Myanmar Multiple Indicator Cluster Survey 1995

Publication date: 1996

ultipl Indicator Cluster urvey 1995 Sf q 1-f .c H c,s f M6.,;, -hri~ E_ ff• t.l AJ I C~f- f 4 f.t>-J Progress of Goals for Myanmar Children National Programme of Action Department of Planning and Statistics Ministry of Health in collaboration with UNICEF February 1997 Yangon,~yanrnar • 4 . Multiple Indicator Cluster Survey 1995 Progress of Goals ·for Myanmar Children National Programme of Action Department of Planning and Statistics Ministry of Health in collaboration with UNICEF February 1997 Yangon, Myanmar ISBN 974-685-002-4 Minister for Health U Saw Tun giving polio oral vaccine on the National Immunization Day Chairman of the National Health Committee, Secretary 1 of the State· Law and Order Restoration Council Lt. General Khin Nyunt giving polio oral vaccine on the National Immunization Day able of Contents Preface . , •. 1 Introduction . 2 Profile of Myanmar· . 3 Achievement status of mid-decade goals for children of Myanmar, 1995 . ; . 4 Goals and achievements . 6 Data sources . 14 Graphs showing national data . : . 17 Graphs showing state/division specific data . 25 Maps of selected indicators . 37 Tables showing state/division specific data . 49 Annexes: . 61 Survey design and methodology . 63 · Definitions used . : . 65 Abbreviations . 68 Preface I t is a great pleasure and an honour for us to launch this user friendly version of the 1995 Multiple Indicator Cluster Survey Report published jointly by the :Department of Planning and Statistics (DPS) of the Ministry of Health and UNICEF. The report reflects the status of achievement of the mid-decade and NP A goals for children. The data contained in this report is disaggregated by urban/ rural location, by gender at both the state/ division and national levels. This report, which is presented in a user friendly format, provides us with an opportunity to take stock of what has been achieved in the 1990s and_ the challenges that remain as we move forward towards the twenty-first century. The data contained in this report will provide a wealth of infor- mation for social sector planners and implementors and stimulate the development of township, state and division programmes of action for children. This report which is based on a multiple indicator cluster survey is the first in a biennial series. As such it will serve multiple functions as a monitoring, planning and advocacy tool to advance the process of achiev- ing the goals for children by the year 2000. Finally, I would like to thank all those involved in the conception and production of this report for their valuable contributions. Dr. Kyi Soe Director General Department of Planning & Statistics Ministry of Health Government of the Union of Myanmar Introduction In September 1990, the leaders of the world agreed on an agenda for children and women for the 1990s. The World Summit Declaration, as it is called, identified 27 goals to be achieved for the well-being of the women and children of the world by the year 2000. The summit also called for all countries to prepare National Programmes of Action (NP A) to facilitate the development and implementation of interventions to achieve the identified goals. Myanmar became a signatory to the Summit Declaration in 1991 and completed its NP A in 1993. Also in 1993, Ministers of Health and Education of the East Asia and Pacific Region met in Manila and adopted the Manila Consensus which called for a series of mid-decade goals to assist in developing momentum towards achieve- ment of the NP A goals. Myanmar's NPA documented the best estimates for indicators relating to the situation of children and women which were intended to be used as a baseline against which to measure progress to- wards the mid-decade and NP A goals. However, conflicting estimates of the size of target popula- tions between different routine data collection systems in the country meant that it was difficult to develop a clear understanding of the situation of children and women. In order to remedy that situation, the Government of Myanmar collaborated with UNICEF to develop a Multiple Indicator Cluster Survey (MICS) specifically designed to monitor progress towards achievement of the mid-decade and NP A goals without having to consider denominator II 1ssues. This report presents the findings and retommendations of MICS which provides the very first consolidated set of data disaggregated at the subnationallevel by urban/ rural residence and gender. The survey which was the result of systematic multisectoral collaboration under, the guidance of the Department of Planning and Statistics (DPS); provides valuable information to facilitate the development and monitoring of subnational programmes of action for children which are essential for the well-being of Myanmar's children. The survey which is intended to be carried out biennially complements data available from other surveys and routine data collection systems in the country. Implementation of MICS was supervised by a Steering Committee and a Technical Working Group chaired by the Director General of DPS and the Assistant Director for Research and Training respectively. These groups included representatives from the Departments of Health, Basic Education and Water Resources Utilization as well as other departments responsible for routine data collection such as the Central Statisti- cal Organization and the Immigration and Man- power Department. DPS also sought and received full cooperation from authoritlt:2 a~ the state/ division, township, ward and village levels. Profile of Myanmar The Union of Myanmar is located in South East Asia adjacent to China and Laos in the East, Thailand in the South East and Bangladesh and India in the West. Myanmar is divided into seven states and seven divisions with a total land mass of 676,578 sq km. As of mid 1996, population was estimated at 45.5 million, of which approximately 33.5 per cent were under the age of 15. Close to 90 per cent of the population observe the buddhist religion which continues to play an important role in Myanmar society. There are three parallel mountain chains, the Western Y oma, the Bago Y oma and the Shan Plateau and three main river systems the Ayeyarwady, the Sittaung and the Than Lwin stretching in a north south direction. The vast majority of the country with the exception of a dry zone in the central regions receives adequate rainfall to sustain significant agricultural produc- tion. With a per capita GDP of US$220 in 1995, Myanmar is classified as a Least Developed Coun- try. Nevertheless, the country has substantial human resources and economic potential which includesundeveloped arable lands, significant water resources for irrigation and power, forest resources covering over 50 per cent of the land area of the country, natural gas, marine resources along a coastline of 2,832 km and substantial mineral wealth which has earned Myanmar the name of the Golden Land. Since 1988 the Government has taken measures to liberalize the economy and encourage investment in productive sectors and infrastructure notably bridges, roads and power plants. However, investment in the social sector has been less dynamic. By late 1996, more than US$ 5.0 billion in foreign investment primarily in the form of joint ventures in the energy and tourism sectors had been approved. Agriculture remains the lifeblood of the economy employing roughly 65 per cent of the population and accounting for 47 per cent of GDP in 1995. Most recent data on mortality indicates an infant mortality rate of 94/1000 live births in 1991 with a target of 50 by 2000, maternal mortality was estimated at 232/100,000 live births in 1994 with a target of 50 per cent reduction. Severe malnutri- tion of under-threes was estimated at approxi- mately 15 per cent in 1995. While the outlook for child survival is generally optimistic despite the data due to the large number of public health initiatives in place, more needs to be done to achieve the goals related to development and protection of children including primary school completion rates, water and sanitation coverage, nutrition and improvement of the situation of children in difficult circumstances. While worthwhile initiatives exist in all of these areas- they are sharply constrained by limited resources from both domestic and international sources. Significant additional investments in the social sectors will be needed if Myanmar is to achieve the goals for children and women by the year 2000 and achieve sustainable economic and social development. Myanmar's entry into ASEAN provides a window of opportunity for learning from the ASEAN model of economic development which relies heavily on investments in basic education and other social services. II Achievement status of mid-decode goals for children of Myanmar, 1995· II ~----Go_a_ls ____ ~f ~~--------ln_di_ca_to_rs ______ ~f f Statusf Universal Child Immunization Neonatal Tetanus Elimination Reduction of Under-5 Measles Polio Elimination Vitamin A Supplementation Iodated Soh Consumption BCG coverage DPT3 coverage OPV coverage Measles coverage Fully Immunized Children TT coverage Cases Deaths Cases Cases Vitamin A capsules received Households consuming. iodot~d salt \ ~---G-oa_ls _____ l ~~--------ln_di_ca_to_rs ______ ~f f Statusl Oral Rehydration Therapy Use Baby Friendly Hospital Malnutrition Basic Education Water and Sanitation Convention on the Rights of the Child Ratification Achieved Under-5 children with diarrhoea treated with ORT Targeted hospitals certified Moderate and severe Severe Retention rate in lost year of primary school Net enrolment rate Entry rate in first year of Access to safe drinking water Access to sanitary excreta disposal Close to Achievement Challenge II Goals and achievements ~----------~-ea_r_2_oo_o_Go_a_l ----------~~~~-----M-i_d--De_ca_de_G_oa_l_l9-95------~ • Reduce infant and under-five child mortality rote to 50 and 70 per 1 000 live births respectively Reduce maternal mortality ratio to 116/1 00,000 live births Maintenance of o high level of immunization coverage (at least 90% of children under one year of age by the year 2000) against diphtheria, pertussis, tetanus, measles, poliomyelitis, tuberculosis and against tetanus for women of child-bearing age Eliminoticn of neonatal tetanus by 1995 Reduction by 95% in measles deaths and reduction by 90% of measle cases compared with pre-immunization levels by 1995, as a major step to the global eradication of measles in the longer run Elevation of immunization coverage of six antigens of the Expanded Programme on Immunization to 80% or more in oil countries Some as Year 2000 Goal Some as Year 2000 Goal -----------------------------------------------------------------------Global eradication of poliomyelitis by the year 2000 Elimination of polio in selected countries and regions Goals Indicators Annual number of deaths of children under-five years of age per 1 000 live births Annual number of deaths of infants under-one years of age per 1 000 live births Annual number of deaths of mother. related to pregnancy and child birth per 100,000 live births Percentage of children 12-23 months immunized against diphtheria, pertussis and tetanus (OPT3) · Percentage of children 12-23 months immunized against measles Percentage of children 12-23 months immunized against poliomyelitis (0PV3) Percentage of children 12-23 months immunized against tuberculosis Percentage of pregnant women immunized against tetanus (TT2) Annual number of coses of neonatal tetanus Annual number of under-five deaths due to measles Annual number of cases of measles ----··--- Annual number of cases of polio Status{%) 1990 1991 1992 1993 1994 1995, MICS 147 94 232 69 . 67 58 73 77 75 68 67 56 71 77 75 70 67 58 73 77 75 67 M 63 80 83 83 56 64 57 66 68 83 189 96 125 71 31 71 40 2 15 29 6 6243 4437 1700 2692 3530 1168 36 58 38 52 28 18 Target{%) 1995 2000 70 50 116 80 90 80 90 80 90 80 90 80 90 0 0 0 0 • ~----------~-ea_r_2o_o_o_Go_ai----------~~~~------Mi_d--De_ca_d_eG_o_al_1_99-5------~ II , Empowerment of oil women to breostfeed their children exclusively for four to six months ond to continue breast- feeding, with complementary food, well info the second yeor Virtual elimination of vitamin A deficiency and its consequences, including blindness Virtual elimination of iodine deficiency disorders Reduce by 50% in the deaths due to diorrhoeo in children under the oge of five years and 25% reduction in the diarrhoea incidence rote Reduction by one-third in the deaths to acute respiratory infections in children under-five years Ending ond preventing free ond low-cost supplies of breostmilk substitutes in oil hospitals ond maternity facilities. Hoving forget hospitals ond maternity facilities achieve "baby-friendly" status in accordance with BFHI global criteria Virtual elimination of vitamin A deficiency Universal iodizotion of solt Achievement of 80% usage of ORT (increased fluids ond continued re~~ing) Proportion of population thot hos o regular supply of ORS available in their community Goals Indicators Proportion of infants less than 4 months ( 120 days) of ag, who are exclusively breastfed Proportion of children 20-23 months who are breastfed Proportion of infants 6-9 months of age who are receiving breastmilk and complementary feeding Proportion of hospitals and maternity facilities targeted for BFHI by end of 1995 Proportion of targeted hospitals and maternity facilities that have been officially designated as "baby friendly" in accordance w~h global criteria Percentage of children between 6-59 months of age receiving one or more doses of vitamin A during last one year Percentage of households consuming any level of iodated salt in the country Percentage of diarrhoea episodes in under-fives treated with oral rehydration salts (ORS) and/or recommended home fluids Percentage of diarrhoea episodes in under-fives given increased fluids and continued feeding Proportion of mothers of under-five who know signs of ARI fo~ seeking health care Status(%) 1990 1991 1992 1993 1994 1995, MICS 30 56 l3 88 4 6 38 29 26 Target(%) 1995 2000 80 80 100 100 80 • ~----------~-eo_r_2_oo_o_Go_o_l ----------~~~~-----M-i_d--De_co_de_G_oo_l_l9-95------~ II Between 1990 and the year 2000, reduction of severe and moderate malnutrition among under-five children by half Univ,ersol access to basic education, and achievement of primary education by at least 80% of primary school-age children through formal schooling or non-formal education of comparable learning standard, with emphasis on reducing the current disparities between boys and girls Reduction of 1990 levels of severe and moderate malnutrition by one-fifth or more Strengthen basic education to achieve reduction by one-third of the gop between (a) primary school enrolment and retention rates in 1990 and universal enrolment and retention in primary education of at least 80% of school-age children, and (b) primary school enrolment and retention rates of boys and girls in 2000 Goals Indicators Percentage of children under-three who fall below minus 2 standard deviations from median weight for age of NCHS/WHO reference population (underweight, moderate & severe) Percentage of children under-three who fall below minus 3 standard deviations from median weight for age of NCHS/WHO reference population (underweight, severe) Percentage of children under-three who fall below minus 2 standard deviations from median weight for age of NCHS/WHO reference population (stunting, moderate & severe) Percentage of children under-three who fall below minus 3 standard deviations from median weight for age of NCHS/WHO reference population (stunting, severe) Proportion of children entering first grade of priniory school who eventually reach grade 5 Male Female Both sexes Proportion of 5-9 years children enrolled in primnry school Mole Female Both sexes Proportion of children of primary school-entry age who enter first year of primary school of that age Male Female Both sexes Status(%) 1990 1991 1992 1993 1994 1995, MICS 37 31 40 11 8 16 40 45 17 20 35 32 25 34 71 85 73 85 62 72 85 76 77 77 Target(%) 1995 2000 30 18 9 5 20 8 43 80 80 100 100 Ill ~----------~-ea_r_2o_o_o_Go_al ____________ ll Universal access to sofe drinking water Universal access to sonitory means of excreta disposal II· Mid-Decade Goall995 Increase water supply coverage so os to narrow the gop between the 1990 levels ond universal access to sofe water supply to the yeor 2000 by one-fourth Increase sanitation coverage so os to narrow the gop between the 1990 levels ond universal access to sonitory means of excreta disposal to the yeor 2000 by one-tenth Ratification of the Convention on the Rights of the Child (CRC) by oil countries Goals Indicators Percentage of population using safe and convenient drinking water Union Urban Rural Percentage of populotion using sanitary excreta disposal Union Urban Rural Depositing the Instruments of Ratification ~,~. ,th the United Notions Legal Office . · Status(%) 1990 1991 1992 1993 1994 1995, MICS 32 46 60 38 49 78 30 44 50 36 52 43 40 70 56 34 44 36 100 Target(%) 1995 2000 49 100 42 100 100 100 II Doto sources Ill . II Figure 1. Population pyramid I • Mole 0 Female I 15% 10% · Age group .lLJ .KJ •u -· .!L64.!.______.__j -~ . 59'---------' -=----54::L-----' ---=--:59:___ _ ____J 5% 0% 5% I I 10% 15% Figure 2. Figure 3. 40 20 II Status and goal of infant and under-5 mortality 160 -r--------------- 140 .1991 D 2000 120 +-------- 80 60 40 20 0 IMR Trend of life expectancy • Male •Total 1974 1984 . 1986 U5MR 1987 100 100 I 0 DPT3 I ~ I • OPV3 I 80 1-- 80 1-- ;- r- ,--~ 60 r= .1-- 60 1-- 1-- r- 40 r-- 40 1-- r- ,-;- n 1--20 0 -_ . -20 0 '85 '86 '87 '88 '89 '90 '91 '92 '93 '94 '95 '85 '86 '87 '88 '89 '90 '91 '92 '93 '94 '95 100 100 r• Measles I I DTT2 I 80 80 ,-- ~r- 60 60 r-~ r--,-- I~ 40 40 ~ r-- r-~ 20 20 r- - 0 0 15 16 17 18 19 10 11 12 13 14 15 '85 '86 '87 '88 '89 '9J '91 '92 '93 '94 '95 Ill I r. I Figure 5. Status and goal of moderate, severe and total malnutrition 50 .1995 40 02000 30 20 10 0 Severe Moderate Severe & Moderate Figure 6. · Trend of access to safe and convenient drinking water 100 . . . -Coverage . , 80 r-- , , - - -Goal , . , . / _/ 60 40 ·------- ~ 20 0 1975 1980 1985 1990 1995 2000 . II Figure 7. Trend of access to sanitary means of excreta .disposal 100 • I . -Coverage I 80 - • - - -Goal I I , I 60 , I , I • 40 20 ~ ~ ~ 0 1975 1980 1985 1990 1995 2000 Figure 8. Challenges for Year 2000 r 100 ,.-----------,---r-----""""' .1995 02000 80+---~~---~ 60 +----1 40 +-----1 20 +-----1 Vitamin A Iodated Salt Consumption Completion of Primary Education II Figure 9. Immunization coverage of BCG : 1995 Yangon Mag way Mon Mandalay Ayeyarwady Sagaing Bago Kay in Tonintharyi Shan (North) Kayoh Koch in Shan (South) Chin Rakhine Shan (East) 0 20 40 60 73 80 83.4 Union 100% II Figure 10. Immunization coverage of DPT3 : 1995 Magway Yangon Mon Bago Mandalay Ayeyarwady Kay in Sogaing Tanintharyi Shan (North) Kachin Chin Shan (South) Kayah Rakhine Shan (East) II 0 20 40 60 80 75.0 Union 100 % Figure 11. Immunization coverage of OPV3 : 1995 Magway Mon Bago Yangon Mandalay Ayeyarwady Kay in Sagaing Tanintharyi Shan (North} Kachin Chin Shan (South} Kayah Rakhine Shan (East} 0 20 40 60 80 75.0 Union 100 % II Figure 12. Immunization coverage of Measles: 1995 0 20 40 60 80 100 % Mon Bago Mag way Mandalay Ayeyarwady Yangon Sagaing Kay in Taninthoryi 64 Shan (North) Kayah Kachin 52 Chin Shan (South) Rakhine 44 Shan (East) 74.8 Union II Figure 13. Immunization coverage of TT2: 1995 0 20 40 60 80 100 % Mandalay Mon Yangon Sagaing Kay in Bago Ayeyorwady Magway I • Shan (North) ! : Tanintharyi I ~ Kayah I : I : I . Rakhine I . ' . I : Shan (South) I : i . ! • Kachin i . I . ~ . Chin Shan (East) 82.6 Union II Figure 14. Percentage of mothers who practice correct ORT: 199 5 Koch in Kay in Chin Sagaing Rakhine Magway Ayeyarwady Mandalay Tanintharyi Shan (North) Shan (South) Yangon Bago Kayah Shan {East) Mon II 0 10 20 23.9 Union 30 40 % 35 Figure 15. Percentage of mothers who know signs and symptoms of ARI for seeking health care 0 10 20 30 40 50 60 % Yangon 57 Kachin Chin Mandalay Rakhine Shan (East) 27 Bago 26 Shan (South) 20 Ayeyarwady Tanintharyi Sagaing Mon Kayah Kay in 10 Mag way 10 Shan (North) 9 26.2 Union II Figure 16. Rakhine Sagaing Kayah Magway Yangon Kay in Bago Tanintharyi Shan (East) Mandalay Ayeyarwady Chin Kachin Shan (North) Shan (South) Mon II 0 Continued breastfeeding at 2 years of age: 1995 20 0 Urban • Rural 40 60 55.8 Union 80 100 % Figure 17. Ayeyarwady Chin Mandalay Mon Kay in Kayah Yangon Sagaing Shan (North) Taninthoryi Bago Mag way Koch in Shan (South) Rakhine Shan (East) 0 Children entering first year of primary school at age 5: 1995 20 40 60 80 DUrban r-~----------------~----~ • Rural - - - - ~· - 76.7 Union 100 % II Figure 18: Distribution of states/divisions by overall challenge foetor Myonmor 1995 Challenge factor represents the gap between the current level of achieve- ment and the year 2000 goal in a state or division. The overall challenge factor is an av- erage of the challenge factor of 10 key indicators. These are: Coverage of BCG, DPT, OPV, Measles, TT and fully immunized children, severe mal- nutrition, net enrolment rate, access to safe water and access to sanitation. States/ divisions in green are relatively close to achieving year 2000 goals. States/ divisions in yellow are likely to achieve the goals but require spe- cial attention. States in brick colour can achieve the goals if intensive financial and techni- cal inputs are made available. Source: Multiple Indicator Cluster Survey, Myanmar, 1995 Indicator II <25% II 25-35% II 36-45% The higher the challenge factor, the greater the efforts needed to achieve the year 2000 goals. II • Figure 19: II Distribution of townships included in Myanmar MICS 1995 Indicator Sample townships included inMKS Figure 20: Infant Mortality Rate, Myanmar, 1991 Source: Myanmar Population Changes and Fertility Survey Preliminary Report 1991 by IMPD Indicator No. of deaths live births 100-116 - 80-99 <80 II Figure 21 : Fully immunized children cf under-one: 1995 Indicator II <60% II 60 -80% II > 80% . Figure 22: Prevalence of moderate and severe malnutrition (<-2SD of the median weight for age in children of under-5): 1995 Indicator II <40% 40 -45% II > 45% II Figure 23: Prevalence of severe malnutritio~ (<-3SD of the median weight for age in children of under-5): 1995 Indicator II >=20% - 15-20% II < 15% II Figure 24: Reaching lost year of primary school: 1995 Indicator II <30% II 30.35% II > 35% II Figure 25: Access to sofe ond convenient drinking water, 1995 II Indicator 11 <49% 11 >49% . l.-,, , , . Figure 26: Access to safe and convenient excreta disposal, 1995 Indicator 11 <42% 11 >42% I Iii State/ Division Kachin Kayah Kay in Chin Mon Rakhine Shan (Jlorth) Shan (East) Shan (South) Ayeyarwady Sago Mag way Mandalay Sagaing Tanintharyi ·-···· ·· Yangon New Settle- men! Area Union U Urban R Rural T = Total u 84 87 88 100 100 61 89 54 84 92 84 97 98 98 90 96 84 90.9 BCG DPT 3 R T u R T 47 57 82 44 54 56 62 87 39 48 79 81 79 74 75 . . . - -~ - 50 55 100 46 52 89 92 82 86 85 49 51 51 43 45 . . . 60 65 70 56 59 38 42 50 36 39 44 55 79 38 49 ···········- · - . _ ----------------------- ------ 90 90 69 78 77 87 a6 I 84 85 85 93 94 92 85 86 . . .•. 88 90 90 81 83 85 87 80 72 73 63 73 76 54 62 ------- · -- ----- - ------- ------- --~- - 90 95 84 89 85 78 83 60 56 59 80.8 83.4 79.4 73.9 75.0 Percentage of 12-23 month-old children immunized with OPV3 Measles u R T u R T 82 44 54 80 42 52 87 39 48 87 48 55 79 74 75 79 70 72 100 46 52 100 45 51 82 86 85 84 86 86 51 43 45 46 43 44 . ············-- . . . . . . . .•••. . 70 56 59 66 55 57 50 36 39 48 36 39 79 39 48 80 35 48 - -- ---- ------------------------- ····--------------------~--- 69 79 78 85 80 81 84 85 85 80 86 84 92 84 86 89 82 83 ······· · · ·········· -·····- --- . . . ._. __ . . ······- ···-· . . .•. _, _______ 90 81 83 84 82 82 ' 80 72 73 98 74 78 78 55 63 79 57 64 ------------------- ----···-· ······--- ·--- -------------· ···--···· ··· ····--···- . 82 89 84 78 84 80 59 56 59 l 58 54 58 79.2 74.0 75.0 81.4 73.6 74.8 FIC TI2 u R T u R T 80 41 52 87 50 52 87 39 48 96 55 66 77 69 71 68 90 88 . . . ~ . . .•. ~ . . · ··· ··~-----·· 100 45 50 41 54 52 82 85 85 91 90 90 46 42 43 22 68 62 63 54 56 93 73 77 48 36 39 89 35 41 74 35 46 66 55 57 - ------·----------------------------------·- ---- ------------------ -----··· -------- 69 75 75 78 86 85 80 85 84 92 85 86 84 79 80 56 87 83 ------- . .• · · ···-··- · ---- --------·····----- -- --- --------·· ·-··--- --- 84 81 82 93 95 95 78 67 69 89 88 88 74 54 61 96 72 75 . . ·-· -··-- -------------- --------·-· ·· ---- -- ----- 74 84 76 95 88 89 53 48 52 100 86 88 75.0 71.2 72.0 80.9 82.9 82.6 II State/ Division Percentage of children under-five who foil below -2SD . (underweight moderate ond severe) Urban Rural Total M F ~ M F ~ M F ~ 1\achin Kayah Kayin· Chin 28 I !4 . t 30 ! ·67 l 19 21 41 24 41 23 1 33 35 1 47 . r 48 59 53 42 41 37 37 37 18 30 51 49 30 29 I 49 · 46 1 27 44 49 51 55 49 52 Mon 44 43 44 40 41 41 41 42 41 Rokhine Shan (North) Shan (East) Shan (South) 'SO 40 45 35 32 34 53 44 49 ! 52 l 38 32 35 I 37 43 48 32 35 Percentage of children under-five who foil below -3SD (underweight severe) Urban Rural · Tote! M F ~ M F ~ M F ~ 8 8 I 7 38 3 5 11 30 5 7 9 35 18 20 19 15 16 16 12 11 12 11 10 11 14 20 ]7 I ]3 18 15 26 26 26 28 26 27 10 16 13 14 16 15 13 16 14 20 18 19 30 31 31 29 29 29 9 10 9 16 8 13 15 8 12 34 22 28 21 22 21 24 22 23 15 6 10 12 14 13 ! 12 12 12 . . ! -., . . --- -·· . . ·-········--- -···-·····-··-··· ----····-··-- . ------ ~-----·····- -· -····· - --- . ----------------- ---··· ---·-··· . --- . ··-··· · ------ . --······-··· ---------------------. ··--···-·-- Ayeyorwody · 44 57 . so 45 41 43 45 43 . 44 6 20 . 13 18 17 18 17 17 17 Bogo· 16 IS 15 18 15 16 17 15 16 Sagoing Tonintharyi 47 37 42 42 I 44 40 10 6 8 17 -:~; - -:~ ~~--~r ~:--:: ~; :: - ~~-~~ --~--~ ~:- ~-- ::--~-- 1 36 25 30 ! 48 40 44 I I 39 32 35 46 43 45 10 6 13 15 16 14 12 33 35 . y~~~;--·---- ,. -~6 ·---·;1----- ~- l-·39 37 38 37 I NewSeHie- 1 43 38 41 40 47 43 42 39 41 13 11 12 15 22 18 13 13 13 men! Area I ' , _ u_nio_n·_· _ __._4o_.o_ 3_9._7_ 3--9-.9"'"'-4-S.5 __ 4_2_.3 __ 4_4.0__,_4_4._2_4l_.o_4_2.9--~-l-3.2--1-2._7 _._17 __ .4_ 1_6._3 _ 1_6 __ .8_,_16_.3_ 1_5._4_ ls_.8_ 8 9 9 11 11 11 10 9 9 M = Mole F Female Bs Both sexes II State/ Division Percentage of children under-three who fall below -2SD {underweight moderate and severe) Urban Rural Total Percentage of children under-three who fall below -3SD {underweight severe) Urban Rural Total ------~-M---F---8s~~--M---F --8-s ~l-M---F---8s~~M---F--~8s~-M---F--B-s~M---F---8-s - Kachin Kayah Kayin Chin Mon Rakhine 29 10 22 1 39 23 I 33 I 1 24 21 43 28 41 37 36 36 .9 30 30 27 29 8 3 7 16 20 18 15 16 15 5 7 12 11 lJ lJ 10 11 . 2~ - -- ~~ ~- 2~- . -- ~ 2 -~~ ·- -~0- .!~. -- ~6--3~· -·· ····- · ~ ----····-~·-··--·-~-·i·· ··· l-4 ······· -- ~~ --···--~~-- ····--~~ ---~~--~~ --- . w ~ ~ ~ ~ u ~ u m ~ n ~ n ~ u ~ ~ n ! • 48 40 44 34 33 34 38 35 36 8 16 lJ ' 14 14 14 13 14 13 25 18 21 32 28 30 31 27 29 ·· ·············· ·· ··· ·······- ·· . l ·· ·· . . . . + . ······· . -- . . . . . . ·····-· ·-·-·····-· ········ . . . . . . . . . . . . . . . . . . . . . -······· •· ···················· . . Shan (North) 30 28 29 9 18 8 14 16 8 13 Shan (East) 51 39 45 1 so 41 46 5o 4o 46 32 17 25 24 22 23 26 21 23 Shan (South) 34 3o 32 37 34 35 36 33 34 1 15 4 1 o 13 14 13 14 11 12 ·······-·--- - -··-·-·- ···· ···-········-· -··-·---·--- ·····-··· ··-···········-······· -·· - ·-···-----·····--·····-····-·- ·-·--- . . •. ·········! ·- . - ·····-·· - ----- · Ayeyarwady 38 59 49 41 37 40 41 40 41 8 24 16 18 15 17 17 . 16 17 Sago 46 43 45 41 42 42 42 43 42 18 ! 15 16 ! 19 16 17 19 16 17 Magway -. r . 45 I 50 47 -·---~o . --- ~2 _ 17 · -- ~~ L . 23 ___ _ 19 ___ ~1··· · · ····-~23 ___ _____ __ 1 . 9 . 21 52 45 45 53 48 . . , . ··--···· Mandalay Sogoing Tonintharyi Yangon New Senle- ment Area Union 32 25 28 42 34 38 40 32 36 34 19 26 l 45 34 40 ; 43 31 38 . 43 31 37 47 40 44 46 37 41 32 27 30 32 29 1 43 34 38 39 44 38.2 36.7 37.6 42.3 37.5 31 I 32 I 42 1 42 I I 28 36 30 I 39 l 37.0 39.6 10 9 10 I 15 13 14 14 12 13 . 10 4 7 19 13 16 18 11 15 13 3 8 21 18 19 18 13 16 8 8 8 15 7 11 10 8 9 17 lJ 14 14 17 15 16 12 14 13.0 12.7 12.8 18.4 14.9 16.6 17.2 14.3 15.8 40.3 , 41.7 --------~--------~--------~--------~~--------~---------L----------- M Male F Female Bs Both sexes • State/ Division Koch in Kayah Kayin Chin Mon Rakhine Shan (North) Shan (East) Shan (South) Ayeyarwady Bago Magway '' ''''''' ,,,,,,,, Mandalay Sagaing Tanintharyi Yangon New Settle- men! Area Union - M Male Female Bs Both sexes II M 25 3 29 !,,,,,,,,,,,,,,,,,,,, 0 12 33 '''' 73 40 13 50 25 33 42 50 0 24 31 34.8 Percenffge of infants less than 4 months of age who ore exclusively breastfed Urban Rural Total F Bs M F Bs M F 67 43 20 40 25 . 21 48 13 5 28 64 40 16 42 20 24 29 20 24 1 29 20 ''''''''''''!'' 20 20 56 40 48 56 38 13 13 23 22 23 ! '21 19 0 14 24 22 23 25 19 ,, , 38 58 22 28 24 29 29 40 40 24 37 30 27 38 29 20 35 27 30 29 27 . 0 20 40 39 40 41 36 17 20 38 55 46 37 46 0 17 6 7 7 9 7 ''''''' 23 32 38 32 34 38 30 33 42 32 28 30 35 29 29 12 4 20 9 3 24 26 25 52 50 52 36 34 19 25 8 25 13 26 20 18.2 25.5 32.4 33.6 32.7 31.3 30.0 " . ,.,.,., ._.,.,.,.,_,. Bs M 28 50 I 24 0 24 63 46 13 20 78 22 14 29 19 33 I 76 28 33 38 60 41 17 8 27 !-· 34 21 31 0 10 88 35 63 23 57 30.1 36.8 Percentage of infants 6-9 r.'ut1ths of age receiving breastmilk and complementary food (timely wmplementary feeding) Urban ' Rural Total \ \ F Bs M F Bs • M F 100 70 41 38 40 43 51 0 0 19 23 20 . 17 22 80 72 63 60 61 63 66 20 15 36 25 31 31 24 40 64 48 50 49 55 48 17 15 52 39 46 44 34 . ,,,,- , . 22 20 29 21 26 26 22 42 62 18 21 20 40 28 so 42 42 32 37 40 36 100 71 33 65 48 38 68 22 20 18 21 19 17 21 25 27 19 33 25 20 33 ',,,,,.,, ''''''''''''''' ' ' ' 38 30 34 41 37 30 40 60 33 44 44 44 41 46 I 50 62 50 50 50 59 58 52 58 50 47 48 60 S,O 74 66 60 40 47 57 67 50.1 42.6 36.5 42.0 38.9 37.8 43.5 Bs 47 19 64 __ , 28 52 40 24 34 38 51 20 26 35 43 54 55 63 40.4 State/ Division Kachin Kayah Kayin Chin Mon Rakhine Shan (North) Shan (East) Shan (South) Ayeyarwady Sago Magway Mandalay Sagaing Tanintharyi Yangon New Settle- ment.Area Union M Male F Female Bs Both sexes Percentage of children 12 to 15 months of age who ore breostfed (continued breostfeeding at one year) Urban Rural Total F Bs Percentage of children 20-23 months of age who ore breostfed (continued breostfeeding at two years) Urban Rural Total M F Bs M F Bs M F Bs M F ~ I M F ~ I M 77 89 8~--64--83 ___ 7_3 +--69--8-4 - 7-6 -+--17--20 ___ 1_8+--19 _ __ 3_2 - 2-5-1--18--3-0--24- 1:: :: :: :: :: :: :: : :: I :: :: 100 100 100 1 86 I 67 60 64 64 50 100 69 87 50 0 38 57 100 86 93 50 29 56 44 70 100 100 100 77 91 100 94 81 83 67 75 95 81 78 84 1 87 71 I 65 84 85 78 59 57 56 56 74 54 1 71 n 1 62 60 l3 40 37 36 46 41 56 48 67 57 48 65 56 84 I 17 20 70 l 14 0 81 75 18 54 50 52 49 45 47 7 17 44 28 17 30 23 86 -~~ -- l - _75_ _ ~ oo 55. 1 13 10 67 69 55 83 70 63 67 71 12 I 26 15 22 22 13 19 64 67 8 58 33 5 13 9 6 33 19 69 66 18 6 11 40 45 ·43 33 28 31 -- ! ···-- -- --- ------ ----------- -- ----- - -- . --- ------ - --- ------· . --- ----- - 93 88 79 84 I 78 85 I 85 87 I 93 94 90 77 85 0 1 00 25 7 4 43 61 68 46 59 88 61 46 52 84 50 63 58 79 85 82 75 81 78 30 33 31 60 83 70 53 77 62 1 oo so a6 I 97 72 as 97 7 4 88 100 50 60 65 85 74 66 81 73 I 61 79 69 73 65 69 68 71 69 100 95 98 88 82 84 97 91 94 B4.6 83.4 83.7 82.2 81.5 82.0 83.3 82.9 83.0 42.4 52.0 41.7 59.3 58.4 58.9 . 55.2 56.9 55.8 II State/ Division Kachin Koyah Kayin Chin Mon Rokhine Shan (North l Shan (East) Shan (South) Ayeyarwady Bago Percentage of infants less than 12 months old receiving any food or drink from a bottle (bottle-feeding rote) Urban Rural Total ~-F- Bs M F F ' 7 0 4 i I o 0 0 l j 3 0 2 0 7 4 12 19 15 0 0 0 15 17 16 11 19 15 4 3 3 18 40 25 29 15 22 6 9 7 5 6 5 8 5 9 13 15 9 2 7 14 1 13 l 5 13 8 . 9 11 8 17 5 Mog~a~ ---·-- L ~ . -~ . --~ - • -·--6~-- 2 Mandalay I 16 9 12 1 16 4 6 2 16 16 16 14 Sagaing 5 5 4 Bs 9 Percentage of infants less than 12 months old ever breostfed (ever breostfed rote) Urban Rural Total M -F-·--B~-lM_F _____ B~-~ M F Bs 100 100 100 i 100 10~-100 1 100 100 100 ! ; 100 100 100 100 100 100 100 100 98 ·----1 . 99 98 98 99 99 100 l 1oo 100 100 ! 100 i 100 100 100 100 100 . 100 99 99 100 99 100 100 100 100 1 100 100 100 100 100 100 7 ····· !- 100 . " 1~0----~-~~ ~ 99 98 9; ··r ~~ 99 99 100 100 ! 100 100 100 8 I 100 100 100 1 100 6 l I 00 I 00 I 00 I 99 . ! . - - !·· 15 ! 100 100 100 ·1 1 1 100 9 1 100 100 100 ·' 100 4 I 1 00 I 00 1 00 : 1 1 00 15 I 100 100 1io I 100 ' ! 99 1 99 99 99 I . ; I 99 l 100 97 99 I . 1 00 1 00 1 1 00 1 00 1 00 99 100 1 100 99 100 99 100 1 100 99 100 98 1 99 98 98 99 97 98 Taninthoryi 5 l 1 oo 96 98 1 98 ~~__~~- ~- 100 97 _.~I_JOD__ 100 I 5 9 7! • I 14 ! 14 ········-·········! 13 17 19 18 15 j 100 ! 99 100 100 Yangon New Sellle- menl Area Union 12 I 20 i 112.8 _____ L M Mole Female Bs = Both sexes 10 11 10 12 15 15 13.7 12.6 1 9.1 10 I 98 99 98 I 100 16 I 98 " ., Jioo 1 8.8 9.3 j 99.7 ~~~9.5 . .:.19_9_.7 _98-.9-'·-99_.5__.~_19_9_._7 _ 98-.8,.--99_.4_ 7 8 1 11 ! i 18 ! 19 ! 13 9 22 8.1 8.6 i 9.8 __ _j_ 100 100 99 99 99 99 99 100 100 99 % of children ·. % of households %of % of households % of households %of mothers who know signs of ARI State/ Division Kachin Kayah Kayin Chin Mon u 19 0 21 0 ! 0 Rakhine i 0 IJ.o.INo<lhJ I ' Shan (East) Shan (South) Ayeyarwady Bago Magway Mandalay Sagaing Taninlharyi I I - ~ 1 1 2 0 0 9 0 -l - i 0 2 42 under-2 receiving Vitamin A R 6 7 46 having salt that diarrhoea tests positive for cases given iodine ORT with access to safe with access to safe & convenient drinking water & convenient excreta disposal r !.u R r l U R T U R T 1 U R T l U R T 7 --~-~-~~~1-3 ---4-0---38~---77 ___ 64---6-7 +-8-0---44---53~-4-8 ---47---47-- 7 I I l 6• 43 o 22 16 1 33 2 21 19 1 35 17 18 85 35 35 85 53 71 64 1 77 74 I 75 33 51 48 4 12 11 58 3 11 10 - · · ·· ·····+-·················· ·· ····-···· ····- . .• -- - - - · · -·· ··-·- - ···-- . . . ····--······ · - · ·······- ···········-··-·· ·-· -- --··- . ·-········-··- - -·-· ·-··-··· ------- -- · 80 42 46 73 26 31 99 54 62 86 65 6-9 63 45 47 7 2 0 7 6 2 6 7 24 2 25 2 2 o I 59 · 51 22 1 l 1o I 6 I 29 l ! 2 1 55 5 6 19 30 9 31 15 5 10 25 20 I 11 I 3ocl 1o 8 1 20 I 34 I 14 16 ! 31 -l---- 6 I 22 I 13 I 6 I ! 28 I 78 ~I 5 1 21 1 11 36 23 20 21 26 21 18 . 23 11 90 61 69 58 43 48 21 28 51 29 33 53 26 34 39 23 91 64 69 67 24 32 13 18 68 67 68 90 74 81 33 23 87 37 45 1 61 23 32 27 ! -- +--. 25 18 40 43 1 57 67 661 64 64 62 29 33 53 56 24 20 26 85 48 54 I 47 30 I ~- - ~---~ ~· · ··· - -~· · · - ·- 24 94 65 75 ' 68 50 8 8 7 1 0 9 8 I 41 26 30 I 77 57 60 I 12 22 I 2 7 I 81 7l l 29 23 23 i 82 47 57 I 68 22 38 22 10 12 33 34 8 9 25 27 18 20 16 l7 28 26 10 10 39 37 14 13 14 16 ·· ·· ···· ······· ··· r L I Yangon I 17 12 13 I 6 5 14 22 21 86 19 66 1 1 59 30 51 60 New Settle· I 2 4 3 1 3 12 11 18 14 15 98 52 90 I 56 36 53 51 48 57 29 47 men! Area I I I ! -~s.s __ ~l._l6_.3_1J_.9 14._2 _._21_.2_ 2_3._6 _ 23-.9-.l'---7-8._1 _ 49-.6- 59.7 _1 56 .3~--27_.o_2_5_.o_26_.2_ U Urban R Rural T Total • State/ Division Kachin. Kayah Kayin Chin Mon Rakhine Shan (North) Shan (East) Shan (South) Ayeyarwady Bago Magway Mandalay Sagaing Tanintharyi Yangon New Settle- ment Area Union M Male Female Bs Both sexes II Percentage of children who eventually reach lost year of primary school (retention rote to lost year of primary school) Urban Rural Total M F B M F Bs 49 53 38 41 39 25 40 29 24 27 24 29 26 27 32 30 34 30 32 33 31 32 46 69 56 41 39 40 42 42 42 40 45 43 32 29 31 34 33 33 52 51 52 33 42 37 36 43 39 33 44 39 28 29 29 29 33 31 54 50 52 28 26 27 31 29 30 32 32 32 33 30 31 33 30 31 40 37 39 42 35 38 41 36 39 35 31 33 19 26 23 31 30 30 41.5 44.1 43.2 32.7 29.1 30.8 35.0 32.2 33.6 Percentage of children enrolled in primary school of primary school oge (net enrolment rote) Urban Rural Total M F F Bs 91 97 93 81 80 81 84 82 84 96 96 96 85 86 85 87 88 87 96 97 97 81 80 81 83 82 83 95 97 96 90 88 90 92 90 92 62 68 64 60 57 60 61 58 61 91 88 89 83 83 83 84 84 . 84 54 62 58 48 50 48 50 52 50 82 89 86 74 73 74 76 76 76 97 100 99 81 83 81 82 84 82 87 93 90 89 89 89 88 89 88 95 88 91 90 89 90 91 90 91 93 91 92 88 89 89 90 90 90 92 94 93 87. 88 88 i 90 91 90 87 82 85 79 80 80 86 84 86 90.3 92.0 1)1.1 83.8 83.9 83.9 85.1 85.2 85.2 Stote/ Division Kachin Kayah Kay in Chin Mon Rakhine Shan (North) Shan (East) Shan (South I Ayeyarwady Bago Mag way Mandalay Sagaing Tanintharyi Yangon Ne~Settle­ ment Area Union M Male Female Bs Both sexes Percentage of school entry oge children currently offending first yeor of primary school (primary school entry rote) Urbon Rurol Toto! M F ~ M F ~ M F ~ 82 85 95 94 83 I 78 94 68 79 61 79 I 79 81 80 65 75 66 72 89 100 94 78 73 75 80 77 79 100 92 . 97 56 55 56 63 59 61 100 88 94 86 85 85 89 86 88 74 44 60 44 31 38 48 33 41 92 85 88 75 75 75 76 76 76 34 1 32 56 60 j 66 62 64 35 33 43 31 38 42 37 79 63 84 81 100 100 100 . 65 75 69 68 77 72 73 93 84 75 84 80 75 86 81 100 87 95 83 80 82 88 82 85 M H M M M M , m m m , 70 75 67 71 . 70 70 I 70 66 68 I l 88.5 89.0 88.9 73.1 74.0 73.5 76.4 77.0 76.7 Percentage of children under fifteen currently enrolled in primary school (gross enrolment rote) Urbon Rurol Toto! M F ~ ~ M F ~ I M F ~ 107 115 110 132 128 130 126 125 126 124 125 124 1 118 108 114 120 110 116 133 117 124 118 113 116 121 114 117 132 123 128 124 117 121 125 118 122 113 117 115 123 111 118 121 113 117 84 96 89 97 95 . 86 95 77 87 1 04 1 00 1 02 119 118 119 117 115 116 67 79 73 70 87 78 69 85 76 112 110 Ill Ill 108 110 Ill 108 110 145 118 130 122 129 126 124 128 126 122 Ill 116 123 113 118 123 113 118 123 114 ll9 129 117 123 128 116 122 114 108 111 132 120 126 127 117 122 I 113 115 11~ 115 117 116 115 116 116 129 115 122 129 130 129 129 125 127 113 114 113 117 118 1 04 Ill 113 118.4 111.8 114.7 ~ 20.5 l 119 118 114 115 115 96 105 117 103 110 I 117.1 118.4 r l9.4 114.9 117.3 • Survey design and methodology The Myanmar MICS was carried out in accor- dance with the handbook produced by the Plan- ning Unit, Evaluation and Research Office, Programme Division of UNICEF, New York. 1. Sample design The Myanmar MiCS employed a two-stage, stratified cluster sampling design. The sampling frame was based on projected population data for 1993 on the basis of 1983 Population Census and 1991 Myanmar Population Change and Fertility Survey. 2. Stratification The whole of Myanmar was included in the MICS sampling frame, except areas where about 2 per cent of the population lives . These remote areas were omitted due to difficulties of communication and transport. The country was divided into a total of 17 strata. According to the administrative structure, each of the 14 states and divisions of the country repre- sents a stratum. Because of its vast surface area and diverse socio-economic conditions, Shan State was divided into three strata: Shan North, Shan South and Shan East. The new settlement town- ships in Yangon and Mandalay constituted a separate stratum. In these townships, the majority of the population can be categorized as the urban poor. These areas hold special interest for future programme implementation. 3. First stage sampling The first-stage units were defined as villages for rural areas and wards for urban areas. Villages and wards are the lowest administrative sub-divisions, each consisting of 250-300 households on average. First-stage units were selected using Probability Proportional to Estimated Size (PPES) separately for each stratum after excluding inaccessible wards and villages. Townships were listed geographically in a serpentine pattern before sample selection to obtain a wide spread of townships. Forty area- based clusters were selected from each stratum. A total of 680 clusters was included for the country. 4. Second stage sampling Within each sample cluster (village or ward), sub- clusters or segments were delineated in the field with the aid of map-sketching. Each segment contained an average of 40 households. Second stage selection was carried out in the field by selecting one segment per cluster randomly. Forty households within the selected segment were interviewed. The total household sample size was 27,200 households. II 5. Determination of sample size and sample selection For sample size determination, ORT use rate for children suffering from diarrhoea was considered as the indicator rare in occurrence, for which the target group were children of under-five. With the precision level of +I- .10 and .05 on the estimate prevalence rate, the sample size was calculated in terms of number of households nh in order to locate the required number of sample children, n in the age range. n = 4* p * (1-p) * deff I eA2 nh = no. of households required= 7.2 n, where n = no. of children under-five to be sampled in each state/division 7.2 = the average number of households which it is necessary to visit in order to find one child of under-five treated with ORT p = expected proportion of children of under-five with diarrhoea to have received ORT (based on 1993 COD Household Survey) deff = design effect e = amount of admissible error (e = .1 0 and .05) These figures were double-checked against rates derived from Myanmar's 1993 projected popula- tion figures and found to be very close to the latter. Using a sample of 1,600 households for each stratum or state/ division, sub-national estimates result in a 10 per cent margin of error. Using a sample of 27,200 households for the whole coun- try, national level estimates result in a 5 per cent margin of error. II The townships selected for MICS had a wide geographical spread. Out of a total of 324 townships in the country, 265 were included in the survey sample. The ratio of urban to rural populations covered by MICS was 1:2.6. According to 1993 projected population figures, the ratio of urban to rural populations is 1:2.56. Definitions used ~--------D_e_m_o~gr_ap_h_y ________ ~l ~~---------'-m_m_un_iz_at_io_n ________ ~ Infant mortality rote Number of deaths of children less than 12 months . . of age, per 1,000 live births. More specifically, this figure represents the probability of dying between birth and 12 months of age. Life expectancy at birth The number of years new born children will live if subjected to the mortality risks prevailing for the cross-section of population at the time of their birth. Under-five mortality rote Number of deaths of children under-five years of age per 1,000 live births. More specifically it represents the probability of dying between birth and five years of age. Maternal mortality rote Number of deaths of women due .to pregnancy related causes per 100,000 live births. Tetanus toxoid coverage of women Percentage of women who have received at least two doses of TT during last pregnancy or a last dose within appropriate interval for number of reported doses in lifetime. BCG/Meosles vaccination coverage among children 12-23 months of age Percentage of children 12-23 months of age given one dose of BCG and measles vaccine. DPT3/0PV3 coverage Percentage of children 12-23 months of age given third dose of DPT and OPV. 11 ____________ Nu_t_rit_io_n __________ ~ll ~----------0-ia_rr_h_oe_a_· --------~ Vitamin A supplementation Percentage of children under two years of age who received vitamin A supplement. Use of iodated salt Percentage of households using iodated salt regard- less of the level of iodization. Prevalence of malnutrition Percentage of children under 59 months who fall below -2 standard deviations (SDs) and -3SDs from the median weight-for-age of the NCHS/WHO standard. Exclusive breastfeeding Percentage of children less than 4 months of age who are exclusively breastfed. Timely complementary feeding Percentage of children 6 to 9 months of age who are receiving breastmilk and complementary foods. Continued breastfeeding Percentage of children 12 - 15 months, 20 - 23 months of age still breastfeeding. II ORT use rate (pre - 1993 definition) Percentage of diCJrrhoea episodes in under-fives treated with oral rehydration salts (ORS) and/ or recommended home fluids such as sugar-salt solution and/ or any other fluid prepared at home or outside. ORT use rate (post- 1993 definition) Percentage of all cases of diarrhoea episode, in the last two weeks, that received incr:eased amount of fluids and continued feeding. Increased fluids include all home made fluids, home available fluids, ORS and water. Continued feeding in- cludes all foods (including breastfeeding) regardless of the quantity of food - decreased, the same or increased. Water is considered as ORT in cases where feeding is conti :med. Acute Respiratory Infections Awareness regarding when to seek help for ARI Percentage of households where mothers know the danger signs of acute respiratory infections (rapid breathing, chest indrawing). I Education Enrolment rates Percentage of children of primary school age (5 - 9 years) enrolled in primary school. The figures represent net enrolment rates. Retention rates . Proportion of children entering first year of primary school of primary school-going age who eventually reach last year of primary school. Primary school entry rate Proportion of children of school-entry age who are currently attending first year of primary school. Water and Sanitation Use of sanitary latrines Percentage of households whose members use latrine facilities defined sanitary such as flush, pour flush and covered latrines within a conve- nient distance of less than 50 yards away from dwelling. Source of drinking water Percentage of houses collecting drinking water from the following sources - tube-well, tap, protected dug well or•protected spring. This figure does take into consideration the amount of water but the distance for convenience is defined as less than 500 yards from the house . II Abbreviations • Bs EPI F FIC HHs IDD M MDG MICS NA NCHS NGO NPA ORT PPES R SD SID T u Whole S/D - Both sexes Expanded Programme on Immunization Female Fully Immunized Children Households Iodine Deficiency Disorders Male Mid-Decade Goals Multiple Indicator Cluster Survey Not available National Centre for Health Statistics Non-Governmental Organization National Programme of Action Oral Rehydration Therapy Probability Proportional to Estimated Size Sampling Rural Standard Deviation State or Division Total Urban Whole State or Division ISBN 974-685-002-4

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