Lebanon - Multiple Indicator Cluster Survey - 2000

Publication date: 2000

United Nations Childrens Fund Preliminary Report on the Multiple Cluster Survey On the Situation of Children in Lebanon Lebanon February 2001 Republic of Lebanon Presidency of the Council of Ministers Central Bureau of Statistics Table of Contents Page 1st. Introduction 4 A. Background 4 B. Purpose of the survey 5 2nd . Methodology 5 A. Sampling 5 B. Survey instruments 5 C. Training and data collection 5 D. Data entry and data processing 6 E. Response rate of the target groups 6 3rd . Preliminary Results 6 A. Characteristics of the households 6 1. Situation of the family 6 2. Drinking water 7 3. Salt iodization 7 B. The Situation of children 8 1. Breastfeeding 8 2. Diarrheal diseases 8 3. Acute respiratory infections 9 4. Immunization 9 5. Pre-school and primary education enrollment 10 6. Working children 10 7. Infant and Child Mortality Rates 11 List Of Tables Table 1 : Number of Households, Women and response rates, Lebanon, 2000 Table 2: Percentage of cases missing information for selected questions, Lebanon, 2000 Table 3: Percent distribution of households by background characteristics and regions, Lebanon, 2000 Table 4: Percent distribution of married women 15-49 by background characteristics and regions, Lebanon, 2000 Table 5: Percentage of population aged 15 years and older that is illiterate by regions, Lebanon, 2000 Table 6: Percent distribution of children age under 5 by background characteristics and regions, Lebanon , 2000 Table 7: Percentage of married women aged 15-49 who are using (or whose partner is using) a contraceptive method, by regions, Lebanon , 2000 Table 8: Percentage of population with access to Improved drinking water by regions, Lebanon, 2000 Table 9: Percentage of households consuming adequately iodized salt by region, Lebanon 2000 Table 10: Percentage of living children by breast feeding status by regions, Lebanon, 2000 Table 11: Percent of under five children with diarrhea in the last two weeks and treatment with ORS or ORT by regions, Lebanon , 2000 Table 12: Percentage of under five children with diarrhea in the last two weeks who took increased fluids & continued to feed during the episode by regions, Lebanon , 2000 Table 13: Percentage of under five children with acute respiratory infection in the last two weeks and treatment by health providers by regions, Lebanon , 2000 Table 14: Percentage of vaccinated children age 12-23 months with DPT/OPV 3 and Measles/MMR by regions, Lebanon, 2000 Table 15: Percent distribution of children aged 36-71 months who attending some form of organized early childhood education programme by regions, Lebanon , 2000 Table 16: Percentage of children entering first grade of primary school who eventually reach grade 5 by regions, Lebanon , 2000 Table 17: Percentage of children 5-14 years of age who are currently working by regions, Lebanon, 2000 Table 18: Infant and under-five children Mortality Rates 1st . Introduction A. Background Lebanon participated in the World Summit for the Survival, Development and Protection of children in New York in 1990 with an official delegation headed by its Prime Minister. This high level participation is considered an expression of the strong commitment of Lebanon to child rights on the eve of the end of the civil war in Lebanon. Since that date, Lebanon has expressed its commitment to child rights at both the official and the civil society levels. At the official level, the Lebanese Parliament ratified in early 1991 the Convention on the Rights of the Child (CRC) without any reservation. An initiative was taken also in 1992 to establish the Parliamentary Committee on Child Rights. The Committee is composed of parliamentarians and activists from the civil society. The committee has taken upon its charge the tasks of proposing the amendment, cancellation and identification of new laws that are in line with CRC. In 1994, the Higher Council for Children was established, to represent a forum for the public and NGO sectors work on the ratification of child rights with the support of international organizations. The main tasks of the council were to follow-up on the implementation of the CRC and to prepare the official reports to the International Committee on the Rights of the Child on the progress made and the obstacles faced. At the level of the civil society, The CRC was given high value by NGOs working on childhood issues. The NGOs saw in the Convention and in the Plan of Action of the World Summit for Children a comprehensive framework for rights to which they had committed themselves earlier. In fact, Lebanon has witnessed over the past decade a proliferation of the number of NGOs that address issues related to children, especially in the area of children with special education needs. The media has also contributed by highlighting the areas of child rights violations. In spite of the political will and high level of commitment, it is not possible to disregard the conditions from which Lebanon has suffered since 1990 and which have somehow limited some of the achievements. In fact, the Lebanese civil war ended in 1990 but left behind it great damage to infrastructure, buildings, property, industries, educational and social institutions, in addition to more than 100,000 killed, 100,000 disabled and about one million internally displaced persons. After the cessation of the armed conflict, the regions of South Lebanon and West Beqaa continued to be under Israeli occupation. In fact, this was a war of attrition that exerted severe pressure on the financial and human capacities in Lebanon and represented a serious obstacle to full-fledged development. Yet, Lebanon was able to reconstruct its infrastructure and improve its health, education and social sectors. A large scale programme was implemented for the Return of the Internally Displaced. The programme has portrayed the solid will of all Lebanese to reunite; many experts see in this programme one of the most successful stories in modern history. In 1993, and in line with international trends, eight goals related to child health were put as targets to be achieved by 1995. Lebanon was indeed able to achieve those goals, and even went beyond them in a number of areas. For this important achievement, the country earned a Recognition Award granted by the Regional Director of UNICEF to the Lebanese Government and to key NGOs in September 1996. In parallel with these achievements, the Higher Council for Children formulated a National Plan of Action for advocacy and mobilization on the national goals. In line with the commitments of Lebanon at the international level and within the context of preparing the National Report on the End-Decade Goals set by the World Summit for Children, a protocol was put forward in early 2000 between the Central Administration of Statistics and UNICEF for conducting a Multiple Indicator Cluster Survey on the Situation of Children. Along this agreement, UNICEF provided technical and material assistance to the Central Administration of Statistics including training of key personnel through training sessions, contracting the services of two local experts, contracting the services of an external consultant for setting the sampling frame. UNICEF office in Beirut contributed also to development of the questionnaires, the training and preparation of the preliminary report. A national committee under the chairmanship of the Director General of Statistics and with members from Ministries of Health, Education, Labor and Social Affairs and UNICEF was established to oversea the work. B. Purpose of the Survey The main objectives of the survey were: 1- To provide reliable data on the situation of women and children in order to prepare the National Report on the End-Decade Goals set at the World Summit for Children held in 1990. 2- To provide information that can be used in the evaluation of the joint projects between the Government of Lebanon and UNICEF 3- To provide data on the largest number of indicators that can be used in developing future plans of cooperation between the Government of Lebanon and UNICEF 4- To develop the database available and build-up the technical capacities of the Central Administration of Statistics in planning and implementing surveys according to international standards. 2nd . Methodology A. Sampling The sample was selected to provide data on health, education, and social indicators related to the situation of children in Lebanon as a whole and in each of the five governorates (South1, North, Beqaa, Beirut, Mount Lebanon), as well as in the four most underserved districts as group (Akkar, Minyeh/Dannieh, Baalbeck, Hermel). The sample was determined at 8125 households distributed on the five governorates. The sampling was done in two stages. The first stage included random selection of 65 ilots from each of the five governorates based on the sampling frame set by the Census of Buildings undertaken in 1995-1996. The second stage was through the selection of 25 households systematically from each of the 25 ilots. For those ilots that had less than 25 households, the total number of households was considered. B. Survey instrument The national committee of the survey reviewed the questionnaires developed by UNICEF at the international level. The necessary modifications were introduced in order to meet the requirements of the government bodies and to fit the local conditions. A number of questions were introduced on the households, the equipment used, the monthly income, employment, education, reasons behind illiteracy and drop-out from school. The questionnaire on the under five children was amended to include more information on early child development. Information was also collected on home injuries and child labor among children aged 6 18 years inside and outside the home. The questionnaires were field tested and modified accordingly. C. Training and data collection The survey team was composed of 12 supervisors and 88 interviewers who worked in the various governorates. They were trained in two sessions. The first was held for three days from 29 to 31 May 2000 and the second was held from 1 3 June 2000. The data was collected from the filed between 1 July and 30 September 2000. Data entry was made between 1 August and 31 October 2000. D. Data entry and data processing Data entry was made using ten computers following ORACLE. In order to guarantee the quality of data entry, the questionnaires were entered twice in parallel and were counterchecked. Data processing started from the beginning of November until the end of 2000, while the present report was prepared in January 2001. 1 The two governorates of Nabatiyyeh and the South were joint together as one governorate for reasons related to the size of the sample and in order to reduce the margin of error. E. Response rate of the target groups The information available in Table -1- indicate that out of 7784 households in the sample, a total of 7231 were found occupied while the rest were vacant. From those information was obtained for 6834 households, hence yielding a response rate of 94.5 percent at national level. There were disparities however in the response rate, highest in Beqaa (98.8 percent) and lowest in Beirut (88.2 percent). It is noteworthy here that the low response rate in Beirut is attributed to the fact that the survey took place in the summer, where many of its inhabitants and of the inhabitants of major cities leave on holidays. It also coincided with the liberation of the regions of South Lebanon and West Beqaa and the subsequent population movements. In addition, there was a relatively high rate of rejection among the target group in Beirut, compared to the other governorates. On the other hand, Table 1- indicates that a total of 4245 women from the target group (i.e. women in child bearing age 15 49 years) have been identified in the households targeted. Of those, 4244 have been interviewed, yielding a response rate of about 100 percent. In addition, information was obtained on 2786 children under five out of 2803 identified in the households, equivalent to a response rate of 99.2 percent. Table 2- indicates that the number of questions for which answers are missing is very low, hence indicating the high quality of the data. 3rd . Preliminary results The present report provides preliminary information on the data made available by the Multi Indicator Cluster Survey and updates the values of the indicators adopted by international organizations. Work is under progress to prepare a comprehensive report on the results of survey and to be presented within a national conference that will formulate recommendations for a national plan over the next ten years. A. Characteristics of the households 1. Situation of the family: its size, age, distribution of its members, adult literacy, and family planning The data provided by the survey (table 3-) indicate that 54.6 percent of the households at national level have at least one child less than 15 years of age, while 28.9 percent have at least one child less than five years of age. In addition, 79.4 percent of households have at least one woman in childbearing age (15 49 years) with significant disparities among regions indicating the difference in reproductive patterns. The average size of the family is 4.6 at national level, with regional disparities ranging from 5.5 persons in the North to 3.9 persons in Beirut. The same table indicates that the proportion of families composed of one person is highest in Beirut (11.5 percent) and lowest in the North (3.7 percent), while the proportion of families made up of 10 persons and more is highest in the North (7.4 percent) and lowest in Beirut (0.7 percent)., which indicates two different demographic patterns. Table 4- indicates that out of the ever-married woman, 94 percent are currently married, while 6 percent are divorced, widowed or separated. This proportion is lowest in Beqaa (4.8 percent) and highest in Beirut (7.6 percent). With respect to adult illiteracy rates, table 5- shows that it is 14 percent at national level (15 years and above) with significant gender disparities (10.8 percent for men and 18.8 percent for women) and regional disparities (highest in the North 19.7 percent and lowest in Beirut (7.8 percent). Gender disparities are noted in all governorates, but are highest in the North and the Beqaa. It is worth noting however that there are no gender disparities in adult illiteracy rates for the age groups 15 44, an achievement that Lebanon can boast above. As for the characteristics of children under five ears of age, table 6- indicates that they are distributed equally among boys and girls. It was found that 8.1 percent of their mothers are illiterate while 38.7 percent have reached secondary or university education with significant regional disparities. number of children and the birth intervals. The last five years have witnessed increased attention on behalf of the Minister of Public Health and Social Affairs in providing family planning services in collaboration with NGOs and with the support of international organizations. The contraceptive prevalence rate at the time of the survey is an important indicator of reproductive health. The results of the MICS survey as revealed in table 7-, indicate that 62.7 percent of the married women in childbearing age (15 49) are using one contraceptive model (modern or traditional). This rate increases with the age of women: 41.2 percent among the 15 19 years age group and 63.9 percent among the 25 49 years age group. The contraceptive prevalence rate has a high positive correlation with with significant regional disparities that reaches its lowest level in Mount Lebanon (58 percent) and its highest in Beirut and Beqaa (72 percent). A comparison between the present contraceptive rate and the one of 1996 indicates an increase, especially in the use of modern methods. 2. Drinking water The availability of safe drinking water is an essential condition for public health, wherein contaminated water transmits diseases. The Government of Lebanon has exerted serious efforts since the end of the war to improve the conditions of drinking water, with respect to increasing the quantity per person and to improving and monitoring its quality. The results in table 8- indicate that 86.5 percent of the Lebanese obtain water through public networks and protected wells, while 8.6 percent obtain it from a source located outside the house, 3.3 percent through cisterns and 1.6 percent from varied sources which means according to international standards that 95 percent of the population get their water in an appropriate way. There are however, significant regional disparities wherein proportion is lowest in the South (88.4 percent) and highest in Beirut (99 percent). It is worth noting in this context that transportation of water is by cars or carried by family members including children and women or animals especially in rural areas of the North, the Beqaa and the South. On the other hand, despite the improvement mode in the quality of water, the provision of safe drinking water remains a serious problem in Lebanon. There is a need for exerting serious efforts related to protection of water sources, water disinfection, regular maintenance of water networks, activation of the monitoring system and proper disposal of wastewater treatment station that is functioning in Lebanon. 3. Salt Iodization Salt iodization is an effective and low cost method for prevention of iodine deficiency disorders. In Lebanon, a national study was conducted in 1993 and revealed a low to moderate level of iodine deficiency disorders in all regions. As a result, and with the support of UNICEF, the two main salt manufacturers were provided with the equipment necessary for salt iodization and the required quantities of potassium iodate to start producing iodized salt. Production started at the beginning of 1995 and the proportion of households using iodized salt reached 91.3 percent at the beginning of 1996. The MICS 2 survey results as shown in table 9-, indicated that 97.6 percent of the salt consumed by households is iodized without any regional disparities. It was found that 10.3 percent of Lebanon consumes iodized salt in small tightly closed boxes imported from the U.S. and France, while 89.7 percent consume local salt produced by the national manufacturers equipped for iodization. The same table reveals that 86.8 percent of the consumed salt includes the quantity of iodate recommended by WHO and UNICEF (more than 15 ppm). This proportion is lowest in Mount Lebanon (82.3 percent) and highest in Beirut and the North (91.5 percent). B. The situation of children 1. Breastfeeding Experts and international organizations agree that exclusive breastfeeding until at least four months and to nearly six months with the introduction of supplementary feeding and continued breastfeeding thereafter is considered one of the best means for infant nutrition and development2. In this context, Lebanon took a number of important actions in 2 Breastfeeding provides the necessary nutrition and immunity against the various diseases. It is also economical and unpolluted. However, a large number of mothers stop breastfeeding early under the influence of commercial advertising, and the misconception that breast milk is not enough and that there is a need to introduce other liquids and solid food. This exposes the child to many health problems. Today, this direction. These were taken after a national survey conducted in 1991 had indicated that only 7 percent of children are exclusively breastfed until four months of age. The action taken was in four directions: I. First: launching of the Baby Friendly Hospital Initiative Second: working towards the implementation of the Decree 118/83 related to banning of free or low cost breastmilk substitutes, though limited success was achieved in this direction. Third: organization of health education activities addressed to mothers through primary health care centers and media campaigns. Fourth: preparations for the organization of a national campaign for improved nutrition in the first two years of life. The results revealed by the MICS 2 Survey indicated the following: · Exclusive breastfeeding: The proportion of exclusively breastfed children has increased from 7 percent in 1991 to 26.6 percent in 2000 with gender differences in favor of females (34.3 percent) compared to males (17.8 percent). There are also regional disparities: the highest rate is in the North (34.5 percent) and the lowest is in Beqaa (12.9 percent). The rate of exclusive breastfeeding goes up to 33.7 percent is WHO definition is adapted (breastfeeding plus clear water), while not8ing that the rate of exclusive breastfeeding decreases with higher educational levels among mothers (secondary and above). · Timely complementary feeding: The MICS 2 survey revealed that 37 percent of children receive solid and semi- solid foods in addition to breastfeeding and only 12 percent continue to be breastfed with other liquids, including powdered milk without complementary feeding, and this recommended by WHO and UNICEF. If however, timely complementary feeding is considered irrespective of the type of milk, then the indicator goes up to 70.4 percent with gender differences in favor of females (81.6 percent) compared to males (58.7 percent). As for regional differences, the highest level of a timely complementary feeding was found in Mount Lebanon (75.5 percent) and the lowest in Beqaa (40.4 percent) · Continued breastfeeding until 12 15 months (20-23 months): Results indicate that 34.7 percent of children in this age group are breastfed with a slight difference in favor of males (38.4 percent) in favor of females (32.6 percent). On the other hand, it is revealed that 12.4 percent of boys and 8.5 percent of girls continue to be breastfed until 20 23 months. This rate is highest in the North (20.7 percent) and lowest in Mount Lebanon (3.8 percent). 2. Diarrheal diseases Diarrheal diseases are a major cause of child morbidity and mortality at the international level. In Lebanon, the Ministry of Public Health launched in 1989 a project on the Control of Diarrheal Diseases. It was able to achieve the goals set for the mid decade and was subsequently selected as one of the four most successful experiences in the world. The results revealed that the MICS 2 survey, table 11- indicate that 19.3 percent of under five children had diarrhea in the two weeks preceding the survey without almost any gender differences, but with significant regional disparities: highest in the Beqaa (23 percent) and lowest in Beirut (18 percent). As indicated in table 11-, the incidence of diarrhea increases with the age of the child and reaches its highest level at 20 23 months, and then sitively the incidence of diarrhea. Results (table 11- indicate that a significant improvement was noted in the correct case management of diarrhea revealed by the increase in the usage of ORS to reach 44.4 percent, and by the increase in the usage of recommended home fluids, including ORS, to 96 percent. On the other hand, the proportion of using IV has decreased to 4.7 percent, which is used in cases of dehydration. With respect to the indicator of continuous feeding during diarrhea, the MICS 2 survey revealed (table 11- that 99 percent of children who had diarrhea continued to be exclusively breastfed (excluding those who have been hospitalized). As for the indicator on increased fluids and continued feeding during diarrhea, it was found as shown in table 12 that this proportion is 29.8 percent. It is worth noting in this context that all studies point to the difficulty of getting an estimate from mothers on the quantity month. However, complementary solid food must be introduced before the end of the six insufficient Moreover iron drops should also be given to the child with the solid food and until the child reaches his sixth month at least as a prevention against anemia caused by the need for iron. The results revealed that the education of the mother ( secondary and above) contributed to the early introduction of liquids (including milk substitutes) and solid food. of fluids taken by children during diarrhea. If however, we consider those children with diarrhea who have received the same quantity of fluids or more and continued feeding during diarrhea, then the proportion would go beyond 80 percent. 3. Acute respiratory infections In 1994, Lebanon launched a project on the Control of Acute Respiratory Infections. A national study had been conducted on the magnitude and management of these diseases. Since then, the project was able to make significant achievements that include: development of protocols for case management of tonsillitis, chronic and acute otitis at home and at the level of primary health care facilities; training of health personnel with the support of specialists from the three faculties of medicine in Lebanon and experts from France and in cooperation with the private medical sector; production of health education material used in raising awareness of caretakers on prevention and correct case management of acute respiratory infections. The results of the MICS 2 survey revealed (table 13-) that 3.5 percent of under five children had an acute respiratory infection3 in the two weeks preceding the survey, with both regional and gender disparities: the highest was highest in the South (4.4 percent) and lowest in Beirut (1.9 percent); it was higher among boys (4.2 percent) than among girls (2.7 percent). The survey revealed also that the probability of getting the infection increases with age starting at six months and reaches its highest incidence at 12 23 months and then starts to decrease gradually. Table 13- indicates that 73.6 percent of children with acute respiratory infections are treated by an appropriate health provider: 49.1 percent by physicians in private clinics, 24.5 percent at a health center, 3.5 percent by a pharmacist, while the rest have been treated by their mothers alone or with the help of others (not health providers). The results showed also that 10.5 percent of sick children have been hospitalized or taken to emergency units with no gender differences, but with regional disparities (see table 13-). 4. Vaccination According to the National Immunization Calendar, a child receives three doses of DPT/polio; the first booster one year after the third dose; the second booster at 4 5 years of age, and; the third booster at the age of 10 12 years. A child receives a dose of measles at 10 months, a first MMR dose at 15 months, and a second dose of MMR at 4 5 years of age. The national vaccination calendar was modified, wherein the measles dose at 10 months was cancelled, and the MMR dose was brought earlier from 15 12 months. The hepatitis B vaccine was introduced in 1998; it is given in three doses: at birth, at the end of the first month and at the fourth month. Thirteen years after launching the Expanded Programme on Immunization, Lebanon was able to eliminate neonatal tetanus and move forward in polio eradication (no polio case has been reported since summer 1994). At present, a plan is under implementation for eliminating measles and rubella. The project involves the Ministries of Public Health, Social Affairs and Education, the NGOs, and the Association of Pediatricians with the support of WHO and UNICEF. The MICS 2 survey revealed that 83 percent of children have a vaccination card or a health registry. Information about vaccination has been obtained from these records in 57 percent of the cases, while information for the rest was obtained from their mothers. Table 14- indicates that 92.6 percent and 82.6 percent of those for which information has been obtained from registers are vaccinated for DPT/polio and MMR respectively. There are however regional disparities wherein the lowest rates are in the North (83.8 percent) and the highest are in Beirut (100 percent). With respect to children for whom information has been obtained from mothers, it was found that 67.6 percent of them were vaccinated for DPT/polio and 69.2 percent for MMR. Seventy three percent have been vaccinated, but their mothers do not know the exact number of doses. 3 Every child under five years who suffered from a cough accompanied by difficulties in breathing or a fast breath caused by a chest problem or a problem unknown by the mother In conclusion, the results in general indicate a slight decrease in the child immunization rates especially in the North for all antigens, but in particular for MMR. These results point out the need to continue with the accelerated vaccination campaigns in the regions with low immunization coverage in the North and Beqaa (Baalbeck, Hermel, Akkar, Minyeh/Dinyeh). 5. Enrollment in pre-school and primary education Education is one of the most important goals set by the World Summit for Children. Education is a necessary ion of children from early entry into the child labor market. It is also an important tool for spreading a culture of human rights, the principals of democracy and the protection of the environment. In short, it is one of the principals of sustainable human development. In Lebanon, both the Government and the society have given early childhood development a special importance. Children enter into educational institutions at an early age. Table 15- indicates that 85.5 percent of children aged 3 5 years are enrolled without any gender disparities. There are however regional disparities in the North (80.8 percent) and the highest in Beirut (92.8 percent). As for enrollment according to age groups, it is revealed that enrollment at 3 years is 72.2 percent and increases until it reaches 92.8 and 92.9 percent for children aged four and five years respectively. Table 15 indicates that regional disparities are noted only for the three years old, while no gender or regional disparities are encountered for children aged four and five years. On the other hand, the same table indicates that pre-school enrollment increases with higher educational levels among mothers. As for primary education, the MICS 2 survey results (table 16-) indicate that the proportion of children enrolled in primary education in 1999 2000 is 98.3 percent without gender or regional disparities. This is an important milestone achieved by Lebanon on its way to Education for All. As for the proportion of children reaching grade 5, results indicate that it is 95.3 percent with gender difference in favor of girls (97 percent) compared to boys (93.8 percent), and without any significant regional disparities, except for the Beqaa where this proportion reaches 90.7 percent. 6. Working Children The phenomenon of child labor was not known in Lebanon before the civil war in 1975 except at a limited scale. Nevertheless, the economic and social conditions that came about as a result of the war and the deterioration in the standards of living have led to an expansion of these phenomena. Since the ratification of the CRC by the Lebanese parliament in 1991, the level of interest in assessing the magnitude of this phenomenon and the reasons leading to it has increased. The media has played a very important role in highlighting this phenomenon, increasing awareness about it and harnessing efforts to address it. At the legislative level, the Lebanese law was amended in 1996, bringing up the minimum age for work from 8 to 13 years. The age of those that can be employed in industry and hazardous work was also determined. In may 1999, decree 700 was issued to outline the jobs that are hazardous by nature or that may pose a danger to the life, health or morals of the young child. The decree forbids the employment of children before 16 years of age according to the type of work. The amended laws have also determined the number of working hours and forbid the employment of the child by benevolent associations before the age of 13 years. As for the magnitude of the phenomenon, the MICS 2 survey gave, for the first time in Lebanon, information about the proportion of working children in the age group 5 14 years (i.e. those working illegally). The most important results as revealed by table 17- are as follows: First: with respect to paid labor, it was found that 0.9 percent of the 5 9 years old and 1.8 percent of the 10 14 years old are working. This proportion is three and a half time higher among girls than among boys. It was also found that this phenomenon is more prevalent in the South and the Beqaa. Second: with respect to unpaid labor, it was found that 2.5 percent and 7.8 percent of the children aged 5 9 and 10 14 years respectively are working without pay. This proportion is two and a half times higher among boys than among girls. It was also more prevalent in the South and the Beqaa and least in Beirut. Third: with respect to domestic work, results indicated that 22.2 percent and 44.5 percent of children aged 5 9 and 10 14 years respectively work at home for less than four hours a day. This is more prevalent among girls naturally. As for the proportion of children who do domestic work for more than 4 hours per day, it is 2 percent and 2.2 percent for the age groups 5 9 and 10 14 years respectively. It is of course more prevalent among girls; highest in the North, and; lowest in Beirut and the Beqaa. The total proportion of working children aged 6 14 years, including paid and unpaid work, inside and outside the home is 45.3 percent. Of course 7.6 percent work outside the home and 1.3 percent work for more than four hours per day in domestic work. This affects their development and education. This phenomenon is also against the CRC and the Lebanese law. 7. Infant and Child Mortality 1) At the National Level Infant and child mortality are considered the most important indicators that reflect the reality of the health, social, economic and living conditions of the population. (Table -18) reveals the average number of life birth or those who remain alive and the proportion of death according to the age group of the mother. The table shows that the average number of life birth for women who belong to the (20-24) age group is 0.32, with a proportion dead of 2%, which is the lowest rate. The older the women gets the higher average of live birth and mortality rate reaching its highest in the age group (45 49) where the average parity is 3.82 and the proportion dead is 6%, which is three times higher than the lowest rate for mothers who belong to the (20-24) age group. The indirect estimations of infant mortality (during the first year) and child mortality (under five years) are based on the information provided by tables (19, 20, 21). The North model taken from (Coale-Demeny) Model life table pattern of mortality was adopted to prepare the indirect estimations of infant mortality q(1) and possible mortality between the age of 1 and 4 q(1-4) and when they reach the age of 5 q(5) which are calculated by using the Trussell equation based on the age group of the mother. The average mortality of infants and children was calculated based on the (20-24) and (25 29) age groups of the mothers. The results were as follows: Estimation of infant and child mortality rate by sex at national and governorate levels Indicator Male Female Male/Female IMR 24 29 26 Child Mortality between 1 and 4 years 6 9 7 Child mortality(U5MR) 30 38 33 We can deduce from the table that infant and child mortality rate at the national level are respectively 26 and 33 for each 1000 life birth. As the gender disparities, the results revealed that the infant and child mortality of the boys are 29 and 38 per 1000 life birth compared to 24 and 30 per 1000 life birth for the girls. . It is worth mentioning here that these indicators reflect the situation of children two to three years before the implementation of the study i.e. in the year 1998. 2) At the governorate level The information at the governorate level (table -20) were studied using the same methodology and the results were as follows: Estimation of infant and child mortality rate at national and governorate levels Indicator Beirut Mount Lebanon South North Bekaa Lebanon IMR 20 19 24 32 40 26 Child mortality between the 1st and 4th year) 5 4 8 12 17 7 U5MR 25 23 32 44 57 33 The results reveal regional disparities. Infant and child mortality are the lowest in Mount Lebanon (19 and 23 respectively) and the highest in the Bekaa (40 and 57 respectively). Table 1 : Number of Households, Women and response rates, Lebanon, 2000 Regions Beirut Mount Lebanon North Beqaa South Lebanon Sample Households 1626 1580 1570 1525 1483 7784 Occupied Households 1495 1401 1494 1465 1376 7231 Completed Households 1319 1288 1444 1448 1335 6834 Households response rate 88.2% 91.9% 96.7% 98.8% 97.0% 94.5% Eligible women 1322 1489 1965 1925 1644 8345 Ever married women 665 793 986 943 858 4245 Interviewed women 665 793 986 943 857 4244 Women response rate 100.0% 100.0% 100.0% 100.0% 99.9% 100.0% Children under 5 288 406 815 656 644 2809 Interviewed children under 5 282 399 815 649 641 2786 Child response rate 97.9% 98.3% 100.0% 98.9% 99.5% 99.2% Table 2: Percentage of cases missing information for selected questions, Lebanon, 2000 Percent of Missing Level of Education 0.0% Year of Education 0.0% Number of hours worked 0.0% Complete birth date for mothers 0.0% Complete birth date for children 0.0% Diarrhoea in last 2 weeks 0.0% Table 3: Percent distribution of households by background characteristics and regions, Lebanon, 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % 1 11.5 6.1 3.7 4.5 5.0 5.9 2-3 30.2 29.6 21.3 21.9 25.2 26.5 4-5 39.0 42.1 30.0 32.8 34.8 37.2 6-7 16.3 17.1 24.6 26.3 25.0 20.7 8-9 2.4 4.4 12.9 10.6 7.8 7.0 Number of HH members 10 + 0.7 0.7 7.4 3.9 2.3 2.6 At least one child age < 15 40.3 50.9 61.7 58.3 62.6 54.6 At least one child age < 5 16.6 24.9 36.0 32.0 37.0 28.9 At least one woman age 15-49 67.8 78.0 84.2 83.3 83.2 79.4 Mean of HH members 3.9 4.2 5.5 5.1 4.8 4.6 Table 4: Percent distribution of married women 15-49 by background characteristics and regions, Lebanon, 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % 15-19 0.4 1.9 2.7 2.0 2.2 2.0 20-24 4.9 9.5 8.7 8.4 8.5 8.6 25-29 10.3 14.8 17.8 17.4 20.3 16.3 30-34 21.7 19.5 19.7 21.6 21.9 20.4 35-39 24.2 21.6 20.9 19.4 20.9 21.3 40-44 19.1 19.8 18.6 16.5 16.0 18.4 Age 45-49 19.5 13.0 11.7 14.6 10.1 13.0 Currently Married 92.4 94.7 94.2 95.2 93.9 94.3 Marital Status Formerly Married 7.6 5.3 5.8 4.8 6.1 5.7 Yes 92.8 88.7 92.1 93.0 93.6 91.1 Ever given Birth No 7.2 11.3 7.9 7.0 6.4 8.9 None 4.6 3.4 14.2 10.7 6.5 7.1 Primary + 40.6 48.5 59.3 63.8 60.1 53.8 Women's Education Level Secondary + 54.8 48.1 26.4 25.5 33.4 39.1 Table 5: Percentage of population aged 15 years and older that is illiterate by regions, Lebanon, 2000 Beirut Mount Lebanon North Beqaa South Lebanon Age / Sex % % % % % % Literate 99.4 99.6 97.9 97.0 97.6 98.5 Male Not known 0.0 0.0 0.0 0.0 0.2 0.0 Literate 93.0 96.4 97.2 96.2 98.1 96.5 Female Not known 5.5 2.8 0.5 0.2 0.8 1.9 Literate 96.3 98.0 97.5 96.6 97.8 97.5 15-24 Total Not known 2.6 1.4 0.2 0.1 0.5 0.9 Literate 99.0 97.4 94.0 97.2 97.2 96.8 Male Not known 0.0 0.0 0.0 0.0 0.2 0.0 Literate 88.6 92.4 88.6 93.5 95.2 92.0 Female Not known 9.0 5.0 0.5 1.9 1.8 3.5 Literate 93.3 95.0 91.5 95.3 96.1 94.3 25-34 Total Not known 4.9 2.5 0.3 1.0 1.1 1.8 Literate 99.4 97.5 90.7 95.5 97.0 96.0 Male Not known 0.0 0.0 0.0 0.0 0.0 0.0 Literate 88.4 95.7 84.6 84.5 91.7 90.9 Female Not known 7.5 2.0 0.4 1.0 0.8 2.0 Literate 93.2 96.5 87.6 89.8 94.3 93.3 35-44 Total Not known 4.2 1.1 0.2 0.5 0.4 1.1 Literate 97.0 96.3 85.5 92.2 94.6 93.6 Male Not known 0.0 0.0 0.0 0.0 0.0 0.0 Literate 90.7 83.4 65.7 65.0 65.1 76.2 Female Not known 2.0 0.3 0.6 0.0 0.0 0.5 Literate 93.4 89.8 75.1 77.8 79.6 84.6 45-54 Total Not known 1.1 0.2 0.3 0.0 0.0 0.3 Literate 96.0 86.9 67.7 75.4 74.3 81.6 Male Not known 0.0 0.0 0.0 0.0 0.0 0.0 Literate 79.1 66.8 43.1 26.4 39.7 55.4 Female Not known 0.7 0.0 0.3 0.0 0.0 0.2 Literate 87.5 77.3 54.6 51.7 57.0 68.6 55-64 Total Not known 0.3 0.0 0.2 0.0 0.0 0.1 Literate 85.6 76.8 51.3 53.4 50.6 66.2 Male Not known 0.0 0.0 0.0 0.0 0.0 0.0 Literate 66.4 49.4 23.5 16.9 18.0 39.3 Female Not known 0.0 0.0 0.0 0.0 0.0 0.0 Literate 75.2 64.0 38.0 36.4 35.5 53.3 65 + Total Not known 0.0 0.0 0.0 0.0 0.0 0.0 Total Percentage of population aged 15 years and older that is Illiterate by regions, Lebanon , 2000 Sex Male Female Total Literate Not known Illiterate Literate Not known Illiterate Literate Not known Illiterate Beirut 96.80 0.00 3.20 85.70 4.70 9.60 90.90 2.50 6.60 Mount Lebanon 94.80 0.00 5.20 87.00 2.30 10.70 90.90 1.20 7.90 North 87.60 0.00 12.40 77.80 0.50 21.70 82.70 0.20 17.10 Beqaa 90.60 0.00 9.40 76.90 0.70 22.40 83.90 0.30 15.80 South 90.50 0.10 9.40 81.20 0.80 18.00 85.80 0.50 13.70 Lebanon 92.30 0.00 7.70 82.80 1.80 15.40 87.50 0.90 11.60 Table 6: Percent distribution of children age under 5 by background characteristics and regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 47.3 51.6 49.7 52.2 47.6 50.0 Sex Female 52.7 48.4 50.3 47.8 52.4 50.0 < 6 months 8.1 7.6 9.9 10.1 7.5 8.5 6-11 months 11.4 11.8 8.7 8.8 10.2 10.2 12-23 months 16.1 15.6 18.6 17.0 19.7 17.5 24-35 months 20.4 25.0 19.4 21.0 18.1 21.3 36-47 months 18.3 18.6 20.2 20.9 21.8 20.0 Age 48-59 month 25.7 21.3 23.2 22.1 22.7 22.5 None 5.4 4.1 16.0 10.0 4.1 8.1 Primary + 34.7 43.5 60.3 62.3 59.8 53.2 Mother's Education Level Secondary + 59.9 52.4 23.7 27.7 36.0 38.7 Table 7: Percentage of married women aged 15-49 who are using (or whose partner is using) a contraceptive method, by regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % 15-19 0.0 71.1 60.0 61.9 41.1 58.8 20-24 46.2 57.2 48.2 29.9 41.0 48.3 25-49 29.1 39.9 34.2 29.2 37.6 36.1 Age Total 29.8 41.5 35.9 29.8 38.0 37.3 None 39.8 48.3 48.4 47.7 67.5 50.9 Primary + 30.5 38.4 36.0 27.7 34.8 35.2 No method Woman's Education Level Secondary + 28.4 44.1 28.5 27.3 37.7 37.7 15-19 31.4 10.3 12.9 7.0 28.6 15.1 20-24 34.6 16.2 24.6 35.4 44.7 27.1 25-49 45.7 38.0 39.9 46.4 48.9 41.9 Age Total 45.2 36.1 38.1 45.0 48.1 40.4 None 45.0 32.0 31.8 31.5 25.8 31.6 Primary + 43.9 36.7 37.1 47.0 53.2 41.9 Any modern method Woman's Education Level Secondary + 46.2 35.7 44.0 45.9 43.2 40.1 15-19 68.6 18.6 27.1 31.1 30.3 26.1 20-24 19.2 26.6 27.2 34.7 14.3 24.6 25-49 25.1 22.2 25.9 24.4 13.5 22.0 Age Total 25.0 22.4 26.0 25.2 13.9 22.2 None 15.2 19.6 19.8 20.9 6.7 17.6 Primary + 25.6 24.8 26.9 25.3 12.0 22.9 Any traditional method Woman's Education Level Secondary + 25.3 20.1 27.5 26.8 19.0 22.2 15-19 100.0 28.9 40.0 38.1 58.9 41.2 20-24 53.8 42.8 51.8 70.1 59.0 51.7 25-49 70.9 60.1 65.8 70.8 62.4 63.9 Age Total 70.2 58.5 64.1 70.2 62.0 62.7 None 60.2 51.7 51.6 52.3 32.5 49.1 Primary + 69.5 61.6 64.0 72.3 65.2 64.8 Any method Woman's Education Level Secondary + 71.6 55.9 71.5 72.7 62.3 62.7 Table 8: Percentage of population with access to Improved drinking water by regions, Lebanon, 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Public water network system 80.5 67.8 63.6 59.1 72.2 68.3 Well 13.3 19.7 19.1 24.5 12.5 18.2 Public water sources outside the house 5.3 10.0 13.1 6.6 3.7 8.6 Population with improved drinking water 99.1 97.5 95.8 90.2 88.4 94.2 Tanker-trunk vendor 0.8 2.3 3.3 9.1 4.1 3.3 Other 0.1 0.2 0.9 0.8 7.6 1.6 Table 9: Percentage of households consuming adequately iodized salt by region, Lebanon 2000 Region Percentage % Households with salt 99.2 0 PPM 1.0 < 15 PPM 7.5 Beirut Result of households with salts 15 + PPM 91.5 Households with salt 99.3 0 PPM 4.0 < 15 PPM 13.8 Mount Lebanon Result of households with salts 15 + PPM 82.3 Households with salt 99.7 0 PPM 0.6 < 15 PPM 7.8 North Result of households with salts 15 + PPM 91.6 Households with salt 98.8 0 PPM 1.4 < 15 PPM 11.5 Beqaa Result of households with salts 15 + PPM 87.1 Households with salt 98.3 0 PPM 0.5 < 15 PPM 10.6 South Result of households with salts 15 + PPM 88.9 Households with salt 99.2 0 PPM 2.1 < 15 PPM 11.1 Lebanon Result of households with salts 15 + PPM 86.8 Table 10: Percentage of living children by breast feeding status by regions, Lebanon, 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 0.0 9.1 29.7 8.9 28.5 17.8 Female 32.2 46.5 38.6 17.0 12.2 34.3 Sex Total 23.3 27.9 35.3 12.9 19.2 26.6 None 100.0 0.0 24.0 0.0 0.0 23.6 Primary + 0.0 35.7 38.3 12.8 17.6 30.4 Exclusive Breastfeeding Mother's Education Level Secondary + 25.5 18.8 22.3 18.4 20.7 20.2 Male 22.8 16.7 33.8 19.6 28.5 24.4 Female 50.5 46.5 38.6 40.1 31.1 41.7 Sex Total 42.9 31.7 36.4 29.7 30.0 33.7 None 100.0 0.0 24.0 18.1 0.0 27.8 Primary + 58.9 42.7 40.8 36.8 39.0 41.6 Children 0-3 months Exclusive Breastfeeding & water only Mother's Education Level Secondary + 25.5 18.8 22.3 18.4 20.7 20.2 Male 60.2 13.9 36.6 20.8 46.5 31.2 Female 45.4 37.7 51.8 19.5 30.7 39.1 Sex Total 54.0 26.7 45.5 20.2 40.4 35.2 None 100.0 0.0 61.0 50.4 65.5 52.5 Primary + 69.4 25.1 45.0 17.9 43.2 38.8 Semi solid /Solid foods and Breastfeeding Mother's Education Level Secondary + 33.4 27.5 38.5 12.3 31.9 29.1 Male 74.3 51.2 61.5 32.4 72.6 58.7 Female 73.9 100.0 72.4 49.3 74.4 81.6 Sex Total 74.1 75.5 67.8 40.4 73.3 70.4 None 100.0 0.0 86.3 55.7 100.0 71.7 Primary + 78.1 58.4 66.2 42.0 74.9 65.0 Children 6-9 months Semi solid/ Solid Foods Mother's Education Level Secondary + 67.6 87.0 61.9 30.9 66.1 75.6 Male 50.4 52.2 37.8 36.1 20.3 38.4 Female 41.1 44.4 26.8 38.0 20.7 32.6 Sex Total 46.4 48.5 33.4 37.1 20.5 34.7 None 100.0 0.0 42.7 0.0 28.8 42.1 Primary + 100.0 78.8 34.4 53.4 25.0 45.6 Children 12-15 months Breastfed Mother's Education Level Secondary + 20.7 28.4 26.6 0.0 13.9 21.3 Male 0.0 5.9 20.2 24.0 8.2 12.4 Female 22.0 0.0 16.7 13.7 4.2 8.5 Sex Total 12.9 3.8 18.8 16.9 6.0 10.6 None 0.0 0.0 0.0 0.0 0.0 0.0 Primary + 100.0 6.6 18.0 26.1 10.3 14.8 Children 20-23 months Breastfed Mother's Education Level Secondary + 0.0 0.0 30.2 0.0 0.0 5.2 Table 11: Percent of under five children with diarrhea in the last two weeks and treatment with ORS or ORT by regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 23.9 19.1 22.3 21.7 18.4 20.4 Female 12.9 17.8 16.5 24.0 19.8 18.3 Sex Total 18.1 18.5 19.4 22.8 19.1 19.3 < 6 months 10.9 14.2 23.6 13.6 26.0 19.0 6-11 months 25.9 20.3 32.7 36.0 29.5 27.1 12-23 months 30.9 35.4 34.4 39.0 24.5 32.7 24-35 months 20.5 21.7 16.1 18.3 19.3 19.4 36-47 months 11.9 11.0 13.2 20.8 13.4 13.4 Age 48-59 month 13.5 8.5 9.7 16.1 13.6 11.2 None 13.0 32.5 21.3 24.1 13.5 22.4 Primary + 23.3 18.3 20.6 24.0 22.9 21.1 Had diarrhea in last 2 weeks Mother's Education Level Secondary + 15.5 17.1 15.0 19.6 13.5 16.1 Male 18.5 25.2 32.7 24.2 30.2 27.7 Female 40.2 17.0 29.2 19.5 19.9 22.2 Sex Total 26.7 21.4 31.2 21.8 24.7 25.1 < 6 months 100.0 78.7 76.4 100.0 71.4 78.7 6-11 months 62.7 27.3 61.5 33.0 45.5 44.0 12-23 months 24.4 35.7 28.0 26.0 35.9 31.4 24-35 months 26.8 9.9 11.5 16.1 0.0 10.2 36-47 months 0.0 0.0 12.8 3.6 2.2 4.7 Age 48-59 month 0.0 0.0 5.9 3.4 7.0 3.9 None 100.0 32.8 31.8 26.1 34.7 32.9 Primary + 28.7 26.9 34.8 19.3 27.5 28.3 Breast milk Mother's Education Level Secondary + 19.9 12.7 17.9 27.0 15.3 16.1 Male 72.5 61.0 55.1 46.3 64.4 58.8 Female 63.7 80.2 50.4 52.2 71.6 65.8 Sex Total 69.2 69.9 53.1 49.3 68.3 62.1 < 6 months 49.7 21.3 21.8 13.3 24.2 22.4 6-11 months 59.9 65.0 34.6 53.4 67.0 55.2 12-23 months 68.9 77.1 66.1 54.8 76.6 70.1 24-35 months 79.9 74.5 56.3 48.8 59.5 65.5 36-47 months 85.9 80.8 71.9 46.7 86.7 73.5 Age 48-59 month 55.9 66.3 44.3 50.4 77.4 60.3 None 49.6 76.3 56.8 40.8 100.0 61.8 Primary + 80.6 61.2 51.9 45.6 59.6 56.4 Gruel Mother's Education Level Secondary + 60.6 75.8 53.7 63.5 89.5 71.9 Male 87.2 65.7 67.2 66.6 68.0 68.1 Female 81.8 70.3 73.8 76.1 68.3 72.1 Sex Total 85.1 67.8 70.0 71.4 68.2 70.0 < 6 months 0.0 41.8 37.2 32.0 39.0 36.9 6-11 months 60.5 52.6 60.1 64.1 66.3 59.9 12-23 months 84.6 64.2 73.8 71.0 77.0 71.4 24-35 months 100.0 70.5 84.5 68.1 66.2 74.2 36-47 months 100.0 91.2 79.4 86.0 74.8 83.6 Age 48-59 month 100.0 88.9 73.6 77.9 71.0 79.5 None 50.4 47.5 56.1 84.6 100.0 61.1 Primary + 89.1 69.1 74.3 69.9 59.3 69.1 Local acceptable Mother's Education Level Secondary + 84.1 68.8 68.5 69.6 89.8 73.7 Table 11: Percent of under five children with diarrhea in the last two weeks and treatment with ORS or ORT by regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 71.4 39.0 48.1 45.2 41.3 45.1 Female 44.1 42.3 40.9 53.3 41.8 43.5 Sex Total 61.1 40.5 45.0 49.3 41.5 44.4 < 6 months 49.7 0.0 49.0 45.6 16.3 29.3 6-11 months 76.6 54.5 41.2 45.4 45.8 49.0 12-23 months 60.1 34.8 36.7 55.3 53.5 42.8 24-35 months 60.5 36.2 35.8 44.3 39.6 39.1 36-47 months 83.6 60.6 52.6 37.3 40.3 50.3 Age 48-59 month 45.0 35.8 73.2 60.1 38.8 50.5 None 100.0 56.5 46.0 32.9 30.5 46.7 Primary + 69.1 41.0 41.3 58.1 37.9 44.2 ORS paket Mother's Education Level Secondary + 51.5 38.8 57.2 32.0 53.4 44.5 Male 53.1 31.7 38.7 23.7 48.8 37.3 Female 54.8 54.1 31.6 28.2 46.9 43.0 Sex Total 53.8 42.0 35.7 26.0 47.8 40.0 < 6 months 0.0 21.3 49.8 37.3 31.5 35.9 6-11 months 49.2 74.3 35.0 19.9 52.4 49.5 12-23 months 69.1 26.4 44.4 37.1 59.1 41.4 24-35 months 72.7 52.7 28.4 36.1 53.3 47.1 36-47 months 69.5 35.7 27.6 14.8 55.4 35.8 Age 48-59 month 22.8 47.7 16.9 9.8 23.4 25.3 None 0.0 59.0 24.4 5.6 65.3 32.1 Primary + 49.6 39.0 29.7 20.5 35.9 33.0 Other milk or infant formula Mother's Education Level Secondary + 61.1 40.6 67.8 50.3 79.7 54.2 Male 71.6 76.7 60.8 46.4 48.7 62.6 Female 58.5 65.1 66.0 40.2 60.0 60.1 Sex Total 66.6 71.3 63.0 43.3 54.8 61.4 < 6 months 49.7 77.4 21.2 20.1 29.9 36.9 6-11 months 76.6 72.4 60.5 39.8 63.8 63.1 12-23 months 73.7 68.6 70.4 50.6 51.4 63.9 24-35 months 70.3 71.4 64.3 42.0 63.2 65.1 36-47 months 47.2 78.1 86.5 42.4 60.6 67.9 Age 48-59 month 56.9 75.8 58.4 46.2 51.8 58.7 None 50.4 47.5 49.8 17.6 100.0 47.5 Primary + 66.7 77.3 69.1 46.0 50.0 62.4 Water with feeding Mother's Education Level Secondary + 67.7 68.8 54.4 47.3 63.1 63.3 Male 100.0 93.7 94.5 89.3 97.9 94.6 Female 100.0 100.0 97.0 98.9 93.7 97.6 Sex Total 100.0 96.6 95.6 94.1 95.7 96.0 < 6 months 100.0 100.0 93.0 100.0 85.8 93.7 6-11 months 100.0 100.0 100.0 93.1 100.0 99.1 12-23 months 100.0 100.0 96.4 95.9 96.0 97.6 24-35 months 100.0 95.3 95.8 90.9 89.5 94.1 36-47 months 100.0 91.2 95.7 97.9 100.0 96.2 Age 48-59 month 100.0 88.9 89.8 87.9 100.0 92.8 None 100.0 100.0 88.3 90.7 100.0 92.5 Primary + 100.0 95.3 96.3 94.8 94.0 95.4 Any recommended treatment Mother's Education Level Secondary + 100.0 97.2 100.0 93.7 100.0 98.0 Table 11: Percent of under five children with diarrhea in the last two weeks and treatment with ORS or ORT by regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 0.0 6.3 5.5 10.7 2.1 5.4 Female 0.0 0.0 3.0 1.1 6.3 2.4 Sex Total 0.0 3.4 4.4 5.9 4.3 4.0 < 6 months 0.0 0.0 7.0 0.0 14.2 6.3 6-11 months 0.0 0.0 0.0 6.9 0.0 0.9 12-23 months 0.0 0.0 3.6 4.1 4.0 2.4 24-35 months 0.0 4.7 4.2 9.1 10.5 5.9 36-47 months 0.0 8.8 4.3 2.1 0.0 3.8 Age 48-59 month 0.0 11.1 10.2 12.1 0.0 7.2 None 0.0 0.0 11.7 9.3 0.0 7.5 Primary + 0.0 4.7 3.7 5.2 6.0 4.6 No treatment Mother's Education Level Secondary + 0.0 2.8 0.0 6.3 0.0 2.0 Table 12: Percentage of under five children with diarrhea in the last two weeks who took increased fluids & continued to feed during the episode by regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 23.9 19.1 22.3 21.7 18.4 20.4 Female 12.9 17.8 16.5 24.0 19.8 18.3 Sex Total 18.1 18.5 19.4 22.8 19.1 19.3 < 6 months 10.9 14.2 23.6 13.6 26.0 19.0 6-11 months 25.9 20.3 32.7 36.0 29.5 27.1 12-23 months 30.9 35.4 34.4 39.0 24.5 32.7 24-35 months 20.5 21.7 16.1 18.3 19.3 19.4 36-47 months 11.9 11.0 13.2 20.8 13.4 13.4 Age 48-59 month 13.5 8.5 9.7 16.1 13.6 11.2 None 13.0 32.5 21.3 24.1 13.5 22.4 Primary + 23.3 18.3 20.6 24.0 22.9 21.1 Had diarrhea in last 2 weeks Mother's Education Level Secondary + 15.5 17.1 15.0 19.6 13.5 16.1 Male 31.4 49.1 53.2 22.9 42.3 44.4 Female 16.0 42.9 33.4 22.3 30.5 33.2 Sex Total 25.6 46.2 44.8 22.6 35.9 39.2 < 6 months 49.7 36.9 33.7 0.0 13.7 26.5 6-11 months 27.1 49.8 35.7 15.6 16.1 32.0 12-23 months 29.5 51.5 47.7 26.6 54.6 46.2 24-35 months 19.3 34.8 48.0 22.4 49.8 38.0 36-47 months 15.6 52.8 42.3 24.2 31.4 37.6 Age 48-59 month 29.1 41.0 57.7 29.2 30.1 39.2 None 0.0 23.7 62.0 19.7 0.0 40.6 Primary + 21.2 35.7 45.3 20.6 33.3 35.0 More Mother's Education Level Secondary + 31.2 57.5 26.0 29.3 47.6 45.6 Male 65.1 50.9 41.3 75.7 56.9 53.4 Female 77.7 54.1 55.4 77.7 68.2 62.4 Sex Total 69.8 52.4 47.3 76.6 63.0 57.6 < 6 months 50.3 63.1 43.1 88.6 79.5 61.6 6-11 months 72.9 50.2 60.3 84.4 81.4 66.3 12-23 months 61.3 43.9 46.7 73.4 45.4 50.0 24-35 months 80.7 65.2 43.6 77.6 50.2 60.3 36-47 months 84.4 47.2 47.8 75.8 68.6 59.7 Age 48-59 month 59.0 59.0 42.3 70.8 69.9 59.8 None 100.0 76.3 27.4 80.3 100.0 53.9 Primary + 73.6 64.3 45.3 79.4 65.2 61.6 Same/Less Mother's Education Level Secondary + 64.4 39.7 74.0 67.8 52.4 52.3 Male 3.5 0.0 5.4 1.4 0.9 2.2 Female 6.3 2.9 11.2 0.0 1.3 4.3 Sex Total 4.5 1.4 7.9 0.7 1.1 3.2 < 6 months 0.0 0.0 23.2 11.4 6.9 11.9 6-11 months 0.0 0.0 4.1 0.0 2.5 1.7 12-23 months 9.2 4.6 5.7 0.0 0.0 3.7 24-35 months 0.0 0.0 8.4 0.0 0.0 1.7 36-47 months 0.0 0.0 10.0 0.0 0.0 2.7 Age 48-59 month 11.9 0.0 0.0 0.0 0.0 1.0 None 0.0 0.0 10.6 0.0 0.0 5.4 Primary + 5.3 0.0 9.4 0.0 1.5 3.5 Drinking during diarrhea Missing/do not know Mother's Education Level Secondary + 4.2 2.8 0.0 2.9 0.0 2.1 Table 12: Percentage of under five children with diarrhea in the last two weeks who took increased fluids & continued to feed during the episode by regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 74.0 80.7 75.6 85.4 83.2 79.8 Female 87.4 69.6 73.9 86.0 77.6 75.9 Sex Total 79.1 75.6 74.9 85.7 80.2 78.0 < 6 months 49.7 80.9 69.4 75.3 64.3 70.6 6-11 months 100.0 100.0 78.2 83.1 83.7 87.9 12-23 months 69.4 81.9 69.5 80.7 75.0 76.0 24-35 months 80.7 64.1 87.4 84.8 76.3 74.5 36-47 months 100.0 91.2 71.5 94.2 84.1 85.1 Age 48-59 month 65.0 47.7 78.3 91.2 95.1 76.4 None 100.0 47.5 70.1 74.1 100.0 67.8 Primary + 77.6 65.6 71.9 90.9 79.3 75.6 Somewhat less/same/more Mother's Education LevelSecondary + 78.9 88.0 90.0 76.3 80.4 85.0 Male 26.0 19.3 22.0 14.6 16.8 19.5 Female 12.6 30.4 21.2 14.0 22.4 22.9 Sex Total 20.9 24.4 21.6 14.3 19.8 21.1 < 6 months 50.3 19.1 23.6 24.7 35.7 26.7 6-11 months 0.0 0.0 21.8 16.9 16.3 12.1 12-23 months 30.6 18.1 26.6 19.3 25.0 22.8 24-35 months 19.3 35.9 8.3 15.2 23.7 24.6 36-47 months 0.0 8.8 23.4 5.8 15.9 13.5 Age 48-59 month 35.0 52.3 21.7 8.8 4.9 23.6 None 0.0 52.5 25.2 25.9 0.0 29.8 Primary + 22.4 34.4 23.9 9.1 20.7 23.2 Much Less/none Mother's Education LevelSecondary + 21.1 12.0 10.0 23.7 19.6 15.0 Male 0.0 0.0 2.5 0.0 0.0 0.7 Female 0.0 0.0 4.9 0.0 0.0 1.2 Sex Total 0.0 0.0 3.5 0.0 0.0 1.0 < 6 months 0.0 0.0 7.0 0.0 0.0 2.7 6-11 months 0.0 0.0 0.0 0.0 0.0 0.0 12-23 months 0.0 0.0 3.9 0.0 0.0 1.2 24-35 months 0.0 0.0 4.3 0.0 0.0 0.9 36-47 months 0.0 0.0 5.1 0.0 0.0 1.4 Age 48-59 month 0.0 0.0 0.0 0.0 0.0 0.0 None 0.0 0.0 4.7 0.0 0.0 2.4 Primary + 0.0 0.0 4.2 0.0 0.0 1.3 Eating during diarrhea Missing/do not know Mother's Education LevelSecondary + 0.0 0.0 0.0 0.0 0.0 0.0 Male 22.3 41.8 38.6 20.1 33.7 35.2 Female 9.7 30.7 25.8 17.1 19.1 23.7 Sex Total 17.6 36.7 33.1 18.6 25.9 29.8 < 6 months 49.7 36.9 20.7 0.0 6.5 19.6 6-11 months 27.1 49.8 26.8 15.6 11.5 28.5 12-23 months 14.3 47.4 32.4 19.4 41.2 36.0 24-35 months 8.5 21.1 43.6 19.2 33.6 27.1 36-47 months 15.6 52.8 28.8 20.5 20.8 30.7 Age 48-59 month 19.8 12.9 46.5 24.8 25.2 26.9 None 0.0 0.0 39.5 19.7 0.0 23.3 Primary + 17.4 21.7 33.4 17.4 23.3 24.8 Received increased fluids and continued eating Mother's Education LevelSecondary + 19.0 53.7 26.0 21.4 36.2 40.0 Table 13: Percentage of under five children with acute respiratory infection in the last two weeks and treatment by health providers by regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 2.5 3.8 5.1 3.6 4.6 4.2 Female 1.4 3.0 1.9 2.0 4.2 2.7 Sex Total 1.9 3.4 3.5 2.8 4.4 3.5 < 6 months 0.0 4.2 2.9 2.0 0.0 2.3 6-11 months 0.0 6.6 3.1 4.2 0.0 3.8 12-23 months 4.9 6.1 5.6 3.2 9.2 6.2 24-35 months 5.7 1.2 2.2 2.8 8.3 3.1 36-47 months 0.0 2.9 3.6 2.3 4.7 3.3 Age 48-59 month 0.0 2.6 3.5 2.9 0.9 2.4 None 0.0 0.0 4.2 0.0 0.0 2.2 Primary + 3.3 4.2 4.5 3.4 5.3 4.4 Had Acute respiratory infection in last 2 weeks Mlother's Education Level Secondary + 1.2 3.1 0.6 2.3 3.5 2.5 Male 0.0 0.6 1.1 0.0 0.4 0.6 Female 0.0 0.0 0.2 0.0 0.0 0.1 Sex Total 0.0 0.3 0.7 0.0 0.2 0.3 < 6 months 0.0 0.0 1.4 0.0 0.0 0.5 6-11 months 0.0 2.3 0.0 0.0 0.0 0.9 12-23 months 0.0 0.0 0.8 0.0 0.0 0.2 24-35 months 0.0 0.0 0.7 0.0 0.0 0.2 36-47 months 0.0 0.0 0.0 0.0 1.0 0.2 Age 48-59 month 0.0 0.0 1.0 0.0 0.0 0.3 None 0.0 0.0 2.4 0.0 0.0 1.3 Primary + 0.0 0.7 0.5 0.0 0.4 0.4 Hospital Mlother's Education Level Secondary + 0.0 0.0 0.0 0.0 0.0 0.0 Male 0.0 1.1 0.9 0.0 1.0 0.8 Female 0.0 0.0 0.0 0.0 2.5 0.5 Sex Total 0.0 0.5 0.4 0.0 1.8 0.7 < 6 months 0.0 0.0 0.0 0.0 0.0 0.0 6-11 months 0.0 4.3 0.0 0.0 0.0 1.7 12-23 months 0.0 0.0 0.0 0.0 2.9 0.7 24-35 months 0.0 0.0 0.7 0.0 3.3 0.8 36-47 months 0.0 0.0 1.4 0.0 3.0 1.1 Age 48-59 month 0.0 0.0 0.0 0.0 0.0 0.0 None 0.0 0.0 0.0 0.0 0.0 0.0 Primary + 0.0 1.3 0.5 0.0 2.0 1.0 Health center or dispensary or mobile Mlother's Education Level Secondary + 0.0 0.0 0.6 0.0 1.5 0.4 Male 2.5 0.5 2.0 2.0 1.9 1.5 Female 1.4 2.3 0.6 0.7 1.4 1.4 Sex Total 1.9 1.4 1.3 1.3 1.7 1.4 < 6 months 0.0 0.0 0.0 2.0 0.0 0.3 6-11 months 0.0 0.0 1.6 4.2 0.0 0.8 12-23 months 4.9 0.0 3.2 2.0 5.4 2.7 24-35 months 5.7 1.2 0.0 0.0 2.9 1.3 36-47 months 0.0 2.9 1.3 1.4 0.8 1.6 Age 48-59 month 0.0 2.6 1.3 0.7 0.0 1.3 None 0.0 0.0 0.9 0.0 0.0 0.5 Primary + 3.3 0.0 1.9 1.4 1.9 1.4 Private physician Mlother's Education Level Secondary + 1.2 2.6 0.0 1.6 1.4 1.7 Table 13: Percentage of under five children with acute respiratory infection in the last two weeks and treatment by health providers by regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 0.0 0.0 0.0 0.4 0.5 0.1 Female 0.0 0.0 0.0 0.3 0.3 0.1 Sex Total 0.0 0.0 0.0 0.4 0.4 0.1 < 6 months 0.0 0.0 0.0 0.0 0.0 0.0 6-11 months 0.0 0.0 0.0 0.0 0.0 0.0 12-23 months 0.0 0.0 0.0 0.0 0.0 0.0 24-35 months 0.0 0.0 0.0 0.8 1.0 0.3 36-47 months 0.0 0.0 0.0 0.0 0.0 0.0 Age 48-59 month 0.0 0.0 0.0 0.9 0.9 0.3 None 0.0 0.0 0.0 0.0 0.0 0.0 Primary + 0.0 0.0 0.0 0.6 0.6 0.2 Pharmacy Mlother's Education Level Secondary + 0.0 0.0 0.0 0.0 0.0 0.0 Male 0.0 0.5 0.0 0.4 0.0 0.2 Female 0.0 0.0 0.0 0.0 0.0 0.0 Sex Total 0.0 0.3 0.0 0.2 0.0 0.1 < 6 months 0.0 0.0 0.0 0.0 0.0 0.0 6-11 months 0.0 0.0 0.0 0.0 0.0 0.0 12-23 months 0.0 1.8 0.0 0.0 0.0 0.5 24-35 months 0.0 0.0 0.0 1.0 0.0 0.1 36-47 months 0.0 0.0 0.0 0.0 0.0 0.0 Age 48-59 month 0.0 0.0 0.0 0.0 0.0 0.0 None 0.0 0.0 0.0 0.0 0.0 0.0 Primary + 0.0 0.7 0.0 0.3 0.0 0.2 Other Mlother's Education Level Secondary + 0.0 0.0 0.0 0.0 0.0 0.0 Male 100.0 56.9 76.7 66.2 83.4 71.8 Female 100.0 74.8 46.1 50.8 100.0 76.4 Sex Total 100.0 64.6 68.2 61.0 91.8 73.6 < 6 months 0.0 0.0 50.0 100.0 0.0 33.5 6-11 months 0.0 100.0 52.1 100.0 0.0 91.2 12-23 months 100.0 0.0 71.7 61.6 89.8 57.6 24-35 months 100.0 100.0 67.1 27.4 86.8 80.0 36-47 months 0.0 100.0 78.5 59.7 100.0 90.0 Age 48-59 month 0.0 100.0 67.2 56.4 100.0 79.1 None 100.0 0.0 77.4 0.0 0.0 77.4 Primary + 100.0 47.2 64.1 58.8 94.2 68.8 Any appropriate provider Mlother's Education Level Secondary + 100.0 83.4 100.0 68.3 85.8 84.3 Table 14 Immunization coverage 12-23 months Regions DPT/0PV 3 M / MMR Total Beirut 94.4% 92.4% 2,691 Mount Lebanon 91.9% 93.4% 14,191 North 81.7% 78.9% 13,492 Beqaa 87.7% 81.4% 5,626 South 97.8% 94.8% 10,297 Lebanon 90.1% 88.0% 46,297 Distribution of children according to source of data Regions Vacconation Card Mother Never Vaccinated Total Beirut 66.9% 33.1% 4.7% 2,691 Mount Lebanon 55.8% 44.2% 0.0% 14,191 North 57.2% 42.8% 4.3% 13,492 Beqaa 44.2% 55.8% 8.1% 5,626 South 72.8% 27.2% 0.4% 10,297 Lebanon 59.2% 40.8% 2.6% 46,297 Table 15: Percent distribution of children aged 36-71 months who attending some form of organized early childhood education programme by regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 93.2 87.6 80.1 82.1 86.3 85.1 Female 92.3 90.7 81.4 85.6 84.4 86.0 Sex Total 92.8 89.2 80.8 83.9 85.3 85.5 36-47 months 86.3 82.6 59.1 65.0 73.5 72.2 48-59 months 95.7 93.6 91.5 92.2 91.9 92.8 Age 60-71 months 95.7 92.1 95.3 93.8 92.2 92.9 None 82.6 74.3 70.2 66.4 74.8 71.2 Primary + 93.5 82.9 79.9 83.2 85.0 83.1 Mother's Education Level Secondary + 93.1 95.7 92.0 93.1 87.7 92.9 Table 16: Percentage of children entering first grade of primary school who eventually reach grade 5 by regions, Lebanon , 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 100.0 100.0 100.0 98.7 98.4 99.5 Female 100.0 100.0 100.0 97.4 100.0 99.7 Percent in Grade 1 reaching Grade 2 Total 100.0 100.0 100.0 98.1 99.2 99.6 Male 100.0 97.6 95.5 98.6 100.0 97.8 Female 100.0 97.2 100.0 98.5 100.0 99.0 Percent in Grade 2 reaching Grade 3 Total 100.0 97.5 97.9 98.6 100.0 98.4 Male 100.0 100.0 95.5 97.2 100.0 98.4 Female 100.0 100.0 97.9 96.4 99.3 98.8 Percent in Grade 3 reaching Grade 4 Total 100.0 100.0 96.7 96.8 99.7 98.6 Male 96.2 97.5 100.0 95.2 98.7 98.0 Female 100.0 100.0 99.1 100.0 98.4 99.4 Percent in Grade 4 reaching Grade 5 Total 97.8 98.9 99.5 96.9 98.6 98.7 Male 96.2 95.2 91.2 90.0 97.1 93.8 Female 100.0 97.2 97.1 92.5 97.7 97.0 Percent who earch Grade 5 of those who enter Grade 1 Total 97.8 96.3 94.2 90.7 97.4 95.3 Table 17: Percentage of children 5-14 years of age who are currently working by regions, Lebanon, 2000 Beirut Mount Lebanon North Beqaa South Lebanon % % % % % % Male 0.3 2.1 2.0 3.0 3.9 2.4 Female 0.0 0.2 0.1 1.7 2.0 0.7 Sex Total 0.1 1.2 1.0 2.4 3.0 1.6 6-9 Years 0.0 1.5 0.3 1.7 2.0 1.2 Paid work Age 10-14 Years 0.2 1.0 1.5 2.9 3.7 1.8 Male 3.2 7.4 8.2 12.3 9.9 8.4 Female 1.2 0.5 4.2 5.9 7.0 3.5 Sex Total 2.3 4.1 6.2 9.4 8.5 6.0 6-9 Years 0.8 2.1 3.2 4.2 6.4 3.4 Unpaid work Age 10-14 Years 3.1 5.4 8.2 13.0 9.9 7.8 Male 33.1 26.2 24.6 33.7 28.0 27.7 Female 50.0 50.4 46.4 57.7 56.2 51.3 Sex Total 40.9 37.8 35.8 44.4 41.7 39.1 5-9 Years 36.0 31.7 25.8 33.1 33.7 30.9 Domestic work: < 4 hours/day Age 6-9 Years 43.5 41.8 42.8 52.0 47.1 44.5 Male 0.2 0.2 0.1 0.0 0.5 0.2 Female 1.6 1.8 4.9 0.9 2.9 2.8 Sex Total 0.9 1.0 2.6 0.4 1.7 1.5 6-9 Years 0.7 0.3 0.5 0.2 0.4 0.4 Domestic work: 4 or more hours /day Age 10-14 Years 1.0 1.4 4.1 0.6 2.5 2.2 Male 35.3 34.0 31.5 42.3 38.3 35.4 Female 51.6 53.5 52.8 60.9 62.3 55.8 Sex Total 42.8 43.3 42.4 50.6 50.0 45.3 6-9 Years 37.2 35.0 28.6 35.8 39.8 34.5 Currently working Age 10-14 Years 45.8 48.9 52.1 60.5 56.9 52.5 Table 18: Infant and Under-five Mortality rates,by regions, Lebanon , 2000 Regions Beirut Mount Lebanon North Beqaa South Lebanon Infant Mortality rate 20.00 19.00 32.00 40.00 24.00 26.00 Child Mortality between 1st and 4th Year 5.00 4.00 12.00 17.00 8.00 7.00 Under-five Mortality rate 25.00 23.00 44.00 57.00 32.00 33.00

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