 0 10 0. 0 79 .4 31 ,3 10 C en tra l 4. 5 1. 1 0. 3 3. 6 6. 9 8. 0 4. 3 2. 1 34 .0 19 .5 2. 0 0. 1 0. 1 4. 4 7. 5 1. 6 0. 0 10 0. 0 64 .8 46 ,9 19 S ou th 4. 3 3. 5 0. 4 2. 1 37 .0 1. 7 5. 6 1. 3 11 .1 9. 6 2. 1 0. 0 0. 0 20 .4 0. 6 0. 1 0. 0 10 0. 0 67 .1 19 ,1 92 P ro vi nc e V ie nt ia ne C ap ita l 9. 5 1. 2 0. 1 0. 1 4. 2 2. 6 0. 0 0. 5 70 .1 4. 3 0. 0 0. 0 0. 1 0. 2 6. 7 0. 4 0. 0 10 0. 0 88 .3 11 ,6 94 P ho ng sa ly 9. 9 4. 3 1. 2 3. 4 0. 6 0. 9 54 .2 0. 0 0. 3 1. 0 4. 1 0. 0 1. 3 18 .7 0. 0 0. 0 0. 1 10 0. 0 74 .7 3, 12 2 Lu an gn am th a 8. 9 10 .4 0. 7 50 .5 0. 4 4. 9 7. 2 0. 0 14 .6 0. 0 0. 4 0. 0 0. 0 1. 9 0. 1 0. 0 0. 0 10 0. 0 97 .6 2, 70 7 O ud om xa y 1. 9 11 .4 0. 6 55 .9 0. 4 0. 1 0. 8 0. 0 7. 2 0. 1 0. 0 0. 0 1. 1 13 .1 1. 5 6. 0 0. 0 10 0. 0 78 .2 5, 18 1 B ok eo 2. 3 1. 9 0. 2 3. 1 0. 0 3. 7 48 .5 0. 0 16 .8 6. 1 3. 3 0. 0 0. 0 8. 4 5. 6 0. 0 0. 0 10 0. 0 76 .6 2, 74 9 Lu an gp ra ba ng 7. 6 10 .2 1. 6 32 .0 0. 7 0. 6 12 .2 0. 0 16 .2 0. 5 0. 1 0. 1 0. 0 17 .2 0. 9 0. 0 0. 0 10 0. 0 81 .1 6, 57 6 H ua ph an h 5. 7 12 .1 0. 3 60 .6 0. 5 0. 0 4. 7 0. 0 3. 0 0. 3 5. 8 0. 0 0. 0 6. 8 0. 0 0. 3 0. 0 10 0. 0 86 .9 5, 16 3 X ay ab ur y 5. 1 4. 5 0. 2 19 .5 1. 7 8. 1 11 .4 2. 6 14 .0 17 .5 1. 7 0. 0 0. 1 7. 7 5. 9 0. 0 0. 0 10 0. 0 67 .2 5, 81 3 X ie ng kh ua ng 2. 5 3. 1 0. 1 21 .9 0. 3 11 .6 22 .5 0. 0 13 .8 11 .3 3. 2 0. 0 0. 1 7. 9 1. 7 0. 0 0. 0 10 0. 0 75 .8 4, 19 8 V ie nt ia ne 1. 1 1. 1 0. 4 7. 6 4. 4 7. 9 6. 1 0. 2 32 .4 16 .4 3. 0 0. 1 0. 1 1. 9 17 .0 0. 3 0. 0 10 0. 0 61 .3 7, 07 9 B or ik ha m xa y 12 .7 0. 2 1. 6 2. 7 6. 8 7. 8 7. 5 0. 0 22 .6 16 .8 2. 8 0. 0 0. 1 3. 7 14 .6 0. 1 0. 0 10 0. 0 61 .8 3, 86 4 K ha m m ua ne 0. 4 0. 3 0. 1 1. 4 12 .8 19 .2 4. 1 1. 0 17 .6 21 .1 3. 8 0. 0 0. 0 7. 0 7. 0 4. 2 0. 0 10 0. 0 56 .9 5, 12 9 S av an na kh et 2. 0 0. 9 0. 2 0. 3 10 .0 7. 4 0. 9 5. 8 20 .8 35 .3 1. 9 0. 3 0. 2 7. 0 3. 7 3. 2 0. 0 10 0. 0 48 .4 14 ,9 54 S ar av an e 3. 2 3. 5 0. 3 1. 4 37 .4 0. 8 4. 7 2. 9 5. 0 16 .3 3. 4 0. 0 0. 0 20 .7 0. 4 0. 1 0. 0 10 0. 0 59 .2 6, 76 0 S ek on g 11 .2 7. 6 0. 2 1. 8 18 .5 3. 1 27 .3 0. 0 5. 4 4. 5 3. 2 0. 0 0. 0 17 .0 0. 1 0. 1 0. 0 10 0. 0 75 .2 1, 80 6 C ha m pa sa ck 3. 8 2. 8 0. 5 3. 1 41 .0 1. 9 2. 1 0. 6 16 .9 3. 7 0. 4 0. 0 0. 0 22 .1 1. 0 0. 1 0. 0 10 0. 0 72 .8 8, 87 7 A tta pe u 4. 3 2. 8 0. 3 0. 5 34 .1 2. 2 4. 9 0. 3 11 .1 19 .4 4. 5 0. 0 0. 2 14 .8 0. 5 0. 0 0. 0 10 0. 0 60 .5 1, 74 9 R es id en ce U rb an 11 .2 5. 2 0. 5 2. 5 3. 8 4. 7 1. 6 0. 2 57 .9 5. 1 0. 6 0. 0 0. 1 1. 2 4. 9 0. 5 0. 0 10 0. 0 87 .6 24 ,8 45 R ur al 2. 7 3. 5 0. 4 16 .9 13 .2 5. 1 10 .5 1. 9 9. 6 15 .2 2. 5 0. 1 0. 2 12 .6 4. 2 1. 4 0. 0 10 0. 0 63 .9 72 ,5 76 .R ur al w ith ro ad 2. 9 3. 6 0. 4 17 .1 13 .7 5. 4 10 .5 2. 0 10 .8 15 .2 2. 4 0. 1 0. 2 9. 6 4. 7 1. 3 0. 0 10 0. 0 66 .5 64 ,8 66 .R ur al w ith ou t r oa d 0. 8 2. 1 0. 6 15 .7 9. 3 2. 4 10 .9 0. 2 0. 0 14 .8 3. 6 0. 1 0. 1 37 .5 0. 1 1. 8 0. 1 10 0. 0 42 .0 7, 71 0 E du ca tio n of h ou se ho ld h ea d N on e 2. 9 3. 4 0. 3 16 .2 12 .2 4. 8 11 .9 1. 1 8. 5 17 .4 3. 5 0. 1 0. 2 13 .6 2. 0 2. 0 0. 0 10 0. 0 61 .2 20 ,7 63 P rim ar y 3. 8 4. 2 0. 5 15 .6 12 .7 5. 1 9. 0 1. 7 14 .9 13 .4 2. 1 0. 0 0. 2 11 .8 4. 0 1. 1 0. 0 10 0. 0 67 .4 45 ,8 54 Lo w er s ec on da ry 6. 0 4. 0 0. 5 11 .8 9. 4 5. 9 7. 0 1. 4 27 .9 11 .1 1. 4 0. 0 0. 2 5. 1 7. 3 0. 8 0. 0 10 0. 0 74 .0 14 ,2 80 U pp er s ec on da ry 6. 4 3. 3 0. 5 4. 9 6. 5 5. 7 3. 1 1. 9 49 .7 7. 8 0. 6 0. 0 0. 0 3. 2 6. 0 0. 6 0. 0 10 0. 0 81 .9 5, 24 1 P os t s ec on da ry n on te rti ar y 9. 6 4. 2 0. 9 6. 3 6. 8 3. 9 3. 2 0. 9 45 .7 6. 7 0. 4 0. 2 0. 0 3. 9 7. 0 0. 3 0. 0 10 0. 0 81 .5 6, 74 0 H ig he r 12 .4 2. 9 0. 0 1. 5 1. 4 2. 3 1. 5 0. 5 68 .9 2. 0 0. 2 0. 0 0. 0 1. 0 4. 9 0. 4 0. 0 10 0. 0 91 .4 4, 38 7 D K /M is si ng 0. 0 0. 0 0. 0 0. 0 16 .0 0. 0 4. 3 8. 0 65 .9 5. 9 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 94 .1 15 6 Ta bl e W S .1 : U se o f i m pr ov ed w at er s ou rc es S ur fa ce w at er B ot tle d w at er * M is si ng N um be r o f ho us eh ol d m em be rs P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to m ai n so ur ce o f d rin ki ng w at er a nd p er ce nt ag e of h ou se ho ld p op ul at io n us in g im pr ov ed d rin ki ng w at er s ou rc es , L ao P D R 2 01 1- 12 M ai n so ur ce o f d ri nk in g w at er To ta l P er ce nt ag e us in g im pr ov ed so ur ce s of dr in ki ng w at er 1 Im pr ov ed s ou rc es C ar t w ith ta nk / d ru m P ro - te ct ed w el l P ro - te ct ed sp rin g U ni m pr ov ed s ou rc es P ip ed w at er R ai n- w at er co lle ct io n B ot tle d w at er * U np ro - te ct ed w el l U np ro - te ct ed sp rin g Ta nk er tru ck Tu be w el l/ bo re ho le 1 M IC S in di ca to r 4. 1; M D G in di ca to r 7. 8 *H ou se ho ld s us in g bo ttl ed w at er a s th e m ai n so ur ce o f d rin ki ng w at er a re c la ss ifi ed in to im pr ov ed o r u ni m pr ov ed d rin ki ng w at er u se rs a cc or di ng to th e w at er s ou rc e us ed fo r o th er p ur po se s su ch a s co ok in g an d ha nd w as hi ng . O th er 23 4 In to dw el lin g In to ya rd /p lo t To n ei gh - bo ur P ub lic ta p/ st an dp ip e W ea lth in de x qu in til e P oo re st 0. 7 2. 6 0. 6 25 .6 9. 9 1. 5 17 .1 0. 1 0. 1 11 .5 3. 6 0. 0 0. 5 24 .5 0. 0 1. 8 0. 0 10 0. 0 58 .1 19 ,4 89 S ec on d 2. 9 4. 2 0. 7 22 .1 13 .4 4. 2 12 .3 0. 9 1. 1 19 .7 3. 0 0. 1 0. 1 12 .6 0. 6 2. 0 0. 0 10 0. 0 61 .9 19 ,4 80 M id dl e 5. 8 6. 2 0. 6 13 .8 16 .4 6. 5 8. 0 1. 8 7. 0 19 .0 2. 2 0. 1 0. 2 7. 6 3. 5 1. 3 0. 0 10 0. 0 66 .2 19 ,4 83 Fo ur th 6. 4 5. 0 0. 3 4. 4 11 .2 9. 7 3. 5 3. 3 30 .0 11 .1 1. 1 0. 1 0. 0 3. 5 10 .1 0. 3 0. 0 10 0. 0 73 .9 19 ,4 80 R ic he st 8. 6 1. 5 0. 1 0. 3 3. 2 3. 0 0. 5 1. 0 71 .4 1. 7 0. 2 0. 0 0. 0 0. 3 7. 8 0. 3 0. 0 10 0. 0 89 .6 19 ,4 89 E th no -li ng ui st ic g ro up o f h ou se ho ld h ea d La o- Ta i 6. 0 3. 7 0. 4 6. 2 11 .2 6. 1 3. 8 2. 3 32 .7 12 .8 0. 8 0. 1 0. 1 6. 3 6. 4 1. 0 0. 0 10 0. 0 72 .4 61 ,4 59 M on -K hm er 2. 1 4. 0 0. 5 23 .7 13 .5 2. 5 12 .8 0. 0 2. 9 14 .0 3. 6 0. 0 0. 2 17 .7 0. 9 1. 7 0. 0 10 0. 0 62 .0 23 ,6 29 H m on g- M ie n 2. 5 4. 8 0. 4 30 .3 4. 0 5. 2 17 .4 0. 0 4. 0 12 .1 5. 6 0. 0 0. 2 11 .3 1. 2 0. 9 0. 0 10 0. 0 68 .7 8, 68 2 C hi ne se -T ib et an 9. 1 4. 2 1. 3 27 .6 0. 0 0. 5 37 .0 0. 0 2. 9 0. 1 3. 5 0. 0 0. 6 12 .7 0. 3 0. 0 0. 1 10 0. 0 82 .6 3, 11 1 O th er , M is si ng , D K 10 .4 0. 0 0. 0 0. 5 24 .7 9. 9 6. 2 0. 0 29 .1 10 .2 1. 6 0. 0 1. 1 3. 1 3. 1 0. 0 0. 0 10 0. 0 80 .9 54 1 To ta l 4. 9 3. 9 0. 4 13 .3 10 .8 5. 0 8. 3 1. 4 21 .9 12 .6 2. 0 0. 1 0. 2 9. 7 4. 4 1. 1 0. 0 10 0. 0 69 .9 97 ,4 21 Ta bl e W S .1 : U se o f i m pr ov ed w at er s ou rc es P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to m ai n so ur ce o f d rin ki ng w at er a nd p er ce nt ag e of h ou se ho ld p op ul at io n us in g im pr ov ed d rin ki ng w at er s ou rc es , L ao P D R 2 01 1- 12 *H ou se ho ld s us in g bo ttl ed w at er a s th e m ai n so ur ce o f d rin ki ng w at er a re c la ss ifi ed in to im pr ov ed o r u ni m pr ov ed d rin ki ng w at er u se rs a cc or di ng to th e w at er s ou rc e us ed fo r o th er p ur po se s su ch a s co ok in g an d ha nd w as hi ng . 1 M IC S in di ca to r 4. 1; M D G in di ca to r 7. 8 M ai n so ur ce o f d ri nk in g w at er To ta l P er ce nt ag e us in g im pr ov ed so ur ce s of dr in ki ng w at er 1 N um be r o f ho us eh ol d m em be rs Im pr ov ed s ou rc es U ni m pr ov ed s ou rc es P ip ed w at er Tu be w el l/ bo re ho le P ro - te ct ed w el l P ro - te ct ed sp rin g R ai n- w at er co lle ct io n S ur fa ce w at er B ot tle d w at er * O th er M is si ng B ot tle d w at er * U np ro - te ct ed w el l U np ro - te ct ed sp rin g Ta nk er tru ck C ar t w ith ta nk / d ru m 24 Some 70 per cent of the population is using an improved source of drinking water – 88 per cent in urban areas and 64 per cent in rural areas. Use of an improved source of drinking water is more common in the Northern region (79 per cent) than in the Central and Southern regions, where only two thirds of the population get their drinking water from an improved source. Across the country, the proportion of the population using an improved source for drinking water varies from a low of 48 per cent in Savannakhet to a high of 98 per cent in Luangnamtha. The proportion of the population using an improved source of drinking water increases steadily from about 60 per cent to 90 per cent or higher with increasing education and increasing wealth quintile. The main source of drinking water varies across the country. The most common source of drinking water in the Northern region is a public tap or standpipe, used by 35 per cent of the population, but this kind of water source is used by less than 5 per cent of the population in the Central and Southern regions. In the Central region, the most commonly used source is bottled water (considered an improved source for 34 per cent of the population who also use an improved source of water for hand washing and cooking). Tubewells or boreholes are the most common source for people in the Southern region (used by 37 per cent of the population). Half the population in the Northern region uses piped drinking water, compared to only 10 per cent in the Central and Southern regions. The second most common sources of drinking water in each region are protected springs in the Northern region (16 per cent), unprotected springs in the Central region (20 per cent) and surface water in the Southern region (20 per cent). Figure WS.1: Percent distribution of household members by source of drinking water, Lao PDR 2011-12 Figure WS.1: Percent distribution of household members by source of drinking water, Lao PDR 2011-12drinking water, Lao PDR 2011-12 Piped into dwelling, d l t Other unimproved Piped into dwelling, yard or plot 9% Surface water Other unimproved 6% Public tap/standpipeU t t d ll Surface water 10% Public tap/standpipe 13%Unprotected well or spring 15% Tubewell/ borehole 4% 15% 4%4% Protected well or spring 13%Rainwater Bottled water 22% Protected well or spring 13%Rainwater 1% Bottled water 22% p g 13%Rainwater 1% 4 25 Treatment of household drinking water is presented in Table WS.2. Respondents to the household questionnaire were asked whether they do anything to treat household drinking water to make it safer to drink, and if so, what method they use. The table presents the distribution of the household population by method of treatment. About 4 in 10 people live in households that don’t do anything to drinking water before drinking it. Fifty-five per cent of people live in households that boil their water before drinking it; any other methods of treating drinking water are used by fewer than 5 per cent of the population. Some households using bottled water from improved water sources do not treat it because they know that it is safe to drink. Table WS.2 also presents the percentage of the population living in households using unimproved sources of drinking water that use an appropriate method to treat it. Boiling water, adding bleach or chlorine, using a water filter, and using solar disinfection are considered appropriate drinking water treatment methods. Only 53 per cent of people living in households that use unimproved sources of drinking water use an appropriate water treatment method prior to drinking water from an unimproved source. Among the population using unimproved sources, the percentage using an appropriate treatment method varies drastically across the country, from a low of 25 per cent in Savannakhet to a high of 94 per cent in Huaphanh. Among those using an unimproved water source examined by ethno-linguistic group, the Lao-Tai are least likely (47 per cent) to use an appropriate water treatment method, while the Hmong-Mien are the most likely (89 per cent). Only 22 per cent of people in the richest wealth quintile who use unimproved water sources treat their water appropriately; far lower than the percentage in the lower wealth quintiles. None Boil Add bleach/ chlorine Strain through a cloth Use water filter Solar dis- infection Let it stand and settle Other Missing/ DK Region North 19.3 80.1 0.1 2.2 1.6 0.0 7.1 0.7 0.0 31,310 76.3 6,449 Central 61.2 34.7 0.7 3.4 1.9 0.0 1.1 0.7 0.0 46,919 38.7 16,532 South 35.4 62.4 0.8 4.4 1.8 0.1 2.3 0.2 0.0 19,192 67.6 6,313 Province Vientiane Capital 76.7 16.5 1.9 2.6 4.0 0.0 1.3 2.3 0.1 11,694 34.7 1,374 Phongsaly 13.1 86.6 0.0 0.1 0.0 0.0 1.2 0.1 0.0 3,122 78.0 789 Luangnamtha 38.6 61.1 0.0 0.0 0.0 0.0 2.3 0.0 0.0 2,707 39.4 64 Oudomxay 17.4 82.1 0.0 0.5 7.1 0.0 31.6 0.2 0.0 5,181 66.7 1,127 Bokeo 38.1 59.6 0.3 1.8 0.8 0.0 3.5 0.3 0.1 2,749 55.3 643 Luangprabang 15.7 84.0 0.3 7.6 0.2 0.0 3.1 2.5 0.0 6,576 82.4 1,240 Huaphanh 6.0 93.7 0.0 0.0 1.8 0.0 0.4 0.0 0.0 5,163 94.1 677 Xayabury 22.3 76.9 0.0 1.8 0.0 0.0 2.9 0.5 0.0 5,813 79.2 1,909 Xiengkhuang 22.2 77.4 0.1 0.0 0.1 0.1 0.0 0.3 0.0 4,198 79.5 1,015 Vientiane 48.2 51.0 0.2 3.0 1.5 0.0 0.8 0.2 0.0 7,079 55.1 2,738 Borikhamxay 42.6 55.8 0.0 1.6 0.7 0.0 0.5 0.0 0.0 3,864 53.1 1,475 Khammuane 58.0 33.4 1.0 7.6 3.4 0.2 3.6 0.1 0.0 5,129 39.1 2,209 Savannakhet 72.1 24.3 0.1 4.2 0.6 0.0 0.8 0.3 0.0 14,954 25.3 7,721 Saravane 36.3 62.4 1.5 2.6 0.5 0.0 0.9 0.0 0.0 6,760 54.6 2,758 Sekong 21.9 77.2 0.1 0.1 1.0 0.0 5.7 0.0 0.0 1,806 78.9 448 Champasack 38.4 58.1 0.6 7.3 3.0 0.2 0.8 0.5 0.0 8,877 81.0 2,416 Attapeu 30.5 68.5 0.1 1.2 1.0 0.1 12.3 0.2 0.0 1,749 65.1 691 Residence Urban 64.0 31.8 1.0 3.1 2.6 0.1 1.9 1.0 0.0 24,845 44.0 3,072 Rural 35.3 62.6 0.3 3.2 1.5 0.0 3.8 0.5 0.0 72,576 54.2 26,223 .Rural with road 35.9 62.0 0.4 3.2 1.4 0.0 3.6 0.5 0.0 64,866 52.9 21,752 .Rural without road 30.7 68.2 0.1 3.4 2.2 0.0 5.3 0.7 0.0 7,710 60.9 4,471 Main source of drinking water Improved 41.6 55.9 0.5 3.3 2.0 0.0 3.5 0.6 0.0 68,126 na na Unimproved 45.1 52.0 0.4 2.9 1.2 0.0 2.8 0.6 0.0 29,295 53.2 29,295 Education of household head None 39.9 57.7 0.1 3.2 1.2 0.0 4.0 0.2 0.1 20,763 49.5 8,057 Primary 36.9 60.9 0.4 3.0 1.5 0.0 3.5 0.6 0.0 45,854 55.6 14,941 Lower secondary 43.7 54.2 0.7 3.4 1.7 0.0 2.7 0.6 0.0 14,280 57.2 3,715 Upper secondary 60.9 33.7 1.2 3.6 2.8 0.1 2.7 0.7 0.0 5,241 51.1 951 Post secondary non tertiary 55.9 40.8 0.7 4.2 3.0 0.0 2.5 0.9 0.0 6,740 41.2 1,246 Higher 68.6 25.6 1.8 2.1 3.7 0.0 1.4 2.1 0.0 4,387 37.2 376 DK/Missing 66.8 30.7 0.0 15.4 0.0 0.0 10.1 0.0 0.0 156 * 9 Wealth index quintile Poorest 31.1 67.9 0.0 1.0 1.3 0.0 5.5 0.4 0.0 19,489 57.0 8,164 Second 28.3 70.4 0.2 2.4 1.1 0.0 3.9 0.3 0.0 19,480 55.3 7,424 Middle 30.2 67.7 0.3 4.3 1.1 0.0 3.7 0.3 0.1 19,483 58.9 6,594 Fourth 47.4 49.6 0.7 5.9 1.4 0.0 2.2 0.9 0.0 19,480 48.9 5,093 Richest 76.0 18.2 1.3 2.3 3.9 0.1 1.2 1.2 0.0 19,489 21.7 2,019 Ethno-linguistic group of household head Lao-Tai 51.8 44.7 0.8 4.3 2.0 0.0 1.9 0.8 0.0 61,459 47.2 16,938 Mon-Khmer 31.7 67.2 0.1 1.2 1.9 0.0 6.7 0.4 0.0 23,629 52.7 8,991 Hmong-Mien 12.0 87.3 0.1 1.7 0.2 0.0 4.5 0.4 0.0 8,682 88.9 2,721 Chinese-Tibetan 32.2 67.6 0.0 0.1 0.0 0.0 2.9 0.0 0.0 3,111 69.4 543 Other, Missing, DK 36.0 60.7 0.3 1.8 1.0 2.8 0.8 1.0 0.0 541 41.9 103 Total 42.6 54.8 0.5 3.2 1.8 0.0 3.3 0.6 0.0 97,421 53.2 29,295 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 MICS indicator 4.2 Table WS.2: Household water treatment Percentage of household population by drinking water treatment method used in the household, and for household members living in households where an unimproved drinking water source is used, the percentage who are using an appropriate treatment method, Lao PDR 2011-12 Water treatment method used in the household Percentage of household members in households using unimproved drinking water sources and using an appropriate water treatment method1 Number of household members in households using unimproved drinking water sources Number of household members na = Not applicable 4 26 None Boil Add bleach/ chlorine Strain through a cloth Use water filter Solar dis- infection Let it stand and settle Other Missing/ DK Region North 19.3 80.1 0.1 2.2 1.6 0.0 7.1 0.7 0.0 31,310 76.3 6,449 Central 61.2 34.7 0.7 3.4 1.9 0.0 1.1 0.7 0.0 46,919 38.7 16,532 South 35.4 62.4 0.8 4.4 1.8 0.1 2.3 0.2 0.0 19,192 67.6 6,313 Province Vientiane Capital 76.7 16.5 1.9 2.6 4.0 0.0 1.3 2.3 0.1 11,694 34.7 1,374 Phongsaly 13.1 86.6 0.0 0.1 0.0 0.0 1.2 0.1 0.0 3,122 78.0 789 Luangnamtha 38.6 61.1 0.0 0.0 0.0 0.0 2.3 0.0 0.0 2,707 39.4 64 Oudomxay 17.4 82.1 0.0 0.5 7.1 0.0 31.6 0.2 0.0 5,181 66.7 1,127 Bokeo 38.1 59.6 0.3 1.8 0.8 0.0 3.5 0.3 0.1 2,749 55.3 643 Luangprabang 15.7 84.0 0.3 7.6 0.2 0.0 3.1 2.5 0.0 6,576 82.4 1,240 Huaphanh 6.0 93.7 0.0 0.0 1.8 0.0 0.4 0.0 0.0 5,163 94.1 677 Xayabury 22.3 76.9 0.0 1.8 0.0 0.0 2.9 0.5 0.0 5,813 79.2 1,909 Xiengkhuang 22.2 77.4 0.1 0.0 0.1 0.1 0.0 0.3 0.0 4,198 79.5 1,015 Vientiane 48.2 51.0 0.2 3.0 1.5 0.0 0.8 0.2 0.0 7,079 55.1 2,738 Borikhamxay 42.6 55.8 0.0 1.6 0.7 0.0 0.5 0.0 0.0 3,864 53.1 1,475 Khammuane 58.0 33.4 1.0 7.6 3.4 0.2 3.6 0.1 0.0 5,129 39.1 2,209 Savannakhet 72.1 24.3 0.1 4.2 0.6 0.0 0.8 0.3 0.0 14,954 25.3 7,721 Saravane 36.3 62.4 1.5 2.6 0.5 0.0 0.9 0.0 0.0 6,760 54.6 2,758 Sekong 21.9 77.2 0.1 0.1 1.0 0.0 5.7 0.0 0.0 1,806 78.9 448 Champasack 38.4 58.1 0.6 7.3 3.0 0.2 0.8 0.5 0.0 8,877 81.0 2,416 Attapeu 30.5 68.5 0.1 1.2 1.0 0.1 12.3 0.2 0.0 1,749 65.1 691 Residence Urban 64.0 31.8 1.0 3.1 2.6 0.1 1.9 1.0 0.0 24,845 44.0 3,072 Rural 35.3 62.6 0.3 3.2 1.5 0.0 3.8 0.5 0.0 72,576 54.2 26,223 .Rural with road 35.9 62.0 0.4 3.2 1.4 0.0 3.6 0.5 0.0 64,866 52.9 21,752 .Rural without road 30.7 68.2 0.1 3.4 2.2 0.0 5.3 0.7 0.0 7,710 60.9 4,471 Main source of drinking water Improved 41.6 55.9 0.5 3.3 2.0 0.0 3.5 0.6 0.0 68,126 na na Unimproved 45.1 52.0 0.4 2.9 1.2 0.0 2.8 0.6 0.0 29,295 53.2 29,295 Education of household head None 39.9 57.7 0.1 3.2 1.2 0.0 4.0 0.2 0.1 20,763 49.5 8,057 Primary 36.9 60.9 0.4 3.0 1.5 0.0 3.5 0.6 0.0 45,854 55.6 14,941 Lower secondary 43.7 54.2 0.7 3.4 1.7 0.0 2.7 0.6 0.0 14,280 57.2 3,715 Upper secondary 60.9 33.7 1.2 3.6 2.8 0.1 2.7 0.7 0.0 5,241 51.1 951 Post secondary non tertiary 55.9 40.8 0.7 4.2 3.0 0.0 2.5 0.9 0.0 6,740 41.2 1,246 Higher 68.6 25.6 1.8 2.1 3.7 0.0 1.4 2.1 0.0 4,387 37.2 376 DK/Missing 66.8 30.7 0.0 15.4 0.0 0.0 10.1 0.0 0.0 156 * 9 Wealth index quintile Poorest 31.1 67.9 0.0 1.0 1.3 0.0 5.5 0.4 0.0 19,489 57.0 8,164 Second 28.3 70.4 0.2 2.4 1.1 0.0 3.9 0.3 0.0 19,480 55.3 7,424 Middle 30.2 67.7 0.3 4.3 1.1 0.0 3.7 0.3 0.1 19,483 58.9 6,594 Fourth 47.4 49.6 0.7 5.9 1.4 0.0 2.2 0.9 0.0 19,480 48.9 5,093 Richest 76.0 18.2 1.3 2.3 3.9 0.1 1.2 1.2 0.0 19,489 21.7 2,019 Ethno-linguistic group of household head Lao-Tai 51.8 44.7 0.8 4.3 2.0 0.0 1.9 0.8 0.0 61,459 47.2 16,938 Mon-Khmer 31.7 67.2 0.1 1.2 1.9 0.0 6.7 0.4 0.0 23,629 52.7 8,991 Hmong-Mien 12.0 87.3 0.1 1.7 0.2 0.0 4.5 0.4 0.0 8,682 88.9 2,721 Chinese-Tibetan 32.2 67.6 0.0 0.1 0.0 0.0 2.9 0.0 0.0 3,111 69.4 543 Other, Missing, DK 36.0 60.7 0.3 1.8 1.0 2.8 0.8 1.0 0.0 541 41.9 103 Total 42.6 54.8 0.5 3.2 1.8 0.0 3.3 0.6 0.0 97,421 53.2 29,295 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 MICS indicator 4.2 Table WS.2: Household water treatment Percentage of household population by drinking water treatment method used in the household, and for household members living in households where an unimproved drinking water source is used, the percentage who are using an appropriate treatment method, Lao PDR 2011-12 Water treatment method used in the household Percentage of household members in households using unimproved drinking water sources and using an appropriate water treatment method1 Number of household members in households using unimproved drinking water sources Number of household members na = Not applicable 4 27 The amount of time it takes to obtain water is presented in Table WS.3 and the person who usually collects the water in Table WS.4. The amount of time reported is the amount of time required to go to the water source, get the water, and return home. Table WS.3 shows that for 63 per cent of households, the source of drinking water is located on the premises, but this varies broadly across provinces and by urban/rural residence. For 31 per cent of households, it takes less than 30 minutes in total to get to the water source and bring water home, while 6 per cent of households spend 30 minutes or more for this purpose. Rural households spend more time collecting water than urban households, but fewer than 10 per cent of rural households need more than 30 minutes to get their water. Water on premises Less than 30 minutes 30 minutes or more Missing/ DK Water on premises Less than 30 minutes 30 minutes or more Missing/ DK Total Region North 47.8 30.5 0.3 0.8 6.1 13.4 1.0 0.1 100.0 31,310 Central 56.3 7.5 0.8 0.2 16.7 12.7 5.7 0.1 100.0 46,919 South 45.9 18.7 2.4 0.1 8.2 17.6 7.0 0.1 100.0 19,192 Province Vientiane Capital 86.0 1.8 0.2 0.3 9.2 2.0 0.1 0.3 100.0 11,694 Phongsaly 31.0 36.9 0.0 6.8 1.8 23.2 0.0 0.2 100.0 3,122 Luangnamtha 55.8 41.7 0.0 0.1 0.6 1.7 0.0 0.0 100.0 2,707 Oudomxay 74.5 3.7 0.0 0.0 9.0 10.7 2.1 0.0 100.0 5,181 Bokeo 48.1 28.4 0.1 0.0 9.2 12.2 1.8 0.2 100.0 2,749 Luangprabang 47.9 32.7 0.2 0.4 2.2 16.0 0.5 0.1 100.0 6,576 Huaphanh 37.3 48.9 0.6 0.1 2.8 8.7 1.5 0.0 100.0 5,163 Xayabury 38.2 28.2 0.8 0.0 14.3 17.7 0.7 0.1 100.0 5,813 Xiengkhuang 64.4 10.0 1.1 0.3 12.6 10.2 1.3 0.1 100.0 4,198 Vientiane 46.7 13.9 0.5 0.2 29.5 8.3 0.9 0.0 100.0 7,079 Borikhamxay 55.8 6.0 0.0 0.0 31.1 6.2 0.8 0.0 100.0 3,864 Khammuane 37.0 17.0 2.9 0.0 19.7 18.8 4.6 0.1 100.0 5,129 Savannakhet 42.0 5.3 0.9 0.1 12.9 23.4 15.2 0.1 100.0 14,954 Saravane 23.5 31.5 4.0 0.2 2.8 25.6 12.3 0.1 100.0 6,760 Sekong 39.3 29.7 6.0 0.2 4.8 13.8 6.3 0.0 100.0 1,806 Champasack 66.2 5.7 1.0 0.0 11.9 11.1 4.2 0.0 100.0 8,877 Attapeu 36.1 23.9 0.2 0.3 14.2 23.4 1.9 0.0 100.0 1,749 Residence Urban 83.4 4.0 0.1 0.2 8.6 2.8 0.9 0.1 100.0 24,845 Rural 40.6 21.6 1.3 0.4 12.7 17.7 5.7 0.1 100.0 72,576 .Rural with road 42.2 22.5 1.3 0.4 12.4 15.8 5.2 0.1 100.0 64,866 .Rural without road 27.1 13.7 0.8 0.5 15.3 33.3 9.3 0.1 100.0 7,710 Education of household head None 36.5 22.8 1.3 0.6 11.4 20.2 7.1 0.2 100.0 20,763 Primary 46.4 19.7 1.0 0.4 12.0 15.5 5.0 0.1 100.0 45,854 Lower secondary 59.2 13.4 1.2 0.2 13.2 10.6 2.2 0.1 100.0 14,280 Upper secondary 73.7 7.3 0.6 0.2 11.3 5.3 1.6 0.0 100.0 5,241 Post secondary non tertiary 73.2 7.7 0.5 0.1 10.6 5.5 2.3 0.1 100.0 6,740 Higher 89.8 1.5 0.0 0.1 5.9 1.9 0.3 0.4 100.0 4,387 DK/Missing 91.1 3.1 0.0 0.0 5.9 0.0 0.0 0.0 100.0 156 Wealth index quintile Poorest 24.0 32.2 1.5 0.5 7.5 27.6 6.7 0.1 100.0 19,489 Second 31.3 28.3 1.6 0.6 10.8 20.4 6.8 0.1 100.0 19,480 Middle 47.1 17.7 1.1 0.3 14.6 13.6 5.5 0.1 100.0 19,483 Fourth 66.9 6.2 0.5 0.3 17.0 6.0 3.0 0.1 100.0 19,480 Richest 88.2 1.1 0.1 0.2 8.3 1.7 0.2 0.2 100.0 19,489 Ethno-linguistic group of household head Lao-Tai 62.1 9.3 0.9 0.2 12.8 10.5 4.1 0.1 100.0 61,459 Mon-Khmer 31.2 28.7 1.5 0.6 8.8 22.4 6.7 0.2 100.0 23,629 Hmong-Mien 36.5 30.7 0.7 0.7 14.7 14.4 2.3 0.0 100.0 8,682 Chinese-Tibetan 37.4 43.7 0.0 1.4 1.8 15.5 0.0 0.1 100.0 3,111 Other, Missing, DK 53.9 26.8 0.0 0.3 8.1 9.2 1.7 0.0 100.0 541 Total 51.5 17.1 1.0 0.4 11.6 13.9 4.5 0.1 100.0 97,421 Table WS.3: Time to source of drinking water Percent distribution of household population according to time to go to source of drinking water, get water and return, for users of improved and unimproved drinking water sources, Lao PDR 2011-12 Number of household members Users of improved drinking water sources Users of unimproved drinking water sources Time to source of drinking water 4 28 Water on premises Less than 30 minutes 30 minutes or more Missing/ DK Water on premises Less than 30 minutes 30 minutes or more Missing/ DK Total Region North 47.8 30.5 0.3 0.8 6.1 13.4 1.0 0.1 100.0 31,310 Central 56.3 7.5 0.8 0.2 16.7 12.7 5.7 0.1 100.0 46,919 South 45.9 18.7 2.4 0.1 8.2 17.6 7.0 0.1 100.0 19,192 Province Vientiane Capital 86.0 1.8 0.2 0.3 9.2 2.0 0.1 0.3 100.0 11,694 Phongsaly 31.0 36.9 0.0 6.8 1.8 23.2 0.0 0.2 100.0 3,122 Luangnamtha 55.8 41.7 0.0 0.1 0.6 1.7 0.0 0.0 100.0 2,707 Oudomxay 74.5 3.7 0.0 0.0 9.0 10.7 2.1 0.0 100.0 5,181 Bokeo 48.1 28.4 0.1 0.0 9.2 12.2 1.8 0.2 100.0 2,749 Luangprabang 47.9 32.7 0.2 0.4 2.2 16.0 0.5 0.1 100.0 6,576 Huaphanh 37.3 48.9 0.6 0.1 2.8 8.7 1.5 0.0 100.0 5,163 Xayabury 38.2 28.2 0.8 0.0 14.3 17.7 0.7 0.1 100.0 5,813 Xiengkhuang 64.4 10.0 1.1 0.3 12.6 10.2 1.3 0.1 100.0 4,198 Vientiane 46.7 13.9 0.5 0.2 29.5 8.3 0.9 0.0 100.0 7,079 Borikhamxay 55.8 6.0 0.0 0.0 31.1 6.2 0.8 0.0 100.0 3,864 Khammuane 37.0 17.0 2.9 0.0 19.7 18.8 4.6 0.1 100.0 5,129 Savannakhet 42.0 5.3 0.9 0.1 12.9 23.4 15.2 0.1 100.0 14,954 Saravane 23.5 31.5 4.0 0.2 2.8 25.6 12.3 0.1 100.0 6,760 Sekong 39.3 29.7 6.0 0.2 4.8 13.8 6.3 0.0 100.0 1,806 Champasack 66.2 5.7 1.0 0.0 11.9 11.1 4.2 0.0 100.0 8,877 Attapeu 36.1 23.9 0.2 0.3 14.2 23.4 1.9 0.0 100.0 1,749 Residence Urban 83.4 4.0 0.1 0.2 8.6 2.8 0.9 0.1 100.0 24,845 Rural 40.6 21.6 1.3 0.4 12.7 17.7 5.7 0.1 100.0 72,576 .Rural with road 42.2 22.5 1.3 0.4 12.4 15.8 5.2 0.1 100.0 64,866 .Rural without road 27.1 13.7 0.8 0.5 15.3 33.3 9.3 0.1 100.0 7,710 Education of household head None 36.5 22.8 1.3 0.6 11.4 20.2 7.1 0.2 100.0 20,763 Primary 46.4 19.7 1.0 0.4 12.0 15.5 5.0 0.1 100.0 45,854 Lower secondary 59.2 13.4 1.2 0.2 13.2 10.6 2.2 0.1 100.0 14,280 Upper secondary 73.7 7.3 0.6 0.2 11.3 5.3 1.6 0.0 100.0 5,241 Post secondary non tertiary 73.2 7.7 0.5 0.1 10.6 5.5 2.3 0.1 100.0 6,740 Higher 89.8 1.5 0.0 0.1 5.9 1.9 0.3 0.4 100.0 4,387 DK/Missing 91.1 3.1 0.0 0.0 5.9 0.0 0.0 0.0 100.0 156 Wealth index quintile Poorest 24.0 32.2 1.5 0.5 7.5 27.6 6.7 0.1 100.0 19,489 Second 31.3 28.3 1.6 0.6 10.8 20.4 6.8 0.1 100.0 19,480 Middle 47.1 17.7 1.1 0.3 14.6 13.6 5.5 0.1 100.0 19,483 Fourth 66.9 6.2 0.5 0.3 17.0 6.0 3.0 0.1 100.0 19,480 Richest 88.2 1.1 0.1 0.2 8.3 1.7 0.2 0.2 100.0 19,489 Ethno-linguistic group of household head Lao-Tai 62.1 9.3 0.9 0.2 12.8 10.5 4.1 0.1 100.0 61,459 Mon-Khmer 31.2 28.7 1.5 0.6 8.8 22.4 6.7 0.2 100.0 23,629 Hmong-Mien 36.5 30.7 0.7 0.7 14.7 14.4 2.3 0.0 100.0 8,682 Chinese-Tibetan 37.4 43.7 0.0 1.4 1.8 15.5 0.0 0.1 100.0 3,111 Other, Missing, DK 53.9 26.8 0.0 0.3 8.1 9.2 1.7 0.0 100.0 541 Total 51.5 17.1 1.0 0.4 11.6 13.9 4.5 0.1 100.0 97,421 Table WS.3: Time to source of drinking water Percent distribution of household population according to time to go to source of drinking water, get water and return, for users of improved and unimproved drinking water sources, Lao PDR 2011-12 Number of household members Users of improved drinking water sources Users of unimproved drinking water sources Time to source of drinking water 4 29 One third of households do not have a source of drinking water on their premises. Of these, Table WS.4 shows that in most households (71 per cent), an adult female is usually the person who collects the drinking water. Adult men and children under the age of 15 collect water in 17 per cent and 12 per cent, respectively. 4 30 4 Adult woman Adult man Female child under age 15 Male child under age 15 Missing/DK Total Region North 43.6 6,065 74.4 11.3 10.4 3.3 0.6 100.0 2,645 Central 24.9 9,247 65.1 23.0 8.4 2.7 0.8 100.0 2,304 South 42.5 3,531 71.8 19.7 5.6 2.9 0.1 100.0 1,501 Province Vientiane Capital 4.9 2,497 41.1 47.3 7.0 1.4 3.2 100.0 122 Phongsaly 64.0 578 88.7 5.8 3.2 1.5 0.8 100.0 370 Luangnamtha 42.9 544 82.1 5.6 9.8 2.5 0.0 100.0 234 Oudomxay 15.2 913 69.9 23.2 5.3 0.9 0.7 100.0 139 Bokeo 37.6 520 66.1 14.3 16.0 3.6 0.0 100.0 195 Luangprabang 47.1 1,371 69.5 7.9 15.3 6.0 1.2 100.0 646 Huaphanh 57.2 869 83.2 4.4 10.8 1.6 0.0 100.0 497 Xayabury 44.4 1,269 63.5 23.4 8.6 3.9 0.6 100.0 563 Xiengkhuang 21.5 762 65.9 11.2 16.8 5.5 0.5 100.0 164 Vientiane 21.5 1,447 52.3 40.5 4.2 2.6 0.4 100.0 311 Borikhamxay 11.9 804 78.9 12.7 2.0 1.7 4.6 100.0 95 Khammuane 41.9 1,078 61.0 26.6 8.4 2.9 1.1 100.0 451 Savannakhet 43.6 2,659 71.5 16.8 8.9 2.5 0.3 100.0 1,160 Saravane 70.5 1,123 81.7 11.7 5.5 1.0 0.1 100.0 792 Sekong 52.4 283 75.2 8.1 12.5 4.2 0.0 100.0 148 Champasack 22.1 1,789 45.0 44.6 3.9 6.5 0.0 100.0 396 Attapeu 49.0 336 85.3 9.1 3.6 2.0 0.0 100.0 165 Residence Urban 7.8 5,177 64.4 23.7 5.7 4.8 1.4 100.0 403 Rural 44.2 13,666 70.9 17.0 8.7 2.9 0.5 100.0 6,046 .Rural with road 42.9 12,285 71.0 17.7 8.0 2.7 0.5 100.0 5,274 .Rural without road 56.0 1,380 69.9 12.6 13.3 4.0 0.2 100.0 773 Education of household head None 49.7 3,833 71.9 14.6 9.4 3.6 0.4 100.0 1,905 Primary 39.3 8,542 70.8 17.0 9.1 2.7 0.4 100.0 3,353 Lower secondary 26.3 2,925 69.3 22.2 5.3 2.4 0.8 100.0 768 Upper secondary 14.7 1,147 60.0 30.3 3.6 4.5 1.7 100.0 169 Post secondary non tertiary 15.0 1,413 65.1 23.4 7.4 3.6 0.5 100.0 211 Higher 4.3 958 (65.1) (17.6) (5.1) (5.4) (6.8) 100.0 41 DK/Missing * 25 * * * * * * 1 Wealth index quintile Poorest 67.8 3,585 75.0 10.8 10.6 3.4 0.3 100.0 2,430 Second 55.3 3,533 72.8 14.8 9.2 2.8 0.4 100.0 1,955 Middle 35.5 3,743 65.6 24.7 6.3 3.0 0.4 100.0 1,328 Fourth 15.2 3,962 58.8 32.8 4.3 2.4 1.6 100.0 604 Richest 3.3 4,019 54.1 37.1 2.5 1.7 4.7 100.0 132 Ethno-linguistic group of household head Lao-Tai 23.5 12,721 65.8 25.0 6.1 2.3 0.8 100.0 2,994 Mon-Khmer 59.4 4,140 74.0 10.8 11.2 3.7 0.4 100.0 2,458 Hmong-Mien 47.8 1,287 69.8 13.5 12.0 4.6 0.1 100.0 615 Chinese-Tibetan 59.3 579 86.5 6.6 5.3 1.6 0.0 100.0 343 Other, Missing, DK 33.2 117 (74.1) (17.0) (0.0) (4.8) (4.0) 100.0 39 Total 34.2 18,843 70.5 17.4 8.5 3.0 0.5 100.0 6,449 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Figures in parentheses are based on 25-49 unweighted cases. Table WS.4: Person collecting water Person usually collecting drinking water Number of households without drinking water on premises Percentage of households without drinking water on premises, and percent distribution of households without drinking water on premises according to the person usually collecting drinking water used in the household, Lao PDR 2011-12 Number of households Percentage of households without drinking water on premises 31 Use of Improved Sanitation Facilities Inadequate disposal of human excreta is associated with a range of diseases including diarrhoeal diseases and polio. Improved sanitation can significantly reduce the prevalence of diarrheal disease, and significantly lessen the adverse health impacts of other disorders responsible for death and disease among millions of children in developing countries. An improved type of sanitation facility is defined as one that hygienically separates human excreta from human contact. Types of improved sanitation facilities include flush or pour-flush toilets (that flush to a piped sewer system, septic tank, or pit latrine), ventilated improved pit latrines, pit latrines with slabs, and composting toilets. Fifty-nine per cent of the population of Lao PDR is living in households using an improved type of sanitation facility, while 38 per cent of the population has no sanitation facilities at all (Table WS.5). Use of improved types of sanitation facilities is more common in the Northern (61 per cent) and Central (68 per cent) regions than in the Southern region (35 per cent), and varies profoundly by urban/rural residence. Nine in ten people in urban areas are using an improved type of sanitation facility, while only 5 in 10 rural people are doing so. The most common types of facilities in urban areas are toilets that flush to a septic tank or pit latrine. In rural areas, a third of the population uses a toilet that flushes to a pit latrine (33 per cent), or simply have no facilities (48 per cent). The use of an improved type of facility varies broadly all across the country, from a low of 22 per cent in Saravane to a high of 98 per cent in Vientiane Capital. As one would expect, use of improved types of sanitation facilities is strongly correlated with wealth (fewer percentage of poorer people using improved types of facilities) and education (fewer percentage of less educated people using improved types of facilities). 4 32 4 P ip ed se w er sy st em S ep tic ta nk P it la tri ne U nk no w n pl ac e/ no t s ur e/ D K w he re R eg io n N or th 0. 1 15 .6 44 .1 0. 0 0. 1 0. 9 0. 4 0. 0 4. 8 0. 0 0. 2 33 .6 10 0. 0 61 .3 31 ,3 10 C en tra l 0. 6 29 .0 37 .3 0. 0 0. 1 0. 6 0. 1 0. 0 1. 2 0. 0 0. 6 30 .4 10 0. 0 67 .8 46 ,9 19 S ou th 0. 4 18 .4 15 .7 0. 0 0. 1 0. 1 0. 0 0. 0 1. 0 0. 4 0. 6 63 .2 10 0. 0 34 .8 19 ,1 92 P ro vi nc e V ie nt ia ne C ap ita l 2. 4 53 .8 40 .8 0. 0 0. 2 0. 4 0. 2 0. 1 0. 2 0. 0 0. 4 1. 4 10 0. 0 97 .9 11 ,6 94 P ho ng sa ly 0. 0 1. 7 31 .0 0. 0 0. 0 1. 3 0. 1 0. 1 3. 7 0. 0 0. 4 61 .8 10 0. 0 34 .1 3, 12 2 Lu an gn am th a 0. 5 8. 6 57 .9 0. 1 0. 2 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 32 .6 10 0. 0 67 .3 2, 70 7 O ud om xa y 0. 0 8. 5 35 .2 0. 0 0. 1 0. 5 0. 0 0. 0 8. 3 0. 0 0. 5 46 .9 10 0. 0 44 .2 5, 18 1 B ok eo 0. 0 4. 7 64 .4 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 30 .5 10 0. 0 69 .3 2, 74 9 Lu an gp ra ba ng 0. 4 13 .1 44 .4 0. 0 0. 3 0. 3 0. 1 0. 2 1. 8 0. 0 0. 1 39 .3 10 0. 0 58 .6 6, 57 6 H ua ph an h 0. 0 28 .0 30 .1 0. 0 0. 0 0. 7 0. 0 0. 0 12 .2 0. 0 0. 3 28 .7 10 0. 0 58 .8 5, 16 3 X ay ab ur y 0. 0 29 .9 55 .3 0. 0 0. 1 2. 6 1. 9 0. 0 3. 4 0. 1 0. 1 6. 8 10 0. 0 89 .7 5, 81 3 X ie ng kh ua ng 0. 0 20 .7 29 .5 0. 0 0. 0 3. 9 0. 0 0. 0 12 .3 0. 0 0. 3 33 .3 10 0. 0 54 .1 4, 19 8 V ie nt ia ne 0. 0 22 .7 64 .1 0. 0 0. 2 1. 1 0. 1 0. 0 0. 4 0. 0 1. 2 10 .1 10 0. 0 88 .2 7, 07 9 B or ik ha m xa y 0. 0 32 .0 51 .8 0. 0 0. 0 0. 2 0. 0 0. 2 0. 0 0. 0 0. 2 15 .6 10 0. 0 84 .0 3, 86 4 K ha m m ua ne 0. 0 14 .8 27 .2 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 9 57 .0 10 0. 0 42 .1 5, 12 9 S av an na kh et 0. 1 19 .1 23 .9 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 4 56 .5 10 0. 0 43 .0 14 ,9 54 S ar av an e 0. 0 18 .0 4. 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 77 .5 10 0. 0 22 .3 6, 76 0 S ek on g 3. 2 4. 2 29 .7 0. 0 0. 0 0. 6 0. 0 0. 0 9. 7 0. 0 0. 5 52 .1 10 0. 0 37 .7 1, 80 6 C ha m pa sa ck 0. 2 21 .6 21 .3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 9 55 .8 10 0. 0 43 .2 8, 87 7 A tta pe u 0. 2 18 .3 17 .7 0. 0 1. 0 0. 1 0. 0 0. 0 0. 7 4. 4 0. 0 57 .6 10 0. 0 37 .2 1, 74 9 R es id en ce U rb an 1. 3 47 .9 41 .4 0. 0 0. 2 0. 4 0. 0 0. 0 0. 5 0. 1 0. 4 7. 7 10 0. 0 91 .3 24 ,8 45 R ur al 0. 1 14 .0 33 .2 0. 0 0. 1 0. 7 0. 2 0. 0 2. 9 0. 1 0. 5 48 .2 10 0. 0 48 .2 72 ,5 76 .R ur al w ith ro ad 0. 1 15 .2 34 .9 0. 0 0. 1 0. 7 0. 2 0. 0 3. 1 0. 1 0. 5 45 .0 10 0. 0 51 .2 64 ,8 66 .R ur al w ith ou t r oa d 0. 0 3. 6 18 .1 0. 0 0. 0 0. 6 0. 3 0. 0 1. 7 0. 0 0. 6 75 .2 10 0. 0 22 .5 7, 71 0 V en til at ed im pr ov ed pi t l at rin e P er ce nt ag e us in g im pr ov ed ty pe o f sa ni ta tio n fa ci lit y O pe n de fe ca tio n (n o fa ci lit y, bu sh , f ie ld ) C om po s- tin g to ile t Im pr ov ed s an ita tio n fa ci lit y P it la tri ne w ith ou t sl ab / op en p it Ta bl e W S .5 : T yp es o f s an ita tio n fa ci lit ie s P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to ty pe o f t oi le t f ac ili ty u se d by th e ho us eh ol d, L ao P D R 2 01 1- 12 Ty pe o f t oi le t f ac ili ty u se d by h ou se ho ld To ta l U ni m pr ov ed s an ita tio n fa ci lit y Fl us h/ po ur fl us h to : N um be r o f ho us eh ol d m em be rs B uc ke t O th er P it la tri ne w ith sl ab Fl us h/ po ur fl us h to s om e- w he re e ls e 33 4 P ip ed se w er sy st em S ep tic ta nk P it la tri ne U nk no w n pl ac e/ no t s ur e/ D K w he re E du ca tio n of h ou se ho ld h ea d N on e 0. 1 11 .2 27 .3 0. 0 0. 1 0. 4 0. 3 0. 0 1. 8 0. 1 0. 2 58 .5 10 0. 0 39 .4 20 ,7 63 P rim ar y 0. 1 17 .6 34 .7 0. 0 0. 1 0. 6 0. 2 0. 0 3. 1 0. 1 0. 5 42 .9 10 0. 0 53 .3 45 ,8 54 Lo w er s ec on da ry 0. 5 27 .2 43 .7 0. 0 0. 1 0. 9 0. 2 0. 0 2. 6 0. 0 0. 7 24 .1 10 0. 0 72 .5 14 ,2 80 U pp er s ec on da ry 0. 8 41 .0 42 .0 0. 0 0. 1 0. 4 0. 1 0. 0 0. 8 0. 1 0. 8 14 .0 10 0. 0 84 .4 5, 24 1 P os t s ec on da ry n on te rti ar y 1. 3 42 .4 42 .3 0. 0 0. 1 0. 7 0. 1 0. 1 0. 6 0. 0 0. 4 12 .0 10 0. 0 86 .9 6, 74 0 H ig he r 2. 8 60 .5 33 .1 0. 0 0. 3 0. 5 0. 0 0. 0 0. 1 0. 0 0. 1 2. 7 10 0. 0 97 .2 4, 38 7 D K /M is si ng 0. 0 56 .1 33 .8 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 .1 10 0. 0 89 .9 15 6 W ea lth in de x qu in til e P oo re st 0. 0 1. 0 10 .3 0. 0 0. 0 0. 8 0. 5 0. 0 5. 3 0. 1 0. 3 81 .6 10 0. 0 12 .7 19 ,4 89 S ec on d 0. 1 5. 3 27 .9 0. 0 0. 1 1. 0 0. 3 0. 1 4. 0 0. 1 0. 6 60 .7 10 0. 0 34 .5 19 ,4 80 M id dl e 0. 0 14 .9 43 .8 0. 0 0. 1 1. 0 0. 1 0. 1 2. 2 0. 2 1. 0 36 .7 10 0. 0 59 .9 19 ,4 83 Fo ur th 0. 2 32 .4 56 .2 0. 0 0. 1 0. 3 0. 0 0. 0 0. 1 0. 1 0. 3 10 .3 10 0. 0 89 .3 19 ,4 80 R ic he st 1. 8 59 .7 38 .0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 3 10 0. 0 99 .6 19 ,4 89 E th no -li ng ui st ic g ro up o f h ou se ho ld h ea d La o- Ta i 0. 6 32 .8 39 .4 0. 0 0. 1 0. 5 0. 2 0. 0 0. 9 0. 1 0. 5 24 .8 10 0. 0 73 .6 61 ,4 59 M on -K hm er 0. 2 3. 4 25 .2 0. 0 0. 2 0. 7 0. 2 0. 0 5. 7 0. 2 0. 4 63 .8 10 0. 0 29 .9 23 ,6 29 H m on g- M ie n 0. 0 8. 9 36 .8 0. 0 0. 0 0. 4 0. 2 0. 0 2. 4 0. 0 0. 4 50 .8 10 0. 0 46 .4 8, 68 2 C hi ne se -T ib et an 0. 0 2. 4 26 .1 0. 0 0. 1 1. 3 0. 1 0. 1 4. 2 0. 0 0. 3 65 .5 10 0. 0 30 .0 3, 11 1 O th er , M is si ng , D K 2. 6 38 .9 29 .5 0. 0 0. 0 0. 6 0. 0 0. 0 0. 7 0. 0 0. 9 26 .8 10 0. 0 71 .7 54 1 To ta l 0. 4 22 .6 35 .3 0. 0 0. 1 0. 6 0. 2 0. 0 2. 3 0. 1 0. 5 37 .9 10 0. 0 59 .2 97 ,4 21 O th er Ty pe o f t oi le t f ac ili ty u se d by h ou se ho ld To ta l P er ce nt ag e us in g im pr ov ed ty pe o f sa ni ta tio n fa ci lit y N um be r o f ho us eh ol d m em be rs Im pr ov ed s an ita tio n fa ci lit y U ni m pr ov ed s an ita tio n fa ci lit y O pe n de fe ca tio n (n o fa ci lit y, bu sh , f ie ld ) Fl us h/ po ur fl us h to : V en til at ed im pr ov ed pi t l at rin e P it la tri ne w ith sl ab C om po s- tin g to ile t Fl us h/ po ur fl us h to s om e- w he re e ls e P it la tri ne w ith ou t sl ab / op en p it B uc ke t Ta bl e W S .5 : T yp es o f s an ita tio n fa ci lit ie s P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to ty pe o f t oi le t f ac ili ty u se d by th e ho us eh ol d, L ao P D R 2 01 1- 12 34 Table WS.6 shows the distribution of the household population by whether or not their household facility is improved or unimproved and shared or not shared with other households. Clearly, sharing sanitation facilities is not at all common in Lao PDR. Some 57 per cent of people use an improved sanitation facility that is not shared with other households, while 38 per cent have no facility at all (referred to in the table as ‘open defecation’). Thus, findings in this table are similar to the findings discussed in Table WS.5. 4 35 4 5 ho us eh ol ds or le ss M or e th an 5 ho us eh ol ds 5 ho us eh ol ds or le ss M or e th an 5 ho us eh ol ds R eg io n N or th 59 .7 0. 2 1. 1 0. 2 0. 1 4. 9 0. 1 0. 1 0. 0 0. 0 33 .6 10 0. 0 31 ,3 10 C en tra l 64 .6 0. 3 2. 1 0. 3 0. 4 1. 7 0. 0 0. 1 0. 0 0. 0 30 .4 10 0. 0 46 ,9 19 S ou th 33 .5 0. 1 0. 8 0. 3 0. 1 1. 4 0. 1 0. 5 0. 0 0. 0 63 .2 10 0. 0 19 ,1 92 P ro vi nc e V ie nt ia ne C ap ita l 94 .1 0. 8 1. 9 0. 7 0. 4 0. 5 0. 0 0. 2 0. 0 0. 0 1. 4 10 0. 0 11 ,6 94 P ho ng sa ly 32 .9 0. 3 0. 5 0. 2 0. 1 3. 9 0. 2 0. 0 0. 0 0. 0 61 .8 10 0. 0 3, 12 2 Lu an gn am th a 66 .8 0. 1 0. 5 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 32 .6 10 0. 0 2, 70 7 O ud om xa y 43 .5 0. 2 0. 4 0. 1 0. 1 8. 2 0. 2 0. 5 0. 0 0. 0 46 .9 10 0. 0 5, 18 1 B ok eo 65 .1 0. 0 3. 5 0. 1 0. 6 0. 2 0. 0 0. 0 0. 0 0. 0 30 .5 10 0. 0 2, 74 9 Lu an gp ra ba ng 56 .7 0. 3 0. 9 0. 6 0. 1 2. 0 0. 1 0. 0 0. 1 0. 0 39 .3 10 0. 0 6, 57 6 H ua ph an h 57 .8 0. 1 0. 7 0. 1 0. 0 12 .4 0. 1 0. 1 0. 0 0. 0 28 .7 10 0. 0 5, 16 3 X ay ab ur y 87 .9 0. 0 1. 7 0. 1 0. 0 3. 4 0. 0 0. 1 0. 0 0. 0 6. 8 10 0. 0 5, 81 3 X ie ng kh ua ng 53 .0 0. 1 0. 8 0. 1 0. 2 12 .4 0. 1 0. 2 0. 0 0. 0 33 .3 10 0. 0 4, 19 8 V ie nt ia ne 85 .0 0. 7 2. 1 0. 1 0. 3 1. 4 0. 1 0. 0 0. 0 0. 2 10 .1 10 0. 0 7, 07 9 B or ik ha m xa y 83 .1 0. 0 0. 8 0. 1 0. 0 0. 3 0. 0 0. 0 0. 1 0. 0 15 .6 10 0. 0 3, 86 4 K ha m m ua ne 39 .8 0. 1 1. 4 0. 4 0. 5 0. 8 0. 0 0. 0 0. 0 0. 0 57 .0 10 0. 0 5, 12 9 S av an na kh et 39 .0 0. 1 3. 0 0. 2 0. 7 0. 4 0. 0 0. 0 0. 0 0. 0 56 .5 10 0. 0 14 ,9 54 S ar av an e 21 .2 0. 1 0. 8 0. 1 0. 1 0. 2 0. 0 0. 0 0. 0 0. 0 77 .5 10 0. 0 6, 76 0 S ek on g 35 .2 0. 4 1. 4 0. 6 0. 1 8. 1 0. 0 1. 9 0. 0 0. 1 52 .1 10 0. 0 1, 80 6 C ha m pa sa ck 41 .9 0. 0 0. 8 0. 3 0. 2 0. 2 0. 1 0. 6 0. 0 0. 1 55 .8 10 0. 0 8, 87 7 A tta pe u 36 .6 0. 3 0. 3 0. 1 0. 0 5. 1 0. 0 0. 0 0. 0 0. 0 57 .6 10 0. 0 1, 74 9 R es id en ce U rb an 88 .0 0. 3 2. 1 0. 4 0. 5 0. 7 0. 1 0. 1 0. 0 0. 0 7. 7 10 0. 0 24 ,8 45 R ur al 46 .3 0. 2 1. 3 0. 2 0. 2 3. 3 0. 0 0. 2 0. 0 0. 0 48 .2 10 0. 0 72 ,5 76 .R ur al w ith ro ad 49 .2 0. 2 1. 4 0. 2 0. 2 3. 5 0. 0 0. 2 0. 0 0. 0 45 .0 10 0. 0 64 ,8 66 .R ur al w ith ou t r oa d 22 .1 0. 1 0. 2 0. 1 0. 1 2. 0 0. 0 0. 2 0. 0 0. 0 75 .2 10 0. 0 7, 71 0 P ub lic fa ci lit y 1 M IC S in di ca to r 4. 3; M D G in di ca to r 7. 9 Ta bl e W S .6 : U se a nd s ha ri ng o f s an ita tio n fa ci lit ie s P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n by u se o f p riv at e an d pu bl ic s an ita tio n fa ci lit ie s an d us e of s ha re d fa ci lit ie s, b y us er s of im pr ov ed a nd u ni m pr ov ed s an ita tio n fa ci lit ie s, L ao P D R 2 01 1- 12 N um be r o f ho us eh ol d m em be rs N ot sh ar ed P ub lic fa ci lit y M is si ng /D K M is si ng /D K To ta l U se rs o f i m pr ov ed s an ita tio n fa ci lit ie s U se rs o f u ni m pr ov ed s an ita tio n fa ci lit ie s S ha re d by S ha re d by O pe n de fe ca tio n (n o fa ci lit y, b us h, fi el d) N ot s ha re d 1 36 4 5 ho us eh ol ds or le ss M or e th an 5 ho us eh ol ds 5 ho us eh ol ds or le ss M or e th an 5 ho us eh ol ds E du ca tio n of h ou se ho ld h ea d N on e 37 .5 0. 1 1. 4 0. 1 0. 4 2. 0 0. 0 0. 1 0. 0 0. 0 58 .5 10 0. 0 20 ,7 63 P rim ar y 51 .4 0. 1 1. 3 0. 3 0. 2 3. 5 0. 0 0. 1 0. 0 0. 0 42 .9 10 0. 0 45 ,8 54 Lo w er s ec on da ry 69 .6 0. 4 1. 8 0. 4 0. 3 2. 9 0. 0 0. 3 0. 0 0. 1 24 .1 10 0. 0 14 ,2 80 U pp er s ec on da ry 80 .7 0. 5 2. 3 0. 3 0. 6 1. 2 0. 1 0. 2 0. 0 0. 1 14 .0 10 0. 0 5, 24 1 P os t s ec on da ry n on te rti ar y 83 .9 0. 6 1. 7 0. 3 0. 4 0. 9 0. 1 0. 1 0. 0 0. 0 12 .0 10 0. 0 6, 74 0 H ig he r 95 .1 0. 8 1. 0 0. 3 0. 0 0. 1 0. 0 0. 1 0. 0 0. 0 2. 7 10 0. 0 4, 38 7 D K /M is si ng 84 .3 0. 0 5. 6 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 .1 10 0. 0 15 6 W ea lth in de x qu in til e P oo re st 12 .1 0. 0 0. 4 0. 1 0. 0 5. 5 0. 0 0. 1 0. 0 0. 0 81 .6 10 0. 0 19 ,4 89 S ec on d 33 .0 0. 1 1. 3 0. 2 0. 0 4. 4 0. 1 0. 2 0. 0 0. 0 60 .7 10 0. 0 19 ,4 80 M id dl e 56 .8 0. 2 2. 1 0. 5 0. 3 2. 9 0. 1 0. 3 0. 0 0. 1 36 .7 10 0. 0 19 ,4 83 Fo ur th 85 .7 0. 4 2. 3 0. 3 0. 6 0. 3 0. 0 0. 1 0. 0 0. 0 10 .3 10 0. 0 19 ,4 80 R ic he st 97 .1 0. 5 1. 4 0. 3 0. 4 0. 1 0. 0 0. 0 0. 0 0. 0 0. 3 10 0. 0 19 ,4 89 E th no -li ng ui st ic g ro up o f h ou se ho ld h ea d La o- Ta i 70 .9 0. 3 1. 9 0. 3 0. 4 1. 3 0. 0 0. 2 0. 0 0. 0 24 .8 10 0. 0 61 ,4 59 M on -K hm er 29 .0 0. 2 0. 6 0. 1 0. 1 6. 0 0. 1 0. 2 0. 0 0. 0 63 .8 10 0. 0 23 ,6 29 H m on g- M ie n 43 .3 0. 1 2. 0 0. 7 0. 2 2. 7 0. 0 0. 1 0. 0 0. 0 50 .8 10 0. 0 8, 68 2 C hi ne se -T ib et an 28 .8 0. 3 0. 5 0. 2 0. 1 4. 3 0. 2 0. 0 0. 0 0. 0 65 .5 10 0. 0 3, 11 1 O th er , M is si ng , D K 70 .4 0. 0 0. 7 0. 6 0. 0 1. 5 0. 0 0. 0 0. 0 0. 0 26 .8 10 0. 0 54 1 To ta l 56 .9 0. 2 1. 5 0. 3 0. 3 2. 7 0. 0 0. 2 0. 0 0. 0 37 .9 10 0. 0 97 ,4 21 Ta bl e W S .6 : U se a nd s ha ri ng o f s an ita tio n fa ci lit ie s P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n by u se o f p riv at e an d pu bl ic s an ita tio n fa ci lit ie s an d us e of s ha re d fa ci lit ie s, b y us er s of im pr ov ed a nd u ni m pr ov ed s an ita tio n fa ci lit ie s, L ao P D R 2 01 1- 12 U se rs o f i m pr ov ed s an ita tio n fa ci lit ie s U se rs o f u ni m pr ov ed s an ita tio n fa ci lit ie s O pe n de fe ca tio n (n o fa ci lit y, b us h, fi el d) To ta l N um be r o f ho us eh ol d m em be rs N ot s ha re d 1 P ub lic fa ci lit y S ha re d by M is si ng /D K N ot sh ar ed P ub lic fa ci lit y S ha re d by M is si ng /D K 1 M IC S in di ca to r 4. 3; M D G in di ca to r 7. 9 37 The percentage distribution of children age 0-2 years according to the place of disposal of the child’s faeces is shown in Table WS.7. Also shown is the percentage of children age 0-2 years whose stools were disposed of safely the last time the child passed stools. Disposal of a child’s faeces is considered safe when it is done either by the child using a toilet or by rinsing the stool into a toilet or latrine. Nationally, only 19 per cent of children’s stools are disposed of safely. The most common way to address stool disposal is to leave them in the open (43 per cent), followed by burial at 19 per cent. Disposal of children’s stools varies dramatically by education and wealth quintile, from only 5 per cent of stools safely disposed of among the lowest categories, increasing to about half of stools safely disposed of among the highest educated and wealthiest. 4 38 4 Child used toilet /latrine Put /rinsed into toilet or latrine Put /rinsed into drain or ditch Thrown into garbage Buried Left in the open Other Missing/ DK Total Type of sanitaton facility in dwelling Improved 23.0 12.4 2.2 9.2 18.1 21.0 11.9 2.2 100.0 35.5 3,336 Unimproved 5.4 3.0 0.4 0.2 12.4 61.8 15.5 1.3 100.0 8.4 190 Open defacation 0.6 0.4 1.1 1.2 19.4 64.9 11.0 1.3 100.0 1.0 3,095 Region North 10.6 6.2 1.4 4.8 11.1 47.6 16.5 1.8 100.0 16.8 2,079 Central 16.4 6.9 2.1 7.6 18.6 36.7 9.6 2.1 100.0 23.3 3,087 South 4.8 6.2 1.1 0.7 29.0 48.5 8.6 1.1 100.0 11.0 1,455 Province Vientiane Capital 32.2 18.0 2.8 20.4 9.9 4.2 9.2 3.3 100.0 50.2 634 Phongsaly 3.0 5.5 1.1 5.5 2.6 73.5 1.6 7.3 100.0 8.5 215 Luangnamtha 14.2 5.9 0.0 5.0 14.5 40.8 18.0 1.5 100.0 20.1 165 Oudomxay 7.4 1.6 0.5 0.9 7.8 57.2 23.0 1.5 100.0 9.1 418 Bokeo 11.3 4.3 1.3 3.7 6.2 68.6 4.1 0.5 100.0 15.6 204 Luangprabang 12.6 7.1 2.7 8.6 13.9 23.9 30.2 0.9 100.0 19.7 421 Huaphanh 12.3 1.1 0.3 0.4 3.2 60.8 21.4 0.5 100.0 13.4 352 Xayabury 13.3 19.2 2.9 10.2 28.4 23.0 0.7 2.2 100.0 32.5 303 Xiengkhuang 11.3 0.9 3.4 2.1 1.1 60.2 19.1 1.8 100.0 12.2 314 Vientiane 27.3 7.7 0.8 10.0 12.7 23.0 16.9 1.7 100.0 35.0 455 Borikhamxay 27.5 3.4 5.7 5.9 17.1 35.2 3.7 1.5 100.0 30.9 245 Khammuane 5.4 1.3 1.1 5.5 13.6 56.9 14.8 1.4 100.0 6.7 377 Savannakhet 5.2 4.6 1.3 1.8 33.7 48.1 3.4 1.9 100.0 9.8 1,063 Saravane 3.3 4.1 0.4 0.2 18.1 69.0 2.9 2.0 100.0 7.4 558 Sekong 6.0 6.4 2.0 0.4 6.2 72.7 5.9 0.4 100.0 12.4 150 Champasack 6.2 8.1 1.4 0.7 48.0 20.2 15.0 0.4 100.0 14.4 625 Attapeu 3.3 5.1 0.9 4.0 9.3 70.1 6.1 1.2 100.0 8.4 122 Residence Urban 27.1 16.1 2.1 13.1 15.1 14.4 9.9 2.3 100.0 43.2 1,431 Rural 7.9 3.9 1.5 3.1 19.5 50.5 12.0 1.6 100.0 11.8 5,191 .Rural with road 8.6 4.2 1.7 3.3 19.4 49.3 11.7 1.8 100.0 12.8 4,554 .Rural without road 2.5 1.9 0.4 1.2 20.2 59.0 14.3 0.5 100.0 4.3 636 Education of household head None 3.1 1.4 0.8 1.0 11.5 70.0 11.1 1.1 100.0 4.5 2,011 Primary 10.2 5.5 1.9 3.5 25.1 41.4 10.7 1.6 100.0 15.7 2,721 Lower secondary 20.1 11.4 2.3 7.7 20.2 22.2 14.3 1.9 100.0 31.4 1,018 Upper secondary 30.3 12.8 1.4 17.9 12.7 8.8 12.6 3.6 100.0 43.1 475 Post secondary non tertiary 26.8 20.6 1.3 12.8 15.5 7.4 11.4 4.1 100.0 47.4 219 Higher 28.6 18.3 4.2 21.3 8.0 5.2 11.4 3.1 100.0 46.9 179 Wealth index quintile Poorest 1.7 0.7 0.8 1.3 10.2 72.1 12.1 1.2 100.0 2.3 1,861 Second 4.7 2.1 1.2 1.4 20.7 56.7 11.8 1.5 100.0 6.8 1,391 Middle 11.1 5.7 2.4 2.8 26.4 37.5 12.4 1.7 100.0 16.8 1,231 Fourth 20.3 13.0 2.4 6.5 29.5 15.9 10.6 1.9 100.0 33.2 1,119 Richest 33.1 17.3 2.0 19.2 9.3 5.7 10.3 3.1 100.0 50.4 1,020 Ethno-linguistic group of household head Lao-Tai 17.8 9.9 2.0 7.8 26.1 23.9 10.7 1.9 100.0 27.7 3,680 Mon-Khmer 4.0 2.5 1.0 1.8 10.0 68.6 10.8 1.2 100.0 6.6 1,857 Hmong-Mien 6.3 1.5 1.8 2.5 8.2 59.9 17.9 1.9 100.0 7.8 839 Chinese-Tibetan 3.1 1.4 1.0 2.5 5.4 74.9 8.8 2.9 100.0 4.6 216 Other, Missing, DK (31.2) (15.4) (0.0) (0.8) (5.5) (31.1) (5.5) (10.5) 100.0 (46.6) 29 Total 12.0 6.5 1.6 5.2 18.5 42.7 11.5 1.8 100.0 18.6 6,622 Note: Figures in parentheses are based on 25-49 unweighted cases. 1 MICS indicator 4.4 Table WS.7: Disposal of child's faeces Percent distribution of children age 0-2 years according to place of disposal of child's faeces, and the percentage of children age 0-2 years whose stools were disposed of safely the last time the child passed stools, Lao PDR 2011-12 Place of disposal of child's faeces Percentage of children whose last stools were disposed of safely1 Number of children age 0-2 years 39 A ‘service ladder’ is a concept developed by the WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation. This allows differences in the quality of drinking water and sanitation to be analysed, and the quality of water to be ranked in a three rung ’ladder’, and sanitation to be ranked in a four rung ladder.1 For sanitation, this gives an understanding of: the proportion of the population with no sanitation facilities at all; those reliant on technologies defined by JMP as ’unimproved’; those sharing sanitation facilities of otherwise acceptable technology; and those using ‘improved’ sanitation facilities. Table WS.8 presents the distribution of the household population by drinking water and sanitation ladders. The table also shows the percentage of household members using both improved sources of drinking water and sanitary means of excreta disposal. In Lao PDR, 46 per cent of households are using both improved drinking water sources and improved sanitation facilities. About 8 in 10 urban households are using both improved drinking water sources and improved sanitation facilities while only about 3 in 10 rural households are doing so. An equally broad spectrum is also seen across provinces. The percentage of households using both improved drinking water sources and improved sanitation facilities varies from a low of 15 to 30 per cent in Saravane, Attapeu, Savannakhet and Khammuane provinces, to a high of 84 per cent in Vientiane Capital, with other provinces ranging from 31 to 66 per cent. Both education level of the household head and household wealth quintile have a strong positive correlation with the percentage of households using both improved drinking water sources and improved sanitation facilities. 1 WHO and UNICEF JMP, 2008. 4 40 4 P ip ed in to d w el lin g, pl ot o r y ar d O th er im pr ov ed S ha re d im pr ov ed fa ci lit ie s U ni m pr ov ed fa ci lit ie s O pe n de fe ca tio n R eg io n N or th 21 .6 57 .8 20 .6 10 0. 0 59 .7 1. 5 5. 1 33 .6 10 0. 0 51 .1 31 ,3 10 C en tra l 23 .2 41 .6 35 .2 10 0. 0 64 .6 3. 2 1. 8 30 .4 10 0. 0 50 .0 46 ,9 19 S ou th 15 .6 51 .5 32 .9 10 0. 0 33 .5 1. 3 2. 0 63 .2 10 0. 0 26 .2 19 ,1 92 P ro vi nc e V ie nt ia ne C ap ita l 51 .5 36 .8 11 .7 10 0. 0 94 .1 3. 8 0. 7 1. 4 10 0. 0 83 .5 11 ,6 94 P ho ng sa ly 14 .5 60 .2 25 .3 10 0. 0 32 .9 1. 2 4. 1 61 .8 10 0. 0 31 .4 3, 12 2 Lu an gn am th a 30 .7 66 .9 2. 4 10 0. 0 66 .8 0. 6 0. 1 32 .6 10 0. 0 66 .0 2, 70 7 O ud om xa y 18 .6 59 .7 21 .8 10 0. 0 43 .5 0. 8 8. 9 46 .9 10 0. 0 40 .3 5, 18 1 B ok eo 9. 6 67 .0 23 .4 10 0. 0 65 .1 4. 2 0. 2 30 .5 10 0. 0 52 .3 2, 74 9 Lu an gp ra ba ng 32 .9 48 .3 18 .9 10 0. 0 56 .7 1. 9 2. 1 39 .3 10 0. 0 54 .3 6, 57 6 H ua ph an h 20 .8 66 .1 13 .1 10 0. 0 57 .8 0. 9 12 .5 28 .7 10 0. 0 53 .3 5, 16 3 X ay ab ur y 17 .5 49 .7 32 .8 10 0. 0 87 .9 1. 8 3. 5 6. 8 10 0. 0 57 .8 5, 81 3 X ie ng kh ua ng 13 .1 62 .7 24 .2 10 0. 0 53 .0 1. 1 12 .6 33 .3 10 0. 0 45 .9 4, 19 8 V ie nt ia ne 11 .8 49 .5 38 .7 10 0. 0 85 .0 3. 2 1. 7 10 .1 10 0. 0 54 .0 7, 07 9 B or ik ha m xa y 24 .4 37 .5 38 .2 10 0. 0 83 .1 0. 9 0. 4 15 .6 10 0. 0 52 .2 3, 86 4 K ha m m ua ne 8. 4 48 .6 43 .1 10 0. 0 39 .8 2. 4 0. 9 57 .0 10 0. 0 29 .9 5, 12 9 S av an na kh et 14 .0 34 .3 51 .6 10 0. 0 39 .0 4. 1 0. 4 56 .5 10 0. 0 29 .4 14 ,9 54 S ar av an e 9. 9 49 .3 40 .8 10 0. 0 21 .2 1. 1 0. 2 77 .5 10 0. 0 15 .0 6, 76 0 S ek on g 23 .8 51 .3 24 .8 10 0. 0 35 .2 2. 5 10 .1 52 .1 10 0. 0 31 .2 1, 80 6 C ha m pa sa ck 18 .3 54 .5 27 .2 10 0. 0 41 .9 1. 3 1. 0 55 .8 10 0. 0 33 .8 8, 87 7 A tta pe u 14 .9 45 .6 39 .5 10 0. 0 36 .6 0. 7 5. 1 57 .6 10 0. 0 25 .6 1, 74 9 R es id en ce U rb an 59 .2 28 .4 12 .4 10 0. 0 88 .0 3. 4 1. 0 7. 7 10 0. 0 79 .1 24 ,8 45 R ur al 8. 1 55 .7 36 .1 10 0. 0 46 .3 1. 9 3. 6 48 .2 10 0. 0 34 .2 72 ,5 76 .R ur al w ith ro ad 8. 8 57 .7 33 .5 10 0. 0 49 .2 2. 1 3. 7 45 .0 10 0. 0 36 .4 64 ,8 66 .R ur al w ith ou t r oa d 2. 9 39 .1 58 .0 10 0. 0 22 .1 0. 5 2. 3 75 .2 10 0. 0 15 .4 7, 71 0 P er ce nt ag e of h ou se ho ld p op ul at io n by d rin ki ng w at er a nd s an ita tio n la dd er s, L ao P D R 2 01 1- 12 Ta bl e W S .8 : D ri nk in g w at er a nd s an ita tio n la dd er s P er ce nt ag e of h ou se ho ld p op ul at io n us in g: Im pr ov ed d rin ki ng w at er so ur ce s an d im pr ov ed sa ni ta tio n 1 M IC S in di ca to r 4. 1; M D G in di ca to r 7. 8 2 M IC S in di ca to r 4. 3; M D G in di ca to r 7. 9 N um be r o f ho us eh ol d m em be rs Im pr ov ed d ri nk in g w at er 1 U ni m pr ov ed dr in ki ng w at er U ni m pr ov ed s an ita tio n To ta l To ta l Im pr ov ed sa ni ta tio n2 41 4 P ip ed in to d w el lin g, pl ot o r y ar d O th er im pr ov ed S ha re d im pr ov ed fa ci lit ie s U ni m pr ov ed fa ci lit ie s O pe n de fe ca tio n E du ca tio n of h ou se ho ld h ea d N on e 10 .7 50 .5 38 .8 10 0. 0 37 .5 1. 9 2. 1 58 .5 10 0. 0 28 .1 20 ,7 63 P rim ar y 15 .0 52 .4 32 .6 10 0. 0 51 .4 2. 0 3. 8 42 .9 10 0. 0 40 .0 45 ,8 54 Lo w er s ec on da ry 24 .1 49 .9 26 .0 10 0. 0 69 .6 2. 9 3. 4 24 .1 10 0. 0 55 .2 14 ,2 80 U pp er s ec on da ry 39 .2 42 .7 18 .1 10 0. 0 80 .7 3. 7 1. 6 14 .0 10 0. 0 69 .0 5, 24 1 P os t s ec on da ry n on te rti ar y 43 .3 38 .2 18 .5 10 0. 0 83 .9 3. 0 1. 1 12 .0 10 0. 0 71 .3 6, 74 0 H ig he r 68 .6 22 .8 8. 6 10 0. 0 95 .1 2. 1 0. 2 2. 7 10 0. 0 88 .3 4, 38 7 D K /M is si ng 57 .5 36 .6 5. 9 10 0. 0 84 .3 5. 6 0. 0 10 .1 10 0. 0 84 .3 15 6 W ea lth in de x qu in til e P oo re st 3. 2 54 .9 41 .9 10 0. 0 12 .1 0. 5 5. 7 81 .6 10 0. 0 10 .5 19 ,4 89 S ec on d 7. 3 54 .6 38 .1 10 0. 0 33 .0 1. 6 4. 8 60 .7 10 0. 0 27 .1 19 ,4 80 M id dl e 14 .0 52 .1 33 .8 10 0. 0 56 .8 3. 1 3. 4 36 .7 10 0. 0 40 .0 19 ,4 83 Fo ur th 24 .5 49 .4 26 .1 10 0. 0 85 .7 3. 6 0. 4 10 .3 10 0. 0 63 .6 19 ,4 80 R ic he st 56 .8 32 .8 10 .4 10 0. 0 97 .1 2. 5 0. 1 0. 3 10 0. 0 87 .1 19 ,4 89 E th no -li ng ui st ic g ro up o f h ou se ho ld h ea d La o- Ta i 28 .3 44 .1 27 .6 10 0. 0 70 .9 2. 7 1. 5 24 .8 10 0. 0 56 .6 61 ,4 59 M on -K hm er 7. 4 54 .6 38 .0 10 0. 0 29 .0 0. 9 6. 3 63 .8 10 0. 0 24 .2 23 ,6 29 H m on g- M ie n 9. 3 59 .4 31 .3 10 0. 0 43 .3 3. 1 2. 8 50 .8 10 0. 0 31 .9 8, 68 2 C hi ne se -T ib et an 15 .5 67 .0 17 .4 10 0. 0 28 .8 1. 2 4. 5 65 .5 10 0. 0 27 .3 3, 11 1 O th er , M is si ng , D K 31 .3 49 .7 19 .1 10 0. 0 70 .4 1. 3 1. 5 26 .8 10 0. 0 65 .1 54 1 To ta l 21 .2 48 .8 30 .1 10 0. 0 56 .9 2. 3 2. 9 37 .9 10 0. 0 45 .7 97 ,4 21 1 M IC S in di ca to r 4. 1; M D G in di ca to r 7. 8 P er ce nt ag e of h ou se ho ld p op ul at io n us in g: N um be r o f ho us eh ol d m em be rs Im pr ov ed d ri nk in g w at er 1 U ni m pr ov ed dr in ki ng w at er To ta l Im pr ov ed sa ni ta tio n2 U ni m pr ov ed s an ita tio n To ta l Im pr ov ed d rin ki ng w at er so ur ce s an d im pr ov ed sa ni ta tio n 2 M IC S in di ca to r 4. 3; M D G in di ca to r 7. 9 Ta bl e W S .8 : D ri nk in g w at er a nd s an ita tio n la dd er s P er ce nt ag e of h ou se ho ld p op ul at io n by d rin ki ng w at er a nd s an ita tio n la dd er s, L ao P D R 2 01 1- 12 © UNFPA Lao PDR / 2012 / Perier 43 V. Marriage and Sexual Activity This chapter addresses the principal factors, other than contraception, that affect a woman’s risk of becoming pregnant – marriage and sexual activity. For most women marriage marks the onset of regular exposure to the risk of pregnancy. Therefore, information on age at marriage is central to an understanding of fertility. Populations in which age at first marriage is low tend to have early childbearing and high fertility. Current Marital Status The percentage distribution of women and men age 15-49 by marital status is shown in Tables MS.1.1 and MS.1.2, according to age group. The term ‘married’ refers to legal or formal marriage, while the term ‘living together’ designates an informal union in which a man and a woman live together but a formal civil or religious ceremony has not taken place. In later tables that do not list ‘living together’ as a separate category, these women are included in the ‘currently married / in a union’ group. Respondents who are currently married, widowed, divorced or separated are referred to as ‘ever married’. Twenty-two per cent of women age 15-49 have never married, 71 per cent are currently married, 2 per cent are living together with a man, and 5 per cent are divorced, separated or widowed. The low proportion of women age 45-49 that have never been married indicates that marriage is nearly universal in Lao PDR. The proportion age 15-49 that have never been married is notably higher among men than among women (32 per cent and 22 per cent, respectively). About two thirds of men (64 per cent) are currently married, 2 per cent are living together with a woman, and 2 per cent are divorced, separated or widowed. A significant proportion of men marry after reaching the age of 25, in contrast to women, who tend to marry before the age of 25. For example, 68 per cent of women age 20-24 are in a union, compared with only 47 per cent of men in the same age group. As with women, however, virtually all men have married by the time they reach 50. Never married Married Living together Divorced Separated Widowed Age 15-19 73.9 22.2 2.6 0.7 0.5 0.1 100.0 24.7 4,415 20-24 27.9 64.2 4.0 2.7 0.9 0.2 100.0 68.2 3,617 25-29 9.7 83.6 2.7 2.9 0.6 0.5 100.0 86.3 3,642 30-34 5.1 88.8 1.7 2.6 0.4 1.3 100.0 90.5 3,015 35-39 3.6 89.8 1.0 3.4 0.4 1.7 100.0 90.8 3,065 40-44 3.1 88.1 1.1 2.8 0.3 4.5 100.0 89.2 2,507 45-49 2.6 85.3 1.2 3.2 0.4 7.3 100.0 86.6 2,215 Total 22.4 70.6 2.2 2.5 0.5 1.8 100.0 72.8 22,476 Marital status Total Table MS.1.1: Current marital status Percent distribution of women age 15-49 by current marital status, according to age, Lao PDR 2011-12 Percentage of women currently in union Number of women 5 44 Never married Married Living together Divorced Separated Widowed Age 15-19 90.6 7.1 1.8 0.1 0.3 0.0 100.0 9.0 2,119 20-24 51.4 41.4 5.3 0.5 1.2 0.2 100.0 46.7 1,557 25-29 18.1 76.0 3.5 1.7 0.5 0.2 100.0 79.5 1,500 30-34 6.7 89.7 1.3 1.4 0.5 0.5 100.0 91.0 1,264 35-39 3.6 93.1 1.2 1.0 0.5 0.7 100.0 94.3 1,445 40-44 1.8 95.7 0.2 1.0 0.1 1.1 100.0 95.9 1,043 45-49 1.5 96.5 0.2 1.2 0.0 0.7 100.0 96.6 1,023 Total 31.8 64.3 2.1 0.9 0.5 0.4 100.0 66.4 9,951 Table MS.1.2: Current marital status Percent distribution of men age 15-49 by current marital status, according to age, Lao PDR 2011-12 Marital status Total Percentage of men currently in union Number of men Age at First Marriage Age at first marriage has a major effect on childbearing because women who marry early have, on average, a longer period of exposure to the risk of pregnancy and give birth to a greater number of children over their lifetimes. LSIS interviewers obtained information on age at first marriage by asking respondents the month and year, or their age, at which they started living with their first partner. The percentage of women and men who were first married by specific ages is shown in Tables MS.2.1 and MS. 2.2 according to age group and residence. The minimum legal age of marriage in Lao PDR is 18 for both women and men (Family Law of Lao PDR No. 05/NA dated 26 July 2008, Chapter 2, Article 9). Among women age 25-49, 37 per cent were married by the age of 18, and 58 per cent were married by the age of 20. The median age at first marriage among women age 25-49 is 19.2 years and has been relatively unchanged over the past two decades. Examining the percentages married before the age of 15 and 18 by different age groups allows us to see the trends in age at marriage over time. The percentage of women who married before the age of 18 slowly increased over time, from 32 per cent among the 45-49 age group to 41 per cent among the 25-29 age group, followed by a slight decrease in the 20-24 age group. However, fewer women in urban areas are getting married before the age of 18 than in rural areas. Men tend to be older than women when they get married. Among men age 25-49, only 15 per cent were married by the age of 18 and 30 per cent by the age of 20. The median age at marriage for men age 25-49 is 22.5 years; three years older than women in the same age range (19.2 years). The median age at marriage among urban men is about three years older than among rural men. More women marry before the age of 18 than men (37 per cent and 15 per cent, respectively). 5 45 15 18 20 22 25 15-19 5.4 na na na na 73.9 4,415 a 20-24 8.9 35.4 56.0 na na 27.9 3,617 19.4 25-29 11.7 40.7 58.8 71.6 86.0 9.7 3,642 19.0 30-34 11.5 37.8 58.4 73.9 86.0 5.1 3,015 19.2 35-39 10.8 37.8 58.9 74.8 86.7 3.6 3,065 19.1 40-44 9.9 35.9 56.4 73.6 86.5 3.1 2,507 19.3 45-49 8.6 32.1 53.6 70.0 84.5 2.6 2,215 19.7 25-49 10.6 37.3 57.5 72.9 86.0 5.2 14,444 19.2 15-19 1.6 na na na na 86.8 1,229 a 20-24 3.3 16.3 33.8 na na 46.9 1,127 a 25-29 5.7 24.3 39.0 53.7 74.7 18.5 1,115 21.5 30-34 5.2 21.6 38.2 55.4 73.3 10.7 899 21.3 35-39 6.4 26.8 46.8 65.0 79.7 5.9 881 20.3 40-44 5.8 26.2 45.7 66.1 82.5 5.0 734 20.4 45-49 5.6 27.2 49.4 66.7 83.5 4.5 664 20.1 25-49 5.7 25.0 43.2 60.5 78.1 9.8 4,293 20.7 15-19 6.9 na na na na 69.0 3,186 a 20-24 11.4 44.1 66.0 na na 19.4 2,490 18.5 25-29 14.3 48.0 67.5 79.6 90.9 5.8 2,527 18.2 30-34 14.1 44.7 67.0 81.7 91.4 2.8 2,116 18.5 35-39 12.5 42.3 63.7 78.8 89.6 2.7 2,184 18.7 40-44 11.5 39.9 60.9 76.8 88.2 2.4 1,773 18.9 45-49 9.8 34.2 55.4 71.4 84.9 1.8 1,551 19.5 25-49 12.7 42.6 63.6 78.1 89.3 3.3 10,151 18.7 Note: The age at first marriage is defined as the age at which the respondent began living with her first spouse/partner. na = Not applicable due to censoring a = Omitted because less than 50 percent of women began living with their spouse or partner for the first time before reaching the beginning of the age group Table MS.2.1: Age at first marriage Percentage of women age 15-49 who were first married by specific exact ages and median age at first marriage, according to current age, Lao PDR 2011-12 Age Percentage first married by exact age: Percentage never married Number of women Median age at first marriage TOTAL URBAN RURAL 5 46 15 18 20 22 25 15-19 1.8 na na na na 90.6 2,119 a 20-24 2.6 12.7 27.1 na na 51.4 1,557 a 25-29 3.0 16.7 31.3 46.2 68.4 18.1 1,500 22.5 30-34 4.3 16.0 33.1 48.8 69.6 6.7 1,264 22.2 35-39 3.2 14.3 28.1 45.7 69.5 3.6 1,445 22.4 40-44 3.8 15.6 30.2 47.1 71.2 1.8 1,043 22.3 45-49 3.0 11.8 24.0 37.4 61.7 1.5 1,023 23.5 25-49 3.4 15.0 29.6 45.4 68.3 7.0 6,275 22.5 15-19 1.6 na na na na 94.2 576 a 20-24 1.5 5.3 12.0 na na 70.1 463 a 25-29 1.4 9.2 15.7 28.3 50.8 31.3 426 24.9 30-34 3.0 6.3 17.6 31.4 50.9 13.3 382 24.8 35-39 1.3 5.0 15.7 32.0 55.3 7.1 373 24.5 40-44 1.5 10.3 20.1 32.9 60.8 2.6 263 23.9 45-49 2.4 8.8 17.7 25.6 50.6 3.4 317 24.9 25-49 1.9 7.8 17.1 30.0 53.2 13.0 1,761 24.6 15-19 1.9 na na na na 89.3 1,543 a 20-24 3.1 15.9 33.4 na na 43.5 1,094 a 25-29 3.6 19.7 37.5 53.4 75.4 12.8 1,074 21.5 30-34 4.8 20.2 39.8 56.4 77.7 3.8 882 21.2 35-39 3.9 17.5 32.4 50.5 74.4 2.4 1,072 21.9 40-44 4.6 17.4 33.6 51.9 74.7 1.6 780 21.8 45-49 3.3 13.2 26.8 42.7 66.6 0.7 706 22.9 25-49 4.0 17.9 34.4 51.4 74.1 4.7 4,514 21.8 Note: The age at first marriage is defined as the age at which the respondent began living with his first spouse/partner. na = Not applicable due to censoring a = Omitted because less than 50 percent of men began living with their spouse or partner for the first time before reaching the beginning of the age group Table MS.2.2: Age at first marriage Percentage of men age 15-49 who were first married by specific exact ages and median age at first marriage, according to current age, Lao PDR 2011-12 Age Percentage first married by exact age: Percentage never married Number of men Median age at first marriage TOTAL URBAN RURAL 5 47 Table MS.3 shows the median age at first marriage among women and men age 25-49, by background characteristics. Women and men age 15-24 are not included in this table because too few are married. Both women and men living in urban areas marry about two years later (20.7 and 22.6 years, respectively) than rural women and men (18.7 and 20.5 years, respectively). The median age at first marriage is a year younger in the North among both women and men compared with other regions, and ranges from a low of 18.2 years among women and 19.8 years among men in Huaphanh to a high of 21.2 years among women and 23.2 years among men in Vientiane Capital. Among both women and men, there is a difference of more than four years in the median age at marriage between those with no education (18.2 and 20.1 years, respectively) and those with post-secondary education (22.7 and 24.5 years, respectively). The median age at marriage is at roughly the same level in the poorest three wealth quintiles, but is about two-and-a-half years later among women and men in the richest quintile. Women and men in Lao-Tai headed households have the highest median age at marriage (19.7 and 21.5 years, respectively) while marriage among women and men in Hmong-Mien headed households occurs, on average, two years earlier (17.5 and 19.4 years, respectively). Women age 25-49 Men age 25-49 Women age 25-49 Men age 25-49 Region Women’s education North 18.5 20.4 None 18.2 20.1 Central 19.6 21.5 Primary 18.5 20.3 South 19.6 21.3 Lower secondary 19.6 21.3 Province Upper secondary 21.6 23.5 Vientiane Capital 21.2 23.2 Post secondary non tertiary 22.7 24.5 Phongsaly 19.0 20.7 Higher a a Luangnamtha 19.2 21.1 Wealth index quintile Oudomxay 18.5 20.4 Poorest 18.4 20.4 Bokeo 18.4 20.4 Second 18.3 20.2 Luangprabang 18.6 20.5 Middle 18.6 20.5 Huaphanh 18.2 19.8 Fourth 19.2 21.0 Xayabury 18.3 20.2 Richest 21.2 23.0 Xiengkhuang 18.8 20.5 Ethno-linguistic group of household head Vientiane 19.0 21.0 Lao-Tai 19.7 21.5 Borikhamxay 18.7 20.7 Mon-Khmer 18.2 20.1 Khammuane 19.1 21.1 Hmong-Mien 17.5 19.4 Savannakhet 18.9 20.9 Chinese-Tibetan 19.1 21.1 Saravane 18.9 20.5 Other, Missing, DK 20.1 21.8 Sekong 18.8 20.9 Champasack 20.3 21.9 Total 19.2 21.1 Attapeu 19.3 21.0 Residence Urban 20.7 22.6 Rural 18.7 20.5 .Rural with road 18.7 20.5 .Rural without road 18.6 20.5 Note: The age at first marriage is defined as the age at which the respondent began living with her/his first spouse/partner. a = Omitted because less than 50 percent of the respondents began living with their spouses/partners for the first time before reaching the beginning of the age group Table MS.3: Median age at first marriage Median age at first marriage among women and men age 25-49 years, Lao PDR 2011-12 5 48 Early Marriage Table MS.4.1 presents the percentage of women age 15-49 years who first married or entered a marital union before their fifteenth birthday, the percentages of women age 20-49 years who first married or entered a marital union before their fifteenth and eighteenth birthdays, and the percentage of women age 15-19 years currently married or in a union. Almost half (45 per cent) of women age 20-49 in the Northern region were married before the age of 18 compared with one third of women in the Central and South regions. The lowest proportions are found in Vientiane Capital (20 per cent) and the highest in Huaphanh (48 per cent). Almost twice as many women are married before 18 in rural areas (43 per cent) than urban areas (23 per cent). The strongest relationship to marriage before 18 is with education, where half of women age 20-49 with no education were married before 18 compared with only 2 per cent of women with some education. A similar inverse relationship is seen by wealth index quintiles. Nearly 6 in 10 women in Hmong-Mien headed households marry before the age of 18; the highest among all ethno-linguistic groups. One in four young women age 15-19 is currently married, with wide variation across provinces – varying from a low of 16 per cent in Vientiane Capital and 20 per cent in Champasack, to a high of 35 per cent in Phongsaly. The proportion currently married is quite different between urban (12 per cent) and rural (30 per cent) areas, and is strongly related to the level of education; 45 per cent of women age 15-19 years with no education are currently married compared with less than 1 per cent among women with some education. Similarly, the proportion of women age 15-19 currently married is high among the lowest wealth quintile (37 per cent) and low among the highest wealth quintiles (11 per cent). The highest percentage of women age 15-19 years currently married is among women in Hmong-Mien headed households (35 per cent). 5 49 Percentage married before age 151 Number of women age 15-49 years Percentage married before age 15 Percentage married before age 182 Number of women age 20-49 years Percentage of women 15-19 years currently married/in union3 Number of women age 15-19 years Region North 11.8 7,057 12.9 44.5 5,654 28.3 1,403 Central 8.2 11,255 9.2 33.4 9,130 22.4 2,125 South 8.1 4,164 8.9 33.8 3,277 24.5 887 Province Vientiane Capital 4.1 3,288 4.4 19.9 2,760 15.5 527 Phongsaly 9.9 666 10.0 40.3 542 35.4 124 Luangnamtha 11.1 627 11.7 39.3 505 27.4 123 Oudomxay 13.9 1,182 15.6 45.6 911 28.6 271 Bokeo 10.9 620 11.7 46.3 496 33.7 124 Luangprabang 11.4 1,473 12.4 42.2 1,226 26.8 248 Huaphanh 12.4 1,086 14.1 48.3 840 23.1 246 Xayabury 11.6 1,402 12.7 46.6 1,136 28.8 267 Xiengkhuang 9.0 930 9.9 41.3 679 23.6 252 Vientiane 8.3 1,677 9.3 38.9 1,393 25.2 284 Borikhamxay 9.8 901 10.8 43.1 717 23.6 184 Khammuane 9.8 1,082 10.8 37.3 876 25.0 206 Savannakhet 11.1 3,376 12.9 38.6 2,705 25.2 672 Saravane 12.9 1,456 13.7 40.5 1,148 30.0 308 Sekong 11.1 388 12.5 41.0 295 25.1 94 Champasack 3.8 1,943 4.5 26.6 1,541 19.9 402 Attapeu 9.0 376 9.3 37.8 294 26.1 83 Residence Urban 4.6 6,649 5.2 23.2 5,420 12.1 1,229 Rural 11.3 15,827 12.4 42.9 12,641 29.6 3,186 .Rural with road 11.2 14,268 12.3 42.8 11,412 29.4 2,856 .Rural without road 12.4 1,559 13.8 43.6 1,229 31.2 330 Education None 17.5 4,660 18.0 49.6 4,212 45.0 448 Primary 11.9 8,955 12.1 44.9 7,575 39.2 1,380 Lower secondary 4.0 4,111 4.7 32.3 2,861 22.2 1,250 Upper secondary 0.9 2,496 1.6 13.2 1,347 6.0 1,149 Post secondary non tertiary 1.6 1,030 1.6 6.4 980 (3.0) 51 Higher 0.7 1,224 0.8 1.8 1,087 0.8 137 Wealth index quintile Poorest 16.3 3,809 17.4 48.0 3,124 36.6 685 Second 13.5 4,088 14.6 46.5 3,227 33.1 860 Middle 9.6 4,309 11.3 42.3 3,390 25.6 919 Fourth 6.8 4,694 7.5 34.7 3,741 22.3 952 Richest 3.4 5,577 4.0 20.6 4,578 11.0 999 Ethno-linguistic group of household head Lao-Tai 6.5 15,151 7.2 31.8 12,323 20.3 2,827 Mon-Khmer 15.1 4,913 17.1 46.7 3,910 31.4 1,003 Hmong-Mien 17.2 1,606 19.1 57.0 1,193 35.1 413 Chinese-Tibetan 11.1 685 11.4 40.5 536 30.1 148 Other, Missing, DK 9.5 121 11.8 32.4 98 (52.3) 24 Total 9.3 22,476 10.3 37.0 18,061 24.7 4,415 Note: Figures in parentheses are based on 25-49 unweighted cases. Table MS.4.1: Early marriage Percentage of women age 15-49 years who first married or entered a marital union before their 15th birthday, percentages of women age 20-49 years who first married or entered a marital union before their 15th and 18th birthdays, and the percentage of women age 15-19 years currently married or in union, Lao PDR 2011-12 1 MICS indicator 8.6 2 MICS indicator 8.7 3 MICS indicator 8.8 Women age 15-49 Women age 20-49 Women age 15-19 5 50 Table MS.4.2 presents the same information for men, and shows that the patterns of marriage before 18 are largely the same as among women. Early marriage is more prevalent in the Northern region, and in the more remote rural areas. The strong relationships with education and with wealth quintiles seen among women are also seen among men. For example, 24 per cent of men with no education were married before 18 compared with only 3 per cent of men with some education. Nine per cent of young men age 15-19 are currently married, compared to 25 per cent of women of the same age. The provinces with the highest percentages are Phongsaly and Saravane (17 per cent). Differences are evident in relation to education, wealth quintile and ethno-linguistic group. The percentage of men age 15-19 who are currently married steadily decreases as their education increases (17 per cent among men with no education compared with only 3 per cent among men with higher education), and as wealth increases (17 per cent in the poorest quintile and 6 per cent in the richest). 5 51 Percentage married before age 151 Number of men age 15- 49 years Percentage married before age 15 Percentage married before age 182 Number of men age 20- 49 years Percentage of men 15-19 years currently married/in union3 Number of men age 15- 19 years Region North 3.1 3,172 3.5 18.0 2,554 10.6 617 Central 3.1 4,990 3.3 13.3 3,888 7.9 1,103 South 2.3 1,789 2.8 12.0 1,390 9.4 399 Province Vientiane Capital 2.5 1,379 2.7 7.6 1,130 6.4 249 Phongsaly 4.2 318 4.6 27.7 245 17.1 72 Luangnamtha 4.4 266 4.4 18.3 216 13.8 51 Oudomxay 3.4 530 4.0 21.1 414 13.6 116 Bokeo 4.8 267 5.1 16.0 220 11.5 48 Luangprabang 1.9 644 2.3 12.5 540 8.9 104 Huaphanh 2.5 511 3.2 21.8 380 8.9 131 Xayabury 2.5 635 3.0 14.6 539 4.2 96 Xiengkhuang 3.2 442 3.6 15.9 311 12.9 131 Vientiane 1.7 721 2.0 10.8 566 4.1 155 Borikhamxay 1.9 390 2.3 13.2 311 6.3 79 Khammuane 2.3 503 2.7 14.6 388 6.8 115 Savannakhet 4.9 1,556 5.0 18.8 1,182 9.4 374 Saravane 2.9 597 3.0 15.4 467 17.1 129 Sekong 2.7 162 3.3 11.8 121 7.8 41 Champasack 2.2 873 2.8 9.8 676 5.4 196 Attapeu 0.8 157 0.9 11.4 125 4.9 33 Residence Urban 1.8 2,800 1.8 7.3 2,224 5.6 576 Rural 3.4 7,151 3.8 17.5 5,608 10.2 1,543 .Rural with road 3.3 6,457 3.7 16.7 5,066 9.6 1,390 .Rural without road 4.9 694 4.8 24.3 542 16.3 152 Education None 6.2 923 6.1 24.0 822 17.2 101 Primary 4.4 3,872 4.7 20.1 3,260 16.4 613 Lower secondary 2.0 2,351 2.3 13.1 1,634 7.3 718 Upper secondary 1.1 1,450 1.5 4.8 836 3.0 614 Post secondary non tertiary 0.4 608 0.4 2.7 590 * 18 Higher 0.5 747 0.3 2.7 690 (3.0) 57 Wealth index quintile Poorest 4.5 1,692 4.7 22.8 1,379 16.6 313 Second 4.6 1,911 5.1 20.8 1,483 11.0 429 Middle 3.1 2,039 3.7 15.9 1,564 9.4 475 Fourth 1.9 2,092 2.2 9.5 1,608 4.5 484 Richest 1.3 2,217 1.2 6.5 1,799 5.9 418 Ethno-linguistic group of household head Lao-Tai 2.0 6,635 2.2 10.9 5,250 5.4 1,385 Mon-Khmer 4.8 2,191 5.2 20.4 1,722 13.3 470 Hmong-Mien 5.6 728 6.1 26.2 556 21.6 172 Chinese-Tibetan 5.6 335 6.1 25.6 259 16.4 76 Other, Missing, DK 3.1 62 4.2 (16.6) 45 * 17 Total 3.0 9,951 3.3 14.6 7,832 9.0 2,119 Table MS.4.2: Early marriage Percentage of men age 15-49 years who first married or entered a marital union before their 15th birthday, percentages of men age 20-49 years who first married or entered a marital union before their 15th and 18th birthdays, and the percentage of men age 15-19 years currently married or in union, Lao PDR 2011-12 Men age 15-49 Men age 20-49 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Figures in parentheses are based on 25-49 unweighted cases. Men age 15-19 1 MICS indicator 8.6 2 MICS indicator 8.7 3 MICS indicator 8.8 5 52 Spousal Age Difference Table MS.5 shows that about one in four women age 15-19 and age 20-24 is currently married to a man who is older by five to nine years (26 and 25 per cent, respectively), while 1 in 10 women of each age group is married to a man 10 or more years older (11 and 9 per cent, respectively). The highest proportions of women age 20-24 who married a man 10 or more years older are found in Vientiane Capital and Sekong (both 14 per cent) and in Vientiane province (12 per cent). A large age difference of 10 or more years between spouses is more prevalent in urban areas than rural areas, particularly for women age 20-24 (15 and 7 per cent, respectively). The prevalence of an age difference of 10 or more years is twice as high in the richest quintile than the poorest quintile among women age 15-19 and 20-24. 5 53 5 Y ou ng er 0- 4 ye ar s ol de r 5- 9 ye ar s ol de r 10 + ye ar s ol de r1 H us ba nd /p ar tn er 's a ge un kn ow n To ta l Y ou ng er 0- 4 ye ar s ol de r 5- 9 ye ar s ol de r 10 + ye ar s ol de r2 H us ba nd /p ar tn er 's a ge un kn ow n To ta l R eg io n N or th 7. 3 58 .6 22 .4 10 .0 1. 7 10 0. 0 39 7 13 .6 54 .5 22 .6 7. 4 1. 9 10 0. 0 92 3 C en tra l 9. 9 48 .6 28 .4 12 .4 0. 7 10 0. 0 47 7 10 .4 52 .7 26 .0 10 .5 0. 5 10 0. 0 1, 11 1 S ou th 4. 9 53 .9 29 .0 11 .6 0. 5 10 0. 0 21 8 14 .8 48 .9 25 .4 8. 3 2. 6 10 0. 0 43 3 P ro vi nc e V ie nt ia ne C ap ita l (1 7. 7) (2 6. 4) (3 6. 6) (1 9. 2) (0 .0 ) 10 0. 0 82 12 .0 48 .2 25 .1 13 .9 0. 7 10 0. 0 24 0 P ho ng sa ly 17 .8 70 .3 7. 6 4. 3 0. 0 10 0. 0 44 25 .4 51 .6 16 .0 6. 4 0. 6 10 0. 0 98 Lu an gn am th a 12 .0 58 .3 17 .9 10 .4 1. 5 10 0. 0 34 16 .6 56 .0 18 .0 8. 8 0. 7 10 0. 0 91 O ud om xa y 8. 6 51 .4 26 .4 12 .3 1. 2 10 0. 0 78 13 .2 50 .2 28 .4 6. 9 1. 3 10 0. 0 16 3 B ok eo 3. 0 52 .1 25 .8 10 .7 8. 3 10 0. 0 42 14 .4 46 .5 23 .5 9. 0 6. 6 10 0. 0 87 Lu an gp ra ba ng 1. 3 55 .9 22 .2 20 .6 0. 0 10 0. 0 66 12 .2 53 .4 25 .9 7. 4 1. 1 10 0. 0 16 4 H ua ph an h 10 .5 70 .6 16 .2 1. 1 1. 6 10 0. 0 57 10 .1 60 .0 19 .9 6. 7 3. 3 10 0. 0 13 0 X ay ab ur y 2. 8 56 .3 31 .5 8. 0 1. 4 10 0. 0 77 9. 8 59 .8 21 .5 7. 5 1. 3 10 0. 0 19 0 X ie ng kh ua ng 8. 8 55 .1 24 .5 11 .6 0. 0 10 0. 0 60 8. 7 61 .4 25 .1 4. 9 0. 0 10 0. 0 10 6 V ie nt ia ne 5. 1 46 .5 38 .6 8. 0 1. 7 10 0. 0 71 6. 9 50 .7 30 .2 12 .2 0. 0 10 0. 0 18 7 B or ik ha m xa y 5. 6 51 .2 29 .8 13 .4 0. 0 10 0. 0 43 12 .8 45 .1 31 .1 9. 3 1. 6 10 0. 0 97 K ha m m ua ne 10 .9 55 .4 28 .2 5. 5 0. 0 10 0. 0 52 10 .5 61 .5 22 .8 5. 2 0. 0 10 0. 0 12 1 S av an na kh et 9. 4 55 .0 21 .1 13 .1 1. 3 10 0. 0 16 9 10 .9 53 .1 24 .3 11 .1 0. 6 10 0. 0 36 0 S ar av an e 6. 5 48 .0 32 .2 12 .6 0. 7 10 0. 0 92 19 .2 48 .8 20 .8 6. 4 4. 8 10 0. 0 18 3 S ek on g 14 .1 40 .6 28 .8 14 .1 2. 4 10 0. 0 24 12 .4 42 .5 27 .3 14 .1 3. 8 10 0. 0 40 C ha m pa sa ck 0. 8 64 .5 24 .4 10 .2 0. 0 10 0. 0 80 11 .5 51 .1 28 .2 8. 6 0. 6 10 0. 0 16 6 A tta pe u 3. 5 54 .8 32 .5 9. 2 0. 0 10 0. 0 21 11 .7 47 .1 32 .0 9. 2 0. 0 10 0. 0 44 R es id en ce U rb an 7. 0 42 .6 31 .4 17 .5 1. 5 10 0. 0 14 8 7. 8 49 .2 27 .6 14 .7 0. 7 10 0. 0 56 7 R ur al 8. 1 55 .0 25 .5 10 .4 1. 0 10 0. 0 94 3 13 .7 53 .7 23 .7 7. 2 1. 6 10 0. 0 1, 90 1 .R ur al w ith ro ad 7. 7 53 .5 27 .0 10 .7 1. 0 10 0. 0 84 0 12 .9 53 .8 24 .3 7. 4 1. 5 10 0. 0 1, 74 5 .R ur al w ith ou t r oa d 11 .3 67 .2 13 .0 7. 9 0. 6 10 0. 0 10 3 22 .7 53 .0 17 .1 5. 1 2. 1 10 0. 0 15 6 P er ce nt d is tri bu tio n of w om en c ur re nt ly m ar rie d/ in u ni on a ge 1 5- 19 a nd 2 0- 24 y ea rs a cc or di ng to th e ag e di ffe re nc e w ith th ei r h us ba nd o r p ar tn er , L ao P D R 2 01 1- 12 Ta bl e M S .5 : S po us al a ge d iff er en ce P er ce nt ag e of c ur re nt ly m ar ri ed /in u ni on w om en a ge 20 -2 4 ye ar s w ho se h us ba nd o r pa rt ne r is : P er ce nt ag e of c ur re nt ly m ar ri ed /in u ni on w om en a ge 1 5- 19 y ea rs w ho se h us ba nd o r pa rt ne r is : N um be r o f w om en a ge 20 -2 4 ye ar s cu rr en tly m ar rie d/ in u ni on N um be r o f w om en a ge 15 -1 9 ye ar s cu rr en tly m ar rie d/ in u ni on 1 M IC S in di ca to r 8. 10 a 2 M IC S in di ca to r 8. 10 b N ot e: A n as te ris k in di ca te s th at a fi gu re is b as ed o n fe w er th an 2 5 un w ei gh te d ca se s an d ha s be en s up pr es se d. F ig ur es in p ar en th es es a re b as ed o n 25 -4 9 un w ei gh te d ca se s. 54 5 Y ou ng er 0- 4 ye ar s ol de r 5- 9 ye ar s ol de r 10 + ye ar s ol de r1 H us ba nd /p ar tn er 's a ge un kn ow n To ta l Y ou ng er 0- 4 ye ar s ol de r 5- 9 ye ar s ol de r 10 + ye ar s ol de r2 H us ba nd /p ar tn er 's a ge un kn ow n To ta l E du ca tio n N on e 11 .0 58 .5 16 .2 11 .2 3. 1 10 0. 0 20 2 16 .3 54 .3 19 .3 7. 5 2. 6 10 0. 0 50 4 P rim ar y 7. 2 51 .4 29 .8 11 .2 0. 4 10 0. 0 54 1 12 .3 51 .7 26 .4 8. 2 1. 4 10 0. 0 1, 04 7 Lo w er s ec on da ry 7. 1 53 .2 27 .9 11 .2 0. 6 10 0. 0 27 7 9. 8 49 .5 28 .8 11 .2 0. 7 10 0. 0 48 3 U pp er s ec on da ry 9. 3 52 .6 23 .1 13 .2 1. 8 10 0. 0 69 10 .6 54 .6 23 .4 11 .0 0. 4 10 0. 0 25 8 P os t s ec on da ry n on te rti ar y * * * * * * 2 10 .6 56 .6 26 .2 6. 6 0. 0 10 0. 0 79 H ig he r * * * * * * 1 12 .1 62 .0 13 .9 10 .0 2. 0 10 0. 0 97 W ea lth in de x qu in til e P oo re st 11 .3 55 .1 21 .4 10 .1 2. 1 10 0. 0 25 1 18 .0 52 .0 20 .9 6. 5 2. 6 10 0. 0 53 6 S ec on d 8. 3 58 .4 21 .8 10 .7 0. 7 10 0. 0 28 5 12 .7 54 .3 23 .2 8. 2 1. 5 10 0. 0 53 4 M id dl e 3. 6 56 .5 30 .5 9. 3 0. 1 10 0. 0 23 5 12 .7 53 .8 25 .8 6. 9 0. 8 10 0. 0 46 4 Fo ur th 6. 7 46 .3 33 .0 12 .1 1. 9 10 0. 0 21 2 8. 3 51 .8 27 .8 10 .8 1. 3 10 0. 0 47 2 R ic he st 11 .1 42 .6 27 .2 19 .0 0. 0 10 0. 0 10 9 9. 3 51 .5 26 .0 12 .8 0. 5 10 0. 0 46 1 E th no -li ng ui st ic g ro up o f h ou se ho ld h ea d La o- Ta i 6. 4 48 .9 31 .7 12 .5 0. 6 10 0. 0 57 5 9. 7 53 .2 26 .2 9. 9 1. 0 10 0. 0 1, 50 8 M on -K hm er 9. 0 57 .2 20 .5 12 .5 0. 8 10 0. 0 31 5 16 .2 47 .7 25 .8 8. 5 1. 8 10 0. 0 61 1 H m on g- M ie n 9. 0 61 .1 20 .7 7. 0 2. 2 10 0. 0 14 5 12 .5 60 .6 17 .9 6. 8 2. 2 10 0. 0 23 1 C hi ne se -T ib et an 20 .0 54 .5 16 .9 3. 7 4. 8 10 0. 0 45 24 .8 56 .4 12 .0 3. 3 3. 5 10 0. 0 10 0 O th er , M is si ng , D K * * * * * * 12 * * * * * * 19 To ta l 8. 0 53 .3 26 .3 11 .4 1. 1 10 0. 0 1, 09 2 12 .4 52 .7 24 .6 9. 0 1. 4 10 0. 0 2, 46 8 Ta bl e M S .5 : S po us al a ge d iff er en ce P er ce nt d is tri bu tio n of w om en c ur re nt ly m ar rie d/ in u ni on a ge 1 5- 19 a nd 2 0- 24 y ea rs a cc or di ng to th e ag e di ffe re nc e w ith th ei r h us ba nd o r p ar tn er , L ao P D R 2 01 1- 12 N ot e: A n as te ris k in di ca te s th at a fi gu re is b as ed o n fe w er th an 2 5 un w ei gh te d ca se s an d ha s be en s up pr es se d. F ig ur es in p ar en th es es a re b as ed o n 25 -4 9 un w ei gh te d ca se s. 2 M IC S in di ca to r 8. 10 b 1 M IC S in di ca to r 8. 10 a P er ce nt ag e of c ur re nt ly m ar ri ed /in u ni on w om en a ge 1 5 - 19 y ea rs w ho se h us ba nd o r pa rt ne r is : N um be r o f w om en a ge 15 -1 9 ye ar s cu rr en tly m ar rie d/ in u ni on P er ce nt ag e of c ur re nt ly m ar ri ed /in u ni on w om en a ge 20 -2 4 ye ar s w ho se h us ba nd o r pa rt ne r is : N um be r o f w om en a ge 20 -2 4 ye ar s cu rr en tly m ar rie d/ in u ni on 55 Attitudes toward Domestic Violence Women and men age 15-49 were asked a number of questions to assess their attitudes towards whether husbands are justified in hitting or beating their wives or partners in a variety of scenarios. These questions were asked to provide an indication of cultural beliefs that tend to be associated with the prevalence of violence against women by their husbands or partners. The main assumption is that respondents that agree with the statements indicating that husbands or partners are justified in beating their wives or partners tend in reality to experience violence in their own marital relationships. The responses to these questions can be found in Tables MS.6.1 and MS.6.2. A higher proportion of women (58 per cent) than men (49 per cent) feel that a husband or partner has a right to hit or beat his wife or partner for at least one of the reasons presented. Women and men most commonly agree and justify violence in instances when the woman neglects the children (46 per cent of women and 35 per cent of men). Some women and men also agree a husband is justified in beating his wife if she demonstrates her autonomy, for example, by going out without telling her husband (32 per cent of women and 25 per cent of men) or arguing with him (27 per cent of women and 25 per cent of men). Around a quarter of women and a fifth of men believe that a husband has a right to hit or beat his wife or partner if she refuses to have sex with him. The least common response justifying beating relates to when the wife burns the food (19 per cent of women and 14 per cent of men). Disaggregation of the results by region shows that the percentage of respondents who believe that beating of the spouse or partner is justified is highest in the South (64 per cent of women and 56 per cent of men) and lowest in the North (52 per cent of women and 43 per cent of men). For women, the acceptance of domestic violence is highest in Sekong (91 per cent) and Xiengkhuang (80 per cent). For men, reported acceptance is not as high as it is among women, but still reaches 79 per cent in Sekong and 77 per cent in Huaphanh. It is interesting to note that the proportion of women expressing accepting attitudes towards wife beating is higher than the proportion of men, at all ages. However, between women and men, no differences are seen by age group in attitudes towards domestic violence. The acceptance of both women and men to wife beating varies little with respect to education and household wealth. By ethno-linguistic group, accepting attitudes toward wife beating are most common among women in Hmong-Mien headed households (69 per cent) and men in Mon-Khmer headed households (53 per cent). 5 56 If she goes out without telling him If she neglects the children If she argues with him If she refuses sex with him If she burns the food For any of these reasons1 Region North 22.0 37.7 21.4 24.9 16.0 51.7 7,057 Central 33.7 48.9 32.1 26.3 21.6 60.1 11,255 South 44.9 53.2 22.0 21.1 19.0 64.1 4,164 Province Vientiane Capital 21.1 40.2 18.6 16.2 12.1 54.4 3,288 Phongsaly 19.8 21.7 19.0 20.5 14.9 39.0 666 Luangnamtha 11.9 33.4 13.9 5.9 9.8 42.0 627 Oudomxay 15.9 27.5 15.4 13.5 7.2 38.3 1,182 Bokeo 32.2 54.0 35.6 39.5 23.8 69.1 620 Luangprabang 17.4 39.7 27.1 22.0 25.7 57.1 1,473 Huaphanh 36.0 61.3 23.8 53.2 17.7 76.8 1,086 Xayabury 22.3 28.3 16.6 19.9 11.7 40.5 1,402 Xiengkhuang 47.0 70.8 53.7 51.9 35.7 80.1 930 Vientiane 34.6 52.7 28.2 25.8 18.4 59.6 1,677 Borikhamxay 13.1 25.5 9.0 11.9 18.1 34.6 901 Khammuane 47.5 60.4 45.1 37.4 29.3 74.3 1,082 Savannakhet 42.9 52.0 43.2 29.7 27.0 62.6 3,376 Saravane 14.4 24.4 14.3 15.0 6.4 33.4 1,456 Sekong 86.2 78.5 47.4 28.2 65.1 91.4 388 Champasack 56.8 66.3 23.5 21.9 19.6 79.7 1,943 Attapeu 58.4 71.0 17.2 33.5 16.9 74.9 376 Residence Urban 29.6 46.0 25.1 19.7 17.4 57.1 6,649 Rural 33.2 46.3 27.5 27.1 20.2 58.7 15,827 .Rural with road 32.7 46.3 27.5 27.0 20.0 58.4 14,268 .Rural without road 37.0 46.6 27.7 27.8 21.6 61.4 1,559 Age 15-19 28.9 44.2 25.5 21.5 17.4 56.4 4,415 20-24 31.3 44.9 26.8 23.8 17.6 57.2 3,617 25-29 32.0 47.9 26.1 25.4 19.6 58.6 3,642 30-34 31.5 46.0 27.0 26.2 18.5 58.4 3,015 35-39 34.9 49.0 28.3 28.4 22.7 61.1 3,065 40-44 34.8 45.9 27.3 25.3 20.2 58.1 2,507 45-49 33.7 46.5 28.0 25.7 21.2 58.5 2,215 Marital/Union status Currently married/in union 33.5 47.4 27.6 27.2 20.5 59.4 16,368 Formerly married/in union 32.8 46.4 28.3 22.4 19.0 57.6 1,077 Never married/in union 27.5 42.2 23.9 18.1 15.8 54.5 5,031 Education None 33.8 44.9 29.6 28.6 23.5 57.0 4,660 Primary 34.2 46.5 27.5 27.7 21.3 59.2 8,955 Lower secondary 32.5 49.4 26.7 24.9 17.4 61.0 4,111 Upper secondary 28.7 47.6 25.2 18.2 14.4 58.4 2,496 Post secondary non tertiary 27.0 42.2 22.5 18.4 16.2 54.0 1,030 Higher 20.6 38.5 18.7 10.2 8.7 49.1 1,224 Wealth index quintile Poorest 32.4 43.7 27.5 28.4 23.1 56.2 3,809 Second 34.1 45.3 29.2 28.5 21.4 57.7 4,088 Middle 32.8 47.2 26.7 26.5 19.9 58.5 4,309 Fourth 33.5 48.0 27.5 25.8 19.1 60.4 4,694 Richest 28.7 46.3 24.2 18.0 15.1 57.9 5,577 Ethno-linguistic group of household head Lao-Tai 32.2 47.2 26.1 23.8 17.5 59.2 15,151 Mon-Khmer 30.6 41.4 25.9 23.8 20.8 53.1 4,913 Hmong-Mien 42.7 58.9 40.6 42.9 33.3 69.4 1,606 Chinese-Tibetan 19.0 31.9 16.8 16.2 16.7 47.7 685 Other, Missing, DK 14.8 34.1 26.3 24.5 17.0 50.5 121 Total 32.1 46.2 26.8 24.9 19.4 58.2 22,476 Table MS.6.1: Attitudes toward domestic violence 1 MICS indicator 8.14 Percentage of women age 15-49 years who believe a husband is justified in beating his wife/partner in various circumstances, Lao PDR 2011- 12 Number of women age 15-49 years Percentage of women age 15-49 years who believe a husband is justified in beating his wife/partner: 5 57 If she goes out without telling him If she neglects the children If she argues with him If she refuses sex with him If she burns the food For any of these reasons1 Region North 18.8 28.3 22.0 16.2 8.0 42.9 3,172 Central 27.5 38.6 28.1 22.0 16.4 50.7 4,990 South 30.6 39.3 20.6 24.7 15.5 55.8 1,789 Province Vientiane Capital 18.2 30.0 20.8 15.4 13.6 44.6 1,379 Phongsaly 10.5 6.3 10.8 7.3 7.9 24.1 318 Luangnamtha 26.1 20.9 23.8 15.6 15.4 37.6 266 Oudomxay 7.4 8.4 17.8 8.9 1.5 26.8 530 Bokeo 18.0 38.1 27.9 26.2 8.0 55.2 267 Luangprabang 24.3 45.2 41.6 11.5 11.1 60.0 644 Huaphanh 35.7 63.7 17.9 46.9 12.8 76.8 511 Xayabury 10.4 9.3 11.4 2.6 3.5 18.2 635 Xiengkhuang 8.4 22.3 9.7 11.7 4.7 32.1 442 Vientiane 11.2 30.1 20.8 14.2 6.8 39.6 721 Borikhamxay 18.0 19.6 18.5 14.8 4.3 23.5 390 Khammuane 44.5 57.6 42.2 35.2 25.5 70.3 503 Savannakhet 45.6 53.4 41.0 31.9 26.6 67.0 1,556 Saravane 33.9 43.4 22.9 44.4 19.2 72.8 597 Sekong 62.6 54.7 30.1 29.7 16.8 78.7 162 Champasack 26.5 35.0 20.6 13.3 15.1 43.4 873 Attapeu 7.8 31.5 1.9 8.4 1.7 36.8 157 Residence Urban 28.2 38.0 27.6 19.0 16.9 49.5 2,800 Rural 24.1 34.4 23.7 21.2 12.3 49.0 7,151 .Rural with road 24.1 34.5 23.7 21.4 12.4 49.2 6,457 .Rural without road 24.4 33.9 23.9 19.3 10.7 46.8 694 Age 15-19 25.7 36.2 25.9 20.3 13.3 50.3 2,119 20-24 24.4 35.2 24.4 19.9 12.3 47.6 1,557 25-29 26.6 37.0 24.8 22.2 14.9 51.3 1,500 30-34 25.6 34.5 25.0 20.4 12.8 48.7 1,264 35-39 24.7 35.7 24.7 20.6 14.6 49.5 1,445 40-44 25.3 35.6 23.5 19.7 13.1 47.9 1,043 45-49 24.1 32.5 24.2 21.4 13.9 47.0 1,023 Marital/Union status Currently married/in union 24.9 34.9 24.0 21.0 13.4 49.0 6,611 Formerly married/in union 29.7 47.0 35.7 27.7 17.5 59.7 177 Never married/in union 25.8 35.8 25.8 19.4 13.7 48.8 3,163 Education None 31.8 38.2 27.7 27.7 17.1 57.3 923 Primary 26.8 36.2 25.7 23.2 14.0 50.6 3,872 Lower secondary 23.4 34.7 24.0 18.6 12.0 47.7 2,351 Upper secondary 23.3 33.7 23.6 17.4 13.1 46.0 1,450 Post secondary non tertiary 22.0 33.7 21.7 17.8 14.4 43.0 608 Higher 21.6 34.9 24.2 13.7 12.0 47.1 747 Wealth index quintile Poorest 25.7 34.0 25.3 23.3 12.0 50.7 1,692 Second 26.7 36.7 24.6 24.4 13.2 52.3 1,911 Middle 24.4 34.1 24.7 20.9 11.7 48.7 2,039 Fourth 24.7 34.9 23.7 19.3 14.1 46.0 2,092 Richest 25.1 37.2 25.7 16.3 16.2 48.5 2,217 Ethno-linguistic group of household head Lao-Tai 25.9 36.3 24.3 19.7 14.6 48.6 6,635 Mon-Khmer 25.6 35.1 27.4 23.6 12.3 52.7 2,191 Hmong-Mien 21.3 36.0 23.9 21.6 10.1 49.2 728 Chinese-Tibetan 18.7 17.4 18.5 15.0 9.7 34.6 335 Other, Missing, DK 24.5 46.7 28.0 29.0 11.9 62.5 62 Total 25.3 35.4 24.8 20.6 13.5 49.1 9,951 1 MICS indicator 8.14 Table MS.6.2: Attitudes toward domestic violence Percentage of men age 15-49 years who believe a husband is justified in beating his wife/partner in various circumstances, Lao PDR 2011-12 Percentage of men age 15-49 years who believe a husband is justified in beating his wife/partner: Number of men age 15- 49 years 5 58 Age at First Sexual Intercourse Although age at first marriage is often used as a proxy for first exposure to sexual intercourse, the two events do not necessarily coincide. In the 2011-12 LSIS, interviewers asked women and men how old they were when they first had sexual intercourse. The percentage of women and men who first had sexual intercourse by specific ages is shown in Tables MS.7.1 and MS.7.2. Among women age 25-49, 9 per cent first had sexual intercourse before the age of 15, 40 per cent before 18, and by age 25 the majority of women (87 per cent) have had sexual intercourse. The median age at first sexual intercourse among women age 25-49 years is 18.8 years, which is slightly lower than the median age at first marriage of 19.2 years seen in Table MS.3. Similar to median age at first marriage, the median age at first sexual intercourse has been relatively unchanged over the past two decades. As is the case with age at first marriage, men tend to initiate sexual activity at slightly older ages than women. The median age at first sex among men age 25-49 is 19.6 years; about a year older than women. The median ages at first intercourse among the different age cohorts suggest no significant change in age at first sexual intercourse among men over the past 20 years. The median age at first sexual intercourse among men age 25-49 years is 19.6 years – almost three years earlier than the median age at first marriage (22.5 years), as seen in Table MS.3. Three in ten men had sexual intercourse before age 18 compared with 4 in 10 women. 15 18 20 22 25 Age 15-19 5.2 na na na na 72.4 4,415 a 20-24 7.9 35.8 58.7 na na 25.9 3,617 19.2 25-29 9.2 40.0 60.5 73.3 86.1 8.9 3,642 18.9 30-34 10.1 40.9 63.5 76.9 86.7 4.8 3,015 18.7 35-39 8.5 40.4 62.8 76.5 87.9 3.7 3,065 18.8 40-44 9.1 39.6 61.8 75.4 87.8 3.0 2,507 18.8 45-49 7.1 36.3 59.9 74.9 87.0 2.7 2,215 19.1 25-49 8.9 39.6 61.7 75.3 87.0 5.0 14,444 18.8 na = Not applicable due to censoring a = Omitted because less than 50 percent of the respondents had sexual intercourse for the first time before reaching the beginning of the age group Table MS.7.1: Age at first sexual intercourse Percentage of women age 15-49 who had first sexual intercourse by specific exact ages, percentage who never had sexual intercourse, and median age at first sexual intercourse, according to current age, Lao PDR 2011-12 Percentage who had first sexual intercourse by exact age: Percentage who never had sexual intercourse Number of women Median age at first sexual intercourse 5 59 15 18 20 22 25 Age 15-19 2.9 na na na na 77.1 2,119 a 20-24 2.4 27.9 54.5 na na 26.4 1,557 19.6 25-29 3.4 33.0 56.2 74.3 88.7 5.0 1,500 19.3 30-34 3.2 31.1 56.3 73.2 86.2 2.5 1,264 19.4 35-39 3.6 29.6 53.3 71.4 84.5 1.6 1,445 19.6 40-44 3.0 26.2 51.5 71.4 85.7 0.9 1,043 19.7 45-49 3.1 26.2 46.9 64.3 79.8 0.8 1,023 20.2 25-49 3.3 29.6 53.3 71.3 85.3 2.3 6,275 19.6 na = Not applicable due to censoring a = Omitted because less than 50 percent of the respondents had sexual intercourse for the first time before reaching the beginning of the age group Table MS.7.2: Age at first sexual intercourse Percentage of men age 15-49 who had first sexual intercourse by specific exact ages, percentage who never had sexual intercourse, and median age at first sexual intercourse, according to current age, Lao PDR 2011-12 Percentage who had first sexual intercourse by exact age: Percentage who never had sexual intercourse Number of men Median age at first sexual intercourse Median age at first sex is shown in Table MS.8 in relation to respondent background characteristics. The median age at first sex is the same among women and men in urban areas at 20.6 years, but differs by a year in rural areas (18.2 years among women and 19.2 years among men). The median age at first sexual intercourse is lowest in the Northern region (17.9 years among women and 18.5 years among men) and highest in the Southern region (19.7 years among women and 21.1 years among men). The median age at first sexual intercourse rises with levels of education and wealth. Women with post-secondary education first had sex, on average, five years later than women with no education (22.8 years and 17.4 years, respectively). A similar pattern is seen among men, although the difference is only about two years. Similarly, the median age at first sex is almost four years later among women in the richest wealth quintile than among women in the poorest, and the same pattern of later sexual initiation with increasing wealth is seen among men. 5 60 Women age 25-49 Men age 25-49 Women age 25-49 Men age 25-49 Region Women’s education North 17.9 18.5 None 17.4 18.4 Central 19.2 19.9 Primary 18.3 19.1 South 19.7 21.1 Lower secondary 19.4 19.7 Province Upper secondary 21.8 20.6 Vientiane Capital 21.2 20.8 Post secondary non tertiary 22.8 20.8 Phongsaly 18.3 16.7 Higher a 21.1 Luangnamtha 17.3 18.3 Wealth index quintile Oudomxay 17.9 19.7 Poorest 17.5 18.5 Bokeo 17.9 18.3 Second 17.8 18.7 Luangprabang 18.4 18.8 Middle 18.4 19.4 Huaphanh 16.8 17.0 Fourth 19.0 20.1 Xayabury 18.2 19.7 Richest 21.2 20.8 Xiengkhuang 18.2 19.2 Ethno-linguistic group of household head Vientiane 18.8 19.7 Lao-Tai 19.4 20.2 Borikhamxay 18.8 19.1 Mon-Khmer 17.6 18.9 Khammuane 18.8 19.9 Hmong-Mien 16.9 17.7 Savannakhet 18.2 19.7 Chinese-Tibetan 17.4 16.9 Saravane 18.9 20.4 Other, Missing, DK 19.8 22.3 Sekong 18.8 21.7 Champasack 20.7 22.1 Total 18.8 19.6 Attapeu 18.8 19.0 Residence Urban 20.6 20.6 Rural 18.2 19.2 .Rural with road 18.3 19.2 .Rural without road 18.0 18.8 a = Omitted because less than 50 percent of the respondents had sexual intercourse for the first time before reaching the beginning of the age group Table MS.8: Median age at first sexual intercourse Median age at first sexual intercourse among women and men age 25-49 years, Lao PDR 2011-12 5 61 Recent Sexual Activity In the absence of contraception, the probability of pregnancy is related to coital frequency. Therefore, information on sexual activity can be used to refine measures of exposure to the risk of pregnancy. Interviewers asked women and men how long ago their last sexual activity occurred. Tables MS.9.1 and MS.9.2 show the per cent distributions of women and men age 15-49 by recent sexual activity. Sixty-three per cent of all women age 15-49 were sexually active in the four weeks before the survey, 10 per cent had been sexually active in the year before the survey but not in the four weeks prior to the interview, and 5 per cent had been sexually active at some time in their lives but not within the previous year. One in every five women (22 per cent) had never had sexual intercourse. The proportion of women who were sexually active during the four weeks before the survey at first increases with age, from 22 per cent among those age 15-19 to 82 per cent among those age 35-39, and then decreases to 69 per cent among those age 45-49. For currently married women, 87 per cent have been sexually active in the four weeks preceding the survey, compared with 3 per cent of formerly married women and 1 per cent of women who have never been married. More rural women are recently sexually active (67 per cent) than urban women (55 per cent). Seven in ten women residing in the Northern region were recently sexually active, compared to 6 in 10 in the other two regions. Substantially more women with no education (76 per cent) were sexually active in the recent past than women with some education (33 per cent). Among wealth quintiles the richest women reported being sexually active in the past four weeks the least (53 per cent). The patterns seen are partially a reflection of the percentages of women who are currently married in each group, but this does not fully explain the differences. 5 62 Within the past 4 weeks Within 1 year* One or more years** Missing Never had sexual intercourse Region North 70.2 7.6 4.2 0.2 17.8 100.0 7,057 Central 60.1 11.3 5.1 0.2 23.4 100.0 11,255 South 60.9 9.3 6.6 0.4 22.8 100.0 4,164 Province Vientiane Capital 51.4 13.5 5.7 0.3 29.2 100.0 3,288 Phongsaly 71.8 9.7 3.6 0.3 14.6 100.0 666 Luangnamtha 73.9 4.7 5.6 0.2 15.6 100.0 627 Oudomxay 64.9 9.8 4.2 0.1 21.1 100.0 1,182 Bokeo 73.0 5.4 4.4 0.3 17.0 100.0 620 Luangprabang 67.1 9.9 4.4 0.4 18.1 100.0 1,473 Huaphanh 73.2 5.7 2.9 0.1 18.1 100.0 1,086 Xayabury 72.1 6.2 4.4 0.0 17.3 100.0 1,402 Xiengkhuang 64.3 7.7 2.3 0.0 25.8 100.0 930 Vientiane 67.0 10.1 4.4 0.0 18.6 100.0 1,677 Borikhamxay 67.5 7.2 3.8 0.2 21.3 100.0 901 Khammuane 62.5 11.5 5.8 0.2 20.1 100.0 1,082 Savannakhet 61.2 11.9 5.7 0.2 21.1 100.0 3,376 Saravane 61.1 9.7 7.4 0.6 21.2 100.0 1,456 Sekong 56.8 11.8 6.9 0.1 24.4 100.0 388 Champasack 60.2 8.9 6.2 0.4 24.2 100.0 1,943 Attapeu 67.6 7.5 4.7 0.0 20.2 100.0 376 Residence Urban 55.0 10.4 5.4 0.3 28.8 100.0 6,649 Rural 66.9 9.5 4.9 0.2 18.5 100.0 15,827 .Rural with road 66.6 9.6 5.0 0.2 18.6 100.0 14,268 .Rural without road 69.9 8.9 4.2 0.2 16.8 100.0 1,559 Age 15-19 21.6 5.3 0.8 0.1 72.3 100.0 4,415 20-24 58.3 12.1 3.6 0.2 25.8 100.0 3,617 25-29 76.1 11.1 3.9 0.0 8.9 100.0 3,642 30-34 80.1 10.2 4.7 0.2 4.8 100.0 3,015 35-39 82.0 8.2 5.9 0.3 3.6 100.0 3,065 40-44 78.3 9.4 8.9 0.4 2.9 100.0 2,507 45-49 68.9 15.1 12.9 0.5 2.6 100.0 2,215 Marital/Union status Currently married/in union 86.5 11.8 1.5 0.2 0.1 100.0 16,368 Formerly married/in union 2.9 17.1 78.2 1.7 0.0 100.0 1,077 Never married/in union 1.3 1.8 0.9 0.1 96.0 100.0 5,031 Marital duration*** 0-4 years 82.0 17.4 0.5 0.0 0.1 100.0 3,151 5-9 years 88.0 10.7 1.1 0.1 0.0 100.0 2,679 10-14 years 89.6 8.6 1.6 0.2 0.1 100.0 2,891 15-19 years 91.3 6.9 1.6 0.2 0.0 100.0 2,327 20-24 years 88.4 9.6 1.8 0.2 0.0 100.0 2,071 25+ years 82.1 14.6 2.9 0.3 0.1 100.0 1,834 Married more than once 82.4 15.1 2.2 0.2 0.1 100.0 1,416 Education None 75.5 9.1 6.9 0.3 8.2 100.0 4,660 Primary 71.5 10.1 5.1 0.2 13.1 100.0 8,955 Lower secondary 58.1 9.3 4.8 0.3 27.5 100.0 4,111 Upper secondary 37.0 8.5 2.6 0.0 51.9 100.0 2,496 Post secondary non tertiary 60.3 14.8 5.5 0.1 19.3 100.0 1,030 Higher 32.8 10.1 3.4 0.1 53.6 100.0 1,224 Wealth index quintile Poorest 70.7 8.8 6.2 0.1 14.1 100.0 3,809 Second 68.9 8.3 5.1 0.2 17.4 100.0 4,088 Middle 65.6 9.2 4.4 0.5 20.3 100.0 4,309 Fourth 62.6 10.1 5.1 0.1 22.1 100.0 4,694 Richest 53.4 11.7 4.7 0.1 30.1 100.0 5,577 Ethno-linguistic group of household head Lao-Tai 61.2 10.5 5.1 0.2 22.9 100.0 15,151 Mon-Khmer 67.0 8.7 5.5 0.3 18.6 100.0 4,913 Hmong-Mien 69.6 7.2 3.6 0.1 19.6 100.0 1,606 Chinese-Tibetan 70.8 7.7 4.7 0.3 16.5 100.0 685 Other, Missing, DK 68.2 10.3 5.6 0.0 15.8 100.0 121 Total 63.4 9.8 5.1 0.2 21.5 100.0 22,476 * Excludes women who had sexual intercourse within the past 4 weeks ** Excludes women who had sexual intercourse within the past 4 weeks or within 1 year *** Excludes women who are not currently married Table MS.9.1: Recent sexual activity Percent distribution of women age 15-49 by timing of last sexual intercourse, Lao PDR 2011-12 Timing of last sexual intercourse Total Number of women 5 63 Among men age 15-49, 64 per cent were sexually active in the four weeks preceding the survey, 12 per cent had had sexual intercourse in the year before the survey but not in the four weeks prior to the survey, and 2 per cent had been sexually active at some time in their lives, but not within the previous year. Twenty-two per cent of men reported they had never had sex – the same proportion as among women. As with women, men’s recent sexual activity at first increases with age, peaks in the late thirties and the early forties (88 per cent), and then declines. Ninety per cent of men currently married/in a union reported recent sexual activity. The proportions of formerly married men who had had recent sexual activity (30 per cent) and of men who have never been married (12 per cent) is higher than those of women with the same marital status. The patterns seen by residence, education, wealth, and ethno-linguistic group are similar to those seen among women. 5 64 Within the past 4 weeks Within 1 year* One or more years** Missing Never had sexual intercourse Region North 72.3 9.9 1.5 0.2 16.0 100.0 3,172 Central 59.8 12.7 2.6 0.5 24.4 100.0 4,990 South 59.6 11.1 3.5 0.5 25.3 100.0 1,789 Province Vientiane Capital 57.8 18.3 2.5 0.8 20.6 100.0 1,379 Phongsaly 75.4 11.6 1.1 0.1 11.8 100.0 318 Luangnamtha 77.1 7.2 1.3 0.9 13.6 100.0 266 Oudomxay 65.9 13.1 1.0 0.0 20.1 100.0 530 Bokeo 77.5 8.2 4.6 0.0 9.8 100.0 267 Luangprabang 70.9 9.9 1.2 0.3 17.7 100.0 644 Huaphanh 74.0 9.4 1.5 0.0 15.1 100.0 511 Xayabury 72.0 8.9 1.5 0.3 17.3 100.0 635 Xiengkhuang 61.3 13.2 1.1 0.2 24.1 100.0 442 Vientiane 65.6 11.1 1.6 0.5 21.2 100.0 721 Borikhamxay 65.9 9.8 0.8 0.4 23.1 100.0 390 Khammuane 58.2 9.3 3.5 0.2 28.8 100.0 503 Savannakhet 57.5 10.2 3.7 0.5 28.1 100.0 1,556 Saravane 64.6 7.6 3.7 1.1 22.9 100.0 597 Sekong 56.7 13.5 2.5 0.0 27.2 100.0 162 Champasack 54.8 13.6 3.9 0.3 27.4 100.0 873 Attapeu 70.2 7.7 1.7 0.0 20.4 100.0 157 Residence Urban 58.3 14.8 2.7 0.5 23.6 100.0 2,800 Rural 65.9 10.2 2.3 0.4 21.2 100.0 7,151 .Rural with road 65.4 10.4 2.4 0.4 21.5 100.0 6,457 .Rural without road 71.0 9.1 1.5 0.2 18.2 100.0 694 Age 15-19 12.9 7.9 2.3 0.1 76.8 100.0 2,119 20-24 49.3 21.0 3.3 0.4 26.1 100.0 1,557 25-29 77.8 13.3 3.3 0.6 4.9 100.0 1,500 30-34 85.8 9.9 1.5 0.6 2.3 100.0 1,264 35-39 88.3 8.4 1.6 0.3 1.4 100.0 1,445 40-44 88.4 7.8 2.4 0.5 0.9 100.0 1,043 45-49 83.7 12.2 2.5 0.8 0.8 100.0 1,023 Marital/Union status Currently married/in union 89.6 9.2 0.6 0.4 0.2 100.0 6,611 Formerly married/in union 30.3 33.1 32.4 4.2 0.0 100.0 177 Never married/in union 11.6 15.1 4.6 0.2 68.5 100.0 3,163 Marital duration*** 0-4 years 86.9 11.8 0.5 0.5 0.2 100.0 1,361 5-9 years 91.9 7.4 0.4 0.1 0.1 100.0 1,132 10-14 years 91.4 7.5 0.1 0.7 0.2 100.0 1,233 15-19 years 92.3 7.0 0.6 0.1 0.0 100.0 1,009 20-24 years 89.4 9.5 0.6 0.2 0.3 100.0 796 25+ years 85.6 12.3 1.4 0.7 0.0 100.0 451 Married more than once 86.4 11.2 1.5 0.8 0.0 100.0 627 Education None 75.1 10.4 2.2 0.4 11.9 100.0 923 Primary 71.5 9.7 2.7 0.4 15.7 100.0 3,872 Lower secondary 57.2 10.8 2.0 0.4 29.6 100.0 2,351 Upper secondary 45.1 10.8 2.2 0.1 41.7 100.0 1,450 Post secondary non tertiary 74.7 14.3 2.6 1.4 7.0 100.0 608 Higher 57.7 23.7 3.1 0.3 15.2 100.0 747 Wealth index quintile Poorest 72.6 8.9 2.2 0.4 16.0 100.0 1,692 Second 66.6 8.5 1.9 0.3 22.6 100.0 1,911 Middle 63.5 10.6 2.4 0.2 23.3 100.0 2,039 Fourth 59.7 12.1 2.7 0.7 24.8 100.0 2,092 Richest 58.7 16.5 2.8 0.5 21.6 100.0 2,217 Ethno-linguistic group of household head Lao-Tai 61.4 12.6 2.6 0.5 22.8 100.0 6,635 Mon-Khmer 66.7 9.2 2.3 0.3 21.5 100.0 2,191 Hmong-Mien 71.6 9.0 1.3 0.0 18.1 100.0 728 Chinese-Tibetan 75.7 10.8 1.1 0.6 11.7 100.0 335 Other, Missing, DK 51.6 6.3 7.1 0.0 35.0 100.0 62 Total 63.8 11.5 2.4 0.4 21.9 100.0 9,951 * Excludes men who had sexual intercourse within the past 4 weeks ** Excludes men who had sexual intercourse within the past 4 weeks or within 1 year *** Excludes men who are not currently married Table MS.9.2: Recent sexual activity Percent distribution of men age 15-49 by timing of last sexual intercourse, Lao PDR 2011-12 Timing of last sexual intercourse Total Number of men 5 © UNFPA Lao PDR / 2012 / Perier 66 VI. Fertility Levels, Trends, Differentials and Preferences Fertility is one of the three principal components of population dynamics that determine the size and structure of the population of a country. This chapter looks at a number of fertility indicators, including: levels, patterns and trends in both current and cumulative fertility; the length of birth intervals; the age at which women initiate childbearing; and fertility preferences. Information on current and cumulative fertility is essential for monitoring population growth. Birth intervals are important because short intervals are strongly associated with childhood mortality. The age at which childbearing begins can also have a major impact on the health and well-being of both the mother and the child. Data on fertility preferences may be a useful indicator of the direction future fertility patterns may take. Data on fertility were collected in several ways. First, each woman was asked the number of sons and daughters who live with her, the number who live elsewhere, and the number born alive and who later died. Next, a complete history of all the woman’s births was obtained, including information on sex, date of birth, and survival status of each child. For living children, a question was asked about whether the child was living in the household or away. For dead children, the age at death was recorded. Finally, information was collected on whether a woman was pregnant at the time of the survey. Current Fertility The level of current fertility is one of the most important topics in this report because of its direct relevance to population policies and programmes. Current fertility can be measured using the age-specific fertility rate (ASFR), the total fertility rate (TFR), the general fertility rate (GFR), and the crude birth rate (CBR). The ASFR provides the age pattern of fertility, while the TFR refers to the number of live births that a woman would have had if she were subject to the current ASFRs throughout her reproductive years (15-49 years). The GFR is expressed as the number of live births per 1,000 women age 15-44, and the CBR is expressed as the number of live births per 1,000 people in the population. The measures of fertility presented in this chapter refer to the three-year period preceding the survey (1-36 months). This time period generates a sufficient number of births to provide reliable, current estimates. 6 Urban Rural Age 15-19 44 114 94 20-24 125 213 185 25-29 126 170 157 30-34 92 109 104 35-39 36 70 60 40-44 13 28 23 45-49 4 12 10 TFR (15-49) 2.2 3.6 3.2 GFR 78 125 111 CBR 20 26 25 Table FE.1: Current fertility Age-specific and total fertility rates, the general fertility rate, and the crude birth rate for the three years preceding the survey, by residence, Lao PDR 2011-12 Residence Total Notes: Age-specific fertility rates are per 1,000 women. Rates for age group 45-49 may be slightly biased due to truncation. Rates are for the period 1- 36 months prior to interview. TFR: Total fertility rate, expressed per woman GFR: General fertility rate, expressed per 1,000 women age 15-44 CBR: Crude birth rate, expressed per 1,000 population 67 ASFRs are presented in Table FE.1 and Figure FE.1. Numerators of ASFRs are calculated by identifying live births that occurred in the period 1 to 36 months preceding the survey (determined from the date of interview and date of birth of the child); they are then classified by the age of the mother (in five-year groups) at the time of the child’s birth. The denominators of these rates are the number of woman-years lived by the survey respondents in each of the five-year age groups during the specified period. For the country as a whole, the ASFR rises from 94 births per 1,000 women age 15-19 to a peak of 185 births among women age 20-24, and then falls steadily, reaching a low of 10 births per 1,000 women age 45-49. Fertility is higher among rural women than it is among urban women, at all ages. The rural- urban differential in fertility is greatest during the peak childbearing ages of 20-24. As Table FE.1 shows, the TFR for Lao PDR for the three-year period preceding the survey is 3.2 children per woman. This means that a Lao woman who is at the beginning of her childbearing years would give birth to just over three children by the end of her reproductive period if she were to go through her childbearing years bearing children at currently observed rates. The TFR in rural areas exceeds the TFR in urban areas by almost one-and-a-half children per woman (3.6 and 2.2 children per woman, respectively). The CBR in Lao PDR is 25 births per 1,000 population. As is the case with other fertility measures, there is a substantial differential in the CBR by urban-rural residence. The CBR is 30 per cent higher in rural areas (26 per 1,000 population) than in urban areas (20 per 1,000 population). The GFR in Lao PDR is 111 live births per 1,000 women of reproductive age. The rate is considerably higher in rural areas (125) than in urban areas (78). Fertility Differentials Table FE.2 presents adolescent birth rates and TFRs for the three years preceding the survey, the percentage of women who are currently pregnant, and the mean number of children ever born (CEB) to women age 40-49, by background characteristics. Figure FE.1: Age-Specific Fertility Rates by Births per 1 000 Figure FE.1: Age-Specific Fertility Rates by Urban-Rural Residence, Lao PDR 2011-12 250 Births per 1,000  women Figure FE.1: Age-Specific Fertility Rates by Urban-Rural Residence, Lao PDR 2011-12 250 Births per 1,000  women 200 250 women 200 150 200 100 150 100 50 100 50 0 50 Age group 0 15‐19 20‐24 25‐29 30‐34 35‐39 40‐44 45‐49 Age group 0 15‐19 20‐24 25‐29 30‐34 35‐39 40‐44 45‐49 Age group Urban Rural Total 5 9 0 4 5 9 30 34 35 39 40 44 45 49 Urban Rural Total 6 68 Adolescent birth rate1 (Age-specific fertility rate for women age 15- 19) Total fertility rate Percentage of women age 15-49 currently pregnant Mean number of children ever born to women age 40- 49 Region North 120 3.2 4.8 5.0 Central 79 2.9 4.9 4.5 South 90 3.9 6.6 5.3 Province Vientiane Capital 37 2.0 3.8 3.1 Phongsaly 145 3.7 5.2 5.0 Luangnamtha 124 2.6 4.7 4.0 Oudomxay 138 3.6 3.9 5.7 Bokeo 149 3.6 4.9 5.0 Luangprabang 95 3.1 5.4 5.3 Huaphanh 137 3.8 5.9 5.9 Xayabury 83 2.2 3.8 3.8 Xiengkhuang 101 3.6 4.5 6.1 Vientiane 86 2.7 5.0 4.1 Borikhamxay 79 2.8 3.9 4.4 Khammuane 108 3.7 4.5 4.9 Savannakhet 99 3.5 6.3 5.4 Saravane 106 4.3 7.5 6.0 Sekong 107 4.5 6.9 5.9 Champasack 70 3.6 5.7 4.7 Attapeu 107 3.6 6.8 5.7 Residence Urban 44 2.2 3.6 3.6 Rural 114 3.6 5.8 5.3 .Rural with road 112 3.4 5.7 5.2 .Rural without road 137 4.8 6.7 6.1 Education None 190 4.8 6.5 5.9 Primary 136 3.3 5.4 5.1 Lower secondary 85 2.7 4.4 3.8 Upper secondary 23 2.6 3.6 2.7 Post secondary non tertiary 2 2.0 5.7 3.2 Higher 0 (1.7) 3.7 2.4 Wealth index quintile Poorest 183 5.3 7.3 6.1 Second 120 3.8 5.9 6.0 Middle 96 3.1 4.8 5.4 Fourth 72 2.4 5.2 4.4 Richest 31 1.9 3.4 3.2 Ethno-linguistic group of household head Lao-Tai 69 2.6 4.5 4.3 Mon-Khmer 132 4.2 6.2 6.1 Hmong-Mien 161 5.5 7.6 7.0 Chinese-Tibetan 141 3.6 4.9 5.0 Total 94 3.2 5.2 4.8 Table FE.2: Fertility by background characteristics Adolescent birth rate and total fertility rate

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