Lesotho Demographic and Health Survey 2014

Publication date: 2016

Lesotho 2014Demographic andHealth Survey Lesotho 2014 D em ographic and H ealth Survey BOPHELO MINISTRY OF HEALTH Lesotho Demographic and Health Survey 2014 Ministry of Health Maseru, Lesotho The DHS Program ICF International Rockville, Maryland, USA May 2016 World Bank The 2014 Lesotho Demographic and Health Survey (2014 LDHS) was implemented by the Lesotho Ministry of Health from 22 September to 7 December 2014. The funding for the LDHS was provided by the government of Lesotho, the United States Agency for International Development (USAID), the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), the World Bank, and the World Health Organization (WHO). ICF International provided technical assistance through The DHS Program, a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide. Additional information about the 2014 LDHS may be obtained from the Ministry of Health, P.O. Box 514, Maseru, Lesotho; Telephone: +266-22-314404; Internet: http://www.gov.ls/health/. Information about The DHS Program may be obtained from ICF International, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; Telephone: +1-301-407-6500; Fax: +1-301-407-6501; E-mail: info@DHSprogram.com; Internet: www.DHSprogram.com. Cover photo of Maletsuyane Falls near Semonkong, Lesotho, is provided courtesy of Joanna Lowell, ICF International. Suggested citation: Ministry of Health [Lesotho] and ICF International. 2016. Lesotho Demographic and Health Survey 2014. Maseru, Lesotho: Ministry of Health and ICF International. Contents • iii CONTENTS TABLES AND FIGURES . vii FOREWORD . xv READING AND UNDERSTANDING TABLES FROM THE 2014 LDHS . xvii ADDITIONAL DHS PROGRAM RESOURCES . xxv ACRONYMS AND ABBREVIATIONS . xxvii MILLENNIUM DEVELOPMENT GOAL INDICATORS . xxix MAP OF LESOTHO . xxx 1 INTRODUCTION AND SURVEY METHODOLOGY . 1 1.1 Survey Objectives . 1 1.2 Sample Design . 1 1.3 Questionnaires . 2 1.4 Blood Pressure Measurement, Anthropometry, Anaemia Testing, and HIV Testing . 3 1.5 Pretest . 4 1.6 Training of Field Staff . 4 1.7 Fieldwork . 5 1.8 Data Processing . 5 1.9 Response Rates . 5 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION . 7 2.1 Drinking Water Sources and Treatment . 7 2.2 Sanitation . 8 2.3 Exposure to Smoke inside the Home . 9 2.4 Household Wealth . 10 2.5 Hand Washing . 10 2.6 Household Population and Composition . 11 2.7 Birth Registration . 12 2.8 Children’s Living Arrangements and Parental Survival . 12 2.9 Education . 13 2.9.1 Educational Attainment . 13 2.9.2 School Attendance . 13 2.10 Distance to a Health Facility . 14 3 CHARACTERISTICS OF RESPONDENTS . 31 3.1 Basic Characteristics of Survey Respondents . 31 3.2 Education and Literacy . 32 3.3 Mass Media Exposure . 33 3.4 Employment . 34 3.5 Occupation . 34 3.6 Health Insurance Coverage . 35 3.7 Tobacco Use . 35 3.8 Time Away from Home . 36 4 MARRIAGE AND SEXUAL ACTIVITY . 57 4.1 Marital Status . 57 4.2 Polygyny . 58 4.3 Age at First Marriage . 59 4.4 Age at First Sexual Intercourse . 59 4.5 Recent Sexual Activity . 60 iv • Contents 5 FERTILITY . 71 5.1 Current Fertility . 71 5.2 Children Ever Born and Living . 72 5.3 Birth Intervals . 73 5.4 Insusceptibility to Pregnancy . 73 5.5 Age at First Birth . 74 5.6 Teenage Childbearing . 75 6 FERTILITY PREFERENCES . 85 6.1 Desire for Another Child . 85 6.2 Ideal Family Size . 86 6.3 Fertility Planning Status . 87 6.4 Wanted Fertility Rates . 88 7 FAMILY PLANNING . 97 7.1 Contraceptive Knowledge and Use . 98 7.2 Source of Modern Contraceptive Methods . 99 7.3 Informed Choice . 100 7.4 Discontinuation of Contraceptives . 100 7.5 Demand for Family Planning . 101 7.6 Contact of Nonusers with Family Planning Providers . 103 8 INFANT AND CHILD MORTALITY . 115 8.1 Infant and Child Mortality . 116 8.2 Biodemographic Risk Factors . 117 8.3 Perinatal Mortality . 117 9 MATERNAL HEALTH CARE . 123 9.1 Antenatal Care Coverage and Content . 124 9.1.1 Skilled Providers . 124 9.1.2 Timing and Number of ANC Visits . 124 9.2 Components of ANC Visits . 125 9.3 Protection against Neonatal Tetanus . 125 9.4 Delivery Services . 126 9.4.1 Institutional Deliveries . 126 9.4.2 Skilled Assistance during Delivery . 127 9.4.3 Delivery by Caesarean . 128 9.5 Postnatal Care . 128 9.5.1 Postnatal Health Check for Mothers . 128 9.5.2 Postnatal Health Checks for Newborns . 129 9.6 Problems in Accessing Health Care . 130 10 CHILD HEALTH . 143 10.1 Birth Weight . 143 10.2 Vaccination of Children . 144 10.3 Symptoms of Acute Respiratory Infection . 145 10.4 Fever . 146 10.5 Diarrhoeal Disease . 146 10.5.1 Prevalence of Diarrhoea . 146 10.5.2 Treatment of Diarrhoea . 147 10.5.3 Feeding Practices . 147 10.5.4 Knowledge of ORS Packets . 148 10.5.5 Men’s Knowledge of Feeding Practices during Diarrhoea . 148 10.6 Disposal of Children’s Stools. 149 11 NUTRITION OF CHILDREN AND ADULTS . 163 11.1 Nutritional Status of Children . 163 11.1.1 Measurement of Nutritional Status among Young Children . 163 11.1.2 Data Collection . 165 Contents • v 11.1.3 Levels of Child Malnutrition . 165 11.2 Infant and Young Child Feeding Practices . 166 11.2.1 Breastfeeding . 166 11.2.2 Exclusive Breastfeeding . 167 11.2.3 Median Duration of Breastfeeding . 167 11.2.4 Complementary Feeding . 168 11.2.5 Minimum Acceptable Diet . 169 11.3 Anaemia Prevalence in Children . 171 11.4 Micronutrient Intake and Supplementation among Children . 172 11.5 Presence of Iodised Salt in Households . 172 11.6 Adults’ Nutritional Status . 172 11.6.1 Nutritional Status of Women . 172 11.6.2 Nutritional Status of Men . 173 11.7 Anaemia Prevalence in Adults . 174 11.8 Micronutrient Intake among Mothers . 174 12 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR . 191 12.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods. 192 12.2 Knowledge about Mother-to-Child Transmission . 193 12.3 HIV/AIDS Attitudes . 194 12.3.1 Attitudes towards People Living with HIV/AIDS . 194 12.3.2 Attitudes towards Negotiating Safer Sexual Relations with Husbands . 195 12.3.3 Attitudes towards Condom Education for Young People . 195 12.4 Multiple Sexual Partners . 195 12.5 Paid Sex . 196 12.6 Coverage of HIV Testing Services. 197 12.6.1 Awareness of HIV Testing Services and Experience with HIV Testing . 197 12.6.2 HIV Testing of Pregnant Women . 198 12.6.3 Reasons for Not Getting Tested for HIV . 199 12.7 Male Circumcision . 199 12.8 Self-reporting of Sexually Transmitted Infections . 200 12.9 Injections . 201 12.10 HIV/AIDS-Related Knowledge and Behaviour among Young People . 201 12.10.1 Knowledge . 201 12.10.2 First Sex . 201 12.10.3 Premarital Sex . 202 12.10.4 Multiple Sexual Partners . 202 12.10.5 Age-mixing in Sexual Relationships . 202 12.10.6 Coverage of HIV Testing Services . 203 13 HIV PREVALENCE . 235 13.1 Coverage Rates for HIV Testing . 235 13.2 HIV Prevalence . 236 13.2.1 HIV Prevalence by Age and Sex . 236 13.2.2 HIV Prevalence by Sexual Risk Behaviour . 239 13.2.3 HIV Prevalence among Young People . 239 13.2.4 HIV Prevalence by Other Characteristics Related to HIV Risk . 240 13.2.5 HIV Prevalence among Couples . 240 13.3 HIV Incidence . 240 14 WOMEN’S EMPOWERMENT . 255 14.1 Married Women’s and Men’s Employment . 255 14.2 Control over Women’s Earnings . 256 14.3 Control over Men’s Earnings . 257 14.4 Women’s and Men’s Ownership of Assets . 258 vi • Contents 14.5 Women’s Participation in Decision Making . 258 14.6 Attitudes towards Wife Beating . 259 15 ADULT AND MATERNAL MORTALITY . 277 15.1 Data . 277 15.2 Direct Estimates of Adult Mortality . 278 15.3 Trends in Adult Mortality . 279 15.4 Direct Estimates of Maternal Mortality . 280 16 TUBERCULOSIS . 285 16.1 Respondents’ Knowledge of Tuberculosis . 285 16.1.1 Awareness of Tuberculosis and Knowledge that Tuberculosis Can Be Cured . 285 16.1.2 Knowledge of Symptoms Associated with Tuberculosis . 286 16.1.3 Knowledge of the Cause of Tuberculosis and Its Mode of Transmission . 286 16.2 Self-Reported Symptoms, Diagnosis, and Treatment . 287 16.2.1 Self-reported Tuberculosis Symptoms . 287 16.2.2 Treatment Seeking for Tuberculosis Symptoms . 287 16.2.3 Tuberculosis Diagnosis and Treatment . 288 16.3 Attitudes towards Those Treated for Tuberculosis . 288 17 NONCOMMUNICABLE DISEASES . 301 17.1 Knowledge of Breast Cancer . 301 17.2 Breast Self-examination and Clinical Exam . 302 17.3 Knowledge of and Experience with Cervical Cancer Exam . 302 17.4 Knowledge and History of Diabetes . 303 17.5 History of High Blood Pressure . 303 17.6 Blood Pressure Status . 304 REFERENCES . 319 APPENDIX A SAMPLE DESIGN . 321 A.1 Introduction . 321 A.2 Sample Frame . 321 A.3 Sample Design and Implementation . 322 A.4 Sample Probabilities and Sampling Weights . 324 APPENDIX B ESTIMATES OF SAMPLING ERRORS . 333 APPENDIX C HIV TESTING METHODOLOGY . 373 APPENDIX D DATA QUALITY TABLES . 377 APPENDIX E PERSONS INVOLVED IN THE 2014 LESOTHO DEMOGRAPHIC AND HEALTH SURVEY . 383 APPENDIX F QUESTIONNAIRES . 387 Tables and Figures • vii TABLES AND FIGURES 1 INTRODUCTION AND SURVEY METHODOLOGY . 1 Table 1.1 Results of the household and individual interviews . 6 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION . 7 Figure 2.1 Household drinking water by residence . 8 Figure 2.2 Household toilet facilities by residence . 9 Figure 2.3 Household wealth by residence . 10 Figure 2.4 Population pyramid . 11 Figure 2.5 Birth registration by district . 12 Figure 2.6 Orphanhood by age . 12 Figure 2.7 Secondary school attendance by wealth quintile . 14 Table 2.1 Household drinking water . 16 Table 2.2 Household sanitation facilities . 17 Table 2.3 Household characteristics . 18 Table 2.4 Wealth quintiles . 19 Table 2.5 Household possessions . 19 Table 2.6 Hand washing . 20 Table 2.7 Household population by age, sex, and residence . 20 Table 2.8 Household composition . 21 Table 2.9 Residency status . 22 Table 2.10 Birth registration of children under age 5 . 23 Table 2.11 Children’s living arrangements and orphanhood . 24 Table 2.12 School attendance by survivorship of parents . 25 Table 2.13.1 Educational attainment of the female household population . 26 Table 2.13.2 Educational attainment of the male household population . 27 Table 2.14 School attendance ratios . 28 Table 2.15 Method of travel and travel time to nearest health facility . 29 Table 2.16 Travel time to health facility by walking. 29 3 CHARACTERISTICS OF RESPONDENTS . 31 Figure 3.1 Education of survey respondents . 32 Figure 3.2 Exposure to mass media . 33 Figure 3.3 Employment by education . 34 Figure 3.4 Occupation . 35 Figure 3.5 Use of tobacco . 36 Table 3.1 Background characteristics of respondents . 38 Table 3.2.1 Educational attainment: Women . 39 Table 3.2.2 Educational attainment: Men . 40 Table 3.3.1 Literacy: Women . 41 Table 3.3.2 Literacy: Men . 42 Table 3.4.1 Exposure to mass media: Women . 43 Table 3.4.2 Exposure to mass media: Men . 44 Table 3.5.1 Employment status: Women . 45 Table 3.5.2 Employment status: Men . 46 Table 3.6 Type of employment: Women . 47 viii • Tables and Figures Table 3.7.1 Occupation: Women . 48 Table 3.7.2 Occupation: Men . 49 Table 3.8.1 Health insurance coverage: Women . 50 Table 3.8.2 Health insurance coverage: Men . 51 Table 3.9.1 Use of tobacco: Women . 52 Table 3.9.2 Use of tobacco: Men . 53 Table 3.10.1 Time away from home: Women . 54 Table 3.10.2 Time away from home: Men . 55 4 MARRIAGE AND SEXUAL ACTIVITY . 57 Figure 4.1 Marital status . 58 Figure 4.2 Median age at first sexual intercourse and first marriage among women and men . 60 Table 4.1 Current marital status . 62 Table 4.2.1 Number of women’s co-wives . 63 Table 4.2.2 Number of men’s wives . 64 Table 4.3 Age at first marriage . 65 Table 4.4 Median age at first marriage by background characteristics . 66 Table 4.5 Age at first sexual intercourse . 67 Table 4.6 Median age at first sexual intercourse by background characteristics . 68 Table 4.7.1 Recent sexual activity: Women . 69 Table 4.7.2 Recent sexual activity: Men . 70 5 FERTILITY . 71 Figure 5.1 Trends in total fertility rate (TFR) by residence . 72 Figure 5.2 Total fertility rate by district . 72 Figure 5.3 Total fertility rate by wealth quintile . 72 Figure 5.4 Birth interval distribution . 73 Figure 5.5 Age at first birth by education . 75 Figure 5.6 Teenage childbearing by district . 75 Table 5.1 Current fertility . 77 Table 5.2 Fertility by background characteristics. 77 Table 5.3.1 Trends in age-specific fertility rates . 78 Table 5.3.2 Trends in age-specific and total fertility rates . 78 Table 5.4 Children ever born and living . 78 Table 5.5 Birth intervals . 79 Table 5.6 Postpartum amenorrhoea, abstinence, and insusceptibility . 80 Table 5.7 Median duration of amenorrhoea, postpartum abstinence, and postpartum insusceptibility . 80 Table 5.8 Menopause . 81 Table 5.9 Age at first birth . 81 Table 5.10 Median age at first birth . 82 Table 5.11 Teenage pregnancy and motherhood . 83 6 FERTILITY PREFERENCES . 85 Figure 6.1 Trends in desire to limit childbearing . 86 Figure 6.2 Ideal family size . 86 Figure 6.3 Ideal family size by number of living children . 87 Figure 6.4 Fertility planning status . 87 Figure 6.5 Trends in wanted and actual fertility . 88 Tables and Figures • ix Table 6.1 Fertility preferences by number of living children . 90 Table 6.2 Desire to limit childbearing . 91 Table 6.3 Ideal number of children by number of living children . 92 Table 6.4 Mean ideal number of children . 93 Table 6.5 Fertility planning status . 94 Table 6.6 Wanted fertility rates . 95 7 FAMILY PLANNING . 97 Figure 7.1 Contraceptive use . 98 Figure 7.2 Trends in contraceptive use . 98 Figure 7.3 Modern contraceptive use by district . 99 Figure 7.4 Modern contraceptive use by education . 99 Figure 7.5 Source of modern contraceptive methods . 100 Figure 7.6 Demand for family planning . 101 Figure 7.7 Trends in total demand for family planning . 102 Figure 7.8 Unmet need by district . 102 Table 7.1 Knowledge of contraceptive methods . 104 Table 7.2 Current use of contraception by age . 105 Table 7.3.1 Trends in the current use of contraception . 105 Table 7.3.2 Current use of contraception by background characteristics . 106 Table 7.4 Source of modern contraceptive methods . 107 Table 7.5 Informed choice . 108 Table 7.6 Twelve-month contraceptive discontinuation rates . 109 Table 7.7 Reasons for discontinuation . 109 Table 7.8 Knowledge of fertile period . 109 Table 7.9.1 Need and demand for family planning among currently married women . 110 Table 7.9.2 Need and demand for family planning for all women and for women who are not currently married . 111 Table 7.10 Future use of contraception . 112 Table 7.11 Exposure to family planning messages . 113 Table 7.12 Contact of nonusers with family planning providers . 114 8 INFANT AND CHILD MORTALITY . 115 Figure 8.1 Trends in early childhood mortality . 116 Figure 8.2 Under-5 mortality by mother’s education . 117 Figure 8.3 Perinatal mortality by district . 117 Table 8.1 Early childhood mortality rates . 119 Table 8.2 Early childhood mortality rates by socioeconomic characteristics . 119 Table 8.3 Early childhood mortality rates by demographic characteristics . 120 Table 8.4 Perinatal mortality . 121 Table 8.5 High-risk fertility behaviour . 122 9 MATERNAL HEALTH CARE . 123 Figure 9.1 Antenatal care coverage trends . 124 Figure 9.2 Trends in place of delivery . 126 Figure 9.3 Institutional deliveries by district . 126 Figure 9.4 Institutional deliveries by mother’s education . 126 Figure 9.5 Delivery assistance . 127 Figure 9.6 Delivery assistance by wealth quintile . 127 Figure 9.7 Postnatal care by place of delivery . 129 x • Tables and Figures Table 9.1 Antenatal care . 131 Table 9.2 Number of antenatal care visits and timing of first visit. 132 Table 9.3 Components of antenatal care . 133 Table 9.4 Tetanus toxoid injections . 134 Table 9.5 Place of delivery . 135 Table 9.6 Assistance during delivery . 136 Table 9.7 Timing of first postnatal check for the mother . 137 Table 9.8 Type of provider of first postnatal check for the mother . 138 Table 9.9 Timing of first postnatal check for the newborn . 139 Table 9.10 Type of provider of first postnatal check for the newborn . 140 Table 9.11 Problems in accessing health care . 141 10 CHILD HEALTH . 143 Figure 10.1 Childhood vaccinations . 144 Figure 10.2 Trends in childhood vaccinations . 145 Figure 10.3 Vaccination coverage by district . 145 Figure 10.4 Diarrhoea prevalence by age . 146 Figure 10.5 Treatment of diarrhoea . 147 Figure 10.6 Feeding practices during diarrhoea . 148 Figure 10.7 Prevalence and treatment of childhood illnesses . 148 Table 10.1 Child’s size and weight at birth . 150 Table 10.2 Vaccinations by source of information . 151 Table 10.3 Vaccinations by background characteristics . 152 Table 10.4 Vaccinations in first year of life . 153 Table 10.5 Prevalence and treatment of symptoms of ARI . 154 Table 10.6 Prevalence and treatment of fever . 155 Table 10.7 Prevalence of diarrhoea . 156 Table 10.8 Diarrhoea treatment . 157 Table 10.9 Feeding practices during diarrhoea . 158 Table 10.10 Knowledge of ORS packets . 159 Table 10.11 Men’s knowledge of feeding practices during diarrhoea. 160 Table 10.12 Disposal of children’s stools . 161 11 NUTRITION OF CHILDREN AND ADULTS . 163 Figure 11.1 Children’s nutritional status . 165 Figure 11.2 Trends in children’s nutritional status . 165 Figure 11.3 Stunting in children by district . 166 Figure 11.4 Breastfeeding practices by age . 167 Figure 11.5 IYCF breastfeeding indicators . 168 Figure 11.6 IYCF indicators on minimum acceptable diet . 170 Figure 11.7 Trends in childhood anaemia. 171 Figure 11.8 Anaemia in children by district . 171 Figure 11.9 Trends in women’s nutritional status . 173 Figure 11.10 Prevalence of anaemia in adults . 174 Table 11.1 Nutritional status of children . 176 Table 11.2 Initial breastfeeding . 178 Table 11.3 Breastfeeding status by age . 179 Table 11.4 Median duration of breastfeeding . 180 Table 11.5 Foods and liquids consumed by children in the day or night preceding the interview . 181 Table 11.6 Infant and young child feeding (IYCF) practices . 182 Tables and Figures • xi Table 11.7 Prevalence of anaemia in children . 183 Table 11.8 Micronutrient intake among children . 184 Table 11.9 Presence of iodised salt in household . 185 Table 11.10.1 Nutritional status of women . 186 Table 11.10.2 Nutritional status of men . 187 Table 11.11.1 Prevalence of anaemia in women . 188 Table 11.11.2 Prevalence of anaemia in men . 189 Table 11.12 Micronutrient intake among mothers . 190 12 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR . 191 Figure 12.1 Trends in HIV Knowledge . 192 Figure 12.2 Comprehensive knowledge of HIV by education . 193 Figure 12.3 Trends in knowledge of maternal-to-child transmission of HIV . 194 Figure 12.4 Multiple sexual partners and condom use . 196 Figure 12.5 Trends in HIV testing . 198 Figure 12.6 Recent HIV testing by wealth quintile . 198 Figure 12.7 STI advice or treatment seeking-behaviour . 200 Figure 12.8 Age at first sex among young people . 201 Figure 12.9 Premarital sex and condom use among young people . 202 Table 12.1 Knowledge of AIDS . 205 Table 12.2 Knowledge of HIV prevention methods . 206 Table 12.3.1 Comprehensive knowledge about HIV/AIDS: Women . 207 Table 12.3.2 Comprehensive knowledge about HIV/AIDS: Men . 208 Table 12.4 Knowledge of prevention of mother-to-child transmission of HIV. 209 Table 12.5.1 Accepting attitudes towards those living with HIV/AIDS: Women . 210 Table 12.5.2 Accepting attitudes towards those living with HIV/AIDS: Men . 211 Table 12.6 Attitudes towards negotiating safer sexual relations with husband . 212 Table 12.7 Adult support of education about condom use to prevent AIDS . 213 Table 12.8.1 Multiple sexual partners: Women . 214 Table 12.8.2 Multiple sexual partners: Men . 215 Table 12.9 Point prevalence and cumulative prevalence of concurrent sexual partners . 216 Table 12.10 Payment for sexual intercourse and condom use at last paid sexual intercourse . 217 Table 12.11.1 Coverage of prior HIV testing: Women . 218 Table 12.11.2 Coverage of prior HIV testing: Men . 219 Table 12.12 Pregnant women counselled and tested for HIV . 220 Table 12.13.1 Opinions on why some individuals choose not to undergo voluntary HIV testing and counselling: Women . 221 Table 12.13.2 Opinions on why some individuals choose not to undergo voluntary HIV testing and counselling: Men . 222 Table 12.14.1 Main reason why respondent has not been tested for HIV: Women . 223 Table 12.14.2 Main reason why respondent has not been tested for HIV: Men . 224 Table 12.15 Male circumcision . 225 Table 12.16 Self-reported prevalence of sexually-transmitted infections (STIs) and STIs symptoms . 226 Table 12.17 Prevalence of medical injections . 227 Table 12.18 Comprehensive knowledge about AIDS and of a source of condoms among young people . 228 Table 12.19 Age at first sexual intercourse among young people . 229 Table 12.20 Premarital sexual intercourse and condom use during premarital sexual intercourse among young people . 230 xii • Tables and Figures Table 12.21.1 Multiple sexual partners in the past 12 months among young people: Women . 231 Table 12.21.2 Multiple sexual partners in the past 12 months among young people: Men. 232 Table 12.22 Age-mixing in sexual relationships among women and men age 15-19 . 233 Table 12.23 Recent HIV tests among young people . 234 13 HIV PREVALENCE . 235 Figure 13.1 HIV prevalence by residence and sex . 237 Figure 13.2 Trends in HIV prevalence . 237 Figure 13.3 HIV prevalence by age . 237 Figure 13.4 HIV prevalence by district . 238 Figure 13.5 HIV prevalence by number of lifetime partners . 239 Figure 13.6 HIV incidence by sex . 241 Table 13.1 Coverage of HIV testing by residence, ecological zone, and district . 242 Table 13.2 Coverage of HIV testing by selected background characteristics . 243 Table 13.3 HIV prevalence by age . 244 Table 13.4 HIV prevalence by socioeconomic characteristics . 245 Table 13.5 HIV prevalence by demographic characteristics . 246 Table 13.6 HIV prevalence by male circumcision . 247 Table 13.7 HIV prevalence by sexual behaviour . 248 Table 13.8 HIV prevalence among young people by background characteristics . 249 Table 13.9 HIV prevalence among young people by sexual behaviour . 250 Table 13.10 HIV prevalence by other characteristics . 251 Table 13.11 Prior HIV testing by current HIV status . 252 Table 13.12 HIV prevalence among couples. 253 14 WOMEN’S EMPOWERMENT . 255 Figure 14.1 Women’s and men’s employment by age. 256 Figure 14.2 Control over women’s earnings. 257 Figure 14.3 Ownership of assets . 258 Figure 14.4 Women’s participation in decision making . 259 Figure 14.5 Attitudes towards wife beating . 260 Table 14.1 Employment and cash earnings of currently married women and men . 262 Table 14.2.1 Control over women’s cash earnings and relative magnitude of women’s cash earnings . 263 Table 14.2.2 Control over men’s cash earnings . 264 Table 14.3 Women’s control over their own earnings and over those of their husbands . 265 Table 14.4.1 Ownership of assets: Women . 266 Table 14.4.2 Ownership of assets: Men . 267 Table 14.5 Participation in decision making . 268 Table 14.6.1 Women’s participation in decision making by background characteristics . 269 Table 14.6.2 Men’s participation in decision making by background characteristics . 270 Table 14.7.1 Attitude towards wife beating: Women . 271 Table 14.7.2 Attitude towards wife beating: Men . 272 Table 14.8 Indicators of women’s empowerment . 273 Table 14.9 Current use of contraception by women’s empowerment . 273 Table 14.10 Ideal number of children and unmet need for family planning by women’s empowerment . 274 Table 14.11 Reproductive health care by women’s empowerment . 274 Table 14.12 Early childhood mortality rates by indicators of women’s empowerment . 275 Tables and Figures • xiii 15 ADULT AND MATERNAL MORTALITY . 277 Figure 15.1 Adult mortality rates among women and men age 15-49 . 279 Figure 15.2 Trends in maternal mortality ratios with confidence intervals . 281 Table 15.1 Completeness of information on siblings . 282 Table 15.2 Adult mortality rates . 282 Table 15.3 Adult mortality probabilities . 283 Table 15.4 Maternal mortality . 283 16 TUBERCULOSIS . 285 Figure 16.1 Tuberculosis knowledge by education . 286 Figure 16.2 Knowledge of the cause of tuberculosis . 286 Figure 16.3 Experience of tuberculosis symptoms . 287 Figure 16.4 Tuberculosis treatment length . 288 Table 16.1 Knowledge of tuberculosis . 290 Table 16.2 Knowledge of specific symptoms of tuberculosis . 291 Table 16.3.1 Knowledge of the cause of tuberculosis: Women . 292 Table 16.3.2 Knowledge of the cause of tuberculosis: Men . 293 Table 16.4 Knowledge of the mode of tuberculosis transmission . 294 Table 16.5.1 Experience of symptoms of tuberculosis: Women . 294 Table 16.5.2 Experience of symptoms of tuberculosis: Men . 295 Table 16.6.1 Treatment seeking for symptoms of tuberculosis: Women . 296 Table 16.6.2 Treatment seeking for symptoms of tuberculosis: Men . 297 Table 16.7 Diagnosis of tuberculosis . 298 Table 16.8 Received medicine for tuberculosis . 299 Table 16.9 Positive attitudes towards those with tuberculosis . 300 17 NONCOMMUNICABLE DISEASES . 301 Figure 17.1 Knowledge of breast cancer by education . 301 Figure 17.2 Knowledge of and experience with Pap smear by education . 303 Figure 17.3 Hypertension and Body Mass Index (BMI) . 304 Table 17.1.1 Knowledge of breast cancer: Women . 306 Table 17.1.2 Knowledge of breast cancer: Men . 307 Table 17.2 Breast self-exam and clinical exam . 308 Table 17.3 Knowledge of, and experience with, the Pap smear exam . 309 Table 17.4 Knowledge of diabetes . 310 Table 17.5 Knowledge of specific symptoms of diabetes . 311 Table 17.6 History of diabetes . 311 Table 17.7 History of high blood pressure and actions taken to lower blood pressure . 312 Table 17.8 Coverage of blood pressure measurement among women and men . 313 Table 17.9.1 Blood pressure status: Women . 314 Table 17.9.2 Blood pressure status: Men . 315 Table 17.10.1 Blood pressure status by health status measures: Women . 316 Table 17.10.2 Blood pressure status by health status measures: Men . 317 APPENDIX A SAMPLE DESIGN . 321 Table A.1 Household distribution . 322 Table A.2 Enumeration areas and households . 322 Table A.3 Sample allocation of clusters and households . 323 Table A.4 Sample allocation of completed interviews with women and men . 323 Table A.5 Sample implementation: Women . 326 xiv • Tables and Figures Table A.6 Sample implementation: Men . 327 Table A.7 Coverage of HIV testing by social and demographic characteristics: Women . 328 Table A.8 Coverage of HIV testing by social and demographic characteristics: Men . 329 Table A.9 Coverage of HIV testing by sexual behaviour characteristics: Women . 330 Table A.10 Coverage of HIV testing by sexual behaviour characteristics: Men . 331 APPENDIX B ESTIMATES OF SAMPLING ERRORS . 333 Table B.1 List of selected variables for sampling errors, Lesotho 2014 . 335 Table B.2 Sampling errors for national sample, Lesotho 2014 . 337 Table B.3 Sampling errors for urban sample, Lesotho 2014 . 339 Table B.4 Sampling errors for rural sample, Lesotho 2014 . 341 Table B.5 Sampling errors for Lowlands sample, Lesotho 2014 . 343 Table B.6 Sampling errors for Foothills sample, Lesotho 2014 . 345 Table B.7 Sampling errors for Mountains sample, Lesotho 2014 . 347 Table B.8 Sampling errors for Senqu River Valley sample, Lesotho 2014 . 349 Table B.9 Sampling errors for Butha-Buthe sample, Lesotho 2014 . 351 Table B.10 Sampling errors for Leribe sample, Lesotho 2014 . 353 Table B.11 Sampling errors for Berea sample, Lesotho 2014 . 355 Table B.12 Sampling errors for Maseru sample, Lesotho 2014 . 357 Table B.13 Sampling errors for Mafeteng sample, Lesotho 2014 . 359 Table B.14 Sampling errors for Mohale’s Hoek sample, Lesotho 2014 . 361 Table B.15 Sampling errors for Quthing sample, Lesotho 2014 . 363 Table B.16 Sampling errors for Qacha’s Nek sample, Lesotho 2014 . 365 Table B.17 Sampling errors for Mokhotlong sample, Lesotho 2014 . 367 Table B.18 Sampling errors for Thaba-Tseka sample, Lesotho 2014 . 369 Table B.19 Sampling errors for adult and maternal mortality rates, Lesotho 2014 . 371 APPENDIX C HIV TESTING METHODOLOGY . 373 Figure C.1 Stage 1 HIV testing algorithm . 373 Figure C.2 Stage 2 Algorithm for HIV incidence testing and serological confirmation . 374 Table C.1 Sensitivity calculations for potential impact of missing viral load results on HIV incidence estimates, Lesotho 2014 . 375 APPENDIX D DATA QUALITY TABLES . 377 Table D.1 Household age distribution . 377 Table D.2.1 Age distribution of eligible and interviewed women . 378 Table D.2.2 Age distribution of eligible and interviewed men . 378 Table D.3 Completeness of reporting . 379 Table D.4 Births by calendar years . 379 Table D.5 Reporting of age at death in days . 380 Table D.6 Reporting of age at death in months . 380 Table D.7 Sibship size and sex ratio of siblings . 381 Foreword • xv FOREWORD he 2014 Lesotho Demographic and Health Survey (LDHS) was implemented by the Ministry of Health (MOH). The 2014 LDHS was the third DHS survey to be conducted in Lesotho in collaboration with the worldwide Demographic and Health Surveys Program. It provides updated estimates of basic demographic and health indicators, including fertility rates and preferences, maternal and child mortality rates, maternal and child health indicators, knowledge and attitudes of women and men about HIV/AIDS and other sexually transmitted diseases, patterns of recent behaviour regarding the use of condoms and other contraceptive methods, and the incidence and prevalence of HIV infection. The MOH wishes to acknowledge the efforts of a number of organisations and individuals who contributed substantially to the success of the survey. First, we would like to acknowledge the financial assistance from the government of Lesotho, the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), the United States Agency for International Development (USAID), the World Health Organization (WHO), and the World Bank. We thank the Bureau of Statistics (BOS) for providing the sample frame, GIS shapefiles corresponding to the LDHS sample points, and the training of enumerators on conducting the household listing. We would like to thank ICF International for technical backstopping throughout the survey. The survey also could not have been carried out successfully without the dedication of the staff of the MOH who planned, participated in, and oversaw the entire LDHS. Finally, we are grateful to the survey respondents who generously gave their time to provide the information that forms the basis of this and future reports. Mr. T.J. Lebakae Principal Secretary Ministry of Health T Reading and Understanding Tables from the 2014 LDHS • xvii READING AND UNDERSTANDING TABLES FROM THE 2014 LDHS xviii • Reading and Understanding Tables from the 2014 LDHS Example 1: Exposure to Mass Media A Question Asked of All Survey Respondents Table 3.4.1 Exposure to mass media: Women Percentage of women age 15-49 who are exposed to specific media on a weekly basis, by background characteristics, Lesotho 2014 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of women Age 15-19 18.9 27.7 54.7 7.2 34.5 1,440 20-24 18.2 27.8 58.2 7.4 32.5 1,325 25-29 15.9 28.8 64.3 7.2 30.2 1,094 30-34 15.3 32.3 63.8 7.8 28.4 957 35-39 14.5 34.5 64.1 9.1 29.6 744 40-44 11.6 28.1 59.9 5.7 33.4 562 45-49 10.9 28.2 61.6 5.9 32.9 499 Residence Urban 25.5 53.7 73.4 14.2 13.8 2,419 Rural 10.6 15.4 52.8 3.3 42.1 4,202 Ecological zone Lowlands 21.4 40.8 70.7 10.6 19.6 4,184 Foothills 8.1 7.9 49.0 0.7 45.7 688 Mountains 5.9 9.2 36.6 1.6 58.9 1,288 Senqu River Valley 7.6 14.5 49.6 3.1 44.9 461 District Butha-Buthe 10.4 21.6 38.6 3.5 51.9 385 Leribe 12.3 26.4 62.9 4.4 30.1 1,064 Berea 18.9 36.5 69.5 8.3 21.6 892 Maseru 24.5 42.9 70.1 12.5 19.2 1,864 Mafeteng 18.7 31.3 70.6 9.7 22.7 576 Mohale’s Hoek 12.2 21.8 59.6 5.6 35.2 519 Quthing 8.8 17.2 55.3 3.3 40.0 315 Qacha’s Nek 11.0 20.8 35.5 4.1 52.5 204 Mokhotlong 4.4 7.2 37.2 1.0 59.7 349 Thaba-Tseka 6.5 9.2 34.9 2.3 61.1 452 Education No education 1.2 14.4 36.8 0.0 61.8 68 Primary incomplete 4.0 12.0 41.2 1.2 53.8 1,178 Primary complete 5.3 18.5 53.8 1.6 41.6 1,375 Secondary 19.8 34.0 67.6 8.3 23.6 3,418 More than secondary 45.6 64.7 74.6 28.5 8.2 581 Wealth quintile Lowest 3.0 1.7 24.8 0.4 73.5 960 Second 6.4 4.1 44.5 0.9 52.0 1,033 Middle 11.4 8.4 59.2 1.1 35.8 1,244 Fourth 17.6 27.3 73.6 5.3 18.6 1,605 Highest 30.5 75.6 77.5 20.9 6.5 1,778 Total 16.0 29.4 60.3 7.3 31.7 6,621 1 3 2 4 5 Reading and Understanding Tables from the 2014 LDHS • xix Step 1: Read the title and subtitle. They tell you the topic and the specific population group being described. In this case, the table is about women age 15-49 and their exposure to different types of media. All eligible female respondents age 15-49 were asked these questions. Step 2: Scan the column headings—highlighted in green in Example 1. They describe how the information is categorized. In this table, the first three columns of data show different types of media that women access at least once a week. The fourth column shows women who access all three media, while the fifth column is women who do not access any of the three types of media at least once a week. The last column lists the number of women interviewed in the survey. Step 3: Scan the row headings—the first vertical column highlighted in blue in Example 1. These show the different ways the data are divided into categories based on population characteristics. In this case, the table presents women’s exposure to media by age, urban-rural residence, ecological zone, district, educational level, and wealth quintile. Most of the tables in the LDHS report will be divided into these same categories. Step 4: Look at the row at the bottom of the table highlighted in red. These percentages represent the totals of all women age 15-49 and their access to different types of media. In this case, 16.0% of women age 15-49 read a newspaper at least once a week, 29.4% watch television weekly, and 60.3% listen to the radio weekly. Step 5: To find out what percentage of women with more than secondary education access all three media weekly, draw two imaginary lines, as shown on the table. This shows that 28.5% of women age 15-49 with more than secondary education access all three types of media weekly. Practice: Use the table in Example 1 to answer the following questions: a) What percentage of women in Lesotho do not access any of the three media at least once a week? b) What age group of women are most likely to watch television weekly? c) Compare women in urban areas to women in rural areas—which group is more likely to listen to the radio weekly? Answers: a) 31.7% b) Women age 35-39: 34.5% of women in this age group watch television weekly c) Women in urban areas, 73.4% listen to the radio weekly, compared to 52.8% of women in rural areas xx • Reading and Understanding Tables from the 2014 LDHS Example 2: Prevalence of Anaemia in Men Comparing and Understanding Patterns Table 11.11.2 Prevalence of anaemia in men Percentage of men age 15-49 with anaemia, by background characteristics, Lesotho 2014 Anaemia status by haemoglobin level Background characteristic Any anaemia <13.0 g/dl Number of men Age 15-19 16.6 672 20-29 9.8 918 30-39 14.2 566 40-49 20.1 364 Smoking status Smokes cigarettes/tobacco 13.5 1,052 Does not smoke 14.5 1,467 Residence Urban 14.8 862 Rural 13.7 1,658 Ecological zone Lowlands 13.2 1,614 Foothills 19.7 239 Mountains 15.9 503 Senqu River Valley 9.3 164 District Butha-Buthe 21.9 140 Leribe 12.0 365 Berea 9.7 360 Maseru 15.1 764 Mafeteng 11.6 229 Mohale’s Hoek 17.0 194 Quthing 6.1 99 Qacha’s Nek 19.9 73 Mokhotlong 20.2 137 Thaba-Tseka 14.1 159 Education No education 18.4 201 Primary incomplete 17.3 844 Primary complete 14.9 294 Secondary 11.1 985 More than secondary 9.8 197 Wealth quintile Lowest 18.8 359 Second 16.1 457 Middle 13.1 511 Fourth 13.9 591 Highest 10.8 601 Total 15-49 14.1 2,520 50-59 23.0 266 Total 15-59 14.9 2,786 Note: Prevalence is adjusted for altitude and for smoking status, if known, using formulas in CDC, 1998. 1 3 2 4 5 Reading and Understanding Tables from the 2014 LDHS • xxi Step 1: Read the title and subtitle. In this case, the table presents anaemia among men age 15-49. Step 2: Identify the information presented in the table— highlighted in green in the table to the right. In this table there is only one indicator—anaemia. Step 3: Look at the row headings to identify the background characteristics. In this table, anaemia is presented by age, smoking status, urban-rural residence, ecological zone, district, education level, and wealth quintile. Step 4: Look at the rows at the bottom of the table to determine the total proportion of men with anaemia. This shows that 14.1% of men age 15-49 in Lesotho are anaemic. Step 5: However, the 2014 LDHS interviewed men age 15-59. Find the row for men age 50-59: what proportion of these men are anaemic? It’s 23.0%. The final row above the footnotes shows that 14.9% of men age 15-59 are anaemic. It is important to note that all of the background characteristics in this table are shown only for men age 15-49. For example, 14.5% of men age 15-49 who do not smoke are anaemic. Practice: By looking at patterns by background characteristics, we can see which groups are more in need of interventions to address anaemia. Resources are often limited; looking for patterns can help programme planners and policy makers determine how to most effectively use resources. To gain a better understanding of differences in the prevalence of anaemia, use the table in Example 2 to consider the following questions: 1. Is anaemia more common in urban or rural areas? 2. What are the lowest and the highest percentages (range) of anaemia by ecological zone? 3. What are the lowest and the highest percentages (range) of anaemia by district? 4. How does the prevalence of anaemia vary by age? 5. Is there a clear pattern of anaemia by education level? 6. Is there a clear pattern of anaemia by wealth quintile? Answers: 1. Anaemia is slightly less common in rural areas (13.7%) than in urban areas (14.8%). However, the difference between these two groups is small. 2. Anaemia is lowest in the Senqu River Valley (9.3%) and highest in Foothills (19.7%). 3. Just 6.1% of men age 15-49 in Quthing are anaemic, compared to a high of 21.9% in Butha-Buthe. 4. Anaemia is highest among men age 50-59 (23.0%), while anaemia is lowest among men age 20-29 (9.8%). 5. Anaemia decreases as level of education increases; 18.4% of men with no education are anaemic, compared to 9.8% of men with more than secondary education. 6. There is a pattern in anaemia by wealth quintile. Anaemia generally decreases as household wealth increases; 18.8% of men age 15- 49 living in households in the lowest wealth quintile are anaemic, compared to 10.8% of men living in households in the highest wealth quintile. xxii • Reading and Understanding Tables from the 2014 LDHS Example 3: Prevalence and Treatment of Symptoms of ARI A Question Asked of a Subgroup of Survey Respondents Table 10.5 Prevalence and treatment of symptoms of ARI Among children under age five, the percentage who had symptoms of acute respiratory infection (ARI) in the two weeks preceding the survey and among children with symptoms of ARI, the percentage for whom advice or treatment was sought from a health facility or provider and the percentage who received antibiotics as treatment, according to background characteristics, Lesotho 2014 Among children under age five: Among children under age five with symptoms of ARI: Percentage for whom advice or treatment was sought from a health facility or provider2 Percentage who received antibiotics Number of children Background characteristic Percentage with symptoms of ARI1 Number of children Age in months <6 2.7 328 * * 9 6-11 4.2 342 * * 14 12-23 5.8 655 (68.8) (23.7) 38 24-35 5.1 572 (57.3) (15.8) 29 36-47 5.2 501 (76.3) (9.8) 26 48-59 3.7 498 * * 18 Sex Male 4.6 1,432 60.5 10.3 65 Female 4.7 1,464 65.7 20.8 69 Cooking fuel Electricity or gas 4.2 952 (71.9) (8.0) 40 Paraffin 5.6 134 * * 8 Coal/lignite * 4 * * 0 Wood/straw3 5.0 1,567 61.8 20.6 78 Animal dung 3.8 238 * * 9 Residence Urban 3.7 841 * * 31 Rural 5.0 2,055 63.0 19.9 103 Ecological zone Lowlands 4.4 1,617 64.4 9.5 72 Foothills 8.1 348 (55.1) (35.9) 28 Mountains 3.8 703 (74.3) (10.8) 27 Senqu River Valley 3.4 228 * * 8 Mother’s education No education (10.7) 26 * * 3 Primary incomplete 7.0 580 (45.9) (12.5) 41 Primary complete 4.0 748 (77.8) (8.5) 30 Secondary 3.9 1,324 (70.1) (22.9) 52 More than secondary 4.1 217 * * 9 Wealth quintile Lowest 4.7 623 (59.9) (15.4) 29 Second 5.2 583 (66.5) (17.8) 31 Middle 4.3 571 (63.4) (18.4) 25 Fourth 5.0 577 * * 29 Highest 4.0 542 * * 21 Total 4.7 2,896 63.1 15.7 135 Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Symptoms of ARI consist of cough accompanied by short, rapid breathing that was chest-related and/or by difficult breathing that was chest-related. 2 Excludes pharmacy, shop, and traditional practitioner 3 Includes grass, shrubs, crop residues 1 3 b 2 a 3 4 Reading and Understanding Tables from the 2014 LDHS • xxiii Step 1: Read the title and subtitle. In this case, the table is about two separate groups of children: all children under age 5 (a) and children under age 5 who had symptoms of acute respiratory infection (ARI) in the two weeks before the survey (b). Step 2: Identify the two panels. First, identify the columns that refer to all children under age 5 (a), and then isolate the columns that refer only to those children under age 5 who had symptoms of ARI in the two weeks before the survey (b). Step 3: Look at the first panel. What percentage of children under age 5 had symptoms of ARI in the two weeks before the survey? It’s 4.7%. Now look at the second panel. How many children under age 5 are there who had symptoms of ARI in the two weeks before the survey? It’s 135 children or 4.7% of the 2,896 children under age 5 (with rounding). The second panel is a subset of the first panel. Step 4: Only 4.7% of children under age 5 who had symptoms of ARI in the two weeks before the survey. Once these children are further divided into the background characteristic categories, there may be too few cases for the percentages to be reliable. • What percentage of children age 36-47 months who had symptoms of ARI in the two weeks before the survey received antibiotics? 9.8%. This percentage is in parentheses because there are between 25 and 49 children (unweighted) in this category. Readers should use this number with caution—it may not be reliable. (For more information on weighted and unweighted numbers, see Example 4.) • What percentage of children age 6-11 months who had symptoms of ARI in the two weeks before the survey received antibiotics? There is no number in this cell—only an asterisk. This is because fewer than 25 children age 6-11 months (unweighted) had symptoms of ARI in the two weeks before the survey. Results for this group are not reported. The subgroup is too small, and therefore the data are not reliable. Note: When parentheses or asterisks are used in a table, the explanation will be noted under the table. If there are no parentheses or asterisks in a table, you can proceed with confidence that enough cases were included in all categories that the data are reliable. xxiv • Reading and Understanding Tables from the 2014 LDHS Example 4: Understanding Sampling Weights in LDHS Tables A sample is a group of people who have been selected for a survey. In LDHS surveys, the sample is designed to represent the national population of age 15-49. In addition to national data, most countries want to collect and report data on smaller geographical or administrative areas. However, doing so requires a minimum sample size per area. For the 2014 LDHS, the survey sample is representative of the country as a whole, for urban and rural areas, for four ecological zones, and for each of Lesotho’s 10 districts. To generate statistics that are representative of the country as a whole and the 10 districts, the number of women surveyed in each district should contribute to the size of the total (national) sample in proportion to the size of the district. However, if some districts have small populations, then a sample allocated in proportion to each district’s population may not include sufficient women from each district for analysis. To solve this problem, districts with small populations are oversampled. For example, let’s say that you have enough money to interview 6,621 women and want to produce results that are representative of Lesotho as a whole and its districts (as in Table 3.1). However, the total population of Lesotho is not evenly distributed among the districts: some districts, such as Leribe, are heavily populated while others, such as Qacha’s Nek are not. Thus, Qacha’s Nek must be oversampled. A sampling statistician determines how many women should be interviewed in each district in order to get reliable statistics. The blue column (1) in the table above shows the actual number of women interviewed in each district. Within the districts, the number of women interviewed ranges from 556 in Quthing to 930 in Maseru. The number of interviews is sufficient to get reliable results in each district. With this distribution of interviews, some districts are overrepresented and some districts are underrepresented. For example, the population in the Qacha’s Nek district is about 3% of the population in Lesotho, while Leribe is about 16% of the population in Lesotho. But as the blue column shows, the number of women interviewed in Qacha’s Nek accounts for about 8% of the total sample of women interviewed (558/6,621) and the number of women interviewed in Leribe accounts for 12% of the total sample of women interviewed (785/6,621). This unweighted distribution of Basotho women does not accurately represent the population. In order to get statistics that are representative of Lesotho, the distribution of the women in the sample needs to be weighted (or mathematically adjusted) such that it resembles the true distribution in the country. Women from a small district, like Qacha’s Nek, should only contribute a small amount to the national total. Women from a large district, like Leribe should contribute much more. Therefore, DHS statisticians mathematically calculate a “weight” which is used to adjust the number of women from each district so that each district’s contribution to the total is proportional to the actual population of the district. The numbers in the purple column (2) represent the “weighted” values. The weighted values can be smaller or larger than the unweighted values at the district level. The total national sample size of 6,621women has not changed after weighting, but the distribution of the women in the districts has been changed to represent their contribution to the total population size. How do statisticians weight each category? They take into account the probability that a woman was selected in the sample. If you were to compare the red column (3) to the actual population distribution of Lesotho, you would see that women in each district are contributing to the total sample with the same weight that they contribute to the population of Lesotho. The weighted number of women in the survey now accurately represents the proportion of women who live in Qacha’s Nek and the proportion of women who live in Leribe. With sampling and weighting, it is possible to interview enough women to provide reliable statistics at the national and district levels. In general, only the weighted numbers are shown in each of the LDHS tables, so don’t be surprised if these numbers seem low in some cases: they may actually represent a larger number of women interviewed. Table 3.1 Background characteristics of respondents Percent distribution of women age 15-49 by selected background characteristics, Lesotho 2014 Women Background characteristic Weighted percent Weighted number Unweighted number District Butha-Buthe 5.8 385 593 Leribe 16.1 1,064 785 Berea 13.5 892 760 Maseru 28.2 1,864 930 Mafeteng 8.7 576 624 Mohale’s Hoek 7.8 519 621 Quthing 4.8 315 556 Qacha’s Nek 3.1 204 558 Mokhotlong 5.3 349 605 Thaba-Tseka 6.8 452 589 Total 15-49 100.0 6,621 6,621 3 2 1 Additional DHS Program Resources • xxv ADDITIONAL DHS PROGRAM RESOURCES The DHS Program Website – Download free DHS reports, standard documentation, key indicator data, and training tools, and view announcements. DHSprogram.com STATcompiler – Build custom tables, graphs, and maps with data from 90 countries and thousands of indicators. Statcompiler.com DHS Program Mobile App – Access key DHS indicators for 90 countries on your mobile device (Apple, Android, or Windows). Search DHS Program in your iTunes or Google Play store DHS Program User Forum – Post questions about DHS data, and search our archive of FAQs. userforum.DHSprogram.com Tutorial Videos – Watch interviews with experts and learn DHS basics, such as sampling and weighting, downloading datasets, and How to Read DHS Tables. www.youtube.com/DHSProgram Datasets – Download DHS datasets for analysis. DHSprogram.com/Data Spatial Data Repository – Download geographically linked health and demographic data for mapping in a geographic information system (GIS). spatialdata.DHSprogram.com Social Media – Follow The DHS Program and join the conversation. Stay up to date through: Facebook www.facebook.com/DHSprogram Twitter www.twitter.com/ DHSprogram Pinterest www.pinterest.com/ DHSprogram LinkedIn www.linkedin.com/ company/dhs-program YouTube www.youtube.com/DHSprogram Blog Blog.DHSprogram.com Acronyms and Abbreviations • xxvii ACRONYMS AND ABBREVIATIONS AIDS acquired immunodeficiency syndrome ANC antenatal care ARI acute respiratory infection ART antiretroviral therapy BMI body mass index BOS Bureau of Statistics CAPI computer-assisted personal interviewing CBD community-based distributor CBR crude birth rate CDC Centers for Diseases Control and Prevention CHAL Christian Health Association of Lesotho CPR contraceptive prevalence rate DBS dried blood spots DEFT design effect DHS Demographic and Health Surveys EA enumeration area ELISA enzyme-linked immunosorbent assay EPI Expanded Programme on Immunization FNCO Food and Nutrition Coordinating Office FRR False Recent Rate GAR gross attendance ratio GFR general fertility rate GIS geographic information system GPI gender parity index HIV human immunodeficiency virus HTS HIV Testing and Counselling Services ICD International Classification of Diseases IFSS internet file streaming system IMPAC integrated management of pregnancy and childbirth IUCD intrauterine contraceptive device IYCF infant and young child feeding LDHS Lesotho Demographic and Health Survey LPG liquid petroleum gas MAD minimum acceptable diet MDG Millennium Development Goal MOH Ministry of Health MMR maternal mortality ratio MTCT mother-to-child transmission MUAC mid-upper-arm circumference xxviii • Acronyms and Abbreviations NAR net attendance ratio NCD noncommunicable disease NCHS National Center for Health Statistics NICD National Institute for Communicable Diseases NRL National Reference Laboratory ORS oral rehydration salts ORT oral rehydration therapy PDA personal digital assistant PEPFAR U.S. President’s Emergency Plan for AIDS Relief PHC Population and Housing Census PMTCT prevention of mother-to-child transmission PY person-years RHF recommended homemade fluids RSA Republic of South Africa SD standard deviation SE standard error STI sexually transmitted infection TB tuberculosis TFR total fertility rate UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USAID United States Agency for International Development VAD vitamin A deficiency VIP ventilated improved pit VMMC voluntary male medical circumcision WHO World Health Organization Millennium Development Goal Indicators • xxix MILLENNIUM DEVELOPMENT GOAL INDICATORS Millennium Development Goal Indicators Lesotho 2014 Sex Total Indicator Female Male 1. Eradicate extreme poverty and hunger 1.8 Prevalence of underweight children under age 5 8.3 12.5 10.3 2. Achieve universal primary education 2.1 Net attendance ratio in primary education1 97.5 93.0 95.3 2.3 Literacy rate of 15- to 24-year-olds2 98.6 90.6a 94.6b 3. Promote gender equality and empower women 3.1 Ratio of girls to boys in primary, secondary, and tertiary education 3.1a Ratio of girls to boys in primary education3 na na 1.0 3.1b Ratio of girls to boys in secondary education3 na na 1.5 3.1c Ratio of girls to boys in tertiary education3 na na 1.0 4. Reduce child mortality 4.1 Under-5 mortality rate4 82 102 85 4.2 Infant mortality rate4 60 78 59 4.3 Proportion of 1-year-old children immunised against measles 92.8 87.6 90.1 5. Improve maternal health 5.1 Maternal mortality ratio5 na na 1024 5.2 Percentage of births attended by skilled health personnel6 na na 77.9 5.3 Contraceptive prevalence rate7 60.2 na na 5.4 Adolescent birth rate8 94.3 na na 5.5 Antenatal care coverage 5.5a Antenatal care coverage: at least one visit9 95.2 na na 5.5b Antenatal care coverage: four or more visits10 74.4 na na 5.6 Unmet need for family planning 18.4 na na 6. Combat HIV/AIDS, malaria, and other diseases 6.1 HIV prevalence among the population age 15-24 13.1 6.0 9.6 6.2 Condom use at last high-risk sex11 81.9 78.7a 80.3b 6.3 Percentage of the population age 15-24 with comprehensive correct knowledge of HIV/AIDS12 37.6 30.9a 34.3b 6.4 Ratio of school attendance of orphans to school attendance of non-orphans age 10-14 0.95 0.90 0.92 Urban Rural Total 7. Ensure environmental sustainability 7.8 Percentage of population using an improved drinking water source13 96.3 76.9 82.2 7.9 Percentage of population with access to improved sanitation14 49.0 51.6 50.9 na = Not applicable 1 The ratio is based on reported attendance, not enrolment, in primary education among primary school age children (age 6-12). The rate also includes children of primary school age enrolled in secondary education. This is a proxy for MDG indicator 2.1, net enrolment ratio. 2 Refers to respondents who attended secondary school or higher or who could read a whole sentence or part of a sentence 3 Based on reported net attendance, not gross enrolment, among 6- to 12-year-olds for primary, 13- to 17-year-olds for secondary, and 18- to 24-year- olds for tertiary education 4 Expressed in terms of deaths per 1,000 live births. Mortality by sex refers to a 10-year reference period preceding the survey. Mortality rates for males and females combined refer to the 5-year period preceding the survey. 5 Expressed in terms of maternal deaths per 100,000 live births in the 7-year period preceding the survey 6 Among births in the 5 years preceding the survey 7 Percentage of currently married women age 15-49 using any method of contraception 8 Equivalent to the age-specific fertility rate for women age 15-19 for the 3-year period preceding the survey, expressed in terms of births per 1,000 women age 15-19 9 With a skilled provider 10 With any health care provider 11 Higher-risk sex refers to sexual intercourse with a non-marital, non-cohabitating partner. Expressed as a percentage of men and women age 15-24 who had higher-risk sex in the past 12 months. 12 Comprehensive knowledge means knowing that consistent use of a condom during sexual intercourse and having just one uninfected faithful partner can reduce the chance of getting HIV, knowing a healthy-looking person can have HIV, and rejecting the two most common local misconceptions about transmission or prevention of HIV. 13 Percentage of de jure population whose main source of drinking water is a household connection (piped), public tap or standpipe, tube well or borehole, protected dug well or spring, rainwater collection, or bottled water 14 Percentage of de jure population whose household has a flush toilet, ventilated improved pit latrine, ordinary pit latrine/pit latrine with a slab, or composting toilet and does not share this facility with other households a Restricted to men in the subsample of households selected for the male interview b The total is calculated as the simple arithmetic mean of the percentages in the columns for male and females. xxx • Map of Lesotho Introduction and Survey Methodology • 1 INTRODUCTION AND SURVEY METHODOLOGY 1 he 2014 Lesotho Demographic and Health Survey (LDHS) was implemented by the Lesotho Ministry of Health (MOH). Data collection took place from 22 September to 7 December 2014. ICF International provided technical assistance through The DHS Program, which is funded by the United States Agency for International Development (USAID) and offers financial support and technical assistance for population and health surveys in countries worldwide. Other agencies and organisations that facilitated the successful implementation of the survey through technical or financial support were the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the World Bank, the World Health Organization (WHO), the Christian Health Association of Lesotho (CHAL), the National University of Lesotho, the Bureau of Statistics (BOS) of the Ministry of Development Planning, and the Food and Nutrition Coordinating Office (FNCO) of the Prime Minister’s Office. 1.1 SURVEY OBJECTIVES The primary objective of the 2014 LDHS project is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the LDHS collected information on fertility levels, marriage, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutrition, childhood and maternal mortality, maternal and child health, awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections (STIs), and other health issues such as smoking, knowledge of breast cancer, and male circumcision. In addition, the 2014 LDHS provides estimates of anaemia prevalence among children age 6-59 months and adults, and gives estimates of hypertension, HIV prevalence and HIV incidence among adults. The 2014 LDHS is a follow-up to the 2004 and 2009 LDHS surveys. The information collected through the LDHS is intended to assist policy makers and programme managers in evaluating and designing programmes and strategies for improving the health of the country’s population. 1.2 SAMPLE DESIGN The sampling frame used for the 2014 LDHS is an updated frame from the 2006 Lesotho Population and Housing Census (PHC) provided by the Lesotho Bureau of Statistics (BOS). The sampling frame excluded nomadic and institutional populations such as persons in hotels, barracks, and prisons. The 2014 LDHS followed a two-stage sample design and was intended to allow estimates of key indicators at the national level as well as in urban and rural areas, four ecological zones,1 and each of Lesotho’s 10 districts.2 The first stage involved selecting sample points (clusters) consisting of enumeration areas (EAs) delineated for the 2006 PHC. A total of 400 clusters were selected, 118 in urban areas and 282 in rural areas.3 The second stage involved systematic sampling of households. A household listing operation was undertaken in all of the selected EAs in July 2014, and households to be included in the survey were randomly selected from these lists. About 25 households were selected from each sample point, for a total sample size of 9,942 1 Lowlands, Foothills, Mountains, and Senqu River Valley. 2 Butha-Buthe, Leribe, Berea, Maseru, Mafeteng, Mohale’s Hoek, Quthing, Qacha’s Nek, Mokhotlong, and Thaba-Tseka. 3 One rural EA was inadvertently dropped from the sample. After the fieldwork was completed, it was determined that the EA had not been visited. T 2 • Introduction and Survey Methodology households. Because of the approximately equal sample sizes in each district, the sample is not self-weighting at the national level, and weighting factors have been added to the data file so that the results will be proportional at the national level. All women age 15-49 who were either permanent residents of the selected households or visitors who stayed in the household the night before the survey were eligible to be interviewed. In half of the households, all men age 15-59 who were either permanent residents of the selected households or visitors who stayed in the household the night before the survey were eligible to be interviewed. In the subsample of households selected for the male survey, blood pressure measurements and anaemia testing were performed among eligible women and men who consented to being tested. With the parent’s or guardian’s consent, children age 6-59 months were also tested for anaemia. In the same subsample of households, blood specimens were collected for laboratory testing of HIV from eligible women and men who consented; height and weight were measured for eligible women, men, and children age 0-59 months; and mid-upper-arm circumference (MUAC) measurements were collected for children age 6-59 months. 1.3 QUESTIONNAIRES Three questionnaires were used for the 2014 LDHS: the Household Questionnaire, the Woman’s Questionnaire, and the Man’s Questionnaire. These questionnaires, based on The DHS Program’s standard Demographic and Health Survey questionnaires, were adapted to reflect the population and health issues relevant to Lesotho. Input was solicited from various stakeholders representing government ministries and agencies, nongovernmental organisations, and international donors. After the preparation of the definitive questionnaires in English, the questionnaires were translated into Sesotho. The Household Questionnaire was used to list all members of and visitors to selected households. Basic demographic information was collected on the characteristics of each person listed, including his or her age, sex, marital status, education, and relationship to the head of the household. For children under age 18, the parents’ survival status was determined. The data on age and sex of household members, obtained in the Household Questionnaire, were used to identify women and men eligible for individual interviews. The Household Questionnaire also collected information on characteristics of the household’s dwelling unit, such as source of water, type of toilet facilities, materials used for the floor of the dwelling unit, and ownership of various durable goods. The Woman’s Questionnaire was used to collect information from all eligible women age 15-49. These women were asked questions on the following topics:  Background characteristics (age, education, media exposure, and so on)  Birth history and child mortality  Knowledge and use of family planning methods  Fertility preferences  Antenatal, delivery, and postnatal care  Breastfeeding and infant feeding practices  Vaccinations and childhood illnesses  Marriage and sexual activity  Women’s work and husbands’ background characteristics Introduction and Survey Methodology • 3  Knowledge, awareness, and behaviour regarding HIV/AIDS and other sexually transmitted infections (STIs)  Adult mortality, including maternal mortality  Knowledge, attitudes, and behaviour related to other health issues (for example, tuberculosis, diabetes, breast and cervical cancer) The Man’s Questionnaire was administered to all men age 15-59 in the subsample of households selected for the male survey. The Man’s Questionnaire collected much of the same information as the Woman’s Questionnaire but was shorter because it did not contain questions to elicit a detailed reproductive history or questions on maternal and child health. In this survey, instead of using paper questionnaires, interviewers used personal digital assistants (PDAs) to record responses during interviews, and team supervisors managed the data using tablet computers. The PDAs and tablets were equipped with Bluetooth technology to enable remote electronic transfer of files (e.g., transfer of assignment sheets from team supervisors to interviewers and transfer of completed questionnaires from interviewers to supervisors). The computer-assisted personal interviewing (CAPI) data collection system employed in the 2014 LDHS was developed by The DHS Program using the mobile version of CSPro. The CSPro software was developed jointly by the U.S. Census Bureau, The DHS Program, and Serpro S. A. 1.4 BLOOD PRESSURE MEASUREMENT, ANTHROPOMETRY, ANAEMIA TESTING, AND HIV TESTING In the half of the households selected for the male survey, the 2014 LDHS incorporated several “biomarkers”: blood pressure measurement, anthropometry, anaemia testing, and HIV testing. In contrast with the data collection procedure for the household and individual interviews, data related to all biomarkers except blood pressure were initially recorded on a paper form (the Biomarker Data Collection Form) and subsequently entered into the team supervisor’s tablet computer. The survey protocol, including biomarker collection, was reviewed and approved by the Lesotho Ministry of Health Research and Ethics Committee and the Institutional Review Board of ICF International. Blood pressure. During the individual interview, three blood pressure measurements were taken from consenting women age 15-49 and men age 15-59 using Omron M3W blood pressure monitors. Measurements were taken at intervals of 10 minutes or more. The average of the second and third measurements was used to classify the respondent with respect to hypertension, according to internationally recommended categories (WHO 1999; NIH 1997). The results, as well as information about the symptoms of high blood pressure and ways in which it can be prevented, were provided to the respondent via the Blood Pressure Findings Report Form and Brochure. Anthropometry. Height and weight measurements were recorded for children age 0-59 months, women age 15-49, and men age 15-59. In addition, mid-upper-arm circumference (MUAC) was recorded for children age 6-59 months. Anaemia testing. Blood specimens for anaemia testing were collected from women age 15-49 and men age 15-59 who voluntarily consented to be tested and from all children age 6-59 months for whom consent was obtained from their parents or the adult responsible for the children. Blood samples were drawn from a drop of blood taken from a finger prick (or a heel prick in the case of children age 6-11 months) and collected in a microcuvette. Haemoglobin analysis was carried out on-site using a battery-operated portable HemoCue analyser. Results were provided verbally and in writing. Parents/guardians of children with a haemoglobin level under 7 g/dl were instructed to take the child to a health facility for follow-up care. Likewise, non- 4 • Introduction and Survey Methodology pregnant women, pregnant women, and men were referred for follow-up care if their haemoglobin levels were below 7 g/dl, 9 g/dl, and 9 g/dl, respectively. All households in which anthropometry and/or anaemia testing was conducted were given a brochure explaining the causes and prevention of anaemia. HIV testing. Interviewers collected blood specimens via finger-prick for laboratory testing for HIV from women age 15-49 and men age 15-59 who consented to be tested. The protocol for blood specimen collection and analysis was based on the anonymous linked protocol developed by The DHS Program. This protocol allows for merging of HIV test results with the sociodemographic data collected in the individual questionnaires after removal of all information that could potentially identify an individual. Interviewers explained the procedure, the confidentiality of the data, and the fact that the test results would not be made available to the respondent. If a respondent consented to HIV testing, five blood spots from the finger prick were collected on a filter paper card to which a barcode label unique to the respondent was affixed. A duplicate label was attached to the Biomarker Data Collection Form. A third copy of the same barcode was affixed to the Dried Blood Spot Transmittal Sheet to track the blood samples from the field to the laboratory. Respondents were asked whether they would consent to having the laboratory store their blood sample for future unspecified testing. If respondents did not consent to additional testing using their sample, it was indicated on the Biomarker Data Collection Form that they refused additional tests using their specimen, and the words “no additional testing” were written on the filter paper card. Each respondent, whether providing consent or not, was given an informational brochure on HIV and a list of nearby sites providing HIV testing and counselling services (HTS). Blood samples were dried overnight and packaged for storage the following morning. Samples were periodically collected from the field and transported to the National Reference Laboratory (NRL) in Maseru. Upon arrival at the NRL, each blood sample was logged into the CSPro HIV Test Tracking System database, given a laboratory number, and stored at -20˚C until tested. The HIV testing protocol stipulated that blood could be tested only after questionnaire data collection had been completed, data had been verified and cleaned, and all unique identifiers other than the anonymous barcode number had been removed from the data file. Testing was performed to estimate HIV prevalence and HIV incidence. The details of the testing algorithm are shown in Appendix C. 1.5 PRETEST Ten women and five men participated in a training to pretest the LDHS survey protocol over a three-week period in June 2014. The majority of participants had worked in various LDHS survey activities previously, including the 2009 LDHS. Participants were employed by the MOH, the BOS, or the Lesotho Planned Parenthood Association. Ten days of classroom instruction were provided. Trainers were from The DHS Program. Pretest field practice took place over four days in both rural and urban locations. Following field practice, a debriefing session was held with the pretest field staff, and modifications to the questionnaires were made based on lessons drawn from the exercise. 1.6 TRAINING OF FIELD STAFF The MOH recruited and trained 100 people for the main fieldwork to serve as supervisors, interviewers, secondary editors, and reserve interviewers. The field staff main training took place over four weeks (6-29 August 2014) at the Khotsong Lodge in Thaba-Bosiu, Lesotho. The training course consisted of instruction regarding interviewing techniques and field procedures, a detailed review of questionnaire content, instruction on how to administer the paper and electronic questionnaires, instruction in weighing and measuring children Introduction and Survey Methodology • 5 and adults, mock interviews between participants in the classroom, practice biomarker collection between participants, and practice interviews with real respondents in areas outside the 2014 sample points. In addition, participants completed limited field practice in blood pressure measurement, anthropometry, anaemia testing, and blood collection for HIV testing.4 Participants were evaluated through homework, in-class exercises, quizzes, and observations made during field practice. Ultimately, 75 participants were selected to serve as interviewers and 15 as team supervisors. The latter received additional training in data quality control procedures, fieldwork coordination, and use of special programmes for the tablet computers. A major challenge was faced by all who attended the main training. During the second week of the training, an interviewer candidate, Ms. Mathebane Ramataboee, was brutally murdered along with a friend. The killings were unrelated to the LDHS. Ms. Ramataboee was a public health nurse working with the EPI Programme at the MOH, and had served as an interviewer in the 2009 LDHS and in the 2014 LDHS pretest. As a well-liked and respected member of the community, her loss was felt keenly by main training participants. 1.7 FIELDWORK Data collection was carried out by 15 field teams, each consisting of one team supervisor, two or three female interviewers, two or three male interviewers, and one driver. All interviewers on each team also served as biomarker technicians. Electronic data files containing interview results were transferred from each interviewer’s PDA to the team supervisor’s tablet each day. Six senior staff members from the MOH coordinated and supervised fieldwork activities. Electronic data files were transferred to the central office every few days via the secured Internet File Streaming System (IFSS). Participants in fieldwork monitoring also included two survey technical specialists from The DHS Program. Data collection took place over a 2.5-month period, from 22 September 2014 through 7 December 2014. The substantial gap between the end of the main training and the start of fieldwork was due to concerns about team safety following political disturbances on 30 August 2014. Immediately prior to the launch, the MOH conducted a two-day refresher training course for interviewers and supervisors at MOH headquarters. 1.8 DATA PROCESSING All electronic data files for the 2014 LDHS were transferred via IFSS to the MOH central office in Maseru, where they were stored on a password-protected computer. The data processing operation included secondary editing, which involved resolution of computer-identified inconsistencies and coding of open-ended questions. The data were processed by one person who took part in the main fieldwork training. Data editing was accomplished using CSPro software. Secondary editing and data processing were initiated in October 2014 and completed in February 2015. 1.9 RESPONSE RATES Table 1.1 shows response rates for the 2014 LDHS. A total of 9,942 households were selected for the sample, of which 9,543 were occupied. Of the occupied households, 9,402 were successfully interviewed, yielding a response rate of 99%. This compares favourably to the 2009 LDHS response rate (98%). 4 Equipment shortages due to procurement issues necessitated that field practice teams share height boards, HemoCue analysers, and blood pressure monitors. 6 • Introduction and Survey Methodology In the interviewed households, 6,818 eligible women were identified for individual interviews; interviews were completed with 6,621 women, yielding a response rate of 97%. In the subsample of households selected for the male survey, 3,133 eligible men were identified and 2,931 were successfully interviewed, yielding a response rate of 94%. The lower response rate for men was likely due to their more frequent and longer absences from the household. The response rates for both women and men were slightly lower in the 2014 LDHS than in the 2009 LDHS (in which response rates were 98% for women and 95% for men). Strikingly, however, the numbers of eligible women and men identified in households in the 2014 LDHS were substantially lower than in the 2009 LDHS. Whereas there was an average of 0.83 eligible women and 0.72 eligible men per household in the 2009 LDHS, the corresponding averages in 2014 were 0.73 and 0.67 (data not shown). The reason for the difference in the average number of eligible women and men between the 2009 and 2014 LDHS surveys is unknown. Possibilities range from a demographic shift in the population of Lesotho to data quality issues such as age displacement or omission of household members (or a combination of both). Table 1.1 Results of the household and individual interviews Number of households, number of interviews, and response rates, according to residence (unweighted), Lesotho 2014 Residence Total Result Urban Rural Household interviews Households selected 2,934 7,008 9,942 Households occupied 2,843 6,700 9,543 Households interviewed 2,798 6,604 9,402 Household response rate1 98.4 98.6 98.5 Interviews with women age 15-49 Number of eligible women 2,282 4,536 6,818 Number of eligible women interviewed 2,202 4,419 6,621 Eligible women response rate2 96.5 97.4 97.1 Interviews with men age 15-59 Number of eligible men 960 2,173 3,133 Number of eligible men interviewed 903 2,028 2,931 Eligible men response rate2 94.1 93.3 93.6 1 Households interviewed/households occupied 2 Respondents interviewed/eligible respondents Housing Characteristics and Household Population • 7 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION 2 Key Findings  Drinking water: Only 77% of rural households have access to an improved source of drinking water, compared with 97% of urban households.  Sanitation: Although the proportion of rural households without a toilet facility is dropping, 38% of households still have none.  Household population and composition: The population of Lesotho is young, with 39% of the population under age 15.  Birth registration: The proportion of children under age 5 whose births are registered with the government has declined slightly since 2009 (from 45% in 2009 to 43% in 2014).  Orphans: Among children under age 18, more than one- quarter are orphans (one or both parents are dead) and over one-third do not live with either parent.  School attendance: The net attendance ratio falls from 94% in primary school to 42% in secondary school. Girls and boys are about equally likely to attend primary school, but girls are much more likely than boys to attend secondary school. nformation on the socioeconomic characteristics of the household population in the LDHS provides context to interpret demographic and health indicators and can furnish an approximate indication of the representativeness of the survey. In addition, this information sheds light on the living conditions of the population. This chapter presents information on source of drinking water, sanitation, exposure to smoke inside the home, wealth, hand washing, household population composition, educational attainment, school attendance, birth registration, and family living arrangements. 2.1 DRINKING WATER SOURCES AND TREATMENT Improved sources of drinking water Include piped water, public taps, standpipes, tube wells, boreholes, protected dug wells and springs, rainwater, and bottled water Sample: Households I 8 • Housing Characteristics and Household Population In Lesotho, almost all urban households (97%), but only 77% of rural households, have access to an improved source of drinking water (Table 2.1). Improved sources protect against outside contamination so that water is more likely to be safe to drink. Urban and rural households rely on different sources of drinking water. Most urban households (70%) have piped water in their dwelling or yard (Figure 2.1). In contrast, rural households mainly rely on public taps (56%), followed by unimproved sources (23%). Only 5% of rural households have piped water on their premises; 37% travel 30 minutes or longer round trip to fetch drinking water (Table 2.1). Clean water is a basic need for human life. Most households (87%) report that they do no treat their water prior to drinking (Table 2.1). One in ten households boils their drinking water, making it the most commonly used water treatment. Despite the fact that a higher proportion of households in rural areas obtains water from unimproved sources compared with urban areas, water treatment is more common in urban areas. Twenty-one percent of households in the urban areas boil their drinking water compared with 7% in the rural areas. Trends: The proportion of households obtaining water from improved sources increased from 79% in 2009 to 84% in 2014. Gains were concentrated in urban households; the proportion of urban households with access to improved drinking water sources increased from 91% to 97%, while the proportion of rural households with access to improved drinking water sources shifted from 74% in 2009 to 77% in 2014. 2.2 SANITATION Improved toilet facilities Include any non-shared toilet of the following types: flush/pour flush toilets to piped sewer systems, septic tanks, and pit latrines; ventilated improved pit (VIP) latrines; and pit latrines with slabs Sample: Households Nearly 5 in 10 households in Lesotho usually use improved toilet facilities, which are defined as non-shared facilities that prevent people from coming into contact with human waste and thus reduce the transmission of cholera, typhoid, and other diseases. Shared toilet facilities of an otherwise acceptable type are especially common in urban areas (Figure 2.2). Twenty-seven percent of households do not use any toilet facility. Figure 2.1 Household drinking water by residence 70 5 26 24 56 46 1 8 6 2 9 7 3 23 16 Urban Rural All Unimproved source Protected well or spring Tubewell or borehole Public tap/standpipe Piped water into dwelling/yard/plot Percent distribution of households by source of drinking water Housing Characteristics and Household Population • 9 The most commonly used improved toilet facility in both urban and rural areas is a pit latrine with slab (referred to in Lesotho as an ordinary pit latrine) (Table 2.2). The proportion of households with an improved toilet facility is higher in rural areas than in the urban areas. Thirty-nine percent of rural households have unimproved toilet facilities or no toilet facilities at all, which increases the risk of disease transmission. Only 6% of households in urban areas lack toilet facilities or have an unimproved facility. Trends: The proportion of urban households with improved toilet facilities has increased since 2009, rising from 26% to 41%. In rural households, the proportion has more than doubled (rising from 22% to 50%). During this same period, the proportion of rural households without any toilet facilities dropped from 45% to 38%. 2.3 EXPOSURE TO SMOKE INSIDE THE HOME Exposure to smoke inside the home, either from cooking with solid fuels or from smoking tobacco, has potentially harmful health effects. Fifty-seven percent of households in Lesotho use some type of solid fuel for cooking, virtually all of it wood (Table 2.3), a figure unchanged since 2009 (58%). Exposure to cooking smoke is greater when cooking takes place inside the house rather than in a separate building or outdoors. In Lesotho, cooking is done inside the house in slightly more than a half of households (53%), a figure identical to 2009. Additionally, in 16% of households someone smokes inside the house daily. Other Housing Characteristics The survey also collected data on access to electricity, flooring materials, and the number of rooms used for sleeping. Sixty-two percent of urban households and 12% of rural households have access to electricity. Nationally, the proportion of households with access to electricity has increased four-fold over the last decade: 7% of households had access to electricity in 2004, 17% in 2009, and 28% in 2014. At 33% each, cement and earth/mud/dung are the most common flooring materials used in Lesotho. By residence, however, differences in flooring material exist. The most common flooring material in rural areas is earth/mud/dung (46%); the most common flooring material in urban areas is cement (50%). Table 2.3 provides complete information on housing characteristics. Figure 2.2 Household toilet facilities by residence 41 50 47 53 11 25 1 1 1 5 38 27 Urban Rural All No facility/bush/field Unimproved facility Shared facility Improved facility Percent distribution of households by type of toilet facilities 10 • Housing Characteristics and Household Population 2.4 HOUSEHOLD WEALTH Wealth index Households are given scores based on the number and kinds of consumer goods they own, ranging from a television to a bicycle or car, plus housing characteristics such as source of drinking water, toilet facilities, and flooring materials. These scores are derived using principal component analysis. National wealth quintiles are compiled by assigning the household score to each usual (de jure) household member, ranking each person in the household population by their score, and then dividing the distribution into five equal categories, each with 20% of the population. Sample: Households In Lesotho, the wealthiest households are concentrated in urban areas. Eighty-five percent of the urban population belongs to the two highest wealth quintiles. More than half (54%) of the rural population falls in the two lowest wealth quintiles (Figure 2.3).Two districts in the Mountains ecological zone of Lesotho have extreme concentrations of poverty; the majority of the population in Mokhotlong and in Thaba-Tseka is in the lowest wealth quintile (53% and 55%, respectively) (Table 2.4). Household Durable Goods The survey also collected information on household effects, means of transportation, agricultural land, and farm animals. Urban households are more likely than rural households are to own a radio (72% versus 51%), television (53% versus 16%), or mobile telephone (96% versus 78%). In contrast, rural households are more likely than urban households are to own agricultural land (61% versus 17%) or farm animals (64% versus 28%). For complete information on household durable goods, see Table 2.5. 2.5 HAND WASHING To obtain hand-washing information, interviewers asked to see the place where members of the household most often wash their hands. Soap and water—the ideal hand washing agent—was seen in 46% of the hand- washing locations that were observed; another 34% had water only (Table 2.6). No water, soap, or other cleaning agent was observed in 18% of handwashing locations. The representativeness of these data is unclear because a place for hand washing was observed in only a small percentage of households (5%). The most common reason interviewers were unable to observe the place where household members usually wash their hands was because there was no designated place for hand washing. Figure 2.3 Household wealth by residence 28 3 26 12 23 31 16 54 7 Urban Rural Percent distribution of de jure population by wealth quintiles Wealthiest Fourth Middle Second Poorest Housing Characteristics and Household Population • 11 2.6 HOUSEHOLD POPULATION AND COMPOSITION Household A person or group of related or unrelated persons who live together in the same dwelling unit(s), who acknowledge one adult male or female as the head of the household, who share the same housekeeping arrangements, and who are considered a single unit. De facto population All persons who stayed in the selected households the night before the interview (whether usual residents or visitors) De jure population All persons who are usual residents of the selected households, whether or not they stayed in the household the night before the interview A total of 31,406 individuals stayed overnight in 9,402 sample households in the 2014 LDHS. Fifty-three percent of them (16,727) were female, and 47% (14,679) were male (Table 2.7). The population pyramid in Figure 2.4 shows their distribution by 5-year age groups and sex. The broad base of the pyramid shows that Lesotho’s population is young, which is typical of developing countries with low life expectancy. The proportion of children under age 15 was 39% in 2014, while the proportion of individuals age 65 and older was 8% (Table 2.7). On average, households in Lesotho comprise 3.3 persons (Table 2.8). Urban households are smaller than rural households (2.8 persons versus 3.6 persons). Women head 36% of all households. The 2014 LDHS also captured information on residency status. In Lesotho, many individuals reside away from their home communities and/or apart from their families for extended periods to pursue work or educational opportunities. Such persons were listed in the household schedule section of the Household Questionnaire, but were not classified as usual residents of their family’s household; instead, they were classified as residing elsewhere, either in Lesotho, in South Africa, or in some other country. As shown in Table 2.9, among males listed in the household schedule, 77% live in the household, 14% live elsewhere in Lesotho, and 9% live in South Africa. Among females listed in the household schedule, 82% live in the household, 14% live elsewhere in Lesotho, and 5% live in South Africa. Figure 2.4 Population pyramid 10 6 2 2 6 10 <5 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+ Age Percent distribution of the household population Male Female 261210 12 • Housing Characteristics and Household Population Trends: The population pyramid is comparable to 2009, when children under age 15 made up 40% of the population and individuals age 65 and older made up 7%. Average household size has decreased since 2009, from 3.6 to 3.3 persons, while the proportion of female-headed households has remained unchanged since 2009. The residency status of individuals listed in the household schedule of the Household Questionnaire is comparable to 2009. 2.7 BIRTH REGISTRATION Registered birth Child has a birth certificate or his/her birth has been registered with the civil authority. Sample: De jure children under age 5 The births of 43% of children under age 5 had been registered with the civil authority at the time of the survey. These births included 18% of children under age 5 with a birth certificate (Table 2.10). Boys and girls are equally likely to be registered. The registration of births varies widely across districts, with children most likely to be registered in Berea and Maseru (Figure 2.5). The percentage of registered children increases with the household’s wealth quintile, from 34% in the lowest wealth quintile to 63% in the highest wealth quintile (Table 2.10). Trends: Registration of children’s births has changed little between 2009 (45%) and 2014 (43%). 2.8 CHILDREN’S LIVING ARRANGEMENTS AND PARENTAL SURVIVAL Orphan A child with one or both parents dead Sample: Children under age 18 Twenty-seven percent of Lesotho children under age 18 are orphans, meaning that one or both of their parents are dead (Table 2.11). The proportion of orphaned children increases rapidly with age, rising from 6% of children under age 2 to 48% of children age 15-17 (Figure 2.6). Orphanhood varies little by residence or district. Only 22% of children under age 18 live with both of their parents; 35% do not live with a biological parent. For information on school attendance by survivorship of parents, see Table 2.12. Figure 2.5 Birth registration by district Percentage of children under age 5 whose births are registered Figure 2.6 Orphanhood by age 6 13 21 37 48 27 <2 2-4 5-9 10-14 15-17 0-17 Percentage of children under age 18 with one or both parents dead, by age of child Age in years Housing Characteristics and Household Population • 13 Trends: Since the 2009 LDHS, the proportion of children under age 18 who are orphaned has changed little (28% versus 27%). 2.9 EDUCATION 2.9.1 Educational Attainment Median educational attainment Number of years of schooling completed by half of the population Sample: De facto household population age 6 and older Overall, 86% of males age 6 and over in Lesotho have ever attended school, compared with 95% of females (Tables 2.13.1 and 2.13.2).The proportions of women and men who have completed secondary school or gone beyond secondary school are identical (10%). Median educational attainment is slightly higher for females (5.7 years) than for males (4.0 years). Trends: Educational attainment at the household level continues to increase. In 2004, 8% of women and 19% of men in surveyed households had no education at all compared with 5% of women and 15% of men in 2009, and 5% of women and 13% of men in 2014. Secondary education has increased from 5% of women and 5% of men completing secondary school in 2004 to 8% of women and 7% of men in 2009, and 10% of women and 10% of men in 2014. Patterns by background characteristics  Urban residents are much more likely to have completed secondary school than rural residents. Among women in urban households, 22% have completed secondary school or beyond compared with 5% of women in rural households. A similar pattern holds for men; 25% of urban men completed secondary school compared with 4% of rural men.  Educational attainment varies by district. Fewer than 1 in 10 women in Quthing, Qacha’s Nek, Mokhotlong, and Thaba-Tseka has no education. Twenty-seven percent of men in Thaba-Tseka have no education.  Educational attainment increases with household wealth among women and men. Thirty percent of women in the wealthiest households have completed secondary school or beyond compared with less than 1% of women in the poorest households. 2.9.2 School Attendance Net attendance ratio (NAR) Percentage of the school-age population that attends primary or secondary school Sample: Children age 6-12 for primary school NAR and children age 13-17 for secondary school NAR Gross attendance ratio (GAR) The total number of primary and secondary school students expressed as a percentage of the official primary and secondary school-age population Sample: Children age 6-12 for primary school GAR and children age 13-17 for secondary school GAR 14 • Housing Characteristics and Household Population Ninety-five percent of girls age 6-12 attend primary school compared with 92% of boys (Table 2.14). The net attendance ratio drops in secondary school: only 51% of girls and 35% of boys age 13-17 attend secondary school. Patterns by background characteristics  Urban children age 13-17 are more likely than their rural counterparts are to attend secondary school (65% versus 34%).  Girls are more likely than boys are to attend secondary school in all the districts of Lesotho. Attendance ranges from a low of 11% in Thaba-Tseka to a high of 46% in Maseru for boys and from a low of 32% in Thaba-Tseka to 60% in both Berea and Leribe for girls.  Girls and boys in the highest wealth quintile are 3 and 10 times more likely to attend secondary school, respectively, than those in the lowest wealth quintile (Figure 2.7). Other Measures of School Attendance The survey also collected data on two other indicators. The gross attendance ratio (GAR), which measures participation at each level of schooling among all those age 5-24, is 122% at the primary school level and 61% at the secondary school level. These figures indicate that children outside the official school age population for that level are attending primary school, and not all who should be attending secondary school are doing so. The gender parity index (GPI), which is the ratio of female to male attendance rates, is close to 1 at primary school level and exceeds 1 at secondary school level. This confirms that there is relatively little difference in overall school attendance by boys and girls at the primary level, but by secondary school, female school attendance is much greater than male attendance. For complete information on these indicators, see Table 2.14. 2.10 DISTANCE TO A HEALTH FACILITY In the 2014 LDHS, interviewers asked about the means of transport used by households to get to the nearest health facility, and the time required getting to the facility. Overall, in 72% of households members walk to the nearest health facility; in 22% of households they travel by car, truck, bus, or taxi, and in 6% they use a combination of walking and bus or taxi (Table 2.15). Among households in which members travel to the nearest health facility by walking, 27% require more than 120 minutes of travel time (Table 2.16). Figure 2.7 Secondary school attendance by wealth quintile 24 40 47 63 74 51 7 20 34 45 69 35 Lowest Second Middle Fourth Highest Total Girls Boys WealthiestPoorest Net attendance ratio for secondary school among children age 13-17 Housing Characteristics and Household Population • 15 LIST OF TABLES For detailed information on household population and housing characteristics, see the following tables:  Table 2.1 Household drinking water  Table 2.2 Household sanitation facilities  Table 2.3 Household characteristics  Table 2.4 Wealth quintiles  Table 2.5 Household possessions  Table 2.6 Hand washing  Table 2.7 Household population by age, sex, and residence  Table 2.8 Household composition  Table 2.9 Residency status  Table 2.10 Birth registration of children under age 5  Table 2.11 Children’s living arrangements and orphanhood  Table 2.12 School attendance by survivorship of parents  Table 2.13.1 Educational attainment of the female household population  Table 2.13.2 Educational attainment of the male household population  Table 2.14 School attendance ratios  Table 2.15 Method of travel and travel time to nearest health facility  Table 2.16 Travel time to health facility by walking 16 • Housing Characteristics and Household Population Table 2.1 Household drinking water Percent distribution of households and de jure population by source of drinking water, time to obtain drinking water, and treatment of drinking water, according to residence, Lesotho 2014 Households Population Characteristic Urban Rural Total Urban Rural Total Source of drinking water Improved source 96.9 77.2 83.6 96.3 76.9 82.2 Piped into dwelling/yard/plot 69.5 4.8 25.6 67.5 4.7 21.9 Public tap/standpipe 24.3 55.7 45.6 25.5 55.5 47.3 Tube well/borehole 1.3 7.8 5.7 1.8 7.5 6.0 Protected well 0.6 3.2 2.3 0.5 3.3 2.5 Protected spring 1.1 5.7 4.2 1.0 5.8 4.5 Rain water 0.0 0.1 0.1 0.0 0.0 0.0 Bottled water 0.1 0.0 0.0 0.1 0.0 0.0 Unimproved source 3.1 22.8 16.4 3.7 23.1 17.8 Unprotected well 1.4 9.8 7.1 1.6 9.7 7.5 Unprotected spring 1.6 11.4 8.2 1.9 11.9 9.1 Tanker truck/car with small tank 0.0 0.5 0.4 0.0 0.5 0.4 Surface water 0.1 1.0 0.7 0.1 1.1 0.8 Total 100.0 100.0 100.0 100.0 100.0 100.0 Time to obtain drinking water (round trip) Water on premises 71.0 6.1 26.9 68.9 6.1 23.3 Less than 30 minutes 23.9 55.9 45.6 24.9 54.9 46.7 30 minutes or longer 5.0 36.6 26.4 6.0 37.5 28.9 Don’t know 0.2 1.4 1.0 0.2 1.5 1.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 Water treatment prior to drinking1 Boiled 21.2 6.7 11.4 21.3 6.7 10.7 Bleach/chlorine added 0.2 0.2 0.2 0.2 0.2 0.2 Strained through cloth 0.5 1.3 1.0 0.5 1.4 1.1 Ceramic, sand or other filter 0.7 0.1 0.3 0.7 0.0 0.2 Other 0.1 0.4 0.3 0.2 0.4 0.3 No treatment 77.7 91.8 87.3 77.7 91.8 87.9 Percentage using an appropriate treatment method2 22.0 7.0 11.8 22.1 6.9 11.0 Number 3,020 6,382 9,402 8,566 22,694 31,260 1 Respondents may report multiple treatment methods, so the sum of treatment may exceed 100%. 2 Appropriate treatment methods include boiling, bleaching, filtering, and solar disinfecting. Housing Characteristics and Household Population • 17 Table 2.2 Household sanitation facilities Percent distribution of households and de jure population by type of toilet/latrine facilities, according to residence, Lesotho 2014 Households Population Type of toilet/latrine facility Urban Rural Total Urban Rural Total Improved 41.1 50.0 47.1 49.0 51.6 50.9 Flush/pour flush to piped sewer system 4.0 0.0 1.3 3.8 0.0 1.0 Flush/pour flush to septic tank 2.7 0.1 1.0 3.0 0.2 0.9 Flush/pour flush to pit latrine 0.0 0.0 0.0 0.0 0.0 0.0 Ventilated improved pit (VIP) latrine 6.1 15.3 12.3 7.2 16.4 13.9 Ordinary pit latrine/pit latrine with slab 28.2 34.5 32.5 35.1 35.0 35.0 Shared facility1 53.2 10.9 24.5 45.4 9.4 19.2 Flush/pour flush to piped sewer system 0.4 0.0 0.1 0.3 0.0 0.1 Flush/pour flush to septic tank 0.3 0.0 0.1 0.3 0.0 0.1 Ventilated improved pit (VIP) latrine 6.8 1.4 3.1 5.9 1.1 2.4 Ordinary pit latrine/pit latrine with slab 45.7 9.5 21.1 39.0 8.2 16.6 Unimproved facility 5.8 39.1 28.4 5.6 39.1 29.9 Flush/pour flush not to sewer/septic tank/pit latrine 0.4 0.0 0.1 0.4 0.0 0.1 Pit latrine without slab/open pit 0.7 1.4 1.2 0.6 1.4 1.2 No facility/bush/field 4.7 37.7 27.1 4.6 37.6 28.6 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number 3,020 6,382 9,402 8,566 22,694 31,260 Note: Total includes 1 household using a flush/pour flush toilet to pit latrine and 1 household using a composting toilet, neither of which is shared. 1 Facilities that would be considered improved if they were not shared by 2 or more households 18 • Housing Characteristics and Household Population Table 2.3 Household characteristics Percent distribution of households by housing characteristics, percentage using solid fuel for cooking, and percent distribution by frequency of smoking in the home, according to residence, Lesotho 2014 Residence Total Housing characteristic Urban Rural Electricity Yes 61.5 11.8 27.8 No 38.5 88.2 72.2 Total 100.0 100.0 100.0 Flooring material Earth/mud/dung 5.6 46.3 33.2 Wood planks 0.5 0.1 0.2 Parquet or polished wood 0.1 0.0 0.0 Vinyl tile/vinyl carpet 20.7 15.2 16.9 Ceramic tiles 13.9 7.3 9.4 Cement 50.4 24.1 32.5 Carpet 8.8 7.0 7.6 Other 0.0 0.1 0.0 Total 100.0 100.0 100.0 Rooms used for sleeping1 One 59.4 39.5 45.9 Two 24.9 41.2 36.0 Three or more 15.0 19.3 17.9 Total 100.0 100.0 100.0 Place for cooking In the house 90.7 34.5 52.6 In a separate building 1.6 10.5 7.6 Outdoors 7.5 54.8 39.6 No food cooked in household 0.2 0.2 0.2 Total 100.0 100.0 100.0 Cooking fuel Electricity 27.4 3.1 10.9 LPG/biogas 50.9 13.2 25.3 Paraffin 12.4 4.0 6.7 Coal 0.0 0.1 0.1 Wood 7.7 65.5 47.0 Straw/shrubs/grass 0.1 2.4 1.7 Agricultural crop 0.1 0.6 0.4 Animal dung 1.0 10.8 7.7 Other 0.1 0.0 0.0 No food cooked in household 0.2 0.2 0.2 Total 100.0 100.0 100.0 Percentage using solid fuel for cooking2 9.0 79.5 56.8 Frequency of smoking in the home Daily 9.5 19.5 16.3 Weekly 2.7 4.7 4.1 Monthly 1.7 2.9 2.5 Less than monthly 1.9 3.3 2.8 Never 84.3 69.5 74.3 Total 100.0 100.0 100.0 Number 3,020 6,382 9,402 LPG = Liquid petroleum gas 1 Total includes 24 households for which respondents indicated that no rooms were used for sleeping. 2 Solid fuel includes coal, wood, straw/shrubs/grass, agricultural crops, and animal dung. Housing Characteristics and Household Population • 19 Table 2.4 Wealth quintiles Percent distribution of the de jure population by wealth quintiles, and the Gini coefficient, according to residence and region, Lesotho 2014 Wealth quintile Total Number of persons Gini coefficient Residence/zone/district Lowest Second Middle Fourth Highest Residence Urban 0.2 3.0 12.4 30.7 53.8 100.0 8,566 0.16 Rural 27.5 26.4 22.9 15.9 7.3 100.0 22,694 0.34 Ecological zone Lowlands 4.8 13.7 21.9 27.5 32.1 100.0 17,606 0.25 Foothills 26.4 29.9 25.3 14.0 4.5 100.0 3,585 0.33 Mountains 47.8 27.3 13.9 7.3 3.7 100.0 7,352 0.41 Senqu River Valley 35.5 27.6 17.2 13.5 6.2 100.0 2,717 0.40 District Butha-Buthe 24.1 26.8 23.7 15.4 10.1 100.0 1,974 0.40 Leribe 8.6 19.8 25.5 28.8 17.2 100.0 4,764 0.28 Berea 11.8 17.2 24.5 17.8 28.7 100.0 3,836 0.33 Maseru 6.4 14.6 15.2 27.3 36.5 100.0 7,590 0.27 Mafeteng 9.5 18.1 25.6 24.9 21.9 100.0 2,808 0.30 Mohale’s Hoek 32.7 22.8 18.9 14.8 10.8 100.0 2,951 0.39 Quthing 22.7 25.3 26.6 15.6 9.7 100.0 1,776 0.35 Qacha’s Nek 34.5 27.2 17.0 12.6 8.7 100.0 1,088 0.43 Mokhotlong 52.8 26.7 9.8 6.2 4.6 100.0 1,961 0.46 Thaba-Tseka 55.2 21.8 14.1 5.9 3.0 100.0 2,513 0.44 Total 20.0 20.0 20.0 20.0 20.0 100.0 31,260 0.36 Table 2.5 Household possessions Percentage of households possessing various household effects, means of transportation, agricultural land, and livestock/farm animals by residence, Lesotho 2014 Residence Total Possession Urban Rural Household effects Radio 72.1 50.8 57.6 Television 52.9 15.8 27.7 Mobile telephone 95.5 78.1 83.7 Non-mobile telephone 7.2 1.1 3.1 Refrigerator 43.3 11.9 22.0 Battery/generator 4.8 13.9 11.0 Solar panel 4.9 21.7 16.3 Computer 17.7 2.6 7.5 Bed/mattress 98.7 94.3 95.7 Internet access 37.4 9.2 18.3 Means of transport Bicycle 3.7 1.6 2.3 Animal drawn cart/scotch cart 1.9 13.1 9.5 Motorcycle/scooter 0.4 0.1 0.2 Car/truck 19.2 6.0 10.2 Ownership of agricultural land 17.0 60.5 46.5 Ownership of farm animals1 27.8 64.0 52.4 Number 3,020 6,382 9,402 1 Cattle, milk cows, bulls, horses, donkeys, mules, goats, sheep, chickens, pigs, or rabbits 20 • Housing Characteristics and Household Population Table 2.6 Hand washing Percentage of households in which the place most often used for washing hands was observed, and among households in which the place for hand washing was observed, percent distribution by availability of water, soap, and other cleansing agents, Lesotho 2014 Percentage of households where place for washing hands was observed Number of households Among households where place for hand washing was observed, percentage with: Number of households with place for hand washing observed Background characteristic Soap and water1 Water only Soap but no water2 No water, no soap, no other cleansing agent Total Residence Urban 11.6 3,020 54.1 34.4 1.2 10.2 100.0 349 Rural 2.4 6,382 28.0 32.5 4.4 35.1 100.0 151 Ecological zone Lowlands 7.0 5,670 52.2 32.8 1.8 13.2 100.0 397 Foothills 2.3 983 * * * * 100.0 23 Mountains 2.2 1,978 23.0 30.9 6.4 39.6 100.0 44 Senqu River Valley 4.7 771 31.0 25.6 0.0 43.3 100.0 36 Wealth quintile Lowest 1.3 1,795 (23.4) (15.4) (6.9) (54.2) 100.0 23 Second 1.6 1,761 (1.8) (22.3) (3.9) (72.0) 100.0 29 Middle 2.5 1,857 (17.1) (37.8) (6.0) (39.1) 100.0 47 Fourth 3.9 2,001 17.4 65.8 1.9 14.9 100.0 77 Highest 16.3 1,987 62.9 28.0 1.2 7.9 100.0 324 Total 5.3 9,402 46.2 33.8 2.2 17.7 100.0 500 Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Soap includes soap or detergent in bar, liquid, powder, or paste form. This column includes households with soap and water only as well as those that had soap and water and another cleansing agent. 2 This column includes households with soap only as well as those with soap and another cleansing agent. Table 2.7 Household population by age, sex, and residence Percent distribution of the de facto household population by 5-year age groups, according to sex and residence, Lesotho 2014 Urban Rural Total Age Male Female Total Male Female Total Male Female Total <5 12.0 9.2 10.5 13.3 12.5 12.9 13.0 11.6 12.2 5-9 11.0 10.6 10.8 15.3 14.2 14.7 14.2 13.2 13.6 10-14 10.8 10.4 10.6 15.9 13.8 14.8 14.5 12.9 13.6 15-19 11.0 10.2 10.6 11.5 8.6 10.0 11.4 9.1 10.1 20-24 10.4 10.5 10.4 8.2 7.7 7.9 8.8 8.5 8.6 25-29 10.2 9.5 9.8 6.1 5.9 6.0 7.2 6.9 7.1 30-34 8.2 9.5 8.9 5.1 4.7 4.9 5.9 6.0 6.0 35-39 7.0 6.6 6.8 3.6 3.9 3.8 4.5 4.7 4.6 40-44 4.5 4.3 4.3 3.5 3.3 3.4 3.7 3.6 3.6 45-49 3.2 3.4 3.3 2.6 3.0 2.8 2.8 3.1 2.9 50-54 2.7 5.2 4.1 2.5 4.5 3.6 2.6 4.7 3.7 55-59 2.3 2.6 2.5 2.5 3.7 3.1 2.4 3.4 2.9 60-64 2.7 2.7 2.7 3.0 3.5 3.3 2.9 3.3 3.1 65-69 1.8 1.8 1.8 2.3 2.7 2.5 2.2 2.4 2.3 70-74 1.0 1.3 1.2 1.9 2.7 2.3 1.7 2.3 2.0 75-79 0.7 0.9 0.8 1.2 2.2 1.7 1.1 1.9 1.5 80 + 0.4 1.2 0.9 1.4 3.1 2.3 1.2 2.5 1.9 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number 3,829 4,741 8,571 10,849 11,986 22,835 14,679 16,727 31,406 Housing Characteristics and Household Population • 21 Table 2.8 Household composition Percent distribution of households by sex of head of household and by household size; mean size of household, and percentage of households with orphans and foster children under age 18 years, according to residence, Lesotho 2014 Residence Total Characteristic Urban Rural Household headship Male 65.2 64.2 64.5 Female 34.8 35.8 35.5 Total 100.0 100.0 100.0 Number of usual members 0 0.5 0.6 0.6 1 27.1 17.4 20.5 2 22.0 17.2 18.8 3 19.1 18.8 18.9 4 15.6 17.1 16.6 5 8.2 12.5 11.1 6 3.8 7.4 6.3 7 2.0 4.3 3.5 8 0.7 2.0 1.6 9+ 0.9 2.5 2.0 Total 100.0 100.0 100.0 Mean size of households 2.8 3.6 3.3 Percentage of households with orphans and foster children under 18 years of age Foster children1 22.0 39.5 33.9 Double orphans 4.2 7.7 6.6 Single orphans2 14.2 21.6 19.2 Foster and/or orphan children 27.4 44.2 38.8 Number of households 3,020 6,382 9,402 Note: Table is based on de jure household members, i.e., usual residents. 1 Foster children are those under age 18 living in households with neither their mother nor their father present. 2 The category of single orphans includes children with one dead parent and an unknown survival status of the other parent. 22 • Housing Characteristics and Household Population Table 2.9 Residency status Percent distribution of males and females listed in the household schedule of the Household Questionnaire by whether they live in the household, elsewhere in Lesotho, in the Republic of South Africa, or in another country, according to background characteristics, Lesotho 2014 Male Female Background characteristic In the household Else- where in Lesotho In RSA In other country Total Number In the household Else- where in Lesotho In RSA In other country Total Number Age 0-9 89.9 8.8 1.2 0.0 100.0 4,369 90.6 8.3 1.0 0.1 100.0 4,494 10-19 83.7 14.7 1.6 0.0 100.0 4,571 81.0 17.9 1.0 0.1 100.0 4,492 20-29 66.6 20.4 12.9 0.1 100.0 3,633 69.8 23.2 6.9 0.1 100.0 3,519 30-39 63.1 17.2 19.7 0.0 100.0 2,466 72.7 14.7 12.5 0.1 100.0 2,403 40-49 62.3 14.2 23.3 0.2 100.0 1,541 73.6 11.9 14.5 0.0 100.0 1,518 50-59 67.2 9.8 23.0 0.0 100.0 1,100 87.1 6.2 6.7 0.0 100.0 1,561 60+ 90.6 5.1 4.3 0.0 100.0 1,488 93.4 5.1 1.4 0.0 100.0 2,242 Residence Urban 81.0 11.8 7.1 0.1 100.0 4,768 85.1 11.3 3.4 0.2 100.0 5,526 Rural 75.8 14.3 9.9 0.0 100.0 14,400 80.1 14.4 5.4 0.0 100.0 14,703 Ecological zone Lowlands 78.6 12.3 9.0 0.0 100.0 10,396 82.8 12.2 4.9 0.1 100.0 11,396 Foothills 74.1 15.5 10.4 0.0 100.0 2,356 78.5 16.4 5.1 0.0 100.0 2,342 Mountains 78.2 15.4 6.3 0.0 100.0 4,600 82.2 14.3 3.5 0.0 100.0 4,568 Senqu River Valley 69.2 15.1 15.6 0.1 100.0 1,817 75.9 16.1 8.0 0.1 100.0 1,923 District Butha-Buthe 79.0 11.4 9.6 0.0 100.0 1,211 84.9 9.5 5.5 0.0 100.0 1,198 Leribe 74.2 14.4 11.4 0.0 100.0 2,977 78.7 15.5 5.8 0.0 100.0 3,246 Berea 79.2 13.5 7.3 0.0 100.0 2,354 81.1 13.9 5.0 0.1 100.0 2,431 Maseru 82.2 11.7 6.0 0.1 100.0 4,290 85.7 11.0 3.0 0.2 100.0 4,742 Mafeteng 77.2 11.9 10.9 0.0 100.0 1,734 82.6 11.8 5.6 0.0 100.0 1,780 Mohale’s Hoek 68.8 16.9 14.3 0.0 100.0 2,011 74.7 18.6 6.7 0.0 100.0 2,097 Quthing 68.9 14.2 16.8 0.1 100.0 1,170 75.3 14.4 10.2 0.1 100.0 1,287 Qacha’s Nek 77.1 12.8 10.1 0.0 100.0 658 85.4 9.6 5.0 0.0 100.0 680 Mokhotlong 79.6 14.3 6.0 0.0 100.0 1,230 81.6 14.9 3.5 0.0 100.0 1,203 Thaba-Tseka 78.7 17.3 3.9 0.0 100.0 1,533 83.4 15.0 1.6 0.0 100.0 1,567 Education1 No education 79.6 11.9 8.5 0.0 100.0 2,469 88.5 8.7 2.6 0.2 100.0 1,142 Some primary 81.0 10.9 8.2 0.0 100.0 8,096 89.7 7.4 2.8 0.0 100.0 7,552 Completed primary 66.3 14.7 19.0 0.0 100.0 1,377 75.8 14.5 9.7 0.0 100.0 2,565 Some secondary 68.6 19.8 11.6 0.0 100.0 3,140 73.3 20.3 6.4 0.0 100.0 4,624 Completed secondary 69.4 18.1 12.2 0.3 100.0 900 71.1 21.4 7.4 0.0 100.0 996 More than secondary 70.3 23.5 5.8 0.4 100.0 845 66.7 28.5 4.2 0.7 100.0 1,033 Don’t know 58.5 11.8 29.7 0.0 100.0 217 45.6 25.3 29.1 0.0 100.0 202 Wealth quintile Lowest 78.7 14.4 6.8 0.0 100.0 3,793 83.7 12.7 3.5 0.0 100.0 3,908 Second 76.5 14.6 8.9 0.0 100.0 3,964 80.3 13.9 5.8 0.0 100.0 3,993 Middle 76.3 13.6 10.1 0.0 100.0 3,885 79.8 13.7 6.5 0.0 100.0 4,123 Fourth 76.1 12.9 11.0 0.0 100.0 3,874 81.5 13.0 5.5 0.0 100.0 4,050 Highest 77.8 13.0 9.1 0.2 100.0 3,652 82.2 14.4 3.2 0.3 100.0 4,154 Total 77.1 13.7 9.2 0.0 100.0 19,168 81.5 13.6 4.9 0.1 100.0 20,229 1 Excludes household population less than age 5 Housing Characteristics and Household Population • 23 Table 2.10 Birth registration of children under age 5 Percentage of de jure children under age 5 whose births are registered with the civil authorities, according to background characteristics, Lesotho 2014 Children whose births are registered Number of children Background characteristic Percentage who had a birth certificate Percentage who did not have a birth certificate Percentage registered Age <2 14.0 25.3 39.3 1,380 2-4 20.6 25.1 45.7 2,338 Sex Male 18.0 24.3 42.4 1,846 Female 18.3 26.0 44.3 1,873 Residence Urban 24.8 29.1 53.9 870 Rural 16.1 24.0 40.1 2,848 Ecological zone Lowlands 20.1 28.0 48.1 1,972 Foothills 19.6 24.8 44.4 471 Mountains 13.4 23.6 37.0 944 Senqu River Valley 18.1 13.5 31.6 332 District Butha-Buthe 17.7 16.1 33.8 254 Leribe 18.7 28.8 47.5 575 Berea 16.8 34.8 51.6 439 Maseru 19.9 30.7 50.5 861 Mafeteng 25.1 19.2 44.4 322 Mohale’s Hoek 10.9 19.2 30.1 342 Quthing 18.9 13.8 32.7 219 Qacha’s Nek 21.4 9.4 30.8 118 Mokhotlong 13.2 30.1 43.3 249 Thaba-Tseka 17.6 20.6 38.1 340 Wealth quintile Lowest 9.5 24.7 34.2 866 Second 14.3 22.6 36.8 801 Middle 17.8 24.6 42.3 772 Fourth 20.8 26.2 47.0 693 Highest 33.6 29.3 62.8 587 Total 18.1 25.2 43.3 3,718 24 • Housing Characteristics and Household Population Table 2.11 Children’s living arrangements and orphanhood Percent distribution of de jure children under age 18 by living arrangements and survival status of parents, the percentage of children not living with a biological parent, and the percentage of children with one or both parents dead, according to background characteristics, Lesotho 2014 Living with both parents Living with mother but not with father Living with father but not with mother Not living with either parent Missing information on father/ mother Total Percent- age not living with a biologi- cal parent Percent- age with one or both parents dead1 Number of children Background characteristic Father alive Father dead Mother alive Mother dead Both alive Only father alive Only mother alive Both dead Age 0-4 28.7 34.9 4.7 3.3 0.2 17.5 0.9 3.4 0.7 5.8 100.0 22.5 10.2 3,718 <2 34.6 46.4 4.3 1.6 0.0 7.7 0.3 0.8 0.3 4.0 100.0 9.1 5.7 1,380 2-4 25.2 28.1 5.0 4.3 0.3 23.3 1.2 4.9 1.0 6.9 100.0 30.3 12.8 2,338 5-9 22.4 22.5 6.1 5.1 0.9 22.5 2.2 7.2 3.5 7.6 100.0 35.4 20.7 4,283 10-14 18.7 18.1 9.3 5.1 1.8 16.2 4.1 11.2 8.7 6.8 100.0 40.3 36.6 4,313 15-17 15.9 13.4 11.3 3.8 3.4 15.3 5.1 13.0 13.5 5.2 100.0 46.9 48.0 1,925 Sex Male 22.1 22.7 7.1 4.9 1.3 18.1 3.0 8.3 6.1 6.5 100.0 35.5 26.7 7,100 Female 22.0 23.6 7.7 4.1 1.3 18.5 2.7 8.1 5.3 6.7 100.0 34.6 26.2 7,140 Residence Urban 29.0 23.6 8.3 3.5 1.5 14.3 2.1 6.5 5.0 6.1 100.0 28.0 24.4 3,233 Rural 20.0 23.0 7.1 4.8 1.3 19.5 3.1 8.7 5.9 6.7 100.0 37.1 27.0 11,006 Ecological zone Lowlands 22.4 24.1 7.3 4.4 1.5 17.8 2.8 7.8 5.1 6.8 100.0 33.5 25.5 7,359 Foothills 18.8 26.1 8.6 3.4 0.9 18.7 3.1 8.7 6.2 5.5 100.0 36.7 28.2 1,762 Mountains 25.4 20.1 7.3 5.2 1.4 18.3 2.8 8.4 6.1 5.0 100.0 35.6 26.9 3,789 Senqu River Valley 14.7 22.4 6.7 4.5 0.5 20.4 2.8 9.3 7.2 11.5 100.0 39.7 28.1 1,330 District Butha-Buthe 20.2 25.5 8.3 4.3 0.8 21.2 2.4 7.5 6.0 3.9 100.0 37.1 25.5 949 Leribe 20.5 22.5 8.2 4.3 1.8 18.3 3.9 7.3 5.4 7.9 100.0 34.8 27.9 2,180 Berea 22.7 21.8 7.1 5.0 1.7 20.0 3.4 9.3 3.8 5.2 100.0 36.5 26.0 1,650 Maseru 26.8 25.0 8.3 4.4 1.7 14.5 2.2 6.3 5.0 5.7 100.0 28.0 24.5 3,068 Mafeteng 13.8 24.2 8.0 4.6 0.8 21.6 2.7 11.9 6.0 6.4 100.0 42.2 30.2 1,270 Mohale’s Hoek 17.2 24.9 5.8 3.7 1.2 17.4 3.1 9.0 7.5 10.2 100.0 37.0 27.9 1,383 Quthing 14.0 23.8 5.4 3.2 0.8 21.9 2.3 9.5 6.8 12.4 100.0 40.4 26.2 868 Qacha’s Nek 17.6 22.3 6.0 4.1 0.5 21.3 4.1 10.6 8.1 5.4 100.0 44.1 30.9 546 Mokhotlong 26.8 19.1 6.8 4.8 1.3 19.7 3.1 8.4 5.9 4.2 100.0 37.1 26.3 1,038 Thaba-Tseka 30.3 20.2 7.0 6.0 1.0 16.2 1.8 6.8 6.0 4.6 100.0 30.9 23.2 1,287 Wealth quintile Lowest 24.1 19.2 9.1 5.3 1.3 17.4 2.6 8.3 6.0 6.7 100.0 34.4 28.3 3,280 Second 19.7 20.8 6.7 5.5 1.2 20.2 2.8 9.6 6.4 7.0 100.0 39.1 27.9 3,130 Middle 17.7 23.3 8.6 3.9 0.8 19.5 3.0 9.5 6.4 7.5 100.0 38.3 29.5 2,931 Fourth 19.4 29.4 7.0 3.7 1.7 17.4 3.4 7.5 4.6 5.9 100.0 33.0 24.9 2,634 Highest 30.9 24.7 5.0 3.7 1.7 16.5 2.4 5.1 4.6 5.4 100.0 28.7 19.7 2,264 Total <15 23.0 24.7 6.8 4.6 1.0 18.8 2.5 7.4 4.5 6.8 100.0 33.2 23.1 12,314 Total <18 22.0 23.2 7.4 4.5 1.3 18.3 2.8 8.2 5.7 6.6 100.0 35.1 26.5 14,239 Note: Table is based on de jure members, i.e., usual residents. 1 Includes children with father dead, mother dead, both dead, and one parent dead but missing information on survival status of the other parent Housing Characteristics and Household Population • 25 Table 2.12 School attendance by survivorship of parents For de jure children age 10-14, the percentage attending school by parental survival and the ratio of the percentage attending, by parental survival, according to background characteristics, Lesotho 2014 Percentage attending school by survivorship of parents Ratio1 Background characteristic Both parents deceased Number Both parents alive and living with at least one parent Number Sex Male 84.2 192 94.4 903 0.89 Female 94.3 184 98.7 904 0.95 Residence Urban 92.4 71 98.4 441 0.94 Rural 88.4 305 95.9 1,366 0.92 Ecological zone Lowlands 92.1 162 99.1 970 0.93 Foothills 90.6 57 96.2 203 0.94 Mountains 82.9 109 91.3 492 0.91 Senqu River Valley 91.5 48 97.7 141 0.94 District Butha-Buthe (91.6) 25 95.3 120 (0.96) Leribe (90.9) 56 98.9 280 (0.92) Berea * 23 100.0 188 * Maseru (88.1) 71 97.8 439 (0.90) Mafeteng (94.5) 30 98.1 124 (0.96) Mohale’s Hoek 87.4 51 94.2 191 0.93 Quthing (93.0) 27 94.4 88 (0.99) Qacha’s Nek 97.9 24 99.5 72 0.98 Mokhotlong 77.1 30 91.2 125 0.85 Thaba-Tseka 83.9 40 92.0 178 0.91 Wealth quintile Lowest 86.0 99 91.4 390 0.94 Second 82.5 91 95.5 343 0.86 Middle 87.5 82 98.6 357 0.89 Fourth 98.8 63 98.9 351 1.00 Highest (100.0) 41 98.8 366 (1.01) Total 89.1 376 96.5 1,807 0.92 Notes: Table is based only on children who usually live in the household. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Ratio of the percentage with both parents deceased to the percentage with both parents alive and living with a parent 26 • Housing Characteristics and Household Population Table 2.13.1 Educational attainment of the female household population Percent distribution of the de facto female household population age 6 and over by highest level of schooling attended or completed and median years completed, according to background characteristics, Lesotho 2014 Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Don’t know Total Number Median years completed Age 6-9 11.9 88.1 0.0 0.0 0.0 0.0 0.0 100.0 1,807 0.5 10-14 0.3 86.1 2.5 11.2 0.0 0.0 0.0 100.0 2,154 4.1 15-19 0.6 17.6 11.3 66.5 3.3 0.5 0.1 100.0 1,516 6.7 20-24 0.4 11.7 16.6 45.1 16.3 9.5 0.3 100.0 1,415 7.8 25-29 1.1 18.7 19.4 32.1 14.1 13.9 0.6 100.0 1,159 7.2 30-34 2.3 19.3 25.5 33.1 8.3 10.8 0.8 100.0 1,009 6.8 35-39 2.3 20.4 25.9 28.7 9.9 10.5 2.2 100.0 787 6.8 40-44 2.3 21.2 31.1 30.2 6.5 8.6 0.2 100.0 597 6.7 45-49 2.7 28.0 29.0 27.1 5.6 6.5 1.1 100.0 518 6.5 50-54 4.1 40.6 24.5 18.1 3.7 7.5 1.4 100.0 790 6.1 55-59 5.8 52.4 19.6 11.9 2.5 5.7 2.1 100.0 567 5.3 60-64 6.5 60.0 16.1 9.9 1.7 4.4 1.3 100.0 550 4.5 65+ 14.8 70.9 7.8 2.8 0.5 1.8 1.4 100.0 1,529 3.0 Residence Urban 2.6 30.0 11.7 33.1 9.8 11.7 1.1 100.0 4,219 6.7 Rural 5.3 53.9 14.7 20.2 3.2 2.2 0.5 100.0 10,178 5.1 Ecological zone Lowlands 2.7 39.1 13.4 29.3 7.0 7.6 0.8 100.0 8,324 6.2 Foothills 4.1 58.1 15.7 18.4 2.1 1.0 0.6 100.0 1,614 5.1 Mountains 8.0 58.5 14.4 15.3 2.2 1.4 0.2 100.0 3,206 4.5 Senqu River Valley 7.7 54.5 13.2 17.7 3.5 2.3 1.1 100.0 1,254 4.8 District Butha-Buthe 4.8 47.8 14.0 24.6 4.6 3.4 0.7 100.0 875 5.6 Leribe 3.9 41.9 15.8 29.7 4.1 4.2 0.3 100.0 2,236 6.0 Berea 2.4 41.0 15.1 25.6 6.6 8.5 0.8 100.0 1,755 6.2 Maseru 2.6 39.8 13.1 27.6 7.6 8.2 1.0 100.0 3,569 6.2 Mafeteng 3.2 48.8 12.8 24.7 5.6 4.7 0.2 100.0 1,287 5.6 Mohale’s Hoek 4.6 56.5 12.9 18.9 3.3 2.6 1.2 100.0 1,392 4.9 Quthing 7.9 54.8 10.4 19.2 4.0 2.6 1.1 100.0 833 4.9 Qacha’s Nek 8.3 53.7 12.9 18.5 4.2 2.3 0.0 100.0 505 4.9 Mokhotlong 7.9 58.2 12.6 17.2 2.3 1.4 0.3 100.0 848 4.5 Thaba-Tseka 9.2 56.7 16.7 14.0 2.0 1.4 0.0 100.0 1,096 4.6 Wealth quintile Lowest 9.6 66.2 14.2 9.0 0.5 0.0 0.5 100.0 2,763 3.7 Second 5.5 60.9 15.6 15.9 1.5 0.3 0.3 100.0 2,757 4.6 Middle 3.5 49.1 15.5 26.3 3.4 1.5 0.6 100.0 2,798 5.6 Fourth 2.7 35.8 14.5 34.8 6.8 4.4 0.9 100.0 2,935 6.3 Highest 1.7 26.0 9.9 31.9 12.3 17.3 0.9 100.0 3,143 7.4 Total 4.5 46.9 13.9 23.9 5.1 5.0 0.7 100.0 14,397 5.7 1 Completed 7th grade at the primary level 2 Completed 5th grade at the secondary level Housing Characteristics and Household Population • 27 Table 2.13.2 Educational attainment of the male household population Percent distribution of the de facto male household population age 6 and over by highest level of schooling attended or completed and median years completed, according to background characteristics, Lesotho 2014 Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Don’t know Total Number Median years completed Age 6-9 15.0 84.9 0.0 0.1 0.0 0.0 0.0 100.0 1,713 0.3 10-14 2.4 91.3 1.2 4.9 0.0 0.0 0.3 100.0 2,133 3.2 15-19 3.7 38.8 9.3 46.0 0.9 0.7 0.7 100.0 1,670 6.0 20-24 4.8 28.2 10.7 33.7 12.0 9.4 1.3 100.0 1,288 6.7 25-29 6.9 29.8 13.4 23.5 13.3 11.8 1.3 100.0 1,059 6.6 30-34 13.7 31.6 14.4 17.2 11.2 10.8 1.1 100.0 869 6.2 35-39 18.8 33.1 9.1 18.9 10.6 8.8 0.7 100.0 664 5.6 40-44 17.1 36.3 13.9 14.9 6.9 9.1 1.7 100.0 549 5.2 45-49 18.8 36.5 11.0 15.5 9.1 7.3 1.9 100.0 408 5.1 50-54 26.6 35.7 13.4 12.4 4.5 5.1 2.2 100.0 376 3.1 55-59 25.4 39.1 8.1 14.3 3.7 6.2 3.2 100.0 360 3.5 60-64 31.5 43.7 7.1 6.6 5.4 4.6 1.1 100.0 429 1.9 65+ 41.3 44.3 3.1 4.2 1.2 3.4 2.4 100.0 893 0.6 Residence Urban 5.3 35.7 7.2 25.7 11.6 13.1 1.2 100.0 3,285 6.4 Rural 15.8 57.6 7.3 14.2 2.6 1.6 0.9 100.0 9,125 3.1 Ecological zone Lowlands 7.2 45.4 8.3 23.4 7.1 7.4 1.1 100.0 6,919 5.5 Foothills 14.2 63.9 7.5 10.3 2.4 1.0 0.7 100.0 1,452 3.1 Mountains 23.9 58.7 5.4 8.1 2.0 1.0 1.0 100.0 2,976 2.0 Senqu River Valley 18.8 57.8 5.7 12.0 2.8 2.0 0.9 100.0 1,063 2.4 District Butha-Buthe 13.2 57.2 6.4 16.7 3.4 2.5 0.6 100.0 780 3.8 Leribe 8.7 51.2 8.8 22.7 4.7 3.1 0.8 100.0 1,869 4.8 Berea 8.3 47.3 9.8 20.2 6.3 7.1 1.1 100.0 1,592 5.2 Maseru 8.2 43.8 7.6 21.7 7.7 9.4 1.6 100.0 2,951 5.5 Mafeteng 11.0 55.1 7.5 17.6 4.7 3.6 0.5 100.0 1,131 4.1 Mohale’s Hoek 19.5 57.7 4.3 11.0 3.9 2.1 1.5 100.0 1,182 2.4 Quthing 17.0 57.4 5.0 14.5 3.0 1.9 1.2 100.0 679 2.8 Qacha’s Nek 16.3 56.1 6.6 14.4 3.5 2.8 0.3 100.0 441 3.3 Mokhotlong 20.8 60.8 5.8 8.3 2.5 1.1 0.7 100.0 794 2.1 Thaba-Tseka 27.1 56.0 6.7 6.9 1.8 1.4 0.1 100.0 991 1.8 Wealth quintile Lowest 27.2 63.1 4.6 4.1 0.5 0.1 0.4 100.0 2,420 1.5 Second 15.5 63.2 7.8 10.6 1.7 0.3 1.0 100.0 2,522 2.9 Middle 11.3 56.0 9.6 17.9 3.3 0.9 1.0 100.0 2,488 4.1 Fourth 7.9 46.6 7.6 27.1 6.3 3.0 1.6 100.0 2,486 5.3 Highest 3.6 30.4 6.8 26.3 13.0 19.0 1.0 100.0 2,493 7.1 Total 13.0 51.8 7.3 17.2 5.0 4.7 1.0 100.0 12,409 4.0 1 Completed 7th grade at the primary level 2 Completed 5th grade at the secondary level 28 • Housing Characteristics and Household Population Table 2.14 School attendance ratios Net attendance ratios (NAR) and gross attendance ratios (GAR) for the de facto household population by sex and level of schooling; and the Gender Parity Index (GPI), according to background characteristics, Lesotho 2014 Net attendance ratio1 Gross attendance ratio2 Background characteristic Male Female Total Gender Parity Index3 Male Female Total Gender Parity Index3 PRIMARY SCHOOL Residence Urban 95.5 92.5 93.9 0.97 121.7 114.0 117.6 0.94 Rural 91.1 95.9 93.5 1.05 125.1 120.1 122.6 0.96 Ecological zone Lowlands 94.9 94.1 94.4 0.99 128.3 113.1 120.2 0.88 Foothills 94.8 95.1 94.9 1.00 130.6 119.9 125.3 0.92 Mountains 87.0 97.2 91.9 1.12 115.2 128.4 121.6 1.11 Senqu River Valley 90.0 95.0 92.4 1.06 124.9 121.1 123.0 0.97 District Butha-Buthe 89.5 94.4 92.0 1.06 130.0 113.9 121.8 0.88 Leribe 94.9 93.1 93.9 0.98 127.6 109.8 118.4 0.86 Berea 96.8 95.3 96.1 0.98 136.2 115.1 125.9 0.85 Maseru 94.3 94.6 94.5 1.00 123.7 118.8 121.0 0.96 Mafeteng 95.0 95.1 95.1 1.00 125.7 118.0 121.8 0.94 Mohale’s Hoek 87.5 97.1 92.2 1.11 115.5 120.8 118.1 1.05 Quthing 92.1 95.8 94.0 1.04 129.1 128.4 128.7 0.99 Qacha’s Nek 94.1 95.3 94.7 1.01 125.9 123.5 124.8 0.98 Mokhotlong 86.7 96.3 91.3 1.11 115.1 134.4 124.3 1.17 Thaba-Tseka 84.4 96.2 90.4 1.14 115.8 118.8 117.3 1.03 Wealth quintile Lowest 86.9 96.1 91.5 1.11 116.9 123.2 120.0 1.05 Second 91.4 96.3 93.9 1.05 129.9 121.3 125.5 0.93 Middle 94.4 97.0 95.7 1.03 129.4 120.4 124.8 0.93 Fourth 96.4 94.1 95.2 0.98 130.8 114.3 122.2 0.87 Highest 93.4 90.8 92.0 0.97 114.6 111.5 113.0 0.97 Total 92.0 95.1 93.6 1.03 124.4 118.7 121.5 0.95 SECONDARY SCHOOL Residence Urban 62.0 67.9 65.2 1.10 93.3 99.7 96.7 1.07 Rural 26.1 43.9 34.3 1.68 39.8 58.5 48.4 1.47 Ecological zone Lowlands 49.1 63.1 55.9 1.28 73.5 88.8 80.9 1.21 Foothills 17.7 35.6 25.8 2.02 27.1 44.2 34.8 1.63 Mountains 13.4 34.0 23.3 2.54 22.1 44.9 33.0 2.03 Senqu River Valley 22.8 35.3 28.6 1.55 35.3 51.4 42.8 1.45 District Butha-Buthe 36.9 52.5 44.3 1.42 53.9 79.7 66.0 1.48 Leribe 44.4 60.0 51.8 1.35 61.5 84.7 72.5 1.38 Berea 37.7 60.4 48.6 1.60 63.4 80.9 71.8 1.28 Maseru 46.3 55.4 50.7 1.20 72.5 78.7 75.5 1.09 Mafeteng 38.4 56.5 47.5 1.47 54.3 72.7 63.6 1.34 Mohale’s Hoek 25.0 39.6 31.7 1.59 36.4 52.8 43.9 1.45 Quthing 28.9 40.8 34.9 1.41 45.5 62.3 53.9 1.37 Qacha’s Nek 27.3 48.8 37.6 1.79 43.8 67.0 54.9 1.53 Mokhotlong 11.9 32.9 22.2 2.78 20.3 43.7 31.8 2.15 Thaba-Tseka 11.0 32.3 20.4 2.94 16.9 40.6 27.3 2.41 Wealth quintile Lowest 6.6 23.7 14.5 3.58 12.1 28.1 19.5 2.32 Second 20.1 39.9 29.0 1.99 31.9 49.5 39.8 1.55 Middle 33.7 46.7 39.9 1.39 48.5 64.0 55.9 1.32 Fourth 45.1 62.7 53.4 1.39 67.3 89.8 77.9 1.34 Highest 69.4 74.4 72.1 1.07 106.0 109.4 107.8 1.03 Total 34.6 50.9 42.4 1.47 52.4 70.5 61.1 1.34 1 The NAR for primary school is the percentage of the primary-school age (6-12 years) population that is attending primary school. The NAR for secondary school is the percentage of the secondary-school age (13-17 years) population that is attending secondary school. By definition the NAR cannot exceed 100%. 2 The GAR for primary school is the total number of primary school students, expressed as a percentage of the official primary-school-age population. The GAR for secondary school is the total number of secondary school students, expressed as a percentage of the official secondary- school-age population. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100% 3 The Gender Parity Index for primary school is the ratio of the primary school NAR (GAR) for females to the NAR (GAR) for males. The Gender Parity Index for secondary school is the ratio of the secondary school NAR (GAR) for females to the NAR (GAR) for males. Housing Characteristics and Household Population • 29 Table 2.15 Method of travel and travel time to nearest health facility Percent distribution of households by transportation method to nearest health facility, and time required to get to nearest health facility by usual means of transportation, according to residence, Lesotho 2014 Residence Total Characteristic Urban Rural Transportation method to nearest health facility Car/truck/bus/taxi 24.4 20.2 21.5 Motorcycle/scooter 0.1 0.1 0.1 Horse/donkey/mule 0.0 1.2 0.8 Walking 71.7 71.9 71.9 Combination walking and bus/taxi 3.3 6.5 5.5 Household doesn’t use nearest health facility 0.3 0.1 0.1 Don’t know nearest health facility 0.2 0.1 0.1 Total1 100.0 100.0 100.0 Time to get to nearest health facility by usual means of transportation <20 minutes 35.9 8.1 17.0 20-40 minutes 39.6 17.7 24.7 41-60 minutes 14.2 16.9 16.0 61-120 minutes 6.3 26.0 19.7 >120 minutes 3.5 30.9 22.1 Don’t know 0.5 0.5 0.5 Total 100.0 100.0 100.0 Number 3,020 6,382 9,402 1 Total includes 1 household using a bicycle and 2 households using other methods of transportation. Table 2.16 Travel time to health facility by walking Among households that travel to the nearest health facility by walking, the percent distribution of the time required to walk to the nearest health facility, according to residence, Lesotho 2014 Residence Total Characteristic Urban Rural Time to get to nearest health facility by walking <20 minutes 28.4 5.5 12.8 20-40 minutes 43.0 11.4 21.6 41-60 minutes 17.2 16.1 16.5 61-120 minutes 8.1 28.1 21.7 >120 minutes 3.2 38.6 27.3 Don’t know 0.0 0.2 0.1 Total 100.0 100.0 100.0 Number 2,167 4,591 6,758 Characteristics of Respondents • 31 CHARACTERISTICS OF RESPONDENTS 3 Key Findings  Education: Among respondents age 15-49, 60% of women and 47% of men in Lesotho have attended some secondary school. However, only 19% of women and 16% of men have completed secondary school or beyond.  Literacy: More women than men can read; 97% of women and 85% of men age 15-49 are literate.  Exposure to mass media: About one-third of women and men have no regular exposure to any mass media.  Employment: Thirty-eight percent of women and 59% of men age 15-49 are currently employed.  Health insurance: Health insurance coverage is extremely low (only 2% have any kind of health insurance).  Tobacco use: Forty-two percent of men and 8% of women age 15-49 use tobacco products. his chapter presents information on the demographic and socioeconomic characteristics of the survey respondents such as age, education, place of residence, marital status, employment, and wealth status. This information is useful for understanding the factors that affect use of reproductive health services, contraceptive use, and other health behaviours. 3.1 BASIC CHARACTERISTICS OF SURVEY RESPONDENTS A total of 6,621 women age 15-49 and 2,931 men age 15-59 were interviewed in the 2014 LDHS. There are more women and men in younger than in older age groups (Table 3.1). Forty-two percent of women and 47% of men are in the 15-24 age group, and 31% of women and 28% of men are in the 25-34 age group. Among respondents age 15-49, women are more likely to be married (54% versus 36%) or widowed (7% versus 2%) than men. Differences were not observed in the proportion of women and men who were living together (1% each) or who were divorced or separated (5% each). Most respondents identify as Christians, but women more so than men (98% versus 92%). Thirty-nine percent of women and 41% of men are Roman Catholic. Men are more likely than women to report that they have no religion (6% versus 1%). Women and men are geographically distributed in a similar pattern. About two-thirds of women and men live in rural areas. A majority of respondents live in the Lowlands (63% of women and 64% of men). Maseru has the highest percentage of respondents in any district and Qacha’s Nek the fewest: 28% of women and 30% of men live in Maseru district while only 3% of all respondents live in Qacha’s Nek. T 32 • Characteristics of Respondents 3.2 EDUCATION AND LITERACY Some secondary education Respondents who had some secondary education, completed secondary school, or attended higher levels of education are included in this measure. Sample: Women and men age 15-49 Literacy Respondents who had not attended school or who had attended only primary school were asked to read all or part of a sentence. Respondents who attended secondary school or had higher education were assumed to be literate. Sample: Women and men age 15-49 Education levels, especially among women, are high in Lesotho (Tables 3.2.1 and 3.2.2). Sixty percent of women and 47% of men age 15-49 have at least some secondary education (Figure 3.1), and 97% of women and 85% of men are literate (Tables 3.3.1 and 3.3.2). One percent of women and 8% of men have no education. Advanced education is relatively rare; only 9% of women and 8% of men have more than secondary education. Trends: Since 2009, the median number of years of schooling completed has changed little. For women, it was 7.0 years in 2009 compared with 6.9 years in 2014; for men, it was 6.2 years in both 2009 and 2014. Literacy rates among women are also unchanged since 2009 (97%); for men, literacy rates have increased from 81% to 85%. Patterns by background characteristics  Younger respondents have more education. Women age 15-19 are nearly twice as likely as women age 45-49 to have attended at least some secondary school (72% versus 39%), and the pattern is similar for men (53% versus 33%) (Tables 3.2.1 and 3.2.2).  Men living in rural areas are more likely not to have any education than their female counterparts (11% versus 1%).  Educational attainment varies widely by district. Sixty-seven percent of women and 58% of men in Maseru have at least some secondary education. In contrast, only 39% of women and 19% of men in Thaba-Tseka have at least some secondary education.  Women and men in the highest wealth quintile are more likely than those in any other wealth quintile to have completed secondary education; 42% of women and men in the highest wealth quintile completed secondary school compared with 2% of women and 1% of men in the lowest wealth quintile. The literacy rate increases with wealth, rising from 92% of women in the lowest quintile to 99% in the highest quintile, Figure 3.1 Education of survey respondents 1 8 18 33 21 12 42 31 10 8 9 8 Women Men Percent distribution of women and men age 15-49 by highest level of schooling attended or completed More than secondary Completed secondary Some secondary Primary complete Primary incomplete No education Characteristics of Respondents • 33 and from 61% of men in the lowest wealth quintile to 96% in the highest wealth quintile (Tables 3.3.1 and 3.3.2).  The literacy rate among women changes little across districts. Among men, Leribe has the highest literacy rate (91%) and Thaba-Tseka has the lowest (63%). 3.3 MASS MEDIA EXPOSURE Exposure to mass media Respondents were asked how often they read a newspaper, listened to the radio, or watched television. Those who responded at least once a week are considered to be regularly exposed to that form of media. Sample: Women and men age 15-49 Mass media often convey messages on family planning, HIV/AIDS awareness, and other health topics. Men and women age 15-49 are about equally likely to be regularly exposed to any and all forms of media, including newspapers, television, and radio (Figure 3.2). Radio is the most common form of media exposure for both women and men across all sub- groups. About one-third of women and men are not regularly exposed to any form of media. Trends: The proportion of people who are not regularly exposed to any mass media has increased slightly since 2009, from 29% to 32% among women and from 33% to 36% among men. Patterns by background characteristics  Rural women are three times more likely than their urban counterparts to have no regular exposure to any form of mass media (42% versus 14%) (Table 3.4.1). The same pattern holds true for men (48% versus 14%) (Table 3.4.2).  Residents of Berea, Mafeteng, and Maseru are more likely to read newspapers, watch television, and listen to the radio than people in other districts. Women and men in Thaba-Tseka are most likely to report no regular exposure to any of the three media (61% and 68%, respectively).  Highly educated women and men have much greater exposure to mass media. Only 8% of women and 8% of men with more than a secondary education lack regular exposure to any media, compared with 62% of women and 73% of men with no education. Figure 3.2 Exposure to mass media 16 29 60 7 32 16 28 56 8 36 Reads newspaper Watches television Listens to radio All three media None of these media Percentage of women and men age 15-49 who are exposed to media on a weekly basis Women Men 34 • Characteristics of Respondents 3.4 EMPLOYMENT Currently employed Respondents who were employed in the seven days before the survey Sample: Women and men age 15-49 Men age 15-49 are more likely to be employed than women age 15-49. Fifty-nine percent of men are currently employed, compared with 38% of women (Tables 3.5.1 and 3.5.2). An additional 11% of men and 9% of women reported working in the past 12 months even though they were not currently employed. Most of the women who worked in the past year:  Did nonagricultural work (83%)  Worked year-round (61%)  Were employed by a nonfamily member (61%)  Were paid entirely in cash (83%) (Table 3.6) Trends: Since 2009, current employment levels have remained stable or slightly declined. Among women, 39% were currently employed in 2009 compared with 38% in 2014; among men, the percentage currently employed has fallen from 62% to 59%. Patterns by background characteristics  Women are more likely to work if they are divorced, separated, or widowed than if they are married, but the reverse is true for men. Never-married women and men are least likely to be employed (Table 3.5.1 and Table 3.5.2).  Women and men in the Lowlands (46% and 64%, respectively) are more likely to be currently employed compared with their counterparts in other ecological zones.  Women with more than secondary education are twice as likely as women with no education and incomplete primary education to be currently employed. Among men, the level of education does not correlate clearly with employment status (Figure 3.3). 3.5 OCCUPATION Occupation Categorised as professional/technical/managerial, clerical, sales and services, skilled manual, unskilled manual, domestic service, agriculture, and other Sample: Women and men age 15-49 who were currently employed or had worked in the 12 months before the survey Figure 3.3 Employment by education 32 31 39 36 6157 58 65 54 76 No education Primary incomplete Primary complete Secondary More than secondary Percentage of women and men age 15-49 who are currently employed Women Men Characteristics of Respondents • 35 Women age 15-49 are most often employed in sales and services (28%), followed by unskilled manual labour (16%) (Table 3.7.1 and Figure 3.4). Men age 15-49 are most commonly employed in agriculture (34%) and skilled manual labour (21%) (Table 3.7.2 and Figure 3.4). Trends: Since 2009, there has been a rise in women and men who work in sales and services and unskilled manual labour, and a decline in those who work in agriculture. Patterns by background characteristics  Agriculture is the leading occupation in rural areas for men (49%), but not women (16%). Sales and services is the leading occupation for women in both urban and rural areas (28% for each).  Women with more than secondary education are twice as likely to work in the professional, technical, and managerial occupations as their male counterparts (52% and 24%, respectively). Men with no education, incomplete primary education, or complete primary education most often work in agriculture. Women with incomplete primary education most commonly work in sales and services or domestic service (26% each), whereas women with complete primary education most commonly work in sales and services (23%), unskilled manual labour (21%), or domestic service (20%).  The proportion of women in professional, technical, and managerial occupations increases with wealth quintile. The women in the highest quintile are eight times more likely to be in a professional, technical, or managerial occupation than women in the lowest quintile. 3.6 HEALTH INSURANCE COVERAGE Ninety-eight percent of both women and men age 15-49 in Lesotho do not have health insurance (Tables 3.8.1 and 3.8.2). Women and men living in urban areas, those with higher levels of education, and those from the wealthiest households are most likely to have health insurance. Trends: The proportion of women who have no health insurance has increased from 91% in 2009 to 98% in 2014. Similarly, the proportion of men without health insurance has increased from 92% in 2009 to 98% in 2014. 3.7 TOBACCO USE Ninety-two percent of women and 58% of men age 15-49 reported that they do not use any tobacco product (Tables 3.9.1 and 3.9.2). Among women who use tobacco products, the vast majority use snuff; among men who use tobacco products, nearly all smoke cigarettes (Figure 3.5). Among men who smoke cigarettes, one in six men (16%) reported smoking 10 or more cigarettes in the 24 hours prior to the interview. Figure 3.4 Occupation 34 1 12 21 18 3 5 10 14 16 11 28 5 10 Agriculture Domestic service Unskilled manual Skilled manual Sales and services Clerical Professional/ technical/ managerial Percentage of women and men age 15-49 by occupation Women Men 36 • Characteristics of Respondents Trends: Tobacco use among men has increased since 2009, from 35% to 42%. During this period, tobacco use among women has remained stable (9% in 2009 versus 8% in 2014). Patterns by background characteristics  Cigarette smoking rises sharply with age among men, from a low of 19% for those age 15-19 to a high of 53% for those age 25-29. After age 30, tobacco use is relatively stable (Table 3.9.2).  Tobacco use varies by residence. Forty-three percent of men in rural areas smoke cigarettes versus 38% in urban areas.  Tobacco use declines markedly by education level; only 34% of men with no education do not use tobacco compared with 76% of men with more than secondary education. Likewise, 73% of women with no education do not use tobacco compared with 99% with more than secondary education.  The use of snuff by women increases dramatically with age, from a low of less than 1% among women 15-19 to a high of 25% among women 45-49. Snuff use among women inversely correlates with education and wealth. 3.8 TIME AWAY FROM HOME Women and men answered a series of questions about whether they had spent time away from home in the past 12 months and the past 5 years. Fifty-one percent of women and 53% of men age 15-49 reported that they had been away for one night or more in the 12 months preceding the survey, and 15% of women and 18% of men had been away for more than one month in the past 12 months. One in five women (21%) and 29% of men have been away for three or more months in the past 5 years (Tables 3.10.1 and 3.10.2). Among these respondents, on average, women made 2.9 trips of 3 months or more in the past 5 years, and men made 2.2 trips. Among respondents age 15-49 who were away for 3 or more months in the past 5 years, about one in three went to South Africa the most recent time they were away (data not shown). The reason for the last visit of 3 or more months varied by sex: 41% of women were away for reasons related to family or marriage, 34% were away for work, and 17% were away for school or university; 62% of men were away for work, 12% for family or marriage, and 11% for school or university (data not shown). Figure 3.5 Use of tobacco 0.3 0 8 8 41 6 1 42 Cigarettes Pipe Snuff Any Percentage of women and men age 15-49 who use specific types of tobacco Women Men Characteristics of Respondents • 37 LIST OF TABLES For detailed information on the characteristics of survey respondents, see the following tables:  Table 3.1 Background characteristics of respondents  Table 3.2.1 Educational attainment: Women  Table 3.2.2 Educational attainment: Men  Table 3.3.1 Literacy: Women  Table 3.3.2 Literacy: Men  Table 3.4.1 Exposure to mass media: Women  Table 3.4.2 Exposure to mass media: Men  Table 3.5.1 Employment status: Women  Table 3.5.2 Employment status: Men  Table 3.6 Type of employment: Women  Table 3.7.1 Occupation: Women  Table 3.7.2 Occupation: Men  Table 3.8.1 Health insurance coverage: Women  Table 3.8.2 Health insurance coverage: Men  Table 3.9.1 Use of tobacco: Women  Table 3.9.2 Use of tobacco: Men  Table 3.10.1 Time away from home: Women  Table 3.10.2 Time away from home: Men 38 • Characteristics of Respondents Table 3.1 Background characteristics of respondents Percent distribution of women and men age 15-49 by selected background characteristics, Lesotho 2014 Women Men Background characteristic Weighted percent Weighted number Unweighted number Weighted percent Weighted number Unweighted number Age 15-19 21.7 1,440 1,542 26.0 691 690 20-24 20.0 1,325 1,300 21.1 561 534 25-29 16.5 1,094 1,072 15.4 410 394 30-34 14.5 957 907 12.6 334 345 35-39 11.2 744 728 10.4 276 275 40-44 8.5 562 582 8.3 221 222 45-49 7.5 499 490 6.3 168 166 Religion Roman Catholic 38.6 2,558 2,514 40.9 1,088 1,018 Lesotho Evangelical 17.1 1,133 1,133 17.9 476 472 Anglican 7.2 477 453 7.8 207 202 Pentecostal 24.9 1,646 1,682 18.8 499 507 Other Christian 10.1 668 691 6.8 180 196 Other non-Christian 1.4 90 83 1.6 42 36 No religion 0.7 49 65 6.3 168 195 Marital status Never married 33.1 2,190 2,201 56.4 1,501 1,464 Married 53.6 3,549 3,556 36.0 959 971 Living together 1.0 63 53 0.9 25 22 Divorced/separated 5.4 358 340 4.9 132 122 Widowed 7.0 461 471 1.7 45 47 Residence Urban 36.5 2,419 2,202 34.6 920 821 Rural 63.5 4,202 4,419 65.4 1,741 1,805 Ecological zone Lowlands 63.2 4,184 3,290 64.3 1,711 1,348 Foothills 10.4 688 670 9.5 252 258 Mountains 19.5 1,288 1,897 19.7 523 734 Senqu River Valley 7.0 461 764 6.5 174 286 District Butha-Buthe 5.8 385 593 5.4 143 222 Leribe 16.1 1,064 785 14.7 390 283 Berea 13.5 892 760 14.3 379 326 Maseru 28.2 1,864 930 30.4 809 427 Mafeteng 8.7 576 624 9.1 242 268 Mohale’s Hoek 7.8 519 621 7.6 202 241 Quthing 4.8 315 556 3.9 105 187 Qacha’s Nek 3.1 204 558 2.8 74 201 Mokhotlong 5.3 349 605 5.4 144 241 Thaba-Tseka 6.8 452 589 6.5 172 230 Education No education 1.0 68 81 8.0 213 237 Primary incomplete 17.8 1,178 1,282 32.9 875 911 Primary complete 20.8 1,375 1,383 11.9 316 317 Secondary 51.6 3,418 3,354 39.2 1,043 972 More than secondary 8.8 581 521 8.0 214 189 Wealth quintile Lowest 14.5 960 1,183 14.1 376 468 Second 15.6 1,033 1,138 18.0 479 501 Middle 18.8 1,244 1,307 20.1 536 542 Fourth 24.2 1,605 1,453 23.2 616 550 Highest 26.9 1,778 1,540 24.6 654 565 Total 15-49 100.0 6,621 6,621 100.0 2,660 2,626 50-59 na na na na 271 305 Total 15-59 na na na na 2,931 2,931 Note: Education categories refer to the highest level of education attended, whether or not that level was completed. na = Not applicable Characteristics of Respondents • 39 Table 3.2.1 Educational attainment: Women Percent distribution of women age 15-49 by highest level of schooling attended or completed, and median years completed, according to background characteristics, Lesotho 2014 Highest level of schooling Total Median years completed Number of women Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Age 15-24 0.1 13.4 14.3 56.0 10.9 5.2 100.0 7.2 2,765 15-19 0.0 15.7 12.3 66.2 5.1 0.7 100.0 6.8 1,440 20-24 0.2 10.9 16.5 44.9 17.3 10.1 100.0 7.8 1,325 25-29 0.8 18.9 20.4 31.6 13.4 14.9 100.0 7.2 1,094 30-34 2.1 19.7 24.8 34.0 6.9 12.5 100.0 6.9 957 35-39 2.1 20.5 26.0 30.9 10.6 9.8 100.0 6.8 744 40-44 1.2 21.3 30.9 31.6 5.9 9.1 100.0 6.7 562 45-49 2.7 28.3 30.2 28.2 4.4 6.2 100.0 6.5 499 Residence Urban 0.7 9.0 14.5 44.9 14.6 16.3 100.0 8.0 2,419 Rural 1.2 22.9 24.4 40.0 7.1 4.4 100.0 6.7 4,202 Ecological zone Lowlands 0.5 11.9 17.4 45.6 12.2 12.3 100.0 7.5 4,184 Foothills 0.8 28.8 27.3 36.5 4.2 2.3 100.0 6.5 688 Mountains 2.6 28.5 27.8 33.5 5.4 2.2 100.0 6.4 1,288 Senqu River Valley 1.4 24.8 22.3 38.4 8.3 4.8 100.0 6.6 461 District Butha-Buthe 1.6 21.6 19.3 40.9 10.1 6.5 100.0 6.9 385 Leribe 0.8 10.7 22.5 51.0 7.5 7.4 100.0 7.0 1,064 Berea 0.3 13.2 20.9 41.8 11.0 12.8 100.0 7.2 892 Maseru 0.7 15.1 16.8 41.4 12.7 13.3 100.0 7.4 1,864 Mafeteng 0.1 17.2 20.2 43.7 11.2 7.5 100.0 7.0 576 Mohale’s Hoek 1.6 22.3 23.6 39.8 7.6 5.1 100.0 6.7 519 Quthing 1.6 26.8 16.2 40.3 10.0 5.1 100.0 6.7 315 Qacha’s Nek 2.4 22.6 23.8 37.1 9.4 4.7 100.0 6.7 204 Mokhotlong 2.5 29.2 26.0 33.8 5.9 2.6 100.0 6.4 349 Thaba-Tseka 2.0 29.7 29.3 32.0 4.5 2.4 100.0 6.4 452 Wealth quintile Lowest 3.2 39.3 32.1 23.6 1.7 0.0 100.0 6.1 960 Second 1.2 29.3 29.9 35.1 3.9 0.6 100.0 6.4 1,033 Middle 0.7 17.1 22.5 49.9 7.2 2.6 100.0 6.8 1,244 Fourth 0.3 11.2 17.3 52.6 11.4 7.2 100.0 7.3 1,605 Highest 0.6 6.0 11.3 40.1 18.0 23.9 100.0 8.9 1,778 Total 1.0 17.8 20.8 41.8 9.8 8.8 100.0 6.9 6,621 1 Completed 7th grade at the primary level 2 Completed 5th grade at the secondary level 40 • Characteristics of Respondents Table 3.2.2 Educational attainment: Men Percent distribution of men age 15-49 by highest level of schooling attended or completed, and median years completed, according to background characteristics, Lesotho 2014 Highest level of schooling Total Median years completed Number of men Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Age 15-24 2.3 32.3 9.8 43.9 6.3 5.4 100.0 6.3 1,252 15-19 0.7 36.9 9.6 50.6 1.5 0.8 100.0 6.1 691 20-24 4.3 26.7 9.9 35.7 12.3 11.1 100.0 6.8 561 25-29 5.8 32.5 15.1 23.0 12.8 10.8 100.0 6.5 410 30-34 13.5 30.5 17.8 16.4 9.6 12.1 100.0 6.2 334 35-39 17.3 34.0 7.7 23.2 7.2 10.7 100.0 5.7 276 40-44 19.9 35.5 11.7 17.9 6.7 8.3 100.0 5.1 221 45-49 14.2 37.6 15.0 19.6 5.7 7.8 100.0 5.7 168 Residence Urban 2.4 18.8 9.3 37.6 13.8 18.1 100.0 7.7 920 Rural 10.9 40.3 13.2 28.1 4.7 2.7 100.0 5.6 1,741 Ecological zone Lowlands 2.9 26.2 12.2 37.9 9.6 11.3 100.0 6.7 1,711 Foothills 13.2 46.8 13.1 21.6 4.2 1.0 100.0 5.2 252 Mountains 21.8 45.7 10.1 16.6 4.1 1.7 100.0 4.1 523 Senqu River Valley 9.2 40.2 12.1 26.3 6.9 5.3 100.0 5.8 174 District Butha-Buthe 8.5 37.0 12.2 33.4 4.5 4.5 100.0 6.1 143 Leribe 5.5 27.9 14.2 42.0 6.1 4.3 100.0 6.3 390 Berea 5.6 26.5 14.7 33.7 10.3 9.3 100.0 6.6 379 Maseru 3.7 29.7 8.8 33.9 9.8 14.1 100.0 6.7 809 Mafeteng 6.6 36.1 16.4 27.5 6.7 6.7 100.0 6.1 242 Mohale’s Hoek 12.4 38.3 9.9 27.8 8.4 3.2 100.0 5.6 202 Quthing 12.1 35.9 7.3 31.4 7.2 6.1 100.0 5.9 105 Qacha’s Nek 7.7 32.6 14.3 31.2 7.8 6.3 100.0 6.2 74 Mokhotlong 16.4 48.5 13.2 13.9 5.4 2.6 100.0 4.1 144 Thaba-Tseka 26.0 44.3 11.0 13.1 3.4 2.1 100.0 3.8 172 Wealth quintile Lowest 26.7 50.9 11.2 10.0 1.2 0.0 100.0 3.2 376 Second 11.3 50.1 12.7 22.8 3.2 0.0 100.0 5.0 479 Middle 5.3 37.7 16.6 33.0 5.9 1.5 100.0 6.0 536 Fourth 3.7 25.6 11.9 44.8 8.2 5.9 100.0 6.7 616 Highest 1.1 12.9 7.8 36.0 16.3 25.9 100.0 8.7 654 Total 15-49 8.0 32.9 11.9 31.4 7.8 8.0 100.0 6.2 2,660 50-59 26.7 39.0 10.2 15.6 3.8 4.7 100.0 3.2 271 Total 15-59 9.7 33.5 11.7 29.9 7.4 7.7 100.0 6.1 2,931 1 Completed 7th grade at the primary level 2 Completed 5th grade at the secondary level Characteristics of Respondents • 41 Table 3.3.1 Literacy: Women Percent distribution of women age 15-49 by level of schooling attended and level of literacy, and percentage literate, according to background characteristics, Lesotho 2014 Secondary school or higher No schooling or primary school Total Percent- age literate1 Number of women Background characteristic Can read a whole sentence Can read part of a sentence Cannot read at all No card with required language Blind/visually impaired Age 15-24 72.2 22.4 4.0 1.3 0.1 0.0 100.0 98.6 2,765 15-19 72.0 23.1 3.7 1.0 0.1 0.0 100.0 98.9 1,440 20-24 72.3 21.6 4.3 1.6 0.1 0.0 100.0 98.3 1,325 25-29 59.9 31.1 6.6 1.9 0.3 0.2 100.0 97.6 1,094 30-34 53.4 33.0 8.2 5.4 0.1 0.0 100.0 94.5 957 35-39 51.3 38.1 6.0 4.5 0.0 0.0 100.0 95.5 744 40-44 46.6 41.0 8.6 3.7 0.0 0.0 100.0 96.3 562 45-49 38.8 44.5 11.6 4.2 0.5 0.4 100.0 94.9 499 Residence Urban 75.8 17.7 4.4 1.7 0.4 0.1 100.0 97.9 2,419 Rural 51.5 37.7 7.3 3.4 0.0 0.0 100.0 96.5 4,202 Ecological zone Lowlands 70.2 23.0 4.7 1.8 0.2 0.1 100.0 97.9 4,184 Foothills 43.1 43.9 9.2 3.9 0.0 0.0 100.0 96.1 688 Mountains 41.1 44.6 9.1 5.1 0.0 0.1 100.0 94.8 1,288 Senqu River Valley 51.5 37.2 7.8 3.5 0.0 0.0 100.0 96.5 461 District Butha-Buthe 57.5 29.2 10.1 3.2 0.0 0.0 100.0 96.8 385 Leribe 65.9 27.4 3.6 2.3 0.6 0.3 100.0 96.9 1,064 Berea 65.6 27.5 4.9 1.9 0.0 0.0 100.0 98.1 892 Maseru 67.4 23.8 6.7 2.1 0.0 0.0 100.0 97.9 1,864 Mafeteng 62.4 31.3 3.6 2.1 0.5 0.1 100.0 97.3 576 Mohale’s Hoek 52.5 37.2 6.8 3.5 0.0 0.0 100.0 96.5 519 Quthing 55.4 34.3 6.4 3.7 0.2 0.0 100.0 96.1 315 Qacha’s Nek 51.2 37.8 6.3 4.7 0.0 0.0 100.0 95.3 204 Mokhotlong 42.3 42.9 9.8 5.0 0.0 0.0 100.0 95.0 349 Thaba-Tseka 39.0 46.6 9.5 4.8 0.0 0.2 100.0 95.0 452 Wealth quintile Lowest 25.3 53.7 13.0 7.8 0.1 0.0 100.0 92.1 960 Second 39.7 45.8 10.2 4.3 0.0 0.0 100.0 95.7 1,033 Middle 59.7 32.6 5.1 2.4 0.2 0.0 100.0 97.4 1,244 Fourth 71.3 23.1 4.1 1.2 0.1 0.2 100.0 98.5 1,605 Highest 82.1 13.8 3.0 0.8 0.3 0.0 100.0 98.9 1,778 Total 60.4 30.4 6.2 2.8 0.1 0.1 100.0 97.0 6,621 1 Refers to women who attended secondary school or higher and women who can read a whole sentence or part of a sentence 42 • Characteristics of Respondents Table 3.3.2 Literacy: Men Percent distribution of men age 15-49 by level of schooling attended and level of literacy, and percentage literate, according to background characteristics, Lesotho 2014 Secondary school or higher No schooling or primary school Total Percent- age literate1 Number of men Background characteristic Can read a whole sentence Can read part of a sentence Cannot read at all No card with required language Blind/visually impaired Age 15-24 55.7 25.6 9.4 9.4 0.0 0.0 100.0 90.6 1,252 15-19 52.8 29.4 9.8 8.0 0.0 0.0 100.0 92.0 691 20-24 59.1 20.9 8.8 11.1 0.0 0.0 100.0 88.9 561 25-29 46.5 27.5 13.2 12.8 0.0 0.0 100.0 87.2 410 30-34 38.1 30.6 11.9 18.7 0.7 0.0 100.0 80.6 334 35-39 41.1 23.8 9.9 25.3 0.0 0.0 100.0 74.7 276 40-44 32.9 25.1 9.0 32.0 0.0 0.9 100.0 67.1 221 45-49 33.2 29.0 16.2 21.0 0.0 0.6 100.0 78.4 168 Residence Urban 69.5 18.8 3.8 7.4 0.2 0.2 100.0 92.1 920 Rural 35.5 30.6 14.4 19.5 0.0 0.1 100.0 80.4 1,741 Ecological zone Lowlands 58.7 24.2 8.3 8.5 0.1 0.2 100.0 91.1 1,711 Foothills 26.9 39.3 13.5 20.3 0.0 0.0 100.0 79.7 252 Mountains 22.4 27.7 15.7 34.2 0.0 0.0 100.0 65.8 523 Senqu River Valley 38.6 27.3 15.9 18.2 0.0 0.0 100.0 81.8 174 District Butha-Buthe 42.3 27.5 16.9 13.3 0.0 0.0 100.0 86.7 143 Leribe 52.4 27.1 11.8 8.6 0.0 0.0 100.0 91.4 390 Berea 53.2 27.9 8.4 10.2 0.0 0.3 100.0 89.5 379 Maseru 57.8 21.4 7.6 12.7 0.3 0.3 100.0 86.8 809 Mafeteng 40.8 34.6 11.4 13.2 0.0 0.0 100.0 86.8 242 Mohale’s Hoek 39.4 24.0 15.2 21.3 0.0 0.0 100.0 78.7 202 Quthing 44.7 22.0 13.4 19.9 0.0 0.0 100.0 80.1 105 Qacha’s Nek 45.4 33.0 9.4 12.3 0.0 0.0 100.0 87.7 74 Mokhotlong 21.9 30.6 15.6 31.9 0.0 0.0 100.0 68.1 144 Thaba-Tseka 18.6 32.9 11.8 36.7 0.0 0.0 100.0 63.3 172 Wealth quintile Lowest 11.2 31.0 18.4 39.4 0.0 0.0 100.0 60.6 376 Second 25.9 34.6 16.8 22.5 0.0 0.2 100.0 77.3 479 Middle 40.4 35.3 12.4 11.9 0.0 0.0 100.0 88.1 536 Fourth 58.9 22.4 7.7 10.7 0.0 0.3 100.0 88.9 616 Highest 78.2 14.7 3.3 3.5 0.3 0.0 100.0 96.2 654 Total 15-49 47.2 26.5 10.7 15.3 0.1 0.1 100.0 84.5 2,660 50-59 24.1 31.1 13.1 30.5 0.0 1.1 100.0 68.4 271 Total 15-59 45.1 26.9 10.9 16.7 0.1 0.2 100.0 83.0 2,931 1 Refers to men who attended secondary school or higher and men who can read a whole sentence or part of a sentence Characteristics of Respondents • 43 Table 3.4.1 Exposure to mass media: Women Percentage of women age 15-49 who are exposed to specific media on a weekly basis, by background characteristics, Lesotho 2014 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of women Age 15-19 18.9 27.7 54.7 7.2 34.5 1,440 20-24 18.2 27.8 58.2 7.4 32.5 1,325 25-29 15.9 28.8 64.3 7.2 30.2 1,094 30-34 15.3 32.3 63.8 7.8 28.4 957 35-39 14.5 34.5 64.1 9.1 29.6 744 40-44 11.6 28.1 59.9 5.7 33.4 562 45-49 10.9 28.2 61.6 5.9 32.9 499 Residence Urban 25.5 53.7 73.4 14.2 13.8 2,419 Rural 10.6 15.4 52.8 3.3 42.1 4,202 Ecological zone Lowlands 21.4 40.8 70.7 10.6 19.6 4,184 Foothills 8.1 7.9 49.0 0.7 45.7 688 Mountains 5.9 9.2 36.6 1.6 58.9 1,288 Senqu River Valley 7.6 14.5 49.6 3.1 44.9 461 District Butha-Buthe 10.4 21.6 38.6 3.5 51.9 385 Leribe 12.3 26.4 62.9 4.4 30.1 1,064 Berea 18.9 36.5 69.5 8.3 21.6 892 Maseru 24.5 42.9 70.1 12.5 19.2 1,864 Mafeteng 18.7 31.3 70.6 9.7 22.7 576 Mohale’s Hoek 12.2 21.8 59.6 5.6 35.2 519 Quthing 8.8 17.2 55.3 3.3 40.0 315 Qacha’s Nek 11.0 20.8 35.5 4.1 52.5 204 Mokhotlong 4.4 7.2 37.2 1.0 59.7 349 Thaba-Tseka 6.5 9.2 34.9 2.3 61.1 452 Education No education 1.2 14.4 36.8 0.0 61.8 68 Primary incomplete 4.0 12.0 41.2 1.2 53.8 1,178 Primary complete 5.3 18.5 53.8 1.6 41.6 1,375 Secondary 19.8 34.0 67.6 8.3 23.6 3,418 More than secondary 45.6 64.7 74.6 28.5 8.2 581 Wealth quintile Lowest 3.0 1.7 24.8 0.4 73.5 960 Second 6.4 4.1 44.5 0.9 52.0 1,033 Middle 11.4 8.4 59.2 1.1 35.8 1,244 Fourth 17.6 27.3 73.6 5.3 18.6 1,605 Highest 30.5 75.6 77.5 20.9 6.5 1,778 Total 16.0 29.4 60.3 7.3 31.7 6,621 44 • Characteristics of Respondents Table 3.4.2 Exposure to mass media: Men Percentage of men age 15-49 who are exposed to specific media on a weekly basis, by background characteristics, Lesotho 2014 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of men Age 15-19 12.9 26.1 46.7 3.8 39.7 691 20-24 17.2 30.0 58.4 8.8 34.5 561 25-29 18.3 27.6 59.4 6.2 33.9 410 30-34 17.6 28.8 62.8 11.5 32.9 334 35-39 14.0 23.8 57.8 8.1 37.4 276 40-44 15.6 30.1 54.2 9.4 38.3 221 45-49 20.3 27.1 60.3 9.4 32.6 168 Residence Urban 28.2 53.5 72.6 15.4 13.9 920 Rural 9.6 14.0 46.9 3.3 47.7 1,741 Ecological zone Lowlands 21.5 36.9 65.8 10.3 24.1 1,711 Foothills 5.5 10.3 43.5 1.9 51.7 252 Mountains 5.9 10.5 32.8 2.6 62.8 523 Senqu River Valley 8.4 13.0 43.8 2.5 50.3 174 District Butha-Buthe 12.2 19.1 36.0 4.9 52.9 143 Leribe 15.1 28.1 59.0 5.2 30.9 390 Berea 17.0 33.0 64.3 10.6 28.4 379 Maseru 22.3 37.7 65.4 9.7 24.3 809 Mafeteng 18.2 28.8 61.9 11.0 32.2 242 Mohale’s Hoek 14.7 18.3 51.6 6.2 41.8 202 Quthing 9.3 15.2 42.3 2.3 47.9 105 Qacha’s Nek 11.2 24.7 43.8 4.9 47.1 74 Mokhotlong 4.6 8.1 32.3 1.9 65.2 144 Thaba-Tseka 4.1 9.3 30.2 2.6 67.8 172 Education No education 0.6 2.7 26.1 0.6 73.2 213 Primary incomplete 3.0 12.8 43.4 0.5 52.2 875 Primary complete 11.0 24.3 61.5 2.2 32.7 316 Secondary 23.8 39.2 66.6 10.9 21.6 1,043 More than secondary 54.3 62.1 74.8 33.6 8.4 214 Wealth quintile Lowest 0.6 3.2 21.1 0.1 77.6 376 Second 6.2 5.2 44.6 1.9 52.6 479 Middle 11.4 13.6 55.1 1.5 38.6 536 Fourth 16.1 30.3 66.4 4.4 22.3 616 Highest 35.9 67.0 74.4 23.5 10.8 654 Total 15-49 16.0 27.6 55.8 7.5 36.0 2,660 50-59 10.2 23.5 58.9 5.1 38.1 271 Total 15-59 15.5 27.3 56.1 7.2 36.2 2,931 Characteristics of Respondents • 45 Table 3.5.1 Employment status: Women Percent distribution of women age 15-49 by employment status, according to background characteristics, Lesotho 2014 Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Total Number of women Background characteristic Currently employed1 Not currently employed Age 15-19 10.4 5.3 84.3 100.0 1,440 20-24 27.9 11.6 60.5 100.0 1,325 25-29 42.9 10.7 46.4 100.0 1,094 30-34 57.2 8.9 34.0 100.0 957 35-39 55.4 7.7 36.9 100.0 744 40-44 54.9 7.9 37.1 100.0 562 45-49 48.8 7.6 43.6 100.0 499 Marital status Never married 26.1 7.2 66.7 100.0 2,190 Married or living together 40.5 9.0 50.5 100.0 3,612 Divorced/separated/widowed 57.1 10.7 32.2 100.0 819 Number of living children 0 23.3 7.9 68.7 100.0 2,152 1-2 45.8 8.3 45.9 100.0 2,897 3-4 45.1 10.5 44.4 100.0 1,169 5+ 35.6 9.3 55.1 100.0 403 Residence Urban 54.2 7.5 38.3 100.0 2,419 Rural 28.3 9.3 62.4 100.0 4,202 Ecological zone Lowlands 45.6 9.0 45.4 100.0 4,184 Foothills 24.6 11.2 64.2 100.0 688 Mountains 23.4 6.2 70.4 100.0 1,288 Senqu River Valley 27.0 8.2 64.8 100.0 461 District Butha-Buthe 24.4 5.4 70.2 100.0 385 Leribe 41.4 11.0 47.7 100.0 1,064 Berea 40.5 10.6 48.9 100.0 892 Maseru 50.8 8.8 40.4 100.0 1,864 Mafeteng 31.9 7.2 60.9 100.0 576 Mohale’s Hoek 28.4 8.9 62.6 100.0 519 Quthing 27.0 9.0 63.9 100.0 315 Qacha’s Nek 23.9 7.1 69.0 100.0 204 Mokhotlong 23.9 5.9 70.2 100.0 349 Thaba-Tseka 24.3 5.4 70.2 100.0 452 Education No education 31.9 6.0 62.2 100.0 68 Primary incomplete 30.5 9.6 59.9 100.0 1,178 Primary complete 38.5 9.3 52.2 100.0 1,375 Secondary 36.1 8.5 55.4 100.0 3,418 More than secondary 61.4 6.2 32.3 100.0 581 Wealth quintile Lowest 17.1 8.1 74.8 100.0 960 Second 26.1 9.6 64.3 100.0 1,033 Middle 31.7 11.3 57.0 100.0 1,244 Fourth 42.6 9.5 47.9 100.0 1,605 Highest 55.6 5.8 38.7 100.0 1,778 Total 37.8 8.6 53.6 100.0 6,621 1 Currently employed is defined as having done work in the past 7 days. Included are persons who did not work in the past 7 days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reason. 46 • Characteristics of Respondents Table 3.5.2 Employment status: Men Percent distribution of men age 15-49 by employment status, according to background characteristics, Lesotho 2014 Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Total Number of men Background characteristic Currently employed1 Not currently employed Age 15-19 35.2 10.0 54.8 100.0 691 20-24 56.2 9.8 34.0 100.0 561 25-29 67.0 14.9 18.1 100.0 410 30-34 73.2 9.0 17.7 100.0 334 35-39 76.0 9.7 14.3 100.0 276 40-44 72.6 11.7 15.7 100.0 221 45-49 68.0 12.3 19.7 100.0 168 Marital status Never married 49.3 9.8 40.9 100.0 1,501 Married or living together 71.7 11.5 16.8 100.0 983 Divorced/separated/widowed 66.0 16.1 17.9 100.0 176 Number of living children 0 50.5 10.5 39.0 100.0 1,607 1-2 72.7 10.6 16.8 100.0 686 3-4 70.8 13.1 16.1 100.0 279 5+ 60.8 12.0 27.2 100.0 87 Residence Urban 69.6 9.9 20.4 100.0 920 Rural 52.9 11.3 35.8 100.0 1,741 Ecological zone Lowlands 64.0 11.4 24.7 100.0 1,711 Foothills 50.7 11.6 37.8 100.0 252 Mountains 49.1 8.9 41.9 100.0 523 Senqu River Valley 47.5 10.3 42.2 100.0 174 District Butha-Buthe 56.7 7.2 36.1 100.0 143 Leribe 62.2 12.9 24.8 100.0 390 Berea 63.1 8.8 28.1 100.0 379 Maseru 63.0 12.9 24.0 100.0 809 Mafeteng 63.3 6.6 30.1 100.0 242 Mohale’s Hoek 50.2 13.3 36.5 100.0 202 Quthing 48.3 11.9 39.7 100.0 105 Qacha’s Nek 45.7 13.0 41.3 100.0 74 Mokhotlong 44.2 7.2 48.6 100.0 144 Thaba-Tseka 50.0 8.3 41.8 100.0 172 Education No education 57.2 11.4 31.4 100.0 213 Primary incomplete 57.9 10.4 31.6 100.0 875 Primary complete 64.5 13.6 21.9 100.0 316 Secondary 54.4 11.3 34.3 100.0 1,043 More than secondary 75.8 5.4 18.8 100.0 214 Wealth quintile Lowest 45.8 9.4 44.8 100.0 376 Second 52.4 12.4 35.2 100.0 479 Middle 55.3 12.9 31.8 100.0 536 Fourth 66.1 10.5 23.5 100.0 616 Highest 66.6 9.2 24.2 100.0 654 Total 15-49 58.7 10.8 30.5 100.0 2,660 50-59 62.5 7.5 29.9 100.0 271 Total 15-59 59.1 10.5 30.4 100.0 2,931 1 Currently employed is defined as having done work in the past 7 days. Included are persons who did not work in the past 7 days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reason. Characteristics of Respondents • 47 Table 3.6 Type of employment: Women Percent distribution of women age 15-49 employed in the 12 months preceding the survey by type of earnings, type of employer, and continuity of employment, according to type of employment (agricultural or nonagricultural), Lesotho 2014 Employment characteristic Agricultural work Nonagricultural work Total Type of earnings Cash only 33.6 90.0 82.9 Cash and in-kind 3.8 1.9 2.2 In-kind only 7.7 1.2 2.2 Not paid 54.9 6.8 12.7 Total 100.0 100.0 100.0 Type of employer Employed by family member 22.9 4.8 6.4 Employed by nonfamily member 30.5 65.2 61.1 Self-employed 46.6 30.0 32.5 Total 100.0 100.0 100.0 Continuity of employment All year 14.9 67.0 61.2 Seasonal 67.7 14.3 20.2 Occasional 17.4 18.7 18.6 Total 100.0 100.0 100.0 Number of women employed during the last 12 months 302 2,549 3,073 Note: Total includes women with missing information on type of employment who are not shown separately. 48 • Characteristics of Respondents Table 3.7.1 Occupation: Women Percent distribution of women age 15-49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Lesotho 2014 Background characteristic Professional/ technical/ managerial Clerical Sales and services Skilled manual Unskilled manual Domestic service Agriculture Missing Total Number of women Age 15-19 3.1 1.4 30.2 4.3 4.9 27.6 15.2 13.3 100.0 226 20-24 4.7 4.4 32.7 4.6 17.1 20.3 10.0 6.2 100.0 524 25-29 12.4 5.9 26.0 11.5 18.4 11.5 7.0 7.2 100.0 586 30-34 13.7 3.5 24.9 15.0 17.9 11.4 8.7 4.9 100.0 632 35-39 10.1 5.7 29.9 13.3 16.3 9.3 8.3 7.1 100.0 470 40-44 13.0 6.2 22.4 10.4 16.2 10.1 12.4 9.2 100.0 353 45-49 10.8 2.3 26.4 10.3 13.7 16.4 12.9 7.1 100.0 282 Marital status Never married 8.6 4.3 29.1 8.8 14.4 18.6 7.2 9.2 100.0 730 Married or living together 11.3 4.5 27.2 11.2 16.3 10.5 11.5 7.4 100.0 1,788 Divorced/separated/widowed 8.9 4.7 26.1 10.6 17.5 20.1 8.0 4.1 100.0 555 Number of living children 0 10.2 3.9 29.9 7.3 13.3 17.3 8.6 9.6 100.0 673 1-2 12.2 5.3 25.2 12.7 17.6 12.7 8.0 6.2 100.0 1,569 3-4 7.0 4.2 30.4 8.7 15.7 13.2 14.7 6.1 100.0 650 5+ 5.1 1.5 27.0 10.7 14.4 17.8 12.6 10.9 100.0 181 Residence Urban 13.1 6.2 27.5 13.2 18.2 11.8 3.4 6.7 100.0 1,493 Rural 7.5 2.9 27.5 8.0 14.1 16.4 15.9 7.7 100.0 1,580 Ecological zone Lowlands 10.8 4.7 28.0 11.0 18.6 12.9 7.5 6.5 100.0 2,283 Foothills 4.4 3.5 28.5 6.6 8.1 25.4 15.8 7.7 100.0 246 Mountains 11.2 3.8 24.7 12.0 8.4 13.9 17.3 8.6 100.0 381 Senqu River Valley 8.4 5.7 24.0 7.2 10.5 15.6 15.8 12.7 100.0 162 District Butha-Buthe 12.1 4.3 28.0 7.7 2.6 18.9 16.7 9.6 100.0 115 Leribe 8.7 2.8 25.7 9.2 21.3 15.9 10.0 6.4 100.0 556 Berea 12.1 4.9 28.1 10.3 13.8 19.0 5.3 6.4 100.0 456 Maseru 9.5 5.0 25.9 13.1 20.3 11.0 7.5 7.7 100.0 1,112 Mafeteng 9.4 5.3 40.7 6.7 10.3 11.6 12.3 3.6 100.0 225 Mohale’s Hoek 9.5 2.2 29.6 9.0 14.5 15.5 9.7 10.1 100.0 194 Quthing 10.1 4.3 28.0 8.7 6.6 18.1 16.3 7.9 100.0 114 Qacha’s Nek 15.2 3.3 27.6 8.4 7.0 12.4 18.1 7.9 100.0 63 Mokhotlong 11.4 4.9 23.4 11.9 9.9 15.9 14.3 8.3 100.0 104 Thaba-Tseka 13.2 8.7 22.3 8.6 8.1 10.5 21.0 7.5 100.0 135 Education No education (0.0) (0.0) (12.8) (23.3) (20.6) (21.8) (18.6) (2.9) 100.0 26 Primary incomplete 0.8 1.0 26.1 11.1 13.3 26.2 16.2 5.3 100.0 473 Primary complete 2.3 1.7 23.2 10.9 20.8 19.8 13.0 8.3 100.0 658 Secondary 6.0 5.0 32.5 12.0 17.9 11.3 8.6 6.6 100.0 1,524 More than secondary 51.7 11.9 17.5 2.8 3.9 0.9 0.9 10.2 100.0 394 Wealth quintile Lowest 2.3 1.7 20.8 12.8 14.8 15.9 18.1 13.6 100.0 242 Second 3.8 1.5 24.4 6.4 13.8 23.2 19.6 7.4 100.0 369 Middle 4.8 2.0 30.6 7.4 17.2 19.0 13.4 5.6 100.0 535 Fourth 8.2 4.5 28.1 12.5 21.1 9.7 9.4 6.3 100.0 837 Highest 18.3 7.5 27.9 11.5 12.7 11.7 3.2 7.2 100.0 1,091 Total 10.2 4.5 27.5 10.5 16.1 14.1 9.8 7.2 100.0 3,073 Note: Figures in parentheses are based on 25-49 unweighted cases. Characteristics of Respondents • 49 Table 3.7.2 Occupation: Men Percent distribution of men age 15-49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Lesotho 2014 Background characteristic Professional/ technical/ managerial Clerical Sales and services Skilled manual Unskilled manual Domestic service Agriculture Missing Total Number of men Age 15-19 1.1 2.7 9.8 9.9 4.0 1.0 63.8 7.6 100.0 313 20-24 2.6 3.5 15.7 19.8 12.5 1.0 38.1 6.8 100.0 370 25-29 6.7 3.4 20.0 22.0 18.1 0.4 24.3 5.1 100.0 335 30-34 6.4 2.2 25.1 24.6 8.6 2.6 23.4 7.1 100.0 275 35-39 7.6 1.6 23.6 23.7 12.4 0.0 25.9 5.1 100.0 236 40-44 8.9 0.6 22.8 20.7 13.0 0.0 19.8 14.2 100.0 186 45-49 6.0 5.0 8.4 29.9 13.0 1.9 29.0 6.8 100.0 135 Marital status Never married 3.0 3.2 13.8 15.5 9.6 1.6 46.1 7.2 100.0 887 Married or living together 7.2 2.7 22.2 25.9 13.1 0.5 20.9 7.6 100.0 818 Divorced/separated/widowed 6.7 0.0 21.5 22.0 15.0 0.0 29.9 4.8 100.0 145 Number of living children 0 3.4 2.9 13.7 16.6 10.5 1.5 44.0 7.4 100.0 981 1-2 6.7 3.0 25.9 26.1 12.4 0.5 21.4 4.1 100.0 571 3-4 10.4 1.5 19.6 24.9 14.4 0.3 18.8 10.2 100.0 234 5+ 0.0 2.1 10.5 16.6 10.2 0.0 39.8 20.7 100.0 63 Residence Urban 8.0 4.4 29.9 23.3 13.5 1.4 10.3 9.2 100.0 732 Rural 3.3 1.6 10.3 18.8 10.3 0.7 49.0 5.9 100.0 1,118 Ecological zone Lowlands 5.3 2.9 21.7 23.4 13.0 1.1 24.5 8.1 100.0 1,289 Foothills 0.0 1.7 15.1 15.7 6.9 1.7 54.8 4.1 100.0 157 Mountains 7.3 1.5 6.8 12.0 7.6 0.0 59.4 5.4 100.0 304 Senqu River Valley 4.5 5.6 10.8 17.7 12.7 1.5 41.1 6.1 100.0 100 District Butha-Buthe 5.8 0.9 18.3 18.2 5.1 0.8 45.6 5.3 100.0 91 Leribe 3.6 2.4 21.5 19.8 5.9 0.4 39.6 6.8 100.0 293 Berea 4.9 2.8 15.5 22.8 9.5 1.7 33.7 9.2 100.0 273 Maseru 6.0 3.2 22.0 25.1 16.7 1.5 17.2 8.3 100.0 615 Mafeteng 2.0 1.8 21.3 18.6 10.9 0.4 40.6 4.4 100.0 169 Mohale’s Hoek 6.3 1.5 11.3 11.7 12.0 0.4 49.2 7.6 100.0 128 Quthing 4.1 5.3 12.5 15.1 6.5 2.3 45.5 8.7 100.0 63 Qacha’s Nek 8.8 3.7 10.6 25.1 10.5 0.0 33.6 7.7 100.0 44 Mokhotlong 5.9 0.7 7.5 13.8 12.0 0.0 54.9 5.2 100.0 74 Thaba-Tseka 7.7 4.6 8.5 12.9 12.0 0.0 52.1 2.2 100.0 100 Education No education 3.1 0.0 10.3 20.5 7.2 1.0 53.4 4.4 100.0 146 Primary incomplete 1.5 1.4 11.2 19.1 12.6 0.4 48.8 5.1 100.0 598 Primary complete 0.9 1.8 18.0 20.9 14.5 1.7 37.8 4.5 100.0 247 Secondary 5.5 4.0 24.1 21.6 12.2 1.1 22.4 9.1 100.0 685 More than secondary 24.3 6.0 24.9 21.6 5.0 1.5 3.8 13.0 100.0 173 Wealth quintile Lowest 0.3 0.9 5.5 12.8 11.6 0.0 66.0 3.1 100.0 208 Second 2.6 1.2 9.5 19.7 8.2 0.5 52.0 6.3 100.0 310 Middle 2.6 2.7 15.0 20.4 13.3 1.7 36.2 8.0 100.0 365 Fourth 3.3 3.8 21.7 24.1 13.5 0.2 24.0 9.3 100.0 472 Highest 12.4 3.4 27.5 21.2 10.6 1.9 16.1 7.0 100.0 496 Total 15-49 5.2 2.7 18.1 20.6 11.6 1.0 33.7 7.2 100.0 1,850 50-59 5.5 0.9 19.4 19.2 11.1 1.8 32.0 10.1 100.0 190 Total 15-59 5.2 2.5 18.2 20.5 11.5 1.1 33.5 7.5 100.0 2,040 50 • Characteristics of Respondents Table 3.8.1 Health insurance coverage: Women Percentage of women age 15-49 with specific types of health insurance coverage, according to background characteristics, Lesotho 2014 Background characteristic Employer-based insurance Mutual health organisation/ community-based insurance Privately purchased commercial insurance Other None Number of women Age 15-19 0.2 0.2 0.1 0.1 99.4 1,440 20-24 0.2 0.3 0.8 0.3 98.5 1,325 25-29 1.3 0.3 0.8 0.3 97.9 1,094 30-34 1.2 1.3 0.5 0.0 97.2 957 35-39 2.1 0.4 0.5 1.0 95.9 744 40-44 1.6 0.8 0.5 0.5 96.6 562 45-49 1.5 0.0 1.0 1.0 97.3 499 Residence Urban 1.8 1.0 1.1 0.6 95.8 2,419 Rural 0.5 0.1 0.3 0.2 99.1 4,202 Ecological zone Lowlands 1.4 0.7 0.8 0.4 96.9 4,184 Foothills 0.2 0.0 0.1 0.4 99.4 688 Mountains 0.0 0.0 0.1 0.1 99.8 1,288 Senqu River Valley 0.3 0.0 0.2 0.5 99.0 461 District Butha-Buthe 0.5 0.1 0.2 0.2 99.1 385 Leribe 0.4 0.1 0.3 0.3 98.9 1,064 Berea 1.2 0.9 1.3 1.0 95.9 892 Maseru 1.9 1.0 0.8 0.3 96.3 1,864 Mafeteng 0.8 0.2 0.5 0.4 98.6 576 Mohale’s Hoek 0.6 0.0 0.0 0.1 99.3 519 Quthing 0.0 0.0 0.3 0.3 99.4 315 Qacha’s Nek 0.4 0.0 0.2 0.9 98.4 204 Mokhotlong 0.0 0.0 0.2 0.0 99.8 349 Thaba-Tseka 0.1 0.0 0.1 0.0 99.7 452 Education No education 0.0 0.0 0.0 0.0 100.0 68 Primary incomplete 0.0 0.0 0.0 0.1 99.9 1,178 Primary complete 0.6 0.4 0.1 0.1 98.9 1,375 Secondary 0.5 0.3 0.5 0.4 98.4 3,418 More than secondary 6.3 2.6 3.3 1.5 88.1 581 Wealth quintile Lowest 0.0 0.0 0.0 0.0 100.0 960 Second 0.3 0.0 0.1 0.2 99.5 1,033 Middle 0.2 0.1 0.1 0.3 99.4 1,244 Fourth 0.6 0.1 0.3 0.4 98.6 1,605 Highest 2.6 1.4 1.8 0.7 94.0 1,778 Total 0.9 0.4 0.6 0.4 97.9 6,621 Characteristics of Respondents • 51 Table 3.8.2 Health insurance coverage: Men Percentage of men age 15-49 with specific types of health insurance coverage, according to background characteristics, Lesotho 2014 Background characteristic Employer based insurance Mutual health organisation/ community-based insurance Privately purchased commercial insurance Other None Number of men Age 15-19 0.0 0.1 0.0 0.1 99.8 691 20-24 0.5 0.0 1.3 0.2 98.1 561 25-29 0.4 0.3 0.4 0.4 98.5 410 30-34 1.9 0.0 0.0 1.2 96.9 334 35-39 2.3 0.5 0.7 0.0 96.6 276 40-44 2.5 0.0 0.2 0.1 97.2 221 45-49 3.9 0.4 0.0 0.0 95.7 168 Residence Urban 2.3 0.5 0.8 0.5 95.9 920 Rural 0.5 0.0 0.2 0.1 99.2 1,741 Ecological zone Lowlands 1.5 0.2 0.6 0.4 97.3 1,711 Foothills 0.9 0.0 0.0 0.3 98.8 252 Mountains 0.1 0.0 0.2 0.0 99.6 523 Senqu River Valley 0.1 0.0 0.0 0.1 99.7 174 District Butha-Buthe 0.5 0.0 0.3 0.0 99.1 143 Leribe 1.1 0.3 0.0 0.4 98.2 390 Berea 1.7 0.2 0.5 0.5 97.2 379 Maseru 1.5 0.2 0.8 0.4 97.2 809 Mafeteng 2.3 0.4 0.4 0.4 96.6 242 Mohale’s Hoek 0.0 0.0 0.0 0.0 100.0 202 Quthing 0.2 0.0 0.5 0.2 99.1 105 Qacha’s Nek 0.0 0.0 0.2 0.3 99.4 74 Mokhotlong 0.4 0.0 0.0 0.0 99.6 144 Thaba-Tseka 0.1 0.0 0.3 0.0 99.6 172 Education No education 0.0 0.0 0.0 0.0 100.0 213 Primary incomplete 0.4 0.0 0.0 0.1 99.5 875 Primary complete 1.3 0.0 0.0 0.9 97.7 316 Secondary 1.2 0.0 0.4 0.0 98.4 1,043 More than secondary 4.3 2.0 3.3 1.5 89.0 214 Wealth quintile Lowest 0.0 0.0 0.0 0.0 100.0 376 Second 0.0 0.0 0.0 0.2 99.8 479 Middle 0.3 0.0 0.3 0.0 99.4 536 Fourth 0.8 0.2 0.1 0.0 98.9 616 Highest 3.6 0.4 1.3 1.0 93.7 654 Total 15-49 1.1 0.2 0.4 0.3 98.0 2,660 50-59 1.3 0.0 0.0 1.2 97.5 271 Total 15-59 1.1 0.1 0.4 0.4 98.0 2,931 52 • Characteristics of Respondents Table 3.9.1 Use of tobacco: Women Percentage of women age 15-49 who smoke cigarettes or a pipe or use other tobacco products, according to background characteristics and maternity status, Lesotho 2014 Uses tobacco Does not use tobacco Number of women Background characteristic Cigarettes Pipe Snuff Other tobacco Age 15-19 0.2 0.0 0.2 0.0 99.7 1,440 20-24 0.6 0.0 1.5 0.1 97.9 1,325 25-29 0.3 0.1 4.7 0.0 95.0 1,094 30-34 0.1 0.0 8.6 0.3 91.1 957 35-39 0.1 0.1 11.2 0.1 88.6 744 40-44 0.2 0.2 23.1 0.1 76.5 562 45-49 0.0 0.0 25.1 0.1 74.8 499 Maternity status Pregnant 0.0 0.0 4.7 0.1 95.3 284 Breastfeeding (not pregnant) 0.1 0.1 5.5 0.2 94.0 951 Neither 0.3 0.0 8.0 0.1 91.7 5,387 Residence Urban 0.6 0.1 4.4 0.0 95.0 2,419 Rural 0.1 0.0 9.2 0.1 90.6 4,202 Ecological zone Lowlands 0.3 0.0 5.4 0.0 94.3 4,184 Foothills 0.1 0.1 10.2 0.3 89.4 688 Mountains 0.1 0.1 11.8 0.2 88.0 1,288 Senqu River Valley 0.0 0.0 10.2 0.3 89.5 461 District Butha-Buthe 0.0 0.0 4.8 0.0 95.2 385 Leribe 0.2 0.0 5.6 0.0 94.1 1,064 Berea 0.4 0.1 6.9 0.0 92.8 892 Maseru 0.4 0.1 5.8 0.1 93.6 1,864 Mafeteng 0.2 0.0 7.7 0.0 92.1 576 Mohale’s Hoek 0.0 0.0 9.3 0.1 90.6 519 Quthing 0.0 0.3 6.2 0.2 93.3 315 Qacha’s Nek 0.3 0.0 18.5 0.4 81.0 204 Mokhotlong 0.0 0.0 12.7 0.0 87.3 349 Thaba-Tseka 0.2 0.0 11.6 0.4 88.2 452 Education No education 0.0 1.3 25.8 0.0 72.9 68 Primary incomplete 0.0 0.0 18.2 0.2 81.7 1,178 Primary complete 0.1 0.0 10.4 0.2 89.4 1,375 Secondary 0.4 0.0 3.4 0.0 96.2 3,418 More than secondary 0.6 0.4 0.3 0.0 99.0 581 Wealth quintile Lowest 0.0 0.0 14.9 0.3 84.9 960 Second 0.2 0.0 10.3 0.2 89.3 1,033 Middle 0.1 0.1 8.2 0.0 91.6 1,244 Fourth 0.3 0.0 5.7 0.0 94.0 1,605 Highest 0.4 0.1 3.0 0.0 96.6 1,778 Total 0.3 0.0 7.5 0.1 92.2 6,621 Characteristics of Respondents • 53 Table 3.9.2 Use of tobacco: Men Percentage of men age 15-49 who smoke cigarettes or a pipe or use other tobacco products and the percent distribution of cigarette smokers by number of cigarettes smoked in preceding 24 hours, according to background characteristics, Lesotho 2014 Uses tobacco Does not use tobacco Number of men Percent distribution of men who smoke cigarettes by number of cigarettes smoked in the past 24 hours Total Number of cigarette smokers Background characteristic Cigarettes Pipe Snuff Other tobacco 0 1-2 3-5 6-9 10+ Age 15-19 18.6 3.3 0.0 2.8 81.4 691 7.7 33.3 45.0 10.0 4.0 100.0 129 20-24 44.8 4.7 0.0 8.4 54.9 561 4.6 21.3 44.4 14.7 14.9 100.0 251 25-29 53.1 7.5 0.4 8.6 46.3 410 8.4 26.7 34.8 15.6 14.5 100.0 217 30-34 50.3 9.6 0.4 7.8 48.5 334 7.5 11.3 34.9 20.4 25.8 100.0 168 35-39 51.3 11.2 0.6 10.8 47.8 276 5.7 14.4 38.0 20.7 21.2 100.0 141 40-44 48.4 6.1 2.3 9.0 49.8 221 11.5 17.4 40.5 12.3 18.3 100.0 107 45-49 47.9 3.7 2.7 13.1 49.5 168 13.7 14.6 43.2 13.5 15.0 100.0 81 Residence Urban 37.9 5.4 0.3 5.6 61.7 920 5.9 18.7 36.2 17.6 21.6 100.0 348 Rural 42.9 6.5 0.7 8.5 56.3 1,741 8.5 21.3 41.5 14.8 13.9 100.0 746 Ecological zone Lowlands 40.6 5.7 0.4 6.1 58.8 1,711 4.8 19.1 39.7 16.5 19.9 100.0 696 Foothills 44.3 5.6 0.0 14.6 55.7 252 16.8 24.4 32.6 17.5 8.7 100.0 112 Mountains 41.3 7.9 0.8 5.6 57.6 523 7.7 24.3 43.1 13.3 11.5 100.0 216 Senqu River Valley 40.8 5.7 1.5 16.2 57.3 174 21.1 16.3 41.5 11.8 9.3 100.0 71 District Butha-Buthe 45.8 6.2 0.3 11.1 53.4 143 18.1 26.8 34.5 9.6 11.0 100.0 65 Leribe 42.6 7.0 0.7 9.7 57.0 390 7.2 24.0 37.2 15.0 16.6 100.0 166 Berea 43.1 8.3 0.0 10.5 56.3 379 4.3 24.6 40.0 16.2 14.8 100.0 164 Maseru 40.4 3.6 0.2 2.9 59.6 809 4.5 14.1 41.3 20.5 19.6 100.0 327 Mafeteng 40.8 8.1 1.0 4.2 57.4 242 1.0 24.8 42.4 9.3 22.5 100.0 98 Mohale’s Hoek 38.4 5.7 1.2 19.9 60.1 202 23.2 14.1 35.6 6.5 20.7 100.0 78 Quthing 36.6 7.1 0.0 8.4 63.4 105 5.0 23.3 46.1 13.4 12.3 100.0 38 Qacha’s Nek 38.5 13.2 2.1 6.8 57.6 74 4.0 24.3 39.1 19.4 13.2 100.0 29 Mokhotlong 39.7 1.6 0.5 2.7 59.7 144 9.2 25.0 30.5 21.3 14.1 100.0 57 Thaba-Tseka 41.5 8.7 1.3 8.2 56.6 172 15.3 20.4 49.0 13.4 2.0 100.0 71 Education No education 63.3 14.9 1.1 11.8 34.3 213 9.4 18.3 44.1 14.3 13.8 100.0 135 Primary incomplete 49.6 8.2 0.8 8.4 49.4 875 10.3 20.5 36.6 15.4 17.2 100.0 434 Primary complete 41.6 5.1 0.5 9.2 57.9 316 7.4 19.2 39.0 19.6 14.7 100.0 131 Secondary 33.0 3.4 0.3 5.9 66.8 1,043 4.7 20.6 43.5 14.4 16.7 100.0 344 More than secondary 23.3 3.4 0.0 4.9 76.1 214 (0.9) (28.4) (32.4) (19.8) (18.6) 100.0 50 Wealth quintile Lowest 44.0 8.0 1.4 9.7 53.7 376 15.6 20.2 42.2 14.6 7.4 100.0 166 Second 46.8 7.2 0.2 8.5 52.5 479 6.0 22.6 39.8 14.2 17.3 100.0 224 Middle 45.9 6.4 0.7 8.9 53.7 536 7.6 20.2 40.5 18.8 12.8 100.0 246 Fourth 40.8 5.4 0.6 6.6 58.7 616 4.9 18.7 39.1 13.9 23.5 100.0 251 Highest 31.7 4.7 0.1 5.2 68.0 654 6.5 21.0 37.9 16.6 18.1 100.0 207 Total 15-49 41.1 6.1 0.5 7.5 58.2 2,660 7.7 20.5 39.8 15.7 16.4 100.0 1,094 50-59 43.4 6.4 2.6 6.9 53.7 271 9.1 19.8 39.1 11.6 20.5 100.0 117 Total 15-59 41.3 6.1 0.7 7.4 57.7 2,931 7.8 20.4 39.7 15.3 16.8 100.0 1,212 Note: Figures in parentheses are based on 25-49 unweighted cases. 54 • Characteristics of Respondents Table 3.10.1 Time away from home: Women In the past 12 months, the percentage of women age 15-49 who have been away from home for 1 or more nights, the percentage who have been away for more than 1 month at a time, and the percentage who have not been away at all; in the past 5 years, the percentage of women who have been away for 3 or more months at a time, and among women who have been away for 3 or more months at a time in the past 5 years, the mean number of times they have been away for 3 or more months, Lesotho 2014 In the past 12 months, percentage of women who have been away for: In the past 5 years, percentage of women who have been away for 3 or more months Number of women Among women who have been away for 3 or more months in the past 5 years, the mean number of times they have been away for 3 or more months Number of women Background characteristic One or more nights More than 1 month Not away Number of women Age 15-19 42.5 16.0 57.5 1,440 16.3 1,440 3.2 235 20-24 49.4 21.5 50.6 1,325 29.5 1,325 3.4 391 25-29 53.8 16.2 46.2 1,094 28.0 1,094 2.7 306 30-34 55.7 13.3 44.3 957 18.9 957 2.6 181 35-39 53.7 9.8 46.3 744 15.5 744 2.5 115 40-44 56.9 9.5 43.1 562 14.5 562 2.7 82 45-49 52.0 10.8 48.0 499 15.4 499 2.3 77 Residence Urban 55.0 12.7 45.0 2,419 19.4 2,419 3.1 469 Rural 48.5 16.5 51.5 4,202 21.8 4,202 2.8 918 Ecological zone Lowlands 56.0 14.6 44.0 4,184 20.5 4,184 2.7 856 Foothills 52.2 19.5 47.8 688 23.6 688 3.0 162 Mountains 35.2 14.1 64.8 1,288 20.2 1,288 3.6 260 Senqu River Valley 46.2 16.4 53.8 461 23.6 461 3.0 109 District Butha-Buthe 39.7 12.3 60.3 385 16.2 385 3.2 62 Leribe 61.9 18.4 38.1 1,064 22.2 1,064 3.0 237 Berea 59.9 15.1 40.1 892 22.1 892 2.4 197 Maseru 54.4 13.8 45.6 1,864 20.0 1,864 2.9 372 Mafeteng 49.3 15.4 50.7 576 21.0 576 1.9 121 Mohale’s Hoek 45.8 16.3 54.2 519 26.6 519 3.4 138 Quthing 39.4 14.4 60.6 315 22.2 315 2.5 70 Qacha’s Nek 52.8 20.3 47.2 204 25.4 204 2.4 52 Mokhotlong 35.7 14.6 64.3 349 20.3 349 5.0 71 Thaba-Tseka 29.0 11.6 71.0 452 14.9 452 3.8 68 Education No education 27.9 7.0 72.1 68 14.0 68 * 10 Primary incomplete 39.9 11.2 60.1 1,178 19.2 1,178 2.6 227 Primary complete 48.8 15.0 51.2 1,375 20.5 1,375 2.4 282 Secondary 52.5 15.7 47.5 3,418 21.2 3,418 3.1 725 More than secondary 71.0 20.9 29.0 581 24.7 581 3.7 144 Wealth quintile Lowest 34.7 12.4 65.3 960 21.1 960 2.7 203 Second 45.7 17.9 54.3 1,033 21.7 1,033 3.0 224 Middle 48.1 15.6 51.9 1,244 22.6 1,244 2.5 281 Fourth 56.8 16.9 43.2 1,605 22.6 1,605 3.2 363 Highest 59.2 13.0 40.8 1,778 17.7 1,778 3.1 316 Total 15-49 50.9 15.1 49.1 6,621 20.9 6,621 2.9 1,387 Note: An asterisk indicates that a figure is based on fewer than 25 cases and has been suppressed. Characteristics of Respondents • 55 Table 3.10.2 Time away from home: Men In the past 12 months, the percentage of men age 15-49 who have been away from home for 1 or more nights, the percentage who have been away for more than 1 month at a time, and the percentage who have not been away at all; in the past 5 years, the percentage of men who have been away for 3 or more months at a time, and among men who have been away for 3 or more months at a time in the past 5 years, the mean number of times they have been away for 3 or more months, Lesotho 2014 In the past 12 months, percentage of men who have been away for: In the past 5 years, percentage of men who have been away for 3 or more months Number of men Among men who have been away for 3 or more months in the past 5 years, the mean number of times they have been away for 3 or more months Number of men Background characteristic One or more nights More than 1 month Not away Number of men Age 15-19 47.4 14.5 52.6 691 18.7 691 1.9 130 20-24 54.0 22.6 46.0 561 35.4 561 2.3 198 25-29 58.1 24.3 41.9 410 40.2 410 2.1 165 30-34 60.6 20.0 39.4 334 33.5 334 1.9 112 35-39 50.6 12.7 49.4 276 25.1 276 2.6 69 40-44 46.9 15.7 53.1 221 22.2 221 2.2 49 45-49 48.6 11.3 51.4 168 22.6 168 (2.3) 38 Residence Urban 55.2 14.6 44.8 920 25.0 920 2.0 230 Rural 51.0 20.0 49.0 1,741 30.5 1,741 2.2 532 Ecological zone Lowlands 55.2 16.5 44.8 1,711 27.5 1,711 2.0 470 Foothills 50.9 19.1 49.1 252 31.8 252 1.6 80 Mountains 45.8 23.4 54.2 523 30.6 523 2.8 160 Senqu River Valley 48.2 16.8 51.8 174 29.3 174 2.5 51 District Butha-Buthe 46.2 14.4 53.8 143 25.9 143 2.7 37 Leribe 58.0 20.8 42.0 390 27.6 390 2.6 108 Berea 53.7 14.5 46.3 379 27.3 379 1.4 104 Maseru 56.9 18.4 43.1 809 29.2 809 1.8 236 Mafeteng 48.6 17.3 51.4 242 28.7 242 1.7 69 Mohale’s Hoek 45.1 18.4 54.9 202 30.9 202 2.9 62 Quthing 53.3 17.7 46.7 105 25.6 105 (2.2) 27 Qacha’s Nek 59.8 17.5 40.2 74 35.1 74 2.3 26 Mokhotlong 48.2 24.2 51.8 144 29.2 144 3.6 42 Thaba-Tseka 35.9 18.1 64.1 172 28.8 172 2.9 50 Education No education 45.2 17.1 54.8 213 27.2 213 2.6 58 Primary incomplete 44.1 17.0 55.9 875 29.8 875 2.1 261 Primary complete 51.2 17.4 48.8 316 32.8 316 1.8 103 Secondary 56.6 18.5 43.4 1,043 26.1 1,043 2.3 273 More than secondary 75.8 23.3 24.2 214 31.1 214 2.4 66 Wealth quintile Lowest 45.3 19.2 54.7 376 29.4 376 2.5 111 Second 43.2 17.9 56.8 479 30.9 479 2.2 148 Middle 54.1 20.9 45.9 536 30.7 536 1.9 165 Fourth 56.2 17.8 43.8 616 26.1 616 2.2 161 Highest 58.5 15.7 41.5 654 27.1 654 2.1 177 Total 15-49 52.5 18.1 47.5 2,660 28.6 2,660 2.2 761 50-59 43.3 11.4 56.7 271 17.1 271 1.9 46 Total 15-59 51.6 17.5 48.4 2,931 27.6 2,931 2.2 808 Note: Figures in parentheses are based on 25-49 unweighted cases. Marriage and Sexual Activity • 57 MARRIAGE AND SEXUAL ACTIVITY 4 Key Findings  Age at first marriage: Marriage is almost universal in Lesotho, but women marry more than 5 years earlier than men, on average. The median age at first marriage is 20.3 years for women age 25-49 and 25.9 years for men age 30-49.  Polygyny: Two percent of married women reported that their husband has more than one (multiple) wives.  Sexual initiation: The median age at first sexual intercourse is 1.8 years earlier than the median age at first marriage for women and 6.4 years earlier for men, indicating that both women and men engage in sex before marriage.  Postponing marriage but not sex: Women and men in Lesotho are waiting longer to get married, but not to initiate sex. Since 2004, the median age at first sexual intercourse has changed little among women (18.7 years in 2004 versus 18.5 years in 2014), while for men, it has dropped from 19.0 years to 18.1. During the same period, the median age at first marriage for women has increased from 19.1 years to 20.3 years and for men from 25.0 years to 25.9 years.  Widowhood: More than 20% of women in their 40s are widowed arriage and sexual activity help determine the extent to which women are exposed to the risk of pregnancy. Thus, they are important determinants of fertility levels. However, the timing and circumstances of marriage and sexual activity also have profound consequences for women’s and men’s lives. This chapter presents information on marital status, polygyny, age at first marriage, and age at first sexual intercourse for both women and men. 4.1 MARITAL STATUS Currently married Women and men who report being married or living together with a partner as though married at the time of the survey Sample: Women and men age 15-49 M 58 • Marriage and Sexual Activity Marriage is nearly universal in Lesotho. By age 45-49, only 6% of women and men have never been married (Table 4.1). Fifty-five percent of women and 37% of men age 15-49 are currently married or living together with a partner as though married (Figure 4.1). Women are more likely than men to be widowed (7% versus 2%) while the proportion of women and men who are divorced or separated is identical (5%). More than one in five women age 40-49 are widowed. Figure 4.1 Marital status Percent distribution of women and men age 15-49 by current marital status Trends: Since 2004, the proportion of women married or living together has increased slightly, from 52% to 55%, while the proportion of widowed women has declined from 9% to 7%. The proportion of men married or living together has not changed substantially, increasing from 38% in 2004 to 39% in 2009 and falling to 37% in 2014. Over this same time period, the proportion of men who were widowed has remained constant at 2%. 4.2 POLYGYNY Polygyny Women who report that their husband or partner has other wives are considered to be in a polygynous marriage. Sample: Currently married women age 15-49 Two percent of women reported that their husband or partner has other wives (Table 4.2.1). While most married women (93%) reported that their husband has no other wives, 5% said they did not know. Men were about as likely as women to report multiple wives (Table 4.2.2). Trends: The percentage of men who reported that they had multiple wives decreased from 5% in 2004 to 3% in 2014. Patterns by background characteristics  Older women are slightly more likely than younger women to have co-wives. About 4% of women age 40- 44 and age 45-49 report their husbands have multiple wives. (Table 4.2.1).  Women are most likely to report co-wives in Mohale’s Hoek (4%) and least likely to do so in Butha-Buthe (0.2%). In contrast, men living in Butha-Buthe, Leribe, Maseru, and Qacha’s Nek were most likely to report having multiple wives (4% each) while those living in Quthing and Thaba-Tseka were least likely (0% each). Never married 33% Married or living together 55% Divorced or separated 5% Widowed 7% Women Never married 56% Married or living together 37% Divorced or separated 5% Widowed 2% Men Marriage and Sexual Activity • 59  In general, less educated women are more likely to have co-wives. Five percent of women with primary incomplete education report that their husband has multiple wives compared with 1% of women with more than secondary education. 4.3 AGE AT FIRST MARRIAGE Median age at first marriage Age by which half of respondents have been married. Sample: Women age 25-49 and men age 30-59 Women tend to marry considerably earlier than men in Lesotho. The median age at first marriage is 20.3 years among women age 25-49 and 25.9 years among men age 30-59 (Table 4.3). While one in four women (25%) marry before their eighteenth birthday, only 4% of men marry that young. Trends: The median age at first marriage for women age 25-49 has increased slowly but steadily over time, from 19.1 years in 2004 to 20.3 years in 2014. Over the same time period, the proportion of women who were married before age 18 declined from 35% to 25%. For men age 30-59, the median age at first marriage increased from 25.0 in 2004 to 25.9 in 2014. Patterns by background characteristics  Urban women marry later than rural women. For women age 25-49, the median age at first marriage is 2.5 years older among urban than among rural women (22.1 years versus 19.6 years) (Table 4.4).  The median age at first marriage for women ranges from 19.3 years in Mokhotlong to 21.0 years in Maseru.  Educated women marry much later. There is almost a 7-year difference in the median age at first marriage between women with the least and most education (18.1 years versus 24.9 years).  Women in wealthy households marry later. The median age at first marriage is over 3 years older in the highest wealth quintile than in the lowest quintile (22.4 years versus 19.0 years). 4.4 AGE AT FIRST SEXUAL INTERCOURSE Median age at first sexual intercourse Age by which half of respondents have had sexual intercourse. Sample: Women and men age 20-49 The median age at first intercourse for women age 20-49 in Lesotho is 18.5 years (Table 4.5). Six percent of women age 20-49 have first sex before age 15, and 42% before age 18. By age 20, 72% of women have had sexual intercourse. On average, men in Lesotho have their first sexual intercourse at younger ages than women. The median age at first intercourse for men age 20-49 is 18.1 years. Twelve percent of men age 20-49 first have sex before age 15 and 49% do so before age 18. By age 20, 70% of men have experienced sexual intercourse. Age at first marriage is widely considered a proxy indicator for the age at which women begin to be exposed to the risks inherent in sexual activity. A comparison of the median age at first intercourse with the median age at first marriage can be used as a measure of whether respondents engage in sex before marriage. The median age 60 • Marriage and Sexual Activity at first intercourse for women age 25-49 in Lesotho is almost 2 years younger than the median age at first marriage of women age 25-49 (18.5 years versus 20.3 years), indicating that many women engage in sex before marriage (Figure 4.2). Thus, women in Lesotho may be exposed to the risk of pregnancy and begin childbearing at an even earlier age than indicated by the median age at first marriage. The median age at first intercourse for men age 25-49 is 18.6 years, which is nearly identical to the median age at first intercourse for women age 25-49 (18.5 years). By contrast, the median age at first marriage for men age 30- 49 is 25.9 years. Thus, on average, men in Lesotho are initiating sexual intercourse many years prior to marriage. Trends: Since 2004, the median age at first sexual intercourse has changed little among women age 20-49 (18.7 years versus 18.5 years) while for men age 20-49, it has dropped from 19.0 years to 18.1 years. The proportion of women age 20-49 engaging in sex before age 18 has increased slightly, from 39% to 42%; the proportion of men age 20-49 engaging in sex before age 18 has shot up, from 34% to 49%. Patterns by background characteristics  Rural and urban women age 20-49 start having sex around the same age. The median age at first sex is 0.4 years younger among rural than among urban women (18.3 years versus 18.7 years) (Table 4.6).  The median age at first sexual intercourse for women age 20-49 ranges from 17.5 years in Quthing to 18.7 years in Butha-Buthe and Berea.  More educated women wait longer before having sex. Among women age 25-49, there is a nearly 3-year difference in the median age at first sex between women with the most and least education (20.3 years versus 17.5 years).  Age at first sexual intercourse increases steadily with household wealth. The median age at first sex in the lowest quintile is 1.2 years younger than in the highest wealth quintile. 4.5 RECENT SEXUAL ACTIVITY The survey also collected data on recent sexual activity. Forty-one percent of women and 48% of men age 15-49 reported having sexual intercourse during the four weeks before the survey. More than one in ten women and men (14% and 13%, respectively) have never had sexual intercourse. For more information on recent sexual activity, see Tables 4.7.1 and 4.7.2. Figure 4.2 Median age at first sexual intercourse and first marriage among women and men 18.5 20.318.6 25.9* Median age at first sex Median age at first marriage Median age in years Women age 25-49 Men age 25-49 *Men age 30-59 Marriage and Sexual Activity • 61 LIST OF TABLES For more information on marriage and sexual activity, see the following tables:  Table 4.1 Current marital status  Table 4.2.1 Number of women’s co-wives  Table 4.2.2 Number of men’s wives  Table 4.3 Age at first marriage  Table 4.4 Median age at first marriage by background characteristics  Table 4.5 Age at first sexual intercourse  Table 4.6 Median age at first sexual intercourse by background characteristics  Table 4.7.1 Recent sexual activity: Women  Table 4.7.2 Recent sexual activity: Men 62 • Marriage and Sexual Activity Table 4.1 Current marital status Percent distribution of women and men age 15-49 by current marital status, according to age, Lesotho 2014 Marital status Total Percentage of respondents currently in union Number of respondents Age Never married Married Living together Divorced Separated Widowed WOMEN 15-19 81.6 17.7 0.0 0.0 0.5 0.1 100.0 17.7 1,440 20-24 41.1 51.8 1.1 1.3 3.7 1.1 100.0 52.9 1,325 25-29 21.3 68.3 0.9 1.3 4.8 3.4 100.0 69.2 1,094 30-34 13.0 67.4 2.5 2.3 6.6 8.3 100.0 69.9 957 35-39 7.0 72.3 0.9 2.3 5.8 11.8 100.0 73.2 744 40-44 5.9 66.3 0.7 2.7 3.5 20.9 100.0 67.0 562 45-49 5.6 61.0 1.0 2.2 5.4 24.8 100.0 62.0 499 Total 33.1 53.6 1.0 1.5 3.9 7.0 100.0 54.6 6,621 MEN 15-19 99.0 1.0 0.0 0.0 0.0 0.0 100.0 1.0 691 20-24 83.3 15.3 0.1 0.2 0.8 0.2 100.0 15.5 561 25-29 42.7 49.3 1.3 1.6 4.6 0.4 100.0 50.6 410 30-34 27.7 59.8 1.8 0.9 7.9 1.9 100.0 61.5 334 35-39 20.3 61.4 2.0 4.4 9.3 2.6 100.0 63.4 276 40-44 7.5 75.5 2.4 1.6 6.2 6.8 100.0 77.9 221 45-49 5.8 76.1 1.0 2.3 7.1 7.6 100.0 77.2 168 Total 15-49 56.4 36.0 0.9 1.2 3.8 1.7 100.0 37.0 2,660 50-59 3.5 67.1 2.3 1.5 6.8 18.8 100.0 69.4 271 Total 15-59 51.5 38.9 1.0 1.2 4.1 3.3 100.0 40.0 2,931 Marriage and Sexual Activity • 63 Table 4.2.1 Number of women’s co-wives Percent distribution of currently married women age 15-49 by number of co-wives, according to background characteristics, Lesotho 2014 Number of co-wives Total Number of women Background characteristic 0 1 2+ Don’t know Age 15-19 94.3 1.0 0.0 4.7 100.0 255 20-24 94.7 1.2 0.1 4.0 100.0 701 25-29 94.0 1.3 0.4 4.3 100.0 757 30-34 93.0 2.8 0.3 3.9 100.0 669 35-39 93.1 0.9 0.7 5.3 100.0 544 40-44 89.0 3.4 0.8 6.8 100.0 377 45-49 93.1 3.5 0.2 3.2 100.0 310 Residence Urban 94.4 1.6 0.1 3.9 100.0 1,150 Rural 92.7 2.0 0.5 4.8 100.0 2,463 Ecological zone Lowlands 93.7 2.1 0.3 3.9 100.0 2,134 Foothills 91.2 2.8 0.2 5.7 100.0 427 Mountains 92.8 0.8 0.6 5.7 100.0 797 Senqu River Valley 93.5 2.3 0.3 3.9 100.0 254 District Butha-Buthe 96.0 0.2 0.0 3.8 100.0 211 Leribe 91.3 2.5 0.1 6.1 100.0 577 Berea 95.4 0.9 0.4 3.3 100.0 461 Maseru 93.6 2.5 0.5 3.5 100.0 968 Mafeteng 92.5 2.3 0.0 5.3 100.0 312 Mohale’s Hoek 91.6 3.5 0.5 4.4 100.0 297 Quthing 92.4 0.4 0.0 7.3 100.0 158 Qacha’s Nek 90.3 0.4 0.0 9.3 100.0 114 Mokhotlong 90.8 0.8 0.3 8.1 100.0 205 Thaba-Tseka 95.9 1.7 1.4 1.0 100.0 308 Education No education 90.2 1.2 2.1 6.5 100.0 47 Primary incomplete 91.2 4.1 0.7 4.0 100.0 695 Primary complete 93.3 1.1 0.4 5.2 100.0 909 Secondary 93.8 1.7 0.2 4.3 100.0 1,665 More than secondary 94.8 0.5 0.2 4.5 100.0 297 Wealth quintile Lowest 94.3 1.3 0.5 4.0 100.0 592 Second 92.9 2.2 0.4 4.5 100.0 602 Middle 92.5 2.9 0.5 4.1 100.0 676 Fourth 93.8 1.7 0.3 4.2 100.0 844 Highest 92.7 1.5 0.3 5.5 100.0 898 Total 93.2 1.9 0.4 4.5 100.0 3,612 64 • Marriage and Sexual Activity Table 4.2.2 Number of men’s wives Percent distribution of currently married men age 15-49 by number of wives, according to background characteristics, Lesotho 2014 Number of wives Total Number of men Background characteristic 1 2+ Age 15-19 * * 100.0 7 20-24 100.0 0.0 100.0 87 25-29 98.4 1.6 100.0 207 30-34 99.4 0.6 100.0 206 35-39 96.1 3.9 100.0 175 40-44 93.6 6.4 100.0 172 45-49 97.6 2.4 100.0 130 Residence Urban 96.9 3.1 100.0 349 Rural 97.7 2.3 100.0 634 Ecological zone Lowlands 97.3 2.7 100.0 593 Foothills 95.3 4.7 100.0 100 Mountains 98.3 1.7 100.0 229 Senqu River Valley 98.9 1.1 100.0 61 District Butha-Buthe 96.0 4.0 100.0 57 Leribe 96.2 3.8 100.0 130 Berea 97.9 2.1 100.0 142 Maseru 96.3 3.7 100.0 291 Mafeteng 99.5 0.5 100.0 87 Mohale’s Hoek 98.1 1.9 100.0 68 Quthing 100.0 0.0 100.0 28 Qacha’s Nek 96.3 3.7 100.0 26 Mokhotlong 97.5 2.5 100.0 64 Thaba-Tseka 100.0 0.0 100.0 91 Education No education 98.1 1.9 100.0 114 Primary incomplete 97.6 2.4 100.0 337 Primary complete 97.5 2.5 100.0 146 Secondary 96.1 3.9 100.0 292 More than secondary 100.0 0.0 100.0 94 Wealth quintile Lowest 98.2 1.8 100.0 164 Second 96.4 3.6 100.0 171 Middle 97.3 2.7 100.0 196 Fourth 98.0 2.0 100.0 206 Highest 97.2 2.8 100.0 246 Total 15-49 97.4 2.6 100.0 983 50-59 98.2 1.8 100.0 188 Total 15-59 97.5 2.5 100.0 1,171 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Marriage and Sexual Activity • 65 Table 4.3 Age at first marriage Percentage of women and men age 15-49 who were first married by specific exact ages and median age at first marriage, according to current age, Lesotho 2014 Percentage first married by exact age: Percentage never married Number of respondents Median age at first marriage Current age 15 18 20 22 25 WOMEN 15-19 1.3 na na na na 81.6 1,440 a 20-24 1.0 17.3 38.8 na na 41.1 1,325 a 25-29 2.6 19.8 40.3 56.6 71.

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