The Gambia Multiple Indicator Cluster Survey 2005/2006 Report: Monitoring the situation of Children and Women

Publication date: 2006

Copyright Gambia Bureau of Statistics 2007 Published 2007 Front Cover: UNICEF/Gam 00705/Giacomo Pirozzi Published by UNICEF UN House 5 Kofi Annan Street Cape Point Bakau,The Gambia All rights reserved. PRINTED BY Polykrome, Dakar Senegal ii • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • iii Contributors to the Report Alieu S M Ndow - Gambia Bureau of Statistics Alieu Sarr - Gambia Bureau of Statistics Sheriffo S T Sonko - UNICEF Banjul Edrissa Ceesay - Gambia Bureau of Statistics Nyakassi Sanyang - Central Bank of The Gambia Omar Ngum - Department of Community Development Lolley Kah Jallow - Gambia Bureau of Statistics Baba Suwareh - Gambia Bureau of Statistics Modou Lamin Cham - Directorate of Planning, DoSHSW Amat Bah - National Nutrition Agency Paul Mendy - Directorate of Planning, DoSBSE Alieu Saho - Gambia Bureau of Statistics We acknowledge the substantial comments on the earlier draft as well as support in data proces- sing from the following colleagues from the MICS Global Team, Blancroft Research International and the Strategic Information Section, Division of Policy and Planning (DPP), UNICEF, New York: Attila Hancioglu, MICS III Global Coordinator Trevor Croft, Blancroft Research International Emma Holmberg, Strategic Information Section, DPP Rhiannon James, Strategic Information Section, DPP Editor: Fodeh Baldeh, University of The Gambia, Kanifing Design and Layout: Polykrome, Dakar, Senegal The Gambia Multiple Indicator Cluster Survey (MICS) was carried out by the Gambia Bureau of Statistics in collaboration with the Department of State for Basic and Secondary Education, the Department of State for Health and Social Welfare, the Women's Bureau, the National Nutrition Agency, the Department of Community Development, the Department of Water Resources and the Department of Social Welfare. Financial and technical support was provided by the United Nations Children's Fund (UNICEF) and the World Bank through their assisted HIV/AIDS Rapid Response Project (HARRP). The survey was conducted as part of the third round of MIC surveys (MICS III), carried out around the world in more than 50 countries, in 2005-2006, following the first two rounds of MIC surveys that were conducted in 1995 and 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 Gambia Bureau of Statistics (GBoS), 2007, The Gambia Multiple Indicator Cluster Survey 2005/2006 Report, Banjul. iv • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report CONTENTS List of Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vi Summary Table of Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi List of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiii Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xiv Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xvi 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 SURVEY OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8 2 Sample and Survey Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 SAMPLE DESIGN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 QUESTIONNAIRES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 TRAINING AND FIELDWORK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12 3 Sample Coverage and the Characteristics of Households . . . . . . . . . . . . . . . . . . . .15 SAMPLE COVERAGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 CHARACTERISTICS OF HOUSEHOLDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 CHARACTERISTICS OF RESPONDENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 4 Child Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19 5 Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 NUTRITIONAL STATUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 BREASTFEEDING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25 SALT IODIZATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 VITAMIN A SUPPLEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 LOW BIRTH WEIGHT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 6 Child Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33 IMMUNIZATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33 TETANUS TOXOID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34 ORAL REHYDRATION TREATMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 CARE SEEKING AND ANTIBIOTIC TREATMENT OF PNEUMONIA . . . . . . . . . . . . .37 SOLID FUEL USE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 MALARIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39 SOURCES AND COSTS OF SUPPLIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40 7 The Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 WATER AND SANITATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 SECURITY OF TENURE AND DURABILITY OF HOUSING . . . . . . . . . . . . . . . . . . . . .46 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • v 8 Reproductive Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49 ANTENATAL CARE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49 ASSISTANCE AT DELIVERY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50 9 Child Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53 10 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55 PRE-SCHOOL ATTENDANCE AND SCHOOL READINESS . . . . . . . . . . . . . . . . . . . . .55 PRIMARY AND SECONDARY SCHOOL PARTICIPATION . . . . . . . . . . . . . . . . . . . . . .55 ADULT LITERACY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59 11 Child Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61 BIRTH REGISTRATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61 CHILD LABOUR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61 CHILD DISCIPLINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62 EARLY MARRIAGE AND POLYGYNY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63 FEMALE GENITAL MUTILATION/CUTTING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64 DOMESTIC VIOLENCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66 12 HIV/AIDS, Sexual Behaviour, and Orphaned and Vulnerable Children . . . . . .69 KNOWLEDGE OF HIV TRANSMISSION AND CONDOM USE . . . . . . . . . . . . . . . . . .69 ORPHANS AND VULNERABLE CHILDREN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 List of References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .76 Appendix A. Sample Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155 Appendix B. List of Personnel Involved in the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 Appendix C. Estimates of Sampling Errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Appendix D. Data Quality Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 Appendix E. MICS Indicators: Numerators and Denominators . . . . . . . . . . . . . . . . . . . . 192 Appendix F. Questionnaires . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198 Appendix G. Urban Definition and Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 vi • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report ABBREVIATIONS AIDS Acquired Immune Deficiency Syndrome BCG Bacillus-Calmette-Guérin CEDAW Convention on the Elimination of Discrimination Against Women CRC Convention on the Rights of the Child CSPro Census and Survey Processing System DoSBSE Department of State for Basic and Secondary Education DoSHSW Department of State for Health and Social Welfare DPT Diphteria, Pertussis and Tetanus EPI Expanded Programme on Immunization FGM/C Female Genital Mutilation/Cutting GBoS Gambia Bureau of Statistics GPI Gender Parity Index HIV Human Immunodeficiency Virus IDD Iodine Deficiency Disorders ITN Insecticide Treated Net IUD Intrauterine Device LAM Lactational Amenorrhea Method LGA Local Government Area MDGs Millennium Development Goals MICS Multiple Indicator Cluster Survey NAR Net Attendance Rate NaNA National Nutrition Agency ORS Oral Rehydration Solution ORT Oral Rehydration Ttreatment OVC Orphans and Vulnerable Children PPM Parts Per Million SPSS Statistical Package for Social Sciences STIs Sexually Transmitted Infections TVET Technical, Vocational Education and Training 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 Notations (x) This notation implies that the percentage or proportion, x, in brackets is calculated on a number of cases that fall in the range 25 to 49 cases. (*) This notation implies that the percentage or proportion, *, in brackets is calculated on a number of cases that fall in the range 1 to 24 unweighted cases and the actual percentage or proportion is not shown but it is represented by an asterisk. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • vii CHILD MORTALITY Child mortality 1 13 Under-five mortality rate 131 per thousand 2 14 Infant mortality rate 93 per thousand NUTRITION Nutritional 6 4 Underweight prevalence 20.3 per cent status 7 Stunting prevalence 22.4 per cent 8 Wasting prevalence 6.4 per cent Breastfeeding 45 Timely initiation of breastfeeding 47.7 per cent 15 Exclusive breastfeeding rate of 0-5 months 40.8 per cent 16 Continued breastfeeding rate at 12-15 months 92.3 per cent at 20-23 months 53.2 per cent 17 Timely complementary feeding rate 43.8 per cent 18 Frequency of complementary feeding 39 per cent 19 Adequately fed infants - 0-11 months 40 per cent Salt iodization 41 Iodized salt consumption 6.6 per cent Vitamin A 42 Vitamin A supplementation (under-fives) 80.1 per cent 43 Vitamin A supplementation (post-partum mothers) 78 per cent Low birth 9 Low birth weight infants 19.9 per cent weight 10 Infants weighed at birth 51.8 per cent CHILD HEALTH Immunization 25 Tuberculosis immunization coverage 96.6 per cent 26 Polio immunization coverage 87.6 per cent 27 DPT immunization coverage 86.8 per cent 28 15 Measles immunization coverage 92.4 per cent 31 Fully immunized children 74.5 per cent 29 Hepatitis B immunization coverage 79.6 per cent 30 Yellow fever immunization coverage 83.5 per cent Tetanus toxoid 32 Neonatal tetanus protection 75.6 per cent Care of illness 33 Use of oral rehydration therapy (ORT) 48.2 per cent 34 Home management of diarrhoea 29.4 per cent 35 Received ORT or increased fluids, and continued feeding 37.9 per cent 23 Care seeking for suspected pneumonia 68.9 per cent 22 Antibiotic treatment of suspected pneumonia 61.3 per cent Solid fuel use 24 29 Solid fuel 90.9 per cent Malaria 36 Household availability of insecticide-treated nets (ITNs) 49.5 per cent 37 22 Under-fives sleeping under insecticide-treated nets 49.0 per cent 38 Under-fives sleeping under mosquito nets 63.0 per cent 39 22 Antimalarial treatment (under-fives) 52.4 per cent 40 Intermittent preventive malaria treatment (pregnant women) 32.5 per cent Topic MICS MDG Indicator Indicator Number Number Indicator Value Summary Table of Findings Multiple Indicator Cluster Survey (MICS) and Millennium Development Goals (MDGs) Indicators, The Gambia, 2005/2006 viii • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Topic MICS MDG Indicator Indicator Number Number Indicator Value Source and 96 Source of supplies (from public sources) cost of supplies Insecticide treated nets per cent Antimalarials 66.9 per cent Antibiotics 65.0 per cent Oral rehydration salts 82.7 per cent 97 Cost of supplies (median costs) Insecticide treated nets Public sources 60.0 Dalasis private sources 137.9 Dalasis Antimalarials Public sources 25.0 Dalasis private sources 85.0 Dalasis Antibiotics Public sources 34.6 Dalasis private sources 68.1 Dalasis Oral rehydration salts Public sources 10.0 Dalasis private sources 10.0 Dalasis ENVIRONMENT Water and 11 30 Use of improved drinking water sources 85.1 per cent Sanitation 13 Water treatment 3.0 per cent 12 31 Use of improved sanitation facilities 84.2 per cent 14 Disposal of child's faeces 81.2 per cent Security of 93 Security of tenure 45.6 per cent tenure and 94 Durability of housing 1.8 per cent durability of 95 32 Slum household 70.2 per cent housing REPRODUCTIVE HEALTH Maternal and 20 Antenatal care provided by skilled personnel 97.8 per cent newborn health 44 Content of antenatal care Blood test taken 89.7 per cent Blood pressure measured 96.6 per cent Urine specimen taken 86.7 per cent Weight measured 97.5 per cent 4 17 Skilled attendant at delivery 56.8 per cent 5 Institutional deliveries 54.5 per cent CHILD DEVELOPMENT Child 46 Support for learning 46.9 per cent Development 47 Father's support for learning 20.6 per cent 51 Non-adult care 17.4 per cent The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • ix Topic MICS MDG Indicator Indicator Number Number Indicator Value EDUCATION Education 52 Pre-school attendance 19.7 per cent 53 School readiness 27.3 per cent 54 Net intake rate in primary education 29.9 per cent 55 6 Net primary school attendance rate 61.0 per cent 56 Net secondary school attendance rate 36.5 per cent 57 7 Children reaching grade five 96.6 per cent 58 Transition rate to secondary school 56.2 per cent 59 7b Primary completion rate 73.6 per cent 61 9 Gender parity index primary school 1.03 ratio secondary school 0.87 ratio Literacy 60 8 Adult literacy rate for females aged 15-24 years 43.1 per cent CHILD PROTECTION Birth 62 Birth registration 55.1 per cent registration Child labour 71 Child labour 24.7 per cent 72 Labourer students 64.5 per cent 73 Student labourers 24.2 per cent Child discipline 74 Child discipline Any psychological/physical punishment 82.4 per cent Early marriage 67 Marriage before age 15 9.9 per cent and polygyny Marriage before age 18 48.7 per cent 68 Young women aged 15-19 currently married/in union 25.1 per cent 70 Polygyny 43.6 per cent 69 Spousal age difference, 10 years and above Women aged 15-19 59.4 per cent Women aged 20-24 56.5 per cent Female genital 66 Approval for FGM/C 71.1 per cent mutilation/ 63 Prevalence of female genital mutilation/cutting Cutting (FGM/C) 78.3 per cent Like daughter to undergo FGM/C 72.9 per cent Domestic 100 Attitudes towards domestic violence 74.0 per cent violence x • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report HIV/AIDS, SEXUAL BEHAVIOUR, AND ORPHANED AND VULNERABLE CHILDREN HIV/AIDS 82 19b Comprehensive knowledge about HIV prevention 39.2 per cent knowledge among young people and attitudes 89 Knowledge of mother- to-child transmission of HIV 66.7 per cent 86 Attitude towards people with HIV/AIDS (no discrimination) 16.3 per cent 87 Women who know where to be tested for HIV 54.7 per cent 88 Women who have been tested for HIV 13.6 per cent 90 Counselling coverage for the prevention of mother-to-child transmission of HIV 45.4 per cent 91 Testing coverage for the prevention of mother-to-child transmission of HIV 20.8 per cent Sexual 84 Women aged 15-19 who had sex before age 15 3.9 per cent behaviour 92 Age-mixing among sexual partners 51.2 per cent 83 19a Condom use with non-regular partners 54.3 per cent 85 Higher risk sex in the last year 16.0 per cent Support to 75 Prevalence of orphans 8.7 per cent orphaned 78 Children's living arrangements 15.9 per cent and vulnerable 76 Prevalence of vulnerable children 12.6 per cent children 77 20 School attendance of orphans versus non-orphans 0.87 Ratio 79 Malnutrition among children orphaned and made vulnerable by HIV/AIDS (Ratio of OVC to non-OVC) 1.10 Ratio 80 Early sex among children orphaned and made vulnerable by HIV/AIDS (Ratio of OVC to non-OVC) 0.80 Ratio Topic MICS MDG Indicator Indicator Number Number Indicator Value The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • xi LIST OF TABLES Table HH.1 Results of household and individual interviews.78 Table HH.2 Household age distribution by sex.79 Table HH.3 Household composition .80 Table HH.4 Women's background characteristics.81 Table HH.5 Children's background characteristics .82 Table CM.1 Child mortality.83 Table CM.2 Children ever born and proportion dead.83 Table NU.1 Child malnourishment .84 Table NU.2 Initial breastfeeding.85 Table NU.3 Breastfeeding .86 Table NU.4 Adequately fed infants .87 Table NU.5 Iodized salt consumption .88 Table NU.6 Children's Vitamin A supplementation.89 Table NU.7 Post-partum mothers'Vitamin A supplementation .90 Table NU.8 Low birth weight infants.91 Table CH.1 Vaccinations in first year of life .92 Table CH.1c Vaccinations in first year of life (continued) .92 Table CH.2 Vaccinations by background characteristics .93 Table CH.2c Vaccinations by background characteristics (continued) .94 Table CH.3 Neonatal tetanus protection.95 Table CH.4 Oral rehydration treatment.96 Table CH.5 Home management of diarrhoea .97 Table CH.6 Care seeking for suspected pneumonia.98 Table CH.7 Antibiotic treatment of pneumonia.99 Table CH.7A Knowledge of the two danger signs of pneumonia .100 Table CH.8 Solid fuel use .101 Table CH.9 Solid fuel use by type of stove or fire.102 Table CH.10 Availability of insecticide treated nets.103 Table CH.11 Children sleeping under bednets .104 Table CH.12 Treatment of children with anti-malarial drugs.105 Table CH.13 Intermittent preventive treatment for malaria .106 Table CH.15 Source and cost of supplies for antimalarials.107 Table CH.16 Source and cost of supplies for antibiotics.108 Table CH.17 Source and cost of supplies for oral rehydration salts .109 Table EN.1 Use of improved water sources .110 Table EN.2 Household water treatment .111 Table EN.3 Time to source of water .112 Table EN.4 Person collecting water .113 Table EN.5 Use of sanitary means of excreta disposal .114 Table EN.6 Disposal of child's faeces .115 Table EN.7 Use of improved water sources and improved sanitation.116 Table EN.8 Security of tenure .117 Table EN.9 Durability of housing.118 Table EN.10 Slum housing.119 xii • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table RH.3 Antenatal care provider .120 Table RH.4 Antenatal care .121 Table RH.5 Assistance during delivery.122 Table CD.1 Family support for learning .123 Table CD.3 Children left alone or with other children .124 Table ED.1 Early childhood education .125 Table ED.2 Primary school entry.126 Table ED.3 Primary school net attendance ratio .127 Table ED.4 Secondary school net attendance ratio.128 Table ED.4W Secondary school age children attending primary school.129 Table ED.5 Children reaching Grade 5.130 Table ED.6 Primary school completion and transition to secondary education.131 Table ED.7 Education gender parity.132 Table ED.8 Adult literacy.133 Table CP.1 Birth registration .134 Table CP.2 Child labour.135 Table CP.3 Labourer students and student labourers .136 Table CP.4 Child discipline.137 Table CP.5 Early marriage and polygyny.138 Table CP.6 Spousal age difference.139 Table CP.7 Female genital mutilation/cutting (FGM/C).140 Table CP.8 Female genital mutilation/cutting (FGM/C) among daughters.141 Table CP.9 Attitudes towards domestic violence.142 Table HA.1 Knowledge of preventing HIV transmission.143 Table HA.2 Identifying misconceptions about HIV/AIDS.144 Table HA.3 Comprehensive knowledge of HIV/AIDS transmission.145 Table HA.4 Knowledge of mother-to-child HIV transmission.146 Table HA.5 Attitudes towards people living with HIV/AIDS .147 Table HA.6 Knowledge of a facility for HIV testing.148 Table HA.7 HIV testing and counselling coverage during antenatal care.149 Table HA.8 Sexual behaviour that increases risk of HIV infection.150 Table HA.9 Condom use at last high-risk sex.151 Table HA.10 Children's living arrangements and orphanhood .152 Table HA.11 Prevalence of orphanhood and vulnerability among children .153 Table HA.12 School attendance of orphaned and vulnerable children.154 Table HA.14 Malnutrition among orphans and vulnerable children.154 Table HA.15 Sexual behaviour among young women by orphanhood and vulnerability status due to AIDS.154 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • xiii List of Figures Figure HH.1: Age and sex distribution of household population . . . . . . . . . . . . . . . . . . . . . . .16 Figure CN 1 Age and sex distribution, Census 2003, The Gambia . . . . . . . . . . . . . . . . . . . . .16 Figure CM.1: Under-5 mortality rates by background characteristics . . . . . . . . . . . . . . . . . . . .20 Figure CM.2: Trend in under-5 mortality rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 Figure NU.1: Percentage of children under-5 who are undernourished . . . . . . . . . . . . . . . . . . .24 Figure NU.2: Percentage of mothers who started breastfeeding within one hour and within one day of birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26 Figure NU.3: Infant feeding patterns by age: Percentage distribution of children aged under 3 years by feeding pattern and age group . . . . . . . . . . . . . . . . . . . . . . . . .27 Figure NU.5: Percentage of households consuming adequately iodized salt . . . . . . . . . . . . . . .28 Figure NU.8: Percentage of infants weighing less than 2500 grams at birth . . . . . . . . . . . . . . .31 Figure CH.1: Percentage of children aged 12-23 months who received the recommended vaccination by 12 months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33 Figure CH.3: Percentage of women with a live birth in the last 12 months who are protected against neonatal tetanus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35 Figure CH.4: Percentage of children aged 0-59 months with diarrhoea who received oral rehydration treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 Figure CH.5: Percentage of children aged 0-59 months with diarrhoea who received ORT or increased fluids, and continued feeding . . . . . . . . . . . . . . . . . . . . . . . . .37 Figure EN 1: Percentage distribution of household members by source of drinking water . . .40 Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70 Figure HA.2: Percentage of young women aged 15-19 and 20-24 who had sex befor ages 15 and 18 respectively and percentage of women aged 20-24 who had sex with a man 10 or years older . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73 xiv • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Acknowledgements The Declaration and Plan of Action adopted at the World Summit for Children, held in New York in September 1990, established a set of goals for the decade 1990 to 2000. With regard to this, a study was first conducted in 1996, another similar or even more comprehensive one was conducted in May/June 2000 and a third one was conducted in December 2005/January 2006. These studies were aimed at monitoring progress made by The Gambia towards the attainment of the mid-decade and end-decade goals set during the above-mentioned Summit. By the ratification of the CRC and CEDAW, The Gambia, like many UN member states, commit- ted itself to the improvement of the plight of children and women by the year 2000. The two conventions are not only comprehensive and holistic in nature but also have a high impact on the plight of children and women when implemented simultaneously. The social and welfare status of both women and children is expected to be markedly improved, thereby enhancing sustainable development in each member state. To evaluate the efforts towards implementation of these conventions, UNICEF in collaboration with other UN agencies such as the WHO, UNFPA and the US Public Health Services developed the Multiple Indicator Cluster Survey (MICS). The MICS is a household survey that examines the behaviour of a comprehensive set of indicators related to the welfare of children and women. The module development for the survey captured data on households (economy), education, child labour, water and sanitation, salt iodization and health, ie oral rehydration solution (ORS), child mortality, tetanus toxoid, maternal and newborn health, HIV/AIDS, Vitamin A supplementation, breastfeeding care of illness, malaria, immunization and anthropometry, etc. In 2005/2006, the Government of The Gambia in collaboration with UNICEF and the World Bank conducted the third MICS to monitor progress made at end-decade as articulated in the National Plan of Action. The survey was conducted through inter-agency collaboration with the Central Statistics Department (CSD), now called Gambia Bureau of Statistics (GBoS), acting as the lead agency. Collaborating agencies included the: • Department of State for Health and Social Welfare(DoSHSW) • Department of State for Basic and Secondary Education (DoSBSE) • Department of Community Development • Women's Bureau • Department of Water Resources • Department of Social Welfare • Gambia Family Planning Association (GFPA). The prototype questionnaires developed by UNICEF were used with some modification to suit local conditions. However, in The Gambia a module on knowledge on rehydration solutions was added to determine the rate at which women know how to prepare the salt-sugar solution (SSS), as an oral rehydration solution (ORS) packet may not be available and/or affordable at certain times when needed. I wish to express my gratitude to all persons and agencies that participated in the different phases of the survey. Our sincere thanks go to UNICEF, Banjul Office, and the World Bank for providing The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • xv the much-needed financial support for the conduct of the MICS III. I am also indebted to the staff of GBoS, namely, Alieu Sarr (Demographer and Survey Coordinator), Edrissa Ceesay (Statistician/Programmer), Wally Ndow, Baba Suwareh and Lolley Jallow-Kah (Programmer). Thanks also go to Alieu Saho for his administrative support and guidance to the field staff. I am also grateful to Sheriffo Sonko, Project Officer, Monitoring and Evaluation, UNICEF, Banjul Office, for editing and providing useful comments on the final report as well as technical and logistical support throughout the design and conduct of the survey. Finally, my sincere thanks go to Ngagne Diakhaté, Project Officer, Statistics/Monitoring, DPP/SI, New York Headquarters, for his technical support in data processing and in solving the structural problems and inconsistencies in our dataset at the analysis stage. Throughout the numerous MICS workshops, Mr Diakhaté was quite supportive to the Gambian team. Again, during a mission to The Gambia in the early stages of the data processing, Messrs Diakhaté and Abdoulaye Sadio, Regional Adviser, Monitoring and Evaluation, also provided useful technical backstopping and advice on the data. For this, I am also grateful to Mr Sadio. I hope that scholars, researchers, institutions, planners and decision-makers will find the MICS III results useful. Alieu S M Ndow Statistician General October 2007 xvi • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report EXECUTIVE SUMMARY The Gambia Multiple Indicator Cluster Survey 2005/2006 is a nationally representative survey of households, children and women. The main objectives of the survey are to provide up-to-date information for assessing the situation of children and women in The Gambia. Another objective is to furnish data needed for monitoring progress towards the goals established at the World Summit for Children and the Millennium Development Goals as a basis for future action. The findings of this survey would also be utilized by government and development partners in planning and monitoring programme implementation. Infant and Under-5 Mortality • The data from the MICS III 2005/2006 show that the infant and under-5 mortality rates were 93 and 131 per 1, 000 respectively. These figures represent an impressive fall in mortality indicators compared to MICS II, which showed 98 and 141 per 1,000 respectively for infant and under-5 mortality. Education • Sixty-one per cent of children of primary school age in The Gambia are attending primary school. Although over the past five years primary school attendance in the Basse LGA has increased from 29 per cent to 46 per cent, it is still among the lowest attendance rates. The lowest primary school attendance (41 per cent) is found in Kuntaur LGA. At the national level, there is a slight difference between male (60 per cent) and female (62 per cent) primary school attendance. • Almost all (97 per cent) of the children who enter the first grade of primary school eventually reach Grade 5. • Literacy level among women aged 15-24 is 43 per cent. The highest level is found in Banjul and the lowest in Basse and Kuntaur, each of which registered less than 20 per cent. Water and Sanitation • Eighty-five per cent of the population has access to improved drinking water - 91 and 81 per cent in the urban1 and rural areas respectively. Apart from Kanifing, which has the highest (91 per cent), the differences among the remaining LGAs are small. • Eighty-four per cent of the population of the country live in households with sanitary means of excreta disposal. The traditional pit latrine is inclusive and this, in most places of the country, is not regarded as a sanitary means of excreta disposal. Child Malnutrition • Twenty per cent of children under-5 in the country are underweight or too thin for their age. Twenty-two per cent of the children are stunted or too short for their age and six per cent are wasted or too thin for their height. 1 See Appendix 7 for definition and list of urban settlements The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • xvii • Children whose mothers have secondary or higher education are the least likely to be under- weight and stunted. • Children of women in the richest quintile are least likely to be underweight and stunted. Breastfeeding • Approximately 53 per cent of children aged less than four months are exclusively breastfed. At age 6-9 months, 44 per cent of children receive breast milk and solid or semi-solid foods. By age 20-23 months, about half (53 per cent) of the children continue to breastfeed. Salt Iodization • About 7 per cent of households in The Gambia have adequately iodized salt, a level considera- bly lower than the recommended level. The percentage of households with adequately iodized salt ranges from 1 per cent in Banjul to 41 per cent in the Basse LGA. Vitamin A Supplementation • Within the six months prior to the MICS, 80 per cent of children aged 6-59 months received a high dose of Vitamin A supplement and a further 4 per cent received the Vitamin A supplement six months prior to that. • About 78 per cent of mothers with a birth in the last 2 years before the MICS received a high dose of Vitamin A supplement within eight weeks of the birth. Low Birth Weight • Approximately 20 per cent of infants were estimated to weigh less than 2,500 grams at birth. Of the total number of births only 52 per cent were weighed. Immunization Coverage • About 98 per cent of children aged 12-23 months received a BCG vaccination by the age of 12 months and the first dose of DPT was given to 93 per cent. The second and third doses of DPT were respectively given to 90 and 82 per cent of children aged 12-23 months. • Similarly, 93 per cent of children received Polio 1 by age 12 months and this declined to 83 per cent for the third dose. • The coverage for measles was 85 per cent among children vaccinated by 12 months of age. • Over half, 55 per cent of the children, had all nine antigens as recommended in the first 12 months of life. • There are small differences of vaccination coverage across sex, education and wealth quintiles (household wealth status). Diarrhoea • About 19 per cent of children aged 0-59 months had diarrhoea in the last two weeks prior to the date of interview of the survey. Of these, 37.9 per cent received one or more of the recom- mended home treatments (ie, were treated with ORS or RHF) and continued feeding. xviii • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Acute Respiratory Infection • Six per cent of under-5 children had an acute respiratory infection in the two weeks prior to the survey. About 69 per cent of these children were taken to an appropriate health provider. Malaria • In The Gambia, 63 per cent of under-5 children slept under a bednet the night prior to the survey interview. However, about 49 per cent of these bednets were impregnated with insecticide. • Approximately 65 per cent of children with a fever in the two weeks prior to the MICS interview were given Paracetamol/Panadol to treat the fever and 58 per cent were given Chloroquine while 13 per cent were given Fansidar. Sixty-three per cent of these children were given any appropriate anti-malarial drug and 48 per cent received the drug within 24 hours of the onset of symptoms. HIV/AIDS • Sixty-five per cent of women aged 15-49 know all three of the main ways to prevent HIV trans- mission - having only one faithful uninfected sex partner, using a condom every time, and abstaining from sex. • Forty-five per cent of women aged 15-49 correctly identified two most common misconceptions of HIV transmission - that HIV can be transmitted through supernatural means, that it can be transmitted through mosquito bites, and that a healthy looking person cannot be infected. • Fifty-five per cent of women aged 15-49 know a place to get tested for AIDS and about 14 per cent have been tested. • The percentage of women who have sufficient knowledge of preventing HIV transmission tends to increase with the level of education but is higher among the poorest than the richest quintiles. Antenatal Care • Almost all pregnant women (99 per cent) receive antenatal care (ANC) one or more times during pregnancy. Assistance at Delivery • A doctor, nurse, or midwife delivered about 57 per cent of births occurring in the year preceding the MICS. This percentage is highest in Banjul (95 per cent) and lowest in Kuntaur (28 per cent). Overall, 56.8 per cent of births occurring in the two years preceding the survey were delivered by skilled personnel and 54.5 per cent of the births were delivered in health facilities. The level of education and wealth quintiles are highly correlated to assistance at delivery by skilled personnel. Birth Registration • Births of 55 per cent of under-5 children have been registered. Birth registration coverage increases with age of child. Coverage is influenced by maternal education and wealth index quintile. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • xix Orphanhood and Living Arrangements of Children • Overall, 62 per cent of children aged 0-14 live with both parents. This proportion is highest for the poorest households and lowest for the richest households. Children who do not live with a biological parent comprise 16 per cent. This percentage increases with the age of the child; it is lowest for the poorest households and highest for the richest households. Children who have one or both parents dead account for 9 per cent of all children aged 0-14. Child Labour • About 25 per cent of children aged 5-14 are engaged in child labour. About 21 per cent of the children aged 5-14 work for family business. • About 2 per cent of these children are engaged in domestic tasks, such as cooking, fetching water, and caring for other children for 28 hours or more in a week. xx • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report The Gambia The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 1 1. INTRODUCTION Background This report is based on The Gambia Multiple Indicator Cluster Survey, conducted in 2005/2006 by the Central Statistics Department, now called The Gambia Bureau of Statistics, in collaboration with the: • Department of State for Basic and Secondary Education • Department of State for Health and Social Welfare • National Nutrition Agency • Women's Bureau • Gambia Family Planning Association • Department of Community Development Financial and technical support was provided by UNICEF and the World Bank. The survey provides valuable information on the situation of children and women in The Gambia, and was based, in large part, on the need to monitor progress towards goals and targets emanating from recent international agreements: the Millennium Declaration, adopted by all 191 United Nations member states in September 2000, and the Plan of Action of A World Fit for Children, adopted by 189 member states at the United Nations Special Session on Children in May 2002. Both of these commitments build upon promises made by the international community at the 1990 World Summit for Children. 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 disaggregate data, including by sex, age and other relevant factors that may lead to disparities, and support a wide range of child-focused research. We will enhance international cooperation to support statistical capacity-building efforts and build community capacity for monitoring, assessment and planning.” (A World Fit for Children, paragraph 60) “…We will conduct periodic reviews at the national and 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: 2 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Introduction “… 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.” Population Policy Faced with largely unfavourable economic conditions, rapid deforestation aggravated by rapid population growth, the Government of The Gambia decided to adopt a National Population Policy in 1992. The policy, designed to curb the rapid rate of population growth, has the overall goal of improving the quality of life and raising the standard of living of the population. This policy was first revised in 1996 and then later in 2006 to reflect the current demographic and socio-economic realities of the country. The revision of the policy was quite participatory and the strategies outlined for the attainment of the objectives took a cue from the experience gained from the implementation of past programmes. The 2007-2015 Policy aims at addressing current population trends which are not considered commensurable with sustainable socio-economic and environmental development. With the suc- cessful implementation of programmes planned under the current policy, it is envisaged that this will result in changes in population trends and address the shortcomings of the past policies, and fill in gaps emerging from new issues in national development strategies. The overall goals of the 2007-2015 National Population Policy are the same as those of the 1992 and 1996 policies, which sought to improve the quality of life by raising the standard of living of the population. In view of the crosscutting nature of some of the activities of the population programme, an attempt has been made to harmonise the National Population Policy with other policies. Key among these are the National Education Policy, the Gambia Environment Action Plan, the Housing, Health and Family Planning policies. The major targets of the National Population Policy are identified as: 1 To reduce the present annual population growth rate of 2.7 per cent (2003 Census) to 2.0 per cent by 2013 2 To reduce the proportion of girls who marry before the age of 18 years by 30 per cent by 2009 and by 80 per cent by 2015 3 To reduce the proportion of girls below 20 years and women below 40 years being pregnant to 50 per cent by 2010 and to 80 per cent by 2015 4 To increase the proportion of deliveries attended by skilled birth attendants to 60 per cent by 2010 5 To achieve an average birth spacing of at least two years for all birth intervals by 2015 6 To increase the gross enrolment ratio (7-15 years) from 91 per cent in 2002/2003 to 100 per cent by 2015 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 3 Introduction 7 To improve the completion rate from 80 per cent in 2002/2003 to 100 per cent by 2015 8 To achieve full immunization coverage of 100 per cent of infants (0-11 months) by 2015 9 To increase the life expectancy of the population from its current level of about 64 years to 70 years by 2013 and to 75 years by 2015 10 To reduce the HIV 1 prevalence rate among pregnant women aged 15-49 from 1.1 per cent in 2005 to less than 1 per cent by 2015 11 To reduce the under-5 mortality rate from 99 per 1,000 live births in 2003 to 54 per 1000 live births by 2015 12 To reduce the rate of urban population growth from 5.9 per cent in 2003 to 4 per cent by 2010 13 To increase the modern contraceptive prevalence rate from the estimated rate of 13.4 per cent in 2001 to 20 per cent by 2009 and 30 per cent by 2015 14 To reduce the maternal mortality rate from 730 per 100,000 live births in 2001 to 260 per 100,000 live births by 2015 15 To reduce the total fertility rate from 5.4 in 2003 to 4.5 by 2015 16 To reduce the infant mortality rate from 75 per 1,000 in 2003 to 56 per 1,000 by 2015 17 To reduce the crude death and birth rates from 9 and 41 per 1,000 respectively in 2003 to 5 and 37 per 1,000 respectively by 2015 18 To reduce the unemployment rate from 6 per cent in 2003 to 4 per cent by 2015. A key strategy identified in the policy geared towards the achievement of these goals is improved access to health services throughout the country and the introduction of measures towards the improvement of the quality of health services in general. Improvements in the area of maternal and child health services have been particularly singled out for attention. Education cannot be divorced from population issues; hence the policy identifies strategies to improve educational attainment, particularly for girls. Other strategies developed relate to youth and women's empowerment, environmental development, agriculture and food security and HIV/AIDS, etc. Health Situation The health sector in The Gambia has, over the years, been under great pressure due to a number of factors, namely: • high population growth rate • inadequate financial and logistic support • shortage of adequate and appropriately trained health staff • high attrition rate • lack of an efficient and effective referral system. Poverty and ignorance have, in some instances, led to inappropriate health seeking behaviour and contributed to ill health. These factors have seriously constrained efforts to reduce morbidity and mortality rates in the country. A considerable number of indices in this report may be affected by the state of health of the population in general and the state of health services in the country in particular. It would be useful, therefore, to provide some information on the state of health of The Gambia in this chapter for a better understanding of some of the findings of this study. 4 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Introduction Health Care Delivery System Until the adoption of the Primary Health Care (PHC) strategy in 1979, the health care delivery system in The Gambia was largely centralized with the only government referral hospitals in Banjul and Bansang. The PHC strategy was adopted with the main aim of making health care more accessible and affordable to the majority of Gambians. A key target of the PHC was mainly rural settlements with a population of over 400 persons. For each PHC village, a village health worker (VHW) and a traditional birth attendant (TBA) are trained to provide primary health care in their communities. The village health workers (VHWs) are assigned the role of maintaining the supply of essential drugs, the provision of outpatient care, making home visits and carrying out health education programmes. The traditional birth attendants assist in deliveries, identify and refer at-risk mothers to health facilities at the tertiary level. At the tertiary level, health services are currently provided by the four government hospitals. These hospitals are located in Banjul, Bwiam, Farafenni and Bansang. The Royal Victoria Teaching Hospital (RVTH), located in Banjul, is the main referral hospital offering specialist consultant services. The hospital operates a pharmacy, laboratory services and a polyclinic, which provides secondary level health services to Banjul and the surrounding urban area. Farafenni Hospital provides referral services to people of the North Bank Region and adjacent rural areas. Although the hospital provides most specialist services, it is yet to be fully operational. Sulayman Junkung Hospital at Bwiam also provides referral services to surrounding villages in both the Western Region and some parts of the Lower River Region. Bansang Hospital, the oldest rural hospital, serves the eastern part of the country with the catchment area covering about a third of the country's population. In addition to operating as a referral hospital, it also has an outpatient department. Health services obtained by government-funded health institutions are complemented by services provided by the private sector and non-governmental organizations (NGOs). Individuals and NGOs have established a number of health facilities, mainly in the urban areas. Probably due to the higher costs involved in the provision of health services by these sectors, only a small proportion of the population is able to afford their services, hence the increasing demand for services from public-funded health facilities. Human Resources In the light of marked improvements both in terms of number of service delivery points and the quality of services, there has been a corresponding increase in the number of technical and professional health personnel. The public health services depend to a large extent on expatriate doctors, the majority of whom are Cubans and Nigerians provided through technical assistance. The increase in the number of doctors serving in the rural areas might have had the most impact, particularly with the posting of Cuban doctors to areas that have never been served by a resident doctor. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 5 Introduction A critical problem the health sector has been facing for many years now is the retention of trained nurses in the system. Nurses have been leaving the service in large numbers and DoSHSW has been facing the problem of trying to replenish those leaving through training. A large number of nurses have, over the years, been attracted to the higher income levels for nurses in Europe and the USA, which has in some instances caused a shortage of nurses for the health sector. Major Challenges of the Health Care System Notwithstanding the significant gains made in the health sector over the years, the sector continues to be faced with major challenges. With a rapidly growing population and increasing pressure on limited resources for the health sector, the sector has, over the years, struggled to meet the demand for services. Inadequate financial and logistical support, shortage of adequately and appropriately trained health staff, high staff attrition and an inefficient referral system have, over the years, aggravated the problems of the sector. These problems have curtailed the gains made in reducing morbidity and mortality in the country. Specialist services are still in high demand in The Gambia. Since most specialists are non-Gambian and usually on technical assistance, the withdrawal of such assistance could adversely affect the quality of services in the country. This state of affairs renders the health service delivery system of the country quite vulnerable. In addition to vulnerability due to reliance on non-Gambian health specialists, health funding in the country is heavily dependent on donor assistance. This raises issues of sustainability in the light of evidence of donor fatigue in the recent past. The introduction of a course in medicine at the University of The Gambia provides a ray of hope in the provision of much-needed trained medical personnel. The first batch of 11 medical doctors graduated from the university in 2006. Notwithstanding the potential of the university to train a sizeable number of doctors and other health personnel, the health sector continues to be faced with the perennial problem of high staff attrition which has aggravated the problem of staff shortages. Health Policy The National Health Policy Framework, 2007-2020, “Health is Wealth”, seeks to address the common health desires of the population through a number of initiatives both in the area of preventive and curative health services. With a vision to improve the health of all Gambians with a per capita income of US$ 1,500 by 2020, the policy has a mission to promote and protect the health of the population. It seeks to promote equity in access and affordability of quality services, maintain ethics and standards, promote health system reforms, and improve staff retention and client satisfaction. Cognizant of the multi-dimensional nature of health and the potential for health status to be influenced by a variety of factors, a number of areas have been identified in the policy that would collectively have the potential to impact on the health status. Under the current policy, areas identified for interventions relate to health care programmes and clinical care delivery, health system streng- thening and capacity development, and technical support services. The policy recognizes the need for community participation and the contribution of traditional medicine to the attainment of the national health goals. 6 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Introduction The major targets of the health policy have been identified as follows: 1 To reduce infant mortality rate from 75 per 1000 to 28 per 1000 by 2015 2 To reduce under-5 mortality rate from 99 per 1000 t0 43 per 1000 by 2015 3 To reduce maternal mortality ratio from 730 per 100,000 to 150 per 100,000 by 2015 4 To increase life expectancy at the national level to from 63.4 to 69 years by 2015 5 To increase life expectancy for women from 65 years to 70 years by 2015 6 To increase life expectancy for men from 62.4 years to 68 years by 2015 7 To reduce malaria incidence by 50% by 2015 8 To reduce HIV/AIDS prevalence (HIV 1 from 1.1% to 0.5% and HIV 2 from 0.7% to 0,1% by 2015) 9 To reduce total fertility rate from 5.4 to 4.6 by 2015 10 To reduce tuberculosis incidence rate from 120 per 100,000 to 60 per 100,000 by 2015 11 To reduce morbidity due to non communicable diseases by 10% by 2015 (2007 base) 12 To reduce morbidity due to other communcable diseases by 50% (2007 base) Education Policy 2004-2015 The aims and objectives of education in The Gambia are synchronized with the education-related Millennium Development Goals (MDGs), Education for All (EFA) goals, the New Partnership for African Development (NEPAD) education-related goals and the country's Poverty Reduction Strategy Paper (PRSP). The policy priorities are identified to allow for the growth of educational opportunities and improve the effectiveness of education at all levels, from early childhood development (ECD) to higher education. Based on these principles and the economic development prospects of the country, the basic aims of the Education Policy are: 1 To promote a broad-based education at the basic level for lifelong learning and training 2 To mainstream gender in the creation of opportunities for all to acquire literacy, livelihood skills and the utilization of these skills in order to earn a living and become economically self-reliant members of the community 3 To develop the physical and mental skills, which will contribute to nation building - economi- cally, socially and culturally in a sustainable environment 4 To encourage creativity and the development of a critical and analytical mind The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 7 Introduction 5 To further an understanding and appreciation of the contribution of science and technology to development 6 To cultivate sound moral and ethical values in the development of life skills 7 To develop a healthy body and an appreciation of the value of a healthy mind in response to life threatening diseases like HIV/AIDS, malaria and tuberculosis 8 To create an awareness of the importance of peace, democracy and human rights, duties and responsibilities of the individual in fostering these qualities 9 To foster an appreciation of and respect for the cultural heritage of The Gambia 10 To promote a sense of patriotism: service, loyalty, integrity and dedication to the nation and humanity. Considering the high population growth rate, the cost of education in relation to the poor and the current share of education in the government budget, the policy has been prioritized in the follo- wing five components aimed at providing equitable access to high quality education to the popula- tion of the country: Access to Education; Quality Education; Vocational and Technical Education; Tertiary and Higher Education. Policy Objectives Given the above priority areas and key strategies in mind, the policy seeks to attain the following objectives: 1 To increase the basic education GER to 100 per cent by 2015, taking into account enrolment in the Madrassas 2 To increase the completion rates in basic education to 100 per cent by 2015 3 To increase the supply of trained teachers and make more efficient use of the teaching force by maintaining the pupil/teacher ratio at 45:1 at the basic level 4 To increase double-shift classes from 25 per cent to 32 per cent by 2015 across all levels 5 To phase out double-shift teachers by 2015 6 To maintain multi-grade teaching in a combined class size not exceeding 40 7 To increase the share of enrolment of girls to 50 per cent of total enrolment at the levels of basic and secondary education by 2015 8 To improve the quality of teaching and learning at all levels 9 To improve learning outcomes at all levels - at least 80 per cent of students will attain minimum grade competencies/mastery levels by 2015 8 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Introduction 10 To increase the enrolment ratio of early childhood by 50 per cent especially in the rural areas by 2015 11 To increase access, for adults and out-of-school youth, to functional literacy and numeracy pro- grammes in order to have the illiterate population by 2015 12 To provide marketable and social skills to enable individuals to deal effectively with the demands and challenges of everyday life 13 To introduce the teaching of the five most commonly used languages - Mandinka, Wollof, Fula, Jola and Serahule - at the basic, senior secondary, higher education levels as subjects 14 To increase the transition rate from Grades 9 to 10 to a minimum of 50 per cent 15 To increase the quota of graduate teachers of Gambian nationality at the level of senior secon- dary from 26 per cent to 100 per cent by 2015 16 To strengthen the institutional and management capacity of the Technical, Vocational Education and Training (TVET) system 17 To establish a sound financial basis for the long-term development and sustainability of TVET 18 To increase cost sharing and cost recovery at post-secondary training institutions 19 To develop and strengthen public - private partnership in the financing of higher education 20 To institutionalize access programmes for higher education, especially for girls, particularly in science, mathematics and technology 21 To improve the organizational structure of the sector for efficient and effective service delivery. National Nutrition Policy The National Nutrition Agency (NaNA) is responsible for the implementation of the 2000-2004 National Nutrition Policy. The goal of the policy is to attain the basic nutritional requirements for the population. The policy also addresses issues that could impact on children's life, eg protecting, promoting and supporting breastfeeding, caring for the socio-economically deprived and nutritionally vulnerable and improving food security at national, community and household levels. The goal of the policy will be realized through the following seven priority substantive areas: • Protecting, promoting and supporting breastfeeding • Improving food security at the national, community and household levels • Improving food standards, quality and safety • Preventing and managing infectious diseases • Preventing and managing micro-nutrient malnutrition • Preventing and managing diet-related non-communicable diseases • Caring for the socio-economically deprived and nutritionally vulnerable. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 9 A key factor in the strategies to attain the policy objectives is an intensive information, education and communication (IEC) programme aimed at sensitizing stakeholders to the critical roles in the successful implementation of programmes identified to meet policy objectives. These programmes do not only target communities but also decision-makers who can influence policy formulation of relevance to the National Nutrition Policy. It is important to note that apart from the national policies discussed above, several laws exist that promote the interest of children and women. Below are the following policies and Acts. • The Children's Act, 2005 • National Youth Policy and Programme of Action • National Policy on the Advancement of Gambian Women • Early Childhood Development Policy Framework • Policy for the Prevention of Sexual Abuse of Students in Schools • Tourism Offences Act , 2005 Survey Objectives The Gambia Multiple Indicator Cluster Survey 2005/2006 has the following primary objectives: • To provide up-to-date information for assessing the situation of children and women in The Gambia • To furnish data needed for monitoring progress towards the goals established in the Millennium Declaration, the goals of A World Fit for Children (WFFC) and other internationally agreed upon goals as a basis for future action • To contribute to the improvement of data and monitoring systems in The Gambia and to strengthen technical expertise in the design, implementation and analysis of such systems. 10 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF /G am 00 59 5/ G ia co m o Pi ro zz i The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 11 2. SAMPLE AND SURVEY METHODOLOGY Sample Design The sample for The Gambia Multiple Indicator Cluster Survey was designed to provide estimates on a large number of indicators on the situation of children and women at the national level, for urban and rural areas, and for eight LGAs (LGAs): Banjul, Kanifing, Brikama, Mansakonko, Kerewan, Kuntaur, Janjangbureh and Basse. The LGAs were identified as the main sampling domains and the sample was selected in two stages. Within each LGA, at least 14 and at most 99 census enumeration areas were selected with probability proportional to size. After a household listing was carried out within the selected enumeration areas, a systematic sample of 6,175 households was drawn. The sample was stratified by LGA and urban and rural areas; it is not self-weighting. For reporting national level results, sample weights are used. A more detailed description of the sample design can be found in Appendix A. Questionnaires Three sets of questionnaires were used in the survey: • a household questionnaire which was used to collect information on all de facto household members, the household and the dwelling • a women's questionnaire administered in each household to all women aged 15-49 • an under-5 questionnaire, administered to mothers or caretakers of all children under-5 living in the household. The questionnaires included the following modules: Household Questionnaire • Household Listing • Education • Water and Sanitation • Household Characteristics • Security of Tenure/Durability of Housing • ITN/Malaria-related questions • Child Labour • Child Discipline • Salt Iodization The Questionnaire for Individual Women was administered to all women aged 15-49 living in the households, and included the following modules: • Child Mortality • Tetanus Toxoid • Maternal and Newborn Health • Marriage and Union • Security of Tenure • Attitudes Towards Domestic Violence • Female Genital Mutilation/Cutting • Sexual Behaviour • HIV Knowledge The Questionnaire for Children Under-5 was administered to mothers or caretakers of children under-5 years of age2 living in the households. Normally, the questionnaire was administered to mothers of under-5 children; in cases when the mother was not listed in the household roster, a primary caretaker for the child was identified and interviewed. The questionnaire included the following modules: • Birth Registration and Early Learning • Child Development • Vitamin A • Breastfeeding • Care of Illness • Malaria • Immunization • Anthropometry • Rehydration Solutions The questionnaires are based on the MICS III model questionnaire.3 Although translated versions of the questionnaires could not be produced for the survey, an attempt was made during the training of data collection personnel to translate all the questions into Mandinka, Fula and Wollof to ensure that there was a common approach to administering the questions to respondents in the local languages. All the questionnaires were pre-tested. Based on the results of the pre-test, modifications were made to the wording of some questions and translation problems identified and suitable alternatives discussed. A copy of The Gambia MICS III questionnaires is provided in Appendix F. In addition to the administration of questionnaires, fieldwork teams tested the salt used for cooking in the households for iodine content, and measured the weights and heights of under-5 children. Details and findings of these measurements are provided in the respective sections of this report. Training and Fieldwork Training for fieldwork staff lasted for 19 days in the Kanifing Municipality. Training included lectures on interviewing techniques and the contents of the questionnaires, and mock interviews between trainees to gain practice in asking questions. In addition, since the questionnaires were not translated into the local languages, it was deemed necessary to conduct interviews in the three main local languages - Mandinka, Fula and Wollof - to ensure that there was a common translation of the questions. Mock interviews were repeated in the local languages to ensure a thorough unders- tanding of the questionnaires. 12 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Sample and Survey Methodology 2 The terms “children under 5”, “children aged 0-4 years”, and “children aged 0-59 months” are used interchangeably in this report. 3 The model MICS III questionnaire can be found at www.childinfo.org, or in UNICEF, 2006 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 13 Sample and Survey Methodology Towards the end of the training period, trainees spent five days in practice interviewing in Kanifing, Brikama and Mansakonko LGAs. This exercise gave the MICS team the opportunity to assess the suitability of the questionnaires and also to gauge the workload based on the sample size of the survey. The data were collected by seven teams; each comprised five interviewers, one driver, one editor/measurer and a supervisor. Fieldwork began in December 2005 and ended in March 2006. There were numerous breaks during the data collection exercise which were due to the observance of religious feasts of the Eid El Adha (locally known as Tobaski), Christmas and the New Year. These breaks delayed the data collection exercise immensely. To avoid the additional cost of teams having to travel to their homes during the holidays, mostly to the Greater Banjul Area, it was decided to begin the data collection in this area. Data Processing Data were entered using the CSPro software. The data were entered on 18 microcomputers and carried out by 36 data entry operators and two data entry supervisors. In order to ensure quality control, all the questionnaires were double entered and internal consistency checks were performed. Procedures and standard programs developed under the global MICS III project and adapted to The Gambia's questionnaires were used throughout. Data processing began simultaneously with data collection in January 2006 and was completed in March 2006. Data were analysed using the Statistical Package for Social Sciences (SPSS) software program, Version 14, and the model syntax and tabulation plans developed by UNICEF for this purpose. 14 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF /G am 00 50 6/ G ia co m o Pi ro zz i The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 15 3. SAMPLE COVERAGE AND THE CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS Sample Coverage Of the 6,175 households selected for the sample, 6,171 were found to be occupied. Of these, 6,071 were successfully interviewed for a household response rate of 98.4 per cent. In the interviewed hou- seholds, 10,252 women aged 15-49 were identified. Of these, 9,982 were successfully interviewed, yielding a response rate of 97.4 per cent. In addition, 6,641 under -5 children were listed in the hou- sehold questionnaire. Copies of the questionnaires were completed for 6,543 of these children, which corresponds to a response rate of 98.5 per cent. Overall response rates of 95.8 per cent and 96.9 per cent are calculated for the women's and under-5's interviews respectively (Table HH.1). The differentials in response rates across LGAs are small. The lowest household response rate of 97.6 per cent is in the Brikama LGA and the highest of 100 per cent is in Banjul and Mansakonko. In the case of women's response rate, the lowest, which is 98.4 per cent, is in Kuntaur and the highest (99.4 per cent) is found in three other LGAs. Banjul has the lowest child response rate of 95.8 per cent. Characteristics of Households The age and sex distribution of the survey population is provided in Table HH.2. The distribution is also used to produce the population pyramid in Figure HH.1. In the 6,071 households successfully interviewed in the survey, 44,877 household members were listed. Of these, 22,072 were males, and 22,805 were females. These figures also indicate that the survey estimated the average household size at 7.4 persons. The percentage distribution of the MICS III survey population by the 5-year age group is very similar to the distribution of the 2003 population of The Gambia for all age groups. However, a marked percentage difference has been noticed between the two distributions at the age group 50-54 for females. This particular age group in the survey showed 4.6 per cent of the female population listed in the survey. This almost doubles the percentage of male population in this age group (2.6 per cent). The 2003 census results show that about 2.4 females were in this age group. The reason for the differences is not yet quite obvious. However, it is assumed that enumerators knowingly or otherwise shifted the women aged 45-49 to the age category 50-54 years to avoid having to interview large numbers of eligible women. For both distributions (survey and census) the age group 0-14 consists of 44 per cent of the population. The age group 15-64 consists of 52 per cent of the population. A similar correspondence exists between the survey and census age distributions for other age groups except the particular one mentioned above. 16 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Sample Coverage and the Characteristics of Households and Respondents Note that the figure below Figure HH.1 is the distribution of the 2003 population by age group. The population pyramid in Figure HH.1 is the distribution of the MICS III population listed by the 5-year age group. In general, under-enumeration of under-5 children due to age shifting to 5-9 years is evident in both the 2003 Census and the MICS III distributions. However, there is evidence of age shifting among women aged 45-49 to 50-54 in Figure HH.1. Figure HH.1. Population pyramid,The Gambia, 2006 Figure CN.1. Pyramid, Population and Housing Census 2003,The Gambia The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 17 Sample Coverage and the Characteristics of Households and Respondents Table HH.3 provides basic background information on the households. Within households, the sex of the household head, LGA, urban/rural status, number of household members and ethnicity of the household head is shown in the table. These background characteristics are also used in subse- quent tables in the report. The figures in the table are also intended to show the number of obser- vations by major categories of analysis in the report. The weighted and unweighted numbers of households are equal, since sample weights were normalized (See Appendix A). The table also shows the proportions of households where at least one child under 18, at least one child under 5, and at least one eligible woman aged 15-49 were found. About 84 per cent of the household heads are males. Rural settlements account for about 52 per cent of household heads. Table HH.3 also shows that 25 per cent of the households have 10 or more persons. Characteristics of Respondents Tables HH.4 and HH.5 provide information on the background characteristics of female respon- dents 15-49 years of age and of under-5 children. In both tables, the total numbers of weighted and unweighted observations are equal, since sample weights have been normalized (standardized). In addition to providing useful information on the background characteristics of children and women, the tables are also intended to show the numbers of observations in each background category. These categories are used in the subsequent tabulations of this report. Table HH.4 provides background characteristics of female respondents aged 15 - 49. The table includes information on the distribution of women according to region, urban-rural areas, age, marital status, motherhood status, education4, wealth index quintiles5, and ethnicity. The table shows that 68.6 per cent of the females interviewed were married at the time of the survey and 57.4 per cent (interviewed females) were in the rural areas. The never-married category accounts for 26.8 per cent of the interviewed females aged 15-49 years. About 61 per cent of these women did not receive any form of formal education. The table also shows that 22.3 per cent of these are in the richest category and 17.1 per cent in the poorest category of the wealth index quintile. Some background characteristics of under-5 children are presented in Table HH.5. These include distribution of children by several attributes: sex, region and area of residence, age in months, mother's or caretaker's education, wealth and ethnicity. Of the under-5 children whose mothers/caretakers were interviewed, 51.1 per cent are males and 64.8 per cent live in the rural areas. The majority of under-5 children who were interviewed are in the age group 12-23 months. They account for 22.7 per cent of the under-5s. Twenty-three per cent are in the poorest households and 16.5 per cent in the richest households. 4 Unless otherwise stated, education refers to educational level attained by the respondent throughout this report when it is used as a background variable. 5 Principal components analysis was performed by using information on the ownership of household goods and amenities (assets) to assign weights to each household asset, and obtain wealth scores for each household in the sample. (The assets used in these calculations were as follows: persons per sleeping room; type of roof, floor and wall of house; type of cooking fuel; ownership of cars, mobiles, refrigerators, TVs and other means of transportation; and type of toilet facilities. Each household was then weighted by the number of household members, and the household population was divided into five groups of equal size, from the poorest quintile to the richest quintile, based on the wealth scores of households they were living in. The wealth index is assumed to capture the underlying long-term wealth through information on the household assets, and is intended to pro- duce a ranking of households by wealth, from poorest to richest. The wealth index does not provide information on absolute poverty, current income or expenditure levels, and the wealth scores calculated are applicable for only the particular data set they are based on. Further information on the construction of the wealth index can be found in Rutstein and Johnson, 2004, and Filmer and Pritchett, 2001. 18 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF /G am 00 51 8/ G ia co m o Pi ro zz i The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 19 4. CHILD MORTALITY One of the overarching goals of the Millennium Development Goals (MDGs) and the WFFC is to reduce infant and under-5 mortality. Specifically, the MDGs call for a reduction in under-5 mortality by two-thirds between 1990 and 2015. Monitoring progress towards this goal is an important but dif- ficult objective. Measuring childhood mortality may seem easy, but attempts using direct questions, such as “Has anyone in this household died in the last year?” give inaccurate results. Using direct measures of child mortality from birth histories is time consuming, more expensive, and requires greater attention to training and supervision. Alternatively, indirect methods develo- ped to measure child mortality produce robust estimates that are comparable with the ones obtained from other sources. Indirect methods minimize the pitfalls of memory lapses, inexact or misinterpreted definitions and poor interviewing technique. Infant mortality rate is the probability of dying before the first birthday. Under-5 mortality rate is the probability of dying before the fifth birthday. In MIC surveys, infant and under-5 mortality rates are calculated based on an indirect estimation technique known as the Brass method (United Nations, 1983; 1990a; 1990b). The data used in the estimation are: the mean number of children ever born for 5-year age groups of women aged 15 to 49, and the proportion of these children who are dead, also for 5-year age groups of women. The technique converts these data into probabilities of dying by taking into account both the mortality risks to which children are exposed and their length of exposure to the risk of dying, assuming a particular model age pattern of mortality. Based on previous information on mortality in The Gambia, the south model life table was selected as most appropriate. Table CM.1 provides estimates of child mortality by various background characteristics, while Table CM.2 provides the basic data used in the calculation of the mortality rates for the national total. These estimates have been calculated by averaging mortality estimates obtained from women aged 25-29 and 30-34, and refer to mid-2003. The infant mortality rate is estimated at 93 per thousand, while the probability of dying at the under-5 mortality rate (U5MR) is around 131 per thousand. As expected, male children experience higher mortality than female children. 20 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Child Mortality Figure CM.2 shows estimates of under-5 mortality by LGA, residence, mother's education and wealth. The LGA differentials should be viewed with caution due to the small sample sizes that some of the estimates are based on; this is particularly the case for Mansakonko and Kuntaur. The urban LGAs (Banjul and Kanifing) are shown as one category to overcome the effect of the small sample size of Banjul. Generally, infant and under-5 mortality rates are lowest in the Brikama LGA and highest in Kuntaur. The under-5 mortality rate in Banjul and Kanifing is 122 per thousand. There are notable differences in mortality in terms of mother's educational level, wealth and ethnicity. In particular, the probabilities of dying among children living in the richest households are considerably lower compared to the national average, ie infant mortality (58 vs 93 per 1000) and under-5 mortality (72 vs 131 per 1000). Figure CM.2 shows the series of U5MR estimates of the survey, based on the responses of women in different age groups, and referring to various points in time, thus showing the estimated trend in U5MR based on the survey. Despite the downward trend in mortality in both the censuses and the MICS estimates, the latter indicate a higher level of mortality during the previous 13 years (1993-2006) when compared to the census mortality estimates. The 2006 U5MR estimate (131 per thousand live births) from the MICS is about 24 per cent higher than the estimate of 99 per thousand live births for the 2003 census. Further qualification of these apparent differences and their determinants should be taken up in a more detailed and separate analysis. Figure CM.1:Under-5 mortality rates by background characteristics,The Gambia The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 21 Child Mortality Figure CM.2:Trend in under-5 Mortality Rates,The Gambia 22 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF /G am 00 65 5/ G ia co m o Pi ro zz i The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 23 5. NUTRITION Nutritional Status Children's nutritional status is a reflection of their overall health. When children have access to adequate food supply, are not exposed to repeated illness, and are well cared for, they are considered well nourished and reach their growth potential. Under-nutrition is associated with more than half of all child deaths worldwide. Undernourished children are more likely to die from common childhood ailments, and those who survive have recurring sicknesses and faltering growth. Three quarters of the children who die from causes related to mal- nutrition were only mildly or moderately malnourished - showing no outward sign of their vulnerability. The MDGs target is to reduce by half the proportion of people who suffer from hunger between 1990 and 2015. The WFFC goal is to reduce the prevalence of malnutrition among under-5 children by at least one third between 2000 and 2010, with special attention to children under 2 years of age. A reduction in the prevalence of malnutrition will assist in the goal to reduce child mortality. In a well-nourished population, there is a reference distribution of height and weight for under-5 children. Under-nourishment in a population can be gauged by comparing children to a reference population. The reference population used in this report is the WHO/CDC/NCHS reference, which was recommended for use by UNICEF and the World Health Organization (WHO) at the time the survey was implemented. Each of the three nutritional status indicators can be expressed in standard deviation units (z-scores) from the median of the reference population. Weight-for-age is a measure of both acute and chronic malnutrition. Children whose weight-for-age is more than two standard deviations below the median of the reference population are considered moderately or severely underweight while those whose weight-for-age is more than three standard deviations below the median are classified as severely underweight. Height-for-age is a measure of linear growth. Children whose height-for-age is more than two standard deviations below the median of the reference population are considered short for their age and are classified as moderately or severely stunted. Those whose height-for-age is more than three standard deviations below the median are classified as severely stunted. Stunting is a reflection of chronic malnutrition as a result of failure to receive adequate nutrition over a long period and recurrent or chronic illness. Finally, children whose weight-for-height is more than two standard deviations below the median of the reference population are classified as moderately or severely wasted, while those who fall more than three standard deviations below the median are severely wasted. Wasting is usually the result of a recent nutritional deficiency. The indicator may exhibit significant seasonal shifts associated with changes in the availability of food or disease prevalence. 24 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Nutrition In the MICS III, weights and heights of all under-5 children were measured using anthropometric equipment recommended by UNICEF (UNICEF, 2006). The findings in this section are based on the results of these measurements. Table NU.1 shows the percentages of children classified into each of these categories, based on the anthropometric measurements that were taken during fieldwork. Additionally, the table includes the percentage of children who are overweight, which takes into account those children whose weight for height is above two standard deviations from the median of the reference population. In Table NU.1, children who were not weighed and measured (approximately 2.3 per cent of children) and those whose measurements are outside a plausible range are excluded. One in five children under-five in The Gambia is moderately underweight (20.3 per cent) and four per cent severely underweight (Table NU.1). Almost a quarter of the children (22 per cent) are moderately stunted or too short for their age. Six per cent are moderately wasted or too thin for their height. Children in Mansakonko, Janjangbureh and Kuntaur are more likely to be underweight than other children. Rural children are more likely to be underweight, stunted or wasted than urban children. Those children whose mothers have primary or higher education are least likely to be underweight and stunted than children of mothers with no education. Figure NU.1: Percentage of children under-5 who are undernourished, The Gambia, 2006 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 25 Nutrition The age pattern shows that a higher proportion of children aged 12-23 months are undernourished according to all the three indices in comparison to children who are younger and older (Figure NU.1). This pattern is expected and is related to the age at which many children cease to be breastfed and are exposed to contamination in water, food and the environment. Child obesity is being recognized even in developing countries as something that should be taken note of as the obesity may persist into adulthood. Two per cent of the children assessed were found to be overweight. Breastfeeding Breastfeeding for the first few years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. However, many mothers stop breastfeeding too soon. There are often pressures to switch to an infant formula, which can contribute to growth faltering and micronutrient malnutrition and is unsafe if clean water is not readily available. The WFFC goal states that children should be exclusively breastfed for six months and continue to be breastfed for two years of age and beyond, and introduced to safe, appropriate and adequate complementary feeding at six months. The WHO/UNICEF have the following feeding recommendations: • Exclusive breastfeeding for the first six months • Continued breastfeeding for two years or more • Safe, appropriate and adequate complementary foods beginning at six months • Frequency of complementary feeding: at least twice per day for 6-8-month-olds; at least three times per day for 9-11 month olds It is also recommended that breastfeeding should be initiated within one hour of birth. The indicators of recommended child feeding practices are as follows: • Exclusive breastfeeding rate (< 6 months & < 4 months) • Timely complementary feeding rate (6-9 months) • Continued breastfeeding rate (12-15 & 20-23 months) • Timely initiation of breastfeeding (within 1 hour of birth) • Frequency of complementary feeding (6-11 months) • Adequately fed infants (0-11 months) Table NU.2 and Figure NU.2 provide the proportion of women who started breastfeeding their infants within one hour of birth, and women who started breastfeeding within one day of birth (which includes those who started within one hour). Approximately 48 per cent of women who gave birth within the previous two years breastfed their babies within one hour after birth and 90 per cent within one day after birth. Women in the Kerewan and Basse LGAs are more likely to breastfeed within the first hour (78 and 59 per cent respectively) and for the first day (96 and 92 per cent respectively). 26 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Nutrition In Table NU.3, breastfeeding status is based on the reports of mothers/caretakers of children's consumption of food and fluids in the 24 hours prior to the interview. Exclusively breastfed refers to infants who received only breast milk (and vitamins, mineral supplements, or medicine). The table shows exclusive breastfeeding of infants during the first six months of life (separately for 0-3 months and 0-5 months), as well as complementary feeding of children 6-9 months and continued breastfeeding of children at 12-15 and 20-23 months of age. Table NU.3 shows that 41 per cent of children aged less than six months are exclusively breastfed. At age 6-9 months, 44 per cent of the children are receiving breast milk and solid or semi-solid foods. By age 12-15 months, 92 per cent are still being breastfed and by age 20-23 months, 53 per cent are still breastfed. Girls are more likely to be exclusively breastfed than boys. Figure NU.3 shows the detailed pattern of breastfeeding by the child's age in months. Even in the earliest ages a considerable proportion of infants are receiving liquids or foods other than breast milk. Children in the rural areas are breastfed longer than to those in the urban areas. Figure NU.2: Percentage of mothers who started breastfeeding within one hour and within one day of birth,The Gambia, 2006 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 27 Nutrition The adequacy of infant feeding in children less than 12 months is provided in Table NU.4. Different criteria of adequate feeding are used, depending on the age of the child. For infants aged 0-5 months, exclusive breastfeeding is considered as adequate feeding. Infants aged 6-8 months are considered to be adequately fed if they receive breast milk and complementary food at least twice a day, while infants aged 9-11 months are considered to be adequately fed if they receive breast milk and eating complementary food at least three times a day. Thirty-three per cent of infants 6-8 months old received breast milk and complementary food at least twice a day. For the infants between 9 and 11 months, 44 per cent received both breast milk and complementary food at least three times a day. As a result of these feeding patterns, only 40 per cent of children aged 0-11 months and 39 per cent aged 6-11 months are adequately and appropriately fed. A higher proportion of infants aged 6-8 months from the urban areas were found to be receiving breast milk and complementary food at least twice a day. Mothers with secondary education are more likely to feed their infants appropriately. Figure NU.3: Percentage distribution of children aged under 3 years by feeding pattern, and age group,The Gambia, 2006 28 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Nutrition Salt Iodization Iodine Deficiency Disorders (IDD) is the world's leading cause of preventable mental retardation and impaired psychomotor development in young children. In its most extreme form, iodine defi- ciency 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). In The Gambia, over 80 per cent of the salt consumed comes from outside the country and most of it is not iodized. Until 2003 salt had not been iodized in The Gambia. However, with assistance from partners, mainly UNICEF, salt is now being iodized in the country. Legislation has also been enacted on salt iodization. Intensive IEC is also currently being implemented to increase the household consumption of iodized salt. In about 90 per cent of households, salt used for cooking was tested for iodine content by using salt test kits testing for the presence of potassium iodate. Table NU.5 shows that in a very small proportion of households (9 per cent), there was no salt available. In Banjul a quarter of households contacted had no salt during the MICS III data collection. In 7 per cent of households, salt was found to contain 15 parts per million (ppm) or more of iodine. Use of iodized salt is highest in the eastern part of the country where 41 per cent of the households in the Basse area had adequately iodized salt. Only 5 per cent of salt in the urban areas was adequately iodized compared to 8 per cent in the rural areas. The results of the survey show that households in the poorest quintiles consumed more iodized salt compared to households in the richest quintiles. Figure NU.5: Percentage of households consuming adequately iodized salt, The Gambia, 2006 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 29 Nutrition Vitamin A Supplements Vitamin A is essential for eye health and proper functioning of the immune system. It is found in foods such as milk, liver, eggs, red or orange fruits, red palm oil and green leafy vegetables, although the amount of vitamin A readily available to the body from these sources varies widely. In the developing areas of the world, where Vitamin A is largely consumed in the form of fruits and vegetables, daily per capita intake is often insufficient to meet dietary requirements. Inadequate intakes are further compromised by increased requirements for the vitamin as children grow or during periods of illness, as well as increased losses during common childhood infections. As a result, vitamin A deficiency is quite prevalent in the developing world and particularly in countries with the highest burden of under-5 deaths. The 1990 World Summit for Children set the goal of virtual elimination of vitamin A deficiency and its consequences, including blindness, by 2000. This goal was also endorsed at the Policy Conference on Ending Hidden Hunger in 1991, the 1992 International Conference on Nutrition, and the UN General Assembly Special Session on Children in 2002. The critical role of vitamin A for child health and immune function also makes control of the deficiency a primary component of child survival efforts, and therefore is critical to the achievement of the fourth MDG: a two-thirds reduction in under-5 mortality by 2015. For countries with Vitamin A deficiency problems, current international recommendations call for high-dose Vitamin A supplementation every four to six months, targeting all children between the ages of 6-59 months living in the affected areas. Providing young children with two high-dose Vitamin A capsules a year (at six-monthly intervals) is a safe, cost-effective, efficient strategy for eliminating Vitamin A deficiency and improving child survival. Giving Vitamin A to new mothers who are breastfeeding helps protect their children during the first months of life and helps to replenish the mother's stores of Vitamin A, which are depleted during pregnancy and lactation. For countries with Vitamin A supplementation programmes, the definition of the indicator is the percentage of children 6-59 months of age receiving at least one high dose of Vitamin A supplement in the last six months. Based on UNICEF/WHO guidelines, NaNA and the DOSHSW recommend that children aged 6-11 months should be given one high dose of Vitamin A capsules (100,000 IU) and children aged 12-59 months should be given a Vitamin A capsule (200,000 IU) every six months. Vitamin A sup- plementation has been incorporated into the Reproductive and Child Health Services in the entire country and all children aged 6-59 months receive a high dose every six months, which is then recorded on their infant welfare cards. Lactating mothers are also supplemented within eight weeks of giving birth due to increased Vitamin A requirements during pregnancy and lactation and encouraged to exclusively breastfeed. The supplement is expected to benefit the young infant in the first six months of life. Within the six months prior to the MICS, 80 per cent of children aged 6-59 months received a high dose of Vitamin A supplement (Table NU.6). Approximately 4 per cent did not receive the supplement in the previous six months but received one prior to that time. Eight per cent of children received a Vitamin A supplement at some time in the past but their mother/caretaker was unable to specify when this was done. Vitamin A supplementation coverage is lower in the urban areas (77 per cent) than in the rural areas (82 per cent). 30 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Nutrition The age pattern of Vitamin A supplementation shows that supplementation in the last six months rises from 76 per cent among children aged 6-11 months to 84 per cent among children aged 12-23 months and then declines with age to 76 per cent among the oldest children. About 78 per cent of mothers who gave birth in the previous two years before the MICS received a Vitamin A supplement within eight weeks of birth (Table NU.7). This percentage is higher in the rural areas (81 per cent) than in the urban areas (72 per cent). The Kanifing Municipality has the lowest Vitamin A coverage at 67 per cent. Mothers' education does not have an effect on the coverage. Vitamin A supplementation is higher among children from the poorest households than those from the richest. Low Birth Weight Weight at birth is a good indicator not only of a mother's health and nutritional status but also the newborn's chances of survival, growth, long-term health and psycho-social 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 an increased risk of dying during their early months and years. Those who survive have an impaired immune function and increased risk of disease; they are likely to remain undernourished, with reduced muscle strength, throughout their lives, and suffer a higher incidence of diabetes and heart disease in later life. Children born underweight also tend to have a lower intelligence quotient (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 the most impact: • the mother's poor nutritional status before conception • short stature (due mostly to under-nutrition and infections during her childhood) • 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. One of the major challenges in measuring the incidence of low birth weight is the fact that more than half of infants in the developing world are not weighed. In the past, most estimates of low birth weight for developing countries were based on data compiled from health facilities. However, these estimates are biased for most developing countries because the majority of newborns are not delivered in facilities, and those who are, represent only a small sample of all births. Since many infants are not weighed at birth, the weights of those who are weighed may bias the sample of all births. The reported birth weights usually cannot be used to estimate the prevalence The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 31 Nutrition 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 (ie 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.6 Overall, 52 per cent of births were weighed at birth and approximately 20 per cent of infants are estimated to weigh less than 2500 grams at birth (Table NU.8). There was no marked variation by LGA (Figure NU.8). The percentage of low birth weight does not vary much by urban and rural areas or by mother's education or by ethnic group. Figure NU.8: Percentage of infants weighing less than 2500 grams at birth, The Gambia, 2006 32 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF /G am 00 59 0/ G ia co m o Pi ro zz i The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 33 6. CHILD HEALTH Immunization MDG 4 aims to reduce child mortality by two thirds between 1990 and 2015. Immunization plays a key part in this goal. Immunization has saved the lives of millions of children in the three decades since the launch of the Expanded Programme on Immunization (EPI) in 1979. Worldwide, there are still 27 million children overlooked by routine immunization and, as a result, vaccine-preventable diseases cause more than two million deaths every year. A WFFC goal is to ensure full immunization of children under one year of age at 90 per cent nationally, with at least 80 percent coverage in every district or equivalent administrative unit. According to the UNICEF WHO guidelines, children should receive a BCG vaccination to protect them against tuberculosis, three doses of DPT to protect them against diphtheria, pertussis and tetanus, three doses of polio vaccine, and a measles vaccination by the age of 12 months. Mothers were asked to provide vaccination cards for under-5. Interviewers copied vaccination information from the cards on to the MICS questionnaire. In The Gambia, Hepatitis B and yellow fever vaccination are also given to children in addition to the others and are also recommended as part of the immunization schedule. It is recommended that Hepatitis B should be given at the same time as DPT and polio and yellow fever vaccination should be given by age nine together with measles. Hepatitis B was introduced in The Gambia in the mid- 1990s while yellow fever vaccines started around 1979. Figure CH.1: Percentage of children aged 12-23 months who received the recommended vaccination by 12 months,The Gambia, 2006 34 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Child Health BCG vaccination coverage is one key MICS indicator (25). Overall, 97.6 per cent of children were vaccinated against tuberculosis by the age of 12 months. DPT 3, according to the results in Table CH.1 and Figure CH.1, shows coverage of 82.4 per cent by 12 months of age. Polio 3 and measles show coverage of 83.3 and 84.9 per cent respectively. One would expect polio coverage to be higher than this, since a great amount of donor funding was made available for its total eradication. Yellow fever coverage indicates that 76.9 per cent of the children were vaccinated by 12 months of age (Table CH.1c). In fact, yellow fever coverage is the lowest compared to the other antigens observed above. Tables CH.2 and CH.2c show vaccination coverage rates among children 12-23 months by back- ground characteristics. The figures indicate children receiving the vaccinations at any time up to the date of the survey, and are based on information from both the vaccination cards and mothers'/caretakers' reports. Overall, total vaccination coverage rate among the sample of children is 74.5 per cent (Table CH.2). Mansakonko LGA has the highest vaccination coverage rate of 86.7 per cent. Kuntaur has the second highest with a rate of 83.7 per cent, followed by Janjangbureh with 81.2 per cent. There is also a slight disparity in the coverage rate among the different ethnic groups with the Mandinka having the highest coverage of 77.0 per cent and the Serer having the lowest (6 per cent). As a whole, the results indicate that there are no large differences in vaccination coverage among the other background characteristics except in household wealth quintiles, where children from the poorest households are more likely to be vaccinated with all antigens compared to children from the richest households. Tetanus Toxoid Generally, there is 75.6 percent protection against neonatal tetanus among mothers with a birth in the last 24 months prior to the survey. Huge disparities exist among the regions, for example, Banjul has the lowest protection rate of 51.3 per cent compared to Mansakonko, which has the highest rate (89.6 per cent.) A similar trend is evident in urban-rural differentials, with the rural areas showing the highest protection rate of 81.4 per cent compared to 64.3 per cent for the urban areas (Figure CH.3). Huge differences exist among wealth quintiles ie mothers from the poorest households are more likely to receive the tetanus toxoid vaccine than mothers from the richest households. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 35 Child Health Overall, 19 per cent of under-5 children had diarrhoea in the two weeks preceding the survey (Table CH.4). There are notable differences in diarrhoea prevalence between the regions, with Kuntaur having a prevalence rate of 31.9 per cent and Mansakonko having the lowest rate (13.2 per cent). The urban areas have a prevalence rate of 15.7 per cent compared to the rural area, with 21.0 per cent. The results indicate that diarrhoea prevalence reduces as age increases with the lowest rate, 6.9 per cent, experienced by children aged 48-59 months. The results further indicate that the peak of diarrhoea prevalence occurs in the weaning period, among children aged 6-23 months (Table CH.4). Oral Rehydration Treatment Diarrhoea is the second leading cause of death among under-5 children worldwide. Most diar- rhoea-related deaths in children are due to dehydration from loss of large quantities of water and electrolytes from the body in liquid stools. Management of diarrhoea - either through oral rehydration salts (ORS) or a recommended home fluid (RHF) - can prevent many of these deaths. Preventing dehydration and malnutrition by increasing fluid intake and continuing to feed the child are also important strategies for managing diarrhoea. The goals are to reduce by one half death due to diarrhoea among under-5 children by 2010 com- pared to 2000 (WFFC) (2) and to reduce by two thirds the mortality rate among under-5 children by 2015 compared to 1990 (MDGs). In addition, the WFFC calls for a reduction in the incidence of diarrhoea by 25 per cent. Figure CH.3: Percentage of women with a live birth in the last 12 months who are protected against neonatal tetanus,The Gambia, 2006 36 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Child Health The indicators are: • Prevalence of diarrhoea • Oral rehydration therapy • Home management of diarrhoea • ORT or increased fluids and continued feeding In the MICS questionnaire, mothers (or caretakers) were asked to report whether their child had had diarrhoea in the two weeks prior to the survey. If so, the mother was asked a series of questions about what the child had to drink and eat during the episode and whether this was more or less than the child usually ate and drank. Overall, ORT use rate was 48.2 per cent and no treatment rate was 51.8 per cent (Table CH.4). Nonetheless, there were disparities in the prevalence by local government area, urban and rural and educational levels (Figure CH.4). Figure CH.4: Percentage of children aged 0-59 months with diarrhoea who received oral rehydration treatment,The Gambia, 2006 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 37 Child Health Generally, 29.4 per cent of diarrhoeal cases were managed at home. About 53 per cent of under-5 children with diarrhoea drank more fluids than usual while 45.2 per cent drank the same or less (Table CH.5). About 53 per cent ate somewhat less, the same or more (continued feeding), but 46 per cent ate much less or none. Nationally, 38 per cent of under-5 children received increased fluids and at the same time continued feeding (Figure CH.5). There are marked differences in the home management of diarrhoea by background characteristics. Basse LGA had the highest home management rate of 48.5 per cent while Mansakonko had the lowest rate (11.6 per cent). (Table CH.5) Figure CH.5: Percentage of children aged 0-59 months with diarrhoea who received ORT or increased fluids, and continued feeding,The Gambia, 2006 38 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Child Health Care Seeking and Antibiotic Treatment of Pneumonia Pneumonia is the leading cause of death in children and the use of antibiotics in under-5s with suspected pneumonia is a key intervention. A WFFC goal is to reduce by one third the deaths due to acute respiratory infections. Children with suspected pneumonia are those who had an illness with a cough accompanied by rapid or difficult breathing and whose symptoms were not due to a problem in the chest and a blocked nose. The indicators are: • Prevalence of suspected pneumonia • Care seeking for suspected pneumonia • Antibiotic treatment for suspected pneumonia • Knowledge of the danger signs of pneumonia Out of the 1,082 children aged 0-59 months surveyed, 9.5 per cent sought care for suspected pneumonia at government hospitals, 47.9 per cent at government health centres, 1.8 per cent at government health posts, 2.4 per cent from village health workers, 1.6 per cent at mobile/outreach clinics and none at other public health facilities (Table CH.6). The prevalence of acute respiratory infection was 5.6 per cent. The lowest prevalence was observed in Banjul (0.6 per cent). Overall, there were no marked differences observed among urban-rural categories (Table CH.6). The results show that most mothers/caretakers of children aged 0-59 months sought care for suspected pneumonia at a pharmacy (10.9 per cent). This is followed by private hospital clinics (6 per cent) and then private physicians, relatives and traditional practitioners each at 1.4 per cent (Table CH.6). About 69 per cent of care seeking for suspected pneumonia was referred to an appropriate provider. Care seeking was highest in the rural areas (72 per cent), compared to the urban areas (64 per cent). Care was sought more for females (71 per cent) compared to males (67 per cent). Overall, 61.3 per cent of children 0-59 months with suspected pneumonia received antibiotic treatment in the last two weeks prior to the survey (Table CH.7). Only 4.1 per cent of mothers/caretakers were able to recognize the two danger signs of pneumonia (fast breathing and difficulty in breathing). Kerewan LGA has the highest proportion of mothers/caretakers who recognize the two danger signs (14.3 per cent). All other LGAs range from a proportion of 0.6 per cent in Banjul to 3.7 per cent in Basse (Table CH.7A). The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 39 Child Health Solid Fuel Use More than 3 billion people around the world rely on solid fuel (biomass and coal) for their basic energy needs, including cooking and heating. Cooking and heating with solid fuel lead to high levels of indoor smoke, a complex mix of health-damaging pollutants. The main problem with the use of solid fuel is products of incomplete combustion, including CO, polyaromatic hydrocarbons, SO2, and other toxic elements. Use of solid fuel 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 fuel as the primary source of domestic energy for cooking. Out of a total of 6,071 households interviewed, 90.9 per cent reported that they used solid fuel for cooking. Among the solid fuel, wood was used by the majority of households (77.8 per cent). The least used is electricity and coal/ignite (0.1 per cent each). Charcoal was the third highest solid fuel used in cooking (12.8 per cent). The use of solid fuel for cooking is highest in Kuntaur (99.6 per cent) and lowest in Banjul (71 per cent). With the exception of Kanifing (84 per cent) and Banjul, over 90 per cent of households in all the other LGAs use solid fuel for cooking (See Table CH.8). Solid fuel use for cooking is more common among rural households than urban ones. Almost all rural households use solid fuel for cooking. Households headed by people with no formal education are more likely to use solid fuel for cooking than those headed by people with higher levels of education. Virtually all the households in the poorest quintiles use solid fuel for cooking. In the MICS III, questions were asked on three main types of stoves: closed stove, open stove/fire or hood, open stove and others. The open stove or hood was found to be the most commonly used stove (74. 1 per cent) followed by the closed stove (19.9 per cent). The least used was the other category (Table CH.9). Malaria Malaria is a leading cause of death of under-5 children in The Gambia. It also contributes to anaemia in children and is a common cause of school absenteeism. Preventive measures, especially the use of mosquito nets treated with insecticide (ITNs), can dramatically reduce malaria mortality rates among children. In areas where malaria is common, international recommendations suggest treating any fever in children as if it were malaria and immediately giving the child a full course of recommended anti- malarial tablets. Children with severe malaria symptoms, such as fever or convulsions, should be taken to a health facility. Also, children recovering from malaria should be given extra liquids and food and, for younger children, should continue breastfeeding. The questionnaire incorporates questions on the availability and use of bednets, both at the household level and among under-5 children, as well as anti-malarial treatment, and intermittent preventive therapy for malaria. Six thousand and seventy-one households were interviewed on the availability of insecticides treated nets. Out of these, 59.4 per cent reported having at least one mosquito net and 49.5 per cent had at least one insecticide treated net (See Table CH.10). 40 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Child Health Banjul households have the lowest proportion of ITNs (28.6 per cent) compared to the highest, Mansakonko, with 76.4 per cent. Households in the rural areas were nearly twice (64.0 per cent) more likely to use ITNs compared to those in the urban areas (31.0 per cent). Out of 6,543 children aged 0-59 months, 63 per cent of mothers or caretakers reported that the child slept under a bednet the night prior to the survey and of this, 49.0 per cent were reported to have slept under an ITN. A large proportion was reported not to have slept under a bednet (36.7 per cent). There were no major differences in bednet and ITN use by gender. Among the LGAs, Mansakonko has both the highest bednet and ITN usage rates (See Table CH.11). Eight per cent of children aged 0-59 months were reported to have had fever two weeks prior to the survey. Children from households headed by the Jola are more likely to have had fever children than the Mandinka and Fula (See Table CH.12). Among the children reported to have had fever, 13.3 per cent were given anti-malarial SP/Fansidar, 57.6 per cent were given chloroquine, 1.6 per cent had Armodaquine, 2.8 per cent had anti-malarial quinine drugs and 2.9 per cent other anti-malarial drugs. In general, about 63 per cent of children had some appropriate anti-malarial drugs and 65.3 per cent were given other medications such as Paracetemol/Panadol/Acetaminophan while 52.4 per cent had some appropriate anti-malarial drugs within 24 hours of the onset of symptoms (Table CH.12). Of the 3,070 women interviewed, 59.1 per cent took medicine to prevent malaria during pregnancy, 21.1 per cent took SP/Fansidar only once, 32.5 per cent took SP/Fansidar two or more times. In Banjul, very few women reported having taken SP/Fansidar two or more times (21.1 per cent). Janjangbureh has the highest percentage of women (49.4 per cent), who reported taking SP/Fansidar only once. No major differences have been observed in SP/Fansidar intake of two or more times by wealth index quintiles (Table CH.13). Sources and Costs of Supplies The results in Table CH.15 show various sources of anti-malarial drugs percentage that are free, and the median cost. Most respondents reported that they obtained anti-malarial drugs from public health facilities (66.9 per cent). Private facilities and other sources (mission and NGO facilities) constituted 20.5 and 12.6 per cent respectively. Eighty-four per cent reported having supplies free from public facilities and 14.7 per cent free from the private sector. The median cost of anti-malarial drugs in public facilities was D25.00 compared to D85.00 in private facilities (Table CH.15). Sixty-five per cent of the respondents reported having their antibiotics supplies from public facilities, while 27.9 per cent reported having them from private facilities. Very few obtained supplies from other sources (7.1 per cent). About 79 per cent obtained supplies free of charge from the public sec- tor while 22.8 per cent obtained theirs for free from private facilities. On average, supplies cost D34.60 in public facilities and D68.10 in private facilities (Table 6.16). The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 41 Sources and Cost of Supplies for Oral Rehydration Salts Oral rehydration salts are obtained from three different sources, namely public, private and others. On average, 82.7 per cent obtained them from public sources, 13.2 per cent from private sources and 4 per cent from other sources. About 93 per cent of the respondents got supplies free of charge from public facilities and 34.6 per cent from private facilities. Median cost of supplies was found to be D10.00 in both public and private facilities (Table CH.17). 42 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF G am bi a/ 20 07 /B .D ow ne s- Th om as The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 43 7.THE ENVIRONMENT Water and Sanitation Safe drinking water is a basic necessity for good health. Unsafe drinking water can be a significant carrier of diseases such as trachoma, cholera, typhoid and schistosomiasis. Drinking water can also be tainted with chemical, physical and radiological contaminants with harmful effects on human health. In addition to its association with disease, access to drinking water may be particularly important for children and women, especially in the rural areas, where they bear the primary responsibility of carrying water, often for long distances. The MDG goal is to reduce by half, between 1990 and 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. The WFFC goal calls for a reduc- tion in the proportion of households without access to hygienic sanitation facilities and affordable safe drinking water by at least one third. The list of indicators used in MICS is as follows: Water • Use of improved drinking water sources • Use of adequate water treatment methods • Time to source of drinking water • Person collecting drinking water Sanitation • Use of improved sanitation facilities • Sanitary disposal of child's faeces The distribution of the population by source of drinking water is shown in Table EN.1 and Figure 7.1. The population using improved sources of drinking water are those using any of the following sources of supply: piped water (into dwelling, yard or plot), public tap/standpipe, tubewell/bore- hole, protected well and rainwater collection. Bottled water is considered as an improved water source only if the household is using an improved water source for other purposes, such as hand- washing and cooking. Generally, 85.1 per cent of the population uses an improved source of drinking water - 91.2 per cent in the urban areas and 81.3 per cent in the rural areas. The data also show that as the level of education of the household heads increases, the more they are likely to have access to improved sources of drinking water. The results of the survey show that the richest households are more likely to have better access to improved sources of drinking water than the poorest households (95 per cent of the richest vs 82.5 per cent of the poorest households) (Table EN.1). 44 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report The Environment When comparing access to improved water source by ethnicity of household heads, the Mandinka have better access to safe drinking water, with 85.8 per cent and those headed by the Serer have the lowest, with 80.4 per cent. Across LGAs, there is not much difference in terms of access to safe drinking water. Kanifing Municipality had the highest proportion with about 91 per cent followed by Banjul with about 81 per cent and the lowest was recorded in Brikama with 79 per cent (Table EN.1). The source of drinking water for the population varies strongly across LGAs (Table EN.1). In Banjul and Kanifing, the most common source of drinking water is piped into dwelling or piped into yard or plot while in the other LGAs less than 10 per cent of their population use drinking water that is piped into their dwelling or into their yard or plot. Unprotected wells, which are the most unsafe source of drinking water, are common in the predo- minantly rural LGAs particularly in Brikama and Janjangbureh LGAs with 20 and 18 per cent respectively of their population using such a source of water. Other than Banjul and Kanifing, the public tap/standpipe is the most important source of drinking water in the other LGAs. Use of in-house water treatment is presented in Table EN.2. Households were asked about ways they may be treating water at home to make it safer to drink - boiling, adding bleach or chlorine, using a water filter and using solar disinfection were considered as proper treatment of drinking water. Table EN.2 shows the percentage of household members using appropriate water treatment methods, separately for all households and households using improved and unimproved drinking water sources. Table EN.2 shows that the use of strain through a cloth is the most common water purification method used by households with 19.4 per cent. The proportion is highest in Janjangbureh with about 35 per cent and lowest in Banjul with 2.1 per cent. The rural - urban differentials show that the method is in most use in the rural rather than the urban areas. Figure EN 1: Percentage distribution of household members by source of drinking water, The Gambia, 2006 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 45 The Environment The second most commonly used method is adding bleach/chlorine and the method was reportedly used more in Kuntaur than the other LGAs. The other methods were not used much across all LGAs. Of the households who get their water from unimproved sources and use water treatment methods, 7.3 per cent use appropriate water treatment methods compared to 2.2 per cent of households who use improved drinking water. Combining all sources of drinking water, only 3 per cent of households use appropriate water purification methods. The amount of time it takes to obtain water is presented in Table EN.3 and the person who usually collected the water in Table EN.4. Note that these results refer to one round trip from the home to the drinking water source. Information on the number of trips made in one day was not collected. Table EN.3 shows that for 33 per cent of households, the drinking water source is on the premises and, as expected, the proportion is highest in Banjul and Kanifing with 80 per cent and 63 per cent respectively. For 46.9 per cent of households, it takes less than 30 minutes to get to the water source and bring water, while 4 per cent spend more than one hour to get water from its source. Excluding those households with water on the premises, the average time to the source of drinking water is 21 minutes. Interestingly, the time spent in urban areas in collecting water is slightly higher than in the rural areas. This could be attributed to the fact that in the urban areas, particularly Banjul and Kanifing, there are few public taps/standpipes and, as such, people spend a lot of time queuing up for water. One striking finding is the high average time spent in Basse in collecting water (31 minutes). Table EN.4 shows that for the majority of households (82 per cent), an adult female is usually the person collecting the water, when the source of drinking water is not on the premises. Adult men collect water in only 7 per cent of cases, while for the rest of the households, female children under age 15 collect water more (9 per cent) compared to the male children of the same age (0.8 per cent). Inadequate disposal of human excreta and personal hygiene is associated with a range of diseases including diarrhoeal diseases and polio. Improved sanitation facilities for excreta disposal include: flush or pour flush to a piped sewerage system, septic tank or latrine; ventilated improved pit latrine, pit latrine with a slab and composting toilet. Sanitary means of excreta disposal include the following: flush to piped sewer system, flush to septic tank, flush to pit (latrine), ventilated improved pit latrine (VIP) and pit latrine with slab. Eight-four per cent of the sampled population live in households using improved sanitation facilities (Table EN.5). This percentage is 93 in the urban areas and 78 per cent in the rural areas. Across regions the proportion of the population with improved sanitary means of excreta disposal ranged from 31 per cent in Janjangbureh to 97 per cent in Banjul. This indicates that the residents of Janjangbureh are less likely than others to use improved toilet facilities. Table EN.5 indicates that use of improved sanitation facilities is strongly correlated with wealth and is profoundly different between the urban and rural areas. In the rural areas, the population mostly use pit latrines with slabs or traditional pit latrines. In contrast, the most common facilities in the urban areas are flush toilets with connection to a sewerage system or septic tank. 46 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report The Environment Safe disposal of a child's faeces was related to a question on whether the last stool by the child was disposed of by use of a toilet or rinsed into a toilet or latrine. Disposal of faeces of children 0-2 years of age is presented in Table 7.6. The data show that most of the mothers or primary caretakers of children put or rinsed the child's faeces into a toilet or latrine and the proportion is higher in Banjul, Kanifing and Brikama, while about 11 per cent reported they throw the faeces into the dusbin. The proportion is highest in Kuntaur and virtually does not exist in Banjul. About 5 per cent reported that the faeces are put or rinsed into the drain or ditch.The proportion is highest in Janjangbureh with 16 per cent and lowest in Kanifing and Brikama with 1.3 per cent of mothers/caretakers in these LGAs reported to dispose of children's faeces in this way. The data indicate that 81 per cent of mothers/caretakers in the country dispose of children's faeces safely. The percentage of mothers/caretakers who dispose of faeces of their children safely is highest in Banjul (93 per cent) and lowest in Kuntaur (42 per cent). A higher proportion of mothers/caretakers dispose of their children's faeces properly in the urban areas than those in the rural areas. The data further reveal that the wealthier the household, the higher the chances of disposing of the children's stool safely. A similar trend has also been observed with the level of education of the mother or the primary caretaker. The more educated the mother/primary caretaker is, the higher the chances of disposing of the child's faeces safely. An overview of the percentage of households with improved sources of drinking water and sanitary means of excreta disposal is presented in Table EN.7. The data show a positive correlation between level of education and access to improved sources of drinking water and using sanitary means of excreta disposal among households on one hand and income level of the household on the other. The more educated the head of the household or the higher the wealth category of the household, the more likely they are to have access to improved sources of drinking water and sanitary means of excreta disposal. Security of Tenure and Durability of Housing Target 11 of the MDGs is the achievement of significant improvements in the lives of at least 100 million slum dwellers, and the related indicator is the proportion of urban household members living in slum housing. In the MICS, three indicators were introduced to measure issues related to slum housing: security of tenure, durability of housing and proportion of people living in slum households. An urban household is considered a slum in the MICS if it fulfils one of the following conditions: improved drinking water sources are not used, improved sanitation facilities are not used, insufficient living area, housing is not durable, or lack of security of tenure. Lack of security of tenure is defined as the lack of formal documentation for the residence or perceived risk of eviction. Table EN.8 is on security of tenure. In the urban areas covered in The Gambia MICS, 41 per cent of households do not have formal documentation for their residences. The proportion is higher in Banjul with 68 per cent and lowest in Mansakonko with 20 per cent. Fifteen per cent of respondents to the household questionnaire indicated that there is a risk of eviction; the proportion is higher in Janjangbureh with 30 per cent and lowest in Brikama with 2 per cent. Combining these figures, it has been observed that 45.6 per cent of households reported that they did not have security of tenure. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 47 The Environment As additional information, Table EN.8 shows that 6 per cent of household members were indeed evicted from any dwelling they were residing during the five years prior to the survey. Across regions, the proportion of those evicted is highest in Kanifing (6.9 per cent). No household members reported they were been evicted in Janjangbureh. The data also indicate that the richest households have more security of tenure but are reported to have experienced more eviction in the past than the poorest households. Structures that household members live in are considered as non-durable in the MICS, if the floor material is natural. Two or more bad conditions were identified with the structure. The findings of the survey in this regard are presented in Table EN.9. Generally, 1.8 per cent of households and 1.9 per cent of household members were reported to be living in dwellings, which are considered as non-durable. Table EN.10 brings together all the five components of slum housing. Overall, 59 per cent of household members were reported to be living in slum housing and, as expected, the proportion is highest for the poorest households (86 per cent) and lowest for the richest households (48 per cent). The proportion of household members reported to be living in slums is also higher for households headed by the Fula (76 per cent) when compared to households headed by other ethnic groups. 48 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF /G am 00 56 2/ G ia co m o Pi ro zz i The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 49 8. REPRODUCTIVE HEALTH 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. A better understanding of foetal growth and development and its relationship to the mothers 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, symptoms and the risks of labour and delivery, it may provide the route for ensuring that pregnant women do, in practice, give birth to babies with the assistance of skilled health care providers. 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 pre- vention and treatment of malaria among pregnant women, management of anaemia during pregnancy and treatment of sexually transmitted infections (STIs) can significantly improve foetal outcomes and 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, eg, malaria and sexually transmitted infactions 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. The WHO recommends a minimum of four antenatal visits based on a review of the effectiveness of different models of antenatal care. The 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 anaemia • Weight/height measurement (optional) Coverage of antenatal care by skilled personnel (doctor, nurse, or midwife) is relatively high in The Gambia with 97.8 per cent of women receiving antenatal care at least once during their last pre- gnancy from these skilled personnel. The lowest level of antenatal care among women with a birth in the two years preceding the survey was found in Kerewan and Kuntaur (96 per cent). Antenatal care coverage is the same in both urban and rural areas, each with about 98 per cent (Table RH.3). The type of personnel providing antenatal care to women aged 15-49 years who gave birth in the two years preceding the survey is presented in Table RH.3. The results show that 73.1 per cent received such care from a nurse/midwife and 12.6 per cent from an auxiliary midwife. However, the use of traditional birth attendants and community health workers for antenatal care is not so much; the proportion is higher in Kerewan for the former and in Kuntaur for the latter. 50 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Reproductive Health The types of services which pregnant women received are shown in Table RH.3. Ninety per cent of the women had their blood samples taken, 96.6 per cent had their pressure measured, 86.5 per cent had their urine specimen taken and 97.5 per cent had their weight measured. Assistance at Delivery Three quarters of all maternal deaths occur during delivery and the immediate post-partum period. The single most critical intervention for safe motherhood is to ensure that a competent health worker with midwifery skills is present at every birth, and transport is available to a referral facility for obstetric care in case of emergency. A WFFC goal is to ensure that women have ready and affordable access to skilled attendance at delivery. The indicators are the proportion of births with a skilled attendant and proportion of institutional deliveries. The skilled attendant at the delivery indicator is also used to track progress towards the MDGs target of reducing the maternal mortality ratio by three quarters between 1990 and 2015. The MICS included a number of questions to assess the proportion of births attended by a skilled attendant. A skilled attendant includes a doctor, nurse, midwife or auxiliary midwife. About 57 per cent of births occurring in the year preceding the MICS were delivered by skilled personnel (Table RH.5). This percentage is highest in Banjul (about 95 per cent) and lowest in Kerewan (28.4 per cent). Women with high levels of education are more likely to have been assisted at delivery by skilled personnel than women with lower levels of education. About 47 per cent of the births in the year preceding the MICS were delivered with the assistance of a nurse/midwife. Doctors assisted with the delivery of about 6 per cent of births and auxiliary midwives helped with about 5 per cent of the deliveries. Generally, about 57 per cent of births were delivered by skilled personnel but these births occurred mostly among women in Banjul, Kanifing and Brikama, where the type of personnel providing delivery assistance is noticeably different from other LGAs. The data further show that women assisted by traditional birth attendants during delivery were more common in the predominantly rural LGAs (Mansakonko, Kerewan, Kuntaur, Janjangbureh and Basse), and those assisted by community health workers were more common in those regions as well. Women with secondary education and above (85 per cent) were more likely to have been delivered by skilled personnel than women with primary (68.1 per cent) or no education at all (49 per cent). On the other hand, women from the richest households (88.6 per cent) were more likely to be delivered by skilled personnel than women from the poorest households (28 per cent). It is worth noting that the data presented on the cadre of health care provider who attended the birth of women should be viewed in consideration of their inherent limitations. This is because in a largely illiterate population like The Gambia it would be extremely difficult, if not impossible, for women interviewed during the MICS to identify the cadre of health care providers who delivered their babies with precision. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 51 Reproductive Health Although during the training of field workers an attempt was made to provide guidelines for the accurate identification of the cadre of health care providers assisting during delivery, it was obser- ved that such data might be fraught with errors. This limitation is however unlikely to significantly affect the proportion of births attended by skilled personnel. This is because women at least are able to definitively say if their deliveries were made in health facilities and the fact that those delivering babies in these facilities are most likely to fall in the skilled personnel category. 52 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF /G am 00 66 3/ G ia co m o Pi ro zz i The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 53 9. 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, the presence of books in the home for the child, and the conditions of care are important indicators of quality of home care. A WFFC 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. This 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 • spending time with children naming • counting • drawing things. Almost half (47 per cent) of under-5 children were reported to have household members engaged in four or more activities that promote learning and school readiness during the three days prece- ding the survey (Table CD.1). The average number of activities that adult members engaged in with children was 3.4 activities. The table also indicates that the father's involvement in such activities was somewhat limited. Only 21 per cent of the under-5s had fathers who engaged in one or more activities to promote learning and school readiness. About 26 per cent of children were living in households without their biological fathers. There are slight gender differentials in terms of adult activities with children with a larger proportion of fathers engaged in activities with male children (22 per cent) than with female children (19 per cent). The proportion of adults engaged in learning and school readiness activities with children in the urban areas is slightly higher (48 per cent) than in the rural areas (46 per cent). Differentials have been observed across regions. Adult engagement in activities with children was highest in Kerewan LGA (89 per cent) and lowest in Banjul (26 per cent). The figures show that children in the richest households are more likely to be engaged in activities that promote learning and school readiness with household members than children in the poorest households. Children of better-educated mothers are slightly more likely to be engaged in such activities than those with less educated mothers. Table CD.3 shows that 13.9 per cent of children aged 0-59 months were left in the care of other children, while 4.4 per cent were left alone during the week preceding the inter- view. Combining the two care indicators, it is calculated that 17 per cent of children were left with inadequate care during the week preceding the survey. Slight differences were observed by the sex of the child or between the urban and rural areas. Inadequate care was more prevalent among children whose mothers had no education (19 per cent), as opposed to children whose mothers had secondary education (11 per cent). Children aged 24-59 months were left under inadequate care in the past week (22 per cent) compared to those aged 0-23 months (12 per cent). 54 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF /G am 00 83 2/ G ia co m o Pi ro zz i The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 55 10. EDUCATION Pre-School Attendance and School Readiness Attendance of pre-school education in an organized learning or child education programme is important for the readiness of children to school. One of the WFFC goals is the promotion of early childhood education. Generally, 19.7 per cent of children aged 36-59 months were reported to be currently attending early childhood schools. Twenty per cent of males and 19.4 per cent females of were attending some form of organized early childhood education programme in The Gambia in 2006 (Table ED.1). Gender differentials in school attendance are small (0.6 per cent); however there exist large diffe- rentials in attendance between the urban and rural areas and also across LGAs. Attendance in the urban areas is 30.2 per cent compared to 13.0 per cent in the rural areas. Among children aged 36-59 months, pre-school attendance is more prevalent in Banjul and Kanifing (36.1 and 34.8 per cent respectively), and less in Kerewan and Kuntaur LGAs (6.6 and 7.5 per cent respectively). Comparatively, a smaller proportion of children (13.7 per cent) have some form of organized early childhood learning activities at age 36-47 months than older children with 28.2 per cent of children aged 48-59 months attending early childhood school. Household poverty status appears to have a positive correlation with school readiness - while the indicator is only 6.7 per cent among the poorest households, it is 41.6 per cent among children living in the richest households. The more educated a woman is, the more likely it is that her children will attend an early childhood education programme. The proportion of children who have early childhood education increases with the level of education of women. Among the ethnic groups, households headed by the Jola tend to send more of their children to early childhood school than other ethnic groups. Thirty-two per cent of their children have some form of early childhood education followed by the Serer (30 per cent), the Mandinka, the Wollof with 19 per cent each and the Fula with the lowest (14 per cent). The table also shows that the proportion of children in the first grade of primary school who attended pre-school the previous year (Table ED.1), an important indicator of school readiness, is nearly a third of the children (27.3 per cent). The proportion among boys is higher (29.6 per cent) than girls (25.2 per cent). Analysis by LGA, urban-rural, mothers' education and wealth index could not be done due to a small number of cases of less than 50 (see Table ED.1). Primary and Secondary School Participation Universal access to basic education and the achievement of primary education by the world's children is one of the most important goals of the MDGs and WFFC. Education is a vital prerequisite for combating poverty, empowering women, protecting children from hazardous and exploitative labour and sexual exploitation, promoting human rights and democracy, protecting the environment, and influencing population growth. 56 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Education 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 5 • Transition rate to secondary school • Net primary completion rate The analysis in Table ED.2 indicates that 29.9 per cent of children who are of primary school entry age (age 7) in The Gambia are currently attending the first grade of primary school. No marked sex differentials have been observed (29.5 per cent for boys compared to 30.4 per cent for girls). However, huge differentials have been observed across LGAs and urban-rural residence. Kanifing LGA has the highest proportion (33.3 per cent) of children of primary school entry age currently attending Grade 1 compared to Kuntaur at 21 per cent. Children's primary school attendance is highest in the urban areas (35.5 per cent) than in the rural areas (27.4 per cent). A positive correlation has been observed between mother's education and school attendance and also between household poverty status and school attendance. Of the children aged 7 whose mothers have at least a secondary school education, 42.0 per cent were attending Grade 1 compared to 28.3 per cent of children whose mothers had never been to school. In the richest households, the proportion is 38.9 per cent, while it is 22.5 per cent among children living in the poorest households. For children of primary school entry age from households headed by the Mandinka 31.1 per cent were currently attending Grade 1 compared to 29.8 per cent of those from households headed by the Jola and 27 per cent of those from Fula headed households. Table ED.3 provides the percentage of children of primary school age attending primary or secondary school. The majority of children of primary school age are attending school (61.0 per cent). However, 39.0 per cent of the children are out of school when they are expected to be attending school. The net attendance ratio varies across regions. Banjul had the highest ratio with 77.6 per cent followed by Kanifing (73.5 per cent) and Kuntaur the lowest ratio (41.2 per cent). Among boys, Kanifing had the highest net attendance rate (75.4 per cent) and Mansakonko the lowest (46.2 per cent). Banjul had the highest rate for girls (81.5 per cent) while Basse had the lowest (45.1 per cent). There are also marked differences in net attendance ratio between the urban and rural areas. The net attendance ratio in the urban areas for boys is 74.8 per cent compared to 52.9 per cent in the rural areas. Among the girls, the net attendance ratio is 72.5 per cent for the urban areas com- pared to 56.5 per cent for the rural areas. There is a positive relationship between children's net attendance ratio and the women's level of education as well as the poverty status of households. The more educated a woman is, the higher the likelihood of her children being sent to primary school, as the indicator ranges from 57.7 per cent of children of women with no education to 80.7 per cent of children of women with secondary education and above. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 57 Education Children from the richest households have a higher attendance rate (75.8 per cent) than children from the poorest households (44.4 per cent). Seven-year-old children have a lower attendance rate (35.3 per cent) than older children, while those aged 11 years have a higher attendance rate (74.5 per cent). Across ethnic groups, children from households headed by the Jola have a net attendance ratio of 72.9 per cent and households headed by the Wollof and Fula have the lowest proportions each with 53 per cent. The secondary school net attendance ratio is presented in Table ED.4. Secondary school attendance rates are relatively lower than those of primary schools with only 36.5 per cent of children of secondary school age attending secondary school. A larger proportion of boys of secondary school going age were found to be attending secondary school than girls. In general, 39.2 per cent of boys were attending school compared to 34.0 per cent of girls. Across LGAs, the net attendance ratio is lowest in Basse for both boys and girls and highest in Banjul. The net attendance ratio for both boys and girls for Banjul is 56.0 per cent compared to only 14.7 per cent in Basse LGA. Across all the regions, the net attendance rate is higher for boys except in Banjul and Mansakonko where the ratio is higher for girls. In the urban areas, slightly above half of the children of secondary school age were attending secondary or higher school compared to 26.4 per cent of their counterparts in the rural areas. The educational attainment of women is positively related to the net attendance ratio. School atten- dance ratios range from 35.0 per cent for children of women with no education to 57.4 per cent for those of women with secondary education and above. The data also show that the richer the household, the higher the net attendance rate of its children. Across the ethnic groups, households headed by the Serer have the highest net attendance ratio. The primary school net attendance ratio of children of secondary school age is presented in Table ED. 4W. About one in four (24.3 per cent) of the children of secondary school age was attending primary school when they should have been attending secondary school. Small differences exist in the proportion of such children attending primary school across the sexes with 25.1 per cent and 23.4 per cent of boys and girls, respectively, attending primary school. This observed phenomenon of older children attending primary school has been found to be more prevalent in Brikama (31.1 per cent) and Janjangbureh (29.5 per cent) LGAs but the least prevalent in Banjul (16.1 per cent). The proportion of children of secondary school age attending primary school is higher in the rural areas (26.3 per cent) than in the urban areas (21.1 per cent). Thirteen-year-old children accounted for the highest (53.1 per cent) proportion of children of secondary school age attending primary school while the 18-year-olds accounted for the lowest (4.3 per cent). Women with primary education had the highest number of children (44.0 per cent) of secondary school age attending primary school and children from the richest households had lower attendance rates than children from the poorest households. The percentage of children entering the first grade who eventually reach Grade 5 is presented in Table ED.5. Of all the children starting Grade 1, the majority of them (96.6 per cent) eventually reach Grade 5. Male children entering the first grade of primary school are more likely to go up to Grade 5 than female children. 58 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Education Across ethnic groups, not much difference has been observed but Kerewan had the highest number of children entering Grade 1 and eventually reaching Grade 5 with 100 per cent and Janjangbureh had the lowest proportion with 87.9 per cent. Virtually no differences have been observed in the proportion of children entering the first grade and reaching the fifth grade in primary school across household poverty status. The net primary school completion rate and transition rate to secondary education is presented in Table ED.6. At the time of the survey the net primary school completion rate was estimated at 73.6 per cent. This value should be distinguished from the gross primary com- pletion ratio which includes children of any age attending the last grade of primary school. However, the sex differential is not much, as the completion rate for males is 74.9 per cent and that of females is 72.4 per cent. Basse had the lowest (47.4 per cent). The net primary school completion rate is higher in the urban areas (84.3 per cent) than in the rural areas (67.7 per cent). Children from the richest households have higher net primary school completion rates (85.6 per cent) than those from the poorest households (60.4 per cent). Children from households headed by the Jola have the highest net primary school completion rate (86.6 per cent) and those headed by the Wollof have the lowest rate (71.1 per cent). Only 56.2 per cent of the children who successfully completed the last grade of primary school transited to the first grade of secondary school. Boys have a higher transition rate to secondary education than girls (61.5 per cent compared to 51.1 per cent). Across the regions, Banjul has the highest transition rate (91.3 per cent) and Basse the lowest (34.2 per cent). The rural-urban differentials are huge, as the transition rate in the urban areas is 74.0 per cent compared to 43.1 per cent in the rural areas. Ironically, children of women with no education have higher transition rates from primary to secondary school (63.8 per cent) than those of women with some formal education. Transition rates across the poverty status of households show that children from rich households have higher transitions rates (87.5 per cent) than those from the poorest households (27.4 per cent). Households headed by the Serer have a higher transition than those of other ethnic groups. The ratio of girls to boys attending primary and secondary education is provided in Table ED.7. These ratios are better known as the Gender Parity Index (GPI). Notice that the ratios included here are obtained from net attendance ratios rather than gross attendance ratios. The last ratios provide an erroneous description of the GPI mainly because in most of the cases the majority of over-aged children attending primary school tend to be boys. The table shows that gender parity for primary school is close to 1.00, indicating no major difference in the primary school attendance of girls and boys. However, the indicator drops to 0.87 for secondary education. The disadvantage of girls regarding secondary school attendance is particularly pronounced in Basse LGA, as well as among children living in the poorest households and also in the rural areas. The GPI in Banjul, Mansakonko, Kuntaur and Janjangbureh shows that more girls than boys attend primary school in these LGAs. The GPI for children of women with no education is the same as those whose mothers or primary caretakers have secondary education or above (1.03) for primary schools. Not much difference has been observed among children of varying household poverty categories and ethnicity of household heads. The disadvantage of girls is particularly pronounced in the rural areas where the GPI is low (0.82), as well as among children living in the poorest households with secondary school gender parity of 0.68. Across LGAs, the secondary school attendance gap between boys and girls is widest in Kuntaur in favour of boys. The secondary school GPI for Kuntaur is 0.60. Only small differences were observed between the urban and rural GPIs. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 59 Education Adult Literacy One of the WFFC goals is to assure adult literacy, which is also an MDG indicator, relating to both men and women. In the MICS, since only a women's questionnaire was administered, the results are based only on females aged 15-24. Literacy was assessed on the ability of women to read a short simple statement or on school attendance. The literacy percentage is presented in Table ED.8. According to the results, 43.1 per cent of the women aged 15-24 were literate. The literacy rates were highest in Banjul (65.2 per cent) and lowest in Basse (13.2 per cent). The data further show that literacy rates are highest in the urban areas. As expected, there are variations in the literate population across age groups. The literacy rate is highest for those aged 15-19 (50.8 per cent) com- pared to those aged 20-24 (34.3 per cent). Literacy rates range from 0.7 per cent for women with no education to 100 per cent for those with secondary education and above. The data also indicate that women living in the richest households have better chances of being literate than those from the poorest households. Across ethnic groups, women from households headed by the Serer have the highest literacy rate (58.5 per cent) while those from households headed by the Fula have the lowest rate (30.2 per cent). 60 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF /G am 00 55 3/ G ia co m o Pi ro zz i The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 61 11. CHILD PROTECTION Birth Registration The Convention on the Rights of the Child states that every child has the right to a name and a nationality and the right to being deprived of his or her identity. Birth registration is a fundamental means of securing these rights for children. The WFFC states the goal to develop systems to ensure the registration of every child at or shortly after birth, and fulfil his or her right to acquire a name and a nationality, in accordance with national laws and relevant international instruments. The indicator is the percentage of under-5 children whose birth is registered. The births of 55.1 per cent of under-5s in The Gambia have been registered (Table CP.1). Mansakonko LGA has the highest percentage of births that were registered (86.4 per cent), followed by Banjul with about 77 per cent. Basse has the lowest proportion of its births being registered (39.4 per cent). Across ethnic groups, only small differences have been observed in birth registration. Children from the richest households (64.3 per cent) are more likely to have their births registered than children from the poorest households (52.1 per cent). Generally, the main reason why a large proportion of births were not registered (28 per cent) was lack of knowledge that a child's birth should be registered. Child Labour Article 32 of the Convention on the Rights of the Child states: "States Parties recognize the right of the child to be protected from economic exploitation and from performing any work that is likely to be hazardous or to interfere with the child's education, or to be harmful to the child's health or physical, mental, spiritual, moral or social development." The WFFC mentions seven strategies to combat child labour and the Millennium Declaration calls for the protection of children against exploitation. In the MICS questionnaire, a number of questions addressed the issue of child labour, that is, children aged 5-14 involved in labour activities. A child is considered to be involved in child labour activities at the time of the survey if during the week preceding the survey: • Ages 5-11: did at least one hour of economic work or 28 hours of domestic work per week • Ages 12-14: did at least 14 hours of economic work or 28 hours of domestic work per week. This definition allows differentiation between child labour and child work to identify the type of work that should be eliminated. As such, the estimate provided here is a minimum of the prevalence of child labour since some children may be involved in hazardous labour activities for a number of hours that could be less than the numbers specified in the criteria explained above. Table CP.2 shows the distribution of children aged 5-14 who were involved in child labour activities by type of work. According to the table, about 25 per cent of children in this age bracket were involved in some form of child labour. Of these children 21.1 per cent were working on family business, 62 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Child Protection 1.8 per cent worked on household chores for 28 hours or more per week,3.3 per cent were engaged in unpaid work outside their households and only 0.6 per cent did paid work. The data further show that boys were more likely to be engaged in paid work than girls. Children in Banjul, Kanifing and Brikama LGAs are less likely to be engaged in work than children in the other LGAs. Similarly, children from the poorest households are more likely to be engaged in work than their counterparts from the richest households. Presented in Table CP.3 is the percentage of children classified as student labourers or as labourer students. Student labourers are children attending school who were involved in child labour activi- ties at the time of the survey. More specifically, about 25 per cent of children aged 5-14 were invol- ved in child labour. Of the child labourers, about 65 per cent were also attending school whereas 24 per cent of the students are also involved in some form of child labour. Across LGAs, child labour is highest in Kerewan (36.1 per cent) and lowest in Banjul (11.5 per cent). Child labour is more prevalent in the rural areas (28.6 per cent) than in the urban areas (16.9 per cent). Children of mothers with no education (26.1 per cent) are more likely to be engaged in child labour than those of mothers with secondary education and above (16.1 per cent). On the other hand, children from the poorest households (33.7 per cent) are more likely to be engaged in child labour than those from the richest households (11.3 per cent). Child Discipline As stated in the WFFC, “children must be protected against any acts of violence …” the Millennium Declaration calls for the protection of children against abuse, exploitation and violence. In The Gambia MICS study, mothers/caretakers of children aged 2-14 were asked a series of questions on the ways parents discipline their children when they misbehave: Note that to administer the child discipline module, one child aged 2-14 years was randomly selected per household for the interview. From the questions asked, two indicators were identified to deter- mine the extent and nature of child discipline. These are: • the number of children aged 2-14 who experience psychological aggression as punishment or minor physical punishment or severe physical punishment • the number of parents/caretakers of children and 2-14 who believe that in order to raise their children properly, they need to physically punish them. In The Gambia, 84.2 per cent of children aged 2-14 were subjected to at least one form of psycho- logical or physical punishment by their mothers/caretakers or other household members. More importantly, 21.5 per cent of children were subjected to severe physical punishment. On the other hand, 31.2 per cent of mothers/caretakers believed that children should be physically punished, contrary to the high prevalence of physical discipline among children. The prevalence rates of both minor and severe physical discipline were higher among boys (71.7 and 22.4 per cent respectively) than girls (69.5 and 20.7 per cent respectively). Psychological or physical punishment of children is highest in Kuntaur (97.4 per cent) and lowest in Janjangbureh (77.2 per cent). There were negligible differences between the urban and rural areas. Children from the poorest households (87.9 per cent) tend to be more psychologically and physically punished than children from the richest households (82.7 per cent) (Table CP.4) The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 63 Child Protection Early Marriage and Polygyny Marriage before the age of 18 is a reality for many young girls. According to UNICEF's worldwide estimates, over 60 million women 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 • the existence of customary or religious laws that condone the practice. In many parts of the world parents encourage the marriage of their daughters while they are still children in hopes that the marriage will benefit them both financially and socially. In actual fact, child marriage is a violation of human rights, compromising the development of girls and often resulting in early pregnancy and social isolation, with little education and poor vocational training reinforcing the gendered nature of poverty. The right to a 'free and full' consent to a marriage is recognized in the Universal Declaration of Human Rights - with the recognition that consent cannot be 'free and full' when one of the parties involved is not sufficiently mature to make an informed decision about a life partner. The Convention on the Elimination of all Forms of Discrimination against Women (CEDAW) mentions the right to protection from child marriage in article 16, which states: "The betrothal and the marriage of a child shall have no legal effect, and all necessary action, including legislation, shall be taken to specify a minimum age for marriage.” While marriage is not considered directly in the Convention on the Rights of the Child, child mar- riage is linked to other rights - such as the right to express their views freely, the right to protection from all forms of abuse; and the right to be protected from harmful traditional practices - and is frequently addressed by the Convention on the Rights of the Child. Other international agreements related to child marriage are the Convention on Consent to Marriage, Minimum Age for Marriage and Registration of Marriages and the African Charter on the Rights and Welfare of the Child and the Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa. Child marriage is also identified by the Pan-African Forum against the Sexual Exploitation of Children as a type of commercial sexual exploitation of children. Young married girls are a unique, though often invisible, group. Required to perform heavy amounts of domestic work, under pressure to demonstrate fertility and responsible for raising children while still children themselves, married girls and child mothers face constrained decision-making and reduced life choices. Boys are also affected by child marriage but the issue impacts girls in far larger numbers and with more intensity. Cohabitation - when a couple lives together as if married - raises the same human rights concerns as marriage. Where a girl lives with a man and takes on the role of caretaker for him, the assumption is often that she has become an adult woman, even if she has not yet reached the age of 18. Additional concerns due to the informality of the relationship - for example, inheritance, citizenship and social recognition - might make girls in informal unions vulnerable in different ways than those who are in formally recognized marriages. 64 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Child Protection Research suggests that many factors interact to place a child at risk of marriage. Poverty, protection of girls, family honour and the provision of stability during unstable social periods are considered as significant factors in determining a girl's risk of becoming married while still a child. Women who married at a younger age are more likely to believe that it is sometimes acceptable for a husband to beat his wife and are more likely to experience domestic violence themselves. The age gap between partners is thought to contribute to these abusive power dynamics and to increase the risk of untimely widowhood. Closely related to the issue of child marriage is the age at which girls become sexually active. Women who are married before the age of 18 tend to have more children than those who marry later in life. Pregnancy-related deaths are known to be a leading cause of mortality for both married and unmarried girls between the ages of 15 and 19, particularly among the youngest of this cohort. There is evi- dence to suggest that girls who marry at a young age are more likely to marry older men, which puts them at an increased risk of HIV infection. Parents seek to marry off their girls to protect their honour, and men often seek younger women as wives as a means to avoid choosing a wife who might already be infected. Two indicators used to determine early marriage among females are the percentage of women married before 15 years of age and the percentage married before 18 years of age. Table ED.5 shows that 10 per cent of women aged 15-49 and married or in union actually marry before their 15th birthday whereas 49 per cent of married or in union women aged 20-49 are married or in union before they reach 18 years of age. The number of women aged 15-49 in polygamous marriage/union accounted for 44 per cent. For women aged 15-49 early marriage is more prevalent in Kerewan and the least prevalent in Banjul. Women in the poorest households and those with no education are more likely to marry at an earlier age than other women. Across ethnic groups, Fula women are more likely to marry at an earlier age than women of other ethnic origins. Another area of interest is the spousal age difference, with the indicator being the percentage of women in marriage/in union younger than their current partner by 10 years or more. Table CP.6 shows the percentage distribution of currently married/in union women aged 15-49 according to the age difference with a husband/partner. The table shows that 59.4 per cent of women aged 15-19 have husbands/partners who are at least 10 years older than them. Interestingly, among women aged 15-19, spousal age difference is highest in Brikama LGAs (71.3 per cent) and lowest in Janjangbureh (37.3 per cent). Among women aged 15-24, spousal age dif- ference is highest in Kerewan (67.1 per cent) and lowest in Basse (43.9 per cent). Across all ages, spousal age difference tends to be higher among women with no education than women with secon- dary education and above. Female Genital Mutilation/Cutting Female genital mutilation/cutting (FGM/C) is the partial or total removal of the female external genitalia or other injury to the female genital organs. FGM/C is always traumatic with immediate complications including excruciating pain, shock, urine retention, ulceration of the genitals and injury to adjacent tissue. Other complications include septicaemia, infertility, obstructed labour, and even death. The procedure is generally carried out on girls between the ages of 4 and 14; it is also done to infants, women who are about to be married and, sometimes, to women who are pregnant with their first child or who have just given birth. It is often performed by traditional practitioners, including midwives, without anaesthesia, using scissors, razor blades or broken glass. FGM/C is a violation of human rights. In the absence of any perceived medical necessity, it subjects girls and women to health risks and has life-threatening consequences. Among those rights violated are the rights to the highest attainable standard of health and to bodily integrity. Furthermore, it could be argued that girls (under 18) cannot be said to give informed consent to such a potentially damaging practice as FGM/C. In the MICS III, a series of 16 questions were asked to determine knowledge of FGM/C, prevalence of FGM/C and details of the type of FGM/C performed. However, in The Gambia, the questions were reduced to 10 after deleting questions considered offensive or sensitive and those that were considered of little importance or interest to the country. Table CP.7 shows the prevalence of FGM/C among women as well as women's attitude towards FGM/C. Overall, 64.3 per cent of women reported that at least one of their living daughters had undergone FGM/C. Among the LGAs, Basse registered the highest proportion of women (91.4 per cent) who had at least one living daughter exposed to FGM/C. Daughters of women living in Banjul are least exposed to FGM/C compared to other LGAs. Daughters whose mothers have no education (69.5 per cent) are more likely to be exposed to the practice of FGM/C compared to daughters whose mothers have primary education (57.7 per cent) or secondary education (41.3 per cent), (see Table CP.8) The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 65 Child Protection U N IC EF -T os ta n G am bi a/ 20 07 /R ac he lU nk ov ic 66 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Child Protection The table shows that 78 per cent of women aged 15-49 had some form of female genital mutilation. The percentages declined from 81 per cent for women without formal education to 71 per cent for women with secondary education and above. The practice of FGM/C is popular among the Mandinka, Fula and Jola ethnic groups, each of which has prevalence rates of more than 80 per cent. The practice is moderate among the Serer ethnic group with a prevalence rate of 45 per cent whereas among the Wollof the practice is unpopular, with a prevalence rate of 12 per cent. The practice appers more common among households in the middle wealth quintiles than the poorest and richest households. Differences have been observed among women in the various LGAs with the practice more common in Basse (99.0 per cent) and Mansakonko (95.9 per cent) and less common in Banjul (44.8 per cent) and Kerewan (60.8 per cent) LGAs. The practice is more common in the rural areas than in the urban areas. FGM/C is practised slightly less among women with secondary education and above than those who either have never been to school or only stopped at primary school. Regarding opinion as to whether the practice should be continued or discontinued, 71.1 per cent of women thought it should be continued while 23 per cent believed it should be discontinued. Across ethnic groups, the belief that the practice should be continued is highest among the Mandinka (89.2 per cent), the Jola (80.7 per cent) and the Fula (79.5 per cent) and least common among the Wollof. Women in the Mansakonko area are more likely to approve of the continuation of the practice of FGM/C than women in other LGAs. Banjul women are less likely to approve of the continuation of the practice. Approval of the continuation of the practice is highest among women with no edu- cation (76.9 per cent) than those with secondary education and above (57.7 per cent). Women from the richest households are less likely to approve of the continuation of the practice than women from the poorest households. Overall, 72.9 per cent of the women interviewed reported that they would like their daughters to be circumcised. Among the LGAs a larger proportion of women in Basse (97.4 per cent) reported that they would like their daughters to be circumcised compared to Banjul with 30.7 per cent. In the rural areas, 81.3 per cent of women were reported to approve of FGM/C for their daughters compared to 61.5 per cent in the urban areas. Women with no education (78.5 per cent) are more likely to approve of FGM/C for their daughters than those with secondary education and above (59.0 per cent). Similarly, a larger proportion of women from the poorest households approved of FGM/C for their daughters than those from the richest households (Table CP.7). Domestic Violence A number of questions were asked of women aged 15-49 to assess their attitudes towards whether husbands are justified to hit or beat their wives/partners for a variety of scenarios. These questions were asked to have an indication of cultural beliefs that tend to be associated with the prevalence of violence against women by their husbands/partners. The main assumption here is that women who agree with the statements indicating that their husbands/partners are justified to beat their wives/partners under the situations described in reality tend to be abused by their own husbands/partners. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 67 Child Protection The responses to these questions are tabulated in Table CP.9. The table shows that 74 per cent of women aged 15-49 believed that a husband is justified in beating his wife/partner under any one of the following circumstances: when she goes out without informing the husband, when she neglects the children, when she argues with him, when she refuses sex with him and when she burns the food. The data show that a woman in Banjul is less likely to approve of wife/partner beating than any woman in other LGAs where more than half of the women approve of the practice. Similarly, poorer women are more likely to approve of wife beating than women in the richest households. On the other hand, the higher the education of a woman is, the less likely it is for her to approve of wife beating. 68 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U N IC EF /G am 00 41 1/ G ia co m o Pi ro zz i The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 69 12. HIV/AIDS, SEXUAL BEHAVIOUR AND ORPHANED AND VULNERABLE CHILDREN Knowledge of HIV Transmission and Condom Use One of the most important prerequisites for reducing the rate of HIV infection is accurate knowledge of how HIV is transmitted and strategies for preventing transmission. Correct information is the first step towards raising awareness and giving young people the tools to protect them from infection. Misconceptions of HIV are common and can confuse young people and hinder prevention efforts. Different regions are likely to have variations in misconceptions, although some appear to be universal (for example that sharing food can transmit HIV or mosquito bites can transmit HIV). The UN General Assembly Special Session on HIV/AIDS (UNGASS) called on governments to improve the knowledge and skills of young people to protect them 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 behaviour to prevent further spread of the disease. The HIV module was administered to women aged 15-49. 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 preventing HIV transmission - having only one faithful uninfected partner, using a condom every time, and abstaining from sex. The results are presented in Table HA.1. In The Gambia, almost all the interviewed women (99 per cent) have heard of HIV/AIDS. However, only 65 per cent of women know of all the three ways of preventing HIV transmission. About 92 per cent of women know of having one faithful uninfected sex partner, 82 per cent know of using a condom every time and 77 per cent know of abstaining from sex as ways of preventing HIV trans- mission. While 97 per cent of women know at least one way, a low proportion of women (3 per cent) do not know any of the three ways. The percentage of women knowing all the three ways of preventing HIV/AIDS transmission was lowest in the Kanifing and Mansakonko LGAs (53 per cent each), followed by Banjul (56 per cent). The percentage of women who knew all three ways was higher in the poorest category than in the richest category. Presented in Table HA.2 is the percentage of women who can correctly identify misconceptions about HIV. The indicator is based on the two most common and relevant misconceptions in The Gambia: that HIV can be transmitted by mosquito bites and supernatural means. The table also provides information on whether women know that HIV cannot be transmitted by sharing food with an infected person, and that HIV can be transmitted by sharing needles. Of the women interviewed, 45 per cent reject the two most common misconceptions and know that a healthy-looking person can be infected. About 62 per cent of women know that HIV cannot be transmitted by mosquito bites, while 75 per cent know that it cannot be transmitted by sharing food. Seventy-three per cent of women know that a healthy-looking person can be infected. 70 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report HIV/AIDS, Sexual behaviour, and Orphaned and Vulnerable Children Across LGAs, women in Banjul, Kanifing and Brikama were found to be more knowledgeable about misconceptions than women in other LGAs with more than half of the women interviewed in these LGAs rejecting the most common misconceptions. They know that a healthy looking person can be infected. Women from the richest households are more knowledgeable about misconceptions than women from the poorest households. Across ethnic groups, Serer women seem to be more knowledgeable about misconceptions than other ethnic groups. Table HA.3 summarizes information from Tables HA.1 and HA.2 and presents the percentage of women who know two ways of preventing HIV transmission and reject three common misconcep- tions. Comprehensive knowledge of HIV prevention methods and transmission is still fairly low, although there are differences across areas of residence. As a whole, 38 per cent of women were found to have comprehensive knowledge of HIV, which was slightly higher in the urban areas (41 per cent). As expected, the percentage of women with comprehensive knowledge increases with the women's education level. (Figure HA.1). Knowledge of mother-to-child transmission of HIV is also an important first step for women to seek HIV testing when they are pregnant to avoid infection in the baby. Women should know that HIV could be transmitted during pregnancy, delivery and breastfeeding. The level of knowledge among women aged 15-49 concerning mother-to-child transmission is presented in Table HA.4. Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission,The Gambia, 2006 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 71 HIV/AIDS, Sexual behaviour, and Orphaned and Vulnerable Children Generally, 94 per cent of women know that HIV can be transmitted from mother to child. The percentage of women who know all three ways of mother-to-child transmission is 67 per cent, while 5 per cent do not know of any specific way. Minor differentials have been observed in know- ledge of mother-to-child transmission among women across educational attainment of women and ethnicity of head of household. Knowledge of mother-to-child transmission is higher in the rural areas (72.7 per cent) than in the urban areas (58.6 per cent). Similarly, women in the poorest house- holds (72.7 per cent) tend to be more knowledgeable on mother-to-child transmission of HIV/AIDS than those from the richest households (56.1 per cent). The indicators on attitude towards people living with HIV measure stigma and discrimination in the community. Stigma and discrimination are low if respondents report a favourable attitude on the following four statements: • would care for family member sick with AIDS • would buy fresh vegetables from a vendor who was HIV positive • thinks that a teacher who is HIV positive should be allowed to teach in school • would not want to keep the HIV status of a family member a secret. Table HA.5 presents the attitudes of women towards people living with HIV/AIDS. About 84 per cent of the women interviewed during the MICS agreed with at least one of the dis- criminatory statements. The analysis of the data by LGA, residence and household poverty status each shows that more than 75 per cent of women agreed with at least one discriminatory statement. It is worth noting that 16.3 per cent of the women agreed with none of the discriminatory state- ments. One out of every 10 women would not care for a family member who was with AIDS, 55 per cent would want to keep secret if a family member was with AIDS, a little more than a third of the women believed that a teacher with HIV should not be allowed to work and half of the women would not buy fresh vegetables from a person with HIV/AIDS. Another important indicator is the knowledge of where to be tested for HIV and use of such services. Questions related to knowledge among women of a facility for HIV testing and whether they have ever been tested is presented in Table HA.6. About 55 per cent of women know where to be tested, while 14 per cent have actually been tested. Of these, a large proportion has been told the result (89 per cent). Women in Kuntaur LGA are less likely to know a place to get tested for HIV than women in other LGAs and those in Banjul, Kanifing and Brikama are more likely to know where to get tested. Women in the Brikama and Kanifing areas are more likely to have been tested for HIV than women from other LGAs with nearly a fifth claiming to have been tested. Knowledge of where to be tested for HIV is more extensive in the urban than rural areas. In the former, 64 per cent of women know where to go for testing whereas in the latter, only 48 per cent know of such a facility. The proportion of women having this knowledge increases with education as well as the wealth status of their households. 72 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report HIV/AIDS, Sexual behaviour, and Orphaned and Vulnerable Children Among women who had given birth within the two years preceding the survey, the proportion who received counselling and HIV testing during antenatal care is presented in Table HA.7. Data in the table show that there is almost universal access to antenatal care in The Gambia. As already observed, nearly 98 per cent of women with a birth in the two years preceding the survey received antenatal care from a health professional during their last pregnancy. About 45 per cent of these women were provided with information of HIV prevention during antenatal visits, 23 per cent were tested for HIV and 21 per cent received the results of their test. Sexual Behaviour Related to HIV Transmission Promoting safer sexual behaviour is critical for reducing HIV prevalence. The use of condoms during sex, especially with non-regular partners, is especially important for reducing the spread of the virus. In most countries, over half of new HIV infections are among young people aged 15-24. Thus a change in behaviour among this age group will be especially important to reduce new infections. A module of questions was administered to women aged 15-24 to assess their exposure to the risk of HIV infection. Risk factors for HIV include sex at an early age, sex with older men, sex with a non-marital non-cohabitating partner and failure to use a condom. The sexual behaviour that increases the risk of HIV infection among women is presented in Table HA.8 and Figure HA.2. Table HA.8 shows that 4 per cent of women aged 15-19 had sex before age 15, and 51 per cent aged 15-24 had sex with men 10 or more years older than them in the 12 months preceding the survey. The first sexual encounter is earlier among women in Kuntaur and later in Banjul. Education appears to delay women's exposure to sex and women from the poorest households seem to encounter sex at an earlier age than those from the richest households. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 73 HIV/AIDS, Sexual behaviour, and Orphaned and Vulnerable Children Figure HA.2: Percentage of young women aged 15-19 and 20-24 who had sex befor ages 15 aand 18 respectively and percentage of women aged 20-24 who had sex with a man 10 or years older, The Gambia, 2006 Condom use during sex with men other than husbands or live-in partners (non-marital, non-coha- biting) was assessed among women aged 15-24 who had sex with such a partner in the previous year (Table HA.9). About 16 per cent of women aged 15-24 reported having sex with a non-regular partner in the 12 months prior to the MICS. Of those women, over half reported using a condom when they had sex with the high risk partner. Forty-five per cent of women aged 15-24 with primary education used a condom during higher risk sex in the year before the MICS while 58 per cent (aged 15-24) with secondary or more education used a condom with such a partner. Orphans and Vulnerable Children As the HIV/AIDS pandemic progresses, more and more children are becoming orphaned and vul- nerable. Children who are orphaned or in vulnerable households may be at an increased risk of neglect or exploitation, if the parents are not available to assist them. Monitoring the variations in different outcomes for orphans and vulnerable children and comparing them to their peers gives us a measure of how well communities and governments are responding to their needs. To monitor these variations, a measurable definition of orphaned and vulnerable children needed to be created. The UNAIDS Monitoring and Evaluation Reference Group developed a proxy definition of children who have been affected by adult morbidity and mortality. This should capture many of the children affected by AIDS in countries where a significant proportion of the adults are HIV infected. 74 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report HIV/AIDS, Sexual behaviour, and Orphaned and Vulnerable Children This definition classifies children as orphaned and vulnerable if they have experienced the death of either parent, if either parent is chronically ill, or if an adult (aged 18-59) in the household either died (after being chronically ill) or was chronically ill in the year prior to the survey. The frequency of children living with neither parent, mother only, and father only is presented in Table HA.10. The proportion of children aged 0-17 living with mother only was 17 per cent (ie 13 per cent father alive and 4 per cent father dead). On the other hand, only 5 per cent of children aged 0-17 years were living with father only (ie 4 per cent mother alive and 1 per cent mother dead). About 9 per cent of children aged 0-17 were reported to have lost one parent. A review of the data presented in the table shows that the living arrangements of children do not differ markedly among children from different backgrounds. Table HA.11 shows that the percentage of orphaned and vulnerable children aged 0-17 was 12.6 per cent. Children in Kuntaur were observed to be more likely to be orphaned and vulnerable (15.3 per cent). Kerewan children were the least likely to be orphaned and vulnerable (6.4 per cent) than children in other LGAs. Urban children are more likely to be orphaned and vulnerable (14.1 per cent) than rural children (11.7 per cent). 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 10-14 for children who have lost both parents (double orphans) 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. In The Gambia, one per cent of children aged 10-14 have lost both parents (Table HA.12). Among these, only 65 per cent are currently attending school. Among children aged 10-14 who have not lost a parent and who live with at least one parent, 72 per cent are attending school. This would suggest that double orphans are disadvantaged compared to non-orphaned children in terms of school attendance. In many countries few services are available to families who have taken in orphaned or vulnerable children. Community-based organizations and governments need to be sure that families are sup- ported to care for these children. The prevalence of malnutrition among orphans and vulnerable children under five years of age is presented in Table HA.14. Of the orphaned or vulnerable children, 22 per cent are underweight, 23 per cent stunted and 6 per cent wasted. Compared to non-orphaned children, there appears not to be many differences in their nutritional status. Research suggests that in some areas children who were orphaned are more likely to have worse sexual and reproductive health outcomes than other children. Table HA.15 presents information on the sexual behaviour of orphaned and vulnerable women aged 15-17. According to the table, the proportion of young orphaned or vulnerable women aged 15-17 who had sex before age 15 is lower (3 per cent) than the non-orphaned or vulnerable children (4 per cent). This is contrary to expectations. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 75 The ratio of the percentages estimated for orphaned and vulnerable children to those who are not orphaned or vulnerable is estimated at 0.8, which indicates only a marginal difference between vulnerable and non-vulnerable children when it comes to the timing of exposure to sex. 76 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report LIST OF REFERENCES 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. 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. 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. Gambia, Government of The, and UNICEF, 2002, The Gambia MICS Report, 2000, Central Statistics Department, Banjul Gambia, Government of The, 2003, Population and Housing Census, Fertility Estimates, Gambia Bureau of Statistics (GBoS), Banjul. Gambia, Government of The, 2003, Population and Housing Census, Housing and Household Characteristics, Gambia Bureau of Statistics (GBoS), Banjul. Gambia, Government of The, 2003, Population and Housing Census, Mortality Estimates, Gambia Bureau of Statistics (GBoS), Banjul. Gambia, Government of The, Education Policy 2004- 2015, Department of State for Education (DoSE), Banjul Gambia, Government of The, The National Health Policy Framework, 2007-2020, Department of State for Health (DoSHSW), Banjul Gambia, Government of The, The National Nutrition Policy 2000- 2004, National Nutrition Agency (NaNA), Banjul Gambia, Government of The, The National Population Policy 2007-2015, National Population Secretariat, Banjul 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 Children's Fund, 2002, A World Fit for Children, New York United Nations Convention on the Rights of the Child (CRC), 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 Population Division United Nations, 1990b. Step-by-step Guide to the Estimation of Child Mortality. New York, UN www.Childinfo.org. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 77 TABLES 78 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report U rb an Ru ra l Ba nj ul Ka ni fin g Br ik am a M an sa ko nk o Ke re w an Ku nt au r Ja nj an gb ur eh Ba ss e To ta l N um be r of ho us eh ol ds Sa m pl ed 29 45 32 30 26 6 18 81 16 91 36 1 76 0 26 6 41 8 53 2 61 75 O cc up ie d 29 45 32 26 26 6 18 81 16 87 36 1 76 0 26 6 41 8 53 2 61 71 In te rv ie w ed 28 90 31 81 26 6 18 37 16 46 36 1 75 4 26 4 41 7 52 6 60 71 Re sp on se ra te 98 .1 98 .6 10 0. 0 97 .7 97 .6 10 0. 0 99 .2 99 .2 99 .8 98 .9 98 .4 N um be r of w om en El ig ib le 43 08 59 44 32 8 28 25 24 45 59 4 10 97 53 4 96 4 14 65 10 25 2 In te rv ie w ed 41 89 57 93 32 6 27 31 23 87 57 3 10 90 50 6 95 8 14 11 99 82 Re sp on se ra te 97 .2 97 .5 99 .4 96 .7 97 .6 96 .5 99 .4 94 .8 99 .4 96 .3 97 .4 O ve ra ll re sp on se ra te 95 .4 96 .1 99 .4 94 .4 95 .3 96 .5 98 .6 94 .0 99 .1 95 .2 95 .8 N um be r of ch ild re n un de r 5 El ig ib le 22 48 43 93 16 7 14 61 13 90 40 4 86 3 44 1 75 4 11 61 66 41 M ot he r/c ar et ak er in te rv ie w ed 22 02 43 41 16 0 14 25 13 76 39 9 85 6 43 1 75 3 11 43 65 43 Re sp on se ra te 98 .0 98 .8 95 .8 97 .5 99 .0 98 .8 99 .2 97 .7 99 .9 98 .4 98 .5 O ve ra ll re sp on se ra te 96 .1 97 .4 95 .8 95 .3 96 .6 98 .8 98 .4 97 .0 99 .6 97 .3 96 .9 R es id en ce LG A Ta bl e H H .1 :R es ul ts of ho us eh ol d an d in di vi du al in te rv ie w s N um be r of ho us eh ol ds ,w om en an d ch ild re n un de r 5 by re su lts of th e ho us eh ol d, w om en 's an d un de r-5 's in te rv ie w s, an d ho us eh ol d, w om en 's an d un de r-5 's re sp on se ra te s, Th e G am bi a, 20 06 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 79 Table HH.2: Household age distribution by sex Percentage distribution of the household population by five-year age groups and dependency age groups, and number of children aged 0-17 years, by sex, The Gambia, 2006 Number Per cent Number Per cent Number Per cent Age 0-4 3306 15.0 3173 13.9 6479 14.4 5-9 3598 16.3 3535 15.5 7134 15.9 10-14 2869 13.0 3407 14.9 6275 14.0 15-19 2518 11.4 2307 10.1 4825 10.8 20-24 1749 7.9 2044 9.0 3793 8.5 25-29 1483 6.7 1935 8.5 3417 7.6 30-34 1204 5.5 1361 6.0 2565 5.7 35-39 1147 5.2 1065 4.7 2212 4.9 40-44 948 4.3 830 3.6 1778 4.0 45-49 763 3.5 546 2.4 1308 2.9 50-54 583 2.6 1048 4.6 1630 3.6 55-59 514 2.3 485 2.1 998 2.2 60-64 484 2.2 393 1.7 877 2.0 65-69 337 1.5 196 .9 533 1.2 70+ 538 2.4 463 2.0 1001 2.2 Missing/DK 32 (.1) 18 (*) 49 (.1) Dependency age groups < 15 9774 44.3 10115 44.4 19888 44.3 15-64 11391 51.6 12014 52.7 23404 52.2 65 + 876 4.0 659 2.9 1535 3.4 Missing/DK 32 (.1) 18 (*) 49 (.1) Children aged 0-17 11386 51.6 11473 50.3 22859 50.9 Adults 18+/Missing/ DK 10686 48.4 11332 49.7 22018 49.1 Total 22072 100.0 22805 100.0 44877 100.0 Males Females Total 80 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table HH.3: Household composition Percentage distribution of households by selected characteristics, The Gambia, 2006 Weighted per cent Weighted Unweighted Sex of household head Male 84.1 5103 5120 Female 15.9 968 951 LGA Banjul 5.1 308 266 Kanifing 30.9 1877 1837 Brikama 27.2 1652 1646 Mansakonko 5.9 357 361 Kerewan 11.8 718 754 Kuntaur 5.0 306 264 Janjangbureh 6.1 370 417 Basse 8.0 483 526 Residence Urban 48.3 2930 2890 Rural 51.7 3141 3181 Number of household members 1 9.4 573 565 2-3 14.0 852 836 4-5 20.0 1216 1200 6-7 18.2 1104 1092 8-9 13.3 806 806 10+ 25.0 1521 1572 Ethnic group of head of household Mandinka 33.7 2043 2068 Wollof 13.1 793 772 Fula 23.2 1409 1412 Jola 11.6 703 685 Serer 4.5 273 265 Other ethnic group 14.0 850 869 Total 100.0 6071 6071 At least one child aged < 18 years 83.6 6071 6071 At least one child aged < 5 years 57.7 6071 6071 At least one woman aged 15-49 years 83.6 6071 6071 Number of households The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 81 Table HH.4:Women's background characteristics Percentage distribution of women aged 15-49 by background characteristics, The Gambia, 2006 Weighted per cent Weighted Unweighted LGA Banjul 3.2 324 326 Kanifing 28.8 2872 2731 Brikama 25.5 2549 2387 Mansakonko 5.3 531 573 Kerewan 10.1 1012 1090 Kuntaur 5.5 547 506 Janjangbureh 8.9 891 958 Basse 12.6 1258 1411 Residence Urban 42.6 4251 4189 Rural 57.4 5731 5793 Age 15-19 22.9 2282 2277 20-24 20.3 2023 2013 25-29 19.2 1915 1924 30-34 13.5 1352 1350 35-39 10.5 1047 1051 40-44 8.2 822 825 45-49 5.4 540 542 Marital/Union status Currently married/in union 68.6 6839 6904 Formerly married/in union 4.6 459 447 Never married/in union 26.8 2671 2618 Motherhood status Ever gave birth 67.5 6739 6774 Never gave birth 32.5 3243 3208 Education None 60.9 6083 6190 Primary 11.7 1173 1150 Secondary + 27.3 2726 2642 Wealth index quintiles Poorest 17.1 1707 1771 Second 19.0 1896 1896 Middle 20.2 2012 2020 Fourth 21.4 2139 2133 Richest 22.3 2228 2162 Ethnic group of head of household Mandinka 35.2 3514 3513 Wollof 13.0 1295 1279 Fula 19.9 1985 1991 Jola 10.9 1086 1015 Serer 3.9 386 379 Other ethnic group 17.2 1716 1805 Total 100.0 9982 9982 Number of women 82 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table HH.5: Children's background characteristics Percentage distribution of children under 5 by background characteristics, The Gambia, 2006 Weighted per cent Weighted Unweighted Sex Male 51.1 3346 3343 Female 48.9 3197 3200 LGA Banjul 3.0 196 160 Kanifing 23.0 1508 1425 Brikama 21.8 1425 1376 Mansakonko 6.2 406 399 Kerewan 12.6 826 856 Kuntaur 7.7 502 431 Janjangbureh 10.4 682 753 Basse 15.3 999 1143 Residence Urban 35.2 2303 2202 Rural 64.8 4240 4341 Age < 6 months 13.0 853 855 6-11 months 10.6 695 696 12-23 months 22.7 1486 1481 24-35 months 20.9 1369 1373 36-47 months 19.1 1247 1242 48-59 months 13.7 893 896 Mother's education None 75.2 4923 4975 Primary 10.8 710 690 Secondary + 13.9 911 878 Wealth index quintiles Poorest 23.4 1532 1575 Second 20.4 1337 1342 Middle 20.5 1344 1351 Fourth 19.1 1248 1249 Richest 16.5 1082 1026 Ethnic group of head of household Mandinka 34.4 2254 2244 Wollof 13.3 870 850 Fula 22.8 1494 1493 Jola 9.1 596 564 Serer 3.2 212 200 Other ethnic group 17.1 1117 1192 Total 100.0 6543 6543 Number of under-5 children The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 83 Table CM.1: Child mortality Infant and under-5 mortality rates, The Gambia, 2006 Infant mortality rate* Under-5 mortality rate** Sex Male 99 140 Female 86 122 LGA Banjul & Kanifing 88 122 Brikama 76 100 Mansakonko 104 154 Kerewan 90 126 Kuntaur 124 195 Janjangbureh 109 165 Basse 121 188 Residence Urban 74 96 Rural 102 150 Mother's education None 97 140 Primary 94 133 Secondary + 54 66 Wealth index quintiles Poorest 106 158 Second 97 139 Middle 101 148 Fourth 88 121 Richest 58 72 Ethnic group of head of household Mandinka 97 140 Wollof 82 111 Fula 100 146 Jola 77 102 Serer 56 69 Other ethnic group 95 136 Total 93 131 * MICS indicator 2; MDG indicator 14 ** MICS indicator 1; MDG indicator 13 Table CM.2: Children ever born and proportion dead Mean number of children ever born and proportion dead by age of women, The Gambia, 2006 Mean number of children ever born Proportion dead Number of women Age 15-19 .098 .086 2282 20-24 .568 .108 2023 25-29 .098 .086 2282 30-34 .568 .108 2023 35-39 1.283 .131 1915 40-44 2.081 .132 1352 45-49 2.727 .140 1047 Total 3.298 .176 822 84 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report * MICS indicator 6; MDG indicator 4 ** MICS indicator 7 *** MICS indicator 8 Table NU.1: Child malnourishment Percentage of children aged 0-59 who are severely or moderately malnourished, The Gambia, 2006 Sex Male 20.5 4.1 22.4 8.5 6.8 1.1 1.9 3276 Female 20.1 3.7 22.4 8.1 6.1 .8 2.7 3110 LGA Banjul 17.5 5.0 17.5 6.9 4.4 .0 .6 196 Kanifing 13.5 1.7 12.3 4.7 4.8 .4 1.8 1493 Brikama 16.8 2.8 19.9 6.5 8.1 1.2 2.9 1413 Mansakonko 27.0 6.1 29.0 9.9 7.4 1.3 1.2 404 Kerewan 23.7 5.2 32.3 15.0 7.0 1.6 5.0 823 Kuntaur 27.3 7.2 25.0 9.5 11.2 2.2 1.9 461 Janjangbureh 26.1 3.8 29.1 9.6 3.7 .3 1.3 682 Basse 23.5 5.0 25.9 8.7 5.6 .7 1.5 914 Residence Urban 14.7 2.2 14.6 5.8 5.0 .4 2.4 2267 Rural 23.4 4.8 26.7 9.6 7.2 1.3 2.3 4119 Age < 6 months 3.8 .9 7.0 2.6 3.7 .8 8.1 828 6-11 months 19.1 3.6 16.4 6.5 9.9 2.2 4.4 679 12-23 months 31.4 7.7 29.4 11.5 12.1 1.9 1.4 1455 24-35 months 24.0 4.3 25.7 9.7 4.2 .4 1.0 1323 36-47 months 17.2 2.2 25.0 8.4 3.4 .2 .6 1226 48-59 months 17.1 2.1 21.6 7.3 4.6 .4 .9 874 Mother's education None 21.9 4.3 24.5 9.2 6.6 1.1 2.4 4788 Primary 19.7 3.5 18.5 7.8 6.8 .8 1.6 697 Secondary + 12.4 1.6 14.6 3.8 5.4 .5 2.3 902 Wealth index quintiles Poorest 25.9 6.4 30.4 11.6 7.3 1.2 2.4 1492 Second 23.1 3.9 27.5 10.3 7.5 1.4 3.0 1296 Middle 21.1 3.2 21.3 7.5 7.4 1.1 2.1 1309 Fourth 15.6 2.9 18.0 5.8 4.3 .7 2.0 1220 Richest 13.5 2.2 11.5 5.0 5.2 .2 1.9 1070 Ethnic group of head of household Mandinka 21.3 3.9 23.6 8.4 7.1 1.3 1.7 2209 Wollof 18.7 2.5 22.7 8.4 5.5 .3 2.5 863 Fula 21.2 4.4 23.2 8.7 6.3 1.0 2.8 1440 Jola 17.8 2.9 20.5 8.3 7.9 1.5 3.4 591 Serer 21.5 4.9 22.4 8.9 5.6 .0 2.4 210 Other ethnic group 19.6 4.5 19.8 7.3 5.3 .6 2.1 1074 Total 20.3 3.9 22.4 8.3 6.4 1.0 2.3 6386 Number of children aged 0-59 months % above - 3 SD* Weight for age Height for age Weight for height % above - 2 SD* % above - 2 SD % above - 3 SD % above - 2 SD % above - 3 SD % above + 32 SD The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 85 Table NU.2: Initial breastfeeding Percentage of women aged 15-49 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, The Gambia, 2006 LGA Banjul 48.7 90.8 75 Kanifing 48.2 85.8 694 Brikama 34.1 91.1 750 Mansakonko 35.0 87.5 167 Kerewan 77.6 96.1 377 Kuntaur 49.0 86.5 232 Janjangbureh 33.3 84.2 313 Basse 58.5 92.4 463 Residence Urban 47.1 87.8 1037 Rural 48.1 90.3 2033 Months since birth < 6 months 47.9 90.0 872 6-11 months 47.8 89.8 713 12-23 months 47.6 88.9 1481 Mother's education None 49.0 89.9 2229 Primary 43.3 90.2 352 Secondary + 45.4 87.0 489 Wealth index quintiles Poorest 48.4 87.4 684 Second 49.8 92.8 647 Middle 46.3 89.9 650 Fourth 46.4 88.6 600 Richest 47.7 88.4 488 Ethnic group of head of household Mandinka 49.4 92.4 1048 Wollof 52.4 89.9 384 Fula 46.6 87.3 706 Jola 38.3 86.1 302 Serer 45.6 91.9 117 Other ethnic group 48.6 87.6 512 Total 47.7 89.5 3070 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 * MICS indicator 45 86 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report * M IC S in di ca to r 15 * ** M IC S in di ca to r 17 ** * M IC S in di ca to r 16 S ex M al e 51 .8 25 0 39 .5 41 0 42 .4 20 2 91 .5 31 4 54 .2 20 5 Fe m al e 53 .1 27 8 42 .0 44 3 45 .2 21 0 93 .2 30 2 52 .2 19 5 LG A Ba nj ul (* ) 10 (* ) 17 (* ) 9 (* ) 23 (* ) 11 Ka ni fin g 51 .6 13 1 42 .9 19 3 44 .9 83 90 .3 16 3 49 .3 73 Br ik am a 59 .0 13 5 48 .5 20 6 37 .8 87 86 .5 14 2 59 .9 94 M an sa ko nk o (4 5. 6) 33 (4 1. 0) 49 (5 7.6 ) 29 (9 7.1 ) 37 (* ) 24 Ke re w an 50 .2 60 34 .4 10 7 62 .6 54 97 .5 80 49 .7 60 Ku nt au r (3 6. 7) 34 23 .6 63 (4 1. 2) 29 91 .9 50 (3 9. 4) 38 Ja nj an gb ur eh 55 .1 52 45 .2 88 (5 2. 1) 43 98 .2 50 (5 9. 8) 41 Ba ss e 56 .3 72 38 .4 12 9 25 .7 77 97 .6 70 57 .5 60 R es id en ce U rb an 54 .9 19 9 45 .1 29 1 55 .1 14 0 90 .3 23 6 44 .8 12 1 Ru ra l 51 .0 33 0 38 .5 56 1 38 .0 27 2 93 .6 38 0 56 .9 27 9 M ot he r's ed uc at io n N on e 51 .9 37 6 39 .8 61 9 40 .9 30 8 94 .7 43 8 55 .0 30 4 Pr im ar y 47 .7 55 43 .6 89 (4 8. 6) 45 84 .0 72 57 .4 52 Se co nd ar y + 57 .2 97 43 .4 14 4 55 .3 59 88 .1 10 7 (3 6. 4) 45 W ea lt h in de x qu in ti le s Po or es t 52 .7 10 7 40 .3 19 1 41 .3 94 96 .6 13 0 56 .5 10 0 Se co nd 49 .5 10 7 41 .4 18 3 46 .1 87 93 .0 11 7 63 .4 89 M id dl e 53 .7 11 1 43 .3 16 7 40 .0 97 92 .7 13 8 57 .0 91 Fo ur th 58 .9 11 7 39 .5 18 4 45 .4 66 93 .5 11 7 37 .6 69 Ri ch es t 45 .7 86 39 .1 12 8 48 .1 67 85 .2 11 5 43 .6 52 Et hn ic gr ou p of he ad of ho us eh ol d M an di nk a 58 .7 18 3 46 .8 27 8 44 .0 15 4 94 .1 21 5 51 .1 12 7 W ol lo f 34 .3 71 28 .4 11 6 (5 0. 6) 49 87 .6 83 40 .0 70 Fu la 52 .9 13 9 41 .3 21 7 44 .8 96 93 .8 12 0 66 .6 96 Jo la (6 3. 9) 39 49 .1 63 (2 9. 7) 32 90 .2 66 (6 6. 4) 39 Se re r (* ) 18 (3 7.4 ) 34 (* ) 11 (* ) 28 (* ) 12 O th er et hn ic gr ou p 48 .0 78 35 .5 14 5 41 .5 69 92 .1 10 4 43 .6 57 To ta l 52 .5 52 8 40 .8 85 3 43 .8 41 1 92 .3 61 6 53 .2 40 1 C hi ld re n 0- 3 m on th s C hi ld re n 0- 5 m on th s C hi ld re n 6- 9 m on th s C hi ld re n 12 -1 5 m on th s C hi ld re n 20 -2 3 m on th s Ta bl e N U .3 :B re as tf ee di ng Pe rc en ta ge of liv in g ch ild re n ac co rd in g to br ea st fe ed in g st at us at ea ch ag e gr ou p, Th e G am bi a, 20 06 N um be ro f ch ild re n Pe rc en ta ge ex cl us iv el y br ea st fe d* Pe rc en ta ge ex cl us iv el y br ea st fe d % re ce iv in g br ea st m ilk & so lid /m us hy fo od ** N um be ro f ch ild re n N um be ro f ch ild re n Pe rc en ta ge br ea st fe d* ** N um be ro f ch ild re n Pe rc en ta ge br ea st fe d* ** N um be ro f ch ild re n The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 87 Table NU.4: Adequately fed infants Percentage of infants under 6 months of age exclusively breastfed, percentage of infants 6-11 months who are breastfed and who ate solid/semi-solid food at least the minimum recommended number of times yesterday and percentage of infants adequately fed, The Gambia, 2006 Sex Male 39.5 28.1 44.4 37.1 38.4 750 Female 42.0 37.6 43.4 40.8 41.5 797 LGA Banjul (21.4) (60.0) (50.0) (53.8) (37.0) 33 Kanifing 42.9 30.9 30.8 30.8 37.8 333 Brikama 48.5 30.5 51.0 40.7 45.2 358 Mansakonko 41.0 39.2 52.6 46.2 43.4 93 Kerewan 34.4 56.3 67.8 62.9 47.7 201 Kuntaur 23.6 31.3 50.0 44.7 34.4 129 Janjangbureh 45.2 29.1 37.4 33.6 40.2 155 Basse 38.4 19.7 25.7 22.6 30.9 246 Residence Urban 45.1 43.9 38.1 40.6 43.1 518 Rural 38.5 27.9 46.8 38.2 38.4 1030 Mother's education None 39.8 30.0 44.4 38.2 39.0 1143 Primary 43.6 35.0 32.2 33.5 39.1 161 Secondary + 43.4 44.7 49.9 47.3 45.0 243 Wealth index quintiles Poorest 40.3 30.2 47.8 40.8 40.6 365 Second 41.4 28.8 58.1 45.3 43.2 334 Middle 43.3 28.9 37.1 32.9 38.4 315 Fourth 39.5 43.2 36.6 39.2 39.4 300 Richest 39.1 38.5 32.3 35.3 37.4 234 Ethnic group of head of household Mandinka 46.8 35.6 47.6 41.9 44.5 522 Wollof 28.4 36.4 53.4 46.3 36.1 203 Fula 41.3 38.6 40.6 39.7 40.6 377 Jola 49.1 8.6 51.4 35.8 42.2 132 Serer 37.4 33.0 30.4 31.1 34.8 57 Other ethnic group 35.5 28.3 31.1 29.8 33.0 257 Total 40.8 32.9 43.9 39.0 40.0 1547 Number of infants aged 0-11 months 0-11 months who were appropriately fed** 6-11 months who received breast milk and complementary food at least the minimum recommended number of times per day* 9-11 months who received breast milk and complementary food at least 3 times in prior 24 hours 0-5 months exclusively breastfed 6-8 months who received breast milk and complementary food at least 2 times in prior 24 hours * MICS indicator 18 ** MICS indicator 19 Percentage of infants 88 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table NU.5: Iodized salt consumption Percentage of households consuming adequately iodized salt, The Gambia, 2006 LGA Banjul 74.4 308 25.6 73.3 1.1 100.0 308 Kanifing 86.5 1877 12.6 84.0 3.4 100.0 1858 Brikama 92.0 1652 7.1 91.4 1.5 100.0 1636 Mansakonko 91.9 357 7.3 90.5 2.2 100.0 354 Kerewan 96.9 718 1.5 96.2 2.3 100.0 707 Kuntaur 92.8 306 6.0 77.9 16.1 100.0 302 Janjangbureh 96.5 370 3.1 86.9 10.0 100.0 368 Basse 92.0 483 4.7 54.1 41.2 100.0 466 Residence Urban 85.8 2930 13.4 81.3 5.3 100.0 2904 Rural 94.5 3141 4.1 88.1 7.7 100.0 3095 Wealth index quintiles Poorest 95.6 1089 3.0 86.9 10.2 100.0 1073 Second 95.8 1140 2.6 93.3 4.1 100.0 1121 Middle 90.8 1175 8.2 84.9 7.0 100.0 1162 Fourth 83.6 1261 15.3 79.0 5.7 100.0 1244 Richest 87.3 1406 12.2 81.7 6.2 100.0 1398 Total 90.3 6071 8.6 84.8 6.6 100.0 5999 Number of households in which salt was tested or with no saltTotal15+ PPM*< 15 PPMNo salt Number of households interviewed Percentage of households in which salt was tested * MICS indicator 41 Percentage of households with Salt test result The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 89 Table NU.6: Children's Vitamin A supplementation Percentage distribution of children aged 6-59 months by whether they have received a high dose of Vitamin A supplement in the last 6 months, The Gambia, 2006 Sex Male 80.1 3.6 8.3 .8 7.1 100.0 2936 Female 80.0 4.3 8.3 .6 6.8 100.0 2755 LGA Banjul 74.7 4.1 17.8 .7 2.7 100.0 178 Kanifing 76.7 3.9 8.1 2.0 9.3 100.0 1315 Brikama 89.5 4.8 1.3 .3 4.0 100.0 1219 Mansakonko 76.0 4.9 13.2 .6 5.3 100.0 356 Kerewan 72.4 8.3 2.5 .1 16.6 100.0 719 Kuntaur 87.3 1.8 7.5 .0 3.4 100.0 439 Janjangbureh 74.6 1.5 18.8 .8 4.4 100.0 594 Basse 81.3 1.5 12.3 .2 4.8 100.0 869 Residence Urban 77.2 4.2 8.6 1.5 8.6 100.0 2012 Rural 81.7 3.8 8.1 .3 6.1 100.0 3679 Age 6-11 months 75.6 1.0 6.1 .5 16.9 100.0 695 12-23 months 84.3 4.0 5.3 .4 6.0 100.0 1486 24-35 months 79.9 6.3 8.3 .3 5.1 100.0 1369 36-47 months 80.3 3.0 10.6 1.0 5.1 100.0 1247 48-59 months 76.4 3.9 11.7 1.6 6.4 100.0 893 Mother's education None 80.0 3.8 8.5 .7 7.1 100.0 4303 Primary 79.6 3.5 9.8 .7 6.4 100.0 620 Secondary + 80.6 5.4 6.1 1.1 6.8 100.0 767 Wealth index quintiles Poorest 77.0 4.8 10.7 .4 7.2 100.0 1341 Second 81.7 5.2 4.8 .1 8.3 100.0 1153 Middle 82.7 3.0 7.3 .6 6.3 100.0 1177 Fourth 81.9 3.1 9.0 .7 5.4 100.0 1064 Richest 77.1 3.6 9.6 2.1 7.7 100.0 955 Ethnic group of head of household Mandinka 79.9 5.1 6.9 .7 7.3 100.0 1976 Wollof 79.4 3.3 9.3 .6 7.3 100.0 754 Fula 82.2 3.4 8.0 .4 6.1 100.0 1277 Jola 81.1 4.4 5.3 .8 8.3 100.0 533 Serer 75.1 2.8 9.8 1.2 11.2 100.0 178 Other ethnic group 78.4 2.8 12.1 1.1 5.6 100.0 972 Total 80.1 3.9 8.3 .7 7.0 100.0 5690 Number of children aged 6-59 monthsTotal Never received Vitamin A Not sure if received Vitamin A Not sure if received Vitamin A Prior to last 6 months Within last 6 months* * MICS indicator 42 Percentage of children who received Vitamin A: 90 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table NU.7: Post-partum mothers' Vitamin A supplementation Percentage of women aged 15-49 with a live birth in the two years preceding the survey by whether they received a high dose of Vitamin A supplement before the infant was eight weeks old, The Gambia, 2006 LGA Banjul 84.2 1.3 75 Kanifing 67.4 1.1 694 Brikama 83.6 1.4 750 Mansakonko 85.4 .0 167 Kerewan 77.3 .7 377 Kuntaur 82.8 .5 232 Janjangbureh 71.7 .6 313 Basse 83.1 .0 463 Residence Urban 71.5 1.0 1037 Rural 81.3 .7 2033 Education None 78.2 .8 2229 Primary 78.4 .0 352 Secondary + 76.3 1.3 489 Wealth index quintiles Poorest 80.6 .6 684 Second 81.6 .5 647 Middle 74.7 .6 650 Fourth 78.8 1.2 600 Richest 72.8 1.1 488 Ethnic group of head of household Mandinka 76.2 .7 1048 Wollof 78.1 .5 384 Fula 78.8 .6 706 Jola 81.1 1.1 302 Serer 76.1 .8 117 Other ethnic group 78.8 1.3 512 Total 78.0 .8 3070 Number of women aged 15-49 *MICS indicator 43 Not sure if received Vitamin A Received Vitamin A sup- plement* The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 91 Table NU.8: Low birth weight infants Percentage of live births in the two years preceding the survey that weighed below 2500 grams at birth, The Gambia, 2006 LGA Banjul 16.9 93.4 75 Kanifing 20.2 78.2 694 Brikama 19.4 59.5 750 Mansakonko 16.7 38.2 167 Kerewan 20.3 49.3 377 Kuntaur 23.9 24.5 232 Janjangbureh 17.8 30.9 313 Basse 20.9 27.5 463 Residence Urban 19.7 74.1 1037 Rural 20.0 40.4 2033 Mother's education None 20.2 44.5 2229 Primary 18.9 59.5 352 Secondary + 19.2 79.3 489 Wealth index quintiles Poorest 20.1 27.7 684 Second 20.4 44.8 647 Middle 20.4 50.7 650 Fourth 18.9 63.5 600 Richest 19.4 81.8 488 Ethnic group of head of household Mandinka 19.8 52.3 1048 Wollof 21.7 49.0 384 Fula 20.0 45.4 706 Jola 18.4 67.2 302 Serer 20.2 75.6 117 Other ethnic group 19.4 47.1 512 Total 19.9 51.8 3070 Number of live births * MICS indicator 9 ** MICS indicator 10 Weighed at birth**Below 2500 grams* Percentage of live births 92 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table CH.1:Vaccinations in first year of life Percentage of children aged 12-23 months immunized against childhood diseases at any time before the survey and before the first birthday, The Gambia, 2006 Vaccinated at any time before the survey According to: Vaccination card 89.7 87.7 86.0 81.6 86.3 86.6 86.6 84.1 83.8 71.9 .0 1486 Mother's report 9.0 8.3 7.2 5.2 6.5 8.9 6.6 3.6 8.6 2.5 .4 1486 Either 98.7 96.1 93.2 86.8 92.8 95.5 93.2 87.6 92.4 74.5 .4 1486 Vaccinated by 12 months of age 97.6 93.1 90.4 82.4 91.9 92.8 90.7 83.3 84.9 55.3 .4 1486 Number of childrenNone All ***** Polio3 ***Polio2Polio1Polio0DPT3**DPT2DPT1BCG* Measles **** * MICS indicator 25 ** MICS indicator 27 *** MICS indicator 26 **** MICS indicator 28; MDG indicator 15 ***** MICS indicator 31 Percentage of live births Table CH.1c: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, The Gambia, 2006 Vaccinated at any time before the survey According to: Vaccination card 85.5 84.3 79.0 83.5 1486 Mother's report 0.1 0.0 0.0 0.0 1486 Either 85.6 84.3 79.0 83.5 1486 Vaccinated by 12 months of age 83.8 81.4 75.4 76.9 1486 Number of children Yellow fever**HepB3*HepB2HepB1 * MICS indicator 29 ** MICS indicator 30 Percentage of children who received: The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 93 Table CH.2:Vaccinations by background characteristics Percentage of children aged 12-23 months currently vaccinated against childhood diseases, The Gambia, 2006 Sex Male 98.6 95.6 92.3 84.7 92.5 95.1 92.0 85.6 91.2 72.7 .6 89.7 757 Female 98.9 96.6 94.0 89.0 93.1 95.9 94.5 89.8 93.7 76.3 .1 91.3 729 LGA Banjul 729 100.0 97.6 95.2 95.3 100.0 92.9 88.1 90.7 78.6 .0 86.0 53 Kanifing 98.0 95.0 91.2 85.9 92.0 93.3 92.2 84.7 89.0 69.7 1.3 90.0 318 Brikama 98.0 96.3 94.0 88.9 88.7 94.4 90.0 83.6 91.8 72.5 .2 88.3 347 Mansakonko 100.0 98.7 96.4 91.4 94.0 96.4 96.3 90.3 98.8 86.7 .0 91.5 85 Kerewan 99.0 90.4 85.7 78.1 90.3 95.4 92.3 84.7 93.3 67.7 .0 90.3 191 Kuntaur 100.0 100.0 97.3 92.8 99.1 99.1 98.2 94.6 96.4 83.7 .0 96.4 127 Janjangbureh 100.0 97.6 95.1 91.5 97.6 96.4 94.5 92.1 92.7 81.2 .0 93.9 150 Basse 98.8 96.9 95.0 81.9 95.0 96.5 95.8 92.7 93.1 74.5 .4 89.6 214 Residence Urban 97.5 95.5 91.5 87.0 91.4 93.6 91.1 85.4 90.7 71.3 1.0 88.4 496 Rural 99.3 96.3 94.0 86.7 93.6 96.4 94.3 88.7 93.3 76.0 .1 91.5 990 Mother's education None 98.4 96.0 93.2 86.8 94.1 96.0 94.2 88.1 92.2 74.9 .5 91.0 1094 Primary 99.5 96.1 92.5 85.0 89.3 91.2 90.5 86.7 90.8 68.7 .0 90.8 175 Secondary + 99.6 96.1 93.7 88.2 89.1 96.6 90.3 86.0 94.5 76.8 .0 87.4 217 Wealth index quintiles Poorest 99.4 96.7 94.0 89.2 96.1 97.4 95.8 91.1 94.6 82.8 .0 95.8 346 Second 99.5 95.0 92.3 85.3 88.8 95.3 94.6 88.5 91.4 72.5 .3 88.6 295 Middle 97.9 96.6 92.9 84.1 92.5 94.3 91.3 86.8 91.0 71.8 .9 90.6 340 Fourth 98.3 94.6 92.8 85.8 94.0 94.6 90.8 82.5 93.4 70.2 .8 87.9 277 Richest 98.7 97.3 93.9 90.5 92.0 96.0 93.3 88.7 91.4 73.5 .0 87.8 227 Ethnic group of head of household Mandinka 98.7 96.6 94.1 88.3 95.2 95.5 94.3 89.7 94.3 77.0 .0 92.5 498 Wollof 99.5 96.2 93.6 89.0 93.2 96.4 93.9 87.2 90.4 74.6 .5 89.7 199 Fula 98.7 96.4 92.5 86.6 93.8 95.5 92.4 86.6 89.9 73.7 .8 89.9 336 Jola 98.6 94.9 92.1 87.8 84.8 94.9 92.3 85.8 91.4 74.3 1.4 93.0 149 Serer 97.9 91.6 85.8 82.1 85.3 90.8 89.3 80.5 91.0 66.1 .0 82.3 59 Other ethnic group 98.6 96.2 94.1 82.9 93.1 96.5 93.3 88.2 94.5 72.3 .0 88.3 245 Total 98.7 96.1 93.2 86.8 92.8 95.5 93.2 87.6 92.4 74.5 .4 90.5 1486 Percen- tage with health card Number of children aged 12-23 monthsNoneAllMeaslesPolio3Polio2Polio1Polio0DPT3DPT2DPT1BCG Percentage of children who received: 94 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table CH.2c:Vaccinations by background characteristics (continued) Percentage of children aged 12-23 months currently vaccinated against childhood diseases, The Gambia, 2006 Sex Male 84.7 83.4 77.4 81.8 89.7 757 Female 86.5 85.2 80.7 85.2 91.3 729 LGA Banjul 86.0 86.0 81.4 74.4 86.0 53 Kanifing 82.7 81.4 75.7 80.6 90.0 318 Brikama 86.3 85.4 81.4 81.8 88.3 347 Mansakonko 90.4 90.3 86.7 89.0 91.5 85 Kerewan 72.2 71.2 67.6 84.1 90.3 191 Kuntaur 93.7 90.0 83.7 91.9 96.4 127 Janjangbureh 93.9 93.3 91.5 86.6 93.9 150 Basse 88.0 85.7 74.9 82.6 89.6 214 Residence Urban 82.0 81.1 76.1 80.2 88.4 496 Rural 87.4 85.8 80.5 85.1 91.5 990 Mother's education None 86.1 84.6 79.6 83.8 91.0 1094 Primary 85.1 83.9 76.6 81.7 90.8 175 Secondary + 83.6 82.7 77.7 83.3 87.4 217 Wealth index quintiles Poorest 91.0 89.5 84.4 90.3 95.8 346 Second 84.1 82.4 76.7 81.0 88.6 295 Middle 83.9 83.3 76.6 83.4 90.6 340 Fourth 83.6 80.5 76.5 81.3 87.9 277 Richest 84.3 84.7 80.3 78.9 87.8 227 Ethnic group of head of household Mandinka 87.0 85.9 81.6 87.4 92.5 498 Wollof 84.9 83.6 79.7 80.0 89.7 199 Fula 85.7 84.4 77.4 81.3 89.9 336 Jola 88.7 88.7 81.6 85.1 93.0 149 Serer 68.8 67.1 63.5 74.0 82.3 59 Other ethnic group 85.3 82.7 77.7 82.6 88.3 245 Total 85.6 84.3 79.0 83.5 90.5 1486 Number of children aged 12-23 months Percentage with health cardYellow FeverHepB3HepB2HepB1 Percentage of children who received: The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 95 Table CH.3: Neonatal tetanus protection Percentage of mothers with a birth in the last 24 months protected against neonatal tetanus, The Gambia, 2006 LGA Banjul 38.2 13.2 .0 .0 .0 51.3 75 Kanifing 46.1 12.1 .2 .2 .0 58.5 694 Brikama 60.6 19.9 .3 .0 .0 80.7 750 Mansakonko 69.9 19.6 .0 .0 .0 89.6 167 Kerewan 74.4 6.2 .0 .0 .0 80.5 377 Kuntaur 49.1 26.4 .9 .5 .0 76.8 232 Janjangbureh 48.8 26.2 .0 .0 .0 75.0 313 Basse 59.4 26.7 .9 .7 .0 87.7 463 Residence Urban 49.7 14.4 .1 .1 .0 64.3 1037 Rural 60.3 20.5 .4 .2 .0 81.4 2033 Mother’s education None 57.0 19.0 .2 .2 .0 76.5 2229 Primary 53.8 20.7 1.0 .0 .0 75.6 352 Secondary + 57.3 14.1 .2 .0 .0 71.6 489 Wealth index quintiles Poorest 61.3 19.4 .7 .3 .0 81.7 684 Second 60.3 18.8 .0 .1 .0 79.1 647 Middle 55.2 21.6 .6 .3 .0 77.7 650 Fourth 53.5 18.2 .0 .1 .0 71.9 600 Richest 51.4 12.5 .2 .0 .0 64.1 488 Ethnic group of head of household Mandinka 58.2 18.2 .2 .0 .0 76.6 1048 Wollof 56.3 18.6 .0 .0 .0 74.9 384 Fula 53.3 19.6 .5 .3 .0 73.6 706 Jola 57.6 14.1 .0 .0 .0 71.7 302 Serer 56.7 9.6 .0 .0 .0 66.3 117 Other ethnic group 58.3 21.5 .9 .7 .0 81.3 512 Total 56.7 18.4 .3 .2 .0 75.6 3070 Protected against tetanus* Received at least 5 doses during lifetime Received at least 4 doses, last within prior 10 years Received at least 3 doses, last within prior 5 years Received at least 2 doses, the last within prior 3 years Received at least 2 doses during last pregnancy Number of mothers Percentage of mothers with a birth in the last 24 months who: * MICS indicator 32 96 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table CH.4: Oral rehydration treatment Percentage of children aged 0-59 months with diarrhoea in the last two weeks and treatment with oral rehydration solution (ORS) or other oral rehydration treatment (ORT), The Gambia, 2006 Sex Male 20.2 3346 39.6 11.0 2.6 50.0 50.0 675 Female 18.0 3197 37.7 8.7 1.3 53.9 46.1 576 LGA Banjul 14.4 196 (26.1) (4.3) (17.4) (52.2) (47.8) 28 Kanifing 15.8 1508 33.3 5.8 2.7 60.4 39.6 238 Brikama 15.5 1425 41.3 10.4 3.8 48.0 52.0 221 Mansakonko 13.2 406 54.7 13.6 5.5 31.7 68.3 54 Kerewan 20.4 826 58.8 5.1 .6 38.3 61.7 169 Kuntaur 31.9 502 22.2 10.0 .0 67.7 32.3 160 Janjangbureh 21.1 682 49.5 15.1 .0 38.5 61.5 144 Basse 23.8 999 29.9 13.6 .7 57.9 42.1 238 Residence Urban 15.7 2303 36.8 6.4 4.8 55.2 44.8 361 Rural 21.0 4240 39.5 11.3 .9 50.4 49.6 890 Age < 6 months 15.6 853 34.3 7.4 1.5 59.1 40.9 133 6-11 months 30.2 695 41.4 13.1 2.1 47.6 52.4 210 12-23 months 28.5 1486 41.5 9.2 2.6 48.9 51.1 424 24-35 months 20.3 1369 37.0 11.2 .6 52.5 47.5 278 36-47 months 11.7 1247 34.3 6.4 2.3 58.9 41.1 146 48-59 months 6.9 893 38.0 12.0 4.7 50.1 49.9 61 Mother's education None 19.9 4923 38.2 9.7 1.4 53.1 46.9 981 Primary 18.3 710 41.7 14.0 3.2 44.0 56.0 130 Secondary + 15.4 911 39.5 7.4 5.3 50.1 49.9 140 Wealth index quintiles Poorest 21.2 1532 37.0 12.9 .6 51.8 48.2 324 Second 19.4 1337 49.0 9.7 2.0 42.8 57.2 260 Middle 20.5 1344 36.2 7.5 .9 57.0 43.0 276 Fourth 18.5 1248 32.3 11.0 3.0 57.1 42.9 231 Richest 14.8 1082 39.2 6.9 5.6 49.7 50.3 160 Ethnic group of head of household Mandinka 17.4 2254 39.8 9.3 2.0 51.6 48.4 393 Wollof 21.0 870 40.4 10.2 1.2 51.0 49.0 183 Fula 20.6 1494 39.6 8.8 1.5 52.2 47.8 308 Jola 13.7 596 32.6 11.9 2.6 55.5 44.5 82 Serer 21.8 212 (42.7) (6.8) (12.4) (42.5) (57.5) 46 Other ethnic group 21.4 1117 35.9 12.0 1.2 52.7 47.3 239 Total 19.1 6543 38.7 9.9 2.0 51.8 48.2 1251 ORT Use Rate * No treatment Pre-packa- ged ORS fluid Recom- mended homemade fluid Fluid from ORS packet Number of children aged 0-59 months Had diarrhoea in last two weeks Number of children aged 0-59 months with diarrhoea Children with diarrhoea who received * MICS indicator 33 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 97 Table CH.5: Home management of diarrhoea Percentage of children aged 0-59 months with diarrhoea in the last two weeks who took increased fluids and continued to feed during the episode, The Gambia, 2006 Sex Male 20.2 3346 53.3 45.1 53.8 45.4 29.5 38.5 675 Female 18.0 3197 52.3 45.2 51.7 46.3 29.1 37.3 576 LGA Banjul 14.4 196 (60.9) (39.1) (60.9) (39.1) (34.8) (43.5) 28 Kanifing 15.8 1508 41.8 55.1 54.2 44.4 21.3 29.8 238 Brikama 15.5 1425 49.3 46.2 52.0 45.1 29.6 40.4 221 Mansakonko 13.2 406 40.1 59.9 43.3 54.9 11.6 28.5 54 Kerewan 20.4 826 35.9 62.9 30.3 69.1 15.3 25.1 169 Kuntaur 31.9 502 49.1 49.5 60.6 38.7 33.3 39.1 160 Janjangbureh 21.1 682 60.3 37.8 49.8 47.3 28.2 38.4 144 Basse 23.8 999 79.1 20.6 65.9 33.8 48.5 53.3 238 Residence Urban 15.7 2303 45.5 51.5 53.6 44.3 23.5 31.9 361 Rural 21.0 4240 55.8 42.6 52.5 46.4 31.7 40.4 890 Age 0-11 months 22.1 1547 40.9 54.9 53.5 43.2 22.5 34.3 342 12-23 months 28.5 1486 57.5 41.7 48.5 51.0 29.6 38.0 424 24-35 months 20.3 1369 58.2 39.9 57.2 41.7 37.9 44.6 278 36-47 months 11.7 1247 52.8 45.8 54.2 45.8 26.8 31.4 146 48-59 months 6.9 893 63.1 36.9 55.3 42.9 33.2 42.8 61 Mother's education None 19.9 4923 53.2 44.6 53.3 45.3 30.2 38.4 981 Primary 18.3 710 51.2 48.8 52.8 46.5 27.7 40.3 130 Secondary + 15.4 911 51.7 45.4 49.5 48.6 25.0 32.8 140 Wealth index quintiles Poorest 21.2 1532 48.7 50.3 46.8 52.4 26.5 34.4 324 Second 19.4 1337 52.8 44.8 50.2 48.3 25.7 37.2 260 Middle 20.5 1344 55.9 41.5 59.1 38.2 36.0 42.8 276 Fourth 18.5 1248 55.7 43.2 58.3 40.9 32.7 41.0 231 Richest 14.8 1082 51.9 44.3 50.5 48.3 24.8 33.3 160 Ethnic group of head of household Mandinka 17.4 2254 53.3 44.1 53.6 44.5 30.9 38.2 393 Wollof 21.0 870 42.4 56.6 51.0 48.6 24.5 35.0 183 Fula 20.6 1494 48.7 49.4 50.9 46.5 25.8 35.3 308 Jola 13.7 596 46.5 48.2 53.4 46.6 27.1 39.0 82 Serer 21.8 212 (49.6) (50.4) (57.0) (43.0) (30.9) (40.8) 46 Other ethnic group 21.4 1117 68.2 30.6 54.2 45.1 35.4 42.3 239 Total 19.1 6543 52.8 45.2 52.8 45.8 29.4 37.9 1251 Received ORT or increased fluids and continued feeding Home manage- ment of diar- rhoea* Ate much less or none Ate somewhat less, same or more Drank the same or less Drank more Number of children aged 0-59 months Had diarrhoea in last two weeks Number of children aged 0-59 months with diar- rhoea Children with diarrhoea who: * MICS indicator 34 98 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report * M IC S in di ca to r 23 Se x M al e 6. 1 33 46 8. 8 46 .5 .9 2. 9 1. 1 .0 8. 4 1. 7 15 .0 .5 .5 .0 .0 1. 0 67 .3 20 3 Fe m al e 5. 1 31 97 10 .3 49 .6 2. 9 1. 7 2. 1 .0 3. 0 1. 2 5. 8 .0 .6 3. 2 .0 1. 9 70 .8 16 3 LG A Ba nj ul .6 19 6 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 1 Ka ni fin g 5. 9 15 08 7.1 40 .5 1. 2 .0 .0 .0 11 .9 1. 2 17 .9 1. 2 1. 2 1. 2 .0 .0 60 .7 89 Br ik am a 4. 4 14 25 8. 7 53 .1 1. 7 1. 7 1. 7 .0 5. 2 1. 7 10 .2 .0 .0 1. 7 .0 .0 72 .3 62 M an sa ko nk o 4. 0 40 6 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 16 Ke re w an 6. 4 82 6 25 .8 45 .2 1. 8 3. 6 .0 .0 3. 6 .0 .0 .0 .0 .0 .0 .0 78 .1 53 Ku nt au r 8. 8 50 2 (5 .2 ) (4 6. 7) (.0 ) (2 .6 ) (1 0. 4) (.0 ) (.0 ) (5 .2 ) (7. 8) (.0 ) (.0 ) (.0 ) (.0 ) (.0 ) (7 0. 1) 44 Ja nj an gb ur eh 6. 5 68 2 (1 0. 1) (5 1. 2) (2 .1 ) (2 .1 ) (.0 ) (.0 ) (1 0. 1) (.0 ) (1 0. 1) (.0 ) (2 .1 ) (.0 ) (.0 ) (2 .1 ) (7 3. 4) 44 Ba ss e 5. 5 99 9 4. 4 53 .6 4. 5 4. 5 .0 .0 3. 0 1. 5 11 .9 .0 .0 .0 .0 .0 70 .0 55 Re si de nc e U rb an 5. 5 23 03 11 .6 42 .1 .8 .0 .0 .0 8. 9 .8 19 .0 .8 .8 1. 6 .0 .0 63 .5 12 8 Ru ra l 5. 6 42 40 8. 3 51 .1 2. 3 3. 6 2. 4 .0 4. 4 1. 8 6. 6 .0 .4 1. 3 .0 2. 2 71 .8 23 8 Ag e 0- 11 m on th s 6. 3 15 47 11 .1 47 .2 2. 7 2. 0 1. 1 .0 8. 9 .8 19 .0 .8 .8 .0 .0 .0 72 .5 98 12 -2 3 m on th s 5. 4 14 86 10 .2 53 .7 1. 4 1. 2 2. 9 .0 4. 4 1. 8 6. 6 .0 .4 1. 3 .0 1. 3 71 .8 80 24 -3 5 m on th s 5. 6 13 69 11 .4 52 .3 .0 3. 5 .0 .0 8. 9 .8 19 .0 .8 .8 .0 .0 1. 4 69 .8 77 36 -4 7 m on th s 5. 0 12 47 8. 0 43 .5 1. 5 .0 3. 7 .0 4. 4 1. 8 6. 6 .0 .4 3. 2 .0 1. 7 63 .0 63 48 -5 9 m on th s 5. 4 89 3 3. 9 38 .6 3. 9 6. 1 .0 .0 (8 .9 ) (.8 ) (1 9. 0) (.8 ) (.8 ) (4 .4 ) (.0 ) (4 .1 ) (6 3. 2) 48 M ot he r's e du ca tio n N on e 5. 3 49 23 10 .3 47 .9 1. 8 2. 6 1. 8 .0 7.9 2. 3 6. 9 .0 .0 1. 6 .0 .8 68 .8 25 9 Pr im ar y 7.8 71 0 7.6 46 .9 1. 5 3. 5 2. 0 .0 3. 6 .0 12 .7 .0 2. 5 1. 9 .0 5. 5 67 .9 55 Se co nd ar y + 5. 7 91 1 7.6 48 .9 2. 0 .0 .0 .0 6. 9 1. 1 10 .7 .0 .0 .0 .0 .0 70 .8 52 W ea lth in de x qu in til es Po or es t 5. 8 15 32 8. 7 48 .3 3. 9 3. 5 1. 3 .0 5. 0 1. 2 12 .1 .4 .0 3. 5 .0 1. 2 68 .2 88 Se co nd 5. 1 13 37 14 .4 46 .3 3. 0 6. 9 3. 3 .0 4. 8 .0 5. 5 .0 1. 7 .0 .0 1. 3 73 .9 68 M id dl e 6. 5 13 44 7.2 56 .1 .0 .0 1. 3 .0 11 .9 4. 1 10 .7 .0 2. 0 .0 .0 1. 2 71 .2 87 Fo ur th 5. 3 12 48 15 .4 39 .7 .0 1. 3 1. 7 .0 5. 0 1. 2 12 .1 .4 .0 3. 2 .0 3. 2 62 .3 66 Ri ch es t 5. 2 10 82 1. 4 46 .3 1. 9 .0 .0 .0 4. 8 .0 5. 5 .0 1. 7 .0 .0 .0 68 .1 56 Et hn ic ity M an di nk a 6. 1 22 54 14 .4 46 .1 .8 3. 4 2. 5 .0 1. 0 2. 6 6. 0 .0 .0 1. 5 .0 2. 2 71 .8 13 7 W ol lo f 7.3 87 0 9. 4 39 .8 .0 1. 8 .0 .0 5. 7 .0 4. 2 .0 .0 .0 .0 .0 59 .4 64 Fu la 4. 3 14 94 3. 1 58 .2 2. 9 1. 7 .0 .0 4. 7 2. 8 19 .0 .0 1. 6 1. 5 .0 .0 72 .0 Fu la Jo la 3. 8 59 6 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 22 Se re r 7.8 21 2 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 17 O th er e th ni c gr ou p 5. 5 11 17 6. 2 48 .9 4. 0 2. 7 1. 9 .0 1. 0 2. 6 6. 0 .0 .0 3. 5 .0 3. 4 71 .5 62 To ta l 5. 6 65 43 9. 5 47 .9 1. 8 2. 4 1. 6 .0 6. 0 1. 4 10 .9 .3 .5 1. 4 .0 1. 4 68 .9 36 6 Ta bl e C H .6 :C ar e se ek in g fo r su sp ec te d pn eu m on ia Pe rc en ta ge o f c hi ld re n ag ed 0 -5 9 m on th s w ith s us pe ct ed p ne um on ia in th e la st tw o w ee ks ta ke n to a h ea lth p ro vi de r, Th e G am bi a, 2 00 6 No . of ch ild re n 0-5 9 m on th s wi th su sp ec ted pn eu m on ia An y ap pr op ria te pr ov ide r* Tra d. Pr ac ti- tio ne r Sh op Re lat ive / fri en d Ot he r pr iva te m ed ica l M ob ile cli nic Ph ar m ac y Pr iva te ph ys ici an Pr iva te ho sp ita l/ cli nic Ot he r pu bli c M ob ile / ou tre ac h cli nic Vil lag e he alt h wo rke r Go vt. he alt h po st Go vt. he alt h ce nt re Go vt. ho sp ita l No . of ch ild re n ag ed 0- 59 m on th s Ha d ac ut e re sp ira to ry inf ec tio n Pu bl ic s ou rc es Pr iv at e so ur ce s C hi ld re n w it h su sp ec te d pn eu m on ia w ho w er e ta ke n to : O th er s ou rc e The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 99 Table CH.7: Antibiotic treatment of pneumonia Percentage of children aged 0-59 months with suspected pneumonia who received antibiotic treatment, The Gambia, 2006 Sex Male 64.1 203 Female 57.9 163 LGA Banjul (*) 1 Kanifing 57.1 89 Brikama 63.6 62 Mansakonko (*) 16 Kerewan 72.8 53 Kuntaur (42.9) 44 Janjangbureh (77.2) 44 Basse 61.2 55 Residence Urban 59.7 128 Rural 62.2 238 Age 0-11 months 60.7 98 12-23 months 62.5 80 24-35 months 64.1 77 36-47 months 55.1 63 48-59 months 64.6 48 Mother's education None 64.9 259 Primary 58.7 55 Secondary + 46.3 52 Wealth index quintiles Poorest 64.6 88 Second 65.6 68 Middle 63.1 87 Fourth 51.1 66 Richest 60.4 56 Ethnic group of head of household Mandinka 63.4 137 Wollof 58.4 64 Fula 69.2 64 Jola (*) 22 Serer (*) 17 Other ethnic group 56.1 62 Total 61.3 366 Number of children with suspected pneumonia in the two weeks prior to the survey Percentage of under 5 with suspected pneumonia who received antibiotics in the last two weeks* * MICS indicator 22 100 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report LG A Ba nj ul .6 23 .8 69 .4 .6 1. 9 8. 8 .0 50 .0 .6 19 6 Ka ni fin g 7.9 21 .7 71 .9 7.1 8. 4 7.1 4. 9 31 .5 3. 5 15 08 Br ik am a 3. 5 35 .2 70 .9 5. 1 8. 8 4. 8 4. 5 25 .5 2. 1 14 25 M an sa ko nk o 5. 0 30 .8 68 .7 6. 1 11 .7 9. 5 7.8 14 .4 3. 2 40 6 Ke re w an 20 .4 44 .9 70 .2 24 .5 28 .7 18 .1 12 .6 16 .5 14 .3 82 6 Ku nt au r 4. 3 34 .6 58 .3 7.3 4. 8 4. 1 6. 1 40 .8 2. 1 50 2 Ja nj an gb ur eh 4. 8 12 .4 65 .9 3. 6 8. 1 23 .0 10 .8 26 .4 1. 3 68 2 Ba ss e 6. 3 22 .9 59 .5 6. 8 7.2 4. 6 3. 3 32 .7 3. 7 99 9 Re si de nc e U rb an 7.5 24 .8 70 .7 6. 9 8. 9 7.8 5. 1 31 .9 3. 2 23 03 Ru ra l 7.1 30 .4 65 .9 8. 9 11 .5 10 .0 6. 9 26 .1 4. 7 42 40 M ot he r's e du ca tio n N on e 7.6 29 .2 66 .0 8. 6 10 .9 9. 1 6. 5 27 .1 4. 4 49 23 Pr im ar y 6. 4 24 .6 71 .2 5. 9 7.6 9. 9 5. 3 27 .1 2. 6 71 0 Se co nd ar y + 6. 1 26 .9 73 .8 7.9 11 .3 9. 3 5. 6 34 .5 4. 3 91 1 W ea lth in de x qu in til es Po or es t 7.1 32 .1 64 .2 7.9 10 .4 12 .4 8. 3 25 .6 4. 1 15 32 Se co nd 6. 8 35 .8 68 .3 10 .0 12 .0 9. 8 6. 4 23 .3 4. 3 13 37 M id dl e 8. 4 25 .2 67 .1 9. 0 11 .7 7.4 5. 8 26 .2 5. 1 13 44 Fo ur th 7.6 23 .8 68 .6 8. 1 10 .4 8. 2 6. 2 31 .1 4. 5 12 48 Ri c h es t 6. 4 23 .3 71 .2 5. 7 7.9 7.5 3. 8 36 .8 2. 6 10 82 Et hn ic g ro up o f h ea d of h ou se ho ld M an di nk a 7.4 29 .4 67 .8 9. 0 11 .4 8. 2 6. 2 26 .2 4. 7 23 15 W ol lo f 7.8 28 .4 66 .2 11 .9 13 .7 14 .7 9. 8 32 .0 6. 7 93 5 Fu la 8. 1 27 .3 66 .1 6. 3 9. 6 9. 1 5. 9 28 .8 3. 1 14 65 Jo la 5. 9 37 .0 74 .9 7.2 9. 6 7.1 5. 8 23 .3 2. 4 59 0 Se re r 9. 8 26 .7 73 .6 11 .6 11 .8 10 .0 3. 7 35 .3 6. 2 16 5 O th er e th ni c gr ou p 5. 5 22 .7 65 .6 6. 1 7.8 8. 0 4. 5 29 .8 2. 9 10 51 To ta l 7.3 28 .4 67 .6 8. 2 10 .6 9. 2 6. 3 28 .2 4. 1 65 43 Ta bl e C H .7 A :K no w le dg e of t he t w o da ng er s ig ns o f p ne um on ia Pe rc en ta ge o f m ot he rs /c ar et ak er s of c hi ld re n ag ed 0 -5 9 m on th s by k no w le dg e of ty pe s of s ym pt om s fo r ta ki ng a c hi ld 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 ot he rs /c ar et ak er s w ho r ec og ni ze fa st a nd d iff ic ul t b re at hi ng a s si gn s fo r se ek in g ca re im m ed ia te ly , T he G am bi a, 2 00 6 N um be r o f m ot he rs / ca re ta ke rs o f c hi ld re n ag ed 0 -5 9 m on th s M ot he rs /c ar et ak er s w ho re co gn ize th e tw o da ng er s ig ns o f pn eu m on ia Ha s ot he r sy m pt om s Is d rin ki ng po or ly Ha s bl oo d in st oo l Ha s di ffi cu lt br ea th in g Ha s fa st br ea th in g De ve lo ps a fe ve r Be co m es si ck er Is n ot a bl e to d rin k or b re as tfe ed Pe rc en ta ge o f m ot he rs /c ar et ak er s of c hi ld re n ag ed 0 -5 9 m on th s w ho t hi nk t ha t a ch ild s ho ul d be t ak en im m ed ia te ly t o a he al th fa ci lit y if th e ch ild The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 101 LG A Ba nj ul .0 7.1 1. 9 .0 .2 .0 44 .0 27 .4 .0 18 .4 .8 10 0. 0 71 .4 30 8 Ka ni fin g .2 5. 0 3. 8 .5 .4 .2 23 .9 59 .4 .5 6. 2 .1 10 0. 0 83 .9 18 77 Br ik am a .0 1. 1 1. 8 .5 .0 .0 6. 2 86 .8 .0 3. 6 .0 10 0. 0 93 .1 16 52 M an sa ko nk o .0 .0 .0 .0 .0 .0 1. 6 94 .7 .0 3. 7 .0 10 0. 0 96 .3 35 7 Ke re w an .0 2. 0 .6 .0 .1 .0 4. 6 91 .1 .5 1. 0 .0 10 0. 0 96 .3 71 8 Ku nt au r .0 .0 .0 .0 .0 .0 5. 7 94 .0 .0 .4 .0 10 0. 0 99 .6 30 6 Ja nj an gb ur eh .0 1. 1 .0 .0 .0 .0 2. 4 96 .0 .2 .2 .0 10 0. 0 98 .7 37 0 Ba ss e .0 .0 .0 .0 .0 .0 4. 7 94 .1 .0 1. 2 .0 10 0. 0 98 .8 48 3 Re si de nc e U rb an .1 4. 6 2. 9 .3 .3 .1 21 .7 62 .0 .4 7.4 .1 10 0. 0 84 .2 29 30 Ru ra l .0 .6 .8 .2 .0 .0 4. 4 92 .5 .1 1. 4 .0 10 0. 0 97 .0 31 41 Ed uc at io n of h ou se ho ld h ea d N on e .0 1. 0 .7 .0 .0 .0 9. 0 85 .2 .3 3. 6 .1 10 0. 0 94 .4 43 50 Pr im ar y .0 3. 4 3. 4 .3 .0 .0 22 .3 65 .0 .3 5. 3 .0 10 0. 0 87 .7 31 3 Se co nd ar y + .2 6. 9 4. 8 1. 0 .5 .1 22 .4 57 .8 .1 6. 1 .0 10 0. 0 80 .5 14 07 W ea lth in de x qu in til es Po or es t .0 .0 .0 .0 .0 .0 1. 4 98 .0 .2 .4 .0 10 0. 0 99 .6 10 89 Se co nd .0 .1 .0 .0 .1 .0 1. 2 96 .9 .1 1. 7 .0 10 0. 0 98 .2 11 40 M id dl e .0 .6 .8 .0 .0 .0 6. 6 88 .2 .3 3. 5 .1 10 0. 0 95 .0 11 75 Fo ur th .0 2. 6 2. 2 .0 .1 .2 16 .5 69 .2 .4 8. 8 .1 10 0. 0 86 .2 12 61 Ri ch es t .3 7.9 5. 2 1. 2 .5 .1 32 .8 45 .7 .2 6. 0 .1 10 0. 0 78 .8 14 06 Et hn ic g ro up o f h ea d of h ou se ho ld M an di nk a .1 1. 4 1. 1 .1 .0 .0 7.0 87 .9 .2 2. 2 .1 10 0. 0 95 .1 20 43 W ol lo f .0 2. 5 2. 1 .3 .0 .0 19 .1 69 .4 .4 6. 2 .0 10 0. 0 89 .0 79 3 Fu la .1 2. 2 1. 4 .2 .1 .0 14 .4 75 .6 .2 5. 8 .1 10 0. 0 90 .1 Fu la Jo la .1 1. 2 1. 1 .3 .0 .3 11 .0 81 .6 .3 4. 0 .1 10 0. 0 93 .1 70 3 Se re r .0 4. 2 1. 5 .4 .0 .0 21 .5 64 .0 .4 8. 0 .0 10 0. 0 85 .8 27 3 O th er e th ni c gr ou p .1 6. 2 4. 5 .7 1. 0 .1 16 .8 66 .4 .2 4. 0 .0 10 0. 0 83 .5 85 0 To ta l .1 2. 5 1. 8 .3 .2 .1 12 .8 77 .8 .2 4. 3 .1 10 0. 0 90 .9 60 71 Ta bl e C H .8 :S ol id fu el u se Pe rc en ta ge d is tr ib ut io n of h ou se ho ld s ac co rd in g to ty pe o f c oo ki ng fu el , a nd p er ce nt ag e of h ou se ho ld s us in g so lid fu el fo r co ok in g, Th e G am bi a, 2 00 6 N um be r o f ho us eh ol ds So lid fu el fo r c oo ki ng * To ta l Pe rc en ta ge o f h ou se ho ld s us in g: O th er so ur ce W oo d Ch ar co al Co al , lig ni te Ke ro se ne Bi og as N at ur al G as El ec tri ci ty Li qu ifi ed P et ro le um G as (L PG ) St ra w , sh ru bs , g ra ss M is si ng * M IC S in di ca to r 24 ;M D G in di ca to r 29 102 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table CH.9: Solid fuel use by type of stove or fire Percentage of households using solid fuel for cooking by type of stove or fire, The Gambia, 2006 LGA Banjul 1.6 2.6 95.3 .0 .5 100.0 220 Kanifing 30.0 6.5 63.0 .4 .1 100.0 1576 Brikama 36.4 1.2 61.9 .5 .0 100.0 1538 Mansakonko 1.4 13.3 85.3 .0 .0 100.0 344 Kerewan 1.8 2.2 96.0 .0 .0 100.0 692 Kuntaur 2.6 17.6 79.8 .0 .0 100.0 304 Janjangbureh 2.5 1.0 96.5 .0 .0 100.0 365 Basse 4.9 15.4 79.7 .0 .0 100.0 477 Residence Urban 23.5 6.0 70.2 .2 .1 100.0 2468 Rural 16.9 5.6 77.3 .2 .0 100.0 3048 Education of household head None 17.6 5.8 76.4 .2 .0 100.0 4109 Primary 22.9 5.2 71.5 .4 .0 100.0 275 Secondary + 27.4 5.9 66.3 .3 .1 100.0 1133 Poorest 1.3 5.6 93.1 .1 .0 100.0 1085 Second 14.1 4.7 81.2 .1 .0 100.0 1119 Middle 24.5 5.3 69.9 .4 .0 100.0 1117 Fourth 31.7 6.0 62.1 .3 .0 100.0 1088 Richest 27.6 7.3 64.5 .4 .2 100.0 1108 Ethnic group of head of household Mandinka 22.7 6.4 70.5 .3 .1 100.0 1942 Wollof 18.9 6.2 74.9 .0 .0 100.0 705 Fula 15.9 5.0 79.0 .2 .0 100.0 1270 Jola 23.1 2.8 73.6 .5 .0 100.0 654 Serer 19.3 5.2 74.6 .5 .5 100.0 234 Other ethnic group 17.3 7.9 74.6 .1 .0 100.0 710 Total 19.9 5.8 74.1 .2 .0 100.0 5516 Number of households using solid fuel for cookingTotalMissingOther stove Open stove or fire Open stove or fire Closed stove Percentage of households using solid fuel for cooking: The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 103 Table CH.10: Availability of insecticide treated nets Percentage of households with at least one insecticide treated net (ITN), The Gambia, 2006 LGA Banjul 41.0 28.6 308 Kanifing 43.7 30.4 1877 Brikama 64.9 56.2 1652 Mansakonko 83.1 76.4 357 Kerewan 61.1 56.9 718 Kuntaur 74.9 66.6 306 Janjangbureh 75.1 67.7 370 Basse 71.7 58.5 483 Residence Urban 48.5 34.0 2930 Rural 69.6 64.0 3141 Education of household head None 62.7 53.0 4350 Primary 58.6 45.8 313 Secondary + 49.4 39.7 1407 Wealth index quintiles Poorest 77.6 65.8 1089 Second 73.9 66.7 1140 Middle 60.4 52.0 1175 Fourth 53.7 42.6 1261 Richest 37.9 27.0 1406 Ethnic group of head of household Mandinka 69.3 61.7 2043 Wollof 44.0 35.9 793 Fula 59.1 45.4 1409 Jola 61.7 53.3 703 Serer 49.5 39.1 273 Other ethnic group 51.9 39.8 850 Total 59.4 49.5 6071 Number of households Percentage of households with at least one insecticide treated net (ITN)* Percentage of households with at least one mosquito net *MICS indicator 36 104 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report * MICS indicator 38 ** MICS indicator 37; MDG indicator 22 Table CH.11: Children sleeping under bednets Percentage of children aged 0-59 months who slept under an insecticide treated net during the previous night,The Gambia, 2006 Sex Male 62.5 48.5 6.1 2.9 .1 37.4 3346 Female 63.5 49.6 6.2 3.4 .1 36.4 3197 LGA Banjul 53.1 42.5 2.5 2.5 .0 46.9 196 Kanifing 49.2 34.3 6.8 4.6 .0 50.8 1508 Brikama 71.9 62.3 2.6 2.3 .4 27.7 1425 Mansakonko 84.6 66.6 7.5 4.6 .0 15.4 406 Kerewan 63.4 54.0 4.9 2.1 .1 36.5 826 Kuntaur 74.5 56.8 10.7 4.0 .0 25.5 502 Janjangbureh 77.8 54.0 9.8 2.7 .0 22.2 682 Basse 48.0 35.0 6.4 2.3 .0 52.0 999 Residence Urban 54.6 38.2 7.5 4.8 .0 45.4 2303 Rural 67.6 54.9 5.4 2.2 .1 32.3 4240 Age 0-11 months 67.2 52.3 6.1 4.7 .1 32.7 1547 12-23 months 63.2 48.6 6.8 2.5 .1 36.8 1486 24-35 months 64.2 50.7 5.3 3.3 .1 35.7 1369 36-47 months 61.3 47.4 6.8 2.7 .2 38.6 1247 48-59 months 55.9 43.9 5.4 1.8 .0 44.1 893 Wealth index quintiles Poorest 68.0 53.5 6.6 2.5 .1 32.0 1532 Second 73.7 62.7 4.9 1.4 .1 26.2 1337 Middle 64.8 49.6 6.7 3.3 .2 35.0 1344 Fourth 59.8 44.9 6.8 4.2 .1 40.1 1248 Richest 44.1 29.8 5.4 4.8 .0 55.9 1082 Ethnic group of head of household Mandinka 74.4 61.3 5.1 2.5 .1 25.4 2254 Wollof 46.3 33.8 4.1 3.1 .0 53.7 870 Fula 63.4 46.6 9.2 4.3 .0 36.6 1494 Jola 68.0 57.3 3.4 2.4 .3 31.7 596 Serer 54.4 45.6 4.3 2.4 .0 45.6 212 Other ethnic group 51.3 35.6 7.5 3.5 .1 48.6 1117 Total 63.0 49.0 6.1 3.1 .1 36.9 6543 Number of women who gave birth in prior two yearsDon't know Don't know if slept under a net Slept under a net but don't know if treated Slept under an untreated net Slept under an insecticide treated net** Slept under a bednet* Percentage of children who: The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 105 Se x M al e 8. 7 33 46 15 .1 55 .9 2. 0 3. 9 .3 2. 8 61 .4 65 .6 3. 1 .4 8. 3 2. 7 50 .2 29 0 Fe m al e 8. 1 31 97 11 .4 59 .5 1. 2 1. 5 .0 2. 9 64 .0 64 .9 2. 0 .8 9. 4 2. 1 54 .8 25 9 LG A Ba nj ul 15 .6 19 6 (8 .0 ) (2 8. 0) (.0 ) (.0 ) (.0 ) (.0 ) (2 8. 0) (8 4. 0) (.0 ) (.0 ) (2 4. 0) (.0 ) (2 8. 0) 31 Ka ni fin g 9. 0 15 08 14 .1 57 .0 2. 3 .8 .0 3. 9 60 .2 67 .2 1. 6 2. 3 17 .2 3. 1 54 .7 13 5 Br ik am a 7.7 14 25 14 .3 64 .3 1. 0 .0 .0 1. 0 66 .9 68 .2 2. 0 .0 11 .7 4. 7 65 .0 11 0 M an sa ko nk o 3. 4 40 6 (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) (* ) 14 Ke re w an 9. 7 82 6 16 .8 56 .7 4. 8 9. 6 .0 .0 65 .1 40 .1 6. 0 .0 4. 9 1. 2 52 .0 80 Ku nt au r 11 .2 50 2 15 .3 54 .1 .0 4. 1 .0 6. 1 64 .3 54 .0 4. 1 .0 2. 0 4. 1 43 .9 56 Ja nj an gb ur eh 6. 5 68 2 (1 0. 3) (7 7.5 ) (2 .1 ) (1 .8 ) (1 .8 ) (4 .1 ) (7 9. 6) (8 9. 7) (2 .1 ) (.0 ) (.0 ) (.0 ) (6 9. 2) 44 Ba ss e 7.9 99 9 4. 1 50 .5 .0 4. 2 .0 5. 2 56 .8 68 .4 1. 1 .0 .0 1. 1 32 .6 79 Re si de nc e U rb an 9. 5 23 03 14 .7 54 .6 1. 5 2. 1 .4 3. 9 59 .3 70 .4 1. 0 1. 5 16 .4 2. 3 53 .7 21 8 Ru ra l 7.8 42 40 12 .5 59 .6 1. 8 3. 2 .0 2. 2 64 .8 61 .9 3. 6 .0 3. 9 2. 5 51 .5 33 1 Ag e in m on th s 0- 11 7.9 15 47 9. 4 52 .9 .9 2. 9 .0 2. 6 57 .1 60 .6 5. 1 .0 5. 8 .9 52 .2 12 3 12 -2 3 10 .5 14 86 10 .7 57 .4 1. 3 3. 3 .0 2. 6 62 .7 61 .7 1. 9 1. 4 8. 9 3. 3 55 .7 15 5 24 -3 5 9. 7 13 69 16 .5 59 .6 2. 1 1. 6 .0 3. 6 63 .9 73 .7 .6 .0 10 .7 1. 6 49 .3 13 3 36 -4 7 5. 9 12 47 10 .2 58 .6 1. 5 5. 9 1. 1 3. 8 67 .2 66 .4 2. 7 1. 4 11 .4 3. 9 50 .0 73 48 -5 9 7.1 89 3 24 .2 61 .9 3. 1 .0 .0 1. 4 65 .0 64 .1 3. 4 .0 7.8 3. 5 54 .1 64 M ot he r's e du ca tio n N on e 7.7 49 23 12 .1 56 .1 2. 1 3. 2 .0 3. 1 62 .8 62 .1 2. 6 .6 4. 9 2. 5 49 .6 38 0 Pr im ar y 10 .3 71 0 11 .2 57 .7 1. 4 1. 6 .0 2. 7 57 .7 72 .8 4. 4 .0 17 .8 2. 9 54 .8 73 Se co nd ar y + 10 .6 91 1 19 .9 63 .4 .0 1. 8 .8 2. 2 65 .6 72 .2 1. 1 1. 1 17 .8 1. 9 61 .3 96 W ea lth in de x qu in til es Po or es t 7.7 15 32 10 .5 56 .6 1. 6 2. 6 .0 1. 0 61 .1 61 .3 4. 9 .0 1. 7 1. 7 48 .2 11 9 Se co nd 7.7 13 37 15 .9 54 .0 2. 9 5. 3 .0 2. 0 62 .8 52 .7 2. 0 .0 4. 0 3. 3 49 .5 10 3 M id dl e 8. 6 13 44 15 .7 57 .8 .0 1. 6 .0 5. 9 63 .3 58 .9 .8 .0 8. 6 4. 1 52 .4 11 6 Fo ur th 7.6 12 48 9. 2 60 .3 1. 0 2. 9 .0 2. 6 65 .2 76 .0 3. 3 .0 12 .4 .0 55 .6 95 Ri ch es t 10 .7 10 82 15 .0 59 .3 2. 7 1. 6 .7 2. 7 61 .2 78 .0 1. 9 2. 7 17 .7 2. 8 56 .6 11 6 Et hn ic g ro up o f h ea d of h ou se ho ld M an di nk a 7.0 22 54 15 .5 57 .1 3. 1 3. 2 .0 3. 0 65 .3 61 .0 4. 7 .0 7.8 2. 8 54 .7 15 7 W ol lo f 9. 6 87 0 19 .2 62 .0 1. 1 3. 4 .0 1. 1 65 .5 55 .5 1. 1 .0 5. 0 3. 7 60 .8 84 Fu la 7.5 14 94 9. 0 57 .2 1. 8 2. 6 .0 1. 0 61 .8 64 .5 .9 1. 9 7.7 2. 9 44 .3 11 2 Jo la 9. 9 59 6 10 .8 48 .4 .0 1. 3 1. 3 5. 4 53 .8 63 .9 .0 1. 8 16 .0 1. 8 53 .8 59 Se re r 14 .8 21 2 (2 1. 4) (5 1. 1) (.0 ) (3 .2 ) (.0 ) (.0 ) (5 4. 4) (7 7.4 ) (.0 ) (.0 ) (1 5. 0) (.0 ) (5 4. 4) 31 Ot he r e th nic gr ou p 9. 5 11 17 9. 1 62 .4 1. 0 2. 3 .0 5. 4 64 .7 77 .3 4. 6 .0 8. 8 1. 5 49 .5 10 6 To ta l 8. 4 65 43 13 .3 57 .6 1. 6 2. 8 .1 2. 9 62 .6 65 .3 2. 6 .6 8. 8 2. 4 52 .4 54 9 Ta bl e C H .1 2: Tr ea tm en t of c hi ld re n w it h an ti -m al ar ia l d ru gs Pe rc en ta ge o f c hi ld re n ag ed 0 -5 9 m on th s w ho w er e ill w ith fe ve r in th e la st tw o w ee ks w ho r ec ei ve d an ti- m al ar ia l d ru gs , T he G am bi a, 2 00 6 N um be r o f ch ild re n w ith fe ve r in la st tw o w ee ks An y ap pr o- pr ia te a nt i- m al ar ia l d ru g w ith in 2 4 ho ur s of o ns et of s ym pt om s* Do n' t kn ow O th er Ib up ro fe n As pi rin Pa ra ce t-a m ol / Pa na do l/ Ac et am in - op he n An y ap pr o- pr ia te a nt i- m al ar ia l dr ug O th er a nt i- m al ar ia l Ar te m is - in in b as ed co m bi n- at io ns Q ui ni ne Am od ia - qu in e Ch lo ro - qu in e SP / Fa ns id ar N um be r of ch ild re n ag ed 0 -5 9 m on th s Ha d a fe ve r i n la st tw o w ee ks C hi ld re n w it h a fe ve r in t he la st t w o w ee ks w ho w er e tr ea te d w it h: A nt i-m al ar ia ls : O th er m ed ic at io ns * M IC S in di ca to r 39 ;M D G in di ca to r 22 106 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report * MICS indicator 40 Table CH.13: Intermittent preventive treatment for malaria Percentage of women aged 15-49 who gave birth during the two years preceding the survey and who received intermittent preventive therapy (IPT) for malaria during pregnancy, The Gambia, 2006 LGA Banjul 35.5 6.6 21.1 6.6 3.9 .0 1.3 75 Kanifing 52.4 12.0 31.8 1.7 11.1 2.4 2.6 694 Brikama 69.1 22.4 41.7 1.6 7.1 .6 1.1 750 Mansakonko 66.3 19.6 42.3 .0 10.7 .0 2.2 167 Kerewan 44.1 6.2 29.1 1.0 23.6 .5 .7 377 Kuntaur 59.2 26.4 26.4 .0 12.0 2.3 .0 232 Janjangbureh 77.4 49.4 27.7 .0 12.5 .0 .0 313 Basse 53.9 25.8 26.0 .4 9.1 1.3 .2 463 Residence Urban 53.1 14.8 30.5 1.7 10.2 1.7 2.0 1037 Rural 62.2 24.3 33.5 .8 12.0 .8 .7 2033 Education None 58.3 22.4 31.0 .9 11.5 .7 .9 2229 Primary 60.6 17.3 37.6 1.2 10.3 1.8 1.2 352 Secondary + 61.6 17.9 35.6 2.1 11.5 2.4 1.8 489 Wealth index quintiles Poorest 61.3 26.9 30.3 .4 12.3 .5 .4 684 Second 62.0 23.0 33.2 .8 11.8 .5 1.6 647 Middle 57.5 21.3 30.8 .5 10.8 1.7 1.2 650 Fourth 57.9 18.5 35.1 1.1 9.6 .6 .5 600 Richest 55.7 13.2 33.6 3.4 12.5 2.6 1.9 488 Ethnic group of head of household Mandinka 63.2 21.7 36.0 .6 12.6 1.5 1.5 1048 Wollof 55.3 20.8 29.4 1.3 9.5 .5 .5 384 Fula 58.0 23.6 28.4 1.1 11.8 .7 1.0 706 Jola 59.3 16.7 35.1 2.2 9.5 1.4 1.8 302 Serer 50.6 10.7 33.1 1.7 9.4 .9 1.8 117 Other ethnic group 56.8 21.6 31.6 1.2 11.1 1.3 .4 512 Total 59.1 21.1 32.5 1.1 11.4 1.1 1.1 3070 Number of women who gave birth in prior two years Percentage of pregnant women who took: Don't know Other medicines Chloro- quine SP/ Fansidar, number unknown SP/Fansidar two or more times* SP/Fansidar only one time Medicine to prevent malaria during pregnancy The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 107 Table CH.15: Source and cost of supplies for antimalarials Percentage distribution of children with fever aged 0-59 months who took antimalarials in the two weeks preceding the survey by source of antimalarials, percentage of children for whom antimalarials were obtained for free, and median cost of antimalarials for those paying for antimalarials, The Gambia, 2006 Sex Male 70.3 19.2 10.5 100.0 178 79.6 13.8 20.1 90.0 Female 63.3 21.9 14.7 100.0 166 89.7 15.5 25.0 80.2 LGA Banjul (*) (*) (*) (*) 9 (*) . 20.0 . Kanifing 50.6 45.5 3.9 100.0 81 76.9 2.9 27.5 87.5 Brikama 72.8 15.8 11.4 100.0 73 93.9 9.3 35.0 79.8 Mansakonko (*) (*) (*) (*) 12 (*) . 25.0 . Kerewan 70.5 12.8 16.7 100.0 52 86.9 .0 62.5 49.4 Kuntaur (68.3) (3.2) (28.5) (100.0) 36 (95.4) (.0) 50.0 150.0 Janjangbureh (69.1) (23.4) (7.4) (100.0) 35 (100.0) (100.0) . . Basse (72.2) (12.9) (14.9) (100.0) 45 (64.0) (.0) 15.0 122.1 Residence Urban 63.3 30.5 6.2 100.0 129 79.1 2.7 28.5 89.7 Rural 69.1 14.5 16.4 100.0 215 87.0 30.0 23.1 60.0 Mother's education None 68.9 16.4 14.7 100.0 238 85.0 16.3 20.0 81.6 Primary (74.3) (14.1) (11.5) (100.0) 42 (82.2) (15.3) 27.7 121.7 Secondary + 54.7 40.2 5.1 100.0 63 82.2 12.1 41.1 88.5 Wealth index quintiles Poorest 79.7 7.7 12.6 100.0 73 85.7 48.9 17.3 35.6 Second 62.9 15.3 21.7 100.0 65 87.7 18.4 32.7 74.1 Middle 71.3 15.2 13.5 100.0 74 86.4 26.1 20.0 48.0 Fourth 70.7 17.5 11.8 100.0 62 86.3 16.8 25.0 75.0 Richest 49.7 46.6 3.8 100.0 71 71.9 3.2 55.8 130.0 Ethnic group of head of household Mandinka 72.8 18.8 8.4 100.0 102 86.7 5.6 36.9 56.4 Wollof 60.8 19.3 20.0 100.0 55 87.3 .0 35.8 119.9 Fula 74.7 14.0 11.3 100.0 69 86.1 20.4 17.1 87.4 Jola (69.1) (13.4) (17.5) (100.0) 32 (90.4) (.0) 17.5 90.1 Serer (75.9) (18.5) (5.6) (100.0) 17 (91.9) (.0) 25.0 477.0 Other ethnic group 52.0 34.5 13.6 100.0 68 66.9 31.0 24.8 71.6 Total 66.9 20.5 12.6 100.0 344 84.2 14.7 25.0 85.4 Number of children with fever in prior 2 weeks who were treated with antima- larials Private**Public**PrivatePublicTotalOtherPrivatePublic* Percentage freeSource of antimalarials Median cost for those not free (in dalasis) * MICS indicator 96 ** MICS indicator 97 108 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table CH.16: Source and cost of supplies for antibiotics Percentage distribution of children aged 0-59 months with suspected pneumonia during the two weeks preceding the survey by source of antibiotics for treatment of pneumonia, percentage of children aged 0-59 months with suspected pneumonia during the two weeks preceding the survey for whom antibiotics were obtained for free, and median cost of antibiotics for those paying for the antibiotics, by type of source of antibiotics, The Gambia, 2006 Sex Male 59.7 32.7 7.6 100.0 131 79.8 27.1 50.0 66.4 Female 72.3 21.4 6.3 100.0 94 77.4 13.9 27.4 77.8 LGA Banjul - - - - - - - - - Kanifing 35.4 62.5 2.1 100.0 51 76.5 16.7 105.0 100.0 Brikama (72.2) (11.8) (16.0) (100.0) 41 92.6 22.7 20.0 75.0 Mansakonko (*) (*) (*) (*) 8 100.0 .0 . 50.0 Kerewan (80.1) (4.9) (14.9) (100.0) 39 72.3 100.0 7.5 . Kuntaur (*) (*) (*) (*) 19 66.7 .0 50.0 62.0 Janjangbureh (68.6) (28.7) (2.7) (100.0) 34 96.1 45.3 15.0 32.8 Basse (73.1) (22.0) (4.9) (100.0) 34 56.6 22.3 40.9 66.1 Residence Urban 47.1 50.1 2.7 100.0 76 83.7 15.9 81.4 100.0 Rural 74.1 16.6 9.3 100.0 149 77.0 33.6 25.0 50.0 Mother's education None 67.6 27.2 5.2 100.0 169 76.0 23.6 30.0 65.0 Primary (60.7) (24.0) (15.3) (100.0) 32 (95.8) (21.9) 50.0 55.8 Secondary + (*) (*) (*) (*) 24 (*) (*) 106.2 155.0 Wealth index quintiles Poorest 83.9 14.4 1.7 100.0 57 77.9 11.1 31.3 50.0 Second 72.7 18.5 8.9 100.0 45 (82.5) (45.6) 12.2 35.8 Middle 63.6 26.1 10.3 100.0 55 89.2 48.2 5.0 68.6 Fourth (58.8) (32.1) (9.1) (100.0) 35 (54.7) (17.9) 58.5 75.0 Richest (31.5) (62.0) (6.4) (100.0) 34 (82.3) (3.8) 156.4 107.6 Ethnic group of head of household Mandinka 71.7 20.3 8.0 100.0 87 90.1 39.3 50.6 57.9 Wollof 54.0 40.8 5.2 100.0 37 (58.4) (6.0) 29.3 50.0 Fula (61.7) (31.7) (6.6) (100.0) 46 (77.3) (19.6) 14.6 80.0 Jola (*) (*) (*) (*) 12 (*) (*) 155.0 75.0 Serer (*) (*) (*) (*) 9 (*) (*) . 90.0 Other ethnic group (67.4) (27.1) (5.5) (100.0) 35 (64.7) (39.5) 35.9 71.3 Total 65.0 27.9 7.1 100.0 225 78.7 22.8 34.6 68.1 Number of children with suspected pneumonia in prior 2 weeks who received antibiotics Private**Public**PrivatePublicTotalOtherPrivatePublic* Percentage freeSource of antibiotics Median cost for those not free (in Dalasis) * MICS indicator 96 ** MICS indicator 97 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 109 Table CH.17: Source and cost of supplies for oral rehydration salts Percentage distribution of children aged 0-59 months with diarrhoea during the two weeks preceding the survey by source of oral rehydration salts for treatment of diarrhoea, percentage of children aged 0-59 months with diarrhoea during the two weeks preceding the survey for whom oral rehydration salts were obtained for free, and median cost of oral rehydration salts for those paying for the oral rehydration salts, by type of source of oral rehydration salts, The Gambia, 2006 Sex Male 83.7 12.3 4.0 100.0 267 93.1 28.4 10.3 12.7 Female 81.5 14.5 4.1 100.0 217 93.3 41.0 11.6 8.8 LGA Banjul (*) (*) (*) (*) 7 (*) (*) . 5.0 Kanifing 49.3 44.0 6.7 100.0 79 91.9 21.2 5.0 13.5 Brikama 90.3 8.8 .8 100.0 91 92.1 27.0 10.0 10.0 Mansakonko 92.8 3.6 3.6 100.0 29 100.0 100.0 . . Kerewan 91.3 2.9 5.8 100.0 99 94.7 33.3 7.6 10.0 Kuntaur (90.3) (.0) (9.7) (100.0) 36 (96.4) . 25.0 . Janjangbureh 88.5 11.5 .0 100.0 71 100.0 88.9 . 15.0 Basse 86.0 9.3 4.7 100.0 71 81.0 50.0 15.0 9.6 Residence Urban 66.2 29.3 4.6 100.0 133 95.2 19.0 5.0 10.0 Rural 89.0 7.2 3.9 100.0 351 92.6 58.6 12.0 10.0 Mother's education None 86.8 9.8 3.4 100.0 375 94.2 47.4 10.0 10.0 Primary 72.7 22.0 5.3 100.0 54 92.5 23.0 100.0 19.6 Secondary + 64.7 27.8 7.5 100.0 55 85.1 12.9 10.0 10.0 Wealth index quintiles Poorest 93.7 2.2 4.1 100.0 120 94.1 68.8 10.0 . Second 89.4 6.2 4.4 100.0 127 95.3 47.8 17.1 7.3 Middle 86.3 12.0 1.7 100.0 100 88.9 53.0 34.3 13.9 Fourth 80.2 18.5 1.3 100.0 75 95.9 44.7 23.8 10.0 Richest 45.5 44.2 10.3 100.0 63 88.8 14.5 7.6 10.7 Ethnic group of head of household Mandinka 81.3 12.5 6.2 100.0 156 96.2 42.4 30.0 9.3 Wollof 77.3 15.6 7.1 100.0 74 93.1 17.1 7.6 13.0 Fula 91.0 7.6 1.5 100.0 122 94.7 31.9 25.0 15.4 Jola (96.0) (4.0) (.0) (100.0) 27 (95.8) .0 . 70.0 Serer (*) (*) (*) (*) 20 (*) (*) . 10.0 Other ethnic group 77.3 19.3 3.4 100.0 86 82.7 48.5 7.6 13.5 Total 82.7 13.2 4.0 100.0 484 93.2 34.6 10.0 10.0 Number of children with diarrhoea in prior 2 weeks who received oral rehydra- tion salts Private**Public**PrivatePublicTotalOtherPrivatePublic* Percentage freeSource of oral rehydration salts Median cost for those not free (in Dalasis) * MICS indicator 96 ** MICS indicator 97 110 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report LG A Ba nj ul 10 .9 66 .5 2. 8 .0 .0 .0 .5 .0 .0 .0 17 .8 1. 5 10 0. 0 80 .8 15 07 Ka ni fin g 16 .6 43 .7 28 .7 .3 1. 4 .0 .3 1. 3 .0 .0 7.7 .1 10 0. 0 91 .0 11 38 3 Br ik am a 4. 7 8. 2 38 .1 19 .4 8. 6 .0 .2 19 .5 .0 .0 1. 2 .1 10 0. 0 79 .2 11 13 2 M an sa ko nk o 1. 1 2. 0 35 .4 30 .0 14 .2 .0 .0 16 .8 .2 .0 .3 .0 10 0. 0 82 .6 29 65 Ke re w an 1. 8 3. 6 49 .1 16 .5 17 .9 .2 .0 10 .7 .0 .0 .2 .0 10 0. 0 89 .1 51 39 Ku nt au r .8 2. 0 6. 8 64 .0 9. 9 .0 .0 16 .6 .0 .0 .0 .0 10 0. 0 83 .4 30 28 Ja nj an gb ur eh 1. 7 1. 8 10 .4 53 .1 14 .8 .0 .0 18 .3 .0 .0 .0 .0 10 0. 0 81 .7 38 61 Ba ss e .9 1. 9 52 .9 28 .3 3. 6 .0 .0 12 .4 .0 .0 .0 .0 10 0. 0 87 .6 58 61 A re a U rb an 13 .4 38 .0 36 .1 1. 9 1. 6 .0 .2 1. 9 .0 .0 6. 7 .2 10 0. 0 91 .2 17 44 8 Ru ra l 1. 9 2. 7 31 .1 33 .7 11 .9 .0 .1 18 .1 .0 .0 .5 .0 10 0. 0 81 .4 27 42 9 Ed uc at io n of h ea d of h ou se ho ld N on e 3. 9 12 .3 34 .8 24 .4 8. 7 .0 .1 13 .2 .0 .0 2. 5 .1 10 0. 0 84 .2 35 14 3 Pr im ar y 6. 9 29 .7 28 .0 17 .7 2. 8 .0 .0 9. 3 .0 .0 5. 0 .5 10 0. 0 85 .2 18 92 Se co nd ar y 17 .3 31 .9 26 .5 8. 5 5. 5 .0 .2 6. 2 .0 .0 4. 0 .0 10 0. 0 89 .8 78 42 W ea lth in de x qu in til es Po or es t .0 .0 16 .4 51 .7 14 .4 .0 .0 17 .3 .1 .0 .1 .0 10 0. 0 82 .5 90 54 Se co nd .0 .7 36 .4 31 .6 10 .7 .1 .0 19 .3 .0 .0 1. 1 .1 10 0. 0 79 .5 89 10 M id dl e .9 4. 4 53 .4 14 .4 8. 1 .0 .5 14 .6 .0 .0 3. 6 .1 10 0. 0 81 .7 89 14 Fo ur th 6. 5 19 .8 46 .9 8. 5 5. 4 .0 .1 6. 6 .0 .0 6. 1 .0 10 0. 0 87 .3 89 48 Ri ch es t 24 .2 56 .8 12 .6 .4 .8 .0 .1 1. 4 .0 .0 3. 5 .2 10 0. 0 94 .9 90 50 Et hn ic g ro up o f h ea d of h ou se ho ld M an di nk a 6. 0 14 .6 36 .1 22 .1 7.0 .1 .1 11 .6 .0 .0 2. 3 .2 10 0. 0 85 .9 15 88 9 W ol lo f 10 .3 22 .4 28 .2 12 .2 9. 7 .0 .1 14 .2 .0 .0 3. 0 .0 10 0. 0 82 .9 57 47 Fu la 3. 0 15 .2 22 .5 33 .9 9. 5 .0 .2 12 .5 .0 .0 3. 2 .0 10 0. 0 84 .3 91 86 Jo la 4. 2 13 .4 35 .9 20 .9 7.0 .1 .1 14 .1 .1 .0 3. 9 .2 10 0. 0 81 .6 48 34 Se re r 9. 2 31 .3 28 .5 4. 5 6. 9 .0 .1 9. 1 .0 .0 10 .5 .0 10 0. 0 80 .4 15 88 O th er e th ni c gr ou p 8. 9 16 .0 42 .2 15 .3 7.2 .0 .1 8. 7 .0 .0 1. 6 .1 10 0. 0 89 .7 76 32 To ta l 6. 3 16 .4 33 .0 21 .3 7.9 .0 .1 11 .8 .0 .0 2. 9 .1 10 0. 0 85 .2 44 87 7 Ta bl e EN .1 :U se o f i m pr ov ed w at er s ou rc es Pe rc en ta ge d is tr ib ut io n of h ou se ho ld p op ul at io n ac co rd in g to m ai n so ur ce o f d ri nk in g w at er a nd p er ce nt ag e of h ou se ho ld m em be rs u si ng im pr ov ed dr in ki ng w at er s ou rc es , T he G am bi a, 2 00 6 N um be r o f ho us eh ol d m em be rs Im pr ov ed so ur ce o f dr in kin g w at er To ta l U ni m pr ov ed s ou rc es M ai n so ur ce o f d rin ki ng w at er Im pr ov ed s ou rc es Su rfa ce w at er O th er U np ro te c- te d w el l Pi pe d in to dw el lin g Pi pe d in to y ar d or p lo t Pu bl ic ta p/ st an d- pi pe Tu be w el l/ bo re ho le Pr ot ec te d w el l Ra in w at er co lle ct io n Bo ttl ed w at er Ta nk er -tr uc k M is si ng The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 111 LG A Ba nj ul 94 .2 .2 3. 5 2. 1 .0 .0 .0 .0 .0 3. 7 15 07 3. 0 12 17 6. 4 29 0 Ka ni fin g 91 .9 .7 3. 9 3. 2 .6 .0 .2 .1 .0 5. 0 11 38 3 4. 3 10 34 8 12 .1 10 35 Br ik am a 71 .0 .1 2. 2 27 .7 .2 .0 .4 .0 .0 2. 5 11 13 2 1. 2 87 93 7.2 23 40 M an sa ko nk o 75 .4 .0 3. 9 20 .7 .0 .0 .5 .0 .0 3. 9 29 65 2. 0 24 50 13 .0 51 5 Ke re w an 83 .6 .0 .9 15 .6 .1 .0 .0 .0 .0 1. 0 51 39 1. 1 45 78 .0 56 1 Ku nt au r 60 .5 .3 5. 7 34 .2 .0 .0 2. 6 .0 .0 5. 7 30 28 3. 9 25 25 14 .6 50 3 Ja nj an gb ur eh 64 .2 .0 .9 34 .5 .0 .0 .0 .0 .0 .9 38 61 .3 31 54 3. 8 70 7 Ba ss e 73 .8 .0 1. 2 25 .0 .0 .0 .0 .0 .0 1. 2 58 61 1. 2 51 33 .8 72 8 Re si de nc e U rb an 92 .1 .4 3. 1 4. 1 .4 .0 .1 .1 .0 3. 8 17 44 8 3. 3 15 90 9 9. 4 15 38 Ru ra l 68 .8 .1 2. 3 29 .2 .1 .0 .5 .0 .0 2. 5 27 42 9 1. 5 22 28 9 6. 6 51 40 Ed uc at io n of h ou se ho ld h ea d N on e 76 .1 .1 2. 3 21 .7 .1 .0 .4 .0 .0 2. 5 35 14 3 1. 7 29 54 8 6. 7 55 95 Pr im ar y 82 .2 .1 5. 1 10 .6 1. 2 .0 .0 .0 .0 6. 4 18 92 5. 8 16 11 9. 9 28 1 Se co nd ar y + 84 .7 .6 3. 5 11 .6 .4 .0 .2 .1 .0 4. 2 78 42 3. 6 70 40 10 .0 80 2 W ea lth in de x qu in til es Po or es t 67 .8 .1 1. 2 30 .9 .0 .0 .0 .0 .0 1. 2 90 54 1. 2 74 72 1. 6 15 81 Se co nd 67 .4 .0 2. 2 31 .0 .0 .0 .4 .0 .0 2. 2 89 10 1. 4 70 82 5. 6 18 28 M id dl e 77 .9 .1 2. 0 20 .1 .2 .0 .3 .0 .0 2. 3 89 14 1. 4 72 49 6. 5 16 65 Fo ur th 83 .3 .5 4. 6 12 .2 .2 .0 1. 0 .0 .0 5. 2 89 48 3. 1 78 11 19 .7 11 38 Ri ch es t 92 .8 .4 3. 2 3. 1 .5 .0 .0 .1 .0 3. 9 90 50 3. 8 85 84 5. 7 46 6 Et hn ic g ro up o f h ea d of h ou se ho ld M an di nk a 80 .3 .0 1. 9 18 .0 .1 .0 .7 .0 .0 2. 1 15 88 9 .7 13 63 6 10 .2 22 53 W ol lo f 74 .8 .5 5. 2 20 .0 .2 .0 .1 .0 .0 5. 6 57 47 5. 1 47 57 8. 1 99 0 Fu la 75 .2 .2 1. 7 22 .6 .4 .0 .1 .1 .0 2. 3 91 86 2. 0 77 39 3. 7 14 47 Jo la 74 .7 .1 3. 1 22 .7 .3 .0 .3 .0 .0 3. 4 48 34 2. 5 39 47 7.4 88 8 Se re r 82 .6 .3 4. 5 12 .5 .3 .0 .0 .0 .0 4. 9 15 88 4. 0 12 77 8. 5 31 1 O th er e th ni c gr ou p 79 .5 .5 2. 5 17 .5 .2 .0 .0 .0 .0 3. 2 76 32 3. 2 68 42 3. 7 79 0 To ta l 77 .9 .2 2. 6 19 .4 .2 .0 .3 .0 .0 3. 0 44 87 7 2. 2 38 19 9 7.3 66 78 Ta bl e EN .2 :H ou se ho ld w at er t re at m en t Pe rc en ta ge d is tr ib ut io n of h ou se ho ld p op ul at io n ac co rd in g to d ri nk in g w at er tr ea tm en t m et ho d us ed in th e ho us eh ol d, a nd p er ce nt ag e of h ou se ho ld po pu la tio n th at a pp lie d an a pp ro pr ia te w at er tr ea tm en t m et ho d, T he G am bi a, 2 00 6 U ni m pr ov ed dr in ki ng w at er so ur ce s Im pr ov ed dr in ki ng w at er s ou rc es A ll dr in ki ng w at er s ou rc es W at er t re at m en t m et ho d us ed in t he h ou se ho ld Ap pr op ria te w at er tr ea tm en t m et ho d* N um be r o f ho us eh ol d m em be rs O th er N on e Bo il Ad d bl ea ch / ch lo rin e St ra in th ro ug h a cl ot h U se w at er fil te r So la r di si n- fe ct io n Le t i t st an d an d se ttl e Do n' t k no w Ap pr op ria te w at er tre at m en t m et ho d N um be r o f ho us eh ol d m em be rs Ap pr op ria t e w at er tre at m en t m et ho d N um be r o f ho us eh ol d m em be rs * M IC S in di ca to r 13 112 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table EN.3:Time to source of water Percentage distribution of households according to time to go to source of drinking water, get water and return, and mean time to source of drinking water, The Gambia, 2006 LGA Banjul 79.6 12.1 3.4 1.9 .0 2.3 .8 100.0 11.4 308 Kanifing 63.2 14.1 8.8 7.4 3.6 2.3 .5 100.0 23.5 1877 Brikama 24.6 36.4 23.8 11.6 3.2 .1 .2 100.0 17.1 1652 Mansakonko 4.4 28.2 35.9 22.7 8.3 .6 .0 100.0 22.6 357 Kerewan 9.9 50.6 21.6 17.2 .4 .3 .0 100.0 14.7 718 Kuntaur 4.3 26.4 42.7 16.1 9.1 .9 .4 100.0 24.2 306 Janjangbureh 7.8 39.5 21.1 22.3 7.8 1.5 .0 100.0 21.1 370 Basse 6.7 16.6 22.7 42.0 11.5 .5 .0 100.0 31.2 483 Residence Urban 55.4 16.7 12.3 9.7 3.7 1.8 .5 100.0 22.4 2930 Rural 12.0 37.8 25.8 18.8 5.0 .5 .1 100.0 19.8 3141 Education of household head None 24.2 30.3 22.5 16.6 5.0 1.1 .3 100.0 20.9 4350 Primary 45.0 23.1 13.9 10.9 4.7 1.9 .6 100.0 21.0 313 Secondary + 57.2 20.3 10.5 8.6 2.3 1.1 .1 100.0 18.5 1407 Wealth index quintiles Poorest 2.5 39.4 30.3 21.1 5.7 .9 .1 100.0 20.6 1089 Second 7.9 40.4 26.2 19.2 4.6 1.4 .3 100.0 18.9 1140 Middle 14.2 33.5 24.0 19.0 7.2 1.4 .7 100.0 22.1 1175 Fourth 38.9 24.7 17.5 13.1 4.2 1.3 .2 100.0 20.8 1261 Richest 87.2 5.7 2.8 2.7 .9 .6 .1 100.0 20.8 1406 Ethnic group of head of household Mandinka 27.1 29.5 20.8 16.7 4.9 .7 .2 100.0 20.9 2043 Wollof 42.5 27.5 15.1 10.8 3.3 .9 .0 100.0 18.9 793 Fula 28.5 28.7 20.5 15.8 4.7 1.5 .2 100.0 20.8 1409 Jola 28.5 30.4 24.3 10.4 4.7 1.0 .6 100.0 19.6 703 Serer 45.9 24.6 17.1 8.6 1.5 2.4 .0 100.0 16.3 273 Other ethnic group 44.7 20.0 14.0 15.2 4.3 1.3 .5 100.0 23.1 850 Total 32.9 27.6 19.3 14.4 4.4 1.1 .3 100.0 20.6 6071 Number of house- holds Mean time to source of drinking water*TotalMissing Don't know 1 hour or more 30 minutes to less than 1 hour 15 minutes to less than 30 minutes Less than 15 minutes Water on premises Time to source of drinking water * The mean time to source of drinking water is calculated based on those households that do not have water on the premises. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 113 Table EN.4: Person collecting water Percentage distribution of households according to the person collecting drinking water used in the household, The Gambia, 2006 LGA Banjul 70.4 14.8 1.9 1.9 1.9 9.3 100.0 63 Kanifing 76.0 12.0 5.9 1.8 .0 4.3 100.0 689 Brikama 82.7 9.0 5.2 .7 .1 2.3 100.0 1245 Mansakonko 84.4 6.3 8.2 .9 .3 .0 100.0 341 Kerewan 79.2 4.0 14.9 .3 .0 1.6 100.0 647 Kuntaur 88.3 3.4 6.3 1.0 .0 1.0 100.0 292 Janjangbureh 83.7 4.2 11.9 .0 .0 .3 100.0 341 Basse 88.2 4.5 5.9 .2 .0 1.3 100.0 450 Residence Urban 76.3 12.1 7.0 1.2 .2 3.3 100.0 1303 Rural 84.7 5.0 8.2 .6 .0 1.5 100.0 2765 Education of household head None 83.3 5.8 8.4 .7 .1 1.8 100.0 3295 Primary 80.4 10.9 4.0 1.2 .6 2.9 100.0 172 Secondary + 75.7 14.5 5.8 1.1 .0 3.0 100.0 601 Wealth index quintiles Poorest 84.8 3.0 10.7 .5 .0 1.0 100.0 1062 Second 85.5 4.3 8.3 .6 .1 1.2 100.0 1051 Middle 82.1 8.0 6.2 .9 .1 2.8 100.0 1007 Fourth 75.1 15.0 6.2 .8 .0 3.0 100.0 769 Richest 75.0 13.0 3.3 2.3 .6 5.8 100.0 180 Ethnic group of head of household Mandinka 82.8 4.9 9.9 .7 .1 1.7 100.0 1489 Wollof 77.1 10.2 8.9 .7 .0 3.2 100.0 455 Fula 81.4 8.7 7.4 1.1 .1 1.4 100.0 1006 Jola 85.8 8.3 2.8 .8 .2 2.1 100.0 502 Serer 79.4 7.6 8.9 .0 .0 4.1 100.0 147 Other ethnic group 82.7 7.9 5.9 .4 .0 3.1 100.0 469 Total 82.0 7.3 7.8 .8 .1 2.1 100.0 4068 Number of households Person collecting drinking water TotalMissing Don't know Male child under 15 Female child under 15 Adult man Adult woman 114 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report LG A Ba nj ul 45 .5 27 .4 1. 8 .0 21 .8 .0 .8 .0 .0 2. 0 .5 .0 10 0. 0 96 .6 15 07 Ka ni fin g 5. 3 32 .9 7.1 .8 49 .6 .6 .0 3. 4 .0 .1 .2 .0 10 0. 0 95 .8 11 38 3 Br ik am a 1. 7 4. 4 1. 9 .5 85 .5 .7 .0 2. 3 .0 2. 6 .1 .2 10 0. 0 94 .0 11 13 2 M an sa ko nk o .0 3. 9 2. 6 .3 58 .7 0 .0 30 .1 .0 4. 2 .0 .2 10 0. 0 65 .5 29 65 Ke re w an .5 1. 2 3. 0 .2 81 .4 .0 .2 3. 8 .0 9. 1 .7 .0 10 0. 0 86 .2 51 39 Ku nt au r .0 .5 .0 .0 76 .6 .0 .0 4. 3 .0 18 .6 .0 .0 10 0. 0 77 .1 30 28 Ja nj an gb ur eh .2 1. 0 .7 .0 28 .8 .0 .0 58 .9 .0 9. 8 .6 .0 10 0. 0 30 .7 38 61 Ba ss e .0 .9 .0 .5 85 .0 .0 .0 11 .8 .0 1. 7 .0 .1 10 0. 0 86 .4 58 61 Re si de nc e U rb an 7.7 25 .0 5. 4 .6 54 .6 .4 .1 5. 2 .0 .7 .2 .0 10 0. 0 93 .3 17 44 8 Ru ra l .6 2. 1 1. 3 .3 74 .0 .3 .0 14 .3 .0 6. 7 .2 .1 10 0. 0 78 .4 27 42 9 Ed uc at io n of h ou se ho ld h ea d N on e 2. 4 7.2 2. 5 .4 69 .5 .2 .1 12 .2 .0 5. 3 .2 .1 10 0. 0 81 .9 35 14 3 Pr im ar y 3. 6 13 .1 5. 2 1. 1 65 .5 .6 .0 8. 8 .0 1. 7 .5 .0 10 0. 0 88 .4 18 92 Se co nd ar y + 7.8 27 .7 4. 4 .6 53 .0 .8 .0 4. 7 .0 .8 .1 .1 10 0. 0 93 .5 78 42 W ea lth in de x qu in til es Po or es t .0 .0 .4 .0 55 .4 .0 .0 25 .1 .0 18 .6 .5 .0 10 0. 0 55 .8 90 54 Se co nd .0 .0 .8 .1 82 .6 .0 .0 14 .7 .0 1. 4 .2 .2 10 0. 0 83 .5 89 10 M id dl e .2 .1 1. 6 .1 89 .4 .0 .1 7.3 .0 .9 .3 .2 10 0. 0 91 .3 89 14 Fo ur th 2. 4 4. 7 5. 6 .7 80 .0 .2 .1 5. 7 .0 .5 .1 .0 10 0. 0 93 .4 89 48 Ri ch es t 14 .2 49 .8 6. 2 1. 3 25 .7 1. 4 .1 1. 1 .0 .2 .0 .0 10 0. 0 97 .2 90 50 Et hn ic ity M an di nk a 2. 1 9. 4 3. 1 .4 73 .4 .6 .0 10 .1 .0 .6 .2 .1 10 0. 0 88 .5 15 88 9 W ol lo f 8. 0 16 .4 3. 3 .2 53 .0 .5 .3 11 .8 .0 6. 6 .0 .0 10 0. 0 80 .8 57 47 Fu la 2. 9 6. 6 1. 9 .2 59 .3 .0 .0 16 .6 .0 11 .8 .5 .1 10 0. 0 71 .0 91 86 Jo la .8 7.9 3. 1 .4 77 .8 .1 .0 4. 7 .0 4. 8 .3 .2 10 0. 0 90 .0 48 34 Se re r 7.8 16 .9 5. 0 1. 9 57 .6 .8 .2 3. 4 .0 6. 0 .3 .0 10 0. 0 89 .3 15 88 O th er e th ni c gr ou p 3. 8 16 .3 2. 8 .7 65 .5 .2 .0 9. 6 .0 .9 .1 .1 10 0. 0 89 .1 76 32 To ta l 3. 4 11 .0 2. 9 .4 66 .5 .3 .1 10 .8 .0 4. 4 .2 .1 10 0. 0 84 .2 44 87 7 Ta bl e E N .5 :U se o f s an it ar y m ea ns o f e xc re ta d is po sa l Pe rc en ta ge d is tr ib ut io n of h ou se ho ld m em be rs a cc or di ng to ty pe o f t oi le t f ac ili ty u se d by th e ho us eh ol d, a nd th e pe rc en ta ge o f h ou se ho ld m em be rs us in g sa ni ta ry m ea ns o f e xc re ta d is po sa l, Th e G am bi a, 2 00 6 Ty pe o f t oi le t fa ci lit y us ed b y ho us eh ol d Fl us h/ po ur fl us h to : Im pr ov ed s an it at io n fa ci lit y N o fa ci lit ie s/ bu sh /fi el d O th er Pi t l at rin e w ith ou t s la b/ op en p it Pi pe d se w er sy st em Se pt ic ta nk Pi t l at rin e Ve nt ila te d im pr ov ed pi t l at rin e Pi t l at rin e w ith s la b Fl us h/ po ur flu sh to un kn ow n pl ac e/ no t su re /d on 't kn ow Fl us h/ po ur flu sh to un kn ow n pl ac e/ no t su re /d on 't kn ow Bu ck et M is si ng Nu m be r of ho us e- ho ld m em be rs Pe rc en ta ge o f po pu la tio n us in g sa ni ta ry m ea ns of e xc re ta di sp os al * To ta l * M IC S in di ca to r 12 ;M D G in di ca to r 31 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 115 Table EN.6: Disposal of child's faeces Percentage distribution of children aged 0-2 years according to place of disposal of child's faeces, and the percentage of children aged 0-2 years whose stools are disposed of safely, The Gambia, 2006 LGA Banjul 2.0 91.1 5.0 .0 .0 .0 1.0 .0 1.0 100.0 93.1 123 Kanifing 1.2 91.5 1.3 1.3 .1 .1 .7 .7 3.1 100.0 92.7 953 Brikama .4 89.3 1.3 3.0 .0 1.2 2.2 .1 2.4 100.0 89.7 995 Mansakonko .4 87.5 4.8 5.1 .0 .0 .4 .0 1.9 100.0 87.9 282 Kerewan .2 80.6 8.8 6.4 .2 .0 1.8 .0 2.0 100.0 80.8 572 Kuntaur .9 41.3 6.0 47.3 .9 1.3 .9 .0 1.4 100.0 42.2 367 Janjangbureh .0 76.1 15.5 7.0 .4 .0 .8 .0 .2 100.0 76.1 469 Basse 2.1 70.8 1.8 24.8 .0 .0 .0 .0 .6 100.0 72.8 685 Residence Urban 1.0 89.6 2.9 2.5 .1 .1 .8 .4 2.7 100.0 90.6 1484 Rural .8 75.7 5.4 14.6 .2 .6 1.3 .0 1.4 100.0 76.5 2962 Mother's education None .8 77.4 5.3 13.0 .2 .4 1.1 .1 1.8 100.0 78.2 3322 Primary .4 87.5 3.1 5.7 .0 .7 .6 .2 1.8 100.0 87.9 483 Secondary + 1.3 90.5 2.0 1.8 .2 .2 1.6 .3 2.1 100.0 91.8 641 Wealth index quintiles Poorest .6 62.0 9.3 24.1 .6 .3 1.8 .1 1.3 100.0 62.6 1078 Second .5 82.3 5.0 9.7 .0 .6 .3 .0 1.6 100.0 82.7 919 Middle .9 83.5 2.6 9.6 .0 .0 1.4 .1 2.0 100.0 84.3 933 Fourth 1.3 88.0 2.7 3.3 .0 1.0 1.2 .3 2.3 100.0 89.3 839 Richest 1.3 93.2 1.5 .6 .2 .0 .5 .5 2.2 100.0 94.5 677 Ethnic group of head of household Mandinka .7 84.2 2.9 8.6 .0 .4 1.0 .0 2.1 100.0 85.0 1530 Wollof .2 75.0 9.3 10.3 .6 .2 .9 .4 3.2 100.0 75.2 584 Fula .7 70.0 8.0 18.0 .1 .6 1.4 .2 1.1 100.0 70.6 1046 Jola .3 90.4 1.6 2.8 .0 .8 1.1 .3 2.7 100.0 90.7 395 Serer .0 94.4 .0 1.4 .0 .0 3.4 .0 .8 100.0 94.4 150 Other ethnic group 2.4 83.1 1.8 10.4 .4 .0 .6 .3 1.1 100.0 85.4 742 Total .9 80.4 4.6 10.6 .2 .4 1.1 .2 1.8 100.0 81.2 4446 Place of disposal of child's faeces Number of children aged 0-2 yearsMissing Don't knowOther Left in the openBuried Thrown into gar- bage Put/rin- sed into drain or ditch Child used toilet Put/rin- sed into toilet or latrine Total Proportion of children whose stools are disposed of safely* * MICS indicator 14 116 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table EN.7: Use of improved water sources and improved sanitation Percentage of household population using both improved drinking water sources and sanitary means of excreta disposal, The Gambia, /2006 LGA Banjul 80.8 96.6 78.5 1507 Kanifing 90.9 95.8 87.1 11383 Brikama 79.0 94.0 74.5 11132 Mansakonko 82.6 65.5 57.5 2965 Kerewan 89.1 86.2 77.7 5139 Kuntaur 83.4 77.1 65.0 3028 Janjangbureh 81.7 30.7 26.4 3861 Basse 87.6 86.4 76.0 5861 Residence Urban 91.2 93.3 84.9 17448 Rural 81.3 78.4 64.6 27429 Education of household head None 84.1 81.9 69.8 35143 Primary 85.2 88.4 75.4 1892 Secondary + 89.8 93.5 84.1 7842 Wealth index quintiles Poorest 82.5 55.8 47.7 9054 Second 79.5 83.5 66.3 8910 Middle 81.3 91.3 74.0 8914 Fourth 87.3 93.4 82.5 8948 Richest 94.9 97.2 92.2 9050 Ethnic group of head of household Mandinka 85.8 88.5 76.3 15889 Wollof 82.8 80.8 70.3 5747 Fula 84.2 71.0 59.6 9186 Jola 81.6 90.0 73.9 4834 Serer 80.4 89.3 72.4 1588 Other ethnic group 89.7 89.1 81.0 7632 Total 85.1 84.2 72.5 44877 Percentage of household population: Number of household members Using improved sources of drinking water and using sanitary means of excreta disposal Using sanitary means of excreta disposal** Using improved sources of drinking water* * MICS indicator 11; MDG indicator 30 ** MICS indicator 12; MDG indicator 31 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 117 Table EN.8: Security of tenure Percentage of household members living in households in urban areas which lack formal documentation for their residence in the dwelling or who feel at risk of eviction from the dwelling, and percentage of household members who were evicted from any dwelling in prior 5 years, The Gambia, 2006. Education of household head None 45.9 16.4 50.4 5.8 8817 Primary 41.0 15.2 45.5 6.0 3460 Secondary + 32.3 12.7 37.3 4.7 5171 Wealth index quintiles Poorest 15.7 26.8 39.2 1.2 308 Second 44.5 13.7 47.8 5.5 1434 Middle 49.7 19.7 53.5 6.0 3137 Fourth 49.1 15.8 53.1 6.5 4694 Richest 32.8 12.6 37.7 4.9 7875 Ethnic group of head of household Mandinka 32.3 12.6 38.0 4.2 5856 Wollof 35.2 13.9 38.7 5.6 2467 Fula 59.4 20.4 64.4 8.1 3385 Jola 41.0 14.4 44.7 6.0 2088 Serer 56.6 20.3 61.5 6.0 1089 Other ethnic group 34.6 13.1 38.5 4.5 2563 Total 40.9 15.1 45.6 5.5 17448 Number of household members Household members evicted from any dwelling in prior 5 years Household does not have security of tenure* Respondent feels there is a risk of eviction Household does not have formal documentation for the residence * MICS indicator 93 118 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report * MICS indicator 94 Table EN.9: Durability of Housing Percentage of households and household members living in the dwellings in urban areas (or in capital city) that are not considered durable, by background characteristics, The Gambia, 2006 Education of household head None 8.2 9.1 .0 .0 2.8 1744 2.8 11166 Primary 1.0 6.7 .0 .0 .5 207 .3 1119 Secondary + 2.6 2.3 .0 .0 .3 980 .2 5164 Wealth index quintiles Poorest 85.1 54.5 .0 .0 48.0 43 50.1 308 Second 30.1 22.5 .0 .0 8.4 249 8.4 1434 Middle 8.8 10.7 .0 .0 1.8 539 1.6 3137 Fourth 1.2 5.3 .0 .0 .2 841 .1 4694 Richest .1 1.0 .0 .0 .0 1258 . 7875 Ethnic group of head of household Mandinka 6.6 6.4 .0 .0 2.2 821 2.2 5856 Wollof 1.7 5.2 .0 .0 .7 424 .7 2467 Fula 6.8 10.0 .0 .0 2.8 694 3.9 3385 Jola 11.7 5.9 .0 .0 .9 331 .9 2088 Serer 3.1 6.7 .0 .0 2.2 191 1.5 1089 Other ethnic group 3.7 3.9 .0 .0 1.0 468 .6 2563 Total 5.8 6.6 .0 .0 1.8 2930 1.9 17448 Number of household members Per cent of household members living in dwellings considered non-dura- ble Number of households Per cent of house- holds living in dwellings conside- red non- durable* Dwelling located in hazardous location Dwelling is vulnera- ble to accidents Dwelling is in poor condition Dwelling has natural floor material The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 119 Table EN.10: Slum housing Percentage of households and household members in the urban areas (or in capital city) that are considered as living in slum housing, by background characteristics, The Gambia, 2006 Education of household head None 2.8 60.3 15.2 9.9 12.8 71.7 1744 60.3 11166 Primary .5 64.0 18.1 11.5 13.3 74.4 207 62.0 1119 Secondary + .3 58.9 12.1 6.4 8.6 66.6 980 56.3 5164 Wealth index quintiles Poorest (48.0) (43.3) (11.2) (4.7) (55.6) (84.9) 43 86.3 308 Second 8.4 57.6 17.8 12.4 16.5 73.0 249 66.3 1434 Middle 1.8 64.7 18.6 14.6 13.0 77.5 539 69.6 3137 Fourth .2 68.4 16.9 12.2 11.4 78.3 841 67.5 4694 Richest .0 53.6 10.2 3.6 8.2 60.6 1258 47.7 7875 Ethnic group of head of household Mandinka 2.2 50.8 12.4 8.1 12.3 62.4 821 52.4 5856 Wollof .7 55.6 10.2 8.0 8.7 64.5 424 51.7 2467 Fula 2.8 76.6 17.6 8.5 12.5 84.1 694 76.2 3385 Jola .9 56.7 21.3 10.5 11.6 72.4 331 65.1 2088 Serer 2.2 72.6 19.3 18.4 12.4 80.4 191 71.5 1089 Other ethnic group 1.0 53.1 9.7 6.5 10.1 62.7 468 49.6 2563 Total 1.8 60.1 14.3 8.9 11.4 70.2 2930 59.2 17448 Lack of use of improved sanitation Number of household members Per cent of household members considered to be living in slum housing Number of house- holds Per cent of house- holds considered to be living in slum hou- sing * Lack of use of improved water source Over- crowding: more than three per- sons per sleeping room Lack of security of tenure Dwelling is consi- dered non- durable * MICS indicator 95; MDG indicator 32 120 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table RH.3: Antenatal care provider Percentage distribution of women aged 15-49 who gave birth in the two years preceding the survey by type of personnel providing antenatal care, The Gambia, 2006 LGA Banjul 1.3 98.7 .0 .0 .0 .0 100.0 100.0 75 Kanifing 10.8 83.9 2.4 .3 1.1 1.5 100.0 97.1 694 Brikama 12.8 85.2 .5 .3 .8 .5 100.0 98.5 750 Mansakonko 22.5 51.9 22.9 .5 .0 2.2 100.0 97.2 167 Kerewan 17.2 59.4 19.2 2.0 2.0 .2 100.0 95.8 377 Kuntaur .5 85.1 10.7 .0 3.2 .5 100.0 96.3 232 Janjangbureh 19.3 36.9 42.6 .6 .3 .3 100.0 98.8 313 Basse 7.2 70.5 21.2 .2 .4 .5 100.0 98.9 463 Residence Urban 11.8 80.0 5.7 .4 .9 1.3 100.0 97.5 1037 Rural 12.2 69.6 16.1 .6 1.0 .5 100.0 97.9 2033 Age 15-19 8.5 74.1 13.3 .0 3.3 .7 100.0 96.0 275 20-24 11.7 73.7 11.4 1.0 .5 1.6 100.0 96.8 810 25-29 11.8 74.8 12.3 .2 .7 .3 100.0 98.8 857 30-34 11.8 73.0 13.6 .9 .5 .2 100.0 98.4 568 35-39 12.1 73.8 12.2 .0 1.0 .9 100.0 98.1 340 40-44 17.8 65.6 13.6 .0 1.8 1.1 100.0 97.1 167 45-49 23.3 53.0 20.1 .0 3.6 .0 100.0 96.4 51 Education None 11.6 71.5 14.7 .6 1.0 .6 100.0 97.8 2229 Primary 9.2 76.4 12.1 .6 .6 1.2 100.0 97.7 352 Secondary + 15.9 78.2 3.4 .2 1.1 1.2 100.0 97.5 489 Wealth index quintiles Poorest 16.1 58.1 23.4 .7 1.4 .3 100.0 97.6 684 Second 12.2 73.6 11.7 .9 .8 .8 100.0 97.5 647 Middle 8.9 77.7 11.1 .3 .8 1.3 100.0 97.7 650 Fourth 9.2 79.3 9.4 .0 1.2 .9 100.0 97.8 600 Richest 13.6 80.1 4.6 .6 .6 .4 100.0 98.3 488 Ethnicity Mandinka 14.0 73.7 10.5 .4 .8 .7 100.0 98.2 1048 Wollof 11.2 70.3 15.1 1.3 1.9 .3 100.0 96.6 384 Fula 11.0 68.4 17.7 .8 1.0 1.1 100.0 97.1 706 Jola 12.3 86.3 .3 .0 .7 .4 100.0 98.9 302 Serer 3.3 90.0 4.1 .0 .8 1.8 100.0 97.4 117 Other ethnic group 11.7 69.2 17.1 .2 1.0 .7 100.0 98.1 512 Total 12.0 73.1 12.6 .5 1.0 .7 100.0 97.8 3070 Other Number of women who gave birth in the preceding two years Any skilled personnel*Total No antenatal care received Traditional birth attendant Auxiliary midwife Nurse/ midwife Medical doctor Person providing antenatal care * MICS indicator 20 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 121 Table RH.4: Antenatal care Percentage of pregnant women receiving antenatal care among women aged 15-49 who gave birth in two years preceding the survey and percentage of pregnant women receiving specific care as part of the antenatal care received, The Gambia, 2006 LGA Banjul 100.0 97.4 100.0 97.4 98.7 75 Kanifing 98.5 93.9 97.1 94.1 96.4 694 Brikama 99.5 97.0 98.3 92.9 98.4 750 Mansakonko 97.8 87.1 93.8 82.8 97.2 167 Kerewan 99.8 95.1 97.5 92.4 98.0 377 Kuntaur 99.5 70.5 91.2 57.6 97.2 232 Janjangbureh 99.7 91.1 95.2 89.9 97.3 313 Basse 99.5 75.4 96.6 73.2 97.3 463 Residence Urban 98.7 94.5 97.5 93.7 96.9 1037 Rural 99.5 87.2 96.2 83.2 97.8 2033 Age 15-19 99.3 87.4 96.6 86.0 96.1 275 20-24 98.4 88.4 95.5 84.9 96.4 810 25-29 99.7 90.1 97.4 87.1 98.4 857 30-34 99.8 91.2 97.7 88.1 98.4 568 35-39 99.1 91.6 95.8 88.5 97.3 340 40-44 98.9 91.0 96.6 87.9 98.4 167 45-49 100.0 81.3 96.4 81.5 96.1 51 Education None 99.4 88.4 96.6 84.9 97.7 2229 Primary 98.8 89.4 96.2 89.3 97.4 352 Secondary + 98.8 95.6 96.9 93.0 96.5 489 Wealth index quintiles Poorest 99.7 84.2 94.6 79.4 97.4 684 Second 99.2 89.0 96.8 86.1 97.9 647 Middle 98.7 90.2 96.7 85.9 97.4 650 Fourth 99.1 90.4 96.7 89.7 96.5 600 Richest 99.6 96.7 99.0 95.2 98.5 488 Ethnicity Mandinka 99.3 91.5 97.4 88.5 97.8 1048 Wollof 99.7 89.6 95.5 85.0 97.4 384 Fula 98.9 86.9 94.9 83.0 96.7 706 Jola 99.6 96.0 97.8 94.1 97.8 302 Serer 98.2 95.6 98.2 94.7 97.3 117 Other ethnic group 99.3 84.7 97.3 83.2 97.8 512 Total 99.3 89.7 96.6 86.7 97.5 3070 Number of women who gave birth in two years preceding survey Percent of pre- gnant women receiving ANC one or more times during pregnancy Weight measured* Urine specimen taken* Blood pressure measured* Blood test taken* Percent of pregnant women who had: * MICS indicator 44 122 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table RH.5: Assistance during delivery Percentage distribution of women aged 15-49 with a birth in two years preceding the survey by type of personnel assisting at delivery, The Gambia, 2006 LGA Banjul 7.9 86.8 .0 1.3 .0 1.3 1.3 1.3 100.0 94.7 94.7 75 Kanifing 8.0 75.0 3.9 5.2 .0 4.1 2.4 1.4 100.0 87.0 84.7 694 Brikama 4.3 60.8 .2 22.3 3.6 5.8 1.7 1.4 100.0 65.3 59.8 750 Mansakonko 6.3 34.0 6.3 41.8 .6 10.0 .6 .6 100.0 46.5 40.8 167 Kerewan 6.2 31.0 7.4 44.6 .5 7.9 2.5 .0 100.0 44.6 44.8 377 Kuntaur .5 24.1 3.8 55.8 2.3 11.6 .5 1.4 100.0 28.4 29.3 232 Janjangbureh 8.6 16.7 9.5 43.5 .3 20.2 .0 1.2 100.0 34.8 34.5 313 Basse 3.2 22.7 8.3 50.8 .9 12.6 .0 1.5 100.0 34.2 32.9 463 Residence Urban 7.5 71.0 4.6 7.9 .5 5.3 2.1 1.3 100.0 83.0 81.4 1037 Rural 4.6 34.1 4.7 42.3 1.7 10.5 1.0 1.1 100.0 43.4 40.7 2033 Age 15-19 6.6 46.9 8.3 26.5 1.6 6.7 2.3 1.0 100.0 61.8 60.0 275 20-24 4.4 49.2 5.2 29.0 .7 9.0 1.3 1.1 100.0 58.8 55.7 810 25-29 5.8 47.5 4.2 29.7 1.5 9.0 1.3 .9 100.0 57.6 55.5 857 30-34 5.1 44.4 5.0 33.2 2.1 8.8 .7 .9 100.0 54.4 51.8 568 35-39 6.9 41.9 2.7 34.8 .7 9.3 1.6 2.2 100.0 51.4 50.3 340 40-44 6.3 49.1 1.8 32.6 1.2 7.8 .7 .6 100.0 57.2 55.1 167 45-49 8.1 32.8 3.5 33.6 2.2 8.4 5.4 6.0 100.0 44.3 46.1 51 Mother's education None 4.4 39.6 4.9 36.5 1.2 10.5 1.4 1.5 100.0 48.9 47.1 2229 Primary 4.9 58.6 4.6 21.5 2.8 6.4 .9 .3 100.0 68.1 65.7 352 Secondary 11.3 69.5 3.7 10.8 .8 2.4 1.3 .2 100.0 84.5 79.9 489 Wealth index quintiles Poorest 4.5 18.9 4.9 52.4 1.3 16.0 .3 1.6 100.0 28.3 26.7 684 Second 4.4 37.1 4.5 40.6 2.3 8.4 1.9 .8 100.0 45.9 44.7 647 Middle 4.1 50.0 4.9 28.9 .9 7.7 1.7 1.8 100.0 59.0 56.8 650 Fourth 7.0 60.2 5.5 17.8 1.5 5.5 1.4 1.2 100.0 72.7 69.5 600 Richest 8.7 76.5 3.3 5.3 .2 4.2 1.5 .2 100.0 88.6 84.9 488 Ethnic group of head of household Mandinka 5.3 46.7 4.6 32.5 1.8 6.4 1.5 1.1 100.0 56.7 54.1 1048 Wollof 5.5 45.2 4.6 37.4 1.4 4.6 1.0 .3 100.0 55.3 54.0 384 Fula 5.5 39.7 4.9 30.2 1.1 14.9 1.9 1.8 100.0 50.0 48.3 706 Jola 4.8 62.6 1.4 19.4 1.5 7.1 1.1 2.1 100.0 68.8 64.8 302 Serer 6.3 77.4 5.0 9.6 .0 .8 .0 .9 100.0 88.7 88.9 117 Other ethnic group 6.4 40.2 6.4 34.0 .7 10.7 1.0 .5 100.0 53.0 50.2 512 Total 5.6 46.5 4.7 30.7 1.3 8.7 1.4 1.2 100.0 56.8 54.5 3070 Person assisting at delivery Number of women who gave birth in preceding two yearsTotal No attendant Other/ missing Relative/ friend Com- munity health worker Traditio- nal birth attendant Auxi- liary midwife Medical doctor Nurse/ midwife Any skilled person- nel * Delivered in health facility ** The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 123 Table CD.1: Family support for learning Percentage of children aged 0-59 months for whom household members are engaged in activities that promote learning and school readiness, The Gambia, 2006 Number of children aged 0-59 months For whom hou- sehold mem- bers engaged in four or more activities that promote lear- ning and school readiness* Living in a hou- sehold without their biological father Mean number of activities the father engaged in with the child For whom the father enga- ged in one or more activities that promote learning and school readiness** Mean number of activities hou- sehold members engage in with the child Percent of pregnant women who had: * MICS indicator 46 ** MICS indicator 47 Sex Male 47.8 3.4 22.2 .4 24.1 3346 Female 46.0 3.3 19.0 .4 26.9 3197 LGA Banjul 25.6 2.8 34.4 .4 23.1 196 Kanifing 48.4 3.4 23.2 .4 26.0 1508 Brikama 44.2 3.4 8.3 .1 23.1 1425 Mansakonko 46.3 3.4 3.9 .0 33.4 406 Kerewan 88.9 4.8 66.7 1.7 23.0 826 Kuntaur 36.8 2.9 17.0 .2 17.0 502 Janjangbureh 30.4 2.7 6.8 .1 29.6 682 Basse 34.6 2.8 11.8 .1 28.8 999 Residence Urban 48.1 3.4 23.5 .4 26.3 2303 Rural 46.3 3.3 19.1 .4 25.0 4240 Age 0-23 months 25.0 2.4 17.6 .3 25.4 3033 24-59 months 65.9 4.2 23.2 .4 25.6 3510 Mother's education None 65.9 3.3 20.7 .4 23.6 4923 Primary 45.0 3.4 17.3 .3 28.0 710 Secondary + 49.6 3.5 23.1 .5 33.5 911 Father's education None 46.2 3.3 19.1 .4 30.0 5566 Primary 40.7 3.1 24.0 .3 .0 201 Secondary + 54.0 3.7 31.1 .7 .0 776 Wealth index quintiles Poorest 46.9 3.3 21.9 .4 21.7 1532 Second 51.2 3.6 20.2 .4 25.1 1337 Middle 45.9 3.3 19.8 .4 24.5 1344 Fourth 42.6 3.2 17.5 .3 28.8 1248 Richest 47.9 3.5 24.0 .4 28.7 1082 Ethnicity Mandinka 51.5 3.5 20.1 .4 25.2 2254 Wollof 48.0 3.4 26.6 .5 21.5 870 Fula 42.6 3.2 22.1 .4 19.7 1494 Jola 50.9 3.6 12.7 .2 27.2 596 Serer 45.5 3.4 34.4 .7 32.1 212 Other ethnic group 40.9 3.1 16.7 .3 34.7 1117 Total 46.9 3.4 20.6 .4 25.5 6543 124 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table CD.3: Children left alone or with other children Percentage of children aged 0-59 months left in the care of other children under the age of 10 years or left alone in the past week, The Gambia, 2006 Sex Male 14.4 4.8 18.1 3346 Female 13.4 4.0 16.6 3197 LGA Banjul 1.9 .6 1.9 196 Kanifing 11.6 3.1 13.8 1508 Brikama 5.9 2.3 7.9 1425 Mansakonko 19.3 5.3 22.4 406 Kerewan 33.5 3.1 36.0 826 Kuntaur 14.2 8.5 19.9 502 Janjangbureh 18.1 .8 18.7 682 Basse 9.9 10.9 19.7 999 Residence Urban 11.8 2.6 13.7 2303 Rural 15.1 5.3 19.4 4240 Age 0-23 months 11.0 1.5 12.0 3033 24-59 months 16.4 6.8 22.0 3510 Mother's education None 15.2 4.9 19.1 4923 Primary 11.9 2.6 13.9 710 Secondary + 8.5 2.6 10.8 911 Wealth index quintiles Poorest 20.0 5.1 24.0 1532 Second 17.1 5.7 21.2 1337 Middle 11.3 4.3 15.0 1344 Fourth 10.9 2.9 13.6 1248 Richest 8.2 3.5 10.6 1082 Ethnicity Mandinka 15.4 4.8 18.8 2254 Wollof 18.2 2.6 20.1 870 Fula 13.0 5.0 17.2 1494 Jola 10.4 2.5 12.7 596 Serer 9.9 2.0 11.9 212 Other ethnic group 11.3 5.5 16.2 1117 Total 13.9 4.4 17.4 6543 Number of children aged 0-59 months Left with inadequate care in past week* Left alone in the past week Left in the care of chil- dren under the age of 10 years in past week Percentage of children aged 0-59 months * MICS indicator 51 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 125 Table ED.1: Early childhood education Percentage of children aged 36-59 months who are attending some form of organized early childhood education programme and percentage of first graders who attended pre-school, The Gambia, 2006 Sex Male 20.0 1117 29.6 51 Female 19.4 1023 25.2 57 LGA Banjul 36.1 75 (*) 5 Kanifing 34.8 568 (43.3) 31 Brikama 20.5 438 (36.3) 33 Mansakonko 22.3 125 (*) 5 Kerewan 6.6 257 (*) 16 Kuntaur 7.5 138 (*) 7 Janjangbureh 10.1 220 (*) 1 Basse 9.6 320 (*) 11 Residence Urban 30.2 836 (39.6) 48 Rural 13.0 1304 17.4 60 Age of child 36-47 months 13.7 1247 . 0 48-59 months 28.2 893 . 0 7 years*** . 0 27.3 108 Mother's education None 14.5 1632 18.7 79 Primary 26.3 230 (*) 6 Secondary + 45.3 278 (*) 23 Wealth index quintiles Poorest 6.7 466 (*) 22 Second 14.3 425 (*) 19 Middle 16.0 417 (*) 15 Fourth 21.8 417 (*) 18 Richest 41.6 415 (53.5) 34 Ethnic group of head of household Mandinka 18.9 739 (20.6) 43 Wollof 18.5 292 (*) 11 Fula 14.1 457 (*) 21 Jola 32.0 206 (*) 12 Serer 30.1 64 (*) 7 Other ethnic group 20.7 383 (*) 14 Total 19.7 2140 27.3 108 Number of children attending first grade Percentage of children attending first grade who attended preschool programme in previous year** Number of children aged 36-59 months Percentage of children aged 36-59 months currently attending early childhood school* * MICS indicator 52 ** MICS indicator 53 126 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table ED.2: Primary school entry Percentage of children of primary school entry age attending Grade 1, The Gambia, 2006 Sex Male 29.5 736 Female 30.4 724 LGA Banjul (35.7) 32 Kanifing 33.3 288 Brikama 32.4 368 Mansakonko 27.9 139 Kerewan 25.5 164 Kuntaur 21.0 117 Janjangbureh 30.5 143 Basse 29.6 207 Area Urban 35.5 456 Rural 27.4 1004 Age 7 29.9 1460 Mother's education None 28.3 1203 Primary 32.6 124 Secondary 42.0 132 Wealth index quintiles Poorest 22.5 354 Second 29.9 326 Middle 29.5 280 Fourth 32.2 257 Richest 38.9 243 Ethnic group of head of household Mandinka 31.1 539 Wollof 25.9 175 Fula 27.0 296 Jola 29.8 141 Serer (27.8) 46 Other ethnic group 34.0 263 Total 29.9 1460 Number of children of primary school entry age Percentage of children of primary school entry age currently attending Grade 1 * The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 127 Table ED.3: Primary school net attendance ratio Percentage of children of primary school age** attending primary or secondary school (NAR), The Gambia, 2006 LGA Banjul 73.8 93 81.5 94 77.6 187 Kanifing 75.4 799 71.7 837 73.5 1636 Brikama 72.7 969 71.3 968 72.0 1938 Mansakonko 46.2 363 66.2 285 55.0 648 Kerewan 51.1 480 47.8 514 49.4 995 Kuntaur 36.2 310 46.3 298 41.2 608 Janjangbureh 51.1 343 64.5 363 58.0 705 Basse 48.0 513 45.1 557 46.5 1070 Residence Urban 74.8 1261 72.5 1311 73.6 2572 Rural 52.9 2609 56.5 2606 54.7 5215 Age** 7 35.0 736 35.6 724 35.3 1460 8 52.8 743 53.9 736 53.4 1479 9 69.9 558 72.2 546 71.0 1104 10 66.0 689 68.6 744 67.4 1434 11 73.5 513 75.5 487 74.5 1000 12 71.5 631 73.0 680 72.3 1311 Mother's education None 56.8 3192 58.6 3223 57.7 6415 Primary 69.4 306 71.4 295 70.4 601 Secondary + 79.9 373 81.5 399 80.7 771 Wealth index quintiles Poorest 42.6 876 46.2 883 44.4 1759 Second 59.0 857 61.4 863 60.2 1721 Middle 63.5 751 59.5 778 61.5 1529 Fourth 67.6 765 68.6 738 68.1 1503 Richest 72.3 621 79.0 655 75.8 1276 Ethnic group of head of household Mandinka 63.8 1389 66.2 1436 65.0 2824 Wollof 52.8 433 53.6 525 53.2 958 Fula 51.9 809 55.0 763 53.4 1573 Jola 76.5 396 69.4 403 72.9 799 Serer 63.4 110 68.7 127 66.2 237 Other ethnic group 56.8 733 61.3 662 58.9 1395 Total 60.0 3871 61.9 3917 61.0 7787 Number of children Net attendance ratio Net attendance ratio* Number of children Net attendance ratio Number of children TotalFemalMale * MICS indicator 55; MDG indicator 6 128 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table ED.4: Secondary school net attendance ratio Percentage of children of secondary school age** attending secondary school or higher (NAR), The Gambia, 2006 LGA Banjul 55.0 93 56.8 102 56.0 195 Kanifing 58.7 783 48.3 866 53.3 1648 Brikama 44.6 857 42.0 867 43.3 1724 Mansakonko 25.4 286 29.8 200 27.2 487 Kerewan 30.7 344 25.3 380 27.9 724 Kuntaur 25.5 204 15.4 221 20.2 425 Janjangbureh 27.6 264 23.4 316 25.3 580 Basse 17.1 387 12.6 472 14.7 859 Residence Urban 56.1 1209 49.2 1370 52.4 2579 Rural 29.1 2009 23.8 2055 26.4 4064 Age** 13 16.8 554 16.1 678 16.4 1232 14 30.6 482 28.3 817 29.2 1299 15 41.8 661 43.8 439 42.6 1100 16 49.1 508 48.9 465 49.0 973 17 49.8 443 46.4 455 48.1 898 18 48.4 570 33.6 571 41.0 1140 Mother's education None 37.9 2904 32.3 3082 35.0 5986 Primary 36.9 116 41.8 148 39.6 264 Secondary + 60.0 198 54.7 194 57.4 392 Wealth index quintiles Poorest 20.8 594 14.2 612 17.5 1207 Second 35.1 648 28.5 690 31.7 1338 Middle 34.5 666 30.9 696 32.7 1361 Fourth 42.4 621 36.6 761 39.2 1382 Richest 60.7 689 57.9 665 59.3 1354 Ethnic group of head of household Mandinka 43.0 1206 38.0 1288 40.4 2494 Wollof 37.4 354 31.5 409 34.3 763 Fula 36.4 589 26.1 669 30.9 1258 Jola 46.8 373 45.1 370 46.0 743 Serer 47.3 100 49.0 121 48.2 221 Other ethnic group 29.5 596 25.4 567 27.5 1163 Total 39.2 3218 34.0 3424 36.5 6642 * MICS indicator 56 Male Female Total Net attendance ratio Number of children Net attendance ratio Number of children Net attendance ratio* Number of children The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 129 Table ED. 4W: Secondary school age children attending primary school Percentage of children of secondary school age** attending primary school, The Gambia, 2006 LGA Banjul 21.3 93 11.4 102 16.1 195 Kanifing 19.8 783 20.8 866 20.3 1648 Brikama 33.1 857 29.1 867 31.1 1724 Mansakonko 22.5 286 25.1 200 23.6 487 Kerewan 25.9 344 18.2 380 21.9 724 Kuntaur 16.9 204 14.9 221 15.8 425 Janjangbureh 26.4 264 32.0 316 29.5 580 Basse 24.0 387 22.1 472 22.9 859 Residence Urban 21.5 1209 20.7 1370 21.1 2579 Rural 27.4 2009 25.2 2055 26.3 4064 Age** 13 55.9 554 50.9 678 53.1 1232 14 41.5 482 35.9 817 38.0 1299 15 23.7 661 18.6 439 21.7 1100 16 15.4 508 9.0 465 12.3 973 17 7.2 443 5.2 455 6.2 898 18 5.9 570 2.8 571 4.3 1140 Mother's education None 23.9 2904 22.1 3082 22.9 5986 Primary 46.9 116 41.6 148 44.0 264 Secondary + 31.1 198 30.8 194 31.0 392 Wealth index quintiles Poorest 27.5 594 24.3 612 25.9 1207 Second 26.8 648 26.9 690 26.9 1338 Middle 27.0 666 23.0 696 24.9 1361 Fourth 24.5 621 25.0 761 24.8 1382 Richest 20.3 689 17.7 665 19.0 1354 Ethnic group of head of household Mandinka 25.3 1206 24.2 1288 24.7 2494 Wollof 19.4 354 17.7 409 18.5 763 Fula 21.0 589 22.2 669 21.6 1258 Jola 33.1 373 30.3 370 31.7 743 Serer 28.2 100 22.9 121 25.3 221 Other ethnic group 27.0 596 22.7 567 24.9 1163 Total 25.1 3218 23.4 3424 24.3 6642 Male Female Total Percentage attending primary school Number of children Percentage attending primary school Number of children Percentage attending primary school Number of children 130 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table ED.5: Children reaching Grade 5 Percentage of children entering first grade of primary school who eventually reach Grade 5, The Gambia, 2006 * MICS indicator 57; MDG indicator 7 Sex Male 99.5 99.3 99.5 99.8 98.1 Female 99.5 98.4 98.0 99.1 95.2 LGA Banjul 100.0 96.8 100.0 100.0 96.8 Kanifing 99.7 99.2 99.6 99.1 97.7 Brikama 100.0 99.8 99.7 100.0 99.5 Mansakonko 100.0 97.3 98.7 100.0 96.0 Kerewan 100.0 100.0 100.0 100.0 100.0 Kuntaur 100.0 100.0 94.0 97.5 91.6 Janjangbureh 97.7 94.5 95.2 100.0 87.9 Basse 99.2 99.4 98.1 98.2 95.0 Residence Urban 99.8 99.1 99.8 99.4 98.1 Rural 99.4 98.7 98.1 99.5 95.7 Mother's education None 99.5 99.1 98.6 99.5 96.7 Primary 100.0 97.3 98.9 100.0 96.3 Secondary + 99.4 97.7 100.0 99.0 96.2 Wealth index quintiles Poorest 99.7 98.5 96.0 100.0 94.3 Second 99.5 98.4 99.6 99.4 96.9 Middle 99.4 99.3 98.1 99.0 95.8 Fourth 99.2 99.0 100.0 99.6 97.8 Richest 100.0 99.0 99.5 99.5 98.0 Ethnic group of head of household Mandinka 99.8 99.2 99.3 99.7 98.1 Wollof 98.3 94.3 94.5 98.7 86.4 Fula 99.1 99.5 99.4 100.0 98.0 Jola 100.0 100.0 100.0 99.2 99.2 Serer 97.5 96.8 98.0 100.0 92.5 Other ethnic group 100.0 99.2 99.2 98.9 97.4 Total 99.5 98.8 98.8 99.5 96.6 Percent attending 2nd grade who were in 1st grade last year Percent attending 3rd grade who were in 2nd grade last year Percent attending 4th grade who were in 3rd grade last year Percent attending 5th grade who were in 4th grade last year Percent who reach Grade 5 of those who enter 1st grade* The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 131 Table ED.6: Primary school completion and transition to secondary education Primary school completion rate and transition rate to secondary education, The Gambia, 2006 Net primary school completion rate* Number of children of primary school completion age Transition rate to secondary education** Number of children who were in the last grade of primary school the previous year * MICS indicator 59; MDG indicator 7b ** MICS indicator 58 Sex Male 74.9 631 61.5 2666 Female 72.4 680 51.1 2767 LGA Banjul (91.3) 27 91.3 160 Kanifing 83.5 310 74.3 1477 Brikama 83.4 317 55.5 1741 Mansakonko 85.7 105 40.2 397 Kerewan 58.4 163 50.4 519 Kuntaur 57.8 105 35.6 299 Janjangbureh 79.7 111 41.4 415 Basse 47.4 172 34.2 425 Residence Urban 84.3 462 74.0 2304 Rural 67.7 848 43.1 3128 Mother's education None 71.0 1086 63.8 4223 Primary 85.7 88 21.9 492 Secondary + 86.3 137 35.2 717 Wealth index quintiles Poorest 60.4 283 27.4 931 Second 76.1 285 45.8 1160 Middle 68.5 253 54.1 1067 Fourth 79.2 249 60.9 1131 Richest 85.6 240 87.5 1144 Ethnic group of head of household Mandinka 75.4 458 63.7 2020 Wollof 71.1 182 57.3 584 Fula 64.6 248 43.2 1075 Jola 86.6 141 54.7 824 Serer (79.1) 46 73.8 187 Other ethnic group 72.4 236 51.2 742 Total 73.6 1311 56.2 5432 132 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table ED.7: Education gender parity Ratio of girls to boys attending primary education and ratio of girls to boys attending secondary education, The Gambia, 2006 * MICS indicator 61; MDG indicator 9 LGA Banjul 80.2 73.8 1.09 56.8 55.0 1.03 Kanifing 71.7 75.6 .95 48.3 58.7 .82 Brikama 71.3 72.5 .98 42.0 44.6 .94 Mansakonko 66.2 45.9 1.44 29.8 25.4 1.17 Kerewan 47.8 51.1 .94 25.3 30.7 .82 Kuntaur 46.3 36.2 1.28 15.4 25.5 .60 Janjangbureh 64.7 51.1 1.27 23.4 27.6 .85 Basse 45.2 48.0 .94 12.6 17.1 .74 Residence Urban 72.4 74.8 .97 49.2 56.1 .88 Rural 56.6 52.8 1.07 23.8 29.1 .82 Mother's education None 58.6 56.8 1.03 32.3 37.9 .85 Primary 71.4 69.4 1.03 41.8 36.9 1.13 Secondary + 81.7 79.6 1.03 54.7 60.0 .91 Wealth index quintiles Poorest 46.3 42.6 1.09 14.2 20.8 .68 Second 61.4 58.9 1.04 28.5 35.1 .81 Middle 59.5 63.4 .94 30.9 34.5 .90 Fourth 68.5 67.6 1.01 36.6 42.4 .86 Richest 79.0 72.3 1.09 57.9 60.7 .95 Ethnic group of head of household Mandinka 66.3 63.7 1.04 38.0 43.0 .88 Wollof 53.6 52.5 1.02 31.5 37.4 .84 Fula 54.8 51.9 1.06 26.1 36.4 .72 Jola 69.4 76.5 .91 45.1 46.8 .96 Serer 68.7 63.4 1.08 49.0 47.3 1.04 Other ethnic group 61.3 56.8 1.08 25.4 29.5 .86 Total 61.9 60.0 1.03 34.0 39.2 .87 Primary school net attendance ratio, girls Primary school net attendance ratio, boys Gender parity index for primary school NAR* Secondary school net attendance ratio, girls Secondary school net attendance ratio, boys Gender parity index for secondary school NAR* The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 133 LGA Banjul 65.2 7.7 154 Kanifing 59.4 4.9 1268 Brikama 52.5 4.0 1154 Mansakonko 36.3 4.9 207 Kerewan 29.5 2.7 375 Kuntaur 16.2 1.8 235 Janjangbureh 27.1 10.8 364 Basse 13.2 1.8 548 Residence Urban 58.4 4.6 1906 Rural 30.9 4.4 2400 Education None .7 4.1 1907 Primary 10.7 14.4 625 Secondary + 100.0 1.4 1774 Age 15-19 50.8 5.0 2282 20-24 34.3 4.0 2023 Wealth index quintiles Poorest 15.7 4.0 650 Second 36.1 3.5 761 Middle 36.8 3.9 871 Fourth 45.7 5.6 987 Richest 67.9 5.0 1037 Ethnic group of head of household Mandinka 49.4 4.1 1559 Wollof 44.1 8.2 633 Fula 30.2 3.2 859 Jola 57.6 3.7 437 Serer 58.5 3.5 118 Other ethnic group 32.2 4.2 684 Missing (*) (*) 15 Total 43.1 4.5 4306 Table ED.8: Adult literacy Percentage of women aged 15-24 who are literate*, The Gambia, 2006 * MICS indicator 60; MDG indicator 8 Percentage literate* Percentage not known** Number of women aged 15-24 134 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Sex Male 56.8 3346 10.7 13.6 28.5 7.0 21.6 11.4 6.4 .8 100.0 522 Female 53.2 3197 9.3 15.4 27.1 6.5 24.1 9.5 6.2 1.8 100.0 511 LGA Banjul 76.9 196 (*) (*) (*) (*) (*) (*) (*) (*) (*) 11 Kanifing 54.9 1508 2.6 4.5 14.2 5.2 32.9 20.0 18.1 2.6 100.0 164 Brikama 55.8 1425 15.4 16.8 5.4 2.4 25.3 22.5 8.6 3.6 100.0 134 Mansakonko 86.4 406 (*) (*) (*) (*) (*) (*) (*) (*) (*) 16 Kerewan 48.0 826 6.8 28.9 8.7 6.8 6.0 23.9 18.0 .8 100.0 112 Kuntaur 52.5 502 25.0 21.1 16.4 15.6 14.1 6.3 .0 1.6 100.0 147 Janjangbureh 62.2 682 18.4 32.9 22.4 .0 22.4 3.9 .0 .0 100.0 69 Basse 39.4 999 4.1 8.1 53.1 7.2 25.5 1.1 .7 .2 100.0 379 Residence Urban 57.1 2303 4.3 5.9 15.5 5.0 31.9 17.2 17.5 2.6 100.0 221 Rural 53.9 4240 11.6 16.8 31.2 7.2 20.4 8.6 3.2 .9 100.0 812 Age 0-11 months 40.0 1547 8.1 14.9 25.3 6.0 22.8 14.6 6.6 1.7 100.0 290 12-23 months 55.5 1486 12.0 14.1 24.2 9.2 23.1 10.1 6.1 1.2 100.0 239 24-35 months 59.2 1369 9.7 13.0 33.4 4.9 24.5 8.5 4.9 1.0 100.0 202 36-47 months 62.1 1247 11.7 15.1 25.2 9.3 20.4 8.9 8.1 1.2 100.0 182 48-59 months 64.2 893 8.6 15.9 35.8 3.2 23.2 6.9 5.6 .9 100.0 120 Mother's education None 53.6 4923 9.7 14.5 29.9 6.9 23.7 9.3 5.0 1.1 100.0 901 Primary 58.6 710 14.2 16.9 17.1 6.9 20.6 14.2 10.1 .0 100.0 69 Secondary + 60.2 911 9.9 12.3 9.8 5.1 13.5 23.7 20.6 5.1 100.0 63 Wealth index quintiles Poorest 52.1 1532 18.7 21.0 22.1 8.8 20.1 7.2 1.4 .7 100.0 330 Second 58.7 1337 8.6 20.4 20.9 8.1 15.6 15.3 10.6 .4 100.0 180 Middle 50.6 1344 6.6 12.1 37.7 5.0 21.5 11.1 4.0 1.9 100.0 256 Fourth 51.5 1248 3.7 6.0 37.3 4.5 29.6 8.8 9.2 1.0 100.0 192 Richest 64.3 1082 2.9 1.4 11.4 6.5 39.7 15.6 18.1 4.3 100.0 74 Ethnicity Mandinka 59.3 2254 8.3 16.4 16.1 11.3 26.6 13.4 6.8 1.2 100.0 244 Wollof 60.2 870 21.5 16.3 10.9 7.1 15.7 12.8 10.8 4.9 100.0 103 Fula 48.5 1494 14.7 17.2 23.5 7.1 22.8 9.7 4.3 .7 100.0 306 Jola 59.5 596 5.2 19.7 10.5 5.2 13.5 31.4 12.7 1.7 100.0 62 Serer 52.7 212 (*) (*) (*) (*) (*) (*) (*) (*) (*) 18 Other ethnic group 49.2 1117 4.3 9.0 51.8 3.3 23.7 3.8 3.4 .6 100.0 300 Total 55.1 6543 10.0 14.5 27.8 6.8 22.8 10.5 6.3 1.3 100.0 1033 Table CP.1: Birth registration Percentage distribution of children aged 0-59 months by whether birth is registered and reasons for non-registration, The Gambia, 2006 * MICS indicator 62 Birth is not registered because: Birth is registe- red* Number of children aged 0-59 months Costs too much Must travel too far Didn't know child should be registered Late, did not want to pay fine Didn't know where to register Other Don't know Missing Total Number of children aged 0-59 months without birth registration The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 135 Table CP.2: Child labour Percentage of children aged 5-14 who are involved in child labour activities by type of work, The Gambia, 2006 * MICS indicator 71 Male Paid work Unpaid work Household chores for 28+ hours/ week Working for family business Total child labour* Number of children aged 5-14 Sex Male .7 2.9 1.0 17.5 20.4 6467 Female .4 3.6 2.6 24.4 28.7 6942 LGA Banjul .4 .0 5.9 7.4 11.5 313 Kanifing .9 3.0 3.2 8.6 12.9 2848 Brikama .6 .6 2.9 18.3 20.8 3436 Mansakonko .9 8.2 1.8 26.1 32.4 1064 Kerewan .2 1.7 .3 35.3 36.1 1718 Kuntaur 1.0 2.4 .0 23.4 25.6 994 Janjangbureh .2 12.7 .7 22.0 32.5 1201 Basse .1 2.2 .3 30.2 31.8 1836 Residence Urban .7 2.8 2.9 12.9 16.9 4482 Rural .5 3.6 1.3 25.2 28.6 8928 Age 5-11 years .5 4.2 1.0 26.7 29.5 9567 12-14 years .6 1.1 3.9 7.2 12.8 3842 School participation Yes .5 3.6 2.2 20.3 24.2 8815 No .6 2.7 1.1 22.7 25.6 4594 Mother's education None .5 3.3 1.6 22.7 26.1 10993 Primary .6 3.6 2.8 16.9 21.4 1056 Secondary + .7 2.5 2.8 11.9 16.1 1360 Wealth index quintiles Poorest .5 5.0 1.2 29.3 33.7 2965 Second .5 3.6 1.8 26.1 29.1 2931 Middle .8 2.9 1.4 20.9 24.6 2718 Fourth .5 2.7 1.9 17.8 21.1 2572 Richest .4 1.6 3.2 7.7 11.3 2223 Ethnicity Mandinka .7 3.9 1.9 21.3 25.2 4861 Wollof .4 3.7 1.3 20.3 24.0 1692 Fula .5 3.2 1.6 23.0 26.3 2667 Jola .8 1.5 3.1 20.5 24.0 1382 Serer .0 2.2 3.5 11.3 15.0 431 Other ethnic group .5 3.0 1.3 21.2 24.7 2376 Total .6 3.3 1.8 21.1 24.7 13409 136 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table CP.3: Labourer students and student labourers Percentage of children aged 5-14 who are labourer students and student labourers, The Gambia, 2006 ** MICS indicator 72 **** MICS indicator 73 Sex Male 20.4 66.9 6467 65.8 1320 20.1 4327 Female 28.7 64.7 6942 63.6 1993 28.3 4488 LGA Banjul 11.5 84.4 313 (87.1) 36 11.8 264 Kanifing 12.9 81.1 2848 81.4 368 13.0 2310 Brikama 20.8 76.7 3436 85.0 716 23.1 2637 Mansakonko 32.4 76.7 1064 82.9 345 35.0 817 Kerewan 36.1 45.3 1718 42.7 620 33.9 779 Kuntaur 25.6 37.5 994 38.3 254 26.2 373 Janjangbureh 32.5 67.1 1201 76.1 390 36.8 805 Basse 31.8 45.2 1836 43.4 584 30.5 831 Residence Urban 16.9 79.4 4482 80.0 757 17.0 3559 Rural 28.6 58.9 8928 59.9 2556 29.1 5257 Age 5-9 years 29.5 62.6 9567 63.9 2821 30.1 5988 10-14 years 12.8 73.6 3842 67.9 491 11.8 2827 Mother's education None 26.1 61.8 10993 61.7 2867 26.1 6789 Primary 21.4 77.1 1056 79.3 226 22.1 814 Secondary + 16.1 89.1 1360 85.9 219 15.5 1212 Wealth index quintiles Poorest 33.7 47.8 2965 50.1 999 35.2 1419 Second 29.1 63.0 2931 66.3 854 30.7 1846 Middle 24.6 63.9 2718 67.3 669 25.9 1736 Fourth 21.1 74.0 2572 74.7 542 21.3 1904 Richest 11.3 85.9 2223 86.2 251 11.3 1911 Ethnicity Mandinka 25.2 68.4 4861 72.5 1223 26.7 3325 Wollof 24.0 54.9 1692 43.0 406 18.8 928 Fula 26.3 55.7 2667 53.3 701 25.1 1486 Jola 24.0 82.0 1382 85.8 332 25.1 1134 Serer 15.0 75.3 431 72.7 65 14.5 325 Other ethnic group 24.7 68.1 2376 63.1 586 22.9 1617 Total 24.7 65.7 13409 64.5 3313 24.2 8815 Percentage of children in child labour* Percentage of children attending school*** Number of children 5-14 years of age Percentage of child labourers who are also attending school** Number of child labourers aged 5-14 Percentage of students who are also invol- ved in child labour**** Number of students aged 5-14 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 137 Table CP.4: Child discipline Percentage of children aged 2-14 according to method of disciplining the child The Gambia, 2006. Sex Male 11.9 73.8 71.7 22.4 83.7 3.7 .8 31.9 2224 Female 10.2 75.3 69.5 20.7 84.7 4.2 .9 30.7 2485 LGA Banjul 6.6 81.5 82.8 15.9 92.7 .0 .7 15.9 175 Kanifing 11.4 70.7 71.5 23.1 83.6 3.8 1.2 27.5 1290 Brikama 16.9 69.7 64.9 16.6 78.2 4.1 .8 13.8 1278 Mansakonko 5.6 68.8 73.8 16.2 87.8 5.9 .6 36.4 304 Kerewan 14.7 78.3 70.5 29.0 84.2 .3 .8 40.0 624 Kuntaur .0 91.4 83.5 30.8 97.4 1.2 1.4 61.3 285 Janjangbureh 8.3 71.7 56.7 13.1 77.2 14.2 .3 43.0 327 Basse 1.5 88.0 79.5 27.1 94.9 3.4 .2 55.6 425 Residence Urban 11.4 72.8 71.4 20.0 84.4 3.1 1.1 27.4 2010 Rural 10.7 75.9 70.0 22.7 84.1 4.5 .6 34.1 2699 Age 2-4 years 11.6 67.6 71.3 16.8 80.4 6.7 1.3 29.4 1007 5-9 years 10.0 75.7 73.2 21.9 85.2 3.7 1.0 31.1 1948 10-14 years 11.7 77.3 67.2 23.8 85.3 2.6 .4 32.4 1754 Mother’s education None 10.4 75.6 71.7 22.8 85.0 3.8 .7 34.2 3615 Primary 9.6 75.3 73.4 22.9 86.1 3.6 .8 25.0 411 Secondary 14.8 68.7 62.6 14.1 78.9 4.9 1.4 19.2 683 Wealth index quintiles Poorest 7.1 80.8 71.9 21.7 87.9 4.4 .6 45.3 987 Second 11.3 76.0 71.1 21.7 85.2 2.5 .9 30.9 986 Middle 12.1 72.2 71.1 23.5 82.9 4.2 .9 28.9 933 Fourth 13.1 71.6 70.5 24.1 82.1 4.1 .7 27.1 881 Richest 11.7 71.8 68.0 16.7 82.7 4.6 1.0 22.8 921 Mandinka 10.9 74.9 71.4 22.5 85.2 3.0 .9 31.7 1692 Ethnicity Wollof 14.3 72.9 67.4 22.8 80.8 4.2 .7 31.2 598 Fula 10.1 73.3 70.0 19.8 83.4 5.7 .7 33.8 1040 Jola 12.2 72.9 73.0 20.7 84.4 2.6 .7 23.3 551 Serer 12.0 76.2 67.6 20.3 84.3 2.7 1.0 25.0 196 Other ethnic group 8.0 78.5 71.2 21.6 86.0 4.8 1.1 34.6 632 Total 11.0 74.6 70.6 21.5 84.2 3.9 .8 31.2 4709 Percentage of children aged 2-14 who experience: Only non-vio- lent disci- pline Psycho- logical punish- ment Minor physical punish- ment Severe physical punish- ment Any psycholo- gical or physi- cal punish- ment * No disci- pline or punish- ment Missing Mother/care- taker believes that the child needs to be physically punished Number of children aged 2-14 years** 138 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table CP.5: Early marriage and polygyny Percentage of women aged 15-49 in marriage or union before their 15th birthday, percentage of women aged 20-49 in marriage or union before their 18th birthday, percentage of women aged 15-19 currently married or in union, and the percentage of married or in union women in a polygynous marriage or union, The Gambia, 2006 LGA Banjul 5.8 324 29.9 242 17.1 81 15.9 169 Kanifing 7.5 2872 31.9 2220 13.1 652 32.9 1613 Brikama 9.5 2549 43.1 1930 16.5 619 37.2 1661 Mansakonko 12.8 531 58.3 407 25.6 124 51.4 390 Kerewan 18.4 1012 47.6 813 33.6 199 48.9 803 Kuntaur 14.1 547 73.5 416 44.1 131 52.5 444 Janjangbureh 8.6 891 68.8 684 33.8 206 53.6 696 Basse 8.4 1258 74.8 988 53.5 270 56.9 1064 Residence Urban 8.1 4251 35.9 3255 15.3 996 33.5 2471 Rural 11.2 5731 58.1 4444 32.6 1286 49.3 4368 Age 15-19 4.8 2282 . 0 25.1 2282 24.2 572 20-24 7.3 2023 35.9 2023 . 0 28.4 1292 25-29 10.5 1915 47.2 1915 . 0 38.0 1597 30-34 15.5 1352 57.2 1352 . 0 48.8 1226 35-39 12.3 1047 53.6 1047 . 0 55.0 948 40-44 15.4 822 60.3 822 . 0 61.5 733 45-49 12.0 540 53.3 540 . 0 63.0 471 Education None 13.6 6083 58.9 5276 50.5 807 48.3 5133 Primary 8.3 1173 48.1 796 23.6 376 35.7 717 Secondary + 2.4 2726 15.8 1627 6.9 1099 24.5 989 Wealth index quintiles Poorest 12.9 1707 65.9 1369 38.9 338 45.0 1401 Second 11.0 1896 54.6 1462 26.6 434 49.4 1378 Middle 12.0 2012 53.0 1550 27.7 462 44.1 1446 Fourth 8.9 2139 46.0 1594 26.6 545 44.1 1419 Richest 5.8 2228 28.7 1724 10.4 504 33.9 1195 Ethnicity Mandinka 8.9 3514 46.3 2647 19.5 867 45.7 2327 Wollof 9.3 1295 44.4 1029 20.7 266 45.4 889 Fula 15.0 1985 64.4 1530 43.1 455 38.6 1540 Jola 6.2 1086 32.8 844 10.5 243 40.9 646 Serer 9.4 386 31.5 307 6.6 79 24.7 213 Other ethnic group 9.1 1716 52.8 1342 32.3 373 49.1 1223 Total 9.9 9982 48.7 7700 25.1 2282 43.6 6839 Percen- tage married before age 15* Number of women aged 15-49 Percentage married before age 18* Number of women aged 20-49 Percentage of women 15-19 married/in union** Number of women aged 15-19 Percentage of women aged 15-49 in poly- gynous mar- riage/ union*** Number of women aged 15-49 currently married/in union * MICS indicator 67 ** MICS indicator 68 *** MICS indicator 70 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 139 Table CP.6: Spousal age difference Percentage distribution of currently married/in union women aged 15-19 and 20-24 according to the age difference with their husband or partner, The Gambia, 2006 Percentage of currently married/in union women aged 15-19 whose husband or partner is: Percentage of currently married/in union women aged 20-24 whose husband or partner is: 0-4 years older 5-9 years older 10+ years older* Husband/ partner's age unk- nown Total Younger 0-4 years older 5-9 years older 10+ years older Hus-band/ partner's age unk- nown Total Number of women aged 15-19 currently married/ in union Number of women aged 20-24 currently married/ in union LGA Banjul (*) (*) (*) (*) (*) 14 (.0) (6.5) (29.0) (58.1) (6.5) (100.0) 31 Kanifing 1.2 14.8 67.9 16.0 100.0 85 1.4 8.3 19.9 55.8 14.5 100.0 290 Brikama 3.0 18.0 71.3 7.7 100.0 102 .4 6.1 22.4 65.5 5.7 100.0 320 Mansakonko (9.1) (29.6) (46.8) (14.5) (100.0) 32 1.5 7.3 26.7 53.2 11.4 100.0 66 Kerewan 5.6 15.3 69.4 9.7 100.0 67 .7 2.1 26.6 67.1 3.5 100.0 133 Kuntaur 5.6 11.1 68.5 14.8 100.0 58 .0 .0 25.4 59.7 14.9 100.0 86 Janjangbureh 4.0 16.0 37.3 42.7 100.0 70 .0 6.6 18.4 47.8 27.2 100.0 126 Basse 2.3 11.6 50.1 36.0 100.0 145 .3 4.9 12.5 43.9 38.4 100.0 240 Residence Urban 1.8 15.1 68.1 14.9 100.0 152 .9 6.9 21.7 59.1 11.4 100.0 462 Rural 4.1 15.2 56.3 24.4 100.0 420 .5 5.0 20.0 55.1 19.4 100.0 830 Education None 2.5 14.6 61.0 21.8 100.0 408 .7 3.4 18.0 59.0 19.0 100.0 896 Primary 6.9 12.0 56.5 24.6 100.0 89 .0 6.4 22.8 57.0 13.8 100.0 165 Secondary + 4.9 22.0 54.4 18.7 100.0 75 .9 14.0 29.4 46.6 9.1 100.0 230 Wealth index quintiles Poorest 5.1 14.5 51.5 28.9 100.0 131 .3 3.0 20.3 55.4 21.0 100.0 260 Second 1.7 21.2 59.7 17.3 100.0 115 .9 2.6 24.0 59.7 12.8 100.0 230 Middle 4.3 12.0 55.1 28.6 100.0 128 .0 5.8 21.3 55.3 17.5 100.0 278 Fourth 2.1 13.9 67.3 16.7 100.0 145 .0 7.6 16.8 58.4 17.2 100.0 277 Richest 5.3 15.3 67.4 12.1 100.0 52 2.1 9.0 21.2 54.2 13.5 100.0 247 Ethnicity Mandinka 3.5 14.4 60.9 21.2 100.0 169 .5 7.5 22.0 55.3 14.7 100.0 408 Wollof 1.7 19.3 50.8 28.3 100.0 55 .6 5.6 21.2 61.3 11.4 100.0 183 Fula 3.9 15.8 62.6 17.7 100.0 196 .6 4.2 18.3 58.4 18.5 100.0 315 Jola 4.1 19.3 68.0 8.5 100.0 26 .0 4.6 23.5 58.9 13.0 100.0 90 Serer (*) (*) (*) (*) (*) 5 (.0) (2.3) (40.6) (54.8) (2.3) (100.0) 45 Other ethnic group 3.8 11.6 54.4 30.3 100.0 121 1.2 5.6 16.2 52.1 24.9 100.0 250 Total 3.5 15.2 59.4 21.9 100.0 572 .6 5.7 20.6 56.5 16.6 100.0 1292 140 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table CP.7: Female genital mutilation/cutting (FGM/C) Percentage of women aged 15-49 who have had any form of female genital mutilation/cutting (FGM/C), type of FGM/C among those who have had FGM/C, the percentage who have had the extreme form of FGM/C (infibulation), and the percentage distribution among women who have heard of FGM/C according to attitudes towards whether the practice of FGM/C should be continued, The Gambia, 2006 LGA Banjul 44.8 324 31.3 65.6 1.2 1.9 30.7 69.3 .0 100.0 324 Kanifing 70.4 2872 55.5 38.2 4.7 1.6 57.9 41.5 .6 100.0 2872 Brikama 87.0 2549 83.7 15.3 .5 .4 84.0 15.6 .4 100.0 2549 Mansakonko 95.9 531 93.5 4.6 1.4 .5 94.0 5.8 .2 100.0 531 Kerewan 60.8 1012 58.7 27.9 13.0 .4 59.1 40.7 .3 100.0 1012 Kuntaur 68.7 547 63.4 17.7 17.9 1.0 67.6 32.2 .2 100.0 547 Janjangbureh 77.2 891 74.6 18.8 5.3 1.3 75.8 24.2 .0 100.0 891 Basse 99.0 1258 92.2 2.3 3.7 1.8 97.4 2.5 .1 100.0 1258 Residence Urban 72.2 4251 59.7 34.4 4.6 1.3 61.5 38.0 .5 100.0 4251 Rural 82.8 5731 79.5 14.5 5.0 .9 81.3 18.5 .2 100.0 5731 Age 15-19 79.9 2282 72.3 22.1 3.9 1.7 74.4 25.2 .4 100.0 2282 20-24 78.2 2023 69.8 24.2 4.8 1.3 72.1 27.7 .2 100.0 2023 25-29 77.2 1915 69.9 23.7 5.7 .7 71.6 28.0 .4 100.0 1915 30-34 78.4 1352 71.6 23.1 4.7 .7 72.8 26.9 .3 100.0 1352 35-39 79.5 1047 72.2 22.0 5.2 .6 73.5 26.0 .5 100.0 1047 40-44 77.7 822 72.6 21.9 4.6 1.0 73.7 25.9 .5 100.0 822 45-49 74.2 540 69.5 23.6 5.9 .9 71.2 28.5 .2 100.0 540 Education None 81.1 6083 76.9 16.4 5.6 1.1 78.8 20.8 .4 100.0 6083 Primary 80.2 1173 71.9 22.5 4.1 1.6 74.3 25.5 .3 100.0 1173 Secondary + 71.2 2726 57.7 37.9 3.5 .8 59.0 40.8 .3 100.0 2726 FGM/C experience No FGM/C .0 2166 3.4 80.2 15.1 1.3 2.7 96.9 .4 100.0 2166 Had FGM/C 100.0 7816 89.1 7.8 2.1 1.0 91.6 8.1 .3 100.0 7816 Wealth index quintiles Poorest 75.4 1707 73.2 17.1 8.6 1.1 75.1 24.6 .3 100.0 1707 Second 86.1 1896 82.6 12.9 3.6 .9 83.7 16.0 .3 100.0 1896 Middle 85.9 2012 80.9 14.1 4.2 .8 82.8 16.8 .4 100.0 2012 Fourth 81.6 2139 73.1 21.9 4.1 .9 75.7 24.1 .3 100.0 2139 Richest 63.9 2228 48.7 45.4 4.3 1.6 50.2 49.4 .4 100.0 2228 Ethnic group of head of household Mandinka 96.5 3514 89.2 8.4 1.6 .8 90.9 8.7 .4 100.0 3514 Wollof 12.1 1295 10.4 70.7 17.6 1.4 9.7 90.1 .2 100.0 1295 Fula 87.8 1985 79.5 14.9 4.3 1.3 82.4 17.2 .3 100.0 1985 Jola 90.8 1086 80.7 15.5 2.8 1.0 82.9 16.7 .4 100.0 1086 Serer 45.5 386 32.6 59.5 6.5 1.4 33.6 65.9 .5 100.0 386 Other ethnic group 79.5 1716 71.2 23.9 3.7 1.1 73.7 26.0 .3 100.0 1716 Total 78.3 9982 71.1 23.0 4.8 1.1 72.9 26.8 .3 100.0 9982 Per cent distribution of women who believe the practice of FGM/C should: Like daughter to be circumcised * MICS indicator 63 *** MICS indicator 66 Had any form of FGM/C* No. of women aged 15-49 Continue *** Be disconti- nued Depends on situation Don't know/ Missing Yes No Don't know Total Number of women aged 15-49 who have heard of FGM/C The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 141 Table CP.8: Female genital mutilation/cutting (FGM/C) Percentage of women with at least one living daughter who has had female genital mutilation (FGM/C) , The Gambia, 2006 LGA Banjul 30.1 135 Kanifing 54.4 1364 Brikama 67.6 1290 Mansakonko 79.4 306 Kerewan 47.2 615 Kuntaur 57.1 335 Janjangbureh 68.1 546 Basse 91.4 747 Residence Urban 55.9 2023 Rural 69.4 3314 Age 15-19 39.4 173 20-24 43.2 740 25-29 59.1 1229 30-34 69.4 1084 35-39 74.1 908 40-44 75.7 732 45-49 72.1 471 Mother's education None 69.5 4038 Primary 57.7 538 Secondary 41.3 761 Wealth index quintiles Poorest 61.3 1097 Second 72.3 1116 Middle 71.2 1079 Fourth 67.2 1080 Richest 47.5 964 Ethnic group of head of household Mandinka 81.6 1846 Wollof 7.1 722 Fula 71.7 1122 Jola 68.4 545 Serer 24.4 196 Other ethnic group 71.7 905 Total 64.3 5337 Daughter had any form of FGM/C * Number of women aged 15-49 years * MICS indicator 65 142 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table CP.9: Attitudes towards domestic violence Percentage of women aged 15-49 who believe a husband is justified in beating his wife/partner in various circumstances, The Gambia, 2006 LGA Banjul 26.4 35.3 16.3 32.8 8.0 48.2 324 Kanifing 34.7 35.5 20.9 42.5 8.9 58.8 2872 Brikama 60.7 57.1 40.7 60.5 18.3 74.2 2549 Mansakonko 55.8 49.4 39.3 59.3 18.2 76.6 531 Kerewan 69.6 58.8 55.7 71.1 21.7 82.6 1012 Kuntaur 78.6 62.4 48.7 93.3 19.1 96.9 547 Janjangbureh 56.7 51.6 33.3 65.1 17.8 72.8 891 Basse 89.3 82.9 56.1 91.5 21.1 97.3 1258 Residence Urban 40.3 39.5 24.5 46.8 9.9 62.4 4251 Rural 69.3 62.9 46.9 72.5 20.5 82.5 5731 Age 15-19 55.0 51.0 37.0 55.8 16.3 71.1 2282 20-24 55.0 51.0 34.4 58.9 15.7 72.6 2023 25-29 56.2 52.6 36.8 62.8 14.9 75.2 1915 30-34 58.2 53.9 37.9 62.4 15.5 73.8 1352 35-39 59.7 55.0 39.3 66.5 16.2 75.6 1047 40-44 61.0 57.3 40.5 70.1 18.2 79.0 822 45-49 61.1 56.9 42.9 66.7 16.4 76.2 540 Marital/Union status Currently married/in union 62.4 57.4 41.3 67.8 17.2 78.5 6839 Formerly married/in union 47.9 45.5 29.5 58.5 13.2 69.1 459 Never married/in union 44.6 42.9 28.5 46.1 13.3 63.2 2671 Education None 66.6 60.0 44.7 71.8 18.2 81.7 6083 Primary 55.1 52.0 34.3 59.3 15.9 73.9 1173 Secondary + 36.4 37.6 22.4 39.6 10.9 56.8 2726 Wealth index quintiles Poorest 72.6 64.4 51.4 79.4 24.3 86.1 1707 Second 68.7 61.4 47.8 72.0 21.3 81.9 1896 Middle 63.9 58.2 41.2 64.7 15.5 79.3 2012 Fourth 55.6 51.3 34.7 60.4 13.4 74.4 2139 Richest 30.2 34.0 16.9 37.2 7.9 52.7 2228 Ethnic group of head of household Mandinka 59.4 55.0 39.4 63.2 15.8 76.6 3514 Wollof 46.9 43.7 32.3 55.6 15.8 66.8 1295 Fula 63.7 57.5 40.2 68.8 17.0 78.9 1985 Jola 51.6 47.9 35.1 52.5 18.4 68.6 1086 Serer 38.0 41.6 23.0 45.1 11.6 61.2 386 Other ethnic group 59.7 56.4 38.5 63.8 14.5 74.5 1716 Total 57.0 53.0 37.4 61.6 16.0 74.0 9982 * MICS indicator 100 Percentage of women aged 15-49 who believe a husband is justified in beating his wife/partner: When she goes out without telling him When she neglects the children When she argues with him When she refuses sex with him When she burns the food For any of these rea- sons* Number of women aged 15-49 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 143 Table HA.1: Knowledge of preventing HIV transmission Percentage of women aged 15-49 who know the main ways of preventing HIV transmission, The Gambia, 2006 LGA Banjul 98.2 71.8 83.4 82.8 55.8 94.8 5.2 324 Kanifing 98.8 86.4 79.3 67.8 53.1 95.3 4.7 2872 Brikama 99.9 97.2 85.2 85.6 78.6 98.3 1.7 2549 Mansakonko 99.3 84.2 72.2 70.7 53.1 93.7 6.3 531 Kerewan 100.0 97.6 94.8 69.3 66.2 99.5 .5 1012 Kuntaur 98.8 91.0 82.6 76.1 67.6 96.0 4.0 547 Janjangbureh 99.3 92.5 72.7 84.5 61.6 97.8 2.2 891 Basse 98.9 95.4 84.4 83.7 72.8 96.9 3.1 1258 Residence Urban 99.0 87.0 81.4 71.8 57.7 95.8 4.2 4251 Rural 99.4 95.1 83.1 81.0 70.5 97.7 2.3 5731 Age 15-19 98.7 89.9 80.1 76.0 63.3 95.4 4.6 2282 20-24 99.3 91.6 83.6 77.2 65.4 97.4 2.6 2023 25-29 99.5 92.0 83.7 77.6 65.1 97.8 2.2 1915 30-34 99.5 93.2 84.5 77.7 67.9 97.2 2.8 1352 35-39 99.5 92.2 83.4 77.5 65.6 97.3 2.7 1047 40-44 99.2 91.6 80.9 77.1 65.8 95.9 4.1 822 45-49 99.3 93.2 77.9 77.4 61.5 98.0 2.0 540 Education None 98.9 91.8 80.8 76.7 64.6 96.1 3.9 6083 Primary 99.4 90.5 81.2 81.1 66.0 97.5 2.5 1173 Secondary + 100.0 91.7 86.5 76.3 65.7 98.4 1.6 2726 Wealth index quintiles Poorest 99.0 93.0 80.3 80.6 67.0 96.9 3.1 1707 Second 99.3 95.0 84.6 79.4 71.0 97.4 2.6 1896 Middle 99.3 93.4 81.6 78.0 66.8 97.1 2.9 2012 Fourth 99.3 91.7 81.7 76.8 64.2 96.6 3.4 2139 Richest 99.4 86.1 83.5 71.9 57.8 96.5 3.5 2228 Ethnic group of head of household Mandinka 99.8 93.3 85.3 78.4 68.2 97.8 2.2 3514 Wollof 99.2 90.9 80.9 73.9 59.9 97.7 2.3 1295 Fula 98.3 90.1 78.5 76.6 63.8 95.2 4.8 1985 Jola 99.4 93.1 84.5 77.8 69.0 97.3 2.7 1086 Serer 99.5 88.5 88.4 75.2 63.2 97.1 2.9 386 Other ethnic group 99.0 90.3 79.4 77.4 62.0 95.9 4.1 1716 Total 99.2 91.6 82.4 77.1 65.1 96.9 3.1 9982 Having only one faithful unin- fected sex partner Heard of AIDS Using a condom every time Abstaining from sex Abstaining from sex Knows at least one way Doesn't know any way Number of women Percentage who know trans- mission can be prevented by: 144 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table HA.2: Identifying misconceptions about HIV/AIDS Percentage of women aged 15-49 who correctly identify misconceptions about HIV/AIDS, The Gambia, 2006 LGA Banjul 65.0 71.5 79.8 51.5 81.6 92.9 324 Kanifing 67.9 77.6 77.8 51.6 79.8 91.5 2872 Brikama 73.0 83.9 75.5 54.5 85.1 97.4 2549 Mansakonko 65.8 78.8 61.6 43.1 71.9 94.4 531 Kerewan 64.4 84.0 75.3 49.0 74.3 96.6 1012 Kuntaur 49.6 58.9 70.4 33.9 60.6 94.7 547 Janjangbureh 47.8 65.0 60.8 28.2 61.0 94.2 891 Basse 40.6 49.0 70.5 23.6 58.4 93.2 1258 Residence Urban 68.6 65.0 76.9 51.3 80.0 92.9 4251 Rural 57.8 71.2 70.7 40.4 71.0 95.4 5731 Age 15-19 66.9 74.0 69.8 47.0 76.3 92.6 2282 20-24 62.4 73.5 72.4 43.7 76.4 95.1 2023 25-29 61.5 74.5 76.3 45.8 74.5 94.5 1915 30-34 62.4 75.5 75.4 46.2 75.9 95.8 1352 35-39 59.7 73.7 76.7 43.9 73.7 94.2 1047 40-44 60.2 73.3 71.9 44.3 73.0 94.9 822 45-49 55.0 71.1 72.0 39.3 66.1 94.3 540 Education None 53.9 68.3 69.7 37.3 67.8 93.5 6083 Primary 61.5 69.5 71.3 41.3 74.9 94.6 1173 Secondary + 81.7 88.5 82.4 64.0 90.5 96.1 2726 Wealth index quintiles Poorest 48.9 64.6 65.9 32.4 63.3 94.2 1707 Second 60.6 74.3 69.4 41.8 73.3 96.1 1896 Middle 61.9 72.2 71.6 42.5 73.0 93.7 2012 Fourth 65.4 76.2 76.0 48.7 77.0 94.4 2139 Richest 72.0 80.2 81.4 56.3 84.5 93.4 2228 Ethnic group of head of household Mandinka 66.0 78.1 74.8 47.5 77.6 96.0 3514 Wollof 62.3 75.2 77.6 47.7 76.7 95.6 1295 Fula 57.8 68.3 68.5 40.0 68.4 92.0 1985 Jola 68.7 79.9 72.6 50.0 79.7 94.7 1086 Serer 73.3 84.0 79.1 57.6 88.1 94.9 386 Other ethnic group 54.0 65.0 72.0 38.0 69.0 92.3 1716 Total 62.4 74.0 73.4 45.0 74.8 94.3 9982 HIV cannot be transmitted by mosquito bites HIV cannot be transmitted by supernatural means A healthy looking person can be infected HIV cannot be transmitted by sharing food HIV can be trans- mitted by sharing needles Number of women Reject two most common misconceptions and know a heal- thy-looking person can be infected Percentage who know that: Percentage who know that: HIV cannot be transmitted by: The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 145 Table HA.3: Comprehensive knowledge of HIV/AIDS transmission Percentage of women aged 15-49 who have comprehensive knowledge of HIV/AIDS transmission, The Gambia, 2006 LGA Banjul 62.3 51.5 37.4 324 Kanifing 71.7 51.6 40.9 2872 Brikama 84.4 54.5 50.1 2549 Mansakonko 65.8 43.1 32.9 531 Kerewan 93.0 49.0 46.8 1012 Kuntaur 78.8 33.9 32.1 547 Janjangbureh 70.1 28.2 24.4 891 Basse 83.4 23.6 23.2 1258 Residence Urban 74.0 51.3 41.9 4251 Rural 81.3 40.4 37.1 5731 Age 15-19 75.8 47.0 39.9 2282 20-24 78.7 43.7 38.5 2023 15-24 77.2 45.5 39.3 4306 25-29 78.9 45.8 39.7 1915 30-34 81.4 46.2 40.3 1352 35-39 79.5 43.9 38.4 1047 40-44 77.5 44.3 38.6 822 45-49 74.3 39.3 35.3 540 Education None 77.5 37.3 33.0 6083 Primary 76.3 41.3 35.1 1173 Secondary + 80.5 64.0 54.5 2726 Wealth index quintiles Poorest 77.8 32.4 30.2 1707 Second 82.9 41.8 38.5 1896 Middle 78.9 42.5 37.4 2012 Fourth 77.8 48.7 41.6 2139 Richest 74.2 56.3 45.7 2228 Ethnic group of head of household Mandinka 81.6 47.5 41.5 3514 Wollof 75.5 47.7 40.1 1295 Fula 75.0 40.0 35.5 1985 Jola 80.7 50.0 43.1 1086 Serer 80.1 57.6 49.2 386 Other ethnic group 75.0 38.0 33.0 1716 Total 78.2 45.0 39.1 9982 * MICS indicator 82; MDG indicator 19b Know 2 ways to prevent HIV transmission Correctly identify 3 misconceptions of HIV transmission Have comprehensive knowledge (identify 2 prevention methods and 3 misconceptions)* Number of women 146 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table HA.4: Knowledge of mother-to-child HIV transmission Percentage of women aged 15-49 who correctly identify means of HIV transmission from mother to child, The Gambia, 2006 LGA Banjul 89.3 85.0 73.0 61.0 54.3 8.9 324 Kanifing 92.1 85.1 76.1 63.0 52.9 6.7 2872 Brikama 96.7 93.4 87.7 83.8 77.5 3.1 2549 Mansakonko 94.2 87.3 85.6 82.3 72.7 5.1 531 Kerewan 98.2 94.8 88.3 87.8 78.0 1.8 1012 Kuntaur 94.9 86.8 79.3 65.8 56.9 3.9 547 Janjangbureh 93.4 86.0 84.2 83.7 73.7 5.8 891 Basse 93.2 85.0 83.3 75.6 67.2 5.6 1258 Residence Urban 93.3 86.9 78.9 68.2 58.6 5.8 4251 Rural 95.1 89.6 85.2 80.7 72.7 4.3 5731 Age 15-19 91.6 84.8 76.7 70.8 60.6 7.1 2282 20-24 94.7 88.5 82.3 75.2 66.2 4.6 2023 25-29 95.1 89.2 84.4 75.5 66.9 4.4 1915 30-34 95.4 90.1 84.9 77.4 69.2 4.0 1352 35-39 95.7 90.2 84.8 77.8 69.9 3.8 1047 40-44 95.1 90.6 85.5 79.0 71.7 4.1 822 45-49 95.2 90.6 85.7 79.6 73.1 4.1 540 Education None 93.4 87.6 81.9 77.5 68.6 5.5 6083 Primary 93.3 86.6 80.7 75.8 66.2 6.1 1173 Secondary + 97.0 91.2 84.6 70.4 62.6 3.0 2726 Wealth index quintiles Poorest 94.2 87.9 83.6 81.7 72.7 4.9 1707 Second 95.8 90.8 86.4 82.6 74.7 3.5 1896 Middle 93.5 87.8 81.5 77.7 68.1 5.8 2012 Fourth 94.6 88.9 82.1 72.6 64.5 4.7 2139 Richest 93.7 87.2 79.6 64.9 56.1 5.6 2228 Ethnic group of head of household Mandinka 96.5 90.6 85.9 78.5 70.2 3.3 3514 Wollof 94.4 88.9 81.5 70.0 62.1 4.8 1295 Fula 92.0 84.7 78.8 75.1 63.9 6.3 1985 Jola 94.4 90.3 82.6 78.5 70.7 5.0 1086 Serer 95.5 91.8 82.9 73.5 66.3 4.0 386 Other ethnic group 92.2 86.2 80.6 71.8 63.7 6.8 1716 Total 94.3 88.5 82.5 75.4 66.7 4.9 9982 * MICS indicator 89 Know AIDS can be trans- mitted from mother to child During pregnancy At delivery Through breast milk All three ways* Did not know any specific way Number of women Percentage who know AIDS can be transmitted: The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 147 Table HA.5: Attitudes towards people living with HIV/AIDS Percentage of women aged 15-49 who have heard of AIDS and who express a discriminatory attitude towards people living with HIV/AIDS, The Gambia, 2006 LGA Banjul 4.4 71.6 22.8 36.3 86.9 13.1 318 Kanifing 5.0 66.3 21.5 34.8 82.3 17.7 2837 Brikama 4.8 66.0 30.5 44.3 85.8 14.2 2545 Mansakonko 8.0 39.6 45.2 53.3 78.0 22.0 527 Kerewan 11.0 62.5 44.7 57.3 86.6 13.4 1012 Kuntaur 6.6 47.4 53.1 58.1 75.3 24.7 541 Janjangbureh 26.9 26.8 53.6 73.7 85.1 14.9 884 Basse 23.1 29.7 53.5 74.9 84.1 15.9 1244 Residence Urban 5.2 62.8 24.4 38.1 81.5 18.5 4210 Rural 13.6 49.9 44.7 59.4 85.3 14.7 5697 Age 15-19 11.1 56.0 32.7 47.6 83.0 17.0 2253 20-24 10.2 55.7 34.1 49.7 83.0 17.0 2010 25-29 9.5 56.6 34.6 51.2 83.9 16.1 1906 30-34 9.7 55.4 37.3 49.8 83.8 16.2 1345 35-39 9.0 53.1 39.3 53.2 83.9 16.1 1042 40-44 9.4 53.4 42.0 50.6 83.7 16.3 815 45-49 10.4 55.4 45.1 56.6 86.8 13.2 537 Education None 12.8 51.3 45.3 59.5 85.5 14.5 6017 Primary 9.4 59.6 34.0 49.3 85.5 14.5 1166 Secondary + 4.1 62.7 16.8 30.5 78.9 21.1 2725 Wealth index quintiles Poorest 17.5 44.1 55.1 68.3 86.3 13.7 1691 Second 10.6 54.1 44.8 60.2 86.2 13.8 1883 Middle 12.0 52.9 37.2 53.7 83.2 16.8 1997 Fourth 7.7 57.1 30.6 43.4 82.6 17.4 2123 Richest 4.4 65.9 18.5 32.0 80.9 19.1 2214 Ethnic group of head of household Mandinka 7.3 56.5 33.5 46.8 82.3 17.7 3508 Wollof 9.7 61.8 35.8 49.3 84.4 15.6 1285 Fula 14.8 49.1 42.5 58.2 84.6 15.4 1952 Jola 4.4 66.2 32.6 44.2 85.6 14.4 1080 Serer 3.6 73.1 20.4 32.0 85.4 14.6 384 Other ethnic group 15.5 44.9 40.1 57.5 83.1 16.9 1698 Total 10.0 55.4 36.1 50.3 83.7 16.3 9907 Would not care for a family mem- ber who was ill with AIDS If a family member had HIV would want to keep it a secret Believe that a teacher with HIV should not be allowed to work Would not buy food from a person with HIV/AIDS Agree with at least one discriminatory statement Agree with none of the discriminatory statements* Number of women who have heard of AIDS Percentage of women who: * MICS indicator 86 148 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table HA.6: Knowledge of a facility for HIV testing Percentage of women aged 15-49 who know where to get an HIV test, percentage of women who have been tested and of those tested the percentage who have been told the result, The Gambia, 2006 LGA Banjul 69.6 9.2 324 (96.7) 30 Kanifing 65.1 18.3 2872 86.2 526 Brikama 66.1 18.8 2549 95.4 480 Mansakonko 52.6 7.2 531 (87.8) 38 Kerewan 41.4 13.9 1012 85.5 141 Kuntaur 26.9 5.7 547 (74.8) 31 Janjangbureh 43.3 7.8 891 78.7 70 Basse 35.8 3.6 1258 (76.2) 46 Residence Urban 63.8 16.6 4251 87.4 706 Rural 48.0 11.4 5731 90.0 656 Age 15-19 50.2 6.5 2282 84.9 147 20-24 58.4 15.3 2023 87.8 310 25-29 57.8 18.0 1915 90.3 345 30-34 57.5 17.2 1352 88.7 232 35-39 54.5 15.6 1047 88.7 164 40-44 50.5 13.5 822 92.0 111 45-49 48.8 9.7 540 86.2 52 Education None 45.6 12.2 6083 88.7 742 Primary 57.2 14.0 1173 90.2 164 Secondary + 73.9 16.7 2726 88.0 456 Wealth index quintiles Poorest 36.0 9.4 1707 88.6 160 Second 50.2 13.3 1896 92.9 252 Middle 52.3 11.9 2012 86.9 239 Fourth 57.7 12.9 2139 88.4 276 Richest 72.2 19.5 2228 87.3 434 Ethnic group of head of household Mandinka 58.1 13.1 3514 88.5 460 Wollof 54.1 14.7 1295 83.3 191 Fula 46.0 12.2 1985 89.9 242 Jola 65.4 18.6 1086 92.1 202 Serer 67.0 16.5 386 92.1 64 Other ethnic group 48.6 11.8 1716 87.9 203 Total 54.7 13.6 9982 88.7 1361 * MICS indicator 87 ** MICS indicator 88 Know a place to get tested* Have been tested** Number of women If tested, have been told result Number of women who have been tested for HIV The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 149 Table HA.7: HIV testing and counselling coverage during antenatal care Percentage of women aged 15-49 who gave birth in the two years preceding the survey and who were offered HIV testing and counselling with their antenatal care, The Gambia, 2006 LGA Banjul 100.0 13.2 6.6 6.6 75 Kanifing 97.1 38.0 29.2 26.2 694 Brikama 98.5 58.0 39.4 38.4 750 Mansakonko 97.2 38.8 12.4 10.1 167 Kerewan 95.8 68.5 29.6 24.9 377 Kuntaur 96.3 41.6 9.0 6.6 232 Janjangbureh 98.8 32.4 9.8 7.1 313 Basse 98.9 35.5 4.3 3.6 463 Residence Urban 97.5 39.7 28.6 25.9 1037 Rural 97.9 48.3 20.2 18.2 2033 Age 15-19 96.0 36.0 23.2 21.0 275 20-24 96.8 41.6 22.4 19.9 810 25-29 98.8 44.4 23.1 20.8 857 30-34 98.4 48.2 23.6 21.5 568 35-49 97.7 54.1 23.2 21.5 559 Education None 97.8 44.6 20.4 18.6 2229 Primary 97.7 47.4 25.6 22.2 352 Secondary + 97.5 47.5 33.1 30.2 489 Wealth index quintiles Poorest 97.6 46.8 15.9 13.8 684 Second 97.5 50.7 25.5 23.7 647 Middle 97.7 44.2 21.3 19.4 650 Fourth 97.8 44.7 24.6 22.4 600 Richest 98.3 38.8 30.2 26.9 488 Ethnic group of head of household Mandinka 98.2 49.1 23.7 21.3 1048 Wollof 96.6 49.9 22.5 19.7 384 Fula 97.1 38.3 21.6 19.5 706 Jola 98.9 53.4 34.3 33.2 302 Serer 97.4 50.1 28.5 26.9 117 Other ethnic group 98.1 38.3 16.1 13.9 512 Total 97.8 45.4 23.0 20.8 3070 Received antenatal care from a health care professional for last pregnancy Were provided information of HIV prevention during ANC visit* Were tested for HIV at ANC visit Received results of HIV test at ANC visit** Number of women who gave birth in the 2 years preceding the survey Percentage of women who: * MICS indicator 90 ** MICS indicator 91 150 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table HA.8: Sexual behaviour that increases risk of HIV infection Percentage of young women aged 15-19 who had sex before age 15, percentage of young women aged 20-24 who had sex before age 18, and percentage of young women aged 15-24 who had sex with a man 10 or more years older, The Gambia, 2006 LGA Banjul .0 81 26.0 72 48.0 50 Kanifing 2.1 652 27.5 616 46.2 462 Brikama 4.2 619 33.0 535 57.9 478 Mansakonko 3.9 124 48.3 83 45.6 95 Kerewan 5.1 199 47.9 176 61.2 208 Kuntaur 9.0 131 61.7 104 59.1 127 Janjangbureh 4.1 206 48.5 157 40.7 185 Basse 5.6 270 68.0 278 47.0 331 Residence Urban 2.0 996 30.4 910 49.3 729 Rural 5.5 1286 48.7 1113 52.3 1207 Age 15-19 3.9 2282 . . 52.0 594 20-24 . . 40.5 2023 50.8 1342 Education None 8.3 807 54.5 1100 57.0 1239 Primary 3.1 376 44.7 249 49.1 272 Secondary + 1.0 1099 16.1 675 35.6 425 Wealth index quintiles Poorest 5.8 338 57.5 312 50.0 369 Second 3.3 434 48.4 327 54.0 370 Middle 6.0 462 44.1 408 51.1 400 Fourth 3.8 545 40.6 442 54.3 450 Richest 1.6 504 22.9 534 45.4 346 Ethnic group of head of household Mandinka 2.2 867 32.1 682 49.9 600 Wollof 2.2 266 34.4 282 55.0 244 Fula 9.3 455 55.8 415 55.9 504 Jola 3.3 243 34.1 195 43.8 168 Serer 1.2 79 28.9 92 46.0 63 Other ethnic group 3.7 373 50.1 358 48.4 356 Total 3.9 2282 40.5 2023 51.2 1935 Percentage of women aged 15-19 who had sex before age 15* Number of women aged 15-19 Percentage of women aged 20-24 who had sex before age 18 Number of women aged 20-24 Percentage who had sex in the 12 months preceding the survey with a man 10 or more years older** Number of women who had sex in the 12 months preceding the survey * MICS indicator 84 ** MICS indicator 92 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 151 Table HA.9: Condom use at last high-risk sex Percentage of young women aged 15-24 who had high risk sex in the previous year and who used a condom at last high risk sex, The Gambia, 2006 LGA Banjul 38.7 32.3 26.0 53.8 1.3 50 Kanifing 41.9 36.4 29.6 46.9 1.4 462 Brikama 45.7 41.4 18.1 48.0 .2 478 Mansakonko 50.6 46.0 13.1 85.4 .9 95 Kerewan 58.4 55.4 8.5 73.7 1.2 208 Kuntaur 63.4 53.8 5.1 50.0 .5 127 Janjangbureh 58.1 50.9 7.5 73.3 .5 185 Basse 74.0 60.5 7.1 79.0 .0 331 Residence Urban 43.3 38.2 26.1 53.8 1.1 729 Rural 57.6 50.3 9.9 55.0 .5 1207 Age 15-19 28.9 26.0 18.1 48.6 .4 594 20-24 76.5 66.3 15.1 57.3 1.1 1342 Education None 73.2 65.0 7.8 53.7 .7 1239 Primary 49.6 43.5 19.6 45.0 .7 272 Secondary + 28.3 23.9 37.8 57.7 .8 425 Wealth index quintiles Poorest 64.4 56.7 7.6 61.4 .4 369 Second 53.7 48.7 14.8 49.1 1.1 370 Middle 53.6 46.0 14.6 46.5 .6 400 Fourth 51.2 45.6 18.4 62.2 .4 450 Richest 39.5 33.4 24.9 52.9 1.1 346 Ethnic group of head of household Mandinka 43.7 38.8 16.3 63.4 .8 600 Wollof 49.6 44.5 9.7 73.1 .9 244 Fula 63.9 57.9 10.7 59.7 .4 504 Jola 45.1 38.5 41.1 39.0 .7 168 Serer 42.9 36.6 26.5 31.9 1.2 63 Other ethnic group 59.3 48.8 13.7 50.4 .8 356 Total 51.3 45.0 16.0 54.3 .7 1935 Ever had sex Had sex in the last 12 months Of those who had sex in last 12 months, the per cent who had sex with non-mari- tal, non-cohabi- ting partner in the last 12 months* Of those who had a non-marital, non-cohabiting partner in the last 12 months, the percentage who used a condom at last sex with such a partner** More than one partner in last 12 months Number of women aged 15-24 * MICS indicator 85 ** MICS indicator 83; MDG indicator 19a 152 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table HA.10: Children's living arrangements and orphanhood Percentage distribution of children aged 0-17 years according to living arrangements, percentage of children aged 0-17 in households not living with a biological parent and percentage of children who are orphans, The Gambia, 2006 Sex Male 64.4 1.0 1.9 10.4 .7 12.4 3.5 4.2 1.2 .3 100.0 13.9 8.4 11386 Female 60.0 1.1 2.2 13.7 .8 13.7 4.0 3.3 .8 .4 100.0 17.8 9.0 11473 LGA Banjul 55.9 1.1 1.3 15.5 .6 15.8 4.4 4.4 1.0 .0 100.0 18.5 8.4 608 Kanifing 58.5 1.4 1.8 137 1.0 15.2 3.7 3.2 .7 .8 100.0 17.9 8.6 5133 Brikama 63.4 1.1 2.5 12.6 1.0 10.5 3.9 3.6 1.2 .3 100.0 17.2 9.6 5645 Mansakonko 52.4 1.0 4.1 20.9 1.2 11.8 5.3 1.9 1.2 .2 100.0 27.2 12.8 1701 Kerewan 68.0 .7 1.2 8.8 .2 14.1 1.9 4.5 .4 .1 100.0 10.9 4.5 2818 Kuntaur 70.9 .5 1.7 9.1 .3 8.0 3.7 4.6 1.1 .0 100.0 11.6 7.3 1676 Janjangbureh 60.5 1.3 1.8 12.6 .3 14.4 2.5 5.2 1.2 .1 100.0 16.1 7.2 2132 Basse 63.8 .8 2.1 6.9 .6 15.1 5.4 3.7 1.4 .2 100.0 10.3 10.3 3146 Residence Urban 58.3 1.3 1.9 13.9 1.0 15.4 3.6 3.2 .7 .6 100.0 18.1 8.6 7993 Rural 64.2 .9 2.2 11.0 .6 11.8 3.9 4.1 1.1 .2 100.0 14.7 8.7 14865 Age 0-4 years 72.8 .3 .1 4.4 .1 18.8 1.5 1.4 .2 .4 100.0 4.9 2.2 6479 5-9 years 64.1 .8 1.6 12.6 .4 12.2 2.9 4.3 .9 .2 100.0 15.4 6.7 7134 10-14 years 56.8 1.6 3.4 15.0 .9 10.2 5.4 5.0 1.4 .2 100.0 20.9 12.7 6275 15-17 years 45.7 2.1 4.8 21.1 2.4 8.6 7.3 4.9 2.1 .8 100.0 30.5 18.9 2971 Wealth index quintiles Poorest 69.0 .8 1.8 9.5 .3 9.0 3.3 5.0 1.2 .1 100.0 12.3 7.5 4975 Second 64.0 1.0 2.1 10.5 .7 12.3 4.2 3.9 1.1 .2 100.0 14.3 9.1 4850 Middle 63.6 .9 2.2 11.1 .9 12.9 3.6 3.3 1.3 .2 100.0 15.1 9.0 4638 Fourth 59.8 1.1 2.2 11.8 .9 15.8 4.8 2.6 .6 .5 100.0 16.0 9.5 4437 Richest 52.4 1.6 2.2 18.5 .9 16.1 2.8 3.9 .7 .8 100.0 23.1 8.3 3959 Ethnic group of head of household Mandinka 62.7 1.1 2.2 11.8 .9 12.4 4.5 3.1 .9 .4 100.0 16.0 9.6 8202 Wollof 66.1 1.2 1.5 11.9 .5 11.7 2.7 3.5 .6 .3 100.0 15.1 6.5 2897 Fula 67.5 1.0 1.7 9.5 .6 11.4 2.8 4.2 1.2 .2 100.0 12.7 7.2 4710 Jola 59.6 1.1 2.6 15.2 1.0 10.1 3.3 5.2 1.5 .4 100.0 19.9 9.6 2336 Serer 59.5 1.6 1.2 11.8 .4 18.9 3.4 1.7 .9 .6 100.0 15.0 7.6 741 Other ethnic group 54.1 .9 2.6 13.8 .6 18.1 4.5 4.2 1.0 .4 100.0 17.7 9.5 3973 Total 62.2 1.0 2.1 12.0 .7 13.0 3.8 3.8 1.0 .3 100.0 15.9 8.7 22859 Living with both parents Only father alive Only mother alive Both are alive Both are dead Father alive Father dead Mother alive Mother dead Impos- sible to determine Total Not living with a biological parent* One or both parents dead** Number of children * MICS indicator 78 ** MICS indicator 75 Living with neither parent Living withmother only Living with father only The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 153 Table HA.11: Prevalence of orphanhood and vulnerability among children Percentage of children aged 0-17 who are orphaned or vulnerable due to AIDS, The Gambia, 2006 Sex Male .5 3.8 4.3 8.4 12.2 11386 Female .7 3.9 4.5 9.0 12.9 11473 LGA Banjul 1.1 5.3 6.5 8.4 14.7 608 Kanifing .9 6.5 7.4 8.6 15.2 5133 Brikama .7 2.4 3.0 9.6 12.0 5645 Mansakonko .3 1.9 2.2 12.8 14.9 1701 Kerewan .2 1.9 2.0 4.5 6.4 2818 Kuntaur 1.1 7.4 8.4 7.3 15.3 1676 Janjangbureh .6 4.3 4.8 7.2 11.4 2132 Basse .2 2.4 2.6 10.3 12.4 3146 Residence Urban .8 5.4 6.2 8.6 14.1 7993 Rural .5 3.0 3.5 8.7 11.7 14865 Age 0-4 years .3 3.6 3.9 2.2 6.0 6479 5-9 years .6 4.0 4.6 6.7 10.9 7134 10-14 years .7 3.8 4.5 12.7 16.5 6275 15-17 years 1.2 4.0 5.0 18.9 22.7 2971 Wealth index quintiles Poorest .6 4.4 4.9 7.5 11.9 4975 Second .5 3.0 3.3 9.1 11.9 4850 Middle .4 2.7 3.1 9.0 11.7 4638 Fourth .5 4.0 4.4 9.5 13.4 4437 Richest 1.2 5.6 6.8 8.3 14.4 3959 Ethnicity Mandinka .6 2.9 12.6 9.6 12.6 8202 Wollof .8 5.5 12.4 6.5 12.4 2897 Fula .6 3.3 10.8 7.2 10.8 4710 Jola .8 4.6 14.0 9.6 14.0 2336 Serer .5 4.4 12.2 7.6 12.2 741 Other ethnic group .5 4.6 14.0 9.5 14.0 3973 Total .6 3.9 12.6 8.7 12.6 22859 Chronically ill parent Chronically ill adult in household Vulnerable children* One or both parents dead** Orphans and vulnerable children Number of children aged 0-17 years * MICS indicator 76 ** MICS indicator 75 154 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Table HA.12: School attendance, orphaned and vulnerable children School attendance by orphaned and vulnerable status among children aged 10-14, The Gambia, 2006 Sex Male 74.6 77.8 .99 2869 Female 69.9 72.9 .76 3407 Residence Urban 69.4 90.4 .77 2120 Rural 73.4 68.0 .92 4155 Wealth index quintiles Poorest 77.1 58.9 1.26 1353 Second 74.2 73.2 .65 1346 Middle 72.6 74.3 1.11 1259 Fourth 71.1 83.7 .90 1239 Richest 63.5 93.8 .61 1078 Total 72.0 75.3 .87 6275 Status Orphaned 22.6 25.9 3.8 141 Vulnerable 21.5 21.9 6.6 240 Orphaned or vulnerable 22.2 23.4 5.6 376 Not orphaned or vulnerable 20.2 22.4 6.5 6010 Total 20.3 22.4 6.4 6386 Ratio OVC to non-OVC* 1.1 1.1 0.9 - Table HA.14: Malnutrition among orphans and vulnerable children Percentage of children aged 0-4 years who are moderately or severely underweight, stunted or wasted by orphanhood and vulnerability due to AIDS, The Gambia, 2006 * MICS indicator 79 Underweight Stunted Wasted Number of children aged 0-4 years Total number of children aged 10-14 Orphans to non-orphans' school attendance ratio* School attendance rate of children of whom both parents are alive and child is living with at least one parent Percentage of children of whom both parents are alive and child is living with at least one parent Background characteristics * MICS indicator 77 MDG indicator 20 Percentage of children aged 0-4 years who are moderately or severely: Status Orphaned 2.0 269 Vulnerable 7.7 80 Orphaned or vulnerable 3.2 326 Not orphaned or vulnerable 4.0 1011 Total 3.8 1338 Ratio OVC to non-OVC* 0.8 . * MICS indicator 80 Table HA.15: Sexual behaviour among young women by orphanhood and vulnerability status due to AIDS Percentage of young women aged 15-17 who had sex before age 15 by vulnerability status and survival status of parents, The Gambia, 2006 Percentage of young women aged 15-17 who had sex before age 15 Number of young women aged 15-17 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 155 APPENDIX A: SAMPLE DESIGN The major features of sample design are described in this appendix. Sample design features include target sample size, sample allocation, sample frame and listing, choice of domains, sampling stages, stratification, and the calculation of sample weights. The primary objective of the sample design for The Gambia Multiple Indicator Cluster Survey was to produce statistically reliable estimates of most indicators, at the national level, for urban and rural areas, and for the eight regions: Banjul, Kanifing, Brikama, Mansakonko, Kerewan, Kuntaur, Janjangbureh and Basse. Regions were identified as the main sampling domains and the sample was selected in two stages. Within each region, at least 14 and at most 99 census enumeration areas were selected with probability proportional to size. After a household listing was carried out within the selected enumeration areas, a systematic sample of 6175 households was drawn. All enumeration areas were accessible and were therefore visited. The sample was stratified by region and is not self- weighting. For reporting national level results, sample weights are used. A two-stage, stratified cluster sampling approach was used for the selection of the survey sample. Sample Size and Sample Allocation The target sample size for The Gambia MICS was calculated as 6,175 households. For the calculation of the sample size, the key indicator used was the proportion of children under five years of age reported ill during the last 2 weeks who received increased fluids and continued feeding during the MICS2 survey, 2000. The following formula was used to estimate the required sample size for these indicators: Where: • n approximately is the required sample size, expressed as number of households, for the KEY indicator. • 4 is the factor to achieve a 95 percent level of confidence. • r = 0.23 is the anticipated level (coverage) of the key indicator - proportion of children under five years of age reported ill during the last two weeks who received increased fluids and conti- nued feeding during the MICS 2, 2000. • 1.06 is the factor to raise sample size by 6 per cent for 94 percent response rate for children under five. • f = 2.08 is the shortened symbol for design effect, deff, • 0.06r is the margin of error to be tolerated, defined as 6 per cent of r (6 per cent thus repre- sents the relative sampling error of r), • p, is the proportion of the smallest group in the total population. Children less than one year or children 12-23 months are among the smallest group of the study population. However, since indicators for these groups are either very low or very high a fairly larger group, ie., chil- dren under 5 was considered, which gives p = 14 per cent. • nh = 9 is the average household size. 156 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix A. Sample Design Formula 1 above gives about 6,253 households. However, 19 households per EA was the sample take that would give number of households (6,175) nearest to 6,253 households. Hence, the actual sample size chosen was 6175 households. The average cluster size in The Gambia MICS was determined as 19 households, based on a number of considerations, including the budget available, and the time that would be needed per team to complete one cluster. Dividing the total number of households by the number of households per cluster, it was calculated that the selection of a total number of 325 clusters would be needed for the entire country. The clusters or EAs were allocated to the eight regions in proportion to their population size. The table below shows the allocation of clusters to the sampling domains. Sampling Frame and Selection of Clusters The soft copy of the 2003 census frame was used for the selection of clusters. Census enumeration areas were defined as primary sampling units (PSUs), and were selected from each of the sampling domains by using systematic pps (probability proportional to size) sampling procedures, based on the estimated sizes of the enumeration areas from the 2003 Population census. The first stage of sampling was thus completed by selecting the required number of enumeration areas from each of the eight regions by urban and rural areas separately. The standard clusters were cumulated along the EAs. The cumulative total Ti for the i-th EA is Ti - 1 + Xi , where i = 1, 2, 3,.N(N = 1453 EAs for rural areas); and Xi is the number of standard clusters in the i-th EA. One can define a range or interval for each EA as follows (Ti - 1 to Ti ). Ti - 1 is the lower limit of the range and Ti is the upper limit of the range. The range defined, associates each EA with a range of numbers which is proportional to the size of the EA. Any selection of EAs that make use of the range can be described as PPS sampling, size being standard clusters in each EA. LGA Census num- ber of house- holds, 2003 Census population, 2003 Census EAs, 2003 Sampled EAs, 2005 Households in EAs selected, 2003 (Sample size) Households to be selected for interviews, 2005 Banjul 6903 35061 92 14 1313 266 Kanifing 49227 322735 634 99 8201 1881 Brikama 45219 389594 724 89 5728 1691 Mansakonko 8469 72167 155 19 1244 361 Kerewan 18298 172835 322 40 2534 760 Kuntaur 7140 78491 124 14 961 266 Janjangbureh 10138 107212 179 22 1274 418 Basse 12638 182586 247 28 1512 532 Total 158032 1360681 2477 325 22767 6175 Table SD1: Sample allocations MICS3, 2005, provisional census population and households by LGA, 2003 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 157 Appendix A. Sample Design In implementing PPS systematic sampling, two separate datasets were used - one corresponds to the urban sampling frame and the other to the rural sampling frame. Using the urban sampling frame TN was 995.28 standard clusters for 1024 EAs. With a sample size, n = 2945 households for the urban areas, in 155 EAs, the sampling interval, k, becomes 6.4 and the random start, r, which is 6 was randomly selected from 1 to 6. By using an SPSS programming syntax, 155 urban EAs were selected by a PPS systematic procedure. The i-th EA, was selected if (Ti - 1 < r +jk d Ti ), where j = 1, 2, .,n-1, n = 155 EAs, k = TN/n. Thus, the probability of selecting the i-th EA, pi, is Xi/k. By using the rural dataset, the above process was repeated with a cumulative total of 1481.69 rural standard clusters, a sample size of 3,230 households in 170 EAs, a sampling interval of 8.7 and a random start of 3. Listing Activities Since the sample frame (the 2003 Population Census) was not up to date, household lists in all selected enumeration areas were updated prior to the selection of households. For this purpose, listing teams were formed, who visited each enumeration area, and listed the occupied households. Compound and Household Listing Forms were completed for this purpose. Selection of Households Lists of households were prepared by the listing teams in the field for each enumeration area. The households were then sequentially numbered from 1 to n (the total number of households in each enumeration area) by the field supervisor in the field, where selection of 19 households in each enumeration area was carried out using circular systematic selection procedures. Calculation of Sample Weights The Gambia Multiple Indicator Cluster Survey sample is not self-weighted. The method of propor- tional allocation of households to each of the regions results in different sampling fractions for the eight regions. For this reason, sample weights were calculated and these were used in the subse- quent analyses of the survey data. The major component of the weight is the reciprocal of the sampling fraction employed in selecting the number of sample households in that particular sampling domain: Wh = 1 / fh The term fh, the sampling fraction at the h-th stratum, is the product of probabilities of selection at every stage in each sampling domain: fh = P1h * P2h * P13h where Pih is the probability of selection of the sampling unit in the i-th stage for the h-th sampling domain. 158 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix A. Sample Design Since the estimated numbers of households per enumeration area prior to the first stage selection (selection of primary sampling units) and the updated number of households per enumeration area were different, individual sampling fractions for households in each enumeration area (cluster) were calculated. The sampling fractions for households in each enumeration area therefore included the probability of selection of the enumeration area in that particular sampling domain and the proba- bility of selection of a household in the sample enumeration area (cluster). A second component which has to be taken into account in the calculation of sample weights is the level of non-response for the household and individual interviews. The adjustment for household non-response is equal to the inverse value of: RR = Number of interviewed households / Number of occupied households listed After the completion of fieldwork, response rates were calculated for each sampling domain. These were used to adjust the sample weights calculated for each cluster. Response rates in The Gambia Multiple Indicator Cluster Survey are shown in Table HH.1 in this report. Similarly, the adjustment for non-response at the individual level (women and under-5 children) is equal to the inverse value of: RR = Completed women's (or under-5s) questionnaires / Eligible women (or under-5s) Numbers of eligible women and under-5 children were obtained from the household listing in the Household Questionnaire in households where interviews were completed. The unadjusted weights for the households were calculated by multiplying the above factors for each enumeration area. These weights were then standardized (or normalized), one purpose of which is to make the sum of the interviewed sample units equal the total sample size at the natio- nal level. Normalization is performed by multiplying the aforementioned unadjusted weights by the ratio of the number of completed households to the total unadjusted weighted number of hou- seholds. A similar standardization procedure was followed in obtaining standardized weights for the women's and under-5's questionnaires. Sample weights were appended to all data sets and analyses were performed by weighting each hou- sehold, woman or under-5 with these sample weights. Table: MICS III weights 1 1 1.159443 1.154301 1.222071 2 1 1.021936 1.046005 1.058057 3 1 .756362 .764721 .767337 3 2 1.063019 1.078038 1.085504 4 1 .918385 .958718 .934663 4 2 1.030991 1.047510 1.056498 5 1 1.000438 .993780 1.017013 5 2 .936575 .933412 .953825 6 1 1.738290 1.781459 1.755386 6 2 1.112196 1.162675 1.149876 7 1 .782617 .774395 .790314 7 2 .903480 .900175 .913660 8 1 1.613439 1.596489 1.629307 8 2 .807293 .831640 .828832 LGA Residence hhweight wmweight Chweight The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 159 APPENDIX B: LIST OF PERSONNEL INVOLVED IN THE SURVEY ENUMERATORS FIELD EDITORS SUPERVISORS DRIVERS COORDINATORS ACCOUNTANT CODING SUPERVISORS 1. Jainaba Jallow 2. Fatou Faye 3. Awa Giggo 4. Ndey Binta Bojang 5. Amie Giggo 6. Fatou Fadera 7. Fatou Camara 8. Bintou Badjie 9. Siga Kolly 10. Amie Bahoum 11. Ramatoulie Bojang 12. Abi Jabang 13. Fatou Jobarteh 14. Omar Jabai 15. Aji Njie 16. Dobally Jobe 17. Amie Bojang 18. Ousainou Mbye 19. Mariama Koteh 20. Mustapha Fofana 21. Antoinette Mendy 22. Baba Conateh 23. Nyara Jammeh 24. Bakary Bojang 25. Binta Touray 26. Saiga Joof 27. Penda Bah 28. Alasana Bojang 29. Sarjo Gitteh 30. Mariama Jatta 31. Mbye Baboucarr Jallow 32. Famara Nyabally 33. Famara Janneh 34. Ebrima Konjira 35. Maimuna Darboe 1. Ousman Cham 2. Alagi Conteh 3. Kalilu Njie 4. Modou Gaye 5. Lamin Barrow 6. Ousman Janneh 7. Fabakary Jawneh 1. Karamo Conteh 2. Amadou Sanyang 3. Joseph Sanneh 4. Demba Jatta 5. Faburama Darboe 6. Bakary Samateh 7. Buya Jammeh 8. Momodou Touray 9. Fakebba Tabally 10. Sambou Darboe 1. Alieu Sarr 2. Momodou Fatajo 3. Alieu Ndow Omar Jobe 1. Sedia Bayo 2. Wally Ndow 1. Gorghi Fye 2. Alieu Bahoum 3. Alieu Saho 4. Baba Suwareh 5. Baboucarr Samba 6. Amadou Chorr 7. Baboucarr Daffeh 160 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix B. List of Personnal invelvrd in the Survey CODERS STORAGE CLERKS Programmers Data Entry Supervisors DATA PROCESSING PERSONNEL DATA ENTRY SUPERVISORS TRAINERS - DATA COLLECTION PERSONNEL 1. Pa Mbowe 2. Pa Edi Ndow 3. Salieu Badjan 4. Alieu Sonko 5. Binta Manneh 6. Baboucarr Jallow 7. Amie Njie 8. Mawiya Ayoub 1. Musa Dumbuya 2. Karamo Marenah 1. Edrissa Ceesay 3. Sainabou Jasseh 2. Lolley Jallow 4. Ebou Jawo 1. Mam Demba Senghore 2. Aminata Hydara 3. Lolley Jobe 4. Yama Jaw 5. Oumie Jobe 6. Fatoumata Gassama 7. Amat Sowe 8. Jabou Sanno 9. Yusufa Jatta 10. Fatou Secka 11. Baboucarr Jallow 12. Sainabou Jobe 13. Haji Tunkara 14. Salimata Janneh 15. Lalah Manneh 16. Abie Faye 17. Amie Bojang 18. Mariama Conteh 19 .Naffie Wadda 20. Awa Njie Saidy 21. Isata Rahman 22. Haddy Darboe 23. Jainaba Bayo 24. Pa Mbowe 25. Saffie Sowe 26. Natoma Gassama 27. Nogoi Secka 28. Agie Sima 29. Sana Fofana 30. Abdou Kadirr Touray 31. Isha Secka 32. Ya Kumba John 33. Awa Coker 34. Pa Salieu Badjan 35. Mariama Nyandu 36. Ebrima Kuyateh 1. Alieu Sarr 2. Edrissa Ceesay 3. Lolley Jallow 4. Momodou Phall 5. Momodou Fatajo 6. Baboucarr Boye 7. Nyakassi Sanyang 8. Abba Sanyang The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 161 APPENDIX C: ESTIMATES OF SAMPLING ERRORS The sample of respondents selected in The Gambia Multiple Indicator Cluster Survey is only one of the samples that could have been selected from the same population, using the same design and size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. The extent of variability is not known exactly, but can be estimated statistically from the survey results. The following sampling error measures are presented in this appendix for each of the selected indicators: • Standard error (se): Sampling errors are usually measured in terms of standard errors for par- ticular indicators (means, proportions etc). Standard error is the square root of the variance. The Taylor linearization method is used for the estimation of standard errors. • Coefficient of variation (se/r) is the ratio of the standard error to the value of the indicator • Design effect (deff) is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption of simple random sampling. The square root of the design effect (deft) is used to show the efficiency of the sample design. A deft value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a deft value above 1.0 indicates the increase in the standard error due to the use of a more complex sample design. • Confidence limits are calculated to show the interval within which the true value for the population can be reasonably assumed to fall. For any given statistic calculated from the survey, the value of that statistics will fall within a range of plus or minus two times the standard error (p + 2.se or p - 2.se) of the statistic in 95 per cent of all possible samples of identical size and design. For the calculation of sampling errors from the MICS data, the SPSS Version 14 Complex Samples module has been used. The results are shown in the tables that follow. In addition to the sampling error measures described above, the tables also include weighted and unweighted counts of deno- minators for each indicator. Sampling errors are calculated for indicators of primary interest, for the national total, for the regions, and for the urban and rural areas. Three of the selected indicators are based on households, eight are based on household members, 13 are based on women, and 15 are based on children under 5. All indicators presented here are in the form of proportions. Table SE 1-SE 12 shows the list of indicators for which sampling errors are calculated, including the base population (denomi- nator) for each indicator. Tables SE 2 to SE 12 show the calculated sampling errors. 162 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors Table SE.1: Indicators selected for sampling error calculations List of indicators selected for sampling error calculations, and base populations (denominators) for each indicator, The Gambia, 2006 MICS Indicator Base Population HOUSEHOLDS 30 Household availability of insecticide treated nets All households 41 Iodized salt consumption All households 74 Child discipline Children aged 2-14 years selected HOUSEHOLD MEMBERS 11 Use of improved drinking water sources All household members 12 Use of improved sanitation facilities All household members 55 Net primary school attendance rate Children of primary school age 56 Net secondary school attendance rate Children of secondary school age 59 Primary completion rate Children of primary school completion age 71 Child labour Children aged 5-14 years 75 Prevalence of orphans Children aged under 18 WOMEN 4 Skilled attendant at delivery Women aged 15-49 years with a live birth in the last 2 years 20 Antenatal care Women aged 15-49 years with a live birth in the last 2 years 60 Adult literacy Women aged 15-24 years 63 Prevalence of female genital mutilation/cutting (FGM/C) Women aged 15-49 years 67 Marriage before age 18 Women aged 20-49 years 70 Polygyny Women aged 15-49 years currently married or in union 82 Comprehensive knowledge about HIV prevention among young people Women aged 15-24 years 83 Condom use with non-regular partners Women aged 15-24 years that had a non-marital, non-cohabiting partner in the last 12 months 84 Age at first sex among young people Women aged 15-24 years 86 Attitude towards people with HIV/AIDS Women aged 15-49 years 88 Women who have been tested for HIV Women aged 15-49 years 89 Knowledge of mother- to-child transmission of HIV Women aged 15-49 years UNDER-5s 6 Underweight prevalence Children under age 5 25 Tuberculosis immunization coverage Children aged 12-23 months 26 Polio immunization coverage Children aged 12-23 months 27 Immunization coverage for DPT Children aged 12-23 months 28 Measles immunization coverage Children aged 12-23 months 31 Fully immunized children Children aged 12-23 months - Acute respiratory infection in last two weeks Children under age 5 22 Antibiotic treatment of suspected pneumonia Children under age 5 with suspected pneumonia in the last 2 weeks - Diarrhoea in last two weeks Children under age 5 35 Received ORT or increased fluids and continued feeding Children under age 5 with diarrhoea in the last 2 weeks 37 Under-fives sleeping under insecticide treated nets Children under age 5 - Fever in last two weeks Children under age 5 39 Antimalarial treatment Children under age 5 with fever in the last 2 weeks 46 Support for learning Children under age 5 62 Birth registration Children under age 5 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 163 Appendix C. Esimates of Sampling errors Table SE.2: Sampling errors:The Gambia Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 HOUSEHOLDS Household availability of ITNs CH.10 0.495 0.009 0.019 2.041 1.429 6071 6071 0.477 0.513 Iodized salt consumption NU.5 0.071 0.005 0.071 2.145 1.465 5512 5524 0.061 0.081 Child discipline CP.4 0.842 0.006 0.007 1.386 1.177 4709 4736 0.830 0.855 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.851 0.013 0.015 7.977 2.824 44877 45721 0.825 0.877 Use of improved sanitation facilities EN.5 0.842 0.008 0.010 2.999 1.732 44877 45721 0.826 0.858 Net primary school attendance rate ED.3 0.609 0.012 0.020 4.971 2.230 7787 7967 0.585 0.633 Net secondary school attendance rate ED.4 0.365 0.011 0.031 3.803 1.950 6642 6774 0.342 0.388 Primary completion rate ED.6 0.736 0.015 0.020 1.526 1.235 1311 1338 0.706 0.765 Child labour CP.2 0.247 0.005 0.022 2.161 1.470 13409 13729 0.236 0.258 Prevalence of orphans HA.10 0.087 0.003 0.037 3.018 1.737 22859 23379 0.080 0.093 WOMEN Skilled attendant at delivery RH.5 0.568 0.012 0.020 1.675 1.294 3070 3093 0.545 0.591 Antenatal care RH.3 0.978 0.002 0.002 0.791 0.889 3070 3093 0.973 0.982 Adult literacy ED.8 0.431 0.012 0.027 2.382 1.543 4306 4290 0.407 0.454 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.783 0.011 0.014 6.962 2.639 9982 9982 0.761 0.805 Marriage before age 18 CP.5 0.487 0.008 0.016 1.785 1.336 7700 7705 0.472 0.502 Polygyny CP.5 0.436 0.008 0.019 1.839 1.356 6839 6904 0.419 0.452 Comprehensive knowledge about HIV prevention among young people HA.3 0.393 0.009 0.023 1.490 1.221 4290 4306 0.374 0.411 Condom use with non-regular partners HA.9 0.543 0.024 0.044 0.675 0.822 310 297 0.495 0.590 Age at first sex among young people HA.8 0.039 0.005 0.124 1.442 1.201 2282 2277 0.030 0.049 Attitude towards people with HIV/AIDS HA.5 0.163 0.005 0.030 1.783 1.335 9907 9906 0.154 0.173 Women who have been tested for HIV HA.6 0.136 0.005 0.035 1.951 1.397 9982 9982 0.127 0.146 Knowledge of mother- to-child transmission of HIV HA.4 0.667 0.006 0.008 1.437 1.199 9982 9982 0.656 0.678 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se 164 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors UNDER-5s Underweight prevalence NU.1 0.203 0.006 0.028 1.277 1.130 6390 6390 0.192 0.214 Tuberculosis immunization coverage CH.2 0.987 0.003 0.003 0.732 0.856 1486 1481 0.982 0.992 Polio immunization coverage CH.2 0.870 0.008 0.009 0.855 0.925 1486 1481 0.854 0.886 Immunization coverage for DPT CH.2 0.863 0.010 0.011 1.132 1.064 1486 1481 0.844 0.882 Measles immunization coverage CH.2 0.920 0.008 0.008 1.177 1.085 1486 1481 0.904 0.935 Fully immunized children CH.2 0.742 0.012 0.016 1.062 1.031 1486 1481 0.718 0.765 Acute respiratory infection in last two weeks CH.6 0.056 0.003 0.056 1.231 1.110 6543 6543 0.050 0.062 Antibiotic treatment of suspected pneumonia CH.7 0.613 0.028 0.045 1.170 1.082 366 362 0.558 0.669 Diarrhoea in last two weeks CH.4 0.191 0.006 0.030 1.385 1.177 6543 6543 0.180 0.203 Received ORT or increased fluids and continued feeding CH.5 0.379 0.018 0.048 1.773 1.331 1251 1260 0.343 0.416 Under-fives sleeping under insecticide treated nets CH.11 0.490 0.013 0.026 4.263 2.065 6543 6543 0.465 0.516 Fever in last two weeks CH.12 0.084 0.004 0.047 1.299 1.140 6543 6543 0.076 0.092 Antimalarial treatment CH.12 0.524 0.021 0.040 0.968 0.984 549 538 0.481 0.566 Support for learning CD.1 0.469 0.008 0.017 1.612 1.270 6543 6543 0.454 0.485 Birth registration CP.1 0.551 0.011 0.020 3.047 1.746 6543 6543 0.529 0.572 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 165 Appendix C. Esimates of Sampling errors Table SE.3: Sampling errors: Urban Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 HOUSEHOLDS Household availability of ITNs CH.10 0.340 0.012 0.037 1.989 1.410 2930 2890 0.315 0.364 Iodized salt consumption NU.5 0.061 0.008 0.129 2.676 1.636 2527 2498 0.045 0.076 Child discipline CP.4 0.844 0.009 0.010 1.142 1.069 2010 1988 0.826 0.861 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.912 0.010 0.012 3.952 1.988 17448 17303 0.891 0.933 Use of improved sanitation facilities EN.5 0.933 0.008 0.009 3.137 1.771 17448 17303 0.917 0.950 Net primary school attendance rate ED.3 0.736 0.011 0.015 1.531 1.237 2572 2563 0.714 0.757 Net secondary school attendance rate ED.4 0.524 0.013 0.025 1.750 1.323 2579 2574 0.498 0.550 Primary completion rate ED.6 0.843 0.019 0.023 1.310 1.144 462 460 0.805 0.882 Child labour CP.2 0.169 0.008 0.045 1.848 1.359 4482 4480 0.154 0.184 Prevalence of orphans HA.10 0.086 0.005 0.057 2.458 1.568 7993 7956 0.076 0.096 WOMEN Skilled attendant at delivery RH.5 0.830 0.012 0.015 1.100 1.049 1037 1020 0.806 0.855 Antenatal care RH.3 0.975 0.005 0.005 0.842 0.918 1037 1020 0.966 0.984 Adult literacy ED.8 0.584 0.014 0.025 1.586 1.259 1906 1877 0.555 0.613 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.722 0.013 0.019 3.779 1.944 4251 4189 0.695 0.749 Marriage before age 18 CP.5 0.359 0.011 0.030 1.597 1.264 3255 3204 0.337 0.380 Polygyny CP.5 0.335 0.011 0.031 1.213 1.101 2471 2438 0.314 0.356 Comprehensive knowledge about HIV prevention among young people HA.3 0.424 0.014 0.034 1.557 1.248 1877 1906 0.396 0.453 Condom use with non-regular partners HA.9 0.538 0.031 0.057 0.695 0.834 190 183 0.477 0.600 Age at first sex among young people HA.8 0.020 0.005 0.256 1.294 1.137 996 985 0.010 0.030 Attitude towards people with HIV/AIDS HA.5 0.185 0.009 0.048 2.182 1.477 4210 4149 0.167 0.203 Women who have been tested for HIV HA.6 0.166 0.008 0.048 1.932 1.390 4251 4189 0.150 0.182 Knowledge of mother- to-child transmission of HIV HA.4 0.586 0.010 0.017 1.732 1.316 4251 4189 0.566 0.606 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se 166 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors UNDER-5s Underweight prevalence NU.1 0.147 0.008 0.053 1.072 1.035 2272 2178 0.132 0.163 Tuberculosis immunization coverage CH.2 0.973 0.006 0.006 0.623 0.789 496 474 0.962 0.985 Polio immunization coverage CH.2 0.838 0.014 0.017 0.716 0.846 496 474 0.809 0.866 Immunization coverage for DPT CH.2 0.859 0.017 0.019 1.087 1.043 496 474 0.826 0.892 Measles immunization coverage CH.2 0.899 0.015 0.017 1.188 1.090 496 474 0.869 0.930 Fully immunized children CH.2 0.705 0.020 0.029 0.949 0.974 496 474 0.664 0.746 Acute respiratory infection in last two weeks CH.6 0.055 0.006 0.100 1.289 1.136 2303 2202 0.044 0.067 Antibiotic treatment of suspected pneumonia CH.7 0.597 0.042 0.070 0.869 0.932 128 120 0.513 0.681 Diarrhoea in last two weeks CH.4 0.157 0.009 0.060 1.467 1.211 2303 2202 0.138 0.176 Received ORT or increased fluids and continued feeding CH.5 0.319 0.027 0.084 1.144 1.070 361 344 0.265 0.373 Under-fives sleeping under insecticide treated nets CH.11 0.382 0.016 0.043 2.527 1.590 2202 2303 0.349 0.415 Fever in last two weeks CH.12 0.095 0.007 0.071 1.169 1.081 2303 2202 0.081 0.108 Antimalarial treatment CH.12 0.537 0.034 0.064 0.950 0.974 218 201 0.468 0.605 Support for learning CD.1 0.481 0.013 0.027 1.539 1.241 2303 2202 0.455 0.508 Birth registration CP.1 0.571 0.014 0.025 1.857 1.363 2303 2202 0.542 0.600 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 167 Appendix C. Esimates of Sampling errors Table SE.4: Sampling errors: Rural Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 HOUSEHOLDS Household availability of ITNs CH.10 0.640 0.014 0.021 2.521 1.588 3141 3181 0.613 0.667 Iodized salt consumption NU.5 0.080 0.007 0.083 1.799 1.341 2985 3026 0.067 0.094 Child discipline CP.4 0.841 0.009 0.010 1.566 1.251 2699 2748 0.824 0.859 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.813 0.020 0.024 7.967 2.823 27429 28418 0.774 0.852 Use of improved sanitation facilities EN.5 0.784 0.012 0.016 2.773 1.665 27429 28418 0.760 0.808 Net primary school attendance rate ED.3 0.546 0.016 0.030 5.822 2.413 5215 5404 0.514 0.579 Net secondary school attendance rate ED.4 0.264 0.014 0.053 4.275 2.068 4064 4200 0.236 0.293 Primary completion rate ED.6 0.677 0.020 0.030 1.626 1.275 848 878 0.637 0.717 Child labour CP.2 0.286 0.007 0.025 2.364 1.537 8928 9249 0.272 0.301 Prevalence of orphans HA.10 0.087 0.004 0.048 3.314 1.820 14865 15423 0.079 0.095 WOMEN Skilled attendant at delivery RH.5 0.434 0.015 0.035 1.922 1.386 2033 2073 0.404 0.464 Antenatal care RH.3 0.979 0.003 0.003 0.755 0.869 2033 2073 0.973 0.984 Adult literacy ED.8 0.309 0.015 0.049 2.591 1.610 2400 2413 0.278 0.339 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.828 0.016 0.019 10.377 3.221 5731 5793 0.796 0.860 Marriage before age 18 CP.5 0.581 0.009 0.016 1.648 1.284 4444 4501 0.562 0.600 Polygyny CP.5 0.493 0.010 0.021 1.928 1.389 4368 4466 0.472 0.513 Comprehensive knowledge about HIV prevention among young people HA.3 0.368 0.011 0.031 1.339 1.157 2413 2400 0.345 0.390 Condom use with non-regular partners HA.9 0.550 0.037 0.068 0.641 0.801 120 114 0.475 0.625 Age at first sex among young people HA.8 0.055 0.008 0.141 1.478 1.216 1286 1292 0.039 0.070 Attitude towards people with HIV/AIDS HA.5 0.147 0.005 0.037 1.362 1.167 5697 5757 0.136 0.158 Women who have been tested for HIV HA.6 0.114 0.006 0.050 1.852 1.361 5731 5793 0.103 0.126 Knowledge of mother-to-child transmission of HIV HA.4 0.727 0.007 0.009 1.235 1.111 5731 5793 0.714 0.740 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se 168 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors UNDER-5s Underweight prevalence NU.1 0.234 0.008 0.032 1.333 1.155 4119 4212 0.219 0.249 Tuberculosis immunization coverage CH.2 0.993 0.002 0.002 0.921 0.960 990 1007 0.988 0.998 Polio immunization coverage CH.2 0.886 0.010 0.011 0.939 0.969 990 1007 0.867 0.906 Immunization coverage for DPT CH.2 0.864 0.012 0.013 1.151 1.073 990 1007 0.841 0.888 Measles immunization coverage CH.2 0.930 0.009 0.009 1.163 1.078 990 1007 0.913 0.947 Fully immunized children CH.2 0.760 0.014 0.019 1.133 1.065 990 1007 0.732 0.789 Acute respiratory infection in last two weeks CH.6 0.056 0.004 0.068 1.193 1.092 4240 4341 0.048 0.064 Antibiotic treatment of suspected pneumonia CH.7 0.622 0.036 0.057 1.300 1.140 238 242 0.551 0.694 Diarrhoea in last two weeks CH.4 0.210 0.007 0.034 1.309 1.144 4240 4341 0.196 0.224 Received ORT or increased fluids and continued feeding CH.5 0.404 0.023 0.056 1.961 1.400 890 916 0.358 0.449 Under-fives sleeping under insecticide treated nets CH.11 0.549 0.018 0.033 5.597 2.366 4341 4240 0.513 0.584 Fever in last two weeks CH.12 0.078 0.005 0.060 1.322 1.150 4240 4341 0.069 0.087 Antimalarial treatment CH.12 0.515 0.026 0.051 0.918 0.958 331 337 0.463 0.568 Support for learning CD.1 0.463 0.010 0.021 1.690 1.300 4240 4341 0.443 0.483 Birth registration CP.1 0.539 0.015 0.027 3.743 1.935 4240 4341 0.510 0.569 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 169 Appendix C. Esimates of Sampling errors Table SE.5: Sampling errors: Banjul Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se HOUSEHOLDS Household availability of ITNs CH.10 0.286 0.040 0.142 2.129 1.459 308 266 0.205 0.367 Iodized salt consumption NU.5 0.015 0.011 0.749 1.699 1.303 230 198 0.000 0.038 Child discipline CP.4 0.927 0.018 0.020 0.744 0.862 175 151 0.891 0.964 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.808 0.041 0.050 2.805 1.675 1507 1300 0.727 0.889 Use of improved sanitation facilities EN.5 0.966 0.015 0.015 1.718 1.311 1507 1300 0.937 0.995 Net primary school attendance rate ED.3 0.770 0.029 0.037 0.744 0.863 187 161 0.713 0.828 Net secondary school attendance rate ED.4 0.560 0.048 0.085 1.545 1.243 1948 168 0.464 0.655 Primary completion rate ED.6 0.913 0.063 0.068 1.083 1.041 27 23 0.788 1.000 Child labour CP.2 0.115 0.022 0.192 1.291 1.136 313 270 0.071 0.159 Prevalence of orphans HA.10 0.084 0.022 0.263 3.318 1.821 608 524 0.040 0.128 WOMEN Skilled attendant at delivery RH.5 0.947 0.016 0.017 0.398 0.631 75 76 0.915 0.980 Antenatal care RH.3 1.000 0.000 0.000 . . 75 76 1.000 1.000 Adult literacy ED.8 0.652 0.051 0.079 1.796 1.340 154 155 0.549 0.755 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.448 0.036 0.081 1.731 1.316 324 326 0.375 0.520 Marriage before age 18 CP.5 0.299 0.025 0.084 0.723 0.851 242 244 0.249 0.349 Polygyny CP.5 0.159 0.028 0.178 1.016 1.008 169 170 0.102 0.216 Comprehensive knowledge about HIV prevention among young people HA.3 0.374 0.042 0.111 1.136 1.066 155 154 0.291 0.457 Condom use with non-regular partners HA.9 0.538 0.006 0.011 0.002 0.041 13 13 0.527 0.550 Age at first sex among young people HA.8 0.000 0.000 . . . 81 82 0.000 0.000 Attitude towards people with HIV/AIDS HA.5 0.131 0.009 0.067 0.219 0.468 318 320 0.114 0.149 Women who have been tested for HIV HA.6 0.092 0.018 0.191 1.198 1.094 324 326 0.057 0.127 Knowledge of mother- to-child transmission of HIV HA.4 0.543 0.037 0.068 1.779 1.334 324 326 0.469 0.617 170 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se UNDER-5s Underweight prevalence NU.1 0.175 0.024 0.137 0.631 0.795 196 160 0.127 0.223 Tuberculosis immunization coverage CH.2 0.977 0.001 0.001 0.001 0.033 53 43 0.975 0.978 Polio immunization coverage CH.2 0.860 0.041 0.047 0.575 0.758 53 43 0.779 0.942 Immunization coverage for DPT CH.2 0.930 0.032 0.034 0.655 0.809 53 43 0.867 0.994 Measles immunization coverage CH.2 0.907 0.052 0.057 1.351 1.162 53 43 0.803 1.000 Fully immunized children CH.2 0.767 0.062 0.081 0.905 0.951 53 43 0.643 0.891 Acute respiratory infection in last two weeks CH.6 0.006 0.006 0.942 0.887 0.942 196 160 0.000 0.018 Antibiotic treatment of suspected pneumonia CH.7 0.000 0.000 . . . 1 1 0.000 0.000 Diarrhoea in last two weeks CH.4 0.144 0.029 0.200 1.067 1.033 196 160 0.086 0.201 Received ORT or increased fluids and continued feeding CH.5 0.435 0.170 0.392 2.598 1.612 28 23 0.094 0.775 Under-fives sleeping under insecticide treated nets CH.11 0.425 0.057 0.135 2.127 1.458 196 160 0.311 0.539 Fever in last two weeks CH.12 0.156 0.028 0.180 0.955 0.977 196 160 0.100 0.213 Antimalarial treatment CH.12 0.280 0.117 0.416 1.619 1.272 31 25 0.047 0.513 Support for learning CD.1 0.256 0.032 0.125 0.849 0.922 196 160 0.192 0.320 Birth registration CP.1 0.769 0.032 0.041 0.892 0.945 196 160 0.706 0.832 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 171 Appendix C. Esimates of Sampling errors Table SE.6: Sampling errors: Kanifing Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se HOUSEHOLDS Household availability of ITNs CH.10 0.286 0.040 0.142 2.129 1.459 308 266 0.205 0.367 Iodized salt consumption NU.5 0.015 0.011 0.749 1.699 1.303 230 198 0.000 0.038 Child discipline CP.4 0.927 0.018 0.020 0.744 0.862 175 151 0.891 0.964 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.808 0.041 0.050 2.805 1.675 1507 1300 0.727 0.889 Use of improved sanitation facilities EN.5 0.966 0.015 0.015 1.718 1.311 1507 1300 0.937 0.995 Net primary school attendance rate ED.3 0.770 0.029 0.037 0.744 0.863 187 161 0.713 0.828 Net secondary school attendance rate ED.4 0.560 0.048 0.085 1.545 1.243 195 168 0.464 0.655 Primary completion rate ED.6 0.913 0.063 0.068 1.083 1.041 27 23 0.788 1.000 Child labour CP.2 0.115 0.022 0.192 1.291 1.136 313 270 0.071 0.159 Prevalence of orphans HA.10 0.084 0.022 0.263 3.318 1.821 608 524 0.040 0.128 WOMEN Skilled attendant at delivery RH.5 0.947 0.016 0.017 0.398 0.631 75 76 0.915 0.980 Antenatal care RH.3 1.000 0.000 0.000 . . 75 76 1.000 1.000 Adult literacy ED.8 0.652 0.051 0.079 1.796 1.340 154 155 0.549 0.755 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.448 0.036 0.081 1.731 1.316 324 326 0.375 0.520 Marriage before age 18 CP.5 0.299 0.025 0.084 0.723 0.851 242 244 0.249 0.349 Polygyny CP.5 0.159 0.028 0.178 1.016 1.008 169 170 0.102 0.216 Comprehensive knowledge about HIV prevention among young people HA.3 0.374 0.042 0.111 1.136 1.066 154 155 0.291 0.457 Condom use with non-regular partners HA.9 0.538 0.006 0.011 0.002 0.041 13 13 0.527 0.550 Age at first sex among young people HA.8 0.000 0.000 . . . 81 82 0.000 0.000 Attitude towards people with HIV/AIDS HA.5 0.131 0.009 0.067 0.219 0.468 318 320 0.114 0.149 Women who have been tested for HIV HA.6 0.092 0.018 0.191 1.198 1.094 324 326 0.057 0.127 Knowledge of mother- to-child transmission of HIV HA.4 0.543 0.037 0.068 1.779 1.334 324 326 0.469 0.617 172 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se UNDER-5s Underweight prevalence NU.1 0.175 0.024 0.137 0.631 0.795 196 160 0.127 0.223 Tuberculosis immunization coverage CH.2 0.977 0.001 0.001 0.001 0.033 53 43 0.975 0.978 Polio immunization coverage CH.2 0.860 0.041 0.047 0.575 0.758 53 43 0.779 0.942 Immunization coverage for DPT CH.2 0.930 0.032 0.034 0.655 0.809 53 43 0.867 0.994 Measles immunization coverage CH.2 0.907 0.052 0.057 1.351 1.162 53 43 0.803 1.000 Fully immunized children CH.2 0.767 0.062 0.081 0.905 0.951 53 43 0.643 0.891 Acute respiratory infection in last two weeks CH.6 0.006 0.006 0.942 0.887 0.942 196 160 0.000 0.018 Antibiotic treatment of suspected pneumonia CH.7 0.000 0.000 . . . 1 1 0.000 0.000 Diarrhoea in last two weeks CH.4 0.144 0.029 0.200 1.067 1.033 196 160 0.086 0.201 Received ORT or increased fluids and continued feeding CH.5 0.435 0.170 0.392 2.598 1.612 28 23 0.094 0.775 Under-fives sleeping under insecticide treated nets CH.11 0.425 0.057 0.135 2.127 1.458 196 160 0.311 0.539 Fever in last two weeks CH.12 0.156 0.028 0.180 0.955 0.977 196 160 0.100 0.213 Antimalarial treatment CH.12 0.280 0.117 0.416 1.619 1.272 31 25 0.047 0.513 Support for learning CD.1 0.256 0.032 0.125 0.849 0.922 196 160 0.192 0.320 Birth registration CP.1 0.769 0.032 0.041 0.892 0.945 196 160 0.706 0.832 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 173 Appendix C. Esimates of Sampling errors Table SE.7: Sampling errors: Brikama Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se HOUSEHOLDS Household availability of ITNs CH.10 0.562 0.019 0.035 2.525 1.589 1652 1646 0.523 0.601 Iodized salt consumption NU.5 0.016 0.004 0.273 1.833 1.354 1530 1519 0.007 0.025 Child discipline CP.4 0.782 0.017 0.022 2.140 1.463 1278 1265 0.748 0.816 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.790 0.021 0.027 4.396 2.097 11132 11048 0.748 0.832 Use of improved sanitation facilities EN.5 0.940 0.009 0.009 2.336 1.528 11132 11048 0.923 0.958 Net primary school attendance rate ED.3 0.719 0.016 0.022 2.382 1.544 1938 1915 0.687 0.751 Net secondary school attendance rate ED.4 0.433 0.017 0.039 2.019 1.421 1724 1718 0.399 0.467 Primary completion rate ED.6 0.834 0.025 0.030 1.389 1.179 317 315 0.784 0.883 Child labour CP.2 0.208 0.011 0.052 2.392 1.547 3436 3398 0.187 0.230 Prevalence of orphans HA.10 0.096 0.006 0.061 2.224 1.491 5645 5583 0.084 0.108 WOMEN Skilled attendant at delivery RH.5 0.653 0.020 0.030 1.168 1.081 750 695 0.613 0.692 Antenatal care RH.3 0.985 0.004 0.004 0.837 0.915 750 695 0.976 0.993 Adult literacy ED.8 0.525 0.018 0.034 1.364 1.168 1154 1083 0.489 0.560 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.870 0.016 0.018 5.153 2.270 2549 2387 0.838 0.901 Marriage before age 18 CP.5 0.431 0.016 0.037 1.915 1.384 1930 1804 0.398 0.463 Polygyny CP.5 0.372 0.017 0.044 1.810 1.346 1661 1548 0.339 0.405 Comprehensive knowledge about HIV prevention among young people HA.3 0.494 0.016 0.033 1.138 1.067 1154 1083 0.462 0.527 Condom use with non-regular partners HA.9 0.480 0.044 0.092 0.607 0.779 87 79 0.392 0.569 Age at first sex among young people HA.8 0.042 0.011 0.253 1.639 1.280 619 583 0.021 0.064 Attitude towards people with HIV/AIDS HA.5 0.142 0.010 0.070 1.943 1.394 2545 2384 0.122 0.162 Women who have been tested for HIV HA.6 0.188 0.011 0.057 1.823 1.350 2549 2387 0.167 0.210 Knowledge of mother- to-child transmission of HIV HA.4 0.775 0.011 0.014 1.525 1.235 2549 2387 0.754 0.796 174 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se UNDER-5s Underweight prevalence NU.1 0.168 0.012 0.070 1.355 1.164 1413 1365 0.144 0.191 Tuberculosis immunization coverage CH.2 0.980 0.006 0.006 0.633 0.796 347 336 0.968 0.993 Polio immunization coverage CH.2 0.834 0.021 0.025 1.068 1.033 347 336 0.792 0.876 Immunization coverage for DPT CH.2 0.887 0.018 0.020 1.055 1.027 347 336 0.851 0.922 Measles immunization coverage CH.2 0.915 0.017 0.019 1.241 1.114 347 336 0.881 0.949 Fully immunized children CH.2 0.725 0.027 0.037 1.218 1.104 347 336 0.672 0.779 Acute respiratory infection in last two weeks CH.6 0.044 0.005 0.120 0.899 0.948 1425 1376 0.033 0.054 Antibiotic treatment of suspected pneumonia CH.7 0.636 0.039 0.061 0.378 0.615 62 59 0.558 0.714 Diarrhoea in last two weeks CH.4 0.155 0.011 0.068 1.166 1.080 1425 1376 0.134 0.176 Received ORT or increased fluids and continued feeding CH.5 0.404 0.028 0.070 0.691 0.831 221 211 0.348 0.460 Under-fives sleeping under insecticide treated nets CH.11 0.623 0.021 0.034 2.660 1.631 1425 1376 0.580 0.666 Fever in last two weeks CH.12 0.077 0.010 0.124 1.767 1.329 1425 1376 0.058 0.096 Antimalarial treatment CH.12 0.650 0.039 0.061 0.701 0.837 110 104 0.571 0.728 Support for learning CD.1 0.442 0.018 0.041 1.806 1.344 1425 1376 0.406 0.478 Birth registration CP.1 0.558 0.026 0.047 3.829 1.957 1425 1376 0.506 0.611 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 175 Appendix C. Esimates of Sampling errors Table SE.8: Sampling errors: Mansakonko Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se HOUSEHOLDS Household availability of ITNs CH.10 0.764 0.030 0.039 1.784 1.336 3572 361 0.704 0.824 Iodized salt consumption NU.5 0.023 0.007 0.316 0.787 0.887 328 331 0.009 0.038 Child discipline CP.4 0.878 0.017 0.019 0.831 0.912 304 307 0.844 0.912 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.826 0.086 0.104 18.655 4.319 2965 2977 0.654 0.999 Use of improved sanitation facilities EN.5 0.655 0.030 0.046 1.432 1.197 2965 2977 0.595 0.715 Net primary school attendance rate ED.3 0.548 0.077 0.141 15.550 3.943 648 647 0.394 0.703 Net secondary school attendance rate ED.4 0.272 0.066 0.243 10.699 3.271 487 488 0.140 0.404 Primary completion rate ED.6 0.857 0.052 0.061 2.337 1.529 105 105 0.752 0.962 Child labour CP.2 0.324 0.027 0.083 3.545 1.883 1064 1064 0.270 0.378 Prevalence of orphans HA.10 0.128 0.013 0.101 2.551 1.597 1701 1704 0.102 0.153 WOMEN Skilled attendant at delivery RH.5 0.465 0.055 0.118 2.137 1.462 167 179 0.356 0.574 Antenatal care RH.3 0.972 0.009 0.009 0.479 0.692 167 179 0.955 0.989 Adult literacy ED.8 0.363 0.074 0.203 5.257 2.293 207 225 0.216 0.511 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.959 0.016 0.017 3.798 1.949 531 573 0.926 0.991 Marriage before age 18 CP.5 0.583 0.030 0.052 1.634 1.278 407 439 0.522 0.643 Polygyny CP.5 0.514 0.025 0.048 1.017 1.008 390 420 0.464 0.563 Comprehensive knowledge about HIV prevention among young people HA.3 0.319 0.045 0.142 2.125 1.458 207 255 0.228 0.409 Condom use with non-regular partners HA.9 0.854 0.072 0.084 0.533 0.730 12 14 0.711 0.997 Age at first sex among young people HA.8 0.039 0.033 0.855 3.911 1.978 124 134 0.000 0.105 Attitude towards people with HIV/AIDS HA.5 0.220 0.026 0.120 2.320 1.523 527 569 0.167 0.273 Women who have been tested for HIV HA.6 0.072 0.012 0.170 1.287 1.134 531 573 0.048 0.097 Knowledge of mother- to-child transmission of HIV HA.4 0.727 0.012 0.017 0.438 0.661 531 573 0.702 0.751 176 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se UNDER-5s Underweight prevalence NU.1 0.270 0.022 0.081 0.970 0.985 404 397 0.226 0.313 Tuberculosis immunization coverage CH.2 1.000 0.000 0.000 . . 85 83 1.000 1.000 Polio immunization coverage CH.2 0.903 0.030 0.033 0.839 0.916 85 83 0.843 0.963 Immunization coverage for DPT CH.2 0.903 0.030 0.033 0.839 0.916 85 83 0.843 0.963 Measles immunization coverage CH.2 0.977 0.016 0.017 0.966 0.983 85 83 0.944 1.000 Fully immunized children CH.2 0.867 0.033 0.038 0.760 0.872 85 83 0.802 0.932 Acute respiratory infection in last two weeks CH.6 0.040 0.010 0.251 1.055 1.027 406 399 0.020 0.061 Antibiotic treatment of suspected pneumonia CH.7 0.507 0.148 0.292 1.313 1.146 16 16 0.212 0.803 Diarrhoea in last two weeks CH.4 0.132 0.032 0.244 3.590 1.895 406 399 0.068 0.196 Received ORT or increased fluids and continued feeding CH.5 0.285 0.081 0.284 1.672 1.293 54 53 0.123 0.446 Under-fives sleeping under insecticide treated nets CH.11 0.666 0.061 0.092 6.733 2.595 406 399 0.543 0.788 Fever in last two weeks CH.12 0.034 0.009 0.267 1.005 1.003 406 399 0.016 0.053 Antimalarial treatment CH.12 0.790 0.093 0.117 0.675 0.821 14 14 0.605 0.976 Support for learning CD.1 0.463 0.031 0.067 1.548 1.244 406 399 0.401 0.526 Birth registration CP.1 0.864 0.019 0.022 1.227 1.108 406 399 0.826 0.902 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 177 Appendix C. Esimates of Sampling errors Table SE.9: Sampling errors: Kerewan Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se HOUSEHOLDS Household availability of ITNs CH.10 0.569 0.031 0.055 2.978 1.726 718 754 0.507 0.632 Iodized salt consumption NU.5 0.024 0.007 0.306 1.667 1.291 697 732 0.009 0.038 Child discipline CP.4 0.842 0.013 0.015 0.820 0.905 624 656 0.817 0.868 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.891 0.015 0.017 1.839 1.356 5139 5414 0.860 0.922 Use of improved sanitation facilities EN.5 0.862 0.015 0.018 1.464 1.210 5139 5414 0.832 0.893 Net primary school atten dance rate ED.3 0.494 0.040 0.080 6.552 2.560 995 1050 0.415 0.573 Net secondary school attendance rate ED.4 0.279 0.037 0.133 5.187 2.277 724 762 0.205 0.353 Primary completion rate ED.6 0.584 0.050 0.086 1.785 1.336 163 172 0.483 0.685 Child labour CP.2 0.361 0.020 0.055 3.065 1.751 1718 1812 0.321 0.400 Prevalence of orphans HA.10 0.045 0.004 0.081 0.922 0.960 2818 2972 0.038 0.052 WOMEN Skilled attendant at delivery RH.5 0.446 0.032 0.072 1.697 1.303 377 406 0.382 0.510 Antenatal care RH.3 0.958 0.010 0.010 0.915 0.956 377 406 0.939 0.977 Adult literacy ED.8 0.295 0.042 0.144 3.473 1.864 375 404 0.210 0.379 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.608 0.058 0.095 15.255 3.906 1012 1090 0.493 0.724 Marriage before age 18 CP.5 0.476 0.022 0.046 1.661 1.289 813 876 0.432 0.520 Polygyny CP.5 0.489 0.028 0.058 2.759 1.661 803 865 0.433 0.546 Comprehensive knowledge about HIV prevention among young people HA.3 0.473 0.030 0.063 1.437 1.199 375 404 0.413 0.532 Condom use with non-regular partners HA.9 0.737 0.055 0.074 0.279 0.529 18 19 0.627 0.847 Age at first sex among young people HA.8 0.051 0.015 0.294 0.994 0.997 199 214 0.021 0.082 Attitude towards people with HIV/AIDS HA.5 0.134 0.014 0.108 1.948 1.396 1012 1090 0.105 0.163 Women who have been tested for HIV HA.6 0.139 0.011 0.075 1.003 1.002 1012 1090 0.118 0.160 Knowledge of mother- to-child transmission of HIV HA.4 0.780 0.016 0.021 1.715 1.309 1012 1090 0.747 0.813 178 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se UNDER-5s Underweight prevalence NU.1 0.237 0.015 0.064 1.101 1.049 823 853 0.207 0.268 Tuberculosis immunization coverage CH.2 0.990 0.007 0.007 0.888 0.943 191 198 0.977 1.000 Polio immunization coverage CH.2 0.843 0.023 0.027 0.787 0.887 191 198 0.797 0.889 Immunization coverage for DPT CH.2 0.773 0.044 0.057 2.144 1.464 191 198 0.686 0.860 Measles immunization coverage CH.2 0.919 0.020 0.022 1.112 1.055 191 198 0.878 0.960 Fully immunized children CH.2 0.677 0.040 0.058 1.409 1.187 191 198 0.598 0.756 Acute respiratory infection in last two weeks CH.6 0.064 0.007 0.108 0.691 0.831 826 856 0.050 0.078 Antibiotic treatment of suspected pneumonia CH.7 0.728 0.048 0.066 0.625 0.790 53 55 0.632 0.823 Diarrhoea in last two weeks CH.4 0.204 0.014 0.070 1.080 1.039 826 856 0.176 0.233 Received ORT or increased fluids and continued feeding CH.5 0.251 0.040 0.159 1.474 1.214 169 175 0.171 0.331 Under-fives sleeping under insecticide treated nets CH.11 0.540 0.039 0.072 5.239 2.289 826 856 0.462 0.618 Fever in last two weeks CH.12 0.097 0.010 0.102 0.953 0.976 826 856 0.077 0.117 Antimalarial treatment CH.12 0.520 0.055 0.106 1.003 1.002 80 83 0.409 0.630 Support for learning CD.1 0.889 0.025 0.029 5.612 2.369 826 856 0.838 0.940 Birth registration CP.1 0.480 0.024 0.050 1.976 1.406 826 856 0.432 0.528 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 179 Appendix C. Esimates of Sampling errors Table SE.10: Sampling errors: Kuntaur Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se HOUSEHOLDS Household availability of ITNs CH.10 0.666 0.028 0.042 0.932 0.965 306 264 0.666 0.028 Iodized salt consumption NU.5 0.169 0.034 0.199 1.995 1.413 287 250 0.102 0.236 Child discipline CP.4 0.974 0.006 0.006 0.378 0.615 285 247 0.962 0.987 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.834 0.069 0.083 9.009 3.002 3028 2652 0.696 0.972 Use of improved sanitation facilities EN.5 0.771 0.068 0.088 6.946 2.636 3028 2652 0.635 0.908 Net primary school attendance rate ED.3 0.412 0.055 0.134 6.640 2.577 608 532 0.301 0.522 Net secondary school attendance rate ED.4 0.279 0.037 0.133 5.187 2.277 724 762 0.205 0.353 Primary completion rate ED.6 0.578 0.075 0.130 2.104 1.451 105 92 0.428 0.728 Child labour CP.2 0.256 0.020 0.079 1.871 1.368 994 872 0.216 0.297 Prevalence of orphans HA.10 0.073 0.013 0.181 3.799 1.949 1676 1476 0.047 0.100 WOMEN Skilled attendant at delivery RH.5 0.284 0.047 0.166 2.351 1.533 232 216 0.190 0.378 Antenatal care RH.3 0.963 0.007 0.007 0.285 0.534 232 216 0.949 0.977 Adult literacy ED.8 0.162 0.042 0.256 2.761 1.661 235 218 0.079 0.245 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.687 0.066 0.095 10.083 3.175 547 506 0.556 0.818 Marriage before age 18 CP.5 0.735 0.035 0.048 2.429 1.559 416 385 0.664 0.805 Polygyny CP.5 0.525 0.013 0.025 0.289 0.537 444 412 0.499 0.552 Comprehensive knowledge about HIV prevention among young people HA.3 0.325 0.026 0.080 0.674 0.821 235 218 0.273 0.377 Condom use with non-regular partners HA.9 0.500 0.000 0.000 0.000 0.000 6 6 0.500 0.500 Age at first sex among young people HA.8 0.090 0.021 0.239 0.677 0.823 131 121 0.047 0.133 Attitude towards people with HIV/AIDS HA.5 0.247 0.025 0.103 1.737 1.318 541 500 0.196 0.298 Women who have been tested for HIV HA.6 0.057 0.017 0.292 2.613 1.616 547 506 0.024 0.091 Knowledge of mother- to-child transmission of HIV HA.4 0.569 0.011 0.019 0.249 0.499 547 506 0.547 0.591 180 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se UNDER-5s Underweight prevalence NU.1 0.273 0.029 0.105 1.626 1.275 461 395 0.216 0.331 Tuberculosis immunization coverage CH.2 1.000 0.000 0.000 . . 127 110 1.000 1.000 Polio immunization coverage CH.2 0.946 0.016 0.017 0.550 0.741 127 110 0.914 0.978 Immunization coverage for DPT CH.2 0.928 0.016 0.017 0.425 0.652 127 110 0.895 0.960 Measles immunization coverage CH.2 0.964 0.018 0.019 1.008 1.004 127 110 0.928 1.000 Fully immunized children CH.2 0.837 0.036 0.043 1.018 1.009 127 110 0.766 0.909 Acute respiratory infection in last two weeks CH.6 0.088 0.018 0.206 1.766 1.329 502 431 0.052 0.125 Antibiotic treatment of suspected pneumonia CH.7 0.429 0.131 0.307 2.612 1.616 44 38 0.166 0.692 Diarrhoea in last two weeks CH.4 0.319 0.024 0.077 1.184 1.088 502 431 0.270 0.368 Received ORT or increased fluids and continued feeding CH.5 0.391 0.076 0.193 3.313 1.820 160 139 0.240 0.542 Under-fives sleeping under insecticide treated nets CH.11 0.568 0.076 0.134 10.181 3.191 502 431 0.416 0.721 Fever in last two weeks CH.12 0.112 0.011 0.093 0.475 0.690 502 431 0.091 0.133 Antimalarial treatment CH.12 0.439 0.051 0.117 0.493 0.702 56 47 0.337 0.542 Support for learning CD.1 0.368 0.016 0.043 0.466 0.683 502 431 0.336 0.400 Birth registration CP.1 0.525 0.045 0.086 3.512 1.874 502 431 0.435 0.615 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 181 Appendix C. Esimates of Sampling errors Table SE.11: Sampling errors: Janjangbureh Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se HOUSEHOLDS Household availability of ITNs CH.10 0.677 0.038 0.056 2.754 1.660 370 417 0.601 0.753 Iodized salt consumption NU.5 0.103 0.017 0.168 1.302 1.141 357 402 0.069 0.138 Child discipline CP.4 0.772 0.025 0.032 1.254 1.120 327 368 0.723 0.821 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.817 0.039 0.047 4.182 2.045 3861 4321 0.739 0.894 Use of improved sanitation facilities EN.5 0.307 0.041 0.134 3.326 1.824 3861 4321 0.225 0.390 Net primary school attendance rate ED.3 0.580 0.037 0.064 4.441 2.107 705 788 0.506 0.654 Net secondary school attendance rate ED.4 0.253 0.030 0.118 3.083 1.756 580 651 0.193 0.313 Primary completion rate ED.6 0.797 0.041 0.052 1.307 1.143 111 124 0.714 0.880 Child labour CP.2 0.325 0.015 0.047 1.442 1.201 1201 1343 0.294 0.355 Prevalence of orphans HA.10 0.072 0.010 0.142 3.699 1.923 2132 2384 0.051 0.092 WOMEN Skilled attendant at delivery RH.5 0.348 0.034 0.099 1.754 1.324 313 336 0.279 0.417 Antenatal care RH.3 0.988 0.006 0.006 0.984 0.992 313 336 0.976 1.000 Adult literacy ED.8 0.271 0.034 0.124 2.222 1.490 364 391 0.204 0.338 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.772 0.048 0.063 12.803 3.578 891 958 0.675 0.869 Marriage before age 18 CP.5 0.688 0.017 0.024 0.959 0.979 684 736 0.654 0.721 Polygyny CP.5 0.536 0.018 0.034 1.013 1.006 696 748 0.499 0.573 Comprehensive knowledge about HIV prevention among young people HA.3 0.256 0.028 0.109 1.577 1.256 364 391 0.200 0.311 Condom use with non-regular partners HA.9 0.733 0.158 0.216 1.786 1.336 14 15 0.417 1.000 Age at first sex among young people HA.8 0.041 0.013 0.317 0.937 0.968 206 222 0.015 0.066 Attitude towards people with HIV/AIDS HA.5 0.149 0.016 0.110 2.023 1.422 884 951 0.116 0.182 Women who have been tested for HIV HA.6 0.078 0.008 0.105 0.893 0.945 891 958 0.062 0.095 Knowledge of mother- to-child transmission of HIV HA.4 0.737 0.016 0.022 1.255 1.120 891 958 0.705 0.769 182 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se UNDER-5s Underweight prevalence NU.1 0.261 0.014 0.053 0.748 0.865 682 753 0.233 0.289 Tuberculosis immunization coverage CH.2 1.000 0.000 0.000 . . 150 165 1.000 1.000 Polio immunization coverage CH.2 0.921 0.026 0.028 1.461 1.209 150 165 0.870 0.972 Immunization coverage for DPT CH.2 0.915 0.016 0.018 0.555 0.745 150 165 0.882 0.947 Measles immunization coverage CH.2 0.927 0.024 0.026 1.435 1.198 150 165 0.878 0.976 Fully immunized children CH.2 0.812 0.038 0.047 1.560 1.249 150 165 0.735 0.888 Acute respiratory infection in last two weeks CH.6 0.065 0.010 0.157 1.282 1.132 682 753 0.044 0.085 Antibiotic treatment of suspected pneumonia CH.7 0.772 0.069 0.090 1.318 1.148 44 49 0.633 0.911 Diarrhoea in last two weeks CH.4 0.211 0.017 0.081 1.314 1.146 682 753 0.177 0.245 Received ORT or increased fluids and continued feeding CH.5 0.384 0.038 0.098 0.946 0.973 144 159 0.308 0.459 Under-fives sleeping under insecticide treated nets CH.11 0.568 0.076 0.134 10.181 3.191 502 431 0.416 0.721 Fever in last two weeks CH.12 0.065 0.012 0.184 1.761 1.327 682 753 0.041 0.089 Antimalarial treatment CH.12 0.692 0.065 0.094 0.950 0.975 44 49 0.563 0.822 Support for learning CD.1 0.304 0.013 0.041 0.566 0.752 682 753 0.279 0.329 Birth registration CP.1 0.622 0.035 0.056 3.936 1.984 682 753 0.551 0.692 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 183 Appendix C. Esimates of Sampling errors Table SE.12: Sampling errors: Basse Standard errors, coefficients of variation, design effects (deff), square root of design effects (deft) and confidence intervals for selected indicators, The Gambia, 2006 Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se HOUSEHOLDS Household availability of ITNs CH.10 0.585 0.027 0.047 1.615 1.271 483 526 0.531 0.640 Iodized salt consumption NU.5 0.425 0.051 0.120 5.292 2.300 452 496 0.323 0.527 Child discipline CP.4 0.949 0.010 0.010 0.960 0.980 425 480 0.929 0.969 HOUSEHOLD MEMBERS Use of improved drinking water sources EN.1 0.876 0.055 0.062 14.335 3.786 5861 6870 0.767 0.985 Use of improved sanitation facilities EN.5 0.864 0.030 0.035 4.077 2.019 5861 6870 0.804 0.925 Net primary school attendance rate ED.3 0.465 0.025 0.055 3.300 1.816 1070 1273 0.414 0.515 Net secondary school attendance rate ED.4 0.147 0.020 0.140 3.341 1.828 859 1000 0.106 0.187 Primary completion rate ED.6 0.474 0.042 0.088 1.429 1.195 172 204 0.390 0.558 Child labour CP.2 0.318 0.014 0.043 1.879 1.371 1836 2183 0.291 0.346 Prevalence of orphans HA.10 0.103 0.009 0.085 3.082 1.755 3146 3713 0.085 0.120 WOMEN Skilled attendant at delivery RH.5 0.342 0.034 0.100 2.708 1.645 463 525 0.274 0.410 Antenatal care RH.3 0.989 0.005 0.005 1.274 1.129 463 525 0.979 0.999 Adult literacy ED.8 0.132 0.024 0.184 3.124 1.768 548 608 0.084 0.181 Prevalence of female genital mutilation/cutting (FGM/C) CP.7 0.990 0.004 0.004 2.183 1.478 1258 1411 0.983 0.998 Marriage before age 18 CP.5 0.748 0.015 0.020 1.311 1.145 988 1110 0.718 0.778 Polygyny CP.5 0.569 0.022 0.038 2.288 1.513 1064 1207 0.525 0.612 Comprehensive knowledge about HIV prevention among young people HA.3 0.222 0.016 0.071 0.882 0.939 608 548 0.190 0.254 Condom use with non-regular partners HA.9 0.790 0.070 0.088 0.588 0.767 24 21 0.651 0.930 Age at first sex among young people HA.8 0.056 0.017 0.300 1.591 1.261 270 301 0.022 0.089 Attitude towards people with HIV/AIDS HA.5 0.159 0.007 0.045 0.531 0.729 1244 1394 0.145 0.173 Women who have been tested for HIV HA.6 0.036 0.006 0.172 1.562 1.250 1258 1411 0.024 0.049 Knowledge of mother- to-child transmission of HIV HA.4 0.672 0.015 0.023 1.505 1.227 1258 1411 0.641 0.703 184 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix C. Esimates of Sampling errors Table Value (r) Standard error (se) Coefficient of variation (se/r) Design effect (deff) Weighted count Unweig- hted count Square root of design effect (deft) Confidence limits r - 2se r + 2se UNDER-5s Underweight prevalence NU.1 0.235 0.018 0.076 1.879 1.371 914 1052 0.200 0.271 Tuberculosis immunization coverage CH.2 0.988 0.007 0.007 0.926 0.962 214 245 0.975 1.000 Polio immunization coverage CH.2 0.927 0.015 0.016 0.833 0.912 214 245 0.896 0.957 Immunization coverage for DPT CH.2 0.819 0.016 0.019 0.396 0.629 214 245 0.788 0.850 Measles immunization coverage CH.2 0.931 0.013 0.014 0.679 0.824 214 245 0.904 0.957 Fully immunized children CH.2 0.745 0.018 0.024 0.398 0.631 214 245 0.710 0.780 Acute respiratory infection in last two weeks CH.6 0.055 0.009 0.154 1.597 1.264 999 1143 0.038 0.073 Antibiotic treatment of suspected pneumonia CH.7 0.612 0.060 0.098 0.887 0.942 55 60 0.492 0.731 Diarrhoea in last two weeks CH.4 0.238 0.019 0.080 2.256 1.502 999 1143 0.200 0.276 Received ORT or increased fluids and continued feeding CH.5 0.533 0.042 0.079 1.952 1.397 238 275 0.449 0.618 Under-fives sleeping under insecticide treated nets CH.11 0.350 0.040 0.114 8.026 2.833 999 1143 0.270 0.430 Fever in last two weeks CH.12 0.079 0.010 0.125 1.515 1.231 999 1143 0.059 0.098 Antimalarial treatment CH.12 0.326 0.064 0.196 1.625 1.275 79 88 0.198 0.454 Support for learning CD.1 0.346 0.013 0.039 0.919 0.959 999 1143 0.319 0.373 Birth registration CP.1 0.394 0.029 0.073 3.932 1.983 999 1143 0.337 0.451 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 185 APPENDIX D: DATA QUALITY TABLES Table DQ.1: Age distibution of household population Single-year age distribution of household population by sex (weighted), The Gambia, 2005/2006 Males Females Males Females Number Per cent Number Per cent Number Per cent Number Per cent 0 761 3.4 817 3.6 41 98 .4 102 .4 1 755 3.4 717 3.1 42 150 .7 145 .6 2 706 3.2 642 2.8 43 113 .5 102 .4 3 638 2.9 583 2.6 44 83 .4 69 .3 4 446 2.0 414 1.8 45 335 1.5 242 1.1 5 842 3.8 807 3.5 46 131 .6 105 .5 6 719 3.3 723 3.2 47 95 .4 58 .3 7 736 3.3 724 3.2 48 113 .5 78 .3 8 743 3.4 736 3.2 49 89 .4 64 .3 9 558 2.5 546 2.4 50 299 1.4 485 2.1 10 689 3.1 744 3.3 51 44 .2 134 .6 11 513 2.3 487 2.1 52 97 .4 211 .9 12 631 2.9 680 3.0 53 94 .4 129 .6 13 554 2.5 678 3.0 54 50 .2 89 .4 14 482 2.2 817 3.6 55 191 .9 217 1.0 15 661 3.0 439 1.9 56 98 .4 116 .5 16 508 2.3 465 2.0 57 77 .3 44 .2 17 443 2.0 455 2.0 58 99 .4 70 .3 18 570 2.6 571 2.5 59 48 .2 38 .2 19 336 1.5 378 1.7 60 322 1.5 279 1.2 20 585 2.7 689 3.0 61 31 .1 12 .1 21 268 1.2 311 1.4 62 51 .2 42 .2 22 313 1.4 344 1.5 63 48 .2 39 .2 23 279 1.3 342 1.5 64 33 .1 22 .1 24 304 1.4 359 1.6 65 161 .7 114 .5 25 467 2.1 576 2.5 66 33 .2 24 .1 26 273 1.2 361 1.6 67 47 .2 20 .1 27 246 1.1 314 1.4 68 57 .3 29 .1 28 289 1.3 399 1.8 69 39 .2 9 .0 29 208 .9 285 1.2 70 164 .7 154 .7 30 536 2.4 605 2.7 71 10 .0 7 .0 31 111 .5 156 .7 72 21 .1 12 .1 32 233 1.1 243 1.1 73 26 .1 12 .1 33 173 .8 202 .9 74 14 .1 7 .0 34 151 .7 156 .7 75 75 .3 71 .3 35 419 1.9 372 1.6 76 17 .1 10 .0 36 191 .9 203 .9 77 10 .0 2 .0 37 172 .8 157 .7 78 20 .1 15 .1 38 218 1.0 198 .9 79 6 .0 2 .0 39 147 .7 135 .6 80+ 175 .8 172 .8 40 504 2.3 413 1.8 DK/ Missing 32 .1 18 .1 Total 22072 100.0 22805 100.0 186 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix D. Data Quality Tables Table DQ.2: Age distribution of eligible and interviewed women Household population of women age 10-54, interviewed women age 15-49, and percentage of eligible women who were interviewed (weighted), by five-year age group, The Gambia, 2005/2006 Table DQ.3: Age distribution of eligible and interviewed under-5s Household population of children aged 0-4, children whose mothers/caretakers were interviewed, and percentage of under-5 children whose mothers/caretakers were interviewed (weighted), by five-year age group, The Gambia, 2005/2006 na: not applicable Note:Weights for both household population of children and interviewed children are household weights. Age is based on the household schedule. na: not applicable Note:Weights for both household population of women and interviewed women are household weights. Age is based on the household schedule. Age 10-14 3407 . . . 15-19 2307 2246 22. 97.4 20-24 2044 1987 20.2 97.2 25-29 1935 1887 19.2 97.5 30-34 1361 1330 13.5 97.7 35-39 1065 1030 10.5 96.7 40-44 830 813 8.3 97.9 45-49 546 531 5.4 97.4 50-54 1048 na Na na 15-49 10088 9823 100.0 97.4 Age 0 1578 1558 24.4 98.7 1 1472 1448 22.7 98.4 2 1348 1330 20.8 98.7 3 1221 1202 18.8 98.5 4 860 842 13.2 97.9 5 1648 na Na na 6 1442 na Na na 7 1460 na Na na 0-4 6479 6382 100.0 98.5 Household population of women aged 10-54 Number Number Per cent Percentage of eligible women interviewed Interviewed women aged 15-49 Household population of children aged 0-7 Number Number Per cent Percentage of eligible women interviewed Interviewed children aged 0-4 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 187 Appendix D. Data Quality Tables Table DQ.4: Age distribution of under-5 children Age distribution of under-5 children by 3-month groups (weighted), The Gambia, 2005/2006 Number Males Per cent Number Females Total Per cent Number Per cent Age in months 0-2 180 5.4 190 6.0 370 5.7 3-5 230 6.9 252 7.9 483 7.4 6-8 153 4.6 157 4.9 309 4.7 9-11 188 5.6 197 6.2 385 5.9 12-14 235 7.0 229 7.2 464 7.1 15-17 218 6.5 207 6.5 426 6.5 18-20 135 4.0 130 4.1 265 4.0 21-23 169 5.1 163 5.1 332 5.1 24-26 223 6.7 191 6.0 414 6.3 27-29 218 6.5 183 5.7 400 6.1 30-32 122 3.6 117 3.7 239 3.7 33-35 159 4.8 157 4.9 317 4.8 36-38 218 6.5 218 6.8 436 6.7 39-41 174 5.2 142 4.4 315 4.8 42-44 110 3.3 94 2.9 204 3.1 45-47 147 4.4 145 4.5 292 4.5 48-50 179 5.4 168 5.2 347 5.3 51-53 119 3.6 109 3.4 228 3.5 54-56 78 2.3 69 2.1 147 2.2 57-59 93 2.8 79 2.5 172 2.6 Total 3346 100.0 3197 100.0 6543 100.0 188 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix D. Data Quality Tables Table DQ.5: Heaping on ages and periods Age and period ratios at boundaries of eligibility by type of information collected (weighted), The Gambia, 2005/2006 * Age or period ratios are calculated as x / ((xn-1 + xn + xn-+) / 3), where x is age or period. na: not applicable Age in household questionnaire 1 1.02 .99 1.00 2 1.01 .99 1.00 Lower Child discipline and child disability 3 1.07 1.07 1.07 4 .69 .69 .69 Upper Under-5 questionnaire 5 1.26 1.24 1.25 Lower Child labour and education 6 .94 .96 .95 8 1.09 1.10 1.10 9 .84 .81 .82 Upper Child disability 10 1.17 1.26 1.22 13 1.00 .94 .96 14 .85 1.27 1.07 Upper Child labour and child discipline 15 1.20 .76 .98 Lower Women's questionnaire 16 .94 1.03 .98 17 .87 .91 .89 Upper Orphaned and vulnerable children 18 .99 .97 .98 23 .93 .98 .96 24 .87 .84 .85 Upper Education 25 1.34 1.33 1.34 48 1.14 1.17 1.15 49 .53 .30 .41 Upper Women's questionnaire 50 2.08 2.13 2.11 Age in women's questionnaire 23 na .97 na 24 na .86 na Upper Sexual behaviour 25 na 1.32 na Months since last birth in women's questionnaire 6-11 na .87 na 12-17 na 1.22 na 18-23 na .84 na Upper Tetanus toxoid and maternal and child health 24-29 na 1.18 na 30-35 na .80 na Males Females Age and period ratios* Total Module or questionnaire Eligibility boundary (lower-upper) The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 189 Appendix D. Data Quality Tables Table DQ.6: Completeness of reporting Percentage of observations missing information for selected questions and indicators (weighted), The Gambia, 2005/2006 Table DQ.7: Presence of mother in the household and the person interviewed for the under-5 questionnaire Distribution of children under five by whether the mother lives in the same household, and the person interviewed for the under-5 questionnaire (weighted), The Gambia, 2005/2006 * Includes "Don't know" responses Age 0 98.6 .0 .0 .1 1.3 .0 .0 100.0 1578 1 97.1 .1 .0 .2 2.7 .0 .0 100.0 1472 2 91.4 .0 .0 .1 8.4 .1 .0 100.0 1348 3 87.9 .1 .1 .8 10.9 .2 .0 100.0 1221 4 88.0 .0 .0 .3 11.6 .0 .1 100.0 860 Total 93.3 .0 .0 .3 6.3 .1 .0 100.0 6479 Questionnaire and Subject Reference group Per cent with missing information* Number of cases Household Salt testing All households surveyed .7 6071 Women Date of Birth All women aged 15-49 Month only 26.6 9982 Month and year missing .0 9982 Date of first birth All women aged 15-49 with at least one live birth Month only 20.7 6739 Month and year missing 20.6 6739 Completed years since first birth All women aged 15-49 with at least one live birth .0 1393 Date of last birth All women aged 15-49 with at least one live birth Month only 10.8 6739 Month and year missing 1.0 6739 Date of first marriage/union All ever married women aged 15-49 Month only 16.7 7311 Month and year missing 51.7 7311 Age at first marriage/union All ever married women aged 15-49 3.9 7311 Age at first intercourse All women age 15-24 who have ever had sex .4 4306 Time since last intercourse All women age 15-24 who have ever had sex .5 2208 Under-5 Date of Birth All under five children surveyed Month only .1 6543 Month and year missing .0 6543 Anthropometry All under five children surveyed Height 1.8 6543 Weight 2.3 6543 Height or Weight 2.3 6543 Mother in the household Mother interviewed Father interviewed Other adult female interviewed Other adult male interviewed Father interviewed Other adult female interviewed Other adult male interviewed Total Number of children aged 0-4 years Mother not in the household 190 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix D. Data Quality Tables Table DQ.8: School attendance by single age Distribution of household population aged 5-24 by educational level and grade attended in the current year (weighted), The Gambia, 2005/2006 Table DQ.9: Sex ratio at birth among children ever born and living Sex ratio at birth among children ever born, children living, and deceased children, by age of women (weighted), The Gambia, 2005/2006 Age 5 26.7 1.3 .8 .1 .1 .0 .0 .0 .0 .0 .0 .0 1.3 .0 66.2 1648 6 28.7 4.2 3.3 .6 .1 .1 .0 .0 .0 .0 .1 .0 3.0 .0 55.2 1442 7 22.0 7.4 14.4 3.0 .7 .3 .0 .0 .1 .0 .0 .0 4.4 .0 38.2 1460 8 12.0 6.4 24.9 8.5 2.3 .6 .3 .0 .1 .0 .1 .0 4.0 .0 30.6 1479 9 2.8 2.3 23.5 22.8 10.2 1.5 .4 .1 .1 .0 .0 .0 3.9 .0 22.2 1104 10 2.0 .9 11.4 18.4 18.5 5.5 1.8 .2 .2 .1 .0 .1 4.5 .0 26.0 1434 11 .7 .7 5.3 12.5 19.4 17.1 6.4 1.0 .2 .1 .1 .1 3.8 .0 20.9 1000 12 .2 .1 2.3 8.3 14.4 16.3 15.7 3.2 1.7 .5 .1 .1 3.9 .1 23.8 1311 13 .5 .1 1.5 4.3 7.2 10.5 21.3 9.2 4.6 1.2 .4 .2 4.4 .0 25.4 1232 14 .3 .1 1.0 .9 2.8 7.0 17.7 10.1 12.4 4.6 1.1 .1 2.7 .0 29.8 1299 15 .0 .0 .3 .6 2.5 4.3 9.2 7.2 15.4 14.2 3.2 .8 4.1 .0 31.6 1100 16 .2 .0 .2 .0 .9 1.8 5.8 3.0 10.7 19.5 10.4 3.3 3.4 .0 35.0 973 17 .0 .0 .0 .1 .7 1.0 2.2 1.7 7.5 13.6 9.9 9.3 2.7 .0 42.5 898 18 .0 .0 .0 .1 .4 .4 1.4 .8 4.1 8.8 8.1 8.4 1.6 .0 54.8 1140 19 .0 .0 .1 .1 .1 .1 .6 .2 2.1 4.4 6.9 7.9 2.1 .0 61.7 714 20 .0 .1 .0 .0 .1 .2 .6 .2 1.0 2.6 2.4 3.8 .7 .0 80.0 1274 21 .0 .0 .0 .0 .7 .0 .6 .1 1.2 2.7 1.8 2.3 1.4 .0 80.1 578 22 .0 .0 .0 .1 .0 .0 .0 .0 .8 .9 2.3 1.6 .7 .0 86.8 657 23 .0 .1 .0 .0 .0 .2 .0 .0 .2 1.0 1.0 1.1 1.1 .0 91.0 620 24 .0 .0 .0 .0 .0 .0 .0 .1 .0 .6 .6 1.2 1.3 .0 92.4 663 Primary school Children Ever Born Children Living Children Deceased Secondary school Number Not atten- ding school Don't know Non-stan- dard cur- riculumPreschool Number of sons ever born Number of daughters ever born Sex ratio Number of sons living Number of daughters living Sex ratio Number of deceased sons Number of deceased daughters Sex ratio Number of women Higher Grade 4 Grade 3 Grade 2 Grade 1 Grade 4 Grade 4 Grade 5 Grade 6 Grade 3 Grade 2 Grade 1 Age 15-19 225 198 1.13 205 186 1.11 19 13 1.52 2282 20-24 1150 1089 1.06 1026 975 1.05 124 115 1.08 2023 25-29 2458 2358 1.04 2137 2111 1.01 321 247 1.30 1915 30-34 2814 2739 1.03 2442 2400 1.02 372 338 1.10 1352 35-39 2855 2625 1.09 2455 2259 1.09 400 366 1.09 1047 40-44 2710 2442 1.11 2232 2044 1.09 478 398 1.20 822 45-49 1861 1713 1.09 1473 1351 1.09 389 362 1.07 540 Total 14072 13165 1.07 11969 11327 1.06 2103 1838 1.14 9982 Note: Sex ratios are calculated as number of males/ number of females The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 191 Appendix D. Data Quality Tables Table DQ.10: Distribution of women by time since last birth Distribution of women aged 15 - 49 with at least one live birth by months since last (weighted), The Gambia, 2005/2006 Months since last birth 0 76 1.9 16 156 4.0 1 142 3.6 17 128 3.2 2 149 3.8 18 118 3.0 3 169 4.3 19 81 2.1 4 176 4.5 20 68 1.7 5 164 4.1 21 83 2.1 6 136 3.5 22 98 2.5 7 103 2.6 23 116 2.9 8 91 2.3 24 106 2.7 9 109 2.8 25 97 2.5 10 135 3.4 26 92 2.3 11 139 3.5 27 102 2.6 12 149 3.8 28 106 2.7 13 139 3.5 29 79 2.0 14 145 3.7 30 65 1.6 15 157 4.0 <= -1 5 .1 Total 3948 100.0 Number Per cent Number Per cent 192 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report A PP EN D IX E :M IC S IN D IC AT O R :N U M ER AT O R S A N D D EN O M IN AT O R S To ta l n um be r o f w om en s ur ve ye d ag ed 1 5- 49 w ith a bi rth in th e 2 ye ar s p re ce di ng th e s ur ve y To ta l n um be r of c hi ld re n un de r ag e fiv ew ho w er e w ei gh ed To ta l n um be r o f c hi ld re n un de r a ge fi ve m ea - su re d To ta l n um be r o f c hi ld re n un de r a ge fi ve w ei - gh ed a nd m ea su re d To ta l n um be r o f l as t l iv e bi rth s in th e 2 ye ar s pr ec ed in g th e su rv ey To ta l n um be r o f l as t l iv e bi rth s in th e 2 ye ar s pr ec ed in g th e su rv ey To ta l n um be r o f h ou se ho ld m em be rs in h ou - se ho ld s s ur ve ye d To ta l n um be r o f h ou se ho ld m em be rs in h ou - se ho ld s s ur ve ye d To ta l n um be r o f h ou se ho ld m em be rs in h ou - se ho ld s s ur ve ye d To ta l n um be r o f c hi ld re n un de r a ge th re e su rv ey ed To ta l n um be r o f i nf an ts a ge d 0- 5 m on th s su rv ey ed To ta l n um be r of c hi ld re n ag ed 1 2- 15 m on th s an d 20 -2 3 m on th s s ur ve ye d To ta l n um be r o f i nf an ts a ge d 6- 9 m on th s su rv ey ed To ta l n um be r o f i nf an ts a ge d 6- 11 m on th s su rv ey ed 1 Un de r-5 m or ta lit y ra te 2 In fa nt m or ta lit y ra te 3 Sk ille d at te nd an t a t d el iv er y 4 Un de rw ei gh t p re va le nc e 5 St un tin g pr ev al en ce 6 W as tin g pr ev al en ce 7 Lo w -b irt hw ei gh t i nf an ts 8 In fa nt s w ei gh ed a t b irt h 9 Us e of im pr ov ed d rin kin g w at er so ur ce s 10 Us e of i m pr ov ed s an ita tio n fa cil iti es 11 W at er tr ea tm en t 12 Di sp os al o f c hi ld 's fa ec es 13 Ex clu siv e b re as tfe ed in g ra te 14 Co nt in ue d br ea st fe ed in g ra te 15 Ti m el y c om pl em en ta ry fe ed in g ra te 16 Fr eq ue nc y of c om pl em en ta ry fe ed in g Pr ob ab ilit y of d yi ng b y ex ac t a ge 5 y ea rs Pr ob ab ilit y of d yi ng b y ex ac t a ge 1 y ea r Nu m be r o f w om en a ge d 15 -4 9 w ith a b irt h in th e 2 ye ar s p re ce di ng th e su rv ey w ho w er e at te nd ed d ur in g ch ild bi rth b y sk ille d he al th p er so nn el Nu m be r o f c hi ld re n un de r a ge fi ve w ho fa ll be lo w m in us tw o st an da rd d ev ia tio ns fr om th e m ed ia n w ei gh t f or a ge o f t he N CH S/ W HO s ta nd ar d (m od er at e an d se ve re ); nu m be r t ha t f al l b el ow m in us th re e st an da rd d ev ia tio ns (s ev er e) Nu m be r o f c hi ld re n un de r a ge fi ve w ho fa ll be lo w m in us tw o st an da rd d ev ia tio ns fr om th e m ed ia n he ig ht fo r a ge o f t he N CH S/ W HO s ta nd ar d (m od er at e an d se ve re ); nu m be r t ha t f al l b el ow m in us th re e st an da rd d ev ia tio ns (s ev er e) Nu m be r o f c hi ld re n un de r a ge fi ve w ho f al l b el ow m in us tw o st an da rd d ev ia tio ns fr om th e m ed ia n w ei gh t f or h ei gh t o f t he N CH S/ W HO st an da rd (m od er at e an d se ve re ); nu m be r t ha t f al l b el ow m in us th re e st an da rd d ev ia tio ns (s ev er e) Nu m be r o f l as t l iv e bi rth s i n th e 2 ye ar s p re ce di ng th e su rv ey w ei gh in g be lo w 2 ,5 00 g ra m s Nu m be r o f l as t l iv e bi rth s i n th e 2 ye ar s p re ce di ng th e su rv ey w ho w er e w ei gh ed a t b irt h Nu m be r o f h ou se ho ld m em be rs li vi ng in h ou se ho ld s u sin g im pr ov ed so ur ce s o f d rin kin g w at er Nu m be r o f h ou se ho ld m em be rs u sin g im pr ov ed sa ni ta tio n fa cil iti es Nu m be r o f h ou se ho ld m em be rs u sin g w at er th at h as b ee n tre at ed Nu m be r o f c hi ld re n un de r a ge th re e w ho se (l as t) st oo ls w er e di sp os ed o f s af el y Nu m be r o f i nf an ts a ge d 0- 5 m on th s w ho a re e xc lu siv el y br ea st fe d Nu m be r o f i nf an ts a ge d 12 -1 5 m on th s, an d 20 -2 3 m on th s, th at a re cu rre nt ly b re as tfe ed in g Nu m be r o f i nf an ts a ge d 6- 9 m on th s w ho a re re ce iv in g br ea st m ilk a nd co m pl em en ta ry fo od s Nu m be r o f i nf an ts a ge d 6- 11 m on th s w ho re ce iv e br ea st m ilk a nd co m pl em en ta ry fo od a t l ea st th e m in im um re co m m en de d nu m be r o f t im es p er da y (tw o tim es p er d ay fo r i nf an ts a ge d 6- 8 m on th s, th re e tim es p er d ay fo r i nf an ts a ge d 9- 11 m on th s) IN D IC AT O R N U M ER AT O R D EN O M IN AT O R The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 193 Appendix E. MICS Indicators: Numerators and Denominators To ta l n um be r o f i nf an ts a ge d 0- 11 m on th s s ur - ve ye d To ta l n um be r o f w om en s ur ve ye d ag ed 1 5- 49 ye ar s w ith a b irt h in th e 2 ye ar s p re ce di ng th e su rv ey To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s w ith s us pe ct ed p ne um on ia i n th e pr ev io us 2 w ee ks To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s w ith s us pe ct ed p ne um on ia i n th e pr ev io us 2 w ee ks To ta l n um be r o f r es id en ts in h ou se ho ld s su r- ve ye d To ta l n um be r of c hi ld re n ag ed 1 2- 23 m on th s su rv ey ed To ta l n um be r of c hi ld re n ag ed 1 2- 23 m on th s su rv ey ed To ta l n um be r of c hi ld re n ag ed 1 2- 23 m on th s su rv ey ed To ta l n um be r of c hi ld re n ag ed 1 2- 23 m on th s su rv ey ed To ta l n um be r of c hi ld re n ag ed 1 2- 23 m on th s su rv ey ed To ta l n um be r of c hi ld re n ag ed 1 2- 23 m on th s su rv ey ed To ta l n um be r of c hi ld re n ag ed 1 2- 23 m on th s su rv ey ed To ta l n um be r o f w om en s ur ve ye d ag ed 1 5- 49 ye ar s w ith a b irt h in th e ye ar p re ce di ng th e su rv ey To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s w ith d ia rrh oe a in th e pr ev io us 2 w ee ks To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s w ith d ia rrh oe a in th e pr ev io us 2 w ee ks To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s w ith d ia rrh oe a in th e pr ev io us 2 w ee ks To ta l n um be r o f h ou se ho ld s s ur ve ye d 17 Ad eq ua te ly fe d in fa nt s 18 An te na ta l c ar e 19 An tib io tic tr ea tm en t o f su sp ec - te d pn eu m on ia 20 Ca re -s ee ki ng fo r su sp ec te d pn eu m on ia 21 So lid fu el 22 Tu be rc ul os is im m un iza tio n co ve ra ge 23 Po lio im m un iza tio n co ve ra ge 24 Im m un iza tio n co ve ra ge fo r di ph - th er ia, p er tu ss is an d te ta nu s ( DP T) 25 M ea sl es im m un iza tio n co ve - ra ge 26 He pa tit is B im m un iza tio n co ve - ra ge 27 Ye llo w fe ve r im m un iza tio n co ve ra ge 28 Fu lly im m un ize d ch ild re n 29 Ne on at al te ta nu s p ro te cti on 30 Us e of o ra l r eh yd ra tio n th er ap y (O RT ) 31 Ho m e m an ag em en t o f d iar rh oe a 32 Re ce iv ed OR T or in cr ea se d flu id s a nd co nt in ue d fe ed in g 33 Ho us eh ol d av ai la bi lit y of in se c- tic id e- tre at ed n et s ( IT Ns ) Nu m be r o f i nf an ts a ge d 0- 11 m on th s w ho a re a pp ro pr ia te ly fe d: in fa nt s ag ed 0 -5 m on th s th at a re e xc lu siv el y br ea st fe d an d in fa nt s ag ed 6 -11 m on th s t ha t a re b re as tfe d an d at e so lid o r s em i-s ol id fo od s t he a pp ro pr ia te n um be r o f t im es (s ee a bo ve ) y es te rd ay Nu m be r o f w om en a ge d 15 -4 9 w ho w er e at te nd ed t o at le as t o nc e du rin g pr eg na nc y in th e 2 ye ar s p re ce di ng th e su rv ey b y sk ille d he al th p er - so nn el Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s w ith su sp ec te d pn eu m on ia in th e pr ev io us 2 w ee ks re ce iv in g an tib io tic s Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s w ith su sp ec te d pn eu m on ia in th e pr ev io us 2 w ee ks w ho a re ta ke n to a n ap pr op ria te h ea lth p ro vi de r Nu m be r o f r es id en ts in h ou se ho ld s w ho u se s ol id fu el (w oo d, ch ar co al , c ro p re sid ue s an d du ng ) a s th e pr im ar y so ur ce o f d om es tic e ne rg y to co ok Nu m be r o f c hi ld re n ag ed 1 2- 23 m on th s r ec ei vi ng B CG v ac cin e be fo re th ei r f irs t b irt hd ay Nu m be r o f c hi ld re n ag ed 1 2- 23 m on th s r ec ei vi ng O PV 3 va cc in e be fo re th ei r f irs t b irt hd ay Nu m be r o f c hi ld re n ag ed 1 2- 23 m on th s r ec ei vi ng D PT 3 va cc in e be fo re th ei r f irs t b irt hd ay Nu m be r o f c hi ld re n ag ed 1 2- 23 m on th s r ec ei vi ng m ea sle s v ac cin e be fo re th ei r f irs t b irt hd ay Nu m be r o f c hi ld re n ag ed 1 2- 23 m on th s i m m un ize d ag ai ns t h ep at iti s b ef or e th ei r f irs t b irt hd ay Nu m be r o f c hi ld re n ag ed 12 -2 3 m on th s i m m un ize d ag ain st ye llo w fe ve r b ef or e t he ir fir st bi rth da y Nu m be r o f c hi ld re n ag ed 1 2- 23 m on th s r ec ei vi ng D PT 1- 3, O PV -1 -3 , B CG a nd m ea sle s v ac cin es b ef or e th ei r f irs t b irt hd ay Nu m be r o f m ot he rs w ith li ve b irt hs in th e pr ev io us y ea r w ho w er e gi ve n at le as t t w o do se s o f t et an us to xo id (T T) v ac cin e w ith in th e ap pr op ria te in te rv al p rio r t o gi vi ng b irt h Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s w ith d ia rrh oe a in th e pr ev io us 2 w ee ks th at re ce iv ed o ra l r eh yd ra tio n sa lts a nd /o r a n ap pr op ria te h ou se - ho ld so lu tio n Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s w ith d ia rrh oe a in th e pr ev io us 2 w ee ks w ho re ce iv ed m or e flu id s A ND c on tin ue d ea tin g so m ew ha t l es s, th e sa m e or m or e fo od Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s w ith d ia rrh oe a w ho re ce iv ed O RT (o ra l r eh yd ra tio n sa lts o r a n ap pr op ria te h ou se ho ld s ol ut io n) o r r ec ei - ve d m or e flu id s A ND co nt in ue d ea tin g so m ew ha t l es s, th e sa m e or m or e fo od Nu m be r o f h ou se ho ld s w ith a t l ea st o ne m os qu ito n et , e ith er p er m an en tly tr ea te d or tr ea te d w ith in th e pr ev io us y ea r IN D IC AT O R N U M ER AT O R D EN O M IN AT O R 194 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix E. MICS Indicators: Numerators and Denominators To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s su rv ey ed To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s su rv ey ed To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s re po rte d to h av e ha d fe ve r i n th e pr ev io us 2 w ee ks To ta l n um be r o f w om en w ho h av e ha d a liv e bi rth w ith in th e 2 ye ar s p re ce di ng th e su rv ey To ta l n um be r o f h ou se ho ld s s ur ve ye d To ta l n um be r of c hi ld re n ag ed 6 -5 9 m on th s su rv ey ed To ta l n um be r o f w om en w ho h ad a liv e b irt h in th e 2 ye ar s p re ce di ng th e su rv ey To ta l n um be r o f w om en w ith a li ve b irt h in th e 2 ye ar s p re ce di ng th e su rv ey To ta l n um be r o f w om en w ith a li ve b irt h in th e 2 ye ar s p re ce di ng th e su rv ey To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s su rv ey ed To ta l n um be r o f c hi ld re n ag ed 0 -5 9 m on th s To ta l n um be r o f h ou se ho ld s s ur ve ye d To ta l n um be r o f h ou se ho ld s s ur ve ye d To ta l n um be r o f h ou se ho ld s s ur ve ye d To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s su rv ey ed To ta l n um be r o f c hi ld re n ag ed 3 6- 59 m on th s su rv ey ed To ta l n um be r o f c hi ld re n in th e fir st g ra de su r- ve ye d To ta l nu m be r of c hi ld re n of p rim ar y sc ho ol en try a ge su rv ey ed 34 Un de r-5 s s le ep in g un de r i ns ec ti- cid e- tr ea te d ne ts 35 Un de r-5 s sle ep in g un de r m os - qu ito n et s 36 An tim ala ria l t re at m en t ( un de r- 5) 37 In te rm itt en t pr ev en tiv e m al ar ia tre at m en t ( pr eg na nt w om en ) 38 Io di ze d sa lt co ns um pt io n 39 Vi ta m in A su pp le m en ta tio n (U nd er -5 s) 40 Vi ta m in A su pp le m en ta tio n (p os t-p ar tu m m ot he rs ) 41 Co nt en t o f a nt en at al ca re 42 Ti m el y in iti at io n of b re as tfe e- di ng 43 Su pp or t f or le ar ni ng 44 Fa th er 's su pp or t f or le ar ni ng 45 Su pp or t f or le ar ni ng : c hi ld re n' s bo ok s 46 Su pp or t fo r le ar ni ng : no n- ch il- dr en 's bo ok s 47 Su pp or t fo r le ar ni ng : m at er ia ls fo r p la y 48 No n- ad ul t c ar e 49 Pr e- sc ho ol a tte nd an ce 50 Sc ho ol re ad in es s 51 Ne t i nt ak e ra te in p rim ar y ed u- ca tio n Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s w ho sl ep t u nd er a n in se ct ici de -tr ea te d m os qu ito n et th e pr ev io us n ig ht Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s w ho sl ep t u nd er a m os qu ito n et th e pr ev io us n ig ht Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s re po rte d to h av e ha d fe ve r i n th e pr ev io us 2 w ee ks w ho w er e tre at ed w ith a n ap pr op ria te a nt im al ar ia l w ith in 2 4 ho ur s o f o ns et Nu m be r o f w om en re ce iv in g ap pr op ria te in te rm itt en t m ed ica tio n to p re ve nt m al ar ia (d ef in ed a s at le as t 2 d os es o f S P/ Fa ns id ar ) d ur in g th e la st pr eg na nc y, le ad in g to a li ve b irt h w ith in th e 2 ye ar s p re ce di ng th e su rv ey Nu m be r o f h ou se ho ld s w ith sa lt te st in g 15 p ar ts p er m illi on o r m or e of io di ne /io da te Nu m be r o f c hi ld re n ag ed 6 -5 9 m on th s r ec ei vi ng a t l ea st o ne h ig h- do se V ita m in A su pp le m en t i n th e pr ev io us 6 m on th s Nu m be r o f w om en w ith a liv e b irt h in th e 2 ye ar s p re ce di ng th e s ur ve y w ho re ce iv ed a hi gh -d os e V ita m in A su pp le m en t w ith in 8 w ee ks af te r b irt h Nu m be r o f w om en w ith a li ve b irt h in th e 2 ye ar s p re ce di ng th e su rv ey w ho re ce iv ed a nt en at al ca re d ur in g th e la st p re gn an cy Nu m be r o f w om en w ith a li ve b irt h in th e 2 ye ar s p re ce di ng th e su rv ey w ho p ut th e ne w bo rn in fa nt to th e br ea st w ith in 1 h ou r o f b irt h Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s liv in g in h ou se ho ld s in w hi ch a n ad ul t h as e ng ag ed in fo ur o r m or e ac tiv iti es to p ro m ot e le ar ni ng a nd sc ho ol re ad in es s i n th e pa st 3 d ay s Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s w ho se fa th er h as e ng ag ed in o ne o r m or e ac tiv iti es to p ro m ot e le ar ni ng a nd sc ho ol re ad in es s i n th e pa st 3 da ys Nu m be r o f h ou se ho ld s w ith th re e or m or e ch ild re n' s b oo ks Nu m be r o f h ou se ho ld s w ith th re e or m or e no n- ch ild re n' s b oo ks Nu m be r o f h ou se ho ld s w ith th re e or m or e m at er ia ls in te nd ed fo r p la y Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s l ef t a lo ne o r i n th e ca re o f a no th er ch ild y ou ng er th an 10 y ea rs o f a ge in th e pa st w ee k Nu m be r o f c hi ld re n ag ed 3 6- 59 m on th s w ho a tte nd so m e fo rm o f e ar ly ch ild ho od e du ca tio n pr og ra m m e Nu m be r o f c hi ld re n in fi rs t g ra de w ho a tte nd ed so m e fo rm o f p re -s ch oo l t he p re vi ou s y ea r Nu m be r o f c hi ld re n of sc ho ol e nt ry a ge w ho a re cu rre nt ly a tte nd in g fir st g ra de IN D IC AT O R N U M ER AT O R D EN O M IN AT O R The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 195 Appendix E. MICS Indicators: Numerators and Denominators To ta l n um be r o f c hi ld re n of p rim ar y s ch oo l a ge su rv ey ed To ta l n um be r o f c hi ld re n of s ec on da ry s ch oo l ag e su rv ey ed To ta l n um be r o f c hi ld re n th at w er e in th e la st gr ad e of p rim ar y sc ho ol d ur in g th e pr ev io us sc ho ol y ea r s ur ve ye d To ta l nu m be r of c hi ld re n of p rim ar y sc ho ol co m pl et io n ag e ( ag e a pp ro pr ia te to fi na l g ra de of p rim ar y sc ho ol ) s ur ve ye d To ta l n um be r o f w om en a ge d 15 -2 4 su rv ey ed Pr op or tio n of b oy s in p rim ar y an d se co nd ar y ed uc at io n To ta l n um be r of c hi ld re n ag ed 0 -5 9 m on th s su rv ey ed To ta l n um be r o f w om en a ge d 15 -4 9 su rv ey ed To ta l n um be r o f w om en a ge d 15 -4 9 su rv ey ed To ta l n um be r o f w om en a ge d 15 -4 9 su rv ey ed w ho h av e at le as t o ne li vi ng d au gh te r To ta l n um be r o f w om en a ge d 15 -4 9 su rv ey ed To ta l n um be r o f w om en a ge d 15 -4 9 an d 20 -4 9 su rv ey ed , b y ag e gr ou ps To ta l n um be r o f w om en a ge d 15 -1 9 su rv ey ed To ta l n um be r o f w om en a ge d 15 -1 9 an d 20 -2 4 ye ar s s ur ve ye d th at a re cu rre nt ly m ar rie d or in un io n To ta l n um be r o f w om en a ge d 15 -1 9 an d 20 -2 4 ye ar s s ur ve ye d th at a re cu rre nt ly m ar rie d or in un io n To ta l n um be r o f w om en a ge d 15 -4 9 su rv ey ed w ho a re cu rre nt ly m ar rie d or in u ni on To ta l n um be r o f c hi ld re n ag ed 5 -1 4 su rv ey ed To ta l n um be r o f c hi ld re n ag ed 5 -1 4 in vo lv ed in ch ild la bo ur a ct iv iti es To ta l n um be r o f c hi ld re n ag ed 5 -1 4 at te nd in g sc ho ol 52 Ne t pr im ar y sc ho ol a tte nd an ce ra te 53 Ne t se co nd ar y sc ho ol a tte n- da nc e ra te 54 Ch ild re n re ac hi ng G ra de 5 55 Tr an si tio n ra te t o se co nd ar y sc ho ol 56 Pr im ar y co m pl et io n ra te 57 Ad ul t l ite ra cy ra te 58 Ge nd er p ar ity in de x 59 Bi rth re gi st ra tio n 60 Pr ev al en ce o f fe m al e ge ni ta l m ut ila tio n/ cu t ti ng (F GM /C ) 61 Pr ev al en ce o f e xt re m e fo rm o f FG M /C 62 Pr ev al en ce o f FG M /C a m on g da ug ht er s 63 Ap pr ov al fo r F GM /C 64 M ar ria ge be fo re ag e 1 5 a nd ag e 1 8 65 Yo un g w om en a ge d 15 -1 9 cu r- re nt ly m ar rie d or in u ni on 66 Sp ou sa l a ge d iff er en ce 67 Po ly gy ny 68 Ch ild la bo ur 69 La bo ur er st ud en ts 70 St ud en t l ab ou re rs Nu m be r o f c hi ld re n of p rim ar y sc ho ol a ge cu rre nt ly a tte nd in g pr im ar y or se co nd ar y sc ho ol Nu m be r o f c hi ld re n of se co nd ar y sc ho ol a ge cu rre nt ly a tte nd in g se co nd ar y sc ho ol o r h ig he r Pr op or tio n of ch ild re n en te rin g th e fir st g ra de o f p rim ar y sc ho ol w ho e ve nt ua lly re ac h gr ad e fiv e Nu m be r o f c hi ld re n w ho w er e in th e la st g ra de o f p rim ar y sc ho ol d ur in g th e pr ev io us sc ho ol y ea r w ho a tte nd se co nd ar y sc ho ol Nu m be r o f c hi ld re n (o f a ny a ge ) a tte nd in g th e la st g ra de o f p rim ar y sc ho ol (e xc lu di ng re pe at er s) Nu m be r o f w om en a ge d 15 -2 4 w ho a re a bl e to re ad a sh or t s im pl e st at em en t a bo ut e ve ry da y lif e Pr op or tio n of g irl s i n pr im ar y an d se co nd ar y ed uc at io n Nu m be r o f c hi ld re n ag ed 0 -5 9 m on th s w ho se b irt hs a re re po rte d re gi st er ed Nu m be r o f w om en a ge d 15 -4 9 w ho re po rte d un de rg oi ng a ny fo rm o f g en ita l m ut ila tio n/ cu tti ng Nu m be r o f w om en a ge d 15 -4 9 w ho re po rte d un de rg oi ng a n ex tre m e fo rm o f g en ita l m ut ila tio n/ cu tti ng (s uc h as in fib ul at io n) Nu m be r o f w om en a ge d 15 -4 9 w ho re po rte d th at a t l ea st o ne d au gh te r h ad u nd er go ne fe m al e ge ni ta l m ut ila tio n/ cu tti ng Nu m be r o f w om en a ge d 15 -4 9 fa vo ur in g th e co nt in ua tio n of fe m al e ge ni ta l m ut ila tio n/ cu tti ng Nu m be r o f w om en w ho w er e fir st m ar rie d or in u ni on b y th e ex ac t a ge o f 1 5 an d th e ex ac t a ge o f 1 8, b y ag e gr ou ps Nu m be r o f w om en a ge d 15 -1 9 ye ar s c ur re nt ly m ar rie d or in u ni on Nu m be r o f w om en m ar rie d/ in u ni on a ge d 15 -1 9 ye ar s a nd 2 0- 24 y ea rs w ith a d iff er en ce in a ge o f 1 0 or m or e ye ar s b et w ee n th em a nd th ei r c ur - re nt sp ou se Nu m be r o f w om en in a p ol yg yn ou s u ni on Nu m be r o f c hi ld re n ag ed 5 -1 4 w ho a re in vo lv ed in ch ild la bo ur Nu m be r o f c hi ld re n ag ed 5 -1 4 in vo lv ed in ch ild la bo ur a ct iv iti es w ho a tte nd sc ho ol Nu m be r o f c hi ld re n ag ed 5 -1 4 at te nd in g sc ho ol w ho a re in vo lv ed in ch ild la bo ur a ct iv iti es IN D IC AT O R N U M ER AT O R D EN O M IN AT O R 196 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix E. MICS Indicators: Numerators and Denominators To ta l n um be r of c hi ld re n ag ed 2 -1 4 se le ct ed an d su rv ey ed To ta l n um be r of c hi ld re n un de r ag e 18 su r- ve ye d To ta l n um be r of c hi ld re n un de r ag e 18 s ur - ve ye d Pr op or tio n of c hi ld re n ag ed 1 0- 14 , bo th o f w ho se p ar en ts ar e a liv e, w ho ar e l iv in g w ith at le as t o ne p ar en t a nd a re a tte nd in g sc ho ol To ta l n um be r o f c hi ld re n ag ed 0 -1 7 su rv ey ed Pr op or tio n of ch ild re n no t c la ss ifi ed a s or ph a- ne d or v ul ne ra bl e un de r ag e fiv e w ho a re m od er at el y or s ev er el y un de rw ei gh t, of a ll ch ild re n no t c la ss ifi ed a s o rp ha ne d or v ul ne ra - bl e un de r a ge fi ve w ho a re w ei gh ed Pr op or tio n of ch ild re n no t c la ss ifi ed a s or ph a- ne d or v ul ne ra bl e ag ed 1 5- 17 w ho h ad s ex be fo re a ge 1 5, o f a ll ch ild re n no t c la ss ifi ed a s or ph an ed o r v ul ne ra bl e ag ed 1 5- 17 su rv ey ed Nu m be r o f o rp ha ne d an d vu ln er ab le c hi ld re n un de r a ge 1 8 su rv ey ed To ta l n um be r o f w om en a ge d 15 -2 4 ye ar s s ur - ve ye d To ta l n um be r o f w om en a ge d 15 -2 4 su rv ey ed w ho h ad a n on -m ar ita l, no n- co ha bi tin g pa rt- ne r i n th e pr ev io us 1 2 m on th s To ta l n um be r o f w om en a ge d 15 -2 4 su rv ey ed To ta l n um be r o f w om en a ge d 15 -2 4 w ho w er e se xu al ly a ct iv e in th e pr ev io us 1 2 m on th s To ta l n um be r o f w om en su rv ey ed To ta l n um be r o f w om en su rv ey ed To ta l n um be r o f w om en su rv ey ed To ta l n um be r o f w om en su rv ey ed 71 Ch ild d isc ip lin e 72 Pr ev al en ce o f o rp ha ns 73 Pr ev al en ce o f vu ln er ab le c hi l- dr en 74 Sc ho ol a tte nd an ce o f or ph an s ve rs us n on -o rp ha ns 75 Ch ild re n' s l iv in g ar ra ng em en ts 76 M al nu tri tio n am on g ch ild re n or ph an ed a nd m ad e vu ln er ab le by H IV /A ID S 77 Ea rly se x am on g ch ild re n or ph an ed a nd m ad e vu ln er ab le by H IV /A ID S 78 Ex te rn al s up po rt to c hi ld re n or ph an ed a nd m ad e vu ln er ab le by H IV /A ID S 79 Co m pr eh en siv e kn ow le dg e of HI V pr ev en tio n am on g yo un g pe op le 80 Co nd om u se w ith n on -re gu la r pa rtn er s 81 Ag e at f irs t se x am on g yo un g pe op le 82 Hi gh er ri sk se x in th e la st y ea r 83 At tit ud e to w ar ds p eo pl e w ith HI V/ AI DS 84 W om en w ho k no w w he re to b e te st ed fo r H IV 85 W om en w ho h av e be en te st ed fo r H IV 86 Kn ow le dg e of m ot he r-t o- ch ild tra ns m iss io n of H IV Nu m be r o f c hi ld re n ag ed 2 -1 4 w ho (1 ) e xp er ie nc e on ly n on -v io le nt a gg re ss io n, (2 ) e xp er ie nc e ps yc ho lo gi ca l a gg re ss io n as p un ish m en t, (3 ) e xp e- rie nc e m in or p hy sic al p un ish m en t, (4 ) e xp er ie nc e se ve re p hy sic al p un ish m en t Nu m be r o f c hi ld re n un de r a ge 1 8 w ith a t l ea st o ne d ea d pa re nt Nu m be r o f c hi ld re n un de r a ge 1 8 w ho h av e a ch ro ni ca lly il l p ar en t, w ho li ve in a h ou se ho ld w he re a n ad ul t a ge d 18 -5 9 ha s d ie d in th e pa st y ea r, or w ho li ve in a h ou se ho ld w he re a n ad ul t a ge d 18 -5 9 ha s b ee n ch ro ni ca lly il l i n th e pa st y ea r Pr op or tio n of d ou bl e or ph an s ( bo th m ot he r a nd fa th er d ea d) a ge d 10 -1 4 at te nd in g sc ho ol Nu m be r o f c hi ld re n ag ed 0 -1 7 no t l iv in g w ith a b io lo gi ca l p ar en t Pr op or tio n of o rp ha ne d or v ul ne ra bl e ch ild re n un de r a ge fi ve w ho a re m od er at el y or se ve re ly u nd er w ei gh t, of a ll or ph an ed a nd v ul ne ra bl e ch il- dr en u nd er a ge fi ve w ho a re w ei gh ed Pr op or tio n of o rp ha ne d an d vu ln er ab le ch ild re n ag ed 1 5- 17 w ho h ad se x be fo re a ge 1 5, o f a ll or ph an ed a nd v ul ne ra bl e ch ild re n ag ed 1 5- 17 su r- ve ye d Nu m be r o f o rp ha ne d an d vu ln er ab le ch ild re n un de r a ge 1 8 w ho se h ou se ho ld s r ec ei ve d fre e ba sic e xt er na l s up po rt in ca rin g fo r t he ch ild Nu m be r o f w om en a ge d 15 -2 4 w ho co rre ct ly id en tif y tw o w ay s o f a vo id in g HI V in fe ct io n an d re je ct th re e co m m on m isc on ce pt io ns o f H IV tr an s- m iss io n Nu m be r o f w om en ag ed 15 -2 4 y ea rs re po rti ng th e u se o f a co nd om d ur in g se xu al in te rc ou rs e w ith th ei r l as t n on -m ar ita l, n on -c oh ab iti ng se x p ar t- ne r i n th e pr ev io us 1 2 m on th s Nu m be r o f w om en a ge d 15 -2 4 w ho h av e ha d se x be fo re a ge 1 5 Nu m be r o f s ex ua lly a ct iv e w om en a ge d 15 -2 4 w ho h av e ha d se x w ith a n on -m ar ita l, no n- co ha bi ta tin g pa rtn er in th e pr ev io us 1 2 m on th s Nu m be r o f w om en e xp re ss in g ac ce pt an ce o n al l f ou r q ue st io ns a bo ut p eo pl e w ith H IV o r A ID S Nu m be r o f w om en w ho st at e kn ow le dg e of a p la ce to b e te st ed Nu m be r o f w om en w ho re po rt be in g te st ed fo r H IV Nu m be r o f w om en w ho co rre ct ly id en tif y al l t hr ee m ea ns o f v er tic al tr an sm iss io n IN D IC AT O R N U M ER AT O R D EN O M IN AT O R The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 197 Appendix E. MICS Indicators: Numerators and Denominators To ta l n um be r o f w om en w ho g av e bi rth in th e pr ev io us 2 4 m on th s s ur ve ye d To ta l n um be r o f w om en w ho g av e bi rth in th e pr ev io us 2 4 m on th s s ur ve ye d To ta l n um be r o f s ex ua lly a ct iv e w om en a ge d 15 -2 4 su rv ey ed Nu m be r o f u rb an h ou se ho ld m em be rs in h ou - se ho ld s s ur ve ye d Nu m be r o f u rb an h ou se ho ld m em be rs in h ou - se ho ld s s ur ve ye d Nu m be r o f h ou se ho ld m em be rs in u rb an h ou - se ho ld s s ur ve ye d To ta l n um be r of c hi ld re n (o r ho us eh ol ds ) f or w ho m su pp lie s w er e ob ta in ed To ta l n um be r of c hi ld re n (o r ho us eh ol ds ) f or w ho m su pp lie s w er e ob ta in ed To ta l n um be r o f w om en su rv ey ed 87 Co un se lli ng c ov er ag e fo r th e pr ev en tio n of m ot he r-t o- ch ild tra ns m iss io n of H IV 88 Te st in g co ve ra ge fo r t he p re ve n- tio n of m ot he r-t o- ch ild tr an sm is- sio n of H IV 89 Ag e- m ix in g am on g se xu al p ar t- ne rs 90 Se cu rit y of te nu re 91 Du ra bi lit y of h ou sin g 92 Sl um h ou se ho ld 93 So ur ce o f s up pl ie s 94 Co st o f s up pl ie s 95 At tit ud es to w ar ds do m es tic vi ol en ce Nu m be r o f w om en w ho g av e bi rth in th e pr ev io us 2 4 m on th s a nd re ce iv ed a nt en at al ca re re po rti ng th at th ey re ce iv ed co un se llin g on H IV /A ID S du rin g th is ca re Nu m be r o f w om en w ho g av e bi rth in th e pr ev io us 2 4 m on th s a nd re ce iv ed a nt en at al ca re re po rti ng th at th ey re ce iv ed th e re su lts o f a n HI V te st du rin g th is ca re Nu m be r o f w om en a ge d 15 -2 4 w ho h ad se x in th e pa st 1 2 m on th s w ith a p ar tn er w ho w as 10 o r m or e ye ar s o ld er th an th ey w er e Nu m be r o f h ou se ho ld m em be rs li vi ng in u rb an h ou se ho ld s w ho la ck fo rm al d oc um en ta tio n fo r t he ir re sid en ce o r w ho fe el a t r isk o f e vi ct io n Nu m be r o f h ou se ho ld m em be rs li vi ng in u rb an d w el lin gs th at a re n ot co ns id er ed d ur ab le Nu m be r o f h ou se ho ld m em be rs li vi ng in u rb an sl um s Nu m be r o f c hi ld re n (o r h ou se ho ld s) fo r w ho m su pp lie s w er e ob ta in ed fr om p ub lic p ro vi de rs , p re se nt ed se pa ra te ly fo r e ac h ty pe o f s up pl y: in se c- tic id e- tre at ed m os qu ito n et s, or al re hy dr at io n sa lts , a nt ib io tic s a nd a nt im al ar ia ls M ed ia n co st o f s up pl ie s o bt ai ne d, p re se nt ed se pa ra te ly fo r e ac h ty pe o f s up pl y a nd w he th er so ur ce d fro m p ub lic o r p riv at e p ro vi de rs : in se ct ici de - tre at ed m os qu ito n et s, or al re hy dr at io n sa lts , a nt ib io tic s a nd a nt im al ar ia ls. Nu m be r o f w om en w ho c on sid er th at a h us ba nd /p ar tn er is ju st ifi ed in h itt in g or b ea tin g hi s w ife in a t l ea st o ne o f t he fo llo w in g cir cu m st an ce s: (1 ) s he g oe s o ut w ith ou t t el lin g hi m , ( 2) sh e ne gl ec ts th e ch ild re n, (3 ) s he a rg ue s w ith h im , ( 4) sh e re fu se s s ex w ith h im , ( 5) sh e bu rn s t he fo od IN D IC AT O R N U M ER AT O R D EN O M IN AT O R 198 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report APPENDIX F: QUESTIONNAIRES Household Questionnaire We are from various government departments (Central Statistics Dept., DoSH, DOSE, etc.). We are wor- king on a project concerned with family health and education. I would like to talk to you about this. The interview will take about 1hr.30 minutes. All the information we obtain will remain strictly confidential and your answers will never be identified. During this time I would like to speak with all mothers or others who take care of children in the household. May I start now? If permission is given, begin the interview. HH1. Enumeration area number: ___ ___ ___ HH3. Interviewer name and number: Name ___ ___ HH5. Day/Month/Year of interview: HH6. Area: Urban.1 Rural. 2 HH 8. Name of head of household: HH9. Result of HH interview: Completed. 1 Not at home.2 Refused.3 HH not found/destroyed.4 Other (specify) 6 HH12. No. of women eligible for interview: ___ ___ HH14. No. of children under age 5: ___ ___ HH16. Data entry clerk: HH2. Household number: ___ ___ HH4. Supervisor name and number: Name ___ ___ ___ ___ / ___ ___ / ___ ___ ___ ___ HH7. Region: LGA: . District: . Settlement: . PHC/NON PHC: . HH10. Respondent to HH questionnaire: Name: Line No: ___ ___ ____ HH11. Total number of household members: ___ ___ ____ HH13. No. of women questionnaires completed: ___ ___ HH15. No. of under-5 questionnaires completed: ___ ___ HOUSEHOLD INFORMATION PANEL HH After all questionnaires for the household have been completed, fill in the following information: Interviewer/supervisor notes: Use this space to record notes about the interview with this household, such as call-back times, incomplete individual interview forms, number of attempts to re-visit, etc. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 199 Appendix F. Questionnaires __ _ __ _ HL 1. Lin e No . HL 3. W ha t is th e re lat ion -sh ip of (N AM E) to th e h ea d o f th e h ou se - ho ld? HL 10 . If a liv e: DO ES (N AM E) S NA TU RA L M OT HE R LIV E IN TH IS HO US E- HO LD ? Re co rd Li ne no . of m ot he r o r 00 fo r ' no ' HL 9. IS (n am e's ) NA TU - RA L M OT HE R AL IV E? 1 Y ES 2 N O HL 11 8 D K HL 11 HL 10 A. If m ot he r d oe s no t li ve in ho us eh old : HA S (n am e's ) M OT HE R BE EN VE RY S IC K FO R AT LE AS T 3 M ON TH S IN TH E P AS T 12 M ON TH S? HL 11. IS (n am e's ) NA TU RA L FA TH ER AL IV E? 1 Y ES 2 N O NE XT LI NE 8 D K NE XT LI NE HL 10 AA . IF NO W HO IS TH E AL TE RN AT IV E CA RE TA KE R? 1P AT ER NA L RE LA TIV E 2 M AT ER NA L RE LA TIV E 3 O TH ER (S PE CI FY ) HL 12 . If a liv e: DO ES (N AM E) S NA TU RA L FA TH ER LI VE IN TH IS HO US E- HO LD ? Re co rd Li ne no . of fa th er or 00 fo r ' no ' HL 12 A. If f ath er do es no t li ve in ho us eh old : HA S (n am e's ) FA TH ER B EE N VE RY S IC K FO R AT LE AS T 3 M ON TH S IN TH E P AS T 12 M ON TH S? HL 4. Is (N AM E) m ale or fe m ale ? 1 M AL E 2 F EM . HO W O LD IS (n am e)? HO W O LD W AS (n am e) ON HI S/ HE R LA ST BI RT HD AY ? Re co rd in co m - ple ted ye ar s 98 =D K* W OM EN 'S IN TE RV IEW HL 6. Ci rcl e L ine no . If w om an is ag e 15 -49 El ig ib le fo r: Fo r c hi ld re n ag e 0- 17 y ea rs as k H L9 -H L1 2A CH ILD LA BO UR M OD UL E HL 7. Fo r e ac h c hil d ag e 5 -14 : W HO IS TH E M OT HE R OR PR IM AR Y CA RE TA KE R OF TH IS C HI LD ? Re co rd Li ne no . of m ot he r/ ca re tak er UN DE R- 5 IN TE RV IEW HL 8. Fo r e ac h c hil d un de r 5 : W HO IS TH E M OT HE R OR PR IM AR Y CA RE TA KE R OF TH IS C HI LD ? Re co rd Li ne no . of m ot he r/ ca re ta- ke r If a ge 18 -59 ye ar s HL 8A . HA S (n am e) BE EN VE RY S IC K FO R A T LE AS T 3 M ON TH S DU RI NG TH E P AS T 12 M ON TH S? HL 2. Na m e LIN E 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 Ar e t he re an y o th er pe rso ns liv ing he re - e ve n i f t he y a re no t m em be rs of yo ur fa m ily or do no t h av e p ar en ts liv ing in th is ho us eh old ? I NC LU DI NG C HI LD RE N AT W OR K OR AT S CH OO L? If ye s, ins ert ch ild 's na m e a nd co m ple te fo rm .Th en , c om ple te th e t ot als be low * S ee in str uc tio ns : to be us ed on ly fo r e lde rly ho us eh old m em be rs (co de m ea nin g “ do no t k no w/ ov er ag e 5 0” ). No w fo r e ac h w om an ag e 1 5-4 9 y ea rs, w rit e h er na m e a nd lin e n um be r a nd ot he r i de nt ify ing in fo rm ati on in th e i nf or m ati on pa ne l o f t he W om en 's Qu es tio nn air e. Fo r e ac h c hil d u nd er ag e 5 , w rit e h is/ he r n am e a nd lin e n um be r A ND th e l ine nu m be r o f h is/ he r m ot he r o r c ar eta ke r i n t he in fo rm ati on pa ne l o f t he Q ue sti on na ire fo r C hil dr en U nd er Fiv e. Yo u s ho uld no w ha ve a se pa ra te qu es tio nn air e f or ea ch el igi ble w om an an d e ac h c hil d u nd er fiv e i n t he ho us eh old . * C od es fo r H L3 : R ela tio ns hip to he ad of ho us eh old : 01 = He ad 03 = So n o r D au gh ter 0 5 = G ra nd ch ild 07 = Pa re nt -In -La w 0 9 = B ro th er or S ist er- In- La w 11 = Ni ec e/N ep he w By B loo d 13 = Ot he r R ela tiv e 15 = No t R ela ted 02 = W ife or H us ba nd 04 = So n o r D au gh ter In -La w 0 6 = Pa re nt 08 = Br ot he r o r S ist er 1 0 = U nc le/ Au nt 12 = Ni ec e/N ep he w By M arr iag e 14 = Ad op ted /Fo ste r/S tep ch ild 98 = Do n't K no w FI RS T, P LE A SE T EL L M E TH E N A M E O F EA CH P ER SO N W H O U SU A LL Y LI VE S H ER E, S TA RT IN G W IT H T H E H EA D O F T H E H O U SE H O LD . Li st th e he ad o f t he h ou se ho ld in li ne 0 1. L is t a ll ho us eh ol d m em be rs (H L2 ), th ei r r el at io ns hi p to th e ho us eh ol d he ad (H L3 ), an d th ei r s ex (H L4 ) Th en a sk :A RE T H ER E A N Y O TH ER S W H O L IV E H ER E, E VE N IF T H EY A RE N O T AT H O M E N O W ? (T H ES E M AY IN CL U D E CH IL D RE N IN S CH O O L O R AT W O RK ). If ye s, c om pl et e lis tin g. Th en , a sk q ue st io ns s ta rt in g w ith H L5 fo r e ac h pe rs on a t a ti m e. A dd a c on tin ua tio n sh ee t i f t he re is n ot e no ug h ro om o n th is p ag e. T ic k he re if c on tin ua tio n sh ee t u se d RE L. 0 1 Y N D K 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 M OT HE R __ _ __ _ __ __ _ __ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ Y N DK 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 M OT HE R __ _ __ _ __ __ _ __ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ Y N DK 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 FA TH ER __ _ __ _ __ __ _ __ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ Y N DK 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 M F 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 AG E __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ 15 -49 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 M OT HE R __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ M OT HE R __ _ __ _ __ __ _ __ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ __ _ Y N D K 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 To tal s Mo the rs De ad (=2 ) ___ _ __ M ot he rs Ve ry Si ck (= 1) __ _ __ _ Fa th er s De ad (= 2 __ _ __ _ Fa th er s V er y Si ck (= 1) W om en 15 -49 __ _ _ Ch ild re n 5-1 4 __ _ __ _ Un de r-5 s __ _ __ _ Ve ry S ick (= 1) __ _ __ _ NA M E H O U S EH O LD L IS TI N G F O R M 200 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires ED 1. Li ne N o ED 1A . N AM E ED 2. HA S (n am e) EV ER A TT EN - DE D SC HO O L OR P RE - SC HO OL ? 1 Y ES ED 3 2 N O N EX T LI N E ED 3A A IS (N AM E) CU RR EN TL Y AT TE N DI N G SC HO O L? 1 Y ES 2 N O (IF A G E IS L ES S TH AN 5 O R M O RE TH AN 2 4 Y EA RS ne xt li ne ) ED 4. DU RI N G TH E (2 00 5- 20 06 ) SC HO O L Y EA R, DI D (n am e) AT TE N D SC HO O L O R PR ES CH O O L AT A N Y TI M E? 1 Y ES 2 N O ED 7 ED 5. SI N CE L AS T (d ay o f t he w ee k) , HO W M AN Y DA YS D ID (n am e) AT TE N D SC HO O L? In se rt nu m be r of d ay s in s pa ce be lo w ED 7. DI D (n am e) AT TE N D SC HO O L O R PR ES CH O O L AT A N Y TI M E DU RI N G TH E PR E- VI O U S SC HO O L YE AR , T HA T IS (2 00 4- 20 05 )? 1 Y ES ED 8 2 N O ED 9 8 DK N EX T LI N E ED 9. W HA T W AS TH E RE AS O N FO R (N AM E) N OT A TT EN - DI N G S CH O O L PR E- SC HO O L PR EV IO U S SC HO O L Y EA R? 1. FI N AN CI AL 2. PR EG N AN CY 3. M AR RI AG E 4. W O RK F O R PA Y 5. DO M ES TI C W O RK (U N PA ID ) 6. OT HE RS -(S PE CI FY ) ED 8. DU RI N G TH AT P RE VI O U S SC HO O L YE AR , W HI CH L EV EL A N D G RA DE DI D (n am e) A TT EN D? LE VE L: 0 P RE -S CH O O L 10 D AY CA RE C EN TR ES 1 P RI M AR Y 11 M AD RA SS A PR IM AR Y 2 S EC O N DA RY (U PP ER BA SI C/ JU N IO R/ SE N IO R) 12 M AD RA SS A SE CO N DA RY 3 HI G HE R (T ER TI AR Y, U N IV ER - SI TY , C O LL EG E) 4 VO CA TI O N AL 6 N O N -S TA N DA RD CU RR IC U LU M 98 D K G RA DE : 98 D K ED 6. DU RI N G TH IS S CH O O L Y EA R, W HI CH L EV EL A N D G RA DE IS (n am e) AT TE N DI N G ? LE VE L: 0 P RE -S CH O O L 10 DA YC AR E CE NT RE S 1 P RI M AR Y 11 M AD RA SS A PR IM AR Y 2 S EC O N DA RY (U PP ER BA SI C/ JU N IO R/ SE N IO R) 12 M AD RA SS A SE CO N - DA RY 3 HI G HE R (T ER TI AR Y, U N I- VE RS IT Y, C O LL EG E) 4 VO CA TI O N AL 6 N O N -S TA N DA RD CU RR IC U LU M 98 DK G RA DE : 98 DK ED 3. W HA T IS TH E HI G HE ST L EV EL O F SC HO O L (n am e) AT TE N DE D? W HA T IS TH E HI G HE ST G RA DE (n am e) CO M PL ET ED A T T HI S LE VE L? LE VE L: 0 PR E- SC HO O L 10 D AY CA RE C EN TR ES 1 PR IM AR Y 11 M AD RA SS A PR IM AR Y 2 S EC O N DA RY (U PP ER BA SI C/ JU N IO R/ SE N IO R) 12 M AD RA SS A SE CO N DA RY 3 HI G HE R (T ER TI AR Y, U N I VE RS IT Y, C O LL EG E) 4 VO CA TI O N AL 6 N O N -S TA N DA RD CU RR IC U LU M 98 D K G RA DE : 98 D K If le ss th an 1 g ra de , e nt er 0 0 LE VE L LE VE L Fo r ho us eh ol d m em be rs a ge 5 a nd a bo ve FO R H O U S EH O LD M EM B ER S A G E 5- 24 Y EA R S ED U C AT IO N M O D U LE ED LI N E 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 YE S N O 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 Y N D K 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 1 2 8 G RA D E __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ G RA D E __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ LE VE L G RA D E __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ __ __ _ __ _ DA YS __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ YE S N O 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E 1 2 NE XT LIN E The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 201 Appendix F. Questionnaires WS1. WHAT IS THE MAIN SOURCE OF DRINKING WATER FOR MEMBERS OF YOUR HOUSEHOLD? WS2. WHAT IS THE MAIN SOURCE OF WATER USED BY YOUR HOUSE- HOLD FOR OTHER PURPOSES SUCH AS COOKING AND HAND- WASHING? WS3. HOW LONG DOES IT TAKE TO GO THERE, GET WATER, AND COME BACK? WS4. WHO USUALLY GOES TO THIS SOURCE TO FETCH THE WATER FOR YOUR HOUSEHOLD? Probe: IS THIS PERSON UNDER AGE 15? WHAT SEX? Circle code that best describes this per- son. WS5. DO YOU TREAT YOUR WATER IN ANY WAY TO MAKE IT SAFER TO DRINK? WS6. WHAT DO YOU USUALLY DO TO THE WATER TO MAKE IT SAFER TO DRINK? ANYTHING ELSE? Record all items mentioned. WS7. WHAT KIND OF TOILET FACILITY DO MEMBERS OF YOUR HOUSEHOLD USUALLY USE? If “flush” or “pour flush”, probe: WHERE DOES IT FLUSH TO? If necessary, ask permission to observe the facility 11 WS5 12 WS5 WS3 96 WS3 11 WS5 12 WS5 995 WS5 2 WS7 8 WS7 95 WS7CC Piped water Piped into dwelling. 11 Piped into yard or plot. 12 Public tap/standpipe. 13 Tubewell/borehole with pump. 21 Dug well Protected well.31 Unprotected well. 32 Rainwater collection. 51 Tanker-truck. 61 Cart with small tank/drum. 71 Surface water (river, stream, dam, lake, Pond, canal, irrigation channel). 81 Bottled water. 91 Other (specify) 96 Piped water Piped into dwelling. 11 Piped into yard or plot. 12 Public tap/standpipe. 13 Tubewell/borehole with hand pump. 21 Dug well Protected well. 31 Unprotected well. 32 Rainwater collection. 51 Tanker-truck. 61 Cart with small tank/drum. 71 Surface water (river, stream, dam, lake, Pond, canal, irrigation channel). 81 Other (specify) 96 No. of minutes. __ __ __ Water on premises. 995 DK. 998 Adult woman. 1 Adult man. 2 Female child (under 15). 3 Male child (under 15). 4 DK. 8 Yes. 1 No. 2 DK. 8 Boil. A Add bleach/chlorine. .B Strain it through a cloth. C Use water filter (ceramic, sand, composite, etc.). D Solar disinfection. E Let it stand and settle. F Other (specify). X DK. Z Flush / pour flush Flush to piped sewer system. 11 Flush to septic tank. 12 Flush to pit (latrine). 13 Flush to somewhere else.14 Flush to unknown place/not sure/DK where. 15 Ventilated Improved Pit latrine (VIP) . 21 Pit latrine with slab. 22 Pit latrine without slab / open pit.23 Bucket.41 No facilities or bush or field. 95 Other (specify) 96 WATER AND SANITATION MODULE WS 202 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires WS7AA. IS THIS FACILITY LOCATED WITHIN YOUR DWELLING, OR YARD OR COMPOUND? WS7BB. HOW FAR IS YOUR HOUSE/RESIDENCE FROM THE NEAREST TOILET FACILTY? WS7CC. HOW FAR IS YOUR HOUSE/RESIDENCE FROM THE NEAREST REFUSE DISPOSAL SITE? WS7DD. HOW FAR IS YOUR KITCHEN/COOKING PLACE FROM THE NEAREST TOILET FACILTY? WS7EE. HOW FAR IS YOUR KITCHEN/COOKING PLACE FROM THE NEAREST DISPOSAL SITE? WS7FF. WHAT HAPPENS WITH THE STOOLS OF YOUNG CHILDREN (0- 3 YEARS) WHEN THEY DO NOT USE THE LATRINE OR TOILET FACILITY? WS7GG DO YOU USE SOAP AFTER TOI LET OR WHEN YOU ROMOVE WASTE/FAECES FROM CHILDREN? WS8. DO YOU SHARE YOUR TOILET FACILITY WITH OTHER HOUSE- HOLDS? WS9. HOW MANY HOUSEHOLDS IN TOTAL USE THIS TOILET FACILITY? WS7CC 1 WS 8 8 WS 8 2 NEXT MODULE Yes, in dwelling/yard/compound. 1 No, outside dwelling/yard/compound. 2 DK 8 Less than 30 metres. 1 30 - 50 metres. 2 51 - 100 metres. 3 Greater than 100metres. 4 Less than 30metres. 1 30 - 50 metres. 2 51 - 100 metres. 3 Greater than 100metres. 4 Less than 30metres. 1 30 - 50 metres. 2 51 - 100 metres. 3 Greater than 100metres. 4 Less than 30metres. 1 30 - 50 metres. 2 51 - 100 metres. 3 Greater than 100metres. 4 Children always use toilet or latrine. 1 Thrown into toilet or latrine. 2 Thrown outside the yard. 3 Buried in the yard. 4 Not disposed of or left on the ground. 5 Other (specify). 6 No young children in household. 8 Yes. 1 No. 2 Yes. 1 No. 2 No. of households (if less than 10). 0 ___ Ten or more households. 10 DK. 98 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 203 Appendix F. Questionnaires HC1A. WHAT IS THE RELIGION OF THE HEAD OF THIS HOUSEHOLD? HC1B. WHAT IS THE MOTHER TON GUE/NATIVE LANGUAGE OF THE HEAD OF THIS HOUSEHOLD? HC1C. TO WHAT ETHNIC GROUP DOES THE HEAD OF THIS HOUSEHOLD BELONG? HC2. HOW MANY ROOMS IN THIS HOU SEHOLD ARE USED FOR SLEE- PING? HC3. Main material of the dwelling floor. Record observation. HC4. Main material of the roof. Record observation. HC5. Main material of the walls. Record observation. Islam. 1 Christianity. 2 Other religion (specify) 6 No religion. 7 Mandinka. 1 Wollof. 2 Jola. 3 Fula. 4 Serer. 5 Other language (specify) 6 Mandinka. 1 Wollof. 2 Jola. 3 Fula. 4 Serer . 5 Other language (specify) 6 No. of rooms. __ __ Natural floor Earth/sand. 11 Dung. 12 Rudimentary floor Wood planks. 21 Palm/bamboo. 22 Finished floor Parquet or polished wood. 31 Vinyl or asphalt strips. 32 Ceramic tiles. 33 Cement. 34 Carpet. 35 Other (specify) 96 Natural roofing No Roof.11 Thatch/palm leaf.12 Rudimentary Roofing Rustic mat. 21 Palm/bamboo. 22 Wood planks. 23 Finished roofing Metal/corrugated iron. 31 Wood. 32 Calamine/cement fiber. 33 Ceramic tiles. 34 Cement. 35 Other (specify) 96 Natural walls No walls.11 Cane/palm/trunks. 12 Dirt. 13 Rudimentary walls Bamboo/ krinting with mud/cement. 21 Stone with mud. 22 Plywood. 24 Carton. 25 Reused wood. 26 Finished walls Cement. 31 Stone with lime/cement. 32 Bricks. 33 Cement blocks. 34 Other (specify) 96 HOUSEHOLD CHARACTERISTICS MODULE HC 204 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires HC6. WHAT TYPE OF FUEL DOES YOUR HOUSEHOLD MAINLY USE FOR COOKING? HC7. IN THIS HOUSEHOLD, IS FOOD COOKED ON AN OPEN FIRE, AN OPEN STOVE OR A CLOSED STOVE? Probe for type. HC7A. DOES THE FIRE/STOVE HAVE A CHIMNEY OR A HOOD? HC8. IS THE COOKING USUALLY DONE IN THE HOUSE, IN A SEPARATE BUILDING, OR OUTDOORS? HC9. DOES YOUR HOUSEHOLD HAVE: ELECTRICITY? A RADIO? A TELEVISION? A MOBILE TELEPHONE? A NON-MOBILE TELEPHONE? A REFRIGERATOR? AN ELECTRICAL GENERATOR? A VIDEO PLAYER? A FAN? A CASSETTE OR VIDEO PLAYER? A SOFA? A CUPBOARD? AN AIR CONDITIONER? HC10. DOES ANY MEMBER OF YOUR HOUSEHOLD OWN: A WATCH? A BICYCLE? A MOTORCYCLE OR SCOOTER? AN ANIMAL-DRAWN CART? A CAR OR TRUCK? A BOAT WITH A MOTOR? HC11. DOES ANY MEMBER OF THIS HOUSEHOLD OWN ANY LAND THAT CAN BE USED FOR AGRICULTURE? HC12. HOW MANY HECTARES OF AGRI CULTURAL LAND DO MEMBERS OF THIS HOUSEHOLD OWN? If more than 97, record '97'. If unknown, record '98'. HC13. DOES THIS HOUSEHOLD OWN ANY LIVESTOCK, HERDS, OR FARM ANIMALS? HC14. HOW MANY OF THE FOLLOWING ANIMALS DOES THIS HOUSE- HOLD HAVE? CATTLE? MILK COWS OR BULLS? HORSES, DONKEYS, OR MULES? GOATS? SHEEP? CHICKENS? If none, record '00'. If more than 97, record '97'. If unknown, record '98'. 01 HC8 02 HC8 03 HC8 04 HC8 3 HC8 6 HC8 2 HC13 2 NEXT MODULE Electricity. 01 Liquid Propane Gas (LPG). 02 Natural gas. 03 Biogas. 04 Kerosene. 05 Coal / Lignite. 06 Charcoal. 07 Wood. 08 Straw/shrubs/grass. 09 Animal dung. 10 Agricultural crop residue. 11 Other (specify) 96 Open fire. 1 Open stove. 2 Closed stove. 3 Other (specify) 6 Yes. 1 No. 2 In the house. 1 In a separate building. 2 Outdoors. 3 Other (specify) 6 Yes No Electricity.1 2 Radio.1 2 Television.1 2 Mobile Telephone.1 2 Non-Mobile Telephone.1 2 Refrigerator.1 2 Electrical Generator.1 2 Video.1 2 Fan.1 2 Cassette or Video player.1 2 Sofa.1 2 Cupboard.1 2 Air conditioner.1 2 Yes No Watch.1 2 Bicycle.1 2 Motorcycle/Scooter .1 2 Animal drawn-cart.1 2 Car/Truck.1 2 Boat with motor.1 2 Yes. 1 No. 2 Hectares.___ ___ Yes. 1 No. 2 Cattle.___ ___ Milk cows or bulls.___ ___ Horses, donkeys, or mules.___ ___ Goats.___ ___ Sheep.___ ___ Chickens.___ ___ The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 205 Appendix F. Questionnaires HC15A. DO YOU OR SOMEONE IN THIS HOUSEHOLD OWN THIS DWEL- LING, OR DO YOU RENT THIS DWELLING? HC15B. DO YOU OR SOMEONE IN THIS HOUSEHOLD HAVE A TITLE DEED FOR THIS DWELLING? HC15C. WHAT KIND OF DOCUMENT DO YOU HAVE FOR THE OWNER- SHIP OF THIS DWELLING? ANYTHING ELSE? Record all items mentioned. HC15D. DO YOU HAVE A WRITTEN REN- TAL CONTRACT FOR THIS DWELLING? HC15E. DO YOU HAVE ANY DOCUMEN- TATION OR AGREEMENT FOR THE RENTAL OF THIS DWEL- LING? If Yes, WHAT KIND OF DOCUMENT OR AGREEMENT DO YOU HAVE FOR THE RENTAL OF THIS DWELLING? ANYTHING ELSE? Record all items mentioned. HC15F. DO YOU FEEL SECURE FROM EVICTION FROM THIS DWELLING? HC15G. HAVE YOU BEEN EVICTED FROM YOUR HOME AT ANY TIME DURING THE PAST 5 YEARS? HC15H. Dwelling located in or near: Observe, and circle all items that des- cribe the location of dwelling. HC15I. Condition of dwelling: Record observation. Record all that apply. HC15J. Dwelling surroundings: Record observation. Record all that apply. 2 HC15D 3 HC15D 1 HC15F HC15F 1 HC15F Own. 1 Rent. 2 Rent free/squatter/other. 3 Yes. 1 No. 2 Certificate of occupation (or adjudication certificate). A Property tax certification. B Utility bills. C Other (specify). X None/No document. Y Yes. 1 No. 2 Informal agreement (written). A Verbal agreement (no document). B Occupied rent free With knowledge of owner. C Without knowledge of owner. D Other (specify). X None/No document. Y Yes. 1 No. 2 DK. 8 Yes. 1 No. 2 Landslide area. A Flood-prone area. B River bank. C Steep hill. D Garbage mountain/pile. E Industrial pollution area. F Railroad. G Power plant. H Flyover. I None of the above. Y Cracks/openings in walls. A No windows. B Windows with broken glass/no glass.C Visible holes in the roof. D Incomplete roof. E Insecure door. F None of the above. Y Very narrow passage between houses instead of road. A Too many power cables connecting to neighborhood's main distribution post. B None of the above. Y SECURITY OF TENURE MODULE ST 206 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires TN1. DOES YOUR HOUSEHOLD HAVE ANY MOSQUITO NETS THAT CAN BE USED WHILE SLEEPING? TN2. HOW MANY MOSQUITO NETS DOES YOUR HOUSEHOLD HAVE? If 7 or more nets, record '7'. TN2AA. HOW MANY BEDS DO YOU HAVE IN THE HOUSEHOLD? TN2BB. HOW MANY OF THESE BEDS HAVE NETS? TN2CC. DO YOU SLEEP UNDER A TREA- TED NET? TN3. IS THE NET (ARE ANY OF THE NETS) ANY OF THE FOLLOWING TYPES? If the respondent does not know the type of the net, explain to him/her the type of nets available. TN3A. WHERE DID YOU GET THE (name of net highest in the list of nets available in the household, in TN3) MOSQUITO NET? TN3B. HOW MUCH DID YOU PAY FOR THE (name of net highest in the list of nets available in the house- hold, in TN3) MOSQUITO NET? TN4. Check TN3 for brand of net(s). Go through the above list in order until one box is checked and follow instructions: 1. Long-lasting treated net mentioned? Go to Next Module 2. Pre-treated net mentioned? Go to TN6 3. Other net mentioned? Continue with TN5 2 NEXT MODULE Yes. 1 No. 2 Number of nets._____ _____ Number of nets. _____ Number of beds with nets._____ _____ Yes. 1 No. 2 Long Lasting Net (LLN). 1 Pre-Treated with Insecticides. 2 Not Treated with Insecticide. 3 Type of Net Not Known. 8 Public sector Govt. hospital.11 Govt. health centre. 12 Govt. health post. 13 Village health worker. 14 Mobile/outreach clinic. 15 Other public (specify).16 Private medical sector Private hospital/clinic. 21 Private physician. 22 Private pharmacy. 23 Mobile clinic . 24 Other private Medical (specify). 26 Other source Relative or friend. 31 Shop . 32 Traditional practitioner . 33 Other (specify). 96 DK. 98 Dalasis.__ __ __ __ Free. 9996 DK. 9998 SECURITY OF TENURE MODULE ST The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 207 Appendix F. Questionnaires TN5. WHEN YOU GOT THE (MOST RECENT) NET, WAS IT ALREADY TREATED WITH AN INSECTICIDE TO KILL OR REPEL MOSQUITOES? TN6. HOW MANY MONTHS AGO WAS THE NET OBTAINED? If less than 1 month ago, record '00'. If answer is “12 months” or “1 year”, probe to determine if net was obtained exactly 12 months ago or earlier or later. TN7. SINCE YOU GOT THE NET HAS IT EVER BEEN SOAKED OR DIPPED IN A LIQUID TO KILL/REPEL MOSQUITOES? TN8. HOW LONG AGO WAS THE MOST RECENT SOAKING/DIPPING DONE? If less than 1 month, record '00'. If answer is “12 months” or “1 year”, probe to determine if net was treated exactly 12 months ago or earlier or later. 2 NEXT MODULE 28 NEXT MODULE Yes. 1 No. 2 DK/not sure. 8 Months ago. __ __ More than 24 months ago. 95 Not sure. 98 Yes. 1 No. 2 DK/not sure. 8 Months ago. __ __ More than 24 months ago. 95 Not sure. 98 208 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires CL1. LINE NO. CL2. NAME CL3. DURING THE PAST WEEK, DID (NAME) DO ANY KIND OF WORK FOR SOMEONE WHO IS NOT A MEMBER OF THIS HOUSEHOLD? IF YES: FOR PAY IN CASH OR KIND? 1 YES, FOR PAY (CASH OR KIND) 2 YES, UNPAID 3 NO TO CL5 CL3AA IF YES ( IN CL3), WHAT TYPE OF WORK? record answer as reported. CL3BB WHY IS THE CHILD WORKING? 1.SUPPORT FAMILY 2.EDUACTION 6.OTHER (SPECIFY) 8. DK CL4. If yes: SINCE LAST (day of the week), ABOUT HOW MANY HOURS DID HE/SHE DO THIS WORK FOR SOMEONE WHO IS NOT A MEMBER OF THIS HOUSEHOLD? If more than one job, include all hours at all jobs. Record response then CL.6 LINE NO. 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 NAME NO. OF HOURS ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ YES PAID UNPAID NO 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 CHILD LABOUR MODULE CL CL1. LINE NO. CL5 AT ANY TIME DURING THE PAST YEAR, DID (name) DO ANY KIND OF WORK FOR SOMEONE WHO IS NOT A MEMBER OF THIS HOUSE- HOLD? If yes: FOR PAY IN CASH OR KIND? 1 YES, FOR PAY (CASH OR KIND) 2 YES, UNPAID 3 NO CL6. DURING THE PAST WEEK, DID (name) HELP WITH HOUSEHOLD CHORES SUCH AS SHOPPING, COLLECTING FIRE- WOOD, COOKING, WASHING, CLEANING , FETCHING WATER, OR CARING FOR CHILDREN? 1 YES 2 NO TO CL8 CL7. If yes: SINCE LAST (day of the week), ABOUT HOW MANY HOURS DID HE/SHE SPEND DOING THESE CHORES? CL8. CL8. DURING THE PAST WEEK, DID (name) DO ANY OTHER FAMILY WORK (ON THE FARM OR IN A BUSINESS OR SELLING GOODS IN THE STREET, COOKING OR LAUNDRY?) 1 YES 2 NO NEXT LINE CL4. If yes: SINCE LAST (day of the week), ABOUT HOW MANY HOURS DID HE/SHE DO THIS WORK? LINE NO. 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 NO. OF HOURS ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ NO. OF HOURS ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ YES NO 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 YES PAID UNPAID NO 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 YES NO 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 209 Appendix F. Questionnaires CHILD DISCIPLINE MODULE CD Table 1: Children aged 12 - 14 years eligible for child discipline questions Review the household listing and list each of the children aged 2-14 years below in order according to their line number (HL1). Do not include other household members outside of the age range 2-14 years. Record the line number, name, sex, age, and the line number of the mother or caretaker for each child. Then record the total number of children aged 2-14 in the box provided (CD7). If there is only one child aged 2-14 years in the household, then skip table 2 and go to CD11 to administer child discipline questions for that child. Table 2: Selection of random child for child discipline questions Use this table to select one child between the ages of 2 and 14 years, if there is more than one child in that age range in the household. Look for the last digit of the household number from the cover page. This is the number of the row you should go to in the table below. Check the total number of eligible children (2- 14) in CD7 above. This is the number of the column you should go to. Find the box where the row and the column meet and circle the number that appears in the box. This is the rank number of the child about whom the questions will be asked. Record the rank number in CD9 below. Finally, record the line number and name of the selected child in CD11 on the next page. Then, find the mother or primary caretaker of that child, and ask the questions, beginning with CD12. CD1. Rank No. LINE 01 02 03 04 05 06 07 08 CD7. TOTAL CHILDREN AGED 2-14 YEARS CD2. Line no. from HL1. LINE __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ CD5. Age from HL5. AGE ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ CD6. Line no. of mother/ caretaker from HL7 or HL8 MOTHER ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ CD4. Sex from HL4. M 1 1 1 1 1 1 1 1 F 2 2 2 2 2 2 2 2 CD3. Name from HL2. NAME CD9. Record the rank number of the selected child from table 2 above Rank number of child.__ __ 8+ 4 5 6 7 8 1 2 3 4 5 7 5 6 7 1 2 3 4 5 6 7 6 6 1 2 3 4 5 6 1 2 3 5 3 4 5 1 2 3 4 5 1 2 4 4 1 2 3 4 1 2 3 4 1 3 2 3 1 2 3 1 2 3 1 2 2 2 1 2 1 2 1 2 1 2 1 1 1 1 1 1 1 1 1 1 1 1 Last digit of the household number 0 1 2 3 4 5 6 7 8 9 CD8. TOTAL NUMBER OF ELIGIBLE CHILDREN IN THE HOUSEHOLD 210 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires CD11. Write name and line no. of the child selected for the module from CD3 and CD2, based on the rank number in CD9. CD12. ALL ADULTS USE CERTAIN WAYS TO TEACH CHILDREN THE RIGHT BEHAVIOUR OR TO ADDRESS A BEHAVIOUR PROBLEM. I WILL READ VARIOUS METHODS THAT ARE USED AND I WANT YOU TO TELL ME IF YOU OR ANYONE ELSE IN YOUR HOUSEHOLD HAS USED THIS METHOD WITH (name) IN THE PAST MONTH OR 2 - 3 MONTHS. CD12A.TOOK AWAY PRIVILEGES, FOR- BADE SOMETHING (name) LIKED OR DID NOT ALLOW HIM/HER TO LEAVE HOUSE). CD12B. EXPLAINED WHY SOMETHING (THE BEHAVIOR) WAS WRONG. CD12C. SHOOK HIM/HER. CD12D. SHOUTED, YELLED AT OR SCREAMED AT HIM/HER. CD12E. GAVE HIM/HER SOMETHING ELSE TO DO. CD12F. SPANKED, HIT OR SLAPPED HIM/HER ON THE BOTTOM WITH BARE HAND. CD12G. HIT HIM/HER ON THE BOTTOM OR ELSEWHERE ON THE BODY WITH SOMETHING LIKE A BELT, HAIRBRUSH, STICK OR OTHER HARD OBJECT. CD12H. CALLED HIM/HER DUMB, LAZY, OR ANOTHER NAME LIKE THAT. CD12I. HIT OR SLAPPED HIM/HER ON THE FACE, HEAD OR EARS. CD12J. HIT OR SLAPPED HIM/HER ON THE HAND, ARM, OR LEG. CD12K. BEAT HIM/HER UP WITH AN IMPLEMENT (HIT OVER AND OVER AS HARD AS ONE COULD). CD13. DO YOU BELIEVE THAT IN ORDER TO BRING UP (RAISE, EDUCATE) (name) PROPERLY, YOU NEED TO PHYSICALLY PUNISH HIM/HER? Identify eligible child aged 2 to 14 in the household using the tables on the preceding page, according to your instructions. Ask to interview the mother or primary caretaker of the selected child (identified by the line number in CD6). Name Line number . _____ _____ Yes. 1 No. 2 Yes. 1 No. 2 Yes. 1 No. 2 Yes. 1 No. 2 Yes. 1 No. 2 Yes. 1 No. 2 Yes. 1 No. 2 Yes. 1 No. 2 Yes. 1 No. 2 Yes. 1 No. 2 Yes. 1 No. 2 Yes. 1 No. 2 Don't know/no opinion.8 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 211 Appendix F. Questionnaires SI1. WE WOULD LIKE TO CHECK WHE- THER THE SALT USED IN YOUR HOUSEHOLD IS IODIZED. MAY I SEE A SAMPLE OF THE SALT USED TO COOK THE MAIN MEAL EATEN BY MEMBERS OF YOUR HOUSE- HOLD LAST NIGHT? Once you have examined the salt, circle number that corresponds to test outcome Not iodized 0 PPM . 1 Less than 15 PPM. 2 15 PPM or more.3 No salt in home.6 Salt not tested.7 SALT IODIZATION MODULE SI SI2. Does any eligible woman age 15-49 reside in the household? Check household listing, column HL6.You should have a questionnaire with the Information Panel filled in for each eligible woman. Yes. Go to QUESTIONNAIRE FOR INDIVIDUAL WOMEN to administer the questionnaire to the first eligible woman. No. Continue. SI3. Does any child under the age of 5 reside in the household? Check household listing, column HL8. You should have a questionnaire with the Information Panel filled in for each eligible child. Yes. Go to QUESTIONNAIRE FOR CHILDREN UNDER FIVE to administer the questionnaire to caretaker of the first eligible child. No. End the interview by thanking the respondent for his/her cooperation. Gather together all questionnaires for this household and tally the number of interviews completed on the cover page. 212 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires UF1. Enumeration Area Number: ___ ___ ___ UF3. Child's Name: UF5. Mother's/Caretaker's Name: UF7. Interviewer name and number: ___ ___ ___ UF9. Result of interview for children under 5 (Codes refer to mother/caretaker.) UF10. NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE HEALTH OF EACH CHILD UNDER THE AGE OF 5 IN YOUR CARE, WHO LIVES WITH YOU NOW. NOW I WANT TO ASK YOU ABOUT (name). IN WHAT MONTH AND YEAR WAS (name) BORN? Probe: WHAT IS HIS/HER BIRTHDAY? If the mother/caretaker knows the exact birth date, also enter the day; otherwise, circle 98 for day. UF11. HOW OLD WAS (name) AT HIS/HER LAST BIRTHDAY? Record age in completed years. UF2. Household number: ___ ___ ___ UF4. Child's Line Number: ___ ___ ___ UF6. Mother's/Caregiver’s Number: ___ ___ ___ UF8. Day/Month/Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ Completed. 1 Not at home. 2 Refused. 3 Partly completed. 4 Incapacitated. 5 Other (specify). 6 Date of birth: Day. __ __ DK day. 98 Month.__ __ DK month.98 Year.__ __ __ __ DK year.9998 Age in completed years.__ UNDER-5 CHILD INFORMATION PANEL UF Questionnaire on Children Under Five This questionnaire is to be administered to all mothers or caretakers (see household listing, column HL8) who care for a child that lives with them and is under the age of 5 years (see household listing, column HL5). A separate questionnaire should be used for each eligible child. Fill in the cluster and household number, and names and line numbers of the child and the mother/caretaker in the space below. Insert your own name and number, and the date. Repeat greeting if not already read to this respondent: WE ARE FROM VARIOUS GOVERNMENT DEPARTMENTS (CENTRAL STATISTICS DEPT., DOSH, ETC.). WE ARE WORKING ON A PROJECT CONCERNED WITH FAMILY HEALTH AND EDUCATION. I WOULD LIKE TO TALK TO YOU ABOUT THIS. THE INTERVIEW WILL TAKE ABOUT 45 MINUTES. ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDEN- TIAL AND YOUR ANSWERS WILL NEVER BE IDENTIFIED. ALSO, YOU ARE NOT OBLIGED TO ANSWER ANY QUESTION YOU DON'T WANT TO, AND YOU MAY WITHDRAW FROM THE INTERVIEW AT ANY TIME. MAY I START NOW? If permission is given, begin the interview. If the respondent does not agree to continue, thank him/her and go to the next interview. Discuss this result with your supervisor for a future revisit. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 213 Appendix F. Questionnaires BR1. DOES (name) HAVE A BIRTH CER- TIFICATE? MAY I SEE IT? BR2. HAS (name's) BIRTH BEEN REGIS- TERED WITH THE CIVIL AUTHORI- TIES? BR3. WHY IS (name's) BIRTH NOT REGISTERED? BR4. DO YOU KNOW HOW TO REGISTER YOUR CHILD'S BIRTH? BR4AA. DO YOU KNOW WHERE TO REGISTER YOUR CHILD? BR4BB. WHERE WAS (name) REGISTERED? BR6. DOES (name) ATTEND ANY ORGA- NIZED LEARNING OR EARLY CHIL- DHOOD EDUCATION PRO- GRAMME, SUCH AS A PRIVATE OR GOVERNMENT FACILITY, INCLU- DING KINDERGARTEN OR COM- MUNITY CHILD CARE? BR7. WITHIN THE LAST SEVEN DAYS, ABOUT HOW MANY HOURS DID (name) ATTEND? BR8. IN THE PAST 3 DAYS, DID YOU OR ANY HOUSEHOLD MEMBER OVER 15 YEARS OF AGE ENGAGE IN ANY OF THE FOLLOWING ACTIVI- TIES WITH (name): If yes, ask: WHO ENGAGED IN THIS ACTIVITY WITH THE CHILD - THE MOTHER, THE CHILD'S FATHER OR ANOTHER ADULT MEMBER OF THE HOUSEHOLD (INCLUDING THE CARETAKER/RESPONDENT)? Circle all that apply. BR8A. READ BOOKS OR LOOK AT PICTURE BOOKS WITH (name)? BR8B. TELL STORIES TO (name)? BR8C. SING SONGS WITH (name)? BR8D. TAKE (name) OUTSIDE THE HOME, COMPOUND, YARD OR ENCLOSURE? BR8E. PLAY WITH (name)? BR8F. SPEND TIME WITH (name) NAMING, COUNTING, AND/OR DRAWING THINGS? 1 BR5 1 BR4AA 8 BR4 2 BR5 8 BR5 2 BR8 8 BR8 Yes, seen.1 Yes, not seen. 2 No3 DK. 8 Yes. 1 No2 DK. 8 Costs too much. 1 Must travel too far. 2 Did not know it should be registered. 3 Did not want to pay fine. 4 Does not know where to register. 5 Other (specify). 6 DK. 8 Yes. 1 No2 Yes. 1 No2 DK. 8 Health Center. 1 Medical & Health Headquarters. 2 DK. 8 Yes. 1 No2 DK. 8 No. Of hours.__ __ Mother Father Other No one Books A B X Y Stories A B X Y Songs A B X Y Take outside A B X Y Play with A B X Y Spend time with A B X Y BIRTH REGISTRATION AND EARLY LEARNING MODULE BR BR5. Check age of child in UF11: Child is 3 or 4 years old? Yes. Continue with BR6 No. Go to BR8 214 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires CE3. I AM INTERESTED IN LEARNING ABOUT THE THINGS THAT (name) PLAYS WITH WHEN HE/SHE IS AT HOME. WHAT DOES (name) PLAY WITH? DOES HE/SHE PLAY WITH HOUSEHOLD OBJECTS, SUCH AS BOWLS, PLATES, CUPS OR POTS? OBJECTS AND MATERIALS FOUND OUTSIDE THE LIVING QUARTERS, SUCH AS STICKS, ROCKS, ANIMALS, SHELLS, OR LEAVES? HOMEMADE TOYS, SUCH AS DOLLS, CARS AND OTHER TOYS MADE AT HOME? TOYS THAT CAME FROM A STORE? If the respondent says “YES” to any of the prompted categories, then probe to learn specifically what the child plays with to ascer- tain the response Code Y if child does not play with any of the items mentioned. CE4. SOMETIMES ADULTS TAKING CARE OF CHILDREN HAVE TO LEAVE THE HOUSE TO GO SHOP- PING, WASH CLOTHES, OR FOR OTHER REASONS AND HAVE TO LEAVE YOUNG CHILDREN WITH OTHERS. SINCE LAST (day of the week) HOW MANY TIMES WAS (name) LEFT IN THE CARE OF ANO- THER CHILD (THAT IS, SOMEONE LESS THAN 10 YEARS OLD)? If 'none' enter 00 CE4AA.SINCE LAST (day of the week) HOW MANY TIMES WAS (name) LEFT IN THE CARE OF ANOTHER PERSON MORE THAN 10 YRS OLD, GRAND PARENT, OR MAID? (If response is 00, skip to CE5) CE4BB 1. WHAT DO THEY DO WITH THEM? Story telling Feeding Riddles OTHER (SPECIFY) CE5. IN THE PAST WEEK, HOW MANY TIMES WAS (name) LEFT ALONE? If 'none' enter 00 Household objects (bowls, plates, cups, pots) …………………….……………….…………………………. A Objects and materials found outside the living quarters (sticks, rocks, animals, shells, leaves) ……………….……………….……………….… B Homemade toys (Dolls, cars and other toys made at home) ……………….……………….……………C Toys that came from a store……………….……………….……………….…………… D No playthings mentioned……………….……………….……………….………………. Y Number of times ____ ____ Number of times for > 10yrs ___ ___ Number of times for grandparent___ ___ Number of times for maid ___ ___ Story telling……………………….A Feeding…………………….………B Riddles………………….………….C Other (Specify)……………………X Number of times ____ ____ CHILD DEVELOPMENT CE The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 215 Appendix F. Questionnaires VA1. HAS (name) EVER RECEIVED A VITA- MIN A CAPSULE (SUPPLEMENT) LIKE THIS ONE? Show capsule or dispenser for diffe- rent doses - 100,000 IU for those 6- 11 months old, 200,000 IU for those 12-59 months old. VA2. HOW MANY MONTHS AGO DID (name) TAKE THE LAST DOSE? (please verify from infant welfare card) VA3. WHERE DID (name) GET THIS LAST DOSE? VA4AA. DOES YOUR CHILD HAVE ANY PROBLEMS SEEING IN THE DAY TIME? VA5AA. DOES YOUR CHILD HAVE ANY PROBLEMS SEEING IN THE NIGHT TIME? VA6AA. IS THIS PROBLEM DIFFERENT FROM OTHER CHILDREN IN YOUR COMMUNITY? VA7AA. DOES YOUR CHILD HAVE NIGHT BLINDNESS? (USE LOCAL TERM FOR NIGHT BLINDNESS) 2 VA4AA 8 VA4AA 2 NEXT MODULE NEXT MODULE Yes. 1 No2 DK. 8 Months ago. __ __ DK. 98 On routine visit to health facility .1 Sick child visit to health facility .2 National Immunization Day campaign. 3 Nutrition Surveillance Program . 4 Other (specify) 6 DK. 8 Yes. 1 No2 DK. 8 Yes. 1 No2 DK. 8 Yes. 1 No2 DK. 8 Yes. 1 No2 DK. 8 VITAMIN A MODULE VA GO TO NEXT MODULE 216 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires BF1. HAS (name) EVER BEEN BREAST- FED? BF1AA. FOR HOW LONG HAS (name) BEEN BREASTFED? BF1BB. DID YOU GIVE (name) THE FIRST MILK THAT COMES OUT OF THE BREAST (COLOSTRUM)? BF1CC. IS THE BREAST MILK THE ONLY SOURCE OF FOOD? BF1DD. IF NO, WHEN DID (name) START OTHER FOODS? BF2. IS HE/SHE STILL BEING BREAST- FED? BF3. SINCE THIS TIME YESTERDAY, DID HE/SHE RECEIVE ANY OF THE FOL- LOWING: Read each item aloud and record res- ponse before proceeding to the next item. BF3A. VITAMIN, MINERAL SUPPLE- MENTS OR MEDICINE? BF3B. PLAIN WATER? BF3C. SWEETENED, FLAVOURED WATER OR FRUIT JUICE OR TEA OR INFU- SION? BF3D. ORAL REHYDRATION SOLUTION (ORS)? BF3E. INFANT FORMULA? BF3F. TINNED, POWDERED OR FRESH MILK? BF3G. ANY OTHER LIQUIDS? BF3H. SOLID OR SEMI-SOLID (MUSHY) FOOD? BF3JJ. WHAT WERE THE REASONS FOR NOT BREASTFEEDING? (Skip this question if answer to BF1 is yes = 1) BF5. SINCE THIS TIME YESTERDAY, HOW MANY TIMES DID (name) EAT SOLID, SEMISOLID, OR SOFT FOODS OTHER THAN LIQUIDS? If 7 or more times, record '7'. 2 BF3 8 BF3 1 BF2 Yes. 1 No2 DK. 8 Months . . Yes. 1 No2 Yes. 1 No2 Age in months . . Yes. 1 No2 DK. 8 Y N DK A. Vitamin supplements.1 2 8 B. Plain water. 1 2 8 C. Sweetened water or juice.1 2 8 D. ORS. 1 2 8 E. Infant formula. 1 2 8 F. Milk. 1 2 8 G. Other liquids. 1 2 8 H. Solid or semi-solid food. 1 2 8 Less or no milk in mother's breast………….….1 Orphan………………………………………….….2 Preferred formula………………………….….….3 Mother ill or sick………………………….…….…4 Child refuse…………………………….….……….5 Other (specify)………………………….….……….6 No. of times. _____ Don't know. 8 BREASTFEEDING MODULE BF BF4. Check BF3H: Child received solid or semi-solid (mushy) food? Yes. Continue with BF5 No or DK. Go to Next Module The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 217 Appendix F. Questionnaires CA1. HAS (name) HAD DIARRHOEA IN THE LAST TWO WEEKS, THAT IS, SINCE (day of the week) OF THE WEEK BEFORE LAST? Diarrhoea is determined as perceived by mother or caretaker, or as three or more loose or watery stools per day, or blood in stool. CA2. DURING THIS LAST EPISODE OF DIARRHOEA, DID (name) DRINK ANY OF THE FOLLOWING: Read each item aloud and record res- ponse before proceeding to the next item. CA2A. A FLUID MADE FROM A SPECIAL PACKET CALLED (local name for ORS packet solution)? CA2B. GOVERNMENT-RECOMMENDED HOMEMADE FLUID? CA2C. A PRE-PACKAGED ORS FLUID FOR DIARRHOEA? CA2AA. DID YOU SEEK ADVICE OR TREATMENT FOR THE DIAR- RHOEA OUTSIDE THE HOME? CA2BB. HOW LONG AFTER THE ONSET OF DIARRHOEA DID YOU SEEK HELP? CA3. DURING (name's) ILLNESS, DID HE/SHE DRINK MUCH LESS, ABOUT THE SAME, OR MORE THAN USUAL? CA4. DURING (name's) ILLNESS, DID HE/SHE EAT LESS, ABOUT THE SAME, OR MORE FOOD THAN USUAL? If “less”, probe: MUCH LESS OR A LITTLE LESS? CA4B. WHERE DID YOU GET THE (local name for ORS packet from CA2A)? 2 CA5 8 CA5 2 CA3 8 CA3 Yes. 1 No.2 DK. 8 Yes No DK A. Fluid from ORS packet 1 2 8 B. Recommended homemade fluid 1 2 8 C. Pre-packaged ORS fluid 1 2 8 Yes. 1 No.2 DK. 8 Same day…………………………………….1 1 - 2 days……………………………….……2 3 days and after…………………………….3 Much less or none. 1 About the same (or somewhat less). 2 More. 3 DK. 8 None. 1 Much less. 2 Somewhat less. 3 About the same. 4 More. 5 DK. 8 Public sector Govt. hospital 11 Govt. health center 12 Govt. health post 13 Village health worker 14 Mobile/outreach clinic 15 Other public (specify) 16 Private medical sector Private hospital/clinic 21 Private physician 22 Private pharmacy 23 Mobile clinic 24 Other private Medical (specify) 26 Other source Relative or friend 31 Shop 32 Traditional practitioner 33 Other (specify) 96 DK.98 CARE OF ILLNESS MODULE CA CA4A. Check CA2A: ORS packet used? Yes. Continue with CA4B No. Go to CA5 218 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires CA4C. HOW MUCH DID YOU PAY FOR THE (local name for ORS packet from CA2A)? CA5. HAS (name) HAD AN ILLNESS WITH A COUGH AT ANY TIME IN THE LAST TWO WEEKS, THAT IS, SINCE (day of the week) OF THE WEEK BEFORE LAST? CA6. WHEN (name) HAD AN ILLNESS WITH A COUGH, DID HE/SHE BREA- THE FASTER THAN USUAL WITH SHORT, QUICK BREATHS OR HAVE DIFFICULTY BREATHING? CA7. WERE THE SYMPTOMS DUE TO A PROBLEM IN THE CHEST OR A BLOCKED NOSE? CA8. DID YOU SEEK ADVICE OR TREAT- MENT FOR THE ILLNESS OUTSIDE THE HOME? CAA8. HOW LONG AFTER THE ONSET OF ILLNESS DID YOU SEEK HELP? CA9. FROM WHERE DID YOU SEEK CARE? ANYWHERE ELSE? Circle all providers mentioned, but do NOT prompt with any sugges- tions. If source is hospital, health center, or clinic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) CA10. WAS (name) GIVEN MEDICINE TO TREAT THIS ILLNESS? CA11. WHAT MEDICINE WAS (name) GIVEN? Circle all medicines given. (Check clinic card for details of prescrip- tion) 2 CA12 8 CA12 2 CA12 8 CA12 2 CA12 6 CA12 2 CA10 8 CA10 2 CA12 8 CA12 Local currency ____ _____ ____ _____ Free 9996 DK 9998 Yes. 1 No.2 DK. 8 Yes. 1 No.2 DK. 8 Problem in chest.1 Blocked nose.2 Both.3 Other (specify) 6 DK. 8 Yes. 1 No.2 DK. 8 Same day…………………………………….1 1 - 2 days………………………………….…2 3 days and after…………………………….3 Public sector Govt. hospital. A Govt. health centre. B Govt. health post. C Village health worker. D Mobile/outreach clinic. E Other public (specify) H Private medical sector Private hospital/clinic. I Private physician. J Private pharmacy . K Mobile clinic . L Other private medical (specify) O Other source Relative or friend.P Shop .Q Traditional practitioner .R Other (specify) X Yes. 1 No.2 DK. 8 Antibiotic. A Paracetamol/Panadol/Acetaminophen.P Aspirin.Q Ibupropfen.R Other (specify) X DK. Z CA11A. Check CA11: Antibiotic given? Yes. Continue with CA11B No. Go to CA12 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 219 Appendix F. Questionnaires CA11B. WHERE DID YOU GET THE ANTI- BIOTIC? CA11C. HOW MUCH DID YOU PAY FOR THE ANTIBIOTIC? CA13.THE LAST TIME (name) PASSED STOOLS, WHAT WAS DONE TO DISPOSE OF THE STOOLS? Ask the following question (CA14) only once for each caretaker. CA14. SOMETIMES CHILDREN HAVE SEVERE ILLNESSES AND SHOULD BE TAKEN IMMEDIATELY TO A HEALTH FACILITY. WHAT TYPES OF SYMPTOMS WOULD CAUSE YOU TO TAKE YOUR CHILD TO A HEALTH FACILITY RIGHT AWAY? Keep asking for more signs or symp- toms until the caretaker cannot recall any additional symptoms. Circle all symptoms mentioned, But do NOT prompt with any sugges- tions. Public sector Govt. hospital 11 Govt. health center 12 Govt. health post 13 Village health worker 14 Mobile/outreach clinic 15 Other public ((specify) 16 Private medical sector Private hospital/clinic 21 Private physician 22 Private pharmacy 23 Mobile clinic 24 Other private Medical (specify) 26 Other source Relative or friend 31 Shop 32 Traditional practitioner 33 Other (specify) 96 DK. 98 Local currency __ __ ___ ___ Free 9996 DK 9998 Child used toilet/latrine. 01 Put/rinsed into toilet or latrine.02 Put/rinsed into drain or ditch. 03 Thrown into garbage (solid waste). 04 Buried. 05 Left in the open. 06 Other (specify) 96 DK. 98 Child not able to drink or breastfeed.A Child becomes sicker. B Child develops a fever. C Child has fast breathing. D Child has difficult breathing.E Child has blood in stool. F Child is drinking poorly.G Not able to eat.H Vomits everything eaten.I Unconscious.J Convulsion.K Other (specify) X Other (specify) Y Other (specify) Z CA11A. Check CA11: Antibiotic given? Yes. Continue with CA11B No. Go to CA12 220 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires ML1. IN THE LAST TWO WEEKS, THAT IS, SINCE (day of the week) OF THE WEEK BEFORE LAST, HAS (name) BEEN ILL WITH A FEVER? ML2. WAS (name) SEEN AT A HEALTH FACILITY DURING THIS ILLNESS? ML3. DID (name) TAKE A MEDICINE FOR FEVER OR MALARIA THAT WAS PROVIDED OR PRESCRIBED AT THE HEALTH FACILITY? ML4. WHAT MEDICINE DID (name) TAKE THAT WAS PROVIDED OR PRESCRI- BED AT THE HEALTH FACILITY? Circle all medicines mentioned. ML5. WAS (name) GIVEN MEDICINE FOR THE FEVER OR MALARIA BEFORE BEING TAKEN TO THE HEALTH FACI- LITY? ML6. WAS (name) GIVEN MEDICINE FOR FEVER OR MALARIA DURING THIS ILL- NESS? ML7. WHAT MEDICINE WAS (name) GIVEN? Circle all medicines given. Ask to see the medication if type is not known. If type of medication is still not determined, show typical anti-malarials to respondent. ML9. HOW LONG AFTER THE FEVER STARTED DID (name) FIRST TAKE (name of anti-malarial from ML4 or ML7)? If multiple anti-malarials mentioned in ML4 or ML7, name all anti-malarial medi- cines mentioned. Record the code for the day on which the first anti-malarial was given. 2 ML10 8 ML10 2 ML6 8 ML6 2 ML5 8 ML5 1 ML7 2 ML8 8 ML8 2 ML8 8 ML8 Yes. 1 No.2 DK. 8 Yes. 1 No.2 DK. 8 Yes. 1 No.2 DK. 8 Anti-malarials: SP/Fansidar.A Chloroquine.B Amodiaquine.C Quinine.D Artemisinin-based combinations.E Other anti-malarial (specify) H Other medications: Paracetamol/Panadol/Acetaminophen.P Aspirin.Q Ibuprofen.R Other (specify) X DK.Z Yes. 1 No.2 DK. 8 Yes. 1 No.2 DK. 8 Anti-malarials: SP/Fansidar.A Chloroquine.B Amodiaquine.C Quinine.D Artemisinin-based combinations.E Other anti-malarial (specify) H Other medications: Paracetamol/Panadol/Acetaminophen.P Aspirin.Q Ibuprofen.R Other (specify) X DK.Z Same day . 0 Next day .1 2 days after the fever. 2 3 days after the fever.3 4 or more days after the fever. 4 DK. 8 MALARIA MODULE FOR UNDER-5S ML ML8. Check ML4 and ML7: Anti-malarial mentioned (codes A - H)? Yes. Continue with ML9 No. Go to ML10 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 221 Appendix F. Questionnaires ML9A. WHERE DID YOU GET THE (name of anti-malarial from ML4 or ML7)? If more than one anti-malarial is men- tioned in ML4 or ML7, refer to the first anti-malarial given for the fever (the anti-malarial given on the day recorded in ML9). ML9B. HOW MUCH DID YOU PAY FOR THE (name of anti-malarial from ML4 or ML7)? Refer to the same anti-malarial as in ML9A above ML10. DID (name) SLEEP UNDER A MOS- QUITO NET LAST NIGHT? ML11. HOW LONG AGO DID YOUR HOU- SEHOLD OBTAIN THE MOSQUITO NET? If less than 1 month, record '00'. If answer is “12 months” or “1 year”, probe to determine if net was trea- ted exactly 12 months ago or earlier or later. ML12. WAS THE NET ONE OF THE FOLLO- WING TYPES? If the respondent does not know the type of the net, explain to him/her the type of nets available. ML13. WHEN YOU GOT THAT NET, WAS IT ALREADY TREATED WITH AN INSECTICIDE TO KILL OR REPEL MOSQUITOES? ML14. SINCE YOU GOT THE MOSQUITO NET, WAS IT EVER SOAKED OR DIPPED IN A LIQUID TO KILL/REPEL MOSQUITOES OR BUGS? ML15. HOW LONG AGO WAS THE NET LAST SOAKED OR DIPPED? If less than 1 month, record '00'. If answer is “12 months” or “1 year”, probe to determine if net was trea- ted exactly 12 months ago or earlier or later. 2 NEXT MODULE 8 NEXT MODULE NEXT MODULE NEXT MODULE ML14 2 NEXT MODULE 8 NEXT MODULE Public sector Govt. hospital11 Govt. health center 12 Govt. health post 13 Village health worker 14 Mobile/outreach clinic 15 Other public (specify) 16 Private medical sector Private hospital/clinic 21 Private physician 22 Private pharmacy 23 Mobile clinic 24 Other private Medical (specify)…………26 Other source Relative or friend 31 Shop 32 Traditional practitioner 33 Other (specify) 96 DK.98 Local currency ____ ____ ____ ____ Free 9996 DK 9998 Yes. 1 No.2 DK. 8 Months ago.__ __ More than 24 months ago.95 Not sure.98 Long Lasting Net (LLN).1 Pre-Treated with Insecticides.2 Not Treated with Insecticide.3 Don't Know.8 Yes. 1 No.2 DK/not sur. 8 Yes. 1 No.2 DK. 8 Months ago.__ __ More than 24 months ago.95 DK.98 222 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires IM1. IS THERE A VACCINATION CARD FOR (name)? (a)Copy dates for each vaccination from the card. (b)Write '44' in day column if card shows that vaccination was given but no date recorded. IM2.BCG BCG IM3A.POLIO AT BIRTH OPV0 IM3B.POLIO 1 OPV1 IM3C.POLIO 2 OPV2 IM3D.POLIO 3 OPV3 IM3EE.POLIO 4 OPV4 IM3FF.POLIO 5 OPV5 IM4A.DPT1/HIB1 DPT1 IM4B.DPT2/HIB2 DPT2 IM4C.DPT3/HIB3 DPT3 IM4EE.DPT4 (BOOSTER) DPT4 IM5A.HEPB1 H1 IM5B.HEPB2 H2 IM5C.HEPB3 H3 IM6.MEASLES MEASLES IM7.YELLOW FEVER YF IM8A.VITAMIN A (1) VITA1 IM8B.VITAMIN A (2) VITA2 IM9. IN ADDITION TO THE VACCINATIONS AND VITAMIN A CAPSULES SHOWN ON THIS CARD, DID (name) RECEIVE ANY OTHER VACCINATIONS - INCLUDING VACCINATIONS RECEI- VED IN CAMPAIGNS OR IMMUNIZA- TION DAYS? Record 'Yes' only if respondent men- tions BCG, OPV 0-3, DPT 1-3, Hepatitis B 1-3, Measles, Yellow Fever vaccine(s), or Vitamin A supplements. IM10. HAS (name) EVER RECEIVED ANY VACCINATIONS TO PREVENT HIM/HER FROM GETTING DISEA- SES, INCLUDING VACCINATIONS RECEIVED IN A CAMPAIGN OR IMMUNIZATION DAY? 2 IM10 3 IM10 1 IM19 2 IM19 8 IM19 2 IM19 8 IM19 Yes, seen. 1 Yes, not seen. 2 No3 Date of Immunization DAY MONTH YEAR Yes. 1 (Probe for vaccinations and write '66' in the corresponding day column on IM2 to IM8B.) No 2 DK. 8 Yes. 1 No2 DK. 8 IMMUNIZATION MODULE IM If an immunization card is available, copy the dates in IM2-IM8 for each type of immunization or vitamin A dose recorded on the card. IM10-IM18 are for recording vaccinations that are not recorded on the card. IM10-IM18 will only be asked when a card is not available. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 223 Appendix F. Questionnaires IM11. HAS (name) EVER BEEN GIVEN A BCG VACCINATION AGAINST TUBERCULOSIS - THAT IS, AN INJECTION IN THE ARM OR SHOULDER THAT CAUSED A SCAR? IM12. HAS (name) EVER BEEN GIVEN ANY “VACCINATION DROPS IN THE MOUTH” TO PROTECT HIM/HER FROM GETTING DISEASES - THAT IS, POLIO? IM13. HOW OLD WAS HE/SHE WHEN THE FIRST DOSE WAS GIVEN - JUST AFTER BIRTH (WITHIN TWO WEEKS) OR LATER? IM14. HOW MANY TIMES HAS HE/SHE BEEN GIVEN THESE DROPS? IM15. HAS (name) EVER BEEN GIVEN “DPT VACCINATION INJECTIONS” - THAT IS, AN INJECTION IN THE THIGH OR BUTTOCKS - TO PRE- VENT HIM/HER FROM GETTING TETANUS, WHOOPING COUGH, DIPHTHERIA? (SOMETIMES GIVEN AT THE SAME TIME AS POLIO) IM16. HOW MANY TIMES? IM17. HAS (name) EVER BEEN GIVEN “MEASLES VACCINATION INJEC- TIONS” OR MMR - THAT IS, A SHOT IN THE ARM AT THE AGE OF 9 MONTHS OR OLDER - TO PREVENT HIM/HER FROM GETTING MEASLES? IM18. HAS (name) EVER BEEN GIVEN “YELLOW FEVER VACCINATION INJECTIONS” - THAT IS, A SHOT IN THE ARM AT THE AGE OF 9 MONTHS OR OLDER - TO PREVENT HIM/HER FROM GETTING YELLOW FEVER? (SOMETIMES GIVEN AT THE SAME TIME AS MEASLES) IM19. PLEASE TELL ME IF (name) HAS PARTICIPATED IN ANY OF THE FOL- LOWING CAMPAIGNS, NATIONAL IMMUNIZATION DAYS AND/OR VITAMIN A OR CHILD HEALTH DAYS: IM19A. NOVEMBER AND DECEMBER/POLIO 2005 IM19B. DECEMBER 2000 MEASLES IM19C. 2001 MENNIGITIS 2 IM15 8 IM15 2 IM17 8 IM17 Yes. 1 No2 DK. 8 Yes. 1 No2 DK. 8 Just after birth (within two weeks. 1 Later. 2 No. of times.__ __ Yes. 1 No2 DK. 8 No. of times.__ __ Yes. 1 No2 DK. 8 Yes. 1 No2 DK. 8 Y N DK NOV.& DEC./POLIO 2005. 1 2 8 DECEMBER 2000 MEASLES. 1 2 8 2001 MENINGITIS. 1 2 8 IM20. Does another eligible child reside in the household for whom this respondent is mother/caretaker? Check household listing, column HL8. Yes. End the current questionnaire and then Go to QUESTIONNAIRE FOR CHILDREN UNDER FIVE to administer the questionnaire for the next eligible child. No. End the interview with this respondent by thanking him/her for his/her cooperation. If this is the last eligible child in the household, go on to ANTHROPOMETRY MODULE. 224 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires AN1. Child's weight. AN2. Child's length or height. Check age of child in UF11: Child under 2 years old. Measure length (lying down). Child age 2 or more years. Measure height (standing up). AN3. Measurer's identification code. AN4. Result of measurement. Kilograms (kg).__ __ . __ Length (cm) Lying down.1 __ __ __ . __ Height (cm) Standing up.2 __ __ __ . __ Measurer code.__ __ Measured.1 Not present.2 Refused.3 Other (specify) 6 ANTHROPOMETRY MODULE AN After questionnaires for all children are complete, the measurer weighs and measures each child. Record weight and length/height below, taking care to record the measurements on the correct question- naire for each child. Check the child's name and line number on the household listing before recording measurements. AN5. Is there another child in the household who is eligible for measurement? Yes. Record measurements for next child. No. End the interview with this household by thanking all participants for their cooperation. Gather together all questionnaires for this household and check that all identification numbers are inserted on each page. Tally on the Household Information Panel the number of interviews completed. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 225 Appendix F. Questionnaires WM1. Enumeration Area Number: ___ ___ ___ WM3. Woman's Name: WM5. Interviewer name and number: WM7. Result of women's interview: ___ ___ ___ WM8. IN WHAT MONTH AND YEAR WERE YOU BORN? WM9. HOW OLD WERE YOU AT YOUR LAST BIRTHDAY? WM2. Household number: ___ ___ ___ WM4. Woman's Line Number: ___ ___ ___ WM6. Day/Month/Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ Completed. 1 Not at home. 2 Refused. 3 Partly completed. 4 Incapacitated. 5 Other (specify). 6 Date of birth: Month.__ __ DK month.98 Year.__ __ __ __ DK year.9998 Age in completed years.__ __ WOMEN'S INFORMATION PANEL WM Questionnaire for Individual Women This module is to be administered to all women age 15 through 49 (see column HL6 of HH listing). Fill in one form for each eligible woman Fill in the EAr and household number, and the name and line number of the woman in the space below. Fill in your name, number and the date. Repeat greeting if not already read to this woman: WE ARE FROM VARIOUS GOVERNMENT DEPARTMENTS (CENTRAL STATISTICS DEPT., DOSH, WOMEN'S BUREAU, DEPT. OF COMMUNITY DEVELOPMENT ETC.). . WE ARE WORKING ON A PROJECT CONCERNED WITH FAMILY HEALTH AND EDUCATION. I WOULD LIKE TO TALK TO YOU ABOUT THIS. THE INTERVIEW WILL TAKE ABOUT 45 MINUTES. ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE IDENTIFIED. ALSO, YOU ARE NOT OBLIGED TO ANS- WER ANY QUESTION YOU DON'T WANT TO, AND YOU MAY WITHDRAW FROM THE INTERVIEW AT ANY TIME. MAY I START NOW? If permission is given, begin the interview. If the woman does not agree to continue, thank her, complete WM7, and go to the next interview. Discuss this result with your supervisor for a future revisit 226 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires WM10. HAVE YOU EVER ATTENDED SCHOOL? WM10AA. WHAT TYPE OF SCHOOL DID YOU ATTEND? WM11. WHAT IS THE HIGHEST LEVEL OF SCHOOL YOU ATTENDED: PRI- MARY, SECONDARY, OR HIGHER? WM12. WHAT IS THE HIGHEST GRADE YOU COMPLETED AT THAT LEVEL? WM14. NOW I WOULD LIKE YOU TO READ THIS SENTENCE TO ME. Show sentences to respondent. If respondent cannot read whole sen- tence, probe: CAN YOU READ PART OF THE SENTENCE TO ME? Example sentences for literacy test: 1. The child is reading a book. 2. The rains came late this year. 3. Parents must care for their children. 4. Farming is hard work. 2 MW14 Yes. 1 No2 Formal school (Western)………………….1 Madrassa (Formal)…………………………2 Adult literacy class in local languages……3 0 PRE-SCHOOL 10 DAYCARE CENTRES 1 PRIMARY 11 MADRASSA PRIMARY 2 SECONDARY (UPPER BASIC/JUNIOR/SENIOR) 12 MADRASSA SECONDARY 3 HIGHER (TERTIARY, UNIVERSITY, COLLEGE) 4 VOCATIONAL 6 NON-STANDARD CURRICULUM 98 DK Grade.___ ___ Cannot read at all.1 Able to read only parts of sentence.2 Able to read whole sentence.3 No sentence in Required language 4 (specify language) Blind/mute, visually/speech impaired.5 WM13. Check WM11: Secondary or higher. Go to Next Module Primary or non-standard curriculum. Continue with WM14 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 227 Appendix F. Questionnaires RS1AA. HAVE YOU EVER SEEN THIS ORS PACKET BEFORE? RS2AA. IF YES, CAN YOU TELL ME ITS PREPARATION? RS3AA. WAS ORS AVAILABLE WHEN YOU NEEDED IT? RS4AA. WHERE DID YOU USUALLY GET IT? (Inform respondent that you will ask details about the source under the under five module) RS5AA. TELL ME HOW TO PREPARE SSS? RS6AA. WHAT DO YOU THINK IS THE USE/BENEFIT OF ORS/SSS? 2 RS5AA 2 RS5AA Yes…………………………………………………………………….1 No…………………………………………………………………….2 Correct……………………………………………………………….1 Incorrect………………………………………………………………2 Always…………………………………………………………………1 Sometimes…………………………….…………………………….2 Rarely……………………………………………….……………….3 Never………………………………………………………………….4 VHW.…………………………………………………………….……1 MCH.……………………………………………………………….….2 HC/Hospital.………………………………………………………….3 Pharmacy.……………………………………….……………….….4 Other(specify).…………………………………….……………….5 Correct.…………………………………………….………………1 Incorrect.…………………………………………….……………….2 Replaces loss fluid.………………………………….…………….1 Stop/cure diarrhoea.…………………………………………….…2 Other (specify).…………………………………….…………….….3 DK.………………………………………………….……………….9 REHYDRATION SOLUTIONS MODULE RS This module is to be administered to mother's/Caretaker's of children under- five 228 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires CM1. NOW I WOULD LIKE TO ASK ABOUT ALL THE BIRTHS YOU HAVE HAD DURING YOUR LIFE. HAVE YOU EVER GIVEN BIRTH? If “No” probe by asking: I MEAN, TO A CHILD WHO EVER BREATHED OR CRIED OR SHOWED OTHER SIGNS OF LIFE - EVEN IF HE OR SHE LIVED ONLY A FEW MINUTES OR HOURS? CM2A. WHAT WAS THE DATE OF YOUR FIRST BIRTH? I MEAN THE VERY FIRST TIME YOU GAVE BIRTH, EVEN IF THE CHILD IS NO LONGER LIVING, OR WHOSE FATHER IS NOT YOUR CURRENT PARTNER. Skip to CM3 only if year of first birth is given. Otherwise, continue with CM2B. CM2B. HOW MANY YEARS AGO DID YOU HAVE YOUR FIRST BIRTH? CM3. DO YOU HAVE ANY SONS OR DAUGHTERS TO WHOM YOU HAVE GIVEN BIRTH WHO ARE NOW LIVING WITH YOU? CM4. HOW MANY SONS LIVE WITH YOU? HOW MANY DAUGHTERS LIVE WITH YOU? CM5. DO YOU HAVE ANY SONS OR DAUGHTERS TO WHOM YOU HAVE GIVEN BIRTH WHO ARE ALIVE BUT DO NOT LIVE WITH YOU? CM6. HOW MANY SONS ARE ALIVE BUT DO NOT LIVE WITH YOU? HOW MANY DAUGHTERS ARE ALIVE BUT DO NOT LIVE WITH YOU? CM7. HAVE YOU EVER GIVEN BIRTH TO A BOY OR GIRL WHO WAS BORN ALIVE BUT LATER DIED? CM8. HOW MANY BOYS HAVE DIED? HOW MANY GIRLS HAVE DIED? CM9. Sum answers to CM4, CM6, and CM8. 2 MARRIAGE/ UNION MODULE CM3 ÚCM2B 2 CM5 2 CM7 2 CM9 Yes.1 No2 Date of first birth Day.___ ___ DK day.98 Month. ___ ___ DK month.98 Year .___ ___ ___ ___ DK year.9998 Completed years since first birth.___ ___ Yes.1 No2 Sons at home.__ __ Daughters at home. __ __ Yes.1 No2 Sons elsewhere. __ __ Daughters elsewhere. __ __ Yes.1 No2 Boys dead. __ __ Girls dead. __ __ Sum __ __ CHILD MORTALITY MODULE CM CM10. JUST TO MAKE SURE THAT I HAVE THIS RIGHT, YOU HAVE HAD IN TOTAL (total number) BIRTHS DURING YOUR LIFE. IS THIS CORRECT? Yes. Go to CM11 No. Check responses and make corrections before proceeding to CM11 This module is to be administered to all women age 15-49. All questions refer only to LIVE births. The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 229 Appendix F. Questionnaires CM11. OF THESE (total number) BIRTHS YOU HAVE HAD, WHEN DID YOU DELIVER THE LAST ONE (EVEN IF HE OR SHE HAS DIED)? If day is not known, enter '98' in space for day. CM13. AT THE TIME YOU BECAME PRE- GNANT WITH (name), DID YOU WANT TO BECOME PREGNANT THEN, DID YOU WANT TO WAIT UNTIL LATER, OR DID YOU WANT NO (MORE) CHILDREN AT ALL? Date of last birth Day/Month/Year. __ __/__ __/__ __ __ __ Then.1 Later. 2 No more. 3 CM12. Check CM11: Did the woman's last birth occur within the last 2 years, that is, since (day and month of interview in 2005)? If child has died, take special care when referring to this child by name in the following modules. No live birth in last 2 years. Go to MARRIAGE/UNION module. Yes, live birth in last 2 years. Continue with CM13 Name of child_______________________ 230 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires TT1. DO YOU HAVE A CARD OR OTHER DOCUMENT WITH YOUR OWN IMMUNIZATIONS LISTED? If a card is presented, use it to assist with answers to the following questions. TT2. WHEN YOU WERE PREGNANT WITH YOUR LAST CHILD, DID YOU RECEIVE ANY INJECTION TO PRE- VENT HIM OR HER FROM GETTING TETANUS, THAT IS CONVULSIONS AFTER BIRTH (AN ANTI-TETANUS SHOT, AN INJECTION AT THE TOP OF THE ARM OR SHOULDER)? TT3. If yes: HOW MANY TIMES DID YOU RECEIVE THIS ANTI-TETANUS INJECTION DURING YOUR LAST PREGNANCY? TT5. DID YOU RECEIVE ANY TETANUS TOXOID INJECTION AT ANY TIME BEFORE YOUR LAST PREGNANCY? TT6. HOW MANY TIMES DID YOU RECEIVE IT? TT7. IN WHAT MONTH AND YEAR DID YOU RECEIVE THE LAST ANTI-TETA- NUS INJECTION BEFORE THAT LAST PREGNANCY? Skip to next module only if year of injection is given. Otherwise, conti- nue with TT8. TT8. HOW MANY YEARS AGO DID YOU RECEIVE THE LAST ANTI-TETANUS INJECTION BEFORE THAT LAST PREGNANCY? 2 TT5 8 TT5 98 TT5 2 NEXT MODULE 8 NEXT MODULE NEXT MODULE TT8 Yes (card seen).1 Yes (card not seen).2 No3 DK. 8 Yes .1 No2 DK. 8 No. of times.__ __ DK. 98 Yes.1 No 2 DK. 8 No. of times.__ __ Month.__ __ DK month.98 Year .__ __ __ __ DK year.9998 Years ago.__ __ TETANUS TOXOID (TT) MODULE TT This module is to be administered to all women with a live birth in the 2 years preceding date of interview. If the woman has had no life births during the 2 years preceding the interview, you should leave this module blank and skip to the next module. TT4. How many TT doses during last pregnancy were reported in TT3? At least two TT injections during last pregnancy. Go to Next Module Fewer than two TT injections during last pregnancy. Continue with TT5 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 231 Appendix F. Questionnaires MN1. IN THE FIRST TWO MONTHS AFTER YOUR LAST BIRTH [THE BIRTH OF NAME], DID YOU RECEIVE A VITA- MIN A DOSE LIKE THIS? Show 200,000 IU capsule or dispenser. Blue (100,000 IU) Red (200,000 IU) MN2. DID YOU SEE ANYONE FOR ANTE- NATAL CARE FOR THIS PREGNANCY? If yes: WHOM DID YOU SEE? ANYONE ELSE? Probe for the type of person seen and cir- cle all answers given. MN2AA. HOW MANY TIMES DID YOU RECEIVE ANTENATAL CARE DURING THIS PREGNANCY? MN3. AS PART OF YOUR ANTENATAL CARE, WERE ANY OF THE FOLLO- WING DONE AT LEAST ONCE? MN3A. WERE YOU WEIGHED? MN3B. WAS YOUR BLOOD PRESSURE MEASURED? MN3C. DID YOU GIVE A URINE SAMPLE? MN3D. DID YOU GIVE A BLOOD SAMPLE? MN3AA. DURING THIS PREGNANCY, WERE YOU GIVEN ANY IRON TABLETS OR IRON SYRUP? MN3BB. DURING THE WHOLE PRE- GNANCY FOR HOW MANY DAYS DID YOU TAKE THE TABLET OR SYRUP? If answer is not numeric, probe for approximate number of days. MN4. DURING ANY OF THE ANTENATAL VISITS FOR THE PREGNANCY, WERE YOU GIVEN ANY INFORMA- TION OR COUNSELED ABOUT AIDS OR THE AIDS VIRUS? MN5. I DON'T WANT TO KNOW THE RESULTS, BUT WERE YOU TESTED FOR HIV/AIDS AS PART OF YOUR ANTENATAL CARE? MN6. I DON'T WANT TO KNOW THE RESULTS, BUT DID YOU GET THE RESULTS OF THE TEST? MN6A. DURING THIS PREGNANCY, DID YOU TAKE ANY MEDICINE IN ORDER TO PREVENT YOU FROM GETTING MALARIA? MN6B. WHICH MEDICINES DID YOU TAKE TO PREVENT MALARIA? Circle all medicines taken. If type of medi- cine is not determined, show typical anti- malarial to respondent. Y MN6A 2 MN4 8 MN4 2 MN6A 8 MN6A 2 MN6E 8 MN6E Yes .1 No2 DK. 8 Health professional: Doctor. A Nurse/midwife. B Auxiliary midwife. C Other person Traditional birth attendant. F Community health worker. G Relative/friend. H Other (specify) X No one. Y Number of times _____ _____ Don't know.98 Yes No Weight. 1 2 Blood pressure. 1 2 Urine sample. 1 2 Blood sample.1 2 Yes .1 No2 DK. 8 Number of days [ ] [ ] DK. 98 Yes .1 No2 DK. 8 Yes .1 No2 DK. 8 Yes .1 No2 DK. 8 Yes .1 No2 DK. 8 SP/Fansidar. A Chloroquine. B Other (specify) X DK. Z MATERNAL AND NEWBORN HEALTH MODULE MN This module is to be administered to all women with a live birth in the 2 years preceding date of interview. Check child mortality module CM12 and record name of last-born child here _____________________. Use this child's name in the following questions, where indicated. MN6C. Check MN6B for medicine taken: SP/Fansidar taken. Continue with MN6D SP/Fansidar not taken. Go to MN6E 232 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires MN6D. HOW MANY TIMES DID YOU TAKE SP/FANSIDAR DURING THIS PRE- GNANCY TO PREVENT MALARIA? MN6E. DURING YOUR LAST PRE- GNANCY DID YOU SLEEP UNDER A MOSQUITO NET MN6F. HOW OFTEN DID YOU USE THE MOSQUITO NET? MN6G. WAS THE NET ONE OF THE FOL- LOWING TYPES? If the respondent does not know the type of the net, explain to him/her the types of nets available. MN7. WHO ASSISTED WITH THE DELI- VERY OF YOUR LAST CHILD (or name)? ANYONE ELSE? Probe for the type of person assisting and circle all answers given. MN8. WHERE DID YOU GIVE BIRTH TO (name)? If source is hospital, health center, or cli- nic, write the name of the place below. Probe to identify the type of source and circle the appropriate code. (Name of place) MN9. WHEN YOUR LAST CHILD (name) WAS BORN, WAS HE/SHE VERY LARGE, LARGER THAN AVERAGE, AVERAGE, SMALLER THAN AVE- RAGE, OR VERY SMALL? MN10. WAS (name) WEIGHED AT BIRTH? MN11. HOW MUCH DID (name) WEIGH? Record weight from health card, if availa- ble. MN12. DID YOU EVER BREASTFEED (name)? MN13. HOW LONG AFTER BIRTH DID YOU FIRST PUT (name)TO THE BREAST? If less than 1 hour, record '00' hours. If less than 24 hours, record hours. Otherwise, record days. MN13AA. FOR HOW LONG DID YOU FEED (name) WITH ONLY BREAST MILK? 2 MN7 8 MN7 2 MN12 8 MN12 2 NEXT MODULE Number of times.___ ___ Yes .1 No2 DK. 8 Throughout the Pregnancy.1 Occasionally.2 Don't Know. 8 Long Lasting Net (LLN).1 Pre-Treated with Insecticides.2 Not Treated with Insecticide.3 Don't Know. 8 Health professional: Doctor. A Nurse/midwife. B Auxiliary midwife. C Other person Traditional birth attendant. F Community health worker. G Relative/friend. H Other (specify) X No one. Y Home Your home.11 Other home.12 Public sector Govt. hospital. 21 Govt. clinic/health center. 22 Other public (specify) 26 Private Medical Sector Private hospital. 31 Private clinic. 32 Private maternity home. 33 Other private medical (specify) 36 Other (specify) 96 Very large. 1 Larger than average. 2 Average. 3 Smaller than average. 4 Very small. 5 DK. 8 Yes .1 No2 DK. 8 MN11A. From card (kilograms) __ . __ __ __ MN11B. From recall (kilograms) __ . __ __ __ DK. 99998 Yes .1 No2 Immediately. 000 Hours.1 __ __ Or Days. 2 __ __ Don't know/remember. 998 Circle appropriate month(s): 0 1 2 3 4 5 6 + The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 233 Appendix F. Questionnaires MA1. ARE YOU CURRENTLY MARRIED OR LIVING TOGETHER WITH A MAN AS IF MARRIED? MA2. HOW OLD WAS YOUR HUSBAND/PARTNER ON HIS LAST BIRTHDAY? MA2A. BESIDES YOURSELF, DOES YOUR HUSBAND/PARTNER HAVE ANY OTHER WIVES? MA2B. HOW MANY OTHER WIVES DOES HE HAVE? MA3. HAVE YOU EVER BEEN MARRIED OR LIVED TOGETHER WITH A MAN? MA4. WHAT IS YOUR MARITAL STATUS NOW: ARE YOU WIDOWED, DIVOR- CED OR SEPARATED? MA5. HAVE YOU BEEN MARRIED OR LIVED WITH A MAN ONLY ONCE OR MORE THAN ONCE? MA6. IN WHAT MONTH AND YEAR DID YOU FIRST MARRY OR START LIVING WITH A MAN AS IF MARRIED? MA8. HOW OLD WERE YOU WHEN YOU STARTED LIVING WITH YOUR FIRST HUSBAND/PARTNER? 3 MA3 2 MA5 MA5 98 MA5 NEXT MODULE Yes, currently married. 1 Yes, living with a man. 2 No, not in union. 3 Age in years. __ __ DK. 98 Yes.1 No 2 Number. __ __ DK. 98 Yes, formerly married.1 Yes, formerly lived with a man. 2 No 3 Widowed.1 Divorced. 2 Separated.3 Only once.1 More than once.2 Month. ___ ___ DK month.98 Year. ___ ___ ___ ___ DK year. 9998 Age in years. __ __ DK. 98 MARRIAGE/UNION MODULE MA MA7. Check MA6: Both month and year of marriage/union known? Go to Next Module Either month or year of marriage/union not known? Continue with MA8 234 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires FG1. HAVE YOU EVER HEARD OF FEMALE CIRCUMCISION? FG2. IN A NUMBER OF COUNTRIES, THERE IS A PRACTICE IN WHICH A GIRL MAY HAVE PART OF HER GENITALS CUT. HAVE YOU EVER HEARD ABOUT THIS PRACTICE? FG3. HAVE YOU YOURSELF BEEN CIR- CUMCISED? FG7. WHO CIRCUMCISED YOU? FG9. HAVE ANY OF YOUR DAUGHTERS BEEN CIRCUMCISED? IF YES, HOW MANY? FG10. TO WHICH OF YOUR DAUGHTERS DID THIS HAPPEN MOST RECENTLY? Record the daughter's name. FG15. WHO DID THE CIRCUMCISION? FG16. DO YOU THINK THIS PRACTICE SHOULD BE CONTINUED OR SHOULD IT BE DISCONTINUED? FG16AA. IN THIS HOUSEHOLD HOW MANY FEMALES HAVE BEEN CIRCUMCISED? FG 16BB. WOULD YOU LIKE YOUR DAUGHTER TO BE CIRCUMCI- SED? 1 FG3 2 NEXT MODULE 2 FG8 00 FG16 Yes.1 No 2 Yes.1 No 2 Yes.1 No 2 Traditional persons Traditional 'circumciser'. 11 Traditional birth attendant.12 Other traditional (specify) 16 Health professional Doctor. 21 Nurse/midwife . 22 Other health professional (specify) 26 DK. 98 Number of daughters circumcised: . __ __ No daughters circumcised. 00 Name of daughter: Traditional persons Traditional 'circumciser'. 11 Traditional birth attendant.12 Other traditional (specify) 16 Health professional Doctor. 21 Nurse/midwife . 22 Other health professional (specify) 26 DK. 98 Continued.1 Discontinued.2 Depends. 3 DK. 8 Number of circumcised females . Yes.1 No FEMALE GENITAL CUTTING MODULE FG FG8. The following questions apply only to women who have at least one living daughter. Check CM4 and CM6, Child Mortality Module: Woman has living daughter? Yes Continue with FG9 No Go to FG16 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 235 Appendix F. Questionnaires DV1. SOMETIMES A HUSBAND IS ANNOYED OR ANGERED BY THINGS THAT HIS WIFE DOES. IN YOUR OPINION, IS A HUSBAND JUSTIFIED IN HITTING OR BEATING HIS WIFE IN THE FOLLOWING SITUATIONS: DV1A. IF SHE GOES OUT WITH OUT TEL- LING HIM? DV1B. IF SHE NEGLECTS THE CHILDREN? DV1C. IF SHE ARGUES WITH HIM? DV1D. IF SHE REFUSES SEX WITH HIM? DV1E. IF SHE BURNS THE FOOD? DV2AA. HAVE YOU EVER BEEN HIT OR BEATEN BY YOUR HUSBAND/PARTNER FOR ANY OF THE REASONS ABOVE? DV3AA. HOW MANY TIMES HAVE YOU BEEN HIT OR BEATEN BY YOUR HUSBAND/PARTNER IN THE LAST 12 MONTHS? NEXT MODULE NEXT MODULE Yes No DK Goes out without telling. 1 2 8 Neglects children. 1 2 8 Argues. 1 2 8 Refuses sex. 1 2 8 Burns food. 1 2 8 Yes.1 No 2 DK. 8 No. of times beaten ______ ______ DK. 98 ATTITUDES TOWARDS DOMESTIC VIOLENCE DV QUESTIONS DV2AA AND 3AA SHOULD BE ADMINISTERED TO WOMEN WHO ARE MARRIED OR ARE LIVING WITH A PARTNER ONLY. CHECK MARRIAGE UNION MODULE (MA1) FOR CONFIRMATION. IF THE RESPONSE IS 3 IN MA1, END THE INTERVIEW AND GO TO THE NEXT MODULE. 236 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires SB1. NOW I NEED TO ASK YOU SOME QUESTIONS ABOUT SEXUAL ACTI- VITY IN ORDER TO GAIN A BETTER UNDERSTANDING OF SOME FAMILY LIFE ISSUES. THE INFORMATION YOU SUPPLY WILL REMAIN STRICTLY CONFI- DENTIAL. HOW OLD WERE YOU WHEN YOU FIRST HAD SEXUAL INTERCOURSE (IF EVER)? SB2. WHEN WAS THE LAST TIME YOU HAD SEXUAL INTERCOURSE? Record 'years ago' only if last inter- course was one or more years ago. If 12 months or more the answer must be recorded in years. SB3. THE LAST TIME YOU HAD SEXUAL INTERCOURSE WAS A CONDOM USED? SB4. WHAT IS YOUR RELATIONSHIP TO THE MAN WITH WHOM YOU LAST HAD SEXUAL INTERCOURSE? If man is 'boyfriend' or 'fiancée', ask: WAS YOUR BOYFRIEND/FIANCÉE LIVING WITH YOU WHEN YOU LAST HAD SEX? If 'yes', circle 1 .If 'no', circle 2. SB5. HOW OLD IS THIS PERSON? If response is DK, probe: ABOUT HOW OLD IS THIS PERSON? SB6. HAVE YOU HAD SEX WITH ANY OTHER MAN IN THE LAST 12 MONTHS? SB7. THE LAST TIME YOU HAD SEXUAL INTERCOURSE WITH THIS OTHER MAN, WAS A CONDOM USED? SB8. WHAT IS YOUR RELATIONSHIP TO THIS MAN? If man is 'boyfriend' or 'fiancée', ask: WAS YOUR BOYFRIEND/FIANCÉE LIVING WITH YOU WHEN YOU LAST HAD SEX? If 'yes', circle 1. If 'no', circle 2. SB9. HOW OLD IS THIS PERSON? If response is DK, probe: ABOUT HOW OLD IS THIS PERSON? SB10. OTHER THAN THESE TWO MEN, HAVE YOU HAD SEX WITH ANY OTHER MAN IN THE LAST 12 MONTHS? SB11. IN TOTAL, WITH HOW MANY DIFFE- RENT MEN HAVE YOU HAD SEX IN THE LAST 12 MONTHS? 00 NEXT MODULE 4 NEXT MODULE 1 SB6 2 NEXT MODULE 1 SB10 2 NEXT MODULE Never had intercourse. 00 Age in years. ___ ___ First time when started living with (first) husband/partner. 95 Days ago. 1 ___ ___ Weeks ago. 2 ___ ___ Months ago. 3 ___ ___ Years ago. 4 ___ ___ Yes.1 No 2 Spouse / cohabiting partner. 1 Man is boyfriend / fiancée. 2 Other friend. 3 Casual acquaintance. 4 Other (specify) 6 Age of sexual partner. __ __ DK. 98 Yes.1 No 2 Yes.1 No 2 Spouse / cohabiting partner. 1 Man is boyfriend / fiancée. 2 Other friend. 3 Casual acquaintance. 4 Other (specify) 6 Age of sexual partner. ___ ___ DK. 98 Yes.1 No 2 No. of partners. ___ ___ SEXUAL BEHAVIOUR MODULE SB CHECK FOR THE PRESENCE OF OTHERS. BEFORE CONTINUING, ENSURE PRIVACY. SB0. Check WM9: Age of respondent is between 15 and 24? Age 25-49 Go to Next Module Age 15-24 Continue with SB1 The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 237 Appendix F. Questionnaires HA1. NOW I WOULD LIKE TO TALK WITH YOU ABOUT SOMETHING ELSE. HAVE YOU EVER HEARD OF THE VIRUS HIV OR AN ILLNESS CAL- LED AIDS? HA2. CAN PEOPLE PROTECT THEMSEL- VES FROM GETTING INFECTED WITH THE AIDS VIRUS BY HAVING ONE SEX PARTNER WHO IS NOT INFECTED AND ALSO HAS NO OTHER PARTNERS? HA3. CAN PEOPLE GET INFECTED WITH THE AIDS VIRUS BECAUSE OF WITCHCRAFT OR OTHER SUPER- NATURAL MEANS? HA4. CAN PEOPLE REDUCE THEIR CHANCE OF GETTING THE AIDS VIRUS BY USING A CONDOM EVERY TIME THEY HAVE SEX? HA5. CAN PEOPLE GET THE AIDS VIRUS FROM MOSQUITO BITES? HA6. CAN PEOPLE REDUCE THEIR CHANCE OF GETTING INFECTED WITH THE AIDS VIRUS BY NOT HAVING SEX AT ALL? HA7. CAN PEOPLE GET THE AIDS VIRUS BY SHARING FOOD WITH A PER- SON WHO HAS AIDS? HA7A. CAN PEOPLE GET THE AIDS VIRUS BY GETTING INJECTIONS WITH A NEEDLE THAT WAS ALREADY USED BY SOMEONE ELSE? HA8. IS IT POSSIBLE FOR A HEALTHY- LOOKING PERSON TO HAVE THE AIDS VIRUS? HA9. CAN THE AIDS VIRUS BE TRANS- MITTED FROM A MOTHER TO A BABY? HA9A. DURING PREGNANCY? HA9B. DURING DELIVERY? HA9C. BY BREASTFEEDING? HA10. IF A TEACHER HAS THE AIDS VIRUS BUT IS NOT SICK, SHOULD HE/SHE BE ALLOWED TO CONTI- NUE TEACHING IN SCHOOL? HA10AA. DID YOUR PARTNER USE A CONDOM WHEN YOU LAST HAD SEX? HA10CC. NAME THREE WAYS OF HIV PREVENTION HA10BB. NAME THREE WAYS OF HIV TRANSMISSION HA11. WOULD YOU BUY FRESH VEGETA- BLES FROM A SHOPKEEPER OR VENDOR IF YOU KNEW THAT THIS PERSON HAD THE AIDS VIRUS? HA12. IF A MEMBER OF YOUR FAMILY BECOMES INFECTED WITH THE AIDS VIRUS, WOULD YOU WANT IT TO REMAIN A SECRET? 2 NEXT MODULE Yes.1 No 2 Yes.1 No 2 DK. 8 Yes.1 No 2 DK. 8 Yes.1 No 2 DK. 8 Yes.1 No 2 DK. 8 Yes.1 No 2 DK. 8 Yes.1 No 2 DK. 8 Yes.1 No 2 DK. 8 Yes.1 No 2 DK. 8 Yes No DK During pregnancy 1 2 8 During delivery 1 2 8 By breastfeeding 1 2 8 Yes.1 No 2 DK/not sure/depends. 8 Yes. 1 NO. 2 Never had sex. 3 DK. .8 . . . DK. 8 . . . DK. 8 Yes.1 No 2 DK/not sure/depends. 8 Yes.1 No 2 DK/not sure/depends. 8 HIV/AIDS MODULE HA 238 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix F. Questionnaires HA12. IF A MEMBER OF YOUR FAMILY BECOMES INFECTED WITH THE AIDS VIRUS, WOULD YOU WANT IT TO REMAIN A SECRET? HA13. IF A MEMBER OF YOUR FAMILY BECAME SICK WITH THE AIDS VIRUS, WOULD YOU BE WILLING TO CARE FOR HIM OR HER IN YOUR HOUSEHOLD? HA15. I DO NOT WANT TO KNOW THE RESULTS, BUT HAVE YOU EVER BEEN TESTED TO SEE IF YOU HAVE HIV, THE VIRUS THAT CAUSES AIDS? HA16. I DO NOT WANT YOU TO TELL ME THE RESULTS OF THE TEST, BUT HAVE YOU BEEN TOLD THE RESULTS? HA17. DID YOU, YOURSELF, ASK FOR THE TEST, WAS IT OFFERED TO YOU AND YOU ACCEPTED, OR WAS IT REQUIRED? HA18. AT THIS TIME, DO YOU KNOW OF A PLACE WHERE YOU CAN GO TO GET SUCH A TEST TO SEE IF YOU HAVE THE AIDS VIRUS? HA18A. If tested for HIV during antenatal care: OTHER THAN AT THE ANTE- NATAL CLINIC, DO YOU KNOW OF A PLACE WHERE YOU CAN GO TO GET A TEST TO SEE IF YOU HAVE THE AIDS VIRUS? 2 HA18 1 END INTERVIEW 2 END INTERVIWE 3 END INTERVIEW Yes.1 No 2 DK/not sure/depends. 8 Yes.1 No 2 DK/not sure/depends. 8 Yes.1 No 2 Yes.1 No 2 Asked for the test 1 Offered and accepted 2 Required 3 Yes.1 No 2 Yes.1 No 2 HA14. Check MN5: Tested for HIV during antenatal care? Yes. Go to HA18A No. Continue with HA15 19. Is the woman a caretaker of any children under five years of age? Yes. GO TO QUESTIONNAIRE FOR CHILDREN UNDER FIVE and administer one questionnaire for each child under five for whom she is the caretaker No. CONTINUE WITH Q.20 20. Does another eligible woman reside in the household? Yes. End the current interview by thanking the woman for her cooperation and GO TO QUESTIONNAIRE FOR INDIVIDUAL WOMEN To administer the questionnaire to the next eligible woman No. End the interview with this woman by thanking her for her cooperation. Gather together all questionnaires for this household and tally the number of interviews completed on the cover page Follow instructions in your Interviewer's Manual The Gambia Multiple Indicator Cluster Survey 2005/2006 Report • 239 APPENDIX G: URBAN DEFINITION AND SETTLEMENTS, 2003 POPULATION AND HOUSING CENSUS The characteristics which distinguish urban from rural areas vary from country to country. As a result of this variation, there is no universal definition for rural and urban. Until recently, there existed no stan- dard criteria for defining urban settlements in The Gambia. Institutions have, over the years, identified urban areas based on their own criteria, the most common being population size, the type of economic activity and the level of infrastructural development. In the 1983 census, Banjul and Kanifing were trea- ted as urban areas for the purpose of presentation of some tables. 2.1 Criteria for Urban Areas With rapid population growth of large settlements, mainly due to the movement of people from the vil- lages, a felt need was expressed from many quarters for the adoption of a standard definition of urban areas. In response to this need, the Central Statistics Department proposed that a scientific approach be taken to adopt a national definition for urban areas. The Department in collaboration with the Department of Physical Planning and other ministries and departments concerned identified settlements as urban if they satisfied most of the following criteria: (i) Commercial importance (ii) Institutional importance (iii) Majority of population should be non-agricultural in occupation (iv) Population should be 5,000 and above (v) Density should be high (vi) Some degree of infrastructural facilities should be available Based on the above criteria, the following settlements have been considered as urban settlements for the purpose of the 2003 Population and Housing Census: 240 • The Gambia Multiple Indicator Cluster Survey 2005/2006 Report Appendix G. Urban Definition and Settlements 1. BANJUL 2. KOLOLI 3. ABUKO 4. KOTU 5. BAKAU WASULUNG 6. LATRI KUNDA GERMAN 7. BAKAU NEW TOWN 8. LATRI KUNDA SABIJI 9. BAKOTEH 10. MANJAI KUNDA 11. BUNDUNNKA KUNDA 12. NEW JESHWANG 13. DIPPA KUNDA 14. OLD JESHWANG 15. EBOE TOWN 16. SERE KUNDA 17. FAJI KUNDA 18. TALINDING KUNJANG 19. BANJULNDING 20. TUJERENG 21. BIJILO 22. BRIKAMA 23. BRUFUT 24. BRIKAMA WELLINGARA 25. BRUFUT BEACH 26. MEDINA SALANDING 27. BRUSUBI 28. SIBANORR 29. DARANKA 30. BWIAM 31. KEREWAN 32. MANSA KONKO CAMP 33. KER SERINGE NGAGA 34. PAKALINDING 35. KOLOLI BEACH 36. SOMA 37. KUNKUJANG KEITA 38. BARRA 39. LAMIN 40. ESSAU 41. BRUFUT MADINA 42. KEREWAN 43. NEMA KUNKU 44. FARAFENNI 45. SINCHU ALAGIE 46. JIGIMARR 47. SINCHU BALIA 48. KAUR JANNEH KUNDA 49. SINCHU SORIE 50. KAUR TOURAY KUNDA 51. SUKUTA 52. KAUR WHARF TOWN 53. SUKUTA SANCHABA 54. BANSANG 55. TRANKILL 56. ALLUNKHARI 57. WELLINGARA 58. BASSE NDING 59. GUNJUR 60. BASSE SANTO SU 61. SANYANG 62. GIROBA KUNDA 63. TANJEH 64. KABA KAMMA 65. BANSANG HOSPITAL AND QUARTER 66. KOBA KUNDA 67. BRIKAMA BA 68. MANNEH KUNDA 69. BRIKAMA NDING 70. MANSAJANG KUNDA 71. DASILAMEH 72. SARE SAMBA TAKO 73. JANJANGBUREH Titre

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