Suriname Multiple Indicator Cluster Survey 2010, Final Report

Publication date: 2013

Suriname Multiple Indicator Cluster Survey 2010 Surinam e 2010 M ultiple Indicator C luster Survey Monitoring the situation of children and women Multiple Indicator Cluster Survey 2010 United Nations Children’s Fund Government of Suriname Suriname   Su Mu 201   Fin Janu   rina ultiple 10  nal R uary, 2 ame  e Ind Repo 2013    icato ort   or Cluuster Surveey                                    The Suriname Multiple  Indicator Cluster Survey  (MICS) was carried out  in 2010 by  the Ministry of  Social Affairs  and Housing  in  collaboration with General Bureau of  Statistics  and  the  Institute  for  Social Research (IMWO) of the University of Suriname. Financial and technical support was provided  by the United Nations Children’s Fund (UNICEF).  MICS  is an  international household  survey programme developed by UNICEF. The Suriname MICS  was conducted as part of the fourth global round of MICS surveys (MICS4). MICS provides up‐to‐date  information  on  the  situation  of  children  and  women  and  measures  key  indicators  that  allow  countries  to  monitor  progress  towards  the  Millennium  Development  Goals  (MDGs)  and  other  internationally agreed upon commitments. Additional  information on  the global MICS project may  be obtained from www.childinfo.org.   Cover photo: UN Suriname/2011/Pelu Vidal  Other photos: UN Suriname/2011/Pelu Vidal  Suggested  citation: Ministry of  Social Affairs  and Housing  and General Bureau of  Statistics, 2012.   Suriname Multiple Indicator Cluster Survey 2010, Final Report: Paramaribo, Suriname.  Printed by Suriprint n.v.         Suriname Multiple Indicator Cluster Survey 2010       Ministry of Social Affairs and Housing    United Nations Children’s Fund    General Bureau of Statistics    Institute for Social Research of the   Anton de Kom University of Suriname  January, 2013 Summary Table of Findings  iv   Suriname MICS4  Summary Table of Findings Multiple  Indicator Cluster Surveys  (MICS) and Millennium Development Goals  (MDG)  Indicators,  Suriname, 2010    Topic MICS4 Indicator Number MDG Indicator Number Indicator Value NUTRITION Nutritional  status    2.1a  2.1b  1.8  Underweight prevalence    Moderate and Severe (‐ 2 SD)    Severe (‐ 3 SD)    5.8  1.3    Percent  Percent    2.2a  2.2b    Stunting prevalence    Moderate and Severe (‐ 2 SD)    Severe (‐ 3 SD)    8.8  2.2    Percent  Percent     2.3a  2.3b    Wasting prevalence    Moderate and Severe (‐ 2 SD)    Severe (‐ 3 SD)    5.0   0.8    Percent  Percent  Breastfeeding  and infant  feeding  2.4    Children ever breastfed  90.4   Percent  2.5    Early initiation of breastfeeding  44.7  Percent  2.6    Exclusive breastfeeding under 6 months  2.8  Percent  2.7    Continued breastfeeding at 1 year  22.7  Percent  2.8    Continued breastfeeding at 2 years  14.9  Percent  2.9    Predominant breastfeeding under 6 months  18.4  Percent  2.10    Duration of breastfeeding  8.0  Months  2.11    Bottle feeding  71.9  Percent  2.12    Introduction of solid, semi‐solid or soft foods  47.0  Percent  2.13    Minimum meal frequency  64.3  Percent  2.14    Age‐appropriate breastfeeding  14.7  Percent  2.15    Milk feeding frequency for non‐breastfed children  80.6  Percent  Low birth  weight  2.18    Low‐birth weight infants  13.9  Percent  2.19    Infants weighed at birth  80.5  Percent  CHILD HEALTH Vaccinations  3.2    Polio  immunization  coverage  (18‐29  months  old  children, before age 12 months)  79.0  Percent  3.4  4.3  Measles  (MMR)  immunization  coverage  (18‐29 months  old children, before age 18 months)  73.9  Percent  3.6    Yellow  fever  immunization  coverage  (18‐29  months  old children, at any time before the survey) 1  64.0  Percent  Tetanus toxoid  3.7    Neonatal tetanus protection  36.4  Percent  Care of illness  3.8    Oral rehydration therapy with continued feeding  60.8  Percent  3.9    Care seeking for suspected pneumonia  75.8  Percent  3.10    Antibiotic treatment of suspected pneumonia  71.2  Percent  Solid fuel use  3.11    Solid fuels  11.4  Percent  Malaria1  3.12    Household availability of insecticide‐treated nets (ITNs)  60.5  Percent  3.13    Households protected by a vector control method  60.9  Percent  3.14    Children under age 5 sleeping under any mosquito net  53.6  Percent  3.15  6.7  Children under age 5 sleeping under insecticide‐treated nets (ITNs)  43.4  Percent  3.16    Malaria diagnostics usage  14.9  Percent  3.17    Antimalarial treatment of children under 5 the same or next day   0.0  Percent  3.18  6.8  Antimalarial treatment of children under age 5   0.0  Percent  3.19    Pregnant  women  sleeping  under  insecticide‐treated  nets (ITNs)  50.5  Percent                                                                   1 Brokopondo and Sipaliwini only  Summary Table of Findings      Suriname MICS4  v WATER AND SANITATION Water and  sanitation  4.1  7.8  Use of improved drinking water sources  95.0  Percent  4.2    Water treatment  10.1  Percent  4.3  7.9  Use of improved sanitation facilities  80.2  Percent  4.4    Safe disposal of child's faeces  22.0  Percent  4.5    Place for handwashing  86.3  Percent  4.6    Availability of soap  96.2  Percent                          REPRODUCTIVE HEALTH   5.3  5.3  Contraceptive prevalence rate  47.6  Percent 5.4  5.6  Unmet need  16.9  Percent  Maternal and  newborn  health    5.5a  5.5b  5.5  Antenatal care coverage    At least once by skilled personnel    At least four times by any provider    94.9  66.8    Percent  Percent  5.6    Content of antenatal care  92.3  Percent      5.7  5.2  Skilled attendant at delivery  92.7  Percent  5.8    Institutional deliveries  92.3  Percent  5.9    Caesarean section  19.0  Percent  CHILD DEVELOPMENT Child  development  6.1    Support for learning  72.9  Percent  6.2    Father's support for learning  25.9  Percent  6.3    Learning materials: children’s books  25.0  Percent  6.4    Learning materials: playthings  58.8  Percent  6.5    Inadequate care  7.1   Percent  6.6    Early child development index  70.9  Percent  6.7    Attendance to early childhood education  34.3  Percent  EDUCATION Literacy and  education  7.1  2.3  Literacy rate among young women  92.1  Percent  7.2    School readiness  75.8  Percent  7.3    Net intake rate in primary education  87.2  Percent  7.4  2.1  Primary school net attendance ratio (adjusted)  95.4  Percent  7.5    Secondary school net attendance ratio (adjusted)  59.4  Percent  7.6  2.2  Children reaching last grade of primary  95.8  Percent  7.7    Primary completion rate  88.2  Percent  7.8    Transition rate to secondary school  79.2  Percent  7.9    Gender parity index (primary school)  1.02   Percent  7.10    Gender parity index (secondary school)  1.24  Percent  CHILD PROTECTION Birth registration  8.1    Birth registration  98.9  Percent  Child labour  8.2    Child labor  9.6  Percent  8.3    School attendance among child laborers  94.2  Percent  8.4    Child labour among students  9.4  Percent  Child discipline  8.5    Violent discipline  86.1  Percent  Early marriage  and Polygyny  8.6    Marriage before age 15  5.4  Percent  8.7    Marriage before age 18  23.0  Percent  8.8    Young women age 15‐19 currently married or in union  11.8  Percent  8.9    Polygyny  3.9  Percent    8.10a  8.10b    Spousal age difference     Women age 15‐19    Women age 20‐24    14.7  17.1    Percent   Percent  Domestic violence  8.14    Attitudes towards domestic violence  12.5  Percent  HIV/AIDS, SEXUAL BEHAVIOUR, AND ORPHANED AND VULNERABLE CHILDREN HIV/AIDS  knowledge and  attitudes  9.1    Comprehensive knowledge about HIV prevention  42.5  Percent  9.2  6.3  Comprehensive  knowledge  about  HIV  prevention  among young people  41.9  Percent  9.3    Knowledge of mother‐to‐child transmission of HIV  51.8  Percent  9.4    Accepting attitude towards people living with HIV  21.1  Percent  9.5    Women who know where to be tested for HIV  85.0  Percent  9.6    Women who have been tested for HIV and know the results  20.3  Percent  9.7    Sexually active young women who have been tested for HIV and know the results  33.4  Percent  9.8    HIV counseling during antenatal care  49.3  Percent  9.9    HIV testing during antenatal care  79.5  Percent  Sexual  behaviour  9.10    Young women who have never had sex  54.7  Percent  9.11    Sex before age 15 among young women  9.6   Percent  Summary Table of Findings  vi   Suriname MICS4  9.12    Age‐mixing among sexual partners  15.0  Percent  9.13    Sex with multiple partners  2.5  Percent  9.14    Condom use during sex with multiple partners  37.2  Percent  9.15    Sex with non‐regular partners  58.8  Percent  9.16  6.2  Condom use with non‐regular partners  55.5  Percent              Orphaned  children  9.17    Children’s living arrangements  7.9  Percent  9.18    Prevalence of children with at least one parent dead  4.6  Percent  9.20  6.4  School attendance of non‐orphans  96.9  Percent  ACCESS TO MASS MEDIA AND USE OF INFORMATION/COMMUNICATION TECHNOLOGY Access to Mass  Media  MT.1    Exposure to mass media  66.4  Percent  Use of  Information  and  Communication  Technology  MT.2    Use  of  computer  in  the  past  12  months  –  persons  15‐24 years  59.8  Percent  MT.3    Use of  the  internet  in  the past 12 months – persons 15‐24 years  48.5  Percent  Table of Contents      Suriname MICS4  vii Table of Contents Summary Table of Findings . iv Table of Contents . vii List of Tables . x List of Figures . xiii List of Abbreviations . xiv Foreword .xv Executive Summary . xvi   1.Introduction . 1 Background . 1 Survey Objectives . 3 2.Sample and Survey Methodology . 4 Sample Design . 4 Questionnaires . 5 Training and Fieldwork . 7 Data Processing . 7 3.Sample Coverage and the Characteristics of Households and Respondents . 8 Sample Coverage . 8 Characteristics of Households . 8 Characteristics of Female Respondents 15‐49 Years of Age and Children Under‐5 . 13 Children’s Living Arrangements and Orphans . 17 4.Nutrition . 20 Nutritional Status . 21 Breastfeeding and Infant and Young Child Feeding . 23 Low Birth Weight . 36 5.Child Health . 38 Immunization . 39 Neonatal Tetanus Protection . 42 Oral Rehydration Treatment . 44 Care Seeking and Antibiotic Treatment of Pneumonia . 52 Solid Fuel Use . 57 Malaria . 60 6.Water and Sanitation . 70 Table of Contents  viii   Suriname MICS4  Use of Improved Water Sources . 71 Use of Improved Sanitation Facilities . 80 Handwashing . 87 7.Reproductive Health . 94 Contraception . 95 Unmet Need . 99 Antenatal Care . 102 Assistance at Delivery . 106 Place of Delivery . 109 8.Child Development . 111 Early Childhood Education and Learning . 112 Early Childhood Development . 119 9.Literacy and Education . 121 Literacy among Young Women . 122 School Readiness . 122 Primary and Secondary School Participation . 125 10.Child Protection . 135 Birth Registration . 136 Child Labour . 136 Child Discipline . 137 Early Marriage and Polygyny . 143 Attitudes toward Domestic Violence . 150 11.HIV/AIDS and Sexual Behaviour . 152 Knowledge about HIV Transmission and Misconceptions about HIV/AIDS . 153 Accepting Attitudes toward People Living with HIV/AIDS . 160 Knowledge of a Place for HIV Testing, Counselling and Testing during Antenatal Care . 160 Sexual Behaviour Related to HIV Transmission . 165 12.Access to Mass Media and Use of Information/Communication Technology . 171 Access to Mass Media . 172 Use of Information/Communication Technology . 174 Appendix A. Sample Design . 178 Sample Size and Sample Allocation . 178 Sampling Frame and Sample Design . 179 Selection of Clusters . 179 Listing Activities . 180 Selection of Households . 181 Calculation of Sample Weights . 182 Appendix B. List of Personnel Involved in the Survey . 184 Table of Contents      Suriname MICS4  ix MICS Technical Committee . 184 MICS Fieldwork Coordination: General Bureau of Statistics . 184 MICS Fieldworkers . 185 MICS Data Processing Coordination: Institute for Social Science Research . 186 Appendix C. Estimates of Sampling Errors . 187 Appendix D. Data Quality Tables . 205 Appendix E. Suriname MICS4 Indicators: Numerators and Denominators . 218 Appendix F. Questionnaires . 226 List of Tables  x   Suriname MICS4  List of Tables Table HH.1: Results of household, women's, and under‐5 interviews . 9  Table HH.2: Household age distribution by sex . 10  Table HH.3: Household composition . 12  Table HH.4: Women's background characteristics . 14  Table HH.5: Under‐5's background characteristics . 16  Table HH.6: Children's living arrangements and orphanhood . 18    Table NU.1: Nutritional status of children . 24  Table NU.2: Initial breastfeeding . 26  Table NU.3: Breastfeeding . 28  Table NU.4: Duration of breastfeeding . 31  Table NU.5: Age‐appropriate breastfeeding . 32  Table NU.6: Introduction of solid, semi‐solid or soft foods . 33  Table NU.7: Minimum meal frequency . 34  Table NU.8: Bottle feeding . 35  Table NU.9: Low birth weight infants. 37    Table CH.1: Vaccinations in first year of life . 40  Table CH.2: Vaccinations by background characteristics . 41  Table CH.3: Neonatal tetanus protection . 43  Table CH.4: Oral rehydration solutions and recommended homemade fluids . 47  Table CH.5: Feeding practices during diarrhoea . 49  Table CH.6: Oral rehydration therapy with continued feeding and other treatments . 51  Table CH.7: Care seeking for suspected pneumonia and antibiotic use during suspected pneumonia . 53  Table CH.8: Knowledge of the two danger signs of pneumonia . 55  Table CH.9: Solid fuel use . 58  Table CH.10: Solid fuel use by place of cooking . 60  Table CH.11: Household availability of  insecticide treated nets and protection by a vector control method  . 62  Table CH.12: Children sleeping under mosquito nets . 63  Table CH.13: Pregnant women sleeping under mosquito nets . 65  Table CH.14: Anti‐malarial treatment of children with anti‐malarial drugs . 67  Table CH.15: Malaria diagnostics usage . 69    Table WS.1: Use of improved water sources . 74  Table WS.2: Household water treatment . 76  Table WS.3: Time to source of drinking water . 79  Table WS.4: Person collecting water . 80  Table WS.5: Types of sanitation facilities . 82  Table WS.6: Use and sharing of sanitation facilities . 84  Table WS.7: Disposal of child's feces. 86  Table WS.8: Drinking water and sanitation ladders . 88  Table WS.9: Water and soap at place for handwashing . 90  Table WS.10: Availability of soap . 92    Table RH.1: Use of contraception . 97  Table RH.2: Unmet need for contraception . 101  Table RH.3: Antenatal care coverage . 103  Table RH.4: Number of antenatal care visits . 104  Table RH.5: Content of antenatal care . 105  Table RH.6: Assistance during delivery . 107  List of Tables      Suriname MICS4  xi Table RH.7: Place of delivery . 110    Table CD.1: Early childhood education . 113  Table CD.2: Support for learning . 114  Table CD.3: Learning materials . 117  Table CD.4: Inadequate care . 118  Table CD.5: Early child development index . 120    Table ED.1: Literacy among young women . 123  Table ED.2: School readiness . 124  Table ED.3: Primary school entry . 126  Table ED.4: Primary school attendance . 127  Table ED.5: Secondary school attendance . 129  Table ED.6: Children reaching last grade of primary school . 132  Table ED.7: Primary school completion and transition to secondary school . 133  Table ED.8: Education gender parity . 134    Table CP.1: Birth registration . 138  Table CP.2: Child labour . 139  Table CP.3: Child labour and school attendance . 141  Table CP.4: Child discipline . 142  Table CP.5: Early marriage and Polygyny . 145  Table CP.6: Trends in early marriage . 147  Table CP.7: Spousal age difference . 148  Table CP.8: Attitudes toward domestic violence . 151    Table  HA.1:  Knowledge  about  HIV  transmission,  misconceptions  about  HIV/AIDS,  and  comprehensive  knowledge about HIV transmission . 155  Table  HA.2:  Knowledge  about  HIV  transmission,  misconceptions  about  HIV/AIDS,  and  comprehensive  knowledge about HIV transmission among young women . 157  Table HA.3: Knowledge of mother‐to‐child HIV transmission . 159  Table HA.4: Accepting attitudes toward people living with HIV/AIDS . 161  Table HA.5: Knowledge of a place for HIV testing . 162  Table HA.6: Knowledge of a place for HIV testing among sexually active young women . 163  Table HA.7: HIV counselling and testing during antenatal care . 164  Table HA.8: Sexual behaviour that increases the risk of HIV infection . 166  Table HA.9: Sex with multiple partners . 167  Table HA.10: Sex with multiple partners among young women . 168  Table HA.11: Sex with non‐regular partners . 170    Table MT.1: Exposure to mass media . 173  Table MT.2: Use of computers and internet . 175    176  Table MT.3: Cell phone ownership and use . 177    Table A1.1: Distribution of population and households by stratum and district, and MICS4 sample design  and outcome . 179  Table A1.2: Stratification of the population in Suriname in 2004 by strata . 180  Table A1.3: Projections of the population by district . 181  Table A1.4: Weights to be applied to the household, women, and child data . 183    Table SE.1: Indicators selected for sampling error calculations . 188  Table SE.2: Sampling errors: Total sample . 190  Table SE.3: Sampling errors: Urban . 191  Table SE.4: Sampling errors: Rural coastal . 192  List of Tables  xii   Suriname MICS4  Table SE.5: Sampling errors: Rural interior . 193  Table SE.6: Sampling errors: Total rural . 194  Table SE.7: Sampling errors: Paramaribo . 195  Table SE.8: Sampling errors: Wanica . 196  Table SE.9: Sampling errors: Nickerie . 197  Table SE.10: Sampling errors: Coronie . 198  Table SE.11: Sampling errors: Saramacca . 199  Table SE.12: Sampling errors: Commewijne . 200  Table SE.13: Sampling errors: Marowijne . 201  Table SE.14: Sampling errors: Para . 202  Table SE.15: Sampling errors: Brokopondo . 203  Table SE.16: Sampling errors: Sipaliwini . 204    Table DQ.1: Age distribution of household population . 205  Table DQ.2: Age distribution of eligible and interviewed women . 206  Table DQ.3: Age distribution of under‐5s in household and under‐5 questionnaires . 207  Table DQ.4: Women's completion rates by socio‐economic characteristics of households . 208  Table DQ.5: Completion rates for under‐5 questionnaires by socio‐economic characteristics of households  . 209  Table DQ.6: Completeness of reporting . 210  Table DQ.7: Completeness of information for anthropometric indicators. 211  Table DQ.8: Heaping in anthropometric measurements . 212  Table DQ.10: Observation of women's health cards . 213  Table DQ.11: Observation of under‐5s birth certificates . 214  Table DQ.12: Observation of vaccination cards . 215  Table  DQ.13:  Presence  of  mother  in  the  household  and  the  person  interviewed  for  the  under‐5  questionnaire . 215  Table DQ.14: Selection of children age 2‐14 years for the child discipline module . 216  Table DQ.15: School attendance by single age . 217  List of Tables      Suriname MICS4  xiii List of Figures Figure HH.1: Age and sex distribution of household population, Suriname, 2010 . 11  Figure NU.1: Percentage of children under age 5 . 22  Figure NU.2: Percentage of mothers who  started breastfeeding within one hour  and within one day of  birth, Suriname, 2010 . 27  Figure NU.3: Infant feeding patterns by age, Suriname 2010 . 29  Figure CH.1: Percentage of children aged 18‐29 months who  received  the  recommended vaccinations at  any time before the survey, Suriname, 2010. 42  Figure CH.2: Percentage of women with a live birth in the last 2 years who are protected against neonatal  tetanus, Suriname, 2010 . 44  Figure CH.3: Percentage of children under age 5 with diarrhoea who received ORS or recommended home  fluids, Suriname, 2010 . 45  Figure CH.4: Treatment of diarrhoea, Suriname, 2010. 46  Figure WS.1: Percent distribution of household members by source of drinking water Suriname, 2010 . 72  Figure  HA.1:  Percentage  of  women  who  have  comprehensive  knowledge  of  HIV/AIDS  transmission,  Suriname, 2010 . 154  Figure HA.2: Sexual behaviour that increases risk of HIV infection, Suriname, 2010 . 165  Figure MT.1: Cell phone use by purpose, Suriname, 2010 . 176  Figure DQ.1: Number of household population by single ages, Suriname, 2010 . 206        List of Abbreviations  xiv   Suriname MICS4  List of Abbreviations AIDS  Acquired Immune Deficiency Syndrome  ANC  Antenatal Care  CEDAW  Convention on the Elimination of all Forms of Discrimination Against Women  CRC  Convention on the Rights of the Child  CSPro  Census and Survey Processing System  DPT  Diphtheria Pertussis Tetanus  ECDI  Early Childhood Development Index  EPI  Expanded Programme on Immunization  GBS  General Bureau of Statistics  GPI  Gender Parity Index  HIV  Human Immunodeficiency Virus  ITN  Insecticide Treated Net  IUD  Intrauterine Device  LAM  Lactational Amenorrhea Method  LPG  Liquified Petroleum Gas  MDG  Millennium Development Goals  MICS  Multiple Indicator Cluster Survey  MMR  Mumps, Measles and Rubella  MoH  Ministry of Health  NAR  Net Attendance Rate  ORS  Oral Rehydration Salts  ORT  Oral Rehydration Treatment  PLOS  Ministry of Planning and Development Co‐operation  RHF  Recommended Home Fluid  SOZAVO  Ministry of Social Affairs and Housing  SPSS  Statistical Package for Social Sciences  STIs  Sexually Transmitted Infections  UNAIDS  United Nations Programme on HIV/AIDS  UNDAP  United Nations Development Plan  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  WSC  World Summit for Children Foreword      Suriname MICS4  xv Foreword With the support of United Nations Children’s Fund (UNICEF), the fourth round of the Multiple Indicators  Cluster Survey (MICS) commenced in 2010 in Suriname. This survey follows up on the MICS3 in Suriname,  conducted  in 2006 by the General Bureau of Statistics  in collaboration with the Ministry of Social Affairs  and Housing  (SOZAVO)  and  the Ministry  of  Planning  and Development  Cooperation  (PLOS).  The  survey  provides valuable information on the situation of children and women in Suriname, and is based to a great  extent on  the need  to monitor progress  towards goals and  targets emanating  from  recent  international  agreements: the Millennium Declaration, adopted by all 191 United Nations Member States in September  2000, and  the Plan of Action of A World Fit For Children, adopted by 189 Member States at  the United  Nations Special Session on Children  in May 2002. Both of these commitments build upon promises made  by  the  international  community  at  the  1990  World  Summit  for  Children.  The  MICS3  data  were  subsequently used for reporting on the progress towards Millennium Development Goals. In signing these  international  agreements,  governments  committed  themselves  to  improve  conditions  for  their  children  and to monitor progress towards that end. UNICEF was assigned a supporting role in this task.  The Multiple Indicator Cluster Survey (MICS) facilitates the collection, preparation and analysis of national  data that constitute an in‐depth and up‐to‐date set of statistics on the well‐being of children in Suriname.  The data can be used as an  input  for national planning and exercise  that permit efforts  to monitor and  evaluate the achievement of the Millennium Development Goals.  This report  is the third MICS report for Suriname based on the fourth round of MICS. The first Suriname  MICS report was based on data collected  in 2000 while the second was based on data collected  in 2006.  This third report of the MICS has been informed by the fourth round of MICS which was executed in 2010.   The Ministry of Social Affairs and Housing wishes to acknowledge all contributed towards the Finalization  of  the Suriname MICS4 Report. Sincerest appreciation goes also  to key stakeholders,  in particular,  those  involved  in conducting the survey, preparing this report and publishing the results; from the fieldworkers  to  the  members  of  the  MICS  Technical  Steering  Committee,  UNICEF  Suriname  Country  Office,  UNICEF  Regional Office and UNICEF Headquarters.    October 2012,    The Minister of Social affairs and Housing  Drs. Alice Amafo, MSC    Executive Summary  xvi   Suriname MICS4  Executive Summary The Suriname Multiple Indicator Cluster Survey (MICS) which was carried out as part of the fourth round of  the global MICS household survey programme with the technical and financial support from UNICEF. MICS   is a nationally representative sample survey of   women aged 15‐49 and children under age  five of 7,407  responding households out of a total of 9,356 sampled households. The main purpose of MICS 2010  is to  support the government of Suriname to generate statistically sound and comparable data for monitoring  the situation of children and women in the country. MICS 4 covers topics related to nutrition, child health,  water and sanitation, reproductive health, child development, literary and education, child protection, HIV  and AIDS, mass media and  the use of  information and communication  technology and attitude  towards  domestic violence.  The results of this MICS reveal interesting similarities and differences between the rural interior area that  is  the principal  spatial domain of  the maroons and  indigenous peoples of Suriname, and  the urban and  rural coastal areas. More favourable outcomes are evident for indicators when reference is made to urban  spaces as opposed to the rural coastal area or the rural interior.  Nutrition  In MICS, weights and heights of all  children under 5 years of age were measured using anthropometric  equipment  recommended  by  UNICEF  (www.childinfo.org).  Findings  are  based  on  the  results  of  these  measurements. Almost 6 percent of children under age five are moderately or severely underweight (5.8  percent) and 1.3 percent are classified as severely underweight. Just under one tenth of children (9%) are  moderately or severely stunted or too short for their age and 5 percent are moderately or severely wasted  or too thin for their height. A higher prevalence of being overweight appears to be consistent with children  whose mothers have higher  levels of educational attainment. Whether underweight, stunted, wasted or  overweight, the data point to higher prevalence rates among boys when compared to girls.  45 percent of mothers are estimated to have initiated breastfeeding of their infants within the first hour of  birth while two  in the three (64%)  initiated such feeding within the first day. Whether within one day or  one hour, greater proportions of mothers from rural districts are observed to have initiated breastfeeding  within such time spans subsequent to their infants’ births when compared to corresponding proportions in  urban areas.   Just 3 percent of children aged  less than six months are exclusively breastfed, a  level considerably  lower  than  recommended. Girls were more  likely  to be  exclusively breastfed  than boys.  For  children under 2  years, more than a half of the children 8‐9 months or in older age groups are no longer breastfed.    Child health  About  83 percent of  children  age  18‐29 months  received  three doses of  the polio  vaccine  at  any  time  before the survey. As much as 91 percent had received at  least a first dose of the polio vaccine. HepB at  birth shows a prevalence of 39 percent of children age 18‐29 months vaccinated at any  time before  the  survey.  In rural communities, 64 percent of these children were  immunized for Yellow Fever before their  first birthday or at  some point prior  to  the  survey. With  respect  to  the vaccine against measles  (MMR),  MICS4 data  indicate that approximately 78 percent of children age18‐29 months were estimated to have  received the measles (MMR) vaccine.  Overall, approximately 10 percent of under  five  children had diarrhoea  in  the  two weeks preceding  the  survey. Diarrhoea prevalence rates were highest in Sipaliwini (13%), Brokopondo (13%) and Wanica (11%)  and  lowest  in Saramacca (6%). Similar rates ranging between 8 percent and 10 percent were observed  in  Executive Summary      Suriname MICS4  xvii the  remaining districts. 72 percent of  the children who were  reported as having diarrhoea  received oral  rehydration treatment. Children from rural districts appear more  likely to have received oral rehydration  treatment when compared to children from urban areas.  Two 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, almost 76 percent were taken to an appropriate provider. Just over a half of the children (51%) of  the children with suspected pneumonia were cared for  in a public sector government health centre. The  vast majority of children were cared for in government health centres in both urban and rural areas.   For Malaria  the  survey  results  relate  specifically  to  the  rural  interior  districts,  namely Brokopondo  and  Sipaliwini.   Almost  61  percent  of  households  have  at  least  one  insecticide  treated  net  and/or  received  indoor residual spraying in the last 12 months preceding the survey. 54 percent of children under the age  of five slept under any mosquito net the night prior to the survey and 43 percent slept under an insecticide  treated net. For pregnant women, 65% of them slept under any mosquito net the night prior to the survey  with a notably lower percentage indicating that they slept under an insecticide treated net.  Water and sanitation   Overall, 95 percent of the population  is using an  improved source of drinking water (99 percent  in urban  areas and 85 percent in rural areas). Compared to the other districts where there are negligible differences  in the proportion of population with  improved source of drinking water, markedly  lower proportions are  observed in Sipaliwini (64%). Ninety‐one  percent  of  the  population  of  Suriname  are  living  in  households  using  improved  sanitation  facilities. This percentage is 98 in urban areas and 71 percent in rural areas. For rural coastal and the rural  interior, the respective percentages are 93 and 42. Faeces of a little more than one fifth of all children 0‐2  years, is disposed of safely (22%). This is alarming especially since the disposal of faeces is safe for less than  one third of every sub‐population of children 0‐2 years.  A specific place  for handwashing was observed  in approximately 74 percent of  the households while 11  percent of all households could not indicate a specific place where household members usually wash their  hands  and  10  percent  of  the  households  did  not  give  any  permission  to  see  the  place  used  for  handwashing. Of those households where place for handwashing was observed, nearly 9 in every 10 (86%)  had both water and soap present at the designated place.   Reproductive Health  Current use of  contraception was  reported by 48 percent of women  currently married or  in union. The  most popular method is the pill which is used by one in four married women in Suriname. The next most  popular  method  is  female  sterilization,  which  accounts  for  11  percent  of  married  women.  Variable  proportions  ranging between  two and  five percent of women  reported use of  the  Intra‐uterine devices  (IUD),  injectables,  and  the  condom.  Less  than  one  percent  use  periodic  abstinence,  withdrawal,  male  sterilization, vaginal methods, or the Lactational Amenorrhea Method (LAM). Contraceptive prevalence  is  highest  in Commewijne at approximately 59%. Though  lower than  in Commewijne, similar magnitudes of  contraceptive prevalence are observed in Wanica (52%), Nickerie (54%) and Saramacca (54%).   Total unmet need  for  contraception  is highest  in  the  rural  interior amounting  to 33 percent. Total met  need  for contraception  is highest  in  rural coastal areas amounting  to 51 percent.  It  is worth noting  that  Sipaliwini  (43%),  Brokopondo  (43%)  and  Marowijne  (60%)  have  the  lowest  percentage  of  demand  for  contraception satisfied.   Executive Summary  xviii   Suriname MICS4  The vast majority of women obtained antenatal care from a doctor, nurse/midwife or a community health  worker,  the  respective proportions being 71 percent, 19 percent and 4 percent.   3 percent  received no  antenatal  care whatsoever.  In  the  rural  interior,  relatively  smaller proportions of women obtained  care  from  doctors  and  relatively  larger  proportions  obtained  care  from  community  health workers  than  are  observed to be the case in any of the other districts.  With respect to women giving birth in the year prior to the MICS survey, as much as 54 percent claimed to  have had such deliveries with assistance from a nurse/midwife while 36 percent claimed to have had such  assistance from doctors.  In the rural  interior, relatively small proportions of women claimed to have had  births  that were delivered by a doctor and  relatively  larger proportions claimed  to have had births  that  were delivered by community health workers when compared  to corresponding estimates  in any of  the  other districts.   92 percent of women 15‐49 with births  in the two years preceding the survey delivered their babies  in a  health facility; 72 percent of women delivered in public sector facilities and 20.8 percent in private sector  facilities. Only 4 percent of women delivered at home.   Child Development Around three quarter s (76 percent) of children aged 36‐59 months was attending pre‐school at the time of  the  survey. Urban‐rural  and district differentials  are  substantial –  the  figure  is  as high  as 44 percent  in  urban  areas,  compared  to  19  percent  in  rural  areas.  For  approximately  73  percent  of  children  36‐59  months, an adult has been engaged in four or more activities that promote learning and school readiness  during  the 3 days preceding  the  survey.  For  a  little more  than  a quarter  (25.9%) of  the  children 36‐59  months, fathers have been involved with one or more activities. A relatively high proportion of children 36‐ 59  months  have  not  been  living  with  their  natural  fathers,  this  proportion  being  in  the  vicinity  of  39  percent.  Leaving children alone or in the presence of other young children is known to increase the risk of accidents.  In  Suriname,  3  percent  of  children  aged  0‐59 months were  left  in  the  care  of  other  children, while  6  percent were left alone during the week preceding the interview. Combining the two care indicators, it is  calculated that 7 percent of children were left with inadequate care during the week preceding the survey.  The Early Child Development Index (ECDI) represents the percentage of children who are developmentally  on  track  in at  least  three of  four domains  (literacy‐numeracy, physical  socio‐emotional and  learning. 71  percent of children aged 36‐59 months were developmentally on track with the ECDI being  lower among  boys (63 percent) than girls (72 percent).   Education and literacy   92 percent of women 15‐24 years in the survey were literate.  Literacy rates in urban areas are higher than  those in rural areas being 96 percent and 80 percent respectively.  Overall, 76 percent of children attending the first grade of primary school were attending pre‐school the  previous  year.  Of  children  who  are  of  primary  school  entry  age  (age  6)  in  Suriname,  87  percent  are  attending the  first grade of primary school. The majority of children of primary school age are attending  school (95%). The primary school age children of the poorest households are estimated to have the lowest  school attendance rates (92%) when compared to children in each of the other wealth status groups.  Only 79 percent of the children that completed successfully the last grade of primary school were found at  the moment the survey to be attending the first grade of secondary school.        Executive Summary      Suriname MICS4  xix The gender parity  index  for primary  school  is close  to 1.00,  indicating  that  there  is no difference  in  the  attendance of  girls  and boys  to primary  school. With  respect  to  the  secondary  level,  the  gender parity  index  is 1.24 and  indicative of higher  school attendance at  the  secondary  level among girls  than among  boys.   Child Protection  Births of 99 percent of children under five years have been registered and there does not appear to be any  major variations in birth registration across sex, age, or education categories.  At  least 10 percent of  children 5‐14 years are engaged  in  child  labour  in Suriname. While  there are no  observed differences across the sexes, there are noteworthy variations across the districts and urban/rural  domains of Suriname.  In districts such as Sipaliwini, Brokopondo, Para and Marowijne, the prevalence of  child labour is observed to be at least equal to or greater than the national estimate of 10 percent. In the  remaining districts, the prevalence of child labour is estimated to be lower than the national estimate.   86 percent of children aged 2‐14 years were subjected  to at  least one  form of psychological or physical  punishment  by  their  mothers/caretakers  or  other  household  members.  12  percent  of  children  were  subjected to severe physical punishment.  13 percent of mothers/caretakers believed that children should  be physically punished.   Almost 6 percent of women 20‐49  years have been married before  their 15th birthday  and 23 percent  before  their  18th  birthday.  The  respective  proportions  are  greatest  in  Sipaliwini  (20%  and  50%)  and  Brokopondo  (11%  and  45%)  and  in  the  rural  interior  (19%  and  48%).  With  respect  to  spousal  age  difference, 15 percent of women 15‐19 years are estimated to be married or in union with a man who is at  least 10 years older.   Overall, 13 percent of the women 15‐49 years believe a husband is justified in beating his wife/partner for  any of the reasons mentioned  in the MICS study. With respect to the belief that a husband  is  justified  in  beating his wife/partner, this was mostly prevalent among women from Sipaliwini (27%) and Brokopondo  (30%).   In Suriname, as much as 56 percent of children 0‐17 years  lived with both parents while 29 percent  lived  with  their mothers  only  despite  the  fact  that  their  fathers were  alive.  Another  6  percent  consisted  of  children who lived with neither parent although both were alive. HIV and AIDS  98 percent of interviewed women 15‐49 years have heard of AIDS. However, the percentage that know of  two ways of preventing HIV transmission is 71 percent. Overall, 43 percent of women were found to have  comprehensive  knowledge of HIV prevention, which was markedly higher  in urban  areas  (47%)  than  in  rural coastal areas (37%), the rural interior (20%) and by extension rural areas (30%). While as much as 93  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 52 percent. Among women 15‐49 years, as much as 85 percent know a place where they can be tested for HIV, while  55 percent have actually been tested. A smaller proportion equivalent to 21 percent have been tested  in  the past 12 months and only 20 percent of those tested in the past 12 months have been told the result.   Among women 15‐49 years who had given birth within  the  two years preceding  the  survey, 91 percent  received antenatal care from a health care professional for their last pregnancy with just under a half (49%)  receiving HIV counselling while receiving antenatal care. During antenatal care, 82 percent were offered a  HIV test and tested for HIV. From the latter set of women, 80 percent had also received the results of their  test.  Executive Summary  xx   Suriname MICS4   55 percent of never married women 15‐24 years never had sex. In the rural coastal areas, a notably larger  proportion estimated to be 63 percent never had sex while in the rural interior the proportion is estimated  to be substantially lower being in the vicinity of 29 percent.  The MICS4 data for Suriname also show that 10 percent of women 15‐24 years had sex before their 15th  birthday. 15 percent of women 15‐24 years who had sex  in  the  last 12 months, had such an experience  with a man who was at least 10 years older.   Fifty‐nine percent of women 15‐24 years report having sex with a non‐regular partner  in  the 12 months  prior to the MICS with only 56 percent of such women claimed to have used a condom when they had such  an experience.   Access to Mass Media and use of Information/communication technology  At least once a week, 77 percent of women in Suriname read a newspaper, 84 percent listen to the radio  and  90  percent watch  television. Overall,  2  percent  do  not  have  regular  exposure  to  any  of  the  three  media, while 66 percent are exposed to all the three types of media at least on a weekly basis.  Moreover, 72 percent have used a  computer, 60 percent used  a  computer during  the  last  year and 46  percent used at  least once a week during the  last month. Overall, 57 percent of women age 15‐24 have  ever used the internet, while 49 percent have surfed the internet during the last year. Almost 4 in every 5  (79 percent) claimed  to have had a cellular phone  that worked. Smaller percentages  indicated  that  they  use  their  phones  to  make  or  receive  call  (69  percent),  to  send  text  messages  (58%),  to  receive  text  messages (60 percent) and to access the internet (9%).   Introduction      Suriname MICS4  1 1. Introduction Background The Multiple  Indicator Cluster Survey  (MICS)  is an  international household survey programme developed  by  the  United  Nations  Children’s  Fund  (UNICEF)  to  assist  countries  in  filling  data  gaps  for  monitoring  human  development  in  general  and  the  situation  of  children  and women  in  particular. MICS  data  are  critical when there  is  lack of continuous and updated disaggregated national data on specific groups and  districts to support evidence‐based planning. The survey  is based,  in  large part, on the needs to monitor  progress towards goals and targets emanating from international agreements: The Millennium Declaration,  adopted by all 191 United Nations Member States  in September 2000, and the Plan of Action of A World  Fit For Children, adopted by 189 Member States at the United Nations Special Session on Children in May  2002. Both of these commitments build upon promises made by the international community at the 1990  World  Summit  for Children.   MICS was originally developed  in  response  to  the 1990 World  Summit  for  Children (WSC) to collect statistically sound, internationally comparable estimates of key indicators used to  assess  the  situation  of  children  and  women  in  the  areas  of  health,  education,  child  protection,  and  HIV/AIDS. MICS indicators enable the monitoring and the measurement of progress towards national goals  and  global  commitments  aimed  at  promoting  the  welfare  of  children,  including  among  others,  the  Millennium Development Goals (MDGs).   The first round of MICS was conducted around 1995 in more than 60 countries. The second round of MICS  was conducted in 2000 followed by the third round in 2006 contributing to an increasing wealth of data to  monitor the situation of children and women.   As part of the global effort to increase the availability of high quality data, UNICEF launched the 4th round  of MICS  (MICS4)  in  2009, with  results  available  from  2010  onwards.  The  increased  frequency  of MICS  rounds helps countries to capture rapid changes in key indicators as the MDG target year 2015 approaches  and aims to expand the evidence‐base for policies and programs.   Since the  inception of MICS, two survey rounds have been carried out  in Suriname:  In 2000 (MICS2) and  2006 (MICS3). This report is based on the fourth round of MICS that was conducted in 2010 by the Ministry  of  Social  Affairs  and Housing, General  Bureau  of  Statistics  (GBS),  and  the  Institute  for  Social  Research  (IMWO) of the University of Suriname.  The MICS of 2006 enabled Suriname to present data on the different goals and objectives that were set in  the international and regional action plans. The Situation Assessment and Analysis of Children in Suriname  (SITAN 2010)2 which is an analysis of achievements in the fulfilment of children’s rights in Suriname against  the guiding framework of the MDGs and the Convention on the Rights of the Child (CRC) is a clear example  of the use of the MICS survey data.  In accordance with international agreements, governments 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 box below).                                                               2 See: Situation Assessment and Analysis of Children's Rights in Suriname 2010  http://undpsuriname.org/index.php?option=com_content&view=article&id=135:situation‐assessment‐and‐analysis‐ of‐childrens‐rights‐in‐suriname‐2010  Introduction  2 Suriname MICS4  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 achieved:   “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.”    Since  its  commitments  to  the  implementation  of  the  CRC  in  1993,  the Government  of  the  Republic  of  Suriname has planned, executed, and evaluated programs to set and improve the basic conditions for the  implementation of  the CRC.  In  this  regard,  the UN Committee on  the Rights of  the Child was  informed  through the Initial Report for the period 1995‐2000 and the Second Country Report, which was presented  in 2007. The recommendations of the UN  for 2000 and 2007 are  interpreted  into a  feasible and realistic  Child Action Plan for the period 2009‐2013. The combined third and fourth country progress report on the  implementation of the CRC will soon be submitted to the Board of Ministers for approval. To this extent, a  permanent monitoring mechanism  for  the Action Plan  for Children will be  installed. The MICS 2010 will  provide useful input for this monitoring mechanism. The MICS allows not only generation of disaggregated  data merely  for  international  reporting, but  is one of  the  key data  sets used by  governments, UNICEF,  other UN agencies, and stakeholders to monitor the achievement of the rights of children and women as  defined  in the CRC and the Convention on the Elimination of All  forms of Discrimination against Women  (CEDAW). Therefore, the findings of the MICS4 survey will enable the government of Suriname to prepare  and evaluate national progress towards goals set  in the Millennium   Declaration and monitor goals set  in  national policies  such as  the Development Plan 2012‐2016 and  the United Nations Development Action  Plan 2012‐2016 (UNDAP).  As agreed  in the UNDAP, the United Nations  in Suriname will support the Government of Suriname  in  its  goal to strengthen its statistical and information systems and its capacity to analyse and interpret the data  for policy formulation and dissemination. The Government has prioritized the 'optimal use of technical, as  well  as  financial  assistance,  through  coherent  planning  and  close monitoring'. Data  collection,  analysis,  information  systems,  and  effective  dissemination  are  needed  to  inform  and  monitor  evidence‐based  policies,  legislative  initiatives, and programming.  In order to monitor the situation of children, efforts are  being made to strengthen the monitoring and evaluation capacity at various levels of implementation. The  Introduction      Suriname MICS4  3 MICS 2006 data have been entered  in  the DEVINFO based data  storage  system: SURINFO. DEVINFO  is a  harmonized system to store, organize, and disseminate disaggregated data to serve as a monitoring tool.  SURINFO will be updated with MICS 2010 data and data from other national sources. The General Bureau  of  Statistics  of  Suriname  is  leading  the  process  to make  SURINFO  accessible  for  policymakers  and  line  ministers for evidence based policy formulation and evaluation of programs.  This final report presents the results of the indicators and topics covered in the survey.  Survey Objectives The 2010 Suriname Multiple Indicator Cluster Survey has as its primary objectives:   To provide up‐to‐date information for assessing the situation of children and women in Suriname;   To  furnish  data  needed  for  monitoring  progress  toward  goals  established  in  the  Millennium  Declaration and other internationally agreed upon goals, as a basis for future action;   To contribute to the improvement of data and monitoring systems in Suriname and to strengthen  technical expertise in the design, implementation, and analysis of such systems.   To generate data on the situation of children and women, including the identification of vulnerable  groups and of disparities, to inform policies and interventions.  Sample and Survey Methodology  4 Suriname MICS4  2. Sample and Survey Methodology Sample Design The sample for the Suriname MICS was designed to provide estimates for a large number of indicators on  the situation of children and women at the national level, for urban, rural coastal and rural interior areas,  and representative for different country levels.  Suriname  is  located on  the northern coast of South America.  It  is bordered  in  the north by  the Atlantic  Ocean,  in  the south by Brazil,  in  the east by French Guyana and  in  the west by Guyana. Topographically  there is a subdivision of the country in the coastal lowlands, the savannah and the highlands in the south  with its tropical rainforest. Approximately 90% of the population, estimated at 493,000 during the Seventh  Population  and Housing Census  in 2004,  lives  in  the  coastal  lowland bordering  the Atlantic Ocean.  The  population density of 3.0 per square kilometre (km2) is among the lowest in South America. The population  density in the coastal area is 17.2/km2, while in the highlands it is approximately 2.9/km2.   The country is divided into ten districts: Paramaribo, Wanica, Nickerie, Coronie, Saramacca, Commewijne,  Marowijne,  Para,  Brokopondo,  and  Sipaliwini  and  62  ‘sub‐districts’  by  law.  The  ‘sub‐districts’  are  sub‐ divisions at the district level. For purposes of conducting the fieldwork during the Seventh Population and  Housing Census  in 2004, the General Bureau of Statistics sub‐divided each sub‐district  in the coastal area  (lowland  and  savannah)  into  enumeration  ‘blocks’.  An  enumeration  ‘block’  is  considered  to  be  a  manageable workload  for a census enumerator  for the  fieldwork period of two weeks and would  ideally  have between 100 and 150 households. In the interior, a somewhat different fieldwork approach was used  due  to  the  geographical  spread  of  villages  to  the  extent  that  teams  consisting  of  5‐7  fieldworkers  canvassed  clusters  of  villages.  These  clusters  are  enumeration  areas  and  were  expected  to  have  approximately 500 households, or the workload of 5 enumerators.   The MICS 2010 sample was selected based on the sample frame from the 2004 census. Based up on this  sample, GBS conducted a specific listing exercise in the field, in order to result in the final MICS clusters for  fieldwork.   In the ten districts of Suriname, three settlement types form the basis for the establishment of  strata that ought to reflect geographical spaces that are more  likely to be  internally homogeneous when  found within the same settlement type but and different when found in different settlement types.  According to settlement types, three strata can be distinguished across the ten districts of Suriname:   An urban stratum.   A rural stratum in the coastal area.   A rural stratum in the interior.  Urban  areas  include  Paramaribo,  Wanica,  Nickerie  (Nw.  Nickerie),  and  Commewijne  (Meerzorg  and  Tamanredjo). Rural Interior areas include Brokopondo and Sipaliwini while rural Coastal areas include the  remainder of Nickerie, the remainder of Commewijne, Coronie, Saramacca, Para, and Marowijne.   The three strata or classes were identified as the main sampling domains and the sample was selected in  two stages meaning that a sample of enumeration blocks were selected in a first stage of selection in each  of the three strata systematically with probability proportion to size. This was followed by a second stage  of selection in which a sample of clusters was selected within the enumeration blocks selected in the first  stage. In accordance with the MICS4 guidelines3, clusters consisted of between 20 and 30 households.  The                                                               3 See www.childinfo.org/mics4_manual.html for the MICS4 Manual.  Sample and Survey Methodology      Suriname MICS4  5 actual  sample  selection  in  the  selected  clusters was  done  as  follows.  In  urban  and  rural  coastal  areas,  where enumeration districts  (EDs) usually  contain  about 150 households, one pointer address  (PA) was  selected at random within the ED. If  it was not the address of a private household, the next address was  taken as the starting point. Twenty adjacent addresses (1 to 20) were then selected around this PA, and a  printed map provided to each team, showing the location of each address. In rural areas the enumeration  areas might  consist of either one village or  several  smaller villages  combined. Where a village was very  isolated,  it  was  treated  as  one  enumeration  area,  even  though  sometimes  it  did  not  contain  many  households.Prior  to  the  start  of  the  MICS4  fieldwork,  cartography  personnel  of  the  GBS  undertook  fieldwork activities  in order to establish as much as possible  (with the exception of the  interior stratum)  the  landmarks  and  the  boundaries  of  each  selected  MICS‐cluster.  This  was  required  to  facilitate  the  interview  teams  in  the  field  with  maps  and  clearly  defined  boundaries.  The  interview  teams  received  during  the  fieldwork  the  instructions  to  gather  information on  each household  encountered within  the  boundaries  of  designated  MICS‐clusters.  For  the  Interior  stratum  where  it  is  relatively  difficult  to  geographically divide each enumeration block  into clusters of households, names of heads of households  were used to select households that were sampled.   The  sample  is  not  self‐weighting  meaning  that  the  sampling  rate  for  households  in  districts  such  as  Sipaliwini  and Brokopondo were higher  than  those  in other districts.  In  reporting national  level  results,  sample weights are used. A more detailed description of the sample design can be found in Appendix A.  Questionnaires MICS questionnaires are designed  in a modular  fashion  that can be easily customized  to  the needs of a  country. 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),  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 questionnaire, administered  to mothers or caretakers  for all children under 5  living  in  the  household.  The Standard MICS Questionnaires4 were revised, adapted, and customized to country specific conditions  and translated into Dutch. The pre‐test of these modified questionnaires was done in June 2010. Based on  the  results of  the pre‐test  the Questionnaires were  finalized  for  the  actual  fieldwork  ensuring  that  the  customized and  translated questionnaires were comparable  to  standard MICS questionnaires. A copy of  the Suriname MICS questionnaires is provided in the Appendix.  The Household Questionnaire included the following modules:   Household Listing Form   Education   Water and Sanitation   Household Characteristics   Insecticide Treated Nets (in Brokopondo and Sipaliwini only)   Indoor Residual Spraying (in Brokopondo and Sipaliwini only)   Child Labour   Child Discipline   Handwashing                                                               4 See www.childinfo.org/mics4_questionnaire.html for the standard MICS4 Questionnaires.  Sample and Survey Methodology  6 Suriname MICS4  The Questionnaire  for  Individual Women was administered  to all women aged 15‐49 years  living  in  the  households, and included the following modules:   Woman’s Background   Access to Mass Media and Use of Information/Communication Technology   Desire For Last Birth   Illness Symptoms   Maternal and Newborn Health   Illness Symptoms   Contraception   Unmet Need   Attitudes Towards Domestic Violence   Marriage/Union   Sexual Behaviour   HIV/AIDS  The Questionnaire for Children Under Five was administered to mothers or caretakers of children under 5  years  of  age5  living  in  the  households.  Normally,  the  questionnaire  was  administered  to  mothers  of  children  under‐5,  while  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:   Age   Birth Registration   Early Childhood Development   Breastfeeding   Care of Illness   Malaria (in Brokopondo and Sipaliwini only)   Immunization (Yellow Fever in Brokopondo and Sipaliwini only)   Anthropometry  In addition to the administration of questionnaires, fieldwork teams observed the place for handwashing  and  measured  the  weights  and  heights  of  children  age  under  5  years.  Details  and  findings  of  these  measurements are provided in the respective sections of the report.  The questionnaires  included very  few non‐standard MICS questions, such as on women’s ownership and  use of cell phones, as well as a further question to mothers of children under 5 whose child’s birth had not  been registered.  It should be noted that the Malaria related modules and questions were only administered in Brokopondo  and Sipaliwini. The same approach was used on vaccination against Yellow Fever.                                                               5 The terms “children under 5”, “children age 0‐4 years”, and “children aged 0‐59 months” are used interchangeably  in this report.  Sample and Survey Methodology      Suriname MICS4  7 Training and Fieldwork Training  for  the  fieldwork  was  conducted  for  11  days  in  July  2010.  Training  included  lectures  on  interviewing techniques, 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 part of  the  second  week practicing interviewing skills.  The  data  were  collected  by  12  teams;  eight  consisting  of  six  persons  (1  supervisor,  1  editor  and  4  interviewers)  and  four  consisting  of  five  persons  (1  supervisor,  1  editor  and  3  interviewers).  Fieldwork  began in July 2010 and concluded in September 2010.   For the anthropometry module, the supervisor was responsible for the measurements. This constitutes a  deviation  from  the  recommended MICS4 guidelines which  require  the existence of a separate dedicated  measurer in each team to enhance the quality of the anthropometric data collected in the field.    Data Processing Data were entered using the CSPro software. The data were entered on 6 microcomputers and carried out  by 15 data entry operators on a shift system basis and one data entry supervisor. 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 MICS4 programme  and  adapted  to  the  Suriname questionnaire were used throughout. Data processing began simultaneously with data collection  in July 2010 and was completed early January 2011. Data were analysed using the Statistical Package for  Social Sciences (SPSS) software program and the model tabulation syntax developed by UNICEF facilitated  the generation of the estimates.  Sample Coverage and the Characteristics of Households and Respondents  8 Suriname MICS4  3. Sample Coverage and the Characteristics of Households and Respondents Sample Coverage Of the 9,356 households selected for the sample, 8,532 were found to be occupied. Successful interviews  were conducted in 7,407 of the 8,532 occupied households resulting in a household response rate of 86.8  percent.  In  the  interviewed households, 7,237 women  (age 15‐49) were  identified. Of  these, 6,290 were  successfully  interviewed, yielding a  response  rate of 86.9 percent.  In addition, 3,462 children under age  five  were  listed  in  the  household  questionnaire.  Questionnaires  were  completed  for  3,308  of  these  children, which corresponds to a response rate of 95.6 percent. Overall response rates of 75.5 and 83.0 are  calculated for the women’s and under‐5’s interviews respectively (Table HH.1, page 9)  In  the  rural  interior,  virtually  all  of  the  sampled  households  were  occupied  (99.3%)  with  respective  proportions of 99.8 percent and 99.2 percent  in Brokopondo and Sipaliwini. The proportions of sampled  households that were occupied were lowest in Wanica (86.3%) and Coronie (86.5%). Household response  rates  are  expressed  as  the  percentage  of  occupied  households  in  which  interviews  were  successfully  conducted  and  were  highest  in  Sipaliwini  (93.8%)  and  Brokopondo  (90.5%)  being  lowest  in  Coronie  (76.2%). In the remaining districts, household response rates ranged between 83.4 percent in Commewijne  and 89.7 percent  in Nickerie. While  there  is not much difference between the household response rates  between  urban  communities  and  those  in  rural  coastal  areas  being  84.4  percent  and  85.6  percent  respectively, markedly higher household response rates are evident in the rural interior (93.0%).   A wide variety of  issues contributed  to  the  low  response  rates  recorded countrywide at household  level  among which absent household members was the dominant. This will  inform  future surveys. Please also  note  that  the  actual number of  interviewed households,  individual women,  and  children under  five  for  Coronie is so low that only few results could be produced for the district. Unfortunately the sample design  did not  include oversampling of district with  low population. This  should be addressed  in  future  sample  designs in Suriname, as not only Coronie was affected by a low absolute sample.  Characteristics of Households The age and sex distribution of the survey population is provided in Table HH.2 (page 10). The distribution  is  also  used  to  produce  the  population  pyramid  in  Figure  HH.1  (page  11).  In  the  7,407  households  successfully  interviewed  in  the  survey,  28,421  household members were  listed. Of  these,  14,021 were  males, and 14,398 were females.   Using  data  from  the  2004  Population  and  Housing  Census  in  Suriname,  the  population  size  was  disaggregated by age and  sex  in accordance with  the  following age group  categories: 0‐14 years, 15‐64  years and 65 years or older. Males in the respective age groups constitute 15.0 percent, 31.7 percent and  2.8 percent. Corresponding  figures  for  females are 14.8 percent, 31.8 percent and 3.2 percent. A similar  age sex distribution is generated using the data from the 2010 Suriname MICS and reveal that males 0‐14  years, 15‐64 years and 65 years or older constitute 15.6 percent, 30 percent and 2.9 percent of the total  population with corresponding estimates for the female population being 14.3 percent, 32.3 percent and  3.7 percent (calculations not shown). Despite the time lapse between the national census in 2004 and the  2010 MICS,  the  age‐sex distribution of  the population  reflected  in  the  context of  the  2010 MICS  seem  consistent  with  population  dynamics  associated  with  expected  temporal  changes  in  components  that  facilitate changes in population sizes. Whether in the context of the 2004 Population and Housing Census  or the 2010 MICS, less than 1 percent of the total population constituted males or females for whom age  was not known. As such, the  low proportion of missing  information  is not expected to seriously threaten  the quality of observations pertaining to age and sex based on the 2010 MICS.  Sa m pl e C ov er ag e a nd  th e C ha ra ct er ist ic s o f H ou se ho ld s a nd  Re sp on de nt s          Su rin am e M IC S4 9   Ta bl e H H .1 : R es ul ts o f h ou se ho ld , w om en 's , a nd u nd er -5 in te rv ie w s N um be r o f h ou se ho ld s, w om en , a nd c hi ld re n un de r 5 b y re su lts o f t he h ou se ho ld , w om en 's , a nd u nd er -5 's in te rv ie w s, a nd h ou se ho ld , w om en 's , a nd u nd er -5 's re sp on se ra te s, S ur in am e, 2 01 0 A re a D is tr ic t To ta l U rb an R ur al P ar am ar ib o W an ic a N ic ke rie C or on ie S ar am ac ca C om m ew ijn e M ar ow ijn e P ar a B ro ko po nd o S ip al iw in i R ur al C oa st al R ur al In te rio r To ta l R ur al H ou se ho ld s S am pl ed 4, 24 3 3 ,0 95 2 ,0 18 5, 11 3 2 ,9 05 1 ,0 13 9 77 1 41 6 08 5 52 5 65 5 77 4 84 1 ,5 34 9, 35 6 O cc up ie d 3, 76 3 2 ,7 65 2 ,0 04 4, 76 9 2 ,6 12 8 74 8 80 1 22 5 29 5 01 5 19 4 91 4 83 1 ,5 21 8, 53 2 In te rv ie w ed 3, 17 6 2 ,3 67 1 ,8 64 4, 23 1 2 ,1 84 7 57 7 89 9 3 4 45 4 18 4 46 4 11 4 37 1 ,4 27 7, 40 7 H ou se ho ld re sp on se ra te 8 4. 4 8 5. 6 9 3. 0 8 8. 7 8 3. 6 8 6. 6 8 9. 7 7 6. 2 8 4. 1 8 3. 4 8 5. 9 83 .7 9 0. 5 9 3. 8 8 6. 8 W om en E lig ib le 3, 28 2 2 ,3 29 1 ,6 26 3, 95 5 2 ,1 97 8 56 7 60 6 4 4 20 4 04 4 85 4 25 3 87 1 ,2 39 7, 23 7 In te rv ie w ed 2, 78 8 2 ,0 36 1 ,4 66 3, 50 2 1 ,8 36 7 49 6 69 5 8 3 75 3 52 4 25 3 60 3 31 1 ,1 35 6, 29 0 W om en 's re sp on se ra te 8 4. 9 8 7. 4 9 0. 2 8 8. 5 8 3. 6 8 7. 5 8 8. 0 9 0. 6 8 9. 3 8 7. 1 8 7. 6 84 .7 8 5. 5 9 1. 6 8 6. 9 W om en 's o ve ra ll re sp on se ra te 7 1. 7 7 4. 8 8 3. 9 7 8. 6 6 9. 9 7 5. 8 7 8. 9 6 9. 1 7 5. 1 7 2. 7 7 5. 3 70 .9 7 7. 4 8 5. 9 7 5. 5 C hi ld re n un de r 5 E lig ib le 1, 05 3 9 76 1 ,4 33 2, 40 9 6 76 3 13 2 30 2 3 1 46 1 25 3 33 1 83 3 55 1 ,0 78 3, 46 2 M ot he rs /c ar et ak er s in te rv ie w ed 9 93 9 32 1 ,3 83 2, 31 5 6 34 2 95 2 23 2 2 1 40 1 19 3 18 1 74 3 33 1 ,0 50 3, 30 8 U nd er -5 's re sp on se ra te 9 4. 3 9 5. 5 9 6. 5 9 6. 1 9 3. 8 9 4. 2 9 7. 0 9 5. 7 9 5. 9 9 5. 2 9 5. 5 95 .1 9 3. 8 9 7. 4 9 5. 6 U nd er -5 's o ve ra ll re sp on se ra te 7 9. 6 8 1. 7 8 9. 8 8 5. 3 7 8. 4 8 1. 6 8 6. 9 7 2. 9 8 0. 7 7 9. 4 8 2. 1 79 .6 8 4. 9 9 1. 4 8 3. 0 Sample Coverage and the Characteristics of Households and Respondents  10 Suriname MICS4  Table HH.2: Household age distribution by sex Percent and frequency distribution of the household population by five-year age groups, dependency age groups, and by child (age 0-17 years) and adult populations (age 18 or more), by sex, Suriname, 2010 Males Females Missing Total Number Percent Number Percent Number Percent Number Percent Age 0-4 1,458 10.4 1,450 10.1 1 40.5 2,908 10.2 5-9 1,460 10.4 1,352 9.4 0 0.0 2,812 9.9 10-14 1,519 10.8 1,276 8.9 0 0.0 2,795 9.8 15-19 1,133 8.1 1,299 9.0 0 0.0 2,433 8.6 20-24 1,132 8.1 1,210 8.4 0 0.0 2,341 8.2 25-29 1,047 7.5 1,160 8.1 0 0.0 2,206 7.8 30-34 871 6.2 947 6.6 0 0.0 1,818 6.4 35-39 925 6.6 985 6.8 0 0.0 1,910 6.7 40-44 904 6.4 945 6.6 0 0.0 1,849 6.5 45-49 914 6.5 915 6.4 0 0.0 1,830 6.4 50-54 656 4.7 711 4.9 0 0.0 1,366 4.8 55-59 525 3.7 588 4.1 0 0.0 1,113 3.9 60-64 430 3.1 431 3.0 0 29.8 862 3.0 65-69 293 2.1 367 2.5 0 0.0 660 2.3 70-74 253 1.8 303 2.1 0 29.8 556 2.0 75-79 171 1.2 187 1.3 0 0.0 358 1.3 80-84 70 0.5 113 0.8 0 0.0 183 0.6 85+ 49 0.3 84 0.6 0 0.0 133 0.5 Missing/DK 213 1.5 75 0.5 0 0.0 288 1.0 Dependency age groups 0-14 4,437 31.6 4,078 28.3 1 40.5 8,516 30.0 15-64 8,537 60.9 9,191 63.8 0 29.8 17,728 62.4 65+ 835 6.0 1,054 7.3 0 29.8 1,889 6.6 Missing/DK 213 1.5 75 0.5 0 0.0 288 1.0 Child and adult populations Children age 0-17 years 5,118 36.5 4,823 33.5 1 40.5 9,941 35.0 Adults age 18+ years 8,690 62.0 9,500 66.0 1 59.5 18,192 64.0 Missing/DK 213 1.5 75 0.5 0 0.0 288 1.0 Total 14,021 100.0 14,398 100.0 1 100.0 28,421 100.0   Table HH.2 shows the age‐sex structure of the household population. The proportions in child, working and  old‐age age groups  (0–14, 15–64 and 65 years and over)  in  the household population of  the sample are  30.0, 62.4 and 6.6 percent, respectively  Table HH.3  (page 12) provides basic background  information on  the households. Within households,  the  sex of the household head, district, urban/rural status, number of household members, and ethnic 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 A, page 178). 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. In accordance  with the MICS sample, households are predominantly male‐headed (64%). The largest ethnic group among  heads  of  households  is  Indian  (Hindustani,  descendants  of  India)  at  28  percent  with  the  next  highest  proportion being headed by  someone who  is a Maroon  (22%). The MICS  sample also estimates  that 20  Sample Coverage and the Characteristics of Households and Respondents      Suriname MICS4 11 percent of households are headed by a Creole person and 15 percent being headed by someone who  is  Javanese.  Figure HH.1: Age and sex distribution of household population, Suriname, 2010   At 20 percent, a  four member household  is  the most common size of households. However, 13 percent  consist of persons living alone while 2 percent have at least 10 persons. These figures also indicate that the  survey estimated the average household size at 3.8.  A  little more than half of all of the households (52%) are headed by someone who attained a secondary‐ level education or higher with another 31 percent being headed by someone attaining education only up  to the primary‐level.  Almost  half  (49%)  of  households  are  located  in  Paramaribo.  Wanica  accounted  for  17  percent  of  the  households in Suriname while Nickerie accounted for 8 percent. Almost 5 percent of the households were  located  in  Commewijne  while  similar  proportions  of  just  over  3  percent  were  located  in  Saramacca,  Marowijne, and Para. Less  than one percent of all households were  located  in Coronie. Consistent with  Suriname’s predominantly urban profile, 72 percent of all households are in areas classified as being urban.  Please  note  the  small  number  of  cases  with  “Missing/DK”  in  background  characteristic  ‘Ethnicity  of  household head’. As this characteristic is used throughout the report and indicator value for “Missing/DK”  is required to be suppressed consistently, the tables in the report presenting this background characteristic  for  households  do  not  include  the  ‘Missing/DK’  category  or,  in  other  words,  the  row  is  suppressed.  Whenever this approach is applied to a table, a note is presented below the table. The implication of this  approach is that the denominator sum will not add up to the total denominator in such tables.      8 6 4 2 0 2 4 6 8 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Percent Figure HH.1: Age and sex distribution of household population, Suriname, 2010 Females Males Sample Coverage and the Characteristics of Households and Respondents  12 Suriname MICS4  Table HH.3: Household composition Percent and frequency distribution of households by selected characteristics, Suriname, 2010 Weighted percent Number of households Weighted Unweighted Sex of household head Male 63.5 4,700 4,573 Female 36.5 2,707 2,833 Missing 0.0 0 1 District Paramaribo 49.1 3,640 2,184 Wanica 17.2 1,275 757 Nickerie 7.6 563 789 Coronie 0.7 51 93 Saramacca 3.3 244 445 Commewijne 4.9 359 418 Marowijne 3.1 226 446 Para 3.3 243 411 Brokopondo 2.5 186 437 Sipaliwini 8.4 619 1,427 Area Urban 71.6 5,301 3,176 Rural Coastal 17.6 1,300 2,367 Rural interior 10.9 806 1,864 Total Rural 28.4 2,106 4,231 Number of household members 1 13.1 971 1,039 2 17.4 1,288 1,230 3 18.3 1,354 1,283 4 19.5 1,447 1,367 5 12.8 946 982 6 8.7 644 668 7 4.2 313 354 8 2.3 169 196 9 1.4 104 121 10+ 2.3 171 167 Education of household head None 10.8 800 1,293 Primary 30.8 2,281 2,526 Secondary + 52.3 3,875 3,158 Other/Non-standard 1.4 107 85 Missing/DK 4.6 344 345 Ethnicity of household head Indigenous/Amerindian 3.7 271 408 Maroon 21.5 1,594 2,454 Creole 19.5 1,447 1,060 Hindustani 27.9 2,069 1,775 Javanese 14.5 1,072 988 Mixed 10.5 777 587 Others 2.3 172 126 Missing/DK 0.1 6 9 Total 100.0 7,407 7,407 Households with at least One child age 0-4 years 28.5 7,407 7,407 One child age 0-17 years 58.2 7,407 7,407 One woman age 15-49 years 71.2 7,407 7,407 Mean household size 3.8 7,407 7,407 Sample Coverage and the Characteristics of Households and Respondents      Suriname MICS4 13 Characteristics of Female Respondents 15-49 Years of Age and Children Under-5 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 (page 14) provides background characteristics of female respondents 15‐49 years of age. The  table  includes  information  on  the  distribution  of  women  according  to  district,  urban‐rural  areas,  age,  marital status, motherhood status, education6, wealth  index quintiles7, and ethnicity. The distribution of  women  15‐49  years  by  background  characteristics  such  as  district,  area  (urban/rural),  and  ethnicity  of  household head is very similar to corresponding distributions observed in the context of households. While  just over  70 percent of  these women  attained  at  least  secondary‐level  education  (71%),  corresponding  proportions attaining at most a primary level education or no education whatsoever are observed to be 21  percent and 6 percent, respectively.   Among  the  15‐49  year  old  women,  the  largest  group  is  aged  15‐19  years  (17%)  with  corresponding  proportions  following  a  generally  downward  trend  in  successive  five‐year  age  groups.  The  smallest  proportion  amounting  to  12  percent  were  age  45‐49  years.  In  accordance  with  the  MICS  sample,  the  proportion of women in each of the wealth quintile groups is inversely related to wealth quintile with the  highest proportion in the wealthiest quintile (21%) and the lowest proportion in the poorest quintile (18%).  More than half of the women 15‐49 years in the MICS sample were currently married or in a common‐law  relationship (54%) compared to 32 percent that were never married or never in a union. Some 10 percent  were  separated  with  substantially  smaller  proportions  being  either    divorced  (2%)  or  widowed  (1%).  Almost two thirds of the women (65%) had given birth in their life and 17 percent indicated that they had a  birth in the past two years.                                                               6Unless otherwise stated, “education” refers to educational level attended by the respondent throughout this report  when it is used as a background variable.  7 Principal components analysis was performed by using information on the ownership of consumer goods, dwelling  characteristics, water and sanitation, and other characteristics that are related to the household’s wealth to assign  weights (factor scores) to each of the household assets. Each household was then assigned a wealth score based on  these weights and the assets owned by that household. The survey household population was then ranked according  to the wealth score of the household they are living in, and was finally divided into 5 equal parts (quintiles) from  lowest (poorest) to highest (richest). The assets used in these calculations were as follows: persons per sleeping  room, type of floor, type of roof, type of wall, type of cooking fuel, other household assets namely: electricity, radio,  television, mobile telephone, non‐mobile telephone, refrigerator, computer, washing machine, ownership of a watch,  bicycle, motor cycle/scooter, car/truck, boat with motor, source of drinking water, and type of sanitary facility. 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. 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 Filmer, D. and Pritchett, L., 2001. “Estimating wealth effects without expenditure data – or  tears: An application to educational enrolments in states of India”. Demography 38(1): 115‐132. Gwatkin, D.R.,  Rutstein, S., Johnson, K. , Pande, R. and Wagstaff. A., 2000. Socio‐Economic Differences in Health, Nutrition, and  Population. HNP/Poverty Thematic Group, Washington, DC: World Bank. Rutstein, S.O. and Johnson, K., 2004. The DHS  Wealth Index. DHS Comparative Reports No. 6. Calverton, Maryland: ORC Macro.   Sample Coverage and the Characteristics of Households and Respondents  14 Suriname MICS4    Table HH.4: Women's background characteristics Percent and frequency distribution of women age 15-49 years by selected background characteristics, Suriname, 2010 Weighted percent Number of women Weighted Unweighted District Paramaribo 48.3 3,037 1,836 Wanica 19.9 1,252 749 Nickerie 7.5 471 669 Coronie 0.5 31 58 Saramacca 3.2 198 375 Commewijne 4.7 296 352 Marowijne 3.3 208 425 Para 3.3 205 360 Brokopondo 2.1 132 331 Sipaliwini 7.3 461 1,135 Area Urban 73.5 4,620 2,788 Rural Coastal 17.1 1,077 2,036 Rural interior 9.4 593 1,466 Total Rural 26.5 1,670 3,502 Age 15-19 17.2 1,085 1,088 20-24 15.8 991 965 25-29 15.5 972 991 30-34 13.0 816 838 35-39 13.5 852 856 40-44 13.2 831 839 45-49 11.8 743 713 Marital/Union status Currently married/in union 54.1 3,406 3,470 Widowed 1.1 72 78 Divorced 2.4 153 133 Separated 10.0 630 750 Never married/in union 31.8 1,998 1,825 Missing 0.5 32 34 Motherhood status Ever gave birth 64.8 4,078 4,343 Never gave birth 34.7 2,180 1,926 Missing 0.5 32 21 Births in last two years Had a birth in last two years 16.9 1,060 1,265 Had no birth in last two years 82.6 5,198 5,004 Missing 0.5 32 21 Education None 5.7 361 718 Primary 21.2 1,335 1,683 Secondary + 71.0 4,463 3,785 Other/Non-standard 1.8 111 85 Missing/DK 0.3 21 19     Sample Coverage and the Characteristics of Households and Respondents      Suriname MICS4 15 Table HH.4: Women's background characteristics (continued) Weighted percent Number of women Weighted Unweighted Wealth index quintile Poorest 17.8 1,117 1,981 Second 19.6 1,231 1,199 Middle 20.3 1,276 1,079 Fourth 21.1 1,328 1,064 Richest 21.3 1,339 967 Ethnicity of household head Indigenous/Amerindian 3.9 246 372 Maroon 24.0 1,510 2,178 Creole 16.8 1,056 762 Hindustani 29.4 1,851 1,613 Javanese 13.8 870 783 Mixed 9.9 621 475 Others 2.1 131 100 Missing/DK 0.1 5 7 Total 100.0 6,290 6,290 Please  note  the  small  number  of  cases  with  “Missing/DK”  in  background  characteristics  ‘Education  of  women’ and  ‘Ethnicity of household head’. As  these characteristics are used  throughout  the  report and  indicator  values  for  “Missing/DK”  are  required  to  be  suppressed  consistently,  the  tables  in  the  report  presenting these background characteristics  for women do not  include the  ‘Missing/DK’ categories or,  in  other words, the rows are suppressed. Whenever this approach  is applied to a table, a note  is presented  below the table. The implication of this approach is that the denominator sum will not add up to the total  denominator in such tables.  Some background characteristics of children under 5 years are presented  in Table HH.5 (page 16). These  include  distribution  of  children  by  several  attributes:  sex,  district,  area,  age  in  months,  mothers  (or  caretaker’s) education, wealth, and ethnicity. The sex composition  is  indicative of an even split between  the sexes with males marginally outnumbering females. The largest group of children were 12‐23 months  (23%)  while  the  smallest  proportion  were  children  under  6  months  (9%).  If,  however,  the  ages  were  distributed  in accordance with 12‐month age groups, children under 5 years will virtually be distributed  evenly, though with the smallest group being age 48‐59 months (18%).  More than half of the children under 5 years reside  in the two districts of Paramaribo (39%) and Wanica  (18%). The rural  interior consisting of Sipaliwini  (16%) and Brokopondo (5%) accounted for  just over one  fifth of all children under 5 years. Nickerie and Marowijne each accounted  for almost 6 percent, but the  smallest  proportion  is  evident  in  Coronie  (0.4%).  Although  the majority  of  children  live  in  urban  areas  (61%),  a  comparison with  the national distribution of  the population by urban/rural  areas  suggest  that  children under age 5 constitute a noteworthy proportion of persons living in rural communities.  A high proportion of children are born  in households headed by a Maroon (42%). Although the group of  Hindustanis constitute  the  largest share of  the national population,  just about 20 percent of all children  under 5 years live in households headed by a  Hindustani. Relatively lower proportions of children under 5  years live in households headed by Creole (13%) and Javanese (11%) persons. More than a half of children  under age 5 were born  to mothers who had at  least a  secondary‐level education  (55%). As much as 14  percent were born to mothers who had no education whatsoever. The MICS sample is consistent with an  inverse relationship between wealth  index quintile groups and the proportion of children  in the different  quintiles. A little more than one third (34%) of the children were in the poorest wealth quintile while a little  more than one tenth were in the wealthiest quintile group (13%).  Sample Coverage and the Characteristics of Households and Respondents  16 Suriname MICS4  Table HH.5: Under-5's background characteristics Percent and frequency distribution of children under five years of age by selected characteristics, Suriname, 2010 Weighted percent Number of under-5 children Weighted Unweighted Sex Male 50.1 1,659 1,644 Female 49.8 1,649 1,663 Missing 0.0 1 1 District Paramaribo 38.5 1,274 634 Wanica 18.1 599 295 Nickerie 5.7 188 223 Coronie 0.4 14 22 Saramacca 2.8 91 140 Commewijne 3.7 122 119 Marowijne 5.8 192 318 Para 3.7 122 174 Brokopondo 5.1 167 333 Sipaliwini 16.2 537 1,050 Area Urban 60.5 2,001 993 Rural Coastal 18.2 603 932 Rural interior 21.3 705 1,383 Total Rural 39.5 1,307 2,315 Age 0-5 months 8.6 286 304 6-11 months 10.9 360 351 12-23 months 22.5 744 711 24-35 months 19.3 640 657 36-47 months 21.0 694 699 48-59 months 17.7 584 586 Mother’s education* None 13.7 454 728 Primary 29.2 967 1,157 Secondary + 55.1 1,824 1,375 Other/Non-standard 1.4 48 35 Missing/DK 0.5 16 13 Wealth index quintile Poorest 34.4 1,139 1,758 Second 20.4 675 564 Middle 17.0 563 401 Fourth 15.2 501 327 Richest 13.0 429 258 Ethnicity of household head Indigenous/Amerindian 4.6 153 215 Maroon 42.0 1,389 1,860 Creole 12.9 428 267 Hindustani 19.5 644 480 Javanese 10.5 346 250 Mixed 9.3 308 207 Others 1.1 38 24 Missing/DK 0.1 3 5 Total 100.0 3,308 3,308 * Mother's education refers to educational attainment of mothers (or caretakers) of children under 5.   Sample Coverage and the Characteristics of Households and Respondents      Suriname MICS4 17 Please  note  the  small  number  of  cases  with  “Missing”,  “Missing/DK”  or  “Others”  in  background  characteristics  ‘Sex’,  ‘Mother’s education’ and  ‘Ethnicity of household head’. As  these characteristics are  used throughout the report and indicator values for “Missing’, “Missing/DK” and “Others” are required to  be  suppressed  consistently,  the  tables  in  the  report  presenting  these  background  characteristics  for  children  under  age  five  do  not  include  these  categories  or,  in  other  words,  the  rows  are  suppressed.  Whenever this approach is applied to a table, a note is presented below the table. The implication of this  approach is that the denominator sum will not add up to the total denominator in such tables.  Children’s Living Arrangements and Orphans Table HH.6 (page 18) presents information on the  living arrangements and orphanhood status of children  under age 18. As much as 56 percent of children 0‐17 years lived with both parents while 29 percent lived  with their mothers only despite the fact that their fathers were alive. Another 6 percent of children  lived  with neither parent although both were alive.  In total, 8 percent of children did not  live with a biological  parent and 5 percent had lost one or both parents. As the wealth of households increase, the likelihood of  the child living with both parents increase. As many as 38 percent of children from the poorest households  lived  only with their mother, despite their father being alive. Saramacca and Nickerie stand out among the  districts, where 79 percent of children  live with both parents. At  the other end of  the scale,  in Coronie,  Brokopondo,  and  Sipaliwini,  less  than  half  of  children  live with  both  their  parents. Over  10  percent  of  children in these three districts do not live with a biological parent.   Due  to  the  low  prevalence  (0.4%)  of  orphans,  that  is  children whose mother  and  father  have  died,  in  Suriname,  it  is not possible to produce the standard MICS table comparing school attendance of orphans  and non‐orphans age 10‐14. However, as  it  is part of an MDG  indicator,  the percentage of non‐orphans  who are attending school should be mentioned: 97%.  Sa m pl e C ov er ag e a nd  th e C ha ra ct er ist ic s o f H ou se ho ld s a nd  Re sp on de nt s  18 Su rin am e M IC S4      Ta bl e H H .6 : C hi ld re n' s liv in g ar ra ng em en ts a nd o rp ha nh oo d P er ce nt d is tri bu tio n of c hi ld re n ag e 0- 17 y ea rs a cc or di ng to li vi ng a rr an ge m en ts , p er ce nt ag e of c hi ld re n ag e 0- 17 y ea rs in h ou se ho ld s no t l iv in g w ith a b io lo gi ca l p ar en t a nd p er ce nt ag e of ch ild re n w ho h av e on e or b ot h pa re nt s de ad , S ur in am e, 2 01 0 Li vi ng w ith bo th pa re nt s Li vi ng w ith n ei th er p ar en t Li vi ng w ith m ot he r o nl y Li vi ng w ith fa th er o nl y Im po ss ib le to de te rm in e To ta l N ot li vi ng w ith a bi ol og ic al pa re nt 1 O ne or bo th pa re nt s de ad 2 N um be r of ch ild re n ag e 0- 17 ye ar s O nl y fa th er al iv e O nl y m ot he r al iv e B ot h al iv e B ot h de ad Fa th er al iv e Fa th er de ad M ot he r al iv e M ot he r de ad Se x* M al e 56 .4 0. 6 0. 7 5. 6 0. 4 28 .7 2. 4 2. 6 0. 4 2. 2 10 0. 0 7. 3 4. 5 5, 11 8 Fe m al e 56 .0 0. 8 0. 4 7. 0 0. 3 28 .4 2. 5 1. 8 0. 5 2. 4 10 0. 0 8. 5 4. 6 4, 82 3 D is tr ic t P ar am ar ib o 51 .2 0. 9 0. 6 5. 3 0. 5 31 .0 3. 0 3. 7 0. 5 3. 3 10 0. 0 7. 2 5. 7 4, 05 0 W an ic a 62 .1 0. 6 0. 7 5. 5 0. 4 25 .3 1. 7 1. 2 0. 7 1. 9 10 0. 0 7. 2 4. 0 1, 80 4 N ic ke rie 78 .8 0. 6 1. 1 3. 1 0. 5 11 .0 2. 0 1. 4 0. 2 1. 3 10 0. 0 5. 3 4. 6 64 9 C or on ie 42 .7 1. 0 0. 0 13 .6 0. 0 39 .8 1. 9 1. 0 0. 0 0. 0 10 0. 0 14 .6 2. 9 56 S ar am ac ca 78 .9 0. 2 0. 4 3. 6 0. 0 9. 2 2. 9 2. 2 1. 1 1. 6 10 0. 0 4. 1 4. 5 30 4 C om m ew ijn e 72 .0 0. 4 0. 1 5. 6 0. 1 16 .2 1. 5 1. 1 0. 0 3. 0 10 0. 0 6. 3 2. 2 40 7 M ar ow ijn e 54 .6 0. 5 0. 6 8. 0 0. 0 30 .7 2. 1 1. 6 0. 4 1. 5 10 0. 0 9. 1 3. 6 52 4 P ar a 53 .3 0. 7 0. 7 8. 4 0. 1 31 .7 2. 0 1. 7 0. 4 1. 2 10 0. 0 9. 8 3. 8 45 1 B ro ko po nd o 46 .0 1. 0 0. 4 11 .5 0. 1 36 .8 2. 3 0. 6 0. 2 1. 0 10 0. 0 13 .0 4. 0 42 3 S ip al iw in i 47 .4 0. 4 0. 4 9. 5 0. 1 37 .6 2. 6 0. 4 0. 0 1. 4 10 0. 0 10 .5 3. 6 1, 27 3 A re a U rb an 55 .7 0. 8 0. 6 5. 2 0. 4 28 .5 2. 6 2. 7 0. 5 2. 9 10 0. 0 7. 1 5. 1 6, 32 4 R ur al C oa st al 65 .8 0. 4 0. 7 6. 4 0. 1 20 .9 2. 0 1. 9 0. 4 1. 4 10 0. 0 7. 6 3. 7 1, 92 2 R ur al in te rio r 47 .1 0. 6 0. 4 10 .0 0. 1 37 .4 2. 6 0. 5 0. 1 1. 3 10 0. 0 11 .1 3. 7 1, 69 5 To ta l R ur al 57 .0 0. 5 0. 5 8. 1 0. 1 28 .6 2. 3 1. 2 0. 3 1. 3 10 0. 0 9. 3 3. 7 3, 61 8 A ge 0- 4 61 .4 0. 3 0. 1 4. 0 0. 2 30 .6 0. 8 1. 2 0. 1 1. 3 10 0. 0 4. 6 1. 6 2, 90 8 5- 9 56 .3 0. 7 0. 4 6. 0 0. 2 29 .7 2. 1 2. 5 0. 5 1. 7 10 0. 0 7. 3 3. 9 2, 81 2 10 -1 4 54 .9 0. 8 0. 9 7. 4 0. 4 26 .8 3. 8 2. 6 0. 6 1. 8 10 0. 0 9. 6 6. 8 2, 79 5 15 -1 7 48 .0 1. 4 1. 2 9. 3 0. 6 25 .4 3. 9 3. 0 0. 6 6. 6 10 0. 0 12 .5 7. 7 1, 42 6     Sa m pl e C ov er ag e a nd  th e C ha ra ct er ist ic s o f H ou se ho ld s a nd  Re sp on de nt s          Su rin am e M IC S4 19   Ta bl e H H .6 : C hi ld re n' s liv in g ar ra ng em en ts a nd o rp ha nh oo d P er ce nt d is tri bu tio n of c hi ld re n ag e 0- 17 y ea rs a cc or di ng to li vi ng a rr an ge m en ts , p er ce nt ag e of c hi ld re n ag e 0- 17 y ea rs in h ou se ho ld s no t l iv in g w ith a b io lo gi ca l p ar en t a nd p er ce nt ag e of ch ild re n w ho h av e on e or b ot h pa re nt s de ad , S ur in am e, 2 01 0 Li vi ng w ith bo th pa re nt s Li vi ng w ith n ei th er p ar en t Li vi ng w ith m ot he r o nl y Li vi ng w ith fa th er o nl y Im po ss ib le to de te rm in e To ta l N ot li vi ng w ith a bi ol og ic al pa re nt 1 O ne or bo th pa re nt s de ad 2 N um be r of ch ild re n ag e 0- 17 ye ar s O nl y fa th er al iv e O nl y m ot he r al iv e B ot h al iv e B ot h de ad Fa th er al iv e Fa th er de ad M ot he r al iv e M ot he r de ad W ea lth in de x qu in til es P oo re st 46 .2 0. 8 0. 7 7. 8 0. 5 38 .0 2. 7 0. 9 0. 1 2. 3 10 0. 0 9. 8 4. 9 2, 89 9 S ec on d 56 .3 0. 4 0. 6 6. 4 0. 1 26 .8 2. 8 3. 1 0. 7 2. 8 10 0. 0 7. 5 4. 6 2, 16 7 M id dl e 59 .0 0. 6 0. 7 5. 6 0. 3 25 .3 2. 4 2. 8 0. 7 2. 7 10 0. 0 7. 1 4. 9 1, 75 6 Fo ur th 63 .6 1. 0 0. 2 5. 4 0. 6 23 .7 1. 8 2. 0 0. 5 1. 3 10 0. 0 7. 1 4. 2 1, 60 9 R ic he st 64 .2 0. 8 0. 6 5. 0 0. 1 21 .9 2. 3 2. 9 0. 1 2. 1 10 0. 0 6. 5 4. 0 1, 51 1 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 73 .0 0. 1 0. 4 5. 9 0. 4 15 .6 0. 8 2. 0 0. 9 0. 9 10 0. 0 6. 9 2. 7 53 6 M ar oo n 41 .3 0. 8 0. 7 8. 9 0. 5 40 .8 3. 0 1. 5 0. 1 2. 4 10 0. 0 10 .8 5. 1 3, 73 7 C re ol e 43 .7 0. 8 0. 6 5. 2 0. 2 40 .2 2. 5 3. 0 0. 5 3. 3 10 0. 0 6. 8 5. 0 1, 46 9 H in du st an i 78 .4 0. 8 0. 5 2. 7 0. 3 10 .3 2. 0 2. 4 0. 5 2. 0 10 0. 0 4. 3 4. 1 2, 13 5 Ja va ne se 72 .7 0. 1 0. 5 5. 1 0. 1 15 .7 0. 8 2. 5 0. 5 2. 1 10 0. 0 5. 7 2. 1 1, 07 1 M ix ed 53 .3 1. 3 0. 7 8. 0 0. 4 26 .1 4. 4 2. 9 1. 0 2. 0 10 0. 0 10 .4 7. 8 84 7 O th er s 74 .0 0. 0 0. 0 0. 3 0. 0 18 .4 1. 2 3. 6 0. 0 2. 4 10 0. 0 0. 3 1. 2 13 8 To ta l 56 .2 0. 7 0. 6 6. 3 0. 3 28 .5 2. 5 2. 2 0. 4 2. 3 10 0. 0 7. 9 4. 6 9, 94 1 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns 1 M IC S in di ca to r 9 .1 7 2 M IC S in di ca to r 9 .1 8 Nutrition  20 Suriname MICS4   4. Nutrition   Nutrition      Suriname MICS4 21 Nutritional Status Children’s  nutritional  status  is  a  reflection  of  their  overall  health.  When  children  have  access  to  an  adequate food supply, are not exposed to repeated illness, and are well cared for, they reach their growth  potential and are considered well nourished.  Malnutrition is associated with more than half of all child deaths worldwide. Undernourished children are  more likely to die from common childhood ailments, 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. A reduction in the prevalence of malnutrition will also 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 based on the WHO growth standards8. 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 classified as severely wasted. Wasting  is usually the result of a  recent nutritional deficiency. The indicator may exhibit significant seasonal shifts associated with changes  in the availability of food or disease prevalence.   In MICS, weights and heights of all  children under 5 years of age were measured using anthropometric  equipment recommended by UNICEF (www.childinfo.org). Findings in this section are based on the results  of these measurements.   Table NU.1 (page 24) 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 above 2 standard deviations from the median of the reference population, and mean z‐scores for  all three anthropometric indicators.  Children whose full birth date (month and year) were not obtained, and children whose measurements are  outside a plausible range are excluded  from Table NU.1. Children are excluded  from one or more of the  anthropometric indicators when their weights and heights have not been measured, whichever applicable.                                                               8 http://www.who.int/childgrowth/standards/second_set/technical_report_2.pdf   Nutrition  22 Suriname MICS4  For example if a child has been weighed but his/her height has not been measured, the child is included in  underweight calculations, but not  in the calculations for stunting and wasting. Percentages of children by  age and reasons for exclusion are shown in the data quality tables DQ.6 and DQ.7 in Appendix D. Overall 13  percent of children did not have both weights and heights measured (Table DQ.6, page 210). Table DQ.7  (page 211) shows  that due  to  incomplete dates of birth,  implausible measurements, and missing weight  and/or height, 15 percent of children have been excluded from calculations of the weight‐for‐age indicator,  while the figures are 19 percent for the height‐for‐age indicator, and 19 percent for the weight‐for‐height  indicator.  Such  relatively  high  rates  of  excluded  children  warrant  cautious  interpretation  of  the  anthropometric indicators.  The MICS shows that almost 6 percent of children under age five  in Suriname are moderately or severely  underweight (5.8 percent) and 1.3 percent are classified as severely underweight. Just under one tenth of  children (9%) are moderately or severely stunted (too short for their age) and 5 percent are moderately or  severely wasted (too thin for their height).   Figure NU.1: Percentage of children under age 5   Wasting prevalence  is  lowest  in  rural  interior areas, but,  in  contrast,  stunting prevalence  is  significantly  higher, mainly driven by 17 percent moderate and  severe stunting  in Sipaliwini. High stunting  levels are  also seen among children of mothers with no education and  in the poorest wealth quintile at 17 and 13  percent, respectively. Considering the caution necessary with this data and the confidence  intervals they  carry, no further observations seem appropriate.  With  reference  to  Figure NU.1  above, undernourishment  is  assessed  children  less  than  6 months,  6‐11  months, 12‐23 months, 24‐35 months, 36‐47 months and 48‐59 months. For children aged 12‐23 months  or  in an older age group, stunting prevalence  is greater  than underweight and wasting prevalence. With  regard to stunting, the highest prevalence rates are observed among children 12‐23 months and declines  markedly  among  children  in  each  of  the  successive  age  groups.  With  regard  to  being  underweight  or  0 2 4 6 8 10 12 14 0 6 12 18 24 30 36 42 48 54 60 Pe rc en t Age (in months) Figure NU.1: Percentage of children under age 5 who are underweight, stunted, and wasted, Suriname, 2010 Underweight Stunted Wasted Nutrition      Suriname MICS4 23 wasted, there appears to be little or no differences in prevalence rates between children in age groups 12‐ 23 months or older age groups.  Breastfeeding and Infant and Young Child Feeding 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.   WHO/UNICEF have the following feeding recommendations:   Exclusive breastfeeding for first six months   Continued breastfeeding for two years or more    Safe and age‐appropriate 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 related to recommended child feeding practices are as follows:   Early initiation of breastfeeding (within 1 hour of birth)   Exclusive breastfeeding rate (< 6 months)   Predominant breastfeeding (< 6 months)   Continued breastfeeding rate (at 1 year and at 2 years)   Duration of breastfeeding   Age‐appropriate breastfeeding (0‐23 months)   Introduction of solid, semi‐solid and soft foods (6‐8 months)   Minimum meal frequency (6‐23 months)   Milk feeding frequency for non‐breastfeeding children (6‐23 months)   Bottle feeding (0‐23 months)    Table  NU.2  (page  26)  provides  the  proportion  of  children  born  in  the  last  two  years  who  were  ever  breastfed, those who were first breastfed within one hour and one day of birth, and those who received a  prelacteal  feed.  These  practices  are  very  important  step  in  the  management  of  lactation  and  the  establishment of a physical and emotional  relationship between  the baby and  the mother. Figure NU.2  (page 27)  is  illustrative of  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). Whether within one day or one hour, greater proportions of mothers from rural  districts such as Sipaliwini (81% and 63%), Para (79% and 53%), Brokopondo (74% and 63%) and Nickerie  (77% and 53%) are observed  to have  initiated breastfeeding within such  time spans subsequent  to  their  infants’ births when compared to corresponding proportions in urban areas such as Paramaribo (52% and  36%) and Wanica (64% and 43%). At the national level, approximately 45 percent of mothers responded to  have  initiated breastfeeding of their  infants within  the  first hour of birth while as much as 64%  initiated  such feeding within the first day.  N ut rit io n  24 Su rin am e M IC S4     Ta bl e N U .1 : N ut rit io na l s ta tu s of c hi ld re n P er ce nt ag e of c hi ld re n un de r a ge 5 b y nu tri tio na l s ta tu s ac co rd in g to th re e an th ro po m et ric in di ce s: w ei gh t f or a ge , h ei gh t f or a ge , a nd w ei gh t f or h ei gh t, S ur in am e, 2 01 0 W ei gh t f or a ge N um be r of ch ild re n un de r ag e 5 H ei gh t f or a ge N um be r of ch ild re n un de r ag e 5 W ei gh t f or h ei gh t N um be r of ch ild re n un de r ag e 5 U nd er w ei gh t M ea n Z- S co re (S D ) St un te d M ea n Z- S co re (S D ) W as te d O ve rw ei gh t M ea n Z- S co re (S D ) pe rc en t b el ow pe rc en t b el ow pe rc en t b el ow pe rc en t ab ov e - 2 S D 1 - 3 S D 2 - 2 S D 3 - 3 S D 4 - 2 S D 5 - 3 S D 6 + 2 S D Se x M al e 6. 2 1. 1 -0 .4 1, 43 9 9. 9 2. 6 -0 .5 1, 37 6 5. 7 0. 9 5. 0 -0 .1 1, 37 0 Fe m al e 5. 3 1. 4 -0 .3 1, 43 2 7. 6 1. 8 -0 .4 1, 36 9 4. 2 0. 8 3. 0 -0 .2 1, 35 5 A re a U rb an 5. 6 1. 1 -0 .3 1, 77 5 6. 8 2. 0 -0 .3 1, 69 2 5. 0 0. 8 4. 3 -0 .2 1, 67 8 R ur al C oa st al 7. 2 1. 8 -0 .4 52 5 8. 8 1. 8 -0 .4 50 0 6. 9 1. 1 4. 9 -0 .2 49 6 R ur al in te rio r 5. 1 1. 1 -0 .5 57 0 14 .9 3. 1 -0 .8 55 2 3. 1 0. 6 2. 2 -0 .1 55 1 To ta l R ur al 6. 1 1. 4 -0 .5 1, 09 5 12 .0 2. 5 -0 .6 1, 05 2 4. 9 0. 8 3. 5 -0 .1 1, 04 7 D is tr ic t P ar am ar ib o 5. 6 1. 1 -0 .2 1, 11 8 5. 8 1. 9 -0 .2 1, 06 7 5. 0 0. 8 4. 2 -0 .1 1, 05 3 W an ic a 5. 6 1. 5 -0 .4 54 2 9. 7 2. 7 -0 .5 52 2 5. 1 0. 8 5. 4 -0 .2 52 2 N ic ke rie 8. 3 1. 5 -0 .4 17 4 5. 9 0. 8 -0 .3 16 7 9. 2 1. 2 4. 8 -0 .3 16 4 C or on ie (* ) (* ) (* ) 14 (* ) (* ) (* ) 14 (* ) (* ) (* ) (* ) 14 S ar am ac ca 4. 8 0. 8 -0 .5 82 6. 8 0. 8 -0 .5 77 5. 1 0. 0 5. 1 -0 .3 77 C om m ew ijn e 8. 9 0. 6 -0 .5 10 4 5. 9 0. 7 -0 .3 90 13 .2 4. 4 2. 9 -0 .6 90 M ar ow ijn e 5. 1 2. 6 -0 .3 16 5 9. 1 2. 7 -0 .5 15 9 2. 7 0. 4 4. 6 0. 0 15 7 P ar a 6. 9 1. 4 -0 .4 10 1 11 .8 2. 2 -0 .5 96 3. 6 0. 7 2. 9 -0 .2 96 B ro ko po nd o 5. 7 0. 4 -0 .4 12 4 7. 5 1. 2 -0 .6 12 7 3. 3 0. 8 3. 3 -0 .2 12 3 S ip al iw in i 4. 9 1. 3 -0 .5 44 6 17 .1 3. 7 -0 .9 42 5 3. 1 0. 6 1. 9 0. 0 42 9 A ge 0- 5 m on th s 11 .0 2. 8 -0 .3 24 5 9. 4 6. 6 -0 .3 22 8 5. 4 1. 9 6. 5 -0 .1 21 5 6- 11 m on th s 5. 8 1. 6 -0 .2 32 4 5. 7 1. 3 0. 1 31 3 8. 6 1. 9 3. 8 -0 .2 31 3 12 -2 3 m on th s 5. 8 0. 9 -0 .3 67 0 12 .0 1. 9 -0 .5 62 8 3. 9 0. 3 5. 5 -0 .1 62 6 24 -3 5 m on th s 5. 1 0. 6 -0 .4 53 7 9. 1 3. 1 -0 .6 50 6 4. 9 1. 3 4. 0 -0 .1 50 7 36 -4 7 m on th s 5. 0 1. 9 -0 .5 58 2 8. 4 1. 8 -0 .6 56 5 3. 7 0. 2 3. 8 -0 .2 55 9 48 -5 9 m on th s 4. 8 0. 7 -0 .5 51 2 6. 6 0. 8 -0 .4 50 5 5. 4 0. 7 1. 4 -0 .4 50 6     N ut rit io n          Su rin am e M IC S4 25 Ta bl e N U .1 : N ut rit io na l s ta tu s of c hi ld re n (c on tin ue d) P er ce nt ag e of c hi ld re n un de r a ge 5 b y nu tri tio na l s ta tu s ac co rd in g to th re e an th ro po m et ric in di ce s: w ei gh t f or a ge , h ei gh t f or a ge , a nd w ei gh t f or h ei gh t, S ur in am e, 2 01 0 W ei gh t f or a ge N um be r of ch ild re n un de r ag e 5 H ei gh t f or a ge N um be r of ch ild re n un de r ag e 5 W ei gh t f or h ei gh t N um be r of ch ild re n un de r ag e 5 U nd er w ei gh t M ea n Z- S co re (S D ) St un te d M ea n Z- S co re (S D ) W as te d O ve rw ei gh t M ea n Z- S co re (S D ) pe rc en t b el ow pe rc en t b el ow pe rc en t b el ow pe rc en t ab ov e - 2 S D 1 - 3 S D 2 - 2 S D 3 - 3 S D 4 - 2 S D 5 - 3 S D 6 + 2 S D M ot he r’s e du ca tio n* N on e 4. 4 0. 8 -0 .5 37 0 17 .0 5. 6 -0 .9 35 7 2. 4 0. 3 2. 2 -0 .1 35 7 P rim ar y 7. 2 1. 8 -0 .4 85 7 10 .6 2. 5 -0 .5 81 7 6. 0 1. 3 2. 4 -0 .2 80 9 S ec on da ry + 5. 2 1. 1 -0 .3 1, 58 6 6. 0 1. 3 -0 .3 1, 51 4 5. 1 0. 7 5. 0 -0 .2 1, 50 3 O th er /N on -s ta nd ar d (1 1. 4) (0 .0 ) (-0 .2 ) 41 (4 .9 ) (0 .0 ) (-0 .3 ) 41 (4 .9 ) (0 .0 ) (4 .9 ) (0 .0 ) 41 W ea lth in de x qu in til e P oo re st 6. 2 1. 6 -0 .5 94 9 13 .4 3. 4 -0 .7 90 2 4. 0 1. 0 3. 1 -0 .1 90 0 S ec on d 5. 6 1. 1 -0 .4 60 7 8. 3 1. 2 -0 .4 58 3 6. 5 0. 7 2. 4 -0 .2 57 9 M id dl e 5. 2 1. 3 -0 .2 50 0 5. 1 1. 5 -0 .2 48 2 6. 0 1. 1 6. 0 -0 .2 47 7 Fo ur th 6. 9 1. 2 -0 .3 44 4 6. 6 2. 7 -0 .3 42 4 5. 2 1. 1 4. 6 -0 .2 42 2 R ic he st 4. 2 0. 5 -0 .2 37 0 5. 5 1. 1 -0 .2 35 3 3. 5 0. 0 5. 6 -0 .1 34 7 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 4. 5 1. 8 -0 .1 13 9 12 .1 3. 6 -0 .6 12 8 1. 8 0. 0 4. 9 0. 3 12 8 M ar oo n 4. 4 1. 1 -0 .4 1, 15 9 11 .1 2. 8 -0 .6 1, 11 9 3. 7 1. 1 3. 4 -0 .1 1, 11 3 C re ol e 6. 3 1. 1 -0 .3 38 3 3. 5 0. 6 -0 .1 36 2 4. 5 0. 7 4. 7 -0 .2 35 8 H in du st an i 9. 1 1. 8 -0 .6 58 7 5. 6 1. 7 -0 .3 56 3 9. 3 0. 8 2. 6 -0 .5 56 1 Ja va ne se 7. 0 1. 9 -0 .5 29 1 11 .9 2. 3 -0 .7 26 7 5. 3 0. 5 6. 3 -0 .1 26 3 M ix ed 2. 8 0. 2 -0 .1 27 9 9. 2 2. 6 -0 .2 27 2 2. 7 0. 7 6. 5 0. 1 27 0 O th er s (* ) (* ) (* ) 32 (* ) (* ) (* ) 32 (* ) (* ) (* ) (* ) 32 To ta l 5. 8 1. 3 -0 .4 2, 87 0 8. 8 2. 2 -0 .4 2, 74 4 5. 0 0. 8 4. 0 -0 .2 2, 72 6 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 2 .1 a an d M D G in di ca to r 1 .8 2 M IC S in di ca to r 2 .1 b 3 M IC S in di ca to r 2 .2 a 4 M IC S in di ca to r 2 .2 b 5 M IC S in di ca to r 2 .3 a 6 M IC S in di ca to r 2 .3 b Nutrition  26 Suriname MICS4    Table NU.2: Initial breastfeeding Percentage of last-born children in the 2 years preceding the survey who were ever breastfed, percentage who were breastfed within one hour of birth and within one day of birth, and percentage who received a prelacteal feed, Suriname, 2010 Percentage who were ever breastfed1 Percentage who were first breastfed: Percentage who received a prelacteal feed Number of last-born children in the two years preceding the survey Within one hour of birth2 Within one day of birth District Paramaribo 88.1 35.8 51.9 53.1 430 Wanica 92.1 43.0 64.0 46.5 191 Nickerie 91.2 52.7 77.2 52.6 61 Coronie (*) (*) (*) (*) 4 Saramacca 91.2 43.9 70.2 54.4 30 Commewijne 86.2 43.8 62.5 45.0 44 Marowijne 87.9 42.4 66.7 40.2 65 Para 92.4 53.0 78.8 53.0 38 Brokopondo 94.7 63.2 74.4 62.4 53 Sipaliwini 94.7 62.8 81.4 37.8 146 Area Urban 89.1 39.2 56.6 50.9 668 Rural Coastal 90.6 44.9 70.9 48.5 193 Rural interior 94.7 62.9 79.5 44.3 199 Total Rural 92.7 54.0 75.3 46.4 392 Months since last birth 0-11 months 92.3 41.7 62.5 50.8 509 12-23 months 88.7 47.5 64.4 47.7 551 Assistance at delivery Skilled attendant 91.2 44.7 63.5 49.8 982 Traditional birth attendant 93.4 51.4 75.9 47.2 57 Place of delivery Public sector health facility 90.5 43.9 62.5 49.7 758 Private sector health facility 94.3 48.5 66.1 52.1 220 Home 90.0 52.2 76.2 41.9 41 Other/Missing 69.3 31.5 55.4 32.5 41 Mother’s education* None 94.9 61.0 77.2 38.8 125 Primary 87.5 49.4 63.7 48.0 305 Secondary + 91.0 38.9 60.6 51.9 609 Other/Non-standard (*) (*) (*) (*) 16 Wealth index quintile Poorest 91.1 54.8 73.7 43.4 341 Second 87.3 42.9 56.1 51.5 212 Middle 88.8 39.7 64.0 45.7 200 Fourth 92.8 31.1 50.3 54.0 167 Richest 93.1 46.1 64.9 59.1 141 Ethnicity of household head* Indigenous/Amerindian 85.3 52.0 70.3 36.5 50 Maroon 91.7 53.3 70.9 45.9 429 Creole 90.7 25.0 48.4 51.4 131 Hindustani 90.8 43.0 59.2 54.0 216 Javanese 86.6 34.1 57.4 47.7 111 Mixed 90.5 43.0 62.0 55.7 104 Others (*) (*) (*) (*) 20 Total 90.4 44.7 63.5 49.2 1,060 * ‘Missing/DK’ categories not shown due to low number of observations (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 2.4 2 MICS indicator 2.5 Nutrition      Suriname MICS4 27 Figure NU.2: Percentage of mothers who started breastfeeding within one hour and within one day of birth, Suriname, 2010   In Table NU.3 (page 28), breastfeeding status  is based on the reports of mothers/caretakers of children’s  consumption  of  food  and  fluids  during  the  previous  day  or  night  prior  to  the  interview.  Exclusively  breastfed  refers  to  infants  who  received  only  breast  milk  (and  vitamins,  mineral  supplements,  or  medicine). The table shows exclusive breastfeeding of infants during the first six months of life, as well as  continued breastfeeding of children at 12‐15 and 20‐23 months of age.   Only about  three percent of  children aged  less  than  six months are exclusively breastfed. By age 12‐15  months,  23  percent of  children  are  still being  breastfed  and  by  age  20‐23 months,  15  percent  are  still  breastfed. Girls were more  likely  to be exclusively breastfed  than boys. This  is also  true with  respect  to  continued breastfeeding whether by age 12‐15 month or 20‐23 months. While there are other interesting  observations  to make,  caution  is  advised  due  to  a  limited  number  of  observations  and  therefore  large  confidence  intervals on  estimates. However,  there  is  an  interesting dynamic  to note  in  the urban/rural  disaggregation, where the urban children have  less chance of breastfeeding exclusively or predominantly  at the young age, but that the opposite holds true for continued breastfeeding at age 2. It would seem that  fewer urban women choose to breastfeed, but that those who do breastfeed continue to do so.   According  to  Figure NU.3  (page 29),  it  is estimated  that 6 percent of  children  are exclusively breastfed  among  those  in  their  first  two months of  life. Among  those  in  their  fourth and  fifth months,  less  than 1  percent (0.8%) was exclusively breastfed. Figure NU.3 also shows that approximately 6 in every 10 infants  in their first two months are breastfed and given milk or formula. This is observed to be the case for nearly  7 in every 10 infants 2‐3 months old. There appears to be consecutive increases in the proportion of infants  who are breastfed and given solid food among infants in successive two‐month age groups comprising the  first  year  of  life.  While  the  proportion  among  infants  in  their  first  two  years  of  life  is  0.6  percent,  it  increased  to  21  percent  among  infants  6‐7  months  and  32  percent  among  those  10‐11  months.  For  52 64 77 70 63 67 79 74 81 57 71 80 75 64 36 43 53 44 44 42 53 63 63 39 45 63 54 45 0 10 20 30 40 50 60 70 80 90 100 Pe rc en t Figure NU.2: Percentage of mothers who started breastfeeding within one hour and within one day of birth, Suriname, 2010 Within one day Within one hour Nutrition  28 Suriname MICS4  children under 2 years, more  than half of  the children 8‐9 months or  in older age groups are no  longer  breastfed.  Among  those  22‐23  months,  approximately  88  percent  were  no  longer  breastfeeding  thus  implying  that about 12 percent of  the  children had  still been breastfeeding while having  solid  food  just  before their second birthday.  Table NU.3: Breastfeeding Percentage of living children according to breastfeeding status at selected age groups, Suriname, 2010 Children age 0-5 months Children age 12-15 months Children age 20-23 months Percent exclusively breastfed1 Percent predominantly breastfed2 Number of children Percent breastfed (Continued breastfeeding at 1 year)3 Number of children Percent breastfed (Continued breastfeeding at 2 years)4 Number of children Sex Male 1.6 18.6 150 19.2 103 12.0 150 Female 4.0 18.1 136 26.8 88 17.5 163 District Paramaribo 1.8 10.7 113 (20.0) 80 15.8 115 Wanica (*) (*) 41 (*) 32 (17.1) 71 Nickerie (*) (*) 15 (*) 6 (*) 18 Coronie (*) (*) 1 (*) 1 (*) 1 Saramacca (*) (*) 8 (*) 8 (*) 7 Commewijne (*) (*) 7 (*) 7 (*) 15 Marowijne (2.4) (11.9) 25 (*) 13 (18.5) 16 Para (*) (*) 10 (*) 6 (*) 13 Brokopondo (4.5) (34.1) 22 (*) 9 (*) 11 Sipaliwini 2.3 40.7 44 39.2 26 6.6 47 Area Urban 1.3 10.1 159 17.2 117 17.8 204 Rural Coastal 6.4 18.1 61 26.8 39 12.2 53 Rural interior 3.1 38.5 66 36.3 35 7.1 57 Total Rural 4.7 28.7 127 31.3 74 9.5 110 Mother’s education None 1.3 28.9 39 (22.0) 30 3.5 44 Primary 5.6 20.4 76 30.5 58 20.2 95 Secondary + 1.9 15.6 165 18.5 100 15.2 167 Non-standard/ Missing/DK (*) (*) 6 (*) 3 (*) 8 Wealth index quintile Poorest 2.4 24.7 116 27.5 54 11.6 96 Second (3.0) (13.5) 39 (29.7) 48 (21.4) 62 Middle (1.3) (14.4) 51 (*) 28 (11.4) 59 Fourth (6.8) (14.7) 49 (*) 31 (18.8) 57 Richest (*) (*) 31 (*) 29 (*) 39 Ethnicity of household head* Indigenous/Amerindian (*) (*) 10 (*) 9 (*) 18 Maroon 1.2 24.2 137 27.8 67 4.6 134 Creole (*) (*) 35 (*) 25 (*) 38 Hindustani (4.0) (5.3) 49 (13.1) 45 (22.5) 68 Javanese (*) (*) 28 (*) 21 (*) 32 Mixed (*) (*) 24 (*) 16 (*) 20 Others (*) (*) 3 (*) 6 (*) 3 Total 2.8 18.4 286 22.7 191 14.9 313 * ‘Missing/DK’ category of ethnicity of household head not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 2.6 2 MICS indicator 2.9 3 MICS indicator 2.7 4 MICS indicator 2.8 Nutrition      Suriname MICS4 29 Figure NU.3: Infant feeding patterns by age, Suriname 2010   Table NU.4 (page 31) shows the median duration of breastfeeding by selected background characteristics.  Among  children under age 3,  the median duration  is 8.0 months  for any breastfeeding, 0.4 months  for  exclusive  breastfeeding,  and  0.5  months  for  predominant  breastfeeding.  With  respect  to  any  breastfeeding, girls were more  likely to have continued breastfeeding than boys. This  is also the case for  children who  living  in  the  rural  interior  as  opposed  to  rural  coastal  areas  or  urban  areas.  The median  duration of any breastfeeding was  longer among children whose mothers had no education than among  those whose mothers had higher levels of education, as well as for particularly the poorest wealth quintile.  The adequacy of infant feeding in children under 24 months is provided in Table NU.5 (page 32). Different  criteria  of  feeding  are  used  depending  on  the  age  of  the  child.  For  infants  aged  0‐5 months,  exclusive  breastfeeding is considered as age‐appropriate feeding, while infants aged 6‐23 months are considered to  be appropriately fed if they are receiving breast milk and solid, semi‐solid or soft food. As a result of these  feeding  patterns,  only  18  percent  of  children  aged  6‐23  months  are  being  appropriately  fed.  Age‐ appropriate  feeding among all  infants age 0‐5 months drops  to 3 percent. Whether 0‐5 months or 6‐23  months, girls are more likely to be adequately breastfed than boys and children from rural areas are more  likely to be adequately fed when compared to those from urban areas. There does not appear to be any  clear pattern of relationship associating the adequacy of  infant feeding  in children under 24 months with  either their mothers’ education or their wealth status.   Appropriate  complementary  feeding  of  children  from  6  months  to  two  years  of  age  is  particularly  important  for growth and development and  the prevention of under nutrition. Continued breastfeeding  beyond six months should be accompanied by consumption of nutritionally adequate, safe and appropriate  complementary  foods  that help meet nutritional  requirements when breast milk  is no  longer  sufficient.  This requires that for breastfed children, two or more meals of solid, semi‐solid or soft foods are needed if  they are six to eight months old, and three or more meals if they are 9‐23 months of age. For children 6‐23  Breastfed and other  milk / formula Breastfed and  complimentary foods Weaned (not  breastfed) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 0‐1 2‐3 4‐5 6‐7 8‐9 10‐11 12‐13 14‐15 16‐17 18‐19 20‐21 22‐23 Percent Age Figure NU.3: Infant feeding patterns by age, Suriname 2010 Exclusively breastfed Breastfed and plain water only Breastfed and non‐milk liquids Breastfed and other milk / formula Breastfed and complimentary foods Weaned (not breastfed) Nutrition  30 Suriname MICS4  months and older who are not breastfed, four or more meals of solid, semi‐solid or soft foods or milk feeds  are needed.  Overall, 47 percent of  infants’ age 6‐8 months received solid, semi‐solid, or soft foods (Table NU.6, page  33). Among currently breastfeeding infants this percentage is 41 while it is 53 among infants currently not  breastfeeding.   Table NU.7 (page 34) presents the proportion of children age 6‐23 months who received semi‐solid or soft  foods  the minimum number of  times or more during  the previous day according  to breastfeeding status  (see the note in Table NU.7 for a definition of minimum number of times for different age groups). Overall,  a  little  less than two‐thirds of the children age 6‐23 months (64 percent) were receiving solid, semi‐solid  and  soft  foods  the minimum number of  times. The disaggregated values  show  that while 70 percent of  urban and 73 percent of rural coastal children enjoy the minimum meal frequency, the percentage in the  rural  interior  is only 38. Large differences are also  found according  to mother’s education and wealth of  the household. Somewhat expected, the children of the higher educated and the wealthier are better off.  Interestingly, the percentage of children receiving the minimum meal frequency increases with age of the  child as well, ranging from 52 percent of children age 6‐8 months to 69 percent of 18‐23 month olds.   Looking  just  at  the  currently  breastfeeding  children  age  6‐23  months,  just  16  percent  of  them  were  receiving  solid,  semi‐solid  and  soft  foods  the  minimum  number  of  times.  Among  non‐breastfeeding  children, as much as 83 percent of the children were receiving solid, semi‐solid and soft foods or milk feeds  4  times  or  more.  As  above,  this  however  masks  large  discrepancies  with  poor  conditions  in  the  rural  interior, especially Sipaliwini where only 51 percent of non‐breastfeeding children enjoyed feeds 4 times or  more.  The continued practice of bottle‐feeding is a concern because of the possible contamination due to unsafe  water and lack of hygiene in preparation. Table NU.8 (page 35) shows that bottle‐feeding is still prevalent  in Suriname with 72 percent of children under 2 years being reported to be fed using a bottle with a nipple.  Greater percentages are observed among  children  from urban areas and  those  from  rural  coastal areas  than among those from the rural interior, at 78, 72, and 52 percent, respectively. Greater percentages can  also  be  observed  among  children  whose  mothers  had  higher  levels  of  educational  attainment,  the  respective percentages ranging between 58 percent among children whose mothers had no education and  76 percent among those whose mothers had at least a secondary school education.      Nutrition      Suriname MICS4 31 Table NU.4: Duration of breastfeeding Median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding among children age 0-35 months, Suriname, 2010 Median duration (in months) of Number of children age 0-35 months Any breastfeeding1 Exclusive breastfeeding Predominant breastfeeding Sex* Male 6.9 0.4 0.6 1,063 Female 10.5 0.4 0.5 966 District Paramaribo 5.7 0.4 0.5 788 Wanica 7.6 0.0 0.5 362 Nickerie 9.0 0.0 0.0 124 Coronie (*) (*) (*) 7 Saramacca 5.5 0.5 2.8 54 Commewijne 5.8 1.4 1.4 74 Marowijne 7.9 0.0 0.5 127 Para 6.5 0.0 0.6 72 Brokopondo 10.1 0.5 1.6 105 Sipaliwini 13.1 0.4 1.0 316 Area Urban 5.8 0.4 0.5 1,231 Rural Coastal 6.6 0.4 0.6 378 Rural Interior 12.6 0.4 1.3 421 Total Rural 10.4 0.4 0.7 799 Mother’s education None 11.4 0.4 1.4 267 Primary 9.8 0.4 0.5 572 Secondary + 5.6 0.4 0.5 1,154 Non-standard/Missing/DK (*) (*) (*) 25 Wealth index quintile Poorest 11.7 0.4 0.5 668 Second 7.5 0.4 0.5 425 Middle 6.1 0.4 0.5 355 Fourth 3.1 0.5 0.6 331 Richest 5.5 0.0 0.5 250 Ethnicity of household head** Indigenous 17.0 0.5 0.6 96 Maroon 10.8 0.4 0.6 843 Creole 6.2 0.4 0.4 250 Hindustani 4.1 0.4 0.4 402 Javanese 5.2 0.5 1.5 219 Mixed 3.8 0.0 0.5 196 Others (*) (*) (*) 24 Median 8.0 0.4 0.5 2,030 Mean for all children (0-35 months) 10.5 0.2 1.4 2,030 * ‘Missing/DK’ categories not shown due to low number of observations (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 2.10       Nutrition  32 Suriname MICS4  Table NU.5: Age-appropriate breastfeeding Percentage of children age 0-23 months who were appropriately breastfed during the previous day, Suriname, 2010 Children age 0-5 months Children age 6-23 months Children age 0-23 months Percent exclusively breastfed1 Number of children Percent currently breastfeeding and receiving solid, semi- solid or soft foods Number of children Percent appropriately breastfed2 Number of children Sex* Male 1.6 150 15.7 575 12.8 724 Female 4.0 136 20.1 528 16.8 665 District Paramaribo 1.8 113 14.5 442 12.0 555 Wanica (*) 41 17.0 203 14.2 244 Nickerie (*) 15 31.6 64 26.5 79 Coronie (*) 1 (*) 5 (*) 5 Saramacca (*) 8 (16.7) 31 16.4 40 Commewijne (*) 7 (20.8) 48 20.5 55 Marowijne (2.4) 25 17.9 64 13.5 89 Para (*) 10 18.5 38 14.7 48 Brokopondo (4.5) 22 12.5 48 10.0 70 Sipaliwini 2.3 44 22.7 160 18.3 204 Area Urban 1.3 159 16.5 697 13.6 856 Rural Coastal 6.4 61 19.9 198 16.7 259 Rural interior 3.1 66 20.3 208 16.2 274 Total Rural 4.7 127 20.1 407 16.4 534 Mother’s education None 1.3 39 14.5 134 11.5 173 Primary 5.6 76 21.1 330 18.2 407 Secondary + 1.9 165 17.1 618 13.9 782 Non-standard/Missing/DK (*) 6 (*) 22 (*) 27 Wealth index quintile Poorest 2.4 116 20.3 335 15.7 451 Second (3.0) 39 18.7 233 16.5 272 Middle (1.3) 51 15.1 209 12.4 260 Fourth (6.8) 49 17.1 180 14.9 229 Richest (*) 31 15.4 148 12.7 179 Ethnicity of household head* Indigenous/Amerindian (*) 10 37.8 54 33.4 64 Maroon 1.2 137 14.3 418 11.1 555 Creole (*) 35 21.0 143 17.2 178 Hindustani (4.0) 49 21.9 237 18.8 287 Javanese (*) 28 20.0 121 18.0 149 Mixed (*) 24 8.8 113 7.3 137 Others (*) 3 (*) 17 (*) 20 Total 2.8 286 17.8 1,104 14.7 1,390 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 2.6 2 MICS indicator 2.14       Nutrition      Suriname MICS4 33 Table NU.6: Introduction of solid, semi-solid or soft foods Percentage of infants age 6-8 months who received solid, semi-solid or soft foods during the previous day, Suriname, 2010 Currently breastfeeding Currently not breastfeeding All Percent receiving solid, semi- solid or soft foods Number of children age 6-8 months Percent receiving solid, semi- solid or soft foods Number of children age 6-8 months Percent receiving solid, semi- solid or soft foods1 Number of children age 6-8 months Sex Male (44.8) 48 (49.2) 51 47.1 99 Female 37.9 47 (57.9) 39 46.9 85 Area Urban (*) 48 (53.1) 64 50.0 113 Rural Coastal (*) 15 (59.0) 19 62.5 33 Rural interior 22.6 32 (*) 6 24.4 38 Total Rural 36.7 46 (52.7) 25 42.3 71 Total 41.4 95 53.0 89 47.0 184 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 2.12     Nutrition  34 Suriname MICS4  Table NU.7: Minimum meal frequency Percentage of children age 6-23 months who received solid, semi-solid, or soft foods (and milk feeds for non-breastfeeding children) the minimum number of times or more during the previous day, according to breastfeeding status, Suriname, 2010 Currently breastfeeding Currently not breastfeeding All Percent receiving solid, semi-solid and soft foods the minimum number of times Number of children age 6-23 months Percent receiving at least 2 milk feeds1 Percent receiving solid, semi-solid and soft foods or milk feeds 4 times or more Number of children age 6-23 months Percent with minimum meal frequency2 Number of children age 6-23 months Sex* Male 15.3 142 81.8 83.6 433 66.8 575 Female 17.0 162 79.2 81.1 366 61.5 528 Age 6-8 months 16.8 95 94.7 88.2 89 51.5 184 9-11 months 16.3 79 94.5 92.9 97 58.3 176 12-17 months 10.9 66 89.1 85.8 221 68.6 287 18-23 months 20.8 64 69.2 76.7 393 69.0 456 District Paramaribo 17.6 103 88.8 87.6 340 71.4 442 Wanica (11.1) 55 89.0 89.0 148 68.0 203 Nickerie (*) 24 85.5 88.7 41 67.3 64 Coronie (*) 2 (*) (*) 3 (*) 5 Saramacca (*) 5 (90.0) (90.0) 26 (79.2) 31 Commewijne (*) 10 (78.9) (86.0) 38 (70.8) 48 Marowijne (20.0) 18 82.9 85.5 46 67.0 64 Para (*) 8 (79.1) (83.7) 30 72.2 38 Brokopondo (0.0) 17 62.9 69.4 31 44.8 48 Sipaliwini 13.1 62 40.8 50.8 98 36.1 160 Area Urban 16.1 175 88.0 87.7 522 69.7 697 Rural Coastal 26.5 49 84.4 87.9 150 72.8 198 Rural interior 10.3 80 46.2 55.3 129 38.1 208 Total Rural 16.5 128 66.7 72.8 278 55.0 407 Mother’s education None 11.1 38 51.5 60.6 96 46.6 134 Primary 18.2 114 76.4 79.0 217 58.1 330 Secondary + 15.8 150 88.7 88.8 468 71.1 618 Non-standard/ Missing/DK (*) 2 (*) (*) 19 (*) 22 Wealth index quintile Poorest 19.5 115 59.2 65.4 219 49.6 335 Second 3.9 69 85.7 89.7 164 64.4 233 Middle (26.2) 43 92.4 88.8 165 75.8 209 Fourth (18.5) 43 90.7 88.2 136 71.4 180 Richest (*) 33 85.4 88.9 115 72.4 148 Ethnicity of household head* Indigenous/Amerindian (8.0) 29 (77.2) (71.8) 25 37.5 54 Maroon 13.0 120 67.4 73.3 298 56.1 418 Creole (19.5) 41 90.2 86.9 102 67.8 143 Hindustani (22.9) 61 89.4 89.0 177 72.1 237 Javanese (*) 30 83.0 85.2 91 69.5 121 Mixed (*) 21 91.5 94.3 92 79.1 113 Others (*) 2 (*) (*) 15 (*) 17 Total 16.2 303 80.6 82.5 800 64.3 1,104 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases; (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 2.15 2 MICS indicator 2.13 Among currently breastfeeding children age 6-8 months, minimum meal frequency is defined as children who also received solid, semi- solid or soft foods 2 times or more. Among currently breastfeeding children age 9-23 months, receipt of solid, semi-solid or soft foods at least 3 times constitutes minimum meal frequency. For non-breastfeeding children age 6-23 months, minimum meal frequency is defined as children receiving solid, semi-solid or soft foods, and milk feeds, at least 4 times during the previous day. Nutrition      Suriname MICS4 35   Table NU.8: Bottle feeding Percentage of children age 0-23 months who were fed with a bottle with a nipple during the previous day, Suriname, 2010 Percentage of children age 0-23 months fed with a bottle with a nipple1 Number of children age 0-23 months Sex* Male 73.7 724 Female 69.8 665 Age 0-5 months 76.5 286 6-11 months 78.2 360 12-23 months 67.0 744 District Paramaribo 80.1 555 Wanica 76.7 244 Nickerie 67.8 79 Coronie (*) 5 Saramacca 63.9 40 Commewijne 66.3 55 Marowijne 81.1 89 Para 70.6 48 Brokopondo 63.6 70 Sipaliwini 48.1 204 Area Urban 78.1 856 Rural Coastal 72.1 259 Rural interior 52.1 274 Total Rural 61.8 534 Mother’s education None 58.3 173 Primary 69.2 407 Secondary + 76.3 782 Non-standard/ Missing/DK (*) 27 Wealth index quintile Poorest 61.8 451 Second 74.1 272 Middle 77.2 260 Fourth 81.7 229 Richest 73.4 179 Ethnicity of household head* Indigenous/Amerindian 67.8 64 Maroon 66.3 555 Creole 80.9 178 Hindustani 77.0 287 Javanese 69.0 149 Mixed 72.9 137 Others (*) 20 Total 71.9 1,390 * ‘Missing/DK’ categories not shown due to low number of observations (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 2.11 Nutrition  36 Suriname MICS4  Low Birth Weight Weight  at  birth  is  a  good  indicator  not  only  of  a  mother's  health  and  nutritional  status  but  also  the  newborn's chances for survival, growth, long‐term health and psychosocial development. Low birth weight  (less than 2,500 grams) carries a range of grave health risks for children. Babies who were undernourished  in the womb face a greatly increased risk of dying during their early months and years. Those who survive  have  impaired  immune  function and  increased risk of disease; they are  likely to remain undernourished,  with reduced muscle strength, throughout their  lives, and suffer a higher  incidence of diabetes and heart  disease  in  later  life. Children born underweight  also  tend  to have  a  lower  IQ  and  cognitive disabilities,  affecting their performance in school and their job opportunities as adults.   In  the developing world,  low birth weight  stems primarily  from  the mother's poor health and nutrition.  Three factors have most impact: the mother's poor nutritional status before conception, short stature (due  mostly to under nutrition and  infections during 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 birth.9  Overall,  Table  NU.9  (page  37)  shows  that  about  81  percent  of  births  were  weighed  at  birth  and  approximately 14 percent of infants are estimated to weigh less than 2,500 grams at birth. On birth weight  there  are  just  slight  and  inconclusive  variations  across  background  characteristics.  However,  some  differences can be seen among districts and elsewhere when looking at percentage weighed at birth.                                                              9 For a detailed description of the methodology, see 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.  Nutrition      Suriname MICS4 37 Table NU.9: Low birth weight infants Percentage of last-born children in the 2 years preceding the survey that are estimated to have weighed below 2500 grams at birth and percentage of live births weighed at birth, Suriname, 2010 Percent of live births: Number of last-born children in the two years preceding the survey Below 2500 grams1 Weighed at birth2 District Paramaribo 14.5 82.3 430 Wanica 15.6 86.0 191 Nickerie 14.2 86.0 61 Coronie (*) (*) 4 Saramacca 10.7 87.7 30 Commewijne (12.1) (83.7) 44 Marowijne 12.2 81.1 65 Para 9.5 80.3 38 Brokopondo 12.4 71.4 53 Sipaliwini 13.0 67.2 146 Area Urban 14.9 83.4 668 Rural Coastal 11.4 83.2 193 Rural interior 12.8 68.3 199 Total Rural 12.1 75.7 392 Mother’s education None 13.3 64.7 125 Primary 15.2 76.9 305 Secondary + 13.3 85.4 609 Non-standard/ Missing/DK (*) (*) 21 Wealth index quintile Poorest 14.2 69.4 341 Second 13.7 81.4 212 Middle 13.4 86.0 200 Fourth 13.9 92.4 167 Richest 13.9 84.4 141 Ethnicity of household head* Indigenous/Amerindian 11.0 67.6 50 Maroon 13.4 74.4 429 Creole 14.7 78.6 131 Hindustani 16.0 92.4 216 Javanese 12.3 82.6 111 Mixed 12.7 89.4 104 Others (*) (*) 20 Total 13.9 80.5 1,060 * ‘Missing/DK’ category of ethnicity of household head not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 2.18 2 MICS indicator 2.19         Child Health  38 Suriname MICS4   5. Child Health   Child Health      Suriname MICS4 39 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 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  the national  vaccination  schedule,  a  child  should  receive one dose of hepatitis  vaccine  at  birth, three doses of Pentavalent to protect against diphtheria, pertussis, tetanus, haemophilias  influenza  type b, and hepatitis b, and three doses of polio vaccine by six months. After their first birthday, children  should  receive  a  dose  of  MMR  to  protect  against  Measles,  Mumps  and  Rubella,  and  a  Yellow  Fever  vaccination for children living in the interior. By the age of 18 months a child should receive a fourth dose  of DPT and polio vaccine.   Information on vaccination coverage was collected for all children under five years of age. All mothers or  caretakers  were  asked  to  provide  vaccination  cards.  If  the  vaccination  card  for  a  child  was  available,  interviewers copied vaccination information from the cards onto the MICS questionnaire. If no vaccination  card was available for the child, the interviewer proceeded to ask the mother to recall whether or not the  child had  received each of  the  vaccinations,  and  for Polio, DPT  and Hepatitis B, how many doses were  received.  The  final  vaccination  coverage  estimates  are  based  on  both  information  obtained  from  the  vaccination card and the mother’s report of vaccinations received by the child.  In the case of Suriname, the Pentavalent vaccine  is given together with DPT and HepB.   However, during  the customisation of  the standard MICS questionnaires,  the  introduction of  the Pentavalent vaccine was  not  added  into  the  final  questionnaires  used  in  the  survey.  This,  due  to  restrictions  pertaining  to  the  uniformity of  the questionnaire  formats.   This  resulted  in underestimation of children  receiving  the DPT  and HepB vaccines now no longer given separately, but as part of the Pentavalent vaccine. The coverage of  DPT and HepB are therefore omitted from this report as the results would be misleading. The coverage of  HepB given at birth is still valid, as well as the results for Polio and Measles (MMR). With regards to Yellow  Fever, the results are presented for Brokopondo and Sipaliwini districts.  The percentage of children age 18  to 29 months who have received each of  the specific vaccinations by  source  of  information  (vaccination  card  and  mother’s  recall)  is  shown  in  Table  CH.1  (page  40).  The  denominator  for  the  table  is comprised of children age 18‐29 months so  that only children who are old  enough to be fully vaccinated are counted. In the first three columns of the table, the numerator includes  all children who were vaccinated at any time before the survey according  to the vaccination card or  the  mother’s report. In the last column, only those children who were vaccinated before their first birthday are  included.  For  children  without  vaccination  cards,  the  proportion  of  vaccinations  given  before  the  first  birthday is assumed to be the same as for children with vaccination cards.  In Suriname,  the MICS4 data  reveal  that about 83 percent of children age 18‐29 months  received  three  doses of the polio vaccine at any time before the survey. As much as 91 percent had received at least a first  dose of the polio vaccine. HepB at birth, the only HepB vaccine that can be tabulated due to the mentioned  design issue, shows a prevalence of 39 percent of children age 18‐29 months vaccinated at any time before  the survey. Figure CH.1 (page 42) presents coverage of each vaccine on the children who were vaccinated  at any time before the survey.   Child Health  40 Suriname MICS4  With respect to the vaccine against measles (MMR), MICS4 data indicate that approximately 78 percent of  children  age18‐29 months were estimated  to have  received  the measles  vaccine. Nonetheless, national  estimates by the Ministry of Health for 2010 and 2011 reveal that Suriname has attained an immunization  profile above the international threshold of 85% for vaccinations against measles (MMR). This discrepancy  should be  investigated  further. There are a number of possible  reasons  for  the difference.  In  the MICS,  issues could be related to data quality, but certainly also to imprecise vaccination cards that have omitted  vaccines.   Discrepancy  is also found on the coverage of Yellow fever vaccination. According to MICS,  in Brokopondo  and Sipaliwini 64 percent of children age 18‐29 were immunized at any time before the survey, but only 15  percent were vaccinated by 12 months of age.  It should be noted  that national  immunization estimates  from the Ministry of Health for children age 12‐23 months in these parts of the country and a part of Para,  are 79 percent  in 2009, 80 percent  in 2010, and 77 percent  in 2011. While  the numbers are not strictly  comparable, the large discrepancy is evident and further investigation is necessary to understand and learn  for future data collection activities.  Table CH.1: Vaccinations in first year of life Percentage of children age 18-29 months immunized against childhood diseases at any time before the survey and before the first birthday (by 18 months of age against measles-MMR), Suriname, 2010 Vaccinated at any time before the survey according to: Vaccinated by 12 months of age Vaccination card Mother's report Either Polio 1 80.1 10.3 90.5 89.9 2 80.0 8.4 88.5 86.5 31 77.1 6.1 83.2 79.0 Measles (MMR)2 70.5 7.4 77.9 73.9 HepB At birth 32.8 5.7 38.5 38.0 Number of children age 18-29 months 746 746 746 746 Yellow fever3 (Brokopondo and Sipaliwini ) 59.3 4.7 64.0 15.1 Number of children age 18-29 months (Brokopondo and Sipaliwini ) 154 154 154 154 1 MICS indicator 3.2; 2 MICS indicator 3.4; MDG indicator 4.3 3 MICS indicator 3.6   Table  CH.2  (page  41)  presents  vaccination  coverage  estimates  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’  (or  caretakers’) reports. Vaccination cards have been seen by the interviewer for 82 percent of children. This  total hides  that while most district  values  center  around  this  total,  the  interviewers  in Marowijne only  managed  to  see  the  card of  every  second  child  (54%).  The  table does not  reveal  any obvious patterns  without  background  characteristics,  although  precisely  Marowijne  have  significantly  lower  vaccination  rates across the board.      Child Health      Suriname MICS4 41 Table CH.2: Vaccinations by background characteristics Percentage of children age 18-29 months currently vaccinated against childhood diseases, Suriname, 2010 Percentage of children who received: Percentage with vaccination card seen Number of children age 18- 29 months Brokopondo and Sipaliwini: Polio Measles (MMR) HepB at birth Percentage of children who received yellow fever Number of children age 18-29 months 1 2 3 Sex* Male 90.7 89.6 85.3 78.0 37.5 81.5 385 62.8 88 Female 90.1 87.5 81.0 77.9 39.5 81.9 361 65.8 66 Region Paramaribo 91.4 90.7 85.7 78.1 34.3 83.6 281 na na Wanica 88.7 87.3 83.1 79.7 39.1 80.3 144 na na Nickerie 97.1 97.1 91.3 75.0 52.2 94.2 45 na na Coronie (*) (*) (*) (*) (*) (*) 2 na na Saramacca (96.8) (96.8) (96.8) (90.3) (45.2) (93.5) 20 na na Commewijne (97.6) (85.4) (85.4) (89.5) (56.1) (85.4) 27 na na Marowijne 69.0 62.9 52.9 47.1 20.0 53.5 43 na na Para (97.6) (97.5) (95.0) (87.2) (48.7) (90.2) 29 na na Brokopondo 95.1 90.0 81.7 70.9 41.7 77.0 31 52.7 31 Sipaliwini 89.7 88.2 80.6 82.9 40.0 81.0 124 66.8 124 Area Urban 91.2 89.9 85.1 78.4 38.2 83.3 459 na na Rural Coastal 87.5 83.5 79.3 73.4 37.4 77.4 133 na na Rural interior 90.7 88.5 80.8 80.6 40.3 80.2 154 64.0 154 Total Rural 89.2 86.2 80.1 77.2 39.0 78.9 287 na na Mother’s education* None 87.2 86.4 77.4 79.6 37.2 77.9 110 61.2 77 Primary 89.3 87.3 81.4 78.5 39.7 78.3 210 70.6 60 Secondary + 92.0 89.6 85.6 76.5 38.6 84.2 409 (50.1) 16 Other/Non-standard (*) (*) (*) (*) (*) (*) 14 (*) 1 Wealth index quintile Poorest 87.3 84.6 76.6 76.7 37.6 75.7 236 65.1 142 Second 91.8 90.2 87.7 78.7 39.3 86.5 153 (*) 11 Middle 94.2 94.2 91.1 77.4 40.6 86.2 148 (*) 1 Fourth 89.2 85.2 78.5 74.0 33.5 76.9 130 (*) 1 Richest (92.3) (91.6) (86.6) (87.3) (43.1) (89.0) 79 - 0 Ethnicity of household head Indigenous/Amerindian 91.3 91.6 83.4 81.5 31.9 87.1 42 (71.4) 11 Maroon 88.4 86.1 79.3 76.1 40.1 76.1 319 63.5 142 Creole 94.0 92.3 89.7 81.8 37.0 89.7 77 - 0 Hindustani 92.3 91.8 89.1 80.5 33.0 90.5 148 - 0 Javanese 90.0 84.3 76.8 78.2 47.9 74.4 81 - 0 Mixed (91.0) (91.0) (91.0) (72.5) (36.2) (87.3) 74 (*) 1 Others (*) (*) (*) (*) (*) (*) 6 - 0 Total 90.5 88.5 83.2 77.9 38.5 81.6 746 64.0 154 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases       Child Health  42 Suriname MICS4  Figure CH.1: Percentage of children aged 18-29 months who received the recommended vaccinations at any time before the survey, Suriname, 2010   Neonatal Tetanus Protection One  of  the  MDGs  is  to  reduce  by  three  quarters  the  maternal  mortality  ratio,  with  one  strategy  to  eliminate maternal tetanus. In addition, another goal is to reduce the incidence of neonatal tetanus to less  than 1 case of neonatal  tetanus per 1000  live births  in every district. A World Fit  for Children goal  is  to  eliminate maternal and neonatal tetanus by 2005.  The strategy for preventing maternal and neonatal tetanus is to assure all pregnant women receive at least  two doses of  tetanus  toxoid vaccine.  If a woman has not  received at  least  two doses of  tetanus  toxoid  during a particular pregnancy, she (and her newborn) are also considered to be protected against tetanus if  the woman:    Received at least two doses of tetanus toxoid vaccine, the last within the previous 3 years;   Received at least 3 doses, the last within the previous 5 years;   Received at least 4 doses, the last within the previous 10 years;   Received 5 or more doses anytime during her life.    To assess the status of tetanus vaccination coverage, women who gave birth during the two years before  the survey were asked  if they had received tetanus toxoid  injections during the pregnancy for their most  recent birth, and  if so, how many. Women who did not receive two or more tetanus toxoid vaccinations  during this pregnancy were then asked about tetanus toxoid vaccinations they may have received prior to  this  pregnancy.  Interviewers  also  asked  women  to  present  their  vaccination  card,  on  which  dates  of  tetanus toxoid are recorded and referred to information from the cards when available.   Table CH.3 (page 43) shows the protection status from tetanus of women who have had a live birth within  the last 2 years. Figure CH.2 (page 44) shows the protection of women against neonatal tetanus by major  background  characteristics. Among women with a  live birth  in  the  last years  in  the different districts of  Suriname,  the  largest  proportion  to  have  been  protected  against  neonatal  tetanus was  in  Brokopondo  (53%)  and  Para  (49%).  The  smallest  proportions  were  observed  in  Paramaribo  (28%).  Given  the  small  proportion that was observed in Paramaribo, it is not surprising that notably smaller proportions of women  in urban areas have been protected against neonatal  tetanus when compared  to  those  in rural areas.  In  fact, similar proportions have been observed  in rural areas whether  in coastal domains or  in the  interior.  There  is  an  inverse  relationship between  the mother’s  education  and  the proportion protected  against  neonatal  tetanus as  those with higher  levels of education appearing  to have  lower  likelihoods of being  90 88 83 38 78 64 0 10 20 30 40 50 60 70 80 90 100 Pe rc en t Figure CH.1: Percentage of children aged 18-29 months who received the recommended vaccinations at any time before the survey, Suriname, 2010 Child Health      Suriname MICS4 43 protected against neonatal tetanus. In Suriname as a whole, 36 percent of women with a  live birth in the  last years were estimated to have been protected against neonatal tetanus.  Table CH.3: Neonatal tetanus protection Percentage of women age 15-49 years with a live birth in the last 2 years protected against neonatal tetanus, Suriname, 2010 Percentage of women who received at least 2 doses during last pregnancy Percentage of women who did not receive two or more doses during last pregnancy but received: Protected against tetanus1 Number of women with a live birth in the last 2 years 2 doses, the last within prior 3 years 3 doses, the last within prior 5 years 4 doses, the last within prior 10 years 5 or more doses during lifetime Area Urban 23.6 8.4 0.5 0.0 0.0 32.5 668 Rural Coastal 32.3 10.0 0.3 0.0 0.3 42.9 193 Rural interior 32.2 10.4 0.4 0.0 0.0 43.0 199 Total Rural 32.3 10.2 0.4 0.0 0.1 42.9 392 District Paramaribo 20.4 7.3 0.0 0.0 0.0 27.7 430 Wanica 30.7 10.5 1.8 0.0 0.0 43.0 191 Nickerie 25.4 15.8 0.0 0.0 0.0 41.2 61 Coronie (*) (*) (*) (*) (*) (*) 4 Saramacca 33.3 10.5 0.0 0.0 0.0 43.9 30 Commewijne (30.0) (2.5) (0.0) (0.0) (0.0) (32.5) 44 Marowijne 31.8 9.8 0.0 0.0 0.8 42.4 65 Para 37.9 9.1 1.5 0.0 0.0 48.5 38 Brokopondo 45.9 6.0 0.8 0.0 0.0 52.6 53 Sipaliwini 27.2 11.9 0.3 0.0 0.0 39.4 146 Education* None 34.8 11.5 0.6 0.0 0.0 46.9 125 Primary 31.7 8.8 0.2 0.0 0.2 40.8 305 Secondary + 22.1 9.0 0.5 0.0 0.0 31.7 609 Other/Non-standard (*) (*) (*) (*) (*) (*) 16 Wealth index quintile Poorest 30.6 9.2 0.4 0.0 0.1 40.3 341 Second 26.3 9.2 0.0 0.0 0.0 35.5 212 Middle 24.8 8.0 0.8 0.0 0.0 33.6 200 Fourth 24.4 7.8 0.0 0.0 0.0 32.2 167 Richest 24.2 11.7 1.2 0.0 0.0 37.0 141 Ethnicity of household head Indigenous/Amerindian 25.2 10.2 0.0 0.0 1.0 36.3 50 Maroon 29.9 8.0 0.3 0.0 0.0 38.2 429 Creole 22.5 14.3 0.0 0.0 0.0 36.7 131 Hindustani 24.3 9.9 0.0 0.0 0.0 34.2 216 Javanese 25.7 8.9 3.0 0.0 0.0 37.6 111 Mixed 24.4 5.3 0.0 0.0 0.0 29.7 104 Others (*) (*) (*) (*) (*) (*) 20 Total 26.8 9.1 0.4 0.0 0.0 36.4 1,060 * ‘Missing/DK’ category of education not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 3.7   Child Health  44 Suriname MICS4  Figure CH.2: Percentage of women with a live birth in the last 12 months who are protected against neonatal tetanus, Suriname, 2010 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.  In the MICS, prevalence of diarrhoea was estimated by asking mothers or caretakers whether their child  under age  five years had an episode of diarrhoea  in  the  two weeks prior  to  the  survey.  In cases where  mothers reported that the child had diarrhoea, a series of questions were asked about the treatment of  the illness, including what the child had to drink and eat during the episode and whether this was more or  less than the child usually drinks and eats.   Overall, approximately 10 percent of under  five  children had diarrhoea  in  the  two weeks preceding  the  survey  (Table CH.4, page 47). Diarrhoea prevalence  rates were highest  in  Sipaliwini  (13%), Brokopondo  28 43 41 44 (32) 42 48 39 33 43 43 43 47 41 32 42 0 10 20 30 40 50 Regions Paramaribo Wanica Nickerie Coronie Saramacca Commewijne Marowijne Para Brokopondo Sipaliwini Area Urban Rural Coastal Rural interior Total Rural Education None Primary Secondary + Total Percent Figure CH.2: Percentage of women with a live birth in the last 2 years who are protected against neonatal tetanus, Suriname, 2010 53 Child Health      Suriname MICS4 45 (13%) and Wanica  (11%) and  lowest  in Saramacca  (6%). Similar  rates  ranging between 8 percent and 10  percent were  observed  in  the  remaining  districts. One  year  old  children were more  likely  to  have  had  diarrhoea in the last two weeks preceding the survey (14%) when compared to children less than 1 year old  (13%), 2 year olds (9%), 3 year olds (7%), and 4 year olds (6%). Diarrhoea prevalence is higher for children  of mothers with no or only primary (both 13%) than for those with secondary or higher education (8%).   Table CH.4 also shows the percentage of children receiving various types of recommended  liquids during  the  episode  of  diarrhoea.  Since  children  may  have  been  given  more  than  one  type  of  liquid,  the  percentages do not necessarily  add  to 100. About 42 percent  received  fluids  from ORS packets or pre‐ packaged ORS fluids and 52 percent received recommended homemade fluids. Tea is as commonly used as  ORS  fluids  and  is  also  the most  common homemade  remedy  (42%), whereas  rice water  and  extract of  guava leaves were given in 12 and 16 percent of cases, respectively. Approximately 72 percent of children  with diarrhoea received one or more of the recommended treatments (i.e., were treated with ORS or RHF),  while 28 percent received no treatment.   Figure CH.3 reveals that children of mothers with secondary education and those residing  in urban areas  were less likely to have received oral rehydration treatment than other children.  Figure CH.3: Percentage of children under age 5 with diarrhoea who received ORS or recommended home fluids, Suriname, 2010   Just 39 percent of under  five  children with diarrhoea were given more  to drink  than usual  (Table CH.5,  page 49). More than one fifth (22%) ate much less, stopped eating, or had never been given food.   Table CH.6 (page 51) provides the proportion of children age 0‐59 months with diarrhoea  in the  last two  weeks who  received oral  rehydration  therapy with  continued  feeding,  and percentage of  children with  diarrhoea who received other treatments. Overall, 63 percent of children with diarrhoea received ORS or  increased  fluids, 81 percent  received ORT  (ORS or  recommended homemade  fluids or  increased  fluids),  and 61 percent of children received ORT and continued feeding, as is the recommendation.  There  are  significant  differences  in  the  home management  of  diarrhoea  by  background  characteristics.  According to Figure CH.4 (below), the proportion of children to have received ORT with continued feeding  is  fairly constant around  the national average across  the groups. However,  the use of ORS or  increased  68 77 76 77 73 80 67 71 60 62 64 66 68 70 72 74 76 78 80 82 Pe rc en t Figure CH.3: Percentage of children under age 5 with diarrhoea who received ORS or recommended home fluids, Suriname, 2010 Child Health  46 Suriname MICS4  fluids is highest with mothers in the rural interior and those with no education and lowest among mothers  in urban areas and with secondary or higher education. This observation is similar to use of ORT.  Figure CH.4: Treatment of diarrhoea, Suriname, 2010   50 60 70 80 90 100 Percent Figure CH.4: Treatment of diarrhoea, Suriname, 2010 ORS or increased fluids ORT (ORS or recommended homemade fluids or increased fluids) ORT with continued feeding Ch ild  He al th           Su rin am e M IC S4 47 Ta bl e C H .4 : O ra l r eh yd ra tio n so lu tio ns a nd re co m m en de d ho m em ad e flu id s P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ith d ia rr ho ea in th e la st tw o w ee ks , a nd tr ea tm en t w ith o ra l r eh yd ra tio n so lu tio ns a nd r ec om m en de d ho m em ad e flu id s, S ur in am e, 20 10 H ad di ar rh oe a in la st tw o w ee ks N um be r of ch ild re n ag e 0- 59 m on th s C hi ld re n w ith d ia rr ho ea w ho re ce iv ed : N um be r o f ch ild re n ag e 0- 59 m on th s w ith di ar rh oe a in la st tw o w ee ks O R S (F lu id fr om O R S pa ck et o r p re - pa ck ag ed O R S flu id ) R ec om m en de d ho m em ad e flu id s O R S o r a ny re co m m en de d ho m em ad e flu id R ic e w at er E xt ra ct gu av a le av es Te a A ny re co m m en de d ho m em ad e flu id Se x* M al e 11 .1 1, 65 9 43 .4 13 .4 14 .5 44 .7 54 .6 75 .3 18 5 Fe m al e 8. 6 1, 64 9 41 .2 9. 2 17 .0 39 .0 48 .1 66 .5 14 1 M is si ng (* ) 1 - - - - - - 0 D is tr ic t P ar am ar ib o 8. 4 1, 27 4 30 .2 9. 4 13 .2 52 .8 58 .5 66 .0 10 7 W an ic a 11 .2 59 9 (3 3. 3) (1 5. 2) (9 .1 ) (3 6. 4) (4 5. 5) (6 9. 7) 67 N ic ke rie 7. 7 18 8 (* ) (* ) (* ) (* ) (* ) (* ) 14 C or on ie (* ) 14 (* ) (* ) (* ) (* ) (* ) (* ) 2 S ar am ac ca 6. 4 91 (* ) (* ) (* ) (* ) (* ) (* ) 6 C om m ew ijn e 8. 7 12 2 (* ) (* ) (* ) (* ) (* ) (* ) 11 M ar ow ijn e 9. 4 19 2 (5 3. 3) (2 3. 3) (2 6. 7) (4 0. 0) (5 0. 0) (7 6. 7) 18 P ar a 9. 2 12 2 (* ) (* ) (* ) (* ) (* ) (* ) 11 B ro ko po nd o 12 .6 16 7 (4 7. 6) (7 .1 ) (1 9. 0) (2 6. 2) (4 2. 9) (6 9. 0) 21 S ip al iw in i 12 .8 53 7 61 .2 14 .2 24 .6 32 .1 50 .0 78 .4 69 A re a U rb an 9. 4 2, 00 1 33 .3 10 .8 10 .8 46 .2 52 .7 67 .7 18 7 R ur al C oa st al 8. 0 60 3 49 .1 12 .9 19 .9 48 .3 54 .9 77 .5 48 R ur al in te rio r 12 .7 70 5 58 .0 12 .5 23 .3 30 .7 48 .3 76 .2 90 To ta l R ur al 10 .6 1, 30 7 54 .9 12 .7 22 .1 36 .9 50 .6 76 .6 13 8 A ge 0- 11 m on th s 12 .5 64 6 35 .5 10 .9 19 .2 31 .7 45 .8 68 .9 81 12 -2 3 m on th s 14 .2 74 4 47 .9 15 .5 14 .3 39 .6 51 .0 71 .4 10 6 24 -3 5 m on th s 8. 7 64 0 43 .9 2. 0 11 .6 53 .2 56 .9 78 .7 56 36 -4 7 m on th s 6. 7 69 4 (3 4. 7) (1 0. 4) (1 2. 2) (4 7. 9) (5 5. 8) (7 0. 4) 46 48 -5 9 m on th s 6. 3 58 4 (4 9. 6) (1 7. 8) (2 1. 5) (4 9. 1) (5 4. 6) (6 7. 9) 37 Ch ild  He al th   48 Su rin am e M IC S4   H ad di ar rh oe a in la st tw o w ee ks N um be r of ch ild re n ag e 0- 59 m on th s C hi ld re n w ith d ia rr ho ea w ho re ce iv ed : N um be r of ch ild re n ag e 0- 59 m on th s w ith di ar rh oe a in l as t tw o w ee ks O R S (F lu id fro m O R S pa ck et or pr e- pa ck ag ed O R S flu id ) R ec om m en de d ho m em ad e flu id s O R S or an y re co m m en de d ho m em ad e flu id R ic e w at er E xt ra ct gu av a le av es Te a A ny re co m m en de d ho m em ad e flu id M ot he r’s e du ca tio n* N on e 12 .1 45 4 57 .6 11 .6 23 .6 25 .5 45 .0 72 .8 55 P rim ar y 11 .6 96 7 49 .9 16 .1 23 .5 49 .5 58 .7 79 .5 11 2 S ec on da ry + 8. 4 1, 82 4 32 .5 8. 4 7. 2 44 .2 50 .6 66 .9 15 3 O th er /N on -s ta nd ar d (1 2. 2) 48 (* ) (* ) (* ) (* ) (* ) (* ) 6 W ea lth in de x qu in til e P oo re st 12 .5 1, 13 9 56 .9 17 .7 19 .6 36 .6 48 .4 72 .9 14 2 S ec on d 11 .1 67 5 32 .0 11 .4 18 .0 57 .5 68 .5 80 .9 75 M id dl e 6. 4 56 3 (* ) (* ) (* ) (* ) (* ) (* ) 36 Fo ur th 10 .3 50 1 (4 5. 4) (7 .9 ) (6 .5 ) (2 8. 5) (4 0. 3) (7 0. 2) 51 R ic he st 5. 0 42 9 (* ) (* ) (* ) (* ) (* ) (* ) 21 Et hn ic ity o f h ou se ho ld h ea d In di ge no us /A m er in di an 18 .0 15 3 (5 8. 4) (8 .8 ) (1 6. 9) (5 2. 4) (6 0. 1) (8 0. 9) 28 M ar oo n 10 .8 1, 38 9 53 .3 17 .2 21 .7 40 .1 54 .4 79 .1 15 0 C re ol e 8. 3 42 8 (* ) (* ) (* ) (* ) (* ) (* ) 36 H in du st an i 9. 6 64 4 (3 4. 7) (4 .4 ) (7 .6 ) (3 1. 4) (3 4. 7) (5 6. 5) 62 Ja va ne se 3. 5 34 6 (* ) (* ) (* ) (* ) (* ) (* ) 12 M ix ed 11 .9 30 8 (3 4. 5) (7 .4 ) (5 .5 ) (4 5. 8) (5 1. 3) (6 7. 6) 37 O th er s (* ) 38 (* ) (* ) (* ) (* ) (* ) (* ) 2 To ta l 9. 8 3, 30 8 42 .4 11 .6 15 .6 42 .2 51 .8 71 .5 32 5 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s     Ch ild  He al th           Su rin am e M IC S4 49   Ta bl e C H .5 : F ee di ng p ra ct ic es d ur in g di ar rh oe a P er ce nt d is tri bu tio n of c hi ld re n ag e 0- 59 m on th s w ith d ia rr ho ea in th e la st tw o w ee ks b y am ou nt o f l iq ui ds a nd fo od g iv en d ur in g ep is od e of d ia rr ho ea , S ur in am e, 2 01 0 H ad di ar rh oe a in la st tw o w ee ks N um be r of ch ild re n ag e 0- 59 m on th s D rin ki ng p ra ct ic es d ur in g di ar rh oe a: Ea tin g pr ac tic es d ur in g di ar rh oe a: N um be r of ch ild re n ag e 0- 59 m on th s w ith di ar rh oe a in la st tw o w ee ks G iv en m uc h le ss to dr in k G iv en so m ew ha t le ss to dr in k G iv en ab ou t th e sa m e to dr in k G iv en m or e to dr in k G iv en no th in g to d rin k M is si ng /D K G iv en m uc h le ss to e at G iv en so m ew ha t le ss to e at G iv en ab ou t th e sa m e to e at G iv en m or e to e at S to pp ed fo od H ad ne ve r be en gi ve n fo od M is si ng /D K To ta l To ta l Se x* M al e 11 .1 1, 65 9 7. 7 14 .6 30 .4 41 .3 0. 0 5. 9 10 0. 0 18 .4 29 .4 33 .3 14 .5 0. 0 1. 7 2. 7 10 0. 0 18 5 Fe m al e 8. 6 1, 64 9 9. 7 19 .2 32 .4 36 .4 1. 1 1. 1 10 0. 0 20 .6 27 .8 39 .7 8. 5 0. 5 2. 5 0. 4 10 0. 0 14 1 D is tr ic t P ar am ar ib o 8. 4 1, 27 4 5. 7 18 .9 30 .2 39 .6 0. 0 5. 7 10 0. 0 13 .2 28 .3 41 .5 15 .1 0. 0 0. 0 1. 9 10 0. 0 10 7 W an ic a 11 .2 59 9 (3 .0 ) (1 2. 1) (3 6. 4) (4 5. 5) (0 .0 ) (3 .0 ) 10 0. 0 (2 4. 2) (3 3. 3) (2 7. 3) (1 2. 1) (0 .0 ) (3 .0 ) (0 .0 ) 10 0. 0 67 N ic ke rie 7. 7 18 8 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 14 C or on ie (* ) 14 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 2 S ar am ac ca 6. 4 91 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 6 C om m ew ijn e 8. 7 12 2 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 11 M ar ow ijn e 9. 4 19 2 (1 0. 0) (1 3. 3) (4 0. 0) (2 6. 7) (3 .3 ) (6 .7 ) 10 0. 0 (1 3. 3) (2 0. 0) (4 0. 0) (1 6. 7) (0 .0 ) (3 .3 ) (6 .7 ) 10 0. 0 18 P ar a 9. 2 12 2 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 11 B ro ko po nd o 12 .6 16 7 (9 .5 ) (1 1. 9) (2 8. 6) (4 7. 6) (2 .4 ) (0 .0 ) 10 0. 0 (2 3. 8) (3 1. 0) (3 5. 7) (9 .5 ) (0 .0 ) (0 .0 ) (0 .0 ) 10 0. 0 21 S ip al iw in i 12 .8 53 7 12 .7 24 .6 26 .1 32 .1 0. 7 3. 7 10 0. 0 23 .1 28 .4 35 .1 9. 0 0. 0 3. 0 1. 5 10 0. 0 69 A re a U rb an 9. 4 2, 00 1 6. 4 15 .1 33 .3 40 .9 0. 0 4. 3 10 0. 0 17 .2 31 .2 35 .5 12 .9 0. 0 2. 1 1. 1 10 0. 0 18 7 R ur al C oa st al 8. 0 60 3 10 .9 13 .3 31 .7 38 .9 1. 2 3. 8 10 0. 0 20 .3 18 .7 40 .0 13 .2 1. 4 1. 2 5. 2 10 0. 0 48 R ur al in te rio r 12 .7 70 5 11 .9 21 .6 26 .7 35 .7 1. 1 2. 9 10 0. 0 23 .3 29 .0 35 .2 9. 1 0. 0 2. 3 1. 1 10 0. 0 90 To ta l R ur al 10 .6 1, 30 7 11 .6 18 .7 28 .5 36 .9 1. 2 3. 2 10 0. 0 22 .2 25 .4 36 .9 10 .5 0. 5 1. 9 2. 6 10 0. 0 13 8 A ge 0- 11 m on th s 12 .5 64 6 4. 5 25 .9 39 .4 26 .4 0. 6 3. 3 10 0. 0 13 .8 30 .2 38 .5 13 .4 0. 0 0. 0 4. 0 10 0. 0 81 12 -2 3 m on th s 14 .2 74 4 10 .5 16 .3 24 .3 44 .2 0. 0 4. 8 10 0. 0 21 .8 31 .8 31 .9 9. 2 0. 0 4. 8 0. 5 10 0. 0 10 6 24 -3 5 m on th s 8. 7 64 0 9. 7 16 .7 19 .6 48 .1 2. 0 3. 9 10 0. 0 25 .9 29 .8 32 .1 8. 2 1. 2 0. 9 2. 0 10 0. 0 56 36 -4 7 m on th s 6. 7 69 4 (9 .0 ) (4 .6 ) (4 2. 2) (3 9. 8) (0 .0 ) (4 .3 ) 10 0. 0 (1 7. 8) (2 4. 2) (4 2. 1) (1 4. 8) (0 .0 ) (1 .1 ) (0 .0 ) 10 0. 0 46 48 -5 9 m on th s 6. 3 58 4 (1 0. 0) (1 2. 3) (3 7. 3) (3 8. 6) (0 .0 ) (1 .8 ) 10 0. 0 (1 6. 7) (2 0. 5) (4 1. 4) (1 8. 2) (0 .0 ) (1 .4 ) (1 .8 ) 10 0. 0 37 Ch ild  He al th   50 Su rin am e M IC S4   Ta bl e C H .5 : F ee di ng p ra ct ic es d ur in g di ar rh ea (c on tin ue d) P er ce nt d is tri bu tio n of c hi ld re n ag e 0- 59 m on th s w ith d ia rr ho ea in th e la st tw o w ee ks b y am ou nt o f l iq ui ds a nd fo od g iv en d ur in g ep is od e of d ia rr ho ea , S ur in am e, 2 01 0 H ad di ar rh oe a in la st tw o w ee ks N um be r of ch ild re n ag e 0- 59 m on th s D rin ki ng p ra ct ic es d ur in g di ar rh oe a: Ea tin g pr ac tic es d ur in g di ar rh oe a: N um be r of ch ild re n ag e 0- 59 m on th s w ith di ar rh oe a in la st tw o w ee ks G iv en m uc h le ss to dr in k G iv en so m ew ha t le ss to dr in k G iv en ab ou t th e sa m e to dr in k G iv en m or e to dr in k G iv en no th in g to d rin k M is si ng /D K G iv en m uc h le ss to e at G iv en so m ew ha t le ss to e at G iv en ab ou t th e sa m e to e at G iv en m or e to e at S to pp ed fo od H ad ne ve r be en gi ve n fo od M is si ng /D K To ta l To ta l M ot he r’s e du ca tio n* N on e 12 .1 45 4 14 .3 17 .7 30 .3 33 .1 0. 0 4. 7 10 0. 0 31 .1 19 .5 33 .9 12 .7 0. 0 0. 9 1. 9 10 0. 0 55 P rim ar y 11 .6 96 7 8. 9 24 .5 23 .2 37 .8 1. 4 4. 1 10 0. 0 23 .4 29 .1 30 .3 10 .6 0. 6 5. 5 0. 5 10 0. 0 11 2 S ec on da ry + 8. 4 1, 82 4 6. 3 10 .7 38 .1 42 .7 0. 0 2. 2 10 0. 0 12 .6 32 .6 41 .8 10 .5 0. 0 0. 0 2. 6 10 0. 0 15 3 O th er /N on -s ta nd ar d (1 2. 2) 48 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 6 W ea lth in de x qu in til e P oo re st 12 .5 1, 13 9 11 .0 18 .0 30 .8 36 .5 1. 1 2. 7 10 0. 0 22 .7 27 .9 32 .4 10 .8 0. 0 3. 3 3. 0 10 0. 0 14 2 S ec on d 11 .1 67 5 14 .0 21 .1 29 .5 32 .6 0. 0 2. 7 10 0. 0 26 .0 23 .8 37 .9 9. 7 0. 0 2. 7 0. 0 10 0. 0 75 M id dl e 6. 4 56 3 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 36 Fo ur th 10 .3 50 1 (3 .8 ) (1 5. 7) (3 4. 9) (4 5. 5) (0 .0 ) (0 .0 ) 10 0. 0 (1 3. 0) (4 5. 5) (2 5. 8) (1 3. 1) (1 .3 ) (0 .0 ) (1 .3 ) 10 0. 0 51 R ic he st 5. 0 42 9 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 21 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 18 .0 15 3 (3 0. 1) (3 5. 4) (1 0. 0) (2 0. 5) (1 .9 ) (2 .2 ) 10 0. 0 (3 9. 8) (2 0. 7) (1 9. 6) (1 0. 0) (0 .0 ) (7 .8 ) (2 .2 ) 10 0. 0 28 M ar oo n 10 .8 1, 38 9 10 .5 16 .1 33 .4 35 .8 0. 7 3. 5 10 0. 0 24 .4 24 .5 35 .1 13 .3 0. 0 0. 3 2. 4 10 0. 0 15 0 C re ol e 8. 3 42 8 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 36 H in du st an i 9. 6 64 4 0. 0 14 .2 52 .1 33 .7 0. 0 0. 0 10 0. 0 12 .0 31 .6 40 .1 7. 7 1. 1 6. 5 1. 1 10 0. 0 62 Ja va ne se 3. 5 34 6 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 12 M ix ed 11 .9 30 8 (5 .4 ) (7 .3 ) (1 2. 8) (6 1. 7) (0 .0 ) (1 2. 8) 10 0. 0 (9 .1 ) (2 9. 0) (4 0. 0) (2 0. 2) (0 .0 ) (0 .0 ) (1 .8 ) 10 0. 0 37 O th er s (* ) 38 (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 2 To ta l 9. 8 3, 30 8 8. 6 16 .6 31 .3 39 .2 0. 5 3. 8 10 0. 0 19 .4 28 .7 36 .1 11 .9 0. 2 2. 0 1. 7 10 0. 0 32 5 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s Child Health      Suriname MICS4 51 Table CH.6: Oral rehydration therapy with continued feeding and other treatments Percentage of children age 0-59 months with diarrhoea in the last two weeks who received oral rehydration therapy with continued feeding, and percentage of children with diarrhoea who received other treatments, Suriname, 2010 Children with diarrhoea who received: Other treatments: Not given any treatment or drug Number of children age 0-59 months with diarrhoea in last two weeks ORS or increased fluids ORT (ORS or recommended homemade fluids or increased fluids) ORT with continued feeding1 Pill or syrup Injection Home remedy, herbal medicine Other Sex Male 62.5 82.8 64.1 83.1 0.0 7.3 21.3 11.5 185 Female 62.9 77.7 56.4 78.6 0.5 9.6 13.9 17.0 141 District Paramaribo 54.7 77.4 66.0 77.4 0.0 13.2 22.6 15.1 107 Wanica (57.6) (75.8) (51.5) (75.8) (0.0) (3.0) (15.2) (21.2) 67 Nickerie (*) (*) (*) (*) (*) (*) (*) (*) 14 Coronie (*) (*) (*) (*) (*) (*) (*) (*) 2 Saramacca (*) (*) (*) (*) (*) (*) (*) (*) 6 Commewijne (*) (*) (*) (*) (*) (*) (*) (*) 11 Marowijne (56.7) (80.0) (66.7) (86.7) (0.0) (6.7) (13.3) (6.7) 18 Para (*) (*) (*) (*) (*) (*) (*) (*) 11 Brokopondo (73.8) (88.1) (64.3) (88.1) (0.0) (7.1) (7.1) (9.5) 21 Sipaliwini 74.6 86.6 61.9 87.3 0.0 9.0 16.4 7.5 69 Area Urban 57.0 76.3 59.1 76.3 0.0 8.6 19.3 18.3 187 Rural Coastal 62.8 85.7 64.0 88.2 1.3 6.5 20.3 7.9 48 Rural interior 74.4 86.9 62.5 87.5 0.0 8.5 14.2 7.9 90 Total Rural 70.4 86.5 63.0 87.7 0.5 7.8 16.4 7.9 138 Age 0-11 months 47.6 74.8 61.0 75.5 0.0 3.7 14.9 23.2 81 12-23 months 69.8 85.4 60.7 85.4 0.6 11.4 16.2 10.5 106 24-35 months 74.7 92.3 65.4 93.4 0.0 10.2 20.6 3.8 56 36-47 months (60.2) (71.5) (59.2) (72.6) (0.0) (5.6) (23.4) (13.1) 46 48-59 months (60.1) (73.7) (55.7) (73.7) (0.0) (9.6) (19.9) (19.4) 37 Mother’s education* None 75.3 86.8 56.7 88.8 0.0 6.8 17.1 6.5 55 Primary 64.3 87.4 60.2 87.4 0.6 12.4 14.3 10.1 112 Secondary + 57.5 74.3 63.0 74.7 0.0 6.1 18.9 19.6 153 Other/Non-standard (*) (*) (*) (*) (*) (*) (*) (*) 6 Wealth index quintile Poorest 70.7 84.2 58.0 85.4 0.0 12.6 16.1 8.4 142 Second 51.9 85.0 59.0 85.0 0.9 4.9 19.7 11.6 75 Middle (*) (*) (*) (*) (*) (*) (*) (*) 36 Fourth (66.3) (78.1) (67.7) (78.1) (0.0) (9.1) (19.5) (18.0) 51 Richest (*) (*) (*) (*) (*) (*) (*) (*) 21 Ethnicity of household head* Indigenous/Amerindian (62.1) (82.7) (44.7) (84.9) (2.4) (0.0) (9.6) (11.3) 28 Maroon 67.1 88.4 64.3 89.2 0.0 13.1 13.8 7.5 150 Creole (*) (*) (*) (*) (*) (*) (*) (*) 36 Hindustani (55.4) (60.8) (44.6) (60.8) (0.0) (4.3) (20.7) (29.4) 62 Javanese (*) (*) (*) (*) (*) (*) (*) (*) 12 Mixed (72.6) (87.2) (78.1) (87.2) (0.0) (1.8) (23.7) (7.3) 37 Others (*) (*) (*) (*) (*) (*) (*) (*) 2 Total 62.6 80.6 60.8 81.2 0.2 8.3 18.1 13.9 325 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 3.8       Child Health  52 Suriname MICS4  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 pneumonia   Knowledge of the danger signs of pneumonia    Table CH.7 (page 53) presents the prevalence of suspected pneumonia and, if care was sought outside the  home,  the  site of care. Specifically, 2 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, a little more than  three quarters (76%) were taken to an appropriate provider. Just over a half of the children (51%) of the  children with suspected pneumonia were cared for in a public sector government health centre. Table CH.7  shows  that  13  percent were  cared  for  by  a  private  physician.  Public  sector  government  hospitals  and  private  hospitals/clinics  provided  care  for  5  percent  and  8  percent,  respectively,  of  all  children  with  suspected pneumonia.   Table CH.7 also presents the use of antibiotics for the treatment of suspected pneumonia  in under‐5s by  sex, age, district, area, age, and socioeconomic factors.  In Suriname, 71 percent of under‐5 children with  suspected pneumonia had received an antibiotic during the two weeks prior to the survey.   Issues  related  to  knowledge  of  danger  signs  of  pneumonia  are  presented  in  Table  CH.8  (page  55).  Obviously, mothers’ knowledge of the danger signs is an important determinant of care‐seeking behaviour.  Overall,  just  10  percent  of  women  know  of  the  two  danger  signs  of  pneumonia  –  fast  and  difficult  breathing. Such knowledge was  relatively more  frequent among mother’s who had secondary education  (12%)  than  among  those  with  lower  levels  of  education  (8%  for  primary  education  and  8%  for  no  education). Compared  to  urban  and  rural  interior  areas,  rural  coastal  areas have higher  proportions of  mothers who had known the two danger signs of pneumonia, the respective proportions being 10 percent,  8 percent, and 14 percent. The most commonly identified symptom for taking a child to a health facility is if  the  child  develops  a  fever  (72%). Nonetheless,  12  percent  of mothers  identified  fast  breathing  and  17  percent of mothers identified difficulty breathing as symptoms for taking children immediately to a health  care  provider.  63  percent  of  mothers  identified  other  symptoms  not  specifically  mentioned  in  the  questionnaire, which should inform future data collection activities.  Ch ild  He al th           Su rin am e M IC S4 53   Ta bl e C H .7 : C ar e se ek in g fo r s us pe ct ed p ne um on ia a nd a nt ib io tic u se d ur in g su sp ec te d pn eu m on ia P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ith s us pe ct ed p ne um on ia in th e la st tw o w ee ks w ho w er e ta ke n to a h ea lth p ro vi de r a nd p er ce nt ag e of c hi ld re n w ho w er e gi ve n an tib io tic s, S ur in am e, 2 01 0 H ad su sp ec te d pn eu m on ia in th e la st tw o w ee ks N um be r of ch ild re n ag e 0- 59 m on th s C hi ld re n w ith s us pe ct ed p ne um on ia w ho w er e ta ke n to : A ny ap pr op . pr ov id er 1 P er ce nt ag e of c hi ld re n w ith su sp ec te d pn eu m on ia w ho re ce iv ed an tib io tic s in th e la st tw o w ee ks 2 N um be r o f ch ild re n ag e 0- 59 m on th s w ith su sp ec te d pn eu m on ia in th e la st tw o w ee ks Pu bl ic s ou rc es Pr iv at e so ur ce s O th er s ou rc e G ov t. ho sp ita l G ov t. he al th ce nt re G ov t. he al th po st V illa ge he al th w or ke r M ob ile / ou tre ac h cl in ic O th er pu bl ic P riv at e ho sp ita l / c lin ic P riv at e ph ys ic ia n O th er pr iv at e m ed ic al R el a- tiv e or fri en d Tr ad . P ra ct i- tio ne r O th er Se x* M al e 2. 9 1, 65 9 (4 .6 ) (5 2. 5) (0 .0 ) (2 .2 ) (1 .1 ) (1 .4 ) (8 .5 ) (1 4. 2) (0 .0 ) (0 .0 ) (1 4. 1) (0 .0 ) (7 2. 1) (7 3. 1) 47 Fe m al e 1. 5 1, 64 9 (6 .7 ) (4 8. 2) (4 .0 ) (4 .0 ) (0 .0 ) (0 .0 ) (7 .9 ) (1 1. 9) (0 .0 ) (2 .4 ) (0 .0 ) (0 .0 ) (8 2. 8) (6 7. 7) 25 D is tr ic t P ar am ar ib o 2. 1 1, 27 4 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 26 W an ic a 1. 4 59 9 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 8 N ic ke rie 3. 1 18 8 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 6 C or on ie 4. 5 14 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 1 S ar am ac ca 0. 7 91 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 1 C om m ew ijn e 3. 3 12 2 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 4 M ar ow ijn e 0. 9 19 2 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 2 P ar a 1. 7 12 2 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 2 B ro ko po nd o 2. 7 16 7 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 5 S ip al iw in i 3. 5 53 7 (1 0. 8) (5 6. 8) (5 .4 ) (1 0. 8) (2 .7 ) (0 .0 ) (0 .0 ) (2 .7 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (8 6. 5) (4 5. 9) 19 A re a U rb an 2. 1 2, 00 1 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 42 R ur al C oa st al 1. 2 60 3 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 7 R ur al in te rio r 3. 3 70 5 (1 0. 9) (5 0. 1) (4 .4 ) (8 .7 ) (2 .2 ) (0 .0 ) (0 .0 ) (4 .3 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (7 8. 4) (4 1. 4) 23 To ta l R ur al 2. 3 1, 30 7 12 .7 49 .3 3. 3 6. 7 1. 7 2. 1 0. 0 5. 6 0. 0 2. 0 2. 1 0. 0 75 .4 51 .2 31 A ge 0- 11 m on th s 2. 3 64 6 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 15 12 -2 3 m on th s 4. 0 74 4 (7 .4 ) (4 6. 3) (3 .5 ) (1 .7 ) (0 .0 ) (2 .2 ) (6 .9 ) (1 5. 3) (0 .0 ) (0 .0 ) (1 5. 8) (0 .0 ) (8 1. 0) (8 2. 6) 30 24 -3 5 m on th s 1. 4 64 0 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 9 36 -4 7 m on th s 1. 8 69 4 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 13 48 -5 9 m on th s 1. 2 58 4 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 7 M ot he r’s e du ca tio n* N on e 3. 9 45 4 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 18 P rim ar y 2. 4 96 7 (4 .3 ) (7 1. 3) (0 .0 ) (2 .2 ) (0 .0 ) (0 .0 ) (8 .5 ) (8 .5 ) (0 .0 ) (2 .6 ) (0 .0 ) (0 .0 ) (7 7. 8) (5 8. 7) 24 S ec on da ry + 1. 7 1, 82 4 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 31 O th er /N on -s ta nd ar d (0 .0 ) 48 - - - - - - - - - - - - - - 0 W ea lth in de x qu in til e P oo re st 2. 6 1, 13 9 (9 .2 ) (5 5. 9) (3 .4 ) (6 .8 ) (1 .7 ) (0 .0 ) (0 .0 ) (3 .4 ) (0 .0 ) (2 .0 ) (0 .0 ) (0 .0 ) (7 8. 7) (4 6. 7) 30 S ec on d 2. 4 67 5 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 16 M id dl e 1. 3 56 3 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 7 Fo ur th 2. 3 50 1 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 11 R ic he st 1. 9 42 9 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 8   Ch ild  He al th   54 Su rin am e M IC S4       Ta bl e C H .7 : C ar e se ek in g fo r s us pe ct ed p ne um on ia a nd a nt ib io tic u se d ur in g su sp ec te d pn eu m on ia ( co nt in ue d) P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ith s us pe ct ed p ne um on ia in th e la st tw o w ee ks w ho w er e ta ke n to a h ea lth p ro vi de r a nd p er ce nt ag e of c hi ld re n w ho w er e gi ve n an tib io tic s, S ur in am e, 2 01 0 H ad su sp ec te d pn eu m on ia in th e la st tw o w ee ks N um be r of ch ild re n ag e 0- 59 m on th s C hi ld re n w ith s us pe ct ed p ne um on ia w ho w er e ta ke n to : A ny ap pr op . pr ov id er 1 P er ce nt ag e of ch ild re n w ith su sp ec te d pn eu m on ia w ho re ce iv ed an tib io tic s in th e la st t w o w ee ks 2 N um be r of ch ild re n ag e 0- 59 m on th s w ith su sp ec te d pn eu m on ia in th e la st tw o w ee ks Pu bl ic s ou rc es Pr iv at e so ur ce s O th er s ou rc e G ov t. ho sp ita l G ov t. he al th ce nt re G ov t. he al th po st V illa ge he al th w or ke r M ob ile / ou tre ac h cl in ic O th er pu bl ic P riv at e ho sp ita l / c lin ic P riv at e ph ys ic ia n O th er pr iv at e m ed ic al R el a- tiv e or fri en d Tr ad . P ra ct i- tio ne r O th er Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 6. 8 15 3 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 M ar oo n 1. 5 1, 38 9 (1 6. 0) (3 5. 1) (5 .0 ) (7 .5 ) (0 .0 ) (0 .0 ) (0 .0 ) (5 .0 ) (0 .0 ) (3 .0 ) (0 .0 ) (0 .0 ) (6 8. 7) (4 9. 1) 20 C re ol e 3. 4 42 8 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 15 H in du st an i 2. 1 64 4 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 13 Ja va ne se 1. 5 34 6 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 5 M ix ed 2. 2 30 8 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 7 O th er s (* ) 38 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 2 To ta l 2. 2 3, 30 8 5. 4 51 .0 1. 4 2. 8 0. 7 0. 9 8. 3 13 .4 0. 0 0. 8 9. 2 0. 0 75 .8 71 .2 73 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 3 .9 2 M IC S in di ca to r 3 .1 0 Ch ild  He al th           Su rin am e M IC S4 55   Ta bl e C H .8 : K no w le dg e of th e tw o da ng er s ig ns o f p ne um on ia P er ce nt ag e of m ot he rs a nd c ar et ak er s of c hi ld re n ag e 0- 59 m on th s by s ym pt om s th at w ou ld c au se to ta ke th e ch ild im m ed ia te ly to a h ea lth fa ci lit y, a nd p er ce nt ag e of m ot he rs w ho re co gn iz e fa st a nd d iff ic ul t b re at hi ng a s si gn s fo r s ee ki ng c ar e im m ed ia te ly , S ur in am e 20 10 Pe rc en ta ge o f m ot he rs /c ar et ak er s of c hi ld re n ag e 0- 59 m on th s w ho th in k th at a c hi ld s ho ul d be ta ke n im m ed ia te ly to a h ea lth fa ci lit y if th e ch ild : M ot he rs /c ar et ak er s w ho re co gn iz e th e tw o da ng er s ig ns of p ne um on ia N um be r o f m ot he rs /c ar et ak er s of c hi ld re n ag e 0- 59 m on th s Is n ot a bl e to d rin k or br ea st fe ed B ec om es si ck er D ev el op s a fe ve r H as fa st br ea th in g H as di ffi cu lty br ea th in g H as bl oo d in st oo l Is dr in ki ng po or ly H as o th er sy m pt om s D is tr ic t P ar am ar ib o 7. 6 28 .3 68 .5 13 .0 18 .8 12 .8 6. 4 60 .1 10 .6 82 5 W an ic a 5. 4 24 .8 67 .6 10 .8 14 .0 9. 0 4. 5 59 .5 7. 7 37 1 N ic ke rie 2. 7 25 .4 66 .6 16 .1 18 .7 14 .3 2. 2 68 .4 14 .3 11 9 C or on ie (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 9 S ar am ac ca 9. 6 20 .2 80 .8 7. 7 18 .3 15 .4 5. 8 56 .7 7. 7 55 C om m ew ijn e 6. 2 25 .0 82 .0 9. 7 15 .3 9. 0 7. 0 67 .4 9. 0 78 M ar ow ijn e 8. 1 16 .2 79 .3 10 .6 14 .1 12 .6 6. 1 78 .3 9. 6 97 P ar a 19 .7 29 .1 74 .4 25 .6 29 .9 25 .6 12 .8 65 .0 25 .6 67 B ro ko po nd o 5. 9 32 .2 70 .8 5. 9 10 .4 5. 9 5. 9 62 .4 5. 9 81 S ip al iw in i 6. 0 21 .3 83 .7 9. 8 15 .5 9. 4 6. 7 71 .6 8. 6 26 5 A re a U rb an 6. 6 27 .1 68 .8 12 .2 17 .1 11 .5 5. 7 60 .9 9. 7 1, 27 6 R ur al C oa st al 9. 5 22 .1 74 .6 14 .9 19 .7 15 .9 6. 6 66 .7 13 .8 34 5 R ur al in te rio r 6. 0 23 .9 80 .7 8. 9 14 .3 8. 6 6. 6 69 .5 8. 0 34 5 To ta l R ur al 7. 7 23 .0 77 .7 11 .9 17 .0 12 .2 6. 6 68 .1 10 .9 69 0 M ot he r's e du ca tio n* N on e 6. 3 22 .9 84 .9 8. 6 15 .6 8. 9 6. 8 68 .1 7. 5 21 8 P rim ar y 6. 2 23 .1 75 .1 9. 8 13 .6 8. 1 6. 2 63 .3 7. 5 52 3 S ec on da ry + 7. 6 27 .5 68 .3 13 .9 19 .0 14 .1 5. 9 62 .8 12 .0 1, 19 0 O th er /N on -s ta nd ar d (3 .8 ) (1 9. 9) (6 2. 5) (7 .7 ) (1 6. 6) (5 .2 ) (3 .8 ) (6 0. 5) (2 .0 ) 29     Ch ild  He al th   56 Su rin am e M IC S4       Ta bl e C H .8 : K no w le dg e of th e tw o da ng er s ig ns o f p ne um on ia (c on tin ue d) P er ce nt ag e of m ot he rs a nd c ar et ak er s of c hi ld re n ag e 0- 59 m on th s by s ym pt om s th at w ou ld c au se to ta ke th e ch ild im m ed ia te ly to a h ea lth fa ci lit y, a nd p er ce nt ag e of m ot he rs w ho re co gn iz e fa st a nd d iff ic ul t b re at hi ng a s si gn s fo r s ee ki ng c ar e im m ed ia te ly , S ur in am e 20 10 Pe rc en ta ge o f m ot he rs /c ar et ak er s of c hi ld re n ag e 0- 59 m on th s w ho th in k th at a c hi ld s ho ul d be ta ke n im m ed ia te ly to a h ea lth fa ci lit y if th e ch ild : M ot he rs /c ar et ak er s w ho r ec og ni ze t he tw o da ng er si gn s of p ne um on ia N um be r o f m ot he rs /c ar et ak er s of c hi ld re n ag e 0- 59 m on th s Is n ot a bl e to d rin k or br ea st fe ed B ec om es si ck er D ev el op s a fe ve r H as fa st br ea th in g H as di ffi cu lty br ea th in g H as bl oo d in st oo l Is dr in ki ng po or ly H as o th er sy m pt om s W ea lth in de x qu in til e P oo re st 6. 0 22 .2 78 .4 8. 3 13 .7 7. 9 5. 4 72 .0 7. 3 57 3 S ec on d 6. 3 27 .7 72 .0 9. 5 15 .7 10 .6 6. 2 58 .5 7. 9 41 3 M id dl e 7. 5 30 .7 66 .6 17 .0 22 .6 17 .3 9. 1 56 .8 14 .0 35 2 Fo ur th 9. 3 25 .3 69 .0 14 .4 14 .9 12 .5 5. 8 61 .1 11 .2 33 8 R ic he st 6. 8 24 .1 69 .0 14 .6 21 .8 13 .6 3. 4 64 .2 13 .1 29 0 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 11 .1 27 .5 76 .8 19 .8 22 .6 20 .1 6. 9 58 .1 19 .8 95 M ar oo n 7. 9 25 .2 78 .7 9. 7 15 .4 9. 6 6. 3 68 .2 7. 9 72 2 C re ol e 6. 0 24 .9 59 .7 13 .5 18 .2 13 .9 6. 9 65 .3 10 .4 26 6 H in du st an i 5. 3 26 .5 71 .2 11 .9 15 .3 9. 7 5. 7 64 .6 9. 7 43 0 Ja va ne se 8. 1 26 .1 72 .4 13 .9 19 .2 15 .1 4. 1 50 .4 11 .9 22 5 M ix ed 6. 1 25 .2 62 .7 14 .2 21 .6 13 .6 6. 1 60 .5 13 .1 19 8 O th er s (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 29 To ta l 7. 0 25 .7 71 .9 12 .1 17 .1 11 .8 6. 0 63 .4 10 .1 1, 96 7 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s Child Health      Suriname MICS4 57 Solid Fuel Use More  than 3 billion people  around  the world  rely on  solid  fuels  for  their basic energy needs,  including  cooking and heating. Solid fuels include biomass fuels, such as wood, charcoal, crops or other agricultural  waste, dung, shrubs and straw, and coal. Cooking and heating with solid fuels leads to high levels of indoor  smoke which contains a complex mix of health‐damaging pollutants. The main problem with  the use of  solid  fuels  is  their  incomplete  combustion,  which  produces  toxic  elements  such  as  carbon  monoxide,  polyaromatic hydrocarbons, and sulphur dioxide (SO2), among others. Use of solid fuels increases the risks  of  incurring  acute  respiratory  illness, pneumonia,  chronic obstructive  lung disease,  cancer,  and possibly  tuberculosis,  asthma, or  cataracts,  and may  contribute  to  low birth weight of babies born  to pregnant  women exposed to smoke. The primary indicator for monitoring use of solid fuels is the proportion of the  population using  solid  fuels as  the primary  source of domestic energy  for cooking,  shown  in Table CH.9  (page 58).  In Suriname, a little over one tenth (11%) of all household members live in households using solid fuels for  cooking. Use of  solid  fuels  is very  low  in urban areas  (6%) but  somewhat higher  in  rural areas where a  quarter of  the household members  (25%)  live  in households using  solid  fuels.  In  the  rural  interior,  the  proportion  is  as high  as 44 percent.  There  is  a  clear  inverse  relationship between  the wealth  status of  households  and  the  proportion  of  persons  living  in  households  that  use  solid  fuels  for  cooking.  In  the  poorest group, 37 percent of all household members are exposed to solid fuels for cooking as opposed to 2  percent  in  second  wealthiest  group  and  virtually  nobody  in  the  wealthiest  group.  The  wealth  status  differentials are somewhat consistent with differences between household members predicated upon the  education level of household heads. Accordingly, it is not surprising that in households where heads had no  education,  the  proportion  of  persons  exposed  to  the  use  of  solid  fuels  for  cooking was  33  percent  as  opposed 5 percent  in cases where household heads had at  least secondary  level education. The  findings  show that exposure to use of solid fuels for cooking is very uncommon among household members in two  districts  –  Paramaribo  (3%)  and  Coronie  (2%)  with  the  former  district  containing  the  richest  set  of  households.  In Sipaliwini, however,  it  is common for the household members (52%) to use solid fuels for  cooking.  The distribution of household members by  type of  cooking  fuel used by households  is depicted  also  in  Table  CH.9.  Liquified  petroleum  gas  (LPG)  is  the  cooking  fuel  most  frequently  used  by  members  of  households in Suriname (86%), this being the case irrespective of area and wealth status. The use of LPG is  also predominant in every district of Suriname except Sipaliwini where 47 percent of household members  were  in  households  that  use  LPG  and  instead,  a  majority  of  approximately  51  percent  of  household  members lived in households that use wood. Urban‐rural differences in poverty status are reflected by the  relatively low use of LPG in households occupied by poorest household members and their relatively high  use of wood as a  fuel  for cooking. This observation  is consistent with outcomes pertaining to the use of  wood as a cooking fuel in rural areas which constitute the poorest areas in Suriname.  Solid fuel use by place of cooking is depicted in Table CH.10. The presence and extent of indoor pollution  are dependent on cooking practices, places used for cooking, as well as types of fuel used. In Suriname, the  majority of household members are  from households  that use  solid  fuels outdoors  (40%). Close  to one  third  of  household  members  (29%)  come  from  households  that  cook  using  solid  fuels  in  a  separate  building.  A  notably  smaller  proportion  amounting  to  19  percent  of  household  members  come  from  households  where  solid  fuels  were  used  in  kitchen  located  in  separate  room  in  the  dwelling  unit.  Ch ild  He al th 58   Su rin am e M IC S4      Ta bl e C H .9 : S ol id fu el u se P er ce nt d is tri bu tio n of h ou se ho ld m em be rs a cc or di ng to ty pe o f c oo ki ng fu el u se d by th e ho us eh ol d, a nd p er ce nt ag e of h ou se ho ld m em be rs li vi ng in h ou se ho ld s us in g so lid fu el s fo r c oo ki ng , S ur in am e, 2 01 0 Pe rc en ta ge o f h ou se ho ld m em be rs in h ou se ho ld s us in g: N um be r of ho us eh ol d m em be rs E le ct ric ity Li qu ef ie d P et ro le um G as (L P G ) N at ur al G as B io ga s K er os en e So lid fu el s O th er fu el N o fo od co ok ed i n th e ho us eh ol d M is si ng To ta l S ol id fu el s fo r co ok in g1 C ha r- co al W oo d S tra w , sh ru bs , gr as s D is tr ic t P ar am ar ib o 2. 3 94 .3 0. 1 0. 1 0. 2 0. 3 2. 2 0. 0 0. 2 0. 2 0. 0 10 0. 0 2. 5 13 ,4 19 W an ic a 1. 0 85 .2 0. 0 0. 0 0. 1 0. 8 12 .5 0. 0 0. 1 0. 2 0. 0 10 0. 0 13 .3 5, 21 7 N ic ke rie 0. 7 88 .8 0. 0 0. 3 0. 0 0. 4 9. 7 0. 0 0. 0 0. 2 0. 0 10 0. 0 10 .1 2, 08 1 C or on ie 2. 7 95 .2 0. 0 0. 0 0. 0 0. 0 2. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 2. 0 16 1 S ar am ac ca 0. 1 83 .9 0. 0 0. 0 0. 2 0. 9 14 .5 0. 0 0. 1 0. 1 0. 3 10 0. 0 15 .4 92 0 C om m ew ijn e 0. 9 83 .8 0. 2 0. 0 0. 0 1. 7 13 .1 0. 0 0. 1 0. 2 0. 0 10 0. 0 14 .8 1, 37 3 M ar ow ijn e 0. 1 87 .2 0. 0 0. 0 0. 2 0. 2 12 .1 0. 0 0. 0 0. 1 0. 0 10 0. 0 12 .3 1, 08 1 P ar a 0. 9 82 .6 0. 0 0. 0 0. 5 0. 3 15 .6 0. 0 0. 0 0. 1 0. 0 10 0. 0 15 .9 1, 05 4 B ro ko po nd o 0. 1 79 .6 0. 0 0. 3 0. 0 0. 8 18 .4 0. 0 0. 0 0. 8 0. 0 10 0. 0 19 .2 77 4 S ip al iw in i 0. 0 46 .9 0. 0 0. 2 0. 3 0. 9 51 .0 0. 1 0. 3 0. 3 0. 1 10 0. 0 51 .9 2, 34 1 A re a U rb an 1. 9 91 .4 0. 1 0. 1 0. 2 0. 5 5. 5 0. 0 0. 2 0. 2 0. 0 10 0. 0 6. 0 20 ,0 66 R ur al C oa st al 0. 6 85 .8 0. 1 0. 0 0. 2 0. 5 12 .5 0. 0 0. 0 0. 1 0. 1 10 0. 0 13 .1 5, 24 0 R ur al in te rio r 0. 0 55 .0 0. 0 0. 2 0. 2 0. 8 42 .9 0. 1 0. 2 0. 4 0. 1 10 0. 0 43 .8 3, 11 4 To ta l R ur al 0. 4 74 .3 0. 1 0. 1 0. 2 0. 7 23 .9 0. 0 0. 1 0. 2 0. 1 10 0. 0 24 .5 8, 35 5 Ed uc at io n of h ou se ho ld h ea d N on e 0. 1 66 .4 0. 0 0. 1 0. 1 1. 1 31 .6 0. 1 0. 0 0. 4 0. 1 10 0. 0 32 .8 3, 07 0 P rim ar y 1. 1 82 .7 0. 1 0. 1 0. 3 0. 5 15 .0 0. 0 0. 1 0. 2 0. 0 10 0. 0 15 .5 9, 08 6 S ec on da ry + 2. 0 92 .7 0. 0 0. 1 0. 1 0. 5 4. 2 0. 0 0. 2 0. 2 0. 1 10 0. 0 4. 6 14 ,3 57 O th er /N on -s ta nd ar d 0. 8 90 .6 0. 0 0. 0 0. 0 1. 2 7. 4 0. 0 0. 0 0. 0 0. 0 10 0. 0 8. 6 40 8 M is si ng /D K 1. 1 88 .7 0. 2 0. 0 0. 2 0. 2 8. 9 0. 0 0. 6 0. 2 0. 0 10 0. 0 9. 1 1, 50 0     Ch ild  He al th           Su rin am e M IC S4 59 Ta bl e C H .9 : S ol id fu el u se ( co nt in ue d) P er ce nt d is tri bu tio n of h ou se ho ld m em be rs a cc or di ng to ty pe o f c oo ki ng fu el u se d by th e ho us eh ol d, a nd p er ce nt ag e of h ou se ho ld m em be rs li vi ng in h ou se ho ld s us in g so lid fu el s fo r c oo ki ng , S ur in am e, 2 01 0 Pe rc en ta ge o f h ou se ho ld m em be rs in h ou se ho ld s us in g: N um be r of ho us eh ol d m em be rs E le ct ric ity Li qu ef ie d P et ro le um G as (L P G ) N at ur al G as B io ga s K er os en e So lid fu el s O th er fu el N o fo od co ok ed i n th e ho us eh ol d M is si ng To ta l S ol id fu el s fo r co ok in g1 C ha r- co al W oo d S tra w , sh ru bs , gr as s W ea lth in de x qu in til es P oo re st 0. 9 60 .5 0. 1 0. 3 0. 4 0. 9 36 .0 0. 0 0. 4 0. 5 0. 0 10 0. 0 36 .9 5, 69 1 S ec on d 2. 3 83 .6 0. 2 0. 1 0. 3 0. 8 12 .1 0. 0 0. 1 0. 4 0. 1 10 0. 0 12 .9 5, 67 9 M id dl e 1. 8 92 .3 0. 0 0. 0 0. 0 0. 4 5. 2 0. 0 0. 1 0. 1 0. 0 10 0. 0 5. 7 5, 68 3 Fo ur th 1. 2 96 .6 0. 0 0. 0 0. 1 0. 6 1. 1 0. 0 0. 1 0. 1 0. 1 10 0. 0 1. 7 5, 67 6 R ic he st 1. 0 99 .0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 0. 0 5, 69 3 Et hn ic ity o f h ou se ho ld h ea d In di ge no us /A m er in di an 0. 2 71 .3 0. 0 0. 0 0. 3 0. 1 27 .4 0. 0 0. 5 0. 1 0. 0 10 0. 0 27 .6 1, 24 8 M ar oo n 0. 6 80 .0 0. 0 0. 1 0. 2 0. 4 18 .4 0. 0 0. 0 0. 2 0. 0 10 0. 0 18 .8 7, 27 9 C re ol e 3. 0 94 .4 0. 0 0. 2 0. 2 0. 2 1. 2 0. 0 0. 2 0. 2 0. 1 10 0. 0 1. 4 4, 91 2 H in du st an i 0. 7 80 .3 0. 2 0. 0 0. 2 1. 4 16 .7 0. 0 0. 3 0. 2 0. 0 10 0. 0 18 .1 7, 74 5 Ja va ne se 0. 8 98 .6 0. 0 0. 1 0. 0 0. 1 0. 5 0. 0 0. 0 0. 0 0. 0 10 0. 0 0. 6 3, 99 7 M ix ed 3. 6 94 .4 0. 0 0. 0 0. 1 0. 2 1. 2 0. 0 0. 1 0. 3 0. 0 10 0. 0 1. 5 2, 69 2 O th er s 6. 1 93 .0 0. 0 0. 0 0. 1 0. 0 0. 2 0. 0 0. 0 0. 6 0. 0 10 0. 0 0. 2 52 3 M is si ng /D K (0 .0 ) (7 9. 2) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (2 0. 8) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) 10 0. 0 (2 0. 8) 26 To ta l 1. 4 86 .4 0. 1 0. 1 0. 2 0. 6 10 .9 0. 0 0. 2 0. 2 0. 0 10 0. 0 11 .4 28 ,4 21 ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s 1 M IC S in di ca to r 3 .1 1     Child Health 60  Suriname MICS4  Table CH.10: Solid fuel use by place of cooking Percent distribution of household members in households using solid fuels by place of cooking, Suriname, 2010 Place of cooking: Number of household members in households using solid fuels for cooking In a separate room used as kitchen Elsewhere in the house In a separate building Outdoors At another place Missing Total District Paramaribo 32.3 0.0 5.0 51.2 0.0 11.4 100.0 335 Wanica 22.6 1.2 17.7 50.2 0.0 8.3 100.0 694 Nickerie 9.2 0.0 15.2 56.7 0.0 19.0 100.0 210 Coronie (*) (*) (*) (*) (*) (*) 100.0 3 Saramacca 11.6 3.5 22.5 37.6 0.0 24.8 100.0 141 Commewijne 27.7 1.6 4.4 57.0 0.0 9.3 100.0 203 Marowijne 3.1 1.1 28.2 49.6 0.0 17.9 100.0 133 Para 8.1 2.1 19.4 45.9 0.0 24.4 100.0 167 Brokopondo 21.8 2.3 43.4 27.3 1.1 4.0 100.0 148 Sipaliwini 17.3 3.7 50.2 25.0 0.0 3.8 100.0 1,216 Area Urban 26.3 0.7 11.9 50.9 0.0 10.1 100.0 1,201 Rural Coastal 8.9 1.9 20.3 49.6 0.0 19.3 100.0 686 Rural interior 17.8 3.6 49.5 25.2 0.1 3.8 100.0 1,364 Total Rural 14.8 3.0 39.7 33.4 0.1 9.0 100.0 2,050 Education of household head None 18.2 4.6 45.2 25.5 0.2 6.3 100.0 1,007 Primary 20.3 0.7 26.6 42.4 0.0 10.0 100.0 1,406 Secondary + 20.9 1.9 12.8 54.7 0.0 9.6 100.0 667 Other/Non-standard (14.3) (0.0) (26.0) (35.6) (0.0) (24.0) 100.0 35 Missing/DK 5.0 0.9 24.7 47.6 0.0 21.8 100.0 136 Wealth index quintiles Poorest 17.7 2.7 37.8 32.9 0.1 8.9 100.0 2,102 Second 18.4 0.7 13.3 59.4 0.0 8.2 100.0 731 Middle 27.0 3.0 14.3 37.0 0.0 18.7 100.0 322 Fourth 26.9 0.0 20.6 52.5 0.0 0.0 100.0 97 Richest - - - - - - - 0 Ethnicity of household head* Indigenous/Amerindian 16.2 2.6 36.4 36.0 0.0 8.8 100.0 344 Maroon 16.5 3.2 44.6 28.9 0.1 6.7 100.0 1,367 Creole 28.8 1.7 4.3 50.2 0.0 14.9 100.0 71 Hindustani 22.3 1.0 15.1 49.8 0.0 11.8 100.0 1,399 Javanese 14.2 0.0 13.9 58.0 0.0 13.9 100.0 24 Mixed 7.0 8.2 8.2 76.6 0.0 0.0 100.0 40 Others (*) (*) (*) (*) (*) (*) 100.0 1 Total 19.1 2.2 29.4 39.9 0.1 9.4 100.0 3,251 * ‘Missing/DK’ category of ethnicity of household head not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases Malaria Malaria  is  a  leading  cause  of  death  of  children  under  age  five  in  many  developing  countries.  It  also  contributes  to anaemia  in children and  is a common cause of school absenteeism. Preventive measures,  especially  the  use  of  mosquito  nets  treated  with  insecticide  (ITNs),  can  dramatically  reduce  malaria  mortality  rates  among  children.  In  areas  where  malaria  is  common,  international  recommendations  suggest treating any fever in children as if it were malaria and immediately giving the child a full course of  Child Health      Suriname MICS4 61 recommended anti‐malarial tablets. Children with severe malaria symptoms, such as fever or convulsions,  should be taken to a health facility. Also, children recovering from malaria should be given extra liquids and  food and, for younger children, should continue breastfeeding.  In Suriname malaria is endemic mainly in the rural interior and therefore the malaria related modules were  only employed  in Brokopondo and Sipaliwini. The modules  incorporates questions on the availability and  use of bed nets, both at household level and among children under five years of age and pregnant women.  In addition, all households were asked whether the interior dwelling walls were sprayed with an insecticide  to kill mosquitoes that spread malaria during the 12 months preceding the survey.   The survey results indicate that almost 61 percent of households have at least one insecticide treated net  and/or  received  indoor  residual  spraying  in  the  last 12 months preceding  the  survey  (Table CH.11, page  62). A notably smaller proportion of households in which the head had no education (55%) had at least one  insecticide treated net when compared to households  in which the head had higher  levels of educational  attainment (68% for primary and 65 % for secondary or higher).  The survey results indicate that 54 percent of children under the age of five slept under any mosquito net  the night prior to the survey and 43 percent slept under an insecticide treated net (Table CH.12, page 63).  There was virtually no gender disparity  in  ITN use among children under  five.  In terms of age categories  among children under  five,  those 0‐11 months were more  likely  than  those  in older age groups  to have  slept under any mosquito net or under an insecticide treated net.   The survey also collected information on whether pregnant women were sleeping under ITNs (Table CH.13,  page 65). Due to a  low sample size of  just 77 pregnant women  living  in households with at  least one ITN  (unweighted), the numbers should be used with caution. Overall, half of pregnant women slept under an  ITN the night before the survey (51%), whereas about two‐thirds slept under any mosquito net (65%).  Questions on the prevalence and treatment of fever were asked for all children under age five. Just under  one fifth (17%) of under five children were ill with fever in the two weeks prior to the survey (Table CH.14,  page  67).  The  mothers  of  children  with  fever  were  asked  which  drugs  were  used  for  treatment  and  somewhat surprisingly  the  respondents did not  indicate use of anti‐malarials at all. This may have  to do  with the period of survey fieldwork and of course with a generally  low  incidence of malaria.  In about 50  percent of cases, the child was treated with paracetamol or similar and in about 20 percent of cases with  an antibiotic drug.   Table CH.15 (page 69) provides the proportion of children age 0‐59 months who had a fever in the last two  weeks and who had a finger or heel stick for malaria testing. Overall, 15 percent of children with a fever in  the last two weeks had a finger or heel stick. The low number of cases does not allow for observations on  patterns in background characteristics.      Child Health 62  Suriname MICS4  Table CH.11: Household availability of insecticide treated nets and protection by a vector control method Percentage of households with at least one mosquito net, percentage of households with at least one long-lasting treated net, percentage of households with at least one insecticide treated net (ITN) and percentage of households which either have at least one ITN or have received indoor residual spraying (IRS) in the last 12 months, rural interior area, Suriname, 2010 Percentage of households with at least one mosquito net Percentage of households with at least one long-lasting treated net Percentage of households with at least one ITN1 Percentage of households with at least one ITN or received IRS during the last 12 months2 Number of households District Brokopondo 73.7 56.8 61.3 61.8 186 Sipaliwini 70.4 58.7 60.2 60.7 619 Education of household head None 61.8 53.9 54.5 54.8 397 Primary 81.8 63.3 67.2 68.0 294 Secondary + 77.3 61.4 65.4 65.4 76 Missing/DK 75.4 57.3 59.9 61.2 33 Wealth index quintiles Poorest 70.7 58.4 60.4 60.9 717 Second 77.1 58.3 62.8 63.4 75 Middle (71.9) (60.0) (60.0) (60.0) 11 Fourth (*) (*) (*) (*) 2 Richest - - - - 0 Ethnicity of household head* Indigenous/Amerindian 91.1 65.1 68.6 69.2 73 Maroon 69.2 57.8 59.8 60.3 716 Creole 100.0 83.2 83.2 83.2 3 Hindustani - - - - 0 Javanese - - - - 0 Mixed (*) (*) (*) (*) 12 Others (*) (*) (*) (*) 1 Total 71.2 58.3 60.5 60.9 806 * ‘Missing/DK’ category of ethnicity of household head not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 3.12 2 MICS indicator 3.13 Ch ild  He al th           Su rin am e M IC S4 63   Ta bl e C H .1 2: C hi ld re n sl ee pi ng u nd er m os qu ito n et s P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ho s le pt u nd er a m os qu ito n et d ur in g th e pr ev io us n ig ht , b y ty pe o f n et , r ur al in te rio r a re a, S ur in am e, 2 01 0 P er ce nt ag e of ch ild re n ag e 0- 59 w ho s ta ye d in th e ho us eh ol d th e pr ev io us n ig ht N um be r of ch ild re n ag e 0- 59 m on th s Pe rc en ta ge o f c hi ld re n w ho : N um be r o f ch ild re n ag e 0- 59 m on th s w ho s le pt in th e ho us eh ol d th e pr ev io us n ig ht P er ce nt ag e of ch ild re n w ho s le pt un de r a n IT N li vi ng in h ou se ho ld s w ith at le as t o ne IT N N um be r o f ch ild re n ag e 0- 59 li vi ng in ho us eh ol ds w ith a t l ea st on e IT N S le pt un de r an y m os qu ito ne t1 S le pt u nd er a n in se ct ic id e tre at ed n et 2 Se x M al e 94 .7 35 4 52 .7 43 .2 33 5 64 .1 22 6 Fe m al e 93 .2 35 1 54 .5 43 .5 32 7 62 .6 22 7 D is tr ic t B ro ko po nd o 95 .2 16 7 54 .3 40 .4 15 9 59 .5 10 8 S ip al iw in i 93 .5 53 7 53 .4 44 .3 50 2 64 .5 34 5 A ge 0- 11 m on th s 98 .5 13 5 65 .6 51 .5 13 3 78 .9 87 12 -2 3 m on th s 95 .2 13 9 52 .3 41 .1 13 2 64 .5 85 24 -3 5 m on th s 94 .4 14 7 57 .4 49 .3 13 9 67 .0 10 2 36 -4 7 m on th s 90 .9 15 1 47 .4 37 .4 13 8 53 .5 96 48 -5 9 m on th s 90 .7 13 2 44 .3 36 .6 12 0 52 .8 83 M ot he r's e du ca tio n* N on e 93 .3 32 1 44 .9 37 .9 29 9 58 .2 19 5 P rim ar y 94 .0 30 3 62 .1 49 .8 28 4 67 .5 21 0 S ec on da ry + 96 .6 74 57 .1 40 .9 72 66 .0 45 O th er /N on -s ta nd ar d (* ) 5 (* ) (* ) 4 (* ) 2 W ea lth in de x qu in til es P oo re st 93 .7 65 2 53 .1 43 .1 61 1 63 .0 41 8 S ec on d 95 .7 48 62 .1 48 .9 46 68 .8 32 M id dl e (* ) 4 (* ) (* ) 4 (* ) 2 Fo ur th (* ) 2 (* ) (* ) 2 - 0 R ic he st - 0 - - 0 - 0     Ch ild  He al th 64   Su rin am e M IC S4      Ta bl e C H .1 2: C hi ld re n sl ee pi ng u nd er m os qu ito n et s (c on tin ue d) P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ho s le pt u nd er a m os qu ito n et d ur in g th e pr ev io us n ig ht , b y ty pe o f n et , r ur al in te rio r a re a, S ur in am e, 2 01 0 P er ce nt ag e of ch ild re n ag e 0- 59 w ho s ta ye d in th e ho us eh ol d th e pr ev io us n ig ht N um be r o f ch ild re n ag e 0- 59 m on th s Pe rc en ta ge o f c hi ld re n w ho : N um be r o f ch ild re n ag e 0- 59 m on th s w ho s le pt in th e ho us eh ol d th e pr ev io us n ig ht P er ce nt ag e of ch ild re n w ho s le pt un de r a n IT N li vi ng in h ou se ho ld s w ith at le as t o ne IT N N um be r o f ch ild re n ag e 0- 59 li vi ng in ho us eh ol ds w ith a t l ea st on e IT N S le pt un de r an y m os qu ito ne t1 S le pt u nd er a n in se ct ic id e tre at ed n et 2 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 90 .6 54 78 .1 59 .4 49 85 .1 34 M ar oo n 94 .2 64 1 51 .3 42 .0 60 4 61 .3 41 4 C re ol e 10 0. 0 1 10 0. 0 10 0. 0 1 10 0. 0 1 H in du st an i - 0 - - 0 - 0 Ja va ne se - 0 - - 0 - 0 M ix ed 93 .4 8 64 .4 35 .6 7 83 .5 3 O th er s - 0 - - 0 - 0 To ta l 93 .9 70 5 53 .6 43 .4 66 2 63 .3 45 3 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 3 .1 4, 2 M IC S in di ca to r 3 .1 5; M D G in di ca to r 6 .7     Ch ild  He al th           Su rin am e M IC S4 65 Ta bl e C H .1 3: P re gn an t w om en s le ep in g un de r m os qu ito n et s P er ce nt ag e of p re gn an t w om en w ho s le pt u nd er a m os qu ito n et d ur in g th e pr ev io us n ig ht , b y ty pe o f n et , r ur al in te rio r a re a, S ur in am e, 2 01 0 P er ce nt ag e of pr eg na nt w om en w ho s ta ye d in th e ho us eh ol d th e pr ev io us n ig ht N um be r o f pr eg na nt w om en Pe rc en ta ge o f p re gn an t w om en w ho : N um be r o f pr eg na nt w om en w ho s le pt in th e ho us eh ol d th e pr ev io us n ig ht P er ce nt ag e of p re gn an t w om en w ho s le pt u nd er an IT N , l iv in g in ho us eh ol ds w ith a t l ea st on e IT N N um be r o f pr eg na nt w om en liv in g in ho us eh ol ds w ith at le as t o ne IT N S le pt u nd er a ny m os qu ito n et S le pt u nd er a n in se ct ic id e tre at ed ne t1 R eg io n B ro ko po nd o (* ) 8 (* ) (* ) 8 (* ) 6 S ip al iw in i 97 .8 38 64 .8 51 .6 37 74 .6 26 A ge 15 -1 9 (* ) 6 (* ) (* ) 6 (* ) 4 20 -2 4 (1 00 .0 ) 13 (8 4. 4) (6 2. 5) 13 (* ) 10 25 -2 9 (1 00 .0 ) 11 (5 5. 6) (4 4. 5) 11 (* ) 7 30 -3 4 (* ) 7 (* ) (* ) 6 (* ) 5 35 -3 9 (* ) 6 (* ) (* ) 6 (* ) 4 40 -4 4 (* ) 3 (* ) (* ) 3 (* ) 2 45 -4 9 - 0 - - 0 - 0 Ed uc at io n* N on e (9 5. 6) 19 (5 4. 5) (5 0. 0) 18 (7 1. 0) 13 P rim ar y 98 .3 23 76 .8 57 .1 23 (7 8. 0) 17 S ec on da ry + (* ) 4 (* ) (* ) 4 (* ) 2 W ea lth in de x qu in til es P oo re st 97 .2 43 65 .4 53 .9 42 74 .7 30 S ec on d (* ) 2 (* ) (* ) 2 (* ) 1 M id dl e - 0 (* ) (* ) 0 - 0 Fo ur th - 0 - - 0 - 0 R ic he st - 0 - - 0 - 0     Ch ild  He al th 66   Su rin am e M IC S4      Ta bl e C H .1 3: P re gn an t w om en s le ep in g un de r m os qu ito n et s (c on tin ue d) P er ce nt ag e of p re gn an t w om en w ho s le pt u nd er a m os qu ito n et d ur in g th e pr ev io us n ig ht , b y ty pe o f n et , r ur al in te rio r a re a, S ur in am e, 2 01 0 P er ce nt ag e of pr eg na nt w om en w ho s ta ye d in th e ho us eh ol d th e pr ev io us n ig ht N um be r o f pr eg na nt w om en Pe rc en ta ge o f p re gn an t w om en w ho : N um be r o f pr eg na nt w om en w ho s le pt in th e ho us eh ol d th e pr ev io us n ig ht P er ce nt ag e of p re gn an t w om en w ho s le pt u nd er an IT N , l iv in g in ho us eh ol ds w ith a t l ea st on e IT N N um be r o f pr eg na nt w om en liv in g in ho us eh ol ds w ith at le as t o ne IT N S le pt u nd er a ny m os qu ito n et S le pt u nd er a n in se ct ic id e tre at ed ne t1 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an (* ) 3 (* ) (* ) 3 (* ) 2 M ar oo n 97 .1 42 61 .8 49 .0 41 70 .4 29 C re ol e - 0 - - 0 - 0 H in du st an i - 0 - - 0 - 0 Ja va ne se - 0 - - 0 - 0 M ix ed (* ) 0 (* ) (* ) 0 (* ) 0 O th er s - 0 - - 0 - 0 To ta l 97 .4 46 64 .9 50 .5 45 72 .8 31 * ‘M is si ng /D K ’ c at eg or y of e th ni ci ty o f h ou se ho ld h ea d no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 3 .1 9 Ch ild  He al th           Su rin am e M IC S4 67 Ta bl e C H .1 4: A nt i-m al ar ia l t re at m en t o f c hi ld re n w ith a nt i-m al ar ia l d ru gs P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ho h ad a fe ve r i n th e la st tw o w ee ks w ho re ce iv ed a nt i-m al ar ia l d ru gs , r ur al in te rio r a re a, S ur in am e, 2 01 0 H ad a fe ve r in la st tw o w ee ks N um be r of ch ild re n ag e 0- 59 m on th s C hi ld re n w ith a fe ve r i n th e la st tw o w ee ks w ho w er e tr ea te d w ith : N um be r of ch ild re n w ith fe ve r in l as t tw o w ee ks A ny a nt i- m al ar ia l dr ug 1 O th er m ed ic at io ns : M is si ng / D K P er ce nt ag e w ho to ok an an ti- m al ar ia l dr ug s am e or ne xt d ay 2 A nt ib io tic pi ll or sy ru p A nt ib io tic in je ct io n P ar ac et am ol / P an ad ol / A ce ta m in - op he n A sp iri n Ib up ro fe n O th er Se x M al e 16 .8 35 4 0. 0 22 .2 0. 0 47 .9 0. 0 0. 0 18 .8 7. 7 0. 0 60 Fe m al e 17 .1 35 1 0. 0 17 .8 0. 9 52 .5 0. 0 0. 0 9. 3 5. 1 0. 0 60 D is tr ic t B ro ko po nd o 18 .9 16 7 0. 0 17 .5 0. 0 54 .0 0. 0 0. 0 19 .0 1. 6 0. 0 32 S ip al iw in i 16 .4 53 7 0. 0 20 .9 0. 6 48 .8 0. 0 0. 0 12 .2 8. 1 0. 0 88 A ge 0- 11 m on th s 15 .0 13 5 (0 .0 ) (2 2. 5) (0 .0 ) (3 7. 5) (0 .0 ) (0 .0 ) (9 .9 ) (5 .0 ) (0 .0 ) 20 12 -2 3 m on th s 19 .4 13 9 0. 0 20 .8 0. 0 56 .6 0. 0 0. 0 22 .6 7. 6 0. 0 27 24 -3 5 m on th s 18 .1 14 7 0. 0 11 .5 1. 9 48 .1 0. 0 0. 0 7. 7 7. 7 0. 0 26 36 -4 7 m on th s 17 .5 15 1 0. 0 17 .3 0. 0 51 .8 0. 0 0. 0 17 .3 3. 9 0. 0 26 48 -5 9 m on th s 14 .7 13 2 (0 .0 ) (3 1. 6) (0 .0 ) (5 5. 3) (0 .0 ) (0 .0 ) (1 0. 6) (7 .9 ) (0 .0 ) 19 M ot he r’s e du ca tio n* N on e 17 .5 32 1 0. 0 20 .9 0. 9 41 .8 0. 0 0. 0 11 .8 9. 1 0. 0 56 P rim ar y 16 .3 30 3 0. 0 22 .7 0. 0 57 .7 0. 0 0. 0 13 .4 4. 1 0. 0 49 S ec on da ry + 15 .0 74 (0 .0 ) (4 .5 ) (0 .0 ) (5 4. 5) (0 .0 ) (0 .0 ) (2 2. 6) (4 .6 ) (0 .0 ) 11 O th er /N on -s ta nd ar d (* ) 5 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 3 W ea lth in de x qu in til es P oo re st 16 .3 65 2 0. 0 19 .6 0. 5 49 .3 0. 0 0. 0 12 .9 6. 7 0. 0 10 6 S ec on d 27 .7 48 (0 .0 ) (2 3. 0) (0 .0 ) (5 7. 6) (0 .0 ) (0 .0 ) (2 2. 9) (3 .9 ) (0 .0 ) 13 M id dl e (* ) 4 - - - - - - - - - 0 Fo ur th (* ) 2 - - - - - - - - - 0 R ic he st - 0 - - - - - - - - - 0     Ch ild  He al th 68   Su rin am e M IC S4      Tab le C H .1 4: A nt i-m al ar ia l t re at m en t o f c hi ld re n w ith a nt i-m al ar ia l d ru gs ( co nt in ue d) P er ce nt ag e of c hi ld re n ag e 0- 59 m on th s w ho h ad a fe ve r i n th e la st tw o w ee ks w ho re ce iv ed a nt i-m al ar ia l d ru gs , r ur al in te rio r a re a, S ur in am e, 2 01 0 H ad a fe ve r in la st tw o w ee ks N um be r of ch ild re n ag e 0- 59 m on th s C hi ld re n w ith a fe ve r i n th e la st tw o w ee ks w ho w er e tr ea te d w ith : N um be r of ch ild re n w ith fe ve r in l as t tw o w ee ks A ny a nt i- m al ar ia l dr ug 1 O th er m ed ic at io ns : M is si ng / D K P er ce nt ag e w ho to ok an an ti- m al ar ia l dr ug s am e or ne xt d ay 2 A nt ib io tic pi ll or sy ru p A nt ib io tic in je ct io n P ar ac et am ol / P an ad ol / A ce ta m in - op he n A sp iri n Ib up ro fe n O th er Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 24 .5 54 (0 .0 ) (1 1. 5) (0 .0 ) (6 5. 4) (0 .0 ) (0 .0 ) (1 1. 5) (7 .7 ) (0 .0 ) 13 M ar oo n 16 .5 64 1 0. 0 21 .2 0. 5 48 .1 0. 0 0. 0 14 .4 6. 3 0. 0 10 6 C re ol e 0. 0 1 - - - - - - - - - 0 H in du st an i - 0 - - - - - - - - - 0 Ja va ne se - 0 - - - - - - - - - 0 M ix ed (* ) 8 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 1 O th er s - 0 - - - - - - - - - 0 To ta l 17 .0 70 5 0. 0 20 .0 0. 4 50 .2 0. 0 0. 0 14 .0 6. 4 0. 0 12 0 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 3 .1 8; M D G in di ca to r 6 .8 2 M IC S in di ca to r 3 .1 7 Child Health          Table CH.15: Malaria diagnostics usage Percentage of children age 0-59 months who had a fever in the last two weeks and who had a finger or heel stick for malaria testing, rural interior area, Suriname, 2010 Had a finger or heel stick1 Number of children age 0-59 months with fever in the last two weeks Sex Male 15.4 60 Female 14.4 60 District Brokopondo 11.1 32 Sipaliwini 16.3 88 Age 0-11 months (17.6) 20 12-23 months 17.0 27 24-35 months 11.5 26 36-47 months 9.7 26 48-59 months (21.0) 19 Mother’s education* None 15.4 56 Primary 16.5 49 Secondary + (*) 11 Other/Non-standard (*) 3 Wealth index quintiles Poorest 14.4 106 Second (19.4) 13 Middle - 0 Fourth - 0 Richest - 0 Ethnicity of household head* Indigenous/Amerindian (42.3) 13 Maroon 11.5 106 Creole - 0 Hindustani - 0 Javanese - 0 Mixed (*) 1 Others - 0 Total 14.9 120 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 3.16     Water and Sanitation 70  Suriname MICS4   6. Water and Sanitation       Water and Sanitation      Suriname MICS4 71 Safe drinking water is a basic necessity for good health. Unsafe drinking water can be a significant carrier of  diseases such as trachoma, cholera, typhoid, and schistosomiasis. Drinking water can also be tainted with  chemical, physical and radiological contaminants with harmful effects on human health. 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    For more details on water and sanitation and to access some reference documents, please visit the UNICEF  childinfo website10.   MICS also collects additional  information on  the availability of  facilities and conditions  for handwashing.  The following indicators are collected:   Place for handwashing observed   Availability of soap    Use of Improved Water Sources The distribution of the population by source of drinking water is shown in Table WS.1 (page 74) and Figure  EN.1 below. 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,  tube  well/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.   Overall, 95 percent of the population is using an improved source of drinking water – 99 percent in urban  areas and 87 percent in rural areas. In the rural coastal areas and rural interior, corresponding proportions  are 96 percent and 71 percent and  indicative of more favourable access to  improved sources of water  in  rural  coastal  areas.  Compared  to  the  other  districts  where  there  are  negligible  differences  in  the  proportion  of  population  with  improved  source  of  drinking  water,  markedly  lower  proportions  are  observed in Sipaliwini (65%).                                                               10 http://www.childinfo.org/wes.html  Wa 72  Ac va wa res dr Sa res co W ev ap int int po as  th ass co fro ho wa res Figu   Us the filt the ho tha wa Su wa ater and Sanitat Surinam ccording to T riable. In Pa ater that is p spectively.  In inking water ramacca (44 spective pop rresponding ith respect t vident betwe pproximately to their dwe terior  in  pa opulation in u a principal s ree  times  as sociated  wit ncentration  om  the  hou ouseholds he ater piped in spect to the  ure WS.1: Percent d se of  in‐hous ey are treati ter, and usin e  percentag ouseholds, fo at  in  Surina ater that has riname  exce ater  that  is b yard tion me MICS4  Table WS.1, t ramaribo, N piped into th n contrast, t r were  in Co 4%), Commew pulations rel g proportions he use of dri een urban an y 80 percent  ellings or yar rticular  was urban areas, source of dri s  likely  (47% th  higher  pr of  househo useholds  wit eaded by som nto dwellings use of rainw distribution of hous se water  tre ng water at  ng solar disin ges of house or household me  a  substa s not been t ept  Commew boiled  (45%) Piped to  d/plot/neighbo 13% Figure the source o ickerie, and  eir dwelling  the  lowest p ommewijne  wijne (67%), ied upon ra s for the othe inking water nd rural area of the popu ds for drinki s  approxima , the populat nking (33% a %  as  oppose roportions  o olds  in  highe th  heads  ha meone with a s or yards as  water as the m sehold members by eatment  is p home to ma fection were ehold memb ds using imp antial major reated. This  wijne  where ) as opposed Piped  dwell 58% or e WS.1: Per source of drinking w Coronie, the or into their proportions o (23%), Brok  Brokopondo inwater as a er districts. r that is piped s, in particul ulation  in ur ing purposes ately  45  per tion in rural  as opposed t ed  to  13%).  of  household er wealth  in aving  no  ed at least a sec their main s main source  source of drinking resented  in  ake it safer to e considered ers using  ap roved and u ity  of  house is the case  e  about  the  d  to  the 44% into  ing % Rainwate collectio 19% rcent distrib e of drinking ater for the  e respective  r yard or plot observed to  kopondo  (32 o (45%) and  a principal so d into dwelli lar, rural dom ban areas cl s, correspon rcent  and  1 areas was m to 13 %) whi In  Suriname d  heads  wit dex  quintile ducation,  it  condary leve sources of dr of drinking w water Suriname, 20 Table WS.2 o drink – boi d as proper t ppropriate w nimproved d ehold memb for water us same  prop % who use d er  on O 5 bution of h g water Sur population o proportions  t was 88 per have been r 2%),  and  Sip Sipaliwini (4 ource  for dr ngs or yards mains in the laimed that  ding proport 15  percent, more than tw ile those in t e,  thrusts  to h  higher  lev s.  Thus, wh should  not  el education  rinking water water.  010 (page 76).  ling, adding  reatment of water  treatm drinking wat bers,  approxi sed for drink ortion  of  ho drinking wat Other  Surface 3% Other u ther 5% ousehold m riname, 201 of any given  of the popu rcent, 88 per relying upon aliwini  (9%) 48%), greater inking water s, the striking  interior are they princip tions in rura respectively wice as likely the rural inte wards more vels  of  educ en  compare be  surprisi had a greate r. The situati Households  bleach or ch f drinking wa ment method ter sources. T imately  69  p king purpose ousehold  me er  that has  improved 5% e water % nimproved 2% members by 10  district is so ulation using rcent and 98  n such source .  In districts r proportions r when com g differences  worth notin pally use wat al areas and  y.  Compared y to rely on r erior were m e  urban  dom cation  and  a ed  to  the  po ng  that  tho er likelihood ion was reve were asked hlorine, using ater. The tab ds,  separate Table WS.2  percent  use  es  in every d embers  use  not been  tre y omewhat   drinking  percent,  es for  its  s  such  as  s of their  pared  to  s that are  ng. While  ter piped  the rural  d  to  the  ainwater  more than  mains  are  a  greater  opulation  ose  from  d of using  ered with   of ways  g a water  ble shows  ly  for  all  indicates  drinking  district of  drinking  eated.  In  Water and Sanitation      Suriname MICS4 73 Suriname,  especially  in urban  areas,  there  is no  custom  to boil water before drinking  it  because piped  water  is  considered  safe.  In  the  rural  interior,  approximately 85 percent of household members  live  in  households  that  apply  no  treatment  to  their  drinking  water  supply  with  similarly  high  proportions  in  Brokopondo (84%) and Sipaliwini (85%). Urbanized districts such as Paramaribo and Wanica had markedly  lower proportions  in households  that apply no  treatment  to  their drinking water  supply,  the  respective  proportions approximating 67 percent and 69 percent, respectively. With respect to household members  in  households  using  an  unimproved  drinking  water  source,  10  percent  used  an  appropriate  water  treatment method. Given  the  relatively  large number of household members  relying on drinking water  from  unimproved  sources  in  Sipaliwini  (35%),  the  relatively  low  proportion  using  an  appropriate water  treatment  method  is  alarming  (6%).  The  appropriate  treatment  of  unimproved  water  increases  with  education of the household head.  W at er  an d S an ita tio n 74   Su rin am e M IC S4   Ta bl e W S. 1: U se o f i m pr ov ed w at er s ou rc es P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to m ai n so ur ce o f d rin ki ng w at er a nd p er ce nt ag e of h ou se ho ld p op ul at io n us in g im pr ov ed d rin ki ng w at er s ou rc es , S ur in am e, 2 01 0 M ai n so ur ce o f d rin ki ng w at er To ta l P er ce nt ag e us in g im pr ov ed so ur ce s of dr in ki ng w at er 1 N um be r of ho us eh ol d m em be rs Im pr ov ed s ou rc es U ni m pr ov ed s ou rc es Pi pe d w at er Tu be - w el l/ bo re - ho le P ro - te ct ed w el l P ro - te ct ed sp rin g R ai n- w at er co lle ct io n B ot tle d w at er * U np ro - te ct ed w el l U np ro - te ct ed sp rin g Ta nk er tru ck C ar t w ith ta nk / dr um S ur fa ce w at er B ot tle d w at er * O th er M is si ng In to dw el lin g In to ya rd /p lo t To ne ig h- bo ur P ub lic ta p/ st an d- pi pe D is tr ic t P ar am ar ib o 76 .8 11 .2 0. 3 0. 6 0. 0 0. 1 0. 1 6. 7 3. 4 0. 0 0. 0 0. 0 0. 0 0. 0 0. 4 0. 4 0. 1 10 0. 0 99 .1 13 ,4 19 W an ic a 56 .2 12 .4 0. 6 0. 3 0. 0 2. 3 0. 6 22 .9 2. 0 0. 5 0. 6 0. 1 0. 4 0. 0 0. 6 0. 2 0. 1 10 0. 0 97 .4 5, 21 7 N ic ke rie 79 .9 8. 1 0. 6 0. 4 0. 0 0. 1 0. 0 3. 6 5. 1 0. 0 0. 0 0. 3 0. 0 1. 5 0. 1 0. 3 0. 0 10 0. 0 97 .9 2, 08 1 C or on ie 77 .9 19 .7 1. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1. 4 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 16 1 S ar am ac ca 39 .5 9. 6 0. 6 0. 0 0. 2 0. 3 0. 0 44 .0 2. 6 0. 8 0. 0 0. 5 0. 1 0. 0 1. 0 1. 0 0. 0 10 0. 0 96 .7 92 0 C om m ew ijn e 17 .7 5. 7 0. 2 0. 0 0. 0 4. 1 0. 5 66 .7 1. 9 0. 8 0. 0 0. 6 0. 0 0. 5 0. 6 0. 8 0. 0 10 0. 0 96 .7 1, 37 3 M ar ow ijn e 23 .0 25 .6 4. 2 0. 1 0. 0 1. 5 1. 2 30 .7 4. 8 4. 3 1. 7 0. 0 0. 0 2. 3 0. 1 0. 4 0. 0 10 0. 0 91 .1 1, 08 1 P ar a 40 .6 32 .2 3. 3 3. 1 1. 8 0. 8 3. 2 10 .7 0. 7 0. 8 0. 2 0. 0 0. 0 2. 5 0. 0 0. 0 0. 0 10 0. 0 96 .5 1, 05 4 B ro ko po nd o 9. 6 22 .5 0. 6 9. 3 0. 0 0. 0 2. 8 44 .5 0. 2 0. 3 0. 7 0. 0 0. 0 8. 8 0. 0 0. 3 0. 5 10 0. 0 89 .4 77 4 S ip al iw in i 1. 5 7. 5 0. 0 3. 0 0. 2 0. 1 4. 5 47 .7 0. 0 0. 1 0. 2 0. 1 0. 1 33 .0 0. 0 1. 6 0. 3 10 0. 0 64 .5 2, 34 1 A re a U rb an 69 .4 11 .0 0. 4 0. 5 0. 0 1. 0 0. 2 13 .0 3. 1 0. 2 0. 2 0. 1 0. 1 0. 0 0. 4 0. 4 0. 1 10 0. 0 98 .6 20 ,0 66 R ur al C oa st al 45 .5 17 .4 2. 0 0. 8 0. 4 0. 7 1. 0 25 .2 2. 9 1. 2 0. 4 0. 2 0. 0 1. 6 0. 4 0. 4 0. 0 10 0. 0 95 .9 5, 24 0 R ur al in te rio r 3. 5 11 .2 0. 1 4. 5 0. 2 0. 1 4. 1 46 .9 0. 1 0. 2 0. 3 0. 1 0. 1 27 .0 0. 0 1. 2 0. 4 10 0. 0 70 .7 3, 11 4 To ta l R ur al 29 .8 15 .1 1. 3 2. 2 0. 3 0. 5 2. 2 33 .3 1. 9 0. 8 0. 4 0. 2 0. 0 11 .1 0. 2 0. 7 0. 1 10 0. 0 86 .5 8, 35 5 Ed uc at io n of h ou se ho ld h ea d N on e 23 .7 15 .8 0. 6 2. 7 0. 1 0. 2 2. 7 33 .6 1. 2 0. 1 0. 3 0. 0 0. 0 17 .3 0. 2 1. 2 0. 2 10 0. 0 80 .7 3, 07 0 P rim ar y 49 .4 16 .3 0. 6 1. 6 0. 2 1. 4 0. 8 23 .6 1. 3 0. 5 0. 2 0. 1 0. 0 3. 2 0. 2 0. 4 0. 1 10 0. 0 95 .2 9, 08 6 S ec on da ry + 70 .0 9. 0 0. 5 0. 2 0. 0 0. 6 0. 4 13 .2 4. 0 0. 4 0. 2 0. 1 0. 1 0. 3 0. 5 0. 4 0. 1 10 0. 0 97 .9 14 ,3 57 O th er /N on -s ta nd ar d 67 .5 6. 0 1. 4 0. 9 0. 0 0. 0 0. 1 13 .9 8. 0 0. 0 0. 0 0. 0 0. 0 1. 2 0. 8 0. 3 0. 0 10 0. 0 97 .7 40 8 M is si ng /D K 59 .0 13 .6 1. 4 0. 9 0. 0 0. 0 0. 6 17 .3 1. 8 0. 0 0. 5 0. 2 0. 0 4. 2 0. 4 0. 2 0. 0 10 0. 0 94 .5 1, 50 0 W ea lth in de x qu in til e P oo re st 4. 5 24 .1 1. 7 4. 5 0. 3 1. 3 2. 8 39 .8 0. 1 1. 4 0. 9 0. 1 0. 4 16 .2 0. 2 1. 3 0. 1 10 0. 0 79 .2 5, 69 1 S ec on d 37 .0 27 .9 0. 8 0. 3 0. 2 1. 5 0. 5 29 .1 1. 3 0. 3 0. 1 0. 0 0. 0 0. 1 0. 2 0. 3 0. 3 10 0. 0 98 .6 5, 67 9 M id dl e 72 .7 6. 8 0. 7 0. 1 0. 0 0. 9 0. 3 14 .5 3. 0 0. 1 0. 0 0. 2 0. 0 0. 0 0. 6 0. 2 0. 0 10 0. 0 98 .9 5, 68 3 Fo ur th 81 .4 2. 2 0. 0 0. 0 0. 0 0. 3 0. 2 9. 9 4. 6 0. 0 0. 0 0. 1 0. 0 0. 0 0. 8 0. 3 0. 1 10 0. 0 98 .7 5, 67 6 R ic he st 93 .3 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 1. 5 4. 8 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 1 0. 0 10 0. 0 99 .8 5, 69 3     W at er  an d S an ita tio n          Su rin am e M IC S4 75 Ta bl e W S. 1: U se o f i m pr ov ed w at er s ou rc es ( co nt in ue d) P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to m ai n so ur ce o f d rin ki ng w at er a nd p er ce nt ag e of h ou se ho ld p op ul at io n us in g im pr ov ed d rin ki ng w at er s ou rc es , S ur in am e, 2 01 0 M ai n so ur ce o f d rin ki ng w at er To ta l P er ce nt ag e us in g im pr ov ed so ur ce s of dr in ki ng w at er 1 N um be r of ho us eh ol d m em be rs Im pr ov ed s ou rc es U ni m pr ov ed s ou rc es Pi pe d w at er Tu be - w el l/ bo re - ho le P ro - te ct ed w el l P ro - te ct ed sp rin g R ai n- w at er co lle ct io n B ot tle d w at er * U np ro - te ct ed w el l U np ro - te ct ed sp rin g Ta nk er tru ck C ar t w ith ta nk / dr um S ur fa ce w at er B ot tle d w at er * O th er M is si ng In to dw el lin g In to ya rd /p lo t To ne ig h- bo ur P ub lic ta p/ st an d- pi pe Et hn ic ity o f h ou se ho ld h ea d In di ge no us /A m er in di an 40 .9 17 .5 0. 6 0. 2 1. 5 2. 9 5. 3 16 .6 2. 0 3. 6 0. 9 0. 0 0. 0 7. 4 0. 0 0. 4 0. 3 10 0. 0 87 .4 1, 24 8 M ar oo n 24 .6 23 .4 1. 1 3. 6 0. 1 0. 5 1. 6 31 .4 0. 3 0. 3 0. 7 0. 0 0. 3 11 .3 0. 0 0. 6 0. 1 10 0. 0 86 .7 7, 27 9 C re ol e 83 .2 7. 6 0. 5 0. 0 0. 0 0. 9 0. 1 3. 2 3. 1 0. 3 0. 0 0. 0 0. 0 0. 0 0. 5 0. 4 0. 1 10 0. 0 98 .7 4, 91 2 H in du st an i 67 .7 8. 8 0. 6 0. 1 0. 0 0. 4 0. 2 18 .3 2. 3 0. 2 0. 0 0. 3 0. 0 0. 0 0. 6 0. 4 0. 1 10 0. 0 98 .4 7, 74 5 Ja va ne se 57 .9 6. 4 0. 2 0. 0 0. 0 1. 8 0. 3 27 .6 4. 9 0. 0 0. 0 0. 0 0. 0 0. 0 0. 5 0. 2 0. 0 10 0. 0 99 .2 3, 99 7 M ix ed 77 .6 7. 6 0. 5 0. 0 0. 0 0. 4 0. 2 6. 5 5. 3 0. 1 0. 0 0. 0 0. 0 0. 5 0. 2 0. 9 0. 2 10 0. 0 98 .0 2, 69 2 O th er s 73 .2 5. 2 0. 0 0. 0 0. 0 0. 0 0. 9 8. 1 11 .2 0. 0 0. 0 0. 0 0. 1 0. 2 0. 7 0. 3 0. 0 10 0. 0 98 .6 52 3 M is si ng /D K (4 .6 ) (2 3. 1) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (1 5. 6) (3 2. 6) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (1 3. 6) (8 .7 ) (0 .0 ) (1 .7 ) 10 0. 0 (7 6. 0) 26 To ta l 57 .8 12 .2 0. 6 1. 0 0. 1 0. 8 0. 8 19 .0 2. 8 0. 4 0. 2 0. 1 0. 1 3. 3 0. 4 0. 5 0. 1 10 0. 0 95 .0 28 ,4 21 ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s 1 M IC S in di ca to r 4 .1 ; M D G in di ca to r 7 .8 * H ou se ho ld s us in g bo ttl ed w at er a s th e m ai n so ur ce o f dr in ki ng w at er a re c la ss ifi ed i nt o im pr ov ed o r un im pr ov ed d rin ki ng w at er u se rs a cc or di ng t o th e w at er s ou rc e us ed f or o th er p ur po se s su ch a s co ok in g an d ha nd w as hi ng .     W at er  an d S an ita tio n 76   Su rin am e M IC S4   Ta bl e W S. 2: H ou se ho ld w at er tr ea tm en t P er ce nt ag e of h ou se ho ld p op ul at io n by d rin ki ng w at er tr ea tm en t m et ho d us ed in th e ho us eh ol d, a nd fo r h ou se ho ld m em be rs li vi ng in h ou se ho ld s w he re a n un im pr ov ed d rin ki ng w at er so ur ce is u se d, th e pe rc en ta ge w ho a re u si ng a n ap pr op ria te tr ea tm en t m et ho d, S ur in am e, 2 01 0 W at er tr ea tm en t m et ho d us ed in th e ho us eh ol d N um be r of ho us eh ol d m em be rs P er ce nt ag e of h ou se ho ld m em be rs in h ou se ho ld s us in g un im pr ov ed d rin ki ng w at er so ur ce s an d us in g an a pp ro pr ia te w at er tr ea tm en t m et ho d1 N um be r o f ho us eh ol d m em be rs in h ou se ho ld s us in g un im pr ov ed d rin ki ng w at er s ou rc es N on e B oi l A dd bl ea ch / ch lo rin e S tra in th ro ug h a cl ot h U se w at er fil te r S ol ar di s- in fe ct io n Le t i t st an d an d se ttl e O th er D is tr ic t P ar am ar ib o 66 .9 18 .5 0. 4 9. 4 4. 9 0. 0 3. 4 1. 0 13 ,4 19 (2 1. 7) 77 W an ic a 68 .6 20 .1 0. 3 7. 6 2. 7 0. 0 1. 9 1. 5 5, 21 7 12 .7 10 6 N ic ke rie 72 .2 22 .1 0. 6 1. 7 0. 8 0. 0 4. 1 0. 2 2, 08 1 16 .9 42 C or on ie 77 .2 19 .7 0. 0 4. 8 0. 0 0. 0 0. 3 0. 0 16 1 - 0 S ar am ac ca 61 .6 27 .2 0. 4 9. 0 1. 5 0. 2 4. 1 1. 2 92 0 (4 3. 6) 21 C om m ew ijn e 43 .8 44 .6 0. 3 6. 5 3. 1 0. 0 4. 0 2. 0 1, 37 3 (4 .4 ) 38 M ar ow ijn e 78 .6 11 .9 0. 4 5. 1 0. 1 0. 1 4. 1 0. 0 1, 08 1 20 .4 94 P ar a 76 .6 14 .1 1. 0 3. 4 0. 5 0. 0 4. 8 0. 0 1, 05 4 24 .2 37 B ro ko po nd o 83 .8 7. 6 0. 6 7. 1 0. 2 0. 0 2. 1 0. 1 77 4 12 .0 82 S ip al iw in i 85 .0 4. 8 1. 0 7. 4 0. 1 0. 0 1. 9 0. 2 2, 34 1 5. 8 83 0 A re a U rb an 66 .7 19 .8 0. 4 8. 5 4. 2 0. 0 3. 1 1. 2 20 ,0 66 13 .9 21 8 R ur al C oa st al 68 .8 22 .6 0. 5 4. 9 0. 7 0. 1 3. 8 0. 3 5, 24 0 23 .4 19 7 R ur al in te rio r 84 .7 5. 5 0. 9 7. 3 0. 1 0. 0 2. 0 0. 2 3, 11 4 6. 4 91 2 To ta l R ur al 74 .7 16 .2 0. 6 5. 8 0. 5 0. 0 3. 1 0. 3 8, 35 5 9. 4 1, 11 0 Ed uc at io n of h ou se ho ld h ea d N on e 81 .0 10 .7 0. 6 5. 0 0. 1 0. 0 3. 5 0. 1 3, 07 0 6. 5 58 7 P rim ar y 70 .0 17 .1 0. 8 9. 3 2. 0 0. 0 3. 5 0. 6 9, 08 6 10 .3 41 8 S ec on da ry + 65 .9 21 .3 0. 3 7. 6 4. 6 0. 0 2. 6 1. 2 14 ,3 57 18 .4 23 6 O th er /N on -s ta nd ar d 65 .8 19 .3 0. 3 8. 8 1. 2 0. 0 10 .8 4. 1 40 8 (* ) 9 M is si ng /D K 70 .5 20 .5 0. 0 5. 0 1. 7 0. 1 3. 5 1. 0 1, 50 0 12 .7 77 W ea lth in de x qu in til e P oo re st 77 .8 9. 4 1. 1 8. 0 0. 3 0. 1 4. 4 0. 4 5, 69 1 9. 9 1, 17 3 S ec on d 68 .4 19 .8 0. 3 8. 0 1. 3 0. 0 3. 6 1. 8 5, 67 9 17 .3 66 M id dl e 67 .4 21 .0 0. 4 7. 8 2. 7 0. 0 4. 0 0. 3 5, 68 3 (8 .6 ) 39 Fo ur th 66 .8 22 .0 0. 5 7. 9 3. 4 0. 0 2. 0 0. 8 5, 67 6 (8 .1 ) 41 R ic he st 65 .1 21 .5 0. 1 6. 9 7. 7 0. 0 1. 6 1. 2 5, 69 3 (* ) 8 W at er  an d S an ita tio n          Su rin am e M IC S4 77 Ta bl e W S. 2: H ou se ho ld w at er tr ea tm en t (c on tin ue d) P er ce nt ag e of h ou se ho ld p op ul at io n by d rin ki ng w at er tr ea tm en t m et ho d us ed in th e ho us eh ol d, a nd fo r h ou se ho ld m em be rs li vi ng in h ou se ho ld s w he re a n un im pr ov ed d rin ki ng w at er so ur ce is u se d, th e pe rc en ta ge w ho a re u si ng a n ap pr op ria te tr ea tm en t m et ho d, S ur in am e, 2 01 0 W at er tr ea tm en t m et ho d us ed in th e ho us eh ol d N um be r of ho us eh ol d m em be rs P er ce nt ag e of h ou se ho ld m em be rs in h ou se ho ld s us in g un im pr ov ed d rin ki ng w at er so ur ce s an d us in g an a pp ro pr ia te w at er tr ea tm en t m et ho d1 N um be r o f ho us eh ol d m em be rs in h ou se ho ld s us in g un im pr ov ed d rin ki ng w at er s ou rc es N on e B oi l A dd bl ea ch / ch lo rin e S tra in th ro ug h a cl ot h U se w at er fil te r S ol ar di s- in fe ct io n Le t it st an d an d se ttl e O th er Et hn ic ity o f h ou se ho ld h ea d In di ge no us /A m er in di an 75 .3 14 .2 0. 5 6. 5 1. 3 0. 2 3. 2 0. 2 1, 24 8 22 .6 15 7 M ar oo n 82 .8 6. 9 0. 7 6. 2 1. 0 0. 0 3. 6 0. 5 7, 27 9 7. 1 96 9 C re ol e 68 .8 16 .2 0. 1 9. 7 3. 2 0. 0 4. 2 1. 6 4, 91 2 (7 .4 ) 45 H in du st an i 70 .3 17 .3 0. 7 6. 6 4. 1 0. 0 3. 0 0. 6 7, 74 5 11 .6 86 Ja va ne se 44 .8 44 .3 0. 4 9. 5 3. 0 0. 0 1. 7 2. 1 3, 99 7 (* ) 16 M ix ed 64 .9 21 .1 0. 1 9. 4 5. 7 0. 0 2. 5 0. 4 2, 69 2 24 .1 47 O th er s 54 .4 32 .0 0. 0 6. 6 8. 0 0. 0 1. 3 0. 0 52 3 (* ) 4 M is si ng /D K (8 9. 0) (1 1. 0) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (8 .7 ) (0 .0 ) 26 (* ) 4 To ta l 69 .1 18 .7 0. 5 7. 7 3. 1 0. 0 3. 1 0. 9 28 ,4 21 10 .1 1, 32 7 ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 4 .2   Water and Sanitation 78  Suriname MICS4  The amount of  time  it  takes  to obtain water  is presented  in Table WS.3  (page 79) and  the person who  usually collected  the water  in Table WS.4  (page 80). 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 WS.3 shows that for 93 percent of all household members, an improved drinking water source is on  the premises, while for another 2 percent of all household members a roundtrip to the improved source is  estimated at less than 30 minutes. Two percent of all main water use is unimproved, while also taking for  than 30 minutes to collect.  Within  the  districts  of  Suriname,  Sipaliwini  has  the  largest  number  of  household  members  after  Paramaribo and Wanica. However,  just over a half of all household members  in Sipaliwini  (51%) had an  improved water source on their premises, this being markedly  lower than  in the other districts  including  Brokopondo (80%). Moreover, approximately 11 percent of household members in Sipaliwini take less than  30 minutes to get to an  improved drinking water source and bring water to the premises with another 1  percent taking at least 30 minutes. Almost one third of household members in Sipaliwini relied roundtrips  to an unimproved source lasting more than 30 minutes.   Table WS.4 shows that for the majority of households without drinking water on premises, an adult female  is usually  the person collecting  the water  (74%). 14 percent of  the households  relied on adult males 15  years or older  to collect drinking water and only 3 percent on children. While  the  low number of cases  prevents detailed analysis,  it can be noted that men become  increasingly responsible for collecting water  with increase in the education of the head of the household.      Water and Sanitation      Suriname MICS4 79   Table WS.3: Time to source of drinking water Percent distribution of household population according to time to go to source of drinking water, get water and return, for users of improved and unimproved drinking water sources, Suriname, 2010 Time to source of drinking water Users of improved drinking water sources Users of unimproved drinking water sources Number of household members Water on premises Less than 30 minutes 30 minutes or more Missing /DK Water on premises Less than 30 minutes 30 minutes or more Missing /DK Total District Paramaribo 98.6 0.3 0.4 0.1 0.1 0.1 0.1 0.2 100.0 13,419 Wanica 97.4 0.5 0.0 0.1 1.5 0.0 0.2 0.3 100.0 5,217 Nickerie 97.8 0.1 0.1 0.0 0.2 1.5 0.1 0.2 100.0 2,081 Coronie 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 161 Saramacca 96.8 0.4 0.0 0.5 1.4 0.6 0.2 0.1 100.0 920 Commewijne 93.9 3.2 0.1 0.0 1.4 0.0 1.1 0.2 100.0 1,373 Marowijne 87.3 3.0 0.8 0.2 4.7 2.3 1.0 0.8 100.0 1,081 Para 92.8 2.5 1.2 0.1 0.7 1.9 0.3 0.6 100.0 1,054 Brokopondo 79.6 6.6 1.0 2.2 0.9 6.3 2.8 0.6 100.0 774 Sipaliwini 50.6 10.7 1.4 1.8 1.0 17.6 15.0 1.9 100.0 2,341 Area Urban 98.0 0.5 0.3 0.1 0.6 0.1 0.2 0.2 100.0 20,066 Rural Coastal 94.4 1.3 0.4 0.1 1.5 1.5 0.4 0.4 100.0 5,240 Rural interior 57.8 9.7 1.3 1.9 0.9 14.8 12.0 1.6 100.0 3,114 Total Rural 80.8 4.4 0.7 0.8 1.3 6.5 4.7 0.8 100.0 8,355 Education of household head None 73.0 5.8 0.9 1.1 0.5 8.7 8.6 1.3 100.0 3,070 Primary 92.3 2.1 0.7 0.3 0.7 2.2 1.2 0.5 100.0 9,086 Secondary + 97.4 0.6 0.2 0.2 0.8 0.3 0.3 0.2 100.0 14,357 Other/Non-standard 96.8 1.0 0.0 0.0 0.8 0.7 0.7 0.0 100.0 408 Missing/DK 93.1 1.4 0.2 0.2 0.7 3.1 1.1 0.2 100.0 1,500 Wealth index quintile Poorest 68.8 7.4 2.0 1.2 2.7 9.5 7.1 1.3 100.0 5,691 Second 98.1 0.6 0.1 0.1 0.5 0.2 0.1 0.4 100.0 5,679 Middle 98.8 0.3 0.0 0.2 0.4 0.1 0.2 0.0 100.0 5,683 Fourth 99.0 0.1 0.0 0.1 0.2 0.0 0.2 0.3 100.0 5,676 Richest 99.9 0.0 0.0 0.0 0.0 0.0 0.1 0.0 100.0 5,693 Ethnicity of household head Indigenous/Amerindian 81.5 5.3 0.5 0.1 2.9 7.0 1.1 1.5 100.0 1,248 Maroon 79.6 4.8 1.4 0.8 1.5 6.0 5.2 0.6 100.0 7,279 Creole 98.3 0.4 0.1 0.2 0.4 0.1 0.3 0.1 100.0 4,912 Hindustani 98.4 0.4 0.0 0.1 0.5 0.0 0.2 0.4 100.0 7,745 Javanese 99.2 0.1 0.0 0.3 0.1 0.2 0.0 0.1 100.0 3,997 Mixed 98.1 0.2 0.0 0.0 0.1 0.7 0.5 0.4 100.0 2,692 Others 99.3 0.0 0.0 0.0 0.4 0.0 0.2 0.0 100.0 523 Missing/DK (84.7) (0.0) (0.0) (0.0) (0.0) (13.6) (0.0) (1.7) 100.0 26 Total 92.9 1.7 0.4 0.3 0.8 2.0 1.5 0.4 100.0 28,421 ( ) Figures that are based on 25-49 unweighted cases     Water and Sanitation 80  Suriname MICS4    Table WS.4: Person collecting water Percentage of households without drinking water on premises, and percent distribution of households without drinking water on premises according to the person usually collecting drinking water used in the household, Suriname, 2010 Percentage of households without drinking water on premises Number of households Person usually collecting drinking water Number of households without drinking water on premises Adult woman Adult man Female child under age 15 Male child under age 15 Missing/DK Total District Paramaribo 1.0 3,640 (*) (*) (*) (*) (*) 100.0 37 Wanica 1.3 1,275 (*) (*) (*) (*) (*) 100.0 17 Nickerie 1.8 563 (*) (*) (*) (*) (*) 100.0 10 Coronie 0.0 51 - - - - - 100.0 0 Saramacca 2.0 244 (*) (*) (*) (*) (*) 100.0 5 Commewijne 3.2 359 (*) (*) (*) (*) (*) 100.0 12 Marowijne 8.1 226 (36.1) (33.3) (0.0) (2.8) (27.8) 100.0 18 Para 5.8 243 (*) (*) (*) (*) (*) 100.0 14 Brokopondo 19.9 186 74.7 17.2 0.0 1.1 6.9 100.0 37 Sipaliwini 48.2 619 83.9 7.8 1.7 0.3 6.2 100.0 299 Area Urban 1.2 5,301 (48.7) (23.1) (5.1) (5.1) (18.0) 100.0 65 Rural Coastal 3.6 1,300 41.7 41.7 0.0 1.1 15.5 100.0 47 Rural interior 41.7 806 82.9 8.9 1.6 0.4 6.3 100.0 336 Total Rural 18.2 2,106 77.8 12.9 1.4 0.5 7.5 100.0 383 Education of household head None 27.8 800 86.1 5.4 1.2 0.4 6.9 100.0 223 Primary 6.1 2,281 66.1 20.6 2.7 0.7 10.0 100.0 140 Secondary + 1.6 3,875 43.1 31.6 3.4 5.4 16.7 100.0 62 Other/Non-standard 2.5 107 (*) (*) (*) (*) (*) 100.0 3 Missing/DK 6.0 344 (82.1) (15.2) (0.0) (0.0) (2.6) 100.0 21 Wealth index quintile Poorest 27.8 1,419 79.5 10.3 2.2 0.9 7.2 100.0 394 Second 1.7 1,467 (29.4) (33.9) (0.0) (6.7) (30.0) 100.0 25 Middle 0.7 1,520 (*) (*) (*) (*) (*) 100.0 11 Fourth 1.1 1,496 (*) (*) (*) (*) (*) 100.0 16 Richest 0.1 1,505 (*) (*) (*) (*) (*) 100.0 2 Ethnicity of household head Indigenous/Amerindian 15.9 271 64.1 28.1 1.0 0.0 6.7 100.0 43 Maroon 21.4 1,594 82.6 8.8 1.4 0.5 6.6 100.0 341 Creole 1.2 1,447 (*) (*) (*) (*) (*) 100.0 17 Hindustani 1.1 2,069 (*) (*) (*) (*) (*) 100.0 22 Javanese 0.8 1,072 (*) (*) (*) (*) (*) 100.0 8 Mixed 1.9 777 (*) (*) (*) (*) (*) 100.0 15 Others 0.3 172 - - - - - 100.0 0 Missing/DK (*) 6 (*) (*) (*) (*) (*) 100.0 1 Total 6.0 7,407 73.5 14.4 1.9 1.1 9.0 100.0 448 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases Use of Improved Sanitation Facilities Inadequate  disposal  of  human  excreta  and  personal  hygiene  is  associated  with  a  range  of  diseases  including diarrhoeal diseases and polio. An  improved sanitation facility  is defined as one that hygienically  separates human excreta from human contact. Improved sanitation can reduce diarrheal disease by more  than  a  third,  and  can  significantly  lessen  the  adverse health  impacts of other disorders  responsible  for  Water and Sanitation      Suriname MICS4 81 death  and disease  among millions of  children  in developing  countries.  Improved  sanitation  facilities  for  excreta disposal include flush or pour flush to a piped sewer system, septic tank, or pit latrine; ventilated  improved pit latrine, pit latrine with slab, and use of a composting toilet.  Ninety‐one  percent  of  the  population  of  Suriname  are  living  in  households  using  improved  sanitation  facilities (Table WS.5, page 82). This percentage is 98 in urban areas and 75 percent in rural areas. For rural  coastal and the rural  interior, the respective percentages are 94 and 42. Residents of Brokopondo  (56%)  and Sipaliwini (37%) are less likely than residents in other districts to use improved facilities.  The table indicates that use of improved sanitation facilities is strongly correlated with wealth, where the  poorest quintile  records only 59 percent use of  improved  sanitation and  the  second quintile  rises  to 96  percent.  Profound  differences  between  urban  and  rural  areas  are  evident  as  well.  In  rural  areas  and  especially in the rural interior, Sipaliwini in particular, the population is more likely to be using pit latrines  without  slabs.  Even more  strikingly  is  the  prevalence  of  no  facilities  in  the  rural  interior  at  35  and  54  percent in Brokopondo and Sipaliwini, respectively. In rural coastal areas and in urban areas, situations in  which  persons  having  no  toilet  facilities  for  use  by  household  members  are  virtually  non‐existent.  In  contrast,  the most common  facilities  in urban areas are  flush  toilets with septic  tank which are used by  approximately 89 percent of all household members in urban areas.  The MDGs and  the WHO  / UNICEF  Joint Monitoring Programme  (JMP)  for Water  Supply and  Sanitation  classify  households  as  using  an  unimproved  sanitation  facility  if  they  are  using  otherwise  acceptable  sanitation facilities but sharing a facility between two or more households or using a public toilet facility.  Thus,  according  to  Table  WS.6  (page  84),  11  percentage‐points  of  the  household  population  using  improved  facilities, but were  sharing  these,  account  for  the difference  from  the prevalence of users of  improved  facilities  to  the  value  of  the  MDG  indicator  on  sanitation,  standing  at  just  80  percent  for  Suriname as a whole. The use of  improved  sanitation  facilities not  shared  is  strongly correlated  to both  education of the head of the household and the wealth of the household, with clear differences from the  non‐educated and the poorest to the highest educated and wealthiest household population.  Safe disposal of a child’s faeces  is disposing of the stool, by the child using a toilet or by rinsing the stool  into a toilet or latrine. Disposal of faeces of children 0‐2 years of age is presented in Table WS.7 (page 86).  In Suriname, the faeces of a little more than one fifth of all children 0‐2 years, is disposed of safely (22%).  This is alarming especially since the disposal of faeces is safe for less than one third of virtually every sub‐ population  of  children  0‐2  years.  There  does  not  appear  to  be  any  clear  pattern  of  association  linking  wealth status or mother’s education to the safe disposal of children’s faeces. It should be noted that there  are marked differences in how the disposal is done, with “thrown into garbage” being the main method in  urban and rural coastal areas at 72 and 59 percent of cases.  In rural  interior an answer other than those  precoded  has  been  provided  by  the  respondent  in  a  third  of  cases.  This  finding  should  be  taking  into  account in future data collection.  W at er  an d S an ita tio n 82   Su rin am e M IC S4   Ta bl e W S. 5: T yp es o f s an ita tio n fa ci lit ie s P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to ty pe o f t oi le t f ac ili ty u se d by th e ho us eh ol d, S ur in am e, 2 01 0 Ty pe o f t oi le t f ac ili ty u se d by h ou se ho ld To ta l N um be r o f ho us eh ol d m em be rs Im pr ov ed s an ita tio n fa ci lit y U ni m pr ov ed s an ita tio n fa ci lit y O pe n de fe ca tio n (n o fa ci lit y, bu sh , f ie ld ) Fl us h/ po ur fl us h to : V en til at ed im pr ov ed pi t l at rin e P it la tri ne w ith sl ab C om po s- tin g to ile t Fl us h/ p ou r flu sh to so m ew he re el se P it la tri ne w ith ou t sl ab / op en p it B uc ke t H an gi ng to ile t/ ha ng in g la tri ne O th er M is si ng P ip ed se w er sy st em S ep tic ta nk P it la tri ne U nk no w n pl ac e/ no t su re /D K w he re D is tr ic t P ar am ar ib o 2. 2 90 .4 0. 5 0. 1 0. 2 4. 5 0. 0 0. 0 1. 7 0. 0 0. 0 0. 2 0. 1 0. 1 10 0. 0 13 ,4 19 W an ic a 0. 8 89 .0 0. 9 0. 0 0. 4 7. 2 0. 0 0. 2 1. 1 0. 0 0. 0 0. 2 0. 0 0. 4 10 0. 0 5, 21 7 N ic ke rie 0. 8 94 .0 0. 4 0. 0 0. 0 4. 2 0. 0 0. 2 0. 3 0. 0 0. 0 0. 0 0. 1 0. 0 10 0. 0 2, 08 1 C or on ie 1. 4 79 .3 0. 0 0. 0 0. 0 17 .3 0. 0 0. 3 0. 0 1. 7 0. 0 0. 0 0. 0 0. 0 10 0. 0 16 1 S ar am ac ca 1. 8 79 .7 1. 7 0. 0 0. 2 10 .9 0. 0 0. 2 5. 2 0. 0 0. 0 0. 0 0. 2 0. 0 10 0. 0 92 0 C om m ew ijn e 0. 7 72 .5 1. 5 0. 1 3. 4 16 .0 0. 0 0. 0 5. 2 0. 0 0. 0 0. 2 0. 0 0. 2 10 0. 0 1, 37 3 M ar ow ijn e 1. 7 35 .7 10 .4 0. 0 0. 0 40 .5 0. 1 0. 0 9. 7 0. 0 0. 0 1. 2 0. 0 0. 7 10 0. 0 1, 08 1 P ar a 1. 1 43 .6 6. 7 0. 1 0. 5 39 .6 0. 0 0. 0 4. 9 0. 0 0. 0 2. 8 0. 0 0. 6 10 0. 0 1, 05 4 B ro ko po nd o 0. 0 17 .4 0. 9 0. 0 4. 8 32 .4 0. 0 0. 0 8. 2 0. 1 0. 0 0. 9 0. 1 35 .2 10 0. 0 77 4 S ip al iw in i 0. 4 7. 9 1. 4 0. 1 0. 6 26 .3 0. 3 0. 0 5. 4 0. 1 0. 3 3. 3 0. 4 53 .7 10 0. 0 2, 34 1 A re a U rb an 1. 7 89 .4 0. 6 0. 1 0. 4 5. 6 0. 0 0. 0 1. 7 0. 0 0. 0 0. 2 0. 0 0. 2 10 0. 0 20 ,0 66 R ur al C oa st al 1. 3 66 .5 4. 3 0. 0 0. 2 21 .8 0. 0 0. 1 4. 4 0. 1 0. 0 0. 9 0. 1 0. 3 10 0. 0 5, 24 0 R ur al in te rio r 0. 3 10 .2 1. 3 0. 1 1. 6 27 .8 0. 2 0. 0 6. 1 0. 1 0. 2 2. 7 0. 3 49 .1 10 0. 0 3, 11 4 To ta l R ur al 0. 9 45 .5 3. 2 0. 0 0. 7 24 .0 0. 1 0. 1 5. 0 0. 1 0. 1 1. 6 0. 2 18 .5 10 0. 0 8, 35 5 Ed uc at io n of h ou se ho ld h ea d N on e 0. 2 38 .8 2. 5 0. 0 0. 7 18 .3 0. 0 0. 0 5. 6 0. 1 0. 1 1. 8 0. 3 31 .7 10 0. 0 3, 07 0 P rim ar y 2. 0 69 .1 1. 7 0. 0 0. 8 16 .8 0. 1 0. 0 3. 8 0. 0 0. 0 0. 7 0. 0 4. 8 10 0. 0 9, 08 6 S ec on da ry + 1. 5 89 .1 0. 8 0. 1 0. 3 5. 7 0. 0 0. 1 1. 5 0. 0 0. 0 0. 2 0. 0 0. 6 10 0. 0 14 ,3 57 O th er /N on -s ta nd ar d 1. 2 89 .5 0. 8 0. 0 0. 0 4. 8 0. 0 0. 0 0. 4 0. 0 0. 0 0. 0 0. 8 2. 3 10 0. 0 40 8 M is si ng /D K 0. 1 75 .1 2. 0 0. 0 0. 4 14 .0 0. 0 0. 0 1. 5 0. 0 0. 0 1. 5 0. 1 5. 1 10 0. 0 1, 50 0 W ea lth in de x qu in til e P oo re st 0. 7 12 .7 4. 1 0. 1 1. 6 39 .8 0. 1 0. 0 10 .4 0. 1 0. 1 2. 6 0. 1 27 .6 10 0. 0 5, 69 1 S ec on d 2. 2 75 .5 2. 4 0. 3 1. 0 14 .9 0. 0 0. 2 2. 9 0. 0 0. 0 0. 3 0. 1 0. 2 10 0. 0 5, 67 9 M id dl e 2. 3 96 .9 0. 2 0. 0 0. 1 0. 5 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 5, 68 3 Fo ur th 1. 6 98 .1 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 10 0. 0 5, 67 6 R ic he st 0. 5 99 .5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 5, 69 3 W at er  an d S an ita tio n          Su rin am e M IC S4 83 Ta bl e W S. 5: T yp es o f s an ita tio n fa ci lit ie s (c on tin ue d) P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n ac co rd in g to ty pe o f t oi le t f ac ili ty u se d by th e ho us eh ol d, S ur in am e, 2 01 0 Ty pe o f t oi le t f ac ili ty u se d by h ou se ho ld To ta l N um be r o f ho us eh ol d m em be rs Im pr ov ed s an ita tio n fa ci lit y U ni m pr ov ed s an ita tio n fa ci lit y O pe n de fe ca tio n (n o fa ci lit y, bu sh , f ie ld ) Fl us h/ po ur fl us h to : V en til at ed im pr ov ed pi t l at rin e P it la tri ne w ith sl ab C om po s- tin g to ile t Fl us h/ p ou r flu sh to so m ew he re el se P it la tri ne w ith ou t sl ab / op en p it B uc ke t H an gi ng to ile t/ ha ng in g la tri ne O th er M is si ng P ip ed se w er sy st em S ep tic ta nk P it la tri ne U nk no w n pl ac e/ no t su re /D K w he re Et hn ic ity o f h ou se ho ld h ea d In di ge no us /A m er in di an 0. 2 43 .5 5. 3 0. 1 1. 8 35 .9 0. 7 0. 0 5. 3 0. 0 0. 2 0. 7 0. 0 6. 4 10 0. 0 1, 24 8 M ar oo n 0. 7 40 .4 2. 5 0. 0 1. 0 26 .3 0. 0 0. 0 6. 8 0. 0 0. 0 1. 7 0. 1 20 .3 10 0. 0 7, 27 9 C re ol e 1. 6 92 .1 0. 6 0. 0 0. 7 3. 9 0. 0 0. 0 0. 3 0. 0 0. 0 0. 3 0. 2 0. 3 10 0. 0 4, 91 2 H in du st an i 2. 2 92 .8 0. 7 0. 0 0. 1 3. 2 0. 0 0. 2 0. 6 0. 0 0. 0 0. 1 0. 1 0. 1 10 0. 0 7, 74 5 Ja va ne se 1. 4 90 .8 0. 9 0. 0 0. 4 4. 8 0. 0 0. 1 1. 4 0. 0 0. 0 0. 3 0. 0 0. 0 10 0. 0 3, 99 7 M ix ed 1. 5 90 .7 0. 5 0. 3 0. 0 4. 2 0. 0 0. 0 2. 8 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 2, 69 2 O th er s 3. 2 90 .9 0. 6 1. 0 0. 0 3. 7 0. 0 0. 0 0. 7 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 52 3 M is si ng /D K (0 .0 ) (3 7. 3) (2 0. 8) (0 .0 ) (0 .0 ) (3 8. 5) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (1 .7 ) (1 .7 ) 10 0. 0 26 To ta l 1. 5 76 .5 1. 4 0. 1 0. 5 11 .0 0. 0 0. 1 2. 7 0. 0 0. 0 0. 6 0. 1 5. 6 10 0. 0 28 ,4 21 ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s       W at er  an d S an ita tio n 84   Su rin am e M IC S4   Ta bl e W S. 6: U se a nd s ha rin g of s an ita tio n fa ci lit ie s P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n by u se o f p riv at e an d pu bl ic s an ita tio n fa ci lit ie s an d us e of s ha re d fa ci lit ie s, b y us er s of im pr ov ed a nd u ni m pr ov ed s an ita tio n fa ci lit ie s, S ur in am e, 2 01 0 U se rs o f i m pr ov ed s an ita tio n fa ci lit ie s U se rs o f u ni m pr ov ed s an ita tio n fa ci lit ie s O pe n de fe ca tio n (n o fa ci lit y, bu sh , fie ld ) To ta l N um be r of ho us eh ol d m em be rs N ot sh ar ed 1 P ub lic fa ci lit y Sh ar ed b y M is si ng /D K N ot sh ar ed P ub lic fa ci lit y Sh ar ed b y M is si ng /D K 5 ho us eh ol ds or le ss M or e th an 5 ho us eh ol ds 5 ho us eh ol ds or le ss M or e th an 5 ho us eh ol ds D is tr ic t P ar am ar ib o 87 .1 0. 8 8. 5 0. 4 1. 2 1. 0 0. 0 1. 0 0. 0 0. 0 0. 1 10 0. 0 13 ,4 19 W an ic a 87 .8 0. 4 8. 0 0. 8 1. 1 1. 3 0. 0 0. 2 0. 0 0. 0 0. 4 10 0. 0 5, 21 7 N ic ke rie 95 .3 0. 2 3. 2 0. 4 0. 3 0. 6 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 2, 08 1 C or on ie 95 .6 0. 0 2. 4 0. 0 0. 0 2. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 16 1 S ar am ac ca 83 .5 1. 0 9. 1 0. 0 0. 8 5. 2 0. 0 0. 4 0. 0 0. 0 0. 0 10 0. 0 92 0 C om m ew ijn e 90 .1 0. 2 3. 4 0. 4 0. 2 4. 4 0. 0 1. 1 0. 0 0. 0 0. 2 10 0. 0 1, 37 3 M ar ow ijn e 72 .2 0. 7 14 .3 0. 0 1. 3 5. 3 0. 4 4. 8 0. 4 0. 0 0. 7 10 0. 0 1, 08 1 P ar a 74 .6 1. 9 10 .1 3. 9 1. 2 3. 8 1. 7 2. 0 0. 0 0. 2 0. 6 10 0. 0 1, 05 4 B ro ko po nd o 32 .0 3. 8 12 .9 4. 9 2. 0 5. 0 1. 3 2. 5 0. 3 0. 1 35 .2 10 0. 0 77 4 S ip al iw in i 24 .8 3. 2 7. 0 1. 3 0. 5 4. 2 1. 9 1. 2 1. 7 0. 3 53 .7 10 0. 0 2, 34 1 A re a U rb an 87 .7 0. 6 7. 9 0. 5 1. 1 1. 2 0. 0 0. 8 0. 0 0. 0 0. 2 10 0. 0 20 ,0 66 R ur al C oa st al 83 .4 0. 8 8. 2 0. 9 0. 7 3. 5 0. 4 1. 5 0. 1 0. 0 0. 3 10 0. 0 5, 24 0 R ur al in te rio r 26 .6 3. 3 8. 5 2. 2 0. 9 4. 4 1. 8 1. 6 1. 4 0. 3 49 .1 10 0. 0 3, 11 4 To ta l R ur al 62 .2 1. 8 8. 3 1. 4 0. 8 3. 9 0. 9 1. 5 0. 6 0. 1 18 .5 10 0. 0 8, 35 5 Ed uc at io n of h ou se ho ld h ea d N on e 47 .4 1. 9 9. 7 1. 1 0. 4 4. 4 1. 0 1. 5 0. 8 0. 1 31 .7 10 0. 0 3, 07 0 P rim ar y 76 .9 1. 2 10 .2 1. 3 1. 0 2. 4 0. 4 1. 7 0. 2 0. 1 4. 8 10 0. 0 9, 08 6 S ec on da ry + 89 .1 0. 6 6. 5 0. 3 1. 0 1. 2 0. 0 0. 5 0. 0 0. 0 0. 6 10 0. 0 14 ,3 57 O th er /N on -s ta nd ar d 84 .4 0. 0 7. 0 2. 6 2. 4 1. 2 0. 0 0. 0 0. 0 0. 0 2. 3 10 0. 0 40 8 M is si ng /D K 82 .0 1. 1 6. 3 0. 8 1. 4 1. 5 0. 5 0. 7 0. 3 0. 2 5. 1 10 0. 0 1, 50 0 W ea lth in de x qu in til e P oo re st 37 .0 2. 4 15 .8 2. 1 1. 7 6. 9 1. 3 4. 1 0. 9 0. 2 27 .6 10 0. 0 5, 69 1 S ec on d 82 .2 0. 8 11 .5 0. 5 1. 3 2. 7 0. 1 0. 8 0. 0 0. 0 0. 2 10 0. 0 5, 67 9 M id dl e 91 .7 0. 4 6. 1 0. 9 0. 8 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 5, 68 3 Fo ur th 94 .9 0. 6 3. 7 0. 2 0. 5 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 5, 67 6 R ic he st 95 .5 0. 5 3. 1 0. 2 0. 7 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 5, 69 3     W at er  an d S an ita tio n          Su rin am e M IC S4 85 Ta bl e W S. 6: U se a nd s ha rin g of s an ita tio n fa ci lit ie s (c on tin ue d) P er ce nt d is tri bu tio n of h ou se ho ld p op ul at io n by u se o f p riv at e an d pu bl ic s an ita tio n fa ci lit ie s an d us e of s ha re d fa ci lit ie s, b y us er s of im pr ov ed a nd u ni m pr ov ed s an ita tio n fa ci lit ie s, S ur in am e, 2 01 0 U se rs o f i m pr ov ed s an ita tio n fa ci lit ie s U se rs o f u ni m pr ov ed s an ita tio n fa ci lit ie s O pe n de fe ca tio n (n o fa ci lit y, bu sh , fie ld ) To ta l N um be r of ho us eh ol d m em be rs N ot sh ar ed 1 P ub lic fa ci lit y Sh ar ed b y M is si ng /D K N ot sh ar ed P ub lic fa ci lit y Sh ar ed b y M is si ng /D K 5 ho us eh ol ds or le ss M or e th an 5 ho us eh ol ds 5 ho us eh ol ds or le ss M or e th an 5 ho us eh ol ds Et hn ic ity o f h ou se ho ld h ea d In di ge no us /A m er in di an 73 .5 1. 2 11 .9 0. 4 0. 5 4. 9 0. 4 0. 9 0. 0 0. 0 6. 4 10 0. 0 1, 24 8 M ar oo n 52 .4 1. 8 13 .5 1. 8 1. 4 3. 9 1. 0 3. 0 0. 6 0. 1 20 .3 10 0. 0 7, 27 9 C re ol e 88 .0 0. 8 8. 0 0. 6 1. 5 0. 6 0. 0 0. 1 0. 0 0. 0 0. 3 10 0. 0 4, 91 2 H in du st an i 93 .2 0. 4 4. 5 0. 3 0. 5 0. 8 0. 0 0. 2 0. 0 0. 0 0. 1 10 0. 0 7, 74 5 Ja va ne se 89 .5 0. 8 6. 4 0. 4 1. 2 1. 2 0. 0 0. 5 0. 0 0. 0 0. 0 10 0. 0 3, 99 7 M ix ed 90 .5 0. 9 4. 9 0. 4 0. 5 2. 4 0. 0 0. 4 0. 0 0. 0 0. 0 10 0. 0 2, 69 2 O th er s 95 .2 0. 0 4. 1 0. 0 0. 0 0. 4 0. 0 0. 0 0. 0 0. 2 0. 0 10 0. 0 52 3 M is si ng /D K (9 6. 6) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (1 .7 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (1 .7 ) 10 0. 0 26 To ta l 80 .2 1. 0 8. 0 0. 8 1. 0 2. 0 0. 3 1. 0 0. 2 0. 0 5. 6 10 0. 0 28 ,4 21 ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s 1 M IC S in di ca to r 4 .3 ; M D G in di ca to r 7 .9 Water and Sanitation 86  Suriname MICS4  Table WS.7: Disposal of child's feces Percent distribution of children age 0-2 years according to place of disposal of child's feces, and the percentage of children age 0-2 years whose stools were disposed of safely the last time the child passed stools, Suriname, 2010 Place of disposal of child's feces Percentage of children whose last stools were disposed of safely1 Number of children age 0-2 years Child used toilet/latrine Put/rinsed into toilet or latrine Put/rinsed into drain or ditch Thrown into garbage Buried Left in the open Other Missing/DK Total Type of sanitation facility in dwelling Improved 8.1 17.0 1.7 65.4 3.0 0.0 3.0 1.8 100.0 25.0 1,670 Unimproved 6.6 11.7 5.4 53.5 8.8 0.0 11.9 2.1 100.0 18.3 115 Open defecation 0.6 1.9 10.9 12.6 28.6 1.1 41.7 2.5 100.0 2.5 243 District Paramaribo 7.4 13.3 1.0 75.7 0.5 0.0 0.5 1.5 100.0 20.7 786 Wanica 10.1 19.1 0.0 64.0 3.4 0.0 1.1 2.2 100.0 29.2 362 Nickerie 14.7 16.8 7.4 56.3 1.6 0.0 2.6 0.5 100.0 31.6 124 Coronie (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 7 Saramacca 2.4 10.8 1.2 68.7 6.0 0.0 8.4 2.4 100.0 13.3 54 Commewijne 10.7 7.1 4.5 70.5 6.3 0.0 0.9 0.0 100.0 17.8 74 Marowijne 3.8 23.1 1.4 57.1 9.0 0.0 3.8 1.9 100.0 26.9 128 Para 4.9 21.6 3.9 59.8 1.0 0.0 5.9 2.9 100.0 26.5 72 Brokopondo 1.9 15.8 7.7 29.7 12.0 0.0 30.6 2.4 100.0 17.7 105 Sipaliwini 3.4 9.9 8.4 15.6 25.0 1.0 33.7 3.1 100.0 13.3 316 Area Urban 8.2 14.9 1.1 71.8 1.6 0.0 0.7 1.6 100.0 23.1 1,229 Rural Coastal 7.9 18.6 3.1 58.8 4.9 0.0 4.8 1.7 100.0 26.6 379 Rural interior 3.0 11.4 8.2 19.1 21.7 0.7 32.9 2.9 100.0 14.4 421 Total Rural 5.4 14.8 5.8 37.9 13.8 0.4 19.6 2.3 100.0 20.2 799 Mother’s education* None 3.2 10.7 7.7 25.8 22.4 1.1 25.9 3.1 100.0 13.9 267 Primary 4.8 18.2 3.8 51.5 7.3 0.0 11.9 2.6 100.0 23.0 572 Secondary + 9.0 14.2 1.5 69.3 2.4 0.0 2.4 1.2 100.0 23.2 1,152 Other/Non-standard (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 25 Wealth index quintile Poorest 3.5 16.3 6.3 33.8 16.1 0.5 21.4 2.2 100.0 19.8 669 Second 9.6 19.0 1.6 62.6 3.0 0.0 2.7 1.5 100.0 28.6 425 Middle 5.2 16.2 1.5 73.7 0.2 0.0 1.5 1.7 100.0 21.5 355 Fourth 10.4 9.6 2.0 73.0 2.2 0.0 1.6 1.2 100.0 19.9 329 Richest 10.7 9.1 0.0 76.2 0.7 0.0 0.0 3.2 100.0 19.8 250 Ethnicity of household head Indigenous/Amerindian 6.3 24.1 1.3 45.8 6.9 0.0 15.1 0.5 100.0 30.4 96 Maroon 4.1 15.4 5.2 44.2 12.6 0.4 16.1 2.2 100.0 19.5 841 Creole 11.5 18.2 1.3 67.6 0.3 0.0 0.3 0.8 100.0 29.7 250 Hindustani 9.4 14.1 2.0 70.0 1.0 0.0 2.1 1.3 100.0 23.5 402 Javanese 9.6 11.7 0.9 70.3 6.0 0.0 1.5 0.0 100.0 21.3 219 Mixed 7.0 10.5 1.3 75.3 0.0 0.0 1.4 4.4 100.0 17.5 196 Others (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 24 Total 7.1 14.9 3.0 58.4 6.4 0.2 8.1 1.9 100.0 22.0 2,028 * ‘Missing/DK’ category of mother’s education not shown due to low number of observations (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 4.4     Water and Sanitation      Suriname MICS4 87 In its 2008 report11, the JMP developed a new way of presenting the access figures, by disaggregating and  refining  the  data  on  drinking‐water  and  sanitation  and  reflecting  them  in  "ladder"  format.  This  ladder  allows a disaggregated analysis of trends in a three rung ladder for drinking‐water and a four‐rung ladder  for  sanitation.  For  sanitation,  this  gives  an  understanding  of  the  proportion  of  population  with  no  sanitation  facilities  at  all,  of  those  reliant  on  technologies  defined  by  JMP  as  "unimproved,"  of  those  sharing  sanitation  facilities  of  otherwise  acceptable  technology,  and  those  using  "improved"  sanitation  facilities.  An  overview  of  the  percentage  of  household members  using  improved  sources  of  drinking water  and  sanitary means of excreta disposal  is presented  in Table WS.8  (page 88).  In Suriname, approximately 79  percent of all household members have improved water sources and improved sanitation. In urban areas,  the  proportion  of  the  population  that  have  improved  water  sources  and  improved  sanitation  is  substantially higher than in rural areas (87 percent as opposed to 59 percent), though in the case of rural  areas much higher proportions of  the population  in  rural  coastal  areas have  such  facilities  (81%) when  compared  to  corresponding proportions  in  the  rural  interior  (23%).  In Brokopondo and Sipaliwini  in  the  rural  interior,  the  respective  proportions  are  31  percent  and  21  percent.  Though  variable, much more  favourable  levels of access  to  improved drinking water and sanitation  is evident  in  the other districts of  Suriname especially in Coronie (96%) and Nickerie (94%).  Handwashing Handwashing  with  water  and  soap  is  the  most  cost  effective  health  intervention  to  reduce  both  the  incidence of diarrhoea and pneumonia  in children under five.  It  is most effective when done using water  and  soap after visiting a  toilet or cleaning a child, before eating or handling  food and, before  feeding a  child.  Monitoring  correct  hand  washing  behaviour  at  these  critical  times  is  challenging.  A  reliable  alternative to observations or self‐reported behaviour is assessing the likelihood that correct hand washing  behaviour takes place by observing if a household has a specific place where people most often wash their  hands and observing  if water and soap (or other  local cleansing materials) are present at a specific place  for hand washing.  In Suriname, a specific place for handwashing was observed in approximately 74 percent of the households  while 11 percent of all households could not indicate a specific place in their dwelling, yard, or plot where  household members usually wash their hands and 10 percent of the households did not give permission for  the interviewer to see the place used for handwashing (Table WS.9, page 90). Of those households where  place for handwashing was observed, nearly 9  in every 10 (86%) had both water and soap present at the  designated place. In 10 percent of the households only water was available at the designated place, while  in 2 percent of the households the place only had soap but no water. The remaining percent of households  had neither water nor soap available at the designated place for hand washing. Higher levels of status with  respect to the education of head and wealth status in households are associated with a greater likelihood  of having water and soap available or soap anywhere in the dwelling.  Only 4 percent of the households did not have any soap present in the household and in the remaining 96  percent either  the  soap was observed or  shown  to  the  interviewer  (Table WS.10, page 92). A place  for  handwashing was more  likely  to  be  observed  in  households  located  in  urban  areas  and  in  households  located in rural coastal areas than in those located in the rural interior.                                                               11 WHO/UNICEF JMP (2008), MDG assessment report ‐ http://www.wssinfo.org/download?id_document=1279   W at er  an d S an ita tio n 88   Su rin am e M IC S4     Ta bl e W S. 8: D rin ki ng w at er a nd s an ita tio n la dd er s P er ce nt ag e of h ou se ho ld p op ul at io n by d rin ki ng w at er a nd s an ita tio n la dd er s, S ur in am e, 2 01 0 Pe rc en ta ge o f h ou se ho ld p op ul at io n us in g: N um be r o f ho us eh ol d m em be rs Im pr ov ed d rin ki ng w at er 1 U ni m pr ov ed dr in ki ng w at er To ta l Im pr ov ed sa ni ta tio n2 U ni m pr ov ed s an ita tio n To ta l Im pr ov ed dr in ki ng w at er so ur ce s an d im pr ov ed sa ni ta tio n P ip ed in to dw el lin g, pl ot o r y ar d O th er im pr ov ed S ha re d im pr ov ed fa ci lit ie s U ni m pr ov ed fa ci lit ie s O pe n de fe ca tio n D is tr ic t P ar am ar ib o 91 .3 8. 2 0. 6 10 0. 0 87 .1 10 .8 2. 0 0. 1 10 0. 0 86 .7 13 ,4 19 W an ic a 70 .5 27 .5 2. 0 10 0. 0 87 .8 10 .3 1. 5 0. 4 10 0. 0 86 .7 5, 21 7 N ic ke rie 93 .2 4. 8 2. 0 10 0. 0 95 .3 4. 1 0. 6 0. 0 10 0. 0 93 .6 2, 08 1 C or on ie 99 .0 1. 0 0. 0 10 0. 0 95 .6 2. 4 2. 0 0. 0 10 0. 0 95 .6 16 1 S ar am ac ca 51 .4 46 .3 2. 3 10 0. 0 83 .5 10 .9 5. 6 0. 0 10 0. 0 82 .1 92 0 C om m ew ijn e 25 .2 72 .0 2. 7 10 0. 0 90 .1 4. 2 5. 5 0. 2 10 0. 0 87 .4 1, 37 3 M ar ow ijn e 53 .0 38 .2 8. 7 10 0. 0 72 .2 16 .3 10 .9 0. 7 10 0. 0 65 .7 1, 08 1 P ar a 73 .5 23 .0 3. 5 10 0. 0 74 .6 17 .1 7. 7 0. 6 10 0. 0 72 .1 1, 05 4 B ro ko po nd o 32 .4 57 .1 10 .6 10 0. 0 32 .0 23 .6 9. 2 35 .2 10 0. 0 31 .4 77 4 S ip al iw in i 9. 0 55 .6 35 .5 10 0. 0 24 .8 12 .1 9. 5 53 .7 10 0. 0 20 .5 2, 34 1 A re a U rb an 83 .5 15 .5 1. 1 10 0. 0 87 .7 10 .1 2. 0 0. 2 10 0. 0 87 .0 20 ,0 66 R ur al C oa st al 65 .7 30 .5 3. 8 10 0. 0 83 .4 10 .7 5. 5 0. 3 10 0. 0 80 .6 5, 24 0 R ur al in te rio r 14 .8 55 .9 29 .3 10 0. 0 26 .6 14 .9 9. 4 49 .1 10 0. 0 23 .2 3, 11 4 To ta l R ur al 46 .7 40 .0 13 .3 10 0. 0 62 .2 12 .3 7. 0 18 .5 10 0. 0 59 .2 8, 35 5 Ed uc at io n of h ou se ho ld h ea d N on e 40 .6 40 .2 19 .1 10 0. 0 47 .4 13 .0 7. 9 31 .7 10 0. 0 45 .8 3, 07 0 P rim ar y 66 .9 28 .5 4. 6 10 0. 0 76 .9 13 .7 4. 7 4. 8 10 0. 0 75 .2 9, 08 6 S ec on da ry + 82 .7 15 .6 1. 6 10 0. 0 89 .1 8. 5 1. 8 0. 6 10 0. 0 88 .0 14 ,3 57 O th er /N on -s ta nd ar d 81 .6 16 .2 2. 3 10 0. 0 84 .4 12 .0 1. 2 2. 3 10 0. 0 83 .3 40 8 M is si ng /D K 74 .3 20 .5 5. 1 10 0. 0 82 .0 9. 7 3. 2 5. 1 10 0. 0 79 .9 1, 50 0         Re pr od uc tiv e H ea lth                  Su rin am e M IC S4 89 Ta bl e W S. 8: D rin ki ng w at er a nd s an ita tio n la dd er s (c on tin ue d) P er ce nt ag e of h ou se ho ld p op ul at io n by d rin ki ng w at er a nd s an ita tio n la dd er s, S ur in am e, 2 01 0 Pe rc en ta ge o f h ou se ho ld p op ul at io n us in g: N um be r o f ho us eh ol d m em be rs Im pr ov ed d rin ki ng w at er 1 U ni m pr ov ed dr in ki ng w at er To ta l Im pr ov ed sa ni ta tio n2 U ni m pr ov ed s an ita tio n To ta l Im pr ov ed dr in ki ng w at er so ur ce s an d im pr ov ed sa ni ta tio n P ip ed in to dw el lin g, pl ot o r y ar d O th er im pr ov ed S ha re d im pr ov ed fa ci lit ie s U ni m pr ov ed fa ci lit ie s O pe n de fe ca tio n W ea lth in de x qu in til e P oo re st 28 .7 50 .7 20 .6 10 0. 0 37 .0 22 .0 13 .4 27 .6 10 0. 0 32 .4 5, 69 1 S ec on d 66 .2 32 .7 1. 2 10 0. 0 82 .2 14 .1 3. 6 0. 2 10 0. 0 81 .3 5, 67 9 M id dl e 82 .4 16 .9 0. 7 10 0. 0 91 .7 8. 2 0. 1 0. 0 10 0. 0 91 .0 5, 68 3 Fo ur th 87 .9 11 .4 0. 7 10 0. 0 94 .9 5. 0 0. 1 0. 0 10 0. 0 94 .2 5, 67 6 R ic he st 98 .1 1. 7 0. 1 10 0. 0 95 .5 4. 5 0. 0 0. 0 10 0. 0 95 .3 5, 69 3 Et hn ic ity o f h ou se ho ld h ea d In di ge no us /A m er in di an 60 .4 27 .0 12 .6 10 0. 0 73 .5 14 .0 6. 2 6. 4 10 0. 0 65 .9 1, 24 8 M ar oo n 48 .3 38 .4 13 .3 10 0. 0 52 .4 18 .6 8. 7 20 .3 10 0. 0 50 .4 7, 27 9 C re ol e 94 .0 5. 1 0. 9 10 0. 0 88 .0 10 .9 0. 8 0. 3 10 0. 0 87 .6 4, 91 2 H in du st an i 78 .8 20 .1 1. 1 10 0. 0 93 .2 5. 7 1. 0 0. 1 10 0. 0 92 .1 7, 74 5 Ja va ne se 68 .8 30 .8 0. 4 10 0. 0 89 .5 8. 8 1. 7 0. 0 10 0. 0 89 .2 3, 99 7 M ix ed 90 .2 8. 1 1. 7 10 0. 0 90 .5 6. 8 2. 8 0. 0 10 0. 0 89 .2 2, 69 2 O th er s 89 .6 9. 7 0. 7 10 0. 0 95 .2 4. 1 0. 7 0. 0 10 0. 0 94 .8 52 3 M is si ng /D K (6 0. 4) (2 4. 3) (1 5. 3) 10 0. 0 (9 6. 6) (0 .0 ) (1 .7 ) (1 .7 ) 10 0. 0 (8 3. 0) 26 To ta l 72 .7 22 .7 4. 7 10 0. 0 80 .2 10 .8 3. 4 5. 6 10 0. 0 78 .9 28 ,4 21 ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s 1 M IC S in di ca to r 4 .1 ; M D G in di ca to r 7 .8 2 M IC S in di ca to r 4 .3 ; M D G in di ca to r 7 .9     W at er  an d S an ita tio n 90   Su rin am e M IC S4     Ta bl e W S. 9: W at er a nd s oa p at p la ce fo r h an dw as hi ng P er ce nt ag e of h ou se ho ld s w he re p la ce fo r h an dw as hi ng w as o bs er ve d an d pe rc en t d is tri bu tio n of h ou se ho ld s by a va ila bi lit y of w at er a nd s oa p at p la ce fo r h an dw as hi ng , S ur in am e, 2 01 0 P er ce nt ag e of ho us eh ol ds w he re p la ce fo r ha nd w as hi ng w as o bs er ve d Pe rc en ta ge o f h ou se ho ld s w he re p la ce fo r h an dw as hi ng w as n ot o bs er ve d To ta l N um be r o f ho us eh ol ds Pe rc en t d is tr ib ut io n of h ou se ho ld s w he re p la ce fo r ha nd w as hi ng w as o bs er ve d, a nd : To ta l N um be r o f ho us eh ol ds w he re p la ce fo r ha nd w as hi ng w as o bs er ve d N ot in dw el lin g/ pl ot / ya rd N o pe rm is si on to s ee O th er re as on s M is si ng W at er a nd so ap ar e av ai la bl e1 W at er is av ai la bl e, so ap is n ot av ai la bl e W at er is n ot av ai la bl e, so ap is av ai la bl e W at er a nd so ap ar e no t av ai la bl e M is si ng D is tr ic t P ar am ar ib o 76 .3 7. 3 11 .9 4. 3 0. 1 10 0. 0 3, 64 0 89 .1 7. 9 2. 1 0. 5 0. 4 10 0. 0 2, 77 8 W an ic a 75 .2 8. 6 10 .0 5. 8 0. 4 10 0. 0 1, 27 5 87 .9 8. 8 2. 5 0. 9 0. 0 10 0. 0 95 8 N ic ke rie 86 .0 2. 4 2. 3 9. 2 0. 0 10 0. 0 56 3 87 .3 10 .1 1. 5 1. 0 0. 1 10 0. 0 48 4 C or on ie 77 .4 6. 5 10 .8 5. 4 0. 0 10 0. 0 51 66 .7 27 .8 4. 2 1. 4 0. 0 10 0. 0 39 S ar am ac ca 67 .0 14 .2 14 .8 3. 6 0. 4 10 0. 0 24 4 88 .6 7. 7 2. 3 1. 0 0. 3 10 0. 0 16 3 C om m ew ijn e 66 .5 10 .0 13 .4 10 .0 0. 0 10 0. 0 35 9 87 .0 7. 9 3. 7 1. 4 0. 0 10 0. 0 23 9 M ar ow ijn e 76 .2 14 .8 4. 9 3. 8 0. 2 10 0. 0 22 6 75 .6 18 .2 4. 1 1. 8 0. 3 10 0. 0 17 2 P ar a 60 .3 27 .0 9. 7 2. 7 0. 2 10 0. 0 24 3 84 .7 10 .9 4. 0 0. 4 0. 0 10 0. 0 14 7 B ro ko po nd o 61 .1 29 .7 2. 1 7. 1 0. 0 10 0. 0 18 6 59 .6 33 .0 3. 0 2. 2 2. 2 10 0. 0 11 4 S ip al iw in i 56 .5 33 .7 1. 0 8. 8 0. 1 10 0. 0 61 9 73 .9 17 .4 2. 4 5. 5 0. 9 10 0. 0 35 0 A re a U rb an 76 .0 7. 4 11 .2 5. 2 0. 2 10 0. 0 5, 30 1 88 .8 8. 3 2. 1 0. 6 0. 2 10 0. 0 4, 02 9 R ur al C oa st al 73 .3 13 .1 7. 9 5. 5 0. 2 10 0. 0 1, 30 0 83 .8 11 .4 3. 5 1. 1 0. 2 10 0. 0 95 3 R ur al in te rio r 57 .5 32 .8 1. 2 8. 4 0. 1 10 0. 0 80 6 70 .4 21 .2 2. 5 4. 7 1. 2 10 0. 0 46 4 To ta l R ur al 67 .3 20 .6 5. 4 6. 6 0. 1 10 0. 0 2, 10 6 79 .4 14 .6 3. 1 2. 3 0. 5 10 0. 0 1, 41 7 Ed uc at io n of h ou se ho ld h ea d N on e 64 .2 25 .2 5. 2 5. 3 0. 1 10 0. 0 80 0 72 .4 20 .3 3. 1 3. 6 0. 7 10 0. 0 51 3 P rim ar y 73 .1 12 .9 8. 1 5. 8 0. 1 10 0. 0 2, 28 1 82 .4 12 .5 3. 1 1. 7 0. 3 10 0. 0 1, 66 7 S ec on da ry + 76 .0 7. 2 11 .1 5. 4 0. 2 10 0. 0 3, 87 5 91 .1 6. 5 1. 9 0. 2 0. 3 10 0. 0 2, 94 5 O th er /N on -s ta nd ar d 84 .7 4. 4 7. 8 3. 1 0. 0 10 0. 0 10 7 82 .7 13 .7 3. 1 0. 6 0. 0 10 0. 0 91 M is si ng /D K 66 .8 13 .3 12 .7 7. 2 0. 0 10 0. 0 34 4 86 .5 10 .5 1. 2 1. 6 0. 2 10 0. 0 23 0         Re pr od uc tiv e H ea lth                  Su rin am e M IC S4 91     Ta bl e W S. 9: W at er a nd s oa p at p la ce fo r h an dw as hi ng ( co nt in ue d) P er ce nt ag e of h ou se ho ld s w he re p la ce fo r h an dw as hi ng w as o bs er ve d an d pe rc en t d is tri bu tio n of h ou se ho ld s by a va ila bi lit y of w at er a nd s oa p at p la ce fo r h an dw as hi ng , S ur in am e, 2 01 0 P er ce nt ag e of ho us eh ol ds w he re p la ce fo r ha nd w as hi ng w as o bs er ve d Pe rc en ta ge o f h ou se ho ld s w he re p la ce fo r h an dw as hi ng w as n ot o bs er ve d To ta l N um be r o f ho us eh ol ds Pe rc en t d is tr ib ut io n of h ou se ho ld s w he re p la ce fo r ha nd w as hi ng w as o bs er ve d, a nd : To ta l N um be r o f ho us eh ol ds w he re p la ce fo r ha nd w as hi ng w as o bs er ve d N ot in dw el lin g/ pl ot / ya rd N o pe rm is si on to s ee O th er re as on s M is si ng W at er a nd so ap ar e av ai la bl e1 W at er is av ai la bl e, so ap is n ot av ai la bl e W at er is n ot av ai la bl e, so ap is av ai la bl e W at er a nd so ap a re no t av ai la bl e M is si ng W ea lth in de x qu in til es P oo re st 60 .2 29 .2 3. 7 6. 9 0. 0 10 0. 0 1, 41 9 66 .7 24 .5 4. 2 3. 7 0. 9 10 0. 0 85 5 S ec on d 71 .2 13 .9 10 .4 4. 2 0. 3 10 0. 0 1, 46 7 79 .5 15 .2 3. 7 1. 4 0. 2 10 0. 0 1, 04 4 M id dl e 77 .5 6. 6 10 .7 5. 3 0. 0 10 0. 0 1, 52 0 90 .2 7. 5 1. 6 0. 6 0. 0 10 0. 0 1, 17 7 Fo ur th 77 .9 4. 5 11 .5 5. 9 0. 3 10 0. 0 1, 49 6 93 .6 3. 6 2. 1 0. 3 0. 3 10 0. 0 1, 16 5 R ic he st 80 .0 2. 7 11 .4 5. 8 0. 1 10 0. 0 1, 50 5 95 .4 3. 5 0. 8 0. 0 0. 3 10 0. 0 1, 20 4 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 69 .2 18 .3 5. 3 7. 3 0. 0 10 0. 0 27 1 79 .1 16 .0 2. 0 2. 2 0. 7 10 0. 0 18 7 M ar oo n 66 .3 23 .8 4. 0 5. 6 0. 3 10 0. 0 1, 59 4 73 .5 20 .3 2. 8 2. 7 0. 8 10 0. 0 1, 05 7 C re ol e 77 .8 6. 6 11 .1 4. 4 0. 2 10 0. 0 1, 44 7 88 .6 9. 4 1. 5 0. 2 0. 3 10 0. 0 1, 12 5 H in du st an i 76 .1 7. 1 10 .4 6. 3 0. 1 10 0. 0 2, 06 9 89 .9 6. 0 3. 0 1. 0 0. 1 10 0. 0 1, 57 5 Ja va ne se 73 .5 9. 2 11 .2 6. 1 0. 1 10 0. 0 1, 07 2 89 .2 7. 4 2. 7 0. 5 0. 3 10 0. 0 78 8 M ix ed 76 .4 4. 7 14 .0 4. 9 0. 1 10 0. 0 77 7 93 .5 4. 7 1. 3 0. 6 0. 0 10 0. 0 59 3 O th er s 68 .0 11 .9 14 .9 5. 2 0. 0 10 0. 0 17 2 89 .1 9. 0 1. 9 0. 0 0. 0 10 0. 0 11 7 To ta l 73 .5 11 .2 9. 6 5. 6 0. 1 10 0. 0 7, 40 7 86 .3 9. 9 2. 4 1. 1 0. 3 10 0. 0 5, 44 5 * ‘M is si ng /D K ’ c at eg or y of e th ni ci ty o f h ou se ho ld h ea d no t s ho w n du e to lo w n um be r o f o bs er va tio ns 1 M IC S in di ca to r 4 .5       W at er  an d S an ita tio n 92   Su rin am e M IC S4     Ta bl e W S. 10 : A va ila bi lit y of s oa p P er ce nt d is tri bu tio n of h ou se ho ld s by a va ila bi lit y of s oa p in th e dw el lin g, S ur in am e, 2 01 0 Pl ac e fo r h an dw as hi ng o bs er ve d Pl ac e fo r h an dw as hi ng n ot o bs er ve d To ta l P er ce nt ag e of ho us eh ol ds w ith so ap an yw he re i n th e dw el lin g1 N um be r of ho us eh ol ds S oa p ob se rv ed So ap n ot o bs er ve d at p la ce fo r h an dw as hi ng S oa p sh ow n N o so ap in ho us eh ol d N ot ab le /D oe s no t w an t to sh ow so ap M is si ng S oa p sh ow n N o so ap in ho us eh ol d N ot ab le /D oe s no t w an t t o sh ow s oa p M is si ng D is tr ic t P ar am ar ib o 69 .6 5. 3 0. 9 0. 2 0. 3 21 .0 1. 7 1. 0 0. 0 10 0. 0 95 .9 3, 64 0 W an ic a 67 .9 6. 7 0. 5 0. 0 0. 0 23 .5 1. 1 0. 3 0. 0 10 0. 0 98 .2 1, 27 5 N ic ke rie 76 .4 8. 9 0. 6 0. 0 0. 1 13 .7 0. 3 0. 0 0. 0 10 0. 0 99 .0 56 3 C or on ie 54 .8 20 .4 2. 2 0. 0 0. 0 22 .6 0. 0 0. 0 0. 0 10 0. 0 97 .8 51 S ar am ac ca 60 .9 4. 9 0. 4 0. 4 0. 2 29 .2 2. 2 1. 6 0. 0 10 0. 0 95 .1 24 4 C om m ew ijn e 60 .4 6. 0 0. 2 0. 0 0. 0 29 .2 2. 2 2. 2 0. 0 10 0. 0 95 .5 35 9 M ar ow ijn e 60 .8 13 .7 1. 6 0. 0 0. 2 20 .9 1. 8 1. 1 0. 0 10 0. 0 95 .3 22 6 P ar a 53 .5 5. 6 1. 2 0. 0 0. 0 34 .5 3. 6 1. 5 0. 0 10 0. 0 93 .7 24 3 B ro ko po nd o 38 .2 19 .9 1. 4 0. 0 1. 6 32 .5 6. 2 0. 2 0. 0 10 0. 0 90 .6 18 6 S ip al iw in i 43 .1 12 .0 0. 9 0. 0 0. 5 40 .3 3. 2 0. 1 0. 0 10 0. 0 95 .4 61 9 A re a U rb an 69 .0 5. 9 0. 7 0. 2 0. 2 21 .6 1. 5 0. 8 0. 0 10 0. 0 96 .6 5, 30 1 R ur al C oa st al 64 .0 8. 2 1. 0 0. 1 0. 1 24 .0 1. 9 0. 8 0. 0 10 0. 0 96 .1 1, 30 0 R ur al in te rio r 42 .0 13 .8 1. 0 0. 0 0. 7 38 .5 3. 9 0. 1 0. 0 10 0. 0 94 .3 80 6 To ta l R ur al 55 .5 10 .3 1. 0 0. 1 0. 4 29 .5 2. 6 0. 6 0. 0 10 0. 0 95 .4 2, 10 6 Ed uc at io n of h ou se ho ld h ea d N on e 48 .4 13 .3 1. 9 0. 1 0. 4 31 .1 4. 4 0. 3 0. 0 10 0. 0 92 .9 80 0 P rim ar y 62 .5 9. 3 0. 9 0. 1 0. 2 23 .7 2. 4 0. 8 0. 1 10 0. 0 95 .5 2, 28 1 S ec on da ry + 70 .7 4. 4 0. 5 0. 2 0. 2 22 .2 1. 0 0. 8 0. 0 10 0. 0 97 .3 3, 87 5 O th er /N on -s ta nd ar d 72 .6 11 .6 0. 5 0. 0 0. 0 14 .9 0. 4 0. 0 0. 0 10 0. 0 99 .1 10 7 M is si ng /D K 58 .5 7. 6 0. 5 0. 0 0. 1 30 .5 1. 6 1. 1 0. 0 10 0. 0 96 .6 34 4         Re pr od uc tiv e H ea lth                  Su rin am e M IC S4 93     Ta bl e W S. 10 : A va ila bi lit y of s oa p (c on tin ue d) P er ce nt d is tri bu tio n of h ou se ho ld s by a va ila bi lit y of s oa p in th e dw el lin g, S ur in am e, 2 01 0 Pl ac e fo r h an dw as hi ng o bs er ve d Pl ac e fo r h an dw as hi ng n ot o bs er ve d To ta l P er ce nt ag e of ho us eh ol ds w ith so ap an yw he re i n th e dw el lin g1 N um be r of ho us eh ol ds S oa p ob se rv ed So ap n ot o bs er ve d at p la ce fo r h an dw as hi ng S oa p sh ow n N o so ap in ho us eh ol d N ot ab le /D oe s no t w an t to sh ow so ap M is si ng S oa p sh ow n N o so ap in ho us eh ol d N ot ab le /D oe s no t w an t t o sh ow s oa p M is si ng W ea lth in de x qu in til e P oo re st 42 .7 14 .8 2. 2 0. 0 0. 6 34 .7 4. 5 0. 6 0. 0 10 0. 0 92 .1 1, 41 9 S ec on d 59 .3 10 .2 1. 3 0. 3 0. 2 25 .5 2. 6 0. 7 0. 0 10 0. 0 95 .0 1, 46 7 M id dl e 71 .1 5. 9 0. 4 0. 0 0. 0 20 .6 0. 9 1. 1 0. 0 10 0. 0 97 .6 1, 52 0 Fo ur th 74 .6 2. 8 0. 2 0. 1 0. 2 20 .8 0. 7 0. 5 0. 1 10 0. 0 98 .2 1, 49 6 R ic he st 76 .9 2. 5 0. 1 0. 2 0. 2 18 .5 0. 6 0. 9 0. 0 10 0. 0 98 .0 1, 50 5 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 56 .1 12 .6 0. 0 0. 0 0. 5 27 .0 2. 4 1. 4 0. 0 10 0. 0 95 .6 27 1 M ar oo n 50 .5 13 .4 1. 8 0. 0 0. 5 29 .1 4. 3 0. 3 0. 0 10 0. 0 93 .1 1, 59 4 C re ol e 70 .1 6. 5 0. 7 0. 3 0. 2 19 .7 1. 6 0. 9 0. 0 10 0. 0 96 .3 1, 44 7 H in du st an i 70 .7 4. 7 0. 4 0. 2 0. 1 21 .9 0. 8 1. 1 0. 0 10 0. 0 97 .4 2, 06 9 Ja va ne se 67 .5 4. 9 0. 9 0. 1 0. 2 25 .2 0. 9 0. 3 0. 2 10 0. 0 97 .6 1, 07 2 M ix ed 72 .4 3. 4 0. 3 0. 2 0. 1 22 .8 0. 6 0. 2 0. 0 10 0. 0 98 .6 77 7 O th er s 61 .9 6. 1 0. 0 0. 0 0. 0 25 .2 1. 9 4. 9 0. 0 10 0. 0 93 .2 17 2 To ta l 65 .2 7. 1 0. 8 0. 1 0. 2 23 .9 1. 8 0. 8 0. 0 10 0. 0 96 .2 7, 40 7 * ‘M is si ng /D K ’ c at eg or y of e th ni ci ty o f h ou se ho ld h ea d no t s ho w n du e to lo w n um be r o f o bs er va tio ns 1 M IC S in di ca to r 4 .6 Reproductive Health 94  Suriname MICS4    7. Reproductive Health         Reproductive Health             Suriname MICS4 95 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 48 percent of women currently married or  in union (Table  RH.1, page 97). The most prevalent method  is  the pill12 which  is used by one  in  four married women  in  Suriname, more  than half of women using  contraception. The  second most prevalent method  is  female  sterilization13, which accounts  for 11 percent of married women. Variable proportions  ranging between  two and  five percent of women  reported use of  the  Intra‐uterine devices  (IUD)14,  injectables15, and  the  male  condom16.  Less  than  one  percent  use  periodic  abstinence17,  withdrawal18,  male  sterilization19,  implants20, the female condom21, or any other method.   Contraceptive prevalence  is highest  in Commewijne at approximately 62 percent. Though  lower  than  in  Commewijne,  a  similar  magnitude  of  contraceptive  prevalence  is  observed  in  Wanica  (52%),  Nickerie  (51%), and Saramacca  (54%). The  lowest contraceptive prevalence  is  in Brokopondo (26%) and Sipaliwini  (25%). Having been married or  in a union, women 15‐24 years are  less  likely  to use contraception  than  older women. Specifically, 42 percent of 15‐19 year olds and 41 percent of 20‐24 year olds reported that  they were currently using contraception. Contraceptive prevalence  is highest among women 35‐39 years  being approximately 56 percent.  Women’s education level  is strongly associated with contraceptive prevalence. The percentage of women  using  any  method  of  contraception  increases  from  19  percent  among  those  with  no  education  to  42  percent among women with primary education, and to 52 percent among women with at least secondary  education. With respect to the most popular methods of contraception, a similar pattern is observed and  women  with  no  education  are  less  likely  than  those  attaining  primary  or  a  minimum  of  a  secondary                                                               12 Women can take a pill every day to avoid becoming pregnant.  13 There are several types of operations a woman can have that will make her sterile, including a “tube tie” or the  removal of the uterus (i.e., a hysterectomy) or ovaries.   14 Women can have a plastic, T‐shaped device placed inside them by a doctor or a nurse. There are two types of IUDs:  hormone IUDs and copper IUDs. Both types are effective in preventing pregnancy. The IUD is a reversible form of  contraception and can be used for up to 5‐10 years (depending on type) before needing to be replaced.  15 An injection of hormone that is released slowly into the bloodstream can be given regularly to women to prevent  pregnancy. The most common type of injectable contraceptive is given every three months.  16 Men can put a thin, rubber sheath on their penis before sexual intercourse.  17 This is also called the safe period, the rhythm method, or the calendar method. This method is based on the  principle that by not having sexual relations on certain days of her monthly cycle, a woman can avoid becoming  pregnant.   18 Men can withdraw from intercourse before climax.  19 This is a comparatively minor operation done on men for contraceptive purposes. It is also called vasectomy.  20 Also called Norplant, these are small rods surgically implanted in a woman’s upper arm. They usually protect a  woman against pregnancy for five or more years.  21 A thin, transparent rubber can be placed in the vagina before sex to avoid pregnancy.  Reproductive Health 96  Suriname MICS4  education  to  have  used  female  sterilization,  the  pill,  and  male  condoms.  In  the  case  of  the  pill,  the  respective rates of contraceptive prevalence are 12 percent, 19 percent, and 28 percent. With respect to  male condoms,  the corresponding rates are zero percent,  two percent, and six percent. Accordingly,  the  principal  choices  of  contraception  seem  to  remain  unchanged  despite  differences  in women’s  level  of  education.   The wealth of  the household  is also  strongly  related  to  the  level of  contraceptive use,  ranging  from 32  percent  among  the  poorest  to  56  percent  among  the  richest.  Certain  methods  also  have  indicative  patterns:  Female  sterilization  ranges  from  a  prevalence  of  7  percent  among  women  in  the  poorest  households to 15 percent in the richest. Similarly, the use of the pill ranges from 17 percent to 25 percent.    Re pr od uc tiv e H ea lth           Su rin am e M IC S4 97 Ta bl e R H .1 : U se o f c on tr ac ep tio n P er ce nt ag e of w om en a ge 1 5- 49 y ea rs c ur re nt ly m ar rie d or in u ni on w ho a re u si ng (o r w ho se p ar tn er is u si ng ) a c on tra ce pt iv e m et ho d, S ur in am e, 2 01 0 N ot us in g an y m et ho d Pe rc en t o f w om en (c ur re nt ly m ar rie d or in u ni on ) w ho a re u si ng : N um be r of w om en cu rr en tly m ar rie d or in un io n Fe m al e st er ili - za tio n M al e st er ili - za tio n IU D In je ct ab le s Im pl an ts P ill M al e co nd om Fe m al e co nd om P er io di c ab st in en ce W ith dr aw al O th er M is si ng A ny m od er n m et ho d A ny tra di - tio na l m et ho d A ny m et ho d1 R eg io n P ar am ar ib o 52 .3 10 .5 0. 1 2. 9 3. 9 0. 1 24 .0 5. 7 0. 0 0. 4 0. 0 0. 0 0. 1 47 .2 0. 4 47 .6 1, 48 4 W an ic a 48 .4 15 .7 0. 0 1. 8 4. 5 0. 2 25 .0 4. 1 0. 0 0. 0 0. 2 0. 0 0. 0 51 .4 0. 2 51 .6 73 5 N ic ke rie 49 .5 7. 0 0. 2 0. 7 4. 7 0. 2 32 .5 5. 1 0. 0 0. 0 0. 0 0. 2 0. 0 50 .3 0. 2 50 .5 32 6 C or on ie (5 4. 3) (1 1. 4) (0 .0 ) (0 .0 ) (1 1. 4) (0 .0 ) (1 7. 1) (5 .7 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (4 5. 7) (0 .0 ) (4 5. 7) 18 S ar am ac ca 46 .3 13 .3 0. 0 2. 8 4. 9 0. 0 29 .8 2. 1 0. 4 0. 4 0. 0 0. 0 0. 0 53 .3 0. 4 53 .7 15 1 C om m ew ijn e 38 .5 18 .0 0. 3 0. 5 6. 7 0. 8 29 .7 4. 3 0. 0 0. 8 0. 5 0. 0 0. 0 60 .2 1. 3 61 .5 20 3 M ar ow ijn e 60 .7 6. 5 0. 5 0. 5 2. 8 0. 0 23 .8 3. 7 0. 0 0. 5 0. 5 0. 5 0. 0 37 .9 1. 4 39 .3 10 5 P ar a 57 .6 6. 3 0. 0 0. 5 3. 1 0. 0 26 .2 6. 3 0. 0 0. 0 0. 0 0. 0 0. 0 42 .4 0. 0 42 .4 10 9 B ro ko po nd o 74 .4 3. 0 0. 0 0. 6 4. 2 0. 0 14 .9 3. 0 0. 0 0. 0 0. 0 0. 0 0. 0 25 .6 0. 0 25 .6 67 S ip al iw in i 74 .9 4. 9 0. 0 0. 8 5. 3 0. 0 11 .7 2. 1 0. 0 0. 0 0. 0 0. 4 0. 0 24 .8 0. 4 25 .1 20 8 A re a U rb an 50 .7 12 .5 0. 1 2. 3 4. 2 0. 2 24 .2 5. 3 0. 0 0. 3 0. 1 0. 0 0. 1 48 .9 0. 4 49 .3 2, 43 0 R ur al C oa st al 49 .4 8. 9 0. 2 1. 2 4. 8 0. 1 31 .2 3. 7 0. 1 0. 1 0. 2 0. 1 0. 0 50 .1 0. 5 50 .6 70 1 R ur al in te rio r 74 .7 4. 4 0. 0 0. 7 5. 0 0. 0 12 .5 2. 3 0. 0 0. 0 0. 0 0. 3 0. 0 25 .0 0. 3 25 .3 27 5 To ta l R ur al 56 .5 7. 7 0. 2 1. 1 4. 8 0. 1 25 .9 3. 3 0. 1 0. 1 0. 2 0. 2 0. 0 43 .0 0. 5 43 .5 97 6 A ge 15 -1 9 57 .9 0. 4 0. 0 0. 0 2. 8 0. 0 29 .2 9. 4 0. 4 0. 0 0. 0 0. 0 0. 0 42 .1 0. 0 42 .1 12 8 20 -2 4 59 .4 0. 4 0. 4 0. 3 3. 7 0. 0 29 .0 6. 2 0. 0 0. 4 0. 1 0. 0 0. 0 40 .1 0. 6 40 .6 38 6 25 -2 9 56 .3 0. 9 0. 1 1. 2 4. 2 0. 3 32 .4 4. 2 0. 0 0. 3 0. 0 0. 0 0. 0 43 .4 0. 3 43 .7 58 5 30 -3 4 50 .1 6. 7 0. 0 2. 4 5. 4 0. 4 29 .9 4. 6 0. 0 0. 4 0. 1 0. 1 0. 0 49 .4 0. 5 49 .9 56 6 35 -3 9 44 .2 14 .1 0. 0 3. 0 5. 8 0. 0 26 .4 6. 4 0. 0 0. 1 0. 0 0. 1 0. 0 55 .7 0. 2 55 .8 62 8 40 -4 4 50 .4 19 .9 0. 1 2. 4 3. 9 0. 3 18 .6 4. 4 0. 0 0. 0 0. 0 0. 1 0. 0 49 .5 0. 1 49 .6 60 8 45 -4 9 56 .0 24 .4 0. 1 2. 3 3. 3 0. 0 10 .9 1. 6 0. 0 0. 7 0. 4 0. 1 0. 3 42 .5 1. 2 43 .7 50 6 Ed uc at io n* N on e 80 .8 4. 1 0. 0 1. 2 2. 2 0. 0 11 .5 0. 0 0. 0 0. 0 0. 0 0. 2 0. 0 18 .9 0. 2 19 .2 17 4 P rim ar y 57 .6 14 .4 0. 1 1. 1 4. 7 0. 2 19 .4 2. 3 0. 0 0. 1 0. 1 0. 1 0. 0 42 .2 0. 2 42 .4 85 9 S ec on da ry + 47 .9 10 .4 0. 1 2. 4 4. 5 0. 2 27 .8 5. 9 0. 0 0. 4 0. 1 0. 0 0. 1 51 .5 0. 5 52 .0 2, 29 4 O th er /N on -s ta nd ar d (5 7. 2) (7 .2 ) (0 .0 ) (0 .0 ) (3 .6 ) (0 .0 ) (2 3. 7) (8 .3 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (0 .0 ) (4 2. 8) (0 .0 ) (4 2. 8) 60     Re pr od uc tiv e H ea lth 98   Su rin am e M IC S4   Ta bl e R H .1 : U se o f c on tr ac ep tio n (c on tin ue d) P er ce nt ag e of w om en a ge 1 5- 49 y ea rs c ur re nt ly m ar rie d or in u ni on w ho a re u si ng (o r w ho se p ar tn er is u si ng ) a c on tra ce pt iv e m et ho d, S ur in am e, 2 01 0 N ot us in g an y m et ho d Pe rc en t o f w om en (c ur re nt ly m ar rie d or in u ni on ) w ho a re u si ng : N um be r of w om en cu rr en tly m ar rie d or in un io n Fe m al e st er ili - za tio n M al e st er ili - za tio n IU D In je ct ab le s Im pl an ts P ill M al e co nd om Fe m al e co nd om P er io di c ab st in en ce W ith dr aw al O th er M is si ng A ny m od er n m et ho d A ny tra di - tio na l m et ho d A ny m et ho d1 W ea lth in de x qu in til e P oo re st 67 .9 6. 8 0. 0 0. 4 4. 7 0. 0 16 .6 3. 0 0. 1 0. 1 0. 1 0. 3 0. 0 31 .6 0. 5 32 .1 52 9 S ec on d 52 .2 11 .0 0. 1 0. 9 5. 0 0. 5 26 .5 3. 7 0. 0 0. 0 0. 2 0. 0 0. 0 47 .7 0. 2 47 .8 68 5 M id dl e 51 .6 10 .7 0. 3 1. 8 5. 5 0. 0 26 .5 3. 4 0. 0 0. 0 0. 0 0. 0 0. 2 48 .2 0. 0 48 .2 71 2 Fo ur th 49 .9 10 .7 0. 1 2. 8 3. 5 0. 0 27 .2 4. 9 0. 0 0. 7 0. 2 0. 0 0. 0 49 .3 0. 9 50 .1 75 9 R ic he st 44 .5 15 .1 0. 0 3. 4 3. 5 0. 3 24 .5 8. 2 0. 0 0. 5 0. 0 0. 0 0. 0 55 .0 0. 5 55 .5 72 0 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 55 .6 7. 6 0. 0 1. 6 8. 3 0. 0 23 .0 3. 4 0. 0 0. 0 0. 0 0. 6 0. 0 43 .8 0. 6 44 .4 15 9 M ar oo n 72 .3 4. 5 0. 0 0. 9 3. 3 0. 0 15 .4 3. 2 0. 0 0. 1 0. 1 0. 2 0. 0 27 .3 0. 3 27 .7 57 0 C re ol e 56 .9 8. 5 0. 0 2. 9 3. 8 0. 0 20 .0 7. 4 0. 1 0. 4 0. 0 0. 0 0. 0 42 .7 0. 4 43 .1 43 4 H in du st an i 47 .6 16 .6 0. 0 2. 8 3. 5 0. 0 26 .2 2. 6 0. 0 0. 4 0. 1 0. 0 0. 1 51 .7 0. 5 52 .2 1, 21 6 Ja va ne se 40 .7 10 .7 0. 4 0. 4 6. 3 0. 8 33 .5 6. 9 0. 0 0. 1 0. 3 0. 0 0. 0 58 .9 0. 4 59 .3 60 1 M ix ed 43 .3 9. 5 0. 0 2. 0 5. 3 0. 0 30 .7 8. 6 0. 0 0. 5 0. 0 0. 0 0. 0 56 .2 0. 5 56 .7 33 6 O th er s 73 .9 6. 9 0. 6 3. 8 3. 8 0. 0 7. 4 3. 8 0. 0 0. 0 0. 0 0. 0 0. 0 26 .1 0. 0 26 .1 88 To ta l 52 .3 11 .1 0. 1 2. 0 4. 4 0. 2 24 .7 4. 7 0. 0 0. 3 0. 1 0. 1 0. 0 47 .2 0. 4 47 .6 3, 40 6 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s 1 M IC S in di ca to r 5 .3 ; M D G in di ca to r 5 .3   Reproductive Health      Suriname MICS4 99   Unmet Need Unmet need for contraception refers to fecund women who are not using any method of contraception,  but who wish to postpone the next birth (spacing) or who wish to stop childbearing altogether (limiting).  Unmet need  is  identified  in MICS by using a set of questions eliciting current behaviours and preferences  pertaining to contraceptive use, fecundity, and fertility preferences.   Table RH.2 (page 101) shows the results of the survey on contraception, unmet need, and the demand for  contraception satisfied.   Unmet need for spacing is defined as percentage of women who are not using a method of contraception  AND are not pregnant and not postpartum amenorrheic22 and are fecund23 and say they want to wait two  or more years for their next birth OR:   are not pregnant and not postpartum amenorrheic and are fecund and unsure whether they want  another child OR   are pregnant and say that pregnancy was mistimed: would have wanted to wait OR   are postpartum amenorrheic and say that the birth was mistimed: would have wanted to wait    Unmet need for limiting is defined as percentage of women who are not using a method of contraception  AND:   are not pregnant and not postpartum amenorrheic and are fecund and say they do not want any  more children OR   are pregnant and say they didn't want to have a child OR   are postpartum amenorrheic and say that they didn't want the birth    Total unmet need  for  contraception  is  simply  the  sum of unmet need  for  spacing  and unmet need  for  limiting.   In Suriname, Table RH.2 shows that unmet need for spacing is 8 percent and unmet need for limiting  is 9  percent  implying  that  total  unmet  need  for  contraception  is  17  percent.  Total  unmet  need  for  contraception is highest in the rural interior amounting to 34 percent. In Brokopondo and Sipaliwini, total  unmet need for contraception  is 33 percent and 34 percent respectively. Table RH.5 produce results that  are indicative of declining total unmet need as women’s wealth status and education levels increase.  Met need for limiting includes women who use a contraceptive method and who want no more children,  those  who  use  male  or  female  sterilization  or  declare  themselves  as  infecund.  Met  need  for  spacing                                                               22 A women is postpartum amenorrheic if she had a birth in last two years and is not currently pregnant, and her  menstrual period has not returned since the birth of the last child  23 A women is considered in fecund if she is neither pregnant nor postpartum amenorrheic, and  (1a) has not had menstruation for at least six months, or (1b) never menstruated, or (1c) her last menstruation  occurred before her last birth, or (1d) in menopause/has had hysterectomy OR  (2) She declares that she has had hysterectomy, or that she has never menstruated or that she is menopausal, or that  she has been trying to get pregnant for 2 or more years without result in response to questions on why she thinks she  is not physically able to get pregnant at the time of survey OR  (3) She declares she cannot get pregnant when asked about desire for future birth OR  (4) She has not had a birth in the preceding 5 years, is currently not using contraception and is currently married and  was continuously married during the last 5 years preceding the survey  Reproductive Health 100  Suriname MICS4  includes women who are using a contraceptive method and who want to have another child or undecided  whether to have another child. The total of met need for spacing and limiting add up to the total met need  for contraception. Table RH.2 shows that met need for spacing is 15 percent and met need for limiting is 33  percent implying that total met need for contraception is 48 percent. Total met need for contraception is  highest  in  rural  coastal  areas  amounting  to  51  percent,  while  urban  areas  amount  to  49  percent.  In  Brokopondo and Sipaliwini, total met need for contraception is 26 percent in both districts, exactly half of  the  highest  met  need  recorded,  in  Commewijne  at  62  percent.  Table  RH.2  produces  results  that  are  indicative of increasing total met need as women’s wealth status and education levels increase.  Using  information  on  contraception  and  unmet  need,  the  percentage  of  demand  for  contraception  satisfied is also estimated from the MICS data. Percentage of demand satisfied is defined as the proportion  of women  currently married  or  in  a marital  union who  are  currently  using  contraception,  of  the  total  demand  for  contraception. The  total demand  for  contraception  includes women who  currently have an  unmet need (for spacing or limiting), plus those who are currently using contraception. Table RH.2 shows  the percentage of demand for contraception satisfied as amounting to 74 percent in Suriname. It is higher  in urban areas (77%) than in rural areas (67%) being notably low in the rural interior (43%). Specifically, it is  worth noting that Sipaliwini (43%), Brokopondo (43%) and Marowijne (60%) have the lowest percentage of  demand  for  contraception  satisfied.  The demand  for  contraception  varies positively with women’s  age,  education,  and  wealth  status.  Women  15‐19  years  have  the  lowest  level  of  satisfied  demand  that  is  estimated  to  be  53  percent, whereas  for women  45‐49  years  the  level  of  satisfaction  increased  to  85  percent.  In  terms of education,  the  satisfaction  level among women with no education  is 33 percent as  opposed to 80 percent among women who at  least attained secondary school. Satisfaction with demand  for contraception is 51 percent among the women of the poorest households and 84 percent among those  of  the  richest,  varying  in  a manner  that  is  consistent with  the  observed  positive  relationship  between  wealth status and unmet need, though there  is a considerable gap between the poorest and the second  wealth quintile.      Reproductive Health      Suriname MICS4 101 Table RH.2: Unmet need for contraception Percentage of women age 15-49 years currently married or in union with an unmet need for family planning and percentage of demand for contraception satisfied, Suriname, 2010 Met need for 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 contraception For spacing For limiting Total For spacing For limiting Total1 District Paramaribo 16.7 31.1 47.8 7.1 8.0 15.2 1,484 75.9 935 Wanica 15.0 36.6 51.6 6.1 10.2 16.4 735 75.9 500 Nickerie 11.8 38.7 50.5 3.8 6.9 10.6 326 82.6 199 Coronie (17.1) (28.6) (45.7) (5.7) (5.7) (11.4) 18 (*) 11 Saramacca 13.7 40.0 53.7 7.7 8.1 15.8 151 77.3 105 Commewijne 16.0 45.8 61.5 5.6 8.0 13.6 203 81.9 153 Marowijne 17.8 21.5 39.3 13.1 13.6 26.6 105 59.6 69 Para 15.2 27.2 42.4 5.8 13.1 18.8 109 69.2 67 Brokopondo 14.9 10.7 25.6 20.8 12.5 33.3 67 43.4 39 Sipaliwini 10.5 15.0 25.5 20.3 13.6 33.9 208 43.0 124 Area Urban 15.6 33.8 49.4 6.6 8.4 15.0 2,430 76.7 1,565 Rural Coastal 15.5 35.2 50.6 6.6 10.0 16.7 701 75.2 472 Rural interior 11.6 14.0 25.6 20.4 13.4 33.8 275 43.1 163 Total Rural 14.4 29.2 43.6 10.5 11.0 21.5 976 67.0 635 Age 15-19 40.5 1.7 42.1 33.3 3.7 37.0 128 53.2 101 20-24 31.9 8.7 40.6 20.3 5.7 26.0 386 61.0 257 25-29 29.7 14.0 43.7 11.1 9.4 20.5 585 68.1 376 30-34 17.7 32.3 50.0 6.3 8.7 14.9 566 77.0 367 35-39 8.8 47.3 56.1 5.3 11.7 17.0 628 76.8 459 40-44 1.5 48.0 49.6 1.0 11.6 12.6 608 79.7 378 45-49 1.3 42.8 44.0 0.6 7.2 7.8 506 85.0 262 Education* None 5.8 13.6 19.4 20.7 17.9 38.6 174 33.4 101 Primary 8.5 34.0 42.4 8.5 13.3 21.8 859 66.0 552 Secondary + 18.4 33.6 52.1 6.3 7.0 13.3 2,294 79.7 1,499 Other/Non-standard (22.8) (22.8) (45.6) (10.0) (5.5) (15.5) 60 (74.6) 37 Wealth index quintile Poorest 11.3 21.0 32.3 17.6 13.4 31.0 529 51.0 335 Second 14.5 33.3 47.8 7.8 12.7 20.5 685 70.0 469 Middle 18.1 30.6 48.6 5.8 8.7 14.5 712 77.0 449 Fourth 16.4 33.7 50.1 5.4 6.3 11.7 759 81.1 469 Richest 14.8 40.7 55.5 4.8 6.0 10.9 720 83.6 478 Ethnicity of household head* Indigenous/Amerindian 20.4 24.1 44.4 10.7 11.6 22.4 159 66.5 106 Maroon 13.1 14.7 27.8 17.9 13.6 31.6 570 46.8 338 Creole 17.1 26.3 43.5 9.2 12.4 21.6 434 66.8 283 Hindustani 11.4 41.0 52.4 4.6 8.0 12.6 1,216 80.7 790 Javanese 18.6 40.7 59.3 3.5 5.7 9.3 601 86.5 412 Mixed 24.6 32.1 56.7 6.2 4.9 11.1 336 83.6 228 Others 6.8 19.3 26.1 6.8 14.8 21.7 88 (54.6) 42 Total 15.3 32.5 47.7 7.7 9.1 16.9 3,406 73.9 2,200 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 5.4; MDG indicator 5.6 Reproductive Health 102  Suriname MICS4  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. The prevention and treatment of malaria among pregnant  women, 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 (e.g.,  malaria and STIs) 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  guidelines  are  specific  on  the  content  on  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)    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 (table 103), the vast majority of women obtained antenatal care  from  a  doctor,  a  nurse/midwife,  or  a  community  health  worker,  the  respective  proportions  being  71  percent,  19  percent  and  4 percent. A  small proportion of women  amounting  to  3 percent  received no  antenatal  care whatsoever.  The  antenatal  care  received  from  any  skilled  personnel  is  91  percent.  It  is  worth  noting  that  the  pattern  of  variation  reflecting  personnel  providing  antenatal  care  remains  unchanged for women irrespective of their characteristics predicated upon district, area, education, wealth  status,  and  age  at  birth. However,  in  Sipaliwini  and Brokopondo  in  the  rural  interior,  relatively  smaller  proportions obtained care  from doctors and relatively  larger proportions obtained care  from community  health workers than are observed to be the case  in any of the other districts. Such an observation  is also  evident among the poorest women and those with no education who make up relatively  larger shares of  eligible women in Sipaliwini and Brokopondo.  Table RH.4 (page104) shows number of antenatal care visits during the last pregnancy during the two years  preceding the survey, regardless of provider by selected characteristics. 67 percent received antenatal care  at least four times. Mothers from the poorest households and those with primary education are less likely  than more advantaged mothers to receive antenatal care four or more times. For example, 59 percent of  the women living in poorest households reported four or more antenatal care visits compared with more  than 70 percent among those living in the richest households. 52 percent of the women with no education  received ANC at least 4 times as opposed to more than 70 percent among women with secondary or higher  levels of education.  Reproductive Health      Suriname MICS4 103 Table RH.3: Antenatal care coverage Percent distribution of women age 15-49 who gave birth in the two years preceding the survey by type of personnel providing antenatal care during the pregnancy for the last birth, Suriname, 2010 Person providing antenatal care No antenatal care received Total Any skilled personnel1 Number of women who gave birth in the preceding two years Medical doctor Nurse/ Midwife Auxiliary midwife Traditional birth attendant Community health worker Other/ Missing District Paramaribo 81.5 10.4 0.8 0.4 0.0 3.1 3.8 100.0 92.7 430 Wanica 74.6 21.9 0.0 0.9 0.9 0.0 1.8 100.0 96.5 191 Nickerie 52.6 45.7 0.0 0.0 0.0 0.0 1.7 100.0 98.3 61 Coronie (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 4 Saramacca 75.4 14.0 3.5 0.0 0.0 3.5 3.5 100.0 93.0 30 Commewijne (92.6) (4.9) (0.0) (0.0) (0.0) (0.0) (2.5) 100.0 (97.5) 44 Marowijne 61.4 32.6 0.0 0.0 0.0 1.5 4.5 100.0 93.9 65 Para 81.8 13.6 0.0 0.0 1.5 0.0 3.0 100.0 95.5 38 Brokopondo 42.1 23.3 0.8 0.0 30.1 0.8 3.0 100.0 66.2 53 Sipaliwini 47.8 30.6 0.6 0.3 16.4 1.4 3.1 100.0 78.9 146 Area Urban 79.2 14.6 0.5 0.5 0.3 2.0 3.0 100.0 94.3 668 Rural Coastal 68.7 25.6 0.5 0.0 0.3 1.1 3.8 100.0 94.9 193 Rural interior 46.3 28.6 0.6 0.2 20.0 1.2 3.0 100.0 75.5 199 Total Rural 57.3 27.2 0.6 0.1 10.3 1.1 3.4 100.0 85.0 392 Mother's age at birth Less than 20 64.8 27.1 1.3 1.0 2.8 0.3 2.8 100.0 93.2 160 20-34 72.3 17.9 0.4 0.3 4.2 2.0 3.0 100.0 90.6 710 35-49 72.4 17.6 0.3 0.0 4.0 1.8 3.8 100.0 90.3 160 Missing (68.6) (17.9) (1.3) (0.0) (5.3) (1.3) (5.5) 100.0 (87.9) 30 Education* None 57.9 20.2 0.6 0.3 14.9 2.6 3.4 100.0 78.7 125 Primary 64.1 24.5 0.3 0.5 6.2 0.9 3.4 100.0 88.9 305 Secondary + 76.7 17.1 0.6 0.3 0.6 1.6 3.0 100.0 94.5 609 Other/Non-standard (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 16 Wealth index quintiles Poorest 57.9 23.2 1.0 0.6 11.9 2.1 3.3 100.0 82.1 341 Second 73.3 20.4 0.2 0.8 0.8 1.0 3.4 100.0 94.0 212 Middle 74.5 19.7 0.8 0.0 0.0 1.7 3.3 100.0 95.1 200 Fourth 83.3 13.7 0.0 0.0 0.0 0.0 3.0 100.0 97.0 167 Richest 80.2 13.9 0.0 0.0 0.0 3.5 2.3 100.0 94.1 141 Ethnicity of household head Indigenous/Amerindian 65.8 22.5 0.0 3.3 4.4 0.0 4.0 100.0 88.3 50 Maroon 61.8 22.7 0.3 0.1 9.3 2.3 3.4 100.0 84.8 429 Creole 81.6 15.9 0.0 0.0 0.0 2.5 0.0 100.0 97.5 131 Hindustani 75.6 20.1 1.8 0.0 0.0 0.5 2.0 100.0 97.5 216 Javanese 73.4 19.7 0.5 0.0 0.0 1.5 5.0 100.0 93.5 111 Mixed 83.0 9.0 0.0 0.0 0.0 1.6 6.4 100.0 92.0 104 Others (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 20 Total 71.1 19.3 0.5 0.4 4.0 1.7 3.1 100.0 94.9 1,060 * ‘Missing/DK’ category of education not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 5.5a; MDG indicator 5.5     Reproductive Health 104  Suriname MICS4    Table RH.4: Number of antenatal care visits Percent distribution of women who had a live birth during the two years preceding the survey by number of antenatal care visits by any provider, Suriname, 2010 Percent distribution of women who had: Number of women who had a live birth in the preceding two years No antenatal care visits One visit Two visits Three visits 4 or more visits1 Missing/DK Total District Paramaribo 4.6 0.8 1.9 4.2 64.2 24.2 100.0 430 Wanica 1.8 0.9 0.9 6.1 74.6 15.8 100.0 191 Nickerie 1.7 0.9 1.7 5.3 78.1 12.3 100.0 61 Coronie (*) (*) (*) (*) (*) (*) 100.0 4 Saramacca 3.5 1.8 0.0 3.5 77.2 14.0 100.0 30 Commewijne (2.5) (0.0) (0.0) (2.5) (76.2) (18.8) 100.0 44 Marowijne 4.5 2.3 0.8 1.5 62.1 28.8 100.0 65 Para 3.0 0.0 1.5 3.0 77.3 15.2 100.0 38 Brokopondo 3.0 1.5 1.5 2.3 58.6 33.1 100.0 53 Sipaliwini 3.1 2.8 1.7 1.4 57.5 33.6 100.0 146 Area Urban 3.5 0.7 1.5 4.7 68.0 21.6 100.0 668 Rural Coastal 3.8 1.3 1.4 3.0 71.9 18.6 100.0 193 Rural interior 3.0 2.4 1.6 1.6 57.8 33.5 100.0 199 Total Rural 3.4 1.9 1.5 2.3 64.7 26.2 100.0 392 Mother's age at birth Less than 20 2.8 1.1 2.6 7.8 68.1 17.5 100.0 160 20-34 3.4 0.7 1.4 3.2 66.7 24.6 100.0 710 35-49 3.8 3.4 0.3 3.4 65.2 23.8 100.0 160 Missing (5.5) (0.0) (5.5) (0.0) (69.2) (19.8) 100.0 30 Education* None 3.4 2.3 1.3 4.9 52.3 35.7 100.0 125 Primary 3.4 1.4 2.5 4.5 63.8 24.3 100.0 305 Secondary + 3.6 0.5 1.1 3.4 70.8 20.7 100.0 609 Other/Non-standard (*) (*) (*) (*) (*) (*) 100.0 16 Wealth index quintiles Poorest 3.3 1.8 2.2 3.8 59.4 29.5 100.0 341 Second 4.2 1.5 1.0 5.2 69.7 18.4 100.0 212 Middle 3.3 0.8 1.1 3.8 68.9 22.1 100.0 200 Fourth 4.0 1.0 1.3 4.0 72.8 16.9 100.0 167 Richest 2.3 0.0 1.2 1.6 70.3 24.7 100.0 141 Ethnicity of household head Indigenous/Amerindian 4.0 5.1 2.1 0.0 73.6 15.2 100.0 50 Maroon 3.4 1.7 1.9 3.4 58.7 30.9 100.0 429 Creole 0.0 0.0 2.9 4.6 69.0 23.5 100.0 131 Hindustani 2.8 0.8 1.3 5.3 80.7 9.1 100.0 216 Javanese 5.0 0.0 0.0 3.0 70.6 21.4 100.0 111 Mixed 8.0 0.5 0.0 1.6 66.5 23.4 100.0 104 Others (*) (*) (*) (*) (*) (*) 100.0 20 Total 3.4 1.2 1.5 3.8 66.8 23.3 100.0 1,060 * ‘Missing/DK’ category of education not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 5.5b; MDG indicator 5.5   Reproductive Health      Suriname MICS4 105 The types of services pregnant women received are shown in Table RH.5 (page 105). Among those women  who have given birth  to a  child during  the  two years preceding  the  survey, 94 percent  reported  that a  blood  sample was  taken during antenatal care visits, 97 percent  reported  that  their blood pressure was  checked, 95 percent  that urine  specimen was  taken, and  in 92 percent of  cases all  three  services were  received. No significant differences can be observed across the background characteristics.  Table RH.5: Content of antenatal care Percentage of women age 15-49 years who had their blood pressure measured, urine sample taken, and blood sample taken as part of antenatal care, Suriname, 2010 Percentage of pregnant women who had: Number of women who had a live birth in the preceding two years Blood pressure measured Urine sample taken Blood sample taken Blood pressure measured, urine and blood sample taken1 District Paramaribo 96.2 91.5 92.3 88.8 430 Wanica 98.2 97.4 96.5 95.6 191 Nickerie 98.3 97.4 94.8 94.8 61 Coronie (*) (*) (*) (*) 4 Saramacca 96.5 96.5 93.0 93.0 30 Commewijne (96.3) (97.5) (96.3) (95.1) 44 Marowijne 94.7 93.2 93.2 90.2 65 Para 97.0 95.5 93.9 93.9 38 Brokopondo 96.2 95.5 95.5 93.2 53 Sipaliwini 96.7 96.9 96.1 95.8 146 Area Urban 97.0 93.8 94.0 91.6 668 Rural Coastal 95.7 94.9 93.0 91.7 193 Rural interior 96.6 96.6 95.9 95.1 199 Total Rural 96.1 95.7 94.5 93.4 392 Mother's age at birth Less than 20 96.7 90.4 94.0 87.7 160 20-34 97.0 95.8 94.6 93.7 710 35-49 95.9 92.8 93.9 91.2 160 Missing (94.5) (94.5) (87.3) (87.3) 30 Education* None 96.6 95.2 95.9 94.6 125 Primary 96.2 95.9 93.6 93.1 305 Secondary + 96.9 93.5 93.9 91.1 609 Other/Non-standard (*) (*) (*) (*) 16 Wealth index quintiles Poorest 96.2 95.0 95.5 93.7 341 Second 96.6 94.6 93.3 91.3 212 Middle 96.7 94.0 92.3 90.6 200 Fourth 97.0 93.4 93.1 90.8 167 Richest 97.7 95.3 96.5 94.2 141 Ethnicity of household head Indigenous/Amerindian 95.1 92.7 91.9 87.6 50 Maroon 96.4 94.9 94.8 93.3 429 Creole 99.6 96.2 97.5 93.3 131 Hindustani 98.0 94.6 94.9 92.6 216 Javanese 95.0 93.1 88.7 88.7 111 Mixed 93.6 93.6 92.0 92.0 104 Others (*) (*) (*) (*) 20 Total 96.7 94.5 94.2 92.3 1,060 * ‘Missing/DK’ category of education not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 5.6 Reproductive Health 106  Suriname MICS4  Assistance at Delivery 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, or  in  the  case of  Suriname, community health care workers. About 93 percent of women 15‐49 years who gave birth in the  two years preceding the survey were assisted by skilled personnel (Table RH.6, page 107). This percentage  is lowest in the rural interior at 77. The more educated a woman is, the more likely she is to have delivered  with the assistance of a skilled attendant.  With  respect  to women  giving birth  in  the  two  years prior  to  the MICS  survey,  as much  as 54 percent  claimed  to have had  such deliveries with  assistance  from  a nurse/midwife while 36 percent  claimed  to  have  had  such  assistance  from  doctors.  Of  the  remaining  groups  of  personnel  who  assisted  with  the  delivery of births, community health workers delivered births for the majority of women (3%). It  is worth  noting  that  the  pattern  of  variation  reflecting  personnel  providing  assistance  with  delivery  remains  unchanged for women irrespective of their characteristics predicated upon district, area, education, wealth  status,  and  age  at  birth.  However,  in  Sipaliwini  and  Brokopondo  in  the  rural  interior,  relatively  small  proportions of women  claimed  to have had births  that were delivered by a doctor and  relatively  larger  proportions claimed to have had births that were delivered by community health workers when compared  to  corresponding  estimates  in  any  of  the  other  districts.  This  observation  is  similar  for women  of  the  poorest households and for those with no education.  Table RH.6 also presents the percent of children delivered by C‐section totals at 19 percent for Suriname.  This hides a relative wide range of prevalence within the background characteristics, notable that an urban  birth is twice as likely as a rural interior birth to be delivered by C‐section, that C‐sections increase with age  of the mother, that births  in private sector  facilities are more  likely to deliver with C‐section than public  facilities,  and  that  c‐section  prevalence  increases  with  education  of  the  mother  and  wealth  of  the  household.     Re pr od uc tiv e H ea lth           Su rin am e M IC S4 10 7 Ta bl e R H .6 : A ss is ta nc e du rin g de liv er y P er ce nt d is tri bu tio n of w om en a ge 1 5- 49 w ho h ad a li ve b irt h in th e tw o ye ar s pr ec ed in g th e su rv ey b y pe rs on a ss is tin g at d el iv er y an d pe rc en ta ge o f b irt hs d el iv er ed b y C -s ec tio n, S ur in am e, 2 01 0 Pe rs on a ss is tin g at d el iv er y N o at te nd an t To ta l D el iv er y as si st ed by a ny sk ill ed at te nd an t1 P er ce nt de liv er ed by C - se ct io n2 N um be r of w om en w ho h ad a liv e bi rth i n pr ec ed in g tw o ye ar s M ed ic al do ct or N ur se / M id w ife A ux ili ar y m id w ife M id w ife /D oc to r in tr ai ni ng Tr ad iti on al bi rth at te nd an t C om m un ity he al th w or ke r R el at iv e/ Fr ie nd O th er D is tr ic t P ar am ar ib o 38 .8 54 .6 0. 8 1. 9 1. 2 0. 4 0. 4 1. 9 0. 0 10 0. 0 96 .2 23 .8 43 0 W an ic a 33 .3 60 .5 1. 8 1. 8 0. 0 0. 9 0. 0 1. 8 0. 0 10 0. 0 97 .4 16 .7 19 1 N ic ke rie 36 .9 60 .5 0. 9 0. 9 0. 0 0. 0 0. 0 0. 9 0. 0 10 0. 0 99 .1 15 .8 61 C or on ie (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) 4 S ar am ac ca 31 .6 59 .6 5. 3 0. 0 0. 0 0. 0 3. 5 0. 0 0. 0 10 0. 0 96 .5 12 .3 30 C om m ew ijn e (3 7. 5) (4 8. 7) (3 .8 ) (3 .8 ) (0 .0 ) (0 .0 ) (1 .2 ) (5 .0 ) (0 .0 ) 10 0. 0 (9 3. 8) (3 3. 7) 44 M ar ow ijn e 35 .6 57 .6 0. 8 0. 8 0. 0 0. 0 4. 5 0. 8 0. 0 10 0. 0 94 .7 13 .6 65 P ar a 39 .4 51 .5 1. 5 0. 0 0. 0 1. 5 3. 0 3. 0 0. 0 10 0. 0 92 .4 18 .2 38 B ro ko po nd o 22 .6 50 .4 2. 3 0. 8 3. 0 15 .0 2. 3 3. 8 0. 0 10 0. 0 75 .9 14 .3 53 S ip al iw in i 37 .2 39 .7 0. 0 0. 6 5. 0 14 .4 1. 4 1. 4 0. 3 10 0. 0 77 .5 9. 7 14 6 A re a U rb an 37 .2 56 .1 1. 2 2. 0 0. 7 0. 5 0. 2 2. 0 0. 0 10 0. 0 96 .5 22 .1 66 8 R ur al C oa st al 36 .7 56 .5 1. 6 0. 5 0. 0 0. 3 2. 9 1. 4 0. 0 10 0. 0 95 .4 16 .7 19 3 R ur al in te rio r 33 .3 42 .6 0. 6 0. 6 4. 5 14 .6 1. 6 2. 0 0. 2 10 0. 0 77 .1 10 .9 19 9 To ta l R ur al 35 .0 49 .4 1. 1 0. 6 2. 3 7. 6 2. 3 1. 7 0. 1 10 0. 0 86 .1 13 .8 39 2 M ot he r's a ge a t b irt h Le ss th an 2 0 29 .5 61 .7 1. 0 0. 3 2. 8 3. 0 0. 6 1. 0 0. 0 10 0. 0 92 .6 9. 5 16 0 20 -3 4 36 .3 53 .4 1. 3 1. 4 1. 3 3. 2 1. 1 2. 0 0. 0 10 0. 0 92 .4 18 .8 71 0 35 -4 9 45 .8 46 .0 1. 0 1. 3 0. 3 3. 0 1. 0 1. 4 0. 3 10 0. 0 94 .1 30 .0 16 0 M is si ng (2 3. 8) (5 6. 7) (0 .0 ) (1 1. 0) (0 .0 ) (1 .3 ) (0 .0 ) (7 .2 ) (0 .0 ) 10 0. 0 (9 1. 4) (1 6. 4) 30 Pl ac e of d el iv er y P ub lic s ec to r h ea lth fa ci lit y 36 .0 55 .9 1. 4 1. 6 0. 1 4. 2 0. 2 0. 6 0. 0 10 0. 0 94 .8 17 .7 75 8 P riv at e se ct or h ea lth fa ci lit y 45 .1 51 .6 0. 5 0. 9 0. 0 0. 2 0. 8 0. 9 0. 0 10 0. 0 98 .1 30 .1 22 0 H om e 5. 3 48 .7 2. 2 3. 2 24 .7 1. 0 11 .0 2. 9 1. 0 10 0. 0 59 .4 0. 0 41 O th er (2 8. 9) (4 0. 8) (0 .0 ) (0 .0 ) (1 0. 8) (1 .5 ) (9 .5 ) (8 .4 ) (0 .0 ) 10 0. 0 (6 9. 8) (0 .0 ) 26     Re pr od uc tiv e H ea lth 10 8  Su rin am e M IC S4   Ta bl e R H .6 : A ss is ta nc e du rin g de liv er y (c on tin ue d) P er ce nt d is tri bu tio n of w om en a ge 1 5- 49 w ho h ad a li ve b irt h in th e tw o ye ar s pr ec ed in g th e su rv ey b y pe rs on a ss is tin g at d el iv er y an d pe rc en ta ge o f b irt hs d el iv er ed b y C -s ec tio n, S ur in am e, 2 01 0 M ed ic al do ct or N ur se / M id w ife A ux ili ar y m id w ife M id w ife /D oc to r in tr ai ni ng Tr ad iti on al bi rth at te nd an t C om m un ity he al th w or ke r R el at iv e/ Fr ie nd O th er Ed uc at io n* N on e 36 .8 43 .2 0. 3 0. 3 5. 5 10 .1 1. 3 2. 1 0. 3 10 0. 0 80 .7 11 .4 12 5 P rim ar y 30 .1 58 .0 2. 3 1. 7 0. 4 5. 0 1. 5 1. 0 0. 0 10 0. 0 92 .0 16 .3 30 5 S ec on da ry + 38 .9 54 .2 0. 9 1. 4 0. 9 0. 7 0. 6 2. 3 0. 0 10 0. 0 95 .4 21 .6 60 9 O th er /N on -s ta nd ar d (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) 16 W ea lth in de x qu in til es P oo re st 34 .2 48 .6 1. 0 0. 5 3. 6 8. 2 2. 1 1. 7 0. 1 10 0. 0 84 .3 12 .1 34 1 S ec on d 28 .6 60 .2 1. 8 3. 1 0. 8 0. 8 0. 5 4. 2 0. 0 10 0. 0 93 .8 17 .6 21 2 M id dl e 40 .0 56 .7 0. 3 1. 1 0. 0 0. 8 0. 3 0. 8 0. 0 10 0. 0 98 .1 18 .2 20 0 Fo ur th 43 .6 51 .1 2. 0 2. 0 0. 0 0. 0 0. 0 1. 3 0. 0 10 0. 0 98 .7 30 .6 16 7 R ic he st 39 .5 54 .6 1. 2 1. 2 0. 0 1. 2 1. 2 1. 2 0. 0 10 0. 0 96 .5 25 .1 14 1 Et hn ic ity o f h ou se ho ld h ea d In di ge no us /A m er in di an 38 .5 49 .3 2. 1 1. 0 0. 8 4. 4 3. 9 0. 0 0. 0 10 0. 0 90 .9 11 .6 50 M ar oo n 31 .7 54 .3 1. 1 1. 1 2. 4 6. 8 1. 0 1. 7 0. 1 10 0. 0 88 .1 13 .2 42 9 C re ol e 39 .9 53 .4 2. 5 1. 3 0. 0 0. 0 0. 4 2. 5 0. 0 10 0. 0 97 .1 31 .0 13 1 H in du st an i 40 .2 55 .8 0. 2 1. 5 0. 8 0. 0 0. 2 1. 3 0. 0 10 0. 0 97 .7 25 .7 21 6 Ja va ne se 29 .7 57 .8 2. 4 3. 0 0. 0 1. 5 2. 5 3. 0 0. 0 10 0. 0 93 .0 14 .3 11 1 M ix ed 42 .2 51 .4 0. 5 2. 1 0. 0 0. 0 0. 6 3. 2 0. 0 10 0. 0 96 .2 22 .8 10 4 O th er s (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 0. 0 (* ) (* ) 20 To ta l 36 .4 53 .6 1. 2 1. 5 1. 3 3. 1 1. 0 1. 9 0. 0 10 0. 0 92 .7 19 .0 1, 06 0 * ‘M is si ng /D K ’ c at eg or y of e du ca tio n no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 5 .7 ; M D G in di ca to r 5 .2 2 M IC S in di ca to r 5 .9     Reproductive Health      Suriname MICS4 109 Place of Delivery Increasing the proportion of births that are delivered in health facilities is an important factor in reducing  the health risks to both the mother and the baby. Proper medical attention and hygienic conditions during  delivery  can  reduce  the  risks  of  complications  and  infection  that  can  cause morbidity  and mortality  to  either the mother or the baby. Table RH.7 (page 110) presents the percent distribution of women age 15‐ 49 who had a  live birth  in the two years preceding the survey by place of delivery and the percentage of  births delivered in a health facility, according to background characteristics.   In Suriname, 92 percent of women 15‐49 with births in the two years preceding the survey delivered their  babies  in  a  health  facility;  72  percent  of women  delivered  in  public  sector  facilities  and  21  percent  in  private sector facilities. Only 4 percent of women delivered at home. Women  in urban areas (95%) were  somewhat more  likely  to deliver  in  a health  facility  than  their  rural  counterparts  (88%)  and  among  the  latter, women  in  the  rural coastal areas were more  likely  than  those  in  the  rural  interior  to deliver  in a  health facility.   It is worth noting that as wealth status increases, women were more likely to deliver their babies in private  sector  facilities  and  less  likely  to do  so  in public  sector  facilities.  In  fact,  in  the wealthiest  status  group  greater proportion of women delivered their babies in private facilities than in public facilities (52 percent  as opposed to 46 percent). In remaining wealth status groups, the majority of women delivered  in public  facilities.        Reproductive Health 110  Suriname MICS4  Table RH.7: Place of delivery Percent distribution of women age 15-49 who had a live birth in two years preceding the survey by place of delivery, Suriname, 2010 Place of delivery Total Delivered in health facility1 Number of women who had a live birth in preceding two years Public sector health facility Private sector health facility Home Other Missing/DK District Paramaribo 65.0 30.4 2.7 0.8 1.2 100.0 95.4 430 Wanica 78.1 15.8 2.6 1.8 1.8 100.0 93.9 191 Nickerie 85.0 5.3 8.8 0.0 0.9 100.0 90.3 61 Coronie (*) (*) (*) (*) (*) 100.0 (*) 4 Saramacca 68.4 24.6 1.8 5.3 0.0 100.0 93.0 30 Commewijne (69.9) (25.1) (0.0) (5.0) (0.0) 100.0 (95.0) 44 Marowijne 75.8 8.3 2.3 12.1 1.5 100.0 84.1 65 Para 80.3 13.6 3.0 1.5 1.5 100.0 93.9 38 Brokopondo 72.2 12.0 9.8 3.8 2.3 100.0 84.2 53 Sipaliwini 72.5 14.4 7.5 3.9 1.7 100.0 86.9 146 Area Urban 69.0 25.5 3.0 1.2 1.2 100.0 94.5 668 Rural Coastal 79.2 11.5 2.7 5.5 1.1 100.0 90.7 193 Rural interior 72.4 13.8 8.1 3.9 1.8 100.0 86.2 199 Total Rural 75.8 12.7 5.5 4.6 1.5 100.0 88.4 392 Mother's age at birth Less than 20 84.9 7.4 3.9 3.6 0.2 100.0 92.3 160 20-34 69.1 22.9 3.8 2.5 1.6 100.0 92.0 710 35-49 69.1 23.8 4.8 1.8 0.5 100.0 92.9 160 Missing (68.8) (25.8) (0.0) (0.0) (5.5) 100.0 (94.5) 30 Number of antenatal care visits None (46.6) (13.5) (11.6) (1.3) (27.0) 100.0 (60.1) 37 1-3 visits 73.4 14.6 8.4 3.6 0.0 100.0 88.0 69 4+ visits 74.9 20.6 2.8 1.4 0.3 100.0 95.5 708 Missing/DK 64.9 24.0 4.6 5.7 0.9 100.0 88.9 247 Education* None 71.2 14.9 7.4 5.3 1.2 100.0 86.1 125 Primary 79.2 10.9 6.2 2.5 1.1 100.0 90.1 305 Secondary + 67.6 26.9 2.1 1.9 1.5 100.0 94.5 609 Other/Non-standard (*) (*) (*) (*) (*) 100.0 (*) 16 Wealth index quintiles Poorest 75.0 9.9 8.3 5.3 1.5 100.0 84.9 341 Second 83.7 9.7 1.9 1.2 3.4 100.0 93.5 212 Middle 74.3 21.3 2.5 1.9 0.0 100.0 95.6 200 Fourth 67.1 29.6 2.0 1.3 0.0 100.0 96.7 167 Richest 46.0 52.4 0.4 0.0 1.2 100.0 98.4 141 Ethnicity of household head Indigenous/Amerindian 76.3 6.0 13.8 3.9 0.0 100.0 82.3 50 Maroon 77.7 11.7 4.9 3.7 2.0 100.0 89.4 429 Creole 66.4 30.7 1.3 1.7 0.0 100.0 97.1 131 Hindustani 74.1 22.4 3.0 0.2 0.2 100.0 96.5 216 Javanese 62.3 33.2 1.0 2.0 1.5 100.0 95.5 111 Mixed 58.9 32.5 3.7 1.6 3.2 100.0 91.4 104 Others (*) (*) (*) (*) (*) 100.0 (*) 20 Total 71.5 20.8 3.9 2.5 1.3 100.0 92.3 1,060 * ‘Missing/DK’ category of education not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 5.8 Child Development      Suriname MICS4 111   8. Child Development     Child Development 112  Suriname MICS4  Early Childhood Education and Learning Readiness of children for primary school can be improved through attendance to early childhood education  programmes  or  through  pre‐school  attendance.  Early  childhood  education  programmes  include  programmes  for  children  that have organised  learning  components as opposed  to baby‐sitting and day‐ care which do not typically have organised educational and learning.   Only  34  percent  of  children  aged  36‐59 months  are  attending  an  organised  early  childhood  education  programme (Table CD.1, page 113).  It  is  important to mention here that  in Suriname the official (formal)  pre‐school starts at the age of four (48 months). This may be seen in the age data, where the attendance  figure for three year olds is 25 percent and then substantially increases to 46 percent for the four year olds.  Urban‐rural  and  district  differentials  are  evident  –  the  figure  is  as  high  as  44  percent  in  urban  areas,  compared  to 20 percent  in  rural  areas. Within  rural  areas,  there  is not much difference between  rural  coastal areas and the rural  interior where respective proportions are 23 percent and 17 percent. Among  children  aged  36‐59 months,  attendance  to  early  childhood  education  is most  prevalent  in  Paramaribo  (49%)  and  Wanica  (37%)  and  lowest  in  Marowijne  (7%).  The  gender  differential  is  insignificant  but  differentials  by  socioeconomic  status  appear  to  be  noteworthy  and  indicative  of  a  positive  association  between  socio‐economic  status  and  attendance.  Sixty‐three percent of  children  living  in  the wealthiest  households attend pre‐school while the figure drops to 16 percent in poorest households.  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, engagement of adults in 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.  Children  should  be  physically  healthy, mentally alert, emotionally secure, socially competent and ready to learn.  Information  on  a  number  of  activities  that  support  early  learning  was  collected  in  the  survey.  These  included  the  involvement of adults with  children  in  the  following activities:  reading books or  looking at  picture books, telling stories, singing songs, taking children outside the home, compound or yard, playing  with children, and spending time with children naming, counting, or drawing things.   For approximately 73 percent of children 36‐59 months, an adult household member has been engaged in  four or more activities that promote learning and school readiness during the 3 days preceding the survey  (Table CD.2, page 114). The  average number of  activities  that  adult household members have engaged  with  children was 4.3. The  table also  indicates  that  the  father’s  involvement  in  such activities has been  somewhat limited. For a little more than a quarter (26%) of the children 36‐59 months, fathers have been  involved with one or more activities. A  relatively high proportion, 39 percent, of children 36‐59 months  have not been living with their natural fathers.      Child Development      Suriname MICS4 113 Table CD.1: Early childhood education Percentage of children age 36-59 months who are attending an organized early childhood education programme, Suriname, 2010 Percentage of children age 36-59 months currently attending early childhood education1 Number of children age 36-59 months Sex Male 33.0 596 Female 35.4 683 District Paramaribo 48.8 486 Wanica 36.8 238 Nickerie 17.5 64 Coronie (*) 7 Saramacca 35.1 37 Commewijne (33.8) 47 Marowijne 7.4 65 Para 34.7 51 Brokopondo 19.4 62 Sipaliwini 16.4 221 Area Urban 44.0 770 Rural Coastal 22.7 225 Rural interior 17.1 283 Total Rural 19.6 509 Age of child 36-47 months 24.6 694 48-59 months 45.8 584 Mother's education* None 9.8 187 Primary 23.8 395 Secondary + 47.1 670 Other/Non-standard (*) 23 Wealth index quintile Poorest 16.2 471 Second 35.2 250 Middle 34.7 208 Fourth 51.9 170 Richest 63.3 179 Ethnicity of household head* Indigenous/Amerindian 23.5 57 Maroon 22.4 547 Creole 50.7 178 Hindustani 37.1 242 Javanese 43.1 127 Mixed 50.8 112 Others (*) 13 Total 34.3 1,278 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 6.7     Child Development 114  Suriname MICS4    Table CD.2: Support for learning Percentage of children age 36-59 months with whom an adult household member engaged in activities that promote learning and school readiness during the last three days, Suriname, 2010 Percentage of children age 36-59 months Mean number of activities Percentage of children not living with their natural father Number of children age 36-59 months With whom adult household members engaged in four or more activities1 With whom the father engaged in one or more activities2 Any adult household member engaged with the child The father engaged with the child Sex Male 71.1 28.4 4.1 0.7 41.1 596 Female 74.5 23.8 4.4 0.7 37.3 683 District Paramaribo 80.2 29.8 4.6 0.9 38.8 486 Wanica 80.3 31.6 4.5 0.9 40.2 238 Nickerie 91.8 31.9 5.0 0.8 8.3 64 Coronie (*) (*) (*) (*) (*) 7 Saramacca 77.2 49.1 4.6 1.6 14.0 37 Commewijne (90.1) (35.2) (5.0) (1.0) (19.7) 47 Marowijne 72.2 23.1 4.3 0.4 35.2 65 Para 80.6 25.0 4.6 0.6 45.8 51 Brokopondo 47.6 9.7 3.0 0.1 48.4 62 Sipaliwini 44.7 9.7 3.1 0.2 53.0 221 Area Urban 80.9 29.6 4.6 0.9 38.5 770 Rural Coastal 80.3 33.9 4.6 0.9 24.8 225 Rural interior 45.3 9.7 3.0 0.2 52.0 283 Total Rural 60.8 20.4 3.7 0.5 40.0 509 Age of child 36-47 months 74.6 28.6 4.3 0.8 38.2 694 48-59 months 70.9 22.8 4.2 0.6 40.2 584 Mother's education* None 40.2 7.7 2.9 0.2 57.9 187 Primary 70.1 15.6 4.0 0.4 40.6 395 Secondary + 83.1 36.9 4.8 1.1 33.1 670 Other/Non-standard (*) (*) (*) (*) (*) 23 Father's education None 47.0 9.8 3.3 0.2 na 67 Primary 68.6 26.9 4.0 0.6 na 209 Secondary + 86.9 51.3 4.9 1.5 na 441 Other/Non-standard (*) (*) (*) (*) na 13 Father not in household 67.1 4.3 4.0 na na 500 Missing/DK 55.3 31.9 3.4 0.6 na 49 Wealth index quintiles Poorest 55.7 13.3 3.5 0.3 51.2 471 Second 74.4 27.1 4.3 0.7 34.5 250 Middle 82.0 25.0 4.6 0.6 34.2 208 Fourth 88.6 44.0 4.9 1.4 26.3 170 Richest 90.6 41.5 5.3 1.2 31.5 179 Ethnicity of household head* Indigenous/Amerindian 77.4 27.6 4.5 0.6 13.3 57 Maroon 56.6 8.0 3.5 0.2 56.5 547 Creole 83.4 27.8 4.8 0.8 46.9 178 Hindustani 86.5 48.9 4.9 1.3 10.0 242 Javanese 83.2 42.9 4.8 1.3 21.1 127 Mixed 91.0 36.8 5.1 1.1 40.1 112 Others (*) (*) (*) (*) (*) 13 Total 72.9 25.9 4.3 0.7 39.1 1,278 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 6.1 2 MICS Indicator 6.2 Child Development      Suriname MICS4 115 In urban areas when compared to rural areas, larger proportions of children have experienced adults who  have facilitated  learning and school readiness activities. As much as 81 percent of children  in urban area  compared  to 61 percent  in  rural  areas had  such  experiences.  It  is worth noting  that  there  is negligible  difference between urban and rural coastal areas where respective proportions amounting to 81 percent  and 80 percent of children have had such experiences. However, marked differences between urban areas  and the rural interior are evident, the latter having 45 percent of children with such experiences.  Strong differentials by district and socio‐economic status have also been observed. Adult engagement  in  activities with  children  is  lowest  in Brokopondo  (48%) and Sipaliwini  (45%) and higher  in  the  remaining  districts being greatest  in Nickerie  (92%). There  is a positive association between  socio‐economic  status  and  adult  engagement  in  activities  with  children  with  proportions  among  children  increasing  from  56  percent among children  in  the poorest quintile  to 91 percent among children  in  the wealthiest quintile.  While  father’s  involvement  showed a  similar pattern with  respect  to urban‐rural differences,  it was  less  predictable  in terms of  its association with socio‐economic status, but nevertheless clear  in general.  It  is  interesting  to note  that  adult household members’ engagement with  children and  fathers’  involvement  with  children  are  positively  associated  with  each  of  mother’s  education  and  father’s  education,  each  increasing with higher levels of educational attainment of children’s mothers as well as their fathers.  Exposure to books  in early years not only provides the child with greater understanding of the nature of  print, but may also give the child opportunities to see others reading, such as older siblings doing school  work. Presence of books  is  important  for  later school performance. The mother/caretaker of all children  under 5 were asked about number of children’s books or picture books they have for the child, household  objects or outside objects, and homemade toys or toys that came from a shop that are available at home.  In Suriname, 25 percent of children under 5 years are living in households where at least 3 children’s books  are present while 12 percent  live  in households with 10 or more children’s books (Table CD.3, page 117).  With respect to having at least three children’s books, there are marked differences in the proportions of  children across districts and area. In terms of the different districts, the lowest proportions among children  are  in  Brokopondo  (5%)  and  Sipaliwini  (3%),  slightly  higher  in  Marowijne  (11%)  and  Para  (16%),  and  markedly higher  in the remaining districts being greatest  in Paramaribo (37%), the primate urban area  in  Suriname. In terms of areas, higher proportions among children are observed in urban areas (34%) than in  rural areas  (11%).  Substantially  low proportions of  children are observed  in  the  rural  interior  (4%) with  evidence of notably higher proportions  in  rural  coastal areas  (19%). There  is also a positive association  between  each  of mother’s  education  and  the  household  socio‐economic  status,  and  the  proportion  of  children living in households where there are at least 3 children’s books.  Table CD.3 also shows that 59 percent of children aged 0‐59 months had 2 or more playthings to play with  in their homes. The playthings in MICS included household objects, homemade toys (such as dolls and cars,  or other toys made at home), toys that came from a store, and household objects (such as pots and bowls)  or materials found outside the home (such as sticks, rocks, animal shells, or leaves). It is interesting to note  that 88 percent of children play with toys that come from a store. In fact, this particular variable is the only  that differ slightly across background characteristics, as children in the rural interior have slightly less sore  bought toys  (75%) compared to urban children (92%). Somewhat expected,  fewer younger children have  two or more playthings than the older children, 46 percent against 68 percent, respectively.  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  interview, and whether children were  left  in the care of other children under 10  years of age.   Child Development 116  Suriname MICS4  Table CD.4 (page 118) shows that 3 percent of children aged 0‐59 months were left alone in the past week  and 6 percent  in the care of another child. Combining the two,  it  is calculated that 7 percent of children  were left with inadequate care during the week preceding the survey. No differences were observed by the  sex  of  the  child  or  between  urban  and  rural  areas.  In  the  rural  interior,  however,  somewhat  higher  proportions of children 0‐59 months were left in inadequate care when compared to their counterparts in  rural coastal areas or in urban areas. Relatively more children aged 24‐59 months were left in inadequate  care (8 percent) when compared to younger children aged 0‐23 months (5 percent), but the difference may  not be statistically significant. The children in Para seem worse off, with 14 percent left in inadequate care,  mainly driven by a high proportion left in the care of other children under age 10.      Child Development      Suriname MICS4 117 Table CD.3: Learning materials Percentage of children under age 5 by numbers of children's books present in the household, and by playthings that child plays with, Suriname, 2010 Household has for the child: Child plays with: Two or more types of playthings2 Number of children under age 5 3 or more children's books1 10 or more children's books Homemade toys Toys from a shop/manufactured toys Household objects/objects found outside Sex* Male 24.5 11.0 28.7 87.7 55.7 58.7 1,659 Female 25.5 13.0 30.4 88.2 56.8 59.0 1,649 District Paramaribo 36.9 18.6 26.0 93.5 54.1 57.7 1,274 Wanica 29.2 15.6 26.4 88.5 55.3 58.3 599 Nickerie 26.8 11.2 27.5 91.3 52.3 55.0 188 Coronie (*) (*) (*) (*) (*) (*) 14 Saramacca 29.3 8.6 22.9 92.1 59.3 61.4 91 Commewijne 30.6 13.1 27.9 91.8 61.2 61.2 122 Marowijne 10.7 1.3 32.4 87.4 61.3 62.6 192 Para 15.5 7.5 28.7 89.7 54.0 52.9 122 Brokopondo 4.8 0.9 26.4 78.1 54.1 56.2 167 Sipaliwini 3.0 0.8 43.8 73.9 61.8 63.0 537 Area Urban 34.4 17.4 26.4 91.9 54.9 58.0 2,001 Rural Coastal 19.1 6.9 28.2 90.0 56.6 58.7 603 Rural interior 3.5 0.8 39.7 74.9 60.0 61.3 705 Total Rural 10.7 3.6 34.4 81.9 58.4 60.1 1,307 Age 0-23 months 15.7 6.3 18.7 82.5 45.0 45.9 1,390 24-59 months 31.8 16.1 37.4 91.9 64.4 68.2 1,918 Mother's education* None 1.7 0.4 37.8 69.2 58.2 54.3 454 Primary 10.5 2.9 32.7 86.9 54.3 58.0 967 Secondary + 38.3 19.3 25.7 93.2 56.7 60.4 1,824 Other/Non-standard (39.6) (26.9) (36.4) (82.8) (68.6) (68.6) 48 Wealth index quintile Poorest 3.9 0.7 37.9 78.4 59.7 61.4 1,139 Second 17.1 6.5 25.4 92.8 54.1 57.9 675 Middle 30.9 15.5 26.2 91.6 53.5 55.0 563 Fourth 46.4 22.2 24.5 92.7 55.4 57.6 501 Richest 61.1 33.9 24.2 95.2 55.5 59.9 429 Ethnicity of household head* Indigenous/Amerindian 6.8 0.5 39.1 86.1 44.7 53.1 153 Maroon 9.3 2.4 33.4 82.9 58.8 60.3 1,389 Creole 40.2 20.9 26.9 93.9 50.3 55.5 428 Hindustani 33.7 17.2 22.2 89.1 59.4 60.3 644 Javanese 38.0 17.6 28.0 93.6 50.4 55.2 346 Mixed 49.4 30.7 29.2 93.7 60.0 60.9 308 Others (*) (*) (*) (*) (*) (*) 38 Total 25.0 12.0 29.5 87.9 56.3 58.8 3,308 * ‘Missing’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 6.3 2 MICS indicator 6.4     Child Development 118  Suriname MICS4  Table CD.4: Inadequate care Percentage of children under age 5 left alone or left in the care of another child younger than 10 years of age for more than one hour at least once during the past week, Suriname, 2010 Percentage of children under age 5 Left alone in the past week Left in the care of another child younger than 10 years of age in the past week Left with inadequate care in the past week1 Number of children under age 5 Sex* Male 2.3 6.3 7.1 1,659 Female 2.7 5.9 7.0 1,649 District Paramaribo 3.2 7.4 8.8 1,274 Wanica 0.7 3.7 3.7 599 Nickerie 0.0 1.4 1.4 188 Coronie (*) (*) (*) 14 Saramacca 0.0 2.9 2.9 91 Commewijne 0.5 1.1 1.1 122 Marowijne 1.9 2.8 3.5 192 Para 2.9 13.2 14.4 122 Brokopondo 3.3 7.5 9.0 167 Sipaliwini 4.8 8.4 9.9 537 Area Urban 2.2 5.8 6.7 2,001 Rural Coastal 1.3 4.7 5.1 603 Rural interior 4.4 8.2 9.7 705 Total Rural 3.0 6.6 7.6 1,307 Age 0-23 months 2.2 4.2 5.3 1,390 24-59 months 2.7 7.5 8.4 1,918 Mother's education* None 4.2 6.4 7.5 454 Primary 2.1 6.6 7.2 967 Secondary + 2.2 5.7 6.7 1,824 Other/Non-standard (6.4) (12.8) (17.0) 48 Wealth index quintile Poorest 3.6 7.0 8.6 1,139 Second 2.1 6.9 7.7 675 Middle 2.4 6.6 6.9 563 Fourth 0.8 2.4 2.4 501 Richest 2.3 6.4 7.8 429 Ethnicity of household head* Indigenous/Amerindian 0.7 5.7 6.0 153 Maroon 3.8 7.8 9.3 1,389 Creole 0.9 6.4 7.4 428 Hindustani 1.0 2.9 2.9 644 Javanese 1.7 4.9 5.4 346 Mixed 3.9 6.2 7.5 308 Others (*) (*) (*) 38 Total 2.5 6.1 7.1 3,308 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases (1) MICS indicator 6.5 Child Development      Suriname MICS4 119 Early Childhood Development Early child development  is defined as an orderly, predictable process along a continuous path,  in which a  child learns to handle more complicated levels of moving, thinking, speaking, feeling and relating to others.  Physical growth, literacy and numeracy skills, socio‐emotional development and readiness to learn are vital  domains of a child’s overall development, which is a basis for overall human development.  A 10‐item module that has been developed for the MICS programme was used to calculate the Early Child  Development Index (ECDI). The indicator is based on some benchmarks that children would be expected to  have if they are developing as the majority of children in that age group. The primary purpose of the ECDI  is to inform public policy regarding the developmental status of children in Suriname.   Each of the 10  items  is used  in one of the four domains, to determine  if children are developmentally on  track in that domain. The domains in question are:   Literacy‐numeracy: Children are  identified as being developmentally on  track based on whether  they can  identify/name at  least  ten  letters of  the alphabet, whether  they can  read at  least  four  simple popular words, and whether they know the name and recognize the symbols of all numbers  from 1  to 10.  If at  least  two of  these are  true,  then  the  child  is  considered developmentally on  track.   Physical:  If  the  child  can pick up a  small object with  two  fingers,  like a  stick or a  rock  from  the  ground and/or the mother/caretaker does not indicate that the child is sometimes too sick to play,  then the child is regarded as being developmentally on track in the physical domain.   Social‐emotional: Children are considered to be developmentally on track  if two of the  following  are true: If the child gets along well with other children, if the child does not kick, bite, or hit other  children and if the child does not get distracted easily   Learning:  If  the  child  follows  simple  directions  on  how  to  do  something  correctly  and/or when  given  something  to  do,  is  able  to  do  it  independently,  then  the  child  is  considered  to  be  developmentally on track in this domain.    ECDI is then calculated as the percentage of children who are developmentally on track in at least three of  these four domains.  The results are presented in Table CD.5 (page 120). In Suriname, 71 percent of children aged 36‐59 months  are developmentally on track. ECDI  is  lower among boys (65%) than girls (76%). As expected, the ECDI  is  higher  in  the older age group, at 73 percent among 48‐59 months old children compared  to 69 percent  among 36‐47 months old  children,  since children mature more  skills with  increasing age. Higher ECDI  is  seen  in children attending early childhood education, at 78 percent against 67 percent for those who are  not  attending.  Children  living  in  the  poorest  households  have  a  lower  ECDI  (60%)  when  compared  to  children living in households belonging to the other wealth quintiles. The analysis of four domains of child  development shows that 97 percent of the children are on track in the learning domain and 98 percent in  the  physical  domain,  but  much  less  on  track  in  literacy‐numeracy  (21%)  and  social‐emotional  (67%)  domains. For each individual domain, the ECDI score is lowest among children living in poorest households,  those of mothers with no education, and among children not attending early childhood education. Child Development 120  Suriname MICS4  Table CD.5: Early child development index Percentage of children age 36-59 months who are developmentally on track in literacy-numeracy, physical, social- emotional, and learning domains, and the early child development index score, Suriname, 2010 Percentage of children age 36-59 months who are developmentally on track for indicated domains Early child development index score1 Number of children age 36-59 months Literacy- numeracy Physical Social- Emotional Learning Sex Male 14.6 97.8 62.5 97.1 65.4 596 Female 26.0 97.9 71.7 97.1 75.7 683 District Paramaribo 28.1 97.9 69.0 97.1 76.0 486 Wanica 23.1 100.0 73.5 99.1 78.6 238 Nickerie 27.8 97.9 78.4 99.0 84.5 64 Coronie (*) (*) (*) (*) (*) 7 Saramacca 15.8 98.2 57.9 98.2 64.9 37 Commewijne (25.4) (100.0) (87.3) (91.5) (80.3) 47 Marowijne 10.2 91.7 62.0 95.4 58.3 65 Para 13.9 97.2 70.8 100.0 70.8 51 Brokopondo 9.7 94.4 60.5 95.2 60.5 62 Sipaliwini 6.7 97.7 53.7 95.8 52.5 221 Area Urban 26.7 98.7 71.7 97.4 77.5 770 Rural Coastal 16.8 96.1 67.9 98.1 69.5 225 Rural interior 7.4 97.0 55.2 95.7 54.3 283 Total Rural 11.6 96.6 60.8 96.7 61.0 509 Age 36-47 months 15.9 97.7 67.2 97.0 69.2 694 48-59 months 26.4 98.0 67.6 97.3 73.0 584 Attendance to early childhood education Attending 32.2 98.4 69.7 97.9 77.7 438 Not attending 14.6 97.6 66.2 96.7 67.4 840 Mother's education* None 6.1 95.2 59.4 94.2 56.6 187 Primary 15.5 98.1 64.9 97.5 68.3 395 Secondary + 27.8 98.4 71.6 97.6 77.1 670 Other/Non-standard (*) (*) (*) (*) (*) 23 Wealth index quintile Poorest 8.5 96.8 59.1 95.9 59.5 471 Second 21.3 98.5 73.1 98.9 75.1 250 Middle 26.5 98.7 75.6 97.1 81.3 208 Fourth 29.4 97.6 74.1 97.6 80.1 170 Richest 36.7 98.9 65.1 97.4 74.5 179 Ethnicity of household head* Indigenous/Amerindian 11.1 97.1 64.9 98.2 66.7 57 Maroon 11.5 97.2 62.7 96.3 63.4 547 Creole 31.0 98.9 72.8 98.9 78.0 178 Hindustani 26.8 97.5 64.6 97.8 73.5 242 Javanese 26.8 98.4 72.8 95.3 75.5 127 Mixed 29.4 100.0 79.4 100.0 85.4 112 Others (*) (*) (*) (*) (*) 13 Total 20.7 97.8 67.4 97.1 70.9 1,278 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 6.6 Literacy and Education      Suriname MICS4 121   9. Literacy and Education     Literacy and Education 122  Suriname MICS4  Literacy among Young Women 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 is assessed on the ability of the respondent to read a  short  simple  statement or based on  school  attendance.  For women 15‐24  years,  the percent  literate  is  presented  in  Table  ED.1  (page  123).  Thus,  it  is  estimated  that  92  percent  of  women  15‐24  years  are  literate. Literacy rates in urban areas are higher than those in rural areas being 96 percent and 80 percent  respectively and have been observed to be substantially lower in the rural interior (54%) than in the rural  coastal areas (93%), the latter having rates that closely approximate those in urban areas. Not surprisingly,  there  is a positive association between  socio‐economic  status of  females 15‐24 years and  literacy  rates  with just 73 percent of women in the poorest households being literate.  School Readiness Attendance to pre‐school education  in an organised  learning or child education programme  is  important  for the readiness of children to school. Table ED.2 (page 124) shows the proportion of children in the first  grade  of  primary  school  who  attended  pre‐school  the  previous  year.  Overall,  76  percent  of  children  attending  the  first grade of primary school were attending pre‐school  the previous year.  In  rural coastal  areas,  the proportion  (78%) was virtually consistent with  that  in urban areas  (79%), but a notably  lower  proportion is observed in the rural interior (67%). Socioeconomic status appears to be positively associated  with school readiness – while the indicator is only 71 percent among the poorest households, it increases  to 91 percent among those children living in the richest households.      Literacy and Education      Suriname MICS4 123 Table ED.1: Literacy among young women Percentage of women age 15-24 years who are literate, Suriname, 2010 Percentage literate1 Percentage not known Number of women age 15-24 years Region Paramaribo 96.5 2.1 1,034 Wanica 96.6 0.9 389 Nickerie 92.0 3.5 153 Coronie (*) (*) 7 Saramacca 97.2 0.9 58 Commewijne 95.6 2.7 98 Marowijne 93.1 2.9 86 Para 92.5 3.3 68 Brokopondo 78.3 7.0 46 Sipaliwini 46.3 4.2 137 Area Urban 96.3 1.8 1,539 Rural Coastal 93.3 3.0 354 Rural interior 54.3 4.9 183 Total Rural 80.0 3.6 537 Education* None 1.6 2.4 50 Primary 69.1 10.4 318 Secondary + 100.0 0.0 1,687 Other/Non-standard (*) (*) 19 Age 15-19 92.8 1.8 1,085 20-24 91.4 2.8 991 Wealth index quintile Poorest 73.3 5.2 388 Second 94.0 1.4 433 Middle 96.3 2.5 398 Fourth 97.4 1.2 414 Richest 98.1 1.5 443 Ethnicity of household head* Indigenous/Amerindian 87.8 4.6 84 Maroon 81.3 3.2 579 Creole 95.9 4.1 358 Hindustani 96.5 1.0 560 Javanese 99.3 0.2 285 Mixed 96.8 2.3 180 Others (*) (*) 29 Total 92.1 2.3 2,076 * ‘Missing/DK’ categories not shown due to low number of observations (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 7.1; MDG indicator 2.3         Literacy and Education 124  Suriname MICS4    Table ED.2: School readiness Percentage of children attending first grade of primary school who attended pre-school the previous year, Suriname, 2010 Percentage of children attending first grade who attended preschool in previous year1 Number of children attending first grade of primary school Sex Male 74.4 385 Female 77.3 350 Region Paramaribo 74.1 270 Wanica 83.5 133 Nickerie (97.0) 37 Coronie (*) 1 Saramacca (81.8) 18 Commewijne (90.6) 29 Marowijne 64.3 43 Para 78.5 38 Brokopondo 77.0 37 Sipaliwini 63.4 128 Area Urban 78.6 438 Rural Coastal 78.1 132 Rural interior 66.5 165 Total Rural 71.6 297 Mother's education* None 62.3 124 Primary 72.6 242 Secondary + 82.8 349 Other/Non-standard (*) 9 Wealth index quintile Poorest 71.3 287 Second 71.2 163 Middle 77.6 120 Fourth 83.3 86 Richest 90.7 78 Ethnicity of household head* Indigenous/Amerindian 74.3 41 Maroon 68.7 354 Creole 81.0 93 Hindustani 86.0 127 Javanese 85.6 62 Mixed (78.1) 48 Others (*) 6 Total 75.8 735 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 7.2   Literacy and Education      Suriname MICS4 125 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   Primary school net attendance ratio (adjusted)   Secondary school net attendance ratio (adjusted)   Female to male education ratio (or gender parity index ‐ GPI) in primary and secondary school    The indicators of school progression include:   Children reaching last grade of primary    Primary completion rate   Transition rate to secondary school    Of children who are of primary  school entry age  (age 6)  in Suriname, 87 percent are attending  the  first  grade of primary school (ED.3, page 126). There does not appear to be much if any differences across sex;  however,  noteworthy  differentials  are  present  by  urban‐rural  areas.  Ninety  percent  of  the  children  of  primary school entrance age in urban areas are estimated to be attending the first grade of primary school  as opposed  to 82 percent  in  rural  areas. While  the proportion observed  in  rural  coastal  areas  (87%)  is  almost as high as that observed for urban areas, the proportion observed in the rural interior is noticeably  lower being estimated at 78 percent. While  there does not appear  to be any clear association between  socio‐economic  status and  the proportion of children of primary  school age attending  the  first grade of  primary school, there does appear to be a positive association between mother’s education and the latter.  For children age 6 whose mothers have at least secondary school education, 91 percent were attending the  first grade while for those with mothers having no education; the corresponding proportion is 74percent.   Table ED.424  (page 127) provides  the percentage of children of primary  school age attending primary or  secondary  school.  The  majority  of  children  of  primary  school  age  are  attending  school  (95%).  Among  children of primary  school age,  the estimates are also consistent with marginally higher  levels of school  attendance among girls  (96%)  than among boys  (95%).  In general,  this pattern across  the  sexes persists  irrespective of children’s background characteristics. Except in Sipaliwini where school attendance among  children of primary school age is estimated to be 89 percent, similar but higher levels of school attendance  are evident  in all of the other districts of Suriname. In urban areas, 97 percent of the children of primary  school age are attending primary or secondary school as opposed to 94 percent  in rural areas. While the  proportion observed in rural coastal areas (97%) is estimated to be just as high as that observed for urban  areas, the proportion observed  in the rural  interior  is noticeably  lower being estimated to be 90 percent.  School attendance among primary school age children is positively associated with mother’s education and  is  estimated  to be  86 percent  for  children whose mothers had no  education  and  98 percent  for  those  whose  mother  had  at  least  secondary  education.  The  primary  school  age  children  of  the  poorest                                                               24 Ratios presented in this table are "adjusted" since they include not only primary school attendance, but also  secondary school attendance in the numerator.  Literacy and Education 126  Suriname MICS4  households are estimated to have the lowest school attendance rates (92%) when compared to children in  each of the other wealth status groups.  Table ED.3: Primary school entry Percentage of children of primary school entry age entering grade 1 (net intake rate), Suriname, 2010 Percentage of children of primary school entry age entering grade 11 Number of children of primary school entry age Sex Male 86.2 316 Female 88.2 302 Region Paramaribo 92.8 232 Wanica 87.3 120 Nickerie 88.2 42 Coronie (*) 2 Saramacca (80.0) 16 Commewijne (83.6) 30 Marowijne 80.7 29 Para 89.8 35 Brokopondo 84.4 27 Sipaliwini 75.3 84 Area Urban 89.8 394 Rural Coastal 87.4 112 Rural interior 77.5 112 Total Rural 82.4 223 Mother's education* None 74.5 84 Primary 85.0 183 Secondary + 91.0 337 Other/Non-standard (*) 9 Wealth index quintile Poorest 82.4 201 Second 86.8 136 Middle 95.7 104 Fourth 88.3 85 Richest 87.3 92 Ethnicity of household head* Indigenous/Amerindian (86.5) 25 Maroon 85.2 255 Creole 91.2 100 Hindustani 91.0 129 Javanese 86.7 58 Mixed (77.2) 43 Others (*) 4 Total 87.2 617 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 7.3     Literacy and Education      Suriname MICS4 127   Table ED.4: Primary school attendance Percentage of children of primary school age attending primary or secondary school (adjusted net attendance ratio), Suriname, 2010 Male Female Total Net attendance ratio (adjusted) Number of children Net attendance ratio (adjusted) Number of children Net attendance ratio (adjusted)1 Number of children Region Paramaribo 97.0 788 97.9 637 97.4 1,425 Wanica 92.5 335 96.5 288 94.3 623 Nickerie 98.3 127 97.0 91 97.8 219 Coronie (*) 12 (*) 11 (*) 23 Saramacca 94.4 59 98.0 56 96.2 115 Commewijne 92.2 57 98.1 89 95.8 146 Marowijne 95.0 101 96.3 83 95.6 184 Para 95.2 87 97.9 85 96.6 172 Brokopondo 93.5 79 95.9 62 94.6 142 Sipaliwini 87.4 224 90.1 227 88.7 451 Area Urban 95.6 1,217 97.5 1,005 96.5 2,222 Rural Coastal 96.0 350 97.4 334 96.7 684 Rural interior 89.0 304 91.3 289 90.1 593 Total Rural 92.7 654 94.6 623 93.6 1,277 Age at beginning of school year 6 87.9 316 92.2 302 90.0 617 7 95.9 312 96.7 270 96.3 582 8 95.1 305 98.1 306 96.6 611 9 96.4 320 97.5 236 96.9 556 10 95.7 298 96.3 255 96.0 553 11 96.6 320 97.9 260 97.1 580 Mother's education None 83.7 251 89.5 205 86.3 456 Primary 94.4 616 96.3 525 95.3 1,142 Secondary + 97.3 949 98.0 859 97.6 1,808 Other/Non-standard (*) 25 (*) 25 (98.0) 51 Missing/DK (100.0) 29 (*) 14 100.0 43 Wealth index quintile Poorest 89.7 546 93.5 483 91.5 1,029 Second 94.7 448 97.0 347 95.7 795 Middle 98.1 324 98.0 310 98.1 635 Fourth 98.1 264 99.4 260 98.7 524 Richest 96.5 289 95.9 228 96.2 517 Ethnicity of household head* Indigenous/Amerindian 95.1 117 95.3 94 95.2 211 Maroon 92.0 707 94.6 633 93.3 1,340 Creole 96.8 282 98.9 246 97.8 528 Hindustani 96.4 393 97.0 350 96.7 743 Javanese 97.0 187 98.0 163 97.5 350 Mixed 94.5 158 98.2 123 96.1 280 Others (*) 27 (*) 18 (92.6) 45 Total 94.6 1,871 96.4 1,629 95.4 3,499 * ‘Missing/DK’ category of ethnicity of household head not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases; (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 7.4; MDG indicator 2.1 Literacy and Education 128  Suriname MICS4    The secondary school net attendance ratio is presented in Table ED.525 (page 129). More dramatic than in  primary  school where 4 percent of  the  children are not attending  school at all,  is  the  fact  that only 59  percent is attending secondary school or pursuing tertiary education. Of the remaining 41% some of them  are either out of school (15%) or attending primary school (26%). Among children of secondary school age,  the estimates are also consistent with markedly higher levels of school attendance among girls (66%) than  among boys (53%). In general, this pattern persists across the sexes  irrespective of children’s background  characteristics though, in the case of children in Sipaliwini and by extension, the rural interior, higher levels  of attendance  (at secondary or higher  levels) among secondary school age children are evident  for boys  than for girls. In this relation, it is worth noting that secondary education is only provided in some parts of  Sipaliwini. The low school attendance on secondary level is to be explained by this fact, and higher levels of  school attendance are evident in all of the other districts of Suriname.   In urban  areas, 66 percent of  the  children of  secondary  school  age  are  attending  secondary or  tertiary  education  institutions  as  opposed  to  44  percent  in  rural  areas. While  the  proportion  observed  in  rural  coastal areas (56%) is somewhat below that observed for urban areas, the proportion observed in the rural  interior is substantially lower being estimated to be 21 percent. School attendance at secondary or higher  levels among secondary school age children  is positively associated with the household’s socio‐economic  status. The children of the poorest households are estimated to have the  lowest school attendance rates  (29%)  at  secondary  or  higher  levels while  the wealthiest  set  of  children  have  school  attendance  rates  estimated to be 83 percent. For children whose mothers had no education, 23 percent are estimated to be  attending  a  secondary  or  tertiary  education  institution  as  opposed  to  73  percent  among  those whose  mother had at least secondary education  The primary  school net attendance  ratio of  children of  secondary  school age  is also presented  in Table  ED.5. Twenty six percent of the children of secondary school age are attending primary school when they  should be attending secondary school. Among children of secondary school age, the proportion attending  primary school  is markedly higher among boys (31%) than among girls (20%). This pattern persists across  the  sexes  irrespective  of  children’s  background  characteristics.  In  Sipaliwini,  Brokopondo,  Para  and  Marowijne,  primary  school  attendance  among  children  of  secondary  school  age  is  observed  to  be  substantially greater than that in all of the other districts of Suriname and is estimated to be 46 percent, 37  percent, 39 percent and 41 percent respectively. Paramaribo, on the other hand, has the  lowest primary  school attendance among children of secondary school age, this being estimated to be 19 percent. In urban  areas, 22 percent of  the  children of  secondary  school  age  are  attending primary  school opposed  to 35  percent in rural areas. While the proportion observed in rural coastal areas (29%) is somewhat higher than  that observed for urban areas, the proportion observed in the rural interior has more than doubled being  estimated to be 43 percent. Primary school attendance among secondary school age children  is  inversely  associated with  children’s  socio‐economic  status and mother’s education. The poorest  set of  secondary  school age  children are estimated  to have  the highest primary  school attendance  rates  (42%) while  the  wealthiest set of children have primary school attendance rates estimated to be 11 percent.                                                                 25 Ratios presented in this table are "adjusted" since they include not only secondary school attendance, but also  attendance to higher levels in the numerator.  Li te ra cy  an d E du ca tio n          Su rin am e M IC S4 12 9 Ta bl e ED .5 : S ec on da ry s ch oo l a tte nd an ce P er ce nt ag e of c hi ld re n of s ec on da ry s ch oo l a ge a tte nd in g se co nd ar y sc ho ol o r h ig he r ( ad ju st ed n et a tte nd an ce ra tio ) a nd p er ce nt ag e of c hi ld re n at te nd in g pr im ar y sc ho ol , S ur in am e, 2 01 0 M al e Fe m al e To ta l N et at te nd an ce ra tio (a dj us te d) 1 P er ce nt at te nd in g pr im ar y sc ho ol N um be r of ch ild re n N et at te nd an ce ra tio (a dj us te d) 1 P er ce nt at te nd in g pr im ar y sc ho ol N um be r of ch ild re n N et at te nd an ce ra tio (a dj us te d) 1 P er ce nt a tte nd in g pr im ar y sc ho ol N um be r of ch ild re n R eg io n P ar am ar ib o 59 .7 27 .1 65 8 76 .2 13 .5 70 2 68 .3 20 .1 1, 36 0 W an ic a 58 .0 27 .1 31 7 67 .0 22 .9 30 1 62 .4 25 .1 61 8 N ic ke rie 54 .4 28 .5 12 5 75 .5 15 .9 12 0 64 .8 22 .3 24 5 C or on ie (* ) (* ) 7 (* ) (* ) 11 (6 9. 7) (2 4. 2) 18 S ar am ac ca 56 .0 24 .2 50 72 .5 17 .5 44 63 .7 21 .1 94 C om m ew ijn e 60 .0 25 .0 78 73 .5 14 .5 65 66 .1 20 .2 14 2 M ar ow ijn e 33 .8 46 .6 67 50 .7 35 .0 71 42 .5 40 .7 13 8 P ar a 41 .8 42 .6 83 55 .8 34 .6 61 47 .8 39 .2 14 5 B ro ko po nd o 31 .0 44 .0 49 45 .2 29 .8 44 37 .7 37 .3 94 S ip al iw in i 16 .8 52 .9 10 3 12 .7 39 .9 13 7 14 .4 45 .5 24 0 A re a U rb an 58 .5 27 .5 1, 06 2 73 .6 16 .5 1, 09 5 66 .2 21 .9 2, 15 7 R ur al C oa st al 49 .4 33 .7 32 3 64 .3 24 .1 28 0 56 .3 29 .2 60 3 R ur al in te rio r 21 .4 50 .0 15 3 20 .6 37 .4 18 2 21 .0 43 .2 33 4 To ta l R ur al 40 .4 38 .9 47 6 47 .1 29 .3 46 2 43 .7 34 .2 93 8 A ge a t b eg in ni ng o f s ch oo l y ea r 12 28 .5 66 .5 32 2 42 .9 54 .0 27 8 35 .2 60 .7 59 9 13 36 .9 55 .1 28 3 58 .7 39 .3 24 8 47 .1 47 .7 53 2 14 62 .0 24 .5 23 5 69 .5 18 .9 22 4 65 .6 21 .8 45 9 15 63 .6 16 .6 21 4 77 .0 7. 5 24 3 70 .7 11 .8 45 8 16 75 .4 3. 7 24 1 75 .1 1. 9 25 4 75 .2 2. 8 49 5 17 63 .4 2. 1 24 2 72 .7 1. 0 31 1 68 .6 1. 5 55 2     Li te ra cy  an d E du ca tio n 13 0  Su rin am e M IC S4   Ta bl e ED .5 : S ec on da ry s ch oo l a tte nd an ce ( co nt in ue d) M al e Fe m al e To ta l N et at te nd an ce ra tio (a dj us te d) 1 P er ce nt at te nd in g pr im ar y sc ho ol N um be r of ch ild re n N et at te nd an ce ra tio (a dj us te d) 1 P er ce nt at te nd in g pr im ar y sc ho ol N um be r of ch ild re n N et at te nd an ce ra tio (a dj us te d) 1 P er ce nt a tte nd in g pr im ar y sc ho ol N um be r of ch ild re n M ot he r's e du ca tio n N on e 16 .0 55 .5 11 0 30 .7 40 .1 11 3 23 .4 47 .8 22 3 P rim ar y 36 .5 47 .4 39 1 51 .7 40 .8 36 4 43 .8 44 .2 75 5 S ec on da ry + 65 .0 28 .9 66 3 81 .1 16 .3 64 0 72 .9 22 .7 1, 30 3 O th er /N on -s ta nd ar d (* ) (* ) 23 (* ) (* ) 15 (5 2. 6) (3 6. 3) 38 N ot in th e ho us eh ol d 60 .2 16 .5 13 2 55 .6 3. 6 16 6 57 .6 9. 3 29 8 M is si ng /D K /C an no t b e de te rm in ed 59 .5 3. 9 21 9 70 .4 2. 5 25 9 65 .4 3. 1 47 8 W ea lth in de x qu in til e P oo re st 25 .3 46 .3 33 1 31 .6 37 .3 33 6 28 .5 41 .8 66 8 S ec on d 46 .6 34 .1 33 9 65 .3 22 .6 34 0 56 .0 28 .3 67 9 M id dl e 56 .9 30 .4 28 7 69 .3 19 .3 26 3 62 .8 25 .1 55 0 Fo ur th 63 .7 24 .9 31 7 79 .8 13 .6 29 0 71 .4 19 .5 60 7 R ic he st 78 .2 16 .1 26 4 86 .1 7. 1 32 8 82 .6 11 .1 59 1 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 45 .4 34 .6 84 46 .5 32 .7 74 45 .9 33 .7 15 8 M ar oo n 33 .5 45 .8 45 0 48 .3 29 .0 48 2 41 .1 37 .1 93 2 C re ol e 63 .9 28 .8 24 6 75 .1 20 .9 23 7 69 .4 25 .0 48 4 H in du st an i 62 .4 21 .6 41 5 71 .1 15 .5 41 0 66 .7 18 .5 82 4 Ja va ne se 65 .1 21 .7 19 3 77 .6 12 .8 18 7 71 .3 17 .4 37 9 M ix ed 54 .7 31 .5 12 1 84 .4 10 .3 13 8 70 .6 20 .2 25 9 O th er s (* ) (* ) 29 (* ) (* ) 27 (7 4. 5) (3 .9 ) 57 To ta l 52 .9 31 .0 1, 53 8 65 .8 20 .3 1, 55 7 59 .4 25 .6 3, 09 5 * ‘M is si ng /D K ’ c at eg or y of e th ni ci ty o f h ou se ho ld h ea d no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 7 .5   Literacy and Education      Suriname MICS4 131 The percentage of children entering  first grade who eventually  reach grade 6  is presented  in Table ED.6  (page 132). Of all children starting grade one, the majority of them (96 percent) will eventually reach grade  six. Notice  that  this number  includes  children  that  repeat grades and  that eventually move up  to  reach  grade six. A greater proportion of girls (97%) than boys (95%) will eventually reach grade 6 having entered  first grade. Across urban and rural areas, the MICS data suggest that there has not been much variation in  the proportion of children reaching grade 6 having entered first grade though somewhat lower proportions  are observed in the cases of Brokopondo (89%) among the districts and the rural interior (91%) among the  areas.  The  proportion  reaching  grade  6  having  entered  grade  1  is  positively  associated  with  mother’s  education  and  is  estimated  to  be  88  percent  for  children  whose  mothers  had  no  education  and  100  percent for those whose mother had at least secondary education.   The primary school completion rate and transition rate to secondary education are presented in Table ED.7  (page 133). The primary completion  rate  is  the  ratio of  the  total number of students,  regardless of age,  entering  the  last  grade  of  primary  school  for  the  first  time,  to  the  number  of  children  of  the  primary  graduation age at the beginning of the current (or most recent) school year. At the moment of the survey,  the primary school completion rate was 90 percent.  Unfortunately, only 79 percent of the children that completed successfully the last grade of primary school  were found at the moment the survey to be attending the first grade of secondary school.  Substantially higher primary school completion rates are observed for girls (100%) than for boys (81%). It is  worth  noting  that  the  primary  school  completion  rate  is  positively  associated  with  children’s  socio‐ economic status and mother’s education.   With respect to transition to secondary school, there does not appear to be difference in the rates of boys  (80%) and girls (79%) and this is also true with respect to differences between urban and rural areas (80%  and 78%, respectively). Compared to other wealth status groups, the lowest rate of transition to secondary  school  is among  children  from  the poorest households,  the  respective  rate being 74 percent against 87  percent for children in the richest households.   The ratio of girls to boys attending primary and secondary education is provided in Table ED.8 (page 134).  These ratios are better known as the Gender Parity  Index  (GPI). Notice  that  the ratios  included here are  obtained  from  net  attendance  ratios  rather  than  gross  attendance  ratios.  The  last  ratios  provide  an  erroneous description of the GPI mainly because  in most of the cases the majority of over‐aged children  attending primary education  tend  to be boys. The  table  shows  that  gender parity  for primary  school  is  close  to 1.00  (1.02),  indicating no difference  in  the attendance of girls and boys  to primary  school. This  outcome holds true despite differences in background characteristics predicated on district, area, mother’s  education, and wealth of household. However, the GPI is observed to be 1.24 for secondary education and  is  indicative of higher school attendance at the secondary  level among girls than among boys. The  lower  school attendance of boys relative to girls  is evident  in every district of Suriname except Sipaliwini where  there  is higher school attendance among boys than among girls. The higher secondary school attendance  among girls  than among boys persists  irrespective of differences  in background characteristics  linked  to  area , children’s mothers’ education and wealth status of household.      Literacy and Education 132  Suriname MICS4    Table ED.6: Children reaching last grade of primary school Percentage of children entering first grade of primary school who eventually reach the last grade of primary school (Survival rate to last grade of primary school), Suriname, 2010 Percent attending grade 1 last school year who are in grade 2 this school year Percent attending grade 2 last school year who are attending grade 3 this school year Percent attending grade 3 last school year who are attending grade 4 this school year Percent attending grade 4 last school year who are attending grade 5 this school year Percent attending grade 5 last school year who are attending grade 6 this school year Percent who reach grade 6 of those who enter grade 11 Sex Male 98.4 99.8 98.6 99.1 98.8 94.8 Female 99.7 99.0 99.6 100.0 98.8 97.1 Region Paramaribo 100.0 99.4 99.2 100.0 99.2 97.8 Wanica 96.7 98.6 100.0 98.4 100.0 93.8 Nickerie 100.0 100.0 (93.0) 100.0 97.5 (90.6) Coronie (*) (*) (*) (*) (*) (*) Saramacca (100.0) (100.0) 100.0 (96.8) (100.0) (96.8) Commewijne (100.0) (100.0) (100.0) (100.0) (*) (*) Marowijne 96.8 100.0 100.0 98.6 (100.0) (95.5) Para 100.0 100.0 100.0 (100.0) (97.9) (97.9) Brokopondo 98.4 98.5 98.1 97.4 (95.7) (88.7) Sipaliwini 98.3 99.4 98.6 100.0 94.8 91.3 Area Urban 99.1 99.2 99.0 99.6 99.5 96.5 Rural Coastal 99.2 100.0 99.6 99.2 98.4 96.4 Rural interior 98.3 99.2 98.4 99.4 95.2 90.7 Total Rural 98.8 99.6 99.1 99.2 97.3 94.2 Mother's education* None 95.7 97.3 97.3 100.0 97.1 88.0 Primary 98.8 100.0 98.4 99.6 98.7 95.6 Secondary + 100.0 100.0 99.8 100.0 100.0 99.8 Other/Non-standard (*) (*) (*) (*) (*) (*) Not in the household (*) (*) (*) (*) (*) (*) Wealth index quintile Poorest 98.2 98.7 99.1 99.7 97.3 93.1 Second 98.2 100.0 99.7 98.6 99.5 96.0 Middle 100.0 100.0 97.2 99.6 98.9 95.7 Fourth 100.0 98.3 100.0 100.0 100.0 98.3 Richest 100.0 100.0 (100.0) 100.0 98.5 (98.5) Ethnicity of household head* Indigenous/Amerindian 100.0 98.9 93.2 100.0 (96.4) (88.9) Maroon 97.3 99.2 98.5 99.5 97.3 92.1 Creole 100.0 100.0 100.0 100.0 100.0 100.0 Hindustani 100.0 100.0 100.0 98.6 99.1 97.7 Javanese (100.0) 100.0 100.0 100.0 100.0 (100.0) Mixed (100.0) (97.0) 100.0 (100.0) (100.0) (97.0) Others (*) (*) (*) (*) (*) (*) Total 99.0 99.4 99.1 99.5 98.8 95.8 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 7.6; MDG indicator 2.2   Literacy and Education      Suriname MICS4 133   Table ED.7: Primary school completion and transition to secondary school Primary school completion rates and transition rate to secondary school, Suriname, 2010 Primary school completion rate1 Number of children of primary school completion age Transition rate to secondary school2 Number of children who were in the last grade of primary school the previous year Sex Male 78.3 320 79.9 283 Female 100.2 260 78.5 268 Region Paramaribo 83.8 257 81.9 248 Wanica 112.1 98 75.4 116 Nickerie 98.6 43 79.8 49 Coronie (*) 2 (*) 3 Saramacca (109.4) 18 (*) 13 Commewijne (76.2) 23 (79.7) 36 Marowijne 88.2 26 (84.4) 23 Para (102.2) 27 (62.2) 22 Brokopondo (98.0) 21 (79.1) 18 Sipaliwini 50.3 66 72.2 23 Area Urban 93.0 382 79.6 401 Rural Coastal 92.3 110 79.4 108 Rural interior 61.7 87 75.2 42 Total Rural 78.8 198 78.2 150 Mother's education None 44.8 70 (88.5) 24 Primary 85.7 204 77.0 143 Secondary + 100.1 286 80.2 314 Other/Non-standard (*) 8 (*) 12 Not in the household - 0 (83.0) 30 Missing/DK/Cannot be determined (*) 12 (77.6) 27 Wealth index quintile Poorest 63.3 150 73.9 89 Second 84.6 130 77.5 125 Middle 97.1 105 82.1 121 Fourth 102.7 90 74.6 112 Richest 106.7 105 87.2 105 Ethnicity of household head Indigenous/Amerindian 75.3 37 (64.3) 24 Maroon 69.7 209 80.6 155 Creole 102.3 92 80.9 100 Hindustani 92.9 133 80.0 148 Javanese 137.5 50 78.9 74 Mixed (91.0) 51 (69.8) 39 Others (*) 8 (*) 11 Total 88.2 580 79.2 551 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 7.7 2 MICS indicator 7.8       Literacy and Education 134  Suriname MICS4    Table ED.8: Education gender parity Ratio of adjusted net attendance ratios of girls to boys, in primary and secondary school, Suriname, 2010 Primary school adjusted net attendance ratio (NAR), girls Primary school adjusted net attendance ratio (NAR), boys Gender parity index (GPI) for primary school adjusted NAR1 Secondary school adjusted net attendance ratio (NAR), girls Secondary school adjusted net attendance ratio (NAR), boys Gender parity index (GPI) for secondary school adjusted NAR2 Region Paramaribo 96.9 95.6 1.01 75.8 59.5 1.27 Wanica 96.5 91.0 1.06 67.0 58.0 1.16 Nickerie 95.2 94.9 1.00 75.5 54.4 1.39 Coronie (*) (*) (*) (*) (*) (*) Saramacca 97.1 92.6 1.05 72.5 56.0 1.29 Commewijne 93.7 92.2 1.02 73.5 60.0 1.22 Marowijne 95.7 94.5 1.01 50.7 33.8 1.50 Para 96.5 94.6 1.02 55.8 41.8 1.33 Brokopondo 95.9 93.5 1.03 45.2 31.0 1.46 Sipaliwini 89.3 87.2 1.02 12.7 16.8 0.75 Area Urban 96.7 94.0 1.03 73.3 58.3 1.26 Rural Coastal 95.4 95.0 1.00 64.3 49.4 1.30 Rural interior 90.7 88.9 1.02 20.6 21.4 0.96 Total Rural 93.2 92.2 1.01 47.1 40.4 1.17 Education of mother/caretaker None 88.7 83.6 1.06 30.7 16.0 1.92 Primary 96.0 94.0 1.02 51.7 36.5 1.42 Secondary + 96.5 95.2 1.01 81.1 65.0 1.25 Other/Non-standard 95.9 100.0 0.96 47.1 56.3 0.84 Not in the household na na na 55.6 60.2 0.92 Missing/DK/Cannot be determined na na na 69.1 58.8 1.18 Wealth index quintile Poorest 92.9 89.2 1.04 31.6 25.3 1.25 Second 97.0 93.8 1.03 65.3 46.6 1.40 Middle 96.9 97.4 1.00 69.3 56.9 1.22 Fourth 97.7 96.0 1.02 79.2 63.7 1.24 Richest 93.2 93.3 1.00 85.6 77.6 1.10 Ethnicity of household head* Indigenous/Amerindian 94.8 95.1 1.00 46.5 45.4 1.02 Maroon 94.4 91.4 1.03 48.3 33.5 1.44 Creole 97.1 94.9 1.02 75.1 63.9 1.17 Hindustani 95.1 94.9 1.00 70.7 62.4 1.13 Javanese 95.9 93.7 1.02 77.6 64.2 1.21 Mixed 98.2 93.5 1.05 83.2 54.7 1.52 Others (*) (*) (*) (*) (*) (*) Total 95.4 93.3 1.02 65.5 52.8 1.24 * ‘Missing/DK’ category of ethnicity of household head not shown due to low number of observations (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 7.9; MDG indicator 3.1 2 MICS indicator 7.10; MDG indicator 3.1    Child Protection      Suriname MICS4 135   10. Child Protection    Child Protection 136  Suriname MICS4  Birth Registration The International Convention on the Rights of the Child states that every child has the right to a name and  a nationality and the right to protection from being deprived of his or her  identity.   Birth registration  is a  fundamental means  of  securing  these  rights  for  children.  The World  Fit  for  Children  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 MICS indicator related to birth registration is the percentage of children under 5 years of  age whose birth is registered.  The births of 99 percent of children under five years  in Suriname have been registered (Table CP.1, page  138). There are no major variations in birth registration across sex, age, or education categories. However,  there is slight variation in children that are registered, but have no birth certificate. Even if all are above 90  percent, it is evident that rural children, those whose mothers have no education, those from the poorest  households, and especially those from Marowijne are less in possession of birth certificates, than children  in other categories.  Further questions were asked to mothers of those children that were not registered: Whether the mother  knows how to register the child and what the main reason is for not registering. However, with a total of  just  56  unregistered  children  in  the  sample,  disaggregated  data  cannot  be  presented.  The  total  result  shows that 45 percent of mothers of children that are not registered do know how to register. As far as the  main  reason  for not  registering,  the majority of mothers gave other  reasons  than  those precoded or no  answer at all.  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 he/she performed the following activities:   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.  Table  CP.2  (page  139)  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 Suriname, 10 percent of children 5‐14 years are engaged  in child  labour. While there are no observed  differences across the sexes, there are noteworthy variations across the districts and urban/rural domains  of  Suriname.  In  districts  such  as  Sipaliwini,  Brokopondo,  Para,  and Marowijne,  the  prevalence  of  child  labour  is  observed  to  be  greater  than  the  national  estimate  of  10  percent.  In  the  respective  areas,  prevalence of child labour among children 5‐14 is estimated to be 30 percent, 20 percent, 10 percent and  13 percent.  In  the  remaining districts,  the prevalence of  child  labour  is estimated  to be  lower  than  the  national estimate with a  low of 4 percent  in Nickerie. Marked difference also characterize the prevalence  of child labour in urban and rural areas being estimated to be higher in the latter (17%) than in the former   Child Protection      Suriname MICS4 137 (5%).  In the rural  interior, the prevalence of child  labour  is estimated to be 27 percent while  in the rural  coastal areas, it is estimated to be 8 percent. The prevalence of child labour among children 5‐14 years is  inversely  associated with  children’s  socio‐economic  status  and mother’s  education.  For  children whose  mothers had no education, 25 percent are estimated to be involved in child labour as opposed to 5 percent  among those whose mother had at least secondary education. Over one fifth (21%) of the poorest children  are estimated to be engaged in child labours as opposed to just 2 percent from the wealthiest quintile.  It is interesting to note that most of the child labour prevalence stems from the younger children, age 5‐11,  and from within that group the children that are engaged in economic activity for at least one hour.  Table CP.3  (page 141) 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  96  percent  of  the  children  5‐14  years  of  age  attending school, 9 percent are also  involved  in child  labour activities. On  the other hand, out of  the 10  percent of  the  children  classified as  child  labourers,  the majority of  them are also attending  school  (94  percent). Variation across background variables is similar to those described for Table CP.2.  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  Suriname MICS survey, respondents to the household questionnaire were asked a series of questions on  the ways adults  in the household tend to use to discipline children during the past month preceding the  survey.    Note  that  for  the  child  discipline  module,  one  child  aged  2‐14  per  household  was  selected  randomly during  fieldwork.   Out of  these questions,  the  two  indicators used  to describe aspects of child  discipline  are:  1)  the  number  of  children  2‐14  years  that  experience  psychological  aggression  as  punishment or physical punishment; and 2) the number of respondents who believe that in order to raise  children properly, they need be physically punished.   In Suriname, Table CP.4 (page 142) reveals that 86 percent of children aged 2‐14 years were subjected to  at least one form of violent psychological or physical punishment by household members, with 60 percent  being subjected to any physical punishment. More  importantly, 12 percent of children were subjected to  severe  physical  punishment. On  the  other  hand,  just  13  percent  of  respondents  believed  that  children  should be physically punished, which implies an interesting contrast with the actual prevalence of physical  discipline.  There do not seem to be much, if any, differences between the proportions of boys and of girls whether in  the context of being subjected to physical violence or physical violence that assumes the  form of severe  physical discipline. With respect to the different wealth status groups, it is worth noting that the greatest  proportion  of  children  subjected  to  at  least  one  form  of  psychological  or  physical  violence  has  been  observed  among  the  poorest  set  of  children.  This  is  also  the  case  among  children  who  belonged  to  households where the head had no education whatsoever. The respondents in the poorest households are  also more inclined to believe that children need physical punishment (21%).       Child Protection 138  Suriname MICS4  Table CP.1: Birth registration Percentage of children under age 5 by whether birth is registered and percentage of children not registered whose mothers/caretakers know how to register birth, Suriname, 2010 Children under age 5 whose birth is registered with civil authorities Number of children Has birth certificate No birth certificate Total registered1 Seen Not seen Sex* Male 49.5 45.4 4.3 99.1 1,659 Female 47.4 47.3 3.9 98.7 1,649 District Paramaribo 51.3 45.9 2.4 99.5 1,274 Wanica 47.5 49.8 2.4 99.7 599 Nickerie 45.3 48.8 5.9 100.0 188 Coronie (*) (*) (*) (*) 14 Saramacca 40.0 56.4 2.9 99.3 91 Commewijne 45.9 49.2 4.9 100.0 122 Marowijne 34.3 51.9 9.7 95.9 192 Para 41.4 51.1 5.7 98.3 122 Brokopondo 48.6 43.2 6.9 98.8 167 Sipaliwini 52.9 38.1 6.1 97.0 537 Area Urban 49.6 47.5 2.4 99.6 2,001 Rural Coastal 40.5 50.6 7.1 98.2 603 Rural interior 51.9 39.3 6.3 97.5 705 Total Rural 46.6 44.5 6.7 97.8 1,307 Age 0-11 months 53.7 40.2 4.4 98.3 646 12-23 months 51.4 44.6 3.0 99.1 744 24-35 months 52.0 44.0 3.2 99.2 640 36-47 months 40.5 54.1 4.3 98.9 694 48-59 months 44.5 48.6 6.0 99.1 584 Mother’s education None 54.3 36.9 6.2 97.4 454 Primary 46.6 46.8 4.8 98.2 967 Secondary + 47.4 49.1 3.2 99.7 1,824 Other/Non-standard (74.3) (18.8) (5.6) (98.7) 48 Wealth index quintile Poorest 48.4 42.9 6.7 97.9 1,139 Second 48.8 47.6 2.5 98.8 675 Middle 49.9 46.3 3.2 99.3 563 Fourth 49.9 47.1 2.8 99.8 501 Richest 44.6 52.9 2.5 100.0 429 Ethnicity of household head* Indigenous/Amerindian 48.6 47.9 1.9 98.4 153 Maroon 51.9 40.0 5.9 97.9 1,389 Creole 46.3 48.1 5.1 99.5 428 Hindustani 47.3 50.1 2.6 100.0 644 Javanese 39.0 58.9 2.1 100.0 346 Mixed 48.0 49.9 1.4 99.3 308 Others 57.3 42.7 0.0 100.0 38 Total 48.5 46.3 4.1 98.9 3,308 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 8.1  Ch ild  Pr ot ec tio n          Su rin am e M IC S4 13 9 Ta bl e C P. 2: C hi ld la bo ur P er ce nt ag e of c hi ld re n by in vo lv em en t i n ec on om ic a ct iv ity a nd h ou se ho ld c ho re s du rin g th e pa st w ee k, a cc or di ng to a ge g ro up s, a nd p er ce nt ag e of c hi ld re n ag e 5- 14 in vo lv ed in c hi ld la bo ur , S ur in am e, 2 01 0 Pe rc en ta ge o f c hi ld re n ag e 5- 11 in vo lv ed in : N um be r of ch ild re n ag e 5- 11 Pe rc en ta ge o f c hi ld re n ag e 12 -1 4 in vo lv ed in : N um be r of ch ild re n ag e 12 - 14 To ta l ch ild la bo ur 1 N um be r of ch ild re n ag e 5- 14 ye ar s Ec on om ic a ct iv ity E co no m ic ac tiv ity fo r at le as t on e ho ur H ou se ho ld ch or es le ss th an 28 h ou rs H ou se ho ld ch or es f or 28 ho ur s or m or e C hi ld la bo ur Ec on om ic a ct iv ity E co no m ic ac tiv ity le ss th an 14 h ou rs E co no m ic ac tiv ity fo r 14 ho ur s or m or e H ou se ho ld ch or es le ss th an 28 h ou rs H ou se ho ld ch or es f or 28 ho ur s or m or e C hi ld la bo ur W or ki ng ou ts id e ho us eh ol d W or ki ng fo r fa m ily bu si ne ss W or ki ng ou ts id e ho us eh ol d W or ki ng fo r fa m ily bu si ne ss P ai d w or k U np ai d w or k P ai d w or k U np ai d w or k Se x M al e 0. 9 3. 6 10 .8 13 .6 40 .5 0. 1 13 .6 2, 05 8 3. 5 3. 8 13 .2 17 .6 0. 5 59 .4 0. 0 0. 5 92 1 9. 6 2, 97 9 Fe m al e 1. 1 3. 3 10 .6 13 .2 45 .1 0. 0 13 .2 1, 85 9 2. 1 3. 1 13 .1 15 .3 0. 7 72 .6 0. 0 0. 7 77 0 9. 5 2, 62 8 D is tr ic t P ar am ar ib o 0. 7 2. 5 4. 9 7. 5 36 .0 0. 1 7. 5 1, 58 3 3. 1 1. 9 7. 8 11 .3 0. 5 61 .2 0. 0 0. 5 70 8 5. 3 2, 29 2 W an ic a 0. 2 3. 0 5. 7 8. 7 41 .1 0. 0 8. 7 67 5 2. 5 4. 0 8. 6 13 .6 0. 5 66 .2 0. 0 0. 5 33 3 6. 0 1, 00 9 N ic ke rie 0. 2 1. 7 5. 0 6. 7 40 .6 0. 0 6. 7 23 0 0. 0 4. 9 6. 9 10 .6 0. 0 71 .1 0. 0 0. 0 14 4 4. 1 37 4 C or on ie (4 .2 ) (2 .1 ) (4 .2 ) (1 0. 4) (6 4. 6) (0 .0 ) (1 0. 4) 26 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 10 7. 5 37 S ar am ac ca 0. 4 0. 0 5. 9 6. 4 54 .2 0. 0 6. 4 12 9 2. 3 0. 0 7. 0 8. 1 0. 0 73 .3 0. 0 0. 0 47 4. 7 17 6 C om m ew ijn e 2. 3 0. 3 4. 3 7. 0 38 .7 0. 0 7. 0 16 6 0. 8 0. 0 6. 2 6. 2 0. 0 71 .3 0. 0 0. 0 72 4. 9 23 8 M ar ow ijn e 1. 4 2. 9 13 .9 17 .3 58 .4 0. 0 17 .3 21 1 2. 1 2. 8 17 .9 20 .0 1. 4 78 .6 0. 0 1. 4 74 13 .2 28 4 P ar a 0. 6 0. 9 12 .8 14 .0 53 .6 0. 0 14 .0 19 0 1. 5 0. 8 19 .8 22 .1 0. 0 77 .1 0. 0 0. 0 77 10 .0 26 7 B ro ko po nd o 0. 7 10 .4 19 .3 26 .4 40 .0 0. 0 26 .4 17 3 4. 3 10 .1 24 .6 32 .6 0. 0 55 .1 0. 0 0. 0 59 19 .7 23 2 S ip al iw in i 2. 8 8. 4 35 .1 37 .8 53 .6 0. 2 37 .9 53 2 6. 5 9. 1 46 .5 47 .5 2. 1 63 .2 0. 3 2. 3 16 6 29 .5 69 8 A re a U rb an 0. 7 2. 5 5. 1 7. 8 37 .5 0. 1 7. 8 2, 44 4 2. 6 2. 6 7. 9 11 .8 0. 4 63 .3 0. 0 0. 4 1, 14 5 5. 4 3, 59 0 R ur al C oa st al 0. 9 1. 5 9. 5 11 .4 52 .3 0. 0 11 .4 76 7 1. 5 2. 2 12 .5 14 .6 0. 3 76 .0 0. 0 0. 3 32 0 8. 2 1, 08 7 R ur al in te rio r 2. 3 8. 9 31 .2 35 .0 50 .3 0. 1 35 .1 70 5 6. 0 9. 4 40 .8 43 .6 1. 5 61 .1 0. 2 1. 7 22 5 27 .0 93 0 To ta l R ur al 1. 6 5. 0 19 .9 22 .7 51 .3 0. 1 22 .8 1, 47 2 3. 4 5. 2 24 .2 26 .6 0. 8 69 .8 0. 1 0. 9 54 5 16 .9 2, 01 7 Sc ho ol a tte nd an ce Ye s 1. 0 3. 3 10 .4 13 .2 43 .0 0. 1 13 .2 3, 74 5 2. 8 3. 4 12 .8 16 .2 0. 6 65 .5 0. 0 0. 6 1, 62 6 9. 4 5, 37 1 N o 1. 0 6. 1 16 .1 17 .7 35 .0 0. 3 17 .7 17 2 3. 3 4. 0 22 .3 24 .9 0. 7 63 .4 0. 7 1. 3 65 13 .2 23 6 M ot he r’s e du ca tio n N on e 2. 1 7. 1 30 .8 33 .5 47 .3 0. 1 33 .6 52 9 5. 0 6. 9 36 .2 38 .2 1. 4 56 .4 0. 2 1. 6 18 5 25 .3 71 4 P rim ar y 0. 8 4. 1 12 .5 15 .7 47 .6 0. 2 15 .7 1, 23 6 1. 7 3. 7 18 .3 20 .8 0. 6 67 .0 0. 0 0. 6 55 7 11 .0 1, 79 2 S ec on da ry + 0. 7 2. 0 4. 3 6. 5 38 .4 0. 0 6. 5 2, 04 5 2. 7 2. 6 5. 5 9. 2 0. 4 65 .8 0. 0 0. 4 89 9 4. 6 2, 94 4 O th er /N on -s ta nd ar d 2. 6 5. 9 12 .9 21 .5 46 .2 0. 0 21 .5 64 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 29 14 .7 93 M is si ng /D K 4. 0 5. 2 7. 8 16 .9 43 .1 0. 0 16 .9 42 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 21 11 .2 63  Ch ild  Pr ot ec tio n 14 0  Su rin am e M IC S4   Ta bl e C P. 2: C hi ld la bo ur ( co nt in ue d) P er ce nt ag e of c hi ld re n by in vo lv em en t i n ec on om ic a ct iv ity a nd h ou se ho ld c ho re s du rin g th e pa st w ee k, a cc or di ng to a ge g ro up s, a nd p er ce nt ag e of c hi ld re n ag e 5- 14 in vo lv ed in c hi ld la bo ur , S ur in am e, 2 01 0 Pe rc en ta ge o f c hi ld re n ag e 5- 11 in vo lv ed in : N um be r of ch ild re n ag e 5- 11 Pe rc en ta ge o f c hi ld re n ag e 12 -1 4 in vo lv ed in : N um be r of ch ild re n ag e 12 - 14 To ta l ch ild la bo ur 1 N um be r of ch ild re n ag e 5- 14 ye ar s Ec on om ic a ct iv ity E co no m ic ac tiv ity fo r at le as t on e ho ur H ou se ho ld ch or es le ss th an 28 h ou rs H ou se ho ld ch or es f or 28 ho ur s or m or e C hi ld la bo ur Ec on om ic a ct iv ity E co no m ic ac tiv ity le ss th an 14 h ou rs E co no m ic ac tiv ity fo r 14 ho ur s or m or e H ou se ho ld ch or es le ss th an 28 h ou rs H ou se ho ld ch or es f or 28 ho ur s or m or e C hi ld la bo ur W or ki ng ou ts id e ho us eh ol d W or ki ng fo r fa m ily bu si ne ss W or ki ng ou ts id e ho us eh ol d W or ki ng fo r fa m ily bu si ne ss P ai d w or k U np ai d w or k P ai d w or k U np ai d w or k W ea lth in de x qu in til e P oo re st 1. 6 5. 9 25 .0 27 .7 50 .3 0. 1 27 .8 1, 19 1 4. 7 5. 6 34 .6 36 .7 1. 3 64 .6 0. 1 1. 4 39 3 21 .2 1, 58 4 S ec on d 1. 2 2. 2 7. 3 9. 9 44 .7 0. 0 9. 9 89 5 3. 2 2. 0 12 .2 15 .5 0. 1 67 .8 0. 0 0. 1 38 6 7. 0 1, 28 2 M id dl e 0. 8 2. 8 5. 9 8. 8 38 .2 0. 2 8. 8 68 7 2. 8 3. 4 6. 7 11 .5 0. 7 64 .6 0. 0 0. 7 31 2 6. 3 1, 00 0 Fo ur th 0. 2 2. 7 1. 5 4. 4 39 .5 0. 0 4. 4 58 7 2. 2 4. 1 5. 2 10 .2 0. 6 67 .1 0. 0 0. 6 30 0 3. 1 88 7 R ic he st 0. 6 1. 8 1. 1 3. 5 32 .0 0. 0 3. 5 55 6 0. 7 1. 8 0. 7 3. 1 0. 0 62 .4 0. 0 0. 0 29 9 2. 3 85 5 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 0. 7 2. 5 17 .0 18 .6 52 .3 0. 2 18 .6 23 2 1. 9 3. 3 19 .5 20 .0 0. 5 73 .1 0. 0 0. 5 96 13 .3 32 8 M ar oo n 1. 4 5. 5 19 .0 22 .2 46 .1 0. 0 22 .3 1, 53 4 3. 9 4. 6 24 .2 27 .0 1. 0 66 .2 0. 1 1. 1 53 0 16 .8 2, 06 4 C re ol e 0. 8 3. 0 4. 6 7. 5 38 .5 0. 0 7. 5 59 0 4. 4 1. 4 7. 5 11 .3 0. 6 62 .4 0. 0 0. 6 28 1 5. 3 87 1 H in du st an i 0. 6 2. 3 4. 4 7. 0 42 .6 0. 2 7. 0 78 4 2. 1 3. 1 8. 2 12 .5 0. 0 65 .1 0. 0 0. 0 42 8 4. 6 1, 21 3 Ja va ne se 1. 4 0. 1 3. 8 4. 9 38 .7 0. 0 4. 9 40 5 1. 8 3. 7 4. 0 7. 6 0. 9 66 .6 0. 0 0. 9 18 2 3. 7 58 8 M ix ed 0. 7 2. 5 2. 7 5. 9 34 .1 0. 0 5. 9 31 7 1. 0 4. 5 4. 5 9. 4 0. 3 63 .5 0. 0 0. 3 14 7 4. 1 46 4 O th er s (0 .0 ) (0 .0 ) (3 .2 ) (3 .2 ) (2 9. 9) (0 .0 ) (3 .2 ) 48 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 26 2. 1 74 To ta l 1. 0 3. 5 10 .7 13 .4 42 .7 0. 1 13 .4 3, 91 6 2. 9 3. 4 13 .1 16 .6 0. 6 65 .4 0. 0 0. 6 1, 69 1 9. 6 5, 60 7 * ‘M is si ng /D K ’ c at eg or y of e th ni ci ty o f h ou se ho ld h ea d no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 8 .2      Child Protection      Suriname MICS4 141 Table CP.3: Child labour and school attendance Percentage of children age 5-14 years involved in child labour who are attending school, and percentage of children age 5-14 years attending school who are involved in child labour, Suriname, 2010 Percentage of children involved in child labour Percentage of children attending school Number of children age 5-14 years Percentage of child labourers who are attending school1 Number of children age 5-14 years involved in child labour Percentage of children attending school who are involved in child labour2 Number of children age 5-14 years attending school Sex Male 9.6 95.2 2,979 93.8 285 9.4 2,835 Female 9.5 96.5 2,628 94.6 250 9.3 2,536 District Paramaribo 5.3 97.5 2,292 100.0 122 5.4 2,233 Wanica 6.0 96.0 1,009 (100.0) 61 6.3 968 Nickerie 4.1 97.7 374 (*) 15 4.0 365 Coronie 7.5 100.0 37 (*) 3 7.5 37 Saramacca 4.7 98.1 176 (*) 8 4.7 173 Commewijne 4.9 97.9 238 (*) 12 5.0 233 Marowijne 13.2 95.4 284 94.6 38 13.1 271 Para 10.0 98.5 267 (100.0) 27 10.1 263 Brokopondo 19.7 93.7 232 96.3 46 20.2 217 Sipaliwini 29.5 87.3 698 86.9 206 29.3 610 Area Urban 5.4 97.1 3,590 100.0 195 5.6 3,486 Rural Coastal 8.2 97.3 1,087 97.1 89 8.2 1,058 Rural interior 27.0 88.9 930 88.6 251 26.9 827 Total Rural 16.9 93.4 2,017 90.8 340 16.4 1,885 Age 5-11 13.4 95.6 3,916 94.2 526 13.2 3,745 12-14 0.6 96.2 1,691 (*) 10 0.6 1,626 Mother’s education None 25.3 85.8 714 86.5 181 25.5 613 Primary 11.0 95.7 1,792 97.0 197 11.2 1,716 Secondary + 4.6 98.1 2,944 99.3 137 4.7 2,889 Other/Non-standard 14.7 99.1 93 (*) 14 14.8 92 Missing/DK 11.2 95.8 63 (*) 7 11.7 61 Wealth index quintile Poorest 21.2 91.1 1,584 91.0 336 21.2 1,443 Second 7.0 96.1 1,282 99.0 89 7.2 1,231 Middle 6.3 97.8 1,000 100.0 63 6.4 977 Fourth 3.1 99.0 887 (*) 28 3.2 879 Richest 2.3 98.3 855 (*) 20 2.3 840 Ethnicity of household head* Indigenous/Amerindian 13.3 96.4 328 92.8 44 12.8 316 Maroon 16.8 92.5 2,064 91.9 347 16.7 1,910 Creole 5.3 98.5 871 (100.0) 46 5.4 858 Hindustani 4.6 97.5 1,213 (100.0) 55 4.7 1,182 Javanese 3.7 97.7 588 (*) 22 3.7 574 Mixed 4.1 97.4 464 (*) 19 4.2 451 Others 2.1 97.8 74 (*) 2 2.1 73 Total 9.6 95.8 5,607 94.2 536 9.4 5,371 * ‘Missing/DK’ category of ethnicity of household head not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 8.3 2 MICS indicator 8.4      Child Protection 142  Suriname MICS4  Table CP.4: Child discipline Percentage of children age 2-14 years according to method of disciplining the child, Suriname, 2010 Percentage of children age 2-14 years who experienced: Number of children age 2-14 years Respondent believes that a child needs to be physically punished Respondents to the child discipline module Only non- violent discipline Psychological aggression Physical punishment Any violent discipline method1 Any Severe Sex Male 7.8 83.2 61.0 11.8 87.0 3,774 13.6 1,869 Female 9.4 80.0 58.6 11.9 85.1 3,526 12.3 1,737 District Paramaribo 11.0 78.9 59.0 11.9 85.0 2,925 13.2 1,587 Wanica 9.1 81.4 52.6 5.8 84.5 1,325 7.6 665 Nickerie 12.0 77.5 49.4 6.7 81.4 467 7.3 261 Coronie 12.3 84.0 46.9 14.8 86.4 44 (14.3) 23 Saramacca 11.6 79.1 48.8 1.7 83.7 222 6.0 119 Commewijne 8.6 78.3 52.1 4.9 83.4 297 6.2 160 Marowijne 5.9 85.4 62.9 12.6 87.0 376 12.6 140 Para 4.8 86.7 57.9 8.1 91.2 334 9.2 135 Brokopondo 2.8 87.6 72.9 20.7 90.3 321 17.6 119 Sipaliwini 2.3 88.5 77.4 24.3 91.5 989 29.4 396 Area Urban 10.2 79.6 56.6 9.6 84.7 4,597 11.1 2,428 Rural Coastal 8.8 82.2 55.1 8.3 85.8 1,393 9.0 664 Rural interior 2.4 88.3 76.3 23.4 91.2 1,310 26.7 515 Total Rural 5.7 85.1 65.4 15.6 88.4 2,704 16.7 1,179 Age 2-4 years 6.9 81.8 65.9 8.9 86.5 1,673 11.9 863 5-9 years 8.9 81.4 65.4 13.4 86.8 2,823 13.2 1,316 10-14 years 9.2 81.8 50.6 12.0 85.1 2,805 13.4 1,427 Education of household head None 3.2 87.9 73.4 22.2 90.0 1,003 na na Primary 7.9 81.5 61.6 13.0 86.1 2,331 na na Secondary + 11.3 79.7 53.5 7.8 84.4 3,468 na na Other/Non-standard 0.0 82.4 62.2 10.9 89.3 104 na na Missing/DK 4.0 83.8 70.0 14.0 90.6 395 na na Respondent's education None na na na na na na 27.6 355 Primary na na na na na na 14.7 982 Secondary + na na na na na na 9.7 2,182 Non-standard na na na na na na 17.6 72 Wealth index quintile Poorest 3.4 87.9 72.9 19.2 91.5 2,192 21.3 852 Second 6.6 83.9 62.7 11.7 88.1 1,633 12.2 767 Middle 11.9 75.2 53.6 8.4 81.3 1,274 11.2 665 Fourth 12.5 79.4 50.3 8.4 83.4 1,129 11.1 646 Richest 14.0 75.7 46.2 4.5 80.5 1,072 6.8 676 Ethnicity of household head* Indigenous/Amerindian 8.9 76.6 56.5 17.0 82.0 403 12.6 172 Maroon 2.5 88.9 73.7 18.4 92.1 2,806 21.7 1,057 Creole 11.6 75.6 57.8 10.0 84.1 1,090 13.8 593 Hindustani 12.4 77.1 47.3 5.3 81.4 1,530 7.4 912 Javanese 15.2 79.4 45.2 2.8 81.2 764 5.7 482 Mixed 12.1 77.7 55.7 10.1 84.2 607 10.2 333 Others 16.5 73.6 30.0 4.2 74.3 91 (10.2) 55 Total 8.6 81.7 59.8 11.8 86.1 7,301 13.0 3,606 * ‘Missing/DK’ category of ethnicity of household head not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 8.5  Child Protection      Suriname MICS4 143 Early Marriage and Polygyny Marriage before the age of 18 is a reality for many young girls. According to UNICEF's worldwide estimates,  over 60 million women age 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  and  practices 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.   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 puts them at increased risk of HIV  infection. The demand for such young wives 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 of age and the  percentage married before 18 years of age. The percentage of women married at various ages is provided  in Table CP.5  (page 145). Among women 20‐49 years  in Suriname, almost 6 percent have been married  before  their  15th  birthday  and  23  percent  before  their  18th  birthday.  The  respective  proportions  are  greatest in Sipaliwini (20% and 50%) and Brokopondo (11% and 45%) and hence in the rural interior (19%  and 48%). The proportions married before their 15th and 18th birthdays also vary  inversely with women’s  education and wealth quintile. For women with no education, respective proportions are estimated to be  19 percent and 48 percent being much  lower at 3 percent and 14 percent,  respectively, among women  with at least secondary education. For the poorest women, respective proportions have been estimated to  be almost 15 percent and 42 percent  compared  to 2 percent and 11 percent among  the women  in  the  richest households. Among women 15‐19 years, 12 percent were estimated  to have been married or  in  union at the time of the survey. Among women 15‐49 years, 5 percent were married before age 15 and 4  percent  are  in  a polygynous marriage or union  at  the  time of  the  survey.  For women 15‐49  years,  the  proportion in polygynous marriage or union is by far the greatest in Sipaliwini (24%) and to a much lesser  extent  in Brokopondo  (11%). Third on  the  list  is Marowijne at 5 percent. The proportion  in polygynous  marriage or union varies  inversely with women’s education and wealth status group. For women with no  education,  the  proportion  is  estimated  to  be  26  percent  and  much  higher  than  2  percent  that  is  characteristic  of  the  experience  of  women  with  at  least  secondary  education.  For  the  women  in  the  poorest  households,  the  proportion  is  estimated  to  be  14  percent  and  for  the  women  in  the  richest  households it is estimated to be less than 1 percent.  Table CP.6 (page 147) presents the proportion of women who were first married or entered into a marital  union before age 15 and 18 by area and age groups. Examining the percentages married before age 15 and  18 by different age groups allow observation of trends in early marriage over time. While the picture is not   Child Protection 144  Suriname MICS4  completely clear,  there does seem  to be a drop  in marriage before age 18  in  the  rural coastal area and  likely also in the urban areas. For the rural interior, the trend is there for a reduction in marriages before  age 15, but not for marriages under age 18.   Another  component  is  the  spousal age difference with an  indicator being  the percentage of married/in  union women with a difference of 10 or more years younger than their current spouse. Table CP.7 (page  148) presents the results of the age difference between husbands and wives. The relatively low number of  young married women does not allow for observations on background characteristics for women age 15‐ 19 and to a certain extent not even for those aged 20‐24.   For women 15‐19 years, 15 percent of them are estimated to be married or in union with a man who is at  least 10 years older. For women 20‐24 years, the corresponding proportion is estimated to be 17 percent.   Ch ild  Pr ot ec tio n          Su rin am e M IC S4 14 5 Ta bl e C P. 5: E ar ly m ar ria ge a nd P ol yg yn y P er ce nt ag e of w om en a ge 1 5- 49 y ea rs w ho fi rs t m ar rie d or e nt er ed a m ar ita l u ni on b ef or e th ei r 1 5t h bi rth da y, p er ce nt ag es o f w om en a ge 2 0- 49 y ea rs w ho fi rs t m ar rie d or e nt er ed a m ar ita l u ni on b ef or e th ei r 15 th a nd 1 8t h bi rth da ys , pe rc en ta ge o f w om en a ge 1 5- 19 y ea rs c ur re nt ly m ar rie d or in u ni on , an d th e pe rc en ta ge o f w om en cu rr en tly m ar rie d or in u ni on w ho a re in a p ol yg yn ou s m ar ria ge o r u ni on , S ur in am e, 2 01 0 P er ce nt ag e m ar rie d be fo re a ge 15 1 N um be r o f w om en ag e 15 -4 9 ye ar s P er ce nt ag e m ar rie d be fo re a ge 15 P er ce nt ag e m ar rie d be fo re a ge 18 2 N um be r o f w om en ag e 20 -4 9 ye ar s P er ce nt ag e of w om en 1 5- 19 y ea rs cu rr en tly m ar rie d/ in un io n3 N um be r o f w om en ag e 15 -1 9 ye ar s P er ce nt ag e of w om en a ge 1 5- 49 y ea rs in po ly gy no us m ar ria ge / u ni on 4 N um be r o f w om en a ge 1 5- 49 y ea rs cu rr en tly m ar rie d/ in u ni on D is tr ic t P ar am ar ib o 3. 6 3, 03 7 3. 6 14 .5 2, 52 9 9. 4 50 8 2. 9 1, 48 4 W an ic a 4. 3 1, 25 2 4. 9 24 .8 1, 03 3 13 .0 21 9 2. 7 73 5 N ic ke rie 4. 6 47 1 5. 1 28 .7 38 8 14 .8 83 0. 3 32 6 C or on ie 3. 4 31 2. 0 18 .0 26 (* ) 4 (2 .9 ) 18 S ar am ac ca 1. 9 19 8 2. 2 28 .6 17 2 16 .0 26 1. 1 15 1 C om m ew ijn e 5. 1 29 6 5. 2 27 .3 23 8 15 .2 57 0. 8 20 3 M ar ow ijn e 9. 4 20 8 10 .6 29 .3 16 2 8. 5 46 5. 1 10 5 P ar a 6. 9 20 5 8. 7 34 .0 16 4 8. 3 41 2. 6 10 9 B ro ko po nd o 11 .8 13 2 11 .1 45 .2 10 8 29 .5 24 11 .3 67 S ip al iw in i 17 .9 46 1 19 .6 50 .2 38 5 15 .5 76 24 .4 20 8 A re a U rb an 3. 8 4, 62 0 4. 0 18 .0 3, 82 6 10 .4 79 4 2. 7 2, 43 0 R ur al C oa st al 5. 8 1, 07 7 6. 4 30 .1 88 7 13 .6 19 0 1. 6 70 1 R ur al in te rio r 16 .5 59 3 17 .8 49 .1 49 3 18 .9 10 0 21 .2 27 5 To ta l R ur al 9. 6 1, 67 0 10 .4 36 .9 1, 37 9 15 .4 29 1 7. 1 97 6 A ge 15 -1 9 3. 8 1, 08 5 na na na 11 .8 1, 08 5 2. 9 12 8 20 -2 4 5. 2 99 1 5. 2 18 .8 99 1 na na 2. 7 38 6 25 -2 9 4. 1 97 2 4. 1 21 .3 97 2 na na 4. 5 58 5 30 -3 4 5. 7 81 6 5. 7 23 .8 81 6 na na 3. 7 56 6 35 -3 9 6. 4 85 2 6. 4 27 .1 85 2 na na 4. 4 62 8 40 -4 4 7. 4 83 1 7. 4 23 .2 83 1 na na 4. 4 60 8 45 -4 9 5. 8 74 3 5. 8 24 .9 74 3 na na 3. 7 50 6      Ch ild  Pr ot ec tio n 14 6  Su rin am e M IC S4   Ta bl e C P. 5: E ar ly m ar ria ge a nd P ol yg yn y P er ce nt ag e of w om en a ge 1 5- 49 y ea rs w ho fi rs t m ar rie d or e nt er ed a m ar ita l u ni on b ef or e th ei r 1 5t h bi rth da y, p er ce nt ag es o f w om en a ge 2 0- 49 y ea rs w ho fi rs t m ar rie d or e nt er ed a m ar ita l u ni on b ef or e th ei r 15 th a nd 1 8t h bi rth da ys , pe rc en ta ge o f w om en a ge 1 5- 19 y ea rs c ur re nt ly m ar rie d or in u ni on , an d th e pe rc en ta ge o f w om en cu rr en tly m ar rie d or in u ni on w ho a re in a p ol yg yn ou s m ar ria ge o r u ni on , S ur in am e, 2 01 0 P er ce nt ag e m ar rie d be fo re a ge 15 1 N um be r o f w om en ag e 15 -4 9 ye ar s P er ce nt ag e m ar rie d be fo re a ge 15 P er ce nt ag e m ar rie d be fo re a ge 18 2 N um be r o f w om en ag e 20 -4 9 ye ar s P er ce nt ag e of w om en 1 5- 19 y ea rs cu rr en tly m ar rie d/ in un io n3 N um be r o f w om en ag e 15 -1 9 ye ar s P er ce nt ag e of w om en a ge 1 5- 49 y ea rs in po ly gy no us m ar ria ge / u ni on 4 N um be r o f w om en a ge 1 5- 49 y ea rs cu rr en tly m ar rie d/ in u ni on Ed uc at io n* N on e 18 .6 36 1 19 .2 47 .7 34 5 19 .9 16 26 .4 17 4 P rim ar y 11 .9 1, 33 5 11 .9 45 .2 1, 15 2 16 .9 18 3 5. 5 85 9 S ec on da ry + 2. 4 4, 46 3 2. 5 13 .6 3, 58 6 10 .5 87 7 1. 8 2, 29 4 O th er /N on -s ta nd ar d 3. 4 11 1 3. 6 18 .7 10 4 (* ) 7 (0 .7 ) 60 W ea lth in de x qu in til e P oo re st 13 .7 1, 11 7 14 .6 42 .1 89 8 19 .8 22 0 14 .0 52 9 S ec on d 6. 6 1, 23 1 7. 4 30 .3 1, 00 8 11 .3 22 3 5. 7 68 5 M id dl e 3. 9 1, 27 6 4. 2 19 .4 1, 06 5 13 .5 21 1 1. 5 71 2 Fo ur th 2. 2 1, 32 8 2. 1 16 .6 1, 11 6 10 .6 21 1 0. 9 75 9 R ic he st 1. 8 1, 33 9 2. 0 11 .0 1, 11 9 3. 8 22 0 0. 5 72 0 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 12 .2 24 6 13 .2 38 .9 20 1 15 .4 45 1. 1 15 9 M ar oo n 9. 5 1, 51 0 10 .5 33 .0 1, 18 7 11 .1 32 3 17 .4 57 0 C re ol e 2. 2 1, 05 6 2. 3 9. 5 87 8 4. 3 17 8 2. 1 43 4 H in du st an i 3. 6 1, 85 1 3. 9 23 .7 1, 57 0 13 .2 28 1 1. 5 1, 21 6 Ja va ne se 5. 1 87 0 5. 1 24 .0 72 1 19 .2 14 9 0. 4 60 1 M ix ed 3. 8 62 1 4. 1 16 .2 53 1 11 .1 90 1. 0 33 6 O th er s 4. 6 13 1 3. 9 9. 6 11 3 (* ) 18 0. 0 88 To ta l 5. 4 6, 29 0 5. 7 23 .0 5, 20 5 11 .8 1, 08 5 3. 9 3, 40 6 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 8 .6 2 M IC S in di ca to r 8 .7 3 M IC S in di ca to r 8 .8 4 M IC S in di ca to r 8 .9  Ch ild  Pr ot ec tio n          Su rin am e M IC S4 14 7 Ta bl e C P. 6: T re nd s in e ar ly m ar ria ge P er ce nt ag e of w om en w ho w er e fir st m ar rie d or e nt er ed in to a m ar ita l u ni on b ef or e ag e 15 a nd 1 8, b y ar ea a nd a ge g ro up s, S ur in am e, 2 01 0 U rb an R ur al C oa st al R ur al In te rio r To ta l R ur al A ll Pe rc en ta ge of w om en m ar rie d be fo re a ge 15 N um be r of w om en ag e 15 - 49 Pe rc en ta ge of w om en m ar rie d be fo re a ge 18 N um be r of w om en ag e 20 - 49 Pe rc en ta ge of w om en m ar rie d be fo re a ge 15 N um be r of w om en ag e 15 - 49 Pe rc en ta ge of w om en m ar rie d be fo re a ge 18 N um be r of w om en ag e 20 - 49 Pe rc en ta ge of w om en m ar rie d be fo re a ge 15 N um be r of w om en ag e 15 - 49 Pe rc en ta ge of w om en m ar rie d be fo re a ge 18 N um be r of w om en ag e 20 - 49 Pe rc en ta ge of w om en m ar rie d be fo re a ge 15 N um be r of w om en ag e 15 - 49 Pe rc en ta ge of w om en m ar rie d be fo re a ge 18 N um be r of w om en ag e 20 - 49 Pe rc en ta ge of w om en m ar rie d be fo re a ge 15 N um be r of w om en ag e 15 - 49 Pe rc en ta ge of w om en m ar rie d be fo re a ge 18 N um be r of w om en ag e 20 - 49 A ge 15 -1 9 3. 1 79 4 na na 3. 2 19 0 na na 10 .5 10 0 na na 5. 7 29 1 na na 3. 8 1, 08 5 na na 20 -2 4 3. 8 74 5 14 .2 74 5 5. 4 16 4 24 .1 16 4 17 .2 82 50 .1 82 9. 4 24 6 32 .8 24 6 5. 2 99 1 18 .8 99 1 25 -2 9 1. 9 70 6 15 .5 70 6 6. 0 15 8 31 .0 15 8 15 .8 10 7 45 .5 10 7 10 .0 26 6 36 .9 26 6 4. 1 97 2 21 .3 97 2 30 -3 4 3. 7 58 5 18 .1 58 5 9. 0 14 8 31 .4 14 8 13 .7 82 50 .0 82 10 .7 23 1 38 .1 23 1 5. 7 81 6 23 .8 81 6 35 -3 9 5. 1 62 0 23 .3 62 0 5. 8 15 5 30 .9 15 5 18 .5 77 49 .7 77 10 .0 23 2 37 .1 23 2 6. 4 85 2 27 .1 85 2 40 -4 4 6. 0 60 5 18 .4 60 5 5. 9 14 5 30 .2 14 5 20 .3 82 47 .1 82 11 .1 22 6 36 .3 22 6 7. 4 83 1 23 .2 83 1 45 -4 9 3. 8 56 5 19 .7 56 5 6. 2 11 6 34 .4 11 6 22 .9 62 54 .9 62 12 .0 17 8 41 .5 17 8 5. 8 74 3 24 .9 74 3 To ta l 3. 8 4, 62 0 18 .0 3, 82 6 5. 8 1, 07 7 30 .1 88 7 16 .5 59 3 49 .1 49 3 9. 6 1, 67 0 36 .9 1, 37 9 5. 4 6, 29 0 23 .0 5, 20 5      Ch ild  Pr ot ec tio n 14 8  Su rin am e M IC S4   Ta bl e C P. 7: S po us al a ge d iff er en ce P er ce nt d is tri bu tio n of w om en c ur re nt ly m ar rie d/ in u ni on a ge 1 5- 19 a nd 2 0- 24 y ea rs a cc or di ng to th e ag e di ffe re nc e w ith th ei r h us ba nd o r p ar tn er , S ur in am e, 2 01 0 Pe rc en ta ge o f cu rr en tly m ar rie d/ in u ni on w om en a ge 1 5- 19 ye ar s w ho se h us ba nd o r p ar tn er is : N um be r of w om en ag e 15 - 19 y ea rs cu rr en tly m ar rie d/ in u ni on Pe rc en ta ge o f cu rr en tly m ar rie d/ in u ni on w om en a ge 2 0- 24 ye ar s w ho se h us ba nd o r p ar tn er is : N um be r of w om en ag e 20 - 24 y ea rs cu rr en tly m ar rie d/ in u ni on Yo un ge r 0- 4 ye ar s ol de r 5- 9 ye ar s ol de r 10 + ye ar s ol de r1 H us ba nd /P ar tn er 's ag e un kn ow n To ta l Yo un ge r 0- 4 ye ar s ol de r 5- 9 ye ar s ol de r 10 + ye ar s ol de r2 H us ba nd /P ar tn er 's ag e un kn ow n To ta l D is tr ic t P ar am ar ib o (0 .0 ) (4 4. 8) (4 1. 4) (1 3. 8) (0 .0 ) 10 0. 0 48 5. 8 46 .2 32 .7 14 .4 1. 0 10 0. 0 17 2 W an ic a (* ) (* ) (* ) (* ) (* ) 10 0. 0 28 (2 .9 ) (3 8. 2) (3 5. 3) (2 3. 5) (0 .0 ) 10 0. 0 57 N ic ke rie (* ) (* ) (* ) (* ) (* ) 10 0. 0 12 4. 9 31 .0 39 .4 21 .0 3. 7 10 0. 0 43 C or on ie - - - - - 10 0. 0 0 (* ) (* ) (* ) (* ) (* ) 10 0. 0 3 S ar am ac ca (* ) (* ) (* ) (* ) (* ) 10 0. 0 4 (1 5. 8) (3 1. 6) (3 4. 2) (1 8. 4) (0 .0 ) 10 0. 0 20 C om m ew ijn e (* ) (* ) (* ) (* ) (* ) 10 0. 0 9 (4 .6 ) (1 8. 5) (4 6. 5) (3 0. 3) (0 .0 ) 10 0. 0 23 M ar ow ijn e (* ) (* ) (* ) (* ) (* ) 10 0. 0 4 (3 .2 ) (5 1. 6) (2 9. 0) (1 2. 9) (3 .2 ) 10 0. 0 15 P ar a (* ) (* ) (* ) (* ) (* ) 10 0. 0 3 (* ) (* ) (* ) (* ) (* ) 10 0. 0 9 B ro ko po nd o (* ) (* ) (* ) (* ) (* ) 10 0. 0 7 (3 .3 ) (3 0. 0) (3 3. 3) (1 3. 3) (2 0. 0) 10 0. 0 12 S ip al iw in i (0 .0 ) (3 7. 9) (2 4. 1) (2 4. 1) (1 3. 8) 10 0. 0 12 6. 2 28 .7 27 .5 12 .5 25 .0 10 0. 0 32 A re a U rb an 0. 0 44 .0 40 .1 13 .9 2. 0 10 0. 0 83 4. 5 42 .7 33 .8 17 .8 1. 3 10 0. 0 26 0 R ur al C oa st al (0 .0 ) (2 8. 8) (5 4. 8) (1 4. 2) (2 .2 ) 10 0. 0 26 9. 0 35 .8 36 .6 17 .3 1. 3 10 0. 0 82 R ur al in te rio r (0 .0 ) (3 8. 3) (3 1. 8) (1 9. 2) (1 0. 7) 10 0. 0 19 5. 5 29 .1 29 .1 12 .7 23 .7 10 0. 0 44 To ta l R ur al 0. 0 32 .8 45 .1 16 .3 5. 8 10 0. 0 45 7. 8 33 .5 34 .0 15 .7 9. 1 10 0. 0 12 7 A ge 15 -1 9 0. 0 40 .1 41 .8 14 .7 3. 3 10 0. 0 12 8 na na na na na na na 20 -2 4 na na na na na na na 5. 6 39 .7 33 .8 17 .1 3. 8 10 0. 0 38 6 Ed uc at io n N on e (* ) (* ) (* ) (* ) (* ) 10 0. 0 3 (2 .4 ) (2 1. 8) (4 3. 9) (5 .5 ) (2 6. 4) 10 0. 0 17 P rim ar y (0 .0 ) (5 1. 9) (3 2. 1) (1 1. 5) (4 .4 ) 10 0. 0 31 2. 6 28 .8 33 .7 26 .1 8. 8 10 0. 0 81 S ec on da ry + 0. 0 36 .2 47 .1 13 .9 2. 7 10 0. 0 92 6. 1 44 .2 34 .1 14 .5 1. 2 10 0. 0 28 2 O th er /N on -s ta nd ar d (* ) (* ) (* ) (* ) (* ) 10 0. 0 0 (* ) (* ) (* ) (* ) (* ) 10 0. 0 5      Ch ild  Pr ot ec tio n          Su rin am e M IC S4 14 9 Ta bl e C P. 7: S po us al a ge d iff er en ce P er ce nt d is tri bu tio n of w om en c ur re nt ly m ar rie d/ in u ni on a ge 1 5- 19 a nd 2 0- 24 y ea rs a cc or di ng to th e ag e di ffe re nc e w ith th ei r h us ba nd o r p ar tn er , S ur in am e, 2 01 0 Pe rc en ta ge o f cu rr en tly m ar rie d/ in u ni on w om en a ge 1 5- 19 ye ar s w ho se h us ba nd o r p ar tn er is : N um be r of w om en ag e 15 - 19 y ea rs cu rr en tly m ar rie d/ in u ni on Pe rc en ta ge o f cu rr en tly m ar rie d/ in u ni on w om en a ge 2 0- 24 ye ar s w ho se h us ba nd o r p ar tn er is : N um be r of w om en ag e 20 - 24 y ea rs cu rr en tly m ar rie d/ in u ni on Yo un ge r 0- 4 ye ar s ol de r 5- 9 ye ar s ol de r 10 + ye ar s ol de r1 H us ba nd /P ar tn er 's ag e un kn ow n To ta l Yo un ge r 0- 4 ye ar s ol de r 5- 9 ye ar s ol de r 10 + ye ar s ol de r2 H us ba nd /P ar tn er 's ag e un kn ow n To ta l W ea lth in de x qu in til e P oo re st 0. 0 37 .6 39 .4 18 .4 4. 7 10 0. 0 43 4. 4 29 .5 37 .2 15 .4 13 .5 10 0. 0 83 S ec on d (0 .0 ) (2 7. 5) (5 9. 6) (1 0. 6) (2 .3 ) 10 0. 0 25 5. 2 36 .5 33 .0 23 .0 2. 3 10 0. 0 90 M id dl e (0 .0 ) (6 1. 6) (3 4. 6) (3 .8 ) (0 .0 ) 10 0. 0 28 7. 1 48 .9 28 .3 13 .3 2. 4 10 0. 0 69 Fo ur th (* ) (* ) (* ) (* ) (* ) 10 0. 0 22 7. 5 38 .3 37 .0 17 .2 0. 0 10 0. 0 73 R ic he st (* ) (* ) (* ) (* ) (* ) 10 0. 0 8 3. 8 47 .8 33 .1 15 .3 0. 0 10 0. 0 71 Et hn ic ity o f h ou se ho ld h ea d In di ge no us /A m er in di an (* ) (* ) (* ) (* ) (* ) 10 0. 0 7 (2 0. 6) (2 3. 3) (3 8. 3) (1 7. 8) (0 .0 ) 10 0. 0 18 M ar oo n 0. 0 31 .7 42 .6 18 .5 7. 2 10 0. 0 36 3. 7 32 .8 38 .0 11 .0 14 .5 10 0. 0 80 C re ol e (* ) (* ) (* ) (* ) (* ) 10 0. 0 8 0. 0 57 .3 19 .2 23 .5 0. 0 10 0. 0 52 H in du st an i (0 .0 ) (4 0. 2) (4 3. 7) (1 6. 1) (0 .0 ) 10 0. 0 37 3. 6 36 .1 41 .8 17 .2 1. 3 10 0. 0 12 0 Ja va ne se (* ) (* ) (* ) (* ) (* ) 10 0. 0 29 7. 1 43 .0 28 .4 19 .6 2. 0 10 0. 0 84 M ix ed (* ) (* ) (* ) (* ) (* ) 10 0. 0 10 (* ) (* ) (* ) (* ) (* ) 10 0. 0 27 O th er s (* ) (* ) (* ) (* ) (* ) 10 0. 0 2 (* ) (* ) (* ) (* ) (* ) 10 0. 0 6 To ta l 0. 0 40 .1 41 .8 14 .7 3. 3 10 0. 0 12 8 5. 6 39 .7 33 .8 17 .1 3. 8 10 0. 0 38 6 * ‘M is si ng /D K ’ c at eg or y of e du ca tio n no t s ho w n du e to lo w n um be r o f o bs er va tio ns ( ) F ig ur es th at a re b as ed o n 25 -4 9 un w ei gh te d ca se s (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 8 .1 0a 2 M IC S in di ca to r 8 .1 0b      Child Protection 150  Suriname MICS4  Attitudes toward Domestic Violence The Suriname MICS4 assessed the attitudes of women age 15‐49 years towards wife/partner beating for a  variety  of  scenarios  by  asking  the  respondents  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.8 (page 151). Overall, 13 percent of women age  15‐49 believe a husband is justified in beating his wife/partner for any of the reasons mentioned. Neglect  of children is the most common reason given why women believe that a man is justified in beating his wife  / partner. In fact, neglect of children is the most common reason irrespective of the women’s background  characteristics. Other  reasons  frequently mentioned by  the women are: “if  she goes out without  telling  him” (3%) and “if she argues with him” (4%).  With respect to the belief that a husband is justified in beating his wife/partner, this was mostly prevalent  among women  from  Sipaliwini  (27%)  and Brokopondo  (30%)  and hence women  from  the  rural  interior  (27%). Paramaribo  is  the only district  that  recorded  less  than 10 percent acceptance. The prevalence of  such a belief was  inversely associated with women’s education and wealth quintile. For women with no  education, the prevalence is estimated to be 26 percent and much higher than 10 percent observed in the  case of women with at least secondary education. For the poorest women, the acceptance is estimated to  be 22 percent and for the women of the richest households, it is estimated to be 6 percent.  Interestingly, the level of acceptance drops with age of the woman, ranging from 19 percent for 15‐19 year  olds to less than 10 percent for 40‐49 year olds.       Child Protection      Suriname MICS4 151 Table CP.8: Attitudes toward domestic violence Percentage of women age 15-49 years who believe a husband is justified in beating his wife/partner in various circumstances, Suriname, 2010 Percentage of women age 15-49 years who believe a husband is justified in beating his wife/partner: Number of women age 15-49 years If she goes out without telling him If she neglects the children If she argues with him If she refuses sex with him If she burns the food For any of these reasons1 District Paramaribo 1.9 6.7 2.0 0.7 0.5 8.8 3,037 Wanica 2.7 8.7 3.2 0.9 1.5 12.1 1,252 Nickerie 4.1 13.8 5.6 1.6 2.2 17.0 471 Coronie 0.0 15.5 3.4 1.7 0.0 19.0 31 Saramacca 2.4 8.5 1.9 1.1 0.5 10.1 198 Commewijne 3.5 8.3 2.8 2.2 0.4 11.9 296 Marowijne 3.5 12.2 6.1 1.2 1.9 16.5 208 Para 3.1 9.2 4.7 1.9 1.9 13.3 205 Brokopondo 10.3 23.9 7.3 3.3 6.0 29.6 132 Sipaliwini 10.4 19.8 11.5 4.7 5.3 26.8 461 Area Urban 2.2 7.6 2.5 0.8 0.9 10.1 4,620 Rural Coastal 3.2 10.8 4.2 1.7 1.4 14.3 1,077 Rural interior 10.4 20.7 10.5 4.4 5.5 27.4 593 Total Rural 5.8 14.3 6.4 2.6 2.9 19.0 1,670 Age 15-19 4.3 14.9 3.7 0.8 2.0 19.1 1,085 20-24 3.4 11.7 3.5 0.9 1.4 14.9 991 25-29 3.3 8.2 3.2 1.5 1.4 11.6 972 30-34 2.8 8.5 4.0 1.4 1.3 10.8 816 35-39 2.6 8.5 3.1 1.6 1.2 11.2 852 40-44 2.6 6.5 3.8 1.4 1.3 8.4 831 45-49 2.8 5.1 4.0 1.5 0.9 8.5 743 Marital/Union status* Currently married/in union 3.0 8.5 3.8 1.4 1.2 11.7 3,406 Formerly married/in union 4.4 10.3 4.1 1.8 1.7 12.8 873 Never married/in union 2.8 10.4 3.0 0.8 1.5 13.5 1,998 Education* None 10.8 19.9 10.1 5.0 6.2 26.0 361 Primary 7.0 13.2 7.3 1.7 2.1 19.0 1,335 Secondary + 1.5 7.5 2.0 0.9 0.8 9.6 4,463 Other/Non-standard 1.2 4.6 1.9 0.9 0.4 6.6 111 Wealth index quintile Poorest 7.3 17.0 7.9 2.8 3.3 22.4 1,117 Second 3.6 11.1 4.7 1.2 1.5 15.7 1,231 Middle 2.5 8.1 2.8 1.5 0.9 11.3 1,276 Fourth 1.7 7.1 2.3 0.8 0.9 8.9 1,328 Richest 1.3 5.0 1.0 0.4 0.7 5.8 1,339 Ethnicity of household head* Indigenous/Amerindian 5.0 12.5 7.0 2.3 2.6 18.5 246 Maroon 6.4 15.3 6.1 2.1 2.9 20.2 1,510 Creole 0.8 4.3 1.1 0.7 0.5 5.6 1,056 Hindustani 3.4 11.3 4.6 1.6 1.4 15.3 1,851 Javanese 1.0 4.3 1.3 0.2 0.5 5.3 870 Mixed 1.5 5.6 1.1 0.7 0.4 6.6 621 Others 0.4 1.7 0.0 0.4 0.4 1.7 131 Total 3.2 9.4 3.6 1.3 1.4 12.5 6,290 * ‘Missing/DK’ categories not shown due to low number of observations 1 MICS indicator 8.14  HIV/AIDS and Sexual Behaviour 152  Suriname MICS4    11. HIV/AIDS and Sexual Behaviour    HIV/AIDS and Sexual Behaviour      Suriname MICS4 153 Knowledge about HIV Transmission and Misconceptions about HIV/AIDS One of  the most  important prerequisites  for reducing  the rate of HIV  infection  is accurate knowledge of  how HIV  is  transmitted  and  strategies  for preventing  transmission. Correct  information  is  the  first  step  towards  raising  awareness  and  giving  young  people  the  tools  to  protect  themselves  from  infection.  Misconceptions  about  HIV  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.  HIV modules were administered to women.  One  indicator which  is both  an MDG  and UNGASS  indicator  is  the percent of  young women who have  comprehensive and correct knowledge of HIV prevention and transmission.  In Suriname MICS all women  who  have  heard  of  AIDS  were  asked  whether  they  knew  of  the  three  main  ways  of  preventing  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,  page  155.  In  Suriname,  98  percent  of  interviewed  women 15‐49 years have heard of AIDS. However,  the percentage  that know of  two ways of preventing  HIV transmission is 71 percent. Eighty‐three percent of women know of having one faithful uninfected sex  partner,  while  79  percent  know  of  using  a  condom  every  time  as  two  main  ways  of  preventing  HIV  transmission.   The  identical  Table  HA.2  (page  157)  shows  the  results  just  for women  15‐24  years  and  indicates  that  virtually every woman 15‐24 years (99 percent) heard of AIDS. Seventy percent knew the two main ways of  preventing HIV transmission. With respect  to knowing about using a condom every time and having one  faithful unaffected partner, the respective proportions among women 15‐24 years are 78 percent and 84  percent. Whether 15‐24 years or 15‐49 years, a  similar profile  is evident among women with  regard  to  awareness of AIDS and knowledge of ways to prevent transmission.  Table HA.1 and Table HA.2 also present the percent of women who can correctly identify misconceptions  concerning HIV. The indicator is based on the two most common and relevant misconceptions in Suriname,  that  HIV  can  be  transmitted  by  supernatural  means  or  by  mosquito  bites.  The  table  also  provides  information on whether women know that HIV cannot be transmitted by sharing food with someone with  AIDS. Of the interviewed women 15‐49 years, 53 percent reject the two most common misconceptions and  know that a healthy‐looking person can be  infected. Eighty‐two percent of women know that HIV cannot  be transmitted by sharing food with someone with AIDS, and 79 percent of women know that supernatural  means are misconceptions concerning the transmission of HIV. Additionally, 81 percent of women 15‐49  years know that a healthy‐looking person can be infected.  Women who have comprehensive knowledge about HIV prevention include women who know of the two  main ways of HIV prevention (having only one faithful uninfected partner and using a condom every time,  who know that a healthy  looking person can have the AIDS virus, and who reject the two most common  misconceptions.  Tables  HA.1  and  HA.2  also  present  the  percentage  of  women  with  comprehensive  knowledge.    Comprehensive  knowledge  of  HIV  prevention  methods  and  transmission  is  still  fairly  low  although there are differences by area of residence. Overall, 43 percent of women 15‐49 and 42 percent of  women 15‐24 were found to have comprehensive knowledge, which was markedly higher  in urban areas  than  in  rural  coastal  areas,  the  rural  interior,  and  by  extension  rural  areas  for  both  age  groups.  As  expected,  the  percentage  of  women  with  comprehensive  knowledge  increases  with  the  woman’s   HIV/AIDS and Sexual Behaviour 154  Suriname MICS4  education  level  (Figure  HA.1,  below).  Women’s  wealth  status  is  also  positively  associated  with  the  proportion of women exhibiting comprehensive knowledge of HIV prevention.   Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission, Suriname, 2010   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  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.3 (page 159). Overall, 93  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 52 percent, while 5 percent of women did not know  of any specific way. There  is not sufficient evidence to claim that women’s socio‐economic status or their  education  is positively or negatively associated  in  their knowledge of mother‐to‐child  transmission. Only  the overall knowledge  that HIV can be  transmitted  from mother  to child  is slightly  lower among women  with no education.  45 60 77 71 19 32 62 53 13 23 51 42 0 25 50 75 100 None Primary Secondary + Suriname Percent Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission, Suriname, 2010 Knows 2 ways to prevent HIV Identify 2 most common misconceptions and know that a healthy looking person can have the AIDS virus Comprehensive knowledge   HI V/ AI DS  an d S ex ua l Be ha vi ou r          Su rin am e M IC S4 15 5 Ta bl e H A .1 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on P er ce nt ag e of w om en a ge 1 5- 49 y ea rs w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s, p er ce nt ag e w ho r ej ec t c om m on m is co nc ep tio ns , a nd p er ce nt ag e w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on , S ur in am e, 2 01 0 P er ce nt ag e w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : P er ce nt ag e of w om en w ho k no w bo th w ay s P er ce nt ag e w ho k no w th at a he al th y lo ok in g pe rs on c an ha ve th e AI D S vi ru s Pe rc en ta ge w ho k no w th at H IV ca nn ot b e tr an sm itt ed b y: P er ce nt ag e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns a nd k no w th at a h ea lth y lo ok in g pe rs on ca n ha ve th e A ID S vi ru s P er ce nt ag e w ith co m pr eh en si ve kn ow le dg e1 N um be r of w om en H av in g on ly o ne fa ith fu l u ni nf ec te d se x pa rtn er U si ng a c on do m ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith so m eo ne w ith A ID S D is tr ic t P ar am ar ib o 98 .9 85 .2 80 .8 72 .8 85 .2 76 .5 84 .2 85 .8 60 .6 49 .0 3, 03 7 W an ic a 98 .7 86 .8 82 .1 74 .2 80 .2 68 .5 79 .3 84 .1 50 .6 42 .6 1, 25 2 N ic ke rie 96 .6 80 .9 77 .4 66 .7 79 .9 67 .3 74 .3 72 .8 47 .4 34 .1 47 1 C or on ie 10 0. 0 84 .5 84 .5 72 .4 81 .0 74 .1 84 .5 91 .4 60 .3 46 .6 31 S ar am ac ca 97 .6 84 .3 81 .3 73 .3 78 .7 65 .1 77 .9 76 .0 48 .5 39 .5 19 8 C om m ew ijn e 98 .0 81 .8 77 .0 67 .3 81 .1 67 .1 76 .3 81 .5 48 .6 37 .1 29 6 M ar ow ijn e 98 .4 83 .1 75 .3 68 .2 78 .8 60 .5 70 .4 81 .6 42 .8 33 .4 20 8 P ar a 98 .9 88 .3 84 .4 78 .6 85 .3 67 .8 76 .9 78 .3 53 .6 45 .8 20 5 B ro ko po nd o 95 .8 80 .4 76 .7 68 .9 74 .6 59 .5 73 .7 75 .5 40 .2 31 .1 13 2 S ip al iw in i 92 .6 64 .9 64 .4 51 .6 60 .3 46 .6 61 .8 59 .2 25 .5 17 .6 46 1 A re a U rb an 98 .7 85 .4 81 .0 72 .8 83 .9 73 .9 82 .1 85 .0 57 .3 46 .5 4, 62 0 R ur al C oa st al 97 .6 83 .3 78 .7 70 .7 78 .9 64 .8 75 .5 76 .6 47 .3 37 .2 1, 07 7 R ur al in te rio r 93 .3 68 .4 67 .2 55 .5 63 .5 49 .5 64 .4 62 .8 28 .7 20 .6 59 3 To ta l R ur al 96 .1 78 .0 74 .6 65 .3 73 .4 59 .4 71 .6 71 .7 40 .7 31 .3 1, 67 0 A ge 15 -2 4 98 .6 84 .2 77 .8 70 .4 81 .1 71 .0 81 .6 86 .4 52 .9 41 .9 2, 07 6 25 -2 9 98 .2 81 .9 79 .9 70 .0 82 .3 70 .7 81 .0 80 .7 55 .0 44 .1 97 2 30 -3 9 98 .4 84 .8 81 .3 72 .1 82 .3 72 .2 79 .7 80 .9 55 .4 44 .3 1, 66 8 40 -4 9 96 .8 82 .0 78 .8 70 .5 79 .2 66 .0 74 .8 76 .1 48 .8 40 .2 1, 57 4 M ar ita l s ta tu s* C ur re nt ly m ar rie d/ in u ni on 97 .8 83 .0 79 .5 70 .6 80 .0 68 .1 77 .7 78 .6 51 .0 41 .2 4, 27 9 Fo rm er ly m ar rie d/ in u ni on 98 .6 84 .5 78 .8 71 .1 83 .5 74 .2 82 .8 87 .7 56 .9 45 .2 1, 99 8      HI V/ AI DS  an d S ex ua l Be ha vi ou r 15 6  Su rin am e M IC S4   Ta bl e H A .1 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on ( co nt in ue d) P er ce nt ag e of w om en a ge 1 5- 49 y ea rs w ho k no w th e m ai n w ay s of p re ve nt in g H IV tr an sm is si on , p er ce nt ag e w ho k no w th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s, p er ce nt ag e w ho r ej ec t c om m on m is co nc ep tio ns , a nd p er ce nt ag e w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on , S ur in am e, 2 01 0 P er ce nt ag e w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : P er ce nt ag e of w om en w ho k no w bo th w ay s P er ce nt ag e w ho k no w th at a he al th y lo ok in g pe rs on c an ha ve th e AI D S vi ru s Pe rc en ta ge w ho k no w th at H IV ca nn ot b e tr an sm itt ed b y: P er ce nt ag e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns a nd k no w th at a h ea lth y lo ok in g pe rs on ca n ha ve th e A ID S vi ru s P er ce nt ag e w ith co m pr eh en si ve kn ow le dg e1 N um be r of w om en H av in g on ly o ne fa ith fu l u ni nf ec te d se x pa rtn er U si ng a c on do m ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith s om eo ne w ith A ID S W om en ’s e du ca tio n* N on e 88 .6 60 .2 59 .6 45 .0 54 .2 37 .1 56 .6 48 .1 19 .3 12 .6 36 1 P rim ar y 95 .9 74 .4 71 .5 59 .9 68 .7 55 .0 66 .0 67 .1 31 .9 23 .2 1, 33 5 S ec on da ry + 99 .7 88 .5 83 .7 76 .7 87 .5 77 .1 85 .6 88 .7 62 .0 50 .9 4, 46 3 O th er /N on -s ta nd ar d 93 .2 72 .4 66 .1 55 .1 70 .0 76 .6 66 .5 76 .4 51 .4 34 .5 11 1 W ea lth in de x qu in til es P oo re st 94 .2 72 .3 69 .5 59 .1 69 .6 51 .9 65 .2 66 .7 32 .3 23 .4 1, 11 7 S ec on d 98 .0 81 .7 77 .9 68 .1 76 .3 62 .7 74 .6 77 .8 42 .8 33 .5 1, 23 1 M id dl e 98 .6 85 .7 80 .7 72 .6 82 .7 74 .9 79 .4 83 .8 55 .8 44 .0 1, 27 6 Fo ur th 99 .2 86 .6 83 .1 75 .4 86 .4 76 .8 86 .2 86 .3 62 .3 51 .2 1, 32 8 R ic he st 99 .6 89 .0 83 .7 76 .7 88 .5 80 .5 88 .7 90 .3 67 .1 56 .4 1, 33 9 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 94 .3 74 .1 69 .9 61 .7 73 .1 60 .3 70 .0 69 .4 41 .6 30 .4 24 6 M ar oo n 97 .0 79 .2 74 .5 65 .3 76 .1 60 .9 72 .1 78 .8 42 .8 33 .0 1, 51 0 C re ol e 99 .9 89 .5 85 .1 77 .9 89 .1 83 .6 87 .3 91 .0 69 .0 57 .4 1, 05 6 H in du st an i 97 .9 83 .8 80 .0 71 .4 79 .6 65 .0 75 .9 74 .8 46 .1 37 .8 1, 85 1 Ja va ne se 98 .9 85 .5 79 .8 71 .1 80 .2 74 .7 86 .5 87 .0 56 .5 44 .3 87 0 M ix ed 99 .7 87 .2 85 .3 78 .0 91 .6 82 .9 89 .2 91 .8 71 .1 58 .2 62 1 O th er s 90 .1 64 .0 66 .0 51 .4 68 .0 62 .8 69 .6 68 .3 44 .7 34 .7 13 1 To ta l 98 .0 83 .4 79 .3 70 .8 81 .1 70 .0 79 .3 81 .5 52 .9 42 .5 6, 29 0 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns 1 M IC S in di ca to r 9 .1  HI V/ AI DS  an d S ex ua l Be ha vi ou r          Su rin am e M IC S4 15 7 Ta bl e H A .2 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on a m on g yo un g w om en P er ce nt ag e of y ou ng w om en a ge 1 5- 24 y ea rs w ho k no w t he m ai n w ay s of p re ve nt in g H IV t ra ns m is si on , pe rc en ta ge w ho k no w t ha t a he al th y lo ok in g pe rs on c an h av e th e A ID S vi ru s, p er ce nt ag e w ho r ej ec t co m m on m is co nc ep tio ns , a nd p er ce nt ag e w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on , S ur in am e, 2 01 0 P er ce nt ag e w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : P er ce nt ag e of w om en w ho k no w bo th w ay s P er ce nt ag e w ho k no w th at a he al th y lo ok in g pe rs on ca n ha ve th e A ID S v iru s Pe rc en ta ge w ho k no w th at H IV ca nn ot b e tr an sm itt ed b y: P er ce nt ag e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns an d kn ow th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s P er ce nt ag e w ith co m pr eh en si ve kn ow le dg e1 N um be r of w om en ag e 15 - 24 H av in g on ly o ne fa ith fu l u ni nf ec te d se x pa rtn er U si ng a c on do m ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith so m eo ne w ith A ID S D is tr ic t P ar am ar ib o 99 .0 85 .3 79 .0 71 .7 85 .4 77 .1 85 .0 89 .9 59 .8 47 .8 1, 03 4 W an ic a 99 .6 88 .4 79 .4 74 .2 76 .4 65 .7 82 .4 85 .8 47 .2 38 .2 38 9 N ic ke rie 96 .9 81 .9 75 .3 65 .5 78 .1 70 .4 73 .8 81 .9 46 .3 34 .9 15 3 C or on ie (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 7 S ar am ac ca 98 .2 86 .2 81 .7 72 .5 84 .4 63 .3 89 .9 82 .6 53 .2 38 .5 58 C om m ew ijn e 98 .9 85 .6 78 .3 72 .2 83 .4 67 .8 81 .1 93 .4 49 .5 41 .2 98 M ar ow ijn e 10 0. 0 81 .1 73 .1 66 .9 77 .1 64 .0 74 .3 86 .3 45 .1 34 .3 86 P ar a 99 .2 86 .7 87 .5 79 .2 90 .0 70 .0 80 .8 84 .2 59 .2 48 .3 68 B ro ko po nd o 96 .5 80 .0 76 .5 69 .6 79 .1 59 .1 78 .3 79 .1 45 .2 33 .9 46 S ip al iw in i 93 .8 65 .3 62 .6 50 .4 61 .1 54 .9 65 .9 66 .5 30 .6 20 .8 13 7 A re a U rb an 99 .1 86 .2 79 .0 72 .2 83 .1 73 .8 83 .5 89 .0 56 .0 45 .0 1, 53 9 R ur al C oa st al 98 .3 83 .0 78 .5 70 .3 80 .5 66 .6 79 .9 83 .7 49 .5 37 .7 35 4 R ur al in te rio r 94 .5 69 .0 66 .1 55 .2 65 .6 56 .0 69 .0 69 .6 34 .2 24 .1 18 3 To ta l R ur al 97 .0 78 .2 74 .3 65 .2 75 .5 63 .0 76 .2 78 .9 44 .3 33 .1 53 7 A ge 15 -1 9 98 .2 83 .2 76 .3 69 .7 79 .8 70 .3 81 .4 87 .4 50 .1 40 .3 1, 08 5 20 -2 4 99 .0 85 .2 79 .4 71 .2 82 .6 71 .8 81 .8 85 .4 56 .1 43 .7 99 1 M ar ita l s ta tu s* E ve r m ar rie d/ in u ni on 98 .1 83 .8 75 .0 68 .5 75 .8 66 .5 77 .7 80 .1 46 .7 37 .0 63 5 N ev er m ar rie d/ in u ni on 98 .8 84 .3 79 .0 71 .2 83 .4 73 .0 83 .4 89 .2 55 .7 44 .0 1, 43 4 W om en ’s e du ca tio n* N on e 85 .5 60 .7 54 .1 40 .9 54 .1 34 .8 47 .5 47 .6 17 .6 11 .8 50 P rim ar y 94 .8 67 .1 62 .4 51 .1 67 .2 56 .8 64 .9 65 .1 33 .6 22 .8 31 8 S ec on da ry + 99 .7 88 .2 81 .6 75 .0 84 .7 74 .9 86 .2 91 .7 57 .9 46 .7 1, 68 7 O th er /N on -s ta nd ar d (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 19      HI V/ AI DS  an d S ex ua l Be ha vi ou r 15 8  Su rin am e M IC S4   Ta bl e H A .2 : K no w le dg e ab ou t H IV tr an sm is si on , m is co nc ep tio ns a bo ut H IV /A ID S, a nd c om pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on a m on g yo un g w om en (c on tin ue d) P er ce nt ag e of y ou ng w om en a ge 1 5- 24 y ea rs w ho k no w t he m ai n w ay s of p re ve nt in g H IV t ra ns m is si on , pe rc en ta ge w ho k no w t ha t a he al th y lo ok in g pe rs on c an h av e th e A ID S vi ru s, p er ce nt ag e w ho r ej ec t co m m on m is co nc ep tio ns , a nd p er ce nt ag e w ho h av e co m pr eh en si ve k no w le dg e ab ou t H IV tr an sm is si on , S ur in am e, 2 01 0 P er ce nt ag e w ho h av e he ar d of A ID S Pe rc en ta ge w ho k no w tr an sm is si on c an b e pr ev en te d by : P er ce nt ag e of w om en w ho k no w bo th w ay s P er ce nt ag e w ho k no w th at a he al th y lo ok in g pe rs on ca n ha ve th e A ID S v iru s Pe rc en ta ge w ho k no w th at H IV ca nn ot b e tr an sm itt ed b y: P er ce nt ag e w ho re je ct th e tw o m os t c om m on m is co nc ep tio ns an d kn ow th at a h ea lth y lo ok in g pe rs on c an h av e th e A ID S v iru s P er ce nt ag e w ith co m pr eh en si ve kn ow le dg e1 N um be r of w om en ag e 15 - 24 H av in g on ly o ne fa ith fu l u ni nf ec te d se x pa rtn er U si ng a c on do m ev er y tim e M os qu ito bi te s S up er na tu ra l m ea ns S ha rin g fo od w ith so m eo ne w ith A ID S W ea lth in de x qu in til es P oo re st 95 .4 72 .7 65 .9 57 .2 71 .0 58 .9 69 .9 73 .5 36 .6 25 .7 38 8 S ec on d 98 .7 82 .9 77 .3 69 .6 78 .6 65 .5 80 .2 84 .3 48 .3 36 .2 43 3 M id dl e 10 0. 0 87 .2 80 .6 73 .7 83 .7 75 .3 81 .5 87 .9 56 .0 45 .3 39 8 Fo ur th 99 .1 87 .1 80 .3 73 .3 85 .2 76 .4 87 .5 93 .0 60 .9 49 .5 41 4 R ic he st 99 .5 89 .9 83 .9 77 .0 86 .3 78 .1 88 .1 92 .3 61 .6 51 .5 44 3 Et hn ic ity o f h ou se ho ld h ea d* In di ge no us /A m er in di an 96 .9 74 .0 68 .5 61 .9 74 .6 64 .0 76 .6 74 .0 45 .1 29 .9 84 M ar oo n 97 .6 80 .0 75 .5 66 .9 77 .1 65 .4 74 .8 83 .5 45 .7 36 .2 57 9 C re ol e 10 0. 0 87 .6 81 .6 74 .1 88 .1 80 .7 89 .1 93 .2 68 .1 54 .7 35 8 H in du st an i 98 .4 86 .4 77 .4 71 .6 81 .7 67 .6 78 .5 82 .7 48 .3 38 .3 56 0 Ja va ne se 99 .4 86 .3 77 .8 70 .7 77 .2 74 .0 89 .3 91 .7 51 .6 41 .0 28 5 M ix ed 10 0. 0 86 .9 84 .4 76 .2 89 .7 81 .5 88 .5 93 .9 68 .2 52 .9 18 0 O th er s 92 .4 73 .6 71 .7 60 .4 69 .7 57 .0 84 .8 71 .5 43 .6 43 .6 29 To ta l 98 .6 84 .2 77 .8 70 .4 81 .1 71 .0 81 .6 86 .4 52 .9 41 .9 2, 07 6 * ‘M is si ng /D K ’ c at eg or ie s no t s ho w n du e to lo w n um be r o f o bs er va tio ns (* ) F ig ur es th at a re b as ed o n le ss th an 2 5 un w ei gh te d ca se s 1 M IC S in di ca to r 9 .2 ; M D G in di ca to r 6 .3  HIV/AIDS and Sexual Behaviour      Suriname MICS4 159 Table HA.3: Knowledge of mother-to-child HIV transmission Percentage of women age 15-49 years who correctly identify means of HIV transmission from mother to child, Suriname, 2010 Percentage who know HIV can be transmitted from mother to child Percent who know HIV can be transmitted: Does not know any of the specific means Number of women During pregnancy During delivery By breastfeeding All three means1 District Paramaribo 94.8 76.6 65.9 77.7 47.9 4.0 3037 Wanica 92.9 78.8 66.6 78.5 53.0 5.7 1252 Nickerie 93.1 88.1 71.0 77.4 60.7 3.5 471 Coronie 100.0 79.3 65.5 96.6 58.6 0.0 31 Saramacca 89.3 80.3 65.1 69.3 50.7 8.3 198 Commewijne 92.1 86.0 69.9 76.6 56.3 5.9 296 Marowijne 90.8 71.1 67.1 88.2 55.8 7.5 208 Para 93.6 78.3 71.7 84.2 58.6 5.3 205 Brokopondo 91.8 66.2 68.6 90.6 54.7 3.9 132 Sipaliwini 86.6 66.8 68.9 83.5 56.6 6.0 461 Area Urban 94.3 78.2 66.5 77.9 50.1 4.5 4620 Rural Coastal 91.5 79.9 68.7 79.6 56.7 6.1 1077 Rural interior 87.8 66.6 68.8 85.1 56.1 5.5 593 Total Rural 90.2 75.2 68.7 81.6 56.5 5.9 1670 Age group 15-24 94.2 74.6 65.3 82.4 50.7 4.4 2076 15-19 93.3 72.8 61.0 81.9 48.6 4.9 1085 20-24 95.1 76.6 69.9 82.8 52.9 3.9 991 25-29 92.9 75.0 66.2 80.3 51.3 5.4 972 30-39 93.9 80.0 69.7 77.8 52.9 4.6 1668 40-49 91.5 79.8 67.3 74.5 52.5 5.3 1574 Marital status* Ever married/in union 92.8 79.0 67.9 78.3 53.1 4.9 4279 Never married/in union 94.1 74.1 65.4 80.1 49.2 4.5 1998 Women’s education* None 78.9 60.7 59.8 76.8 50.8 9.7 361 Primary 88.4 74.8 66.1 79.8 54.7 7.5 1335 Secondary + 96.2 79.7 68.2 78.9 51.0 3.5 4463 Other/Non-standard 86.7 77.0 63.5 77.2 54.2 6.5 111 Wealth index quintiles Poorest 88.3 70.2 65.5 84.1 55.0 5.9 1117 Second 91.5 74.1 65.0 80.2 50.5 6.5 1231 Middle 94.2 79.6 68.7 79.4 54.3 4.4 1276 Fourth 95.2 79.6 68.1 77.1 50.9 4.0 1328 Richest 95.9 82.2 67.8 74.4 48.8 3.6 1339 Ethnicity of household head* Indigenous/Amerindian 88.9 80.1 74.1 82.7 64.8 5.4 246 Maroon 92.4 66.0 68.3 89.1 53.5 4.6 1510 Creole 96.7 76.3 64.9 85.6 51.1 3.2 1056 Hindustani 91.9 83.6 66.2 69.3 50.4 6.0 1851 Javanese 94.7 83.6 66.8 75.3 51.5 4.2 870 Mixed 97.0 81.4 69.5 79.4 50.9 2.6 621 Others 73.0 64.2 59.6 54.5 39.1 17.1 131 Total 93.2 77.4 67.1 78.9 51.8 4.8 6290 * ‘Missing/DK’ categories not shown due to low number of observations 1 MICS indicator 9.3  HIV/AIDS and Sexual Behaviour 160  Suriname MICS4  Accepting Attitudes toward People Living with HIV/AIDS 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 is 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.4 (page  161)  presents  the  attitudes  of women  towards  people  living with HIV/AIDS.  Specifically,  96  percent  of  women interviewed agree with at least one of the above‐mentioned accepting attitudes while 21 percent  have responded favourably expressing accepting attitudes on all four  indicators. The survey does provide  evidence that seem consistent with positive association between women’s education and the proportion  expressing  favourable  responses  toward  accepting  attitudes  in  the  context  of  stigmatization.  A  similar  positive association is also supported when women’s socio‐economic status is taken into account.  Knowledge of a Place for HIV Testing, Counselling and Testing during Antenatal Care Another  important  indicator  is the knowledge of where to be tested for HIV and use of such services.   In  order to protect themselves and to prevent  infecting others,  it  is  important  for  individuals to know their  HIV status. Knowledge of own status  is also a critical factor  in the decision to seek treatment. Questions  related to knowledge among women of a facility for HIV testing and whether they have ever been tested  are presented in Table HA.5 (page 162). With respect to women 15‐49 years, as much as 85 percent know a  place  where  they  can  be  tested,  while  55  percent  have  actually  been  tested.  A  smaller  proportion  equivalent to 21 percent has been tested  in the past 12 months and 20 percent have been tested  in the  past 12 months and have been told the result. For these women, the greater the socio‐economic status,  greater proportions expressed knowledge of a place to be tested.   Table HA.6 (page 163) presents the same results for sexually active young women. The proportion of young  women who have been tested and have been told the result within the last 12 months provides a measure  of the effectiveness of interventions that promote HIV counselling and testing among young people. This is  important to know, because young people may feel that there are barriers to accessing services related to  sensitive issues, such as sexual health. With respect to younger women 15‐24 years, 57 percent had sex in  the past 12 months. Among them, 91 percent know a place where they can be tested, while 63 percent  have actually been tested with a smaller proportion equivalent to 35 percent being tested  in the past 12  months and percent have been tested in the past 12 months and told the result. For these women, greater  proportions expressed knowledge of a place to be tested, the greater the socio‐economic status and the  higher  their  level of  education. Whether women were  15‐24  years or  15‐49  years,  smaller proportions  from rural areas, in particular, the rural interior, claim to have had knowledge of a place where one can be  tested when compared to their counterparts from urban areas.  Among women 15‐49 years who had given birth within the two years preceding the survey, the percentage  who  received  counselling  and HIV  testing during  antenatal  care  is presented  in  Table HA.7  (page  164).  Some 91 percent of  these women  received antenatal care  from a health care professional  for  their  last  pregnancy with  just under a half  (49%)  receiving HIV  counselling while  receiving antenatal  care. During  antenatal care, 82 percent were offered a HIV test and tested for HIV, and 80 percent received the results  of  their  tests.  During  antenatal  care,  just  under  one  half  (46%)  of  the women  received  counselling  in  addition to being offered a HIV test, being tested, and being given the results.       HIV/AIDS and Sexual Behaviour      Suriname MICS4 161 Table HA.4: Accepting attitudes toward people living with HIV/AIDS Percentage of women age 15-49 years who have heard of AIDS who express an accepting attitude towards people living with HIV/AIDS, Suriname, 2010 Percentage of women who: Number of women who have heard of AIDS Are willing to care for a family member with the AIDS virus in own home Would buy fresh vegetables from a shopkeeper or vendor who has the AIDS virus Believe that a female teacher with the AIDS virus and is not sick should be allowed to continue teaching Would not want to keep secret that a family member got infected with the AIDS virus Agree with at least one accepting attitude Express accepting attitudes on all four indicators1 District Paramaribo 79.6 65.4 80.7 47.3 97.8 24.4 3,002 Wanica 67.3 52.9 70.1 54.0 96.3 19.6 1,235 Nickerie 64.1 49.0 60.5 48.8 92.9 16.7 455 Coronie 75.9 58.6 72.4 46.6 93.1 20.7 31 Saramacca 63.7 50.8 64.2 55.5 92.6 21.6 193 Commewijne 66.4 56.3 66.1 59.5 93.2 23.1 290 Marowijne 67.0 48.3 59.6 55.5 94.5 16.5 204 Para 73.0 51.7 67.1 57.3 94.1 23.3 203 Brokopondo 70.0 49.2 53.0 49.5 91.5 15.5 126 Sipaliwini 67.4 28.3 34.6 54.4 89.4 8.6 427 Area Urban 75.1 61.3 76.6 49.9 97.1 23.0 4,562 Rural Coastal 67.4 50.2 63.3 52.8 93.5 18.6 1,051 Rural interior 68.0 33.0 38.8 53.3 89.9 10.1 553 Total Rural 67.6 44.3 54.8 53.0 92.2 15.7 1,604 Age 15-24 75.9 55.3 74.1 47.5 96.3 18.7 2,047 15-19 74.3 52.5 73.0 48.0 96.1 17.4 1,065 20-24 77.7 58.4 75.2 46.9 96.6 20.0 982 25-29 72.1 59.6 69.3 48.8 94.6 20.2 955 30-39 71.1 57.6 69.0 52.0 95.9 21.9 1,641 40-49 72.3 56.3 69.9 54.8 95.7 24.0 1,523 Marital status* Ever married/in union 71.2 56.3 68.0 52.8 95.4 21.2 4,183 Never married/in union 77.4 58.1 77.0 46.3 96.6 20.8 1,971 Women’s education* None 65.9 21.8 28.4 52.2 86.7 6.2 320 Primary 64.0 40.2 49.2 58.3 92.9 14.3 1,280 Secondary + 76.3 64.3 80.5 48.6 97.3 24.2 4,449 Other/Non-standard 72.8 49.5 64.8 43.5 93.5 18.7 103 Wealth index quintiles Poorest 66.4 37.7 46.9 56.9 91.8 13.4 1,053 Second 69.5 51.2 65.0 52.3 94.4 16.7 1,206 Middle 75.5 59.3 74.0 49.8 97.0 21.4 1,258 Fourth 76.5 64.6 80.0 48.8 97.5 26.0 1,317 Richest 76.4 67.1 83.5 47.2 97.4 26.1 1,333 Ethnicity of household head* Indigenous/Amerindian 63.4 42.9 59.6 55.5 94.3 13.3 232 Maroon 76.1 49.2 60.5 50.3 94.4 16.3 1,465 Creole 80.7 67.9 85.7 48.1 98.4 27.0 1,056 Hindustani 64.2 50.4 62.5 54.4 94.5 18.6 1,811 Javanese 76.4 63.6 81.5 49.4 96.9 25.7 861 Mixed 80.5 71.0 86.2 47.5 98.4 27.7 619 Others 64.7 54.9 62.6 39.3 91.2 12.5 118 Total 73.2 56.9 70.9 50.7 95.8 21.1 6,166 * ‘Missing/DK’ categories not shown due to low number of observations 1 MICS indicator 9.4    HIV/AIDS and Sexual Behaviour 162  Suriname MICS4  Table HA.5: Knowledge of a place for HIV testing Percentage of women age 15-49 years who know where to get an HIV test, percentage of women who have ever been tested, percentage of women who have been tested in the last 12 months, and percentage of women who have been tested in the last 12 months and have been told the result, Suriname, 2010 Percentage of women who: Know a place to get tested1 Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result2 Number of women District Paramaribo 89.9 58.0 23.0 21.9 3,037 Wanica 82.0 48.6 20.4 19.4 1,252 Nickerie 76.5 40.5 12.5 11.7 471 Coronie 89.7 56.9 19.0 19.0 31 Saramacca 78.7 43.2 13.9 13.6 198 Commewijne 81.8 44.7 15.4 14.1 296 Marowijne 84.9 65.9 30.1 28.5 208 Para 86.7 58.1 22.2 20.8 205 Brokopondo 85.2 71.6 32.9 32.3 132 Sipaliwini 73.7 61.1 22.2 21.1 461 Area Urban 87.2 54.3 21.7 20.5 4,620 Rural Coastal 80.5 50.1 18.6 17.7 1,077 Rural interior 76.3 63.4 24.6 23.6 593 Total Rural 79.0 54.8 20.7 19.8 1,670 Age 15-19 77.7 20.4 11.9 11.4 1,085 20-24 91.2 61.0 31.9 30.3 991 25-29 90.7 76.6 31.4 30.0 972 30-34 87.8 72.0 26.5 25.2 816 35-39 87.4 64.9 18.9 17.2 852 40-44 82.0 50.4 16.5 16.3 831 45-49 77.4 39.9 11.1 10.1 743 Marital status* Ever married/in union 85.4 63.6 24.4 23.2 4,279 Never married/in union 84.1 34.9 15.0 14.1 1,998 Wealth index quintiles Poorest 76.7 59.9 26.4 24.9 1,117 Second 81.9 56.0 22.6 22.1 1,231 Middle 85.4 54.2 21.4 20.4 1,276 Fourth 89.8 51.5 18.9 17.7 1,328 Richest 89.7 51.8 18.7 17.4 1,339 Ethnicity of household head* Indigenous/Amerindian 77.3 51.4 17.8 16.3 246 Maroon 84.5 65.0 30.2 28.8 1,510 Creole 95.7 65.2 28.1 26.2 1,056 Hindustani 76.7 39.8 12.8 12.3 1,851 Javanese 87.7 48.1 16.3 15.2 870 Mixed 96.0 66.8 25.9 25.0 621 Others 67.1 44.2 8.6 8.6 131 Total 85.0 54.5 21.4 20.3 6,290 * ‘Missing/DK’ categories not shown due to low number of observations 1 MICS indicator 9.5 2 MICS indicator 9.6    HIV/AIDS and Sexual Behaviour      Suriname MICS4 163 Table HA.6: Knowledge of a place for HIV testing among sexually active young women Percentage of women age 15-24 years who have had sex in the last 12 months, and among women who have had sex in the last 12 months, the percentage who know where to get an HIV test, percentage of women who have ever been tested, percentage of women who have been tested in the last 12 months, and percentage of women who have been tested in the last 12 months and have been told the result, Suriname, 2010 Percentage who have had sex in the last 12 months Number of women age 15-24 years Percentage of women who: Number of women age 15- 24 years who have had sex in the last 12 months Know a place to get tested Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result1 District Paramaribo 57.4 1,034 94.4 65.2 39.0 37.3 594 Wanica 49.8 389 90.5 59.5 32.8 31.9 194 Nickerie 48.4 153 82.8 54.6 23.0 23.0 74 Coronie (*) 7 (*) (*) (*) (*) 5 Saramacca 54.1 58 84.7 55.9 27.1 27.1 31 Commewijne 45.0 98 (92.7) (61.7) (30.8) (27.1) 44 Marowijne 68.6 86 85.0 65.8 35.0 34.2 59 Para 59.2 68 93.0 66.2 33.8 32.4 40 Brokopondo 80.0 46 88.0 70.7 34.8 34.8 37 Sipaliwini 76.6 137 79.5 60.1 28.7 26.4 105 Area Urban 54.7 1,539 93.5 63.2 36.4 34.9 842 Rural Coastal 56.3 354 85.1 61.8 31.0 30.5 199 Rural interior 77.4 183 81.7 62.8 30.3 28.5 141 Total Rural 63.5 537 83.7 62.2 30.7 29.7 341 Age 15-19 38.6 1,085 87.2 47.1 29.4 28.3 419 20-24 77.0 991 92.6 71.6 37.7 36.1 763 Marital status* Ever married/in union 95.7 635 89.2 75.2 41.3 39.9 608 Never married/in union 39.8 1,434 92.2 50.2 28.0 26.6 571 Women’s education* None 81.2 50 71.7 61.6 33.0 27.9 40 Primary 68.5 318 81.9 67.8 35.1 33.4 218 Secondary + 53.7 1,687 93.8 62.2 35.0 33.8 906 Other/Non-standard (*) 19 (*) (*) (*) (*) 16 Wealth index quintiles Poorest 70.1 388 81.0 62.2 31.9 30.4 272 Second 57.1 433 92.1 67.3 39.0 39.0 247 Middle 58.3 398 92.5 64.3 30.0 29.6 232 Fourth 50.1 414 93.8 62.9 41.8 38.6 208 Richest 50.5 443 96.1 57.4 32.0 29.8 224 Ethnicity of household head* Indigenous/Amerindian 69.5 84 82.6 57.4 24.0 20.4 58 Maroon 65.4 579 87.0 63.3 35.5 34.1 379 Creole 60.3 358 98.0 64.9 40.7 38.7 216 Hindustani 38.5 560 85.4 63.6 31.9 31.2 216 Javanese 68.1 285 96.9 60.4 31.8 30.1 194 Mixed 60.0 180 93.5 66.8 40.7 40.7 108 Others (*) 29 (*) (*) (*) (*) 11 Total 57.0 2,076 90.7 62.9 34.8 33.4 1,182 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 9.7      HIV/AIDS and Sexual Behaviour 164  Suriname MICS4  Table HA.7: HIV counselling and testing during antenatal care Among women age 15-49 who gave birth in the last 2 years, percentage of women who received antenatal care from a health professional during the last pregnancy, percentage who received HIV counselling, percentage who were offered and accepted an HIV test and received the results, Suriname, 2010 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 Received HIV counselling during antenatal care1 Were offered an HIV test and were tested for HIV during antenatal care Were offered an HIV test and were tested for HIV during antenatal care, and received the results2 Received HIV counselling, were offered an HIV test, accepted and received the results District Paramaribo 92.7 43.5 80.8 76.9 38.8 430 Wanica 96.5 47.4 79.8 79.8 45.6 191 Nickerie 98.3 43.8 79.8 78.9 42.1 61 Coronie (*) (*) (*) (*) (*) 4 Saramacca 93.0 33.3 68.4 66.7 28.1 30 Commewijne (97.5) (51.4) (88.9) (88.9) (50.1) 44 Marowijne 93.9 57.6 84.1 84.1 56.1 65 Para 95.5 62.1 87.9 84.8 57.6 38 Brokopondo 66.2 61.7 85.7 85.0 59.4 53 Sipaliwini 78.9 61.9 82.8 80.6 60.0 146 Area Urban 94.3 45.2 80.9 78.4 41.7 668 Rural Coastal 94.9 50.9 81.9 80.7 47.9 193 Rural interior 75.5 61.9 83.6 81.7 59.8 199 Total Rural 85.0 56.5 82.7 81.2 53.9 392 Age group 15-24 91.9 48.0 79.8 77.9 44.2 374 15-19 91.1 47.9 73.1 71.2 42.9 108 20-24 92.3 48.0 82.5 80.5 44.7 267 25-29 93.3 53.1 83.5 80.7 49.6 303 30-39 85.7 48.0 86.3 84.1 45.3 189 40-49 90.1 47.4 77.4 76.1 45.8 195 Marital status* Ever married/in union 90.9 48.9 81.9 80.4 46.3 903 Never married/in union 90.8 51.0 79.5 73.4 44.5 153 Women’s education* None 78.7 59.4 79.4 77.5 56.0 125 Primary 88.9 49.9 78.6 77.2 47.4 305 Secondary + 94.5 47.2 83.6 81.0 43.7 609 Other/Non-standard (*) (*) (*) (*) (*) 16 Wealth index quintiles Poorest 82.1 57.9 81.7 79.5 55.2 341 Second 94.0 45.6 77.3 75.5 42.2 212 Middle 95.1 49.9 87.4 86.0 46.6 200 Fourth 97.0 42.7 79.6 76.7 41.7 167 Richest 94.1 41.4 81.6 79.2 35.5 141 Ethnicity of household head Indigenous/Amerindian 88.3 49.0 77.7 77.7 49.0 50 Maroon 84.8 57.6 83.0 79.8 54.2 429 Creole 97.5 46.5 85.5 83.8 42.3 131 Hindustani 97.5 41.4 82.5 81.5 40.1 216 Javanese 93.5 39.5 76.1 74.6 33.5 111 Mixed 92.0 47.0 80.4 77.7 43.4 104 Others (*) (*) (*) (*) (*) 20 Total 90.9 49.3 81.6 79.5 46.2 1,060 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 9.8 2 MICS indicator 9.9  HIV/AIDS and Sexual Behaviour      Suriname MICS4 165 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  age  15‐24  years  thus  a  change  in  behaviour among this age group will be especially important to reduce new infections.  A set of questions  was administered to all women 15‐49 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.   Table HA.8 (page 166) and Figure HA.2 below, present the frequency of sexual behaviours that increase the  risk of HIV  infection among women.  In Suriname, 55 percent of never married women 15‐24 years never  had  sex  (sexual  intercourse).  In  the  rural  coastal  areas,  a notably  larger proportion  estimated  to be 63  percent never had sex while in the rural interior the proportion is estimated to be substantially lower at 29  percent. Figure HA.2 shows that 10 percent of women 15‐24 years had sex before their 15th birthday. The  urban‐rural difference shows 7 percent  in urban areas and 19 percent  in rural areas. In the rural  interior,  however, it is estimated that approximately one third (33%) of the women 15‐24 years had sex before their  15th birthday being substantially higher than corresponding proportions observed in the rural coastal areas  (9%) and in urban areas (7%). With respect to women 15‐24 years who had sex in the last 12 months with a  man who was at  least 10  years older, proportions of women with  such experiences did not  vary much  across urban‐rural domains in Suriname.   Figure HA.2: Sexual behaviour that increases risk of HIV infection, Suriname, 2010     7 9 33 18 10 15 17 10 14 15 0 10 20 30 40 Urban Rural Coastal Rural interior Total Rural Total Percent Figure HA.2: Sexual behaviour that increases risk of HIV infection, Suriname, 2010 Women 15‐19 who had sex before age 15 Women age 15‐24 years who had sex in the last year with a man 10 or more years older  HIV/AIDS and Sexual Behaviour 166  Suriname MICS4    Table HA.8: Sexual behaviour that increases the risk of HIV infection Percentage of never-married young women age 15-24 years who have never had sex, percentage of young women age 15-24 years who have had sex before age 15, and percentage of young women age 15-24 years who had sex with a man 10 or more years older during the last 12 months, Suriname, 2010 Percentage of never-married women age 15-24 years who have never had sex1 Number of never-married women age 15- 24 years Percentage of women age 15-24 years who had sex before age 152 Number of women age 15-24 years Percentage of women age 15-24 years who had sex in the last 12 months with a man 10 or more years older3 Number of women age 15-24 years who had sex in the 12 months preceding the survey District Paramaribo 50.0 758 6.9 1,034 14.5 594 Wanica 63.3 282 6.9 389 12.1 194 Nickerie 76.5 95 8.7 153 21.6 74 Coronie (*) 4 (*) 7 (*) 5 Saramacca 78.0 31 6.4 58 20.3 31 Commewijne 78.3 65 0.5 98 (38.4) 44 Marowijne 40.8 59 17.7 86 12.5 59 Para 52.2 51 8.3 68 15.5 40 Brokopondo 26.9 21 35.7 46 13.0 37 Sipaliwini 29.5 67 32.6 137 9.3 105 Area Urban 55.1 1,117 6.8 1,539 15.3 842 Rural Coastal 63.1 229 9.3 354 16.9 199 Rural interior 28.9 88 33.4 183 10.3 141 Total Rural 53.6 318 17.5 537 14.2 341 Age 15-19 66.4 931 10.1 1,085 11.4 419 20-24 33.1 503 9.0 991 17.0 763 Marital status* Ever married/in union na na 17.6 635 18.9 608 Never married/in union 54.7 1,434 6.0 1,434 10.7 571 Women’s education* None (22.5) 18 33.2 50 10.4 40 Primary 48.9 164 26.2 318 18.0 218 Secondary + 56.3 1,239 5.6 1,687 14.2 906 Other/Non-standard (*) 13 (*) 19 (*) 16 Wealth index quintiles Poorest 41.0 209 24.5 388 15.5 272 Second 57.4 291 9.7 433 17.1 247 Middle 53.7 280 8.2 398 12.3 232 Fourth 61.5 304 3.5 414 19.6 208 Richest 55.6 350 3.1 443 10.6 224 Ethnicity of household head* Indigenous/Amerindian 44.2 53 15.4 84 17.4 58 Maroon 39.4 398 18.6 579 10.2 379 Creole 43.8 278 8.2 358 15.3 216 Hindustani 82.9 393 3.1 560 18.4 216 Javanese 49.9 159 5.6 285 17.0 194 Mixed 45.2 132 7.5 180 19.2 108 Others (*) 21 (*) 29 (*) 11 Total 54.7 1,434 9.6 2,076 15.0 1,182 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 9.10 2 MICS indicator 9.11 3 MICS indicator 9.12  HIV/AIDS and Sexual Behaviour      Suriname MICS4 167   Table HA.9: Sex with multiple partners Percentage of women age 15-49 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with more than one partner in the last 12 months and among those who had sex with multiple partners, the percentage who used a condom at last sex, Suriname, 2010 Percentage of women who: Percent of women age 15-49 years who had more than one sexual partner in the last 12 months, who also reported that a condom was used the last time they had sex2 Number of women age 15-49 years who had more than one sexual partner in the last 12 months Ever had sex Had sex in the last 12 months Had sex with more than one partner in last 12 months1 Number of women age 15-49 years District Paramaribo 85.5 74.7 2.8 3,037 43.1 84 Wanica 84.1 76.2 2.5 1,252 (*) 32 Nickerie 82.2 76.0 1.1 471 (*) 5 Coronie 91.4 81.0 3.4 31 (*) 1 Saramacca 86.7 80.3 0.5 198 (*) 1 Commewijne 81.6 74.2 0.2 296 (*) 1 Marowijne 88.0 82.8 2.4 208 (*) 5 Para 86.4 80.6 3.3 205 (*) 7 Brokopondo 95.5 84.9 2.1 132 (*) 3 Sipaliwini 95.0 81.6 3.4 461 (25.6) 16 Area Urban 84.8 75.0 2.5 4,620 39.4 118 Rural Coastal 85.5 79.6 1.7 1,077 (29.5) 18 Rural interior 95.1 82.3 3.1 593 (30.4) 19 Total Rural 88.9 80.6 2.2 1,670 29.9 37 Age 15-24 61.9 57.0 3.0 2,076 39.3 62 25-29 93.9 87.4 4.5 972 (44.3) 44 30-39 98.3 90.4 1.9 1,668 (26.9) 32 40-49 99.4 80.7 1.1 1,574 (*) 17 Marital status* Ever married/in union 99.9 90.5 2.1 4,279 22.4 88 Never married/in union 55.9 46.5 3.2 1,998 55.8 65 Women’s education* None 97.9 80.7 2.1 361 (*) 8 Primary 93.4 83.9 2.1 1,335 (31.9) 29 Secondary + 82.5 73.8 2.5 4,463 40.2 112 Other/Non-standard 90.0 80.7 3.0 111 (*) 3 Wealth index quintiles Poorest 92.0 80.6 2.8 1,117 40.4 31 Second 85.4 76.6 2.7 1,231 (21.1) 33 Middle 86.4 77.0 2.2 1,276 (*) 29 Fourth 83.6 75.3 2.8 1,328 (35.8) 37 Richest 82.9 73.6 1.9 1,339 (*) 25 Ethnicity of household head* Indigenous/Amerindian 90.3 85.6 3.6 246 (*) 9 Maroon 89.0 78.4 3.0 1,510 42.7 46 Creole 87.2 74.8 3.7 1,056 (52.9) 39 Hindustani 79.2 70.4 0.7 1,851 (*) 14 Javanese 89.7 83.7 2.0 870 (*) 17 Mixed 89.6 80.5 4.1 621 (*) 25 Others 82.9 68.4 2.5 131 (*) 3 Total 85.9 76.5 2.5 6,290 37.2 154 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 9.13 2 MICS indicator 9.14    HIV/AIDS and Sexual Behaviour 168  Suriname MICS4  Table HA.10: Sex with multiple partners among young women Percentage of women age 15-24 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with more than one partner in the last 12 months and among those who had sex with multiple partners, the percentage who used a condom at last sex, Suriname, 2010 Percentage of women age 15-24 years who: Percent of women age 15-24 years who had more than one sexual partner in the last 12 months, who also reported that a condom was used the last time they had sex Number of women age 15-24 years who had more than one sexual partner in the last 12 months Ever had sex Had sex in the last 12 months Had sex with more than one partner in last 12 months Number of women age 15-24 years District Paramaribo 63.4 57.4 3.4 1,034 (*) 35 Wanica 53.2 49.8 2.6 389 (*) 10 Nickerie 51.2 48.4 1.7 153 (*) 3 Coronie (*) (*) (*) 7 - 0 Saramacca 57.8 54.1 0.0 58 - 0 Commewijne 47.8 45.0 0.0 98 - 0 Marowijne 72.0 68.6 3.4 86 (*) 3 Para 60.8 59.2 5.0 68 (*) 3 Brokopondo 87.8 80.0 0.9 46 - 0 Sipaliwini 84.3 76.6 5.6 137 (*) 8 Area Urban 59.7 54.7 2.9 1,539 (40.7) 45 Rural Coastal 59.1 56.3 2.5 354 (*) 9 Rural interior 85.2 77.4 4.4 183 (*) 8 Total Rural 68.0 63.5 3.2 537 (35.6) 17 Age 15-19 42.5 38.6 1.8 1,085 (*) 20 20-24 83.0 77.0 4.3 991 (31.3) 42 Marital status* Ever married/in union 99.1 95.7 3.7 635 (15.5) 23 Never married/in union 45.3 39.8 2.6 1,434 (51.5) 37 Women’s education* None 92.1 81.2 6.9 50 (*) 3 Primary 74.0 68.5 2.1 318 (*) 7 Secondary + 58.4 53.7 2.9 1,687 (41.6) 48 Other/Non-standard (*) (*) (*) 19 (*) 2 Wealth index quintiles Poorest 77.5 70.1 3.3 388 (*) 13 Second 61.1 57.1 3.6 433 (*) 16 Middle 61.7 58.3 3.2 398 (*) 13 Fourth 54.9 50.1 2.8 414 (*) 12 Richest 55.6 50.5 2.1 443 (*) 9 Ethnicity of household head* Indigenous/Amerindian 72.0 69.5 6.8 84 (*) 6 Maroon 72.6 65.4 3.3 579 (32.4) 19 Creole 66.0 60.3 2.3 358 (*) 8 Hindustani 41.3 38.5 1.3 560 (*) 7 Javanese 72.1 68.1 4.4 285 (*) 13 Mixed 65.8 60.0 4.6 180 (*) 8 Others (*) (*) (*) 29 (*) 1 Total 61.9 57.0 3.0 2,076 39.3 62 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases   Sexual behaviour and condom use during sex was assessed in all women and separately for women age 15‐ 24 years of age who had sex with multiple partners in the previous year (Tables HA.9 and HA.10, pages 167  and 168).   Only 3 percent of women 15‐49 years of age report having sex with more than one partner  in   HIV/AIDS and Sexual Behaviour      Suriname MICS4 169 the  last 12 months.   Of those women, a  little more than a third (37%) report using a condom when they  had sex the last time. For young women, age 15‐24, the numbers are practically the same, with 3 percent  reporting more  than one partner and 39 percent using condom at  last sex. Observations on background  characteristics are impossible due to the low prevalence of multiple partners among women.  Tables HA.11 (page 170) presents the percentage of women age 15‐24 years who ever had sex, percentage  who  had  sex  in  the  last  12 months,  percentage who  have  had  sex with  a  non‐marital,  non‐cohabiting  partner  in the  last 12 months and among those who had sex with a non‐marital, non‐cohabiting partner,  the percentage who used a condom the last time they had sex with such a partner. Sex with non‐partners  in the past 12 months appears relatively even across most background characteristics, except of course on  age and marital  status. However,  there are  large differences between districts with a  low prevalence  in  Saramacca  (22%), Nickerie  (27%),  and Commewijne  (35%)  to high prevalence  in Para  (70%), Marowijne  (68%), and Paramaribo (65%).  On whether a condom was used during the last such sexual encounter, unfortunately the low prevalence in  some districts makes comparison difficult. Nevertheless, condom use  is not common  in the rural  interior  (34%) compared to the urban area (60%). Condom use is also much lower for women with no education or  from households in the poorest quintile.       HIV/AIDS and Sexual Behaviour 170  Suriname MICS4  Table HA.11: Sex with non-regular partners Percentage of women age 15-24 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with a non- marital, non-cohabiting partner in the last 12 months and among those who had sex with a non-marital, non-cohabiting partner, the percentage who used a condom the last time they had sex with such a partner, Suriname, 2010 Percentage of women 15-24 who: Number of women age 15- 24 years Percentage who had sex with a non-marital, non- cohabiting partner in the last 12 months1 Number of women age 15-24 years who had sex in the last 12 months Percentage of women age 15-24 years who had sex with a non- marital, non-cohabiting partner in the last 12 months, who also reported that a condom was used the last time they had sex with such a partner2 Number of women age 15-24 years who had sex in last 12 months with a non-marital, non-cohabiting partner Ever had sex Had sex in the last 12 months District Paramaribo 63.4 57.4 1,034 64.9 594 62.7 385 Wanica 53.2 49.8 389 59.5 194 50.7 115 Nickerie 51.2 48.4 153 27.4 74 (55.2) 20 Coronie (*) (*) 7 (*) 5 (*) 2 Saramacca 57.8 54.1 58 22.0 31 (*) 7 Commewijne 47.8 45.0 98 34.7 44 (*) 15 Marowijne 72.0 68.6 86 68.3 59 47.6 40 Para 60.8 59.2 68 70.4 40 52.0 28 Brokopondo 87.8 80.0 46 51.1 37 (48.9) 19 Sipaliwini 84.3 76.6 137 60.1 105 29.0 63 Area Urban 59.7 54.7 1,539 62.0 842 59.7 522 Rural Coastal 59.1 56.3 354 46.1 199 51.3 92 Rural interior 85.2 77.4 183 57.7 141 33.6 82 Total Rural 68.0 63.5 537 50.9 341 43.0 174 Age 15-19 42.5 38.6 1,085 70.5 419 57.3 295 20-24 83.0 77.0 991 52.4 763 54.2 400 Marital status* Ever married/in union 99.1 95.7 635 20.6 608 48.9 125 Never married/in union 45.3 39.8 1,434 99.4 571 57.0 567 Women’s education* None 92.1 81.2 50 51.0 40 17.8 21 Primary 74.0 68.5 318 50.0 218 43.6 109 Secondary + 58.4 53.7 1,687 61.1 906 58.9 554 Other/Non-standard (*) (*) 19 (*) 16 (*) 10 Wealth index quintiles Poorest 77.5 70.1 388 57.2 272 37.2 156 Second 61.1 57.1 433 56.1 247 59.8 139 Middle 61.7 58.3 398 58.1 232 67.1 135 Fourth 54.9 50.1 414 55.8 208 60.9 116 Richest 55.6 50.5 443 67.3 224 56.0 151 Ethnicity of household head* Indigenous/Amerindian 72.0 69.5 84 57.4 58 (53.6) 33 Maroon 72.6 65.4 579 70.9 379 54.5 268 Creole 66.0 60.3 358 75.1 216 58.3 162 Hindustani 41.3 38.5 560 30.0 216 56.9 65 Javanese 72.1 68.1 285 46.3 194 52.7 90 Mixed 65.8 60.0 180 67.0 108 57.9 72 Others (*) (*) 29 (*) 11 (*) 4 Total 61.9 57.0 2,076 58.8 1,182 55.5 696 * ‘Missing/DK’ categories not shown due to low number of observations ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 9.15 2 MICS indicator 9.16; MDG indicator 6.2  Access to Mass Media and Use of Information/Communication Technology      Suriname MICS4 171   12. Access to Mass Media and Use of Information/Communication Technology              Access to Mass Media and Use of Information/Communication Technology 172  Suriname MICS4  The 2011 Suriname MICS collected information on exposure to mass media and the use of computers and  the internet.  Information is collected on:   exposure to newspapers/magazines, radio and television among women age 15‐49,   use of computers among 15‐24 year‐olds, and   use of the internet among 15‐24 year‐olds.  Access to Mass Media The proportion of women 15‐49 years who read a newspaper, listen to the radio, and watch television at  least  once  a week  is  shown  in  Table MT.1  (page  173). At  least  once  a week,  77  percent  of women  in  Suriname  read a newspaper, 84 percent  listen  to  the  radio, and 90 percent watch  television. Overall, 2  percent do not have regular exposure to any of the three media, while 66 percent are exposed to all the  three  types  of  media  at  least  on  a  weekly  basis.  There  are  no  clear  patterns  of  association  between  women’s age and their reported exposure to all  three types of mass media. However, there are definite  patterns of association between attributes such as area, women’s education, and socio‐economic status on  one hand, and exposure to all types of mass media on the other.   Only 1 percent of women with no education are exposed to all three media once a week, while this is the  case for 45 percent of women with primary education, and 78 percent of women with secondary or higher  education. The very  low  rate  for women with no education  is of  course driven by only 2 percent being  exposed  to  newspaper,  but  there  are  low  rates  for  radio  (55%)  and  TV  (45%)  as  well.  As  expected  a  somewhat  similar  pattern  can  be  found when  looking  at wealth  quintiles.  Much  larger  proportions  of  women were exposed to all the media types in urban areas (75 percent) than in rural areas (44 percent). In  the rural interior, exposure to all three types of media was very low with only 13 percent of women having  exposure to all. Exposure of women to all three media was greatest in Paramaribo (77 percent) and lowest  in Sipaliwini (9 percent).       Access to Mass Media and Use of Information/Communication Technology      Suriname MICS4 173 Table MT.1: Exposure to mass media Percentage of women age 15-49 years who are exposed to specific mass media on a weekly basis, Suriname 2010 Percentage of women age 15-49 who: All three media at least once a week1 No media at least once a week Number of women age 15- 49 years Read a newspaper at least once a week Listen to the radio at least once a week Watch television at least once a week Age 15-19 77.1 85.8 93.1 67.3 1.5 1,085 20-24 80.3 83.3 89.2 67.4 1.9 991 25-29 75.0 82.7 90.0 64.1 1.6 972 30-34 75.5 85.2 90.2 66.7 1.2 816 35-39 76.9 82.1 89.5 65.4 1.6 852 40-44 77.3 84.7 87.8 66.5 1.6 831 45-49 75.6 85.2 89.6 67.7 1.4 743 District Paramaribo 87.3 87.6 94.9 76.8 0.8 3,037 Wanica 83.7 88.1 94.3 72.2 0.7 1,252 Nickerie 64.7 83.5 94.1 55.2 1.6 471 Coronie 79.3 93.1 96.6 74.1 0.0 31 Saramacca 88.8 83.5 93.9 72.3 0.5 198 Commewijne 80.3 91.8 94.8 72.8 0.0 296 Marowijne 58.8 75.8 82.1 45.6 3.1 208 Para 75.0 81.7 86.7 61.7 2.5 205 Brokopondo 38.4 61.0 72.2 27.2 7.6 132 Sipaliwini 14.7 57.8 46.9 9.4 7.6 461 Area Urban 85.3 87.9 94.7 74.7 0.8 4,620 Rural Coastal 72.0 82.3 90.8 60.0 1.6 1,077 Rural interior 20.0 58.5 52.5 13.4 7.6 593 Total Rural 53.5 73.8 77.2 43.5 3.7 1,670 Education* None 2.0 55.4 44.6 1.0 0.8 361 Primary 57.2 77.7 84.5 45.3 4.2 1,335 Secondary + 89.2 88.4 95.2 78.4 0.8 4,463 Other/Non-standard 69.7 87.9 94.3 62.2 1.5 111 Wealth index quintile Poorest 39.1 63.1 62.4 24.3 5.5 1,117 Second 73.9 83.3 91.5 60.6 1.4 1,231 Middle 85.3 87.4 95.9 74.7 0.5 1,276 Fourth 88.6 91.0 97.9 80.2 0.2 1,328 Richest 91.7 92.7 98.2 85.3 0.7 1,339 Ethnicity of household head* Indigenous/Amerindian 61.3 70.7 80.6 50.0 7.7 246 Maroon 52.0 77.3 76.2 43.9 2.8 1,510 Creole 88.8 92.2 95.0 80.8 0.8 1,056 Hindustani 82.1 85.5 94.8 70.0 1.0 1,851 Javanese 91.8 87.8 97.4 80.4 0.1 870 Mixed 88.3 86.9 93.4 76.2 1.0 621 Others 69.8 67.3 94.4 51.9 1.1 131 Total 76.9 84.2 90.0 66.4 1.6 6,290 * ‘Missing/DK’ categories not shown due to low number of observations 1 MICS indicator MT.1  Access to Mass Media and Use of Information/Communication Technology 174  Suriname MICS4  Use of Information/Communication Technology The questions on computer and  internet use were asked only  to 15‐24 year old women. As displayed  in  Table MT.2 (page 175), 72 percent of 15‐24 year old women had ever used a computer, 60 percent used a  computer during the last year, and 46 percent used at least once a week during the last month. Overall, 57  percent of women age 15‐24 ever used the internet, while 49 percent browsed the internet during the last  year. The proportion of young women who used the internet more frequently, at least once a week during  the  last month was  smaller,  at 37 percent. While  there  appears  to be  little or no differences between  younger women 15‐19 years and their older counterparts 20‐24 years with respect to both computer and  internet usage, observations from MICS4 in Suriname suggest that use of both a computer and the internet  is strongly associated with area, women’s  education, and household wealth.   While  12 percent of women with primary  education  report  using  a  computer during  the  last  year,  the  corresponding  proportion  among  women  with  secondary  or  higher  education  was  71  percent.  It  is  noteworthy that all women without education have never used a computer. Women living in urban areas  were almost twice as likely as those in rural areas to have used a computer during the last year (68 percent  and  35  percent,  respectively).  For  women  from  the  rural  interior,  it  was  as  low  as  11  percent.  The  proportion of women that used a computer during the last 12 months was observed to be greater among  women,  the higher  their household wealth quintile. While  it was observed  to be 20 percent among  the  women  in the poorest households,  it was as high as 89 percent  in the richest quintile. The proportion of  women that used a computer during the  last year was greatest  in Paramaribo (71 percent) and  lowest  in  Sipaliwini (7 percent).  With respect to  internet use during the  last 12 months, 7 percent of women with primary education had  engaged in such a practice compared to a much higher proportion amounting to 58 percent among women  with higher levels of educational attainment. Women living in urban areas were more than twice as likely  to have used the internet in the last 12 months when compared to their counterparts from rural areas (57  percent and 24 percent respectively). Only 5 percent of the women living in the rural interior had used the  internet during  the  last 12months.  The proportion of women  that used  the  internet during  the  last  12  months  was  observed  to  be  greater  among  women,  the  higher  their  household  wealth.  While  it  was  observed  to be 10 percent among  the women  in  the poorest households,  it was as high as 77 percent  among  the wealthiest.  Internet use  in  the  last 12 months was  lowest among women  from Sipaliwini  (4  percent) and highest among women from Paramaribo (61 percent).        Access to Mass Media and Use of Information/Communication Technology      Suriname MICS4 175 Table MT.2: Use of computers and internet Percentage of young women age 15-24 who have ever used a computer, percentage who have used a computer during the last 12 months, and frequency of use during the last one month, Suriname, 2010 Percentage of women age 15-24 who have: Percentage of women age 15-24 who have: Number of women age 15-24 years Ever used a computer Used a computer during the last 12 months1 Used a computer at least once a week during the last one month Ever used the internet Used the internet during the last 12 months2 Used the internet at least once a week during the last one month Age 15-19 71.7 59.6 45.8 56.6 47.5 36.4 1,085 20-24 72.0 60.0 46.9 57.2 49.7 38.5 991 District Paramaribo 81.0 70.7 57.9 69.4 60.6 49.6 1,034 Wanica 78.1 63.1 48.1 57.5 49.8 34.3 389 Nickerie 71.1 56.8 37.6 51.9 39.1 25.1 153 Coronie (*) (*) (*) (*) (*) (*) 7 Saramacca 68.8 50.5 44.0 49.5 42.2 32.1 58 Commewijne 75.0 61.7 43.4 61.7 51.2 41.7 98 Marowijne 52.0 35.4 20.0 27.4 20.6 10.3 86 Para 65.8 48.3 31.7 41.7 35.0 25.0 68 Brokopondo 32.2 20.0 7.0 11.3 7.8 2.6 46 Sipaliwini 13.4 7.7 4.2 7.4 3.6 2.7 137 Area Urban 79.8 68.3 54.1 65.9 57.1 44.9 1,539 Rural Coastal 65.2 47.9 33.7 42.9 33.8 23.1 354 Rural interior 18.1 10.8 4.9 8.4 4.6 2.7 183 Total Rural 49.1 35.3 23.9 31.1 23.9 16.1 537 Education* None 0.0 0.0 0.0 0.0 0.0 0.0 50 Primary 21.6 12.4 6.8 11.7 7.3 3.9 318 Secondary + 83.4 70.7 55.2 67.0 57.8 44.8 1,687 Other/Non-standard (*) (*) (*) (*) (*) (*) 19 Wealth index quintile Poorest 30.1 20.1 10.8 16.3 10.4 6.0 388 Second 66.7 49.9 32.8 46.2 36.3 26.0 433 Middle 79.0 64.8 47.5 64.3 54.8 37.1 398 Fourth 86.0 71.7 58.8 70.2 60.3 47.0 414 Richest 93.8 88.6 77.9 83.8 77.3 67.5 443 Ethnicity of household head* Indigenous/Amerindian 56.1 37.4 28.4 40.1 28.6 22.2 84 Maroon 47.6 34.8 20.4 28.9 21.0 12.6 579 Creole 84.5 76.7 66.6 72.3 64.6 53.7 358 Hindustani 78.7 65.8 51.4 65.3 57.1 42.7 560 Javanese 85.4 73.7 60.8 75.4 66.2 54.2 285 Mixed 89.7 75.2 58.4 66.8 58.2 48.4 180 Others (*) (*) (*) (*) (*) (*) 29 Total 71.8 59.8 46.3 56.9 48.5 37.4 2,076 * ‘Missing/DK’ categories not shown due to low number of observations (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator MT.2 2 MICS indicator MT.3      Ac 176 Th da ob wo ph pe pr the liv ed int ur the Gr pu Fig Figu     ccess to Mass M 6  Surinam he Suriname  aily  basis  du btained  from omen  claime hones  to ma ercent), and t oportion of y e proportion ing  in  highe ducation wer ternet when ban areas of e four purpo reater propo urposes when gure MT.1 be ure MT.1: Cell phon 75 0 25 50 75 100 Percent Ma Media and Use o me MICS4  MICS added ring  the  sev m  Table MT.3 ed  to have a ke or  receiv to access th young wome n using cellul er  socio‐eco re more  tha n compared  f Suriname,  oses mention ortions of yo n compared  elow is a gra ne use by purpose, S 65 68 11 Urban Figure M ake/Receive c of Information/ d the questio ven  days  pre 3  (page 177 a  cellular ph ve call  (69 pe e internet (9 en using cell lar phones w onomic  statu n  twice as  l to  their cou notably grea ned above w ung women to correspon phical repres Suriname, 2010   58 48 4 Rural Co MT.1: Cell ph calls Send /Communicatio ons on owne eceding  the  )  for  young  hone  that w ercent),  to s 9%). Educatio ular phones  was higher in us  groups.  ikely  to  send nterparts w ater proporti when compar   from rural  nding propo sentation of  42 48 5 oastal R hone use by d text messag on Technology ership and us survey  to  t women 15‐ orks.  Smalle send  text me on and weal for all of the n the cases o In  particular d  text messa ho attained  ions indicate red to corres coastal area rtions for the some of the 2 19 20 2 Rural interior y purpose, ges Rece se and patte the  standard ‐24  years. A er percentag essages  (58% th status see e abovement f women wit r,  those  att ages,  receive primary edu ed that they  sponding pro as used cellu e rural interi e discrepanci 53 38 2 Tota Suriname, ive text messa rn of use of  d  questionna Almost 4  in  e es  indicated %),  to  receiv em to matte tioned purpo th higher lev taining  at  le e  text messa ucation as  t used cellula oportions fo ular phones  f ior.  ies found.  8 38 4 l Rural 2010 ages' Acc cellular pho aire.  The  re every  5  (79  d  that  they u ve  text mess er in determ oses. In all in vels of educa east  seconda ages, and ac heir highest  ar phones fo or rural coast for each of t 69 58 60 Total cess internet ones on a  sults  are  percent)  use  their  sages  (60  ining the  nstances,  ation and  ary  level  ccess  the  level.  In  r each of  tal areas.  the  focal  9  Access to Mass Media and Use of Information/Communication Technology      Suriname MICS4 177 Table MT.3: Cell phone ownership and use Percentage of young women age 15-24 who own a cell phone that works, percentage who have used a cell phone during the last 7 days, and purpose of use among those with at least almost daily use during the last 7 days, Suriname, 2010 Percentage of women age 15-24 who: Number of women age 15- 24 years Own a cell phone that works In the past week, at least almost daily used a cell phone to: Make/Receive calls Send text messages Receive text messages' Access internet Age 15-19 74.6 64.2 57.6 57.7 7.5 1,085 20-24 83.7 74.3 58.3 62.9 11.1 991 District Paramaribo 85.3 78.9 67.4 70.9 12.5 1,034 Wanica 81.5 66.1 60.1 62.2 8.6 389 Nickerie 74.5 57.1 46.3 46.0 4.5 153 Coronie (*) (*) (*) (*) (*) 7 Saramacca 69.7 65.1 55.0 54.1 5.5 58 Commewijne 84.0 70.1 65.1 64.5 6.1 98 Marowijne 54.9 56.0 34.9 39.4 2.3 86 Para 71.7 58.3 54.2 54.2 8.3 68 Brokopondo 76.5 49.6 28.7 29.6 4.3 46 Sipaliwini 49.6 38.9 15.4 16.3 1.8 137 Area Urban 84.0 74.8 64.8 67.9 10.9 1,539 Rural Coastal 68.9 58.2 48.3 47.6 5.3 354 Rural interior 56.3 41.6 18.8 19.6 2.4 183 Total Rural 64.6 52.6 38.2 38.1 4.3 537 Education* None 53.1 36.8 2.5 10.8 0.0 50 Primary 56.2 48.1 25.8 25.5 3.5 318 Secondary + 83.8 74.0 65.8 68.3 10.6 1,687 Other/Non-standard (*) (*) (*) (*) (*) 19 Wealth index quintile Poorest 60.0 46.7 25.4 26.6 1.8 388 Second 74.2 64.7 49.7 53.4 4.6 433 Middle 83.8 72.2 64.5 66.9 11.5 398 Fourth 85.2 78.6 69.0 71.9 11.3 414 Richest 90.1 81.1 78.3 79.4 16.1 443 Ethnicity of household head* Indigenous/Amerindian 67.4 49.3 36.7 43.9 6.9 84 Maroon 69.7 59.8 39.2 42.3 3.4 579 Creole 86.8 82.9 75.7 77.1 12.8 358 Hindustani 75.7 63.9 55.1 58.2 8.0 560 Javanese 92.1 79.2 79.9 76.8 17.8 285 Mixed 88.9 82.3 68.9 73.6 10.1 180 Others (*) (*) (*) (*) (*) 29 Total 79.0 69.0 57.9 60.2 9.2 2,076 * ‘Missing/DK’ categories not shown due to low number of observations (*) Figures that are based on less than 25 unweighted cases       Appendix A. Sample Design 178  Suriname MICS4  Appendix A. Sample Design The major  features of  the sample design are described  in  this appendix. Sample design  features  include  target  sample  size,  sample  allocation,  sampling  frame  and  listing,  choice  of  domains,  sampling  stages,  stratification, and the calculation of sample weights.   The  primary  objective  of  the  sample  design  for  the  Suriname Multiple  Indicator  Cluster  Survey was  to  produce  statistically  reliable  estimates  of  most  indicators,  at  the  national  level,  for  areas  classified  as  urban,  rural  coastal  and  rural  interior,  and  for  the  10  districts  of  the  country  –  Paramaribo,  Wanica,  Nickerie, Coronie, Marowijne, Commewijne, Sarramacca, Para, Brokopondo, and Sipaliwini.   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 the Suriname MICS was calculated as 9,000 households. For the calculation of  the sample size, the key indicator used was the number of children younger than 5 years of age who had  had diarrhoea  in the past two weeks before the survey using the estimate of the  last MICS3 survey. The  following formula was used to estimate the required sample size for this indicator:  )])(()12.0[( )]1.1)()(1)((4[ _ 2 npr frrn    where   n is the required sample size, expressed as number of households   4 is a factor to achieve the 95 percent level of confidence   r is the predicted or anticipated value of the indicator, expressed in the form of a proportion   1.1 is the factor necessary to raise the sample size by 10 percent for the expected non‐response  [the actual factor will be based on the non‐response level experienced in previous surveys in the  country]   f is the shortened symbol for deff (design effect)    0.12r  is the margin of error to be tolerated at the 95 percent  level of confidence, defined as 12  percent of r (relative margin of error of r)   p is the proportion of the total population upon which the indicator, r, is based   _ nis the average household size (number of persons per household).    For the calculation, r (the number of children younger than 5 years of age who had had diarrhoea  in the  past two weeks before the survey) was assumed to be 10.6 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 10.3 percent,  _ n (average household size) was taken as 4, and the response  rate was assumed to be 90%.   The resulting number of households from this exercise was about 9,000  in total. The average number of  households  selected  per  cluster  for  the  Suriname MICS was  determined  as  20  households,  based  on  a  number of considerations,  including  the design effect,  the budget available, and  the  time  that would be  needed per team to complete one cluster.  Appendix A. Sample Design      Suriname MICS4 179 Sampling Frame and Sample Design Suriname  is  divided  into  10  districts  and  62  ‘ressorten’  by  law.  The  ‘ressorten’  are  subdivisions  at  the  district level. For purposes of conducting the fieldwork during the Seventh Population and Housing Census  the General Bureau of Statistics subdivided each ressort  in  the coastal area  (lowland and savannah)  into  ‘telblokken’. A ‘telblok’ also called an enumeration block, was considered to be the manageable workload  for a Census enumerator for the fieldwork period of two weeks and would ideally have between 100 and  150 objects. An object can be any kind of building or a construction work,  like, churches, schools, stores,  houses, dwellings  etc.  In  order  to  clarify: not  every object  stands  for  a dwelling or  living  quarters of  a  household. In the interior (rainforest) a somewhat different fieldwork approach was used, whereby teams  consisting of 5‐7 fieldworkers canvassed clusters of villages. These clusters were called  ‘telgebieden’ and  were expected to have approximately 500 households, or the workload of 5 interviewers. “Telgebied” can  also be called an enumeration area.  The 2004 census frame was used for the selection of clusters as the results of the 2004 Census provide a  basis for provisional estimates on the number of households. Thus, the ‘telblokken’ and ‘telgebieden’ were  considered  the best  currently available  subdivisions by  the General Bureau of Statistics and  formed  the  basis  for  the MICS  2010  sample  design.  The  2004  Population  Census  provided  the  sampling  frame  for  MICS4, and Table A1.1 below shows the distribution of the population and households around the country.  Also  shown  in  the  table are  the number of clusters and  sample households allocated  to each district  in  MICS4. As  in MICS3, three geographical strata were used  in MICS 4: urban areas; rural coastal areas; and  rural areas in the interior of the country.   Table A1.1: Distribution of population and households by stratum and district, and MICS4 sample design and outcome 2004 Population Census MICS 4 Sample Design MICS 4 Achieved Sample Households Population Average household size Clusters Households Clusters Households successfully interviewed Suriname 123,463 492,829 4.0 450 9,000 448 7,407 Stratum Urban 87,542 356,399 4.1 200 4,000 200 3,176 Rural coastal 22,257 88,079 4.0 150 3,000 149 2,367 Rural interior 13,664 48,351 3.5 100 2,000 99 1,864 District Paramaribo 59,392 242,946 4.1 136 2,720 136 2,184 Wanica 20,928 85,986 4.1 48 960 48 757 Nickerie 9,488 36,639 3.9 47 940 47 789 Coronie 932 2,887 3.1 7 140 7 93 Saramacca 4,309 15,980 3.7 29 580 29 445 Commewijne 6,363 24,649 3.9 27 540 27 418 Marowijne 3,987 16,642 4.2 27 540 27 446 Para 4,400 18,749 4.3 29 580 28 411 Brokopondo 3,749 14,215 3.8 24 480 24 437 Sipaliwini 9,915 34,136 3.4 76 1,520 75 1,427 Nw. Nickerie (Nickerie) 3,698 13,842 3.7 8 160 8 120 Meerzorg(Commewijne) 2,068 8,115 3.9 4 80 4 55 Tamanredjo (Commewijne) 1,456 5,510 3.8 4 80 4 60 Selection of Clusters Each  of  the  10  districts  in  the  country  is  allocated  to  one  of  these  strata,  but with  three  towns  (Nw.  Nickerie  in  Nickerie  district,  and  Meerzorg  and  Tamanredjo  in  Commewijne  district)  being  counted  as  urban, even though they are located in what are otherwise rural districts. The allocation of districts to the  three strata is shown in Table A1.2 below as follows:  Appendix A. Sample Design 180  Suriname MICS4    Table A1.2: Stratification of the population in Suriname in 2004 by strata Strata Population (Seventh Population and Housing Census) Urban Urban (Paramaribo, Wanica, Nw. Nickerie, Meerzorg, and Tamanredjo) 356,399 Rural Rural Coastal (remainder of Nickerie, remainder of Commewijne, Coronie, Saramacca, Para, and Marowijne) 88,079 Rural Interior (Brokopondo and Sipaliwini) 48,351 Total 492,829   In the case of MICS3, the total sample had been about 6,000 households. Survey results had been reported  not only for the three strata, but also for a five‐way breakdown of districts. This was achieved by grouping  districts  as  follows:  Paramaribo; Wanica  and  Para; Nickerie,  Coronie  and  Saramacca;  Commewijne  and  Marowijne; and Brokopondo and Sipaliwini. In the case of MICS4, the sample size was  increased to 9,000  households. One of the main benefits of this increase was that it would permit the reporting of indicators  at the district level.  The allocation within each stratum was done with probability proportional to size, where the population of  each area  (from  the 2004 census) was used as  the measure of  size.  It was only after  the  fieldwork was  completed  that  it  was  realized  that  the  samples  allocated  to  several  of  the  individual  districts  were  insufficient  to provide  satisfactory estimates  for many of  the variables. A more equal allocation  to each  district would have provided more precise estimates for the smaller districts.     It  should  be  noted  that,  according  to  sampling  theory,  it  is  the  size  of  the  sample,  rather  than  the  proportion of the population covered, that  is the key factor  in determining the precision of the estimate.  Several districts have  sample  sizes  that  are  around  the  500  level, which  is  slightly on  the  low  side. An  allocation of about 700 households would have been more appropriate, which could have been achieved  by  reducing  the  allocation  for  Paramaribo.  In  the  rural  interior,  the  allocation  for  Brokopondo  might  usefully  have  been  increased, with  a  corresponding  reduction  in  Sipaliwini. Only  140  households were  allocated to Cornie, reflecting  its small population of  less than 1,000 households, but  it would have been  necessary  to  cover  a  larger  number  of  households  there  (say  300  or  400)  in  order  to  obtain  reliable  estimates.  The actual sample selection in the selected clusters was done as follows. In urban and rural coastal areas,  where enumeration districts  (EDs) usually  contain  about 150 households, one pointer address  (PA) was  selected at random within the ED. If  it was not the address of a private household, the next address was  taken as the starting point. Twenty adjacent addresses (1 to 20) were then selected around this PA, and a  printed map provided to each team, showing the location of each address. In rural areas the enumeration  areas might  consist of either one village or  several  smaller villages  combined. Where a village was very  isolated,  it  was  treated  as  one  enumeration  area,  even  though  sometimes  it  did  not    contain  many  households.   Listing Activities There were some fieldwork activities conducted by the Cartography Unit of the GBS prior to the survey as a  means  of  establishing,  as  much  as  possible  (with  the  exception  of  the  interior)  the  landmarks  and  boundaries of each selected MICS‐cluster. This was done to facilitate the interview teams in the field with  maps and clearly defined boundaries. This was required to facilitate the  interview teams  in the field with  Appendix A. Sample Design      Suriname MICS4 181 maps and clearly defined boundaries. The  interview teams received during the fieldwork the  instructions  to gather information on each household encountered within the boundaries of designated MICS‐clusters.  For the Interior stratum where it is relatively difficult to geographically divide each enumeration block into  clusters of households, names of heads of households were used to select households that were sampled.   Selection of Households Unfortunately  no  full  listing was  carried  out  for  this  survey, which would  have  provided  an  up‐to‐date  sampling frame for each selected enumeration area. In future surveys, a listing team should prepare an up‐ to‐date numbered list of households in each selected area. This list should be sent to the head office of the  General Bureau of Statistics, who would  then select a random sample of 20 households  from across  the  whole list, using systematic sampling. This methodology would provide more precise estimates that can be  obtained from the “compact sample” approach that was adopted in many enumeration areas.   In designing the survey, only three main sampling strata (urban, rural coastal, and rural interior) were used,  but within the strata the sample clusters were allocated to districts (and the three towns) in proportion to  their  size.  It  should  be  remembered  that  three  towns  were  treated  in  a  special  way,  so  the  districts  containing them (Nickerie and Commewijne) were split up and weights applied to the separate elements  before they were finally combined.   No  full  listing exercise was  carried out  in MICS4,  so  there were no up‐to‐date  size estimates  for all  the  selected clusters. To get the correct weights, it was decided to weigh up to the latest population figures, as  reflected  in  the  official  population  projections  for  2004‐2024.  The  official  projections  provide  three  scenarios of growth  (high, constant and  low). For MICS  the constant model was used, which assumes a  total  fertility  rate of 2.52, male and  female expectation of  life of 67.4 and 72.8  respectively and no net  migration.  Table A1.3 below shows the relevant district figures for the 2004 census, the constant projections for 2012,  the  annual  growth  rate  for  each  district  implied  by  these  figures,  and  the  implied  growth  multiplier  between  2004  and  2010.  The  growth  was  estimated  using  the  standard  growth  formula  pt=p0ert.  The  column  in the Excel design weight template that  is normally used for recording the  listing sizes was filled  with values  calculated directly by multiplying  the original  size measure by  the growth multiplier  for  the  appropriate district. In using this method of calculation, we assumed that there has been no change in the  average household size between 2004 and 2010.    Table A1.3: Projections of the population by district Population 2004 Projection 2012 Implied annual growth rate (%) Implied growth multiplier, 2004-2010 Suriname 492,829 545,615 1.27 1.0793 District Paramaribo 242,946 273,002 1.46 1.0914 Wanica 85,986 97,981 1.63 1.1029 Nickerie 36,639 40,042 1.11 1.0689 Coronie 2,887 20,560 1.07 1.0666 Saramacca 15,980 1.07 1.0666 Commewijne 24,649 27,484 1.36 1.0851 Marowijne 16,642 16,348 -0.02 0.9867 Para 18,749 22,589 2.32 1.1500 Brokopondo 14,215 13,768 -0.03 0.9763 Sipaliwini 34,136 33,841 -0.01 0.9935 Appendix A. Sample Design 182  Suriname MICS4  Calculation of Sample Weights The  Suriname  Multiple  Indicator  Cluster  Survey  sample  is  not  self‐weighting.  Essentially,  by  allocating  sampling units disproportionately  in each of  the  regions, different  sampling  fractions were used  in each  region. For this reason, sample weights were calculated and these were used in the subsequent analyses of  the survey data.  The major component of  the weight  is  the reciprocal of  the sampling  fraction employed  in selecting  the  number of sample households in that particular sampling stratum (h) and PSU (i):  hi hi f W 1   The  term  fhi,  the  sampling  fraction  for  the  i‐th  sample  PSU  in  the  h‐th  stratum,  is  the  product  of  probabilities of selection at every stage in each sampling stratum:  hihihi ppf 21    where pshi is the probability of selection of the sampling unit at stage s for the i‐th sample PSU in the h‐th  sampling stratum.  The  sampling  fractions  for  households  in  each  enumeration  area  (cluster)  included  the  first  stage  probability of selection of the enumeration area in that particular sampling stratum and the second stage  probability of selection of a household in the sample enumeration area (cluster).   A second component in the calculation of sample weights takes into account the level of non‐response for  the  household  and  individual  interviews.  The  adjustment  for  household  non‐response  is  equal  to  the  inverse value of:  RRh = Number of interviewed households in stratum h/ Number of occupied households listed in stratum h  After the completion of fieldwork, response rates were calculated for each sampling stratum. These were  used  to adjust  the  sample weights calculated  for each cluster. Response  rates  in  the Suriname Multiple  Indicator Cluster Survey are shown in Table HH.1 (page 9) in this report.  Similarly, the adjustment for non‐response at the  individual  level (women and under‐5 children) for each  stratum is equal to the inverse value of:  RRh = Completed women’s (or under‐5’s) questionnaires in stratum h / Eligible women (or under‐5s) in stratum h  The  non‐response  adjustment  factors  for  women's  and  under‐5's  questionnaires  were  applied  to  the  adjusted household weights. Numbers of eligible women and under‐5  children were obtained  from  the  roster  of  household  members  in  the  Household  Questionnaire  for  households  where  interviews  were  completed.  The weights  for  the households were  calculated by multiplying  the above  factors  for each enumeration  area.  These  weights  were  then  standardized  (or  normalized),  one  purpose  of  which  is  to  make  the  weighted  sum  of  the  interviewed  sample  units  equal  the  total  sample  size  at  the  national  level.  Normalization is achieved by dividing the full sample weights (adjusted for non‐response) by the average of  these weights  across  all  households  at  the  national  level.  This  is  performed  by multiplying  the  sample  weights by a constant factor equal to the unweighted number of households at the national level divided  by the weighted total number of households (using the full sample weights adjusted for non‐response).  A  similar  standardization procedure was  followed  in obtaining  standardized weights  for  the women’s and  under‐5’s questionnaires.  In the 483 sample enumeration areas  (clusters), adjusted  (normalized) weights  varied between a minimum of 0.406618  in the case of women  in clusters 392 to 450 and a maximum of  Appendix A. Sample Design      Suriname MICS4 183 2.036209  in the case of children  in clusters 126 to 169 and clusters 462 to 465. Using the standard MICS  template, and  incorporating the growth rates shown above, the normalized weights were found to be as  shown in Table A1.4 below.  Table A1.4: Weights to be applied to the household, women, and child data hhweight wmweight chweight Cluster 1 to 125 1.666781 1.670331 2.015016 126 to 169 1.684311 1.687899 2.036209 170 to 177 1.632359 1.635835 1.973402 178 to 180 1.657094 1.660623 2.003305 181 to 184 1.657094 1.660623 2.003305 186 to 232 0.548778 0.533539 0.654314 233 to 240 0.547593 0.532387 0.652901 242 to 276 0.547593 0.532387 0.652901 277 to 299 0.557094 0.541624 0.664229 300 to 332 0.506596 0.492528 0.604021 333 to 367 0.590414 0.574019 0.703958 368 to 391 0.426726 0.399582 0.503419 392 to 450 0.434240 0.406618 0.512282 451 to 461 1.666781 1.670331 2.015016 462 to 465 1.684311 1.687899 2.036209 466 1.657094 1.660623 2.003305 467 to 483 0.434240 0.409349 0.512282   Sample weights were appended to all data sets and analyses were performed by weighting each  household, woman, and under‐5 with these sample weights.  Appendix B. List of Personnel Involved in the Survey 184  Suriname MICS4  Appendix B. List of Personnel Involved in the Survey MICS Technical Committee Member’s name Area of specialization Pahalwankhan, Faranaaz  Head of Research and Planning, Ministry of Social Affairs and Housing,  survey management  Warso, Jacqueline  Policy staff member Research and Planning, Ministry of Social Affairs  and Housing, survey management  Glebova, Ksenia  HIV/AIDS officer, UNICEF, MICS focal point and TC secretary 2009‐2011  Hirasingh, Prya  Monitoring and Evaluation Specialist, UNICEF Suriname  Eersteling‐Hammen,  Claudine  Child Survival and Development officer, UNICEF Suriname  Fung A Loi, Jo‐Ann  Manager  Social Statistics, General Bureau of Statistics, sampling expert  Algoe, Maltie  Head of National Health Information System Ministry of Health, health  data expert  MacNack‐Van Kats,  Marian  Policy advisor, Ministry of Social Affairs and Housing, child development  specialist  Mangoen, Els  Staff member Research Planning and Monitoring, Ministry of Education  and Community Development, education data expert  Van Kanten, Elly  Consultant Family and Community Health, PAHO Suriname  Brielle, Judith  Assistant representative, UNFPA Suriname  Vis, Simone  Education specialist, UNICEF Suriname   Hidalgo‐Sanchis, Paula  Social Policy and Poverty specialist, UNDP Suriname  MICS Fieldwork Coordination: General Bureau of Statistics Name Function Drs. Iwan Sno, M. Sc.  MICS Coordinator  Drs. Eartha Groenfelt  MICS Survey Coordinator  Ms. Jacquelina Sontohartono  MICS Assistant Coordinator Coastal   Drs. Guillano Koornaar  MICS Assistant Coordinator Interior  Ms. Astrid Hunte  Assistant Logistics  Ms. Miriam Ramdhari  Assistant Data entry   Ms. Edith Ritfeld  Assistant Data entry (part time)      Appendix B. List of Personnel Involved in the Survey      Suriname MICS4 185 MICS Fieldworkers Name First Name Name First Name Adriaans‐Nelson  Merlien  Misidjan  Patricia  Akima  Samaidy  Misidjang  Munita  Alensie  Marijke  Mungroo  Carmelita  Babel  Euredice  Neslo  Mirella  Baino  Monique  Olan  Dominique  Berrenstein  Charissa  Omouth  Sarajane  Bhikharie  Varsha  Pansa  Tinza  Biserta  Gerda  Pansa  Glenda  Boldewijn  Debora  Pinas  Miriam  Caupain  Naomi  Podrono  Pamela  Corinde  Ingrid  Poeketi  Isolda  Daschveld  Adelien  Pryor  Ruth  De Mees  Ilangha  Rahaman  Roxan  Dors  Jo‐Ann  Ramautarsing  Ingrid  Eduards  Nancy  Ramroep  Jankipersad  Eduards  Regina  Reding  Natasja  Esajas  Maira  Rigters  Daniella  Gonsalves Jardin de Ponte  Sara  Sabajo  Jerry  Hankers  Henna  Sante  Danitsia  Harper  Henna  Sheik Zahoeri  Jasmien  Hoefdraad  Vivian  Starke  Henna  Hoepel  Lucretia  Strijder  Joel  Huur  Hugo  Thakoersing  Radjkoemarie  Jabini  Astrano  Tojosemito  Lorette  Jahangir  Fauzia  Van Dalen  Brigitte  Karjamenawi  Karwan  Verbond  Denise  Kasmo  Jan  Vliet  Natashia  Kliwon  Brain  Wezer  Eunice  Lobles‐Lemen  Haidy  Wijnstein  Cherida  Luxemburg  Melanie      Mawdo  Mariska      Appendix B. List of Personnel Involved in the Survey 186  Suriname MICS4  MICS Data Processing Coordination: Institute for Social Science Research Name First Name Function Dundas  Benjamin  Supervisor  Moe Soe Let  Natashia  Supervisor  Altenberg  Judith  Data keyer  Bendt  Jennifer  Data keyer  Gopal  Lalini  Data keyer  Graham  Orphilia  Data keyer  Hardjopawiro  Nancy  Data keyer  Marengo  Alexandra  Data keyer  Moestro  Ypsila  Data keyer  Ondunk  Gittan  Data keyer  Overman  Loraine  Data keyer  Plein  Denice  Data keyer  Pryor  Burnithia  Data keyer  Stomp  Hellen  Data keyer  Tilborg  Shyreeta  Data keyer  Van Brussel   Stephanie  Data keyer  Vlijter  Lenea  Data keyer    Appendix C. Estimates of Sampling Errors      Suriname MICS4 187 Appendix C. Estimates of Sampling Errors The sample of respondents selected  in the Suriname 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  the  estimates  from  all possible  samples.  The  extent of variability is not known exactly, but can be estimated statistically from the survey data.  The following sampling error measures 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  of  the  estimate. The Taylor linearization method is used for the estimation of standard errors.   Coefficient of variation (se/r) is the ratio of the standard error to the value of the indicator, and is a  measure of the relative sampling error.   Design effect (deff)  is the ratio of the actual variance of an  indicator, under the sampling method  used  in  the survey,  to  the variance calculated under  the assumption of simple random sampling.  The square root of the design effect (deft)  is used to show the efficiency of the sample design  in  relation  to  the precision. A deft value of 1.0  indicates  that  the  sample design  is as efficient as a  simple  random sample, while a deft value above 1.0  indicates  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, with  a  specified  level  of  confidence.  For  any  given  statistic  calculated from the survey, the value of that statistic will fall within a range of plus or minus two  times the standard error (r + 2.se or r – 2.se) of the statistic in 95 percent of all possible samples of  identical size and design.     For the calculation of sampling errors from MICS data, SPSS Version 18 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 level, for the districts, and  for urban,  rural  coastal,  rural  interior,  and  total  rural  areas. One of  the  selected  indicators  is based on  households, 6 are based on household members, 19 are based on women, and 17 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.16 show the calculated sampling errors for selected domains.  Note that indicators related to malaria modules are only included in the tables for rural interior and for the  two districts of Brokopondo and Sipaliwini.        Appendix C. Estimates of Sampling Errors 188  Suriname MICS4    Table SE.1: Indicators selected for sampling error calculations List of indicators selected for sampling error calculations, and base populations (denominators) for each indicator, Suriname, 2010 MICS4 Indicator Base Population Households 3.12 Household availability of insecticide-treated nets (ITNs)26 All households Household members 4.1 Use of improved drinking water sources All household members 4.3 Use of improved sanitation All household members 7.5 Secondary school net attendance ratio (adjusted) Children of secondary school age 8.2 Child labour Children age 5-14 years 9.18 Prevalence of children with one or both parents dead Children age 0-17 years 8.5 Violent discipline Children age 2-14 years Women - Pregnant women26 Women age 15-49 years 3.19 Pregnant women sleeping under insecticide-treated nets (ITNs)26 Pregnant women 5.3 Contraceptive prevalence Women age 15-49 years who are currently married or in union 5.4 Unmet need Women age 15-49 years who are currently married or in union 5.5a Antenatal care coverage – at least once by skilled personnel Women age 15-49 years with a live birth in the 2 years preceding the survey 5.5b Antenatal care coverage – at least four times by any provider Women age 15-49 years with a live birth in the 2 years preceding the survey 5.7 Skilled attendant at delivery Women age 15-49 years with a live birth in the 2 years preceding the survey 5.8 Institutional deliveries Women age 15-49 years with a live birth in the 2 years preceding the survey 5.9 Caesarean section Women age 15-49 years with a live birth in the 2 years preceding the survey 7.1 Literacy rate among young women Women age 15-24 years 8.7 Marriage before age 18 Women age 20-49 years 8.9 Polygyny Women age 15-49 years who are currently married or in union 9.2 Comprehensive knowledge about HIV prevention among young people Women age 15-24 years 9.3 Knowledge of mother- to-child transmission of HIV Women age 15-49 years 9.4 Accepting attitudes towards people living with HIV Women age 15-49 years who have heard of HIV 9.6 Women who have been tested for HIV and know the results Women age 15-49 years 9.7 Sexually active young women who have been tested for HIV and know the results Women age 15-24 years who have had sex in the 12 months preceding the survey 9.11 Sex before age 15 among young women Women age 15-24 years 9.16 Condom use with non-regular partners Women age 15-24 years who had a non-marital, non-cohabiting partner in the 12 months preceding the survey Children under age 5 2.1a Underweight prevalence Children under age 5 2.2a Stunting prevalence Children under age 5 2.3a Wasting prevalence Children under age 5 2.6 Exclusive breastfeeding under 6 months Total number of infants under 6 months of age 2.14 Age-appropriate breastfeeding Children age 0-23 months - Received polio immunization Children age 12-23 months - Received measles (MMR) immunization Children age 12-23 months - Diarrhoea in the previous 2 weeks Children under age 5 - Illness with a cough in the previous 2 weeks Children under age 5 - Fever in last two weeks Children under age 5                                                              26 Brokopondo and Sipaliwini districts only  Appendix C. Estimates of Sampling Errors      Suriname MICS4 189   Table SE.1: Indicators selected for sampling error calculations (continued) List of indicators selected for sampling error calculations, and base populations (denominators) for each indicator, Suriname, 2010 3.8 Oral rehydration therapy with continued feeding Children under age 5 with diarrhoea in the previous 2 weeks 3.10 Antibiotic treatment of suspected pneumonia Children under age 5 with suspected pneumonia in the previous 2 weeks 3.15 Children under age 5 sleeping under insecticide-treated nets (ITNs) 27 Children under age 5 3.18 Anti-malarial treatment of children under age 527 Children under age 5 reported to have had fever in the previous 2 weeks 6.1 Support for learning Children age 36-59 months 6.7 Attendance to early childhood education Children age 36-59 months 8.1 Birth registration Children under age 5                                                                  27 Brokopondo and Sipaliwini districts only  Appendix C. Estimates of Sampling Errors 190  Suriname MICS4  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, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.9503 0.00395 0.004 2.450 1.565 28,421 7,407 0.942 0.958 Use of improved sanitation 4.3 0.8023 0.00970 0.012 4.392 2.096 28,421 7,407 0.783 0.822 Secondary school net attendance ratio (adjusted) 7.5 0.5937 0.01224 0.021 1.967 1.402 3,095 3,166 0.569 0.618 Child labour 8.2 0.0955 0.00548 0.057 2.186 1.479 5,607 6,289 0.085 0.107 Prevalence of children with one or both parents dead 9.18 0.0458 0.00337 0.074 2.923 1.710 9,941 11,228 0.039 0.053 Violent discipline 8.5 0.8609 0.00794 0.009 2.028 1.424 7,301 3,856 0.845 0.877 Women Contraceptive prevalence 5.3 0.4760 0.01014 0.021 1.429 1.196 3,406 3,470 0.456 0.496 Unmet need 5.4 0.1693 0.00841 0.050 1.745 1.321 3,406 3,470 0.152 0.186 Antenatal care coverage - at least once by skilled personnel 5.5a 0.9087 0.00845 0.009 1.087 1.043 1,060 1,265 0.892 0.926 Antenatal care coverage – at least four times by any provider 5.5b 0.6679 0.01587 0.024 1.436 1.198 1,060 1,265 0.636 0.700 Skilled attendant at delivery 5.7 0.9266 0.00881 0.010 1.442 1.201 1,060 1,265 0.909 0.944 Institutional deliveries 5.8 0.9229 0.00965 0.010 1.655 1.287 1,060 1,265 0.904 0.942 Caesarean section 5.9 0.1899 0.01282 0.067 1.350 1.162 1,060 1,265 0.164 0.216 Literacy rate among young women 7.1 0.9213 0.00648 0.007 1.188 1.090 2,076 2,053 0.908 0.934 Marriage before age 18 8.7 0.2299 0.00713 0.031 1.495 1.223 5,205 5,202 0.216 0.244 Polygyny 8.9 0.0395 0.00381 0.097 1.329 1.153 3,406 3,470 0.032 0.047 Comprehensive knowledge about HIV prevention among young people 9.2 0.4190 0.01317 0.031 1.463 1.209 2,076 2,053 0.393 0.445 Knowledge of mother- to-child transmission of HIV 9.3 0.5181 0.00766 0.015 1.479 1.216 6,290 6,290 0.503 0.533 Accepting attitudes towards people living with HIV 9.4 0.2111 0.00691 0.033 1.751 1.323 6,166 6,108 0.197 0.225 Women who have been tested for HIV and know the results 9.6 0.2032 0.00644 0.032 1.612 1.270 6,290 6,290 0.190 0.216 Sexually active young women who have been tested for HIV and know the results 9.7 0.3336 0.01680 0.050 1.571 1.254 1,182 1,238 0.300 0.367 Sex before age 15 among young women 9.11 0.0956 0.00682 0.071 1.103 1.050 2,076 2,053 0.082 0.109 Condom use with non-regular partners 9.16 0.5550 0.01661 0.030 0.773 0.879 696 693 0.522 0.588 Children under age 5 Underweight prevalence 2.1a 0.0577 0.00416 0.072 0.896 0.946 2,870 2,812 0.049 0.066 Stunting prevalence 2.2a 0.0880 0.00583 0.066 1.141 1.068 2,744 2,697 0.076 0.100 Wasting prevalence 2.3a 0.0499 0.00444 0.089 1.117 1.057 2,726 2,682 0.041 0.059 Exclusive breastfeeding under 6 months 2.6 0.0277 0.00881 0.318 0.872 0.934 286 304 0.010 0.045 Age-appropriate breastfeeding 2.14 0.1471 0.01021 0.069 1.133 1.064 1,390 1,366 0.127 0.168 Received polio immunization - 0.8318 0.01194 0.014 0.740 0.860 742 728 0.808 0.856 Received measles (MMR) immunization - 0.7794 0.01543 0.020 0.974 0.987 721 705 0.749 0.810 Diarrhoea in the previous 2 weeks - 0.0984 0.00682 0.069 1.732 1.316 3,308 3,308 0.085 0.112 Illness with a cough in the previous 2 weeks - 0.0220 0.00353 0.160 1.910 1.382 3,308 3,308 0.015 0.029 Oral rehydration therapy with continued feeding 3.8 0.6078 0.02215 0.036 0.706 0.840 325 344 0.564 0.652 Antibiotic treatment of suspected pneumonia 3.10 0.7120 0.02953 0.041 0.327 0.572 73 78 0.653 0.771 Support for learning 6.1 0.7290 0.01479 0.020 1.423 1.193 1,278 1,285 0.699 0.759 Attendance to early childhood education 6.7 0.3427 0.01278 0.037 0.931 0.965 1,278 1,285 0.317 0.368 Birth registration 8.1 0.9890 0.00235 0.002 1.673 1.293 3,308 3,308 0.984 0.994     Appendix C. Estimates of Sampling Errors      Suriname MICS4 191 Table SE.3: Sampling errors: Urban Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.9858 0.00317 0.003 2.287 1.512 20,066 3,176 0.979 0.992 Use of improved sanitation 4.3 0.8774 0.01304 0.015 5.021 2.241 20,066 3,176 0.851 0.903 Secondary school net attendance ratio (adjusted) 7.5 0.6617 0.01715 0.026 1.697 1.303 2,157 1,292 0.627 0.696 Child labour 8.2 0.0545 0.00660 0.121 1.818 1.348 3,590 2,150 0.041 0.068 Prevalence of children with one or both parents dead 9.18 0.0509 0.00498 0.098 1.944 1.394 6,324 3,787 0.041 0.061 Violent discipline 8.5 0.8471 0.01167 0.014 1.528 1.236 4,597 1,454 0.824 0.870 Women Contraceptive prevalence 5.3 0.4926 0.01333 0.027 1.042 1.021 2,430 1,466 0.466 0.519 Unmet need 5.4 0.1509 0.01103 0.073 1.392 1.180 2,430 1,466 0.129 0.173 Antenatal care coverage - at least once by skilled personnel 5.5a 0.9429 0.01020 0.011 0.777 0.881 668 403 0.923 0.963 Antenatal care coverage – at least four times by any provider 5.5b 0.6800 0.02318 0.034 0.992 0.996 668 403 0.634 0.726 Skilled attendant at delivery 5.7 0.9653 0.00938 0.010 1.055 1.027 668 403 0.947 0.984 Institutional deliveries 5.8 0.9455 0.01293 0.014 1.303 1.141 668 403 0.920 0.971 Caesarean section 5.9 0.2207 0.01956 0.089 0.895 0.946 668 403 0.182 0.260 Literacy rate among young women 7.1 0.9635 0.00626 0.006 1.033 1.016 1,539 929 0.951 0.976 Marriage before age 18 8.7 0.1799 0.00907 0.050 1.288 1.135 3,826 2,309 0.162 0.198 Polygyny 8.9 0.0266 0.00463 0.174 1.210 1.100 2,430 1,466 0.017 0.036 Comprehensive knowledge about HIV prevention among young people 9.2 0.4498 0.01694 0.038 1.076 1.037 1,539 929 0.416 0.484 Knowledge of mother- to-child transmission of HIV 9.3 0.5011 0.00984 0.020 1.079 1.039 4,620 2,788 0.481 0.521 Accepting attitudes towards people living with HIV 9.4 0.2302 0.00887 0.039 1.220 1.105 4,562 2,753 0.212 0.248 Women who have been tested for HIV and know the results 9.6 0.2052 0.00834 0.041 1.188 1.090 4,620 2,788 0.189 0.222 Sexually active young women who have been tested for HIV and know the results 9.7 0.3485 0.02250 0.065 1.131 1.063 842 508 0.303 0.394 Sex before age 15 among young women 9.11 0.0678 0.00815 0.120 0.974 0.987 1,539 929 0.052 0.084 Condom use with non-regular partners 9.16 0.5967 0.02004 0.034 0.524 0.724 522 315 0.557 0.637 Children under age 5 Underweight prevalence 2.1a 0.0556 0.00581 0.104 0.566 0.752 1,775 881 0.044 0.067 Stunting prevalence 2.2a 0.0680 0.00790 0.116 0.825 0.908 1,692 840 0.052 0.084 Wasting prevalence 2.3a 0.0504 0.00619 0.123 0.667 0.816 1,678 833 0.038 0.063 Exclusive breastfeeding under 6 months 2.6 0.0126 0.01280 1.013 1.024 1.012 159 79 0.000 0.038 Age-appropriate breastfeeding 2.14 0.1363 0.01398 0.103 0.704 0.839 856 425 0.108 0.164 Received polio immunization - 0.8508 0.01670 0.020 0.499 0.706 459 228 0.817 0.884 Received measles (MMR) immunization - 0.7839 0.02238 0.029 0.654 0.808 447 222 0.739 0.829 Diarrhoea in the previous 2 weeks - 0.0937 0.01007 0.107 1.185 1.089 2,001 993 0.074 0.114 Illness with a cough in the previous 2 weeks - 0.0211 0.00531 0.252 1.357 1.165 2,001 993 0.010 0.032 Oral rehydration therapy with continued feeding 3.8 0.5912 0.03459 0.059 0.455 0.675 187 93 0.522 0.660 Antibiotic treatment of suspected pneumonia 3.10 * * * * * 42 21 * * Support for learning 6.1 0.8088 0.02046 0.025 1.031 1.015 770 382 0.768 0.850 Attendance to early childhood education 6.7 0.4397 0.01867 0.042 0.539 0.734 770 382 0.402 0.477 Birth registration 8.1 0.9960 0.00203 0.002 1.019 1.009 2,001 993 0.992 1.000     Appendix C. Estimates of Sampling Errors 192  Suriname MICS4  Table SE.4: Sampling errors: Rural coastal Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.9587 0.01135 0.012 7.694 2.774 5,240 2,367 0.936 0.981 Use of improved sanitation 4.3 0.8340 0.01272 0.015 2.763 1.662 5,240 2,367 0.809 0.859 Secondary school net attendance ratio (adjusted) 7.5 0.5630 0.01623 0.029 1.176 1.085 603 1,100 0.531 0.595 Child labour 8.2 0.0817 0.00964 0.118 2.461 1.569 1,087 1,987 0.062 0.101 Prevalence of children with one or both parents dead 9.18 0.0367 0.00412 0.112 1.693 1.301 1,922 3,518 0.028 0.045 Violent discipline 8.5 0.8582 0.01366 0.016 1.856 1.362 1,393 1,211 0.831 0.886 Women Contraceptive prevalence 5.3 0.5063 0.01516 0.030 1.215 1.102 701 1,323 0.476 0.537 Unmet need 5.4 0.1668 0.01123 0.067 1.199 1.095 701 1,323 0.144 0.189 Antenatal care coverage - at least once by skilled personnel 5.5a 0.9488 0.01159 0.012 1.018 1.009 193 369 0.926 0.972 Antenatal care coverage – at least four times by any provider 5.5b 0.7189 0.02372 0.033 1.025 1.012 193 369 0.671 0.766 Skilled attendant at delivery 5.7 0.9537 0.00945 0.010 0.745 0.863 193 369 0.935 0.973 Institutional deliveries 5.8 0.9075 0.01417 0.016 0.880 0.938 193 369 0.879 0.936 Caesarean section 5.9 0.1666 0.01671 0.100 0.740 0.860 193 369 0.133 0.200 Literacy rate among young women 7.1 0.9329 0.01039 0.011 1.157 1.076 354 672 0.912 0.954 Marriage before age 18 8.7 0.3009 0.01177 0.039 1.103 1.050 887 1,675 0.277 0.324 Polygyny 8.9 0.0163 0.00482 0.297 1.923 1.387 701 1,323 0.007 0.026 Comprehensive knowledge about HIV prevention among young people 9.2 0.3770 0.02141 0.057 1.310 1.144 354 672 0.334 0.420 Knowledge of mother- to-child transmission of HIV 9.3 0.5672 0.01223 0.022 1.240 1.113 1,077 2,036 0.543 0.592 Accepting attitudes towards people living with HIV 9.4 0.1857 0.01006 0.054 1.328 1.153 1,051 1,987 0.166 0.206 Women who have been tested for HIV and know the results 9.6 0.1769 0.00942 0.053 1.240 1.114 1,077 2,036 0.158 0.196 Sexually active young women who have been tested for HIV and know the results 9.7 0.3048 0.02382 0.078 1.015 1.007 199 380 0.257 0.352 Sex before age 15 among young women 9.11 0.0933 0.01300 0.139 1.340 1.158 354 672 0.067 0.119 Condom use with non-regular partners 9.16 0.5129 0.03788 0.074 1.005 1.003 92 176 0.437 0.589 Children under age 5 Underweight prevalence 2.1a 0.0720 0.00935 0.130 1.061 1.030 525 812 0.053 0.091 Stunting prevalence 2.2a 0.0883 0.01034 0.117 1.027 1.013 500 773 0.068 0.109 Wasting prevalence 2.3a 0.0687 0.01128 0.164 1.523 1.234 496 767 0.046 0.091 Exclusive breastfeeding under 6 months 2.6 0.0640 0.01460 0.228 0.334 0.578 61 95 0.035 0.093 Age-appropriate breastfeeding 2.14 0.1674 0.01689 0.101 0.821 0.906 259 402 0.134 0.201 Received polio immunization - 0.7926 0.02616 0.033 0.841 0.917 131 203 0.740 0.845 Received measles (MMR) immunization - 0.7343 0.02588 0.035 0.683 0.827 129 200 0.683 0.786 Diarrhoea in the previous 2 weeks - 0.0803 0.00979 0.122 1.208 1.099 603 932 0.061 0.100 Illness with a cough in the previous 2 weeks - 0.0119 0.00391 0.327 1.205 1.098 603 932 0.004 0.020 Oral rehydration therapy with continued feeding 3.8 0.6403 0.03324 0.052 0.355 0.596 48 75 0.574 0.707 Antibiotic treatment of suspected pneumonia 3.10 * * * * * 7 11 * * Support for learning 6.1 0.8033 0.02503 0.031 1.372 1.171 225 347 0.753 0.853 Attendance to early childhood education 6.7 0.2274 0.02266 0.100 1.011 1.006 225 347 0.182 0.273 Birth registration 8.1 0.9824 0.00934 0.010 4.700 2.168 603 932 0.964 1.000     Appendix C. Estimates of Sampling Errors      Suriname MICS4 193 Table SE.5: Sampling errors: Rural interior Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweight ed count Confidence limits r - 2se r + 2se Households Household availability of insecticide- treated nets (ITNs) 3.12 0.6046 0.01463 0.024 1.668 1.292 806 1,864 0.575 0.634 Household members Use of improved drinking water sources 4.1 0.7069 0.02210 0.031 4.393 2.096 3,114 1,864 0.663 0.751 Use of improved sanitation 4.3 0.2657 0.02121 0.080 4.296 2.073 3,114 1,864 0.223 0.308 Secondary school net attendance ratio (adjusted) 7.5 0.2098 0.01654 0.079 1.276 1.130 334 774 0.177 0.243 Child labour 8.2 0.2703 0.01595 0.059 2.775 1.666 930 2,152 0.238 0.302 Prevalence of children with one or both parents dead 9.18 0.0372 0.00482 0.130 2.546 1.596 1,695 3,923 0.028 0.047 Violent discipline 8.5 0.9123 0.01019 0.011 1.545 1.243 1,310 1,191 0.892 0.933 Women Pregnant women - 0.0778 0.00644 0.083 0.846 0.920 593 1,466 0.065 0.091 Pregnant women sleeping under insecticide-treated nets (ITNs) 3.19 0.5047 0.04761 0.094 0.998 0.999 45 111 0.409 0.600 Contraceptive prevalence 5.3 0.2526 0.02046 0.081 1.508 1.228 275 681 0.212 0.293 Unmet need 5.4 0.3378 0.02193 0.065 1.462 1.209 275 681 0.294 0.382 Antenatal care coverage - at least once by skilled personnel 5.5a 0.7550 0.02697 0.036 1.935 1.391 199 493 0.701 0.809 Antenatal care coverage – at least four times by any provider 5.5b 0.5781 0.02429 0.042 1.191 1.091 199 493 0.529 0.627 Skilled attendant at delivery 5.7 0.7708 0.02945 0.038 2.415 1.554 199 493 0.712 0.830 Institutional deliveries 5.8 0.8622 0.02434 0.028 2.452 1.566 199 493 0.813 0.911 Caesarean section 5.9 0.1094 0.01413 0.129 1.008 1.004 199 493 0.081 0.138 Literacy rate among young women 7.1 0.5432 0.03778 0.070 2.594 1.611 183 452 0.468 0.619 Marriage before age 18 8.7 0.4911 0.01641 0.033 1.311 1.145 493 1,218 0.458 0.524 Polygyny 8.9 0.2119 0.01879 0.089 1.438 1.199 275 681 0.174 0.249 Comprehensive knowledge about HIV prevention among young people 9.2 0.2407 0.02037 0.085 1.024 1.012 183 452 0.200 0.281 Knowledge of mother- to-child transmission of HIV 9.3 0.5614 0.01502 0.027 1.343 1.159 593 1,466 0.531 0.591 Accepting attitudes towards people living with HIV 9.4 0.1014 0.00925 0.091 1.285 1.134 553 1,368 0.083 0.120 Women who have been tested for HIV and know the results 9.6 0.2357 0.01236 0.052 1.243 1.115 593 1,466 0.211 0.260 Sexually active young women who have been tested for HIV and know the results 9.7 0.2854 0.02514 0.088 1.082 1.040 141 350 0.235 0.336 Sex before age 15 among young women 9.11 0.3340 0.02378 0.071 1.147 1.071 183 452 0.286 0.382 Condom use with non-regular partners 9.16 0.3360 0.03497 0.104 1.102 1.050 82 202 0.266 0.406 Children under age 5 Underweight prevalence 2.1a 0.0509 0.00601 0.118 0.835 0.914 570 1,119 0.039 0.063 Stunting prevalence 2.2a 0.1488 0.01192 0.080 1.214 1.102 552 1,084 0.125 0.173 Wasting prevalence 2.3a 0.0314 0.00478 0.152 0.813 0.902 551 1,082 0.022 0.041 Exclusive breastfeeding under 6 months 2.6 0.0307 0.01706 0.556 1.262 1.124 66 130 0.000 0.065 Age-appropriate breastfeeding 2.14 0.1617 0.02211 0.137 1.940 1.393 274 539 0.117 0.206 Received polio immunization - 0.8081 0.01754 0.022 0.587 0.766 151 297 0.773 0.843 Received measles (MMR) immunization - 0.8060 0.02335 0.029 0.983 0.992 144 283 0.759 0.853 Diarrhoea in the previous 2 weeks - 0.1273 0.01155 0.091 1.659 1.288 705 1,383 0.104 0.150 Illness with a cough in the previous 2 weeks - 0.0333 0.00595 0.179 1.521 1.233 705 1,383 0.021 0.045 Fever in last two weeks - 0.1698 0.01447 0.085 2.051 1.432 705 1,383 0.141 0.199 Oral rehydration therapy with continued feeding 3.8 0.6249 0.03216 0.051 0.772 0.879 90 176 0.561 0.689 Antibiotic treatment of suspected pneumonia 3.10 * * * * * 23 46 * * Children under age 5 sleeping under insecticide-treated nets (ITNs) 3.15 0.4335 0.02186 0.050 2.526 1.589 662 1,299 0.390 0.477 Anti-malarial treatment of children under age 5 3.18 0.0000 0.00000 0.000 na na 120 235 0.000 0.000 Support for learning 6.1 0.4531 0.02654 0.059 1.577 1.256 283 556 0.400 0.506 Attendance to early childhood education 6.7 0.1708 0.02317 0.136 2.104 1.451 283 556 0.124 0.217 Appendix C. Estimates of Sampling Errors 194  Suriname MICS4  Birth registration 8.1 0.9746 0.00454 0.005 1.151 1.073 705 1,383 0.966 0.984   Table SE.6: Sampling errors: Total rural Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.8648 0.01085 0.013 4.257 2.063 8,355 4,231 0.843 0.887 Use of improved sanitation 4.3 0.6221 0.01180 0.019 2.506 1.583 8,355 4,231 0.599 0.646 Secondary school net attendance ratio (adjusted) 7.5 0.4371 0.01252 0.029 1.193 1.092 938 1,874 0.412 0.462 Child labour 8.2 0.1686 0.00910 0.054 2.446 1.564 2,017 4,139 0.150 0.187 Prevalence of children with one or both parents dead 9.18 0.0369 0.00315 0.085 2.073 1.440 3,618 7,441 0.031 0.043 Violent discipline 8.5 0.8844 0.00865 0.010 1.758 1.326 2,704 2,402 0.867 0.902 Women Contraceptive prevalence 5.3 0.4348 0.01215 0.028 1.204 1.097 976 2,004 0.410 0.459 Unmet need 5.4 0.2150 0.01002 0.047 1.191 1.091 976 2,004 0.195 0.235 Antenatal care coverage - at least once by skilled personnel 5.5a 0.8504 0.01510 0.018 1.544 1.242 392 862 0.820 0.881 Antenatal care coverage – at least four times by any provider 5.5b 0.6474 0.01726 0.027 1.124 1.060 392 862 0.613 0.682 Skilled attendant at delivery 5.7 0.8608 0.01639 0.019 1.930 1.389 392 862 0.828 0.894 Institutional deliveries 5.8 0.8845 0.01431 0.016 1.726 1.314 392 862 0.856 0.913 Caesarean section 5.9 0.1375 0.01085 0.079 0.854 0.924 392 862 0.116 0.159 Literacy rate among young women 7.1 0.8002 0.01691 0.021 2.008 1.417 537 1,124 0.766 0.834 Marriage before age 18 8.7 0.3688 0.00959 0.026 1.143 1.069 1,379 2,893 0.350 0.388 Polygyny 8.9 0.0714 0.00663 0.093 1.329 1.153 976 2,004 0.058 0.085 Comprehensive knowledge about HIV prevention among young people 9.2 0.3306 0.01597 0.048 1.294 1.138 537 1,124 0.299 0.363 Knowledge of mother- to-child transmission of HIV 9.3 0.5652 0.00952 0.017 1.290 1.136 1,670 3,502 0.546 0.584 Accepting attitudes towards people living with HIV 9.4 0.1566 0.00737 0.047 1.378 1.174 1,604 3,355 0.142 0.171 Women who have been tested for HIV and know the results 9.6 0.1978 0.00754 0.038 1.255 1.120 1,670 3,502 0.183 0.213 Sexually active young women who have been tested for HIV and know the results 9.7 0.2968 0.01741 0.059 1.059 1.029 341 730 0.262 0.332 Sex before age 15 among young women 9.11 0.1752 0.01214 0.069 1.146 1.071 537 1,124 0.151 0.200 Condom use with non-regular partners 9.16 0.4297 0.02737 0.064 1.153 1.074 174 378 0.375 0.484 Children under age 5 Underweight prevalence 2.1a 0.0610 0.00549 0.090 1.013 1.007 1,095 1,931 0.050 0.072 Stunting prevalence 2.2a 0.1201 0.00795 0.066 1.109 1.053 1,052 1,857 0.104 0.136 Wasting prevalence 2.3a 0.0491 0.00594 0.121 1.400 1.183 1,047 1,849 0.037 0.061 Exclusive breastfeeding under 6 months 2.6 0.0467 0.01128 0.242 0.641 0.800 127 225 0.024 0.069 Age-appropriate breastfeeding 2.14 0.1645 0.01403 0.085 1.346 1.160 534 941 0.136 0.193 Received polio immunization - 0.8009 0.01537 0.019 0.739 0.860 283 500 0.770 0.832 Received measles (MMR) immunization - 0.7721 0.01778 0.023 0.866 0.931 274 483 0.737 0.808 Diarrhoea in the previous 2 weeks - 0.1056 0.00776 0.073 1.475 1.215 1,307 2,315 0.090 0.121 Illness with a cough in the previous 2 weeks - 0.0234 0.00368 0.157 1.372 1.171 1,307 2,315 0.016 0.031 Oral rehydration therapy with continued feeding 3.8 0.6303 0.02381 0.038 0.608 0.780 138 251 0.583 0.678 Antibiotic treatment of suspected pneumonia 3.10 0.5119 0.05674 0.111 0.721 0.849 31 57 0.398 0.625 Support for learning 6.1 0.6083 0.01965 0.032 1.462 1.209 509 903 0.569 0.648 Attendance to early childhood education 6.7 0.1959 0.01622 0.083 1.507 1.228 509 903 0.163 0.228 Birth registration 8.1 0.9782 0.00493 0.005 2.639 1.624 1,307 2,315 0.968 0.988     Appendix C. Estimates of Sampling Errors      Suriname MICS4 195 Table SE.7: Sampling errors: Paramaribo Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.9913 0.00252 0.003 1.607 1.268 13,419 2,184 0.986 0.996 Use of improved sanitation 4.3 0.8707 0.01764 0.020 6.035 2.457 13,419 2,184 0.835 0.906 Secondary school net attendance ratio (adjusted) 7.5 0.6826 0.02008 0.029 1.516 1.231 1,360 816 0.642 0.723 Child labour 8.2 0.0531 0.00817 0.154 1.825 1.351 2,292 1,375 0.037 0.069 Prevalence of children with one or both parents dead 9.18 0.0568 0.00661 0.116 1.978 1.407 4,050 2,430 0.044 0.070 Violent discipline 8.5 0.8501 0.01297 0.015 1.256 1.121 2,925 952 0.824 0.876 Women Contraceptive prevalence 5.3 0.4760 0.01711 0.036 1.052 1.026 1,484 897 0.442 0.510 Unmet need 5.4 0.1527 0.01406 0.092 1.370 1.170 1,484 897 0.125 0.181 Antenatal care coverage - at least once by skilled personnel 5.5a 0.9269 0.01404 0.015 0.754 0.868 430 260 0.899 0.955 Antenatal care coverage – at least four times by any provider 5.5b 0.6423 0.02748 0.043 0.851 0.923 430 260 0.587 0.697 Skilled attendant at delivery 5.7 0.9615 0.01258 0.013 1.109 1.053 430 260 0.936 0.987 Institutional deliveries 5.8 0.9538 0.01563 0.016 1.438 1.199 430 260 0.923 0.985 Caesarean section 5.9 0.2385 0.02512 0.105 0.900 0.949 430 260 0.188 0.289 Literacy rate among young women 7.1 0.9648 0.00784 0.008 1.131 1.063 1,034 625 0.949 0.980 Marriage before age 18 8.7 0.1445 0.01052 0.073 1.368 1.169 2,529 1,529 0.123 0.166 Polygyny 8.9 0.0290 0.00657 0.227 1.374 1.172 1,484 897 0.016 0.042 Comprehensive knowledge about HIV prevention among young people 9.2 0.4784 0.02037 0.043 1.038 1.019 1,034 625 0.438 0.519 Knowledge of mother- to-child transmission of HIV 9.3 0.4793 0.01163 0.024 0.995 0.997 3,037 1,836 0.456 0.503 Accepting attitudes towards people living with HIV 9.4 0.2435 0.01178 0.048 1.367 1.169 3,002 1,815 0.220 0.267 Women who have been tested for HIV and know the results 9.6 0.2190 0.01097 0.050 1.290 1.136 3,037 1,836 0.197 0.241 Sexually active young women who have been tested for HIV and know the results 9.7 0.3733 0.02399 0.064 0.881 0.938 594 359 0.325 0.421 Sex before age 15 among young women 9.11 0.0688 0.00939 0.136 0.858 0.926 1,034 625 0.050 0.088 Condom use with non-regular partners 9.16 0.6266 0.02335 0.037 0.541 0.735 385 233 0.580 0.673 Children under age 5 Underweight prevalence 2.1a 0.0558 0.00710 0.127 0.531 0.729 1,118 556 0.042 0.070 Stunting prevalence 2.2a 0.0584 0.00817 0.140 0.644 0.802 1,067 531 0.042 0.075 Wasting prevalence 2.3a 0.0496 0.00760 0.153 0.641 0.801 1,053 524 0.034 0.065 Exclusive breastfeeding under 6 months 2.6 0.0179 0.01818 1.018 1.037 1.018 113 56 0.000 0.054 Age-appropriate breastfeeding 2.14 0.1196 0.01634 0.137 0.697 0.835 555 276 0.087 0.152 Received polio immunization - 0.8571 0.02054 0.024 0.479 0.692 281 140 0.816 0.898 Received measles (MMR) immunization - 0.7810 0.02805 0.036 0.626 0.791 275 137 0.725 0.837 Diarrhoea in the previous 2 weeks - 0.0836 0.01166 0.140 1.124 1.060 1,274 634 0.060 0.107 Illness with a cough in the previous 2 weeks - 0.0205 0.00633 0.309 1.264 1.124 1,274 634 0.008 0.033 Oral rehydration therapy with continued feeding 3.8 0.6604 0.04008 0.061 0.372 0.610 107 53 0.580 0.741 Antibiotic treatment of suspected pneumonia 3.10 * * * * * 26 13 * * Support for learning 6.1 0.8017 0.02201 0.027 0.734 0.857 486 242 0.758 0.846 Attendance to early childhood education 6.7 0.4876 0.02241 0.046 0.484 0.696 486 242 0.443 0.532 Birth registration 8.1 0.9953 0.00277 0.003 1.029 1.015 1,274 634 0.990 1.000       Appendix C. Estimates of Sampling Errors 196  Suriname MICS4    Table SE.8: Sampling errors: Wanica Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.9745 0.00969 0.010 2.856 1.690 5,217 757 0.955 0.994 Use of improved sanitation 4.3 0.8783 0.01972 0.022 2.750 1.658 5,217 757 0.839 0.918 Secondary school net attendance ratio (adjusted) 7.5 0.6240 0.03087 0.049 1.486 1.219 618 367 0.562 0.686 Child labour 8.2 0.0601 0.01362 0.227 1.963 1.401 1,009 599 0.033 0.087 Prevalence of children with one or both parents dead 9.18 0.0401 0.00786 0.196 1.714 1.309 1,804 1,071 0.024 0.056 Violent discipline 8.5 0.8450 0.02641 0.031 2.098 1.449 1,325 395 0.792 0.898 Women Contraceptive prevalence 5.3 0.5159 0.02543 0.049 1.137 1.066 735 440 0.465 0.567 Unmet need 5.4 0.1636 0.02124 0.130 1.448 1.203 735 440 0.121 0.206 Antenatal care coverage - at least once by skilled personnel 5.5a 0.9649 0.01604 0.017 0.859 0.927 191 114 0.933 0.997 Antenatal care coverage – at least four times by any provider 5.5b 0.7456 0.04871 0.065 1.414 1.189 191 114 0.648 0.843 Skilled attendant at delivery 5.7 0.9737 0.01434 0.015 0.906 0.952 191 114 0.945 1.000 Institutional deliveries 5.8 0.9386 0.02139 0.023 0.897 0.947 191 114 0.896 0.981 Caesarean section 5.9 0.1667 0.02603 0.156 0.551 0.742 191 114 0.115 0.219 Literacy rate among young women 7.1 0.9657 0.00941 0.010 0.619 0.787 389 233 0.947 0.984 Marriage before age 18 8.7 0.2476 0.01888 0.076 1.181 1.087 1,033 618 0.210 0.285 Polygyny 8.9 0.0273 0.00727 0.267 0.875 0.935 735 440 0.013 0.042 Comprehensive knowledge about HIV prevention among young people 9.2 0.3820 0.03709 0.097 1.352 1.163 389 233 0.308 0.456 Knowledge of mother- to-child transmission of HIV 9.3 0.5300 0.02219 0.042 1.479 1.216 1,252 749 0.486 0.574 Accepting attitudes towards people living with HIV 9.4 0.1962 0.01380 0.070 0.891 0.944 1,235 739 0.169 0.224 Women who have been tested for HIV and know the results 9.6 0.1936 0.01331 0.069 0.849 0.921 1,252 749 0.167 0.220 Sexually active young women who have been tested for HIV and know the results 9.7 0.3190 0.05172 0.162 1.416 1.190 194 116 0.216 0.422 Sex before age 15 among young women 9.11 0.0687 0.01593 0.232 0.920 0.959 389 233 0.037 0.101 Condom use with non-regular partners 9.16 0.5072 0.04060 0.080 0.448 0.670 115 69 0.426 0.588 Children under age 5 Underweight prevalence 2.1a 0.0562 0.01085 0.193 0.591 0.769 542 267 0.034 0.078 Stunting prevalence 2.2a 0.0973 0.01929 0.198 1.085 1.042 522 257 0.059 0.136 Wasting prevalence 2.3a 0.0506 0.01133 0.224 0.684 0.827 522 257 0.028 0.073 Exclusive breastfeeding under 6 months 2.6 * * * * * 41 20 * * Age-appropriate breastfeeding 2.14 0.1417 0.03033 0.214 0.900 0.949 244 120 0.081 0.202 Received polio immunization - 0.8310 0.02955 0.036 0.435 0.660 144 71 0.772 0.890 Received measles (MMR) immunization - 0.7971 0.04270 0.054 0.767 0.876 140 69 0.712 0.883 Diarrhoea in the previous 2 weeks - 0.1119 0.02110 0.189 1.317 1.148 599 295 0.070 0.154 Illness with a cough in the previous 2 weeks - 0.0136 0.00836 0.617 1.537 1.240 599 295 0.000 0.030 Oral rehydration therapy with continued feeding 3.8 * * * * * 67 33 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 8 4 * * Support for learning 6.1 0.8034 0.04628 0.058 1.573 1.254 238 117 0.711 0.896 Attendance to early childhood education 6.7 0.3675 0.03218 0.088 0.517 0.719 238 117 0.303 0.432 Birth registration 8.1 0.9966 0.00338 0.003 0.995 0.998 599 295 0.990 1.000     Appendix C. Estimates of Sampling Errors      Suriname MICS4 197   Table SE.9: Sampling errors: Nickerie Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.9792 0.01645 0.017 10.449 3.233 2,081 789 0.946 1.000 Use of improved sanitation 4.3 0.9532 0.01357 0.014 3.249 1.803 2,081 789 0.926 0.980 Secondary school net attendance ratio (adjusted) 7.5 0.6476 0.05543 0.086 4.430 2.105 245 330 0.537 0.758 Child labour 8.2 0.0410 0.01683 0.410 3.577 1.891 374 498 0.007 0.075 Prevalence of children with one or both parents dead 9.18 0.0463 0.01085 0.234 2.358 1.536 649 886 0.025 0.068 Violent discipline 8.5 0.8138 0.03113 0.038 2.289 1.513 467 359 0.751 0.876 Women Contraceptive prevalence 5.3 0.5051 0.02417 0.048 1.103 1.050 326 473 0.457 0.553 Unmet need 5.4 0.1063 0.01869 0.176 1.737 1.318 326 473 0.069 0.144 Antenatal care coverage - at least once by skilled personnel 5.5a 0.9826 0.00834 0.008 0.353 0.594 61 88 0.966 0.999 Antenatal care coverage – at least four times by any provider 5.5b 0.7806 0.03951 0.051 0.793 0.891 61 88 0.702 0.860 Skilled attendant at delivery 5.7 0.9913 0.00851 0.009 0.729 0.854 61 88 0.974 1.000 Institutional deliveries 5.8 0.9031 0.05545 0.061 3.058 1.749 61 88 0.792 1.000 Caesarean section 5.9 0.1584 0.04391 0.277 1.259 1.122 61 88 0.071 0.246 Literacy rate among young women 7.1 0.9196 0.02507 0.027 1.853 1.361 153 219 0.869 0.970 Marriage before age 18 8.7 0.2867 0.03096 0.108 2.574 1.604 388 550 0.225 0.349 Polygyny 8.9 0.0033 0.00234 0.721 0.800 0.894 326 473 0.000 0.008 Comprehensive knowledge about HIV prevention among young people 9.2 0.3487 0.02669 0.077 0.684 0.827 153 219 0.295 0.402 Knowledge of mother- to-child transmission of HIV 9.3 0.6071 0.01376 0.023 0.531 0.728 471 669 0.580 0.635 Accepting attitudes towards people living with HIV 9.4 0.1668 0.01574 0.094 1.149 1.072 455 645 0.135 0.198 Women who have been tested for HIV and know the results 9.6 0.1166 0.01350 0.116 1.181 1.087 471 669 0.090 0.144 Sexually active young women who have been tested for HIV and know the results 9.7 0.2298 0.04036 0.176 0.957 0.978 74 105 0.149 0.311 Sex before age 15 among young women 9.11 0.0873 0.03225 0.369 2.846 1.687 153 219 0.023 0.152 Condom use with non-regular partners 9.16 * * * * * 20 26 * * Children under age 5 Underweight prevalence 2.1a 0.0830 0.01849 0.223 0.907 0.953 174 203 0.046 0.120 Stunting prevalence 2.2a 0.0588 0.01535 0.261 0.827 0.909 167 195 0.028 0.089 Wasting prevalence 2.3a 0.0920 0.02007 0.218 0.912 0.955 164 190 0.052 0.132 Exclusive breastfeeding under 6 months 2.6 * * * * * 15 19 * * Age-appropriate breastfeeding 2.14 0.2646 0.03567 0.135 0.615 0.784 79 95 0.193 0.336 Received polio immunization - 0.9130 0.04452 0.049 1.248 1.117 45 51 0.824 1.000 Received measles (MMR) immunization - 0.7499 0.04097 0.055 0.439 0.662 45 50 0.668 0.832 Diarrhoea in the previous 2 weeks - 0.0767 0.01393 0.182 0.608 0.780 188 223 0.049 0.105 Illness with a cough in the previous 2 weeks - 0.0314 0.01582 0.504 1.827 1.352 188 223 0.000 0.063 Oral rehydration therapy with continued feeding 3.8 * * * * * 14 14 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 6 5 * * Support for learning 6.1 0.9175 0.04189 0.046 1.716 1.310 64 75 0.834 1.000 Attendance to early childhood education 6.7 0.1753 0.03687 0.210 0.696 0.834 64 75 0.102 0.249 Birth registration 8.1 1.0000 0.00000 0.000 na na 188 223 1.000 1.000     Appendix C. Estimates of Sampling Errors 198  Suriname MICS4    Table SE.10: Sampling errors: Coronie Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 1.0000 0.00000 0.000 na na 161 93 1.000 1.000 Use of improved sanitation 4.3 0.9558 0.02525 0.026 1.388 1.178 161 93 0.905 1.000 Secondary school net attendance ratio (adjusted) 7.5 * * * * * 18 33 * * Child labour 8.2 0.0746 0.03121 0.418 0.931 0.965 37 67 0.012 0.137 Prevalence of children with one or both parents dead 9.18 0.0291 0.02024 0.695 1.478 1.216 56 103 0.000 0.070 Violent discipline 8.5 * * * * * 44 42 * * Women Contraceptive prevalence 5.3 * * * * * 18 35 * * Unmet need 5.4 * * * * * 18 35 * * Antenatal care coverage - at least once by skilled personnel 5.5a * * * * * 4 7 * * Antenatal care coverage – at least four times by any provider 5.5b * * * * * 4 7 * * Skilled attendant at delivery 5.7 * * * * * 4 7 * * Institutional deliveries 5.8 * * * * * 4 7 * * Caesarean section 5.9 * * * * * 4 7 * * Literacy rate among young women 7.1 * * * * * 7 14 * * Marriage before age 18 8.7 0.1800 0.05308 0.295 0.935 0.967 26 50 0.074 0.286 Polygyny 8.9 * * * * * 18 35 * * Comprehensive knowledge about HIV prevention among young people 9.2 * * * * * 7 14 * * Knowledge of mother- to-child transmission of HIV 9.3 0.5862 0.03805 0.065 0.340 0.583 31 58 0.510 0.662 Accepting attitudes towards people living with HIV 9.4 0.2069 0.04880 0.236 0.827 0.910 31 58 0.109 0.304 Women who have been tested for HIV and know the results 9.6 0.1897 0.06330 0.334 1.486 1.219 31 58 0.063 0.316 Sexually active young women who have been tested for HIV and know the results 9.7 * * * * * 5 9 * * Sex before age 15 among young women 9.11 * * * * * 7 14 * * Condom use with non-regular partners 9.16 * * * * * 2 4 * * Children under age 5 Underweight prevalence 2.1a * * * * * 14 22 * * Stunting prevalence 2.2a * * * * * 14 22 * * Wasting prevalence 2.3a * * * * * 14 22 * * Exclusive breastfeeding under 6 months 2.6 * * * * * 1 1 * * Age-appropriate breastfeeding 2.14 * * * * * 5 8 * * Received polio immunization - * * * * * 2 3 * * Received measles (MMR) immunization - * * * * * 1 2 * * Diarrhoea in the previous 2 weeks - * * * * * 14 22 * * Illness with a cough in the previous 2 weeks - * * * * * 14 22 * * Oral rehydration therapy with continued feeding 3.8 * * * * * 2 3 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 1 1 * * Support for learning 6.1 * * * * * 7 11 * * Attendance to early childhood education 6.7 * * * * * 7 11 * * Birth registration 8.1 * * * * * 14 22 * *     Appendix C. Estimates of Sampling Errors      Suriname MICS4 199   Table SE.11: Sampling errors: Saramacca Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.9672 0.01057 0.011 1.565 1.251 920 445 0.946 0.988 Use of improved sanitation 4.3 0.8349 0.02628 0.031 2.225 1.492 920 445 0.782 0.887 Secondary school net attendance ratio (adjusted) 7.5 0.6374 0.04593 0.072 1.552 1.246 94 171 0.546 0.729 Child labour 8.2 0.0466 0.01460 0.313 1.540 1.241 176 322 0.017 0.076 Prevalence of children with one or both parents dead 9.18 0.0450 0.01398 0.310 2.519 1.587 304 555 0.017 0.073 Violent discipline 8.5 0.8374 0.02445 0.029 0.953 0.976 222 218 0.789 0.886 Women Contraceptive prevalence 5.3 0.5368 0.02370 0.044 0.641 0.801 151 285 0.489 0.584 Unmet need 5.4 0.1579 0.02314 0.147 1.144 1.070 151 285 0.112 0.204 Antenatal care coverage - at least once by skilled personnel 5.5a 0.9298 0.02847 0.031 0.695 0.834 30 57 0.873 0.987 Antenatal care coverage – at least four times by any provider 5.5b 0.7719 0.03906 0.051 0.485 0.697 30 57 0.694 0.850 Skilled attendant at delivery 5.7 0.9649 0.01610 0.017 0.429 0.655 30 57 0.933 0.997 Institutional deliveries 5.8 0.9298 0.02438 0.026 0.510 0.714 30 57 0.881 0.979 Caesarean section 5.9 0.1228 0.02720 0.221 0.384 0.620 30 57 0.068 0.177 Literacy rate among young women 7.1 0.9725 0.01543 0.016 0.961 0.980 58 109 0.942 1.000 Marriage before age 18 8.7 0.2862 0.02798 0.098 1.242 1.114 172 325 0.230 0.342 Polygyny 8.9 0.0105 0.00763 0.725 1.587 1.260 151 285 0.000 0.026 Comprehensive knowledge about HIV prevention among young people 9.2 0.3853 0.05219 0.135 1.242 1.115 58 109 0.281 0.490 Knowledge of mother- to-child transmission of HIV 9.3 0.5067 0.03323 0.066 1.652 1.285 198 375 0.440 0.573 Accepting attitudes towards people living with HIV 9.4 0.2158 0.02217 0.103 1.060 1.029 193 366 0.172 0.260 Women who have been tested for HIV and know the results 9.6 0.1360 0.01832 0.135 1.069 1.034 198 375 0.099 0.173 Sexually active young women who have been tested for HIV and know the results 9.7 0.2712 0.03973 0.147 0.463 0.681 31 59 0.192 0.351 Sex before age 15 among young women 9.11 0.0642 0.02861 0.446 1.471 1.213 58 109 0.007 0.121 Condom use with non-regular partners 9.16 * * * * * 7 13 * * Children under age 5 Underweight prevalence 2.1a 0.0480 0.02169 0.452 1.277 1.130 82 125 0.005 0.091 Stunting prevalence 2.2a 0.0678 0.02046 0.302 0.775 0.880 77 118 0.027 0.109 Wasting prevalence 2.3a 0.0508 0.02796 0.550 1.895 1.377 77 118 0.000 0.107 Exclusive breastfeeding under 6 months 2.6 * * * * * 8 13 * * Age-appropriate breastfeeding 2.14 0.1639 0.03792 0.231 0.629 0.793 40 61 0.088 0.240 Received polio immunization - * * * * * 20 31 * * Received measles (MMR) immunization - * * * * * 20 31 * * Diarrhoea in the previous 2 weeks - 0.0643 0.01689 0.263 0.659 0.812 91 140 0.031 0.098 Illness with a cough in the previous 2 weeks - 0.0071 0.00745 1.043 1.087 1.043 91 140 0.000 0.022 Oral rehydration therapy with continued feeding 3.8 * * * * * 6 9 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 1 1 * * Support for learning 6.1 0.7719 0.03446 0.045 0.378 0.615 37 57 0.703 0.841 Attendance to early childhood education 6.7 0.3509 0.06033 0.172 0.895 0.946 37 57 0.230 0.472 Birth registration 8.1 0.9929 0.00704 0.007 0.973 0.986 91 140 0.979 1.000     Appendix C. Estimates of Sampling Errors 200  Suriname MICS4    Table SE.12: Sampling errors: Commewijne Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.9669 0.01346 0.014 2.361 1.537 1,373 418 0.940 0.994 Use of improved sanitation 4.3 0.9009 0.02415 0.027 2.725 1.651 1,373 418 0.853 0.949 Secondary school net attendance ratio (adjusted) 7.5 0.6613 0.07373 0.111 3.786 1.946 142 157 0.514 0.809 Child labour 8.2 0.0488 0.01469 0.301 1.217 1.103 238 263 0.019 0.078 Prevalence of children with one or both parents dead 9.18 0.0218 0.01412 0.649 4.321 2.079 407 462 0.000 0.050 Violent discipline 8.5 0.8337 0.02816 0.034 1.098 1.048 297 193 0.777 0.890 Women Contraceptive prevalence 5.3 0.6155 0.02738 0.044 0.802 0.895 203 254 0.561 0.670 Unmet need 5.4 0.1360 0.02458 0.181 1.301 1.141 203 254 0.087 0.185 Antenatal care coverage - at least once by skilled personnel 5.5a * * * * * 44 48 * * Antenatal care coverage – at least four times by any provider 5.5b * * * * * 44 48 * * Skilled attendant at delivery 5.7 * * * * * 44 48 * * Institutional deliveries 5.8 * * * * * 44 48 * * Caesarean section 5.9 * * * * * 44 48 * * Literacy rate among young women 7.1 0.9561 0.01546 0.016 0.598 0.773 98 106 0.925 0.987 Marriage before age 18 8.7 0.2734 0.01327 0.049 0.259 0.509 238 293 0.247 0.300 Polygyny 8.9 0.0081 0.00792 0.977 1.973 1.405 203 254 0.000 0.024 Comprehensive knowledge about HIV prevention among young people 9.2 0.4117 0.04359 0.106 0.824 0.908 98 106 0.324 0.499 Knowledge of mother- to-child transmission of HIV 9.3 0.5625 0.01514 0.027 0.327 0.572 296 352 0.532 0.593 Accepting attitudes towards people living with HIV 9.4 0.2311 0.02784 0.120 1.492 1.221 290 343 0.175 0.287 Women who have been tested for HIV and know the results 9.6 0.1415 0.02710 0.192 2.122 1.457 296 352 0.087 0.196 Sexually active young women who have been tested for HIV and know the results 9.7 * * * * * 44 49 * * Sex before age 15 among young women 9.11 0.0055 0.00564 1.027 0.612 0.782 98 106 0.000 0.017 Condom use with non-regular partners 9.16 * * * * * 15 14 * * Children under age 5 Underweight prevalence 2.1a 0.0891 0.03296 0.370 1.365 1.168 104 103 0.023 0.155 Stunting prevalence 2.2a 0.0592 0.01972 0.333 0.628 0.792 90 91 0.020 0.099 Wasting prevalence 2.3a 0.1322 0.04672 0.353 1.731 1.316 90 92 0.039 0.226 Exclusive breastfeeding under 6 months 2.6 * * * * * 7 9 * * Age-appropriate breastfeeding 2.14 0.2048 0.02635 0.129 0.213 0.462 55 51 0.152 0.257 Received polio immunization - * * * * * 27 25 * * Received measles (MMR) immunization - * * * * * 25 24 * * Diarrhoea in the previous 2 weeks - 0.0874 0.04652 0.532 3.200 1.789 122 119 0.000 0.180 Illness with a cough in the previous 2 weeks - 0.0328 0.03089 0.941 3.546 1.883 122 119 0.000 0.095 Oral rehydration therapy with continued feeding 3.8 * * * * * 11 10 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 4 2 * * Support for learning 6.1 * * * * * 47 47 * * Attendance to early childhood education 6.7 * * * * * 47 47 * * Birth registration 8.1 1.0000 0.00000 0.000 na na 122 119 1.000 1.000     Appendix C. Estimates of Sampling Errors      Suriname MICS4 201   Table SE.13: Sampling errors: Marowijne Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.9114 0.03441 0.038 6.522 2.554 1,081 446 0.843 0.980 Use of improved sanitation 4.3 0.7219 0.03611 0.050 2.890 1.700 1,081 446 0.650 0.794 Secondary school net attendance ratio (adjusted) 7.5 0.4249 0.03425 0.081 1.306 1.143 138 273 0.356 0.493 Child labour 8.2 0.1319 0.01491 0.113 1.087 1.043 284 561 0.102 0.162 Prevalence of children with one or both parents dead 9.18 0.0358 0.00830 0.232 2.062 1.436 524 1,034 0.019 0.052 Violent discipline 8.5 0.8704 0.03734 0.043 3.413 1.847 376 277 0.796 0.945 Women Contraceptive prevalence 5.3 0.3925 0.04180 0.106 1.560 1.249 105 214 0.309 0.476 Unmet need 5.4 0.2664 0.03255 0.122 1.155 1.075 105 214 0.201 0.331 Antenatal care coverage - at least once by skilled personnel 5.5a 0.9394 0.02822 0.030 1.833 1.354 65 132 0.883 0.996 Antenatal care coverage – at least four times by any provider 5.5b 0.6212 0.04961 0.080 1.370 1.170 65 132 0.522 0.720 Skilled attendant at delivery 5.7 0.9470 0.01998 0.021 1.041 1.020 65 132 0.907 0.987 Institutional deliveries 5.8 0.8409 0.03687 0.044 1.331 1.154 65 132 0.767 0.915 Caesarean section 5.9 0.1364 0.02487 0.182 0.688 0.829 65 132 0.087 0.186 Literacy rate among young women 7.1 0.9314 0.02686 0.029 1.965 1.402 86 175 0.878 0.985 Marriage before age 18 8.7 0.2931 0.01893 0.065 0.571 0.755 162 331 0.255 0.331 Polygyny 8.9 0.0514 0.01808 0.352 1.428 1.195 105 214 0.015 0.088 Comprehensive knowledge about HIV prevention among young people 9.2 0.3429 0.04924 0.144 1.873 1.368 86 175 0.244 0.441 Knowledge of mother- to-child transmission of HIV 9.3 0.5576 0.02704 0.048 1.257 1.121 208 425 0.504 0.612 Accepting attitudes towards people living with HIV 9.4 0.1651 0.01956 0.118 1.158 1.076 204 418 0.126 0.204 Women who have been tested for HIV and know the results 9.6 0.2847 0.02157 0.076 0.969 0.984 208 425 0.242 0.328 Sexually active young women who have been tested for HIV and know the results 9.7 0.3417 0.04858 0.142 1.249 1.117 59 120 0.245 0.439 Sex before age 15 among young women 9.11 0.1771 0.03325 0.188 1.320 1.149 86 175 0.111 0.244 Condom use with non-regular partners 9.16 0.4756 0.06832 0.144 1.516 1.231 40 82 0.339 0.612 Children under age 5 Underweight prevalence 2.1a 0.0513 0.01238 0.241 0.857 0.926 165 273 0.027 0.076 Stunting prevalence 2.2a 0.0913 0.02137 0.234 1.442 1.201 159 263 0.049 0.134 Wasting prevalence 2.3a 0.0269 0.01311 0.487 1.699 1.303 157 260 0.001 0.053 Exclusive breastfeeding under 6 months 2.6 * * * * * 25 42 * * Age-appropriate breastfeeding 2.14 0.1351 0.03462 0.256 1.507 1.228 89 148 0.066 0.204 Received polio immunization - 0.5286 0.06499 0.123 1.170 1.081 42 70 0.399 0.659 Received measles (MMR) immunization - 0.4714 0.05447 0.116 0.822 0.906 42 70 0.362 0.580 Diarrhoea in the previous 2 weeks - 0.0943 0.02000 0.212 1.483 1.218 192 318 0.054 0.134 Illness with a cough in the previous 2 weeks - 0.0094 0.00542 0.575 0.998 0.999 192 318 0.000 0.020 Oral rehydration therapy with continued feeding 3.8 * * * * * 18 30 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 2 3 * * Support for learning 6.1 0.7222 0.05201 0.072 1.443 1.201 65 108 0.618 0.826 Attendance to early childhood education 6.7 0.0741 0.02577 0.348 1.036 1.018 65 108 0.023 0.126 Birth registration 8.1 0.9591 0.02661 0.028 5.723 2.392 192 318 0.906 1.000     Appendix C. Estimates of Sampling Errors 202  Suriname MICS4    Table SE.14: Sampling errors: Para Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator 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 Household members Use of improved drinking water sources 4.1 0.9652 0.02749 0.028 9.238 3.039 1,054 411 0.910 1.000 Use of improved sanitation 4.3 0.7461 0.03978 0.053 3.425 1.851 1,054 411 0.667 0.826 Secondary school net attendance ratio (adjusted) 7.5 0.4776 0.03169 0.066 0.982 0.991 145 245 0.414 0.541 Child labour 8.2 0.0996 0.02780 0.279 3.887 1.972 267 452 0.044 0.155 Prevalence of children with one or both parents dead 9.18 0.0380 0.00784 0.207 1.286 1.134 451 764 0.022 0.054 Violent discipline 8.5 0.9115 0.02272 0.025 1.459 1.208 334 229 0.866 0.957 Women Contraceptive prevalence 5.3 0.4241 0.04812 0.113 1.801 1.342 109 191 0.328 0.520 Unmet need 5.4 0.1885 0.02977 0.158 1.101 1.049 109 191 0.129 0.248 Antenatal care coverage - at least once by skilled personnel 5.5a 0.9545 0.01506 0.016 0.340 0.583 38 66 0.924 0.985 Antenatal care coverage – at least four times by any provider 5.5b 0.7727 0.05180 0.067 0.993 0.997 38 66 0.669 0.876 Skilled attendant at delivery 5.7 0.9242 0.02718 0.029 0.686 0.828 38 66 0.870 0.979 Institutional deliveries 5.8 0.9394 0.02278 0.024 0.593 0.770 38 66 0.894 0.985 Caesarean section 5.9 0.1818 0.05021 0.276 1.102 1.050 38 66 0.081 0.282 Literacy rate among young women 7.1 0.9250 0.01915 0.021 0.629 0.793 68 120 0.887 0.963 Marriage before age 18 8.7 0.3403 0.04037 0.119 2.083 1.443 164 288 0.260 0.421 Polygyny 8.9 0.0262 0.02153 0.822 3.454 1.859 109 191 0.000 0.069 Comprehensive knowledge about HIV prevention among young people 9.2 0.4833 0.04748 0.098 1.074 1.036 68 120 0.388 0.578 Knowledge of mother- to-child transmission of HIV 9.3 0.5861 0.03838 0.065 2.180 1.477 205 360 0.509 0.663 Accepting attitudes towards people living with HIV 9.4 0.2331 0.03108 0.133 1.918 1.385 203 356 0.171 0.295 Women who have been tested for HIV and know the results 9.6 0.2083 0.02368 0.114 1.221 1.105 205 360 0.161 0.256 Sexually active young women who have been tested for HIV and know the results 9.7 0.3239 0.06627 0.205 1.404 1.185 40 71 0.191 0.456 Sex before age 15 among young women 9.11 0.0833 0.03408 0.409 1.810 1.345 68 120 0.015 0.152 Condom use with non-regular partners 9.16 0.5200 0.05699 0.110 0.638 0.799 28 50 0.406 0.634 Children under age 5 Underweight prevalence 2.1a 0.0694 0.02183 0.314 1.054 1.027 101 144 0.026 0.113 Stunting prevalence 2.2a 0.1176 0.02701 0.230 0.949 0.974 96 136 0.064 0.172 Wasting prevalence 2.3a 0.0365 0.01824 0.500 1.287 1.134 96 137 0.000 0.073 Exclusive breastfeeding under 6 months 2.6 * * * * * 10 14 * * Age-appropriate breastfeeding 2.14 0.1471 0.03676 0.250 0.722 0.850 48 68 0.074 0.221 Received polio immunization - * * * * * 28 40 * * Received measles (MMR) immunization - * * * * * 27 39 * * Diarrhoea in the previous 2 weeks - 0.0920 0.02214 0.241 1.015 1.008 122 174 0.048 0.136 Illness with a cough in the previous 2 weeks - 0.0172 0.01206 0.700 1.486 1.219 122 174 0.000 0.041 Oral rehydration therapy with continued feeding 3.8 * * * * * 11 16 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 2 3 * * Support for learning 6.1 0.8056 0.07272 0.090 2.397 1.548 51 72 0.660 0.951 Attendance to early childhood education 6.7 0.3472 0.05790 0.167 1.050 1.025 51 72 0.231 0.463 Birth registration 8.1 0.9828 0.01297 0.013 1.719 1.311 122 174 0.957 1.000     Appendix C. Estimates of Sampling Errors      Suriname MICS4 203 Table SE.15: Sampling errors: Brokopondo Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweight ed count Confidence limits r - 2se r + 2se Households Household availability of insecticide- treated nets (ITNs) 3.12 0.6133 0.02458 0.040 1.111 1.054 186 437 0.564 0.662 Household members Use of improved drinking water sources 4.1 0.8942 0.02492 0.028 2.862 1.692 774 437 0.844 0.944 Use of improved sanitation 4.3 0.3197 0.03048 0.095 1.862 1.365 774 437 0.259 0.381 Secondary school net attendance ratio (adjusted) 7.5 0.3773 0.03706 0.098 1.280 1.131 94 220 0.303 0.451 Child labour 8.2 0.1971 0.02172 0.110 1.616 1.271 232 543 0.154 0.240 Prevalence of children with one or both parents dead 9.18 0.0404 0.00965 0.239 2.379 1.543 423 991 0.021 0.060 Violent discipline 8.5 0.9029 0.02262 0.025 1.617 1.272 321 278 0.858 0.948 Women Pregnant women - 0.0634 0.01167 0.184 0.756 0.869 132 331 0.040 0.087 Pregnant women sleeping under insecticide-treated nets (ITNs) 3.19 * * * * * 8 20 * * Contraceptive prevalence 5.3 0.2560 0.03399 0.133 1.013 1.007 67 168 0.188 0.324 Unmet need 5.4 0.3333 0.03968 0.119 1.183 1.088 67 168 0.254 0.413 Antenatal care coverage - at least once by skilled personnel 5.5a 0.6617 0.06031 0.091 2.145 1.464 53 133 0.541 0.782 Antenatal care coverage – at least four times by any provider 5.5b 0.5865 0.04914 0.084 1.314 1.147 53 133 0.488 0.685 Skilled attendant at delivery 5.7 0.7594 0.04724 0.062 1.612 1.270 53 133 0.665 0.854 Institutional deliveries 5.8 0.8421 0.04962 0.059 2.444 1.563 53 133 0.743 0.941 Caesarean section 5.9 0.1429 0.03132 0.219 1.057 1.028 53 133 0.080 0.205 Literacy rate among young women 7.1 0.7826 0.05029 0.064 1.695 1.302 46 115 0.682 0.883 Marriage before age 18 8.7 0.4519 0.04356 0.096 2.061 1.436 108 270 0.365 0.539 Polygyny 8.9 0.1131 0.01969 0.174 0.646 0.804 67 168 0.074 0.152 Comprehensive knowledge about HIV prevention among young people 9.2 0.3391 0.04662 0.137 1.105 1.051 46 115 0.246 0.432 Knowledge of mother- to-child transmission of HIV 9.3 0.5468 0.03620 0.066 1.745 1.321 132 331 0.474 0.619 Accepting attitudes towards people living with HIV 9.4 0.1546 0.01973 0.128 0.941 0.970 126 317 0.115 0.194 Women who have been tested for HIV and know the results 9.6 0.3233 0.02777 0.086 1.163 1.079 132 331 0.268 0.379 Sexually active young women who have been tested for HIV and know the results 9.7 0.3478 0.06359 0.183 1.622 1.274 37 92 0.221 0.475 Sex before age 15 among young women 9.11 0.3565 0.05745 0.161 1.640 1.281 46 115 0.242 0.471 Condom use with non-regular partners 9.16 * * * * * 19 47 * * Children under age 5 Underweight prevalence 2.1a 0.0567 0.01487 0.262 1.017 1.009 124 247 0.027 0.086 Stunting prevalence 2.2a 0.0751 0.01765 0.235 1.130 1.063 127 253 0.040 0.110 Wasting prevalence 2.3a 0.0328 0.01191 0.363 1.086 1.042 123 244 0.009 0.057 Exclusive breastfeeding under 6 months 2.6 * * * * * 22 44 * * Age-appropriate breastfeeding 2.14 0.1000 0.03247 0.325 1.628 1.276 70 140 0.035 0.165 Received polio immunization - 0.8167 0.02517 0.031 0.250 0.500 30 60 0.766 0.867 Received measles (MMR) immunization - 0.7091 0.07722 0.109 1.561 1.249 28 55 0.555 0.864 Diarrhoea in the previous 2 weeks - 0.1261 0.01948 0.154 1.143 1.069 167 333 0.087 0.165 Illness with a cough in the previous 2 weeks - 0.0270 0.01403 0.519 2.485 1.576 167 333 0.000 0.055 Fever in last two weeks - 0.1892 0.02575 0.136 1.435 1.198 167 333 0.138 0.241 Oral rehydration therapy with continued feeding 3.8 * * * * * 21 42 * * Antibiotic treatment of suspected pneumonia 3.10 * * * * * 5 9 * * Children under age 5 sleeping under insecticide-treated nets (ITNs) 3.15 0.4038 0.03453 0.086 1.565 1.251 159 317 0.335 0.473 Anti-malarial treatment of children under age 5 3.18 0.0000 0.00000 0.000 na na 32 63 0.000 0.000 Support for learning 6.1 0.4758 0.05878 0.124 1.704 1.305 62 124 0.358 0.593 Attendance to early childhood education 6.7 0.1935 0.05019 0.259 1.985 1.409 62 124 0.093 0.294 Birth registration 8.1 0.9880 0.00393 0.004 0.433 0.658 167 333 0.980 0.996     Appendix C. Estimates of Sampling Errors 204  Suriname MICS4  Table SE.16: Sampling errors: Sipaliwini Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, Suriname, 2010 MICS Indicator Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Square root of design effect (deft) Weighted count Unweight ed count Confidence limits r - 2se r + 2se Households Household availability of insecticide- treated nets (ITNs) 3.12 0.6020 0.01754 0.029 1.830 1.353 619 1,427 0.567 0.637 Household members Use of improved drinking water sources 4.1 0.6450 0.02801 0.043 4.885 2.210 2,341 1,427 0.589 0.701 Use of improved sanitation 4.3 0.2478 0.02624 0.106 5.268 2.295 2,341 1,427 0.195 0.300 Secondary school net attendance ratio (adjusted) 7.5 0.1444 0.01567 0.109 1.099 1.048 240 554 0.113 0.176 Child labour 8.2 0.2946 0.01972 0.067 3.010 1.735 698 1,609 0.255 0.334 Prevalence of children with one or both parents dead 9.18 0.0362 0.00556 0.154 2.602 1.613 1,273 2,932 0.025 0.047 Violent discipline 8.5 0.9153 0.01134 0.012 1.514 1.231 989 913 0.893 0.938 Women Pregnant women - 0.0819 0.00763 0.093 0.877 0.937 461 1,135 0.067 0.097 Pregnant women sleeping under insecticide-treated nets (ITNs) 3.19 0.5165 0.05403 0.105 1.052 1.026 37 91 0.408 0.625 Contraceptive prevalence 5.3 0.2515 0.02475 0.098 1.666 1.291 208 513 0.202 0.301 Unmet need 5.4 0.3392 0.02606 0.077 1.551 1.245 208 513 0.287 0.391 Antenatal care coverage - at least once by skilled personnel 5.5a 0.7889 0.02869 0.036 1.775 1.332 146 360 0.732 0.846 Antenatal care coverage – at least four times by any provider 5.5b 0.5750 0.02793 0.049 1.146 1.070 146 360 0.519 0.631 Skilled attendant at delivery 5.7 0.7750 0.03622 0.047 2.702 1.644 146 360 0.703 0.847 Institutional deliveries 5.8 0.8694 0.02798 0.032 2.476 1.574 146 360 0.813 0.925 Caesarean section 5.9 0.0972 0.01530 0.157 0.957 0.978 146 360 0.067 0.128 Literacy rate among young women 7.1 0.4629 0.04362 0.094 2.571 1.603 137 337 0.376 0.550 Marriage before age 18 8.7 0.5021 0.01683 0.034 1.072 1.036 385 948 0.468 0.536 Polygyny 8.9 0.2437 0.02397 0.098 1.596 1.264 208 513 0.196 0.292 Comprehensive knowledge about HIV prevention among young people 9.2 0.2077 0.02151 0.104 0.945 0.972 137 337 0.165 0.251 Knowledge of mother- to-child transmission of HIV 9.3 0.5656 0.01626 0.029 1.221 1.105 461 1,135 0.533 0.598 Accepting attitudes towards people living with HIV 9.4 0.0856 0.01049 0.123 1.476 1.215 427 1,051 0.065 0.107 Women who have been tested for HIV and know the results 9.6 0.2106 0.01360 0.065 1.261 1.123 461 1,135 0.183 0.238 Sexually active young women who have been tested for HIV and know the results 9.7 0.2636 0.02472 0.094 0.809 0.900 105 258 0.214 0.313 Sex before age 15 among young women 9.11 0.3264 0.02538 0.078 0.984 0.992 137 337 0.276 0.377 Condom use with non-regular partners 9.16 0.2903 0.04063 0.140 1.234 1.111 63 155 0.209 0.372 Children under age 5 Underweight prevalence 2.1a 0.0493 0.00647 0.131 0.778 0.882 446 872 0.036 0.062 Stunting prevalence 2.2a 0.1709 0.01391 0.081 1.133 1.064 425 831 0.143 0.199 Wasting prevalence 2.3a 0.0310 0.00512 0.165 0.730 0.854 429 838 0.021 0.041 Exclusive breastfeeding under 6 months 2.6 0.0233 0.02300 0.989 1.980 1.407 44 86 0.000 0.069 Age-appropriate breastfeeding 2.14 0.1830 0.02794 0.153 2.079 1.442 204 399 0.127 0.239 Received polio immunization - 0.8059 0.02104 0.026 0.668 0.817 121 237 0.764 0.848 Received measles (MMR) immunization - 0.8289 0.02210 0.027 0.782 0.884 117 228 0.785 0.873 Diarrhoea in the previous 2 weeks - 0.1276 0.01388 0.109 1.816 1.347 537 1,050 0.100 0.155 Illness with a cough in the previous 2 weeks - 0.0352 0.00648 0.184 1.297 1.139 537 1,050 0.022 0.048 Fever in last two weeks - 0.1638 0.01703 0.104 2.222 1.491 537 1,050 0.130 0.198 Oral rehydration therapy with continued feeding 3.8 0.6194 0.03935 0.064 0.874 0.935 69 134 0.541 0.698 Antibiotic treatment of suspected pneumonia 3.10 * * * * * 19 37 * * Children under age 5 sleeping under insecticide-treated nets (ITNs) 3.15 0.4430 0.02654 0.060 2.801 1.674 502 982 0.390 0.496 Anti-malarial treatment of children under age 5 3.18 0.0000 0.00000 0.000 na na 88 172 0.000 0.000 Support for learning 6.1 0.4468 0.02955 0.066 1.523 1.234 221 432 0.388 0.506 Attendance to early childhood education 6.7 0.1644 0.02618 0.159 2.150 1.466 221 432 0.112 0.217 Birth registration 8.1 0.9705 0.00583 0.006 1.245 1.116 537 1,050 0.959 0.982   Appendix D. Data Quality Tables      Suriname MICS4 205 Appendix D. Data Quality Tables Table DQ.1: Age distribution of household population Single-year age distribution of household population by sex, Suriname, 2010 Males Females Missing Males Females Missing Number Percent Number Percent Number Percent Number Percent Number Percent Number Percent Age Age 0 298 2.1 264 1.8 0 0.0 43 171 1.2 203 1.4 0 0.0 1 332 2.4 320 2.2 1 40.5 44 177 1.3 169 1.2 0 0.0 2 296 2.1 269 1.9 0 0.0 45 171 1.2 224 1.6 0 0.0 3 292 2.1 314 2.2 0 0.0 46 179 1.3 196 1.4 0 0.0 4 240 1.7 283 2.0 0 0.0 47 190 1.4 167 1.2 0 0.0 5 285 2.0 226 1.6 0 0.0 48 186 1.3 159 1.1 0 0.0 6 237 1.7 258 1.8 0 0.0 49 189 1.3 170 1.2 0 0.0 7 315 2.2 304 2.1 0 0.0 50 161 1.1 138 1.0 0 0.0 8 308 2.2 285 2.0 0 0.0 51 158 1.1 161 1.1 0 0.0 9 315 2.2 278 1.9 0 0.0 52 111 0.8 160 1.1 0 0.0 10 297 2.1 248 1.7 0 0.0 53 115 0.8 123 0.9 0 0.0 11 300 2.1 259 1.8 0 0.0 54 110 0.8 128 0.9 0 0.0 12 311 2.2 259 1.8 0 0.0 55 109 0.8 134 0.9 0 0.0 13 333 2.4 273 1.9 0 0.0 56 100 0.7 108 0.7 0 0.0 14 278 2.0 238 1.7 0 0.0 57 113 0.8 106 0.7 0 0.0 15 217 1.5 229 1.6 0 0.0 58 102 0.7 113 0.8 0 0.0 16 229 1.6 237 1.6 0 0.0 59 102 0.7 127 0.9 0 0.0 17 235 1.7 278 1.9 0 0.0 60 101 0.7 97 0.7 0 0.0 18 238 1.7 299 2.1 0 0.0 61 99 0.7 84 0.6 0 29.8 19 214 1.5 256 1.8 0 0.0 62 92 0.7 78 0.5 0 0.0 20 261 1.9 258 1.8 0 0.0 63 54 0.4 84 0.6 0 0.0 21 212 1.5 240 1.7 0 0.0 64 84 0.6 88 0.6 0 0.0 22 215 1.5 259 1.8 0 0.0 65 69 0.5 74 0.5 0 0.0 23 214 1.5 218 1.5 0 0.0 66 63 0.4 79 0.5 0 0.0 24 229 1.6 235 1.6 0 0.0 67 50 0.4 60 0.4 0 0.0 25 196 1.4 278 1.9 0 0.0 68 69 0.5 73 0.5 0 0.0 26 221 1.6 225 1.6 0 0.0 69 42 0.3 80 0.6 0 0.0 27 249 1.8 225 1.6 0 0.0 70 48 0.3 77 0.5 0 29.8 28 189 1.4 206 1.4 0 0.0 71 49 0.3 52 0.4 0 0.0 29 191 1.4 226 1.6 0 0.0 72 58 0.4 44 0.3 0 0.0 30 201 1.4 184 1.3 0 0.0 73 55 0.4 55 0.4 0 0.0 31 183 1.3 173 1.2 0 0.0 74 43 0.3 74 0.5 0 0.0 32 161 1.1 166 1.2 0 0.0 75 35 0.3 47 0.3 0 0.0 33 157 1.1 190 1.3 0 0.0 76 29 0.2 40 0.3 0 0.0 34 169 1.2 234 1.6 0 0.0 77 31 0.2 33 0.2 0 0.0 35 182 1.3 190 1.3 0 0.0 78 32 0.2 30 0.2 0 0.0 36 171 1.2 230 1.6 0 0.0 79 43 0.3 37 0.3 0 0.0 37 211 1.5 185 1.3 0 0.0 80+ 118 0.8 197 1.4 0 0.0 38 166 1.2 207 1.4 0 0.0 DK/ 39 195 1.4 173 1.2 0 0.0 Missing 213 1.5 75 0.5 0 0.0 40 201 1.4 193 1.3 0 0.0 41 196 1.4 193 1.3 0 0.0 42 158 1.1 186 1.3 0 0.0 Total 14,021 100.0 14,398 100.0 1 100.0     Appendix D. Data Quality Tables 206  Suriname MICS4  Figure DQ.1: Number of household population by single ages, Suriname, 2010   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, by five-year age groups, Suriname, 2010 Household population of women age 10-54 years Interviewed women age 15-49 years Percentage of eligible women interviewed (Completion rate) Number Number Percent Age 10-14 1,276 na na na 15-19 1,299 1,104 17.2 85.0 20-24 1,210 1,009 15.7 83.4 25-29 1,160 991 15.5 85.4 30-34 947 831 13.0 87.8 35-39 985 868 13.5 88.1 40-44 945 847 13.2 89.6 45-49 915 756 11.8 82.6 50-54 711 na na na Total (15-49) 7,461 6,406 100.0 85.9 Ratio of 50-54 to 45-49 0.78     0 50 100 150 200 250 300 350 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 Number Age Figure DQ.1: Number of household population by single ages, Suriname, 2010 Males Females Appendix D. Data Quality Tables      Suriname MICS4 207   Table DQ.3: Age distribution of under-5s in household and under-5 questionnaires Household population of children age 0-7, children age 0-4 whose mothers/caretakers were interviewed, and percentage of under-5 children whose mothers/caretakers were interviewed, by single ages, Suriname, 2010 Household population of children 0-7 years Interviewed under-5 children Percentage of eligible under- 5s interviewed (Completion rate) Number Number Percent Age 0 562 537 19.4 95.4 1 653 623 22.6 95.5 2 565 534 19.3 94.6 3 606 580 21.0 95.7 4 523 489 17.7 93.5 5 511 na na na 6 495 na na na 7 619 na na na Total (0-4) 2,908 2,763 100.0 95.0 Ratio of 5 to 4 0.98       Appendix D. Data Quality Tables 208  Suriname MICS4    Table DQ.4: Women's completion rates by socio-economic characteristics of households Household population of women age 15-49, interviewed women age 15-49, and percentage of eligible women who were interviewed, by selected social and economic characteristics of the household, Suriname, 2010 Household population of women age 15-49 years Interviewed women age 15-49 years Percent of eligible women interviewed (Completion rates) Number Percent Number Percent Region Paramaribo 3,661 49.1 3,060 47.8 83.6 Wanica 1,442 19.3 1,261 19.7 87.5 Nickerie 545 7.3 483 7.5 88.6 Coronie 35 0.5 32 0.5 90.6 Saramacca 230 3.1 205 3.2 89.3 Commewijne 347 4.7 302 4.7 86.9 Marowijne 246 3.3 215 3.4 87.6 Para 251 3.4 213 3.3 84.7 Brokopondo 165 2.2 141 2.2 85.5 Sipaliwini 538 7.2 493 7.7 91.6 Area Urban 5,480 73.4 4,655 72.7 85.0 Rural Coastal 1,278 17.1 1,117 17.4 87.4 Rural interior 703 9.4 634 9.9 90.2 Total Rural 1,981 26.6 1,751 27.3 88.4 Household size 1-3 1,894 25.4 1,700 26.5 89.8 4-6 3,994 53.5 3,423 53.4 85.7 7+ 1,572 21.1 1,282 20.0 81.5 Education of household head None 653 8.8 562 8.8 86.0 Primary 2,173 29.1 1,891 29.5 87.0 Secondary + 4,146 55.6 3,551 55.4 85.6 Other/Non-standard 104 1.4 89 1.4 85.7 Missing/DK 385 5.2 313 4.9 81.3 Wealth index quintiles Poorest 1,310 17.6 1,166 18.2 89.0 Second 1,463 19.6 1,252 19.5 85.5 Middle 1,510 20.2 1,292 20.2 85.6 Fourth 1,577 21.1 1,344 21.0 85.2 Richest 1,601 21.5 1,352 21.1 84.5 Ethnicity of household head Indigenous/Amerindian 282 3.8 254 4.0 90.0 Maroon 1,818 24.4 1,560 24.4 85.8 Creole 1,294 17.3 1,067 16.7 82.5 Hindustani 2,149 28.8 1,876 29.3 87.3 Javanese 1,025 13.7 882 13.8 86.1 Mixed 733 9.8 628 9.8 85.7 Others 153 2.1 133 2.1 86.6 Missing/DK 6 0.1 5 0.1 80.3 Total 7,461 100.0 6,406 100.0 85.9     Appendix D. Data Quality Tables      Suriname MICS4 209   Table DQ.5: Completion rates for under-5 questionnaires by socio-economic characteristics of households Household population of under-5 children, under-5 questionnaires completed, and percentage of under-5 children for whom interviews were completed, by selected socio-economic characteristics of the household, Suriname, 2010 Household population of under-5 children Interviewed under-5 children Percent of eligible under-5s with completed under-5 questionnaires (Completion rates) Number Percent Number Percent Region Paramaribo 1,127 38.7 1,057 38.2 93.8 Wanica 527 18.1 497 18.0 94.2 Nickerie 161 5.5 157 5.7 97.6 Coronie 13 0.4 12 0.4 95.7 Saramacca 80 2.8 77 2.8 95.9 Commewijne 105 3.6 102 3.7 96.8 Marowijne 169 5.8 161 5.8 95.5 Para 108 3.7 103 3.7 95.1 Brokopondo 151 5.2 142 5.1 93.8 Sipaliwini 468 16.1 456 16.5 97.4 Area Urban 1,759 60.5 1,659 60.0 94.3 Rural Coastal 530 18.2 506 18.3 95.5 Rural interior 619 21.3 598 21.6 96.5 Total Rural 1,149 39.5 1,104 40.0 96.0 Household size 1-3 394 13.5 385 13.9 97.6 4-6 1,539 52.9 1,477 53.5 95.9 7+ 975 33.5 901 32.6 92.4 Education of household head None 459 15.8 441 16.0 96.1 Primary 919 31.6 860 31.1 93.5 Secondary + 1,323 45.5 1,265 45.8 95.6 Other/Non-standard 34 1.2 32 1.2 95.1 Missing/DK 173 6.0 165 6.0 95.0 Wealth index quintiles Poorest 1,007 34.6 960 34.7 95.3 Second 591 20.3 562 20.4 95.2 Middle 502 17.2 468 17.0 93.4 Fourth 441 15.2 416 15.1 94.4 Richest 369 12.7 356 12.9 96.5 Ethnicity of household head Indigenous/Amerindian 129 4.4 128 4.6 99.1 Maroon 1,238 42.6 1,167 42.2 94.2 Creole 376 12.9 355 12.9 94.5 Hindustani 561 19.3 535 19.4 95.4 Javanese 304 10.5 288 10.4 94.5 Mixed 262 9.0 256 9.3 97.5 Others 35 1.2 31 1.1 89.0 Missing/DK 3 0.1 3 0.1 100.0 Total 2,908 100.0 2,763 100.0 95.0     Appendix D. Data Quality Tables 210  Suriname MICS4    Table DQ.6: Completeness of reporting Percentage of observations that are missing information for selected questions and indicators, Suriname, 2010 Questionnaire and type of missing information Reference group Percent with missing/incomplete information* Number of cases Household Age All household members 1.4 28,783 Starting time of interview All households interviewed 1.7 7,407 Ending time of interview All households interviewed 2.0 7,407 Women Woman's date of birth All women age 15-49 Only month 0.1 6,290 Both month and year 0.0 6,290 Date of last birth All women age 15-49 with a live birth in last 2 years Only month 0.4 4,078 Both month and year 0.2 4,078 Date of first marriage/union All ever married women age 15-49 Only month 18.5 4,292 Both month and year 19.3 4,292 Age at first marriage/union All ever married women age 15-49 with year of first marriage not known 2.9 4,292 Age at first intercourse All women age 15-24 who have ever had sex 1.3 1,284 Time since last intercourse All women age 15-24 who have ever had sex 1.6 1,284 Starting time of interview All women interviewed 1.3 6,290 Ending time of interview All women interviewed 1.9 6,290 Under-5 Date of birth All under-5 children Only month 0.3 3,308 Both month and year 0.0 3,308 Anthropometric measurements All under-5 children Weight 12.8 3,308 Height 16.3 3,308 Both weight and height 12.6 3,308 Starting time of interview All under-5 children 2.5 3,308 Ending time of interview All under-5 children 3.3 3,308 * Includes "Don't know" responses     Appendix D. Data Quality Tables      Suriname MICS4 211   Table DQ.7: Completeness of information for anthropometric indicators Distribution of children under 5 by completeness of information for anthropometric indicators, Suriname, 2010 Valid weight and date of birth Reason for exclusion from analysis Total Percent of children excluded from analysis Number of children under 5 Weight not measured Incomplete date of birth Weight not measured, incomplete date of birth Flagged cases (outliers) Weight by age <6 months 84.5 14.8 0.0 0.0 0.7 100.0 15.5 304 6-11 months 89.7 9.7 0.3 0.0 0.3 100.0 10.3 351 12-23 months 87.5 12.1 0.1 0.1 0.1 100.0 12.5 711 24-35 months 83.3 16.1 0.5 0.0 0.2 100.0 16.7 657 36-47 months 82.3 16.6 0.6 0.3 0.3 100.0 17.7 699 48-59 months 84.6 14.2 0.9 0.3 0.0 100.0 15.4 586 Total 85.0 14.2 0.4 0.2 0.2 100.0 15.0 3,308 Valid height and date of birth Reason for exclusion from analysis Total Percent of children excluded from analysis Number of children under 5 Height not measured Incomplete date of birth Height not measured, incomplete date of birth Flagged cases (outliers) Height by age <6 months 77.3 21.1 0.0 0.0 1.6 100.0 22.7 304 6-11 months 87.2 11.4 0.3 0.0 1.1 100.0 12.8 351 12-23 months 82.0 17.4 0.1 0.1 0.3 100.0 18.0 711 24-35 months 78.1 21.0 0.3 0.2 0.5 100.0 21.9 657 36-47 months 81.3 17.3 0.6 0.3 0.6 100.0 18.7 699 48-59 months 84.0 14.8 0.9 0.3 0.0 100.0 16.0 586 Total 81.5 17.4 0.4 0.2 0.5 100.0 18.5 3,308 Valid weight and height Reason for exclusion from analysis Total Percent of children excluded from analysis Number of children under 5 Weight not measured Height not measured Weight and height not measured Flagged cases (outliers) Weight by height <6 months 74.3 0.3 6.6 14.5 4.3 100.0 25.7 304 6-11 months 86.9 0.0 1.7 9.7 1.4 100.0 12.8 351 12-23 months 81.3 0.4 5.8 11.7 0.7 100.0 18.6 711 24-35 months 78.1 0.3 5.2 15.8 0.3 100.0 21.6 657 36-47 months 79.8 0.9 1.6 15.7 1.4 100.0 19.6 699 48-59 months 83.6 0.2 0.9 14.0 0.7 100.0 15.7 586 Total 80.7 0.4 3.5 13.8 1.2 100.0 18.9 3,308       Appendix D. Data Quality Tables 212  Suriname MICS4  Table DQ.8: Heaping in anthropometric measurements Distribution of weight and height/length measurements by digits reported for decimals, Suriname, 2010 Weight Height or length Digits Number Percent Number Percent 0 299 10.6 784 27.5 1 286 10.1 230 8.1 2 252 8.9 278 9.8 3 292 10.3 288 10.1 4 291 10.3 272 9.6 5 309 10.9 316 11.1 6 293 10.3 225 7.9 7 260 9.2 171 6.0 8 282 10.0 126 4.4 9 269 9.5 156 5.5 0 or 5 608 21.5 1,100 38.7 Total 2,833 100.0 2,846 100.0   Table DQ.9: Observation of bednets and places for hand washing Percentage of bednets in all households interviewed observed by the interviewer (in Brokopondo and Sipaliwini only), and percentage of places for handwashing observed by the interviewer in all interviewed households, Suriname, 2010 Percentage of bednets observed by interviewer Total number of bednets Place for handwashing Total Number of households interviewed Observed Not observed Not in the dwelling, plot, or yard No permission to see Other Region Paramaribo na na 76.3 7.3 11.9 4.3 100.0 2,184 Wanica na na 75.2 8.6 10.0 5.8 100.0 757 Nickerie na na 86.1 2.7 2.3 9.0 100.0 789 Coronie na na 77.4 6.5 10.8 5.4 100.0 93 Saramacca na na 67.0 14.2 14.8 3.6 100.0 445 Commewijne na na 67.2 11.7 12.2 8.9 100.0 418 Marowijne na na 76.2 14.8 4.9 3.8 100.0 446 Para na na 60.3 27.0 9.7 2.7 100.0 411 Brokopondo 38.2 531 61.1 29.7 2.1 7.1 100.0 437 Sipaliwini 31.2 2,030 56.5 33.7 1.0 8.8 100.0 1,427 Area Urban na na 76.0 7.4 11.2 5.2 100.0 3,176 Rural Coastal na na 73.5 12.9 7.9 5.5 100.0 2,367 Rural interior 32.9 2,561 57.6 32.8 1.2 8.4 100.0 1,864 Total Rural na na 66.5 21.7 4.9 6.8 100.0 4,231 Wealth index quintiles Poorest 32.2 2,246 58.8 30.9 2.6 7.6 100.0 2,457 Second 37.1 263 70.2 15.9 9.1 4.5 100.0 1,423 Middle 44.4 44 77.8 6.7 10.1 5.3 100.0 1,272 Fourth 80.0 5 78.8 4.4 10.7 5.8 100.0 1,181 Richest 0.0 3 80.3 2.8 10.8 6.0 100.0 1,074 Total 32.9 2,561 70.6 15.6 7.6 6.1 100.0 7,407     Appendix D. Data Quality Tables      Suriname MICS4 213   Table DQ.10: Observation of women's health cards Percent distribution of women with a live birth in the last 2 years by presence of a health card, and the percentage of health cards seen by the interviewers, Suriname, 2010 Woman does not have health card Woman has health card Missing/DK Total Percent of health cards seen by the interviewer (1)/(1+2)*100 Number of women with a live birth in the last two years Seen by the interviewer (1) Not seen by the interviewer (2) Region Paramaribo 34.2 19.6 43.8 2.3 100.0 30.9 260 Wanica 33.3 15.8 48.2 2.6 100.0 24.7 114 Nickerie 35.2 17.0 46.6 1.1 100.0 26.8 88 Coronie 28.6 14.3 57.1 0.0 100.0 20.0 7 Saramacca 12.3 22.8 64.9 0.0 100.0 26.0 57 Commewijne 27.1 18.8 52.1 2.1 100.0 26.5 48 Marowijne 34.8 5.3 56.1 3.8 100.0 8.6 132 Para 31.8 9.1 57.6 1.5 100.0 13.6 66 Brokopondo 60.9 4.5 33.1 1.5 100.0 12.0 133 Sipaliwini 53.3 8.1 34.4 4.2 100.0 19.0 360 Area Urban 33.3 18.4 46.2 2.2 100.0 28.5 403 Rural Coastal 30.6 12.5 54.7 2.2 100.0 18.5 369 Rural interior 55.4 7.1 34.1 3.4 100.0 17.2 493 Total Rural 44.8 9.4 42.9 2.9 100.0 18.0 862 Wealth index quintiles Poorest 51.3 8.1 37.4 3.3 100.0 17.7 645 Second 30.7 18.1 46.0 5.1 100.0 28.3 215 Middle 30.2 16.6 52.7 0.6 100.0 23.9 169 Fourth 29.5 17.4 53.0 0.0 100.0 24.7 132 Richest 31.7 12.5 54.8 1.0 100.0 18.6 104 Total 41.1 12.3 44.0 2.7 100.0 21.8 1,265     Appendix D. Data Quality Tables 214  Suriname MICS4    Table DQ.11: Observation of under-5s birth certificates Percent distribution of children under 5 by presence of birth certificates,and percentage of birth calendar seen, Suriname, 2010 Child does not have birth certificate Child has birth certificate Don't know/Missing Total Percent of birth certificates seen by the interviewer (1)/(1+2)*100 Number of children under age 5 Seen by the interviewer (1) Not seen by the interviewer (2) Region Paramaribo 2.2 51.3 45.9 0.6 100.0 52.8 634 Wanica 2.4 47.5 49.8 0.3 100.0 48.8 295 Nickerie 5.8 45.7 47.5 0.9 100.0 49.0 223 Coronie 9.1 40.9 50.0 0.0 100.0 45.0 22 Saramacca 3.6 40.0 56.4 0.0 100.0 41.5 140 Commewijne 5.9 47.1 47.1 0.0 100.0 50.0 119 Marowijne 13.5 34.3 51.9 0.3 100.0 39.8 318 Para 6.3 41.4 51.1 1.1 100.0 44.7 174 Brokopondo 7.2 48.6 43.2 0.9 100.0 52.9 333 Sipaliwini 8.7 52.9 38.1 0.4 100.0 58.1 1,050 Area Urban 2.3 49.6 47.5 0.5 100.0 51.1 993 Rural Coastal 8.5 40.3 50.6 0.5 100.0 44.3 932 Rural interior 8.3 51.8 39.3 0.5 100.0 56.9 1,383 Total Rural 8.4 47.2 43.9 0.5 100.0 51.8 2,315 Child's age 0 7.2 53.8 38.7 0.3 100.0 58.2 649 1 5.4 50.4 44.0 0.1 100.0 53.4 716 2 6.2 49.5 43.9 0.3 100.0 53.0 658 3 7.0 41.8 50.2 1.0 100.0 45.4 697 4 7.0 44.0 48.1 0.9 100.0 47.8 588 Total 6.6 47.9 45.0 0.5 100.0 51.6 3,308     Appendix D. Data Quality Tables      Suriname MICS4 215   Table DQ.12: Observation of vaccination cards Percent distribution of children under 5 by presence of a vaccination card, and the percentage of vaccination cards seen by the interviewers, Suriname, 2010 Child does not have vaccination card Child has vaccination card Total Percent of vaccination cards seen by the interviewer (1)/(1+2)*100 Number of children under age 5 Had vaccination card previously Never had vaccination card Seen by the interviewer (1) Not seen by the interviewer (2) Don't know/Missing Region Paramaribo 0.3 3.5 77.3 18.8 0.2 100.0 80.5 634 Wanica 0.3 2.4 80.7 16.6 0.0 100.0 82.9 295 Nickerie 0.9 1.8 88.8 8.5 0.0 100.0 91.2 223 Coronie 4.5 4.5 86.4 4.5 0.0 100.0 95.0 22 Saramacca 0.7 5.0 75.0 19.3 0.0 100.0 79.5 140 Commewijne 0.8 2.5 82.4 14.3 0.0 100.0 85.2 119 Marowijne 1.3 9.7 59.1 29.6 0.3 100.0 66.7 318 Para 0.0 1.1 79.9 19.0 0.0 100.0 80.8 174 Brokopondo 0.9 7.5 64.6 27.0 0.0 100.0 70.5 333 Sipaliwini 0.7 3.4 74.3 21.3 0.3 100.0 77.7 1,050 Area Urban 0.3 2.9 79.2 17.5 0.1 100.0 81.9 993 Rural Coastal 1.0 5.2 73.9 19.8 0.1 100.0 78.8 932 Rural interior 0.7 4.4 71.9 22.7 0.2 100.0 76.0 1,383 Total Rural 0.8 4.7 72.7 21.6 0.2 100.0 77.1 2,315 Child's age 0 1.5 18.6 65.8 13.9 0.2 100.0 82.6 649 1 0.3 1.3 81.8 16.3 0.3 100.0 83.4 716 2 0.8 0.2 77.7 21.3 0.2 100.0 78.5 658 3 0.1 0.6 73.5 25.7 0.1 100.0 74.1 697 4 0.7 0.5 73.8 25.0 0.0 100.0 74.7 588 Total 0.7 4.2 74.7 20.3 0.2 100.0 78.6 3,308   Table DQ.13: 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, Suriname, 2010 Mother in the household Mother not in the household Total Number of children under 5 Mother interviewed Father interviewed Other adult female interviewed Other adult male interviewed Father interviewed Other adult female interviewed Other adult male interviewed Age 0 97.5 0.1 0.2 0.0 0.0 2.2 0.0 100.0 562 1 93.6 0.3 0.2 0.3 0.1 5.5 0.0 100.0 653 2 92.5 0.1 0.5 0.0 0.0 6.7 0.2 100.0 565 3 90.0 0.2 0.1 0.3 0.2 8.9 0.4 100.0 606 4 90.9 0.1 0.4 0.0 0.2 8.4 0.0 100.0 523 Total 92.9 0.1 0.3 0.1 0.1 6.3 0.1 100.0 2,908       Appendix D. Data Quality Tables 216  Suriname MICS4    Table DQ.14: Selection of children age 2-14 years for the child discipline module Percent of households with at least two children age 2-14 years where correct selection of one child for the child discipline module was performed, Suriname, 2010 Percent of households where correct selection was performed Number of households with 2 or more children age 2-14 years Region Paramaribo 89.5 486 Wanica 91.3 229 Nickerie 97.3 183 Coronie 100.0 22 Saramacca 91.4 116 Commewijne 91.3 92 Marowijne 81.7 202 Para 87.3 158 Brokopondo 89.3 196 Sipaliwini 88.7 630 Area Urban 90.7 778 Rural Coastal 88.9 710 Rural interior 88.9 826 Total Rural 88.9 1,536 Number of children age 2-14 years 2 92.0 1,117 3 90.8 622 4 83.1 575 Total 89.5 2,314              Ap pe nd ix  D.  Da ta  Qu al ity  Ta bl es           Su rin am e M IC S4 21 7   Tab le D Q .1 5: S ch oo l a tte nd an ce b y si ng le a ge D is tri bu tio n of h ou se ho ld p op ul at io n ag e 5- 24 b y ed uc at io na l l ev el a nd g ra de a tte nd ed in th e cu rr en t ( or m os t r ec en t) sc ho ol y ea r, S ur in am e, 2 01 0 C ur re nt ly a tte nd in g M is si ng / D K To ta l N um be r of ho us eh ol d m em be rs N ot a tte nd in g sc ho ol P re sc ho ol Pr im ar y sc ho ol Se co nd ar y sc ho ol H ig he r ed uc at io n O th er , no t re gu la r G ra de S pe ci al ed uc at io n Ju ni or e du ca tio n (M U LO , LB G O , LT S) G ra de Se ni or e du ca tio n (H AV O , VW O , IM EO , N A TI N ) G ra de S pe ci al ed uc at io n 1 2 3 4 5 6 D K 1 2 3 4 D K 1 2 3 4 D K A ge a t b eg in ni ng o f s ch oo l y ea r 5 4. 9 68 .4 24 .9 0. 6 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 9 10 0. 0 47 7 6 3. 9 5. 9 70 .5 16 .7 2. 5 0. 0 0. 0 0. 0 0. 2 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 3 10 0. 0 61 1 7 2. 3 0. 1 20 .6 60 .9 13 .0 0. 8 0. 1 0. 2 0. 2 0. 5 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 3 0. 0 0. 0 0. 9 10 0. 0 59 0 8 2. 3 0. 3 4. 3 23 .3 56 .0 11 .8 0. 2 0. 0 0. 3 0. 5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 3 0. 0 0. 0 0. 6 10 0. 0 60 1 9 1. 9 0. 1 2. 3 11 .9 27 .1 44 .9 10 .0 0. 4 0. 2 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1. 1 10 0. 0 55 4 10 2. 8 0. 1 0. 8 6. 6 17 .7 19 .9 40 .8 8. 8 0. 6 0. 6 0. 8 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 5 10 0. 0 55 5 11 1. 4 0. 2 0. 2 1. 9 10 .6 17 .3 24 .3 36 .4 0. 2 0. 7 4. 4 0. 5 0. 5 0. 0 0. 4 0. 0 0. 0 0. 0 0. 0 0. 0 0. 7 0. 0 0. 0 0. 6 10 0. 0 57 1 12 3. 7 0. 0 0. 1 1. 1 5. 1 9. 0 20 .0 24 .1 0. 1 1. 5 25 .1 8. 6 0. 7 0. 0 0. 3 0. 0 0. 4 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 10 0. 0 60 2 13 5. 3 0. 0 0. 4 0. 3 2. 0 7. 3 14 .5 21 .6 0. 1 1. 6 17 .2 22 .5 5. 9 0. 6 0. 0 0. 4 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 10 0. 0 52 9 14 11 .2 0. 0 0. 0 0. 2 1. 3 2. 0 9. 0 9. 2 0. 0 0. 7 25 .5 19 .0 15 .9 4. 4 0. 0 0. 1 0. 4 0. 0 0. 4 0. 0 0. 0 0. 0 0. 4 0. 5 10 0. 0 45 7 15 16 .0 0. 0 0. 1 0. 0 0. 8 0. 8 2. 5 6. 6 0. 0 0. 9 13 .7 19 .1 18 .2 15 .4 0. 1 2. 6 0. 9 0. 4 0. 5 0. 0 0. 4 0. 0 0. 0 1. 1 10 0. 0 45 7 16 21 .5 0. 0 0. 0 0. 0 0. 1 0. 3 1. 5 0. 5 0. 0 0. 3 8. 5 15 .1 15 .7 18 .1 0. 7 13 .6 2. 1 1. 0 0. 1 0. 0 0. 5 0. 0 0. 0 0. 4 10 0. 0 49 5 17 28 .5 0. 0 0. 0 0. 0 0. 0 0. 1 0. 5 0. 5 0. 0 0. 3 3. 7 6. 8 13 .5 17 .8 0. 0 10 .8 11 .3 2. 9 1. 2 0. 0 0. 0 0. 9 0. 3 0. 8 10 0. 0 55 0 18 28 .8 0. 0 0. 0 0. 0 0. 1 0. 2 0. 0 0. 2 0. 0 0. 0 1. 4 5. 8 9. 9 17 .0 0. 0 12 .1 13 .0 7. 4 2. 7 0. 4 0. 0 1. 0 0. 0 0. 0 10 0. 0 44 0 19 43 .7 0. 0 0. 0 0. 0 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 1. 8 2. 1 6. 6 9. 8 0. 0 11 .3 8. 6 4. 1 4. 1 0. 1 0. 0 6. 4 0. 7 0. 3 10 0. 0 53 1 20 55 .4 0. 0 0. 0 0. 0 0. 4 0. 0 0. 4 0. 0 0. 0 0. 0 0. 2 1. 5 2. 4 5. 9 0. 0 6. 8 7. 1 7. 9 2. 4 0. 1 0. 0 7. 0 1. 6 0. 9 10 0. 0 45 8 21 59 .0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 5 0. 5 1. 3 5. 4 0. 4 4. 0 5. 4 5. 7 3. 0 0. 5 0. 1 13 .0 0. 7 0. 5 10 0. 0 45 7 22 68 .5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 6 0. 1 1. 0 4. 5 0. 0 4. 8 5. 8 1. 3 1. 7 0. 1 0. 0 10 .8 0. 7 0. 0 10 0. 0 41 8 23 67 .9 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 7 0. 7 0. 8 0. 8 0. 0 3. 3 5. 1 2. 4 1. 8 0. 0 0. 0 15 .2 1. 0 0. 0 10 0. 0 49 7 24 76 .2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 3. 6 3. 1 3. 1 0. 0 0. 0 14 .0 0. 0 0. 0 10 0. 0 47 0     Ap pe nd ix  E.  Su rin am e M IC S4  In di ca to rs : N um er at or s a nd  De no m in at or s 21 8  Su rin am e M IC S4   A pp en di x E. S ur in am e M IC S4 In di ca to rs : N um er at or s an d D en om in at or s M IC S4 IN D IC A TO R N um er at or D en om in at or M D G 28 2. N U TR IT IO N 2. 1a   2. 1b   U nd er w ei gh t p re va le nc e  N um be r o f ch ild re n u nd er  ag e 5  wh o  (a ) fa ll b el ow  m in us  tw o s ta nd ar d d ev ia tio ns  (m od er at e a nd  se ve re )   (b ) fa ll b el ow  m in us  th re e s ta nd ar d d ev ia tio ns  (se ve re )  fr om  th e m ed ia n w ei gh t fo r a ge  of  th e W HO  sta nd ar d  To ta l nu m be r o f ch ild re n u nd er  ag e 5   M DG  1.8   2. 2a   2. 2b   St un tin g p re va le nc e   N um be r o f ch ild re n u nd er  ag e 5  wh o  (a ) fa ll b el ow  m in us  tw o s ta nd ar d d ev ia tio ns  (m od er at e a nd  se ve re )   (b ) fa ll b el ow  m in us  th re e s ta nd ar d d ev ia tio ns  (se ve re )   fr om  th e m ed ia n h ei gh t fo r a ge  of  th e W HO  sta nd ar d  To ta l nu m be r o f ch ild re n u nd er  ag e 5     2. 3a   2. 3b   W as tin g p re va le nc e  N um be r o f ch ild re n u nd er  ag e 5  wh o  (a ) fa ll b el ow  m in us  tw o s ta nd ar d d ev ia tio ns  (m od er at e a nd  se ve re )  (b ) fa ll b el ow  m in us  th re e s ta nd ar d d ev ia tio ns  (se ve re )  fr om  th e m ed ia n w ei gh t fo r h ei gh t o f th e W HO  sta nd ar d  To ta l nu m be r o f ch ild re n u nd er  ag e 5     2. 4  Ch ild re n e ve r b re as tf ed   N um be r o f w om en  w ith  a  liv e b irt h i n t he  2  ye ar s p re ce di ng  th e  su rv ey  wh o b re as tf ed  th e c hi ld  at  an y t im e  To ta l n um be r o f w om en  w ith  a  liv e b irt h i n t he  2  ye ar s p re ce di ng  th e  su rv ey     2. 5  Ea rly  ini tia tio n o f b re as tf ee di ng   Nu m be r o f w om en  wi th  a  liv e b irt h i n t he  2  ye ar s pr ec ed in g t he  su rv ey   w ho  pu t th e n ew bo rn  inf an t to  th e b re as t w ith in  1 h ou r o f bi rth   To ta l n um be r o f w om en  w ith  a  liv e b irt h i n t he  2  ye ar s p re ce di ng  th e  su rv ey     2. 6  Ex cl us iv e b re as tf ee di ng  un de r 6  m on th s  N um be r o f i nf an ts  u nd er  6  m on th s o f a ge  w ho  a re  e xc lu siv el y  br ea st fe d  To ta l nu m be r o f in fa nt s u nd er  6 m on th s o f a ge      2. 7  Co nt in ue d b re as tf ee di ng  at  1 y ea r   N um be r  of  c hi ld re n  ag e  12 ‐15  m on th s  w ho  a re  c ur re nt ly   br ea st fe ed in g  To ta l nu m be r o f ch ild re n a ge  12 ‐15  m on th s    2. 8  Co nt in ue d b re as tf ee di ng  at  2 y ea rs   N um be r  of  c hi ld re n  ag e  20 ‐23  m on th s  w ho  a re  c ur re nt ly   br ea st fe ed in g  To ta l nu m be r o f ch ild re n a ge  20 ‐23  m on th s    2. 9  Pr ed om in an t b re as tf ee di ng  un de r 6  m on th s   N um be r o f in fa nt s u nd er  6 m on th s o f a ge  wh o r ec ei ve d b re as t m ilk  as   th e p re do m in an t so ur ce  of  no ur ish m en t du rin g t he  pr ev io us  da y  To ta l nu m be r o f in fa nt s u nd er  6 m on th s o f a ge     2. 10   Du ra tio n o f b re as tf ee di ng Th e a ge  in  m on th s w he n 5 0 p er ce nt  of  ch ild re n a ge  0‐ 35  m on th s d id  no t re ce iv e b re as t m ilk  du rin g t he  pr ev io us  da y   2. 11   Bo tt le  fe ed in g  N um be r o f c hi ld re n a ge  0‐ 23  m on th s w ho  w er e f ed  w ith  a  bo tt le   du rin g t he  pr ev io us  da y  To ta l nu m be r o f ch ild re n a ge  0‐ 23  m on th s                                                                            28  MD G in di ca to rs a s of F eb ru ar y 20 10   Ap pe nd ix  E.  Su rin am e M IC S4  In di ca to rs : N um er at or s a nd  De no m in at or s          Su rin am e M IC S4 21 9 M IC S4 IN D IC A TO R N um er at or D en om in at or M D G 28 2. 12   In tr od uc tio n o f so lid , se m i‐so lid  or  so ft  fo od s   N um be r o f in fa nt s a ge  6‐ 8 m on th s w ho  re ce iv ed  so lid , se m i‐so lid  or   so ft  fo od s d ur in g t he  pr ev io us  da y  To ta l nu m be r o f in fa nt s a ge  6‐ 8 m on th s    2. 13   M in im um  m ea l fr eq ue nc y  N um be r o f c hi ld re n a ge  6‐ 23  m on th s r ec ei vi ng  so lid , s em i‐so lid  an d  so ft  fo od s ( pl us  m ilk  fe ed s f or  no n‐b re as tf ed  ch ild re n)  th e m in im um   tim es  or  m or e,  ac co rd in g t o b re as tf ee di ng  sta tu s,  du rin g t he  pr ev io us   da y  To ta l nu m be r o f ch ild re n a ge  6‐ 23  m on th s    2. 14   Ag e‐a pp ro pr ia te  br ea st fe ed in g   N um be r o f c hi ld re n a ge  0‐ 23  m on th s a pp ro pr ia te ly  fe d d ur in g t he   pr ev io us  da y   To ta l nu m be r o f ch ild re n a ge  0‐ 23  m on th s    2. 15   M ilk  fe ed in g f re qu en cy  fo r n on ‐br ea st fe d c hi ld re n  N um be r o f n on ‐br ea st fe d c hi ld re n a ge  6‐ 23  m on th s w ho  re ce iv ed  at   le as t 2  m ilk  fe ed in gs  du rin g t he  pr ev io us  da y  To ta l nu m be r o f n on ‐br ea st fe d c hi ld re n a ge  6‐ 23  m on th s    2. 18   Lo w ‐bi rt hw ei gh t in fa nt s  N um be r o f l as t l iv e  bi rt hs  in  th e  2  ye ar s p re ce di ng  th e  su rv ey   w ei gh in g b el ow  2,5 00  gr am s a t b irt h  To ta l nu m be r o f la st  liv e b irt hs  in  th e 2  ye ar s p re ce di ng  th e s ur ve y    2. 19   In fa nt s w ei gh ed  at  bir th   N um be r o f la st  liv e b irt hs  in  th e 2  ye ar s p re ce di ng  th e s ur ve y w ho   w er e w ei gh ed  at  bir th   To ta l nu m be r o f la st  liv e b irt hs  in  th e 2  ye ar s p re ce di ng  th e s ur ve y    3. C H IL D H EA LT H 3. 2  Po lio  im m un iza tio n c ov er ag e  N um be r o f c hi ld re n a ge  12 ‐23  m on th s w ho  re ce iv ed  O PV 3 v ac ci ne   be fo re  th ei r fi rs t b irt hd ay   To ta l nu m be r o f ch ild re n a ge  12 ‐23  m on th s    3. 4  M ea sle s (M M R)  im m un iza tio n c ov er ag e  N um be r o f c hi ld re n a ge  12 ‐23  m on th s w ho  re ce iv ed  m ea sle s ( M M R) va cc in e b ef or e t he ir f irs t b irt hd ay   To ta l nu m be r o f ch ild re n a ge  12 ‐23  m on th s  M DG  4.3   3. 6  Ye llo w  fe ve r im m un iza tio n c ov er ag e  N um be r o f c hi ld re n  ag e 1 2‐2 3 m on th s w ho  re ce iv ed  ye llo w  fe ve r  va cc in e b ef or e t he ir f irs t b irt hd ay   To ta l nu m be r o f ch ild re n a ge  12 ‐23  m on th s    3. 7  N eo na ta l te ta nu s p ro te ct io n   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  w ith  a  liv e b irt h i n t he  2  ye ar s  pr ec ed in g t he  su rv ey  w ho  w er e g iv en  at  le as t t w o d os es  of  te ta nu s  to xo id  va cc in e w ith in  th e a pp ro pr ia te  int er va l pr io r to  giv in g b irt h  To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs  wi th  a l iv e b irt h in  th e 2  ye ar s  pr ec ed in g t he  su rv ey     3. 8  O ra l re hy dr at io n t he ra py  wi th  co nt in ue d f ee di ng   N um be r o f c hi ld re n u nd er  ag e 5  w ith  di ar rh oe a i n t he  pr ev io us  2  w ee ks  w ho  re ce iv ed  O RT  (O RS  pa ck et  or  re co m m en de d h om em ad e  flu id  or  in cr ea se d f lu id s)  an d c on tin ue d f ee di ng  du rin g t he  ep iso de  of   di ar rh oe a  To ta l n um be r o f ch ild re n u nd er  ag e 5  wi th  di ar rh oe a in  th e p re vi ou s 2   w ee ks     3. 9  Ca re ‐se ek in g f or  su sp ec te d p ne um on ia   N um be r o f c hi ld re n u nd er  ag e 5  w ith  su sp ec te d p ne um on ia  in  th e  pr ev io us  2 w ee ks  wh o w er e t ak en  to  an  ap pr op ria te  he al th  pr ov id er   To ta l n um be r o f c hi ld re n u nd er  ag e 5  w ith  su sp ec te d p ne um on ia  in   th e p re vi ou s 2  we ek s    3. 10   An tib io tic  tre at m en t o f su sp ec te d p ne um on ia   N um be r o f c hi ld re n u nd er  ag e 5  w ith  su sp ec te d p ne um on ia  in  th e  pr ev io us  2 w ee ks  wh o r ec ei ve d a nt ib io tic s  To ta l n um be r o f c hi ld re n u nd er  ag e 5  w ith  su sp ec te d p ne um on ia  in   th e p re vi ou s 2  we ek s    3. 11   So lid  fu el s  N um be r o f h ou se ho ld  m em be rs  in  ho us eh ol ds  th at  us e s ol id  fu el s a s  th e p rim ar y s ou rc e o f d om es tic  en er gy  to  co ok   To ta l nu m be r o f h ou se ho ld  m em be rs     Ap pe nd ix  E.  Su rin am e M IC S4  In di ca to rs : N um er at or s a nd  De no m in at or s 22 0  Su rin am e M IC S4   M IC S4 IN D IC A TO R N um er at or D en om in at or M D G 28 3. 12   Ho us eh ol d a va ila bi lit y o f in se ct ic id e‐t re at ed  ne ts  (IT N s) N um be r o f h ou se ho ld s w ith  at  lea st  on e in se ct ic id e t re at ed  ne t (I TN ) To ta l nu m be r o f h ou se ho ld s   3. 13   Ho us eh ol ds  pr ot ec te d b y a  ve ct or  co nt ro l m et ho d  N um be r o f h ou se ho ld s w ith  at  le as t o ne  in se ct ic id e‐t re at ed  ne t (I TN )  or  th at  re ce iv ed  sp ra yi ng  th ro ug h a n I RS  ca m pa ig n i n t he  la st  12   m on th s p re ce di ng  th e s ur ve y  To ta l nu m be r o f h ou se ho ld s    3. 14   Ch ild re n u nd er  ag e 5  sle ep in g u nd er  an y t yp e o f m os qu ito  ne t  N um be r o f c hi ld re n  un de r a ge  5  w ho  sl ep t u nd er  a ny  ty pe  o f  m os qu ito  ne t th e p re vi ou s n ig ht   To ta l nu m be r o f ch ild re n u nd er  ag e 5     3. 15   Ch ild re n u nd er  ag e 5  sle ep in g u nd er  in se ct ic id e‐t re at ed  ne ts   (IT N s)   N um be r o f c hi ld re n  un de r a ge  5  w ho  sl ep t u nd er  an  in se ct ic id e‐ tr ea te d m os qu ito  ne t (I TN ) th e p re vi ou s n ig ht   To ta l nu m be r o f ch ild re n u nd er  ag e 5   M DG  6.7   3. 16   M al ar ia  dia gn os tic s u sa ge   N um be r o f c hi ld re n u nd er  ag e 5  re po rt ed  to  ha ve  ha d f ev er  in  th e  pr ev io us  2 w ee ks  wh o h ad  a f in ge r o r h ee l st ic k fo r m al ar ia  te st in g  To ta l n um be r o f c hi ld re n u nd er  ag e 5  re po rt ed  to  ha ve  ha d f ev er  in   th e p re vi ou s 2  we ek s    3. 17   An ti‐m al ar ia l tr ea tm en t o f c hi ld re n u nd er  ag e 5  th e s am e o r  ne xt  da y  N um be r o f c hi ld re n u nd er  ag e 5  re po rt ed  to  ha ve  ha d f ev er  in  th e  pr ev io us  2 w ee ks  wh o w er e t re at ed  wi th  an y a nt i‐m al ar ia l dr ug  wi th in   th e s am e o r n ex t d ay  of  on se t o f sy m pt om s  To ta l n um be r o f c hi ld re n u nd er  ag e 5  re po rt ed  to  ha ve  ha d f ev er  in   th e p re vi ou s 2  we ek s    3. 18   An ti‐m al ar ia l tr ea tm en t o f ch ild re n u nd er  ag e 5   N um be r o f c hi ld re n u nd er  ag e 5  re po rt ed  to  ha ve  ha d f ev er  in  th e  pr ev io us  2 w ee ks  wh o r ec ei ve d a ny  an tim al ar ia l tr ea tm en t   To ta l n um be r o f c hi ld re n u nd er  ag e 5  re po rt ed  to  ha ve  ha d f ev er  in   th e p re vi ou s 2  we ek s  M DG  6.8   3. 19   Pr eg na nt  w om en  s le ep in g  un de r  in se ct ic id e‐t re at ed  n et s  (IT N s)   N um be r o f p re gn an t w om en  w ho  sle pt  un de r a n i ns ec tic id e‐t re at ed   ne t (I TN ) th e p re vi ou s n ig ht   To ta l nu m be r o f p re gn an t w om en     4. W A TE R A N D S A N IT A TI O N 4. 1  U se  of  im pr ov ed  dr in ki ng  wa te r so ur ce s  N um be r o f h ou se ho ld  m em be rs  us in g i m pr ov ed  so ur ce s o f d rin ki ng   w at er   To ta l nu m be r o f h ou se ho ld  m em be rs   M DG  7.8   4. 2  W at er  tre at m en t  N um be r o f h ou se ho ld  m em be rs  u sin g u ni m pr ov ed  d rin ki ng  w at er   w ho  us e a n a pp ro pr ia te  tre at m en t m et ho d  To ta l n um be r o f h ou se ho ld  m em be rs  in  ho us eh ol ds  us in g u ni m pr ov ed   dr in ki ng  wa te r so ur ce s    4. 3  U se  of  im pr ov ed  sa ni ta tio n  N um be r o f h ou se ho ld  m em be rs  us in g i m pr ov ed  sa ni ta tio n f ac ili tie s  w hi ch  ar e n ot  sh ar ed   To ta l nu m be r o f h ou se ho ld  m em be rs   M DG  7.9   4. 4  Sa fe  dis po sa l of  ch ild ’s  fa ec es   N um be r o f c hi ld re n a ge  0‐ 2 y ea rs  w ho se  la st  st oo ls w er e d isp os ed  of   sa fe ly   To ta l nu m be r o f ch ild re n a ge  0‐ 2 y ea rs     4. 5  Pl ac e f or  ha nd w as hi ng   N um be r o f h ou se ho ld s w ith  a  sp ec ifi c p la ce  fo r h an d w as hi ng  w he re   w at er  an d s oa p a re  pr es en t  To ta l nu m be r o f h ou se ho ld s    4. 6  Av ai la bi lit y o f so ap N um be r o f h ou se ho ld s w ith  so ap  an yw he re  in  th e d w el lin g  To ta l nu m be r o f h ou se ho ld s   5. R EP RO D U CT IV E H EA LT H Ap pe nd ix  E.  Su rin am e M IC S4  In di ca to rs : N um er at or s a nd  De no m in at or s          Su rin am e M IC S4 22 1 M IC S4 IN D IC A TO R N um er at or D en om in at or M D G 28 5. 3  Co nt ra ce pt iv e p re va le nc e r at e  N um be r o f w om en  ag e 1 5‐4 9 y ea rs  cu rr en tly  m ar rie d o r in  un io n w ho   ar e  us in g  (o r w ho se  p ar tn er  is  u sin g)  a  (m od er n  or  tr ad iti on al )  co nt ra ce pt iv e m et ho d   To ta l n um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o a re  cu rr en tly  m ar rie d o r  in  un io n  M DG  5.3   5. 4  U nm et  ne ed   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  w ho  ar e c ur re nt ly  m ar rie d o r in   un io n w ho  ar e f ec un d a nd  w an t t o s pa ce  th ei r b irt hs  or  lim it  th e  nu m be r o f c hi ld re n  th ey  h av e  an d  w ho  a re  n ot  cu rr en tly  u sin g  co nt ra ce pt io n  To ta l n um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o a re  cu rr en tly  m ar rie d o r  in  un io n  M DG  5.6   5. 5a   5. 5b   An te na ta l ca re  co ve ra ge   N um be r o f w om en  a ge  1 5‐4 9  ye ar s w ho  w er e  at te nd ed  d ur in g  pr eg na nc y in  th e 2  ye ar s p re ce di ng  th e s ur ve y  (a ) a t le as t o nc e b y s ki lle d p er so nn el   (b ) a t le as t fo ur  tim es  by  an y p ro vi de r  To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs  wi th  a l iv e b irt h in  th e 2  ye ar s  pr ec ed in g t he  su rv ey   M DG  5.5   5. 6  Co nt en t o f a nt en at al  ca re   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  w ith  a  liv e b irt h i n t he  2  ye ar s  pr ec ed in g t he  su rv ey  w ho  ha d t he ir  bl oo d p re ss ur e m ea su re d a nd   ga ve  ur in e a nd  blo od  sa m pl es  du rin g t he  las t p re gn an cy   To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs  wi th  a l iv e b irt h in  th e 2  ye ar s  pr ec ed in g t he  su rv ey     5. 7  Sk ill ed  at te nd an t a t d el iv er y  N um be r o f w om en  ag e 1 5‐4 9 y ea rs  w ith  a  liv e b irt h i n t he  2  ye ar s  pr ec ed in g t he  su rv ey  w ho  w er e a tt en de d d ur in g c hi ld bi rt h b y s ki lle d  he al th  pe rs on ne l  To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs  wi th  a l iv e b irt h in  th e 2  ye ar s  pr ec ed in g t he  su rv ey   M DG  5.2   5. 8  In st itu tio na l de liv er ie s  N um be r o f w om en  ag e 1 5‐4 9 y ea rs  w ith  a  liv e b irt h i n t he  2  ye ar s  pr ec ed in g t he  su rv ey  wh o d el iv er ed  in  a h ea lth  fa ci lit y  To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs  wi th  a l iv e b irt h in  th e 2  ye ar s  pr ec ed in g t he  su rv ey     5. 9  Ca es ar ea n s ec tio n  N um be r o f la st  liv e b irt hs  in  th e 2  ye ar s p re ce di ng  th e s ur ve y w ho   w er e d el iv er ed  by  ca es ar ea n s ec tio n  To ta l nu m be r o f la st  liv e b irt hs  in  th e 2  ye ar s p re ce di ng  th e s ur ve y    6. C H IL D D EV EL O PM EN T 6. 1  Su pp or t fo r le ar ni ng   N um be r o f c hi ld re n  ag e  36 ‐59  m on th s w ith  w ho m  a n  ad ul t h as   en ga ge d i n f ou r o r m or e a ct iv iti es  to  pr om ot e l ea rn in g a nd  sc ho ol   re ad in es s in  th e p as t 3  da ys   To ta l nu m be r o f ch ild re n a ge  36 ‐59  m on th s    6. 2  Fa th er ’s  su pp or t fo r le ar ni ng   N um be r o f c hi ld re n a ge  36 ‐59  m on th s w ho se  fa th er  ha s e ng ag ed  in   on e o r m or e a ct iv iti es  to  pr om ot e le ar ni ng  an d s ch oo l re ad in es s in  th e  pa st  3 d ay s  To ta l nu m be r o f ch ild re n a ge  36 ‐59  m on th s    6. 3  Le ar ni ng  m at er ia ls:  ch ild re n’ s b oo ks    N um be r o f c hi ld re n u nd er  ag e 5  w ho  ha ve  th re e o r m or e c hi ld re n’ s  bo ok s  To ta l nu m be r o f ch ild re n u nd er  ag e 5     6. 4  Le ar ni ng  m at er ia ls:  pla yt hi ng s N um be r o f ch ild re n u nd er  ag e 5  wi th  tw o o r m or e p la yt hi ng s  To ta l nu m be r o f ch ild re n u nd er  ag e 5   6. 5  In ad eq ua te  ca re   N um be r o f c hi ld re n u nd er  ag e 5  le ft  al on e o r in  th e c ar e o f a no th er   ch ild  yo un ge r t ha n 1 0 y ea rs  of  ag e f or  m or e t ha n o ne  ho ur  at  le as t  on ce  in  th e p as t w ee k  To ta l nu m be r o f ch ild re n u nd er  ag e 5     Ap pe nd ix  E.  Su rin am e M IC S4  In di ca to rs : N um er at or s a nd  De no m in at or s 22 2  Su rin am e M IC S4   M IC S4 IN D IC A TO R N um er at or D en om in at or M D G 28 6. 6  Ea rly  ch ild  de ve lo pm en t in de x  N um be r o f c hi ld re n a ge  36 ‐59  m on th s w ho  ar e d ev el op m en ta lly  on   tr ac k i n  lit er ac y‐n um er ac y,  p hy sic al , s oc ia l‐e m ot io na l, a nd  le ar ni ng   do m ai ns   To ta l nu m be r o f ch ild re n a ge  36 ‐59  m on th s    6. 7  At te nd an ce  to  ea rly  ch ild ho od  ed uc at io n  N um be r o f c hi ld re n a ge  36 ‐59  m on th s w ho  ar e a tt en di ng  an  ea rly   ch ild ho od  ed uc at io n p ro gr am m e  To ta l nu m be r o f ch ild re n a ge  36 ‐59  m on th s    7. L IT ER A CY A N D E D U CA TI O N 7. 1  Li te ra cy  ra te  am on g y ou ng  wo m en   N um be r o f w om en  ag e 1 5‐2 4 y ea rs  w ho  ar e a bl e t o r ea d a  sh or t  sim pl e s ta te m en t a bo ut  ev er yd ay  lif e o r w ho  at te nd ed  se co nd ar y o r  hi gh er  ed uc at io n  To ta l nu m be r o f w om en  ag e 1 5‐2 4 y ea rs   M DG  2.3   7. 2  Sc ho ol  re ad in es s  N um be r o f ch ild re n i n f irs t g ra de  of  pr im ar y s ch oo l w ho  at te nd ed  pr e‐ sc ho ol  du rin g t he  pr ev io us  sc ho ol  ye ar   To ta l nu m be r o f ch ild re n a tt en di ng  th e f irs t g ra de  of  pr im ar y s ch oo l    7. 3  N et  int ak e r at e in  pr im ar y e du ca tio n  N um be r o f c hi ld re n o f s ch oo l‐e nt ry  ag e w ho  en te r t he  fir st  gr ad e o f  pr im ar y s ch oo l  To ta l nu m be r o f ch ild re n o f sc ho ol ‐en tr y a ge     7. 4  Pr im ar y s ch oo l ne t a tt en da nc e r at io  (a dj us te d)   N um be r o f ch ild re n o f p rim ar y s ch oo l ag e c ur re nt ly  at te nd in g p rim ar y  or  se co nd ar y s ch oo l   To ta l nu m be r o f ch ild re n o f p rim ar y s ch oo l ag e   M DG  2.1   7. 5  Se co nd ar y s ch oo l ne t a tt en da nc e r at io  (a dj us te d)   N um be r o f c hi ld re n  of  se co nd ar y  sc ho ol  a ge  cu rr en tly  a tt en di ng   se co nd ar y s ch oo l or  hig he r   To ta l nu m be r o f ch ild re n o f se co nd ar y s ch oo l ag e    7. 6  Ch ild re n r ea ch in g la st  gr ad e o f p rim ar y  Pr op or tio n o f ch ild re n e nt er in g t he  fir st  gr ad e o f p rim ar y s ch oo l w ho  ev en tu al ly  re ac h la st  gr ad e M DG  2.2   7. 7  Pr im ar y c om pl et io n r at e  N um be r o f c hi ld re n  at te nd in g  th e  la st  g ra de  o f p rim ar y  sc ho ol   (e xc lu di ng  re pe at er s)   To ta l n um be r o f c hi ld re n  of  p rim ar y s ch oo l c om pl et io n  ag e  (a ge   ap pr op ria te  to  fin al  gr ad e o f p rim ar y s ch oo l)    7. 8  Tr an sit io n r at e t o s ec on da ry  sc ho ol   N um be r o f c hi ld re n a tt en di ng  th e l as t g ra de  of  pr im ar y s ch oo l d ur in g  th e p re vi ou s s ch oo l y ea r w ho  ar e i n  th e f irs t g ra de  of  se co nd ar y  sc ho ol  du rin g t he  cu rr en t sc ho ol  ye ar    To ta l n um be r o f c hi ld re n a tt en di ng  th e l as t g ra de  of  pr im ar y s ch oo l  du rin g t he  pr ev io us  sc ho ol  ye ar     7. 9  Ge nd er  pa rit y in de x (p rim ar y s ch oo l)  Pr im ar y s ch oo l ne t a tt en da nc e r at io  (a dj us te d)  fo r g irl s  Pr im ar y s ch oo l ne t a tt en da nc e r at io  (a dj us te d)  fo r b oy s M DG  3.1   7. 10   Ge nd er  pa rit y in de x (s ec on da ry  sc ho ol )  Se co nd ar y s ch oo l ne t a tt en da nc e r at io  (a dj us te d)  fo r g irl s  Se co nd ar y s ch oo l ne t a tt en da nc e r at io  (a dj us te d)  fo r b oy s M DG  3.1   8. C H IL D P RO TE CT IO N 8. 1  Bi rt h r eg ist ra tio n N um be r o f ch ild re n u nd er  ag e 5  wh os e b irt hs  ar e r ep or te d r eg ist er ed To ta l nu m be r o f ch ild re n u nd er  ag e 5   8. 2  Ch ild  lab ou r  N um be r o f ch ild re n a ge  5‐ 14  ye ar s w ho  ar e in vo lv ed  in  ch ild  lab ou r To ta l nu m be r o f ch ild re n a ge  5‐ 14  ye ar s   8. 3  Sc ho ol  at te nd an ce  am on g c hi ld  lab ou re rs   N um be r o f c hi ld re n a ge  5‐ 14  ye ar s w ho  ar e i nv ol ve d i n c hi ld  la bo ur   an d a re  cu rr en tly  at te nd in g s ch oo l  To ta l nu m be r o f ch ild re n a ge  5‐ 14  ye ar s in vo lv ed  in  ch ild  lab ou r     Ap pe nd ix  E.  Su rin am e M IC S4  In di ca to rs : N um er at or s a nd  De no m in at or s          Su rin am e M IC S4 22 3 M IC S4 IN D IC A TO R N um er at or D en om in at or M D G 28 8. 4  Ch ild  lab ou r a m on g s tu de nt s  N um be r o f c hi ld re n a ge  5‐ 14  ye ar s w ho  ar e i nv ol ve d i n c hi ld  la bo ur   an d a re  cu rr en tly  at te nd in g s ch oo l  To ta l nu m be r o f ch ild re n a ge  5‐ 14  ye ar s a tt en di ng  sc ho ol     8. 5  Vi ol en t d isc ip lin e  N um be r o f c hi ld re n a ge  2‐ 14  ye ar s w ho  ex pe rie nc ed  ps yc ho lo gi ca l  ag gr es sio n o r p hy sic al  pu ni sh m en t d ur in g t he  pa st  m on th    To ta l nu m be r o f ch ild re n a ge  2‐ 14  ye ar s     8. 6  M ar ria ge  be fo re  ag e 1 5  N um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o w er e f irs t m ar rie d o r in  un io n  by  th e e xa ct  ag e o f 1 5  To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs     8. 7  M ar ria ge  be fo re  ag e 1 8  N um be r o f w om en  ag e 2 0‐4 9 y ea rs  wh o w er e f irs t m ar rie d o r in  un io n  by  th e e xa ct  ag e o f 1 8  To ta l nu m be r o f w om en  ag e 2 0‐4 9 y ea rs     8. 8  Yo un g w om en  ag e 1 5‐1 9 y ea rs  cu rr en tly  m ar rie d o r in  un io n  N um be r o f w om en  ag e 1 5‐1 9 y ea rs  w ho  ar e c ur re nt ly  m ar rie d o r in   un io n  To ta l nu m be r o f w om en  ag e 1 5‐1 9 y ea rs     8. 9  Po ly gy ny   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o a re  in  a p ol yg yn ou s u ni on   To ta l n um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o a re  cu rr en tly  m ar rie d o r  in  un io n    8. 10 a  8. 10 b  Sp ou sa l ag e d iff er en ce    N um be r o f w om en  cu rr en tly  m ar rie d o r in  un io n w ho se  sp ou se  is  10   or  m or e y ea rs  old er ,   (a ) fo r w om en  ag e 1 5‐1 9 y ea rs ,   (b ) fo r w om en  ag e 2 0‐2 4 y ea rs   To ta l nu m be r o f w om en  cu rr en tly  m ar rie d o r in  un io n   (a ) a ge  15 ‐19  ye ar s,    (b ) a ge  20 ‐24  ye ar s    8. 14   At tit ud es  to w ar ds  do m es tic  vio le nc e  N um be r o f w om en  w ho  st at e t ha t a  hu sb an d/ pa rt ne r is  ju st ifi ed  in   hi tt in g  or  b ea tin g  hi s  w ife  in  a t  le as t  on e  of  t he  f ol lo w in g  ci rc um st an ce s:  (1 ) s he  go es  ou t w ith ou t t el lin g h im , (2 ) s he  ne gl ec ts   th e c hi ld re n,  (3 ) sh e a rg ue s w ith  hi m , (4 ) sh e r ef us es  se x w ith  hi m , (5 )  sh e b ur ns  th e f oo d  To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs     9. H IV /A ID S, S EX U A L BE H A V IO U R A N D O RP H A N S 9. 1  Co m pr eh en siv e k no w le dg e a bo ut  HI V p re ve nt io n  N um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o c or re ct ly  ide nt ify  tw o w ay s o f  pr ev en tin g H IV  inf ec tio n,  kn ow  th at  a h ea lth y lo ok in g p er so n c an  ha ve   HI V,  an d  re je ct  th e t w o  m os t c om m on  m isc on ce pt io ns  ab ou t H IV   tr an sm iss io n  To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs     9. 2  Co m pr eh en siv e  kn ow le dg e  ab ou t  HI V  pr ev en tio n  am on g  yo un g p eo pl e  N um be r o f w om en  ag e 1 5‐2 4 y ea rs  wh o c or re ct ly  ide nt ify  tw o w ay s o f  pr ev en tin g H IV  in fe ct io n1 2 , k no w  th at  a  he al th y l oo ki ng  pe rs on  ca n  ha ve  HI V,  an d r ej ec t th e t w o m os t co m m on  m isc on ce pt io ns  ab ou t H IV   tr an sm iss io n  To ta l nu m be r o f w om en  ag e 1 5‐2 4 y ea rs    M DG  6.3   9. 3  Kn ow le dg e o f m ot he r‐to ‐ch ild  tra ns m iss io n o f H IV   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  w ho  co rr ec tly  id en tif y a ll t hr ee   m ea ns  of  m ot he r‐to ‐ch ild  tra ns m iss io n o f H IV   To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs     9. 4  Ac ce pt in g a tt itu de s to w ar ds  pe op le  liv in g w ith  HI V  N um be r o f w om en  ag e 1 5‐4 9 y ea rs  ex pr es sin g a cc ep tin g a tt itu de s o n  al l fo ur  qu es tio ns  to w ar d p eo pl e li vi ng  wi th  HI V  To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o h av e h ea rd  of  HI V    Ap pe nd ix  E.  Su rin am e M IC S4  In di ca to rs : N um er at or s a nd  De no m in at or s 22 4  Su rin am e M IC S4   M IC S4 IN D IC A TO R N um er at or D en om in at or M D G 28 9. 5  W om en  wh o k no w  wh er e t o b e t es te d f or  HI V  N um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o s ta te  kn ow le dg e o f a  pla ce  to   be  te st ed  fo r H IV   To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs     9. 6  W om en  wh o h av e b ee n t es te d f or  HI V a nd  kn ow  th e r es ul ts   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  w ho  ha ve  be en  te st ed  fo r H IV  in   th e 1 2 m on th s p re ce di ng  th e s ur ve y a nd  wh o k no w  th ei r re su lts   To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs     9. 7  Se xu al ly  ac tiv e y ou ng  w om en  w ho  ha ve  be en  te st ed  fo r H IV   an d k no w  th e r es ul ts   N um be r o f w om en  ag e 1 5‐2 4 y ea rs  w ho  ha ve  h ad  se x i n  th e 1 2  m on th s p re ce di ng  th e s ur ve y,  wh o h av e b ee n t es te d f or  HI V i n t he  12   m on th s p re ce di ng  th e s ur ve y a nd  wh o k no w  th ei r re su lts   To ta l n um be r o f w om en  ag e 1 5‐2 4 y ea rs  w ho  ha ve  ha d s ex  in  th e 1 2  m on th s p re ce di ng  th e s ur ve y    9. 8  HI V c ou ns el lin g d ur in g a nt en at al  ca re   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  w ho  ga ve  bi rt h i n t he  2  ye ar s  pr ec ed in g t he  su rv ey  an d r ec ei ve d a nt en at al  ca re , re po rt in g t ha t th ey   re ce iv ed  co un se lli ng  on  HI V d ur in g a nt en at al  ca re   To ta l n um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o g av e b irt h i n t he  2  ye ar s  pr ec ed in g t he  su rv ey     9. 9  HI V t es tin g d ur in g a nt en at al  ca re   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  w ho  ga ve  bi rt h i n t he  2  ye ar s  pr ec ed in g t he  su rv ey  an d r ec ei ve d a nt en at al  ca re , re po rt in g t ha t th ey   w er e o ffe re d a nd  ac ce pt ed  an  H IV  te st  du rin g a nt en at al  ca re  an d  re ce iv ed  th ei r re su lts   To ta l n um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o g av e b irt h i n t he  2  ye ar s  pr ec ed in g t he  su rv ey     9. 10   Yo un g w om en  wh o h av e n ev er  ha d s ex   N um be r o f n ev er  m ar rie d w om en  ag e 1 5‐2 4 y ea rs  w ho  ha ve  ne ve r  ha d s ex   To ta l nu m be r o f n ev er  m ar rie d w om en  ag e 1 5‐2 4 y ea rs     9. 11   Se x b ef or e a ge  15  am on g y ou ng  wo m en   N um be r o f w om en  ag e 1 5‐2 4 y ea rs  w ho  ha ve  ha d s ex ua l in te rc ou rs e  be fo re  ag e 1 5  To ta l nu m be r o f w om en  ag e 1 5‐2 4 y ea rs     9. 12   Ag e‐m ix in g a m on g s ex ua l pa rt ne rs   N um be r o f w om en  ag e 1 5‐2 4 y ea rs  w ho  ha d s ex  in  th e 1 2 m on th s  pr ec ed in g t he  su rv ey  wi th  a p ar tn er  wh o w as  10  or  m or e y ea rs  old er   To ta l n um be r o f w om en  ag e 1 5‐2 4 y ea rs  w ho  ha ve  ha d s ex  in  th e 1 2  m on th s p re ce di ng  th e s ur ve y    9. 13   Se x w ith  m ul tip le  pa rt ne rs   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  w ho  ha ve  ha d s ex ua l in te rc ou rs e  w ith  m or e t ha n o ne  pa rt ne r in  th e 1 2 m on th s p re ce di ng  th e s ur ve y  To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs     9. 14   Co nd om  us e d ur in g s ex  wi th  m ul tip le  pa rt ne rs   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o r ep or t h av in g h ad  m or e t ha n  on e s ex ua l p ar tn er  in  th e 1 2 m on th s p re ce di ng  th e s ur ve y w ho  al so   re po rt ed  th at  a c on do m  wa s u se d t he  las t ti m e t he y h ad  se x  To ta l n um be r o f w om en  ag e 1 5 ‐4 9 y ea rs  w ho  re po rt ed  ha vi ng  ha d  m or e t ha n o ne  se xu al  pa rt ne r in  th e 1 2 m on th s p re ce di ng  th e s ur ve y    9. 15   Se x w ith  no n‐r eg ul ar  pa rt ne rs   N um be r o f se xu al ly  ac tiv e w om en  ag e 1 5‐2 4 y ea rs  w ho  ha ve  ha d s ex   w ith  a  n on ‐m ar ita l,  no n‐c oh ab ita tin g  pa rt ne r i n  th e  12  m on th s  pr ec ed in g t he  su rv ey   To ta l n um be r o f w om en  ag e 1 5‐2 4 y ea rs  w ho  ha ve  ha d s ex  in  th e 1 2  m on th s p re ce di ng  th e s ur ve y    9. 16   Co nd om  us e w ith  no n‐r eg ul ar  pa rt ne rs   N um be r o f w om en  ag e 1 5‐2 4 y ea rs  re po rt in g t he  us e o f a  co nd om   du rin g s ex ua l in te rc ou rs e w ith  th ei r la st  no n‐m ar ita l, n on ‐co ha bi tin g  se x p ar tn er  in  th e 1 2 m on th s p re ce di ng  th e s ur ve y  To ta l n um be r o f w om en  ag e 1 5‐2 4 y ea rs  wh o h ad  a  no n‐m ar ita l, n on ‐ co ha bi tin g p ar tn er  in  th e 1 2 m on th s p re ce di ng  th e s ur ve y  M DG  6.2   9. 17   Ch ild re n’ s li vi ng  ar ra ng em en ts N um be r o f ch ild re n a ge  0‐ 17  ye ar s n ot  liv in g w ith  a b io lo gi ca l pa re nt To ta l nu m be r o f ch ild re n a ge  0‐ 17  ye ar s    9. 18   Pr ev al en ce  of  ch ild re n w ith  on e o r b ot h p ar en ts  de ad N um be r o f ch ild re n a ge  0‐ 17  ye ar s w ith  on e o r b ot h p ar en ts  de ad To ta l nu m be r o f ch ild re n a ge  0‐ 17  ye ar s   Ap pe nd ix  E.  Su rin am e M IC S4  In di ca to rs : N um er at or s a nd  De no m in at or s          Su rin am e M IC S4 22 5 M IC S4 IN D IC A TO R N um er at or D en om in at or M D G 28 9. 20   Sc ho ol  at te nd an ce  of  no n‐o rp ha ns   N um be r o f ch ild re n a ge  10 ‐14  ye ar s,  wh os e p ar en ts  ar e a liv e,  wh o a re   liv in g w ith  on e o r b ot h p ar en ts , an d w ho  ar e a tt en di ng  sc ho ol   To ta l n um be r o f c hi ld re n a ge  10 ‐14  ye ar s,  w ho se  pa re nt s a re  al iv e,   an d w ho  ar e li vi ng  wi th  on e o r b ot h p ar en ts   M DG  6.4   10 . A CC ES S TO M A SS M ED IA A N D U SE O F IN FO RM A TI O N /C O M M U N IC A TI O N T EC H N O LO G Y M T. 1  Ex po su re  to  m as s m ed ia   N um be r o f w om en  ag e 1 5‐4 9 y ea rs  wh o,  at  lea st  on ce  a  w ee k,  re ad  a  ne w sp ap er  or  m ag az in e,  lis te n t o t he  ra di o,  an d w at ch  te le vi sio n  To ta l nu m be r o f w om en  ag e 1 5‐4 9 y ea rs     M T. 2  U se  of  co m pu te rs   N um be r o f y ou ng  w om en  ag e 1 5‐2 4 y ea rs  w ho  us ed  a  co m pu te r  du rin g t he  las t 1 2 m on th s  To ta l nu m be r o f w om en  ag e 1 5‐2 4 y ea rs     M T. 3  U se  of  int er ne t  N um be r o f y ou ng  wo m en  ag e 1 5‐2 4 w ho  us ed  th e in te rn et  du rin g t he   la st  12  m on th s  To ta l nu m be r o f w om en  ag e 1 5‐2 4 y ea rs     Appendix F. Questionnaires 226  Suriname MICS4    Appendix F. Questionnaires   Appendix Suriname x F. Questionna e MICS4 2 aires  27 Ap 228 pendix F. Ques 8  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  29 Ap 230 pendix F. Ques 0  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  31 Ap 232 pendix F. Ques 2  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  33 Ap 234 pendix F. Ques 4  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  35 Ap 236 pendix F. Ques 6  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  37 Ap 238 pendix F. Ques 8  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  39 Ap 240 pendix F. Ques 0  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  41 Ap 242 pendix F. Ques 2  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  43 Ap 244 pendix F. Ques 4  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  45 Ap 246   pendix F. Ques 6  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  47 Ap 248 pendix F. Ques 8  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  49 Ap 250 pendix F. Ques 0  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  51 Ap 252 pendix F. Ques 2  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  53 Ap 254 pendix F. Ques 4  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  55 Ap 256 pendix F. Ques 6  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  57 Ap 258 pendix F. Ques 8  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  59 Ap 260 pendix F. Ques 0  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  61 Ap 262 pendix F. Ques 2  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  63 Ap 264 pendix F. Ques 4  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  65 Ap 266 pendix F. Ques 6  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  67 Ap 268 pendix F. Ques 8  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  69 Ap 270 pendix F. Ques 0  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  71 Ap 272 pendix F. Ques 2  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  73 Ap 274 pendix F. Ques 4  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  75 Ap 276 pendix F. Ques 6  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  77 Ap 278 pendix F. Ques 8  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  79 Ap 280 pendix F. Ques 0  Surinam tionnaires me MICS4    Appendix Suriname x F. Questionna e MICS4 2 aires  81 Ap 282 pendix F. Ques 2  Surinam tionnaires me MICS4    Suriname Multiple Indicator Cluster Survey 2010 Surinam e 2010 M ultiple Indicator C luster Survey Monitoring the situation of children and women Multiple Indicator Cluster Survey 2010 United Nations Children’s Fund Government of Suriname Suriname << /ASCII85EncodePages false /AllowTransparency false /AutoPositionEPSFiles true /AutoRotatePages /None /Binding /Left /CalGrayProfile (Dot Gain 20%) /CalRGBProfile (sRGB IEC61966-2.1) /CalCMYKProfile (U.S. Web Coated \050SWOP\051 v2) /sRGBProfile (sRGB IEC61966-2.1) /CannotEmbedFontPolicy /Error /CompatibilityLevel 1.4 /CompressObjects /Tags /CompressPages true /ConvertImagesToIndexed true /PassThroughJPEGImages true /CreateJobTicket false /DefaultRenderingIntent /Default /DetectBlends true /DetectCurves 0.0000 /ColorConversionStrategy /CMYK /DoThumbnails false /EmbedAllFonts true /EmbedOpenType false /ParseICCProfilesInComments 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