Republic of Macedonia: Monitoring the situation of children and women: Multiple Indicator Cluster Survey 2005-2006

Publication date: 2007

Republic of Macedonia Multiple Indicator Cluster Survey 2005-2006 Republic of Macedonia Monitoring the situation of children and women Multiple Indicator Cluster Survey 2005-2006 R epublic of M acedonia 2005-2006 M ultiple Indicator C luster S urvey M IC S State Statistical Office MICS IS B N 9 78 -9 98 9- 16 7- 91 -1 122 Multiple Indicator Cluster Survey - 2005-2006 1Republic of Macedonia REPUBLIC OF MACEDONIA Multiple Indicator Cluster Survey 2005-2006 STATE STATISTICAL OFFICE September 2007 2 Multiple Indicator Cluster Survey - 2005-2006 Contributors to the report: Suzana Stojanovska Vesna Dimitrovska Rut Feuk The Multiple Indicator Cluster Survey (MICS) in the Republic of Macedonia was carried by the State Statistical Office in cooperation and with technical and financial support from the United Nations Children’s Fund (UNICEF). The survey has been conducted as part of the third round of MICS surveys (MICS3), carried out around the world in more than 50 countries, in 2005-2006, following the first two rounds of MICS surveys that were conducted in 1995 and the year 2000. Survey tools are based on the models and standards developed by the global MICS project, designed to collect information on the situation of children and women in countries around the world. Additional information on the global MICS project may be obtained from www.childinfo.org. Financial support was also provided by the British Embassy in Skopje and the United Nations Development Programme (UNDP). Republic of Macedonia - Multiple Indicator Cluster Survey 2005-2006. Final Report, Skopje, State Statistical Office of the Republic of Macedonia. CIP - Katalogizacija vo publikacija Nacionalna i univerzitetska biblioteka “Sv. Kliment Ohridski”, Skopje 364-784/-785-053.2(497.7)”2005/06” 364-784/-785-053.2(497.7)”2005/06” 614.1-055.26(497.7)”2005/06” 614.1-053.2(497.7)”2005/06” MULTIPLE indicator cluster survey : 2005-2006 : final report / contributors to the report Suzana Stojanovska, Vesna Dimitrovska, Rut Feuk. - Skopje : State statistical office, 2007. - 174 str. : tabeli ; 29 sm ISBN 978-9989-167-91-1 a) Deca - Zdravstvena sostojba - Makedonija - 2005-2006 - Istra`uvawa b) @eni - Zdravstvena sostojba - Makedonija - 2005-2006 - Istra`uvawa COBISS.MK-ID 70467594 3Republic of Macedonia Summary Table of Findings Multiple Indicator Cluster Surveys (MICS) and Millennium Development Goals (MDG) Indicators, Republic of Macedonia, 2005-2006 Topic MICS Indicator Number MDG Indicator Number Indicator Value CHILD MORTALITY Child mortality 1 13 Under-five mortality rate 17 per 1000 2 14 Infant mortality rate 16 per 1000 NUTRITION Nutritional status 6 4 Underweight prevalence 2 percent 7 Stunting prevalence 9 percent 8 Wasting prevalence 2 percent Breastfeeding 45 Timely initiation of breastfeeding 27 percent 15 Exclusive breastfeeding rate 16 percent 16 Continued breastfeeding rate at 12-15 months at 20-23 months 45 22 percent percent 17 Timely complementary feeding rate 18 percent 18 Frequency of complementary feeding 17 percent 19 Adequately fed infants 16 percent 9 Proportion of low-birth -weight infants 6 percent 10 Proportion of infants weighed at birth 93 percent CHILD HEALTH Immunization 25 Tuberculosis immunization coverage 97 percent 26 Polio immunization coverage 81 percent 27 DPT immunization coverage 82 percent 28 15 Measles/Mumps/Rubella immunization coverage 80 percent 31 Fully immunized children 60 percent 34 Home management of diarrhoea 6 percent 35 Received ORT or increased fluids, and continued feeding 45 percent 23 Care seeking for suspected pneumonia 93 percent 22 Antibiotic treatment of suspected pneumonia 74 percent Solid fuel use 24 29 Solid fuels 36 percent ENVIRONMENT Water and Sanitation 11 30 Use of improved drinking water sources 99 percent 13 Water treatment 11 percent 12 31 Use of improved sanitation facilities 93 percent 14 Disposal of child’s faeces 50 percent REPRODUCTIVE HEALTH Contraception and unmet need 21 19c Contraceptive prevalence 14 percent 98 Unmet need for family planning 34 percent 99 Demand satisfied for family planning 29 percent Maternal and newborn health 20 Antenatal care 98 percent 44 Content of antenatal care 99 percent 4 17 Skilled attendant at delivery 98 percent 5 Institutional deliveries 98 percent CHILD DEVELOPMENT Child development 46 Support for learning 85 percent 47 Father’s support for learning 61 percent 48 Support for learning: children’s books 49 percent 49 Support for learning: non-children’s books 51 percent 50 Support for learning: materials for play 1 percent 51 Non-adult care 9 percent EDUCATION 4 Multiple Indicator Cluster Survey - 2005-2006 Topic MICS Indicator Number MDG Indicator Number Indicator Value Education 52 Pre-school attendance (age 3-4 years) 11 percent 53 School readiness 76 percent 54 Net intake rate in primary education 95 percent 55 6 Net primary school attendance rate 95 percent 56 Net secondary school attendance rate 63 percent 58 Transition rate to secondary school 95 percent 59 7b Primary completion rate 83 percent 61 9 Gender parity index primary school secondary school 0.96 1.15 ratio ratio Literacy 60 8 Adult literacy rate 97 percent CHILD PROTECTION Birth registration 62 Birth registration 94 percent Child labour 71 Child labour 6 percent 72 Labourer students 94 percent 73 Student labourers 6 percent Child discipline 74 Child discipline Any psychological/physical punishment 69 percent Early marriage 67 Marriage before age 15 Marriage before age 18 1 12 percent percent 68 Young women aged 15-19 currently married/in union 2 percent 69 Spousal age difference 10 percent Domestic violence 100 Attitudes towards domestic violence 21 percent Disability 101 Child disability 10 percent HIV/AIDS, SEXUAL BEHAVIOUR, AND ORPHANED AND VULNERABLE CHILDREN HIV/AIDS knowledge and attitudes 82 19b Comprehensive knowledge about HIV prevention among young people 24 percent 89 Knowledge of mother- to-child transmission of HIV 56 percent 86 Attitude towards people with HIV/AIDS 16 percent 87 Women who know where to be tested for HIV 45 percent 88 Women who have been tested for HIV 3 percent 90 Counselling coverage for the prevention of mother-to-child transmission of HIV 12 percent Sexual behaviour 84 Age at first sex among young people 1 percent 92 Age-mixing among sexual partners 5 percent 83 19a Condom use with non-regular partners 70 percent 85 Higher risk sex in the last year 80 percent Orphanhood 75 Prevalence of orphans 2 percent 78 Children’s living arrangements 0.4 percent 5Republic of Macedonia Table of Contents Summary Table of Findings .3 Table of Contents .5 List of Tables .7 List of Figures .9 List of Abbreviations .10 Acknowledgements .11 Executive Summary .12 I. Introduction .15 Background .15 Survey Objectives .16 II. Sample and Survey Methodology .17 Sample Design .17 Questionnaires .19 Training and Fieldwork .19 Data Processing .19 III. Sample Coverage and the Characteristics of Households and Respondents .21 Sample Coverage .21 Characteristics of Households .21 Characteristics of Respondents .22 IV. Child Mortality .23 V. Nutrition .25 Nutritional Status .25 Breastfeeding .26 Low Birth Weight .28 VI. Child Health .31 Immunization .31 Oral Rehydratation Treatement .32 Care Seeking and Antibiotic Treatment of Pneumonia .34 Solid Fuel Use .35 VII. Environment .37 Water and Sanitation .37 VIII. Reproductive Health .41 Contraception .41 Antenatal Care .42 Assistance at Delivery .43 IX. Child Development .45 X. Education .47 Pre-School Attendance and School Readiness .47 Primary and Secondary School Participation .48 Adult Literacy .49 6 Multiple Indicator Cluster Survey - 2005-2006 XI. Child Protection .51 Birth Registration .51 Child Labour .51 Child Discipline .52 Early Marriage .53 Domestic Violence .54 Child Disability .54 XII. HIV/AIDS, Sexual Behaviour, and Orphaned Children .55 Knowledge of HIV Transmission and Condom Use .55 Sexual Behaviour Related to HIV Transmission .58 Children’s Living Arrangements and Orphanhood .59 Tables .61 List of References .121 Appendixes .123 Appendix A. List of Personnel Involved in the Survey .125 Appendix B. Sample Design .128 Appendix C. Estimates of Sampling Errors .129 Appendix D. Data Quality Tables .142 Appendix E. MICS Indicators: Numerators and Denominators .149 Appendix F. Questionnaires .153 7Republic of Macedonia List of Tables Table HH.1: Results of household and individual interviews .62 Table HH.2: Household age distribution by sex .62 Table HH.3: Household composition .63 Table HH.4: Women’s background characteristics .64 Table HH.5: Children’s background characteristics .65 Table CM.1: Child mortality .66 Table CM.2: Children ever born and proportion dead .66 Table NU.1: Child malnourishment .67 Table NU.2: Initial breastfeeding .68 Table NU.3: Breastfeeding .69 Table NU.3w. Infant feeding patterns by age .70 Table NU.4: Adequately fed infants .71 Table NU.8: Low birth weight infants .72 Table CH.1: Vaccinations in first year of life .73 Table CH.2: Vaccinations by background characteristics .73 Table CH.4: Oral rehydration treatment .74 Table CH.5: Home management of diarrhoea .75 Table CH.6: Care seeking for suspected pneumonia .76 Table CH.7: Antibiotic treatment of pneumonia .77 Table CH.7A: Knowledge of the two danger signs of pneumonia .78 Table CH.8: Solid fuel use .79 Table CH.9: Solid fuel use by type of stove or fire .80 Table EN.1: Use of improved water sources .81 Table EN.2: Household water treatment .82 Table EN.3: Time to source of water .83 Table EN.4: Person collecting water .83 Table EN.5: Use of sanitary means of excreta disposal .84 Table EN.6: Disposal of child’s faeces .85 Table EN.7: Use of improved water sources and improved sanitation .86 Table RH.1: Use of contraception .87 Table RH.2: Unmet need for contraception .88 Table RH.3: Antenatal care provider .89 Table RH.4: Antenatal care .90 Table RH.5: Assistance during delivery .91 Table CD.1: Family support for learning .92 Table CD.2: Learning materials .93 Table CD.3: Children left alone or with other children.94 Table ED.1: Early childhood education .95 Table ED.2: Primary school entry .96 Table ED.3: Primary school net attendance ratio .97 Table ED.4: Secondary school net attendance ratio .98 Table ED. 4W: Secondary school age children attending primary school .99 Table ED.6: Primary school completion and transition to secondary education .100 Table ED.7: Education gender parity .101 Table ED.8: Adult literacy .102 Table CP.1: Birth registration .103 Table CP.2: Child labour .104 Table CP.3: Labourer students and student labourers .105 Table CP.4: Child discipline .106 Table CP.5: Early marriage .107 Table CP.6: Spousal age difference .108 8 Multiple Indicator Cluster Survey - 2005-2006 Table CP.9: Attitudes toward domestic violence .109 Table CP.10: Child disability .110 Table HA.1: Knowledge of preventing HIV transmission .111 Table HA.2: Identifying misconceptions about HIV/AIDS .112 Table HA.3: Comprehensive knowledge of HIV/AIDS transmission .113 Table HA.4: Knowledge of mother-to-child HIV transmission .114 Table HA.5: Attitudes toward people living with HIV/AIDS .115 Table HA.6: Knowledge of a facility for HIV testing .116 Table HA.7: HIV testing and counselling coverage during antenatal care .117 Table HA.8: Sexual behaviour that increases risk of HIV infection .118 Table HA.9: Condom use at last high-risk sex .119 Table HA.10: Children’s living arrangements and orphanhood .120 9Republic of Macedonia List of Figures Figure HH.1: Age and sex distribution of household population . .21 Figure CM.1: Under-5 mortality rates by background characteristics .24 Figure CM.2: Children ever born and proportion dead .24 Figure NU.1: Percentage of children under age five who are undernourished .26 Figure NU.2: Percentage of mothers who started breastfeeding within one hour and within one day of birth .27 Figure NU.3: Infant feeding patterns by age: Percentage distribution of children aged under 3 years by feeding pattern by age group .28 Figure NU.5: Percentage of Infants Weighing Less Than 2500 Grams at Birth, Republic of Macedonia, 2005 .29 Figure CH.1: Percentage of children aged 12-23 months who received the recommended vaccination by 12 months .32 Figure CH.2: Percentage of children aged 18-29 months currently vaccinated against childhood diseases, Republic of Macedonia, 2005.32 Figure CH.3: Percentage of children aged 0-59 months with diarrhoea who received oral rehydration treatment .33 Figure CH.4: Percentage of children aged 0-59 months with diarrhoea who received ORT or increased fluids, AND continued feeding .34 Figure EN.1: Percentage distribution of household members by source of drinking water 37 Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission .57 Figure HA.2: Sexual behaviour that increases risk of HIV infection .58 10 Multiple Indicator Cluster Survey - 2005-2006 List of Abbreviations AIDS Acquired Immune Deficiency Syndrome BCG Bacillis-Cereus-Geuerin (Tuberculosis) CSPro Census and Survey Processing System DPT Diphteria Pertussis Tetanus EPI Expanded Programme on Immunization GPI Gender Parity Index (female to male ratio of primary school or secondary school attendance) HIV Human Immunodeficiency Virus IUD Intrauterine Device LAM Lactational Amenorrhea Method MDG Millennium Development Goals MICS Multiple Indicator Cluster Survey MoH Ministry of Health NAR Net Attendance Rate ppm Parts Per Million ORT Oral Rehydration Treatment SPSS Statistical Package for Social Sciences UNAIDS United Nations Programme on HIV/AIDS UNDP United Nations Development Programme UNFPA United Nations Population Fund UNGASS United Nations General Assembly Special Session on HIV/AIDS UNICEF United Nations Children’s Fund WFFC World Fit for Children WHO World Health Organization 11Republic of Macedonia Acknowledgements The State Statistical Office, responsible for implementing MICS-2005 in Republic of Macedonia (Multiple Indicator Cluster Survey on children’s and women’s situation) expresses its gratitude to the United Nations Children’s Fund (UNICEF) for providing methodological and advisory assistance in conducting the survey. We would particularly like to thank the British Embassy, UNICEF and UNDP for their generous financial contributions. UNICEF also contributed funding for training and equipment and technical support through its offices in Republic of Macedonia, Geneva and New York. The UNICEF country and regional offices and the Global MICS team provided invaluable and ongoing support and we hope to continue to work in such a productive way in future. The four regional workshops arranged for survey teams for thirteen countries currently using this methodology were very useful to ensure that the survey met high international standards and increased the skills and knowledge of our survey teams. Special thanks to Mr. Trevor Croft for his kind and professional technical assistance and for providing quality control. We address special thanks to the survey team comprised of a large number of people and institutions. Over one hundred people were involved in technical and field work. The survey teams, including coordinators, field staff and data entry staff, carried out the work diligently. We would like to thank the 5 287 households, which agreed to participate and be interviewed. We would also like to thank the following Ministries and other organizations for their excellent cooperation: Ministry of Health - including the Republic Institute for Health Protection; Ministry of Education and Science; Ministry of Local-Self Governance; Ministry of Labour and Social Policy; Ministry of Environment and Physical Planning; and World Health Organization. 12 Multiple Indicator Cluster Survey - 2005-2006 The 2005 Republic of Macedonia Multiple Indicator Cluster Survey (MICS) is a nationally representative survey of households, women and children. The main objectives of the survey are to provide up-to-date information for assessing the situation of children and women in Republic of Macedonia, and to supply the data needed for monitoring progress towards the World Fit for Children goals. In addition, the purpose of the MICS survey is to provide data needed for evaluating how far we have come midway into the decade in reaching the child-related Millennium Development Goals (MDGs). Fieldwork was conducted in the period November 2005. Education Eleven percent of children aged 36-59 months are attending early childhood education. The attendance is almost ten times higher in urban areas than rural areas. Overall, 95 percent of children of primary school age (ages7-14) in Republic of Macedonia are attending primary school (at 2005/2006 school year). There is virtually no difference between male/female and urban/rural rates. Overall, 63 percent of children of secondary school age (ages 15–18) in Republic of Macedonia are attending secondary school. There is a higher proportion of girls (68 percent) of this age attending secondary school than that of boys (59 percent). In urban areas, 71 percent of children attend school while in rural areas 56 percent attend. Water and Sanitation Ninety one percent of the population has water that is piped either into the dwelling or the yard/ plot. Such access is higher in urban areas (96 percent) than in rural areas (84 percent). In rural areas, 10 percent of the population has a tubewell/borehole with a pump and 4 percent has a protected well. Ninety three percent of the population use sanitary means of excreta disposal. Ninety percent have a flush toilet connected either to a sewage system or septic tank. Septic tanks are much more common in rural areas; 53 percent of the rural population use a septic tank, whereas in urban areas 12 percent of the population fall into this category. Child Malnutrition Two percent of children under age five are underweight, 9 percent are too short for their age (stunted) and 2 percent are too thin for their height (wasted). Children whose mothers have secondary education are the least likely to be underweight and stunted compared to children of mothers with less education. Breastfeeding Approximately 16 percent of children aged less than six months are exclusively breastfed, a level considerably lower than recommended. At age 6- 9 months, 18 percent of children are receiving breast milk and solid or semi-solid foods. By age 20-23 months, 22 percent continue to be breastfed. Immunization Ninety seven percent of children aged 18-29 months received a BCG vaccination by the age of 12 months and the first dose of DPT was given to 94 percent. The percentage declines for subsequent doses of DPT to 90 percent for the second dose, and 82 percent for the third dose. Similarly, 95 percent of children received Polio 1 by age 12 months and this declines to 81 percent by the third dose. Eighty percent of children received a measles vac- cine (in the form of the measles -mumps - rubella (MMR) vaccine) by the age of 18 months. Sixty percent of children had all eight recom- mended vaccinations according to the national immunization schedule. Acute Respiratory Infection Six percent of under five children had an acute respiratory infection in the two weeks prior to the survey. Virtually all of these children were taken to an appropriate health provider. Executive Summary 13Republic of Macedonia Integrated Management of Childhood Infections (IMCI) Among children under five who were reported to have had diarrhoea in the two weeks preceding the MICS, 45 percent received ORT or increased fluids and continued feeding as recommended under the IMCI program. Thirty seven percent of mothers/caretakers who recognized the two danger signs of pneumonia indicating that a child should be taken immediately to a health facility. Seventy four percent of mothers reported administering an antibiotic to a child suffering from suspected pneumonia in the two last weeks. HIV/AIDS Twenty two percent of women aged 15-49 know three ways to prevent the sexual transmission of HIV transmission: 61 percent believe that having only one faithful uninfected sex partner can prevent HIV transmission, 60 percent believe that using a condom during each act of sexual intercourse, and abstaining from sex (28 percent), can prevent HIV transmission. This proportion is higher among women with more education. Thirty two percent of women aged 15-49 correctly identified three misconceptions about HIV transmission and infection -that HIV cannot be transmitted by sharing food, or by supernatural means, and that a healthy-looking person can be infected with HIV. Sixty two percent of women of reproductive age know all three ways in which HIV can be transmitted from mother to child. Forty five percent of women know a place to get tested for HIV. Three percent had been tested of whom 92 percent had been given the result. Eighty four percent of women express a discriminatory attitude towards people with HIV/ AIDS. Twenty four percent of women have comprehen- sive knowledge of HIV/AIDS transmission, with the proportion having comprehensive knowledge being strongly positively associated with the woman`s level of education. Contraception Current use of contraception was reported by 14 percent of married or in union women. The most popular method is condom, which is used by 5 percent of married women, followed by pill and diaphragm. Antenatal Care Virtually all women in Republic of Macedonia receive some type of prenatal care and 98 percent receive antenatal care from skilled personnel (doctor, nurse, midwife). Assistance at Delivery In the two years prior to the survey, 84 percent of deliveries were assisted by a medical doctor and 14 percent by a nurse/midwife. Less than 1 percent of deliveries did not have any assistance at delivery. Birth Registration The births of 94 percent of children under five years of age in Republic of Macedonia have been registered. There are no significant variations in birth registration across sex, age, urban/rural or education categories. Child Labour Six percent of children age 5-14 are involved in some form of child labour. Less than 1 percent of children 5-14 years old engage in paid work. About 3 percent participate in unpaid work outside the household, and 3 percent of children are engaged in family businesses. Orphaned Children and Living Arrangements of Children Overall 94 percent of children aged 0-17 are living with both parents. Children who are not living with a biological parent comprise 0.4 percent, but children for whom one or both parents are dead amount to almost 2 percent of all children aged 0-17 years. It is more likely that a father will be dead than a mother. 14 Multiple Indicator Cluster Survey - 2005-2006 15Republic of Macedonia Background This report is based on the Republic of Macedo- nia Multiple Indicator Cluster Survey, conducted in 2005 by the State Statistical Office (SSO). The survey provides valuable information on the situation of children and women in Republic of Macedonia and was based, in large part, on the needs to monitor progress towards goals and tar- gets emanating from recent international agree- ments: the Millennium Declaration, adopted by all 191 United Nations Member States in Septem- ber 2000, and the Plan of Action of A World Fit For Children, adopted by 189 Member States at I Introduction the United Nations Special Session on Children in May 2002. Both of these commitments build upon promises made by the international commu- nity at the 1990 World Summit for Children. In signing these international agreements, gov- ernments committed themselves to improving conditions for their children and to monitoring progress towards that end. UNICEF was assigned a supporting role in this task (see table below). The Macedonian Government released its first report on the Millennium Development Goals Table 1.1 A Commitment to Action: National and International Reporting Responsibilities The governments that signed the Millennium Declaration and the World Fit for Children Declaration and Plan of Action also committed themselves to monitoring progress towards the goals and objectives they contained: “We will monitor regularly at the national level and, where appropriate, at the regional level and assess progress towards the goals and targets of the present Plan of Action at the national, regional and global levels. Accordingly, we will strengthen our national statistical capacity to collect, analyse and disaggregate data, including by sex, age and other relevant factors that may lead to disparities, and support a wide range of child-focused research. We will enhance international cooperation to support statistical capacity-building efforts and build community capacity for monitoring, assessment and planning.” (A World Fit for Children, paragraph 60) “…We will conduct periodic reviews at the national and subnational levels of progress in order to address obstacles more effectively and accelerate actions.…” (A World Fit for Children, paragraph 61) The Plan of Action (paragraph 61) also calls for the specific involvement of UNICEF in the preparation of periodic progress reports: “… As the world’s lead agency for children, the United Nations Children’s Fund is requested to continue to prepare and disseminate, in close collaboration with Governments, relevant funds, programmes and the specialized agencies of the United Nations system, and all other relevant actors, as appropriate, information on the progress made in the implementation of the Declaration and the Plan of Action.” Similarly, the Millennium Declaration (paragraph 31) calls for periodic reporting on progress: “…We request the General Assembly to review on a regular basis the progress made in implementing the provisions of this Declaration, and ask the Secretary-General to issue periodic reports for consideration by the General Assembly and as a basis for further action.” 16 Multiple Indicator Cluster Survey - 2005-2006 (MDGs) in June 2005. The report was structured around the eight MDGs and provided MDG indicators which were adapted to the country’s national development context. Of the 48 MDG indicators, there are currently 12 for which the SSO has appropriate data. The MICS survey has generated data for another 9 indicators, not previously available in the country. A National Action Plan for Children was adopted by the government in February 2005, which reviewed progress made and steps to take to improve the situation of children in the country. The plan will serve as the basis for policy formulation on children’s rights for the next 10 years. The Macedonian government has prepared its first report to the Committee on the Rights of the Child (CRC) and has reported on the progress made against the World Fit for Children (WFFC) goals. The MICS data is very timely for providing a valu- able evidence-base for these ongoing processes. This final report presents the results of the indica- tors and topics covered in the survey. Survey Objectives The 2005 Republic of Macedonia Multiple Indicator Cluster Survey has as its primary objectives:  To provide up-to-date information for assessing the situation of children and women in Republic of Macedonia;  To furnish data needed for monitoring progress toward goals established by the Millennium Declaration, the goals of A World Fit For Children (WFFC), and other internationally agreed upon goals, as a basis for future action;  To contribute to the improvement of data and monitoring systems in Republic of Macedonia and to strengthen technical expertise in the design, implementation, and analysis of such systems. 17Republic of Macedonia Sample Design The sample for the Republic of Macedonia Multiple Indicator Cluster Survey (MICS) was designed to provide estimates on a large number of indicators on the situation of children and women at the national level, and for some of the indicators at lower levels (urban and rural areas, and for eight regions). In addition, the sample was designed to provide reliable estimates of many indicators for the Roma population. The Republic of Macedonia MICS 2005 sample design used a stratified two stage model, where geographical strata are 8 NUTS3 (Nomenclature of territorial units for statistics) regions (Skopski Region, Pelagoniski Region, Vardarski Region, North-East Region, South-West Region, South- East Region, Poloski Region and East Region.), and 2 strata (urban and rural) in each region, yielding 16 strata. A total sample of 5250 households was designed, with 350 clusters selected and 15 households selected within each cluster. The sample is further stratified to include specific strata for the Roma population, dividing all strata into Roma and non-Roma strata, yielding an additional 12 strata (4 of the original strata did not have clusters selected for the Roma sub- sample), with 70 clusters being allocated for the Roma population of the original 350. The sample frame is the Population Census from 2002, using data on subpopulations of women aged from 12-46 year, children from 0-2 and the Roma population. II Sample and Survey Methodology The allocation of clusters to each domain was performed by taking the number of women aged 12-46 from the Census 2002 data and using the ratio of the number of women in each stratum to the total to determine the distribution of the clusters to each stratum (350* mj/∑mj, where mj is the number of woman aged 12-46 in the strata according to the 2002 Census), as follows: 18 Multiple Indicator Cluster Survey - 2005-2006 Selection of clusters The selection of clusters was performed by generating a list of all clusters in each stratum, ordered by the total number of women aged 12- 46 at the time of the census in 2002 (who would be 15-49 at the time of the survey in 2005), with the cluster with the largest number of women listed first. From this list, the first K clusters were selected, where K is the number of clusters to be selected in the stratum, according to the selection table above. This selection of the clusters with the largest numbers of women has led to a bias in the overall sample selected, in particular clusters containing households with larger than average numbers of household members. As households with large numbers of members tend to be from the poorer communities, this bias is likely to produce results that are somewhat worse than the true picture of the population. After reviewing the results, however, the overall bias does not appear to be large, but may vary in different regions. Selection of households within clusters Fertility levels in Republic of Macedonia are low and households with a child under 5 account for less than 20 percent of households nationally. As these levels would require a very large overall sample to provide a sufficiently large sample for estimates for children under 5, households with children under the age of 5 were over sampled. The selection of households was performed by sorting the list of households in each cluster into two groups: households with children under 5, and those without children under 5. From these two groups, 12 households were to be selected from the first group and 3 households from the second group. The information concerning the identification of households with children under 5 was based on the 2002 census data, for children aged 0, 1 and 2 at the time of the census (Nov. 1, 2002), and updated with information on households registering a birth in 2003 and 2004 according to vital registration data for 2003 and 2004 respectively. The selection of the 12 households was per- formed by using random selection within the first group. Within the second group, the households were ordered according to whether the household had an eligible woman (eligibility for the women’s survey was defined as women aged 12-46 ac- cording to the census data) or not, with house- holds with eligible women being listed before those without eligible women. The selection of the 3 households in the second group was again performed randomly. Separate weighting of data is necessary for each household depending on the urban and rural strata in the 8 regions, as well whether the sample cluster was from the Roma sub sample or not, and whether it belonged to the group of households with children under 5 or the group of households without children under 5. Additionally, the household member data and the individual women’s questionnaire data are further weighted Region Region (HH7) Urban/ Rural (HH6) Total ED Total Women 12-46 Roma Women 12-46 Total Clusters Roma Clusters Non-Roma Clusters Skopski (Skopje) 1 1 1435 113833 6627 75 31 44 1 2 400 37555 426 25 1 24 Pelagoniski (Bitola) 2 1 593 40204 1987 26 9 17 2 2 478 17239 28 12 0 12 Vardarski (Veles) 3 1 293 24752 425 16 1 15 3 2 202 9096 158 6 2 4 North-East (Kumanovo) 4 1 246 27219 1383 18 6 12 4 2 374 17391 24 12 0 12 South-West (Ohrid) 5 1 278 27273 751 18 4 14 5 2 438 31472 99 21 1 20 South-East (Strumica) 6 1 267 19655 98 14 0 14 6 2 353 24291 58 16 0 16 Poloski (Tetovo) 7 1 267 25404 1267 17 4 13 7 2 590 60613 137 40 1 39 East (Stip) 8 1 472 34709 1877 23 9 14 8 2 419 16804 100 11 1 10 Total 7105 527510 15445 350 70 280 19Republic of Macedonia to adjust for biases in the distribution by age group and sex to match the census distribution. Questionnaires Three sets of questionnaires were used in the survey: 1) a household questionnaire which was used to collect information on all de jure household members (usual residents of the household), the household, and the dwelling; 2) a women’s questionnaire administered in each household to all women aged 15-49 years; and 3) an under-5 children’s questionnaire, administered to mothers or caretakers of all children under 5 living in the household. The questionnaires included the following modules: The Household Questionnaire included the following modules:  Household Listing  Education  Water and Sanitation  Household Characteristics  Child Labour  Child Discipline  Disability The Questionnaire for Individual Women was administered to all women aged 15-49 years living in the households, and included the following modules:  Child Mortality  Maternal and Newborn Health  Marriage/Union  Contraception  Attitudes Towards Domestic Violence  Sexual Behaviour  HIV/AIDS The Questionnaire for Children under-5 was administered to mothers or caretakers of children under-5 years of age1 living in the households. Normally, the questionnaire was administered to mothers of under-5 children; in cases when the mother was not listed in the household roster, a primary caretaker for the child was identified and interviewed. The questionnaire included the following modules:  Birth Registration and Early Learning  Child Development  Breastfeeding  Care of Illness  Immunization  Anthropometry The questionnaires are based on the MICS3 model questionnaire2. From the MICS3 model English version, the questionnaires were translated into Macedonian and Albanian languages and were pre-tested in eight municipalities in urban and rural areas, during 13-14 October 2005. Based on the results of the pre-test, modifications were made to the wording and translation of the questionnaires. A copy of the Republic of Macedonia MICS questionnaires is provided in Appendix F. Training and Fieldwork Training for the fieldwork was conducted for 15 days in 5 cities: Kumanovo, Tetovo, Skopje, Stip and Ohrid, (3 days at each point) from October 17 to October 31, 2005. Training included lectures on interviewing techniques and the contents of the questionnaires, and mock interviews between trainees to gain practice in asking questions. Towards the end of the training period, trainees spent 2 days in practice interviewing in 8 municipalities within the Skopski region. Data was collected by 20 teams; each comprised 4 interviewers, one driver, one editor/measurer and a supervisor. Fieldwork began on November 4 and concluded on November 30, 2005. Data Processing Data was entered using the CSPro software. The data was entered on 20 microcomputers and carried out by 20 data entry operators and 4 data entry supervisors. In order to ensure quality control, all questionnaires were double entered and internal consistency checks were performed. Procedures and standard programs developed under the global MICS3 project and adapted to Republic of Macedonia questionnaire were used throughout. Data processing began simultaneously with data collection on November 10, 2005 and was completed on December 15, 2005. Data was analysed using the Statistical Package for Social Sciences (SPSS) software program, Version 14, and the model syntax and tabulation plans developed by UNICEF for this purpose. 20 Multiple Indicator Cluster Survey - 2005-2006 21Republic of Macedonia III Sample Coverage and the Characteristics of Households and Respondents Table HH.2 and Figure HH.1 show the five-year age distribution of household members by sex. This distribution is almost the same for male and female. Due to the low fertility, there is a small number of children in the 0-4 age group. The largest number of persons is found in the 15-19 age group. The number in each age group then steadily declines up to the age group 30-34 with a slight increase in the 35-39 age group. After 40 years of age, the population starts to fall slowly, until age 55 when there is a bigger decline. The male/female ratio shows some variations over the first 50 years of life and then the number of women definitely exceeds that of men. Twenty six percent of the population comprises the group of children aged 0-17. The proportion of males who are children is slightly higher compared to females who are children (27 versus 25 percent). Sample Coverage Originally, 5250 households were selected for the sample. During the fieldwork the number of households identified increased to 5379, due to the fact that in some cases, more than one household was found in one dwelling. In these cases, the MICS3 guidelines were followed, and in the cases where two households were found in one dwelling, both households were included in the survey. Of the total of 5379 households, 5287 were found to be occupied. Of these, 4701 were successfully interviewed for a household response rate of 89 percent. In the interviewed households, 7539 women (age 15-49) were iden- tified. Of these, 7397 were successfully inter- viewed, yielding a response rate of 98 percent. In addition, 4578 children under age five were listed in the household questionnaire. Of these, questionnaires were completed for 4548, which corresponds to a response rate of 99 percent. Overall response rates of 87 and 88 percent are calculated for the women’s and under-5’s inter- views respectively (Table HH.1). The response rates were similar across regions and areas. Characteristics of Households The age and sex distribution of the survey population is provided in Table HH.2. The distribution is also used to produce the population pyramid in Figure HH.1. In the 4701 households successfully interviewed in the survey, 26 423 household members were listed. Of these, 13 249 were male, and 13 174 were female. These figures also indicate that the survey estimated the average household size at 5.6 household members which is appropriate to the data from the 2002 census (5.5). Figure HH.1: Age and sex distribution of household population, Republic of Macedonia, 2005 Percent  Males  Females 22 Multiple Indicator Cluster Survey - 2005-2006 The artificially large population at the end of the curve results from the fact that all people over the age of 70 were considered a single group. Table HH.3 provides basic background information on the households. Within households, the sex of the household head, region, urban/rural status, number of household members, and ethnicity3 group of the household head are shown in the table. These background characteristics are also used in subsequent tables in this report; the figures in the table are also intended to show the numbers of observations by major categories of analysis in the report. The weighted and unweighted numbers of households are equal, since sample weights were normalized (See Appendix B). The table also shows the proportions of households where at least one child under 18, at least one child under 5, and at least one eligible woman age 15-49 were found. About 61 percent of the households are urban and 39 percent of households are rural. The Skopski region comprises the largest of the eight regions with 26 percent of households while East region is the next largest with 14 percent. According to the ethnic group of the head of the household, 65 percent are Macedonian, 25 percent are Albanian and about 3 percent are Roma. Most of the households have between 2 and 7 members. Twenty percent of the households contain at least one child under age five and 97 percent contain at least one woman age 15-49. Note that the weighted and unweighted numbers of cases varies quite widely for some characteristics, such as the number of household members and ethnic group of head. This is due to the over sampling of households with children under the age of 5 and of Roma households and is to be expected with the complex sample design used in this survey. Because of the complex nature of the sample design, even after weighting of the data there may be some characteristics for which the sample distribution according to certain characteristics does not match with the census distribution for those same characteristics. Characteristics of Respondents Tables HH.4 and HH.5 provide information on the background characteristics of female respondents 15-49 years of age and of children under age 5. In both tables, the total numbers of weighted and unweighted observations are equal, since sample weights have been normalized (standardized). In addition to providing useful information on the background characteristics of women and children, the tables are also intended to show the numbers of observations in each background category. These categories are used in the subsequent tabulations of this report. Table HH.4 provides background characteristics of female respondents 15-49 years of age. The table includes information on the distribution of women according to region, urban-rural areas, age, marital status, motherhood status, education4, wealth index quintiles5, and ethnicity. Women aged 15-19 comprise the greatest percentage of the sample at around 15 percent. This percentage declines steadily across age groups until age 45- 49 where it is 13 percent. Approximately 58 percent of women in the sample are currently married and 59 percent have ever had a birth. The majority of women have had at least some secondary education while only 4 percent have had no education. According to the ethnic group of the head of the household, the percentage of women is larger in the Macedonian group (61 percent) than the Albanian group (29 percent). Women from Roma ethnic group comprise 3 percent of the sample. Some background characteristics of children under 5 are presented in Table HH.5. These include distribution of children by several attributes: sex, region and area of residence, age in months, mother’s or caretaker’s education, wealth, and ethnicity. Fifty three percent of the children are male and forty seven percent are female. The age distribution of children under five is well balanced. Approximately 7 percent of mothers of children under age five have no education, while the majority of mothers (55 percent) have primary education. Note that, for children whose mothers did not live in the household, the education of the child’s caretaker is used. According to the ethnic group of the head of the household, the percentage of children under five is larger in the Albanian group (about 46 percent) than the Macedonian group (38 percent). This differs from the distribution of children by ethnic group found in the census where 6 percent of the total population of children under-5 are Macedonian and 2 percent of children under 5 are Albanian. This difference may be the result of the complex sample design and the potential bias described earlier. 23Republic of Macedonia IV Child Mortality One of the overarching goals of the Millennium Development Goals (MDGs) and the World Fit for Children (WFFC) is to reduce infant and under- five mortality. Specifically, the MDGs call for the reduction in under-five mortality by two-thirds between 1990 and 2015. Monitoring progress towards this goal is an important but difficult objective. Measuring childhood mortality may seem easy, but attempts using direct questions, such as “Has anyone in this household died in the last year?” give inaccurate results. Using direct measures of child mortality from birth histories is time consuming, more expensive, and requires greater attention to training and supervision. Alternatively, indirect methods developed to measure child mortality produce robust estimates that are comparable with the ones obtained from other sources. Indirect methods minimize the pitfalls of memory lapses, inexact or misinterpreted definitions, and poor interviewing technique. The infant mortality rate is the probability of dying before the first birthday. The under-five mortality rate is the probability of dying before the fifth birthday. In the Republic of Macedonia MICS, infant and under five mortality rates are calculated based on a variant of the indirect estimation technique known as the Brass method (United Nations, 1983; 1990a; 1990b). For the application of the technique, women are classified into 5-year groups of time since first birth (TSFB), namely 0-4, 5-9, 10-14, 15-19 and 20-24 years, and average numbers of children ever born and proportion dead among these children are calculated for each group of women. The proportions dead calculated for each group are very closely related to mortality risks. The technique converts the proportions dead into conventional mortality risks by using several assumptions in regard to the length of exposure to the risk of dying among children born to each group of women, on the distribution of deaths of children over time, and on the level and pattern of fertility prevalent in the population. Simulations on model data have shown that proportions dead by TSFB groups of women can be converted into probabilities of dying by using modelled relationships, namely into 2q0 (probability of dying before age 2) for proportion dead among children of women in the 0-4 years TSFB group, under- 5 mortality rates for the 5-9, 10-14 and 15-19 year TSFB groups, and 15q0 (probability of dying before age 15) for the 20-24 years TSFB group. The technique also time-locates these estimates, again by using several assumptions. This is necessary because children of women who have had their first births long ago have been exposed to mortality risks for a longer period of time, and therefore, their mortality experience refers to farther back in time, compared to that of children born to women who have had their first births recently. The final step in the calculations is the conversion of the estimated mortality risks into comparable probabilities of dying for each estimate derived from different TSFB groups of women. The so- called Coale-Demeny model life tables are used for this purpose. Coale-Demeny model life tables are life table schedules at different levels of mortality, that embody typical age patterns of mortality in human populations, categorized into 4 ‘families’ of such typical patterns – North, South, East and West models. Using typical relationships between 2q0, 5q0 and 15q0 and the infant mortality rate embodied in these model life tables, the initial estimates of mortality are converted into 24 Multiple Indicator Cluster Survey - 2005-2006 infant mortality rates, while the estimates of 2q0 and 15q0 are converted into estimates of 5q0 (Note that the 5-9, 10-14 and 15-19 year TSFB groups produce estimates of under-5 mortality rates at the initial calculation stage). By expressing mortality risks at different points in time with the same indicator, it then becomes possible to show trends in mortality during the last 15-20 years. For the calculations in this report, the East model life table was selected as most appropriate, based on previous information on the age pattern of mortality in Republic of Macedonia. Although relatively small, the survey estimates give higher infant and under five mortality rates than the official statistics. According to data from the Institute for Mother and Child Health Protection 2005, infant mortality rate is 12.8 per 1000 live births and under 5 mortality rate is 14.4 per 1000 live births. This difference may have been due to sample design, but may also reflect some under–reporting in the health statistics. Nevertheless, the focus in the use of these data should not be on the absolute level of mortality, but rather on the differences between groups of the population where substantial differences can be observed. Table CM.1 provides estimates of child mortality by various background characteristics, while Table CM.2 provides the basic data used in the calculation of the mortality rates for the national total. The infant mortality rate is estimated at 16 per thousand, while the probability of dying under-5 (U5MR) is around 17 per thousand. These estimates are based on the information collected from women who have had their first birth 0-4 years ago, and refer to mid-2003. There is some difference between the probabilities of dying between urban and rural areas; 10 versus 26 per 1000. There are also differences in mortality in terms of educational levels and wealth. Differentials in under-5 mortality rates by background characteristics are also shown in Figure CM.1. Figure CM.2 shows the series of U5MR estimates of the survey, based on responses of women in different age groups, and referring to various points in time, thus showing the estimated trend in U5MR based on the survey. The MICS estimates indicate a decline in mortality during the last 15 years. The trend indicated by the survey results are in broad agreement with those from the vital registration data and are positive. Figure CM.2: Trend in under-5 mortality rates, Republic of Macedonia, 2005 Figure CM.1 Under-5 mortality rates by background characteristics, Republic of Macedonia, 2005 Area Urban Rural Mother’s Education Primary Wealth Quintiles Poorest 60 % Republic of Macedonia average Under Five Mortality Per 1000 Live Births Vital registrationU5MR (TSFB Version) Un de r-5 M or ta lit y Ra te 25Republic of Macedonia V Nutrition Nutritional Status Children’s nutritional status is a reflection of their overall health. When children have access to an adequate food supply, are not exposed to repeated illness, and are well cared for, they reach their growth potential and are considered well nourished. Malnutrition is associated with more than half of all children deaths worldwide. Undernourished children are more likely to die from common childhood ailments, and for those who survive, have recurring sicknesses and faltering growth. Three-quarters of the children who die from causes related to malnutrition were only mildly or moderately malnourished – showing no outward sign of their vulnerability. The Millennium Development target is to reduce by half the proportion of people who suffer from hunger between 1990 and 2015. The World Fit for Children goal is to reduce the prevalence of malnutrition among children under five years of age by at least one-third (between 2000 and 2010), with special attention to children under 2 years of age. A reduction in the prevalence of malnutrition will assist in the goal to reduce child mortality. In a well-nourished population, there is a reference distribution of height and weight for children under age five. Under-nourishment in a population can be gauged by comparing children to a reference population. The reference population used in this report is the WHO/CDC/NCHS reference, which was recommended for use by UNICEF and the World Health Organization at the time the survey was implemented. Each of the three nutritional status indicators can be expressed in standard deviation units (z-scores) from the median of the reference population. Weight-for-age is a measure of both acute and chronic malnutrition. Children whose weight- for-age is more than two standard deviations below the median of the reference population are considered moderately or severely underweight while those whose weight-for-age is more than three standard deviations below the median are classified as severely underweight. Height-for-age is a measure of linear growth. Children whose height-for-age is more than two standard deviations below the median of the reference population are considered short for their age and are classified as moderately or severely stunted. Those whose height-for-age is more than three standard deviations below the median are classified as severely stunted. Stunting is a reflection of chronic malnutrition as a result of failure to receive adequate nutrition over a long period and recurrent or chronic illness. Finally, children whose weight-for-height is more than two standard deviations below the median of the reference population are classified as moderately or severely wasted, while those who fall more than three standard deviations below the median are severely wasted. Wasting is usually the result of a recent nutritional deficiency. The indicator may exhibit significant seasonal shifts associated with changes in the availability of food or disease prevalence. In MICS, weights and heights of all children under-5 years of age were measured using 26 Multiple Indicator Cluster Survey - 2005-2006 anthropometric equipment recommended by UNICEF (UNICEF, 2006). Findings in this section are based on the results of these measurements. Table NU.1 shows percentages of children classified into each of these categories, based on the anthropometric measurements that were taken during fieldwork. Additionally, the table includes the percentage of children who are overweight, which takes into account those children whose weight for height is more than two standard deviations above the median of the reference population. In Table NU.1, children who were not weighed and measured (approximately 7 percent of children) and those whose measurements are outside a plausible range are excluded. In addition, a small number of children whose birth dates are not known are excluded. About 2 percent of children under age five in Republic of Macedonia are moderately underweight and less than half a percent are classified as severely underweight (Table NU.1). Nine percent of children are stunted or too short for their age and 2 percent are wasted or too thin for their height. Figure NU.1: Percentage of children under-5 who are Pe rc en t Age (in Months) Underweight Stunted Wasted There is no difference between the percentage of male and female children that are moderately underweight. Boys appear to be more likely to be stunted than girls, while the girls appear to be more likely to be wasted than boys. Children in the South West region are more likely to be underweight, while the children in the South East and North East regions are more likely to be stunted than other children. Those children whose mothers have secondary education are the least likely to be underweight and stunted compared to children of mothers with no education. Roma children are twice as likely to be stunted and are more likely to be underweight than Macedonian or Albanian children. The age pattern shows that a higher percentage of children aged 6-11 months are undernourished according to all three indices in comparison to children who are younger and older (Figure NU.1). This pattern is expected and is related to the age at which many children cease to be breastfed and are exposed to contamination in water, food, and environment. More than 10 percent of children are overweight, with children in urban areas and children in richer households more likely to be overweight. Breastfeeding Breastfeeding for the first few years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. However, many mothers stop breastfeeding too soon and there are often pressures to switch to infant formula, which can contribute to growth faltering and micronutrient malnutrition and is unsafe if clean water is not readily available. The World Fit for Children goal states that children should be exclusively breastfed for 6 months and continue to be breastfed with safe, appropriate and adequate complementary feeding for up to 2 years of age and beyond. WHO/UNICEF have the following feeding recommendations:  Exclusive breastfeeding for first six months  Continued breastfeeding for two years or more  Safe, appropriate and adequate complementary foods beginning at 6 months  Frequency of complementary feeding: 2 times per day for 6-8 month olds; 3 times per day for 9-11 month olds It is also recommended that breastfeeding be initiated within one hour of birth. The indicators of recommended child feeding practices are as follows:  Exclusive breastfeeding rate (< 6 months & < 4 months)  Timely complementary feeding rate (6-9 months)  Continued breastfeeding rate (12-15 & 20-23 months) 27Republic of Macedonia Figure NU.2 Percentage of mothers who started breastfeeding within one hour and within one day of birth, Republic of Macedonia, 2005 Pe rc en t Within one day Within one hour Sk op sk i Pe la go ni sk i Va rd ar sk i No rth E as t Su ot h W es t Su ot h Ea st Po lo sk i Ea st Ur ba n Ru ra l Re pu bl ic o f M ac ed on ia av er ag e  Timely initiation of breastfeeding (within 1 hour of birth)  Frequency of complementary feeding (6-11 months)  Adequately fed infants (0-11 months) Table NU.2 provides the proportion of women who started breastfeeding their infants within one hour of birth, and women who started breastfeeding within one day of birth (which includes those who started within one hour). Within the 2 years prior to the MICS survey, 81 percent of women aged 15-49 years started breastfeeding within one day of birth. Twenty seven percent started breastfeeding within one hour of birth. Rural women are more likely to start breastfeeding in the first hour after birth (30 percent) than women from urban areas (24 percent). The women’s level of education is negatively related to the likelihood of starting breastfeeding within the first hour, but positively related to starting breastfeeding in the first day. The percentage of women who breastfed within the first hour declines with increasing education from 33 percent among those with no education to 28 percent among women with primary education, and to 23 percent among women with secondary education. In Table NU.3, breastfeeding status is based on the reports of mothers/caretakers of children’s consumption of food and fluids in the 24 hours prior to the interview. Exclusively breastfed refers to infants who received only breast milk (and possibly vitamins, mineral supplements, or medicine). The table shows exclusive breastfeeding of infants during the first six months of life (separately for 0-3 months and 0- 5 months), as well as complementary feeding of children 6-9 months and continued breastfeeding of children at 12-15 and 20-23 months of age. Approximately 16 percent of children aged less than six months are exclusively breastfed, a level considerably lower than recommended. A higher percentage of children from urban areas are exclusively breastfed (20 percent), against 28 Multiple Indicator Cluster Survey - 2005-2006 Figure NU.3 Infant feeding patterns by age: Percent distribution of children aged under 3 years by feeding pattern by age group, Republic of Macedonia, 2005 Pe rc en t Age (in Months) 10 percent of rural children. Poorer children are more likely to be breastfed then children from the richest quintiles (10 percent versus 2 percent). Twenty one percent of Albanian children are exclusively breastfed, compared with only 3 percent of Roma children. At age 6-9 months, 18 percent of children are receiving breast milk and solid or semi-solid foods. By age 12-15 months, 45 percent of children are still being breastfed and by age 20- 23 months, 22 percent are still breastfed. Girls were more likely to be exclusively breastfed than boys, while boys had higher levels than girls for timely complementary feeding. Continued breastfeeding at age 20-23 months is more prevalent in urban areas (26 percent) than in rural areas (17 percent), although there is little difference at ages 12-25 months. The percentage of children who are breastfed at 12-15 months varies according to the mother’s education, and there are also significant differences when the child is aged 20-23 months. In this latter age group, children of mothers with no education have a significantly higher breastfeeding rate (48 percent) than for children whose mothers have a secondary education (8 percent). In the same age group, there is a big disparity in breastfeeding rate among the children from Roma and Macedonian ethnic group. This percentage is significantly higher among the Roma children (53 percent) than among the Macedonian children (12 percent). Figure NU.3 shows the detailed pattern of breastfeeding status by the child’s age in months. Even at the earliest ages, the majority of children are receiving liquids or foods other than breast milk. About 40 percent of infants aged 0-1 months are exclusively breastfeed, and this proportion drops rapidly until it is close to zero by four months. (See Table NU.3w) The adequacy of infant feeding in children under 12 months is provided in Table NU.4. Different criteria of adequate feeding are used depending on the age of the child. For infants aged 0-5 months, exclusive breastfeeding is considered as adequate feeding. Infants aged 6-8 months are considered to be adequately fed if they are receiving breastmilk plus complementary food at least two times per day, while infants aged 9-11 months are considered to be adequately fed if they are receiving breastmilk and eating complementary food at least three times a day. Seventeen percent of infants aged 6-11 months received breastmilk and complementary food at least the minimum recommended number of times per day. The administration of breastmilk and complementary food is much common among male infants (18 percent) than among female infants (15 percent). Rural children appear more likely to be adequately fed than urban. Infants whose mothers have secondary education are less likely to be adequately fed (8 percent) compared with those whose mothers have primary education (23 percent). Twenty nine percent of infants from the poorest quintile and only 7 percent from the richest one are adequately fed. While 15 percent of Macedonian and 39 percent of Roma received breastmilk and complementary food at least the minimum recommended number of times per day, this percentage is only 9 among Albanian infants. Sixteen percent of all infants (aged 0-11) are appropriately fed. The results show no real difference between the sexes, nor between children in urban versus rural areas, but show a decline from around 20 percent for the children of mother’s with no education and primary education groups to less than 10 percent for the children of mother’s with secondary education. Low Birth Weight Weight at birth is a good indicator not only of a mother’s health and nutritional status but also the newborn’s chances for survival, growth, long-term health and psychosocial development. Low birth weight (less than 2,500 grams) carries a range of grave health risks for children. Babies who were undernourished in the womb face a greatly increased risk of dying during their early months and years. Those who survive have impaired immune function and increased risk of disease; they are likely to remain undernourished, with reduced muscle strength, throughout their lives, and suffer a higher incidence of diabetes and heart disease in later life. Children born underweight also tend to have a lower IQ and 29Republic of Macedonia cognitive disabilities, affecting their performance in school and their job opportunities as adults. In the developing world, low birth weight stems primarily from the mother’s poor health and nutrition. Three factors have most impact: the mother’s poor nutritional status before conception, short stature (due mostly to under nutrition and infections during her childhood), and poor nutrition during the pregnancy. Inadequate weight gain during pregnancy is particularly important since it accounts for a large proportion of foetal growth retardation. Moreover, diseases such as diarrhoea and malaria, which are common in many developing countries, can significantly impair foetal growth if the mother becomes infected while pregnant. In the industrialized world, cigarette smoking during pregnancy is the leading cause of low birth weight. In developed and developing countries alike, teenagers who give birth when their own bodies have yet to finish growing run the risk of bearing underweight babies. One of the major challenges in measuring the incidence of low birth weight is the fact that more than half of infants in the developing world are not weighed. In the past, most estimates of low birth weight for developing countries were based on data compiled from health facilities. However, these estimates are biased for most developing countries because the majority of newborns are not delivered in facilities, and those who are represent only a selected sample of all births. Because many infants are not weighed at birth and those who are weighed may be a biased sample of all births, the reported birth weights usually cannot be used to estimate the prevalence of low birth weight among all children. Therefore, the percentage of births weighing below 2500 grams is estimated from two items in the questionnaire: the mother’s assessment of the child’s size at birth (i.e., very small, smaller than average, average, larger than average, very large) and the mother’s recall of the child’s weight or the weight as recorded on a health card if the child was weighed at birth6 . Overall, ninety-three percent of births were weighed at birth and approximately 6 percent of infants are estimated to weigh less than 2500 grams at birth (Table NU.8). The prevalence of low birth weight does not vary much by urban and rural areas or by mother’s education. Figure NU.5 Percentage of Infants Weighing Less Than 2500 Grams at Birth, Republic of Macedonia, 2005 Pe rc en t Sk op sk i Pe la go ni sk i Va rd ar sk i No rth E as t Su ot h W es t Su ot h Ea st Po lo sk i Ea st Re pu bl ic o f M ac ed on ia av er ag e Regions 30 Multiple Indicator Cluster Survey - 2005-2006 31Republic of Macedonia Immunization The Millennium Development Goal (MDG) 4 is to reduce child mortality by two thirds between 1990 and 2015. Immunization plays a key part in this goal. Immunizations have saved the lives of millions of children in the three decades since the launch of the Expanded Programme on Immunization (EPI) in 1974. Worldwide there are still 27 million children overlooked by routine immunization and as a result, vaccine-preventable diseases cause more than 2 million deaths to children under the age of five every year. A World Fit for Children goal is to ensure full immunization of children under one year of age at 90 percent nationally, with at least 80 percent coverage in every district or equivalent administrative unit. According to UNICEF and WHO guidelines, a child in Republic of Macedonia should receive a BCG vaccination to protect against tuberculosis, three doses of DPT to protect against diphtheria, pertussis, and tetanus, three doses of polio vaccine, and a measles vaccination, all within the first few months of life (at 13 months for Measles). Mothers were asked to provide vaccination cards for children under the age of five. Interviewers copied vaccination information from the cards onto the MICS3 questionnaire. Overall, the mother or caretaker was able to show the health card (health record book) for 75 percent of children aged 18-29 months, 14 percent reported that they had the health card but were not able to show it and 11 percent reported that they did not have a health card for the child. If the child did not have a card or the mother was VI Child Health not able to show the card, the mother was asked to recall whether or not the child had received each of the vaccinations and, for DPT and Polio, how many times. The percentage of children aged 18 to 29 months who received each of the vaccinations is shown in Table CH.1. The denominator for the table is comprised of children aged 18-29 months so that only children who are old enough to be fully vaccinated are counted. In the top panel, the numerator includes all children who were vaccinated at any time before the survey according to the vaccination card or the mother’s report. In the bottom panel, only those who were vaccinated before 12 months of age (18 months for measles) are included. For children without vaccination cards, the proportion of vaccinations given before 12 months of age is assumed to be the same as for children with vaccination cards. Approximately 97 percent of children aged 18- 29 months received a BCG vaccination by the age of 12 months and the first dose of DPT was given to 94 percent. The percentage declines for subsequent doses of DPT to 90 percent for the second dose, and 82 percent for the third dose (Figure CH.1). Similarly, 95 percent of children received Polio 1 by age 12 months and this declines to 81 percent by the third dose. The coverage for measles vaccine by 18 months is 80 percent. The percentage of children who had all eight recommended vaccinations by 12 months of age (18 months for measles) is 60 percent. The coverage figures for whether a child has ever received BCG, DPT1, Polio 1, and Measles seem to be in line with the official statistics, however, the DPT3 and Polio 3 figures show a drop off. 32 Multiple Indicator Cluster Survey - 2005-2006 Looking more closely at table CH.1, this drop of is largely in the cases where the mother reported the vaccinations, and not in the vaccinations according to the health card. It seems likely that at least some of this is because mothers do not remember the number of DPT and Polio vaccinations, although they remember that the child received at least one vaccination. This has been found in other surveys where mother’s reporting has been compared directly with the vaccination card held at the health centre. However it is also likely that there is some drop off in the vaccination rates from DPT1 to DPT3 and from Polio 1 to Polio 3 in certain groups of the population. This appears to be the case, for example, for child whose mother’s are less educated and for Roma children (see CH.2). Figure CH.1: Percentage of children aged 18-29 months who received the recommended vaccinations by 12 months, Republic of Macedonia, 20057 Table CH.2 shows vaccination coverage rates among children 18-29 months by background characteristics. The figures indicate children receiving the vaccinations at any time up to the date of the survey, and are based on information from both the vaccination cards and mothers’/ caretakers’ reports. The percentage of children currently vaccinated against childhood diseases is 76. Male and female children are vaccinated at roughly the same rate. Urban children are more likely to be vaccinated (80 percent) than rural children (70 percent). Vaccination coverage is higher among children whose mothers have secondary education. Albanian (65 percent) and Roma (66 percent) children are less likely to be vaccinated, compared to Macedonian children (88 percent). Oral Rehydration Treatment Diarrhoea is the second leading cause of death among children under five worldwide. Most diarrhoea-related deaths in children are due to dehydration from loss of large quantities of water and electrolytes from the body in liquid stools. Management of diarrhoea – either through oral rehydration salts (ORS) or a recommended home fluid (RHF) - can prevent many of these deaths. Preventing dehydration and malnutrition by increasing fluid intake and continuing to feed the child are also important strategies for managing diarrhoea. The goals are to: 1) reduce by one half death due to diarrhoea among children under five by 2010 compared to 2000 (A World Fit for Children); and 2) reduce by two thirds the mortality rate among children under five by 2015 compared to 1990 (Millennium Development Goals). In addition, the World Fit for Children calls for a reduction in the incidence of diarrhoea by 25 percent. The indicators are: Prevalence of diarrhoea Oral rehydration therapy (ORT) Home management of diarrhoea (ORT or increased fluids) AND continued feeding ________________ * Measles includes children who received the vaccination by 18 months Figure CH.2 Percentage of children aged 18-29 months currently vaccinated against childhood diseases, Republic of Macedonia, 2005 Area Urban Rural Mother’s Education No education Primary Secondary+ Wealth Quintiles Poorest Second Middle Fourth Richest Ethnicity Macedonian Albanian Roma Other Republic of Macedonia average Percent 33Republic of Macedonia In the MICS questionnaire, mothers (or caretakers) were asked to report whether their child had had diarrhoea in the two weeks prior to the survey. If so, the mother was asked a series of questions about what the child had to drink and eat during the episode and whether this was more or less than the child usually ate and drank. Overall, 7 percent of children under five had diarrhoea in the two weeks preceding the survey (Table CH.4). Diarrhoea prevalence was highest in Pelagoniski region at 25 percent. The prevalence of diarrhoea among girls (9 percent) was higher than among boys (6 percent). The peak of diarrhoea prevalence occurs in the weaning period, among children age 0-11 months at 20 percent. Table CH.4 also shows the percentage of children receiving various types of recommended liquids during the episode of diarrhoea. Since mothers were able to name more than one type of liquid, the percentages do not necessarily add to 100. About 24 percent received fluids from ORS packets and 63 percent received recommended homemade fluids. Eighty one percent of children aged 0-59 months with diarrhoea received oral rehydration treatment. Children from urban areas were more likely to receive ORT (85 percent) than those from rural areas (76 percent). Eighty six percent of children of mothers with secondary education received ORT, compared to seventy two percent of children whose mothers have no education. The ORT use rate is highest among the Macedonian children (87 percent). The ORT use rate among children from Albanian, Roma and other ethnic groups is virtually the same (around 74 – 77 percent). Fourteen percent of under five children with diarrhoea drank more than usual while 84 percent drank the same or less (Table CH.5). Fifty five percent ate somewhat less, the same or more (continued feeding), but forty two ate much less or ate almost none. Girls are more likely to eat somewhat less, the same or more (66 percent) than boys (40 percent). Figure CH.3 Percentage of children aged 0-59 months with diarrhoea who received oral rehydration treatment, Republic of Macedonia, 2005 Ur ba n Ru ra l No ne Pr im ar y Se co nd ar y+ M ac ed on ia n Al ba ni an Ro m a Ot he r Re pu bl ic o f M ac ed on ia av er ag e Pe rc en t 34 Multiple Indicator Cluster Survey - 2005-2006 The indicator of home management of diarrhoea is defined as children with diarrhoea who drank more and continued feeding (eating the same, more, or somewhat less). This follows WHO/ UNICEF recommendations that children should drink more than usual and should continue eating while being treated at home for diarrhoea. Overall 6 percent of children are receiving increased fluids and continuing to eat while being treated for diarrhoea. There are significant differences in the home management of diarrhoea by background characteristics. Combining the information in Table CH.5 with those in Table CH.4 on oral rehydration therapy, it is observed that 45 percent of children either received ORT or fluid intake was increased, and at the same time, feeding was continued, as is the recommendation. Children from the rural areas are almost three times less likely to follow recommended treatment (23 percent) than children from urban areas (61 percent). There is important association between the mother’s education level and socio-economic status of the households. Twenty two percent of children whose mothers have primary education received ORT or increased fluids and continued feeding, compared with 78 percent whose mothers have secondary education. There are differences across ethnic groups. Only 17 percent of children from Albanian ethnic group received increased fluids and continued feeding compared to 30 percent of Roma children and 70 percent of Macedonian children. Care Seeking and Antibiotic Treatment of Pneumonia Pneumonia is the leading cause of death in children and the use of antibiotics in under-5s with suspected pneumonia is a key intervention. A World Fit for Children goal is to reduce by one-third the deaths due to acute respiratory infections. Children with suspected pneumonia are those who had an illness with a cough accompanied by rapid or difficult breathing and whose symptoms were NOT due to a problem in the chest and a blocked nose. The indicators are:  Prevalence of suspected pneumonia  Care seeking for suspected pneumonia  Antibiotic treatment for suspected pneumo- nia  Knowledge of the danger signs of pneumo- nia Table CH.6 presents the prevalence of suspected pneumonia and, if care was sought outside the home, the site of care. Six percent of children aged 0-59 months were reported to have had symptoms of pneumonia during the two weeks preceding the survey. Of these children, 93 percent were taken to an appropriate provider. 26 percent of these children were taken to a hospital, 16 percent to a health centre, 29 percent to a government health post, and 12 percent to a private hospital clinic. There are no differences between regions, urban/rural and wealth quintiles in terms of children taken to an appropriate provider. Small differences were observed among children whose mothers have secondary education. These children were more likely to be taken to a private hospital clinic than to a government hospital (39 versus 23 percent). Roma children were less likely to be taken to any appropriate provider (92 percent). Table CH.7 presents the use of antibiotics for the treatment of suspected pneumonia in under-5s by sex, age, residence, and socioeconomic factors. In Republic of Macedonia, 74 percent of under- 5 children with suspected pneumonia during the two weeks prior to the survey had received an antibiotic. The table also shows that the percentage of under-5 children with suspected pneumonia who received antibiotics varies among education groups and it is higher among those whose mother’s have at least secondary education. This percent is also higher for boys than for girls, and among the children that belong to the Roma ethnic group. Figure CH.4 Percentage of children aged 0-59 with diarrhoea who received ORT or increased fluids, AND continued feeding Republic of Macedonia, 2005 Area Urban Rural Mother’s Education No education Primary Secondary+ Ethnicity Macedonian Albanian Roma Other Republic of Macedonia average Percent 35Republic of Macedonia Issues related to knowledge of danger signs of pneumonia are presented in Table CH.7A. Obviously, mothers’ knowledge of the danger signs is an important determinant of care-seeking behaviour. Overall, 37 percent of women know of the two danger signs of pneumonia – fast breathing and difficult breathing. The most common response, given by 91 percent of mothers, is that they would take their child to a health facility right away if he/she developed a fever. Fifty five percent said that the child becoming sicker would cause them to take the child to a health facility and 54 percent mentioned difficulty breathing. Forty three percent of mothers cited fast breathing, and 37 percent blood in the stools, as reasons for taking a child to a health facility right away. The less frequently reported signs were drinking poorly (26 percent) and inability to drink or breastfeed (25 percent). Rural mothers and those with primary education were more likely to mention at least two signs for seeking care than other mothers. Solid Fuel Use More than 3 billion people around the world rely on solid fuels (biomass and coal) for their basic energy needs, including cooking and heating. Cooking and heating with solid fuels leads to high levels of indoor smoke, a complex mix of health-damaging pollutants. The main problem with the use of solid fuels is products of incomplete combustion, including CO, polyaromatic hydrocarbons, SO2, and other toxic elements. Use of solid fuels increases the risks of acute respiratory illness, pneumonia, chronic obstructive lung disease, cancer, and possibly tuberculosis, low birth weight, cataracts, and asthma. The primary indicator is the proportion of the population using solid fuels as the primary source of domestic energy for cooking. Information on the type of fuel used for cooking is another measure of the socio-economic status of the household. Table CH.8 shows that 36 percent of the households use solid fuel for cooking (principally wood). About 61 percent use electricity. Households in urban areas are more likely to use electricity for cooking. The use of wood is higher among the poorest households (78 percent) and households where the head of the household is without education (63 percent). There is a substantial difference in use of electricity for cooking between the richest and the poorest households (89 versus 21 percent). Solid fuel use alone is a poor proxy for indoor air pollution, since the concentration of the pollutants is different when the same fuel is burnt in different stoves or fires. Use of closed stoves with chimneys minimizes indoor pollution, while open stove or fire with no chimney or hood means that there is no protection from the harmful effects of solid fuels. The type of stove used with a solid fuel is depicted in Table CH.9. Of the households using solid fuels, 87 percent of households use a closed stove with chimney, and only 13 percent use open stove of fire with chimney or hood. There are no differences between regions, urban/ rural and different wealth quintiles. 36 Multiple Indicator Cluster Survey - 2005-2006 37Republic of Macedonia VII Environment Water and Sanitation Safe drinking water is a basic necessity for good health. Unsafe drinking water can be a significant carrier of diseases such as trachoma, cholera, and typhoid. Drinking water can also be tainted with chemical, physical and radiological contaminants with harmful effects on human health. In addition to its association with disease, access to drinking water may be particularly important for women and children, especially in rural areas, who bear the primary responsibility for carrying water, often for long distances. The MDG goal is to reduce by half, between 1990 and 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. The World Fit for Children goal calls for a reduction in the proportion of households without access to hygienic sanitation facilities and affordable and safe drinking water by at least one-third. The list of indicators used in MICS is as follows: Water  Use of improved drinking water sources  Use of adequate water treatment method  Time to source of drinking water  Person collecting drinking water Sanitation  Use of improved sanitation facilities  Sanitary disposal of child’s faeces The distribution of the population by source of drinking water is shown in Table EN.1 and Figure EN.1. The population using improved sources of drinking water are those using any of the following types of supply: piped water (into dwelling, yard or plot), public tap/standpipe, tubewell/borehole, protected well, protected spring, and rainwater collection. Bottled water is considered as an improved water source only if the household is using an improved water source for other purposes, such as hand washing and cooking. Figure EN.1: Percent distribution of the population by source of drinking water, Republic of Macedonia, 2005 Ninety one percent of the population has water that is piped either into the dwelling or the yard/ plot. Such access is higher in urban areas (96 percent) than in rural areas (84 percent). In rural areas, 9 percent of the population has a tubewell/borehole with a pump and 4 percent has a protected well. Piped into yard Public tap Tubewell/borehole Protected well Protected spring Other Piped into dwelling 38 Multiple Indicator Cluster Survey - 2005-2006 The source of drinking water for the population varies by region (Table EN.1). In the Skopski re- gion, 95 percent of the population uses drinking water that is piped into their dwelling or into their yard or plot. In contrast, only about 73 percent of those residing in the South East region have piped water. There are differences in terms of access to a wa- ter supply piped into the dwelling or yard/plot among the richest and poorest households (100 versus 74 percent), and in terms of education of the head of the household -- 96 percent into the households where the household head has sec- ondary education or more and 85 percent into the households where the household head has no education. Use of in-house water treatment is presented in Table EN.2. Households were asked of ways they may be treating water at home to make it safer to drink – boiling, adding bleach or chlorine, using a water filter, and using solar disinfection were considered as proper treatment of drinking wa- ter. The table shows the percentages of house- hold members using appropriate water treatment methods Eleven percent of the household population use an appropriate water treatment method. Eight seven percent of household members used no wa- ter treatment method. The most common method is boiling. Households using water sources from rural areas are more likely to use an appropriate water treatment than those from urban areas (14 versus 10 percent). The poorest households are more likely to use a water treatment method than the richest one. The amount of time it takes to obtain water is presented in Table EN.3 and the person who usu- ally collected the water in Table EN.4. Note that these results refer to one roundtrip from home to drinking water source. Information on the number of trips made in one day was not collected. Table EN.3 shows that for 96 percent of house- holds, the drinking water source is on the premis- es. For 0.3 percent of households, it takes less than 30 minutes to get to the water source and bring water, while 0.5 percent of households spend more than 1 hour for this purpose. Exclud- ing those households with water on the premises, the average time to the source of drinking water is 19 minutes. For those households without ac- cess to water on the premises, the time spent in urban areas in collecting water is higher than in rural areas. Table EN.4 shows that for the majority of house- holds, an adult female is usually the person col- lecting the water (63 percent), when the source of drinking water is not on the premises. Adult men collect water in 33 percent of cases, while almost no female or male children under age 15 collect water. Inadequate disposal of human excreta and per- sonal hygiene is associated with a range of dis- eases including diarrhoeal diseases and polio. Improved sanitation facilities for excreta disposal include: flush or pour flush to a piped sewer sys- tem, septic tank, or latrine; ventilated improved pit latrine, pit latrine with slab, and composting toilet. Ninety three percent of the population in Repub- lic of Macedonia is living in households with a sanitary means of excreta disposal - 97 percent in urban areas and 88 percent in rural areas (Ta- ble EN.5). Ninety percent have a flush toilet con- nected either to a sewage system or septic tank. Septic tanks are much more common in rural areas; 53 percent of the rural population use a septic tank, whereas in urban areas 12 percent of the population fall into this category. In urban areas less than 1 percent uses a pit latrine with slab, while the proportion in rural areas is around 2 percent. The coverage of the population with a flush toi- let linked to a sewage system is lowest in the Poloski region (23 percent), which also has the highest proportion of toilets linked to aseptic tank (72 percent). There are some disparities in the use of flush toilet piped to the sewer system be- tween the household population from the Albani- an ethnic group (only 34 percent use this type of sanitation facility) and the Macedonian and Roma population (75 and 80 percent). Safe disposal of a child’s faeces is disposing of the stool, by the child using a toilet or by rins- ing the stool into a toilet or latrine. Disposal of faeces of children 0-2 years of age is presented in Table EN.6. The proportion of children whose stools are disposed of safely is 50 percent. The likelihood of safely disposing of the child’s fae- ces increases with the education of the mother or caretaker. The percentage of children whose stools are thrown into garbage is almost 40 per- cent. Twenty one percent of children used a toi- let or latrine. This percentage is higher in urban areas (26 percent) than in rural areas (14 per- cent). Roma children are less likely to use a toilet or latrine (10 percent). The disposal of stools by putting or rinsing them into a toilet or latrine is 39Republic of Macedonia more common among rural children (34 percent) compared to children from urban areas (25 per- cent). An overview of the percentage of household members who use improved sources of drinking water and sanitary means of excreta disposal is presented in Table EN.7. Overall, 92 percent of the population use improved sources of drinking water and sanitary means of excreta disposal. Ninety nine percent use improved sources of drinking water and 93 percent use sanitary means of excreta disposal. The percentage who use both improved sources of drinking water and sanitary means of excreta disposal is higher in urban than in rural areas (97 versus 87 percent), increases with the level of education of the head of household. There is important association between the use of improved water sources and improved sanitation and socio-economic status of the households. Only 76 percent of the poorest household population use improved sources of drinking water and sanitary means of excreta disposal, compared to 100 percent of the household population from the richest quintiles. 40 Multiple Indicator Cluster Survey - 2005-2006 41Republic of Macedonia VIII Reproductive health Contraception Appropriate family planning is important to the health of women and children by: 1) preventing pregnancies that are too early or too late; 2) extending the period between births; and 3) limiting the number of children. A World Fit for Children goal is access by all couples to information and services to prevent pregnancies that are too early, too closely spaced, too late or too many. Current use of contraception was reported by 14 percent of women currently married or in union (Table RH.1). The most popular method is the condom which is used by 5 percent of women currently married or in union, followed by the pill, which accounts for 3 percent of married women. One percent of married women use diaphragm, foam or jelly as a contraceptive method. Less than 1 percent use periodic abstinence, withdrawal, female sterilization, vaginal methods, or the lactational amenorrhea method (LAM). Use of any traditional method is three times as high in rural areas as compared with urban places. Use of the pill is higher in urban areas. Contraceptive prevalence is highest in the South West region at 19 percent and almost as high in the Skopski region at 18 percent. Fifteen percent of married women in the Pelagoniski and Poloski region and 12 percent in the East use a method of contraception.In the Vardarski, North East and South East, contraceptive use is rare; less than 10 percent of married women reported using any method.Adolescents are far less likely to use contraception than older women. Only about 1 percent of married or in union women aged 15-19 currently use a method of contraception compared to 12 percent of 20-24 year olds. Women’s education level is strongly associated with contraceptive prevalence. Use increases with educational level. The percentage of women using any method of contraception rises from 8 percent among those with no education to 12 percent among women with primary education, and to 17 percent among women with secondary or higher education. In addition to differences in prevalence, the method mix varies by education. About 3 percent of contraceptive users with primary education use the condom. Similarly, 7 percent of contraceptive users with secondary or higher education use the condom and 3 percent use pill. There are no significant differences between the women from different ethnic groups. The modern methods of contraception prevail in women from the richest quintiles, while traditional methods are more frequently used by poorer women. However, even the poorest women are more likely to use a modern method than a traditional method. Interestingly, the middle income group of women have the lowest rate of contraceptive use overall. Unmet need8 for contraception refers to fecund women who are not using any method of contraception, but who wish to postpone the next birth or who wish to stop childbearing altogether. Unmet need is identified in MICS by using a set 42 Multiple Indicator Cluster Survey - 2005-2006 of questions eliciting current behaviours and preferences pertaining to contraceptive use, fecundity, and fertility preferences. Women in unmet need for spacing includes women who are currently married (or in union), fecund (are currently pregnant or think that they are physically able to become pregnant), currently not using contraception, and want to space their births. Pregnant women are considered to want to space their births when they did not want the child at the time they got pregnant. Women who are not pregnant are classified in this category if they want to have a(nother) child, but want to have the child at least two years later, or after marriage. Women in unmet need for limiting are those women who are currently married (or in union), fecund (are currently pregnant or think that they are physically able to become pregnant), currently not using contraception, and want to limit their births. The latter group includes women who are currently pregnant but had not wanted the pregnancy at all, and women who are not currently pregnant but do not want to have a(nother) child. Total unmet need for contraception is simply the sum of unmet need for spacing and unmet need for limiting. Using information on contraception and unmet need, the percentage of demand for contraception satisfied is also estimated from the MICS data. Percentage of demand for contraception satisfied is defined as the proportion of women currently married or in union who are currently using contraception, of the total demand for contraception. The total demand for contraception includes women who currently have an unmet need (for spacing or limiting), plus those who are currently using contraception. Table RH.2 shows the results of the survey on contraception, unmet need, and the demand for contraception satisfied. While 14 percent of women aged 15-49 years currently married or in union use contraception, the total unmet need for contraception is 34 percent. There are some differences among women by age group, urban/ rural and educational level. Five percent of women have unmet need for spacing. This percentage is highest among women aged 20-29. Women with no education are less likely to have unmet need for spacing (2 percent), compared to women with secondary education (6 percent). Albanian women and women from the category of other ethnic groups are most likely to have an unmet need for spacing. Twenty nine percent of women have unmet need for limiting. Urban women are more likely to have unmet need for limiting than rural. The percentage is highest among women aged 40-44. The percentage of demand for contraception satisfied is 29 percent. This percentage is higher in rural areas (35 percent) than in urban (24 percent). Women with no education are less likely to have demand for contraception satisfied, than women with secondary education (13 percent versus 33 percent). The percent is lowest among Roma women (20 percent). Antenatal Care The antenatal period presents important opportunities for reaching pregnant women with a number of interventions that may be vital to their health and well-being and that of their infants. Better understanding of foetal growth and development and its relationship to the mother’s health has resulted in increased attention to the potential of antenatal care as an intervention to improve both maternal and newborn health. For example, if the antenatal period is used to inform women and families about the danger signs and symptoms and about the risks of labour and delivery, it may provide the route for ensuring that pregnant women do, in practice, deliver with the assistance of a skilled health care provider. The antenatal period also provides an opportunity to supply information on birth spacing, which is recognized as an important factor in improving infant survival. Tetanus immunization during pregnancy can be life-saving for both the mother and infant. According to the Republic of Macedonia immunization protocol tetanus immunization is not standard practice. Management of anaemia during pregnancy and treatment of STIs can significantly improve foetal outcomes and improve maternal health. Adverse outcomes such as low birth weight can be reduced through a combination of interventions to improve women’s nutritional status and prevent infections during pregnancy. More recently, the potential of the antenatal period as an entry point for HIV prevention and care, in particular for the prevention of HIV transmission from mother to child, has led to renewed interest in access to and use of antenatal services. WHO recommends a minimum of four antenatal visits based on a review of the effectiveness of different models of antenatal care. WHO 43Republic of Macedonia guidelines are specific on the content of antenatal care visits, which include:  Blood pressure measurement  Urine testing for bateriuria and proteinuria  Blood testing to detect syphilis and severe anemia  Weight/height measurement (optional) In Republic of Macedonia blood testing during antenatal care is only conducted to detect sever anemia and syphilis testing is only conducted on signs of the infection as determined by the medical practitioner. Coverage of antenatal care by skilled personnel (a doctor, nurse, midwife or auxiliary midwife) is almost universal in Republic of Macedonia with 98 percent of women receiving antenatal care at least once during the pregnancy. Antenatal care coverage is almost the same in urban and rural areas. The type of personnel providing antenatal care to women aged 15-49 years who gave birth in the two years preceding is presented in Table RH.3. 94 percent of women with a birth in the two years prior to the survey received antenatal care from a doctor and 4 percent from a nurse or midwife. Health assistance providing antenatal care for women with no education is 85 percent and for those with secondary education is 99 percent. Women from the Roma ethnic group are less likely to receive antenatal care from a doctor than Macedonian women (79 versus 98 percent). The types of services pregnant women received are shown in table RH.4. Virtually all women in Republic of Macedonia received specific care as part of the antenatal care during pregnancy. 96 percent of women aged 15-49 had blood sample taken, 93 percent had blood pressure measured, 96 percent had urine specimen taken and 94 percent had their weight measured. These percentages are lowest among pregnant women from the poorest quintile, the Roma ethnic group and among women with no education. There are no significant differences between women from urban/rural areas. Assistance at Delivery Globally, three quarters of all maternal deaths occur during delivery and the immediate post-partum period. The single most critical intervention for safe motherhood is to ensure a competent health worker with midwifery skills is present at every birth, and transport is available to a referral facility for obstetric care in case of emergency. A World Fit for Children goal is to ensure that women have ready and affordable access to skilled attendance at delivery. The indicators are the proportion of births with a skilled attendant and proportion of institutional deliveries. The skilled attendant at delivery indicator is also used to track progress toward the Millennium Development target of reducing the maternal mortality ratio by three quarters between 1990 and 2015. The MICS included a number of questions to assess the proportion of births attended by a skilled attendant. A skilled attendant includes a doctor, nurse, midwife or auxiliary midwife. About 98 percent of births occurring in the year prior to the MICS survey were delivered by skilled personnel (Table RH.5). The more educated a woman is, the more likely she is to have delivered with the assistance of a skilled person. About 84 percent of births in the year prior to the MICS survey were delivered with assistance by a doctor. Nurses or midwives assisted with the delivery of 14 percent of births. The percentage assisted by a doctor is lower among Roma women (70 percent) and women with no education (78 percent). About 1 percent of births were delivered with the assistance of a relative or friend, and less than 1 percent with the assistance of a traditional birth attendant. 44 Multiple Indicator Cluster Survey - 2005-2006 45Republic of Macedonia IX Child Development It is well recognized that a period of rapid brain development occurs in the first 3-4 years of life, and the quality of home care is the major determinant of the child’s development during this period. In this context, adult activities with children, presence of books in the home, for the child, and the conditions of care are important indicators of quality of home care. A World Fit for Children goal is that “children should be physi- cally healthy, mentally alert, emotionally secure, socially competent and ready to learn.” Information on a number of activities that sup- port early learning was collected in the survey. These included the involvement of adults with children in the following activities: reading books or looking at picture books, telling stories, singing songs, taking children outside the home, com- pound or yard, playing with children, and spend- ing time with children naming, counting, or draw- ing things. For 85 percent of children under the age of five, an adult engaged in four or more activities that promote learning and school readiness during the 3 days preceding the survey (Table CD.1). The average number of activities that adults engaged in with children is 5. The table also indicates that the father’s involvement in one or more activities occurred for 61 percent of children. Only 3 per- cent of children are living in a household without their fathers. Exposure to books in the early years not only pro- vides the child with greater understanding of the nature of print, but may also give the child op- portunities to see others reading, such as older siblings doing school work. Presence of books is important for later school performance and IQ scores. In Republic of Macedonia, 51 percent of children are living in households where at least 3 non- children’s books are present (Table CD.2). Forty nine percent of children aged 0-59 months have 3 or more children’s books. While no gender differentials are observed, urban children appear to have more access to both types of books than those living in rural households. The proportion of under-5 children who have 3 or more children’s books is 60 percent in urban areas, compared to 36 percent in rural areas. Children from the poorest households appear to have less access to both types of books than those living in the richest households. Twenty one percent of under-5 children living in poorest households live in households with more than 3 children’s books, while the figure is 89 percent in the richest households. Children from the Roma and Albanian ethnic groups have the lowest access to children’s books (32 and 27 percent). Table CD.2 also shows that 65 percent of children play with toys that come from a store, about 19 percent of children play with homemade toys, 6 percent of children play with household objects and 6 percent with objects found outside the home (note that percentages do not add up to 100 as children may play with more than one type of toy). About 8 percent had none of the playthings asked to the mothers/caretakers. The highest percentages of children who have none of the playthings are from the Roma population (about 17 percent) and the group where the mother has no education (about 17 percent). Leaving children alone or in the presence of other young children is known to increase the risk of accidents. In MICS, two questions were asked to find out whether children aged 0-59 months were left alone during the week preceding the 46 Multiple Indicator Cluster Survey - 2005-2006 interview, and whether children were left in the care of other children under 10 years of age. Table CD.3 shows that 8 percent of children aged 0-59 months were left in the care of other children, while 3 percent were left alone during the week preceding the interview. Combining the two care indicators, it is calculated that 9 percent of children were left with inadequate care during the week preceding the survey. No clear differences are observed by the level of mother’s education or between urban and rural areas. On the other hand, inadequate care was more prevalent among female children (11 percent), as opposed to male (8 percent). Children aged 24-59 months were left with inadequate care more (12 percent) than those who were aged 0-23 months (4 percent). Small differences are observed in regard to socioeconomic status of the household. 47Republic of Macedonia X Education Pre-School Attendance and School Readiness Attendance to pre-school education in an organized learning or child education program is important for the readiness of children to school. One of the World Fit for Children goals is the promotion of early childhood education. Only 11 percent of children aged 36-59 months are attending pre-school (Table ED.1). A higher percentage of boys (15 percent) compared to girls (6 percent) are attending pre-school. Urban- rural and regional differentials are significant – children in urban areas are about ten times as likely to attend early learning activities (the figure is as high as 19 percent in urban areas, compared to less than 2 percent in rural areas). There are regional variations ranging from 1 percent in Poloski to 23 percent in Vardarski region. Differentials by socioeconomic status are significant. Twenty five percent of children living in the richest households attend pre-school, while the figure drops to only 1 percent in the poorest households. Relatively few children attend at age 48-59 months (8 percent) when compared to children aged 36-47 months (13 percent). There are some differences in the attendance rate of children from different ethnic groups - only 2 percent of Albanian children attend pre-school education compared to 17 percent of Macedonian children. This figure is 4 percent for the Roma children. Finally, mother’s education appears to be strongly related to the likelihood that a child will attend an early childhood education. The percentage of children attending increases from less than 2 percent to 23 percent as the mother’s education increases from primary to secondary or higher education. The table also shows the proportion of children in the first grade of primary school who attended pre-school the previous year (Table ED.1), an important indicator of school readiness. Overall, 76 percent of children who are currently age 6 or 7 and attending the first grade of primary school 48 Multiple Indicator Cluster Survey - 2005-2006 were attending pre-school the previous year. The proportion among males is higher (87 percent) than females (64 percent), while this proportion is almost the same among children living in urban and rural areas. Primary and Secondary School Participation Universal access to basic education and the achievement of primary education by the world’s children is one of the most important goals of the Millennium Development Goals and A World Fit for Children. Education is a vital prerequisite for combating poverty, empowering women, protecting children from hazardous and exploitative labour and sexual exploitation, promoting human rights and democracy, protecting the environment, and influencing population growth. The indicators for primary and secondary school attendance include:  Net intake rate in primary education  Net primary school attendance rate  Net secondary school attendance rate  Net primary school attendance rate of children of secondary school age  Female to male education ratio (or gender parity index - GPI) The indicators of school progression include:  Transition rate to secondary school  Net primary completion rate Of children who are of primary school entry age (age 7) in Republic of Macedonia, 95 percent are attending the first grade of primary school (ED.2). There are no significant differences between boys and girls, urban and rural areas and regions. A positive correlation with mother’s education and socioeconomic status is observed; for children age 7 whose mothers have at least secondary school education, 98 percent were attending the first grade, compared to 83 percent of children whose mothers have no education. In the richest households, the proportion is around 98 percent, while it is 86 percent among children living in the poorest households. Roma children have the lowest levels with only 63 percent attending the first grade of primary school. Table ED.3 provides the percentage of children of primary school age attending primary or secondary school. Overall, 95 percent of children of primary school age (ages 7-14) in Republic of Macedonia are attending primary school or secondary school (Table ED.3). The lowest proportion of children attending primary school can be observed in the poorest wealth quintile. This proportion varies from 87 percent in the poorest wealth quintile to 49Republic of Macedonia 100 percent in the richest one. The attendance rate of Roma children is lower in comparison to other ethnic groups (61 percent). In urban areas, 93 percent of children attend school while in rural areas 97 percent attend. This difference is principally because of the lower attendance rate for the Roma population, and the Roma live predominantly in the urban areas. School attendance in the South East and Pelagoniski region is lower than in the other regions at 81 percent. At the national level, there is a small difference between male and female primary school attendance. The secondary school net attendance ratio is presented in Table ED.4. Overall, 63 percent of children of secondary school age (ages 15–18) in Republic of Macedonia are attending secondary school (Table ED.4). This percentage is the lowest in the South East region, (37) and among the children of the Roma population, only 17 percent. In urban areas, 71 percent of children attend school while in rural areas 56 percent attend. The attendance of secondary school is strongly determined by the socio-economic status of the households. It ranges from 34 percent in the poorest quintile to 90 percent in the richest quintile. Seventy four percent of Macedonian children of secondary school age attend secondary school, while only 17 percent of Roma children of the same age attend secondary school. There is a higher proportion of girls (68 percent) of this age attending secondary school than of boys (59 percent). The primary school net attendance ratio of children of secondary school age is presented in Table ED.4W. Three percent of the children of secondary school age are attending primary school when they should be attending secondary school. This percentage is higher among the children from the poorest households (3 percent), than among the children from the richest households (1 percent). The highest percentage of children of secondary school age that should be attending secondary school is among the children from Albanian ethnic group - 7 percent, compared with the Macedonian children where this percentage is less than 1 percent. Overall 5 percent of boys of secondary school age are still in primary school, whereas only 1 percent of girls of the same age are in primary school. The net primary school completion rate and transition rate to secondary education are presented in Table ED.6. At the time of the survey, 83 percent of the children of primary school completion age (age 14) were attending the last grade of primary education. This value should be distinguished from the gross primary completion ratio which includes children of any age attending the last grade of primary. The primary school completion rate measures the proportion of children completing primary school at (or before) the recommended age. There are no significant variations in primary school completion across sex or urban and rural areas. However, the lowest percentage of children attending the last grade of primary education can be observed in the poorest wealth quintile. This percentage is lower among children who belong to the Roma ethnic group (45 percent), compared to 87 percent of Macedonian children, and among children whose mothers have no education. The secondary school transition rate measures the proportion of children transitioning directly from primary school to secondary school. Ninety five percent of children that attended the last grade of primary school in the previous year were found at the time of the survey to be attending the first grade of secondary school. There is virtually no difference between urban and rural children, or males and females, however Roma children are significantly less likely to transition to secondary school (only 27 percent) than other children (more than 90 percent). The ratio of girls to boys attending primary and secondary education is provided in Table ED.7. The table shows that gender parity for primary school is 0.96, indicating that boys have a slight advantage in attendance at primary school. However, the indicator rises to 1.15 for secondary education indicating that girls are substantially more likely to attend secondary school. Adult Literacy One of the World Fit for Children goals is to assure adult literacy. Adult literacy is also an MDG indicator, relating to both men and women. In MICS, since only a women’s questionnaire was administered, the results are based only on females age 15-24. Literacy was assessed on the ability of women to read a short simple statement or on school attendance. The percentage literate is presented in Table ED.8. The vast majority of the women (97 percent) aged 15-24 in Republic of Macedonia are literate. Overall, there are no substantial differences in the literacy rate among the regions as well as urban and rural areas. The literacy level is strongly associated with women’s education. The literacy percentage declines from 100 percent among those with secondary education to 19 percent among the women with no education. Roma women are less likely to be literate than Macedonian or Albanian women (61 versus 99 percent). 50 Multiple Indicator Cluster Survey - 2005-2006 51Republic of Macedonia XI Child Protection Birth Registration The Convention on the Rights of the Child states that every child has the right to a name and a nationality and the right to protection from being deprived of his or her identity. Birth registration is a fundamental means of securing these rights for children. The World Fit for Children states the goal to develop systems to ensure the registration of every child at or shortly after birth, and fulfil his or her right to acquire a name and a nationality, in accordance with national laws and relevant international instruments. The indicator is the percentage of children under 5 years of age whose birth is registered. The births of 94 percent of children under-5 years in Republic of Macedonia have been registered (Table CP.1). There are no significant variations in birth registration across sex, age, or socio- economic categories. Children in the Pelagoniski region are significantly less likely to have their births registered than other children. There are also somewhat lower levels of birth registration of children of mother’s with no or primary education compared with those with secondary education. Macedonian children are registered at slightly higher rates than children of other ethnic groups. Eighty nine percent of infants (children aged 0- 11 months) were registered, while 95 percent of those aged 24 months and older were registered, suggesting that some children’s births may be registered not at their birth, but a little later in life. Child Labour Article 32 of the Convention on the Rights of the Child states: “States Parties recognize the right of the child to be protected from economic exploitation and from performing any work that is likely to be hazardous or to interfere with the child’s education, or to be harmful to the child’s health or physical, mental, spiritual, moral or social development.” The World Fit for Children mentions nine strategies to combat child labour and the MDGs call for the protection of children against exploitation. In the MICS questionnaire, a number of questions addressed the issue of child labour, that is, children 5-14 years of age involved in labour activities. A child is considered to be involved in child labour activities at the moment of the survey if during the week preceding the survey:  Ages 5-11: at least one hour of economic work or 28 hours of domestic work per week.  Ages 12-14: at least 14 hours of economic work or 28 hours of domestic work per week. This definition allows differentiation between child labour and child work to identify the type of work that should be eliminated. As such, the estimate provided here is a minimum of the prevalence of child labour since some children may be involved in hazardous labour activities for a number of hours that could be less than the numbers specified in the criteria explained above. Table CP.2 presents the results of child labour by the type of work. Percentages do not add up to the total child labour as children may be involved in more than one type of work. In Republic of Macedonia, the MICS survey estimates that 6 percent of children aged 5-14 years are involved in child labour activities. Much less than 1 percent of children are engaged in paid 52 Multiple Indicator Cluster Survey - 2005-2006 work. About 3 percent participate in unpaid work for someone other than a household member and 3 percent are working for family business. Boys are somewhat more likely to participate in unpaid work outside household and for family business than girls, and younger children (aged 5-11) are more likely than older children (aged 12-14) to be involved in activities considered as child labour, however, this is due to the stricter definition of child labour for the younger children. Levels of child labour vary from less than 1 percent in South East region to almost 15 percent in Vardarski region. Table CP.3 presents the percentage of children classified as student labourers or as labourer students. Student labourers are the children attending school that were involved in child labour activities at the moment of the surveys. More specifically, of the 85 percent of the children 5- 14 years of age attending school, 6 percent are also involved in child labour activities. On the other hand, out of the 6 percent of the children classified as child labourers, the majority of them are also attending school (95 percent). Child Discipline As stated in A World Fit for Children, “children must be protected against any acts of violence …” and the Millennium Declaration calls for the protection of children against abuse, exploitation and violence. In the Republic of Macedonia MICS survey, mothers/caretakers of children age 2-14 years were asked a series of questions on the ways parents tend to use to discipline their chil- dren when they misbehave. Note that for the child discipline module, one child aged 2-14 per household was selected randomly during field- work. Out of these questions, the two indicators used to describe aspects of child discipline are: 1) the number of children 2-14 years that expe- rience psychological aggression as punishment or minor physical punishment or severe physical punishment; and 2) the number of parents/care- takers of children 2-14 years of age that believe that in order to raise their children properly, they need to physically punish them. In Republic of Macedonia almost 70 percent of children aged 2-14 years are subjected to at least one form of psychological or physical punishment by their mothers/caretakers or other household members. More importantly, 16 percent of children are subjected to severe physical punishment. On the other hand, mothers/caretakers who believed that children should be physically punished are only 7 percent, which implies an interesting contrast with the actual prevalence of physical discipline. Male children are subjected more to severe physical discipline (19 percent) than female children (11 percent). It is very interesting that differentials with respect to many of the background variables are relatively small. Children aged between 5-9 years, Roma children and children from other ethnic groups as well as children from the poorest groups are more likely to experience severe 53Republic of Macedonia physical punishment. In contrast, children living in the richest households, children in Macedonian households and children whose mother’s have at least secondary education are all more likely to have been disciplined only using non-violent means, that is not using psychological or physical means to discipline the child. Early Marriage Marriage before the age of 18 is a reality for many young girls. According to UNICEF’s worldwide estimates, over 60 million women aged 20-24 were married/in union before the age of 18. Factors that influence child marriage rates include: the state of the country’s civil registration system, which provides proof of age for children; the existence of an adequate legislative framework with an accompanying enforcement mechanism to address cases of child marriage; and the existence of customary or religious laws that condone the practice. In many parts of the world parents encourage the marriage of their daughters while they are still children in hopes that the marriage will benefit them both financially and socially, while also relieving financial burdens on the family. In actual fact, child marriage is a violation of human rights, compromising the development of girls and often resulting in early pregnancy and social isolation, with little education and poor vocational training reinforcing the gendered nature of poverty. The right to ‘free and full’ consent to a marriage is recognized in the Universal Declaration of Human Rights - with the recognition that consent cannot be ‘free and full’ when one of the parties involved is not sufficiently mature to make an informed decision about a life partner. The Convention on the Elimination of all Forms of Discrimination against Women mentions the right to protection from child marriage in article 16, which states: “The betrothal and the marriage of a child shall have no legal effect, and all necessary action, including legislation, shall be taken to specify a minimum age for marriage.” While marriage is not considered directly in the Convention on the Rights of the Child, child marriage is linked to other rights - such as the right to express their views freely, the right to protection from all forms of abuse, and the right to be protected from harmful traditional practices - and is frequently addressed by the Committee on the Rights of the Child. Other international agreements related to child marriage are the Convention on Consent to Marriage, Minimum Age for Marriage and Registration of Marriages and the African Charter on the Rights and Welfare of the Child and the Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa. Child marriage was also identified by the Pan-African Forum against the Sexual Exploitation of Children as a type of commercial sexual exploitation of children. Young married girls are a unique, though often invisible, group. Required to perform heavy amounts of domestic work, under pressure to demonstrate fertility, and responsible for raising children while still children themselves, married girls and child mothers face constrained decision- making and reduced life choices. Boys are also affected by child marriage but the issue impacts girls in far larger numbers and with more intensity. Cohabitation - when a couple lives together as if married - raises the same human rights concerns as marriage. Where a girl lives with a man and takes on the role of caregiver for him, the assumption is often that she has become an adult woman, even if she has not yet reached the age of 18. Additional concerns due to the informality of the relationship - for example, inheritance, citizenship and social recognition - might make girls in informal unions vulnerable in different ways than those who are in formally recognized marriages. Research suggests that many factors interact to place a child at risk of marriage. Poverty, protection of girls, family honour and the provision of stability during unstable social periods are considered as significant factors in determining a girl’s risk of becoming married while still a child. Women who married at younger ages were more likely to believe that it is sometimes acceptable for a husband to beat his wife and were more likely to experience domestic violence themselves. The age gap between partners is thought to contribute to these abusive power dynamics and to increase the risk of untimely widowhood. Closely related to the issue of child marriage is the age at which girls become sexually active. Women who are married before the age of 18 tend to have more children than those who marry later in life. Pregnancy related deaths are known to be a leading cause of mortality for both married and unmarried girls between the ages of 15 and 19, particularly among the youngest of this cohort. There is evidence to suggest that girls who marry at young ages are more likely to marry older men which may put them at increased risk of HIV infection. Parents seek to marry off their girls to protect their honour. The demand for this young wife to reproduce and the power imbalance resulting from the age differential lead to very low condom use among such couples. Two of the indicators are to estimate the percentage of women married before 15 years 54 Multiple Indicator Cluster Survey - 2005-2006 of age and percentage married before 18 years of age. The legal age of marriage in Republic of Macedonia is 18 without parental consent. A competent court can in a non-contentious decision permit a person who has attained 16 years of age to enter into marriage, provided that the court is of the opinion that the person possesses the physical and psychological maturity required. The court bases its opinion on the findings provided by a medical institution, as well as through the expert assistance provided by the Centre for Social Work. The percentage of women married at various ages is provided in Table CP.5. At the national level the percentage married before age 15 is just 1 percent, while the percentage married before age 18 is 12 percent. This percentage varies among the women from different ethnic groups. The percentage married before age 15 and before age 18 is the highest among the women of the Roma ethnic group (11 percent before age 15 and 49 percent before age 18). There is no difference in the percentage married before age 15 in urban and rural areas, but a difference appears in the percentage married before age 18 (10 percent in urban areas compared with 16 percent in rural areas). Women with no education are more likely to have married before age 15 (11 percent). Overall, 2 percent of women currently 15-19 years of age are married/in union. For this age group, the proportions currently married are highest in the Roma population and in the group with no education. Another component is the spousal age difference with an indicator being the percentage of married/ in union women 10 or more years younger than their current spouse. Table CP.6 presents the results of the age difference between husbands and wives. The majority of women aged 20-24 have spouses aged 0-4 years older. Ten percent of women have a husband/partner 10 and more years older. There is no significant difference between women from urban and rural areas. Women with lower educational level are less likely to have a 10 and more years older spouse than more educated women (2 versus 14 percent). Macedonian women are more likely to have their husband/partner 10+ years older, than women from other ethnic groups. Domestic Violence A number of questions were asked to women age 15-49 years to assess their attitudes towards whether husbands are justified to hit or beat their wives/partners for a variety of scenarios. These questions were asked to have an indication of cultural beliefs that tend to be associated with the prevalence of violence against women by their husbands/partners. The main assumption here is that women that agree with the statements indicating that husbands/partners are justified to beat their wives/partners under the situations described in reality tend to be abused by their own husbands/partners. The responses to these questions can be found in Table CP.9. Twenty one percent of women aged 15-49 believe a husband is justified in beating his wife/partner in various circumstances. Women from rural areas are more likely to believe a husband is justified in beating his wife when she goes out without telling him, when she neglects the children and when she argues with him. Attitudes toward domestic violence are strongly associated with women’s education. Thirty six percent of women with no education agree with any of these reasons, while this percentage is lower among women with secondary education (11 percent). Women in the poorest quintile (32 percent) are more likely to believe one or more of the reasons are justified than women in the richest quintile (8 percent). Women from the Roma ethnic group are more likely to believe a husband is justified in beating his wife when she goes out, neglects the children and argues with him, than Macedonian women. Child Disability One of the World Fit for Children goals is to protect children against abuse, exploitation, and violence, including the elimination of discrimination against children with disabilities. For children age 2 through 9 years, a series of questions were asked to assess a number of disabilities or impairments, such as sight impairment, deafness, and difficulties with speech. This approach rests in the concept of functional disability developed by WHO and aims to identify the implications of any impairment or disability for the development of the child (e.g. health, nutrition, education, etc.). Table CP.10 presents the results of these questions. Ten percent of children 2-9 years of age have at least one reported disability. This percentage is higher in the poorest quintile at 12 percent compared to 8 percent in the richest quintile. Roma children are more likely to have at least one reported disability. Three percent of children are not learning to do things like other children his/her age, 2 percent of children have no understanding of instructions and 1 percent has difficulty seeing, either in the daytime or at night. In thirteen percent of children aged 3- 9, their mothers or caretakers believe that their speech is not normal. Nine percent of children aged 2 are reported as not being able to name at least one object. 55Republic of Macedonia XII HIV/AIDS, Sexual Behaviour, and Orphaned Children Knowledge of HIV Transmission and Condom Use One of the most important prerequisites for reducing the rate of HIV infection is accurate knowledge of how HIV is transmitted and strategies for preventing transmission. Correct information is the first step toward raising awareness and giving young people the tools to protect themselves from infection. Misconceptions about HIV/AIDS are common and can confuse young people and hinder prevention efforts. Different regions are likely to have variations in misconceptions although some appear to be universal (for example that sharing food can transmit HIV or mosquito bites can transmit HIV). The UN General Assembly Special Session on HIV/AIDS (UNGASS) called on governments to improve the knowledge and skills of young people to protect themselves from HIV. The indicators to measure this goal as well as the MDG of reducing HIV infections by half include improving the level of knowledge of HIV and its prevention, and changing behaviours to prevent further spread of the disease. The HIV/ AIDS module was administered to women 15-49 years of age. One indicator which is both an MDG and UNGASS indicator is the percentage of young women who have comprehensive and correct knowledge of HIV prevention and transmission. Women were asked whether they knew of the three main ways of HIV transmission – having only one faithful uninfected partner, using a condom every time, and abstaining from sex. The results are presented in Table HA.1. In Republic of Macedonia 80 percent of interviewed women aged 15-49 have heard of AIDS. There was a significant difference between women with no education (34 percent) and women with secondary education (96 percent). The poorest quintile (58 percent) is significantly less likely to have heard of AIDS than the richest quintile (96 percent). Ninety five percent of Macedonian women have heard of AIDS, but less than 60 percent of women from other ethnic groups have heard of AIDS. 56 Multiple Indicator Cluster Survey - 2005-2006 Women in the MICS were read several statements about means of HIV transmission and asked to state whether they believed the three statements on main ways of preventing HIV were true. The three main ways are “having only one faithful uninfected sex partner”, “using a condom every time” and “abstaining from sex”. Among women aged 15-49, 61 percent believed that having only one uninfected sex partner can prevent HIV transmission, 60 percent know using a condom every time can prevent HIV transmission, and 28 percent know of abstaining from sex as a way of preventing HIV transmission. Overall, 22 percent know all three ways and 71 percent are aware of at least one of the means of preventing transmission. Thirty percent of women do not know any of these three ways. Regionally, women in Vardarski region (85 percent aware of at least one way) are better informed than in Poloski region (57 percent). Women in urban areas (80 percent) are better informed than women in rural areas (58 percent). Knowledge of preventing HIV transmission increased significantly with educational level. The percentage of women (15-49) who know all three ways of preventing transmission is lowest among women with no education (4 percent), while it is 27 percent among women with secondary education, and knowledge of at least one way of preventing transmission is only 22 percent for women with no education but 91 percent for women with at least secondary education. Differences in knowledge across age groups are not particularly large. In general, women from Albanian and Roma ethnic group are less informed than Macedonian women. While 77 percent of Macedonian women believe that using a condom every time can prevent HIV/AIDS transmission, this percentage is significantly lower among women from Albanian and Roma ethnic groups (34 percent). Table HA.2 presents the percentage of women who can correctly identify misconceptions concerning HIV. The indicator is based on the two most common and relevant misconceptions in Republic of Macedonia, that HIV can be transmitted by supernatural means and sharing food. The table also provides information on whether women know that HIV cannot be transmitted by mosquito bites, and that HIV can be transmitted by sharing needles. Of the interviewed women, 32 percent reject the two most common misconceptions and know that a healthy-looking person can be infected. Seventy one percent of women know that HIV cannot be transmitted by supernatural means, and 41 percent of women know that HIV cannot be transmitted by mosquito bites, while 57 percent of women know that a healthy-looking person can be infected. Women in rural areas are less likely to identify both misconceptions than urban women (19 versus 41 percent). Women with secondary education (49 percent) are more likely to recognize both misconceptions than women with primary (11 percent) or no education (3 percent). There are significant differences among women from different ethnic groups. Only 8 percent of Roma women can identify both misconceptions, compared with Macedonian women where this percentage is 43. Identification of both misconceptions is also positively correlated with the socio-economic status measured by the wealth quintiles – 9 percent of the poorest quintile identified both misconceptions, compared with 52 percent of the richest quintile. Table HA.3 summarizes information from Tables HA.1 and HA.2 and presents the percentage of women who know two ways of preventing HIV transmission and reject three common misconceptions. Comprehensive knowledge of HIV prevention methods and transmission is still fairly low although there are differences by area of residence. The first column shows the percentage of women who know two ways of preventing HIV transmission-having one faithful uninfected partner and using a condom every time. Roughly half of women know these two ways. The second column shows the percentage of women who correctly identify two misconceptions about HIV transmission-that it can be transmitted through mosquito bites, and that a healthy looking person cannot be infected. Roughly one third of women correctly identified these as misconceptions. Finally, the third column of the table shows the percentage of women who have comprehensive knowledge of HIV transmission. These are women who know two prevention methods and three misconceptions. Twenty four percent of women aged 15-49 fell into this category. Overall, 51 percent of women report knowing two prevention methods while in urban areas 57 percent of women identified both methods. Seventy percent of the richest quintile know two prevention methods compared with only 29 percent of the poorest quintile. Level of education is highly associated with knowledge of HIV. Knowledge of preventing 57Republic of Macedonia HIV transmission increased significantly with educational level. The percentage of women (15-49) who know both means of preventing transmission is lowest among women with no education (13 percent) or primary education (32 percent), while it is 68 percent among women with secondary education. Twenty four percent of women aged 15-49 correctly identified the two ways to prevent HIV transmission and rejected the three misconceptions about HIV/AIDS. Women in rural areas are less likely to have comprehensive correct knowledge about HIV/AIDS than urban women (14 versus 30 percent). Comprehensive correct knowledge is highest among the Macedonian population (33 percent) than the other ethnic groups (less than 8 percent for either the Albanian population or the Roma population). Thirty seven percent of secondary educated women have comprehensive correct knowledge about HIV/AIDS, compared with only 7 percent or less of women with primary or no education. In the poorest quintile only 5 percent have comprehensive correct knowledge while that figure rises to 40 percent in the richest quintile. Comprehensive correct knowledge varies by region from a low of 12 percent in Poloski region to a high of 39 percent in Vardarski region. A key indicator used to measure countries’ responses to the HIV/AIDS epidemic is the proportion of young people 15-24 years who know two methods of preventing HIV reject two misconceptions and know that a healthy looking person can have HIV. Twenty seven percent of young women have comprehensive correct knowledge of HIV/AIDS (Figure HA.1). Figure HA.1 Percent of women who have com- prehensive knowledge of HIV/AIDS transmis- sion, Republic of Macedonia, 2005 Pe rc en t None Primary Secondary+ Republic of Macedonia average Knows 2 ways to prevent HIV Identify 3 misconceptions Comprehensive knowledge that HIV can be transmitted during pregnancy, delivery, and through breastfeeding. The level of knowledge among women age 15-49 years concerning mother-to-child transmission is presented in Table HA.4. Overall, seventy one percent of women know that HIV can be transmitted from mother to child. The percentage of women who know all three ways of mother-to- child transmission is 56 percent, while 9 percent of women did not know of any specific way. Knowledge of all three ways in which HIV can be transmitted from mother to child is higher in urban areas (61 percent) than in rural areas (47 percent); it is also significantly higher among the more educated women (72 percent among women with secondary education against 17 percent among women with no education). Women from the Albanian and Roma ethnic group are less likely to correctly identify means of HIV transmission from mother to child than Macedonian women (29 percent versus 70 percent). When asked specifically about the mechanisms through which mother to child transmission can take place, about 69 percent said that transmission during pregnancy was possible, 60 percent said that transmission at delivery was possible, and 62 percent agreed that HIV can be transmitted through breast milk. The indicators on attitudes toward people living with HIV measure stigma and discrimination in the community. Stigma and discrimination are low if respondents report an accepting attitude on the following four questions: 1) would care for family member sick with AIDS; 2) would buy fresh vegetables from a vendor who was HIV positive; 3) thinks that a female teacher who is HIV positive should be allowed to teach in school; and 4) would not want to keep HIV status of a family member a secret. Table HA.5 presents the attitudes of women towards people living with HIV/AIDS. Eighty four percent of women aged 15-49 agreed with at least one discriminatory statement towards people with HIV/AIDS, while only 16 percent expressed accepting attitudes. Only 5 percent of women would not care for a family member who was sick with AIDS, 65 percent would not buy fresh vegetables from person with HIV/AIDS and 55 percent believe that a female teacher with HIV should not be allowed to work. Urban women (18 percent) are more likely to express accepting attitudes than rural women (13 percent). Women aged 25-29 are most likely to show accepting attitudes. Twenty eight percent of women with no education agree with none of the discriminatory statements, compared to only 9 percent of those with primary education. Roma women are most likely to Knowledge of mother-to-child transmission of HIV is also an important first step for women to seek HIV testing when they are pregnant to avoid infection in the baby. Women should know 58 Multiple Indicator Cluster Survey - 2005-2006 express no discriminatory attitudes (23 percent). For all background categories, including region, urban/rural, age groups, education, wealth index and ethnic group, the proportion expressing a discriminatory attitude increases from the first to the fourth question. Another important indicator is the knowledge of where to be tested for HIV and use of such services. The indicators shown in Table HA.6 are designed to monitor whether women are aware of places to get tested for HIV, the extent to which they have been tested, and the extent to which those tested have been told the results of the test. In some places, a relatively large proportion of people who are tested do not return to get their results due to fear of having the disease, fear that their privacy will be violated, or other reasons. Forty five percent of women of reproductive age in Republic of Macedonia know a place to get tested for HIV. Women living in urban areas are most likely to know a place compared to those of rural areas. Women living in Pelagoniski region know a place to be tested (64 percent) more than any other region, followed by East region (55 percent), while this percent is lowest in the Poloski region (28 percent). Only 17 percent of women with primary education know a place to get tested compared to 68 percent of women with secondary education. Women from the Albanian ethnic group are less likely to know a place to get tested (18 percent) compared to Macedonian women (60 percent). Only 3 percent of women have actually been tested. Again this percentage is higher among women with secondary education (5 percent) than among those with no or primary education (0.3 percent). The vast majority of women who have been tested were told their results (92 percent). Among women who had given birth within the two years preceding the survey, the percentage who received HIV/AIDS counselling during antenatal care is presented in Table HA.7. Ninety eight percent of women in Republic of Macedonia received antenatal care from a health professional for last pregnancy, however, only 12 percent of women were provided information about HIV prevention during antenatal care visit. The percentage is higher in urban areas (14 percent) than in rural areas (9 percent). Receipt of HIV counselling increased with level of education from 7 percent for women with no education to 17 percent for women with secondary education. Macedonian women were the most likely (20 percent) of any ethnic group to have been provided information about HIV prevention. Sexual Behaviour Related to HIV Transmission Promoting safer sexual behaviour is critical for reducing HIV prevalence. The use of condoms during sex, especially with non-regular partners, is especially important for reducing the spread of HIV. In most countries over half of new HIV infections are among young people 15-24 years thus a change in behaviour among this age group will be especially important to reduce new infections. A module of questions was administered to women 15-24 years of age to assess their risk of HIV infection. Risk factors for HIV include sex at an early age, sex with older men, sex with a non-marital non-cohabitating partner, and failure to use a condom. The frequency of sexual behaviours that increase the risk of HIV infection among women is presented in Table HA.8 and Figure HA.2. Among women aged 15-19 in Republic of Macedonia, less than 1 percent had sex before age 15. Eight percent of women aged 20-24 years had sex before age 18. There is a significant difference between women from urban areas (10 percent) and rural areas (5 percent) and between women with no education (26 percent) and those with secondary education (7 percent). Women from the Roma ethnic group are more likely to had sex before 18 (27 percent), compared with women from other ethnic groups. Five percent of women aged 15-24 who had sex in the 12 months prior to the survey stated that they had sex with a man 10 or more years older. Women in urban areas are less likely to have had sex with a man 10+ years older than rural women (2 versus 15 percent). Figure HA.2 Sexual behaviour that increases risk of HIV infection, Republic of Macedonia, 2005 Women 15-19 who had sex before age 15 Women 20-24 who had sex before age 18 Women 20-24 who had sex in last 12 months with a man 10 years or more Pe rc en t Urban Rural Republic of Macedonia average 59Republic of Macedonia Promoting safer sexual behaviour is critical for reducing HIV prevalence. The use of condoms during sex, especially with non-regular partners is especially important for reducing the spread of HIV. Over half of new HIV infections are among young people 15-24 years, thus a change in behaviour among this age group will be especially important to reduce new infections. Condom use during sex with men other than husbands or live-in partners (non-marital, non- cohabiting) was assessed in women 15-24 years of age who had sex with such a partner in the previous year (Table HA.9). Almost 80 percent of women 15-24 years who had sex in the 12 months prior to the survey report having sex with a non-regular partner in the 12 months prior to the survey. Of those women, 70 percent report using a condom when they had sex with their last high risk partner. Twenty four percent of women with primary education report using a condom during higher risk sex in the year before the survey while 73 percent of women with secondary or more education used a condom with such a partner. Seventy six percent of women in urban areas used a condom during the last high risk sex compared to 46 percent of women in rural areas. Children’s living arrangements and orphanhood Children who are orphaned or living away from their parents may be at increased risk of impoverishment, discrimination, denial of property rights to inheritance, various forms of abuse, neglect, and exploitation of their labor or sexuality. Monitoring the condition level of orphaned children and the living arrangements of children assists in identifying those who may be at risk and in tracking changes over time. The frequency of children living with neither parent, mother only, and father only is presented in Table HA.10. Overall 94 percent of children aged 0-17 are living with both parents. Children who are not living with either biological parent comprise 0.4 percent, but children one or both of whose parents are dead amount to almost 2 percent of all children aged 0-17 years. It is more likely that the child’s father will be dead than their mother. Four percent of children live with their mother only and their father lives elsewhere, but that percentage reaches almost 12 percent in the South East region. 60 Multiple Indicator Cluster Survey - 2005-2006 Endnotes 1 The terms “children under 5”, “children age 0-4 years”, and “children aged 0-59 months” are used interchangeably in this report. 2 The model MICS3 questionnaire can be found at www.childinfo.org, or in UNICEF, 2006. 3 This was determined by asking “To what ethnic group does the head of the household belong?”. 4 Unless otherwise stated, “education” refers to the highest educational level attended by the respondent throughout this report when it is used as a background variable. 5 Principal components analysis was performed by using information on the ownership of household goods and amenities (assets) to assign weights to each household asset, and obtain wealth scores for each household in the sample (The assets used in these calculations were as follows: persons per sleeping room, type of the floor, type of the roof, type of the walls, type of cooking fuel and other assets: electricity, radio, television, mobile telephone, non-mobile telephone, refrigerator, dish washer, computer, washing machine, watch, bicycle, motorcycle/scooter, animal drawn- cart, car/truck, boat with motor, tractor. Each household was then weighted by the number of household members, and the household population was divided into five groups of equal size, from the poorest quintile to the richest quintile, based on the wealth scores of households they were living in. The wealth index is assumed to capture the underlying long-term wealth through information on the household assets, and is intended to produce a ranking of households by wealth, from poorest to richest. The wealth index does not provide information on absolute poverty, current income or expenditure levels, and the wealth scores calculated are applicable for only the particular data set they are based on. Further information on the construction of the wealth index can be found in Rutstein and Johnson, 2004, and Filmer and Pritchett, 2001. 6 For a detailed description of the methodology, see Boerma, Weinstein, Rutstein and Sommerfelt, 1996. 7 All means “percent of children who missed out on at least one of the eight recommended doses” 8 Unmet need measurement in MICS is somewhat different than that used in other household surveys, such as the Demographic and Health Surveys (DHS). In DHS, more detailed information is collected on additional variables, such as postpartum amenhorrea, and sexual activity. Results from the two types of surveys are strictly not comparable. 61Republic of Macedonia I Tables The Tables included in this final report are grouped into the following topics: Sample and Survey characteristics Child mortality Nutrition Child Health Environment Reproductive Health Child Development Education Child protection HIV/AIDS, Sexual Behaviour and Orphaned Children Tables are shown with breakdowns by background characteristics such as sex, region, urban-rural residence, mother’s education, wealth index quintiles and ethnicity. The sample sizes are not always large enough to produce reliable estimates for all these breakdowns, so for proportions or percentages, the recommended minimum size of the denominator is 25 unweighted cases. A percentage with an unweighted denominator less than 25 cases is not shown in the table, while a percentage based on less than 50 cases is shown in parentheses. Each table has footnotes which indicate the MICS and MDG indicators included in the table. 62 Multiple Indicator Cluster Survey - 2005-2006 Table HH.1: Results of household and individual interviews Number of households, women, and children under 5 by results of the household, women’s and under- five’s interviews, and household, women’s and under-five’s response rates, Republic of Macedonia, 2005 Residence Region Urban Rural Skop-ski Pelagoni-ski Vardar-ski North East South West South East Poloski East Total Number of households Sampled households 3170 2209 1511 606 330 450 625 462 858 537 5379 Occupied households 3119 2168 1463 602 328 443 610 459 848 534 5287 Interviewed households 2751 1950 1271 575 313 412 524 442 686 478 4701 Household response rate 88.2 89.9 86.9 95.5 95.4 93.0 85.9 96.3 80.9 89.5 88.9 Number of women Eligible women 4266 3273 2188 810 435 747 761 658 1263 677 7539 Interviewed women 4187 3210 2160 808 433 742 734 652 1218 650 7397 Women response rate 98.1 98.1 98.7 99.8 99.5 99.3 96.5 99.1 96.4 96.0 98.1 Women’s overall response rate 86.6 88.2 85.8 95.3 95.0 92.4 82.9 95.4 78.0 85.9 87.2 Number of children under 5 Eligible children under 5 2637 1941 1486 474 289 471 414 408 659 377 4578 Mother/Caretaker Interviewed 2615 1933 1475 471 289 471 411 407 651 373 4548 Child response rate 99.2 99.6 99.3 99.4 100.0 100.0 99.3 99.8 98.8 98.9 99.3 Children’s overall response rate 87.5 89.6 86.2 94.9 95.4 93.0 85.3 96.1 79.9 88.6 88.3 Table HH.2: Household age distribution by sex Percentage distribution of the household population by five-year age groups and dependency age groups, and number of children aged 0-17 years, by sex, Republic of Macedonia, 2005 Males Females Total Number Percent Number Percent Number Percent Age 0-4 823 6.2 774 5.9 1597 6.0 5-9 960 7.2 903 6.9 1863 7.1 10-14 1074 8.1 1012 7.7 2086 7.9 15-19 1105 8.3 1048 8.0 2152 8.1 20-24 1087 8.2 1020 7.7 2107 8.0 25-29 1019 7.7 977 7.4 1997 7.6 30-34 978 7.4 951 7.2 1929 7.3 35-39 992 7.5 958 7.3 1950 7.4 40-44 976 7.4 935 7.1 1911 7.2 45-49 949 7.2 908 6.9 1857 7.0 50-54 822 6.2 840 6.4 1662 6.3 55-59 604 4.6 635 4.8 1239 4.7 60-64 562 4.2 607 4.6 1169 4.4 65-69 517 3.9 581 4.4 1099 4.2 70+ 741 5.6 956 7.3 1698 6.4 Missing/DK 38 .3 69 .5 107 .4 Dependency age groups < 15 2858 21.6 2689 20.4 5546 21.0 15-64 9095 68.6 8878 67.4 17973 68.0 65 + 1259 9.5 1537 11.7 2796 10.6 Missing/DK 38 .3 69 .5 107 .4 Children aged 0-17 3547 26.8 3260 24.7 6806 25.8 Adults 18+/Missing/ DK 9703 73.2 9914 75.3 19617 74.2 Total 13249 100,0 13174 100,0 26423 100,0 63Republic of Macedonia Table HH.3: Household composition Percentage distribution of households by selected characteristics, Republic of Macedonia, 2005 Number of households Weighted percent Weighted Unweighted Sex of household head Male 92.4 4343 4294 Female 7.6 358 407 Region Skopski 26.1 1226 1271 Pelagoniski 12.7 597 575 Vardarski 6.8 320 313 North-East 7.4 347 412 South-West 11.9 559 524 South-East 9.0 422 442 Poloski 12.6 593 686 East 13.5 635 478 Residence Urban 60.8 2857 2751 Rural 39.2 1844 1950 Number of household members 1 .7 33 39 2-3 13.9 651 618 4-5 56.5 2655 1920 6-7 20.0 940 1348 8-9 5.4 255 450 10+ 3.6 167 326 Ethnicity Macedonian 65.2 3064 2265 Albanian 25.0 1176 1407 Roma 2.6 120 701 Other 7.2 340 328 Total 100,0 4701 4701 At least one child aged < 18 years 68.0 - - At least one child aged < 5 years 20.1 - - At least one woman aged 15-49 years 96.8 - - 64 Multiple Indicator Cluster Survey - 2005-2006 Table HH.4: Women’s background characteristics Percentage distribution of women aged 15-49 years by background characteristics, Republic of Macedonia, 2005 Number of households Weighted percent Weighted Unweighted Region Skopski 28.0 2069 2160 Pelagoniski 11.0 817 808 Vardarski 6.3 467 433 North-East 8.2 605 742 South-West 10.9 808 734 South-East 8.3 613 652 Poloski 14.4 1068 1218 East 12.8 949 650 Residence Urban 60.1 4445 4187 Rural 39.9 2952 3210 Age 15-19 15.3 1129 1158 20-24 14.9 1103 1528 25-29 14.6 1078 1637 30-34 14.1 1041 1072 35-39 14.2 1054 630 40-44 13.9 1027 659 45-49 13.0 965 713 Marital/Union status Currently married/in union 57.5 4251 5165 Formerly married/in union 3.3 242 251 Never married/in union 39.3 2904 1981 Motherhood status Ever gave birth 58.7 4346 5188 Never gave birth 41.3 3051 2209 Education None 3.6 263 779 Primary 40.4 2988 3822 Secondary + 56.0 4146 2796 Wealth index quintiles Poorest 18.3 1354 2275 Second 18.1 1336 1569 Middle 20.2 1498 1348 Fourth 21.3 1577 1265 Richest 22.1 1632 940 Ethnicity Macedonian 61.4 4545 3193 Albanian 29.0 2145 2468 Roma 2.5 184 1246 Other 7.1 522 490 Total 100,0 7397 7397 65Republic of Macedonia Table HH.5: Children’s background characteristics Percentage distribution of children under five years of age by background characteristics, Republic of Macedonia, 2005 Number of households Weighted percent Weighted Unweighted Sex Male 53.4 2428 2322 Female 46.6 2118 2223 Region Skopski 37.2 1691 1473 Pelagoniski 9.1 415 471 Vardarski 6.1 279 289 North-East 7.2 329 471 South-West 8.7 397 410 South-East 8.3 377 407 Poloski 16.3 742 651 East 7.0 316 373 Residence Urban 54.3 2467 2615 Rural 45.7 2080 1930 Age < 6 months 7.2 326 233 6-11 months 9.3 421 275 12-23 months 18.4 837 924 24-35 months 19.4 881 939 36-47 months 23.5 1067 1039 48-59 months 22.3 1016 1135 Mother’s education None 7.1 324 588 Primary 54.8 2491 2595 Secondary + 38.1 1732 1362 Wealth index quintiles Poorest 28.2 1282 1653 Second 21.7 988 931 Middle 19.4 883 789 Fourth 19.3 879 705 Richest 11.3 515 467 Ethnicity Macedonian 37.5 1704 1698 Albanian 46.1 2097 1661 Roma 5.1 231 829 Other 11.3 514 357 Total 100,0 4547 4545 66 Multiple Indicator Cluster Survey - 2005-2006 Table CM.1: Early child mortality Infant and under-five mortality rates by background characteristics, Republic of Macedonia, 2005 Infant mortality rate* Under-five mortality rate** Sex Male 19 21 Female 9 10 Residence Urban 9 10 Rural 23 26 Women’s education None/Primary 25 28 Secondary + - - Wealth index quintiles Poorest 60% 22 25 Richest 40% - - Total 16 17 East Model. Reference date: June 2003 * MICS indicator 2; MDG indicator 14 ** MICS indicator 1; MDG indicator 13 Table CM.2: Children ever born and proportion dead Mean number of children ever born, children surviving and proportion dead by age of women, Republic of Macedonia, 2005 Mean number of children ever born Mean number of children surviving Proportion dead Number of women Age 15-19 .003 .002 .045 1129 20-24 .069 .065 .057 1103 25-29 .429 .425 .009 1078 30-34 .872 .855 .020 1041 35-39 .960 .893 .069 1054 40-44 .561 .520 .073 1027 45-49 .726 .671 .076 965 Total .505 .479 .051 7397 67Republic of Macedonia Table NU.1: Child malnourishment Percentage of children aged 0-59 months who are severely or moderately malnourished, Republic of Macedonia, 2005 Weight for age Height for age Weight for height Number of children aged 0-59 months % below % below % above % below % below % below % below % above - 2 SD* - 3 SD* + 2 SD - 2 SD** - 3 SD** - 2 SD*** - 3 SD*** + 2 SD Sex Male 2.3 .3 9.2 10.4 2.7 1.9 .2 10.6 9.2 Female 2.3 .2 7.2 6.8 1.8 2.8 1.3 10.6 7.2 Region Skopski 2.2 .2 9.9 6.5 1.5 2.4 .2 7.7 9.9 Pelagoniski 3.6 .6 9.2 7.5 3.3 1.4 .3 9.1 9.2 Vardarski .2 .0 4.9 9.2 2.6 1.1 .0 13.8 4.9 North-East 3.5 .2 9.7 17.7 4.1 .6 .4 19.9 9.7 South-West 8.4 .9 9.2 8.1 5.2 13.9 7.6 13.9 9.2 South-East 1.1 .2 5.1 18.4 2.0 .7 .2 14.3 5.1 Poloski .4 .1 5.6 7.1 1.6 .6 .0 7.2 5.6 East 1.0 .0 10.1 3.4 .8 .2 .0 13.9 10.1 Residence Urban 2.4 .4 9.7 8.2 2.5 1.3 .3 12.3 9.7 Rural 2.2 .1 6.7 9.2 2.1 3.5 1.3 8.7 6.7 Age < 6 months .3 .0 13.5 1.8 .0 2.1 .6 8.0 13.5 6-11 months 7.3 .7 3.1 13.4 1.6 11.4 .2 4.7 3.1 12-23 months 3.4 .5 5.7 13.6 4.4 1.7 .5 13.9 5.7 24-35 months 2.3 .1 8.2 7.5 2.2 3.9 2.9 9.1 8.2 36-47 months 1.6 .4 9.0 8.3 2.0 .6 .1 9.0 9.0 48-59 months 1.0 .0 9.8 6.7 1.8 .3 .1 13.8 9.8 Mother’s education None 5.3 .5 11.5 17.4 5.2 1.2 .2 7.2 11.5 Primary 3.0 .4 5.5 9.2 2.5 3.3 1.2 9.7 5.5 Secondary + .7 .0 11.8 6.2 1.4 1.1 .2 12.7 11.8 Wealth index quintiles Poorest 3.9 .3 6.9 11.2 3.0 3.5 .1 9.9 6.9 Second 2.0 .4 5.8 7.7 1.8 1.1 .3 9.0 5.8 Middle 2.2 .2 7.5 10.3 2.9 1.0 .4 10.6 7.5 Fourth 1.2 .3 7.9 6.4 1.6 4.3 3.3 12.4 7.9 Richest .8 .0 18.5 4.8 1.3 1.5 .4 13.1 18.5 Ethnicity Macedonian 1.5 .2 11.6 7.8 2.0 2.3 1.6 13.4 11.6 Albanian 2.8 .3 5.1 8.0 2.2 2.8 .3 8.3 5.1 Roma 5.8 .8 17.1 16.6 5.4 1.5 .5 6.9 17.1 Other 1.1 .0 5.5 11.2 1.9 .4 .0 13.4 5.5 Total 2.3 .3 8.3 8.7 2.3 2.3 .8 10.6 8.3 * MICS indicator 6; MDG indicator 4 ** MICS indicator 7 *** MICS indicator 8 68 Multiple Indicator Cluster Survey - 2005-2006 Table NU.2: Initial breastfeeding Percentage of women aged 15-49 years with a birth in the two years preceding the survey who breastfed their baby within one hour of birth and within one day of birth, Republic of Macedonia, 2005 Percent who started breastfeeding within one hour of birth* Percent who started breastfeeding within one day of birth Number of women with a live birth in the two years preceding the survey Region Skopski 16.0 80.0 213 Pelagoniski 23.8 90.4 46 Vardarski 41.3 88.2 18 North-East 46.2 90.7 39 South-West 48.1 57.7 59 South-East 34.9 91.0 36 Poloski 22.2 79.1 115 East 33.0 90.4 41 Residence Urban 23.6 86.7 308 Rural 30.1 73.7 257 Months since birth < 6 months 27.7 93.3 103 6-11 months 22.8 85.5 150 12-23 months 28.0 74.4 313 Mother’s education None 32.9 68.0 35 Primary 27.9 77.4 334 Secondary + 23.1 88.6 197 Wealth index quintiles Poorest 36.3 80.2 158 Second 25.4 75.4 102 Middle 29.4 86.4 104 Fourth 14.8 80.5 138 Richest 25.3 82.1 64 Ethnicity Macedonian 31.0 80.4 174 Albanian 26.8 77.7 306 Roma 24.6 82.0 19 Other 14.6 95.1 67 Total 26.6 80.8 566 * MICS indicator 45 69Republic of Macedonia Table NU.3: Breastfeeding Percentage of living children according to breastfeeding status at each age group, Republic of Macedonia, 2005 Children 0-3 months Children 0-5 months Children 6-9 months Children 12-15 months Children 20-23 months Percent exclusively breastfed Number of children Percent exclusively breastfed* Number of children Percent receiving breastmilk and solid/ mushy food** Number of children Percent breastfed*** Number of children Percent breastfed*** Number of children Sex Male 21.8 154 15.8 217 21.2 185 44.9 184 16.7 130 Female 30.2 57 16.8 108 11.2 109 44.5 112 28.0 111 Residence Urban 25.3 157 20.1 198 11.5 167 47.6 144 26.4 122 Rural 20.6 54 10.0 128 25.5 126 42.1 153 17.3 119 Mother’s education None (*) (*) (8.4) 49 (34.9) 9 (81.0) 38 (47.9) 11 Primary 34.9 115 21.0 199 33.0 118 43.4 185 27.5 148 Secondary + 12.6 54 8.7 78 (5.5) 165 29.7 73 8.1 82 Wealth index quintiles Poorest 15.6 73 10.0 124 34.2 84 44.8 111 40.4 57 Second (13.6) 45 (8.9) 69 (45.3) 24 52.2 73 9.9 61 Middle (12.7) 44 (10.0) 56 (11.5) 58 (48.5) 48 (23.8) 47 Fourth (*) 40 (47.1) 60 (*) 71 (34.9) 33 17.1 49 Richest (*) 9 (*) 18 (*) 56 (32.2) 31 (15.5) 27 Ethnicity Macedonian (13.7) 66 9.8 92 9.1 111 48.4 89 12.1 85 Albanian 37.9 100 21.4 185 (14.8) 79 41.8 173 24.4 125 Roma (2.8) 33 (3.0) 36 (48.0) 12 56.7 14 53.3 9 Other (*) 15 (*) 12 (*) 91 (*) 21 (*) 23 Total 24.1 211 16.2 326 17.5 293 44.8 296 21.9 241 * MICS indicator 15 ** MICS indicator 17 *** MICS indicator 16 70 Multiple Indicator Cluster Survey - 2005-2006 Table NU.3w. Infant feeding patterns by age Percentage distribution of children aged under 3 years by feeding pattern by age group, Republic of Macedonia, 2005 Infant feeding pattern Exclusively breastfed Breastfed and plain water only Breastfed and non-milk liquids Breastfed and other milk / formula Breastfed and other complimentary foods Weaned (not breastfed) Total Number of children Age in months 0-1 40.4 4.5 7.4 44.1 1.1 2.5 100.0 95 2-3 10.8 23.4 28.7 27.3 1.6 8.2 100.0 116 4-5 1.5 4.0 7.0 65.3 7.8 14.4 100.0 114 6-7 .0 1.1 28.7 35.5 23.4 11.3 100.0 163 8-9 .0 13.1 1.9 5.7 10.1 69.2 100.0 130 10-11 .2 .2 6.6 9.1 45.7 38.2 100.0 127 12-13 .0 .0 1.3 7.3 40.4 51.0 100.0 181 14-15 .2 .2 3.7 7.8 26.2 61.9 100.0 115 16-17 .0 4.3 .8 2.2 15.1 77.6 100.0 170 18-19 .1 .7 1.2 9.8 16.0 72.2 100.0 130 20-21 .7 .0 1.0 0.9 21.7 75.7 100.0 117 22-23 .0 .9 2.2 4.0 12.5 80.4 100.0 124 24-25 .0 .8 .1 1.1 11.8 86.2 100.0 181 26-27 .0 .0 .5 1.5 9.1 88.8 100.0 136 28-29 .0 .0 .0 .1 3.7 96.3 100.0 197 30-31 .0 .0 .0 2.4 5.9 91.7 100.0 129 32-33 .0 .0 .0 .0 3.5 96.5 100.0 146 34-35 .0 .0 .0 .0 3.6 96.4 100.0 92 Total 2.2 2.7 4.9 11.2 15.0 64.0 100.0 2464 71Republic of Macedonia Table NU.4: Adequately fed infants Percentage of infants under 6 months of age exclusively breastfed, percentage of infants 6-11 months who are breastfed and who ate solid/semi-solid food at least the minimum recommended number of times yesterday and percentage of infants adequately fed, Republic of Macedonia, 2005 Percentage of infants 0-5 months exclusively breastfed 6-8 months who received breastmilk and complementary food at least 2 times in prior 24 hours 9-11 months who received breastmilk and complementary food at least 3 times in prior 24 hours 6-11 months who received breastmilk and complementary food at least the minimum recommended number of times per day* 0-11 months who were appropriately fed** Number of infants aged 0-11 months Sex Male 15.8 18.9 14.8 17.7 16.8 466 Female 16.8 (10.5) 18.7 15.0 15.7 280 Residence Urban 20.1 7.9 27.4 14.1 16.9 422 Rural 10.0 (29.1) 9.1 19.4 15.7 324 Mother’s education None (8.4) (30.4) (42.1) 37.5 17.5 71 Primary 21.0 39.0 9.6 22.5 21.7 401 Secondary + 8.7 (2.8) (29.5) 8.1 8.3 274 Wealth index quintiles Poorest 10.0 (41.6) 16.3 29.5 20.0 252 Second (8.9) (46.7) (16.4) 28.0 16.7 116 Middle (10.0) (7.9) (7.4) 7.7 8.6 143 Fourth (47.1) (*) (25.7) (7.7) 23.0 153 Richest (*) (*) (*) (*) (6.3) 82 Ethnicity Macedonian 9.8 (5.6) 37.3 15.3 13.2 236 Albanian 21.4 (15.2) 5.6 8.8 15.6 343 Roma (3.0) (42.0) (33.9) 38.8 14.7 54 Other (*) (*) (*) (*) (26.2) 114 Total 16.2 16.3 17.0 16.6 16.4 746 * MICS indicator 18 ** MICS indicator 19 72 Multiple Indicator Cluster Survey - 2005-2006 Table NU.8: Low birth weight infants Percentage of live births in the 2 years preceding the survey that weighed below 2500 grams at birth, Republic of Macedonia, 2005 Percentage of live births: Number of live birthsBelow 2500 grams* Weighed at birth** Region Skopski 5.4 88.1 213 Pelagoniski 4.9 95.0 46 Vardarski 5.7 98.7 18 North East 6.9 95.7 39 South West 10.1 93.3 59 South East 7.5 98.7 36 Poloski 6.9 95.8 115 East 5.3 95.2 41 Residence Urban 5.3 94.8 308 Rural 7.8 90.4 257 Mother’s education None 10.5 83.3 35 Primary 6.6 90.8 334 Secondary + 5.4 97.9 197 Wealth index quintiles Poorest 7.8 85.0 158 Second 7.2 92.3 102 Middle 5.5 95.9 104 Fourth 5.3 97.9 138 Richest 5.4 96.7 64 Ethnicity Macedonian 5.4 97.0 174 Albanian 7.0 90.6 306 Roma 6.9 76.9 19 Other 6.3 96.9 67 Total 6.4 92.8 566 * MICS indicator 9 ** MICS indicator 10 73Republic of Macedonia Table CH.1: Vaccinations in first year of life Percentage of children aged 18-29 months immunized against childhood diseases at any time before the survey and before the first birthday, Republic of Macedonia, 2005 Percentage of children who received: Number of children aged 18-29 monthsBCG* DPT1 DPT2 DPT3** Polio1 Polio2 Polio3*** Measles**** All***** None Vaccinated at any time before the survey According to: Vaccination card 74.3 74.6 74.0 71.6 73.8 73.3 72.1 67.6 64.9 .0 884 Mother’s report 19.1 14.9 13.2 10.1 17.6 16.2 9.4 15.2 6.2 .9 884 Either 98.0 96.6 94.3 88.3 97.0 95.0 86.4 88.4 75.5 1.0 884 Vaccinated by 12 months of age 97.2 94.0 90.1 82.1 94.6 91.7 80.8 80.4 60.2 1.0 884 * MICS indicator 25 ** MICS indicator 27 *** MICS indicator 26 **** MICS indicator 28; MDG indicator 15; note that for Measles this is the proportion vaccinated by 18 months of age ***** MICS indicator 31 Table CH.2: Vaccinations by background characteristics Percentage of children aged 18-29 months currently vaccinated against childhood diseases, Republic of Macedonia, 2005 Percentage of children who received: Number of children aged 18-29 monthsBCG DPT1 DPT2 DPT3 Polio1 Polio2 Polio3 Measles All None Percent with health card Sex Male 97.9 95.7 93.2 86.6 96.5 94.4 82.3 88.3 71.5 1.0 70.5 401 Female 98.0 97.3 95.2 89.7 97.4 95.4 90.0 88.5 78.9 1.0 79.0 483 Residence Urban 97.5 97.0 95.0 89.5 96.1 95.1 91.7 89.2 80.4 1.5 82.6 479 Rural 98.5 96.0 93.3 86.7 98.0 94.9 80.1 87.6 69.5 .3 66.3 406 Mother’s education None 91.2 88.4 86.1 83.3 90.8 87.9 84.4 70.8 64.6 5.3 68.8 42 Primary 98.6 97.2 94.9 87.0 97.3 94.8 83.8 87.6 72.5 .7 71.5 533 Secondary + 97.8 96.6 94.3 91.1 97.2 96.2 91.1 91.9 81.7 .9 82.1 309 Wealth index quintiles Poorest 95.9 93.9 91.6 85.2 94.7 90.2 75.1 79.8 60.1 2.8 67.1 220 Second 98.8 97.4 96.2 93.8 98.1 97.3 92.1 92.2 84.0 .0 83.8 239 Middle 100.0 99.4 96.7 88.5 99.1 98.2 91.2 88.9 79.2 .0 73.2 176 Fourth 97.9 96.5 93.3 85.3 95.9 93.4 89.1 91.4 79.1 .7 81.4 154 Richest 96.9 95.7 92.9 85.5 97.7 97.7 85.9 93.2 77.1 1.2 65.1 95 Ethnicity Macedonian 98.5 97.6 96.9 95.3 97.8 97.5 94.1 93.7 88.3 .9 89.8 351 Albanian 97.8 96.3 92.7 82.3 96.4 93.1 78.8 86.2 65.0 1.0 61.4 439 Roma 95.6 91.1 85.4 82.6 94.3 88.5 84.8 74.7 66.4 3.4 75.5 40 Other 97.0 96.2 94.2 89.8 98.5 96.5 93.3 80.5 76.2 .0 90.8 55 Total 98.0 96.6 94.3 88.3 97.0 95.0 86.4 88.4 75.5 1.0 75.1 884 74 Multiple Indicator Cluster Survey - 2005-2006 Table CH.4: Oral rehydration treatment Percentage of children aged 0-59 months with diarrhoea in the last two weeks and treatment with oral rehydration solution (ORS) or other oral rehydration treatment (ORT), Republic of Macedonia, 2005 Had diarrhoea in last two weeks Number of children aged 0-59 months Children with diarrhoea who received: Number of children aged 0-59 months with diarrhoea Fluid from ORS packet Recommended homemade fluid No treatment ORT Use Rate * Sex Male 5.6 2428 25.0 58.5 22.6 77.4 136 Female 9.1 2118 22.8 65.8 15.9 84.1 193 Region Skopski 3.7 1691 32.1 43.4 31.6 68.4 63 Pelagoniski 24.5 415 (5.8) (94.0) (3.4) (96.6) 101 Vardarski 2.4 279 (*) (*) (*) (*) 7 North-East 4.6 329 (21.5) (46.5) (32.9) (67.1) 15 South-West 9.7 397 (59.2) (15.7) (27.4) (72.6) 39 South-East 4.6 377 (*) (*) (*) (*) 18 Poloski 3.6 742 (40.1) (48.4) (29.6) (70.4) 27 East 18.8 316 (13.3) (82.5) (6.4) (93.6) 59 Residence Urban 7.6 2467 18.6 69.9 14.7 85.3 187 Rural 6.8 2080 30.3 53.5 23.9 76.1 142 Age < 6 months 5.6 326 (*) (*) (*) (*) 18 0-11 months 20.1 421 (33.3) (61.7) (6.1) (93.9) 85 12-23 months 14.1 837 16.4 77.2 13.6 86.4 118 24-35 months 4.9 881 16.1 51.3 37.4 62.6 44 36-47 months 3.3 1067 29.6 44.9 32.6 67.4 35 48-59 months 2.9 1016 (33.0) (51.8) (24.8) (75.2) 30 Mother’s education None 6.2 324 26.3 48.2 28.3 71.7 20 Primary 7.2 2491 31.0 54.6 20.8 79.2 179 Secondary + 7.5 1732 13.3 76.4 14.3 85.7 130 Wealth index quintiles Poorest 10.0 1282 33.7 56.2 14.1 85.9 129 Second 8.3 988 15.5 66.0 20.9 79.1 82 Middle 4.3 883 (30.6) (49.3) (31.6) (68.4) 38 Fourth 2.4 879 (26.5) (39.9) (44.2) (55.8) 21 Richest 11.5 515 (*) (*) (*) (*) 59 Ethnicity Macedonian 9.1 1704 12.5 77.4 13.3 86.7 155 Albanian 6.4 2097 32.1 51.6 23.2 76.8 134 Roma 9.0 231 33.9 49.9 22.7 77.3 21 Other 3.7 514 (44.6) (37.4) (26.4) (73.6) 19 Total 7.2 4547 23.7 62.8 18.7 81.3 329 * MICS indicator 33 75Republic of Macedonia Table CH.5: Home management of diarrhoea Percentage of children aged 0-59 months with diarrhoea in the last two weeks who took increased fluids and continued to feed during the episode, Republic of Macedonia, 2005 Had diarrhoea in last two weeks Number of children aged 0-59 months Children with diarrhoea who: Home manage- ment of diarrhoea (increased fluids and continued feeding)* Received ORT or increased fluids AND continued feeding** Number of children aged 0-59 months with diarrhoea Drank more Drank the same or less Ate somewhat less, same or more Ate much less or none Sex Male 5.6 2428 20.7 74.1 39.8 59.6 8.5 26.4 136 Female 9.1 2118 9.0 90.2 65.9 29.7 4.3 57.3 193 Region Skopski 3.7 1691 18.9 78.3 39.2 60.6 6.0 26.1 63 Pelagoniski 24.5 415 (6.5) (91.7) 51.2 (40.6) (1.6) (48.0) 101 Vardarski 2.4 279 (*) (*) (*) (*) (*) (*) 7 North-East 4.6 329 (37.8) (56.6) (65.9) (34.1) (13.6) (46.9) 15 South-West 9.7 397 (5.3) (89.4) (45.2) (52.4) (3.7) (22.0) 39 South-East 4.6 377 (*) (*) (*) (*) (*) (*) 18 Poloski 3.6 742 (36.1) (60.0) (47.8) (52.2) (22.3) (37.2) 27 East 18.8 316 (9.7) (90.0) (83.5) (16.5) (2.8) (80.3) 59 Residence Urban 7.6 2467 14.1 84.7 69.4 26.6 6.1 61.2 187 Rural 6.8 2080 13.5 82.0 36.3 62.5 6.0 22.6 142 Age 0-11 months 13.8 746 6.4 90.1 57.5 35.9 2.7 52.9 103 12-23 months 14.1 837 9.7 87.8 60.1 39.7 5.4 50.6 118 24-35 months 4.9 881 25.7 72.2 43.5 54.5 9.4 26.0 44 36-47 months 3.3 1067 21.9 74.7 53.5 42.5 11.4 33.4 35 48-59 months 2.9 1016 (29.3) (70.7) (45.7) (54.3) (9.3) (31.2) 30 Mother’s education None 6.2 324 9.9 76.4 49.8 41.8 6.4 34.8 20 Primary 7.2 2491 16.9 79.8 33.0 62.8 5.0 21.5 179 Secondary + 7.5 1732 10.2 89.8 86.2 13.8 7.4 77.5 130 Wealth index quintiles Poorest 10.0 1282 12.7 84.8 27.4 65.3 5.0 20.3 129 Second 8.3 988 13.7 82.1 71.3 28.7 4.4 60.6 82 Middle 4.3 883 (29.7) (67.4) (39.6) (60.4) (9.7) (20.7) 38 Fourth 2.4 879 (8.3) (87.1) (75.2) (24.8) (8.3) (41.0) 21 Richest 11.5 515 (*) (*) (*) (*) (*) (*) 59 Ethnicity Macedonian 9.1 1704 8.8 91.1 79.0 16.2 5.4 69.6 155 Albanian 6.4 2097 16.3 81.0 29.5 69.2 4.5 17.3 134 Roma 9.0 231 30.5 60.2 39.8 59.6 9.9 29.7 21 Other 3.7 514 (19.2) (65.3) (57.3) (42.7) (18.5) (48.4) 19 Total 7.2 4547 13.8 83.5 55.1 42.1 6.1 44.5 329 * MICS indicator 34 ** MICS indicator 35 76 Multiple Indicator Cluster Survey - 2005-2006 Table CH.6: Care seeking for suspected pneumonia Percentage of children aged 0-59 months with suspected pneumonia in the last two weeks taken to a health provider, Republic of Macedonia, 2005 Had acute respiratory infection1 Number of children aged 0-59 months Children with suspected pneumonia who were taken to: Any appropriate provider* Number of children aged 0-59 months with suspected pneumonia Public sources Private sources Govt. Hospital Govt. health centre Govt. health post Other public Private hospital/ clinic Private physician Pharmacy Mobile clinic Sex Male 7.2 2428 22.6 13.0 31.6 2.7 16.9 8.8 .0 1.1 95.0 176 Female 4.7 2118 31.3 22.2 24.3 1.4 4.2 2.0 1.1 3.9 88.5 100 Region Skopski 3.0 1691 21.5 3.8 54.2 .0 .2 8.3 .0 11.9 97.4 50 Pelagoniski 16.1 415 (10.4) (27.5) (46.4) (2.5) (.0) (8.5) (.0) (.0) (95.4) 67 Vardarski 15.2 279 (9.5) (3.9) (8.8) (.0) (77.9) (1.7) (.0) (.0) (*) 43 North-East 3.2 329 (*) (*) (*) (*) (*) (*) (*) (*) (*) 10 South-West 6.8 397 (39.3) (24.6) (18.2) (.0) (2.2) (8.0) (4.1) (.0) (85.8) 27 South-East 11.9 377 51.0 17.2 12.1 2.9 .0 .0 .0 .0 83.2 45 Poloski 3.6 742 38.6 24.6 5.7 8.6 .0 6.3 .0 .0 83.8 27 East 2.4 316 (*) (*) (*) (*) (*) (*) (*) (*) 100.0 8 Residence Urban 5.6 2467 22.5 20.7 15.0 1.9 24.3 6.4 .0 4.3 93.7 139 Rural 6.6 2080 29.0 11.9 43.1 2.6 .0 6.2 .8 .0 91.6 137 Age 0-11 months 3.4 746 (26.3) (23.8) (25.0) (2.8) (2.4) (10.7) (.0) (.0) (91.0) 25 12-23 months 10.6 837 23.4 11.3 44.5 .6 2.9 12.5 .0 2.2 95.1 88 24-35 months 4.6 881 35.3 14.3 28.4 1.6 2.5 1.8 2.7 4.8 88.6 41 36-47 months 7.7 1067 20.6 19.9 13.1 2.1 35.7 1.2 .0 .0 91.5 82 48-59 months 3.9 1016 31.6 17.4 30.3 6.7 .8 4.9 .0 5.1 94.8 39 Mother’s education None 9.3 324 13.7 40.6 11.7 .0 2.3 18.8 .0 .0 87.1 30 Primary 6.6 2491 29.4 13.4 39.5 .9 1.1 4.4 .7 3.6 90.8 166 Secondary + 4.6 1732 22.7 13.2 13.7 5.9 39.1 5.6 .0 .0 98.7 80 Wealth index quintiles Poorest 9.8 1282 27.3 19.7 37.3 2.3 1.2 5.5 .0 .0 92.6 126 Second 7.3 988 20.1 8.8 22.0 .0 39.3 6.0 .0 2.7 96.4 72 Middle 4.0 883 (30.3) (17.1) (23.3) (6.9) (.0) (12.1) (.0) (.0) (89.7) 35 Fourth 2.9 879 (20.2) (23.4) (16.9) (.0) (9.7) (.0) (4.3) (15.3) (85.5) 26 Richest 3.3 515 (*) (*) (*) (*) (*) (*) (*) (*) (*) 17 Ethnicity Macedonian 6.9 1704 21.5 21.5 14.5 3.3 28.0 7.7 .0 .0 96.6 117 Albanian 5.5 2097 21.4 10.8 49.0 2.0 .0 7.1 1.0 5.1 92.8 115 Roma 5.7 231 52.0 12.1 24.6 .0 7.6 1.0 .0 .0 91.5 13 Other 5.9 514 (47.3) (19.4) (10.5) (.0) (.0) (.0) (.0) (.0) (77.2) 30 Total 6.1 4547 25.8 16.3 29.0 2.2 12.3 6.3 .4 2.1 92.7 276 * MICS indicator 23 77Republic of Macedonia Table CH.7: Antibiotic treatment of pneumonia Percentage of children aged 0-59 months with suspected pneumonia who received antibiotic treatment, Republic of Macedonia, 2005 Had acute respiratory infection Number of children aged 0-59 Percent of children aged 0-59 months with suspected pneumonia who received antibiotics in the last two weeks* Number of children aged 0-59 months with suspected pneumonia in the two weeks prior to the survey Sex Male 7.2 2428 81.2 176 Female 4.7 2118 60.6 100 Residence Urban 5.6 2467 75.9 139 Rural 6.6 2080 71.5 137 Age 0-11 months 3.4 746 (46.4) 25 12-23 months 10.6 837 84.6 88 24-35 months 4.6 881 59.1 41 36-47 months 7.7 1065 81.2 82 48-59 months 3.9 1016 66.2 39 Mother’s education None 9.3 324 68.1 30 Primary 6.6 2491 70.1 166 Secondary + 4.6 1732 83.4 80 Wealth index quintiles Poorest 9.8 1282 73.4 126 Second 7.3 988 82.0 72 Middle 4.0 883 (63.8) 35 Fourth 2.9 879 (71.0) 26 Richest 3.3 515 (*) 17 Ethnicity Macedonian 6.9 1704 74.2 117 Albanian 5.5 2097 76.1 115 Roma 5.7 231 82.9 13 Other 5.9 514 (58.7) 30 Total 6.1 4547 73.7 276 * MICS indicator 22 78 Multiple Indicator Cluster Survey - 2005-2006 Table CH.7A: Knowledge of the two danger signs of pneumonia Percentage of mothers/caretakers of children aged 0-59 months by knowledge of types of symptoms for taking a child immediately to a health facility, and percentage of mothers/caretakers who recognize fast and difficult breathing as signs for seeking care immediately, Republic of Macedonia, 2005 Percentage of mothers/caretakers of children aged 0-59 months who think that a child should be taken immediately to a health facility if the child: Mothers/ caretakers who recognize the two danger signs of pneumonia* Number of mothers/ caretakers of children aged 0-59 months Is not able to drink or breastfeed Becomes sicker Develops a fever Has fast breathing Has difficult breathing Has blood in stool Is drinking poorly Has other symptoms Region Skopski 21.6 61.9 93.7 48.5 61.5 45.5 32.0 10.8 44.0 1691 Pelagoniski 6.7 30.6 90.6 11.1 41.5 19.2 11.2 41.8 10.7 415 Vardarski 3.6 21.7 72.4 12.5 18.9 .9 13.2 35.8 .8 279 North-East 20.4 68.6 93.9 64.3 49.5 42.8 14.3 10.1 39.8 329 South-West 38.5 46.8 89.5 31.0 44.5 31.6 16.5 7.2 21.5 397 South-East 41.3 39.2 98.5 41.6 50.4 44.4 35.0 45.1 40.0 377 Poloski 39.9 78.0 91.4 64.0 71.6 44.1 37.5 7.5 56.6 742 East 24.7 39.7 88.6 28.5 33.4 25.8 4.8 14.2 25.8 316 Residence Urban 21.9 48.5 93.2 39.1 48.5 37.2 18.9 18.8 33.3 2467 Rural 29.4 62.7 89.4 47.8 59.4 37.3 33.5 15.7 40.3 2080 Mother’s education None 36.0 53.2 94.8 44.0 52.7 39.6 36.9 13.4 37.9 324 Primary 27.6 63.2 92.3 49.3 60.9 40.5 29.1 12.7 41.9 2491 Secondary + 20.1 43.4 89.6 33.9 43.0 32.2 18.4 24.9 28.6 1732 Wealth index quintiles Poorest 28.4 53.3 92.0 42.8 57.1 39.1 32.6 19.8 36.7 1282 Second 24.7 58.4 93.4 44.3 53.5 41.5 25.5 13.2 35.6 988 Middle 18.9 56.3 86.5 41.0 49.5 31.9 17.7 24.8 35.0 883 Fourth 34.6 56.3 91.8 46.6 53.5 36.9 30.2 13.3 41.2 879 Richest 14.4 47.8 94.1 38.7 51.0 34.5 14.0 13.3 32.4 515 Ethnicity Macedonian 18.3 34.8 89.9 26.3 33.9 27.8 11.8 27.3 19.5 1704 Albanian 26.0 71.4 93.6 53.4 67.2 42.6 31.1 7.6 46.2 2097 Roma 24.0 43.0 90.8 37.9 37.4 24.3 18.6 11.3 27.9 231 Other 46.8 60.0 87.9 58.9 69.7 52.8 51.9 27.2 57.6 514 Total 25.3 55.0 91.4 43.1 53.5 37.3 25.6 17.4 36.5 4547 79Republic of Macedonia Table CH.8: Solid fuel use Percentage distribution of households according to type of cooking fuel, and percentage of households using solid fuels for cooking Republic of Macedonia, 2005 Electricity Liquefied Petroleum Gas (LPG) Wood Other source Total Solid fuels for cooking* Number of households Region Skopski 82.8 1.0 15.3 1.0 100.0 15.3 1226 Pelagoniski 66.3 3.7 30.0 .0 100.0 30.0 597 Vardarski 58.5 13.0 28.5 .0 100.0 28.5 320 North-East 43.7 .1 54.3 2.0 100.0 54.3 347 South-West 37.8 .1 62.1 .0 100.0 62.1 559 South-East 56.8 .1 41.9 1.2 100.0 41.9 422 Poloski 55.7 .0 44.2 .1 100.0 44.2 593 East 51.7 6.7 41.6 .0 100.0 41.6 635 Residence Urban 71.5 3.8 23.8 .8 100.0 23.8 2857 Rural 44.4 .5 55.1 .1 100.0 55.1 1844 Education of household head None 36.3 .4 63.2 .1 100.0 63.2 159 Primary 50.0 1.3 48.5 .1 100.0 48.5 2115 Secondary + 71.9 3.7 23.4 .9 100.0 23.4 2425 Wealth index quintiles Poorest 21.4 .2 78.2 .2 100.0 78.2 837 Second 43.2 2.0 54.8 .1 100.0 54.8 913 Middle 57.2 .2 42.4 .2 100.0 42.4 963 Fourth 85.1 3.4 10.8 .8 100.0 10.8 956 Richest 89.4 6.3 2.9 1.4 100.0 2.9 1032 Ethnicity Macedonian 65.6 3.8 29.8 .7 100.0 29.8 3064 Albanian 51.4 .1 48.4 .2 100.0 48.4 1176 Roma 64.7 .0 34.5 .9 100.0 34.5 120 Other 49.0 .5 50.5 .0 100.0 50.5 340 Total 60.8 2.5 36.1 .5 100.0 36.1 4701 * MICS indicator 24; MDG Indicator 29 80 Multiple Indicator Cluster Survey - 2005-2006 Table CH.9: Solid fuel use by type of stove or fire Percentage of households using solid fuels for cooking by type of stove or fire, Republic of Macedonia, 2005 Percentage of households using solid fuels for cooking: Number of households using solid fuels for cookingClosed stove with chimney Open stove or fire with chimney or hood Other stove Total Region Skopski 85.9 14.1 .0 100.0 199 Pelagoniski 77.7 22.2 .1 100.0 179 Vardarski 99.8 .2 .0 100.0 91 North-East 87.9 12.1 .0 100.0 195 South-West 78.8 18.2 3.0 100.0 347 South-East 78.9 20.8 .3 100.0 177 Poloski 96.2 3.7 .1 100.0 262 East 92.7 7.3 .0 100.0 264 Residence Urban 88.9 11.0 .1 100.0 699 Rural 84.8 14.1 1.1 100.0 1017 Education of household head None 91.5 4.4 4.0 100.0 101 Primary 85.2 14.1 .7 100.0 1029 Secondary + 87.9 12.0 .0 100.0 585 Wealth index quintiles Poorest 84.3 14.1 1.7 100.0 655 Second 90.8 9.1 .0 100.0 501 Middle 85.6 14.4 .0 100.0 410 Fourth 78.8 20.9 .3 100.0 110 Richest (99.5) (.5) (.0) 100.0 39 Ethnicity Macedonian 88.2 11.3 .5 100.0 931 Albanian 86.0 12.9 1.1 100.0 570 Roma 94.0 6.0 .0 100.0 43 Other 76.9 22.8 .3 100.0 172 Total 86.5 12.9 .7 100.0 1715 81Republic of Macedonia Table EN.1: Use of improved water sources Percentage distribution of household population according to main source of drinking water and percentage of household members using improved drinking water sources, Republic of Macedonia, 2005 Improved sources Unimproved sources Total Improved source of drinking water* Number of household members Piped into dwelling Piped into yard/ plot Public tap/ stand-pipe Tube-well/ bore-hole Pro-tected well Pro-tected spring Bottled water Region Skopski 91.5 3.5 1.5 2.4 .1 1.0 .0 .0 100.0 100.0 6596 Pelagoniski 93.6 2.1 .4 .9 .0 2.8 .1 .1 100.0 99.9 2585 Vardarski 83.4 7.5 .2 .6 8.2 .0 .0 .1 100.0 99.9 1453 North-East 77.7 .4 .1 8.3 4.4 9.1 .0 .0 100.0 100.0 1785 South-West 93.1 1.0 .1 .1 4.5 .0 .0 1.3 100.0 98.7 2820 South-East 68.2 4.3 7.2 16.9 .2 .2 .0 3.1 100.0 96.9 1871 Poloski 88.1 1.6 0.8 7.4 .7 .0 .0 1.5 100.0 98.5 3773 East 96.8 .7 .7 .0 1.4 .1 .0 .3 100.0 99.7 2585 Residence Urban 95.3 1.1 1.8 .1 .3 1.2 .0 .2 100.0 99.8 13355 Rural 79.7 4.3 .5 9.1 3.5 1.4 .0 1.4 100.0 98.6 10114 Education of household head None 75.6 8.9 5.2 3.3 5.5 .4 .0 1.1 100.0 98.9 1009 Primary 83.5 3.8 1.6 6.1 2.0 1.6 .0 1.3 100.0 98.7 11497 Secondary + 95.1 .5 .5 1.8 1.0 1.1 .0 .0 100.0 100.0 10957 Wealth index quintiles Poorest 62.0 11.5 4.1 9.7 6.2 4.1 .0 2.4 100.0 97.6 4703 Second 89.3 .9 0.9 6.2 1.5 1.1 .0 .0 100.0 100.0 4698 Middle 93.7 .0 1.3 2.7 .0 1.3 .0 1.0 100.0 99.0 4681 Fourth 97.9 .0 .0 1.2 .7 .1 .0 .0 100.0 100.0 4708 Richest 99.9 .0 .0 .0 .0 .0 .1 .0 100.0 100.0 4679 Ethnicity Macedonian 91.3 1.8 1.0 2.9 1.1 1.8 .0 .1 100.0 99.9 13365 Albanian 85.8 3.2 .1 5.6 3.3 .9 .0 1.0 100.0 99.0 7777 Roma 86.3 9.0 2.4 1.2 .0 .0 .0 1.0 100.0 99.0 689 Other 80.1 1.8 8.0 6.0 .1 .1 .0 3.9 100.0 96.1 1637 Total 88.6 2.5 1.3 4.0 1.7 1.3 .0 .7 100.0 99.3 23468 * MICS indicator 11; MDG indicator 3 82 Multiple Indicator Cluster Survey - 2005-2006 Table EN.2: Household water treatment Percentage distribution of household population according to drinking water treatment method used in the household, and percentage of household population that applied an appropriate water treatment method, Republic of Macedonia, 2005 Water treatment method used in the household All drinking water sources None Boil Add bleach/ chlorine Strain through a cloth Use water filter Solar dis- infection Let it stand and settle Other Don’t know Appropriate water treatment method* Number of household members Region Skopski 95.5 1.0 .0 .2 3.1 .0 .0 .1 .1 4.1 6596 Pelagoniski 95.8 4.0 .0 .0 .0 .0 .0 .1 .0 4.0 2585 Vardarski 99.1 .8 .0 .2 .0 .0 .0 .0 .0 .8 14537 North-East 84.8 15.1 2.3 .5 .0 .0 .0 .0 .0 15.1 1785 South-West 61.9 30.4 13.8 2.5 14.9 1.6 7.6 .1 .2 34.5 2820 South-East 98.1 1.9 .0 .0 .1 .0 .0 .0 .0 1.9 1871 Poloski 76.8 15.8 .7 4.9 0.3 .0 2.5 .0 .0 16.8 3773 East 84.6 8.4 .0 .1 4.9 .0 2.0 .1 .0 13.3 2585 Residence Urban 89.0 7.1 1.0 .3 3.2 .0 1.1 .1 .1 9.5 13355 Rural 84.2 12.0 3.2 2.4 3.3 .4 2.1 .0 .0 13.5 10114 Education of household head None 87.8 11.3 5.7 .9 4.9 .3 .1 .0 .0 11.7 1009 Primary 86.5 10.0 2.3 1.5 2.3 .0 2.0 .0 .1 10.9 11497 Secondary + 87.3 8.1 1.2 1.0 4.1 .4 1.2 .1 .0 11.6 10957 Wealth index quintiles Poorest 83.8 14.0 5.4 2.1 5.1 .1 .2 .1 .0 14.1 4703 Second 87.9 9.7 2.1 1.1 1.3 .0 1.1 .0 .2 10.6 4698 Middle 86.5 10.2 .5 .6 2.1 .0 2.7 .0 .0 12.2 4681 Fourth 90.3 4.6 .7 1.2 3.1 .0 .3 .1 .0 8.2 4708 Richest 86.0 7.4 1.0 1.0 4.7 .9 3.5 .1 .0 11.2 4679 Ethnicity Macedonian 89.4 6.8 1.2 .6 3.3 .3 1.4 .1 .0 9.3 13365 Albanian 79.5 15.7 3.9 2.5 3.9 .0 2.2 .0 .1 17.5 7777 Roma 93.4 2.2 .0 2.0 1.4 .0 .0 .3 0.8 3.6 689 Other 99.0 .7 .1 .1 .2 .0 .0 .1 .0 .9 1637 Total 86.9 9.2 1.9 1.2 3.3 .2 1.5 .1 .1 11.3 23468 * MICS indicator 13 83Republic of Macedonia Table EN.3: Time to source of water Percentage distribution of households according to time to go to source of drinking water, get water and return, and mean time to source of drinking water, Republic of Macedonia, 2005 Time to source of drinking water Mean time to source of drinking water* Number of households Water on premises Less than 15 minutes 15 minutes to less than 30 minutes 30 minutes to less than 1 hour 1 hour or more Don’t know Total Region Skopski 98.9 .4 .1 .0 .3 .3 100.0 (*) 1226 Pelagoniski 99.0 .1 .1 .0 .1 .7 100.0 (*) 597 Vardarski 99.7 .3 .0 .0 .0 .0 100.0 (*) 320 North-East 83.4 9.6 .5 6.2 .3 .0 100.0 (18.4) 347 South-West 99.8 .1 .0 .0 .0 .0 100.0 (*) 559 South-East 80.8 12.2 1.3 1.6 4.0 .1 100.0 19.6 422 Poloski 97.0 1.0 1.2 .0 .0 .8 100.0 13.3 593 East 98.6 1.0 .1 .2 .0 .2 100.0 (13.6) 635 Residence Urban 97.1 1.1 .1 1.0 .7 .0 100.0 28.9 2857 Rural 94.4 3.9 .7 .1 .2 .7 100.0 10.0 1844 Education of household head None 89.6 6.5 .6 2.6 .7 .0 100.0 (15.9) 159 Primary 93.0 4.3 .7 .7 .8 .5 100.0 16.9 2115 Secondary + 99.1 .1 .0 .4 .2 .2 100.0 (*) 2425 Wealth index quintiles Poorest 83.1 10.1 .9 2.2 2.6 1.1 100.0 18.9 837 Second 97.7 2.0 .1 .1 .1 .0 100.0 (8.5) 913 Middle 97.6 .1 .7 1.1 .0 .4 100.0 (*) 963 Fourth 99.9 .0 .0 .0 .0 .0 100.0 (*) 956 Richest 100.0 .0 .0 .0 .0 .0 100.0 (*) 1032 Ethnicity Macedonian 96.8 2.3 .1 .7 .1 .0 100.0 14.3 3064 Albanian 97.5 .4 .7 .1 .3 1.0 100.0 (*) 1176 Roma 97.1 2.6 .3 .0 .0 .0 100.0 (6.9) 120 Other 83.3 7.7 1.4 2.2 5.0 .4 100.0 26.2 340 Total 96.0 2.2 .3 .6 .5 .3 100.0 19.0 4701 * The mean time to source of drinking water is calculated based on those households that do not have water on the premises. Table EN.4: Person collecting water Percentage distribution of households according to the person collecting drinking water used in the household, Republic of Macedonia, 2005 Person collecting drinking water Number of householdsAdult woman Adult man Female child under age 15 Male child under age 15 Don’t know Total Residence Urban 51.6 46.9 .1 .0 1.4 100.0 84 Rural 71.6 20.7 .2 .0 7.4 100.0 103 Education of household head None (87.9) (10.6) (1.3) (.2) (.0) 100.0 17 Primary 67.8 26.2 .0 .0 6.0 100.0 148 Secondary + (10.7) (89.3) (.0) (.0) (.0) 100.0 22 Total 62.7 32.4 .1 .0 4.7 100.0 187 84 Multiple Indicator Cluster Survey - 2005-2006 Table EN.5: Use of sanitary means of excreta disposal Percentage distribution of household population according to type of toilet facility used by the household, and the percentage of household population using sanitary means of excreta disposal, Republic of Macedonia, 2005 Type of toilet facility used by household Total Percent of population using sanitary means of excreta disposal* Number of household members Improved sanitation facility Unimproved sanitation facility Flush/pour flush to: Ventilated improved pit latrine Pit latrine with slab Flush/ pour flush to some- where else Flush/pour flush to unknown place/not sure/ don’t know Pit latrine without slab/ open pit Other No facilities/ bush/field Piped sewer system Septic tank Pit latrine Region Skopski 67.0 27.7 .3 .0 .0 2.6 2.2 .0 .2 .0 100.0 95.0 6596 Pelagoniski 60.9 17.2 .5 .0 .3 13.1 .4 5.5 .1 2.1 100.0 78.9 2585 Vardarski 78.7 11.0 .9 .0 .1 1.9 .0 7.4 .0 .0 100.0 90.7 1453 North-East 66.8 18.8 .2 .0 8.0 5.5 .0 .8 .0 .0 100.0 93.8 1785 South-West 57.0 34.5 .2 .0 .1 6.1 .0 .8 1.2 .0 100.0 91.8 2820 South-East 47.3 28.5 9.7 .0 .1 .0 .0 14.3 .0 .1 100.0 85.7 1871 Poloski 23.4 72.3 .8 .0 3.4 .1 .0 .0 .0 .0 100.0 99.8 3773 East 96.9 .2 .8 .3 .1 .0 .0 1.6 .0 .0 100.0 98.3 2585 Residence Urban 83.1 12.4 .7 .1 .7 1.7 .1 1.1 .1 .0 100.0 96.9 13355 Rural 30.7 53.0 2.0 .0 1.9 5.8 1.4 4.4 .3 .5 100.0 87.5 10114 Education of household head None 47.1 28.7 6.0 .0 .7 11.7 1.5 3.5 .2 .5 100.0 82.5 1009 Primary 48.6 38.6 1.7 .1 1.5 3.7 .9 4.5 .4 .2 100.0 90.3 11497 Secondary + 74.4 20.8 .3 .0 1.0 2.5 .3 .4 .0 .3 100.0 96.5 10957 Wealth index quintiles Poorest 31.3 37.9 5.3 .2 2.9 9.6 3.0 7.7 1.0 1.2 100.0 77.5 4703 Second 51.8 36.8 .2 .0 2.1 5.6 .2 3.3 .0 .0 100.0 90.9 4698 Middle 58.3 38.4 .6 .0 .0 1.3 .0 1.4 .0 .0 100.0 97.3 4681 Fourth 69.9 27.8 .0 .0 1.0 .8 .1 .4 .0 .0 100.0 98.7 4708 Richest 91.6 8.4 .0 .0 .0 .0 .0 .0 .0 .0 100.0 99.9 4679 Ethnicity Macedonian 75.3 16.7 1.0 .0 1.1 2.4 .1 3.3 .0 .0 100.0 94.2 13365 Albanian 33.8 55.0 .6 .0 1.7 5.8 1.8 .9 .4 .0 100.0 91.1 7777 Roma 80.3 10.3 2.1 1.1 .1 2.7 1.4 .4 1.6 .0 100.0 93.9 689 Other 58.9 26.1 5.4 .0 .1 1.8 .2 4.5 .0 3.1 100.0 90.4 1637 Total 60.5 29.9 1.2 .0 1.2 3.5 .7 2.5 .2 .2 100.0 92.9 23468 * MICS indicator 12; MDG indicator 31 85Republic of Macedonia Table EN.6: Disposal of child’s faeces Percentage distribution of children aged 0-2 years according to place of disposal of child’s faeces, and the percentage of children aged 0-2 years whose stools are disposed of safely, Republic of Macedonia, 2005 Place of disposal of child’s faeces Proportion of children whose stools are disposed of safely* Number of children aged 0-2 years Child used toilet Put/rinsed into toilet or latrine Put/rinsed into drain or ditch Thrown into garbage Left in the open Other Don’t know Total Region Skopski 30.7 18.0 7.3 35.3 .0 7.2 1.5 100.0 48.6 875 Pelagoniski 9.8 31.7 2.1 54.0 1.3 .7 .3 100.0 41.5 250 Vardarski 22.4 70.2 .0 7.1 .0 .0 .4 100.0 92.6 104 North-East 8.0 67.5 .0 16.7 .1 7.2 .4 100.0 75.6 178 South-West 22.3 17.3 .9 47.3 .6 9.1 2.5 100.0 39.6 258 South-East 6.3 7.9 12.5 63.5 1.4 4.6 3.9 100.0 14.1 201 Poloski 10.8 42.9 .5 33.3 .2 6.9 5.3 100.0 53.7 450 East 34.6 24.7 .3 36.5 .4 3.5 .1 100.0 59.3 175 Residence Urban 26.1 25.1 2.4 38.1 .3 6.7 1.3 100.0 51.2 1348 Rural 13.8 34.0 5.9 37.7 .4 5.0 3.2 100.0 47.8 1144 Mother’s education None 6.2 31.5 3.9 46.8 2.3 7.9 1.3 100.0 37.7 197 Primary 15.9 33.0 5.5 34.8 .3 7.4 3.1 100.0 48.9 1446 Secondary + 31.5 22.2 1.5 41.1 .0 3.0 .7 100.0 53.6 849 Wealth index quintiles Poorest 11.6 30.1 8.9 37.8 1.1 6.7 3.8 100.0 41.7 757 Second 21.2 35.3 1.9 33.1 .0 7.1 1.3 100.0 56.6 570 Middle 19.4 26.9 2.5 44.5 .2 5.0 1.6 100.0 46.3 457 Fourth 27.1 26.3 1.8 38.3 .0 5.7 .8 100.0 53.5 441 Richest 34.6 22.0 .9 36.8 .0 3.2 2.5 100.0 56.6 267 Ethnicity Macedonian 22.9 25.5 1.4 46.4 .5 2.5 .8 100.0 48.4 898 Albanian 17.2 35.2 4.8 31.9 .1 7.5 3.3 100.0 52.4 1217 Roma 9.9 23.8 2.9 47.3 .4 14.7 1.1 100.0 33.7 141 Other 34.4 15.3 10.8 30.8 1.3 5.4 2.0 100.0 49.7 235 Total 20.5 29.2 4.0 37.9 .4 5.9 2.1 100.0 49.6 2492 * MICS indicator 14 86 Multiple Indicator Cluster Survey - 2005-2006 Table EN.7: Use of improved water sources and improved sanitation Percentage of household population using both improved drinking water sources and sanitary means of excreta disposal, Republic of Macedonia, 2005 Percentage of household population: Using improved sources of drinking water* Using sanitary means of excreta disposal** Using improved sources of drinking water and using sanitary means of excreta disposal Number of household members Region Skopski 100.0 95.0 95.0 6596 Pelagoniski 99.9 78.9 78.9 2585 Vardarski 99.9 90.7 90.6 1453 North-East 100.0 93.8 93.8 1785 South-West 98.7 91.8 91.6 2820 South-East 96.9 85.7 82.7 1871 Poloski 98.5 99.8 98.4 3773 East 99.7 98.3 98.0 2585 Residence Urban 99.8 96.9 96.8 13355 Rural 98.6 87.5 86.5 10114 Education of household head None 98.9 82.5 81.7 1009 Primary 98.7 90.3 89.3 11497 Secondary + 100.0 96.5 96.5 10957 Wealth index quintiles Poorest 97.6 77.5 75.9 4703 Second 100.0 90.9 90.9 4698 Middle 99.0 97.3 96.3 4681 Fourth 100.0 98.7 98.7 4708 Richest 100.0 99.9 99.9 4679 Ethnicity Macedonian 99.9 94.2 94.1 13365 Albanian 99.0 91.1 90.4 7777 Roma 99.0 93.9 93.1 689 Other 96.1 90.4 86.6 1637 Total 99.3 92.9 92.3 23468 * MICS indicator 11; MDG indicator 30 ** MICS indicator 12; MDG indicator 31 87Republic of Macedonia Table RH.1: Use of contraception Percentage of women aged 15-49 years currently married or in union who are using (or whose partner is using) a contraceptive method, Republic of Macedonia, 2005 Not using any method Percentage of women (currently married or in union) who are using: Number of women currently married or in union Female sterili- zation Pill IUD Condom Diaph-ragm/ foam/ jelly Other modern methods LAM Periodic abstin- ence With- drawal Other Any modern method Any traditional method Any method* Region Skopski 82.5 .4 .8 1.1 9.3 .8 .8 .3 .1 .1 3.7 13.4 4.2 17.5 1119 Pelagoniski 84.7 1.5 2.2 .5 2.7 4.1 .0 .0 .2 .0 4.2 11.0 4.3 15.3 485 Vardarski 92.1 .0 .5 .0 7.3 .0 .0 .0 .0 .0 .1 7.8 .1 7.9 225 North-East 94.4 4.2 .6 .0 .7 .0 .0 .0 .0 .0 .1 5.5 .1 5.6 339 South-West 80.6 .0 6.6 .5 4.2 .9 .1 .0 1.6 5.4 .0 12.4 7.0 19.4 480 South-East 99.1 .0 .1 .0 .4 .2 .0 .0 .2 .0 .0 .7 .2 .9 375 Poloski 84.6 .5 4.3 .0 4.6 3.2 .1 2.2 .0 .1 .3 12.8 2.7 15.4 640 East 87.7 .0 3.8 .1 .9 1.0 .0 .0 1.8 .0 4.7 5.8 6.5 12.3 587 Residence Urban 88.5 .3 1.9 .7 4.7 1.6 .3 .7 .4 .1 .7 9.6 1.9 11.5 2447 Rural 83.7 1.2 3.2 .1 4.3 1.2 .1 .0 .6 1.5 4.1 10.1 6.2 16.3 1805 Age 15-19 98.7 .0 .0 .0 1.2 .0 .0 .0 .0 .1 .1 1.2 .1 1.3 20 20-24 88.3 .0 1.2 .1 4.6 .6 .0 3.8 .1 .9 .2 6.7 5.1 11.7 91 25-29 91.4 .3 1.4 .3 3.8 .5 .2 .2 .5 .4 1.1 6.4 2.3 8.6 519 30-34 82.8 .1 2.5 .2 10.3 .5 .1 .0 .4 .3 2.6 13.8 3.4 17.2 783 35-39 81.3 1.6 3.4 .0 4.8 2.0 .1 1.3 .0 .9 4.5 11.9 6.8 18.7 964 40-44 89.9 .8 3.0 1.5 1.4 1.6 .0 .0 .7 .9 .1 8.4 1.7 10.1 963 45-49 88.2 .5 1.6 .0 3.1 2.0 .9 .0 .8 .6 2.3 8.1 3.7 11.8 911 Number of living children** 0 99.1 .0 .0 .0 .4 .0 .0 .0 .0 .5 .0 .4 .5 .9 138 1 79.2 .0 4.3 .0 14.0 .1 .0 1.3 .2 .2 .5 18.5 2.3 20.8 321 2 86.1 .2 3.1 .2 4.6 1.3 .5 .0 .6 .4 3.0 9.9 4.0 13.9 2074 3 89.0 1.6 1.9 .1 2.9 1.4 .1 1.2 .6 .1 1.1 7.9 3.1 11.0 1099 4+ 84.2 1.3 .9 2.0 3.2 3.0 .1 .0 .1 2.7 2.5 10.5 5.3 15.8 619 Education None 91.7 .3 .3 .0 1.2 .9 .0 1.6 .0 .2 3.7 2.8 5.5 8.3 192 Primary 88.5 1.1 2.3 .0 2.6 1.2 .1 .6 .4 1.2 1.9 7.4 4.2 11.5 2269 Secondary + 83.4 .3 2.9 1.0 7.3 1.8 .5 .0 .6 .0 2.3 13.6 3.0 16.6 1791 Wealth index quintiles Poorest 85.7 .5 2.1 .0 4.4 1.1 .1 .4 .2 3.2 2.1 8.3 6.0 14.3 786 Second 84.8 2.5 3.0 1.6 2.3 .3 .0 .0 1.0 .2 4.3 9.7 5.5 15.2 807 Middle 91.6 .1 1.2 .1 2.3 1.7 .0 1.7 .3 .1 .8 5.5 2.9 8.4 845 Fourth 90.6 .2 .9 .2 5.2 1.5 .1 .0 .9 .1 .5 8.0 1.5 9.4 889 Richest 79.9 .4 5.0 .3 8.0 2.3 .9 .0 .0 .0 3.1 16.9 3.2 20.1 924 Ethnicity Macedonian 86.8 .7 2.8 .7 4.3 1.5 .3 .0 .8 .0 2.2 10.2 3.0 13.2 2537 Albanian 85.6 .6 1.8 .1 4.5 1.6 .2 1.1 .1 2.1 2.3 8.8 5.6 14.4 1281 Roma 82.6 2.7 .4 .0 4.7 1.7 .0 2.5 .2 .4 4.8 9.5 7.9 17.4 129 Other 89.1 .1 3.7 .0 6.4 .2 .0 .0 .1 .0 .5 10.3 .6 10.9 305 Total 86.5 .7 2.5 .4 4.5 1.4 .3 .4 .5 .7 2.2 9.8 3.7 13.5 4251 * MICS indicator 21; MDG indicator 19C Table RH.1: Use of contraception Percentage of women aged 15-49 years currently married or in union who are using (or whose partner is using) a contraceptive method, Republic of Macedonia, 2005 Not using any method Percentage of women (currently married or in union) who are using: Number of women currently married or in union Female sterili- zation Pill IUD Condom Diaph-ragm/ foam/ jelly Other modern methods LAM Periodic abstin- ence With- drawal Other Any modern method Any traditional method Any method* Region Skopski 82.5 .4 .8 1.1 9.3 .8 .8 .3 .1 .1 3.7 13.4 4.2 17.5 1119 Pelagoniski 84.7 1.5 2.2 .5 2.7 4.1 .0 .0 .2 .0 4.2 11.0 4.3 15.3 485 Vardarski 92.1 .0 .5 .0 7.3 .0 .0 .0 .0 .0 .1 7.8 .1 7.9 225 North-East 94.4 4.2 .6 .0 .7 .0 .0 .0 .0 .0 .1 5.5 .1 5.6 339 South-West 80.6 .0 6.6 .5 4.2 .9 .1 .0 1.6 5.4 .0 12.4 7.0 19.4 480 South-East 99.1 .0 .1 .0 .4 .2 .0 .0 .2 .0 .0 .7 .2 .9 375 Poloski 84.6 .5 4.3 .0 4.6 3.2 .1 2.2 .0 .1 .3 12.8 2.7 15.4 640 East 87.7 .0 3.8 .1 .9 1.0 .0 .0 1.8 .0 4.7 5.8 6.5 12.3 587 Residence Urban 88.5 .3 1.9 .7 4.7 1.6 .3 .7 .4 .1 .7 9.6 1.9 11.5 2447 Rural 83.7 1.2 3.2 .1 4.3 1.2 .1 .0 .6 1.5 4.1 10.1 6.2 16.3 1805 Age 15-19 98.7 .0 .0 .0 1.2 .0 .0 .0 .0 .1 .1 1.2 .1 1.3 20 20-24 88.3 .0 1.2 .1 4.6 .6 .0 3.8 .1 .9 .2 6.7 5.1 11.7 91 25-29 91.4 .3 1.4 .3 3.8 .5 .2 .2 .5 .4 1.1 6.4 2.3 8.6 519 30-34 82.8 .1 2.5 .2 10.3 .5 .1 .0 .4 .3 2.6 13.8 3.4 17.2 783 35-39 81.3 1.6 3.4 .0 4.8 2.0 .1 1.3 .0 .9 4.5 11.9 6.8 18.7 964 40-44 89.9 .8 3.0 1.5 1.4 1.6 .0 .0 .7 .9 .1 8.4 1.7 10.1 963 45-49 88.2 .5 1.6 .0 3.1 2.0 .9 .0 .8 .6 2.3 8.1 3.7 11.8 911 Number of living children** 0 99.1 .0 .0 .0 .4 .0 .0 .0 .0 .5 .0 .4 .5 .9 138 1 79.2 .0 4.3 .0 14.0 .1 .0 1.3 .2 .2 .5 18.5 2.3 20.8 321 2 86.1 .2 3.1 .2 4.6 1.3 .5 .0 .6 .4 3.0 9.9 4.0 13.9 2074 3 89.0 1.6 1.9 .1 2.9 1.4 .1 1.2 .6 .1 1.1 7.9 3.1 11.0 1099 4+ 84.2 1.3 .9 2.0 3.2 3.0 .1 .0 .1 2.7 2.5 10.5 5.3 15.8 619 Education None 91.7 .3 .3 .0 1.2 .9 .0 1.6 .0 .2 3.7 2.8 5.5 8.3 192 Primary 88.5 1.1 2.3 .0 2.6 1.2 .1 .6 .4 1.2 1.9 7.4 4.2 11.5 2269 Secondary + 83.4 .3 2.9 1.0 7.3 1.8 .5 .0 .6 .0 2.3 13.6 3.0 16.6 1791 Wealth index quintiles Poorest 85.7 .5 2.1 .0 4.4 1.1 .1 .4 .2 3.2 2.1 8.3 6.0 14.3 786 Second 84.8 2.5 3.0 1.6 2.3 .3 .0 .0 1.0 .2 4.3 9.7 5.5 15.2 807 Middle 91.6 .1 1.2 .1 2.3 1.7 .0 1.7 .3 .1 .8 5.5 2.9 8.4 845 Fourth 90.6 .2 .9 .2 5.2 1.5 .1 .0 .9 .1 .5 8.0 1.5 9.4 889 Richest 79.9 .4 5.0 .3 8.0 2.3 .9 .0 .0 .0 3.1 16.9 3.2 20.1 924 Ethnicity Macedonian 86.8 .7 2.8 .7 4.3 1.5 .3 .0 .8 .0 2.2 10.2 3.0 13.2 2537 Albanian 85.6 .6 1.8 .1 4.5 1.6 .2 1.1 .1 2.1 2.3 8.8 5.6 14.4 1281 Roma 82.6 2.7 .4 .0 4.7 1.7 .0 2.5 .2 .4 4.8 9.5 7.9 17.4 129 Other 89.1 .1 3.7 .0 6.4 .2 .0 .0 .1 .0 .5 10.3 .6 10.9 305 Total 86.5 .7 2.5 .4 4.5 1.4 .3 .4 .5 .7 2.2 9.8 3.7 13.5 4251 * MICS indicator 21; MDG indicator 19C 88 Multiple Indicator Cluster Survey - 2005-2006 Table RH.2: Unmet need for contraception Percentage of women aged 15-49 years currently married or in union with an unmet need for family planning and percentage of demand for contraception satisfied, Republic of Macedonia, 2005 Current use of contraception* Unmet need for contraception Number of women currently married or in union Percentage of demand for contraception satisfied***** Number of women currently married or in union with need for contraceptionFor spacing** For limiting*** Total**** Region Skopski 17.5 8.7 32.1 40.7 1119 30.1 653 Pelagoniski 15.3 2.7 30.6 33.2 485 31.6 236 Vardarski 7.9 .8 26.0 26.8 225 22.7 78 North-East 5.6 1.5 20.2 21.7 339 20.4 92 South-West 19.4 3.6 20.2 23.8 480 44.9 207 South-East .9 2.3 43.8 46.1 375 2.0 176 Poloski 15.4 8.0 20.6 28.6 640 35.1 282 East 12.3 3.8 31.5 35.4 587 25.8 280 Residence Urban 11.5 4.9 31.3 36.2 2447 24.1 1166 Rural 16.3 5.3 24.8 30.1 1805 35.1 838 Age 15-19 1.3 10.2 2.0 12.2 20 9.7 (3) 20-24 11.7 19.5 19.9 39.4 91 22.9 46 25-29 8.6 16.8 28.1 44.9 519 16.1 278 30-34 17.2 11.3 30.7 42.0 783 29.0 463 35-39 18.7 1.4 27.1 28.5 964 39.7 455 40-44 10.1 .0 38.4 38.4 963 20.8 467 45-49 11.8 .8 19.4 20.3 911 36.9 292 Education None 8.3 2.4 54.3 56.7 192 12.7 125 Primary 11.5 4.5 26.8 31.2 2269 27.0 970 Secondary + 16.6 6.2 28.0 34.1 1791 32.7 909 Wealth index quintiles Poorest 14.3 6.6 26.3 32.9 786 30.3 371 Second 15.2 4.0 30.1 34.1 807 30.8 398 Middle 8.4 2.5 26.7 29.2 845 22.2 318 Fourth 9.4 6.8 26.4 33.3 889 22.1 380 Richest 20.1 5.5 32.7 38.2 924 34.4 538 Ethnicity Macedonian 13.2 2.8 30.0 32.7 2537 28.7 1166 Albanian 14.4 7.3 26.4 33.7 1281 29.9 616 Roma 17.4 2.5 19.4 21.9 129 44.3 51 Other 10.9 16.3 29.0 45.3 305 19.4 171 Total 13.5 5.1 28.5 33.6 4251 28.7 2004 * MICS indicator 21; MDG indicator 19C **** MICS indicator 98 ***** MICS indicator 99 89Republic of Macedonia Table RH.3: Antenatal care provider Percentage distribution of women aged 15-49 who gave birth in the two years preceding the survey by type of personnel providing antenatal care. Republic of Macedonia, 2005 Person providing antenatal care** No antenatal care received Total Any skilled personnel* Number of women who gave birth in the preceding two years Medical doctor Nurse/ midwife Auxiliary midwife Traditional birth attendant Other Region Skopski 89.8 6.9 1.3 .0 1.5 .5 100.0 98.0 213 Pelagoniski 97.4 .4 .0 .0 .0 1.8 100.0 97.8 46 Vardarski 98.1 .3 .0 .0 .0 1.6 100.0 98.4 18 North-East 99.1 .0 .0 .0 .0 .9 100.0 99.1 39 South-West 98.3 .0 .0 .4 .0 1.3 100.0 98.3 59 South-East 96.9 .0 .0 .0 .0 3.1 100.0 96.9 36 Poloski 92.1 5.3 .0 .0 .3 2.3 100.0 97.4 115 East 99.7 .0 .0 .0 .0 .3 100.0 99.7 41 Residence Urban 95.1 2.6 .0 .0 1.0 1.2 100.0 97.7 308 Rural 92.4 5.0 1.1 .1 .1 1.2 100.0 98.5 257 Age 15-19 96.5 .6 .0 .0 .0 2.9 100.0 97.1 7 20-24 85.4 5.9 .0 .0 7.0 1.3 100.0 91.3 45 25-29 92.4 5.6 .8 .1 .0 1.1 100.0 98.8 186 30-34 95.8 3.1 .0 .0 .0 1.1 100.0 98.9 242 35+ 95.8 .4 1.6 .0 .4 1.8 100.0 97.8 85 Education None 84.6 .2 .0 .0 9.1 5.7 100.0 84.8 35 Primary 92.0 5.8 .9 .1 .1 1.2 100.0 98.7 334 Secondary + 98.6 .8 .0 .0 .0 .6 100.0 99.4 197 Wealth index quintiles Poorest 86.5 6.8 1.1 .2 2.0 3.4 100.0 94.3 158 Second 95.1 3.3 1.2 .0 .0 .5 100.0 99.5 102 Middle 92.9 6.5 .0 .0 .3 .2 100.0 99.5 104 Fourth 99.9 .1 .0 .0 .0 .0 100.0 100.0 138 Richest 98.4 .0 .0 .0 .0 1.6 100.0 98.4 64 Ethnicity Macedonian 98.3 .1 .0 .2 .0 1.3 100.0 98.4 174 Albanian 91.3 6.8 .9 .0 .1 .9 100.0 99.0 306 Roma 78.5 .0 .0 .0 16.2 5.3 100.0 78.5 19 Other 98.5 .0 .0 .0 .0 1.5 100.0 98.5 67 Total 93.9 3.7 .5 .0 .6 1.2 100.0 98.1 566 * MICS indicator 20 90 Multiple Indicator Cluster Survey - 2005-2006 Table RH.4: Antenatal care Percentage of pregnant women receiving antenatal care among women aged 15-49 years who gave birth in two years preceding the survey and percentage of pregnant women receiving specific care as part of the antenatal care received, Republic of Macedonia, 2005 Percentage of pregnant women receiving ANC one or more times during pregnancy Percentage of pregnant women who had: Number of women who gave birth in two years preceding surveyBlood test taken* Blood pressure measured* Urine specimen taken* Weight measured* Region Skopski 99.5 97.3 96.7 97.3 95.3 213 Pelagoniski 98.2 96.0 93.0 96.0 88.1 46 Vardarski 98.4 97.5 97.5 97.5 97.5 18 North-East 99.1 98.2 99.1 96.8 99.1 39 South-West 98.7 87.2 75.0 86.3 98.5 59 South-East 96.9 91.8 95.1 91.3 93.0 36 Poloski 97.7 96.5 90.6 96.0 88.6 115 East 99.7 99.0 99.3 98.5 99.6 41 Residence Urban 98.8 95.9 96.3 95.5 95.4 308 Rural 98.8 95.7 89.4 95.4 92.8 257 Age 15-19 97.1 96.5 96.7 96.5 96.4 7 20-24 98.7 87.2 87.4 85.4 86.9 45 25-29 98.9 94.7 96.8 94.5 95.5 186 30-34 98.9 97.7 92.7 97.5 96.8 242 35+ 98.2 97.3 89.5 96.9 87.7 86 Education None 94.3 79.7 61.5 79.9 60.2 35 Primary 98.8 95.7 93.2 95.2 95.4 334 Secondary + 99.4 98.8 98.8 98.7 98.2 197 Wealth index quintiles Poorest 96.6 87.7 91.2 87.6 88.8 158 Second 99.5 98.9 91.5 98.3 91.1 102 Middle 99.8 99.5 99.2 99.3 96.3 104 Fourth 100.0 99.4 89.7 98.9 99.2 138 Richest 98.4 97.1 98.4 96.4 98.4 64 Ethnicity Macedonian 98.7 97.4 89.4 97.0 96.8 174 Albanian 99.1 96.2 95.6 96.0 93.7 306 Roma 94.7 73.4 75.6 72.9 75.7 19 Other 98.5 96.3 96.9 95.5 95.4 67 Total 98.8 95.8 93.2 95.5 94.2 566 * MICS indicator 44 91Republic of Macedonia Table RH.5: Assistance during delivery Percentage distribution of women aged 15-49 with a birth in two years preceding the survey by type of personnel assisting at delivery, Republic of Macedonia, 2005 Person assisting at delivery No attend- ant Total Any skilled pers-onnel* Deliv-ered in health facility** Number of women who gave birth in preceding two years Medical doctor Nurse/ mid-wife Aux-iliary mid-wife Trad-itional birth attend- ant Other Region Skopski 86.7 9.9 .5 .1 2.8 .0 100.0 97.1 97.2 213 Pelagoniski 92.2 7.8 .0 .0 .0 .0 100.0 100.0 100.0 46 Vardarski 66.5 33.4 .0 .0 .1 .0 100.0 99.9 99.9 18 North-East 87.6 10.4 .4 .0 1.5 .0 100.0 98.5 98.5 39 South-West 98.2 1.7 .0 .1 .0 .0 100.0 99.9 99.9 59 South-East 93.6 5.2 .4 .0 .9 .0 100.0 99.1 98.7 36 Poloski 67.0 30.8 .0 .3 1.3 .6 100.0 97.8 98.0 115 East 83.2 14.1 .0 .3 .0 2.4 100.0 97.3 97.6 41 Residence Urban 83.2 15.0 .0 .1 1.2 .4 100.0 98.3 98.4 308 Rural 84.8 12.6 .5 .1 1.8 .2 100.0 97.9 97.9 257 Age 15-19 96.3 3.3 .0 .2 .2 .0 100.0 99.6 99.6 7 20-24 72.3 19.8 .3 .3 7.2 .0 100.0 92.5 92.4 45 25-29 84.3 14.8 .1 .1 .5 .2 100.0 99.2 99.4 186 30-34 83.0 15.0 .0 .1 1.5 .4 100.0 98.0 98.0 242 35-39 91.6 5.7 1.4 .0 0.7 .5 100.0 98.7 98.7 81 40-44 72.3 27.7 .0 .0 .0 .0 100.0 100.0 100.0 4 45-49 (*) (*) (*) (*) (*) (*) (*) (*) (*) 0 Education None 78.7 10.4 .4 .3 10.2 .0 100.0 89.4 89.6 35 Primary 81.6 16.0 .4 .2 1.4 .4 100.0 98.0 98.0 334 Secondary + 88.9 11.0 .0 .0 .0 .1 100.0 99.9 100.0 197 Wealth index quintiles Poorest 83.1 11.8 .5 .3 3.5 .9 100.0 95.3 95.2 158 Second 82.4 15.4 .7 .0 1.4 .0 100.0 98.5 98.6 102 Middle 81.6 16.5 .0 .2 1.3 .3 100.0 98.2 98.6 104 Fourth 82.4 17.6 .0 .0 .0 .0 100.0 100.0 100.0 138 Richest 95.4 4.6 .0 .0 .0 .0 100.0 100.0 100.0 64 Ethnicity Macedonian 86.7 12.3 .0 .0 .2 .7 100.0 99.0 99.2 174 Albanian 80.9 17.1 .4 .1 1.4 .1 100.0 98.3 98.3 306 Roma 69.9 11.9 .0 .9 17.3 .0 100.0 81.8 82.1 19 Other 95.0 4.2 .2 .2 .5 .0 100.0 99.4 99.3 67 Total 83.9 13.9 .3 .1 1.5 .3 100.0 98.1 98.2 566 * MICS indicator 4; MDG indicator 17 ** MICS indicator 5 92 Multiple Indicator Cluster Survey - 2005-2006 Table CD.1: Family support for learning Percentage of children aged 0-59 months for whom household members are engaged in activities that promote learning and school readiness, Republic of Macedonia, 2005 Percentage of children aged 0-59 months For whom household members engaged in four or more activities that promote learning and school readiness* Mean number of activities household members engage in with the child For whom the father engaged in one or more activities that promote learning and school readiness** Mean number of activities the father engaged in with the child Living in a household without their natural father Number of children aged 0-59 months Sex Male 84.9 4.9 62.3 1.3 2.2 2428 Female 85.6 5.0 58.8 1.3 3.2 2118 Region Skopski 90.1 5.1 69.4 1.4 .9 1691 Pelagoniski 82.6 4.9 49.1 1.2 11.2 415 Vardarski 86.2 5.1 20.1 .4 10.9 279 North East 84.7 4.8 56.4 1.1 1.2 329 South West 85.7 5.1 68.4 1.4 2.1 397 South East 84.4 4.8 66.5 1.8 1.4 377 Poloski 70.9 4.4 54.4 1.3 .8 742 East 96.5 5.6 68.0 1.6 1.4 316 Residence Urban 87.2 5.1 62.0 1.5 4.0 2467 Rural 83.0 4.8 59.2 1.1 1.0 2080 Age 0-23 months 72.3 4.3 50.3 1.0 4.3 1583 24-59 months 92.2 5.3 66.2 1.5 1.8 2963 Mother’s education None 57.7 4.0 48.3 1.2 2.7 324 Primary 82.8 4.8 59.2 1.2 1.2 2491 Secondary + 93.9 5.4 65.2 1.6 4.7 1732 Father’s education None 56.3 3.9 47.6 1.2 .0 158 Primary 80.6 4.7 57.1 1.1 .0 2129 Secondary + 91.8 5.3 68.2 1.6 .0 2139 Father not in HH 89.6 5.4 8.4 .2 100.0 120 Wealth index quintiles Poorest 76.0 4.5 53.6 1.1 2.1 1282 Second 84.6 4.9 49.5 .9 7.8 988 Middle 86.4 5.1 55.9 1.2 .6 883 Fourth 91.7 5.2 80.2 1.6 .7 879 Richest 96.4 5.6 74.9 2.1 1.2 515 Ethnicity Macedonian 92.5 5.3 62.8 1.6 5.2 1704 Albanian 80.1 4.7 57.5 1.1 .8 2097 Roma 72.2 4.3 55.3 1.3 3.4 231 Other 88.0 4.9 69.2 1.4 1.3 514 Total 85.2 5.0 60.7 1.3 2.6 4547 * MICS indicator 46 ** MICS Indicator 47 93Republic of Macedonia Table CD.2: Learning materials Percentage of children aged 0-59 months living in households containing learning materials. Republic of Macedonia. 2005 Children living in households with: Child has: Child plays with: Number of children aged 0-59 months 3 or more non-children’s books* 3 or more children’s books** House- hold objects Objects and materials found outside the home Home-made toys Toys that came from a store No play- things ment- ioned 3 or more types of play-things *** Sex Male 48.6 47.8 4.9 6.8 15.4 65.4 9.8 .5 2428 Female 53.4 50.3 6.3 5.2 22.9 63.5 5.0 .5 2118 Region Skopski 41.2 47.0 6.6 4.8 21.3 66.0 4.3 .6 1691 Pelagoniski 60.3 56.5 7.0 6.2 12.2 60.8 13.8 .0 415 Vardarski 30.4 61.5 .0 8.0 2.9 81.3 7.8 .0 279 North East 46.3 33.1 3.0 2.3 18.7 72.1 4.2 .0 329 South West 64.8 61.2 9.6 5.3 8.2 67.2 11.2 .3 397 South East 61.3 55.3 3.5 9.7 8.5 67.3 12.2 .5 377 Poloski 55.6 33.3 3.4 8.1 30.4 50.2 10.5 .3 742 East 71.1 68.9 7.8 7.1 27.8 65.9 2.8 1.7 316 Residence Urban 51.6 59.9 4.6 5.9 17.2 68.0 8.1 .7 2467 Rural 49.8 35.9 6.7 6.3 20.9 60.4 7.0 .2 2080 Age 0-23 months 45.2 41.9 5.2 2.0 14.6 60.0 19.4 .2 1583 24-59 months 53.8 52.7 5.7 8.2 21.2 66.9 1.2 .6 2963 Mother’s education None 24.4 10.9 7.4 12.9 26.2 38.0 16.9 .1 324 Primary 42.7 29.2 6.5 7.4 19.0 62.2 7.9 .6 2491 Secondary + 67.3 84.5 3.8 2.9 17.4 72.8 5.3 .4 1732 Wealth index quintiles Poorest 30.5 21.3 8.7 8.9 17.6 55.7 10.5 .2 1282 Second 52.9 40.4 5.0 6.7 26.0 57.6 6.4 .2 988 Middle 55.4 51.1 3.7 2.1 16.6 70.1 9.8 .3 883 Fourth 55.0 73.3 4.8 5.8 18.1 71.4 5.3 1.4 879 Richest 82.2 88.9 2.8 5.1 13.6 78.5 2.4 .4 515 Ethnicity Macedonian 71.4 77.6 5.0 5.2 16.7 67.7 7.6 .4 1704 Albanian 42.4 26.5 6.7 6.3 21.4 61.2 7.3 .6 2097 Roma 36.5 32.0 6.3 8.2 28.1 47.2 16.6 1.2 231 Other 23.1 52.9 2.0 7.0 11.5 75.3 4.3 .0 514 Total 50.8 48.9 5.5 6.1 18.9 64.5 7.6 .5 4547 * MICS indicator 49 ** MICS indicator 48 *** MICS indicator 50 94 Multiple Indicator Cluster Survey - 2005-2006 Table CD.3: Children left alone or with other children Percentage of children aged 0-59 months left in the care of other children under the age of 10 years or left alone in the past week, Republic of Macedonia, 2005 Percentage of children aged 0-59 months Left in the care of children under the age of 10 years in past week Left alone in the past week Left with inadequate care in past week* Number of children aged 0-59 months Sex Male 5.8 3.2 7.9 2428 Female 10.0 2.2 10.9 2118 Region Skopski 6.6 2.9 8.9 1691 Pelagoniski 8.6 1.5 9.0 415 Vardarski 3.4 1.1 4.5 279 North East 13.2 1.8 13.9 329 South West 15.0 3.8 16.3 397 South East 5.6 2.7 7.0 377 Poloski 6.9 2.2 6.9 742 East 6.6 5.7 10.5 316 Residence Urban 7.4 2.4 8.7 2467 Rural 8.2 3.1 10.0 2080 Age 0-23 months 3.8 1.2 4.4 1583 24-59 months 9.9 3.5 11.9 2963 Mother’s education None 6.3 4.2 8.0 324 Primary 7.8 1.7 8.3 2491 Secondary + 7.9 3.9 10.9 1732 Wealth index quintiles Poorest 6.6 2.3 7.3 1282 Second 12.6 1.6 13.3 988 Middle 8.0 .8 8.4 883 Fourth 4.6 2.3 5.9 879 Richest 6.3 9.6 13.6 515 Ethnicity Macedonian 9.3 4.2 12.3 1704 Albanian 8.1 1.6 8.5 2097 Roma 3.3 2.3 4.6 231 Other 3.1 2.8 4.6 514 Total 7.8 2.7 9.3 4547 * MICS indicator 51 95Republic of Macedonia Table ED.1: Early childhood education Percentage of children aged 36-59 months who are attending some form of organized early childhood education programme and percentage of first graders who attended pre-school, Republic of Macedonia,2005 Percent of children aged 36-59 months currently attending early childhood education* Number of children aged 36-59 months Percent of children attending first grade who attended preschool program in previous year** Number of children attending first grade Sex Male 15.1 1103 86.9 143 Female 5.8 979 63.6 132 Region Skopski 13.7 825 73.6 75 Pelagoniski 8.8 166 (80.5) 24 Vardarski 22.6 175 (*) 5 North East 5.8 152 (*) 8 South West 6.5 140 (51.3) 61 South East 9.5 177 (*) 8 Poloski .9 308 94.6 64 East 13.1 141 (91.6) 29 Residence Urban 18.5 1127 77.2 152 Rural 1.5 956 73.8 123 Age of child 36-47 months 12.9 1067 - - 48-59 months 8.4 1016 - - 6 years - - 85.3 84 7 years - - 71.5 191 Mother’s education None .7 142 (86.7) 32 Primary 1.8 1057 68.2 170 Secondary + 23.0 883 88.2 73 Wealth index quintiles Poorest 1.4 529 83.0 83 Second 9.0 435 80.2 47 Middle 4.5 428 75.2 35 Fourth 21.7 442 63.4 86 Richest 24.7 249 (*) 23 Ethnicity Macedonian 16.9 809 77.3 142 Albanian 1.5 902 76.5 118 Roma 3.5 92 56.6 6 Other 25.0 279 (*) 9 Total 10.7 2082 75.7 275 * MICS indicator 52 ** MICS indicator 53 96 Multiple Indicator Cluster Survey - 2005-2006 Table ED.2: Primary school entry Percentage of children of primary school entry age attending grade 1, Republic of Macedonia,2005 Percent of children of primary school entry age currently attending grade 1* Number of children of primary school entry age** Sex Male 95.8 162 Female 94.6 173 Region Skopski 96.3 95 Pelagoniski 82.8 16 Vardarski (*) 32 North East (*) 8 South West 98.7 76 South East (73.9) 14 Poloski 97.5 64 East (93.5) 30 Residence Urban 94.4 189 Rural 96.2 146 Mother’s education None 82.6 47 Primary 96.6 184 Secondary + 98.2 104 Wealth index quintiles Poorest 86.3 87 Second 98.9 62 Middle 96.5 65 Fourth 99.0 106 Richest (98.1) 14 Ethnicity Macedonian 96.2 137 Albanian 97.4 132 Roma 63.1 10 Other (93.0) 56 Total 95.2 335 * MICS indicator 54 ** Primary school entry age is 7 97Republic of Macedonia Table ED.3: Primary school net attendance ratio Percentage of children of primary school age** attending primary or secondary school (NAR), Republic of Macedonia, 2005 Male Female Total Net attendance ratio Number of children Net attendance ratio Number of children Net attendance ratio* Number of children Region Skopski 97.7 464 94.5 391 96.2 855 Pelagoniski 86.0 108 78.1 151 81.4 260 Vardarski 97.9 55 99.4 92 98.8 147 North-East 93.6 132 92.8 70 93.3 201 South-West 99.2 209 99.3 331 99.3 540 South-East 90.8 126 67.2 85 81.3 211 Poloski 99.2 388 97.2 287 98.3 674 East 97.4 146 95.7 98 96.7 244 Residence Urban 95.3 791 89.3 675 92.6 1466 Rural 97.8 837 96.3 829 97.0 1666 Age 7 96.3 162 95.5 173 95.9 335 8 95.8 201 90.4 159 93.4 360 9 97.6 191 97.9 160 97.7 351 10 97.7 181 90.5 214 93.8 395 11 95.8 168 90.5 198 92.9 366 12 97.7 152 94.2 134 96.1 287 13 95.6 377 96.5 195 95.9 572 14 97.3 196 91.6 271 94.0 467 Mother’s education None 79.5 113 82.5 167 81.3 280 Primary 96.9 1047 92.8 990 94.9 2036 Secondary + 99.9 468 99.4 347 99.7 815 Wealth index quintiles Poorest 89.9 458 82.1 409 86.2 867 Second 98.7 350 94.1 329 96.5 678 Middle 99.6 337 96.7 296 98.2 632 Fourth 98.8 267 99.8 304 99.4 572 Richest 99.9 216 100.0 166 99.9 382 Ethnicity Macedonian 99.1 627 95.7 589 97.5 1217 Albanian 98.0 798 97.7 752 97.8 1550 Roma 65.9 55 57.8 82 61.1 137 Other 89.7 147 67.7 81 81.9 229 Total 96.6 1628 93.2 1504 94.9 3132 * MICS indicator 55; MDG indicator 6 ** Primary school age range covers ages 7-14 98 Multiple Indicator Cluster Survey - 2005-2006 Table ED.4: Secondary school net attendance ratio Percentage of children of secondary school age** attending secondary school or higher (NAR), Republic of Macedonia, 2005 Male Female Total Net attendance ratio Number of children Net attendance ratio Number of children Net attendance ratio* Number of children Region Skopski 64.9 206 62.8 189 63.9 395 Pelagoniski (58.5) 164 74.1 78 63.5 242 Vardarski (*) 28 (64.6) 60 45.8 88 North-East (92.2) 74 81.3 70 86.9 143 South-West (57.3) 82 60.5 86 59.0 167 South-East (25.5) 106 49.3 91 36.5 197 Poloski 55.2 188 67.8 123 60.2 312 East (*) 72 89.4 93 89.2 166 Residence Urban 64.1 353 77.5 427 71.4 781 Rural 55.6 568 56.4 362 55.9 930 Age 15 63.3 298 71.2 152 65.9 450 16 71.7 191 74.4 204 73.1 395 17 44.0 200 75.1 215 60.1 415 18 55.4 232 52.2 219 53.8 450 Wealth index quintiles Poorest 33.0 250 34.6 166 33.7 416 Second 47.6 231 55.8 181 51.2 412 Middle 71.4 180 70.6 121 71.1 301 Fourth (83.4) 110 88.1 135 86.0 245 Richest (85.9) 151 92.6 186 89.6 337 Ethnicity Macedonian 63.1 393 82.4 479 73.7 872 Albanian 61.4 402 50.8 240 57.4 642 Roma 15.7 37 20.5 20 17.4 57 Other (46.3) 88 28.4 50 39.8 139 Total 58.8 921 67.8 790 63.0 1710 * MICS indicator 56 ** Secondary school age range covers ages 15-18 99Republic of Macedonia Table ED.4w: Secondary school age children attending primary school Percentage of children of secondary school age** attending primary school, Republic of Macedonia, 2005 Male Female Total Percent attending primary school Number of children Percent attending primary school Number of children Percent attending primary school Number of children Region Skopski 4.8 206 2.4 189 3.7 395 Pelagoniski (.4) 164 .0 78 .3 242 Vardarski (*) 28 (.2) 60 .5 88 North-East (.1) 74 .0 70 .1 143 South-West (13.4) 82 1.3 86 7.2 167 South-East (.0) 106 .1 91 .1 197 Poloski 12.0 188 1.2 123 7.7 312 East (*) 72 .5 93 2.0 166 Residence Urban 2.1 353 1.2 427 1.6 781 Rural 7.0 568 .7 362 4.6 930 Age** 15 12.3 298 4.7 152 9.7 450 16 4.4 191 .2 204 2.2 395 17 .0 200 .0 215 .0 415 18 1.1 232 .1 219 .6 450 Wealth index quintiles Poorest 4.8 250 1.0 166 3.3 416 Second 4.5 231 .2 181 2.6 412 Middle 5.3 180 1.6 121 3.8 301 Fourth (13.2) 110 1.1 135 6.5 245 Richest (.7) 151 1.3 186 1.0 337 Ethnicity Macedonian 1.0 393 .5 479 .7 872 Albanian 9.7 402 1.9 240 6.8 642 Roma 3.8 37 3.5 20 3.7 57 Other (3.6) 88 .2 50 2.4 139 Total 5.2 921 1.0 790 3.2 1710 100 Multiple Indicator Cluster Survey - 2005-2006 Table ED.6: Primary school completion and transition to secondary education Primary school completion rate and transition rate to secondary education, Republic of Macedonia, 2005 Net primary school completion rate* Number of children of primary school completion age Transition rate to secondary education** Number of children who were in the last grade of primary school the previous year Sex Male 85.0 196 93.7 241 Female 80.8 271 96.1 143 Region Skopski 80.0 90 88.9 88 Pelagoniski 94.4 38 100.0 22 Vardarski 100.0 36 98.6 8 North-East 61.3 46 97.8 19 South-West 79.2 67 86.3 61 South-East 84.8 54 99.2 39 Poloski 80.9 110 97.4 57 East 98.8 26 99.6 89 Residence Urban 81.3 174 95.1 177 Rural 83.3 293 94.1 208 Mother’s education None 75.7 47 100.0 9 Primary 79.0 325 99.1 87 Secondary + 98.3 94 96.3 23 Wealth index quintiles Poorest 61.9 114 91.7 46 Second 87.8 129 99.2 79 Middle 92.1 95 84.2 89 Fourth 75.8 60 99.7 70 Richest 99.6 69 97.9 100 Ethnicity Macedonian 86.6 209 99.7 199 Albanian 80.5 225 90.8 157 Roma 44.6 11 26.9 8 Other 84.3 22 98.5 21 Total 82.6 467 94.6 385 * MICS indicator 59; MDG indicator 7b ** MICS indicator 58 101Republic of Macedonia Table ED.7: Education gender parity Ratio of girls to boys attending primary education and ratio of girls to boys attending secondary education, Republic of Macedonia, 2005 Primary school net attendance ratio (NAR), girls Primary school net attendance ratio (NAR), boys Gender parity index (GPI) for primary school NAR* Secondary school net attendance ratio (NAR), girls Secondary school net attendance ratio (NAR), boys Gender parity index (GPI) for secondary school NAR* Region Skopski 94.5 97.7 .97 62.8 64.9 .97 Pelagoniski 78.1 86.0 .91 74.1 (58.5) (1.27) Vardarski 99.4 97.9 1.02 (64.6) (*) (*) North-East 92.8 93.6 .99 81.3 (92.2) (.88) South-West 99.3 99.2 1.00 60.5 (57.3) (1.06) South-East 67.2 90.8 .74 49.3 (25.5) (1.94) Poloski 97.2 99.2 .98 67.8 55.2 1.23 East 95.7 97.4 .98 89.4 (*) (*) Residence Urban 89.3 95.3 .94 77.5 64.1 1.21 Rural 96.3 97.8 .99 56.4 55.6 1.01 Mother’s education None 82.5 79.5 1.04 - - - Primary 92.8 96.9 .96 - - - Secondary + 99.4 99.9 1.00 - - - Wealth index quintiles Poorest 82.1 89.9 .91 34.6 33.0 1.05 Second 94.1 98.7 .95 55.8 47.6 1.17 Middle 96.7 99.6 .97 70.6 71.4 .99 Fourth 99.8 98.8 1.01 88.1 (83.4) (1.06) Richest 100.0 99.9 1.00 92.6 (85.9) (1.08) Ethnicity Macedonian 95.7 99.1 .97 82.4 63.1 1.31 Albanian 97.7 98.0 1.00 50.8 61.4 .83 Roma 57.8 65.9 .88 20.5 15.7 1.31 Other 67.7 89.7 .75 28.4 (46.3) (.61) Total 93.2 96.6 .96 67.8 58.8 1.15 * MICS indicator 61; MDG indicator 9 102 Multiple Indicator Cluster Survey - 2005-2006 Table ED.8: Adult literacy Percentage of women aged 15-24 years that are literate*, Republic of Macedonia, 2005 Percent literate* Percent not known** Number of women aged 15-24 years Region Skopski 97.0 .0 614 Pelagoniski 96.4 .0 251 Vardarski 99.4 .0 183 North-East 98.5 .0 175 South-West 95.8 .1 216 South-East 87.6 2.8 199 Poloski 99.0 .6 342 East 99.1 .0 253 Residence Urban 97.2 .2 1331 Rural 96.4 .6 902 Education None 18.5 .1 46 Primary 93.3 1.6 495 Secondary + 100.0 .0 1692 Age 15-19 96.9 .4 1129 20-24 96.8 .3 1103 Wealth index quintiles Poorest 88.3 1.0 395 Second 95.2 .8 430 Middle 99.7 .1 407 Fourth 99.7 .0 458 Richest 99.9 .0 542 Ethnicity Macedonian 98.7 .0 1424 Albanian 98.7 .4 613 Roma 60.4 .0 52 Other 83.4 4.0 143 Total 96.8 .4 2233 * MICS indicator 60; MDG indicator 8 103Republic of Macedonia Table CP.1: Birth registration Percentage distribution of children aged 0-59 months by whether birth is registered and reasons for non-registration, Republic of Macedonia, 2005 Birth is registered* Don’t know Number of children aged 0-59 months without birth registration Sex Male 92.8 1.5 2428 Female 95.0 1.7 2118 Region Skopski 98.7 .8 1691 Pelagoniski 68.4 5.7 415 Vardarski 99.5 .2 279 North-East 96.6 .0 329 South-West 93.8 3.1 397 South-East 97.5 1.1 377 Poloski 90.8 1.6 742 East 95.9 2.0 316 Residence Urban 94.6 1.5 2467 Rural 92.9 1.7 2080 Age 0-11 months 88.7 2.7 746 12-23 months 92.9 1.1 837 24-35 months 95.8 1.2 881 36-47 months 95.9 .9 1067 48-59 months 94.4 2.3 1016 Mother’s education None 91.5 4.3 324 Primary 91.8 1.9 2491 Secondary + 97.1 .6 1732 Wealth index quintiles Poorest 88.5 3.8 1282 Second 93.5 .7 988 Middle 97.3 1.1 883 Fourth 95.3 .4 879 Richest 99.1 .6 515 Ethnicity Macedonian 96.2 1.1 1704 Albanian 92.4 1.9 2097 Roma 91.9 1.6 231 Other 92.5 1.7 514 Total 93.8 1.6 4547 * MICS indicator 62 104 Multiple Indicator Cluster Survey - 2005-2006 Table CP.2: Child labour Percentage of children aged 5-14 years who are involved in child labour activities by type of work, Republic of Macedonia, 2005 Working outside household Household chores for 28+ hours/ week Working for family business Total child labour* Number of children aged 5-14 yearsPaid work Unpaid work Sex Male .1 4.1 .0 3.1 6.8 2034 Female .2 2.5 .1 2.2 4.6 1915 Region Skopski .1 .7 .0 1.6 2.4 1171 Pelagoniski .2 6.6 .0 8.3 13.1 332 Vardarski .0 .2 .0 14.6 14.8 173 North-East .1 .5 .0 .8 1.4 259 South-West .0 4.7 .0 1.6 5.0 643 South-East .0 .2 .0 .4 .6 276 Poloski .2 8.2 .1 .1 8.6 791 East .4 .6 .0 6.5 7.5 304 Residence Urban .1 2.6 .1 3.9 6.6 1962 Rural .1 4.0 .0 1.5 4.8 1987 Age 5-11 years .2 4.5 .0 4.0 8.1 2624 12-14 years .0 .9 .0 .1 1.0 1325 School participation Yes .1 3.6 .0 3.1 6.4 3343 No .2 1.4 .0 .5 2.2 606 Mother’s education None .3 1.2 .0 .4 2.0 370 Primary .1 3.6 .0 1.0 4.5 2466 Secondary + .0 3.2 .1 7.0 9.5 1112 Wealth index quintiles Poorest .3 3.4 .0 1.8 4.1 1097 Second .1 4.5 .0 .1 4.6 836 Middle .1 4.8 .1 4.8 9.8 746 Fourth .1 1.5 .0 .9 2.5 727 Richest .0 1.5 .0 7.8 9.3 543 Ethnicity Macedonian .1 1.8 .1 3.5 4.9 1567 Albanian .1 4.4 .0 .9 5.3 1902 Roma 1.2 3.4 .0 2.0 6.6 186 Other .0 3.5 .0 10.7 12.1 294 Total .1 3.3 .0 2.7 5.7 3949 * MICS indicator 71 105Republic of Macedonia Table CP.3: Labourer students and student labourers Percentage of children aged 5-14 years who are labourer students and student labourers, Republic of Macedonia, 2005 Percent of children in child labour* Percent of children attending school*** Number of children 5-14 years of age Percent of child labourers who are also attending school** Number of child labourers aged 5-14 Percent of students who are also involved in child labour**** Number of students aged 5-14 Sex Male 6.8 86.5 2034 95.0 138 7.4 1760 Female 4.6 82.7 1915 93.0 88 5.1 1583 Region Skopski 2.4 83.3 1171 (77.1) 28 2.2 975 Pelagoniski 13.1 75.2 332 96.6 44 16.9 250 Vardarski 14.8 92.1 173 (*) 26 16.0 160 North-East 1.4 81.3 259 (*) 4 1.6 211 South-West 5.0 87.9 643 (97.3) 32 5.6 565 South-East .6 77.8 276 (*) 2 .6 214 Poloski 8.6 88.7 791 95.6 68 9.3 702 East 7.5 87.6 304 (*) 23 8.2 266 Residence Urban 6.6 80.0 1962 92.4 130 7.6 1570 Rural 4.8 89.2 1987 96.7 96 5.2 1773 Age 5-11 years 8.1 79.3 2624 94.2 212 9.6 2080 12-14 years 1.0 95.3 1325 (*) 14 1.0 1263 Mother’s education None 2.0 64.7 370 (46.8) 8 1.5 240 Primary 4.5 85.9 2466 94.3 112 5.0 2118 Secondary + 9.5 88.6 1112 97.5 106 10.5 986 Wealth index quintiles Poorest 4.1 75.9 1097 88.0 45 4.8 833 Second 4.6 86.4 836 (95.5) 39 5.1 722 Middle 9.8 91.0 746 (100.0) 73 10.7 679 Fourth 2.5 90.0 727 (90.7) 18 2.5 654 Richest 9.3 83.8 543 (*) 50 10.1 455 Ethnicity Macedonian 4.9 86.9 1567 94.7 76 5.3 1362 Albanian 5.3 86.9 1902 96.9 102 6.0 1652 Roma 6.6 55.0 186 (51.4) 12 6.1 102 Other 12.1 77.1 294 (*) 36 15.7 227 Total 5.7 84.7 3949 94.2 226 6.4 3343 ** MICS indicator 72 **** MICS indicator 73 106 Multiple Indicator Cluster Survey - 2005-2006 Table CP.4: Child discipline Percentage of children aged 2-14 years according to method of disciplining the child, Republic of Macedonia, 2005 Percentage of children 2-14 years of age who experience: Mother/ caretaker believes that the child needs to be physically punished Number of children aged 2-14 years** Only non-violent discipline Psych-ological punishment Minor physical punishment Severe physical punishment Any psych- ological or physical punishment* No discipline or punishment Sex Male 22.5 59.5 53.8 19.0 72.7 4.4 7.6 1176 Female 26.8 53.9 51.3 10.8 64.6 6.5 6.1 838 Region Skopski 25.9 56.4 57.8 21.2 70.3 2.4 4.7 608 Pelagoniski 24.5 67.9 46.5 20.3 74.3 1.2 9.6 176 Vardarski 19.0 56.4 44.2 7.1 63.7 6.4 14.6 118 North-East 34.9 39.3 53.9 14.4 56.6 8.5 2.1 135 South-West 21.7 54.4 54.7 19.9 76.6 1.7 10.6 269 South-East 16.3 73.7 60.3 19.6 83.1 .7 1.3 180 Poloski 28.7 51.4 42.3 7.4 58.8 12.5 9.9 367 East 16.4 63.0 58.4 3.6 71.8 11.8 4.6 162 Residence Urban 27.8 52.2 50.8 14.7 65.7 5.2 8.4 1040 Rural 20.5 62.5 54.9 16.6 73.2 5.4 5.4 974 Age 2-4 years 22.7 56.2 57.3 15.0 71.4 5.9 5.4 470 5-9 years 20.9 60.5 59.5 20.5 72.2 6.9 10.0 600 10-14 years 27.3 55.6 46.3 12.7 66.5 4.0 5.8 944 Mother’s education None 9.6 54.2 65.0 12.6 75.3 9.8 6.6 144 Primary 19.7 62.9 54.4 15.8 72.4 7.1 6.5 1157 Secondary + 34.7 48.5 47.6 15.9 63.2 1.4 7.7 714 Wealth index quintiles Poorest 21.4 62.3 52.7 23.1 72.1 6.4 7.5 535 Second 15.5 59.8 60.7 12.8 77.7 3.9 7.6 398 Middle 17.2 65.4 59.7 11.8 76.1 6.7 7.2 401 Fourth 24.3 54.1 57.2 19.2 68.8 5.5 10.0 375 Richest 50.1 37.9 28.1 6.6 45.4 3.1 1.0 306 Ethnicity Macedonian 32.7 48.6 48.3 13.6 63.1 3.6 5.4 932 Albanian 19.8 64.6 54.6 14.2 73.6 5.5 7.3 815 Roma 10.1 65.7 69.4 20.2 77.7 12.2 12.5 82 Other 8.3 63.6 59.7 29.5 78.2 9.5 11.0 185 Total 24.3 57.2 52.8 15.6 69.3 5.3 7.0 2015 * MICS indicator 74 107Republic of Macedonia Table CP.5: Early marriage Percentage of women aged 15-49 years in marriage or union before their 15th birthday, percentage of women aged 20-49 years in marriage or union before their 18th birthday, percentage of women aged 15-19 years currently married or in union, Republic of Macedonia, 2005 Percent married before age 15* Number of women aged 15-49 years Percent married before age 18* Number of women aged 20-49 years Percent of women 15- 19 married/in union** Number of women aged 15-19 years Region Skopski .7 2069 6.8 1791 .4 277 Pelagoniski 1.5 817 13.4 690 2.3 127 Vardarski .4 467 8.7 392 .2 75 North-East 1.1 605 16.4 509 .4 96 South-West 1.0 808 11.9 693 2.6 115 South-East 3.2 613 32.6 496 5.7 117 Poloski .6 1068 9.9 886 .2 182 East .5 949 10.8 810 4.1 140 Residence Urban 1.0 4445 9.7 3816 1.2 629 Rural 1.1 2952 15.5 2452 2.5 500 Age 15-19 .2 1129 NA NA 1.8 1129 20-24 .3 1103 3.6 1103 NA NA 25-29 .8 1078 4.5 1078 NA NA 30-34 2.3 1041 9.9 1041 NA NA 35-39 1.9 1054 28.2 1054 NA NA 40-44 1.2 1027 17.0 1027 NA NA 45-49 .5 965 9.0 965 NA NA Education None 10.8 263 34.7 245 8.6 18 Primary 1.4 2988 19.6 2718 2.7 270 Secondary + .1 4146 4.0 3304 1.4 841 Wealth index quintiles Poorest 2.1 1354 19.0 1132 3.2 222 Second 2.2 1336 17.6 1105 .5 231 Middle .7 1498 12.0 1298 3.2 200 Fourth .2 1577 7.6 1366 2.5 211 Richest .3 1632 6.0 1367 .1 265 Ethnicity Macedonian .5 4545 10.4 3862 2.2 683 Albanian .7 2145 9.2 1799 .3 347 Roma 11.4 184 48.6 155 11.2 29 Other 3.6 522 23.7 452 1.7 71 Total 1.0 7397 12.0 6268 1.8 1129 * MICS indicator 67 ** MICS indicator 68 108 Multiple Indicator Cluster Survey - 2005-2006 Table CP.6: Spousal age difference Percentage distribution of currently married/in union women aged 20-24 years according to the age difference with their husband or partner, Republic of Macedonia, 2005 Percentage of currently married/in union women aged 20-24 years whose husband or partner is: Number of women aged 20-24 years currently married/ in union Younger 0-4 years older 5-9 years older 10+ years older* Total Region Skopski 2.5 55.0 36.6 5.9 100.0 22 Pelagoniski 10.6 40.7 18.4 30.3 100.0 11 Vardarski .0 59.0 31.0 10.0 100.0 5 North-East .6 51.0 39.1 9.3 100.0 5 South-West 4.2 73.8 17.7 4.2 100.0 9 South-East 1.9 45.6 49.9 2.7 100.0 14 Poloski 4.1 62.8 30.0 3.1 100.0 14 East 3.6 40.4 33.1 22.9 100.0 9 Residence Urban 5.0 55.9 28.8 10.3 100.0 48 Rural 2.3 50.9 37.4 9.4 100.0 43 Education None 9.0 72.8 16.7 1.5 100.0 12 Primary 3.5 47.1 40.0 9.4 100.0 48 Secondary + 1.9 55.6 28.6 13.9 100.0 31 Wealth index quintiles Poorest 5.9 57.8 31.6 4.8 100.0 32 Second .9 50.7 27.6 20.8 100.0 25 Middle 2.7 55.7 36.1 5.4 100.0 19 Fourth 7.4 43.9 43.5 5.2 100.0 10 Richest .0 51.2 35.8 (13.0) 100.0 5 Ethnicity Macedonian 3.5 50.5 31.1 15.0 100.0 40 Albanian 3.7 51.0 38.0 7.2 100.0 25 Roma 3.6 73.8 21.8 .8 100.0 13 Other 4.4 48.0 40.0 7.6 100.0 13 Total 3.7 53.5 32.9 9.8 100.0 91 * MICS indicator 69 109Republic of Macedonia Table CP.9: Attitudes toward domestic violence Percentage of women aged 15-49 years who believe a husband is justified in beating his wife/partner in various circumstances, Republic of Macedonia, 2005 Percentage of women aged 15-49 years who believe a husband is justified in beating his wife/partner: Number of women aged 15-49 years When she goes out without telling him When she neglects the children When she argues with him When she refuses sex with him When she burns the food For any of these reasons* Region Skopski 16.0 12.8 17.2 5.3 6.7 25.3 2069 Pelagoniski 3.7 6.6 3.1 1.7 1.1 7.9 817 Vardarski 4.8 8.7 5.1 2.7 2.3 9.5 467 North-East 7.1 9.8 5.0 3.2 1.9 10.7 605 South-West 25.9 41.6 19.1 18.0 14.6 44.8 808 South-East 2.2 2.1 .3 1.5 .4 3.1 613 Poloski 22.7 26.4 20.0 14.5 7.3 29.1 1068 East 1.5 12.0 3.6 3.8 1.9 15.3 949 Residence Urban 9.4 12.4 7.8 6.3 5.2 15.4 4445 Rural 16.5 20.7 16.6 7.6 5.2 28.9 2952 Age 15-19 7.8 11.0 8.7 4.4 5.6 14.2 1129 20-24 10.2 10.2 10.8 6.6 4.7 16.0 1103 25-29 13.9 15.1 14.4 7.6 7.6 21.3 1078 30-34 20.3 21.5 13.9 7.2 4.4 30.8 1041 35-39 9.5 20.8 8.5 6.2 1.3 23.5 1054 40-44 11.4 12.7 10.5 9.2 5.9 17.3 1027 45-49 13.2 19.6 13.0 6.5 7.0 22.9 965 Marital/Union status Currently married/in union 13.3 18.4 12.4 8.1 5.4 23.7 4251 Formerly married/in union 23.6 29.3 9.0 4.0 5.1 30.9 242 Never married/in union 9.8 10.7 10.0 5.1 5.0 15.5 2904 Education None 24.1 28.9 25.5 21.4 16.7 35.9 263 Primary 20.2 24.0 19.6 9.6 7.3 32.8 2988 Secondary + 5.7 8.9 4.5 3.8 3.0 11.1 4146 Wealth index quintiles Poorest 23.1 23.6 20.3 9.6 10.2 31.6 1354 Second 14.3 20.5 15.2 12.0 6.5 26.5 1336 Middle 10.4 15.7 8.4 4.4 2.2 19.4 1498 Fourth 10.6 14.0 9.4 4.9 3.6 21.0 1577 Richest 4.9 7.0 5.3 4.2 4.4 8.1 1632 Ethnicity Macedonian 5.7 10.4 4.6 5.0 3.8 12.6 4545 Albanian 25.0 26.6 24.1 9.6 8.4 36.5 2145 Roma 25.7 33.0 29.8 21.6 10.4 47.4 184 Other 11.7 11.3 11.2 5.6 2.3 16.9 522 Total 12.2 15.7 11.4 6.8 5.2 20.7 7397 * MICS indicator 100 110 Multiple Indicator Cluster Survey - 2005-2006 Table CP.10: Child disability Percentage of children aged 2-9 years with disability reported by their mother or caretaker according to the type of disability, Republic of Macedonia, 2005 Percentage of children aged 2-9 years with reported disability by type of disability Percent of children aged 2-9 years with at least one reported disability* Number of children aged 2-9 years 3-9 years Number of children aged 3-9 years 2 years Number of children aged 2 years Delay in sitting, standing or walking Difficulty seeing, either in the daytime or at night Appears to have difficulty hearing No under- standing of instr- uctions Difficulty in walking, moving arms, weakness or stiffness Have fits, become rigid, lose concious- ness Not learning to do things like other children his/her age No speak-ing / cannot be under- stood in words Appears mentally backward, dull, or slow Speech is not normal Cannot name at least one object Region Skopski 1.7 2.3 .1 3.2 1.6 2.8 3.1 3.8 3.7 13.0 1019 17.2 897 5.4 121 Pelagoniski .8 1.0 .1 6.0 .5 .9 3.1 2.7 .7 8.6 233 10.1 210 8.2 23 Vardarski 1.0 .4 1.1 .9 6.6 7.8 .9 1.2 .7 11.4 144 8.0 131 3.2 13 North-East .3 .5 .1 .6 .3 .1 2.8 3.5 .4 6.3 194 16.7 171 14.0 23 South-West .4 .5 .3 1.1 .2 .4 1.4 1.7 .4 3.7 401 4.6 365 22.7 36 South-East 1.0 1.0 1.3 .7 .7 .2 1.1 1.1 1.0 5.5 213 6.5 196 6.8 17 Poloski .9 .8 .3 2.2 .9 .9 6.7 1.8 .9 10.8 446 11.0 391 4.3 55 East 2.8 1.8 2.0 2.2 1.1 1.3 1.6 5.6 1.4 12.9 238 25.4 223 13.6 15 Residence Urban 1.6 1.6 .5 2.4 1.8 2.5 4.1 3.3 1.2 10.6 1616 16.0 1456 6.4 160 Rural .8 1.0 .3 2.5 .6 .8 1.7 2.4 2.5 9.1 1271 9.8 1127 10.8 144 Age of child 2-4 .9 .8 .5 2.4 1.7 1.9 2.2 3.7 2.3 11.2 1024 14.4 721 - - 5-6 2.7 2.7 .7 3.5 1.9 2.1 4.0 3.7 2.3 11.1 817 12.3 817 - - 7-9 .4 .8 .2 1.7 .3 1.3 3.0 1.5 1.0 7.8 1046 13.3 1046 - - Mother’s education None .9 1.6 .5 2.5 .8 1.0 3.1 3.6 .9 9.4 242 14.1 221 6.2 21 Primary 1.6 1.7 .3 3.2 1.4 2.2 3.3 3.6 2.6 11.7 1625 13.8 1444 10.9 181 Secondary + .6 .8 .6 1.2 1.2 1.2 2.5 1.7 .8 7.3 1021 12.2 919 4.7 102 Wealth index quintiles Poorest 1.7 1.3 .9 3.0 .9 1.5 2.8 3.2 3.5 12.0 734 16.8 647 8.4 87 Second .4 .8 .1 3.1 1.9 2.1 1.4 2.3 2.0 10.5 635 15.5 555 5.5 80 Middle .6 1.0 .2 .7 .5 2.4 5.2 3.0 1.4 12.5 548 8.0 492 17.0 55 Fourth .7 1.0 .6 1.4 .1 .2 1.8 2.0 .7 5.9 599 12.0 551 6.3 49 Richest 3.4 3.7 .1 4.6 3.9 3.3 4.9 4.6 .4 7.5 371 12.8 339 5.2 32 Ethnicity Macedonian .9 .9 .6 1.5 1.2 1.3 1.3 1.6 .6 6.4 1195 11.9 1078 5.5 117 Albanian 1.6 1.9 .1 2.3 1.5 2.3 4.6 3.8 3.0 12.4 1245 15.7 1093 9.6 152 Roma 1.6 2.7 1.5 10.3 1.3 2.3 3.4 3.5 3.6 22.0 144 10.5 127 15.8 17 Other .9 .3 .7 3.0 .2 .9 2.9 4.0 .5 8.0 303 10.7 286 12.2 17 Total 1.2 1.4 .4 2.4 1.3 1.8 3.0 2.9 1.8 9.9 2887 13.3 2584 8.5 304 * MICS indicator 101 111Republic of Macedonia Table HA.1: Knowledge of preventing HIV transmission Percentage of women aged 15-49 years who know the main ways of preventing HIV transmission, Republic of Macedonia, 2005 Heard of AIDS Percentage who know transmission can be prevented by: Number of women Having only one faithful uninfected sex partner Using a condom every time Abstaining from sex Knows all three ways Knows at least one way Doesn’t know any way Region Skopski 74.4 53.4 53.0 19.1 14.4 65.6 34.4 2069 Pelagoniski 92.9 77.0 76.0 35.7 30.7 84.5 15.5 817 Vardarski 85.9 73.0 70.8 31.3 26.4 85.2 14.8 467 North-East 73.6 53.6 60.6 46.9 36.8 66.2 33.8 605 South-West 85.2 74.0 70.5 31.1 27.1 79.0 21.0 808 South-East 72.1 56.8 59.7 19.4 13.9 68.5 31.5 613 Poloski 67.1 47.2 44.2 28.2 19.3 56.6 43.4 1068 East 97.9 69.5 67.6 27.2 19.0 80.2 19.8 949 Residence Urban 87.3 68.4 67.6 29.8 23.2 80.2 19.8 4445 Rural 69.1 49.8 49.4 24.4 18.8 57.7 42.3 2952 Age 15-19 84.6 63.3 64.2 35.9 27.4 76.5 23.5 1129 20-24 88.1 65.9 70.9 32.6 24.5 81.4 18.6 1103 25-29 84.1 62.0 60.6 21.9 17.4 73.3 26.7 1078 30-34 69.5 52.3 53.0 24.8 19.9 59.0 41.0 1041 35-39 74.7 62.8 56.9 26.1 22.3 68.0 32.0 1054 40-44 82.0 63.0 58.5 28.5 20.4 72.4 27.6 1027 45-49 76.2 56.4 57.1 22.7 17.4 66.7 33.3 965 Education None 34.0 20.0 14.4 6.0 4.1 22.1 77.9 263 Primary 61.7 41.9 37.0 21.0 15.7 48.4 51.6 2988 Secondary + 96.2 77.3 80.1 33.9 26.7 90.8 9.2 4146 Wealth index quintiles Poorest 58.1 39.4 33.9 19.9 15.2 44.8 55.2 1354 Second 74.1 51.6 53.8 24.5 15.3 63.4 36.6 1336 Middle 79.9 59.1 59.8 29.8 23.4 69.8 30.2 1498 Fourth 87.8 70.6 67.5 31.3 23.5 81.4 18.6 1577 Richest 95.8 78.8 81.3 31.3 27.9 91.1 8.9 1632 Ethnicity Macedonian 94.9 75.5 76.7 34.2 27.0 87.9 12.1 4545 Albanian 56.0 36.7 34.0 18.7 13.3 43.7 56.3 2145 Roma 56.4 43.1 34.1 14.8 12.2 48.2 51.8 184 Other 58.1 40.2 35.4 12.2 9.8 47.8 52.2 522 Total 80.1 61.0 60.3 27.7 21.5 71.2 28.8 7397 112 Multiple Indicator Cluster Survey - 2005-2006 Table HA.2: Identifying misconceptions about HIV/AIDS Percentage of women aged 15-49 years who correctly identify misconceptions about HIV/AIDS, Republic of Macedonia, 2005 Percentage who know that: Reject two most common misconceptions and know a healthy-looking person can be infected Percentage who know that: Number of women HIV cannot be transmitted by: A healthy looking person can be infected HIV cannot be transmitted by mosquito bites HIV can be transmitted by sharing needles Supernatural means Sharing food Region Skopski 68.1 44.9 50.5 35.3 39.5 68.2 2069 Pelagoniski 88.9 50.4 73.4 42.9 56.1 82.5 817 Vardarski 79.3 64.5 67.6 50.5 39.7 83.9 467 North-East 64.1 38.5 38.8 26.8 36.6 67.8 605 South-West 78.1 23.4 52.8 17.1 25.1 77.0 808 South-East 63.1 47.2 54.8 29.3 29.7 70.3 613 Poloski 53.5 32.3 46.8 20.6 43.4 59.2 1068 East 80.8 43.2 76.3 36.8 54.9 87.8 949 Residence Urban 78.9 51.0 66.5 40.9 45.6 81.4 4445 Rural 59.1 28.5 41.6 18.5 34.7 60.5 2952 Age 15-19 73.8 45.3 60.0 32.7 45.8 75.8 1129 20-24 81.2 53.7 69.2 43.0 50.3 82.3 1103 25-29 76.0 43.6 62.2 37.3 47.1 76.4 1078 30-34 61.0 35.3 45.0 26.5 35.9 65.1 1041 35-39 65.4 38.0 43.9 24.1 38.2 66.2 1054 40-44 73.9 38.4 59.3 29.7 38.1 76.0 1027 45-49 63.9 38.5 55.0 29.5 31.6 68.7 965 Education None 13.4 6.6 11.8 3.4 4.0 19.4 263 Primary 50.5 21.5 29.9 10.8 30.0 52.2 2988 Secondary + 89.4 59.0 78.6 49.1 51.8 91.5 4146 Wealth index quintiles Poorest 46.3 18.0 27.5 8.6 25.7 48.0 1354 Second 59.6 31.3 47.6 20.2 35.9 67.1 1336 Middle 72.5 47.4 57.1 36.9 41.1 73.2 1498 Fourth 80.3 46.2 65.1 37.2 42.9 79.8 1577 Richest 90.3 61.8 79.1 51.5 57.0 92.1 1632 Ethnicity Macedonian 85.0 54.3 72.9 42.9 47.5 89.7 4545 Albanian 48.3 20.5 27.4 12.2 34.1 45.4 2145 Roma 42.1 14.6 20.7 8.2 15.1 48.5 184 Other 52.0 33.4 45.9 26.6 25.5 51.2 522 Total 71.0 42.0 56.5 32.0 41.3 73.1 7397 113Republic of Macedonia Table HA.3: Comprehensive knowledge of HIV/AIDS transmission Percentage of women aged 15-49 years who have comprehensive knowledge of HIV/AIDS transmission, Republic of Macedonia, 2005 Know 2 ways to prevent HIV transmission Correctly identify 3 misconceptions about HIV transmission Have comprehensive knowledge (identify 2 prevention methods and 3 misconceptions)* Number of women Region Skopski 41.5 35.3 24.1 2069 Pelagoniski 68.8 42.9 35.8 817 Vardarski 59.8 50.5 39.0 467 North-East 49.7 26.8 18.8 605 South-West 66.6 17.1 14.6 808 South-East 49.5 29.3 21.7 613 Poloski 37.8 20.6 12.0 1068 East 58.2 36.8 28.8 949 Residence Urban 57.0 40.9 30.0 4445 Rural 42.9 18.5 13.7 2952 Age 15-19 54.3 32.7 23.4 1129 20-24 57.3 43.0 29.9 1103 15-24 55.8 37.8 26.6 2233 25-29 49.6 37.3 24.8 1078 30-34 47.1 26.5 20.9 1041 35-39 51.9 24.1 19.9 1054 40-44 51.0 29.7 24.2 1027 45-49 47.6 29.5 20.9 965 Education None 12.9 3.4 2.3 263 Primary 31.7 10.8 7.1 2988 Secondary + 68.0 49.1 36.7 4146 Wealth index quintiles Poorest 29.4 8.6 5.4 1354 Second 44.4 20.2 16.3 1336 Middle 50.5 36.9 25.0 1498 Fourth 57.6 37.2 27.0 1577 Richest 70.1 51.5 39.6 1632 Ethnicity Macedonian 65.6 42.9 32.5 4545 Albanian 28.3 12.2 7.5 2145 Roma 30.4 8.2 6.2 184 Other 29.2 26.6 17.2 522 Total 51.4 32.0 23.5 7397 * MICS indicator 82; MDG indicator 19b 114 Multiple Indicator Cluster Survey - 2005-2006 Table HA.4: Knowledge of mother-to-child HIV transmission Percentage of women aged 15-49 years who correctly identify means of HIV transmission from mother to child, Republic of Macedonia, 2005 Know AIDS can be transmitted from mother to child Percentage who know AIDS can be transmitted: Did not know any specific way Number of women During pregnancy At delivery Through breastmilk All three ways* Region Skopski 65.9 64.4 58.6 58.3 54.4 8.5 2069 Pelagoniski 87.3 82.9 73.5 82.6 70.8 5.6 817 Vardarski 79.2 77.3 74.6 71.0 67.1 6.8 467 North-East 63.3 63.1 51.9 53.6 47.8 10.3 605 South-West 71.9 71.2 58.2 62.5 55.2 13.3 808 South-East 66.1 63.0 58.0 56.4 52.8 6.0 613 Poloski 55.1 54.7 43.8 42.8 39.3 12.1 1068 East 88.7 85.4 69.3 79.9 63.8 9.2 949 Residence Urban 77.4 75.7 67.2 67.7 61.0 9.9 4445 Rural 61.1 59.1 48.8 53.9 47.1 8.0 2952 Age 15-19 71.6 69.2 56.8 59.5 52.2 13.0 1129 20-24 77.3 75.7 65.0 66.8 61.4 10.8 1103 25-29 74.7 72.4 64.5 66.2 59.3 9.4 1078 30-34 60.7 59.5 49.9 53.9 47.4 8.8 1041 35-39 68.2 67.8 60.3 61.6 57.3 6.5 1054 40-44 73.7 71.7 65.8 67.9 61.4 8.3 1027 45-49 69.6 66.9 56.0 59.3 48.7 6.5 965 Education None 19.0 18.9 17.7 17.6 17.1 15.0 263 Primary 51.6 49.2 38.8 44.3 35.7 10.1 2988 Secondary + 88.1 86.6 77.7 78.0 72.1 8.1 4146 Wealth index quintiles Poorest 45.9 43.3 34.4 38.4 33.5 12.2 1354 Second 65.8 64.8 53.9 57.0 49.5 8.3 1336 Middle 68.4 66.3 60.7 59.5 54.1 11.6 1498 Fourth 79.4 77.0 65.8 69.2 60.1 8.4 1577 Richest 90.0 89.0 79.3 82.1 75.3 5.8 1632 Ethnicity Macedonian 86.9 84.7 75.6 77.8 70.0 8.0 4545 Albanian 42.9 42.0 31.7 34.3 29.3 13.1 2145 Roma 42.5 39.3 35.6 36.5 32.3 14.0 184 Other 56.6 54.9 46.2 50.2 44.2 1.4 522 Total 70.9 69.1 59.8 62.2 55.5 9.1 7397 * MICS indicator 89 115Republic of Macedonia Table HA.5: Attitudes toward people living with HIV/AIDS Percentage of women aged 15-49 years who have heard of AIDS who express a discriminatory attitude towards people living with HIV/AIDS, Republic of Macedonia, 2005 Percentage of women who: Number of women who have heard of AIDS Would not care for a family member who was sick with AIDS If a family member had HIV would want to keep it a secret Believe that a female teacher with HIV should not be allowed to work Would not buy fresh vegetables from a person with HIV/AIDS Agree with at least one discriminatory statement Agree with none of the discriminatory statements* Region Skopski 3.8 44.7 45.0 57.2 81.8 18.2 1540 Pelagoniski 1.7 29.5 50.7 62.7 81.4 18.6 759 Vardarski 2.0 45.1 46.4 55.8 82.7 17.3 401 North-East 4.7 32.8 56.9 64.1 81.9 18.1 445 South-West 3.7 67.3 68.5 76.5 91.3 8.7 688 South-East 3.3 25.2 48.1 55.4 71.4 28.6 442 Poloski 15.5 32.8 69.8 73.9 88.0 12.0 717 East 2.3 38.2 59.1 72.3 88.9 11.1 929 Residence Urban 2.7 43.0 49.3 60.1 82.2 17.8 3882 Rural 8.2 36.0 65.5 73.8 87.4 12.6 2040 Age 15-19 6.2 42.7 54.7 62.6 83.9 16.1 956 20-24 5.0 40.6 47.6 58.6 81.0 19.0 972 25-29 4.6 37.3 46.5 60.6 79.5 20.5 907 30-34 2.9 48.3 64.3 74.0 91.1 8.9 724 35-39 7.4 30.8 60.7 72.8 81.8 18.2 787 40-44 4.2 43.9 57.5 66.8 87.3 12.7 842 45-49 1.1 41.0 56.7 61.3 85.1 14.9 735 Education None 8.7 25.5 48.0 52.3 72.5 27.5 89 Primary 7.1 39.1 68.3 77.7 91.0 9.0 1844 Secondary + 3.4 41.6 48.9 59.1 81.0 19.0 3989 Wealth index quintiles Poorest 10.7 29.7 67.2 75.8 88.5 11.5 787 Second 5.4 32.6 60.7 70.9 87.7 12.3 991 Middle 2.6 46.3 52.4 61.4 83.3 16.7 1197 Fourth 3.0 41.5 58.9 69.7 85.7 14.3 1384 Richest 3.9 45.9 43.3 53.7 78.4 21.6 1564 Ethnicity Macedonian 2.5 40.3 50.2 61.6 81.3 18.7 4313 Albanian 9.8 44.7 66.8 74.6 92.2 7.8 1201 Roma 9.3 26.0 53.2 61.5 76.8 23.2 104 Other 11.6 33.7 75.8 72.9 92.4 7.6 303 Total 4.6 40.6 54.9 64.8 84.0 16.0 5922 * MICS indicator 86 116 Multiple Indicator Cluster Survey - 2005-2006 Table HA.6: Knowledge of a facility for HIV testing Percentage of women aged 15-49 years who know where to get an HIV test, percentage of women who have been tested and, of those tested the percentage who have been told the result, Republic of Macedonia, 2005 Know a place to get tested* Have been tested** Number of women If tested, have been told result Number of women who have been tested for HIV Region Skopski 44.2 5.2 2069 (96.8) 108 Pelagoniski 63.6 2.8 817 (83.7) 23 Vardarski 47.8 2.9 467 (*) 14 North-East 36.4 .2 605 (*) 1 South-West 47.4 1.4 808 (*) 11 South-East 41.8 1.3 613 (*) 8 Poloski 28.0 1.5 1068 (*) 17 East 54.8 4.7 949 (83.0) 45 Residence Urban 55.7 4.0 4445 96.0 178 Rural 29.2 1.6 2952 (78.6) 49 Age 15-19 48.5 2.1 1129 (*) 24 20-24 57.9 3.1 1103 (99.3) 34 25-29 51.7 3.8 1078 (78.2) 41 30-34 39.4 6.0 1041 (99.4) 62 35-39 33.1 .2 1054 (*) 2 40-44 40.4 3.1 1027 (*) 32 45-49 43.5 3.3 965 (*) 32 Education None 5.9 .4 263 (*) 1 Primary 16.7 .3 2988 (68.5) 8 Secondary + 68.1 5.2 4146 93.1 217 Wealth index quintiles Poorest 19.7 .8 1354 (*) 11 Second 29.2 1.2 1336 (98.1) 16 Middle 41.9 2.4 1498 (68.6) 37 Fourth 55.4 4.9 1577 (95.3) 77 Richest 72.2 5.2 1632 (99.8) 85 Ethnicity Macedonian 60.4 3.7 4545 90.9 167 Albanian 17.9 .6 2145 (*) 13 Roma 20.5 1.1 184 (*) 2 Other 32.0 8.5 522 (*) 45 Total 45.1 3.1 7397 92.3 226 * MICS indicator 87 ** MICS indicator 88 117Republic of Macedonia Table HA.7: HIV testing and counselling coverage during antenatal care Percentage of women aged 15-49 years who gave birth in the two years preceding the survey who were offered HIV counselling with their antenatal care, Republic of Macedonia, 2005 Percentage of women who: Number of women who gave birth in the 2 years preceding the survey Received antenatal care from a health care professional for last pregnancy Were provided information about HIV prevention during ANC visit* Region Skopski 98.0 7.5 213 Pelagoniski 97.8 39.8 46 Vardarski 98.4 11.9 18 North-East 99.1 6.2 39 South-West 98.3 5.3 59 South-East 96.9 6.1 36 Poloski 97.4 5.2 115 East 99.7 39.0 41 Residence Urban 97.7 14.0 308 Rural 98.5 8.9 257 Age 15-19 97.1 51.5 7 20-24 91.3 7.9 45 25-29 98.8 14.5 186 30-34 98.9 5.6 242 35-49 97.8 21.3 86 Education None 84.8 7.1 35 Primary 98.7 8.8 334 Secondary + 99.4 17.4 197 Wealth index quintiles Poorest 94.3 15.1 158 Second 99.5 7.6 102 Middle 99.5 5.0 104 Fourth 100.0 6.0 138 Richest 98.4 32.8 64 Ethnicity Macedonian 98.4 20.1 174 Albanian 99.0 8.9 306 Roma 78.5 15.0 19 Other 98.5 1.5 67 Total 98.1 11.7 566 * MICS indicator 90 118 Multiple Indicator Cluster Survey - 2005-2006 Table HA.8: Sexual behaviour that increases risk of HIV infection Percentage of young women aged 15-19 years who had sex before age 15, percentage of young women aged 20-24 who had sex before age 18, and percentage of young women aged 15-24 who had sex with a man 10 or more years older, Republic of Macedonia, 2005 Percentage of women aged 15-19 who had sex before age 15* Number of women aged 15-19 years Percentage of women aged 20-24 who had sex before age 18 Number of women aged 20-24 years Percentage who had sex in the 12 months preceding the survey with a man 10 or more years older** Number of women who had sex in the 12 months preceding the survey Region Skopski 1.0 277 3.1 337 (.8) 104 Pelagoniski .4 127 11.3 124 (5.0) 64 Vardarski .2 75 18.2 107 (*) 66 North-East .1 96 14.6 79 (*) 28 South-West .2 115 2.5 101 (*) 22 South-East 2.4 117 21.1 82 (3.7) 77 Poloski .1 182 5.1 160 (*) 45 East .1 140 6.9 113 (*) 38 Residence Urban 1.0 629 10.4 701 1.9 326 Rural .1 500 4.5 402 (15.0) 118 Age 15-19 .6 1129 . 0 13.6 119 20-24 . 0 8.3 1103 2.4 325 Education None 4.8 18 26.3 28 (*) 11 Primary 1.2 270 9.2 225 (25.0) 71 Secondary + .3 841 7.4 850 1.7 362 Wealth index quintiles Poorest 1.6 222 10.2 173 (22.9) 65 Second .2 231 3.2 199 (8.5) 62 Middle .0 200 11.9 207 (.7) 84 Fourth .1 211 9.7 247 (2.8) 104 Richest 1.0 265 6.7 276 .2 128 Ethnicity Macedonian .8 683 9.5 742 5.6 387 Albanian .0 347 2.1 267 (*) 23 Roma 1.3 29 27.4 23 (*) 13 Other 1.2 71 12.3 72 (*) 20 Total .6 1129 8.3 1103 5.4 444 * MICS indicator 84 ** MICS indicator 92 119Republic of Macedonia Table HA.9: Condom use at last high-risk sex Percentage of young women aged 15-24 years who had high risk sex in the previous year and who used a condom at last high risk sex, Republic of Macedonia, 2005 Ever had sex Had sex in the last 12 months Had sex with more than one partner in last 12 months Number of women aged 15-24 years Percent who had sex with non-marital, non-cohabiting partner* Number of women aged 15-24 years who had sex in last 12 months Percent who used a condom at last sex with a non-marital, non-cohabiting partner** Number of women aged 15-24 years who had sex in last 12 months with a non- marital, non-cohabiting partner Region Skopski 20.8 16.9 .6 614 81.6 104 (74.7) 85 Pelagoniski 41.3 25.5 1.6 251 81.3 64 (72.2) 52 Vardarski 44.8 36.1 4.5 183 92.2 66 (*) 61 North-East 19.5 16.1 .0 175 81.2 28 (*) 23 South-West 10.4 10.0 .0 216 58.8 22 (*) 13 South-East 45.4 38.8 1.7 199 81.0 77 (81.0) 62 Poloski 17.2 13.3 .7 342 70.5 45 (*) 32 East 17.9 14.9 1.5 253 63.1 38 (*) 24 Residence Urban 30.1 24.5 1.2 1331 85.4 326 76.0 278 Rural 18.2 13.0 1.1 902 62.1 118 (46.4) 73 Age 15-19 11.8 10.5 1.2 1129 87.8 119 70.0 104 20-24 39.0 29.4 1.1 1103 76.0 325 69.8 247 Education None 34.4 24.0 .2 46 12.3 11 (*) 1 Primary 17.5 14.3 1.6 495 30.7 71 (24.0) 22 Secondary + 27.3 21.4 1.0 1692 90.7 362 73.0 328 Wealth index quintiles Poorest 19.6 16.5 2.3 395 49.0 65 (26.9) 32 Second 20.7 14.5 .1 430 65.6 62 (66.6) 41 Middle 26.2 20.7 1.0 407 79.5 84 (59.4) 67 Fourth 26.2 22.8 1.0 458 84.6 104 (77.6) 88 Richest 31.5 23.6 1.3 542 96.6 128 82.1 123 Ethnicity Macedonian 34.4 27.2 1.8 1424 88.9 387 70.1 344 Albanian 5.3 3.8 .0 613 3.4 23 (*) 1 Roma 40.8 25.6 .4 52 14.1 13 (*) 2 Other 14.3 13.7 .2 143 21.4 20 (*) 4 Total 25.3 19.9 1.1 2233 79.2 444 69.8 351 * MICS indicator 85 ** MICS indicator 83; MDG indicator 19a 120 Multiple Indicator Cluster Survey - 2005-2006 Table HA.10: Children’s living arrangements and orphanhood Percentage distribution of children aged 0-17 years according to living arrangements, percentage of children aged 0-17 years in households not living with a biological parent and percentage of children who are orphans, Republic of Macedonia, 2005 Living with both parents Living with neither parent Living with mother only Living with father only Imposs- ible to deter- mine Total Not living with a bio-logical parent* One or both parents dead** Number of children Only father alive Only mother alive Both are alive Both are dead Father alive Father dead Mother alive Mother dead Sex Male 95.6 .0 .0 .4 .2 2.4 .7 .3 .3 .0 100.0 .6 1.3 3547 Female 92.0 .0 .0 .1 .1 4.8 2.4 .4 .1 .1 100.0 .2 2.7 3260 Region Skopski 95.0 .0 .0 .6 .2 .3 3.8 .1 .1 .0 100.0 .7 4.0 2039 Pelagoniski 89.0 .0 .0 .1 .9 8.2 .2 1.6 .0 .0 100.0 1.0 1.1 664 Vardarski 88.7 .0 .0 .0 .0 6.7 3.8 .3 .0 .5 100.0 .0 3.8 342 North-East 94.1 .0 .3 .1 .0 3.9 .6 .8 .1 .1 100.0 .4 1.1 486 South-West 87.7 .1 .0 .2 .0 11.9 .0 .0 .0 .0 100.0 .3 .2 905 South-East 96.9 .0 .0 .2 .0 .9 .8 1.0 .1 .1 100.0 .2 .9 533 Poloski 98.1 .0 .0 .1 .0 .3 .4 .1 .9 .0 100.0 .1 1.4 1295 East 95.7 .0 .0 .2 .0 3.8 .0 .1 .0 .1 100.0 .2 .1 543 Residence Urban 92.0 .0 .0 .4 .3 3.9 2.7 .5 .1 .1 100.0 .7 3.1 3428 Rural 95.7 .0 .0 .1 .0 3.2 .4 .2 .3 .0 100.0 .2 .8 3379 Age 0-4 years 97.0 .0 .0 .1 .0 2.3 .3 .2 .1 .0 100.0 .1 .3 1597 5-9 years 94.9 .0 .1 .1 .1 3.7 1.0 .1 .1 .0 100.0 .2 1.2 1863 10-14 years 90.5 .0 .0 .7 .1 5.3 2.9 .0 .5 .0 100.0 .8 3.4 2086 15-17 years 94.0 .0 .0 .1 .6 1.8 1.8 1.3 .2 .2 100.0 .7 2.6 1260 Wealth index quintiles Poorest 92.5 .0 .0 .1 .0 5.9 .7 .4 .1 .1 100.0 .2 .9 1851 Second 95.3 .0 .0 .1 .0 2.6 1.7 .2 .0 .2 100.0 .1 1.7 1481 Middle 96.2 .1 .1 .2 .2 1.0 1.2 1.0 .0 .0 100.0 .5 1.6 1290 Fourth 92.2 .0 .0 .0 .0 6.3 1.3 .0 .1 .0 100.0 .1 1.4 1194 Richest 93.3 .0 .0 1.1 .7 .4 3.6 .0 1.0 .0 100.0 1.8 5.2 991 Ethnicity Macedonian 91.1 .0 .0 .5 .2 5.4 2.0 .7 .0 .0 100.0 .7 2.3 2793 Albanian 96.3 .0 .0 .1 .1 2.4 .6 .0 .4 .0 100.0 .2 1.2 3121 Roma 93.5 .0 .2 .2 .1 2.6 2.2 .4 .1 .6 100.0 .5 2.7 309 Other 94.3 .0 .0 .2 .1 .8 4.0 .2 .1 .3 100.0 .3 4.2 584 Total 93.9 .0 .0 .3 .1 3.5 1.5 .3 .2 .1 100.0 .4 1.9 6806 * MICS indicator 78 ** MICS indicator 75 121Republic of Macedonia Boerma, J. T., Weinstein, K. I., Rutstein, S.O., and Sommerfelt, A. E. , 1996. Data on Birth Weight in Developing Countries: Can Surveys Help? Bulletin of the World Health Organization, 74(2), 209-16. Blanc, A. and Wardlaw, T. 2005. “Monitoring Low Birth Weight: An Evaluation of International Esti- mates and an Updated Estimation Procedure”. WHO Bulletin, 83 (3), 178-185. Filmer, D. and Pritchett, L., 2001. Estimating wealth effects without expenditure data – or tears: An ap- plication to educational enrolments in states of India. Demography 38(1): 115-132. Rutstein, S.O. and Johnson, K., 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. Cal- verton, Maryland: ORC Macro. UNICEF, 2006. Monitoring the Situation of Children and Women. Multiple Indicator Cluster Survey Man- ual, New York. United Nations, 1983. Manual X: Indirect Techniques for Demographic Estimation (United Nations publica- tion, Sales No. E.83.XIII.2). United Nations, 1990a. QFIVE, United Nations Pro- gram for Child Mortality Estimation. New York, UN Pop Division United Nations, 1990b. Step-by-step Guide to the Estimation of Child Mortality. New York, UN WHO and UNICEF, 1997. The Sisterhood Method for Estimating Maternal Mortality. Guidance notes for potential users, Geneva. www.Childinfo.org. List of references 122 Multiple Indicator Cluster Survey - 2005-2006 123Republic of Macedonia I Appendixes 124 Multiple Indicator Cluster Survey - 2005-2006 125Republic of Macedonia Project Director M.sc Blagica Novkovska Technical Coordinator Violeta Panovska Field Coordinator Suzana Stojanovska Natasa Pendevska Data Processing/Programming Helena Papazovska Mira Deleva Liljana Taseva Orhideja Krstanova Sampling Ana Adamcevska Vesna Dimitrovska Questionnaire Design Violeta Panovska Suzana Stojanovska Natasa Pendevska Members of the Steering Committee Stanka Petkovska Valentina Velickovska Svetlana Gorgieva Emica Stamenkovska Marija Kisman Biljana Ancevska Elena Koseva Rut Feuk Andrijana Micevska Vesna Bisheva Dzuteska Appendix A. List of Personnel Involved in the Survey 126 Multiple Indicator Cluster Survey - 2005-2006 The major features of sample design are described in this appendix. Sample design features include target sample size, sample allocation, sample frame and listing, choice of domains, sampling stages, stratification, and the calculation of sample weights. The primary objective of the sample design for the Republic of Macedonia Multiple Indicator Cluster Survey was to produce statistically reliable estimates of most indicators, at the national level, for urban and rural areas, and for the eight regions Skopski, Pelagoniski, Vardarski, North East, South West, South East, Poloski and East of the country. Urban and rural areas in each of the eight regions were defined as the sampling domains. The sample was further stratified to include specific strata for the Roma population, dividing all strata into Roma and non-Roma strata, yielding an additional 12 strata (4 of the original strata did not have clusters selected for the Roma sub sample), with 70 clusters being allocated for the Roma population of the original 350. A multi-stage, stratified cluster sampling approach was used for the selection of the survey sample. Sample Size and Sample Allocation The target sample size for Republic of Macedonia MICS was calculated as 5250 households. For the calculation of the sample size, the key indicator used was the proportion of children which had Acute Respiratory infections during the past two weeks among children aged 0-4 years. The following formula was used to estimate the required sample size for these indicators: n = [ 4 (r) (1-r) (f) (1.1) ][ (0.12r)2 (p) (nh) ] where  n is the required sample size, expressed as number of households  4 is a factor to achieve the 95 per cent level of confidence  r proportion of children which had Acute Respiratory infections during the past two weeks  1.25 is the factor necessary to raise the sample size by 20 percent for non-response  f is the shortened symbol for deff (design effect)  0.25 is the margin of error to be tolerated at the 95 per cent level of confidence, defined as 25 per cent of r (relative sampling error of r)  p is the proportion of the total population upon which the indicator, r, is based  nh is the average household size. For the calculation, r (percentage of children which had Acute Respiratory infections during the past two weeks) was assumed to be 12 percent. The value of deff (design effect) was taken as 1.5 based on estimates from previous surveys, p (percentage of children aged 0- 4 years in the total population) was taken as 6.1 percent, and nh (average household size) was taken as 3.56 households. With these parameters and using the formula the required sample size, expressed as the number of households, was 4052. For the Roma population, we assumed r (percentage of children which had Acute Respiratory infections during the past two weeks) to be 20 percent. The value of deff (design effect) was taken as 1.5, non-response will be 20 percent or a factor of 1.2 necessary to raise the sample size, relative error will be 0.2, p (percentage of children aged 0-4 years in the total population) was taken as 0.15 percent, and nh (average household size) was taken as 4.5. With these parameters and using the formula the required sample size, expressed as the number of households, was 1067. Appendix B. Sample Design 127Republic of Macedonia The final sample size calculated as 5250 households (350 clusters * 15 households per cluster). In each region, the clusters (primary sampling units) were distributed to urban and rural domains, proportional to the size of urban and rural populations in that region. The table below (SD.1) shows the allocation of clusters to the sampling domains. Table SD.1: Allocation of Sample Clusters (Primary Sampling Units) to Sampling Domains Region Clusters Non Roma Clusters Roma Clusters Skopksi Urban 75 44 31 Rural 25 24 1 Pelagoniski Urban 26 17 9 Rural 12 12 0 Vardarski Urban 16 15 1 Rural 6 4 2 North East Urban 18 12 6 Rural 12 12 0 South West Urban 18 14 4 Rural 21 20 1 South East Urban 14 14 0 Rural 16 16 0 Poloski Urban 17 13 4 Rural 40 39 1 East Urban 23 14 9 Rural 11 10 1 Total 350 280 70 The allocation of the total clusters to each domain was performed by taking the number of women aged 12-46 from the Census 2002 data (so that the women would be 15-49 in 2005), and using the ratio of the number of women in each stratum to the total to determine the distribution of the clusters to each stratum (350 * mj / ∑ mj. where mj is the number of woman aged 12-46 in the strata according to the 2002 Census). Following the allocation of clusters to each domain, the allocation of clusters to the Roma strata was performed in a similar manner to the overall allocation of clusters, by (70 * mrj / ∑ mrj, where mrj is the number of Roma woman aged 12-46 in the strata). The remaining clusters in each strata were allocated to the non-Roma population The cluster size in Republic of Macedonia MICS was determined as 15 households, based on a number of considerations, including the budget available, and the time that would be needed per team to complete one cluster. Sampling Frame and Selection of Clusters The sample frame is the Population Census from 2002, using data on subpopulations of women aged 12-46 year (so that the women would be 15-49 in 2005), children from 0-2, and the Roma population for the selection of clusters. Census enumeration areas were defined as primary sampling units (PSUs). Sampling was performed by generating a list of all clusters in each stratum, ordered by the total number of women aged 12-46 at the time of the census in 2002 (who would be 15-49 at the time of the survey in 2005), with the cluster with the largest number of women listed first. From this list, the first K clusters were selected, where K is the number of clusters to be selected in the stratum. Selection of Households The selection of households was performed by sorting the list of households in each cluster into two groups: households with children under 5, and those without children under 5. From these two groups, 12 households were to be selected from the first group and 3 households from the second group. The information concerning the identification of households with children under 5 was based on the 2002 census data, for children aged 0,1 and 2 at the time of the census (Nov. 1, 2002), and updated with information on households registering a birth in 2003 and 2004 according to vital registration data for 2003 and 2004 respectively. Calculation of Sample Weights The Republic of Macedonia Multiple Indicator Cluster Survey sample is not self-weighted. For weighting the data, initially, stratum level weights were calculated, based on urban-rural within region, and separately for non-Roma and for Roma, and for households with children under-5, and for households without children under-5 based on the sampling information collected. Stratum level weights would be applicable if sampling with probability proportional to size (PPS) method of selecting clusters had been used. As the method of selecting clusters was based on selecting the largest K clusters in the stratum, where K is the number of clusters to be selected, it was not possible to use this approach, and so cluster level weights have been calculated. 128 Multiple Indicator Cluster Survey - 2005-2006 The cluster level weights were calculated as follows. The mathematical expression of the probability for the first stage of selection for the ith cluster in each stratum is given as: P1i = a mi/Smi, where P1i is the first-stage selection probability, a represents the number of clusters selected in the particular stratum, mi is the measure of size (number of women aged 12-46 according to the census) in the ith cluster of the stratum and Smi is the summation of the mi values over the entire stratum, or the total number of women in the stratum. At the second stage of the selection, the probabilities of selection of households in the two subgroups are given as: P2i = ni(c)/mi(c) and P2i = ni(nc)/mi(nc), where mi(c) and mi(nc) represent, respectively, the total number of households in the ith cluster that have children and those that do not, and ni(c) and ni(nc) represent, respectively, the number of households selected in the ith cluster that have children and those that do not. The overall probability is the product of the probabilities at the two stages, or Pi = P1i P2i Weights computed at the cluster level applying the inverse of the probability of selection were calculated. These were then adjusted for non-response at the stratum level, and then normalized to the total sample of households to produce the final household weights. These same weights were used for the household member data. For the women’s and for the children’s data, the household weights were adjusted for non-response to the women’s and the children’s questionnaires respectively, and normalized to the total number of women and children interviewed, as is standard in MICS (and other household surveys). However, due to the biased age/sex distribution found in the survey data (resulting from the selection of clusters being based on those clusters with the largest number of eligible women), the data for the household members and for women were further weighted to adjust the age/sex distribution to the age/sex distribution found in the census. This adjustment was performed based on five-year groups of age. These adjusted weights were then normalized to the total number of household members and women, respectively. The same adjustment was not done for the children’s data as there is only one five-year age group in the children’s data. Although there are some differences in the sex distribution from the survey data compared to the census data, the differences were not considered sufficient to adjust the weighting for this group. Sample weights were appended to all data sets and analyses were performed by weighting each household, household member, woman or child under age 5 with these sample weights. 129Republic of Macedonia The sample of respondents selected in Republic of Macedonia Multiple Indicator Cluster Survey is only one of the samples that could have been selected from the same population, using the same design and size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. The extent of variability is not known exactly, but can be estimated statistically from the survey results. The following sampling error measures are presented in this appendix for each of the selected indicators:  Standard error (se): Sampling errors are usually measured in terms of standard errors for particular indicators (means, proportions etc). Standard error is the square root of the variance. The Taylor linearization method is used for the estimation of standard errors.  Coefficient of variation (se/r) is the ratio of the standard error to the value of the indicator  Design effect (deff) is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption of simple random sampling. The square root of the design effect (deft) is used to show the efficiency of the sample design. A deft value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a deft value above 1.0 indicates the increase in the standard error due to the use of a more complex sample design.  Confidence limits are calculated to show the interval within which the true value for the population can be reasonably assumed to fall. For any given statistic calculated from the survey, the value of that statistics will fall within a range of plus or minus two times the standard error (p+2.se or p–2.se) of the statistic in 95 percent of all possible samples of identical size and design. For the calculation of sampling errors from MICS data, SPSS Version 14 Complex Samples module has been used. The results are shown in the tables that follow. In addition to the sampling error measures described above, the tables also include weighted and unweighted counts of denominators for each indicator. Sampling errors are calculated for indicators of primary interest, for the national total, for the regions, and for urban and rural areas. One of the selected indicators is based on household data, 6 are based on household members, 10 are based on women, and 12 are based on children under 5. All indicators presented here are in the form of proportions. Table SE.1 shows the list of indicators for which sampling errors are calculated, including the base population (denominator) for each indicator. Tables SE.2 to SE.12 show the calculated sampling errors for the total sample, urban and rural areas and for each of the eight regions. Appendix C. Estimates of Sampling Errors 130 Multiple Indicator Cluster Survey - 2005-2006 Table SE.1: Indicators selected for sampling error calculations List of indicators selected for sampling error calculations, and base populations (denominators) for each indicator, Republic of Macedonia, 2005 MICS Indicator Base Population HOUSEHOLDS 74 Child discipline Children aged 2-14 years selected HOUSEHOLD MEMBERS 11 Use of improved drinking water sources All household members 12 Use of improved sanitation facilities All household members 55 Net primary school attendance rate Children of primary school age 56 Net secondary school attendance rate Children of secondary school age 59 Primary completion rate Children of primary school completion age 71 Child labour Children aged 5-14 years WOMEN 4 Skilled attendant at delivery Women aged 15-49 years with a live birth in the last 2 years 20 Antenatal care Women aged 15-49 years with a live birth in the last 2 years 21 Contraceptive prevalence Women aged 15-49 currently married/in union 60 Adult literacy Women aged 15-24 years 67 Marriage before age 18 Women aged 20-49 years 82 Comprehensive knowledge about HIV prevention among young people Women aged 15-24 years 83 Condom use with non-regular partners Women aged 15-24 years that had a non-marital, non-cohabiting partner in the last 12 months 84 Age at first sex among young people Women aged 15-24 years 86 Attitude towards people with HIV/AIDS Women aged 15-49 years 89 Knowledge of mother- to-child transmission of HIV Women aged 15-49 years UNDER-5s 6 Underweight prevalence Children under age 5 25 Tuberculosis immunization coverage Children aged 12-23 months 26 Polio immunization coverage Children aged 12-23 months 27 Immunization coverage for DPT Children aged 12-23 months 28 Measles immunization coverage Children aged 12-23 months 31 Fully immunized children Children aged 12-23 months - Acute respiratory infection in last two weeks Children under age 5 22 Antibiotic treatment of suspected pneumonia Children under age 5 with suspected pneumonia in the last 2 weeks - Diarrhoea in last two weeks Children under age 5 35 Received ORT or increased fluids and continued feeding Children under age 5 with diarrhoea in the last 2 weeks 46 Support for learning Children under age 5 62 Birth registration Children under age 5 131Republic of Macedonia Table SE.2: Sampling errors: Total sample Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.693 0.026 0.038 11.493 3.390 2015 3564 0.641 0.746 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.993 0.003 0.003 6.359 2.522 23468 4701 0.987 0.999 Use of improved sanitation facilities EN.5 0.929 0.011 0.012 8.365 2.892 23468 4701 0.907 0.950 Net primary school attendance rate ED.3 0.949 0.008 0.009 3.674 1.917 3132 2624 0.933 0.966 Net secondary school attendance rate ED.4 0.630 0.031 0.049 5.505 2.346 1710 1336 0.568 0.692 Primary completion rate ED.6 0.826 0.032 0.039 1.650 1.285 467 232 0.762 0.890 Child labour CP.2 0.057 0.013 0.221 12.506 3.536 3949 4233 0.032 0.082 WOMEN Skilled attendant at delivery RH.5 0.981 0.007 0.007 3.672 1.916 566 1436 0.967 0.995 Antenatal care RH.3 0.981 0.007 0.007 3.431 1.852 566 1436 0.967 0.994 Contraceptive prevalence RH.1 0.135 0.014 0.107 9.219 3.036 4251 5165 0.106 0.164 Adult literacy ED.8 0.968 0.006 0.006 2.866 1.693 2233 2686 0.957 0.980 Marriage before age 18 (women age 20-24) CP.5 0.036 0.006 0.156 1.395 1.181 1103 1528 0.025 0.047 Comprehensive knowledge about HIV prevention among young people HA.3 0.235 0.016 0.070 11.090 3.330 7397 7397 0.202 0.268 Condom use with non-regular partners HA.9 0.698 0.022 0.032 0.455 0.675 351 197 0.654 0.742 Age at first sex among young people HA.8 0.006 0.003 0.513 1.846 1.359 1129 1158 0.000 0.012 Attitude towards people with HIV/AIDS HA.5 0.160 0.016 0.098 9.341 3.056 5922 5158 0.129 0.191 Knowledge of mother- to-child transmission of HIV HA.4 0.555 0.020 0.035 11.408 3.378 7397 7397 0.515 0.594 UNDER-5s Underweight prevalence NU.1 0.023 0.004 0.191 3.621 1.903 4107 4198 0.014 0.032 Tuberculosis immunization coverage CH.2 0.980 0.006 0.006 1.509 1.229 843 920 0.968 0.991 Polio immunization coverage CH.2 0.864 0.022 0.025 3.629 1.905 834 910 0.821 0.908 Immunization coverage for DPT CH.2 0.883 0.019 0.021 3.086 1.757 818 890 0.845 0.921 Measles immunization coverage CH.2 0.884 0.017 0.019 2.548 1.596 828 895 0.850 0.919 Fully immunized children CH.2 0.755 0.028 0.037 3.829 1.957 834 907 0.699 0.811 Acute respiratory infection in last two weeks CH.6 0.061 0.010 0.161 7.643 2.765 4547 4545 0.041 0.080 Antibiotic treatment of suspected pneumonia CH.7 0.737 0.050 0.068 4.145 2.036 276 321 0.637 0.837 Diarrhoea in last two weeks CH.4 0.072 0.014 0.197 13.821 3.718 4547 4545 0.044 0.101 Received ORT or increased fluids and continued feeding CH.5 0.445 0.083 0.186 8.318 2.884 329 302 0.280 0.610 Support for learning CD.1 0.852 0.017 0.020 10.664 3.266 4547 4545 0.818 0.887 Birth registration CP.1 0.938 0.012 0.013 11.868 3.445 4547 4545 0.914 0.963 132 Multiple Indicator Cluster Survey - 2005-2006 Table SE.3: Sampling errors: Urban areas Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.657 0.038 0.057 12.974 3.602 1040 2054 0.582 0.733 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.998 0.001 0.001 0.703 0.838 13355 2751 0.997 1.000 Use of improved sanitation facilities EN.5 0.969 0.011 0.011 10.703 3.272 13355 2751 0.947 0.991 Net primary school attendance rate ED.3 0.926 0.014 0.015 4.049 2.012 1466 1375 0.897 0.954 Net secondary school attendance rate ED.4 0.714 0.050 0.070 8.790 2.965 781 717 0.614 0.814 Primary completion rate ED.6 0.813 0.038 0.047 0.980 0.990 174 104 0.737 0.889 Child labour CP.2 0.066 0.022 0.337 18.490 4.300 1962 2292 0.022 0.111 WOMEN Skilled attendant at delivery RH.5 0.983 0.011 0.011 6.021 2.454 308 845 0.961 1.000 Antenatal care RH.3 0.977 0.012 0.012 5.144 2.268 308 845 0.953 1.000 Contraceptive prevalence RH.1 0.115 0.018 0.154 9.057 3.010 2447 2935 0.079 0.150 Adult literacy ED.8 0.972 0.005 0.006 1.677 1.295 1331 1551 0.961 0.983 Marriage before age 18 (women age 20-24) CP.5 0.033 0.007 0.204 1.308 1.144 701 915 0.020 0.047 Comprehensive knowledge about HIV prevention among young people HA.3 0.300 0.024 0.079 11.341 3.368 4445 4187 0.253 0.348 Condom use with non-regular partners HA.9 0.760 0.024 0.032 0.482 0.694 278 150 0.711 0.808 Age at first sex among young people HA.8 0.010 0.006 0.554 1.965 1.402 629 636 0.000 0.021 Attitude towards people with HIV/AIDS HA.5 0.178 0.022 0.123 10.173 3.189 3882 3095 0.134 0.222 Knowledge of mother- to-child transmission of HIV HA.4 0.610 0.027 0.045 13.187 3.631 4445 4187 0.555 0.665 UNDER-5s Underweight prevalence NU.1 0.024 0.003 0.144 1.217 1.103 2153 2390 0.017 0.031 Tuberculosis immunization coverage CH.2 0.975 0.009 0.009 1.664 1.290 460 530 0.958 0.993 Polio immunization coverage CH.2 0.917 0.016 0.018 1.869 1.367 456 525 0.884 0.950 Immunization coverage for DPT CH.2 0.895 0.028 0.031 4.235 2.058 453 520 0.840 0.951 Measles immunization coverage CH.2 0.892 0.021 0.023 2.319 1.523 454 518 0.850 0.933 Fully immunized children CH.2 0.805 0.036 0.045 4.325 2.080 458 525 0.732 0.877 Acute respiratory infection in last two weeks CH.6 0.056 0.013 0.229 8.194 2.863 2467 2615 0.031 0.082 Antibiotic treatment of suspected pneumonia CH.7 0.759 0.076 0.100 5.820 2.412 139 184 0.607 0.912 Diarrhoea in last two weeks CH.4 0.076 0.022 0.296 18.827 4.339 2467 2615 0.031 0.121 Received ORT or increased fluids and continued feeding CH.5 0.612 0.090 0.148 6.272 2.504 187 183 0.431 0.793 Support for learning CD.1 0.872 0.023 0.026 12.430 3.526 2467 2615 0.826 0.918 Birth registration CP.1 0.946 0.015 0.016 11.483 3.389 2467 2615 0.916 0.976 133Republic of Macedonia Table SE.4: Sampling errors: Rural areas Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.732 0.036 0.049 9.952 3.155 974 1510 0.660 0.804 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.986 0.007 0.007 7.020 2.649 10114 1950 0.972 1.000 Use of improved sanitation facilities EN.5 0.875 0.020 0.023 7.336 2.708 10114 1950 0.835 0.916 Net primary school attendance rate ED.3 0.970 0.010 0.010 4.316 2.078 1666 1249 0.950 0.990 Net secondary school attendance rate ED.4 0.559 0.039 0.071 3.896 1.974 930 619 0.480 0.638 Primary completion rate ED.6 0.833 0.046 0.055 1.932 1.390 293 128 0.741 0.925 Child labour CP.2 0.048 0.012 0.245 5.902 2.429 1987 1941 0.025 0.072 WOMEN Skilled attendant at delivery RH.5 0.979 0.007 0.008 1.590 1.261 257 591 0.964 0.994 Antenatal care RH.3 0.985 0.005 0.005 1.040 1.020 257 591 0.975 0.995 Contraceptive prevalence RH.1 0.163 0.024 0.148 9.495 3.081 1805 2230 0.115 0.211 Adult literacy ED.8 0.964 0.012 0.012 4.333 2.082 902 1135 0.941 0.987 Marriage before age 18 (women age 20-24) CP.5 0.041 0.010 0.241 1.534 1.239 402 613 0.021 0.061 Comprehensive knowledge about HIV prevention among young people HA.3 0.137 0.018 0.131 8.669 2.944 2952 3210 0.101 0.173 Condom use with non-regular partners HA.9 0.464 0.046 0.099 0.389 0.624 73 47 0.373 0.556 Age at first sex among young people HA.8 0.001 0.000 0.333 0.060 0.245 500 522 0.000 0.002 Attitude towards people with HIV/AIDS HA.5 0.126 0.018 0.145 6.230 2.496 2040 2063 0.089 0.162 Knowledge of mother- to-child transmission of HIV HA.4 0.471 0.026 0.055 8.764 2.960 2952 3210 0.419 0.523 UNDER-5s Underweight prevalence NU.1 0.022 0.008 0.383 5.979 2.445 1955 1808 0.005 0.039 Tuberculosis immunization coverage CH.2 0.985 0.007 0.007 1.372 1.171 383 390 0.970 0.999 Polio immunization coverage CH.2 0.801 0.035 0.044 3.037 1.743 378 385 0.730 0.872 Immunization coverage for DPT CH.2 0.867 0.025 0.029 1.988 1.410 365 370 0.817 0.917 Measles immunization coverage CH.2 0.876 0.028 0.032 2.704 1.645 374 377 0.820 0.932 Fully immunized children CH.2 0.695 0.035 0.050 2.198 1.482 376 382 0.625 0.765 Acute respiratory infection in last two weeks CH.6 0.066 0.015 0.226 6.927 2.632 2080 1930 0.036 0.096 Antibiotic treatment of suspected pneumonia CH.7 0.715 0.066 0.092 2.917 1.708 137 137 0.583 0.847 Diarrhoea in last two weeks CH.4 0.068 0.016 0.238 8.046 2.837 2080 1930 0.036 0.101 Received ORT or increased fluids and continued feeding CH.5 0.226 0.052 0.231 1.835 1.355 142 119 0.121 0.330 Support for learning CD.1 0.830 0.025 0.030 8.532 2.921 2080 1930 0.780 0.880 Birth registration CP.1 0.929 0.020 0.022 11.740 3.426 2080 1930 0.889 0.969 134 Multiple Indicator Cluster Survey - 2005-2006 Table SE.5: Sampling errors: Skopski Region Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.703 0.047 0.066 10.730 3.276 608 1033 0.610 0.796 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 1.000 0.000 0.000 . . 6596 1271 1.000 1.000 Use of improved sanitation facilities EN.5 0.950 0.015 0.015 5.725 2.393 6596 1271 0.920 0.979 Net primary school attendance rate ED.3 0.962 0.012 0.012 3.089 1.758 855 788 0.938 0.986 Net secondary school attendance rate ED.4 0.639 0.049 0.077 3.989 1.997 395 377 0.540 0.738 Primary completion rate ED.6 0.800 0.103 0.129 4.006 2.002 90 61 0.593 1.000 Child labour CP.2 0.024 0.009 0.398 4.987 2.233 1171 1307 0.005 0.042 WOMEN Skilled attendant at delivery RH.5 0.971 0.017 0.017 4.644 2.155 213 463 0.938 1.000 Antenatal care RH.3 0.980 0.015 0.015 5.470 2.339 213 463 0.950 1.000 Contraceptive prevalence RH.1 0.175 0.030 0.171 9.199 3.033 1119 1472 0.115 0.236 Adult literacy ED.8 0.970 0.009 0.009 2.151 1.467 614 787 0.953 0.988 Marriage before age 18 (women age 20-24) CP.5 0.019 0.005 0.255 0.561 0.749 337 444 0.009 0.029 Comprehensive knowledge about HIV prevention among young people HA.3 0.241 0.028 0.115 9.039 3.006 2069 2160 0.186 0.296 Condom use with non-regular partners HA.9 (0.747) (0.042) (0.057) (0.447) (0.669) (84.666) (48) (0.662) (0.832) Age at first sex among young people HA.8 0.010 0.009 0.922 3.006 1.734 277 343 0.000 0.029 Attitude towards people with HIV/AIDS HA.5 0.182 0.034 0.188 10.309 3.211 1540 1318 0.114 0.250 Knowledge of mother- to-child transmission of HIV HA.4 0.544 0.031 0.057 8.438 2.905 2069 2160 0.481 0.606 UNDER-5s Underweight prevalence NU.1 0.022 0.004 0.199 1.195 1.093 1434 1327 0.013 0.031 Tuberculosis immunization coverage CH.2 0.975 0.012 0.012 1.622 1.273 332 295 0.952 0.998 Polio immunization coverage CH.2 0.959 0.014 0.015 1.440 1.200 330 293 0.931 0.987 Immunization coverage for DPT CH.2 0.936 0.020 0.021 1.955 1.398 329 292 0.895 0.976 Measles immunization coverage CH.2 0.907 0.026 0.029 2.290 1.513 331 291 0.855 0.958 Fully immunized children CH.2 0.863 0.035 0.041 3.040 1.744 331 294 0.793 0.933 Acute respiratory infection in last two weeks CH.6 0.030 0.008 0.255 2.910 1.706 1691 1473 0.014 0.045 Antibiotic treatment of suspected pneumonia CH.7 0.723 0.052 0.072 0.835 0.914 50 63 0.619 0.827 Diarrhoea in last two weeks CH.4 0.037 0.008 0.221 2.810 1.676 1691 1473 0.021 0.054 Received ORT or increased fluids and continued feeding CH.5 0.261 0.030 0.116 0.349 0.591 63 74 0.201 0.322 Support for learning CD.1 0.901 0.021 0.023 7.377 2.716 1691 1473 0.859 0.943 Birth registration CP.1 0.987 0.005 0.005 3.320 1.822 1691 1473 0.976 0.998 135Republic of Macedonia Table SE.6: Sampling errors: Pelagoniski Region Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.743 0.080 0.108 13.935 3.733 176 414 0.582 0.904 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.999 0.001 0.001 0.553 0.744 2585 575 0.997 1.000 Use of improved sanitation facilities EN.5 0.789 0.058 0.073 11.595 3.405 2585 575 0.673 0.905 Net primary school attendance rate ED.3 0.814 0.061 0.074 6.551 2.560 260 271 0.693 0.935 Net secondary school attendance rate ED.4 0.635 0.134 0.211 11.763 3.430 242 153 0.367 0.903 Primary completion rate ED.6 (0.944) (0.028) (0.03) (0.38) (0.616) (38) (26) (0.887) (1) Child labour CP.2 0.131 0.060 0.455 13.733 3.706 332 440 0.012 0.251 WOMEN Skilled attendant at delivery RH.5 1.000 0.000 0.000 0.060 0.245 46 130 0.999 1.000 Antenatal care RH.3 0.978 0.014 0.014 1.200 1.096 46 130 0.950 1.000 Contraceptive prevalence RH.1 0.153 0.041 0.264 7.152 2.674 485 566 0.072 0.234 Adult literacy ED.8 0.964 0.008 0.009 0.606 0.779 251 312 0.948 0.981 Marriage before age 18 (women age 20-24) CP.5 0.043 0.009 0.208 0.333 0.577 124 173 0.025 0.061 Comprehensive knowledge about HIV prevention among young people HA.3 0.358 0.063 0.176 13.870 3.724 817 808 0.232 0.483 Condom use with non-regular partners HA.9 (0.722) (0.079) (0.11) (0.847) (0.92) (52) (28) (0.563) (0.881) Age at first sex among young people HA.8 0.004 0.002 0.569 0.172 0.414 127 139 0.000 0.008 Attitude towards people with HIV/AIDS HA.5 0.186 0.038 0.205 6.471 2.544 759 672 0.110 0.262 Knowledge of mother- to-child transmission of HIV HA.4 0.708 0.031 0.044 3.857 1.964 817 808 0.645 0.771 UNDER-5s Underweight prevalence NU.1 0.036 0.008 0.208 0.712 0.844 388 439 0.021 0.051 Tuberculosis immunization coverage CH.2 0.947 0.031 0.032 1.448 1.203 46 78 0.886 1.000 Polio immunization coverage CH.2 0.924 0.029 0.031 0.901 0.949 46 78 0.866 0.981 Immunization coverage for DPT CH.2 0.915 0.029 0.032 0.821 0.906 45 77 0.857 0.973 Measles immunization coverage CH.2 0.834 0.032 0.038 0.567 0.753 46 78 0.770 0.898 Fully immunized children CH.2 0.823 0.032 0.039 0.541 0.736 45 77 0.758 0.887 Acute respiratory infection in last two weeks CH.6 0.161 0.057 0.353 11.255 3.355 415 471 0.048 0.275 Antibiotic treatment of suspected pneumonia CH.7 (0.717) (0.144) (0.201) (4.821) (2.196) (67) (48) (0.429) (1) Diarrhoea in last two weeks CH.4 0.245 0.090 0.368 20.668 4.546 415 471 0.064 0.425 Received ORT or increased fluids and continued feeding CH.5 (0.48) (0.133) (0.278) (2.631) (1.622) (101) (38) (0.213) (0.746) Support for learning CD.1 0.826 0.063 0.076 12.889 3.590 415 471 0.700 0.952 Birth registration CP.1 0.684 0.093 0.136 18.795 4.335 415 471 0.498 0.870 136 Multiple Indicator Cluster Survey - 2005-2006 Table SE.7: Sampling errors: Vardarski Region Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.637 0.144 0.226 19.325 4.396 118 217 0.349 0.924 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.999 0.001 0.001 0.133 0.364 1453 313 0.998 1.000 Use of improved sanitation facilities EN.5 0.907 0.069 0.076 17.806 4.220 1453 313 0.768 1.000 Net primary school attendance rate ED.3 0.988 0.008 0.008 0.724 0.851 147 125 0.972 1.000 Net secondary school attendance rate ED.4 0.458 0.125 0.273 3.896 1.974 88 63 0.209 0.708 Primary completion rate ED.6 (*) (*) (*) (*) (*) (*) 6 (*) (*) Child labour CP.2 0.148 0.143 0.969 33.844 5.818 173 209 0.000 0.434 WOMEN Skilled attendant at delivery RH.5 0.999 0.001 0.001 0.103 0.321 18 90 0.997 1.000 Antenatal care RH.3 0.984 0.012 0.012 0.757 0.870 18 90 0.961 1.000 Contraceptive prevalence RH.1 0.079 0.054 0.686 12.211 3.494 225 304 0.000 0.187 Adult literacy ED.8 0.994 0.004 0.004 0.453 0.673 183 170 0.987 1.000 Marriage before age 18 (women age 20-24) CP.5 0.019 0.007 0.371 0.296 0.544 107 113 0.005 0.033 Comprehensive knowledge about HIV prevention among young people HA.3 0.390 0.042 0.108 3.236 1.799 467 433 0.305 0.474 Condom use with non-regular partners HA.9 (*) (*) (*) (*) (*) (*) 23 (*) (*) Age at first sex among young people HA.8 0.002 0.001 0.440 0.018 0.133 75 57 0.000 0.003 Attitude towards people with HIV/AIDS HA.5 0.173 0.068 0.392 11.334 3.367 401 353 0.037 0.309 Knowledge of mother- to-child transmission of HIV HA.4 0.671 0.081 0.120 12.716 3.566 467 433 0.510 0.832 UNDER-5s Underweight prevalence NU.1 0.002 0.002 1.028 0.650 0.806 274 279 0.000 0.007 Tuberculosis immunization coverage CH.2 1.000 0.000 0.000 . . 46 61 1.000 1.000 Polio immunization coverage CH.2 0.905 0.067 0.075 3.157 1.777 46 61 0.770 1.000 Immunization coverage for DPT CH.2 0.936 0.047 0.050 2.208 1.486 46 61 0.842 1.000 Measles immunization coverage CH.2 0.853 0.064 0.075 1.958 1.399 46 61 0.725 0.981 Fully immunized children CH.2 0.822 0.084 0.103 2.920 1.709 46 61 0.653 0.991 Acute respiratory infection in last two weeks CH.6 0.152 0.090 0.589 17.948 4.236 279 289 0.000 0.332 Antibiotic treatment of suspected pneumonia CH.7 (*) (*) (*) (*) (*) (*) 23 (*) (*) Diarrhoea in last two weeks CH.4 0.024 0.008 0.321 0.728 0.853 279 289 0.009 0.039 Received ORT or increased fluids and continued feeding CH.5 (*) (*) (*) (*) (*) (*) 12 (*) (*) Support for learning CD.1 0.862 0.040 0.046 3.842 1.960 279 289 0.782 0.942 Birth registration CP.1 0.995 0.003 0.003 0.605 0.778 279 289 0.989 1.000 137Republic of Macedonia Table SE.8: Sampling errors: North East Region Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.566 0.110 0.195 16.140 4.017 135 327 0.345 0.786 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 1.000 0.000 0.000 . . 1785 412 1.000 1.000 Use of improved sanitation facilities EN.5 0.938 0.021 0.022 3.112 1.764 1785 412 0.896 0.980 Net primary school attendance rate ED.3 0.933 0.014 0.015 0.779 0.883 201 244 0.905 0.961 Net secondary school attendance rate ED.4 0.869 0.034 0.039 1.342 1.158 143 131 0.801 0.938 Primary completion rate ED.6 (0.613) (0.064) (0.104) (0.46) (0.678) (46) (28) (0.486) (0.74) Child labour CP.2 0.014 0.010 0.721 3.081 1.755 259 414 0.000 0.035 WOMEN Skilled attendant at delivery RH.5 0.985 0.011 0.012 1.370 1.170 39 160 0.962 1.000 Antenatal care RH.3 0.991 0.009 0.009 1.455 1.206 39 160 0.974 1.000 Contraceptive prevalence RH.1 0.056 0.041 0.741 16.281 4.035 339 503 0.000 0.138 Adult literacy ED.8 0.985 0.005 0.005 0.456 0.675 175 259 0.975 0.995 Marriage before age 18 (women age 20-24) CP.5 0.031 0.007 0.229 0.259 0.509 79 155 0.017 0.045 Comprehensive knowledge about HIV prevention among young people HA.3 0.188 0.045 0.241 9.945 3.154 605 742 0.097 0.278 Condom use with non-regular partners HA.9 (*) (*) (*) (*) (*) (*) 13 (*) (*) Age at first sex among young people HA.8 0.001 0.000 0.424 0.016 0.127 96 104 0.000 0.002 Attitude towards people with HIV/AIDS HA.5 0.181 0.057 0.313 9.072 3.012 445 419 0.068 0.295 Knowledge of mother- to-child transmission of HIV HA.4 0.478 0.064 0.134 12.217 3.495 605 742 0.350 0.606 UNDER-5s Underweight prevalence NU.1 0.035 0.010 0.296 1.427 1.195 318 452 0.014 0.055 Tuberculosis immunization coverage CH.2 0.997 0.003 0.003 0.278 0.527 56 89 0.990 1.000 Polio immunization coverage CH.2 0.932 0.025 0.027 0.857 0.926 56 89 0.883 0.982 Immunization coverage for DPT CH.2 0.918 0.022 0.024 0.574 0.758 56 88 0.873 0.962 Measles immunization coverage CH.2 0.923 0.029 0.031 0.968 0.984 54 85 0.866 0.980 Fully immunized children CH.2 0.880 0.028 0.032 0.643 0.802 55 86 0.823 0.936 Acute respiratory infection in last two weeks CH.6 0.032 0.012 0.395 2.384 1.544 329 471 0.007 0.056 Antibiotic treatment of suspected pneumonia CH.7 (*) (*) (*) (*) (*) (*) 22 (*) (*) Diarrhoea in last two weeks CH.4 0.046 0.012 0.264 1.574 1.255 329 471 0.022 0.070 Received ORT or increased fluids and continued feeding CH.5 (0.469) (0.084) (0.18) (1.258) (1.122) (15) (45) (0.3) (0.638) Support for learning CD.1 0.847 0.038 0.045 5.165 2.273 329 471 0.771 0.922 Birth registration CP.1 0.966 0.025 0.026 8.802 2.967 329 471 0.916 1.000 138 Multiple Indicator Cluster Survey - 2005-2006 Table SE.9: Sampling errors: South West Region Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.766 0.071 0.092 10.555 3.249 269 381 0.624 0.907 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.987 0.011 0.011 5.126 2.264 2820 524 0.965 1.000 Use of improved sanitation facilities EN.5 0.918 0.025 0.028 4.492 2.119 2820 524 0.867 0.969 Net primary school attendance rate ED.3 0.993 0.003 0.003 0.445 0.667 540 330 0.987 0.999 Net secondary school attendance rate ED.4 0.590 0.093 0.158 4.567 2.137 167 129 0.404 0.775 Primary completion rate ED.6 (0.792) (0.124) (0.157) (2.533) (1.591) (67) (28) (0.543) (1) Child labour CP.2 0.050 0.021 0.423 4.630 2.152 643 487 0.008 0.093 WOMEN Skilled attendant at delivery RH.5 0.999 0.001 0.001 0.107 0.327 59 139 0.998 1.000 Antenatal care RH.3 0.983 0.011 0.011 0.888 0.942 59 139 0.961 1.000 Contraceptive prevalence RH.1 0.194 0.048 0.245 7.863 2.804 480 544 0.099 0.289 Adult literacy ED.8 0.958 0.036 0.037 7.469 2.733 216 237 0.887 1.000 Marriage before age 18 (women age 20-24) CP.5 0.024 0.008 0.330 0.334 0.578 101 128 0.008 0.039 Comprehensive knowledge about HIV prevention among young people HA.3 0.146 0.040 0.272 9.224 3.037 808 734 0.066 0.225 Condom use with non-regular partners HA.9 (*) (*) (*) (*) (*) (*) 9 (*) (*) Age at first sex among young people HA.8 0.002 0.001 0.739 0.089 0.299 115 109 0.000 0.004 Attitude towards people with HIV/AIDS HA.5 0.087 0.037 0.420 9.144 3.024 688 542 0.014 0.161 Knowledge of mother- to-child transmission of HIV HA.4 0.552 0.066 0.119 12.735 3.569 808 734 0.421 0.683 UNDER-5s Underweight prevalence NU.1 0.084 0.047 0.559 9.780 3.127 321 344 0.000 0.177 Tuberculosis immunization coverage CH.2 0.958 0.026 0.027 1.478 1.216 87 91 0.907 1.000 Polio immunization coverage CH.2 0.915 0.033 0.036 1.218 1.103 87 90 0.850 0.980 Immunization coverage for DPT CH.2 0.947 0.026 0.027 1.128 1.062 84 86 0.895 0.999 Measles immunization coverage CH.2 0.858 0.053 0.062 2.054 1.433 86 89 0.751 0.964 Fully immunized children CH.2 0.820 0.066 0.080 2.626 1.621 87 90 0.688 0.952 Acute respiratory infection in last two weeks CH.6 0.068 0.014 0.201 1.206 1.098 397 410 0.041 0.095 Antibiotic treatment of suspected pneumonia CH.7 (0.572) (0.052) (0.09) (0.404) (0.635) (27) (38) (0.469) (0.676) Diarrhoea in last two weeks CH.4 0.097 0.043 0.441 8.569 2.927 397 410 0.011 0.183 Received ORT or increased fluids and continued feeding CH.5 (0.22) (0.047) (0.215) (0.481) (0.693) (39) (38) (0.125) (0.314) Support for learning CD.1 0.857 0.053 0.062 9.279 3.046 397 410 0.751 0.962 Birth registration CP.1 0.938 0.032 0.034 7.058 2.657 397 410 0.874 1.000 139Republic of Macedonia Table SE.10: Sampling errors: South East Region Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.831 0.058 0.070 7.784 2.790 180 328 0.715 0.946 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.969 0.022 0.023 7.328 2.707 1871 442 442.000 1.000 Use of improved sanitation facilities EN.5 0.857 0.057 0.067 11.693 3.420 1871 442 442.000 0.971 Net primary school attendance rate ED.3 0.813 0.032 0.040 1.182 1.087 211 172 172.000 0.878 Net secondary school attendance rate ED.4 0.365 0.065 0.179 2.093 1.447 197 115 173.000 0.496 Primary completion rate ED.6 (0.848) (0.078) (0.092) (1.132) (1.064) (54) (25) (174) (1) Child labour CP.2 0.006 0.003 0.517 0.507 0.712 276 315 315.000 0.012 WOMEN Skilled attendant at delivery RH.5 0.991 0.008 0.009 1.149 1.072 36 140 0.974 1.000 Antenatal care RH.3 0.969 0.019 0.020 1.698 1.303 36 140 0.931 1.000 Contraceptive prevalence RH.1 0.009 0.004 0.417 0.815 0.903 375 491 0.002 0.017 Adult literacy ED.8 0.876 0.040 0.045 3.714 1.927 199 258 0.796 0.955 Marriage before age 18 (women age 20-24) CP.5 0.117 0.040 0.346 2.628 1.621 82 167 0.036 0.198 Comprehensive knowledge about HIV prevention among young people HA.3 0.217 0.054 0.248 11.157 3.340 613 652 0.109 0.325 Condom use with non-regular partners HA.9 (0.81) (0.061) (0.076) (1.104) (1.051) (62) (46) (0.687) (0.933) Age at first sex among young people HA.8 0.024 0.019 0.776 1.359 1.166 117 91 0.000 0.062 Attitude towards people with HIV/AIDS HA.5 0.286 0.067 0.233 9.965 3.157 442 459 0.152 0.419 Knowledge of mother- to-child transmission of HIV HA.4 0.528 0.059 0.112 9.079 3.013 613 652 0.410 0.646 UNDER-5s Underweight prevalence NU.1 0.011 0.006 0.551 1.276 1.130 359 388 0.000 0.023 Tuberculosis immunization coverage CH.2 0.985 0.015 0.015 1.344 1.159 68 90 0.955 1.000 Polio immunization coverage CH.2 0.849 0.030 0.035 0.627 0.792 68 90 0.789 0.909 Immunization coverage for DPT CH.2 0.890 0.024 0.027 0.539 0.734 68 90 0.841 0.939 Measles immunization coverage CH.2 0.862 0.031 0.036 0.707 0.841 68 90 0.801 0.924 Fully immunized children CH.2 0.752 0.023 0.030 0.242 0.492 68 90 0.707 0.797 Acute respiratory infection in last two weeks CH.6 0.119 0.042 0.350 6.732 2.595 377 407 0.036 0.203 Antibiotic treatment of suspected pneumonia CH.7 0.615 0.130 0.211 4.038 2.010 45 58 0.356 0.874 Diarrhoea in last two weeks CH.4 0.046 0.014 0.305 1.839 1.356 377 407 0.018 0.075 Received ORT or increased fluids and continued feeding CH.5 (*) (*) (*) (*) (*) (*) 24 (*) (*) Support for learning CD.1 0.844 0.045 0.053 6.277 2.505 377 407 0.754 0.934 Birth registration CP.1 0.975 0.012 0.012 2.235 1.495 377 407 0.952 0.998 140 Multiple Indicator Cluster Survey - 2005-2006 Table SE.11: Sampling errors: Pololski Region Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.588 0.069 0.117 10.506 3.241 0 536 0.450 0.726 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.985 0.013 0.013 8.151 2.855 3773 686 0.959 1.000 Use of improved sanitation facilities EN.5 0.998 0.001 0.001 0.392 0.626 3773 686 0.996 1.000 Net primary school attendance rate ED.3 0.983 0.009 0.009 2.315 1.522 674 495 0.966 1.000 Net secondary school attendance rate ED.4 0.602 0.072 0.120 5.763 2.401 312 267 0.458 0.746 Primary completion rate ED.6 (0.809) (0.062) (0.076) (1.143) (1.069) (110) (47) (0.686) (0.933) Child labour CP.2 0.086 0.037 0.426 12.377 3.518 791 722 0.013 0.160 WOMEN Skilled attendant at delivery RH.5 0.978 0.011 0.012 1.218 1.104 115 201 0.955 1.000 Antenatal care RH.3 0.974 0.016 0.016 1.965 1.402 115 201 0.943 1.000 Contraceptive prevalence RH.1 0.154 0.038 0.245 8.800 2.966 640 805 0.079 0.230 Adult literacy ED.8 0.990 0.006 0.006 1.487 1.220 342 439 0.978 1.000 Marriage before age 18 (women age 20-24) CP.5 0.031 0.012 0.398 1.086 1.042 160 218 0.006 0.055 Comprehensive knowledge about HIV prevention among young people HA.3 0.120 0.029 0.242 9.655 3.107 1068 1218 0.062 0.177 Condom use with non-regular partners HA.9 (*) (*) (*) (*) (*) (*) 14 (*) (*) Age at first sex among young people HA.8 0.001 0.000 0.416 0.020 0.143 182 221 0.000 0.001 Attitude towards people with HIV/AIDS HA.5 0.120 0.029 0.244 6.918 2.630 717 852 0.061 0.179 Knowledge of mother- to-child transmission of HIV HA.4 0.393 0.045 0.114 10.261 3.203 1068 1218 0.303 0.483 UNDER-5s Underweight prevalence NU.1 0.004 0.002 0.591 0.906 0.952 715 620 0.000 0.009 Tuberculosis immunization coverage CH.2 0.989 0.007 0.007 0.752 0.867 157 145 0.975 1.000 Polio immunization coverage CH.2 0.577 0.038 0.067 0.826 0.909 149 138 0.500 0.653 Immunization coverage for DPT CH.2 0.670 0.115 0.172 7.493 2.737 141 126 0.440 0.900 Measles immunization coverage CH.2 0.873 0.055 0.063 3.524 1.877 145 130 0.763 0.983 Fully immunized children CH.2 0.397 0.052 0.130 1.523 1.234 151 138 0.294 0.501 Acute respiratory infection in last two weeks CH.6 0.036 0.010 0.267 1.723 1.313 742 651 0.017 0.055 Antibiotic treatment of suspected pneumonia CH.7 0.851 0.027 0.032 0.284 0.533 27 51 0.797 0.905 Diarrhoea in last two weeks CH.4 0.036 0.009 0.247 1.479 1.216 742 651 0.018 0.054 Received ORT or increased fluids and continued feeding CH.5 (0.372) (0.076) (0.203) (1.003) (1.002) (27) (42) (0.221) (0.523) Support for learning CD.1 0.709 0.062 0.087 12.146 3.485 742 651 0.585 0.834 Birth registration CP.1 0.908 0.039 0.043 11.679 3.417 742 651 0.830 0.985 141Republic of Macedonia Table SE.12: Sampling errors: East Region Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Republic of Macedonia, 2005 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweighted count Confidence limits r - 2se r + 2se HOUSEHOLDS Child discipline CP.4 0.718 0.066 0.092 7.067 2.658 162 328 0.586 0.850 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.997 0.002 0.002 0.709 0.842 2585 478 0.993 1.000 Use of improved sanitation facilities EN.5 0.983 0.013 0.013 4.742 2.178 2585 478 0.958 1.000 Net primary school attendance rate ED.3 0.967 0.020 0.021 2.536 1.592 244 199 0.926 1.000 Net secondary school attendance rate ED.4 0.892 0.029 0.032 0.856 0.925 166 101 0.834 0.949 Primary completion rate ED.6 (*) (*) (*) (*) (*) (*) 11 (*) (*) Child labour CP.2 0.075 0.051 0.684 12.777 3.574 304 339 0.000 0.177 WOMEN Skilled attendant at delivery RH.5 0.973 0.025 0.026 2.697 1.642 41 113 0.922 1.000 Antenatal care RH.3 0.997 0.002 0.002 0.218 0.467 41 113 0.993 1.000 Contraceptive prevalence RH.1 0.123 0.046 0.373 9.349 3.058 587 480 0.031 0.214 Adult literacy ED.8 0.991 0.004 0.004 0.393 0.627 253 224 0.983 0.999 Marriage before age 18 (women age 20-24) CP.5 0.060 0.037 0.613 3.096 1.760 113 130 0.000 0.134 Comprehensive knowledge about HIV prevention among young people HA.3 0.288 0.066 0.229 13.822 3.718 949 650 0.156 0.420 Condom use with non-regular partners HA.9 (*) (*) (*) (*) (*) (*) 16 (*) (*) Age at first sex among young people HA.8 0.001 0.001 0.835 0.063 0.252 140 94 0.000 0.003 Attitude towards people with HIV/AIDS HA.5 0.111 0.039 0.348 8.221 2.867 929 543 0.034 0.189 Knowledge of mother- to-child transmission of HIV HA.4 0.638 0.081 0.127 18.360 4.285 949 650 0.476 0.799 UNDER-5s Underweight prevalence NU.1 0.010 0.005 0.540 1.036 1.018 297 349 0.000 0.021 Tuberculosis immunization coverage CH.2 1.000 0.000 0.000 . . 51 71 1.000 1.000 Polio immunization coverage CH.2 0.869 0.046 0.053 1.305 1.142 51 71 0.776 0.961 Immunization coverage for DPT CH.2 0.898 0.033 0.037 0.814 0.902 49 70 0.833 0.964 Measles immunization coverage CH.2 0.879 0.071 0.081 3.316 1.821 51 71 0.737 1.000 Fully immunized children CH.2 0.750 0.070 0.094 1.845 1.358 51 71 0.609 0.891 Acute respiratory infection in last two weeks CH.6 0.024 0.010 0.403 1.489 1.220 316 373 0.005 0.043 Antibiotic treatment of suspected pneumonia CH.7 (*) (*) (*) (*) (*) (*) 18 (*) (*) Diarrhoea in last two weeks CH.4 0.188 0.102 0.544 25.490 5.049 316 373 0.000 0.392 Received ORT or increased fluids and continued feeding CH.5 (0.803) (0.146) (0.181) (3.753) (1.937) (59) (29) (0.512) (1) Support for learning CD.1 0.965 0.017 0.017 3.097 1.760 316 373 0.932 0.999 Birth registration CP.1 0.959 0.017 0.018 2.685 1.639 316 373 0.925 0.993 142 Multiple Indicator Cluster Survey - 2005-2006 Appendix D. Data Quality Tables Table DQ.1: Age distribution of household population Single-year age distribution of household population by sex (weighted), Republic of Macedonia,2005 Males Females Males Females Number Percent Number Percent Number Percent Number Percent 0 165 1.2 106 .8 41 95 .7 95 .7 1 150 1.1 151 1.1 42 301 2.3 301 2.3 2 137 1.0 166 1.3 43 205 1.5 205 1.5 3 206 1.6 166 1.3 44 224 1.7 224 1.7 4 165 1.2 184 1.4 45 211 1.6 211 1.6 5 250 1.9 240 1.8 46 138 1.0 138 1.0 6 156 1.2 171 1.3 47 198 1.5 198 1.5 7 162 1.2 173 1.3 48 229 1.7 229 1.7 8 201 1.5 159 1.2 49 173 1.3 173 1.3 9 191 1.4 160 1.2 50 309 2.3 309 2.3 10 181 1.4 214 1.6 51 149 1.1 149 1.1 11 168 1.3 198 1.5 52 127 1.0 127 1.0 12 152 1.1 134 1.0 53 145 1.1 145 1.1 13 377 2.8 195 1.5 54 92 .7 92 .7 14 196 1.5 271 2.1 55 231 1.7 231 1.7 15 298 2.2 152 1.2 56 142 1.1 142 1.1 16 191 1.4 204 1.5 57 89 .7 89 .7 17 200 1.5 215 1.6 58 67 .5 67 .5 18 232 1.8 219 1.7 59 75 .6 75 .6 19 184 1.4 258 2.0 60 143 1.1 143 1.1 20 252 1.9 265 2.0 61 124 .9 124 .9 21 156 1.2 244 1.9 62 98 .7 98 .7 22 212 1.6 209 1.6 63 91 .7 91 .7 23 246 1.9 169 1.3 64 106 .8 106 .8 24 221 1.7 133 1.0 65 111 .8 111 .8 25 160 1.2 322 2.4 66 46 .4 46 .4 26 204 1.5 219 1.7 67 96 .7 96 .7 27 208 1.6 183 1.4 68 154 1.2 154 1.2 28 201 1.5 136 1.0 69 109 .8 109 .8 29 247 1.9 117 .9 70 102 .8 102 .8 30 242 1.8 279 2.1 71 29 .2 29 .2 31 202 1.5 210 1.6 72 58 .4 58 .4 32 188 1.4 194 1.5 73 60 .5 60 .5 33 183 1.4 160 1.2 74 71 .5 71 .5 34 165 1.2 108 .8 75 84 .6 84 .6 35 181 1.4 158 1.2 76 79 .6 79 .6 36 219 1.7 204 1.5 77 76 .6 76 .6 37 229 1.7 191 1.4 78 33 .2 33 .2 38 202 1.5 212 1.6 79 17 .1 17 .1 39 161 1.2 193 1.5 80+ 133 1.0 133 1.0 40 151 1.1 166 1.3 DK/Missing 38 .3 69 .5 Total 13249 100.0 13174 100.0 143Republic of Macedonia Table DQ.2: Age distribution of eligible and interviewed women Household population of women age 10-54, interviewed women age 15-49, and percentage of eligible women who were interviewed (weighted), by five-year age group, Republic of Macedonia,2005 Household population of women age 10-54 Interviewed women age 15-49 Percent of eligible women interviewed Number Number Percent Age 10-14 1012 15-19 1048 1016 15.3 97.0 20-24 1020 993 14.9 97.4 25-29 977 968 14.6 99.1 30-34 951 937 14.1 98.5 35-39 958 949 14.3 99.0 40-44 935 919 13.8 98.3 45-49 908 868 13.0 95.6 50-54 840 na na na 15-49 6796 6650 100.0 97.8 na: not applicable Note: Weights for both household population of women and interviewed women are household weights. Age is based on the household schedule. Table DQ.3: Age distribution of eligible and interviewed under-5s Household population of children age 0-4, children whose mothers/caretakers were interviewed, and percentage of under-5 children whose mothers/caretakers were interviewed (weighted), by five-year age group, Republic of Macedonia,2005 Household population of children age 0-7 Interviewed children age 0-4 Percent of eligible children interviewed Number Number Percent Age 0 272 270 17.0 99.5 1 301 299 18.9 99.4 2 304 300 18.9 98.8 3 372 370 23.3 99.3 4 349 347 21.9 99.5 5 490 na na na 6 327 na na na 7 335 na na na 0-4 1597 1586 100.0 99.3 na: not applicable Note: Weights for both household population of children and interviewed children are household weights. Age is based on the household schedule. 144 Multiple Indicator Cluster Survey - 2005-2006 Table DQ.4: Age distribution of under-5 children Age distribution of under-5 children by 3-month groups (weighted), Republic of Macedonia,2005 Males Females Total Number Percent Number Percent Number Percent Age in months 0-2 136 5.6 47 2.2 183 4.0 3-5 81 3.3 61 2.9 142 3.1 6-8 176 7.2 78 3.7 254 5.6 9-11 74 3.0 93 4.4 167 3.7 12-14 152 6.3 89 4.2 241 5.3 15-17 109 4.5 115 5.4 223 4.9 18-20 89 3.7 96 4.5 185 4.1 21-23 99 4.1 88 4.2 188 4.1 24-26 114 4.7 124 5.9 238 5.2 27-29 100 4.1 175 8.3 276 6.1 30-32 99 4.1 91 4.3 190 4.2 33-35 96 3.9 81 3.8 177 3.9 36-38 122 5.0 147 6.9 269 5.9 39-41 220 9.1 102 4.8 322 7.1 42-44 165 6.8 106 5.0 271 6.0 45-47 99 4.1 105 4.9 204 4.5 48-50 113 4.7 85 4.0 199 4.4 51-53 143 5.9 142 6.7 284 6.3 54-56 94 3.9 98 4.6 192 4.2 57-59 146 6.0 194 9.2 340 7.5 Total 2428 100.0 2118 100.0 4547 100.0 145Republic of Macedonia Table DQ.5: Heaping on ages and periods Age and period ratios at boundaries of eligibility by type of information collected (weighted), Republic of Macedonia,2005 Age and period ratios* Eligibility boundary (lower-upper) Module or questionnaire Males Females Total Age in household questionnaire 1 .99 1.07 1.03 2 .83 1.03 .93 Lower Child discipline and child disability 3 1.22 .96 1.09 4 .79 .94 .86 Upper Under-5 questionnaire 5 1.32 1.21 1.26 Lower Child labour and education 6 .82 .88 .85 8 1.09 .97 1.03 9 1.00 .90 .95 Upper Child disability 10 1.01 1.12 1.06 13 1.56 .97 1.29 14 .68 1.31 .94 Upper Child labour and child discipline 15 1.30 .73 1.03 Lower Women’s questionnaire 16 .83 1.07 .94 17 .96 1.01 .99 Upper Orphans 18 .97 .93 .95 23 1.09 .99 1.05 24 1.06 .64 .85 Upper Education 25 .82 1.43 1.15 48 1.15 1.26 1.20 49 .73 .39 .57 Upper Women’s questionnaire 50 1.47 1.94 1.69 Age in women’s questionnaire 23 na .97 na 24 na .65 na Upper Sexual behaviour 25 na 1.44 na Months since last birth in women’s questionnaire 6-11 na 1.10 na 12-17 na 1.06 na 18-23 na .90 na Upper Maternal and child health 24-29 na 1.17 na 30-35 na .83 na * Age or period ratios are calculated as x / ((xn-1 + xn + xn+1) / 3), where x is age or period. na: not applicable 146 Multiple Indicator Cluster Survey - 2005-2006 Table DQ.6: Completeness of reporting Percentage of observations missing information for selected questions and indicators (weighted), Republic of Macedonia,2005 Questionnaire and Subject Reference group Percent with missing information* Number of cases Women Date of Birth All women age 15-49 Month only 1.5 7397 Month and year missing .0 7397 Date of first birth All women age 15-49 with at least one live birth Month only 2.2 4346 Month and year missing .6 4346 Completed years since first birth All women age 15-49 with at least one live birth 2.1 24 Date of last birth All women age 15-49 with at least one live birth Month only 1.3 4346 Month and year missing .1 4346 Date of first marriage/union All ever married women age 15-49 Month only 7.3 4493 Month and year missing 7.4 4493 Age at first marriage/union All ever married women age 15-49 .7 4493 Age at first intercourse All women age 15-24 who have ever had sex 3.5 2233 Time since last intercourse All women age 15-24 who have ever had sex 14.2 564 Under-5 Date of Birth All under five children surveyed Month only .4 4547 Month and year missing .0 4547 Anthropometry All under five children surveyed Height 6.4 4547 Weight 6.8 4547 Height or Weight 6.8 4547 * Includes “Don’t know” responses Table DQ.7: Presence of mother in the household and the person interviewed for the under-5 questionnaire Distribution of children under five by whether the mother lives in the same household, and the person interviewed for the under-5 questionnaire (weighted), Republic of Macedonia,2005 Mother in the household Mother not in the household Mother interviewed Father interviewed Other adult female interviewed Other adult male interviewed Total Number of children aged 0-4 years Age 0 99.8 .0 .2 100.0 272 1 100.0 .0 .0 100.0 301 2 99.6 .0 .4 100.0 304 3 99.4 .0 .6 100.0 372 4 99.6 .2 .2 100.0 349 Total 99.7 .0 .3 100.0 1597 147Republic of Macedonia Table DQ.8: School attendance by single age Distribution of household population age 5-24 by educational level and grade attended in the current year, Republic of Macedonia, 2005 Primary school Secondary school Preschool Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 99 Grade 1 Grade 2 Grade 3 Grade 4 Higher Not attending school Total Number Age 5 26.8 .6 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 72.6 100.0 490 6 42.4 25.5 .6 .0 .0 .0 .0 .0 .0 1.2 .0 .0 .0 .0 .0 30.3 100.0 327 7 .8 57.1 38.1 .6 .0 .0 .0 .0 .0 .0 .0 .1 .0 .0 .0 3.3 100.0 335 8 .6 2.2 48.8 39.8 2.6 .1 .0 .0 .0 .0 .0 .0 .0 .0 .0 6.0 100.0 360 9 .6 .3 4.6 67.2 25.0 .6 .0 .0 .0 .0 .0 .0 .1 .0 .0 1.6 100.0 351 10 .0 .2 .5 5.3 68.6 17.7 1.5 .0 .0 .0 .0 .0 .0 .0 .0 6.2 100.0 395 11 .0 .1 .5 .3 12.2 48.7 30.7 .4 .0 .0 .0 .0 .0 .0 .0 7.1 100.0 366 12 .1 .1 .0 .2 .4 2.8 64.4 19.9 8.3 .0 .0 .0 .0 .0 .0 3.8 100.0 287 13 .0 .0 .5 .1 .1 .5 10.8 52.2 31.7 .0 .0 .0 .0 .0 .0 4.1 100.0 572 14 .0 .0 .0 .0 .3 .0 .4 10.6 48.9 .0 25.3 8.5 .0 .0 .0 6.0 100.0 467 15 .0 .1 .1 .0 .0 .1 .2 .7 8.5 .0 53.4 11.3 1.2 .0 .0 24.3 100.0 450 16 .0 2.0 .0 .0 .0 .1 .0 .0 .1 .0 2.8 41.7 26.1 2.5 .0 24.7 100.0 395 17 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .8 1.0 38.2 20.1 .0 39.9 100.0 415 18 .0 .0 .0 .0 .6 .0 .0 .0 .0 .0 .0 2.3 5.3 33.8 12.4 45.6 100.0 450 19 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .5 .5 3.9 6.6 23.6 64.8 100.0 442 20 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .4 38.2 61.3 100.0 517 21 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .2 .0 .0 .2 30.5 69.1 100.0 400 22 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .1 25.3 74.6 100.0 421 23 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 13.8 86.2 100.0 415 24 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 .0 14.1 85.9 100.0 354 Total 3.4 3.6 4.0 4.9 5.1 3.2 4.5 5.0 5.7 .0 4.6 3.3 3.8 3.4 8.5 37.0 100.0 8209 Table DQ.9: Sex ratio at birth among children ever born and living Sex ratio at birth among children ever born, children living, and deceased children, by age of women (weighted), Republic of Macedonia, 2005 Children Ever Born Children Living Children deceased Number of women Number of sons ever born Number of daughters ever born Sex ratio Number of sons living Number of daughters living Sex ratio Number of deceased sons Number of deceased daughters Sex ratio Age 15-19 3 7 .42 3 7 .42 0 0 .57 1129 20-24 76 63 1.20 71 62 1.16 4 1 3.21 1103 25-29 462 415 1.11 458 409 1.12 4 6 .74 1078 30-34 908 960 .95 890 947 .94 18 12 1.48 1041 35-39 1011 1810 .56 942 1764 .53 70 46 1.53 1054 40-44 576 2376 .24 534 2352 .23 42 24 1.76 1027 45-49 701 2147 .33 648 2091 .31 53 56 .95 965 Total 3738 7777 .48 3546 7632 .46 191 145 1.32 7397 Note: Sex ratios are calculated as number of males/ number of females 148 Multiple Indicator Cluster Survey - 2005-2006 Table DQ.10: Distribution of women by time since last birth Distribution of women aged 15-49 with at least one live birth, by months since last birth (weighted), Republic of Macedonia, 2005 Months since last birth Number Percent Months since last birth Number Percent 0 22 3.1 16 24 3.3 1 11 1.6 17 21 2.9 2 26 3.6 18 24 3.3 3 7 1.0 19 25 3.5 4 20 2.8 20 17 2.4 5 15 2.1 21 21 3.0 6 29 4.1 22 28 3.9 7 16 2.3 23 17 2.4 8 49 6.9 24 34 4.7 9 14 2.0 25 21 3.0 10 16 2.2 26 19 2.6 11 25 3.6 27 27 3.7 12 25 3.5 28 36 5.0 13 46 6.4 29 21 2.9 14 22 3.1 30 17 2.3 15 18 2.5 Total 714 100.0 149Republic of Macedonia Appendix E. Global MICS Indicators: Numerators and Denominators INDICATOR NUMERATOR DENOMINATOR 1 Under-five mortality rate Probability of dying by exact age 5 years 2 Infant mortality rate Probability of dying by exact age 1 year 3 Maternal mortality ratio Number of deaths of women from pregnancy-related causes in a given year Number of live births in the year (expressed per 100,000 births) 4 Skilled attendant at delivery Number of women aged 15-49 years with a birth in the 2 years preceding the survey that were attended during childbirth by skilled health personnel Total number of women surveyed aged 15-49 years with a birth in the 2 years preceding the survey 5 Institutional deliveries Number of women aged 15-49 years with a birth in the 2 years preceding the survey that delivered in a health facility Total number of women surveyed aged 15-49 years with a birth in 2 years preceding the survey 6 Underweight prevalence Number of children under age five that fall below minus two standard deviations from the median weight for age of the NCHS/WHO standard (moderate and severe); number that fall below minus three standard deviations (severe) Total number of children under age five that were weighed 7 Stunting prevalence Number of children under age five that fall below minus two standard deviations from the median height for age of the NCHS/WHO standard (moderate and severe); number that fall below minus three standard deviations (severe) Total number of children under age five measured 8 Wasting prevalence Number of children under age five that fall below minus two standard deviations from the median weight for height of the NCHS/WHO standard (moderate and severe); number that fall below minus three standard deviations (severe) Total number of children under age five weighed and measured 9 Low-birth weight infants Number of last live births in the 2 years preceding the survey weighing below 2,500 grams Total number of last live births in the 2 years preceding the survey 10 Infants weighed at birth Number of last live births in the 2 years preceding the survey that were weighed at birth Total number of last live births in the 2 years preceding the survey 11 Use of improved drinking water sources Number of household members living in households using improved sources of drinking water Total number of household members in households surveyed 12 Use of improved sanitation facilities Number of household members using improved sanitation facilities Total number of household members in households surveyed 13 Water treatment Number of household members using water that has been treated Total number of household members in households surveyed 14 Disposal of child’s faeces Number of children under age three whose (last) stools were disposed of safely Total number of children under age three surveyed 15 Exclusive breastfeeding rate Number of infants aged 0-5 months that are exclusively breastfed Total number of infants aged 0-5 months surveyed 16 Continued breastfeeding rate Number of infants aged 12-15 months, and 20-23 months, that are currently breastfeeding Total number of children aged 12-15 months and 20-23 months surveyed 17 Timely complementary feeding rate Number of infants aged 6-9 months that are receiving breastmilk and complementary foods Total number of infants aged 6-9 months surveyed 18 Frequency of complementary feeding Number of infants aged 6-11 months that receive breastmilk and complementary food at least the minimum recommended number of times per day (two times per day for infants aged 6-8 months, three times per day for infants aged 9-11 months) Total number of infants aged 6-11 months surveyed 19 Adequately fed infants Number of infants aged 0-11 months that are appropriately fed: infants aged 0-5 months that are exclusively breastfed and infants aged 6-11 months that are breastfed and ate solid or semi-solid foods the appropriate number of times (see above) yesterday Total number of infants aged 0-11 months surveyed 20 Antenatal care Number of women aged 15-49 years that were attended at least once during pregnancy in the 2 years preceding the survey by skilled health personnel Total number of women surveyed aged 15-49 years with a birth in the 2 years preceding the survey 21 Contraceptive prevalence Number of women currently married or in union aged 15-49 years that are using (or whose partner is using) a contraceptive method (either modern or traditional) Total number of women aged 15-49 years that are currently married or in union 22 Antibiotic treatment of suspected pneumonia Number of children aged 0-59 months with suspected pneumonia in the previous 2 weeks receiving antibiotics Total number of children aged 0-59 months with suspected pneumonia in the previous 2 weeks 23 Care-seeking for suspected pneumonia Number of children aged 0-59 months with suspected pneumonia in the previous 2 weeks that are taken to an appropriate health provider Total number of children aged 0-59 months with suspected pneumonia in the previous 2 weeks 24 Solid fuels Number of residents in households that use solid fuels (wood, charcoal, crop residues and dung) as the primary source of domestic energy to cook Total number of residents in households surveyed 25 Tuberculosis immunization coverage Number of children aged 12-23 months receiving BCG vaccine before their first birthday Total number of children aged 12-23 months surveyed 150 Multiple Indicator Cluster Survey - 2005-2006 INDICATOR NUMERATOR DENOMINATOR 26 Polio immunization coverage Number of children aged 12-23 months receiving OPV3 vaccine before their first birthday Total number of children aged 12-23 months surveyed 27 Immunization coverage for diphtheria, pertussis and tetanus (DPT) Number of children aged 12-23 months receiving DPT3 vaccine before their first birthday Total number of children aged 12-23 months surveyed 28 Measles immunization coverage Number of children aged 12-23 months receiving measles vaccine before their first birthday Total number of children aged 12-23 months surveyed 29 Hepatitis B immunization coverage Number of children aged 12-23 months immunized against hepatitis before their first birthday Total number of children aged 12-23 months surveyed 30 Yellow fever immunization coverage * Number of children aged 12-23 months immunized against yellow fever before their first birthday Total number of children aged 12-23 months surveyed 31 Fully immunized children Number of children aged 12-23 months receiving DPT1-3, OPV-1-3, BCG and measles vaccines before their first birthday Total number of children aged 12-23 months surveyed 32 Neonatal tetanus protection* Number of mothers with live births in the previous year that were given at least two doses of tetanus toxoid (TT) vaccine within the appropriate interval prior to giving birth Total number of women surveyed aged 15-49 years with a birth in the year preceding the survey 33 Use of oral rehydration therapy (ORT) Number of children aged 0-59 months with diarrhoea in the previous 2 weeks that received oral rehydration salts and/or an appropriate household solution Total number of children aged 0-59 months with diarrhoea in the previous 2 weeks 34 Home management of diarrhoea Number of children aged 0-59 months with diarrhoea in the previous 2 weeks that received more fluids AND continued eating somewhat less, the same or more food Total number of children aged 0-59 months with diarrhoea in the previous 2 weeks 35 Received ORT or increased fluids and continued feeding Number of children aged 0-59 months with diarrhoea that received ORT (oral rehydration salts or an appropriate household solution) or received more fluids AND continued eating somewhat less, the same or more food Total number of children aged 0-59 months with diarrhoea in the previous 2 weeks 36 Household availability of insecticide- treated nets (ITNs)* Number of households with at least one mosquito net, either permanently treated or treated within the previous year Total number of households surveyed 37 Under-fives sleeping under insecticide- treated nets * Number of children aged 0-59 months that slept under an insecticide- treated mosquito net the previous night Total number of children aged 0-59 months surveyed 38 Under-fives sleeping under mosquito nets * Number of children aged 0-59 months that slept under a mosquito net the previous night Total number of children aged 0-59 months surveyed 39 Antimalarial treatment (under- fives)* Number of children aged 0-59 months reported to have had fever in the previous 2 weeks that were treated with an appropriate antimalarial within 24 hours of onset Total number of children aged 0-59 months reported to have had fever in the previous 2 weeks 40 Intermittent preventive malaria treatment (pregnant women)* Number of women receiving appropriate intermittent medication to prevent malaria (defined as at least 2 doses of SP/Fansidar) during the last pregnancy, leading to a live birth within the 2 years preceding the survey Total number of women that have had a live birth within the 2 years preceding the survey 41 Iodized salt consumption* Number of households with salt testing 15 parts per million or more of iodine/iodate Total number of households surveyed 42 Vitamin A supplementation (under- fives)* Number of children aged 6-59 months receiving at least one high-dose vitamin A supplement in the previous 6 months Total number of children aged 6-59 months surveyed 43 Vitamin A supplementation (post- partum mothers) * Number of women with a live birth in the 2 years preceding the survey that received a high-dose vitamin A supplement within 8 weeks after birth Total number of women that had a live birth in the 2 years preceding the survey 44 Content of antenatal care * Number of women with a live birth in the 2 years preceding the survey that received antenatal care during the last pregnancy Total number of women with a live birth in the 2 years preceding the survey 45 Timely initiation of breastfeeding Number of women with a live birth in the 2 years preceding the survey that put the newborn infant to the breast within 1 hour of birth Total number of women with a live birth in the 2 years preceding the survey 46 Support for learning Number of children aged 0-59 months living in households in which an adult has engaged in four or more activities to promote learning and school readiness in the past 3 days Total number of children aged 0-59 months surveyed 47 Father’s support for learning Number of children aged 0-59 months whose father has engaged in one or more activities to promote learning and school readiness in the past 3 days Total number of children aged 0-59 months 48 Support for learning: children’s books Number of households with three or more children’s books Total number of households surveyed 49 Support for learning: non-children’s books Number of households with three or more non-children’s books Total number of households surveyed 50 Support for learning: materials for play Number of households with three or more materials intended for play Total number of households surveyed 51 Non-adult care Number of children aged 0-59 months left alone or in the care of another child younger than 10 years of age in the past week Total number of children aged 0-59 months surveyed 52 Pre-school attendance Number of children aged 36-59 months that attend some form of early childhood education programme Total number of children aged 36-59 months surveyed 53 School readiness Number of children in first grade that attended some form of pre- school the previous year Total number of children in the first grade surveyed 54 Net intake rate in primary education Number of children of school-entry age that are currently attending first grade Total number of children of primary- school entry age surveyed 55 Net primary school attendance rate Number of children of primary-school age currently attending primary or secondary school Total number of children of primary- school age surveyed 56 Net secondary school attendance rate Number of children of secondary-school age currently attending secondary school or higher Total number of children of secondary-school age surveyed 151Republic of Macedonia INDICATOR NUMERATOR DENOMINATOR 57 Children reaching grade five Proportion of children entering the first grade of primary school that eventually reach grade five 58 Transition rate to secondary school Number of children that were in the last grade of primary school during the previous school year that attend secondary school Total number of children that were in the last grade of primary school during the previous school year surveyed 59 Primary completion rate Number of children (of any age) attending the last grade of primary school (excluding repeaters) Total number of children of primary school completion age (age appropriate to final grade of primary school) surveyed 60 Adult literacy rate Number of women aged 15-24 years that are able to read a short simple statement about everyday life Total number of women aged 15-24 years surveyed 61 Gender parity index Proportion of girls in primary and secondary education Proportion of boys in primary and secondary education 62 Birth registration Number of children aged 0-59 months whose births are reported registered Total number of children aged 0-59 months surveyed 63 Prevalence of female genital mutilation/cutting (FGM/C) * Number of women aged 15-49 years that reported undergoing any form of genital mutilation/cutting Total number of women aged 15-49 years surveyed 64 Prevalence of extreme form of FGM/C * Number of women aged 15-49 years that reported undergoing an extreme form of genital mutilation/cutting (such as infibulation) Total number of women aged 15-49 years surveyed 65 Prevalence of FGM/C among daughters * Number of women aged 15-49 years that reported that at least one daughter had undergone female genital mutilation/cutting Total number of women aged 15-49 years surveyed that have at least one living daughter 66 Approval for FGM/C * Number of women aged 15-49 years favouring the continuation of female genital mutilation/cutting Total number of women aged 15-49 years surveyed 67 Marriage before age 15 and age 18 Number of women that were first married or in union by the exact age of 15 and the exact age of 18, by age groups Total number of women aged 15-49 years and 20-49 years surveyed, by age groups 68 Young women aged 15-19 years currently married or in union Number of women aged 15-19 years currently married or in union Total number of women aged 15-19 years surveyed 69 Spousal age difference Number of women married/in union aged 15-19 years and 20-24 years with a difference in age of 10 or more years between them and their current spouse Total number of women aged 15-19 and 20-24 years surveyed that are currently married or in union 70 Polygyny * Number of women in a polygynous union Total number of women aged 15-49 years surveyed that are currently married or in union 71 Child labour Number of children aged 5-14 years that are involved in child labour Total number of children aged 5-14 years surveyed 72 Labourer students Number of children aged 5-14 years involved in child labour activities that attend school Total number of children aged 5-14 years involved in child labour activities 73 Student labourers Number of children aged 5-14 years attending school that are involved in child labour activities Total number of children aged 5-14 years attending school 74 Child discipline Number of children aged 2-14 years that (1) experience only non- violent aggression, (2) experience psychological aggression as punishment, (3) experience minor physical punishment, (4) experience severe physical punishment Total number of children aged 2-14 years selected and surveyed 75 Prevalence of orphans Number of children under age 18 with at least one dead parent Total number of children under age 18 surveyed 76 Prevalence of vulnerable children Number of children under age 18 that have a chronically ill parent, that live in a household where an adult aged 18-59 years has died in the past year, or that live in a household where an adult aged 18-59 years has been chronically ill in the past year Total number of children under age 18 surveyed 77 School attendance of orphans versus non-orphans Proportion of double orphans (both mother and father dead) aged 10- 14 years attending school Proportion of children aged 10-14 years, both of whose parents are alive, that are living with at least one parent and are attending school 78 Children’s living arrangements Number of children aged 0-17 years not living with a biological parent Total number of children aged 0-17 years surveyed 79 Malnutrition among children orphaned and made vulnerable by HIV/AIDS Proportion of orphaned or vulnerable children under age five that are moderately or severely underweight, of all orphaned and vulnerable children under age five that are weighed Proportion of children not classified as orphaned or vulnerable under age five that are moderately or severely underweight, of all children not classified as orphaned or vulnerable under age five that are weighed 80 Early sex among children orphaned and made vulnerable by HIV/AIDS Proportion of orphaned and vulnerable children aged 15-17 years that had sex before age 15, of all orphaned and vulnerable children aged 15-17 years surveyed Proportion of children not classified as orphaned or vulnerable aged 15-17 years that had sex before age 15, of all children not classified as orphaned or vulnerable aged 15-17 years surveyed 81 External support to children orphaned and made vulnerable by HIV/AIDS Number of orphaned and vulnerable children under age 18 whose households received free basic external support in caring for the child Number of orphaned and vulnerable children under age 18 surveyed 82 Comprehensive knowledge about HIV prevention among young people Number of women aged 15-24 years that correctly identify two ways of avoiding HIV infection and reject three common misconceptions about HIV transmission Total number of women aged 15-24 years surveyed 83 Condom use with non-regular partners Number of women aged 15-24 years reporting the use of a condom during sexual intercourse with their last non-marital, non-cohabiting sex partner in the previous 12 months Total number of women aged 15-24 years surveyed that had a non-marital, non-cohabiting partner in the previous 12 months 84 Age at first sex among young people Number of women aged 15-24 years that have had sex before age 15 Total number of women aged 15-24 surveyed 85 Higher risk sex in the last year Number of sexually active women aged 15-24 years that have had sex with a non-marital, non-cohabitating partner in the previous 12 months Total number of women aged 15-24 that were sexually active in the previous 12 months 86 Attitude towards people with HIV/ AIDS Number of women expressing acceptance on all four questions about people with HIV or AIDS Total number of women surveyed 87 Women who know where to be tested for HIV Number of women that state knowledge of a place to be tested Total number of women surveyed 152 Multiple Indicator Cluster Survey - 2005-2006 INDICATOR NUMERATOR DENOMINATOR 88 Women who have been tested for HIV Number of women that report being tested for HIV Total number of women surveyed 89 Knowledge of mother-to-child transmission of HIV Number of women that correctly identify all three means of vertical transmission Total number of women surveyed 90 Counselling coverage for the prevention of mother-to-child transmission of HIV Number of women that gave birth in the previous 24 months and received antenatal care reporting that they received counselling on HIV/AIDS during this care Total number of women that gave birth in the previous 24 months surveyed 91 Testing coverage for the prevention of mother-to-child transmission of HIV Number of women that gave birth in the previous 24 months and received antenatal care reporting that they received the results of an HIV test during this care Total number of women that gave birth in the previous 24 months surveyed 92 Age-mixing among sexual partners Number of women aged 15-24 years that had sex in the past 12 months with a partner who was 10 or more years older than they were Total number of sexually active women aged 15-24 years surveyed 93 Security of tenure Number of household members living in urban households that lack formal documentation for their residence or that feel at risk of eviction Number of urban household members in households surveyed 94 Durability of housing Number of household members living in urban dwellings that are not considered durable Number of urban household members in households surveyed 95 Slum household Number of household members living in urban slums Number of household members in urban households surveyed 96 Source of supplies Number of children (or households) for whom supplies were obtained from public providers, presented separately for each type of supply: insecticide-treated mosquito nets, oral rehydration salts, antibiotics and antimalarials Total number of children (or households) for whom supplies were obtained 97 Cost of supplies Median cost of supplies obtained, presented separately for each type of supply and whether sourced from public or private providers: insecticide-treated mosquito nets, oral rehydration salts, antibiotics and antimalarials. Total number of children (or households) for whom supplies were obtained 98 Unmet need for family planning Number of women that are currently married or in union that are fecund and want to space their births or limit the number of children they have and that are not currently using contraception Total number of women interviewed that are currently married or in union 99 Demand satisfied for family planning Number of women currently married or in union that are currently using contraception Number of women currently married or in union that have an unmet need for contraception or that are currently using contraception 100 Attitudes towards domestic violence Number of women that consider that a husband/partner is justified in hitting or beating his wife in at least one of the following circumstances: (1) she goes out without telling him, (2) she neglects the children, (3) she argues with him, (4) she refuses sex with him, (5) she burns the food Total number of women surveyed 101 Child disability Number of children aged 2-9 years with at least one of nine reported disabilities: (1) delay in sitting, standing or walking, (2) difficulty seeing, either in the daytime or at night, (3) appears to have difficulty hearing, (4) difficulty in understanding instructions, (5) difficulty walking or moving arms or has weakness or stiffness of limbs, (6) has fits, becomes rigid, loses consciousness, (7) does not learn to do things like other children his/her age, (8) cannot speak or cannot be understood in words, (9) appears mentally backward, dull or slow Total number of children aged 2-9 surveyed * Global MICS indictor not included in the Macedonian 2005 MICS survey. 153Republic of Macedonia HOUSEHOLD QUESTIONNAIRE We are from the State Statistical office of the Republic of Macedonia. We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (number) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. HOUSEHOLD INFORMATION PANEL HH HH1. Cluster number: HH2. Household number: ___ ___ ___ ___ ___ ___ HH3. Interviewer name and number: HH4. Supervisor name and number: Name ___ ___ Name ___ ___ HH5. Day/Month/Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ HH6. Area: Urban . 1 Rural . 2 HH7. Region: Skopski . 1 Pelagoniski . 2 Vardarski . 3 North East . 4 South West . 5 South East . 6 Poloski . 7 East . 8 HH 8. Name of head of household: After all questionnaires for the household have been completed, fill in the following information: HH9. Result of HH interview: Completed.1 Refused .2 Not at home .3 HH not found/destroyed .4 Other (specify) ___________________________ 6 HH10. Respondent to HH questionnaire: Name: Line No: ___ ___ HH11. Total number of household members: ___ ___ HH12. No. of women eligible for interview: HH13. No. of women questionnaires completed: ___ ___ ___ ___ HH14. No. of children under age 5: HH15. No. of child questionnaires completed: ___ ___ ___ ___ Interviewer/supervisor notes: Use this space to record notes about the interview with this household, such as call-back times, incomplete individual interview forms, number of attempts to re-visit, etc. HH16. Data entry clerk: ___ ___ Appendix F. Questionnaires 154 Multiple Indicator Cluster Survey - 2005-2006 HOUSEHOLD LISTING FORM HL FIRST, PLEASE TELL ME THE NAME OF EACH PERSON WHO USUALLY LIVES HERE, STARTING WITH THE HEAD OF THE HOUSEHOLD. LIST THE HEAD OF THE HOUSEHOLD IN LINE 01. LIST ALL HOUSEHOLD MEMBERS (HL2), THEIR RELATIONSHIP TO THE HOUSEHOLD HEAD (HL3), AND THEIR SEX (HL4). THEN ASK: ARE THERE ANY OTHERS WHO LIVE HERE, EVEN IF THEY ARE NOT AT HOME NOW? (THESE MAY INCLUDE CHILDREN IN SCHOOL OR AT WORK). IF YES, COMPLETE LISTING. THEN, ASK QUESTIONS STARTING WITH HL5 FOR EACH PERSON AT A TIME. ADD A CONTINUATION SHEET IF THERE ARE MORE THAN 15 HOUSEHOLD MEMBERS. TICK HERE IF CONTINUATION SHEET USED  ELIGIBLE FOR: WOMEN’S INTERVIEW CHILD LABOUR MODULE UNDER-5 INTERVIEW FOR CHILDREN AGE 0-17 YEARS ASK HL9-HL12 HL1. Line no. HL2. Name HL3. What is the relation- ship of (name) to the head of the house- hold? HL4. Is (name) male or female? 1 male 2 fem. HL5. How old is (name)? How old was (name) on his/her last birthday? Record in completed years 98=dk* HL6. Circle Line no. if woman is age 15-49 HL7. For each child age 5-14: Who is the mother or primary caretaker of this child? Record Line no. of mother/ caretaker HL8. For each child under 5: Who is the mother or primary caretaker of this child? Record Line no. of mother/ caretaker HL9. Is (name’s) natural mother alive? 1 yes 2 no HL11 8 dk HL11 HL10. If alive: Does (name’s) natural mother live in this household? Record Line no. of mother or 00 for ‘no’ HL11. Is (name’s) natural father alive? 1 yes 2 no next line 8 dk next line HL12. If alive: Does (name’s) natural father live in this household? Record Line no. of father or 00 for ‘no’ line name rel. m f age 15-49 mother mother y n dk mother y n dk father 01 0 1 1 2 ___ ___ 01 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 02 ___ ___ 1 2 ___ ___ 02 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 03 ___ ___ 1 2 ___ ___ 03 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 04 ___ ___ 1 2 ___ ___ 04 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 05 ___ ___ 1 2 ___ ___ 05 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 06 ___ ___ 1 2 ___ ___ 06 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 07 ___ ___ 1 2 ___ ___ 07 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 08 ___ ___ 1 2 ___ ___ 08 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 09 ___ ___ 1 2 ___ ___ 09 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 10 ___ ___ 1 2 ___ ___ 10 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 11 ___ ___ 1 2 ___ ___ 11 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 12 ___ ___ 1 2 ___ ___ 12 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 13 ___ ___ 1 2 ___ ___ 13 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 14 ___ ___ 1 2 ___ ___ 14 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ 15 ___ ___ 1 2 ___ ___ 15 ___ ___ ___ ___ 1 2 8 ___ ___ 1 2 8 ___ ___ Are there any other persons living here – even if they are not members of your family or do not have parents living in this household? Including children at work or at school? If yes, insert child’s name and complete form. Then, complete the totals below. Women 15-49 Children 5-14 Under-5s Totals ___ ___ ___ ___ ___ ___ * See instructions: to be used only for elderly household members (code meaning “do not know/over age 50”). NOW FOR EACH WOMAN AGE 15-49 YEARS, WRITE HER NAME AND LINE NUMBER AND OTHER IDENTIFYING INFORMATION IN THE INFORMATION PANEL OF THE WOMEN’S QUESTIONNAIRE. FOR EACH CHILD UNDER AGE 5, WRITE HIS/HER NAME AND LINE NUMBER AND THE LINE NUMBER OF HIS/HER MOTHER OR CARETAKER IN THE INFORMATION PANEL OF THE QUESTIONNAIRE FOR CHILDREN UNDERFIVE. YOU SHOULD NOW HAVE A SEPARATE QUESTIONNAIRE FOR EACH ELIGIBLE WOMAN AND EACH CHILD UNDER FIVE IN THE HOUSEHOLD. * Codes for HL3: Relationship to head of household: 01 = Head 02 = Wife or Husband 03 = Son or Daughter 04 = Son or Daughter In-Law 05 = Grandchild 06 = Parent 07 = Parent-In-Law 08 = Brother or Sister 09 = Brother or Sister-In-Law 10 = Uncle/Aunt 11 = Niece/Nephew By Blood 12 = Niece/Nephew By Marriage 13 = Other Relative 14 = Adopted/Foster/Stepchild 15 = Not Related 98 = Don’t Know 155Republic of Macedonia EDUCATION MODULE ED for household members age 5 and above for household members age 5-24 years ED1. Line no. ED1A. Name ED2. Has (name) ever attended school or preschool? 1 yesED3 2 no  next line ED3. What is the highest level of school (name) attended? What is the highest grade (name) completed at this level? Level: 0 pre-school 1 primary 2 secondary 3 higher 6 non-standard curriculum 8 dk Grade: 98 dk if less than 1 grade, enter 00. ED4. During the (2005-2006) school year, did (name) attend school or preschool at any time? 1 yes 2 noED7 ED5. Since last (day of the week), how many days did (name) attend school? insert number of days in space below. ED6. during this/that school year, which level and grade is/was (name) attending? level: 0 Preschool 1 primary 2 secondary 3 higher 6 non-standard curriculum 8 dk grade: 98 dk ED7. Did (name) attend school or preschool at any time during the previous school year, that is (2004- 2005)? 1 yes 2 no  next line 8 dk  next line ED8. During that previous school year, which level and grade did (name) attend? level: 0 Preschool 1 primary 2 secondary 3 higher 6 non-standard curriculum 8 dk grade: 98 dk LINE YES NO LEVEL GRADE YES NO DAYS LEVEL GRADE Y N DK LEVEL GRADE 01 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 02 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 03 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 04 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 05 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 06 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 07 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 08 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 09 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 10 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 11 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 12 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 13 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 14 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 15 1 2NEXT LINE 0 1 2 3 6 8 ___ ___ 1 2 ___ 0 1 2 3 6 8 ___ ___ 1 2 8 0 1 2 3 6 8 ___ ___ 156 Multiple Indicator Cluster Survey - 2005-2006 WATER AND SANITATION MODULE WS WS1. What is the main source of drinking water for members of your household? Piped water Piped into dwelling . 11 Piped into yard or plot . 12 Public tap/standpipe . 13 Tube well/borehole . 21 Dug well Protected well . 31 Unprotected well . 32 Water from spring Protected spring . 41 Unprotected spring . 42 Rainwater collection . 51 Tanker-truck . 61 Cart with small tank/drum . 71 Surface water (river, stream, dam, lake, pond, canal, irrigation channel) . 81 Bottled water .91 Other (specify) _____________________________________ 96 11WS5 12WS5 WS3 96WS3 WS2. What is the main source of water used by your household for other purposes such as cooking and handwashing? Piped water Piped into dwelling . 11 Piped into yard or plot . 12 Public tap/standpipe . 13 Tube well/borehole . 21 Dug well Protected well . 31 Unprotected well . 32 Water from spring Protected spring . 41 Unprotected spring . 42 Rainwater collection . 51 Tanker-truck . 61 Cart with small tank/drum . 71 Surface water (river, stream, dam, lake, pond, canal, irrigation channel) . 81 Other (specify) _____________________________________ 96 11WS5 12WS5 WS3. How long does it take to go there, GET water, and come back? No. of minutes .__ __ __ Water on premises . 995 DK . 998 995WS5 WS4. Who usually goes to this source to fetch the water for your household? Probe: Is this person under age 15? What sex? Circle code that best describes this person. Adult woman . 1 Adult man . 2 Female child (under 15) . 3 Male child (under 15) . 4 DK . 8 WS5. Do you treat your water in any way to make it safer to drink? Yes . 1 No . 2 DK . 8 2WS7 8WS7 WS6. What do you usually do to the water to make it safer to drink? Anything else? Record all items mentioned. Boil A Add bleach/chlorine . B Strain it through a cloth . C Use water filter (ceramic, sand, composite, etc.) . D Solar disinfection .E Let it stand and settle .F Other (specify) _____________________________________ X DK . Z WS7. What kind of toilet facility do members of your household usually use? If “flush” or “pour flush”, probe: Where does it flush to? If necessary, ask permission to observe the facility. Flush / pour flush Flush to piped sewer system . 11 Flush to septic tank . 12 Flush to pit (latrine) . 13 Flush to somewhere else . 14 Flush to unknown place/not sure/DK where . 15 Ventilated Improved Pit latrine (VIP) . 21 Pit latrine with slab . 22 Pit latrine without slab / open pit . 23 No facilities or bush or field . 95 Other (specify) _____________________________________ 96 95 NEXT MODULE WS8. Do you share this facility with other households? Yes . 1 No . 2 2 NEXT MODULE WS9. How many households use this toilet facility? No. of households (if less than 10) . _0_ ___ Ten or more households . 10 DK . 98 157Republic of Macedonia HOUSEHOLD CHARACTERISTICS MODULE HC HC1a. What is the religion of the head of this household? Orthodox. 1 Islamic . 2 Catholics . 3 Protestants . 5 Other religion (specify) ________________________________ 6 No religion . 7 No reply. . 15 HC1b. What is the mother tongue/native language of the head of this household? MacedonianMacedM . 1 Albanian . 3 Turkish . 8 Romas . 5 Vlach . 4 Serbian . 27 Bosniac. 10 Other language (specify) _______________________________ 6 No reply. . 15 HC1c. To what ethnic group does the head of this household belong? MMMmmmMacedonians. . 1 Albanians . 3 Turks . 8 Rhomas . 5 Vlachs. 4 Serbs . 27 Bosniacs . 10 Other (specify) ______________________________________ 6 No reply. . 15 HC2. How many rooms in this household are used for sleeping? No. of rooms . __ __ HC3. Main material of the dwelling floor: Record observation. Natural floor Earth/sand . 11 Rudimentary floor Wood planks . 21 Bamboo . 22 Finished floor Parquet or polished wood . 31 Vinyl or asphalt strips . 32 Ceramic tiles . 33 Cement . 34 Carpet . 35 Other (specify) _____________________________________ 96 HC4. Main material of the roof: Record observation. Natural roofing No Roof . 11 Thatch . 12 Sod . 13 Rudimentary Roofing Rustic mat . 21 Bamboo . 22 Wood planks . 23 Finished roofing Metal . 31 Wood . 32 Calamine/cement fibre . 33 Ceramic tiles . 34 Cement . 35 Roofing shingles . 36 Other (specify) _____________________________________ 96 158 Multiple Indicator Cluster Survey - 2005-2006 HC5. Main material of the walls: Record observation. Natural walls No walls . 11 Cane /trunks . 12 Dirt . 13 Rudimentary walls Bamboo with mud . 21 Stone with mud . 22 Uncovered adobe . 23 Plywood . 24 Carton . 25 Reused wood . 26 Finished walls Cement . 31 Stone with lime/cement . 32 Bricks . 33 Cement blocks . 34 Covered adobe . 35 Wood planks/shingles . 36 Other (specify) _____________________________________ 96 HC6. What type of fuel does your household mainly use for cooking? Electricity . 01 Liquid Propane Gas (LPG) . 02 Coal / Lignite . 06 Charcoal . 07 Wood . 08 Straw/shrubs/grass . 09 Agricultural crop residue . 11 Other (specify) _____________________________________ 96 01HC8 02HC8 HC7. In this household, is food cooked on a stove or an open fire? Probe for type. Open fire . 1 Open stove . 2 Closed stove . 3 Other (specify) _____________________________________ 96 3HC8 6HC8 HC7a. DOES THE FIRE/STOVE HAVE A CHIMNEY OR A HOOD? Yes . 1 No . 2 HC8. Is the cooking usually done in the house, in a separate building, or outdoors? In the house . 1 In a separate building . 2 Outdoors . 3 Other (specify) _____________________________________ 6 HC9. Does your household have: Electricity? A radio? A television? A mobile telephone? A non-mobile telephone? A refrigerator? A computer? Yes No Electricity .1 2 Radio .1 2 Television .1 2 Mobile Telephone .1 2 Non-Mobile Telephone .1 2 Refrigerator .1 2 Dish washing machine .1 2 Computer .1 2 Washing machine (clothes) .1 2 HC10. Does any member of your household own: A watch? A bicycle? A motorcycle or scooter? An animal-drawn cart? A car or truck? A boat with a motor? A tractor? Yes No Watch . 1 2 Bicycle . 1 2 Motorcycle/Scooter . 1 2 Animal drawn-cart . 1 2 Car/Truck . 1 2 Boat with motor . 1 2 Tractor . 1 2 159Republic of Macedonia CHILD LABOUR MODULE CL TO BE ADMINISTERED TO MOTHER/CARETAKER OF EACH CHILD IN THE HOUSEHOLD AGE 5 THROUGH 14 YEARS. FOR HOUSEHOLD MEMBERS BELOW AGE 5 OR ABOVE AGE 14, LEAVE ROWS BLANK. Now I would like to ask about any work children in this household may do. CL1. Line no. CL2. Name CL3. During the past week, did (name) do any kind of work for someone who is not a member of this household? If yes: for pay in cash or kind? 1 yes, for pay (cash or kind) 2 yes, unpaid 3 no to CL5 CL4. If yes: Since last (day of the week), about how many hours did he/she do this work for someone who is not a member of this household? if more than one job, include all hours at all jobs. record response thencl.6 CL5. At any time during the past year, did (name) do any kind of work for someone who is not a member of this household? If yes: for pay? 1 yes, for pay (cash or kind) 2 yes, unpaid 3 no CL6. During the past week, did (name) help with household chores such as shopping, collecting firewood, cleaning, fetching water, or caring for children? 1 yes 2 noto CL8 CL7. If yes: Since last (day of the week), about how many hours did he/she spend doing these chores? CL8. During the past week, did (name) do any other family work (on the farm or in a business or selling goods in the street?) 1 yes 2 no  next line CL9. If yes: Since last (day of the week), about how many hours did he/she do this work? LINE YES YES NO. NAME PAID UNPAID NO NO. HOURS PAID UNPAID NO YES NO NO. HOURS YES NO NO. HOURS 01 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 02 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 03 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 04 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 05 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 06 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 07 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 08 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 09 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 10 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 11 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 12 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 13 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 14 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 15 1 2 3 ____ ____ 1 2 3 1 2 ____ ____ 1 2 ____ ____ 160 Multiple Indicator Cluster Survey - 2005-2006 TABLE 1: CHILDREN AGED 2-4 YEARS ELIGIBLE FOR CHILD DISCIPLINE QUESTIONS Review the household listing and list each of the children aged 2-14 years below in order according to their line number (HL1). Do not include other household members outside of the age range 2-14 years. Record the line number, name, sex, age, and the line number of the mother or caretaker for each child. Then record the total number of children aged 2-14 in the box provided (CD7). CD1. Rank no. CD2. Line no. from HL1. CD3. Name from HL2. CD4. Sex from HL4. CD5. Age from HL5. CD6. Line no. of mother/ caretaker from HL7 or HL8. LINE LINE NAME M F AGE MOTHER 01 __ __ 1 2 ___ ___ ___ ___ 02 __ __ 1 2 ___ ___ ___ ___ 03 __ __ 1 2 ___ ___ ___ ___ 04 __ __ 1 2 ___ ___ ___ ___ 05 __ __ 1 2 ___ ___ ___ ___ 06 __ __ 1 2 ___ ___ ___ ___ 07 __ __ 1 2 ___ ___ ___ ___ 08 __ __ 1 2 ___ ___ ___ ___ CD7. TOTAL CHILDREN AGED 2-14 YEARS _ _ If there is only one child age 2-14 years in the household, then skip table 2 and go to CD9; write down the rank number of the child and continue with CD11 CHILD DISCIPLINE MODULE TABLE 2: SELECTION OF RANDOM CHILD FOR CHILD DISCIPLINE QUESTIONS Use this table to select one child between the ages of 2 and 14 years, if there is more than one child in that age range in the household. Look for the last digit of the household number from the cover page. This is the number of the row you should go to in the table below. Check the total number of eligible children (2-14) in CD7 above. This is the number of the column you should go to. Find the box where the row and the column meet and circle the number that appears in the box. This is the rank number of the child about whom the questions will be asked. Record the rank number in CD9 below. Finally, record the line number and name of the selected child in CD11 on the next page. Then, find the mother or primary caretaker of that child, and ask the questions, beginning with CD12. CD8. TOTAL NUMBER OF ELIGIBLE CHILDREN IN THE HOUSEHOLD Last digit of the questionnaire number 1 2 3 4 5 6 7 8+ 0 1 2 2 4 3 6 5 4 1 1 1 3 1 4 1 6 5 2 1 2 1 2 5 2 7 6 3 1 1 2 3 1 3 1 7 4 1 2 3 4 2 4 2 8 5 1 1 1 1 3 5 3 1 6 1 2 2 2 4 6 4 2 7 1 1 3 3 5 1 5 3 8 1 2 1 4 1 2 6 4 9 1 1 2 1 2 3 7 5 CD9. Record the rank number of the selected child Rank number of child.__ __ 161Republic of Macedonia CHILD DISCIPLINE MODULE CD Identify eligible child aged 2 to 14 in the household using the tables on the preceding page, according to your instructions. Ask to interview the mother or primary caretaker of the selected child (identified by the line number in CD6). CD11. Write name and line no. of the child selected for the module from CD3 and CD2, based on the rank number in CD9. Name ____________________________________________ Line number . __ __ CD12. All adults use certain ways to teach children the right behaviour or to address a behaviour problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month. CD12a. Took away privileges, forbade something (name) liked or did not allow him/her to leave house). Yes . 1 No . 2 CD12b. Explained why something (the behavior) was wrong. Yes . 1 No . 2 CD12c. Shook him/her. Yes . 1 No . 2 CD12d. Shouted, yelled at or screamed at him/her. Yes . 1 No . 2 CD12e. Gave him/her something else to do. Yes . 1 No . 2 CD12f. Spanked, hit or slapped him/her on the bottom with bare hand. Yes . 1 No . 2 CD12g. Hit him/her on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object. Yes . 1 No . 2 CD12h. Called him/her dumb, lazy, or another name like that. Yes . 1 No . 2 CD12i. Hit or slapped him/her on the face, head or ears. Yes . 1 No . 2 CD12j. Hit or slapped him/her on the hand, arm, or leg. Yes . 1 No . 2 CD12k. Beat him/her up with an implement (hit over and over as hard as one could). Yes . 1 No . 2 CD13. Do you believe that in order to bring up (raise, educate) (name) properly, you need to physically punish him/her? Yes . 1 No . 2 Don’t know/no opinion . 8 162 Multiple Indicator Cluster Survey - 2005-2006 DISABILITY DA To be administered to caretakers of all children 2 through 9 years old living in the household. For household members below age 2 or above age 9, leave rows blank I WOULD LIKE TO ASK YOU IF ANY CHILDREN IN THIS HOUSEHOLD AGED 2 THROUGH 9 HAS ANY OF THE HEALTH CONDITIONS I AM GOING TO MENTION TO YOU. DA1. Line no. DA2. Child’s name DA3. Compared with other children, does or did (name) have any serious delay in sitting, standing, or walking? DA4. Compared with other children, does (name) have difficulty seeing, either in the daytime or at night? DA5. Does (name) appear to have difficulty hearing? (uses hearing aid, hears with difficulty, completely deaf?) DA6. When you tell (name) to do something, does he/she seem to understand what you are saying? DA7. Does (name) have difficulty in walking or moving his/her arms or does he/she have weakness and/ or stiffness in the arms or legs? DA8. Does (name) sometimes have fits, become rigid, or lose consc- iousness? DA9. Does (name) learn to do things like other children his/her age? DA10. Does (name) speak at all (can he/she make him or herself understood in words; can say any recognizable words)? DA11. (For 3-9 year olds): Is (name)’s speech in any way different from normal (not clear enough to be understood by people other than the immediate family)? DA12. (For 2-year- olds): Can (name) name at least one object (for example, an animal, a toy, a cup, a spoon)? DA13. Compared with other children of the same age, does (name) appear in any way mentally backward, dull or slow? LINE NAME Y N Y N Y N Y N Y N Y N Y N Y N Y N Y N Y N 01 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 02 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 03 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 04 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 05 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 06 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 07 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 08 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 09 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 10 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 11 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 12 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 13 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 14 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 15 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 SI2. Does any eligible woman age 15-49 reside in the household? Check household listing, column HL6.You should have a questionnaire with the Information Panel filled in for each eligible woman.  Yes.Go to QUESTIONNAIRE FOR INDIVIDUAL WOMEN to administer the questionnaire to the first eligible woman.  No.Continue. SI3. Does any child under the age of 5 reside in the household? Check household listing, column HL8. You should have a questionnaire with the Information Panel filled in for each eligible child.  Yes.Go to QUESTIONNAIRE FOR CHILDREN UNDER FIVE to administer the questionnaire to caretaker of the first eligible child.  No.End the interview by thanking the respondent for his/her cooperation. Gather together all questionnaires for this household and tally the number of interviews completed on the cover page. 163Republic of Macedonia QUESTIONNAIRE FOR INDIVIDUAL WOMEN WOMEN’S INFORMATION PANEL WM This module is to be administered to all women age 15 through 49 (see column HL6 of HH listing). Fill in one form for each eligible woman Fill in the name and line number of the woman and the household and cluster numbers in the space below. Fill in your name, number and the date, and then read the greeting. If is given permission, proceed with the interview. WM1. Cluster number: WM2. Household number: ___ ___ ___ ___ ___ ___ WM3. Woman’s Name: WM4. Woman’s Line Number: ___ ___ WM5.Interviewer name and number: WM6. Day/Month/Year of interview: ___ ___ ___ ___ / ___ ___ / ___ ___ ___ ___ WM7. Result of women’s interview Completed . 1 Not at home . 2 Refused . 3 Partly completed . 4 Incapacitated . 5 Other (specify) ______________________________________ 6 Repeat greeting if not already read to this woman: We are from the State Statistical office of the Republic of Macedonia. We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about (number) minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don’t want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the woman does not agree to continue, thank her and go to the next interview. WM8. IN WHAT MONTH AND YEAR WERE YOU BORN? Date of birth: Month . __ __ DK month . 98 Year . __ __ __ __ DK year . 9998 WM9. HOW OLD WERE YOU AT YOUR LAST BIRTHDAY? Age (in completed years) . __ __ WM10. HAVE YOU EVER ATTENDED SCHOOL? Yes . 1 No . 2 2WM14 WM11. WHAT IS THE HIGHEST LEVEL OF SCHOOL YOU ATTENDED: PRIMARY, SECONDARY, OR HIGHER? Primary . 1 Secondary . 2 Higher . 3 WM12. WHAT IS THE HIGHEST GRADE YOU COMPLETED AT THAT LEVEL? Grade. __ __ WM13. Check WM11:  Secondary or higher.Go to Next Module  Primary.Continue with WM14 WM14. NOW I WOULD LIKE YOU TO READ THIS SENTENCE TO ME. Show sentences to respondent. If respondent cannot read whole sentence, probe: CAN YOU READ PART OF THE SENTENCE TO ME? Example sentences for literacy test: 1. The child is reading a book. 2. The rains came late this year. 3. Parents must care for their children. 4. Farming is hard work. Cannot read at all . 1 Able to read only parts of sentence . 2 Able to read whole sentence . 3 No sentence in required language _________________________ 4 (specify language) Blind/visually impaired . 5 164 Multiple Indicator Cluster Survey - 2005-2006 CHILD MORTALITY MODULE CM This module is to be administered to all women age 15-49. All questions refer only to LIVE births. CM1. Now i would like to ask about all the births you have had during your life. Have you ever given birth? If “No” probe by asking: I mean, to a child who ever breathed or cried or showed other signs of life – even if he or she lived only a few minutes or hours? Yes . 1 No . 2 2 marriage/union module CM2a. What was the date of your first birth? I mean the very first time you gave birth, even if the child is no longer living, or whose father is not your current partner. SKIP TO CM3 ONLY IF YEAR OF FIRST BIRTH IS GIVEN. OTHERWISE, CONTINUE WITH CM2B. Date of first birth Day . __ __ DK day . 98 Month . __ __ DK month . 98 Year . __ __ __ __ DK year . 9998 CM3 CM2b CM2b. How many years ago did you have your first birth? Completed years since first birth . __ __ CM3. Do you have any sons or daughters to whom you have given birth who are now living with you? Yes . 1 No . 2 2CM5 CM4. How many sons live with you? How many daughters live with you? Sons at home . __ __ Daughters at home . __ __ CM5. Do you have any sons or daughters to whom you have given birth who are alive but do not live with you? Yes . 1 No . 2 2CM7 CM6. How many sons are alive but do not live with you? How many daughters are alive but do not live with you? Sons elsewhere . __ __ Daughters elsewhere . __ __ CM7. Have you ever given birth to a boy or girl who was born alive but later died? Yes . 1 No . 2 2CM9 CM8. How many boys have died? How many girls have died? Boys dead . __ __ Girls dead . __ __ CM9. Sum answers to CM4, CM6, and CM8. Sum . __ __ CM10. Just to make sure that i have this right, you have had in Total (Total number) births during your life. is this correct?  Yes.Go to CM11  No.Check responses and make corrections before proceeding to CM11 CM11. Of these (total number) births you have had, when did you deliver the last one (even if he or she has died)? If day is not known, enter ‘98’ in space for day. Date of last birth Day/Month/Year . __ __/__ __/__ __ __ __ CM12. Check CM11: Did the woman’s last birth occur within the last 2 years, that is, since __________________ If child has died, take special care when referring to this child by name in the following modules.  Yes, live birth in last 2 years.Go to MATERNAL AND NEWBORN HEALTH MODULE Name of child_______________________  No live birth in last 2 years.Go to MARRIAG/UNION module. 165Republic of Macedonia MATERNAL AND NEWBORN HEALTH MODULE MN This module is to be administered to all women with a live birth in the 2 years preceding date of interview. Check child mortality module CM12 and record name of last-born child here _____________________. Use this child’s name in the following questions, where indicated. MN2. Did you see anyone for antenatal care for this pregnancy? If yes: Whom did you see? Anyone else? Probe for the type of person seen and circle all answers given. Health professional: Doctor . A Nurse/midwife . B Auxiliary midwife . C Other person Traditional birth attendant .F Community health worker . G Relative/friend . H Other (specify) ______________________________________ X No one . Y YMN7 MN2A. How many times did you see anyone for antenatal care for this regnancy? Number. MN3. As part of your antenatal care, were any of the following done at least once? MN3a. Were you weighed? MN3b. Was your blood pressure measured? MN3c. Did you give a urine sample? MN3d. Did you give a blood sample? Yes No Weight .1 2 Blood pressure .1 2 Urine sample .1 2 Blood sample .1 2 MN4. During any of the antenatal visits for the pregnancy, were you given any information or counseled about AIDS or the AIDS virus? Yes . 1 No . 2 DK . 8 MN7. Who assisted with the delivery of your last child (or name)? Anyone else? Probe for the type of person assisting and circle all answers given. Health professional: Doctor . A Nurse/midwife . B Auxiliary midwife . C Other person Traditional birth attendant .F Community health worker . G Relative/friend . H Other (specify) ______________________________________ X No one . Y MN8. Where did you give birth to (name)? If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Home Your home . 11 Other home . 12 Public sector Govt. hospital . 21 Govt. clinic/health center . 22 Other public (specify) _____________________________ 26 Private Medical Sector Private hospital . 31 Private clinic . 32 Private maternity home . 33 Other private medical (specify) _______________________ 36 Other (specify) _____________________________________ 96 MN9. When your last child (name) was born, was he/she very large, larger than average, average, smaller than average, or very small? Very large . 1 Larger than average . 2 Average . 3 Smaller than average . 4 Very small . 5 DK . 8 MN10. Was (name) weighed at birth? Yes . 1 No . 2 DK . 8 2MN12 8MN12 MN11. How much did (name) weigh? Record weight from health card, if available. From card .1 (kilograms) __ . __ __ __ From recall .2 (kilograms) __ . __ __ __ DK . 99998 MN12. did you ever breastfeed (name)? Yes . 1 No . 2 2 NEXT MODULE MN13. How long after birth did you first put (name) to the breast? If less than 1 hour, record ‘00’ hours. If less than 24 hours, record hours. Otherwise, record days. Immediately . 000 Hours . 1 __ __ or Days . 2 __ __ Don’t know/remember . 998 166 Multiple Indicator Cluster Survey - 2005-2006 MARRIAGE/UNION MODULE MA Ask questions for all women age 15-49. MA1. Are you currently married or living together with a man as if married? Yes, currently married . 1 Yes, living with a man . 2 No, not in union . 3 3MA3 MA2. How old was your husband/partner on his last birthday? Age in years . __ __ DK . 98 MA5 98MA5 MA3. Have you ever been married or lived together with a man? Yes, formerly married . 1 Yes, formerly lived with a man . 2 No . 3 3NEXT MODULE MA4. What is your marital status now: are you widowed, divorced or separated? Widowed . 1 Divorced . 2 Separated . 3 MA5. Have you been married or lived with a man only once or more than once? Only once . 1 More than once . 2 MA6. In what month and year did you first marry or start living with a man as if married? Month . __ __ DK month . 98 Year . __ __ __ __ DK year . 9998 MA7. Check MA6:  Both month and year of marriage/union?Go to Next Module  Either month or year of marriage/union not known?Continue with MA8 MA8. How old were you when you started living with your first husband/ partner? Age in years . __ __ 167Republic of Macedonia CONTRACEPTION AND UNMET NEED CP CP1. I would like to talk with you about another subject – family planning – and your reproductive health. Are you pregnant now? Yes, currently pregnant . 1 No . 2 Unsure or DK . 8 2CP2 8CP2 CP1a. At the time you became pregnant did you want to become pregnant then, did you want to wait until later, or did you not want to have any more children? Then . 1 Later . 2 Not want more children . 3 1CP4b 2CP4b 3CP4b CP2. Some people use various ways or methods to delay or avoid a pregnancy. Are you currently doing something or using any method to delay or avoid getting pregnant? Yes . 1 No . 2 2CP4a CP3. Which method are you using? Do not prompt. If more than one method is mentioned, circle each one. Female sterilization . A Male sterilization . B Pill . C IUD . D Injections .E Implants .F Condom . G Female condom . H Diaphragm . I Foam/jelly .J Lactational amenorrhoea method (LAM) . K Periodic abstinence .L Withdrawal . M Other (specify) ______________________________________ X CP4a. Now I would like to ask some questions about the future. Would you like to have (a/another) child, or would you prefer not to have any (more) children? CP4b. If currently pregnant: Now I would like to ask some questions about the future. After the child you are now expecting, would you like to have another child, or would you prefer not to have any (more) children? Have (a/another) child . 1 No more/none . 2 Says she cannot get pregnant . 3 Undecided/don’t know . 8 2CP4d 3next module 8CP4d CP4c. How long would you like to wait before the birth of (a/another) child? Months . 1 __ __ Years . 2 __ __ Soon/now . 993 Says she cannot get pregnant . 994 After marriage . 995 Other . 996 Don’t know . 998 994next module CP4D. Check CP1:  currently pregnant? go to next module  not currently pregnant or unsure?continue with cp4e CP4E. Do you think that you are physically able to get pregnant at this time? Yes . 1 No . 2 DK . 8 ATTITUDES TOWARD DOMESTIC VIOLENCE DV DV1. Sometimes a husband is annoyed or angered by things that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the following situations: DV1a. If she goes out with out telling him? DV1b. If she neglects the children? DV1c. If she argues with him? DV1d. If she refuses sex with him? DV1e. If she burns the food? Yes No DK Goes out without telling .1 2 8 Neglects children .1 2 8 Argues .1 2 8 Refuses sex .1 2 8 Burns food .1 2 8 168 Multiple Indicator Cluster Survey - 2005-2006 SEXUAL BEHAVIOUR MODULE SB Check for the presence of others. Before continuing, ensure privacy. SB0. Check WM9: Age of respondent is between 15 and 24?  Age 25-49.Go to Next Module  Age 15-24.Continue with SB1 SB1. Now I need to ask you some questions about sexual activity in order to gain a better understanding of some family life issues. The information you supply will remain strictly confidential. How old were you when you first had sexual intercourse (if ever)? Never had intercourse . 00 Age in years . __ __ First time when started living with (first) husband/partner . 95 00next module SB2. When was the last time you had sexual intercourse? Record ‘years ago’ only if last intercourse was one or more years ago. If 12 months or more the answer must be recorded in years. Days ago . 1 __ __ Weeks ago . 2 __ __ Months ago . 3 __ __ Years ago . 4 __ __ 4next module SB3. The last time you had sexual intercourse was a condom used? Yes . 1 No . 2 SB4. What is your relationship to the man with whom you last had sexual intercourse? If man is ‘boyfriend’ or ‘fiancée’, ask: Was your boyfriend/fiancée living with you when you last had sex? If ‘yes’, circle 1 .If ‘no’, circle 2. Spouse / cohabiting partner . 1 Man is boyfriend / fiancée . 2 Other friend . 3 Casual acquaintance . 4 Other (specify) ______________________________________ 6 1SB6 SB5. how old is this person? If response is DK, probe: About how old is this person? Age of sexual partner . __ __ DK . 98 SB6. Have you had sex with any other man in the last 12 months? Yes . 1 No . 2 2next module SB7. The last time you had sexual intercourse with this other man, was a condom used? Yes . 1 No . 2 SB8. What is your relationship to this man? If man is ‘boyfriend’ or ‘fiancée’, ask: Was your boyfriend/fiancée living with you when you last had sex? If ‘yes’, circle 1. If ‘no’, circle 2. Spouse / cohabiting partner . 1 Man is boyfriend / fiancée . 2 Other friend . 3 Casual acquaintance . 4 Other (specify) ______________________________________ 6 1SB10 SB9. how old is this person? If response is DK, probe: About how old is this person? Age of sexual partner . __ __ DK . 98 SB10. Other than these two men, have you had sex with any other man in the last 12 months? Yes . 1 No . 2 2next module SB11. In Total, with how many different men have you had sex in the last 12 months? No. of partners . __ __ 169Republic of Macedonia HIV/AIDS MODULE HA This module is to be administered to all women age 15-49. HA1. Now I would like to talk with you about something else. Have you ever heard of the virus HIV or an illness called AIDS? Yes . 1 No . 2 2 next module HA2. Can people protect themselves from getting infected with the AIDS virus by having one sex partner who is not infected and also has no other partners? Yes . 1 No . 2 DK . 8 HA3. Can people get infected with the AIDS virus because of witchcraft or other supernatural means? Yes . 1 No . 2 DK . 8 HA4. Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex? Yes . 1 No . 2 DK . 8 HA5. Can people get the AIDS virus from mosquito bites? Yes . 1 No . 2 DK . 8 HA6. Can people reduce their chance of getting infected with the AIDS virus by not having sex at all? Yes . 1 No . 2 DK . 8 HA7. Can people get the AIDS virus by sharing food with a person who has AIDS? Yes . 1 No . 2 DK . 8 HA7a. Can people get the AIDS virus by getting injections with a needle that was already used by someone else? Yes . 1 No . 2 DK . 8 HA8. Is it possible for a healthy-looking person to have the AIDS virus? Yes . 1 No . 2 DK . 8 HA9. Can the AIDS virus be transmitted from a mother to a baby? a. During pregnancy? b. During delivery? c. By breastfeeding? Yes No DK During pregnancy .1 2 8 During delivery .1 2 8 By breastfeeding .1 2 8 HA10. If a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in school? Yes . 1 No . 2 DK/not sure/depends . 8 HA11. Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus? Yes . 1 No . 2 DK/not sure/depends . 8 HA12. If a member of your family became infected with the AIDS virus, would you want it to remain a secret? Yes . 1 No . 2 DK/not sure/depends . 8 HA13. If a member of your family became sick with the AIDS virus, would you be willing to care for him or her in your household? Yes . 1 No . 2 DK/not sure/depends . 8 HA15. I do not want to know the results, but have you ever been tested to see if you have HIV, the virus that causes AIDS? Yes . 1 No . 2 2HA18 HA16. I do not want you to tell me the results of the test, but have you been told the results? Yes . 1 No . 2 HA17. Did you, yourself, ask for the test, was it offered to you and you accepted, or was it required? Asked for the test . 1 Offered and accepted . 2 Required . 3 HA18. At this time, do you know of a place where you can go to get such a test to see if you have the AIDS virus? HA18A. If tested for HIV during antenatal care: Other than at the antenatal clinic, do you know of a place where you can go to get a test to see if you have the AIDS virus? Yes . 1 No . 2 170 Multiple Indicator Cluster Survey - 2005-2006 QUESTIONNAIRE FOR CHILDREN UNDER FIVE UNDER-FIVE CHILD INFORMATION PANEL UF This questionnaire is to be administered to all mothers or caretakers (see household listing, column HL8) who care for a child that lives with them and is under the age of 5 years (see household listing, column HL5). A separate form should be used for each eligible child. Fill in the cluster and household line number, and names and line numbers of the child and the mother/caretaker in the space below. Insert your own name and number. UF1. Cluster number: UF2. Household number: ___ ___ ___ ___ ___ ___ UF3. Child’s Name: UF4. Child’s Line Number: ___ ___ UF5. Mother’s/Caretaker’s Name: UF6. Mother’s/Caretaker’s Line Number: ___ ___ UF7. Interviewer name and number: UF8. Day/Month/Year of interview: ___ ___ ___ ___ / ___ ___ / ___ ___ ___ ___ UF9. Result of interview for children under 5 (Codes refer to adult Respondent.) Completed . 1 Not at home . 2 Refused . 3 Partly completed . 4 Incapacitated . 5 Other (specify) ______________________________________ 6 Repeat greeting if not already read to this respondent: We are from the State Statistical office of the Republic of Macedonia. We are working on a project concerned with family health and education. I would like to talk to you about this. The interview will take about 20 minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. Also, you are not obliged to answer any question you don’t want to, and you may withdraw from the interview at any time. May I start now? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/ her and go to the next interview. UF10. Now I would like to ask you some questions about the health of each child under the age of 5 in your care, who lives with you now. Now I want to ask you about (name). In what month and year was (name) born? Probe: What is his/her birthday? If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day. Date of birth: Day . __ __ DK day . 98 Month . __ __ DK month . 98 Year . __ __ __ __ DK year . 9998 UF11. How old was (name) at his/her last birthday? Record age in completed years. Age in completed years .__ 171Republic of Macedonia BIRTH REGISTRATION AND EARLY LEARNING MODULE BR BR1. Does (name) have a birth certificate? May I see it? Yes, seen . 1 Yes, not seen . 2 No . 3 DK . 8 1BR5 BR2. Has (name’s) birth been registered with the civil authorities? Yes . 1 No . 2 DK . 8 1BR5 8BR4 BR3. Why is (name’s) birth not registered? Costs too much . 1 Must travel too far . 2 Did not know it should be registered . 3 Did not want to pay fine . 4 Does not know where to register . 5 Other (specify) ______________________________________ 6 DK . 8 BR4. Do you know how to register your child’s birth? Yes . 1 No . 2 BR5. Check age of child in UF11: Child is 3 or 4 years old ?  Yes.Continue with BR6  No.Go to BR8 BR6. Does (name) attend any organized learning or early childhood education programme, such as a private or government facility, including kindergarten or community child care? Yes . 1 No . 2 DK . 8 2BR8 8BR8 BR7. Within the last seven days, about how many hours did (name) attend? No. of hours . __ __ BR8. In the past 3 days, did you or any household member over 15 years of age engage in any of the following activities with (name): If yes, ask: who engaged in this activity with the child - the mother, the child’s father or another adult member of the household (including the caretaker/respondent)? Circle all that apply. Mother Father Other No one BR8a. Read books or look at picture books with (name)? Books A B X Y BR8b. Tell stories to (name)? Stories A B X Y BR8c. Sing songs with (name)? Songs A B X Y BR8d. Take (name) outside the home, compound, yard or enclosure? Take outside A B X Y BR8e. Play with (name)? Play with A B X Y BR8f. Spend time with (name) naming, counting, and/or drawing things? Spend time with A B X Y 172 Multiple Indicator Cluster Survey - 2005-2006 CHILD DEVELOPMENT CE Question CE1 is to be administered only once to each caretaker CE1. How many books are there in the household? Please include schoolbooks, but not other books meant for children, such as picture books If ‘none’ enter 00 Number of non-children’s books .0 __ Ten or more non-children’s books . 10 CE2. How many children’s books or picture books do you have for (name)? If ‘none’ enter 00 Number of children’s books .0 __ Ten or more books . 10 CE3. I am interested in learning about the things that (name) plays with when he/she is at home. What does (name) play with? Does he/she play with household objects, such as bowls, plates, cups or pots? objects and materials found outside the living quarters, such as sticks, rocks, animals, shells, or leaves? homemade toys, such as dolls, cars and other toys made at home? toys that came from a store? If the respondent says “YES” to any of the prompted categories, then probe to learn specifically what the child plays with to ascertain the response Code Y if child does not play with any of the items mentioned. Household objects (bowls, plates, cups, pots) . A Objects and materials found outside the living quarters (sticks, rocks, animals, shells, leaves) . B Homemade toys (dolls, cars and other toys made at home) . C Toys that came from a store . D No playthings mentioned . Y CE4. Sometimes adults taking care of children have to leave the house to go shopping, wash clothes, or for other reasons and have to leave young children with others. since last (day of the week) how many times was (name) left in the care of another child (that is, someone less than 10 years old)? If ‘none’ enter 00 Number of times . __ __ CE5. In the past week, how many times was (name) left alone? If ‘none’ enter 00 Number of times . __ __ BREASTFEEDING MODULE BF BF1. Has (name) ever been breastfed? Yes . 1 No . 2 DK . 8 2BF3 8BF3 BF2. Is he/she still being breastfed? Yes . 1 No . 2 DK . 8 BF3. Since this time yesterday, did he/she receive any of the following: Read each item aloud and record response before proceeding to the next item. BF3a. vitamin, mineral supplements or medicine? BF3b. plain water? BF3c. sweetened, flavoured water or fruit juice or tea or infusion? BF3d. oral rehydration solution (ORS)? BF3e. infant formula? BF3f. tinned, powdered or fresh milk? BF3g. any other liquids? BF3h. solid or semi-solid (mushy) food? Y N DK A. Vitamin supplements . 1 2 8 B. Plain water . 1 2 8 C. Sweetened water or juice . 1 2 8 D. ORS . 1 2 8 E. Infant formula . 1 2 8 F. Milk . 1 2 8 G. Other liquids . 1 2 8 H. Solid or semi-solid food . 1 2 8 BF4. Check BF3H: Child received solid or semi-solid (mushy) food?  Yes.Continue with BF5  No or DK.Go to Next Module BF5. Since this time yesterday, how many times did (name) eat solid, semisolid, or soft foods other than liquids? If 7 or more times, record ‘7’. No. of times .___ Don’t know . 8 173Republic of Macedonia CARE OF ILLNESS MODULE CA CA1. Has (name) had diarrhoea in the last two weeks, that is, since (day of the week) of the week before last? Diarrhoea is determined as perceived by mother or caretaker, or as three or more loose or watery stools per day, or blood in stool. Yes . 1 No . 2 DK . 8 2CA5 8CA5 CA2. During this last episode of diarrhoea, did (name) drink any of the following: Read each item aloud and record response before proceeding to the next item. CA2a. A fluid made from a special packet called [local name or ORS packet solution]? CA2b. Government-recommended homemade fluid? Yes No DK A. Fluid from ORS packet . 1 2 8 B. Recommended homemade fluid . 1 2 8 CA3. During (name’s) illness, did he/she drink much less, about the same, or more than usual? Much less or none . 1 About the same (or somewhat less) . 2 More . 3 DK . 8 CA4. During (name’s) illness, did he/she eat less, about the same, or more food than usual? If “less”, probe: much less or a little less? None . 1 Much less . 2 Somewhat less . 3 About the same . 4 More . 5 DK . 8 CA5. Has (name) had an illness with a cough at any time in the last two weeks, that is, since (day of the week) of the week before last? Yes . 1 No . 2 DK . 8 2CA12 8CA12 CA6. When (name) had an illness with a cough, did he/she breathe faster than usual with short, quick breaths or have difficulty breathing? Yes . 1 No . 2 DK . 8 2CA12 8CA12 CA7. Were the symptoms due to a problem in the chest or a blocked nose? Problem in chest . 1 Blocked nose . 2 Both . 3 Other (specify) ______________________________________ 6 DK . 8 2CA12 6CA12 CA8. Did you seek advice or treatment for the illness outside the home? Yes . 1 No . 2 DK . 8 2CA10 8CA10 CA9. From where did you seek care? Anywhere else? Circle all providers mentioned, But do NOT prompt with any suggestions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) Public Sector Govt. hospital . A Govt. health centre . B Govt. health post . C Village health worker . D Mobile/outreach clinic .E Other public (specify) _____________________________ H Private Medical Sector Private hospital/clinic . I Private physician .J Private Pharmacy . K Mobile clinic .L Other private medical (specify) ________________________ O Other source Relative or friend . P Shop . Q Traditional practitioner . R Other (specify) ______________________________________ X CA10. Was (name) given medicine to treat this illness? Yes . 1 No . 2 DK . 8 2CA12 8CA12 174 Multiple Indicator Cluster Survey - 2005-2006 CA11. What medicine was (name) given? Circle all medicines given. Antibiotic . A Paracetamol/Panadol/Acetaminophen . P Aspirin . Q Ibupropfen . R Other (specify) ______________________________________ X DK . Z CA12. Check UF11: Child aged under 3?  Yes.Continue with CA13  No.Go to CA14 CA13. The last time (name) passed stools, what was done to dispose of the stools? Child used toilet/latrine . 01 Put/rinsed into toilet or latrine . 02 Put/rinsed into drain or ditch . 03 Thrown into garbage (solid waste) . 04 Buried . 05 Left in the open . 06 Other (specify) _____________________________________ 96 DK . 98 Ask the following question (CA14) only once for each mother/caretaker. CA14. Sometimes children have severe illnesses and should be taken immediately to a health facility. What types of symptoms would cause you to take your child to a health facility right away? Keep asking for more signs or symptoms until the mother/caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any suggestions. Child not able to drink or breastfeed . A Child becomes sicker . B Child develops a fever . C Child has fast breathing . D Child has difficult breathing .E Child has blood in stool .F Child is drinking poorly . G Other (specify) ______________________________________ X Other (specify) ______________________________________ Y Other (specify) ______________________________________ Z 175Republic of Macedonia IMMUNIZATION MODULE IM If an immunization card is available, copy the dates in IM2-IM8 for each type of immunization or vitamin A dose recorded on the card. IM10-17 are for recording vaccinations that are not recorded on the card. IM10-17 will only be asked when a card is not available. IM1. Is there a vaccination card for (name)? Yes, seen . 1 Yes, not seen . 2 No . 3 2IM10 3IM10 (a) Copy dates for each vaccination from the card. (b) Write ‘44’ in day column if card shows that vaccination was given but no date recorded. Date of Immunization DAY MONTH YEAR IM2. BCG BCG IM3b. Polio 1 OPV1 IM3c. Polio 2 OPV2 IM3d. Polio 3 OPV3 IM4a. DPT1 DPT1 IM4b. DPT2 DPT2 IM4c. DPT3 DPT3 IM5a. HepB1 (DPT)H1 IM5b. HepB2 (DPT)H2 IM5c. HepB3 (DPT)H3 IM6. MMR Measles IM10. Has (name) ever received any vaccinations to prevent him/her from getting diseases, including vaccinations received in a campaign or immunization day? Yes . 1 No . 2 DK . 8 2IM20 8IM20 IM11. Has (name) ever been given a BCG vaccination against tuberculosis – that is, an injection in the arm or shoulder that caused a scar? Yes . 1 No . 2 DK . 8 IM12. Has (name) ever been given any “vaccination drops in the mouth” to protect him/her from getting diseases – that is, polio? Yes . 1 No . 2 DK . 8 2IM15 8IM15 IM13. How old was he/she when the first dose was given – just after birth (within two weeks) or later? Just after birth (within two weeks) . 1 Later . 2 IM14. How many times has he/she been given these drops? No. of times . __ __ IM15. Has (name) ever been given “DPT vaccination injections” – that is, an injection in the thigh or buttocks – to prevent him/her from getting tetanus, whooping cough, diphtheria? (sometimes given at the same time as polio) Yes . 1 No . 2 DK . 8 2IM17 8IM17 IM16. How many times? No. of times . __ __ IM17. Has (name) ever been given “MMR vaccination injections” – that is, a shot in the arm at the age of 13 months or older - to prevent him/her from getting measles? Yes . 1 No . 2 DK . 8 IM20. Does another eligible child reside in the household for whom this respondent is caretaker? Check household listing, column HL8.  Yes.End the current questionnaire and then Go to QUESTIONNAIRE FOR CHILDREN UNDER FIVE to administer the questionnaire for the next eligible child.  No.End the interview with this respondent by thanking him/her for his/her cooperation. If this is the last eligible child in the household, go on to ANTHROPOMETRY MODULE. 176 Multiple Indicator Cluster Survey - 2005-2006 ANTHROPOMETRY MODULE AN After questionnaires for all children are complete, the measurer weighs and measures each child. Record weight and length/height below, taking care to record the measurements on the correct questionnaire for each child. Check the child’s name and line number on the household listing before recording measurements. AN1. Child’s weight. Kilograms (kg) .__ __ . __ AN2. Child’s length or height. Check age of child in UF11:  Child under 2 years old.Measure length (lying down).  Child age 2 or more years.Measure height (standing up). Length (cm) Lying down . 1 __ __ __ . __ Height (cm) Standing up . 2 __ __ __ . __ AN3. Measurer’s identification code. Measurer code .__ __ __ AN4. Result of measurement. Measured. 1 Not present . 2 Refused . 3 Other (specify) ______________________________________ 6 AN5. Is there another child in the household who is eligible for measurement?  Yes.Record measurements for next child.  No.End the interview with this household by thanking all participants for their cooperation. Gather together all questionnaires for this household and check that all identification numbers are inserted on each page. Tally on the Household Information Panel the number of interviews completed. Follow instructions in your Interviewer’s Manual. 122 Multiple Indicator Cluster Survey - 2005-2006 Republic of Macedonia Multiple Indicator Cluster Survey 2005-2006 Republic of Macedonia Monitoring the situation of children and women Multiple Indicator Cluster Survey 2005-2006 R epublic of M acedonia 2005-2006 M ultiple Indicator C luster S urvey M IC S State Statistical Office MICS IS B N 9 78 -9 98 9- 16 7- 91 -1

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