Thailand Multiple Indicator Cluster Survey December 2005-February 2006: Final Report

Publication date: 2006

Monitoring the Situation of Children and Women Thailand Multiple Indicator Cluster Survey December 2005 – February 2006 FINAL REPORT National Statistical Office Ministry of Information and Communication Technology Photo by : © UNICEF-Thailand/2006/Mohan THAILAND Multiple Indicator Cluster Survey December 2005 – February 2006 Thailand National Statistical Office UNICEF United Nations Children’s Fund In collaboration with: Ministry of Social Development & Human Security Ministry of Education Ministry of Public Health Contributors to the report: Consultant Mr. Sue Lo-Utai Ms. Jirawan Boonperm Project Staff Ms. Porntip Sriwatcharin Ms. Srisamai Sapyaprapa Ms. Oranuch Hutajata Ms. Arpaporn Amonthum Ms. Pannee Pattanapradit Mr. Komin Nimnuan Mr. Apichart Thunyahan The Thailand Multiple Indicator Cluster Survey (MICS) was carried by the National Statistical Office in collaboration with the Ministry of Social Development & Human Security, the Ministry of Education and the Ministry of Public Health. Financial and technical support was provided by the United Nations Children’s Fund (UNICEF) and the United Nations Development Programme (UNDP). The United Nations Educational, Scientific and Cultural Organisation (UNESCO) provided technical support for the contents of the survey. The survey has been conducted as part of the third round of MICS surveys (MICS3), carried out around the world in more than 50 countries, in 2005-2006, following the first two rounds of MICS surveys that were conducted in 1995 and the year 2000. Survey tools are based on the models and standards developed by the global MICS project, designed to collect information on the situation of children and women in countries around the world. Additional information on the global MICS project may be obtained from www.childinfo.org. Suggested citation: Thailand National Statistical Office. 2006. Thailand Multiple Indicator Cluster Survey December 2005- February 2006, Final Report. Bangkok, Thailand: National Statistical Office. The Thailand Multiple Indicator Cluster Survey (MICS) December 2005 – February 2006 was developed, for the first time, to collect data on situations of all children in Thailand to be used as tools in monitoring and evaluation of child development in Thailand. As also indicated in the Thailand Millennium Development Goals Report (2004), the quality and availability of disaggregated data on the situation of children in Thailand was limited. Moreover, data were obtained from various sources using different methods of collection and definitions. Finally, the results from the Thailand MICS will provide reliable and up to date information on children in Thailand that can be studied and compared internationally. This project was implemented by the National Statistical Office (NSO) in cooperation with the Ministry of Social Development and Human Security, Ministry of Education and Minis- try of Public Health as well as other government agencies whom all contributed signifi- cantly to the implementation process. Members of the steering committee for the Thailand MICS included: Advisory Board and Technical committee The National Statistical Office would also like to thank UNICEF Thailand (Bastiaan van‘t Hoff, Prasert Tepanart, Chayanit Wangdee, Temika Satayawiboon, Sunee Leenothai (MICS consultant)) for funding the survey and for providing technical support to data collection and analysis of the survey’s results as well as for the publication of national and provincial reports. The Office would also like to thank the UNICEF Headquarters in New York for providing knowledge and advice in data processing and a model for report preparation. Moreover, the United Nations Development Programme (UNDP) provided additional fund- ing for the analysis and publication of the survey. In addition, the Office would like to thank UNESCO and other United Nations agencies for providing technical advice in the MICS indicators that fit well within the Thai context. It is expected that this situation survey will pave ways for periodically and continuously monitoring and assessing the situation of chil- dren living in Thailand. National Statistical Office Ministry of Information Technology and Communications Acknowledgements ����������� �� �-����������������� TABLE OF CONTENTS Acknowledgements Table of Contents . i List of Tables . iii List of Figures . v List of Abbreviations . vi Summary Table of Findings . vii Executive Summary. xi 1. Introduction . 1 1.1 Background . 1 1.2 Mics in Thailand. 2 1.3 Survey Objectives . 3 2. Sample and Survey Methodology . 5 2.1 Sample Plan . 5 2.2 Sample Size . 5 2.3 Questionnaires . 6 2.4 Questionnaires Testing . 7 2.5 Data Collection and Processing . 8 2.5.1 Training For Field Staff . 8 2.5.2 Data Collection . 9 2.5.3 Data Processing . 9 2.6 Post-Enumeration Survey . 10 3. Sample Coverage and the Characteristics of Households and Respondents .11 3.1 Sample Coverage .11 3.2 Characteristics of Households .11 3.3 Characteristics of Respondents . 13 4. Results 4.1 Nutrition . 15 4.1.1 Nutritional Status . 15 4.1.2 Breastfeeding . 17 4.1.3 Salt Iodization . 21 4.1.4 Birth Weight . 22 4.2. Child Health . 24 4.2.1 Immunization Coverage . 24 4.2.2 Tetanus Immunization . 26 4.2.3 Oral Rehydration Treatment . 27 4.2.4 Care Seeking and Antibiotic Treatment of Pneumonia . 29 4.2.5 Solid Fuel Use . 31 �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 4.3 Environment . 32 4.3.1 Drinking Water . 32 4.3.2 Disposal of Excreta. 34 4.3.3 Disposal of Children’s Faeces . 35 4.3.4 Living in Slum Housing . 36 4.4 Reproductive Health . 36 4.4.1 Contraception . 36 4.4.2 Antenatal Care . 37 4.4.3 Assistance at Birth . 38 4.5 Child Development . 39 4.6 Education . 41 4.6.1 Pre-School Attendance and School Readiness . 41 4.6.2 Primary and Secondary School Participation . 42 4.6.3 Adult Literacy . 45 4.7 Child Protection . 45 4.7.1 Early Marriage . 45 4.7.2 Child Disability . 46 4.8 HIV/AIDS Infection, Orphaned and Vulnerable Children . 47 4.8.1 Knowledge of HIV Transmission . 47 4.8.2 Test For HIV . 50 4.8.3 Orphans and Vulnerable Children . 51 4.8.4 Orphans and Vulnerable Children School Attendance . 52 List of References . 53 STATISTICAL TABLES . -1- to -62- Appendix A. Definition . (A1) Appendix B. Sample Design . (A7) Appendix C. Estimates of Sampling Errors . (A19) Appendix D. Data Quality Tables . (A29) Appendix E. MICS Indicators: Numerators and Denominators . (A43) Appendix F. Questionnaires . (A49) Appendix G. TABLES: Education of Children aged 6-11 Years and 12-17 Years . (A83) ������������ ����� ������������� �� ��� �� ��� � �� ���������� �� �������� LIST OF TABLES Table 1 Results of household and individual interviews . -1- Table 2 Household age distribution by sex . -2- Table 3 Household composition . -3- Table 4 Women’s background characteristics . -4- Table 5 Children’s background characteristics . -5- Table 6 Child malnourishment . -6- Table 7 Initial breastfeeding . -7- Table 8 Breastfeeding . -8- Table 9 Adequately fed infants . -9- Table 10 Iodized salt consumption (which salt was tested) . -10- Table 11 Iodized salt consumption (which salt was labtested) . -11- Table 12 Low birth weight infants . -12- Table 13 Vaccinations in first year of life . -13- Table 13 Vaccinations in first year of life (continued) . -14- Table 14 Vaccinations by background characteristics . -15- Table 14 Vaccinations by background characteristics (continued). -16- Table 15 Neonatal tetanus protection . -17- Table 16 Oral rehydration treatment . -18- Table 17 Home management of diarrhoea . -19- Table 18 Care seeking for suspected pneumonia . -20- Table 19 Antibiotic treatment of pneumonia. -21- Table 20 Knowledge of the two danger signs of pneumonia . -22- Table 21 Solid fuel use . -23- Table 22 Solid fuel use by type of stove or fire . -24- Table 23 Use of improved water sources . -25- Table 24 Household water treatment . -26- Table 25 Time to source of water . -27- Table 26 Person collecting water . -28- Table 27 Use of sanitary means of excreta disposal . -29- Table 28 Disposal of child’s faeces . -30- Table 29 Use of improved water sources and improved sanitation. -31- Table 30 Slum housing . -32- Table 31 Use of contraception . -33- Table 32 Antenatal care provider . -34- Table 33 Antenatal care . -35- Table 34 Assistance during delivery . -36- Table 35 Family support for learning . -37- Table 36 Learning materials . -38- Table 37 Children left alone or with other children . -39- Table 38 Early childhood education . -40- Table 39 Primary school entry . -41- �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 40 Primary school net attendance ratio . -42- Table 41 Secondary school net attendance ratio . -43- Table 42 Secondary school age children attending primary school . -44- Table 43 Children reaching grade 5 . -45- Table 44 Primary school completion and transition to secondary education . -46- Table 45 Education gender parity . -47- Table 46 Adult literacy . -48- Table 47 Early marriage and polygyny . -49- Table 48 Spousal age difference . -50- Table 49 Child disability . -51- Table 50 Knowledge of preventing HIV transmission. -52- Table 51 Identifying misconceptions about HIV/AIDS . -53- Table 52 Comprehensive knowledge of HIV/AIDS transmission. -54- Table 53 Knowledge of mother-to-child HIV transmission . -55- Table 54 Attitudes toward people living with HIV/AIDS . -56- Table 55 HIV testing and counselling coverage during antenatal care . -57- Table 56 Children’s living arrangements and orphanhood . -58- Table 57 Prevalence of orphanhood and vulnerability among children . -59- Table 58 School attendance of orphaned and vulnerable children . -60- Table 59 Support for children orphaned and vulnerable . -61- Table 60 Malnutrition among orphans and vulnerable children . -62- ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� LIST OF FIGURES Figure 1 Age and sex distribution of household population . 12 Figure 2 Percentage of children under-5 who are undernourished. 16 Figure 3 Percentage of mothers who started breastfeeding within one hour and within one day of birth . 18 Figure 4 Infant feeding patterns by age: Percent distribution of children aged under 3 years by feeding pattern by age group . 19 Figure 5 Percentage of households consuming adequately iodized salt . 21 Figure 6 Percentage of infants weighing less than 2,500 grams at birth . 23 Figure 7 Percentage of children aged 12-23 months who received the recommended vaccination by 12 months . 24 Figure 8 Percentage of women with a live birth in the last 12 months who are protected against neonatal tetanus . 25 Figure 9 Percentage of children aged 0-59 months with diarrhoea who received oral reahydration treatment . 27 Figure 10 Percentage of children aged 0-59 months with diarrhoea who received ORT or increased fluids, AND continued feeding . 27 Figure 11 Percentage distribution of household members by source of drinking water . 31 Figure 12 Percent of women who have comprehensive knowledge of HIV/AIDS transmission . 46 �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� AIDS Acquired Immune Deficiency Syndrome BCG Bacillis-Cereus-Geuerin (Tuberculosis) DPT Diphteria Pertussis Tetanus EPI Expanded Programme on Immunization HIV Human Immunodeficiency Virus IDD Iodine Deficiency Disorders ITN Insecticide Treated Net IUD Intrauterine Device LAM Lactational Amenorrhea Method MDG Millennium Development Goals NSO National Statistical Office MICS Multiple Indicator Cluster Survey MoH Ministry of Health NAR Net Attendance Rate ppm Parts Per Million SPSS Statistical Package for Social Sciences UNAIDS United Nations Programme on HIV/AIDS UNDP United Nations Development Programme UNFPA United Nations Population Fund UNGASS United Nations General Assembly Special Session on HIV/AIDS UNICEF United Nations Children’s Fund WFFC World Fit For Children WHO World Health Organization LIST OF ABBREVIATIONS ������������ ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Summary Table of Findings Multiple Indicator Cluster Surveys (MICS) and Millennium Development Goals (MDG) Indicators, Thailand, 2005-2006 Topic MICS MDG Indicator Value Whole Central Northern Northeas- Southern Indicator Indicator Kingdom Region Region tern Region Number Number (Incl.BKK) Region NUTRITION Nutritional 6 4 Underweight prevalence Percent 9.3 6.1 7.1 11.5 12.5 status 7 Stunting prevalence Percent 11.9 8.9 10.4 12.3 18.3 8 Wasting prevalence Percent 4.1 3.9 3.9 3.8 5.4 Breast- 45 Timely initiation of Percent 49.6 43.0 41.6 54.4 58.3 feeding breastfeeding 15 Exclusive breastfeeding rate Percent 5.4 2.4 10.9 6.0 5.2 16 Continued breastfeeding rate Percent 18.7 18.5 12.3 15.0 34.3 at 20-23 months 17 Timely complementary feeding Percent 42.6 25.6 50.0 46.2 59.9 rate 18 Frequency of complementary Percent 34.8 19.8 45.9 38.3 46.4 feeding 19 Adequately fed infants Percent 20.9 11.5 30.7 23.0 25.6 Salt 41 Iodized salt consumption Percent 47.2 59.7 53.7 22.6 60.3 iodization Low birth 9 Low birth weight infants Percent 9.2 8.9 9.1 9.5 9.3 weight 10 Infants weighed at birth Percent 98.7 99.5 98.0 98.4 98.5 CHILD HEALTH Immuni- 25 Tuberculosis immunization Percent 98.0 - - - - zation coverage 26 Polio immunization coverage Percent 91.5 - - - - 27 DPT immunization coverage Percent 91.4 - - - - 28 15 Measles immunization coverage Percent 91.4 - - - - 31 Fully immunized children Percent 83.3 - - - - 29 Hepatitis B immunization Percent 85.7 - - - - coverage Tetanus 32 Neonatal tetanus protection Percent 89.2 88.0 90.7 89.0 90.4 toxoid Care of 33 Use of oral rehydration therapy Percent 68.3 64.5 63.1 78.1 55.9 illness (ORT) 34 Home management of diarrhoea Percent 3.8 2.4 4.9 2.9 7.3 35 Received ORT or increased fluids, Percent 46.4 44.8 44.6 50.8 40.4 and continued feeding 23 Care seeking for suspected Percent 84.0 83.5 84.5 84.6 81.3 pneumonia 22 Antibiotic treatment of suspected Percent 64.8 70.1 54.7 69.3 58.1 pneumonia Solid fuel 24 29 Solid fuels Percent 36.9 9.1 51.5 66.6 9.0 use ���� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Topic MICS MDG Indicator Value Whole Central Northern Northeas- Southern Indicator Indicator Kingdom Region Region tern Region Number Number (Incl.BKK) Region ENVIRONMENT Water and 11 30 Use of improved drinking water Percent 94.0 98.1 95.0 94.4 81.5 Sanitation sources 13 Water treatment Percent 27.4 38.6 25.4 16.2 29.3 12 31 Use of improved sanitation Percent 99.2 99.8 99.6 99.5 96.6 facilities 14 Disposal of child’s faeces Percent 64.6 63.3 71.4 68.5 51.8 95 32 Slum household Percent 9.9 - - - - REPRODUCTIVE HEALTH Contracep- 21 19c Contraceptive prevalence Percent 71.5 69.5 75.7 75.8 59.9 tion 20 Antenatal care Percent 97.8 97.8 98.2 98.9 95.3 Maternal 44 Content of antenatal care Percent 98.8 98.5 98.7 99.2 98.7 and newborn 4 17 Skilled attendant at delivery Percent 97.3 99.4 94.6 98.6 92.8 health 5 Institutional deliveries Percent 96.7 99.3 94.1 97.9 92.0 CHILD DEVELOPMENT Child 46 Support for learning Percent 78.6 78.0 79.1 78.0 81.0 development 47 Father’s support for learning Percent 57.5 65.5 57.5 43.6 74.2 48 Support for learning: children’s Percent 42.6 52.0 40.0 37.4 39.0 books 49 Support for learning: Percent 68.3 68.8 68.6 68.9 65.8 non-children’s books 50 Support for learning: materials Percent 31.1 28.3 29.0 32.6 34.9 for play 51 Non-adult care Percent 13.2 9.9 15.2 15.9 11.4 EDUCATION Education 52 Pre-school attendance Percent 60.7 58.8 78.3 57.8 54.3 53 School readiness Percent 99.4 99.6 97.8 100.0 100.0 54 Net intake rate in primary Percent 69.6 63.5 61.0 75.8 75.1 education 55 6 Net primary school attendance Percent 97.9 97.8 97.5 98.3 97.5 rate 56 Net secondary school attendance Percent 79.8 76.2 82.4 84.5 71.5 rate 57 7 Children reaching grade five Percent 98.9 98.5 98.3 99.3 99.2 58 Transition rate to secondary Percent 97.2 97.3 98.2 97.6 94.9 school 59 7b Primary completion rate Percent 86.8 84.5 84.7 92.6 79.5 61 9 Gender parity index primary school Ratio 1.0 1.0 1.0 1.0 1.0 secondary school Ratio 1.1 1.1 1.0 1.1 1.3 Literacy 60 8 Adult literacy rate Percent 96.4 96.7 95.2 98.0 93.2 ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Topic MICS MDG Indicator Value Whole Central Northern Northeas- Southern Indicator Indicator Kingdom Region Region tern Region Number Number (Incl.BKK) Region CHILD PROTECTION Early 67 Marriage before age 15 Percent 2.3 1.8 3.0 2.5 2.8 marriage Marriage before age 18 Percent 19.7 14.5 23.5 23.8 20.5 and 68 Young women aged 15-19 Percent 14.6 17.3 15.0 13.2 12.3 polygyny currently married/in union 69 Spousal age difference age 15-19 years Percent 14.5 18.7 11.7 9.8 18.5 age 20-24 years Percent 13.0 13.4 14.6 13.1 10.1 Disability 101 Child disability Percent 12.3 11.9 7.5 13.1 16.1 HIV/AIDS, SEXUAL BEHAVIOUR, AND ORPHANED AND VULNERABLE CHILDREN HIV/AIDS 82 19b Comprehensive knowledge Percent 46.1 - - - - knowledge about HIV prevention among and attitudes young people 89 Knowledge of mother- to-child Percent 68.3 62.1 72.3 74.8 65.4 transmission of HIV 86 Attitude towards people with Percent 20.7 19.9 27.4 19.2 17.8 HIV/AIDS 90 Counselling coverage for the Percent 86.2 85.0 89.5 87.6 82.7 prevention of mother-to-child transmission of HIV 91 Testing coverage for the Percent 84.0 88.6 85.5 83.8 74.9 prevention of mother-to-child transmission of HIV Support to 75 Prevalence of orphans Percent 4.7 4.5 6.5 4.3 4.5 orphaned 78 Children’s living arrangements Percent 19.3 15.1 21.3 25.6 9.8 and 76 Prevalence of vulnerable Percent 2.7 2.6 3.1 2.9 2.3 vulnerable children children 77 20 School attendance of orphans Ratio 1.0 1.0 1.0 0.9 0.7 versus non-orphans 81 External support to children Percent 21.4 15.4 34.1 15.9 26.6 orphaned and made vulnerable Note : Please see Appendix E for MICS indicators : Numberators and Denominators ����������� �� �-����������������� From December 2005–February 2006, the National Statistical Office of Thailand surveyed 43,400 households across the country on a number of key indicators related to the well being of children and women. Data gathered under this Multiple Indicator Cluster Survey (MICS) was disaggregated under several categories, including region, gender, language and age group. NUTRITIONAL STATUS OF CHILDREN NUTRITIONAL STATUS The survey indicates that nearly one in 10 children (9.3 per cent) below the age of 5 is mod- erately underweight. These children live mainly in the South and Northeast regions of the country and come from very poor households. Of all the children surveyed, just 0.4 per cent is severely underweight, and most of these severely malnourished children are between 1- 2 years old. Nearly 12 per cent of children are too short for their age (stunted), while just over 4 per cent are too thin for their height (wasted). The problem of overweight was observed in 6.9 per cent of all children, while 10 per cent of children in the Central region, which includes Bangkok, were overweight. Overweight children are mainly found in rich and very rich households and in municipal areas. BREASTFEEDING Mother’s milk provides the best source of nutrients for infants and is all an infant needs for the first six months of life. However, the survey shows that only 7.6 per cent of infants are exclusively breastfed during the first three months of life. The exclusive breastfeeding rate declines even further, to 5.4 per cent, for infants aged 0-5 months. The lowest percentage of exclusive breastfeeding was found in the Central region, including Bangkok, and in house- holds where mothers had no education completed. Of infants aged 6-9 months, 42.6 per cent received breast milk together with complementary food (either solid or semi-solid food). Of infants aged 0-11 months, 20.9 per cent were found to be “adequately fed”, which refers to the minimum number of times they received breast milk together with complementary (solid/semi-solid) food recommended by physicians. The survey indicates that children in the North region were the most “adequately fed” compared to other regions. EXECUTIVE SUMMARY ��� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� SALT IODIZATION Iodine Deficiency Disorders (IDD) are the world’s leading cause of preventable mental re- tardation and impaired psychomotor development in young children. Iodine deficiency is most commonly and visibly associated with goitre. IDD, however, takes its greatest toll on children in terms of impaired mental growth and development, contributing in turn to poor school performance, reduced intellectual ability and impaired work performance. In order to determine whether Thai households consume an adequate amount of iodised salt, a sample of household salt was collected in each household surveyed and the salt was tested for iodine content in a laboratory. The results from the tests show that 45.1 per cent of house- holds consume salt that does not have any iodine. In the South and Central regions, includ- ing Bangkok, rates for consumption of adequately iodized salt are higher, at 60.3 and 59.7 per cent, respectively. The lowest figures were observed for the Northeast region (22.6 per cent). Municipal households consume higher proportions of adequately iodized salt than non-municipal households (62.0 per cent versus 39.9 per cent), while very rich households consume nearly three times more than the very poor (68.6 per cent versus 23.6 per cent). BIRTH WEIGHT The survey indicates that 9.2 per cent of all infants weigh less than 2,500 grams when born. The highest proportions of new born infants weighing less than 2,500 grams were found in the Northeast (9.5 per cent) and in the South (9.3 per cent). Infants from very poor house- holds accounted for the highest proportion (10.0 per cent) of infants with low birth weights. CHILD’S HEALTH IMMUNIZATION COVERAGE According to UNICEF and World Health Organization guidelines, a child should receive a BCG vaccination to protect against tuberculosis; three doses of DPT to protect against diph- theria, pertussis, and tetanus; three doses of polio vaccine; and a measles vaccination by the age of 12 months or before the first birthday. Information on immunization coverage was received from vaccination records or the reports of mothers/caretakers. The percentage of fully immunised children totals 83.3 per cent, while the percentage of children who receive all three vaccinations for polio and Hepatitis B before their first birthday is 93.6 per cent and 88.3 per cent, respectively. ������������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� ENVIRONMENT DRINKING WATER The survey indicates that 94.0 per cent of the population (97.6 per cent in municipal areas and 92.5 per cent in the non-municipal areas) has access to improved drinking water sources. Regarding drinking water sources, 36.9 per cent of the population depends upon rain wa- ter, 24.9 per cent on bottled water and 21.0 per cent on piped water connected into the dwelling. People living in the Central region, including Bangkok, have the highest access to improved drinking water sources (98.1 per cent), while people in the South have the lowest access (81.5 per cent). Water from unprotected wells is considered the least hygienic among all water sources, and 2.8 per cent of the population rely on this source for their drinking water. EXCRETA DISPOSAL Over 99 per cent of the population live in households with improved sanitation facilities. The most common improved sanitation facility is a flush/pour flush toilet with a connec- tion to a septic tank (90.9 per cent). The South region has the lowest rates of improved sanitation facilities (96.6 per cent). Safe disposal of the faeces of 0-2 year old children was found in 64.6 per cent of households. The most common safe disposal methods used include putting or rinsing solid wastes into flush/pour flush toilets or latrines (40.4 per cent) and having the child using the toilet (24.2 per cent). SLUM HOUSEHOLD The survey indicates that 9.9 per cent of the households are considered overcrowded and inappropriate for living. The numbers of very poor and poor families living in slum hous- ing were 21.5 per cent and 15.9 per cent, respectively. Most households living in slum hous- ing are among either non-Thai speaking households (24.1 per cent); or those whose family head has only a primary education (27.6 per cent). ��� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� REPRODUCTIVE HEALTH CONTRACEPTION Among women between 15-49 years of age and currently married or in a union, contracep- tive use is 71.5 per cent. Among non-Thai speaking women, 48 per cent report not using any form of contraception. With regard to the choice of contraceptive methods, 70.1 per cent of married/in union women use modern methods, which include contraceptive pills (30.9 per cent), female sterilization (24.5 per cent) and injections (10.4 per cent). Contracep- tive prevalence is highest in the North and Northeast, at about 75 per cent, and lowest in the South, at 56.8 per cent. EDUCATION PRE-SCHOOL EDUCATION The survey indicates that 60.7 per cent of children aged 36-59 months are attending early childhood education programmes. The highest proportions of children attending such programmes are found in the North (78.3 per cent) and the lowest in the South (54.3 per cent). Children 4-5 years of age participate in early childhood education programmes at a higher rate than children in the three-year-old age group (75.3 per cent and 48 per cent, respectively). The attendance rates for municipal and non-municipal children are 63.9 per cent and 59.4 per cent, respectively. PRIMARY AND SECONDARY SCHOOL EDUCATION Around 98 per cent of children between 7-12 years old (at the time of the survey) are attend- ing primary school. The percentage of secondary school age children (between 13-18 years) attending second- ary school is 79.8 per cent. Secondary school attendance rates are higher for girls than for boys (83.1 per cent versus 68.9 per cent). The secondary school attendance rates for the Northeast (84.5 per cent) and the North (82.4 per cent) are higher than those of other re- gions, while the South has the lowest attendance rate (71.5 per cent). The ratio of girls to boys attending secondary education or higher, also called the Gender Parity Index, is high in every region, particularly in the South, where attendance rates for girls and boys are 79.9 per cent and 63.6 per cent, respectively. The survey indicates that 96.4 per cent of women between 15-24 years are literate, but there are some disparities between regions. The proportion of literate women from the Central region, including Bangkok, is high at 98 per cent, while the literacy rates for women in the South trails all other regions at 93.2 per cent. ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� EARLY MARRIAGE The percentage of Thai women below 18 years who are married or in union is 19.7 per cent. If disaggregated by region, the Northeast and the North have the highest percentages of women married or in union, at 23.8 per cent and 23.5 per cent, respectively. The Central region, including Bangkok, has the lowest proportion (14.5 per cent). The majority of women married or in union before the age of 18 live in municipal areas have received a primary education or no education (59.6 per cent), and nearly 30 per cent of these women live in non-Thai speaking households. The percentage of women who were married or in union before 15 years of age is 2.3 per cent, with the highest percentages in the North (3.0 per cent) and in the South (2.8 per cent). CHILD DISABILITY The percentage of children aged 2-9 years with a disability reported by their mothers/care- takers is 12.3 per cent, with the highest proportions found in the South (16.1 per cent) and the Northeast (13.1 per cent). When segregated by types of disabilities, the data show that 7.1 per cent of these children exhibit delayed learning capacity in comparison to their peers; 3.3 per cent appear mentally retarded, dull or slow; and 0.9 per cent exhibit slow develop- ment in sitting, standing or walking. Some 5.4 per cent of children with learning difficulties do not speak or cannot be understood. In addition, the survey indicates that 11.5 per cent of all two-year-old children cannot name even one object. HIV/AIDS KNOWLEDGE OF HIV/AIDS TRANSMISSION The percentage of women aged 15-49 years who know the three main methods of prevent- ing HIV/AIDS transmission (being faithful to one partner, using condoms, and abstaining from sex) was 49 per cent. Women in the Central region and the South are less knowledge- able on how to prevent HIV/AIDS (42.7 per cent and 46.2 per cent, respectively) than women in the other regions. Nearly 95 per cent of women know at least one way of preventing HIV/AIDS. Nearly 47 per cent of women have comprehensive knowledge on how HIV/AIDS is trans- mitted. Women from the Northeast and the North show the highest proportions compared to other regions (50.2 per cent and 48.3 per cent). Women from non-municipal areas have better understanding on HIV/AIDS transmission than those from municipal areas. ��� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� In total, 93.3 per cent of women know that HIV can be transmitted from mother to child. The percentage of women who know that HIV can be transmitted during pregnancy and through breast milk are 87.6 per cent and 82.4 per cent, respectively, while 76.3 per cent know that the disease can be transmitted during delivery. Around 68.3 per cent of women can correctly identify three ways of HIV transmission. Women from the Northeast and the North have higher knowledge of HIV transmission (74.8 per cent and 72.3 per cent, respec- tively), while women from the Central region, including Bangkok, and the South have less knowledge (62.1 per cent and 65.4 per cent, respectively). ORPHANS AND VULNERABLE CHILDREN In Thailand, only 63 per cent of children between 0-17 years of age are living with both parents. The number of children not living with a biological parent accounts for 19.3 per cent (25.6 per cent in the Northeast and 21.3 per cent in the North). The numbers of children in the 5-9 and 0-4 age groups not living with a biological parent account for 21.3 per cent and 19.6 per cent, respectively. A total of 4.7 per cent of the children comes from households where one or both parents are no longer alive, and many of these children live in poor or very poor households. In total, 7.1 per cent of children aged between 0-17 years are considered orphans (4.7 per cent) or vulnerable (2.7). If disaggregated by region, the North has the highest proportion of orphans or vulnerable children (9.2 per cent). 1.1 Background This report is based on the Thailand Multiple Indicator Cluster Survey (MICS), which was conducted from December 2005 to February 2006 by the National Statistical Office (NSO). The survey provides valuable information on the situation of children and women in Thailand, and was based in large part on the need to monitor progress towards the goals and targets emanating from recent international agreements. These agreements include 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. In signing these 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 table below). A Commitment to Action: National and International Reporting Responsibilities The governments that signed the Millennium Declaration and the World Fit for Children Declaration and Plan of Action also committed themselves to monitoring progress towards the goals and objectives they contained: “We will monitor regularly at the national level and, where appropriate, at the regional level and assess progress towards the goals and targets of the present Plan of Action at the national, regional and global levels. Accordingly, we will strengthen our national statistical capacity to collect, analyse and disaggre- gate 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 sub national 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.” 1. BACKGROUND AND OBJECTIVES � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 1.2 MICS IN THAILAND Thailand is one of the countries that signed the Millennium Declaration, and the Plan of Action of A World Fit for Children. In signing these international agreements, the Thai government committed itself to improving conditions for all children in Thailand and to monitoring progress towards that end. The Thailand MICS was therefore developed and used as a tool to monitor progress towards set objectives and to provide standard information and data on children in Thailand that can be studied and compared internationally. Before the survey, as stated in the first report of the Millennium Development Goals (MDG), indicators on the situation of children in Thailand were incomplete, and data were obtained from various sources using different methods of collection and definitions. Therefore, the data could not be integrated. As a result, these indicators could not be used to assess and monitor the development of children effectively. In addition, Thailand lacked sub-level and otherwise disaggregated data, especially at the provincial level, which are needed for designing policies and measures to appropriately and directly address the situation of children. The Thailand MICS was carried out by the National Statistical Office (NSO) with support from UNICEF Thailand. Other Thai ministries supporting children’s overall development also took part in the survey. These included the Ministries of Social Development and Human Security, Education and Public Health. Data at both the national and the provincial (26 provinces) levels were collected. It is expected that this survey will create processes for regularly monitoring and assessing the situation of children in Thailand. The Thailand MICS emphasized monitoring the situation relating to indicators reflecting the goals of the Plan of Action of A World Fit for Children, the Millennium Development Goals (MDG) and other goals from commitments between international organizations and the committed countries. The findings from the survey will be a large and important source of data for monitoring outcomes towards achievement of the MDG-plus Goals for Thailand. ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 1.3 SURVEY OBJECTIVES The Thailand MICS primary objectives include: • providing up-to-date information for assessing the situation of children and women in Thailand; • furnishing data needed for monitoring progress toward goals established by the Millen- nium Development Goals (MDG), the goals of A World Fit for Children (WFFC) and other internationally agreed upon goals, as a basis for future action at national and pro- vincial level; and • contributing to the improvement of data and monitoring systems on the situation of children and women in Thailand and strengthening technical expertise for the design, implementation, and analysis of such systems. ����������� �� �-����������������� 2.1 SAMPLING PLAN The Thailand MICS was carried out by a sample survey method that used a stratified two- stage sampling plan. The primary sample units (PSU) consisted of blocks (in municipal areas) or villages (in non-municipal areas). The secondary sample units consisted of collective households systematically drawn from a household listing. The plan is designed to provide estimates of situation indicators for children and women at the national level, for municipal and non-municipal areas, and for four regions: Central (including Bangkok), North, Northeast and South. The household listing is obtained from “The Basic Household Information Survey” conducted every two years by the National Statistical Office (NSO). In the survey, members of each household located in the block/village samples are counted. Data on basic household information from the survey are to be used as the sample frame in various survey projects of the NSO. Data from the 2006 Basic Household Information Survey were used as the frame for household samples in the Thailand MICS. Thirty collective household samples per block/ village sample were selected in both municipal and non-municipal areas. Field staff then created a Listing of Household Samples by adding together all the names of household heads and the addresses. After a household listing was carried out within the selected 30 households in each block/village, a systematic sample of households was drawn. For national-level results, sample data were weighted in accordance with sampling plan. (See Appendix for details of the sampling plan and weighting of data.) A “block” is an operational boundary in a municipal area that is made up of approximately 100 to 200 households. Blocks are established on a map so that field staff know the exact area they are to cover in the survey. A “village” is an administrative unit, a community, in a non-municipal area governed by a village head (Phuyaiban) or a district head (Kamnan). 2.2 SAMPLE SIZE The MICS national-level report included 1,449 block/village samples. Thirty collective household samples per block/village samples were selected and a total of 43,470 household samples were obtained. For MICS provincial-level reports, 1,032 block/village samples were selected and 30,960 household samples were included. 2. SAMPLE AND SURVEY METHODOLOGY � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Number of Block/Village Sample and Household Samples by Regions Region National Level Report Provincial Level Report Block/village Household Block/village Household samples samples samples samples Bangkok 78 2,340 156 4,680 Central 492 14,760 156 4,680 (excl. Bangkok) North 309 9,270 216 6,480 North East 324 9,720 168 5,040 South 246 7,390 336 10,080 Total 1,449 43,470 1,032 30,960 2.3 QUESTIONNAIRES Three sets of questionnaires were used in the survey: 1) a household questionnaire which was used to collect information on all de jure household members, 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 of all children under 5 living in the household. Each questionnaire included different modules as follows: • The Household Questionnaire o Household Listing o Education o Support for Orphans and Vulnerable Children o Child Labour o Disability o Drinking Water and Disposal of Excreta o Household Characteristics o Salt Iodization ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� • The Questionnaire for Individual Women o Child Mortality o Tetanus Toxoid o Maternal and Newborn Health o Marriage and Union o Contraception o HIV/AIDS • The Questionnaire for Children Under the Age of 5 was administered to mothers or caretakers of children in this age group. In cases where the mother was not listed in the household roster, a primary caretaker for the child was identified and interviewed. o Birth Registration and Early Learning o Child Development o Breastfeeding o Care of Illness o Immunization o Anthropometry The three set of questionnaires were based on the English version of the MICS model questionnaire. The model questionnaires were translated into Thai by the NSO MICS co- ordinators in September 2005. In addition to the administration of questionnaires, fieldwork teams tested salt used for cooking in the households surveyed for presence of iodine, and measured the weight and height of children under 5 years of age. 2.4 QUESTIONNAIRE TESTING The Thai MICS questionnaires went through two pre-tests, first in Ratchaburi province and later in Ayutthaya province. Based on the results of the two pre-tests, modifications on wording and terminology in the Thai version were made to make them more suitable for the Thai population. The first pre-test in Ratchaburi province was held during October 10-12, 2005. The interview was conducted by the NSO MICS co-ordinators themselves to determine if the interviewee would understand the questions/wording used and to find out if there were any problems with particular modules. Results from the first pre-test were discussed among the NSO MICS co-ordinators, and the questionnaires were revised accordingly. � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� During the pre-test survey in Ratchaburi province, the NSO MICS co-ordinators obtained information on maternal and child health from the staff of Health Centre IV on topics such as birth registration for children born in hospitals, child vaccination, maternal tetanus prevention, contraception and antenatal care. The knowledge and information obtained from this process were used to improve the questionnaires and prepare field work manuals. The second pre-test in Ayutthaya province was carried out by field staff using the revised questionnaires under the observation of the NSO MICS co-ordinators. Before commencing the test survey, field staffwere provided with training on definitions and the survey’s objectives. Again, results from the pre-test, especially in relation to questions that interviewees did not understand or did not want to answer, were discussed among the NSO MICS co-ordinators and field staff. These related to questions that were considered either sensitive or difficult to answer due to the degree of detailed information required. In the case of child vaccination, respondents were asked what kind of vaccines the child had received, and when and how many times the child had received the vaccines. The discussion contributed positively to the interview process and the accuracy of the survey results. It took about 2-2.5 hours per household to finish all three questionnaires. After the second pre-test, a final revision was made to both the questionnaires and the field work manuals to be used in the Thailand MICS. 2.5 DATA COLLECTION AND PROCESSING 2.5.1 TRAINING FOR FIELD STAFF In November 2005, before data collection, a three-day training programme was provided to 145 field staff from the North and Northeast regions in Khon Kaen province, and in Krabi province for 160 field staff from the South and Central (including Bangkok) regions. The NSO MICS co-ordinators and representatives from UNICEF Thailand participated in both training sessions as observers. Instructors from the Ministry of Public Health provided information on antenatal care, attendance at birth, child vaccination, maternal tetanus vaccination and oral rehydration treatment for children with diarrhoea. The knowledge and information acquired through the training were useful for the interview process and the accuracy of the survey results. ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 2.5.2 DATA COLLECTION Administratively, Thailand is divided into 76 provinces, including Bangkok (Metropolis). In Bangkok, the field work was carried out under the responsibility of the Director of the Data Management Division of the Bangkok Metropolitan Administration (BMA), while Provincial Statistical Officers were responsible for the field work undertaken in the other 75 provinces. In each province, data were collected by three teams of four field staff, three interviewers and one supervisor. The supervisor provided advice on field work, helped in solving problems arising during the field work, and checked the completeness of data after the survey. The NSO MICS co-ordinators provided overall supervision, with continuous visits to the field. The fieldwork began in December 2005 and concluded in February 2006. Additional data collected from 26 targeted provinces during March–May 2006 and will be published in separate provincial reports. 2.5.3 DATA PROCESSING After the fieldwork, the team supervisor checked the data collected during the interview for completeness. Then the Provincial Statistical Officer in each province and the Director of the Data Management Division of the BMA randomly rechecked the data before sending all the questionnaires to the NSO for processing. Upon receiving the questionnaires from the 76 provinces, the collected data were entered on 30 microcomputers by data entry operators and data entry supervisors using CSPro software. In order to ensure quality control, editing and structural checks, all questionnaires were double entered for verification and internal consistency checks were performed, followed by secondary editing. The data entry and verification used CSPro programme applications that were developed under the global MICS project by UNICEF to be used as standard processing procedures worldwide. In Thailand, the standard CSPro programme was modified appropriately to the Thai version questionnaires. The modification was done by NSO staff that had been trained on data processing by MICS experts from UNICEF. Data entry and data verification for the national level report began in February 2006 and was completed in April 2006. For the provincial reports, the process was completed in June 2006. Data were analysed using the Statistical Package for Social Sciences (SPSS) software programme, Version 14, and the model syntax and tabulation plans developed by UNICEF for this purpose. �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 2.6 POST-ENUMERATION SURVEY The Thailand MICS covered a large number of samples from all 76 provinces in the country. It was expected that data deviation could possibly occur from the work of the field staff, or the interviewees. Therefore, the NSO operated a post enumeration survey (PES) in Bangkok and 22 provinces selected from all four regions to aid data users in their consideration of data quality. The PES consisted of 150 block/village samples, in both municipal and non- municipal areas. Collective household samples – 20 households per block/village for a total of 3,000 household samples – were selected from the listing of household samples of the MICS survey. Staff were sent in to repeat the survey in these areas. Matching of questionnaires from the actual survey and the repeated survey was carried out and data were analysed for deviation. ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 3.1 SAMPLE COVERAGE Of the 43,440 households selected for the sample, 42,302 were found to be occupied. Of these, 40,511 were successfully interviewed, yielding a response rate of 95.8 percent. (See details in Table 1). In the interviewed households, 37,187 eligible women (aged 15-49) were identified. Of these eligible women, 36,960 were successfully interviewed, yielding a response rate of 99.4 percent. In addition, 9,444 children under the age of 5 were listed as being eligible in the households. The mothers and/or caretakers of 9,409 of these children (99.6 per cent) were successfully interviewed. (See Table 1). Differentials in response rates by areas showed 94.9 percent of the households in municipal areas and 96.9 percent in non-municipal areas. Participant differentials in response rates were observed, with the highest in the North Region (98.8 percent), followed by the Northeast Region (98.1 percent), and the South and the Central regions’ same low response rate of 93 percent. 3.2 CHARACTERISTICS OF HOUSEHOLDS The age and sex distribution of the surveyed population is provided in Table 2. Based on the 40,511 sample households successfully interviewed, household members were listed and were estimated to a total population of 65,064,070 household members by statistical systematic methodology (See detail in appendix B). Of these, 31,951,196 were male and 33,112,873 were female. The child population (aged 0-14 years) was projected to be 14,847,917 children, accounting for 22.8 percent of the projected total population. The labour age population (aged 15-64 years) was projected at 45,634,287 members, or 70.1 percent of the total. The elderly population (65 years and older), was projected at 4,851,865 members, or 7.0 percent of the total. In addition, of the surveyed population, 27.9 percent were children aged 0-17 years, and 72.1 percent adults aged 18 years and over. 3. SAMPLE COVERAGE AND THE CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 3 provides basic background information on the households. The distribution of households by area of residence showed that 31.5 percent of the households (5,677,957 households) were located in municipal areas and 68.5 percent (12,353,113 households) were located in non-municipal areas. The Central Region, including Bangkok, had the highest percentage of households (35.4 percent), followed by 32.1 percent in the Northeast Region Most of the households (44.4 percent) had 2-3 members, and most had a male head of household (70.0 percent). Households having at least one child under the age of 5 accounted for 21.5 percent of all households, while 71.8 percent of households had at least one woman aged 15-49 years. Regarding language, Thai was spoken in 93.8 percent of the households, while other languages (including Yawee and hill tribe languages) were used in 6.2 percent of the households. Figure 1 Age and sex distribution of household population, Thailand, 2005-2006 ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 3.3 CHARACTERISTICS OF RESPONDENTS Table 4 provides background characteristics of female respondents 15-49 years of age. The table includes information on the distribution of women according to region, residential areas, age, marital status, motherhood status, education, wealth index quintiles and ethnicity. About 32.6 percent of the women were residing in municipal areas and 67.4 percent in non- municipal areas. With regard to marital status, 66.9 percent of the women were married/in union, and 64.4 percent had given birth(s). The education level of more than half of the women (52.4 percent) was secondary and beyond, with only 2.9 percent being non-educated. Table 5 shows some background characteristics of children under the age of 5, 50.9 percent of whom were male and 49.1 percent of whom were female. Of the children under 5 years of age, one in five (20 percent) was 12 months old and over. Mothers of about half of the under-5 children (51.9 percent) had a primary school level education. In addition, 89.3 percent of the children were born to Thai speaking households, and 10.7 percent to households speaking other languages. ����������� ��-������������������� 4.1 NUTRITION 4.1.1 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 maximum 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, while those who survive often experience recurring illnesses and faltering growth. Three-quarters of the children who die from causes related to malnutrition are 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 World Fit for Children goal is to reduce the prevalence of malnutrition among children under 5 years of age by at least one-third (between 2000 and 2010), with special attention to children under 2 years of age. A reduction in the prevalence of malnutrition will assist in the goal to reduce child mortality. In a well-nourished population, there is a standard distribution of height and weight for children under 5 years of age. Under-nourishment in a population can be gauged by comparing children to a reference distribution. The reference population used here is the WHO/CDC/NCHS reference, which is recommended for use by UNICEF and WHO. Each of the three nutritional status indicators can be expressed in standard deviation units (called “z-scores”) from the median of this reference population. Weight for age is a measure of both acute and chronic malnutrition. Children whose weight for age is more than two standard deviations below the median of the reference population are considered moderately or severely underweight, while those whose weight for age is more than three standard deviations below the median are classified as severely underweight. Height for age is a measure of linear growth. Children whose height for age is more than two standard deviations below the median of the reference population are considered short for their age and are classified as moderately or severely stunted. Those whose height for age is more than three standard deviations below the median are classified as severely stunted. Stunting is a reflection of chronic malnutrition as a result of failure to receive adequate nutrition over a long period and recurrent or chronic illness. Finally, children whose weight for height is more than two standard deviations below the median of the reference population are classified as moderately or severely wasted, while those who fall more than three standard deviations below the median are severely wasted. Wasting 4. RESULTS �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 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. Findings in this section were based on the results of these measurements. Table 6 shows the percentage of children classified into each of these three categories, based on the anthropometric measurements that were taken during fieldwork. In addition, a table showing the percentage of children who are overweight (having weight for height more than two standard deviations above the median of the reference population) has been included. The figures in Table 6 exclude children who were not weighed and measured (approximately 2.9 percent) and those whose measurements were outside a plausible range. In addition, a small number of children whose birth dates are not known are also excluded. Almost one in 10 children under 5 years of age (9.3 percent) in Thailand are moderately underweight, while only 0.4 percent are classified as severely underweight. About 11.9 percent of children are moderately stunted, or too short for their age, and 4.1 percent are moderately wasted, or too thin for their height. Only 0.6 percent of the children are severely wasted. Figure 2 Percentage of children aged 0-59 months who are undernourished, Thailand, 2005-2006 ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Children in the South region are more likely to be underweight and stunted than children in other regions. Of the children in the South region, 12.5 percent are moderately underweight, 18.3 percent moderately stunted and 4.1 percent moderately wasted. The proportion of children in the Central (including Bangkok) who are moderately underweight is 6.1 percent, while 8.9 percent are moderately stunted, which is lower than other regions. In addition, children with mothers having secondary or higher education are less likely to be underweight and moderately stunted (6.4 percent and 9.7 percent, respectively) than children of non-educated mothers (13.1 percent and 17.6 percent, respectively). Similarly, proportions of children living in wealthy households who are moderately underweight (4.1 percent) and moderately stunted (6.7 percent), are less than those living in very poor households (15.2 percent and 15.7percent, respectively). The age pattern shows that 18.2 percent of children aged 12–23 months are moderately stunted and 6.2 percent moderately wasted, which is higher than for other age groups. These characteristics could be due to the fact that children are usually not breastfed when they are 12-23 months. As a result, the chance of children having unclean food and drinking water and contaminated environment is higher than breastfed children. Insignificant gender differentials are found. In Thailand, 6.9 percent of the children are overweight. The largest proportion of overweight children is found in the Central Region (10.8 percent), followed by the South Region (8.3 percent), with the least in the Northeast Region (4.6 percent). Overweight children are found more in municipal (10.4 percent) than in non-municipal households (5.5 percent), and more among children below 6 months of age (8.5 percent). About 8.8 percent of overweight children have mothers with an education level of secondary school and higher; while 11.3 percent live in very rich households, compared to 3.0 percent of children in poor households. 4.1.2 BREASTFEEDING Breastfeeding for the first few years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. However, many mothers stop breastfeeding too soon, and they are often pressured to switch to infant formula, which can contribute to faltering growth and micronutrient malnutrition. Use of instant formula is unsafe if clean water is not readily available. The World Summit for Children goal states that children should be exclusively breastfed for 6 months and continued breastfeeding with safe, appropriate and adequate complementary feeding up to 2 years of age and beyond. �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� WHO/UNICEF have the following feeding recommendations: � Exclusive breastfeeding for first six months � Continued breastfeeding for two years or more � Safe, appropriate and adequate complementary foods beginning at 6 months � Frequency of complementary feeding: 2 times per day for 6-8 month olds; 3 times per day for 9-11 month olds It is also recommended that breastfeeding be initiated within one hour of birth. The indicators of recommended child feeding practices are as follows: � Exclusive breastfeeding rate (< 6 months and < 4 months) � Timely complementary feeding rate (6-9 months) � Continued breastfeeding rate (12-15 and 20-23 months) � Timely initiation of breastfeeding (within 1 hour of birth) � Frequency of complementary feeding (6-11 months) � Adequately fed infants (0-11 months) Table 7 provides the proportion of women who started breastfeeding their infants within one hour of birth, and the women who started breastfeeding their infants within one day of birth (which includes those who started within one hour). About half of the women (49.6 percent) started breastfeeding their baby within one hour of birth. The highest proportion is found among women in the South Region (58.3 percent), and the lowest among women in the North Region (41.6 percent). Differentials are clearly seen with respect to women’s residential area, women’s education and household socioeconomic status. The percentage breakdowns for starting breastfeeding within one hour of birth were: non-municipal women (51.7 percent) compared to municipal women (43.6 percent); women with no education (52.8 percent) compared to women with a secondary school level education or beyond (49.8 percent); and women of very poor households (53.8 percent) compared to women of very rich households (42.7 percent). The proportion of women who started breastfeeding within one day of birth (which includes those who started within one hour) is 84.8 percent. The highest proportion was among women in the South and the Northeast (about 89.0 percent). A higher proportion of non- municipal women (87.2 percent) started breastfeeding their infants within one day of birth compared to municipal women (78.2 percent). Insignificant differentials are found between infant’s age, mother’s education and household wealth in breastfeeding within one day of birth. ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 8 shows exclusive breastfeeding of infants during the first 6 months of life (separately for 0-3 months and 0-5 months), as well as complementary feeding of children aged 6-9 months and continued breastfeeding of children at 12-15 months and at 20-23 months of age. Exclusively breastfed refers to infants who received only breast milk and vitamins, mineral supplements or medicine. Approximately 7.6 percent of children aged 0-3 months are exclusively breastfed, and the proportion decreases to 5.4 percent for infants aged 0-5 months. At age 6-9 months, 42.6 percent of children are receiving breast milk and solid or semi-solid foods. By age 12-15 months, 31.6 percent of children are still being breastfed, and by age 20-23 months, 18.7 percent are still breastfed. Breastfeeding of infants/children is associated with background characteristics. Exclusive breastfeeding of infants during the first 0-3 months and 0-5 months of life is found the most in women of the North Region (14.5 percent and 10.9 percent, respectively). In the Central Region (including Bangkok), the proportion of exclusively breastfed infants is very low (3.7 percent for those 0-3 months old, and 2.4 percent for those 0-5 months old). Mothers with secondary education level and beyond exclusively breastfed their infants the most (8.5 percent for the 0-3 month old and 6.5 percent for the 0-5 month old infants). Figure 3 Percentage of mothers who started breastfeeding within one hour and within one day of birth, Thailand, 2005-2006 �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Gender differentials are observed in terms of breastfeeding of infants aged 20-23 months. Notably, among the four regions, infants in the South are breastfed until the age of 20-23 months the most (34.3 percent), and in the North (12.3 percent) the least. Most of the 20-23 month old breastfed infants have a mother with no education (34.6 percent) and live in non- Thai speaking households (42.9 percent). Figure 4 Infant feeding patterns by age: Percent distribution of children aged under 3 years by feeding pattern by age group,Thailand, 2005-2006 The adequacy of infant feeding in children under 12 months is provided in Table 9. Different criteria of adequate feeding are used depending on the age of the child: • Infants aged 0-5 months, exclusive breastfeeding is considered as adequate feeding. • Infants aged 6-8 months are considered to be adequately fed if they are receiving breast milk and complementary food at least two times per day. • Infants aged 9-11 months are considered to be adequately fed if they are receiving breast milk and eating complementary food at least three times a day. From Table 9, only 5.4 percent of infants aged 0-5 months are exclusively breastfed, a level considerably lower than recommended by WHO. At age 6-8 months, 39.4 percent of infants are adequately fed, and at age 9-11 months, 29.9 percent of infants are. As a result of these feeding patterns, only 34.8 percent of infants aged 6-11 months are being adequately fed, and the proportion is less among 0-11 month old infants at 20.9 percent. ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� The difference in adequate feeding is associated with children’s background characteristics. Children in the North Region are adequately fed the most (30.7 percent), while children in the Central Region (including Bangkok) are adequately fed the least (11.5 percent). A lower proportion of municipal children (13.5 percent) are adequately fed than non-municipal children (23.9 percent). Moreover, adequate feeding is negatively related to mother’s education and household wealth. Children with non-educated mothers (23.4 percent) are adequately fed more than those with educated mothers (21.9 percent primary level, and 19.9 percent secondary level and beyond). Similarly, children of poor households are more adequately fed than those of very rich households (25.1 percent and 14.4 percent, respectively). 4.1.3 SALT IODIZATION Iodine Deficiency Disorders (IDD) are the world’s leading cause of preventable mental retardation and impaired psychomotor development in young children. In its most extreme form, iodine deficiency causes cretinism. It also increases the risks of stillbirth and miscarriage in pregnant women. Iodine deficiency is most commonly and visibly associated with goitre. IDD takes its greatest toll in impaired mental growth and development, contributing in turn to poor school performance, reduced intellectual ability and impaired work performance. The international goal is to achieve sustainable elimination of iodine deficiency by 2005. The indicator is the percentage of households consuming adequately iodized salt (>15 parts per million). Iodine deficiency in food causes goitre (enlargement of the thyroid gland). Iodine deficiency during the antenatal period, in infants or childhood causes brain damage. Universal Salt Iodization (USI) is a low cost measure that can prevent Iodine Deficiency Disorders (IDD). In this survey, salt consumed in the surveyed households was tested for iodine by two methods. Method 1, using I-KIT, was done by fieldwork staff, and shows whether iodine is present. This method of testing does not determine how much iodine is present in the salt or whether the salt is adequately iodized. Method 2 was carried out in the laboratory to determine iodine content in the salt samples collected during the interviews. Adequately iodized salt must have at least 15 ppm (parts per million) of iodine. Table 10 presents the results of iodine test using the I-KIT (Method 1). As shown in the table, 9.9 percent of households did not have salt for consumption and 90.1 percent of households had salt. The household salt was tested at the time of the interview for the presence of iodine in the salt. The result of the iodine test shows that 32.6 percent of households having salt tested consumed salt with no iodine, while 57.6 percent had iodized salt. Use of iodized �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� salt in municipal households is not much higher than in non-municipal households (63.3 percent and 54.9 percent, respectively). The highest proportion of households using iodized salt is found in the South Region, and the lowest in the Northeast Region (35.4 percent). (See details in Table 10) A quantitative test for iodine content in salt by Method 2 was done in the laboratory. The test was conducted by the Institute of Nutrition, Mahidol University/INMU, using a special iodine checker machine. The results show that 45.1 percent of the households consumed salts that do not have any iodine; 7.7 percent use inadequately iodized salt (containing 5- 14.9 ppm of iodine) and 47.2 percent use adequately iodized salt (containing at least 15.0 ppm of iodine) for consumption. The proportions of household consumption of adequately iodized salt in all the regions are: 60.3 percent in the South, 59.7 percent in the Central Region (including Bangkok), 53.7 percent in the North, and only 22.6 percent in the Northeast. Municipal households use adequately iodized salt more than non-municipal households (62.0 percent and 39.9 percent, respectively); and very rich households more than the very poor (68.6 percent and 23.6 percent, respectively). Figure 5 Percentage of households consuming adequately iodized salt, Thailand, 2005-2006 4.1.4 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 systems 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 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. Because many infants are not weighed at birth, and those who are weighed may be a biased sample of all births, 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 2,500 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. Percentage of births weighing less than 2,500 grams is calculated from the total number of infants with birth weight less than 2,500 grams divided by the total number of infants weighed. In Thailand, 98.7 percent of infants were weighed at birth, and 9.2 percent had a birth weight less than 2,500 grams. The incidence of low birth weight is not significantly affected by region, residential area, mother’s education and household language, and varies slightly between very poor and very rich households (10.0 percent and 8.5 percent, respectively). (See details in Table 12) � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 4.2 CHILD HEALTH 4.2.1 IMMUNIZATION COVERAGE Millennium Development Goal (MDG) 4 is to reduce child mortality by two thirds between 1990 and 2015. Immunization plays a key role in the realization of 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. One goal of A World Fit for Children is to ensure full immunization of children under one year of age at 90 percent nationally, with at least 80 percent coverage in every province. According to UNICEF and WHO guidelines, a child should receive a BCG vaccination to protect against tuberculosis; three doses of DPT to protect against diphtheria, pertussis, and tetanus; three doses of polio vaccine; and a measles vaccination by the age of 12 months. In the survey, mothers or caretakers were asked to provide vaccination records for children under 5 years of age. Interviewers copied vaccination information from the records onto the MICS3 questionnaire. Table 4 shows that 88.4 percent of children had health records. If the child did not have any record, the interviewer would read brief information about each vaccination to the mother or caretaker, who was then asked to recall whether or not the child had received any of the vaccinations and, for DPT and Polio, how many times. Figure 6 Percentage of infants weighing less than 2,500 grams at birth,Thailand, 2005-2006 � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 13 shows the percentage of children aged 12-23 months who received each of the vaccinations divided into two panels. In the top panel, the numerator includes all children who were vaccinated at any time before the survey according to the vaccination records or the mother or caretaker’s report. In the bottom panel, only those who were vaccinated before their first birthday are included. For children without vaccination records, the proportion of vaccinations given before the first birthday is assumed to be the same as for children with vaccination records. Approximately, 98 percent of children aged 12-23 months received a BCG vaccination before their first birthday. The percentage of children receiving the first dose of DPT before their first birthday is 97.1 percent. The percentage for subsequent doses of DPT declines slightly to 95.6 percent and 91.4 percent for the second dose and third dose, respectively. Similarly, the percentage of children receiving the first dose of polio vaccination is higher than for the second and third doses (97.6 percent, 95.9 percent and 91.5 percent, respectively). For measles vaccination, 91.4 percent of the children received the vaccine before their first birthday. Of children aged 12-23 months, 83.3 percent received all eight recommended vaccinations by their first birthday. (See details in Table 13). Figure 7 Percentage of children aged 12-23 months who received the recommended vaccinations by 12 months, Thailand, 2005-2006 Similar to DPT and polio vaccinations, the percentage of children receiving the first dose is higher than the second, and the second higher than the third (88.3 percent, 87.6 percent and 85.7 percent, respectively). �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� For vaccination of children before their second birthday, about 89.7 percent of children aged 12-23 months had received all eight recommended vaccinations at any time before the survey and only 1.3 percent had received none. For individual vaccines, 98.1 percent of children aged 12-23 months had received BCG, 93.5 percent DPT, 93.6 percent polio, and 96.1 percent measles. With respect to the background characteristics of vaccinated children, children in the North Region have the highest coverage of all the recommended vaccinations (95.4 percent), followed by children in the Northeast (94.0 percent); the lowest proportion (83.9 percent) was found among children in the Central Region (including Bangkok). There is little variation by sex, residential area, mother’s education and household wealth. (See details in Table 14) 4.2.2 TETANUS IMMUNIZATION 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 one case of neonatal tetanus per 1,000 live births in every province. The relevant World Fit for Children goal is to eliminate maternal and neonatal tetanus by 2005. Tetanus vaccination of pregnant women is aimed at preventing neonatal tetanus, one of the major causes of infant death. All pregnant women should receive at least two doses of the vaccine during pregnancy for complete protection against maternal and neonatal tetanus. However, women (and their newborns) are also considered to be protected if the following conditions are met: • Received at least two doses of tetanus toxoid vaccine, the last within the prior three years; • Received at least three doses, the last within the prior five years; • Received at least four doses, the last within 10 years; • Received at least five doses during lifetime. Table 15 shows the percentage of mothers with a live birth in the last 12 months before the interview. In Thailand, 89.2 percent of the women received vaccine against tetanus during pregnancy, which 80.8 percent received at least two doses during their last pregnancy. The proportion of women receiving at least two doses of tetanus toxoid vaccine, the last within the prior three years and receiving at least three doses, the last within the prior five years were 7.7 percent and 0.7 percent, respectively. The percentage of vaccination against tetanus for women is not much different between all groups of background characteristics. ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 4.2.3 ORAL REHYDRATION TREATMENT Diarrhoea is the second leading cause of death among children under the age of 5 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. International goals regarding diarrhoea in children are to: 1) by 2010, reduce by one-half the deaths due to diarrhoea among children under the age of 5 as compared to 2000 (A World Fit for Children); and 2) by 2025, reduce by two-thirds the mortality rate among children under five as compared to 1990 (Millennium Development Goals). In addition, A World Fit for Children calls for a reduction in the incidence of diarrhoea by 25 percent. The indicators for reaching these goals are: • Prevalence of diarrhoea • Oral rehydration therapy (ORT) • Home management of diarrhoea • ORT or increased fluids AND continued feeding Figure 8 Percentage of women with a live birth in the last 12 months who are protected against neonatal tetanus, Thailand, 2005-2006 �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� In the MICS questionnaire, mothers (or caretakers) were asked to report whether their child had diarrhoea in the two weeks prior to the survey. If so, the mother was asked a series of questions about what the child had to drink and eat during the period and whether this was more or less than the child usually ate and drank. Table 16 shows that in the two weeks preceding the survey, 8.7 percent of children aged 0-59 months had diarrhoea, and that most were in the 12-23 month old and 0-11 month age groups (15.0 percent and 10.7 percent, respectively). Of those children with diarrhoea, 68.3 percent received ORT with oral rehydration solution (ORS). Table 16 also shows the percentage of children receiving various types of recommended liquids during the period of diarrhoea. Since mothers were able to name more than one type of liquid, the percentages do not necessarily add to 100. About 43 percent of children received fluids from ORS packets; 24.3 percent received pre-packaged ORS fluids; and 22.5 percent received recommended homemade fluids. The use rate of ORS or other fluids is associated with the child’s sex, region and the socioeconomic status of the child’s household. The rate for boys (71.0 percent) was slightly higher than that for girls (65.0 percent). The rate was also higher for children in the Northeast Region (78.1 percent) and lowest in the South (55.9 percent). Children of very rich households (75.4 percent) received ORS or other fluids more than those of poor households (67.8 percent). Notably, almost one in three children with diarrhoea (31.7 percent) received no treatment, with the highest level of non-treatment among children in the South (44.1 percent). Figure 9 Percentage of children aged 0-59 months with diarrhoea who received oral rehydration treatment, Thailand, 2005-2006 ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 17 shows that 46.4 percent of children aged 0-59 months with diarrhea received ORT or increased fluids and continued feeding. There are differences in the home management of diarrhoea by background characteristics. In the South, 7.3 percent of children received ORT or increased fluids and continued feeding; 5.0 percent of children with mother a having education of secondary level or higher; and 7.8 percent children belonged to non-Thai speaking households. Figure 10 Percentage of children aged 0-59 months with diarrhoea who received ORT or increased fluids, and continued feeding, Thailand, 2005-2006 4.2.4 CARE SEEKING AND ANTIBIOTIC TREATMENT OF CHILDREN WITH SUSPECTED PNEUMONIA, Pneumonia is the leading cause of death in children, and the use of antibiotics in children under the age of 5 with suspected pneumonia is a key intervention. The relevant World Fit for Children goal is to reduce by one-third deaths due to acute respiratory infections. Children with suspected pneumonia are those who have an illness with a cough accompanied by rapid or difficult breathing and whose symptoms are 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 18 shows that 4.5 percent of children aged 0-59 months were reported to have had acute respiratory infection during the two weeks preceding the survey, with the highest proportion among children in the North (6.5 percent). Of these children, 6.2 percent were children 12-23 months of age; 6.6 percent were from very poor households; 84 percent were taken to an appropriate health care provider; and more were municipal children (85.0 percent) than non-municipal children (79.9 percent). Children with suspected pneumonia were taken mostly to government hospitals (36.3 percent) and government health centres (26.2 percent). Only 23.3 percent were taken to a private hospital/clinic. About 1 percent of children with suspected pneumonia were treated with drugs purchased from a pharmacy or drugstore. Table 19 shows the percentage of children aged 0-59 months with suspected pneumonia who received antibiotic treatment by sex, region, residence, age and socioeconomic factors. In Thailand, 64.8 percent of children with suspected pneumonia received an antibiotic treatment during the two weeks prior to the survey. The percentage was slightly higher in municipal areas (68.1 percent) than in the non-municipal areas (64.0 percent). In comparison to other regions, children in the North comprised the lowest percentage of children receiving antibiotics (54.7 percent), while children in the Central Region (including Bangkok) had the highest percentage (70.1 percent), followed by children in the Northeast (69.3 percent). In addition, children aged 24-35 months (70.9 percent) were treated with antibiotics more than any other age groups. Children of rich households received more antibiotic treatment than those of poor households (84.8 percent and 49.2 percent, respectively). Issues related to knowledge of the danger signs of pneumonia are presented in Table 20. Obviously, mothers’ knowledge of the danger signs is an important determinant of care- seeking behaviour. In this survey, mothers/caretakers were asked about their knowledge of the danger signs that prompted care seeking for their children in their real life experience. The most commonly identified symptom for taking a child to a health facility was when the child develops a fever (87.7 percent). Other identified signs for taking children immediately to a health care provider included when the child became sicker (36.7 percent), fast breathing (25.2 percent) and difficult breathing (24.8 percent). Overall, 15.1 percent of women knew of ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� the two danger signs of pneumonia – fast and difficult breathing. Approximately, 16-17 percent of these women were in the Central Region (including Bangkok), the Northeast and the South. The lowest percentage of women knowing the two danger signs of pneumonia was in the North (6.8 percent). (See details in Table 20) 4.2.5 SOLID FUEL USE More than three billion people around the world rely on solid fuels (biomass, charcoal and wood) for their basic energy needs, including cooking and heating. Cooking and heating with solid fuels lead to high levels of indoor smoke made up of a complex mix of health- damaging pollutants. The main problem with the use of solid fuels is that it increases the risks of acute respiratory illness, pneumonia, chronic obstructive lung disease, cancer, and possibly tuberculosis, low birth weight, cataracts and asthma. The primary indicator is the proportion of the population using solid fuels as the primary source of domestic energy for cooking. Solid fuel use alone is a poor proxy indicator for indoor air pollution, since the concentration of the pollutants is different when the same fuel is burnt in different stoves or fires. Table 21 shows that 36.9 percent of households in Thailand are using solid fuels for cooking. Use of solid fuels was very low in municipal areas (11.3 percent), but very high in non- municipal areas, where almost half of the households (47.2 percent) were using solid fuels. Differentials with respect to household wealth and the educational level of the household head were also significant. The table clearly shows that very poor households and households with a non-educated household head use solid fuels more than other groups. Poorest households use solid fuel for cooking the most (90.1 percent), especially compared to rich and very rich households (5.4 percent and 0.4 percent, respectively). Similarly, use of solid fuels was positively associated with the educational level of the household head. While more than half of the households with a non-educated head (52.5 percent) use solid fuels, only 12.5 percent of households with a household head that has an education of secondary level and beyond do so. In Thailand, the solid fuels used for cooking the most were charcoal (18.8 percent) and wood (18.0 percent), especially in the Northeast (32.6 percent and 33.9 percent, respectively) followed by the North (24.3 percent and 27.0 percent, respectively). Households in the South and the Central regions (including Bangkok) used solid fuels for cooking the least (only 9 percent). Most of the households in these two regions used LPG for cooking (84.5 percent in the Central Region, including Bangkok, and 86.2 percent in the South). �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Among the households that used solid fuels for cooking, 94.4 percent of the households used closed stoves and 4.3 percent used an open stove or fire with no chimney or hood. The latter were mostly used in the South Region (8.8 percent), with the lowest figure found in the Central Region (including Bangkok) at just 2.6 percent. In addition, the use of an open stove or fire with no chimney or hood was associated with the education level of the head of the household and household wealth. Households with non-educated heads and very poor households used open stoves or fires with no chimney or hood the most (6.1 percent and 4.9 percent, respectively). (See details in Table 22) 4.3 ENVIRONMENT 4.3.1 DRINKING WATER 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 that have harmful effects on human health. In addition, access to drinking water may be particularly important for women and children, particularly in rural areas, since they bear the primary responsibility for carrying water, often for very 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 goals of A World Fit for Children call for at least a one-third reduction in the proportion of households without access to hygienic sanitation facilities and affordable and safe drinking water. The lists of indicators used in MICS are as follows: Water � Use of improved drinking water sources � Use of adequate water treatment method � Time to source of drinking water � Person collecting drinking water Sanitation � Use of improved sanitation facilities � Sanitary disposal of child’s faeces The distribution of population by main sources of drinking water is shown in Table 23. The populations using improved drinking water sources are those who use any of the following ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� types of supply: piped into dwelling or yard/plot, public tap, tube-well, protected well, protected rainwater and bottled water. Bottled water is considered as an improved water source only if the household is using an improved water source for other purposes, such as hand washing and cooking. Figure 11 Percentage distribution of household members by source of drinking water, Thailand, 2005-2006 Overall, 94.0 percent of the population have access to improved drinking water sources, of which 97.6 percent are living in municipal areas and 92.5 percent in non-municipal areas. In the Central Region (including Bangkok), 98.1 percent of the population gets its drinking water from an improved source, whereas only 81.5 percent people in the Southern Region do so. The situation in the South is considerably worse than in other regions. The source of drinking water for the population varies strongly by region (Table 23). Bottled water use is highest in the Central Region (including Bangkok) at 36.5 percent, followed by the South (28.3 percent) and the North (26.9 percent). The second most important source of drinking water is piped water. In the Central Region (including Bangkok), the North and the South, 33.8 percent, 25.8 percent and 10.4 percent, respectively, use water that is piped into their dwelling or into their yard or plot. Notably, the population in the Northeast Region uses collected rainwater for drinking the most (66.3 percent); in the South, 11.6 percent of the population use water from unprotected wells for drinking, higher than in the other regions. Use of in-house water treatment is presented in Table 24. Households were asked about the ways they may be treating water at home to make it safer to drink. Boiling, adding bleach or � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� chlorine, using a water filter and using solar disinfection were considered proper treatments for drinking water. The table shows that 56.1 percent of the Thai population drink untreated water and 27.4 percent use appropriately treated water. Sources of water before treatment are from both improved and un-improved drinking water sources (33.0 percent and 14.8 percent, respectively). The population in the Central Region (including Bangkok) uses an appropriate water treatment method the most (38.6 percent), and the most used method is a water filter (27.4 percent). In contrast, the population in the Northeast uses an appropriate water treatment method the least (16.2 percent), The most popular methods used for water treatment in the Northeast are straining through a cloth (10.0 percent) and letting the water stand and settle (22.1 percent). Neither of these is considered appropriate. Use of appropriate in-house water treatment is associated with residential area and socioeconomic status. The percentage of the municipal population appropriately treating water is approximately double that of non-municipal areas (43.4 percent and 20.5 percent, respectively). The higher the wealth status of the households, the higher the percentage of the population using appropriate in-house water treatment: 15.3 percent in very poor households, 26.8 percent in medium wealth households, and 46.3 percent in very rich households. Table 25 shows that for 91.5 percent of households, the drinking water source is on the premise and no one has to collect water from elsewhere, while 8.1 percent of households had to go to outside water sources. For these households, the average amount of time to obtain water (one round trip from home to drinking water source) was about 10 minutes. The percentage of the population having to get to water sources is highest in the Northeast Region (11.5 percent), and for these households it took 14 minutes to obtain water. Table 26 shows that for the majority of households, an adult female (61.4 percent) is usually the person collecting the water when the source of drinking water is not on the premises. Adult men collecting water comprise of 32.0 percent of all cases. 4.3.2 DISPOSAL OF EXCRETA Inadequate disposal of human excreta and personal hygiene is associated with a range of diseases, including diarrhoeal diseases and polio. Improved sanitation facilities include: flush/ pour flush toilets connected to sewage systems, septic tanks or pit latrines; and pit latrines with slabs. � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 27 shows that 99.2 percent of the population living in households use improved sanitation facilities. Almost all of the population in municipal areas (99.7 percent) use improved sanitation facilities; however, a slightly lower percentage of improved sanitation facilities use is found in the non-municipal areas (99.0 percent). The population in the South Region are a bit less likely to use improved sanitation facilities (96.6 percent) than other regions (about 99 percent). Among those having improved sanitation facilities, the most common facility is a flush toilet with a connection to septic tank (90.9 percent). Unimproved sanitation facilities in- clude use of flush or pour flush to rivers or canals, pit latrines without slabs, or simply having no facilities at all (using bush and field). Unimproved sanitation facilities are mostly used in the South (3.3 percent) and in households with a non-educated head (3.5 percent), very poor households (2.1 percent) and non-Thai speaking households (6.2 percent). 4.3.3 DISPOSAL OF CHILDREN’S FAECES Safe disposal of a child’s faeces is defined as the disposal of the child’s last stool by having the child using the toilet, or the faeces being put or rinsed into a flush/pour flush toilet connected to piped sewer system or into a latrine and pit latrine with slabs. Safe disposal of the faeces of children 0-2 years of age was found in 64.6 percent of the children’s households, with the highest percentage in the North (71.4 percent) and the lowest in the South (51.8 percent). Safe disposal methods used are putting or rinsing faeces into flush/pour flush toilets or latrines (40.4 percent) and having the child use a toilet (24.2 percent). Children of households with a mother who has a secondary level education or above (18.9 percent) use a safe disposal method more often than children with non-educated mothers (65.4 percent compared to 51.9 percent). (See details in Table 28) Table 28 also shows unsafe disposal methods of children’s faeces. The unsafe disposal methods include putting faeces in the garbage (16.4 percent), burying it (9.1 percent) and leaving it in the open (7.2 percent). Regional differentials exist. The unsafe disposal method practiced most frequently in the Central Region (including Bangkok) is putting children’s faeces in the garbage (26.3 percent), while in the Northeast it is burying the faeces (15.9 percent). In the South, the unsafe methods practiced most are putting faeces in the garbage (20.0 percent) and leaving it in the open (14.6 percent). An overview of the percentage of households with improved sources of drinking water and sanitary means of excreta disposal is presented in Table 29. Overall, 94 percent of the population in Thailand has access to improved drinking water sources and 99.2 percent use �� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� improved sanitation facilities for excreta disposal. The percentage of the population having access to both improved drinking water sources and improved sanitation facilities was 93.6 percent. Of these, the highest proportion, 97.9 percent, are living in the Central Region (including Bangkok), while the lowest proportion, 79.8 percent, are in the Southern Region. A higher percentage is also found among households having a head of household with an education level of secondary and beyond (96.7 percent). Non-Thai speaking households show a lower percentage (64.9 percent). (See details in Table 29) 4.3.4 LIVING IN SLUM HOUSING The survey on living in slum housing was done only among populations living in municipal areas. There are three definitions for slum housing: 1) over-crowding, meaning more than three persons per sleeping room; 2) lack of improved water sources for use; and 3) lack of improved sanitation facilities for use. Table 30 shows that in Thailand, a total of 5,677,957 households in municipal area of these 9.9 percent live in slum conditions. Of these households, 7.7 percent are over-crowded; 2.3 percent lack improved water sources; and 0.2 percent lack improved sanitation facilities. Most of the households living in slum conditions are found among households with non- educated household heads or with just primary education (13.8 percent), very poor households (21.5 percent), and non-Thai speaking households (32.6 percent). 4.4 REPRODUCTIVE HEALTH 4.4.1 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. In this study, contraception means the use of any contraceptive methods by women aged 15-49 years currently married or in union, with and without marriage certification. Use of any method of contraception is reported by 71.5 percent of women, aged 15-49, currently married or in union (Table 31). With regard to contraceptive method of choice, 70.1 percent of married women in Thailand used a modern method, which include contraceptive pill (30.9 percent), female sterilization (24.5 percent) and injection (10.4 percent). ����������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Use of condom, IUD, and male sterilization are reported among about 1 percent by the women and 1.4 percent use any traditional method. The traditional methods used include periodic abstinence (0.6 percent), withdrawal (0.4 percent) and others (0.5 percent). Contraceptive prevalence is highest in the North and Northeast at about 75 percent, followed by 69.5 percent in the Central Region (including Bangkok) and the lowest in the South at 59.9 percent. About 74-78 percent of married or in union women aged 25-39 years currently use a method of contraception, compared to 66.4 percent of 15-19 year olds and 62.5 percent of 45-49 year olds. Additionally, the number of contraceptive users among women having 2 or 3 living children is 81 percent. Married women living in non-municipal areas currently use any contraceptive methods more than municipal women (72.9 percent compared to 67.9 percent). Women’s education level is strongly associated with contraceptive prevalence. The percentage of women using any method of contraception rises from 58.4 percent among those with no education to 74.1 percent among women with a primary education. Women from poor households (75.1 percent) use contraception at a higher rate than very rich women (68.7 percent). 4.4.2 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) Antenatal care (by a doctor, nurse, or midwife) coverage is relatively high in Thailand, with 97.8 percent of women aged 15-49 years who gave birth in the two years preceding the survey receiving antenatal care at least once during the pregnancy. The care was provided by a medical doctor (62.9 percent), a nurse/midwife (33.0 percent) and a traditional birth attendant /community health worker (1.0 percent). Only 1.2 percent of the pregnant women did not receive ANC during pregnancy. (See details in Table 32) About 95-98 percent of women aged 15-49 years in all regions received ANC provided by skilled personnel (doctor, nurse, or midwife) at least once during pregnancy. The highest level of antenatal care is found in women with a secondary education level or higher (98.5 percent), more than for women with no education (90.5 percent). No significant variables are found for other background characteristics. It is noted that women in the South received ANC from traditional birth attendant /community health worker at higher rate than in other regions. Almost all of the women aged 15-49 years (98.8 percent) had received ANC at least once during pregnancy. The types of services pregnant women received were blood chemistry, blood pressure measurement, urine testing, and weight measurement. (See details in Table 33) 4.4.3 ASSISTANCE AT BIRTH 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. 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 present and the 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. Skilled assistance at delivery is defined as assistance provided by a doctor, nurse, midwife or auxiliary nurse/midwife. Table 34 shows that 97.3 percent of births occurring in the preceding two years prior to the survey were delivered by skilled personnel. This percentage is highest in the Central Region (including Bangkok) at 99.4 percent, followed by the Northeast at 98.6 percent, and with the lowest rate in the South at 92.8 percent. In addition, women in the South received the highest levels of assistance at birth from a nurse/midwife (41.1 percent) and from a traditional birth attendant/community health worker (7.2 percent). Assistance at birth is significantly associated with women’s education and the socioeconomic status of the women’s households. The more educated a woman is, the more likely she is to have delivered with the assistance of a skilled attendant (81.1 percent among those with no education, 95.3 percent among women with primary education, and 99.3 percent among women with secondary or higher education). Women from very poor households received assistance from skilled attendants during delivery at 92.7 percent, compared to 99.8 percent of very rich women (99.8 percent). In regard to delivery facilities, 96.7 percent had their births in health facilities, both government and private. Prevalence of delivery facilities vary with women’s background characteristics, similar to assistance at delivery by skilled personnel. A remark should be made that the 63.6 percent of the interviewees who delivered by “medical doctor” could be an error because the Thai generally call any health personnel (such as public health worker, nurse, midwife and physician) “medical doctor”. 4.5 CHILD DEVELOPMENT It is well recognized that a period of rapid brain development occurs in the first 3-4 years of life, and the quality of home care is the major determinant of the child’s development during this period. In this context, adult activities with children, presence of books for the child in the home, and the conditions of care are important indicators of the quality of home care. A World Fit for Children goal is that “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 almost four in five (78.6 percent) children under the age of 5, an adult engaged in more than four activities that promote learning and school readiness during the three days preceding the survey (Table 35). The average number of activities that adults engaged in with children was four. The table also indicates that the father’s involvement in one or more activities was 57.5 percent. The average number of activities that the father engaged in with children was 2.2. The percentage of children aged 0-59 months living in a household without fathers was 33.9 percent. There is very little gender differential in terms of fathers engaged in activities with male children (58.9 percent) or female children (56.1 percent). Larger proportions of fathers engaged in learning and school readiness activities in municipal areas (65.6 percent) than in non-municipal areas (54.3 percent). Insignificant differentials of adult engagement in activities with children (approximately 78-81 percent) are observed by region. On the other hand, strong differentials of father involvement are recognized: the lowest in the Northeast (43.6 percent), increases to 57.5 percent in the North, and to 74.2 percent, the highest, in the South. The findings are negatively associated with the living arrangements of the children. The percentage of children living in a household without their fathers was highest in the Northeast at 47.3 percent, which decreased to 35.0 percent in the North and 16 percent in the South. Educated fathers (primary level and secondary and higher) engaged more in such activities with children than those with no education (77.4 percent, 81.0 percent and 84.8 percent, respectively). Exposure to children’s and non-children’s books in the early years not only provides the child with reading activities, but also gives the child opportunities to see older children, including siblings and cousins, reading in the household. Presence of books is important for later school performance and IQ scores. In Thailand, 68.3 percent of children are living in households where at least three non- children’s books are present (Table 36). However, 42.6 percent of children aged 0-59 months have children’s books. The median number of non-children’s books is much higher than that of children’s books (seven and two books, respectively). Municipal children appear to have more access to both types of books than those living in non-municipal households (72.6 percent and 66.6 percent, respectively). Age differentials exist in terms of children’s books. In the households of 51.7 percent of children aged 24-59 months, there are three or more children’s books, while the figure is 28.8 percent for children aged 0-23 months. ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 36 also shows that 31.1 percent of children aged 0-59 months had three or more playthings to play with in their homes, while 8.4 percent had none. In the MICS, four types of playthings were included: (1) household objects, such as plates, bowls, pots, spoons, etc.; (2) objects and materials found outside the home used as toys, such as sticks, stones, rocks, shells, leaves, etc.; (3) homemade toys, dolls, cars, etc.; and (4) toys that came from a store or given as a present. Children aged 0-59 months played with toys from store/present the most( 77.3 percent), while all other types of toys accounted for about 32-39 percent. The proportion of male and female children who have three or more playthings to play with is close: 30 percent among male children and 32.2 percent among female children. The proportion of children having three or more playthings to play with is less in municipal households than that in non-municipal homes (27.5 percent and 32.5 percent, respectively), and children aged 24-59 months have more than the 0-23 month old children (37.4 percent and 21.5 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. Table 37 shows that 11 percent of children aged 0-59 months were left in the care of other children, while 3 percent were left alone during the week preceding the interview. Combining the two care indicators, it is calculated that 13.2 percent of children were left with inadequate care during the week preceding the survey. Differences were observed by residential areas, sex of the child, socioeconomic status of households, and language used in the household. Inadequate care was more prevalent among children living in municipal households (14.5 percent) than those living in non-municipal areas (10.0 percent), and a higher proportion among children 24-59- months (15.7 percent) than with children 0-23 months (9.4 percent). Children living in very rich households had been left with inadequate care over twice as much as those of very poor households (18.2 percent and 7.2 percent, respectively). Moreover, children living in non-Thai speaking households (21.4 percent) were left under inadequate care more than those in Thai speaking households. 4.6 EDUCATION 4.6.1 PRE-SCHOOL ATTENDANCE AND SCHOOL READINESS Receiving a pre-school education in an organized learning or child education programme is important for preparing children to go to school. One of the A World Fit for Children goals is the promotion of early childhood education. � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 38 shows that over half of the children aged 36-59 months (60.7 percent) are currently attending some form of organized early childhood education programme - participating in early childhood centres or pre-school development programmes organized by private or public sectors, including kindergarten or community child care centres. Differences by residential areas and region are observed. The proportion of municipal children attending a pre-school programme is higher than that of non-municipal children (63.9 percent and 59.4 percent, respectively). Percentage of children in the North who are currently attending pre-school education (78.3 percent) is higher than that of children in other regions (approximately 54-58 percent). Of the children currently attending a pre-school education programme, 73.5 percent are 48- 59 month old children and 67.2 percent are children of mothers having secondary or higher education. Gender differentials are slightly observed. On the other hand, differences in regard to socioeconomic status of the households are found. Attendance of children from poor households is lower than from very rich household children (54.8 percent and 77.6 percent, respectively). In addition, 99.4 percent of children in the first grade of primary school attended pre-school the previous year (Table 38), an important indicator of school readiness. Differences in term of sex of the child, region and residential areas for pre-schooler in continuing to first grade education are minimal. 4.6.2 PRIMARY AND SECONDARY SCHOOL PARTICIPATION Universal access to basic education is one of the most important Millennium Development Goals. Education is a vital prerequisite for combating poverty, empowering women, protecting children from exploitative labour and sexual exploitation, promoting human rights and democracy, protecting the environment, and influencing population growth. The indicators for primary and secondary school attendance include: • Net intake rate in primary education • Net primary school attendance rate • Net secondary school attendance rate • Net primary school attendance rate of children of secondary school age • Female to male education ratio (GPI) ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� The indicators of school progression include: • Survival rate to grade five • Transition rate to secondary school • Net primary completion rate In Table 39, of children who are of primary school entry age (age 7) in Thailand, 69.6 percent are attending the first grade. Sex differentials are slightly observed at 70.7 percent for boys and 68.6 percent for girls. Significant differentials are present by region and residential areas. In the Northeast and South regions, the percentage of primary school age children attending Grade 1 (Prathom 1) is at about 75 percent, while it is just 63.5 percent in the Central Region (including Bangkok) and lowest, at 61.0 percent, in the North Region. Children’s participation in primary school is a little more timely in non-municipal areas (71.1 percent) than in municipal areas (65.6 percent). A positive correlation with mother’s education is observed. For children whose mothers have no education, 59.2 percent were attending the first grade, while the figure is about 70 percent among children whose mothers are educated. (See details in Table 39) PRIMARY SCHOOL LEVEL Table 40 provides the percentage of children of primary school age attending primary school. The majority of children of primary school age are attending school (97.9 percent). Differentials by residential areas are very insignificant (98.0 percent for municipal children and 97.8 percent for those living in non-municipal areas). Regional differentials are hardly observed, and children’s background characteristics have no impact on the percentage of children of primary school age attending school. In the MICS, children aged 7-12 years are classified as being primary school age children due to the following reasons: In Thailand, the school year starts in May. Data collection for the MICS was carried out from December 2005 to February 2006, which was the end of the 2005 school year. Pursuant to the Compulsory Education Act B.E. 2545, children who are going to be 7 years old must attend the first grade. Therefore, during the data collection period of the MICS, these children may reach 7 years of age. These children, however, would have been 6 years old when they started school in May 2005. As a result, the children identified as being 7 years old in this survey were actually 6 years old when the school year started. ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� SECONDARY SCHOOL LEVEL Table 41 shows that 79.8 percent of the children of secondary school age (age 13-18) are attending secondary school or higher. Girls attend at a higher level than boys (83.1 percent and 76.6 percent, respectively). Differences by region are observed. Children in the Northeast Region have the highest attendance rate at 84.5 percent, followed by those in the North (82.4 percent), with the lowest level in the South (71.5 percent). There is no difference in regard to residential areas, but positive correlation with mother’s education and socioeconomic status is observed. Of those boys and girls whose mothers have at least secondary school education, 93.7 percent were attending secondary school or higher, while the proportion dropped to 54.3 percent among children whose mothers have no education. In rich households, the proportion was around 88.5 percent, while 74.9 percent of children living in the poorest households were attending. The primary school net attendance ratio of children of secondary school age (age 13-18) is presented in Table 42. Only 2.3 percent of the children of secondary school age are attending primary school when they should be attending secondary school (boys at 2.6 percent and girls at 2.0 percent). The highest proportion is found among children in the South, at 3.9 percent, while the lowest is in the Northeast, at 1.5 percent. Of these children, 11.5 percent are 13 years old; 10.6 percent have mothers with no education; and 7.2 percent living in non-Thai speaking households. (See details in Table 42) The percentage of children entering first grade (Prathom 1) who eventually reach Grade 6 is presented in Table 43. Of all children starting Grade 1, almost all of them (99.8 percent) will eventually reach Grade 6. (Notice that this number includes children that repeat grades and that eventually move up to reach grade five.) Insignificant differences by region, residential area and background characteristics are observed with regard to children’s attendance. The net primary school completion rate and transition rate to secondary education is presented in Table 44. At the time of the survey, only 86.8 percent of the children of primary completion age were attending the last grade of primary education, while 97.2 percent of children who had completed the last grade of primary school were attending the first grade of secondary school. The lowest proportion was found in children living in the south (79.5 percent). Children whose mothers had no education having a lower rate than those having primary, or secondary or higher education (56.4 percent, 87.9 percent and 90.5 percent, respectively). No significant differences in transition rate to secondary education among children with different mother tongues were found. ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 45 shows the ratio of girls to boys attending primary and secondary education or higher. 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. Gross ratios provide an erroneous description of the GPI, mainly because in most of the cases the majority of over-age children attending primary education tend to be boys. The table shows that gender parity for primary school is 1.00 and 1.1 for secondary education. These figures indicate that there is no difference in the attendance of girls and boys in primary and secondary school. 4.6.3 ADULT LITERACY One of the A 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 aged 15-24 years. Literacy was assessed on the ability of women who had never attended school or had only a primary school level of education to read a short simple statement. From the Table 46, 96.4 percent of women aged 15-24 years in Thailand are literate. Little difference is seen by region, residential area, and women’s age. However, differences are found in terms of socio-economic status. The proportion of women from very wealthy households who are literate is higher than that of women from very poor households (97.9 percent and 92.8 percent, respectively). A lower percentage of literacy is shown among women from non-Thai speaking households (at 82.3 percent) as compared to Thai speaking households (at 97.7 percent). 4.7 CHILD PROTECTION 4.7.1 EARLY MARRIAGE According to UNICEF’s worldwide estimates, over 60 million women aged 20-24 were married/in union before the age of 18. Factors that influence child marriage rates include: the state of the country’s civil registration system, which provides proof of age for children; the existence of an adequate legislative framework with an accompanying enforcement mechanism to address cases of child marriage; and the existence of customary or religious laws that condone the practice. 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. These are factors that reinforce the gendered nature of poverty. Women � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� married at younger ages are more likely to dropout of school, experience higher levels of fertility, domestic violence and maternal mortality. The percentage of Thai women aged 15-19 years who were married or in union is 14.6 percent. Differences by region, women’s education and socioeconomic status of the household are observed. Of these women, the most, 14.6 percent, are in the Central Region (including Bangkok), followed by the North (15.0 percent) and the lowest in the South (12.3 percent). Almost half of the women (47.5 percent) have a primary education. Most of these 15-19 year old women live in very poor households (17.5 percent), compared to 6.9 percent living in very rich households. The percentage of women aged 15-19 years who were married or in union before 15 years of age is 2.3 percent, rising to 3.0 percent in the North Region, which is the highest. Of these women, 8.1 percent have no education and 2.7 percent live in non-municipal areas. Women who were married/in union before 18 years of age account for 19.7 percent. Almost one in four (23 percent) of these women are living in the North and the Northeast and more in the non-municipal areas (22.7 percent) than in the municipal areas (13.6 percent). Women with low levels of education tend to get married before reaching 18 years. The rate for women with only a primary education is 32.5 percent and this falls to 27.1 percent for women with a secondary education and 10.6 percent for women with higher education. Similarly, higher levels of very poor women got married before the age of 18 years (28.1 percent), compared to 18.0 percent among rich women and 9.1 percent among the very rich. (See details in Table 47) Table 48 shows spousal age differences. From the table, 97.8 percent of 15-19 year old married/in union women have an older husband or partner. Half of these women (50.2 percent) have a husband/partner who is 0-4 years older, 33.1 percent have a husband/ partner who is 5-9 years older and 14.5 percent have a husband/partner who is 10 or more years older. Only 1.6 percent of married/in union women have a younger husband/partner. Similarly, among married/in union women aged 20-24 years, 48.7 percent have a husband partner who is 0-4 year older, 29.9 percent have a husband/partner who is 5-9 years older and 7.8 percent have younger husband/partner. 4.7.2 CHILD DISABILITY One of the A World Fit for Children goals is to protect children against abuse, exploitation, and violence, including the elimination of discrimination against children with disabilities. For children between 2-9 years of age, a series of questions were asked to assess a number of ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� disabilities/impairments, such as sight impairment, deafness and difficulties with speech. This approach rests in the concept of functional disability developed by WHO and aims to identify the implications of any impairment or disability for the development of the child (such as health, nutrition and education). Table 49 presents the percentage of children aged 2-9 years with a disability reported by their mother/caretaker. Of these children, 12.3 percent are reported to have at least one disability, with the highest proportion (16.1 percent) living in the South and the lowest in the North (7.5 percent). Differences by mother’s education and socioeconomic status of households are present. About 15 percent of children aged 2-9 years that reported having at least one disability have mothers with no education and about 14 percent live in poor households. In addition, 11.5 percent of 2-year-old children cannot name at least one object, with the highest percentage (13.7 percent) found in the Central Region (including Bangkok), the lowest in the North (9.8 percent). Figures for children living in municipal areas (14.1 percent) are higher than those for non-municipal children (10.5 percent). In addition, the percentage of 3-9 year old children whose speech is not normal is 2.9 percent. The highest proportion of these children is found in the North (3.8 percent), very poor households (3.8 percent) and among those having mothers with no education (4.1 percent). 4.8 HIV/AIDS INFECTION, ORPHANED AND VULNERABLE CHILDREN 4.8.1 KNOWLEDGE OF HIV/AIDS TRANSMISSION One of the most important prerequisites for reducing the rate of HIV infection is accurate knowledge of how HIV is transmitted and strategies for preventing transmission. Correct information is the first step toward raising awareness and giving young people the tools to protect themselves from infection. Misconceptions about HIV 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 that mosquito bites can transmit HIV). The UN General Assembly Special Session on HIV/AIDS (UNGASS) called on governments to improve the knowledge and skills of young people to protect themselves from HIV. The indicators to measure this goal, as well as the MDG of reducing HIV infections by half, include improving the level of knowledge of HIV and its prevention and changing behaviours to prevent further spread of the disease. The HIV module was administered to women 15- 49 years of age. � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� One indicator, which is both an MDG and UNGASS indicator, is the percentage of young women who have comprehensive and correct knowledge of HIV prevention and transmission. Women were asked whether they knew of the three main ways of HIV transmission – having only one faithful uninfected partner, using a condom every time you have sex, and abstaining from sex. The results are presented in Table 50. Table 50 shows that 98.3 percent of women aged 15-49 years in Thailand have heard of AIDS. However, the percentage of women who know all three main ways of preventing HIV transmission is only 49 percent. When asked, 85.5 percent of the women know that transmission of HIV/AIDS could be prevented by using condoms every time they have sex; 80.1 percent of the women know that having only one faithful uninfected sex partner could prevent transmission of HIV/AIDS; and 60.3 percent believe that abstaining from sex could prevent HIV/AIDS transmission. Overall, 94.7 percent of these women know at least one prevention method for HIV/AIDS, and only 5.3 percent do not know any method. Among those who do not know any method, 29.9 percent are women with no education and 12.6 percent live in non-Thai speaking households. The highest prevalence of not knowing any method of prevention is among women in the South (6.6 percent) and the least is in the Northeast (3.8 percent). Table 51 presents the percentage of women aged 15-49 years who correctly identify misconceptions about HIV/AIDS transmission. Of these, 93.1 percent know that HIV cannot be transmitted by supernatural means; 71.6 percent know that HIV is not caused by mosquito bites; and 77.9 percent know that a healthy-looking person can be infected by HIV. Overall, 62.2 percent of the women reject the two most common misconceptions of HIV transmission and also know that a healthy-looking person could be infected. Level of education is positively associated with knowledge on misconceptions of HIV transmission. Differences by women’s education and socioeconomic status of the households are evident. Women with no education (34.7 percent) are less knowledgeable than women with primary education (59.2 percent) and secondary or higher education (66.3 percent); as are very poor women (57.6 percent) compared to rich women (65.7 percent). Women in the South had the lowest percentage to correctly identify the three misconceptions about HIV transmission (56.2 percent). Table 51 also shows that 78.3 percent of women aged 15-49 years know that HIV cannot be transmitted by sharing food with AIDS patients, and 95.6 percent know that HIV can be transmitted by sharing needles. The correctly identified knowledge is positively related to women’s education. The percentage of women with no education who know that HIV cannot ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� be transmitted by sharing food with AIDS patients is at 49.6 percent, and this rises to 76.2 percent among women with primary education and to 81.8 percent for secondary education or higher. In summary (Table 52), 72.1 percent of the women know two ways of preventing HIV transmission and 62.2 percent know all three misconceptions about HIV transmission. Only 46.6 percent of the women have comprehensive knowledge of HIV/AIDS transmission, which includes knowing two ways of preventing HIV transmission and rejecting three misconceptions. This comprehensive knowledge of HIV/AIDS transmission is positively correlated with women’s education. The percentage of women with no education having comprehensive knowledge of HIV/AIDS transmission (23.1 percent) is lower than that of women with primary education (46.5 percent) and among women with secondary or higher education (48.1 percent). Figure 12 Percent of women who have comprehensive knowledge of HIV/AIDS transmission, Thailand, 2005-2006 Knowledge of mother-to-child transmission of HIV is also an important first step for women to seek HIV testing when they are pregnant in order to avoid infection in the baby. Women should know that HIV can be transmitted during pregnancy, during delivery and through breastfeeding. The level of knowledge among women age 15-49 years concerning mother-to-child transmission is presented in Table 53. Overall, 93.3 percent of women in Thailand know that HIV can be transmitted from mother to child. The percentages of women knowing that � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� HIV is transmitted from mother to child during pregnancy, at delivery and through breast milk are 87.6 percent, 82.4 percent, and 76.3 percent, respectively. In addition, 68.3 percent of the women know all three methods of mother-to-child transmission of HIV, while about 5 percent of the women do not know a method. The knowledge of mother-to-child transmission of HIV is associated with women’s education: the percentage of women with no education (55.1 percent) is lower than that of women with a primary education (70.8 percent) In the MICS, women were interviewed for their attitudes toward people having HIV/AIDS by being asked four questions on whether they: 1) would care for a family member infected with AIDS; 2) would buy food from a vendor who was HIV positive; 3) think that a female teacher who is HIV positive should be allowed to teach in school; and 4) would want to keep the HIV status of a family member a secret. Table 54 shows that 36.7 percent of women aged 15-49 years would want to keep the HIV status of a family member a secret, 29.2 percent thought that an HIV positive teacher should not be allowed to work and 65.3 percent would not buy food from a vendor with HIV/ AIDS. It is noted that almost all groups of women give more importance to the issue of not buying food from a vendor with HIV/AIDS than allowing an HIV positive teacher to work. Overall, note should be taken that 79.3 percent of the women agreed with at least one of the four discriminatory statements, and the highest is found among the women in the South (82.2 percent). One in five women (20.7 percent) agrees with none of the discriminatory statements, the highest rate being found among women in the North (27.4 percent). 4.8.2 TEST FOR HIV HIV testing is necessary for pregnant women because it can prevent transmission of the disease from mother to child. It has to be done with the women’s consent. Table 55 shows that 97.8 percent of women aged 15-49 years who had given birth within the two years preceding the survey received antenatal care from a health professional. From the table, 86.2 percent of the women received counselling and information about HIV prevention during their antenatal visit; and 87.5 percent were tested for HIV. Of those who were tested for HIV, 84.0 percent received the results of HIV testing during the visit. It is noted that the percentage of women receiving HIV test results is different by region, women’s education and language used in the households. Of all the regions, the percentage of women in the South receiving the test results is the lowest at 74.9 percent, while 88.6 percent of women in the Central Region (including Bangkok) received the test results. Women with no education ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� (58.3 percent) received the test results less than women with secondary or higher education (88.2 percent); and a higher percentage of Thai speaking women received test results than non-Thai speaking women (86.4 percent and 67.7 percent, respectively). 4.8.3 ORPHANS AND VULNERABLE CHILDREN Orphans are children who have experienced the death of either parent or both parents. Vulnerable children include children with a parent who is chronically ill, and children having an adult (aged 18-59) in the household who either died (after being chronically ill) or who was chronically ill in the year prior to the survey. Children who are orphaned or living away from their parents may be at increased risk of discrimination, neglect or various forms of exploitation – including harmful labour or sexual exploitation. Monitoring the children and the living arrangements for children who have lost both parents as compared to children whose parents are alive (and who live with at least one of these parents), is one way to identify children who are at risk and ensure that children’s rights are being met. In Thailand, of children aged 0-17 years, 63.0 percent are living with both parents; 19.3 percent are not living with a parent; 4.7 percent are orphaned, with one or both parents dead. In addition, 11.5 percent of children are living with only their mother while their father is still alive. Children living with neither parent, while both are alive, account for 17.5 percent. Younger children, aged 5-9 years, are not living with parents the most (21.3 percent), followed by 0-4 year old children (19.6 percent) and 10-14 years (18.6 percent). Differences in living with neither parent exist by region, residential area and socio-economic status. Children living with neither parent are mostly found in the Northeast (25.6 percent), followed by the North (21.3), The lowest rate is in the South (9.8 percent). Non-municipal children live with neither parent more often than municipal children (20.9 percent and 15.2 percent, respectively). The percentage of children living in the poorest households with neither parent is higher than that of the very wealthy households (25.4 percent and 10.5 percent, respectively). Table 57 shows the percentage of orphaned and vulnerable children aged 0-17 years. In Thailand, 7.1 percent of the children are considered orphaned and vulnerable. Of these children, 4.7 percent are orphans and 2.7 percent vulnerable children. � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� 4.8.4 ORPHANS AND VULNERABLE CHILDREN SCHOOL ATTENDANCE Children who are orphaned or in vulnerable households may be at increased risk of neglect or exploitation if the parents are not available to assist them. One of the measures developed for the assessment of the status of orphaned and vulnerable children relative to their peers looks at the school attendance of children aged 10-14 for children who have lost both parents versus children whose parents are alive (and who live with at least one of these parents). If children whose parents have died do not have the same access to school as their peers, then families and schools are not ensuring that these children’s rights are being met Data collected on orphaned or vulnerable children include not only those who have parents who are sick with HIV/AIDS or have died from the virus, but also children aged 0-17 years whose parents have died or who were too ill to work for three consecutive months during the 12 months preceding the survey. In Thailand, of children aged 10-14 years whose parents have died, 95.5 percent are currently attending school, which is slightly lower than that of children whose parents are still alive and who are living with one or both parents (96.4 percent). When the school attendance ratio of double orphans is compared to non-orphans and the ratio of orphaned/vulnerable children is compared to non-orphans, the value is 1.0, indicating that both groups of children have the same opportunity to attend school. (See details in Table 58) The level and type of support provided to households caring for orphaned and vulnerable children is presented in Table 59. In Thailand, among families that have taken in children who are orphaned or vulnerable, 78.6 percent of these families received no support at all. Children whose families receive any support (medical, emotional and psychosocial, social/ material, or educational) account for 21.4 percent. The percentage of orphaned and vulnerable children whose households have received all four types of support is only 0.1 percent. (See details in Table 59) The prevalence of malnutrition among orphans and vulnerable children 0-4 years of age is presented in Table 60. In Thailand, the proportion of orphaned and vulnerable children who are underweight, moderately or severely stunted or wasted is higher than that of non- orphaned or non-vulnerable children. The ratio for each type of malnutrition between the two groups is 1.4, 1.2 and 1.4, respectively. ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� List of References Boerma, J. T., Weinstein, K. I., Rutstein, S.O., and Sommerfelt, A. E. , 1996. Data on Birth Weight in Developing Countries: Can Surveys Help? Bulletin of the World Health Organization, 74(2), 209-16. Blanc, A. and Wardlaw, T. 2005. “Monitoring Low Birth Weight: An Evaluation of International Estimates and an Updated Estimation Procedure”. WHO Bulletin, 83 (3), 178- 185. Filmer, D. and Pritchett, L., 2001. Estimating wealth effects without expenditure data – or tears: An application to educational enrolments in states of India. Demography 38(1): 115- 132. Rutstein, S.O. and Johnson, K., 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, Maryland: ORC Macro. UNICEF, 2006. Monitoring the Situation of Children and Women. Multiple Indicator Cluster Survey Manual, New York. United Nations, 1983. Manual X: Indirect Techniques for Demographic Estimation (United Nations publication, Sales No. E.83.XIII.2). United Nations, 1990a. QFIVE, United Nations Program for Child Mortality Estimation. New York, UN Pop Division United Nations, 1990b. Step-by-step Guide to the Estimation of Child Mortality. New York, UN WHO and UNICEF, 1997. The Sisterhood Method for Estimating Maternal Mortality. Guidance notes for potential users, Geneva. www.Childinfo.org. ����������� ��-�������������������� � STATISTICAL TABLES ������������ ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 1 Results of household and individual interviews Number of households, women, and children under 5 by results of the household, women's and under-five's interviews, and household, women's and under-five's response rates, Thailand, 2005-2006 Residence Region Urban Rural Central (incl.BKK) North Northeast South Total Number of households Sampled 25,020 18,420 17,070 9,270 9,720 7,380 43,440 Occupied 24,248 18,054 16,536 9,105 9,509 7,152 42,302 Interviewed 23,019 17,492 15,501 9,000 9,332 6,678 40,511 Response rate 94.9 96.9 93.7 98.8 98.1 93.4 95.8 Number of women Eligible 21,402 15,785 15,052 7,358 8,337 6,440 37,187 Interviewed 21,265 15,695 14,925 7,353 8,313 6,369 36,960 Response rate 99.4 99.4 99.2 99.9 99.7 98.9 99.4 Overall response rate 94.3 96.3 92.9 98.8 97.9 92.3 95.2 Number of children under 5 Eligible 4,636 4,808 3,232 1,667 2,479 2,066 9,444 Mother/Caretaker interviewed 4,624 4,785 3,223 1,664 2,470 2,052 9,409 Response rate 99.7 99.5 99.7 99.8 99.6 99.3 99.6 Overall response rate 94.7 96.4 93.5 98.7 97.8 92.7 95.4 ��� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 2 Household age distribution by sex Percent distribution of the household population by five-year age groups and dependency age groups, and number of children aged 0-17 years, by sex, Thailand, 2005-2006 Males Females Total Number Percent Number Percent Number Percent Age 0-4 2,472,620 7.7 2,384,674 7.2 4,857,293 7.5 5-9 2,450,477 7.7 2,331,078 7.0 4,781,554 7.3 10-14 2,662,506 8.3 2,546,564 7.7 5,209,069 8.0 15-19 2,677,765 8.4 2,566,527 7.8 5,244,291 8.1 20-24 2,699,298 8.4 2,623,789 7.9 5,323,087 8.2 25-29 2,697,061 8.4 2,661,753 8.0 5,358,813 8.2 30-34 2,677,058 8.4 2,796,744 8.4 5,473,801 8.4 35-39 2,650,692 8.3 2,867,209 8.7 5,517,900 8.5 40-44 2,520,844 7.9 2,721,855 8.2 5,242,698 8.1 45-49 2,261,829 7.1 2,441,433 7.4 4,703,261 7.2 50-54 1,795,196 5.6 1,949,818 5.9 3,745,014 5.8 55-59 1,348,938 4.2 1,475,604 4.5 2,824,542 4.3 60-64 1,033,267 3.2 1,167,612 3.5 2,200,879 3.4 65-69 825,958 2.6 981,160 3.0 1,807,118 2.8 70+ 1,177,691 3.7 1,597,057 4.8 2,774,748 4.3 Dependency age groups < 15 7,585,602 23.7 7,262,315 21.9 14,847,917 22.8 15-64 22,361,946 70.0 23,272,341 70.3 45,634,287 70.1 65 + 2,003,649 6.3 2,578,217 7.8 4,581,865 7.0 Children aged 0-17 9,262,792 29.0 8,912,013 26.9 18,174,805 27.9 Adults 18+/Missing/ DK 22,688,405 71.0 24,200,860 73.1 46,889,264 72.1 Total 31,951,196 100.0 33,112,873 100.0 65,064,070 100.0 ������������ ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 3 Household composition Percent distribution of households by selected characteristics, Thailand, 2005-2006 Number of households Weighted percent Weighted Unweighted Sex of household head Male 70.0 12,622,526 27,490 Female 30.0 5,408,544 13,021 Region Central (incl.BKK) 35.4 6,375,706 15,501 North 19.6 3,532,411 9,000 Northeast 32.1 5,787,064 9,332 South 13.0 2,335,889 6,678 Residence Urban 31.5 5,677,957 23,019 Rural 68.5 12,353,113 17,492 Number of household members 1 10.6 1,910,984 4,867 2-3 44.4 8,003,939 18,185 4-5 33.9 6,120,793 13,246 6-7 9.0 1,626,472 3,379 8-9 1.6 280,799 621 10+ 0.5 88,083 213 Language Thai 93.8 16,907,969 38,407 Other Languages 6.2 1,123,101 2,104 Total 100.0 18,031,070 40,511 At least one child aged < 18 years 58.8 18,031,070 40,511 At least one child aged < 5 years 21.5 18,031,070 40,511 At least one woman aged 15-49 years 71.8 18,031,070 40,511 ��� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 4 Women's background characteristics Percent distribution of women aged 15-49 years by background characteristics, Thailand, 2005-2006 Number of women Weighted percent Weighted Unweighted Region Central (incl.BKK) 37.7 6,991,862 14,925 North 17.4 3,229,399 7,353 Northeast 31.7 5,883,420 8,313 South 13.1 2,437,448 6,369 Residence Urban 32.6 6,042,565 21,265 Rural 67.4 12,499,563 15,695 Age 15-19 13.7 2,542,192 4,788 20-24 14.0 2,598,520 3,996 25-29 14.2 2,639,148 4,969 30-34 15.0 2,788,662 5,581 35-39 15.3 2,842,828 6,089 40-44 14.6 2,707,544 6,161 45-49 13.1 2,423,234 5,376 Marital/Union status Currently married/in union 66.9 12,411,412 24,383 Formerly married/in union 6.1 1,132,616 2,601 Never married/in union 27.0 4,998,100 9,976 Motherhood status Ever gave birth 64.4 11,950,256 24,018 Never gave birth 35.6 6,591,872 12,942 Education None 2.9 546,232 1,197 Primary 44.6 8,265,232 15,492 Secondary + 52.4 9,712,623 20,225 Wealth index quintiles Poorest 16.6 3,086,179 4,264 Second 18.1 3,351,453 5,603 Middle 19.8 3,675,322 7,352 Fourth 22.4 4,145,686 9,359 Richest 23.1 4,283,487 10,382 Language Thai 93.3 17,298,134 34,775 Other Languages 6.7 1,243,995 2,185 Total 100.0 18,542,128 36,960 ������������ ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 5 Children's background characteristics Percent distribution of children under five years of age by background characteristics, Thailand, 2005-2006 Number of under-5 children Weighted percent Weighted Unweighted Sex Male 50.9 2,462,868 4,857 Female 49.1 2,374,812 4,552 Region Central (incl.BKK) 30.7 1,486,052 3,223 North 15.7 761,416 1,664 Northeast 37.2 1,799,842 2,470 South 16.3 790,370 2,052 Residence Urban 28.3 1,368,046 4,624 Rural 71.7 3,469,634 4,785 Age < 6 months 9.4 452,889 873 6-11 months 10.4 504,390 981 12-23 months 20.2 974,861 1,932 24-35 months 19.9 961,118 1,872 36-47 months 20.2 975,476 1,907 48-59 months 20.0 968,946 1,844 Mother’s education None 4.2 204,334 409 Primary 51.9 2,506,123 4,468 Secondary + 43.9 2,119,833 4,509 Wealth index quintiles Poorest 22.0 1,066,064 1,530 Second 21.4 1,033,595 1,747 Middle 21.2 1,027,632 2,111 Fourth 18.7 903,767 2,147 Richest 16.7 806,622 1,874 Language Thai 89.3 4,320,845 8,459 Other Languages 10.7 516,835 950 Total 100.0 4,837,680 9,409 ��� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 6 Child malnourishment Percentage of children aged 0-59 months who are severely or moderately malnourished, Thailand, 2005-2006 Weight for age Height for age Weight for height % below % below % below % below % below % below % above - 2 SD* - 3 SD* - 2 SD** - 3 SD** - 2 SD*** - 3 SD*** + 2 SD Number of children aged 0-59 months Sex Male 9.0 0.5 11.8 1.8 3.9 0.8 7.0 2,348,863 Female 9.6 0.4 12.0 1.9 4.3 0.5 6.7 2,283,349 Region Central (incl.BKK) 6.1 0.2 8.9 1.5 3.9 0.6 10.0 1,392,369 North 7.1 0.6 10.4 1.5 3.9 0.7 5.2 751,874 Northeast 11.5 0.4 12.3 1.8 3.8 0.5 4.5 1,736,991 South 12.5 0.8 18.3 3.2 5.4 1.1 8.3 750,977 Residence Urban 5.6 0.3 8.7 1.0 3.9 0.6 10.4 1,282,847 Rural 10.7 0.5 13.2 2.2 4.2 0.7 5.5 3,349,365 Age < 6 months 1.7 0.0 7.0 1.4 3.0 0.4 8.5 427,670 6-11 months 6.1 0.2 10.2 2.1 5.6 0.5 6.4 489,182 12-23 months 10.9 1.2 18.2 2.4 6.2 1.1 6.2 932,725 24-35 months 9.0 0.3 8.6 1.5 2.4 0.3 7.0 922,950 36-47 months 10.7 0.1 11.5 2.0 3.1 0.5 6.0 927,148 48-59 months 11.8 0.4 12.5 1.6 4.4 0.8 7.9 932,537 Mother’s education None 13.1 1.2 17.6 3.4 8.0 2.0 5.6 197,735 Primary 11.3 0.4 13.3 2.1 3.6 0.5 5.4 2,419,111 Secondary + 6.4 0.4 9.7 1.4 4.2 0.6 8.8 2,007,974 Wealth index quintiles Poorest 15.2 0.4 15.7 2.0 4.6 0.5 3.0 1,029,191 Second 9.7 0.5 13.3 1.9 3.6 0.6 4.4 989,378 Middle 9.7 0.7 12.9 2.5 4.5 1.0 7.2 995,318 Fourth 6.0 0.2 9.3 1.6 3.7 0.8 10.1 869,199 Richest 4.1 0.2 6.7 0.9 3.9 0.3 11.3 749,125 Language Thai 8.0 0.3 10.4 1.5 3.8 0.6 7.3 4,134,170 Other Languages 20.0 1.6 24.5 4.4 6.8 1.3 3.5 498,041 Total 9.3 0.4 11.9 1.9 4.1 0.6 6.9 4,632,212 * MICS indicator 6; MDG indicator 4 ** MICS indicator 7 *** MICS indicator 8 ������������ ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 7 Initial breastfeeding Percentage of women aged 15-49 years with a birth in the two years preceding the survey who breastfed their baby within one hour of birth and within one day of birth, Thailand, 2005-2006 Percentage who started breastfeeding within one hour of birth* Percentage who started breastfeeding within one day of birth** Number of women with a live birth in the two years preceding the survey Region Central (incl.BKK) 43.0 79.4 601,010 North 41.6 81.1 261,631 Northeast 54.4 89.1 657,569 South 58.3 89.3 328,568 Residence Urban 43.6 78.2 485,353 Rural 51.7 87.2 1,363,425 Months since birth < 6 months 51.2 85.7 488,740 6-11 months 50.9 85.7 479,847 12-23 months 48.0 83.9 880,075 Mother’s education None 52.8 89.0 55,531 Primary 48.8 88.0 679,618 Secondary + 49.8 82.7 1,112,114 Wealth index quintiles Poorest 53.8 87.4 382,922 Second 54.2 91.1 391,831 Middle 47.2 84.0 389,377 Fourth 48.5 84.0 369,375 Richest 42.7 76.0 315,273 Language Thai 48.1 84.0 1,614,236 Other Languages 59.6 90.4 234,542 Total 49.6 84.8 1,848,778 * MICS indicator 45 � � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Ta bl e 8 B re as tfe ed in g Pe rc en ta ge o f l iv in g ch ild re n a cc o rd in g to b re as tfe ed in g st at us a t e ac h ag e gr o u p, T ha ila n d, 2 00 5- 20 06 Ch ild re n 0 -3 m o n th s Ch ild re n 0 -5 m o n th s Ch ild re n 6 -9 m o n th s Ch ild re n 1 2- 15 m o n th s Ch ild re n 2 0- 23 m o n th s Pe rc en t e xc lu si ve ly br ea st fe d N um be r o f ch ild re n Pe rc en t e xc lu si ve ly br ea st fe d* N um be r o f ch ild re n % r ec ei vi ng br ea st m ilk & so lid / m us hy fo od ** N um be r o f ch ild re n Pe rc en t br ea st fe d* ** N um be r o f ch ild re n Pe rc en t br ea st fe d* ** N um be r o f ch ild re n Se x M al e 7. 1 14 6, 31 0 5. 4 23 3, 83 8 42 .7 18 7, 56 6 30 .3 17 3, 52 5 18 .2 14 7, 46 9 Fe m al e 8. 1 13 7, 25 2 5. 3 21 9, 05 2 42 .4 16 2, 20 0 33 .0 15 9, 42 8 19 .1 14 0, 78 8 R eg io n Ce nt ra l (i nc l.B KK ) 3. 7 87 ,5 85 2. 4 14 6, 21 6 25 .6 11 0, 73 3 24 .3 11 9, 27 3 18 .5 89 ,4 90 N or th 14 .5 37 ,5 96 10 .9 59 ,7 75 50 .0 48 ,2 53 36 .1 54 ,8 90 12 .3 61 ,4 66 N or th ea st 8. 4 10 5, 82 8 6. 0 16 4, 65 3 46 .2 13 0, 31 7 30 .5 10 7, 21 7 15 .0 89 ,8 17 So ut h 7. 3 52 ,5 54 5. 2 82 ,2 45 59 .9 60 ,4 63 46 .0 51 ,5 73 34 .3 47 ,4 85 R es id en ce Ur ba n 5. 0 79 ,9 81 3. 5 13 5, 74 8 30 .5 99 ,0 64 24 .1 10 3, 03 3 16 .5 77 ,9 74 R ur al 8. 5 20 3, 58 1 6. 2 31 7, 14 1 47 .4 25 0, 70 2 34 .9 22 9, 92 0 19 .5 21 0, 28 3 M ot he r’s e du ca tio n N on e 2. 1 11 ,2 23 1. 6 14 ,2 99 55 .7 9, 29 6 54 .4 12 ,9 27 34 .6 13 ,0 96 Pr im ar y 6. 5 96 ,8 31 4. 0 17 7, 79 9 42 .4 15 8, 05 5 33 .9 16 0, 12 6 21 .1 14 5, 55 4 Se co nd ar y + 8. 5 17 5, 15 5 6. 5 26 0, 17 7 42 .2 18 2, 20 4 27 .2 15 9, 54 7 14 .3 12 9, 60 7 W ea lth in de x qu in til es Po or es t 9. 4 56 ,5 57 7. 3 83 ,5 18 49 .3 70 ,5 71 40 .9 82 ,6 65 16 .3 67 ,2 10 Se co nd 8. 0 67 ,5 49 5. 4 10 0, 31 3 48 .4 77 ,8 13 33 .1 59 ,5 10 19 .9 53 ,8 90 M id dl e 6. 1 57 ,0 34 4. 6 10 4, 37 1 41 .1 74 ,0 40 31 .5 73 ,6 45 26 .1 62 ,1 44 Fo ur th 4. 2 52 ,0 03 2. 6 87 ,9 57 42 .4 65 ,1 88 26 .3 57 ,4 88 15 .4 58 ,5 55 R ic he st 10 .0 50 ,4 20 7. 3 76 ,7 30 29 .7 62 ,1 54 22 .5 59 ,6 46 14 .7 46 ,4 59 La ng u a ge Th ai 8. 5 24 9, 55 0 5. 8 40 1, 10 9 39 .1 30 7, 17 5 28 .6 29 3, 50 0 16 .6 26 5, 63 6 O th er L an gu ag es 0. 4 34 ,0 13 2. 0 51 ,7 80 67 .5 42 ,5 90 53 .5 39 ,4 53 42 .9 22 ,6 21 To ta l 7. 6 28 3, 56 3 5. 4 45 2, 88 9 42 .6 34 9, 76 6 31 .6 33 2, 95 3 18 .7 28 8, 25 7 * M IC S in di ca to r 1 5 * * * M IC S in di ca to r 1 7 * * * M IC S in di ca to r 1 6 � ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 9 Adequately fed infants Percentage of infants under 6 months of age exclusively breastfed, percentage of infants 6-11 months who are breastfed and who ate solid/semi-solid food at least the minimum recommended number of times yesterday and percentage of infants adequately fed, Thailand, 2005-2006 Percent of infants 0-5 months exclusively breastfed 6-8 months who received breastmilk and complementary food at least 2 times in prior 24 hours 9-11 months who received breastmilk and complementary food at least 3 times in prior 24 hours 6-11 months who received breastmilk and complementary food at least the minimum recommended number of times per day* 0-11 months who were appropriatel y fed** Number of infants aged 0-11 months Sex Male 5.4 40.9 27.6 34.8 21.2 503,833 Female 5.3 37.4 32.1 34.7 20.5 453,446 Region Central (incl.BKK) 2.4 20.0 19.5 19.8 11.5 308,601 North 10.9 47.4 44.4 45.9 30.7 137,130 Northeast 6.0 46.2 30.0 38.3 23.0 348,858 South 5.2 52.3 37.7 46.4 25.6 162,689 Residence Urban 3.5 26.7 19.4 22.9 13.5 280,536 Rural 6.2 44.0 34.5 39.5 23.9 676,743 Mother’s education None 1.6 72.0 19.4 41.6 23.4 31,344 Primary 4.0 42.5 29.7 36.1 21.9 401,128 Secondary + 6.5 35.2 30.7 33.1 19.9 523,629 Wealth index quintiles Poorest 7.3 44.4 34.7 39.6 25.1 186,274 Second 5.4 51.2 40.0 46.1 27.1 214,980 Middle 4.6 39.3 30.7 35.4 19.8 205,999 Fourth 2.6 31.5 26.6 29.2 16.3 181,026 Richest 7.3 25.4 15.9 20.3 14.4 169,000 Language Thai 5.8 34.6 27.6 31.0 19.1 851,062 Other Languages 2.0 68.1 59.9 65.5 34.5 106,217 Total 5.4 39.4 29.9 34.8 20.9 957,279 * MICS indicator 18 ** MICS indicator 19 ���� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 10 Iodized salt consumption Percentage of households consuming adequately iodized salt, Thailand, 2005-2006 Percent of households with Salt test result Percent of households in which salt was tested Number of households interviewed No salt No Colour Colour Total Number of households in which salt was tested or with no salt Region Central (incl.BKK) 81.6 6,375,706 18.4 16.0 65.6 100.0 6,375,706 North 94.3 3,532,411 5.7 26.7 67.7 100.0 3,532,411 Northeast 95.5 5,787,064 4.5 60.1 35.4 100.0 5,787,064 South 94.0 2,335,889 6.0 18.6 75.4 100.0 2,335,752 Residence Urban 81.1 5,677,957 18.9 17.7 63.3 100.0 5,677,821 Rural 94.3 12,353,113 5.7 39.4 54.9 100.0 12,353,113 Wealth index quintiles Poorest 95.9 3,671,968 4.1 53.9 41.9 100.0 3,671,968 Second 94.5 3,501,742 5.5 45.0 49.5 100.0 3,501,742 Middle 89.5 3,587,851 10.5 31.5 58.1 100.0 3,587,851 Fourth 83.9 3,820,422 16.1 19.6 64.3 100.0 3,820,422 Richest 87.2 3,449,088 12.8 12.8 74.5 100.0 3,448,952 Language Thai 89.7 16,907,969 10.3 32.7 57.0 100.0 16,907,832 Other Languages 96.4 1,123,101 3.6 30.9 65.5 100.0 1,123,101 Total 90.1 18,031,070 9.9 32.6 57.6 100.0 18,030,933 * MICS indicator 41 ������������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Ta bl e 11 Io di ze d sa lt co n su m pt io n Pe rc en ta ge o f h ou se ho ld s co n su m in g ad eq u at el y io di ze d sa lt, T ha ila nd , 2 00 5- 20 06 Pe rc en t o f h o u se ho ld s w ith s al t t es t r es ul t i n la b. Pe rc en t o f ho us eh ol ds in w hi ch s al t w a s te st ed N um be r o f ho us eh ol ds in te rv ie we d N um be r o f ho us eh ol ds in w hi ch s al t w a s la bt es te d N on io di ze d1 / In ad eq ua te ly io di ze d2 / Ad eq ua te ly io di ze d 3/ To ta l N um be r o f ho us eh ol ds in w hi ch s al t w a s te st ed o r w ith n o sa lt R eg io n Ce nt ra l (i nc l.B KK ) 81 .6 6, 37 5, 70 6 73 2, 56 5 30 .9 9. 3 59 .7 10 0. 0 6, 37 5, 70 6 N or th 94 .3 3, 53 2, 41 1 36 5, 64 0 38 .6 7. 7 53 .7 10 0. 0 3, 53 2, 41 1 N or th ea st 95 .5 5, 78 7, 06 4 60 4, 11 9 73 .9 3. 6 22 .6 10 0. 0 5, 78 7, 06 4 So ut h 94 .0 2, 33 5, 88 9 25 8, 02 0 27 .0 12 .8 60 .3 10 0. 0 2, 33 5, 75 2 R es id en ce Ur ba n 81 .1 5, 67 7, 95 7 65 1, 50 7 29 .0 9. 0 62 .0 10 0. 0 5, 67 7, 82 1 R ur al 94 .3 12 ,3 53 ,1 13 1, 30 8, 83 7 53 .1 7. 1 39 .9 10 0. 0 12 ,3 53 ,1 13 W ea lth in de x qu in til es Po or es t 95 .9 3, 67 1, 96 8 38 0, 58 5 69 .9 6. 5 23 .6 10 0. 0 3, 67 1, 96 8 Se co nd 94 .5 3, 50 1, 74 2 36 7, 08 3 57 .9 5. 9 36 .2 10 0. 0 3, 50 1, 74 2 M id dl e 89 .5 3, 58 7, 85 1 36 4, 90 9 46 .1 7. 3 46 .7 10 0. 0 3, 58 7, 85 1 Fo ur th 83 .9 3, 82 0, 42 2 44 5, 26 1 32 .6 9. 8 57 .6 10 0. 0 3, 82 0, 42 2 R ic he st 87 .2 3, 44 9, 08 8 40 2, 50 6 22 .8 8. 6 68 .6 10 0. 0 3, 44 8, 95 2 La ng u a ge Th ai 89 .7 16 ,9 07 ,9 69 1, 85 1, 69 5 45 .3 7. 9 46 .9 10 0. 0 16 ,9 07 ,8 32 O th er L an gu ag es 96 .4 1, 12 3, 10 1 10 8, 64 9 41 .4 5. 0 53 .6 10 0. 0 1, 12 3, 10 1 To ta l 90 .1 18 ,0 31 ,0 70 1, 96 0, 34 4 45 .1 7. 7 47 .2 10 0. 0 18 ,0 30 ,9 33 1/ N on io di ze d m e an 0 - 4. 9 pp m 2/ In ad eq ua te ly io di ze d m ea n 5 -1 4. 9 pp m 3/ A de qu at el y io di ze d m ea n 1 5 + pp m . ���� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 12 Low birth weight infants Percentage of live births in the 2 years preceding the survey that weighed below 2500 grams at birth, Thailand, 2005-2006 Percent of live births: Below 2500 grams* Weighed at birth** Number of live births Region Central (incl.BKK) 8.9 99.5 601,010 North 9.1 98.0 261,631 Northeast 9.5 98.4 657,569 South 9.3 98.5 328,568 Residence Urban 8.8 99.5 485,353 Rural 9.4 98.4 1,363,425 Mother’s education None 9.6 87.5 55,531 Primary 9.0 98.6 679,618 Secondary + 9.3 99.4 1,112,114 Wealth index quintiles Poorest 10.0 97.2 382,922 Second 8.8 99.0 391,831 Middle 9.0 99.0 389,377 Fourth 9.6 99.1 369,375 Richest 8.5 99.5 315,273 Language Thai 9.1 99.4 1,614,236 Other Languages 9.7 94.2 234,542 Total 9.2 98.7 1,848,778 * MICS indicator 9 ** MICS indicator 10 ������������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 13 Vaccinations in first year of life Percentage of children age 12-23 months immunized against childhood diseases at any time before the survey and before the first birthday, Thailand, 2005-2006 Percentage of children who received: BCG* DPT1 DPT2 DPT3** Polio1 Polio2 Polio3*** Measles**** All ***** None Number of children Vaccinated at any time before the survey According to: Vaccination card 88.3 88.3 88.3 88.2 88.3 88.3 88.2 85.8 85.7 0.0 974,861 Mother’s report 9.7 9.1 7.8 5.3 9.6 8.2 5.4 10.3 3.9 1.3 974,861 Either 98.1 97.5 96.1 93.5 97.9 96.5 93.6 96.1 89.7 1.3 974,861 Vaccinated by 12 months of age 98.0 97.1 95.6 91.4 97.6 95.9 91.5 91.4 83.3 1.3 974,861 * MICS indicator 25 ** MICS indicator 27 *** MICS indicator 26 **** MICS indicator 28; MDG indicator 15 ***** MICS indicator 31 ���� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 13 Vaccinations in first year of life (continued) Percentage of children aged 12-23 months immunized against childhood diseases at any time before the survey and before the first birthday, Thailand, 2005-2006 Percentage of children who received: HepB1 HepB2 HepB3* Number of children aged 12-23 months Vaccinated at any time before the survey According to: Vaccination card 88.2 87.8 87.5 974,861 Mother’s report 0.2 0.6 0.8 974,861 Either 88.4 88.4 88.3 974,861 Vaccinated by 12 months of age 88.3 87.6 85.7 974,861 * MICS indicator 29 ������������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 14 Vaccinations by background characteristics Percentage of children aged 12-23 months currently vaccinated against childhood diseases, Thailand, 2005-2006 Percentage of children who received: BCG DPT1 DPT2 DPT3 Polio1 Polio2 Polio3 Measles All None Percent with health card Number of children aged 12-23 months Sex Male 97.9 96.7 95.6 93.3 97.8 96.6 94.7 96.0 91.0 1.6 89.4 494,092 Female 98.3 98.2 96.8 93.7 98.1 96.4 92.4 96.3 88.3 0.9 87.3 480,770 Region Central (incl.BKK) 97.6 96.9 94.7 90.7 97.2 94.7 88.9 94.6 83.9 1.7 81.9 314,450 North 98.8 98.0 97.8 97.5 99.3 98.7 96.8 97.7 95.4 0.7 96.0 167,940 Northeast 98.6 98.9 98.1 96.9 98.1 97.3 96.0 96.7 94.0 1.1 92.4 330,929 South 97.1 95.0 93.3 88.0 97.5 96.2 94.4 96.3 86.0 1.6 84.6 161,542 Residence Urban 97.5 97.1 95.5 91.8 97.0 95.2 90.1 96.2 87.0 1.7 84.5 278,651 Rural 98.3 97.6 96.4 94.2 98.3 97.0 95.0 96.1 90.7 1.1 89.9 696,210 Mother’s education None 96.1 96.1 95.7 93.4 98.6 96.8 90.7 90.3 87.7 1.4 87.7 45,167 Primary 98.1 98.0 96.6 93.7 97.6 96.4 94.1 96.5 90.5 1.3 89.4 483,522 Secondary + 98.2 97.1 95.8 93.5 98.2 96.6 93.3 96.4 89.0 1.3 87.3 445,658 Wealth index quintiles Poorest 96.5 96.6 95.9 93.9 96.8 95.6 94.5 95.9 91.7 2.1 89.7 228,504 Second 99.1 98.9 98.1 95.8 98.8 97.9 96.0 96.9 93.4 0.9 93.1 194,161 Middle 99.2 98.1 95.3 92.0 98.3 96.7 94.2 93.9 87.2 0.6 85.4 204,290 Fourth 97.5 96.2 95.4 94.7 97.3 95.7 92.1 95.4 89.2 2.1 90.1 186,044 Richest 98.3 97.6 96.1 90.8 98.7 96.9 90.2 99.2 86.0 0.6 82.4 161,862 Language Thai 98.2 98.0 96.8 94.9 98.0 96.6 93.7 96.4 90.8 1.3 89.5 863,605 Other Languages 96.9 93.5 90.8 82.5 97.2 95.4 92.9 94.2 80.9 1.3 79.6 111,256 Total 98.1 97.5 96.1 93.5 97.9 96.5 93.6 96.1 89.7 1.3 88.4 974,861 ���� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 14 Vaccinations by background characteristics (continued) Percentage of children aged 12-23 months currently vaccinated against childhood diseases, Thailand, 2005-2006 Percentage of children who received: HepB1 HepB2 HepB3 Percent with health card Number of children aged 12-23 months Sex Male 89.4 89.4 89.4 89.4 494,092 Female 87.3 87.3 87.2 87.3 480,770 Region Central (incl.BKK) 81.9 81.9 81.9 81.9 314,450 North 96.0 96.0 95.9 96.0 167,940 Northeast 92.4 92.4 92.4 92.4 330,929 South 84.6 84.6 84.6 84.6 161,542 Residence Urban 84.5 84.5 84.4 84.5 278,651 Rural 89.9 89.9 89.9 89.9 696,210 Mother’s education None 87.7 87.7 87.7 87.7 45,167 Primary 89.4 89.4 89.4 89.4 483,522 Secondary + 87.3 87.3 87.3 87.3 445,658 Wealth index quintiles Poorest 89.7 89.7 89.7 89.7 228,504 Second 93.1 93.1 93.1 93.1 194,161 Middle 85.4 85.4 85.3 85.4 204,290 Fourth 90.1 90.1 90.1 90.1 186,044 Richest 82.4 82.4 82.4 82.4 161,862 Language Thai 89.5 89.5 89.5 89.5 863,605 Other Languages 79.6 79.6 79.6 79.6 111,256 Total 88.4 88.4 88.3 88.4 974,861 ������������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 15 Neonatal tetanus protection Percentage of mothers with a birth in the last 12 months protected against neonatal tetanus, Thailand, 2005-2006 Percent of mothers with a birth in the last 12 months who: Received at least 2 doses during last pregnancy Received at least 2 doses, the last within prior 3 years Received at least 3 doses, last within prior 5 years Protected against tetanus* Number of mothers Region Central (incl.BKK) 78.8 9.0 0.2 88.0 601,010 North 84.3 5.7 0.7 90.7 261,631 Northeast 80.4 7.7 0.8 89.0 657,569 South 82.2 7.2 1.1 90.4 328,568 Residence Urban 79.2 8.1 0.5 87.8 485,353 Rural 81.3 7.6 0.7 89.6 1,363,425 Education None 72.7 9.7 0.2 82.6 55,531 Primary 80.9 7.5 0.6 89.0 679,618 Secondary + 81.1 7.8 0.7 89.7 1,112,114 Wealth index quintiles Poorest 79.8 6.1 0.0 85.9 382,922 Second 83.5 7.0 0.6 91.0 391,831 Middle 82.1 7.2 1.9 91.1 389,377 Fourth 79.3 9.7 0.3 89.3 369,375 Richest 78.7 9.0 0.5 88.2 315,273 Language Thai 81.4 7.9 0.6 89.9 1,614,236 Other Languages 76.5 6.4 1.3 84.3 234,542 Total 80.8 7.7 0.7 89.2 1,848,778 * MICS indicator 32 �� � ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 16 Oral rehydration treatment Percentage of children aged 0-59 months with diarrhoea in the last two weeks and treatment with oral rehydration solution (ORS) or other oral rehydration treatment (ORT), Thailand, 2005-2006 Children with diarrhoea who received: Had diarrhoea in last two weeks Number of children aged 0-59 months Fluid from ORS packet Recommende d homemade fluid Prepackaged ORS fluid No treatment ORT Use Rate * Number of children aged 0-59 months with diarrhoea Sex Male 9.3 2,462,868 26.0 23.7 42.3 29.0 71.0 228,616 Female 8.0 2,374,812 22.4 21.0 43.9 35.0 65.0 191,130 Region Central (incl.BKK) 8.0 1,486,052 25.2 22.8 32.9 35.5 64.5 118,304 North 8.9 761,416 17.9 23.7 39.6 36.9 63.1 67,911 Northeast 9.2 1,799,842 23.9 23.7 55.4 21.9 78.1 166,024 South 8.5 790,370 30.3 17.8 33.5 44.1 55.9 67,508 Residence Urban 8.0 1,368,046 26.0 22.0 29.8 36.1 63.9 109,545 Rural 8.9 3,469,634 23.7 22.6 47.7 30.2 69.8 310,201 Age 0-11 months 10.7 957,279 26.7 19.8 38.1 35.2 64.8 102,718 12-23 months 15.0 974,861 21.1 22.0 42.3 33.5 66.5 146,437 24-35 months 7.6 961,118 24.7 19.5 48.0 22.8 77.2 73,258 36-47 months 6.6 975,476 23.0 31.7 45.5 30.9 69.1 64,868 48-59 months 3.4 968,946 33.3 21.1 45.6 35.0 65.0 32,467 Mother’s education None 9.5 204,334 34.7 15.1 51.0 30.1 69.9 19,495 Primary 8.5 2,506,123 27.9 22.4 39.5 32.2 67.8 213,414 Secondary + 8.8 2,119,833 19.3 23.2 46.2 31.4 68.6 186,677 Wealth index quintiles Poorest 10.2 1,066,064 18.7 25.0 44.5 31.0 69.0 108,864 Second 7.3 1,033,595 25.3 19.4 48.7 32.2 67.8 75,357 Middle 10.3 1,027,632 24.9 19.3 44.8 34.6 65.4 105,504 Fourth 9.1 903,767 28.5 19.4 37.6 32.8 67.2 82,433 Richest 5.9 806,622 27.3 33.7 36.0 24.6 75.4 47,589 Language Thai 8.6 4,320,845 24.6 22.3 42.6 31.3 68.7 370,616 Other Languages 9.5 516,835 22.2 23.4 46.1 34.8 65.2 49,131 Total 8.7 4,837,680 24.3 22.5 43.0 31.7 68.3 419,746 * MICS indicator 33 �� ���������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 17 Home management of diarrhoea Percentage of children aged 0-59 months with diarrhoea in the last two weeks who took increased fluids and continued to feed during the episode, Thailand, 2005-2006 Children with diarrhoea who: Had diarrhoea in last two weeks Number of children aged 0-59 months Drank more Drank the same or less Ate somewhat less, same or more Ate much less or none Home management of diarrhoea* Received ORT or increased fluids AND continued feeding** Number of children aged 0-59 months with diarrhoea Sex Male 9.3 2,462,868 8.1 91.7 65.2 34.8 3.4 44.1 228,616 Female 8.0 2,374,812 5.9 93.8 73.5 26.5 4.3 49.1 191,130 Region Central (incl.BKK) 8.0 1,486,052 3.8 95.9 70.7 29.3 2.4 44.8 118,304 North 8.9 761,416 11.4 88.6 70.1 29.9 4.9 44.6 67,911 Northeast 9.2 1,799,842 6.7 93.0 67.2 32.8 2.9 50.8 166,024 South 8.5 790,370 9.3 90.5 69.4 30.6 7.3 40.4 67,508 Residence Urban 8.0 1,368,046 5.9 94.1 69.8 30.2 4.2 42.1 109,545 Rural 8.9 3,469,634 7.5 92.2 68.7 31.3 3.6 47.9 310,201 Age 0-11 months 10.7 957,279 7.9 92.1 70.5 29.5 3.7 45.3 102,718 12-23 months 15.0 974,861 7.6 92.1 70.0 30.0 4.2 46.4 146,437 24-35 months 7.6 961,118 6.6 93.4 63.9 36.1 4.5 49.3 73,258 36-47 months 6.6 975,476 6.9 93.1 68.7 31.3 2.2 42.1 64,868 48-59 months 3.4 968,946 3.6 94.9 72.1 27.9 3.6 52.2 32,467 Mother’s education None 9.5 204,334 1.3 98.7 72.5 27.5 0.0 54.4 19,495 Primary 8.5 2,506,123 6.7 93.3 65.3 34.7 3.0 43.9 213,414 Secondary + 8.8 2,119,833 8.1 91.4 72.9 27.1 5.0 48.4 186,677 Wealth index quintiles Poorest 10.2 1,066,064 7.2 92.8 63.6 36.4 3.2 42.5 108,864 Second 7.3 1,033,595 8.7 90.6 78.5 21.5 6.3 55.5 75,357 Middle 10.3 1,027,632 5.7 94.3 70.6 29.4 4.1 44.2 105,504 Fourth 9.1 903,767 2.9 96.5 69.9 30.1 2.1 46.6 82,433 Richest 5.9 806,622 14.2 85.8 61.5 38.5 3.3 45.4 47,589 Language Thai 8.6 4,320,845 6.9 92.8 69.1 30.9 3.2 45.9 370,616 Other Languages 9.5 516,835 8.4 91.6 68.0 32.0 7.8 49.9 49,131 Total 8.7 4,837,680 7.1 92.7 69.0 31.0 3.8 46.4 419,746 * MICS indicator 34 ���� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Ta bl e 18 Ca re s ee ki ng fo r s us pe ct ed p n e u m o n ia Pe rc en ta ge o f c hi ld re n ag ed 0 -5 9 m o n th s w ith s us pe ct ed p ne u m o n ia in th e la st tw o w ee ks ta ke n to a h ea lth p ro vi de r, T ha ila n d, 2 00 5- 20 06 Ch ild re n w ith s us pe ct ed p n eu m o n ia w ho w er e ta ke n to : Pu bl ic s o u rc es Pr iv a te s ou rc es O th er s ou rc e H ad a cu te re sp ira to ry in fe ct io n1 N um be r o f ch ild re n a ge d 0- 59 m o n th s G ov t. H os pi ta l G ov t. he al th ce n tre G ov t. he al th po st Vi lla ge he al th w o rk e r Pr iv at e ho sp ita l/ cl in ic Pr iv at e ph ys ic ia n Ph ar m ac y R el at iv e / fri en d Sh op An y a pp ro pr ia te pr ov id er * N o. c hi ld re n 0- 59 m on th s w ith s us pe ct ed pn eu m on ia Se x M al e 5. 1 2, 46 2, 86 8 30 .8 8. 7 29 .1 3. 6 24 .6 2. 6 2. 3 1. 5 0. 0 83 .0 12 6, 26 7 Fe m al e 3. 9 2, 37 4, 81 2 43 .7 8. 5 22 .3 2. 8 21 .6 1. 7 0. 8 3. 8 2. 7 85 .3 93 ,3 23 R eg io n Ce nt ra l (i nc l.B KK ) 2. 9 1, 48 6, 05 2 43 .2 6. 3 24 .9 1. 4 17 .1 5. 1 2. 4 4. 4 0. 0 83 .5 42 ,9 59 N or th 6. 5 76 1, 41 6 32 .2 4. 8 25 .5 4. 1 36 .5 1. 7 3. 2 1. 8 0. 0 84 .5 49 ,7 40 N or th ea st 5. 6 1, 79 9, 84 2 33 .1 12 .4 32 .8 4. 2 18 .3 1. 1 0. 2 1. 8 2. 5 84 .6 10 1, 24 8 So ut h 3. 2 79 0, 37 0 45 .4 4. 7 3. 8 1. 0 28 .0 3. 1 2. 7 3. 7 0. 0 81 .3 25 ,6 42 R es id en ce Ur ba n 3. 1 1, 36 8, 04 6 42 .4 6. 3 4. 5 0. 0 32 .5 3. 6 2. 5 1. 5 0. 0 79 .9 42 ,9 29 R ur al 5. 1 3, 46 9, 63 4 34 .8 9. 1 31 .5 4. 0 21 .1 1. 9 1. 4 2. 8 1. 4 85 .0 17 6, 66 0 Ag e 0- 11 m on th s 2. 3 95 7, 27 9 37 .1 2. 7 16 .6 0. 0 33 .7 1. 5 5. 6 4. 6 0. 0 84 .5 21 ,6 07 12 -2 3 m on th s 6. 2 97 4, 86 1 39 .6 10 .7 29 .3 8. 1 24 .3 1. 1 0. 4 2. 5 1. 7 89 .1 60 ,1 27 24 -3 5 m on th s 5. 2 96 1, 11 8 36 .1 5. 5 24 .8 0. 0 26 .6 2. 0 2. 1 2. 5 0. 0 84 .1 50 ,2 52 36 -4 7 m on th s 4. 3 97 5, 47 6 26 .9 20 .9 15 .3 2. 9 24 .5 1. 0 1. 4 0. 6 3. 4 79 .1 42 ,2 92 48 -5 9 m on th s 4. 7 96 8, 94 6 40 .7 0. 5 38 .3 2. 3 12 .2 5. 6 1. 0 3. 3 0. 0 81 .4 45 ,3 12 M ot he r’s e du ca tio n N on e 4. 0 20 4, 33 4 62 .1 0. 0 12 .4 0. 0 26 .2 4. 0 0. 0 4. 0 0. 0 88 .2 8, 13 0 Pr im ar y 5. 0 2, 50 6, 12 3 32 .1 7. 0 33 .0 4. 3 23 .4 2. 6 1. 3 2. 9 0. 8 83 .6 12 5, 05 5 Se co nd ar y + 4. 1 2, 11 9, 83 3 40 .0 11 .7 17 .7 2. 0 23 .0 1. 6 2. 2 1. 8 1. 7 84 .2 86 ,4 04 W ea lth in de x qu in til es Po or es t 6. 6 1, 06 6, 06 4 32 .1 7. 3 38 .6 2. 3 15 .1 1. 4 2. 5 5. 5 1. 5 84 .9 70 ,1 87 Se co nd 4. 5 1, 03 3, 59 5 39 .5 9. 2 30 .4 12 .1 20 .3 2. 5 0. 5 0. 7 3. 1 88 .0 46 ,1 26 M id dl e 4. 7 1, 02 7, 63 2 38 .6 11 .2 26 .7 0. 0 32 .1 1. 9 1. 4 0. 0 0. 0 86 .8 48 ,2 72 Fo ur th 3. 3 90 3, 76 7 33 .1 4. 4 8. 3 0. 0 30 .8 5. 3 1. 3 0. 9 0. 0 76 .0 29 ,7 22 R ic he st 3. 1 80 6, 62 2 41 .7 11 .1 4. 0 0. 0 26 .2 1. 1 1. 8 4. 1 0. 0 78 .0 25 ,2 82 La ng u a ge Th ai 4. 7 4, 32 0, 84 5 33 .8 9. 2 26 .9 3. 4 24 .7 2. 0 1. 8 2. 7 1. 2 84 .5 20 1, 11 6 O th er L an gu ag es 3. 6 51 6, 83 5 63 .2 1. 8 18 .0 1. 4 8. 0 5. 3 0. 0 0. 0 0. 0 78 .2 18 ,4 73 To ta l 4. 5 4, 83 7, 68 0 36 .3 8. 6 26 .2 3. 3 23 .3 2. 2 1. 6 2. 5 1. 1 84 .0 21 9, 58 9 * M IC S in di ca to r 2 3 ������������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 19 Antibiotic treatment of pneumonia Percentage of children aged 0-59 months with suspected pneumonia who received antibiotic treatment, Thailand, 2005-2006 Percentage of under fives with suspected pneumonia who received antibiotics in the last two weeks* Number of children with suspected pneumonia in the two weeks prior to the survey Sex Male 64.4 126,267 Female 65.5 93,323 Region Central (incl.BKK) 70.1 42,959 North 54.7 49,740 Northeast 69.3 101,248 South 58.1 25,642 Residence Urban 68.1 42,929 Rural 64.0 176,660 Age 0-11 months 59.8 21,607 12-23 months 65.6 60,127 24-35 months 70.9 50,252 36-47 months 60.0 42,292 48-59 months 64.1 45,312 Mother’s education None 71.2 8,130 Primary 65.4 125,055 Secondary + 63.5 86,404 Wealth index quintiles Poorest 66.3 70,187 Second 49.2 46,126 Middle 69.0 48,272 Fourth 84.8 29,722 Richest 58.2 25,282 Language Thai 65.6 201,116 Other Languages 56.3 18,473 Total 64.8 219,589 * MICS indicator 22 ���� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Ta bl e 20 K no w le dg e of th e tw o d an ge r s ig ns o f p n e u m o n ia Pe rc en ta ge o f m o th er s/ ca re ta ke rs o f c hi ld re n a ge d 0- 59 m o n th s by kn o w le dg e of ty pe s o f s ym pt om s fo r t ak in g a ch ild im m ed ia te ly to a h ea lth fa ci lit y, an d pe rc en ta ge o f m o th er s/ ca re ta ke rs w ho re co gn iz e fa st an d di ffi cu lt br ea th in g as s ig n s fo r se ek in g ca re im m e di at el y, Th ai la nd , 2 00 5- 20 06 Pe rc en ta ge o f m o th er s/ ca re ta ke rs o f c hi ld re n a ge d 0- 59 m o n th s w ho th in k th at a c hi ld s ho u ld b e ta ke n im m ed ia te ly to a h ea lth fa ci lit y if th e ch ild : Is n ot a bl e to dr in k or br ea st fe ed Be co m 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 lt br ea th in g H as bl oo d in st oo l Is dr in kin g po or ly H as o th er sy m pt om s M ot he rs /c ar et ak er s w ho r e co gn ize th e tw o da ng er s ig ns o f pn eu m on ia * N um be r o f m o th er s/ ca re ta ke r s o f c hi ld re n ag ed 0- 59 m on th s R eg io n Ce nt ra l (i nc l.B KK ) 14 .3 36 .2 87 .8 25 .6 25 .5 23 .8 10 .0 46 .6 17 .8 1, 48 6, 05 2 N or th 6. 5 27 .7 92 .0 16 .6 15 .2 17 .9 3. 6 36 .5 6. 8 76 1, 41 6 N or th ea st 11 .8 37 .5 86 .4 27 .1 29 .1 24 .8 9. 1 44 .3 16 .0 1, 79 9, 84 2 So ut h 15 .5 44 .2 86 .2 28 .6 22 .6 22 .4 8. 7 46 .2 15 .8 79 0, 37 0 R es id en ce Ur ba n 13 .8 33 .9 86 .8 27 .1 26 .4 23 .9 9. 0 47 .0 17 .6 1, 36 8, 04 6 R ur al 11 .8 37 .8 88 .0 24 .5 24 .1 22 .7 8. 2 43 .0 14 .1 3, 46 9, 63 4 M ot he r's e du ca tio n N on e 9. 7 45 .1 90 .8 23 .2 20 .2 20 .8 8. 3 45 .1 14 .1 20 4, 33 4 Pr im ar y 11 .1 36 .1 87 .8 24 .2 24 .8 22 .2 8. 2 42 .4 14 .0 2, 50 6, 12 3 Se co nd ar y + 14 .1 36 .3 87 .2 26 .6 25 .1 24 .3 8. 7 45 .9 16 .4 2, 11 9, 83 3 W ea lth in de x qu in til es Po or es t 10 .6 35 .2 88 .9 24 .4 24 .8 20 .3 7. 1 40 .8 13 .0 1, 06 6, 06 4 Se co nd 12 .7 39 .0 86 .8 26 .3 28 .0 26 .9 9. 6 44 .8 16 .3 1, 03 3, 59 5 M id dl e 12 .1 37 .1 89 .5 25 .2 21 .9 21 .8 7. 3 42 .5 13 .5 1, 02 7, 63 2 Fo ur th 13 .1 36 .3 85 .2 23 .1 23 .0 21 .3 8. 8 44 .5 14 .4 90 3, 76 7 R ic he st 13 .7 35 .4 87 .6 27 .4 26 .1 25 .1 10 .0 49 .0 19 .0 80 6, 62 2 La ng u a ge Th ai 11 .4 34 .3 88 .0 24 .9 24 .6 22 .7 8. 2 43 .4 14 .8 4, 32 0, 84 5 O th er L an gu ag es 19 .8 56 .5 85 .2 27 .7 26 .3 26 .0 10 .4 50 .0 17 .3 51 6, 83 5 To ta l 12 .3 36 .7 87 .7 25 .2 24 .8 23 .0 8. 5 44 .1 15 .1 4, 83 7, 68 0 ������������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Ta bl e 21 So lid fu el u se Pe rc en t d is tri bu tio n o f h ou se ho ld s ac co rd in g to ty pe o f c o o ki ng fu el , a n d pe rc en ta ge o f h ou se ho ld s us in g s o lid fu el s fo r c o o ki n g, T ha ila n d, 2 00 5- 20 06 Pe rc en ta ge o f h ou se ho ld s us in g: El ec tri ci ty Li qu ifie d Pe tro le um G as (LP G ) Bi og as Co al , lig ni te Ch ar co al W o o d Ag ric ul tu ra l cr o p re si du e To ta l So lid fu el s fo r c oo kin g* N um be r o f ho us eh ol ds ha ve co o ki ng Pe rc en ta ge o f ho us eh ol ds ha ve n o co o ki ng N um be r o f ho us eh ol ds R eg io n Ce nt ra l (i nc l.B KK ) 6. 0 84 .5 0. 4 0. 0 6. 8 2. 2 0. 0 10 0. 0 9. 1 5, 56 3, 84 2 12 .7 6, 37 5, 70 6 N or th 2. 3 45 .8 0. 3 0. 1 24 .3 27 .0 0. 2 10 0. 0 51 .6 3, 39 6, 28 6 3. 9 3, 53 2, 41 1 N or th ea st 1. 1 32 .0 0. 2 0. 1 32 .6 33 .9 0. 1 10 0. 0 66 .6 5, 61 6, 54 6 2. 9 5, 78 7, 06 4 So ut h 4. 3 86 .2 0. 4 0. 0 5. 3 3. 6 0. 0 10 0. 0 9. 0 2, 22 1, 01 1 4. 9 2, 33 5, 88 9 R es id en ce Ur ba n 7. 1 81 .3 0. 2 0. 0 6. 2 5. 1 0. 0 10 0. 0 11 .3 4, 83 4, 98 9 14 .8 5, 67 7, 95 7 R ur al 1. 9 50 .5 0. 3 0. 1 23 .9 23 .2 0. 1 10 0. 0 47 .3 11 ,9 62 ,6 97 3. 2 12 ,3 53 ,1 13 Ed uc at io n of h ou se ho ld h ea d N on e 2. 7 44 .5 0. 2 0. 1 21 .7 30 .7 0. 1 10 0. 0 52 .6 1, 03 9, 42 2 4. 5 1, 08 8, 53 2 Pr im ar y 2. 0 52 .3 0. 3 0. 1 23 .4 21 .9 0. 1 10 0. 0 45 .5 11 ,1 66 ,6 71 3. 3 11 ,5 46 ,2 08 Se co nd ar y + 7. 0 80 .1 0. 4 0. 0 6. 9 5. 6 0. 1 10 0. 0 12 .5 4, 54 2, 11 1 14 .9 5, 33 6, 19 1 W ea lth in de x qu in til es Po or es t 1. 7 8. 0 0. 1 0. 0 44 .7 45 .3 0. 2 10 0. 0 90 .1 3, 57 8, 71 3 2. 5 3, 67 1, 96 8 Se co nd 2. 6 41 .3 0. 4 0. 1 29 .4 25 .9 0. 2 10 0. 0 55 .6 3, 39 0, 68 2 3. 2 3, 50 1, 74 2 M id dl e 4. 3 68 .5 0. 4 0. 1 14 .4 12 .4 0. 1 10 0. 0 26 .8 3, 33 6, 95 7 7. 0 3, 58 7, 85 1 Fo ur th 5. 9 88 .3 0. 4 0. 0 2. 2 3. 2 0. 0 10 0. 0 5. 4 3, 34 3, 02 3 12 .5 3, 82 0, 42 2 R ic he st 2. 6 96 .7 0. 2 0. 0 0. 3 0. 2 0. 0 10 0. 0 0. 4 3, 14 8, 31 0 8. 7 3, 44 9, 08 8 La ng u a ge Th ai 3. 3 60 .4 0. 3 0. 1 18 .5 17 .3 0. 1 10 0. 0 35 .9 15 ,6 96 ,3 18 7. 2 16 ,9 07 ,9 69 O th er L an gu ag es 4. 3 44 .3 0. 2 0. 0 23 .3 27 .8 0. 0 10 0. 0 51 .1 1, 10 1, 36 8 1. 9 1, 12 3, 10 1 To ta l 3. 4 59 .4 0. 3 0. 0 18 .8 18 .0 0. 1 10 0. 0 36 .9 16 ,7 97 ,6 85 6. 8 18 ,0 31 ,0 70 * M IC S in di ca to r 2 4; M D G In di ca to r 29 ���� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 22 Solid fuel use by type of stove or fire Percentage of households using solid fuels for cooking by type of stove or fire, Thailand, 2005-2006 Percentage of households using solid fuels for cooking: Closed stove with chimney Open stove or fire with chimney or hood Open stove or fire with no chimney or hood Other stove Total Number of households using solid fuels for cooking Region Central (incl.BKK) 95.8 1.1 2.6 0.4 100.0 505,253 North 96.1 0.7 3.1 0.0 100.0 1,753,101 Northeast 93.7 1.5 4.8 0.0 100.0 3,743,276 South 87.6 2.8 8.8 0.8 100.0 199,557 Residence Urban 95.4 0.9 3.4 0.3 100.0 546,306 Rural 94.3 1.3 4.4 0.0 100.0 5,654,881 Education of household head None 93.2 0.7 6.1 0.0 100.0 546,230 Primary 94.4 1.4 4.1 0.1 100.0 5,079,076 Secondary + 94.8 1.0 4.2 0.0 100.0 569,274 Wealth index quintiles Poorest 93.4 1.7 4.9 0.0 100.0 3,224,655 Second 94.5 1.1 4.3 0.0 100.0 1,885,983 Middle 96.7 0.6 2.6 0.1 100.0 895,893 Fourth 98.2 0.2 0.8 0.7 100.0 180,612 Richest 99.3 0.3 0.4 0.0 100.0 14,044 Language Thai 94.5 1.3 4.1 0.1 100.0 5,638,065 Other Languages 92.6 1.0 6.4 0.0 100.0 563,122 Total 94.4 1.3 4.3 0.0 100.0 6,201,187 ������������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Ta bl e 23 Us e o f i m pr ov e d w at er s ou rc es Pe rc en t d is tri bu tio n o f h ou se ho ld m em be rs a cc o rd in g to m ai n so u rc e o f d rin ki ng w at er a n d pe rc en ta ge o f h ou se ho ld m em be rs u si ng im pr ov e d dr in ki ng w at er s ou rc es , T ha ila nd , 20 05 -2 00 6 M ai n so u rc e o f d rin ki ng w at er Im pr ov e d so u rc e s Un im pr ov e d so ur ce s Pi pe d in to dw el lin g Pi pe d in to ya rd /p lo t a nd Pu bl ic ta p/ st an dp ip e Tu be w e ll/ bo re ho le Pr ot ec te d w e ll R ai nw at er Bo ttl ed w a te r1 Un pr ot ec te d w e ll Ta nk er tru ck Su rfa ce w a te r Bo ttl ed w a te r1 O th er To ta l Im pr ov ed so u rc e o f dr in kin g w a te r* N um be r o f ho us eh ol d m e m be rs R eg io n Ce nt ra l (i nc l.B KK ) 33 .8 1. 9 2. 2 1. 9 21 .8 36 .5 0. 4 0. 2 0. 1 0. 8 0. 3 10 0. 0 98 .1 22 ,5 59 ,7 62 N or th 25 .8 3. 5 6. 6 9. 2 23 .0 26 .9 1. 3 0. 0 2. 7 0. 8 0. 2 10 0. 0 95 .0 11 ,7 19 ,8 85 N or th ea st 9. 6 0. 8 4. 1 3. 0 66 .3 10 .6 2. 6 1. 8 0. 4 0. 6 0. 1 10 0. 0 94 .4 21 ,9 53 ,1 81 So ut h 10 .4 1. 1 6. 4 14 .2 20 .9 28 .3 11 .6 0. 1 1. 1 5. 7 0. 0 10 0. 0 81 .5 8, 83 1, 24 2 R es id en ce Ur ba n 37 .0 2. 2 2. 3 1. 9 10 .6 43 .5 0. 6 0. 2 0. 1 1. 2 0. 3 10 0. 0 97 .6 19 ,6 30 ,2 55 R ur al 14 .1 1. 5 5. 0 6. 7 48 .3 16 .9 3. 8 0. 9 1. 1 1. 5 0. 1 10 0. 0 92 .5 45 ,4 33 ,8 15 Ed uc at io n of h ou se ho ld h ea d N on e 22 .5 3. 4 5. 0 10 .9 26 .9 13 .8 9. 0 1. 2 4. 9 2. 0 0. 5 10 0. 0 82 .4 3, 90 4, 26 3 Pr im ar y 18 .1 1. 7 4. 8 5. 8 45 .0 18 .6 3. 1 0. 9 0. 6 1. 3 0. 2 10 0. 0 93 .9 43 ,1 77 ,6 28 Se co nd ar y + 27 .7 1. 5 2. 6 2. 8 19 .8 42 .5 1. 0 0. 2 0. 4 1. 4 0. 2 10 0. 0 96 .9 17 ,7 82 ,2 72 W ea lth in de x qu in til es Po or es t 10 .8 2. 7 4. 7 5. 6 64 .8 1. 8 4. 6 2. 0 2. 2 0. 3 0. 3 10 0. 0 90 .5 12 ,7 59 ,3 99 Se co nd 16 .6 1. 8 5. 2 6. 1 56 .2 7. 7 3. 4 0. 7 1. 2 1. 0 0. 1 10 0. 0 93 .6 12 ,9 27 ,4 08 M id dl e 21 .5 1. 3 4. 7 6. 5 38 .4 21 .1 3. 5 0. 4 0. 5 1. 8 0. 2 10 0. 0 93 .6 13 ,0 88 ,6 53 Fo ur th 20 .4 1. 3 4. 3 5. 8 20 .9 41 .7 2. 6 0. 4 0. 2 2. 3 0. 2 10 0. 0 94 .3 13 ,1 62 ,1 86 R ic he st 35 .4 1. 5 2. 1 2. 3 5. 5 51 .2 0. 2 0. 1 0. 0 1. 6 0. 1 10 0. 0 98 .0 13 ,1 26 ,4 24 La ng u a ge Th ai 21 .9 1. 6 4. 2 4. 7 37 .4 26 .3 1. 6 0. 3 0. 4 1. 3 0. 2 10 0. 0 96 .2 60 ,2 36 ,3 64 O th er L an gu ag es 9. 9 3. 0 3. 6 12 .0 31 .1 7. 8 18 .2 5. 3 6. 2 2. 3 0. 4 10 0. 0 67 .6 4, 82 7, 70 6 To ta l 21 .0 1. 8 4. 2 5. 3 36 .9 24 .9 2. 8 0. 7 0. 8 1. 4 0. 2 10 0. 0 94 .0 65 ,0 64 ,0 70 * M IC S in di ca to r 1 1; M D G in di ca to r 30 ���� ��������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Ta bl e 24 H ou se ho ld w at er tr ea tm en t Pe rc en t d is tri bu tio n o f h ou se ho ld p op ul at io n ac c o rd in g to dr in ki ng w at er tr ea tm en t m et ho d us ed in th e ho u se ho ld , a nd p er ce n ta ge o f h ou se ho ld p op ul at io n th at a pp lie d an ap pr op ria te w at er tr ea tm en t m et ho d, T ha ila n d, 2 00 5- 20 06 W at er tr ea tm e n t m et ho d u se d in th e ho u se ho ld Al l d rin ki n g w at er so u rc es Im pr ov e d dr in ki ng w at er s ou rc es Un im pr ov e d dr in ki ng w at er s ou rc es N on e Bo il Ad d bl ea ch / ch lo rin e St ra in th ro ug h a c lo th Us e w a te r filt er So la r di sin fe ct io n Le t i t st an d a n d se ttl e O th er Ap pr op ria te w a te r tre at m en t m e th od * N um be r o f ho us eh ol d m e m be rs Ap pr op ria te w a te r tre at m en t m e th od N um be r o f ho us eh ol d m e m be rs Ap pr op ria te w a te r tre at m en t m e th od N um be r o f ho us eh ol d m e m be rs R eg io n Ce nt ra l (i nc l.B KK ) 55 .1 13 .6 0. 2 2. 3 27 .4 0. 6 5. 2 0. 1 38 .6 22 ,5 59 ,7 62 54 .9 13 ,8 97 ,8 25 12 .4 8, 66 1, 93 6 N or th 53 .2 7. 3 1. 0 7. 2 12 .5 5. 4 19 .7 0. 2 25 .4 11 ,7 19 ,8 85 30 .4 7, 98 2, 85 3 14 .7 3, 73 7, 03 1 N or th ea st 56 .1 8. 0 0. 9 10 .0 5. 2 2. 5 22 .1 0. 3 16 .2 21 ,9 53 ,1 81 16 .8 18 ,3 97 ,9 49 13 .4 3, 55 5, 23 2 So ut h 62 .6 18 .9 0. 4 7. 0 10 .9 0. 3 2. 8 0. 1 29 .3 8, 83 1, 24 2 36 .5 4, 69 5, 99 4 21 .2 4, 13 5, 24 7 R es id en ce Ur ba n 50 .2 14 .2 0. 3 2. 7 31 .8 0. 6 4. 7 0. 2 43 .4 19 ,6 30 ,2 55 68 .9 10 ,6 13 ,4 66 13 .5 9, 01 6, 78 9 R ur al 58 .7 10 .1 0. 8 8. 0 7. 7 2. 7 16 .8 0. 2 20 .5 45 ,4 33 ,8 15 21 .9 34 ,3 61 ,1 56 15 .9 11 ,0 72 ,6 59 Ed uc at io n of h ou se ho ld h ea d N on e 56 .1 19 .8 0. 3 8. 2 8. 6 2. 1 10 .2 0. 0 30 .2 3, 90 4, 26 3 30 .8 2, 67 8, 10 4 28 .7 1, 22 6, 15 9 Pr im ar y 57 .3 10 .1 0. 6 7. 4 10 .8 2. 5 15 .9 0. 2 22 .9 43 ,1 77 ,6 28 26 .0 32 ,5 39 ,5 27 13 .6 10 ,6 38 ,1 01 Se co nd ar y + 53 .2 12 .3 0. 6 3. 6 26 .5 1. 1 7. 5 0. 1 37 .6 17 ,7 82 ,2 72 57 .0 9, 67 4, 87 9 14 .4 8, 10 7, 39 3 W ea lth in de x qu in til es Po or es t 56 .9 9. 0 0. 6 9. 4 1. 9 4. 0 24 .2 0. 2 15 .3 12 ,7 59 ,3 99 15 .1 11 ,3 11 ,7 25 16 .9 1, 44 7, 67 4 Se co nd 55 .3 9. 0 0. 5 10 .1 5. 7 3. 1 20 .7 0. 4 17 .7 12 ,9 27 ,4 08 18 .3 11 ,1 03 ,0 85 14 .2 1, 82 4, 32 3 M id dl e 56 .6 11 .9 1. 2 7. 4 12 .5 2. 0 12 .6 0. 2 26 .8 13 ,0 88 ,6 53 31 .2 9, 48 9, 19 6 15 .1 3, 59 9, 45 7 Fo ur th 61 .3 12 .1 0. 4 3. 9 18 .2 1. 0 6. 0 0. 1 30 .4 13 ,1 62 ,1 86 45 .7 6, 92 6, 03 1 13 .4 6, 23 6, 15 5 R ic he st 50 .4 14 .4 0. 4 1. 4 36 .0 0. 3 2. 8 0. 0 46 .3 13 ,1 26 ,4 24 81 .1 6, 14 4, 58 6 15 .7 6, 98 1, 83 8 La ng u a ge Th ai 55 .0 10 .3 0. 6 6. 8 16 .0 2. 2 13 .9 0. 2 27 .5 60 ,2 36 ,3 64 33 .5 42 ,0 87 ,5 46 13 .4 18 ,1 48 ,8 17 O th er L an gu ag es 70 .9 24 .1 0. 2 1. 9 2. 7 0. 2 4. 0 0. 0 26 .6 4, 82 7, 70 6 25 .5 2, 88 7, 07 6 28 .3 1, 94 0, 63 0 To ta l 56 .1 11 .3 0. 6 6. 4 15 .0 2. 1 13 .2 0. 2 27 .4 65 ,0 64 ,0 70 33 .0 44 ,9 74 ,6 22 14 .8 20 ,0 89 ,4 47 * M IC S in di ca to r 1 3 ������������� ����� ������������� �� ��� �� ��� � �� ���������� �� �������� Table 25 Time to source of water Percent distribution of households according to time to go to source of drinking water, get water and return, and mean time to source of drinking water, Thailand, 2005-2006 Time to source of drinking water Water on premises Less than 15 minutes 15 minutes to less than 30 minutes 30 minutes to less than 1 hour 1 hour or more Don't know Total Mean time to source of drinking water* Number of households Region Central (incl.BKK) 96.4 2.7 0.1 0.1 0.0 0.6 100.0 6.8 6,375,706 North 91.4 7.3 0.8 0.2 0.1 0.2 100.0 7.5 3,532,411 Northeast 88.5 8.2 0.9 1.1 0.9 0.5 100.0 13.9 5,787,064 South 89.1 9.6 0.8 0.4 0.0 0.1 100.0 6.9 2,335,889 Residence Urban 95.5 3.7 0.5 0.3 0.0 0.1 100.0 8.8 5,677,957 Rural 90.3 7.5 0.7 0.6 0.5 0.5 100.0 10.8 12,353,113 Education of household head None 90.3 7.2 1.0 0.6 0.7 0.3 100.0 13.2 1,088,532 Primary 90.7 7.1 0.7 0.6 0.4 0.4 100.0 10.8 11,546,208 Secondary + 94.0 4.9 0.4 0.2 0.1 0.5 100.0 8.2 5,336,191 Wealth index quintiles Poorest 88.1 8.8 1.0 0.8 1.0 0.3 100.0 13.4 3,671,968 Second 90.0 8.0 0.7 0.7 0.3 0.2 100.0 9.9 3,501,742 Middle 91.7 6.8 0.6 0.4 0.1 0.4 100.0 8.

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