Lao Social Indicator Survey 2011-12

Publication date: 2012

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 for the three years preceding the survey, percentage of women age 15-49 currently pregnant, and mean number of children ever born to women age 40-49, Lao PDR 2011-12 1 MICS indicator 5.1; MDG indicator 5.4 Note: Figures in parentheses are based on 125-249 unweighted woman-years of exposure. 6 69 For every 1,000 girls age 15–19 there are 94 births. Girls living in the Northern region have a higher fertility rate (120 per 1,000 girls) compared with girls who live in the Central and Southern regions. A big difference in birth rates is found between urban and rural adolescents. The fertility rate among girls living in rural areas is nearly three times higher than among girls living in urban areas (114 and 44 births per 1,000 adolescents, respectively). Bokeo province has the highest adolescent fertility rate of all the provinces (149 births per 1,000 girls), followed by Phongsaly, Oudomxay and Huaphanh provinces (145, 138 and 137 births, respectively). Further analysis shows that girls with lower education levels have a much higher fertility rate. Similarly, girls from the poorest wealth quintile have a much higher fertility rate compared with girls from the richest wealth quintile. The fertility rate among adolescent girls of Lao-Tai headed households is about half the level observed among girls of other ethno-linguistic groups. With regard to TFR among women age 15-49, those living in the South have a higher fertility rate (3.9 births) than those in the Northern and Central regions (3.2 and 2.9 births, respectively). There are substantial differentials in the TFR across provinces, with a low of 2.0 children per woman in Vientiane Capital. Sekong and Saravane provinces have the highest TFR (4.5 and 4.3 children, respectively). The TFR is inversely related to mothers’ education. The TFR of women with no education is nearly three times higher than of women with higher education. Similarly, the TFR is also inversely related to wealth quintile; the TFR of women in the poorest quintile is about three times higher than the TFR of women in the richest quintile. Fertility also varies by ethno-linguistic group; women of Hmong-Mien headed households have a TFR of 5.5, higher than other ethno-linguistic groups, and double that of women in Lao-Tai headed households. Table FE.2 also presents a crude assessment of trends in the various subgroups by comparing current fertility with a measure of completed fertility – the mean number of children ever born to women age 40-49. The mean number of children ever born to older women, who are nearing the end of their reproductive period, is an indicator of the average completed fertility of women who began childbearing over the three decades preceding the survey. If fertility remained constant over time and the reported data on both children ever born and births during the three years preceding the survey are reasonably accurate, the TFR and the mean number of children ever born for women age 40-49 would be expected to be similar. When fertility levels have been falling, the TFR will be substantially lower than the mean number of children ever born to women age 40-49. The comparison of current fertility at the country level with completed fertility suggests that fertility has fallen by one-and-a-half children per woman during the past few decades, from 4.8 to 3.2 children. The table also reveals that substantial declines in fertility have taken place in both rural areas (from 5.3 to 3.6) and urban areas (from 3.6 to 2.2). The differences between the levels of current and completed fertility are highest in the Northern region (1.9 children), particularly Luangprabang and Huaphanh (both 2.2 children), and in Xiengkhuang (2.5 children), in rural areas with roads (1.8 children), among primary school educated women (1.8 children) and among women in the second and middle wealth quintile (2.2 children each). The percentage of women currently pregnant is a useful measure of current fertility, although not all women who are pregnant are likely to be included because they may not be aware that they are pregnant or may be reluctant to disclose a pregnancy in its early stages. Five per cent of women reported that they were pregnant at the time of the survey. The highest percentages of women currently pregnant are found in the Southern region (7 per cent), in the more remote rural areas (7 per cent), and among women with no education and the poorest women (7 per cent each). 6 70 Fertility Trends Table FE.3 uses information from the retrospective birth histories obtained from the 2011-12 LSIS respondents to examine the trends in ASFR, and TFRs for successive three-year periods preceding the survey. To calculate these rates, births were classified according to the period of time in which the birth occurred and the mother’s age at the time of birth. Because birth histories have not been collected for women age 50 and over, the rates for older age groups become progressively more truncated for periods more distant from the survey date. For example, rates cannot be calculated for women age 45-49 for periods 6-8 years or more prior to the survey because women in those age groups would have been 50 years or older at the time of the survey. Based on the trend in ASFRs and the TFR from 15 years before the survey to the most recent three-years prior to the survey, there is evidence that the TFR has declined over the period. 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 recent three-year period prior to the survey (2009-11). Children Ever Born and Living Table FE.4 presents the distribution of all women and currently married women by the number of children ever born, according to five-year age groups. The table also shows the mean number of children ever born and the mean number of living children. Data on the number of children ever born reflect the accumulation of births to women over their entire reproductive lifespan and therefore have limited reference to current fertility levels, particularly when a country has experienced a decline in fertility. However, the information on children ever born is useful for observing how average family size varies across age groups and also for observing the level of primary infertility. 0-2 3-5 6-8 9-11 12-14 Mother's age at birth 15-19 94 102 111 127 116 20-24 185 204 219 245 264 25-29 157 174 196 212 246 30-34 104 121 142 166 197 35-39 60 71 91 108 169 40-44 23 33 64 (77) na 45-49 10 9 na na na Total Fertility Rate 3.2 3.6 4.1 4.7 5.0 Note: Figures in parentheses are based on 125-249 unweighted woman-years of exposure. Table FE.3: Trends in age-specific fertility rates and total fertility rate Age-specific fertility rates and total fertility rate for three-year periods preceding the survey, by mother's age at the time of the birth, Lao PDR 2011-12 Number of years preceding the survey na = Not applicable due to censoring 6 71 The results show that 86 per cent of women age 15-19 have never given birth. This proportion declines rapidly to 17 per cent for women age 25-29 and to 6 per cent or lower for women age 35 and older. On average, Lao women attain a parity of 5.1 children per woman by the end of their childbearing years. This number is higher than the TFR of 3.2 per woman; a difference that is attributable to the decrease in fertility. Some women achieve much higher parity by the time they reach 40; a small proportion of women have 10 or more births by the end of their childbearing years. One in five women age 45-49 has given birth to eight or more children. Results for younger, currently married women differ from those for all women because the majority of younger women were likely to be unmarried with no children. Differences at older ages generally reflect the impact of marital dissolution. Only 3 per cent of currently married women age 45-49 have never had a child. If the desire for children is universal in Lao PDR; this percentage represents a rough measure of primary infertility or the inability to bear children. As expected, the mean number of children ever born and the mean number of children surviving rise monotonically with increasing age. A comparison of the mean number of living children with the mean number of children ever born shows that currently, by the end of their child bearing years, married women have lost an average of one child each. Age 0 1 2 3 4 5 6 7 8 9 10+ 15-19 86.0 10.6 2.7 0.6 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 4,415 0.180 0.161 20-24 40.5 31.4 18.6 6.5 2.2 0.6 0.1 0.0 0.0 0.0 0.0 100.0 3,617 1.010 0.920 25-29 16.8 21.6 29.0 15.7 9.3 4.7 1.7 0.6 0.4 0.1 0.0 100.0 3,642 2.064 1.850 30-34 8.4 11.0 26.1 21.6 13.3 8.5 5.9 2.7 1.4 0.8 0.4 100.0 3,015 2.998 2.609 35-39 5.8 5.6 20.9 20.2 14.9 10.9 8.2 5.3 3.9 2.5 1.9 100.0 3,065 3.821 3.238 40-44 5.4 5.1 13.4 16.0 15.1 12.5 10.2 8.0 6.1 4.2 4.0 100.0 2,507 4.501 3.703 45-49 5.4 4.4 8.2 13.5 13.4 13.3 12.5 9.1 7.4 4.3 8.4 100.0 2,215 5.100 4.110 Total 29.2 13.9 16.9 12.5 8.7 6.2 4.6 3.0 2.2 1.3 1.6 100.0 22,476 2.460 2.089 15-19 46.2 40.4 10.9 2.4 0.0 0.1 0.0 0.0 0.0 0.0 0.0 100.0 1,092 0.698 0.627 20-24 17.1 42.8 26.3 9.5 3.3 0.9 0.2 0.1 0.0 0.0 0.0 100.0 2,468 1.427 1.299 25-29 7.5 22.7 32.7 17.9 10.5 5.3 2.0 0.8 0.4 0.1 0.0 100.0 3,142 2.322 2.080 30-34 3.4 10.5 27.8 23.3 13.9 9.1 6.3 2.9 1.6 0.9 0.4 100.0 2,728 3.198 2.782 35-39 2.1 4.8 21.7 21.1 15.7 11.6 8.5 5.6 4.2 2.7 2.1 100.0 2,782 4.024 3.415 40-44 2.2 4.8 13.3 16.4 15.6 12.8 10.5 8.7 6.6 4.6 4.4 100.0 2,238 4.732 3.897 45-49 2.5 3.8 7.9 14.5 14.1 13.2 13.4 9.5 7.5 4.5 9.0 100.0 1,917 5.310 4.289 Total 8.6 17.2 22.0 16.4 11.3 8.0 5.9 3.9 2.8 1.8 2.1 100.0 16,368 3.193 2.716 ALL WOMEN CURRENTLY MARRIED WOMEN Table FE.4: Children ever born and living Percent distribution of all women and currently married women age 15-49 by number of children ever born, mean number of children ever born and mean number of living children, according to age group, Lao PDR 2011-12 Number of children ever born Total Number of women Mean number of children ever born Mean number of living children 6 72 Birth Intervals A birth interval is defined as the length of time between two successive live births. The study of birth intervals is important in understanding the health status of young children. Research has shown that short birth intervals are closely associated with the poor health of children, especially during infancy. Children born too soon after a previous birth, especially if the interval between the births is less than two years, are at increased risk of health problems and death at a young age. Longer birth intervals improve the health status of both mother and child. Table FE.5 presents the distribution of second and higher-order births in the five years preceding the survey by the number of months since the previous birth, according to background characteristics. The table also presents the median number of months since the preceding birth. The median birth interval is 34 months, indicating that half of non-first births to women in Lao PDR occur less than three years after a previous birth. Twenty-eight per cent have an interval of less than two years, and 14 per cent of births are less than 18 months apart. Twenty-five per cent of births occur 24-35 months after the previous birth and 47 per cent are at least three years apart. 6 73 7-17 18-23 24-35 36-47 48-59 60+ Region North 15.1 15.0 27.9 14.8 8.6 18.6 100.0 2,543 31.8 Central 13.5 12.8 22.7 15.4 11.2 24.4 100.0 3,421 36.5 South 14.6 13.6 26.4 17.1 10.0 18.3 100.0 1,737 33.3 Province Vientiane Capital 6.2 7.4 15.8 13.7 14.1 42.7 100.0 583 52.5 Phongsaly 18.7 14.8 33.0 13.5 8.6 11.5 100.0 280 28.3 Luangnamtha 12.8 15.9 25.8 18.4 8.9 18.3 100.0 169 34.2 Oudomxay 13.1 14.6 34.5 14.7 8.0 15.1 100.0 492 31.1 Bokeo 13.1 14.9 30.5 16.6 8.6 16.1 100.0 244 31.3 Luangprabang 14.5 12.0 25.6 16.8 10.7 20.5 100.0 567 35.1 Huaphanh 19.6 22.1 29.0 11.5 6.1 11.7 100.0 498 26.6 Xayabury 11.9 9.3 13.4 14.3 9.5 41.5 100.0 294 48.5 Xiengkhuang 14.3 17.6 29.4 16.2 9.8 12.6 100.0 375 30.6 Vientiane 7.5 13.1 21.7 15.8 11.7 30.2 100.0 476 40.9 Borikhamxay 10.4 10.0 21.0 18.6 15.1 24.8 100.0 254 41.5 Khammuane 16.6 16.7 22.4 13.8 11.6 18.9 100.0 433 31.3 Savannakhet 18.4 13.1 24.6 15.7 9.2 19.1 100.0 1,301 32.6 Saravane 16.3 15.7 27.1 17.0 9.8 14.1 100.0 721 30.6 Sekong 12.9 17.9 34.7 16.3 8.2 9.9 100.0 211 29.1 Champasack 13.9 9.7 22.3 18.0 10.6 25.4 100.0 651 39.4 Attapeu 11.5 13.8 29.0 15.2 10.6 19.9 100.0 154 34.2 Residence Urban 8.0 8.5 19.2 17.1 12.7 34.6 100.0 1,326 46.3 Rural 15.6 14.8 26.5 15.3 9.5 18.3 100.0 6,374 32.2 .Rural with road 15.1 14.7 26.0 15.5 9.7 19.1 100.0 5,461 32.8 .Rural without road 18.6 15.6 29.5 14.3 8.4 13.6 100.0 914 29.3 Age 15-19 31.1 31.7 28.8 7.7 0.2 0.5 100.0 171 21.8 20-29 17.0 16.2 28.4 16.6 9.6 12.1 100.0 3,751 30.0 30-39 11.1 10.5 22.3 15.1 11.0 30.0 100.0 3,084 39.9 40-49 9.5 9.8 20.2 14.3 10.6 35.5 100.0 694 44.8 Sex of preceding birth Male 13.4 14.2 24.9 15.6 10.3 21.5 100.0 3,934 34.6 Female 15.2 13.2 25.6 15.6 9.8 20.6 100.0 3,767 33.7 Survival of preceding birth Living 11.9 13.3 25.7 16.3 10.5 22.3 100.0 6,809 35.5 Dead 32.3 16.8 22.1 10.4 6.5 11.9 100.0 891 24.2 Birth order 2-3 13.7 13.3 23.3 15.3 10.8 23.7 100.0 4,255 35.9 4-6 14.5 14.0 26.3 16.7 9.1 19.4 100.0 2,348 33.3 7+ 16.2 14.9 30.5 14.6 9.4 14.5 100.0 1,097 29.8 Education None 17.5 16.5 29.9 15.9 8.3 11.8 100.0 3,013 29.1 Primary 13.8 12.9 24.2 14.6 10.3 24.1 100.0 3,139 35.5 Lower secondary 8.7 11.6 17.3 16.5 12.0 33.9 100.0 944 45.3 Upper secondary 9.4 7.9 18.4 16.1 15.6 32.6 100.0 331 46.6 Post secondary non tertiary 9.2 5.2 23.3 18.0 14.2 30.2 100.0 168 45.0 Higher 8.7 9.0 18.2 22.3 11.0 30.9 100.0 106 41.8 Wealth index quintile Poorest 18.5 18.1 30.7 15.9 7.5 9.3 100.0 2,740 27.9 Second 15.9 14.3 28.5 15.0 9.7 16.6 100.0 1,768 31.4 Middle 12.5 13.5 22.2 16.6 11.4 23.8 100.0 1,349 37.3 Fourth 9.8 7.4 16.8 14.9 12.7 38.4 100.0 996 48.6 Richest 5.7 6.2 15.4 15.0 13.8 43.9 100.0 847 54.2 Ethno-linguistic group of household head Lao-Tai 10.9 9.5 19.4 15.3 12.1 32.9 100.0 3,706 44.0 Mon-Khmer 17.6 16.0 29.6 16.4 8.9 11.5 100.0 2,535 29.4 Hmong-Mien 17.1 21.2 33.0 15.0 6.7 7.0 100.0 1,157 27.2 Chinese-Tibetan 16.5 16.0 31.6 16.0 8.9 11.0 100.0 265 29.2 Other, Missing, DK (24.2) (27.1) (23.3) (6.3) (5.7) (13.4) 100.0 38 (24.2) Total 14.3 13.7 25.2 15.6 10.1 21.1 100.0 7,701 34.1 Note: Figures in parentheses are based on 25-49 unweighted cases. Months preceding birth Total Table FE.5: Birth intervals Percent distribution of non-first births in the five years preceding the survey by number of months since preceding birth, and median number of months since preceding birth, according to background characteristics, Lao PDR 2011-12 Number of non-first births Median number of months since preceding birth 6 74 The median birth interval increases with age of the mother, ranging from 21.8 months for births to women age 15-19 to 44.8 months for births to women age 40-49. The longer birth interval among older women may be attributed in part to a decrease in fecundity as women grow older. There is no substantial difference in the median birth interval by the child’s sex. However, the median birth interval is almost a year shorter if the previous child died than if the previous child is still alive. The median duration decreases as birth order increases. The median interval for births to urban women is 14 months longer than for rural women (46.3 and 32.2 months, respectively), and ranges from 26.6 months in Huaphanh to 52.5 months in Vientiane Capital. The median number of months since the preceding birth among non-first births is longest for births to women who have gone to upper secondary school but do not have more than a secondary education (46.6 months). The shortest median birth interval is for births to women with no education (29.1 months). The median birth interval increases monotonically by wealth quintile from 27.9 months in the poorest quintile to 54.2 in the richest quintile. Women in Lao- Tai headed households have considerably longer birth intervals (44.0 months) compared with those in other ethno-linguistic groups (all less than 30 months). Age at First Birth The age at which childbearing commences is an important determinant of the overall level of fertility as well as of the health and welfare of the mother and the child. In some societies, postponement of first births due to an increase in age at marriage has contributed to overall fertility decline. Table FE.6 shows the percentage of women in Lao PDR who have given birth by specific ages, according to age at the time of the survey. Some 4 per cent of women age 25-49 give birth by the age of 15, and 19 per cent give birth by 18. Two in five (39 per cent) women have become mothers by the age of 20. The percentage of women giving birth by each exact age has varied little over time and the median age at first birth is unchanged at around 21 years. 15 18 20 22 25 Age 15-19 1.2 na na na na 86.0 4,415 a 20-24 2.5 18.2 37.9 na na 40.5 3,617 a 25-29 3.6 21.4 41.8 59.0 76.1 16.8 3,642 20.9 30-34 4.2 21.0 40.7 60.1 78.3 8.4 3,015 20.9 35-39 3.3 19.8 40.3 60.7 79.3 5.8 3,065 20.9 40-44 3.5 18.1 38.0 57.5 78.2 5.4 2,507 21.2 45-49 3.4 15.2 33.8 53.3 73.6 5.4 2,215 21.6 25-49 3.6 19.4 39.4 58.5 77.2 9.0 14,444 21.1 na = Not applicable due to censoring a = Omitted because less than 50 percent of women had a birth before reaching the beginning of the age group Table FE.6: Age at first birth Percentage of women age 15-49 who gave birth by specific exact ages, percentage who have never given birth, and median age at first birth, according to current age, Lao PDR 2011-12 Percentage who gave birth by exact age: Percentage who have never given birth Number of women Median age at first birth 6 75 Table FE.7 presents the median age at first birth by background characteristics. The median is presented for women age 25-49 to ensure that half of the women in every subgroup have already given birth. In Lao PDR the median age at first birth for women age 25-49 is 21.1 years. The median age at first birth for women age 25-49 in urban areas (22.6 years) is 2 years later than the median age at first birth in rural areas (20.5 years), and is lowest in the North at 20.4 years. The median age at first birth ranges from 19.8 years in Huaphanh to 23.2 years in Vientiane Capital. Median age at first birth increases with education and wealth. For example, women in the highest wealth quintile delay the onset of their childbearing by almost three years relative to women in the lowest two wealth quintiles. Women in Hmong-Mien headed households have the lowest age at first birth at 19.4 years. Women age 25-49 Women age 25-49 Region Education North 20.4 None 20.1 Central 21.5 Primary 20.3 South 21.3 Lower secondary 21.3 Province Upper secondary 23.5 Vientiane Capital 23.2 Post secondary non tertiary 24.5 Phongsaly 20.7 Higher a Luangnamtha 21.1 Wealth index quintile Oudomxay 20.4 Poorest 20.4 Bokeo 20.4 Second 20.2 Luangprabang 20.5 Middle 20.5 Huaphanh 19.8 Fourth 21.0 Xayabury 20.2 Richest 23.0 Xiengkhuang 20.5 Ethno-linguistic group of household head Vientiane 21.0 Lao-Tai 21.5 Borikhamxay 20.7 Mon-Khmer 20.1 Khammuane 21.1 Hmong-Mien 19.4 Savannakhet 20.9 Chinese-Tibetan 21.1 Saravane 20.5 Other, Missing, DK (21.8) Sekong 20.9 Champasack 21.9 Total 21.1 Attapeu 21.0 Residence Urban 22.6 Rural 20.5 .Rural with road 20.5 .Rural without road 20.5 a = Omitted because less than 50 percent of the women had a birth before reaching the beginning of the age group Table FE.7: Median age at first birth Median age at first birth among women age 25-49 years, Lao PDR 2011-12 6 76 Early Childbearing Sexual activity and childbearing early in life carry significant risks for young people all around the world. Teenage pregnancy is a major health concern because of its association with higher morbidity and mortality for both mother and child. Childbearing during the teenage years frequently has adverse social consequences as well, particularly on educational attainment, because women who become mothers in their teenage years are more likely to curtail their education. Table FE. 11 presents some early childbearing indicators for women age 15-19 and 20-24 while Table FE. 12 presents the trends for early child bearing. As shown in Table FE.11, 18 per cent of women age 15-19 have begun child bearing: 14 per cent have already had a birth, and 4 per cent are pregnant with their first child. While only 2 per cent of women age 15 have started childbearing; 40 per cent of women are either mothers or are pregnant with their first child by the age of 19. More teenagers in rural areas have started childbearing than their urban counterparts (21 and 9 per cent, respectively). A higher percentage of teenagers in the Northern region have begun childbearing than in the other regions; 28 per cent of teenagers in Bokeo, 25 per cent in Phongsaly, and 24 per cent in Luangnamtha have given birth or are currently pregnant. There is a strong inverse relationship between early childbearing and women’s education; more teenagers with lower education have started childbearing than those who are better educated. Thirty- six per cent of teenagers with no education, but less than 1 per cent with some education have begun childbearing. Four times as many teenagers in the lowest wealth quintile started childbearing early compared with women in the highest wealth quintile (28 per cent and 7 per cent, respectively). 6 77 Have had a live birth Are pregnant with first child Have begun childbearing Have had a live birth before age 15 Region North 17.5 4.3 21.8 1.6 1,403 26.0 1,170 Central 11.7 3.5 15.2 0.6 2,125 12.8 1,792 South 13.7 4.0 17.7 1.8 887 18.8 654 Province Vientiane Capital 6.9 2.4 9.3 0.0 527 3.8 583 Phongsaly 19.3 6.1 25.4 2.0 124 25.7 116 Luangnamtha 21.1 2.4 23.5 2.3 123 24.8 114 Oudomxay 19.1 2.5 21.6 3.2 271 27.7 208 Bokeo 22.1 5.8 27.9 0.9 124 33.9 109 Luangprabang 17.5 3.5 21.0 0.9 248 17.9 226 Huaphanh 15.5 5.9 21.4 1.8 246 35.2 162 Xayabury 13.0 4.5 17.5 0.0 267 23.3 236 Xiengkhuang 14.1 4.1 18.2 2.1 252 22.5 137 Vientiane 11.9 5.5 17.4 0.5 284 14.4 258 Borikhamxay 16.2 0.9 17.1 1.4 184 19.4 138 Khammuane 13.3 3.1 16.4 1.3 206 18.4 171 Savannakhet 12.9 4.1 17.0 0.3 672 16.1 505 Saravane 17.2 5.4 22.6 3.9 308 23.0 256 Sekong 15.6 5.1 20.6 2.8 94 24.4 60 Champasack 10.3 2.0 12.3 0.0 402 12.6 280 Attapeu 15.2 7.5 22.7 1.7 83 23.7 59 Residence Urban 6.5 2.4 8.9 0.4 1,229 5.9 1,127 Rural 16.9 4.4 21.2 1.5 3,186 23.7 2,490 .Rural with road 16.5 4.3 20.7 1.4 2,856 22.9 2,298 .Rural without road 20.3 5.4 25.7 1.7 330 33.7 192 Age 15 1.1 1.0 2.1 0.5 920 na na 16 4.2 2.2 6.4 0.8 928 na na 17 10.3 3.5 13.8 1.4 905 na na 18 23.5 7.2 30.8 1.5 867 na na 19 34.0 5.7 39.7 1.7 794 na na Education None 29.2 7.1 36.2 4.6 448 35.2 605 Primary 22.6 5.6 28.2 2.1 1,380 24.9 1,309 Lower secondary 11.5 3.5 15.1 0.1 1,250 16.4 630 Upper secondary 2.6 1.3 3.9 0.0 1,149 3.2 427 Post secondary non tertiary (0.0) (2.6) (2.6) (0.0) 51 0.2 166 Higher 0.4 0.0 0.4 0.0 137 0.0 480 Wealth index quintile Poorest 24.1 4.3 28.4 3.7 685 35.9 643 Second 19.3 5.6 25.0 1.8 860 27.0 666 Middle 14.4 3.4 17.7 1.2 919 19.6 622 Fourth 11.0 4.2 15.2 0.0 952 11.9 696 Richest 4.9 2.0 6.9 0.0 999 4.2 991 Ethno-linguistic group of household head Lao-Tai 10.3 3.2 13.5 0.5 2,827 12.8 2,381 Mon-Khmer 20.4 4.2 24.5 2.1 1,003 26.5 815 Hmong-Mien 22.3 5.9 28.2 3.5 413 38.7 276 Chinese-Tibetan 18.4 3.2 21.6 2.2 148 22.2 120 Other, Missing, DK * * * * 24 (16.7) 25 Total 14.0 3.8 17.8 1.2 4,415 18.2 3,617 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 FE.11: Early childbearing 1 MICS indicator 5.2 Percentage of women age 15-19 who: Percentage of women age 15-19 years who have had a live birth or who are pregnant with the first child and percentage of women age 15-19 years who have begun childbearing, percentage of women who have had a live birth before age 15, and percentage of women age 20-24 who have had a live birth before age 18, Lao PDR 2011-12 Number of women age 15-19 Number of women age 20- 24 Percentage of women age 20- 24 who have had a live birth before age 181 6 78 Almost one in five women age 20-24 reported having had their first live birth before their eighteenth birthday. There is significant regional variation; the Northern region has a higher percentage of women who had their first live birth before 18 years of age (26 per cent). Between urban and rural women, the percentage of women who had a live birth before age 18 is significantly different (6 and 24 per cent, respectively). The percentage of women age 20-24 who have had a child by 18 varies by province, with Huaphanh and Bokeo having the highest proportions (35 and 34 per cent, respectively), and Vientiane Capital having only 4 per cent. Early childbearing has a strong association with education; the proportion of women age 20-24 who reported having had a live birth by 18 decreases dramatically with increasing education. Thirty-five per cent of women with no education had a live birth by 18 compared with only 3 per cent of women with upper secondary education. Table FE.11 further reveals that early childbearing is most common among women in the poorest quintile (36 per cent), and in Hmong-Mien headed households (39 per cent). Table FE. 12 shows the trends in early child bearing of women who have had a live birth, by age group and residence. Three per cent of women had a live birth before the age of 15, while 19 per cent of women had a live birth before the age of 18. There are differences in early child bearing between urban and rural women – 23 per cent of women had a live birth before the age of 18 in rural areas compared with 10 per cent in urban areas. Similarly, 4 per cent of women had a live birth before the age of 15 in rural areas and only 1 per cent in urban areas. Comparing age groups, there appears to be a declining trend in the percentage of women giving birth before 18 in urban areas, from 13 per cent in women age 40-44 to 6 per cent in women age 20-24; however, the pattern in rural areas seems to indicate an increase in the percentage who gave birth before 18 from the oldest age groups to the 30- 34 and 25-29 age groups, and then a hint of a decline in the younger 20-24 age group. 6 79 P er ce nt ag e of w om en w ith a li ve bi rth b ef or e ag e 15 N um be r o f w om en P er ce nt ag e of w om en w ith a li ve bi rth b ef or e ag e 18 N um be r o f w om en P er ce nt ag e of w om en w ith a li ve bi rth b ef or e ag e 15 N um be r o f w om en P er ce nt ag e of w om en w ith a li ve bi rth b ef or e ag e 18 N um be r o f w om en P er ce nt ag e of w om en w ith a li ve bi rth b ef or e ag e 15 N um be r o f w om en P er ce nt ag e of w om en w ith a li ve bi rth b ef or e ag e 18 N um be r o f w om en A ge 15 -1 9 0. 4 1, 22 9 na na 1. 5 3, 18 6 na na 1. 2 4, 41 5 na na 20 -2 4 0. 4 1, 12 7 5. 9 1, 12 7 3. 4 2, 49 0 23 .7 2, 49 0 2. 5 3, 61 7 18 .2 3, 61 7 25 -2 9 0. 7 1, 11 5 9. 2 1, 11 5 4. 8 2, 52 7 26 .8 2, 52 7 3. 6 3, 64 2 21 .4 3, 64 2 30 -3 4 1. 2 89 9 9. 8 89 9 5. 4 2, 11 6 25 .7 2, 11 6 4. 2 3, 01 5 21 .0 3, 01 5 35 -3 9 2. 5 88 1 11 .7 88 1 3. 6 2, 18 4 23 .0 2, 18 4 3. 3 3, 06 5 19 .8 3, 06 5 40 -4 4 1. 5 73 4 12 .6 73 4 4. 4 1, 77 3 20 .4 1, 77 3 3. 5 2, 50 7 18 .1 2, 50 7 45 -4 9 2. 4 66 4 10 .9 66 4 3. 9 1, 55 1 17 .0 1, 55 1 3. 4 2, 21 5 15 .2 2, 21 5 To ta l 1. 2 6, 64 9 9. 7 5, 42 0 3. 7 15 ,8 27 23 .3 12 ,6 41 2. 9 22 ,4 76 19 .2 18 ,0 61 na = N ot a pp lic ab le Ta bl e FE .1 2: T re nd s in e ar ly c hi ld be ar in g U rb an R ur al A ll P er ce nt ag e of w om en w ho h av e ha d a liv e bi rth , b y ag e 15 a nd 1 8, b y re si de nc e an d ag e gr ou p, L ao P D R 2 01 1- 12 6 80 Desire For More Children Information on fertility preference provides family planning programmes with an understanding of the potential demand for family planning in a given population. The 2011-12 LSIS asked women a series of questions to ascertain their fertility preferences, including the desire to have another child, and the length of time they would like to wait before having another child. Sterilised women were considered to want no more children, and therefore they were not asked questions about their desire for more children. Pregnant women were asked about their current pregnancy – whether they had wanted to become pregnant or not, and if not, whether they had wanted the pregnancy later or not at all, and, if later, how long they would have wanted to wait. Table FE 8 shows the distribution of currently married women age 15-49 by desire for more children, according to the number of living children. Pregnant women are included in the table and the number of living children includes the current pregnancy, counting the pregnancy as an additional child. Table FE 8 shows that 9 per cent of married women want to have another child soon. One in five women (19 per cent) wants to have another child later (two or more years) – these women can be considered potential contraceptive users for birth spacing. More than half (58 per cent) of women want no more children or are sterilised. Four per cent of women consider themselves unable to become pregnant. See also Figure FE.2. The desire for more children is related to the number of living children women already have. Four in five currently married women with no children want to have a child, with 47 per cent expressing the desire to have a child soon, 23 per cent wanting to delay having a child for at least two years, and 8 per cent undecided as to when to have a child. For women with one or more living children, the desire to stop childbearing altogether increases with the number of children. For example, only 15 per cent of currently married women with one child report that they want no more children (including those women who are sterilized) compared with 89 per cent of women with six or more children. Only 3 per cent of women with five or more living children want more children. 0 1 2 3 4 5 6+ Desire for future birth Have another soon** 46.5 14.6 6.1 2.9 1.2 0.7 0.4 8.5 Have another later*** 23.4 52.3 21.4 7.6 4.0 1.9 1.6 19.4 Have another, undecided when 8.0 8.1 4.8 1.9 1.9 0.5 0.8 4.1 Undecided 7.8 6.5 6.7 4.6 3.9 2.8 2.1 5.3 Want no more 4.2 13.9 53.4 70.4 76.8 81.4 84.2 53.3 Sterilised**** 0.3 1.0 4.0 8.2 7.4 6.1 4.5 4.6 Declared infecund 8.7 2.9 2.5 3.2 4.0 5.7 5.5 3.8 Other, Missing 1.0 0.9 1.2 1.1 0.8 0.9 1.0 1.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 1,186 3,100 4,273 3,105 1,874 1,279 1,550 16,368 * The number of living children includes current pregnancy ** Wants next birth within two years *** Wants to delay next birth for two or more years **** Includes only female sterilisation Table FE.8: Fertility preferences by number of living children Percent distribution of currently married women age 15-49 by desire for children, according to number of living children, Lao PDR 2011-12 Number of living children* Total 6 81 Figure FE.2: Desire for more children among currently married women, Lao PDR 2011-12 Want no more Figure FE.2: Desire for more children among currently married women, Lao PDR 2011-12 Want no more,  53%53% Undecided 5% Sterilised 5% Have another Undecided, 5% Sterilised, 5% Have another,  undecided  Declared  infecund, 4% when, 4% infecund, 4% Other, Missing,  1% Have another Have another  1% soon, 8%later, 19% soon, 8%later, 19% Desire to Limit Childbearing Table FE.9 shows, by number of living children, the percentage of currently married women age 15-49 who want no more children (or who are sterilised), according to background characteristics. The results provide information on variations in the potential demand for fertility control. A greater percentage of women in rural areas (59 per cent), women with no education (63 per cent), and women in the poorest wealth quintile (60 per cent) report wanting no more children compared with women in urban areas (55 per cent), women with some education (37 per cent), and women in the richest quintile (54 per cent). This finding may seem contradictory to expectations. However, the rural, uneducated and poorest women all tend to have more children than their urban, educated, or richer counterparts. As such, interpretation of the relationship between urban and rural women, education level, or wealth quintile and fertility preferences needs to be based on comparisons within parity categories. For example, considering women with three living children (roughly the current TFR), 68 per cent of women with no education want no more children compared with 86 per cent of women with upper secondary or higher education. Women with no education do not reach this level until they have six children. Similarly, there is no real difference in desire for limiting children by wealth quintile among women with six or more children, but among women with two or three living children, the desire to limit childbearing increases markedly with wealth. 6 82 0 1 2 3 4 5 6+ Region North 6.0 15.3 67.7 85.5 90.9 93.2 92.8 63.5 Central 4.1 14.7 52.0 75.6 77.8 82.4 85.6 53.6 South 3.0 14.3 51.9 75.2 87.6 89.2 88.4 59.5 Province Vientiane Capital 3.9 23.4 67.4 82.0 87.2 (81.9) (86.9) 55.8 Phongsaly 2.7 16.0 67.6 88.9 84.1 92.8 95.9 64.1 Luangnamtha 2.7 11.8 65.8 87.2 96.3 (92.8) (95.7) 61.4 Oudomxay 12.3 18.4 70.2 86.6 94.0 94.4 91.8 67.9 Bokeo 1.7 12.4 65.8 85.9 79.2 91.3 85.9 59.1 Luangprabang 7.0 13.3 63.3 84.0 91.0 91.1 87.7 62.3 Huaphanh 8.7 11.7 45.4 80.6 95.4 95.0 98.7 67.8 Xayabury 3.0 17.9 80.6 88.5 89.4 (93.6) (95.5) 60.4 Xiengkhuang (0.0) 5.0 39.5 74.9 89.7 89.0 90.3 55.9 Vientiane 3.6 7.5 48.1 74.9 71.4 78.2 74.3 49.5 Borikhamxay (0.0) 9.8 37.6 78.3 84.9 89.3 94.1 53.7 Khammuane 7.1 15.1 46.8 71.3 83.2 87.6 95.3 55.9 Savannakhet 5.3 13.4 43.2 71.3 70.1 79.4 83.4 52.4 Saravane 1.7 11.9 42.6 68.2 81.9 87.2 88.3 55.8 Sekong 6.9 18.4 41.3 67.8 77.2 77.5 79.4 55.1 Champasack 2.7 14.4 54.1 78.9 93.7 92.6 91.2 61.1 Attapeu (4.0) 19.0 75.8 90.6 95.4 95.2 88.8 69.9 Residence Urban 3.4 16.1 61.6 83.2 87.6 88.5 90.9 55.4 Rural 5.1 14.3 55.5 76.9 83.3 87.3 88.4 58.8 .Rural with road 4.8 14.3 56.0 78.0 83.8 87.4 88.2 58.6 .Rural without road 8.0 14.5 49.1 66.7 80.4 86.3 89.5 61.2 Education None 9.6 18.9 49.3 68.3 78.2 85.3 86.2 63.2 Primary 4.0 15.7 59.6 80.7 87.2 88.3 90.8 61.4 Lower secondary 2.7 13.1 57.7 82.4 90.4 87.2 92.5 52.2 Upper secondary 2.0 9.0 56.7 85.9 (80.2) * * 42.0 Post secondary non tertiary 1.1 16.5 61.4 86.0 84.5 (99.4) * 54.3 Higher 5.0 14.7 61.1 (87.5) * * * 37.0 Wealth index quintile Poorest 8.0 18.8 48.3 68.0 79.2 85.1 88.4 60.1 Second 3.6 11.8 51.9 76.3 86.6 88.6 88.4 59.8 Middle 5.0 13.2 59.2 78.0 83.8 89.9 87.9 59.1 Fourth 3.9 14.1 60.5 83.8 85.4 87.2 89.9 57.3 Richest 3.4 16.6 61.7 84.2 87.9 86.0 91.5 53.9 Ethno-linguistic group of household head Lao-Tai 4.4 15.0 60.3 82.9 88.2 89.1 90.6 57.5 Mon-Khmer 5.7 16.0 53.2 72.4 79.9 86.5 88.4 60.7 Hmong-Mien 3.6 8.8 28.9 47.6 73.0 81.5 83.9 53.7 Chinese-Tibetan 4.2 12.9 50.9 85.0 86.5 94.1 96.0 58.2 Total 4.5 14.8 57.4 78.6 84.2 87.5 88.7 57.9 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. * The number of living children includes current pregnancy Table FE.9: Desire to limit childbearing Percentage of currently married women age 15-49 who want no more children, by number of living children, Lao PDR 2011- 12 Number of living children* Total 6 83 Fertility Planning Status The issue of unplanned and unwanted fertility was further investigated in the 2011-12 LSIS by asking women with births in the two years preceding the survey whether the births were wanted at the time (“wanted then”), wanted at a later time (“wanted later”), or not wanted at all. For women who were pregnant at the time of the interview, this question was asked with reference to the current pregnancy. In the interpretation of these results, it is important to consider that a woman may declare a birth (or pregnancy) as wanted once the child is born even if that was not her feeling during pregnancy, and this rationalisation would result in an underestimation of the true extent of unwanted births. Nevertheless, these results provide some insight into the degree to which couples are able to control their fertility. Table FE.10 shows the percentage distribution of last births in the two years preceding the survey or current pregnancy, by fertility planning status, according to birth order and mother’s age at birth. Seven of every eight births (87 per cent) were reported as wanted at the time, 5 per cent were wanted but wanted later, and 7 per cent were not wanted at all (“unwanted”). The proportion of births wanted at the time of conception generally declines with both increasing birth order and mother’s age. Wanted then Wanted later Wanted no more Missing Total Birth order 1 92.8 5.2 1.5 0.5 100.0 1,549 2 90.2 5.2 2.8 1.8 100.0 1,392 3 87.1 4.7 6.1 2.0 100.0 835 4+ 77.1 3.1 17.4 2.5 100.0 1,439 Mother's age at birth <20 90.0 6.6 2.2 1.2 100.0 884 20-24 89.9 5.4 3.5 1.1 100.0 1,552 25-29 86.9 3.7 7.5 1.8 100.0 1,246 30-34 82.8 3.2 11.0 3.1 100.0 687 35-39 72.6 2.6 22.2 2.6 100.0 363 40-44 69.4 0.9 29.5 0.3 100.0 106 45-49 (65.2) (6.5) (22.9) (5.4) 100.0 30 Total 86.9 4.5 7.0 1.6 100.0 5,215 * includes current pregnancy Note: Figures in parentheses are based on 25-49 unweighted cases. Table FE.10: Fertility planning status Percent distribution of last birth or current pregnancy to women age 15-49 in the two years preceding the survey, by planning status of the birth or pregnancy, according to birth order and mother's age at birth, Lao PDR 2011-12 Planning status of birth* Number of women 6 © UNFPA Lao PDR / 2012 / Perier 85 VII. Reproductive Health This chapter presents information from the 2011-12 LSIS on contraceptive knowledge, use and need. Information on women’s knowledge of family planning methods provides a measure of the level of awareness of contraception in the population and indicates the success of information, education and communication programmes. Information on contraceptive use and need can help assess the success of family planning programmes. This chapter also presents findings from several areas of importance to maternal health, including antenatal, delivery and post-natal care. The data presented in this chapter provide an opportunity to identify critical issues affecting the health status of Lao women. This information will assist policy makers, planners and other collaborators in the health sector to formulate appropriate strategies and interventions to provide quality reproductive health services and a series of well-timed interventions to improve maternal health. Contraception Appropriate family planning can improve the health of women and children by: 1) preventing pregnancies that are too early or too late; 2) extending the period of time between births; and 3) limiting the number of children. It is critical that all couples should have access to information and services to prevent pregnancies that are too early, too late, too closely spaced or too many. Knowledge of contraceptive methods Knowledge of family planning is a prerequisite to obtaining access to and using a suitable contraceptive method in a timely and effective manner. Interviewers collected information regarding knowledge of contraceptive methods by describing each method and asking female and male respondents if she/he had heard of it. Using this approach, interviewers collected information about eight modern family planning methods: female and male sterilization; the IUD; injectables; Implants; the pill; and male and female condoms. Two traditional methods were also asked about: the rhythm method (periodic abstinence) and withdrawal. Interviewers also recorded any other methods that respondents mentioned. Table RH.1 shows the percentage of all respondents, currently married respondents, and sexually active unmarried respondents, age 15-49, who have heard of any contraceptive method, by specific method. Knowledge of at least one method of contraception is nearly universal among both women and men, regardless of marital status and sexual experience. Over 90 per cent of women and men have heard of a modern method. Both women and men are more familiar with modern methods of contraception (94 and 95 per cent, respectively) than with traditional methods (68 and 69 per cent, respectively). Unmarried sexually active women and men know of modern methods in similar proportions as their married counterparts. 7 86 Method All women Currently married women Sexually active unmarried women* All men Currently married men Sexually active unmarried men*1 Any method 94.0 95.6 95.5 95.3 97.0 98.4 Any modern method 93.6 95.2 95.5 94.7 96.4 97.9 Female sterilization 77.4 80.1 77.2 70.6 77.6 70.7 Male sterilization 48.0 49.3 50.9 45.7 49.8 43.1 IUD 72.4 76.9 71.6 59.8 69.8 55.4 Injectables 89.1 92.2 87.3 79.1 86.2 75.0 Implants 44.6 47.7 32.7 30.2 34.3 22.7 Pill 91.0 93.4 90.0 85.0 90.4 85.8 Male condom 84.5 85.4 91.7 90.9 92.5 95.9 Female condom 33.9 34.2 44.5 29.0 31.7 33.2 Any traditional method 68.4 76.3 71.5 69.2 79.4 72.0 Periodic abstinence/Rhythm 65.0 72.7 59.9 57.5 69.7 52.0 Withdrawal 52.4 60.5 51.1 55.2 62.8 63.7 Other 2.9 3.5 0.6 2.5 3.2 0.5 Mean number of methods known 6.6 7.0 6.6 6.1 6.7 6.0 Number of respondents 22,476 16,368 95 9,951 6,611 422 Table RH.1: Knowledge of contraceptive methods Percentage of all respondents, currently married respondents, and sexually active unmarried respondents age 15-49 who have heard of any contraceptive method, by specific method, Lao PDR 2011-12 * Had last sexual intercourse within the 28 days preceding the survey Women Men Nine in ten women have heard about the pill and about injectables. More men report knowledge of the pill (85 per cent) and the male condom (91 per cent) than any other contraceptive methods. The least known methods among women are the female condom (34 per cent), while the least known among men are the female condom (29 per cent) and implants (30 per cent). Current use of contraceptive methods Current use of contraceptive methods is one of the indicators most frequently used to assess the success of family planning programmes. This section focuses on the levels, trends and differentials in current use of family planning. Table RH.2 presents the percentage of women age 15 to 49 years who are currently married or in union and using (or whose partner is using) a contraceptive method. Further reference to ‘currently married’ in this section includes both formally married women and women who reported themselves to be living with a man (but who are not formally married). Fifty 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. Five per cent of married women are sterilized, and all other modern methods are used by fewer than 2 per cent of married women. Five per cent of married women report using periodic abstinence. 7 87 7 P er ce nt ag e of w om en a ge 1 5- 49 y ea rs c ur re nt ly m ar rie d or in u ni on w ho a re u si ng (o r w ho se p ar tn er is u si ng ) a c on tra ce pt iv e m et ho d, L ao P D R 2 01 1- 12 Fe m al e st er ili - za tio n M al e st er ili - za tio n IU D In je ct ab le s Im pl an ts P ill M al e co nd om Fe m al e co nd om D ia ph ra gm /F oa m /J el ly LA M P er io di c ab st in en ce W ith dr aw al O th er M is si ng A ny m od er n m et ho d A ny tr ad i- tio na l m et ho d A ny m et ho d1 R eg io n N or th 43 .1 4. 4 0. 0 1. 7 17 .1 0. 1 27 .0 0. 5 0. 0 0. 0 1. 4 4. 1 0. 5 0. 0 0. 1 50 .8 6. 2 57 .0 5, 44 6 C en tra l 52 .3 4. 4 0. 0 1. 6 10 .8 0. 1 20 .4 1. 6 0. 0 0. 0 0. 3 5. 7 2. 6 0. 2 0. 1 38 .9 8. 9 47 .8 7, 98 7 S ou th 58 .5 5. 3 0. 0 1. 2 14 .7 0. 1 12 .5 0. 7 0. 0 0. 0 0. 1 4. 3 2. 5 0. 0 0. 1 34 .5 7. 1 41 .6 2, 93 5 Pr ov in ce V ie nt ia ne C ap ita l 51 .1 4. 6 0. 1 2. 5 3. 9 0. 0 21 .2 3. 4 0. 1 0. 0 0. 2 9. 3 3. 3 0. 3 0. 0 35 .8 13 .1 48 .9 2, 11 6 P ho ng sa ly 55 .3 14 .3 0. 0 6. 2 13 .8 0. 0 8. 0 0. 5 0. 0 0. 0 0. 0 1. 3 0. 6 0. 0 0. 0 42 .8 1. 9 44 .7 54 1 Lu an gn am th a 43 .6 6. 0 0. 0 1. 5 17 .1 0. 0 28 .8 0. 4 0. 0 0. 0 0. 5 1. 9 0. 2 0. 0 0. 1 53 .7 2. 8 56 .5 47 7 O ud om xa y 38 .7 2. 3 0. 0 1. 3 18 .2 0. 0 24 .3 0. 1 0. 0 0. 0 7. 3 7. 4 0. 4 0. 0 0. 1 46 .2 15 .2 61 .4 88 4 B ok eo 40 .0 13 .3 0. 0 0. 1 25 .3 0. 0 15 .8 0. 6 0. 0 0. 0 0. 3 4. 1 0. 5 0. 0 0. 0 55 .1 4. 9 60 .0 47 6 Lu an gp ra ba ng 50 .4 1. 6 0. 0 1. 2 13 .6 0. 0 25 .3 0. 8 0. 0 0. 0 0. 1 6. 6 0. 4 0. 0 0. 2 42 .5 7. 3 49 .8 1, 14 1 H ua ph an h 48 .3 1. 5 0. 0 1. 9 16 .1 0. 1 27 .8 1. 1 0. 0 0. 0 0. 0 2. 0 1. 1 0. 0 0. 1 48 .6 3. 2 51 .8 83 1 X ay ab ur y 30 .3 1. 7 0. 1 1. 1 18 .5 0. 4 43 .6 0. 3 0. 1 0. 0 0. 7 2. 9 0. 4 0. 0 0. 1 65 .8 4. 0 69 .8 1, 09 6 X ie ng kh ua ng 38 .0 0. 8 0. 0 3. 4 10 .1 0. 0 15 .2 2. 6 0. 0 0. 0 0. 0 17 .7 12 .0 0. 1 0. 4 32 .1 30 .2 62 .3 66 3 V ie nt ia ne 53 .9 1. 3 0. 0 1. 1 9. 0 0. 0 29 .4 0. 9 0. 0 0. 0 0. 9 2. 5 1. 0 0. 0 0. 3 41 .6 4. 8 46 .3 1, 28 8 B or ik ha m xa y 47 .0 2. 8 0. 0 1. 0 15 .9 0. 0 26 .7 1. 2 0. 0 0. 0 0. 0 4. 7 0. 7 0. 0 0. 1 47 .6 5. 6 53 .1 66 4 K ha m m ua ne 49 .5 7. 9 0. 0 0. 8 23 .0 0. 1 14 .6 0. 7 0. 0 0. 0 0. 0 1. 4 1. 9 0. 1 0. 1 47 .1 3. 6 50 .6 78 4 S av an na kh et 58 .6 6. 3 0. 0 0. 9 12 .6 0. 1 16 .5 0. 6 0. 0 0. 0 0. 4 2. 6 1. 2 0. 2 0. 1 37 .1 4. 4 41 .5 2, 47 2 S ar av an e 56 .6 5. 0 0. 0 1. 1 17 .7 0. 1 12 .9 0. 8 0. 0 0. 0 0. 3 4. 1 1. 4 0. 0 0. 2 37 .6 6. 0 43 .6 1, 04 4 S ek on g 68 .3 5. 3 0. 0 1. 3 12 .5 0. 0 5. 1 0. 6 0. 1 0. 0 0. 0 1. 3 5. 3 0. 1 0. 1 24 .9 6. 9 31 .8 27 3 C ha m pa sa ck 59 .4 5. 2 0. 0 0. 8 11 .7 0. 2 13 .5 0. 7 0. 0 0. 0 0. 0 5. 1 3. 3 0. 0 0. 1 32 .1 8. 5 40 .7 1, 33 8 A tta pe u 51 .8 7. 3 0. 0 3. 3 19 .7 0. 0 13 .0 0. 5 0. 0 0. 0 0. 0 4. 4 0. 0 0. 0 0. 1 43 .8 4. 5 48 .3 28 0 R es id en ce U rb an 47 .5 6. 7 0. 0 2. 9 7. 4 0. 1 20 .6 2. 8 0. 1 0. 0 0. 3 8. 5 3. 0 0. 1 0. 1 40 .6 12 .0 52 .6 4, 30 1 R ur al 51 .4 3. 8 0. 0 1. 1 15 .8 0. 1 21 .4 0. 5 0. 0 0. 0 0. 8 3. 7 1. 5 0. 1 0. 1 42 .6 6. 1 48 .8 12 ,0 66 .R ur al w ith ro ad 50 .0 3. 9 0. 0 1. 1 16 .0 0. 1 22 .2 0. 6 0. 0 0. 0 0. 8 3. 8 1. 6 0. 1 0. 1 43 .8 6. 3 50 .2 10 ,8 45 .R ur al w ith ou t r oa d 63 .6 2. 7 0. 0 1. 3 13 .8 0. 0 14 .2 0. 0 0. 0 0. 0 0. 7 2. 6 1. 0 0. 0 0. 0 32 .0 4. 3 36 .4 1, 22 2 A ge 1 5- 19 73 .8 0. 1 0. 0 0. 1 5. 0 0. 0 16 .4 0. 7 0. 0 0. 0 1. 3 1. 7 0. 9 0. 0 0. 2 22 .3 4. 1 26 .4 1, 09 2 20 -2 4 58 .5 0. 7 0. 0 0. 5 9. 2 0. 0 23 .6 1. 0 0. 0 0. 0 1. 4 3. 2 1. 8 0. 0 0. 1 35 .0 6. 6 41 .6 2, 46 8 25 -2 9 45 .4 1. 8 0. 0 1. 1 14 .0 0. 1 28 .6 1. 3 0. 1 0. 0 0. 7 4. 5 2. 3 0. 1 0. 1 47 .0 7. 6 54 .7 3, 14 2 30 -3 4 40 .5 4. 5 0. 1 1. 9 17 .5 0. 2 24 .3 1. 9 0. 0 0. 0 0. 7 6. 1 2. 2 0. 1 0. 2 50 .5 9. 3 59 .8 2, 72 8 35 -3 9 37 .6 6. 9 0. 0 2. 8 19 .3 0. 0 22 .6 0. 7 0. 0 0. 0 0. 3 7. 3 2. 2 0. 2 0. 0 52 .4 10 .1 62 .4 2, 78 2 40 -4 4 49 .4 8. 1 0. 0 2. 2 15 .2 0. 0 16 .2 1. 0 0. 0 0. 0 0. 2 5. 8 1. 6 0. 1 0. 1 42 .9 7. 8 50 .7 2, 23 8 45 -4 9 68 .3 9. 3 0. 0 1. 5 7. 4 0. 2 7. 8 0. 5 0. 0 0. 0 0. 0 3. 6 1. 4 0. 1 0. 1 26 .6 5. 1 31 .7 1, 91 7 Ta bl e R H .2 : U se o f c on tr ac ep tio n Pe rc en t o f w om en (c ur re nt ly m ar rie d or in u ni on ) w ho a re u si ng : N um be r o f w om en cu rr en tly m ar rie d or in u ni on N ot u si ng an y m et ho d 1 M IC S in di ca to r 5 .3 ; M D G in di ca to r 5 .3 88 7 P er ce nt ag e of w om en a ge 1 5- 49 y ea rs c ur re nt ly m ar rie d or in u ni on w ho a re u si ng (o r w ho se p ar tn er is u si ng ) a c on tra ce pt iv e m et ho d, L ao P D R 2 01 1- 12 Fe m al e st er ili - za tio n M al e st er ili - za tio n IU D In je ct ab le s Im pl an ts P ill M al e co nd om Fe m al e co nd om D ia ph ra gm /F oa m /J el ly LA M P er io di c ab st in en ce W ith dr aw al O th er M is si ng A ny m od er n m et ho d A ny tr ad i- tio na l m et ho d A ny m et ho d1 N um be r o f l iv in g ch ild re n 0 85 .9 0. 3 0. 1 0. 1 0. 7 0. 0 8. 5 1. 6 0. 0 0. 0 0. 0 1. 7 1. 3 0. 0 0. 2 11 .2 3. 2 14 .3 1, 56 2 1 57 .1 1. 0 0. 0 0. 5 7. 5 0. 0 25 .2 1. 5 0. 0 0. 0 1. 0 4. 3 1. 8 0. 1 0. 1 35 .7 7. 3 43 .0 3, 06 4 2 38 .7 4. 2 0. 0 2. 4 14 .8 0. 2 29 .4 1. 3 0. 0 0. 0 0. 6 6. 0 2. 2 0. 2 0. 1 52 .3 9. 1 61 .4 4, 14 8 3 39 .6 8. 5 0. 0 2. 2 17 .0 0. 0 22 .6 1. 2 0. 0 0. 0 0. 5 5. 8 2. 4 0. 0 0. 1 51 .6 8. 9 60 .5 2, 98 5 4+ 51 .3 6. 2 0. 0 1. 5 18 .6 0. 1 14 .5 0. 5 0. 0 0. 0 0. 7 4. 9 1. 6 0. 1 0. 1 41 .4 7. 4 48 .8 4, 60 8 Ed uc at io n N on e 62 .0 2. 3 0. 0 0. 8 16 .6 0. 2 12 .8 0. 1 0. 0 0. 0 0. 9 3. 4 0. 9 0. 0 0. 1 32 .7 5. 3 38 .0 3, 97 2 P rim ar y 45 .7 5. 1 0. 0 1. 2 16 .4 0. 0 25 .0 0. 6 0. 0 0. 0 0. 7 3. 8 1. 4 0. 0 0. 1 48 .4 6. 0 54 .4 7, 29 4 Lo w er s ec on da ry 45 .1 5. 5 0. 1 2. 3 9. 4 0. 1 25 .6 1. 3 0. 0 0. 0 0. 5 6. 3 3. 8 0. 1 0. 2 44 .2 10 .9 55 .1 2, 72 9 U pp er s ec on da ry 50 .8 3. 7 0. 0 2. 9 5. 1 0. 0 23 .2 3. 0 0. 3 0. 0 0. 2 8. 4 2. 2 0. 2 0. 1 38 .2 11 .1 49 .3 1, 10 6 P os t s ec on da ry n on 50 .6 9. 3 0. 0 3. 2 4. 6 0. 2 16 .6 3. 1 0. 0 0. 0 0. 1 9. 7 2. 0 0. 5 0. 0 37 .1 12 .3 49 .4 77 4 H ig he r 52 .7 5. 5 0. 0 2. 6 3. 1 0. 0 8. 9 8. 0 0. 0 0. 0 0. 6 11 .5 6. 7 0. 4 0. 2 28 .1 19 .4 47 .4 49 4 W ea lth in de x qu in til e P oo re st 61 .1 1. 1 0. 0 0. 5 16 .0 0. 0 15 .2 0. 3 0. 0 0. 0 1. 7 3. 2 0. 8 0. 0 0. 1 33 .2 5. 9 39 .1 3, 02 7 S ec on d 54 .4 2. 6 0. 0 0. 9 18 .7 0. 1 18 .5 0. 3 0. 0 0. 0 0. 6 2. 6 1. 3 0. 0 0. 1 41 .2 4. 6 45 .7 3, 15 4 M id dl e 46 .9 4. 8 0. 0 1. 2 16 .6 0. 1 23 .7 0. 5 0. 0 0. 0 0. 5 3. 8 1. 8 0. 1 0. 1 46 .9 6. 2 53 .1 3, 21 6 Fo ur th 43 .7 5. 7 0. 0 1. 6 12 .8 0. 1 27 .6 0. 8 0. 0 0. 0 0. 4 4. 9 2. 3 0. 1 0. 2 48 .6 7. 9 56 .5 3, 40 7 R ic he st 47 .1 8. 0 0. 0 3. 3 4. 9 0. 1 20 .0 3. 4 0. 1 0. 0 0. 1 9. 5 3. 2 0. 2 0. 1 39 .9 13 .0 52 .9 3, 56 4 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 45 .7 5. 7 0. 0 1. 7 13 .1 0. 1 24 .2 1. 4 0. 0 0. 0 0. 2 5. 4 2. 3 0. 1 0. 1 46 .3 8. 1 54 .4 10 ,7 89 M on -K hm er 57 .0 2. 1 0. 0 0. 7 16 .4 0. 1 18 .4 0. 2 0. 0 0. 0 1. 6 2. 8 0. 6 0. 0 0. 1 38 .0 5. 1 43 .2 3, 72 1 H m on g- M ie n 68 .4 1. 5 0. 0 1. 0 7. 5 0. 0 7. 3 0. 7 0. 0 0. 0 1. 8 8. 3 3. 3 0. 1 0. 1 18 .0 13 .6 31 .7 1, 23 3 C hi ne se -T ib et an 56 .9 6. 8 0. 0 3. 5 17 .3 0. 0 12 .2 0. 5 0. 0 0. 0 0. 6 1. 6 0. 6 0. 0 0. 4 40 .3 3. 2 43 .5 53 0 O th er , M is si ng , D K 50 .4 2. 4 0. 0 8. 5 12 .8 0. 0 12 .1 6. 7 0. 0 0. 0 0. 6 6. 6 0. 0 0. 0 0. 0 42 .4 7. 2 49 .6 96 To ta l 50 .4 4. 6 0. 0 1. 6 13 .6 0. 1 21 .2 1. 1 0. 0 0. 0 0. 6 4. 9 1. 9 0. 1 0. 1 42 .1 7. 7 49 .8 16 ,3 68 1 M IC S in di ca to r 5 .3 ; M D G in di ca to r 5 .3 N ot u si ng an y m et ho d Pe rc en t o f w om en (c ur re nt ly m ar rie d or in u ni on ) w ho a re u si ng : N um be r o f w om en cu rr en tly m ar rie d or in u ni on Ta bl e R H .2 : U se o f c on tr ac ep tio n 89 Some 42 per cent of married women are using a modern method of family planning. The three most popular methods in the country are also the three most popular methods in each of the three regions surveyed. However, prevalence varies across the three regions. Use is highest in the Northern region, where 50 per cent of married women are using a modern method of contraception, compared with 39 per cent of women in the Central region and 35 per cent of women in the Southern region. Use of any contraceptive method, modern or traditional, follows an expected pattern by age, being lowest among 15-19 year-olds, rising to a peak among women in their thirties, and then declining among older women. Only 2 in 10 married women age 15-19 are using a modern method of contraception compared with 5 in 10 women in their thirties. Female sterilization is the only method to noticeably break from this age pattern; increasing gradually with age. After peaking at 48 per cent among women with primary education, use of a modern method actually declines as education increases. Use of injectables steadily decreases with increasing education, while use of periodic abstinence increases. Use of an intrauterine device (IUD) and female sterilization rises with increasing wealth quintile. Meanwhile, use of a modern method tends to increase with increasing wealth quintile, but peaks among women in the fourth wealth quintile, not the highest (in which women report more use of periodic abstinence). Use of a modern method is similarly prevalent among urban and rural women. Source of modern contraceptive methods Information on where women obtain their contraceptive methods is important for family planning programme managers and implementers. Interviewers asked women who reported using a modern method of contraception where they had most recently obtained it. The results are shown in Table RH.3. Source Female sterilization IUD Injectables Pill Male condom Total* Public sector 90.5 80.2 88.3 57.6 33.6 71.3 Government hospital 90.1 75.2 30.3 23.3 21.9 34.8 Government health centre 0.3 4.4 47.4 27.5 8.8 29.6 Family planning clinic 0.0 0.0 0.0 0.0 2.0 0.1 Mobile clinic 0.0 0.0 1.2 0.9 0.7 0.8 Field worker 0.0 0.1 9.0 5.7 0.3 5.8 Other public sector 0.1 0.4 0.3 0.2 0.0 0.2 Private medical sector 7.4 16.2 10.4 38.5 57.5 25.7 Private Hospital/Clinic 5.5 14.4 3.2 3.7 5.8 4.2 Private Pharmacy 0.0 0.6 4.8 33.8 51.7 20.0 Private Doctor 0.0 0.7 1.7 0.9 0.0 1.0 Private mobile clinic 0.0 0.4 0.0 0.0 0.0 0.0 Private field worker 0.0 0.0 0.5 0.1 0.0 0.2 Other Private 1.9 0.0 0.1 0.0 0.0 0.2 Other source 2.0 3.6 1.3 3.9 9.0 3.0 Shop 0.0 0.0 0.1 1.7 0.0 0.9 Friend/Relative 0.0 0.0 0.3 1.0 0.7 0.6 Other source 1.8 2.8 0.5 0.5 2.6 0.8 Missing 0.2 0.8 0.4 0.7 5.7 0.7 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 749 254 2,220 3,463 182 6,888 Table RH.3: Source of modern contraceptive methods Percent distribution of users of modern contraceptive methods age 15-49 by most recent source of method, according to method, Lao PDR 2011-12 *Total includes other modern methods but excludes lactational amenorrhea method (LAM) 7 90 Thirty-five per cent of users obtained their contraceptive method from a government hospital, and 30 per cent from a government health centre. The public sector is the major source of modern contraceptive methods in Lao PDR, serving 71 per cent of users. By comparison, 26 per cent of current users reported that their modern method of contraceptive was obtained from the private medical sector. Unmet Need ‘Women with an unmet need for contraception’ refers to fecund women who are not using any method of contraception, but who wish to postpone the next birth (spacing) or who wish to stop childbearing altogether (limiting). Women with an unmet need are identified in the 2011-12 LSIS by using a set of questions eliciting current behaviour and preferences pertaining to contraceptive use, fecundity and fertility preferences. ‘Women with a met need for contraception’ refers to women who are using a contraceptive method. The combination of women with unmet need and women with met need for family planning constitutes the total demand for family planning. Table RH.4 shows the levels of met need for contraception, unmet need, total demand for contraception and the proportion of demand for contraception satisfied. Women with an unmet need for spacing are defined as women who are not using a method of contraception AND who are: • Not pregnant and not postpartum amenorrheic,1 and are fecund2 and say they want to wait two or more years for their next birth, or are unsure when they want their next birth OR • Not pregnant and not postpartum amenorrheic, and are fecund and unsure whether they want another child OR • Pregnant and say that pregnancy was mistimed, that is they would have would have wanted to wait OR • Postpartum amenorrheic and say that the previous birth was mistimed, and they would have wanted to wait Women with an unmet need for limiting are defined as women who are not using a method of contraception AND who are: • Not pregnant and not postpartum amenorrheic, and are fecund and say they do not want any more children OR • Pregnant and say they did not want to get pregnant OR • Postpartum amenorrheic and say that they did not want the previous birth 1 A women is postpartum amenorrheic if she had a birth in last two years and is not currently pregnant, and her menstrual period has not returned since the birth of the last child 2 A women is considered infecund if she is neither pregnant nor postpartum amenorrheic, and (1a) Has not menstruated in the last six months, or (1b) never menstruated, or (1c) her last menstruation occurred before her last birth and her last birth was more than five years ago, or (1d) in menopause/has had a hysterectomy in response to a question on the timing of her last period OR (2) She declares that she has had a hysterectomy, or that she has never menstruated or that she is menopausal in response to questions on why she thinks she is not physically able to get pregnant at the time of survey OR (3) She declares she cannot get pregnant when asked about desire for future birth OR (4) She has not had a birth in the preceding five years and was married five or more years ago, and that she has been trying to get pregnant for two or more years without result or she reports she is too old in response to questions on why she thinks she is not physically able to get pregnant at the time of survey. 7 91 Total unmet need for contraception is simply the sum of unmet need for spacing and unmet need for limiting. One in five 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 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. Unmet need varies from a low of 10 per cent in Xiengkhuang to a high of 25 per cent in Champasack and Vientiane provinces, and is higher in the more remote rural areas without all access roads (28 per cent) than in both urban areas and rural areas with all access roads (19 per cent). Unmet need is highest among women with no education (26 per cent) and decreases with increasing wealth, with the exception of the richest wealth quintile. Unmet need is highest among women in Hmong-Mien headed households (31 per cent) and lowest in Lao-Tai headed households (18 per cent). Total unmet need varies little by age. However, unmet need for spacing and limiting follow expected age patterns, with declining unmet need for spacing, but increasing unmet need for limiting, up to age group 40-44, followed by a slight decline in the 45-49 age group as women reach menopause and are no longer in need of family planning. Unmet need for spacing is highest in the Central region (10 per cent), particularly Vientiane Capital and Vientiane province, and in the upper secondary and the higher education groups (12 and 13 per cent, respectively). Unmet need for limiting is highest in the South (17 per cent), rural areas without roads (19 per cent), among women with no education (17 per cent) and among the poorest women (16 per cent). 7 92 7 Fo r sp ac in g Fo r lim iti ng To ta l Fo r sp ac in g Fo r lim iti ng To ta l2 Fo r sp ac in g Fo r lim iti ng To ta l R eg io n N or th 13 .9 43 .1 57 .0 6. 5 10 .2 16 .7 20 .4 53 .3 73 .7 5, 44 6 77 .3 70 .8 4, 01 5 C en tra l 16 .8 31 .0 47 .8 9. 6 10 .9 20 .6 26 .4 42 .0 68 .4 7, 98 7 69 .9 57 .3 5, 46 3 S ou th 12 .2 29 .4 41 .6 7. 3 16 .8 24 .1 19 .5 46 .2 65 .7 2, 93 5 63 .3 52 .7 1, 92 8 Pr ov in ce V ie nt ia ne C ap ita l 16 .5 32 .4 48 .9 10 .3 12 .7 23 .0 26 .8 45 .1 71 .9 2, 11 6 68 .0 50 .1 1, 52 1 P ho ng sa ly 4. 6 40 .1 44 .7 10 .0 12 .2 22 .2 14 .7 52 .3 67 .0 54 1 66 .8 63 .9 36 2 Lu an gn am th a 11 .6 44 .9 56 .5 10 .2 10 .8 21 .1 21 .9 55 .7 77 .6 47 7 72 .9 70 .0 37 0 O ud om xa y 14 .0 47 .4 61 .4 4. 0 8. 6 12 .6 18 .0 55 .9 73 .9 88 4 83 .0 72 .3 65 4 B ok eo 15 .6 44 .4 60 .0 8. 1 7. 2 15 .3 23 .7 51 .7 75 .3 47 6 79 .7 73 .6 35 9 Lu an gp ra ba ng 13 .6 36 .3 49 .8 5. 4 15 .3 20 .7 19 .0 51 .6 70 .6 1, 14 1 70 .6 60 .4 80 5 H ua ph an h 9. 5 42 .3 51 .8 5. 5 10 .7 16 .2 14 .9 53 .1 68 .0 83 1 76 .1 71 .4 56 6 X ay ab ur y 22 .4 47 .4 69 .8 6. 4 6. 0 12 .4 28 .8 53 .4 82 .2 1, 09 6 84 .9 80 .8 90 0 X ie ng kh ua ng 21 .6 40 .8 62 .3 5. 1 5. 2 10 .4 26 .7 46 .0 72 .7 66 3 85 .7 44 .2 48 2 V ie nt ia ne 18 .8 27 .5 46 .3 12 .6 12 .5 25 .1 31 .4 40 .1 71 .4 1, 28 8 64 .9 59 .5 92 0 B or ik ha m xa y 20 .1 33 .0 53 .1 7. 1 6. 8 13 .9 27 .2 39 .8 67 .0 66 4 79 .3 70 .9 44 5 K ha m m ua ne 17 .2 33 .4 50 .6 7. 0 11 .5 18 .5 24 .2 44 .9 69 .2 78 4 73 .2 68 .1 54 2 S av an na kh et 13 .8 27 .7 41 .5 10 .3 11 .0 21 .3 24 .0 38 .8 62 .8 2, 47 2 66 .1 59 .6 1, 55 3 S ar av an e 13 .9 29 .7 43 .6 7. 7 15 .2 22 .9 21 .6 44 .9 66 .5 1, 04 4 65 .5 57 .0 69 4 S ek on g 6. 8 25 .0 31 .8 5. 8 19 .0 24 .8 12 .6 44 .0 56 .7 27 3 56 .2 44 .0 15 5 C ha m pa sa ck 12 .7 27 .9 40 .7 7. 3 18 .1 25 .4 20 .0 46 .1 66 .1 1, 33 8 61 .6 48 .6 88 4 A tta pe u 8. 7 39 .6 48 .3 7. 1 14 .5 21 .6 15 .8 54 .1 69 .9 28 0 69 .1 62 .6 19 6 R es id en ce U rb an 17 .2 35 .4 52 .6 9. 3 9. 9 19 .2 26 .5 45 .3 71 .8 4, 30 1 73 .2 56 .9 3, 08 9 R ur al 14 .2 34 .5 48 .8 7. 8 12 .4 20 .2 22 .0 46 .9 68 .9 12 ,0 66 70 .7 62 .9 8, 31 8 .R ur al w ith ro ad 14 .9 35 .2 50 .2 7. 6 11 .7 19 .3 22 .5 47 .0 69 .5 10 ,8 45 72 .2 64 .1 7, 53 7 .R ur al w ith ou t r oa d 8. 3 28 .1 36 .4 9. 1 18 .5 27 .6 17 .4 46 .5 63 .9 1, 22 2 56 .9 51 .2 78 1 M et n ee d fo r c on tr ac ep tio n Ta bl e R H .4 : U nm et n ee d fo r c on tr ac ep tio n P er ce nt ag e of w om en a ge 1 5- 49 y ea rs c ur re nt ly m ar rie d or in u ni on w ith a n un m et n ee d fo r f am ily p la nn in g an d pe rc en ta ge o f d em an d fo r c on tra ce pt io n sa tis fie d, L ao P D R 2 01 1- 12 U nm et n ee d fo r c on tr ac ep tio n N um be r o f w om en cu rr en tly m ar rie d or in u ni on P er ce nt ag e of de m an d fo r co nt ra ce pt io n sa tis fie d N um be r o f w om en cu rr en tly m ar rie d or in un io n w ith n ee d fo r co nt ra ce pt io n To ta l d em an d fo r co nt ra ce pt io n P er ce nt ag e of de m an d fo r co nt ra ce pt io n sa tis fie d by m od er n m et ho ds 1 M IC S in di ca to r 5 .3 ; M D G in di ca to r 5 .3 2 M IC S in di ca to r 5 .4 ; M D G in di ca to r 5 .6 93 7 Fo r sp ac in g Fo r lim iti ng To ta l Fo r sp ac in g Fo r lim iti ng To ta l2 Fo r sp ac in g Fo r lim iti ng To ta l A ge 1 5- 19 22 .8 3. 6 26 .4 20 .7 1. 9 22 .6 43 .5 5. 5 49 .0 1, 09 2 53 .9 48 .2 53 5 20 -2 4 30 .2 11 .5 41 .6 16 .7 4. 3 21 .0 46 .8 15 .8 62 .6 2, 46 8 66 .5 58 .2 1, 54 5 25 -2 9 26 .8 27 .9 54 .7 10 .6 7. 6 18 .2 37 .4 35 .5 72 .9 3, 14 2 75 .0 65 .5 2, 29 0 30 -3 4 15 .4 44 .3 59 .8 7. 3 12 .2 19 .6 22 .8 56 .6 79 .3 2, 72 8 75 .3 64 .4 2, 16 5 35 -3 9 5. 4 57 .1 62 .4 3. 9 17 .3 21 .2 9. 3 74 .4 83 .6 2, 78 2 74 .7 63 .0 2, 32 6 40 -4 4 1. 6 49 .1 50 .7 2. 0 20 .8 22 .9 3. 6 70 .0 73 .6 2, 23 8 68 .9 58 .6 1, 64 6 45 -4 9 0. 9 30 .9 31 .7 0. 7 14 .4 15 .2 1. 6 45 .3 46 .9 1, 91 7 67 .7 56 .7 90 0 Ed uc at io n N on e 7. 3 30 .8 38 .0 9. 0 16 .8 25 .8 16 .3 47 .6 63 .9 3, 97 2 59 .5 52 .6 2, 53 6 P rim ar y 15 .4 39 .0 54 .4 6. 4 11 .0 17 .4 21 .8 50 .0 71 .8 7, 29 4 75 .8 68 .5 5, 23 5 Lo w er s ec on da ry 20 .0 35 .1 55 .1 8. 5 9. 5 18 .0 28 .5 44 .6 73 .1 2, 72 9 75 .4 61 .1 1, 99 4 U pp er s ec on da ry 23 .4 25 .9 49 .3 13 .1 8. 6 21 .8 36 .5 34 .6 71 .1 1, 10 6 69 .4 54 .0 78 6 P os t s ec on da ry n on te rti ar y 17 .2 32 .3 49 .4 8. 3 9. 2 17 .5 25 .5 41 .5 67 .0 77 4 73 .8 55 .6 51 9 H ig he r 22 .6 24 .8 47 .4 14 .7 6. 1 20 .8 37 .3 30 .9 68 .2 49 4 69 .5 42 .0 33 7 W ea lth in de x qu in til e P oo re st 9. 6 29 .5 39 .1 9. 5 16 .2 25 .6 19 .0 45 .7 64 .7 3, 02 7 60 .4 53 .9 1, 95 9 S ec on d 11 .7 34 .0 45 .7 8. 7 12 .9 21 .5 20 .4 46 .9 67 .3 3, 15 4 68 .0 62 .0 2, 12 2 M id dl e 15 .9 37 .3 53 .1 7. 0 10 .8 17 .8 22 .9 48 .1 71 .0 3, 21 6 74 .9 66 .8 2, 28 2 Fo ur th 19 .2 37 .3 56 .5 6. 5 9. 7 16 .2 25 .7 47 .0 72 .6 3, 40 7 77 .8 67 .5 2, 47 4 R ic he st 17 .8 35 .1 52 .9 9. 3 9. 9 19 .2 27 .1 45 .0 72 .1 3, 56 4 73 .4 55 .5 2, 57 0 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 17 .8 36 .6 54 .4 7. 4 10 .5 17 .9 25 .2 47 .1 72 .3 10 ,7 89 75 .2 64 .3 7, 80 1 M on -K hm er 9. 6 33 .5 43 .2 8. 4 13 .3 21 .7 18 .1 46 .8 64 .8 3, 72 1 66 .6 61 .1 2, 41 2 H m on g- M ie n 10 .0 21 .7 31 .7 12 .2 18 .2 30 .5 22 .2 40 .0 62 .1 1, 23 3 51 .0 31 .9 76 6 C hi ne se -T ib et an 6. 2 37 .3 43 .5 13 .0 11 .5 24 .5 19 .2 48 .8 68 .1 53 0 63 .9 60 .2 36 0 O th er , M is si ng , D K 22 .6 27 .0 49 .6 5. 4 14 .7 20 .1 28 .0 41 .7 69 .7 96 71 .2 61 .7 67 To ta l 15 .0 34 .7 49 .8 8. 2 11 .8 19 .9 23 .2 46 .5 69 .7 16 ,3 68 71 .4 61 .3 11 ,4 07 1 M IC S in di ca to r 5 .3 ; M D G in di ca to r 5 .3 2 M IC S in di ca to r 5 .4 ; M D G in di ca to r 5 .6 M et n ee d fo r c on tr ac ep tio n U nm et n ee d fo r c on tr ac ep tio n To ta l d em an d fo r co nt ra ce pt io n P er ce nt ag e of de m an d fo r co nt ra ce pt io n sa tis fie d P er ce nt ag e of de m an d fo r co nt ra ce pt io n sa tis fie d by m od er n m et ho ds N um be r o f w om en cu rr en tly m ar rie d or in un io n w ith n ee d fo r co nt ra ce pt io n N um be r o f w om en cu rr en tly m ar rie d or in u ni on Ta bl e R H .4 : U nm et n ee d fo r c on tr ac ep tio n P er ce nt ag e of w om en a ge 1 5- 49 y ea rs c ur re nt ly m ar rie d or in u ni on w ith a n un m et n ee d fo r f am ily p la nn in g an d pe rc en ta ge o f d em an d fo r c on tra ce pt io n sa tis fie d, L ao P D R 2 01 1- 12 94 Met need for limiting includes women who are using (or whose partner is using) a contraceptive method and who want no more children, have used male or female sterilization, or declare themselves as infecund. Met need for spacing includes women who are using (or whose partner is using) a contraceptive method and who want to have another child or are undecided whether to have another child. The sum of met need for spacing and limiting is the total met need for contraception. Half of all married women have a met need for contraception – 15 per cent for spacing and 35 per cent for limiting. The total demand for contraception and the percentage of demand for contraception that is satisfied are also estimated from the 2011-2012 Lao PDR data using information on contraception and unmet need. The total demand for contraception includes women who currently have an unmet need (for spacing or limiting) plus those who are currently using contraception. The percentage of demand satisfied is defined as the proportion of women currently married or in a marital union who are currently using contraception, of the total demand for contraception. The total demand for contraception includes women who currently have an unmet need (for spacing or limiting), plus those who are currently using contraception. Seven in 10 married women have a demand for contraception – 23 per cent for spacing and 47 per cent for limiting. Total demand is highest in the Northern region (74 per cent), and ranges between 57 per cent in Sekong and 82 per cent in Xayabury. Total demand increases with age up to 35-39 and then declines in the older age groups. In general, of the total demand for contraception, one third is for spacing and two thirds for limiting; however, total demand for spacing exceeds total demand for limiting for women with upper secondary or higher education, and, as expected, for younger women. Table RH.4 shows that the total met need (50 per cent) is higher than the total unmet need for family planning (20 per cent). The table also highlights that the percentage of demand for contraception satisfied (71 per cent) is high, though the demand satisfied in rural areas without roads is still relatively low (57 per cent). The percentage of demand satisfied is highest in the North (77 per cent) and lowest in the South (63 per cent). The percentage of demand for contraception satisfied by modern methods is somewhat lower (61 per cent). Antenatal Care The antenatal period presents important opportunities for reaching pregnant women with a number of interventions that may be vital to their health and well-being and to that of their infants. Better understanding of the relationship between a mother’s health and foetal growth and development continues to inform what interventions should be undertaken during the time a pregnant woman seeks antenatal care (ANC). For example, if the antenatal period is used to inform women and families about the danger signs and symptoms of pregnancy-related problems, and about the risks associated with labour and delivery, it may provide a route for communicating the importance of delivering with the assistance of a health professional. The antenatal period also provides an opportunity to supply information on birth spacing, which is recognized as an important factor in improving infant survival. Tetanus immunization during pregnancy, for example, can be life-saving for both the mother and infant. The prevention and treatment of malaria among pregnant women, management of anaemia during pregnancy, and treatment of STIs can all significantly improve foetal outcomes and maternal health. Adverse outcomes such as low birth weight can be reduced by improving women’s nutritional status and preventing infections such as malaria and sexually transmitted infections (STIs) during the antenatal period. More recently, the potential of the antenatal period as an entry point for HIV prevention and care, in particular for the prevention of HIV transmission from mother to child, has led to renewed interest in access to and use of antenatal services. 7 95 WHO recommends a minimum of four antenatal visits based on a review of the effectiveness of different models of antenatal care. WHO guidelines are specific on the content of ANC visits, which should include: • Blood pressure measurement • Urine testing for bacteriuria and proteinuria • Blood testing to detect syphilis and severe anaemia • Weight/height measurement (optional) The quality of ANC can be measured by the qualifications of the provider and the number and frequency of ANC visits. Antenatal care quality can also be monitored through the content of services received and the kinds of information given to women during their visits. These services raise awareness of the danger signs during pregnancy, delivery and the post-natal period. They also improve the health- seeking behaviour of the client, educate the client about birth preparedness issues, and provide basic preventive and therapeutic care. The 2011-2012 LSIS obtained information on ANC coverage from the responses of women who gave birth in the two years preceding the survey. Table RH.5 shows the percentage distribution of mothers in the two years preceding the survey by type of personnel providing ANC. About fifty-four per cent of women age 15-49 years who gave birth in the two years preceding the survey received ANC from a skilled provider3 – 46 per cent from a medical doctor, 7 per cent from a nurse or midwife, and 2 per cent from an auxiliary midwife. Only 1 per cent of women received care from a traditional birth attendant or community health worker. About 4 in every 10 Lao women (44 per cent) who gave birth in the two years preceding the survey did not receive any ANC. While this percentage is substantial, it represents a marked improvement. The 2006 MICS found that only 35 per cent of women received ANC from a skilled provider and as many as 6 in 10 women did not receive any ANC. The improvement in ANC coverage over the last five years has been impressive. In the Central region, 63 per cent of women received ANC from health personnel, compared with 49 per cent in the South and 45 per cent in the North. Eighty-three per cent of women in urban areas received ANC from health provider, compared with 46 per cent in rural areas. ANC coverage by health professional is highly correlated with women’s education and wealth. More than 90 per cent of women with upper secondary school or more education received ANC from a health professional, while only 23 per cent of those with no education did so. Ninety-two per cent of women in the richest quintile received ANC from a health professional, compared with only 23 per cent of women in the poorest quintile. The receipt of a health professional’s care varied across provinces, and was reported by the fewest women in Phongsaly and Oudomxay (25 and 35 per cent, respectively). Nine in ten women in Vientiane Capital received ANC from a health professional. In Lao-Tai headed households, 72 per cent of women received ANC from a health professional. However, this figure drops to 36 per cent of women in Mon-Khmer headed households, 25 per cent in Chinese-Tibetan headed households, and 24 per cent in Hmong-Mien headed households. In summary, ANC was received by a higher percentage of women who live in urban areas (especially in Vientiane Capital where 9 in 10 women received ANC), those with at least upper secondary education, and the wealthiest women. 3 In the Lao context, ‘skilled provider/ skilled professional’ is replaced by the term ‘health professional’, which includes doctor, nurse, mid-wife and auxiliary mid-wife. 7 96 7 Medical doctor Nurse/ Midwife Auxiliary midwife Traditional birth attendant Community health worker Other Region North 34.2 9.2 1.6 0.7 1.1 1.3 52.0 100.0 45.0 1,377 Central 56.1 5.5 1.6 0.5 0.2 1.1 35.0 100.0 63.3 1,989 South 40.3 6.4 1.8 0.2 0.2 0.7 50.4 100.0 48.6 940 Province Vientiane Capital 80.9 7.9 1.0 0.4 0.0 1.5 8.3 100.0 89.8 415 Phongsaly 23.1 2.1 0.0 0.0 0.5 1.2 73.0 100.0 25.2 148 Luangnamtha 45.6 13.4 3.3 0.4 0.0 0.8 36.5 100.0 62.3 99 Oudomxay 27.3 2.4 5.3 0.6 3.2 0.3 61.0 100.0 34.9 266 Bokeo 33.5 4.4 0.0 0.0 0.0 0.0 62.1 100.0 37.9 141 Luangprabang 33.2 11.7 1.2 0.9 0.4 2.1 50.6 100.0 46.0 280 Huaphanh 19.7 22.1 0.3 0.0 0.0 0.7 57.2 100.0 42.1 237 Xayabury 64.3 6.5 0.0 2.5 2.1 3.2 21.4 100.0 70.9 205 Xiengkhuang 34.4 15.1 0.9 0.0 0.0 0.9 48.8 100.0 50.3 200 Vientiane 70.1 3.6 0.5 0.0 0.0 0.8 25.1 100.0 74.1 295 Borikhamxay 60.2 0.0 0.5 0.0 0.0 0.5 38.8 100.0 60.7 162 Khammuane 38.5 7.0 2.1 1.3 0.8 1.1 49.3 100.0 47.5 233 Savannakhet 46.4 2.9 2.9 0.6 0.3 1.2 45.7 100.0 52.2 683 Saravane 34.6 10.9 2.3 0.0 0.0 1.8 50.4 100.0 47.8 361 Sekong 33.3 7.1 0.0 0.0 0.0 0.3 59.3 100.0 40.4 99 Champasack 47.2 3.6 0.3 0.4 0.3 0.0 48.2 100.0 51.1 397 Attapeu 40.4 0.0 9.2 0.0 0.5 0.0 49.9 100.0 49.6 83 Residence Urban 75.8 6.4 1.2 0.6 0.2 1.5 14.3 100.0 83.4 957 Rural 37.0 7.1 1.8 0.4 0.6 1.0 52.2 100.0 45.9 3,349 .Rural with road 40.4 7.7 1.7 0.5 0.6 1.0 48.3 100.0 49.7 2,928 .Rural without road 13.5 2.7 2.7 0.3 0.4 0.8 79.5 100.0 19.0 421 Mother's age at birth Less than 20 41.0 7.5 1.1 0.5 0.5 0.5 48.9 100.0 49.6 745 20-34 48.2 7.0 1.7 0.4 0.5 1.2 40.9 100.0 56.9 3,087 35-49 36.3 5.3 2.1 0.5 0.0 1.2 54.6 100.0 43.8 474 Education None 17.3 4.1 1.7 0.3 0.3 1.1 75.2 100.0 23.1 1,248 Primary 46.5 7.6 2.1 0.9 0.8 0.9 41.2 100.0 56.1 1,763 Lower secondary 62.8 8.8 1.0 0.2 0.3 1.2 25.7 100.0 72.7 693 Upper secondary 82.0 7.7 0.7 0.0 0.0 0.3 9.3 100.0 90.3 334 Post secondary non tertiary 81.0 12.1 1.2 0.0 0.0 1.3 4.4 100.0 94.3 146 Higher 84.3 6.9 1.8 0.0 0.0 3.9 3.1 100.0 93.0 122 Wealth index quintile Poorest 17.0 4.2 1.7 0.4 0.8 0.8 75.2 100.0 22.9 1,178 Second 33.4 6.9 1.8 0.5 0.5 1.5 55.5 100.0 42.1 927 Middle 49.7 9.9 2.4 1.0 0.6 0.9 35.5 100.0 62.0 810 Fourth 67.1 8.5 1.5 0.4 0.2 0.9 21.4 100.0 77.1 707 Richest 84.6 6.3 0.8 0.2 0.0 1.5 6.6 100.0 91.7 684 Ethno-linguistic group of household head Lao-Tai 61.9 8.1 1.4 0.7 0.3 1.5 26.0 100.0 71.5 2,401 Mon-Khmer 28.1 5.2 2.9 0.2 1.0 0.7 61.9 100.0 36.2 1,213 Hmong-Mien 17.6 5.9 0.3 0.2 0.2 0.2 75.5 100.0 23.9 530 Chinese-Tibetan 20.0 4.2 0.4 0.3 0.0 0.0 75.1 100.0 24.6 140 Other, Missing, DK * * * * * * * * * 21 Total 45.6 6.9 1.7 0.5 0.5 1.1 43.8 100.0 54.2 4,306 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Table RH.5: Antenatal care coverage 1 MICS indicator 5.5a; MDG indicator 5.5 Percent distribution of women age 15-49 who gave birth in the two years preceding the survey by type of personnel providing antenatal care during the pregnancy for the last birth, Lao PDR 2011-12 Person providing antenatal care Number of women who gave birth in the preceding two years No antenatal care received Any skilled personnel1Total 97 ANC is most beneficial in preventing adverse pregnancy outcomes when it is received early in the pregnancy and continued through to delivery. It is important that ANC be given to pregnant women at the early stages of pregnancy in order to provide them with information about healthy practices and services that decrease the likelihood of certain complications during delivery. The minimum four antenatal visits recommended by UNICEF and WHO include at least one visit in the first trimester (three months) of pregnancy, one visit in the second trimester and two visits during the third trimester. Table RH.6 presents the percentage distribution of women by the number of ANC visits they received, among women who had a live birth in the two years preceding the survey. Thirty-seven per cent of women made four or more visits for ANC during their pregnancy. Fourteen per cent of women made two or three antenatal visits, and 5 per cent had only one antenatal visit. Differentials by background characteristics in the percentage of women who made at least four ANC visits are as would be expected. The percentage of women making four or more visits for ANC increases sharply with increasing wealth and education level. Only 1 in 10 women from the poorest households, and those with no education received ANC four or more times compared with as many as 8 in 10 women in the richest quintile and women with at least upper secondary education. Seventy-one per cent of women in urban areas received four or more ANC visits, compared with only 27 per cent of women in rural areas. A higher percentage of women age 20-34 had at least four ANC visits (41 per cent) compared with younger and older women (27 and 28 per cent, respectively). Only 3 in 10 women in the Northern and Southern regions received four or more ANC visits, compared with 47 per cent of women in the Central region. 7 98 No antenetal care visits One visit Two visits Three visits 4 or more visits1 DK/Missing Total Number of women who had a live birth in the preceding two years Region North 52.0 5.2 4.8 9.1 28.7 0.1 100.0 1,377 Central 35.0 4.3 5.4 8.5 46.5 0.4 100.0 1,989 South 50.4 4.6 5.9 10.2 28.3 0.5 100.0 940 Province Vientiane Capital 8.3 2.0 1.4 5.4 82.0 1.0 100.0 415 Phongsaly 73.0 5.6 5.9 6.1 9.4 0.0 100.0 148 Luangnamtha 36.5 6.8 7.3 14.9 34.6 0.0 100.0 99 Oudomxay 61.0 11.1 4.7 9.8 13.4 0.0 100.0 266 Bokeo 62.1 4.4 2.4 3.8 26.9 0.4 100.0 141 Luangprabang 50.6 2.8 2.8 12.0 31.4 0.5 100.0 280 Huaphanh 57.2 3.2 7.5 7.9 24.3 0.0 100.0 237 Xayabury 21.4 2.8 4.4 9.0 62.5 0.0 100.0 205 Xiengkhuang 48.8 4.9 4.0 8.5 32.9 0.9 100.0 200 Vientiane 25.1 3.1 5.8 10.8 54.8 0.5 100.0 295 Borikhamxay 38.8 1.8 4.6 7.8 46.9 0.0 100.0 162 Khammuane 49.3 7.2 6.0 9.3 28.2 0.0 100.0 233 Savannakhet 45.7 5.8 7.9 9.1 31.5 0.0 100.0 683 Saravane 50.4 5.8 7.6 12.2 23.2 0.8 100.0 361 Sekong 59.3 3.4 6.7 5.3 25.3 0.0 100.0 99 Champasack 48.2 4.1 4.5 10.3 32.7 0.2 100.0 397 Attapeu 49.9 2.7 4.7 7.4 33.6 1.8 100.0 83 Residence Urban 14.3 2.3 3.5 8.6 70.6 0.7 100.0 957 Rural 52.2 5.3 5.8 9.2 27.2 0.2 100.0 3,349 .Rural with road 48.3 5.7 6.2 9.9 29.7 0.2 100.0 2,928 .Rural without road 79.5 3.1 3.2 4.2 9.9 0.1 100.0 421 Mother's age at birth Less than 20 48.9 7.8 6.5 10.1 26.8 0.0 100.0 745 20-34 40.9 4.0 5.1 9.0 40.7 0.4 100.0 3,087 35-49 54.6 4.3 5.2 7.8 28.0 0.1 100.0 474 Education None 75.2 5.0 5.1 6.0 8.8 0.1 100.0 1,248 Primary 41.2 6.0 6.6 11.9 34.0 0.3 100.0 1,763 Lower secondary 25.7 3.4 4.7 9.8 56.0 0.4 100.0 693 Upper secondary 9.3 1.9 3.5 6.5 78.0 0.7 100.0 334 Post secondary non tertiary 4.4 2.2 1.8 6.9 84.8 0.0 100.0 146 Higher 3.1 0.0 2.0 5.8 87.0 2.1 100.0 122 Wealth index quintile Poorest 75.2 5.1 4.8 5.5 9.1 0.2 100.0 1,178 Second 55.5 6.8 8.3 10.2 19.3 0.0 100.0 927 Middle 35.5 4.9 6.9 10.9 41.4 0.3 100.0 810 Fourth 21.4 4.2 4.2 13.0 56.8 0.4 100.0 707 Richest 6.6 1.1 1.4 7.4 82.6 0.8 100.0 684 Ethno-linguistic group of household head Lao-Tai 26.0 3.7 4.8 10.0 55.0 0.4 100.0 2,401 Mon-Khmer 61.9 5.8 6.8 8.8 16.5 0.3 100.0 1,213 Hmong-Mien 75.5 6.4 4.4 5.2 8.5 0.0 100.0 530 Chinese-Tibetan 75.1 4.1 4.0 10.7 6.1 0.0 100.0 140 Other, Missing, DK * * * * * * * 21 Total 43.8 4.7 5.3 9.1 36.9 0.3 100.0 4,306 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Percent distribution of women who had a live birth during the two years preceding the survey by number of antenatal care visits by any provider, Lao PDR 2011-12 Percent distribution of women who had: Table RH.6: Number of antenatal care visits 1 MICS indicator 5.5b; MDG indicator 5.5 7 99 Measuring the components of ANC is essential for assessing the quality of ANC services. Pregnancy complications are a primary source of maternal and child morbidity and mortality. Therefore, pregnant women should routinely receive information on the signs of complications, and be tested for them at all ANC visits. To help assess the quality of antenatal services, respondents were asked whether they received certain screening tests during at least one of their ANC visits (see Table RH.7). Among those women who had a live birth during the two years preceding the survey, 47 per cent reported that their blood pressure was checked, 23 per cent reported that a urine specimen was taken, and 23 per cent reported that a blood sample was taken during an ANC visit. Only 18 per cent of women reported that they received all three types of ANC services. Women in the Central region (especially in Vientiane Capital), age 20-34, urban residents, women with at least upper secondary education, and women in the highest wealth quintiles were more likely to report receiving each of the specified services. 7 100 Blood pressure measured Urine sample taken Blood sample taken Blood pressure measured, urine and blood sample taken1 Region North 43.5 17.7 15.8 12.7 1,377 Central 52.5 29.4 32.1 25.2 1,989 South 39.9 15.2 15.3 12.0 940 Province Vientiane Capital 88.4 68.5 72.8 62.6 415 Phongsaly 24.9 11.0 4.8 3.5 148 Luangnamtha 58.4 21.7 25.4 17.0 99 Oudomxay 36.3 9.2 2.2 1.9 266 Bokeo 36.7 19.8 24.2 17.5 141 Luangprabang 44.8 32.0 29.4 26.5 280 Huaphanh 36.8 3.6 4.0 1.6 237 Xayabury 69.6 26.9 25.9 21.9 205 Xiengkhuang 40.7 12.5 8.3 8.3 200 Vientiane 52.5 19.6 19.5 14.9 295 Borikhamxay 60.3 24.6 23.4 21.9 162 Khammuane 40.2 12.9 19.0 9.9 233 Savannakhet 36.6 21.6 26.4 17.8 683 Saravane 34.7 17.7 16.0 13.0 361 Sekong 37.4 4.0 2.8 2.8 99 Champasack 44.2 16.5 19.1 14.2 397 Attapeu 45.1 11.7 9.8 8.6 83 Residence Urban 77.9 49.2 54.1 43.6 957 Rural 38.0 14.9 14.4 11.1 3,349 .Rural with road 41.0 16.0 15.8 12.1 2,928 .Rural without road 17.4 7.6 4.7 4.0 421 Mother's age at birth Less than 20 39.4 17.4 16.9 12.0 745 20-34 50.0 24.6 25.8 20.3 3,087 35-49 38.6 17.5 16.7 15.3 474 Education None 17.9 6.6 5.9 4.3 1,248 Primary 47.2 19.6 19.3 14.9 1,763 Lower secondary 64.1 30.6 32.0 25.3 693 Upper secondary 82.7 52.0 57.2 47.2 334 Post secondary non tertiary 88.8 50.7 58.7 46.1 146 Higher 92.8 68.3 72.9 58.2 122 Wealth index quintile Poorest 18.0 5.7 4.2 3.5 1,178 Second 34.8 13.5 12.5 10.0 927 Middle 50.1 21.6 19.5 15.8 810 Fourth 68.2 29.0 33.0 24.3 707 Richest 87.0 58.2 65.0 52.0 684 Ethno-linguistic group of household head Lao-Tai 62.4 32.6 35.1 27.7 2,401 Mon-Khmer 30.5 11.5 9.5 7.8 1,213 Hmong-Mien 19.2 5.1 4.1 2.7 530 Chinese-Tibetan 23.8 10.7 7.3 6.5 140 Other, Missing, DK * * * * 21 Total 46.9 22.6 23.2 18.3 4,306 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Table RH.7: Content of antenatal care 1 MICS indicator 5.6 Percentage of women age 15-49 years who had their blood pressure measured, urine sample taken, and blood sample taken as part of antenatal care, Lao PDR 2011-12 Number of women who had a live birth in the preceding two years Percentage of pregnant women who had: 7 101 Use of Iron Pills Iron deficiency anaemia occurs when iron stores are exhausted and the supply of iron to the tissues is insufficient. Pregnant women are especially at risk of problems resulting from iron deficiency anaemia, which can contribute to the severity of complications during childbirth, such as haemorrhage, premature delivery and low birth weight. To prevent iron deficiency anaemia, iron pills are usually supplied to pregnant women during their ANC visits. It is recommended that pregnant women take at least 90 iron pills during their pregnancy. Table RH.8 presents the percentage distribution of women by the number of iron pills they took during pregnancy, among women who had a live birth in the two years preceding the survey. Nearly one half (48 per cent) did not take any iron pills during their pregnancy, a quarter took fewer than 90 iron pills and one quarter took the recommended number of 90 iron pills or more. Thus, among the 52 per cent of women who took iron pills during pregnancy, 49 per cent had taken 90 or more iron pills, 46 per cent had taken fewer than 90 iron pills, and the other 5 per cent did not know how many pills they had taken. Differentials in receiving the recommended level of iron supplementation by education and wealth of women are as expected. Differences are not very large according to the age of mothers. While 37 per cent of women in Lao-Tai headed households had taken 90 or more iron pills, this figure drops to 13 per cent of women in Chinese-Tibetan headed households, 11 per cent of women in Mon-Khmer headed households, and 8 per cent of women in Hmong-Mien headed households.7 102 Did not take iron pills during pregnancy <90 90+ DK/Missing Region North 53.8 24.7 19.4 2.1 1,377 Central 42.0 23.7 32.3 2.0 1,989 South 50.8 23.9 19.6 5.7 940 Province Vientiane Capital 16.4 33.1 49.5 0.9 415 Phongsaly 75.3 14.2 9.2 1.4 148 Luangnamtha 35.0 16.2 47.1 1.6 99 Oudomxay 70.5 12.2 16.4 1.0 266 Bokeo 61.2 9.1 25.2 4.5 141 Luangprabang 50.6 27.9 18.6 2.8 280 Huaphanh 59.6 20.2 17.4 2.9 237 Xayabury 18.3 64.4 16.6 0.7 205 Xiengkhuang 53.7 7.8 35.8 2.7 200 Vientiane 28.4 29.0 42.5 0.1 295 Borikhamxay 37.3 17.7 44.9 0.0 162 Khammuane 59.6 18.7 15.9 5.8 233 Savannakhet 55.0 23.5 19.1 2.4 683 Saravane 51.0 23.8 18.5 6.7 361 Sekong 64.1 25.8 8.3 1.9 99 Champasack 47.0 23.7 24.1 5.1 397 Attapeu 52.9 23.3 15.7 8.2 83 Residence Urban 20.7 30.6 46.4 2.2 957 Rural 55.4 22.2 19.4 3.0 3,349 .Rural with road 52.2 23.6 21.1 3.1 2,928 .Rural without road 77.6 12.9 7.2 2.3 421 Mother's age at birth Less than 20 52.9 25.6 19.0 2.5 745 20-34 45.1 24.4 27.7 2.8 3,087 35-49 56.0 20.0 20.3 3.7 474 Education None 77.8 13.9 5.5 2.9 1,248 Primary 45.5 27.7 23.3 3.4 1,763 Lower secondary 32.0 26.0 40.0 2.1 693 Upper secondary 9.7 35.7 52.0 2.6 334 Post secondary non tertiary 12.1 27.8 59.9 0.2 146 Higher 6.8 29.1 62.6 1.6 122 Wealth index quintile Poorest 75.5 16.7 5.1 2.6 1,178 Second 59.7 20.6 16.7 3.0 927 Middle 41.0 27.9 27.7 3.4 810 Fourth 27.2 31.5 37.9 3.3 707 Richest 12.5 29.2 56.5 1.8 684 Ethno-linguistic group of household head Lao-Tai 30.7 29.2 36.9 3.1 2,401 Mon-Khmer 66.0 20.2 11.0 2.8 1,213 Hmong-Mien 76.3 13.5 8.1 2.0 530 Chinese-Tibetan 75.7 10.6 12.5 1.2 140 Other, Missing, DK * * * * 21 Total 47.7 24.1 25.4 2.8 4,306 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Table RH.8: Iron pills taken during pregnancy Percent distribution of women age 15-49 who had a live birth in the two years preceding the survey by the number of iron pills taken during pregnancy, Lao PDR 2011-12 Iron pills taken during pregnancy Number of women who had a live birth in the preceding two years 7 103 Assistance at Delivery The single most critical intervention for safe motherhood is to ensure a competent health professional with midwifery skills is present at every birth, and transport is available to a referral facility for obstetric care in case of emergency. A World Fit for Children (WFFC) goal is to ensure that women have ready and affordable access to skilled attendance at delivery, and progress towards this goal is indicated by the proportion of women assisted during childbirth by a health professional and the proportion of women who deliver in health facilities. The term ‘health professional’ includes a doctor, nurse, midwife or auxiliary midwife. The indicator measuring health professional attendance is also used to track progress toward the Millennium Development Goal of reducing the maternal mortality ratio by three quarters between 1990 and 2015. Table FH.9 presents the percentage distribution of women age 15-49 who had a live birth in the two years preceding the survey, according to the person who assisted at the delivery. About forty-two per cent were assisted at the time of delivery by a health professional. Specifically, doctors assisted 37 per cent of women, nurses and midwives assisted 4 per cent, and auxiliary midwives assisted 2 per cent of women. Beyond professional delivery attendance, 3 in 10 women reported assistance from a relative or friend, while smaller percentages reported assistance from a traditional birth attendant or some other source (12 and 13 per cent, respectively). Assistance from a health professional at delivery increased dramatically over the five years prior to the survey, from 20 per cent (2006 MICS) to 42 per cent. 7 104 7 M ed ic al do ct or N ur se / M id w ife A ux ili ar y m id w ife Tr ad iti on al bi rth at te nd an t C om m un ity he al th w or ke r R el at iv e/ Fr ie nd O th er R eg io n N or th 25 .5 4. 7 0. 8 5. 2 1. 9 42 .2 15 .4 4. 2 10 0. 0 31 .0 2. 3 1, 37 7 C en tra l 49 .2 2. 2 1. 4 7. 7 2. 0 20 .8 13 .9 2. 8 10 0. 0 52 .8 5. 1 1, 98 9 S ou th 26 .0 4. 4 2. 7 30 .6 1. 5 24 .7 7. 0 3. 2 10 0. 0 33 .1 2. 7 94 0 Pr ov in ce V ie nt ia ne C ap ita l 80 .9 4. 0 0. 4 6. 0 1. 9 6. 2 0. 5 0. 0 10 0. 0 85 .4 15 .0 41 5 P ho ng sa ly 17 .6 1. 2 0. 0 1. 3 5. 2 55 .8 17 .7 1. 2 10 0. 0 18 .7 0. 4 14 8 Lu an gn am th a 39 .3 2. 4 2. 7 9. 5 0. 6 33 .2 11 .8 0. 5 10 0. 0 44 .4 1. 2 99 O ud om xa y 18 .9 1. 8 1. 5 1. 3 1. 8 70 .8 2. 6 1. 3 10 0. 0 22 .2 1. 1 26 6 B ok eo 27 .6 4. 5 0. 0 2. 3 0. 0 45 .7 13 .7 6. 2 10 0. 0 32 .1 4. 3 14 1 Lu an gp ra ba ng 29 .7 5. 8 1. 1 5. 2 1. 0 34 .9 16 .4 5. 7 10 0. 0 36 .7 2. 8 28 0 H ua ph an h 13 .7 10 .7 0. 0 3. 5 2. 2 22 .6 38 .7 8. 5 10 0. 0 24 .5 1. 8 23 7 X ay ab ur y 39 .7 3. 8 0. 5 15 .1 2. 5 29 .8 5. 1 3. 6 10 0. 0 44 .0 4. 0 20 5 X ie ng kh ua ng 32 .1 2. 7 1. 9 5. 9 2. 1 45 .8 8. 6 0. 9 10 0. 0 36 .7 2. 3 20 0 V ie nt ia ne 53 .5 0. 9 0. 0 3. 0 3. 5 29 .9 1. 9 7. 3 10 0. 0 54 .4 3. 1 29 5 B or ik ha m xa y 55 .8 0. 5 0. 0 4. 2 1. 2 20 .7 15 .1 2. 6 10 0. 0 56 .3 3. 0 16 2 K ha m m ua ne 29 .0 2. 8 3. 3 13 .9 1. 5 28 .5 15 .0 6. 1 10 0. 0 35 .1 2. 5 23 3 S av an na kh et 38 .5 1. 7 2. 0 10 .2 1. 7 15 .8 28 .0 2. 1 10 0. 0 42 .2 2. 3 68 3 S ar av an e 21 .7 6. 4 3. 0 19 .4 1. 6 36 .9 5. 1 5. 9 10 0. 0 31 .1 1. 4 36 1 S ek on g 23 .4 1. 2 0. 0 2. 3 0. 6 69 .7 2. 8 0. 0 10 0. 0 24 .6 0. 5 99 C ha m pa sa ck 32 .2 4. 3 3. 3 42 .3 0. 9 5. 5 10 .0 1. 5 10 0. 0 39 .9 4. 3 39 7 A tta pe u 18 .1 0. 0 1. 5 56 .4 4. 9 10 .0 5. 9 3. 1 10 0. 0 19 .7 2. 6 83 R es id en ce U rb an 75 .5 3. 3 0. 8 3. 7 0. 6 10 .0 5. 7 0. 3 10 0. 0 79 .6 10 .0 95 7 R ur al 25 .5 3. 5 1. 7 14 .2 2. 2 33 .8 14 .9 4. 2 10 0. 0 30 .7 1. 9 3, 34 9 .R ur al w ith ro ad 27 .8 3. 8 1. 7 13 .7 2. 4 32 .7 13 .7 4. 2 10 0. 0 33 .3 2. 1 2, 92 8 .R ur al w ith ou t r oa d 9. 3 1. 7 1. 5 18 .0 0. 6 41 .1 23 .3 4. 6 10 0. 0 12 .4 0. 0 42 1 M ot he r's a ge a t b irt h Le ss th an 2 0 35 .3 4. 5 1. 3 11 .7 1. 9 30 .8 12 .4 2. 1 10 0. 0 41 .0 1. 8 74 5 20 -3 4 38 .2 3. 4 1. 4 11 .4 2. 0 27 .9 12 .4 3. 3 10 0. 0 43 .0 3. 9 3, 08 7 35 -4 9 28 .1 2. 7 2. 0 15 .5 1. 2 28 .5 16 .4 5. 5 10 0. 0 32 .9 5. 2 47 4 Ta bl e R H .9 : A ss is ta nc e du rin g de liv er y P er ce nt d is tri bu tio n of w om en a ge 1 5- 49 w ho h ad a li ve b irt h in th e tw o ye ar s pr ec ed in g th e su rv ey b y pe rs on a ss is tin g at d el iv er y an d pe rc en ta ge o f b irt hs d el iv er ed b y ca es ar ea n se ct io n (C -s ec tio n) , L ao P D R 20 11 -1 2 N um be r o f w om en w ho ha d a liv e bi rth in pr ec ed in g tw o ye ar s Pe rs on a ss is tin g at d el iv er y N o at te nd an t To ta l D el iv er y as si st ed b y an y he al th pr of es si on al 1 P er ce nt d el iv er ed b y C -s ec tio n2 1 M IC S in di ca to r 5 .7 ; M D G in di ca to r 5 .2 2 M IC S in di ca to r 5 .9 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. 105 7 M ed ic al do ct or N ur se / M id w ife A ux ili ar y m id w ife Tr ad iti on al bi rth at te nd an t C om m un ity he al th w or ke r R el at iv e/ Fr ie nd O th er Pl ac e of d el iv er y P ub lic s ec to r h ea lth fa ci lit y 91 .4 6. 2 1. 3 0. 0 0. 1 0. 3 0. 6 0. 0 10 0. 0 98 .9 9. 7 1, 57 8 P riv at e se ct or h ea lth fa ci lit y (9 3. 0) (2 .8 ) (0 .0 ) (1 .2 ) (0 .0 ) (0 .0 ) (3 .0 ) (0 .0 ) 10 0. 0 (9 5. 8) (1 6. 3) 37 H om e 3. 5 2. 0 1. 7 19 .8 3. 1 46 .3 18 .9 4. 8 10 0. 0 7. 2 0. 0 2, 51 8 O th er 7. 3 1. 5 0. 0 12 .7 0. 9 47 .7 9. 5 20 .4 10 0. 0 8. 8 0. 0 11 4 M is si ng /D K 3. 8 0. 0 0. 0 0. 0 0. 0 2. 0 94 .1 0. 0 10 0. 0 3. 8 0. 0 59 Ed uc at io n N on e 13 .2 2. 1 0. 7 9. 2 1. 2 44 .2 22 .8 6. 6 10 0. 0 16 .1 0. 6 1, 24 8 P rim ar y 29 .8 3. 4 1. 6 17 .6 2. 1 30 .3 12 .2 2. 9 10 0. 0 34 .8 2. 5 1, 76 3 Lo w er s ec on da ry 55 .6 5. 3 2. 9 9. 3 3. 3 16 .0 6. 3 1. 3 10 0. 0 63 .9 4. 2 69 3 U pp er s ec on da ry 80 .6 4. 6 1. 0 4. 9 0. 6 5. 5 2. 5 0. 2 10 0. 0 86 .3 10 .3 33 4 P os t s ec on da ry n on te rti ar y 83 .7 4. 9 0. 9 3. 6 0. 3 6. 4 0. 2 0. 0 10 0. 0 89 .6 14 .0 14 6 H ig he r 88 .7 3. 9 0. 2 2. 7 1. 5 1. 7 1. 2 0. 0 10 0. 0 92 .8 18 .1 12 2 W ea lth in de x qu in til e P oo re st 8. 9 1. 7 0. 3 11 .5 2. 0 46 .1 21 .6 7. 9 10 0. 0 10 .8 0. 1 1, 17 8 S ec on d 20 .0 2. 7 1. 2 14 .6 2. 3 39 .2 17 .2 2. 8 10 0. 0 23 .9 1. 1 92 7 M id dl e 36 .4 6. 2 2. 4 15 .2 1. 4 24 .9 11 .3 2. 2 10 0. 0 45 .0 2. 2 81 0 Fo ur th 56 .2 5. 1 3. 0 13 .7 2. 2 13 .7 5. 3 0. 8 10 0. 0 64 .3 5. 7 70 7 R ic he st 86 .8 2. 9 1. 1 3. 3 1. 2 3. 0 1. 5 0. 2 10 0. 0 90 .7 13 .1 68 4 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 52 .1 4. 2 2. 2 14 .3 2. 0 16 .0 8. 0 1. 3 10 0. 0 58 .5 5. 8 2, 40 1 M on -K hm er 17 .0 2. 8 0. 9 12 .1 2. 0 40 .3 18 .4 6. 4 10 0. 0 20 .8 0. 8 1, 21 3 H m on g- M ie n 15 .2 2. 5 0. 0 2. 8 1. 1 50 .1 22 .5 5. 8 10 0. 0 17 .8 1. 4 53 0 C hi ne se -T ib et an 17 .0 1. 3 0. 0 5. 7 0. 9 59 .8 13 .6 1. 6 10 0. 0 18 .3 0. 9 14 0 O th er , M is si ng , D K * * * * * * * * * * * 21 To ta l 36 .6 3. 5 1. 5 11 .9 1. 9 28 .5 12 .9 3. 3 10 0. 0 41 .5 3. 7 4, 30 6 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. 1 M IC S in di ca to r 5 .7 ; M D G in di ca to r 5 .2 2 M IC S in di ca to r 5 .9 Pe rs on a ss is tin g at d el iv er y N o at te nd an t To ta l D el iv er y as si st ed b y an y he al th pr of es si on al 1 P er ce nt d el iv er ed b y C -s ec tio n2 N um be r o f w om en w ho ha d a liv e bi rth in pr ec ed in g tw o ye ar s Ta bl e R H .9 : A ss is ta nc e du rin g de liv er y P er ce nt d is tri bu tio n of w om en a ge 1 5- 49 w ho h ad a li ve b irt h in th e tw o ye ar s pr ec ed in g th e su rv ey b y pe rs on a ss is tin g at d el iv er y an d pe rc en ta ge o f b irt hs d el iv er ed b y ca es ar ea n se ct io n (C -s ec tio n) , L ao P D R 20 11 -1 2 106 A significantly higher proportion of women 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). Only 7 per cent of women who delivered at home were attended by a health professional. The proportion of urban women assisted by a health professional (80 per cent) is more than double that of women in rural areas (31 per cent). The vast majority of women in Vientiane Capital (85 per cent) received professional attendance at delivery. Slightly more than half of women in Borikhamxay and Vientiane provinces received professional assistance, while all other provinces reported smaller percentages, and the lowest levels were reported in Attapeu and Phongsaly. The percentage of women assisted at delivery by a health professional increases steadily with education and wealth quintile. More than half of women in Lao-Tai headed households were assisted by a health professional, compared with only one in five women in other ethno-linguistic groups. Table RH.9 also presents the proportion of births delivered by caesarean section (C-section), which totaled 4 per cent. The most highly educated mothers and those in the wealthiest quintiles had a higher percentage of births delivered by C-section than other women. Fifteen per cent of women in Vientiane Capital reported delivering by C-section. Place of Delivery Increasing the proportion of births delivered in health facilities is an important factor in reducing health risks to both mothers and babies. Proper medical attention and hygienic conditions during delivery can reduce the risk of complications and infection that can cause the death or serious illness of the mother and/or the newborn baby. Table RH.10 presents the percentage distribution of women age 15-49 who had a live birth in the two years preceding the survey, according to place of delivery. Thirty-eight per cent of births in Lao PDR are delivered in a health facility; the majority in public sector facilities. Six in 10 births occur in the woman’s home. The percentage of health facility deliveries more than doubled from 17 per cent at the time of the 2006 MICS to 38 per cent in the current survey, while home deliveries decreased sharply from 85 to 59 per cent. The Central region has the highest proportion of health facility deliveries (50 per cent), ranging by province from less than 20 per cent in Phongsaly and Attapeu to more than 50 per cent in Vientiane Capital, Vientiane province and Borikhamxay. Delivery in a health facility is more common among mothers age 20-34 (39 per cent), mothers who had at least four ANC visits (69 per cent), mothers with at least upper secondary education, and mothers in the highest wealth quintiles. Urban births are notably more likely than rural births to be delivered in a health facility (74 and 27 per cent, respectively). Some 52 per cent of women in Lao-Tai headed households give birth in a health facility, compared with only 20 per cent of those in Mon-Khmer headed households, 19 per cent of those in Chinese-Tibetan headed households, and 17 per cent of those in Hmong-Mien headed households. 7 107 7 Public sector health facility Private sector health facility Home Other DK /Missing Region North 27.1 0.6 69.7 1.6 1.0 100.0 27.7 1,377 Central 48.7 1.3 47.1 1.8 1.1 100.0 50.0 1,989 South 25.1 0.3 66.1 6.0 2.5 100.0 25.4 940 Province Vientiane Capital 81.6 2.3 15.1 0.5 0.5 100.0 83.9 415 Phongsaly 18.1 0.0 81.1 0.4 0.4 100.0 18.1 148 Luangnamtha 42.3 0.0 56.7 0.0 1.0 100.0 42.3 99 Oudomxay 20.5 0.3 77.0 1.9 0.3 100.0 20.8 266 Bokeo 25.5 5.2 63.7 3.3 2.3 100.0 30.7 141 Luangprabang 34.1 0.0 64.0 1.2 0.7 100.0 34.1 280 Huaphanh 21.4 0.0 74.6 1.5 2.5 100.0 21.4 237 Xayabury 33.1 0.0 64.9 2.0 0.0 100.0 33.1 205 Xiengkhuang 34.7 0.0 62.6 0.0 2.7 100.0 34.7 200 Vientiane 52.8 0.5 45.3 1.3 0.1 100.0 53.3 295 Borikhamxay 51.7 0.5 47.8 0.0 0.0 100.0 52.2 162 Khammuane 27.1 2.4 67.9 0.9 1.7 100.0 29.6 233 Savannakhet 37.7 1.2 55.5 4.1 1.5 100.0 38.9 683 Saravane 26.5 0.2 59.1 11.1 3.1 100.0 26.7 361 Sekong 25.6 0.0 62.6 10.0 1.9 100.0 25.6 99 Champasack 25.1 0.3 70.3 1.7 2.6 100.0 25.5 397 Attapeu 18.7 0.5 80.8 0.0 0.0 100.0 19.2 83 Residence Urban 72.7 1.5 23.1 1.2 1.4 100.0 74.2 957 Rural 26.4 0.7 68.6 3.1 1.4 100.0 27.0 3,349 .Rural with road 28.5 0.8 66.7 2.7 1.4 100.0 29.2 2,928 .Rural without road 11.6 0.0 81.7 5.5 1.2 100.0 11.6 421 Mother's age at birth Less than 20 36.0 1.3 58.8 2.6 1.2 100.0 37.3 745 20-34 38.0 0.8 57.2 2.7 1.3 100.0 38.8 3,087 35-49 28.8 0.2 66.3 2.4 2.2 100.0 29.1 474 Number of antenatal care visits None 10.6 0.2 82.1 4.1 3.0 100.0 10.8 1,885 1-3 visits 36.4 1.1 60.4 2.1 0.0 100.0 37.5 820 4+ visits 67.4 1.5 29.8 1.2 0.1 100.0 68.9 1,588 DK/Missing * * * * * * * 14 Education None 14.9 0.1 77.9 5.5 1.6 100.0 15.0 1,248 Primary 29.6 0.9 66.4 1.8 1.4 100.0 30.4 1,763 Lower secondary 54.6 1.0 41.6 1.8 1.0 100.0 55.6 693 Upper secondary 79.1 2.2 17.4 0.3 1.1 100.0 81.3 334 Post secondary non tertiary 84.1 0.6 13.0 0.6 1.7 100.0 84.7 146 Higher 86.2 4.2 8.4 0.0 1.2 100.0 90.4 122 Wealth index quintile Poorest 10.4 0.1 83.0 4.8 1.7 100.0 10.5 1,178 Second 21.3 0.3 74.9 2.5 1.0 100.0 21.6 927 Middle 36.9 0.5 58.9 2.4 1.4 100.0 37.4 810 Fourth 53.9 1.2 41.8 1.8 1.3 100.0 55.1 707 Richest 84.4 3.0 10.9 0.4 1.3 100.0 87.4 684 Ethno-linguistic group of household head Lao-Tai 50.5 1.3 45.6 1.2 1.4 100.0 51.8 2,401 Mon-Khmer 19.9 0.2 72.2 6.4 1.3 100.0 20.1 1,213 Hmong-Mien 16.4 0.3 81.4 0.4 1.5 100.0 16.7 530 Chinese-Tibetan 19.1 0.0 77.3 2.4 1.2 100.0 19.1 140 Other, Missing, DK * * * * * * * 21 Total 36.7 0.8 58.5 2.7 1.4 100.0 37.5 4,306 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Table RH.10: Place of delivery 1 MICS indicator 5.8 Percent distribution of women age 15-49 who had a live birth in two years preceding the survey by place of delivery, Lao PDR 2011-12 Number of women who had a live birth in preceding two years Place of delivery Total Delivered in health facility1 108 Post-natal Health Checks The post-natal period begins immediately after birth and extends for about six weeks. It is a time when the mother’s body returns to how it was before pregnancy. A large proportion of maternal and neonatal deaths occur during the 48 hours after delivery, and these first two days following delivery are critical for monitoring complications arising from the delivery. Thus, post-natal care (PNC) is important for both the mother and the child, not only to treat complications arising from the delivery, but also to provide the mother with important information on how to care for herself and her child. Post-partum stay in health facility Table RH.11 presents the percentage distribution of women age 15-49 years who gave birth in a health facility in the two years prior to the survey, according to duration of stay in the health facility. Sixty-five per cent of women stayed in the health facility for 12 hours or more after their delivery, 44 per cent of women stayed for 1-2 days and 17 per cent stayed for three or more days. In general, stays of 12 or more hours increased with education and wealth. As may be expected, a higher percentage of women with C-section deliveries stayed for 12 or more hours relative to women without C-sections (93 and 62 per cent, respectively). Differences in the duration of stay were not very large according to region, age of mother or type of health facility. 7 109 Less than 6 hours 6-11 hours 12-23 hours 1-2 days 3 days or more DK/ Missing Region North 26.1 7.4 3.8 47.0 15.3 0.4 100.0 66.1 381 Central 25.7 8.3 4.1 43.7 16.9 1.3 100.0 64.8 995 South 24.6 9.8 2.7 39.7 21.2 1.9 100.0 63.7 239 Province Vientiane Capital 3.7 6.5 5.9 53.5 29.8 0.6 100.0 89.2 348 Phongsaly (46.4) (8.5) (2.3) (20.5) (19.9) (2.4) 100.0 (42.7) 27 Luangnamtha 24.6 25.2 18.4 20.7 11.0 0.0 100.0 50.1 42 Oudomxay 12.4 5.7 0.7 75.9 5.4 0.0 100.0 82.0 55 Bokeo 3.8 0.0 0.0 60.7 33.1 2.5 100.0 93.8 43 Luangprabang 24.4 4.5 2.7 56.2 12.2 0.0 100.0 71.1 95 Huaphanh 52.2 7.6 6.2 25.9 8.1 0.0 100.0 40.2 51 Xayabury 27.2 6.0 0.0 44.1 22.7 0.0 100.0 66.8 68 Xiengkhuang 38.6 9.5 0.7 42.3 7.7 1.1 100.0 50.8 69 Vientiane 26.2 7.7 6.4 50.1 9.6 0.0 100.0 66.1 157 Borikhamxay 40.4 10.8 0.0 38.9 9.9 0.0 100.0 48.8 85 Khammuane 14.3 11.8 1.3 52.5 17.1 3.0 100.0 70.9 69 Savannakhet 49.0 8.9 3.4 26.6 9.0 3.0 100.0 39.1 266 Saravane 29.9 15.9 0.8 36.1 16.3 0.9 100.0 53.2 96 Sekong 34.5 3.2 0.0 31.8 18.8 11.7 100.0 50.6 25 Champasack 15.7 6.9 5.3 45.5 26.6 0.0 100.0 77.4 101 Attapeu (33.0) (2.4) (2.4) (37.5) (20.7) (4.1) 100.0 (60.6) 16 Residence Urban 19.4 7.5 4.8 46.3 21.6 0.3 100.0 72.8 710 Rural 30.4 8.9 3.1 42.0 13.7 1.9 100.0 58.8 905 .Rural with road 31.0 9.1 3.1 41.7 14.2 0.9 100.0 59.0 856 .Rural without road 20.7 6.0 2.3 46.5 5.6 18.9 100.0 54.4 49 Mother's age at birth Less than 20 31.2 8.2 4.7 39.0 15.6 1.4 100.0 59.3 278 20-34 24.6 8.2 3.4 45.5 17.3 0.9 100.0 66.3 1,199 35-49 23.0 9.2 6.0 39.7 19.0 3.1 100.0 64.7 138 Type of health facility Public 25.6 8.5 3.9 44.1 16.8 1.1 100.0 64.8 1,578 Private (24.9) (0.0) (0.0) (36.5) (34.4) (4.2) 100.0 (70.9) 37 Type of delivery C-section 5.5 1.1 4.1 11.8 77.6 0.0 100.0 93.4 159 Not via C-section 27.8 9.1 3.8 47.4 10.6 1.3 100.0 61.8 1,456 Education None 33.2 10.6 1.8 36.3 11.8 6.4 100.0 49.8 187 Primary 31.3 7.6 3.3 44.8 12.0 1.0 100.0 60.1 537 Lower secondary 26.5 9.0 4.5 42.2 17.9 0.0 100.0 64.5 385 Upper secondary 19.2 8.0 3.7 45.0 23.3 0.7 100.0 72.1 271 Post secondary non tertiary 12.8 9.7 3.9 50.7 22.9 0.0 100.0 77.5 124 Higher 11.9 4.6 8.1 47.9 27.4 0.0 100.0 83.5 110 Wealth index quintile Poorest 25.6 14.0 2.4 41.3 7.9 8.9 100.0 51.6 124 Second 37.7 6.6 2.3 42.1 8.9 2.4 100.0 53.4 200 Middle 33.8 12.0 2.4 40.8 10.8 0.3 100.0 53.9 303 Fourth 29.7 6.9 3.6 42.6 17.3 0.0 100.0 63.5 390 Richest 14.7 6.8 5.6 47.5 25.0 0.4 100.0 78.1 598 Ethno-linguistic group of household head Lao-Tai 24.2 8.2 4.2 44.3 18.5 0.5 100.0 67.0 1,243 Mon-Khmer 33.0 9.4 2.2 42.7 8.3 4.5 100.0 53.1 243 Hmong-Mien 24.4 7.5 4.2 49.0 14.8 0.0 100.0 68.0 88 Chinese-Tibetan (28.0) (8.1) (4.5) (22.1) (31.0) (6.4) 100.0 (57.6) 27 Other, Missing, DK * * * * * * * * 13 Total 25.6 8.3 3.8 43.9 17.2 1.2 100.0 64.9 1,615 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. 1 MICS indicator 5.10 Table RH.11: Post-partum stay in health facility Percent distribution of women age 15-49 years who gave birth in a health facility in the two years preceding the survey by duration of stay in health facility, Lao PDR 2011-12 Duration of stay in health facility Total 12 hours or more1 Number of women who gave birth in a health facility in the preceding two years 7 110 Post-natal health checks for newborns Safe motherhood programmes have recently increased emphasis on the importance of PNC, recommending that all women and newborns receive a health check within two days of delivery. To assess the extent of PNC utilization, women were asked whether they and their newborn received a health check after the delivery, the timing of the first check, and the type of health provider for the woman’s last birth in the two years preceding the survey. Table RH.12 presents the percentage of newborns born in the last two years who received health checks or PNC visits. Less than half (41 per cent) received either a health check or PNC visit within two days of delivery. Four in 10 received a health check while in the health facility or at home, while 7 per cent received a PNC visit within two days following delivery. The majority of newborns (88 per cent) did not complete a PNC visit at any time after delivery. More newborns received health checks or PNC visits in the Central region (50 per cent) than in the Southern (37 per cent) and Northern (30 per cent) regions. PNC for newborns varied across provinces, ranging from 84 per cent in Vientiane Capital to 20 per cent in Oudomxay. Mothers of newborns born in a health facility as opposed to in the home more frequently reported health checks and PNC visits (84 per cent and 15 per cent, respectively). PNC was increasingly reported for newborns as education and wealth increased. Mothers of newborns in Lao- Tai headed households reported newborn PNC within two days of delivery more frequently than other ethno-linguistic groups (56 per cent). 7 111 7 W ith in 2 d ay s of d el iv er y 2- 6 da ys a fte r de liv er y A fte r t he fir st w ee k N o po st -n at al ca re v is it D K /M is si ng To ta l R eg io n N or th 29 .6 5. 7 2. 0 1. 1 90 .7 0. 6 10 0. 0 30 .2 1, 37 7 C en tra l 48 .4 9. 9 1. 8 3. 3 84 .6 0. 4 10 0. 0 49 .5 1, 98 9 S ou th 36 .4 4. 5 3. 0 1. 7 90 .3 0. 5 10 0. 0 37 .0 94 0 P ro vi nc e V ie nt ia ne C ap ita l 83 .5 9. 9 3. 7 10 .3 75 .7 0. 4 10 0. 0 84 .0 41 5 P ho ng sa ly 21 .8 2. 2 2. 9 1. 3 93 .6 0. 0 10 0. 0 22 .3 14 8 Lu an gn am th a 44 .9 8. 7 0. 0 1. 7 89 .5 0. 0 10 0. 0 46 .2 99 O ud om xa y 19 .7 1. 6 0. 3 0. 0 98 .1 0. 0 10 0. 0 19 .7 26 6 B ok eo 27 .6 0. 8 0. 3 1. 2 97 .4 0. 3 10 0. 0 27 .6 14 1 Lu an gp ra ba ng 36 .0 7. 1 2. 7 1. 4 87 .7 1. 1 10 0. 0 36 .0 28 0 H ua ph an h 18 .6 6. 5 2. 0 0. 7 90 .7 0. 0 10 0. 0 20 .5 23 7 X ay ab ur y 45 .7 12 .6 4. 6 2. 0 78 .9 2. 0 10 0. 0 46 .8 20 5 X ie ng kh ua ng 37 .1 1. 6 0. 7 0. 9 96 .8 0. 0 10 0. 0 37 .1 20 0 V ie nt ia ne 54 .2 9. 1 1. 0 1. 1 88 .7 0. 0 10 0. 0 56 .3 29 5 B or ik ha m xa y 34 .7 16 .5 0. 6 0. 0 82 .9 0. 0 10 0. 0 35 .3 16 2 K ha m m ua ne 36 .9 11 .5 3. 1 0. 8 84 .6 0. 0 10 0. 0 38 .6 23 3 S av an na kh et 35 .0 10 .5 1. 2 2. 2 85 .1 1. 0 10 0. 0 36 .3 68 3 S ar av an e 34 .7 6. 6 2. 5 2. 1 88 .8 0. 0 10 0. 0 35 .5 36 1 S ek on g 25 .2 0. 6 0. 0 0. 0 99 .4 0. 0 10 0. 0 25 .7 99 C ha m pa sa ck 36 .4 4. 4 4. 7 1. 7 88 .0 1. 1 10 0. 0 36 .7 39 7 A tta pe u 58 .0 0. 0 0. 8 1. 7 97 .0 0. 4 10 0. 0 58 .0 83 R es id en ce U rb an 70 .5 12 .6 4. 3 6. 4 75 .8 0. 9 10 0. 0 70 .9 95 7 R ur al 31 .0 5. 9 1. 5 1. 0 91 .2 0. 4 10 0. 0 31 .9 3, 34 9 .R ur al w ith ro ad 33 .3 6. 3 1. 6 1. 1 90 .7 0. 4 10 0. 0 34 .3 2, 92 8 .R ur al w ith ou t r oa d 14 .7 3. 3 1. 0 0. 7 95 .1 0. 0 10 0. 0 15 .2 42 1 H ea lth c he ck s w hi le in fa ci lit y an d he al th c he ck s at h om e fo llo w in g de liv er y re fe r t o ch ec ks p ro vi de d by a ny h ea lth p ro vi de r r eg ar dl es s of ti m in g. A ny h ea lth c he ck fo llo w in g de liv er y or p os t-n at al c ar e vi si t w ith in 2 d ay s of d el iv er y in cl ud es c he ck s pe rfo rm ed w hi le in th e he al th fa ci lit y an d at h om e fo llo w in g de liv er y, re ga rd le ss o f t im in g, a s w el l a s po st -n at al ca re v is its w ith in tw o da ys o f d el iv er y 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. P os t- na ta l c ar e vi si t 1 M IC S in di ca to r 5. 11 Ta bl e R H .1 2: P os t- na ta l h ea lth c he ck s fo r ne w bo rn s P er ce nt ag e of n ew bo rn s bo rn in th e la st tw o ye ar s w ho re ce iv ed h ea lth c he ck s an d po st -n at al c ar e (P N C ) v is its fr om a ny h ea lth p ro vi de r a fte r b irt h, L ao P D R 2 01 1- 12 H ea lth c he ck w hi le in fa ci lit y or a t h om e fo llo w in g de liv er y A ny h ea lth c he ck fo llo w in g de liv er y or p os t-n at al c ar e vi si t w ith in tw o da ys o f d el iv er y1 N um be r o f b irt hs in th e tw o ye ar s pr ec ed in g th e su rv ey 112 7 W ith in 2 d ay s of d el iv er y 2- 6 da ys a fte r de liv er y A fte r t he fir st w ee k N o po st -n at al ca re v is it D K /M is si ng To ta l M ot he r' s ag e at b ir th Le ss th an 2 0 38 .1 6. 5 2. 4 1. 3 89 .5 0. 3 10 0. 0 38 .7 74 5 20 -3 4 41 .1 7. 6 2. 2 2. 6 87 .1 0. 5 10 0. 0 41 .9 3, 08 7 35 -4 9 33 .6 7. 4 1. 5 0. 9 89 .8 0. 5 10 0. 0 34 .8 47 4 P la ce o f d el iv er y H om e 13 .9 3. 4 1. 6 0. 8 94 .0 0. 2 10 0. 0 15 .0 2, 51 8 H ea lth fa ci lit y 83 .9 14 .1 3. 1 4. 4 77 .4 0. 9 10 0. 0 84 .0 1, 61 5 P ub lic 83 .8 14 .0 3. 2 4. 4 77 .4 1. 0 10 0. 0 83 .8 1, 57 8 P riv at e (8 5. 0) (1 8. 0) (0 .0 ) (4 .4 ) (7 7. 6) (0 .0 ) 10 0. 0 (9 0. 8) 37 O th er /D K /M is si ng 4. 7 2. 6 0. 6 2. 2 93 .8 0. 9 10 0. 0 7. 3 17 3 E du ca tio n N on e 15 .7 4. 0 0. 5 0. 3 95 .1 0. 0 10 0. 0 16 .3 1, 24 8 P rim ar y 35 .4 6. 3 2. 2 1. 6 89 .2 0. 7 10 0. 0 36 .3 1, 76 3 Lo w er s ec on da ry 57 .9 10 .0 2. 1 2. 5 84 .6 0. 8 10 0. 0 58 .8 69 3 U pp er s ec on da ry 76 .6 11 .7 4. 3 5. 2 77 .9 0. 8 10 0. 0 77 .6 33 4 P os t s ec on da ry n on te rti ar y 83 .4 22 .1 3. 2 6. 9 67 .8 0. 0 10 0. 0 84 .5 14 6 H ig he r 92 .9 13 .7 10 .1 14 .6 61 .7 0. 0 10 0. 0 92 .9 12 2 W ea lth in de x qu in til e P oo re st 12 .8 2. 8 0. 6 0. 4 96 .0 0. 2 10 0. 0 13 .6 1, 17 8 S ec on d 24 .5 5. 5 1. 0 0. 8 92 .5 0. 3 10 0. 0 25 .4 92 7 M id dl e 42 .4 6. 9 2. 4 1. 8 88 .7 0. 2 10 0. 0 43 .3 81 0 Fo ur th 59 .2 14 .5 1. 9 2. 4 79 .6 1. 7 10 0. 0 60 .5 70 7 R ic he st 83 .7 10 .9 6. 3 7. 6 74 .7 0. 4 10 0. 0 83 .8 68 4 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 55 .0 10 .6 3. 2 3. 5 82 .1 0. 6 10 0. 0 56 .1 2, 40 1 M on -K hm er 22 .2 3. 9 0. 7 0. 5 94 .4 0. 5 10 0. 0 23 .0 1, 21 3 H m on g- M ie n 15 .7 1. 7 0. 3 0. 0 97 .8 0. 2 10 0. 0 15 .7 53 0 C hi ne se -T ib et an 17 .9 2. 4 2. 2 0. 4 95 .0 0. 0 10 0. 0 18 .4 14 0 O th er , M is si ng , D K * * * * * * * * 21 To ta l 39 .8 7. 4 2. 1 2. 2 87 .8 0. 5 10 0. 0 40 .6 4, 30 6 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. H ea lth c he ck s w hi le in fa ci lit y an d he al th c he ck s at h om e fo llo w in g de liv er y re fe r t o ch ec ks p ro vi de d by a ny h ea lth p ro vi de r r eg ar dl es s of ti m in g. A ny h ea lth c he ck fo llo w in g de liv er y or p os t-n at al c ar e vi si t w ith in 2 d ay s of d el iv er y in cl ud es c he ck s pe rfo rm ed w hi le in th e he al th fa ci lit y an d at h om e fo llo w in g de liv er y, re ga rd le ss o f t im in g, a s w el l a s po st -n at al ca re v is its w ith in tw o da ys o f d el iv er y 1 M IC S in di ca to r 5. 11 H ea lth c he ck w hi le in fa ci lit y or a t h om e fo llo w in g de liv er y P os t- na ta l c ar e vi si t A ny h ea lth c he ck fo llo w in g de liv er y or p os t-n at al c ar e vi si t w ith in tw o da ys o f d el iv er y1 N um be r o f b irt hs in th e tw o ye ar s pr ec ed in g th e su rv ey Ta bl e R H .1 2: P os t- na ta l h ea lth c he ck s fo r ne w bo rn s P er ce nt ag e of n ew bo rn s bo rn in th e la st tw o ye ar s w ho re ce iv ed h ea lth c he ck s an d po st -n at al c ar e (P N C ) v is its fr om a ny h ea lth p ro vi de r a fte r b irt h, L ao P D R 2 01 1- 12 113 Table RH.13 shows the distribution of newborns born in the two years prior to the survey who received a PNC visit within one week of delivery, according to the location and provider of that first PNC. Among newborns receiving PNC within one week of birth, 82 per cent received the PNC from a health professional, and 54 per cent received PNC at a public sector health facility. Among the newborns who received a PNC visit and were born at a health facility, most received PNC from a health professional (96 per cent). Of babies born at home who received a PNC visit, 52 per cent received PNC from a health professional, and 34 per cent received PNC from a traditional birth attendant. 7 114 H om e P ub lic S ec to r P riv at e se ct or D oc to r/ nu rs e/ m id w ife A ux ili ar y m id w ife C om m un ity he al th w or ke r Tr ad iti on al b irt h at te nd an t R eg io n N or th 55 .0 45 .0 0. 0 10 0. 0 73 .7 2. 7 9. 2 14 .4 10 0. 0 10 6 C en tra l 36 .7 62 .6 0. 7 10 0. 0 78 .5 7. 4 3. 9 10 .2 10 0. 0 23 3 S ou th 61 .6 38 .4 0. 0 10 0. 0 68 .7 10 .6 7. 8 13 .0 10 0. 0 71 R es id en ce U rb an 40 .5 58 .9 0. 5 10 0. 0 87 .7 7. 7 1. 4 3. 2 10 0. 0 16 2 R ur al 49 .1 50 .5 0. 3 10 0. 0 67 .6 6. 1 8. 9 17 .4 10 0. 0 24 8 .R ur al w ith ro ad 48 .2 51 .4 0. 4 10 0. 0 69 .0 6. 6 9. 6 14 .8 10 0. 0 23 0 .R ur al w ith ou t r oa d * * * * * * * * * 18 M ot he r' s ag e at b ir th Le ss th an 2 0 42 .2 57 .8 0. 0 10 0. 0 74 .4 9. 2 2. 7 13 .7 10 0. 0 66 20 -3 4 45 .0 54 .4 0. 6 10 0. 0 77 .9 6. 2 6. 8 9. 1 10 0. 0 30 1 35 -4 9 (5 6. 2) (4 3. 8) (0 .0 ) 10 0. 0 (6 0. 7) (6 .4 ) (4 .8 ) (2 8. 1) 10 0. 0 42 P la ce o f d el iv er y H om e 95 .1 4. 9 0. 0 10 0. 0 42 .1 9. 8 14 .4 33 .8 10 0. 0 12 6 H ea lth fa ci lit y 23 .2 76 .2 0. 6 10 0. 0 90 .9 5. 5 2. 2 1. 3 10 0. 0 27 8 P ub lic 22 .0 78 .0 0. 0 10 0. 0 91 .5 5. 6 2. 3 0. 6 10 0. 0 27 1 P riv at e * * * * * * * * * 7 O th er /D K /M is si ng * * * * * * * * * 5 E du ca tio n N on e 33 .0 67 .0 0. 0 10 0. 0 71 .9 9. 4 5. 4 13 .3 10 0. 0 56 P rim ar y 52 .3 47 .1 0. 6 10 0. 0 62 .6 7. 6 8. 4 21 .4 10 0. 0 14 9 Lo w er s ec on da ry 43 .5 56 .5 0. 0 10 0. 0 86 .8 2. 7 4. 9 5. 5 10 0. 0 84 U pp er s ec on da ry (4 6. 3) (5 3. 7) (0 .0 ) 10 0. 0 (7 7. 3) (9 .2 ) (6 .9 ) (6 .7 ) 10 0. 0 54 P os t s ec on da ry n on te rti ar y (3 9. 1) (5 8. 6) (2 .3 ) 10 0. 0 (9 0. 7) (5 .4 ) (2 .3 ) (1 .6 ) 10 0. 0 37 H ig he r (5 0. 2) (4 9. 8) (0 .0 ) 10 0. 0 (9 4. 0) (6 .0 ) (0 .0 ) (0 .0 ) 10 0. 0 29 W ea lth in de x qu in til e P oo re st (5 9. 2) (4 0. 8) (0 .0 ) 10 0. 0 (4 9. 1) (4 .1 ) (1 8. 8) (2 8. 0) 10 0. 0 40 S ec on d 42 .4 57 .6 0. 0 10 0. 0 63 .3 8. 3 10 .2 18 .2 10 0. 0 60 M id dl e 50 .8 48 .1 1. 1 10 0. 0 74 .5 7. 7 4. 9 12 .8 10 0. 0 75 Fo ur th 35 .6 64 .4 0. 0 10 0. 0 81 .1 6. 9 4. 8 7. 2 10 0. 0 11 5 R ic he st 49 .5 49 .8 0. 7 10 0. 0 86 .0 6. 0 1. 2 6. 7 10 0. 0 11 8 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 46 .2 53 .3 0. 5 10 0. 0 77 .1 7. 2 4. 3 11 .4 10 0. 0 33 1 M on -K hm er 42 .3 57 .7 0. 0 10 0. 0 65 .6 5. 3 15 .9 13 .1 10 0. 0 56 H m on g- M ie n * * * * * * * * * 11 C hi ne se -T ib et an * * * * * * * * * 6 O th er , M is si ng , D K * * * * * * * * * 5 To ta l 45 .7 53 .9 0. 4 10 0. 0 75 .5 6. 7 5. 9 11 .8 10 0. 0 40 9 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. Ta bl e R H .1 3: P os t- na ta l c ar e (P N C ) v is its fo r ne w bo rn s To ta l N um be r o f n ew bo rn s bo rn in th e pr ec ed in g tw o ye ar s w ith a P N C vi si t w ith in th e fir st w ee k of li fe Lo ca tio n of fi rs t P N C v is it To ta l P ro vi de r of fi rs t P N C v is it P er ce nt d is tri bu tio n of n ew bo rn s bo rn in th e la st tw o ye ar s w ho re ce iv ed a P N C v is it w ith in o ne w ee k of d el iv er y, b y lo ca tio n an d pr ov id er o f t he fi rs t P N C v is it, L ao P D R 2 01 1- 12 7 115 Post-natal health checks for mothers Table RH.14 presents the percentage of women age 15-49 who gave birth in the two years prior to the survey who received health checks or PNC visits. PNC for mothers follows similar trends to those observed for newborns; however, the proportion of women reporting recommended care is generally less than that reported for newborns. Less than half of mothers (40 per cent) received either a health check after delivery or a PNC visit within two days of delivery. Thirty-nine per cent received a health check after delivery while in the health facility or at home, while 3 per cent received a PNC visit within two days following delivery. The majority of women (93 per cent) did not have a PNC visit at any time after delivery. More women received health checks or PNC visits in the Central region (48 per cent) than in the Southern (36 per cent) and Northern (29 per cent) regions. PNC for women varied across provinces, ranging from 81 per cent in Vientiane Capital to 17 per cent in Huaphanh. Women who gave birth in a health facility as opposed to in the home more frequently reported health checks and PNC visits (84 per cent and 13 per cent, respectively). PNC was increasingly reported for women as education and wealth increased. Women in Lao-Tai headed households reported a health check after delivery or a PNC visit within two days of delivery more frequently than other ethno-linguistic groups (54 per cent). 7 116 7 W ith in 2 da ys o f de liv er y 2- 6 da ys af te r de liv er y A fte r t he fir st w ee k N o po st - na ta l c ar e vi si t D K /M is si ng To ta l R eg io n N or th 28 .7 2. 5 1. 4 0. 7 95 .2 0. 2 10 0. 0 29 .4 1, 37 7 C en tra l 47 .3 4. 1 1. 5 3. 2 91 .1 0. 1 10 0. 0 48 .2 1, 98 9 S ou th 35 .5 2. 0 2. 9 2. 0 93 .0 0. 1 10 0. 0 35 .8 94 0 P ro vi nc e V ie nt ia ne C ap ita l 80 .9 4. 9 3. 8 9. 1 82 .2 0. 0 10 0. 0 81 .4 41 5 P ho ng sa ly 22 .2 1. 8 2. 5 0. 4 95 .3 0. 0 10 0. 0 22 .7 14 8 Lu an gn am th a 43 .9 1. 1 0. 0 0. 0 98 .9 0. 0 10 0. 0 45 .0 99 O ud om xa y 19 .0 0. 0 0. 0 0. 3 99 .7 0. 0 10 0. 0 19 .0 26 6 B ok eo 29 .1 1. 5 0. 3 1. 2 96 .6 0. 3 10 0. 0 29 .1 14 1 Lu an gp ra ba ng 35 .1 1. 9 2. 4 0. 4 95 .0 0. 4 10 0. 0 35 .5 28 0 H ua ph an h 15 .5 4. 4 0. 7 0. 0 95 .0 0. 0 10 0. 0 17 .0 23 7 X ay ab ur y 44 .6 6. 0 3. 6 2. 5 87 .4 0. 5 10 0. 0 46 .2 20 5 X ie ng kh ua ng 37 .1 2. 1 0. 7 0. 9 96 .4 0. 0 10 0. 0 37 .1 20 0 V ie nt ia ne 53 .8 6. 1 1. 0 0. 5 92 .5 0. 0 10 0. 0 54 .7 29 5 B or ik ha m xa y 34 .7 2. 7 1. 6 0. 5 95 .2 0. 0 10 0. 0 35 .3 16 2 K ha m m ua ne 36 .4 3. 7 1. 9 2. 6 91 .2 0. 7 10 0. 0 37 .2 23 3 S av an na kh et 33 .7 3. 7 0. 5 2. 5 93 .3 0. 0 10 0. 0 35 .4 68 3 S ar av an e 34 .7 1. 9 2. 7 2. 7 92 .7 0. 0 10 0. 0 35 .4 36 1 S ek on g 24 .9 0. 3 0. 0 0. 0 99 .7 0. 0 10 0. 0 25 .0 99 C ha m pa sa ck 34 .5 2. 8 4. 5 2. 1 90 .3 0. 2 10 0. 0 34 .5 39 7 A tta pe u 55 .8 0. 0 0. 0 0. 9 99 .1 0. 0 10 0. 0 55 .8 83 R es id en ce U rb an 69 .3 4. 4 3. 1 5. 9 86 .4 0. 2 10 0. 0 69 .5 95 7 R ur al 30 .0 2. 7 1. 4 1. 1 94 .7 0. 1 10 0. 0 30 .9 3, 34 9 .R ur al w ith ro ad 32 .4 2. 9 1. 5 1. 1 94 .4 0. 1 10 0. 0 33 .3 2, 92 8 .R ur al w ith ou t r oa d 13 .9 1. 5 0. 9 0. 9 96 .5 0. 3 10 0. 0 14 .4 42 1 M ot he r' s ag e at b ir th Le ss th an 2 0 35 .8 2. 3 1. 6 1. 1 94 .9 0. 2 10 0. 0 36 .6 74 5 20 -3 4 40 .5 3. 0 1. 9 2. 6 92 .4 0. 1 10 0. 0 41 .0 3, 08 7 35 -4 9 32 .1 4. 8 1. 4 1. 1 92 .4 0. 2 10 0. 0 34 .1 47 4 Ta bl e R H .1 4: P os t- na ta l h ea lth c he ck s fo r m ot he rs P er ce nt ag e of w om en a ge 1 5- 49 y ea rs w ho g av e bi rth in th e 2 ye ar s pr ec ed in g th e su rv ey w ho re ce iv ed h ea lth c he ck s an d po st -n at al c ar e (P N C ) v is its fr om a ny h ea lth p ro vi de r a fte r b irt h, L ao P D R 2 01 1- 12 H ea lth c he ck w hi le in fa ci lit y or a t h om e fo llo w in g de liv er y A ny h ea lth c he ck fo llo w in g de liv er y or p os t-n at al c ar e vi si t w ith in tw o da ys o f d el iv er y1 N um be r o f w om en w ho g av e bi rth in th e tw o ye ar s pr ec ed in g th e su rv ey P os t- na ta l c ar e vi si t 1 M IC S in di ca to r 5. 12 H ea lth c he ck s w hi le in fa ci lit y an d he al th c he ck s at h om e fo llo w in g de liv er y re fe r t o ch ec ks p ro vi de d by a ny h ea lth p ro vi de r r eg ar dl es s of ti m in g. A ny h ea lth c he ck fo llo w in g de liv er y or p os t-n at al c ar e vi si t w ith in 2 d ay s of d el iv er y in cl ud es c he ck s pe rfo rm ed w hi le in th e he al th fa ci lit y an d at h om e fo llo w in g de liv er y, re ga rd le ss o f t im in g, a s w el l a s po st -n at al ca re v is its w ith in tw o da ys o f d el iv er y 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. 117 7 W ith in 2 da ys o f de liv er y 2- 6 da ys af te r de liv er y A fte r t he fir st w ee k N o po st - na ta l c ar e vi si t D K /M is si ng To ta l P la ce o f d el iv er y H om e 12 .4 2. 5 1. 3 1. 0 95 .2 0. 1 10 0. 0 13 .4 2, 51 8 H ea lth fa ci lit y 83 .5 4. 2 2. 8 4. 0 88 .9 0. 2 10 0. 0 83 .6 1, 61 5 P ub lic 83 .3 4. 1 2. 9 4. 0 88 .9 0. 2 10 0. 0 83 .4 1, 57 8 P riv at e (9 0. 8) (7 .6 ) (0 .0 ) (4 .4 ) (8 8. 0) (0 .0 ) 10 0. 0 (9 0. 8) 37 O th er /D K /M is si ng 4. 7 2. 4 0. 6 1. 7 95 .3 0. 0 10 0. 0 7. 1 17 3 Ty pe o f d el iv er y C -s ec tio n 95 .0 8. 3 7. 6 11 .6 72 .0 0. 5 10 0. 0 95 .0 15 9 N ot v ia C -s ec tio n 36 .6 2. 9 1. 6 1. 8 93 .6 0. 1 10 0. 0 37 .4 4, 14 7 E du ca tio n N on e 15 .8 1. 2 0. 7 0. 5 97 .5 0. 1 10 0. 0 16 .4 1, 24 8 P rim ar y 33 .7 2. 6 1. 6 1. 6 94 .0 0. 2 10 0. 0 34 .4 1, 76 3 Lo w er s ec on da ry 56 .9 5. 6 2. 1 2. 1 90 .2 0. 0 10 0. 0 57 .9 69 3 U pp er s ec on da ry 76 .7 4. 1 3. 9 5. 1 86 .6 0. 3 10 0. 0 77 .3 33 4 P os t s ec on da ry n on te rti ar y 80 .1 10 .2 1. 2 6. 3 82 .2 0. 0 10 0. 0 81 .2 14 6 H ig he r 90 .2 3. 6 9. 1 14 .9 72 .5 0. 0 10 0. 0 90 .2 12 2 W ea lth in de x qu in til e P oo re st 12 .6 1. 2 0. 6 0. 2 97 .9 0. 1 10 0. 0 13 .4 1, 17 8 S ec on d 24 .2 2. 1 0. 7 1. 3 95 .9 0. 0 10 0. 0 24 .6 92 7 M id dl e 41 .5 2. 8 2. 1 2. 1 92 .8 0. 1 10 0. 0 42 .4 81 0 Fo ur th 56 .5 6. 1 1. 8 3. 2 88 .6 0. 3 10 0. 0 58 .0 70 7 R ic he st 81 .8 4. 9 5. 0 5. 6 84 .3 0. 1 10 0. 0 81 .9 68 4 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 53 .4 4. 5 2. 7 3. 5 89 .2 0. 1 10 0. 0 54 .3 2, 40 1 M on -K hm er 21 .7 1. 5 0. 4 0. 3 97 .6 0. 1 10 0. 0 22 .4 1, 21 3 H m on g- M ie n 16 .0 0. 9 0. 4 0. 0 98 .7 0. 0 10 0. 0 16 .1 53 0 C hi ne se -T ib et an 18 .3 0. 8 2. 2 0. 4 96 .6 0. 0 10 0. 0 18 .3 14 0 O th er , M is si ng , D K * * * * * * * * 21 To ta l 38 .8 3. 1 1. 8 2. 2 92 .8 0. 1 10 0. 0 39 .5 4, 30 6 N um be r o f w om en w ho g av e bi rth in th e tw o ye ar s pr ec ed in g th e su rv ey 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. 1 M IC S in di ca to r 5. 12 H ea lth c he ck s w hi le in fa ci lit y an d he al th c he ck s at h om e fo llo w in g de liv er y re fe r t o ch ec ks p ro vi de d by a ny h ea lth p ro vi de r r eg ar dl es s of ti m in g. A ny h ea lth c he ck fo llo w in g de liv er y or p os t-n at al c ar e vi si t w ith in 2 d ay s of d el iv er y in cl ud es c he ck s pe rfo rm ed w hi le in th e he al th fa ci lit y an d at h om e fo llo w in g de liv er y, re ga rd le ss o f t im in g, a s w el l a s po st -n at al ca re v is its w ith in tw o da ys o f d el iv er yH ea lth c he ck w hi le in fa ci lit y or a t h om e fo llo w in g de liv er y P os t- na ta l c ar e vi si t A ny h ea lth c he ck fo llo w in g de liv er y or p os t-n at al c ar e vi si t w ith in tw o da ys o f d el iv er y1 Ta bl e R H .1 4: P os t- na ta l h ea lth c he ck s fo r m ot he rs P er ce nt ag e of w om en a ge 1 5- 49 y ea rs w ho g av e bi rth in th e 2 ye ar s pr ec ed in g th e su rv ey w ho re ce iv ed h ea lth c he ck s an d po st -n at al c ar e (P N C ) v is its fr om a ny h ea lth p ro vi de r a fte r b irt h, L ao P D R 2 01 1- 12 118 Table RH.15 shows the distribution of the women who gave birth in the two years prior to the survey and did receive a PNC visit within one week of delivery, according to the location and provider of the first PNC visit. Among these women, 74 per cent received PNC from a health professional and 30 per cent received PNC at a public sector health facility. Among the women who received a PNC visit and delivered at a health facility, most received PNC from a health professional (95 per cent). Among the women who received a PNC visit and had delivered at home, 50 per cent received PNC from a health professional, and 34 per cent received PNC from a traditional birth attendant. 7 Home Public Sector Doctor/ nurse/ midwife Auxiliary midwife Communi ty health worker Traditiona l birth attendant Region North (87.1) (12.9) 100.0 (64.7) (2.9) (13.8) (18.5) 100.0 42 Central 59.5 40.5 100.0 67.3 10.2 8.0 14.5 100.0 102 South (77.9) (22.1) 100.0 (68.5) (2.1) (12.2) (17.2) 100.0 36 Residence Urban (61.2) (38.8) 100.0 (92.3) (0.0) (2.4) (5.3) 100.0 58 Rural 73.7 26.3 100.0 54.9 10.1 13.9 21.1 100.0 123 .Rural with road 72.7 27.3 100.0 56.8 11.0 15.1 17.1 100.0 113 .Rural without road * * * * * * * * 10 Mother's age at birth Less than 20 (75.3) (24.7) 100.0 (68.3) (4.8) (9.6) (17.3) 100.0 26 20-34 64.9 35.1 100.0 73.1 5.8 10.1 11.0 100.0 127 35-49 * * * * * * * * 27 Place of delivery Home 98.1 1.9 100.0 37.9 11.8 16.7 33.6 100.0 80 Health facility 46.5 53.5 100.0 91.5 3.2 5.3 0.0 100.0 96 Public 44.9 55.1 100.0 91.2 3.3 5.5 0.0 100.0 93 Private * * * * * * * * 3 Other/DK/Missing * * * * * * * * 5 Type of delivery C-section * * * * * * * * 24 Not via C-section 73.1 26.9 100.0 61.8 7.9 11.8 18.4 100.0 157 Education None * * * * * * * * 21 Primary 72.8 27.2 100.0 50.1 6.1 14.8 29.0 100.0 63 Lower secondary (59.0) (41.0) 100.0 (80.8) (8.6) (7.3) (3.3) 100.0 44 Upper secondary * * * * * * * * 25 Post secondary non tertiary * * * * * * * * 16 Higher * * * * * * * * 11 Wealth index quintile Poorest * * * * * * * * 20 Second * * * * * * * * 22 Middle (75.1) (24.9) 100.0 (53.5) (7.7) (17.4) (21.4) 100.0 34 Fourth (67.1) (32.9) 100.0 (73.0) (16.8) (3.2) (7.0) 100.0 47 Richest (65.1) (34.9) 100.0 (83.6) (0.0) (2.4) (13.9) 100.0 58 Ethno-linguistic group of household head Lao-Tai 70.5 29.5 100.0 67.7 8.4 8.9 15.0 100.0 148 Mon-Khmer * * * * * * * * 21 Hmong-Mien * * * * * * * * 7 Chinese-Tibetan * * * * * * * * 4 Other, Missing, DK * * * * * * * * 1 Total 69.6 30.4 100.0 66.9 6.9 10.2 16.0 100.0 181 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 RH.15: Post-natal care (PNC) visits for mothers Percent distribution of women age 15-49 years who gave birth in the preceding 2 years and received a post-natal care visit within one week of delivery, by location and provider of the first post-natal care visit, Lao PDR 2011-12 Location of first post- natal care visit Total Provider of first post-natal care visit Total Number of women who gave birth in the two years preceding survey and received a post- natal care visit within one week of delivery 119 Table RH.16 presents information about health checks and PNC visits for mothers and newborns. Thirty-eight per cent of both mothers and newborns received a health check or PNC visit within two days of delivery. For nearly 6 in 10 (58 per cent) mother-newborn pairs, neither the mother nor the newborn received any health check or PNC visit. In the Central region, 47 per cent of both mothers and newborns received PNC. This figure was less in the Southern (35 per cent) and in the Northern (28 per cent) regions. Eighty-one per cent of both mothers and newborns who delivered at a health facility received PNC, compared with only 13 per cent of those who delivered at home. It was rare that a mother or newborn received care without the other also receiving care. Higher percentages of PNC were reported for both mothers and newborns two days after delivery if the mothers were from urban areas (especially in Vientiane Capital, with 79 per cent), had more education or were relatively wealthy. 7 120 7 Both mothers and newborns Mothers only Newborns only Neither mother nor newborn DK/Missing Total Region North 28.2 1.1 1.9 68.7 0.1 100.0 1,377 Central 46.6 1.7 2.9 48.8 0.0 100.0 1,989 South 34.8 0.9 2.1 62.2 0.1 100.0 940 Province Vientiane Capital 78.7 2.7 5.3 13.3 0.0 100.0 415 Phongsaly 22.3 0.4 0.0 77.3 0.0 100.0 148 Luangnamtha 44.4 0.6 1.8 53.3 0.0 100.0 99 Oudomxay 18.7 0.3 1.0 80.0 0.0 100.0 266 Bokeo 27.3 1.5 0.0 70.9 0.3 100.0 141 Luangprabang 33.9 1.6 2.1 62.4 0.0 100.0 280 Huaphanh 15.1 1.9 5.4 77.7 0.0 100.0 237 Xayabury 44.7 1.0 1.6 52.2 0.5 100.0 205 Xiengkhuang 37.1 0.0 0.0 62.9 0.0 100.0 200 Vientiane 54.7 0.0 1.7 43.7 0.0 100.0 295 Borikhamxay 34.3 1.0 1.0 63.7 0.0 100.0 162 Khammuane 33.7 3.6 5.0 57.8 0.0 100.0 233 Savannakhet 33.6 1.8 2.7 61.9 0.0 100.0 683 Saravane 34.8 0.6 0.7 63.9 0.0 100.0 361 Sekong 25.0 0.0 0.6 74.3 0.0 100.0 99 Champasack 33.1 1.3 3.4 62.0 0.2 100.0 397 Attapeu 54.8 1.0 3.1 41.0 0.0 100.0 83 Residence Urban 68.2 1.2 2.6 27.9 0.1 100.0 957 Rural 29.5 1.3 2.4 66.7 0.0 100.0 3,349 .Rural with road 31.7 1.5 2.6 64.1 0.0 100.0 2,928 .Rural without road 14.4 0.0 0.8 84.8 0.0 100.0 421 Mother's age at birth Less than 20 35.7 0.9 3.0 60.5 0.0 100.0 745 20-34 39.6 1.3 2.2 56.7 0.0 100.0 3,087 35-49 31.9 2.0 2.8 63.2 0.2 100.0 474 Place of delivery Home 12.6 0.8 2.4 84.2 0.0 100.0 2,518 Health facility 81.2 2.3 2.7 13.7 0.1 100.0 1,615 Public 80.9 2.4 2.8 13.8 0.1 100.0 1,578 Private (90.8) (0.0) (0.0) (9.2) (0.0) 100.0 37 Other/DK/Missing 7.1 0.0 0.2 92.7 0.0 100.0 173 Type of delivery C-section 91.0 3.6 1.1 3.9 0.5 100.0 159 Not via C-section 36.1 1.2 2.5 60.2 0.0 100.0 4,147 Education None 15.4 1.0 0.9 82.7 0.0 100.0 1,248 Primary 33.2 1.1 3.0 62.5 0.1 100.0 1,763 Lower secondary 56.1 1.8 2.8 39.4 0.0 100.0 693 Upper secondary 75.2 2.1 2.4 20.3 0.0 100.0 334 Post secondary non tertiary 79.4 1.8 5.1 13.8 0.0 100.0 146 Higher 88.4 1.8 4.5 5.3 0.0 100.0 122 Wealth index quintile Poorest 12.8 0.5 0.8 85.9 0.0 100.0 1,178 Second 23.4 1.2 1.9 73.4 0.0 100.0 927 Middle 40.4 2.0 2.9 54.7 0.0 100.0 810 Fourth 56.2 1.5 4.0 38.0 0.3 100.0 707 Richest 80.1 1.8 3.7 14.3 0.0 100.0 684 Ethno-linguistic group of household head Lao-Tai 52.2 2.0 3.8 42.0 0.1 100.0 2,401 Mon-Khmer 22.0 0.4 1.0 76.6 0.0 100.0 1,213 Hmong-Mien 15.5 0.6 0.2 83.7 0.0 100.0 530 Chinese-Tibetan 17.4 0.9 1.0 80.7 0.0 100.0 140 Other, Missing, DK * * * * * * 21 Total 38.1 1.3 2.4 58.1 0.1 100.0 4,306 Table RH.16: Post-natal health checks for mothers and newborns Number of women age 15-49 years who gave birth in the 2 years preceding the survey 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. Health checks or post-natal care visits within 2 days of delivery includes checks performed while in the health facility and at home following delivery, regardless of timing, as well as post-natal care visits within two days of delivery Health check following delivery or post-natal care visit within two days of delivery for: Percent distribution of women age 15-49 who gave birth in the two years preceding the survey by receipt of health checks and post-natal care (PNC) visits within 2 days of delivery, for the mother and newborn, Lao PDR 2011-12 © UNFPA Lao PDR / 2012 / Chang 122 VIII. Adult and Maternal Mortality Adult and maternal mortality rates are key indicators of the health status of a population. In Lao PDR, they are also national development indicators. Estimation of these mortality rates requires comprehensive and accurate reporting of adult and maternal deaths. Estimates of adult and maternal mortality are based on the sibling history data collected in the Maternal Mortality Module of the 2011-12 LSIS Women’s Questionnaire. To obtain a sibling history, the 2011-12 LSIS interviewers first asked each female respondent to list all of the children born to her biological mother, starting with the firstborn. The interviewer then asked the respondent whether each of these siblings was still alive. For siblings still alive at the time of the survey, the respondent was asked the current age of each. For siblings who have died, the respondent was asked to report how old the sibling was at the time of his/her death, and the number of years that have passed since the death (how long ago did the sibling die). When a respondent could not provide precise information on age at death or years since death, approximate but quantitative answers were accepted. These are the data used to estimate adult mortality. To estimate maternal mortality, further information was collected on sisters who died at the age of 12 or older. Respondents were asked three questions to determine whether the sibling deaths were maternal: ‘Was [NAME OF SISTER] pregnant when she died?’; and, if the response was negative, ‘Did she die during childbirth?’; and, if negative again, ‘Did she die within two months after the end of a pregnancy or childbirth?’ The term ‘maternal mortality’ used in this chapter corresponds to the term ‘pregnancy-related mortality’ defined by WHO as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death.1 In keeping with this definition, the LSIS Maternal Mortality Module measures only the timing of deaths, and not the cause of death. Note that the LSIS asked the respondent about deaths within two months of termination of pregnancy in full knowledge that the definition of a maternal death is within 42 days of termination of pregnancy; asking the respondent to report age at death within 42 days expects a level of accuracy of reporting that is unrealistic for most respondents, especially when reporting events that occurred in the past – assuming that respondents can report relative to a two-month time span is more realistic. This chapter also includes a summary measure (35q15) that represents the probability of dying between 15 and 50. Assessment of Data Quality Table DQ. 20 (see Appendix D) shows that the 2011-12 LSIS recorded a total of 116,669 sibling histories. The survival status was not reported for 54 siblings (0.05 per cent). Among surviving siblings, current age was not reported for 117 siblings (0.1 per cent). Among deceased siblings, both age at death (AD) and years since death (YSD) were missing for 17 siblings (0.1 per cent). Both age at death and years since death were reported for more than 99 per cent of deceased siblings. The sex ratio of the enumerated siblings (the ratio of brothers to sisters multiplied by 100) is 107 (Table DQ. 21 in Appendix D), which is higher than the expected value of 102–106; a difference that may suggest some under reporting of sisters. Of the sisters who were reported as having died age between 15 and 49, 4 per cent of deaths could not be classified as either maternal or non-maternal. 1 http://www.who.int/healthinfo/statistics/indmaternalmortality/en/index.html 8 123 Estimates of Adult Mortality One way to assess the quality of data used to estimate maternal mortality is to evaluate the plausibility and stability of overall adult mortality estimates. If the estimated rates of overall adult mortality are implausible, rates based on a subset of deaths — maternal mortality in particular — are likely to have serious problems. Of course, levels and trends in overall adult mortality have important implications for Lao health and social programmes in their own right. The direct estimation of adult mortality uses the reported ages at death and years since death of the respondents’ brothers and sisters. Mortality rates are calculated by dividing the number of deaths in each age group of women and men by the total person-years of exposure to the risk of dying in that age group during a specified period prior to the survey. To have a sufficiently large number of adult deaths to generate a robust estimate, the rates are calculated for the seven-year period preceding the survey (roughly 2005 to 2011). Nevertheless, the age-specific mortality rates obtained in this manner are subject to considerable sampling variation. Table MM.1 shows age-specific mortality rates for women and men age 15-49 for the seven-year period preceding the survey. The level of adult mortality is slightly higher among men than women (3.1 and 2.3 deaths per 1,000 population, respectively). Age-specific mortality rates are higher for men than women in all age groups, except 15-19 year olds. The age-specific mortality rates generally show the expected increases with increasing age, for both women and men. Table MM.2 presents the risk of dying between the ages of 15 and 50 (35q15) for women and men for the seven years preceding the survey. Based on the 2011-12 LSIS, 8.4 per cent of women and 11.7 per cent of men are likely to die between ages of 15 and 50. Age Deaths Exposure years Mortality rates* Deaths Exposure years Mortality rates* 15-19 76 43,871 1.73 55 46,996 1.17 20-24 67 51,754 1.30 112 54,237 2.06 25-29 72 48,721 1.49 113 50,449 2.24 30-34 82 41,758 1.96 116 44,609 2.60 35-39 71 34,023 2.09 116 35,252 3.29 40-44 89 24,120 3.69 129 24,064 5.37 45-49 76 14,435 5.28 122 14,948 8.16 Total 15-49** 534 258,684 2.27 762 270,557 3.12 MM.1: Adult mortality rates Direct estimates of female and male mortality rates for the seven years preceding the survey, by five-year age groups, Lao PDR 2011-12 * Expressed per 1,000 population ** Age-adjusted rate Female Male 8 124 Age Percentage of female deaths that are maternal Maternal deaths Exposure (years) Maternal mortality rates (per 1000 years of exposure) 15-19 15.1 11 43,871 0.26 20-24 31.0 21 51,754 0.40 25-29 34.5 25 48,721 0.51 30-34 26.5 22 41,758 0.52 35-39 15.0 11 34,023 0.31 40-44 8.2 7 24,120 0.30 45-49 7.2 5 14,435 0.38 Total 15-49**** 19.2 102 258,684 0.38 General fertility rate* 107 Maternal mortality ratio** 357 CI: (269, 446) Lifetime risk of maternal death*** 0.012 MM.3: Maternal mortality Direct estimates of maternal mortality for the seven years preceding the survey, by five-year age groups, Lao PDR 2011-12 2 MICS indicator 5.13; MDG indicator 5.1 CI: Confidence interval * Expressed per 1,000 woman-years of exposure ** Maternal mortality ratio is calculated as the maternal mortality rate divided by the general fertility rate, expressed per 1,000 women age 15- 49 *** Calculated as 1-(1-MMR)TFR where TFR represents the total fertility rate for the seven years preceding the survey **** The maternal mortality rate and general fertility rate are age-adjusted Survey Women 35q15* Men 35q15 * Lao PDR 2011-12 84 117 MM.2: Adult mortality probabilities The probability of dying between the ages of 15 and 50 for women and men for the seven years preceding the survey, Lao PDR 2011-12 * The probability of dying between exact ages 15 and 50, expressed per 1,000 person-years of exposure Estimates of Maternal Mortality Table MM.3 presents direct estimates of maternal mortality for the seven-year period preceding the survey (roughly 2005 to 2011), which is long enough to generate a robust estimate (the mid-point of the time period to which the maternal mortality estimates refer is 2008). The maternal mortality rate among women age 15-49 is 0.38 maternal deaths per 1,000 woman-years of exposure. By five-year age groups, the maternal mortality rate is highest among women age 25-34 (0.5 maternal deaths per 1,000 woman-years of exposure). Confidence intervals for the maternal mortality rates can be found in Appendix Table SE.27. According to the 2011-12 LSIS, maternal deaths represent 19 per cent of all deaths of women age 15-49. The percentage of female deaths that are maternal varies by age, ranging from 7 per cent among women age 45-49 to 35 per cent of all deaths among women age 25-29. The maternal mortality rate can be converted to a maternal mortality ratio (MMR – expressed as deaths per 100,000 live births) by dividing the maternal mortality rate by the general fertility rate (GFR) of 107 that prevailed during the same time period, and multiplying the result by 100,000. This procedure produces a maternal mortality ratio of 357 deaths per 100,000 live births during the seven-year period preceding the survey. In other words, for every 1,000 live births in Lao PDR, about four women (3.57) died during pregnancy, during childbirth, or within two months of childbirth during the seven years preceding the 2011-12 LSIS. The lifetime risk of maternal death (0.012) indicates that about 1 per cent of women died during pregnancy, during childbirth, or within two months of childbirth. 8 125 796 530 433 405 357 1995 2000 2005 2010 Deaths per 100,000 live births Year Figure MM.1: Trend in maternal mortality ratios, Lao PDR 1995-2012 Census 1995 LRHS 2000 LHS 2003 Census 2005 LSIS 2011-12 446 269 Every survey estimate contains a level of uncertainty. The point MMR estimate of 357 should more appropriately be interpreted as an interval estimate. The LSIS survey data are able to tell us with 95 per cent certainty that the MMR falls somewhere between 269 and 446 deaths per 1,000 live births during the seven year period preceding the survey. The previous estimate of MMR from the 2005 Census is 405 deaths per 1,000 live births, which falls within the confidence interval of the current survey estimate; thus, while the LSIS estimate appears lower, the LSIS is unable to detect a statistically significant change from the Census estimate. 8 © UNFPA Lao PDR / 2012 / Perier 127 IX. Child Health Vaccinations Millennium Development Goal (MDG) 4 is to reduce child mortality by two thirds between 1990 and 2015. Immunization plays a key part in this goal. Immunizations have saved the lives of millions of children in the almost four decades since the launch of the Expanded Programme on Immunization (EPI) in 1974. Some 27 million children worldwide are still overlooked by routine immunization, and as a result, vaccine-preventable diseases cause more than 2 million deaths every year. A World Fit for Children (WFFC) goal is to ensure full immunization of children less than one year of age at 90 per cent nationally, with at least 80 per cent coverage in every district or equivalent administrative unit. According to UNICEF and WHO guidelines, a child should receive a Bacille-Calmette-Guerin (BCG) vaccination to protect against tuberculosis; three doses of Diphteria Pertussis Tetanus (DPT) to protect against diphtheria, pertussis and tetanus; three doses of polio vaccine; and a measles vaccination by the age of 12 months. The pentavalent vaccine DPT-HepB-Hib, introduced in October 2009, has replaced the previous DPT vaccine. This new vaccine protects against diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type b. The vaccination schedule followed by the Expanded National Immunization Programme provides all the above-mentioned vaccinations. The vaccination policy in Lao PDR calls for BCG vaccination at birth, three doses of DPT-HepB-Hib vaccine at approximately 6, 10 and 14 weeks of age, three doses of oral polio vaccine at approximately the same time pentavalent is given, and measles vaccine after reaching 9 months of age. All vaccinations should be received during the first year of life. Taking into consideration this vaccination schedule, estimates for full immunization coverage from the LSIS are based on children age 12-23 months. Information on vaccination coverage was collected for all children under five years of age. All mothers or caretakers were asked to provide vaccination cards. If the vaccination card for a child was available, interviewers copied vaccination information from the cards onto the LSIS questionnaire. If no vaccination card was available for the child or if a vaccine on the card had not been recorded as being given, the interviewer asked the mother/caretaker to recall whether or not the child had received each of the vaccinations, and (for polio, DPT, and hepatitis B) how many doses were received. The final vaccination coverage estimates are based on both information obtained from the vaccination card and the mother’s report of vaccinations received by the child. The percentage of children age 12 to 23 months who have received each vaccine is shown in Table CH.1, according to source of information (vaccination card and mother’s recollection). The denominator for every column of the table is comprised of children age 12-23 months so that only children who are old enough to be fully vaccinated are counted. In the first three columns of the table, the numerator includes all children who were vaccinated at any time before the survey according to the vaccination card or the mother’s report. In the last column, only those children who were vaccinated before their first birthday are included in the numerator. For children without vaccination cards, the proportion of vaccinations given before the first birthday is assumed to be the same as it is for children with vaccination cards. The calculation of “all vaccinations” includes BCG, DPT+HepB+HiB 1-3, Polio 1-3, and measles. Hepatitis B at birth is not considered in the calculation of “all vaccinations” or “no vaccinations.” 9 128 Vaccination card Mother's report Either BCG1 44.7 33.6 78.3 77.1 Polio 1 44.3 34.0 78.3 76.5 2 41.6 26.8 68.4 65.5 32 37.0 15.6 52.6 49.1 HepB at birth 27.6 9.3 36.9 36.6 DPT-HepB-HiB 1 44.6 32.2 76.8 75.1 2 41.8 25.4 67.2 64.2 33 36.8 18.6 55.5 51.5 Measles4 34.0 29.7 63.7 55.3 All vaccinations 33.5 9.4 42.9 34.0 No vaccinations 0.0 15.7 15.7 15.9 Number of children age 12-23 months 2,141 2,141 2,141 2,141 HepB at birth is not included in the calculation of “All vaccinations” and “No vaccinations" Vaccinated at any time before the survey according to Vaccinated by 12 months of age 4 MICS indicator 3.4; MDG indicator 4.3 Table CH.1: Vaccinations in first year of life Percentage of children age 12-23 months immunized against childhood diseases at any time before the survey and before the first birthday, Lao PDR 2011-12 1 MICS indicator 3.1; 2 MICS indicator 3.2; 3 MICS indicator 3.3 Some 34 per cent of children age 12-23 months received all the recommended vaccinations before their first birthday; 43 per cent were fully vaccinated at some point prior to the survey. Seventy-seven per cent of children age 12-23 months had received a BCG vaccination by the age of 12 months and 75 per cent had received the first dose of DPT. The proportion receiving subsequent doses of DPT by 12 months of age declines to 64 per cent receiving the second dose, and 52 per cent receiving the third dose. A similar trend is apparent in follow-up doses of polio vaccine, with 77 per cent of children receiving polio 1 by 12 months of age but only 49 per cent receiving the third dose (Figure CH.1). While nearly two thirds of children (64 per cent) were vaccinated against measles, only about half (55 per cent) had received the vaccine by 12 months of age. The late administration of measles vaccine (to some children) is the main contributing factor to the difference between the 43 per cent of children receiving all vaccinations and only 34 per cent receiving all vaccinations by their first birthday. Only 37 per cent of infants receive hepatitis B vaccine at birth (which is not included in the calculation of “all vaccinations” or “no vaccinations” in Table CH.1 or CH.2). The current coverage of all vaccinations by 12 months of age shows dramatic improvement compared to 2006 MICS data reporting 14 per cent coverage of 12 to 23-month-olds. Despite dramatic improvement, however, the ultimate coverage goal is yet to be reached. 9 129 Table CH.2 presents vaccination coverage estimates among children age 12-23 months according to background characteristics. The table reports the percentage of children vaccinated at any time up to the date of the survey and is based on information from both the vaccination cards and mothers’/ caretakers’ reports. Vaccination cards were seen by interviewers for nearly half (47 per cent) of the children, although the percentage seen varied from region to region. The highest percentage of vaccination cards seen was in the North (59 per cent), followed by 45 per cent in the Central region and only 35 per cent of children in the South. Vaccination coverage does not vary much by children’s gender. About half of children in urban areas have received all vaccinations (54 per cent), compared to only 39 per cent of rural children. Nearly half of the children in the Southern region had received all vaccinations (48 per cent), compared with 45 per cent in the Northern and only 40 per cent in the Central region. A wide degree of variation is observed across the country by province; the LSIS found the lowest coverage in Phongsaly and Savannakhet, where fewer than 25 per cent have received all the recommended vaccinations, and the highest coverage in Xayabury at 79 per cent. Full vaccination coverage steadily increases with the mother’s education. Only 24 per cent of children whose mothers have no education are fully vaccinated compared with73 per cent of children of higher educated mothers. Similarly, only 29 per cent of children in the lowest wealth quintile are fully vaccinated, compared with 61 per cent of children in the highest wealth quintile, even though vaccinations are provided free of charge. Children of Hmong-Mien headed households have the lowest vaccination coverage compared with children in other ethno-linguistic households; only 20 per cent have received all vaccinations and as many as 35 per cent have not received any vaccinations. 9 77 75 64 52 76 66 49 55 34 0 10 20 30 40 50 60 70 80 90 BCG DPT HepB… DPT HepB… DPT HepB… Polio1 Polio2 Polio3 Measles All P er ce nt Figure CH.1: Percentage of children age 12-23 months who received the recommended vaccinations by 12 months of age, Lao PDR 2011-12 130 9 1 2 3 HepB at birth 1 2 3 Sex Male 76.5 76.0 67.0 52.0 36.1 75.8 67.2 55.4 61.4 17.3 41.2 46.6 1,087 Female 80.1 80.6 69.9 53.1 37.8 78.0 67.2 55.5 66.1 14.0 44.7 47.6 1,055 Region North 78.9 78.9 69.4 55.5 38.5 76.0 66.4 56.2 62.1 14.0 44.6 58.9 696 Central 72.9 73.1 64.4 48.5 39.1 72.9 64.1 52.6 59.5 20.7 39.5 44.5 984 South 88.9 88.4 75.8 57.0 29.9 86.7 75.2 60.6 75.1 7.3 47.5 34.8 461 Province Vientiane Capital 86.1 82.8 81.1 65.4 66.7 86.1 79.9 66.5 71.3 13.9 53.4 61.8 179 Phongsaly 51.9 56.1 45.3 28.4 26.1 52.2 37.6 23.8 42.4 29.9 21.1 36.1 71 Luangnamtha 93.2 93.6 87.6 72.4 53.6 87.8 76.7 67.9 78.0 3.0 57.5 60.1 52 Oudomxay 82.4 83.1 67.3 50.7 40.9 82.6 67.9 54.4 57.9 7.2 36.4 61.4 145 Bokeo 71.0 65.5 54.0 40.3 27.4 61.8 47.3 37.6 53.2 22.6 31.1 48.9 76 Luangprabang 85.2 84.4 76.7 59.5 48.4 79.9 72.1 59.1 64.6 11.5 50.1 65.1 138 Huaphanh 67.3 70.1 59.7 52.6 15.6 65.5 60.1 52.9 53.9 24.2 38.2 57.2 121 Xayabury 97.8 95.5 94.3 83.8 58.5 96.6 95.5 91.8 88.2 2.2 79.0 72.9 93 Xiengkhuang 70.1 77.2 67.2 41.8 25.7 72.3 60.0 36.5 48.6 18.3 27.8 49.4 106 Vientiane 86.8 83.9 73.6 57.1 44.4 85.2 75.1 68.7 74.8 12.4 52.3 60.3 160 Borikhamxay 92.5 83.8 73.3 61.2 52.5 86.5 72.2 65.6 75.1 6.5 57.0 51.4 94 Khammuane 84.8 83.1 76.9 58.7 39.6 84.3 78.9 66.6 72.7 10.6 45.4 50.9 114 Savannakhet 50.4 54.9 43.1 30.2 23.0 52.2 44.1 34.0 40.4 36.7 22.7 21.9 331 Saravane 92.4 91.6 77.9 65.1 31.8 90.5 77.7 67.6 81.0 3.5 57.8 38.7 183 Sekong 92.3 92.6 75.6 49.1 18.1 82.2 62.4 40.3 74.8 6.4 33.0 27.7 52 Champasack 87.4 86.5 77.4 54.6 31.0 86.5 79.1 61.8 72.8 9.0 44.1 32.6 188 Attapeu 75.8 77.4 58.5 41.2 31.3 75.8 61.6 49.6 58.7 17.9 35.4 36.0 39 Residence Urban 86.3 84.2 77.6 63.8 60.9 84.3 78.7 67.7 71.7 11.1 54.0 56.9 506 Rural 75.8 76.5 65.6 49.1 29.4 74.5 63.6 51.7 61.2 17.1 39.4 44.1 1,635 .Rural with road 77.4 77.5 66.4 50.6 30.8 75.7 64.6 53.8 62.4 16.0 41.1 45.9 1,447 .Rural without road 63.9 68.5 59.6 37.1 18.5 65.5 56.0 35.5 52.5 25.4 26.5 30.3 188 Mother’s education None 62.0 64.7 48.5 32.8 17.1 59.9 46.0 33.4 44.9 27.7 24.4 31.6 649 Primary 79.5 79.5 69.8 54.9 32.9 79.1 68.5 57.1 66.2 14.0 44.6 47.9 876 Lower secondary 91.2 88.1 84.2 67.0 52.2 87.9 84.2 72.0 75.2 7.6 55.9 59.7 309 Upper secondary 95.4 92.3 89.4 68.8 68.6 94.8 88.5 76.5 84.9 3.7 60.1 60.5 170 Post secondary non tertiary 97.3 95.2 91.9 75.6 79.6 95.2 94.6 86.0 82.4 2.7 65.6 71.2 82 Higher 97.8 96.0 93.1 83.3 85.4 96.3 93.2 86.9 87.4 2.2 73.0 69.5 55 Wealth index quintile Poorest 65.7 69.3 54.4 38.4 17.6 63.8 50.3 36.8 50.5 23.8 28.8 36.8 585 Second 71.3 71.7 59.7 46.2 22.8 69.6 57.8 46.6 55.6 20.8 36.1 42.6 443 Middle 83.6 80.3 71.9 57.5 36.9 82.4 72.3 59.4 68.8 11.1 47.3 50.3 392 Fourth 85.7 84.9 77.8 59.9 48.8 83.7 79.0 67.6 72.2 12.1 51.9 52.3 388 Richest 95.1 92.6 89.6 71.5 75.8 94.9 89.9 81.4 81.9 4.0 61.0 61.4 334 Ethno-linguistic group of household head Lao-Tai 86.0 84.3 77.5 61.2 48.3 85.3 78.5 66.9 72.7 10.4 51.7 53.1 1,180 Mon-Khmer 74.9 77.1 64.6 48.6 23.8 73.2 60.5 49.1 61.3 15.9 37.5 40.5 593 Hmong-Mien 56.6 58.2 42.1 27.5 18.9 52.4 39.5 26.6 35.3 35.1 20.0 36.9 287 Chinese-Tibetan 61.3 64.8 53.6 38.7 23.5 61.4 42.8 31.5 44.2 26.4 28.6 41.8 65 Other, Missing, DK * * * * * * * * * * * * 15 Total 78.3 78.3 68.4 52.6 36.9 76.8 67.2 55.5 63.7 15.7 42.9 47.1 2,141 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. HepB at birth is not included in the calculation of “None” and “All” columns Table CH.2: Vaccinations by background characteristics Number of children age 12-23 months Percentage of children who received: Polio DPT-HepB-HiB BCG Measles None Percentage with vaccination card seen Percentage of children age 12-23 months currently vaccinated against childhood diseases, Lao PDR 2011-12 All 131 Neonatal Tetanus Protection The prevention of maternal and neonatal tetanus is critical to maternal and child health. MDG and WFFC both outline goals for the reduction of maternal and infant mortality via strategies to eliminate tetanus among these populations. Specifically, pregnant women should receive at least two doses of tetanus toxoid vaccine. If a woman has not received at least two doses of tetanus toxoid during pregnancy, she (and her newborn) are also considered to be protected against tetanus if the woman has received: • At least two doses of tetanus toxoid vaccine, the last within the previous 3 years • At least 3 doses, the last within the previous 5 years • At least 4 doses, the last within the previous 10 years • Five or more doses at any time during her life To assess the status of tetanus vaccination coverage, women who had a live birth during the two years before the survey were asked if they had received tetanus toxoid injections during the pregnancy for their most recent birth, and if so, how many. Women who did not receive two or more tetanus toxoid vaccinations during this pregnancy were then asked about tetanus toxoid vaccinations they may have received prior to this pregnancy. Interviewers also asked women to present their vaccination card on which dates of tetanus toxoid injections are recorded and referred to information from the cards when available. Table CH.3 presents the results. Some 66 per cent of women with a live birth in the previous two years were protected against tetanus; an improvement over the 56 per cent estimated in the 2006 MICS survey (based on women with live births in the previous two years). Thirty-six per cent of women interviewed in the LSIS reported receiving two or more tetanus toxoid doses during their last pregnancy (similar to the 38 per cent reported in 2006 MICS). Twenty-nine per cent of women did not receive two doses during their last pregnancy but were still protected by having received earlier doses of tetanus toxoid: 22 per cent received two doses; including a dose in the previous three years, 4 per cent received three doses, including a dose within the previous 5 years; 3 per cent received four doses, including a dose within the previous 10 years; and five or more doses during their lifetime. Protection against tetanus ranges from a high of 82 per cent among women in Xayabury province to a low of 44 per cent in Phongsaly province. Seventy-four per cent of women residing in urban areas were protected, while only 63 per cent of women residing in rural areas were protected, falling to 54 per cent among women living in rural areas without roads. Nearly three quarters (73 per cent) of women living in Lao-Tai headed households were protected against tetanus, compared with only about half of women in Hmong-Mien (53 per cent) and Chinese-Tibetan (54 per cent) households. 9 132 2 doses, the last within prior 3 years 3 doses, the last within prior 5 years 4 doses, the last within prior 10 years 5 or more doses during lifetime Region North 37.7 27.8 3.2 2.3 0.8 71.8 1,377 Central 34.0 19.1 4.5 4.0 1.4 63.0 1,989 South 39.7 18.5 2.2 1.5 0.7 62.7 940 Province Vientiane Capital 49.7 19.9 3.6 4.0 0.4 77.6 415 Phongsaly 22.6 19.6 0.7 0.4 0.4 43.7 148 Luangnamtha 32.6 25.8 10.4 5.9 1.2 76.0 99 Oudomxay 48.0 27.6 1.3 0.5 0.0 77.4 266 Bokeo 25.7 40.5 3.1 2.6 0.4 72.4 141 Luangprabang 38.6 29.4 3.3 2.8 1.6 75.8 280 Huaphanh 29.1 31.1 3.5 3.1 0.4 67.2 237 Xayabury 54.6 19.9 3.7 2.4 1.5 82.0 205 Xiengkhuang 15.4 25.9 6.8 4.3 0.7 53.0 200 Vientiane 33.0 19.1 7.5 10.1 3.1 72.7 295 Borikhamxay 37.7 28.7 7.0 6.0 1.0 80.4 162 Khammuane 45.3 15.3 2.5 1.0 3.1 67.2 233 Savannakhet 25.5 15.7 3.3 1.7 1.2 47.4 683 Saravane 31.1 16.2 1.2 2.1 0.8 51.3 361 Sekong 36.8 12.6 4.9 0.8 0.4 55.6 99 Champasack 49.7 23.8 2.1 0.7 0.4 76.8 397 Attapeu 32.6 10.1 3.9 4.1 2.6 53.3 83 Residence Urban 40.8 22.5 4.6 4.5 1.5 73.9 957 Rural 35.2 21.5 3.3 2.4 1.0 63.4 3,349 .Rural with road 36.0 21.9 3.2 2.7 1.0 64.8 2,928 .Rural without road 29.6 18.8 4.2 0.8 0.6 54.1 421 Education None 25.1 17.9 2.8 0.9 0.4 47.1 1,248 Primary 39.1 22.6 3.3 2.9 1.0 68.9 1,763 Lower secondary 40.4 25.8 4.9 3.8 1.3 76.2 693 Upper secondary 47.3 24.0 3.9 5.1 3.0 83.3 334 Post secondary non tertiary 48.0 23.9 4.3 5.1 1.5 82.8 146 Higher 47.2 17.3 8.4 9.2 1.9 84.0 122 Wealth index quintile Poorest 27.8 21.7 2.0 1.1 0.2 52.6 1,178 Second 34.9 19.8 3.3 2.1 0.9 61.0 927 Middle 38.2 21.9 5.7 3.6 1.0 70.6 810 Fourth 40.6 24.7 3.2 4.0 2.3 74.8 707 Richest 46.8 21.2 4.8 5.2 1.7 79.8 684 Ethno-linguistic group of household head Lao-Tai 41.1 22.5 4.0 3.7 1.5 72.8 2,401 Mon-Khmer 34.5 19.0 2.8 1.6 0.6 58.5 1,213 Hmong-Mien 21.5 24.5 4.0 2.7 0.4 53.2 530 Chinese-Tibetan 25.6 23.2 3.9 1.3 0.4 54.4 140 Other, Missing, DK * * * * * * 21 Total 36.4 21.7 3.6 2.9 1.1 65.8 4,306 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Table CH.3: Neonatal tetanus protection Percentage of women age 15-49 years with a live birth in the last 2 years protected against neonatal tetanus, Lao PDR 2011-12 Protected against tetanus1 1 MICS indicator 3.7 Percentage of women who received at least 2 doses during last pregnancy Percentage of women who did not receive two or more doses during last pregnancy but received: Number of women with a live birth in the last 2 years 9 133 72 63 63 74 63 47 69 76 83 83 84 66 Regions North Central South Residence Urban Rural Education None Primary Lower secondary Upper secondary Post secondary non … Higher Lao PDR Figure CH.2: Percentage of women with a live birth in the last 2 years who are protected against neonatal tetanus, Lao PDR 2011-12 66 0 20 40 60 80 100 Lao PDR Percent Figure CH.2 shows the percentage of women protected against neonatal tetanus by region, residence and level of education. Women’s education level and protection against tetanus are highly correlated. Eighty-three per cent of women with upper secondary or higher education were protected against neonatal tetanus during their previous pregnancy, compared with only 47 per cent of those with no education. Similarly, 80 per cent of women in the highest wealth quintile were protected against tetanus during their previous pregnancy, compared with only 53 per cent of the poorest women. 9 134 Oral Rehydration Treatment Diarrhoea is the second leading cause of death among children age under five worldwide. Most diarrhoea-related deaths in children are due to dehydration from loss of large quantities of water and electrolytes from the body in liquid stools. Management of diarrhoea – either through oral rehydration salts (ORS) or a recommended home fluid (RHF) – can prevent many of these deaths. Preventing dehydration and malnutrition by increasing fluid intake and continuing to feed the child are also important strategies for managing diarrhoea. The goals are to: 1) reduce by one half the deaths due to diarrhoea among children age under five by 2010 compared to 2000 (WFFC); and 2) reduce by two thirds the mortality rate among children age under five by 2015 compared to 1990 (MDG). In addition, the WFFC calls for a reduction in the incidence of diarrhoea by 25 per cent. In the LSIS, the prevalence of diarrhoea was estimated by asking mothers or caretakers whether their child age under five years had an episode of diarrhoea in the two weeks prior to the survey. When mothers reported that the child had diarrhoea, questions were asked about the treatment of the illness, including what the child had to drink and eat during the episode and whether this was more or less than usual. Ten per cent of children age under five had diarrhoea in the two weeks preceding the survey (Table CH.4). Diarrhoea prevalence was higher in the Northern (15 per cent) than in the Southern (8 per cent) and Central region (7 per cent). The peak of diarrhoea prevalence occurs among children age 12-23 months. Table CH.4 also shows the percentage of children receiving recommended liquids during the episode of diarrhoea. Since children may have been given more than one type of liquid, the percentages do not necessarily add to 100. Thirty-seven per cent of children with diarrhoea received fluids from ORS packets, 16 per cent received pre-packaged ORS fluids, and 13 per cent received RHFs. Thus, nearly half (48 per cent) of children with diarrhoea received ORS or an RHF during the episode of diarrhoea. The 2006 MICS also reported half of children with diarrhoea receiving fluids either from ORS packets, ORS pre-package fluids, or RHFs (51 per cent), but the 2006 MICS reported somewhat lower use of ORS packets (31 per cent) and higher use of RHFs (30 per cent). 9 135 Recommended homemade fluids Fluid from ORS packet Pre-packaged ORS fluid ORS (Fluid from ORS packet or pre-packaged ORS fluid) Coconut water or rice water Sex Male 10.5 5,593 39.9 16.3 45.2 13.7 51.8 589 Female 9.5 5,474 33.1 16.3 39.0 11.7 42.6 520 Region North 15.3 3,502 39.2 19.5 46.0 12.5 51.0 537 Central 7.4 5,154 33.2 11.5 38.5 13.0 44.2 381 South 7.9 2,411 36.6 16.8 39.4 12.9 44.2 191 Province Vientiane Capital 5.3 1,058 (67.0) (25.2) (81.9) (23.2) (88.2) 56 Phongsaly 16.0 368 29.3 22.2 30.3 1.1 30.3 59 Luangnamtha 10.0 280 31.3 39.5 66.6 47.4 78.7 28 Oudomxay 16.8 676 38.1 44.3 50.8 2.5 50.8 113 Bokeo 23.8 335 43.7 7.4 44.3 13.6 54.5 80 Luangprabang 17.7 752 45.5 12.7 48.2 17.1 50.3 133 Huaphanh 12.1 606 26.5 5.5 32.0 16.8 47.9 73 Xayabury 10.4 486 (52.9) (6.6) (59.5) (8.9) (61.6) 51 Xiengkhuang 12.3 540 27.0 0.0 27.0 0.0 27.0 67 Vientiane 4.3 767 (33.0) (15.7) (33.0) (12.4) (37.3) 33 Borikhamxay 6.9 402 (49.1) (28.8) (52.6) (50.1) (77.9) 28 Khammuane 6.5 603 (13.6) (8.4) (22.0) (14.7) (31.4) 39 Savannakhet 8.9 1,784 26.1 8.4 30.9 8.0 34.6 158 Saravane 10.4 923 30.0 6.3 32.8 8.2 36.5 96 Sekong 12.2 269 12.4 9.8 21.2 9.8 31.0 33 Champasack 6.0 1,003 (58.6) (35.6) (58.6) (21.9) (62.4) 61 Attapeu 1.0 216 * * * * * 2 Residence Urban 5.4 2,319 57.5 24.8 64.6 21.0 69.4 126 Rural 11.2 8,748 34.1 15.2 39.5 11.7 44.7 983 .Rural with road 10.5 7,661 35.3 14.9 40.7 12.4 46.3 806 .Rural without road 16.3 1,086 28.4 16.4 33.6 8.4 37.6 178 Age 0-11 months 11.4 2,307 24.7 13.1 30.5 5.6 33.7 262 12-23 months 15.0 2,141 41.2 20.1 46.9 15.1 50.9 322 24-35 months 9.8 2,193 44.4 17.4 51.7 17.7 59.1 215 36-47 months 7.7 2,302 33.2 12.5 37.3 14.1 44.6 177 48-59 months 6.2 2,124 42.0 16.5 45.9 11.3 51.5 132 Mother’s education None 13.1 3,580 29.7 12.9 34.2 11.6 40.4 471 Primary 10.2 4,556 39.5 16.2 44.6 10.5 47.5 466 Lower secondary 6.8 1,613 44.1 26.3 54.2 21.3 64.7 110 Upper secondary 5.2 695 (54.8) (18.0) (57.7) (22.4) (67.3) 36 Post secondary non tertiary 5.5 368 * * * * * 20 Higher 2.3 255 * * * * * 6 Wealth index quintile Poorest 15.0 3,233 30.6 11.5 35.0 9.2 39.7 486 Second 11.6 2,346 32.0 15.6 36.8 11.4 42.7 272 Middle 8.4 2,019 44.6 20.0 51.5 11.1 55.5 170 Fourth 5.7 1,807 53.6 24.2 55.6 25.3 62.2 102 Richest 4.7 1,663 51.7 29.5 69.3 26.7 76.1 78 Ethno-linguistic group of household head Lao-Tai 6.4 6,030 40.0 18.7 46.1 16.6 51.5 388 Mon-Khmer 14.3 3,189 38.7 17.2 44.4 9.9 49.0 457 Hmong-Mien 13.6 1,439 28.0 8.3 30.5 9.2 36.7 196 Chinese-Tibetan 17.3 357 28.1 20.7 39.9 19.6 45.9 62 Other, Missing, DK 12.4 52 * * * * * 7 Total 10.0 11,067 36.7 16.3 42.3 12.7 47.5 1,109 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. Number of children age 0- 59 months with diarrhoea in last two weeks Table CH.4: Oral rehydration solutions and recommended homemade fluids Percentage of children age 0-59 months with diarrhoea in the last two weeks, and treatment with oral rehydration solutions and recommended homemade fluids, Lao PDR 2011-12 ORS or any recommended homemade fluid Had diarrhoea in last two weeks Number of children age 0-59 months Children with diarrhoea who received: Oral rehydration solution (ORS) 9 136 51 44 44 40 43 56 62 76 48 0 10 20 30 40 50 60 70 80 North Central South Poorest Second Middle Fourth Richest Lao PDR P er ce nt Figure CH.3: Percentage of children under age 5 with diarrhoea who received oral rehydration treatment, Lao PDR 2011-12 Mothers and caretakers are encouraged to continue feeding and to increase the amount of liquids given to their children when they suffer from diarrhoeal illnesses. These practices help to reduce the risk of dehydration and also minimize the adverse consequences of diarrhoea on the child’s nutritional state. Mothers and caretakers in the LSIS were asked whether they gave the child who had diarrhoea in the two weeks preceding the survey more or less fluid and food than usual. Feeding practices for children with diarrhoea are presented in Table CH.5. While most children with diarrhoea do continue eating and drinking, they do not receive increased amounts of fluid. When asked whether children were given nothing, less, the same or more than usual to eat during the episode of diarrhoea, 92 per cent of children were reported to have been given either somewhat less, about the same, or more than usual to eat. These are the children who continued feeding, as is recommended. When asked whether children were given less, about the same, or more than usual to drink (including breastmilk) during the episode of diarrhoea, only 27 per cent of children were given more liquids than usual. Seven per cent of children with diarrhoea were given much less than usual to drink, and 4 per cent were given much less to eat. 9 137 9 Se x M al e 10 .5 5, 59 3 6. 7 28 .7 32 .5 28 .8 1. 2 2. 0 10 0. 0 3. 7 38 .5 33 .0 19 .9 0. 5 3. 1 1. 3 10 0. 0 58 9 Fe m al e 9. 5 5, 47 4 6. 7 30 .7 34 .4 25 .5 1. 7 0. 9 10 0. 0 3. 4 38 .8 35 .2 18 .1 2. 0 1. 8 0. 7 10 0. 0 52 0 R eg io n N or th 15 .3 3, 50 2 5. 8 30 .9 30 .9 30 .6 0. 6 1. 1 10 0. 0 3. 9 40 .0 28 .7 23 .8 0. 5 2. 3 0. 7 10 0. 0 53 7 C en tra l 7. 4 5, 15 4 6. 0 25 .9 40 .1 23 .7 2. 0 2. 3 10 0. 0 3. 0 31 .1 44 .6 16 .9 0. 5 2. 2 1. 8 10 0. 0 38 1 S ou th 7. 9 2, 41 1 11 .0 33 .8 27 .1 25 .0 2. 3 0. 9 10 0. 0 3. 7 50 .1 27 .9 9. 9 4. 5 3. 5 0. 4 10 0. 0 19 1 Pr ov in ce V ie nt ia ne C ap ita l 5. 3 1, 05 8 (1 6. 9) (3 8. 7) (1 3. 1) (2 6. 0) (0 .0 ) (5 .3 ) 10 0. 0 (8 .5 ) (3 8. 2) (2 1. 6) (2 8. 8) (0 .0 ) (2 .9 ) (0 .0 ) 10 0. 0 56 P ho ng sa ly 16 .0 36 8 8. 7 51 .9 24 .7 13 .7 0. 0 1. 1 10 0. 0 4. 4 61 .9 25 .5 8. 2 0. 0 0. 0 0. 0 10 0. 0 59 Lu an gn am th a 10 .0 28 0 14 .7 51 .5 26 .0 7. 8 0. 0 0. 0 10 0. 0 11 .0 52 .4 24 .5 12 .2 0. 0 0. 0 0. 0 10 0. 0 28 O ud om xa y 16 .8 67 6 0. 9 18 .1 43 .6 34 .9 0. 0 2. 5 10 0. 0 0. 9 18 .9 37 .9 39 .8 0. 0 0. 0 2. 5 10 0. 0 11 3 B ok eo 23 .8 33 5 11 .7 33 .8 21 .7 32 .2 0. 0 0. 6 10 0. 0 9. 1 59 .5 19 .2 2. 0 3. 5 6. 7 0. 0 10 0. 0 80 Lu an gp ra ba ng 17 .7 75 2 5. 0 26 .7 25 .8 39 .2 2. 6 0. 8 10 0. 0 4. 1 29 .2 23 .6 41 .4 0. 0 1. 7 0. 0 10 0. 0 13 3 H ua ph an h 12 .1 60 6 3. 7 21 .7 33 .3 41 .3 0. 0 0. 0 10 0. 0 2. 4 43 .9 35 .5 13 .6 0. 0 4. 6 0. 0 10 0. 0 73 X ay ab ur y 10 .4 48 6 (4 .3 ) (4 3. 1) (3 7. 2) (1 3. 2) (0 .0 ) (2 .2 ) 10 0. 0 (0 .0 ) (4 7. 4) (3 2. 9) (1 5. 3) (0 .0 ) (2 .2 ) (2 .2 ) 10 0. 0 51 X ie ng kh ua ng 12 .3 54 0 0. 0 25 .1 47 .5 22 .0 5. 3 0. 0 10 0. 0 0. 0 15 .6 63 .7 20 .7 0. 0 0. 0 0. 0 10 0. 0 67 V ie nt ia ne 4. 3 76 7 (4 .0 ) (3 4. 7) (4 7. 4) (8 .1 ) (3 .7 ) (2 .1 ) 10 0. 0 (7 .9 ) (3 9. 0) (3 8. 6) (4 .3 ) (0 .0 ) (8 .2 ) (2 .1 ) 10 0. 0 33 B or ik ha m xa y 6. 9 40 2 (1 5. 5) (2 2. 7) (4 2. 6) (1 9. 3) (0 .0 ) (0 .0 ) 10 0. 0 (6 .6 ) (2 2. 0) (5 1. 2) (1 0. 0) (7 .1 ) (3 .2 ) (0 .0 ) 10 0. 0 28 K ha m m ua ne 6. 5 60 3 (1 0. 6) (3 5. 7) (8 .7 ) (3 7. 7) (2 .6 ) (4 .6 ) 10 0. 0 (5 .2 ) (5 1. 5) (6 .4 ) (3 1. 6) (0 .0 ) (3 .2 ) (2 .0 ) 10 0. 0 39 S av an na kh et 8. 9 1, 78 4 2. 2 18 .0 52 .4 24 .0 1. 3 2. 1 10 0. 0 0. 0 29 .9 54 .2 11 .3 0. 0 1. 2 3. 4 10 0. 0 15 8 S ar av an e 10 .4 92 3 14 .9 29 .0 24 .3 26 .5 4. 5 0. 8 10 0. 0 2. 0 53 .3 25 .2 5. 0 7. 3 6. 3 0. 8 10 0. 0 96 S ek on g 12 .2 26 9 0. 9 38 .2 33 .1 25 .0 0. 0 2. 8 10 0. 0 0. 0 51 .1 31 .4 11 .4 5. 0 1. 0 0. 0 10 0. 0 33 C ha m pa sa ck 6. 0 1, 00 3 (9 .1 ) (4 0. 1) (2 8. 4) (2 2. 3) (0 .0 ) (0 .0 ) 10 0. 0 (8 .6 ) (4 5. 4) (3 0. 8) (1 5. 2) (0 .0 ) (0 .0 ) (0 .0 ) 10 0. 0 61 A tta pe u 1. 0 21 6 * * * * * * * * * * * * * * * 2 P er ce nt d is tri bu tio n of c hi ld re n ag e 0- 59 m on th s w ith d ia rr ho ea in th e la st tw o w ee ks b y am ou nt o f l iq ui ds a nd fo od g iv en d ur in g ep is od e of d ia rr ho ea , L ao P D R 2 01 1- 12 Ta bl e C H .5 : F ee di ng p ra ct ic es d ur in g di ar rh oe a H ad di ar rh oe a in la st tw o w ee ks N um be r o f ch ild re n ag e 0- 59 m on th s D rin ki ng p ra ct ic es d ur in g di ar rh oe a: Ea tin g pr ac tic es d ur in g di ar rh oe a: G iv en m uc h le ss to dr in k G iv en so m ew ha t le ss to dr in k G iv en ab ou t th e sa m e to dr in k G iv en m or e to dr in k G iv en m or e to e at S to pp ed fo od H ad ne ve r be en gi ve n fo od N um be r o f ch ild re n ag e 0- 59 m on th s w ith di ar rh oe a in la st tw o w ee ks To ta l M is si ng / D K G iv en no th in g to d rin k M is si ng / D K G iv en m uc h le ss to ea t G iv en so m ew ha t le ss to e at G iv en ab ou t th e sa m e to ea t To ta l 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. 138 9 R es id en ce U rb an 5. 4 2, 31 9 8. 0 29 .5 25 .7 33 .6 0. 0 3. 2 10 0. 0 6. 4 39 .9 27 .8 22 .9 0. 0 2. 1 0. 9 10 0. 0 12 6 R ur al 11 .2 8, 74 8 6. 6 29 .7 34 .4 26 .5 1. 6 1. 3 10 0. 0 3. 2 38 .5 34 .8 18 .5 1. 4 2. 5 1. 1 10 0. 0 98 3 .R ur al w ith ro ad 10 .5 7, 66 1 6. 9 29 .7 32 .3 27 .9 1. 8 1. 4 10 0. 0 3. 4 39 .5 33 .2 18 .5 1. 5 2. 8 1. 0 10 0. 0 80 6 .R ur al w ith ou t r oa d 16 .3 1, 08 6 5. 0 29 .5 44 .0 20 .1 0. 6 0. 8 10 0. 0 2. 1 34 .1 42 .0 18 .5 0. 7 1. 0 1. 6 10 0. 0 17 8 A ge 0 -1 1 m on th s 11 .4 2, 30 7 7. 0 27 .9 41 .0 20 .4 2. 6 1. 0 10 0. 0 2. 4 28 .5 37 .9 17 .7 2. 1 10 .4 1. 0 10 0. 0 26 2 12 -2 3 m on th s 15 .0 2, 14 1 7. 2 34 .4 25 .7 30 .7 0. 9 1. 0 10 0. 0 5. 0 43 .1 30 .8 19 .6 1. 0 0. 0 0. 5 10 0. 0 32 2 24 -3 5 m on th s 9. 8 2, 19 3 5. 1 28 .9 34 .8 28 .3 0. 6 2. 3 10 0. 0 3. 6 37 .5 34 .2 21 .7 1. 6 0. 0 1. 4 10 0. 0 21 5 36 -4 7 m on th s 7. 7 2, 30 2 7. 5 26 .1 33 .2 30 .9 0. 5 1. 7 10 0. 0 3. 6 42 .9 32 .2 19 .7 0. 3 0. 0 1. 4 10 0. 0 17 7 48 -5 9 m on th s 6. 2 2, 12 4 6. 7 27 .4 35 .1 25 .9 2. 8 2. 1 10 0. 0 2. 3 44 .4 36 .1 15 .3 0. 5 0. 0 1. 3 10 0. 0 13 2 M ot he r’s e du ca tio n N on e 13 .1 3, 58 0 5. 9 27 .6 38 .6 24 .2 1. 9 1. 9 10 0. 0 3. 0 37 .7 38 .3 15 .7 1. 7 1. 7 1. 7 10 0. 0 47 1 P rim ar y 10 .2 4, 55 6 4. 9 32 .2 30 .7 30 .7 1. 1 0. 3 10 0. 0 2. 6 39 .1 31 .0 23 .3 1. 0 3. 0 0. 1 10 0. 0 46 6 Lo w er s ec on da ry 6. 8 1, 61 3 10 .8 33 .6 26 .7 26 .5 0. 0 2. 4 10 0. 0 3. 4 44 .9 29 .7 17 .8 0. 0 2. 7 1. 5 10 0. 0 11 0 U pp er s ec on da ry 5. 2 69 5 (2 4. 0) (1 7. 2) (2 1. 5) (2 2. 8) (3 .4 ) (1 1. 2) 10 0. 0 (1 8. 8) (2 9. 2) (3 6. 3) (1 2. 6) (0 .0 ) (0 .0 ) (3 .0 ) 10 0. 0 36 P os t s ec on da ry n on te rti ar y 5. 5 36 8 * * * * * * * * * * * * * * * 20 H ig he r 2. 3 25 5 * * * * * * * * * * * * * * * 6 W ea lth in de x qu in til e P oo re st 15 .0 3, 23 3 6. 0 28 .2 34 .4 27 .7 1. 6 1. 9 10 0. 0 3. 0 38 .0 36 .2 19 .0 0. 8 1. 2 1. 8 10 0. 0 48 6 S ec on d 11 .6 2, 34 6 2. 8 32 .2 35 .8 26 .1 2. 4 0. 6 10 0. 0 1. 4 39 .7 34 .2 17 .1 2. 9 4. 0 0. 6 10 0. 0 27 2 M id dl e 8. 4 2, 01 9 7. 6 26 .7 35 .9 29 .2 0. 0 0. 6 10 0. 0 2. 9 37 .2 32 .6 24 .8 0. 5 2. 1 0. 0 10 0. 0 17 0 Fo ur th 5. 7 1, 80 7 12 .3 40 .2 26 .0 18 .8 1. 2 1. 6 10 0. 0 5. 7 47 .8 27 .6 13 .9 0. 0 3. 9 1. 1 10 0. 0 10 2 R ic he st 4. 7 1, 66 3 15 .5 22 .6 22 .8 35 .3 0. 0 3. 8 10 0. 0 13 .4 30 .8 31 .2 19 .9 1. 1 3. 6 0. 0 10 0. 0 78 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 6. 4 6, 03 0 9. 9 27 .3 32 .4 27 .7 1. 1 1. 6 10 0. 0 4. 2 39 .7 31 .4 18 .9 1. 5 3. 6 0. 7 10 0. 0 38 8 M on -K hm er 14 .3 3, 18 9 4. 2 27 .3 35 .2 30 .0 1. 7 1. 5 10 0. 0 2. 5 36 .4 35 .7 21 .3 1. 0 1. 6 1. 5 10 0. 0 45 7 H m on g- M ie n 13 .6 1, 43 9 4. 0 34 .3 35 .4 22 .7 1. 8 1. 8 10 0. 0 4. 0 35 .1 40 .4 16 .7 1. 2 1. 7 1. 0 10 0. 0 19 6 C hi ne se -T ib et an 17 .3 35 7 10 .5 50 .2 23 .8 15 .5 0. 0 0. 0 10 0. 0 3. 9 61 .8 21 .3 8. 0 0. 8 4. 1 0. 0 10 0. 0 62 O th er , M is si ng , D K 12 .4 52 * * * * * * * * * * * * * * * 7 To ta l 10 .0 11 ,0 67 6. 7 29 .7 33 .4 27 .3 1. 4 1. 5 10 0. 0 3. 6 38 .7 34 .0 19 .0 1. 2 2. 5 1. 0 10 0. 0 1, 10 9 Ta bl e C H .5 : F ee di ng p ra ct ic es d ur in g di ar rh oe a P er ce nt d is tri bu tio n of c hi ld re n ag e 0- 59 m on th s w ith d ia rr ho ea in th e la st tw o w ee ks b y am ou nt o f l iq ui ds a nd fo od g iv en d ur in g ep is od e of d ia rr ho ea , L ao P D R 2 01 1- 12 Ea tin g pr ac tic es d ur in g di ar rh oe a: To ta l N um be r o f ch ild re n ag e 0- 59 m on th s w ith di ar rh oe a in la st tw o w ee ks G iv en m uc h le ss to dr in k G iv en so m ew ha t le ss to dr in k G iv en ab ou t th e sa m e to dr in k G iv en m or e to dr in k G iv en no th in g to d rin k M is si ng / D K G iv en m uc h le ss to ea t G iv en so m ew ha t le ss to e at G iv en ab ou t th e sa m e to ea t G iv en m or e to e at S to pp ed fo od H ad ne ve r be en gi ve n fo od M is si ng / D K 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. H ad di ar rh oe a in la st tw o w ee ks N um be r o f ch ild re n ag e 0- 59 m on th s D rin ki ng p ra ct ic es d ur in g di ar rh oe a: To ta l 139 Table CH.6 presents the percentage of children age 0-59 months with diarrhoea in the two weeks prior to the survey who received oral rehydration therapy (ORT) with continued feeding. Oral rehydration therapy is defined as being given one of the following: fluid from an ORS packet; fluid from a pre- packaged ORS liquid; an RHF (such as rice water with salt or coconut water); or more fluids than usual. Combining the information from Table CH.4 on oral rehydration salts and RHFs with the information from Table CH.5 on drinking practices provides the data for calculating the percentage of children given ORT. Combining the calculation of ORT with information from Table CH.5 on eating practices provides the data for calculating the percentage of children given ORT with continued feeding. Some 57 per cent of children with diarrhoea received ORT and continued feeding at the same time, as recommended. The 2006 MICS estimated that 49 per cent of children had received ORT and continued feeding (among children with diarrhoea in the two weeks prior to the survey). A higher percentage of children with diarrhoea received ORT and continued feeding in the Northern (61 per cent) than in the Southern and Central regions. Seventy-one per cent of children in urban areas received ORT and continued feeding, compared with only 56 per cent of rural children. Treatment of children with diarrhoea with ORT and continued feeding increases by wealth quintile, with 70 per cent of children in the richest wealth quintile receiving ORT and continued feeding, compared with about 65 per cent of children in the middle quintiles and 55 per cent and 52 per cent in the lowest wealth quintiles, respectively. Twenty per cent were not given any type of treatment. Table CH.6 also presents the percentage of children with diarrhoea who received other treatments. About one quarter of children (28 per cent) received an anti-motility treatment,1 and 16 per cent received an antibiotic pill or syrup, while only 1 per cent of children received zinc. Four per cent were given a home remedy or herbal medicine. 1 ‘Anti-motility’ treatment is used to reduce the frequency of bowel movements (peristalsis) by slowing the pace of fluids going through the bowel. 9 140 9 A nt i- bi ot ic A nt i- m ot ili ty Zi nc O th er U nk no w n A nt i- bi ot ic N on - an tib io tic U nk no w n Se x M al e 60 .6 65 .1 60 .7 16 .0 28 .7 1. 2 2. 3 0. 5 2. 5 0. 7 1. 6 0. 8 4. 2 8. 1 18 .1 58 9 Fe m al e 54 .4 56 .8 53 .6 15 .3 27 .9 0. 7 1. 6 0. 2 3. 4 0. 7 1. 3 0. 8 3. 6 6. 5 22 .2 52 0 R eg io n N or th 62 .7 65 .8 61 .4 16 .0 22 .9 1. 5 1. 2 0. 4 3. 6 0. 3 2. 0 1. 0 3. 7 7. 8 18 .9 53 7 C en tra l 52 .0 56 .1 53 .4 14 .6 34 .6 0. 2 2. 7 0. 0 2. 0 1. 6 0. 6 0. 5 2. 8 7. 6 20 .3 38 1 S ou th 54 .8 58 .4 54 .1 16 .9 31 .0 0. 8 2. 8 1. 1 3. 0 0. 0 1. 7 1. 0 6. 8 5. 4 22 .6 19 1 Pr ov in ce V ie nt ia ne C ap ita l (8 5. 3) (8 8. 2) (7 6. 8) (1 9. 1) (3 1. 8) (0 .0 ) (6 .5 ) (0 .0 ) (0 .0 ) 3. 9 (0 .0 ) (0 .0 ) (0 .0 ) 20 .7 (0 .0 ) 56 P ho ng sa ly 37 .8 37 .8 35 .6 18 .7 12 .1 0. 0 2. 2 1. 9 9. 3 1. 0 0. 8 0. 0 1. 3 32 .3 35 .2 59 Lu an gn am th a 68 .5 80 .6 72 .1 3. 4 2. 5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 4. 3 1. 8 16 .9 28 O ud om xa y 64 .2 64 .2 64 .2 7. 5 27 .2 0. 0 0. 0 0. 0 2. 4 0. 0 1. 8 1. 1 7. 2 3. 3 18 .7 11 3 B ok eo 63 .6 71 .0 58 .8 14 .5 8. 3 1. 3 0. 0 1. 4 1. 4 0. 0 0. 8 0. 7 1. 5 12 .5 15 .3 80 Lu an gp ra ba ng 74 .2 75 .0 70 .7 19 .3 34 .7 1. 9 1. 8 0. 0 6. 2 0. 9 4. 2 0. 9 2. 4 2. 5 14 .3 13 3 H ua ph an h 52 .4 59 .8 55 .0 17 .0 6. 0 0. 0 2. 4 0. 0 2. 7 0. 0 1. 2 0. 0 7. 5 4. 6 23 .1 73 X ay ab ur y (6 8. 3) (7 0. 4) (6 8. 2) (3 1. 1) (5 3. 6) (8 .9 ) (2 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (2 .2 ) (4 .5 ) (0 .0 ) (4 .4 ) (1 3. 0) 51 X ie ng kh ua ng 41 .5 41 .5 41 .5 10 .3 49 .0 1. 4 0. 0 0. 0 0. 0 0. 0 1. 2 0. 0 6. 8 1. 4 32 .7 67 V ie nt ia ne (3 3. 0) (3 7. 3) (3 3. 3) (1 1. 9) (3 9. 1) (0 .0 ) (8 .2 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (1 1. 0) (2 4. 6) 33 B or ik ha m xa y (5 9. 1) (7 7. 9) (7 1. 4) (2 1. 5) (1 6. 3) (0 .0 ) (0 .0 ) (0 .0 ) (9 .4 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (6 .3 ) (1 5. 9) 28 K ha m m ua ne (4 8. 4) (5 7. 9) (5 5. 2) (3 .5 ) (3 6. 6) (0 .0 ) (2 .7 ) (0 .0 ) (3 .2 ) (0 .0 ) (0 .0 ) (0 .0 ) (3 .2 ) (1 3. 5) (1 8. 8) 39 S av an na kh et 48 .2 50 .7 50 .7 16 .9 31 .4 0. 0 1. 9 0. 0 2. 3 2. 5 1. 0 1. 2 2. 9 3. 6 22 .6 15 8 S ar av an e 50 .2 52 .6 50 .8 13 .1 30 .2 0. 0 3. 3 2. 1 2. 9 0. 0 1. 3 1. 0 7. 2 7. 1 28 .5 96 S ek on g 37 .3 43 .9 40 .0 4. 1 27 .9 0. 0 2. 1 0. 0 0. 0 0. 0 1. 0 2. 8 5. 8 2. 0 31 .0 33 C ha m pa sa ck (7 1. 0) (7 4. 8) (6 6. 1) (2 7. 8) (3 3. 4) (2 .7 ) (2 .4 ) (0 .0 ) (4 .8 ) (0 .0 ) (2 .7 ) (0 .0 ) (6 .9 ) (4 .7 ) (9 .2 ) 61 A tta pe u * * * * * * * * * * * * * * * 2 Ta bl e C H .6 : O ra l r eh yd ra tio n th er ap y w ith c on tin ue d fe ed in g an d ot he r t re at m en ts P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ith d ia rr ho ea in th e la st tw o w ee ks w ho re ce iv ed o ra l r eh yd ra tio n th er ap y w ith c on tin ue d fe ed in g, a nd p er ce nt ag e of c hi ld re n w ith d ia rr ho ea w ho re ce iv ed o th er tr ea tm en ts , L ao P D R 2 01 1- 12 O R S o r in cr ea se d flu id s N um be r o f ch ild re n ag e 0- 59 m on th s w ith di ar rh oe a in la st tw o w ee ks O R T (O R S o r re co m m en de d ho m em ad e flu id s or in cr ea se d flu id s) O R T w ith co nt in ue d fe ed in g1 C hi ld re n w ith d ia rr ho ea w ho re ce iv ed : Pi ll or s yr up In je ct io n In tra - ve no us O th er tr ea tm en ts : H om e re m ed y, he rb al m ed ic in e O th er N ot g iv en an y tre at m en t or d ru g 1 M IC S in di ca to r 3 .8 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. 141 9 A nt i- bi ot ic A nt i- m ot ili ty Zi nc O th er U nk no w n A nt i- bi ot ic N on - an tib io tic U nk no w n R es id en ce U rb an 74 .7 78 .1 71 .2 21 .5 30 .2 0. 9 4. 9 0. 9 2. 2 0. 0 1. 6 1. 2 1. 3 11 .5 7. 0 12 6 R ur al 55 .5 59 .0 55 .6 14 .9 28 .1 1. 0 1. 6 0. 3 3. 1 0. 8 1. 5 0. 8 4. 3 6. 8 21 .7 98 3 .R ur al w ith ro ad 57 .2 61 .0 57 .3 15 .9 28 .9 1. 0 2. 0 0. 4 3. 2 1. 0 1. 8 0. 7 4. 3 7. 0 19 .9 80 6 .R ur al w ith ou t r oa d 47 .4 50 .3 48 .1 10 .4 24 .4 0. 7 0. 2 0. 0 2. 3 0. 0 0. 0 1. 1 4. 3 6. 0 29 .7 17 8 A ge 0 -1 1 m on th s 44 .7 47 .6 42 .3 16 .3 26 .2 1. 4 2. 7 0. 4 1. 4 1. 6 1. 5 0. 9 2. 8 7. 5 28 .4 26 2 12 -2 3 m on th s 62 .2 65 .4 61 .0 18 .0 31 .3 1. 0 2. 8 0. 7 2. 2 0. 0 1. 5 0. 7 2. 8 9. 8 15 .6 32 2 24 -3 5 m on th s 66 .9 70 .8 67 .0 21 .0 29 .7 1. 2 1. 4 0. 0 4. 6 1. 5 0. 4 1. 4 3. 8 5. 0 14 .7 21 5 36 -4 7 m on th s 54 .5 59 .6 57 .7 6. 7 27 .2 0. 0 1. 5 0. 6 3. 8 0. 0 3. 2 0. 5 5. 6 4. 5 22 .8 17 7 48 -5 9 m on th s 61 .4 64 .4 62 .3 12 .1 24 .6 0. 8 0. 5 0. 0 4. 2 0. 5 0. 7 0. 2 6. 7 8. 6 19 .3 13 2 M ot he r’s e du ca tio n N on e 50 .7 55 .2 52 .3 8. 1 23 .9 1. 1 1. 4 0. 7 2. 0 0. 4 2. 5 1. 0 5. 0 5. 8 25 .4 47 1 P rim ar y 60 .8 62 .4 59 .0 20 .1 32 .1 1. 1 2. 6 0. 0 4. 0 0. 8 0. 2 0. 6 3. 6 8. 5 18 .1 46 6 Lo w er s ec on da ry 66 .0 72 .4 69 .5 23 .6 32 .3 0. 0 2. 2 0. 0 4. 2 0. 0 1. 8 1. 1 2. 0 4. 1 12 .4 11 0 U pp er s ec on da ry (6 9. 2) (7 8. 8) (6 2. 5) (2 4. 2) (2 1. 6) (1 .5 ) (2 .8 ) (0 .0 ) (0 .0 ) (6 .0 ) (4 .5 ) (0 .0 ) (2 .3 ) (1 4. 1) (8 .6 ) 36 P os t s ec on da ry n on te rti ar y * * * * * * * * * * * * * * * 20 H ig he r * * * * * * * * * * * * * * * 6 W ea lth in de x qu in til e P oo re st 54 .1 56 .9 54 .6 10 .2 24 .6 1. 2 1. 1 0. 2 2. 3 0. 2 1. 8 0. 9 4. 9 4. 5 25 .1 48 6 S ec on d 50 .7 54 .6 51 .7 13 .5 30 .9 0. 2 2. 7 0. 4 5. 7 1. 4 1. 5 0. 6 3. 1 8. 6 24 .2 27 2 M id dl e 65 .7 68 .6 65 .9 22 .1 31 .8 0. 0 2. 6 0. 3 3. 0 0. 4 0. 5 0. 8 4. 7 9. 2 13 .0 17 0 Fo ur th 62 .0 68 .6 62 .3 25 .9 30 .9 3. 8 1. 0 0. 5 1. 1 0. 0 1. 6 0. 0 1. 2 13 .6 10 .4 10 2 R ic he st 80 .8 85 .1 69 .7 29 .7 31 .4 0. 7 5. 2 1. 4 0. 0 2. 8 1. 5 2. 0 2. 3 8. 4 1. 6 78 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 60 .5 63 .9 59 .0 21 .2 36 .1 1. 4 3. 1 0. 0 2. 5 1. 2 1. 0 0. 3 2. 8 7. 4 14 .5 38 8 M on -K hm er 61 .5 64 .7 62 .0 12 .8 25 .0 0. 6 1. 1 0. 4 4. 0 0. 3 2. 1 1. 1 4. 5 6. 6 21 .6 45 7 H m on g- M ie n 45 .4 50 .1 46 .4 13 .2 27 .2 1. 0 1. 7 0. 6 1. 8 1. 1 1. 3 1. 4 5. 7 6. 6 23 .1 19 6 C hi ne se -T ib et an 49 .8 54 .0 47 .0 8. 2 8. 1 0. 8 1. 1 1. 8 2. 0 0. 0 0. 8 0. 0 0. 7 14 .0 32 .4 62 O th er , M is si ng , D K * * * * * * * * * * * * * * * 7 To ta l 57 .7 61 .2 57 .4 15 .7 28 .3 1. 0 2. 0 0. 4 3. 0 0. 7 1. 5 0. 8 3. 9 7. 3 20 .0 1, 10 9 In je ct io n In tra - ve no us H om e re m ed y, he rb al m ed ic in e O th er Ta bl e C H .6 : O ra l r eh yd ra tio n th er ap y w ith c on tin ue d fe ed in g an d ot he r t re at m en ts P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ith d ia rr ho ea in th e la st tw o w ee ks w ho re ce iv ed o ra l r eh yd ra tio n th er ap y w ith c on tin ue d fe ed in g, a nd p er ce nt ag e of c hi ld re n w ith d ia rr ho ea w ho re ce iv ed o th er tr ea tm en ts , 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. 1 M IC S in di ca to r 3 .8 C hi ld re n w ith d ia rr ho ea w ho re ce iv ed : O th er tr ea tm en ts : N ot g iv en an y tre at m en t or d ru g N um be r o f ch ild re n ag e 0- 59 m on th s w ith di ar rh oe a in la st tw o w ee ks O R S o r in cr ea se d flu id s O R T (O R S o r re co m m en de d ho m em ad e flu id s or in cr ea se d flu id s) O R T w ith co nt in ue d fe ed in g1 Pi ll or s yr up 142 61 53 54 71 56 55 52 66 62 70 57 0 20 40 60 80 Regions North Central South Area Urban Rural Wealth index quintile Poorest Second Middle Fourth Richest Lao PDR Figure CH.4: Percentage of children under age 5 with diarrhoea who received ORT or increased fluids, AND continued feeding, Lao PDR 2011-12 57 0 20 40 60 80 Lao PDR Percent Care Seeking and Antibiotic Treatment of Pneumonia Pneumonia is one of the leading causes of death in children. Administering antibiotics to children with suspected pneumonia is a key intervention. A WFFC goal is to reduce the deaths due to acute respiratory infections by one third. In the LSIS, the prevalence of suspected pneumonia was estimated by asking mothers and caretakers whether their children age under five had an illness with a cough accompanied by rapid or difficult breathing, and whether symptoms were due to a problem in the chest, or a problem involving both the chest and a blocked nose. 9 143 9 G ov t. ho sp ita l G ov t. he al th ce nt re V ill ag e he al th w or ke r M ob ile / ou tre ac h cl in ic P riv at e ho sp ita l/ cl in ic P riv at e ph ys ic ia n P riv at e ph ar m ac y M ob ile cl in ic R el at iv e or fr ie nd O th er Se x M al e 3. 6 5, 59 3 23 .6 16 .5 7. 6 0. 0 8. 0 1. 3 3. 7 0. 4 0. 2 0. 0 53 .2 55 .7 20 2 Fe m al e 2. 9 5, 47 4 23 .8 19 .5 7. 3 1. 4 4. 9 1. 9 4. 5 0. 7 0. 0 0. 4 55 .9 59 .7 16 1 R eg io n N or th 2. 4 3, 50 2 22 .9 11 .1 13 .1 0. 0 5. 8 4. 4 3. 9 2. 4 0. 0 0. 8 56 .5 59 .9 86 C en tra l 3. 0 5, 15 4 31 .1 17 .7 2. 1 1. 4 11 .0 1. 2 5. 2 0. 0 0. 0 0. 0 59 .5 65 .3 15 6 S ou th 5. 0 2, 41 1 14 .8 22 .7 10 .3 0. 0 1. 6 0. 0 2. 7 0. 0 0. 3 0. 0 46 .4 45 .6 12 1 Pr ov in ce V ie nt ia ne C ap ita l 2. 1 1, 05 8 * * * * * * * * * * * * 22 P ho ng sa ly 5. 9 36 8 (2 6. 8) (8 .1 ) (8 .8 ) (0 .0 ) (0 .0 ) (0 .0 ) (3 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (4 3. 8) (4 6. 4) 22 Lu an gn am th a 0. 4 28 0 * * * * * * * * * * * * 1 O ud om xa y 1. 0 67 6 * * * * * * * * * * * * 7 B ok eo 4. 5 33 5 (1 8. 0) (1 1. 0) (4 .4 ) (0 .0 ) (3 .4 ) (1 4. 3) (7 .2 ) (0 .0 ) (0 .0 ) (4 .4 ) (5 1. 1) (6 4. 1) 15 Lu an gp ra ba ng 3. 4 75 2 * * * * * * * * * * * * 25 H ua ph an h 2. 1 60 6 * * * * * * * * * * * * 13 X ay ab ur y 0. 4 48 6 * * * * * * * * * * * * 2 X ie ng kh ua ng 0. 2 54 0 * * * * * * * * * * * * 1 V ie nt ia ne 1. 6 76 7 * * * * * * * * * * * * 13 B or ik ha m xa y 1. 2 40 2 * * * * * * * * * * * * 5 K ha m m ua ne 2. 8 60 3 * * * * * * * * * * * * 17 S av an na kh et 5. 5 1, 78 4 (2 6. 7) (1 5. 4) (3 .4 ) (2 .2 ) (8 .4 ) (0 .0 ) (4 .1 ) (0 .0 ) (0 .0 ) (0 .0 ) (5 1. 5) (5 9. 5) 98 S ar av an e 8. 6 92 3 7. 0 24 .7 7. 2 0. 0 0. 0 0. 0 3. 8 0. 0 0. 0 0. 0 38 .9 46 .7 80 S ek on g 10 .5 26 9 28 .3 18 .3 7. 8 0. 0 1. 2 0. 0 1. 1 0. 0 0. 0 0. 0 54 .9 35 .8 28 C ha m pa sa ck 1. 3 1, 00 3 * * * * * * * * * * * * 13 A tta pe u 0. 3 21 6 * * * * * * * * * * * * 1 R es id en ce U rb an 2. 1 2, 31 9 56 .8 4. 5 3. 1 4. 5 24 .6 0. 0 8. 5 0. 0 0. 7 0. 0 79 .0 74 .3 49 R ur al 3. 6 8, 74 8 18 .6 19 .9 8. 1 0. 0 3. 8 1. 8 3. 4 0. 7 0. 0 0. 2 50 .6 54 .8 31 4 .R ur al w ith ro ad 3. 6 7, 66 1 19 .9 20 .3 7. 9 0. 0 4. 4 1. 7 3. 5 0. 7 0. 0 0. 2 52 .3 56 .9 27 7 .R ur al w ith ou t r oa d 3. 4 1, 08 6 (8 .7 ) (1 6. 8) (1 0. 0) (0 .0 ) (0 .0 ) (2 .7 ) (2 .7 ) (0 .0 ) (0 .0 ) (0 .0 ) (3 7. 8) (3 9. 1) 37 2 M IC S in di ca to r 3 .1 0 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. Ta bl e C H .7 : C ar e se ek in g fo r s us pe ct ed p ne um on ia a nd a nt ib io tic u se d ur in g su sp ec te d pn eu m on ia N um be r o f c hi ld re n ag e 0- 59 m on th s w ith s us pe ct ed pn eu m on ia in th e la st tw o w ee ks Pu bl ic s ou rc es Pr iv at e so ur ce s O th er s ou rc e P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ith s us pe ct ed p ne um on ia in th e la st tw o w ee ks w ho w er e ta ke n to a h ea lth p ro vi de r a nd p er ce nt ag e of c hi ld re n w ho w er e gi ve n an tib io tic s, L ao P D R 2 01 1- 12 H ad su sp ec te d pn eu m on ia in th e la st tw o w ee ks N um be r o f ch ild re n ag e 0- 59 m on th s P er ce nt ag e of ch ild re n w ith su sp ec te d pn eu m on ia w ho re ce iv ed a nt ib io tic s in th e la st tw o w ee ks 2 A ny ap pr op ria te pr ov id er 1 C hi ld re n w ith s us pe ct ed p ne um on ia w ho w er e ta ke n to : 1 M IC S in di ca to r 3 .9 144 9 G ov t. ho sp ita l G ov t. he al th ce nt re V ill ag e he al th w or ke r M ob ile / ou tre ac h cl in ic P riv at e ho sp ita l/ cl in ic P riv at e ph ys ic ia n P riv at e ph ar m ac y M ob ile cl in ic R el at iv e or fr ie nd O th er A ge 0 -1 1 m on th s 2. 9 2, 30 7 14 .3 6. 0 5. 1 3. 2 3. 2 2. 9 3. 9 1. 3 0. 0 0. 0 36 .0 48 .5 67 12 -2 3 m on th s 4. 0 2, 14 1 28 .0 22 .8 7. 6 0. 0 5. 2 2. 0 4. 5 0. 0 0. 0 0. 0 57 .1 56 .2 85 24 -3 5 m on th s 3. 3 2, 19 3 23 .2 26 .5 7. 8 0. 0 7. 9 0. 0 4. 8 1. 7 0. 5 0. 0 65 .5 60 .3 71 36 -4 7 m on th s 3. 8 2, 30 2 23 .9 18 .4 8. 7 0. 0 7. 6 1. 2 0. 0 0. 0 0. 0 0. 0 58 .3 58 .3 87 48 -5 9 m on th s 2. 4 2, 12 4 29 .2 12 .2 7. 6 0. 0 9. 9 2. 0 9. 5 0. 0 0. 0 1. 3 51 .9 65 .6 52 M ot he r’s e du ca tio n N on e 3. 3 3, 58 0 10 .8 20 .6 6. 8 0. 0 2. 5 1. 8 0. 5 0. 0 0. 0 0. 6 40 .4 38 .4 11 8 P rim ar y 3. 6 4, 55 6 21 .5 18 .3 9. 5 1. 3 5. 7 0. 7 5. 5 0. 0 0. 2 0. 0 53 .5 62 .0 16 5 Lo w er s ec on da ry 2. 9 1, 61 3 (3 9. 0) (1 8. 3) (4 .4 ) (0 .0 ) (1 6. 0) (0 .0 ) (4 .5 ) (4 .4 ) (0 .0 ) (0 .0 ) (7 5. 2) (7 7. 7) 47 U pp er s ec on da ry 2. 3 69 5 * * * * * * * * * * * * 16 P os t s ec on da ry n on te rti ar y 2. 6 36 8 * * * * * * * * * * * * 9 H ig he r 3. 2 25 5 * * * * * * * * * * * * 8 W ea lth in de x qu in til e P oo re st 4. 1 3, 23 3 10 .3 18 .9 11 .5 0. 0 0. 7 1. 2 2. 0 0. 6 0. 0 0. 5 42 .1 47 .4 13 2 S ec on d 4. 3 2, 34 6 21 .4 21 .8 4. 4 0. 0 3. 1 0. 0 1. 8 0. 0 0. 4 0. 0 48 .7 49 .0 10 1 M id dl e 2. 5 2, 01 9 31 .1 14 .1 8. 1 0. 0 11 .9 3. 1 7. 7 0. 0 0. 0 0. 0 63 .6 63 .9 50 Fo ur th 2. 4 1, 80 7 (3 0. 6) (2 1. 2) (4 .9 ) (0 .0 ) (1 7. 2) (0 .0 ) (9 .1 ) (2 .7 ) (0 .0 ) (0 .0 ) (6 9. 7) (8 8. 3) 44 R ic he st 2. 1 1, 66 3 (6 2. 4) (3 .2 ) (3 .2 ) (6 .3 ) (1 8. 6) (7 .4 ) (6 .9 ) (0 .0 ) (0 .0 ) (0 .0 ) (8 5. 5) (7 1. 9) 34 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 3. 2 6, 03 0 27 .3 16 .3 4. 9 1. 1 10 .8 1. 3 6. 2 0. 6 0. 0 0. 0 56 .8 60 .1 19 3 M on -K hm er 4. 5 3, 18 9 20 .8 21 .3 11 .0 0. 0 1. 6 1. 5 2. 0 0. 6 0. 2 0. 0 54 .3 54 .3 14 4 H m on g- M ie n 1. 3 1, 43 9 * * * * * * * * * * * * 18 C hi ne se -T ib et an 1. 9 35 7 * * * * * * * * * * * * 7 O th er , M is si ng , D K 1. 9 52 * * * * * * * * * * * * 1 To ta l 3. 3 11 ,0 67 23 .7 17 .8 7. 5 0. 6 6. 6 1. 6 4. 1 0. 6 0. 1 0. 2 54 .4 57 .4 36 3 H ad su sp ec te d pn eu m on ia in th e la st tw o w ee ks N um be r o f ch ild re n ag e 0- 59 m on th s C hi ld re n w ith s us pe ct ed p ne um on ia w ho w er e ta ke n to : P er ce nt ag e of ch ild re n w ith su sp ec te d pn eu m on ia w ho re ce iv ed a nt ib io tic s in th e la st tw o w ee ks 2 N um be r o f c hi ld re n ag e 0- 59 m on th s w ith s us pe ct ed pn eu m on ia in th e la st tw o w ee ks Pu bl ic s ou rc es Pr iv at e so ur ce s O th er s ou rc e A ny ap pr op ria te pr ov id er 1 Ta bl e C H .7 : C ar e se ek in g fo r s us pe ct ed p ne um on ia a nd a nt ib io tic u se d ur in g su sp ec te d pn eu m on ia P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ith s us pe ct ed p ne um on ia in th e la st tw o w ee ks w ho w er e ta ke n to a h ea lth p ro vi de r a nd p er ce nt ag e of c hi ld re n w ho w er e gi ve n an tib io tic s, 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 3 .1 0 1 M IC S in di ca to r 3 .9 145 Table CH.7 presents the prevalence of suspected pneumonia and, if care was sought outside the home, the site of care. Three per cent of children age 0 - 59 months were reported to have had symptoms of pneumonia during the two weeks preceding the survey. At 9 and 11 per cent, respectively, prevalence of pneumonia among children was higher in Saravane and Sekong than in other provinces. Fifty-four per cent of all children with suspected pneumonia were taken to an appropriate healthcare provider. A smaller proportion of children with suspected pneumonia were taken to a healthcare provider in the Southern (46 per cent) compared with children in the Northern (57 per cent) and Central (60 per cent) regions. A larger proportion of children living in urban than rural areas were taken to a healthcare provider (79 per cent and 51 per cent, respectively). Table CH.7 also presents the use of antibiotics for the treatment of suspected pneumonia. Fifty-seven per cent of children under the age of five with suspected pneumonia during the two weeks prior to the survey had received an antibiotic. The percentage of children being treated with antibiotics is similar to the percentage of children who are taken to an appropriate healthcare provider. Antibiotic treatment of suspected pneumonia is lower than the national average among the poorest households (47 per cent) and among children whose mothers or caretakers have no education (38 per cent). The use of antibiotics rises somewhat with the age of the child. Mothers’ knowledge of the danger signs of illness is an important determinant of care-seeking behaviour. Women were asked to identify, without suggestions from the interviewer, what symptoms would prompt them to immediately take a child to a health facility. Responses are presented in Table CH.8. Special consideration is given to the symptoms difficult breathing and fast breathing since these are two particularly dangerous symptoms and may be signs of pneumonia. Fourteen per cent of women identified difficult breathing as a reason to take a child to a health facility right away, and 7 per cent stated that fast breathing would prompt them to do so. However, only 3 per cent of mothers and caretakers reported both symptoms as reason to take their child to a health facility. The most commonly identified symptoms for taking a child to a health facility are fever (reported by 79 per cent), cough (43 per cent), and drinking poorly (reported by 39 per cent). 9 146 9 Is n ot a bl e to dr in k or br ea st fe ed B ec om es si ck er D ev el op s a fe ve r H as fa st br ea th in g H as d iff ic ul t br ea th in g H as b lo od in s to ol H as di ar rh oe a H as a co ug h Is d rin ki ng po or ly H as o th er sy m pt om s R eg io n N or th 6. 0 23 .9 77 .9 9. 5 21 .0 7. 5 6. 2 45 .6 44 .8 12 .2 5. 3 2, 51 8 C en tra l 1. 6 11 .6 79 .5 4. 1 9. 8 1. 4 1. 7 34 .7 40 .2 18 .9 1. 0 3, 78 2 S ou th 2. 0 28 .1 80 .3 9. 9 14 .2 7. 9 3. 8 60 .0 25 .8 9. 4 3. 7 1, 63 1 P ro vi nc e V ie nt ia ne C ap ita l 4. 8 8. 7 84 .4 9. 0 21 .4 4. 7 5. 8 40 .6 53 .4 17 .9 3. 4 86 3 P ho ng sa ly 20 .6 72 .5 60 .7 12 .0 41 .9 22 .9 1. 5 30 .7 15 .1 11 .7 8. 5 25 2 Lu an gn am th a 11 .9 22 .6 65 .3 8. 4 34 .9 20 .7 11 .0 49 .1 28 .0 10 .5 3. 9 21 2 O ud om xa y 0. 7 14 .5 64 .1 5. 9 8. 9 8. 0 0. 9 18 .3 17 .2 12 .0 3. 2 45 7 B ok eo 1. 4 18 .7 90 .9 5. 6 13 .2 3. 4 2. 4 75 .0 58 .7 20 .2 1. 3 23 9 Lu an gp ra ba ng 9. 7 33 .1 85 .7 22 .0 32 .7 6. 2 15 .2 51 .4 63 .4 4. 9 13 .0 55 7 H ua ph an h 1. 6 16 .9 86 .0 3. 9 13 .1 1. 3 0. 9 72 .4 54 .0 23 .2 0. 7 39 6 X ay ab ur y 1. 6 2. 3 84 .5 3. 1 10 .3 0. 5 7. 4 32 .1 60 .5 7. 9 2. 5 40 5 X ie ng kh ua ng 0. 9 20 .6 86 .8 2. 8 5. 2 1. 0 0. 5 50 .2 46 .3 9. 0 1. 3 35 7 V ie nt ia ne 0. 2 15 .0 81 .1 1. 2 3. 9 0. 2 0. 5 22 .9 31 .5 6. 5 0. 2 57 9 B or ik ha m xa y 1. 0 22 .2 85 .1 0. 5 2. 7 0. 3 0. 9 40 .3 66 .8 6. 5 0. 0 29 8 K ha m m ua ne 1. 8 12 .0 65 .5 2. 5 11 .3 0. 7 1. 1 30 .4 29 .9 28 .2 0. 0 41 3 S av an na kh et 0. 5 6. 7 76 .5 4. 0 7. 0 0. 2 0. 3 31 .8 30 .7 27 .9 0. 3 1, 27 3 S ar av an e 2. 8 44 .0 85 .7 17 .3 19 .7 19 .2 8. 4 55 .3 12 .8 4. 5 7. 4 62 1 S ek on g 0. 8 41 .1 65 .0 11 .9 8. 4 0. 5 1. 1 62 .1 58 .7 1. 9 5. 0 17 3 C ha m pa sa ck 2. 1 16 .7 76 .5 3. 5 13 .0 1. 2 1. 1 68 .1 21 .2 15 .5 0. 7 68 7 A tta pe u 0. 0 0. 0 92 .7 6. 3 4. 2 0. 4 0. 0 39 .7 62 .5 11 .1 0. 7 14 9 R es id en ce U rb an 2. 7 12 .2 84 .4 7. 9 16 .6 3. 5 4. 2 44 .2 48 .5 16 .3 3. 2 1, 79 3 R ur al 3. 2 20 .8 77 .6 6. 8 13 .5 5. 0 3. 4 43 .1 35 .8 14 .4 2. 8 6, 13 8 .R ur al w ith ro ad 2. 8 20 .1 78 .7 6. 8 13 .3 4. 9 3. 4 42 .7 36 .5 14 .1 2. 9 5, 43 2 .R ur al w ith ou t r oa d 5. 9 26 .5 69 .1 6. 4 15 .4 5. 8 3. 3 46 .0 31 .0 16 .1 2. 7 70 5 Ta bl e C H .8 : K no w le dg e of th e tw o da ng er s ig ns o f p ne um on ia P er ce nt ag e of m ot he rs /c ar et ak er s of c hi ld re n ag e 0- 59 m on th s w ho th in k th at a c hi ld s ho ul d be ta ke n im m ed ia te ly to a he al th fa ci lit y if th e ch ild : P er ce nt ag e of m ot he rs a nd c ar et ak er s of c hi ld re n ag e 0- 59 m on th s by s ym pt om s th at w ou ld c au se th em to ta ke th e ch ild im m ed ia te ly to a h ea lth fa ci lit y, a nd p er ce nt ag e of m ot he rs w ho re co gn iz e fa st a nd d iff ic ul t br ea th in g as s ig ns fo r s ee ki ng c ar e im m ed ia te ly , L ao P D R 2 01 1- 12 M ot he rs /c ar et ak er s w ho re co gn iz e th e tw o da ng er s ig ns o f pn eu m on ia N um be r o f m ot he rs /c ar et ak er s of c hi ld re n ag e 0- 59 m on th s N ot e: 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. 147 9 Is n ot a bl e to dr in k or br ea st fe ed B ec om es si ck er D ev el op s a fe ve r H as fa st br ea th in g H as d iff ic ul t br ea th in g H as b lo od in s to ol H as di ar rh oe a H as a co ug h Is d rin ki ng po or ly H as o th er sy m pt om s M ot he r’ s ed uc at io n N on e 3. 0 26 .6 73 .4 6. 4 12 .2 6. 0 3. 2 42 .0 29 .8 13 .6 2. 2 2, 21 9 P rim ar y 2. 8 18 .0 80 .4 7. 1 14 .3 4. 8 3. 7 45 .1 40 .2 14 .3 3. 0 3, 34 2 Lo w er s ec on da ry 3. 4 13 .6 82 .4 6. 8 13 .9 2. 8 3. 1 42 .1 44 .0 17 .0 3. 0 1, 28 6 U pp er s ec on da ry 2. 5 11 .4 82 .9 6. 3 17 .5 2. 2 3. 3 37 .9 44 .1 16 .8 2. 9 57 2 P os t s ec on da ry n on te rti ar y 6. 7 10 .5 86 .0 10 .6 22 .5 4. 8 4. 6 51 .8 49 .4 14 .5 5. 3 30 0 H ig he r 3. 1 15 .5 79 .6 11 .5 17 .0 5. 5 7. 0 40 .6 46 .9 16 .9 5. 8 21 2 W ea lth in de x qu in til e P oo re st 3. 2 27 .7 74 .0 7. 7 12 .9 6. 3 3. 8 44 .9 31 .4 12 .7 3. 3 2, 02 5 S ec on d 3. 1 22 .3 78 .0 5. 7 13 .1 5. 6 3. 3 44 .4 36 .8 14 .2 2. 4 1, 65 7 M id dl e 3. 6 16 .8 80 .5 7. 6 13 .7 4. 8 3. 7 42 .4 38 .9 15 .9 3. 1 1, 48 8 Fo ur th 2. 3 12 .5 82 .0 6. 0 15 .3 2. 5 2. 5 44 .9 43 .2 15 .7 3. 0 1, 38 5 R ic he st 3. 1 10 .6 83 .7 8. 1 17 .1 3. 1 4. 4 39 .3 47 .0 16 .5 2. 7 1, 37 5 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 2. 4 13 .7 81 .3 6. 4 14 .3 3. 4 3. 1 42 .6 40 .2 16 .7 2. 3 4, 67 4 M on -K hm er 3. 9 23 .6 76 .0 8. 9 13 .6 5. 8 4. 7 42 .3 36 .8 12 .8 4. 4 2, 14 8 H m on g- M ie n 3. 3 28 .0 79 .3 6. 3 12 .3 5. 1 2. 6 51 .4 41 .2 10 .0 3. 0 81 7 C hi ne se -T ib et an 8. 5 43 .5 64 .9 4. 3 27 .1 15 .5 5. 0 42 .6 20 .3 13 .4 2. 7 25 5 O th er , M is si ng , D K (0 .0 ) (2 6. 2) (8 2. 6) (1 1. 3) (6 .4 ) (9 .2 ) (1 0. 3) (3 0. 4) (2 9. 8) (1 5. 4) (0 .0 ) 38 To ta l 3. 1 18 .9 79 .1 7. 0 14 .2 4. 7 3. 6 43 .4 38 .7 14 .8 2. 9 7, 93 1 N ot e: 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. P er ce nt ag e of m ot he rs /c ar et ak er s of c hi ld re n ag e 0- 59 m on th s w ho th in k th at a c hi ld s ho ul d be ta ke n im m ed ia te ly to a he al th fa ci lit y if th e ch ild : M ot he rs /c ar et ak er s w ho re co gn iz e th e tw o da ng er s ig ns o f pn eu m on ia N um be r o f m ot he rs /c ar et ak er s of c hi ld re n ag e 0- 59 m on th s Ta bl e C H .8 : K no w le dg e of th e tw o da ng er s ig ns o f p ne um on ia P er ce nt ag e of m ot he rs a nd c ar et ak er s of c hi ld re n ag e 0- 59 m on th s by s ym pt om s th at w ou ld c au se th em to ta ke th e ch ild im m ed ia te ly to a h ea lth fa ci lit y, a nd p er ce nt ag e of m ot he rs w ho re co gn iz e fa st a nd d iff ic ul t br ea th in g as s ig ns fo r s ee ki ng c ar e im m ed ia te ly , L ao P D R 2 01 1- 12 148 Solid Fuel Use More than 3 billion people around the world rely on solid fuels (biomass and coal) for their basic energy needs, including cooking and heating. This leads to high levels of indoor smoke, which contains a complex mix of health-damaging pollutants. The main problem with the use of solid fuels is their incomplete combustion, which produces toxic elements including carbon monoxide, poly-aromatic hydrocarbons, and sulphur dioxide (SO2). Use of solid fuels increases the risk of incurring acute respiratory illness, pneumonia, chronic obstructive lung disease, cancer and possibly tuberculosis or asthma, and may contribute to the low birth weight of babies born to pregnant women exposed to smoke. The primary indicator for monitoring use of solid fuels is the proportion of the population using solid fuels as the primary source of domestic energy for cooking, as shown in Table CH.9. 9 149 9 Co al , lig ni te C ha r- co al W oo d S tra w , sh ru bs , gr as s R eg io n N or th 0. 5 0. 4 0. 1 0. 1 0. 2 1. 7 96 .9 0. 0 0. 0 0. 1 0. 0 10 0. 0 98 .8 31 ,3 10 C en tra l 3. 0 2. 7 0. 3 0. 1 0. 6 27 .2 66 .1 0. 0 0. 0 0. 0 0. 0 10 0. 0 93 .9 46 ,9 19 S ou th 0. 2 0. 4 0. 0 0. 1 0. 3 34 .0 65 .1 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .3 19 ,1 92 P ro vi nc e V ie nt ia ne C ap ita l 10 .1 8. 0 0. 9 0. 3 1. 4 51 .8 27 .4 0. 0 0. 0 0. 1 0. 0 10 0. 0 80 .6 11 ,6 94 P ho ng sa ly 0. 3 0. 3 0. 0 0. 0 0. 0 0. 1 99 .1 0. 1 0. 0 0. 1 0. 0 10 0. 0 99 .3 3, 12 2 Lu an gn am th a 0. 3 0. 0 0. 1 0. 0 0. 2 0. 4 98 .8 0. 3 0. 0 0. 0 0. 0 10 0. 0 99 .6 2, 70 7 O ud om xa y 0. 1 0. 1 0. 0 0. 0 0. 0 0. 5 99 .3 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .8 5, 18 1 B ok eo 0. 4 2. 0 0. 0 0. 5 0. 1 0. 6 96 .4 0. 0 0. 0 0. 0 0. 0 10 0. 0 97 .2 2, 74 9 Lu an gp ra ba ng 1. 0 0. 7 0. 4 0. 0 0. 2 0. 7 96 .8 0. 0 0. 0 0. 1 0. 1 10 0. 0 97 .7 6, 57 6 H ua ph an h 0. 6 0. 1 0. 0 0. 0 0. 0 0. 1 98 .9 0. 0 0. 0 0. 4 0. 0 10 0. 0 99 .0 5, 16 3 X ay ab ur y 0. 4 0. 3 0. 0 0. 1 0. 5 7. 4 91 .2 0. 0 0. 1 0. 0 0. 0 10 0. 0 99 .1 5, 81 3 X ie ng kh ua ng 1. 7 0. 5 0. 0 0. 0 0. 0 0. 2 97 .6 0. 0 0. 0 0. 0 0. 0 10 0. 0 97 .8 4, 19 8 V ie nt ia ne 1. 0 2. 2 0. 1 0. 0 0. 2 6. 7 89 .7 0. 2 0. 0 0. 0 0. 0 10 0. 0 96 .7 7, 07 9 B or ik ha m xa y 0. 4 1. 1 0. 6 0. 1 0. 0 14 .7 83 .2 0. 0 0. 0 0. 0 0. 0 10 0. 0 97 .8 3, 86 4 K ha m m ua ne 0. 4 0. 4 0. 0 0. 1 1. 1 16 .9 81 .0 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .1 5, 12 9 S av an na kh et 0. 3 0. 6 0. 0 0. 0 0. 2 32 .1 66 .7 0. 0 0. 0 0. 1 0. 0 10 0. 0 99 .1 14 ,9 54 S ar av an e 0. 1 0. 2 0. 0 0. 0 0. 1 17 .9 81 .7 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .7 6, 76 0 S ek on g 0. 0 0. 1 0. 0 0. 0 0. 0 11 .3 88 .6 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .9 1, 80 6 C ha m pa sa ck 0. 2 0. 6 0. 0 0. 1 0. 5 55 .8 42 .7 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .1 8, 87 7 A tta pe u 0. 6 0. 5 0. 0 0. 0 0. 1 8. 5 90 .2 0. 0 0. 0 0. 0 0. 0 10 0. 0 98 .9 1, 74 9 R es id en ce U rb an 5. 6 5. 2 0. 6 0. 3 0. 8 40 .1 47 .3 0. 0 0. 0 0. 0 0. 1 10 0. 0 88 .2 24 ,8 45 R ur al 0. 3 0. 2 0. 0 0. 0 0. 3 13 .6 85 .5 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .4 72 ,5 76 .R ur al w ith ro ad 0. 3 0. 3 0. 0 0. 0 0. 3 13 .8 85 .3 0. 0 0. 0 0. 1 0. 0 10 0. 0 99 .3 64 ,8 66 .R ur al w ith ou t r oa d 0. 0 0. 0 0. 0 0. 0 0. 2 12 .2 87 .6 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 7, 71 0 M is si ng To ta l O th er fu el Ta bl e C H .9 : S ol id fu el u se P er ce nt ag e of h ou se ho ld m em be rs in h ou se ho ld s us in g: P er ce nt d is tri bu tio n of h ou se ho ld m em be rs a cc or di ng to ty pe o f c oo ki ng fu el u se d by th e ho us eh ol d, a nd p er ce nt ag e of h ou se ho ld m em be rs li vi ng in h ou se ho ld s us in g so lid fu el s fo r c oo ki ng , L ao P D R 2 01 1- 12 S ol id fu el s E le ct ric ity Li qu ef ie d P et ro le um G as (L P G ) N at ur al G as B io ga s N o fo od co ok ed in th e ho us eh ol d S ol id fu el s fo r co ok in g1 N um be r o f ho us eh ol d m em be rs 1 M IC S in di ca to r 3. 11 150 9Co al , lig ni te C ha r- co al W oo d S tra w , sh ru bs , gr as s E du ca tio n of h ou se ho ld h ea d N on e 0. 3 0. 2 0. 0 0. 0 0. 2 11 .4 87 .7 0. 1 0. 0 0. 0 0. 0 10 0. 0 99 .4 20 ,7 63 P rim ar y 0. 7 0. 5 0. 0 0. 0 0. 3 17 .5 80 .8 0. 0 0. 0 0. 0 0. 0 10 0. 0 98 .6 45 ,8 54 Lo w er s ec on da ry 1. 4 1. 3 0. 3 0. 1 0. 6 22 .5 73 .8 0. 0 0. 0 0. 1 0. 0 10 0. 0 96 .9 14 ,2 80 U pp er s ec on da ry 5. 0 4. 9 0. 4 0. 0 0. 7 35 .6 53 .2 0. 0 0. 0 0. 1 0. 0 10 0. 0 89 .5 5, 24 1 P os t s ec on da ry n on te rti ar y 3. 0 3. 8 0. 4 0. 4 0. 5 37 .0 54 .7 0. 0 0. 0 0. 1 0. 1 10 0. 0 92 .2 6, 74 0 H ig he r 11 .9 10 .7 1. 1 0. 3 1. 1 40 .7 34 .1 0. 0 0. 0 0. 0 0. 1 10 0. 0 75 .9 4, 38 7 D K /M is si ng 16 .1 6. 8 0. 0 0. 0 0. 0 35 .6 41 .4 0. 0 0. 0 0. 0 0. 0 10 0. 0 77 .0 15 6 W ea lth in de x qu in til e P oo re st 0. 0 0. 0 0. 0 0. 0 0. 1 0. 5 99 .3 0. 1 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 19 ,4 89 S ec on d 0. 0 0. 0 0. 0 0. 0 0. 1 4. 7 95 .1 0. 0 0. 0 0. 1 0. 0 10 0. 0 99 .9 19 ,4 80 M id dl e 0. 0 0. 0 0. 0 0. 0 0. 1 12 .0 87 .7 0. 0 0. 0 0. 1 0. 0 10 0. 0 99 .9 19 ,4 83 Fo ur th 0. 5 0. 0 0. 0 0. 0 0. 6 31 .9 66 .8 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .3 19 ,4 80 R ic he st 7. 5 7. 5 0. 8 0. 4 1. 1 52 .6 29 .9 0. 0 0. 0 0. 1 0. 1 10 0. 0 83 .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 2. 4 2. 3 0. 2 0. 1 0. 6 30 .9 63 .3 0. 0 0. 0 0. 1 0. 0 10 0. 0 94 .9 61 ,4 59 M on -K hm er 0. 1 0. 0 0. 0 0. 0 0. 0 2. 5 97 .2 0. 1 0. 0 0. 0 0. 0 10 0. 0 99 .8 23 ,6 29 H m on g- M ie n 0. 6 0. 2 0. 1 0. 0 0. 0 0. 7 98 .3 0. 1 0. 0 0. 0 0. 0 10 0. 0 99 .1 8, 68 2 C hi ne se -T ib et an 0. 5 0. 2 0. 0 0. 0 0. 2 0. 4 98 .7 0. 0 0. 0 0. 0 0. 0 10 0. 0 99 .3 3, 11 1 O th er , M is si ng , D K 4. 9 8. 2 0. 0 0. 0 0. 6 24 .6 61 .1 0. 0 0. 0 0. 0 0. 6 10 0. 0 86 .3 54 1 To ta l 1. 6 1. 5 0. 2 0. 1 0. 4 20 .3 75 .8 0. 0 0. 0 0. 0 0. 0 10 0. 0 96 .5 97 ,4 21 Ta bl e C H .9 : S ol id fu el u se P er ce nt d is tri bu tio n of h ou se ho ld m em be rs a cc or di ng to ty pe o f c oo ki ng fu el u se d by th e ho us eh ol d, a nd p er ce nt ag e of h ou se ho ld m em be rs li vi ng in h ou se ho ld s us in g so lid fu el s fo r c oo ki ng , L ao P D R 2 01 1- 12 P er ce nt ag e of h ou se ho ld m em be rs in h ou se ho ld s us in g: N um be r o f ho us eh ol d m em be rs E le ct ric ity Li qu ef ie d P et ro le um G as (L P G ) N at ur al G as B io ga s S ol id fu el s O th er fu el M is si ng N o fo od co ok ed in th e ho us eh ol d To ta l S ol id fu el s fo r co ok in g1 1 M IC S in di ca to r 3. 11 151 The vast majority of households in Lao PDR (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. Solid fuel is essentially the only source of cooking fuel across rural areas (99 per cent of rural households), and while lower in urban areas, remains the main source for urban households (88 per cent). Use of gas and electricity is essentially seen only among the richest households. The predominant fuels for cooking purposes are wood and charcoal. To assess whether household members are exposed to air pollution from the burning of solid fuels, LSIS asked where the household cooking is usually done; the farther away from the general living area, the fewer the pollutants inhaled by household members. Solid fuel use by place of cooking is depicted in Table CH.10. Eighty-one per cent of household members in Lao PDR live where cooking is done inside the house. While this percentage is fairly consistent across background characteristics, what varies is whether the cooking is done in a separate room designated as an area for cooking, or elsewhere in the household living area. As education and wealth quintile increase, the percentage of household members living where the cooking is done in a separate room designated as a kitchen steadily increases. 9 152 In a separate room used as kitchen Elsewhere in the house In a separate building Outdoors At another place Missing Total Region North 42.8 41.6 14.4 0.8 0.0 0.4 100.0 30,940 Central 52.5 24.1 18.2 4.6 0.5 0.2 100.0 44,051 South 60.2 27.1 7.4 4.3 1.0 0.1 100.0 19,066 Province Vientiane Capital 59.7 21.4 11.5 6.7 0.2 0.5 100.0 9,422 Phongsaly 21.8 61.4 16.4 0.2 0.0 0.3 100.0 3,100 Luangnamtha 41.1 54.2 4.5 0.2 0.0 0.0 100.0 2,695 Oudomxay 41.7 54.0 4.1 0.1 0.0 0.1 100.0 5,172 Bokeo 38.4 32.4 27.1 1.9 0.0 0.1 100.0 2,672 Luangprabang 55.0 35.0 7.3 1.7 0.1 1.0 100.0 6,426 Huaphanh 26.6 40.8 32.2 0.2 0.0 0.1 100.0 5,111 Xayabury 58.6 26.3 13.4 0.8 0.0 0.9 100.0 5,763 Xiengkhuang 17.9 40.0 40.9 1.2 0.0 0.0 100.0 4,106 Vientiane 44.0 28.6 21.9 5.4 0.0 0.0 100.0 6,848 Borikhamxay 46.5 20.1 31.0 2.3 0.1 0.0 100.0 3,781 Khammuane 68.7 9.1 14.9 6.8 0.5 0.1 100.0 5,080 Savannakhet 57.5 25.4 12.2 3.7 1.0 0.1 100.0 14,813 Saravane 70.7 19.0 5.6 3.8 0.7 0.1 100.0 6,740 Sekong 41.8 35.9 13.2 8.9 0.3 0.0 100.0 1,803 Champasack 57.6 31.2 6.9 2.9 1.4 0.0 100.0 8,793 Attapeu 51.2 28.9 10.6 8.8 0.4 0.0 100.0 1,730 Residence Urban 62.8 18.2 14.3 4.2 0.2 0.1 100.0 21,918 Rural 47.2 34.2 14.9 3.0 0.5 0.3 100.0 72,138 .Rural with road 48.3 32.1 15.7 3.1 0.5 0.3 100.0 64,429 .Rural without road 38.3 51.3 7.6 2.2 0.4 0.1 100.0 7,710 Education of household head None 44.1 41.1 11.6 2.6 0.4 0.2 100.0 20,637 Primary 50.2 30.9 15.3 3.1 0.4 0.2 100.0 45,228 Lower secondary 53.3 24.6 17.1 4.2 0.6 0.2 100.0 13,834 Upper secondary 56.1 22.7 15.1 5.6 0.1 0.4 100.0 4,691 Post secondary non tertiary 60.9 19.3 16.1 3.2 0.3 0.2 100.0 6,217 Higher 65.7 15.7 13.8 4.2 0.5 0.0 100.0 3,330 DK/Missing 65.5 18.2 16.2 0.0 0.0 0.0 100.0 120 Wealth index quintile Poorest 28.3 62.9 6.1 1.9 0.6 0.1 100.0 19,484 Second 48.2 32.7 15.7 2.8 0.2 0.4 100.0 19,467 Middle 55.5 20.5 19.4 3.7 0.7 0.2 100.0 19,463 Fourth 59.7 17.9 17.6 4.1 0.5 0.3 100.0 19,352 Richest 65.0 15.7 15.1 4.0 0.0 0.1 100.0 16,290 Ethno-linguistic group of household head Lao-Tai 58.2 21.4 15.9 3.8 0.5 0.2 100.0 58,308 Mon-Khmer 46.0 39.7 10.7 2.9 0.5 0.3 100.0 23,591 Hmong-Mien 23.0 56.8 18.5 1.4 0.1 0.3 100.0 8,602 Chinese-Tibetan 24.8 60.3 14.7 0.1 0.0 0.1 100.0 3,089 Other, Missing, DK 67.7 15.5 6.7 10.0 0.0 0.0 100.0 467 Total 50.9 30.5 14.7 3.3 0.4 0.2 100.0 94,057 Table CH.10: Solid fuel use by place of cooking Percent distribution of household members in households using solid fuels by place of cooking, Lao PDR 2011-12 Number of household members in households using solid fuels for cooking Place of cooking: 9 153 Malaria Malaria is not only a cause of death of children age under five in Lao PDR, but also contributes to anaemia in children and school absenteeism. Preventive measures can dramatically reduce malaria mortality rates among children. Death rates associated with malaria (all ages) were estimated to be 14 and 0.4 per 100,000 population in the years 1995 and 2006, respectively (Government of Lao PDR and The United Nations, 2008). In areas where malaria is common, WHO recommends Indoor Residual Spraying, the use of insecticide treated bed-nets and prompt treatment of confirmed cases with recommended anti-malarial drugs. International recommendations also suggest treating any fever in children as if it were malaria and immediately giving the child a full course of recommended anti-malarial tablets. Children with severe malaria symptoms, such as fever or convulsions, should be taken to a health facility. Children recovering from malaria should also be given extra liquids and food, and younger babies and infants should continue breastfeeding. Insecticide-treated mosquito nets (ITNs), if used properly, are very effective in offering protection against mosquitoes and other insects. The use of ITNs is one of the main health interventions applied to reduce malaria transmission and it is promoted by the Lao Ministry of Health (MoH). The MoH estimated an average of 2.7 people per ITN in malaria risk areas in the fiscal year 2009-2010. The MoH also estimated that 84 per cent of the population in malaria risk areas was protected by ITNs (MoH, 2010). The LSIS questionnaire included questions on the availability of ITNs at the household level and use of bed nets by household members. 9 154 Percentage of households with at least one mosquito net Percentage of households with at least one long-lasting treated net Percentage of households with at least one ITN1 Number of households Region North 93.1 51.0 58.3 6,065 Central 93.5 28.4 41.0 9,247 South 98.2 41.1 60.1 3,531 Province Vientiane Capital 83.2 18.5 25.0 2,497 Phongsaly 72.7 50.6 51.0 578 Luangnamtha 94.1 40.2 45.5 544 Oudomxay 94.7 86.3 86.3 913 Bokeo 95.6 46.4 51.9 520 Luangprabang 92.1 61.3 69.9 1,371 Huaphanh 97.8 25.2 38.7 869 Xayabury 97.7 39.1 50.6 1,269 Xiengkhuang 96.8 5.1 27.9 762 Vientiane 97.1 21.3 32.8 1,447 Borikhamxay 97.4 45.9 67.0 804 Khammuane 97.2 39.1 51.8 1,078 Savannakhet 97.4 38.8 52.1 2,659 Saravane 98.4 47.2 73.1 1,123 Sekong 98.0 73.4 76.5 283 Champasack 98.3 24.4 44.8 1,789 Attapeu 97.4 83.0 84.3 336 Residence Urban 89.1 27.2 37.6 5,177 Rural 96.2 42.2 54.9 13,666 .Rural with road 96.8 40.9 53.9 12,285 .Rural without road 91.1 54.2 63.8 1,380 Education of household head None 92.1 42.2 52.6 3,833 Primary 96.8 42.0 54.6 8,542 Lower secondary 96.5 33.4 48.2 2,925 Upper secondary 90.4 25.0 35.3 1,147 Post secondary non tertiary 93.3 32.4 44.9 1,413 Higher 78.4 25.0 32.8 958 DK/Missing * * * 25 Wealth index quintile Poorest 90.0 51.0 58.2 3,585 Second 97.3 46.8 57.7 3,533 Middle 99.5 40.4 55.9 3,743 Fourth 99.6 32.1 48.3 3,962 Richest 85.0 22.7 32.9 4,019 Ethno-linguistic group of household head Lao-Tai 95.2 32.5 46.8 12,721 Mon-Khmer 94.6 56.9 65.4 4,140 Hmong-Mien 92.8 32.7 39.5 1,287 Chinese-Tibetan 75.2 40.0 41.8 579 Other, Missing, DK 86.5 29.6 34.1 117 Total 94.2 38.1 50.2 18,843 Table CH.11: Household availability of insecticide treated nets Percentage of households with at least one mosquito net, percentage of households with at least one long-lasting treated net, and percentage of households with at least one insecticide treated net (ITN), Lao PDR 2011-12 1 MICS indicator 3.12 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 9 155 LSIS results indicate that 50 per cent of households have at least one ITN and 94 per cent of households have at least one mosquito net (Table CH.11). The availability of at least one mosquito net per household is above 90 per cent in all provinces except in Vientiane Capital and Phongsaly (83 and 73 per cent, respectively). The percentage of households with at least one mosquito net falls below 90 per cent among groups including households headed by someone with higher education (78 per cent), the richest wealth quintile households (85 per cent), and Chinese-Tibetan headed households (75 per cent). Six in 10 households in the Northern and Southern regions have at least one ITN, compared with only 4 in 10 households in the Central region. Household possession of ITNs varies greatly across provinces. Fewer than half of households (ranging from 25 to 46 per cent) have an ITN in Vientiane Capital, Xiengkhuang, Vientiane, Huaphanh, Champasak and Luangnamtha provinces. The percentage is 70 per cent or greater in Luangprabang, Saravane, Sekong, Attapeu and Oudomxay provinces, while the percentage in the remaining provinces varies between 50 per cent and 67 per cent. The percentage of households owning an ITN is lower among the highest educated, wealthiest and urban households. 9 156 9 S le pt u nd er a ny m os qu ito n et 1 S le pt u nd er a n in se ct ic id e tre at ed n et 2 Se x M al e 94 .6 5, 59 3 87 .1 43 .5 5, 29 3 83 .0 2, 77 5 Fe m al e 94 .9 5, 47 4 87 .6 43 .0 5, 19 8 82 .2 2, 71 8 R eg io n N or th 97 .1 3, 50 2 83 .8 50 .2 3, 40 1 88 .2 1, 93 6 C en tra l 93 .1 5, 15 4 86 .0 32 .8 4, 79 9 74 .4 2, 11 4 S ou th 95 .0 2, 41 1 95 .6 54 .8 2, 29 1 87 .0 1, 44 3 Pr ov in ce V ie nt ia ne C ap ita l 97 .6 1, 05 8 73 .3 20 .7 1, 03 2 77 .6 27 5 P ho ng sa ly 99 .0 36 8 48 .7 33 .5 36 4 76 .8 15 9 Lu an gn am th a 99 .8 28 0 90 .5 38 .6 27 9 90 .3 11 9 O ud om xa y 97 .3 67 6 86 .6 80 .0 65 7 92 .8 56 7 B ok eo 96 .0 33 5 85 .9 40 .0 32 2 83 .7 15 4 Lu an gp ra ba ng 98 .7 75 2 83 .5 57 .3 74 1 90 .7 46 9 H ua ph an h 92 .5 60 6 90 .4 27 .8 56 1 73 .5 21 2 X ay ab ur y 98 .1 48 6 93 .9 50 .9 47 6 94 .7 25 6 X ie ng kh ua ng 91 .8 54 0 85 .6 20 .3 49 6 65 .5 15 4 V ie nt ia ne 95 .5 76 7 93 .5 18 .4 73 2 56 .5 23 9 B or ik ha m xa y 98 .3 40 2 94 .2 62 .3 39 5 95 .5 25 8 K ha m m ua ne 97 .9 60 3 91 .7 42 .3 59 1 74 .9 33 3 S av an na kh et 87 .0 1, 78 4 86 .7 40 .4 1, 55 3 73 .3 85 5 S ar av an e 99 .7 92 3 95 .4 63 .7 92 1 89 .0 65 8 S ek on g 97 .3 26 9 90 .7 70 .1 26 1 85 .0 21 5 C ha m pa sa ck 89 .5 1, 00 3 96 .7 36 .9 89 8 84 .1 39 4 A tta pe u 97 .7 21 6 97 .5 73 .5 21 1 88 .6 17 5 R es id en ce U rb an 96 .9 2, 31 9 81 .3 31 .0 2, 24 8 78 .0 89 2 R ur al 94 .2 8, 74 8 89 .0 46 .6 8, 24 3 83 .5 4, 60 0 .R ur al w ith ro ad 94 .3 7, 66 1 90 .8 46 .1 7, 22 6 84 .6 3, 93 9 .R ur al w ith ou t r oa d 93 .6 1, 08 6 76 .5 49 .9 1, 01 7 76 .9 66 1 1 M IC S in di ca to r 3 .1 4, 2 M IC S in di ca to r 3 .1 5; M D G in di ca to r 6 .7 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. P er ce nt ag e of c hi ld re n w ho s le pt u nd er a n IT N liv in g in h ou se ho ld s w ith at le as t o ne IT N N um be r o f c hi ld re n ag e 0- 59 li vi ng in ho us eh ol ds w ith a t l ea st on e IT N Ta bl e C H .1 2: C hi ld re n sl ee pi ng u nd er m os qu ito n et s P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ho s le pt u nd er a m os qu ito n et d ur in g th e pr ev io us n ig ht , b y ty pe o f n et , L ao P D R 2 01 1- 12 N um be r o f c hi ld re n ag e 0- 59 m on th s P er ce nt ag e of c hi ld re n ag e 0- 59 w ho s ta ye d in th e ho us eh ol d th e pr ev io us n ig ht Pe rc en ta ge o f c hi ld re n w ho : N um be r o f c hi ld re n ag e 0- 59 m on th s w ho s le pt in th e ho us eh ol d th e pr ev io us n ig ht 157 9 S le pt u nd er a ny m os qu ito n et 1 S le pt u nd er a n in se ct ic id e tre at ed n et 2 A ge 0 -1 1 m on th s 95 .5 2, 30 7 87 .1 41 .6 2, 20 3 81 .6 1, 12 5 12 -2 3 m on th s 94 .8 2, 14 1 87 .0 44 .3 2, 03 0 84 .5 1, 06 3 24 -3 5 m on th s 94 .2 2, 19 3 87 .7 43 .6 2, 06 5 81 .3 1, 10 8 36 -4 7 m on th s 94 .7 2, 30 2 88 .0 43 .7 2, 18 0 84 .1 1, 13 3 48 -5 9 m on th s 94 .7 2, 12 4 87 .0 43 .0 2, 01 2 81 .4 1, 06 3 M ot he r’s e du ca tio n N on e 94 .1 3, 58 0 82 .9 46 .2 3, 36 9 81 .8 1, 90 2 P rim ar y 94 .3 4, 55 6 92 .5 48 .2 4, 29 5 85 .4 2, 42 4 Lo w er s ec on da ry 96 .4 1, 61 3 91 .2 35 .4 1, 55 5 80 .7 68 3 U pp er s ec on da ry 96 .1 69 5 79 .5 28 .3 66 8 77 .5 24 4 P os t s ec on da ry n on te rti ar y 98 .2 36 8 82 .8 30 .8 36 2 73 .6 15 1 H ig he r 95 .1 25 5 61 .3 23 .9 24 2 66 .1 88 W ea lth in de x qu in til e P oo re st 93 .7 3, 23 3 80 .7 49 .7 3, 02 9 83 .7 1, 79 6 S ec on d 95 .4 2, 34 6 91 .7 49 .0 2, 23 8 86 .3 1, 27 0 M id dl e 94 .1 2, 01 9 96 .8 47 .6 1, 89 9 85 .0 1, 06 4 Fo ur th 94 .9 1, 80 7 96 .4 38 .3 1, 71 5 81 .3 80 8 R ic he st 96 .8 1, 66 3 73 .1 23 .3 1, 60 9 67 .7 55 4 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 94 .9 6, 03 0 90 .3 38 .4 5, 72 2 80 .2 2, 74 1 M on -K hm er 94 .9 3, 18 9 87 .0 58 .4 3, 02 7 86 .5 2, 04 4 H m on g- M ie n 93 .1 1, 43 9 82 .8 33 .2 1, 33 9 80 .9 55 0 C hi ne se -T ib et an 98 .3 35 7 59 .8 29 .4 35 1 76 .5 13 5 O th er , M is si ng , D K 97 .4 52 86 .7 44 .5 51 * 23 To ta l 94 .8 11 ,0 67 87 .4 43 .2 10 ,4 90 82 .6 5, 49 2 N um be r o f c hi ld re n ag e 0- 59 m on th s w ho s le pt in th e ho us eh ol d th e pr ev io us n ig ht P er ce nt ag e of c hi ld re n w ho s le pt u nd er a n IT N liv in g in h ou se ho ld s w ith at le as t o ne IT N N um be r o f c hi ld re n ag e 0- 59 li vi ng in ho us eh ol ds w ith a t l ea st on e IT N Ta bl e C H .1 2: C hi ld re n sl ee pi ng u nd er m os qu ito n et s P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ho s le pt u nd er a m os qu ito n et d ur in g th e pr ev io us n ig ht , b y ty pe o f n et , 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. 2 M IC S in di ca to r 3 .1 5; M D G in di ca to r 6 .7 1 M IC S in di ca to r 3 .1 4, P er ce nt ag e of c hi ld re n ag e 0- 59 w ho s ta ye d in th e ho us eh ol d th e pr ev io us n ig ht N um be r o f c hi ld re n ag e 0- 59 m on th s Pe rc en ta ge o f c hi ld re n w ho : 158 Data presented in Table CH. 12 indicate that 87 per cent of children under the age of five slept under a mosquito net the night prior to the survey and 43 per cent slept under an ITN. These findings are similar to levels measured in the 2006 MICS (87 per cent and 41 per cent, respectively). Among children living in households that have an ITN, 83 per cent slept under an ITN the night prior to the survey. There are no gender or age disparities in ITN use among children age under five. Patterns in the use of ITNs across background characteristics shown in Table CH.12 are generally the same as the patterns observed for household possession of an ITN. 9 159 9 S le pt u nd er a ny m os qu ito n et S le pt u nd er a n in se ct ic id e tre at ed n et 1 R eg io n N or th 98 .5 33 9 88 .5 48 .1 33 4 88 .2 18 2 C en tra l 95 .1 54 7 89 .3 32 .7 52 1 73 .0 23 3 S ou th 96 .6 27 4 96 .0 57 .7 26 4 85 .9 17 7 Pr ov in ce V ie nt ia ne C ap ita l 10 0. 0 12 6 75 .5 16 .5 12 6 * 29 P ho ng sa ly 10 0. 0 35 64 .8 39 .7 35 (8 2. 4) 17 Lu an gn am th a 10 0. 0 30 86 .0 46 .9 30 (9 2. 4) 15 O ud om xa y 98 .3 47 93 .1 82 .9 46 (9 4. 3) 40 B ok eo 96 .5 30 92 .5 48 .5 29 (8 9. 0) 16 Lu an gp ra ba ng 10 0. 0 80 82 .7 51 .5 80 (8 4. 2) 49 H ua ph an h 94 .7 64 95 .7 24 .7 61 * 18 X ay ab ur y 10 0. 0 53 10 0. 0 45 .9 53 (8 9. 1) 27 X ie ng kh ua ng 88 .8 42 (8 7. 2) (1 8. 8) 37 * 12 V ie nt ia ne 97 .0 84 97 .7 26 .3 82 (6 2. 9) 34 B or ik ha m xa y (1 00 .0 ) 35 (9 2. 3) (5 7. 5) 35 * 20 K ha m m ua ne 96 .9 48 97 .0 48 .5 47 (8 0. 3) 28 S av an na kh et 91 .4 21 2 92 .7 40 .2 19 3 70 .9 11 0 S ar av an e 10 0. 0 10 9 93 .4 64 .4 10 9 85 .7 82 S ek on g 99 .4 27 90 .7 65 .7 27 82 .5 21 C ha m pa sa ck 91 .9 11 2 10 0. 0 42 .3 10 3 (8 6. 2) 50 A tta pe u 10 0. 0 26 97 .1 82 .5 26 88 .7 24 R es id en ce U rb an 98 .0 23 9 81 .2 32 .6 23 4 81 .1 94 R ur al 96 .0 92 1 93 .2 46 .0 88 4 81 .6 49 9 .R ur al w ith ro ad 95 .7 81 7 94 .5 46 .2 78 1 83 .1 43 4 .R ur al w ith ou t r oa d 99 .0 10 4 83 .4 44 .6 10 3 71 .5 64 Ta bl e C H .1 3: P re gn an t w om en s le ep in g un de r m os qu ito n et s P er ce nt ag e of p re gn an t w om en w ho s le pt u nd er a m os qu ito n et d ur in g th e pr ev io us n ig ht , b y ty pe o f n et , L ao P D R 2 01 1- 12 P er ce nt ag e of p re gn an t w om e w ho s ta ye d in th e ho us eh ol d th e pr ev io us n ig ht N um be r o f pr eg na nt w om en Pe rc en ta ge o f p re gn an t w om en w ho : N um be r o f p re gn an t w om en w ho s le pt in th e ho us eh ol d th e pr ev io us ni gh t P er ce nt ag e of p re gn an t w om en w ho s le pt u nd er a n IT N , l iv in g in h ou se ho ld s w ith at le as t o ne IT N N um be r o f p re gn an t w om en li vi ng in ho us eh ol ds w ith a t le as t o ne IT N 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. 1 M IC S in di ca to r 3 .1 9 160 9 S le pt u nd er a ny m os qu ito n et S le pt u nd er a n in se ct ic id e tre at ed n et 1 A ge 1 5- 19 96 .0 22 8 89 .8 42 .1 21 9 78 .2 11 8 20 -2 4 95 .4 34 3 91 .8 45 .2 32 7 87 .5 16 9 25 -2 9 97 .5 28 9 90 .9 41 .9 28 2 78 .1 15 1 30 -3 4 96 .0 18 7 88 .3 43 .2 17 9 79 .5 97 35 -3 9 97 .8 84 93 .3 43 .2 82 (8 3. 2) 43 40 -4 4 * 24 * * 24 * 11 45 -4 9 * 5 * * 5 * 2 Ed uc at io n N on e 96 .0 30 3 89 .0 49 .7 29 1 86 .6 16 7 P rim ar y 96 .7 48 1 93 .5 49 .1 46 5 81 .6 27 9 Lo w er s ec on da ry 93 .1 18 1 93 .4 31 .8 16 9 83 .3 65 U pp er s ec on da ry 10 0. 0 90 87 .1 30 .1 90 (6 8. 2) 40 P os t s ec on da ry n on te rti ar y 99 .1 58 83 .2 30 .6 58 (7 1. 4) 25 H ig he r (1 00 .0 ) 46 (7 8. 2) (2 5. 8) 46 * 17 W ea lth in de x qu in til e P oo re st 98 .1 27 8 89 .4 54 .5 27 3 89 .4 16 6 S ec on d 96 .9 24 3 89 .7 48 .1 23 6 84 .2 13 4 M id dl e 95 .1 20 5 97 .9 49 .1 19 5 81 .6 11 7 Fo ur th 93 .9 24 4 98 .1 37 .3 22 9 75 .3 11 3 R ic he st 98 .1 18 9 76 .9 21 .6 18 6 65 .6 61 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 96 .1 68 4 92 .1 37 .1 65 7 75 .0 32 5 M on -K hm er 97 .7 30 7 91 .2 60 .6 30 0 89 .8 20 2 H m on g- M ie n 94 .7 12 3 90 .7 31 .1 11 6 (8 6. 6) 42 C hi ne se -T ib et an 96 .8 34 60 .8 42 .7 33 (8 8. 7) 16 O th er , M is si ng , D K * 13 * * 13 * 7 To ta l 96 .4 1, 16 0 90 .7 43 .2 1, 11 8 81 .5 59 3 Pe rc en ta ge o f p re gn an t w om en w ho : N um be r o f p re gn an t w om en w ho s le pt in th e ho us eh ol d th e pr ev io us ni gh t P er ce nt ag e of p re gn an t w om en w ho s le pt u nd er a n IT N , l iv in g in h ou se ho ld s w ith at le as t o ne IT N N um be r o f p re gn an t w om en li vi ng in ho us eh ol ds w ith a t le as t o ne IT N Ta bl e C H .1 3: P re gn an t w om en s le ep in g un de r m os qu ito n et s P er ce nt ag e of p re gn an t w om en w ho s le pt u nd er a m os qu ito n et d ur in g th e pr ev io us n ig ht , b y ty pe o f n et , 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. 1 M IC S in di ca to r 3 .1 9 P er ce nt ag e of p re gn an t w om e w ho s ta ye d in th e ho us eh ol d th e pr ev io us n ig ht N um be r o f pr eg na nt w om en 161 Table CH.13 presents shows that 91 per cent of pregnant women slept under a mosquito net during the night prior to the survey, and 43 per cent of pregnant women slept under an ITN. Patterns in the use of ITNs by pregnant women across background characteristics are very similar to the patterns observed for household possession of ITNs and use of ITNs by children age under five. There is a great deal of variability across provinces, and the lowest usage is among the highest educated and highest wealth quintile. Questions on the prevalence and treatment of fever were asked of mothers and caretakers for all children under the age of five. Fourteen per cent of children under five were ill with fever in the two weeks prior to the survey (Table CH.14). The prevalence of fever is highest among children age 12-23 months (18 per cent) and ranges across the provinces from 4 per cent in Champasack to 23 per cent in Khammuane. 9 162 9 S P / Fa ns id ar C hl or oq ui ne A m od ia - qu in e Q ui ni ne C oa rte m (C om bi na tio n w ith ar te m is in in ) A rte su na te O th er an ti- m al ar ia l A ny a nt i- m al ar ia l dr ug 1 A nt ib io tic pi ll or sy ru p A nt ib io tic in je ct io n P ar ac et - am ol / P an ad ol / A ce ta m in - op he n A sp iri n Ib up ro fe n O th er M is si ng / D K Se x M al e 14 .7 5, 59 3 0. 6 0. 6 0. 2 0. 3 0. 0 0. 0 0. 3 1. 4 22 .3 5. 0 64 .7 2. 0 0. 9 13 .8 1. 3 0. 5 82 1 Fe m al e 13 .6 5, 47 4 0. 7 0. 9 0. 7 0. 0 0. 3 0. 0 1. 3 2. 4 20 .5 4. 3 65 .9 1. 4 0. 6 11 .1 0. 8 1. 8 74 6 R eg io n N or th 16 .9 3, 50 2 0. 6 0. 7 0. 5 0. 2 0. 0 0. 0 0. 8 1. 9 19 .3 6. 6 70 .5 1. 9 0. 4 10 .2 1. 7 1. 3 59 0 C en tra l 16 .2 5, 15 4 0. 7 0. 8 0. 4 0. 2 0. 2 0. 0 0. 7 1. 8 22 .2 3. 7 61 .2 1. 9 1. 2 15 .1 0. 8 1. 0 83 4 S ou th 5. 9 2, 41 1 0. 5 0. 2 0. 0 0. 0 0. 6 0. 0 0. 8 2. 1 26 .1 2. 4 67 .6 0. 2 0. 0 7. 3 0. 0 1. 5 14 3 Pr ov in ce V ie nt ia ne C ap ita l 22 .2 1, 05 8 0. 9 1. 9 1. 6 0. 0 0. 0 0. 0 1. 9 2. 5 34 .1 3. 5 61 .9 0. 5 1. 4 12 .4 2. 0 2. 5 23 4 P ho ng sa ly 15 .0 36 8 0. 0 1. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1. 0 9. 2 0. 0 54 .4 0. 0 0. 0 36 .9 3. 5 1. 0 55 Lu an gn am th a 5. 1 28 0 * * * * * * * * * * * * * * * * 14 O ud om xa y 21 .5 67 6 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 21 .6 5. 0 62 .0 0. 6 0. 0 5. 2 0. 0 0. 0 14 5 B ok eo 20 .4 33 5 0. 8 0. 8 0. 8 0. 0 0. 0 0. 0 0. 0 1. 6 14 .9 0. 0 61 .7 2. 4 0. 0 8. 1 0. 8 0. 0 68 Lu an gp ra ba ng 16 .2 75 2 1. 9 1. 0 1. 9 0. 0 0. 0 0. 0 3. 9 5. 8 19 .4 19 .6 83 .9 2. 7 1. 9 12 .8 1. 9 4. 9 12 2 H ua ph an h 20 .4 60 6 0. 0 0. 7 0. 0 0. 0 0. 0 0. 0 0. 0 0. 7 11 .8 1. 6 75 .7 0. 0 0. 0 6. 7 3. 2 0. 7 12 4 X ay ab ur y 12 .7 48 6 0. 0 1. 9 0. 0 1. 9 0. 0 0. 0 0. 0 1. 9 42 .5 9. 4 82 .4 8. 7 0. 0 1. 7 1. 9 0. 0 62 X ie ng kh ua ng 11 .7 54 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 11 .3 1. 3 82 .2 0. 0 0. 0 31 .0 0. 0 0. 0 63 V ie nt ia ne 11 .5 76 7 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1. 4 1. 4 20 .3 1. 6 49 .3 1. 6 5. 5 8. 5 1. 4 0. 0 88 B or ik ha m xa y 5. 1 40 2 (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (4 1. 6) (1 2. 4) (6 7. 0) (4 .1 ) (8 .2 ) (1 6. 6) (0 .0 ) (0 .0 ) 20 K ha m m ua ne 23 .0 60 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 23 .5 8. 6 58 .6 0. 7 0. 0 20 .0 0. 7 0. 0 13 9 S av an na kh et 16 .2 1, 78 4 1. 3 0. 7 0. 0 0. 6 0. 6 0. 0 0. 0 2. 6 13 .4 2. 2 60 .5 3. 9 0. 0 13 .3 0. 0 0. 8 28 8 S ar av an e 4. 1 92 3 (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (3 7. 6) (6 .5 ) (6 6. 8) (0 .0 ) (0 .0 ) (6 .0 ) (0 .0 ) (0 .0 ) 38 S ek on g 12 .5 26 9 0. 0 1. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1. 0 31 .9 0. 0 63 .6 0. 0 0. 0 6. 4 0. 0 0. 0 34 C ha m pa sa ck 4. 2 1, 00 3 (1 .6 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (2 .8 ) (4 .4 ) (2 4. 2) (0 .0 ) (5 7. 0) (0 .0 ) (0 .0 ) (1 3. 2) (0 .0 ) (4 .4 ) 43 A tta pe u 13 .3 21 6 0. 0 0. 0 0. 0 0. 0 2. 9 0. 0 0. 0 2. 9 7. 0 3. 2 89 .4 1. 2 0. 0 1. 2 0. 0 1. 0 29 R es id en ce U rb an 15 .8 2, 31 9 0. 5 0. 0 0. 4 0. 5 0. 5 0. 0 0. 7 2. 0 29 .6 4. 8 62 .8 2. 7 1. 5 16 .6 1. 1 1. 0 36 6 R ur al 13 .7 8, 74 8 0. 7 0. 9 0. 4 0. 1 0. 1 0. 0 0. 8 1. 8 19 .0 4. 6 66 .0 1. 4 0. 6 11 .3 1. 1 1. 2 1, 20 1 .R ur al w ith ro ad 13 .5 7, 66 1 0. 6 0. 9 0. 4 0. 1 0. 1 0. 0 0. 9 1. 7 20 .9 5. 2 68 .0 1. 6 0. 6 11 .1 0. 8 1. 2 1, 03 2 .R ur al w ith ou t r oa d 15 .6 1, 08 6 1. 1 1. 2 0. 7 0. 0 0. 0 0. 0 0. 0 2. 3 7. 3 1. 2 54 .4 0. 6 0. 0 12 .6 2. 4 1. 1 16 9 P er ce nt ag e w ho to ok a n an ti- m al ar ia l dr ug s am e or ne xt d ay 2 Ta bl e C H .1 4: A nt i-m al ar ia l t re at m en t o f c hi ld re n w ith a nt i-m al ar ia l d ru gs N um be r of ch ild re n ag e 0- 59 m on th s P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ho h ad fe ve r i n th e la st tw o w ee ks w ho re ce iv ed a nt i-m al ar ia l d ru gs , L ao P D R 2 01 1- 12 H ad a fe ve r in la st tw o w ee ks N um be r of ch ild re n w ith fe ve r in la st tw o w ee ks A nt i-m al ar ia ls : C hi ld re n w ith a fe ve r i n th e la st tw o w ee ks w ho w er e tr ea te d w ith : O th er m ed ic at io ns : 1 M IC S in di ca to r 3 .1 8; M D G in di ca to r 6 .8 2 M IC S in di ca to r 3 .1 7 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. 163 9 S P / Fa ns id ar C hl or oq ui ne A m od ia - qu in e Q ui ni ne C oa rte m (C om bi na tio n w ith ar te m is in in ) A rte su na te O th er an ti- m al ar ia l A ny a nt i- m al ar ia l dr ug 1 A nt ib io tic pi ll or sy ru p A nt ib io tic in je ct io n P ar ac et - am ol / P an ad ol / A ce ta m in - op he n A sp iri n Ib up ro fe n O th er M is si ng / D K A ge 0 -1 1 m on th s 13 .3 2, 30 7 0. 6 0. 0 0. 8 0. 0 0. 0 0. 0 0. 0 1. 0 17 .5 1. 6 58 .4 3. 0 0. 7 10 .8 0. 6 1. 0 30 8 12 -2 3 m on th s 18 .1 2, 14 1 0. 9 0. 0 0. 4 0. 4 0. 0 0. 0 0. 0 0. 9 23 .8 2. 9 66 .8 1. 4 1. 4 12 .7 0. 9 0. 3 38 8 24 -3 5 m on th s 14 .2 2, 19 3 0. 7 0. 7 0. 0 0. 0 0. 7 0. 0 1. 1 1. 8 22 .1 7. 1 67 .6 1. 9 0. 6 11 .0 1. 3 1. 1 31 0 36 -4 7 m on th s 14 .3 2, 30 2 0. 0 2. 2 0. 7 0. 3 0. 1 0. 0 2. 1 3. 4 20 .5 5. 3 62 .1 1. 3 0. 8 15 .8 1. 5 1. 5 32 8 48 -5 9 m on th s 11 .0 2, 12 4 1. 2 0. 7 0. 0 0. 0 0. 0 0. 0 0. 5 2. 5 23 .3 7. 5 73 .3 1. 1 0. 0 11 .9 1. 1 2. 3 23 3 M ot he r’s e du ca tio n N on e 13 .6 3, 58 0 0. 8 0. 8 0. 4 0. 0 0. 1 0. 0 0. 0 1. 7 13 .3 3. 4 64 .1 2. 0 0. 5 9. 0 1. 4 0. 9 48 6 P rim ar y 14 .7 4, 55 6 0. 1 0. 4 0. 2 0. 2 0. 3 0. 0 0. 9 1. 8 22 .3 6. 6 66 .8 1. 6 0. 5 11 .5 1. 0 1. 2 67 0 Lo w er s ec on da ry 13 .0 1, 61 3 2. 7 1. 0 0. 6 0. 8 0. 0 0. 0 1. 6 3. 2 28 .7 3. 6 63 .3 0. 9 0. 5 22 .9 0. 4 1. 9 21 0 U pp er s ec on da ry 15 .7 69 5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 22 .9 0. 8 60 .6 3. 8 3. 8 10 .2 2. 7 0. 0 10 9 P os t s ec on da ry n on te rti ar y 11 .9 36 8 (0 .0 ) (5 .2 ) (5 .2 ) (0 .0 ) (0 .0 ) (0 .0 ) (5 .2 ) (5 .2 ) (3 2. 7) (0 .0 ) (6 6. 2) (0 .8 ) (0 .0 ) (1 4. 8) (0 .0 ) (5 .2 ) 44 H ig he r 18 .5 25 5 (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (4 6. 9) (8 .7 ) (7 4. 2) (0 .0 ) (2 .4 ) (2 1. 3) (0 .0 ) (0 .0 ) 47 W ea lth in de x qu in til e P oo re st 14 .5 3, 23 3 0. 7 0. 1 0. 3 0. 0 0. 2 0. 0 0. 0 1. 0 13 .2 4. 2 64 .2 1. 4 0. 0 6. 3 0. 8 0. 8 46 9 S ec on d 13 .0 2, 34 6 0. 6 0. 4 0. 6 0. 0 0. 0 0. 0 0. 8 1. 7 17 .3 6. 5 68 .9 1. 4 0. 4 14 .3 0. 5 1. 0 30 5 M id dl e 12 .8 2, 01 9 1. 1 2. 3 0. 0 0. 4 0. 0 0. 0 1. 8 3. 4 23 .3 4. 6 70 .2 1. 9 0. 8 14 .0 1. 7 2. 2 25 9 Fo ur th 13 .9 1, 80 7 0. 3 0. 5 0. 0 0. 0 0. 7 0. 0 1. 0 1. 9 26 .8 5. 8 66 .0 2. 2 1. 3 18 .4 1. 6 0. 7 25 1 R ic he st 17 .0 1, 66 3 0. 6 0. 8 1. 3 0. 6 0. 0 0. 0 0. 8 1. 9 33 .2 2. 6 58 .0 2. 1 2. 0 14 .4 1. 0 1. 3 28 3 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 13 .5 6, 03 0 0. 3 0. 4 0. 5 0. 3 0. 2 0. 0 0. 9 1. 7 27 .4 3. 9 66 .1 2. 0 1. 2 15 .7 1. 0 0. 8 81 6 M on -K hm er 16 .0 3, 18 9 1. 1 0. 8 0. 6 0. 0 0. 2 0. 0 0. 5 2. 3 15 .7 7. 4 63 .7 1. 5 0. 2 6. 8 0. 7 1. 5 51 1 H m on g- M ie n 13 .0 1, 43 9 1. 2 1. 6 0. 0 0. 0 0. 0 0. 0 1. 2 1. 6 14 .1 1. 8 71 .3 1. 6 0. 7 11 .8 1. 6 1. 6 18 6 C hi ne se -T ib et an 13 .3 35 7 0. 0 1. 2 0. 0 0. 0 0. 0 0. 0 0. 0 1. 2 6. 5 0. 0 46 .6 0. 0 0. 0 23 .8 2. 5 1. 2 48 O th er , M is si ng , D K 12 .1 52 * * * * * * * * * * * * * * * * 6 To ta l 14 .2 11 ,0 67 0. 7 0. 7 0. 4 0. 2 0. 2 0. 0 0. 7 1. 9 21 .5 4. 7 65 .3 1. 7 0. 8 12 .5 1. 1 1. 2 1, 56 7 Ta bl e C H .1 4: A nt i-m al ar ia l t re at m en t o f c hi ld re n w ith a nt i-m al ar ia l d ru gs P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ho h ad fe ve r i n th e la st tw o w ee ks w ho re ce iv ed a nt i-m al ar ia l d ru gs , L ao P D R 2 01 1- 12 H ad a fe ve r in la st tw o w ee ks N um be r of ch ild re n ag e 0- 59 m on th s C hi ld re n w ith a fe ve r i n th e la st tw o w ee ks w ho w er e tr ea te d w ith : N um be r of ch ild re n w ith fe ve r in la st tw o w ee ks A nt i-m al ar ia ls : O th er m ed ic at io ns : P er ce nt ag e w ho to ok a n an ti- m al ar ia l dr ug s am e or ne xt d ay 2 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 3 .1 7 1 M IC S in di ca to r 3 .1 8; M D G in di ca to r 6 .8 164 Mothers were asked to report what medicines were given to a child with fever, including medicines given at home and medicines given or prescribed at a health facility. Only 2 per cent of children with fever in the two weeks prior to the survey were treated with an anti-malarial drug, and only 1 per cent received an anti-malarial drug either on the same day or the day after the onset of symptoms. The anti-malarial drugs include chloroquine, amodiaquine, quinine, Fansidar or sulfadoxine- pyrimethamine (SP), artimisinin combination drugs (Coartem), and artesunate. The first-line medication for treatment of malaria in Lao PDR is Coartem and artesunate. One per cent of children with fever were given chloroquine and 1 per cent were given SP/Fansidar. Less than 1 per cent received any other type of anti-malarial. Two-thirds of children with fever (65 per cent) were given acetaminophen, Paracetemol or Panadol. One in four children with fever were given an antibiotic. 9 165 Had a finger or heel stick1 Number of children age 0-59 months with fever in the last two weeks Had a finger or heel stick1 Number of children age 0-59 months with fever in the last two weeks Sex Age Male 9.0 821 0-11 months 5.7 308 Female 9.2 746 12-23 months 8.8 388 Region 24-35 months 7.6 310 North 7.3 590 36-47 months 9.5 328 Central 10.0 834 48-59 months 15.7 233 South 11.4 143 Mother’s education Province None 7.9 486 Vientiane Capital 12.6 234 Primary 9.6 670 Phongsaly 4.7 55 Lower secondary 6.4 210 Luangnamtha * 14 Upper secondary 14.8 109 Oudomxay 5.0 145 Post secondary non (2.3) 44 Bokeo 6.4 68 Higher (19.6) 47 Luangprabang 11.3 122 Wealth index quintile Huaphanh 3.7 124 Poorest 7.2 469 Xayabury 16.3 62 Second 9.7 305 Xiengkhuang 1.9 63 Middle 8.0 259 Vientiane 5.8 88 Fourth 11.0 251 Borikhamxay (4.1) 20 Richest 11.1 283 Khammuane 5.2 139 Ethno-linguistic group of household head Savannakhet 13.6 288 Lao-Tai 11.5 816 Saravane (0.0) 38 Mon-Khmer 7.8 511 Sekong 8.7 34 Hmong-Mien 2.0 186 Champasack (23.3) 43 Chinese-Tibetan 6.6 48 Attapeu 11.8 29 Other, Missing, DK * 6 Residence Urban 12.3 366 Total 9.1 1,567 Rural 8.1 1,201 .Rural with road 8.5 1,032 .Rural without road 6.1 169 1 MICS indicator 3.16 Table CH.15: Malaria diagnostics usage Percentage of children age 0-59 months who had a fever in the last two weeks and who had a finger or heel stick for malaria testing, Lao PDR 2011-12 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 CH.15 presents the percentage of children age under five who had a fever in the two weeks prior to the survey and who had a finger or heel stick to test for malaria. Nine percent of children with a fever had a finger or heel stick (12 per cent in urban areas and 8 per cent in rural areas). Boys and girls with fever are tested in similar proportions. The percentage of children who had a finger or heel stick to test for malaria is higher than the national average in Luangprabang, Attapeu, Vientiane Capital, Savannakhet, Xayabury and Champasack provinces. A higher percentage of four year-old children (16 per cent) are tested for malaria than younger children (ranging from 6 per cent to 10 per cent). Children in Hmong-Mien headed households have the lowest prevalence malaria testing (2 per cent). 9 © UNICEF Lao PDR / 2012 / Noorani 167 X. Nutrition Nutritional Status Children’s nutritional status is a reflection of their overall health. When children have access to an adequate food supply, are not exposed to repeated illness, and are well cared for, they reach their growth potential and are considered well nourished. Malnutrition is associated with more than half of all child deaths worldwide. Undernourished children are more likely to die from common childhood ailments. Undernourished children who survive are subject to recurring sicknesses and faltering growth. Three quarters of children who die from causes related to malnutrition are only mildly or moderately malnourished – showing no outward sign of their vulnerability. The Millennium Development Goal target is to reduce by half the proportion of people who suffer from hunger between 1990 and 2015. A reduction in the prevalence of malnutrition will also assist in the goal of reducing child mortality. There is a reference distribution of height and weight for children age under five in a well-nourished population. Under-nourishment in a population can be gauged by comparing children to a reference population. The reference population used in this report is based on the WHO growth standards.1 Each of the three nutritional status indicators can be expressed in standard deviation units (‘z-scores’) from the median of the reference population (the nutritional status indicators were also calculated based on the formerly used 1977 NCHS/CDC/WHO reference population, and are shown in Table NU.A1 at the end of this chapter). Weight-for-age is a measure of both acute and chronic malnutrition. Children whose weight-for-age is more than two standard deviations below the median of the reference population are considered moderately or severely underweight while those whose weight-for-age is more than three standard deviations below the median are classified as severely underweight. Height-for-age is a measure of linear growth. Children whose height-for-age is more than two standard deviations below the median of the reference population are considered short for their age and are classified as moderately or severely stunted. Those whose height-for-age is more than three standard deviations below the median are classified as severely stunted. Stunting is a reflection of chronic malnutrition as a result of failure to receive adequate nutrition over a long period of time and recurrent or chronic illness. Finally, children whose weight-for-height is more than two standard deviations below the median of the reference population are classified as moderately or severely wasted, while those who fall more than three standard deviations below the median are classified as severely wasted. Wasting is usually the result of a recent nutritional deficiency. The indicator may exhibit significant seasonal shifts associated with changes in the availability of food or disease prevalence. Weight-for-height can also be used to classify children as overweight – those who are more than two standard deviations above the median of the reference population are classified as being overweight. In the LSIS, the weights and heights of all children under 5 years of age were measured using anthropometric equipment recommended by international standards for household-based surveys. Findings in this section are based on the results of these measurements. Table NU.1 shows the percentages of children classified into each of the above described categories, based on the anthropometric measurements taken during field work. The table also includes the mean z-scores for each of the three anthropometric indicators, and the percentage of children who are overweight. 1 http://www.who.int/childgrowth/standards/second_set/technical_report_2.pdf 10 168 10 O ve rw ei gh t P er ce nt a bo ve - 2 S D 1 - 3 S D 2 - 2 S D 3 - 3 S D 4 - 2 S D 5 - 3 S D 6 + 2 S D Se x M al e 26 .7 6. 9 -1 .3 5, 47 3 45 .7 19 .9 -1 .8 5, 35 9 6. 4 1. 3 2. 0 -0 .4 5, 39 4 Fe m al e 26 .4 7. 5 -1 .3 5, 34 1 42 .6 17 .6 -1 .7 5, 25 9 5. 4 1. 5 2. 1 -0 .4 5, 27 7 R eg io n N or th 26 .2 7. 4 -1 .3 3, 45 2 51 .4 22 .5 -2 .0 3, 38 7 5. 3 1. 7 2. 6 -0 .2 3, 41 5 C en tra l 23 .1 5. 9 -1 .2 5, 02 3 38 .1 15 .5 -1 .6 4, 93 4 5. 4 1. 2 2. 2 -0 .4 4, 94 1 S ou th 34 .7 9. 7 -1 .5 2, 33 9 46 .6 20 .3 -1 .9 2, 29 7 7. 9 1. 3 0. 9 -0 .7 2, 31 5 Pr ov in ce V ie nt ia ne C ap ita l 16 .3 2. 2 -0 .8 1, 00 3 19 .3 3. 6 -0 .9 98 0 7. 2 0. 9 2. 2 -0 .4 98 2 P ho ng sa ly 34 .1 15 .6 -1 .6 35 9 61 .1 36 .6 -2 .5 34 0 5. 1 1. 8 4. 3 -0 .1 34 9 Lu an gn am th a 40 .4 16 .9 -1 .7 28 0 53 .2 29 .2 -1 .9 26 8 21 .2 9. 2 5. 0 -0 .7 27 3 O ud om xa y 28 .7 7. 0 -1 .4 66 7 54 .9 28 .0 -2 .1 66 0 4. 6 1. 3 2. 7 -0 .3 66 6 B ok eo 23 .7 4. 3 -1 .3 32 7 46 .0 18 .7 -1 .8 32 5 4. 7 1. 6 1. 6 -0 .3 32 5 Lu an gp ra ba ng 19 .8 4. 7 -1 .2 74 2 45 .6 15 .6 -1 .8 73 9 3. 1 0. 6 1. 4 -0 .2 73 8 H ua ph an h 23 .5 4. 6 -1 .4 59 7 61 .1 23 .7 -2 .3 59 0 1. 9 0. 1 1. 7 0. 0 59 1 X ay ab ur y 23 .2 5. 8 -1 .2 48 1 39 .0 12 .8 -1 .6 46 6 5. 5 1. 9 3. 7 -0 .2 47 3 X ie ng kh ua ng 19 .9 4. 0 -1 .1 52 9 52 .9 21 .7 -2 .0 52 0 2. 0 0. 7 3. 1 0. 1 52 3 V ie nt ia ne 18 .9 3. 4 -1 .1 74 4 42 .6 18 .9 -1 .8 73 8 4. 6 1. 2 4. 3 -0 .2 72 9 B or ik ha m xa y 19 .8 4. 3 -1 .1 39 5 40 .8 16 .1 -1 .6 39 1 6. 2 1. 5 2. 9 -0 .3 38 5 K ha m m ua ne 29 .4 7. 3 -1 .4 59 9 40 .8 14 .2 -1 .6 59 5 7. 1 1. 3 0. 7 -0 .7 60 0 S av an na kh et 28 .2 9. 6 -1 .4 1, 75 2 40 .8 19 .1 -1 .7 1, 71 0 5. 0 1. 5 1. 3 -0 .5 1, 72 2 S ar av an e 41 .2 13 .8 -1 .7 90 6 54 .4 26 .9 -2 .1 88 2 8. 6 1. 6 1. 3 -0 .7 88 7 S ek on g 46 .0 14 .9 -1 .9 25 8 62 .7 36 .8 -2 .5 25 2 7. 3 1. 1 1. 7 -0 .5 25 7 C ha m pa sa ck 26 .3 4. 7 -1 .3 97 0 36 .7 11 .5 -1 .5 96 0 6. 8 0. 9 0. 4 -0 .6 96 6 A tta pe u 32 .0 8. 5 -1 .5 20 4 39 .7 12 .7 -1 .6 20 3 10 .6 1. 9 0. 8 -0 .8 20 5 R es id en ce U rb an 16 .1 2. 9 -0 .9 2, 26 3 27 .4 8. 3 -1 .2 2, 21 3 5. 4 1. 4 2. 3 -0 .3 2, 21 4 R ur al 29 .3 8. 3 -1 .4 8, 55 1 48 .6 21 .5 -1 .9 8, 40 5 6. 1 1. 4 2. 0 -0 .4 8, 45 7 .R ur al w ith ro ad 29 .0 7. 9 -1 .4 7, 49 1 47 .8 20 .5 -1 .9 7, 36 4 6. 1 1. 4 2. 0 -0 .4 7, 40 0 .R ur al w ith ou t r oa d 31 .6 11 .3 -1 .6 1, 06 1 53 .8 28 .4 -2 .1 1, 04 2 5. 7 1. 3 2. 2 -0 .4 1, 05 7 W as te d M ea n Z- S co re (S D ) M ea n Z- S co re (S D ) P er ce nt b el ow P er ce nt b el ow P er ce nt b el ow W ei gh t f or h ei gh t N um be r o f ch ild re n un de r a ge 5 Ta bl e N U .1 : N ut rit io na l s ta tu s of c hi ld re n P er ce nt ag e of c hi ld re n un de r a ge 5 b y nu tri tio na l s ta tu s ac co rd in g to th re e an th ro po m et ric in di ce s: w ei gh t f or a ge , h ei gh t f or a ge , a nd w ei gh t f or h ei gh t, La o P D R 2 01 1- 12 N um be r o f ch ild re n un de r a ge 5 W ei gh t f or a ge U nd er w ei gh t M ea n Z- S co re (S D ) H ei gh t f or a ge N um be r o f ch ild re n un de r a ge 5 St un te d 1 M IC S in di ca to r 2 .1 a an d M D G in di ca to r 1 .8 2 M IC S in di ca to r 2 .1 b 3 M IC S in di ca to r 2 .2 a, 4 M IC S in di ca to r 2 .2 b 5 M IC S in di ca to r 2 .3 a, 6 M IC S in di ca to r 2 .3 b E ac h of th e in di ce s is e xp re ss ed in s ta nd ar d de vi at io n un its (S D ) f ro m th e m ed ia n of th e W H O C hi ld G ro w th S ta nd ar ds a do pt ed in 2 00 6. T he in di ce s in th is ta bl e ar e N O T co m pa ra bl e to th os e ba se d on th e pr ev io us ly u se d 19 77 N C H S /C D C /W H O R ef er en ce . N ot e: F or L ua ng N am th a, th e fig ur es o f W ei gh t-f or -A ge , H ei gh t-f or -A ge a nd W ei gh t-f or -H ei gh t, in cl ud in g w as tin g an d ov er w ei gh t, sh ou ld b e in te rp re te d w ith c au tio n du e to e xt re m e he ap in g of v al ue s fo r h ei gh t an d w ei gh t 169 10 O ve rw ei gh t P er ce nt a bo ve - 2 S D 1 - 3 S D 2 - 2 S D 3 - 3 S D 4 - 2 S D 5 - 3 S D 6 + 2 S D A ge 0 -5 m on th s 12 .7 5. 4 -0 .6 1, 14 6 20 .0 8. 8 -0 .8 1, 11 6 6. 4 2. 2 7. 3 0. 1 1, 09 3 6- 11 m on th s 18 .1 3. 9 -1 .0 1, 10 9 23 .0 7. 6 -1 .1 1, 08 9 8. 0 1. 7 1. 8 -0 .5 1, 10 6 12 -2 3 m on th s 25 .5 7. 2 -1 .3 2, 09 1 44 .0 18 .5 -1 .8 2, 04 4 6. 8 1. 7 1. 6 -0 .5 2, 07 6 24 -3 5 m on th s 30 .5 10 .1 -1 .5 2, 13 9 50 .8 22 .7 -2 .0 2, 08 6 7. 4 1. 9 1. 5 -0 .4 2, 10 4 36 -4 7 m on th s 30 .3 7. 1 -1 .5 2, 25 6 52 .0 23 .4 -2 .1 2, 22 8 4. 4 0. 9 1. 4 -0 .4 2, 23 5 48 -5 9 m on th s 31 .7 7. 1 -1 .6 2, 07 3 53 .5 21 .4 -2 .1 2, 05 6 3. 9 0. 5 1. 1 -0 .4 2, 05 8 M ot he r’s e du ca tio n N on e 35 .0 12 .0 -1 .6 3, 49 2 57 .9 29 .9 -2 .2 3, 41 3 5. 8 1. 6 2. 2 -0 .4 3, 46 2 P rim ar y 26 .2 6. 3 -1 .3 4, 46 7 43 .2 17 .7 -1 .8 4, 39 0 5. 9 1. 1 1. 9 -0 .4 4, 41 0 Lo w er s ec on da ry 20 .3 3. 4 -1 .1 1, 57 5 34 .0 8. 6 -1 .4 1, 55 4 6. 7 1. 8 1. 8 -0 .4 1, 54 2 U pp er s ec on da ry 12 .8 2. 1 -0 .9 67 5 23 .1 3. 9 -1 .1 66 7 5. 1 0. 9 1. 7 -0 .3 66 7 P os t s ec on da ry n on te rti ar y 17 .5 1. 8 -1 .0 36 3 28 .7 8. 2 -1 .2 35 9 6. 2 1. 9 3. 3 -0 .4 35 7 H ig he r 4. 2 0. 0 -0 .6 24 3 15 .0 2. 3 -0 .8 23 6 4. 8 0. 8 3. 2 -0 .3 23 3 W ea lth in de x qu in til e P oo re st 36 .5 12 .0 -1 .7 3, 17 3 60 .6 31 .8 -2 .3 3, 11 1 6. 4 1. 3 2. 0 -0 .4 3, 14 4 S ec on d 29 .6 9. 0 -1 .4 2, 30 9 50 .2 21 .7 -1 .9 2, 25 3 6. 4 1. 6 2. 5 -0 .4 2, 28 0 M id dl e 25 .2 5. 3 -1 .3 1, 97 1 41 .9 14 .3 -1 .7 1, 94 5 5. 8 1. 6 1. 7 -0 .4 1, 95 0 Fo ur th 19 .4 3. 5 -1 .1 1, 75 8 31 .7 10 .1 -1 .4 1, 73 2 5. 2 1. 5 2. 0 -0 .4 1, 73 0 R ic he st 12 .1 1. 6 -0 .8 1, 60 4 19 .7 3. 9 -1 .0 1, 57 7 5. 1 1. 0 2. 1 -0 .3 1, 56 8 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 21 .5 4. 5 -1 .1 5, 89 0 33 .4 10 .2 -1 .4 5, 80 4 6. 1 1. 3 1. 5 -0 .5 5, 79 8 M on -K hm er 36 .7 11 .6 -1 .6 3, 12 7 55 .5 28 .8 -2 .2 3, 05 5 6. 5 1. 4 1. 9 -0 .5 3, 10 2 H m on g- M ie n 21 .3 5. 5 -1 .2 1, 39 6 60 .5 28 .0 -2 .2 1, 37 6 2. 2 0. 9 4. 3 0. 1 1, 38 0 C hi ne se -T ib et an 42 .8 20 .4 -1 .8 35 1 60 .9 37 .6 -2 .4 33 3 13 .1 6. 3 3. 3 -0 .4 34 1 O th er , M is si ng , D K 24 .4 2. 0 -1 .3 51 45 .2 15 .0 -1 .6 50 3. 9 0. 0 4. 9 -0 .4 51 To ta l 26 .6 7. 2 -1 .3 10 ,8 14 44 .2 18 .8 -1 .8 10 ,6 18 5. 9 1. 4 2. 0 -0 .4 10 ,6 71 3 M IC S in di ca to r 2 .2 a, 4 M IC S in di ca to r 2 .2 b 2 M IC S in di ca to r 2 .1 b W ei gh t f or a ge N um be r o f ch ild re n un de r a ge 5 H ei gh t f or a ge N um be r o f ch ild re n un de r a ge 5 W ei gh t f or h ei gh t N um be r o f ch ild re n un de r a ge 5 U nd er w ei gh t N ot e: F or L ua ng N am th a, th e fig ur es o f W ei gh t-f or -A ge , H ei gh t-f or -A ge a nd W ei gh t-f or -H ei gh t, in cl ud in g w as tin g an d ov er w ei gh t, sh ou ld b e in te rp re te d w ith c au tio n du e to e xt re m e he ap in g of v al ue s fo r h ei gh t an d w ei gh t E ac h of th e in di ce s is e xp re ss ed in s ta nd ar d de vi at io n un its (S D ) f ro m th e m ed ia n of th e W H O C hi ld G ro w th S ta nd ar ds a do pt ed in 2 00 6. T he in di ce s in th is ta bl e ar e N O T co m pa ra bl e to th os e ba se d on th e pr ev io us ly u se d 19 77 N C H S /C D C /W H O R ef er en ce . 1 M IC S in di ca to r 2 .1 a an d M D G in di ca to r 1 .8 5 M IC S in di ca to r 2 .3 a, 6 M IC S in di ca to r 2 .3 b P er ce nt b el ow P er ce nt b el ow P er ce nt b el ow M ea n Z- S co re (S D ) St un te d M ea n Z- S co re (S D ) W as te d M ea n Z- S co re (S D ) Ta bl e N U .1 : N ut rit io na l s ta tu s of c hi ld re n P er ce nt ag e of c hi ld re n un de r a ge 5 b y nu tri tio na l s ta tu s ac co rd in g to th re e an th ro po m et ric in di ce s: w ei gh t f or a ge , h ei gh t f or a ge , a nd w ei gh t f or h ei gh t, La o P D R 2 01 1- 12 170 Children whose full birth date (month and year) were not obtained, and children whose measurements were outside a plausible range, are excluded from Table NU.1. Children were also excluded from one or more of the anthropometric indicators when their weight and/or height have not been measured, whichever is applicable. For example, children who have been weighed but not measured are included in underweight calculations, but not in the calculations for stunting and wasting. The percentages of children according to age and reasons for exclusion are shown in data quality tables DQ.6 and DQ.7. Incompleteness of date reporting is a reason for being excluded from analysis for only a trivial number of cases (0.1 per cent). In total, 97 per cent of children had both their weights and heights measured (Table DQ.7). Whether due to incomplete dates of birth, implausible measurements, or missing weight and/or height data, 2 per cent of children were excluded from calculations of the weight-for-age indicator, 4 per cent were excluded from the height-for-age indicator, and 4 per cent were excluded from the weight-for-height indicator. One in four children in Lao PDR under the age of five years is moderately underweight (27 per cent) and 7 per cent are severely underweight (Table NU.1). Almost one half of children (44 per cent) are moderately stunted (too short for their age) and 19 per cent are severely stunted. Six per cent of children are moderately wasted (too thin for their height), and 1 per cent are severely wasted. The highest rates of underweight (35 per cent) and wasting (8 per cent) is found among children in the Southern region. Children in the Northern and Southern regions exhibit a higher prevalence of stunting (51 per cent and 47 per cent, respectively) than children in the Central region (38 per cent). Occurrence of underweight children in urban and rural areas is also notably different (16 per cent and 29 per cent, respectively). High proportions of children are severely underweight in Phongsaly (16 per cent), Luangnamtha (17 per cent), Saravane (14 per cent) and Sekong (15 per cent) – all double the national prevalence of severe underweight. High proportions (more than one in four children) are severely stunted in Phongsaly (37 per cent), Luangnamtha (29 per cent), Oudomxay (28 per cent), Saravane (27 per cent) and Sekong (37 per cent). The prevalence of wasting is especially high in Luangnamtha, where one in five children are either moderately or severely wasted. .0 10.0 20.0 30.0 40.0 50.0 60.0 0 6 12 18 24 30 36 42 48 54 60 P er ce nt Age (in Months) Figure NU.1: Percentage of children under age 5 who are underweight, stunted and wasted, Lao PDR 2011-12 Age (in Months) Underweight Stunted Wasted 10 171 The percentage of children who are underweight and stunted increases dramatically and steadily with the decreasing education level of the mother; as many as 35 per cent of children whose mothers have no education are underweight and 58 per cent are stunted. Similarly, as many as 37 per cent of children from the poorest quintile are underweight and 61 per cent are stunted. Equal proportions of boys and girls are underweight, stunted and wasted. The proportion of underweight and stunted children in Chinese-Tibetan headed households is much higher than the national average (20 per cent severely underweight and 38 per cent severely stunted). The age pattern of malnutrition shows an increasing prevalence of underweight and stunted children, especially among those age 6-35 months (Figure NU.1). The percentage of children who are underweight and stunted tends to level out after 36 months of age. This age pattern for malnutrition might be related to low levels of knowledge of appropriate young child feeding practices. With increasing age, many children cease to be breastfed, and with the introduction of complementary foods, may be exposed to contaminants from water, food and the environment. Breastfeeding and Infant and Young Child Feeding Breast milk contains the perfect combination of proteins, carbohydrates and fats to enhance infant growth and brain development. It also contains antibodies to protect against infection, and thus can help reduce death from common childhood illnesses, including diarrhoea and pneumonia. It is free from contaminants, contains enough water to be sufficient in the hottest climates, costs nothing, and results in infants being less prone to diabetes, heart disease, eczema, asthma and allergic disorders. WHO and UNICEF recommend the following infant feeding practices: • Exclusive breastfeeding for the first six months • Continued breastfeeding for two years or more • Safe, appropriate and adequate complementary foods beginning at 6 months • Frequency of complementary feeding: twice per day for 6-8 month olds; three times per day for 9-11 month olds It is also recommended that breastfeeding be initiated within one hour of birth. The indicators related to recommended child feeding practices are as follows: • Ever breastfed • Early initiation of breastfeeding (within 1 hour of birth) • Exclusive breastfeeding (< 6 months) • Predominant breastfeeding (< 6 months) • Continued breastfeeding (at 1 year and at 2 years) • Duration of breastfeeding • Age-appropriate breastfeeding (0-23 months) • Introduction of solid, semi-solid or soft foods (6-8 months) • Minimum meal frequency (6-23 months) • Milk feeding frequency for non-breastfeeding children (6-23 months) • Bottle feeding (0-23 months) 10 172 Within one hour of birth2 Within one day of birth Region North 95.8 42.8 80.1 13.8 1,377 Central 96.0 36.1 65.7 43.9 1,989 South 94.6 39.7 66.6 40.6 940 Province Vientiane Capital 95.2 45.9 76.8 37.7 415 Phongsaly 96.9 60.4 86.1 14.1 148 Luangnamtha 96.1 35.3 88.5 13.3 99 Oudomxay 96.1 22.2 56.9 16.0 266 Bokeo 96.1 41.0 79.4 22.7 141 Luangprabang 95.4 44.9 81.0 19.8 280 Huaphanh 93.0 36.4 84.3 8.7 237 Xayabury 97.9 66.4 95.9 3.0 205 Xiengkhuang 95.9 58.9 78.0 7.3 200 Vientiane 98.1 51.3 87.7 24.7 295 Borikhamxay 97.4 23.8 91.0 48.5 162 Khammuane 94.0 30.0 48.3 69.5 233 Savannakhet 96.0 21.9 45.8 56.8 683 Saravane 95.2 54.5 74.3 23.9 361 Sekong 96.3 44.0 70.2 12.8 99 Champasack 92.8 23.3 57.9 58.4 397 Attapeu 98.6 48.7 69.8 61.4 83 Residence Urban 94.6 46.7 77.0 33.5 957 Rural 95.9 36.9 68.6 33.6 3,349 .Rural with road 96.0 37.7 69.5 32.5 2,928 .Rural without road 95.4 30.8 62.3 41.4 421 Months since last birth 0-11 months 96.4 39.4 69.4 34.2 2,170 12-23 months 96.9 39.3 73.1 33.7 2,004 Assistance at delivery Skilled attendant 96.3 48.1 78.6 32.8 1,789 Traditional birth attendant 97.3 32.2 61.3 54.2 513 Other 97.6 33.9 67.6 30.0 1,795 No one/Missing 68.9 22.9 48.7 20.9 209 Place of delivery Public sector health facility 96.2 48.7 78.9 31.3 1,578 Private sector health facility (100.0) (48.9) (77.0) (49.2) 37 Home 97.3 33.9 67.1 36.1 2,518 Other/Missing 66.1 23.7 42.3 14.0 173 Mother’s education None 96.2 31.1 63.2 33.6 1,248 Primary 95.3 37.8 69.7 34.8 1,763 Lower secondary 96.4 46.1 79.4 30.6 693 Upper secondary 92.4 49.0 75.1 35.2 334 Post secondary non tertiary 97.6 50.9 83.0 25.7 146 Higher 96.7 56.6 78.2 37.2 122 Wealth index quintile Poorest 95.7 32.0 64.9 29.7 1,178 Second 97.0 35.0 65.8 35.3 927 Middle 95.0 39.1 71.9 32.0 810 Fourth 95.6 46.3 77.5 37.2 707 Richest 94.4 49.1 77.5 36.1 684 Ethno-linguistic group of household head Lao-Tai 94.7 41.6 71.0 39.5 2,401 Mon-Khmer 96.6 33.7 63.4 32.7 1,213 Hmong-Mien 97.1 34.2 78.6 14.7 530 Chinese-Tibetan 96.6 54.6 88.3 9.3 140 Other, Missing, DK * * * * 21 Total 95.6 39.1 70.5 33.6 4,306 Table NU.2: Initial breastfeeding Percentage of last-born children in the 2 years preceding the survey who were ever breastfed, percentage who were breastfed within one hour of birth and within one day of birth, and percentage who received a prelacteal feed, Lao PDR 2011-12 1 MICS indicator 2.4 2 MICS indicator 2.5 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. Percentage who were first breastfed: Number of last-born children in the two years preceding the survey Percentage who were ever breastfed1 Percentage who received a prelacteal feed 10 173 Table NU.2 shows the percentage of children born in the two years preceding the survey who were ever breastfed, and the percentage who were first breastfed within one hour or within one day of birth. Early initiation of breastfeeding is a very important step in the management of lactation and the establishment of a physical and emotional relationship between the baby and the mother. Thirty- nine per cent of babies in Lao PDR are breastfed for the first time within one hour of birth, while 71 per cent start breastfeeding within one day of birth. These figures do not meet the recommendations for breastfeeding outlined above. The percentage of babies who breastfeed within one day of birth is especially low in Khammuane (48 per cent) and Savannakhet (46 per cent). About one half of babies delivered in a health facility are breastfed within the first hour of birth, compared to only one third of babies delivered at home. Only 3 in 10 babies born to a mother with no education or to mothers in the lowest wealth quintile are breastfed within the first hour of birth. The highest prevalence (55 per cent) of breastfeeding within the first hour of birth is found among children born to Chinese-Tibetan-headed households. Table NU.2 also presents the percentage of children born in the two years preceding the survey who received a prelacteal feed. A ‘prelacteal feed’ is any liquid feeding other than breast milk that is given to a baby before breastfeeding is established. WHO and UNICEF discourage the practice of prelacteal feeding as it may discourage the practice of breastfeeding. Women responding to the LSIS were asked whether their baby was given anything to drink other than breast milk within the first three days of being born. One third of babies are given a prelacteal feed. The practice is especially common in some provinces in central and southern Lao PDR, including Khammuane, Savannakhet, Champasack and Attapeu (over 50 per cent), but far less common in the North (14 per cent). The practice of providing prelacteal feeds does not vary across the educational or wealth status of the mother. Mothers who delivered with the assistance of a traditional birth attendant and mothers who delivered in a private sector health facility more commonly reported their babies receiving prelacteal feeds (54 and 49 per cent) than other mothers. 80 66 67 77 69 70 43 36 40 47 37 39 0 10 20 30 40 50 60 70 80 90 North Central South Urban Rural Lao PDR P er ce nt Figure NU.2: Percentage of mothers who started breastfeeding within one hour and within one day of birth, Lao PDR 2012 Within one day Within one hourWithin one day Within one hour 10 174 Table NU.3 presents the breastfeeding status of children age under two years, showing rates of exclusive and predominant breastfeeding during the first six months of life, and continued breastfeeding at 12-15 and 20-23 months. Breastfeeding status is based on reports given by mothers and caretakers of children’s consumption of food and fluids during the previous day (both day and night). Exclusive breastfeeding refers to infants who receive only breast milk and no other fluids or food (babies who receive ORS, vitamins, mineral supplements or medicine are still considered to be exclusively breastfed if they receive no liquid or food other than breast milk). Predominant breastfeeding refers to infants who receive breast milk as the predominant source of nourishment. Babies who receive certain fluids (water, water-based drinks, fruit juice, ritual fluids, ORS, drops, vitamins, minerals and medicines) in addition to breast milk are still considered to be predominantly breastfed if they do not receive anything else (such as non-human milk and food-based fluids). 10 175 Percent exclusively breastfed1 Percent predominantly breastfed2 Number of children Percent breastfed (Continued breastfeeding at 1 year)3 Number of children Percent breastfed (Continued breastfeeding at 2 years)4 Number of children Sex Male 38.8 66.7 574 73.5 381 43.0 336 Female 42.0 69.8 608 72.4 377 37.0 333 Region North 60.5 83.7 355 78.6 259 41.3 200 Central 32.9 65.7 557 67.1 341 34.2 316 South 29.7 53.4 270 76.5 159 50.3 152 Province Vientiane Capital 30.5 53.7 119 (58.9) 52 (15.6) 67 Phongsaly 59.7 80.9 38 (70.6) 27 (45.1) 23 Luangnamtha (73.8) (89.3) 25 (74.5) 21 (52.2) 16 Oudomxay 61.7 88.7 79 89.0 60 (51.1) 36 Bokeo 41.8 63.7 35 81.9 27 (54.0) 20 Luangprabang (45.0) (85.9) 56 (70.6) 45 (47.7) 41 Huaphanh 77.2 82.7 62 (82.2) 44 (35.4) 31 Xayabury 61.7 87.4 59 (72.3) 35 (13.1) 33 Xiengkhuang 73.8 87.8 59 (82.2) 33 (28.9) 31 Vientiane 56.0 83.4 76 58.2 65 (32.2) 48 Borikhamxay 45.0 76.7 45 (60.8) 30 (21.7) 29 Khammuane 13.4 47.0 58 77.2 45 (54.9) 33 Savannakhet 16.5 62.4 201 69.2 116 45.2 108 Saravane 28.0 53.3 102 74.5 57 69.1 66 Sekong 62.3 78.4 27 89.2 24 (58.2) 13 Champasack 20.1 44.4 111 (69.7) 63 (27.0) 63 Attapeu 42.5 65.1 29 (91.7) 16 (61.1) 10 Residence Urban 38.2 66.7 239 58.5 169 20.8 161 Rural 41.0 68.7 943 77.2 589 46.1 507 .Rural with road 42.4 68.2 839 77.1 526 44.6 450 .Rural without road 30.1 73.1 104 77.8 63 57.7 57 Mother’s education None 45.1 75.0 346 85.9 229 58.6 204 Primary 35.0 61.7 459 72.2 312 43.2 260 Lower secondary 44.4 72.4 212 66.1 115 19.8 99 Upper secondary 38.4 60.3 83 58.2 58 11.6 62 Post secondary non tertiary (40.6) (75.6) 40 (57.5) 31 * 22 Higher (45.6) (73.9) 41 * 13 * 20 Wealth index quintile Poorest 46.6 77.1 287 88.3 197 62.0 182 Second 39.7 67.0 273 84.0 165 45.5 124 Middle 41.8 66.5 239 69.4 146 39.3 140 Fourth 36.8 68.3 199 59.3 146 26.0 104 Richest 34.1 58.8 184 51.1 105 13.6 118 Ethno-linguistic group of household head Lao-Tai 33.0 61.0 653 61.8 411 27.2 377 Mon-Khmer 38.5 72.4 325 87.0 212 59.3 184 Hmong-Mien 68.0 85.2 166 88.6 105 48.8 78 Chinese-Tibetan 63.1 84.9 34 (74.9) 25 (75.0) 21 Other, Missing, DK * * 3 * 4 * 9 Total 40.4 68.3 1,182 73.0 758 40.0 668 Table NU.3: Breastfeeding Percentage of living children according to breastfeeding status at selected age groups, Lao PDR 2011-12 1 MICS indicator 2.6 3 MICS indicator 2.7 Children age 0-5 months Children age 12-15 months 4 MICS indicator 2.8 Children age 20-23 months 2 MICS indicator 2.9 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. 10 176 Forty per cent of children age less than six months are exclusively breastfed. While this level is considerably lower than recommended, it indicates wider practice of exclusive breastfeeding than in the recent past, when the 2006 MICS found that only 26 per cent of infants age 0-5 months were exclusively breastfed. The percentage of infants being exclusively breastfed is twice as high in the Northern (61 per cent) as in the Central and Southern regions. The percentage varies greatly by province, from a low of 13 per cent in Khammuane to a high of 77 per cent in Huaphanh. Nationally, nearly 7 in 10 infants (68 per cent) are being predominantly breastfed. At 12-15 months, 73 per cent of children are still being breastfed and at 20-23 months, 40 per cent are still breastfed. The prevalence of exclusive breastfeeding does not vary greatly by urban and rural residence or by mother’s education or wealth quintile. Figure NU.3 illustrates infant feeding patterns by the age of child in months. Even at the earliest ages, the majority of children are receiving liquid or food other than breast milk. By the end of the sixth month, the percentage of children exclusively breastfed is about 10 per cent. The figure shows food and liquid other than breast milk being introduced far too early, which is harmful to infants’ health. The median duration of exclusive breastfeeding is only 2.7 months (Table NU.4). The median duration of children receiving any breastfeeding is 20 months, and the median falls with rising education of the mother and rising wealth quintile. The median duration for children to be predominantly breastfed is 9 months. Figure NU.3: Infant feeding patterns by age, Lao PDR 2011-12 Percent Figure NU.3: Infant feeding patterns by age, Lao PDR 2011-12 90% 100% Percent Figure NU.3: Infant feeding patterns by age, Lao PDR 2011-12 Weaned (not breastfed) 90% 100% Weaned (not breastfed) 80% 90% B tf d d li t ( ) 70% 80% Breastfed and complimentary foods 60% 70% 80% Breastfed and complimentary foods 50% 60% 40% 50% 30% 40% 50% 20% 30% Exclusively breastfed10% 20% 30% Exclusively breastfed10% 20% Exclusively breastfed 0% 10% 0-1 2-3 4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-19 20-21 22-23 A 0% 0-1 2-3 4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-19 20-21 22-23 Age 0-1 2-3 4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-19 20-21 22-23 Age Exclusively breastfed Breastfed and plain water only Breastfed and non-milk liquidsExclusively breastfed Breastfed and plain water only Breastfed and non-milk liquids Breastfed and other milk / formula Breastfed and complimentary foods Weaned (not breastfed)Breastfed and other milk / formula Breastfed and complimentary foods Weaned (not breastfed) 10 177 Any breastfeeding1 Exclusive breastfeeding Predominant breastfeeding Sex Male 18.7 0.7 5.1 3,324 Female 18.9 1.4 4.9 3,317 Region North 20.4 3.6 7.2 2,084 Central 16.9 0.7 4.3 3,099 South 20.0 0.6 3.3 1,458 Province Vientiane Capital 14.4 0.7 2.8 639 Phongsaly 20.7 3.7 5.7 216 Luangnamtha 18.2 4.6 6.6 166 Oudomxay 22.0 3.5 19.2 419 Bokeo 22.5 1.1 5.3 204 Luangprabang 21.5 0.7 5.8 423 Huaphanh 20.0 5.0 11.5 353 Xayabury 17.1 3.9 6.7 303 Xiengkhuang 18.4 4.2 7.6 315 Vientiane 15.1 3.4 5.3 455 Borikhamxay 14.4 2.0 4.6 246 Khammuane 20.6 0.5 2.1 378 Savannakhet 20.4 0.5 5.1 1,068 Saravane 27.3 0.6 4.5 558 Sekong 23.4 3.7 7.6 151 Champasack 16.0 0.5 2.0 626 Attapeu 22.5 1.9 11.3 123 Residence Urban 15.1 0.8 4.1 1,434 Rural 20.5 1.1 5.3 5,207 .Rural with road 20.2 1.3 5.2 4,569 .Rural without road 21.8 0.6 7.2 638 Mother’s education None 23.4 2.0 8.2 2,020 Primary 19.3 0.7 4.1 2,729 Lower secondary 15.9 0.7 4.9 1,018 Upper secondary 14.7 1.6 3.5 475 Post secondary non tertiary 14.4 0.6 5.8 221 Higher 10.9 2.0 4.0 179 Wealth index quintile Poorest 23.5 2.1 8.2 1,869 Second 21.0 0.7 5.8 1,398 Middle 17.3 1.0 4.6 1,234 Fourth 14.8 0.7 4.5 1,118 Richest 13.8 0.7 3.2 1,022 Ethno-linguistic group of household head Lao-Tai 15.5 0.7 3.7 3,687 Mon-Khmer 22.8 0.7 6.6 1,864 Hmong-Mien 21.8 4.3 8.0 845 Chinese-Tibetan 26.5 3.9 6.5 217 Median 18.8 1.0 5.0 6,641 Mean for all children (0-35 months) 19.5 2.7 9.3 6,641 Table NU.4: Duration of breastfeeding Number of children age 0-35 months Median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding among children age 0- 35 months, Lao PDR 2011-12 1 MICS indicator 2.10 Median duration (in months) of 10 178 The percentage of children under 24 months being breastfed in an age-appropriate manner is shown in Table NU.5. The criteria for determining whether or not a child is receiving age-appropriate breastfeeding varies according to the age of the child. For infants age 0-5 months, exclusive breastfeeding is considered to be age-appropriate feeding. Infants age 6-23 months are considered to be appropriately breastfed if they are receiving breast milk and solid, semi-solid or soft food. Forty per cent of children age 0-5 months are being exclusively breastfed, and 35 per cent of children age 6-23 months are breastfeeding and receiving solid, semi-solid or soft foods. As a result of these feeding patterns, only 37 per cent of children age 0-23 months are being breastfed age-appropriately. 10 179 Percent exclusively breastfed1 Number of children Percent currently breastfeeding and receiving solid, semi-solid or soft foods Number of children Percent appropriately breastfed2 Number of children Sex Male 38.8 574 33.6 1,673 34.9 2,246 Female 42.0 608 37.2 1,594 38.6 2,202 Region North 60.5 355 35.0 1,041 41.4 1,396 Central 32.9 557 34.9 1,521 34.3 2,078 South 29.7 270 37.1 705 35.1 974 Province Vientiane Capital 30.5 119 23.0 305 25.1 424 Phongsaly 59.7 38 38.7 106 44.3 144 Luangnamtha (73.8) 25 46.4 73 53.4 99 Oudomxay 61.7 79 25.2 205 35.4 284 Bokeo 41.8 35 43.8 110 43.3 145 Luangprabang (45.0) 56 44.0 222 44.2 278 Huaphanh 77.2 62 27.3 174 40.4 236 Xayabury 61.7 59 29.1 151 38.3 210 Xiengkhuang 73.8 59 30.5 156 42.3 215 Vientiane 56.0 76 47.6 246 49.6 322 Borikhamxay 45.0 45 42.6 126 43.2 171 Khammuane 13.4 58 57.9 191 47.5 249 Savannakhet 16.5 201 26.5 496 23.6 697 Saravane 28.0 102 48.6 263 42.9 365 Sekong 62.3 27 27.1 74 36.5 101 Champasack 20.1 111 31.5 314 28.5 425 Attapeu 42.5 29 27.3 54 32.6 83 Residence Urban 38.2 239 26.7 776 29.4 1,015 Rural 41.0 943 38.1 2,491 38.9 3,434 .Rural with road 42.4 839 38.8 2,182 39.8 3,021 .Rural without road 30.1 104 33.1 309 32.3 413 Mother’s education None 45.1 346 38.3 960 40.1 1,306 Primary 35.0 459 36.4 1,350 36.0 1,809 Lower secondary 44.4 212 35.0 496 37.8 708 Upper secondary 38.4 83 29.8 259 31.9 342 Post secondary non tertiary (40.6) 40 22.4 113 27.2 153 Higher (45.6) 41 24.4 88 31.1 129 Wealth index quintile Poorest 46.6 287 38.7 895 40.6 1,182 Second 39.7 273 41.3 665 40.8 938 Middle 41.8 239 36.9 606 38.3 845 Fourth 36.8 199 29.0 570 31.1 769 Richest 34.1 184 27.5 531 29.2 715 Ethno-linguistic group of household head Lao-Tai 33.0 653 31.7 1,847 32.0 2,500 Mon-Khmer 38.5 325 40.0 890 39.6 1,215 Hmong-Mien 68.0 166 39.4 408 47.6 574 Chinese-Tibetan 63.1 34 47.2 100 51.2 134 Other, Missing, DK * 3 * 21 (38.8) 25 Total 40.4 1,182 35.4 3,266 36.7 4,448 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 NU.5: Age-appropriate breastfeeding 2 MICS indicator 2.14 Children age 0-5 months Children age 6-23 months Children age 0-23 months Percentage of children age 0-23 months who were appropriately breastfed during the previous day, Lao PDR 2011-12 1 MICS indicator 2.6 10 180 Continued breastfeeding beyond six months of age should be accompanied by the consumption of nutritionally adequate, safe and appropriate complementary foods that help meet nutritional requirements when breast milk is no longer sufficient. Solid, semi-solid, or soft foods should be introduced at 6-8 months. Overall, 52 per cent of infants age 6-8 are receiving solid, semi-solid, or soft food (Table NU.6). Fifty per cent of breastfeeding infants are receiving solid, semi-solid, or soft food, while 72 per cent of infants who are not breastfeeding are receiving such food. The findings indicate that recommended feeding practices are not being followed. Some infants age 6-8 months are being introduced to complementary food too late, and some are stopping breastfeeding too early. With half of all 6-8 month-old infants not being fed age-appropriately, all communities could benefit from infant and young child feeding (IYCF) interventions. IYCF training should include demonstrations of food preparation targeted at health staff and caregivers in the community. Minimum standards for the number of times a child should receive solid, semi-solid or soft food vary depending on the child’s age and whether or not the child is still breastfeeding. Currently, breastfeeding children age 6-8 months are considered as meeting the minimum meal frequency standard if, in addition to breast milk, they also receive solid, semi-solid, or soft food two or more times a day. Currently, breastfeeding children age 9-23 months are considered to meet the minimum mean frequency if, in addition to breast milk, they also receive solid, semi-solid, or soft food three or more times per day. Non-breastfeeding children age 6-23 months are considered to meet the minimum meal frequency if they receive solid, semi-solid, or soft food or milk feeds at least four times per day. Table NU.7 presents the percentage of children age 6-23 months who received solid, semi-solid, or soft food (or milk feeds among those not breastfeeding) the minimum number of times or more during the day or night preceding the interview, according to breastfeeding status. Forty-three per cent of children age 6-23 months are receiving at least the minimum number of feedings per day. The same proportion of girls and boys (43 per cent) achieve the minimum meal frequency. The proportion achieving minimum meal frequency is drastically low (below 15 per cent) in Oudomxay, Huaphanh and Sekong. The percentage of children reaching minimum meal frequency is greater among those not breastfeeding (56 per cent) than among those who are currently breastfeeding (37 per cent). Percent receiving solid, semi-solid or soft foods Number of children age 6- 8 months Percent receiving solid, semi-solid or soft foods Number of children age 6-8 months Percent receiving solid, semi-solid or soft foods1 Number of children age 6- 8 months Sex Male 46.1 269 (70.6) 34 48.9 303 Female 54.2 204 (72.9) 31 56.6 235 Region North 41.2 161 * 13 44.0 174 Central 55.7 198 (71.4) 37 58.2 235 South 50.9 115 * 14 52.6 129 Residence Urban 45.9 77 (70.2) 34 53.3 111 Rural 50.3 396 (73.4) 31 52.0 427 .Rural with road 52.8 344 * 24 53.7 367 .Rural without road 34.2 53 * 7 41.6 59 Total 49.6 473 71.7 65 52.3 538 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 NU.6: Introduction of solid, semi-solid or soft foods 1 MICS indicator 2.12 Currently breastfeeding Currently not breastfeeding All Percentage of infants age 6-8 months who received solid, semi-solid or soft foods during the previous day, Lao PDR 2011-12 10 181 Sex Male 36.5 1,127 50.5 56.8 546 43.1 1,673 Female 36.7 1,061 51.9 54.9 533 42.8 1,594 Age 6-8 months 43.9 473 91.7 85.3 65 48.9 538 9-11 months 33.0 498 82.7 80.7 89 40.2 587 12-17 months 32.5 776 56.5 60.0 341 40.9 1,117 18-23 months 39.9 440 38.7 46.5 584 43.6 1,024 Region North 28.3 773 32.8 39.0 268 31.1 1,041 Central 39.2 932 59.8 61.7 589 47.9 1,521 South 44.7 483 50.3 61.0 222 49.8 705 Province Vientiane Capital 28.0 142 84.4 75.3 164 53.4 305 Phongsaly 40.0 79 (18.0) (38.1) 27 39.5 106 Luangnamtha 48.7 51 (39.2) (44.5) 22 47.4 73 Oudomxay 8.9 171 (14.8) (9.5) 34 9.0 205 Bokeo 35.4 84 (40.6) (56.9) 26 40.4 110 Luangprabang 46.0 163 38.6 48.6 59 46.7 222 Huaphanh 10.9 128 16.1 17.5 45 12.6 174 Xayabury 29.7 96 52.1 54.0 56 38.7 151 Xiengkhuang 29.8 105 22.2 44.3 51 34.5 156 Vientiane 55.2 145 55.6 68.5 101 60.6 246 Borikhamxay 62.3 61 45.8 64.4 65 63.4 126 Khammuane 62.6 136 61.2 61.0 54 62.1 191 Savannakhet 26.5 342 54.3 47.6 154 33.0 496 Saravane 53.7 201 28.8 45.6 61 51.8 263 Sekong 9.4 59 (33.7) (21.1) 15 11.7 74 Champasack 49.9 179 61.6 74.0 135 60.3 314 Attapeu 29.4 43 (55.1) (41.0) 11 31.9 54 Residence Urban 34.7 381 76.0 70.4 395 52.9 776 Rural 37.0 1,806 36.8 47.5 685 39.9 2,491 .Rural with road 38.0 1,564 36.8 48.2 618 40.9 2,182 .Rural without road 30.5 242 37.3 40.6 66 32.6 309 Mother’s education None 32.4 774 31.0 34.9 186 32.9 960 Primary 37.9 917 42.5 52.8 433 42.7 1,350 Lower secondary 44.2 289 56.9 56.8 207 49.5 496 Upper secondary 35.9 122 72.5 76.2 138 57.3 259 Post secondary non tertiary (27.0) 50 68.3 71.3 63 51.6 113 Higher (47.5) 35 (95.2) (80.4) 52 67.1 88 Wealth index quintile Poorest 31.1 752 11.4 22.8 143 29.8 895 Second 39.3 510 23.6 32.4 155 37.7 665 Middle 38.5 393 40.8 47.5 213 41.7 606 Fourth 41.7 296 59.1 66.8 275 53.8 570 Richest 38.2 237 85.3 80.3 293 61.5 531 Ethno-linguistic group of household head Lao-Tai 41.3 1,034 60.9 63.4 813 51.0 1,847 Mon-Khmer 33.3 735 17.6 27.9 155 32.4 890 Hmong-Mien 28.3 326 21.5 35.7 82 29.8 408 Chinese-Tibetan 39.8 81 (23.9) (41.8) 19 40.2 100 Other, Missing, DK * 11 * * 10 * 21 Total 36.6 2,187 51.2 55.9 1,079 43.0 3,266 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. 1 MICS indicator 2.15 Among currently breastfeeding children age 6-8 months, minimum meal frequency is defined as children who also received solid, semi-solid or soft foods 2 times or more. Among currently breastfeeding children age 9-23 months, receipt of solid, semi-solid or soft foods at least 3 times constitutes minimum meal frequency. For non- breastfeeding children age 6-23 months, minimum meal frequency is defined as children receiving solid, semi-solid or soft foods, and milk feeds, at least 4 times during the previous day. 2 MICS indicator 2.13 Table NU.7: Minimum meal frequency Number of children age 6-23 months Percent with minimum meal frequency2 Number of children age 6- 23 months Percentage of children age 6-23 months who received solid, semi-solid, or soft foods (and milk feeds for non-breastfeeding children) the minimum number of times or more during the previous day, according to breastfeeding status, Lao PDR 2011-12 Percent receiving solid, semi-solid and soft foods the minimum number of times Currently breastfeeding Number of children age 6- 23 months All Percent receiving solid, semi-solid and soft foods or milk feeds 4 times or more Currently not breastfeeding Percent receiving at least 2 milk feeds1 10 182 Minimum meal frequency among non-breastfed children is more common among urban children (70 per cent) than among rural children (48 per cent). The workload of rural women is substantial, including rice cultivation and the gathering of forest products, firewood and water. During the heaviest work seasons, women may be away from the home for up to 10 hours at a time. At such times, multiple feeding of complementary foods would be virtually impossible without the cooperation of other household members. In rural areas, women traditionally raise the children, so increasing male responsibility in the care and feeding of infants and young children may be an appropriate way to distribute the heavy workload carried by many rural women. The percentage of non-breastfed children achieving minimum mean frequency declines steadily and sharply by the education level and wealth quintile of the mother. As few as 23 per cent of the poorest children who are not being breastfed are able to receive the minimum number of daily feedings. The percentage of 6-23 month-olds achieving minimal meal frequency is lower among the Mon-Khmer (32 per cent) and Hmong-Mien (30 per cent) than among the Chinese-Tibetan (40 per cent) and Lao-Tai (51 per cent). The practice of bottle-feeding is of concern due to possible contamination from unsafe water and potential lack of hygiene in preparation. Table NU.8 shows that bottle-feeding is still prevalent in Lao PDR. One in 10 children under 6 months of age is fed using a bottle with a teat. The proportion increases with age, resulting in nearly 2 in 10 children (18 per cent) age 0-23 months being fed using a bottle with a teat. The highest prevalence of bottle-feeding is seen among children of mothers with the highest levels of education and in the highest wealth quintiles, where nearly half of children are using a bottle with a teat. The use of a bottle declines steadily with decreasing education and decreasing wealth quintile. Appropriate, relevant information should be directed towards informing women who may be unaware of the dangers affiliated with the incorrect use of a bottle with a teat. Percentage of children age 0-23 months fed with a bottle with a teat1 Number of children age 0- 23 months Percentage of children age 0-23 months fed with a bottle with a teat1 Number of children age 0- 23 months Sex Residence Male 17.4 2,246 Urban 33.9 1,015 Female 17.5 2,202 Rural 12.6 3,434 Age .Rural with road 12.9 3,021 0-5 months 11.3 1,182 .Rural without road 10.4 413 6-11 months 23.6 1,125 Mother’s education 12-23 months 17.6 2,141 None 5.4 1,306 Region Primary 15.6 1,809 North 10.7 1,396 Lower secondary 24.7 708 Central 21.4 2,078 Upper secondary 37.3 342 South 18.7 974 Post secondary non tertiary 38.2 153 Province Higher 47.7 129 Vientiane Capital 48.9 424 Wealth index quintile Phongsaly 5.3 144 Poorest 4.5 1,182 Luangnamtha 9.7 99 Second 7.7 938 Oudomxay 2.3 284 Middle 15.7 845 Bokeo 14.4 145 Fourth 25.2 769 Luangprabang 18.0 278 Richest 45.5 715 Huaphanh 4.7 236 Ethno-linguistic group of household head Xayabury 20.6 210 Lao-Tai 26.3 2,500 Xiengkhuang 5.0 215 Mon-Khmer 6.0 1,215 Vientiane 26.9 322 Hmong-Mien 5.7 574 Borikhamxay 13.1 171 Chinese-Tibetan 5.0 134 Khammuane 13.8 249 Other, Missing, DK (25.4) 25 Savannakhet 12.0 697 Saravane 9.6 365 Total 17.5 4,448 Sekong 7.0 101 Champasack 31.0 425 Attapeu 10.4 83 1 MICS indicator 2.11 Note: Figures in parentheses are based on 25-49 unweighted cases. Table NU.8: Bottle feeding Percentage of children age 0-23 months who were fed with a bottle with a teat during the previous day, Lao PDR 2011-12 10 183 Salt Iodization Iodine Deficiency Disorders (IDDs) are the world’s leading cause of preventable mental retardation and impaired psychomotor development in young children. In its most extreme form, iodine deficiency causes cretinism. It also increases the risks of stillbirth and miscarriage in pregnant women. Iodine deficiency is most commonly and visibly associated with goitre. IDD takes its greatest toll in impaired mental growth and development, contributing in turn to poor school performance, reduced intellectual ability and impaired work performance. The international goal2 was to achieve sustainable elimination of iodine deficiency by 2005. The relevant indicator is the percentage of households consuming adequately iodized salt (>15 parts per million). However, the LSIS did not categorize test result by parts per million, but rather determined the presence or absence of a colour change in a test kit, indicating whether the salt was iodized or not. The Lao government established an IDD control programme using increased iodine intake through Universal Salt Iodisation (USI) as its main strategy. In 1995, the Prime Minister issued a decree number 42 requiring that all salt, locally produced or sold on the market, be iodized. 2 The recommendation is based on the declaration at the UN General Assembly Special Session in 2002 that set the goal of sustainable elimination of IDD by 2005 (Sustainable Elimination of Iodine Deficiency , UNICEF, 2008) 10 184 Percent distribution of households by consumption of iodized salt, Lao PDR 2011-12 Not iodized Iodized Total Region North 99.2 6,065 0.2 17.4 82.4 100.0 6,028 Central 97.9 9,247 1.2 19.1 79.7 100.0 9,167 South 95.8 3,531 2.8 23.1 74.1 100.0 3,479 Province Vientiane Capital 97.5 2,497 1.3 9.5 89.2 100.0 2,467 Phongsaly 98.6 578 0.0 8.7 91.3 100.0 570 Luangnamtha 99.7 544 0.1 0.7 99.2 100.0 543 Oudomxay 99.8 913 0.0 5.4 94.6 100.0 912 Bokeo 98.6 520 1.3 11.5 87.2 100.0 519 Luangprabang 98.7 1,371 0.2 4.6 95.2 100.0 1,356 Huaphanh 99.7 869 0.0 78.1 21.9 100.0 867 Xayabury 99.3 1,269 0.1 11.6 88.3 100.0 1,261 Xiengkhuang 99.0 762 0.6 52.8 46.6 100.0 759 Vientiane 98.4 1,447 0.5 23.2 76.3 100.0 1,431 Borikhamxay 99.5 804 0.5 6.2 93.4 100.0 803 Khammuane 98.0 1,078 1.9 22.1 76.0 100.0 1,076 Savannakhet 97.3 2,659 1.7 19.0 79.4 100.0 2,631 Saravane 96.6 1,123 3.0 13.9 83.1 100.0 1,118 Sekong 97.3 283 2.4 25.7 72.0 100.0 282 Champasack 94.8 1,789 3.0 29.5 67.5 100.0 1,749 Attapeu 97.6 336 0.9 18.0 81.0 100.0 331 Residence Urban 98.1 5,177 1.0 12.4 86.6 100.0 5,133 Rural 97.9 13,666 1.2 21.9 76.9 100.0 13,541 .Rural with road 98.0 12,285 1.2 22.2 76.6 100.0 12,187 .Rural without road 96.5 1,380 1.7 19.3 79.0 100.0 1,354 Wealth index quintile Poorest 98.0 3,585 1.5 22.3 76.2 100.0 3,566 Second 97.7 3,533 1.4 22.9 75.7 100.0 3,501 Middle 98.1 3,743 1.0 21.1 77.9 100.0 3,712 Fourth 97.9 3,962 1.2 18.7 80.2 100.0 3,922 Richest 98.0 4,019 0.8 12.4 86.8 100.0 3,973 Ethno-linguistic group of household head Lao-Tai 97.8 12,721 1.4 19.0 79.7 100.0 12,606 Mon-Khmer 98.0 4,140 1.0 16.5 82.4 100.0 4,099 Hmong-Mien 99.4 1,287 0.1 38.5 61.4 100.0 1,281 Chinese-Tibetan 98.8 579 0.0 6.0 94.0 100.0 572 Other, Missing, DK 96.9 117 2.5 6.7 90.8 100.0 116 Total 97.9 18,843 1.2 19.3 79.5 100.0 18,674 Percent of households with No salt Table NU.9: Iodized salt consumption Salt test result Number of households in which salt was tested or with no salt Percentage of households in which salt was tested Number of households Table NU.9 presents the percentage of households with using iodized salt. Nationally, interviewers tested the salt used for cooking in 98 per cent of LSIS households. The salt was tested for the presence or absence of potassium iodate by using rapid test kits. One per cent of households were reported to have no salt available. Salt was found to be iodized in 80 per cent of households. The 2006 MICS found 84 per cent of households to have iodized salt. The use of iodized salt is less common in the Southern (74 per cent) than in the Central (80 per cent) and Northern (82 per cent) regions (Figure NU.4). The presence of iodized salt is drastically low among households in Huaphanh (only 22 per cent) and Xiengkhuang (47 per cent). Overall, a higher percentage of urban households have use iodized salt (87 per cent) than do rural households (77 per cent), but there is not much difference between households in rural areas with roads (77 per cent) and 10 185 households in rural areas without roads (79 per cent). The presence of iodized salt does not vary much by wealth quintile, with the exception of iodized salt being more common in the richest households (87 per cent). Only 6 in 10 Hmong-Mien-headed households were found to have iodized salt. The goal of eliminating iodine deficiency is considered attainable when more than 90 per cent of households are using adequately iodized salt. Thus, LSIS results indicate that further work is needed to promote the use of iodized salt. Some of the obstacles to achieving universal use of iodized salt include small factories in the country that produce non-iodized salt and the importation of non-iodized salt. Note that iodized salt tends to lose its iodine content over time (Diosady et. al., 1998), so qualities of preservation of iodized salt will also be reflected in the results. Field teams reported that test kits did not always produce uniform results. One test kit may have produced no colour change (indicating that salt is not iodized), while another of the same type of test kit (made by the same manufacturer) would produce a colour change on the same sample of salt (indicating the salt is iodized). It is unclear how variability across test kits may have affected the final results of the testing. Children’s Vitamin A Supplementation Vitamin A is essential for eye health and proper functioning of the immune system. It is found in food such as milk, liver, eggs, red and orange fruit, red palm oil and green leafy vegetables, although the amount of vitamin A readily available to the body from these sources varies widely. In developing areas of the world, where vitamin A is largely consumed in the form of fruit and vegetables, daily per capita intake is often insufficient to meet dietary requirements. Inadequate intake is further compromised by increased requirements for vitamin A as children grow, increased requirements during periods of illness, and increased losses during common childhood infections. As a result, vitamin A deficiency is quite prevalent in the developing world, particularly in countries with the highest burden of child mortality. 82 80 74 87 77 80 0 10 20 30 40 50 60 70 80 90 100 P er ce nt Figure NU.4: Percentage of households consuming iodized salt, Lao PDR 2011-12 10 186 The 1990 World Summit for Children set the goal of virtual elimination of vitamin A deficiency and its consequences, including blindness, by the year 2000. This goal was also endorsed at the Policy Conference on Ending Hidden Hunger in 1991, the 1992 International Conference on Nutrition, and the UN General Assembly’s Special Session on Children in 2002. The critical role of vitamin A for child health and immune function also makes control of deficiency a primary component of child survival efforts, and therefore critical to the achievement of the fourth Millennium Development Goal: a two- thirds reduction in under-five mortality by the year 2015. For countries with vitamin A deficiency problems, current international recommendations call for high-dose vitamin A supplementation every four to six months, targeted at all children between the ages of six to 59 months living in affected areas. Providing young children with two high-dose vitamin A capsules a year is a safe, cost-effective, efficient strategy for eliminating vitamin A deficiency and improving child survival. Giving vitamin A to new mothers who are breastfeeding also helps protect their children during the first months of life and helps to replenish the mother’s stores of vitamin A, which are depleted during pregnancy and lactation. In countries with vitamin A supplementation programmes, the relevant indicator is: the percentage of children 6-59 months of age receiving at least one high dose vitamin A supplement in the last six months. Based on UNICEF/WHO guidelines, the Lao PDR Ministry of Health recommends that children age 6-11 months be given one high dose vitamin A capsule, and children age 12-59 months be given a vitamin A capsule every 6 months. In some parts of the country, vitamin A capsules are given when children (age 6-59 months) have contact with health providers for immunization. It is also recommended that mothers take a vitamin A supplement within six weeks of giving birth, due to increased vitamin A requirements during pregnancy and lactation. Normally, vitamin A campaigns are conducted twice a year. LSIS interviewers collected data on vitamin A coverage in two ways. First, mothers and caretakers were asked to present children’s vaccinations cards. If the card indicated that the child had received vitamin A, the date of the most recent vitamin A supplementation was recorded in the questionnaire. Mothers and caretakers were also asked whether the child had received a vitamin A dose within the six months prior to the survey, and were shown a sample vitamin A dose. Table NU.10 presents the percentage of children age 6-59 months who received a vitamin A high dose within the six months prior to the survey. According to data from vaccinations cards, only 4 per cent of children received vitamin A supplementation in the 6 months prior to the survey. Fifty-nine per cent of mothers and caretakers asked reported that the children under their care had been given a high dose of vitamin A in the 6 months prior to the survey. This is much higher than the 18 per cent reported in the 2006 MICS, which also collected data on coverage from both cards and caretaker reports. However, caretakers responding to the MICS were requested to specify how long prior to the survey was the most recent dose given, while the LSIS asked whether a dose was given in the previous 6 months (yes/no question). Conversely, the 59 per cent coverage reported in the LSIS is lower than levels reported in provincial administrative records, which estimate 90 per cent coverage among children age 6-59 months. Vitamin A supplementation coverage is lower in the Central region (51 per cent) than in the Northern and Southern (66 and 67 per cent, respectively), while urban and rural respondents reported equal coverage. The proportion of children reported to have received a vitamin A supplement is especially low in Savannakhet (32 per cent). The percentage of children receiving vitamin A supplementation rises steadily with mother’s level of education. The percentage receiving a supplement in the previous six months increases from 49 per cent among children whose mothers have no education to 61 per cent of those whose mothers have primary education, and 73 per cent among children of mothers with upper secondary or higher education. 10 187 Vaccination card or mother's handbook Mother's report Sex Male 3.5 58.8 59.3 5,019 Female 3.5 58.7 58.9 4,866 Region North 4.5 66.0 66.3 3,147 Central 3.7 50.1 50.6 4,597 South 1.5 66.8 66.9 2,141 Province Vientiane Capital 8.4 59.0 60.0 939 Phongsaly 0.7 48.4 48.4 330 Luangnamtha 3.5 80.5 80.9 255 Oudomxay 4.3 53.2 54.0 596 Bokeo 3.9 72.8 73.3 300 Luangprabang 2.5 74.8 75.0 696 Huaphanh 5.0 51.7 51.9 544 Xayabury 11.4 87.9 88.1 426 Xiengkhuang 1.9 52.5 52.9 481 Vientiane 5.9 63.6 64.2 691 Borikhamxay 0.7 48.1 48.1 357 Khammuane 3.0 70.0 70.5 545 Savannakhet 1.4 31.6 32.0 1,583 Saravane 2.4 81.3 81.4 821 Sekong 0.3 39.7 40.0 242 Champasack 1.2 64.3 64.3 892 Attapeu 0.9 50.2 50.4 186 Residence Urban 6.2 60.7 61.5 2,080 Rural 2.8 58.2 58.5 7,805 .Rural with road 3.0 59.6 59.8 6,822 .Rural without road 1.0 49.0 49.1 982 Age 6-11 months 9.4 43.6 45.3 1,125 12-23 months 5.9 58.2 58.7 2,141 24-35 months 2.8 61.2 61.4 2,193 36-47 months 1.5 62.5 62.5 2,302 48-59 months 0.8 60.7 60.8 2,124 Mother’s education None 1.4 48.5 48.6 3,234 Primary 3.4 60.9 61.3 4,097 Lower secondary 4.9 64.9 65.7 1,401 Upper secondary 7.3 72.7 72.9 612 Post secondary non 7.3 71.8 72.8 328 Higher 10.7 72.1 72.7 214 Wealth index quintile Poorest 1.5 50.5 50.6 2,946 Second 2.1 56.9 57.1 2,073 Middle 3.7 60.6 61.0 1,780 Fourth 5.5 66.2 66.9 1,608 Richest 6.8 67.5 68.2 1,479 Ethno-linguistic group of household head Lao-Tai 4.9 64.4 64.9 5,377 Mon-Khmer 2.0 55.5 55.7 2,863 Hmong-Mien 1.2 42.0 42.0 1,273 Chinese-Tibetan 2.0 60.7 60.9 323 Other, Missing, DK (6.3) (58.7) (58.7) 49 Total 3.5 58.8 59.1 9,885 Note: Figures in parentheses are based on 25-49 unweighted cases. Table NU.10: Children's vitamin A supplementation Percentage of children age 6-59 months receiving a high dose vitamin A supplement in the last 6 months, Lao PDR 2011-12 Percentage of children who received Vitamin A in the last 6 months1 Number of children age 6- 59 months 1 MICS indicator 2.17 Percentage who received Vitamin A in the last 6 months according to: 10 188 Low Birth Weight Weight at birth is a good indicator not only of a mother’s health and nutritional status but also the newborn’s chances for survival, growth, long-term health and psychosocial development. Low birth weight (less than 2,500 grams) carries a range of grave health risks for children. Babies who were undernourished in the womb face a greatly increased risk of dying during their early months and years. Those who survive have impaired immune function and increased risk of disease; they are likely to remain undernourished, with reduced muscle strength, throughout their lives, and suffer a higher incidence of diabetes and heart disease in later life. Children born underweight also tend to have a lower IQ and cognitive disabilities, affecting their performance in school and their job opportunities as adults. In the developing world, low birth weight stems primarily from the mother’s poor health and nutrition. Three factors have most impact: the mother’s poor nutritional status before conception; short stature (due mostly to under nutrition and infections during the mother’s childhood); and poor nutrition during pregnancy. Inadequate weight gain during pregnancy is particularly important since it accounts for a large proportion of foetal growth retardation. Moreover, diseases such as diarrhoea and malaria, which are common in many developing countries, can significantly impair foetal growth if the mother becomes infected while pregnant. In the industrialized world, cigarette smoking during pregnancy is the leading cause of low birth weight. In developed and developing countries alike, teenagers who give birth when their own bodies have yet to finish growing run the risk of bearing underweight babies. One of the major challenges in measuring the incidence of low birth weight is the fact that more than half of infants in the developing world are not weighed. In the past, most estimates of low birth weight for developing countries were based on data compiled from health facilities. However, these estimates are biased for most developing countries because the majority of newborns are not delivered in health facilities, and those who are represent only a selected sample of all births. Because many infants are not weighed at birth and those who are weighed may be a biased sample of all births, the reported birth weights usually cannot be used to estimate the prevalence of low birth weight among all children. Therefore, the percentage of newborns weighing below 2,500 grams is estimated from two items in the questionnaire: the mother’s assessment of the child’s size at birth (i.e., very small, smaller than average, average, larger than average, very large); and the mother’s recall of the child’s weight or the weight as recorded on a health card if the child was weighed at birth.3 3 For a detailed description of the methodology, see Boerma, J. T., Weinstein, K. I., Rutstein, S.O., and Sommer- felt, A. E., 1996. Data on Birth Weight in Developing Countries: Can Surveys Help? Bulletin of the World Health Organization, 74(2), 209-16. 10 189 Below 2500 grams1 Weighed at birth2 Region North 13.0 33.2 1,377 Central 13.9 55.8 1,989 South 19.6 28.0 940 Province Vientiane Capital 12.6 91.9 415 Phongsaly 6.5 18.6 148 Luangnamtha 12.5 46.2 99 Oudomxay 10.2 21.5 266 Bokeo 19.3 33.8 141 Luangprabang 19.4 38.7 280 Huaphanh 11.3 29.3 237 Xayabury 10.2 49.6 205 Xiengkhuang 18.5 37.2 200 Vientiane 9.0 64.3 295 Borikhamxay 9.9 60.5 162 Khammuane 22.0 37.8 233 Savannakhet 13.5 40.6 683 Saravane 22.8 29.7 361 Sekong 12.8 20.8 99 Champasack 18.2 30.3 397 Attapeu 20.5 17.7 83 Residence Urban 12.2 80.2 957 Rural 15.6 31.7 3,349 .Rural with road 15.5 34.5 2,928 .Rural without road 15.8 12.1 421 Mother’s education None 17.3 14.4 1,248 Primary 14.6 37.9 1,763 Lower secondary 14.1 64.7 693 Upper secondary 11.3 85.8 334 Post secondary non tertiary 11.5 92.1 146 Higher 10.3 92.8 122 Wealth index quintile Poorest 18.2 10.7 1,178 Second 15.2 23.9 927 Middle 14.0 45.4 810 Fourth 13.0 66.3 707 Richest 11.5 94.4 684 Ethno-linguistic group of household head Lao-Tai 13.9 60.6 2,401 Mon-Khmer 18.1 19.1 1,213 Hmong-Mien 13.1 19.4 530 Chinese-Tibetan 7.8 18.2 140 Other, Missing, DK * * 21 Total 14.8 42.5 4,306 Table NU.11: Low birth weight infants Percentage of last-born children in the 2 years preceding the survey that are estimated to have weighed below 2500 grams at birth and percentage of last-born children weighed at birth, Lao PDR 2011-12 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Percent of last-born children: Number of last- born children in the last 2 years 1 MICS indicator 2.18 2 MICS indicator 2.19 10 190 Forty-three per cent of babies were weighed at birth and 15 per cent of infants are estimated to weigh less than 2,500 grams at birth (Table NU.11). Twenty per cent of babies in the South have low birth weight, compared with 13 and 14 per cent in the Northern and Central regions, respectively (Figure NU.5). The higher percentage in the South may be the result of food insecurity brought on by the flooding of Typhoon Ketsana in that part of the country. However, the percentage of low birth weight does not vary much by urban and rural areas (12 and 16 per cent, respectively). The prevalence of low birth weight children decreases steadily with increases in mothers’ education levels and increasing wealth quintile. Seventeen per cent of babies born to mothers with no education are of low birth weight, while 10 per cent of babies born to mothers with higher education are of low birth weight. 13 14 20 12 16 15 0 5 10 15 20 25 North Central South Urban Rural Lao PDR P er ce nt Figure NU.5: Percentage of infants weighing less than 2500 grams at birth, Lao PDR 2011-12 0 North Central South Urban Rural Lao PDR 10 191 10 O ve rw ei gh t P er ce nt a bo ve - 2 S D - 3 S D - 2 S D - 3 S D - 2 S D - 3 S D + 2 S D Se x M al e 32 .1 6. 3 -1 .4 5, 48 1 38 .6 15 .3 -1 .6 5, 34 8 5. 3 0. 6 1. 2 -0 .6 5, 36 0 Fe m al e 32 .6 7. 3 -1 .4 5, 34 5 37 .4 14 .2 -1 .6 5, 23 9 5. 4 0. 7 1. 6 -0 .6 5, 21 6 R eg io n N or th 32 .0 7. 1 -1 .5 3, 45 7 44 .7 17 .8 -1 .8 3, 38 0 4. 5 0. 8 1. 6 -0 .4 3, 38 0 C en tra l 28 .9 5. 5 -1 .3 5, 02 8 32 .3 12 .0 -1 .4 4, 91 2 5. 2 0. 7 1. 6 -0 .6 4, 90 4 S ou th 40 .2 9. 1 -1 .6 2, 34 1 40 .3 16 .0 -1 .7 2, 29 4 7. 0 0. 4 0. 7 -0 .8 2, 29 2 Pr ov in ce V ie nt ia ne C ap ita l 19 .1 2. 6 -0 .9 1, 00 3 14 .4 2. 3 -0 .7 97 6 7. 1 0. 4 1. 5 -0 .6 97 8 P ho ng sa ly 39 .5 16 .3 -1 .7 35 9 54 .4 31 .8 -2 .2 34 0 3. 8 0. 6 2. 5 -0 .3 34 6 Lu an gn am th a 43 .7 17 .3 -1 .8 28 0 47 .1 23 .5 -1 .8 26 5 19 .3 3. 9 2. 6 -0 .9 26 8 O ud om xa y 35 .0 7. 0 -1 .5 66 8 50 .0 22 .0 -1 .9 66 1 3. 6 0. 6 1. 0 -0 .5 65 7 B ok eo 30 .3 4. 3 -1 .4 32 8 41 .3 14 .6 -1 .7 32 4 3. 7 0. 8 0. 6 -0 .5 32 4 Lu an gp ra ba ng 25 .4 4. 1 -1 .3 74 3 38 .1 12 .2 -1 .6 73 7 2. 2 0. 2 1. 7 -0 .4 73 4 H ua ph an h 31 .2 3. 9 -1 .5 59 7 52 .5 17 .5 -2 .1 58 8 1. 5 0. 0 1. 6 -0 .3 58 2 X ay ab ur y 27 .5 4. 9 -1 .4 48 2 31 .8 9. 9 -1 .4 46 5 5. 8 1. 2 1. 9 -0 .5 46 8 X ie ng kh ua ng 26 .9 3. 4 -1 .3 53 0 45 .1 17 .3 -1 .8 52 0 1. 9 0. 3 1. 4 -0 .2 52 2 V ie nt ia ne 27 .2 3. 2 -1 .3 74 6 37 .0 14 .1 -1 .5 72 8 3. 9 0. 7 3. 6 -0 .4 73 0 B or ik ha m xa y 24 .4 2. 8 -1 .2 39 5 34 .4 11 .3 -1 .4 38 7 5. 7 0. 5 1. 9 -0 .5 38 4 K ha m m ua ne 36 .8 7. 0 -1 .6 60 0 35 .1 11 .6 -1 .4 59 4 6. 5 0. 6 0. 8 -0 .8 59 2 S av an na kh et 34 .2 8. 9 -1 .5 1, 75 4 35 .2 15 .4 -1 .6 1, 70 7 5. 1 1. 0 1. 0 -0 .7 1, 69 8 S ar av an e 47 .7 13 .0 -1 .8 90 6 48 .2 20 .8 -1 .9 87 8 6. 8 0. 0 1. 1 -0 .8 88 0 S ek on g 52 .0 14 .9 -1 .9 25 8 56 .2 32 .0 -2 .3 25 3 6. 8 0. 7 1. 0 -0 .7 25 5 C ha m pa sa ck 30 .6 4. 2 -1 .4 97 2 30 .5 8. 6 -1 .4 95 9 6. 5 0. 7 0. 3 -0 .7 95 4 A tta pe u 37 .9 7. 9 -1 .6 20 5 32 .9 10 .7 -1 .5 20 4 9. 9 0. 5 0. 1 -0 .9 20 3 R es id en ce U rb an 20 .5 2. 8 -1 .1 2, 26 4 21 .9 5. 6 -1 .0 2, 20 0 5. 8 0. 6 1. 7 -0 .5 2, 19 6 R ur al 35 .4 7. 8 -1 .5 8, 56 3 42 .2 17 .1 -1 .7 8, 38 6 5. 2 0. 6 1. 3 -0 .6 8, 38 0 .R ur al w ith ro ad 34 .9 7. 5 -1 .5 7, 49 9 41 .4 16 .0 -1 .7 7, 34 8 5. 3 0. 6 1. 4 -0 .6 7, 34 2 .R ur al w ith ou t r oa d 39 .5 10 .1 -1 .7 1, 06 4 48 .0 24 .8 -2 .0 1, 03 8 5. 0 0. 8 0. 8 -0 .6 1, 03 8 N ot e: F or L ua ng N am th a, th e fig ur es o f W ei gh t-f or -A ge , H ei gh t-f or -A ge a nd W ei gh t-f or -H ei gh t, in cl ud in g w as tin g an d ov er w ei gh t, sh ou ld b e in te rp re te d w ith c au tio n du e to e xt re m e he ap in g of v al ue s fo r h ei gh t a nd w ei gh t M ea n Z- S co re (S D ) P er ce nt b el ow P er ce nt b el ow P er ce nt b el ow E ac h of th e in di ce s is e xp re ss ed in s ta nd ar d de vi at io n un its (S D ) f ro m th e m ed ia n of th e 19 77 N C H S /C D C /W H O R ef er en ce . T he in di ce s in th is ta bl e ar e N O T co m pa ra bl e to in di ce s ba se d on th e cu rr en t W H O C hi ld G ro w th S ta nd ar ds a do pt ed in 2 00 6. Ta bl e N U .A 1: N ut rit io na l s ta tu s of c hi ld re n ba se d on th e fo rm er N C H S/ C D C /W H O In te rn at io na l R ef er en ce P op ul at io n P er ce nt ag e of c hi ld re n un de r a ge 5 b y nu tri tio na l s ta tu s ac co rd in g to th re e an th ro po m et ric in di ce s: w ei gh t f or a ge , h ei gh t f or a ge , a nd w ei gh t f or h ei gh t, ba se d on th e fo rm er N C H S /C D C /W H O In te rn at io na l R ef er en ce P op ul at io n, L ao P D R 2 01 1- 12 W ei gh t f or a ge N um be r o f ch ild re n un de r a ge 5 H ei gh t f or a ge N um be r o f ch ild re n un de r a ge 5 W ei gh t f or h ei gh t N um be r o f ch ild re n un de r a ge 5 U nd er w ei gh t M ea n Z- S co re (S D ) St un te d M ea n Z- S co re (S D ) W as te d 192 10 O ve rw ei gh t P er ce nt a bo ve - 2 S D - 3 S D - 2 S D - 3 S D - 2 S D - 3 S D + 2 S D A ge 0 -5 m on th s 5. 5 0. 8 -0 .1 1, 15 0 10 .8 2. 1 -0 .5 1, 07 9 2. 5 0. 6 6. 2 0. 3 1, 02 7 6- 11 m on th s 21 .1 3. 6 -1 .2 1, 11 3 19 .4 4. 8 -1 .1 1, 08 9 4. 7 0. 8 1. 2 -0 .4 1, 09 4 12 -2 3 m on th s 39 .1 8. 7 -1 .7 2, 09 4 41 .0 15 .4 -1 .7 2, 04 7 8. 9 0. 9 1. 1 -0 .8 2, 05 7 24 -3 5 m on th s 38 .1 11 .0 -1 .7 2, 14 0 38 .9 16 .0 -1 .6 2, 09 1 7. 0 0. 7 0. 6 -0 .7 2, 10 8 36 -4 7 m on th s 35 .8 6. 2 -1 .6 2, 25 6 45 .3 19 .1 -1 .9 2, 22 8 3. 9 0. 5 1. 0 -0 .6 2, 23 4 48 -5 9 m on th s 36 .6 6. 1 -1 .7 2, 07 3 50 .2 20 .0 -2 .0 2, 05 3 3. 4 0. 3 0. 6 -0 .6 2, 05 6 M ot he r’s e du ca tio n N on e 41 .2 11 .5 -1 .7 3, 49 6 52 .2 24 .7 -2 .0 3, 40 8 5. 1 0. 6 1. 2 -0 .6 3, 42 6 P rim ar y 32 .1 6. 0 -1 .5 4, 47 1 37 .0 13 .2 -1 .6 4, 37 5 5. 1 0. 6 1. 2 -0 .6 4, 36 4 Lo w er s ec on da ry 25 .8 2. 8 -1 .2 1, 57 7 26 .9 6. 5 -1 .2 1, 55 0 6. 3 0. 9 1. 8 -0 .5 1, 53 5 U pp er s ec on da ry 17 .9 2. 6 -1 .0 67 7 17 .6 2. 7 -0 .9 66 4 5. 3 0. 5 1. 7 -0 .5 66 3 P os t s ec on da ry n on te rti ar y 23 .5 1. 7 -1 .1 36 3 20 .7 5. 3 -1 .1 35 5 7. 8 0. 4 2. 9 -0 .6 35 5 H ig he r 5. 3 0. 0 -0 .7 24 3 9. 3 0. 7 -0 .6 23 3 4. 4 0. 2 1. 5 -0 .4 23 3 W ea lth in de x qu in til e P oo re st 43 .6 11 .6 -1 .8 3, 17 6 55 .4 26 .6 -2 .1 3, 10 7 5. 2 0. 5 0. 9 -0 .6 3, 11 9 S ec on d 35 .9 8. 3 -1 .5 2, 31 3 43 .6 16 .7 -1 .8 2, 25 0 5. 3 0. 5 2. 0 -0 .5 2, 24 6 M id dl e 30 .5 4. 6 -1 .4 1, 97 3 33 .8 10 .4 -1 .5 1, 93 8 5. 1 1. 1 1. 0 -0 .6 1, 93 2 Fo ur th 23 .8 3. 4 -1 .2 1, 76 0 25 .5 6. 7 -1 .2 1, 72 2 5. 6 0. 7 1. 4 -0 .6 1, 71 6 R ic he st 16 .5 1. 5 -0 .9 1, 60 5 14 .6 2. 6 -0 .8 1, 57 0 5. 9 0. 4 1. 9 -0 .5 1, 56 4 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 26 .8 4. 1 -1 .3 5, 89 3 27 .0 7. 1 -1 .2 5, 78 2 6. 0 0. 6 1. 2 -0 .6 5, 75 2 M on -K hm er 43 .0 11 .2 -1 .7 3, 13 4 50 .0 24 .2 -2 .0 3, 05 3 5. 2 0. 7 1. 0 -0 .6 3, 06 3 H m on g- M ie n 28 .2 4. 8 -1 .4 1, 39 8 53 .7 21 .5 -2 .0 1, 37 0 1. 3 0. 5 2. 6 -0 .1 1, 37 1 C hi ne se -T ib et an 46 .3 21 .0 -1 .8 35 1 54 .8 33 .2 -2 .2 33 1 11 .0 2. 1 2. 8 -0 .6 33 8 O th er , M is si ng , D K 34 .4 2. 0 -1 .5 51 39 .2 9. 2 -1 .5 50 7. 0 0. 0 3. 1 -0 .6 51 To ta l 32 .3 6. 8 -1 .4 10 ,8 27 38 .0 14 .7 -1 .6 10 ,5 86 5. 4 0. 6 1. 4 -0 .6 10 ,5 76 P er ce nt b el ow P er ce nt b el ow P er ce nt b el ow Ta bl e N U .A 1: N ut rit io na l s ta tu s of c hi ld re n ba se d on th e fo rm er N C H S/ C D C /W H O In te rn at io na l R ef er en ce P op ul at io n P er ce nt ag e of c hi ld re n un de r a ge 5 b y nu tri tio na l s ta tu s ac co rd in g to th re e an th ro po m et ric in di ce s: w ei gh t f or a ge , h ei gh t f or a ge , a nd w ei gh t f or h ei gh t, ba se d on th e fo rm er N C H S /C D C /W H O In te rn at io na l R ef er en ce P op ul at io n, L ao P D R 2 01 1- 12 W ei gh t f or a ge N um be r o f ch ild re n un de r a ge 5 H ei gh t f or a ge N um be r o f ch ild re n un de r a ge 5 W ei gh t f or h ei gh t N um be r o f ch ild re n un de r a ge 5 U nd er w ei gh t M ea n Z- S co re (S D ) St un te d M ea n Z- S co re (S D ) W as te d M ea n Z- S co re (S D ) E ac h of th e in di ce s is e xp re ss ed in s ta nd ar d de vi at io n un its (S D ) f ro m th e m ed ia n of th e 19 77 N C H S /C D C /W H O R ef er en ce . T he in di ce s in th is ta bl e ar e N O T co m pa ra bl e to in di ce s ba se d on th e cu rr en t W H O C hi ld G ro w th S ta nd ar ds a do pt ed in 2 00 6. N ot e : F or L ua ng N am th a, th e fig ur es o f W ei gh t-f or -A ge , H ei gh t-f or -A ge a nd W ei gh t-f or -H ei gh t, in cl ud in g w as tin g an d ov er w ei gh t, sh ou ld b e in te rp re te d w ith c au tio n du e to e xt re m e he ap in g of v al ue s fo r h ei gh t a nd w ei gh t © UNICEF Lao PDR / 2012 / Noorani 194 XI. Child Mortality One of the overarching goals of the Millennium Development Goals (MDGs) is the reduction of infant and under-five mortality. Specifically, the MDGs call for a two-thirds reduction in under-five mortality between 1990 and 2015. Monitoring progress towards this goal is an important but difficult objective. The infant mortality rate is defined as the probability of dying before the first birthday. The under-five mortality rate is defined as the probability of dying before the fifth birthday. In the 2011-12 LSIS, infant and under-five mortality rates are calculated based on a direct estimation technique that employs a full birth history as part of the women’s questionnaire. A full birth history provides the data needed to calculate direct estimates of infant and child mortality. The birth history module starts with a series of summary questions about the respondent’s experience with childbearing (the number of sons and daughters living with the mother, the number who live elsewhere, and the number who have died). These questions are followed by a retrospective birth history, in which each respondent was asked to list each of her births, starting with the first. For each birth, data were obtained on gender, month and year of birth, survivorship status and current age, or, if the child is dead, age at death. Particular attention was paid to the known pitfalls and issues in collecting birth history data through careful training and fieldwork monitoring. The early childhood mortality results presented in this report are defined as follows: • Neonatal mortality: the probability of dying within the first month of life • Infant mortality: the probability of dying before the first birthday • Post-neonatal mortality: the probability of dying after the first month of life but before the first birthday, calculated as the difference between infant and neonatal mortality • Child mortality: the probability of dying between the first and fifth birthday • Under-five mortality: the probability of dying between birth and the fifth birthday All rates are expressed per 1,000 live births, except for child mortality, which is expressed per 1,000 children surviving to 12 months of age. Trends in Early Childhood Mortality Table CM.1 shows the trends in neonatal, post-neonatal, infant, child and under-five mortality rates for successive two-year periods preceding the survey, at the national level. For the most recent two- year period preceding the survey, infant mortality was 68 deaths per 1,000 live births, and under-five mortality was 79 deaths per 1,000 live births. This means that approximately 1 in every 13 children born in Lao PDR dies before reaching his or her fifth birthday. According to age disaggregation during the two-year period immediately prior to the survey, 86 per cent of under-five deaths took place during the first year of the child’s life. Half of the infant deaths occurred during the neonatal period. Among the children who died before the age of five, 40 per cent died in the first month of life. The trend in early childhood mortality since the mid-1990s can be examined by looking at changes in the mortality rates over the successive two-year periods prior to the survey. The 2011-12 LSIS results indicate that all child mortality rates have declined over time. For example, the infant mortality rate declined from 123 deaths per 1,000 live births in the mid-1990s to 91 deaths per 1,000 live births in the mid-2000s, and continued to decline to 68 deaths per 1,000 live births in 2010-11. Similarly, the under-five mortality rate halved from around 164 deaths per 1,000 live births in the mid-1990s to 79 deaths per 1,000 live births in 2010-11. 11 195 Early Childhood Mortality Rates by Socioeconomic and Demographic Characteristics While Table CM.1 presented mortality estimates for the country as a whole, LSIS data also allows us to estimate infant and child mortality rates among sub-populations. Differentials in early childhood mortality rates by selected socio-economic and demographic characteristics are presented in Tables CM.2 and CM.3, and Figure CM.1 for the most recent five-year period preceding the survey (2007- 11). Rates are calculated for this period of time to ensure a sufficient number of cases within each category on which to base the estimates. The national rates presented in Table CM.1 can be calculated for a two-year period before the survey at the national level, but for population sub-groups, such as provinces, there are not enough cases over a two-year period on which to base the estimates, thus the period needs to be expanded to five years prior to the survey. Table CM.2 indicates that the risk of dying in early childhood is lowest in the Central region (73 deaths per 1,000 live births), while the risk of dying in the Northern and Southern regions exceeds 100 deaths per 1,000 live births. The survey results indicate that the early childhood mortality rates for rural areas are double those for urban areas (for example, under-five mortality rates for the five years preceding the survey of 100 deaths per 1,000 live births in rural areas and 45 in urban areas). The differentials in mortality levels are somewhat larger by province. Vientiane Capital and Vientiane province have the lowest under-five mortality rates of 32 and 37 deaths per 1,000 live births, respectively, while Phongsaly and Khammuane provinces have the highest rates, at 151 and 138 deaths per 1,000 live births, respectively. As expected, mothers’ education is inversely related to children’s risk of dying. Children of mothers with no education have mortality rates more than two times higher than those of children of mothers with post-secondary or higher education (for example, under-five mortality decreases from 116 deaths per 1,000 live births for children of mothers with no education to around 40 for children of mothers with post-secondary or higher education). A child’s risk of dying generally decreases as wealth increases. Children born to mothers in the poorest wealth quintile have more than double the risk of dying than children born to mothers in the richest Neonatal mortality rate1 Post-neonatal mortality rate2 Infant mortality rate3 Child mortality rate4 Under-five mortality rate5 Years preceding the survey 0-1 32 36 68 11 79 2-3 34 41 75 14 88 4-5 42 46 87 21 106 6-7 46 45 91 27 115 8-9 53 51 104 30 131 10-11 52 64 116 34 146 12-13 59 65 124 38 157 14-15 49 69 118 36 150 16-17 56 68 123 46 164 18-19 54 59 114 64 170 5 MICS indicator 1.1; MDG indicator 4.1 Post-neonatal mortality rates are computed as the difference between the infant and neonatal mortality rates Table CM.1: Early childhood mortality rates Neonatal, post-neonatal, infant, child and under-five mortality rates for two year periods preceding the survey, Lao PDR 2011- 12 1 MICS indicator 1.3 2 MICS indicator 1.4 3 MICS indicator 1.2; MDG indicator 4.2 4 MICS indicator 1.5 11 196 quintiles. Infant mortality decreases from over 95 deaths per 1,000 live births for children born to mothers in the two poorest quintiles to 27 deaths per 1,000 live births for children born to mothers in the richest quintile. For all types of early childhood mortality, children in Chinese-Tibetan headed households have higher rates than children of other ethno-linguistic groups. Children of Lao-Tai and Hmong-Mien headed households have the lowest rates of early childhood mortality, at roughly half the levels of Chinese- Tibetan headed households. Neonatal mortality rate Post-neonatal mortality rate Infant mortality rate Child mortality rate Under-five mortality rate Region North 48 38 86 19 104 Central 26 37 63 10 73 South 36 51 88 15 101 Province Vientiane Capital 15 (12) (27) (5) (32) Phongsaly 62 58 120 36 151 Luangnamtha 28 25 54 8 61 Oudomxay 58 29 87 15 100 Bokeo 42 50 92 21 110 Luangprabang 35 49 84 26 107 Huaphanh 62 38 100 20 118 Xayabury (45) (14) (59) (7) (65) Xiengkhuang 21 31 53 15 67 Vientiane 10 20 31 7 37 Borikhamxay (24) (21) (45) (7) (52) Khammuane 62 69 131 8 138 Savannakhet 28 52 81 14 94 Saravane 35 63 98 16 113 Sekong 44 27 71 24 93 Champasack 38 51 89 8 97 Attapeu 27 31 58 21 77 Residence Urban 22 16 39 6 45 Rural 39 46 85 16 100 .Rural with road 39 43 82 14 94 .Rural without road 39 70 108 31 136 Mother's education None 44 52 96 22 116 Primary 35 44 80 12 91 Lower secondary 24 24 47 7 54 Upper secondary 34 11 (45) (3) (48) Post secondary non tertiary (23) (10) (32) (8) (40) Higher * * * * * Wealth index quintile Poorest 40 55 95 27 120 Second 47 51 98 11 109 Middle 43 34 77 8 85 Fourth 17 30 47 6 53 Richest 18 10 27 6 33 Ethno-linguistic group of household head Lao-Tai 32 38 70 7 76 Mon-Khmer 43 45 88 22 108 Hmong-Mien 27 31 58 18 74 Chinese-Tibetan 62 69 131 34 160 Note: An asterisk indicates that a figure is based on fewer than 250 unweighted cases and has been suppressed. Figures in parentheses are based on 250-499 unweighted cases. Post-neonatal mortality rates are computed as the difference between the infant and neonatal mortality rates Table CM.2: Early childhood mortality rates by socioeconomic characteristics Neonatal, post-neonatal, infant, child and under-five mortality rates for the five year period preceding the survey, by socioeconomic characteristics, Lao PDR 2011-12 11 197 The demographic characteristics of both mothers and children have been found to play an important role in children’s survival probability. Table CM.3 presents mortality rates by demographic characteristics (sex of child, mother’s age at birth, birth order and previous birth interval). The data show some difference in infant mortality rates between male and female children, at 82 and 70 deaths per 1,000 live births for males and females, respectively. Neonatal mortality rates for male children are higher than for female children, but do not differ after the neonatal period. Typically, the relationship between maternal age at birth and childhood mortality is ‘U-shaped’, being higher among children born to mothers age under 20 and over 35 than among those age 20-34. This pattern is also found in the 2011-12 LSIS, where neonatal mortality rates are highest among children born to mothers age less than 20 and over 35 at birth (53 deaths per 1,000 live births and 46 deaths per 1,000 live births, respectively). Neonatal mortality is higher among children born first and ‘high order’ births (the seventh child and above) than among children born second to sixth, while fourth and higher order births suffer higher post-neonatal and child mortality. Research has shown that short birth intervals significantly reduce a child’s chance of survival, and this is confirmed by the 2011-12 LSIS: children have an elevated risk of dying if they were born within two years of a preceding birth. The risk reduces to its lowest at a birth spacing of three years. Neonatal mortality rate Post-neonatal mortality rate Infant mortality rate Child mortality rate Under-five mortality rate Sex of child Male 41 41 82 14 95 Female 30 40 70 14 83 Mother's age at birth Less than 20 53 44 97 16 112 20-34 30 38 67 12 79 35-49 46 51 97 22 117 Birth order 1 41 31 72 11 82 2-3 30 35 65 11 75 4-6 34 49 83 20 101 7+ 44 70 114 21 132 Previous birth interval* < 2 years 51 49 100 17 116 2 years 27 50 76 17 92 3 years 12 22 34 12 46 4+ years 20 22 42 6 47 Post-neonatal mortality rates are computed as the difference between the infant and neonatal mortality rates * Excludes first order births Table CM.3: Early childhood mortality rates by demographic characteristics Neonatal, post-neonatal, infant, child and under-five mortality rates for the five year period preceding the survey, by demographic characteristics, Lao PDR 2011-12 11 198 Comparison of Early Childhood Mortality Rates with Estimates from Other Sources Figure CM.2 shows the series of under-five mortality rate estimates derived from the 2011-12 LSIS together with estimates from other sources. The LSIS estimates indicate a decline in child mortality during the last 20 years. The declining trend indicated by the survey results is in broad agreement with those estimated from earlier surveys. The mortality trends depicted by the 2005 Lao Census and the 2005 Lao Reproductive Health Survey (LRHS) are also declining, although LSIS estimates are considerably higher. Analysis (unpublished) was undertaken of the mean number of children surviving and the mean number of dead children from the LRHS and the LSIS calculated back to the date of the LRHS (October 2005). This analysis shows the mean number of children surviving in 2005 to be similar in both surveys (ratio of LSIS : LRHS = 1.05), but 76 per cent more dead children were reported in the LSIS than in the LRHS (ratio 1.76), indicating that the under-five mortality rates from the LRHS are considerably under-estimated. 104 73 101 45 100 116 91 54 48 40 41 120 109 85 Regions North Central South Area Urban Rural Mother's Education None Primary Lower secondary Upper secondary Post secondary non tertiary Higher Wealth Quintiles Poorest Second Middle Figure CM.1: Under-5 mortality rates by background characteristics, Lao PDR 2011-12 109 85 53 33 0 20 40 60 80 100 120 Second Middle Fourth Richest Per 1,000 live births 11 199 Data Quality Observations The 2011-12 LSIS is subject to the same measurement issues that exist in all household surveys. Regardless of the quality of the survey, three main factors could influence the precision of measurements: 1) Birth transference (surveyors falsely recording children’s ages to reduce their workload) 2) Event omission (surveyors excluding children from the survey to reduce workload or to avoid parents experiencing painful recollection) 3) Sample design and implementation issues Each of these issues contributes to potential under-estimation of child mortality in most household surveys (see the data quality tables [Appendix D] produced for the birth history data). The quality of birth history data is briefly addressed below. The issue of missing data is important to all variables in the survey. Generally, data for missing cases are not imputed, with the exception of the variables in the birth history, where a bias would often be significant, as dates of events are more often missing for the least educated and the less wealthy women. It is typical that children of these women also suffer the highest mortality, and without imputation, mortality would often be under estimated. However, in the 2011-12 LSIS, imputation was only necessary for less than 2 per cent of children’s birth dates and therefore had insignificant impact on the results. The data quality tables presented in Appendix D allows the following observations (although these observations are also found in the majority of surveys, in Lao PDR and globally): 50 100 150 200 250 Per 1,000 live births Figure CM.2: Trend in under-5 mortality rates, Lao PDR 1980-2011 0 50 1980 1985 1990 1995 2000 2005 2010 Year Lao Social Indicator Survey 2011-12 (Direct) Lao Reproductive Health Survey 2005 (Direct) Lao Reproductive Health Survey 2005 (Indirect) Lao Census 2005 (Indirect) Lao Reproductive Health Survey 2000 (Direct) Lao Census 1995 (Indirect) Lao Fertility and Birth Spacing Survey 1994 (Direct) Lao Social Indicator Survey 1993 (Indirect) 11 200 Table DQ.1: This table presents the distribution of the household population by single years of age. The larger number of 50-year-old women compared with those of age 49 years is of concern, as well as the larger number of 14-year-old girls. This ‘age heaping’ is common in household surveys due to the tendency of respondents to report in round numbers (at age 50) and because of the work-reducing behaviour of interviewers. The impact on quality is a deficit in the numbers of women reporting their birth histories; however these women do not tend to have recent births so their effect on mortality estimates is generally insignificant. Table DQ.4.1: Interview completion rates for women in settings that typically carry a higher risk of mortality (rural women, less educated women, women in the poorest households) are no different from those of other women. Women in large households had slightly lower response rates than other women, but the effect of this difference would be insignificant. Table DQ.16: While there is room for slight fluctuation, the global sex ratio (boys : girls) of children ever born is generally around 1.05. The overall sex ratio observed in the LSIS is very close to this figure and no particular bias is observed. Table DQ.17: This table presents the distribution of births by year, the percentage with complete date information, the sex ratio at birth and calendar year ratio for each year. Interviewers performed well in obtaining complete birth dates (almost 100 per cent for living children and 94 per cent for dead children). While there is some fluctuation in the reporting of years of birth there is no significant heaping on particular years, showing no evidence of birth transference. Table DQ.18: This table presents the distribution of the deaths before 1 month, according to age at death in days. It shows the expected pattern of more deaths in the first few days of life and minimal heaping on numbers ending in 0 or 5. The percentage of early neonatal deaths (0-6 days) is as expected, at around three quarters of neonatal deaths (0-30 days). Table DQ.19: This table is designed to capture quality of information obtained on age at death in months. The focus is to review whether respondents and interviewers are heaping responses at the ages of one month and 12 months or one year, as these are the cut-off ages for the specific mortality rates. While there is no evidence of heaping at one month, the data do suggest some heaping in reporting of deaths at one year, and the heaping increases with older reported deaths. Interviewers were instructed to probe for the age at death in months if it was reported as one year, specifically to determine whether the death occurred before or after the child’s first birthday. However, in a number of cases, deaths were recorded as occurring at one year of age without specifying the exact month of age. Analyses of other survey data have indicated that children reported to have died at “one year” will have typically died after their first birthday. Here, deaths reported at “one year” are considered as occurring after the first year of life, and the assumption does not appear to have affected infant mortality estimates. In summary, the data appear of good quality, and there are no serious concerns about the quality of the mortality estimates. 11 © UNICEF Lao PDR / 2012 / Noorani 202 XII. Child Development Early Childhood Education and Learning The readiness of children for primary school can be improved through early childhood education programmes and pre-school attendance. Early childhood education programmes include programmes for children that have organised learning components, and that do not include baby-sitting or day- care, which typically do not include organised education and learning. Twenty-three per cent of children age 36-59 months are attending an organised early childhood education programme (Table CD.1). Children engage in early childhood education programmes primarily in urban areas. Fifty-five per cent of children age 36-59 months attend an education programme, compared with only 15 per cent of rural children and only 6 per cent of children in rural areas without road access. Thirty per cent of children in the Central region attend early childhood education, compared with only 12 per cent of children in the Southern region. Stark differentials are seen by socioeconomic status. Seventy-three per cent of children living in the richest households attend early childhood education programmes, compared with only 5 per cent of children in the poorest households. Only 7 per cent of children whose mothers have no education attend early childhood education programmes, compared with 45 per cent of children whose mothers have a lower secondary school education. Moreover, 36 per cent of children in Lao-Tai headed households attend early childhood education programmes, compared with only 7 per cent of children in Hmong-Mien and 9 per cent of children in Mon-Khmer headed households. 12 203 Percentage of children age 36-59 months currently attending early childhood education1 Number of children age 36-59 months Sex Male 20.9 2,269 Female 25.3 2,157 Region North 21.0 1,418 Central 29.7 2,055 South 11.7 953 Province Vientiane Capital 69.6 419 Phongsaly 10.0 152 Luangnamtha 28.4 114 Oudomxay 13.4 257 Bokeo 20.3 131 Luangprabang 27.5 329 Huaphanh 21.9 253 Xayabury 24.1 182 Xiengkhuang 16.7 225 Vientiane 30.2 312 Borikhamxay 16.1 157 Khammuane 16.3 226 Savannakhet 17.3 716 Saravane 4.3 365 Sekong 15.3 118 Champasack 17.7 377 Attapeu 12.1 92 Residence Urban 54.7 885 Rural 15.1 3,540 .Rural with road 16.4 3,092 .Rural without road 6.0 448 Age of child 36-47 months 16.5 2,302 48-59 months 30.1 2,124 Mother’s education None 6.7 1,560 Primary 18.2 1,827 Lower secondary 44.5 595 Upper secondary 64.4 220 Post secondary non tertiary 72.6 147 Higher 90.9 76 Wealth index quintile Poorest 5.3 1,364 Second 9.4 948 Middle 19.2 785 Fourth 34.8 688 Richest 73.0 640 Ethno-linguistic group of household head Lao-Tai 35.9 2,343 Mon-Khmer 8.7 1,325 Hmong-Mien 7.2 594 Chinese-Tibetan 12.9 140 Other, Missing, DK * 23 Total 23.0 4,426 Percentage of children age 36-59 months who are attending an organized early childhood education programme, Lao PDR 2011-12 Table CD.1: Early childhood education 1 MICS indicator 6.7 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 12 204 It is recognized that a period of rapid brain development occurs in the first 3 to 4 years of life, and that the quality of homecare is the major determinant of a child’s development during this period. In this context, adults spending ‘quality time’ with children, the presence of children’s books in the home, opportunities for play to stimulate the imagination, and the conditions of care are all important indicators of quality of home care. Children should be physically healthy, mentally alert, emotionally secure, socially competent and ready to learn. Information on a number of activities that support early learning was collected in the survey. These included the involvement of adults with children in the following activities: reading books or looking at picture books; telling stories; singing songs; taking children outside the home, compound or yard; playing with children; and spending time with children naming, counting or drawing things. Table CD.2 presents the percentage of children age 36-59 months who engaged with an adult household member in activities that promote learning and school readiness within the three days prior to the survey. Fifty-seven per cent of children engaged with an adult household member in four or more such activities. The average number of activities in which adults engaged with children was 3.7. Fifty- two per cent of children had engaged with their fathers in at least one activity. The average number of activities in which fathers involved themselves with 3 and 4 year-olds was 1.3. Eleven per cent of children were living in a household without their fathers. 12 205 12 W ith w ho m a du lt ho us eh ol d m em be rs e ng ag ed in fo ur o r m or e ac tiv iti es 1 W ith w ho m th e fa th er en ga ge d in o ne o r m or e ac tiv iti es 2 A ny a du lt ho us eh ol d m em be r e ng ag ed w ith th e ch ild Th e fa th er en ga ge d w ith th e ch ild Se x M al e 57 .5 52 .2 3. 7 1. 3 11 .4 2, 26 9 Fe m al e 57 .4 50 .7 3. 7 1. 3 11 .4 2, 15 7 R eg io n N or th 62 .4 60 .0 3. 9 1. 6 5. 8 1, 41 8 C en tra l 57 .1 51 .8 3. 7 1. 3 13 .5 2, 05 5 S ou th 50 .8 38 .0 3. 4 0. 9 14 .9 95 3 Pr ov in ce V ie nt ia ne C ap ita l 85 .3 64 .3 5. 0 2. 1 17 .1 41 9 P ho ng sa ly 39 .2 46 .7 3. 3 1. 9 5. 4 15 2 Lu an gn am th a 53 .4 66 .1 3. 4 1. 7 6. 2 11 4 O ud om xa y 87 .1 60 .3 4. 9 1. 5 3. 1 25 7 B ok eo 54 .0 76 .2 3. 7 2. 2 7. 5 13 1 Lu an gp ra ba ng 57 .9 56 .1 3. 7 1. 2 7. 1 32 9 H ua ph an h 44 .4 44 .5 3. 2 1. 0 6. 6 25 3 X ay ab ur y 91 .6 84 .0 5. 3 2. 5 5. 4 18 2 X ie ng kh ua ng 51 .0 54 .0 3. 7 1. 2 6. 7 22 5 V ie nt ia ne 65 .0 63 .2 4. 4 1. 4 10 .6 31 2 B or ik ha m xa y 57 .2 61 .8 3. 8 1. 3 5. 9 15 7 K ha m m ua ne 43 .6 33 .3 2. 7 1. 0 17 .7 22 6 S av an na kh et 43 .3 42 .5 3. 0 0. 8 15 .3 71 6 S ar av an e 40 .8 26 .3 2. 9 0. 6 12 .1 36 5 S ek on g 54 .4 45 .7 3. 6 1. 0 6. 4 11 8 C ha m pa sa ck 55 .1 39 .8 3. 6 1. 1 22 .1 37 7 A tta pe u 67 .6 66 .9 4. 4 1. 6 7. 5 92 R es id en ce U rb an 77 .5 60 .4 4. 7 1. 8 16 .0 88 5 R ur al 52 .4 49 .2 3. 5 1. 2 10 .2 3, 54 0 .R ur al w ith ro ad 53 .7 50 .2 3. 5 1. 2 10 .5 3, 09 2 .R ur al w ith ou t r oa d 43 .8 42 .8 3. 1 1. 1 8. 0 44 8 1 M IC S in di ca to r 6 .1 2 M IC S In di ca to r 6 .2 Ta bl e C D .2 : S up po rt fo r l ea rn in g P er ce nt ag e of c hi ld re n ag e 36 -5 9 m on th s w ith w ho m a n ad ul t h ou se ho ld m em be r e ng ag ed in a ct iv iti es th at p ro m ot e le ar ni ng a nd s ch oo l r ea di ne ss d ur in g th e la st th re e da ys , L ao P D R 2 01 1- 12 Pe rc en ta ge o f c hi ld re n ag e 36 -5 9 m on th s M ea n nu m be r o f a ct iv iti es P er ce nt ag e of c hi ld re n no t l iv in g w ith th ei r na tu ra l f at he r N um be r o f c hi ld re n ag e 36 -5 9 m on th s na = N ot a pp lic ab le 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. 206 12 W ith w ho m a du lt ho us eh ol d m em be rs e ng ag ed in fo ur o r m or e ac tiv iti es 1 W ith w ho m th e fa th er en ga ge d in o ne o r m or e ac tiv iti es 2 A ny a du lt ho us eh ol d m em be r e ng ag ed w ith th e ch ild Th e fa th er en ga ge d w ith th e ch ild A ge o f c hi ld 36 -4 7 m on th s 56 .0 50 .5 3. 7 1. 3 11 .9 2, 30 2 48 -5 9 m on th s 59 .0 52 .5 3. 8 1. 3 10 .8 2, 12 4 M ot he r’s e du ca tio n N on e 39 .4 41 .8 2. 9 0. 9 8. 8 1, 56 0 P rim ar y 59 .4 51 .4 3. 8 1. 2 12 .2 1, 82 7 Lo w er s ec on da ry 74 .0 60 .9 4. 5 1. 7 12 .4 59 5 U pp er s ec on da ry 90 .4 72 .1 5. 1 2. 3 12 .5 22 0 P os t s ec on da ry n on te rti ar y 89 .2 68 .6 5. 3 2. 2 21 .5 14 7 H ig he r 92 .6 86 .0 5. 5 3. 1 12 .4 76 Fa th er ’s e du ca tio n N on e 39 .3 42 .9 2. 8 0. 9 na 66 8 P rim ar y 51 .2 49 .4 3. 5 1. 2 na 1, 79 7 Lo w er s ec on da ry 63 .8 65 .7 4. 1 1. 7 na 71 4 U pp er s ec on da ry 72 .9 73 .1 4. 5 2. 1 na 32 0 P os t s ec on da ry n on te rti ar y 83 .4 76 .9 4. 9 2. 4 na 23 4 H ig he r 87 .5 76 .8 5. 2 2. 4 na 18 5 Fa th er n ot in h ou se ho ld 61 .4 15 .3 3. 8 0. 4 na 50 3 D K /M is si ng * * * * na 5 W ea lth in de x qu in til e P oo re st 41 .9 44 .5 3. 1 1. 0 6. 0 1, 36 4 S ec on d 47 .1 49 .1 3. 3 1. 1 7. 8 94 8 M id dl e 59 .5 49 .6 3. 7 1. 2 14 .6 78 5 Fo ur th 72 .4 57 .5 4. 4 1. 5 17 .2 68 8 R ic he st 87 .2 65 .5 5. 1 2. 1 18 .1 64 0 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 67 .5 53 .7 4. 1 1. 5 16 .2 2, 34 3 M on -K hm er 47 .7 47 .2 3. 3 1. 1 6. 7 1, 32 5 H m on g- M ie n 41 .8 51 .4 3. 2 1. 0 4. 2 59 4 C hi ne se -T ib et an 46 .0 57 .1 3. 3 1. 9 5. 6 14 0 O th er , M is si ng , D K * * * * * 23 To ta l 57 .4 51 .5 3. 7 1. 3 11 .4 4, 42 6 Ta bl e C D .2 : S up po rt fo r l ea rn in g P er ce nt ag e of c hi ld re n ag e 36 -5 9 m on th s w ith w ho m a n ad ul t h ou se ho ld m em be r e ng ag ed in a ct iv iti es th at p ro m ot e le ar ni ng a nd s ch oo l r ea di ne ss d ur in g th e la st th re e da ys , 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. 1 M IC S in di ca to r 6 .1 2 M IC S In di ca to r 6 .2 na = N ot a pp lic ab le Pe rc en ta ge o f c hi ld re n ag e 36 -5 9 m on th s M ea n nu m be r o f a ct iv iti es P er ce nt ag e of c hi ld re n no t l iv in g w ith th ei r na tu ra l f at he r N um be r o f c hi ld re n ag e 36 -5 9 m on th s 207 There are no gender differentials in terms of adults engaging with children; household members, including fathers, engaged in activities with boys and girls alike. A larger percentage of children in urban areas engaged with adults in learning and school readiness activities (78 per cent) than in rural areas (52 per cent). Strong differentials are observed by education level of the mother and father, and also by socio-economic status. The percentage of children who have an adult engage with them in four or more learning activities rises steadily with every increase in level of education, and the percentage more than doubles from the poorest to the richest households. Eighty-seven per cent of children living in the richest households had an adult engage with them in four or more learning related activities, as opposed to 42 per cent of those living in the poorest households. Fathers’ involvement showed a similar pattern in terms of engagement in such activities. Exposure to books in the early years not only provides the child with greater understanding of the nature of print, but may also give the child opportunities to see others reading, such as older siblings doing school work. The presence of books is also important for later school performance. Mothers and caretakers of children age under five were asked about the number of children’s books or picture books they have. By stimulating the imagination, play also contributes to brain development. Mothers and caretakers were asked what items children play with, including homemade toys, toys purchased from a shop, and other household objects or objects found around the home. In Lao PDR, only 5 per cent of children under the age of five years live in households with at least three children’s books (Table CD.3). The proportion of children with 10 or more books declines to 1 per cent (seen more among the richest and highest education categories). No differentials are observed between girls and boys. A higher percentage of urban than rural children have access to three or more children’s books (16 per cent and 2 per cent, respectively). 12 208 12 3 or more children's books1 10 or more children's books Homemade toys Toys from a shop/manufactured toys Household objects/objects found outside Sex Male 4.5 1.1 26.5 47.7 53.6 42.3 5,593 Female 5.6 1.3 22.7 45.3 53.9 39.4 5,474 Region North 2.9 0.5 23.3 36.2 55.8 35.8 3,502 Central 7.6 2.1 24.4 57.3 55.7 45.9 5,154 South 2.8 0.2 27.1 38.3 46.6 37.5 2,411 Province Vientiane Capital 24.2 8.6 16.8 80.6 45.5 45.5 1,058 Phongsaly 3.9 1.0 18.8 26.2 45.3 29.7 368 Luangnamtha 2.8 0.0 36.1 38.5 53.2 45.7 280 Oudomxay 2.4 0.5 17.6 22.4 82.0 30.4 676 Bokeo 3.0 0.6 23.3 44.7 64.1 45.0 335 Luangprabang 4.7 1.0 27.3 38.5 43.7 37.8 752 Huaphanh 1.3 0.0 26.0 28.2 64.4 37.4 606 Xayabury 1.9 0.0 17.9 62.6 31.3 31.1 486 Xiengkhuang 1.4 0.0 39.9 46.7 72.8 58.8 540 Vientiane 4.4 1.3 23.5 49.3 65.6 48.2 767 Borikhamxay 3.8 0.9 12.8 48.0 40.1 34.9 402 Khammuane 1.4 0.2 24.7 52.0 54.8 42.8 603 Savannakhet 3.9 0.1 26.9 54.1 56.0 44.8 1,784 Saravane 1.0 0.1 17.8 26.6 36.9 24.7 923 Sekong 2.5 0.3 26.7 24.7 33.8 25.6 269 Champasack 4.7 0.2 32.0 50.9 56.6 48.3 1,003 Attapeu 2.7 0.2 45.2 46.7 57.4 57.6 216 Residence Urban 16.4 4.9 19.2 75.8 50.7 49.1 2,319 Rural 2.0 0.2 26.1 38.7 54.5 38.7 8,748 .Rural with road 2.2 0.2 25.9 40.9 54.7 39.6 7,661 .Rural without road 0.5 0.1 27.1 23.7 53.8 32.8 1,086 Age of child 0-23 months 1.9 0.6 12.6 34.7 34.5 24.1 4,448 24-59 months 7.1 1.5 32.8 54.4 66.7 52.2 6,619 Mother’s education None 0.7 0.1 25.4 23.0 54.0 31.0 3,580 Primary 2.2 0.2 26.3 47.5 54.2 42.6 4,556 Lower secondary 8.1 1.5 23.0 67.8 55.3 50.2 1,613 Upper secondary 16.4 4.3 19.2 77.4 47.6 49.2 695 Post secondary non tertiary 24.6 6.0 23.2 84.0 54.6 55.0 368 Higher 39.7 16.0 12.0 85.0 47.0 47.2 255 Wealth index quintile Poorest 0.5 0.0 26.9 17.7 53.6 29.2 3,233 Second 1.0 0.0 27.6 35.2 52.7 36.7 2,346 Middle 1.5 0.1 26.0 52.5 56.9 46.5 2,019 Fourth 4.6 0.6 23.4 71.8 55.5 52.4 1,807 Richest 24.3 7.0 15.9 83.7 49.8 50.1 1,663 Ethno-linguistic group of household head Lao-Tai 8.3 2.0 23.3 65.7 53.6 47.8 6,030 Mon-Khmer 1.0 0.0 25.2 22.1 51.8 30.0 3,189 Hmong-Mien 0.6 0.1 29.4 25.3 59.7 38.0 1,439 Chinese-Tibetan 2.6 0.7 25.0 24.5 49.5 32.3 357 Other, Missing, DK 13.4 1.7 11.9 54.3 54.0 45.6 52 Total 5.0 1.2 24.6 46.5 53.7 40.9 11,067 1 MICS indicator 6.3 2 MICS indicator 6.4 Table CD.3: Learning materials Two or more types of playthings2 Percentage of children under age 5 by numbers of children's books present in the household, and by playthings that child plays with, Lao PDR 2011-12 Household has for the child: Number of children under age 5 Child plays with: 209 Table CD.3 also shows that 41 per cent of children under the age of five had two or more playthings in their homes. ‘Play things’ refers to homemade toys (including dolls and cars), toys purchased from a store, and household objects (such as pots and bowls) and objects and materials found outside the home (such as sticks, rocks, animal shells and leaves). It is notable that 47 per cent of children play with toys that come from a store while 25 per cent play with homemade toys, and this pattern is seen in both urban and rural areas. The percentage of children who have two or more types of playthings rises with increasing wealth quintile. Leaving children alone or only in the presence of other young children is known to increase the risk of accidents. Mothers and caretakers were asked two questions to establish whether children age 0-59 months had been left alone during the week preceding the interview, and whether children were left in the care of other children under 10 years of age. Table CD.4 shows that 12 per cent of children age under five had been left in the care of other children age under 10. Six 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. A child under five years of age left only in the care of another child or left alone is considered inadequately cared for. The LSIS 2011-2012 found that 14 per cent of children were left with inadequate care during the week preceding the survey, either by being left in the care of another child or being left alone. Interestingly, a higher percentage of rural children were either left alone (7 per cent) or left in the care of other children (14 per cent) than urban children (3 percent and 7 percent, respectively). A higher percentage of children age 24-59 months were left with inadequate care (18 per cent) than children age 0-23 months (8 per cent). Differences were observed with regard to both the education level and socio-economic status of the household. Eight per cent of children living in the richest households were left with inadequate care, compared with 20 per cent of children living in the poorest households. 12 210 Left alone in the past week Left in the care of another child younger than 10 years of age in the past week Left with inadequate care in the past week1 Number of children under age 5 Sex Male 6.9 12.8 15.0 5,593 Female 5.2 11.4 13.0 5,474 Region North 6.1 14.3 16.4 3,502 Central 4.4 9.5 11.2 5,154 South 9.5 14.6 16.4 2,411 Province Vientiane Capital 7.7 9.0 12.5 1,058 Phongsaly 7.3 7.2 10.0 368 Luangnamtha 8.0 22.4 24.1 280 Oudomxay 3.4 4.5 5.3 676 Bokeo 7.9 15.6 19.5 335 Luangprabang 7.1 16.8 19.7 752 Huaphanh 6.9 25.0 26.5 606 Xayabury 4.0 10.4 12.6 486 Xiengkhuang 1.0 14.5 15.0 540 Vientiane 5.4 9.0 10.5 767 Borikhamxay 0.6 4.1 4.1 402 Khammuane 1.8 4.2 5.2 603 Savannakhet 4.8 11.4 13.3 1,784 Saravane 14.0 20.7 23.5 923 Sekong 11.8 21.4 23.7 269 Champasack 5.3 7.8 8.5 1,003 Attapeu 7.2 11.0 14.0 216 Residence Urban 3.0 6.6 8.0 2,319 Rural 6.9 13.6 15.6 8,748 .Rural with road 6.8 13.2 15.3 7,661 .Rural without road 6.9 16.2 17.7 1,086 Age of child 0-23 months 2.8 6.7 7.6 4,448 24-59 months 8.2 15.8 18.3 6,619 Mother’s education None 7.3 16.5 18.1 3,580 Primary 6.4 11.8 14.1 4,556 Lower secondary 4.1 7.6 9.3 1,613 Upper secondary 4.4 7.2 8.6 695 Post secondary non tertiary 4.4 7.5 9.1 368 Higher 2.8 3.4 4.6 255 Wealth index quintile Poorest 8.3 17.9 19.7 3,233 Second 6.0 14.2 15.6 2,346 Middle 5.5 8.8 10.9 2,019 Fourth 4.7 7.9 10.4 1,807 Richest 3.9 6.5 8.3 1,663 Ethno-linguistic group of household head Lao-Tai 4.9 8.9 10.8 6,030 Mon-Khmer 8.0 15.4 17.2 3,189 Hmong-Mien 6.0 17.9 19.4 1,439 Chinese-Tibetan 8.7 14.7 17.6 357 Other, Missing, DK 5.7 13.1 13.1 52 Total 6.0 12.1 14.0 11,067 Percentage of children under age 5 left alone or left in the care of another child younger than 10 years of age for more than one hour at least once during the past week, Lao PDR 2011-12 1 MICS indicator 6.5 Percentage of children under age 5 Table CD.4: Inadequate care 12 211 Early Childhood Development ‘Early child development’ is defined as an orderly, predictable process along a continuous path, in which a child learns to handle more complicated levels of moving, thinking, speaking, feeling and relating to others. Physical growth, literacy and numeracy skills, socio-emotional development and readiness to learn are vital domains of a child’s overall development, which is a basis for overall human development. A 10-item module is used to calculate the Early Child Development Index (ECDI). The ECDI is based on benchmarks that children are expected to reach if they are progressing in their development as the majority of children in their age group develop. The primary purpose of the ECDI is to inform public policy regarding the developmental status of children in Lao PDR. Each of the 10 items is used in one of four domains to determine whether children are developmentally on track in that domain. The domains in question are: • Literacy-numeracy: Children are identified as being developmentally on track according to whether they can identify/name at least 10 letters of the alphabet, whether they can read at least four simple, popular words, and whether they know the names and recognize the symbols of all numbers from 1 to 10. If at least two of these capabilities are found, the child is considered developmentally on track • Physical: If the child can pick up a small object such as a stick or a rock from the ground with two fingers, and/or the mother or caretaker does not indicate that the child is sometimes too sick to play, then the child is regarded as being developmentally on track in the physical domain • Social-emotional: Children are considered to be developmentally on track if two of the following are true: the child gets along well with other children; the child does not kick, bite or hit other children; and the child does not get distracted easily • Learning: If the child follows simple directions on how to do something correctly and/or when given something to do, is able to do it independently, then the child is considered to be developmentally on track in this domain ECDI is calculated as the percentage of children who are developmentally on track in at least three of these four domains. 12 212 Literacy-numeracy Physical Social-Emotional Learning Sex Male 18.1 97.9 83.9 93.6 79.9 2,269 Female 21.5 98.0 86.7 93.6 82.8 2,157 Region North 16.7 98.1 84.7 95.4 81.5 1,418 Central 23.1 98.4 86.7 92.0 81.2 2,055 South 16.8 96.7 82.8 94.3 81.1 953 Province Vientiane Capital 56.4 99.3 88.1 96.7 90.2 419 Phongsaly 13.3 97.8 64.3 97.6 68.2 152 Luangnamtha 28.6 99.0 81.0 81.8 69.0 114 Oudomxay 8.0 99.6 71.6 98.9 72.2 257 Bokeo 13.3 97.0 85.5 95.6 81.7 131 Luangprabang 29.0 99.7 95.0 98.8 94.1 329 Huaphanh 5.5 96.4 93.0 93.5 86.3 253 Xayabury 20.4 95.9 92.2 93.5 84.0 182 Xiengkhuang 9.8 96.7 93.8 83.0 77.9 225 Vientiane 22.9 98.7 75.9 95.6 74.8 312 Borikhamxay 27.4 100.0 85.4 98.9 86.5 157 Khammuane 11.0 99.6 82.3 92.9 79.2 226 Savannakhet 10.9 97.5 90.2 88.6 79.3 716 Saravane 12.6 94.2 72.8 92.3 70.9 365 Sekong 12.5 97.5 84.6 87.4 79.3 118 Champasack 23.7 98.1 89.2 97.2 88.4 377 Attapeu 10.8 100.0 94.1 99.1 94.2 92 Residence Urban 42.4 99.4 87.1 96.5 87.8 885 Rural 14.1 97.6 84.8 92.8 79.7 3,540 .Rural with road 14.8 97.6 84.4 93.5 80.0 3,092 .Rural without road 9.2 97.2 87.4 88.1 77.1 448 Age 36-47 months 15.1 97.3 85.1 91.9 79.3 2,302 48-59 months 24.8 98.6 85.4 95.4 83.5 2,124 Preschool attendance Attending preschool 53.4 99.4 87.8 98.2 91.0 1,019 Not attending preschool 9.7 97.5 84.5 92.2 78.4 3,406 Mother’s education None 7.1 97.1 82.7 89.1 74.0 1,560 Primary 17.2 98.2 86.1 95.5 83.3 1,827 Lower secondary 33.2 98.2 86.5 95.3 86.4 595 Upper secondary 53.8 99.6 92.4 99.4 95.5 220 Post secondary non tertiary 60.8 98.4 86.4 98.2 87.6 147 Higher 57.4 100.0 85.6 99.1 89.6 76 Wealth index quintile Poorest 6.6 97.9 84.1 90.7 76.6 1,364 Second 8.3 96.6 84.3 90.7 77.6 948 Middle 18.1 97.8 84.7 95.2 82.1 785 Fourth 30.2 98.5 87.1 96.7 85.6 688 Richest 55.2 99.6 87.9 98.6 91.1 640 Ethno-linguistic group of household head Lao-Tai 30.0 98.5 86.6 96.3 85.8 2,343 Mon-Khmer 8.1 97.1 83.8 91.0 76.9 1,325 Hmong-Mien 6.0 97.3 85.7 89.2 76.0 594 Chinese-Tibetan 15.5 98.0 75.2 89.9 70.0 140 Other, Missing, DK * * * * * 23 Total 19.7 97.9 85.3 93.6 81.3 4,426 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 MICS indicator 6.6 Table CD.5: Early child development index Percentage of children age 36-59 months who are developmentally on track in literacy-numeracy, physical, social-emotional, and learning domains, and the early child development index score, Lao PDR 2011-12 Percentage of children age 36-59 months who are developmentally on track for indicated domains Early child development index score1 Number of children age 36-59 months 12 213 The percentage of children age 36-59 months who are developmentally on track in the literacy- numeracy, physical, social-emotional and learning domains, and the ECDI score, are presented in Table CD.5. Eight in 10 children age 36-59 months are developmentally on track. The analysis of the four domains of child development shows that most children are on track in three out of the four learning domains: physical, social-emotional, and learning, but only one of every five children age three and four years is developmentally on track in literacy-numeracy. However, half of children who are attending preschool are on track in the literacy-numeracy domain, compared to only 10 per cent of children not attending preschool. Note that while most children are on track in the domains other than literacy-numeracy, only 6 in 10 children in Phongsaly are on track in the social-emotional domain, and the percentage is also lower than the national average in Oudomxay and Saravane. 12 © UNFPA Lao PDR / 2012 / Perier 215 XIII. Literacy and Education Literacy among Young People One of the World Fit for Children goals is to assure adult literacy. Adult literacy is also a Millennium Development Goal (MDG) indicator relating to both men and women. Literacy is assessed in the LSIS by assuming respondents with secondary or higher education can read, and by asking respondents with primary education or less to read a short simple statement. The percentage of 15-24 year-olds who are literate is presented in Tables ED.1.1 and ED.1.2. Sixty-nine per cent of young women and 77 per cent of young men are literate in Lao PDR. Among both women and men the highest percentage of literacy is found 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 young women and 70 per cent among young men. Ninety-one per cent of women and 92 per cent of men in urban areas are literate, compared with 60 per cent of women and 72 per cent of men in rural areas. Among those who stated that primary school was the highest level of schooling they attended, just 46 per cent of young women and 45 per cent of young men were actually able to read the statement shown to them. The literacy rate is positively correlated with socio-economic status, ranging from 29 per cent of women and 49 per cent of men of the poorest quintile, to 96 per cent of both women and men of the richest quintile. Some 82 per cent of women and 84 per cent of men of Lao-Tai headed households are literate, compared with only 30 per cent of women and 43 per cent of men of Chinese-Tibetan headed households. 13 216 13 Percentage literate1 Percentage not known Number of women age 15-24 years Region North 65.2 0.3 2,573 Central 76.3 0.7 3,918 South 55.3 0.4 1,541 Province Vientiane Capital 92.9 0.7 1,110 Phongsaly 52.7 0.3 241 Luangnamtha 57.5 0.0 237 Oudomxay 50.6 0.0 479 Bokeo 62.0 0.5 233 Luangprabang 70.3 0.5 474 Huaphanh 67.3 0.2 408 Xayabury 84.0 0.4 502 Xiengkhuang 77.5 1.1 389 Vientiane 84.1 0.6 542 Borikhamxay 78.7 0.8 322 Khammuane 68.0 0.2 378 Savannakhet 58.6 0.6 1,177 Saravane 38.6 0.8 564 Sekong 61.2 0.0 154 Champasack 65.1 0.2 682 Attapeu 67.9 0.0 141 Residence Urban 90.6 0.4 2,356 Rural 59.7 0.5 5,676 .Rural with road 61.5 0.6 5,153 .Rural without road 41.4 0.0 523 Education None 0.4 0.2 1,054 Primary 45.6 1.4 2,689 Lower secondary 100.0 0.0 1,880 Upper secondary 100.0 0.0 1,577 Post secondary non tertiary 100.0 0.0 216 Higher 100.0 0.0 617 Age 15-19 72.3 0.4 4,415 20-24 64.3 0.5 3,617 Wealth index quintile Poorest 28.7 0.4 1,328 Second 48.9 0.4 1,526 Middle 71.8 0.5 1,540 Fourth 83.9 0.6 1,648 Richest 95.7 0.5 1,990 Ethno-linguistic group of household head Lao-Tai 81.6 0.4 5,208 Mon-Khmer 45.3 0.3 1,818 Hmong-Mien 48.6 1.4 689 Chinese-Tibetan 30.1 0.2 269 Other, Missing, DK (62.2) (0.0) 49 Total 68.7 0.5 8,032 Percentage of women age 15-24 years who are literate, Lao PDR 2011-12 Table ED.1.1: Literacy among young women 1 MICS indicator 7.1; MDG indicator 2.3 Note: Figures in parentheses are based on 25-49 unweighted cases. 217 13 Percentage literate1 Percentage not known Number of men age 15-24 years Region North 78.7 0.5 1,133 Central 79.4 0.8 1,866 South 69.7 1.1 677 Province Vientiane Capital 95.2 0.6 504 Phongsaly 51.1 2.1 130 Luangnamtha 70.1 0.5 94 Oudomxay 76.4 0.0 204 Bokeo 81.5 0.0 90 Luangprabang 82.7 0.6 197 Huaphanh 86.6 0.4 198 Xayabury 89.2 0.0 219 Xiengkhuang 87.8 2.2 194 Vientiane 90.4 0.0 250 Borikhamxay 88.4 1.3 128 Khammuane 74.1 1.0 183 Savannakhet 58.8 0.7 607 Saravane 62.8 0.8 223 Sekong 76.3 0.0 62 Champasack 71.0 1.6 340 Attapeu 83.9 0.0 52 Residence Urban 92.0 0.7 1,039 Rural 71.7 0.8 2,637 .Rural with road 73.3 0.8 2,388 .Rural without road 55.5 0.6 249 Education None 0.0 0.0 187 Primary 44.7 2.3 1,163 Lower secondary 100.0 0.0 1,077 Upper secondary 100.0 0.0 874 Post secondary non tertiary 100.0 0.0 104 Higher 100.0 0.0 271 Age 15-19 79.0 0.4 2,119 20-24 75.3 1.2 1,557 Wealth index quintile Poorest 48.9 0.7 567 Second 64.8 0.6 734 Middle 77.5 0.7 778 Fourth 91.0 1.1 786 Richest 95.5 0.7 812 Ethno-linguistic group of household head Lao-Tai 83.9 0.9 2,407 Mon-Khmer 62.8 0.4 798 Hmong-Mien 81.2 0.2 301 Chinese-Tibetan 43.1 1.5 140 Other, Missing, DK (65.4) (0.0) 30 Total 77.4 0.7 3,676 Table ED.1.2: Literacy among young men Percentage of men age 15-24 years who are literate, Lao PDR 2011-12 Note: Figures in parentheses are based on 25-49 unweighted cases. 218 School Readiness It is important that children attend pre-school education in an organised learning or child education programme in order to be ready to attend school. Table ED.2 shows that 24 per cent of children in Lao PDR are attending the first grade of primary school, having also attended pre-school the previous year. The percentage of boys and girls who attended pre-school is about the same (23 and 25 per cent, respectively). Thirty-two per cent of children in the Central region attended pre-school, compared with only 21 per cent of children in the Northern and 15 per cent in the Southern regions. Fifty-one per cent of children in urban areas attended pre-school the previous year compared with 20 per cent of children living in rural areas. Children in Vientiane Capital (68 per cent), Vientiane province (47 per cent), and Xayabury province (41 per cent) attend preschool in higher proportions than anywhere else. Socio-economic status is highly correlated with school readiness – only 10 per cent of children from the poorest households attended pre-school, while 67 per cent of children living in the richest households did so. While 64 per cent of children of mothers with post-secondary, non-tertiary education attended pre-school, only 13 per cent of children whose mothers have no education attended. Thirty-five per cent of children in Lao-Tai headed households attended pre-school, compared with only 15 per cent of children in Chinese Tibetan-headed households and 13 per cent of children in Mon-Khmer and Hmong- Mien headed households. 13 219 Percentage of children attending first grade who attended preschool in previous year1 Number of children attending first grade of primary school Sex Male 22.8 2,177 Female 24.7 2,036 Region North 21.4 1,446 Central 31.5 1,682 South 14.6 1,084 Province Vientiane Capital 67.9 228 Phongsaly 6.2 152 Luangnamtha 26.7 82 Oudomxay 25.5 320 Bokeo 25.7 122 Luangprabang 25.8 301 Huaphanh 7.5 314 Xayabury 40.7 155 Xiengkhuang 23.6 161 Vientiane 46.7 235 Borikhamxay 21.4 132 Khammuane 16.3 266 Savannakhet 23.6 661 Saravane 5.6 477 Sekong 20.8 139 Champasack 25.3 375 Attapeu 8.4 94 Residence Urban 50.6 556 Rural 19.6 3,657 .Rural with road 20.3 3,208 .Rural without road 14.5 449 Mother's education None 12.8 1,713 Primary 25.4 1,893 Lower secondary 41.9 374 Upper secondary 60.4 106 Post secondary non tertiary 63.7 90 Higher (59.7) 34 Mother not in household * 1 Wealth index quintile Poorest 10.3 1,403 Second 15.1 1,116 Middle 26.7 828 Fourth 44.1 508 Richest 66.6 358 Ethno-linguistic group of household head Lao-Tai 34.6 2,073 Mon-Khmer 13.4 1,464 Hmong-Mien 12.6 528 Chinese-Tibetan 14.5 126 Other, Missing, DK * 22 Total 23.7 4,213 Percentage of children attending first grade of primary school who attended pre-school the previous year, Lao PDR 2011-12 Table ED.2: School readiness 1 MICS indicator 7.2 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. 13 220 Primary and Secondary School Participation Universal access to basic education and the achievement of primary education by the world’s children is one of the most important goals of the MDGs and A World Fit for Children. Education is a vital prerequisite for combating poverty, empowering women, protecting children from hazardous and exploitative labour and sexual exploitation, promoting human rights and democracy, protecting the environment and influencing population growth. The indicators for primary and secondary school attendance include: • Net intake rate in primary education • Primary school net attendance ratio (adjusted) • Secondary school net attendance ratio (adjusted) • Female-to-male education ratio (or gender parity index [GPI]) in primary and secondary school The indicators of school progression include: • Children reaching last grade of primary school • Primary completion rate • Rate of transition to secondary school In Lao PDR, the education system currently follows a 5+4+3 formula for the primary, lower secondary and upper secondary levels (five grades in primary school, four in lower secondary school and three in upper secondary school). Children enter primary school at the age of 6, lower secondary school at age 11, and upper secondary school at age 15. There are 5 grades in primary school, 4 grades in lower secondary school and 3 grades in upper secondary school. In primary school grades are referred to as year 1 to year 5 or standard 1 to standard 5, in lower secondary school grades are referred to as year 1 to year 4, and in upper secondary school grades are referred to as year 1 to year 3. The school year typically runs from September of one year to June of the following year. Table ED.3 shows that in Lao PDR, 64 per cent of all children of primary school entry age are entering grade 1, while the percentage of girls is slightly higher than boys (66 per cent and 62 per cent, respectively). Significant differentials exist across regions, provinces and urban-rural areas. In the Northern and Central regions, two-thirds of 6-year-old children are entering primary school, while in the South, only 53 per cent are entering at the correct age. Children’s initiation to primary school is higher in urban areas (81 per cent) than in rural areas (60 per cent). A strong positive correlation with both mother’s education and socio-economic status is observed. Among children age 6 whose mothers have no education, only half are entering the first grade, while nearly 90 per cent of 6-year- olds of the highest educated mothers enter primary school. The percentage entering primary school also rises dramatically by wealth quintile, from 48 per cent among children in the poorest households, to 83 per cent in the richest. Seventy-four per cent of 6-year-old children in Lao-Tai headed households are entering primary school, compared to only 42 per cent of children in Chinese-Tibetan headed households. 13 221 Percentage of children of primary school entry age entering grade 11 Number of children of primary school entry age Sex Male 61.5 1,158 Female 66.1 1,213 Region North 67.1 850 Central 66.9 1,003 South 52.7 517 Province Vientiane Capital 84.6 188 Phongsaly 51.8 84 Luangnamtha 58.5 72 Oudomxay 62.5 160 Bokeo 61.5 76 Luangprabang 67.5 190 Huaphanh 72.1 133 Xayabury 84.3 134 Xiengkhuang 67.9 108 Vientiane 73.3 158 Borikhamxay 82.9 90 Khammuane 62.7 134 Savannakhet 50.6 326 Saravane 46.7 202 Sekong 66.4 58 Champasack 54.8 214 Attapeu 51.9 43 Residence Urban 81.2 418 Rural 60.1 1,952 .Rural with road 62.4 1,691 .Rural without road 45.7 261 Mother's education None 48.8 900 Primary 68.7 1,038 Lower secondary 82.0 265 Upper secondary 83.7 83 Post secondary non tertiary (87.6) 45 Higher (88.5) 40 Wealth index quintile Poorest 48.2 728 Second 57.3 552 Middle 73.2 440 Fourth 78.5 365 Richest 83.2 286 Ethno-linguistic group of household head Lao-Tai 74.2 1,225 Mon-Khmer 52.7 761 Hmong-Mien 57.3 295 Chinese-Tibetan 41.7 80 Other, Missing, DK * 10 Total 63.9 2,371 Percentage of children of primary school entry age entering grade 1 (net intake rate), Lao PDR 2011-12 Table ED.3: Primary school entry 1 MICS indicator 7.3 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. 13 222 The primary school net attendance ratio is the percentage of children of primary school age (6 to 10 years) who are attending primary school. The adjusted primary school net attendance ratio (shown in Table ED.4) is the percentage of children of primary school age who are attending primary or secondary school. The majority of children of primary school age are attending school (85 per cent). However, 15 per cent of primary school-age children are out of school when they are expected to be participating. In urban areas, 95 per cent of children attend school while in rural areas attendance is only 83 per cent. A positive correlation exists with regard to mother’s education and the socio-economic status of households. While 95 per cent of children of mothers with lower secondary school education are attending school, only 74 per cent of children of mothers with no education are attending. In the richest households, the proportion is 97 per cent, and 71 per cent among children living in the poorest households. Nationally, boys and girls of primary school age attend school in equal proportion, but among the poorest households, the percentage of girls who attend school (68 per cent) is slightly lower than the percentage of boys (74 per cent). Ninety-two per cent of children of primary school age in Lao-Tai headed households attend school, but the proportion is lower among children living in other ethno-linguistic households. 13 223 Net attendance ratio (adjusted) Number of children Net attendance ratio (adjusted) Number of children Net attendance ratio (adjusted)1 Number of children Region North 88.4 2,064 85.5 2,101 87.0 4,165 Central 86.0 2,639 86.7 2,726 86.4 5,365 South 78.4 1,337 79.3 1,327 78.8 2,664 Province Vientiane Capital 94.6 481 97.9 476 96.2 957 Phongsaly 80.5 224 76.3 198 78.5 422 Luangnamtha 84.0 175 84.3 153 84.1 328 Oudomxay 88.0 370 80.7 395 84.2 765 Bokeo 86.5 184 81.1 182 83.8 366 Luangprabang 88.4 440 87.8 468 88.1 908 Huaphanh 93.0 376 87.6 365 90.3 741 Xayabury 93.3 294 94.2 340 93.8 634 Xiengkhuang 92.0 267 89.2 293 90.5 559 Vientiane 93.0 405 92.0 421 92.5 826 Borikhamxay 95.9 235 94.8 218 95.3 452 Khammuane 84.2 372 85.2 350 84.7 722 Savannakhet 74.4 880 77.0 968 75.7 1,849 Saravane 73.4 501 75.1 505 74.2 1,006 Sekong 85.3 142 85.2 136 85.3 278 Champasack 81.2 572 82.1 569 81.6 1,142 Attapeu 77.8 122 76.5 116 77.1 238 Residence Urban 94.4 1,119 95.4 1,151 94.9 2,270 Rural 83.1 4,921 82.3 5,002 82.7 9,923 .Rural with road 84.5 4,322 84.2 4,396 84.4 8,717 .Rural without road 72.3 599 68.2 606 70.2 1,205 Age at beginning of school year 6 63.6 1,158 69.8 1,213 66.8 2,371 7 85.2 1,205 82.7 1,243 83.9 2,449 8 90.1 1,269 89.9 1,319 90.0 2,588 9 93.2 1,194 90.6 1,101 92.0 2,295 10 92.5 1,213 90.4 1,277 91.5 2,490 Mother's education None 75.9 2,301 72.6 2,247 74.2 4,548 Primary 88.5 2,601 89.8 2,727 89.1 5,328 Lower secondary 96.1 692 94.1 706 95.1 1,398 Upper secondary 94.4 215 98.7 222 96.6 437 Post secondary non tertiary 99.6 153 99.8 175 99.7 328 Higher 98.7 77 97.9 76 98.3 154 DK/Missing * 1 * 0 * 1 Wealth index quintile Poorest 73.8 1,625 67.8 1,657 70.8 3,282 Second 81.1 1,453 83.0 1,442 82.0 2,895 Middle 91.0 1,216 92.0 1,270 91.5 2,486 Fourth 93.9 974 95.4 999 94.6 1,973 Richest 96.5 771 98.0 785 97.3 1,556 Ethno-linguistic group of household head Lao-Tai 91.1 3,218 92.5 3,371 91.8 6,589 Mon-Khmer 75.8 1,860 74.2 1,824 75.0 3,684 Hmong-Mien 86.2 712 79.6 736 82.8 1,449 Chinese-Tibetan 75.9 229 69.9 196 73.1 424 Other, Missing, DK * 21 (70.2) 26 (69.2) 47 Total 85.2 6,040 84.7 6,153 84.9 12,193 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 ED.4: Primary school attendance 1 MICS indicator 7.4; MDG indicator 2.1 Percentage of children of primary school age attending primary or secondary school (adjusted net attendance ratio), Lao PDR 2011-12 Male Female Total 13 224 The secondary school net attendance ratio is the percentage of children of secondary school age (11 to 17 years) who are attending secondary school. The adjusted secondary school net attendance ratio (shown in Table ED.5) is the percentage of children of secondary school age who are attending secondary school or higher. Table ED.5 also presents the percentage of children of secondary school age who are attending primary school. Only about half (45 per cent) of children of secondary school age are attending secondary school. Of the remaining half, 25 per cent are attending primary school, while 30 per cent are not attending school at all. Thirty per cent of children of secondary school age in the North and South are attending primary school, compared to 20 per cent of children in the Central region. In rural areas, 29 per cent of children of secondary school age are attending primary school, compared to only 11 per cent of children in urban areas. Two thirds of children age 11 are still attending primary school. While the percentage of secondary school-aged children attending primary school declines steadily with the increasing education of the mother, as many as 37 per cent of children of mothers who have no education are attending primary school. The decline in the proportion of secondary school-aged children attending primary school according to increasing wealth quintile is dramatic, dropping from a high of 43 per cent among those from the poorest quintile (6 per cent). Some 18 per cent of secondary school-aged children of Lao-Tai headed households are attending primary school, compared with more than 30 per cent of children in Mon-Khmer, Hmong-Mien and Chinese-Tibetan headed households. 13 225 13 N et a tte nd an ce ra tio (a dj us te d) 1 P er ce nt a tte nd in g pr im ar y sc ho ol N um be r o f ch ild re n N et a tte nd an ce ra tio (a dj us te d) 1 P er ce nt a tte nd in g pr im ar y sc ho ol N um be r o f ch ild re n N et a tte nd an ce ra tio (a dj us te d) 1 P er ce nt a tte nd in g pr im ar y sc ho ol N um be r o f ch ild re n R eg io n N or th 46 .1 32 .2 2, 61 2 40 .5 26 .7 2, 61 1 43 .3 29 .5 5, 22 3 C en tra l 49 .1 22 .8 3, 77 3 52 .2 17 .5 3, 80 4 50 .7 20 .1 7, 57 7 S ou th 32 .8 34 .4 1, 73 7 33 .0 24 .2 1, 58 9 32 .9 29 .5 3, 32 6 Pr ov in ce V ie nt ia ne C ap ita l 76 .8 9. 7 66 2 76 .1 8. 6 85 2 76 .4 9. 1 1, 51 4 P ho ng sa ly 35 .8 37 .7 28 5 32 .4 30 .3 23 4 34 .3 34 .4 51 9 Lu an gn am th a 44 .2 33 .8 23 1 40 .4 26 .4 23 8 42 .3 30 .0 46 9 O ud om xa y 38 .4 40 .4 45 5 32 .8 30 .5 48 0 35 .5 35 .3 93 6 B ok eo 44 .8 33 .0 19 4 37 .3 27 .4 23 3 40 .7 29 .9 42 7 Lu an gp ra ba ng 46 .9 31 .4 48 1 37 .6 31 .0 50 7 42 .1 31 .2 98 8 H ua ph an h 53 .3 32 .5 55 7 48 .3 28 .8 47 5 51 .0 30 .8 1, 03 2 X ay ab ur y 53 .1 18 .7 40 9 50 .1 13 .5 44 3 51 .5 16 .0 85 2 X ie ng kh ua ng 60 .0 24 .8 41 0 57 .0 17 .7 42 1 58 .5 21 .2 83 1 V ie nt ia ne 61 .1 19 .6 60 1 57 .6 17 .0 53 9 59 .5 18 .4 1, 14 0 B or ik ha m xa y 55 .6 18 .7 33 4 50 .1 16 .9 32 1 52 .9 17 .8 65 5 K ha m m ua ne 38 .6 28 .6 48 9 37 .4 26 .1 40 0 38 .0 27 .5 88 8 S av an na kh et 28 .0 29 .4 1, 27 8 37 .5 21 .0 1, 27 1 32 .8 25 .2 2, 55 0 S ar av an e 24 .7 41 .4 58 4 19 .7 29 .4 54 4 22 .3 35 .6 1, 12 8 S ek on g 36 .6 49 .8 16 3 36 .1 40 .4 16 2 36 .4 45 .1 32 5 C ha m pa sa ck 37 .3 26 .0 83 1 42 .5 14 .9 72 7 39 .7 20 .8 1, 55 8 A tta pe u 35 .5 36 .7 15 9 31 .7 32 .9 15 6 33 .6 34 .8 31 5 R es id en ce U rb an 70 .3 13 .4 1, 80 4 74 .3 9. 6 1, 95 8 72 .4 11 .4 3, 76 2 R ur al 37 .3 32 .6 6, 31 8 35 .0 25 .8 6, 04 6 36 .2 29 .3 12 ,3 65 .R ur al w ith ro ad 39 .4 31 .5 5, 65 3 37 .1 25 .1 5, 39 4 38 .3 28 .4 11 ,0 47 .R ur al w ith ou t r oa d 19 .7 41 .9 66 5 17 .2 31 .5 65 3 18 .5 36 .7 1, 31 8 A ge a t b eg in ni ng o f s ch oo l y ea r 11 21 .9 69 .9 1, 39 3 27 .2 61 .2 1, 29 7 24 .5 65 .7 2, 69 0 12 36 .6 48 .9 1, 24 1 42 .4 40 .5 1, 27 1 39 .5 44 .6 2, 51 2 13 47 .6 32 .0 1, 20 7 52 .1 20 .1 1, 25 6 49 .9 25 .9 2, 46 3 14 55 .2 16 .9 1, 19 6 53 .7 10 .7 1, 22 2 54 .4 13 .7 2, 41 8 15 57 .6 7. 9 1, 08 2 53 .4 3. 8 98 2 55 .6 5. 9 2, 06 4 16 52 .9 3. 8 1, 02 8 45 .9 1. 3 98 2 49 .5 2. 6 2, 01 0 17 47 .9 0. 8 97 5 39 .5 0. 6 99 4 43 .7 0. 7 1, 96 9 Ta bl e ED .5 : S ec on da ry s ch oo l a tte nd an ce P er ce nt ag e of c hi ld re n of s ec on da ry s ch oo l a ge a tte nd in g se co nd ar y sc ho ol o r h ig he r ( ad ju st ed n et a tte nd an ce ra tio ) a nd p er ce nt ag e of c hi ld re n at te nd in g pr im ar y sc ho ol , L ao P D R 2 01 1- 12 M al e Fe m al e To ta l 1 M IC S in di ca to r 7 .5 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. 226 13 N et a tte nd an ce ra tio (a dj us te d) 1 P er ce nt a tte nd in g pr im ar y sc ho ol N um be r o f ch ild re n N et a tte nd an ce ra tio (a dj us te d) 1 P er ce nt a tte nd in g pr im ar y sc ho ol N um be r o f ch ild re n N et a tte nd an ce ra tio (a dj us te d) 1 P er ce nt a tte nd in g pr im ar y sc ho ol N um be r o f ch ild re n M ot he r's e du ca tio n N on e 26 .2 41 .2 2, 68 5 22 .3 32 .7 2, 61 0 24 .3 37 .0 5, 29 4 P rim ar y 44 .4 29 .8 3, 47 4 46 .2 24 .7 3, 15 0 45 .2 27 .4 6, 62 4 Lo w er s ec on da ry 73 .7 12 .8 83 0 79 .4 8. 1 82 1 76 .5 10 .4 1, 65 2 U pp er s ec on da ry 85 .4 8. 6 24 5 84 .6 8. 3 28 3 85 .0 8. 5 52 8 P os t s ec on da ry n on te rti ar y 78 .8 6. 3 28 2 89 .2 5. 3 29 7 84 .1 5. 8 57 9 H ig he r 96 .4 3. 6 79 92 .7 3. 7 12 0 94 .2 3. 6 19 8 M ot he r n ot in h ou se ho ld 53 .9 3. 0 36 7 37 .7 0. 7 59 3 43 .9 1. 6 96 1 C an no t b e de te rm in ed 40 .2 0. 6 15 8 31 .6 0. 0 12 9 36 .3 0. 3 28 7 D K /M is si ng * * 1 * * 1 * * 3 W ea lth in de x qu in til e P oo re st 13 .6 48 .9 1, 54 8 8. 9 35 .9 1, 50 6 11 .3 42 .5 3, 05 4 S ec on d 29 .2 36 .4 1, 80 5 26 .0 32 .5 1, 73 3 27 .6 34 .5 3, 53 8 M id dl e 44 .6 27 .9 1, 86 4 45 .4 22 .1 1, 73 0 45 .0 25 .1 3, 59 4 Fo ur th 63 .0 16 .4 1, 68 9 63 .6 11 .8 1, 58 2 63 .3 14 .2 3, 27 0 R ic he st 81 .9 7. 3 1, 21 7 82 .1 5. 1 1, 45 3 82 .0 6. 1 2, 67 0 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 54 .2 20 .1 4, 84 9 58 .2 15 .0 4, 85 6 56 .2 17 .6 9, 70 4 M on -K hm er 27 .6 40 .9 2, 13 2 21 .5 33 .8 2, 00 4 24 .6 37 .5 4, 13 6 H m on g- M ie n 38 .8 39 .0 79 6 28 .3 30 .7 83 5 33 .4 34 .7 1, 63 1 C hi ne se -T ib et an 28 .1 42 .1 28 3 25 .7 26 .7 27 5 26 .9 34 .5 55 9 O th er , M is si ng , D K 37 .2 38 .7 62 (1 4. 4) (3 5. 1) 34 29 .1 37 .4 96 To ta l 44 .7 28 .3 8, 12 2 44 .6 21 .8 8, 00 4 44 .6 25 .1 16 ,1 26 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. 1 M IC S in di ca to r 7 .5 M al e Fe m al e To ta l Ta bl e ED .5 : S ec on da ry s ch oo l a tte nd an ce P er ce nt ag e of c hi ld re n of s ec on da ry s ch oo l a ge a tte nd in g se co nd ar y sc ho ol o r h ig he r ( ad ju st ed n et a tte nd an ce ra tio ) a nd p er ce nt ag e of c hi ld re n at te nd in g pr im ar y sc ho ol , L ao P D R 2 01 1- 12 227 The percentage of children entering first grade who eventually reach the last grade of primary school is presented in Table ED.6. Of all children starting grade one, the vast majority of them (95 per cent) will reach the last grade. Notice that this figure includes children that repeat grades but do eventually reach the last grade. Ninety-five per cent of both girls and boys who entered grade one reach grade five. In the Northern and Central regions, 98 per cent and 96 per cent of children in grade one reach grade five (including repetition), compared with 87 per cent in the South. Only 4 per cent more urban than rural children are likely to reach grade five. All children of mothers with upper secondary school or higher education reach grade five if they started grade one, compared with 94 per cent of children of mothers with no education. Ninety-two per cent of children of households belonging to the middle quintile reach grade five if they enter grade one, compared with all children of the households belonging to the richest quintile. Once they enter grade one, 99 per cent of children in Chinese-Tibetan headed households reach grade five, compared with only 93 per cent of children in Mon-Khmer headed households. 13 228 Percent attending grade 1 last school year who are in grade 2 this school year Percent attending grade 2 last school year who are attending grade 3 this school year Percent attending grade 3 last school year who are attending grade 4 this school year Percent attending grade 4 last school year who are attending grade 5 this school year Percent who reach grade 5 of those who enter grade 11 Sex Male 98.6 99.3 99.0 98.0 95.0 Female 98.8 99.6 98.1 98.4 94.9 Region North 99.8 99.8 99.6 98.4 97.6 Central 98.1 99.4 99.7 98.8 96.1 South 97.8 98.7 94.2 96.1 87.4 Province Vientiane Capital 99.3 100.0 100.0 98.3 97.6 Phongsaly 100.0 100.0 100.0 100.0 100.0 Luangnamtha 99.2 100.0 100.0 99.5 98.7 Oudomxay 99.6 100.0 100.0 98.6 98.3 Bokeo 100.0 100.0 100.0 98.0 98.0 Luangprabang 99.6 99.5 99.1 98.5 96.7 Huaphanh 100.0 99.5 98.6 98.4 96.5 Xayabury 100.0 100.0 100.0 97.1 97.1 Xiengkhuang 100.0 99.3 99.3 98.7 97.3 Vientiane 98.7 100.0 99.4 99.7 97.8 Borikhamxay 99.3 100.0 100.0 100.0 99.3 Khammuane 97.7 98.8 100.0 98.5 95.0 Savannakhet 96.7 98.9 99.5 98.2 93.4 Saravane 95.9 98.6 93.0 93.1 81.9 Sekong 99.4 98.4 98.7 96.9 93.5 Champasack 98.6 98.7 93.0 96.9 87.7 Attapeu 100.0 99.2 99.4 100.0 98.7 Residence Urban 98.9 99.9 99.7 99.2 97.8 Rural 98.6 99.3 98.3 97.9 94.2 .Rural with road 98.5 99.4 98.3 98.2 94.5 .Rural without road 99.3 98.5 98.0 95.5 91.6 Mother's education None 97.7 98.8 98.9 98.0 93.6 Primary 99.2 99.6 98.5 98.1 95.5 Lower secondary 100.0 100.0 97.0 99.5 96.5 Upper secondary 100.0 100.0 100.0 100.0 100.0 Post secondary non 100.0 100.0 100.0 100.0 100.0 Higher (100.0) * * (100.0) * Mother not in household * * * * * Wealth index quintile Poorest 98.6 99.1 98.4 96.6 93.0 Second 98.3 99.1 97.9 98.8 94.3 Middle 97.9 99.2 97.4 97.5 92.3 Fourth 99.6 100.0 100.0 98.4 98.0 Richest 99.5 100.0 100.0 100.0 99.5 Ethno-linguistic group of household head Lao-Tai 99.2 99.7 98.6 98.3 95.9 Mon-Khmer 97.7 98.6 98.3 97.9 92.7 Hmong-Mien 99.3 99.7 98.3 98.2 95.5 Chinese-Tibetan 99.7 100.0 100.0 99.4 99.0 Other, Missing, DK * * * * * Total 98.7 99.4 98.6 98.2 94.9 Table ED.6: Children reaching last grade of primary school 1 MICS indicator 7.6; MDG indicator 2.2 Percentage of children entering first grade of primary school who eventually reach the last grade of primary school (Survival rate to last grade of primary school), Lao PDR 2011-12 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. 13 229 However, if it is assumed that children repeating grades do not progress to the next grade, the ‘survival rate’ – or percentage of children entering first grade of primary school who eventually reach the last grade of primary school – will change, as shown in Table ED.6A. In accordance with this assumption, the ‘survival rate’ in Lao PDR is 65 per cent, meaning that 65 per cent of both girls and boys who entered grade one reach grade five. In the Northern and Central regions, 76 per cent and 67 per cent of children in grade one reach grade five, respectively, compared with 49 per cent in the South. Children in urban areas are more likely to reach grade five than children in rural areas (78 per cent and 63 per cent, respectively). The survival rate of primary school children is also positively correlated with the education level of mothers. More than 75 per cent of children of mothers with at least lower secondary school or higher education reach grade five if they started grade one, compared with 60 per cent of children of mothers with no education. Similarly, more than 75 per cent of children of households belonging to the fourth and richest quintile reach grade five, if they enter grade one. Once they enter grade one, 87 per cent of children in Chinese-Tibetan headed households reach grade five, compared with only 67 per cent of children in Lao-Tai headed households. 13 230 13 Percent attending grade 1 last school year who are in grade 2 this school year Percent attending grade 2 last school year who are attending grade 3 this school year Percent attending grade 3 last school year who are attending grade 4 this school year Percent attending grade 4 last school year who are attending grade 5 this school year Percent who reach grade 5 of those who enter grade 1 Sex Male 72.8 95.6 96.7 96.7 65.1 Female 74.0 96.1 95.2 96.6 65.4 Region North 83.0 96.5 97.6 97.5 76.2 Central 74.8 95.5 96.7 97.0 67.0 South 59.4 95.4 91.5 93.8 48.6 Province Vientiane Capital 93.4 99.1 98.1 98.3 89.4 Phongsaly 92.0 96.8 96.3 99.2 85.1 Luangnamtha 93.2 95.0 98.6 99.5 86.9 Oudomxay 91.2 100.0 99.2 96.6 87.4 Bokeo 87.5 97.7 98.7 98.0 82.6 Luangprabang 89.9 96.7 97.6 98.5 83.5 Huaphanh 59.5 93.2 94.6 97.0 50.8 Xayabury 92.0 95.5 98.5 95.7 82.8 Xiengkhuang 84.4 96.3 98.0 98.1 78.2 Vientiane 90.2 97.2 96.9 99.0 84.1 Borikhamxay 85.3 94.8 97.8 96.9 76.6 Khammuane 64.5 89.3 93.3 93.2 50.0 Savannakhet 63.5 95.2 96.4 96.1 55.9 Saravane 45.8 96.6 87.0 89.9 34.6 Sekong 55.6 90.3 95.4 93.3 44.7 Champasack 79.0 95.8 92.5 95.0 66.5 Attapeu 73.4 96.4 98.1 99.3 68.9 Residence Urban 84.9 96.3 97.9 98.0 78.4 Rural 71.3 95.8 95.5 96.3 62.8 .Rural with road 71.3 96.0 95.4 96.7 63.1 .Rural without road 71.9 93.6 96.5 92.1 59.8 Mother's education None 68.4 94.6 95.6 96.9 59.9 Primary 74.2 96.5 96.4 96.4 66.6 Lower secondary 85.8 96.6 94.4 98.8 77.3 Upper secondary 84.5 94.3 97.8 98.3 76.6 Post secondary non tertiary 85.9 100.0 97.8 94.6 79.4 Higher (92.1) (97.4) * (100.0) * Mother not in household * * * * * Wealth index quintile Poorest 67.8 95.3 96.1 94.0 58.4 Second 69.9 95.3 94.1 98.1 61.5 Middle 72.4 95.8 94.6 95.4 62.6 Fourth 85.2 96.5 98.1 97.4 78.6 Richest 87.9 97.4 98.9 98.5 83.4 Ethno-linguistic group of household head Lao-Tai 74.6 95.9 96.5 97.0 67.0 Mon-Khmer 68.1 95.5 94.7 95.4 58.8 Hmong-Mien 78.6 96.2 95.8 97.7 70.8 Chinese-Tibetan 92.9 96.7 98.2 98.5 86.8 Other, Missing, DK * * * * * Total 73.4 95.9 96.0 96.7 65.3 Table ED.6A: Children reaching last grade of primary school Percentage of children entering first grade of primary school who eventually reach the last grade of primary school (Survival rate to last grade of primary school, assuming repeaters do not progress to the next grade), Lao PDR 2011-12 Assumes repeaters do NOT progress to the next grade 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. 231 The primary school completion rate and the transition rate to secondary education are presented in Table ED.7. The primary school completion rate is the ratio of the total number of students, regardless of age, entering the last grade of primary school for the first time, to the number of children of the primary graduation age at the beginning of the current (or most recent) school year. The primary school completion rate for all of Lao PDR is 94 per cent. The rate varies considerably across provinces from as high as 129 per cent in Luangnamtha and as low as 59 per cent in Saravane. The completion rate among boys (101 per cent) is 12 points higher than that among girls (88 per cent). Children in the South have a lower completion rate (72 per cent) compared with children in the Northern and Central region (99 per cent). Children of mothers who have no education have a lower completion rate (81 per cent) than other children. The primary school completion rate is especially low among children in the poorest quintile (64 per cent). While the primary completion rate is over 100 per cent among the children of Lao-Tai and Hmong-Mien household heads, it is only 73 per cent and 77 per cent among the Chinese-Tibetan and Mon-Khmer households. Ninety-one per cent of children who successfully completed the last grade of primary school went on to attend the first grade of secondary school. The transition rate to secondary school is above 90 per cent for most but not all background characteristics shown in Table ED.7. Children in the North, in rural areas without roads, from the lowest wealth quintiles, and in Mon-Khmer headed households have lower than average transition rates to secondary school. 13 232 Primary school completion rate1 Number of children of primary school completion age Transition rate to secondary school2 Number of children who were in the last grade of primary school the previous year Sex Male 100.5 1,213 91.1 1,008 Female 88.2 1,277 90.7 959 Region North 102.6 833 88.3 689 Central 98.8 1,121 93.0 956 South 71.5 536 90.3 323 Province Vientiane Capital 110.8 203 95.7 212 Phongsaly 86.1 84 100.0 50 Luangnamtha 129.3 62 84.3 49 Oudomxay 81.0 158 97.6 111 Bokeo 87.7 67 94.3 48 Luangprabang 112.7 182 82.7 137 Huaphanh 119.0 138 89.8 174 Xayabury 102.9 142 78.1 120 Xiengkhuang 111.0 123 97.6 143 Vientiane 114.5 169 94.0 182 Borikhamxay 112.4 96 97.3 92 Khammuane 84.4 151 83.9 94 Savannakhet 83.8 379 88.9 233 Saravane 58.6 191 91.7 75 Sekong 95.2 49 89.9 44 Champasack 73.6 248 88.2 169 Attapeu 87.6 49 97.9 34 Residence Urban 107.8 473 94.9 520 Rural 91.0 2,017 89.5 1,447 .Rural with road 93.8 1,783 90.5 1,325 .Rural without road 69.2 233 78.1 122 Mother's education None 80.8 898 88.3 520 Primary 100.2 1,095 89.8 873 Lower secondary 102.1 308 95.6 324 Upper secondary 103.7 84 100.0 95 Post secondary non tertiary 92.4 78 94.9 84 Higher (101.1) 26 (100.0) 30 Mother not in household * 0 (91.2) 19 Wealth index quintile Poorest 64.2 605 82.8 202 Second 92.3 590 86.8 413 Middle 109.1 525 90.5 526 Fourth 111.3 435 95.6 451 Richest 106.0 335 94.5 375 Ethno-linguistic group of household head Lao-Tai 102.7 1,370 92.4 1,267 Mon-Khmer 77.3 757 85.5 423 Hmong-Mien 105.4 267 92.7 228 Chinese-Tibetan 72.5 88 92.2 42 Other, Missing, DK * 9 * 8 Total 94.2 2,490 90.9 1,967 Table ED.7: Primary school completion and transition to secondary school 1 MICS indicator 7.7 2 MICS indicator 7.8 Primary school completion rates and transition rate to secondary school, Lao PDR 2011-12 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. 13 233 The ratio of girls to boys attending primary and secondary education is provided in Table ED.8. This ratio is better known as the Gender Parity Index (GPI) and is obtained from adjusted net attendance ratios. The GPI for primary school is close to 1.00, indicating no difference in the attendance of girls and boys across most of the background characteristics in the table. The GPI is also 1.00 for secondary school, indicating no gender disparity between boys and girls, although there are disparities in some sub-groups of the population. Across the provinces, the GPI is lowest in Luangprabang (0.80) and Saravane (0.80). The secondary school educational disadvantage of girls is pronounced among children living in the poorest households (0.66), and among children in Hmong-Mien headed households (0.73). 13 234 Ratio of adjusted net attendance ratios of girls to boys, in primary and secondary school, Lao PDR 2011-12 Primary school adjusted net attendance ratio (NAR), girls Primary school adjusted net attendance ratio (NAR), boys Gender parity index (GPI) for primary school adjusted NAR1 Secondary school adjusted net attendance ratio (NAR), girls Secondary school adjusted net attendance ratio (NAR), boys Gender parity index (GPI) for secondary school adjusted NAR2 Region North 85.5 88.4 0.97 40.5 46.1 0.88 Central 86.7 86.0 1.01 52.2 49.1 1.06 South 79.3 78.4 1.01 33.0 32.8 1.00 Province Vientiane Capital 97.9 94.6 1.03 76.1 76.8 0.99 Phongsaly 76.3 80.5 0.95 32.4 35.8 0.91 Luangnamtha 84.3 84.0 1.00 40.4 44.2 0.91 Oudomxay 80.7 88.0 0.92 32.8 38.4 0.85 Bokeo 81.1 86.5 0.94 37.3 44.8 0.83 Luangprabang 87.8 88.4 0.99 37.6 46.9 0.80 Huaphanh 87.6 93.0 0.94 48.3 53.3 0.91 Xayabury 94.2 93.3 1.01 50.1 53.1 0.94 Xiengkhuang 89.2 92.0 0.97 57.0 60.0 0.95 Vientiane 92.0 93.0 0.99 57.6 61.1 0.94 Borikhamxay 94.8 95.9 0.99 50.1 55.6 0.90 Khammuane 85.2 84.2 1.01 37.4 38.6 0.97 Savannakhet 77.0 74.4 1.03 37.5 28.0 1.34 Saravane 75.1 73.4 1.02 19.7 24.7 0.80 Sekong 85.2 85.3 1.00 36.1 36.6 0.99 Champasack 82.1 81.2 1.01 42.5 37.3 1.14 Attapeu 76.5 77.8 0.98 31.7 35.5 0.89 Residence Urban 95.4 94.4 1.01 74.3 70.3 1.06 Rural 82.3 83.1 0.99 35.0 37.3 0.94 .Rural with road 84.2 84.5 1.00 37.1 39.4 0.94 .Rural without road 68.2 72.3 0.94 17.2 19.7 0.87 Mother's education None 72.6 75.9 0.96 22.3 26.2 0.85 Primary 89.8 88.5 1.02 46.2 44.4 1.04 Lower secondary 94.1 96.1 0.98 79.4 73.7 1.08 Upper secondary 98.7 94.4 1.05 84.6 85.4 0.99 Post secondary non tertiary 99.8 99.6 1.00 89.2 78.8 1.13 Higher 97.9 98.7 0.99 92.7 96.4 0.96 Cannot be determined na na na 37.7 53.9 0.70 Wealth index quintile Poorest 67.8 73.8 0.92 8.9 13.6 0.66 Second 83.0 81.1 1.02 26.0 29.2 0.89 Middle 92.0 91.0 1.01 45.4 44.6 1.02 Fourth 95.4 93.9 1.02 63.6 63.0 1.01 Richest 98.0 96.5 1.02 82.1 81.9 1.00 Ethno-linguistic group of household head Lao-Tai 92.5 91.1 1.02 58.2 54.2 1.07 Mon-Khmer 74.2 75.8 0.98 21.5 27.6 0.78 Hmong-Mien 79.6 86.2 0.92 28.3 38.8 0.73 Chinese-Tibetan 69.9 75.9 0.92 25.7 28.1 0.92 Other, Missing, DK (70.2) * * (14.4) 37.2 (0.39) Total 84.7 85.2 0.99 44.6 44.7 1.00 Table ED.8: Education gender parity 1 MICS indicator 7.9; MDG indicator 3.1 2 MICS indicator 7.10; MDG indicator 3.1 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. na = Not applicable 13 © UNICEF Lao PDR / 2012 / Noorani 236 XIV. Child Protection Birth Registration The International Convention on the Rights of the Child states that every child has the right to a name and a nationality and the right to protection from being deprived of his or her identity. Birth registration is a fundamental means of securing these rights for children. The World Fit for Children outlines a goal to develop systems to ensure the registration of every child at or shortly after birth and to fulfil his or her right to acquire a name and a nationality, in accordance with national laws and relevant international instruments. The MICS indicator related to birth registration is the percentage of children under five years of age whose birth is registered. 14 237 Sex Male 16.7 16.4 41.2 74.3 5,593 40.5 1,437 Female 16.6 15.9 42.8 75.2 5,474 43.1 1,356 Region North 16.3 9.1 42.0 67.3 3,502 16.0 1,145 Central 15.9 24.1 39.0 79.0 5,154 55.6 1,082 South 18.6 9.4 48.5 76.5 2,411 67.6 566 Province Vientiane Capital 29.3 42.2 13.7 85.2 1,058 23.7 157 Phongsaly 2.2 3.0 39.0 44.1 368 13.6 206 Luangnamtha 28.2 15.8 53.0 96.9 280 * 9 Oudomxay 45.9 9.6 42.0 97.5 676 * 17 Bokeo 9.8 11.1 43.6 64.5 335 9.2 119 Luangprabang 7.0 15.3 54.9 77.1 752 49.1 172 Huaphanh 1.1 1.0 3.9 6.0 606 0.4 570 Xayabury 16.5 8.1 64.5 89.1 486 (74.9) 53 Xiengkhuang 16.7 6.7 57.2 80.6 540 78.2 105 Vientiane 19.6 16.8 40.8 77.3 767 76.4 174 Borikhamxay 32.5 24.2 33.8 90.6 402 (72.6) 38 Khammuane 6.1 14.4 55.6 76.1 603 26.6 144 Savannakhet 5.8 25.0 43.1 74.0 1,784 61.1 464 Saravane 35.7 8.7 38.3 82.7 923 51.7 160 Sekong 4.6 11.3 54.1 70.0 269 90.9 81 Champasack 8.6 9.4 50.7 68.7 1,003 69.6 314 Attapeu 9.6 10.0 75.3 94.8 216 (71.0) 11 Residence Urban 28.5 30.3 29.0 87.8 2,319 53.5 283 Rural 13.5 12.4 45.4 71.3 8,748 40.5 2,510 .Rural with road 14.5 13.0 45.2 72.8 7,661 40.0 2,087 .Rural without road 6.4 8.0 46.8 61.1 1,086 42.6 423 Age 0-11 months 21.0 12.2 26.9 60.1 2,307 55.3 921 12-23 months 17.9 16.6 39.8 74.2 2,141 39.7 551 24-35 months 15.5 16.9 44.7 77.1 2,193 38.5 503 36-47 months 15.6 17.8 47.7 81.2 2,302 27.0 434 48-59 months 12.8 17.5 51.7 81.9 2,124 33.4 384 Mother’s education None 11.4 8.6 45.9 66.0 3,580 35.5 1,219 Primary 13.7 14.3 47.0 75.0 4,556 46.4 1,140 Lower secondary 21.8 22.6 35.2 79.5 1,613 47.6 330 Upper secondary 33.5 29.5 27.0 90.0 695 45.9 70 Post secondary non tertiary 32.6 40.8 20.8 94.2 368 (38.9) 21 Higher 40.7 42.4 11.7 94.8 255 * 13 Wealth index quintile Poorest 12.9 6.0 47.0 65.9 3,233 35.0 1,103 Second 10.3 10.8 47.4 68.5 2,346 40.1 739 Middle 14.2 14.0 47.7 75.9 2,019 45.4 486 Fourth 19.3 22.9 38.7 80.9 1,807 61.3 344 Richest 32.8 38.6 21.3 92.8 1,663 44.6 120 Ethno-linguistic group of household head Lao-Tai 20.1 22.7 38.8 81.5 6,030 53.0 1,113 Mon-Khmer 14.1 9.9 46.8 70.8 3,189 42.8 932 Hmong-Mien 8.7 4.7 44.1 57.6 1,439 25.9 610 Chinese-Tibetan 10.1 6.7 48.1 64.9 357 11.9 125 Other, Missing, DK 38.2 16.9 20.5 75.5 52 * 13 Total 16.6 16.1 42.0 74.8 11,067 41.8 2,793 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 CP.1: Birth registration 1 MICS indicator 8.1 Number of children without birth registration Percentage of children under age 5 whose birth is registered and percentage of children not registered whose mothers/caretakers know how to register birth, Lao PDR 2011-12 Total registered1 No birth certificate Has birth certificate Seen Not seen Children under age 5 whose birth is registered with civil authorities Percent of children whose mother/caretaker knows how to register birth Number of children Children under age 5 whose birth is not registered 14 238 Mothers and caretakers of children age under five years were asked whether the children have a birth certificate. Respondents reporting that a child had a certificate were asked to show the certificate to the interviewer (all children reported to have birth certificates are considered registered). Respondents reporting that a child did not have a certificate were asked whether the child is registered with the civil authorities. Table CP.1 presents the percentage of children who are registered. Seventy-five 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, compared to only 7 in 10 rural children. At least 65 per cent of children are registered in every province, with the exception of Phongsaly and Huaphanh, where only 44 per cent and 6 per cent are registered, respectively. The highest proportions of children registered are found in Oudomxay, Luangnamtha and Attapeu (98, 97, and 95 per cent, respectively). There are no significant variations in birth registration by the sex of the child. While the percentage of children registered increases with the increasing age of the child, the percentage of children who are registered but have no birth certificate also increases with age (from 27 to 52 per cent). The percentage of children who are registered steadily increases as mothers’ education and wealth increase. The percentage of children registered is highest among Lao-Tai headed households (82 per cent) and lowest among Hmong-Mien headed households (58 per cent). Mothers and caretakers who reported a child as having no birth certificate and being unregistered with the civil authorities were asked whether they know how to register the child’s birth. Table CP.1 presents the percentage of unregistered children whose mothers and caretakers know how to register a birth. This percentage varies dramatically across the country and is especially low in the Northern region, where only 16 per cent of those who have not registered know how to register a birth. The percentage is also very low among those living in Hmong-Mien and Chinese-Tibetan headed households (26 and 12 per cent, respectively). Child Discipline As stated in A World Fit for Children, “children must be protected against any acts of violence …” and the Millennium Declaration calls for the protection of children against abuse, exploitation and violence. Respondents to the 2011-12 LSIS household questionnaire were asked a series of questions on the ways adults in the household teach children the right behaviour or address a behaviour problem. Only one child was selected at random per household, and questions were asked about the methods used on that particular child, by any adult in the household. The child was selected at random from all children age 2-14 living in the household. Figures were then appropriately weighted to reflect all children age 2-14 in all of the households interviewed. The percentage of children age 2-14 who experience psychological aggression or physical punishment from an adult in their household is presented in Table CP.2. The table also presents the percentage of children who are disciplined in only non-violent ways. Non-violent forms of discipline include taking away privileges, forbidding the child to do something, not allowing the child to leave the house, or explaining to the child why a particular behaviour was wrong, or distracting the child from the undesirable behaviour by providing a desirable alternative. Psychological aggression includes shouting, yelling, screaming or calling the child ‘dumb’, ‘lazy’ or a similar negative term. Physical punishment includes shouting, hitting somewhere on the body using a bare hand or an object, hitting the face, head or ears, or beating the child repeatedly and as hard as possible. Severe physical punishment includes hitting the face, head or ears, or beating the child repeatedly and as hard as possible. Psychological and physical forms of punishment or aggression are considered violent methods of discipline. Seventy-six 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. The percentage of children who experience violent discipline exceeds 60 per cent in all but two provinces: Attapeu (48 per cent) and Borikhamxay (35 per cent). The percentage of children who experience violent discipline remains high across all education levels and wealth quintiles – one of the few statistics that does not vary 14 239 considerably by education and wealth. While the percentage of children who experience severe physical punishment does decline with increasing education and wealth, the percentage who experience any physical punishment or psychological aggression holds steady. 14 240 Any Severe Sex Male 18.3 72.9 46.5 9.0 77.1 15,583 42.8 7,100 Female 20.3 68.9 42.0 6.2 74.3 15,786 40.6 7,213 Region North 15.5 77.3 39.0 8.9 79.5 10,527 37.9 4,749 Central 19.4 69.6 47.1 7.8 75.5 14,093 40.9 6,772 South 24.8 63.3 46.6 5.2 70.2 6,749 50.0 2,791 Province Vientiane Capital 16.8 66.1 54.6 7.4 76.6 2,655 35.0 1,582 Phongsaly 28.0 58.7 47.5 9.7 63.2 1,059 76.7 456 Luangnamtha 16.3 74.0 52.3 17.6 75.6 896 6.8 429 Oudomxay 12.3 80.4 19.0 6.1 81.5 1,912 94.2 775 Bokeo 14.6 82.7 32.0 4.9 85.1 927 21.1 398 Luangprabang 13.4 78.9 38.7 3.8 81.5 2,229 17.1 1,056 Huaphanh 14.8 82.3 57.2 21.0 84.1 1,900 33.3 714 Xayabury 14.7 76.6 32.8 1.8 78.5 1,604 20.5 921 Xiengkhuang 18.2 79.6 27.1 5.9 79.9 1,467 50.3 608 Vientiane 14.0 79.4 64.4 8.9 84.5 2,152 49.4 1,092 Borikhamxay 37.3 34.4 16.0 1.7 35.3 1,188 23.8 595 Khammuane 18.5 77.5 40.5 6.3 80.5 1,762 70.9 793 Savannakhet 19.6 70.0 51.2 10.1 77.7 4,870 31.8 2,102 Saravane 37.1 53.9 39.4 1.6 61.3 2,488 21.5 942 Sekong 13.5 74.8 63.4 16.2 85.1 707 78.8 244 Champasack 12.2 72.6 50.8 4.8 78.7 2,929 72.7 1,334 Attapeu 48.1 43.7 36.4 9.4 48.4 624 11.3 270 Residence Urban 20.0 66.5 47.0 6.9 74.3 6,135 35.3 3,422 Rural 19.1 71.9 43.6 7.8 76.1 25,233 43.7 10,891 .Rural with road 19.5 71.7 43.0 7.2 75.8 22,208 42.7 9,739 .Rural without road 16.1 73.4 47.6 12.2 78.2 3,025 52.1 1,152 Age 2-4 years 22.1 61.2 48.5 7.2 68.7 6,666 39.9 3,224 5-9 years 16.3 74.6 50.0 8.8 79.6 12,055 43.0 5,216 10-14 years 20.6 72.4 36.5 6.7 75.7 12,648 41.5 5,873 Education of household head None 18.5 71.0 45.9 10.2 76.0 7,079 na na Primary 19.6 71.6 43.0 7.9 75.8 15,275 na na Lower secondary 17.2 73.1 44.6 5.8 77.7 4,678 na na Upper secondary 16.8 68.7 48.7 3.8 76.3 1,521 na na Post secondary non tertiary 23.1 66.0 42.0 4.5 72.1 1,764 na na Higher 27.0 58.4 46.5 3.9 68.3 1,019 na na Respondent's education None na na na na na na 45.7 2,870 Primary na na na na na na 43.9 6,743 Lower secondary na na na na na na 39.2 2,482 Upper secondary na na na na na na 37.5 893 Post secondary non tertiary na na na na na na 29.9 856 Higher na na na na na na 27.1 467 Wealth index quintile Poorest 18.7 72.8 44.8 11.0 76.7 8,249 46.9 3,017 Second 19.1 72.6 43.3 7.7 76.5 7,243 45.4 2,902 Middle 19.9 70.6 43.2 6.7 75.2 6,321 43.7 2,937 Fourth 18.4 71.5 44.6 5.8 76.2 5,294 40.0 2,898 Richest 20.9 63.5 45.9 4.5 72.5 4,262 30.9 2,559 Ethno-linguistic group of household head Lao-Tai 20.2 68.8 44.3 5.1 74.2 17,180 38.8 9,116 Mon-Khmer 18.9 72.6 43.7 9.9 77.4 9,217 45.7 3,515 Hmong-Mien 15.6 76.6 43.9 11.2 79.7 3,739 50.0 1,158 Chinese-Tibetan 17.6 70.7 52.3 16.2 73.8 1,095 48.0 463 Other, Missing, DK 33.6 48.1 25.9 3.4 58.5 138 43.5 61 Total 19.3 70.8 44.2 7.6 75.7 31,369 41.7 14,313 na = Not applicable Table CP.2: Child discipline 1 MICS indicator 8.5 Number of children age 2- 14 years Respondent believes that a child needs to be physically punished Percentage of children age 2-14 years who experienced: Percentage of children age 2-14 years according to method of disciplining the child, Lao PDR 2011-12 Only non- violent discipline Psychological aggression Any violent discipline method1 Physical punishment Respondents to the child discipline module 14 241 Eight per cent of children experience severe physical punishment from an adult in their household. The percentage is double the national average (16 per cent or higher) in Sekong, Luangnamtha and Huaphanh. Two in 10 children in Huaphanh experience severe physical punishment. By ethno-linguistic group, the percentage is highest among children in Chinese-Tibetan households (16 per cent). Respondents to the child discipline module were also asked “Do you believe that in order to bring up, raise, or educate a child properly, the child needs to be physically punished?” The percentage of respondents who answered “yes” to this question is presented in Table CP.2. Four in 10 Lao adults believe physical punishment is necessary to properly raise a child. This opinion varies considerably across provinces, from a low of 7 per cent in Luangnamtha to a high of 94 per cent in Oudomxay. Over 70 per cent of adults in Phongsaly, Oudomxay, Khammuane, Sekong and Champasack hold this opinion. Orphans Children who are orphaned may be at increased risk of neglect or exploitation if parents are not available to assist them. Monitoring the variation in different outcomes for orphans and comparing them to their peers gives us a measure of how well communities and governments are responding to their needs. Household respondents were asked to identify whether the biological father and biological mother were alive, and whether they live in the same household, for every child age 0-17 years. The percentages of children living with both parents, neither parent, mother only and father only are presented in Table CP.3. Eighty-four per cent of children age 0-17 years live with both parents, while 6 per cent live with neither parent. Single motherhood is not common in Lao PDR; only 7 per cent of children live with their mother but not their father. Five per cent of children have lost their mother, or father, or both mother and father as a result of death. The proportion of children who are not living with either biological parent is highest in Champasack (10 per cent). 14 242 O nl y fa th er a liv e O nl y m ot he r al iv e B ot h ar e al iv e B ot h ar e de ad Fa th er al iv e Fa th er de ad M ot he r al iv e M ot he r de ad Se x M al e 84 .5 0. 4 0. 6 4. 4 0. 3 4. 3 2. 9 1. 0 1. 0 0. 6 10 0. 0 5. 7 5. 3 20 ,9 80 Fe m al e 83 .4 0. 4 0. 5 5. 6 0. 5 4. 1 2. 9 0. 8 1. 1 0. 7 10 0. 0 7. 0 5. 3 20 ,8 59 R eg io n N or th 87 .6 0. 3 0. 5 3. 4 0. 5 2. 5 2. 9 0. 7 1. 3 0. 4 10 0. 0 4. 7 5. 5 13 ,8 35 C en tra l 82 .1 0. 4 0. 6 5. 7 0. 4 5. 3 2. 5 1. 2 0. 9 1. 1 10 0. 0 7. 0 4. 7 19 ,1 17 S ou th 82 .4 0. 6 0. 5 5. 9 0. 3 4. 5 3. 8 0. 6 1. 1 0. 3 10 0. 0 7. 4 6. 4 8, 88 8 Pr ov in ce V ie nt ia ne C ap ita l 78 .1 0. 5 0. 6 5. 9 0. 1 7. 4 2. 4 1. 7 0. 8 2. 6 10 0. 0 7. 1 4. 4 3, 70 3 P ho ng sa ly 87 .3 0. 2 0. 6 3. 1 0. 9 1. 7 3. 4 0. 7 1. 6 0. 5 10 0. 0 4. 8 6. 7 1, 39 9 Lu an gn am th a 85 .1 0. 2 0. 4 3. 6 0. 7 2. 2 4. 6 1. 5 1. 1 0. 5 10 0. 0 4. 9 7. 1 1, 15 4 O ud om xa y 89 .1 0. 1 0. 3 3. 3 0. 3 2. 0 2. 5 0. 8 1. 1 0. 5 10 0. 0 4. 0 4. 3 2, 54 3 B ok eo 86 .3 0. 4 0. 5 3. 3 1. 1 3. 2 3. 4 0. 5 1. 2 0. 1 10 0. 0 5. 4 6. 6 1, 21 3 Lu an gp ra ba ng 86 .2 0. 4 0. 6 3. 8 0. 4 2. 7 3. 2 0. 8 1. 6 0. 4 10 0. 0 5. 1 6. 1 2, 85 3 H ua ph an h 88 .8 0. 3 0. 8 3. 4 0. 1 2. 3 2. 2 0. 5 1. 2 0. 3 10 0. 0 4. 6 4. 6 2, 54 1 X ay ab ur y 88 .4 0. 2 0. 4 3. 3 0. 5 3. 2 2. 6 0. 3 0. 9 0. 3 10 0. 0 4. 4 4. 6 2, 13 1 X ie ng kh ua ng 86 .3 0. 2 0. 3 4. 6 0. 5 2. 2 3. 1 1. 2 0. 9 0. 7 10 0. 0 5. 6 5. 0 2, 04 1 V ie nt ia ne 85 .3 0. 2 0. 1 5. 3 0. 1 4. 9 1. 4 1. 5 0. 7 0. 4 10 0. 0 5. 7 2. 6 2, 90 5 B or ik ha m xa y 87 .4 0. 0 0. 3 4. 2 0. 4 4. 4 1. 2 1. 1 0. 8 0. 3 10 0. 0 4. 9 2. 7 1, 60 9 K ha m m ua ne 80 .5 0. 9 0. 5 6. 0 1. 0 6. 4 2. 6 0. 9 0. 8 0. 5 10 0. 0 8. 4 5. 8 2, 32 3 S av an na kh et 80 .8 0. 3 0. 9 6. 4 0. 4 5. 1 3. 1 1. 0 1. 0 1. 0 10 0. 0 8. 0 5. 7 6, 53 6 S ar av an e 84 .1 0. 5 0. 6 4. 2 0. 3 4. 9 4. 0 0. 4 0. 7 0. 3 10 0. 0 5. 6 6. 1 3, 24 9 S ek on g 85 .5 0. 6 0. 5 2. 8 0. 5 2. 9 4. 8 0. 3 1. 9 0. 2 10 0. 0 4. 4 8. 3 93 3 C ha m pa sa ck 78 .8 0. 8 0. 4 8. 8 0. 2 5. 0 3. 6 0. 8 1. 4 0. 3 10 0. 0 10 .2 6. 4 3, 88 7 A tta pe u 89 .2 0. 6 0. 4 2. 6 0. 8 2. 5 2. 7 0. 2 0. 8 0. 1 10 0. 0 4. 4 5. 3 81 8 R es id en ce U rb an 80 .2 0. 5 0. 7 6. 7 0. 3 5. 6 2. 4 1. 3 0. 7 1. 6 10 0. 0 8. 2 4. 7 8, 76 9 R ur al 85 .0 0. 4 0. 5 4. 5 0. 4 3. 8 3. 0 0. 8 1. 1 0. 4 10 0. 0 5. 8 5. 5 33 ,0 71 .R ur al w ith ro ad 84 .8 0. 4 0. 5 4. 6 0. 4 4. 0 3. 0 0. 8 1. 1 0. 4 10 0. 0 5. 8 5. 4 29 ,2 07 .R ur al w ith ou t r oa d 86 .4 0. 3 0. 5 4. 4 0. 8 2. 6 2. 9 0. 6 1. 3 0. 3 10 0. 0 6. 0 5. 7 3, 86 3 1 M IC S in di ca to r 9 .1 7 2 M IC S in di ca to r 9 .1 8 Ta bl e C P. 3: C hi ld re n' s liv in g ar ra ng em en ts a nd o rp ha nh oo d P er ce nt d is tri bu tio n of c hi ld re n ag e 0- 17 y ea rs a cc or di ng to li vi ng a rr an ge m en ts , p er ce nt ag e of c hi ld re n ag e 0- 17 y ea rs in h ou se ho ld s no t l iv in g w ith a b io lo gi ca l p ar en t a nd p er ce nt ag e of c hi ld re n w ho h av e on e or bo th p ar en ts d ea d, L ao P D R 2 01 1- 12 Li vi ng w ith m ot he r o nl y Li vi ng w ith fa th er o nl y Im po ss ib le to de te rm in e N ot li vi ng w ith a bi ol og ic al pa re nt 1 O ne o r b ot h pa re nt s de ad 2 N um be r o f ch ild re n ag e 0- 17 y ea rs Li vi ng w ith bo th p ar en ts Li vi ng w ith n ei th er p ar en t To ta l 14 243 O nl y fa th er a liv e O nl y m ot he r al iv e B ot h ar e al iv e B ot h ar e de ad Fa th er al iv e Fa th er de ad M ot he r al iv e M ot he r de ad A ge 0 -4 88 .5 0. 1 0. 2 3. 9 0. 0 5. 7 0. 7 0. 4 0. 2 0. 2 10 0. 0 4. 3 1. 3 10 ,9 49 5- 9 86 .0 0. 5 0. 4 4. 8 0. 2 3. 8 2. 1 1. 0 0. 9 0. 4 10 0. 0 5. 8 4. 1 12 ,1 66 10 -1 4 82 .4 0. 4 0. 7 4. 9 0. 5 3. 6 4. 3 1. 1 1. 6 0. 4 10 0. 0 6. 6 7. 6 12 ,6 41 15 -1 7 74 .9 0. 7 1. 0 7. 7 1. 3 3. 5 5. 6 1. 2 1. 7 2. 6 10 0. 0 10 .6 10 .2 6, 08 3 W ea lth in de x qu in til es P oo re st 86 .8 0. 3 0. 4 2. 2 0. 6 3. 1 3. 9 0. 7 1. 7 0. 3 10 0. 0 3. 5 7. 0 10 ,3 83 S ec on d 86 .3 0. 3 0. 5 3. 6 0. 3 3. 6 3. 3 0. 6 1. 0 0. 4 10 0. 0 4. 8 5. 4 9, 38 6 M id dl e 83 .5 0. 5 0. 6 5. 5 0. 5 4. 1 3. 0 0. 8 1. 1 0. 4 10 0. 0 7. 0 5. 7 8, 53 6 Fo ur th 82 .0 0. 6 0. 6 7. 8 0. 2 4. 1 1. 9 1. 2 0. 7 1. 0 10 0. 0 9. 2 3. 9 7, 37 8 R ic he st 78 .5 0. 3 0. 6 7. 8 0. 2 7. 2 1. 6 1. 5 0. 5 1. 7 10 0. 0 8. 9 3. 3 6, 15 6 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 81 .4 0. 5 0. 6 6. 7 0. 3 5. 4 2. 4 1. 0 0. 8 0. 9 10 0. 0 8. 1 4. 6 23 ,4 95 M on -K hm er 86 .9 0. 3 0. 5 2. 7 0. 5 3. 0 3. 8 0. 6 1. 4 0. 3 10 0. 0 4. 0 6. 4 11 ,7 90 H m on g- M ie n 88 .8 0. 1 0. 4 2. 9 0. 4 2. 3 2. 8 0. 8 1. 2 0. 4 10 0. 0 3. 8 4. 9 4, 91 4 C hi ne se -T ib et an 85 .4 0. 2 0. 5 2. 7 0. 9 1. 5 5. 2 1. 3 1. 6 0. 5 10 0. 0 4. 4 8. 5 1, 43 6 O th er , M is si ng , D K 80 .8 1. 3 0. 0 7. 9 0. 5 3. 5 1. 9 1. 9 0. 5 1. 8 10 0. 0 9. 6 4. 2 20 5 To ta l 84 .0 0. 4 0. 5 5. 0 0. 4 4. 2 2. 9 0. 9 1. 1 0. 7 10 0. 0 6. 3 5. 3 41 ,8 40 N ot li vi ng w ith a bi ol og ic al pa re nt 1 O ne o r b ot h pa re nt s de ad 2 N um be r o f ch ild re n ag e 0- 17 y ea rs Li vi ng w ith n ei th er p ar en t Li vi ng w ith m ot he r o nl y Li vi ng w ith fa th er o nl y Im po ss ib le to de te rm in e To ta l 1 M IC S in di ca to r 9 .1 7 2 M IC S in di ca to r 9 .1 8 Li vi ng w ith bo th p ar en ts 14 244 One of the measures developed for the assessment of the status of orphaned children relative to their peers compares the school attendance of children who have lost both parents with that of children whose parents are alive (and who live with at least one of these parents). The comparison is made among children age 10-14 years and is shown in Table CP.4. Nationally, less than 1 per cent of children age 10-14 have lost both parents. Among children who have lost both parents, 67 per cent are currently attending school. However, 84 per cent of non-orphan children (who have not lost both parents and who live with at least one parent) are attending school. Although more than half of orphan children age 10-14 do go to school, they are disadvantaged when compared with non-orphaned children in terms of school attendance; thus, the orphan to non-orphan school attendance ratio is less than one (0.8). Percentage of children whose mother and father have died (orphans) Percentage of children of whom both parents are alive and child is living with at least one parent (non- orphans) Number of children age 10-14 years Percentage of children who are orphans and are attending school1 Total number of orphan children age 10-14 years Percentage of children who are non- orphans and are attending school2 Total number of non- orphan children age 10-14 years Orphans to non-orphans school attendance ratio Sex Male 0.4 87.5 6,275 (71.7) 27 85.7 5,492 (0.84) Female 0.6 86.7 6,366 (63.1) 37 81.8 5,519 (0.77) Residence Urban 0.4 85.2 2,596 * 11 93.2 2,212 * Rural 0.5 87.6 10,046 64.6 53 81.4 8,799 0.79 Total 0.5 87.1 12,641 66.8 64 83.8 11,011 0.80 Table CP.4: School attendance of orphans and non-orphans 2 MICS indicator 9.20; MDG indicator 6.4 1 MICS indicator 9.19; MDG indicator 6.4 School attendance of children age 10-14 years by orphanhood, Lao PDR 2011-12 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. 14 © UNFPA Lao PDR / 2012 / Perier 246 XV. HIV/AIDS and Sexual Behaviour The law on HIV/AIDS Control and Prevention approved by the National Assembly in 2010 is comprised of 12 parts and 71 articles. The purpose of the law is to define effective principles, regulations, measures, management and monitoring of HIV/AIDS control and prevention in order to reduce HIV infection and AIDS and promote good health and an HIV-free environment for all Lao people, so they can contribute to the development and the protection of the country.1 HIV prevalence in Lao PDR is low at an estimated 0.2 per cent among adults age 15-49 in the general population. The total number of people living with HIV was estimated to be 9,000 in 2010, but this figure is expected to increase to 14,000 people in 2015.2 Prevalence is also low among most-at-risk populations. In surveys of female sex workers, HIV prevalence was found to be 0.9 per cent in 2000, 2 per cent in 2004, 0.4 per cent in 2008, and 0.9 per cent in 2011. Surveillance of men who have sex with men (MSM) indicated an HIV prevalence of 5.6 per cent in Vientiane Capital in 2007, and 0 per cent in Luangprabang in 2009. Among MSM who identified as transgendered, prevalence was 4.2 per cent in Vientiane Capital and Savannakhet in 2010.3 Based on passive report cases from 17 provinces, the cumulative numbers of people with HIV/AIDS from 1990-2011 are: 4,942 people HIV positive; 3,105 people with AIDS; and 1,290 deaths.4 The National Strategy and Action Plan for HIV/AIDS/STI Control and Prevention 2011-2015 is to maintain the present low level of HIV prevalence (below 1 per cent) in the general adult (age 15-49) population, and to ensure HIV prevalence among most-at-risk populations remains lower than 5%. Knowledge about HIV Transmission and Misconceptions about HIV/AIDS The 2001 United Nations General Assembly Special Session on HIV/AIDS (UNGASS) and the 2011 Political Declaration on HIV/AIDS adopted at the 2011 UN General Assembly High Level Meeting on AIDS5 called on governments to reduce risk-taking behaviour and encourage responsible sexual behaviour among their populations. One of the most important prerequisites for reducing the rate of HIV infection is accurate knowledge of how HIV is transmitted and strategies for preventing transmission. Correct information is the first step towards raising awareness and giving people the tools to protect themselves from infection. In Lao PDR, 84 per cent of women and 92 per cent of men have heard of AIDS (Tables HA.1.1 and HA.1.2). The proportion of people who have heard of AIDS is higher in urban than rural areas, and urban women and men have heard of AIDS in equal proportion; but in rural areas, 8 in 10 women have heard of AIDS, compared with 9 in 10 men. A substantial proportion – 44 per cent – of women with no education and in the poorest households have never heard of AIDS. The proportion of women and men in Chinese-Tibetan headed households who have heard of AIDS is substantially lower than among other ethno-linguistic groups. All women and men who have heard of AIDS were asked whether they knew of the two main ways of preventing HIV transmission – having only one faithful, uninfected sex partner who has no other partners, and using a condom during all sexual intercourse – and 67 per cent of women and 82 per cent of men knew both. Knowledge of the main ways of preventing AIDS is especially low among women 1 Law Lao PDR National Assembly, 2010 2 National Strategy and Action Plan on HIV/AIDS/STI 2011-2015 3 Surveillance of SW and MSM 2000-2010 4 Passive case report, cumulative number of HIV/AIDS from 1990-2011 5 UNGASS, United Nations, 2011 15 247 and men with no education; only one third of women and one half of men with no education who have heard of AIDS, know of the two main ways of preventing the transmission of HIV. As part of the effort to assess HIV and AIDS knowledge, the LSIS obtained information on common misconceptions about HIV transmission. Respondents were asked whether they think it is possible for a healthy-looking person to have HIV, and whether they believe HIV can be transmitted through mosquito bites, supernatural means, or sharing food with a person who has HIV. About 6 in 10 Lao women and men know that a person may appear healthy and also be HIV-positive (57 per cent of women and 62 per cent of men). Among the misconceptions asked about, the two most common were that HIV can be transmitted by mosquitoes or by sharing food. Only 37 per cent of women and 48 per cent of men have heard of HIV and also know that it cannot be transmitted through mosquito bites. Only 58 per cent of women and 68 per cent of men have heard of HIV and also know that it cannot be acquired by sharing food with someone who has AIDS. Comprehensive knowledge about HIV and AIDS is defined as: (1) knowing that both condom use and limiting sex to one uninfected partner who has no other partners are ways to prevent HIV transmission; (2) being aware that a healthy-looking person can be HIV-positive; and (3) rejecting two common misconceptions about AIDS – that it can be transmitted through mosquito bites or by sharing food with someone who has AIDS. The LSIS indicates that comprehensive knowledge of AIDS is not common, at only 2 in 10 women and 3 in 10 men. There is a very strong correlation between both education and wealth quintile and comprehensive knowledge; the proportion of people having comprehensive knowledge increases by about 10 per cent with every increase in education (see Figure HA.1) and quintile level. The proportion of the population with comprehensive knowledge varies greatly across provinces, from a high of 40 per cent of women in Xayabury and 48 per cent of men in Borikhamxay, to a low of 8 per cent of women in Oudomxay and 17 per cent of men in Saravane. 15 248 15 H av in g on ly on e fa ith fu l un in fe ct ed se x pa rtn er U si ng a co nd om ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith s om eo ne w ith A ID S R eg io n N or th 79 .3 69 .9 69 .2 65 .6 48 .9 40 .0 61 .6 54 .8 24 .4 22 .8 7, 05 7 C en tra l 88 .8 78 .8 78 .4 72 .7 62 .0 38 .2 68 .4 65 .0 26 .7 24 .7 11 ,2 55 S ou th 79 .1 64 .8 62 .6 56 .2 56 .3 31 .0 65 .4 46 .1 19 .7 17 .0 4, 16 4 Pr ov in ce V ie nt ia ne C ap ita l 97 .7 90 .6 89 .8 85 .0 76 .2 55 .4 85 .3 81 .3 40 .9 38 .1 3, 28 8 P ho ng sa ly 53 .4 43 .0 43 .2 39 .5 28 .3 17 .4 28 .5 24 .8 10 .0 9. 7 66 6 Lu an gn am th a 75 .0 59 .9 61 .2 54 .1 43 .6 38 .5 46 .9 55 .1 26 .0 23 .4 62 7 O ud om xa y 55 .4 44 .3 45 .8 41 .5 19 .9 21 .3 34 .2 39 .5 8. 4 7. 9 1, 18 2 B ok eo 91 .1 88 .0 83 .8 82 .1 71 .3 41 .4 67 .2 69 .4 30 .8 29 .7 62 0 Lu an gp ra ba ng 85 .5 71 .6 69 .9 65 .5 49 .7 50 .5 72 .6 59 .0 29 .2 26 .2 1, 47 3 H ua ph an h 88 .3 83 .3 82 .7 79 .1 60 .1 32 .8 69 .0 49 .6 17 .7 15 .9 1, 08 6 X ay ab ur y 95 .1 88 .8 87 .1 86 .0 66 .2 60 .9 87 .1 75 .2 41 .5 40 .1 1, 40 2 X ie ng kh ua ng 86 .5 79 .7 75 .4 71 .4 71 .4 29 .1 44 .2 51 .5 21 .7 20 .3 93 0 V ie nt ia ne 93 .1 73 .6 81 .0 69 .7 60 .7 28 .7 64 .6 58 .2 19 .6 17 .7 1, 67 7 B or ik ha m xa y 85 .9 77 .1 81 .7 75 .3 46 .7 41 .4 65 .1 67 .5 28 .5 26 .8 90 1 K ha m m ua ne 92 .5 81 .9 79 .3 74 .4 54 .2 36 .3 65 .7 57 .1 19 .6 18 .5 1, 08 2 S av an na kh et 78 .3 68 .9 65 .7 61 .3 52 .9 28 .4 62 .3 58 .2 19 .6 17 .6 3, 37 6 S ar av an e 62 .1 50 .1 46 .6 42 .0 34 .4 26 .2 48 .7 36 .0 12 .3 10 .4 1, 45 6 S ek on g 64 .2 58 .7 60 .6 56 .8 27 .7 25 .6 41 .1 42 .6 9. 5 9. 3 38 8 C ha m pa sa ck 95 .2 76 .8 74 .0 65 .6 77 .2 37 .0 84 .1 56 .0 27 .6 23 .6 1, 94 3 A tta pe u 77 .1 66 .1 68 .1 62 .4 62 .2 23 .6 58 .2 38 .2 18 .2 16 .6 37 6 R es id en ce U rb an 95 .3 89 .2 88 .5 84 .5 73 .9 52 .8 82 .3 79 .7 40 .1 37 .5 6, 64 9 R ur al 79 .3 66 .7 65 .9 60 .2 49 .7 31 .0 58 .7 49 .3 18 .2 16 .4 15 ,8 27 .R ur al w ith ro ad 80 .8 68 .6 67 .8 62 .2 51 .0 31 .9 60 .0 51 .1 19 .1 17 .3 14 ,2 68 .R ur al w ith ou t r oa d 65 .8 50 .1 48 .9 42 .8 38 .2 22 .1 46 .6 32 .6 10 .0 8. 1 1, 55 9 1 M IC S in di ca to r 9 .1 * T w o m os t c om m on m is co nc ep tio ns : ( 1) A ID S c an b e tra ns m itt ed b y m os qu ito b ite s an d (2 ) A ID S c an b e tra ns m itt ed b y sh ar in g fo od w ith s om eo ne w ith A ID S . Ta bl e H A .1 .1 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on P er ce nt ag e of w om en a ge 1 5- 49 y ea rs w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s, p er ce nt ag e w ho re je ct c om m on m is co nc ep tio ns * , an d pe rc en ta ge w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on L ao P D R 2 01 1- 12 P er ce nt ag e w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : P er ce nt ag e of w om en w ho k no w bo th w ay s P er ce nt ag e w ho kn ow th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s N um be r of w om en Pe rc en ta ge w ho k no w th at H IV c an no t be tr an sm itt ed b y: P er ce nt a g e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns * a nd kn ow th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s P er ce nt a g e w ith co m pr eh en si ve kn ow le dg e1 249 15 H av in g on ly on e fa ith fu l un in fe ct ed se x pa rtn er U si ng a co nd om ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith s om eo ne w ith A ID S A ge 1 5- 24 84 .2 73 .1 72 .8 67 .3 58 .8 39 .6 65 .4 59 .0 26 .3 24 .0 8, 03 2 25 -2 9 84 .7 76 .4 75 .3 70 .7 59 .5 39 .7 68 .4 62 .0 27 .5 25 .8 3, 64 2 30 -3 9 84 .3 73 .7 72 .3 67 .4 55 .4 35 .8 65 .7 57 .6 23 .0 21 .0 6, 07 9 40 -4 9 82 .9 71 .2 70 .6 65 .1 53 .4 34 .0 64 .1 55 .3 21 .9 20 .1 4, 72 2 M ar ita l s ta tu s E ve r m ar rie d/ in u ni on 83 .3 72 .9 71 .7 66 .8 55 .0 35 .2 64 .4 56 .5 22 .6 20 .7 17 ,4 45 N ev er m ar rie d/ in u ni on 86 .4 75 .2 75 .6 69 .8 63 .3 45 .0 70 .2 64 .7 32 .0 29 .6 5, 03 1 Ed uc at io n N on e 56 .3 41 .4 39 .2 34 .6 24 .6 16 .6 32 .6 26 .9 6. 1 5. 2 4, 66 0 P rim ar y 85 .7 73 .4 72 .7 66 .5 54 .2 32 .1 64 .5 53 .2 17 .7 15 .7 8, 95 5 Lo w er s ec on da ry 94 .5 85 .6 85 .7 80 .4 69 .7 43 .2 77 .0 70 .8 30 .0 27 .8 4, 11 1 U pp er s ec on da ry 99 .0 92 .9 93 .0 88 .7 79 .3 56 .8 88 .5 85 .6 45 .2 42 .3 2, 49 6 P os t s ec on da ry n on te rti ar y 99 .0 95 .6 95 .1 92 .2 82 .3 68 .0 92 .1 89 .4 54 .6 52 .2 1, 03 0 H ig he r 99 .0 95 .7 94 .2 91 .2 88 .1 71 .0 93 .4 91 .9 62 .0 58 .2 1, 22 4 W ea lth in de x qu in til e P oo re st 56 .1 41 .7 40 .4 35 .6 24 .5 19 .5 34 .2 27 .0 7. 1 6. 0 3, 80 9 S ec on d 74 .9 60 .5 59 .6 53 .2 42 .6 25 .3 51 .4 39 .8 12 .6 10 .9 4, 08 8 M id dl e 87 .2 75 .4 74 .9 69 .0 56 .8 33 .2 66 .1 56 .7 19 .6 17 .9 4, 30 9 Fo ur th 94 .9 85 .8 84 .8 79 .7 68 .7 44 .5 77 .8 71 .0 31 .2 29 .0 4, 69 4 R ic he st 98 .2 92 .6 92 .1 88 .0 79 .4 55 .8 87 .2 83 .9 44 .0 41 .1 5, 57 7 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 93 .0 84 .4 83 .7 78 .6 68 .5 44 .1 77 .8 69 .3 31 .5 29 .1 15 ,1 51 M on -K hm er 64 .4 50 .5 49 .8 44 .9 32 .6 24 .2 43 .3 35 .2 10 .5 9. 2 4, 91 3 H m on g- M ie n 72 .9 54 .7 53 .2 45 .7 34 .5 21 .0 36 .2 37 .7 9. 8 8. 4 1, 60 6 C hi ne se -T ib et an 52 .7 39 .8 38 .1 34 .0 25 .8 20 .4 28 .5 29 .0 10 .8 10 .0 68 5 O th er , M is si ng , D K 81 .3 68 .4 63 .3 57 .2 52 .7 45 .7 61 .3 58 .0 28 .2 20 .2 12 1 To ta l 84 .0 73 .4 72 .6 67 .4 56 .8 37 .4 65 .7 58 .3 24 .7 22 .7 22 ,4 76 N um be r of w om en P er ce nt ag e of w om en w ho k no w bo th w ay s P er ce nt ag e w ho kn ow th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ho k no w th at H IV c an no t be tr an sm itt ed b y: P er ce nt ag e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns * a nd kn ow th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s P er ce nt a g e w ith co m pr eh en si ve kn ow le dg e1 Ta bl e H A .1 .1 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on P er ce nt ag e of w om en a ge 1 5- 49 y ea rs w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s, p er ce nt ag e w ho re je ct c om m on m is co nc ep tio ns * , an d pe rc en ta ge w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on L ao P D R 2 01 1- 12 * T w o m os t c om m on m is co nc ep tio ns : ( 1) A ID S c an b e tra ns m itt ed b y m os qu ito b ite s an d (2 ) A ID S c an b e tra ns m itt ed b y sh ar in g fo od w ith s om eo ne w ith A ID S . 1 M IC S in di ca to r 9 .1 P er ce nt ag e w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : 250 15 H av in g on ly on e fa ith fu l un in fe ct ed se x pa rtn er U si ng a co nd om ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith s om eo ne w ith A ID S R eg io n N or th 88 .8 83 .5 82 .8 79 .6 54 .3 51 .1 76 .4 63 .8 30 .3 28 .9 3, 17 2 C en tra l 93 .5 88 .1 87 .1 84 .0 68 .0 48 .4 78 .6 71 .5 34 .6 33 .0 4, 99 0 S ou th 90 .4 84 .1 83 .3 78 .8 59 .0 41 .0 80 .3 63 .2 24 .1 22 .8 1, 78 9 Pr ov in ce V ie nt ia ne C ap ita l 97 .4 92 .7 91 .8 88 .5 77 .3 65 .6 84 .9 80 .8 48 .2 46 .1 1, 37 9 P ho ng sa ly 68 .6 63 .4 59 .1 56 .5 40 .2 45 .6 48 .8 51 .9 28 .9 27 .2 31 8 Lu an gn am th a 85 .4 74 .9 65 .8 61 .5 46 .9 56 .2 60 .8 63 .1 36 .6 30 .9 26 6 O ud om xa y 80 .7 69 .5 74 .1 67 .3 48 .5 41 .2 58 .7 50 .5 23 .4 22 .0 53 0 B ok eo 98 .4 95 .8 92 .2 90 .1 75 .8 63 .4 79 .4 80 .3 47 .9 45 .9 26 7 Lu an gp ra ba ng 89 .6 84 .7 84 .3 80 .9 55 .1 56 .0 88 .2 66 .8 28 .9 27 .9 64 4 H ua ph an h 95 .7 93 .7 93 .7 91 .8 59 .7 32 .2 81 .0 57 .8 18 .2 18 .1 51 1 X ay ab ur y 96 .6 94 .3 94 .8 93 .4 55 .0 65 .2 94 .7 76 .0 37 .8 37 .5 63 5 X ie ng kh ua ng 96 .0 94 .0 93 .5 92 .6 62 .5 35 .7 81 .4 73 .2 22 .0 21 .8 44 2 V ie nt ia ne 96 .5 92 .1 90 .7 88 .5 79 .1 43 .2 79 .8 73 .4 34 .3 32 .8 72 1 B or ik ha m xa y 98 .0 92 .3 92 .5 91 .2 68 .8 71 .5 91 .4 66 .2 48 .6 47 .9 39 0 K ha m m ua ne 97 .9 91 .8 91 .3 87 .0 62 .8 48 .0 75 .5 71 .1 30 .4 29 .3 50 3 S av an na kh et 85 .6 78 .1 76 .8 72 .6 57 .6 33 .6 69 .5 63 .3 24 .0 22 .2 1, 55 6 S ar av an e 94 .2 84 .0 82 .8 75 .5 50 .9 37 .3 79 .8 63 .8 17 .5 16 .6 59 7 S ek on g 86 .9 71 .9 81 .6 68 .3 56 .5 44 .9 70 .5 62 .9 28 .0 25 .3 16 2 C ha m pa sa ck 87 .7 85 .1 82 .6 81 .3 60 .3 42 .9 81 .0 64 .1 28 .1 26 .8 87 3 A tta pe u 94 .9 90 .9 91 .0 88 .6 85 .0 40 .6 89 .0 56 .0 22 .5 21 .5 15 7 R es id en ce U rb an 97 .2 93 .7 91 .7 89 .4 77 .5 62 .0 88 .3 81 .6 46 .7 44 .5 2, 80 0 R ur al 89 .2 82 .8 82 .5 78 .6 55 .9 42 .4 74 .3 62 .0 25 .3 24 .2 7, 15 1 .R ur al w ith ro ad 90 .7 84 .6 84 .0 80 .3 57 .4 43 .4 76 .0 63 .8 26 .1 25 .0 6, 45 7 .R ur al w ith ou t r oa d 75 .9 66 .8 68 .6 62 .8 41 .9 34 .1 58 .4 45 .3 17 .4 16 .8 69 4 1 M IC S in di ca to r 9 .1 * T w o m os t c om m on m is co nc ep tio ns : ( 1) A ID S c an b e tra ns m itt ed b y m os qu ito b ite s an d (2 ) A ID S c an b e tra ns m itt ed b y sh ar in g fo od w ith s om eo ne w ith A ID S . N um be r of m en Ta bl e H A .1 .2 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on P er ce nt ag e of m en a ge 1 5- 49 y ea rs w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s, p er ce nt ag e w ho re je ct c om m on m is co nc ep tio ns * , an d pe rc en ta ge w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on L ao P D R 2 01 1- 12 P er ce nt ag e w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : P er ce nt ag e of m en w ho kn ow b ot h w ay s P er ce nt ag e w ho kn ow th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ho k no w th at H IV c an no t be tr an sm itt ed b y: P er ce nt a g e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns * a nd kn ow th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s P er ce nt a g e w ith co m pr eh en si ve kn ow le dg e1 251 15 H av in g on ly on e fa ith fu l un in fe ct ed se x pa rtn er U si ng a co nd om ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith s om eo ne w ith A ID S A ge 1 5- 24 88 .6 81 .7 81 .5 77 .3 60 .4 46 .3 74 .2 63 .5 29 .2 27 .6 3, 67 6 25 -2 9 93 .2 88 .7 88 .4 85 .7 64 .9 53 .7 82 .5 70 .9 35 .5 34 .2 1, 50 0 30 -3 9 93 .2 87 .9 86 .7 83 .3 63 .2 47 .8 79 .1 70 .3 32 .1 30 .4 2, 70 9 40 -4 9 93 .2 88 .7 86 .8 84 .3 61 .1 46 .9 81 .2 68 .6 31 .1 30 .1 2, 06 6 M ar ita l s ta tu s E ve r m ar rie d/ in u ni on 92 .8 87 .9 86 .6 83 .5 62 .0 47 .7 79 .4 68 .6 31 .2 29 .9 6, 78 8 N ev er m ar rie d/ in u ni on 88 .6 81 .6 81 .8 77 .6 61 .9 48 .5 75 .8 65 .2 31 .6 29 .9 3, 16 3 Ed uc at io n N on e 71 .2 58 .6 56 .0 50 .1 30 .5 25 .7 47 .1 37 .1 10 .2 9. 1 92 3 P rim ar y 88 .3 81 .6 81 .0 76 .7 52 .9 38 .4 72 .0 57 .5 20 .8 19 .6 3, 87 2 Lo w er s ec on da ry 95 .2 90 .7 90 .6 87 .9 66 .7 50 .2 83 .1 73 .4 32 .3 30 .9 2, 35 1 U pp er s ec on da ry 98 .9 95 .7 94 .7 92 .3 78 .6 61 .2 90 .9 82 .7 45 .5 43 .9 1, 45 0 P os t s ec on da ry n on te rti ar y 99 .9 97 .6 95 .7 93 .7 80 .6 68 .7 94 .8 88 .6 53 .6 51 .4 60 8 H ig he r 99 .9 98 .1 97 .2 96 .0 85 .8 75 .4 95 .5 92 .1 63 .4 61 .0 74 7 W ea lth in de x qu in til e P oo re st 77 .2 67 .1 67 .6 62 .2 39 .8 33 .3 60 .0 44 .6 14 .4 13 .4 1, 69 2 S ec on d 87 .3 80 .7 78 .4 74 .7 50 .1 37 .9 67 .4 57 .0 20 .5 19 .2 1, 91 1 M id dl e 93 .2 88 .2 87 .9 84 .6 61 .4 46 .5 80 .6 67 .7 29 .0 27 .6 2, 03 9 Fo ur th 97 .2 93 .3 92 .9 90 .2 71 .3 52 .6 86 .5 77 .2 36 .7 35 .6 2, 09 2 R ic he st 99 .0 95 .7 94 .1 91 .7 80 .9 64 .8 91 .5 84 .8 50 .6 48 .4 2, 21 7 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 95 .8 91 .8 90 .7 88 .0 70 .0 52 .9 84 .9 75 .0 37 .3 35 .7 6, 63 5 M on -K hm er 83 .1 73 .8 74 .8 69 .4 47 .0 38 .3 66 .7 51 .7 18 .8 17 .6 2, 19 1 H m on g- M ie n 86 .7 79 .8 78 .6 74 .6 47 .7 35 .9 66 .5 56 .0 19 .1 18 .8 72 8 C hi ne se -T ib et an 71 .0 61 .5 55 .3 50 .9 35 .5 37 .5 45 .8 44 .4 20 .9 18 .7 33 5 O th er , M is si ng , D K 95 .7 87 .0 84 .2 81 .2 51 .2 57 .1 85 .5 82 .5 34 .6 31 .8 62 To ta l 91 .5 85 .9 85 .1 81 .6 62 .0 48 .0 78 .2 67 .5 31 .3 29 .9 9, 95 1 N um be r of m en P er ce nt ag e of m en w ho kn ow b ot h w ay s P er ce nt ag e w ho kn ow th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ho k no w th at H IV c an no t be tr an sm itt ed b y: P er ce nt a g e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns * a nd kn ow th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s P er ce nt a g e w ith co m pr eh en si ve kn ow le dg e1 Ta bl e H A .1 .2 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on P er ce nt ag e of m en a ge 1 5- 49 y ea rs w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s, p er ce nt ag e w ho re je ct c om m on m is co nc ep tio ns * , an d pe rc en ta ge w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on L ao P D R 2 01 1- 12 1 M IC S in di ca to r 9 .1 * T w o m os t c om m on m is co nc ep tio ns : ( 1) A ID S c an b e tra ns m itt ed b y m os qu ito b ite s an d (2 ) A ID S c an b e tra ns m itt ed b y sh ar in g fo od w ith s om eo ne w ith A ID S . P er ce nt ag e w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : 252 Data on knowledge of HIV transmission among young women and men age 15-24 are presented separately in Tables HA.2.1 and HA.2.2. The findings are very similar in both level and pattern according to background characteristics as those found among the population age 15-49. The LSIS shows that knowledge of HIV (how it is transmitted and how it can be prevented) is very low in Lao households. In particular, the majority of people who are poor and have lower levels of education do not understand HIV transmission and do not know how to protect themselves from HIV infection. Women have poorer knowledge than men on all indicators related to HIV knowledge. 35 66 80 89 92 91 67 6 18 30 45 55 62 25 5 16 28 42 52 58 23 0 10 20 30 40 50 60 70 80 90 100 None Primary Lower Upper Post Higher Lao PDR P er ce nt Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission, Lao PDR 2011-12 6 5 0 None Primary Lower secondary Upper secondary Post secondary non tertiary Higher Lao PDR Knows 2 ways to prevent HIV Identify 3 misconceptions Comprehensive knowledge 15 253 15 H av in g on ly on e fa ith fu l un in fe ct ed s ex pa rtn er U si ng a co nd om ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith s om eo ne w ith A ID S R eg io n N or th 79 .9 70 .5 69 .9 66 .1 49 .9 42 .9 61 .2 56 .8 26 .0 24 .2 2, 57 3 C en tra l 89 .0 78 .1 78 .7 72 .3 65 .2 39 .8 68 .6 65 .0 28 .6 26 .2 3, 91 8 S ou th 79 .2 64 .8 62 .8 56 .7 57 .2 33 .7 64 .4 47 .5 21 .0 17 .8 1, 54 1 Pr ov in ce V ie nt ia ne C ap ita l 97 .4 90 .7 89 .5 84 .8 79 .0 55 .8 86 .5 79 .4 42 .4 40 .4 1, 11 0 P ho ng sa ly 60 .8 47 .1 49 .1 43 .5 33 .2 21 .5 31 .8 30 .4 12 .9 12 .3 24 1 Lu an gn am th a 79 .7 66 .4 64 .5 59 .0 51 .1 47 .3 50 .3 60 .3 31 .0 28 .1 23 7 O ud om xa y 57 .3 47 .4 49 .1 44 .4 21 .9 23 .6 35 .6 43 .0 10 .1 9. 6 47 9 B ok eo 91 .6 88 .7 85 .2 84 .0 73 .0 41 .3 69 .7 70 .1 31 .5 30 .6 23 3 Lu an gp ra ba ng 85 .2 71 .2 70 .4 66 .5 49 .1 55 .9 72 .4 60 .0 30 .9 27 .7 47 4 H ua ph an h 87 .1 79 .8 79 .2 74 .4 60 .4 35 .6 65 .5 50 .6 18 .9 16 .8 40 8 X ay ab ur y 94 .2 89 .0 87 .1 85 .8 65 .6 63 .7 86 .9 76 .5 43 .6 41 .9 50 2 X ie ng kh ua ng 82 .7 72 .8 70 .2 64 .7 67 .6 33 .8 41 .8 49 .9 24 .6 22 .1 38 9 V ie nt ia ne 94 .1 70 .6 80 .9 67 .3 63 .0 32 .0 64 .8 61 .3 23 .2 20 .0 54 2 B or ik ha m xa y 87 .1 76 .0 82 .5 74 .1 48 .5 42 .5 64 .4 69 .4 28 .8 26 .3 32 2 K ha m m ua ne 92 .3 82 .8 81 .6 76 .5 58 .8 40 .6 66 .6 57 .3 23 .3 21 .4 37 8 S av an na kh et 80 .2 70 .3 68 .2 63 .5 59 .1 29 .2 64 .1 59 .3 20 .9 18 .7 1, 17 7 S ar av an e 62 .1 47 .3 46 .1 40 .5 35 .9 25 .5 47 .3 36 .2 12 .4 10 .2 56 4 S ek on g 72 .2 65 .5 67 .8 63 .4 30 .6 30 .8 46 .4 49 .2 9. 7 9. 2 15 4 C ha m pa sa ck 95 .8 79 .7 75 .6 68 .7 79 .7 43 .5 84 .2 58 .8 31 .5 26 .5 68 2 A tta pe u 74 .5 62 .6 62 .4 56 .6 62 .4 21 .6 56 .8 36 .1 17 .0 15 .2 14 1 R es id en ce U rb an 95 .1 88 .4 87 .3 83 .0 75 .4 54 .3 81 .5 79 .1 41 .9 38 .7 2, 35 6 R ur al 79 .6 66 .8 66 .8 60 .8 51 .9 33 .5 58 .7 50 .6 19 .8 17 .9 5, 67 6 .R ur al w ith ro ad 81 .0 68 .3 68 .6 62 .5 53 .2 34 .3 60 .1 52 .4 20 .7 18 .7 5, 15 3 .R ur al w ith ou t r oa d 66 .1 51 .6 49 .5 44 .4 38 .4 25 .3 45 .2 33 .4 11 .4 9. 2 52 3 1 M IC S in di ca to r 9 .2 ; M D G in di ca to r 6 .3 * T w o m os t c om m on m is co nc ep tio ns : ( 1) A ID S c an b e tra ns m itt ed b y m os qu ito b ite s an d (2 ) A ID S c an b e tra ns m itt ed b y sh ar in g fo od w ith s om eo ne w ith A ID S . N ot e: 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. N um be r of w om en ag e 15 -2 4 Ta bl e H A .2 .1 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on a m on g yo un g w om en P er ce nt ag e of y ou ng w om en a ge 1 5- 24 y ea rs w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s, p er ce nt ag e w ho re je ct c om m on m is co nc ep tio ns * , an d pe rc en ta ge w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on L ao P D R 2 01 1- 12 P er ce nt ag e w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : P er ce nt ag e of w om en w ho k no w bo th w ay s P er ce nt ag e w ho kn ow th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ho k no w th at H IV c an no t be tr an sm itt ed b y: P er ce nt ag e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns * a nd k no w th at a h ea lth y lo ok in g pe rs on ca n ha ve th e A ID S v iru s P er ce nt a g e w ith co m pr eh en si ve kn ow le dg e1 254 15 H av in g on ly on e fa ith fu l un in fe ct ed s ex pa rtn er U si ng a co nd om ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith s om eo ne w ith A ID S A ge 1 5- 19 83 .1 71 .5 71 .5 65 .3 58 .1 39 .2 63 .0 57 .1 25 .6 23 .3 4, 41 5 20 -2 4 85 .5 75 .1 74 .4 69 .8 59 .6 40 .1 68 .4 61 .3 27 .1 24 .7 3, 61 7 M ar ita l s ta tu s E ve r m ar rie d/ in u ni on 82 .3 71 .5 70 .3 65 .1 54 .2 34 .9 61 .5 54 .4 21 .2 18 .9 3, 75 7 N ev er m ar rie d/ in u ni on 85 .8 74 .5 75 .0 69 .3 62 .8 43 .7 68 .8 63 .0 30 .7 28 .4 4, 27 5 Ed uc at io n N on e 49 .1 35 .8 32 .9 29 .0 21 .4 14 .2 28 .0 22 .6 4. 4 3. 6 1, 05 4 P rim ar y 79 .8 64 .5 64 .3 57 .5 47 .7 29 .7 55 .4 46 .1 14 .3 12 .4 2, 68 9 Lo w er s ec on da ry 91 .5 80 .6 82 .0 75 .5 66 .0 41 .4 71 .1 63 .6 26 .9 24 .6 1, 88 0 U pp er s ec on da ry 98 .6 92 .3 92 .7 88 .4 79 .2 56 .5 86 .6 84 .1 44 .4 41 .5 1, 57 7 P os t s ec on da ry n on te rti ar y 98 .3 94 .4 92 .7 90 .8 78 .8 71 .2 93 .0 85 .9 51 .9 49 .5 21 6 H ig he r 98 .9 95 .2 92 .1 88 .6 89 .9 66 .1 92 .0 89 .1 58 .8 53 .8 61 7 W ea lth in de x qu in til e P oo re st 57 .8 42 .9 42 .6 37 .2 25 .6 21 .6 34 .9 29 .9 7. 2 6. 2 1, 32 8 S ec on d 75 .2 60 .7 60 .8 54 .7 43 .7 28 .5 51 .3 42 .3 14 .2 12 .5 1, 52 6 M id dl e 86 .7 74 .8 74 .3 68 .3 60 .0 35 .7 65 .1 56 .6 22 .3 20 .2 1, 54 0 Fo ur th 94 .7 85 .7 85 .2 80 .0 71 .4 49 .2 78 .0 72 .0 35 .2 32 .5 1, 64 8 R ic he st 97 .9 91 .1 90 .8 85 .9 81 .1 55 .1 86 .5 82 .2 44 .0 40 .5 1, 99 0 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 92 .7 83 .8 83 .5 78 .1 71 .1 46 .5 77 .5 69 .6 33 .8 30 .9 5, 20 8 M on -K hm er 67 .2 53 .2 53 .5 48 .3 36 .5 26 .9 45 .5 38 .2 12 .0 11 .0 1, 81 8 H m on g- M ie n 75 .9 57 .8 56 .9 49 .4 37 .1 26 .9 40 .3 43 .9 12 .9 11 .2 68 9 C hi ne se -T ib et an 55 .0 41 .8 40 .2 36 .2 27 .6 25 .4 31 .9 33 .1 13 .1 12 .6 26 9 O th er , M is si ng , D K (7 8. 8) (6 3. 1) (5 5. 9) (5 2. 2) (5 1. 5) (3 4. 9) (5 5. 0) (5 6. 1) (1 8. 5) (1 3. 7) 49 To ta l 84 .2 73 .1 72 .8 67 .3 58 .8 39 .6 65 .4 59 .0 26 .3 24 .0 8, 03 2 P er ce nt a g e w ith co m pr eh en si ve kn ow le dg e1 N um be r of w om en ag e 15 -2 4 Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : P er ce nt ag e of w om en w ho k no w bo th w ay s P er ce nt ag e w ho kn ow th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ho k no w th at H IV c an no t be tr an sm itt ed b y: P er ce nt ag e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns * a nd k no w th at a h ea lth y lo ok in g pe rs on ca n ha ve th e A ID S v iru s Ta bl e H A .2 .1 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on a m on g yo un g w om en P er ce nt ag e of y ou ng w om en a ge 1 5- 24 y ea rs w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s, p er ce nt ag e w ho re je ct c om m on m is co nc ep tio ns * , an d pe rc en ta ge w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on L ao P D R 2 01 1- 12 N ot e: 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. * T w o m os t c om m on m is co nc ep tio ns : ( 1) A ID S c an b e tra ns m itt ed b y m os qu ito b ite s an d (2 ) A ID S c an b e tra ns m itt ed b y sh ar in g fo od w ith s om eo ne w ith A ID S . 1 M IC S in di ca to r 9 .2 ; M D G in di ca to r 6 .3 P er ce nt ag e w ho h av e he ar d of A ID S 255 15 H av in g on ly on e fa ith fu l un in fe ct ed se x pa rtn er U si ng a co nd om ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith s om eo ne w ith A ID S R eg io n N or th 86 .4 79 .7 79 .3 75 .1 52 .9 51 .0 72 .0 60 .4 29 .3 27 .9 1, 13 3 C en tra l 90 .3 84 .4 83 .8 80 .5 66 .2 45 .9 75 .1 66 .4 30 .9 29 .3 1, 86 6 S ou th 87 .3 77 .6 78 .9 72 .3 57 .2 39 .8 75 .4 60 .9 24 .2 22 .6 67 7 Pr ov in ce V ie nt ia ne C ap ita l 95 .5 88 .0 89 .7 84 .9 75 .3 61 .4 81 .3 76 .6 44 .5 42 .1 50 4 P ho ng sa ly 69 .5 62 .0 59 .1 54 .9 40 .6 47 .9 49 .2 59 .0 31 .5 29 .6 13 0 Lu an gn am th a 83 .7 70 .7 61 .4 56 .2 44 .6 55 .8 57 .6 60 .9 33 .0 28 .3 94 O ud om xa y 79 .5 66 .4 71 .3 63 .5 49 .1 40 .2 54 .4 46 .6 20 .8 18 .5 20 4 B ok eo 97 .6 93 .5 91 .3 87 .8 70 .7 63 .4 77 .6 79 .6 46 .4 45 .2 90 Lu an gp ra ba ng 84 .4 79 .0 77 .3 73 .3 50 .8 51 .8 82 .9 57 .2 22 .6 22 .1 19 7 H ua ph an h 93 .3 90 .2 90 .5 88 .0 58 .9 36 .4 75 .7 54 .0 22 .1 21 .7 19 8 X ay ab ur y 95 .0 91 .7 93 .1 90 .7 56 .5 68 .0 92 .8 74 .8 39 .7 39 .3 21 9 X ie ng kh ua ng 93 .7 91 .4 90 .1 89 .8 60 .7 40 .9 80 .3 71 .3 24 .2 24 .2 19 4 V ie nt ia ne 95 .5 89 .8 89 .3 86 .3 79 .1 37 .6 77 .1 70 .0 28 .2 26 .4 25 0 B or ik ha m xa y 98 .3 90 .0 90 .6 88 .1 64 .3 73 .4 93 .2 60 .7 44 .3 43 .0 12 8 K ha m m ua ne 96 .3 89 .9 89 .9 85 .6 64 .4 48 .5 76 .7 68 .5 30 .6 30 .0 18 3 S av an na kh et 79 .2 74 .1 71 .2 68 .2 55 .9 31 .3 63 .1 55 .5 20 .2 18 .3 60 7 S ar av an e 92 .0 75 .9 79 .9 67 .8 52 .6 37 .2 73 .4 60 .4 20 .5 19 .1 22 3 S ek on g 81 .7 65 .2 76 .4 61 .8 49 .3 37 .7 65 .6 60 .1 21 .0 19 .5 62 C ha m pa sa ck 84 .2 79 .4 77 .3 75 .4 57 .8 42 .3 77 .1 62 .3 28 .3 26 .4 34 0 A tta pe u 94 .3 87 .3 88 .2 83 .6 82 .8 37 .4 85 .2 54 .6 17 .2 16 .3 52 R es id en ce U rb an 95 .7 90 .6 89 .2 86 .3 75 .4 57 .9 86 .9 77 .6 41 .9 39 .5 1, 03 9 R ur al 85 .7 78 .2 78 .4 73 .8 54 .5 41 .7 69 .2 58 .0 24 .1 22 .9 2, 63 7 .R ur al w ith ro ad 87 .0 79 .7 79 .8 75 .3 56 .1 42 .7 70 .5 59 .1 25 .0 23 .7 2, 38 8 .R ur al w ith ou t r oa d 73 .8 63 .8 65 .1 58 .6 39 .4 32 .7 56 .8 47 .4 15 .7 15 .3 24 9 1 M IC S in di ca to r 9 .2 ; M D G in di ca to r 6 .3 * T w o m os t c om m on m is co nc ep tio ns : ( 1) A ID S c an b e tra ns m itt ed b y m os qu ito b ite s an d (2 ) A ID S c an b e tra ns m itt ed b y sh ar in g fo od w ith s om eo ne w ith A ID S . N ot e: 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. N um be r o f m en ag e 15 -2 4 Ta bl e H A .2 .2 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on a m on g yo un g m en P er ce nt ag e of y ou ng m en a ge 1 5- 24 y ea rs w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s, p er ce nt ag e w ho re je ct c om m on m is co nc ep tio ns * , an d pe rc en ta ge w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on L ao P D R 2 01 1- 12 P er ce nt ag e w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : P er ce nt ag e of m en w ho kn ow b ot h w ay s P er ce nt ag e w ho kn ow th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ho k no w th at H IV c an no t be tr an sm itt ed b y: P er ce nt a g e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns * a nd kn ow th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s P er ce nt a g e w ith co m pr eh en si ve kn ow le dg e1 256 15 H av in g on ly on e fa ith fu l un in fe ct ed se x pa rtn er U si ng a co nd om ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith s om eo ne w ith A ID S A ge 1 5- 19 85 .4 77 .7 78 .4 73 .3 56 .8 43 .1 71 .6 59 .9 26 .0 24 .6 2, 11 9 20 -2 4 92 .8 87 .2 85 .7 82 .7 65 .3 50 .7 77 .7 68 .5 33 .4 31 .7 1, 55 7 M ar ita l s ta tu s E ve r m ar rie d/ in u ni on 90 .9 84 .7 83 .5 79 .8 59 .8 44 .8 74 .2 63 .6 27 .9 26 .6 95 5 N ev er m ar rie d/ in u ni on 87 .7 80 .6 80 .8 76 .4 60 .6 46 .9 74 .2 63 .5 29 .6 28 .0 2, 72 1 Ed uc at io n N on e 57 .4 47 .7 40 .9 37 .9 24 .4 20 .0 27 .7 29 .8 10 .5 9. 4 18 7 P rim ar y 79 .7 70 .0 70 .2 64 .3 45 .0 33 .7 61 .1 46 .6 16 .7 15 .4 1, 16 3 Lo w er s ec on da ry 91 .9 85 .2 86 .3 82 .0 60 .6 46 .1 76 .6 66 .1 25 .9 24 .7 1, 07 7 U pp er s ec on da ry 98 .1 93 .6 92 .8 89 .6 79 .2 60 .0 89 .6 80 .0 43 .6 41 .6 87 4 P os t s ec on da ry n on te rti ar y 10 0. 0 96 .4 97 .2 95 .3 85 .9 62 .5 95 .7 85 .7 49 .9 48 .0 10 4 H ig he r 99 .6 97 .0 96 .6 95 .2 80 .6 69 .5 95 .4 88 .0 53 .9 51 .7 27 1 W ea lth in de x qu in til e P oo re st 71 .3 60 .7 61 .4 55 .2 36 .1 32 .9 54 .4 39 .6 12 .7 11 .7 56 7 S ec on d 83 .0 76 .2 73 .7 70 .2 49 .7 37 .5 61 .0 54 .0 20 .3 18 .6 73 4 M id dl e 89 .0 82 .1 82 .3 78 .1 57 .6 47 .4 74 .9 62 .4 28 .3 27 .4 77 8 Fo ur th 95 .6 89 .4 91 .2 86 .6 71 .0 49 .6 84 .1 73 .4 34 .1 32 .4 78 6 R ic he st 98 .4 93 .5 92 .5 89 .5 79 .6 59 .5 89 .7 80 .4 44 .6 42 .5 81 2 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 92 .9 87 .3 87 .0 83 .3 68 .6 50 .6 81 .4 70 .1 34 .3 32 .7 2, 40 7 M on -K hm er 79 .3 69 .6 71 .5 65 .6 45 .5 36 .6 60 .5 48 .0 17 .8 16 .2 79 8 H m on g- M ie n 85 .9 78 .9 77 .5 73 .5 48 .1 38 .5 64 .8 56 .9 21 .2 20 .9 30 1 C hi ne se -T ib et an 70 .8 59 .6 54 .6 49 .7 35 .8 41 .9 48 .1 49 .2 22 .7 20 .3 14 0 O th er , M is si ng , D K (9 6. 8) (8 4. 1) (7 5. 2) (7 2. 0) (4 0. 7) (5 8. 9) (8 2. 2) (8 3. 9) (2 9. 6) (2 3. 7) 30 To ta l 88 .6 81 .7 81 .5 77 .3 60 .4 46 .3 74 .2 63 .5 29 .2 27 .6 3, 67 6 P er ce nt a g e w ith co m pr eh en si ve kn ow le dg e1 N um be r o f m en ag e 15 -2 4 Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : P er ce nt ag e of m en w ho kn ow b ot h w ay s P er ce nt ag e w ho kn ow th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ho k no w th at H IV c an no t be tr an sm itt ed b y: P er ce nt a g e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns * a nd kn ow th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s Ta bl e H A .2 .2 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on a m on g yo un g m en P er ce nt ag e of y ou ng m en a ge 1 5- 24 y ea rs w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s, p er ce nt ag e w ho re je ct c om m on m is co nc ep tio ns * , an d pe rc en ta ge w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on L ao P D R 2 01 1- 12 N ot e: 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. 1 M IC S in di ca to r 9 .2 ; M D G in di ca to r 6 .3 * T w o m os t c om m on m is co nc ep tio ns : ( 1) A ID S c an b e tra ns m itt ed b y m os qu ito b ite s an d (2 ) A ID S c an b e tra ns m itt ed b y sh ar in g fo od w ith s om eo ne w ith A ID S . P er ce nt ag e w ho h av e he ar d of A ID S 257 Knowledge of mother-to-child transmission of HIV Awareness of the potential risk of mother-to-child transmission of HIV is the first step in motivating women to seek HIV testing when they are pregnant, in order to avoid infecting their baby. In the LSIS, women and men were asked whether they think that HIV can be transmitted during pregnancy, during delivery, and through breastfeeding. The results are presented in Tables HA.3.1 and HA.3.2. Eight 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). Fifty-five and 57 per cent of women and men, respectively, are aware of all three modes of mother-to-child transmission. Patterns across background characteristics are essentially the same among men and women. Prevalence of the knowledge of modes of mother-to-child transmission varies drastically by education and wealth quintile, essentially doubling with increasing education level and wealth quintile. Eight per cent of women and 9 per cent of men are not aware of any of the three modes of mother-to-child transmission. The proportion of women and men who know none of the three modes of transmission is highest in Luangnamtha; among 19 per cent of women and 27 per cent of men. 15 258 15 During pregnancy During delivery By breastfeeding All three means1 Region North 70.5 67.0 59.1 63.6 54.4 8.8 7,057 Central 82.2 78.6 62.5 73.5 57.5 6.6 11,255 South 71.2 66.0 54.7 65.7 51.4 7.9 4,164 Province Vientiane Capital 93.2 88.9 70.3 80.8 63.3 4.5 3,288 Phongsaly 40.7 39.0 35.9 38.2 34.2 12.8 666 Luangnamtha 56.1 54.5 44.8 46.3 42.7 18.9 627 Oudomxay 47.6 46.0 41.0 44.9 39.2 7.7 1,182 Bokeo 87.0 79.6 69.3 79.9 62.6 4.1 620 Luangprabang 74.4 71.2 51.2 60.8 44.0 11.2 1,473 Huaphanh 82.0 77.7 74.1 71.6 64.8 6.2 1,086 Xayabury 90.2 85.5 83.9 88.5 81.2 4.9 1,402 Xiengkhuang 78.4 76.7 71.9 68.6 64.7 8.1 930 Vientiane 84.7 81.2 60.9 74.5 57.1 8.4 1,677 Borikhamxay 81.2 80.4 50.4 77.6 50.1 4.7 901 Khammuane 83.0 77.5 67.6 78.4 64.2 9.5 1,082 Savannakhet 71.4 67.7 54.7 64.4 50.0 6.9 3,376 Saravane 53.7 49.1 42.4 46.5 38.9 8.5 1,456 Sekong 60.2 59.1 57.6 59.3 56.7 3.9 388 Champasack 87.0 80.4 63.2 81.0 59.2 8.1 1,943 Attapeu 68.6 64.5 55.2 67.1 54.1 8.5 376 Residence Urban 91.5 88.3 71.4 81.0 65.4 3.9 6,649 Rural 70.2 66.1 55.2 63.8 51.2 9.1 15,827 .Rural with road 71.9 67.8 56.5 65.3 52.5 8.9 14,268 .Rural without road 55.3 50.4 43.2 50.6 39.0 10.5 1,559 Age group 15-24 76.6 72.1 60.2 68.0 54.9 7.6 8,032 15-19 75.0 70.3 58.6 66.6 53.3 8.0 4,415 20-24 78.4 74.2 62.2 69.7 56.8 7.1 3,617 25-29 79.2 75.5 62.5 71.1 57.9 5.5 3,642 30-39 76.4 73.0 58.8 69.0 54.5 7.9 6,079 40-49 74.5 71.0 59.2 68.7 55.5 8.4 4,722 Marital status Ever married/in union 75.8 72.0 59.7 69.1 55.6 7.6 17,445 Never married/in union 79.0 74.7 60.8 68.4 54.8 7.4 5,031 Education None 43.9 39.9 33.6 38.8 30.4 12.5 4,660 Primary 76.9 72.5 60.2 70.8 56.2 8.7 8,955 Lower secondary 89.9 86.4 71.2 81.4 66.4 4.6 4,111 Upper secondary 95.3 92.6 75.3 84.9 69.2 3.6 2,496 Post secondary non tertiary 97.3 95.1 77.5 84.4 69.5 1.7 1,030 Higher 96.8 93.0 75.3 81.8 67.2 2.1 1,224 Wealth index quintile Poorest 43.9 40.1 35.0 39.5 31.5 12.2 3,809 Second 64.6 60.0 50.5 58.9 46.7 10.4 4,088 Middle 78.8 74.8 62.3 71.4 57.8 8.4 4,309 Fourth 89.4 85.6 70.2 82.4 66.3 5.4 4,694 Richest 94.9 91.6 73.5 83.1 67.0 3.3 5,577 Ethno-linguistic group of household head Lao-Tai 87.6 83.6 68.5 79.2 63.6 5.4 15,151 Mon-Khmer 53.1 49.7 42.3 47.8 38.8 11.2 4,913 Hmong-Mien 60.4 56.0 47.0 52.4 41.7 12.5 1,606 Chinese-Tibetan 37.6 35.7 28.6 31.7 27.0 15.1 685 Other, Missing, DK 68.7 62.5 51.6 62.0 46.6 12.6 121 Total 76.5 72.6 60.0 68.9 55.4 7.5 22,476 1 MICS indicator 9.3 Table HA.3.1: Knowledge of mother-to-child HIV transmission Percentage of women age 15-49 years who correctly identify means of HIV transmission from mother to child, Lao PDR 2011-12 Percent who know HIV can be transmitted:Percentage who know HIV can be transmitted from mother to child Number of women Does not know any of the specific means 259 During pregnancy During delivery By breastfeeding All three means1 Region North 78.5 75.4 62.8 67.3 56.0 10.3 3,172 Central 85.7 81.2 66.5 71.7 57.0 7.9 4,990 South 80.4 77.2 64.5 72.6 59.0 10.0 1,789 Province Vientiane Capital 89.5 85.8 70.0 72.4 58.6 7.9 1,379 Phongsaly 59.5 57.4 56.3 53.0 50.6 9.2 318 Luangnamtha 58.8 55.7 50.6 52.6 46.9 26.6 266 Oudomxay 67.4 65.8 60.7 62.5 58.2 13.4 530 Bokeo 93.2 85.7 71.2 82.9 61.7 5.2 267 Luangprabang 76.3 72.4 40.9 51.3 29.5 13.3 644 Huaphanh 91.9 87.5 81.4 79.2 71.3 3.8 511 Xayabury 90.8 89.5 76.7 84.6 72.7 5.9 635 Xiengkhuang 91.4 87.8 81.9 69.3 63.3 4.6 442 Vientiane 91.4 88.4 64.4 75.1 59.0 5.1 721 Borikhamxay 84.1 81.5 74.7 79.8 73.2 13.9 390 Khammuane 90.4 82.7 70.9 79.3 62.1 7.5 503 Savannakhet 76.9 71.3 56.7 65.7 47.2 8.7 1,556 Saravane 79.5 74.4 62.2 69.4 55.4 14.7 597 Sekong 81.7 80.7 67.2 65.9 62.4 5.2 162 Champasack 81.8 80.4 64.9 76.5 60.9 5.9 873 Attapeu 75.3 66.7 68.8 69.7 57.9 19.6 157 Residence Urban 91.7 88.6 75.1 75.8 64.0 5.4 2,800 Rural 78.8 74.7 61.0 68.4 54.3 10.4 7,151 .Rural with road 80.1 76.0 62.4 69.5 55.4 10.5 6,457 .Rural without road 66.4 62.5 48.6 57.9 43.7 9.5 694 Age group 15-24 77.9 73.5 61.3 65.3 52.8 10.7 3,676 15-19 74.3 69.9 57.7 61.8 49.4 11.1 2,119 20-24 82.7 78.5 66.3 70.2 57.4 10.1 1,557 25-29 85.6 82.0 68.4 73.6 60.9 7.6 1,500 30-39 84.9 81.5 66.2 73.1 58.9 8.3 2,709 40-49 85.0 81.4 67.4 73.7 59.3 8.1 2,066 Marital status Ever married/in union 84.6 81.1 66.9 73.2 59.3 8.2 6,788 Never married/in union 77.8 73.3 60.9 64.4 52.1 10.8 3,163 Education None 52.4 47.6 38.6 44.2 33.6 18.8 923 Primary 77.3 73.0 58.7 67.0 51.9 11.0 3,872 Lower secondary 88.0 84.6 71.2 76.3 63.3 7.2 2,351 Upper secondary 92.8 89.1 76.7 80.0 67.8 6.1 1,450 Post secondary non tertiary 96.9 94.1 76.3 80.5 65.4 2.9 608 Higher 96.8 94.6 78.4 75.5 65.4 3.0 747 Wealth index quintile Poorest 62.9 58.9 48.0 52.8 41.8 14.3 1,692 Second 76.0 70.9 59.0 65.2 51.4 11.3 1,911 Middle 83.8 80.4 66.3 73.9 59.6 9.4 2,039 Fourth 90.9 87.2 73.5 80.3 66.3 6.3 2,092 Richest 93.5 90.6 73.9 76.0 62.5 5.4 2,217 Ethno-linguistic group of household head Lao-Tai 88.8 85.0 70.5 76.4 62.2 6.9 6,635 Mon-Khmer 69.6 65.5 52.2 59.1 46.1 13.6 2,191 Hmong-Mien 78.4 74.7 63.7 63.5 53.5 8.3 728 Chinese-Tibetan 50.7 48.0 42.3 42.4 36.2 20.3 335 Other, Missing, DK 76.3 71.2 63.4 61.6 49.0 19.4 62 Total 82.4 78.6 65.0 70.4 57.0 9.0 9,951 1 MICS indicator 9.3 Table HA.3.2: Knowledge of mother-to-child HIV transmission Percentage of men age 15-49 years who correctly identify means of HIV transmission from mother to child, Lao PDR 2011-12 Percentage who know HIV can be transmitted from mother to child Percent who know HIV can be transmitted: Does not know any of the specific means Number of men 15 260 Accepting Attitudes towards People Living with HIV/AIDS (Stigma and Discrimination) The indicators on attitudes towards people living with HIV measure stigma and discrimination in the community. Stigma and discrimination are low if respondents report an accepting attitude on the following four questions: 1) would you care for a family member in your own household who is sick with AIDS?; 2) would you buy fresh vegetables from a vendor who is HIV-positive?; 3) do you think that a female teacher who is HIV-positive should be allowed to continue teaching in school?; and 4) would you not want to keep HIV status of a family member a secret? Tables HA.4.1 and HA.4.2 present the percentages of women and men who hold accepting attitudes towards people living with HIV/AIDS, among those who have heard of AIDS. In Lao PDR, 94 per cent of women and men who have heard of AIDS have at least one accepting attitude towards people living with HIV/AIDS. As with HIV knowledge, patterns and differentials across the background characteristics of people with accepting attitudes are generally the same among women and men. The most common accepting attitude pertains to secrecy. Most people who have heard of AIDS (8 in 10) agree that if they had a family member who was sick with AIDS, they would not feel the need to keep the HIV status of the person a secret. Accepting attitudes are held by a much smaller percentage of people with respect to the other three indicators. Only 4 in 10 women said they would buy fresh vegetables from a shopkeeper or a vendor who has HIV. However, the percentage of women who would buy fresh vegetables from a vendor who has HIV increases tremendously with increasing education, with positive responses from 8 in 10 women with a higher education level. Only 4 in 10 women said that they would be willing to care for a family member with AIDS in their household, and this figure is even lower among women in rural areas without roads (26 per cent). Only 48 per cent of women believe that if a female teacher is HIV-positive, she should be allowed to continue teaching. The percentage of people expressing positive attitudes towards people who are living with HIV/AIDS regarding all four indicators asked about is very low: among only 17 per cent of women and 14 per cent of men. The percentage of people with accepting attitudes on all four indicators varies significantly across provinces, from highs of 32 and 31 per cent among women in Borikhamxay and Bokeo provinces, to lows of 1 per cent in Sekong and 5 per cent in Phongsaly. The range across provinces among men ranges from lows of 2 per cent in Phongsaly and 4 per cent in Laungprabang, to highs of 23 per cent in Savannakhet and 25 per cent in Bokeo. Accepting attitudes towards people living HIV/AIDS is generally rather low. Educational programmes to provide knowledge regarding HIV and AIDS, transmission, prevention, and behavior information could be targeted especially at particular provinces. 15 261 15 A re w ill in g to c ar e fo r a fa m ily m em be r w ith th e A ID S v iru s in o w n ho m e W ou ld b uy fr es h ve ge ta bl es fr om a sh op ke ep er o r v en do r w ho ha s th e A ID S v iru s B el ie ve th at a fe m al e te ac he r w ith th e A ID S v iru s an d is n ot si ck s ho ul d be a llo w ed to co nt in ue te ac hi ng W ou ld n ot w an t t o ke ep se cr et th at a fa m ily m em be r g ot in fe ct ed w ith th e A ID S v iru s A gr ee w ith a t le as t o ne ac ce pt in g at tit ud e E xp re ss a cc ep tin g at tit ud es o n al l f ou r in di ca to rs 1 R eg io n N or th 34 .4 36 .1 38 .0 83 .8 93 .2 12 .6 5, 59 7 C en tra l 52 .5 51 .3 55 .6 76 .3 94 .7 21 .9 9, 99 5 S ou th 30 .8 36 .6 43 .8 80 .9 93 .8 9. 5 3, 29 3 Pr ov in ce V ie nt ia ne C ap ita l 53 .3 67 .7 67 .8 72 .4 96 .2 25 .3 3, 21 1 P ho ng sa ly 16 .2 24 .1 29 .3 81 .5 89 .1 4. 5 35 6 Lu an gn am th a 46 .4 41 .8 49 .6 79 .7 95 .4 18 .8 47 1 O ud om xa y 21 .6 22 .4 18 .7 76 .1 85 .1 5. 9 65 4 B ok eo 58 .2 45 .0 55 .5 78 .5 92 .3 30 .5 56 4 Lu an gp ra ba ng 42 .3 47 .0 41 .4 78 .5 91 .8 17 .1 1, 26 0 H ua ph an h 18 .3 21 .7 26 .5 89 .8 94 .7 6. 3 95 9 X ay ab ur y 35 .2 40 .5 43 .3 92 .5 98 .3 8. 4 1, 33 3 X ie ng kh ua ng 36 .6 30 .0 33 .1 85 .2 95 .6 11 .6 80 4 V ie nt ia ne 58 .0 51 .2 51 .5 85 .9 95 .3 26 .3 1, 56 1 B or ik ha m xa y 57 .2 48 .4 58 .9 78 .4 91 .7 31 .6 77 4 K ha m m ua ne 37 .9 33 .2 39 .7 76 .5 93 .4 11 .1 1, 00 1 S av an na kh et 57 .2 45 .7 55 .1 71 .9 93 .8 19 .6 2, 64 4 S ar av an e 47 .6 31 .2 37 .6 71 .4 90 .1 11 .6 90 5 S ek on g 4. 2 30 .4 36 .1 91 .8 96 .3 0. 9 24 9 C ha m pa sa ck 24 .0 41 .1 49 .0 84 .6 95 .4 9. 9 1, 84 9 A tta pe u 44 .0 30 .1 36 .0 77 .5 93 .6 7. 4 29 0 R es id en ce U rb an 49 .2 63 .1 65 .2 74 .9 96 .2 22 .9 6, 33 8 R ur al 40 .3 34 .7 39 .8 81 .5 93 .1 14 .0 12 ,5 48 .R ur al w ith ro ad 41 .6 35 .8 40 .6 81 .5 93 .4 14 .5 11 ,5 23 .R ur al w ith ou t r oa d 25 .8 23 .0 30 .5 81 .5 89 .7 7. 9 1, 02 5 Ta bl e H A .4 .1 : A cc ep tin g at tit ud es to w ar d pe op le li vi ng w ith H IV /A ID S P er ce nt ag e of w om en a ge 1 5- 49 y ea rs w ho h av e he ar d of A ID S w ho e xp re ss a n ac ce pt in g at tit ud e to w ar ds p eo pl e liv in g w ith H IV /A ID S , L ao P D R 2 01 1- 12 N um be r o f w om en w ho ha ve h ea rd o f A ID S Pe rc en ta ge o f w om en w ho : 1 M IC S in di ca to r 9 .4 262 15 A re w ill in g to c ar e fo r a fa m ily m em be r w ith th e A ID S v iru s in o w n ho m e W ou ld b uy fr es h ve ge ta bl es fr om a sh op ke ep er o r v en do r w ho ha s th e A ID S v iru s B el ie ve th at a fe m al e te ac he r w ith th e A ID S v iru s an d is n ot si ck s ho ul d be a llo w ed to co nt in ue te ac hi ng W ou ld n ot w an t t o ke ep se cr et th at a fa m ily m em be r g ot in fe ct ed w ith th e A ID S v iru s A gr ee w ith a t le as t o ne ac ce pt in g at tit ud e E xp re ss a cc ep tin g at tit ud es o n al l f ou r in di ca to rs 1 A ge 1 5- 24 45 .1 43 .0 48 .9 74 .3 92 .9 16 .0 6, 76 0 15 -1 9 43 .4 39 .2 45 .8 73 .8 91 .9 14 .3 3, 66 8 20 -2 4 47 .0 47 .5 52 .6 75 .0 94 .2 18 .2 3, 09 3 25 -2 9 46 .5 49 .5 53 .1 77 .9 95 .0 20 .2 3, 08 5 30 -3 9 42 .2 44 .9 46 .2 82 .5 94 .5 16 .7 5, 12 7 40 -4 9 39 .2 41 .4 46 .3 84 .7 95 .0 16 .4 3, 91 4 M ar ita l s ta tu s E ve r m ar rie d/ in u ni on 42 .2 42 .3 46 .1 81 .3 94 .4 16 .4 14 ,5 40 N ev er m ar rie d/ in u ni on 47 .0 50 .8 55 .7 72 .7 93 .3 18 .9 4, 34 6 Ed uc at io n N on e 29 .5 17 .8 23 .0 76 .4 87 .5 5. 7 2, 62 5 P rim ar y 40 .0 33 .9 38 .4 82 .5 93 .8 12 .8 7, 67 3 Lo w er s ec on da ry 46 .8 49 .3 52 .9 80 .5 95 .2 19 .3 3, 88 7 U pp er s ec on da ry 51 .8 64 .2 69 .0 74 .9 96 .4 24 .9 2, 47 0 P os t s ec on da ry n on te rti ar y 51 .6 77 .3 77 .2 80 .9 97 .8 32 .2 1, 02 0 H ig he r 58 .7 82 .0 84 .9 69 .0 99 .3 31 .4 1, 21 2 W ea lth in de x qu in til e P oo re st 26 .2 17 .5 21 .4 77 .1 87 .2 5. 1 2, 13 7 S ec on d 34 .0 23 .5 28 .8 81 .4 92 .2 7. 8 3, 06 3 M id dl e 40 .6 34 .4 41 .3 82 .2 94 .0 13 .4 3, 75 6 Fo ur th 48 .3 51 .4 54 .2 82 .2 95 .3 20 .6 4, 45 2 R ic he st 53 .0 67 .2 69 .8 74 .6 97 .1 26 .2 5, 47 8 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 47 .6 51 .0 55 .7 80 .0 96 .1 19 .9 14 ,0 93 M on -K hm er 30 .4 24 .3 27 .1 77 .7 88 .6 8. 1 3, 16 3 H m on g- M ie n 32 .2 22 .7 22 .7 78 .4 88 .1 8. 5 1, 17 0 C hi ne se -T ib et an 24 .3 23 .8 32 .7 76 .9 87 .8 6. 5 36 1 O th er , M is si ng , D K 53 .9 43 .4 42 .0 55 .8 88 .2 18 .2 99 To ta l 43 .3 44 .2 48 .3 79 .3 94 .1 17 .0 18 ,8 86 1 M IC S in di ca to r 9 .4 Pe rc en ta ge o f w om en w ho : N um be r o f w om en w ho ha ve h ea rd o f A ID S Ta bl e H A .4 .1 : A cc ep tin g at tit ud es to w ar d pe op le li vi ng w ith H IV /A ID S P er ce nt ag e of w om en a ge 1 5- 49 y ea rs w ho h av e he ar d of A ID S w ho e xp re ss a n ac ce pt in g at tit ud e to w ar ds p eo pl e liv in g w ith H IV /A ID S , L ao P D R 2 01 1- 12 263 15 A re w ill in g to c ar e fo r a fa m ily m em be r w ith th e A ID S v iru s in o w n ho m e W ou ld b uy fr es h ve ge ta bl es fr om a sh op ke ep er o r v en do r w ho ha s th e A ID S v iru s B el ie ve th at a fe m al e te ac he r w ith th e A ID S v iru s an d is n ot si ck s ho ul d be a llo w ed to co nt in ue te ac hi ng W ou ld n ot w an t t o ke ep se cr et th at a fa m ily m em be r g ot in fe ct ed w ith th e A ID S v iru s A gr ee w ith a t le as t o ne ac ce pt in g at tit ud e E xp re ss a cc ep tin g at tit ud es o n al l f ou r in di ca to rs 1 R eg io n N or th 24 .6 35 .2 32 .9 85 .5 94 .8 8. 0 2, 81 7 C en tra l 49 .4 48 .4 54 .8 74 .8 93 .7 18 .8 4, 66 8 S ou th 35 .6 38 .3 41 .9 77 .2 92 .2 11 .7 1, 61 7 Pr ov in ce V ie nt ia ne C ap ita l 46 .3 62 .9 65 .4 71 .8 95 .0 21 .0 1, 34 3 P ho ng sa ly 10 .7 13 .9 16 .1 91 .4 94 .8 2. 3 21 8 Lu an gn am th a 30 .2 51 .5 56 .2 71 .6 96 .5 6. 1 22 8 O ud om xa y 42 .3 19 .9 26 .7 84 .6 91 .7 9. 0 42 8 B ok eo 48 .5 52 .8 55 .4 88 .4 97 .1 24 .8 26 3 Lu an gp ra ba ng 9. 8 56 .7 30 .8 75 .6 92 .0 3. 6 57 7 H ua ph an h 23 .2 19 .4 24 .1 88 .0 93 .9 7. 2 48 9 X ay ab ur y 19 .9 32 .3 33 .9 95 .4 98 .6 7. 3 61 4 X ie ng kh ua ng 35 .9 37 .3 46 .3 81 .6 93 .0 11 .5 42 4 V ie nt ia ne 46 .7 42 .7 48 .1 77 .7 94 .8 13 .7 69 6 B or ik ha m xa y 41 .4 31 .7 46 .6 76 .4 85 .5 13 .9 38 2 K ha m m ua ne 51 .9 42 .9 50 .0 77 .5 94 .3 19 .5 49 2 S av an na kh et 59 .6 47 .0 54 .6 72 .8 94 .2 22 .7 1, 33 1 S ar av an e 22 .8 30 .7 32 .0 81 .0 91 .3 5. 8 56 2 S ek on g 46 .7 32 .1 45 .1 77 .0 95 .3 15 .5 14 1 C ha m pa sa ck 42 .0 42 .5 45 .9 72 .6 91 .7 14 .7 76 5 A tta pe u 40 .2 51 .0 55 .9 87 .0 95 .0 15 .1 14 9 R es id en ce U rb an 45 .3 60 .9 64 .4 72 .9 95 .4 20 .4 2, 72 0 R ur al 36 .7 34 .7 37 .8 81 .0 93 .1 11 .5 6, 38 2 .R ur al w ith ro ad 37 .0 35 .4 38 .7 81 .1 93 .2 11 .9 5, 85 5 .R ur al w ith ou t r oa d 33 .1 26 .7 28 .0 79 .4 92 .4 7. 8 52 7 Ta bl e H A .4 .2 : A cc ep tin g at tit ud es to w ar d pe op le li vi ng w ith H IV /A ID S P er ce nt ag e of m en a ge 1 5- 49 y ea rs w ho h av e he ar d of A ID S w ho e xp re ss a n ac ce pt in g at tit ud e to w ar ds p eo pl e liv in g w ith H IV /A ID S , L ao P D R 2 01 1- 12 Pe rc en ta ge o f m en w ho : N um be r o f m en w ho h av e he ar d of A ID S 1 M IC S in di ca to r 9 .4 264 15 A re w ill in g to c ar e fo r a fa m ily m em be r w ith th e A ID S v iru s in o w n ho m e W ou ld b uy fr es h ve ge ta bl es fr om a sh op ke ep er o r v en do r w ho ha s th e A ID S v iru s B el ie ve th at a fe m al e te ac he r w ith th e A ID S v iru s an d is n ot si ck s ho ul d be a llo w ed to co nt in ue te ac hi ng W ou ld n ot w an t t o ke ep se cr et th at a fa m ily m em be r g ot in fe ct ed w ith th e A ID S v iru s A gr ee w ith a t le as t o ne ac ce pt in g at tit ud e E xp re ss a cc ep tin g at tit ud es o n al l f ou r in di ca to rs 1 A ge 1 5- 24 39 .9 39 .9 45 .0 72 .4 91 .6 13 .0 3, 25 6 15 -1 9 39 .5 36 .6 41 .8 69 .8 89 .9 11 .5 1, 81 0 20 -2 4 40 .4 43 .9 49 .1 75 .7 93 .7 14 .8 1, 44 5 25 -2 9 39 .5 43 .9 48 .8 78 .5 94 .5 14 .7 1, 39 9 30 -3 9 39 .7 45 .1 45 .7 82 .4 95 .0 15 .3 2, 52 3 40 -4 9 37 .5 42 .5 44 .8 84 .1 95 .3 14 .4 1, 92 5 M ar ita l s ta tu s E ve r m ar rie d/ in u ni on 38 .6 42 .0 44 .4 82 .0 94 .9 14 .3 6, 30 0 N ev er m ar rie d/ in u ni on 40 .7 43 .6 48 .8 70 .8 91 .3 14 .0 2, 80 2 Ed uc at io n N on e 30 .1 17 .3 22 .0 75 .0 88 .5 2. 8 65 7 P rim ar y 33 .3 29 .0 31 .8 80 .5 92 .6 8. 1 3, 42 0 Lo w er s ec on da ry 41 .0 43 .4 46 .7 79 .2 93 .6 15 .4 2, 23 9 U pp er s ec on da ry 47 .0 54 .6 59 .6 76 .6 94 .9 20 .2 1, 43 4 P os t s ec on da ry n on te rti ar y 45 .1 69 .9 67 .7 82 .2 97 .8 24 .3 60 7 H ig he r 50 .1 78 .5 83 .1 71 .5 98 .5 28 .5 74 6 W ea lth in de x qu in til e P oo re st 26 .6 21 .9 22 .8 81 .3 91 .1 4. 6 1, 30 6 S ec on d 33 .7 27 .8 33 .4 80 .2 92 .3 8. 9 1, 66 9 M id dl e 37 .8 36 .5 39 .9 81 .4 93 .7 11 .5 1, 90 1 Fo ur th 45 .0 49 .3 53 .7 79 .5 94 .7 18 .8 2, 03 3 R ic he st 47 .1 64 .9 66 .6 72 .4 95 .7 21 .9 2, 19 4 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 43 .2 49 .2 52 .8 78 .2 94 .9 17 .1 6, 35 3 M on -K hm er 31 .5 28 .0 30 .8 80 .2 91 .8 8. 2 1, 82 2 H m on g- M ie n 29 .6 25 .1 25 .2 79 .8 90 .0 6. 7 63 1 C hi ne se -T ib et an 23 .4 21 .7 29 .5 75 .6 90 .6 2. 4 23 8 O th er , M is si ng , D K 26 .7 41 .3 32 .0 71 .9 83 .2 12 .6 59 To ta l 39 .3 42 .5 45 .8 78 .6 93 .8 14 .2 9, 10 2 1 M IC S in di ca to r 9 .4 Pe rc en ta ge o f m en w ho : N um be r o f m en w ho h av e he ar d of A ID S Ta bl e H A .4 .2 : A cc ep tin g at tit ud es to w ar d pe op le li vi ng w ith H IV /A ID S P er ce nt ag e of m en a ge 1 5- 49 y ea rs w ho h av e he ar d of A ID S w ho e xp re ss a n ac ce pt in g at tit ud e to w ar ds p eo pl e liv in g w ith H IV /A ID S , L ao P D R 2 01 1- 12 265 Knowledge of a HIV Testing Location The National Strategy and Action Plan on HIV/AIDS/STI 2011-2015 defines the following expected outcomes by 2015: Quality assured Voluntary Counseling and Testing (VCT) services available in all 94 priority districts; and 80 per cent of most-at-risk populations report they have received an HIV test and know the results within the previous 12 months. In order to protect themselves and to prevent infecting others, it is important for individuals to know their HIV status. This knowledge is also a critical factor in the decision to seek treatment. All women and men were asked if they know where they can go for an HIV test, whether they have ever been tested, whether they have been tested within the 12 months prior to the survey, and whether they know the result of the test. The findings are presented in Tables HA.5.1 and HA.5.2. Thirty-seven per cent of women and 47 per cent of men know where they can go to be tested. Seven per cent of women and men age 15-49 have been tested for HIV at some time. Nationally, 3 per cent of both women and men had been tested for HIV within the 12 months prior to the survey, and 2 per cent had been tested and told the result within the 12 months prior to the survey. While urban-rural differences in knowing where one can go for an HIV test are to be expected, the difference is rather large. Fifty-six per cent of women who live in urban areas know where to be tested for HIV, while only 18 per cent women who live in rural areas without roads know where they can go. Similarly, 62 per cent of urban men know where to go for a test, while only 29 per cent of men in rural areas without roads know where they can get an HIV test. Ten per cent or more of women and men have had at least one HIV test in their life in Vientiane Capital (18 and 14 per cent respectively), Bokeo (11 per cent of women), and Savannakhet (10 per cent of women and men), and Vientiane (10 per cent of men). The lowest level of having ever been tested is in Xiengkhuang province (1 per cent of women) and Sekong (2 per cent of men). The percentage of people who have ever been tested for HIV rises steadily with increasing education and wealth quintile. Six per cent of women and men in the highest wealth quintile have been tested within the 12 months prior to the survey and told the results. 15 266 15 Know a place to get tested1 Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result2 Number of women Region North 36.1 4.0 1.1 1.0 7,057 Central 38.1 9.8 3.8 3.5 11,255 South 37.0 5.0 1.6 1.3 4,164 Province Vientiane Capital 51.5 17.5 7.0 6.4 3,288 Phongsaly 32.4 1.7 1.1 0.8 666 Luangnamtha 26.3 6.5 1.6 1.4 627 Oudomxay 33.8 1.0 0.5 0.5 1,182 Bokeo 51.0 11.3 2.5 2.5 620 Luangprabang 26.7 6.4 1.6 1.4 1,473 Huaphanh 49.6 2.1 0.8 0.8 1,086 Xayabury 37.2 2.2 0.6 0.4 1,402 Xiengkhuang 25.9 0.9 0.3 0.2 930 Vientiane 22.5 4.9 1.9 1.5 1,677 Borikhamxay 20.0 5.2 1.4 1.0 901 Khammuane 36.1 4.7 1.7 1.6 1,082 Savannakhet 41.6 10.0 3.9 3.8 3,376 Saravane 26.0 3.0 0.6 0.4 1,456 Sekong 27.0 2.7 0.4 0.4 388 Champasack 45.1 7.5 2.8 2.4 1,943 Attapeu 47.5 2.3 0.3 0.3 376 Residence Urban 56.2 14.2 5.5 5.0 6,649 Rural 29.3 4.1 1.3 1.2 15,827 .Rural with road 30.6 4.4 1.4 1.3 14,268 .Rural without road 18.0 1.3 0.3 0.2 1,559 Age 15-24 36.2 5.2 2.7 2.3 8,032 15-19 33.0 2.5 1.3 1.1 4,415 20-24 40.1 8.6 4.3 3.8 3,617 25-29 40.2 11.1 3.8 3.5 3,642 30-39 37.6 8.2 2.4 2.2 6,079 40-49 36.6 5.7 1.5 1.5 4,722 Marital status Ever married/in union 37.0 8.4 2.9 2.6 17,445 Never married/in union 38.3 2.6 1.3 1.2 5,031 Education None 14.5 1.3 0.3 0.3 4,660 Primary 33.0 5.7 1.7 1.6 8,955 Lower secondary 44.1 8.7 3.1 2.7 4,111 Upper secondary 54.7 11.6 4.8 4.2 2,496 Post secondary non tertiary 69.1 18.8 7.4 7.1 1,030 Higher 70.5 15.0 6.1 5.8 1,224 Wealth index quintile Poorest 15.0 1.1 0.3 0.2 3,809 Second 25.6 2.4 0.8 0.7 4,088 Middle 34.7 4.0 1.3 1.1 4,309 Fourth 42.2 7.2 2.3 1.9 4,694 Richest 59.0 16.9 6.5 6.2 5,577 Ethno-linguistic group of household head Lao-Tai 44.9 9.4 3.5 3.2 15,151 Mon-Khmer 23.6 2.2 0.5 0.4 4,913 Hmong-Mien 14.1 1.2 0.5 0.4 1,606 Chinese-Tibetan 19.6 1.2 0.5 0.3 685 Other, Missing, DK 46.0 20.3 9.2 8.5 121 Total 37.3 7.1 2.5 2.3 22,476 Table HA.5.1: Knowledge of a place for HIV testing Percentage of women age 15-49 years who know where to get an HIV test, percentage of women who have ever been tested, percentage of women who have been tested in the last 12 months, and percentage of women who have been tested and have been told the result, Lao PDR 2011-12 1 MICS indicator 9.5 2 MICS indicator 9.6 Percentage of women who: 267 15 Know a place to get tested1 Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result2 Number of men Region North 45.3 4.1 1.3 1.2 3,172 Central 43.7 9.8 3.7 3.1 4,990 South 56.7 5.7 2.0 1.5 1,789 Province Vientiane Capital 51.0 14.4 6.6 5.4 1,379 Phongsaly 20.7 3.6 1.4 1.4 318 Luangnamtha 29.4 4.6 1.4 1.2 266 Oudomxay 46.0 2.5 0.7 0.7 530 Bokeo 48.2 9.2 2.9 2.1 267 Luangprabang 48.2 5.2 1.9 1.9 644 Huaphanh 58.8 3.8 1.2 1.2 511 Xayabury 48.9 2.5 0.3 0.3 635 Xiengkhuang 43.9 4.1 1.9 1.3 442 Vientiane 38.0 9.8 1.5 1.3 721 Borikhamxay 27.6 3.1 1.2 0.8 390 Khammuane 44.1 8.4 3.7 2.8 503 Savannakhet 43.6 9.6 3.4 3.0 1,556 Saravane 54.8 6.6 1.8 0.9 597 Sekong 69.1 2.2 0.3 0.3 162 Champasack 53.2 5.6 2.3 2.0 873 Attapeu 70.0 6.4 2.9 2.7 157 Residence Urban 62.3 12.4 5.3 4.6 2,800 Rural 40.4 5.2 1.6 1.3 7,151 .Rural with road 41.5 5.4 1.6 1.3 6,457 .Rural without road 29.3 3.3 1.2 1.2 694 Age 15-24 40.4 4.0 2.0 1.6 3,676 15-19 37.1 2.3 1.3 1.1 2,119 20-24 44.9 6.3 2.9 2.3 1,557 25-29 49.1 8.4 2.8 2.6 1,500 30-39 50.0 9.3 3.3 2.9 2,709 40-49 51.1 9.5 2.8 2.1 2,066 Marital status Ever married/in union 48.9 8.6 2.8 2.3 6,788 Never married/in union 41.4 4.4 2.3 2.0 3,163 Education None 19.1 2.4 1.0 0.8 923 Primary 38.2 5.1 1.6 1.4 3,872 Lower secondary 47.8 6.1 2.2 1.8 2,351 Upper secondary 57.0 8.2 3.8 3.2 1,450 Post secondary non tertiary 75.0 13.6 4.0 3.3 608 Higher 76.0 20.9 8.1 6.4 747 Wealth index quintile Poorest 27.3 1.5 0.5 0.4 1,692 Second 38.0 4.4 1.4 1.1 1,911 Middle 45.3 4.4 1.1 0.8 2,039 Fourth 51.9 9.4 3.0 2.6 2,092 Richest 64.6 14.6 6.4 5.5 2,217 Ethno-linguistic group of household head Lao-Tai 53.0 9.4 3.4 2.8 6,635 Mon-Khmer 35.9 2.8 0.8 0.6 2,191 Hmong-Mien 33.1 2.2 1.0 1.0 728 Chinese-Tibetan 16.7 1.8 1.1 1.1 335 Other, Missing, DK 50.1 19.3 14.1 10.6 62 Total 46.5 7.2 2.6 2.2 9,951 Table HA.5.2: Knowledge of a place for HIV testing Percentage of men age 15-49 years who know where to get an HIV test, percentage of men who have ever been tested, percentage of men who have been tested in the last 12 months, and percentage of men who have been tested and have been told the result, Lao PDR 2011-12 Percentage of men who: 1 MICS indicator 9.5 2 MICS indicator 9.6 268 Tables HA.6.1 and HA.6.2 present the same findings as Tables HA.5.1 and HA.5.2, but for sexually active young people age 15-24. Some 46 per cent of young women and 42 per cent of young men had sexual intercourse in the 12 months prior to the survey (and were considered sexually active). Note that among the never-married, 3 per cent of young women and 22 per cent of young men reported having had intercourse in the previous 12 months. Sexually active young people know where to go for an HIV test, in equal proportion to the general population (36 per cent of young women and 45 per cent of young men). Patterns in testing coverage generally mimic the patterns observed among the population age 15-49 (higher among urban than rural areas, rising with higher education levels and wealth quintiles). Four 4 per cent of sexually active young women and 3 per cent of young men had been tested within the previous 12 months and told the results. Testing among either young women or men is higher than the national average in Vientiane Capital, Bokeo, Xiengkhuang, Vientiane, Khammuane, Savannakhet and Champasack. However, the gender differential in coverage of testing is quite pronounced in Vientiane Capital, where only 2 per cent of young men report having been tested in the previous 12 months and told their results, compared with 13 per cent of young women. 15 269 Know a place to get tested Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result1 Region North 54.4 2,573 35.7 5.4 1.6 1.4 1,401 Central 42.6 3,918 35.9 12.6 7.2 6.6 1,668 South 42.9 1,541 35.3 5.8 2.8 2.0 662 Province Vientiane Capital 32.7 1,110 52.7 23.0 14.0 13.4 363 Phongsaly 60.4 241 34.0 3.4 1.9 1.4 145 Luangnamtha 59.5 237 27.3 10.2 3.1 2.1 141 Oudomxay 51.6 479 37.2 1.5 1.1 1.1 248 Bokeo 58.0 233 50.1 14.7 4.1 4.1 135 Luangprabang 51.0 474 28.9 8.3 1.0 1.0 242 Huaphanh 52.2 408 39.9 3.1 1.5 1.5 213 Xayabury 55.3 502 35.2 2.2 0.7 0.4 278 Xiengkhuang 43.0 389 20.4 0.3 0.3 0.3 167 Vientiane 50.2 542 22.0 7.7 3.7 2.3 272 Borikhamxay 46.4 322 17.7 6.5 3.4 2.8 149 Khammuane 47.9 378 31.1 6.5 3.6 3.6 181 Savannakhet 45.4 1,177 43.0 15.8 9.0 8.3 535 Saravane 48.1 564 24.1 2.8 1.0 0.6 272 Sekong 41.1 154 19.9 2.8 0.5 0.5 63 Champasack 38.0 682 47.0 10.5 5.9 4.1 259 Attapeu 48.0 141 50.3 3.2 0.6 0.6 68 Residence Urban 33.3 2,356 55.4 19.6 10.9 9.5 785 Rural 51.9 5,676 30.5 5.8 2.6 2.3 2,946 .Rural with road 52.0 5,153 31.3 6.2 2.8 2.6 2,678 .Rural without road 51.3 523 22.5 1.7 0.4 0.2 268 Age 15-19 26.8 4,415 29.9 5.5 2.9 2.8 1,185 20-24 70.4 3,617 38.4 10.2 5.0 4.3 2,545 Marital status Ever married/in union 95.9 3,757 35.2 8.6 4.3 3.8 3,602 Never married/in union 3.0 4,275 49.4 11.3 5.5 5.5 128 Education None 68.2 1,054 14.3 1.8 0.8 0.8 719 Primary 61.0 2,689 31.2 6.2 2.9 2.5 1,639 Lower secondary 42.9 1,880 45.2 12.3 6.2 5.3 806 Upper secondary 22.8 1,577 56.7 17.6 9.2 8.3 359 Post secondary non tertiary 38.9 216 78.3 30.5 13.1 11.4 84 Higher 20.0 617 67.9 18.2 12.5 12.5 123 Wealth index quintile Poorest 61.1 1,328 17.8 2.0 0.5 0.4 812 Second 55.1 1,526 29.8 3.7 2.2 1.9 841 Middle 47.1 1,540 36.3 5.7 2.4 2.0 725 Fourth 43.3 1,648 42.9 12.7 5.8 4.5 714 Richest 32.1 1,990 57.8 22.7 12.8 12.3 638 Ethno-linguistic group of household head Lao-Tai 42.3 5,208 43.9 12.1 6.2 5.4 2,202 Mon-Khmer 52.5 1,818 26.7 4.2 1.6 1.5 955 Hmong-Mien 55.9 689 16.6 1.3 0.8 0.6 385 Chinese-Tibetan 58.4 269 20.2 3.9 1.2 0.7 157 Other, Missing, DK (64.7) 49 (50.2) (23.1) (17.0) (17.0) 32 Total 46.4 8,032 35.7 8.7 4.4 3.8 3,731 Note: Figures in parentheses are based on 25-49 unweighted cases. Table HA.6.1: Knowledge of a place for HIV testing among sexually active young women Percentage of women age 15-24 years who have had sex in the last 12 months, and among women who have had sex in the last 12 months, the percentage who know where to get an HIV test, percentage of women who have ever been tested, percentage of women who have been tested in the last 12 months, and percentage of women who have been tested and have been told the result, Lao PDR 2011-12 1 MICS indicator 9.7 Percentage who have had sex in the last 12 months Number of women age 15-24 years who have had sex in the last 12 months Percentage of women who: Number of women age 15-24 years 15 270 Know a place to get tested Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result1 Region North 55.0 1,133 42.6 3.7 1.3 1.3 623 Central 37.1 1,866 42.6 8.2 4.4 3.3 692 South 32.5 677 61.4 8.0 5.2 3.7 220 Province Vientiane Capital 45.7 504 48.3 9.2 4.9 2.4 230 Phongsaly 69.8 130 21.6 3.6 0.7 0.7 90 Luangnamtha 60.2 94 22.9 1.8 0.9 0.9 57 Oudomxay 50.1 204 41.8 2.6 1.1 1.1 102 Bokeo 62.2 90 46.7 8.1 2.8 2.8 56 Luangprabang 44.6 197 46.1 7.3 2.2 2.2 88 Huaphanh 59.4 198 56.6 2.8 2.2 2.2 118 Xayabury 50.9 219 51.1 1.9 0.0 0.0 112 Xiengkhuang 44.7 194 36.9 4.9 4.0 3.0 87 Vientiane 37.6 250 33.9 11.4 3.6 3.6 94 Borikhamxay 35.4 128 21.7 3.5 1.8 0.0 45 Khammuane 25.8 183 40.5 9.8 7.1 7.1 47 Savannakhet 31.0 607 48.3 7.8 4.3 4.3 188 Saravane 35.6 223 58.5 6.3 2.2 0.0 80 Sekong 29.7 62 54.5 0.0 0.0 0.0 19 Champasack 30.2 340 63.6 12.2 9.5 7.9 103 Attapeu 37.4 52 68.4 (0.0) (0.0) (0.0) 19 Residence Urban 38.3 1,039 60.7 10.1 5.8 4.0 398 Rural 43.1 2,637 39.9 5.1 2.4 2.1 1,137 .Rural with road 42.1 2,388 41.3 4.9 2.4 2.0 1,006 .Rural without road 52.4 249 29.6 6.1 2.3 2.3 131 Age 15-19 20.8 2,119 41.3 4.9 3.3 2.6 441 20-24 70.3 1,557 46.9 7.0 3.3 2.6 1,094 Marital status Ever married/in union 97.2 955 42.7 6.2 2.7 2.1 929 Never married/in union 22.3 2,721 49.4 6.6 4.1 3.3 606 Education None 47.5 187 7.5 0.0 0.0 0.0 89 Primary 49.4 1,163 35.6 4.5 1.9 1.6 575 Lower secondary 35.6 1,077 45.9 5.2 2.7 2.5 384 Upper secondary 30.2 874 56.1 7.8 3.8 2.3 264 Post secondary non tertiary 56.5 104 71.2 15.5 11.1 11.1 59 Higher 61.0 271 71.7 13.5 7.5 4.9 165 Wealth index quintile Poorest 52.2 567 23.9 1.8 0.3 0.3 296 Second 43.2 734 39.6 5.0 2.8 2.3 317 Middle 38.2 778 44.8 3.8 2.0 1.7 297 Fourth 35.0 786 53.2 8.9 4.1 3.8 275 Richest 43.0 812 63.0 11.7 6.7 4.6 349 Ethno-linguistic group of household head Lao-Tai 38.2 2,407 54.7 9.3 5.0 3.8 918 Mon-Khmer 42.2 798 33.4 2.0 0.1 0.1 337 Hmong-Mien 55.7 301 33.7 1.8 1.0 1.0 168 Chinese-Tibetan 71.0 140 15.3 1.3 0.7 0.7 99 Other, Missing, DK (41.3) 30 * * * * 12 Total 41.8 3,676 45.3 6.4 3.3 2.6 1,535 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. 1 MICS indicator 9.7 Table HA.6.2: Knowledge of a place for HIV testing among sexually active young men Percentage of men age 15-24 years who have had sex in the last 12 months, and among men who have had sex in the last 12 months, the percentage who know where to get an HIV test, percentage of men who have ever been tested, percentage of men who have been tested in the last 12 months, and percentage of men who have been tested and have been told the result, Lao PDR 2011-12 Percentage who have had sex in the last 12 months Number of men age 15-24 years Percentage of men who: Number of men age 15-24 years who have had sex in the last 12 months 15 271 Counselling and Testing during Antenatal Care The National Strategy and Action Plan on HIV/AIDS/STI 2011-2015 estimates that the number of pregnant women who are HIV-positive will rise from 280 in 2010 to 410 in 2015. The National Strategy and Action Plan on HIV/AIDS/STI 2011-2015 defines the following expected outcomes (with regard to prevention of mother-to-child transmission) by 2015: 50 per cent of ANC attendants to receive Provider Initiated Counselling and Testing (PICT); 90 per cent of identified HIV-positive pregnant women to receive antiretroviral medicines to reduce the risk of mother-to-child transmission; and 100% of infants born to identified HIV-infected mothers to receive antiretroviral drugs. Table HA.7 presents the percentage of women who received information and HIV testing during antenatal care, among those who gave birth within the two years preceding the survey. Some 54 per cent of women received antenatal care from a healthcare professional during 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, were tested, and told the result. The percentage of women who were offered an HIV test, were tested and told the result exceeds the national average of 6 per cent of women in only four provinces: Vientiane Capital (26 per cent); Luangprabang (11 per cent); Savannakhet (9 per cent); and Champasack (8 per cent). The percentage rises steadily from below 1 per cent to over 20 per cent with increasing education level and wealth quintile. Note that testing among ethno-linguistic groups other than Lao-Tai is especially low. 15 272 15 R ec ei ve d an te na ta l c ar e fro m a he al th c ar e pr of es si on al fo r l as t pr eg na nc y R ec ei ve d H IV co un se lli ng d ur in g an te na ta l c ar e1 W er e of fe re d an H IV te st an d w er e te st ed fo r H IV du rin g an te na ta l c ar e W er e of fe re d an H IV te st a nd w er e te st ed fo r H IV d ur in g an te na ta l c ar e, an d re ce iv ed th e re su lts 2 R ec ei ve d H IV c ou ns el lin g, w er e of fe re d an H IV te st , a cc ep te d an d re ce iv ed th e re su lts R eg io n N or th 45 .0 7. 8 3. 3 3. 3 3. 1 1, 37 7 C en tra l 63 .3 16 .2 10 .5 9. 1 7. 0 1, 98 9 S ou th 48 .6 9. 7 5. 1 4. 2 3. 9 94 0 Pr ov in ce V ie nt ia ne C ap ita l 89 .8 40 .0 30 .0 25 .6 20 .4 41 5 P ho ng sa ly 25 .2 2. 5 0. 8 0. 8 0. 8 14 8 Lu an gn am th a 62 .3 14 .4 2. 4 2. 4 2. 4 99 O ud om xa y 34 .9 4. 3 0. 7 0. 7 0. 3 26 6 B ok eo 37 .9 6. 9 4. 1 4. 1 3. 1 14 1 Lu an gp ra ba ng 46 .0 19 .0 10 .5 10 .5 10 .3 28 0 H ua ph an h 42 .1 1. 0 1. 0 1. 0 0. 6 23 7 X ay ab ur y 70 .9 5. 9 1. 5 1. 5 1. 5 20 5 X ie ng kh ua ng 50 .3 5. 0 0. 0 0. 0 0. 0 20 0 V ie nt ia ne 74 .1 2. 7 4. 0 3. 1 1. 3 29 5 B or ik ha m xa y 60 .7 12 .2 3. 6 1. 0 0. 5 16 2 K ha m m ua ne 47 .5 8. 3 1. 9 1. 9 1. 8 23 3 S av an na kh et 52 .2 14 .5 9. 2 8. 6 6. 8 68 3 S ar av an e 47 .8 7. 2 2. 7 2. 0 1. 8 36 1 S ek on g 40 .4 1. 0 0. 7 0. 7 0. 7 99 C ha m pa sa ck 51 .1 15 .8 9. 0 7. 5 7. 2 39 7 A tta pe u 49 .6 1. 6 1. 6 1. 6 1. 1 83 R es id en ce U rb an 83 .4 29 .5 20 .3 18 .3 15 .7 95 7 R ur al 45 .9 7. 1 3. 2 2. 7 2. 0 3, 34 9 .R ur al w ith ro ad 49 .7 7. 8 3. 5 3. 0 2. 2 2, 92 8 .R ur al w ith ou t r oa d 19 .0 2. 3 1. 2 0. 7 0. 7 42 1 Ta bl e H A .7 : H IV c ou ns el lin g an d te st in g du rin g an te na ta l c ar e A m on g w om en a ge 1 5- 49 w ho g av e bi rth in th e la st 2 y ea rs , p er ce nt ag e of w om en w ho re ce iv ed a nt en at al c ar e fro m a h ea lth p ro fe ss io na l d ur in g th e la st p re gn an cy , p er ce nt ag e w ho re ce iv ed H IV c ou ns el lin g, p er ce nt ag e w ho w er e of fe re d an d ac ce pt ed a n H IV te st a nd re ce iv ed th e re su lts , L ao P D R 2 01 1- 12 N um be r o f w om en w ho g av e bi rth in th e 2 ye ar s pr ec ed in g th e su rv ey Pe rc en ta ge o f w om en w ho : 1 M IC S in di ca to r 9 .8 2 M IC S in di ca to r 9 .9 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. 273 15 R ec ei ve d an te na ta l c ar e fro m a he al th c ar e pr of es si on al fo r l as t pr eg na nc y R ec ei ve d H IV co un se lli ng d ur in g an te na ta l c ar e1 W er e of fe re d an H IV te st an d w er e te st ed fo r H IV du rin g an te na ta l c ar e W er e of fe re d an H IV te st a nd w er e te st ed fo r H IV d ur in g an te na ta l c ar e, an d re ce iv ed th e re su lts 2 R ec ei ve d H IV c ou ns el lin g, w er e of fe re d an H IV te st , a cc ep te d an d re ce iv ed th e re su lts A ge 1 5- 24 55 .2 10 .6 6. 4 5. 3 4. 2 1, 83 7 15 -1 9 49 .4 6. 5 3. 5 3. 3 3. 1 52 5 20 -2 4 57 .5 12 .2 7. 5 6. 0 4. 7 1, 31 2 25 -2 9 58 .0 14 .7 8. 6 7. 7 6. 6 1, 19 3 30 -3 9 51 .4 12 .3 6. 7 6. 0 5. 0 1, 10 2 40 -4 9 35 .2 8. 1 5. 8 5. 8 3. 9 17 5 M ar ita l s ta tu s E ve r m ar rie d/ in u ni on 54 .2 12 .1 7. 0 6. 2 5. 1 4, 30 2 N ev er m ar rie d/ in u ni on * * * * * 4 Ed uc at io n N on e 23 .1 1. 4 0. 3 0. 3 0. 3 1, 24 8 P rim ar y 56 .1 8. 8 4. 4 3. 7 2. 4 1, 76 3 Lo w er s ec on da ry 72 .7 18 .6 11 .4 9. 8 7. 5 69 3 U pp er s ec on da ry 90 .3 31 .5 21 .6 20 .0 18 .1 33 4 P os t s ec on da ry n on te rti ar y 94 .3 44 .6 25 .2 21 .0 19 .6 14 6 H ig he r 93 .0 40 .0 27 .4 25 .7 25 .7 12 2 W ea lth in de x qu in til e P oo re st 22 .9 1. 6 0. 4 0. 4 0. 4 1, 17 8 S ec on d 42 .1 4. 0 2. 1 1. 8 1. 2 92 7 M id dl e 62 .0 10 .6 4. 7 4. 0 2. 8 81 0 Fo ur th 77 .1 17 .7 9. 6 7. 9 6. 3 70 7 R ic he st 91 .7 37 .0 25 .3 22 .8 19 .9 68 4 Et hn o- lin gu is tic g ro up o f h ou se ho ld h ea d La o- Ta i 71 .5 19 .6 12 .0 10 .5 8. 7 2, 40 1 M on -K hm er 36 .2 2. 5 0. 9 0. 9 0. 7 1, 21 3 H m on g- M ie n 23 .9 1. 2 0. 5 0. 5 0. 3 53 0 C hi ne se -T ib et an 24 .6 2. 9 0. 0 0. 0 0. 0 14 0 O th er , M is si ng , D K * * * * * 21 To ta l 54 .2 12 .1 7. 0 6. 2 5. 1 4, 30 6 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. 1 M IC S in di ca to r 9 .8 2 M IC S in di ca to r 9 .9 Pe rc en ta ge o f w om en w ho : N um be r o f w om en w ho g av e bi rth in th e 2 ye ar s pr ec ed in g th e su rv ey Ta bl e H A .7 : H IV c ou ns el lin g an d te st in g du rin g an te na ta l c ar e A m on g w om en a ge 1 5- 49 w ho g av e bi rth in th e la st 2 y ea rs , p er ce nt ag e of w om en w ho re ce iv ed a nt en at al c ar e fro m a h ea lth p ro fe ss io na l d ur in g th e la st p re gn an cy , p er ce nt ag e w ho re ce iv ed H IV c ou ns el lin g, p er ce nt ag e w ho w er e of fe re d an d ac ce pt ed a n H IV te st a nd re ce iv ed th e re su lts , L ao P D R 2 01 1- 12 274 Sexual Behaviour Related to HIV Transmission The National Strategy and Action Plan on HIV/AIDS/STI 2011-2015 defines the following expected outcomes (with regard to condom programming) by 2015: 90 per cent of most-at-risk populations to report easy access to condoms; and 6 million condoms distributed annually until 2015. Promoting safer sexual behaviour is critical for reducing HIV prevalence. In most countries, over half of new HIV infections are among young people age 15-24 years, so a change in behaviour among this age group will be especially important to reduce new infections. Not all risk factors for HIV were asked about in the LSIS, but those that can be measured among young people include: sex with a non-marital non-cohabiting partner (only among the never-married); sex at an early age (before 15); and young women having sex with older men (men 10 or more years older than themselves). 15 275 Percentage of never-married women age 15-24 years who have never had sex1 Number of never-married women age 15- 24 years Percentage of women age 15-24 years who had sex before age 152 Number of women age 15-24 years Percentage of women age 15-24 years who had sex in the last 12 months with a man 10 or more years older3 Number of women age 15-24 years who had sex in the 12 months preceding the survey Region North 94.4 1,197 9.4 2,573 9.2 1,401 Central 96.9 2,249 4.5 3,918 12.1 1,668 South 98.1 829 6.2 1,541 11.4 662 Province Vientiane Capital 95.1 764 2.2 1,110 15.3 363 Phongsaly 96.1 95 5.1 241 6.0 145 Luangnamtha 86.6 104 13.7 237 9.6 141 Oudomxay 98.0 230 9.4 479 10.9 248 Bokeo 95.8 98 15.2 233 11.9 135 Luangprabang 99.1 229 6.5 474 11.6 242 Huaphanh 86.8 216 15.0 408 6.0 213 Xayabury 95.5 225 4.8 502 8.1 278 Xiengkhuang 100.0 218 7.8 389 9.4 167 Vientiane 94.1 276 4.4 542 12.1 272 Borikhamxay 95.8 172 4.2 322 12.2 149 Khammuane 98.6 188 6.0 378 5.6 181 Savannakhet 99.1 630 5.2 1,177 13.0 535 Saravane 99.7 261 10.6 564 10.8 272 Sekong 97.8 86 8.6 154 16.8 63 Champasack 97.1 412 1.6 682 10.3 259 Attapeu 99.1 70 8.7 141 12.7 68 Residence Urban 95.7 1,596 2.1 2,356 16.3 785 Rural 96.9 2,679 8.2 5,676 9.4 2,946 .Rural with road 96.9 2,430 8.1 5,153 9.7 2,678 .Rural without road 97.3 250 9.0 523 6.7 268 Age 15-19 97.8 3,264 5.2 4,415 13.2 1,185 20-24 92.3 1,011 7.9 3,617 9.8 2,545 Marital status Ever married/in union na na 13.4 3,757 10.9 3,602 Never married/in union 96.5 4,275 0.3 4,275 9.8 128 Education None 96.8 311 17.3 1,054 9.2 719 Primary 96.5 1,015 10.0 2,689 10.6 1,639 Lower secondary 96.1 1,078 3.3 1,880 13.0 806 Upper secondary 97.5 1,229 0.1 1,577 12.6 359 Post secondary non tertiary 95.5 134 0.2 216 5.7 84 Higher 94.7 508 0.0 617 9.2 123 Wealth index quintile Poorest 96.6 499 14.8 1,328 8.9 812 Second 96.8 673 10.3 1,526 9.9 841 Middle 97.6 801 5.5 1,540 9.1 725 Fourth 96.8 921 3.4 1,648 12.2 714 Richest 95.3 1,382 1.0 1,990 15.2 638 Ethno-linguistic group of household head Lao-Tai 96.3 2,987 3.8 5,208 11.8 2,202 Mon-Khmer 97.7 847 9.9 1,818 11.2 955 Hmong-Mien 96.3 307 15.1 689 7.5 385 Chinese-Tibetan 92.4 118 12.2 269 4.3 157 Other, Missing, DK * 17 (5.6) 49 (10.1) 32 Total 96.5 4,275 6.4 8,032 10.9 3,731 na = Not applicable 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 HA.8.1: Sexual behaviour that increases the risk of HIV infection Percentage of never-married young women age 15-24 years who have never had sex, percentage of young women age 15-24 years who have had sex before age 15, and percentage of young women age 15-24 years who had sex with a man 10 or more years older during the last 12 months, Lao PDR 2011-12 1 MICS indicator 9.10 3 MICS indicator 9.12 2 MICS indicator 9.11 15 276 15 Percentage of never-married men age 15-24 years who have never had sex1 Number of never- married men age 15- 24 years Percentage of men age 15-24 years who had sex before age 152 Number of men age 15- 24 years Region North 62.6 774 4.6 1,133 Central 78.1 1,433 2.1 1,866 South 83.1 513 1.3 677 Province Vientiane Capital 65.5 404 1.5 504 Phongsaly 43.8 84 3.8 130 Luangnamtha 59.8 59 6.1 94 Oudomxay 73.6 139 4.5 204 Bokeo 45.8 55 5.3 90 Luangprabang 73.2 147 1.6 197 Huaphanh 53.0 143 11.7 198 Xayabury 69.5 147 0.5 219 Xiengkhuang 74.4 137 3.0 194 Vientiane 72.5 204 1.3 250 Borikhamxay 80.0 100 0.0 128 Khammuane 92.0 139 1.7 183 Savannakhet 88.4 448 3.2 607 Saravane 90.6 144 2.9 223 Sekong 87.6 48 1.5 62 Champasack 78.6 283 0.3 340 Attapeu 81.9 38 0.6 52 Residence Urban 70.2 867 1.4 1,039 Rural 76.7 1,854 3.2 2,637 .Rural with road 76.7 1,701 3.0 2,388 .Rural without road 77.0 153 5.9 249 Age 15-19 84.6 1,920 2.9 2,119 20-24 50.6 801 2.4 1,557 Marital status Ever married/in union na na 7.0 955 Never married/in union 74.6 2,721 1.2 2,721 Education None 80.7 110 5.6 187 Primary 74.5 734 5.0 1,163 Lower secondary 80.2 834 2.2 1,077 Upper secondary 80.1 736 0.8 874 Post secondary non tertiary 48.5 79 0.0 104 Higher 42.9 228 0.2 271 Wealth index quintile Poorest 75.5 346 6.4 567 Second 79.6 497 4.6 734 Middle 77.4 589 1.4 778 Fourth 76.5 626 1.6 786 Richest 66.2 663 0.8 812 Ethno-linguistic group of household head Lao-Tai 74.2 1,900 1.4 2,407 Mon-Khmer 81.1 541 5.0 798 Hmong-Mien 73.8 174 4.9 301 Chinese-Tibetan 43.1 87 7.2 140 Other, Missing, DK * 19 (0.0) 30 Total 74.6 2,721 2.7 3,676 na = Not applicable. 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 HA.8.2: Sexual behaviour that increases the risk of HIV infection Percentage of never-married young men age 15-24 years who have never had sex, and percentage of young men age 15-24 years who have had sex before age 15, Lao PDR 2011-12 1 MICS indicator 9.10 2 MICS indicator 9.11 277 Tables HA.8.1 and HA.8.2 indicate that 3 per cent of never-married women age 15-24 and 25 per cent of young never-married men have had sexual intercourse. The percentage does not vary by background characteristics among women, but it does among men. Over half the never-married young men in Phongsaly and Bokeo report they have had sexual intercourse. The proportions of 15-24 year-olds that have had sex before 15 years are 6 per cent among women and 3 per cent among men. The percentage of women who have sex before 15 increases in relation to decreasing wealth quintile (up to 15 per cent among the poorest women). Only 2 per cent of urban young women report having sex before the age of 15, compared with 8 per cent of rural women. The percentage of young women and men having sex before 15 is highest in Huaphanh, Bokeo and Laungnamtha provinces, and the percentage tends to be a bit lower among men than women. In addition, 11 per cent of young women who had sex in the 12 months before the survey had sex with a man who was 10 or more years older than themselves (Figure HA.2). Self-reporting of Sexually Transmitted Infections Information about the prevalence of sexually transmitted infections (STIs) is not only useful as a marker of unprotected sexual intercourse, but also because STI infection is a co-factor in HIV transmission. The LSIS asked respondents who have ever had sexual intercourse whether they had a disease that they acquired through sexual contact in the previous 12 months. They were also asked whether, in the previous 12 months, they had any genital discharge or a genital sore or ulcer. These symptoms have been shown to be useful in identifying STIs in men. For women, however, discharge is less easily interpreted as a symptom of STI because women experience non-STI conditions of the reproductive tract that also produce discharge. 9 5 6 2 8 6 9 12 11 16 9 11 0 2 4 6 8 10 12 14 16 18 North Central South Urban Rural Lao PDR P er ce nt Figure HA.2: Sexual behaviour that increases risk of HIV infection, Lao PDR 2011-12 Women 15-24 who had sex before age 15 Women 15-24 who had sex in last 12 months with a man 10 years or more olderWomen 15-24 who had sex in last 12 months with a man 10 years or more older 15 278 Seven 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 previous 12 months (Table HA.9.1), compared to only 2 per cent of men (Table HA.9.2). Given the low prevalence among men, variations across background characteristics are rather small. Reporting of an STI or STI symptom is especially high among women in Bokeo (18 per cent), followed by women in Vientiane Capital (10 per cent). The lowest prevalence is reported among women in Xiengkhuang province, at 1 per cent. 15 279 STI Bad-smelling/ abnormal genital discharge Genital sore or ulcer STI/ genital discharge/ sore or ulcer Region North 4.5 5.2 3.1 7.0 5,801 Central 3.5 5.2 2.2 7.0 8,624 South 5.6 5.3 2.4 8.3 3,214 Province Vientiane Capital 7.0 6.9 3.3 10.4 2,328 Phongsaly 4.4 5.9 0.7 6.1 568 Luangnamtha 6.2 4.6 5.2 9.5 529 Oudomxay 5.3 5.7 1.4 6.5 933 Bokeo 14.7 16.7 8.0 17.9 515 Luangprabang 2.8 4.1 5.7 8.2 1,206 Huaphanh 4.2 5.0 1.6 5.4 890 Xayabury 0.6 0.9 0.8 1.7 1,160 Xiengkhuang 0.3 0.7 0.1 0.9 691 Vientiane 4.4 4.3 2.2 6.2 1,366 Borikhamxay 2.8 2.3 0.5 3.4 709 Khammuane 2.0 3.7 1.8 5.0 865 Savannakhet 1.3 6.6 2.2 7.5 2,664 Saravane 5.5 6.3 3.5 9.2 1,148 Sekong 2.9 4.5 3.5 4.5 294 Champasack 6.1 5.3 1.6 8.7 1,472 Attapeu 5.7 2.8 1.1 6.0 300 Residence Urban 5.8 6.1 2.8 8.8 4,733 Rural 3.6 4.9 2.4 6.6 12,905 .Rural with road 3.7 4.9 2.3 6.7 11,608 .Rural without road 2.8 4.5 2.9 6.2 1,297 Age 15-24 4.2 5.9 2.4 7.7 3,904 15-19 3.2 4.8 2.4 6.3 1,222 20-24 4.7 6.5 2.4 8.3 2,683 25-29 5.0 5.6 3.0 8.0 3,318 30-39 4.7 5.8 2.6 7.8 5,825 40-49 3.0 3.5 2.1 5.4 4,591 Marital status Currently married/in union 4.3 5.2 2.5 7.3 16,359 Formerly married/in union 2.4 4.5 2.3 5.8 1,077 Never married/in union 2.9 7.4 1.9 7.4 202 Education None 2.4 4.4 2.3 5.4 4,278 Primary 3.9 5.1 2.6 7.2 7,780 Lower secondary 5.8 5.7 2.5 8.4 2,980 Upper secondary 6.4 7.6 2.3 9.5 1,201 Post secondary non tertiary 5.2 5.4 2.6 8.2 832 Higher 6.2 5.7 3.2 9.1 568 Wealth index quintile Poorest 2.4 4.4 2.5 5.7 3,271 Second 2.8 4.5 2.5 5.8 3,375 Middle 4.3 5.0 2.5 7.1 3,436 Fourth 4.2 5.1 2.5 7.3 3,657 Richest 6.7 6.9 2.4 9.6 3,901 Ethno-linguistic group of household head Lao-Tai 4.6 5.5 2.3 7.7 11,675 Mon-Khmer 3.4 5.1 3.5 6.8 3,999 Hmong-Mien 2.9 4.0 1.8 4.9 1,292 Chinese-Tibetan 3.3 4.1 1.4 5.3 571 Other, Missing, DK 2.6 1.7 1.0 2.6 102 Total 4.2 5.2 2.5 7.2 17,638 Table HA.9.1: Self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms Among women age 15-49 who ever had sexual intercourse, the percentage reporting having an STI and/or symptoms of an STI in the past 12 months, Lao PDR 2011-12 Percentage of women who reported having in the past 12 months: Number of women who ever had sexual intercourse 15 280 STI Abnormal genital discharge Genital sore or ulcer STI/ genital discharge/ sore or ulcer Region North 1.3 1.2 1.0 1.7 2,665 Central 1.6 1.6 1.0 2.3 3,774 South 0.7 0.8 1.1 1.3 1,336 Province Vientiane Capital 1.8 1.4 0.9 2.3 1,094 Phongsaly 0.0 0.0 0.0 0.0 280 Luangnamtha 1.2 1.0 1.3 2.1 230 Oudomxay 2.4 1.4 1.8 2.4 423 Bokeo 1.2 1.4 2.5 2.7 241 Luangprabang 2.3 2.2 0.8 2.5 531 Huaphanh 0.9 1.0 1.0 1.6 434 Xayabury 0.8 0.6 0.4 0.8 526 Xiengkhuang 1.0 0.7 0.7 1.0 336 Vientiane 0.8 1.0 1.2 1.8 568 Borikhamxay 1.4 1.7 0.3 1.7 300 Khammuane 3.1 1.8 1.7 3.8 358 Savannakhet 1.5 2.4 1.0 2.7 1,118 Saravane 0.5 0.4 1.3 1.5 460 Sekong 0.8 0.6 1.8 1.8 118 Champasack 0.7 1.2 1.2 1.2 634 Attapeu 1.0 1.0 0.0 1.0 125 Residence Urban 2.1 1.6 1.1 2.6 2,138 Rural 1.0 1.2 1.0 1.7 5,638 .Rural with road 1.1 1.3 1.1 1.8 5,070 .Rural without road 0.7 1.1 0.5 1.3 568 Age 15-24 2.2 2.4 1.9 3.1 1,642 15-19 1.7 1.2 1.4 2.7 491 20-24 2.5 2.9 2.1 3.3 1,151 25-29 2.5 1.9 1.4 3.2 1,426 30-39 0.9 0.9 0.7 1.5 2,660 40-49 0.3 0.7 0.5 0.8 2,048 Marital status Currently married/in union 1.0 1.1 0.9 1.6 6,601 Formerly married/in union 4.3 3.8 2.6 5.5 177 Never married/in union 3.1 2.7 1.8 3.7 997 Education None 0.8 0.9 0.5 1.4 812 Primary 1.4 1.5 1.2 2.0 3,263 Lower secondary 1.4 1.5 0.9 1.8 1,656 Upper secondary 0.9 1.3 1.1 2.0 846 Post secondary non tertiary 1.3 1.0 0.4 1.8 566 Higher 2.1 1.3 1.7 2.8 633 Wealth index quintile Poorest 0.9 1.1 0.9 1.5 1,421 Second 1.2 1.4 1.0 2.2 1,479 Middle 1.5 1.7 1.4 2.0 1,565 Fourth 1.2 1.3 0.7 1.8 1,573 Richest 1.8 1.3 1.1 2.2 1,738 Ethno-linguistic group of household head Lao-Tai 1.4 1.5 1.0 2.0 5,123 Mon-Khmer 1.4 1.4 1.3 2.1 1,721 Hmong-Mien 0.6 0.2 0.4 0.9 596 Chinese-Tibetan 0.6 0.4 1.2 1.3 296 Other, Missing, DK (4.6) (2.2) (0.0) (4.6) 40 Total 1.3 1.3 1.0 1.9 7,776 Table HA.9.2: Self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms Among men age 15-49 who ever had sexual intercourse, the percentage reporting having an STI and/or symptoms of an STI in the past 12 months, Lao PDR 2011-12 Percentage of men who reported having in the past 12 months: Number of men who ever had sexual intercourse 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. 15 281 It is important for people experiencing STIs to be able to recognize them and seek appropriate treatment. If respondents reported an STI or an STI symptom (discharge, sore, ulcer) in the previous 12 months, they were asked if they sought advice or treatment, and from whom. Figure HA.3 presents the percentage of women and men with an STI or STI symptom who sought treatment or care. Fifty-four per cent of women and 45 per cent of men sought advice or treatment from a clinic, hospital, private doctor, or other health professional. Twelve per cent of women and 17 per cent of men sought advice or treatment from a shop or pharmacy. Twenty-five per cent of women and 31 per cent of men did not seek any advice or treatment for their STI or STI symptom. 54 12 7 25 45 17 4 31 0 10 20 30 40 50 60 Clinic/ hospital/ private doctor/ Advice or medicine from shop/pharmacy Advice or treatment from any other source No advice or treatment P er ce nt 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, Lao PDR 2011-12 Women Men Clinic/ hospital/ private doctor/ other health professional Advice or medicine from shop/pharmacy Advice or treatment from any other source No advice or treatment 15 © UNFPA Lao PDR / 2010 / Perier 283 XVI. Access to Mass Media and Use of Information/Communication Technology The 2011-12 LSIS collected information on exposure to mass media and use of computers and the Internet. Information was collected on: • Exposure to newspapers or magazines, radio, and television among women and men age 15-49 • Use of computers among women and men age 15-24 • Use of the Internet among women and men age 15-24 Access to Mass Media The proportion of women who read a newspaper, listen to the radio and watch television at least once a week is shown in Table MT.1.1. Only 13 per cent of women in Lao PDR read a newspaper at least once a week. One in three women listen to the radio at least once a week, while as many as three quarters of women watch television at least once a week. Five per cent of women age 15-49 do not have regular exposure to any of the three media, and only 7 per cent are exposed to all the three types of media at least once a week. 16 284 Read a newspaper at least once a week Listen to the radio at least once a week Watch television at least once a week Age 15-19 17.1 41.9 78.8 9.9 6.8 4,415 20-24 15.6 38.3 75.5 9.6 6.3 3,617 25-29 13.1 33.7 75.1 6.6 5.5 3,642 30-34 9.9 29.2 75.3 4.8 3.5 3,015 35-39 8.3 29.1 72.9 4.0 4.5 3,065 40-44 10.4 30.6 75.5 4.4 3.8 2,507 45-49 9.6 31.6 75.5 5.2 4.1 2,215 Region North 8.1 24.2 68.0 3.8 7.6 7,057 Central 16.6 39.3 81.6 9.4 3.9 11,255 South 9.3 37.8 72.9 4.8 4.4 4,164 Province Vientiane Capital 31.1 46.5 95.5 19.4 1.8 3,288 Phongsaly 10.0 10.7 38.2 4.7 10.6 666 Luangnamtha 9.9 19.8 67.1 6.9 8.8 627 Oudomxay 4.9 14.3 68.9 2.3 5.5 1,182 Bokeo 4.7 26.4 74.2 2.7 4.4 620 Luangprabang 10.5 42.7 72.8 4.8 3.9 1,473 Huaphanh 7.2 17.3 61.0 3.6 12.2 1,086 Xayabury 9.0 26.0 79.5 3.0 9.3 1,402 Xiengkhuang 15.8 21.6 63.4 5.8 13.4 930 Vientiane 12.4 25.5 86.2 5.4 4.7 1,677 Borikhamxay 12.0 36.8 89.1 8.4 2.8 901 Khammuane 7.5 42.5 81.7 4.2 2.6 1,082 Savannakhet 8.9 43.6 68.6 4.4 3.6 3,376 Saravane 7.7 43.7 57.4 5.0 4.1 1,456 Sekong 4.0 27.9 65.8 2.0 10.9 388 Champasack 11.9 36.6 86.3 5.6 2.8 1,943 Attapeu 8.0 31.2 70.9 2.7 6.9 376 Residence Urban 27.1 38.2 94.3 14.8 2.0 6,649 Rural 6.5 32.6 67.9 3.4 6.5 15,827 .Rural with road 6.9 32.9 70.2 3.6 6.3 14,268 .Rural without road 2.7 30.4 46.7 1.4 7.5 1,559 Education None 0.0 21.5 43.9 0.0 0.3 4,660 Primary 4.0 33.4 74.9 2.1 8.8 8,955 Lower secondary 13.2 36.7 90.1 6.8 6.7 4,111 Upper secondary 27.4 44.3 95.5 14.6 2.4 2,496 Post secondary non tertiary 46.5 45.4 96.3 25.4 1.4 1,030 Higher 62.0 51.6 96.3 35.0 1.0 1,224 Wealth index quintile Poorest 0.9 23.8 28.3 0.3 10.7 3,809 Second 3.6 29.9 56.8 1.4 10.1 4,088 Middle 7.5 33.3 86.9 3.8 4.4 4,309 Fourth 12.4 36.9 94.8 6.4 1.7 4,694 Richest 31.3 43.1 97.2 17.8 1.2 5,577 Ethno-linguistic group of household head Lao-Tai 16.7 38.7 87.6 9.1 3.7 15,151 Mon-Khmer 3.5 28.5 54.6 1.7 7.4 4,913 Hmong-Mien 3.8 20.4 43.8 1.5 11.7 1,606 Chinese-Tibetan 5.7 7.7 40.3 3.0 6.4 685 Other, Missing, DK 18.7 44.6 71.1 10.7 4.2 121 Total 12.6 34.3 75.7 6.8 5.2 22,476 Percentage of women age 15-49 years who are exposed to specific mass media on a weekly basis, Lao PDR 2011-12 Percentage of women age 15-49 who: Table MT.1.1: Exposure to mass media 1 MICS indicator MT.1 Number of women age 15-49 years All three media at least once a week1 No media at least once a week 16 285 Not surprisingly, larger proportions of women are exposed to all the media types in urban areas (15 per cent) than in rural areas (3 per cent). Exposure of women to all the three mass media is higher in the Central region (9 per cent) than in the Southern (5 per cent) and Northern region (4 per cent). Exposure to all three types of media is significantly higher in Vientiane Capital (19 per cent) than any other province (the next highest is 8 per cent in Borikhamxay). The percentage of women exposed to all three media types on a weekly basis rises steadily with increasing education level and increasing wealth quintile. Differentials by wealth quintile are similar in level to the differentials across provinces, varying from 0.3 per cent exposure to all three media among women in the lowest wealth quintile to 18 per cent of women in the highest wealth quintile. Differentials in exposure to all three media are greatest by education level, while differentials in exposure to television on a weekly basis are greatest by wealth quintile. The percentage of women exposed to all three media types on a weekly basis is highest among women in Lao-Tai headed households (9 per cent). The most common type of media to which all ethno-linguistic groups are regularly exposed is television (viewed regularly by 40-88 per cent of women of different ethno-linguistic households), followed by radio. Men report a slightly higher level of exposure to newspaper and radio than women. Eighteen per cent of men read a newspaper or magazine at least once a week and 42 per cent listen to the radio at least once a week. On a par with women, three quarters of men watch television on a weekly basis. Nine per cent of men do not have regular exposure to any of the three media, while 10 per cent are exposed to all the three types of media at least once a week. Table MT.1.2 shows that relationships between exposure to mass media and background characteristics are generally similar to those observed among women. 16 286 Read a newspaper at least once a week Listen to the radio at least once a week Watch television at least once a week Age 15-19 17.5 42.5 80.6 9.8 8.0 2,119 20-24 18.2 45.9 75.6 11.6 10.5 1,557 25-29 17.1 40.9 75.3 9.3 10.2 1,500 30-34 15.7 40.4 75.3 8.2 8.7 1,264 35-39 17.7 40.7 74.9 9.8 7.4 1,445 40-44 17.0 43.4 74.9 10.1 7.4 1,043 45-49 19.9 42.9 74.1 10.7 8.3 1,023 Region North 13.5 29.7 68.5 6.9 14.7 3,172 Central 21.6 48.4 81.3 12.7 5.3 4,990 South 13.5 48.2 75.9 7.8 7.6 1,789 Province Vientiane Capital 39.4 56.3 95.1 26.9 2.4 1,379 Phongsaly 18.0 19.4 50.3 7.8 18.8 318 Luangnamtha 12.6 21.1 68.9 8.4 13.9 266 Oudomxay 15.6 35.5 77.0 12.9 10.3 530 Bokeo 22.8 40.1 74.7 11.9 9.2 267 Luangprabang 8.8 40.1 60.9 4.2 13.9 644 Huaphanh 14.8 25.1 69.6 5.0 16.5 511 Xayabury 9.5 22.5 74.5 2.8 18.1 635 Xiengkhuang 24.3 40.9 68.7 12.7 14.1 442 Vientiane 17.7 38.6 86.5 9.5 5.8 721 Borikhamxay 27.7 37.9 86.4 6.9 3.3 390 Khammuane 7.7 51.0 82.6 5.3 5.1 503 Savannakhet 9.9 49.9 68.7 5.3 5.6 1,556 Saravane 13.6 51.6 62.8 6.6 7.1 597 Sekong 9.2 35.9 64.9 6.3 19.8 162 Champasack 12.8 47.5 86.0 7.3 5.8 873 Attapeu 21.5 51.9 80.2 16.9 7.4 157 Residence Urban 34.0 47.7 92.7 20.5 3.1 2,800 Rural 11.1 40.3 69.8 5.8 10.9 7,151 .Rural with road 11.6 40.5 72.4 6.1 10.0 6,457 .Rural without road 6.5 39.0 46.1 3.3 19.4 694 Education None 0.0 29.7 43.3 0.0 1.3 923 Primary 6.7 39.7 66.4 3.6 14.2 3,872 Lower secondary 14.2 41.0 84.6 7.4 9.3 2,351 Upper secondary 24.3 49.9 92.8 14.8 4.0 1,450 Post secondary non tertiary 48.7 50.9 92.8 26.5 2.6 608 Higher 67.4 55.1 96.3 40.3 1.5 747 Wealth index quintile Poorest 4.1 32.7 31.6 1.5 22.8 1,692 Second 9.8 40.1 59.8 4.3 14.6 1,911 Middle 13.1 39.9 87.8 7.0 5.5 2,039 Fourth 17.2 45.1 94.4 10.2 2.5 2,092 Richest 38.9 51.6 96.8 23.8 1.5 2,217 Ethno-linguistic group of household head Lao-Tai 21.5 45.7 87.1 12.3 5.1 6,635 Mon-Khmer 9.0 40.2 57.5 5.6 13.8 2,191 Hmong-Mien 10.3 29.5 46.9 4.0 22.6 728 Chinese-Tibetan 10.1 15.8 50.0 4.3 15.4 335 Other, Missing, DK 21.3 58.6 61.8 13.3 11.4 62 Total 17.6 42.4 76.3 9.9 8.7 9,951 1 MICS indicator MT.1 Table MT.1.2: Exposure to mass media Percentage of men age 15-49 years who are exposed to specific mass media on a weekly basis, Lao PDR 2011-12 Percentage of men age 15-49 who: All three media at least once a week1 No media at least once a week Number of men age 15- 49 years 16 287 Use of Information/Communication Technology Only 15-24 year old women and men were asked questions on computer and Internet use. As displayed in Table MT.2.1, 17 per cent of 15-24 year-old women have ever used a computer, 14 per cent had used a computer within the previous year and 11 per cent had used a computer at least once a week during the previous month. Nine per cent of women age 15-24 had ever used the Internet, while 8 per cent had used the Internet within the previous year. Only 6 per cent of young women used the Internet as frequently as once a week or more during the previous month. While use of a computer or the Internet is fairly low across most of the country, about half of young women in Vientiane capital had used a computer in the previous year and one third had used the Internet in the previous year. As expected, both computer and Internet use increase steadily with increasing education level and increasing wealth quintile. Less than 1 per cent of women with primary education reported using a computer during the last year, compared with 79 per cent of women with higher education. Use of computer in the previous year climbed from less than 1 per cent among women in the two lowest wealth quintiles to 45 per cent among women in the highest. Use of the Internet in the previous year rises from less than 1 per cent in the lowest wealth quintile to 26 per cent among young women in the richest. 16 288 Ever used a computer Used a computer during the last 12 months1 Used a computer at least once a week during the last one month Ever used the internet Used the internet during the last 12 months2 Used the internet at least once a week during the last one month Age 15-19 14.8 12.0 9.2 6.9 6.1 4.7 4,415 20-24 19.5 16.1 12.5 10.6 9.3 7.3 3,617 Region North 8.5 5.7 3.7 2.6 1.9 1.0 2,573 Central 24.5 21.2 16.8 13.9 12.5 10.3 3,918 South 11.8 8.9 6.9 4.9 4.2 2.4 1,541 Province Vientiane Capital 55.0 48.9 40.2 35.9 32.0 27.5 1,110 Phongsaly 2.7 2.4 1.4 0.8 0.8 0.8 241 Luangnamtha 8.8 4.3 2.2 2.2 0.7 0.5 237 Oudomxay 2.8 2.2 1.7 1.6 1.2 0.9 479 Bokeo 8.7 7.5 5.2 4.4 3.6 2.9 233 Luangprabang 14.7 10.6 5.2 5.0 3.6 1.6 474 Huaphanh 5.4 3.4 2.3 2.0 1.8 0.4 408 Xayabury 13.1 7.9 6.5 2.2 1.4 0.6 502 Xiengkhuang 10.6 7.8 5.5 3.0 2.6 1.7 389 Vientiane 12.6 10.0 7.6 5.7 5.5 3.7 542 Borikhamxay 14.2 13.2 11.5 6.3 6.0 5.0 322 Khammuane 13.5 11.6 6.8 5.2 4.6 3.0 378 Savannakhet 12.1 9.9 7.2 5.4 5.0 3.9 1,177 Saravane 4.8 3.2 1.6 1.4 1.1 0.5 564 Sekong 4.7 4.5 3.9 1.9 1.9 0.8 154 Champasack 20.2 15.3 12.4 8.4 7.1 4.1 682 Attapeu 6.8 6.0 4.6 5.0 4.4 3.4 141 Residence Urban 43.3 37.9 30.3 24.4 21.9 17.6 2,356 Rural 6.0 3.9 2.5 2.0 1.5 1.0 5,676 .Rural with road 6.5 4.3 2.8 2.2 1.7 1.0 5,153 .Rural without road 0.8 0.6 0.3 0.1 0.0 0.0 523 Education None 0.1 0.0 0.0 0.1 0.1 0.0 1,054 Primary 1.3 0.3 0.2 0.4 0.3 0.2 2,689 Lower secondary 7.3 5.2 3.4 2.6 1.9 1.2 1,880 Upper secondary 31.8 26.0 19.3 13.8 12.1 9.0 1,577 Post secondary non tertiary 65.7 51.8 34.7 23.2 19.5 14.2 216 Higher 88.0 79.1 66.8 58.4 53.0 43.6 617 Wealth index quintile Poorest 0.2 0.1 0.1 0.0 0.0 0.0 1,328 Second 2.2 0.9 0.3 0.5 0.5 0.1 1,526 Middle 4.5 2.5 1.1 0.7 0.6 0.1 1,540 Fourth 14.5 10.5 7.3 5.2 4.0 2.5 1,648 Richest 51.0 44.7 36.0 29.3 26.2 21.3 1,990 Ethno-linguistic group of household head Lao-Tai 23.8 19.9 15.6 12.5 11.0 8.6 5,208 Mon-Khmer 3.3 2.2 1.2 0.7 0.5 0.4 1,818 Hmong-Mien 6.1 3.9 2.2 2.3 2.0 0.8 689 Chinese-Tibetan 2.6 2.0 1.7 1.7 1.7 1.3 269 Other, Missing, DK 16.3 16.3 8.1 10.6 10.6 6.0 49 Total 16.9 13.9 10.7 8.6 7.5 5.8 8,032 2 MICS indicator MT.3 Percentage of women age 15-24 who have: 1 MICS indicator MT.2 Table MT.2.1: Use of computers and internet Percentage of young women age 15-24 who have ever used a computer, percentage who have used a computer during the last 12 months, and frequency of use during the last one month, Lao PDR 2011-12 Percentage of women age 15-24 who have: Number of women age 15-24 years 16 289 Similar proportions of young men as young women had used a computer and the Internet during the previous year, as shown in Table MT.2.2. Sixteen per cent of 15-24 year-old men had used a computer and 9 per cent had used the Internet during the previous year. Differentials by background characteristics among young men are similar to those observed among young women. Use of computers and the Internet is most common in Vientiane Capital, and also rises steadily with increasing education level and wealth quintile. Less than one per cent of young men in the poorest households had used the Internet during the previous year, compared with 36 per cent among young men in the richest households. While use of computers and the Internet is limited to a minority of the population, a significantly higher proportion of young men of Lao-Tai headed households had used computers (22 per cent) or accessed the internet (14 per cent) in the 12 months prior to the survey than young men of other ethno-linguistic groups. 16 290 Ever used a computer Used a computer during the last 12 months1 Used a computer at least once a week during the last one month Ever used the internet Used the internet during the last 12 months2 Used the internet at least once a week during the last one month Age 15-19 17.3 14.5 11.4 9.5 8.1 6.3 2,119 20-24 21.6 17.8 13.5 12.3 11.1 8.7 1,557 Region North 10.3 7.9 5.7 4.7 4.0 2.7 1,133 Central 26.5 22.7 17.8 15.7 14.0 11.0 1,866 South 13.8 10.6 8.0 6.7 5.7 5.0 677 Province Vientiane Capital 57.2 50.4 42.2 36.4 33.8 27.3 504 Phongsaly 9.3 4.5 2.7 0.4 0.4 0.4 130 Luangnamtha 7.0 5.3 3.1 3.1 3.1 3.1 94 Oudomxay 4.3 2.4 1.8 2.0 1.6 1.0 204 Bokeo 18.3 14.8 8.7 11.9 9.1 6.2 90 Luangprabang 12.6 10.6 7.3 9.3 8.4 5.9 197 Huaphanh 8.1 6.0 6.0 2.5 1.7 1.2 198 Xayabury 14.6 12.7 9.5 5.3 4.8 2.4 219 Xiengkhuang 14.0 7.0 4.5 6.8 4.9 3.7 194 Vientiane 18.5 16.1 10.0 7.9 6.4 4.9 250 Borikhamxay 9.4 5.7 3.7 3.2 3.2 1.9 128 Khammuane 19.6 15.6 12.8 9.2 8.7 6.6 183 Savannakhet 13.9 13.2 9.3 9.3 7.6 5.4 607 Saravane 6.5 4.3 2.1 2.5 2.1 1.7 223 Sekong 7.1 6.6 3.8 2.4 2.4 1.6 62 Champasack 19.2 14.9 12.0 10.0 8.5 7.7 340 Attapeu 17.3 14.8 11.3 8.3 6.7 5.1 52 Residence Urban 47.6 42.0 34.1 29.6 27.1 21.4 1,039 Rural 7.9 5.6 3.6 3.2 2.4 1.7 2,637 .Rural with road 8.5 6.0 3.9 3.5 2.6 1.9 2,388 .Rural without road 2.6 1.7 1.3 0.4 0.4 0.4 249 Education None 0.4 0.0 0.0 0.0 0.0 0.0 187 Primary 2.1 1.2 0.9 1.1 1.0 0.6 1,163 Lower secondary 7.8 5.9 3.9 4.2 3.0 2.7 1,077 Upper secondary 32.7 27.0 19.7 15.0 13.1 9.4 874 Post secondary non tertiary 59.8 48.3 39.3 29.5 22.1 14.6 104 Higher 91.2 81.9 68.3 63.6 60.4 49.9 271 Wealth index quintile Poorest 0.3 0.1 0.0 0.2 0.2 0.0 567 Second 2.9 2.1 1.4 0.7 0.6 0.6 734 Middle 7.8 4.4 2.6 1.1 0.5 0.3 778 Fourth 19.5 15.2 10.6 7.6 6.2 4.9 786 Richest 57.6 51.3 41.5 39.2 35.5 27.5 812 Ethno-linguistic group of household head Lao-Tai 26.2 22.4 17.4 15.1 13.5 10.5 2,407 Mon-Khmer 3.9 2.4 1.6 1.4 0.8 0.5 798 Hmong-Mien 8.5 4.9 2.4 4.0 3.3 2.4 301 Chinese-Tibetan 5.2 3.6 2.7 1.1 1.1 1.1 140 Other, Missing, DK 30.6 27.7 24.1 13.1 13.1 9.5 30 Total 19.2 15.9 12.3 10.7 9.4 7.3 3,676 1 MICS indicator MT.2 2 MICS indicator MT.3 Table MT.2.2: Use of computers and internet Percentage of young men age 15-24 who have ever used a computer, percentage who have used a computer during the last 12 months, and frequency of use during the last one month, Lao PDR 2011-12 Percentage of men age 15-24 who have: Percentage of men age 15-24 who have: Number of men age 15- 24 years 16 291 References Committee for Planning and Investment, National Statistics Center, Supported by UNFPA. 2007. Lao Reproductive Health Survey 2005 UNFPA Project LAO/02/PO7: Strengthening the Data Base for Population and Development Planning. Vientiane Capital, Lao PDR. Department of Statistics and UNICEF. 2008. Lao PDR Multiple Indicator Cluster Survey 2006, Final Report. Vientiane, Lao PDR: Department of Statistics and UNICEF. Diosady, L.L., Alberti, J.O, VenkateshMannar, M.G. and FitzGerald, S. - Stability of Iodine in Iodized Salt Used for Correction of Iodine Deficiency Disorders II Food and Nutrition Bulletin 19(3) 239-49, 1998. Government of Lao PDR and the United Nations. 2008. Millennium Development Goals, Progress Report, 2008, Lao PDR. Vientiane, Lao PDR. Lao People’s Democratic Republic National Assembly, 2010. Law on HIV/AIDS Control and Prevention, No. 01/NA Vientiane Capital, 29 June 2010. Ministry of Health, Department of Planning and Finance, Government of Lao PDR. 2011. National Health Statistic Report FY 2009-2010. Statistics Division, Department of Planning and Finance, Ministry of Health. Vientiane, Lao PDR. United Nations, 2011. UN General Assembly, Sixty-fifth session, Agenda item 10. Political Declaration on HIV and AIDS: Intensifying our Efforts to Eliminate HIV and AIDS, A/RES/65/277, 10 June 2011. World Health Organization and UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP), 2008.Progress on Drinking Water and Sanitation: Special Focus on Sanitation. UNICEF, New York and WHO, Geneva. 292 Appendix A. Sample Design The primary objective of the sample design for the 2011-12 Lao Social Indicator Survey (LSIS) was to produce statistically reliable estimates of most indicators, at the national level, for urban and rural areas, and for each of the 17 provinces of the country. The survey was designed to provide information on fertility and early childhood mortality, family planning, reproductive and child health, nutrition, water and sanitation, child protection, child development and education, use of mass media and information technology, knowledge and behaviour regarding HIV/AIDS, and adult and maternal mortality. All women age 15-49 who were usual residents of the selected households were eligible for the survey. A male survey was also conducted in half of the households. All men aged 15-49 who were usual residents of every second household visited by the field team were eligible for the male survey. The sizes of the provinces vary greatly, ranging from 16,000 to 140,000 households and this posed a challenge for the sample design. A multi-stage, stratified cluster sampling approach was used for the selection of the survey sample. Urban areas, rural areas with roads, and rural areas without roads in each of the 17 provinces were defined as the sampling strata. Sampling Frame The sampling frame for this survey consisted of all villages in the country, arranged by province, with appropriate size estimates (number of households) and other relevant information about each village. The list of villages is updated each year, with the most recent update prior to the design in December 2009. Table SD.1 shows the distribution of villages and households by province, according to whether the village is classified as urban, rural with road, or rural without road.     Table SD.1.   Villages and households in Lao PDR, by province and locality (urban, rural with and without road)          Villages Households  Code  Province  No. of  districts    Total  Urban  Rural  with  road  Rural  w/o  road    Total  Urban  Rural  with  road  Rural  w/o  road    Lao PDR  143    8703 1378 6051 1274 1,021,674 315,998  623,453  82,223 1  Vientiane Capital   9    491 264 223 3 130,470 90,909  39,405  156 2  Phongsaly  7    542 52 347 143 29,461 5,294  18,282  5,885 3  Luangnamtha  5    355 37 271 47 28,523 6,294  19,809  2,420 4  Oudomxay  7    472 49 303 120 46,299 9,389  29,203  7,707 5  Bokeo  5    291 42 212 37 25,968 5,625  18,525  1,818 6  Luangprabang  12    794 160 413 221 71,579 25,063  33,018  13,498 7  Huaphanh  8    727 28 646 53 45,453 6,141  37,067  2,245 8  Xayabury  11    447 97 316 34 67,003 20,772  43,702  2,529 9  Xiengkhuang  8    509 69 394 46 40,439 11,455  27,231  1,753 10  Vientiane  13    518 87 408 23 83,947 22,277  60,054  1,616 11  Borikhamxay  7    326 56 251 19 42,988 13,086  28,836  1,066 12  Khammuane  9    590 114 368 108 61,569 18,207  36,607  6,755 13  Savannakhet  15    1006 154 724 128 140,086 35,184  96,382  8,520 14  Saravane  8    612 32 551 29 59,750 4,871  53,412  1,467 15  Sekong  4    235 20 138 77 15,970 3,853  9,254  2,863 16  Champasack  10    639 95 383 161 109,263 31,569  58,376  19,318 17  Attapeu  5    150 22 103 25 22,906 6,009  14,290  2,607 Source:  Surveys Division, Department of Statistics        293 Sample Size and Sample Allocation For the calculation of the sample size, the key indicator used was the contraceptive prevalence rate (modern method). The following formula was used to estimate the required sample size for this indicator: where • n is the required sample size, expressed as number of households • 4 is a factor to achieve the 95 percent level of confidence • r is the predicted or anticipated value of the indicator, expressed in the form of a proportion • 1.1 is the factor necessary to raise the sample size by 10 per cent for the expected non-response [the actual factor will be based on the non-response level experienced in previous surveys in the country] • f is the shortened symbol for deff (design effect) • se.r is the margin of error to be tolerated at the 95 percent level of confidence, defined as 12 per cent of r (relative margin of error of r) for the national estimates and 20 percent of r for the provincial estimates • p is the proportion of the total population upon which the indicator, r, is based • is the average household size (number of persons per household) The calculations shown in Table SD.2 suggested the need for a sample size of 27,000 households, if this key indicator was to be measured to the required degree of precision (a relative margin of 0.2, implying a coefficient of variation of 0.1). However, this calculation was based on the results of the 2005 Lao Reproductive Health Survey (LRHS), and it was considered possible to reduce the sampling errors in the LSIS as a result of the two modifications to the sample design: increasing the number of primary sampling units (PSUs) covered relative to the LRHS (and at the same time reducing the ‘take’ in each one); and changing the way in which the sample was allocated across the provinces. It was therefore recommended that the sample size for LSIS be set at 20,000 households, visiting 1,000 villages, but reducing the ‘take’ to 20 households per village. Various methods were available for allocating the sample to the different provinces. At one extreme is the method of equal allocation used in both the 2005 LRHS and the 2006 Multiple Indicator Cluster Survey (MICS), but this method is inefficient for producing national estimates. At the other extreme is the method of proportional allocation, where the share of the total sample that a province gets depends on its size. This method is good for producing national estimates, but not for producing provincial estimates as the sampling error will be large in the smaller provinces where the sample size is small. As a compromise the allocation was based on the square root of the size of each province, with a minimum of 1,000 households selected in each province and a maximum of 1,500 households. After arriving at the sample size allocation for each province the number of villages selected per province was calculated using a fixed ‘take’ of 20 households per village. Once the number of villages for a province was determined, the villages (PSUs) were distributed to the urban, rural with road and rural without road domains, in proportion with the number of households in each domain. The resulting allocation of sample villages to the provinces is shown in Table SD.3.1 1 In the process of finalizing the sample selection, a few changes were made to the allocation, resulting in a net loss of one village and leaving 999 villages in the final sample. A further one village was inaccessible at the time of fieldwork, resulting in a total of 998 villages in the final data file. )])(().[( )]1.1)()(1)((4[ _2 nprse frrn  294 Table SD.2.  Estimating the required sample size, using contraceptive prevalence rate as the key indicator      Prevalence  Standard  error   Coefficient  of variation  Design  effect  Relevant  group as  proportion  of total pop  Average  house‐ hold size  Accept‐ able  relative  margin  Required  sample size  using MICS  formula       r se  se/r deff p nh   N     TOTAL  = 27,003 Lao PDR  0.35600  0.00900  0.025 3.700 0.077 5.8 0.12  (4,349) Vientiane Capital  0.37720  0.02890  0.077 4.450 0.077 5.2 0.2  1,917 Phongsaly  0.36310  0.04250  0.117 2.480 0.077 5.8 0.2  1,017 Luangnamtha  0.39150  0.03910  0.100 1.760 0.077 5.5 0.2  675 Oudomxay  0.41520  0.03800  0.092 3.440 0.077 6.1 0.2  1,078 Bokeo  0.54050  0.04770  0.088 4.980 0.077 5.6 0.2  1,026 Luangprabang  0.30360  0.03230  0.106 2.830 0.077 5.7 0.2  1,545 Huaphanh  0.38900  0.04190  0.108 4.390 0.077 6.5 0.2  1,439 Xayabury  0.57170  0.04480  0.078 5.100 0.077 5.4 0.2  960 Xiengkhuang  0.23980  0.03430  0.143 3.560 0.077 6.3 0.2  2,430 Vientiane  0.36460  0.03240  0.089 3.660 0.077 5.5 0.2  1,573 Borikhamxay  0.41590  0.04060  0.098 3.600 0.077 5.8 0.2  1,183 Khammuane  0.35960  0.03890  0.108 3.160 0.077 5.5 0.2  1,388 Savannakhet  0.30500  0.03530  0.116 3.030 0.077 6.3 0.2  1,487 Saravane  0.28430  0.03540  0.125 3.080 0.077 6.1 0.2  1,724 Sekong  0.12590  0.02370  0.188 3.080 0.077 6.7 0.2  4,330 Champasack  0.29900  0.03010  0.101 2.270 0.077 5.7 0.2  1,267 Attapeu  0.22100  0.02670  0.121 2.300 0.077 5.6 0.2  1,964 Xaysomboon SR  0.27360  0.05230  0.191 4.480 0.077 5.9 0.2  2,735     Table SD.3: Allocation of Villages (PSUs) to Sampling Strata    Region    Number of Villages     Urban Rural with  road  Rural without road  Total  Vientiane Capital     52 23 0 75  Phongsaly    9 33 8 50  Luangnamtha    11 34 5 50  Oudomxay   11 34 9 54  Bokeo    11 35 4 50  Luangprabang    23 31 13 67  Huaphanh   7 44 3 54  Xayabury    20 42 2 64  Xiengkhuang   14 34 2 50  Vientiane    18 47 1 66  Borikhamxay   16 35 1 52  Khammuane   18 37 7 62  Savannakhet   19 50 5 74  Saravane    5 55 1 61  Sekong    13 28 9 50  Champasack   20 37 13 70  Attapeu    13 32 5 50  Total    280 631 88 999    Sample Selection Before selecting the sample villages, village size was reviewed. Those with fewer than 20 households were grouped with an adjacent village and if either was selected in the sample, both were included, but considered as one village. The selection of the villages was performed by first ordering the list of villages according to the three types of locality (urban, rural with road, rural without road). Villages were selected with probability proportional to the number of households in the village, based on a fixed interval of selection and a random start chosen between 0 and the sampling interval. 295 Villages that contained 300 households or more were segmented into two or more roughly equal segments and one segment was selected in each village prior to the listing. The number of segments used depended on the number of households in the village, as follows: Households Segmentation 0 - 299 No segmentation 300 - 599 2 segments 600 - 899 3 segments 900 - 1199 4 segments Listing Activities Since the sampling frame was not up-to-date, a new listing of households was conducted in all the sample enumeration areas prior to the selection of households. For this purpose, teams were formed to visit each enumeration area and to list the occupied households. The listing operation took place from November 2010 to early January 2011 with 70 operators covering all 999 enumeration areas. In each province there were two teams each consisting of a lister and a mapper, except in Champasack, where three teams were assigned. Selection of Households Lists of households for each enumeration area were prepared by the listing teams in the field. The households were then sequentially numbered from 1 to n (the total number of households in each enumeration area) at the Surveys Division of the Lao Statistics Bureau, where the selection of 20 households in each enumeration area was carried out using a systematic selection procedure beginning from a random start. Calculation of Sample Weights The LSIS sample is not self-weighted. By allocating numbers of households to each of the provinces non-proportionally, different sampling fractions were used in each province since the size of the provinces varied. For this reason, sample weights were calculated and used in the subsequent analyses of the survey data. The sampling strata used in the calculation of the weights were the 17 provinces. The major component of the weight is the reciprocal of the sampling fraction employed in selecting the number of sample households in that particular sampling stratum (h) and PSU (i): The term fhi, the sampling fraction for the i-th sample PSU in the h-th stratum, is the product of probabilities of selection at every stage in each sampling stratum: where pshi is the probability of selection of the sampling unit at stage s for the i-th sample PSU in the h-th sampling stratum. The sampling probabilities will be calculated separately for each sampling stage and for each PSU. We use the following notations: P1hi : first-stage sampling probability of the i-th PSU in stratum h P2hi : second-stage sampling probability of selecting a household within the i-th PSU   hi hi fW 1      The  term  fhi,  the  sampling  fraction  for  the  i‐th  sample PSU  in  the h‐th  stratum,  is  the product of  probabilities of selection at every stage in each sampling stratum:    hihihi ppf 21      where pshi is the probability of selection of the sampling unit at stage s  for the i‐th sample PSU in the  h‐th  sampling  stratum.   The  sampling probabilities will be calculated separately  for each  sampling  stage and for each PSU. We use the following notations:  P1hi : first‐stage sampling probability of the i‐th PSU in stratum h P2hi : second‐stage sampling probability of selecting a household within the i‐th PSU Let ah be the number of PSUs selected in stratum h, Mhi the number of households according to the  sampling  frame  in  the  i‐th  PSU,  and  ∑Mhi  the  total  number  of  households  in  the  stratum.  The  probability of selecting the i‐th PSU in the 2011‐12 LSIS sample was calculated as follows:    M M a = P hi hih 1hi    Let bhi be  the proportion of households  in the selected segment compared  to the total number of  households  in PSU  i  in stratum h  if the EA  is segmented, otherwise bhi = 1. Then the probability of  selecting cluster i in the sample is:    hib M M a = P hi hih 1hi   Let  hiM  be the number of households listed in the household listing operation in cluster i in stratum  h, let  him  be the number of households selected in the PSU. The second stage selection probability  for each household in the PSU is calculated as follows:    hi hi hi M mP  2   The overall selection probability of each household in PSU i of stratum h is therefore the product of  the two stages selection probabilities:   hihihi PPP 21  or  hi hi hi hih hi M m M M a = P    Since the estimated number of households  in each enumeration area  (PSU)  in the sampling  frame  used  for  the  first stage selection and  the updated number of households  in  the enumeration area  from  the  listing  were  different,  individual  sampling  fractions  for  households  in  each  sample  enumeration  area  (village)  were  calculated.    The  sampling  fractions  for  households  in  each  enumeration  area  (village),  therefore,  included  the  first  stage  probability  of  selection  of  the    hi hi fW 1      The  term  fhi,  the  sampling  fraction  for  the  i‐th  sample PSU  in  the h‐th  stratum,  is  the product of  probabilities of selection at every stage in each sampling stratum:    hihihi ppf 21      where pshi is the probability of selection of the sampling unit at stage s  for the i‐th sample PSU in the  h‐th  sampling  stratum.   The  sampling probabilities will be calculated separately  for each  sampling  stage and for each PSU. We use the following notations:  P1hi : first‐stage sampling probability of the i‐th PSU in stratum h P2hi : second‐stage sampling probability of selecting a household within the i‐th PSU Let ah be the number of PSUs selected in stratum h, Mhi the number of households according to the  sampling  frame  in  the  i‐th  PSU,  and  ∑Mhi  the  total  number  of  households  in  the  stratum.  The  probability of selecting the i‐th PSU in the 2011‐12 LSIS sample was calculated as follows:    M M a = P hi hih 1hi    Let bhi be  the proportion of households  in the selected segment compared  to the total number of  households  in PSU  i  in stratum h  if the EA  is segmented, otherwise bhi = 1. Then the probability of  selecting cluster i in the sample is:    hib M M a = P hi hih 1hi   Let  hiM  be the number of households listed in the household listing operation in cluster i in stratum  h, let  him  be the number of households selected in the PSU. The second stage selection probability  for each household in the PSU is calculated as follows:    hi hi hi M mP  2   The overall selection probability of each household in PSU i of stratum h is therefore the product of  the two stages selection probabilities:   hihihi PPP 21  or  hi hi hi hih hi M m M M a = P    Since the estimated number of households  in each enumeration area  (PSU)  in the sampling  frame  used  for  the  first stage selection and  the updated number of households  in  the enumeration area  from  the  listing  were  different,  individual  sampling  fractions  for  households  in  each  sample  enumeration  area  (village)  were  calculated.    The  sampling  fractions  for  households  in  each  enumeration  area  (village),  therefore,  included  the  first  stage  probability  of  selection  of  the  296   hi hi fW 1      The  term  fhi,  the  sampling  fraction  for  the  i‐th  sample PSU  in  the h‐th  stratum,  is  the product of  probabilities of selection at every stage in each sampling stratum:    hihihi ppf 21      where pshi is the probability of selection of the sampling unit at stage s  for the i‐th sample PSU in the  h‐th  sampling  stratum.   The  sampling probabilities will be calculated separately  for each  sampling  stage and for each PSU. We use the following notations:  P1hi : first‐stage sampling probability of the i‐th PSU in stratum h P2hi : second‐stage sampling probability of selecting a household within the i‐th PSU Let ah be the number of PSUs selected in stratum h, Mhi the number of households according to the  sampling  frame  in  the  i‐th  PSU,  and  ∑Mhi  the  total  number  of  households  in  the  stratum.  The  probability of selecting the i‐th PSU in the 2011‐12 LSIS sample was calculated as follows:    M M a = P hi hih 1hi    Let bhi be  the proportion of households  in the selected segment compared  to the total number of  households  in PSU  i  in stratum h  if the EA  is segmented, otherwise bhi = 1. Then the probability of  selecting cluster i in the sample is:    hib M M a = P hi hih 1hi     hiM    liste d in the household listing operation in cluster i in stratum    l ated as follows:    hi hi hi M mP  2   The overall selection probability of each household in PSU i of stratum h is therefore the product of  the two stages selection probabilities:   hihihi PPP 21  or  hi hi hi hih hi M m M M a = P    Since the estimated number of households  in each enumeration area  (PSU)  in the sampling  frame  used  for  the  first stage selection and  the updated number of households  in  the enumeration area  from  the  listing  were  different,  individual  sampling  fractions  for  households  in  each  sample  enumeration  area  (village)  were  calculated.    The  sampling  fractions  for  households  in  each  enumeration  area  (village),  therefore,  included  the  first  stage  probability  of  selection  of  the  Let ah be the number of PSUs selected in stratum h, Mhi the number of households according to the sampling frame in the i-th PSU, and ∑Mhi the total number of households in the stratum. The probability of selecting the i-th PSU in the 2011-12 LSIS sample was calculated as follows: Let bhi be the proportion of households in the selected segment compared to the total number of households in PSU i in stratum h if the EA is segmented, otherwise bhi = 1. Then the probability of selecting cluster i in the sample is: Let be the number of households listed in the household listing operation in cluster i in stratum h, let be the number of households selected in the PSU. The second stage selection probability for each household in the PSU is calculated as follows: The overall selection probability of each household in PSU i of stratum h is therefore the product of the two stages selection probabilities: or Since the estimated number of households in each enumeration area (PSU) in the sampling frame used for the first stage selection and the updated number of households in the enumeration area from the listing were different, individual sampling fractions for households in each sample enumeration area (village) were calculated. The sampling fractions for households in each enumeration area (village), therefore, included the first stage probability of selection of the enumeration area in that particular sampling stratum and the second stage probability of selection of a household in the sample enumeration area (village). A second component in the calculation of sample weights takes into account the level of non-response for the household and individual interviews. The adjustment for household non-response is equal to the inverse value of: RRh = Number of interviewed households in stratum h / Number of occupied households listed in stratum h After the completion of fieldwork, response rates were calculated for each sampling stratum. These were used to adjust the sample weights calculated for each village. Response rates in the LSIS are shown in Table HH.1 of this report. Similarly, the adjustment for non-response at the individual level (women, men, and children age under 5) for each stratum is equal to the inverse value of: RRh = Completed women’s (or men’s or under-5’s) questionnaires in stratum h / Eligible women (or men or under-5s) in stratum h The non-response adjustment factors for women’s, men’s and under-5’s questionnaires are applied to the adjusted household weights. Numbers of eligible women, men and under-5 children were obtained from the roster of household members in the Household Questionnaire for households where interviews were completed.   hi hi fW 1      The  term  fhi,  the  sampling  fraction  for  the  i‐th  sample PSU  in  the h‐th  stratum,  is  the product of  probabilities of selection at every stage in each sampling stratum:    hihihi ppf 21      where pshi is the probability of selection of the sampling unit at stage s  for the i‐th sample PSU in the  h‐th  sampling  stratum.   The  sampling probabilities will be calculated separately  for each  sampling  stage and for each PSU. We use the following notations:  P1hi : first‐stage sampling probability of the i‐th PSU in stratum h P2hi : second‐stage sampling probability of selecting a household within the i‐th PSU Let ah be the number of PSUs selected in stratum h, Mhi the number of households according to the  sampling  frame  in  the  i‐th  PSU,  and  ∑Mhi  the  total  number  of  households  in  the  stratum.  The  probability of selecting the i‐th PSU in the 2011‐12 LSIS sample was calculated as follows:    M M a = P hi hih 1hi    Let bhi be  the proportion of households  in the selected segment compared  to the total number of  households  in PSU  i  in stratum h  if the EA  is segmented, otherwise bhi = 1. Then the probability of  selecting cluster i in the sample is:    hib M M a = P hi hih 1hi   Let  hiM  be the number of households listed in the household listing operation in cluster i in stratum  h, let  him  be the number of households selected in the PSU. The second stage selection probability  for each household in the PSU is calculated as follows:    hi hi hi M mP  2   The overall selection probability of each household in PSU i of stratum h is therefore the product of  the two stages selection probabilities:   hihihi PPP 21  or  hi hi hi hih hi M m M M a = P    Since the estimated number of households  in each enumeration area  (PSU)  in the sampling  frame  used  for  the  first stage selection and  the updated number of households  in  the enumeration area  from  the  listing  were  different,  individual  sampling  fractions  for  households  in  each  sample  enumeration  area  (village)  were  calculated.    The  sampling  fractions  for  households  in  each  enumeration  area  (village),  therefore,  included  the  first  stage  probability  of  selection  of  the    hi hi fW 1      The  term  fhi,  the  sampling  fraction  for  the  i‐th  sample PSU  in  the h‐th  stratum,  is  the product of  probabilities of selection at every stage in each sampling stratum:    hihihi ppf 21      where pshi is the probability of selection of the sampling unit at stage s  for the i‐th sample PSU in the  h‐th  sampling  stratum.   The  sampling probabilities will be calculated separately  for each  sampling  stage and for each PSU. We use the following notations:  P1hi : first‐stage sampling probability of the i‐th PSU in stratum h P2hi : second‐stage sampling probability of selecting a household within the i‐th PSU Let ah be the number of PSUs selected in stratum h, Mhi the number of households according to the  sampling  frame  in  the  i‐th  PSU,  and  ∑Mhi  the  total  number  of  households  in  the  stratum.  The  probability of selecting the i‐th PSU in the 2011‐12 LSIS sample was calculated as follows:    M M a = P hi hih 1hi    Let bhi be  the proportion of households  in the selected segment compared  to the  total number of  households  in PSU  i  in stratum h  if the EA  is segmented, otherwise bhi = 1. Then the probability of  selecting cluster i in the sample is:    hib M M a = P hi hih 1hi   Let  hiM  be the number of households listed in the household listing operation in cluster i in stratum  h, let  him  be the number of households selected in the PSU. The second stage selection probability  for each household in the PSU is calculated as follows:    hi hi hi M mP  2   The overall selection probability of each household in PSU i of stratum h is therefore the product of  the two stages selection probabilities:   hihihi PPP 21  or  hi hi hi hih hi M m M M a = P    Since the estimated number of households  in each enumeration area  (PSU)  in the sampling  frame  used  for  the  first stage selection and  the updated number of households  in  the enumeration area  from  the  listing  were  different,  individual  sampling  fractions  for  households  in  each  sample  enumeration  area  (village)  were  calculated.    The  sampling  fractions  for  households  in  each  enumeration  area  (village),  therefore,  included  the  first  stage  probability  of  selection  of  the    hi hi fW 1      The  term  fhi,  the  sampling  fraction  for  the  i‐th  sample PSU  in  the h‐th  stratum,  is  the product of  probabilities of selection at every stage in each sampling stratum:    hihihi ppf 21      where pshi is the probability of selection of the sampling unit at stage s  for the i‐th sample PSU in the  h‐th  sampling  stratum.   The  sampling probabilities will be calculated separately  for each  sampling  stage and for each PSU. We use the following notations:  P1hi : first‐stage sampling probability of the i‐th PSU in stratum h P2hi : second‐stage sampling probability of selecting a household within the i‐th PSU Let ah be the number of PSUs selected in stratum h, Mhi the number of households according to the  sampling  frame  in  the  i‐th  PSU,  and  ∑Mhi  the  total  number  of  households  in  the  stratum.  The  probability of selecting the i‐th PSU in the 2011‐12 LSIS sample was calculated as follows:    M M a = P hi hih 1hi    Let bhi be  the proportion of households  in the selected segment compared  to the total number of  households  in PSU  i  in stratum h  if the EA  is segmented, otherwise bhi = 1. Then the probability of  selecting cluster i in the sample is:    hib M M a = P hi hih 1hi      i  in stratum    him     hi hi hi M mP  2   The overall selection probability of each household in PSU i of stratum h is therefore the product of  the two stages selection probabilities:   hihihi PPP 21  or  hi hi hi hih hi M m M M a = P    Since the estimated number of households  in each enumeration area  (PSU)  in the sampling  frame  used  for  the  first stage selection and  the updated number of households  in  the enumeration area  from  the  listing  were  different,  individual  sampling  fractions  for  households  in  each  sample  enumeration  area  (village)  were  calculated.    The  sampling  fractions  for  households  in  each  enumeration  area  (village),  therefore,  included  the  first  stage  probability  of  selection  of  the    hi hi fW 1      The  term  fhi,  the  sampling  fraction  for  the  i‐th  sample PSU  in  the h‐th  stratum,  is  the product of  probabilities of selection at every stage in each sampling stratum:    hihihi ppf 21      where pshi is the probability of selection of the sampling unit at stage s  for the i‐th sample PSU in the  h‐th  sampling  stratum.   The  sampling probabilities will be calculated separately  for each  sampling  stage and for each PSU. We use the following notations:  P1hi : first‐stage sampling probability of the i‐th PSU in stratum h P2hi : second‐stage sampling probability of selecting a household within the i‐th PSU Let ah be the number of PSUs selected in stratum h, Mhi the number of households according to the  sampling  frame  in  the  i‐th  PSU,  and  ∑Mhi  the  total  number  of  households  in  the  stratum.  The  probability of selecting the i‐th PSU in the 2011‐12 LSIS sample was calculated as follows:    M M a = P hi hih 1hi    Let bhi be  the proportion of households  in the selected segment compared  to the total number of  households  in PSU  i  in stratum h  if the EA  is segmented, otherwise bhi = 1. Then the probability of  selecting cluster i in the sample is:    hib M M a = P hi hih 1hi   Let  hiM  be the number of households listed in the household listing operation in cluster i in stratum  h, let  him  be the number of households selected in the PSU. The second stage selection probability  for each household in the PSU is calculated as follows:    hi hi hi M mP  2   The overall selection probability of each household in PSU i of stratum h is therefore the product of  the two stages selection probabilities:   hihihi PPP 21  or  hi hi hi hih hi M m M M a = P    Since the estimated number of households  in each enumeration area  (PSU)  in the sampling  frame  used  for  the  first stage selection and  the updated number of households  in  the enumeration area  from  the  listing  were  different,  individual  sampling  fractions  for  households  in  each  sample  enumeration  area  (village)  were  calculated.    The  sampling  fractions  for  households  in  each  enumeration  area  (village),  therefore,  included  the  first  stage  probability  of  selection  of  the    hi hi fW 1      The  term  fhi,  the  sampling  fraction  for  the  i‐th  sample PSU  in  the h‐th  stratum,  is  the product of  probabilities of selection at every stage in each sampling stratum:    hihihi ppf 21      where pshi is the probability of selection of the sampling unit at stage s  for the i‐th sample PSU in the  h‐th  sampling  stratum.   The  sampling probabilities will be calculated separately  for each  sampling  stage and for each PSU. We use the following notations:  P1hi : first‐stage sampling probability of the i‐th PSU in stratum h P2hi : second‐stage sampling probability of selecting a household within the i‐th PSU Let ah be the number of PSUs selected in stratum h, Mhi the number of households according to the  sampling  frame  in  the  i‐th  PSU,  and  ∑Mhi  the  total  number  of  households  in  the  stratum.  The  probability of selecting the i‐th PSU in the 2011‐12 LSIS sample was calculated as follows:    M M a = P hi hih 1hi    Let bhi be  the proportion of households  in the selected segment compared  to the total number of  households  in PSU  i  in stratum h  if the EA  is segmented, otherwise bhi = 1. Then the probability of  selecting cluster i in the sample is:    hib M M a = P hi hih 1hi   Let  hiM  be the number of households listed in the household listing operation in cluster i in stratum  h, let  him  be the number of households selected in the PSU. The second stage selection probability  for each household in the PSU is calculated as follows:    hi hi hi M mP  2   The overall selection probability of each household in PSU i of stratum h is therefore the product of  the two stages selection probabilities   hihihi PPP 21  or  hi hi hi hih hi M m M M a = P    Since the estimated number of households  in each enumeration area  (PSU)  in the sampling  frame  used  for  the  first stage selection and  the updated number of households  in  the enumeration area  from  the  listing  were  different,  individual  sampling  fractions  for  households  in  each  sample  enumeration  area  (village)  were  calculated.    The  sampling  fractions  for  households  in  each  enumeration  area  (village),  therefore,  included  the  first  stage  probability  of  selection  of  the  297 The sample weights for the households were calculated by multiplying by 1/RRh for each enumeration area. These weights were then standardized (or normalized); one purpose of this is to make the weighted sum of the interviewed sample units equal the total sample size at the national level. Normalization is performed by multiplying the sample weights by a constant factor equal to the unweighted number of households at the national level divided by the weighted total number of households (using the un-normalized sample weights). A similar standardization procedure was followed in obtaining standardized weights for the women’s and under-5’s questionnaires. Adjusted (normalized) weights varied between 0.141 and 3.841 in the 998 sample enumeration areas (villages). Sample weights were appended to all data sets and analyses were performed by weighting each household, woman, man or under-5 with these sample weights. enumeration area  in that particular sampling stratum and the second stage probability of selection  of a household in the sample enumeration area (village).     A  second  component  in  the  calculation  of  sample weights  takes  into  account  the  level  of  non‐ response for the household and individual interviews. The adjustment for household non‐response is  equal to the inverse value of:    RRh = Number of interviewed households in stratum h /   Number of occupied households listed in stratum h    After the completion of fieldwork, response rates were calculated for each sampling stratum. These  were used  to adjust the sample weights calculated  for each village. Response rates  in the LSIS are  shown in Table HH.1 of this report.    Similarly, the adjustment for non‐response at the  individual  level (women, men, and children aged  under 5) for each stratum is equal to the inverse value of:    RRh = Completed women’s (or men’s or under‐5’s) questionnaires in stratum h /   Eligible women (or men or under‐5s) in stratum h    The non‐response adjustment factors for women's, men’s and under‐5's questionnaires are applied  to  the adjusted household weights.   Numbers of eligible women, men and under‐5 children were  obtained  from  the  roster of household members  in  the Household Questionnaire  for households  where interviews were completed.    The  sample  weights  for  the  households  were  calculated  by  multip   hiW   for  ea ch  enumeration area. These weights were then standardized (or normalized)  is  to  make the weighted sum of the interviewed sample units equal the total sample size at the national  level.   Normalization  is performed by multiplying the sample weights by a constant factor equal to  the unweighted number of households at the national level divided by the weighted total number of  households  (using  the  un‐normalized  sample  weights).  A  similar  standardization  procedure  was  followed in obtaining standardized weights for the women’s and under‐5’s questionnaires. Adjusted  (normalized)  weights  varied  between  0.141  and  3.841  in  the  998  sample  enumeration  areas  (villages).    Sample weights were  appended  to  all data  sets  and  analyses were performed by weighting each  household, woman, man or under‐5 with these sample weights.     298 Appendix B. List of Personnel Involved in the Survey LSIS Steering Committee 1 Profressor Dr. Eksavang Vongvichit Minister of Ministry of Health (MoH) 2 Dr. Ponemek Dalaloy Former Minister of Ministry of Health 3 Dr. Bounthavy Sisouphanthong Deputy Minister of Ministry of Planning and Investment (MPI) 4 Mr. Leetou Boapao Deputy Minister of Ministry of Education and Sports (MoES) 5 Associate Profressor Dr. Somok Kingsada Deputy Minister of MoH 6 Professor Dr. Boungnong Boupha Former Director General of National Institute of Public Health (NIOPH), MoH 7 Dr. Samaychanh Boupha Deputy Minister, Head of Lao statistics Bureau, MPI 8 Mr. Khamphone Phoutthavong Director of Finance Department, MoH 9 Mr. Somkhanh Didalavong Deputy Director General of Department of Planning, Director of Education Statistics and Information Technology Center, MOES 10 Mr. Khamphet Manivong Former Acting Director of Finance and Planning Department, MoH LSIS Technical Task Force for preparation, collection, analysis, report and disseminate the result of survey as following: 1 Dr. Bounfeng Phoummalaysith Deputy Director General of Cabinet, MoH 2 Ms. Phonesaly Souksavath Director General, Department of Social Statistics, Lao Statistics Bureau, MPI 3 Dr. Vanhphanom Sichalearn Director General of Postgraduate Training and Research, University of Health Science, MoH 4 Dr. Lamphone Syharkhang Deputy Director of Food and Drug Department, MoH 5 Dr. Anonh Xeuatvongsa Deputy Director of MCH Center, MoH 6 Dr. Phouthone Soutthalack Deputy Director of Center for HIV/AIDS/STI 7 Dr. Bouasy Houngvanthong Director of Malaria Parasites and Insects Center, MoH 8 Dr. Phengta Vongphachan Director of Laboratory and Epidemiology Center, MoH 9 Dr. Soutsakhone Chanthaphone Director of National Centre for environment Health and Water Supply, MoH 10 Dr. Keonakhone Houmboun Director of Health System Research Division, NIOPH, MoH 11 Dr. Mayfong Mayxay Chief of Study Unit, Postgraduate Training and Research, UHS, MoH 12 Ms. Thirakha Chanthalanouvong Deputy Director General, Department of Social Statistic, Lao Statistics Bureau ,MPI 13 Mr. Thipsavanh Intharack Deputy Director General, Department of Social Statistic , Lao Statistics Bureau, MPI 14 Dr. Alongkone Phengsavanh Chief of Science Study Unit, Postgraduate Training and Research, UHS, MoH 299 16 Dr. Chandavone Phoxay Director of Strengthening Health System Project, MoH 17 Dr. Chansaly Phoummavong Deputy Manager of Health Services Improvement Project , MoH LSIS Secretaries Group 1 Dr. Swady Kingkeo Director of Statistical Division, DPIC, MoH 2 Dr. Manithong Vonglokham Deputy Director of Health System Research Division, NIOPH, MoH 3 Dr. Soutthanou Nanthanonty Deputy Director, Health System Development Project, MoH 4 Dr. Sysavanh Chanthavilay Postgraduate Training and Research, UHS, MoH 5 Dr. Phetsavanh Phoummachan Postgraduate Training and Research, UHS, MoH 6 Dr. Phouthone Phoummavongsa Postgraduate Training and Research, UHS, MoH 7 Dr. Somphou Sayasone Deputy Director National Health Research Coordination Office,NIOPH, MoH 8 Dr. Thatsavone Phirom Technical Staff of Statistical Division, DPIC,MOH LSIS Review Team (Results and Report of LSIS) 1 Dr. Bounfeng Phoummalaysith Deputy Director general of Cabinet, MoH 2 Ms. Phonesaly Souksavath Director General of Department of Social Statistics, Lao Statistics Bureau, MPI 3 Ms. Jane DAVIES Education Specialist of UNICEF 4 Ms. Pafoualee Leechuefoung Assistant Representative of UNFPA 5 Dr. Soutsakhone Chanthaphone Director of National Centre for environment Health and Water Supply, MoH 6 Dr. Swady Kingkeo Director of Statistical Division, DPIC, MoH 7 Ms. Thirakha Chanthalanouvong Deputy Director General of Department of Social Statistic, Lao Statistics Bureau ,MPI 8 Dr. Keonakhone Houmboun Director of Health System Research Division, NIOPH, MoH 9 Dr. Anonh Xeuatvongsa Chief of Expended Programme on Immunization, MOH 10 Dr. Bounthom Phengdy Director of Nutrition Center Hygiene and Health Promotion Department, MoH 11 Dr. Latsamy Siengsounthone Director of Health Information Division, NIOPH, MoH 12 Dr. Khampasong Setthavansay Chief of Technical Division, UHS, MoH 13 Dr. Kongsay Phounphenghack Deputy Chief of Expended Programme Immunization, MoH 14 Dr. Suvankham Phommaseng Deputy Chief of Health Promotion Nutrition, Hygiene and Prevention Department, MoH 15 Dr. Panome Sayamoungkhoun Mother and Child Health Center, MoH 16 Dr. Manithong Vonglokham Deputy Director of Health System Research Division, NIOPH, MoH 15 Dr. Founkham Lattanavong Deputy Director General of Planning and International Cooperation, MoH 300 17 Mr. Kingphet Atsanavong Director of IT Division, Lao Statistics Bureau, MPI 18 Mr. Phetsavanh Boutlasy Senior Staff of Department of Social Statistics, Lao Statistics Bureau ,MPI 19 Mr. Pangkham Thikeo Senior Staff of Department of Social Statistics, Lao Statistics Bureau ,MPI 20 Mr. Kongkhan Phanthay Senior Staff of Department of Planning, MOES 21 Dr. Khanti Thongkham Senior Staff of Surveillance and Counseling Unit, Center for HIV/AIDS/STI, MOH 22 Mr. Sengkeo Phengsana Deputy Director of Education Research Division, Education and Sports Research Center, MoES 23 Dr. Thatsavone Phirom Technical Staff of Statistical Division, DPIC,MOH 24 Ms. Alivanh Phanlavong Technical Staff of Statistical Division, DPIC,MOH 25 Ms. Phonemany Inthasone Technical Staff of Statistical Division, DPIC,MOH 26 Mr. Khin Kyu Coordinator of Lao social Indicators Survey 27 Mr. Souksavanh Phomchaly Ministry of Labour and Social Welfare (MoLSW) 28 Dr. Khamlay Manivong UNAIDS 29 Ms. Somphavanh Nakhavong Monitoring and Evaluation Officer of UNICEF 30 Ms. Suzie Albone Health Specialist of UNICEF 31 Ms. Uma Palaniappan Nutrition Specialist of UNICEF 32 Dr. Thomas D’Agnes Health Program Manager USAID/RDMA/Lao PDR 33 Dr. Supachai Douangchak National Professional Officer, WHO 34 Dr. KhanNgeun Oudomephone WFP 35 Mr. Vilone Viphongsay WFP LSIS Report Writing Group 1 Dr. Keonakhone Houmboun Director of Health System Research Division, NIOPH, MoH 2 Dr. Swady Kingkeo Director of Statistical Division, DPIC, MoH 3 Ms. Thirakha Chanthalanouvong Deputy Director General of Department of Social Statistic, Lao Statistics Bureau ,MPI 4 Dr. Bounthom Phengdy Director of Nutrition Center Hygiene and Health Promotion Department, MoH 5 Dr. Kia Reinis Survey Specialist, ICF International 6 Dr Kongdeuan Bouphavanh Academies affair of University of Health Sciences, MoH 7 Dr. Latsamy Siengsounthone Director of Health Information Division, NIOPH, MoH 8 Mr. Phetsavanh Boutlasy Senior Staff of Department of Social Statistics, Lao Statistics Bureau ,MPI 9 Mr. Pangkham Thikeo Senior Staff of Department of Social Statistics, Lao Statistics Bureau ,MPI 10 Dr. Panome Sayamoungkhoun Mother and Child Health Center, MoH 11 Dr. Khanti Thongkham Senior Staff of Surveillance and Counseling Unit, Center for HIV/AIDS/STI, MOH 12 Mr. Sengkeo Phengsana Deputy Director of Education Research Division, Education and Sports Research Center, MoES 13 Dr. Thatsavone Phirom Technical Staff of Statistical Division, DPIC,MOH 14 Mr. Trevor Croft Technical Director, ICF International 301 1 Ms. Thirakha Chanthalanouvong Deputy Director General of Department of Social Statistic, Lao Statistics Bureau ,MPI 2 Mr. Kingphet Atsanavong Director of IT Division, Lao Statistics Bureau, MPI 3 Mr. Trevor Croft Technical Director, ICF International 4 Mr. Pangkham Thikeo Senior Staff of Department of Social Statistics, Lao Statistics Bureau ,MPI 5 Mr. Phetsavanh Boutlasy Senior Staff of Department of Social Statistics, Lao Statistics Bureau ,MPI 6 Ms. Samta Sacktikun Technical Staff of Department of Social Statistics, Lao Statistics Bureau ,MPI 7 Ms. Phaithong Vonglokham Technical Staff of IT Division, Lao Statistics Bureau, MPI LSIS Trainers of household listing 1 Dr. Swady Kingkeo Director of Statistical Division, DPIC, MoH 2 Dr. Keonakhone Houmboun Director of Health System Research Division, NIOPH, MoH 3 Dr. Alongkone Phengsavanh Chief of Science Study Unit, UHS, MoH 4 Ms. Thirakha Chanthalanouvong Deputy Director General of Department of Social Statistic, Lao Statistics Bureau ,MPI 5 Dr. Chansaly Phoummavong Deputy Manager of Health Services Improvement Project , MoH 6 Dr. Manithong Vonglokham Deputy Director of Health System Research Division, NIOPH, MoH 7 Dr. Somphou Sayasone Deputy Director National Health Research Coordination Office,NIOPH, MoH LSIS Trainers for field data collection 1 Dr. Swady Kingkeo Director of Statistical Division, DPIC, MoH 2 Dr. Keonakhone Houmboun Director of Health System Research Division, NIOPH, MoH 3 Mr. Thipsavanh Intharack Deputy Director General of Department of Social Statistic , Lao Statistics Bureau, MPI 4 Dr. Manithong Vonglokham Deputy Director of Health System Research Division, NIOPH, MoH 5 Dr. Panome Sayamoungkhoun Mother and Child Health Center, MoH 6 Dr. Latsamy Siengsounthone Director of Health Information Division, NIOPH, MoH 7 Mr. Vilaysook Sysulard Senior Technical Staff, Lao Social Bureau, MPI Data Entry and Data Processing Supervisors 302 1 Mr. Longtor Yongvang Provincial Department of Planning and Investment, Vientiane Capital, MPI 2 Dr. Manychansot Inthalansy Panning and Finance Department, MoH 3 Mr. Malaivong Vongsavanthong Provincial Department of Planning and Investment, Vientiane Capital 4 Mr. Syvisay Thapbouly Lao Statistics Bureau, MPI Phongsaly Province 1 Mr. Duangsavanh Lavongmany Provincial Department of Planning and Investment, Phongsaly Province 2 Dr. Thatsavone Phirom Statistic Division, DPF,MOH 3 Mr. Somchan Chomkeo Provincial Health Department, Phongsaly Province 4 Dr. Soulydet Vilayvong University of Health Science, MoH Luangnamtha Province 1 Mr. Areyai Chansavanh Provincial Department of Planning and Investment, Luangnamthar Province 2 Dr. Daovilay Banchongphanid Cabinet, MoH 3 Ms. Mone Ayseng Provincial Department of Planning and Investment, Luangnamtha Province 4 Dr. Manyvan Sawady Health care Department, MoH Oudomxay Province 1 Mr. Uthone Keoduangchit Provincial Department of Planning and Investment Department , Oudomxay Province 2 Dr. Viengnakone Vongsay University of Health Science, MoH 3 Mr. Chanmany Chadthangeun Provincial Health Department, Oudomxay Province 4 Mr. Amlien Phonsylar Mother and Child Health Center, MoH Bokeo Province 1 Mr. Sengthavy Phimmasone Provincial Health Department, Bokeo Province 2 Ms. Ladsamy Yearlor Lao Statistics Bureau, MPI 3 Mr. Khamsing Syliphanyar Provincial Health Department, Bokeo Province 4 Ms. Buakeo Phommavong Mather and Child Health Center, MoH Luangprabang Province 1 Mr. Buathong Suksavah Provincial Department of Planning and Investment , Luangprabang Province 2 Mr. Koudkeo Euansaiyasen Organization and Personal Department, MoH 3 Mr. Syphone Mithmaythy Provincial Department of Planning and Investment , Vientiane Province 4 Dr. Somchid Kanyarvong Organization and Personal Department, MoH Household listing Team Vientiane Capital 303 1 Mr. Somphone Sukhavong Provincial Department of Planning and Investment , Huaphanh Province 2 Mr. Khienthong Lortakun Malaria Parasites and Insects Institute, MoH 3 Mr. Phetvisay Syphanvong Provincial Department of Planning and Investment , Huaphanh Province 4 Dr. Bounyord Moonkharlak National Institute of Public Health, MoH Xayabury Province 1 Mr. Khamphey Sinthavong Provincial Department of Planning and Investment, Vientiane Capital, MPI 2 Dr. Thongin Lienvilaysak Malaria Parasites and Insects Institute, MoH 3 Mr. Bunkhen Vudthisook Provincial Department of Planning and Investment, Xayabury Province 4 Dr. Vankham LardPhommachan Cabinet, MoH Xiengkhuang Province 1 Mr. Kuangyang Provincial Department of Planning and Investment, Xiengkhuang Province 2 Dr. Somnuen Phongsysay Mother and Child Health Centre, MoH 3 Mr Tortvilay Provincial Department of Planning and Investment, Xiengkhuang Province 4 Dr. Nyalun Vongpaseud National Institute of Public health, MoH Vientiane Province 1 Mr. Khamlar Phakvarndvongsook Provincial Department of Planning and Investment, Vientian province 2 Dr. Synuane Phomkhe Hygiene and Prevention Department, MoH 3 Mr. Khan Xayasit Provincial Department of Planning and Investment, Vientiane Province 4 Mr. Bunthang Provincial Heath Department, Vientiane province Borikhamxay Province 1 Mr. Khamvarnchay Savanhak Provincial Department of Planning and Investment, Borikhamxay Province 2 Dr. Bangone Bunheung National Institute of Public health, MoH 3 Mr. Khao Phonesavang Provincial Department of Planning and Investment, Borikhamxay Province 4 Ms. Bunta Phasavanh National Institute of Public health, MoH Khammuane Province 1 Mr. Sukkhy Linnalard Provincial Department of Planning and Investment, Khammuane Province 2 Mr. Syva Syharlard Sathathirad hospital, MoH 3 Mr. Sai Syphansay Provincial Department of Planning and Investment, Khammuane Province 4 Dr. Bounpone Vannalat National Center for Environment Health and Water Supply, MoH Huaphanh Province 304 1 Mr. Borlysud Udthavong Provincial Department of Planning and Investment, Savannakhet Province 2 Ms. Sompong Chanthapanya Mother and Child Health Centre, MoH 3 Ms. Khanikone Sayasarn Provincial Department of Planning and Investment, Savannakhet Province 4 Mr. Daoheuang Syharphone Statistic Division, DPF, MoH 5 Ms. Lidthana Keosuvan Lao Statistics Bureau, MPI 6 Mr. Khen Phommasone Skin Health Care Centre, MoH Saravane Province 1 Mr. Syvilay Luangviserd Provincial Department of Planning and Investment, Saravane Province 2 Dr. Khamphan Inthalangsy Mother and Child Health Centre, MoH 3 Mr. Vilaphone Keodalar Provincial Department of Planning and Investment, Saravane Province 4 Mr. Inthong Bunmany Lao Statistics Bureau, MPI Sekong Province 1 Ms. Phone Keoduangdy Provincial Department of Planning and Investment, Sekong Province 2 Ms. Senthar Santhikoun Lao Statistics Bureau, MPI 3 Mr. Phaivanh Phimmasen Provincial Department of Planning and Investment, Sekong Province 4 Mr. Sompharnid Vongdeuan Lao Statistics Bureau, MPI Champasack Province 1 Mr. Soukthavy Sarvalad Provincial Department of Planning and Investment, Champasack Province 2 Ms. Keomanysay Phaithavong Motor and Child Hospital, MoH 3 Mr. Khammarn Khounvansy Provincial Department of Planning and Investment, Champasack Province 4 Ms. Kadkeo Upalarvong Mitaphap Hospital, MoH Attapeu Province 1 Mr. Sorlasak Veosy Provincial Department of Planning and Investment, Attapeu Province 2 Ms. Sompong Khodyotha Statistic Division, DPF, MoH 3 Ms. Chaiphone Sengsysavang Provincial Department of Planning and Investment, Attapeu Province 4 Mr. Darlarvanh Phommalay Statistic Division, MoH Savannakhet Province 305 1 Mr. Thongsavanh Homesombad Mahosot Hospital, MoH 2 Mr. Intong Bunmany Lao Statistics Bureau, MPI 3 Mr Khamluk Sayagneun Provincial Health Department, Pongsaly Province 4 Mrs. Beuakeo Paisylay Provincial Health Department, Pongsaly Province 5 Dr Thatsavone Phirom Statistics Division, DPF, MoH 6 Mr Bounsavanh SengYord Provincial Department of Planning and Investment, Pongsaly Province 7 Mr ThongVanh Lachomsy Provincial Department of Planning and Investment, Pongsaly Province Team 2: Luangnamtha Province 1 Dr. Bounyord Mounlarlak National Institute of Public Health, MoH 2 Ms. Manyvan Lardsythong Provincial Department of Planning and Investment, Luangnamtha Province 3 Ms. Bouavan Phanthavong Provincial Health Department, Luangnamtha Province 4 Dr. Keovylay Thongsuksong Provincial Health Department, Luangnamtha Province 5 Mr. Monechan Sandkomand Provincial Health Department, Luangnamtha Province 6 Dr. Sand Khamphavong Provincial Health Department, Vientiane capital 7 Ms. Mone Ayseng Provincial Department of Planning and Investment, Luangnamtha Province Team 3: Oudomxay Province 1 Dr. Nikhom Chanthalansy Provincial Health Department , Oudomxay Province 2 Mr. Visay Sookkaserm Provincial Department of Planning and Investment, Oudomxay Province 3 Ms. Darvone Khounsangoaun Provincial Health Department , Oudomxay Province 4 Ms. Lidtanar Keosuvan Lao Statistics Bureau, MPI 5 Mr. Chanmany Chantangeun Provincial Department of Planning and Investment, Oudomxay Province 6 Dr. Daovilai Banchongphanid Cabinet, MoH 7 Mr. Uthone Keoduangchid Provincial Department of Planning and Investment Oudomxay Province Team 4: Bokeo Province 1 Dr. Phonethip Budthasavong Provincial Health Department, Bokeo Province 2 Mr. Sengthavy Phimmasone Provincial Department of Planning and Investment, Bokeo Province 3 Ms. Boaukeo Phommavong Mother and Child Health Centre, MoH 4 Ms. Vilaiphone Phongsavanh Provincial Health Department, Bokeo Province 5 Mr. Vilakone Khindalak Department of Planning and Finance, MoH 6 Ms. Bouachan Vysaiphone Provincial Health Department, Bokeo Province 7 Mr. Khamsouk Euenchueng Provincial Health Department, Bokeo Province Team 5: Luangprabang Province 1 Dr. Thongchan Thammavongchid Provincial Health Department, Luangprabang Province 2 Mr. Ungeun Sengthar Provincial Department of Planning and Investment Luangprabang Province LSIS Field Data Collection Teams Team 1: Phongsaly Province 306 3 Dr. Sengchan Duangphachan Organization and Personnel Department, MoH 4 Dr. Somphone Khamphanvong Department of Food and Drug, MoH 5 Mr. Suliyar Champasing Provincial Department of Planning and Investment, Luangprabang Province 6 Ms. Keolarny Kaidhongsar Finance Division, DPF, MoH 7 Ms. Thamonechid Borlavong Provincial Department of Planning and Investment, Vientiane Capital Team 6: Xayabury Province 1 Mr. Phadthanong Thammavong Provincial Department of Planning and Investment, Xayabury Province 2 Mr. Somparnid Vongdeuan Lao Statistics Bureau, MPI 3 Ms. Somsavang Manyvong Department of Planning and Finance, MoH 4 Ms. Malaithong Keomany Organization and Personnel Department of, MoH 5 Dr. Somsanid Sybounmar Provincial Health Department, Xayabury Province 6 Dr. Bounleuan Keopaseud Provincial Health Department, Xayabury Province 7 Mr. Bounken Voudthisook Provincial Department of Planning and Investment, Xayabury Province Team 7: Luangprabang and Xayabury Province 1 Dr. Bounpone Vannalad National Centre for environment Health and Water Supply, MoH 2 Mr. Bouathong Suksavand Provincial Department of Planning and Investment, Luangprabang Province 3 Mr. Khen Phommasone Skin Health care Centre, MoH 4 Mr. Koudphet Phommathaid Provincial Health Department, Luangprabang Province 5 Ms. Monethalak Banpharsid Lao Statistics Bureau, MPI 6 Mr. Syvar Syharlard Sathathilard Hospital, MoH 7 Ms. Sykhai Manydeng Provincial Health Department, Luangprabang Province Team 8: Huaphanh Province 1 Dr. Amlien Phonsylar Mother and Child Health Cantre, MoH 2 Mr. Somphone Soukkhavong Provincial Department of Planning and Investment, Huanphanh Province 3 Dr. Eompheng Thipvongphan Provincial Health Department PHO, Huaphanh Province 4 Ms. Somphiew Thipphavong Provincial Health Department PHO, Huaphanh Province 5 Dr. Sinlarsouk Provincial Health Department PHO, Huaphanh Province 6 Ms. Soukdarvone Meuangvong Department of Inspection, MoH 7 Mr. Saisanid Phoudthapanyar Provincial Health Department, Houanphan Province Team 9: Xiengkhuang Province 1 Dr. Thongin Lienvylaysack Malaria Parasites and Insects Institute, MoH 2 Mr. Kouayang Provincial Department of Planning and Investment, Xienkhuang Province 307 3 Dr. Darlor Saysoua Provincial Health Department, Xiengkhuang Province 4 Ms. Ladsamy Yelor Lao Statistics Bureau, MPI 5 Dr. Viengsamone Vongsaiyalard Provincial Health Department, Xiengkhuang Province 6 Mr Tordvilai Phommysai Provincial Department of Planning and Investment , Xiengkhuang Province 7 Mr. Phedsavanh Syvongsai Provincial Department of Planning and Investment, Xiengkhuang Province Team 10: Vientiane Province 1 Dr. Bountang Phedlarvan Provincial Health Department , Vientiane Province 2 Dr. Khamlar Phanvardvongsouk Chief of Management, DP, Keoudom district, PPI, Vientiane Province, MPI 3 Mr. Chan Phongthady Provincial Department of Planning and Investment, Vientiane Province 4 Ms. Phonemany Inthasone Statistic Division, DPF, MoH 5 Ms. Sinthavone Inthavong Provincial Department of Planning and Investment, Vientiane Province 6 Dr. Phimphone Suthammavong Provincial Health Department, Vientiane Province 7 Mr. Kadsamar Phommalay Statistic Division, DPF, MoH Team 11: Borikhamxay Province 1 Dr. Phetsavanh Vongsedone Provincial Health Department, Borikhamxay Province 2 Mr. Thongsai Sengaloun Provincial Department of Planning and Investment, Vientiane Capital 3 Dr. Synauen Phomkhe Department of Hygiene and prevention, MoH 4 Mr. Chanthavone Khounsombath Provincial Department of Planning and Investment, Vientiane Capital 5 Dr. Phetsamone Nonethavy Provincial Department of Planning and Investment, Vientiane Capital 6 Dr. Khamsone Siphanthavong Provincial Health Department, Borikhamxay Province 7 Mr. Phonethip Eounchan Provincial Department of Planning and Investment, Borikhamxay Province Team 12: Vientiane and Borikhamxay Province 1 Dr. Phetsamone Vongphuthone Provincial Health Department, Borikhamxay Province 2 Ms. Phuangmarlar Larsharsy Lao Statistics Bureau, MPI 3 Dr. Phonethap Panyarchack Provincial Health Department, Vientiane Capital 4 Mr. Keomanysai Phaithavong Mother and child Hospital, MoH 5 Mr. Sidthasone Vilaichid Provincial Department of Planning and Investment, Borikhamxay Province 6 Ms. Phetsarkone Bounyarvong Lao Statistics Bureau, MPI 7 Mr. Longthao Yongvar Provincial Department of Planning and Investment, Vientiane Capital Team 13: Khammuane Province 1 Dr. Sonesai Pharphonthulard Provincial Health Department, Khammuane Province 2 Mr. Somphet Khodthavong Provincial Department of Planning and Investment, Khammuane Province 308 3 Ms. Sydar Suvannalarsy Provincial Health Department, Khammuane Province 4 Ms. Manychan Inthavong Provincial Health Department, Khammuane Province 5 Mr. Bounmy Manysy Provincial Department of Planning and Investment, Khammuane Province 6 Ms. Phanmahar Suvannalard Department of Planning and Finance, MoH 7 Ms. Ammalar thanavongsy Statistics Division, DPF, MoH Team 14: Savannakhet Province 1 Dr. Daovaly Alarmarthithardar Provincial Health Department, Savannakhet Province 2 Mr. Borlisud Udthavong Provincial Department of Planning and Investment, Savannakhet Province 3 Ms. Bouathong Vannalardsaysy Provincial Health Department, Savannakhet Province 4 Mr. Parn Phanthavong National Institute of Public Health, MoH 5 Ms. Sengdeuan Saiyalard Provincial Department of Planning and Investment, Savannakhet Province 6 Ms. Manyvone Keophonevilai Provincial Department of Planning and Investment, Savannakhet Province 7 Ms. Vilai Phothilard Provincial Department of Planning and Investment, Savannakhet Province Team 15: Khammuane and Savannakhet Province 1 Dr. Khanpaseud Sengngarm National Institute of Public Health, MoH 2 Mr. Syamphone Sandboudtalard Provincial Department of Planning and Investment, Khammuane Province 3 Ms. Darlarvone Saiyasack National Centre for environment Health and Water Supply, MoH 4 Ms. Khinnarlone Mingsavanh Provincial Health Department, Khammuane Province 5 Ms. Phounid Keokandchan Provincial Department of Planning and Investment PPI, Khammuane Province, MPI 6 Mr. Phiewphar Mhaotouchang Provincial Department of Planning and Investment, Vientiane Capital 7 Ms. Puymamy Vorviengkham Provincial Health Department, Khammuane Province Team 16: Saravanh Province 1 Mr. Somvisai Singvongsar Provincial Health Department, Saravanh Province 2 Dr. Sommak Manyvan National Institute of Public Health, MoH 3 Ms. Daoheuang Syharphone Statistic division, DPF,MoH 4 Dr. Soukthavyphone Larlienthavysay Provincial Health Department, Saravanh Province 5 Mr. Bounmy Indarvong Provincial Department of Planning and Investment, Saravanh Province 6 Ms. Phudoy Suvannasy Provincial Department of Planning and Investment, Saravanh Province 7 Ms. Kedkeo Upalavong Mithapap Hospital, MoH Team 17: Champasack Province 1 Dr. Viengsy souphackdy Provincial Health Department, Champasack Province 2 Mr. Bounlone Phonsiengsar Provincial Department of Planning and Investment, Champasack Province 3 Mr. Somphet Keoarphone Statistic Division, DPF, MoH 309 4 Ms. Soudthakesy Luanglard Provincial Health Department, Champasack Province 5 Ms. Banthalai Kadmarlar Provincial Health Department, Champasack Province 6 Mr. Bouaphan Saisana Provincial Department of Planning and Investment, Champasack Province 7 Mr. Sounthaly Phanthanongsack Provincial Department of Planning and Investment, Champasack Province Team 18: Saravanh and Champasack Province 1 Mr. Khanthavy Pathoummavan Provincial Health Department, Saravanh Province 2 Mr. Souksamai Phommavongsar Provincial Health Department, Saravanh Province 3 Dr. Sengmany Ouneup Department of Inspection, MoH 4 Ms. Phounsavan Phommasulid Provincial Health Department, Saravanh Province 5 Mr. Sylilai Luangvisaid Department of planning and Investment Saravanh Province, MPI 6 Ms. Sysuphan vongphusai Provincial Department of Planning and Investment, Saravanh Province 7 Dr. vongthakoun Somsamoud Department of Food and Drug, MOH Team 19: Sekong Province 1 Ms. Kinnalone Chandarvong Provincial Health Department, Sekong Province 2 Mr. Phaivan Phimmasend Provincial Department of Planning and Investment, Sekong Province 3 Dr. Choummaly Chanthavong Provincial Health Department, Sekong Province 4 Dr. Sydar Saiyavong National Institute of Public Health, MoH 5 MS. Pone Onmanyvan Provincial Department of Planning and Investment, Sekong Province 6 Mr. Phouvan Thammavong Mahosot Hospital, MoH 7 Mr. Soukkaserm Kounkhammer Provincial Department of Planning and Investment, Sekong Province Team 20: Attapeu Province 1 Mr. Noupard Phomkandkeo Provincial Health Department, Attapeu Province 2 Mr. Chaipone Sengsysavang Provincial Department of Planning and Investment, Attapu Province 3 Mr. Phosy thongdy Provincial Health Department, Attapeu Province 4 Ms. Sompong Chanthapanyar Mother and Child Health Centre, MoH 5 Ms. Phongphet Phommasone Department of Inspection, MoH 6 Dr. Sommack Suliyarmid Provincial Health Department, Attapeu Province 7 Mr. Sorlisack Veosy Provincial Department of Planning and Investment, Attapeu Province 310 1 Mr. Thipsavanh Intharack Deputy Director General, of Department of Social Statistic Survey Department, Lao Statistics Bureau, MPI 2 Mr. Peter Wingfield-Digby Statistical Consultant 3 Dr. Swady Kingkeo Director of Statistical Division, DPIC, MoH Finance Team 1 Ms. Phouvieng Khammany Health Services Improvement Project , DPF, MoH 2 Ms. Souchalit Nokeo Deputy Director of Administrative and Cooperation Division, Lao Statistics Bureau, MPI 3 Mr. Bounmy Sybunheung Department of Planning and Finance, MoH 4 Mr. Saysuban Sylapaseud Cabinet, MoH Editor 1 Mr. Frazer Henderson Consultant Key financial and technical agencies involved UNFPA Dr. Esther Muia, Representative, UNFPA Lao PDR Ms. Mieko Yabuta, former Representative, UNFPA Lao PDR Ms. Pafoualee Leechuefoung, Assistant Representative, UNFPA Lao PDR Ms. Della R. Sherratt, SBA Coordinator, UNFPA Lao PDR Ms. Siriphone Sally Sakulku, MNCH Coordinator, UNFPA Lao PDR Mr. Diego De La Rosa, Communication Officer, UNFPA Lao PDR Ms. Sonenaly Phetsavong, Programme Assistant, UNFPA Lao PDR Dr. Christophe Lefranc, Data Advisor, UNFPA Asia and the Pacific Regional Office UNICEF Mr. Timothy Schaffter, Representative, UNICEF Lao PDR Ms. Julia Rees, Deputy Representative, UNICEF Lao PDR Ms. Mizuho Okimoto-Kaewtathip, Chief of Social Policy, UNICEF Lao PDR Ms. Somphavanh Nakhavong, M&E Officer, UNICEF Lao PDR Mr. Marc Vergara, Chief of Communication, UNICEF Lao PDR Ms. Viorica Berdaga, Chief of Health and Nutrition, UNICEF Lao PDR Ms. Uma Palaniappen, Nutrition Specialist, UNICEF Lao PDR Ms. Suzie Albone, Health Specialist, UNICEF Lao PDR Ms. Kirsten Di Martino, Chief of Child Protection, UNICEF Lao PDR Ms. Verity Rushton, Child Protection Specialist, UNICEF Lao PDR Mr. Mahboob Ahmed Bajwa, Chief of Water, Sanitation and Hygiene, UNICEF Lao PDR Ms. Emmanuelle Abrioux, Chief of Education, UNICEF Lao PDR Ms. Susan Southern, Operations Manager, UNICEF Lao PDR Ms. Phetsamay Somchanmavong, Programme Assistant, UNICEF Lao PDR Sampling Design 311 MICS Experts Ms. Rhiannon James, MICS Regional Advisor, UNICEF EAPRO Mr. Attila Hancioglu, Senior Advisor, MICS Global Coordinator, UNICEF HQ Mr. Turgay Unalan, MICS Household Survey Expert, UNICEF HQ Ms. Ivana Bjelic, MICS Data Processing Expert, UNICEF HQ ICF International Dr. Kia Reinis, Survey Specialist/Data Quality Coordinator Mr. Trevor Croft, Technical Director Dr. Pav Govindasamy, Regional Coordinator for Anglophone Africa and Asia USAID Dr. Aye Aye Thwin, Director Office of Public Health, USAID Regional Development Mission for Asia Dr. Thomas D’Agnes, Health Program Manager, USAID Lao PDR 312 Appendix C. Estimates of Sampling Errors The sample of respondents selected in the Lao Social Indicator Survey is only one of the samples that could have been selected from the same population, using the same design and size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between the estimates from all possible samples. The extent of variability is not known exactly, but can be estimated statistically from the survey data. The following sampling error measures for each of the selected indicators are presented in this appendix:  Standard error (se): Sampling errors are usually measured in terms of standard errors for particular indicators (means, proportions etc). Standard error is the square root of the variance of the estimate. The Taylor linearization method is used for the estimation of standard errors.  Coefficient of variation (se/r) is the ratio of the standard error to the value of the indicator, and is a measure of the relative sampling error.  Design effect (deff) is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption of simple random sampling. The square root of the design effect (deft) is used to show the efficiency of the sample design in relation to the precision. A deft value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a deft value above 1.0 indicates an increase in the standard error due to the use of a more complex sample design.  Confidence limits are calculated to show the interval within which the true value for the population can be reasonably assumed to fall, with a specified level of confidence. For any given statistic calculated from the survey, the value of that statistic will fall within a range of plus or minus two times the standard error (r + 2.se or r – 2.se) of the statistic in 95 percent of all possible samples of identical size and design. Sampling errors for adult and maternal mortality were calculated using a custom program written using SAS version 9.2. The calculation of all other sampling errors presented in the report was done using SPSS Version 19 Complex Samples module. The results are shown in the tables that follow. In addition to the sampling error measures described above, the tables also include weighted and unweighted counts of denominators for each indicator. Sampling errors are calculated for indicators of primary interest, for the national level, for urban areas, rural areas, rural areas with road access, rural areas without road access, for North, Central, and South regions, and for each of the 17 provinces, including Vientiane Capital. Two of the selected indicators are based on households, five are based on household members, 34 are based on women, 10 are based on men and 19 are based on children under five years of age. All indicators presented here are in the form of proportions. Table SE.1 shows the list of indicators for which sampling errors are calculated, including the base population (denominator) for each indicator. Tables SE.2 to SE.27 show the calculated sampling errors for selected domains. 313 Table SE.1: Indicators selected for sampling error calculations List of indicators selected for sampling error calculations, and base populations (denominators) for each indicator, Lao PDR 2011-12 MICS4 Indicator Base Population HOUSEHOLDS 2.16 Iodized salt consumption All households in which salt was tested or with no salt 3.12 Household availability of insecticide-treated nets (ITNs) All households HOUSEHOLD MEMBERS 4.1 Use of improved drinking water sources All household members 4.3 Use of improved sanitation All household members 7.5 Secondary school net attendance ratio (adjusted) Children of secondary school age 9.18 Prevalence of children with one or both parents dead Children age 0-17 years 8.5 Violent discipline Children age 2-14 years WOMEN 7.1 Literacy rate among young women Women age 15-24 years - Currently married/in union Women age 15-49 years 8.7 Marriage before age 18 Women age 20-49 years - Children ever born Women age 15-49 years - Children living Women age 15-49 years - Children ever born to women age 40-49 Women age 40-49 years 5.2 Early childbearing Women age 20-24 years - Pregnant women Women age 15-49 years - Want no more children Women age 15-49 years who are currently married or in union - Want to delay birth at least 2 years Women age 15-49 years who are currently married or in union - Knows any contraceptive method Women age 15-49 years who are currently married or in union 5.3 Contraceptive prevalence Women age 15-49 years who are currently married or in union 5.4 Unmet need Women age 15-49 years who are currently married or in union 5.5a Antenatal care coverage - at least once by skilled personnel Women age 15-49 years with a live birth in the 2 years preceding the survey 5.5b Antenatal care coverage – at least four times by any provider Women age 15-49 years with a live birth in the 2 years preceding the survey 5.7 Skilled attendant at delivery Women age 15-49 years with a live birth in the 2 years preceding the survey 5.8 Institutional deliveries Women age 15-49 years with a live birth in the 2 years preceding the survey 5.9 Caesarean section Women age 15-49 years with a live birth in the 2 years preceding the survey 3.19 Pregnant women sleeping under insecticide-treated nets (ITNs) Pregnant women 9.2 Comprehensive knowledge about HIV prevention among young people Women age 15-24 years 9.3 Knowledge of mother- to-child transmission of HIV Women age 15-49 years 9.4 Accepting attitudes towards people living with HIV Women age 15-49 years who have heard of HIV 9.6 Women who have been tested for HIV and know the results Women age 15-49 years 9.7 Sexually active young women who have been tested for HIV and know the results Women age 15-24 years who have had sex in the 12 months pre- ceding the survey 9.11 Sex before age 15 among young women Women age 15-24 years - Total fertility rate Women-years of exposure to childbearing 314 - Adolescent birth rates (15-19) Women-years of exposure to childbearing among those age 15-19 years 1.3 Neonatal mortality Children exposed to the risk of mortality 1.4 Post-neonatal mortality Children exposed to the risk of mortality 1.2 Infant mortality Children exposed to the risk of mortality 1.5 Child mortality Children exposed to the risk of mortality 1.1 Under five mortality Children exposed to the risk of mortality MEN 7.1 Literacy rate among young men Men age 15-24 years - Currently married/in union Men age 15-49 years 8.7 Marriage before age 18 Men age 20-49 years - Knows any contraceptive method Men age 15-24 years 9.2 Comprehensive knowledge about HIV prevention among young people Men age 15-24 years 9.3 Knowledge of mother- to-child transmission of HIV Men age 15-49 years 9.4 Accepting attitudes towards people living with HIV Men age 15-49 years who have heard of HIV 9.6 Men who have been tested for HIV and know the results Men age 15-49 years 9.7 Sexually active young men who have been tested for HIV and know the results Men age 15-24 years who have had sex in the 12 months preceding the survey 9.11 Sex before age 15 among young men Men age 15-24 years UNDER-5s 2.1a Underweight prevalence Children under age 5 2.2a Stunting prevalence Children under age 5 2.3a Wasting prevalence Children under age 5 2.6 Exclusive breastfeeding under 6 months Total number of infants under 6 months of age 2.14 Age-appropriate breastfeeding Children age 0-23 months - Tuberculosis immunization coverage Children age 12-23 months - Received polio immunization Children age 12-23 months - Received DPT-HepB-Hib immunization Children age 12-23 months - Received measles immunization Children age 12-23 months - Received Hepatitis B immunization Children age 12-23 months - Diarrhoea in the previous 2 weeks Children under age 5 - Illness with a cough in the previous 2 weeks Children under age 5 - Fever in last two weeks Children under age 5 3.8 Oral rehydration therapy with continued feeding Children under age 5 with diarrhoea in the previous 2 weeks 3.10 Antibiotic treatment of suspected pneumonia Children under age 5 with suspected pneumonia in the previous 2 weeks 3.15 Children under age 5 sleeping under insecticide-treated nets (ITNs) Children under age 5 3.18 Anti-malarial treatment of children under age 5 Children under age 5 reported to have had fever in the previous 2 weeks 6.1 Support for learning Children age 36-59 months 6.7 Attendance to early childhood education Children age 36-59 months 8.1 Birth registration Children under age 5 315 Ta bl e S E .2 : S am pl in g er ro rs : T ot al s am pl e r - 2 se r + 2 se Io di ze d  sa lt  co ns um pt io n  2. 16 0. 79 5 0. 00 7 0. 00 9 5. 39 6 2. 32 3 18 67 4 18 69 3 0. 78 2 0. 80 9 H ou se ho ld  a va ila bi lit y  of  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 12 0. 50 2 0. 00 9 0. 01 8 6. 46 3 2. 54 2 18 84 3 18 84 3 0. 48 3 0. 52 0 U se  o f i m pr ov ed  d ri nk in g  w at er  s ou rc es 4. 1 0. 69 9 0. 01 1 0. 01 6 10 .7 27 3. 27 5 97 42 1 18 84 3 0. 67 7 0. 72 1 U se  o f i m pr ov ed  s an ita tio n 4. 3 0. 56 9 0. 01 0 0. 01 8 8. 39 9 2. 89 8 97 42 1 18 84 3 0. 54 8 0. 59 0 Se co nd ar y  sc ho ol  n et  a tt en da nc e  ra tio  (a dj us te d) 7. 5 0. 44 6 0. 00 9 0. 01 9 5. 07 1 2. 25 2 16 12 6 16 68 3 0. 42 9 0. 46 4 Pr ev al en ce  o f c hi ld re n  w ith  o ne  o r  bo th  p ar en ts  d ea d 9. 18 0. 05 3 0. 00 2 0. 03 5 3. 03 8 1. 74 3 41 84 0 43 41 1 0. 04 9 0. 05 7 Vi ol en t d is ci pl in e 8. 5 0. 75 7 0. 00 6 0. 00 7 2. 51 0 1. 58 4 31 36 9 14 54 7 0. 74 6 0. 76 8 Li te ra cy  r at e  am on g  yo un g  w om en 7. 1 0. 68 7 0. 01 0 0. 01 5 4. 09 9 2. 02 5 80 32 81 56 0. 66 6 0. 70 8 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 72 8 0. 00 4 0. 00 6 2. 10 5 1. 45 1 22 47 6 22 47 6 0. 72 0 0. 73 7 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 37 0 0. 00 6 0. 01 5 2. 33 6 1. 52 8 18 06 1 17 91 8 0. 35 9 0. 38 1 Ch ild re n  ev er  b or n ‐ 2. 46 0 0. 02 6 0. 01 1 2. 49 2 1. 57 8 22 47 6 22 47 6 2. 40 7 2. 51 3 Ch ild re n  liv in g ‐ 2. 08 9 0. 02 1 0. 01 0 2. 35 6 1. 53 5 22 47 6 22 47 6 2. 04 7 2. 13 1 Ch ild re n  ev er  b or n  to  w om en  a ge  4 0‐ 49 ‐ 4. 78 2 0. 05 9 0. 01 2 2. 05 7 1. 43 4 47 22 46 22 4. 66 5 4. 89 9 Ea rl y  ch ild be ar in g 5. 2 0. 18 2 0. 00 8 0. 04 5 1. 62 3 1. 27 4 36 17 35 98 0. 16 5 0. 19 8 Pr eg na nt  w om en ‐ 0. 05 2 0. 00 2 0. 03 4 1. 42 9 1. 19 5 22 47 6 22 47 6 0. 04 8 0. 05 5 W an t n o  m or e  ch ild re n ‐ 0. 57 9 0. 00 5 0. 00 9 1. 79 2 1. 33 9 16 36 8 16 55 0 0. 56 9 0. 59 0 W an t t o  de la y  bi rt h  at  le as t 2  y ea rs ‐ 0. 19 4 0. 00 4 0. 02 0 1. 58 2 1. 25 8 16 36 8 16 55 0 0. 18 6 0. 20 1 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 94 0 0. 00 4 0. 00 4 6. 20 5 2. 49 1 22 47 6 22 47 6 0. 93 2 0. 94 8 Co nt ra ce pt iv e pr ev al en ce 5 3 0 49 8 0 00 7 0 01 4 3 04 1 1 74 4 16 36 8 16 55 0 0 48 4 0 51 1 S ta nd ar d er ro rs , c oe ffi ci en ts o f v ar ia tio n, d es ig n ef fe ct s (d ef f), s qu ar e ro ot o f d es ig n ef fe ct s (d ef t) an d co nf id en ce in te rv al s fo r s el ec te d in di ca to rs , L ao P D R 2 01 1- 12 S ta nd ar d er ro r ( se ) V al ue ( r) M IC S In di ca to r H O U S E H O LD M E M B E R S W O M E N H O U S E H O LD S C on fid en ce li m its U nw ei gh te d co un t W ei gh te d co un t S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) D es ig n ef fe ct (d ef f) C oe ffi ci en t o f va ria tio n (s e/ r) Co nt ra ce pt iv e  pr ev al en ce 5. 3 0. 49 8 0. 00 7 0. 01 4 3. 04 1 1. 74 4 16 36 8 16 55 0 0. 48 4 0. 51 1 U nm et  n ee d 5. 4 0. 19 9 0. 00 5 0. 02 3 2. 20 6 1. 48 5 16 36 8 16 55 0 0. 19 0 0. 20 9 A nt en at al  c ar e  co ve ra ge  ‐  at  le as t o nc e  by  s ki lle d  pe rs on ne l 5. 5a 0. 54 2 0. 01 3 0. 02 4 2. 91 0 1. 70 6 43 06 44 44 0. 51 7 0. 56 8 A nt en at al  c ar e  co ve ra ge  –  a t l ea st  fo ur  ti m es  b y  an y  pr ov id er 5. 5b 0. 36 9 0. 01 2 0. 03 2 2. 66 1 1. 63 1 43 06 44 44 0. 34 5 0. 39 2 Sk ill ed  a tt en da nt  a t d el iv er y 5. 7 0. 41 5 0. 01 2 0. 02 9 2. 66 2 1. 63 2 43 06 44 44 0. 39 1 0. 44 0 In st itu tio na l d el iv er ie s 5. 8 0. 37 5 0. 01 2 0. 03 1 2. 53 0 1. 59 0 43 06 44 44 0. 35 2 0. 39 8 Ca es ar ea n  se ct io n 5. 9 0. 03 7 0. 00 3 0. 09 2 1. 43 6 1. 19 8 43 06 44 44 0. 03 0 0. 04 4 Pr eg na nt  w om en  s le ep in g  un de r  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 19 0. 43 2 0. 01 8 0. 04 2 1. 51 9 1. 23 3 11 18 11 36 0. 39 6 0. 46 8 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 24 0 0. 00 7 0. 02 8 2. 02 0 1. 42 1 80 32 81 56 0. 22 6 0. 25 3 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 55 4 0. 00 7 0. 01 3 4. 55 1 2. 13 3 22 47 6 22 47 6 0. 54 0 0. 56 8 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 17 0 0. 00 5 0. 03 1 3. 64 4 1. 90 9 18 88 6 18 36 6 0. 15 9 0. 18 0 W om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 02 3 0. 00 1 0. 06 4 2. 19 7 1. 48 2 22 47 6 22 47 6 0. 02 0 0. 02 6 Se xu al ly  a ct iv e  yo un g  w om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 03 8 0. 00 4 0. 11 4 2. 03 4 1. 42 6 37 31 39 19 0. 03 0 0. 04 7 Se x  be fo re  a ge  1 5  am on g  yo un g  w om en 9. 11 0. 06 4 0. 00 4 0. 05 8 1. 88 7 1. 37 4 80 32 81 56 0. 05 7 0. 07 2 To ta l f er til ity  r at e ‐ 3. 17 0. 07 0. 02 2 3. 31 2 1. 82 0 63 27 9 62 83 5 3. 03 3. 31 A do le sc en t b ir th  r at es  (A SF R  15 ‐1 9) 5. 1 0. 09 4 0. 00 4 0. 04 1 2. 04 5 1. 43 0 12 47 6 12 68 8 0. 08 7 0. 10 2 N eo na ta l m or ta lit y 1. 3 31 .8 2. 9 0. 09 0 1. 08 4 1. 04 1 44 01 45 45 26 .1 37 .6 Po st ‐n eo na ta l m or ta lit y 1. 4 36 .2 3. 2 0. 08 9 1. 24 5 1. 11 6 44 24 45 66 29 .8 42 .7 In fa nt  m or ta lit y 1. 2 68 .1 4. 4 0. 06 4 1. 20 3 1. 09 7 44 28 45 70 59 .3 76 .8 Ch ild  m or ta lit y 1. 5 11 .4 1. 8 0. 15 8 1. 23 0 1. 10 9 44 32 45 80 7. 8 15 .0 U nd er  fi ve  m or ta lit y 1. 1 78 .7 4. 7 0. 05 9 1. 23 7 1. 11 2 44 63 46 09 69 .4 88 .1 316 r - 2 se r + 2 se Li te ra cy  r at e  am on g  yo un g  m en 7. 1 0. 77 4 0. 01 1 0. 01 4 2. 36 3 1. 53 7 36 76 36 82 0. 75 3 0. 79 5 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 66 4 0. 00 6 0. 00 9 1. 61 4 1. 27 0 99 51 99 51 0. 65 2 0. 67 6 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 14 6 0. 00 5 0. 03 5 1. 62 9 1. 27 6 78 32 78 00 0. 13 5 0. 15 6 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 95 3 0. 00 4 0. 00 4 3. 19 2 1. 78 7 99 51 99 51 0. 94 5 0. 96 0 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 27 6 0. 01 0 0. 03 5 1. 76 7 1. 32 9 36 76 36 82 0. 25 7 0. 29 6 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 57 0 0. 00 8 0. 01 3 2. 36 7 1. 53 8 99 51 99 51 0. 55 5 0. 58 6 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 14 2 0. 00 5 0. 03 6 1. 89 4 1. 37 6 91 02 90 84 0. 13 2 0. 15 2 M en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 02 2 0. 00 2 0. 08 8 1. 74 0 1. 31 9 99 51 99 51 0. 01 8 0. 02 6 Se xu al ly  a ct iv e  yo un g  m en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 02 6 0. 00 5 0. 17 8 1. 35 0 1. 16 2 15 35 16 09 0. 01 7 0. 03 5 Se x  be fo re  a ge  1 5  am on g  yo un g  m en 9. 11 0. 02 7 0. 00 3 0. 11 6 1. 37 9 1. 17 4 36 76 36 82 0. 02 1 0. 03 3 U nd er w ei gh t p re va le nc e 2. 1a 0. 26 6 0. 00 8 0. 03 0 3. 50 1 1. 87 1 10 81 4 10 81 4 0. 25 0 0. 28 2 St un tin g  pr ev al en ce 2. 2a 0. 44 2 0. 00 8 0. 01 8 2. 60 1 1. 61 3 10 61 8 10 61 3 0. 42 6 0. 45 7 W as tin g  pr ev al en ce 2. 3a 0. 05 9 0. 00 3 0. 05 3 1. 88 6 1. 37 3 10 67 1 10 68 3 0. 05 3 0. 06 6 Ex cl us iv e  br ea st fe ed in g  un de r  6  m on th s 2. 6 0. 40 4 0. 01 7 0. 04 1 1. 36 0 1. 16 6 11 82 11 68 0. 37 1 0. 43 8 A ge ‐a pp ro pr ia te  b re as tf ee di ng 2. 14 0. 36 7 0. 01 0 0. 02 7 1. 90 3 1. 38 0 44 48 44 33 0. 34 7 0. 38 7 Tu be rc ul os is  im m un iz at io n  co ve ra ge ‐ 0. 78 3 0. 01 3 0. 01 6 2. 04 7 1. 43 1 21 35 21 66 0. 75 8 0. 80 8 Re ce iv ed  p ol io  im m un iz at io n ‐ 0. 52 6 0. 01 6 0. 03 0 2. 12 4 1. 45 7 21 36 21 65 0. 49 4 0. 55 7 Re ce iv ed  D PT ‐H ep B‐ H ib  im m un iz at io n ‐ 0. 55 5 0. 01 6 0. 02 9 2. 22 5 1. 49 2 21 33 21 63 0. 52 3 0. 58 7 Re ce iv ed  m ea sl es  im m un iz at io n ‐ 0. 63 7 0. 01 4 0. 02 2 1. 85 1 1. 36 0 21 33 21 61 0. 60 9 0. 66 5 D ia rr ho ea  in  th e  pr ev io us  2  w ee ks ‐ 0. 10 0 0. 00 4 0. 03 7 1. 67 2 1. 29 3 11 06 7 11 06 7 0. 09 3 0. 10 8 Ill ne ss  w ith  a  c ou gh  in  th e  pr ev io us  2  w ee ks ‐ 0. 03 3 0. 00 3 0. 08 6 2. 80 1 1. 67 4 11 06 7 11 06 7 0. 02 7 0. 03 8 Fe ve r  in  la st  tw o  w ee ks ‐ 0. 14 2 0. 00 5 0. 03 7 2. 48 5 1. 57 6 11 06 7 11 06 7 0. 13 1 0. 15 2 O ra l r eh yd ra tio n  th er ap y  w ith  c on tin ue d  fe ed in g 3. 8 0. 57 4 0. 01 9 0. 03 3 1. 67 0 1. 29 2 11 09 11 69 0. 53 6 0. 61 1 C on fid en ce li m its S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) U N D E R -5 s M IC S In di ca to r O ra l r eh yd ra tio n  th er ap y  w ith  c on tin ue d  fe ed in g 3. 8 0. 57 4 0. 01 9 0. 03 3 1. 67 0 1. 29 2 11 09 11 69 0. 53 6 0. 61 1 A nt ib io tic  tr ea tm en t o f s us pe ct ed  p ne um on ia 3. 10 0. 57 4 0. 04 2 0. 07 3 2. 66 3 1. 63 2 36 3 36 7 0. 49 0 0. 65 9 Ch ild re n  un de r  ag e  5  sl ee pi ng  u nd er  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 15 0. 43 2 0. 01 1 0. 02 5 5. 05 4 2. 24 8 10 49 0 10 59 8 0. 41 1 0. 45 4 A nt i‐m al ar ia l t re at m en t o f c hi ld re n  un de r  ag e  5 3. 18 0. 01 2 0. 00 3 0. 27 3 1. 35 5 1. 16 4 15 67 15 51 0. 00 5 0. 01 8 Su pp or t f or  le ar ni ng 6. 1 0. 57 4 0. 01 3 0. 02 3 3. 17 0 1. 78 0 44 26 44 76 0. 54 8 0. 60 1 A tt en da nc e  to  e ar ly  c hi ld ho od  e du ca tio n 6. 7 0. 23 0 0. 01 0 0. 04 2 2. 41 1 1. 55 3 44 26 44 76 0. 21 1 0. 25 0 Bi rt h  re gi st ra tio n 8. 1 0. 74 8 0. 00 8 0. 01 1 4. 14 2 2. 03 5 11 06 7 11 06 7 0. 73 1 0. 76 4 317 Ta bl e S E .3 : S am pl in g er ro rs : U rb an a re as r - 2 se r + 2 se Io di ze d  sa lt  co ns um pt io n  2. 16 0. 86 6  0. 01 0  0. 01 2 4. 30 7 2. 07 5 51 33 46 94 0. 84 5 0. 88 6 H ou se ho ld  a va ila bi lit y  of  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 12 0. 37 6  0. 01 6  0. 04 3 5. 29 3 2. 30 1 51 77 47 30 0. 34 4 0. 40 8 U se  o f i m pr ov ed  d ri nk in g  w at er  s ou rc es 4. 1 0. 87 6  0. 01 2  0. 01 4 6. 56 4 2. 56 2 24 84 5 47 30 0. 85 2 0. 90 1 U se  o f i m pr ov ed  s an ita tio n 4. 3 0. 88 0  0. 01 1  0. 01 3 5. 79 5 2. 40 7 24 84 5 47 30 0. 85 7 0. 90 2 Se co nd ar y  sc ho ol  n et  a tt en da nc e  ra tio  (a dj us te d) 7. 5 0. 72 4  0. 01 5  0. 02 1 4. 07 3 2. 01 8 37 62 36 62 0. 69 4 0. 75 4 Pr ev al en ce  o f c hi ld re n  w ith  o ne  o r  bo th  p ar en ts  d ea d 9. 18 0. 04 7  0. 00 4  0. 08 0 2. 60 3 1. 61 3 87 69 83 95 0. 03 9 0. 05 4 Vi ol en t d is ci pl in e 8. 5 0. 74 3  0. 01 2  0. 01 6 2. 35 1 1. 53 3 61 35 31 94 0. 71 9 0. 76 7 Li te ra cy  r at e  am on g  yo un g  w om en 7. 1 0. 90 6  0. 01 0  0. 01 1 2. 52 5 1. 58 9 23 56 21 38 0. 88 5 0. 92 6 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 64 7  0. 00 9  0. 01 4 2. 28 9 1. 51 3 66 49 59 70 0. 62 8 0. 66 6 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 23 2  0. 01 0  0. 04 2 2. 51 3 1. 58 5 54 20 47 91 0. 21 3 0. 25 1 Ch ild re n  ev er  b or n ‐ 1. 70 4  0. 03 8  0. 02 2 2. 38 5 1. 54 4 66 49 59 70 1. 62 8 1. 78 0 Ch ild re n  liv in g ‐ 1. 54 9  0. 03 2  0. 02 1 2. 24 7 1. 49 9 66 49 59 70 1. 48 5 1. 61 4 Ch ild re n  ev er  b or n  to  w om en  a ge  4 0‐ 49 ‐ 3. 58 5  0. 08 8  0. 02 4 2. 03 8 1. 42 7 13 98 12 58 3. 41 0 3. 76 1 Ea rl y  ch ild be ar in g 5. 2 0. 05 9  0. 00 8  0. 13 5 1. 08 7 1. 04 2 11 27 95 9 0. 04 3 0. 07 5 Pr eg na nt  w om en ‐ 0. 03 6  0. 00 3  0. 08 7 1. 67 4 1. 29 4 66 49 59 70 0. 03 0 0. 04 2 W an t n o  m or e  ch ild re n ‐ 0. 55 4  0. 01 0  0. 01 8 1. 53 7 1. 24 0 43 01 39 33 0. 53 4 0. 57 4 W an t t o  de la y  bi rt h  at  le as t 2  y ea rs ‐ 0. 21 7  0. 00 8  0. 03 7 1. 48 2 1. 21 7 43 01 39 33 0. 20 1 0. 23 3 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 97 6  0. 00 3  0. 00 4 3. 11 7 1. 76 6 66 49 59 70 0. 96 9 0. 98 3 Co nt ra ce pt iv e  pr ev al en ce 5. 3 0. 52 6  0. 01 2  0. 02 3 2. 33 8 1. 52 9 43 01 39 33 0. 50 1 0. 55 0 S ta nd ar d er ro rs , c oe ffi ci en ts o f v ar ia tio n, d es ig n ef fe ct s (d ef f), s qu ar e ro ot o f d es ig n ef fe ct s (d ef t) an d co nf id en ce in te rv al s fo r s el ec te d in di ca to rs , L ao P D R 2 01 1- 12 M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W O M E N W ei gh te d co un t U nw ei gh te d co un t C on fid en ce li m its H O U S E H O LD S H O U S E H O LD M E M B E R S U nm et  n ee d 5. 4 0. 19 2  0. 00 8  0. 04 0 1. 50 0 1. 22 5 43 01 39 33 0. 17 7 0. 20 8 A nt en at al  c ar e  co ve ra ge  ‐  at  le as t o nc e  by  s ki lle d  pe rs on ne l 5. 5a 0. 83 4  0. 02 2  0. 02 7 3. 16 7 1. 78 0 95 7 89 0 0. 79 0 0. 87 8 A nt en at al  c ar e  co ve ra ge  –  a t l ea st  fo ur  ti m es  b y  an y  pr ov id er 5. 5b 0. 70 6  0. 02 3  0. 03 2 2. 25 7 1. 50 2 95 7 89 0 0. 66 0 0. 75 2 Sk ill ed  a tt en da nt  a t d el iv er y 5. 7 0. 79 6  0. 02 0  0. 02 5 2. 25 1 1. 50 0 95 7 89 0 0. 75 6 0. 83 7 In st itu tio na l d el iv er ie s 5. 8 0. 74 2  0. 02 2  0. 02 9 2. 17 7 1. 47 6 95 7 89 0 0. 69 8 0. 78 5 Ca es ar ea n  se ct io n 5. 9 0. 10 0  0. 01 2  0. 12 1 1. 44 3 1. 20 1 95 7 89 0 0. 07 6 0. 12 5 Pr eg na nt  w om en  s le ep in g  un de r  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 19 0. 32 6  0. 04 1  0. 12 5 1. 58 6 1. 25 9 23 4 21 1 0. 24 4 0. 40 7 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 38 7  0. 01 4  0. 03 5 1. 69 0 1. 30 0 23 56 21 38 0. 35 9 0. 41 4 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 65 4  0. 01 3  0. 01 9 4. 21 4 2. 05 3 66 49 59 70 0. 62 9 0. 67 9 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 22 9  0. 01 1  0. 04 7 3. 61 3 1. 90 1 63 38 56 22 0. 20 8 0. 25 0 W om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 05 0  0. 00 4  0. 08 4 2. 24 2 1. 49 7 66 49 59 70 0. 04 2 0. 05 9 Se xu al ly  a ct iv e  yo un g  w om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 09 5  0. 01 6  0. 17 0 2. 21 1 1. 48 7 78 5 72 9 0. 06 3 0. 12 8 Se x  be fo re  a ge  1 5  am on g  yo un g  w om en 9. 11 0. 02 1  0. 00 4  0. 18 3 1. 52 6 1. 23 5 23 56 21 38 0. 01 3 0. 02 9 To ta l f er til ity  r at e ‐ 2. 21 0. 08 0. 03 6 1. 66 2 1. 28 9 18 75 9 16 75 9 2. 05 2. 37 A do le sc en t b ir th  r at es  (A SF R  15 ‐1 9) 5. 1 0. 04 4 0. 00 5 0. 11 3 1. 81 4 1. 35 5 35 09 32 35 0. 03 4 0. 05 4 N eo na ta l m or ta lit y 1. 3 22 .5 4. 3 0. 19 2 1. 49 8 1. 22 4 21 93 20 35 13 .8 31 .1 Po st ‐n eo na ta l m or ta lit y 1. 4 16 .1 3. 8 0. 23 8 1. 80 4 1. 34 3 21 94 20 37 8. 5 23 .8 In fa nt  m or ta lit y 1. 2 38 .6 5. 6 0. 14 4 1. 49 6 1. 22 3 21 94 20 38 27 .5 49 .7 Ch ild  m or ta lit y 1. 5 6. 5 2. 1 0. 33 2 1. 33 2 1. 15 4 22 02 20 40 2. 2 10 .7 U nd er  fi ve  m or ta lit y 1. 1 44 .8 6. 2 0. 13 9 1. 63 8 1. 28 0 22 04 20 44 32 .4 57 .2 318 r - 2 se r + 2 se Li te ra cy  r at e  am on g  yo un g  m en 7. 1 0. 92 0  0. 01 1  0. 01 2 1. 49 7 1. 22 3 10 39 94 7 0. 89 9 0. 94 2 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 58 7  0. 01 4  0. 02 3 1. 92 1 1. 38 6 28 00 25 17 0. 56 0 0. 61 5 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 07 3  0. 00 8  0. 11 0 1. 86 7 1. 36 6 22 24 19 72 0. 05 7 0. 08 9 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 97 2  0. 00 4  0. 00 5 1. 86 6 1. 36 6 28 00 25 17 0. 96 3 0. 98 1 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 39 5  0. 02 2  0. 05 5 1. 87 3 1. 36 8 10 39 94 7 0. 35 1 0. 43 8 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 64 0  0. 01 4  0. 02 2 2. 15 2 1. 46 7 28 00 25 17 0. 61 2 0. 66 8 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 20 4  0. 01 0  0. 05 1 1. 61 8 1. 27 2 27 20 24 51 0. 18 3 0. 22 5 M en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 04 6  0. 00 5  0. 11 3 1. 52 6 1. 23 5 28 00 25 17 0. 03 5 0. 05 6 Se xu al ly  a ct iv e  yo un g  m en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 04 0  0. 01 1  0. 28 0 1. 14 5 1. 07 0 39 8 35 4 0. 01 8 0. 06 2 Se x  be fo re  a ge  1 5  am on g  yo un g  m en 9. 11 0. 01 4  0. 00 5  0. 36 8 1. 77 1 1. 33 1 10 39 94 7 0. 00 4 0. 02 4 U nd er w ei gh t p re va le nc e 2. 1a 0. 16 1  0. 00 9  0. 05 7 1. 28 2 1. 13 2 22 63 20 31 0. 14 3 0. 18 0 St un tin g  pr ev al en ce 2. 2a 0. 27 4  0. 01 2  0. 04 4 1. 42 6 1. 19 4 22 13 19 88 0. 25 0 0. 29 8 W as tin g  pr ev al en ce 2. 3a 0. 05 4  0. 00 6  0. 10 9 1. 34 5 1. 16 0 22 14 19 89 0. 04 2 0. 06 6 Ex cl us iv e  br ea st fe ed in g  un de r  6  m on th s 2. 6 0. 38 2  0. 03 9  0. 10 2 1. 37 0 1. 17 1 23 9 21 3 0. 30 4 0. 46 1 A ge ‐a pp ro pr ia te  b re as tf ee di ng 2. 14 0. 29 4  0. 02 1  0. 07 0 1. 89 6 1. 37 7 10 15 91 5 0. 25 3 0. 33 6 Tu be rc ul os is  im m un iz at io n  co ve ra ge ‐ 0. 86 3  0. 02 2  0. 02 5 1. 86 2 1. 36 5 50 5 46 7 0. 81 9 0. 90 6 Re ce iv ed  p ol io  im m un iz at io n ‐ 0. 63 8  0. 03 1  0. 04 9 1. 98 2 1. 40 8 50 6 46 8 0. 57 5 0. 70 0 Re ce iv ed  D PT ‐H ep B‐ H ib  im m un iz at io n ‐ 0. 67 7  0. 03 0  0. 04 4 1. 89 1 1. 37 5 50 6 46 8 0. 61 8 0. 73 7 Re ce iv ed  m ea sl es  im m un iz at io n ‐ 0. 71 7  0. 02 8  0. 04 0 1. 85 3 1. 36 1 50 6 46 9 0. 66 0 0. 77 3 D ia rr ho ea  in  th e  pr ev io us  2  w ee ks ‐ 0. 05 4  0. 00 6  0. 10 4 1. 30 2 1. 14 1 23 19 20 81 0. 04 3 0. 06 6 Ill ne ss  w ith  a  c ou gh  in  th e  pr ev io us  2  w ee ks ‐ 0. 02 1  0. 00 4  0. 18 5 1. 52 4 1. 23 5 23 19 20 81 0. 01 3 0. 02 9 Fe ve r  in  la st  tw o  w ee ks ‐ 0. 15 8  0. 01 2  0. 07 5 2. 18 2 1. 47 7 23 19 20 81 0. 13 4 0. 18 1 C on fid en ce li m its S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t M E N U N D E R -5 s M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) O ra l r eh yd ra tio n  th er ap y  w ith  c on tin ue d  fe ed in g 3. 8 0. 71 2  0. 05 5  0. 07 7 1. 79 7 1. 34 1 12 6 12 3 0. 60 2 0. 82 2 A nt ib io tic  tr ea tm en t o f s us pe ct ed  p ne um on ia 3. 10 0. 74 3  0. 08 7  0. 11 7 1. 94 7 1. 39 5 49 50 0. 56 9 0. 91 8 Ch ild re n  un de r  ag e  5  sl ee pi ng  u nd er  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 15 0. 31 0  0. 01 9  0. 06 2 3. 48 4 1. 86 6 22 48 20 28 0. 27 1 0. 34 8 A nt i‐m al ar ia l t re at m en t o f c hi ld re n  un de r  ag e  5 3. 18 0. 01 0  0. 00 6  0. 55 2 1. 02 3 1. 01 2 36 6 32 0 0. 00 0 0. 02 2 Su pp or t f or  le ar ni ng 6. 1 0. 77 5  0. 02 2  0. 02 8 2. 16 7 1. 47 2 88 5 78 8 0. 73 1 0. 81 9 A tt en da nc e  to  e ar ly  c hi ld ho od  e du ca tio n 6. 7 0. 54 7  0. 02 7  0. 05 0 2. 37 8 1. 54 2 88 5 78 8 0. 49 2 0. 60 2 Bi rt h  re gi st ra tio n 8. 1 0. 87 8  0. 01 4  0. 01 6 3. 61 3 1. 90 1 23 19 20 81 0. 85 1 0. 90 5 319 Ta bl e S E .4 : S am pl in g er ro rs : R ur al a re as r - 2 se r + 2 se Io di ze d  sa lt  co ns um pt io n  2. 16 0. 76 9  0. 00 9  0. 01 1 5. 83 3 2. 41 5 13 54 1 13 99 9 0. 75 1 0. 78 6 H ou se ho ld  a va ila bi lit y  of  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 12 0. 54 9  0. 01 1  0. 02 0 7. 10 7 2. 66 6 13 66 6 14 11 3 0. 52 7 0. 57 2 U se  o f i m pr ov ed  d ri nk in g  w at er  s ou rc es 4. 1 0. 63 8  0. 01 4  0. 02 2 11 .8 13 3. 43 7 72 57 6 14 11 3 0. 61 0 0. 66 6 U se  o f i m pr ov ed  s an ita tio n 4. 3 0. 46 3  0. 01 3  0. 02 7 9. 15 2 3. 02 5 72 57 6 14 11 3 0. 43 8 0. 48 9 Se co nd ar y  sc ho ol  n et  a tt en da nc e  ra tio  (a dj us te d) 7. 5 0. 36 2  0. 01 0  0. 02 7 5. 33 7 2. 31 0 12 36 5 13 02 1 0. 34 2 0. 38 1 Pr ev al en ce  o f c hi ld re n  w ith  o ne  o r  bo th  p ar en ts  d ea d 9. 18 0. 05 5  0. 00 2  0. 03 9 3. 14 9 1. 77 4 33 07 1 35 01 6 0. 05 0 0. 05 9 Vi ol en t d is ci pl in e 8. 5 0. 76 1  0. 00 6  0. 00 8 2. 55 0 1. 59 7 25 23 3 11 35 3 0. 74 8 0. 77 3 Li te ra cy  r at e  am on g  yo un g  w om en 7. 1 0. 59 7  0. 01 3  0. 02 2 4. 13 3 2. 03 3 56 76 60 18 0. 57 1 0. 62 2 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 76 2  0. 00 4  0. 00 6 1. 82 4 1. 35 0 15 82 7 16 50 6 0. 75 3 0. 77 1 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 42 9  0. 00 6  0. 01 5 2. 17 4 1. 47 4 12 64 1 13 12 7 0. 41 6 0. 44 1 Ch ild re n  ev er  b or n ‐ 2. 77 8  0. 03 2  0. 01 1 2. 36 4 1. 53 8 15 82 7 16 50 6 2. 71 4 2. 84 1 Ch ild re n  liv in g ‐ 2. 31 6  0. 02 5  0. 01 1 2. 22 5 1. 49 2 15 82 7 16 50 6 2. 26 6 2. 36 6 Ch ild re n  ev er  b or n  to  w om en  a ge  4 0‐ 49 ‐ 5. 28 5  0. 07 2  0. 01 4 2. 14 7 1. 46 5 33 25 33 64 5. 14 1 5. 42 8 Ea rl y  ch ild be ar in g 5. 2 0. 23 7  0. 01 1  0. 04 4 1. 60 9 1. 26 9 24 90 26 39 0. 21 6 0. 25 8 Pr eg na nt  w om en ‐ 0. 05 8  0. 00 2  0. 03 6 1. 34 5 1. 16 0 15 82 7 16 50 6 0. 05 4 0. 06 2 W an t n o  m or e  ch ild re n ‐ 0. 58 8  0. 00 6  0. 01 0 1. 88 1 1. 37 1 12 06 6 12 61 7 0. 57 6 0. 60 0 W an t t o  de la y  bi rt h  at  le as t 2  y ea rs ‐ 0. 18 5  0. 00 4  0. 02 4 1. 59 5 1. 26 3 12 06 6 12 61 7 0. 17 7 0. 19 4 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 92 4  0. 00 5  0. 00 6 6. 78 2 2. 60 4 15 82 7 16 50 6 0. 91 4 0. 93 5 Co nt ra ce pt iv e  pr ev al en ce 5. 3 0. 48 8  0. 00 8  0. 01 7 3. 28 3 1. 81 2 12 06 6 12 61 7 0. 47 1 0. 50 4 S ta nd ar d er ro rs , c oe ffi ci en ts o f v ar ia tio n, d es ig n ef fe ct s (d ef f), s qu ar e ro ot o f d es ig n ef fe ct s (d ef t) an d co nf id en ce in te rv al s fo r s el ec te d in di ca to rs , L ao P D R 2 01 1- 12 M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W O M E N W ei gh te d co un t U nw ei gh te d co un t C on fid en ce li m its H O U S E H O LD S H O U S E H O LD M E M B E R S U nm et  n ee d 5. 4 0. 20 2  0. 00 6  0. 02 8 2. 46 7 1. 57 1 12 06 6 12 61 7 0. 19 1 0. 21 3 A nt en at al  c ar e  co ve ra ge  ‐  at  le as t o nc e  by  s ki lle d  pe rs on ne l 5. 5a 0. 45 9  0. 01 4  0. 03 0 2. 78 6 1. 66 9 33 49 35 54 0. 43 1 0. 48 7 A nt en at al  c ar e  co ve ra ge  –  a t l ea st  fo ur  ti m es  b y  an y  pr ov id er 5. 5b 0. 27 2  0. 01 2  0. 04 5 2. 64 0 1. 62 5 33 49 35 54 0. 24 8 0. 29 6 Sk ill ed  a tt en da nt  a t d el iv er y 5. 7 0. 30 7  0. 01 3  0. 04 2 2. 79 7 1. 67 2 33 49 35 54 0. 28 1 0. 33 2 In st itu tio na l d el iv er ie s 5. 8 0. 27 0  0. 01 2  0. 04 5 2. 60 6 1. 61 4 33 49 35 54 0. 24 6 0. 29 4 Ca es ar ea n  se ct io n 5. 9 0. 01 9  0. 00 3  0. 13 9 1. 31 1 1. 14 5 33 49 35 54 0. 01 3 0. 02 4 Pr eg na nt  w om en  s le ep in g  un de r  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 19 0. 46 0  0. 02 0  0. 04 4 1. 49 2 1. 22 1 88 4 92 5 0. 42 0 0. 50 0 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 17 9  0. 00 7  0. 04 1 2. 17 4 1. 47 4 56 76 60 18 0. 16 4 0. 19 3 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 51 2  0. 00 8  0. 01 7 4. 72 3 2. 17 3 15 82 7 16 50 6 0. 49 5 0. 52 9 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 14 0  0. 00 6  0. 04 1 3. 47 6 1. 86 4 12 54 8 12 74 4 0. 12 8 0. 15 1 W om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 01 2  0. 00 1  0. 09 4 1. 73 1 1. 31 6 15 82 7 16 50 6 0. 01 0 0. 01 4 Se xu al ly  a ct iv e  yo un g  w om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 02 3  0. 00 3  0. 14 0 1. 49 2 1. 22 2 29 46 31 90 0. 01 7 0. 03 0 Se x  be fo re  a ge  1 5  am on g  yo un g  w om en 9. 11 0. 08 2  0. 00 5  0. 06 1 1. 99 0 1. 41 1 56 76 60 18 0. 07 2 0. 09 2 To ta l f er til ity  r at e ‐ 3. 58 0. 08 0. 02 3 3. 35 3 1. 83 1 44 52 0 46 09 8 3. 41 3. 74 A do le sc en t b ir th  r at es  (A SF R  15 ‐1 9) 5. 1 0. 11 4 0. 00 5 0. 04 1 1. 90 2 1. 37 9 89 67 94 53 0. 10 5 0. 12 4 N eo na ta l m or ta lit y 1. 3 38 .9 2. 6 0. 06 6 1. 29 3 1. 13 7 87 89 93 68 33 .8 44 .1 Po st ‐n eo na ta l m or ta lit y 1. 4 46 .3 3. 2 0. 06 9 1. 86 0 1. 36 4 88 07 93 84 39 .9 52 .7 In fa nt  m or ta lit y 1. 2 85 .2 4. 1 0. 04 8 1. 60 3 1. 26 6 88 10 93 87 77 .1 93 .4 Ch ild  m or ta lit y 1. 5 15 .9 1. 5 0. 09 4 1. 29 5 1. 13 8 88 49 94 47 12 .9 18 .8 U nd er  fi ve  m or ta lit y 1. 1 99 .7 4. 2 0. 04 2 1. 53 5 1. 23 9 88 73 94 69 91 .3 10 8. 2 320 r - 2 se r + 2 se Li te ra cy  r at e  am on g  yo un g  m en 7. 1 0. 71 7  0. 01 4  0. 01 9 2. 46 1 1. 56 9 26 37 27 35 0. 68 9 0. 74 4 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 69 4  0. 00 6  0. 00 9 1. 41 1 1. 18 8 71 51 74 34 0. 68 2 0. 70 7 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 17 5  0. 00 6  0. 03 6 1. 62 8 1. 27 6 56 08 58 28 0. 16 2 0. 18 7 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 94 5  0. 00 5  0. 00 5 3. 51 4 1. 87 4 71 51 74 34 0. 93 5 0. 95 5 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 22 9  0. 01 0  0. 04 5 1. 66 4 1. 29 0 26 37 27 35 0. 20 9 0. 25 0 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 54 3  0. 00 9  0. 01 7 2. 46 2 1. 56 9 71 51 74 34 0. 52 5 0. 56 1 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 11 5  0. 00 6  0. 04 8 2. 00 9 1. 41 7 63 82 66 33 0. 10 4 0. 12 6 M en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 01 3  0. 00 2  0. 14 0 1. 87 6 1. 37 0 71 51 74 34 0. 00 9 0. 01 6 Se xu al ly  a ct iv e  yo un g  m en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 02 1  0. 00 5  0. 23 1 1. 42 5 1. 19 4 11 37 12 55 0. 01 1 0. 03 0 Se x  be fo re  a ge  1 5  am on g  yo un g  m en 9. 11 0. 03 2  0. 00 4  0. 12 1 1. 32 8 1. 15 2 26 37 27 35 0. 02 5 0. 04 0 U nd er w ei gh t p re va le nc e 2. 1a 0. 29 3  0. 00 9  0. 03 2 3. 73 8 1. 93 4 85 51 87 83 0. 27 5 0. 31 2 St un tin g  pr ev al en ce 2. 2a 0. 48 6  0. 00 9  0. 01 8 2. 65 7 1. 63 0 84 05 86 25 0. 46 8 0. 50 3 W as tin g  pr ev al en ce 2. 3a 0. 06 1  0. 00 4  0. 06 0 2. 01 7 1. 42 0 84 57 86 94 0. 05 3 0. 06 8 Ex cl us iv e  br ea st fe ed in g  un de r  6  m on th s 2. 6 0. 41 0  0. 01 9  0. 04 5 1. 35 7 1. 16 5 94 3 95 5 0. 37 3 0. 44 7 A ge ‐a pp ro pr ia te  b re as tf ee di ng 2. 14 0. 38 9  0. 01 1  0. 02 9 1. 86 3 1. 36 5 34 34 35 18 0. 36 6 0. 41 1 Tu be rc ul os is  im m un iz at io n  co ve ra ge ‐ 0. 75 8  0. 01 5  0. 02 0 2. 12 1 1. 45 6 16 31 16 99 0. 72 8 0. 78 9 Re ce iv ed  p ol io  im m un iz at io n ‐ 0. 49 1  0. 01 8  0. 03 6 2. 16 5 1. 47 1 16 30 16 97 0. 45 5 0. 52 7 Re ce iv ed  D PT ‐H ep B‐ H ib  im m un iz at io n ‐ 0. 51 7  0. 01 9  0. 03 6 2. 33 4 1. 52 8 16 28 16 95 0. 47 9 0. 55 4 Re ce iv ed  m ea sl es  im m un iz at io n ‐ 0. 61 2  0. 01 6  0. 02 6 1. 87 6 1. 37 0 16 27 16 92 0. 58 0 0. 64 5 D ia rr ho ea  in  th e  pr ev io us  2  w ee ks ‐ 0. 11 2  0. 00 4  0. 03 9 1. 70 3 1. 30 5 87 48 89 86 0. 10 4 0. 12 1 Ill ne ss  w ith  a  c ou gh  in  th e  pr ev io us  2  w ee ks ‐ 0. 03 6  0. 00 3  0. 09 5 3. 02 9 1. 74 0 87 48 89 86 0. 02 9 0. 04 3 Fe ve r  in  la st  tw o  w ee ks ‐ 0. 13 7  0. 00 6  0. 04 2 2. 54 5 1. 59 5 87 48 89 86 0. 12 6 0. 14 9 C on fid en ce li m its S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t M E N U N D E R -5 s M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) Fe ve r  in  la st  tw o  w ee ks 0. 13 7  0. 00 6  0. 04 2 2. 54 5 1. 59 5 87 48 89 86 0. 12 6 0. 14 9 O ra l r eh yd ra tio n  th er ap y  w ith  c on tin ue d  fe ed in g 3. 8 0. 55 6  0. 02 0  0. 03 5 1. 63 3 1. 27 8 98 3 10 46 0. 51 7 0. 59 5 A nt ib io tic  tr ea tm en t o f s us pe ct ed  p ne um on ia 3. 10 0. 54 8  0. 04 6  0. 08 3 2. 65 0 1. 62 8 31 4 31 7 0. 45 7 0. 63 9 Ch ild re n  un de r  ag e  5  sl ee pi ng  u nd er  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 15 0. 46 6  0. 01 3  0. 02 7 5. 63 3 2. 37 3 82 43 85 70 0. 44 0 0. 49 1 A nt i‐m al ar ia l t re at m en t o f c hi ld re n  un de r  ag e  5 3. 18 0. 01 2  0. 00 4  0. 31 2 1. 45 4 1. 20 6 12 01 12 31 0. 00 4 0. 01 9 Su pp or t f or  le ar ni ng 6. 1 0. 52 4  0. 01 5  0. 02 8 3. 23 5 1. 79 9 35 40 36 88 0. 49 5 0. 55 4 A tt en da nc e  to  e ar ly  c hi ld ho od  e du ca tio n 6. 7 0. 15 1  0. 00 9  0. 06 0 2. 38 7 1. 54 5 35 40 36 88 0. 13 3 0. 16 9 Bi rt h  re gi st ra tio n 8. 1 0. 71 3  0. 01 0  0. 01 4 4. 35 8 2. 08 8 87 48 89 86 0. 69 3 0. 73 3 321 Ta bl e S E .5 : S am pl in g er ro rs : R ur al a re as w ith r oa ds r - 2 se r + 2 se Io di ze d  sa lt  co ns um pt io n  2. 16 0. 76 6  0. 00 9  0. 01 2 6. 00 6 2. 45 1 12 18 7 12 47 3 0. 74 8 0. 78 5 H ou se ho ld  a va ila bi lit y  of  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 12 0. 53 9  0. 01 2  0. 02 2 7. 08 0 2. 66 1 12 28 5 12 56 6 0. 51 6 0. 56 3 U se  o f i m pr ov ed  d ri nk in g  w at er  s ou rc es 4. 1 0. 66 4  0. 01 5  0. 02 2 12 .0 10 3. 46 6 64 86 6 12 56 6 0. 63 5 0. 69 3 U se  o f i m pr ov ed  s an ita tio n 4. 3 0. 49 2  0. 01 4  0. 02 8 9. 65 3 3. 10 7 64 86 6 12 56 6 0. 46 4 0. 52 0 Se co nd ar y  sc ho ol  n et  a tt en da nc e  ra tio  (a dj us te d) 7. 5 0. 38 3  0. 01 1  0. 02 8 5. 48 5 2. 34 2 11 04 7 11 53 0 0. 36 2 0. 40 4 Pr ev al en ce  o f c hi ld re n  w ith  o ne  o r  bo th  p ar en ts  d ea d 9. 18 0. 05 4  0. 00 2  0. 04 2 3. 06 5 1. 75 1 29 20 7 30 52 7 0. 05 0 0. 05 9 Vi ol en t d is ci pl in e 8. 5 0. 75 8  0. 00 7  0. 00 9 2. 53 2 1. 59 1 22 20 8 10 05 7 0. 74 4 0. 77 1 Li te ra cy  r at e  am on g  yo un g  w om en 7. 1 0. 61 5  0. 01 4  0. 02 2 4. 26 4 2. 06 5 51 53 54 05 0. 58 8 0. 64 2 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 76 0  0. 00 5  0. 00 6 1. 83 2 1. 35 3 14 26 8 14 72 3 0. 75 1 0. 77 0 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 42 8  0. 00 7  0. 01 6 2. 25 3 1. 50 1 11 41 2 11 71 6 0. 41 4 0. 44 2 Ch ild re n  ev er  b or n ‐ 2. 71 0  0. 03 3  0. 01 2 2. 40 7 1. 55 2 14 26 8 14 72 3 2. 64 3 2. 77 7 Ch ild re n  liv in g ‐ 2. 27 0  0. 02 6  0. 01 2 2. 27 1 1. 50 7 14 26 8 14 72 3 2. 21 7 2. 32 2 Ch ild re n  ev er  b or n  to  w om en  a ge  4 0‐ 49 ‐ 5. 19 7  0. 07 6  0. 01 5 2. 21 4 1. 48 8 29 90 29 98 5. 04 5 5. 34 9 Ea rl y  ch ild be ar in g 5. 2 0. 22 9  0. 01 1  0. 04 8 1. 62 6 1. 27 5 22 98 23 98 0. 20 7 0. 25 1 Pr eg na nt  w om en ‐ 0. 05 7  0. 00 2  0. 03 9 1. 36 6 1. 16 9 14 26 8 14 72 3 0. 05 3 0. 06 2 W an t n o  m or e  ch ild re n ‐ 0. 58 6  0. 00 6  0. 01 1 1. 80 1 1. 34 2 10 84 5 11 22 1 0. 57 3 0. 59 8 W an t t o  de la y  bi rt h  at  le as t 2  y ea rs ‐ 0. 18 7  0. 00 5  0. 02 5 1. 58 2 1. 25 8 10 84 5 11 22 1 0. 17 8 0. 19 6 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 93 2  0. 00 5  0. 00 5 6. 11 2 2. 47 2 14 26 8 14 72 3 0. 92 2 0. 94 3 Co nt ra ce pt iv e  pr ev al en ce 5. 3 0. 50 2  0. 00 9  0. 01 7 3. 37 9 1. 83 8 10 84 5 11 22 1 0. 48 4 0. 51 9 S ta nd ar d er ro rs , c oe ffi ci en ts o f v ar ia tio n, d es ig n ef fe ct s (d ef f), s qu ar e ro ot o f d es ig n ef fe ct s (d ef t) an d co nf id en ce in te rv al s fo r s el ec te d in di ca to rs , L ao P D R 2 01 1- 12 M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W O M E N W ei gh te d co un t U nw ei gh te d co un t C on fid en ce li m its H O U S E H O LD S H O U S E H O LD M E M B E R S U nm et  n ee d 5. 4 0. 19 3  0. 00 6  0. 03 1 2. 56 9 1. 60 3 10 84 5 11 22 1 0. 18 1 0. 20 5 A nt en at al  c ar e  co ve ra ge  ‐  at  le as t o nc e  by  s ki lle d  pe rs on ne l 5. 5a 0. 49 7  0. 01 5  0. 03 1 2. 92 6 1. 71 0 29 28 30 67 0. 46 6 0. 52 8 A nt en at al  c ar e  co ve ra ge  –  a t l ea st  fo ur  ti m es  b y  an y  pr ov id er 5. 5b 0. 29 7  0. 01 4  0. 04 6 2. 77 0 1. 66 4 29 28 30 67 0. 27 0 0. 32 5 Sk ill ed  a tt en da nt  a t d el iv er y 5. 7 0. 33 3  0. 01 5  0. 04 4 2. 96 3 1. 72 1 29 28 30 67 0. 30 3 0. 36 2 In st itu tio na l d el iv er ie s 5. 8 0. 29 2  0. 01 4  0. 04 6 2. 72 8 1. 65 2 29 28 30 67 0. 26 5 0. 31 9 Ca es ar ea n  se ct io n 5. 9 0. 02 1  0. 00 3  0. 14 0 1. 30 2 1. 14 1 29 28 30 67 0. 01 5 0. 02 7 Pr eg na nt  w om en  s le ep in g  un de r  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 19 0. 46 2  0. 02 1  0. 04 6 1. 44 5 1. 20 2 78 1 80 9 0. 42 0 0. 50 4 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 18 7  0. 00 8  0. 04 2 2. 20 1 1. 48 3 51 53 54 05 0. 17 2 0. 20 3 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 52 5  0. 00 9  0. 01 7 4. 79 0 2. 18 9 14 26 8 14 72 3 0. 50 7 0. 54 3 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 14 5  0. 00 6  0. 04 2 3. 47 0 1. 86 3 11 52 3 11 64 2 0. 13 3 0. 15 7 W om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 01 3  0. 00 1  0. 09 5 1. 72 6 1. 31 4 14 26 8 14 72 3 0. 01 0 0. 01 5 Se xu al ly  a ct iv e  yo un g  w om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 02 6  0. 00 4  0. 14 1 1. 48 6 1. 21 9 26 78 28 69 0. 01 8 0. 03 3 Se x  be fo re  a ge  1 5  am on g  yo un g  w om en 9. 11 0. 08 1  0. 00 5  0. 06 5 2. 04 3 1. 42 9 51 53 54 05 0. 07 1 0. 09 2 To ta l f er til ity  r at e ‐ 3. 44 0. 09 0. 02 5 3. 31 2 1. 82 0 40 14 9 41 11 3 3. 27 3. 61 A do le sc en t b ir th  r at es  (A SF R  15 ‐1 9) 5. 1 0. 11 2 0. 00 5 0. 04 4 1. 89 3 1. 37 6 81 17 84 58 0. 10 2 0. 12 2 N eo na ta l m or ta lit y 1. 3 39 .0 2. 8 0. 07 1 1. 30 0 1. 14 0 76 50 80 47 33 .4 44 .5 Po st ‐n eo na ta l m or ta lit y 1. 4 42 .8 3. 1 0. 07 3 1. 73 7 1. 31 8 76 65 80 60 36 .6 49 .1 In fa nt  m or ta lit y 1. 2 81 .8 4. 0 0. 04 9 1. 43 3 1. 19 7 76 66 80 61 73 .8 89 .9 Ch ild  m or ta lit y 1. 5 13 .6 1. 5 0. 10 7 1. 21 2 1. 10 1 76 94 81 09 10 .7 16 .5 U nd er  fi ve  m or ta lit y 1. 1 94 .3 4. 2 0. 04 5 1. 40 9 1. 18 7 77 11 81 24 85 .9 10 2. 8 322 r - 2 se r + 2 se Li te ra cy  r at e  am on g  yo un g  m en 7. 1 0. 73 3  0. 01 4  0. 01 9 2. 54 8 1. 59 6 23 88 24 67 0. 70 5 0. 76 2 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 69 0  0. 00 7  0. 01 0 1. 44 2 1. 20 1 64 57 66 74 0. 67 7 0. 70 4 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 16 7  0. 00 7  0. 04 0 1. 68 5 1. 29 8 50 66 52 20 0. 15 4 0. 18 1 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 95 5  0. 00 5  0. 00 5 3. 19 3 1. 78 7 64 57 66 74 0. 94 5 0. 96 4 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 23 7  0. 01 1  0. 04 6 1. 60 1 1. 26 5 23 88 24 67 0. 21 6 0. 25 9 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 55 4  0. 01 0  0. 01 7 2. 48 4 1. 57 6 64 57 66 74 0. 53 5 0. 57 3 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 11 9  0. 00 6  0. 04 9 1. 94 8 1. 39 6 58 55 60 48 0. 10 7 0. 13 0 M en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 01 3  0. 00 2  0. 14 9 1. 91 8 1. 38 5 64 57 66 74 0. 00 9 0. 01 7 Se xu al ly  a ct iv e  yo un g  m en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 02 0  0. 00 5  0. 25 1 1. 45 4 1. 20 6 10 06 11 03 0. 01 0 0. 03 1 Se x  be fo re  a ge  1 5  am on g  yo un g  m en 9. 11 0. 03 0  0. 00 4  0. 12 5 1. 18 0 1. 08 6 23 88 24 67 0. 02 2 0. 03 7 U nd er w ei gh t p re va le nc e 2. 1a 0. 29 0  0. 01 0  0. 03 5 3. 89 1 1. 97 2 74 91 75 77 0. 27 0 0. 31 1 St un tin g  pr ev al en ce 2. 2a 0. 47 8  0. 00 9  0. 02 0 2. 61 3 1. 61 7 73 64 74 42 0. 46 0 0. 49 7 W as tin g  pr ev al en ce 2. 3a 0. 06 1  0. 00 4  0. 06 5 2. 07 8 1. 44 2 74 00 74 92 0. 05 3 0. 06 9 Ex cl us iv e  br ea st fe ed in g  un de r  6  m on th s 2. 6 0. 42 4  0. 02 0  0. 04 7 1. 38 9 1. 17 8 83 9 84 0 0. 38 3 0. 46 4 A ge ‐a pp ro pr ia te  b re as tf ee di ng 2. 14 0. 39 8  0. 01 2  0. 03 1 1. 89 9 1. 37 8 30 21 30 45 0. 37 3 0. 42 2 Tu be rc ul os is  im m un iz at io n  co ve ra ge ‐ 0. 77 4  0. 01 5  0. 02 0 2. 02 0 1. 42 1 14 45 14 77 0. 74 3 0. 80 5 Re ce iv ed  p ol io  im m un iz at io n ‐ 0. 50 6  0. 01 9  0. 03 8 2. 23 2 1. 49 4 14 43 14 74 0. 46 8 0. 54 5 Re ce iv ed  D PT ‐H ep B‐ H ib  im m un iz at io n ‐ 0. 53 8  0. 02 0  0. 03 8 2. 43 0 1. 55 9 14 41 14 72 0. 49 7 0. 57 8 Re ce iv ed  m ea sl es  im m un iz at io n ‐ 0. 62 4  0. 01 7  0. 02 8 1. 84 9 1. 36 0 14 40 14 70 0. 58 9 0. 65 8 D ia rr ho ea  in  th e  pr ev io us  2  w ee ks ‐ 0. 10 5  0. 00 5  0. 04 5 1. 80 6 1. 34 4 76 61 77 49 0. 09 6 0. 11 5 Ill ne ss  w ith  a  c ou gh  in  th e  pr ev io us  2  w ee ks ‐ 0. 03 6  0. 00 4  0. 10 4 3. 12 7 1. 76 8 76 61 77 49 0. 02 9 0. 04 4 Fe ve r  in  la st  tw o  w ee ks ‐ 0. 13 5  0. 00 6  0. 04 7 2. 62 2 1. 61 9 76 61 77 49 0. 12 2 0. 14 7 C on fid en ce li m its S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t M E N U N D E R -5 s M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) Fe ve r  in  la st  tw o  w ee ks 0. 13 5  0. 00 6  0. 04 7 2. 62 2 1. 61 9 76 61 77 49 0. 12 2 0. 14 7 O ra l r eh yd ra tio n  th er ap y  w ith  c on tin ue d  fe ed in g 3. 8 0. 57 3  0. 02 2  0. 03 8 1. 60 6 1. 26 7 80 6 84 5 0. 53 0 0. 61 6 A nt ib io tic  tr ea tm en t o f s us pe ct ed  p ne um on ia 3. 10 0. 56 9  0. 05 1  0. 09 0 2. 91 1 1. 70 6 27 7 27 3 0. 46 7 0. 67 2 Ch ild re n  un de r  ag e  5  sl ee pi ng  u nd er  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 15 0. 46 1  0. 01 3  0. 02 9 5. 33 8 2. 31 0 72 26 74 03 0. 43 4 0. 48 8 A nt i‐m al ar ia l t re at m en t o f c hi ld re n  un de r  ag e  5 3. 18 0. 01 2  0. 00 4  0. 34 2 1. 49 9 1. 22 4 10 32 10 42 0. 00 4 0. 02 0 Su pp or t f or  le ar ni ng 6. 1 0. 53 7  0. 01 6  0. 03 0 3. 35 7 1. 83 2 30 92 31 62 0. 50 4 0. 56 9 A tt en da nc e  to  e ar ly  c hi ld ho od  e du ca tio n 6. 7 0. 16 4  0. 01 0  0. 06 2 2. 36 0 1. 53 6 30 92 31 62 0. 14 4 0. 18 5 Bi rt h  re gi st ra tio n 8. 1 0. 72 8  0. 01 0  0. 01 4 4. 23 7 2. 05 9 76 61 77 49 0. 70 7 0. 74 8 323 Ta bl e S E .6 : S am pl in g er ro rs : R ur al a re as w ith ou t r oa ds r - 2 se r + 2 se Io di ze d  sa lt  co ns um pt io n  2. 16 0. 79 0  0. 02 1  0. 02 6 3. 91 8 1. 97 9 13 54 15 26 0. 74 8 0. 83 1 H ou se ho ld  a va ila bi lit y  of  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 12 0. 63 8  0. 03 4  0. 05 3 7. 77 5 2. 78 8 13 80 15 47 0. 57 0 0. 70 7 U se  o f i m pr ov ed  d ri nk in g  w at er  s ou rc es 4. 1 0. 42 0  0. 04 4  0. 10 6 12 .5 22 3. 53 9 77 10 15 47 0. 33 1 0. 50 9 U se  o f i m pr ov ed  s an ita tio n 4. 3 0. 22 1  0. 03 0  0. 13 4 7. 86 8 2. 80 5 77 10 15 47 0. 16 2 0. 28 0 Se co nd ar y  sc ho ol  n et  a tt en da nc e  ra tio  (a dj us te d) 7. 5 0. 18 5  0. 02 3  0. 12 4 5. 16 3 2. 27 2 13 18 14 91 0. 13 9 0. 23 0 Pr ev al en ce  o f c hi ld re n  w ith  o ne  o r  bo th  p ar en ts  d ea d 9. 18 0. 05 7  0. 00 7  0. 11 8 3. 79 2 1. 94 7 38 63 44 89 0. 04 4 0. 07 1 Vi ol en t d is ci pl in e 8. 5 0. 78 2  0. 01 9  0. 02 4 2. 69 7 1. 64 2 30 25 12 96 0. 74 4 0. 82 0 Li te ra cy  r at e  am on g  yo un g  w om en 7. 1 0. 41 4  0. 03 6  0. 08 7 3. 28 9 1. 81 3 52 3 61 3 0. 34 2 0. 48 6 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 78 4  0. 01 2  0. 01 6 1. 62 9 1. 27 6 15 59 17 83 0. 75 9 0. 80 8 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 43 6  0. 01 5  0. 03 5 1. 32 6 1. 15 2 12 29 14 11 0. 40 5 0. 46 6 Ch ild re n  ev er  b or n ‐ 3. 39 7  0. 10 4  0. 03 0 2. 15 9 1. 46 9 15 59 17 83 3. 19 0 3. 60 4 Ch ild re n  liv in g ‐ 2. 73 8  0. 07 7  0. 02 8 1. 89 8 1. 37 8 15 59 17 83 2. 58 4 2. 89 1 Ch ild re n  ev er  b or n  to  w om en  a ge  4 0‐ 49 ‐ 6. 06 7  0. 20 1  0. 03 3 1. 58 1 1. 25 8 33 5 36 6 5. 66 6 6. 46 9 Ea rl y  ch ild be ar in g 5. 2 0. 33 7  0. 03 7  0. 11 1 1. 50 2 1. 22 6 19 2 24 1 0. 26 2 0. 41 2 Pr eg na nt  w om en ‐ 0. 06 7  0. 00 6  0. 09 6 1. 17 4 1. 08 4 15 59 17 83 0. 05 4 0. 08 0 W an t n o  m or e  ch ild re n ‐ 0. 61 2  0. 02 1  0. 03 4 2. 61 6 1. 61 8 12 22 13 96 0. 57 0 0. 65 4 W an t t o  de la y  bi rt h  at  le as t 2  y ea rs ‐ 0. 17 0  0. 01 3  0. 07 7 1. 70 2 1. 30 5 12 22 13 96 0. 14 4 0. 19 6 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 85 1  0. 02 8  0. 03 3 10 .8 53 3. 29 4 15 59 17 83 0. 79 5 0. 90 6 Co nt ra ce pt iv e  pr ev al en ce 5. 3 0. 36 4  0. 02 2  0. 06 0 2. 88 5 1. 69 8 12 22 13 96 0. 32 0 0. 40 7 S ta nd ar d er ro rs , c oe ffi ci en ts o f v ar ia tio n, d es ig n ef fe ct s (d ef f), s qu ar e ro ot o f d es ig n ef fe ct s (d ef t) an d co nf id en ce in te rv al s fo r s el ec te d in di ca to rs , L ao P D R 2 01 1- 12 M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W O M E N W ei gh te d co un t U nw ei gh te d co un t C on fid en ce li m its H O U S E H O LD S H O U S E H O LD M E M B E R S U nm et  n ee d 5. 4 0. 27 6  0. 01 6  0. 05 9 1. 87 4 1. 36 9 12 22 13 96 0. 24 3 0. 30 9 A nt en at al  c ar e  co ve ra ge  ‐  at  le as t o nc e  by  s ki lle d  pe rs on ne l 5. 5a 0. 19 0  0. 02 7  0. 14 0 2. 23 3 1. 49 4 42 1 48 7 0. 13 7 0. 24 3 A nt en at al  c ar e  co ve ra ge  –  a t l ea st  fo ur  ti m es  b y  an y  pr ov id er 5. 5b 0. 09 9  0. 01 9  0. 18 7 1. 87 4 1. 36 9 42 1 48 7 0. 06 2 0. 13 6 Sk ill ed  a tt en da nt  a t d el iv er y 5. 7 0. 12 4  0. 01 9  0. 15 2 1. 59 5 1. 26 3 42 1 48 7 0. 08 7 0. 16 2 In st itu tio na l d el iv er ie s 5. 8 0. 11 6  0. 01 8  0. 15 4 1. 50 6 1. 22 7 42 1 48 7 0. 08 0 0. 15 2 Ca es ar ea n  se ct io n 5. 9 0. 00 0  0. 00 0  0. 00 0 na na 42 1 48 7 0. 00 0 0. 00 0 Pr eg na nt  w om en  s le ep in g  un de r  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 19 0. 44 6  0. 06 3  0. 14 1 1. 84 1 1. 35 7 10 3 11 6 0. 32 0 0. 57 1 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 09 2  0. 01 4  0. 15 7 1. 51 6 1. 23 1 52 3 61 3 0. 06 3 0. 12 1 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 39 0  0. 02 5  0. 06 3 4. 59 2 2. 14 3 15 59 17 83 0. 34 1 0. 44 0 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 07 9  0. 01 6  0. 19 8 3. 71 8 1. 92 8 10 25 11 02 0. 04 8 0. 11 1 W om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 00 2  0. 00 1  0. 59 2 0. 95 3 0. 97 6 15 59 17 83 0. 00 0 0. 00 3 Se xu al ly  a ct iv e  yo un g  w om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 00 2  0. 00 2  1. 01 2 0. 66 0 0. 81 2 26 8 32 1 0. 00 0 0. 00 6 Se x  be fo re  a ge  1 5  am on g  yo un g  w om en 9. 11 0. 09 0  0. 01 4  0. 15 6 1. 46 6 1. 21 1 52 3 61 3 0. 06 2 0. 11 8 To ta l f er til ity  r at e ‐ 4. 78 0. 27 0. 05 7 3. 21 1 1. 79 2 43 71 49 85 4. 23 5. 33 A do le sc en t b ir th  r at es  (A SF R  15 ‐1 9) 5. 1 0. 13 7 0. 01 6 0. 11 3 1. 92 9 1. 38 9 85 0 99 6 0. 10 6 0. 16 8 N eo na ta l m or ta lit y 1. 3 38 .7 7. 0 0. 18 0 1. 30 9 1. 14 4 11 39 13 21 24 .8 52 .7 Po st ‐n eo na ta l m or ta lit y 1. 4 69 .6 13 .0 0. 18 7 2. 61 1 1. 61 6 11 42 13 24 43 .5 95 .6 In fa nt  m or ta lit y 1. 2 10 8. 3 16 .9 0. 15 6 2. 69 9 1. 64 3 11 44 13 26 74 .5 14 2. 0 Ch ild  m or ta lit y 1. 5 31 .0 5. 6 0. 17 9 1. 43 0 1. 19 6 11 55 13 38 19 .9 42 .2 U nd er  fi ve  m or ta lit y 1. 1 13 6. 0 16 .3 0. 12 0 2. 29 2 1. 51 4 11 62 13 45 10 3. 4 16 8. 5 324 r - 2 se r + 2 se Li te ra cy  r at e  am on g  yo un g  m en 7. 1 0. 55 5  0. 04 2  0. 07 5 1. 89 0 1. 37 5 24 9 26 8 0. 47 1 0. 63 8 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 73 4  0. 01 6  0. 02 2 1. 01 2 1. 00 6 69 4 76 0 0. 70 2 0. 76 6 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 24 3  0. 01 8  0. 07 5 1. 10 9 1. 05 3 54 2 60 8 0. 20 6 0. 28 0 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 85 9  0. 02 7  0. 03 2 4. 72 3 2. 17 3 69 4 76 0 0. 80 4 0. 91 4 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 15 3  0. 03 4  0. 22 3 2. 39 5 1. 54 7 24 9 26 8 0. 08 5 0. 22 1 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 43 7  0. 02 8  0. 06 3 2. 37 4 1. 54 1 69 4 76 0 0. 38 2 0. 49 3 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 07 8  0. 01 9  0. 25 1 3. 10 3 1. 76 2 52 7 58 5 0. 03 9 0. 11 7 M en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 01 2  0. 00 5  0. 39 8 1. 40 2 1. 18 4 69 4 76 0 0. 00 2 0. 02 1 Se xu al ly  a ct iv e  yo un g  m en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 02 3  0. 01 4  0. 57 8 1. 21 3 1. 10 1 13 1 15 2 0. 00 0 0. 05 1 Se x  be fo re  a ge  1 5  am on g  yo un g  m en 9. 11 0. 05 9  0. 02 1  0. 35 5 2. 09 1 1. 44 6 24 9 26 8 0. 01 7 0. 10 0 U nd er w ei gh t p re va le nc e 2. 1a 0. 31 6  0. 02 2  0. 07 1 2. 77 8 1. 66 7 10 61 12 06 0. 27 1 0. 36 0 St un tin g  pr ev al en ce 2. 2a 0. 53 8  0. 02 5  0. 04 7 3. 07 9 1. 75 5 10 42 11 83 0. 48 8 0. 58 9 W as tin g  pr ev al en ce 2. 3a 0. 05 7  0. 00 8  0. 14 0 1. 41 4 1. 18 9 10 57 12 02 0. 04 1 0. 07 3 Ex cl us iv e  br ea st fe ed in g  un de r  6  m on th s 2. 6 0. 30 1  0. 04 4  0. 14 7 1. 06 5 1. 03 2 10 4 11 5 0. 21 2 0. 39 0 A ge ‐a pp ro pr ia te  b re as tf ee di ng 2. 14 0. 32 3  0. 02 6  0. 07 9 1. 40 5 1. 18 5 41 3 47 3 0. 27 2 0. 37 4 Tu be rc ul os is  im m un iz at io n  co ve ra ge ‐ 0. 63 9  0. 05 3  0. 08 4 2. 73 6 1. 65 4 18 5 22 2 0. 53 2 0. 74 6 Re ce iv ed  p ol io  im m un iz at io n ‐ 0. 37 1  0. 03 9  0. 10 6 1. 45 8 1. 20 7 18 7 22 3 0. 29 3 0. 44 9 Re ce iv ed  D PT ‐H ep B‐ H ib  im m un iz at io n ‐ 0. 35 5  0. 03 9  0. 11 1 1. 49 7 1. 22 4 18 7 22 3 0. 27 6 0. 43 3 Re ce iv ed  m ea sl es  im m un iz at io n ‐ 0. 52 5  0. 04 7  0. 08 9 1. 95 7 1. 39 9 18 6 22 2 0. 43 1 0. 61 9 D ia rr ho ea  in  th e  pr ev io us  2  w ee ks ‐ 0. 16 3  0. 01 2  0. 07 2 1. 26 2 1. 12 3 10 86 12 37 0. 14 0 0. 18 7 Ill ne ss  w ith  a  c ou gh  in  th e  pr ev io us  2  w ee ks ‐ 0. 03 4  0. 00 7  0. 22 0 2. 11 0 1. 45 3 10 86 12 37 0. 01 9 0. 04 9 Fe ve r  in  la st  tw o  w ee ks ‐ 0. 15 6  0. 01 4  0. 09 2 1. 93 3 1. 39 0 10 86 12 37 0. 12 7 0. 18 4 C on fid en ce li m its S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t M E N U N D E R -5 s M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) Fe ve r  in  la st  tw o  w ee ks 0. 15 6  0. 01 4  0. 09 2 1. 93 3 1. 39 0 10 86 12 37 0. 12 7 0. 18 4 O ra l r eh yd ra tio n  th er ap y  w ith  c on tin ue d  fe ed in g 3. 8 0. 48 1  0. 04 7  0. 09 8 1. 76 2 1. 32 7 17 8 20 1 0. 38 7 0. 57 4 A nt ib io tic  tr ea tm en t o f s us pe ct ed  p ne um on ia 3. 10 (0 .3 91 ) (0 .1 06 ) (0 .2 71 ) (2 .0 31 ) (1 .4 25 ) 37 44 (0 .1 79 ) (0 .6 03 ) Ch ild re n  un de r  ag e  5  sl ee pi ng  u nd er  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 15 0. 49 9  0. 04 2  0. 08 3 8. 10 9 2. 84 8 10 17 11 67 0. 41 6 0. 58 3 A nt i‐m al ar ia l t re at m en t o f c hi ld re n  un de r  ag e  5 3. 18 0. 01 1  0. 00 8  0. 71 8 1. 06 9 1. 03 4 16 9 18 9 0. 00 0 0. 02 7 Su pp or t f or  le ar ni ng 6. 1 0. 43 8  0. 03 6  0. 08 2 2. 74 4 1. 65 7 44 8 52 6 0. 36 6 0. 51 0 A tt en da nc e  to  e ar ly  c hi ld ho od  e du ca tio n 6. 7 0. 06 0  0. 02 0  0. 33 1 3. 70 1 1. 92 4 44 8 52 6 0. 02 0 0. 10 0 Bi rt h  re gi st ra tio n 8. 1 0. 61 1  0. 03 0  0. 04 8 4. 54 7 2. 13 2 10 86 12 37 0. 55 2 0. 67 0 325 Ta bl e S E .7 : S am pl in g er ro rs : N or th r eg io n r - 2 se r + 2 se Io di ze d  sa lt  co ns um pt io n  2. 16 0. 82 4  0. 00 8  0. 01 0 3. 17 9 1. 78 3 60 28 73 64 0. 80 9 0. 84 0 H ou se ho ld  a va ila bi lit y  of  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 12 0. 58 3  0. 01 5  0. 02 6 7. 16 7 2. 67 7 60 65 74 08 0. 55 2 0. 61 4 U se  o f i m pr ov ed  d ri nk in g  w at er  s ou rc es 4. 1 0. 79 4  0. 01 7  0. 02 2 13 .3 79 3. 65 8 31 31 0 74 08 0. 76 0 0. 82 8 U se  o f i m pr ov ed  s an ita tio n 4. 3 0. 59 7  0. 01 7  0. 02 9 9. 32 9 3. 05 4 31 31 0 74 08 0. 56 3 0. 63 2 Se co nd ar y  sc ho ol  n et  a tt en da nc e  ra tio  (a dj us te d) 7. 5 0. 43 3  0. 01 4  0. 03 2 4. 98 4 2. 23 2 52 23 64 88 0. 40 6 0. 46 1 Pr ev al en ce  o f c hi ld re n  w ith  o ne  o r  bo th  p ar en ts  d ea d 9. 18 0. 05 5  0. 00 3  0. 05 2 2. 62 8 1. 62 1 13 83 5 17 09 6 0. 04 9 0. 06 0 Vi ol en t d is ci pl in e 8. 5 0. 79 5  0. 00 8  0. 01 0 2. 15 2 1. 46 7 10 52 7 58 16 0. 77 9 0. 81 0 Li te ra cy  r at e  am on g  yo un g  w om en 7. 1 0. 65 2  0. 01 6  0. 02 5 3. 70 8 1. 92 6 25 73 32 21 0. 62 0 0. 68 5 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 77 2  0. 00 5  0. 00 7 1. 50 4 1. 22 7 70 57 87 93 0. 76 1 0. 78 3 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 44 5  0. 00 8  0. 01 8 1. 85 3 1. 36 1 56 54 70 34 0. 42 9 0. 46 1 Ch ild re n  ev er  b or n ‐ 2. 60 1  0. 03 6  0. 01 4 1. 81 5 1. 34 7 70 57 87 93 2. 52 9 2. 67 2 Ch ild re n  liv in g ‐ 2. 17 8  0. 02 9  0. 01 3 1. 76 9 1. 33 0 70 57 87 93 2. 12 1 2. 23 5 Ch ild re n  ev er  b or n  to  w om en  a ge  4 0‐ 49 ‐ 5. 01 4  0. 08 6  0. 01 7 1. 74 4 1. 32 1 14 24 17 80 4. 84 2 5. 18 6 Ea rl y  ch ild be ar in g 5. 2 0. 26 0  0. 01 3  0. 05 2 1. 37 6 1. 17 3 11 70 14 62 0. 23 3 0. 28 7 Pr eg na nt  w om en ‐ 0. 04 8  0. 00 3  0. 05 5 1. 32 0 1. 14 9 70 57 87 93 0. 04 3 0. 05 3 W an t n o  m or e  ch ild re n ‐ 0. 63 5  0. 00 7  0. 01 1 1. 53 0 1. 23 7 54 46 67 78 0. 62 0 0. 64 9 W an t t o  de la y  bi rt h  at  le as t 2  y ea rs ‐ 0. 17 5  0. 00 6  0. 03 3 1. 57 2 1. 25 4 54 46 67 78 0. 16 4 0. 18 7 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 93 8  0. 00 6  0. 00 7 5. 69 1 2. 38 6 70 57 87 93 0. 92 6 0. 95 0 Co nt ra ce pt iv e pr ev al en ce 5 3 0 57 0 0 01 0 0 01 8 2 81 7 1 67 8 54 46 67 78 0 55 0 0 59 0 S ta nd ar d er ro rs , c oe ffi ci en ts o f v ar ia tio n, d es ig n ef fe ct s (d ef f), s qu ar e ro ot o f d es ig n ef fe ct s (d ef t) an d co nf id en ce in te rv al s fo r s el ec te d in di ca to rs , L ao P D R 2 01 1- 12 M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W O M E N W ei gh te d co un t U nw ei gh te d co un t C on fid en ce li m its H O U S E H O LD S H O U S E H O LD M E M B E R S Co nt ra ce pt iv e  pr ev al en ce 5. 3 0. 57 0  0. 01 0  0. 01 8 2. 81 7 1. 67 8 54 46 67 78 0. 55 0 0. 59 0 U nm et  n ee d 5. 4 0. 16 7  0. 00 6  0. 03 5 1. 67 4 1. 29 4 54 46 67 78 0. 15 6 0. 17 9 A nt en at al  c ar e  co ve ra ge  ‐  at  le as t o nc e  by  s ki lle d  pe rs on ne l 5. 5a 0. 45 0  0. 01 9  0. 04 3 2. 63 3 1. 62 3 13 77 17 24 0. 41 1 0. 48 9 A nt en at al  c ar e  co ve ra ge  –  a t l ea st  fo ur  ti m es  b y  an y  pr ov id er 5. 5b 0. 28 7  0. 01 7  0. 05 9 2. 43 9 1. 56 2 13 77 17 24 0. 25 3 0. 32 1 Sk ill ed  a tt en da nt  a t d el iv er y 5. 7 0. 31 0  0. 01 7  0. 05 6 2. 42 2 1. 55 6 13 77 17 24 0. 27 6 0. 34 5 In st itu tio na l d el iv er ie s 5. 8 0. 27 7  0. 01 6  0. 05 7 2. 15 3 1. 46 7 13 77 17 24 0. 24 5 0. 30 9 Ca es ar ea n  se ct io n 5. 9 0. 02 3  0. 00 4  0. 17 3 1. 19 2 1. 09 2 13 77 17 24 0. 01 5 0. 03 1 Pr eg na nt  w om en  s le ep in g  un de r  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 19 0. 48 1  0. 03 0  0. 06 3 1. 50 3 1. 22 6 33 4 41 5 0. 42 1 0. 54 2 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 24 2  0. 01 0  0. 04 3 1. 89 0 1. 37 5 25 73 32 21 0. 22 2 0. 26 3 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 54 4  0. 01 1  0. 02 0 4. 06 9 2. 01 7 70 57 87 93 0. 52 2 0. 56 5 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 12 6  0. 00 8  0. 06 1 3. 66 6 1. 91 5 55 97 68 56 0. 11 0 0. 14 1 W om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 01 0  0. 00 1  0. 11 9 1. 25 4 1. 12 0 70 57 87 93 0. 00 8 0. 01 2 Se xu al ly  a ct iv e  yo un g  w om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 01 4  0. 00 3  0. 22 0 1. 23 1 1. 10 9 14 01 17 68 0. 00 8 0. 02 1 Se x  be fo re  a ge  1 5  am on g  yo un g  w om en 9. 11 0. 09 4  0. 00 7  0. 07 2 1. 71 8 1. 31 1 25 73 32 21 0. 08 0 0. 10 7 To ta l f er til ity  r at e ‐ 3. 15 0. 10 0. 03 1 2. 70 9 1. 64 6 19 89 4 24 81 6 2. 95 3. 35 A do le sc en t b ir th  r at es  (A SF R  15 ‐1 9) 5. 1 0. 12 0 0. 00 6 0. 05 1 1. 66 9 1. 29 2 39 85 50 19 0. 10 7 0. 13 2 N eo na ta l m or ta lit y 1. 3 48 .5 3. 9 0. 08 0 1. 18 6 1. 08 9 35 92 45 13 40 .7 56 .2 Po st ‐n eo na ta l m or ta lit y 1. 4 37 .8 3. 1 0. 08 1 1. 08 0 1. 03 9 35 94 45 17 31 .7 43 .9 In fa nt  m or ta lit y 1. 2 86 .3 5. 0 0. 05 8 1. 19 0 1. 09 1 35 97 45 20 76 .2 96 .3 Ch ild  m or ta lit y 1. 5 19 .1 2. 3 0. 12 3 1. 22 5 1. 10 7 36 20 45 52 14 .4 23 .8 U nd er  fi ve  m or ta lit y 1. 1 10 3. 7 5. 5 0. 05 3 1. 28 4 1. 13 3 36 27 45 62 92 .7 11 4. 8 326 r - 2 se r + 2 se Li te ra cy  r at e  am on g  yo un g  m en 7. 1 0. 78 7  0. 01 5  0. 01 9 1. 92 1 1. 38 6 11 33 14 69 0. 75 8 0. 81 7 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 71 2  0. 00 8  0. 01 2 1. 41 0 1. 18 8 31 72 40 55 0. 69 5 0. 72 9 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 18 0  0. 00 7  0. 04 2 1. 22 5 1. 10 7 25 54 32 50 0. 16 5 0. 19 4 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 96 2  0. 00 4  0. 00 4 1. 56 6 1. 25 1 31 72 40 55 0. 95 5 0. 97 0 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 27 9  0. 01 5  0. 05 3 1. 57 2 1. 25 4 11 33 14 69 0. 24 9 0. 30 8 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 56 0  0. 01 1  0. 02 0 1. 99 3 1. 41 2 31 72 40 55 0. 53 8 0. 58 2 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 08 0  0. 00 5  0. 06 9 1. 45 7 1. 20 7 28 17 35 70 0. 06 9 0. 09 1 M en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 01 2  0. 00 2  0. 16 4 1. 30 1 1. 14 1 31 72 40 55 0. 00 8 0. 01 6 Se xu al ly  a ct iv e  yo un g  m en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 01 3  0. 00 4  0. 30 7 1. 05 4 1. 02 6 62 3 82 6 0. 00 5 0. 02 2 Se x  be fo re  a ge  1 5  am on g  yo un g  m en 9. 11 0. 04 6  0. 00 6  0. 13 0 1. 19 5 1. 09 3 11 33 14 69 0. 03 4 0. 05 8 U nd er w ei gh t p re va le nc e 2. 1a 0. 26 2  0. 00 8  0. 03 2 1. 50 7 1. 22 8 34 52 41 65 0. 24 5 0. 27 8 St un tin g  pr ev al en ce 2. 2a 0. 51 4  0. 01 1  0. 02 1 1. 94 7 1. 39 5 33 87 40 76 0. 49 2 0. 53 6 W as tin g  pr ev al en ce 2. 3a 0. 05 3  0. 00 4  0. 07 6 1. 32 2 1. 15 0 34 15 41 17 0. 04 5 0. 06 1 Ex cl us iv e  br ea st fe ed in g  un de r  6  m on th s 2. 6 0. 60 5  0. 02 8  0. 04 6 1. 38 6 1. 17 7 35 5 42 9 0. 54 9 0. 66 0 A ge ‐a pp ro pr ia te  b re as tf ee di ng 2. 14 0. 41 4  0. 01 4  0. 03 3 1. 31 9 1. 14 8 13 96 16 81 0. 38 7 0. 44 2 Tu be rc ul os is  im m un iz at io n  co ve ra ge ‐ 0. 78 9  0. 01 9  0. 02 4 1. 87 8 1. 37 0 69 5 84 2 0. 75 0 0. 82 7 Re ce iv ed  p ol io  im m un iz at io n ‐ 0. 55 5  0. 02 5  0. 04 4 2. 05 9 1. 43 5 69 3 83 9 0. 50 6 0. 60 4 Re ce iv ed  D PT ‐H ep B‐ H ib  im m un iz at io n ‐ 0. 56 2  0. 02 5  0. 04 4 2. 12 6 1. 45 8 69 4 84 1 0. 51 2 0. 61 1 Re ce iv ed  m ea sl es  im m un iz at io n ‐ 0. 62 1  0. 02 2  0. 03 6 1. 73 3 1. 31 7 68 9 83 3 0. 57 7 0. 66 5 D ia rr ho ea  in  th e  pr ev io us  2  w ee ks ‐ 0. 15 3  0. 00 8  0. 04 9 1. 84 6 1. 35 9 35 02 42 26 0. 13 8 0. 16 8 Ill ne ss  w ith  a  c ou gh  in  th e  pr ev io us  2  w ee ks ‐ 0. 02 4  0. 00 3  0. 11 4 1. 37 1 1. 17 1 35 02 42 26 0. 01 9 0. 03 0 Fe ve r  in  la st  tw o  w ee ks ‐ 0. 16 9  0. 00 9  0. 05 4 2. 46 0 1. 56 9 35 02 42 26 0. 15 1 0. 18 7 C on fid en ce li m its S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t M E N U N D E R -5 s M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) Fe ve r  in  la st  tw o  w ee ks 0. 16 9  0. 00 9  0. 05 4 2. 46 0 1. 56 9 35 02 42 26 0. 15 1 0. 18 7 O ra l r eh yd ra tio n  th er ap y  w ith  c on tin ue d  fe ed in g 3. 8 0. 61 4  0. 02 3  0. 03 8 1. 52 5 1. 23 5 53 7 65 6 0. 56 7 0. 66 1 A nt ib io tic  tr ea tm en t o f s us pe ct ed  p ne um on ia 3. 10 0. 59 9  0. 04 8  0. 08 0 1. 04 2 1. 02 1 86 11 0 0. 50 3 0. 69 5 Ch ild re n  un de r  ag e  5  sl ee pi ng  u nd er  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 15 0. 50 2  0. 01 9  0. 03 7 5. 81 3 2. 41 1 34 01 41 11 0. 46 5 0. 54 0 A nt i‐m al ar ia l t re at m en t o f c hi ld re n  un de r  ag e  5 3. 18 0. 01 3  0. 00 5  0. 34 5 1. 13 9 1. 06 7 59 0 70 2 0. 00 4 0. 02 3 Su pp or t f or  le ar ni ng 6. 1 0. 62 4  0. 01 8  0. 02 8 2. 29 4 1. 51 5 14 18 17 10 0. 58 8 0. 65 9 A tt en da nc e  to  e ar ly  c hi ld ho od  e du ca tio n 6. 7 0. 21 0  0. 01 6  0. 07 6 2. 64 9 1. 62 7 14 18 17 10 0. 17 8 0. 24 2 Bi rt h  re gi st ra tio n 8. 1 0. 67 3  0. 01 5  0. 02 2 4. 23 8 2. 05 9 35 02 42 26 0. 64 3 0. 70 3 327 Ta bl e S E .8 : S am pl in g er ro rs : C en tr al r eg io n r - 2 se r + 2 se Io di ze d  sa lt  co ns um pt io n  2. 16 0. 79 7  0. 01 2  0. 01 5 5. 87 8 2. 42 4 91 67 70 31 0. 77 3 0. 82 0 H ou se ho ld  a va ila bi lit y  of  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 12 0. 41 0  0. 01 4  0. 03 3 5. 46 2 2. 33 7 92 47 70 82 0. 38 3 0. 43 8 U se  o f i m pr ov ed  d ri nk in g  w at er  s ou rc es 4. 1 0. 64 7  0. 01 6  0. 02 4 7. 52 1 2. 74 2 46 91 9 70 82 0. 61 6 0. 67 8 U se  o f i m pr ov ed  s an ita tio n 4. 3 0. 64 6  0. 01 4  0. 02 2 6. 23 4 2. 49 7 46 91 9 70 82 0. 61 8 0. 67 5 Se co nd ar y  sc ho ol  n et  a tt en da nc e  ra tio  (a dj us te d) 7. 5 0. 50 7  0. 01 4  0. 02 7 4. 40 7 2. 09 9 75 77 59 50 0. 48 0 0. 53 4 Pr ev al en ce  o f c hi ld re n  w ith  o ne  o r  bo th  p ar en ts  d ea d 9. 18 0. 04 7  0. 00 3  0. 06 4 2. 97 2 1. 72 4 19 11 7 14 91 1 0. 04 1 0. 05 3 Vi ol en t d is ci pl in e 8. 5 0. 75 5  0. 00 9  0. 01 2 2. 25 0 1. 50 0 14 09 3 52 29 0. 73 8 0. 77 3 Li te ra cy  r at e  am on g  yo un g  w om en 7. 1 0. 76 3  0. 01 4  0. 01 9 3. 26 7 1. 80 7 39 18 29 57 0. 73 5 0. 79 1 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 71 0  0. 00 7  0. 01 0 1. 96 9 1. 40 3 11 25 5 83 93 0. 69 6 0. 72 4 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 33 4  0. 00 9  0. 02 6 2. 33 3 1. 52 7 91 30 67 52 0. 31 7 0. 35 2 Ch ild re n  ev er  b or n ‐ 2. 27 8  0. 04 1  0. 01 8 2. 48 7 1. 57 7 11 25 5 83 93 2. 19 5 2. 36 1 Ch ild re n  liv in g ‐ 1. 96 9  0. 03 3  0. 01 7 2. 41 0 1. 55 2 11 25 5 83 93 1. 90 2 2. 03 6 Ch ild re n  ev er  b or n  to  w om en  a ge  4 0‐ 49 ‐ 4. 45 6  0. 08 2  0. 01 9 1. 70 8 1. 30 7 23 99 17 63 4. 29 1 4. 62 1 Ea rl y  ch ild be ar in g 5. 2 0. 12 8  0. 01 1  0. 08 7 1. 47 1 1. 21 3 17 92 13 16 0. 10 6 0. 15 1 Pr eg na nt  w om en ‐ 0. 04 9  0. 00 3  0. 05 6 1. 36 0 1. 16 6 11 25 5 83 93 0. 04 3 0. 05 4 W an t n o  m or e  ch ild re n ‐ 0. 53 6  0. 00 9  0. 01 6 1. 74 5 1. 32 1 79 87 60 05 0. 51 9 0. 55 3 W an t t o  de la y  bi rt h  at  le as t 2  y ea rs ‐ 0. 20 5  0. 00 6  0. 02 9 1. 31 4 1. 14 6 79 87 60 05 0. 19 3 0. 21 7 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 94 1  0. 00 6  0. 00 6 4. 90 2 2. 21 4 11 25 5 83 93 0. 93 0 0. 95 2 Co nt ra ce pt iv e  pr ev al en ce 5. 3 0. 47 8  0. 01 0  0. 02 0 2. 29 6 1. 51 5 79 87 60 05 0. 45 9 0. 49 8 S ta nd ar d er ro rs , c oe ffi ci en ts o f v ar ia tio n, d es ig n ef fe ct s (d ef f), s qu ar e ro ot o f d es ig n ef fe ct s (d ef t) an d co nf id en ce in te rv al s fo r s el ec te d in di ca to rs , L ao P D R 2 01 1- 12 M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W O M E N W ei gh te d co un t U nw ei gh te d co un t C on fid en ce li m its H O U S E H O LD S H O U S E H O LD M E M B E R S U nm et  n ee d 5. 4 0. 20 6  0. 00 7  0. 03 2 1. 63 4 1. 27 8 79 87 60 05 0. 19 2 0. 21 9 A nt en at al  c ar e  co ve ra ge  ‐  at  le as t o nc e  by  s ki lle d  pe rs on ne l 5. 5a 0. 63 3  0. 02 0  0. 03 1 2. 58 9 1. 60 9 19 89 15 25 0. 59 3 0. 67 2 A nt en at al  c ar e  co ve ra ge  –  a t l ea st  fo ur  ti m es  b y  an y  pr ov id er 5. 5b 0. 46 5  0. 01 9  0. 04 0 2. 16 6 1. 47 2 19 89 15 25 0. 42 8 0. 50 3 Sk ill ed  a tt en da nt  a t d el iv er y 5. 7 0. 52 8  0. 01 9  0. 03 6 2. 17 5 1. 47 5 19 89 15 25 0. 49 0 0. 56 6 In st itu tio na l d el iv er ie s 5. 8 0. 50 0  0. 01 9  0. 03 7 2. 13 5 1. 46 1 19 89 15 25 0. 46 3 0. 53 8 Ca es ar ea n  se ct io n 5. 9 0. 05 1  0. 00 6  0. 12 1 1. 21 0 1. 10 0 19 89 15 25 0. 03 9 0. 06 4 Pr eg na nt  w om en  s le ep in g  un de r  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 19 0. 32 7  0. 03 0  0. 09 2 1. 52 9 1. 23 7 52 1 37 2 0. 26 7 0. 38 7 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 26 2  0. 01 0  0. 03 9 1. 55 9 1. 24 9 39 18 29 57 0. 24 2 0. 28 3 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 57 5  0. 01 0  0. 01 8 3. 72 2 1. 92 9 11 25 5 83 93 0. 55 4 0. 59 6 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 21 9  0. 00 8  0. 03 7 2. 90 9 1. 70 6 99 95 74 95 0. 20 3 0. 23 5 W om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 03 5  0. 00 3  0. 07 7 1. 79 6 1. 34 0 11 25 5 83 93 0. 03 0 0. 04 0 Se xu al ly  a ct iv e  yo un g  w om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 06 6  0. 00 9  0. 13 6 1. 67 9 1. 29 6 16 68 12 83 0. 04 8 0. 08 4 Se x  be fo re  a ge  1 5  am on g  yo un g  w om en 9. 11 0. 04 5  0. 00 4  0. 09 8 1. 34 7 1. 16 0 39 18 29 57 0. 03 6 0. 05 4 To ta l f er til ity  r at e ‐ 2. 91 0. 10 0. 03 4 2. 84 3 1. 68 6 31 67 3 23 48 4 2. 71 3. 11 A do le sc en t b ir th  r at es  (A SF R  15 ‐1 9) 5. 1 0. 07 9 0. 00 6 0. 07 4 1. 91 8 1. 38 5 59 45 44 94 0. 06 7 0. 09 1 N eo na ta l m or ta lit y 1. 3 26 .1 3. 4 0. 13 1 1. 34 3 1. 15 9 50 28 38 24 19 .3 33 .0 Po st ‐n eo na ta l m or ta lit y 1. 4 37 .0 3. 9 0. 10 7 1. 49 3 1. 22 2 50 41 38 33 29 .1 44 .9 In fa nt  m or ta lit y 1. 2 63 .1 5. 2 0. 08 2 1. 40 9 1. 18 7 50 42 38 34 52 .8 73 .5 Ch ild  m or ta lit y 1. 5 9. 9 1. 8 0. 18 7 1. 41 4 1. 18 9 50 54 38 44 6. 2 13 .5 U nd er  fi ve  m or ta lit y 1. 1 72 .3 5. 5 0. 07 6 1. 39 5 1. 18 1 50 69 38 55 61 .4 83 .3 328 r - 2 se r + 2 se Li te ra cy  r at e  am on g  yo un g  m en 7. 1 0. 79 4  0. 01 6  0. 02 0 2. 15 9 1. 46 9 18 66 13 92 0. 76 2 0. 82 6 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 63 5  0. 01 0  0. 01 5 1. 46 3 1. 20 9 49 90 37 11 0. 61 6 0. 65 4 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 13 3  0. 00 8  0. 06 2 1. 67 9 1. 29 6 38 88 28 72 0. 11 6 0. 14 9 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 95 5  0. 00 6  0. 00 6 2. 87 1 1. 69 4 49 90 37 11 0. 94 4 0. 96 7 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 29 3  0. 01 6  0. 05 5 1. 73 7 1. 31 8 18 66 13 92 0. 26 1 0. 32 5 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 57 0  0. 01 2  0. 02 1 2. 11 0 1. 45 3 49 90 37 11 0. 54 6 0. 59 4 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 18 8  0. 00 8  0. 04 5 1. 63 8 1. 28 0 46 68 35 25 0. 17 1 0. 20 5 M en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 03 1  0. 00 3  0. 11 2 1. 47 7 1. 21 5 49 90 37 11 0. 02 4 0. 03 8 Se xu al ly  a ct iv e  yo un g  m en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 03 3  0. 00 8  0. 24 9 1. 09 3 1. 04 5 69 2 51 3 0. 01 7 0. 05 0 Se x  be fo re  a ge  1 5  am on g  yo un g  m en 9. 11 0. 02 1  0. 00 5  0. 23 0 1. 56 0 1. 24 9 18 66 13 92 0. 01 1 0. 03 0 U nd er w ei gh t p re va le nc e 2. 1a 0. 23 1  0. 01 1  0. 04 6 2. 34 2 1. 53 0 50 23 37 45 0. 20 9 0. 25 2 St un tin g  pr ev al en ce 2. 2a 0. 38 1  0. 01 3  0. 03 3 2. 47 8 1. 57 4 49 34 36 86 0. 35 6 0. 40 6 W as tin g  pr ev al en ce 2. 3a 0. 05 4  0. 00 4  0. 07 7 1. 24 5 1. 11 6 49 41 36 88 0. 04 6 0. 06 3 Ex cl us iv e  br ea st fe ed in g  un de r  6  m on th s 2. 6 0. 32 9  0. 02 5  0. 07 7 1. 18 7 1. 08 9 55 7 40 9 0. 27 8 0. 37 9 A ge ‐a pp ro pr ia te  b re as tf ee di ng 2. 14 0. 34 3  0. 01 7  0. 04 9 1. 94 1 1. 39 3 20 78 15 60 0. 31 0 0. 37 7 Tu be rc ul os is  im m un iz at io n  co ve ra ge ‐ 0. 72 9  0. 02 2  0. 03 0 1. 77 7 1. 33 3 98 3 75 1 0. 68 6 0. 77 3 Re ce iv ed  p ol io  im m un iz at io n ‐ 0. 48 5  0. 02 2  0. 04 5 1. 45 4 1. 20 6 98 4 75 2 0. 44 1 0. 52 9 Re ce iv ed  D PT ‐H ep B‐ H ib  im m un iz at io n ‐ 0. 52 6  0. 02 2  0. 04 3 1. 52 0 1. 23 3 98 2 75 0 0. 48 1 0. 57 1 Re ce iv ed  m ea sl es  im m un iz at io n ‐ 0. 59 5  0. 02 3  0. 03 9 1. 64 6 1. 28 3 98 4 75 2 0. 54 9 0. 64 1 D ia rr ho ea  in  th e  pr ev io us  2  w ee ks ‐ 0. 07 4  0. 00 5  0. 06 7 1. 35 6 1. 16 5 51 54 38 33 0. 06 4 0. 08 4 C on fid en ce li m its S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t M E N U N D E R -5 s M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) D ia rr ho ea  in  th e  pr ev io us  2  w ee ks 0. 07 4  0. 00 5  0. 06 7 1. 35 6 1. 16 5 51 54 38 33 0. 06 4 0. 08 4 Ill ne ss  w ith  a  c ou gh  in  th e  pr ev io us  2  w ee ks ‐ 0. 03 0  0. 00 3  0. 11 1 1. 48 4 1. 21 8 51 54 38 33 0. 02 3 0. 03 7 Fe ve r  in  la st  tw o  w ee ks ‐ 0. 16 2  0. 00 8  0. 05 0 1. 86 6 1. 36 6 51 54 38 33 0. 14 6 0. 17 8 O ra l r eh yd ra tio n  th er ap y  w ith  c on tin ue d  fe ed in g 3. 8 0. 53 4  0. 03 7  0. 07 0 1. 60 0 1. 26 5 38 1 28 5 0. 45 9 0. 60 8 A nt ib io tic  tr ea tm en t o f s us pe ct ed  p ne um on ia 3. 10 0. 65 3  0. 05 5  0. 08 5 1. 27 4 1. 12 9 15 6 95 0. 54 2 0. 76 4 Ch ild re n  un de r  ag e  5  sl ee pi ng  u nd er  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 15 0. 32 8  0. 01 6  0. 04 9 4. 21 1 2. 05 2 47 99 35 99 0. 29 5 0. 36 0 A nt i‐m al ar ia l t re at m en t o f c hi ld re n  un de r  ag e  5 3. 18 0. 01 0  0. 00 5  0. 48 5 1. 36 2 1. 16 7 83 4 59 6 0. 00 0 0. 01 9 Su pp or t f or  le ar ni ng 6. 1 0. 57 1  0. 01 9  0. 03 3 2. 17 0 1. 47 3 20 55 15 29 0. 53 4 0. 60 8 A tt en da nc e  to  e ar ly  c hi ld ho od  e du ca tio n 6. 7 0. 29 7  0. 01 6  0. 05 5 1. 92 4 1. 38 7 20 55 15 29 0. 26 4 0. 32 9 Bi rt h  re gi st ra tio n 8. 1 0. 79 0  0. 01 2  0. 01 5 3. 32 9 1. 82 5 51 54 38 33 0. 76 6 0. 81 4 329 Ta bl e S E .9 : S am pl in g er ro rs : S ou th r eg io n r - 2 se r + 2 se Io di ze d  sa lt  co ns um pt io n  2. 16 0. 74 1  0. 01 5  0. 02 0 4. 93 1 2. 22 1 34 79 42 98 0. 71 2 0. 77 1 H ou se ho ld  a va ila bi lit y  of  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 12 0. 60 1  0. 02 2  0. 03 7 8. 81 5 2. 96 9 35 31 43 53 0. 55 7 0. 64 5 U se  o f i m pr ov ed  d ri nk in g  w at er  s ou rc es 4. 1 0. 67 0  0. 02 9  0. 04 3 16 .2 48 4. 03 1 19 19 2 43 53 0. 61 3 0. 72 8 U se  o f i m pr ov ed  s an ita tio n 4. 3 0. 33 5  0. 02 3  0. 06 8 10 .0 29 3. 16 7 19 19 2 43 53 0. 29 0 0. 38 0 Se co nd ar y  sc ho ol  n et  a tt en da nc e  ra tio  (a dj us te d) 7. 5 0. 32 9  0. 01 7  0. 05 2 5. 59 3 2. 36 5 33 26 42 45 0. 29 5 0. 36 3 Pr ev al en ce  o f c hi ld re n  w ith  o ne  o r  bo th  p ar en ts  d ea d 9. 18 0. 06 4  0. 00 4  0. 06 6 3. 43 2 1. 85 3 88 88 11 40 4 0. 05 5 0. 07 2 Vi ol en t d is ci pl in e 8. 5 0. 70 2  0. 01 3  0. 01 8 2. 68 1 1. 63 7 67 49 35 02 0. 67 6 0. 72 7 Li te ra cy  r at e  am on g  yo un g  w om en 7. 1 0. 55 3  0. 02 4  0. 04 4 4. 79 7 2. 19 0 15 41 19 78 0. 50 4 0. 60 2 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 70 5  0. 00 9  0. 01 3 2. 10 7 1. 45 2 41 64 52 90 0. 68 7 0. 72 3 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 33 8  0. 01 1  0. 03 2 2. 14 6 1. 46 5 32 77 41 32 0. 31 6 0. 35 9 Ch ild re n  ev er  b or n ‐ 2. 71 4  0. 05 9  0. 02 2 2. 36 2 1. 53 7 41 64 52 90 2. 59 7 2. 83 1 Ch ild re n  liv in g ‐ 2. 26 3  0. 04 2  0. 01 8 1. 84 9 1. 36 0 41 64 52 90 2. 17 9 2. 34 6 Ch ild re n  ev er  b or n  to  w om en  a ge  4 0‐ 49 ‐ 5. 28 3  0. 15 7  0. 03 0 2. 92 6 1. 71 1 89 9 10 79 4. 96 9 5. 59 6 Ea rl y  ch ild be ar in g 5. 2 0. 18 8  0. 02 1  0. 10 9 2. 26 3 1. 50 4 65 4 82 0 0. 14 7 0. 22 9 Pr eg na nt  w om en ‐ 0. 06 6  0. 00 4  0. 06 0 1. 33 4 1. 15 5 41 64 52 90 0. 05 8 0. 07 4 W an t n o  m or e  ch ild re n ‐ 0. 59 5  0. 00 9  0. 01 5 1. 30 0 1. 14 0 29 35 37 67 0. 57 7 0. 61 4 W an t t o  de la y  bi rt h  at  le as t 2  y ea rs ‐ 0. 19 7  0. 00 9  0. 04 6 1. 94 0 1. 39 3 29 35 37 67 0. 17 9 0. 21 5 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 93 9  0. 01 1  0. 01 1 10 .1 87 3. 19 2 41 64 52 90 0. 91 8 0. 96 0 Co nt ra ce pt iv e  pr ev al en ce 5. 3 0. 41 6  0. 01 7  0. 04 2 4. 62 4 2. 15 0 29 35 37 67 0. 38 2 0. 45 1 S ta nd ar d er ro rs , c oe ffi ci en ts o f v ar ia tio n, d es ig n ef fe ct s (d ef f), s qu ar e ro ot o f d es ig n ef fe ct s (d ef t) an d co nf id en ce in te rv al s fo r s el ec te d in di ca to rs , L ao P D R 2 01 1- 12 M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W O M E N W ei gh te d co un t U nw ei gh te d co un t C on fid en ce li m its H O U S E H O LD S H O U S E H O LD M E M B E R S U nm et  n ee d 5. 4 0. 24 1  0. 01 4  0. 05 7 3. 82 9 1. 95 7 29 35 37 67 0. 21 4 0. 26 8 A nt en at al  c ar e  co ve ra ge  ‐  at  le as t o nc e  by  s ki lle d  pe rs on ne l 5. 5a 0. 48 6  0. 02 8  0. 05 7 3. 65 4 1. 91 2 94 0 11 95 0. 43 0 0. 54 1 A nt en at al  c ar e  co ve ra ge  –  a t l ea st  fo ur  ti m es  b y  an y  pr ov id er 5. 5b 0. 28 3  0. 02 4  0. 08 5 3. 41 4 1. 84 8 94 0 11 95 0. 23 5 0. 33 2 Sk ill ed  a tt en da nt  a t d el iv er y 5. 7 0. 33 1  0. 02 6  0. 07 9 3. 70 2 1. 92 4 94 0 11 95 0. 27 9 0. 38 4 In st itu tio na l d el iv er ie s 5. 8 0. 25 4  0. 02 2  0. 08 8 3. 17 4 1. 78 2 94 0 11 95 0. 20 9 0. 29 9 Ca es ar ea n  se ct io n 5. 9 0. 02 7  0. 00 6  0. 22 0 1. 57 6 1. 25 6 94 0 11 95 0. 01 5 0. 03 8 Pr eg na nt  w om en  s le ep in g  un de r  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 19 0. 57 7  0. 03 1  0. 05 4 1. 36 1 1. 16 7 26 4 34 9 0. 51 5 0. 63 9 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 17 8  0. 01 5  0. 08 4 3. 03 6 1. 74 2 15 41 19 78 0. 14 8 0. 20 8 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 51 4  0. 01 8  0. 03 4 6. 52 6 2. 55 5 41 64 52 90 0. 47 9 0. 54 9 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 09 5  0. 01 0  0. 10 9 5. 00 0 2. 23 6 32 93 40 15 0. 07 4 0. 11 5 W om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 01 3  0. 00 3  0. 19 3 2. 68 6 1. 63 9 41 64 52 90 0. 00 8 0. 01 9 Se xu al ly  a ct iv e  yo un g  w om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 02 0  0. 00 6  0. 29 9 1. 56 2 1. 25 0 66 2 86 8 0. 00 8 0. 03 2 Se x  be fo re  a ge  1 5  am on g  yo un g  w om en 9. 11 0. 06 2  0. 01 1  0. 17 6 4. 06 8 2. 01 7 15 41 19 78 0. 04 1 0. 08 4 To ta l f er til ity  r at e ‐ 3. 89 0. 16 0. 04 2 3. 87 7 1. 96 9 11 71 2 14 68 3 3. 57 4. 22 A do le sc en t b ir th  r at es  (A SF R  15 ‐1 9) 5. 1 0. 09 0 0. 00 9 0. 09 5 2. 60 5 1. 62 7 25 45 31 75 0. 07 3 0. 10 7 N eo na ta l m or ta lit y 1. 3 36 .5 4. 1 0. 11 3 1. 26 3 1. 12 4 23 62 30 66 28 .2 44 .8 Po st ‐n eo na ta l m or ta lit y 1. 4 51 .2 8. 2 0. 15 9 3. 28 7 1. 81 3 23 66 30 71 34 .9 67 .5 In fa nt  m or ta lit y 1. 2 87 .7 9. 3 0. 10 6 2. 54 7 1. 59 6 23 66 30 71 69 .2 10 6. 3 Ch ild  m or ta lit y 1. 5 14 .7 2. 5 0. 17 4 1. 21 4 1. 10 2 23 77 30 91 9. 6 19 .7 U nd er  fi ve  m or ta lit y 1. 1 10 1. 1 9. 1 0. 09 0 2. 19 3 1. 48 1 23 81 30 96 83 .0 11 9. 2 330 r - 2 se r + 2 se Li te ra cy  r at e  am on g  yo un g  m en 7. 1 0. 69 7  0. 02 6  0. 03 7 2. 53 2 1. 59 1 67 7 82 1 0. 64 6 0. 74 8 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 66 3  0. 01 3  0. 02 0 1. 70 6 1. 30 6 17 89 21 85 0. 63 6 0. 68 9 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 12 0  0. 01 0  0. 08 4 1. 61 6 1. 27 1 13 90 16 78 0. 10 0 0. 14 0 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 93 0  0. 01 2  0. 01 2 4. 45 7 2. 11 1 17 89 21 85 0. 90 7 0. 95 3 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 22 6  0. 01 7  0. 07 4 1. 29 8 1. 13 9 67 7 82 1 0. 19 3 0. 25 9 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 59 0  0. 01 9  0. 03 2 3. 13 9 1. 77 2 17 89 21 85 0. 55 2 0. 62 7 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 11 7  0. 01 1  0. 09 3 2. 30 0 1. 51 6 16 17 19 89 0. 09 5 0. 13 9 M en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 01 5  0. 00 3  0. 22 4 1. 72 0 1. 31 2 17 89 21 85 0. 00 9 0. 02 2 Se xu al ly  a ct iv e  yo un g  m en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 03 7  0. 01 5  0. 39 8 1. 62 8 1. 27 6 22 0 27 0 0. 00 7 0. 06 6 Se x  be fo re  a ge  1 5  am on g  yo un g  m en 9. 11 0. 01 3  0. 00 4  0. 30 5 0. 99 6 0. 99 8 67 7 82 1 0. 00 5 0. 02 1 U nd er w ei gh t p re va le nc e 2. 1a 0. 34 7  0. 02 3  0. 06 6 6. 69 1 2. 58 7 23 39 29 04 0. 30 2 0. 39 3 St un tin g  pr ev al en ce 2. 2a 0. 46 6  0. 01 7  0. 03 7 3. 48 1 1. 86 6 22 97 28 51 0. 43 1 0. 50 1 W as tin g  pr ev al en ce 2. 3a 0. 07 9  0. 00 9  0. 11 4 3. 17 8 1. 78 3 23 15 28 78 0. 06 1 0. 09 7 Ex cl us iv e  br ea st fe ed in g  un de r  6  m on th s 2. 6 0. 29 7  0. 02 8  0. 09 3 1. 20 5 1. 09 8 27 0 33 0 0. 24 2 0. 35 3 A ge ‐a pp ro pr ia te  b re as tf ee di ng 2. 14 0. 35 1  0. 02 0  0. 05 8 2. 17 5 1. 47 5 97 4 11 92 0. 31 0 0. 39 2 Tu be rc ul os is  im m un iz at io n  co ve ra ge ‐ 0. 88 9  0. 01 6  0. 01 8 1. 46 2 1. 20 9 45 7 57 3 0. 85 8 0. 92 1 Re ce iv ed  p ol io  im m un iz at io n ‐ 0. 57 0  0. 04 1  0. 07 2 3. 91 8 1. 97 9 45 9 57 4 0. 48 8 0. 65 1 Re ce iv ed  D PT ‐H ep B‐ H ib  im m un iz at io n ‐ 0. 60 6  0. 04 2  0. 06 9 4. 18 3 2. 04 5 45 7 57 2 0. 52 3 0. 69 0 Re ce iv ed  m ea sl es  im m un iz at io n ‐ 0. 75 1  0. 02 3  0. 03 0 1. 60 0 1. 26 5 46 0 57 6 0. 70 5 0. 79 7 D ia rr ho ea  in  th e  pr ev io us  2  w ee ks ‐ 0. 07 9  0. 00 7  0. 09 4 2. 28 0 1. 51 0 24 11 30 08 0. 06 5 0. 09 4 C on fid en ce li m its S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t M E N U N D E R -5 s M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) D ia rr ho ea  in  th e  pr ev io us  2  w ee ks 0. 07 9  0. 00 7  0. 09 4 2. 28 0 1. 51 0 24 11 30 08 0. 06 5 0. 09 4 Ill ne ss  w ith  a  c ou gh  in  th e  pr ev io us  2  w ee ks ‐ 0. 05 0  0. 00 9  0. 18 7 5. 57 8 2. 36 2 24 11 30 08 0. 03 1 0. 06 9 Fe ve r  in  la st  tw o  w ee ks ‐ 0. 05 9  0. 00 6  0. 10 3 2. 01 6 1. 42 0 24 11 30 08 0. 04 7 0. 07 1 O ra l r eh yd ra tio n  th er ap y  w ith  c on tin ue d  fe ed in g 3. 8 0. 54 1  0. 04 2  0. 07 7 1. 57 9 1. 25 7 19 1 22 8 0. 45 8 0. 62 4 A nt ib io tic  tr ea tm en t o f s us pe ct ed  p ne um on ia 3. 10 0. 45 6  0. 07 7  0. 17 0 3. 89 4 1. 97 3 12 1 16 2 0. 30 1 0. 61 1 Ch ild re n  un de r  ag e  5  sl ee pi ng  u nd er  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 15 0. 54 8  0. 02 4  0. 04 4 6. 92 6 2. 63 2 22 91 28 88 0. 49 9 0. 59 7 A nt i‐m al ar ia l t re at m en t o f c hi ld re n  un de r  ag e  5 3. 18 0. 01 5  0. 01 0  0. 65 3 1. 66 7 1. 29 1 14 3 25 3 0. 00 0 0. 03 5 Su pp or t f or  le ar ni ng 6. 1 0. 50 8  0. 03 5  0. 06 9 6. 02 4 2. 45 4 95 3 12 37 0. 43 8 0. 57 7 A tt en da nc e  to  e ar ly  c hi ld ho od  e du ca tio n 6. 7 0. 11 7  0. 01 4  0. 12 3 2. 47 8 1. 57 4 95 3 12 37 0. 08 8 0. 14 6 Bi rt h  re gi st ra tio n 8. 1 0. 76 5  0. 01 9  0. 02 5 6. 05 0 2. 46 0 24 11 30 08 0. 72 7 0. 80 3 331 Ta bl e S E .1 0: S am pl in g er ro rs : V ie nt ia ne C ap ita l r - 2 se r + 2 se Io di ze d  sa lt  co ns um pt io n  2. 16 0. 89 2  0. 01 1  0. 01 2 1. 65 1 1. 28 5 24 67 13 50 0. 87 1 0. 91 4 H ou se ho ld  a va ila bi lit y  of  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 12 0. 25 0  0. 02 5  0. 10 0 4. 58 5 2. 14 1 24 97 13 66 0. 20 0 0. 30 0 U se  o f i m pr ov ed  d ri nk in g  w at er  s ou rc es 4. 1 0. 88 1  0. 02 1  0. 02 4 5. 93 8 2. 43 7 11 69 4 13 66 0. 83 9 0. 92 4 U se  o f i m pr ov ed  s an ita tio n 4. 3 0. 94 1  0. 00 8  0. 00 8 1. 46 2 1. 20 9 11 69 4 13 66 0. 92 6 0. 95 7 Se co nd ar y  sc ho ol  n et  a tt en da nc e  ra tio  (a dj us te d) 7. 5 0. 76 4  0. 02 5  0. 03 3 2. 93 2 1. 71 2 15 14 82 1 0. 71 3 0. 81 5 Pr ev al en ce  o f c hi ld re n  w ith  o ne  o r  bo th  p ar en ts  d ea d 9. 18 0. 04 4  0. 00 6  0. 13 7 1. 73 0 1. 31 5 37 03 20 27 0. 03 2 0. 05 6 Vi ol en t d is ci pl in e 8. 5 0. 76 6  0. 02 0  0. 02 6 1. 94 0 1. 39 3 26 55 86 5 0. 72 6 0. 80 7 Li te ra cy  r at e  am on g  yo un g  w om en 7. 1 0. 92 9  0. 01 6  0. 01 8 2. 31 9 1. 52 3 11 10 57 4 0. 89 6 0. 96 1 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 64 4  0. 01 5  0. 02 3 1. 66 7 1. 29 1 32 88 17 40 0. 61 4 0. 67 3 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 19 9  0. 01 4  0. 07 2 1. 86 5 1. 36 6 27 60 14 64 0. 17 1 0. 22 8 Ch ild re n  ev er  b or n ‐ 1. 47 8  0. 05 2  0. 03 5 1. 72 2 1. 31 2 32 88 17 40 1. 37 5 1. 58 2 Ch ild re n  liv in g ‐ 1. 40 7  0. 04 8  0. 03 4 1. 68 7 1. 29 9 32 88 17 40 1. 31 2 1. 50 3 Ch ild re n  ev er  b or n  to  w om en  a ge  4 0‐ 49 ‐ 3. 09 3  0. 11 9  0. 03 8 1. 47 9 1. 21 6 70 5 37 9 2. 85 5 3. 33 0 Ea rl y  ch ild be ar in g 5. 2 0. 03 8  0. 01 1  0. 29 8 1. 04 3 1. 02 1 58 3 29 8 0. 01 5 0. 06 1 Pr eg na nt  w om en ‐ 0. 03 8  0. 00 5  0. 13 7 1. 30 7 1. 14 3 32 88 17 40 0. 02 8 0. 04 9 W an t n o  m or e  ch ild re n ‐ 0. 55 8  0. 01 7  0. 03 0 1. 27 2 1. 12 8 21 16 11 27 0. 52 4 0. 59 1 W an t t o  de la y  bi rt h  at  le as t 2  y ea rs ‐ 0. 20 1  0. 01 1  0. 05 5 0. 87 0 0. 93 3 21 16 11 27 0. 17 9 0. 22 4 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 97 8  0. 00 6  0. 00 6 2. 50 2 1. 58 2 32 88 17 40 0. 96 7 0. 98 9 Co nt ra ce pt iv e  pr ev al en ce 5. 3 0. 48 9  0. 02 2  0. 04 4 2. 10 5 1. 45 1 21 16 11 27 0. 44 6 0. 53 2 S ta nd ar d er ro rs , c oe ffi ci en ts o f v ar ia tio n, d es ig n ef fe ct s (d ef f), s qu ar e ro ot o f d es ig n ef fe ct s (d ef t) an d co nf id en ce in te rv al s fo r s el ec te d in di ca to rs , L ao P D R 2 01 1- 12 M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W O M E N W ei gh te d co un t U nw ei gh te d co un t C on fid en ce li m its H O U S E H O LD S H O U S E H O LD M E M B E R S U nm et  n ee d 5. 4 0. 23 0  0. 01 5  0. 06 6 1. 45 8 1. 20 7 21 16 11 27 0. 20 0 0. 26 0 A nt en at al  c ar e  co ve ra ge  ‐  at  le as t o nc e  by  s ki lle d  pe rs on ne l 5. 5a 0. 89 8  0. 03 7  0. 04 1 3. 33 4 1. 82 6 41 5 22 3 0. 82 3 0. 97 2 A nt en at al  c ar e  co ve ra ge  –  a t l ea st  fo ur  ti m es  b y  an y  pr ov id er 5. 5b 0. 82 0  0. 04 2  0. 05 1 2. 65 1 1. 62 8 41 5 22 3 0. 73 6 0. 90 4 Sk ill ed  a tt en da nt  a t d el iv er y 5. 7 0. 85 4  0. 03 7  0. 04 3 2. 41 3 1. 55 3 41 5 22 3 0. 78 0 0. 92 7 In st itu tio na l d el iv er ie s 5. 8 0. 83 9  0. 03 8  0. 04 5 2. 36 3 1. 53 7 41 5 22 3 0. 76 3 0. 91 5 Ca es ar ea n  se ct io n 5. 9 0. 15 0  0. 02 4  0. 16 2 1. 03 0 1. 01 5 41 5 22 3 0. 10 2 0. 19 9 Pr eg na nt  w om en  s le ep in g  un de r  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 19 0. 16 5  0. 05 1  0. 30 7 1. 23 4 1. 11 1 12 6 67 0. 06 4 0. 26 7 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 40 4  0. 02 1  0. 05 3 1. 07 7 1. 03 8 11 10 57 4 0. 36 1 0. 44 7 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 63 3  0. 02 0  0. 03 2 2. 98 7 1. 72 8 32 88 17 40 0. 59 3 0. 67 3 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 25 3  0. 01 7  0. 06 6 2. 53 5 1. 59 2 32 11 17 00 0. 21 9 0. 28 6 W om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 06 4  0. 00 7  0. 10 7 1. 37 1 1. 17 1 32 88 17 40 0. 05 1 0. 07 8 Se xu al ly  a ct iv e  yo un g  w om en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 13 4  0. 02 7  0. 20 0 1. 15 7 1. 07 6 36 3 18 8 0. 08 1 0. 18 8 Se x  be fo re  a ge  1 5  am on g  yo un g  w om en 9. 11 0. 02 2  0. 00 6  0. 27 3 0. 97 5 0. 98 8 11 10 57 4 0. 01 0 0. 03 5 To ta l f er til ity  r at e ‐ 2. 03 0. 14 0. 06 7 1. 58 3 1. 25 8 93 71 49 83 1. 76 2. 31 A do le sc en t b ir th  r at es  (A SF R  15 ‐1 9) 5. 1 0. 03 7 0. 00 7 0. 19 6 1. 36 7 1. 16 9 16 49 85 1 0. 02 2 0. 05 1 N eo na ta l m or ta lit y 1. 3 15 .3 4. 9 0. 32 1 0. 86 5 0. 93 0 10 12 53 8 5. 5 25 .2 Po st ‐n eo na ta l m or ta lit y 1. 4 (1 1. 6) (4 .6 ) (0 .4 02 ) (1 .0 51 ) (1 .0 25 ) 10 12 53 8 (2 .3 ) (2 0. 8) In fa nt  m or ta lit y 1. 2 (2 6. 9) (6 .3 ) (0 .2 33 ) (0 .8 35 ) (0 .9 14 ) 10 12 53 8 (1 4. 4) (3 9. 4) Ch ild  m or ta lit y 1. 5 (4 .8 ) (4 .9 ) (1 .0 08 ) (2 .3 69 ) (1 .5 39 ) 10 14 53 9 (0 .0 ) (1 4. 5) U nd er  fi ve  m or ta lit y 1. 1 (3 1. 6) (8 .7 ) (0 .2 77 ) (1 .3 39 ) (1 .1 57 ) 10 14 53 9 (1 4. 1) (4 9. 1) 332 r - 2 se r + 2 se Li te ra cy  r at e  am on g  yo un g  m en 7. 1 0. 95 2  0. 01 7  0. 01 8 1. 66 0 1. 28 8 50 4 27 3 0. 91 9 0. 98 5 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 58 9  0. 02 2  0. 03 7 1. 43 2 1. 19 7 13 79 73 4 0. 54 5 0. 63 2 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 07 6  0. 01 2  0. 15 6 1. 19 5 1. 09 3 11 30 60 3 0. 05 2 0. 09 9 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 98 2  0. 00 6  0. 00 6 1. 39 1 1. 17 9 13 79 73 4 0. 97 0 0. 99 4 Co m pr eh en si ve  k no w le dg e  ab ou t H IV  p re ve nt io n  am on g  yo un g  pe op le 9. 2 0. 42 1  0. 03 9  0. 09 2 1. 67 2 1. 29 3 50 4 27 3 0. 34 4 0. 49 8 Kn ow le dg e  of  m ot he r‐  to ‐c hi ld  tr an sm is si on  o f H IV   9. 3 0. 58 6  0. 02 6  0. 04 5 2. 11 7 1. 45 5 13 79 73 4 0. 53 3 0. 63 9 A cc ep tin g  at tit ud es  to w ar ds  p eo pl e  liv in g  w ith  H IV 9. 4 0. 21 0  0. 01 7  0. 08 2 1. 29 7 1. 13 9 13 43 71 7 0. 17 6 0. 24 5 M en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 6 0. 05 4  0. 01 0  0. 18 4 1. 40 2 1. 18 4 13 79 73 4 0. 03 4 0. 07 3 Se xu al ly  a ct iv e  yo un g  m en  w ho  h av e  be en  te st ed  fo r  H IV  a nd  k no w  th e  re su lts 9. 7 0. 02 4  0. 01 3  0. 52 5 0. 85 0 0. 92 2 23 0 12 4 0. 00 0 0. 05 0 Se x  be fo re  a ge  1 5  am on g  yo un g  m en 9. 11 0. 01 5  0. 00 8  0. 56 4 1. 28 2 1. 13 2 50 4 27 3 0. 00 0 0. 03 1 U nd er w ei gh t p re va le nc e 2. 1a 0. 16 3  0. 01 7  0. 10 3 1. 08 5 1. 04 1 10 03 52 8 0. 12 9 0. 19 6 St un tin g  pr ev al en ce 2. 2a 0. 19 3  0. 01 8  0. 09 2 1. 05 0 1. 02 5 98 0 51 5 0. 15 8 0. 22 9 W as tin g  pr ev al en ce 2. 3a 0. 07 2  0. 01 1  0. 15 7 0. 98 6 0. 99 3 98 2 51 6 0. 05 0 0. 09 5 Ex cl us iv e  br ea st fe ed in g  un de r  6  m on th s 2. 6 0. 30 5  0. 06 4  0. 21 0 1. 18 4 1. 08 8 11 9 62 0. 17 6 0. 43 3 A ge ‐a pp ro pr ia te  b re as tf ee di ng 2. 14 0. 25 1  0. 03 3  0. 13 4 1. 34 4 1. 15 9 42 4 22 6 0. 18 4 0. 31 8 Tu be rc ul os is  im m un iz at io n  co ve ra ge ‐ 0. 86 1  0. 05 5  0. 06 4 2. 34 5 1. 53 1 17 9 94 0. 75 0 0. 97 1 Re ce iv ed  p ol io  im m un iz at io n ‐ 0. 65 4  0. 05 4  0. 08 3 1. 20 4 1. 09 7 17 9 94 0. 54 5 0. 76 2 Re ce iv ed  D PT ‐H ep B‐ H ib  im m un iz at io n ‐ 0. 66 5  0. 06 6  0. 09 9 1. 80 9 1. 34 5 17 9 94 0. 53 3 0. 79 7 Re ce iv ed  m ea sl es  im m un iz at io n ‐ 0. 71 3  0. 06 4  0. 09 0 1. 88 3 1. 37 2 17 9 94 0. 58 5 0. 84 2 D ia rr ho ea  in  th e  pr ev io us  2  w ee ks ‐ 0. 05 3  0. 01 2  0. 23 2 1. 65 6 1. 28 7 10 58 55 6 0. 02 8 0. 07 7 C on fid en ce li m its S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W ei gh te d co un t U nw ei gh te d co un t M E N U N D E R -5 s M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) D ia rr ho ea  in  th e  pr ev io us  2  w ee ks 0. 05 3  0. 01 2  0. 23 2 1. 65 6 1. 28 7 10 58 55 6 0. 02 8 0. 07 7 Ill ne ss  w ith  a  c ou gh  in  th e  pr ev io us  2  w ee ks ‐ 0. 02 1  0. 00 8  0. 35 7 1. 53 2 1. 23 8 10 58 55 6 0. 00 6 0. 03 6 Fe ve r  in  la st  tw o  w ee ks ‐ 0. 22 2  0. 02 3  0. 10 3 1. 68 1 1. 29 7 10 58 55 6 0. 17 6 0. 26 7 O ra l r eh yd ra tio n  th er ap y  w ith  c on tin ue d  fe ed in g 3. 8 (0 .7 68 ) (0 .0 77 ) (0 .1 00 ) (0 .8 53 ) (0 .9 24 ) 56 27 (0 .6 15 ) (0 .9 21 ) A nt ib io tic  tr ea tm en t o f s us pe ct ed  p ne um on ia 3. 10 * * * * * 22 12 * * Ch ild re n  un de r  ag e  5  sl ee pi ng  u nd er  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 15 0. 20 7  0. 02 8  0. 13 6 2. 61 9 1. 61 8 10 32 54 4 0. 15 0 0. 26 3 A nt i‐m al ar ia l t re at m en t o f c hi ld re n  un de r  ag e  5 3. 18 0. 02 5  0. 01 4  0. 54 5 0. 94 0 0. 97 0 23 4 12 5 0. 00 0 0. 05 2 Su pp or t f or  le ar ni ng 6. 1 0. 85 3  0. 02 6  0. 03 0 1. 17 7 1. 08 5 41 9 22 2 0. 80 1 0. 90 4 A tt en da nc e  to  e ar ly  c hi ld ho od  e du ca tio n 6. 7 0. 69 6  0. 03 4  0. 04 9 1. 19 7 1. 09 4 41 9 22 2 0. 62 8 0. 76 4 Bi rt h  re gi st ra tio n 8. 1 0. 85 2  0. 02 7  0. 03 2 3. 20 9 1. 79 1 10 58 55 6 0. 79 8 0. 90 6 333 Ta bl e S E .1 1: S am pl in g er ro rs : P ho ng sa ly r - 2 se r + 2 se Io di ze d  sa lt  co ns um pt io n  2. 16 0. 91 3  0. 03 1  0. 03 4 11 .1 88 3. 34 5 57 0 94 2 0. 85 2 0. 97 5 H ou se ho ld  a va ila bi lit y  of  in se ct ic id e‐ tr ea te d  ne ts  (I TN s) 3. 12 0. 51 0  0. 04 2  0. 08 3 6. 81 3 2. 61 0 57 8 95 6 0. 42 5 0. 59 4 U se  o f i m pr ov ed  d ri nk in g  w at er  s ou rc es 4. 1 0. 74 7  0. 05 9  0. 07 8 17 .3 97 4. 17 1 31 22 95 6 0. 63 0 0. 86 5 U se  o f i m pr ov ed  s an ita tio n 4. 3 0. 32 9  0. 05 2  0. 15 8 11 .7 10 3. 42 2 31 22 95 6 0. 22 5 0. 43 3 Se co nd ar y  sc ho ol  n et  a tt en da nc e  ra tio  (a dj us te d) 7. 5 0. 34 3  0. 03 6  0. 10 6 5. 03 2 2. 24 3 51 9 85 4 0. 27 0 0. 41 6 Pr ev al en ce  o f c hi ld re n  w ith  o ne  o r  bo th  p ar en ts  d ea d 9. 18 0. 06 7  0. 00 9  0. 13 3 2. 90 4 1. 70 4 13 99 22 97 0. 04 9 0. 08 4 Vi ol en t d is ci pl in e 8. 5 0. 63 2  0. 02 1  0. 03 3 1. 42 2 1. 19 3 10 59 75 3 0. 59 1 0. 67 4 Li te ra cy  r at e  am on g  yo un g  w om en 7. 1 0. 52 7  0. 06 1  0. 11 6 5. 68 5 2. 38 4 24 1 38 3 0. 40 5 0. 64 9 Cu rr en tly  m ar ri ed /i n  un io n ‐ 0. 81 2  0. 01 7  0. 02 1 2. 07 6 1. 44 1 66 6 10 80 0. 77 8 0. 84 6 M ar ri ag e  be fo re  a ge  1 8 8. 7 0. 40 3  0. 02 5  0. 06 3 2. 34 2 1. 53 0 54 2 88 0 0. 35 2 0. 45 4 Ch ild re n  ev er  b or n ‐ 2. 72 1  0. 10 5  0. 03 9 2. 07 7 1. 44 1 66 6 10 80 2. 51 1 2. 93 1 Ch ild re n  liv in g ‐ 2. 24 5  0. 08 8  0. 03 9 2. 16 1 1. 47 0 66 6 10 80 2. 06 9 2. 42 1 Ch ild re n  ev er  b or n  to  w om en  a ge  4 0‐ 49 ‐ 5. 04 9  0. 21 7  0. 04 3 1. 44 8 1. 20 3 12 7 21 1 4. 61 6 5. 48 3 Ea rl y  ch ild be ar in g 5. 2 0. 25 7  0. 03 5  0. 13 8 1. 19 7 1. 09 4 11 6 18 3 0. 18 6 0. 32 8 Pr eg na nt  w om en ‐ 0. 05 2  0. 00 8  0. 15 0 1. 32 7 1. 15 2 66 6 10 80 0. 03 7 0. 06 8 W an t n o  m or e  ch ild re n ‐ 0. 64 1  0. 02 8  0. 04 4 3. 02 2 1. 73 8 54 1 87 8 0. 58 4 0. 69 7 W an t t o  de la y  bi rt h  at  le as t 2  y ea rs ‐ 0. 15 6  0. 01 7  0. 11 2 2. 02 4 1. 42 3 54 1 87 8 0. 12 1 0. 19 1 Kn ow s  an y  co nt ra ce pt iv e  m et ho d ‐ 0. 74 8  0. 04 5  0. 06 0 11 .4 84 3. 38 9 66 6 10 80 0. 65 8 0. 83 7 Co nt ra ce pt iv e  pr ev al en ce 5. 3 0. 44 7  0. 03 7  0. 08 3 4. 92 5 2. 21 9 54 1 87 8 0. 37 3 0. 52 2 S ta nd ar d er ro rs , c oe ffi ci en ts o f v ar ia tio n, d es ig n ef fe ct s (d ef f), s qu ar e ro ot o f d es ig n ef fe ct s (d ef t) an d co nf id en ce in te rv al s fo r s el ec te d in di ca to rs , L ao P D R 2 01 1- 12 M IC S In di ca to r V al ue ( r) S ta nd ar d er ro r ( se ) C oe ffi ci en t o f va ria tio n (s e/ r) D es ig n ef fe ct (d ef f) S qu ar e ro ot o f d es ig n ef fe ct ( de ft ) W O M E N W ei gh te d co un t U nw ei gh te d co un t C on fid en ce li m its H O U S E H O LD S H O U S E H O LD M E M