The Selected Districts of Papua Province Multiple Indicator Cluster Survey 2011, Final Report.

Publication date: 2013

Indonesia SELECTED DISTRICTS OF PAPUA PROVINCE Multiple Indicator Cluster Survey 2011 Monitoring the situation of children and women 2 MULTIPLE INDICATOR CLUSTER SURVEY 2011 The Selected Districts of Papua Province Multiple Indicator Cluster Survey (MICS) was carried out in 2011 by Badan Pusat Statistik (BPS) under the leadership of the National Development Planning Agency (BAPPENAS) and the Ministry of Home Affairs. Financial and technical support was provided by the United Nations Children’s Fund (UNICEF). MICS is an international household survey programme developed by UNICEF. The Selected Districts of Papua Province MICS was conducted as part of the fourth global round of MICS surveys (MICS4). MICS provides up-to-date information on the situation of children and women, and measures key indicators that allow countries to monitor progress towards the Millennium Development Goals (MDGs) and other internationally agreed upon commitments. Additional information on the global MICS project may be obtained from www.childinfo.org. Suggested citation: BPS. [2013]. The Selected Districts of Papua Province Multiple Indicator Cluster Survey 2011, Final Report. Jakarta, Indonesia: BPS. MULTIPLE INDICATOR CLUSTER SURVEY 2011 March, 2013 Indonesia SELECTED DISTRICTS OF PAPUA PROVINCE Multiple Indicator Cluster Survey 2011 Monitoring the situation of children and women ii MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 iii Multiple Indicator Cluster Surveys (MICS) and Millennium Development Goals (MDGs) Indicators, Selected Districts of Papua Province, Indonesia, 2011 1.1 1.2 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.13 2.14 2.15 2.17 2.18 2.19 3.1 3.2 3.3 3.4 3.5 3.7 3.11 3.12 3.14 3.15 3.16 3.17 3.18 4.1 4.2 4.3 6.7 6.8 Indicator Under-five mortality rate Infant mortality rate Children ever breastfed Early initiation of breastfeeding Exclusive breastfeeding under 6 months Continued breastfeeding at 1 year Continued breastfeeding at 2 years Predominant breastfeeding under 6 months Duration of breastfeeding Bottle feeding Minimum meal frequency Age-appropriate breastfeeding Milk feeding frequency for non-breastfed children Vitamin A supplementation (children under age 5) Low-birth weight infants Infants weighed at birth Tuberculosis immunization coverage Polio immunization coverage Immunization coverage for diphtheria, pertussis and tetanus (DPT) Measles immunization coverage Hepatitis B immunization coverage Neonatal tetanus protection Solid fuels Household availability of insecticide-treated nets (ITNs) Children under age 5 sleeping under any mosquito net Children under age 5 sleeping under insecticide-treated nets (ITNs) Malaria diagnostics usage Antimalarial treatment of children under 5 the same or next day Antimalarial treatment of children under age 5 Merauke 48 39 92.3 44.1 23.3 87.0 33.6 35.6 20.0 45.8 52.0 41.6 76.5 71.4 12.5 83.2 96.3 81.4 70.1 92.2 69.2 71.5 54.2 60.5 60.3 41.7 24.2 6.7 13.0 Jayawijaya 122 86 94.2 38.5 55.0 89.9 79.0 59.5 - 17.4 59.6 68.8 93.2 33.1 7.9 28.3 62.7 35.5 30.9 43.8 32.2 46.9 83.3 10.5 18.3 8.9 12.1 0.2 0.8 Biak Numfor 62 48 93.4 19.0 38.3 61.8 44.3 42.9 18.7 49.9 50.8 39.7 79.5 80.7 16.5 71.4 90.8 58.8 57.3 86.0 48.7 73.6 50.1 46.2 47.2 41.9 44.5 35.9 45.7 per 1,000 per 1,000 per cent per cent per cent per cent per cent per cent months per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent Value Topic Child mortality NUTRITION Breastfeeding and infant feeding Vitamin A Low birth weight CHILD HEALTH Vaccinations Tetanus toxoid Solid fuel use Malaria CHILD MORTALITY SUMMARY TABLE OF FINDINGS MICS4 Indicator Number MDGs Indicator Number iv MULTIPLE INDICATOR CLUSTER SURVEY 2011 1 Results for child labour for age group 5-17 can be found in the report in Table CP.2 4.1 4.2 4.3 5.1 5.2 5.3 5.5a 5.5b 5.6 5.7 5.8 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 8.1 8.2 8.3 8.4 8.5 8.6 8.7 7.8 7.9 5.4 5.3 5.5 5.2 2.3 2.1 2.2 Indicator Use of improved drinking water sources Water treatment Use of improved sanitation Adolescent birth rate Early childbearing Contraceptive prevalence rate Unmet need Antenatal care coverage: • At least once by skilled personnel • At least four times by any provider Content of antenatal care Skilled attendant at delivery Institutional deliveries Literacy rate among young people • women age 15-24 years • men age 15-24 years School readiness Net intake rate in primary education Primary school net attendance ratio (adjusted) Secondary school net attendance ratio (adjusted) Children reaching last grade of primary Primary completion rate Transition rate to secondary school Gender parity index (primary school) Gender parity index (secondary school) Birth registration Child labour School attendance among child labourers Child labour among students Violent discipline Marriage before age 15: • women age 15-49 years • men age 15-49 years Marriage before age 18 • women age 20-49 years • men age 20-49 years Merauke 54.3 76.7 64.0 77 11.1 51.8 12.1 96.4 89.6 40.3 85.7 61.1 90.2 92.4 48.3 73.0 96.5 70.5 98.6 88.1 96.5 0.98 1.17 65.9 20.4 91.2 27.6 86.5 9.9 1.1 34.1 3.4 Jayawijaya 34.9 26.1 23.6 145 36.9 33.7 11.5 57.1 36.0 12.0 35.6 27.6 60.2 71.8 12.5 69.6 81.7 54.1 94.2 90.9 94.7 1.04 0.92 19.7 36.2 72.0 49.6 92.1 15.6 1.5 46.8 11.0 Biak Numfor 87.0 71.0 74.5 59 10.2 42.5 11.1 90.1 65.7 18.6 77.3 42.6 90.3 92.2 29.2 70.7 96.4 75.4 97.3 115.7 96.1 1.03 1.01 32.7 22.0 90.6 29.6 91.5 3.8 0.5 20.2 3.9 per cent per cent per cent per 1,000 per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent ratio ratio per cent per cent per cent per cent per cent per cent per cent per cent per cent Value Topic Water and sanitation Contraception Maternal and newborn health Literacy and education Birth registration Child labour (age 15-14)1 Child discipline Early marriage MICS4 Indicator Number MDGs Indicator Number WATER AND SANITATION REPRODUCTIVE HEALTH EDUCATION CHILD PROTECTION MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 v 8.8 8.10b 8.14 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.10 9.11 9.12 6.3 Indicator Young women age 15-19 years currently married or in union Young men age 15-19 years currently married or in union Spousal age difference women age 20-24 years Attitudes towards domestic violence • women age 15-49 years • men age 15-49 years Comprehensive knowledge about HIV prevention • women age 15-49 years • men age 15-49 years Comprehensive knowledge about HIV prevention among young people • women age 15-24 years • men age 15-24 years Knowledge of mother-to-child transmission of HIV • women age 15-49 years • men age 15-49 years Accepting attitudes towards people living with HIV • women age 15-49 years • men age 15-49 years Know a place to get tested for HIV • women age 15-49 years • men age 15-49 years Have been tested and have been told result • women age 15-49 years • men age 15-49 years Sexually active young women who have been tested for HIV and know the result • women age 15-49 years • men age 15-49 years Young women who have never had sex Young men who have never had sex Sex before age 15 among young people • women age 15-24 years • men age 15-24 years Age-mixing among sexual partners • women age 15-24 years • men age 15-24 years Merauke 21.0 2.7 14.7 31.1 32.5 25.4 17.8 30.2 14.6 59.7 53.7 21.5 22.1 41.2 43.9 3.7 3.0 9.6 3.9 89.4 77.8 2.0 2.5 21.2 2.1 Jayawijaya 41.4 9.2 25.1 59.4 66.6 12.7 14.1 14.1 13.8 41.0 58.4 8.2 10.8 23.9 33.6 2.0 3.7 2.8 0.0 86.2 79.9 16.3 7.5 22.0 0.0 Biak Numfor 7.9 1.1 9.0 50.6 37.2 24.0 28.1 24.7 26.2 69.4 65.1 13.9 11.4 33.2 39.2 1.3 5.6 0.9 5.1 86.9 74.7 2.7 0.7 14.1 1.1 per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent percent percent Value Topic Domestic violence HIV/AIDS knowledge and attitudes Sexual behaviour MICS4 Indicator Number MDGs Indicator Number HIV/AIDS, SEXUAL BEHAVIOUR, AND ORPHANED MULTIPLE INDICATOR CLUSTER SURVEY 2011vi MULTIPLE INDICATOR CLUSTER SURVEY 2011 9.13 9.14 9.15 9.17 9.18 9.21 TA.3 TA.4 Indicator Sex with multiple partners • women age 15-49 years • men age 15-49 years Condom use during sex with multiple partners • men age 15-49 years Sex with non-regular partners • women age 15-24 years • men age 15-24 years Children’s living arrangements Prevalence of children with one or both parents dead Male circumcision Alcohol use • women age 15-49 years • men age 15-49 years Use of alcohol before age 15 • women age 15-49 years • men age 15-49 years Merauke 0.6 3.5 (25.5) 8.9 49.8 10.4 7.0 63.0 1.2 20.9 0.3 6.3 Jayawijaya 1.2 13.9 8.4 8.3 38.6 7.4 9.2 11.8 2.5 12.9 3.7 5.4 Biak Numfor 0.7 5.7 21.8 20.7 58.2 12.3 7.5 24.6 2.9 24.8 2.1 7.8 per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent Value Topic Orphaned Children Male circumcision Alcohol use MICS4 Indicator Number MDGs Indicator Number ALCOHOL USE MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 viiMULTIPLE INDICATOR CLUSTER SURVEY 2011 TABLE OF CONTENTS Summary table of findings Table of contents List of tables List of figures List of abbreviations Acknowledgements Six selected MICS districts in Papua and West Papua provinces Executive summary 1. INTRODUCTION 1.1. Background 1.2. Survey objectives 1.3. Limitations of the survey 2. SAMPLE AND SURVEY METHODOLOGY 2.1. Sample design 2.2. Questionnaires 2.3. Training and fieldwork 2.4. Data processing 3. SAMPLE COVERAGE AND THE CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS 3.1. Sample coverage 3.2. Characteristics of households 3.3. Characteristics of female and male respondents 15-49 years of age and children under-5 4. CHILD MORTALITY 5. NUTRITION 5.1. Breastfeeding 5.2. Vitamin A supplements 5.3. Low birth weight 6. CHILD HEALTH 6.1. Immunization 6.2. Neonatal tetanus protection 6.3. Solid fuel use 6.4. Malaria 7. WATER AND SANITATION 7.1. Use of improved water sources 7.2. Use of improved sanitation facilities 7.3. Distance between water source and closest excreta disposal iii vii ix xii xiii xv xvi xvii 1 1 2 2 5 5 5 6 7 9 9 10 12 17 21 21 30 32 35 35 39 41 44 51 51 59 65 MULTIPLE INDICATOR CLUSTER SURVEY 2011viii MULTIPLE INDICATOR CLUSTER SURVEY 2011 67 67 71 74 76 81 84 84 87 87 89 90 97 97 99 105 105 115 117 121 121 129 132 137 145 147 151 155 157 159 163 167 179 185 195 8. REPRODUCTIVE HEALTH 8.1. Fertility 8.2. Contraception 8.3. Unmet need 8.4. Antenatal care 8.5. Malaria testing and protection during antenatal care visit 8.6. Assistance at delivery 8.7. Place of delivery 9. LITERACY AND EDUCATION 9.1. Literacy among young women and men 9.2. School readiness 9.3. Primary and secondary school participation 10. CHILD PROTECTION 10.1. Birth registration 10.2. Child labour 10.3. Child discipline 10.4. Early marriage 10.5. Type of marriage registration 10.6. Attitudes toward domestic violence 11. HIV/AIDS, SEXUAL BEHAVIOUR, AND ORPHANS 11.1. Knowledge about HIV transmission and misconceptions About HIV/AIDS 11.2. Accepting attitudes toward people living with HIV/AIDS 11.3. Knowledge of a place for HIV testing and counselling 11.4. Sexual behaviour related to HIV transmission 11.5. Orphans 11.6. Male circumcision 12. ALCOHOL USE 13. MIGRATION 14. FLOOR AREA PER PERSON Appendix A. Sample design Appendix B. List of personnel involved in the survey Appendix C. Data quality tables Appendix D. Estimates of sampling errors Appendix E. MICS indicators: numerators and denominator Appendix F. Questionnaires MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 ixMULTIPLE INDICATOR CLUSTER SURVEY 2011 LIST OF TABLES Table HH.1: Results of household, women’s, men’s and under-5 interviews Table HH.2: Household age distribution by sex Table HH.3: Household composition Table HH.4: Women’s background characteristics Table HH.4M: Men’s background characteristics Table HH.5: Under-5’s background characteristics Table CM.1: Children ever born, children surviving and proportion dead Table CM.2: Child mortality Table NU.1: Initial breastfeeding Table NU.2: Breastfeeding Table NU.3: Duration of breastfeeding Table NU.4: Age-appropriate breastfeeding Table NU.5: Introduction of solid, semi-solid or soft foods Table NU.6: Minimum meal frequency Table NU.7: Bottle feeding Table NU.8: Children’s vitamin A supplementation Table NU.9: Low birth weight infants Table CH.1: Vaccinations in first year of life Table CH.2: Vaccinations by background characteristics Table CH.3: Neonatal tetanus protection Table CH.4: Solid fuel use Table CH.5: Solid fuel use by place of cooking Table CH.6: Household availability of insecticide-treated nets and protection by a vector control method Table CH.7: Children sleeping under mosquito nets Table CH.8: Anti-malarial treatment of children with anti-malarial drugs Table CH.9: Malaria diagnostics usage Table WS.1: Use of improved water sources Table WS.2: Household water treatment Table WS.3: Time to source of drinking water Table WS.4: Person collecting water Table WS.5: Types of sanitation facilities Table WS.6: Use and sharing of sanitation facilities Table WS.7: Drinking water and sanitation ladders Table WS.8: Distance between water source and closest excreta disposal Table RH.1: Adolescent birth rate and total fertility rate Table RH.2: Early childbearing Table RH.3: Trends in early childbearing Table RH.4: Use of contraception Table RH.4A: Unmet need for contraception Table RH.5: Antenatal care coverage Table RH.6: Number of antenatal care visits 9 10 11 13 15 16 18 18 23 24 25 26 27 28 29 31 33 36 38 40 42 43 45 46 47 50 53 56 57 58 60 61 64 65 68 69 70 72 75 78 79 x MULTIPLE INDICATOR CLUSTER SURVEY 2011 Table RH.7: Content of antenatal care Table RH.8: Malaria testing and protection during antenatal care visit Table RH.9: Treatment for malaria Table RH.10: Assistance during delivery Table RH.11: Place of delivery Table ED.1: Literacy among young women Table ED.1M: Literacy among young men Table ED.2: School readiness Table ED.3: Primary school entry Table ED.4: Primary school attendance Table ED.5: Secondary school attendance Table ED.6: Children reaching last grade of primary school Table ED.7: Primary school completion and transition to secondary school Table ED.8: Education gender parity Table CP.1: Birth registration Table CP.2: Child labour Table CP.3: Child labour and school attendance Table CP.4: Child discipline Table CP.5: Early marriage among women Table CP.5M: Early marriage among men Table CP.6: Trends in early marriage among women Table CP.6M: Trends in early marriage among men Table CP.7: Spousal age difference Table CP.8: Type of marriage registration Table CP.9: Attitudes toward domestic violence among women Table CP.9M: Attitudes toward domestic violence among men Table HA.1: Knowledge about HIV transmission, misconceptions about HIV/AIDS, and comprehensive knowledge about HIV transmission among women Table HA.1M: Knowledge about HIV transmission, misconceptions about HIV/AIDS, and comprehensive knowledge about HIV transmission among men Table HA.2: Knowledge about HIV transmission, misconceptions about HIV/AIDS, and comprehensive knowledge about HIV transmission among young women Table HA.2M: Knowledge about HIV transmission, misconceptions about HIV/AIDS, and comprehensive knowledge about HIV transmission among young men Table HA.3: Knowledge of mother-to-child HIV transmission among women Table HA.3M: Knowledge of mother-to-child HIV transmission among men Table HA.4: Accepting attitudes toward people living with HIV/AIDS among women Table HA.4M: Accepting attitudes toward people living with HIV/AIDS among men 80 81 83 85 86 87 88 89 91 92 93 94 95 96 98 101 104 106 109 110 112 113 114 116 118 119 123 124 125 126 128 129 130 131 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 xi Table HA.5: Knowledge of a place for HIV testing among women Table HA.5M: Knowledge of a place for HIV testing among men Table HA.6: Knowledge of a place for HIV testing among sexually active young women Table HA.6M: Knowledge of a place for HIV testing among sexually active young men Table HA.7: Sexual behaviour that increases the risk of HIV infection among young women Table HA.7M: Sexual behaviour that increases the risk of HIV infection among young men Table HA.8: Sex with multiple partners among women Table HA.8M: Sex with multiple partners among men Table HA.9: Sex with multiple partners among young women Table HA.9M: Sex with multiple partners among young men Table HA.10: Sex with non-regular partners among young women Table HA.10M: Sex with non-regular partners among young men Table HA.11: Children’s living arrangements and orphanhood Table HA.12: Male circumcision Table HA.13: Provider and location of circumcision Table TA.1: Use of alcohol among women Table TA.1M: Use of alcohol among men Table MI.1: Migration Table FA.1: Floor area per person Table DQ.1: Age distribution of household population Table DQ.2: Age distribution of eligible and interviewed women Table DQ.2M: Age distribution of eligible and interviewed men Table DQ.3: Age distribution of under-5s in household and under-5 questionnaires Table DQ.4: Women’s completion rates by socio-economic characteristics of households Table DQ.4M: Men’s completion rates by socio-economic characteristics of households Table DQ.5: Completion rates for under-5 questionnaires by socio-economic characteristics of households Table DQ.6: Completeness of reporting Table DQ.7: Observation of bednets Table DQ.8: Observation of women’s health cards Table DQ.9: Observation of under-5s birth certificates Table DQ.10: Observation of vaccination cards Table DQ.11: Presence of mother in the household and the person interviewed for the under-5 questionnaire Table DQ.12: Selection of children age 2-14 years for the child discipline module Table DQ.13: School attendance by single age Table DQ.14: Sex ratio at birth among children ever born and living Table SE.1: Indicators selected for sampling error calculations Table SE.2: Sampling errors: Merauke District Table SE.3: Sampling errors: Jayawijaya District Table SE.4: Sampling errors: Biak Numfor District 133 134 135 136 138 139 140 141 142 143 144 145 146 148 149 152 153 156 157 167 168 168 169 169 170 171 172 173 173 174 174 175 175 176 177 180 181 182 183 xii MULTIPLE INDICATOR CLUSTER SURVEY 2011 19 22 27 37 39 49 52 62 63 67 71 77 97 99 115 122 LIST OF FIGURES Figure CM.1: Under-5 mortality rates by background characteristics Figure NU.1: Percentage of mothers who started breastfeeding within one hour and within one day of birth Figure NU.2: Percentage of children age 6-23 months who were appropriately breastfed during the previous day by mother’s education and wealth index Figure CH.1: Percentage of children aged 12-23 months who received the recommended vaccinations by 12 months Figure CH.2: Percentage of women with a live birth in the last 12 months who are protected against neonatal tetanus Figure CH.3: Percentage of children age 0-59 months who had a fever in the last two weeks and who had a finger or heel stick for malaria testing Figure WS.1: Per cent distribution of household members by source of drinking water Figure WS.2: Percentage of household population using improved (not shared) sanitation facilities Figure WS.3: Percentage of household population using improved drinking water sources and improved sanitation Figure RH.1: Percentage of women age 15-19 who have had a live birth or who are pregnant with the first child, or who have begun childbearing before age 15 by district Figure RH.2: Percentage of currently married women aged 15-49 years using contraceptive methods Figure RH.3: Percentage of women age 15-49 who gave birth in the two years preceding the survey who received antenatal care at least once by skilled personnel Figure CP.1: Percentage of children under age 5 whose birth is registered Figure CP.2: Percentage of children under 5-17 involved in child labour Figure CP.3: Percentage of women and men aged 20-49 years married before their 18th birthday Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 xiii AIDS Acquired Immune Deficiency Syndrome BCG Bacillis-Cereus-Geuerin (Tuberculosis) CDC Center for Disease Control CEDAW Convention on the Elimination of All Forms of Discrimination against Women COSIT Central Organization for Statistics and Information Technology CRC Convention on the Rights of the Child DPT Diptheria, Pertussis, and Tetanus GPI Gender Parity Index Hep B Hepatitis B HIV Human Immunodeficiency Virus IUD Intrauterine Device LAM Lactational Amenorrhea Method LAS League of Arab States MDGs Millennium Development Goals MICS Multiple Indicator Cluster Survey MICS4 The fourth round of the Multiple Indicator Cluster Survey MMR Measles, Mumps, and Rubella MOH Ministry of Health MOI Ministry of Interior NAR Net Attendance Rate NCHS National Center for Health Statistics (USA) PPS Probability Proportional to Size PSU Primary Sampling Unit SD Standard Deviation SPSS Statistical Package for Social Sciences SSD Suleimaniya Statistical Directorate TFR Total Fertility Rate UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund WFFC World Fit For Children WHO World Health Organization LIST OF ABBREVIATIONS MULTIPLE INDICATOR CLUSTER SURVEY 2011xiv MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 xvMULTIPLE INDICATOR CLUSTER SURVEY 2011 The Selected Districts of Papua Multiple Indicator Cluster Survey 2011 was conducted by the Statistics Indonesia – Badan Pusat Statistik (BPS) – with technical and financial support from UNICEF. Similar Survey was also conducted at the same time in West Papua Province. The Selected Districts of Papua Multiple Indicator Cluster Survey was designed to collect information across a broad number of social indicators covering education, environment, health and child protection sectors in the three districts of Biak Numfor, Jayawijaya and Merauke. This report comprises a full analysis of the data for all the indicators covered by the survey. A Steering Committee, consisting of BAPPENAS, BPS, and UNICEF, led the planning, conduct and dissemination of the survey. A team of sectoral experts from relevant ministries reviewed the global survey tools and customized them. Data collection and data entry was led by the provincial BPS office under the close supervision and guidance of central BPS. The tabulation, data processing and report writing work were supported by an independent consultant. The report was finalized by a team consisting of BPS’s Directorate of Social Welfare Statistics and UNICEF Indonesia Monitoring and Evaluation Officers. We would like to acknowledge the guidance and quality assurance provided by MICS Specialists in UNICEF Headquarters in New York and Regional Office in Bangkok. Special thanks are due to all the master trainers, interviewers, supervisors and editors for their hard work and commitment during the survey implementation. Finally, we would like to thank the communities and households who participated in the survey for their willingness to give their time to provide valuable information about their lives. Without their collaboration this survey would not have been possible. We hope the findings of this report will be of valuable service to policy makers and the planners and researchers of different institutions for further developing appropriate measures to improve the lives of children and women in the three survey districts. Any suggestion and comments for further improvement of the report are most welcome. ACKNOWLEDGEMENTS Dra. Nina Sardjunani, MA Deputy Minister for Human Resources and Culture, Ministry of National Development Planning/ BAPPENAS Drs. Wynandin Imawan, M.Sc Deputy Director General for Social Statistics, BPS Angela Kearney Representative, UNICEF xvi MULTIPLE INDICATOR CLUSTER SURVEY 2011 SIX SELECTED MICS DISTRICTS IN PAPUA AND WEST PAPUA PROVINCES West Papua Province Papua Province MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 xvii The Selected Districts of Papua Province Multiple Indicator Cluster Survey (MICS) is a sample survey of households, women, men and children covering the Districts of Merauke, Jayawijaya and Biak Numfor. The survey of 3,000 selected households was conducted in 2011 and was part of the fourth round of the Multiple Indicator Cluster Surveys Programme of UNICEF. CHILD MORTALITY The infant mortality rates are estimated at 39, 86 and 48 per thousand in the districts of Merauke, Jayawijaya and Biak Numfor respectively. The probabilities of dying under age 5 (U5MR) are 48, 122 and 62 per thousand in the districts of Merauke, Jayawijaya and Biak Numfor respectively. NUTRITION Breastfeeding. Women in Biak Numfor District were the least likely to start breastfeeding within one hour (19 per cent) compared with women in Merauke (44 per cent) and Jayawijaya (39 per cent). Breastfeeding within one day of birth was higher in Jayawijaya District (86 per cent) than in Biak Numfor (70 per cent) and Merauke (64 per cent). Exclusive and predominant breastfeeding among children age less than six months are higher in Jayawijaya District (55 and 60 per cent respectively) than the other two districts (Merauke: 23 and 36 respectively; Biak Numfor: 38 and 43 respectively). Appropriate feeding among children aged 6-23 months is highest in Jayawijaya District (74 per cent) compared with Merauke (47 per cent) and Biak Numfor (40 per cent) districts. More children age 6-23 months (60 per cent) were receiving solid, semi-solid and soft foods the minimum number of times in Jayawijaya compared with those in Merauke (52 per cent) and Biak Numfor (51 per cent). Bottle feeding among children age 6-23 months was considerably lower in Jayawijaya District (17 per cent) compared with Merauke (46 per cent) and Biak Numfor (50 per cent). Vitamin A supplements. Vitamin A supplementation coverage within the six months prior to the survey was considerably lower in Jayawijaya District (33 per cent) compared with Merauke (71 per cent) and Biak Numfor (81 per cent) districts. Low birth weight. The estimated percentage of infants weighing less than 2,500 grams at birth was considerably lower in Jayawijaya (8 per cent) than Merauke (13 per cent) and Biak Numfor (17 per cent) districts. These percentages of births weighing below 2,500 grams are based only on the mother’s recollection of the child’s weight, or the weight as recorded on a health card if the child was weighed at birth. EXECUTIVE SUMMARY xviii MULTIPLE INDICATOR CLUSTER SURVEY 2011 CHILD HEALTH Immunization. In general, percentages of currently vaccinated children aged 12-23 months by different vaccines fluctuated across districts, but it is worth noting that Polio 1, DPT 3 and HepB at birth are considerably lagging behind in Jayawijaya. HepB at birth has low coverage across the districts, particularly Jayawijaya District (Merauke, 58 per cent; Jayawijaya, 12 per cent; Biak Numfor, 30 per cent). Tetanus toxoid. Tetanus toxoid coverage among women age 15-49 years with a live birth in the last 2 years is considerably lower in Jayawijaya District compared with the other districts (Jayawijaya, 47 per cent; Merauke, 72 per cent; Biak Numfor, 74 per cent). Solid fuel use. Solid fuel use is very common among households in Jayawijaya District, where 83 per cent of households use solid fuel, mostly wood. About half the households in Merauke (54 per cent) and Biak Numfor (50 per cent) are using solid fuel, also mostly wood. Malaria. Differentials exist in the availability of ITNs among districts where the availability is least in Jayawijaya District (11 per cent) and most in Merauke District (61 per cent). The percentage of this indicator is 46 per cent in Biak Numfor District. Compared with other districts, the percentages of children under the age of five who slept under any mosquito net or an insecticide-treated net are considerably lower in Jayawijaya District (18 and 9 per cent respectively). These percentages are 60 per cent and 42 per cent for Merauke and 47 per cent and 42 per cent for Biak Numfor District. Compared with the other districts, which also showed a low percentage in these indicators, Jayawijaya District was strikingly lacking in anti-malarial treatment. The percentage of children receiving any anti-malarial drug in Jayawijaya was less than one per cent compared with 13 per cent in Merauke and 46 per cent in Biak Numfor. Similarly, none of the children in Jayawijaya took an anti-malarial drug same or next day compared with 7 per cent in Merauke and 36 per cent in Biak Numfor District. The proportion of children age 0-59 months who had a fever in the last two weeks and who had a finger or heel stick for malaria testing was highest in Biak Numfor District (45 per cent) compared with 24 per cent in Merauke and only 12 per cent in Jayawijaya District. WATER AND SANITATION Water. The situation in Jayawijaya District is considerably worse than in other districts; only 35 per cent of the population in this district gets its drinking water from an improved source. The percentages in Merauke and Biak Numfor districts are 54 and 87 per cent respectively. In Biak Numfor, only 14 per cent of the population uses drinking water that is piped into their dwelling or into their yard or plot. More drastically, only five and one per cent of the population use piped water in Merauke and Jayawijaya respectively. In Jayawijaya District, the most important source of drinking water is surface water (river, stream, dam, lake, pond, canal, irrigation channel) (39 per cent) (an unimproved source). In Merauke, bottled water is the most important source (17 per cent) (an improved source) while in Biak Numfor it is rainwater collection (24 per cent) (an improved source). In-house water treatment. In spite of poor indicators of drinking water from an improved source in Jayawijaya, only about a quarter of household members using unimproved drinking water sources in this district (26 per cent) use appropriate water treatment MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 xix methods. 64 per cent of them do not use any treatment. About 77 and 71 per cent of household members in Merauke and Biak Numfor respectively using unimproved drinking water sources are using an appropriate water treatment method. Time and person to obtain water. Most of the households in Biak Numfor have an improved drinking water source on the premises (80 per cent). This is contrary to households in Jayawijaya (24 per cent) and Merauke (41 per cent). For household users from unimproved drinking water sources, it takes less than 30 minutes to get to the water source and bring water for 46 and 8 per cent of households in Jayawijaya and Biak Numfor districts. More adult women in Jayawijaya (69 per cent) and Biak Numfor (61 per cent) districts collect water than adult men and children. In Merauke District slightly more adult men (49 per cent) than adult women (45 per cent) collect water. Sanitation. Almost two-thirds of the population in Jayawijaya District has no facility or use bushes or fields (59 per cent). No facility or use of bushes or fields is much less common in Merauke (5 per cent) and Biak Numfor (8 per cent). About 49 per cent of the population in Merauke and 86 per cent in Biak Numfor use facilities that flush to a septic tank or pit (latrines). About 75 per cent of the household population in Biak Numfor District is using an improved sanitation facility which is not shared; higher than in Merauke District (64 per cent) and considerably higher than in Jayawijaya (24 per cent). REPRODUCTIVE HEALTH Fertility. The total fertility rate (TFR) is highest in Jayawijaya District (4.5 children per woman) and lowest in Merauke District (3 children per woman). TFR in Biak Numfor District is 3.5 children per woman. Similarly, the adolescent birth rate is considerably higher in Jayawijaya District (145 births per 1,000 women) compared with the rates in Merauke (77 births per 1,000 women) and Biak Numfor (59 births per 1,000 women). Early childbearing. Compared with the other two districts, a considerably higher percentage of giving birth before age 18 was seen in Jayawijaya (37 per cent). The rate was 11 per cent in Merauke and 10 per cent in Biak Numfor. Contraception. The lowest current use of contraception among currently married women age 15-49 was seen in Jayawijaya District (34 per cent), mostly traditional methods. This compares with 43 per cent in Biak Numfor District and 52 per cent in Merauke District, where women mostly use modern methods. The most popular methods in Jayawijaya are Withdrawal (9 per cent), injectables (9 per cent) and Diaphragm/foam/jelly (7 per cent). The most popular methods in Biak Numfor are IUD (18 per cent) and injectables (9 per cent). The most popular methods in Merauke are IUD (29 per cent) and the implants (13 per cent). Antenatal care. Antenatal care (by a doctor, nurse or midwife) is high in Merauke District (96 per cent) and Biak Numfor District (90 per cent) and low in Jayawijaya District (57 per cent). Within each of the three districts, antenatal care is provided mostly by midwives, followed by doctors. xx MULTIPLE INDICATOR CLUSTER SURVEY 2011 The percentage of mothers who received antenatal care at least four times was 90, 36 and 66 per cent in Merauke, Jayawijaya and Biak Numfor districts respectively. Women living in Jayawijaya were less likely to have all three tests made. These tests are: taking blood sample, checking blood pressure and taking urine specimen. Assistance at delivery. The percentage of babies delivered by skilled personnel was 86, 36 and 77 per cent in Merauke, Jayawijaya and Biak Numfor districts respectively. These deliveries were mostly assisted by midwives. Delivery in a health facility. The percentage of babies delivered in a health facility was 61, 28 and 43 per cent in Merauke, Jayawijaya and Biak Numfor districts respectively. LITERACY AND EDUCATION Literacy among young women and men. The lowest literacy rate in young women is in Jayawijaya District (60 per cent) compared with 90 per cent each in Merauke and Biak Numfor districts. For men, literacy rates among the three districts are similar to those among women except that in Jayawijaya District (72 per cent) more men are literate than women (60 per cent). Male literacy rates in Merauke and Biak Numfor districts are 92 per cent each. School readiness. About 48 per cent of children in Merauke who are currently attending the first grade of primary school were attending pre-school the previous year. This is compared with 13 per cent in Jayawijaya and 29 per cent in Biak Numfor District. Net intake rate in primary education. Of children who are of primary school entry age (age 7) in Biak Numfor, 70.7 per cent are attending the first grade of primary school. This indicator is 69 per cent in Jayawijaya and 73 per cent in Merauke District. Net primary school attendance rate. The majority of children of primary school age in Merauke (97 per cent) and Biak Numfor (96 per cent) are attending primary school or secondary school. A lower net primary school attendance rate was seen in Jayawijaya (82 per cent). Net secondary school attendance rate. Compared with primary education, fewer children of secondary school age in Merauke (71 per cent) and Biak Numfor (75 per cent) are attending secondary school or higher. Again, a lower net secondary school attendance rate was seen in Jayawijaya (54 per cent). Survival rate to grade five. Of all children starting grade one, the majority of them in each of the three districts will eventually reach grade five. Primary completion rate. Primary completion rate was lowest rate in Merauke (88 per cent) and the highest rates in Biak Numfor (116 per cent). The primary completion rate in Jayawijaya is 91 per cent. Transition rate to secondary school. Most children who successfully completed the last grade of primary school were found at the moment of the survey to be attending the first grade of secondary school (Merauke, 97 per cent; Jayawijaya, 95 per cent; Biak Numfor, 96 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 xxi Gender parity index. The gender parity for primary school is 0.98 in Merauke, 1.04 in Jayawijaya and 1.03 in Biak Numfor. In Jayawijaya and Biak Numfor, more girls attend primary school than boys. The gender parity for secondary school is 1.17 in Merauke, 0.92 in Jayawijaya and 1.01 in Biak Numfor. This means that more girls in Merauke attend secondary school while in Jayawijaya girls are disadvantaged in attending secondary school. CHILD PROTECTION Birth registration. Birth registration is strikingly low in Jayawijaya (20 per cent) and in Biak Numfor Districts (33 per cent) compared with Merauke District (66 per cent). Child labour. Child labour is more profound in Jayawijaya Districts where almost one third of children 5-17 are involved in child labour (36 per cent). This compares with 20 and 22 per cent in Merauke and Biak Numfor districts respectively. The percentage of child labourers who are attending school in Jayawijaya is lower than in the two other districts. On the other hand, the percentage of children attending school who are involved in child labour in Jayawijaya is higher than in the two other districts. Child discipline. High percentages of children age 2-14 years were subjected to at least one form of psychological or physical punishment by their mothers/caretakers or other household members in each of the three districts (Merauke, 87 per cent; Jayawijaya, 92 per cent; Biak Numfor, 92 per cent). More importantly, considerable percentages of children were subjected to severe physical punishment (Merauke, 24 per cent; Jayawijaya, 31 per cent; Biak Numfor, 26 per cent). Early marriage. The percentage of women age 15-19 years who are currently married or in union is significantly higher in Jayawijaya (41 per cent) and significantly lower in Biak Numfor District (8 per cent) when compared with Merauke District (21 per cent). The percentage of women married before age 15 and age 18 was considerably higher in Jayawijaya District (16 and 47 per cent respectively) compared with Merauke District (10 and 34 per cent respectively) and Biak Numfor (4 and 20 per cent respectively). The percentage of young men age 15-19 years who are currently married or in union is higher in Jayawijaya District (9 per cent) compared with Merauke (3 per cent) and Biak Numfor (1 per cent). Among men, marriage/ union before age 15 and 18 is not common, except for Jayawijaya District which shows that 11 per cent of men are married/ in union before age 18 compared with three and four per cent in Merauke and Biak Numfor districts respectively. About 25 per cent women age 20-24 in Jayawijaya District are currently married to a man who is older by ten years or more. This is compared with Merauke (15 per cent) and Biak Numfor districts (9 per cent). Domestic Violence. Differences in the percentage of women who believe that a husband is justified in beating his wife were clear among districts. 59 per cent of women in Jayawijaya District accept this type of violence. This percentage is reduced in Biak Numfor and Merauke districts to 51 and 31 per cent respectively. Patterns of domestic violence indicators for men are similar to those of women but with smaller percentages. xxii MULTIPLE INDICATOR CLUSTER SURVEY 2011 HIV/AIDS, SEXUAL BEHAVIOUR AND ORPHANS Knowledge of HIV transmission. Lower percentages of the interviewed women have heard of AIDS in Jayawijaya District than in the other two districts (Merauke, 85 per cent; Jayawijaya, 63 per cent; Biak Numfor, 96 per cent). Comprehensive knowledge (knowing 2 ways of preventing HIV transmission and rejecting three common misconceptions) of HIV prevention methods and transmission among women age 15-49 is drastically lower in Jayawijaya District (13 per cent) than Merauke (25 per cent) and Biak Numfor (24 per cent) districts. Results were higher for women age 15-24. Comprehensive knowledge among men age 15-49 is lower in Jayawijaya District (14 per cent) and Merauke (18 per cent) than in Biak Numfor (28 per cent) district. Unlike for women, comprehensive knowledge was lower among men in the younger age group 15-24 than knowledge of men age 15-49. Knowledge of mother-to-child transmission of HIV. Knowledge of mother-to-child HIV transmission among women was highest in the district of Biak Numfor (69 per cent) and lowest in Jayawijaya (41 per cent). Knowledge of mother-to-child HIV transmission from mother to child was generally higher among men than women, particularly in Jayawijaya. Attitudes toward people living with HIV. The percentage of women agreeing to all accepting attitudes toward people living with HIV is highest in Merauke District (22 per cent) compared with Biak Numfor District (14 per cent) and Jayawijaya District (8 per cent). Knowledge of where to be tested for HIV. A small but higher percentage of women age 15-49 have been tested and received a result in Merauke (4 per cent) compared with Jayawijaya (2 per cent) and Biak Numfor (1 per cent). Higher percentages were reported among men 15-49 in Jayawijaya (4 per cent) and Biak Numfor (6 per cent). The percentage of men who have been tested and received a result in Merauke is three per cent. Knowledge of where to be tested for HIV among sexually active young women was higher in Merauke District (10 per cent) and considerably lower in Jayawijaya (3 per cent) and Biak Numfor (1 per cent). Among sexually active young men, five per cent have been tested in the last 12 months and received a result in Biak Numfor District compared with four per cent in Merauke District. None of the young men in Jayawijaya District have been tested in the last 12 months and received a result. Sexual Behaviour Related to HIV Transmission. About one in six women age 15-24 years in Jayawijaya District (16 per cent) had sex before age 15. This compares with much lower percentages in Merauke (2 per cent) and Biak Numfor districts (3 per cent). Fewer men than women had sex before age 15, particularly in Jayawijaya District where only eight per cent of men had sex before age 15. This compares with lower percentages in Merauke (3 per cent) and Biak Numfor districts (1 per cent). Sex with multiple partners. Sex with multiple partners is higher among men age 15-49 years than among women in the same age category. Fewer than one per cent of women in each of the three districts reported having sex with more than one partner in last 12 months. This compares with a high 14 per cent of men in Jayawijaya reporting having sex with more than one partner in the last 12 months, six per cent in Biak Numfor and four per cent in Merauke District. Similar results were observed among women age 15-24 years. Results among men age 15-24 years were lower than those among men 15-49 years. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 xxiii 2 Orphanhood in this report refers to children orphaned by any cause, not only HIV/AIDS. Sex with non-regular partners. Sex with non-marital, non-cohabiting partners in the last 12 months among women 15-24 is considerably higher in Biak Numfor District (21 per cent) than in Merauke (9 per cent) and Jayawijaya (8 per cent) districts. This indicator is considerably higher among men than among women where 58 per cent of young men age 15-24 years in Biak Numfor had sex with a non-marital, non-cohabiting partner in the last 12 months compared with 50 per cent in Merauke and 39 per cent in Jayawijaya District. Orphaned Children.2 Nine per cent of children aged 0-17 years in Jayawijaya are orphans who have lost one or both parent. The percentage of orphans is slightly lower in Biak Numfor (8 per cent) and in Merauke (7 per cent) districts. Male circumcision. Circumcision is more prevalent in Merauke District (63 per cent) than in Biak Numfor (25 per cent) and Jayawijaya districts (12 per cent). In each district, most circumcision was performed at home by health workers/professionals. Alcohol use. About three per cent each of the women age 15-49 years in districts of Jayawijaya and Biak Numfor had at least one drink of alcohol on one or more days during the last month. Alcohol use is considerably higher among men in the same age group with about one quarter of men age 15-49 years in Biak Numfor reporting having at least one drink of alcohol on one or more days during the last one month. This compares with percentages of 21 and 13 in Merauke and Jayawijaya districts respectively. MULTIPLE INDICATOR CLUSTER SURVEY 2011xxiv MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 1MULTIPLE INDICATOR CLUSTER SURVEY 2011 1 INTRODUCTION 1.1. BACKGROUND This report is based on the Selected Districts of Papua Province Multiple Indicator Cluster Survey, conducted in 2011 by the BPS. The survey provides valuable information on the situation of children and women in three selected districts of Papua Province: Merauke, Jayawijaya and Biak Numfor, and was based, in large part, on the need to furnish up-to- date information on the situation of children and women in the selected districts of Papua Province to inform planning. Indonesia as a whole shows good performance on most social indicators, however, there are disparities within provinces. This survey forms part of the fourth round of the global MICS surveys initiated in 1995 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 subnational levels of progress in order to address obstacles more effectively and accelerate actions.…” (A World Fit for Children, paragraph 61) 2 MULTIPLE INDICATOR CLUSTER SURVEY 2011 The Plan of Action (paragraph 61) also calls for the specific involvement of UNICEF in the preparation of periodic progress reports: “… As the world’s lead agency for children, the United Nations Children’s Fund is requested to continue to prepare and disseminate, in close collaboration with Governments, relevant funds, programmes and the specialized agencies of the United Nations system, and all other relevant actors, as appropriate, information on the progress made in the implementation of the Declaration and the Plan of Action.” Similarly, the Millennium Declaration (paragraph 31) calls for periodic reporting on progress: “…We request the General Assembly to review on a regular basis the progress made in implementing the provisions of this Declaration, and ask the Secretary- General to issue periodic reports for consideration by the General Assembly and as a basis for further action.” This final report presents the results of the indicators and topics covered in the survey. 1.2. SURVEY OBJECTIVES The 2011 Selected Districts of Papua Province Multiple Indicator Cluster Survey has as its primary objectives: • To provide up-to-date information for assessing the situation of children and women in three selected districts of Papua Province; • To furnish data needed for monitoring progress toward district and provincial development plan targets, as a basis for future action; • To contribute to the improvement of data and monitoring systems in Indonesia and to strengthen technical expertise in the design, implementation, and analysis of such systems. • To generate data on the situation of children and women, including the identification of vulnerable groups and of disparities, to inform policies and interventions. 1.3 LIMITATIONS OF THE SURVEY Papua and West Papua are Indonesia’s two eastern most provinces. Together the two pronvinces have an estimated population of about 3.6 million (Census 2010). Much of the provinces’ land is covered by forest. As such, travel to and around Papua and West Papua is a provinces’s challenge. The main cities are not connected by road. Expensive boat or plane charter is the only option in many instances. As a result all survey costs are extremely high and data collection requires special effort. For this reason, the MICS in selected districts of Papua and West Papua was not representative of the two provinces as that would have required much higher budget availability. The coastal areas of these provinces have been influenced by outside culture, but the tribal groups in the interior have by and large preserved traditional cultures and have MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 3 limited contact with the outside world. Therefore, accurate concepts regarding age and other such information can be challenging to collect. During supervision visits by UNICEF and Statistics Indonesia (BPS), it was observed that elders and mothers could not provide accurate information about their ages and their children’s ages despite probing by the interviewers and use of local calendars. MULTIPLE INDICATOR CLUSTER SURVEY 20114 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 5MULTIPLE INDICATOR CLUSTER SURVEY 2011 2 SAMPLE AND SURVEY METHODOLOGY 2.1. SAMPLE DESIGN The sample for the 2011 Selected Districts of Papua Province Multiple Indicator Cluster Survey (MICS) was designed to provide estimates for a large number of indicators on the situation of children and women at the district level. The three districts of Merauke, Jayawijaya and Biak Numfor were included in this survey. The sample was selected in two stages. Within each district, a specified number of census enumeration areas were selected systematically with probability proportional to size. After a household listing was carried out within the selected enumeration areas, a systematic sample of 25 households was drawn in each sample enumeration area. The total sample size was 3,000 households (1,000 for each district). The sample is not self-weighting and sample weights are used. A more detailed description of the sample design can be found in Appendix A. 2.2. QUESTIONNAIRES Four sets of questionnaires were used in the survey: 1) a household questionnaire which was used to collect information on all de jure household members (usual residents), the household, and the dwelling; 2) a women’s questionnaire administered in each household to all women aged 15-49 years; 3) a men’s questionnaire administered in each household to all men aged 15-49 years; and 4) an under-5 questionnaire, administered to mothers or caretakers for all children under 5 living in the household. The questionnaires included the following modules: The Household Questionnaire included the following modules: • Household Listing Form • Education • Water and Sanitation • Household Characteristics • Insecticide-treated Nets • Child Labour • Child Discipline The Questionnaire for Individual Women was administered to all women aged 15-49 years living in the households, and included the following modules: • Women’s Background • Child Mortality • Desire for Last Birth • Maternal and Newborn Health • Contraception 6 MULTIPLE INDICATOR CLUSTER SURVEY 2011 • Unmet Need • Attitudes Towards Domestic Violence • Marriage/Union • Sexual Behaviour • HIV/AIDS • Alcohol Use The Questionnaire for Individual Men was administered to all men aged 15-49 years living in the households, and included the following modules: • Men’s Background • Attitudes Towards Domestic Violence • Marriage/Union • Sexual Behaviour • HIV/AIDS • Circumcision • Alcohol Use The Questionnaire for Children Under-Five was administered to mothers or caretakers of children under 5 years of age3 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: • Age • Birth Registration • Breastfeeding • Malaria • Immunization The questionnaires are based on the MICS4 model questionnaire.4 From the MICS4 model English version, the questionnaires were translated into Bahasa Indonesia and were pre- tested in Kemtuk Village in Jayapura district and Bagai Village in Keerom district in Papua Province during 18 – 22 July 2011. Based on the results of the pre-test, modifications were made to the wording and translation of the questionnaires. A copy of the Selected Districts of Papua Province MICS questionnaires is provided in Appendix F. 2.3. TRAINING AND FIELDWORK Training of trainers for the field was conducted for 12 days during 4-15 July 2011 in Bogor. Enumerator training was conducted in Manokwari for 15 days during 19 September- 3 October 2011. Training included lectures on interviewing techniques and the contents of the questionnaires, and mock interviews between trainees to gain practice in asking questions. Towards the end of the training period, trainees spent one and half days in practice interviewing in Jayapura district. The data was collected by four teams; each was comprised of four interviewers, one editor, and a supervisor. Fieldwork began in 5 October 2011 and concluded in 5 December 2011. 3 The terms “children under 5”, “children age 0-4 years”, and “children aged 0-59 months” are used interchangeably in this report. 4 The model MICS4 questionnaires can be found at www.childinfo.org MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 7 2.4. DATA PROCESSING Data was entered using the CSPro software. The data was entered on 12 microcomputers, carried out by 12 data entry operators under the supervision of one secondary editor and one data entry supervisor. In order to ensure quality control, all questionnaires were double-entered and internal consistency checks were performed. Procedures and standard programmes developed under the global MICS4 programme and adapted to the Selected Districts of Papua MICS questionnaire were used throughout. Data processing began simultaneously with data collection in 8 October 2011 and was completed in 31 December 2011. Data was analysed using the Statistical Package for Social Sciences (SPSS) software programme, Version 18, and the model syntax and tabulation plans developed by UNICEF were used for this purpose. MULTIPLE INDICATOR CLUSTER SURVEY 20118 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 9MULTIPLE INDICATOR CLUSTER SURVEY 2011 3.1. SAMPLE COVERAGE Of the 3,000 households selected for the three districts sample, 2,900 were found to be occupied. Of these, 2,866 were successfully interviewed for a household response rate of 98.8 per cent. In the interviewed households, 3,017 women (age 15-49 years) were identified. Of these, 2,784 were successfully interviewed, yielding a response rate of 92.3 per cent within interviewed households. In addition, 2,996 men (age 15-49 years) were listed in the household questionnaire. Questionnaires were completed for 2,568 of eligible men, a response rate of 85.7 per cent within interviewed households. There were 1,561 children under age five listed in the household questionnaire. Questionnaires were completed for 1,511 of these children, which corresponds to a response rate of 96.8 per cent within interviewed households. Overall response rates of 91.2, 84.7 and 95.7 are calculated for the women’s, men’s and under-5’s interviews respectively (Table HH.1). The household response rate was similar among the three districts of Merauke, Jayawijaya and Biak Numfor; whereas the women, men and children response rates were Households Sampled Occupied Interviewed Household response rate Women Eligible Interviewed Women’s response rate Women’s overall response rate Men Eligible Interviewed Men’s response rate Men’s overall response rate Children under 5 Eligible Mothers/caretakers interviewed Under-5’s response rate Under-5’s overall response rate Urban 1,075 1,041 1,027 98.7 1,215 1,085 89.3 88.1 1,301 1,063 81.7 80.6 545 517 94.9 93.6 Rural 1,925 1,859 1,839 98.9 1,802 1,699 94.3 93.3 1,695 1,505 88.8 87.8 1,016 994 97.8 96.8 Merauke 1,000 936 914 97.6 958 841 87.8 85.7 1,012 763 75.4 73.6 443 420 94.8 92.6 Jayawijaya 1,000 976 966 99.0 956 886 92.7 91.7 869 745 85.7 84.9 507 492 97.0 96.0 Biak Numfor 1,000 988 986 99.8 1,103 1,057 95.8 95.6 1,115 1,060 95.1 94.9 611 599 98.0 97.8 Total 3,000 2,900 2,866 98.8 3,017 2,784 92.3 91.2 2,996 2,568 85.7 84.7 1,561 1,511 96.8 95.7 Table HH.1: Results of household, women’s, men’s and under-5 interviews Number of households, women, men and children under 5 by results of the household, women’s and under-5’s interviews, and household, women’s and under-5’s response rates, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Area District 3 SAMPLE COVERAGE AND THE CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS 10 MULTIPLE INDICATOR CLUSTER SURVEY 2011 generally lower in the districts of Merauke and Jayawijaya. It is worth noting that male response rates in Merauke District were around 75 per cent and results for this district should be interpreted with some caution, as the response rates are low. 3.2. CHARACTERISTICS OF HOUSEHOLDS The age and sex distribution of the three districts survey population is provided in Table HH.2. In the 2,866 households successfully interviewed in the survey, 12,070 household members were listed. Of these, 6,182 were males, and 5,888 were females. The age structure of the selected three districts of Papua is experiencing rapid growth with a larger proportion of its population in the younger age groups than in the older age groups. About 37 per cent of the population is under the age of 15 years. About 42 per cent of the population in the three districts comprise children 0-17 years. Tables HH.3 - HH.5 provide basic information on the households, female respondents age 15-49, male respondents 15-49 and children under-5 by presenting the unweighted, as well as the weighted numbers. Information on the basic characteristics of households, women, men and children under-5 interviewed in the survey is essential for the interpretation of findings presented later in the report and can also provide an indication Age 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Dependency age groups 0-14 15-64 65+ Child and adult populations Children age 0-17 years Adults age 18+ years Total for 3 districts Number 698 765 669 522 456 540 453 457 304 316 302 184 108 54 24 24 5 7 2,132 3,641 115 2,451 3,437 5,888 Number 817 810 728 522 407 485 430 444 410 353 276 211 128 86 33 22 13 7 2,354 3,666 162 2,682 3,501 6,182 Per cent 11.9 13.0 11.4 8.9 7.8 9.2 7.7 7.8 5.2 5.4 5.1 3.1 1.8 0.9 0.4 0.4 0.1 0.1 36.2 61.8 2.0 41.6 58.4 100.0 Per cent 13.2 13.1 11.8 8.4 6.6 7.8 7.0 7.2 6.6 5.7 4.5 3.4 2.1 1.4 0.5 0.4 0.2 0.1 38.1 59.3 2.6 43.4 56.6 100.0 Number 1,515 1,574 1,397 1,044 864 1,025 883 900 715 669 577 395 235 141 57 47 18 15 4,486 7,308 277 5,133 6,938 12,070 Per cent 12.5 13.0 11.6 8.6 7.2 8.5 7.3 7.5 5.9 5.5 4.8 3.3 1.9 1.2 0.5 0.4 0.2 0.1 37.2 60.5 2.3 42.5 57.5 100.0 Table HH.2: Household age distribution by sex Per cent and frequency distribution of the household population by five-year age groups, dependency age groups, and by child (age 0-17 years) and adult populations (age 18 or more), by sex, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 FemalesMales Total MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 11 District Merauke Jayawijaya Biak Numfor Sex of household head Male Female Area Urban Rural Number of household members 1 2 3 4 5 6 7 8 9 10+ Education of household head None Primary SMP/SM Higher Missing/DK Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Missing/DK Total for 3 districts Households with at least One child age 0-4 years One child age 0-17 years One woman age 15-49 years One man age 15-49 years Mean household size Unweighted 914 966 986 2,546 320 1,027 1,839 181 425 536 613 458 274 155 115 53 56 440 878 1147 399 2 1,829 541 250 114 131 1 2,866 2,866 2,866 2,866 2,866 2,866 43.6 27.9 28.6 89.1 10.9 39.5 60.5 6.0 14.9 19.4 21.7 15.7 9.3 5.3 3.8 1.9 2.0 12.6 32.8 40.4 14.0 0.1 54.5 25.9 9.4 4.5 5.8 0.0 100.0 40.8 76.1 81.7 78.8 4.2 Weighted 1,248 799 819 2,555 311 1,132 1,734 172 427 556 622 451 267 151 109 55 56 362 940 1159 402 2 1,561 741 269 129 165 1 2,866 2,866 2,866 2,866 2,866 2,866 Table HH.3: Household composition Per cent and frequency distribution of households by selected characteristics, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of households Weighted per cent of the representativeness of the survey. The remaining tables in this report are presented only with weighted numbers. See Appendix A for more details about the weighting. Table HH.3 provides basic background information on the households. Within households, the sex of the household head, area, number of household members, education of household head and ethnicity of the household head are shown in the table. In addition to districts, these background characteristics are used in subsequent tables in this report; the figures in the table are also intended to show the numbers of observations by major categories of analysis in the report. 12 MULTIPLE INDICATOR CLUSTER SURVEY 2011 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 with at least one child under 18, at least one child under 5, at least one eligible woman age 15-49 and at least one man age 15-49. The table also shows the weighted average household size estimated by the survey. About 44 per cent of the three districts Papua Province sample resides in Merauke, 28 per cent reside in Jayawijaya and 29 per cent reside in Biak Numfor. Most of the households consisted of 4 members (22 per cent) and the mean household size is 4 members. About half of the survey sample consisted of households with Papuan heads (55 per cent), followed with Javanese heads of households which accounted for about a quarter of the survey sample (25 per cent). The remaining quarter of the survey sample was headed by other ethnic groups from: Sulawesi, Maluku and others. Forty-one per cent of the households contained at least one child under-five years of age, 82 per cent contained at least one woman aged 15-49 years and 79 per cent contained at least one man aged 15-49 years. Weighted and unweighted number of cases were generally similar except for districts and some of the ethnicity of household head categories. There seems to be oversampling in Merauke District and some undersampling in Jayawijaya and Biak Numfor districts. Similarly there seems to be oversampling for Papua ethnic group and under sampling for Java. 3.3. CHARACTERISTICS OF FEMALE AND MALE RESPONDENTS 15-49 YEARS OF AGE AND CHILDREN UNDER-5 Tables HH.4, HH.4M and HH.5 provide information on the background characteristics of female and male respondents 15-49 years of age and of children under age 5. In all three tables, the total numbers of weighted and unweighted observations are equal, since sample weights have been normalized (standardized). In addition to providing useful information on the background characteristics of women and children, the tables are also intended to show the numbers of observations in each background category. These categories are used in the subsequent tabulations of this report. Table HH.4 provides background characteristics of female respondents 15-49 years of age. The table includes information on the distribution of women according to district, area, age, marital status, motherhood status, births in last two years, education5, wealth index quintiles6 and ethnicity of the household head. 5 Unless otherwise stated, “education” refers to educational level attended by the respondent throughout this report when it is used as a background variable. 6 Principal components analysis was performed by using information on the ownership of consumer goods, dwelling characteristics, water and sanitation, and other characteristics that are related to the household’s wealth to assign weights (factor scores) to each of the household assets. Each household was then assigned a wealth score based on these weights and the assets owned by that household. The survey household population was then ranked according to the wealth score of the household they are living in, and was finally divided into 5 equal parts (quintiles) from lowest (poorest) to highest (richest). The assets used in these calculations were as follows: source of drinking water, type of sanitation facility, persons per sleeping room, type of floor, type of roof, type of wall, type of cooking fuel, household assets, household members assets, ownership of dwelling, ownership of agricultural land, ownership of livestock, and ownership of bank account. The wealth index is assumed to capture the underlying long-term wealth through information on the household assets, and is intended to produce a ranking of households by wealth, from poorest to richest. The wealth index does not provide information on absolute poverty, current income or expenditure levels. The wealth scores calculated are applicable for only the particular data set they are based on. Further information on the construction of the wealth index can be found in Filmer, D. and Pritchett, L., 2001. “Estimating wealth effects without expenditure data – or tears: An application to educational enrolments in states of India”. Demography 38(1): 115-132. Gwatkin, D.R., Rutstein, S., Johnson, K. , Pande, R. and Wagstaff. A., 2000. Socio-Economic Differences in Health, Nutrition, and Population. HNP/Poverty Thematic Group, Washington, DC: World Bank. Rutstein, S.O. and Johnson, K., 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, Maryland: ORC Macro. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 13 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age of woman 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Marital/Union status Currently married/in union Widowed Divorced Separated Never married/in union Motherhood status Ever gave birth Never gave birth Births in last two years Had a birth in last two years Had no birth in last two years Education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts Unweighted 841 886 1,057 1,085 1,699 465 399 504 432 421 289 274 2,086 74 25 53 546 2,002 782 571 2,213 474 727 1,237 346 696 471 484 560 573 1,759 488 285 128 124 2,784 42.7 26.9 30.4 42.2 57.8 16.6 14.5 18.2 14.9 15.1 10.3 10.5 75.3 2.4 0.9 1.6 19.8 72.1 27.9 19.5 80.5 13.0 28.4 45.7 13.0 19.2 18.2 18.9 21.3 22.3 53.9 24.5 10.8 5.2 5.6 100.0 Weighted 1,189 748 848 1,174 1,610 462 403 506 414 420 288 291 2,096 68 24 45 551 2,006 778 544 2,240 362 789 1,272 361 536 506 528 594 621 1,501 682 302 144 156 2,784 Table HH.4: Women’s background characteristics Per cent and frequency distribution of women age 15-49 years by selected background characteristics, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of women Weighted per cent 14 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Table HH.4 provides background characteristics of female respondents 15-49 years of age. The table includes information on the distribution of women according to district, residence, age, marital status, motherhood status, births in last two years, education, wealth index quintiles and ethnicity of the household head. About 43 per cent of female respondents 15-49 years of age live in Merauke, 27 per cent in Jayawijaya and 30 per cent in Biak Numfor. About 58 per cent of these women live in urban areas while the remaining 42 per cent live in rural areas. Of the 2,784 successfully interviewed women, 2,086 women (75 per cent) were currently married or in union, 546 women (20 per cent) were never married or in union and fewer women (5 per cent) were widowed, divorced or separated. Seventy-two per cent of women gave birth while 28 per cent never did. To assess their education, women were asked about highest level of school they reached. About 13 per cent of all women never attended any form of education. The majority (46 per cent) of all women have junior or senior secondary (SMP/ SM) education, 28 per cent have primary education and only 13 per cent have higher than secondary education. Weighted and unweighted number of cases were generally similar except for districts and ethnicity of head of household. Similarly, Table HH.4M provides background characteristics of male respondents 15-49 years of age. The table shows information on the distribution of men according to district, area, age, marital status, education, wealth index quintiles, and ethnicity. Men’s characteristics are generally similar to those of women, except that more men than women are not married or in union (32 per cent) whereas most of the remaining survey sample were currently married or in union (66 per cent). Some background characteristics of children under-five are presented in Table HH.5. These include distribution of children by several attributes: sex, district, area of residence, age, mother’s or caretaker’s education, wealth and ethnicity. The percentage of male children under-five is slightly higher compared with female (54 per cent vs 46 per cent respectively). Slightly less than one-fifth of children were under one year of age (19 per cent), 18 per cent were 12-23 months, 20 per cent were 24-35 months, 21 per cent were 36-47 months and 21 per cent were 48-59 months. The majority (61 per cent) of these children reside in rural areas whereas 39 per cent reside in urban areas. Thirteen per cent of children’s mothers or care takers were uneducated, 30 per cent had primary education, 46 per cent had secondary education (SMP/SM) while 11 per cent had higher education. Weighted and unweighted number of cases were generally similar, except for districts. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 15 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age of Man 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Marital/Union status Currently married/in union Widowed Divorced Separated Never married/in union Education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Missing/DK Total for 3 districts Unweighted 763 745 1,060 1,063 1,505 443 332 391 365 385 350 302 1,665 24 15 31 833 187 586 1393 402 617 415 478 531 527 1,619 480 244 109 115 1 2,568 45.2 24.4 30.4 44.9 55.1 16.4 12.9 15.9 14.3 14.9 13.5 12.2 65.5 0.9 0.5 1.1 32.1 5.6 24.8 54.1 15.4 18.9 17.3 19.3 22.5 21.9 52.7 26.7 9.8 4.8 5.9 0.0 100.0 Weighted 1,161 627 780 1,153 1,415 420 330 407 368 383 347 313 1,681 23 12 27 825 145 636 1,390 396 486 445 496 577 563 1,354 686 252 123 152 1 2,568 Table HH.4M: Men’s background characteristics Per cent and frequency distribution of men age 15-49 years by selected background characteristics, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of men Weighted per cent MULTIPLE INDICATOR CLUSTER SURVEY 201116 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Age 0-5 months 6-11 months 12-23 months 24-35 months 36-47 months 48-59 months Mother’s education* None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts Unweighted 420 492 599 799 712 517 994 139 155 280 304 332 301 265 428 661 157 425 284 290 273 239 1,065 194 134 51 118 1,511 38.1 28.0 33.9 54.2 45.8 38.6 61.4 9.1 10.1 18.4 20.3 21.4 20.7 13.3 29.5 45.9 11.2 22.2 20.0 20.3 19.6 17.9 61.8 18.3 9.6 4.0 10.3 100.0 Weighted 576 424 512 819 692 583 928 138 153 279 306 323 313 201 446 694 170 335 302 307 297 270 934 276 146 60 155 1,511 Table HH.5: Under-5’s background characteristics Per cent and frequency distribution of children under five years of age by selected characteristics, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of under-5 children Weighted per cent * Mother’s education refers to educational attainment of mothers and caretakers of children under 5. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 17MULTIPLE INDICATOR CLUSTER SURVEY 2011 4 CHILD MORTALITY One of the overarching goals of the Millennium Development Goals (MDGs) is the reduction of infant and under-five mortality. Specifically, the MDGs call for the reduction in under-five mortality by two-thirds between 1990 and 2015. Monitoring progress towards this goal is an important but difficult objective. Measuring childhood mortality may seem easy, but attempts using direct questions, such as “Has anyone in this household died in the last year?” give inaccurate results. Using direct measures of child mortality from birth histories is time-consuming, more expensive, and requires greater attention to training and supervision. Alternatively, indirect methods developed to measure child mortality produce robust estimates that are comparable with the ones obtained from other sources. Indirect methods minimize the pitfalls of memory lapses, inexact or misinterpreted definitions, and poor interviewing technique. The infant mortality rate is the probability of dying before the first birthday. The under- five mortality rate is the probability of dying before the fifth birthday. In MICS surveys, infant and under five mortality rates are calculated based on an indirect estimation technique known as the Brass method.7 The data used in the estimation are: the mean number of children ever born for five year age groups of women from age 15 to 49, and the proportion of these children who are dead, also for five-year age groups of women (Table CM.1). The technique converts the proportions dead among children of women in each age group into probabilities of dying by taking into account the approximate length of exposure of children to the risk of dying, assuming a particular model age pattern of mortality. Based on previous information on mortality in Indonesia, the West model life table was selected as most appropriate. It should be noted that the infant and child mortality estimates presented in the report are based on relatively small numbers of cases which can lead to unstable estimates. Therefore, interpretation of these estimated should be treated with caution. Table CM.2 provides estimates of child mortality. The infant mortality rates are estimated at 39, 86 and 48 per thousand in the districts of Merauke, Jayawijaya and Biak Numfor respectively. The probabilities of dying under age 5 (U5MR) are 48, 122 and 62 per thousand in the districts of Merauke, Jayawijaya and Biak Numfor respectively. These estimates have been calculated by averaging mortality estimates obtained from women age 25-29 and 30-34, and refer roughly to 2006. These mortality estimates show a clear disadvantage in Jayawijaya District compared with Merauke and Biak Numfor. The overall combined three districts infant and under-five mortality rates were 58 and 78 per thousand respectively. The Indonesian Demographic and Health survey conducted in 2007 gave a figure of 41 and 64 per thousand for infant and under-five mortality rates for the 10-year period preceding the survey using the direct method of mortality estimation. 7 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 Programme for Child Mortality Estimation. New York, UN Pop Division. United Nations, 1990b. Step-by-step Guide to the Estimation of Child Mortality. New York, UN. 18 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total for 3 districts Mean 0.089 0.533 0.997 1.331 1.704 1.838 2.085 1.136 Mean 0.077 0.484 0.932 1.208 1.509 1.633 1.812 1.018 Total 41 215 505 551 716 529 607 3,163 Total 35 195 472 500 635 470 527 2,834 0.141 0.092 0.065 0.093 0.114 0.111 0.131 0.104 Number of women 462 403 506 414 420 288 291 2,784 Table CM.1: Children ever born, children surviving and proportion dead Mean and total numbers of children ever born, children surviving and proportion dead by age of women, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Children ever born Children surviving Proportion dead District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papuan Others Total for 3 districts 39 86 48 61 55 36 70 106 68 39 27 112 66 36 33 15 79 21 58 48 122 62 79 77 45 96 153 94 48 32 162 90 45 41 17 110 25 78 Table CM.2: Child mortality Infant and under-five mortality rates, West Model, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 1 MICS indicator 1.2; MDG indicator 4.2 2 MICS indicator 1.1; MDG indicator 4.1 Rates refer to 2006, West Model was assumed to approximate the age pattern of mortality in Indonesia Infant mortality rate1 Under-five mortality rate2 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 19 For the combined three districts, there is some difference between the probabilities of dying among males and females. There are also significant differences in mortality in terms of area of residence, educational levels, wealth and ethnicity. Mortality rates are approximately double in rural areas compared with urban. As expected, sharp negative association between mortality and education is observed; for example the under-five mortality rate decreased from 153 per thousand for children with uneducated mothers to 32 per thousand for children with mothers with higher education. Similarly, under- five mortality rate decreased sharply from 162 per thousand among children living in the poorest household to 17 per thousand among those living in the richest households. Mortality was considerably greater among children whose household heads are Papuan compared with others. Differentials in under-5 mortality rates by selected background characteristics are shown in Figure CM.1. Figure CM. 1: Under-5 mortality rates by background characteristics, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest Ethznicity Papuan Other 0 50 100 150 Per 1,000 live births 48 122 62 45 96 153 94 48 32 162 90 45 41 17 110 25 MULTIPLE INDICATOR CLUSTER SURVEY 201120 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 21MULTIPLE INDICATOR CLUSTER SURVEY 2011 5 NUTRITION 5.1. BREASTFEEDING Breastfeeding for the first few years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. However, many mothers stop breastfeeding too soon and there are often pressures to switch to infant formula, which can contribute to growth faltering and micronutrient malnutrition and is unsafe if clean water is not readily available. WHO/UNICEF provide the following feeding recommendations: • Exclusive breastfeeding for first six months • Continued breastfeeding for two years or more • Safe and age-appropriate complementary foods beginning at 6 months • Frequency of complementary feeding: 2 times per day for 6-8 month olds; 3 times per day for 9-11 month olds It is also recommended that breastfeeding be initiated within one hour of birth. The indicators related to recommended child feeding practices are as follows: • Early initiation of breastfeeding (within 1 hour of birth) • Exclusive breastfeeding rate (< 6 months) • Predominant breastfeeding (< 6 months) • Continued breastfeeding rate (at 1 year and at 2 years) • Duration of breastfeeding • Age-appropriate breastfeeding (0-23 months) • Introduction of solid, semi-solid and soft foods (6-8 months) • Minimum meal frequency (6-23 months) • Milk feeding frequency for non-breastfeeding children (6-23 months) • Bottle feeding (0-23 months) Table NU.1 charts the proportion of children born in the last two years who were ever breastfed and those who were first breastfed within one hour and one day of birth. Although a very important step in management of lactation and establishment of a physical and emotional relationship between the baby and the mother, only 35 per cent of babies in the three selected districts of Papua Province were breastfed for the first time within one hour of birth, while 73 per cent of newborns start breastfeeding within one day of birth. Women differed in the timing of initial breastfeeding according to districts, particularly when considering initiation of breastfeeding within one hour. Women in Biak Numfor District were the least likely to start breastfeeding within one hour (19 per cent) compared with women in Merauke (44 per cent) and Jayawijaya (39 per cent) (Figure NU.1). 22 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Breastfeeding within one day of birth was higher in Jayawijaya District (86 per cent) than in Biak Numfor (70 per cent) and Merauke (64 per cent). It was also noticed that initial breastfeeding was highest among children born in the poorest households compared with the others. Children born in private hospitals (61 per cent) were more likely to be initially breastfed appropriately within one hour compared with those born in public sector hospitals (27 per cent) and those born at home (35 per cent). Children born by mothers whose head of household was Javanese were more likely to be initially breastfed with an hour (53 per cent) compared with households whose heads belong to other ethnic groups. In Table NU.2, 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, as well as continued breastfeeding of children at 12-15 and 20-23 months of age. For the three districts of Papua Province, only 39 per cent of children aged less than six months are exclusively breastfed and 46 per cent are predominantly breastfed. Exclusive and predominant breast feeding are higher in Jayawijaya District (55 and 60 per cent respectively) compared with the other two districts (Merauke: 23 and 36 respectively; Biak Numfor: 38 and 43 respectively). At age 12-15 months, 80 per cent of the children are breastfed, while this percentage is 48 per cent for children aged 20-23 months. Continued breastfeeding indicators by background characteristics are not reported due to small number of cases. Table NU.3 shows the median duration of breastfeeding by selected background characteristics. Among children under age 3, the median duration is 22 months for any -breastfeeding, two months for exclusive breastfeeding, and four months for predominant breastfeeding. Results show that the median duration of breastfeeding was least at Biak Numfor (19 months) district compared with Merauke (20 months) districts. The median duration of breastfeeding shows a positive correlation with mother’s education and wealth. Figure NU.1: Percentage of mothers who started breastfeeding within one hour and within one day of birth, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 100 90 80 70 60 50 40 30 20 10 0 Merauke P er c en t UrbanJayawijaya Within one day Within one hour RuralBiak Numfor Three districts 44 64 86 38 19 70 63 33 36 80 87 64 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 23 District Merauke Jayawijaya Biak Numfor Area Urban Rural Months since birth 0-11 months 12-23 months Assistance at delivery Skilled attendant Traditional birth attendant Other Missing Place of delivery* Public sector health facility Private sector health facility Home Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 92.3 94.2 93.4 91.7 94.4 92.6 94.1 92.4 (90.9) 95.7 96.3 89.2 (100.0) 94.5 97.1 92.3 93.0 91.1 96.5 93.4 90.9 90.5 94.3 93.8 96.1 95.7 (*) (79.1) 93.2 44.1 38.5 19.0 32.8 36.1 35.1 33.8 36.4 (19.4) 33.6 36.2 26.6 (61.3) 35.0 44.7 39.3 33.8 17.4 40.3 29.4 35.4 30.8 36.4 30.2 53.4 31.4 (*) (35.1) 34.7 63.9 86.4 69.7 63.4 80.2 72.3 73.2 66.0 (68.3) 92.2 84.7 54.2 (77.8) 84.0 91.8 75.3 71.4 51.8 93.3 69.3 73.2 62.0 63.5 79.8 70.4 55.5 (*) (58.4) 72.9 204 174 167 237 307 296 242 365 34 129 16 190 53 297 79 122 279 64 125 101 102 112 105 322 105 58 21 37 544 Table NU.1: Initial breastfeeding Percentage of last-born children in the 2 years preceding the survey who were ever breastfed, percentage who were breastfed within one hour of birth and within one day of birth, and percentage who received a prelacteal feed, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 *3 cases with missing place of delivery not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 2.4 2 MICS indicator 2.5 Percentage who were ever breastfed1 Percentage who were first breastfed: Number of last-born children in the two years preceding the surveyWithin one hour of birth2 Within one day of birth 24 MULTIPLE INDICATOR CLUSTER SURVEY 2011 The adequacy of infant feeding in children under 24 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, while infants aged 6-23 months are considered to be adequately fed if they are receiving breastmilk and solid, semi-solid or soft food. As a result of these feeding patterns, half of the children aged 6-23 months are being appropriately fed (52 per cent). The level of age-appropriate feeding is highest in Jayawijaya District (74 per cent) compared with Merauke (47 per cent) and Biak Numfor (40 per cent) districts. Appropriate feeding was higher among children residing in rural areas (57 per cent) compared with urban areas (46 per cent). Appropriate feeding showed negative correlation with mother’s education and wealth i.e. the percentage of appropriate feeding increases as the level of mother education decreases and it also increases as the wealth decreases (Figure NU.2). Similar patterns were observed for children age 0-23 months. Appropriate complementary feeding of children from 6 months to two years of age is particularly important for growth and development and the prevention of undernutrition. Continued breastfeeding beyond six months should be accompanied by consumption of nutritionally adequate, safe and appropriate complementary foods that help meet nutritional requirements when breast milk is no longer sufficient. This requires that for breastfed children, two or more meals of solid, semi-solid or soft foods are needed if they are six to eight months old, and three or more meals if they are 9-23 months of age. For children 6-23 months and older who are not breastfed, four or more meals of solid, semi- solid or soft foods or milk feeds are needed. District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Total for 3 districts (23.3) 55.0 38.3 37.3 41.4 (36.8) 40.6 39.1 (35.6) 59.5 42.9 46.0 46.5 (47.9) 45.1 46.2 (*) (89.9) (61.8) (81.0) 79.3 (78.9) 81.0 80.0 (33.6) (*) (44.3) (44.3) (53.8) (45.3) 50.7 48.3 46 48 44 77 61 55 83 138 33 33 31 41 56 44 54 97 35 21 31 51 36 39 48 87 Table NU.2: Breastfeeding Percentage of living children according to breastfeeding status at selected age groups, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Children age 0-5 months Children age 12-15 months Children age 20-23 months Per cent exclusively breastfed1 Per cent predominantly breastfed2 Per cent breastfed (Continued breastfeeding at 1 year)3 Per cent breastfed (Continued breastfeeding at 2 years)4 Number of children Number of children Number of children ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on less than 25 unweighted cases 1 MICS indicator 2.6 2 MICS indicator 2.9 3 MICS indicator 2.7 4 MICS indicator 2.8 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 25 Overall, 32 per cent of infants age 6-8 received solid, semi-solid, or soft foods (Table NU.5). Among currently breastfeeding infants this percentage is 31 while it is 34 among infants currently not breastfeeding. Table NU.6 presents the proportion of children age 6-23 months who received semi-solid or soft foods the minimum number of times or more during the previous day according to breastfeeding status (see the note in Table NU.6 for a definition of minimum number of times for different age groups). Overall, slightly more than half of the children age 6-23 months (54 per cent) were receiving solid, semi-solid and soft foods the minimum number of times (Merauke, 52 per cent; Jayawijaya, 60 per cent; Biak Numfor, 51 per cent). District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Median Mean for all children (0-35 months) 20.0 18.7 20.4 22.1 20.3 22.7 23.8 20.1 10.1 20.3 19.6 19.7 19.8 24.2 20.3 19.8 (14.2) (*) 21.8 22.2 0.6 2.9 1.4 0.9 2.1 1.5 1.6 3.2 2.2 0.7 0.5 2.9 2.0 0.7 0.7 0.7 2.5 0.4 1.9 (4.8) (*) 1.6 2.4 0.6 3.5 1.8 1.6 2.3 2.3 1.9 4.4 2.4 0.7 0.6 3.6 2.4 0.7 1.4 0.7 3.1 0.4 2.1 (4.8) (*) 2.1 3.6 324 259 293 492 384 347 528 115 231 429 101 187 167 194 172 155 535 165 86 35 89 876 876 Table NU.3: Duration of breastfeeding Median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding among children age 0-35 months, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Median duration (in months) of Any breastfeeding1 Exclusive breastfeeding Predominant breastfeeding Number of children age 0-35 months ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 2.10 26 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts (23.3) 55.0 38.3 37.3 41.4 (36.8) 40.6 (56.6) (43.3) 33.2 (*) (54.1) (34.0) (*) (28.8) (*) 50.6 (*) (*) (*) (*) 39.1 41.6 68.8 39.7 48.4 49.8 43.9 52.9 73.2 57.2 43.4 28.0 78.3 44.1 46.2 37.7 37.2 56.9 45.7 41.1 (*) 19.0 49.0 46.8 74.3 40.1 52.1 52.4 45.9 57.2 81.0 61.1 46.7 28.2 87.4 48.0 46.4 40.6 38.6 59.0 55.5 (*) (*) 16.8 52.2 46 48 44 77 61 55 83 26 30 68 14 33 29 23 30 24 84 27 12 4 15 138 160 121 150 234 198 192 240 55 106 214 56 87 76 94 89 85 260 76 46 20 49 431 206 169 194 310 259 247 323 80 136 283 70 119 105 117 119 108 344 103 59 24 64 569 Table NU.4: Age-appropriate breastfeeding Percentage of children age 0-23 months who were appropriately breastfed during the previous day, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Children age 0-5 months Children age 6-23 months Children age 0-23 months Per cent exclusively breastfed1 Per cent appropriately breastfed2 Per cent currently breastfeeding and receiving solid, semi-solid or soft foods Number of children Number of children Number of children ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 2.6 2 MICS indicator 2.14 The continued practice of bottle-feeding is a concern because of the possible contamination due to unsafe water and lack of hygiene in preparation. Table NU.7 shows that thirty-nine per cent of children under 6 months are fed using a bottle with a nipple. Bottle feeding is considerably lower in Jayawijaya District (17 per cent) compared with Merauke (46 per cent) and Biak Numfor (50 per cent). Bottle feeding is higher in urban areas, among children of the more educated richer women. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 27 Sex Male Female Area Urban Rural Total for 3 districts (24.8) (39.6) (*) (39.8) 31.4 (27.6) (36.4) (22.2) (42.0) 31.9 (39.6) (29.8) (25.7) 57.0 (33.5) 34 28 26 35 62 8 13 16 5 21 42 41 42 41 83 Table NU.5: Introduction of solid, semi-solid or soft foods Percentage of infants age 6-8 months who received solid, semi-solid or soft foods during the previous day, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Currently breastfeeding Currently not breastfeeding All Per cent receiving solid, semi-solid or soft foods Per cent receiving solid, semi-solid or soft foods1 Per cent receiving solid, semi-solid or soft foods Number of children age 6-8 months Number of children age 6-8 months Number of children age 6-8 months ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 2.12 Figure NU.2: Percentage of children age 6-23 months who were appropriately breastfed during the previous day by mother’s education and wealth index, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 100 90 80 70 60 50 40 30 20 10 0 None P er c en t Poorest Mother’s education Wealth index Primary Second Middle Fourth RichestSMP/SM Higher 81 87 48 46 41 39 61 47 28 28 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Sex Male Female Age 6-8 months 9-11 months 12-17 months 18-23 months Area Urban Rural Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 41.9 56.9 35.2 48.0 42.0 28.1 43.8 54.3 46.8 47.9 43.3 53.4 45.4 42.3 45.6 (*) 39.2 27.5 44.9 48.1 46.4 51.5 37.3 26.8 (*) 45.2 51 13 60 70 55 21 9 34 60 65 59 5 22 64 33 2 21 33 35 34 61 22 15 10 26 124 (76.5) (*) 79.5 74.3 86.6 (*) (*) (86.2) 68.4 89.1 69.5 (53.9) (71.5) 77.7 (93.4) (*) (*) (65.6) (86.6) (100.0) 68.6 (*) (*) (*) (*) 79.7 109 108 90 164 143 62 61 113 71 127 180 50 84 150 24 84 55 62 55 50 198 54 32 10 22 307 73.4 81.6 74.3 70.0 80.6 79.3 100.0 81.4 65.5 82.0 66.7 53.9 63.2 68.5 97.9 0.0 62.6 59.9 80.2 95.5 66.3 72.4 94.6 86.5 (*) 74.7 52.0 59.6 50.8 54.5 52.7 41.1 50.8 60.6 55.4 59.5 49.1 53.5 49.1 50.2 76.0 58.9 45.5 38.7 58.6 67.3 51.1 57.5 (55.5) (*) (59.8) 53.7 160 121 150 234 198 83 70 148 131 192 240 55 106 214 56 87 76 94 89 85 260 76 46 20 49 431 Table NU.6: Minimum meal frequency Percentage of children age 6-23 months who received solid, semi-solid, or soft foods (and milk feeds for non-breastfeeding children) the minimum number of times or more during the previous day, according to breastfeeding status, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Currently breastfeeding Currently not breastfeeding All Per cent receiving solid, semi-solid and soft foods the minimum number of times Number of children age 6-23 months Number of children age 6-23 months Per cent receiving solid, semi-solid and soft foods or milk feeds 4 times or more Per cent with minimum meal frequency2 Per cent receiving at least 2 milk feeds1 Number of children age 6-23 months ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 2.15 2 MICS indicator 2.13 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 29 District Merauke Jayawijaya Biak Numfor Sex Male Female Age 0-5 months 6-11 months 12-23 months Area Urban Rural Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 45.8 17.4 49.9 39.4 38.1 34.5 39.7 40.3 46.1 33.1 7.7 38.5 40.3 68.6 9.2 38.7 39.8 49.8 58.1 30.2 48.1 51.8 (*) (57.8) 38.8 206 169 194 310 259 138 153 279 247 323 80 136 283 70 119 105 117 119 108 344 103 59 24 64 569 Table NU.7: Bottle feeding Percentage of children age 0-23 months who were fed with a bottle with a nipple during the previous day, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of children age 0-23 months Percentage of children age 0-23 months fed with a bottle with a nipple1 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 2.11 30 MULTIPLE INDICATOR CLUSTER SURVEY 2011 5.2. 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 and 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 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-five deaths. The 1990 World Summit for Children set the goal of virtual elimination of vitamin A deficiency and its consequences, including blindness, by the year 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’s Special Session on Children in 2002. The critical role of vitamin A for child health and immune function also makes control of deficiency a primary component of child survival efforts, and therefore critical to the achievement of the fourth Millennium Development Goal: a two-thirds reduction in under-five mortality by the year 2015. For countries with vitamin A deficiency problems, current international recommendations call for high-dose vitamin A supplementation every four to six months, targeted to all children between the ages of six to 59 months living in affected areas. Providing young children with two high-dose vitamin A capsules a year 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 vitamin A supplement in the last six months. As per the 2011 WHO recommendations, the Indonesian Ministry of Health recommends that children aged 6-59 months be given two high dose Vitamin A capsules every 6 months. In Indonesia, Vitamin A capsules are generally distributed through two National Campaigns held in February and August. Indonesian post-partum women also receive a Vitamin A capsule within eight weeks after delivery, though 2011 WHO Guidelines do not recommend this anymore. Within the six months prior to the Selected Districts of Papua Province MICS, 64 per cent of children aged 6-59 months received a high dose Vitamin A supplement (Table NU.8). About 62 per cent of children received a high dose of vitamin A supplement according to mothers report. Vitamin A supplementation coverage is considerable lower in Jayawijaya District (33 per cent) compared with Merauke (71 per cent) and Biak Numfor (81 per cent) districts. The age pattern of Vitamin A supplementation shows that supplementation in the last six months rises from 52 per cent among children aged 6-11 months to 67 per cent among children aged 12-23 months and 24-35 months each, then declines to 62 per cent among children 36-47 months and increases to 66 per cent among 48-59 months. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 31 The mother’s level of education is also related to the likelihood of Vitamin A supplementation. The percentage receiving a supplement in the last six months increases from 25 per cent among children whose mothers have no education, to 64 per cent of those whose mothers have primary education, to 73 per cent of those whose mothers have secondary education and to 74 per cent among children of mothers with higher education. District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Age 6-11 months 12-23 months 24-35 months 36-47 months 48-59 months Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 18.0 1.7 4.3 10.0 7.6 11.5 7.3 14.7 15.0 8.7 5.8 4.0 0.8 6.3 12.3 11.5 0.6 8.2 8.5 12.6 16.3 2.8 24.9 13.6 (20.7) 13.1 8.9 66.8 33.0 80.7 63.5 61.0 62.1 62.4 47.2 65.5 64.7 61.1 65.8 24.9 62.6 69.9 73.0 37.3 63.0 73.7 66.7 74.3 59.9 73.9 67.4 (55.6) 51.2 62.3 71.4 33.1 80.7 64.8 63.3 62.6 65.1 51.6 67.0 67.2 62.4 66.3 24.9 64.4 72.5 73.9 38.0 66.9 76.3 67.9 75.0 60.0 81.1 68.6 (64.6) 54.8 64.1 530 376 468 742 632 528 845 153 279 306 323 313 176 416 625 156 303 272 285 267 246 850 249 133 56 140 1,373 Table NU.8: Children’s vitamin A supplementation Per cent distribution of children age 6-59 months by receipt of a high dose vitamin A supplement in the last 6 months, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Percentage of children who received Vitamin A during the last 6 months1 Child health book/ vaccination card Percentage who received Vitamin A according to: Mother’s report Number of children age 6-59 months ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 2.17 32 MULTIPLE INDICATOR CLUSTER SURVEY 2011 5.3. LOW BIRTH WEIGHT Weight at birth is a good indicator not only of a mother’s health and nutritional status but also the newborn’s chances for survival, growth, long-term health and psychosocial development. Low birth weight (less than 2,500 grams) carries a range of grave health risks for children. Babies who were undernourished in the womb face a greatly increased risk of dying during their early months and years. Those who survive have impaired immune function and increased risk of disease; they are likely to remain undernourished, with reduced muscle strength, throughout their lives, and suffer a higher incidence of diabetes and heart disease in later life. Children born underweight also tend to have a lower IQ and cognitive disabilities, affecting their performance in school and their job opportunities as adults. In the developing world, low birth weight stems primarily from the mother’s poor health and nutrition. Three factors have most impact: the mother’s poor nutritional status before conception, short stature (due mostly to under nutrition and infections during her childhood), and poor nutrition during the pregnancy. Inadequate weight gain during pregnancy is particularly important since it accounts for a large proportion of foetal growth retardation. Moreover, diseases such as diarrhoea and malaria, which are common in many developing countries, can significantly impair foetal growth if the mother becomes infected while pregnant. In the industrialized world, cigarette smoking during pregnancy is the leading cause of low birth weight. In developed and developing countries alike, teenagers who give birth when their own bodies have yet to finish growing run the risk of bearing underweight babies. One of the major challenges in measuring the incidence of low birth weight is the fact that more than half of infants in the developing world are not weighed. In the past, most estimates of low birth weight for developing countries were based on data compiled from health facilities. However, these estimates are biased for most developing countries because the majority of newborns are not delivered in facilities, and those who are represent only a selected sample of all births. Because many infants are not weighed at birth and those who are weighed may be a biased sample of all births, the reported birth weights usually cannot be used to estimate the prevalence of low birth weight among all children. Therefore, in standard MICS methodology, the percentage of births weighing below 2,500 grams is estimated from two items in the questionnaire: the mother’s assessment of the child’s size at birth (i.e., very small, smaller than average, average, larger than average, very large) and the mother’s recall of the child’s weight or the weight as recorded on a health card if the child was weighed at birth.8 For the Selected Districts of Papua Province 2011 MICS, information on mother’s assessment of the child’s size at birth was not collected. Therefore reporting of percentage of births weighing below 2,500 grams is only based on 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. 8 For a detailed description of the methodology, see Boerma, J. T., Weinstein, K. I., Rutstein, S.O., and Sommerfelt, A. E. , 1996. Data on Birth Weight in Developing Countries: Can Surveys Help? Bulletin of the World Health Organization, 74(2), 209-16. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 33 District Merauke Jayawijaya Biak Numfor Area Urban Rural Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 12.5 7.9 16.5 13.1 13.3 0.0 12.5 14.3 12.0 9.4 18.2 14.1 12.0 11.2 18.2 10.3 10.5 (13.1) (6.9) 13.2 83.2 28.3 71.4 79.4 48.7 9.6 56.2 73.1 89.6 10.5 60.8 66.2 87.9 93.0 41.1 91.8 93.3 (90.0) (94.9) 62.1 204 174 167 237 307 79 122 279 64 125 101 102 112 105 322 105 58 21 37 544 Table NU.9: Low birth weight infants Percentage of last-born children in the 2 years preceding the survey that are estimated to have weighed below 2,500 grams at birth and percentage of live births weighed at birth, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of last- born children in the two years preceding the survey Below 2,500 grams1 Per cent of live births: Weighed at birth2 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 2.18 (only based on 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) 2 MICS indicator 2.19 Overall, 62 per cent of births were weighed at birth with approximately 13 per cent of infants estimated to weigh less than 2,500 grams at birth (Table NU.9). There are variations by districts. The lowest estimated percentage of infants weighing less than 2,500 grams at birth was in Jayawijaya (8 per cent) compared with 13 per cent in Merauke and 17 per cent in Biak Numfor District. MULTIPLE INDICATOR CLUSTER SURVEY 201134 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 35MULTIPLE INDICATOR CLUSTER SURVEY 2011 6 CHILD HEALTH 6.1. IMMUNIZATION The Millennium Development Goal (MDG) 4 is to reduce child mortality by two thirds between 1990 and 2015. Immunization plays a key part in this goal. Immunizations have saved the lives of millions of children in the three decades since the launch of the Expanded Programme on Immunization (EPI) in 1974. Worldwide there are still 27 million children overlooked by routine immunization and as a result, vaccine-preventable diseases cause more than 2 million deaths every year. A World Fit for Children goal is to ensure full immunization of children under one year of age at 90 per cent nationally, with at least 80 per cent coverage in every district or equivalent administrative unit. According to UNICEF and WHO guidelines, a child should receive a BCG vaccination to protect against tuberculosis, three doses of DPT to protect against diphtheria, pertussis, and tetanus, three doses of polio vaccine, and a measles vaccination by the age of 12 months. According to the national immunization schedule, by a first birthday each child in Indonesia should receive through routine immunization - a BCG vaccination to protect against tuberculosis, three doses of DPT to protect against Diphtheria, Pertussis, and Tetanus, four doses of polio vaccine, four doses of Hepatitis B vaccine and a measles or MMR vaccination at the age of 9 months or older. Taking into consideration this vaccination schedule, the estimates for full immunization coverage from the Selected Districts of Papua Province MICS are based on children age 12-23 months. Information on vaccination coverage was collected for all children under five years of age. All mothers or caretakers were asked to provide vaccination cards. If the vaccination card for a child was available, interviewers copied vaccination information from the cards onto the MICS questionnaire. If no vaccination card was available for the child, the interviewer proceeded to ask the mother to recall whether or not the child had received each of the vaccinations, and for Polio, DPT and Hepatitis B, how many doses were received. The final vaccination coverage estimates are based on both information obtained from the vaccination card and the mother’s report of vaccinations received by the child. The percentage of children age 12 to 23 months who have received each of the specific vaccinations by source of information (vaccination card and mother’s recall) is shown in Table CH.1. The denominator for the table is comprised of children age 12-23 months so that only children who are old enough to be fully vaccinated are counted. In the first three columns of the table, the numerator includes all children who were vaccinated at 36 MULTIPLE INDICATOR CLUSTER SURVEY 2011 any time before the survey according to the vaccination card or the mother’s report. In the last column, only those children who were vaccinated before their first birthday, as recommended, are included. For children without vaccination cards, the proportion of vaccinations given before the first birthday is assumed to be the same as for children with vaccination cards. Considering the three selected districts of Papua Province, approximately 85 per cent of children age 12-23 months received a BCG vaccination by the age of 12 months and the first dose of DPT was given to 85 per cent. The percentage declines for subsequent doses of DPT to 76 per cent for the second dose and 56 per cent for the third dose (Figure CH.1). Similarly, 59 per cent of children received Polio 1 by age 12 months and this increases to 78 per cent for the second dose and then declines to 60 per cent by the fourth dose. The coverage for measles/ MMR vaccine by 12 months is 75 per cent. There is also a decline in the Hepatitis B vaccination from 84 per cent for the first dose to 76 per cent for the second dose and 52 per cent for the third dose. As a result, the percentage of children who had all the recommended vaccinations by their first birthday is low at only 35 per cent. BCG1 Polio 1 2 3 42 DPT 1 2 33 Measles4 HepB At birth 1 2 35 DPT/ HepB 1 2 3 All vaccinations No vaccinations Number of children age 12-23 months 39.5 38.6 38.2 37.5 35.4 40.5 40.6 40.2 37.2 27.5 40.0 40.7 39.9 32.8 32.8 31.5 35.1 0.0 279 45.8 20.1 39.3 27.3 25.5 44.1 35.7 15.4 39.8 8.7 44.1 35.2 12.4 34.4 26.3 13.7 3.9 12.9 279 85.3 58.7 77.5 64.8 60.9 84.6 76.3 55.6 77.1 36.2 84.1 75.9 52.3 67.3 59.1 45.1 39.0 12.9 279 85.3 58.7 77.5 64.8 60.4 84.6 76.3 55.6 74.8 36.2 84.1 75.9 52.3 67.3 59.1 45.1 34.8 12.9 279 Table CH.1: Vaccinations in first year of life Percentage of children age 12-23 months immunized against childhood diseases at any time before the survey and before the first birthday, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Vaccinated by 12 months of age Child health book/ vaccination card Vaccinated at any time before the survey according to Mother’s report Either 1 MICS indicator 3.1 2 MICS indicator 3.2 3 MICS indicator 3.3 4 MICS indicator 3.4; MDG indicator 4.3 5 MICS indicator 3.5 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 37 Figure CH.1: Percentage of children age12-23 months who received the recommended vaccinations by 12 months, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011. 100 90 80 70 60 50 40 30 20 10 0 B C G D P T 1 D P T 2 D P T 3 P o lio 1 H ep B 0 P o lio 2 H ep B 1 P o lio 3 H ep B 2 P o lio 4 M ea sl es A ll H ep B 3 P er c en t 85 85 76 56 59 78 75 84 76 52 3536 65 60 Table CH.2 presents vaccination coverage estimates among children 12-23 months by background characteristics. The figures indicate children receiving the vaccinations at any time up to the date of the survey and are based on information from both the vaccination cards and mothers’/caretakers’ reports. Vaccination cards have been seen by the interviewer for only 40 per cent of children (Jayawijaya, 55 per cent; Merauke 27 per cent; Biak Numfor, 34 per cent). Compared with all elected districts, the survey results show that Jayawijaya District has the lowest coverage for all vaccinations as well as the lowest full vaccination coverage of only 16 per cent. The full vaccination coverage in Merauke and Biak Numfor districts was 58 and 37 per cent respectively. Often given to infants at the time of birth, BCG vaccine and DPT 1 (85 per cent each) have the highest coverage. In general, percentages of currently vaccinated children aged 12-23 months by the different vaccines fluctuated across districts, but it is worth noting that Polio 1, DPT 3 and HepB at birth are considerably lagging behind in Jayawijaya. HepB at birth has low coverage overall and among districts particularly among Jayawijaya District (Merauke, 54 per cent; Jayawijaya, 9 per cent; Biak Numfor, 31 per cent) Mother’s education is highly positively associated with vaccination coverage – Children of mothers with secondary or higher level of education are more than twice as likely to be vaccinated as those born to mothers with no education. 38 MULTIPLE INDICATOR CLUSTER SURVEY 2011 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r S ex M al e Fe m al e A re a U rb an R u ra l M o th er ’s e d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 75 .5 32 .9 60 .7 62 .3 54 .7 73 .2 47 .5 (1 6. 9) 43 .4 71 .5 (7 2. 7) 12 .2 (5 7) 58 .3 74 .3 (8 8. 7) 43 .7 (8 8. 8) (7 9. 3) (* ) (7 3. 1) 58 .7 96 .3 62 .7 90 .8 86 .4 84 90 .2 81 .4 (4 5. 4) 86 91 (9 7) 54 .3 (9 4. 7) 91 .4 89 .5 (9 5. 7) 78 .9 (9 8. 6) (8 8. 3) (* ) (9 6. 0) 85 .3 91 .5 50 83 .5 77 .5 77 .5 82 .6 73 .6 (3 5. 8) 77 .5 85 (8 5. 5) 40 .8 (8 4. 7) 86 .2 87 .8 (8 6. 5) 70 .5 (9 5. 9) (6 7. 3) (* ) (8 6. 0) 77 .5 81 .4 43 .2 63 .9 65 .6 63 .9 72 .2 59 .2 (2 4. 9) 64 .6 73 (6 9. 5) 24 .3 (7 2. 2) 69 .6 76 .5 (8 0) 53 .2 (9 1. 6) (6 4. 4) (* ) (8 5. 8) 64 .8 81 .4 35 .5 58 .8 62 .2 59 .5 69 .6 54 .2 (2 0. 3) 61 .2 67 .9 (6 9. 5) 18 .9 (6 8. 8) 65 .7 71 .1 (7 8. 4) 48 .2 (8 9. 8) (6 4. 4) (* ) (8 0. 8) 60 .9 97 .1 59 .8 90 .1 85 84 .1 90 .7 79 .7 (3 8. 8) 87 .4 90 .5 (9 7) 47 .5 (9 1. 5) 94 91 ( 97 ) 77 (1 00 ) (8 8. 3) (* ) (9 5. 9) 84 .6 91 .4 52 .2 77 .6 75 .8 76 .9 84 .2 69 .8 (3 1. 7) 78 .8 81 (9 1. 8) 35 (8 1. 4) 80 .3 87 .5 (9 2. 8) 65 .5 (9 8. 6) (7 9. 6) (* ) (9 3) 76 .3 70 .1 30 .9 57 .3 52 .4 59 .5 61 .2 51 (1 4. 6) 62 .2 60 .2 (6 1. 7) 12 .4 (6 0. 5) 58 .5 63 .8 (7 6. 9) 42 .7 (8 0. 2) (5 7. 4) (* ) (8 0. 9) 55 .6 92 .2 43 .8 86 7 6. 3 78 84 .1 71 .6 (3 5. 3) 73 82 .9 (9 7) 32 .4 (8 5. 4) 88 .3 85 .1 (9 0. 8) 67 .4 (9 4. 8) (8 2. 6) (* ) (9 6. 0) 77 .1 58 .2 11 .8 30 .3 40 .1 31 .5 44 .6 29 .5 (7 .8 ) 34 .6 43 .3 (3 6. 9) 7. 4 (4 0) 30 .9 40 .4 (5 8. 9) 19 .9 (6 9. 7) (4 9. 5) (* ) (5 5. 6) 36 .2 97 .2 59 .2 88 .7 84 .6 83 .5 90 .8 78 .9 (3 8. 2) 86 .1 90 ( 97 ) 47 .4 (8 8. 4) 94 .3 91 ( 97 ) 76 .3 (1 00 ) (8 8. 3) (* ) (9 6) 84 .1 91 .7 51 .3 76 .6 75 .9 75 .9 82 .2 70 .7 (3 2. 6) 78 .2 81 (8 8. 1) 36 .4 (7 8) 82 8 7. 5 (9 0. 2) 64 .2 (9 8. 6) (8 2. 8) (* ) (9 3) 75 .9 69 .2 32 .2 48 .7 49 .4 55 .8 59 .5 46 .5 (1 7. 8) 51 .9 58 .5 (5 8. 7) 13 (5 4. 9) 52 61 .8 (7 4. 5) 39 .6 (7 6. 4) (5 1. 2) (* ) (8 0. 9) 52 .3 2. 7 36 .4 5. 9 11 .8 14 .2 9. 2 15 .8 (5 4. 6) 10 7 .3 (3 ) 45 .7 (5 .2 ) 4. 2 7. 6 (3 ) 18 .5 0. 0 (1 1. 7) (* ) (4 .0 ) 12 .9 58 .4 15 .6 36 .5 40 .5 37 .4 48 .9 31 .5 (9 .4 ) 28 .4 46 .8 (5 2. 9) 3. 7 (3 6. 6) 41 .3 48 .5 (6 3) 25 .7 (7 3. 2) (3 5. 2) (* ) (6 1. 5) 39 54 .7 27 .4 33 .5 40 .5 39 48 .6 33 (1 4. 1) 31 48 .1 (9 7) 7 .8 30 .3 40 .1 58 .4 59 .1 25 .4 69 .9 49 .4 (* ) (6 1. 7) 39 .8 10 4 74 10 0 14 9 12 9 12 1 15 7 33 65 14 1 40 54 51 59 57 57 17 0 50 29 13 31 27 9 Ta b le C H .2 : V ac ci n at io n s b y b ac kg ro u n d c h ar ac te ri st ic s P er ce n ta g e o f ch ild re n a g e 12 -2 3 m o n th s cu rr en tl y va cc in at ed a g ai n st c h ild h o o d d is ea se s, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 ( ) Fi g u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es P o lio D P T H ep B A t b ir th A t b ir th 1 1 2 2 3 3 N o n e A ll 3 1 2 B C G M ea sl es P er ce n ta g e w it h va cc in at io n c ar d se en N u m b er o f ch ild re n a g e 12 -2 3 m o n th s P er ce n ta g e o f ch ild re n w h o r ec ei ve d : MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 39 6.2. NEONATAL TETANUS PROTECTION One of the MDGs is to reduce by three quarters the maternal mortality ratio, with one strategy to eliminate maternal tetanus. In addition, another goal is to reduce the incidence of neonatal tetanus to less than 1 case of neonatal tetanus per 1,000 live births in every district. A World Fit for Children goal is to eliminate maternal and neonatal tetanus by 2005. The strategy for preventing maternal and neonatal tetanus is to assure all pregnant women receive at least two doses of tetanus toxoid vaccine. If a woman has not received two doses of tetanus toxoid during a particular pregnancy, she (and her newborn) are also considered to be protected against tetanus if the woman: • Received at least two doses of tetanus toxoid vaccine, the last within the previous 3 years; • Received at least 3 doses, the last within the previous 5 years; • Received at least 4 doses, the last within the previous 10 years; • Received at least 5 doses anytime during life. To assess the status of tetanus vaccination coverage, women who gave birth during the two years before the survey were asked if they had received tetanus toxoid injections during the pregnancy for their most recent birth, and if so, how many. Women who did not receive two or more tetanus toxoid vaccinations during this pregnancy were then asked about tetanus toxoid vaccinations they may have received prior to this pregnancy. Interviewers also asked women to present their vaccination card, on which dates of tetanus toxoid are recorded and referred to information from the cards when available. District Merauke Jayawijaya Biak Numfor Area Urban Rural Mother’s Education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 Per cent Figure CH.2: Percentage of women with a live birth in the last 12 months who are protected against neonatal tetanus, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011. 71 47 74 71 59 33 62 74 65 38 63 71 70 83 40 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Table CH.3 shows the protection status from tetanus of women who have had a live birth within the last 2 years. Figure CH.2 shows the protection of women against neonatal tetanus by major background characteristics. The results of the survey indicate that tetanus toxoid coverage in the three selected districts of Papua Province is at 64 per cent and least in Jayawijaya District (Jayawijaya, 47 per cent; Merauke, 72 per cent; Biak Numfor, 74 per cent). It is worth noting that tetanus toxoid protection is much lower among the poorest households (38 per cent) compared with the richest households (83 per cent). Similarly, tetanus toxoid protection increases from 33 per cent among women with no education to 65 per cent among women with higher education. District Merauke Jayawijaya Biak Numfor Area Urban Rural Education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 42.1 35.2 58.0 43.6 45.6 29.9 43.2 49.6 45.1 29.1 45.7 45.4 53.5 52.6 43.5 39.6 55.7 (*) (*) 44.8 25.8 11.6 14.2 23.5 13.3 2.9 18.4 22.0 16.1 9.0 16.4 25.3 14.2 25.7 12.6 31.0 17.0 (*) (*) 17.7 0.7 0.0 1.4 1.6 0.0 0.0 0.0 1.1 1.2 0.0 0.0 0.0 1.3 2.1 0.5 0.8 2.4 (*) (*) 0.7 2.9 0.0 0.0 1.9 0.5 0.0 0.0 1.6 2.4 0.0 1.4 0.0 1.4 2.8 0.0 2.8 2.7 (*) (*) 1.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 (*) (*) 0.0 71.5 46.9 73.6 70.6 59.4 32.7 61.6 74.2 64.7 38.1 63.5 70.7 70.5 83.2 56.5 74.2 77.7 (*) (*) 64.3 204 174 167 237 307 79 122 279 64 125 101 102 112 105 322 105 58 21 37 544 Table CH.3: Neonatal tetanus protection Percentage of women age 15-49 years with a live birth in the last 2 years protected against neonatal tetanus, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 3.7 Percentage of women who received at least 2 doses during last pregnancy Number of women with a live birth in the last 2 years Percentage of women who did not receive two or more doses during last pregnancy but received: 2 doses, the last within prior 3 years 3 doses, the last within prior 5 years 4 doses, the last within prior 10 years 5 or more doses during lifetime Protected against tetanus1 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 41 6.3. SOLID FUEL USE More than 3 billion people around the world rely on solid fuels for their basic energy needs, including cooking and heating. Solid fuels include biomass fuels, such as wood, charcoal, crops or other agricultural waste, dung, shrubs and straw, and coal. Cooking and heating with solid fuels leads to high levels of indoor smoke, which contains a complex mix of health-damaging pollutants. The main problem with the use of solid fuels is their incomplete combustion, which produces toxic elements such as carbon dioxide, polyaromatic hydrocarbons, and sulphur dioxide, among others. Use of solid fuels increases the risks of incurring acute respiratory illness, pneumonia, chronic obstructive lung disease, cancer, and possibly tuberculosis, asthma or cataracts, and may contribute to low birth weight. The primary indicator for monitoring use of solid fuels is the proportion of the population using solid fuels as the primary source of domestic energy for cooking. Table CH.4 shows that solid fuel use is common in the three selected districts of Papua Province where 61 per cent of all households are using solid fuel for cooking. The findings show that use of solid fuels is very common among households in Jayawijaya District where 83 per cent of households use solid fuel, mostly wood. About half the households in Merauke (54 per cent) and Biak Numfor (50 per cent) are using solid fuel, also mostly wood. Use of solid fuels is low in urban areas (25 per cent), but very high in rural areas, where most of the households (85 per cent) are using solid fuels. Differentials with respect to household wealth and the educational level of the household head are also significant. The findings show that use of solid fuels is more uncommon among households whose household heads are Papuan compared with households from other ethnic groups. Solid fuel by place of cooking is shown in Table CH.5. The presence and extent of indoor pollution are dependent on cooking practices, places used for cooking, as well as types of fuel used. About half the sample cooks in a separate room used as a kitchen (48 per cent), 11 per cent cook elsewhere in the house, 38 per cent cook in a separate building and about four per cent cook outdoors. Most of the household members in Merauke (79 per cent) and 46 per cent in Biak Numfor cook in a separate room while most of the household members in Jayawijaya cook in a separate building (60 per cent). 42 MULTIPLE INDICATOR CLUSTER SURVEY 2011 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l E d u ca ti o n o f h o u se h o ld h ea d N o n e P ri m ar y S M P /S M H ig h er M is si n g /D K W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d * P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 0. 0 0. 2 0. 1 0. 0 0. 2 0. 0 0. 0 0. 1 0. 5 0. 0 0. 0 0. 0 0. 0 0. 2 0. 4 0. 1 0. 1 0. 0 0. 0 1. 1 0. 1 0. 3 0. 0 0. 5 0. 7 0. 0 0. 0 0. 2 0. 2 1. 1 0. 0 0. 0 0. 0 0. 0 0. 1 1. 3 0. 1 0. 2 0. 7 0. 6 1. 1 0. 3 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 3 0. 0 44 .9 16 .5 49 .0 73 .5 14 .5 6. 0 25 .6 47 .0 67 .2 69 .4 0. 0 1. 0 22 .7 72 .7 97 .2 21 .1 50 .2 88 .5 85 .0 52 .8 38 .7 0. 3 0. 1 0. 4 0. 1 0. 4 0. 0 0. 5 0. 2 0. 3 0. 0 0. 1 0. 8 0. 5 0. 0 0. 0 0. 5 0. 0 0. 0 0. 0 0. 0 0. 3 0. 0 0. 2 0. 0 0. 0 0. 1 0. 4 0. 0 .0 0. 0 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 1 53 .8 83 .1 49 .6 25 .0 84 .6 93 .3 73 .4 52 .3 29 .8 30 .6 99 .4 98 .1 76 .4 26 .2 0. 9 77 .9 48 .6 10 .8 14 .0 44 .7 60 .2 0. 1 0. 0 0. 0 0. 0 0. 1 0. 0 0. 1 0. 0 0. 0 0. 0 0. 2 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 5 0. 0 0. 3 0. 6 0. 1 0. 3 0. 2 0. 2 0. 9 0. 0 0. 1 0. 1 0. 4 0. 9 0. 1 0. 1 1. 0 0. 1 0. 4 0. 0 0. 3 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 54 .2 83 .3 50 .1 25 .1 85 .2 93 .7 74 .0 52 .6 30 .2 30 .6 99 .9 98 .9 77 .0 26 .2 0. 9 78 .6 48 .6 10 .8 14 .0 44 .7 60 .6 5, 05 0 3, 19 2 3, 82 8 4, 94 3 7, 12 8 1, 21 4 4, 04 9 5, 02 4 1, 77 1 13 2, 41 2 2, 41 7 2, 41 6 2, 41 3 2, 41 3 6, 99 1 2, 67 8 1, 13 5 54 1 72 4 12 ,0 70 Ta b le C H .4 : S o lid f u el u se P er c en t d is tr ib u ti o n o f h o u se h o ld m em b er s ac co rd in g t o t yp e o f co o ki n g f u el u se d b y th e h o u se h o ld , a n d p er ce n ta g e o f h o u se h o ld m em b er s liv in g in h o u se h o ld s u si n g so lid f u el s fo r co o ki n g , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 *1 c as e w it h m is si n g “ E th n ic it y o f h o u se h o ld h ea d ” n o t sh o w n ( ) Fi g u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es 1 M IC S in d ic at o r 3. 11 E le ct ri ci ty Li q u efi ed P et ro le u m G as ( LP G ) N o f o o d co o ke d in t h e h o u se h o ld To ta l S o lid f u el s fo r co o ki n g 1 N at u ra l G as K er o se n e C o al , lig n it e W o o d C h ar - co al S tr aw , sh ru b s, g ra ss S o lid f u el s N u m b er o f h o u se h o ld m em b er s P er ce n ta g e o f h o u se h o ld m em b er s in h o u se h o ld s u si n g : MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 43 District Merauke Jayawijaya Biak Numfor Area Urban Rural Education of household head* None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 78.7 17.6 46.3 51.0 47.4 23.0 56.6 48.1 52.4 22.6 60.0 60.3 61.8 (*) 36.5 81.0 83.1 67.8 93.7 48.0 3.0 21.4 6.2 14.8 9.7 19.2 8.5 9.2 10.7 19.2 8.0 5.6 2.0 (*) 13.7 1.3 3.5 0.0 0.0 10.5 14.9 60.0 38.5 24.5 40.2 57.5 31.7 36.3 33.7 57.5 26.5 27.4 33.8 (*) 44.8 17.0 13.4 28.7 6.3 37.5 3.3 0.7 8.9 9.7 2.7 0.0 3.3 6.3 3.0 0.6 5.4 6.6 2.4 (*) 4.9 0.7 0.0 3.5 0.0 3.8 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.1 0.0 0.0 (*) 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.1 0.3 0.0 0.0 0.1 0.1 0.0 0.0 0.0 (*) 0.1 0.0 0.0 0.0 0.0 0.1 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 (*) 100.0 100.0 100.0 100.0 100.0 100.0 2,739 2,659 1,917 1,243 6,072 1,138 2,997 2,642 534 2,411 2,390 1,859 633 22 5,492 1,300 122 76 324 7,315 Table CH.5: Solid fuel use by place of cooking Per cent distribution of household members in households using solid fuels by place of cooking, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 *4 cases with missing “Education of household head” and 1 case with missing “Ethnicity of household head” not shown (*) Figures that are based on fewer than 25 unweighted cases In a separate room used as kitchen Elsewhere in the house In a separate building Outdoors At another place Missing Number of household members in households using solid fuels for cooking Total Place of cooking: 44 MULTIPLE INDICATOR CLUSTER SURVEY 2011 6.4. MALARIA Malaria is a leading cause of death of children under age five in Papua Province. It also contributes to anaemia in children and is a common cause of school absenteeism. Preventive measures can dramatically reduce malaria mortality rates among children. In areas where malaria is common, the WHO recommends Indoor Residual Spraying (IRS), use of insecticide-treated bednets (ITNs) and prompt treatment of confirmed cases with recommended anti-malarial drugs. International recommendations also 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. Insecticide-treated mosquito nets, or ITNs, if used properly, are very effective in offering protection against mosquitos and other insects. The use of ITNs is one of the main health interventions applied to reduce malaria transmission in Papua. The questionnaire incorporates questions on the availability and use of bed nets, both at household level and among children under five years of age and pregnant women. In the 2011 Selected Districts of Papua Province MICS results indicate that 43 per cent of households have at least one insecticide-treated net (Table CH.6). The percentage of households with at least one mosquito net was 54 per cent and the percentage of households with at least one long-lasting treated net is 43 per cent. Differentials exist in the availability of ITNs among districts where the availability is least in Jayawijaya District (11 per cent) and most in Merauke District (61 per cent). The percentage of this indicator is 46 per cent in Biak Numfor. Availability of at least one ITN does not show any clear increasing trend by education and wealth. This percentage is higher among households with Javanese heads (56 per cent) compared with those households with Papuan heads (37 per cent). Results indicate that 44 per cent of children under the age of five slept under any mosquito net the night prior to the survey and 33 per cent slept under an insecticide- treated net (Table CH.7). Compared with other districts, the percentages of children under the age of five who slept under any mosquito net or an insecticide-treated net are considerably lower in Jayawijaya District (18 and 9 per cent respectively). These percentages are 60 per cent and 42 per cent for Merauke and 47 per cent and 42 per cent for Biak Numfor. There were no significant gender disparities in ITN use among children under five. Results on the proportion of pregnant women who slept under a mosquito net during the previous night have been suppressed due to inadequate sample sizes. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 45 District Merauke Jayawijaya Biak Numfor Area Urban Rural Education of household head* None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 73.4 24.3 54.3 45.8 59.8 27.0 70.3 54.3 41.2 24.0 79.3 79.7 58.9 35.5 47.8 69.9 51.4 43.8 58.3 54.3 60.5 10.4 46.2 33.6 48.2 20.2 56.8 42.7 28.6 18.0 61.6 65.3 45.7 26.7 37.0 56.2 35.6 38.8 46.9 42.5 60.5 10.5 46.2 33.6 48.3 20.2 56.8 42.7 28.6 18.0 61.7 65.3 45.7 26.7 37.0 56.2 35.6 38.8 46.9 42.5 1,248 799 819 1,132 1,734 362 940 1,159 402 639 557 533 565 572 1,561 741 269 129 165 2,866 Table CH.6: Household availability of insecticide treated nets and protection by a vector control method Percentage of households with at least one mosquito net, percentage of households with at least one long- lasting treated net, percentage of households with at least one insecticide-treated net (ITN) and percentage of households which either have at least one ITN or have received indoor residual spraying (IRS) in the last 12 months, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 *2 cases with missing “Education of household head” and 1 case with missing “Ethnicity of household head” not shown 1 MICS indicator 3.12 Percentage of households with at least one mosquito net Percentage of households with at least one long- lasting treated net Percentage of households with at least one ITN1 Number of households 46 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Age 0-11 months 12-23 months 24-35 months 36-47 months 48-59 months Mother’s education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 97.7 98.4 98.5 98.4 97.9 97.5 98.6 97.8 98.4 98.3 98.4 97.9 98.5 99.2 98.6 93.3 98.9 99.2 97.9 96.4 98.4 98.1 98.5 100.0 96.0 96.4 98.2 576 424 512 819 692 583 928 290 279 306 323 313 201 446 694 170 335 302 307 297 270 934 276 146 60 155 1,511 60.3 18.3 47.2 44.5 43.5 31.1 52.1 41.1 43.0 48.3 45.2 42.2 14.4 56.9 46.5 34.4 26.0 66.5 66.0 44.2 16.2 43.0 53.1 30.7 29.3 46.9 44.0 41.7 8.9 41.9 32.7 32.4 21.6 39.4 30.3 34.0 34.5 34.1 29.8 11.2 39.4 37.4 19.3 19.1 50.5 49.4 30.9 11.9 33.3 31.2 24.5 29.3 38.1 32.6 562 417 504 806 678 568 915 284 274 301 317 306 198 443 684 158 331 299 301 286 266 916 272 146 58 149 1,483 59.2 52.2 63.0 60.3 60.0 46.0 67.2 57.1 63.5 63.0 60.2 57.0 (67.6) 60.6 62.5 41.9 71.1 68.1 67.4 54.3 29.1 65.1 48.9 55.2 (*) 59.9 60.2 396 71 335 436 366 266 536 151 147 165 180 160 33 288 409 73 89 222 220 163 109 469 174 65 27 95 803 Table CH.7: Children sleeping under mosquito nets Percentage of children age 0-59 months who slept under a mosquito net during the previous night, by type of net, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 3.14, 2 MICS indicator 3.15; MDG indicator 6.7 Percentage of children age 0-59 who stayed in the household the previous night Number of children age 0-59 months who slept in the household the previous night Percentage of children who slept under an ITN living in households with at least one ITN Number of children age 0-59 living in households with at least one ITN Percentage of children who: Number of children age 0-59 months Slept under any mosquito net1 Slept under an insecticide- treated net2 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 47 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Age 0-11 months 12-23 months 24-35 months 36-47 months 48-59 months Mother’s education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Others Total for 3 districts 27.4 31.5 31.1 32.5 26.7 34.6 26.8 31.3 31.2 33.2 27.2 26.5 25.0 28.9 32.0 28.8 29.8 21.3 34.7 34.6 28.4 30.5 27.0 32.9 27.5 29.8 576 424 512 819 692 583 928 290 279 306 323 313 201 446 694 170 335 302 307 297 270 934 276 146 155 1,511 0.0 0.0 0.4 0.0 0.4 0.0 0.3 0.0 0.0 0.7 0.0 0.0 0.0 0.0 0.3 0.0 0.0 0.0 0.0 0.6 0.0 0.2 0.0 0.0 (0.0) 0.1 0.0 0.0 10.7 3.6 4.0 2.9 4.4 1.0 1.0 7.4 4.2 4.8 0.0 4.1 4.9 2.0 0.0 5.3 8.6 2.2 2.8 6.0 0.0 0.0 (0.0) 3.8 0.0 0.0 1.7 0.3 1.1 0.7 0.5 0.0 0.0 0.8 0.8 1.6 0.0 0.5 0.9 0.0 0.0 2.0 0.0 1.4 0.0 1.0 0.0 0.0 (0.0) 0.6 1.0 0.0 1.6 0.9 0.9 1.3 0.6 0.0 0.0 2.3 2.0 0.0 0.0 0.0 1.8 0.0 0.0 0.0 2.2 0.9 1.0 0.9 0.0 0.0 (3.6) 0.9 1.0 0.2 4.5 2.6 1.1 1.8 2.1 0.6 0.0 5.8 0.0 3.0 0.4 2.7 2.4 0.0 0.2 2.1 5.6 0.6 1.1 2.6 2.1 0.0 0.0 2.0 0.9 0.0 1.4 0.3 1.6 0.7 0.9 2.3 0.0 1.5 0.0 0.0 0.0 1.2 0.9 0.0 0.0 0.0 1.4 2.1 0.0 0.8 1.8 0.0 0.0 0.8 10.2 0.7 26.7 11.2 16.1 14.6 12.1 8.7 20.5 13.8 13.8 9.2 0.0 10.0 16.7 19.4 2.3 11.0 14.1 14.5 26.4 11.7 14.1 17.3 (17.1) 13.2 13.0 0.8 45.7 18.0 25.2 22.0 20.1 12.6 21.5 31.3 20.8 16.8 0.4 18.5 26.9 21.4 2.5 18.1 31.9 22.3 30.2 22.3 18.1 17.3 (20.6) 20.9 Table CH.8: Anti-malarial treatment of children with anti-malarial drugs Percentage of children age 0-59 months who had fever in the last two weeks who received anti-malarial drugs, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 3.18; MDG indicator 6.8 Had a fever in last two weeks Number of children age 0-59 months Anti- malari- als: SP/ Fansidar Anti-ma- larials: Chloro- quine Anti- malarials: Quinine/ Kina Anti-ma- larials: Artesdi- aquine Anti- malar- ials: Arsua- mon Anti- malari- als: Ar- terakin/ Artekin Anti- malarials: Other Anti- malarial Anti- malarials: Any anti- malarial drug1 Children with a fever in the last two weeks who were treated with: Anti-malarials: 48 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Age 0-11 months 12-23 months 24-35 months 36-47 months 48-59 months Mother’s education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Others Total for 3 districts 7.1 2.4 24.4 10.2 14.1 15.1 9.2 17.7 9.4 18.2 10.0 2.1 0.4 7.5 14.2 24.3 1.4 12.6 14.4 15.4 16.5 12.8 7.5 10.3 (14.5) 11.8 1.3 0.7 0.5 0.7 1.0 1.4 0.4 2.3 0.0 0.9 0.8 0.0 0.0 0.9 0.8 1.5 0.0 1.5 0.9 1.1 0.9 0.7 1.0 0.0 (2.6) 0.8 51.5 38.6 61.3 51.1 51.2 56.7 46.6 47.6 53.0 46.3 57.8 52.0 23.7 49.3 57.0 57.5 20.9 47.3 61.8 62.3 64.0 44.8 54.3 66.3 (71.3) 51.1 1.3 0.0 0.0 0.0 1.1 1.0 0.0 0.0 0.0 0.0 0.0 2.5 0.0 0.0 0.9 0.0 0.0 0.0 0.0 0.0 2.7 0.0 2.8 0.0 (0.0) 0.5 0.0 1.2 1.0 1.1 0.0 0.0 1.2 0.3 0.0 2.8 0.0 0.0 0.0 1.2 0.7 0.0 0.0 0.4 0.6 1.3 1.1 0.6 0.0 2.7 (0.0) 0.7 33.4 9.8 24.5 24.0 22.2 27.8 19.6 27.3 21.2 19.6 23.6 25.1 3.0 22.5 27.1 28.7 8.9 25.8 22.9 23.7 39.7 16.3 44.5 37.0 (17.0) 23.2 2.3 1.6 0.0 1.8 0.5 0.5 2.0 3.4 0.0 0.0 2.3 0.8 1.7 1.4 1.4 0.0 3.3 2.5 0.9 0.0 0.0 2.0 0.0 0.0 (0.0) 1.3 6.7 0.2 35.9 12.3 19.1 16.0 14.3 8.2 15.2 22.4 12.9 15.9 0.4 13.7 19.4 14.1 1.6 13.1 24.6 15.0 21.2 17.1 13.8 9.3 (10.3) 15.1 158 133 159 266 185 202 249 91 87 102 88 83 50 129 222 49 100 64 107 103 77 285 74 48 43 450 Table CH.8: Anti-malarial treatment of children with anti-malarial drugs (continued) Percentage of children age 0-59 months who had fever in the last two weeks who received anti-malarial drugs, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 3.17 Other medica- tions: Antibiotic injection Other medications: Paracetamol/ Panadol/ Ace taminophan Other medica- tions: Aspirin Other medica- tions: Ibuprofen Other medica- tions: Other Other DK Percentage who took an anti- malarial drug same or next day 1 Num- ber of children with fever in last two weeks Other medications: MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 49 Questions on the prevalence and treatment of fever were asked for all children under age five. Slightly fewer than one in three (30 per cent) of under five children were ill with fever in the two weeks prior to the survey (Merauke, 27 per cent; Jayawijaya, 32 per cent; Biak Numfor, 31 per cent (Table CH.8) ). Fever prevalence slightly declined with age. There was no clear trend in this indicator with mother’s education or wealth. Mothers were asked to report all of the medicines given to a child to treat the fever, including both medicines given at home and medicines given or prescribed at a health facility. Overall, only 17 per cent of children with fever in the last two weeks were treated with an “appropriate” anti-malarial drug and 12 per cent received anti-malarial drugs either on the same day or day after the onset of symptoms. “Appropriate” anti-malarial drugs include chloroquine, SP (sulfadoxine-pyrimethamine), artimisine combination drugs, etc. Compared with the other districts that also showed a low percentage in these indicators, Jayawijaya District was strikingly lacking in anti-malarial treatment. The percentage of children receiving any anti-malarial drug in Jayawijaya was less than one per cent compared with 10 per cent in Merauke and 37 per cent in Biak Numfor. Similarly, none of the children in Jayawijaya took an anti-malarial drug same or next day compared with 5 per cent in Merauke and 29 per cent in Biak Numfor. Overall in the three districts, four per cent of children with fever were given chloroquine and a very negligible per cent were given SP/ Fansidar. None received artemisinin combination therapy and most of the children were given anti-malarial drug (13 per cent). About half the children (51 per cent) were given other types of medicines that are not anti-malarial, including paracetamol, panadol and acetaminophan. Urban children (18 per cent) are similarly treated appropriately as rural children (17 per cent). Children 0-11 months and children from the poorest households were disadvantaged in receiving appropriate ant-malarial drug. Girls (21 per cent) were more likely to receive appropriate anti-malarial drugs than boys (15 per cent). Figure CH.3: Percentage of children age 0-59 months who had a fever in the last two weeks and who had a finger or heel stick for malaria testing, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 60 55 50 45 40 35 30 25 20 15 10 5 0 P er c en t None PoorestSecondary MiddlePrimary SecondHigher Fourth Richest 5 34 47 8 16 36 34 45 19 Mother’s education Wealth index MULTIPLE INDICATOR CLUSTER SURVEY 201150 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Age 0-11 months 12-23 months 24-35 months 36-47 months 48-59 months Mother’s education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 24.2 12.1 44.5 27.0 28.8 37.8 19.6 28.2 25.0 29.6 35.6 19.6 4.7 18.9 33.9 47.2 7.9 15.7 35.5 33.9 44.7 29.2 23.0 20.1 38.6 (35.3) 27.8 158 133 159 266 185 202 249 91 87 102 88 83 50 129 222 49 100 64 107 103 77 285 74 48 14 43 450 Table CH.9: Malaria diagnostics usage Percentage of children age 0-59 months who had a fever in the last two weeks and who had a finger or heel stick for malaria testing, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 3.16 Number of children age 0-59 months with fever in the last two weeks Had a finger or heel stick1 Table CH.9 provides the proportion of children age 0-59 months who had a fever in the last two weeks and who had a finger or heel stick for malaria testing. Overall, 28 per cent of children with a fever in the last two weeks had a finger or heel stick. Biak Numfor District showed the highest value for this indicator (45 per cent) compared with 24 per cent in Merauke and only 12 per cent in Jayawijaya. Having a finger or heel stick for malaria testing is more common in urban areas (38 per cent) than in rural areas (20 per cent). This indicator increases dramatically by mother’s education; from only 5 per cent among children of uneducated women to 47 per cent among children with higher education. A similar pattern is seen by wealth where the percentage of children age 0-59 months who had a fever in the last two weeks and who had a finger or heel stick for malaria testing increased from 8 per cent for children living in the poorest households to 45 per cent for those living in the richest (Figure CH.3). MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 51MULTIPLE INDICATOR CLUSTER SURVEY 2011 7 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 women and children, especially in rural areas, who bear the primary responsibility for carrying water, often for long distances. The MDG goal (7, C) is to reduce by half, between 1990 and 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. The World Fit for Children goal calls for a reduction in the proportion of households without access to hygienic sanitation facilities and affordable and safe drinking water by at least one- third. The list of indicators used in MICS is as follows: Water • Use of improved drinking water sources • Use of adequate water treatment method • Time to source of drinking water • Person collecting drinking water Sanitation • Use of improved sanitation facilities • Sanitary disposal of child’s faeces For more details on water and sanitation and to access some reference documents, please visit the UNICEF childinfo website.9 7.1. USE OF IMPROVED WATER SOURCES The distribution of the population by main source of drinking water is shown in Table WS.1 and Figure WS.1. The population using improved sources of drinking water are those using any of the following types of supply: piped water (into dwelling, compound, yard or plot, to neighbour, public tap/standpipe), tube well/borehole, protected well, protected spring and rainwater collection. Bottled water is considered as an improved water source only if the household is using an improved water source for handwashing and cooking. 9 http://www.childinfo.org/wes.html 52 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Overall, 60 per cent of the population in the three districts is using an improved source of drinking water – 78 per cent in urban areas and 47 per cent in rural areas. The situation in Jayawijaya District is considerably worse than in other districts; only 35 per cent of the population in this district gets its drinking water from an improved source. The percentage of population in Merauke and Biak Numfor Districts are 54 and 87 per cent respectively. The source of drinking water for the population varies strongly by district (Table WS.1). In Biak Numfor, only 14 per cent of the population uses drinking water that is piped into their dwelling or into their yard or plot. More drastically, only five and one per cent of the population use piped water in Merauke and Jayawijaya respectively. In Jayawijaya District, the most important source of drinking water is surface water (river, stream, dam, lake, pond, canal, irrigation channel) (39 per cent) (an unimproved source). In Merauke, bottled water is the first most important source (17 per cent) (an improved source) while in Biak Numfor it is rainwater collection (24 per cent) (an improved source). Figure WS.1: Per cent distribution of household members by source of drinking water, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Piped into dwelling, yard, plot or neighbour 12% Public tap/standpipe 4% Tubewell/borehole 2% Bottled water 22% Surface water 16% Other unimproved 3% Unprotected well or spring 16% Rain-water collection 14% Protected well or spring 11% MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 53 District Merauke Jayawijaya Biak Numfor Area Urban Rural Education of household head* None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 5.4 0.7 13.5 13.1 2.3 1.5 3.5 7.7 14.9 0.0 0.3 4.7 10.4 18.2 6.6 3.2 11.9 12.4 8.9 6.7 0.3 1.2 5.7 4.0 1.1 0.0 0.9 3.1 4.7 0.0 0.3 1.6 6.1 3.3 2.9 0.9 1.2 3.3 2.6 2.3 11.4 3.1 6.1 5.7 8.8 4.9 9.7 7.0 5.9 1.2 7.3 13.1 13.0 3.2 6.4 11.6 7.0 6.3 5.6 7.5 4.1 2.7 2.7 0.3 5.3 3.6 3.2 4.0 1.0 3.9 5.2 4.6 2.5 0.1 3.2 2.8 4.0 5.3 3.0 3.3 8.7 10.7 23.7 6.6 19.0 8.9 15.6 15.2 10.4 9.0 23.1 22.1 13.0 2.6 18.1 10.1 4.8 6.7 7.6 14.0 17.2 8.8 22.4 36.0 3.2 1.4 8.4 21.3 32.9 0.0 0.0 3.1 22.5 57.7 5.8 26.2 40.3 47.2 26.0 16.6 1.2 0.7 9.8 3.9 3.7 1.1 3.6 4.0 5.6 0.2 3.5 8.4 3.7 3.2 6.1 0.1 0.6 1.4 1.7 3.8 2.3 0.0 2.1 3.3 0.4 0.8 1.8 2.1 0.6 0.4 3.1 2.6 1.9 0.2 2.2 0.6 1.8 1.3 0.0 1.6 3.6 7.1 1.0 5.0 2.9 5.9 4.1 2.7 4.3 6.9 5.8 2.6 2.7 0.6 5.3 1.4 1.2 1.3 2.3 3.7 Table WS.1: Use of improved water sources Per cent distribution of household population according to main source of drinking water and percentage of household population using improved drinking water sources, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Piped water Improved sources Main source of drinking water Into dwelling Tube- well/ bore- hole Pro- tected well Pro- tected spring Rain- water collection Bottled water** Into yard/ plot To neigh- bour Public tap/ stand-pipe * 13 cases with missing “Education of household head” and 1 case with missing “Ethnicity of household head” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases ** Households using bottled water as the main source of drinking water are classified into improved or unimproved drinking water users according to the water source used for other purposes such as cooking and handwashing. 1 MICS indicator 4.1; MDG indicator 7.8 54 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Education of household head* None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 11.1 8.8 3.2 3.9 10.8 5.3 11.5 7.3 3.9 8.8 16.3 10.2 4.5 0.2 8.6 10.5 4.6 1.3 3.1 8.0 10.7 39.1 3.6 1.2 26.3 45.7 18.6 9.7 7.3 51.6 15.7 10.5 2.2 0.0 20.7 8.1 3.8 0.2 30.3 16.0 10.2 4.2 0.9 10.6 2.3 2.5 5.4 7.2 4.0 0.5 0.3 6.6 11.8 9.1 1.5 13.5 13.1 6.5 4.8 5.7 0.0 0.6 0.0 0.1 0.2 0.2 0.1 0.2 0.3 0.4 0.2 0.2 0.1 0.0 0.3 0.0 0.0 0.0 0.0 0.2 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 54.3 34.9 87.0 78.0 46.8 28.1 50.9 67.0 80.2 21.5 48.6 62.8 75.8 89.1 56.6 56.9 72.9 85.2 57.6 59.6 5,050 3,192 3,828 4,943 7,128 12,14 4,049 5,024 1,771 2,412 2,417 2,416 2,413 2,413 6,991 2,678 1,135 541 724 12,070 8.0 11.8 5.0 1.5 12.6 17.8 9.8 6.0 3.2 16.7 15.7 5.1 2.8 0.0 9.9 7.4 3.5 4.1 2.6 8.1 4.1 0.0 0.3 3.3 0.8 0.1 3.2 1.6 0.5 0.0 3.0 2.9 1.9 1.2 1.8 2.5 1.7 0.0 0.7 1.8 1.5 0.5 0.0 1.5 0.3 0.4 0.6 1.1 0.6 0.6 0.3 1.6 1.0 0.4 0.6 1.1 0.4 2.7 0.8 0.8 Table WS.1: Use of improved water sources (continued) Per cent distribution of household population according to main source of drinking water and percentage of household population using improved drinking water sources, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Unimproved sources Main source of drinking water Unpro- tected well Surface water Bottled water* Other Total Percentage using improved sources of drinking water1 Number of household members Unpro- tected spring Tanker truck Cart with tank/ drum * 13 cases with missing “Education of household head” and 1 case with missing “Ethnicity of household head” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases ** Households using bottled water as the main source of drinking water are classified into improved or unimproved drinking water users according to the water source used for other purposes such as cooking and handwashing. 1 MICS indicator 4.1; MDG indicator 7.8 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 55 Use of household water treatment is presented in Table WS.2. Households were asked of ways they may be treating water at home to make it safer to drink. Boiling water, adding bleach or chlorine, using a water filter, and using solar disinfection are considered as proper treatment of drinking water. The table shows water treatment by all households and the percentage of household members living in households using unimproved water sources but using appropriate water treatment methods. About 55 per cent of households in the selected districts of Papua Province use appropriate water treatment for unimproved drinking water sources and 34 per cent do not use any method for water treatment. The most common methods of water treatment are boiling (65 per cent), letting water stand and settle (34 per cent) and straining through a cloth (24 per cent). There exist large differentials in use of appropriate water treatment among districts. Household members in Jayawijaya District show only 26 per cent use of appropriate water treatment methods and 64 per cent of them do not use any treatment. It was also observed that appropriate water treatment use is greater in urban areas and among educated women. Appropriate water treatment use is 71 per cent in Biak Numfor and 77 per cent in Merauke District. The amount of time it takes to obtain water is presented in Table WS.3 and the person who usually collected the water in Table WS.4. Note that these results refer to one roundtrip from home to drinking water source. Information on the number of trips made in one day was not collected. Table WS.3 shows that for about half of household members who use an improved source of drinking water, the source is on the premises. For eight per cent, it takes less than 30 minutes to get to the water source and bring water, while three per cent of household members spend 30 minutes or more for this purpose. For users of unimproved drinking water sources, water is on premises for 12 per cent of household members. One fifth of household members take less than 30 minutes to get to the water source and bring water (21 per cent) and for seven per cent it takes more than 30 minutes. In rural areas considerably more household members spend time in collecting water compared with those in urban areas. 56 MULTIPLE INDICATOR CLUSTER SURVEY 2011 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l M ai n s o u rc e o f d ri n ki n g w at er Im p ro ve d U n im p ro ve d E d u ca ti o n o f h o u se h o ld h ea d * N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d * P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 25 .6 64 .1 20 .4 43 .3 27 .7 26 .7 45 .0 65 .6 25 .5 33 .5 34 .2 69 .8 6. 4 10 .7 27 .8 55 .8 32 .4 34 .2 45 .1 45 .3 24 .8 34 .1 0. 3 1. 2 2. 2 1. 9 0. 6 1. 7 0. 4 0. 0 0. 4 1. 0 4. 2 0. 0 0. 3 0. 7 1. 9 2. 8 1. 1 0. 9 1. 5 0. 0 2. 7 1. 1 0. 0 0. 4 0. 0 0. 3 0. 0 0. 2 0. 0 0. 5 0. 0 0. 0 0. 4 0. 0 0. 0 0. 2 0. 3 0. 0 0. 1 0. 0 0. 5 0. 0 0. 0 0. 1 49 .3 1. 9 39 .8 26 .9 38 .5 34 .8 32 .2 11 .6 43 .4 32 .6 29 .6 7. 6 51 .9 46 .3 39 .0 23 .9 27 .1 44 .4 32 .8 34 .8 59 .0 33 .7 0. 0 0. 0 0. 4 0. 2 0. 1 0. 2 0. 0 0. 0 0. 2 0. 2 0. 0 0. 0 0. 1 0. 0 0. 2 0. 4 0. 1 0. 2 0. 4 0. 0 0. 0 0. 1 5, 05 0 3, 19 2 3, 82 8 4, 94 3 7, 12 8 7, 18 8 4, 88 2 1, 21 4 4, 04 9 5, 02 4 1, 77 1 2, 41 2 2, 41 7 2, 41 6 2, 41 3 2, 41 3 6, 99 1 2, 67 8 1, 13 5 54 1 72 4 12 ,0 70 76 .7 26 .1 71 .0 47 .2 56 .7 n a 54 .6 23 .3 66 .2 55 .3 61 .6 22 .7 90 .3 79 .4 56 .5 26 .3 44 .2 72 .8 51 .8 54 .4 91 .2 54 .6 2, 30 8 2, 07 8 49 7 1, 08 8 3, 79 5 n a 4, 88 2 87 3 1, 99 0 1, 65 7 35 1 1, 89 4 1, 24 2 89 8 58 4 26 3 3, 03 4 1, 15 4 30 7 80 30 7 4, 88 2 73 .5 35 .9 78 .3 55 .4 71 .8 72 .2 54 .6 34 .4 73 .9 65 .8 63 .6 30 .0 92 .6 88 .5 71 .8 42 .4 66 .9 64 .8 54 .1 53 .2 74 .6 65 .1 0 .1 0. 1 0. 4 0. 2 0. 2 0. 2 0. 2 0. 2 0. 1 0. 2 0. 3 0. 1 0. 2 0. 3 0. 1 0. 4 0. 1 0. 2 0. 0 0. 0 1. 2 0. 2 3 1. 4 3. 9 31 .3 23 .3 24 .6 26 .5 20 .6 10 .0 27 .7 23 .7 26 .6 3. 6 34 .6 32 .4 29 .3 20 .7 20 .7 25 .9 22 .0 29 .3 49 .4 24 .1 Ta b le W S .2 : H o u se h o ld w at er t re at m en t P er ce n ta g e o f h o u se h o ld p o p u la ti o n b y d ri n ki n g w at er t re at m en t m et h o d u se d in t h e h o u se h o ld , a n d f o r h o u se h o ld m em b er s liv in g in h o u se h o ld s w h er e an u n im p ro ve d d ri n ki n g w at er s o u rc e is u se d , t h e p er ce n ta g e w h o a re u si n g a n a p p ro p ri at e tr ea tm en t m et h o d , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 20 11 W at er t re at m en t m et h o d u se d in t h e h o u se h o ld N o n e U se w at er fi lt er S o la r d is - in fe ct io n Le t it st an d a n d se tt le O th er N u m b er o f h o u se h o ld m em b er s P er ce n ta g e o f h o u se h o ld m em b er s in h o u se h o ld s u si n g u n im p ro ve d d ri n ki n g w at er s o u rc es a n d u si n g a n a p p ro p ri at e w at er t re at m en t m et h o d 1 N u m b er o f h o u se h o ld m em b er s in h o u se h o ld s u si n g u n im p ro ve d d ri n ki n g w at er s o u rc es B o il A d d b le ac h / ch lo ri n e S tr ai n th ro u g h a cl o th *1 3 ca se s w it h m is si n g “ E d u ca ti o n o f h o u se h o ld h ea d ” a n d 1 c as e w it h m is si n g “ E th n ic it y o f h o u se h o ld h ea d ” n o t sh o w n 1 M IC S in d ic at o r 4. 2 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 57 District Merauke Jayawijaya Biak Numfor Area Urban Rural Education of household head* None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 40.9 23.6 80.0 69.6 34.3 15.5 36.8 57.3 74.7 7.0 32.5 49.3 67.1 87.8 44.3 48.3 64.5 76.2 47.5 48.7 21.1 8.7 1.9 13.1 10.8 7.9 14.4 12.1 7.2 2.9 16.7 13.9 16.1 9.1 6.3 25.2 17.5 9.6 7.3 11.7 16.0 45.9 8.0 5.6 32.4 52.6 23.7 16.2 9.2 60.3 24.5 16.3 4.7 1.2 29.8 12.7 4.2 3.1 13.2 21.4 8.1 8.7 2.8 1.8 9.9 11.1 10.1 3.9 2.4 14.4 10.1 6.4 1.8 0.0 7.0 4.6 3.5 1.5 18.5 6.6 0.4 1.9 0.3 1.5 0.2 0.3 0.9 0.7 1.0 0.9 0.1 0.6 1.7 0.6 0.4 0.6 1.9 0.7 3.5 0.8 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 5,050 3,192 3,828 4,943 7,128 1,214 4,049 5,024 1,771 2,412 2,417 2,416 2,413 2,413 6,991 2,678 1,135 541 724 12,070 9.5 8.9 5.6 6.9 9.0 10.7 9.6 7.7 4.2 10.0 12.4 9.9 7.0 1.3 8.9 6.9 6.8 8.5 6.7 8.1 3.8 2.4 1.2 1.5 3.3 1.9 4.2 1.9 1.3 4.4 3.4 3.7 1.5 0.0 3.3 1.5 1.6 0.5 3.5 2.6 0.1 0.0 0.2 0.0 0.2 0.0 0.3 0.0 0.0 0.1 0.3 0.0 0.2 0.0 0.1 0.2 0.0 0.0 0.0 0.1 Table WS.3: Time to source of drinking water Per cent distribution of household population according to time to go to source of drinking water, get water and return, for users of improved and unimproved drinking water sources, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Users of improved drinking water sources Users of unimproved drinking water sources Time to source of drinking water Water on premises Water on premises Less than 30 minutes 30 minutes or more Missing/ DK Total Number of house- hold membersLess than 30 minutes 30 minutes or more Missing/ DK * 13 cases with missing “Education of household head” and 1 case with missing “Ethnicity of household head” not shown 58 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Table WS.4 shows that for 59 per cent of households, 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 29 per cent of cases, while for the rest of the households, female (7 per cent) or male children (4 per cent) under age 15 collect water. District Merauke Jayawijaya Biak Numfor Area Urban Rural Education of household head* None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 34.7 70.7 18.3 15.8 55.9 76.7 47.7 29.8 18.2 89.5 49.6 35.3 16.5 3.0 53.3 25.0 17.3 14.6 39.0 40.0 2.2 11.4 1.6 4.4 7.1 7.9 6.6 5.3 9.1 9.8 6.0 2.0 0.0 (*) 8.6 0.9 (0.0) (*) (4.4) 6.7 2.0 5.8 1.9 0.8 4.4 6.2 2.6 3.8 3.3 5.2 3.3 1.7 2.2 (*) 4.7 0.3 (0.0) (*) (6.8) 3.8 1.8 1.1 1.0 8.6 0.0 0.0 1.2 2.1 4.0 0.0 0.0 2.0 9.3 (*) 0.0 3.1 (5.8) (*) (6.5) 1.3 0.4 0.1 0.6 0.0 0.3 0.2 0.2 0.5 0.0 0.1 0.3 0.0 1.8 (*) 0.2 0.9 (0.0) (*) (0.0) 0.3 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 (*) 100.0 100.0 100.0 100.0 100.0 100.0 433 565 150 178 969 278 449 345 73 572 276 188 93 17 832 185 46 19 64 1,147 1,248 799 819 1,132 1,734 362 940 1,159 402 639 557 533 565 572 1,561 741 269 129 165 2,866 44.7 69.0 60.7 47.8 60.8 69.5 54.9 57.0 51.1 70.7 57.5 41.9 30.5 (*) 67.3 35.5 (25.4) 36.7 (46.6) 58.8 49.0 12.5 34.2 38.3 27.4 16.2 34.6 31.4 32.5 14.2 32.9 52.4 56.2 (*) 19.2 59.4 (68.8) (*) (35.6) 29.1 Table WS.4: Person collecting water Percentage of households without drinking water on premises, and per cent distribution of households without drinking water on premises according to the person usually collecting drinking water used in the household, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Person usually collecting drinking waterPercentage of households without drinking water on premises Female child under age 15 Male child under age 15 Missing DK Total Number of households without drinking water on premises Number of house- holds Adult woman Adult man * 2 cases with missing “Education of household head” and 1 case with missing “Ethnicity of household head” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 59 7.2. USE OF IMPROVED SANITATION FACILITIES Inadequate disposal of human excreta and personal hygiene is associated with a range of diseases including diarrhoeal diseases and polio. An improved sanitation facility is defined as one that hygienically separates human excreta from human contact. Improved sanitation can reduce diarrhoeal disease by more than a third, and can significantly lessen the adverse health impacts of other disorders responsible for death and disease among millions of children in developing countries. Improved sanitation facilities for excreta disposal include flush or pour flush to a piped sewer system, septic tank, or pit latrine; ventilated improved pit latrine, pit latrine with slab, and use of a composting toilet. Forty-threeper cent of the population of three selected districts of Papua Province is living in households that use improved sanitation facilities that flush to septic tank or flush into tanks (13 per cent) or use pit latrine with slab (13 per cent) (Table WS.5). About one fifth of the population have no facility or use bush or field (20 per cent). 60 MULTIPLE INDICATOR CLUSTER SURVEY 2011 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l E d u ca ti o n o f h o u se h o ld h ea d * N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d * P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 35 .0 24 .2 69 .7 67 .0 26 .7 9. 8 28 .4 52 .4 73 .6 1. 1 14 .8 44 .5 69 .3 86 .1 36 .5 42 .9 66 .4 69 .9 52 .3 43 .2 3 1. 1 0. 4 0. 8 4. 2 19 .7 7. 3 23 .1 10 .8 2. 5 3. 6 33 .0 21 .8 8. 1 0. 2 5. 6 36 .2 9. 0 9. 1 14 .0 13 .3 0. 2 0. 3 0. 7 0. 6 0. 2 0. 2 0. 3 0. 6 0. 3 0. 1 0. 3 0. 3 0. 6 0. 7 0. 4 0. 0 1. 7 0. 5 0. 0 0. 4 12 .2 6. 7 1. 2 2. 6 10 .4 10 .3 10 .9 4. 8 3. 1 7. 2 15 .4 9. 7 3. 6 0. 3 5. 6 9. 3 3. 2 4. 2 23 .9 7. 2 1. 0 0. 0 0. 3 1. 1 0. 1 0. 0 1. 3 0. 2 0. 0 0. 0 0. 7 0. 9 0. 9 0. 0 0. 1 1. 9 0. 0 0. 0 0. 0 0. 5 1. 0 0. 1 2. 4 2. 8 0. 1 0. 7 1. 7 0. 9 1. 3 0. 2 1. 5 1. 8 2. 5 0. 0 1. 4 0. 0 3. 9 0. 0 0. 0 1. 2 0. 6 0. 6 0. 1 0. 3 0. 6 0. 0 0. 7 0. 4 0. 1 0. 4 1. 0 0. 8 0. 0 0. 0 0. 5 0. 8 0. 0 0. 0 0. 0 0. 4 4 .9 59 .3 7. 7 4. 0 31 .4 67 .6 19 .4 13 .9 7. 4 84 .9 13 .4 2. 6 0. 0 0. 0 34 .4 0. 2 0. 9 0. 2 1. 4 20 .2 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 5, 05 0 3, 19 2 3, 82 8 4, 94 3 7, 12 8 1, 21 4 4, 04 9 5, 02 4 1, 77 1 2, 41 2 2, 41 7 2, 41 6 2, 41 3 2, 41 3 6, 99 1 2, 67 8 1, 13 5 54 1 72 4 12 ,0 70 13 .9 8. 2 16 .5 17 .1 10 .6 4. 0 14 .2 15 .4 11 .4 2. 5 19 .7 17 .0 14 .5 12 .5 15 .1 8. 5 14 .7 16 .2 8. 4 13 .2 0. 0 0. 0 0. 3 0. 3 0. 0 0. 0 0. 0 0. 2 0. 3 0. 0 0. 0 0. 0 0. 3 0. 2 0. 1 0. 1 0. 2 0. 0 0. 0 0. 1 0. 0 0. 1 0. 4 0. 0 0. 3 0. 0 0. 1 0. 3 0. 0 0. 0 0. 1 0. 5 0. 1 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 0. 1 Ta b le W S .5 : T yp es o f sa n it at io n f ac ili ti es P er c en t d is tr ib u ti o n o f h o u se h o ld p o p u la ti o n a cc o rd in g t o t yp e o f to ile t fa ci lit y u se d b y th e h o u se h o ld , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 Fl u sh t o se p ti c ta n k Fl u sh / p o u r fl u sh t o so m ew h er e el se P it la tr in e w it h o u t sl ab / o p en p it B u ck et Fl u sh /p o u r fl u sh t o : Im p ro ve d s an it at io n f ac ili ty U n im p ro ve d s an it at io n f ac ili ty Ty p e o f to ile t fa ci lit y u se d b y h o u se h o ld H an g in g to ile t/ h an g in g la tr in e O th er O p en d ef ec at io n (n o fa ci lit y, b u sh , fi el d ) To ta l To ta l N u m b er o f h o u se h o ld m em b er s Fl u sh to p it (l at ri n e) Fl u sh t o u n kn o w n p la ce / N o t su re / D K w h er e V en ti la te d im p ro ve d p it la tr in e *1 3 c as es w it h m is si n g “ E d u ca ti o n o f h o u se h o ld h ea d ” a n d 1 c as e w it h m is si n g “ E th n ic it y o f h o u se h o ld h ea d ” n o t sh o w n ( ) F ig u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 61 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l E d u ca ti o n o f h o u se h o ld h ea d * N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d * P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 64 .0 23 .6 74 .5 72 .4 45 .7 16 .6 50 .0 64 .3 77 .6 3. 2 44 .6 64 .8 78 .8 91 .7 42 .3 77 .7 73 .9 81 .5 71 .0 56 .6 0. 0 1. 2 0. 2 0. 5 0. 3 0. 8 0. 1 0. 6 0. 0 0. 0 0. 7 0. 5 0. 7 0. 0 0. 5 0. 1 0. 9 0. 0 0. 0 0. 4 12 .3 4. 8 2. 5 4. 2 9. 3 8. 3 11 .5 4. 8 3. 3 5. 5 15 .3 9. 6 4. 7 0. 8 5. 4 10 .0 4. 8 3. 3 20 .9 7. 2 0 .3 0. 1 1. 4 1. 2 0. 1 0. 1 1. 0 0. 5 0. 0 0. 1 0. 2 0. 9 1. 6 0. 0 0. 3 0. 1 3. 6 0. 0 0. 0 0. 6 2 .5 2. 5 0. 7 1. 9 2. 0 2. 8 2. 0 1. 6 1. 6 2. 0 3. 4 2. 9 1. 1 0. 2 2. 2 1. 8 0. 4 1. 4 3. 0 1. 9 0 .1 0. 4 0. 0 0. 1 0. 2 0. 0 0. 3 0. 1 0. 0 0. 4 0. 0 0. 1 0. 2 0. 0 0. 2 0. 1 0. 0 0. 0 0. 0 0. 1 4. 9 59 .3 7. 7 4. 0 31 .4 67 .6 19 .4 13 .9 7. 4 84 .9 13 .4 2. 6 0. 0 0. 0 34 .4 0. 2 0. 9 0. 2 1. 4 20 .2 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 5, 05 0 3, 19 2 3, 82 8 4, 94 3 7, 12 8 1, 21 4 4, 04 9 5, 02 4 1, 77 1 2, 41 2 2, 41 7 2, 41 6 2, 41 3 2, 41 3 6, 99 1 2, 67 8 1, 13 5 54 1 72 4 12 ,0 70 4. 2 2. 3 1. 6 5. 2 1. 2 1. 0 4. 0 3. 1 0. 8 1. 0 5. 1 4. 4 2. 6 1. 2 3. 4 1. 8 4. 0 2. 0 0. 0 2. 9 1 1. 3 4. 7 10 .6 9. 6 9. 1 2. 3 10 .5 10 .2 9. 0 2. 4 16 .1 13 .0 9. 3 5. 8 10 .4 7. 6 9. 9 10 .4 3. 6 9. 3 0. 6 1. 2 0. 8 0. 9 0. 8 0. 5 1. 1 0. 8 0. 3 0. 6 1. 2 1. 1 0. 9 0. 3 0. 8 0. 5 1. 6 1. 1 0. 0 0. 8 Ta b le W S .6 : U se a n d s h ar in g o f sa n it at io n f ac ili ti es P er c en t d is tr ib u ti o n o f h o u se h o ld p o p u la ti o n b y u se o f p ri va te a n d p u b lic s an it at io n f ac ili ti es a n d u se o f sh ar ed f ac ili ti es , b y u se rs o f im p ro ve d a n d u n im p ro ve d s an it at io n fa ci lit ie s, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 N o t sh ar ed 1 M is si n g / D K N o t sh ar ed P u b lic fa ci lit y S h ar ed b y U se rs o f im p ro ve d s an it at io n f ac ili ti es U se rs o f u n im p ro ve d s an it at io n f ac ili ti es S h ar ed b y 5 h o u se h o ld s o r le ss M o re t h an 5 h o u se h o ld s O p en d ef ec at io n (n o fa ci lit y, b u sh , fi el d ) To ta l N u m b er o f h o u se h o ld m em b er s P u b lic fa ci lit y 5 h o u se h o ld s o r le ss M o re t h an 5 h o u se h o ld s *1 3 ca se s w it h m is si n g “ E d u ca ti o n o f h o u se h o ld h ea d ” a n d 1 c as e w it h m is si n g “ E th n ic it y o f h o u se h o ld h ea d ” n o t sh o w n 1 M IC S in d ic at o r 4. 3; M D G in d ic at o r 7. 9 62 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Almost two-thirds of the population of Jayawijaya District has no facility or use bush or field (59 per cent). No facility or use of bush or field is much less common in Merauke (5 per cent) and Biak Numfor (8 per cent). About 49 per cent of the population in Merauke and 70 per cent in Biak Numfor use facilities that flush to septic tank or pit (latrines). The percentage of the population who have no facility or use bush or field is higher in rural areas (31 per cent) than urban areas (4 per cent). The table indicates that no facility or use of bush or field is strongly correlated with education of household head and wealth. The MDGs and the WHO / UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation classify households as using an unimproved sanitation facility if they are using otherwise acceptable sanitation facilities but sharing a facility between two or more households or using a public toilet facility. As shown in Table WS.6, 57 per cent of the household population is using an improved sanitation facility with Biak Numfor District (75 per cent) showing the highest percentage in this indicator and Jayawijaya the lowest (24 per cent). About 13 per cent of the household population are using an improved sanitation facility but this facility is shared with others. As expected, improved sanitation facility correlates strongly with area, education of head of household and wealth (Figure WS.2). For example, the percentage of households using an improved sanitation facility increases dramatically from threeper cent among the poorest household population to 92 per cent for the richest. In its 2008 report, the JMP developed a new way of presenting the access figures, by disaggregating and refining the data on drinking water and sanitation and reflecting them in “ladder” format. This ladder allows a disaggregated analysis of trends in a three rung ladder for drinking water and a four-rung ladder for sanitation. For sanitation, this gives an understanding of the proportion of population with no sanitation facilities at all, of those reliant on technologies defined by JMP as “unimproved,” of those sharing Figure WS.2: Percentage of household population using improved (not shared) sanitation facilities, Districts of Merauke, Jayawijya and Biak Numfor, Papua Province, Indonesia, 2011. District Merauke Jayawijaya Biak Numfor Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 Per cent 64 24 74 72 46 17 50 64 78 3 45 65 79 92 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 63 sanitation facilities of otherwise acceptable technology, and those using “improved” sanitation facilities. Table WS.7 presents the percentages of household population by drinking water and sanitation ladders. The table also shows the percentage of household members using improved sources of drinking water and sanitary means of excreta disposal. About 41 per cent of household population use both improved drinking sources and sanitation with clear correlation with background characteristics (Figure WS.3). Wide disparities exist among districts: The highest percentage of household population that use both improved drinking sources and sanitation was seen in Biak Numfor (65 per cent), followed by Merauke (39 per cent) and the lowest percentage was seen in Jayawijaya (only 16 per cent). Urban areas have a higher use of both improved drinking sources and sanitation (59 per cent) than rural (29 per cent). Strong positive associations exist for this indicator by education of head of household and wealth. Figure WS.3: Percentage of household population using improved drinking water sources and improved sanitation, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 Per cent 39 16 65 59 29 11 31 48 65 2 22 40 60 82 64 MULTIPLE INDICATOR CLUSTER SURVEY 2011 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l E d u ca ti o n o f h o u se h o ld h ea d * N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d * P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 13 .8 3. 0 37 .3 34 .6 7. 1 2. 7 10 .4 22 .0 37 .2 0. 2 3. 8 13 .5 22 .2 52 .4 15 .2 14 .5 34 .9 39 .4 22 .2 18 .4 6 4. 0 23 .6 74 .5 72 .4 45 .7 16 .6 50 .0 64 .3 77 .6 3. 2 44 .6 64 .8 78 .8 91 .7 42 .3 77 .7 73 .9 81 .5 71 .0 56 .6 16 .0 9. 4 13 .3 16 .2 11 .5 4. 5 15 .7 14 .8 10 .1 4. 0 23 .1 19 .0 13 .5 7. 3 15 .1 10 .0 16 .4 13 .6 3. 6 13 .4 1 5. 1 7. 7 4. 6 7. 4 11 .5 11 .2 14 .8 7. 0 4. 8 7. 9 18 .9 13 .6 7. 6 1. 0 8. 1 12 .0 8. 8 4. 7 23 .9 9. 8 4. 9 59 .3 7. 7 4. 0 31 .4 67 .6 19 .4 13 .9 7. 4 84 .9 13 .4 2. 6 0. 0 0. 0 34 .4 0. 2 0. 9 0. 2 1. 4 20 .2 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 3 9. 1 15 .6 65 .2 59 .4 28 .5 10 .8 31 .3 48 .2 64 .9 1. 8 22 .4 39 .8 60 .4 81 .6 33 .5 47 .2 54 .1 67 .6 52 .9 41 .2 5, 05 0 3, 19 2 3, 82 8 4, 94 3 7, 12 8 1, 21 4 4, 04 9 5, 02 4 1, 77 1 2, 41 2 2, 41 7 2, 41 6 2, 41 3 2, 41 3 6, 99 1 2, 67 8 1, 13 5 54 1 72 4 12 ,0 70 40 .5 31 .9 49 .7 43 .3 39 .6 25 .4 40 .5 45 .0 43 .0 21 .3 44 .8 49 .4 53 .6 36 .7 41 .4 42 .5 38 .0 45 .7 35 .4 41 .2 45 .7 65 .1 13 .0 22 .0 53 .2 71 .9 49 .1 33 .0 19 .8 78 .5 51 .4 37 .2 24 .2 10 .9 43 .4 43 .1 27 .1 14 .8 42 .4 40 .4 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 Ta b le W S .7 : D ri n ki n g w at er a n d s an it at io n la d d er s P er ce n ta g e o f h o u se h o ld p o p u la ti o n b y d ri n ki n g w at er a n d s an it at io n la d d er s, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 P ip ed in to d w el lin g , p lo t o r ya rd Im p ro ve d sa n it at io n 2 S h ar ed im p ro ve d fa ci lit ie s U n im p ro ve d fa ci lit ie s Im p ro ve d d ri n ki n g w at er 1 P er ce n ta g e o f h o u se h o ld p o p u la ti o n u si n g : U n im p ro ve d s an it at io n O p en d ef ec at io n To ta l Im p ro ve d d ri n ki n g w at er so u rc es an d im p ro ve d sa n it at io n N u m b er o f h o u se h o ld m em b er s O th er im p ro ve d U n im p ro ve d d ri n ki n g w at er To ta l *1 3 ca se s w it h m is si n g “ E d u ca ti o n o f h o u se h o ld h ea d ” a n d 1 c as e w it h m is si n g “ E th n ic it y o f h o u se h o ld h ea d ” n o t sh o w n 1 M IC S in d ic at o r 4. 1; M D G in d ic at o r 7. 8 2 M IC S in d ic at o r 4. 3; M D G in d ic at o r 7. 9 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 65 7.3. DISTANCE BETWEEN WATER SOURCE AND CLOSEST EXCRETA DISPOSAL In cities, toilets are connected to septic tanks with absorption fields. In order to avoid the contamination of drinking water by sewage, the Indonesian Ministry of Public Works recommends that the distance between the septic tank absorption field and the water source be at least 10 metres. About 52 per cent of households in all three districts reported that their water source is 10 or more metres away from the closest excreta place while about 39 per cent did not know how much the distance was. By district the proportion of households reporting water sources 10 or more metres away from the closest excreta place was 64, 53 and 29 per cent in Merauke, Biak Numfor and Jayawijaya respectively. In Jayawijaya District two thirds of households (66 per cent) did not know the distance between their water source and the closest excreta disposal place (Table WS.8) compared with 24 and 35 per cent in Merauke and Biak Numfor. District Merauke Jayawijaya Biak Numfor Area Urban Rural Education of household head* None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 23.8 65.7 35.0 40.8 36.7 61.4 35.7 33.9 42.0 67.9 27.0 23.5 30.7 43.1 43.4 22.8 40.2 37.1 46.0 38.4 0.9 1.8 1.2 0.9 1.4 2.3 1.2 1.2 0.6 3.2 1.1 0.9 0.6 0.3 1.7 0.4 0.5 1.4 0.0 1.2 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 5,050 3,192 3,828 4,943 7,128 1,214 4,049 5,024 1,771 2,412 2,417 2,416 2,413 2,413 6,991 2,678 1,135 541 724 12,070 11.1 3.2 10.4 13.5 5.6 3.7 7.6 9.8 12.5 1.4 9.6 9.2 11.5 12.4 8.0 9.0 14.6 8.4 7.1 8.8 64.1 29.3 53.4 44.8 56.2 32.6 55.6 55.1 44.9 27.5 62.3 66.4 57.2 44.2 46.8 67.7 44.7 53.1 46.9 51.5 Table WS.8: Distance between water source and closest excreta disposal Percentage of household population by distance between water source and closest excreta disposal, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Percentage of household population by distance between water source and closest excreta disposal DK Missing Total Number of household members Less than 10 meters 10 meters or more * 13 cases with missing “Education of household head” and 1 case with missing “Ethnicity of household head” not shown MULTIPLE INDICATOR CLUSTER SURVEY 201166 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 67MULTIPLE INDICATOR CLUSTER SURVEY 2011 8 REPRODUCTIVE HEALTH 8.1. FERTILITY In MICS4, adolescent birth rates and total fertility rates are calculated by using information on the date of last birth of each woman and are based on the one-year period (1-12 months) preceding the survey. Rates are underestimated by a very small margin due to absence of information on multiple births (twins, triplets etc) and on women having multiple deliveries during the one year period preceding the survey. Table RH.1 shows adolescent birth rates and total fertility rate. The adolescent birth rate (age-specific fertility rate for women age 15-19) is defined as the number of births to women age 15-19 years during the one year period preceding the survey, divided by the average number of women age 15-19 (number of women-years lived between ages 15 through 19, inclusive) during the same period, expressed per 1,000 women. The total fertility rate (TFR) is calculated by summing the age-specific fertility rates calculated for each of the 5-year age groups of women, from age 15 through to age 49. The TFR denotes the average number of children to which a woman will have given birth by the end of her reproductive years if current fertility rates prevailed. Figure RH.1: Percentage of women age 15-19 who have had a live birth or who are pregnant with the first child, or who have begun childbearing before age 15 by district, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 35 30 25 20 15 10 5 0 P er c en t Have had a live birth Are pregnant with first child Have begun childbearing Have had a live birth before age 15 23 14 1 1 7 7 31 15 9 4 02 Merauke Biak NumforJayawijaya 68 MULTIPLE INDICATOR CLUSTER SURVEY 2011 The TFR in the three selected districts of Papua Province for the one-year period preceding the survey is 3.5 children per woman. TFR is highest in Jayawijaya District (4.5 children per woman) and lowest in Merauke District (3 children per woman). TFR in Biak Numfor District is 3.5 children per woman. Table RH.1 also show differentials in fertility by area residence, education, wealth quintile and ethnicity. TFR deceases as mother’s education increases and also with increasing wealth. TFR is higher among households headed by Papuan compared with others. The adolescent birth rate (Age-specific fertility rate for women age 15-19) is 90 births per 1,000 women. The adolescent birth rate is considerably higher in Jayawijaya District (145 births per 1,000 women) compared with the rates in Merauke (77 births per 1,000 women) and Biak Numfor (59 births per 1,000 women). The birth rate is highest among rural adolescents, poorest adolescents and those with no education, and those whose heads of household are Papuan. Sexual activity and childbearing early in life carry significant risks for young people all around the world. Table RH.2 presents some early childbearing indicators for women age 15-19 and 20-24 while Table RH.3 presents the trends for early childbearing. As shown in Table RH.2, 14 per cent of women age 15-19 have already given birth, three per cent are pregnant with their first child, 17 per cent have begun childbearing and one per cent given birth to a live baby before age 15. All these indicators are considerably higher in Jayawijaya District than in Merauke and Biak Numfor districts (Figure RH.1). District Merauke Jayawijaya Biak Numfor Area Urban Rural Women’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Others Total for 3 districts 77 145 59 68 106 248 66 77 92 192 97 42 77 38 100 72 90 3.0 4.5 3.5 3.4 3.6 5.5 3.3 3.7 2.4 4.6 4.0 3.5 3.4 2.4 4.0 3.0 3.5 Table RH.1: Adolescent birth rate and total fertility rate Adolescent birth rates and total fertility rates, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Adolescent birth rate1 (Age-specific fertility rate for women age 15-19) Total fertility rate 1 MICS indicator 5.1; MDG indicator 5.4 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 69 Seventeen per cent of women aged 20-24 years gave birth before reaching 18 years of age. Across the three districts, a considerably higher birthrate before age 18 for this age group was seen in Jayawijaya (37 per cent). This percentage was 11 per cent in Merauke and 10 per cent in Biak Numfor. District Merauke Jayawijaya Biak Numfor Area Urban Rural Education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 14.2 23.3 7.2 12.4 15.2 (32.9) 12.4 13.0 8.5 30.5 10.0 10.0 16.5 4.3 4.1 15.6 (12.1) (*) (*) 14.0 0.8 7.3 1.7 1.5 3.8 (11.0) 8.0 1.1 0.0 7.8 1.3 3.4 1.6 0.8 3.5 1.6 (3.8) (*) (*) 2.8 15.0 30.6 9.0 14.0 19.1 (43.9) 20.3 14.1 8.5 38.3 11.4 13.3 18.1 5.1 17.6 17.2 (15.9) (*) (*) 16.8 0.6 4.0 0.0 0.2 2.1 (7.1) 2.3 0.6 0.0 5.8 0.0 0.0 1.0 0.0 1.7 0.0 (0.0) (*) (*) 1.3 172 120 171 203 259 31 73 336 22 84 93 83 106 97 285 86 45 27 15 462 11.1 36.9 10.2 7.8 25.4 (36.2) 30.1 16.6 (*)7 40.1 (12.5) 19.4 12.1 4.6 22.4 11.1 (12.2) (*) (*) 17.1 193 97 113 190 213 36 68 210 89 75 51 81 102 94 216 109 38 18 21 403 Table RH.2: Early childbearing Percentage of women age 15-19 years who have had a live birth or who are pregnant with the first child and percentage of women age 15-19 years who have begun childbearing, percentage of women who have had a live birth before age 15, and percentage of women age 20-24 who have had a live birth before age 18, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Have had a live birth Are pregnant with first child Have begun childbearing Have had a live birth before age 15 Number of women age 15-19 Percentage of women age 20-24 who have had a live birth before age 181 Number of women age 20-24 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 5.2 Percentage of women age 15-19 who: 70 MULTIPLE INDICATOR CLUSTER SURVEY 2011 A g e 15 -1 9 20 -2 4 25 -2 9 30 -3 4 35 -3 9 40 -4 4 45 -4 9 To ta l f o r 3 d is tr ic ts 0. 2 0. 9 2. 0 1. 1 3. 5 6. 4 1. 1 1. 9 20 3 19 0 24 0 16 3 17 3 11 3 92 1, 17 4 n a 7. 8 14 .1 11 .7 10 .9 14 .1 8. 9 11 .4 n a 19 0 24 0 16 3 17 3 11 3 92 97 0 2. 1 2. 6 4. 5 2. 9 4. 2 5. 8 4. 6 3. 7 25 9 21 3 26 6 25 1 24 7 17 5 19 9 1, 61 0 n a 25 .4 21 .0 23 .0 19 .2 25 .5 22 .5 22 .5 46 2 40 3 50 6 41 4 42 0 28 8 29 1 2, 78 4 n a 21 3 26 6 25 1 24 7 17 5 19 9 1, 35 2 n a 17 .1 17 .7 18 .5 15 .8 21 .0 18 .2 17 .9 1. 3 1. 8 3. 3 2. 2 3. 9 6. 0 3. 5 3. 0 n a 40 3 50 6 41 4 42 0 28 8 29 1 2, 32 2 Ta b le R H .3 : T re n d s in e ar ly c h ild b ea ri n g P er ce n ta g e o f w o m en w h o h av e h ad a li ve b ir th , b y ag e 15 a n d 1 8, b y ar ea a n d a g e g ro u p , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 P er ce n ta g e o f w o m en w it h a liv e b ir th b ef o re a g e 15 N u m b er o f w o m en ag e 15 -4 9 U rb an R u ra l A ll N u m b er o f w o m en ag e 20 -4 9 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 18 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 15 N u m b er o f w o m en ag e 20 -4 9 N u m b er o f w o m en ag e 15 -4 9 N u m b er o f w o m en ag e 20 -4 9 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 18 N u m b er o f w o m en ag e 15 -4 9 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 15 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 18 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 71 8.2. CONTRACEPTION Appropriate family planning is important to the health of women and children by: 1) preventing pregnancies that are too early or too late; 2) extending the period between births; and 3) limiting the number of children. Access by all couples to information and services to prevent pregnancies that are too early, too closely spaced, too late or too many is critical. Current use of contraception in the three selected districts of Papua Province was reported by 44 per cent of women currently married or in union (Table RH.4). The lowest current use was seen in Jayawijaya District (34 per cent), mostly traditional methods, compared with 43 per cent in Biak Numfor District and 52 per cent in Merauke District where women mostly use modern method (Figure RH.2). The most popular methods in Jayawijaya are others (9 per cent), injectables (9 per cent) and Lactational Amenorrhoea Method (LAM) (7 per cent). The most popular methods in Biak Numfor are injectables (18 per cent) and implants (9 per cent). The most popular methods in Merauke are injectables (29 per cent) and the pill (13 per cent). Only about 31 per cent of women aged 15-19 currently use a method of contraception compared with 41 per cent of 20-24 years old and 50 per cent of 35-39 years old women. Women’s education levels are associated with contraceptive prevalence. The percentage of women using any method of contraception rises from 26 per cent among those with no education to 43 per cent among women with primary education, to 51 per cent among women with secondary education, and drops to 44 per cent among women with higher education. In addition to differences in prevalence, the method mix varies by education. Most contraceptive users with no or primary education use ‘others’ (11 per cent). In contrast most contraceptive users with higher education use injectables (17 per cent). Use of any contraceptive method did not show clearly the expected positive association between contraceptive use and number of living children a woman. Figure RH.2: Percentage of currently married women aged 15-49 years using contraceptive methods, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 100 90 80 70 60 50 40 30 20 10 0 P er c en t Merauke Jayawijaya Biak Numfor Traditional Method No MethodModern Method 50 2 17 5 48 66 16 38 57 72 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Ta b le R H .4 : U se o f co n tr ac ep ti o n P er ce n ta g e o f w o m en a g e 15 -4 9 ye ar s cu rr en tl y m ar ri ed o r in u n io n w h o a re u si n g ( o r w h o se p ar tn er is u si n g ) a co n tr ac ep ti ve m et h o d , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l A g e 15 -1 9 20 -2 4 25 -2 9 30 -3 4 35 -3 9 40 -4 4 45 -4 9 N u m b er o f liv in g c h ild re n 0 1 2 3 4+ N u m b er o f w o m en cu rr en tl y m ar ri ed o r in u n io n w it h n ee d fo r co n tr a- ce p ti o n 93 6 61 5 54 6 81 2 1, 28 4 99 28 3 43 1 38 2 38 6 25 6 25 8 25 7 44 1 49 3 40 1 50 4 1 M IC S in d ic at o r 5. 3; M D G in d ic at o r 5. 3 48 .2 66 .3 57 .5 52 .2 58 .3 69 .4 59 .2 52 .8 55 .2 50 .4 53 .7 64 .0 98 .5 59 .7 42 .4 46 .8 51 .4 2. 4 1. 4 3. 8 4. 6 1. 1 0. 0 0. 0 1. 1 1. 5 2. 8 5. 0 6. 8 0. 0 0. 0 1. 6 4. 8 4. 9 1 2. 8 3. 0 5. 8 8. 3 7. 9 4. 4 8. 5 7. 3 10 .0 10 .1 7. 8 4. 8 1. 5 8. 9 11 .1 9. 1 7. 0 1. 2 0. 5 1. 0 1. 8 0. 4 0. 0 1. 1 0. 7 1. 0 0. 6 0. 7 2. 4 0. 0 0. 7 1. 8 1. 1 0. 8 2 8. 9 9. 3 18 .1 22 .8 18 .7 15 .3 20 .9 26 .4 20 .1 20 .9 18 .6 12 .6 0. 0 22 .3 28 .5 21 .2 20 .3 4 .1 2. 3 8. 8 2. 6 6. 1 0. 7 3. 4 4. 5 5. 1 6. 9 6. 5 2. 8 0. 0 1. 5 5. 8 8. 3 6. 3 0. 0 0. 0 0. 5 0. 2 0. 1 0. 0 0. 0 0. 2 0. 0 0. 0 0. 3 0. 4 0. 0 0. 0 0. 2 0. 4 0. 0 IU D Fe m al e st er ili za - ti on In je ct - ab le s M al e st er ili za - ti on Im pl an ts Pi ll N ot us in g an y m et ho d P er c en t o f w o m en ( cu rr en tl y m ar ri ed o r in u n io n ) w h o a re u si n g : M al e co nd om D ia - ph ra gm / fo am / je lly Fe m al e co nd om La ct a- tio na l am en or - rh oe a m et ho d (L A M ) Pe ri od ic ab st i- ne nc e/ R hy th m W it h- dr aw al A ny m od er n m et ho d A ny m et ho d1 A ny t ra - di ti on al m et ho d 0. 2 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 6 0. 0 0. 0 0. 0 0. 4 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 6. 8 0. 1 1. 4 2. 6 6. 6 2. 6 3. 2 2. 3 1. 2 1. 3 0. 0 0. 0 2. 3 2. 7 2. 8 2. 0 49 .6 16 .4 38 .0 40 .4 34 .5 20 .3 33 .8 40 .3 37 .7 41 .3 38 .9 30 .4 1. 5 33 .3 49 .0 45 .3 39 .2 1. 0 1. 1 2. 5 3. 2 0. 3 0. 0 0. 0 0. 5 1. 3 3. 5 2. 5 1. 1 0. 0 1. 0 2. 6 2. 0 0. 9 0. 3 0. 0 0. 3 0. 2 0. 2 0. 0 0. 0 0. 2 0. 0 0. 6 0. 0 0. 6 0. 0 0. 2 0. 3 0. 0 0. 4 0. 7 9. 4 1. 7 2. 6 4. 1 3. 6 4. 4 3. 1 3. 5 2. 9 3. 6 3. 9 0. 0 3. 6 3. 0 3. 1 6. 0 2. 2 17 .3 4. 6 7. 4 7. 2 10 .2 7. 0 6. 9 7. 1 8. 2 7. 4 5. 6 0. 0 7. 0 8. 6 7. 9 9. 3 5 1. 8 33 .7 42 .5 47 .8 41 .7 30 .6 40 .8 47 .2 44 .8 49 .6 46 .3 36 .0 1. 5 40 .3 57 .6 53 .2 48 .6 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 73 Ta b le R H .4 : U se o f co n tr ac ep ti o n ( co n ti n u ed ) P er ce n ta g e o f w o m en a g e 15 -4 9 ye ar s cu rr en tl y m ar ri ed o r in u n io n w h o a re u si n g ( o r w h o se p ar tn er is u si n g ) a co n tr ac ep ti ve m et h o d , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 E d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts N u m b er o f w o m en cu rr en tl y m ar ri ed o r in u n io n w it h n ee d fo r co n tr a- ce p ti o n 73 .7 56 .3 49 .0 55 .8 75 .4 55 .8 50 .0 48 .4 48 .3 67 .6 37 .1 48 .3 50 .7 57 .9 55 .9 0. 0 3. 0 2. 2 5. 4 0. 1 2. 1 1. 9 2. 3 6. 0 2. 2 2. 5 2. 6 3. 6 3. 4 2. 5 0. 6 7. 9 11 .9 4. 5 0. 6 7. 8 9. 1 13 .5 10 .1 2. 6 17 .0 13 .1 8. 6 5. 3 8. 1 0. 0 0. 6 1. 1 2. 9 0. 0 0. 0 0. 8 0. 6 3. 3 0 .4 1. 3 1. 2 2. 3 3. 1 1. 0 6. 3 22 .4 24 .7 17 .3 5. 0 21 .8 28 .5 24 .3 23 .7 11 .3 33 .6 28 .8 22 .4 21 .9 20 .3 0. 7 5. 1 6. 0 4. 8 2. 1 7. 0 5. 8 6. 1 3. 3 4. 4 5. 4 4. 3 5. 1 6. 0 4. 8 0. 0 0. 2 0. 2 0. 0 0. 0 0. 0 0. 0 0. 2 0. 4 0. 0 0. 2 0. 8 0. 0 0. 0 0. 1 IU D Fe m al e st er ili za - ti on In je ct - ab le s M al e st er ili za - ti on Im pl an ts Pi ll N ot us in g an y m et ho d P er c en t o f w o m en ( cu rr en tl y m ar ri ed o r in u n io n ) w h o a re u si n g : M al e co nd om D ia - ph ra gm / fo am / je lly Fe m al e co nd om La ct a- tio na l am en or - rh oe a m et ho d (L A M ) Pe ri od ic ab st i- ne nc e/ R hy th m W it h- dr aw al A ny m od er n m et ho d A ny m et ho d1 A ny t ra - di ti on al m et ho d 0. 0 0. 0 0. 0 0. 7 0. 0 0. 0 0. 0 0. 4 0. 0 0. 0 0. 3 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 7. 6 1. 3 1. 3 0. 0 7. 5 1. 9 0. 0 0. 6 0. 0 4. 0 0. 0 0. 5 0. 0 0. 0 2. 1 7. 6 39 .1 46 .1 35 .6 7. 8 38 .7 46 .1 47 .5 46 .9 20 .9 60 .3 50 .8 42 .1 39 .7 36 .8 0. 0 0. 3 1. 5 6. 7 0. 0 0. 6 1. 1 1. 6 3. 9 1. 2 1. 3 0. 4 6. 5 2. 4 1. 4 0. 0 0. 4 0. 2 0. 0 0. 0 0. 4 0. 4 0. 2 0. 2 0. 1 0. 5 0. 0 0. 7 0. 0 0. 2 11 .0 2. 5 1. 9 1. 9 9. 3 2. 7 2. 5 1. 6 0. 8 6. 3 0. 8 0. 0 0. 0 0. 0 3. 5 18 .7 4. 5 4. 8 8. 6 16 .8 5. 6 3. 9 4. 1 4. 8 11 .6 2. 6 0. 9 7. 2 2. 4 7. 3 26 .3 43 .7 51 .0 44 .2 24 .6 44 .2 50 .0 51 .6 51 .7 32 .4 62 .9 51 .7 49 .3 42 .1 44 .1 32 3 67 7 87 3 22 3 45 9 37 6 41 3 42 5 42 3 1, 08 8 57 3 21 8 91 12 5 2, 09 6 (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es 1 M IC S in d ic at o r 5. 3; M D G in d ic at o r 5. 3 74 MULTIPLE INDICATOR CLUSTER SURVEY 2011 8.3. UNMET NEED Unmet need for contraception refers to fecund women who are not using any method of contraception, but who wish to postpone the next birth (spacing) or who wish to stop childbearing altogether (limiting). Unmet need is identified in MICS by using a set of questions eliciting current behaviours and preferences pertaining to contraceptive use, fecundity, and fertility preferences. Table RH.5 shows the levels of met need for contraception, unmet need, and the demand for contraception satisfied. Unmet need for spacing is defined as the percentage of women who are not using a method of contraception AND • are not pregnant and not postpartum amenorrheic10 and are fecund11 and say they want to wait two or more years for their next birth OR • are not pregnant and not postpartum amenorrheic and are fecund and unsure whether they want another child OR • are pregnant and say that pregnancy was mistimed: would have wanted to wait OR • are postpartum amenorrheic and say that the birth was mistimed: would have wanted to wait Unmet need for limiting is defined as percentage of women who are not using a method of contraception AND • are not pregnant and not postpartum amenorrheic and are fecund and say they do not want any more children OR • are pregnant and say they do not want to have a child OR • are postpartum amenorrheic and say that they did not want the birth Total unmet need for contraception is the sum of unmet need for spacing and unmet need for limiting. In this survey data was not completely collected to allow for the proper calculation of the unmet need indicators. More specifically, data was not collected on return of the menstrual period of a woman. Nonetheless results for these indicators are presented so as to give some indication of the levels of unmet need for contraception. Total unmet need for contraception in the three districts of Papua is about 12 per cent, i.e. 12 per cent of women are not using contraceptives but want to stop having children (limit) or postpone the next pregnancy for at least two years (space) (Table RH.4A). Slightly more women are in unmet need for limiting for contraception (6.7 per cent) than in unmet need in for spacing for contraception (5 per cent). 10 A women is postpartum amenorrheic if she had a birth in last two years and is not currently pregnant, and her menstrual period has not returned since the birth of the last child 11 A women is considered infecund if she is neither pregnant nor postpartum amenorrheic, and (1a) has not had menstruation for at least six months, or (1b) never menstruated, or (1c) her last menstruation occurred before her last birth, or (1d) in menopause/has had hysterectomy OR (2) She declares that she has had hysterectomy, or that she has never menstruated or that she is menopausal, or that she has been trying to get pregnant for 2 or more years without result in response to questions on why she thinks she is not physically able to get pregnant at the time of survey OR (3) She declares she cannot get pregnant when asked about desire for future birth OR (4) She has not had a birth in the preceding 5 years, is currently not using contraception and is currently married and was continuously married during the last 5 years preceding the survey MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 75 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 23.0 18.0 18.1 22.6 18.7 30.2 33.3 32.4 19.5 15.7 7.0 2.7 12.3 15.9 26.0 22.2 14.0 16.0 22.8 26.3 22.2 15.7 27.6 24.5 15.4 21.5 20.2 28.9 15.8 24.5 25.1 23.1 0.4 7.5 15.0 25.3 34.0 39.3 33.2 13.9 27.9 25.0 22.0 10.9 28.3 27.3 25.3 29.6 16.8 35.3 27.2 33.9 20.6 23.9 51.9 33.8 42.5 47.8 41.8 30.6 40.8 47.4 44.8 49.7 46.3 36.0 26.3 43.8 51.0 44.2 24.9 44.2 50.0 51.6 51.7 32.5 62.9 51.7 49.3 42.1 44.1 4.7 5.0 5.4 5.2 4.8 14.7 8.7 5.8 5.0 2.6 2.5 1.6 4.0 4.6 4.9 7.6 5.4 5.1 3.9 6.4 4.0 5.7 4.2 3.1 4.2 6.0 5.0 7.4 6.5 5.8 6.8 6.6 3.8 1.2 4.7 5.5 9.8 12.8 8.4 7.3 9.1 5.0 5.2 6.6 9.5 5.9 5.9 6.0 7.4 4.3 7.3 11.7 7.6 6.7 12.1 11.5 11.2 12.1 11.4 18.5 9.9 10.5 10.5 12.5 15.3 10.0 11.3 13.8 9.9 12.9 12.0 14.5 9.8 12.3 10.1 13.1 8.5 10.4 15.9 13.6 11.7 81.1 74.6 79.1 79.8 78.5 62.3 80.5 81.8 81.0 80.0 75.2 78.2 69.8 76.1 83.7 77.5 67.5 75.3 83.6 80.8 83.7 71.3 88.1 83.2 75.7 75.6 79.1 936 615 546 812 1284 99 283 431 382 386 256 258 323 677 873 223 459 376 413 425 423 1,088 573 218 91 125 2,096 598 278 293 486 684 49 143 250 212 240 158 119 121 390 531 127 170 221 247 271 261 496 409 136 60 69 1,170 Table RH.4A: Unmet need for contraception Percentage of women age 15-49 years currently married or in union with an unmet need for family planning and percentage of demand for contraception satisfied, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 For spacing For limiting Total Met need for contraception Unmet need for contraception For spacing For limiting Total Percentage of demand for contraception satisfied Number of women currently married or in union with need for contraception Number of women currently married or in union 76 MULTIPLE INDICATOR CLUSTER SURVEY 2011 8.4. ANTENATAL CARE The antenatal period presents important opportunities for reaching pregnant women with a number of interventions that may be vital to their health and well-being and that of their infants. Better understanding of foetal growth and development and its relationship to the mother’s health has resulted in increased attention to the potential of antenatal care as an intervention to improve both maternal and newborn health. For example, if the antenatal period is used to inform women and families about the danger signs and symptoms and about the risks of labour and delivery, it may provide the route for ensuring that pregnant women do, in practice, deliver with the assistance of a skilled health care provider. The antenatal period also provides an opportunity to supply information on birth spacing, which is recognized as an important factor in improving infant survival. Tetanus immunization during pregnancy can be life-saving for both the mother and infant. The prevention and treatment of malaria among pregnant women, management of anaemia during pregnancy and treatment of STIs can significantly improve foetal outcomes and improve maternal health. Adverse outcomes such as low birth weight can be reduced through a combination of interventions to improve women’s nutritional status and prevent infections (e.g. malaria and STIs) during pregnancy. More recently, the potential of the antenatal period as an entry point for HIV prevention and care, in particular for the prevention of HIV transmission from mother to child, has led to renewed interest in access to and use of antenatal services. WHO recommends a minimum of four antenatal visits based on a review of the effectiveness of different models of antenatal care. WHO guidelines are specific on the content on antenatal care visits, which include: • Blood pressure measurement • Urine testing for bateriuria and proteinuria • Blood testing to detect syphilis and severe anaemia • Weight/height measurement (optional) The type of personnel providing antenatal care to women aged 15-49 years who gave birth in the two years preceding is presented in Table RH.5. Coverage of antenatal care (by a doctor, nurse or midwife) is high in Merauke District (96 per cent) and Biak Numfor District (90 per cent) and low in Jayawijaya District (57 per cent). Within each of the three districts, antenatal care is provided mostly by midwives, followed by doctors. Antenatal care coverage is higher in urban areas (93 per cent) than in rural (73 per cent). Most women who sought antenatal care were older women (34-49 years), had higher education and lived in households among the richest fifth wealth quintile (Figure RH.3). UNICEF and WHO recommend a minimum of at least four antenatal care visits during pregnancy. Table RH.6 shows number of antenatal care visits during the last pregnancy during the two years preceding the survey, regardless of provider, by selected characteristics. About 79 per cent of mothers received antenatal care more than once and 65 per cent of mothers received antenatal care at least four times. The percentage of mothers who received antenatal care at least four times was 90, 36 and 66 per cent in Merauke, Jayawijaya and Biak Numfor districts respectively. Mothers from the poorest households, those with primary education and those whose head of household is Papuan are less likely than more advantaged mothers to receive antenatal care four or more times. For example, 26 per cent of the women living in the poorest households reported four or more antenatal care visits compared with 95 per cent among those living in the richest households. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 77 Figure RH.3: Percentage of women age 15-49 who gave birth in the two years preceding the survey who received antenatal care at least once by skilled personnel, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age Less than 20 20-34 35-49 Education None Primary SMP/SM Higher Wealth quintiles Poorest Second Middle Fourth Richest 0.0 20.0 40.0 60.0 80.0 100.0 Per cent 96 57 90 93 73 74 83 83 39 82 90 98 44 82 95 95 100 The types of services pregnant women received are shown in table RH.7. Among those women who have given birth to a child during the two years preceding the survey, 79 per cent reported that a blood sample was taken during antenatal care visits, 51 per cent reported that their blood pressure was checked, 32 per cent that a urine specimen was taken and for 25 per cent all three tests were made. Women living in Jayawijaya were less likely to have all three tests made. Similarly, women with no education, poor women, younger women (age less than 20 years) and older women (35-49 years) weare also less likely to receive all tests. 78 MULTIPLE INDICATOR CLUSTER SURVEY 2011 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l M o th er ’s a g e at b ir th Le ss t h an 2 0 20 -3 4 35 -4 9 E d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 0. 6 10 .4 5. 5 4. 8 5. 6 4. 6 5. 0 7. 3 8. 0 6. 9 4. 9 0. 7 9. 4 1. 8 6. 6 6. 9 0. 6 7. 0 1. 1 2. 2 (* ) (8 .4 ) 5. 3 0 .0 2. 3 0. 0 0. 0 1. 3 3. 8 0. 4 0. 0 1. 4 1. 9 0. 2 0. 0 3. 3 0. 0 0. 0 0. 0 0. 0 1. 3 0. 0 0. 0 (* ) (0 .0 ) 0. 7 0. 0 1. 3 1. 3 0. 0 1. 5 0. 0 1. 1 0. 3 1. 6 1. 0 0. 7 0. 0 1. 5 1. 2 1. 4 0. 0 0. 0 1. 4 0. 0 0. 0 (* ) (0 .0 ) 0. 8 3 .6 39 .3 8. 6 6. 8 24 .1 22 .2 15 .6 16 .2 57 .8 15 .4 8. 8 1. 9 50 .9 16 .9 3. 6 5. 4 0. 0 27 .2 0. 0 1. 2 (* ) (0 .0 ) 16 .6 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 96 .4 57 .1 90 .1 93 .2 73 .1 74 .0 82 .9 83 .5 39 .3 81 .7 90 .2 98 .1 44 .3 82 .0 95 .0 94 .6 10 0. 0 70 .1 10 0. 0 98 .8 (* ) (9 5. 9) 81 .9 20 4 17 4 16 7 23 7 30 7 70 40 0 74 79 12 2 27 9 64 12 5 10 1 10 2 11 2 10 5 32 2 10 5 58 21 37 54 4 38 .2 21 .8 24 .1 45 .3 15 .7 25 .7 29 .3 28 .0 7. 9 19 .4 31 .2 60 .3 9. 5 20 .8 25 .4 34 .6 55 .5 22 .9 35 .4 42 .4 (* ) (3 3. 4) 28 .6 57 .5 24 .8 60 .5 43 .1 51 .8 43 .7 48 .7 48 .2 23 .4 55 .4 54 .2 37 .1 25 .4 59 .4 62 .9 53 .2 43 .8 40 .3 63 .6 54 .2 (* ) (5 4. 0) 48 .0 Ta b le R H .5 : A n te n at al c ar e co ve ra g e P er c en t d is tr ib u ti o n o f w o m en a g e 15 -4 9 w h o g av e b ir th in t h e tw o y ea rs p re ce d in g t h e su rv ey b y ty p e o f p er so n n el p ro vi d in g a n te n at al c ar e d u ri n g t h e p re g n an cy f o r th e la st b ir th , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 D o ct o r M id w if e P er so n p ro vi d in g a n te n at al c ar e N u rs e Tr ad it io n al b ir th at te n d an t To ta l A n y sk ill ed p er so n n el 1 N u m b er o f w o m en w h o g av e b ir th in th e p re ce d in g tw o y ea rs C o m m u n it y h ea lt h w o rk er N o a n te n at al ca re r ec ei ve d ( ) Fi g u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es 1 M IC S in d ic at o r 5. 5a ; M D G in d ic at o r 5. 5 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 79 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l M o th er ’s a g e at b ir th Le ss t h an 2 0 20 -3 4 35 -4 9 E d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 3. 3 8. 4 6. 8 4. 2 7. 4 7. 9 5. 8 5. 4 4. 3 9. 9 5. 4 3. 4 8. 0 8. 0 6. 7 6. 4 0. 7 9. 1 1. 0 1. 4 (* ) (3 .9 ) 6. 0 1 .3 10 .8 13 .5 4. 8 10 .5 8. 5 8. 0 7. 7 10 .3 10 .7 6. 6 6. 7 10 .5 7. 3 14 .5 4. 7 3. 2 12 .3 0. 0 7. 0 (* ) (0 .0 ) 8. 1 89 .6 36 .0 65 .7 80 .7 53 .1 57 .0 67 .0 62 .9 18 .6 60 .6 75 .9 84 .2 25 .8 64 .5 67 .7 78 .9 95 .4 44 .6 97 .9 90 .4 (* ) (9 2. 0) 65 .2 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 20 4 17 4 16 7 23 7 30 7 70 40 0 74 79 12 2 27 9 64 12 5 10 1 10 2 11 2 10 5 32 2 10 5 58 21 37 54 4 3. 6 39 .3 8. 6 6. 8 24 .1 22 .2 15 .6 16 .2 57 .8 15 .4 8. 8 1. 9 50 .9 16 .9 3. 6 5. 4 0. 0 27 .2 0. 0 1. 2 (* ) (4 .1 ) 16 .6 2 .1 5. 6 5. 4 3. 5 4. 8 4. 4 3. 5 7. 8 9. 0 3. 4 3. 3 3. 8 4. 8 3. 4 7. 5 4. 7 0. 7 6. 8 1. 1 0. 0 (* ) (0 .0 ) 4. 2 Ta b le R H .6 : N u m b er o f an te n at al c ar e vi si ts P er c en t d is tr ib u ti o n o f w o m en w h o h ad a li ve b ir th d u ri n g t h e tw o y ea rs p re ce d in g t h e su rv ey b y n u m b er o f an te n at al c ar e vi si ts b y an y p ro vi d er , D is tr ic ts o f M er au ke , Ja ya w ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 N o a n te n et al ca re v is it s O n e vi si t P er c en t d is tr ib u ti o n o f w o m en w h o h ad : Tw o vi si ts T h re e v is it s N u m b er o f w o m en w h o h ad a li ve b ir th in t h e p re ce d in g t w o y ea rs 4 o r m o re vi si ts 1 To ta l ( ) Fi g u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es 1 M IC S in d ic at o r 5. 5b ; M D G in d ic at o r 5. 5 80 MULTIPLE INDICATOR CLUSTER SURVEY 2011 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l M o th er ’s a g e at b ir th Le ss t h an 2 0 20 -3 4 35 -4 9 E d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 69 .2 30 .6 50 .7 59 .3 45 .0 44 .3 53 .2 47 .0 20 .6 48 .6 58 .2 63 .5 22 .7 44 .6 66 .8 64 .2 62 .6 40 .2 71 .4 56 .7 (* ) (7 0. 5) 51 .2 40 .3 12 .0 18 .6 30 .3 20 .2 18 .3 26 .7 19 .2 5. 4 23 .2 28 .1 35 .6 6. 2 20 .7 29 .6 33 .0 36 .5 14 .2 48 .6 32 .7 (* ) (2 5. 7) 24 .6 20 4 17 4 16 7 23 7 30 7 70 40 0 74 79 12 2 27 9 64 12 5 10 1 10 2 11 2 10 5 32 2 10 5 58 21 37 54 4 91 .7 56 .1 88 .9 92 .6 69 .2 73 .5 80 .7 78 .2 36 .5 75 .5 89 .2 97 .0 41 .4 77 .2 93 .6 91 .7 10 0. 0 66 .8 99 .0 98 .8 (* ) (9 1. 8) 79 .4 48 .6 20 .3 24 .9 41 .3 25 .3 22 .2 34 .1 32 .2 10 .0 31 .0 36 .0 46 .0 9. 3 28 .0 34 .3 44 .7 48 .6 19 .2 56 .2 48 .6 (* ) (3 9. 7) 32 .3 Ta b le R H .7 : C o n te n t o f an te n at al c ar e P er ce n ta g e o f w o m en a g e 15 -4 9 ye ar s w h o h ad t h ei r b lo o d p re ss u re m ea su re d , u ri n e sa m p le t ak en , a n d b lo o d s am p le t ak en a s p ar t o f an te n at al c ar e, D is tr ic ts o f M er au ke , Ja ya w ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 B lo o d p re ss u re m ea su re d U ri n e sa m p le ta ke n P er ce n ta g e o f p re g n an t w o m en w h o h ad : B lo o d s am p le ta ke n B lo o d p re ss u re m ea su re d , u ri n e an d b lo o d s am p le t ak en 1 N u m b er o f w o m en w h o h ad a li ve b ir th in t h e p re ce d in g t w o y ea rs ( ) Fi g u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es 1 M IC S in d ic at o r 5. 6 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 81 8.5. MALARIA TESTING AND PROTECTION DURING ANTENATAL CARE VISIT Pregnant women are particularly vulnerable to malaria as pregnancy reduces a woman’s immunity to malaria, making her more susceptible to malaria infection and increasing the risk of illness, severe anaemia and death. For the unborn child, maternal malaria increases the risk of spontaneous abortion, stillbirth, premature delivery and low birth weight - a leading cause of child mortality.12 District Merauke Jayawijaya Biak Numfor Area Urban Rural Education of household head None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 204 174 167 237 307 79 122 279 64 125 101 102 112 105 322 105 58 21 37 544 23.4 7.9 56.2 41.2 33.2 21.5 27.7 40.0 42.0 24.0 22.1 43.5 41.2 41.1 44.6 24.2 44.0 37.3 17.6 36.6 71.7 88.7 42.1 58.8 60.9 78.5 61.8 58.8 58.0 61.2 74.3 50.4 58.8 58.9 50.1 75.8 56.0 62.7 74.6 60.0 4.8 3.4 0.8 0.0 5.1 0.0 10.6 0.5 0.0 14.8 3.5 4.4 0.0 0.0 4.4 0.0 0.0 0.0 7.8 2.9 98 18 92 90 118 6 52 122 28 15 43 54 48 49 103 50 22 13 19 208 47.9 10.4 55.5 37.7 38.6 8.0 42.3 43.6 44.2 11.8 42.5 53.0 43.0 46.1 32.0 47.8 38.1 62.8 51.7 38.2 49.7 10.5 56.7 32.5 54.0 14.0 49.0 46.9 34.7 24.7 55.9 55.7 42.2 33.1 43.5 49.4 21.1 54.7 54.0 43.4 Table RH.8: Malaria testing and protection during antenatal care visit Percentage of women age 15-49 years who had a live birth during the two years preceding the survey who were tested for malaria and who received an ITN during any antenatal care visit by malaria test result, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Percentage of pregnant women whose malaria test was: Number of women who had a live birth in the two years preceeding the survey Positive (malaria present) Negative (no malaria) DK/ Missing Number of women who had a live birth in the last two years and who received antenatal care and recieved malaria test Percentage of women who received antenatal care (ANC) and had malaria blood test Percentage of women who received an ITN during antenatal visit 12 http://www.who.int/features/2003/04b/en/ 82 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Based on available evidence, WHO recommends a three-pronged approach to the prevention and management of malaria during pregnancy: • Insecticide-treated nets (ITNs) • Intermittent preventive treatment • Effective case management of malarial illness. In Indonesia, especially in malaria endemic areas, there is a policy to conduct a rapid diagnostic test (RDT) for malaria during antenatal visits. Insecticide-treated nets (ITNs) are also distributed to all pregnant women during the first antenatal visit. Furthermore, anti malarial drug is given to those pregnant mothers with positive malaria blood test results. At the request of the Ministry of Health MICS in selected districts of Papua incorporated additional questions designed to assess the implementation of this policy. Table RH.8 shows that 38 per cent of women in the three selected districts of Papua Province who received antenatal care had a malaria blood test. The percentage is higher in Biak Numfor (56 per cent) and Merauke districts (48 per cent) but lower in Jayawijaya District (10 per cent). However, among those who received malaria tests, Jayawijaya District has the lowest percentage of women whose blood tested positive for malaria (8 per cent), while in Merauke and Biak Numfor districts, there were 36 per cent and 56 per cent respectively. Sleeping under ITNs is an important measure for protecting pregnant women and their newborns from malaria-carrying mosquitoes. The percentage of women who received an ITN during antenatal visit in the three selected districts of Papua was reported as 43 per cent. The percentage was the highest in Biak Numfor District (57 per cent) followed by Merauke District (50 per cent) and the lowest was Jayawijaya District (11 per cent). Table RH.9 shows that of those women whose blood tested positive for malaria, 12 per cent were given any anti-malarial drug in the three selected districts. By district the percentages were 28, 8 and 1 per cent in Biak Numfor, Merauke and Jayawijaya. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 83 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l E d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 96 .4 57 .1 90 .1 93 .2 73 .1 39 .3 81 .7 90 .2 98 .1 44 .3 82 .0 95 .0 94 .6 10 0. 0 70 .1 10 0. 0 98 .8 10 0. 0 95 .9 81 .9 0. 0 0. 0 2. 6 0. 5 1. 0 0. 0 0. 6 1. 2 0. 0 0. 0 0. 8 1. 1 1. 4 0. 7 0. 8 0. 0 0. 0 3. 8 2. 1 0. 8 1. 3 0. 1 1. 6 1. 1 0. 9 0. 0 2. 1 1. 0 0. 0 0. 2 0. 0 1. 0 3. 7 0. 0 0. 9 1. 4 0. 0 0. 0 2. 8 1. 0 0. 0 0. 0 1. 9 0. 7 0. 4 0. 0 0. 0 0. 8 1. 3 0. 0 0. 7 1. 5 0. 8 0. 0 1. 0 0. 0 0. 0 0. 0 0. 0 0. 6 0. 0 0. 0 2. 0 0. 6 0. 6 0. 0 0. 5 0. 5 2. 2 0. 0 1. 1 0. 8 1. 2 0. 0 0. 6 0. 0 0. 0 6. 6 0. 0 0. 6 2. 0 0. 4 7. 2 2. 8 3. 3 0. 0 1. 2 3. 8 6. 9 1. 1 0. 7 8. 5 0. 8 4. 7 3. 7 3. 8 1. 3 0. 0 0. 0 3. 1 0. 7 0. 0 0. 5 0. 6 0. 3 0. 0 0. 0 0. 8 0. 0 0. 0 0. 0 0. 9 0. 0 1. 3 0. 3 1. 3 0. 0 0. 0 0. 0 0. 4 0. 0 0. 0 0. 6 0. 0 0. 3 0. 0 0. 8 0. 0 0. 0 0. 0 0. 0 0. 9 0. 0 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 0. 2 0. 0 0. 0 1. 3 0. 7 0. 2 0. 0 0. 0 0. 8 0. 0 0. 0 0. 0 0. 6 0. 8 0. 6 0. 4 0. 6 0. 0 0. 0 0. 0 0. 4 0. 5 0. 0 8. 0 2. 3 2. 9 0. 0 3. 3 2. 6 4. 7 0. 0 1. 7 9. 2 2. 1 1. 1 3. 9 1. 7 0. 0 0. 0 0. 0 2. 7 2 .6 0. 0 10 .2 4. 7 3. 6 1. 7 4. 2 4. 3 6. 1 0. 0 3. 6 8. 4 3. 9 5. 5 4. 7 2. 6 2. 3 9. 2 2. 8 4. 1 2 04 17 4 16 7 23 7 30 7 79 12 2 27 9 64 12 5 10 1 10 2 11 2 10 5 32 2 10 5 58 21 37 54 4 7. 6 1. 2 28 .0 12 .0 11 .6 1. 7 9. 8 13 .9 18 .6 2. 3 7. 9 21 .6 13 .5 15 .5 13 .2 10 .1 5. 9 19 .0 9. 1 11 .8 0. 0 0. 0 0. 7 0. 5 0. 0 0. 0 0. 0 0. 4 0. 0 0. 0 0. 0 1. 1 0. 0 0. 0 0. 4 0. 0 0. 0 0. 0 0. 0 0. 2 1. 3 0. 7 8. 8 3. 5 3. 3 0. 0 2. 9 3. 9 6. 4 1. 0 1. 8 5. 0 3. 2 6. 6 4. 5 2. 6 1. 2 3. 2 0. 0 3. 4 Ta b le R H .9 : T re at m en t fo r m al ar ia P er ce n ta g e o f w o m en a g e 15 -4 9 ye ar s w h o h ad a li ve b ir th d u ri n g t h e tw o y ea rs p re ce d in g t h e su rv ey , w h o r ec ei ve d a n te n at al c ar e (A N C ) an d w h o se b lo o d t es te d p o si ti ve f o r m al ar ia , b y ty p e o f m ed ic in e g iv en d u ri n g t h e vi si t, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 P er ce n ta g e o f w o m en w h o re ce iv ed an te n at al ca re ( A N C ) Q u in in e- K in a A rt er ak in / A rt ek in A rs u a- m o n A rt es d i- aq u in e P er c en t o f w o m en ( cu rr en tl y m ar ri ed o r in u n io n ) w h o a re u si n g : O th er an ti - m al ar ia l A n ti b io ti c: P ill / S yr u p N u m b er o f w o m en w h o g av e b ir th in t h e p re ce d in g tw o y ea rs P ar ac et am o l/ P an ad o l/ A ce ta m in o - p h en A n ti b io ti c: In je ct io n O th er Ib u p ro - fe n A n y m ed ic in e to p re ve n t m al ar ia a t an y A N C vi si t d u ri n g p re g n an cy S P /F an - si d ar C h lo ro - q u in e 84 MULTIPLE INDICATOR CLUSTER SURVEY 2011 8.6. ASSISTANCE AT DELIVERY Three quarters of all maternal deaths occur during delivery and the immediate post- partum period. The single most critical intervention for safe motherhood is to ensure a competent health worker with midwifery skills is present at every birth, and transport is available to a referral facility for obstetric care in case of emergency. A World Fit for Children goal is to ensure that women have ready and affordable access to skilled attendance at delivery. The indicators are the proportion of births with a skilled attendant and proportion of institutional deliveries. The skilled attendant at delivery indicator is also used to track progress toward the Millennium Development target of reducing the maternal mortality ratio by three quarters between 1990 and 2015. The MICS included a number of questions to assess the proportion of births attended by a skilled attendant. A skilled attendant includes a doctor, nurse or midwife. About 67 per cent of births occurring in the two years preceding the MICS survey were delivered by skilled personnel (Doctor, 17 per cent; Nurse, 47 per cent; Midwife, 3 per cent) (Table RH.8). The percentages of babies who were delivered by skilled personnel were 86, 36 and 77 per cent in Merauke, Jayawijaya and Biak Numfor districts respectively. These deliveries were mostly assisted by midwives. Delivery by skilled personnel is higher among women who delivered in a public sector health facility (100 per cent) than among women who delivered at home (42 per cent). Rural, uneducated, poorest women and women from households with Papuan heads are less likely to be assisted by skilled personnel. 8.7. PLACE OF DELIVERY Increasing the proportion of births that are delivered in health facilities is an important factor in reducing the health risks to both the mother and the baby. Proper medical attention and hygienic conditions during delivery can reduce the risks of complications and infection that can cause morbidity and mortality to either the mother or the baby. Table RH.10 presents the percentage distribution of women age 15-49 that had a live birth in the two years preceding the survey by place of delivery, and the percentage of births delivered in a health facility, according to background characteristics. About 45 per cent of births in the three selected districts of Papua Province were delivered in a health facility. The percentages of babies who were delivered in a health facility were 61, 28 and 43 per cent in Merauke, Jayawijaya and Biak Numfor districts respectively. Delivery in a health facility was highest among women who had four or more visits (59 per cent) compared with only eight per cent among women with no education. Rural, uneducated, poorest women and women from households with Papuan heads are were less likely to give birth in a health facility. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 85 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l M o th er ’s a g e at b ir th Le ss t h an 2 0 20 -3 4 35 -4 9 P la ce o f d el iv er y P u b lic s ec to r h ea lt h f ac ili ty P ri va te s ec to r h ea lt h f ac ili ty H o m e O th er E d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 20 .9 13 .2 17 .4 28 .5 8. 7 13 .2 17 .0 23 .3 45 .5 (1 1. 1) 0. 7 (* ) 7. 2 12 .5 17 .2 39 .6 6. 5 14 .4 13 .2 21 .6 32 .7 15 .4 15 .5 19 .0 (* ) (1 7. 4) 17 .4 0. 7 0. 6 9. 0 0. 0 5. 7 4. 0 3. 5 0. 9 0. 0 (0 .0 ) 5. 9 (* ) 1. 3 5. 3 3. 3 1. 1 2. 5 8. 1 5. 5 0. 6 0. 0 5. 4 0. 0 0. 0 (* ) (0 .0 ) 3. 2 4. 1 53 .2 6. 1 9. 6 28 .8 33 .1 19 .3 14 .5 0. 0 (0 .0 ) 37 .1 (* ) 66 .7 21 .5 10 .8 3. 6 66 .9 11 .7 7. 5 6. 0 1. 6 32 .8 2. 5 2. 9 (* ) (0 .0 ) 20 .4 0. 6 1. 3 0. 5 0. 5 1. 0 0. 0 0. 9 0. 8 0. 0 (0 .0 ) 1. 4 (* ) 2. 4 0. 9 0. 1 1. 2 2. 7 0. 0 0. 0 0. 7 0. 0 1. 3 0. 0 0. 0 (* ) (0 .0 ) 0. 8 0. 0 7. 0 0. 0 2. 3 2. 2 1. 1 1. 3 8. 6 0. 0 (0 .0 ) 4. 1 (* ) 10 .2 2. 1 0. 6 0. 0 5. 0 3. 8 2. 0 0. 0 0. 0 3. 8 0. 0 0. 0 (* ) (0 .0 ) 2. 2 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 (1 00 .0 ) 10 0. 0 (* ) 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 (* ) (1 00 .0 0) 10 0. 0 85 .7 35 .6 77 .3 83 .7 54 .3 56 .7 68 .8 67 .8 10 0. 0 (9 5. 0) 41 .9 (* ) 17 .8 61 .2 78 .6 89 .2 18 .0 64 .6 76 .5 89 .3 95 .1 50 .4 89 .5 92 .4 (* ) (9 3. 8) 67 .1 2 04 17 4 16 7 23 7 30 7 70 40 0 74 19 0 53 29 7 3 79 12 2 27 9 64 12 5 10 1 10 2 11 2 10 5 32 2 10 5 58 21 37 54 4 64 .1 18 .2 56 .4 52 .5 42 .9 39 .3 49 .3 42 .3 52 .1 (8 3. 9) 37 .8 (* ) 9. 5 47 .1 57 .2 48 .9 10 .0 45 .8 59 .1 64 .1 62 .4 31 .2 71 .4 73 .4 (* ) (4 7. 1) 47 .1 0. 7 4. 2 3. 6 2. 8 2. 7 4. 3 2. 5 2. 2 2. 4 (0 .0 ) 3. 4 (* ) 1. 1 1. 6 4. 1 0. 7 1. 5 4. 4 4. 3 3. 6 0. 0 3. 8 2. 5 0. 0 (* ) (0 .0 ) 2. 7 8. 9 2. 2 7. 1 3. 9 8. 0 5. 1 6. 2 7. 3 0. 0 (5 .0 ) 9. 6 (* ) 1. 6 8. 9 6. 6 4. 9 4. 9 11 .8 8. 5 3. 4 3. 3 6. 3 8. 1 4. 7 (* ) (6 .2 ) 6. 2 Ta b le R H .1 0: A ss is ta n ce d u ri n g d el iv er y P er c en t d is tr ib u ti o n o f w o m en a g e 15 -4 9 w h o h ad a li ve b ir th in t h e tw o y ea rs p re ce d in g t h e su rv ey b y p er so n a ss is ti n g a t d el iv er y, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 N o at te n d an t O th er / m is si n g R el at iv e / Fr ie n d C o m m u n it y h ea lt h w o rk er Tr ad it io n al b ir th at te n d an t N u rs e M id w if e D o ct o r P er so n a ss is ti n g a t d el iv er y To ta l D el iv er y as si st ed b y an y sk ill ed at te n d an t1 N u m b er o f w o m en w h o h ad a li ve b ir th in p re ce d in g t w o ye ar s ( ) Fi g u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es (* ) Fi g u re s th at a re b as ed o n le ss fe w er t h an 2 5 u n w ei g h te d c as es 1 M IC S in d ic at o r 5. 7; M D G in d ic at o r 5. 2; MULTIPLE INDICATOR CLUSTER SURVEY 201186 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Mother’s age at birth Less than 20 20-34 35-49 Number of antenatal care visits None 1-3 visits 4+ visits Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 37.7 71.9 57.4 26.1 76.8 57.1 54.3 54.3 92.0 71.4 40.5 87.7 69.9 46.6 20.4 88.4 63.2 65.5 37.3 14.5 66.8 44.9 27.0 (*) (27.0) 54.6 1.2 0.5 0.0 1.0 0.3 0.0 0.8 0.0 0.0 0.0 0.9 0.0 0.0 1.2 0.0 0.7 0.0 1.2 1.2 0.0 0.3 1.2 2.0 (*) (0.0) 0.6 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 61.1 27.6 42.6 72.9 22.9 42.9 44.9 45.7 8.0 28.6 58.6 12.3 30.1 52.2 79.6 10.9 36.8 33.4 61.5 85.5 32.9 53.8 71.0 (*) (73.0) 44.7 204 174 167 237 307 70 400 74 90 99 354 79 122 279 64 125 101 102 112 105 322 105 58 21 37 544 45.7 25.3 31.8 50.7 22.7 34.6 34.1 39.6 6.5 28.6 43.9 12.3 27.7 39.2 57.7 10.9 36.1 32.4 50.9 47.7 31.9 24.5 47.9 (*) (57.8) 34.9 15.4 2.3 10.8 22.2 0.2 8.2 10.8 6.0 1.5 0.0 14.7 0.0 2.4 13.0 21.9 0.0 0.7 1.0 10.6 37.8 1.1 29.4 23.0 (*) (15.2) 9.8 Table RH.11: Place of delivery Per cent distribution of women age 15-49 who had a live birth in two years preceding the survey by place of delivery, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Place of delivery Home Other Total Delivered in health facility1 Number of women who had a live birth in preceding two years Public sector health facility Private sector health facility ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 5.8 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 87MULTIPLE INDICATOR CLUSTER SURVEY 2011 9 LITERACY AND EDUCATION 9.1. LITERACY AMONG YOUNG WOMEN AND MEN One of the World Fit for Children goals is to assure adult literacy. Adult literacy is also an MDG indicator, relating to both men and women. In MICS, since only a women’s questionnaire was administered, the results are based only on females age 15-24. Literacy was assessed on the ability of women to read a short simple statement or on school attendance. The per cents literate are presented in Table ED.1. District Merauke Jayawijaya Biak Numfor Area Urban Rural Education None Primary SMP/SM Higher Age 15-19 20-24 Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 90.2 60.2 90.3 95.0 72.5 2.4 45.7 98.6 100.0 82.5 83.0 45.7 74.6 89.4 96.3 99.2 72.4 97.4 99.2 95.2 91.8 82.7 365 217 283 393 471 67 141 545 111 462 403 159 144 163 208 191 501 195 83 45 40 865 Table ED.1: Literacy among young women Percentage of women age 15-24 years who are literate, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 1 MICS indicator 7.1; MDG indicator 2.3 Number of women age 15-24 yearsPercentage literate1 88 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Table ED.1 indicates that 83 per cent of women age 15-24 in the three districts of Papua are literate with the lowest percentage in Jayawijaya District (60 per cent) compared with 90 per cent each in Merauke and Biak Numfor districts. Literacy status varies greatly by area of residence (Urban, 95 per cent; Rural, 73 per cent). Of women who stated that primary school was their highest level of education, just 46 per cent were actually able to read the statement shown to them. Four per cent of women who stated that junior secondary school was their highest level of education were not able to read the statement shown. Literacy among young women is positively associated with the wealth index. Only 46 per cent of women living in the poorest households are literate compared with 99 per cent of women living in the richest ones. Literacy rate was lowest among women who live in household with Papuan head of households. Table ED.1M shows that literacy among men 15-24 (88 per cent) is slightly higher than literacy among women (83 per cent). Literacy rates among the three districts are similar to those among women except that in Jayawijaya District (72 per cent) more men are literate than women (60 per cent). Similarly, more men from households with Papuan heads are literate (83 per cent) than women (72 per cent). District Merauke Jayawijaya Biak Numfor Area Urban Rural Education None Primary SMP/SM Higher Age 15-19 20-24 Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 92.4 71.8 92.2 95.8 81.6 0.0 58.5 98.6 (100.0) 88.5 88.0 60.1 87.4 91.0 96.8 99.2 83.0 97.0 (*) (*) (*) 88.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 (0.0) 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 (*) (*) (*) 0.0 327 146 278 356 395 24 136 512 78 420 330 121 141 165 169 155 439 168 67 38 39 751 Table ED.1M: Literacy among young men Percentage of men age 15-24 years who are literate, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 1 MICS indicator 7.1; MDG indicator 2.3 Percentage not known Number of men age 15-24 years Percentage literate1 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 89 9.2. SCHOOL READINESS Attendance of pre-school education in an organised learning or child education programme is important for the readiness of children to attend school. Table ED.2 shows the proportion of children in the first grade of primary school who attended pre-school the previous year. Overall, 32 per cent of children who are currently attending the first grade of primary school were attending pre-school the previous year (Merauke, 48 per cent; Jayawijaya, 13 per cent; Biak Numfor, 29 per cent). The proportion among females is slightly higher (35 per cent) than males (29 per cent). Socioeconomic status appears to have a positive correlation with school readiness – among the richest households, the percentage of children who are currently attending the first grade of primary school who were attending pre-school the previous year is 70 per cent while the indicator is only 8 per cent among the poorest households. There was a clear trend linking pre-school attendance with mother’s education (No education, 16 per cent; Primary, 28 per cent; Secondary, 40 per cent, Higher, 44 per cent). District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 48.3 12.5 29.2 29.2 34.9 48.0 22.6 15.7 27.7 39.6 44.1 8.4 21.4 30.3 47.3 70.2 (*) (*) (*) (*) (*) 31.8 170 127 142 238 202 159 280 54 173 177 30 93 113 98 74 61 296 77 28 19 20 439 Table ED.2: School readiness Percentage of children attending first grade of primary school who attended pre-school the previous year, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 1 MICS indicator 7.2 Number of children attending first grade of primary school Percentage of children attending first grade who attended preschool in previous year1 (*) Figures that are based on fewer than 25 unweighted cases 90 MULTIPLE INDICATOR CLUSTER SURVEY 2011 9.3. PRIMARY AND SECONDARY SCHOOL PARTICIPATION Universal access to basic education and the achievement of primary education by the world’s children is one of the most important goals of the Millennium Development Goals and A World Fit for Children. Education is a vital prerequisite for combating poverty, empowering women, protecting children from hazardous and exploitative labour and sexual exploitation, promoting human rights and democracy, protecting the environment, and influencing population growth. The indicators for primary and secondary school attendance include: • Net intake rate in primary education • Primary school net attendance ratio (adjusted) • Secondary school net attendance ratio (adjusted) • Female to male education ratio (or gender parity index - GPI) in primary and secondary school The indicators of school progression include: • Children reaching last grade of primary • Primary completion rate • Transition rate to secondary school Of children who are of primary school entry age (age 7) in the three selected districts of Papua Province, 71 per cent are attending the first grade of primary school (Table ED.3) with more males attending (74 per cent) than females (68 per cent). Significant differentials are present by districts and area of residence. Attendance is highest in Merauke (73 per cent) and lowest in Jayawijaya (70 per cent). Children’s participation to primary school is higher in urban areas (76 per cent) than in rural areas (69 per cent). A positive correlation between mother’s education and socioeconomic status is observed; for children age 7 whose mothers have at least secondary school education, 70 per cent were attending the first grade, compared with 60 for children whose mothers have no education. In the richest households, this percentage is around 69 per cent, while it is only 51 per cent among children living in the poorest households. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 91 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 73.0 69.1 70.7 74.4 67.6 76.2 68.1 60.0 72.4 74.4 70.2 51.2 77.2 73.6 83.4 69.0 68.0 83.7 62.2 65.0 93.0 71.2 130 92 92 166 147 121 193 49 100 142 22 63 72 66 64 48 201 55 23 21 13 314 Table ED.3: Primary school entry Percentage of children of primary school entry age entering grade 1 (net intake rate), Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of children of primary school entry age Percentage of children of primary school entry age entering grade 11 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 7.3 Table ED.4 provides the percentage of children of primary school age (7 to 12 years) who are attending primary or secondary school. The majority of children of primary school age in the three selected districts are attending school (92 per cent) (Merauke, 97 per cent; Jayawijaya, 82 per cent; Biak Numfor, 96 per cent). However, 8 per cent of the children are out of school when they are expected to be participating in school. Mothers’ education is associated with primary or secondary school attendance of children of primary school age, increasing from 73 per cent for mothers with no education to 93 per cent for mothers with primary education, to 98 per cent for those who have secondary education and to 99 per cent for those with higher education. In urban areas 97 per cent of children attend school while in rural areas attendance is 90 per cent. The secondary school net attendance ratio is presented in Table ED.5. Only 68 per cent of children of secondary school age (13 to 18 years) are attending secondary school. 92 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age at beginning of school year 7 8 9 10 11 12 Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 97.5 80.3 95.0 96.0 89.7 89.0 92.3 92.4 93.9 91.9 92.2 70.4 93.7 96.9 97.8 76.7 91.2 96.9 99.5 98.9 87.8 98.3 100.0 (96.7) (97.8) 91.9 382 259 285 322 604 166 166 141 159 169 125 135 351 364 77 205 212 197 155 158 567 181 82 40 56 926 95.4 83.3 97.8 98.0 90.0 88.2 95.1 92.8 92.3 96.9 92.1 75.8 92.9 98.7 100.0 75.3 95.1 95.6 98.8 100.0 89.3 99.1 97.9 (100.0) (99.0) 93.0 333 236 297 323 544 147 160 132 131 152 145 134 346 312 75 167 189 192 175 144 542 172 63 39 53 867 96.5 81.7 96.4 97.0 89.8 88.6 93.7 92.6 93.2 94.2 92.1 73.1 93.3 97.7 98.9 76.1 93.1 96.2 99.1 99.4 88.5 98.7 99.1 98.3 98.4 92.4 716 495 583 645 1,148 314 326 273 289 321 270 269 696 675 153 372 401 389 330 302 1,108 353 145 79 109 1,793 Table ED.4: Primary school attendance Percentage of children of primary school age attending primary or secondary school (adjusted net attendance ratio), Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 1 MICS indicator 7.4; MDG indicator 2.1 Net attendance ratio (adjusted) Male Female Total Net attendance ratio (adjusted) Net attendance ratio (adjusted)1 Number of children Number of children Number of children ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 93 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l A g e at b eg in n in g o f sc h o o l ye ar 13 14 15 16 17 18 M o th er ’s e d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er C an n o t b e d et er m in ed W ea lt h in d ex q u in ti le P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 65 .1 56 .5 75 .2 80 .8 55 .2 70 .9 66 .0 67 .3 64 .3 67 .3 64 .2 40 .6 60 .4 84 .6 (9 0. 2) 62 .1 37 .5 52 .9 62 .5 85 .7 93 .2 62 .1 67 .8 84 .9 (* ) (* ) 66 .8 76 .0 51 .7 75 .6 82 .9 60 .0 71 .5 76 .7 80 .8 71 .1 58 .6 55 .7 47 .5 69 .6 83 .4 (9 1. 6) 54 .1 38 .5 62 .4 67 .9 81 .0 95 .0 61 .9 80 .7 88 .0 (8 6. 6) (7 4. 2) 69 .8 70 .5 54 .1 75 .4 81 .8 57 .6 71 .1 71 .4 73 .8 67 .6 62 .8 60 .2 43 .6 64 .9 84 .0 90 .9 58 .1 38 .0 57 .6 64 .8 83 .3 94 .1 62 .0 74 .4 86 .4 87 .7 (7 3. 3) 68 .3 6. 5 8. 3 11 .3 3. 3 13 .2 18 .0 11 .4 8. 3 7. 8 1. 5 0. 9 12 .8 15 .4 4. 9 (2 .8 ) 0. 8 15 .9 10 .4 11 .8 6. 1 0. 0 12 .4 3. 8 0. 0 (* ) (* ) 8. 7 5. 9 5. 5 5. 0 1. 1 8. 8 13 .6 11 .1 2. 8 0. 0 1. 3 1. 2 11 .4 9. 8 2. 2 (0 .0 ) 0. 9 10 .4 9. 4 5. 5 2. 7 0. 0 7. 2 2. 6 0. 0 (0 .0 ) (1 0. 0) 5. 5 6. 2 6. 9 8. 3 2. 3 11 .0 16 .0 11 .3 5. 6 4. 0 1. 4 1. 0 12 .2 12 .6 3. 5 1. 5 0. 8 13 .1 9. 9 9. 1 4. 3 0. 0 10 .0 3. 2 0. 0 0. 0 (5 .4 ) 7. 2 27 0 16 5 26 0 31 6 37 8 13 8 13 2 11 3 11 2 10 2 96 10 1 23 1 19 6 51 11 5 11 9 14 9 15 1 13 5 13 9 45 6 10 6 72 26 35 69 4 26 4 16 5 22 8 28 1 37 6 11 5 13 5 10 4 10 7 11 0 85 76 22 5 19 8 40 11 7 12 0 14 3 11 3 14 8 13 3 40 4 10 9 68 34 41 65 7 53 4 33 0 48 7 59 7 75 4 25 4 26 8 21 8 21 9 21 2 18 1 17 8 45 6 39 4 91 23 2 23 9 29 2 26 5 28 4 27 2 86 0 21 4 14 0 60 76 1, 35 1 Ta b le E D .5 : S ec o n d ar y sc h o o l a tt en d an ce P er ce n ta g e o f ch ild re n o f se co n d ar y sc h o o l a g e at te n d in g s ec o n d ar y sc h o o l o r h ig h er ( ad ju st ed n et a tt en d an ce r at io ) an d p er ce n ta g e o f ch ild re n a tt en d in g p ri m ar y sc h o o l, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 1 M IC S in d ic at o r 7. 5 To ta l Fe m al e M al e N et at te n d an ce ra ti o (a d ju st ed )1 N et at te n d an ce ra ti o (a d ju st ed )1 N et at te n d an ce ra ti o (a d ju st ed )1 P er c en t at te n d in g p ri m ar y sc h o o l P er c en t at te n d in g p ri m ar y sc h o o l P er c en t at te n d in g p ri m ar y sc h o o l N u m b er o f ch ild re n N u m b er o f ch ild re n N u m b er o f ch ild re n ( ) Fi g u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es 94 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 100.0 99.8 99.8 100.0 99.3 99.3 100.0 100.0 100.0 100.0 100.0 100.0 99.0 100.0 100.0 100.0 99.6 100.0 100.0 100.0 100.0 99.8 99.4 99.6 99.9 100.0 99.7 100.0 99.6 100.0 99.8 99.5 100.0 99.6 100.0 99.3 100.0 100.0 99.6 100.0 100.0 100.0 100.0 99.7 100.0 99.5 100.0 100.0 98.8 100.0 99.6 97.9 100.0 100.0 100.0 98.4 100.0 100.0 100.0 100.0 99.5 100.0 100.0 100.0 100.0 99.7 98.6 98.1 99.5 100.0 96.3 98.2 99.1 94.2 98.6 100.0 100.0 100.0 96.9 97.9 100.0 100.0 97.9 100.0 100.0 100.0 100.0 98.8 99.2 99.4 98.9 98.6 100.0 99.2 99.2 97.9 98.7 100.0 100.0 100.0 98.7 97.5 100.0 100.0 98.6 100.0 100.0 100.0 100.0 99.2 97.3 96.5 98.0 98.6 94.2 96.7 97.5 90.3 97.2 99.5 100.0 98.0 94.7 94.8 100.0 100.0 95.4 100.0 100.0 100.0 100.0 97.2 Table ED.6: Children reaching last grade of primary school Percentage of children entering first grade of primary school who eventually reach the last grade of primary school (Survival rate to last grade of primary school), Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 1MICS indicator 7.6; MDG indicator 2.2 Per cent attending grade 1 last year who are in grade 2 this year Per cent attending grade 3 last year who are attending grade 4 this year Per cent attending grade 5 last year who are attending grade 6 this year Per cent attending grade 2 last year who are attending grade 3 this year Per cent attending grade 4 last year who are attending grade 5 this year Per cent who reach grade 6 of those who enter grade 11 The results show a clear association between mothers’ education and wealth on secondary school net attendance ratio. For the three selected districts, this ratio is 44 per cent for children whose mothers are uneducated and increases to 91 per cent for children whose mothers education is higher than secondary. Moreover, secondary school net attendance ratio increased from 38 per cent in the poorest households to 94 per cent in the richest households. The percentage of children entering first grade who eventually reach the last grade of primary school is presented in Table ED.6. Of all children starting grade one, the majority of them (97 per cent) will eventually reach the last grade. Notice that this number includes children that repeat grades and that eventually move up to reach last grade. Children of mothers with no education and those from households whose heads are Papuan are the least likely to eventually reach the last grade of primary school. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 95 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 88.1 90.9 115.7 107.1 89.2 101.6 95.5 (98.8) 102.2 85.0 (*) 92.8 90.0 102.2 (109.2) 97.0 95.2 (108.9) (*) (*) (*) 97.5 116 68 85 125 145 90 180 36 109 101 25 52 65 56 43 53 166 50 25 7 17 270 96.5 94.7 96.1 94.3 97.6 96.1 95.9 (*) 97.7 96.6 (*) (88.3) (95.7) (95.0) (97.5) 100.0 95.6 (98.0) (95.3) (*) (*) 96.0 101 51 84 115 121 111 124 17 102 98 18 31 54 44 51 56 135 48 28 8 16 236 Table ED.7: Primary school completion and transition to secondary school Primary school completion rates and transition rate to secondary school, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 1 MICS indicator 7.7 2 MICS indicator 7.8 Primary school completion rate1 Number of children of primary school completion age Transition rate to secondary school2 Number of children who were in the last grade of primary school the previous year ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases The primary school completion rate and transition rate to secondary education are presented in Table ED.7. The primary completion rate is the ratio of the total number of students, regardless of age, entering the last grade of primary school for the first time, to the number of children of primary graduation age at the beginning of the current (or most recent) school year. At the moment of the survey, the primary school completion rate was 98 per cent. Large differences were observed in the primary completion rate by districts with the lowest rates found in Merauke (88 per cent) and the highest rates in Biak Numfor (116 per cent). The primary completion rate was lower in rural areas (86 per cent) compared with urban (102 per cent). The primary completion rate was also higher for male children (107) compared with female children (89 per cent). About 96 per cent of the children who successfully completed the last grade of primary school were found at the moment the survey to be attending the first grade of secondary school (Merauke, 97 per cent; Jayawijaya, 95 per cent; Biak Numfor, 96 per cent). The transition rate for females (98 per cent) was higher than for males (94 per cent). The MULTIPLE INDICATOR CLUSTER SURVEY 201196 MULTIPLE INDICATOR CLUSTER SURVEY 2011 transition rate increased from 82 per cent for children whose mothers have primary education to 96 per cent for children whose mothers have secondary or higher education. The ratio of girls to boys attending primary and secondary education is provided in Table ED.8. These ratios are better known as the Gender Parity Index (GPI). Notice that the ratios included here are obtained from net attendance ratios rather than gross attendance ratios. The last ratios provide an erroneous description of the GPI mainly because in most of the cases the majority of over-aged children attending primary education tend to be boys. The table shows that gender parity for primary school is 1.01, indicating that almost equal numbers of girls and boys attend primary school (Merauke, 0.98; Jayawijaya, 1.04; Biak Numfor, 1.03). The indicator did not vary greatly by background characteristics. The gender parity for secondary education is considerably higher in Merauke District (1.17) and considerably lower in Jayawijaya (0.92). This means that more girls in Merauke attend secondary school while in Jayawijaya girls are disadvantaged in attending secondary school. GPI for secondary school was markedly higher for children whose mothers have little or no primary education. District Merauke Jayawijaya Biak Numfor Area Urban Rural Education of mother/ caretaker None Primary SMP/SM Higher Cannot be determined Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 95.4 83.3 97.8 98.0 90.0 75.8 92.9 98.7 100.0 na 75.3 95.1 95.6 98.8 100.0 89.3 99.1 97.9 100.0 99.0 93.0 97.5 80.3 95.0 96.0 89.7 70.4 93.7 96.9 97.8 na 76.7 91.2 96.9 99.5 98.9 87.8 98.3 100.0 96.7 97.8 91.9 0.98 1.04 1.03 1.02 1.00 1.08 0.99 1.02 1.02 na 0.98 1.04 0.99 0.99 1.01 1.02 1.01 0.98 1.03 1.01 1.01 76.0 51.7 75.6 82.9 60.0 47.5 69.6 83.4 91.6 54.1 38.5 62.4 67.9 81.0 95.0 61.9 80.7 88.0 86.6 74.2 69.8 65.1 56.5 75.2 80.8 55.2 40.6 60.4 84.6 90.2 62.1 37.5 52.9 62.5 85.7 93.2 62.1 67.8 84.9 89.0 72.2 66.8 1.17 0.92 1.01 1.03 1.09 1.17 1.15 0.99 1.02 0.87 1.03 1.18 1.09 0.95 1.02 1.00 1.19 1.04 0.97 1.03 1.04 Table ED.8: Education gender parity Ratio of adjusted net attendance ratios of girls to boys, in primary and secondary school, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 1 MICS indicator 7.9; MDG indicator 3.1 2 MICS indicator 7.10; MDG indicator 3.1 Primary school adjusted net attendance ratio (NAR), girls Gender parity index (GPI) for primary school adjusted NAR1 Secondary school adjusted net attendance ratio (NAR), boys Primary school adjusted net attendance ratio (NAR), boys Secondary school adjusted net attendance ratio (NAR), girls Gender parity index (GPI) for secondary school adjusted NAR2 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 97MULTIPLE INDICATOR CLUSTER SURVEY 2011 10 CHILD PROTECTION 10.1. BIRTH REGISTRATION The International Convention on the Rights of the Child states that every child has the right to a name and a nationality and the right to protection from being deprived of his or her identity. Birth registration is a fundamental means of securing these rights for children. The World Fit for Children states the goal to develop systems to ensure the registration of every child at or shortly after birth, and fulfil his or her right to acquire a name and a nationality, in accordance with national laws and relevant international instruments. The indicator is the percentage of children under-5 years of age whose birth is registered. Only 42 per cent of children under-five years in the three selected districts have been registered (Table CP.1). Birth registration is strikingly low in Jayawijaya District, for children living in rural areas and whose mothers have no education, and those from the poorest households (Figure CP.1). Among children whose birth was not registered, only 26 per cent of mothers/caretakers know how to register birth. Knowledge of how to register birth is least in Jayawijaya District where only 13 per cent of mother caretakers know how to register birth. These percentages are 31 and 35 per cent in Merauke and Biak Numfor districts. Figure CP.1: Percentage of children under age 5 whose birth is registered, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011. District Merauke Jayawijaya Biak Numfor Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest 0 20 40 60 80 100 Per cent 66 20 33 60 30 9 29 51 75 5 30 41 59 83 98 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Age 0-11 months 12-23 months 24-35 months 36-47 months 48-59 months Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 11.6 2.6 8.2 8.1 7.8 5.9 9.2 11.3 7.6 11.1 4.9 5.1 0.9 7.2 10.0 9.9 0.5 11.6 12.7 11.6 3.7 5.5 9.2 9.7 12.2 18.8 7.9 65.9 19.7 32.7 41.6 41.8 60.2 30.1 33.8 38.0 44.4 45.3 45.9 8.8 29.3 51.1 74.9 5.3 29.6 40.9 58.7 82.7 17.8 85.7 78.6 81.8 72.5 41.7 576 424 512 819 692 583 928 290 279 306 323 313 201 446 694 170 335 302 307 297 270 934 276 146 60 155 1,511 31.2 13.9 34.9 26.8 25.0 42.7 20.0 28.8 30.1 26.1 26.2 18.2 3.3 19.9 41.3 (46.8) 6.7 22.1 38.1 54.6 (52.7) 22.2 (51.3) (60.6) (*) (45.3) 26.0 196 340 345 478 403 232 649 192 173 170 176 169 184 316 339 43 318 212 181 123 47 768 39 31 11 43 881 35.5 11.0 12.8 20.5 21.4 33.6 13.0 13.4 19.4 21.4 23.0 26.8 2.1 10.9 28.1 40.6 0.2 11.3 17.4 29.3 52.3 5.7 53.3 41.9 48.9 35.7 20.9 18.8 6.1 11.6 13.0 12.6 20.7 7.9 9.2 11.0 11.9 17.3 14.0 5.8 11.2 13.1 24.5 4.5 6.7 10.8 17.8 26.7 6.6 23.3 27.1 20.8 18.0 12.8 Table CP.1: Birth registration Percentage of children under age 5 by whether birth is registered and percentage of children not registered whose mothers/caretakers know how to register birth, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Children under age 5 whose birth is registered with civil authorities Has birth certificate Children under age 5 whose birth is not registered No birth certificate Total registered1 Number of children Per cent of children whose mother/ caretaker knows how to register birth Number of children without birth registrationSeen Not seen ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 8.1 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 99 10.2. CHILD LABOUR Article 32 of the Convention on the Rights of the Child states: “States Parties recognize the right of the child to be protected from economic exploitation and from performing any work that is likely to be hazardous or to interfere with the child’s education, or to be harmful to the child’s health or physical, mental, spiritual, moral or social development.” The World Fit for Children mentions nine strategies to combat child labour and the MDGs call for the protection of children against exploitation. In the Selected Districts of Papua Province 2011 MICS questionnaire, a number of questions addressed the issue of child labour, that is, children 5-17 years13 of age involved in labour activities. A child is considered to be involved in child labour activities at the moment of the survey if during the week preceding the survey: • Ages 5-11: at least one hour of economic work or 28 hours of domestic work per week. • Ages 12-14: at least 14 hours of economic work or 28 hours of domestic work per week. • Ages 15-17: at least 43 hours of economic work or 43 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 smaller than the numbers specified in the criteria explained above. Table CP.2 presents the results of child labour by the type of work. Percentages do not add up to the total child labour as children may be involved in more than one type of work. 13 The standard MICS module has an age range of 5-14 years, this has been amended in the Papua MICS as per national definition. Results of the standard indicators are included in the summary table of findings Figure CP.2: Percentage of children under 5-17 involved in child labour, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest 0 20 40 60 80 100 Per cent 20 36 22 17 30 40 26 20 14 42 30 26 15 10 100 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Table CP.2 presents the results of child labour by the type of work. The Selected Districts of Papua Province 2011 MICS survey estimates that about one in four children aged 5-17 years are involved in child labour (25 per cent). Child labour is more profound in Jayawijaya Districts where one in three the children 5-17 are involved in child labour (36 per cent). Results for children 5-14 years as per the definition of the MICS indicator are presented in the summary table of findings. Children who do not participate in school have lower percentages of child labour (23 per cent) compared with those who go to school (26 per cent). Variations in child labour also exist by other background characteristics, with clear sharp negative association with mothers’ education and wealth (Figure CP.2). Child labour rates are considerably lower among the age group 15-17 years (1 per cent) when compared with the younger age group 12-14 years (3 per cent) and age group 5-11 years (41 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 101 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r S ex M al e Fe m al e A re a U rb an R u ra l S ch o o l a tt en d an ce Ye s N o M o th er ’s e d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 2. 5 0. 9 4. 1 3. 5 1. 5 2. 1 2. 8 2. 9 0. 5 1. 3 2. 8 3. 0 1. 0 2. 2 2. 8 4. 8 1. 3 0. 9 2. 9 1. 5 2. 6 0. 7 3. 5 2. 5 51 .6 47 .1 50 .0 39 .5 60 .8 46 .2 51 .9 54 .0 27 .5 52 .4 50 .2 48 .7 48 .3 49 .5 49 .3 56 .2 48 .2 43 .8 50 .1 54 .9 36 .5 44 .2 53 .7 49 .8 0. 2 0. 0 0. 0 0. 2 0. 0 0. 2 0. 0 0. 1 0. 0 0. 0 0. 0 0. 2 0. 0 0. 0 0. 0 0. 4 0. 0 0. 0 0. 0 0. 0 1. 0 0. 0 0. 0 0. 1 33 .6 55 .8 37 .3 42 .5 40 .0 29 .1 48 .4 41 .9 38 .2 65 .0 44 .6 32 .5 23 .3 63 .0 52 .5 40 .9 24 .7 17 .0 51 .4 22 .3 22 .6 15 .4 41 .5 41 .3 82 0 62 6 70 5 1, 11 5 1, 03 6 79 3 1, 35 8 1, 81 2 33 9 33 0 80 6 84 0 17 5 46 8 45 5 47 9 39 5 35 4 1, 34 5 40 5 17 8 10 2 12 1 2, 15 1 4. 5 0. 7 3. 8 3. 1 3. 2 3. 0 3. 3 3. 6 0. 9 1. 5 3. 8 3. 1 3. 5 0. 9 3. 2 4. 5 5. 5 1. 7 2. 6 4. 5 1. 1 7. 3 4. 3 3. 2 29 .9 55 .8 35 .0 39 .9 38 .2 27 .0 46 .2 39 .4 37 .6 64 .4 42 .5 29 .7 20 .9 63 .0 50 .8 36 .9 21 .9 14 .4 50 .1 17 .6 20 .6 10 .8 39 .6 39 .1 33 .6 55 .8 37 .3 42 .5 40 .0 29 .1 48 .4 41 .9 38 .2 65 .0 44 .6 32 .5 23 .3 63 .0 52 .5 40 .9 24 .7 17 .0 51 .4 22 .3 22 .6 15 .4 41 .5 41 .3 Ta b le C P. 2: C h ild la b o u r P er ce n ta g e o f ch ild re n b y in vo lv em en t in e co n o m ic a ct iv it y an d h o u se h o ld c h o re s d u ri n g t h e p as t w ee k, a cc o rd in g t o a g e g ro u p s, a n d p er ce n ta g e o f ch ild re n a g e 5- 17 in vo lv ed in c h ild la b o u r, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 P ai d w o rk H o u se h o ld ch o re s le ss th an 2 8 h o u rs H o u se h o ld ch o re s fo r 28 h o u rs o r m o re C h ild la b o u r N u m b er o f ch ild re n ag e 5- 11 W o rk in g o u ts id e h o u se h o ld E co n o m ic a ct iv it y P er ce n ta g e o f ch ild re n a g e 5- 11 in vo lv ed in U n p ai d w o rk W o rk in g fo r fa m ily b u si n es s E co n o m ic ac ti vi ty f o r at le as t o n e h o u r (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es 1 M IC S in d ic at o r 8. 2 102 MULTIPLE INDICATOR CLUSTER SURVEY 2011 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r S ex M al e Fe m al e A re a U rb an R u ra l S ch o o l a tt en d an ce Ye s N o M o th er ’s e d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 7. 1 5. 3 8. 7 10 .7 3. 3 6. 0 7. 8 6. 7 10 .4 4. 3 9. 6 7. 0 0. 0 5. 2 9. 7 13 .9 3. 5 2. 4 8. 0 2. 9 6. 1 0. 0 (1 5. 7) 7. 1 3. 9 3. 1 6. 1 4. 9 3. 8 3. 3 5. 0 4. 4 4. 6 4. 2 4. 5 4. 6 2. 9 3. 9 3. 8 3. 3 9. 2 2. 2 4. 3 3. 6 7. 2 7. 0 (1 .6 ) 4. 4 1. 2 1. 7 1. 4 1. 9 0. 9 1. 6 1. 2 1. 4 1. 5 2. 2 1. 5 1. 1 0. 0 0. 9 3. 1 1. 7 0. 7 0. 0 2. 0 0. 0 0. 0 3. 5 (0 .0 ) 1. 4 4. 1 1. 7 1. 4 2. 8 2. 3 2. 7 2. 5 2. 5 2. 9 4. 2 2. 6 1. 6 2. 9 3. 3 3. 5 2. 6 1. 9 1. 0 3. 6 0. 0 2. 2 3. 5 (0 .0 ) 2. 6 53 .1 82 .1 56 .7 64 .5 59 .8 44 .9 72 .2 59 .4 81 .9 90 .4 67 .0 48 .7 33 .5 93 .4 75 .4 61 .7 43 .0 27 .9 73 .6 37 .0 40 .8 32 .9 (7 0. 2) 62 .2 76 .5 74 .0 83 .8 67 .2 89 .8 75 .8 79 .5 79 .9 66 .0 76 .2 78 .0 78 .7 81 .4 72 .4 78 .9 82 .8 81 .4 75 .7 76 .7 81 .1 78 .4 86 .9 (7 8. 5) 78 .1 33 2 22 6 26 2 42 2 39 7 30 1 51 9 71 6 10 4 14 1 33 0 29 6 53 17 3 19 5 15 8 14 7 14 7 50 9 14 8 78 29 55 82 0 0. 7 2. 4 3. 4 3. 0 1. 0 1. 8 2. 2 2. 2 0. 8 0. 0 4. 1 1. 1 0. 0 2. 6 2. 8 3. 4 1. 1 0. 0 3. 0 0. 0 2. 0 0. 0 (0 .0 ) 2. 1 2. 9 0. 0 0. 0 1. 0 1. 4 1. 1 1. 2 1. 1 1. 4 2. 0 1. 1 0. 6 2. 9 2. 4 0. 5 0. 9 1. 2 1. 0 1. 6 0. 0 2. 2 0. 0 (0 .0 ) 1. 2 20 .4 36 .2 22 .0 26 .1 24 .3 17 .2 30 .2 25 .8 22 .5 40 .4 26 .3 20 .4 14 .2 41 .8 30 .4 26 .1 14 .9 9. 7 31 .5 13 .9 13 .1 10 .1 23 .7 25 .2 1, 41 9 98 3 1, 21 7 1, 86 5 1, 75 3 1, 38 9 2, 22 9 3, 01 3 60 5 55 3 1, 40 6 1, 36 0 29 9 72 6 80 8 77 2 67 2 64 0 2, 26 8 65 1 32 1 16 5 21 3 3, 61 8 Ta b le C P. 2: C h ild la b o u r P er ce n ta g e o f ch ild re n b y in vo lv em en t in e co n o m ic a ct iv it y an d h o u se h o ld c h o re s d u ri n g t h e p as t w ee k, a cc o rd in g t o a g e g ro u p s, a n d p er ce n ta g e o f ch ild re n a g e 5- 17 in vo lv ed in c h ild la b o u r, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 E co n o m ic a ct iv it y P er ce n ta g e o f ch ild re n a g e 12 -1 4 in vo lv ed in W o rk in g o u ts id e h o u se h o ld P ai d w o rk U n p ai d w o rk H o u se h o ld ch o re s le ss th an 2 8 h o u rs H o u se h o ld ch o re s fo r 28 h o u rs o r m o re C h ild la b o u r To ta l ch ild la b o u r N u m b er o f ch ild re n ag e 5- 17 ye ar s N u m b er o f ch ild re n ag e 12 -1 4 W o rk in g fo r fa m ily b u si n es s E co n o m ic ac tv it y le ss th an 1 4 h o u rs E co n o m ic ac ti vi ty f o r 14 h o u rs o r m o re (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es 1 M IC S in d ic at o r 8. 2 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 103 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r S ex M al e Fe m al e A re a U rb an R u ra l S ch o o l a tt en d an ce Ye s N o M o th er ’s e d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 14 .4 5. 3 15 .3 19 .3 6. 4 8. 6 16 .5 8. 8 25 .3 10 .4 18 .7 9. 9 3. 3 12 .6 17 .8 22 .7 7. 6 3. 1 13 .8 15 .6 8. 4 (0 .0 ) (1 5. 4) 12 .9 0. 0 2. 0 0. 6 0. 4 0. 8 0. 0 1. 1 0. 1 2. 1 3. 2 0. 5 0. 0 0. 0 3. 1 0. 0 1. 0 0. 0 0. 0 1. 0 0. 0 0. 0 (0 .0 ) (0 .0 ) 0. 6 85 .4 70 .1 85 .4 70 .5 94 .4 82 .2 82 .3 84 .9 74 .5 70 .1 83 .5 83 .6 87 .9 78 .2 80 .0 80 .1 86 .9 85 .3 82 .6 80 .4 85 .0 (8 2. 5) (7 8. 8) 82 .3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 (0 .0 ) (0 .0 ) 0. 0 0. 0 2. 0 0. 6 0. 4 0. 8 0. 0 1. 1 0. 1 2. 1 3. 2 0. 5 0. 0 0. 0 3. 1 0. 0 1. 0 0. 0 0. 0 1. 0 0. 0 0. 0 (0 .0 ) (0 .0 ) 0. 6 26 7 13 1 24 9 32 8 32 0 29 5 35 2 48 6 16 1 82 27 0 22 4 71 85 15 8 13 4 13 1 13 9 41 5 98 64 34 36 64 7 20 .4 36 .2 22 .0 26 .1 24 .3 17 .2 30 .2 25 .8 22 .5 40 .4 26 .3 20 .4 14 .2 41 .8 30 .4 26 .1 14 .9 9. 7 31 .5 13 .9 13 .1 10 .1 23 .7 25 .2 1, 41 9 98 3 1, 21 7 1, 86 5 1, 75 3 1, 38 9 2, 22 9 3, 01 3 60 5 55 3 1, 40 6 1, 36 0 29 9 72 6 80 8 77 2 67 2 64 0 2, 26 8 65 1 32 1 16 5 21 3 3, 61 8 3. 4 3. 3 7. 3 3. 6 6. 2 2. 4 7. 0 5. 0 4. 6 3. 2 7. 5 3. 6 0. 9 3. 7 4. 9 8. 6 6. 4 0. 5 5. 7 3. 1 6. 4 (2 .6 ) (0 .0 ) 4. 9 68 .2 74 .0 61 .6 70 .2 63 .4 54 .3 77 .3 61 .9 81 .8 80 .7 75 .3 57 .0 49 .6 91 .0 77 .2 74 .8 60 .8 38 .2 73 .9 52 .7 62 .3 (3 5. 3) (6 2. 3) 66 .8 1. 9 3. 6 7. 4 5. 3 3. 4 1. 3 6. 9 4. 0 5. 4 2. 1 7. 4 2. 4 1. 8 6. 7 6. 1 6. 9 2. 7 0. 0 6. 4 0. 0 2. 5 (0 .0 ) (0 .0 ) 4. 4 Ta b le C P. 2: C h ild la b o u r (c o n ti n u ed ) P er ce n ta g e o f ch ild re n b y in vo lv em en t in e co n o m ic a ct iv it y an d h o u se h o ld c h o re s d u ri n g t h e p as t w ee k, a cc o rd in g t o a g e g ro u p s, a n d p er ce n ta g e o f ch ild re n a g e 5- 17 in vo lv ed in c h ild la b o u r, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 C h ild la b o u r H o u se h o ld ch o re s fo r 28 h o u rs o r m o re H o u se h o ld ch o re s le ss th an 2 8 h o u rs E co n o m ic ac ti vi ty fo r 14 h o u rs o r m o re E co n o m ic ac tv it y le ss th an 1 4 h o u rs W o rk in g fo r fa m ily b u si n es s U n p ai d w o rk P ai d w o rk E co n o m ic a ct iv it y W o rk in g o u ts id e h o u se h o ld P er ce n ta g e o f ch ild re n a g e 15 -1 7 in vo lv ed in N u m b er o f ch ild re n ag e 15 -1 7 To ta l ch ild la b o u r1 N u m b er o f ch ild re n ag e 5- 17 ye ar s ( ) F ig u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es 1 M IC S in d ic at o r 8. 2 104 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Table CP.3 presents the percentage of children age 5-17 years involved in child labour who are attending school and percentage of children age 5-17 years attending school who are involved in child labour. Of the 83 per cent of the children 5-17 years of age attending school, 31 per cent are also involved in child labour activities. On the other hand, out of the 32 per cent of the children who are involved in child labour, the majority of them are also attending school (83 per cent). The percentage of child labourers who are attending school in Jayawijaya is considerably lower than in the two other districts. On the other hand, the percentage of children attending school who are involved in child labour in Jayawijaya is considerably higher than in the two other districts. District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Age 5-11 12-14 Mother’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 1,419 983 1,217 1,865 1,753 1,389 2,229 2,151 1,467 553 1,406 1,360 299 726 808 772 672 640 2,268 651 321 165 213 3,618 83.9 68.5 86.8 76.7 80.7 86.4 75.8 85.4 57.1 58.6 83.4 88.2 89.9 65.8 80.1 84.8 94.2 92.8 76.1 86.7 83.9 (*) 93.3 78.5 380 466 325 631 541 302 869 888 284 309 472 332 58 409 306 245 127 84 909 120 62 20 61 1,172 25.7 45.9 26.2 31.6 29.5 21.0 37.3 41.9 13.5 55.0 33.7 23.9 18.2 59.7 37.5 31.4 19.2 12.6 39.2 17.2 17.5 10.2 29.8 30.5 1,241 695 1,077 1,532 1,481 1,244 1,770 1,812 1,201 329 1,170 1,227 287 451 654 662 622 623 1,761 604 298 158 191 3,013 26.8 47.5 26.7 33.8 30.8 21.8 39.0 41.3 19.3 55.8 33.6 24.4 19.5 56.3 37.9 31.8 18.8 13.2 40.1 18.4 19.4 12.0 28.8 32.4 87.5 70.8 88.5 82.2 84.5 89.6 79.4 84.2 81.9 59.5 83.2 90.3 96.0 62.1 81.0 85.8 92.5 97.5 77.6 92.8 93.0 95.9 90.0 83.3 Table CP.3: Child labour and school attendance Percentage of children age 5-17 years involved in child labour who are attending school, and percentage of children age 5-17 years attending school who are involved in child labour, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of children age 5-17 years Percentage of child labourers who are attending school Number of children age 5-17 years involved in child labour Percentage of children attending school who are involved in child labour Number of children age 5-17 years attending school Percentage of children involved in child labour Percentage of children attending school ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 105 10.3. CHILD DISCIPLINE As stated in A World Fit for Children, “children must be protected against any acts of violence …” and the Millennium Declaration calls for the protection of children against abuse, exploitation and violence. In the Selected Districts Papua Province MICS survey, mothers/caretakers of children age 2-14 years were asked a series of questions on the ways parents tend to use to discipline their children when they misbehave. Note that for the child discipline module, one child aged 2-14 per household was selected randomly during fieldwork. Out of these questions, the two indicators used to describe aspects of child discipline are: 1) the number of children 2-14 years that experience psychological aggression as punishment or minor physical punishment or severe physical punishment; and 2) the number of parents/caretakers of children 2-14 years of age that believe that in order to raise their children properly, they need to physically punish them. In the three selected districts of Papua, 91 per cent of children age 2-14 years were subjected to at least one form of psychological or physical punishment by their mothers/ caretakers or other household members (Merauke, 89 per cent; Jayawijaya, 92 per cent; Biak Numfor, 92 per cent) (Table CP.4). More importantly, 26 per cent of children were subjected to severe physical punishment (Merauke, 24 per cent; Jayawijaya, 31 per cent; Biak Numfor, 26 per cent). Children age 2-4 (91 per cent) and age 4-9 (92 per cent) were subjected to at least one psychological or physical punishment more than older children age 10-14 (86 per cent). Generally, education did not show a clear association with child discipline. It is of importance also to indicate that comparatively few parents/caretakers believe that in order to raise their children properly, they need to physically punish them (33 per cent), when in practice 91 per cent indicated the opposite implying an interesting contrast with the actual prevalence of physical discipline. 10.4. EARLY MARRIAGE Marriage before the age of 18 is a reality for many young girls. According to UNICEF’s worldwide estimates, over 64 million women age 20-24 were married/in union before the age of 18. Factors that influence child marriage rates include: the state of the country’s civil registration system, which provides proof of age for children; the existence of an adequate legislative framework with an accompanying enforcement mechanism to address cases of child marriage; and the existence of customary or religious laws that condone the practice. In many parts of the world parents encourage the marriage of their daughters while they are still children in hopes that the marriage will benefit them both financially and socially, while also relieving financial burdens on the family. In actual fact, child marriage is a violation of human rights, compromising the development of girls and often resulting in early pregnancy and social isolation, with little education and poor vocational training reinforcing the gendered nature of poverty. The right to ‘free and full’ consent to a marriage is recognized in the Universal Declaration of Human Rights - with the recognition that consent cannot be ‘free and full’ when one of the parties involved is not sufficiently mature to make an informed decision about a life partner. The Convention on the Elimination of all Forms of Discrimination against Women mentions the right to protection from child marriage in article 16, which states: “The betrothal and the marriage of a child shall have no legal effect, and all necessary action, including legislation, shall be taken to specify a minimum age for marriage.” While marriage is not considered directly in the Convention on the Rights of the Child, child 106 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Age 2-4 years 5-9 years 10-14 years Education of household head None Primary SMP/SM Higher Respondent’s education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 67.4 79.2 76.9 75.5 72.1 74.4 73.5 81.5 77.3 65.3 76.1 76.9 72.6 69.4 na na na na 78.8 79.6 73.3 69.4 65.5 81.0 52.9 69.4 71.3 71.6 73.8 23.5 30.5 25.8 27.7 24.6 25.5 26.6 25.3 27.4 25.4 28.1 29.0 25.1 22.3 na na na na 34.4 34.0 26.7 14.6 17.6 34.8 6.0 16.1 17.0 19.7 26.2 86.5 92.1 91.5 90.2 89.1 90.2 89.4 91.2 92.4 85.9 89.8 91.6 89.3 87.1 na na na na 92.4 90.9 88.5 90.8 84.9 93.4 79.6 90.3 85.5 84.1 89.7 1,521 1,104 1,283 2,031 1,876 1,436 2,471 877 1,591 1,440 359 1,278 1,705 560 381 1,332 1,746 448 852 852 823 721 659 2,448 719 341 169 229 3,907 28.8 46.0 26.8 33.7 32.2 23.9 38.5 30.4 34.2 33.4 na na na na 52.7 40.0 26.1 21.2 52.2 42.1 33.6 18.5 15.9 42.2 19.6 20.0 16.0 32.6 33.0 819 534 575 989 939 729 1,200 461 766 701 na na na na 200 650 845 233 403 402 382 384 358 1,088 454 188 87 111 1,928 10.9 6.3 7.5 8.3 8.7 8.6 8.4 5.1 6.5 12.8 7.7 6.6 8.9 11.5 na na na na 5.8 7.2 9.1 7.8 13.6 5.1 17.0 8.6 11.2 15.6 8.5 78.9 85.0 85.0 82.4 82.9 81.8 83.1 79.9 86.0 80.6 82.8 85.3 82.2 78.1 na na na na 86.8 84.8 80.8 83.4 75.8 87.6 72.6 76.9 74.9 75.3 82.6 Table CP.4: Child discipline Percentage of children age 2-14 years according to method of disciplining the child, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Any Severe Any violent discipline method1 Number of children age 2-14 years Respondents to the child discipline module Respondent believes that the child needs to be physically punished Only non- violent discipline Psychological aggression Physical punishment Percentage of children age 2-14 years who experienced: ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 8.5 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 107 marriage is linked to other rights - such as the right to express their views freely, the right to protection from all forms of abuse, and the right to be protected from harmful traditional practices - and is frequently addressed by the Committee on the Rights of the Child. Other international agreements related to child marriage are the Convention on Consent to Marriage, Minimum Age for Marriage and Registration of Marriages and the African Charter on the Rights and Welfare of the Child and the Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa. Child marriage was also identified by the Pan-African Forum against the Sexual Exploitation of Children as a type of commercial sexual exploitation of children. Young married girls are a unique, though often invisible, group. Required to perform heavy amounts of domestic work, under pressure to demonstrate fertility, and responsible for raising children while still children themselves, married girls and child mothers face constrained decision-making and reduced life choices. Boys are also affected by child marriage but the issue impacts girls in far larger numbers and with more intensity. Cohabitation - when a couple lives together as if married - raises the same human rights concerns as marriage. Where a girl lives with a man and takes on the role of caregiver for him, the assumption is often that she has become an adult woman, even if she has not yet reached the age of 18. Additional concerns due to the informality of the relationship - for example, inheritance, citizenship and social recognition - might make girls in informal unions vulnerable in different ways than those who are in formally recognized marriages. Research suggests that many factors interact to place a child at risk of marriage. Poverty, protection of girls, family honour and the provision of stability during unstable social periods are considered as significant factors in determining a girl’s risk of becoming married while still a child. Women who married at younger ages were more likely to believe that it is sometimes acceptable for a husband to beat his wife and were more likely to experience domestic violence themselves. The age gap between partners is thought to contribute to these abusive power dynamics and to increase the risk of untimely widowhood. Closely related to the issue of child marriage is the age at which girls become sexually active. Women who are married before the age of 18 tend to have more children than those who marry later in life. Pregnancy related deaths are known to be a leading cause of mortality for both married and unmarried girls between the ages of 15 and 19, particularly among the youngest of this cohort. There is evidence to suggest that girls who marry at young ages are more likely to marry older men which puts them at 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. The demand for this young wife to reproduce and the power imbalance resulting from the age differential lead to very low condom use among such couples. Three of the indicators are to estimate the percentage of women currently married/ in union, percentage married before 15 years of age and percentage married before 18 years of age. About one in five young women age 15-19 years is currently married or in union (22 per cent) (Table CP.5). This percentage is significantly higher in Jayawijaya (41 per cent) and significantly lower in Biak Numfor District (8 per cent) when compared with Merauke District (21 per cent). This indicator is strongly related to wealth where it decreases from 65 per cent among the poorest women to only four per cent among the richest women. 108 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Ten per cent of women aged 15-49 years were married before age 15 while 34 per cent of women aged 20-49 years were married before age 18. The percentage of women married before age 15 and age 18 was considerably higher in Jayawijaya District (16 and 47 per cent respectively) compared with Merauke District (10 and 34 per cent respectively) and Biak Numfor (4 and 20 per cent respectively). The percentage of men married at various ages is provided in Table CP.5M. Only three per cent of young men age 15-19 years are currently married or in union. This percentage is higher in Jayawijaya District (9 per cent) compared withwith Merauke (3 per cent) and Biak Numfor (1 per cent). Among men, marriage/ union before age 15 and 18 is not common, except for Jayawijaya District which shows that 11 per cent of men are married/ in union before age 18 compared with three and four per cent in Merauke and Biak Numfor respectively. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 109 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 11.0 17.0 4.0 6.5 13.5 na 7.4 10.0 9.7 11.0 12.1 15.0 15.6 19.7 5.7 0.0 18.4 11.4 12.0 7.3 5.0 10.6 13.5 9.6 5.7 3.2 10.6 34.1 46.8 20.2 22.3 41.6 na 29.1 33.6 29.9 32.3 37.6 42.2 52.9 47.9 26.5 3.6 50.4 37.0 38.5 28.9 16.2 34.9 41.5 25.5 11.8 20.0 33.5 1,017 628 677 970 1,352 na 403 506 414 420 288 291 331 716 937 338 452 413 445 488 524 1,216 596 257 117 137 2,322 21.0 41.4 7.9 15.9 25.8 21.5 na na na na na na (64.5) 34.0 16.0 (*) 51.7 18.0 17.7 19.4 4.3 22.1 27.0 19.7 (*) (*) 21.5 172 120 171 203 259 462 na na na na na na 31 73 336 22 84 93 83 106 97 285 86 45 27 19 462 9.9 15.6 3.8 6.0 12.2 4.6 7.4 10.0 9.7 11.0 12.1 15.0 15.5 18.8 4.9 0.0 17.4 9.7 11.0 6.6 4.3 9.6 12.2 8.7 5.3 3.3 9.6 1,189 748 848 1,174 1,610 462 403 506 414 420 288 291 362 789 1,272 361 536 506 528 594 621 1,501 682 302 144 156 2,784 Table CP.5: Early marriage among women Percentage of women age 15-49 years who first married or entered a marital union before their 15th birthday, percentages of women age 20-49 years who first married or entered a marital union before their 15th and 18th birthdays, and percentage of women age 15-19 years currently married or in union, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Percentage married before age 15 Percentage married before age 182 Number of women age 20-49 years Percentage of women 15-19 years currently married/in union3 Number of women age 15-19 years Percentage married before age 151 Number of women age 15-49 years ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 8.6 2 MICS indicator 8.7 3 MICS indicator 8.8 110 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 1.1 1.7 0.7 0.3 1.8 0.8 0.3 0.8 1.2 1.9 1.8 3.9 1.7 0.7 0.6 2.4 1.7 1.2 0.4 0.1 1.4 0.9 1.1 0.0 0.0 1.1 3.4 11.0 3.9 3.0 7.4 5.3 3.7 3.6 7.9 7.0 5.5 11.5 5.9 5.4 2.8 12.4 5.8 6.6 2.2 1.5 8.4 2.8 2.7 0.7 1.2 5.5 989 550 609 962 1,186 0 330 407 368 383 347 313 135 563 1,066 384 424 359 402 484 478 1,095 609 210 101 133 2,148 2.7 9.2 1.1 0.8 5.3 3.3 na na na na na na (*) 4.8 2.6 (*) 12.9 2.7 3.5 0.0 0.0 4.1 0.0 (3.5) (*) (*) 3.3 173 77 171 191 229 420 na na na na na na 10 73 325 12 62 86 95 93 85 260 77 42 23 19 420 1.1 1.5 0.5 0.3 1.6 0.4 0.8 0.3 0.8 1.2 1.9 1.8 3.6 1.5 0.6 0.6 2.1 1.8 1.0 0.4 0.1 1.3 0.8 0.9 0.0 0.0 1.0 1,161 627 780 1,153 1,415 420 330 407 368 383 347 313 145 636 1,390 396 486 445 496 577 563 1,354 686 252 123 152 2,568 Table CP.5M: Early marriage among men Percentage of men age 15-49 years who first married or entered a marital union before their 15th birthday, percentages of men age 20-49 years who first married or entered a marital union before their 15th and 18th birthdays, and percentage of men age 15-19 years currently married or in union, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Percentage married before age 15 Percentage married before age 182 Number of men age 20-49 years Percentage of men 15-19 years currently married/in union3 Number of men age 15- 19 years Percentage married before age 151 Number of men age 15- 49 years *1 case with missing “Ethnicity of household head” (15-46) and 1 case with missing “Ethnicity of household head” (20-46) not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 8.6 2 MICS indicator 8.7 3 MICS indicator 8.8 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 111 Table CP.6 present the proportion of women who were first married or entered into a marital union before age 15 and 18 by residence and age groups. Examining the percentages married before age 15 and 18 by different age groups allow us to see the trends in early marriage over time. For example, examining the age pattern for women aged 20-49 years (Figure CP.3), it is clear that the prevalence of early marriage has declined over time; 42 per cent of women aged 45-49 years were married before their 18th birthday compared with 29 per cent of women aged 20-24 years. The percentage of women who were first married before age 18 is higher in rural areas than urban. Table CP.6M presents similar results for men and shows that early marriage is uncommon among men 20-49 with no clear trend over time. 112 MULTIPLE INDICATOR CLUSTER SURVEY 2011 A g e 15 -1 9 20 -2 4 25 -2 9 30 -3 4 35 -3 9 40 -4 4 45 -4 9 To ta l f o r 3 d is tr ic ts 4. 0 3. 8 9. 5 1. 1 8. 4 7. 6 8. 5 6. 0 20 3 19 0 24 0 16 3 17 3 11 3 92 1, 17 4 n a 18 .6 26 .0 16 .6 22 .6 25 .8 25 .3 22 .3 n a 19 0 24 0 16 3 17 3 11 3 92 97 0 5. 0 10 .7 10 .4 15 .3 12 .8 15 .0 18 .1 12 .2 25 9 21 3 26 6 25 1 24 7 17 5 19 9 1, 61 0 n a 38 .5 40 .5 38 .6 39 .1 45 .2 50 .0 41 .6 46 2 40 3 50 6 41 4 42 0 28 8 29 1 2, 78 4 n a 21 3 26 6 25 1 24 7 17 5 19 9 1, 35 2 n a 29 .1 33 .6 29 .9 32 .3 37 .6 42 .2 33 .5 4. 6 7. 4 10 .0 9. 7 11 .0 12 .1 15 .0 9. 6 n a 40 3 50 6 41 4 42 0 28 8 29 1 2, 32 2 Ta b le C P. 6: T re n d s in e ar ly m ar ri ag e am o n g w o m en P er ce n ta g e o f w o m en w h o w er e fi rs t m ar ri ed o r en te re d in to a m ar it al u n io n b ef o re a g e 15 a n d 1 8, b y ar ea a n d a g e g ro u p s, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 15 U rb an R u ra l A ll N u m b er o f w o m en ag e 15 -4 9 N u m b er o f w o m en ag e 20 -4 9 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 18 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 15 N u m b er o f w o m en ag e 20 -4 9 N u m b er o f w o m en ag e 15 -4 9 N u m b er o f w o m en ag e 20 -4 9 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 18 N u m b er o f w o m en ag e 15 -4 9 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 15 P er ce n ta g e o f w o m en w it h a li ve b ir th b ef o re ag e 18 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 113 A g e 15 -1 9 20 -2 4 25 -2 9 30 -3 4 35 -3 9 40 -4 4 45 -4 9 To ta l f o r 3 d is tr ic ts 0. 0 0. 6 0. 0 0. 0 0. 8 0. 5 0. 0 0. 3 19 1 16 5 21 9 17 0 17 7 12 3 10 7 1, 15 3 1. 5 1. 5 2. 0 7. 7 5. 1 0. 0 3. 0 0 16 5 21 9 17 0 17 7 12 3 10 7 96 2 0. 7 1. 0 0. 7 1. 6 1. 6 2. 6 2. 7 1. 6 22 9 16 5 18 8 19 7 20 6 22 4 20 5 1, 41 5 9. 0 6. 3 4. 9 8. 0 8. 1 8. 4 7. 4 42 0 33 0 40 7 36 8 38 3 34 7 31 3 2, 56 8 0 16 5 18 8 19 7 20 6 22 4 20 5 1, 18 6 5 .3 3. 7 3. 6 7. 9 7. 0 5. 5 5. 5 0. 4 0. 8 0. 3 0. 8 1. 2 1. 9 1. 8 1. 0 0 33 0 40 7 36 8 38 3 34 7 31 3 2, 14 8 Ta b le C P. 6M : T re n d s in e ar ly m ar ri ag e am o n g m en P er ce n ta g e o f m en w h o w er e fi rs t m ar ri ed o r en te re d in to a m ar it al u n io n b ef o re a g e 15 a n d 1 8, b y ar ea a n d a g e g ro u p s, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 P er ce n ta g e o f m en w it h a liv e b ir th b ef o re a g e 15 U rb an R u ra l A ll N u m b er o f m en ag e 15 -4 9 N u m b er o f m en ag e 20 -4 9 P er ce n ta g e o f m en w it h a liv e b ir th b ef o re a g e 18 P er ce n ta g e o f m en w it h a liv e b ir th b ef o re a g e 15 N u m b er o f m en ag e 20 -4 9 N u m b er o f m en ag e 15 -4 9 N u m b er o f m en ag e 20 -4 9 P er ce n ta g e o f m en w it h a liv e b ir th b ef o re a g e 18 N u m b er o f m en ag e 15 -4 9 P er ce n ta g e o f m en w it h a liv e b ir th b ef o re a g e 15 P er ce n ta g e o f m en w it h a liv e b ir th b ef o re a g e 18 114 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-19 20-24 Education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 29.4 35.5 28.0 22.4 36.4 0.0 30.9 (35.0) (29.8) 31.1 (27.0) 30.0 (36.8) 31.2 39.5 (17.5) 28.0 36.3 (*) (*) (*) 30.9 14.7 25.1 9.0 18.5 15.2 0.0 16.5 (20.2) (27.7) 15.3 (0.0) 18.9 (15.2) 18.3 19.3 (8.7) 15.0 12.4 (*) (*) (*) 16.5 4.0 4.6 2.7 3.9 3.9 0.0 3.9 (9.0) (3.5) 2.4 (6.7) 4.7 (14.4) 2.2 1.7 (1.7) 5.9 1.5 (*) (*) (*) 3.9 100.0 100.0 100.0 100.0 100.0 0.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 140 82 60 111 171 0 283 34 53 164 32 67 30 63 68 54 147 93 21 8 13 283 8.1 0.0 17.0 8.0 7.4 0.0 7.6 (0.0) (4.8) 9.9 (8.9) 3.8 (0.0) 12.3 6.7 (12.4) 8.9 6.9 (*) (*) (*) 7.6 43.8 34.8 43.4 47.2 37.1 0.0 41.1 (35.8) (34.2) 41.3 (57.4) 42.7 (33.6) 36.0 32.8 (59.6) 42.2 42.9 (*) (*) (*) 41.1 Table CP.7: Spousal age difference Per cent distribution of women currently married/in union age 20-24 years according to the age difference with their husband or partner, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 5-9 years older 10+ years older1 Husband/ partner’s age unknown Total Percentage of currently married/in union women age 20-24 years whose husband or partner is: Number of women age 20-24 years currently married/ in union Younger 0-4 years older ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 8.10b Another component is the spousal age difference with an indicator being the percentage of married/in union women who are 10 or more years younger than their current spouse. Table CP.7 presents the results of the age difference between husbands and wives. The results show that there are some important spousal age differences in the selected districts of Papua. About 17 per cent of women age 20-24 are currently married to a man who is older by ten years or more. About 25 per cent of women age 20-24 in Jayawijaya District are currently married to a man who is older by ten years or more. This compares with lower percentages in Merauke (15 per cent) and Biak Numfor districts (9 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 115 14 MICS Indicator 8.10a Figure CP.3 Percentage of women and men aged 20-49 years married before their 18th birthday, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 50 45 40 35 30 25 20 15 10 5 0 P er c en t Age (in years) Women 0 2015 4035105 3025 5045 Man About 18 per cent14 of women age 15-19 are currently married to men who are older by ten years (Results for women 15-19 by background characteristics were suppressed due to inadequate sample size). 10.5 TYPE OF MARRIAGE REGISTRATION Marriage is considered official if it is registered under civil registration and both parties have the marriage certificate as important legal evidence that can protect the right of both parties and their future children. Although official or legal marriage registration has been regulated by government, in Indonesia marriages are sometimes registred through other means. Women and children can be denied their rights, such as inheritance and birth certificates, as a result of unofficial marriages. They can also face violence and discrimination. Table CP.8 shows the types of marriage registration occurring in the three selected districts of Papua Province. The table indicates that among women currently married or in union in the three selected districts, the proportion whose marriage is officially registered (civil registration) was only 56 per cent (84 per cent in Merauke District, 51 per cent in Biak Numfor District and 20 per cent in Jayawijaya District). 116 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age of woman 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 55.6 38.7 62.3 69.3 41.6 32.5 38.1 51.1 56.0 58.8 61.2 50.5 24.6 53.5 57.7 68.9 37.2 44.2 53.1 56.6 70.4 53.1 38.5 56.5 84.9 79.0 52.2 13.6 79.1 25.0 28.7 41.1 57.9 39.5 34.7 41.2 34.7 30.3 30.2 83.0 30.8 25.0 27.0 85.2 26.7 19.1 22.5 21.1 59.4 6.9 23.9 12.7 23.0 36.4 4.2 49.2 44.2 23.2 31.0 41.8 33.7 28.1 33.9 24.7 21.8 20.2 44.1 24.5 25.3 25.0 48.8 31.3 24.5 19.0 14.5 46.9 7.9 10.7 11.4 8.5 28.0 886 607 509 764 1,237 84 256 410 365 379 254 253 320 647 827 207 450 353 389 399 411 1,008 572 217 88 117 2,001 84.2 20.4 51.0 76.1 44.3 35.4 52.4 52.2 53.1 58.0 66.6 66.7 10.8 54.1 69.2 83.2 2.4 47.5 64.0 78.9 94.2 20.3 97.1 93.5 88.2 76.4 56.4 Table CP.8: Type of marriage registration Per cent distribution of women currently married/in union age 15-49 according to type of marriage registration, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Religious ceremony Traditional ceremony Community acceptance Type of marriage registration Number of women age 15-49 years currently married/in union Civil registration MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 117 10.6 ATTITUDES TOWARD DOMESTIC VIOLENCE A number of questions were asked of women and men age 15-49 years to assess their attitudes towards whether husbands are justified to hit or beat their wives for a variety of scenarios. These questions were asked to gain an indication of cultural beliefs that tend to be associated with the prevalence of violence against women by their husbands. The main assumption here is that women that agree with the statements indicating that husbands are justified to beat their wives under the situations described in reality tend to be abused by their own husbands and similarly, men who agree with the statements in reality tend to exercise violence towards their wives. The responses to these questions can be found in Table CP.9 and CP 9M. Overall, 45 per cent of women feel that the husband has a right to hit or beat his wife for at least one of a variety of reasons. Women who approve husband violence, in most cases agree and justify violence in instances when they neglect the children (30 per cent), or if they demonstrate their autonomy, e.g. go out without telling their husbands (22 per cent) or argue with them (25 per cent). Around 15 per cent of women believe that their partner has a right to hit or beat them if they refuse to have sex with him; 11 per cent if they burn the food. Differences in this indicator were clear among districts, where 59 per cent of women in Jayawijaya District accept this type of violence. This percentage is reduced in Biak Numfor and Merauke Districts to 51 and 31 per cent respectively. Association of domestic violence with education is clear where more than two-thirds of women with no education (59 per cent) justify this type of violence, while a lower percentage was observed for women who have higher education (35 per cent). Acceptance is more present among those living in poorest households (59 per cent) compared with richest households (35 per cent). Results on domestic violence for men are presented in Table CP.9M. Overall, 42 per cent of men feel that the husband has a right to hit or beat his wife for at least one of a variety of reasons, a percentage slightly lower than that for women (45 per cent). Men who approve husband violence, in most cases agree and justify violence in instances when wives go out without telling their husbands (26 per cent) or argue with them (25 per cent). Generally, a similar pattern to women is observed in this indicator among districts but with lower percentages. 118 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Marital/Union status Currently married/ in union Formerly married /in union Never married/ in union Education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 21.8 39.2 34.4 29.5 30.9 39.2 34.4 31.4 26.0 26.2 24.5 26.5 27.6 41.6 37.7 39.1 31.2 28.6 25.8 39.0 31.3 30.1 27.4 25.0 37.4 20.0 23.8 17.2 32.6 30.3 15.4 38.8 27.0 21.5 27.9 35.4 27.2 24.8 20.4 21.8 22.1 21.7 24.4 25.0 28.2 39.7 26.6 23.1 14.7 40.0 26.7 24.2 20.8 16.3 33.4 16.1 15.1 11.1 18.1 25.2 7.4 30.3 13.5 11.9 18.0 18.2 14.6 15.9 12.8 15.0 16.2 14.8 16.2 15.7 12.4 33.9 17.2 11.3 7.3 31.7 16.2 12.0 9.8 9.0 22.3 7.2 9.2 1.6 10.2 15.4 4.0 21.1 12.4 9.2 12.6 13.5 9.9 12.8 9.7 8.8 12.4 10.7 10.9 11.5 11.9 18.2 14.3 8.8 5.6 19.0 15.3 10.9 7.8 4.5 17.8 1.6 5.8 3.1 6.3 11.2 31.1 59.4 50.6 41.0 47.3 56.5 49.3 46.0 38.0 40.1 36.9 40.6 42.7 50.9 50.3 59.1 45.7 42.6 35.0 58.9 47.3 43.3 41.0 34.7 54.6 31.4 34.7 25.2 43.7 44.6 13.7 31.3 18.4 17.9 21.3 26.7 21.9 20.5 16.1 16.7 17.9 16.8 18.9 25.9 21.9 31.1 22.9 17.3 11.2 31.3 23.3 16.9 17.1 12.3 25.1 13.7 13.1 4.9 23.0 19.9 33.1 60.9 51.3 42.2 49.0 56.6 50.9 47.3 39.9 41.2 39.2 43.5 44.5 52.2 50.8 61.5 47.7 43.7 35.7 61.0 48.8 45.0 42.3 35.7 55.7 33.3 37.1 25.2 46.9 46.1 1,189 748 848 1,174 1,610 462 403 506 414 420 288 291 2,096 137 551 362 789 1,272 361 536 506 528 594 621 1,501 682 302 144 156 2,784 13.4 32.6 25.5 18.6 24.9 27.5 25.5 21.7 18.3 19.6 20.2 21.6 21.5 30.4 22.9 35.5 22.4 20.9 12.8 32.6 24.4 22.3 20.1 13.4 29.1 13.5 14.4 9.6 19.9 22.2 Table CP.9: Attitudes toward domestic violence among women Percentage of women age 15-49 years who believe a husband is justified in beating his wife/partner in various circumstances, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 If she neglects the children If she argues with him If she refuses sex with him Percentage of women age 15-49 years who believe a husband is justified in beating his wife/partner: If she burns the food For any of these reasons1 If she argues with parent- in-law For any of the 6 reasons Number of women age 15- 49 years If she goes out without telling him ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 8.14 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 119 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Marital/Union status Currently married/ in union Formerly married /in union Never married/ in union Education None Primary SMP/SM Higher Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 19.5 50.8 21.9 17.6 36.3 27.7 29.3 29.6 28.7 27.8 27.3 24.0 29.1 35.6 24.7 56.5 29.3 26.2 21.1 51.0 30.5 29.9 18.8 13.4 38.4 17.7 10.9 16.7 17.4 27.9 17.8 48.8 19.1 16.9 33.0 25.4 25.0 26.6 29.4 25.1 26.8 21.3 26.4 37.5 23.5 52.5 31.2 22.7 18.2 51.2 29.3 25.0 15.3 12.4 36.7 15.2 7.1 17.2 14.1 25.8 9.4 32.4 6.6 8.3 18.9 11.4 15.0 13.7 18.9 16.2 12.0 11.7 15.1 25.3 11.4 37.1 17.0 11.9 9.1 32.5 14.1 14.3 7.3 5.1 20.7 8.2 3.6 5.5 6.9 14.1 6.0 29.5 6.6 5.1 17.4 10.1 10.1 10.7 14.4 13.9 10.9 13.5 13.4 21.7 8.2 33.4 14.1 10.2 6.5 30.0 14.1 11.1 4.5 2.8 19.4 3.2 2.3 2.6 7.8 11.9 32.5 66.6 37.2 29.1 53.0 43.3 48.2 44.7 42.5 41.4 39.7 34.9 42.7 50.7 40.6 73.3 47.3 40.0 30.7 70.5 47.3 45.7 30.5 22.7 56.8 28.9 20.0 26.2 22.9 42.2 19.3 32.4 16.9 15.1 27.2 28.0 28.0 23.4 22.6 18.7 16.0 14.0 20.1 30.6 24.5 41.0 23.2 21.6 13.0 37.0 22.2 21.1 16.3 14.6 28.3 16.1 8.3 17.8 15.0 21.8 34.4 67.5 39.1 31.7 53.9 47.1 51.3 46.1 43.4 41.7 40.5 36.1 43.8 55.0 43.5 74.5 48.4 41.9 32.6 71.1 49.7 46.3 33.2 24.8 58.5 30.2 21.7 27.1 26.7 43.9 1,161 627 780 1,153 1,415 420 330 407 368 383 347 313 1,681 62 825 145 636 1,390 396 486 445 496 577 563 1,354 686 252 123 152 2,568 15.0 51.3 19.4 14.8 33.6 21.6 30.5 25.6 26.4 26.7 22.8 23.0 27.0 35.2 20.8 55.0 29.5 22.6 16.6 53.5 29.0 25.1 13.9 9.3 38.6 11.0 6.7 12.7 10.4 25.2 Table CP.9M: Attitudes toward domestic violence among men Percentage of men age 15-49 years who believe a husband is justified in beating his wife/partner in various circumstances, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 If she neglects the children If she argues with him If she refuses sex with him Percentage of men age 15-49 years who believe a husband is justified in beating his wife/partner: If she burns the food For any of these reasons1 If she argues with parent- in-law For any of the 6 reasons Number of men age 15- 49 years If she goes out without telling him *1 cases with missing “Ethnicity of household head” not shown ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 8.14 MULTIPLE INDICATOR CLUSTER SURVEY 2011120 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 121MULTIPLE INDICATOR CLUSTER SURVEY 2011 11 HIV/AIDS, SEXUAL BEHAVIOUR, AND ORPHANS 11.1. KNOWLEDGE ABOUT HIV TRANSMISSION AND MISCONCEPTIONS ABOUT HIV/AIDS One of the most important prerequisites for reducing the rate of HIV infection is accurate knowledge of how HIV is transmitted and strategies for preventing transmission. Correct information is the first step towards raising awareness and giving young people the tools to protect themselves from infection. Misconceptions about HIV are common and can confuse young people and hinder prevention efforts. Different regions are likely to have variations in misconceptions although some appear to be universal (for example that sharing food can transmit HIV or mosquito bites can transmit HIV). The UN General Assembly Special Session on HIV/AIDS (UNGASS) called on governments to improve the knowledge and skills of young people to protect themselves from HIV. The indicators to measure this goal as well as the MDG of reducing HIV infections by half include improving the level of knowledge of HIV and its prevention, and changing behaviours to prevent further spread of the disease. HIV modules were administered to women and men 15-49 years of age. One indicator which is both an MDG and UNGASS indicator is the per cent of young women who have comprehensive and correct knowledge of HIV prevention and transmission. In MICS conducted in three districts in Papua, all women who have heard of AIDS were asked whether they knew of the two main ways of preventing HIV transmission – having only one faithful uninfected partner and using a condom every time. The results are presented in Table HA.1 for women age 15-49. In the three selected districts of Papua Province, about 80 per cent of the interviewed women have heard of AIDS with clear differentials among districts (Merauke, 84 per cent; Jayawijaya, 59 per cent; Biak Numfor, 96 per cent). The percentage of women who know of both main ways of preventing HIV transmission is only 37 per cent. Fifty-two per cent of women know of having one faithful uninfected sex partner and 45 per cent know of using a condom every time as main ways of preventing HIV transmission. Differentials were observed in the percentage of women who know of both main ways of preventing HIV transmission by districts, with the least knowledge in Jayawijaya District (20 per cent) compared with 43 and 45 per cent in Merauke and Biak Numfor districts respectively. Lower knowledge was observed among women with lower education, those ever married or in union, the poorest women and women with Papuan heads of household. The results for women age 15-24 are separately presented in Table HA.2. The percentage of women who have heard of AIDS is 85 per cent and the percentage of women who 122 MULTIPLE INDICATOR CLUSTER SURVEY 2011 know of both main ways of preventing HIV transmission is slightly higher for this age group (41 per cent) compared with the age group 15-49 (37 per cent). Differentials of these indicators are generally similar to those for age group 15-49 showing only slightly higher percentages in most categories. Table HA.1 and HA.2 also present the percentages of women who can correctly identify misconceptions concerning HIV. The indicator is based on the two most common and relevant misconceptions in the three districts of Papua Province, that HIV can be transmitted by supernatural means and sharing food with someone with AIDS. The table also provides information on whether women know that HIV cannot be transmitted by mosquito bites. Of the interviewed women, 33 per cent reject the two most common misconceptions and know that a healthy-looking person can be infected. Sixty per cent of women know that HIV cannot be transmitted by supernatural means, and 51 per cent of women know that HIV cannot be transmitted by sharing food with someone with AIDS, while 56 per cent of women know that a healthy-looking person can be infected. Results for women age 14-24 were generally similar to those of women age 15-49. Women who have comprehensive knowledge about HIV prevention include women who know of the two main ways of HIV prevention (having only one faithful uninfected partner and using a condom every time), who know that a healthy looking person can have the AIDS virus, and who reject the two most common misconceptions. Tables HA.1 and HA.2 also present the percentage of women with comprehensive knowledge. Overall, only 20 per cent of women age 15-49 were found to have comprehensive knowledge, which was higher in urban areas (33 per cent) compared with rural (11 per cent). Comprehensive knowledge is drastically low in Jayawijaya District (9 per cent) compared with Merauke (25 per cent) and Biak Numfor (24 per cent). As expected, the percentage of women with comprehensive knowledge increases with the woman’s education level (Figure HA.1). Comprehensive knowledge was at the lowest level among women with no education (1 per cent) and increased to 45 per cent among women higher education. Women residing in the poorest households show only two per cent comprehensive knowledge compared withwith 41 per cent in the richest households. Women living in households with Javanese heads have higher levels of comprehensive knowledge compared with others. Similar results were observed for women age 15-24. Figure HA.1: Percentage of women who have comprehensive knowledge of HIV/AIDS transmission, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 70 60 50 40 30 20 10 0 P er c en t None Primary HigherSecondary Indentify 2 most common misconceptions and know that a healthy looking person can have the AIDS Comprehensive knowledge Knows 2 ways to prevent HIV 45 6868 48 27 48 10 20 28 6 4 2 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 123 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l A g e 15 -2 4 25 -2 9 30 -3 9 40 -4 9 M ar it al s ta tu s E ve r m ar ri ed /in u n io n N ev er m ar ri ed /in u n io n W o m en ’s e d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 84 .5 63 .2 95 .7 94 .9 72 .9 86 .7 86 .0 81 .3 73 .3 79 .6 92 .5 35 .6 74 .6 95 .0 10 0. 0 49 .3 80 .2 85 .9 93 .8 97 .9 76 .1 85 .1 94 .4 94 .8 92 .6 82 .2 66 .8 37 .0 72 .3 77 .0 48 .5 67 .4 64 .3 59 .3 48 .6 57 .3 73 .2 11 .1 45 .6 75 .6 89 .1 16 .9 54 .9 63 .4 74 .5 86 .9 48 .3 70 .0 80 .8 78 .4 80 .1 60 .5 38 .4 25 .1 46 .9 50 .5 27 .9 44 .5 39 .5 34 .9 28 .6 33 .7 52 .7 10 .8 22 .9 46 .3 64 .7 17 .4 27 .8 32 .2 47 .6 57 .2 32 .1 36 .8 50 .5 59 .5 46 .1 37 .4 63 .9 44 .4 72 .0 77 .3 49 .3 66 .4 66 .3 60 .1 50 .1 58 .3 72 .3 22 .9 46 .7 72 .3 91 .3 30 .9 49 .4 60 .1 76 .1 83 .1 52 .0 67 .0 79 .0 76 .1 74 .4 61 .1 57 .5 38 .8 59 .7 66 .0 43 .8 58 .6 55 .5 53 .7 42 .1 49 .7 66 .9 17 .5 40 .4 63 .8 79 .2 27 .4 47 .4 50 .1 62 .7 73 .4 45 .9 56 .4 67 .2 72 .5 63 .5 53 .1 41 .5 20 .2 41 .2 50 .3 25 .1 41 .5 40 .2 34 .6 24 .7 32 .4 49 .1 4. 1 19 .8 45 .4 67 .9 7. 2 26 .1 32 .0 47 .6 59 .9 24 .8 43 .0 54 .8 56 .7 52 .3 35 .7 25 .4 12 .7 24 .0 34 .2 12 .3 24 .4 25 .2 20 .7 15 .4 19 .8 28 .8 1. 5 10 .1 27 .0 47 .6 2. 1 15 .1 17 .7 27 .9 40 .9 13 .2 26 .2 34 .5 41 .7 38 .5 21 .6 1, 18 9 74 8 84 8 1, 17 4 1, 61 0 86 5 50 6 83 5 57 9 2, 23 3 55 1 36 2 78 9 1, 27 2 36 1 53 6 50 6 52 8 59 4 62 1 1, 50 1 68 2 30 2 14 4 15 6 2, 78 4 57 .9 41 .0 62 .7 73 .9 40 .9 56 .5 61 .1 55 .3 46 .0 53 .2 61 .3 16 .2 42 .9 65 .4 82 .2 21 .8 49 .1 54 .6 64 .6 78 .7 45 .6 57 .3 72 .2 75 .6 79 .1 54 .8 53 .1 30 .5 57 .0 63 .8 36 .9 55 .9 50 .9 43 .2 41 .7 45 .6 58 .9 8. 8 37 .1 58 .4 76 .2 14 .0 41 .5 50 .6 61 .3 68 .5 38 .8 55 .0 62 .0 64 .6 67 .5 48 .2 43 .8 25 .7 45 .3 55 .1 28 .0 43 .2 43 .7 37 .4 32 .9 37 .7 46 .3 5. 7 27 .9 47 .9 68 .4 9. 9 34 .3 39 .2 48 .5 60 .4 30 .0 44 .8 53 .6 57 .7 62 .3 39 .4 Ta b le H A .1 : K n o w le d g e ab o u t H IV t ra n sm is si o n , m is co n ce p ti o n s ab o u t H IV /A ID S , a n d c o m p re h en si ve k n o w le d g e ab o u t H IV t ra n sm is si o n a m o n g w o m en P er ce n ta g e o f w o m en a g e 15 -4 9 ye ar s w h o k n o w t h e m ai n w ay s o f p re ve n ti n g H IV t ra n sm is si o n , p er ce n ta g e w h o k n o w t h at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S v ir u s, p er ce n ta g e w h o r ej ec t co m m o n m is co n ce p ti o n s, a n d p er ce n ta g e w h o h av e co m p re h en si ve k n o w le d g e ab o u t H IV t ra n sm is si o n , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 S h ar in g fo o d w it h so m eo n e w it h A ID S S u p er n at u ra l m ea n s M o sq u it o b it es P er ce n ta g e w h o k n o w th at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S v ir u s P er ce n ta g e o f w o m en w h o k n o w b o th w ay s U si n g a co n d o m ev er y ti m e H av in g o n ly o n e fa it h fu l u n in fe ct ed se x p ar tn er P er ce n ta g e w h o h av e h ea rd o f A ID S P er ce n ta g e w h o k n o w tr an sm is si o n c an b e p re ve n te d b y: P er ce n ta g e w h o k n o w t h at H IV ca n n o t b e tr an sm it te d b y: P er ce n ta g e w h o re je ct t h e tw o m o st c o m m o n m is co n ce p ti o n s an d k n o w t h at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S v ir u s P er ce n ta g e w it h co m p re h en si ve kn o w le d g e1 N u m b er o f w o m en 1 M IC S in d ic at o r 9. 1 124 MULTIPLE INDICATOR CLUSTER SURVEY 2011 90 .9 83 .1 95 .1 95 .2 86 .3 88 .9 94 .5 93 .3 85 .7 90 .0 90 .9 55 .1 82 .9 94 .9 98 .6 77 .0 85 .3 91 .4 96 .5 98 .2 87 .7 91 .3 95 .7 96 .4 94 .1 90 .3 54 .1 41 .5 72 .0 71 .5 44 .2 55 .3 65 .7 57 .2 51 .3 55 .3 59 .0 17 .5 37 .8 63 .3 76 .5 30 .3 47 .7 52 .5 68 .5 77 .2 52 .3 57 .0 68 .0 76 .4 55 .6 56 .5 44 .4 39 .8 54 .4 58 .9 36 .1 46 .8 54 .8 49 .1 37 .4 44 .0 51 .3 18 .6 27 .6 51 .3 69 .3 29 .1 34 .4 43 .1 53 .5 66 .1 43 .4 43 .5 61 .4 62 .6 46 .6 46 .3 74 .1 60 .9 80 .8 83 .0 64 .7 71 .5 82 .6 75 .0 66 .3 72 .2 74 .5 39 .7 59 .3 78 .2 88 .5 52 .0 63 .0 69 .8 84 .1 90 .3 67 .4 75 .6 84 .8 87 .0 79 .4 72 .9 62 .1 53 .9 59 .2 67 .9 52 .2 59 .7 63 .3 62 .4 52 .6 57 .7 62 .4 32 .1 44 .8 63 .9 75 .9 44 .8 50 .2 56 .2 65 .8 74 .9 54 .9 62 .1 68 .7 71 .6 59 .3 59 .2 36 .0 23 .4 41 .6 48 .2 23 .6 34 .2 43 .2 34 .1 30 .5 33 .1 38 .0 9. 1 15 .2 40 .4 55 .1 13 .3 25 .2 27 .7 44 .7 56 .3 28 .6 37 .5 50 .0 54 .5 33 .3 34 .6 17 .8 14 .1 28 .1 27 .8 13 .7 18 .7 26 .6 19 .6 18 .0 19 .7 20 .8 4. 2 6. 5 23 .8 34 .4 6. 8 12 .3 16 .8 26 .6 33 .8 17 .0 21 .5 29 .9 30 .2 16 .1 20 .0 1, 16 1 62 7 78 0 1, 53 1, 41 5 75 1 40 7 75 1 65 9 1, 74 3 82 5 14 5 63 6 1, 39 0 39 6 48 6 44 5 49 6 57 7 56 3 1, 35 4 68 6 25 2 12 3 15 2 2, 56 8 48 .6 44 .9 76 .5 58 .2 54 .5 52 .9 60 .1 59 .8 53 .4 56 .9 54 .6 23 .4 43 .7 62 .2 66 .9 34 .6 49 .8 60 .1 65 .1 67 .1 52 .8 59 .3 66 .5 58 .9 52 .8 56 .2 60 .1 43 .7 70 .2 68 .8 51 .3 57 .1 68 .0 62 .1 52 .6 58 .4 60 .6 23 .1 43 .3 66 .3 72 .5 32 .8 50 .0 60 .8 70 .8 75 .8 54 .2 63 .1 69 .3 73 .8 56 .4 59 .1 38 .1 33 .2 59 .4 47 .4 40 .1 40 .7 47 .2 46 .1 40 .9 43 .8 42 .4 16 .8 30 .1 49 .0 54 .9 23 .6 34 .3 46 .5 51 .9 56 .1 39 .9 48 .2 50 .6 50 .1 34 .7 43 .4 Ta b le H A .1 M : K n o w le d g e ab o u t H IV t ra n sm is si o n , m is co n ce p ti o n s ab o u t H IV /A ID S , a n d c o m p re h en si ve k n o w le d g e ab o u t H IV t ra n sm is si o n a m o n g m en P er ce n ta g e o f m en a g e 15 -4 9 ye ar s w h o k n o w t h e m ai n w ay s o f p re ve n ti n g H IV t ra n sm is si o n , p er ce n ta g e w h o k n o w t h at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S v ir u s, p er ce n ta g e w h o r ej ec t co m m o n m is co n ce p ti o n s, a n d p er ce n ta g e w h o h av e co m p re h en si ve k n o w le d g e ab o u t H IV t ra n sm is si o n , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 *1 c as e w it h m is si n g “ E th n ic it y o f h o u se h o ld h ea d ” n o t sh o w n 1 M IC S in d ic at o r 9. 1 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l A g e 15 -2 4 25 -2 9 30 -3 9 40 -4 9 M ar it al s ta tu s E ve r m ar ri ed /in u n io n N ev er m ar ri ed /in u n io n M en ’s e d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d * P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts S h ar in g fo o d w it h so m eo n e w it h A ID S S u p er n at u ra l m ea n s M o sq u it o b it es P er ce n ta g e w h o k n o w th at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S v ir u s P er ce n ta g e o f m en w h o kn o w b o th w ay s U si n g a co n d o m ev er y ti m e H av in g o n ly o n e fa it h fu l u n in fe ct ed se x p ar tn er P er ce n ta g e w h o h av e h ea rd o f A ID S P er ce n ta g e w h o k n o w tr an sm is si o n c an b e p re ve n te d b y: P er ce n ta g e w h o k n o w t h at H IV ca n n o t b e tr an sm it te d b y: P er ce n ta g e w h o re je ct t h e tw o m o st c o m m o n m is co n ce p ti o n s an d k n o w t h at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S v ir u s P er ce n ta g e w it h co m p re h en si ve kn o w le d g e1 N u m b er o f m en MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 125 89 .0 71 .2 95 .8 96 .0 79 .0 86 .9 86 .6 80 .7 92 .0 31 .7 69 .7 95 .2 10 0. 0 61 .7 84 .4 87 .9 96 .2 98 .1 82 .4 91 .5 95 .3 92 .1 (9 4. 7) 86 .7 75 .5 40 .5 77 .4 81 .5 55 .6 66 .2 68 .7 61 .5 72 .5 12 .6 40 .7 76 .0 92 .0 23 .3 63 .0 68 .2 82 .8 89 .9 55 .4 84 .3 88 .5 79 .0 (7 8. 3) 67 .4 46 .5 32 .3 51 .4 55 .7 35 .2 45 .6 43 .3 36 .5 51 .5 14 .1 22 .8 49 .1 67 .9 25 .4 32 .7 41 .3 57 .3 58 .3 38 .4 47 .3 63 .3 64 .0 (4 6. 6) 44 .5 71 .5 49 .9 72 .4 79 .7 55 .2 64 .5 68 .6 61 .6 70 .5 19 .9 45 .3 72 .6 90 .3 37 .1 56 .8 66 .1 79 .2 84 .2 57 .8 77 .8 86 .9 68 .7 (7 2. 0) 66 .4 61 .5 47 .0 63 .7 68 .4 50 .4 61 .7 55 .0 50 .6 65 .5 13 .3 36 .3 65 .2 81 .5 36 .3 52 .7 55 .8 66 .8 74 .9 54 .1 60 .0 73 .5 75 .7 (5 7. 4) 58 .6 49 .8 22 .6 45 .2 55 .2 30 .1 41 .3 41 .7 34 .6 47 .5 3. 0 20 .4 45 .4 72 .3 9. 2 36 .1 37 .1 53 .3 63 .4 31 .3 52 .0 65 .0 54 .8 (5 4. 8) 41 .5 30 .2 14 .1 24 .7 36 .3 14 .5 25 .6 23 .0 20 .3 27 .9 0. 0 12 .0 26 .1 46 .1 2. 0 22 .0 17 .4 34 .1 40 .2 16 .3 32 .9 41 .8 33 .0 (3 8. 0) 24 .4 36 5 21 7 28 3 39 3 47 1 46 2 40 3 40 2 46 2 67 14 1 54 5 11 1 15 9 14 4 16 3 20 8 19 1 50 1 19 5 83 45 40 86 5 57 .5 45 .6 63 .7 71 .1 44 .3 56 .0 57 .1 52 .2 60 .3 16 .9 37 .6 62 .1 77 .1 33 .1 49 .2 55 .5 63 .3 75 .0 50 .8 59 .1 71 .7 63 .3 (7 5. 7) 56 .5 58 .9 39 .2 64 .7 71 .2 43 .1 55 .1 56 .7 52 .4 58 .8 8. 2 38 .2 61 .0 81 .4 19 .2 51 .7 58 .9 70 .9 70 .4 47 .6 64 .2 73 .3 65 .1 (7 1. 0) 55 .9 45 .1 32 .0 49 .3 57 .5 31 .2 43 .2 43 .2 40 .6 45 .4 6. 1 26 .1 47 .0 68 .4 16 .1 40 .5 41 .2 54 .2 57 .5 36 .2 48 .0 61 .4 49 .3 (6 2. 5) 43 .2 Ta b le H A .2 : K n o w le d g e ab o u t H IV t ra n sm is si o n , m is co n ce p ti o n s ab o u t H IV /A ID S , a n d c o m p re h en si ve k n o w le d g e ab o u t H IV t ra n sm is si o n a m o n g y o u n g w o m en P er ce n ta g e o f yo u n g w o m en a g e 15 -2 4 ye ar s w h o k n o w t h e m ai n w ay s o f p re ve n ti n g H IV t ra n sm is si o n , p er ce n ta g e w h o k n o w t h at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S vi ru s, p er ce n ta g e w h o r ej ec t co m m o n m is co n ce p ti o n s, a n d p er ce n ta g e w h o h av e co m p re h en si ve k n o w le d g e ab o u t H IV t ra n sm is si o n , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 ( ) Fi g u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es 1 M IC S in d ic at o r 9. 2; M D G in d ic at o r 6. 3 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l A g e 15 -1 9 20 -2 4 M ar it al s ta tu s E ve r m ar ri ed /in u n io n N ev er m ar ri ed /in u n io n W o m en ’s e d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d * P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts S h ar in g fo o d w it h so m eo n e w it h A ID S S u p er n at u ra l m ea n s M o sq u it o b it es P er ce n ta g e w h o k n o w th at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S v ir u s P er ce n ta g e o f w o m en w h o k n o w b o th w ay s U si n g a co n d o m ev er y ti m e H av in g o n ly o n e fa it h fu l u n in fe ct ed se x p ar tn er P er ce n ta g e w h o h av e h ea rd o f A ID S P er ce n ta g e w h o k n o w tr an sm is si o n c an b e p re ve n te d b y: P er ce n ta g e w h o k n o w t h at H IV ca n n o t b e tr an sm it te d b y: P er ce n ta g e w h o re je ct t h e tw o m o st c o m m o n m is co n ce p ti o n s an d k n o w t h at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S v ir u s P er ce n ta g e w it h co m p re h en si ve kn o w le d g e1 N u m b er o f w o m en ag e 15 - 24 126 MULTIPLE INDICATOR CLUSTER SURVEY 2011 91 .1 80 .2 90 .9 93 .4 84 .8 89 .0 88 .8 80 .9 90 .5 (3 6. 7) 74 .1 94 .1 96 .7 75 .6 82 .2 91 .0 95 .0 96 .5 85 .8 94 .2 94 .3 (9 1. 9) (8 8. 3) 88 .9 54 .6 35 .5 66 .5 68 .4 43 .4 56 .1 54 .2 45 .6 57 .2 (9 .1 ) 31 .5 60 .3 78 .0 33 .0 41 .9 50 .6 69 .0 75 .0 53 .9 47 .6 70 .3 (7 9. 5) (5 4. 2) 55 .3 43 .0 43 .1 53 .1 57 .1 37 .5 48 .8 44 .3 35 .4 49 .1 (1 9. 2) 28 .2 50 .2 65 .2 33 .7 37 .7 41 .8 52 .8 64 .1 45 .3 45 .9 64 .2 (4 5. 3) (3 8. 5) 46 .8 72 .6 60 .9 75 .7 81 .5 62 .4 68 .9 74 .8 62 .0 73 .4 (2 6. 3) 52 .6 75 .5 92 .1 48 .8 59 .6 70 .4 83 .0 88 .6 66 .5 79 .1 83 .2 (7 9. 8) (6 6. 9) 71 .5 61 .9 54 .7 59 .8 67 .8 52 .5 60 .2 59 .2 49 .9 61 .7 (2 3. 6) 42 .9 63 .9 72 .7 43 .1 53 .0 62 .1 64 .8 70 .8 57 .2 65 .7 64 .8 (6 4. 8) (4 9. 5) 59 .7 35 .8 21 .0 39 .3 47 .6 22 .2 33 .3 35 .5 27 .8 35 .5 (7 .5 ) 13 .4 37 .0 60 .8 14 .2 22 .3 30 .0 43 .3 55 .4 31 .5 32 .7 51 .0 (5 4. 4) (2 2. 9) 34 .2 14 .6 13 .8 26 .2 27 .0 11 .3 15 .9 22 .4 13 .6 19 .7 (4 .9 ) 2. 9 19 .9 43 .2 4. 6 9. 6 17 .7 25 .1 32 .3 17 .8 15 .1 33 .2 (2 9. 4) (9 .0 ) 18 .7 32 7 14 6 27 8 35 6 39 5 42 0 33 0 12 4 62 7 24 13 6 51 2 78 12 1 14 1 16 5 16 9 15 5 43 9 16 8 67 38 39 75 1 42 .5 44 .8 69 .2 54 .9 51 .0 49 .1 57 .7 48 .9 53 .6 (8 .8 ) 29 .9 59 .3 64 .2 35 .6 38 .6 57 .7 62 .6 63 .5 51 .9 53 .2 67 .1 (4 5. 8) (4 4. 3) 52 .9 56 .1 40 .6 67 .0 67 .1 48 .1 54 .5 60 .5 49 .5 58 .6 (1 1. 8) 29 .8 63 .2 78 .6 26 .7 44 .0 58 .2 73 .4 74 .0 52 .5 62 .8 70 .8 (6 3. 9) (5 4. 8) 57 .1 33 .4 32 .1 53 .8 44 .8 37 .1 36 .8 45 .8 36 .3 41 .6 (6 .6 ) 19 .8 45 .3 57 .8 19 .6 27 .0 44 .0 52 .3 53 .6 38 .0 44 .2 55 .0 (4 0. 3) (3 2. 8) 40 .7 Ta b le H A .2 M : K n o w le d g e ab o u t H IV t ra n sm is si o n , m is co n ce p ti o n s ab o u t H IV /A ID S , a n d c o m p re h en si ve k n o w le d g e ab o u t H IV t ra n sm is si o n a m o n g y o u n g m en P er ce n ta g e o f yo u n g m en a g e 15 -2 4 ye ar s w h o k n o w t h e m ai n w ay s o f p re ve n ti n g H IV t ra n sm is si o n , p er ce n ta g e w h o k n o w t h at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S vi ru s, p er ce n ta g e w h o r ej ec t co m m o n m is co n ce p ti o n s, a n d p er ce n ta g e w h o h av e co m p re h en si ve k n o w le d g e ab o u t H IV t ra n sm is si o n , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 ( ) Fi g u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es 1 M IC S in d ic at o r 9. 2; M D G in d ic at o r 6. 3 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l A g e 15 -1 9 20 -2 4 M ar it al s ta tu s E ve r m ar ri ed /in u n io n N ev er m ar ri ed /in u n io n W o m en ’s e d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts S h ar in g fo o d w it h so m eo n e w it h A ID S S u p er n at u ra l m ea n s M o sq u it o b it es P er ce n ta g e w h o k n o w th at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S v ir u s P er ce n ta g e o f m en w h o kn o w b o th w ay s U si n g a co n d o m ev er y ti m e H av in g o n ly o n e fa it h fu l u n in fe ct ed se x p ar tn er P er ce n ta g e w h o h av e h ea rd o f A ID S P er ce n ta g e w h o k n o w tr an sm is si o n c an b e p re ve n te d b y: P er ce n ta g e w h o k n o w t h at H IV ca n n o t b e tr an sm it te d b y: P er ce n ta g e w h o re je ct t h e tw o m o st c o m m o n m is co n ce p ti o n s an d k n o w t h at a h ea lt h y lo o ki n g p er so n c an h av e th e A ID S v ir u s P er ce n ta g e w it h co m p re h en si ve kn o w le d g e1 N u m b er o f m en ag e 15 - 24 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 127 Tables HA.1M and HA.2M present the HIV/ AIDS indicators for men age 15-49 and 15- 24 respectively. The percentage of comprehensive knowledge is slightly lower among men age 15-49 (20 per cent) compared with women (21 per cent). Similar trends were observed in variations by background characteristic in comprehensive knowledge for men as were observed for women. Unlike for women, comprehensive knowledge was lower among men in the younger age group 15-24 (19 per cent) than among men age 15- 49 (20 per cent). Knowledge of mother-to-child transmission of HIV is also an important first step in encouraging women to seek HIV testing when they are pregnant to avoid infection in the baby. Women should know that HIV can be transmitted during pregnancy, during delivery, and through breastfeeding. The level of knowledge among women age 15-49 years concerning mother-to-child transmission is presented in Table HA.3. About 72 per cent of women know that HIV can be transmitted from mother to child, 68 per cent during pregnancy, 63 per cent during delivery and 65 per cent by breastfeeding. The percentage of women who know all three ways of mother-to-child transmission is 58 per cent, while eight per cent of women did not know of any specific way. District differentials exist with the highest percentage for this indicator in the district of Biak Numfor (70 per cent) and the lowest in Jayawijaya (37 per cent). The impact of education on knowledge is also clear, with the percentage among women with no education 20 per cent, rising to 45 per cent among women who have primary education, to 68 per cent among women with secondary education and rising to reach the maximum of 84 per cent among women who higher education. Wealth index is also positively correlated, with knowledge of the transmission from mother to child amounting to 27 per cent among women of the poorest 20 per cent of households, rising gradually to reach 79 per cent for women of the richest 20 per cent of households. Knowledge of mother-to-child HIV transmission from mother to child is similar among men (58 per cent) and women (58 per cent) (Table HA.3). About 75 per cent of men know that HIV can be transmitted during pregnancy, 66 per cent during delivery and 70 per cent by breastfeeding. The percentage of men who know all three ways of mother-to-child transmission is 58 per cent, while 11 per cent of men did not know of any specific way. 128 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age group 15-24 15-19 20-24 25-29 30-39 40-49 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 74.8 50.8 82.6 86.7 59.1 76.6 75.9 77.4 74.2 70.5 59.1 68.2 80.8 24.1 58.9 84.2 96.0 33.8 63.9 72.2 84.1 94.0 61.7 76.1 89.1 87.7 83.1 70.7 64.5 46.3 75.7 79.0 51.4 67.6 68.2 67.0 66.4 63.9 52.0 60.7 72.6 21.3 51.9 73.4 92.7 31.3 57.2 63.4 72.4 85.9 56.9 63.8 76.3 80.6 76.7 63.0 71.3 48.7 78.9 82.6 56.5 73.6 73.0 74.2 71.6 66.6 56.2 64.9 78.1 24.2 55.4 80.8 90.6 32.9 61.1 71.0 79.7 87.9 60.4 70.8 81.4 79.9 83.0 67.5 59.7 41.0 69.4 73.0 46.5 62.9 62.0 64.0 62.0 57.3 46.3 55.3 67.0 18.8 46.7 68.0 83.9 27.1 51.8 58.1 66.3 80.0 51.9 57.4 71.0 74.3 72.8 57.6 6.3 8.5 8.6 4.4 9.9 5.9 6.2 5.5 8.5 6.8 10.3 7.8 6.5 8.4 12.5 6.1 1.0 12.0 11.9 8.3 5.2 1.9 9.9 5.5 3.1 4.5 5.3 7.6 1,189 748 848 1,174 1,610 865 462 403 506 835 579 2,233 551 362 789 1,272 361 536 506 528 594 621 1,501 682 302 144 156 2,784 78.2 54.7 87.2 90.5 63.0 80.9 80.7 81.1 77.5 74.5 63.0 71.8 86.0 27.2 62.2 88.9 99.0 37.3 68.2 77.6 88.6 96.1 66.2 79.7 91.2 90.3 87.3 74.6 Table HA.3: Knowledge of mother-to-child HIV transmission among women Percentage of women age 15-49 years who correctly identify means of HIV transmission from mother to child, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 During pregnancy During delivery By breastfeeding Per cent who know HIV can be transmitted: All three means1 Does not know any of the specific means Number of women Per centage who know HIV can be transmitted from mother to child 1 MICS indicator 9.3 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 129 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age group 15-24 15-19 20-24 25-29 30-39 40-49 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Total for 3 districts 74.9 66.2 82.1 83.5 68.0 71.3 69.4 73.7 82.5 80.3 68.5 75.3 74.3 38.4 60.4 81.7 88.1 54.3 65.6 75.1 85.8 89.1 75.0 63.0 62.9 73.1 72.7 60.6 61.1 58.4 64.6 69.8 71.4 63.2 67.5 63.0 36.0 52.3 71.5 79.9 50.6 55.6 67.0 75.1 77.5 66.0 68.1 65.8 74.5 75.1 65.0 64.8 64.8 64.8 78.5 72.9 65.4 70.8 66.9 38.7 58.5 76.1 75.5 53.2 64.7 70.7 76.9 78.6 69.5 53.7 58.4 65.1 63.7 53.9 53.1 49.7 57.5 63.3 63.3 55.4 60.2 54.2 33.4 46.8 64.1 65.5 43.8 52.0 58.4 65.9 67.9 58.3 10.2 12.9 8.9 7.5 12.9 12.6 13.3 11.7 7.5 9.4 11.1 9.9 11.6 13.7 16.0 8.7 6.5 16.9 15.1 9.7 7.0 5.5 10.5 1,161 627 780 1,153 1,415 751 420 330 407 751 659 1,743 825 145 636 1390 396 486 445 496 577 563 2,568 80.7 70.2 86.1 87.7 73.4 76.3 75.6 77.1 87.1 84.0 74.6 80.1 79.3 41.4 66.9 86.2 92.2 60.1 70.2 81.8 89.5 92.8 79.8 Table HA.3M: Knowledge of mother-to-child HIV transmission among men Percentage of men age 15-49 years who correctly identify means of HIV transmission from mother to child, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 During pregnancy During delivery By breastfeeding Per cent who know HIV can be transmitted: All three means1 Does not know any of the specific means Number of men Per centage who know HIV can be transmitted from mother to child 1 MICS indicator 9.3 11.2 ACCEPTING ATTITUDES TOWARD PEOPLE LIVING WITH HIV/AIDS The indicators on attitudes toward people living with HIV measure stigma and discrimination in the community. Stigma and discrimination are low if respondents report an accepting attitude on the following four questions: 1) Would care for family member sick with AIDS; 2) would buy fresh vegetables from a vendor who is HIV positive; 3) thinks that a female teacher who is HIV positive should be allowed to teach in school; and 4) would not want to keep HIV status of a family member a secret. Table HA.4 presents the attitudes of women towards people living with HIV/AIDS. In the three districts of Papua Province, 15 per cent of women who have heard of AIDS agree with all four accepting attitude. The most common accepting attitude is willing to care for a family member with the AIDS virus in own home (63 per cent), followed by belief that a female teacher with the AIDS virus and is not sick should be allowed to continue (55 per cent), followed by not wanting to keep secret that a family member got infected with the AIDS virus (54 per cent) and lastly buying fresh vegetables from a shopkeeper or vendor who has the AIDS virus (43 per cent). 130 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age group 15-24 15-19 20-24 25-29 30-39 40-49 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 51 49 38.1 52.8 39.6 44.1 43.2 45.2 46.4 49.2 43.9 46 46 33.8 39 47.1 58.2 33.4 39.1 41.6 49.1 56.6 38.3 56 50.8 59.2 44.6 46 65.9 56.6 49.9 65.8 51.2 63.4 61.7 65.4 58.5 56.1 52.7 55.9 66.8 33.8 45.7 61.9 75.6 36 49.6 56.7 64 69.9 49.1 66.5 67.2 73.9 65.8 58.3 62.4 29.8 58.6 47.5 60.8 48.9 51.1 46.4 50.2 56.5 64.7 55.2 51.4 33.3 56.6 56.2 51.9 40.5 62.1 56.1 57.1 51.3 48.6 64 54.5 61.2 53.9 54.3 93.7 91.2 90.5 92.8 91.4 92.6 93.1 92 91.1 92.4 91.8 91.6 93.7 84.2 90.7 92.8 94.8 84.7 92 91.1 94 94.3 88.7 97.2 95.9 95.1 88.3 92.1 21.5 8.2 13.9 16.9 15.3 13.5 15.2 11.5 16.3 17.6 17.9 15.8 17 3.7 12.6 17.1 22.9 7.1 13.3 12.9 20.4 20.2 9.9 24.7 19.9 28.2 11.2 16.1 1,004 472 811 1,114 1,174 750 401 349 436 678 424 1,779 509 129 589 1,209 361 264 405 453 557 608 1,142 581 285 136 144 2,288 65.7 69.3 60.2 67.2 62 66.6 67.7 65.4 65 64.3 60.6 63.1 69.4 53.6 62.8 64.3 72 55.5 60.2 65.5 67.4 67.9 59.5 72.8 71.7 72.4 49.4 64.5 Table HA.4: Accepting attitudes toward people living with HIV/AIDS among women Percentage of women age 15-49 years who have heard of AIDS who express an accepting attitude towards people living with HIV/AIDS, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Would buy fresh vegetables from a shopkeeper or vendor who has the AIDS virus Believe that a female teacher with the AIDS virus and is not sick should be allowed to continue teaching Would not want to keep secret that a family member got infected with the AIDS virus Percentage of women who: Agree with at least one accepting attitude Express accepting attitudes on all four indicators1 Number of women who have heard of AIDS Are willing to care for a family member with the AIDS virus in own home 1 MICS indicator 9.4 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 131 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age group 15-24 15-19 20-24 25-29 30-39 40-49 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 59.7 43.7 36.5 58.5 39.8 48.8 47.7 50.3 51.2 51.8 43 47.1 51.9 23 35.3 51.6 62.1 30.9 38.8 44.7 55.5 64 37.2 60.8 60.3 64.7 58.5 48.7 60.8 51 43.8 64.7 42.7 53.7 54 53.2 54.4 55.1 49.2 52.2 55.2 31.2 38.1 55.9 68.8 40.2 40.2 45.6 58.7 71.4 43.8 63.6 60.2 67.7 60.5 53.1 59.1 41.1 63.1 54.5 58.1 53.1 50.9 55.9 54 55.7 62.6 57.9 53.1 32.6 59 57.2 54.7 37.6 62.1 65.9 57.9 55.7 52.5 61.5 54.3 64.5 62.2 56.4 96.3 90.5 94.3 97.3 91.8 95.5 94.3 97 93.6 94.7 93.2 93.5 96.1 79.9 90.7 95.7 97.9 85.2 92.2 96.5 96.8 97.8 91.8 97.3 96.2 97.7 96.9 94.4 22.1 10.8 11.4 20.1 12.6 14.6 14.2 15 18 17 15.6 16.9 14.6 5 8.5 18.2 22 4.9 11.2 16.2 17.6 25.7 8.8 26.2 20.5 23.8 19.3 16.1 1,056 521 742 1,097 1,221 668 374 293 385 701 565 1,569 749 80 527 1,320 391 375 380 454 556 553 1,188 627 241 119 143 2,318 77.5 70.8 57 74.4 65 72.6 72.2 73 72.1 70.1 63.3 67.8 73 55 65.2 70 76.2 64.1 58.4 69.2 71.1 79.3 61.5 82.8 72.2 72.8 70.2 69.5 Table HA.4M: Accepting attitudes toward people living with HIV/AIDS among men Percentage of men age 15-49 years who have heard of AIDS who express an accepting attitude towards people living with HIV/AIDS, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Would buy fresh vegetables from a shopkeeper or vendor who has the AIDS virus Believe that a female teacher with the AIDS virus and is not sick should be allowed to continue teaching Would not want to keep secret that a family member got infected with the AIDS virus Percentage of men who: Agree with at least one accepting attitude Express accepting attitudes on all four indicators1 Number of men who have heard of AIDS Are willing to care for a family member with the AIDS virus in own home *1 case with missing “Ethnicity of household head” not shown 1 MICS indicator 9.4 132 MULTIPLE INDICATOR CLUSTER SURVEY 2011 The percentage of women agreeing to all accepting attitudes is highest in Merauke District (21 per cent) compared with Biak Numfor District (14 per cent) and Jayawijaya District (8 per cent). And as expected; accepting attitudes increase with women’ education. Accepting attitudes toward people living with HIV/AIDS is similar among men (16 per cent) compared with women (16 per cent) (Table HA4.M) with similar trends by background characteristics. 11.3. KNOWLEDGE OF A PLACE FOR HIV TESTING AND COUNSELLING Another important indicator is the knowledge of where to be tested for HIV and use of such services. In order to protect themselves and to prevent infecting others, it is important for individuals to know their HIV status. Knowledge of own status is also a critical factor in the decision to seek treatment. Questions related to knowledge among women of a facility for HIV testing and whether they have ever been tested is presented in Table HA.5. Thirty-four per cent of women knew where to be tested, while 13 per cent have actually been tested. Of these, three per cent has been tested within the last 12 months, and three per cent of them were told the result within the last 12 months. Jayawijaya District generally lagged behind in these indicators. It should be noted that these results do not include women with birth delivered by health professional. Generally similar patterns but with higher percentages were observed for the same indicators among men (Table HA.5M). MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 133 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age group 15-24 15-19 20-24 25-29 30-39 40-49 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 17.3 5.9 11.8 15.5 10.4 14.1 8.9 20 17.4 11.9 7 13.6 8.4 1.1 9.6 15.5 20.4 1.9 11.5 17.9 14.6 16.2 10.6 14.7 14.3 12.2 19.1 12.6 4.5 2.6 2.6 4.1 2.9 3.8 2.2 5.5 5.6 2.5 2.4 3.7 2.2 0.2 2.9 3.7 6.7 0.9 2.8 3.5 4.7 4.9 2.8 4.4 3.2 4.6 4.8 3.4 3.7 2 1.3 3.6 1.7 3 1.7 4.5 3.5 1.9 1.7 2.7 1.6 0.0 2.1 2.7 5.3 0.7 1.7 2.3 2.9 4.5 1.8 3.3 2.9 3.8 3.4 2.5 1,189 748 848 1,174 1,610 865 462 403 506 835 579 2,233 551 362 789 1,272 361 536 506 528 594 621 1,501 682 302 144 156 2,784 41.2 23.9 33.2 48.7 23.5 34.4 28.4 41.3 37.6 36.1 27.9 33.7 35.8 3.9 22.7 40.3 67.6 9.9 25.7 34.5 38.9 57 26.9 36.7 47 52.3 51.2 34.1 Table HA.5: Knowledge of a place for HIV testing among women Percentage of women age 15-49 years who know where to get an HIV test, percentage of women who have ever been tested, percentage of women who have been tested in the last 12 months, and percentage of women who have been tested in the last 12 months and have been told the result, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result2 Percentage of women who: Number of women Know a place to get tested1 1 MICS indicator 9.5 2 MICS indicator 9.6 134 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age group 15-24 15-19 20-24 25-29 30-39 40-49 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 17.5 12.2 19.8 22.7 12.2 10 7.3 13.3 28.4 17.3 17.4 19.2 12.1 3.5 8.9 18.7 28.5 4.8 12.9 17.5 21.1 25.8 15.9 16.2 20 25.8 17.4 16.9 4.9 5.7 7.3 8.5 3.7 4.1 3.4 4.9 8.9 7 4.7 6.3 4.9 1.3 2.4 6.8 9.8 2.4 3.2 4.9 7.4 10.2 6.1 4.5 6.3 11.3 4.7 5.9 3 3.7 5.6 5.8 2.5 2.6 2.1 3.2 6.5 4.7 3.1 4.4 3.1 0.0 1.5 4.3 8.3 1 2.3 3.9 5.7 6.1 4.2 2.9 5.6 5.4 2.8 4.0 1,161 627 780 1,153 1,415 751 420 330 407 751 659 1,743 825 145 636 1,390 396 486 445 496 577 563 1,354 686 252 123 152 2,568 43.9 33.6 39.1 56.6 26.4 32.8 24.9 42.8 50.8 42.7 38.3 41.7 36.3 10 20 42.9 72.6 18 26.3 35.3 47.9 65.7 34.5 40.8 50.5 67.9 44.7 40 Table HA.5M: Knowledge of a place for HIV testing among men Percentage of men age 15-49 years who know where to get an HIV test, percentage of men who have ever been tested, percentage of men who have been tested in the last 12 months, and percentage of men who have been tested in the last 12 months and have been told the result, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result2 Percentage of men who: Number of men Know a place to get tested1 *1 case with missing “Ethnicity of household head” not shown 1 MICS indicator 9.5 2 MICS indicator 9.6 Table HA.6 and HA.6M presents the same results for sexually active young women and young men. The proportion of young women who have been tested and have been told the result within the last 12 months provides a measure of the effectiveness of interventions that promote HIV counselling and testing among young people. This is important to know, because young people may feel that there are barriers to accessing services related to sensitive issues, such as sexual health. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 135 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age group 15-19 20-24 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 365 217 283 393 471 462 403 402 462 67 141 545 111 159 144 163 208 191 501 195 83 45 40 865 50.3 18 30.9 49 28.1 22.9 42.2 37.3 (31.9) 2.5 20 41.4 (75.2) 6.5 36.2 43.2 39.8 62.5 29.3 46.7 (44.1) (*) (*) 36.7 29.9 9.4 16.1 27.6 16.2 12.1 24.4 20.7 (22.7) 0.0 8.2 24.7 (44.6) 0.8 18.8 27.1 20.9 40.1 16.1 28 (20.6) (*) (*) 20.9 11.3 3.3 0.9 10.2 4 5.2 7.1 5.7 (14.9) 0.0 0.0 8.3 (16.1) 0.0 3.9 4.9 8.4 16.5 3.1 11.1 (8.4) (*) (*) 6.6 9.6 2.8 0.9 10.2 2.3 4.7 5.9 4.6 (14.9) 0.0 0.0 6.9 (14.5) 0.0 2.8 2.8 6.8 16.5 2.8 8.4 (8.4) (*) (*) 5.6 186 105 97 160 227 110 278 350 38 36 81 231 39 84 56 84 95 68 212 120 31 11 14 387 51.1 48.3 34.1 40.7 48.2 23.8 68.9 87 8.1 54.5 57.1 42.4 35.3 53 39.2 51.3 45.8 35.6 42.4 61.2 37.1 24.4 (34.3) 44.8 Table HA.6: Knowledge of a place for HIV testing among sexually active young women Percentage of women age 15-24 years who have had sex in the last 12 months, and among women who have had sex in the last 12 months, the percentage who know where to get an HIV test, percentage of women who have ever been tested, percentage of women who have been tested in the last 12 months, and percentage of women who have been tested in the last 12 months and have been told the result, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of women age 15-24 years Know a place to get tested Have ever been tested Percentage of women who: Have been tested in the last 12 months Have been tested in the last 12 months and have been told result1 Number of women age 15-24 years who have had sex in the last 12 months Percentage who have had sex in the last 12 months ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.7 Slightly fewer than half of women had sex in the last 12 months (45 per cent). Among these, 37 per cent know a place to get tested, 21 per cent have been tested, seven per cent have been tested in the last 12 months and seven per cent have been tested in the last 12 months and have been told the result. About one in four men have had sex in the last 12 months (25 per cent). Among these, 40 per cent know a place to get tested, 18 per cent have been tested, six per cent have been tested in the last 12 months and three per cent have been tested in the last 12 months and have been told the result. 136 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age group 15-19 20-24 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 327 146 278 356 395 420 330 124 627 24 136 512 78 121 141 165 169 155 439 168 67 38 39 751 45.4 19.2 48.6 63.8 19.9 24.7 46.4 33.7 50 (*) 10.7 46.1 70.4 12.6 (*) (45.8) (56.7) (60.8) 37.4 (*) (*) (*) (*) 40.4 17.4 10.1 24.6 25 12.3 10 21.3 16.3 21 (*) 7 22 24.1 5.9 (*) (14.2) (30.2) (26.8) 15.6 (*) (*) (*) (*) 18.2 5.8 1.2 10.6 6.6 6.3 1 8.5 6.2 6.8 (*) 4.5 6.5 11.9 1.1 (*) (7.5) (10.2) (12.9) 5.1 (*) (*) (*) (*) 6.4 3.9 0.0 5.1 3.2 3.7 0.0 4.7 3.6 3.3 (*) 4.5 1.9 11.9 0.0 (*) (5.8) (5.2) (6) 2.7 (*) (*) (*) (*) 3.4 79 44 67 89 101 52 138 111 79 9 36 122 22 47 27 40 39 36 128 34 15 7 5 190 24 30.3 24 24.9 25.6 12.3 41.7 89.3 12.6 39.3 26.6 23.9 27.6 38.8 19.4 24.2 23 23.6 29.1 20.5 22.9 (18.8) (12.3) 25.3 Table HA.6M: Knowledge of a place for HIV testing among sexually active young men Percentage of men age 15-24 years who have had sex in the last 12 months, and among men who have had sex in the last 12 months, the percentage who know where to get an HIV test, percentage of men who have ever been tested, percentage of men who have been tested in the last 12 months, and percentage of men who have been tested in the last 12 months and have been told the result, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of men age 15-24 years Know a place to get tested Have ever been tested Percentage of men who: Have been tested in the last 12 months Have been tested in the last 12 months and have been told result1 Number of men age 15-24 years who have had sex in the last 12 months Percentage who have had sex in the last 12 months ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.7 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 137 11.4. SEXUAL BEHAVIOUR RELATED TO HIV TRANSMISSION Promoting safer sexual behaviour is critical for reducing HIV prevalence. The use of condoms during sex, especially with non-regular partners, is especially important for reducing the spread of HIV. In most countries, over half of new HIV infections are among young people age 15-24 years, thus a change in behaviour among this age group will be especially important to reduce new infections. A set of questions was administered to all women 15-49 years of age to assess their risk of HIV infection. Risk factors for HIV include sex at an early age, sex with older men, sex with a non-marital, non-cohabitating partner, and failure to use a condom. The frequency of sexual behaviours that increase the risk of HIV infection among women is presented in Table HA.7 and Figure HA.2. About 87 per cent of never-married women age 15-24 have never had sex, seven per cent had sex before age 15, and 18 per cent had sex in the last 12 months with a man 10 or more years older. The percentage of women age 15-24 years who had sex before age 15 varied markedly by district with about one in five women in Jayawijaya District (19 per cent) having sex before age 15. This compares to much lower percentages in Merauke (2 per cent) and Biak Numfor districts (3 per cent). This indicator shows a strong association between sexual behaviour and area of residence, wealth and ethnicity, with the highest percentages of women who had sex before age 15 occurring in rural areas, among the poorest women and among women whose head of household are Papuan. The frequency of sexual behaviours that increase the risk of HIV infection among men is presented in Table HA.7M. The percentage of never-married men age 15-24 years who have never had sex (77 per cent) was lower than for women (88 per cent). Similarly fewer men than women had sex before age 15 (Men, 3 per cent, Women 6 per cent) and considerably fewer men had sex in the last 12 months with a woman 10 or more years older (1 per cent) than women had sex in the last 12 months with a man 10 or more years older (20 per cent). The percentage of men age 15-24 years who had sex before age 15 varied by district with about eight per cent of men in Jayawijaya District having sex before age 15. This compared with a lower percentage in Merauke (3 per cent) and a considerably lower percentage in Biak Numfor districts (1 per cent). Contrary to the results of women, where this indicator is higher in rural areas, the results show that the indicator is higher among men living in urban areas. 138 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age group 15-19 20-24 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 184 81 197 241 222 355 107 na 462 12 61 313 76 47 90 81 116 128 276 78 50 35 24 462 2.0 16.3 2.7 3.0 8.2 5.9 5.7 11.4 1.0 18.1 12.9 3.5 0.8 21.3 3.5 3.0 3.1 0.0 8.5 2.2 3.8 (0.0) (*) 5.8 365 217 283 393 471 462 403 402 462 67 141 545 111 159 144 163 208 191 501 195 83 45 40 865 21.2 22.0 14.1 21.1 18.7 23.4 18.2 20.5 (11.5) 15.0 30.9 17.9 (11.0) 15.2 17.9 28.9 24.9 8.0 15.1 20.0 (36.0) (*) (*) 19.7 186 105 97 160 227 110 278 350 38 36 81 231 39 84 56 84 95 68 212 120 31 11 14 387 89.4 86.2 86.9 87.5 88.0 92.2 73.1 na 87.8 (*) 78.3 90.9 83.0 80.5 81.9 87.2 92.7 90.4 83.2 95.8 (94.8) (87.1) (*) 87.8 Table HA.7: Sexual behaviour that increases the risk of HIV infection among young women Percentage of never-married young women age 15-24 years who have never had sex, percentage of young women age 15-24 years who have had sex before age 15, and percentage of young women age 15-24 years who had sex with a man 10 or more years older during the last 12 months, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of never- married women age 15-24 years Percentage of women age 15-24 years who had sex before age 152 Number of women age 15- 24 years Percentage of women age 15- 24 years who had sex in the last 12 months with a man 10 or more years older3 Number of women age 15-24 years who had sex in the 12 months preceding the survey Percentage of never- married women age 15-24 years who have never had sex1 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.10 2 MICS indicator 9.11 3 MICS indicator 9.12 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 139 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age group 15-19 20-24 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 279 100 248 317 310 404 223 na 627 14 106 438 68 73 120 139 154 141 353 142 63 37 32 627 2.5 7.5 0.7 2.6 3.0 3.2 2.3 5.9 2.2 (0.0) 1.3 3.5 1.6 4.8 6.8 3.1 0.4 0.0 4.4 0.0 2.5 (0.0) (0.0) 2.8 327 146 278 356 395 420 330 124 627 24 136 512 78 121 141 165 169 155 439 168 67 38 39 751 2.1 0.0 1.1 0.0 2.3 0.0 1.7 2.1 0.0 (*) (0.0) 1.3 (3.4) 0.0 (*) (4.1) (0.0) (2.0) 0.6 (*) (*) (*) (*) 1.2 79 44 67 89 101 52 138 111 79 9 36 122 22 47 27 40 39 36 128 34 15 7 5 190 77.8 79.9 74.7 73.4 80.5 84.0 64.0 na 76.9 (*) 77.1 77.8 69.4 74.4 83.9 70.3 79.4 76.1 71.9 88.5 77.9 (66.3) (90.7) 76.9 Table HA.7M: Sexual behaviour that increases the risk of HIV infection among young men Percentage of never-married young men age 15-24 years who have never had sex, percentage of young men age 15-24 years who have had sex before age 15, and percentage of young men age 15-24 years who had sex with a woman 10 or more years older during the last 12 months, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of never- married men age 15-24 years Percentage of men age 15-24 years who had sex before age 152 Number of men age 15- 24 years Percentage of men age 15-24 years who had sex in the last 12 months with a man 10 or more years older3 Number of men age 15-24 years who had sex in the 12 months preceding the survey Percentage of never- married men age 15-24 years who have never had sex1 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.10 2 MICS indicator 9.11 3 MICS indicator 9.12 140 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Sexual behaviour was assessed in all women and separately for women age 15-24 years of age who had sex with multiple partners in the previous year (Tables HA.8 and HA.9). A negligible number of women 15-49 (1 per cent) and 15-24 (1 per cent) years of age report having sex with more than one partner. Results of sexual behaviour and condom use during sex among men are presented in Table HA.8M and results of sexual behaviour for men are presented in HA.9M. Sex with multiple partners is higher among men than among women where about seven per cent of men 15-49 years of age report having sex with more than one partner in the last 12 months. Of those men, only 16 per cent report using a condom when they had sex the last time. The percentage of men who report having sex with more than one partner are slightly higher among younger men age 15-24 (4 per cent). District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-24 15-19 20-24 25-29 30-39 40-49 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 77.8 61.7 67.2 68.9 71.2 44.8 23.8 68.9 79 85 79.4 85.3 9.1 62.7 79.1 68.9 63.2 62.4 70.9 76.1 71.9 70 64.3 83.2 70.8 62.8 76.7 70.3 0.6 1.2 0.7 0.9 0.7 0.8 0.7 1 0.8 0.7 0.8 0.7 1.3 1.2 1.3 0.3 0.9 1.5 1 0.7 0.7 0.1 1.2 0.5 0.0 0.0 0.0 0.8 1,189 748 848 1,174 1,610 865 462 403 506 835 579 2,233 551 362 789 1,272 361 536 506 528 594 621 1,501 682 302 144 156 2,784 84.8 89.5 75.2 78.6 86.5 53.1 29 80.6 92.8 97.4 99 99.9 15 96.7 92.7 76 73.8 92.7 83.9 85.9 78.6 76.3 82.9 88.5 78.3 71.1 82.7 83.1 Table HA.8: Sex with multiple partners among women Percentage of women age 15-49 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with more than one partner in the last 12 months and among those who had sex with multiple partners, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Had sex in the last 12 months Had sex with more than one partner in last 12 months1 Number of women age 15-49 years Ever had sex Percentage of women who: 1 MICS indicator 9.13 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 141 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-24 15-19 20-24 25-29 30-39 40-49 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 70.1 67.9 65 67.1 68.8 25.3 12.3 41.7 75.8 87.1 90.3 91.8 17.9 74.1 73.7 63.7 71.9 69.4 63.9 66.3 68.5 71.2 65.8 69.2 74.5 69.9 70.5 68 3.5 13.9 5.7 5.8 7.5 3.7 2.7 4.9 8.5 8.2 7.4 8.3 3.3 12.3 7.7 6.2 5.1 14.4 6.8 4.9 4.6 3.8 10.8 1.5 1.5 7.2 1.8 6.7 (25.5) 8.4 21.8 26.5 9.2 (25.8) (*) (*) (16.2) 13.2 13.5 10.8 43.5 0.0 4.6 22.7 (*) 1.8 (26.3) (18.4) (35.2) (*) 14.4 (*) (*) (*) (*) 15.9 1,161 627 780 1,153 1,415 751 420 330 407 751 659 1,743 825 145 636 1,390 396 486 445 496 577 563 1,354 686 252 123 152 2,568 41 87 44 67 106 27 11 16 35 61 49 145 27 18 49 86 20 70 30 24 26 22 147 10 4 9 3 172 76 85.4 72.7 74.9 79.3 35.6 19.2 56.4 84 96.1 99.3 99.9 29.5 89.6 83 71.5 84 88 71.1 77.6 74.5 75.6 79 73.9 78.1 77.2 76.2 77.3 Table HA.8M: Sex with multiple partners among men Percentage of men age 15-49 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with more than one partner in the last 12 months and among those who had sex with multiple partners, the percentage who used a condom at last sex, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Had sex in the last 12 months Had sex with more than one partner in last 12 months1 Number of men age 15- 49 years Per cent of men age 15-49 years who had more than one sexual partner in the last 12 months, who also reported that a condom was used the last time they had sex2 Number of men age 15-49 years who had more than one sexual partner in the last 12 months Ever had sex Percentage of men who: *1 case with missing “Ethnicity of household head” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.13 2 MICS indicator 9.14 142 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-19 20-24 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 51.1 48.3 34.1 40.7 48.2 23.8 68.9 87 8.1 54.5 57.1 42.4 35.3 53 39.2 51.3 45.8 35.6 42.4 61.2 37.1 24.4 34.3 44.8 0.8 0.6 1.1 0.9 0.8 0.7 1 0.5 1.2 0.0 1 0.6 2.3 1.4 1 0.8 0.7 0.4 1.4 0.0 0.0 (0.0) (0.0) 0.8 365 217 283 393 471 462 403 402 462 67 141 545 111 159 144 163 208 191 501 195 83 45 40 865 54.8 67.8 39.5 46.4 58.6 29 80.6 100 12.2 85 66 47.8 43.5 76.2 48.5 56.9 48.2 39.2 54.2 61.9 42.8 31 41.6 53.1 Table HA.9: Sex with multiple partners among young women Percentage of women age 15-24 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with more than one partner in the last 12 months and among those who had sex with multiple partners, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Had sex in the last 12 months Had sex with more than one partner in last 12 months Number of women age 15-24 years Ever had sex Percentage of women age 15-24 years who: ( ) Figures that are based on 25-49 unweighted cases MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 143 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-19 20-24 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 24.0 30.3 24.0 24.9 25.6 12.3 41.7 89.3 12.6 (39.3) 26.6 23.9 27.6 38.8 19.4 24.2 23.0 23.6 29.1 20.5 22.9 18.8 12.3 25.3 3.1 8.5 1.8 2.7 4.5 2.7 4.9 13.4 1.7 (3.7) 1.5 4.5 1.8 8.3 5.4 1.2 3.1 1.6 5.1 1.0 2.5 (4.5) (0.0) 3.7 327 146 278 356 395 420 330 124 627 24 136 512 78 121 141 165 169 155 439 168 67 38 39 751 33.2 45.2 33.4 34.7 36.3 19.2 56.4 98.7 23.1 (50.5) 39.9 33.1 39.7 55.4 27.3 40.6 27.8 30.6 42.2 25.2 27.2 35.6 20.0 35.6 Table HA.9M: Sex with multiple partners among young men Percentage of men age 15-24 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with more than one partner in the last 12 months and among those who had sex with multiple partners, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Had sex in the last 12 months Had sex with more than one partner in last 12 months Number of men age 15-24 years Ever had sex Percentage of men age 15-24 years who: ( ) Figures that are based on 25-49 unweighted cases Tables HA.10 presents the percentages of women age 15-24 years who ever had sex, percentage who had sex in the last 12 months, and percentage who have had sex with a non-marital, non-cohabiting partner in the last 12 months. About 53 per cent of women age 15-24 years ever had sex and 45 per cent of women had sex in the last 12 months. About 12 per cent of women had sex with a non-marital, non- cohabiting partner in the last 12 months. This percentage is considerably higher in Biak Numfor District (21 per cent) compared with Merauke (9 per cent) and Jayawijaya (8 per cent) districts. Sex with non-marital, non-cohabiting partner in the last 12 months is considerably higher among men (50 per cent) (Table HA.10M) than among women (12 per cent) (Table HA.10). 144 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-19 20-24 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 51.1 48.3 34.1 40.7 48.2 23.8 68.9 87 8.1 54.5 57.1 42.4 35.3 53 39.2 51.3 45.8 35.6 42.4 61.2 37.1 (24.4) (34.3) 44.8 365 217 283 393 471 462 403 402 462 67 141 545 111 159 144 163 208 191 501 195 83 45 40 865 186 105 97 160 227 110 278 350 38 36 81 231 39 84 56 84 95 68 212 120 31 11 14 387 8.9 8.3 20.7 17.1 7.8 19.7 8.5 2.4 (97.8) 2.5 11.7 11 (23.6) 6 20.2 12.9 8.2 14.9 17.9 2.7 (5.3) (*) (*) 11.7 54.8 67.8 39.5 46.4 58.6 29 80.6 100 12.2 85 66 47.8 43.5 76.2 48.5 56.9 48.2 39.2 54.2 61.9 42.8 (31) (41.6) 53.1 Table HA.10: Sex with non-regular partners among young women Percentage of women age 15-24 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with a non-marital, non-cohabiting partner in the last 12 months, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Had sex in the last 12 months Number of women age 15-24 years Percentage who had sex with a non-marital, non- cohabiting partner in the last 12 months1 Number of women age 15-24 years who had sex in the last 12 months Ever had sex Percentage of women 15-24 who: ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.15 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 145 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-19 20-24 Marital status Ever married/in union Never married/in union Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 24 30.3 24 24.9 25.6 12.3 41.7 89.3 12.6 (39.3) 26.6 23.9 27.6 38.8 19.4 24.2 23 23.6 29.1 20.5 22.9 (18.8) (12.3) 25.3 327 146 278 356 395 420 330 124 627 24 136 512 78 121 141 165 169 155 439 168 67 38 39 751 79 44 67 89 101 52 138 111 79 9 36 122 22 47 27 40 39 36 128 34 15 7 5 190 49.8 38.6 58.2 60.9 40.7 81.2 38.5 15.3 99.1 (*) (33.5) 56.9 (56) 36 (59) (*) (*) (*) 54.3 (*) (*) (*) (*) 50.1 33.2 45.2 33.4 34.7 36.3 19.2 56.4 98.7 23.1 (50.5) 39.9 33.1 39.7 55.4 27.3 40.6 27.8 30.6 42.2 25.2 27.2 (35.6) (20.0) 35.6 Table HA.10M: Sex with non-regular partners among young men Percentage of men age 15-24 years who ever had sex, percentage who had sex in the last 12 months, percentage who have had sex with a non-marital, non-cohabiting partner in the last 12 months, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Had sex in the last 12 months Number of men age 15-24 years Percentage who had sex with a non-marital, non- cohabiting partner in the last 12 months1 Number of men age 15-24 years who had sex in the last 12 months Ever had sex Percentage of men 15-24 who: ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.15 11.5. ORPHANS Children who are orphaned may be at increased risk of neglect or exploitation if the parents are not available to assist them. Monitoring the variations in different outcomes for orphans and comparing them to their peers gives us a measure of how well communities and governments are responding to their needs. The frequency of children living with neither parent, mother only, or father only is presented in Table HA.11. In the three selected districts of Papua Province, about eight per cent of children aged 0-17 years have lost one or both parent and about 10 per cent are 146 MULTIPLE INDICATOR CLUSTER SURVEY 2011 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r S ex M al e Fe m al e A re a U rb an R u ra l A g e 0- 4 5- 9 10 -1 4 15 -1 7 W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 81 8 2. 7 75 80 .7 78 .1 76 .7 81 .2 86 .3 83 .3 77 .1 59 .1 85 .7 76 .5 78 .8 75 .1 81 .3 76 .7 84 .7 84 .6 83 .2 82 .1 79 .5 1. 3 1 0. 8 1. 3 0. 8 1. 6 0. 7 0. 1 1 1. 1 3. 1 0. 4 2. 2 1. 1 0. 6 0. 8 1. 3 0. 8 0. 2 1. 1 0. 0 1 2. 8 1. 6 6. 8 3. 6 4. 2 4. 6 3. 4 5. 5 4. 4 2. 3 2. 1 1. 9 3. 6 3. 5 6. 3 4. 3 4. 2 3. 7 3. 4 5. 3 0. 7 3. 9 2. 8 5. 4 2. 7 3. 4 3. 5 3. 1 3. 7 1. 7 3 5. 3 5. 1 4. 2 4. 7 3. 5 3. 6 1 4. 5 1. 9 2 1. 3 1. 0 3. 5 0. 6 1 1. 3 1 0. 9 1. 2 0. 8 0. 5 0. 6 1. 5 1. 7 1 0. 8 0. 9 1. 6 0. 7 1. 2 0. 3 0. 3 1. 1 1. 3 1 1. 7 1. 4 1. 2 1. 1 1. 8 1. 9 1. 1 0. 6 1. 1 1. 7 3. 4 1. 7 1. 8 1. 5 1. 2 0. 7 1. 6 0. 4 0. 0 1. 8 4. 1 1. 4 0. 7 0. 5 0. 6 0. 6 0. 6 0. 5 0. 7 0. 4 0. 4 0. 4 2. 1 0. 4 0. 7 0. 6 0. 7 0. 6 0. 6 0. 5 1 0. 0 0. 9 0. 6 7 9. 2 7. 5 7. 5 8. 1 8. 4 7. 4 2. 9 6. 5 10 .7 16 7 .6 11 8 .6 7. 8 3. 2 9. 8 3. 9 3. 5 4. 6 7. 3 7. 8 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 1, 99 5 1, 40 6 1, 73 1 2, 68 2 2, 45 1 1, 98 5 3, 14 8 1, 51 5 1, 57 4 1, 39 7 64 7 1, 05 8 1, 11 7 1, 07 7 97 1 91 0 3, 21 5 92 0 46 5 22 8 30 5 5, 13 3 10 .4 7. 4 12 .3 9. 6 10 .9 12 9 .1 5. 1 7. 2 11 .7 26 .5 5. 2 11 .9 11 .2 11 .6 11 .5 11 .2 8. 6 8. 7 7. 2 9. 8 10 .2 0. 7 0. 4 1. 3 0. 8 0. 8 0. 8 0. 8 0. 3 0. 5 1. 2 1. 9 0. 3 1. 1 1 1 .2 0. 5 1. 1 0. 3 0. 2 0. 4 0. 8 0. 8 0. 6 1. 2 1. 4 0. 9 1. 1 0. 9 1. 1 0. 2 0. 9 1. 4 2. 5 0. 9 1. 2 1. 5 1. 2 0. 3 1. 2 0. 5 1. 1 0. 0 1. 3 1 7. 8 4. 9 8. 8 6. 6 8. 1 8. 7 6. 5 4. 5 4. 8 7. 9 19 3 .6 7. 5 7. 6 8. 6 9. 9 7. 5 7 7. 3 5. 7 7. 7 7. 3 Ta b le H A .1 1: C h ild re n ’s li vi n g a rr an g em en ts a n d o rp h an h o o d P er c en t d is tr ib u ti o n o f ch ild re n a g e 0- 17 y ea rs a cc o rd in g t o li vi n g a rr an g em en ts , p er ce n ta g e o f ch ild re n a g e 0- 17 y ea rs in h o u se h o ld s n o t liv in g w it h a b io lo g ic al p ar en t an d p er ce n ta g e o f ch ild re n w h o h av e o n e o r b o th p ar en ts d ea d , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 O n ly m o th er al iv e Li vi n g w it h n ei th er p ar en t Li vi n g w it h m o th er o n ly Li vi n g w it h fa th er o n ly N u m b er o f ch ild re n ag e 0- 17 ye ar s O n e o r b o th p ar en ts d ea d 2 N o t liv in g w it h a b io lo g ic al p ar en t1 To ta l M o th er d ea d M o th er al iv e Fa th er d ea d Fa th er al iv e B o th ar e d ea d B o th ar e al iv e Im p o ss ib le to d et er m in e O n ly fa th er al iv e Li vi n g w it h b o th p ar en ts 1 M IC S in d ic at o r 9. 17 2 M IC S in d ic at o r 9. 18 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 147 not living with a biological parent. 80 per cent of children live with both parents. Higher percentages of orphans were found in the older age group 15-17, in Jayawijaya District, in urban areas, in the poorest quintile and living in households whose heads are Papuan. 11.6. MALE CIRCUMCISION Evidence has shown that male circumcision (the complete removal of the foreskin of the penis) reduces the risk of heterosexually acquired HIV infection in men by approximately 60 per cent15 and is safe when performed by well-trained health professionals in properly equipped settings. In countries and regions with heterosexual epidemics and high HIV and low male circumcision prevalence, male circumcision is being included in comprehensive HIV prevention packages. Alone, male circumcision is only partially protective, however, when combined with HIV testing and counselling services, condoms, safer sexual practices and treatment of Sexually Transmitted Infections, however, it is highly effective. It may already be performed for religious, medical, or cultural reasons and can be carried out at birth, during adolescence, or at other times during a man’s life. In Indonesia, circumcision among males is traditionally done among Moslems. It is also often performed as part of local traditional practice, although it is mostly influenced by Islamic religion. Many Moslem males are circumcised when they are still a child or before puberty as an important step to be done before they become an adult. Thus, in predominantly Christian or non Moslem areas, like Papua land, the prevalence of male circumcision is largely influenced by Moslem population. The prevalence of male circumcision is presented in table HA.12, which also shows the age of circumcision. About 39 per cent of men aged 15-49 are circumcised. The prevalence is highest at the age group 25-29 years and shows a marked difference according to area of residence (50 urban, 30 rural). Circumcision is more prevalent in Merauke District (63 per cent) than in Biak Numfor (25 per cent) and Jayawijaya districts (12 per cent). The majority of circumcised men went through the procedure at the age groups 5-11 years (49 per cent) and 12-17 years (47 per cent). Table HA.13 shows the provider and location of circumcision. Most circumcision was performed by health worker/professional (74 per cent) while traditional practitioner/ family/ friend performed 14 per cent of the circumcisions. About 12 per cent was performed by others and about half of the circumcisions were performed at home (52 per cent). 15 See for example: Bailey RC, Moses S, Parker CB, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial [see comment]. Lancet 2007; 369:643–56. 148 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Age 15-24 15-19 20-24 25-29 30-39 40-49 Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 1,161 627 780 1,153 1,415 751 420 330 407 751 659 145 636 1,390 396 486 445 496 577 563 1,354 686 252 123 152 2,568 2 2.3 1.9 1.6 2.4 1.5 1.8 1.3 1.4 2.4 2.3 (*) 3.7 0.9 2.7 (*) 3.8 4.5 0.6 1.3 (2.5) 2.1 1.4 (4.9) (0.0) 2.0 45 58 61.4 52.4 44.8 50.2 43.6 56.7 48.8 47 51 (*) 50.7 47.5 53.1 (*) 52.5 44.4 51.6 47.7 (63.3) 46.6 54.5 (62) (42.9) 49.1 51.6 38.5 33.4 43.4 52.2 47.9 54.6 41.1 47.5 48 45.2 (*) 44 49.6 43.4 (*) 43.7 51.1 46.2 47.6 (34.2) 50.2 41 (27.4) (53.1) 47.1 0.6 1.3 0.7 0.9 0.4 0.0 0.0 0.0 1.2 0.9 0.6 (*) 0.7 0.8 0.0 (*) 0.0 0.0 0.7 1.2 (0.0) 0.2 1.6 (0.0) (4.0) 0.7 0.8 0.0 2.6 1.7 0.2 0.4 0.0 0.9 1.2 1.7 0.8 (*) 0.8 1.2 0.8 (*) 0.0 0.0 0.9 2.2 (0.0) 0.8 1.5 (5.8) (0.0) 1.1 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 732 74 192 572 426 247 124 123 186 311 254 12 246 591 149 8 127 183 323 357 30 679 221 29 40 998 63 11.8 24.6 49.6 30.1 32.9 29.5 37.1 45.6 41.5 38.5 8.1 38.7 42.5 37.5 1.6 28.6 36.8 56 63.4 2.2 98.9 87.6 23.4 26.1 38.8 Table HA.12: Male Circumcision Percentage of men age 15-49 years who report having been circumcised, and per cent distribution of men by age of circumcision, by background characteristics, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Number of men age 15- 49 years 1-4 years 5-11 years Age at circumcision: 12-17 years 18+ years Don’t know/ Missing Total Number of men circumcised Per cent cir- cumcised1 *1 case with missing “Ethnicity of household head” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.21 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 149 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l A g e 15 -2 4 1 5- 19 2 0- 24 25 -2 9 30 -3 9 40 -4 9 E d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d * P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 11 .7 17 .4 14 .2 11 .9 13 .6 9. 6 11 8. 2 9 11 20 .3 (* ) 14 .8 11 13 .1 (* ) 19 .6 10 .9 11 .1 12 .7 (2 .5 ) 11 .1 19 .1 (9 .5 ) (1 2. 9) 12 .6 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 13 .3 32 .6 19 .4 16 .2 15 .5 17 .2 17 .4 17 18 .5 16 .1 12 .6 (* ) 12 17 .4 17 .8 (* ) 22 .2 12 .2 14 .4 17 .3 (3 7. 4) 13 .1 17 .7 (2 2. 5) (3 2. 7) 15 .9 18 .6 7. 1 26 .4 27 .3 8. 5 15 .1 10 20 .2 23 .6 20 .1 19 .2 (* ) 14 .7 20 .7 22 .7 (* ) 13 6 .4 20 .2 27 .6 (9 .1 ) 20 .2 16 .4 (2 8. 2) (1 9. 4) 19 .3 56 .8 44 .1 45 47 .9 61 .4 51 .7 56 .2 47 .2 47 .9 56 56 .8 (* ) 61 .7 50 .1 51 (* ) 48 .9 65 54 .9 48 .3 (3 3. 9) 55 .8 55 .7 (3 6. 8) (3 2. 6) 53 .6 0. 0 4. 2 4. 4 1. 9 0. 2 0. 5 0. 0 1. 1 0. 4 1. 3 2. 1 (* ) 0. 3 1. 4 1. 6 (* ) 0. 0 0. 4 0. 9 2. 2 (3 ) 0. 9 2 (0 .0 ) (0 .0 ) 1. 2 11 .2 11 .9 4. 3 6. 6 14 .4 15 .1 16 .4 13 .7 9. 6 6. 5 9. 3 (* ) 11 .3 10 .2 6. 9 (* ) 15 .9 15 .9 9. 6 4. 3 (1 6. 7) 9. 9 8. 2 (8 .8 ) (1 5. 3) 9. 9 73 2 74 19 2 57 2 42 6 24 7 12 4 12 3 18 6 31 1 25 4 12 24 6 59 1 14 9 8 12 7 18 3 32 3 35 7 30 67 9 22 1 29 40 99 8 0. 0 0. 0 0. 6 0. 2 0. 0 0. 4 0. 0 0. 9 0. 0 0. 0 0. 0 (* ) 0. 0 0. 2 0. 0 (* ) 0. 0 0. 0 0. 0 0. 3 (0 .0 ) 0. 0 0. 0 (3 .7 ) (0 .0 ) 0. 1 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 70 .5 76 .9 78 81 .8 59 .8 78 .8 82 .3 75 .3 79 .3 70 .5 63 .4 (* ) 65 .2 73 .7 82 .4 (* ) 67 .4 59 .3 72 .4 81 (9 2. 6) 71 .4 74 .6 (7 0. 5) (6 3. 5) 72 .4 17 .8 5. 6 7. 2 6. 1 26 .6 11 .2 6. 7 15 .7 11 .7 18 .5 16 .4 (* ) 20 15 .1 4. 5 (* ) 13 29 .9 16 .5 6 (4 .9 ) 17 .6 6. 3 (1 6. 3) (2 3. 5) 14 .9 0. 0 0. 0 0. 6 0. 2 0. 0 0. 4 0. 0 0. 9 0. 0 0. 0 0. 0 (* ) 0. 0 0. 2 0. 0 (* ) 0. 0 0. 0 0. 0 0. 3 (0 .0 ) 0. 0 0. 0 (3 .7 ) (0 .0 ) 0. 1 Ta b le H A .1 3: P ro vi d er a n d lo ca ti o n o f ci rc u m ci si o n P er c en t d is tr ib u ti o n o f ci rc u m ci se d m en b y p er so n p er fo rm in g c ir cu m ci si o n a n d t h e lo ca ti o n w h er e ci rc u m ci si o n w as p er fo m ed , b y b ac kg ro u n d c h ar ac te ri st ic s, D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 O th er P er so n p er fo rm in g c ir cu m ci si o n : P la ce o f ci rc u m ci si o n : N u m b er o f m en ci rc u m ci se d To ta l D o n ’t kn o w / M is si n g R it u al si te A t h o m e H o m e o f a h ea lt h w o rk er / p ro fe ss io n al H ea lt h fa ci lit y To ta l D o n ’t kn o w / M is si n g O th er h o m e/ p la ce H ea lt h w o rk er / p ro fe ss io n al Tr ad it io n al p ra ct it io n er / fa m ily /f ri en d *1 c as e w it h m is si n g “ E th n ic it y o f h o u se h o ld h ea d ” n o t sh o w n ( ) Fi g u re s th at a re b as ed o n 2 5- 49 u n w ei g h te d c as es (* ) Fi g u re s th at a re b as ed o n f ew er t h an 2 5 u n w ei g h te d c as es MULTIPLE INDICATOR CLUSTER SURVEY 2011150 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 151MULTIPLE INDICATOR CLUSTER SURVEY 2011 12 ALCOHOL USE Excessive alcohol use also increases the risk of many harmful health conditions. In the long-term, excessive drinking can lead to cardiovascular problems, neurological impairments, liver disease and social problems. Alcohol abuse is also associated with injuries and violence, including intimate partner violence and child maltreatment.16 Information was collected on alcohol use among women and men 15-49 years old. This information will help to understand lifetime and current use of alcohol and intensity of use. In table TA.1 women’s use of alcohol is shown. About two per cent of women 15-49 years old had at least one drink of alcohol on one or more days during the last one month. About two per cent of women of the same age group first drank alcohol before the age of 15 while 85 per cent of women never had one drink of alcohol. Among the youngest age group, the proportion of women who had at least one drink of alcohol before age 15 is higher than among the other age groups. The proportion of men that consume alcohol is much higher than the proportion of women who consume alcohol (see table TA.1M). Twenty per cent of men 15-49 years old had at least one drink of alcohol on one or more days during the last one month. Use of alcohol before the age of 15 is also more common among men than among women (seven per cent of men age 15-49 years drank alcohol before age 15, compared with two per cent of women). The highest proportion of alcohol use by men is found in Biak Numfor District (25 per cent). The use of alcohol by women and men varies somewhat by education and by area. Particularly among men, alcohol use is more common in urban areas and among men with higher education. 16 US Centers for Disease Control and Prevention, http://www.cdc.gov/ 152 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Area Urban Rural Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 93 84.8 74.2 88.3 81 87.6 84.4 83 85.7 84.7 84.5 85.5 92.1 84.3 85.2 79.3 86.1 86.5 81.3 83.3 88 77.8 96.7 90 91.3 89.0 85.1 0.3 3.7 2.1 4.4 3.1 1.7 0.8 1.1 0 0.3 1.1 2.3 1.3 2.1 2 1 3.6 2.3 1.4 1.2 0.7 3 0.2 0.5 0 1.2 2 1.2 2.5 2.9 1.8 3.3 1 1.5 2.7 2.2 2.2 2.2 1.9 2 2.4 2.1 1.1 2.4 2.3 2.4 1.9 1.3 3.3 0.6 0.8 0.5 0.0 2.0 1,189 748 848 462 403 506 414 420 288 291 1,174 1,610 362 789 1,272 361 536 506 528 594 621 1501 682 302 144 156 2,784 Table TA.1: Use of alcohol among women Percentage of women age 15-49 who have never had one drink of alcohol, percentage who first had one drink of alcohol before age 15, and percentage of women who have had at least one drink of alcohol on one or more days during the last one month, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 1 MICS indicator TA.3 2 MICS indicator TA.4 Never had one drink of alcohol Percentage of women who: Had at least one drink of alcohol before age 151 Number of women age 15-49 yearsHad at least one drink of alcohol on one or more days during the last one month2 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 153 District Merauke Jayawijaya Biak Numfor Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Area Urban Rural Education None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 36.5 48.4 28.1 56.8 23.1 24.6 32.2 33.5 43.1 43.6 30.1 42.4 62 43 34.8 25.1 50.4 38.1 37.7 29.4 31 34.3 51.5 30.4 23.1 15.6 36.9 6.3 5.4 7.8 10.9 7.1 5.7 4.8 6.1 4.9 5.7 7.2 6 3.6 6 7.2 6.1 6.3 5.3 6.3 7 7.5 7.2 2.8 10.2 7.9 10.1 7 20.9 12.9 24.8 14.4 23.5 25.4 22.6 19.7 19.6 15.5 23.5 17.3 9.2 18.1 20.6 25.7 13.8 21.6 21.5 22.2 21 25.2 10.4 17.7 24.9 18.9 20.1 1,161 627 780 420 330 407 368 383 347 313 1,153 1,415 145 636 1,390 396 486 445 496 577 563 1,354 686 252 123 152 2,568 Table TA.1M: Use of alcohol among men Percentage of men age 15-49 who have never had one drink of alcohol, percentage who first had one drink of alcohol before age 15, and percentage of men who have had at least one drink of alcohol on one or more days during the last one month, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 1 MICS indicator TA.3 2 MICS indicator TA.4 Never had one drink of alcohol Percentage of men who: Had at least one drink of alcohol before age 151 Number of men age 15- 49 yearsHad at least one drink of alcohol on one or more days during the last one month2 *1 case with missing “Ethnicity of household head” not shown MULTIPLE INDICATOR CLUSTER SURVEY 2011154 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 155MULTIPLE INDICATOR CLUSTER SURVEY 2011 13 MIGRATION Table MI.1 shows that heads of households of more than two-thirds of households in Merauke were not born in Papua (68 per cent), with a mean number of 21 years since moving to Papua. The main reason of migration was transmigration. On the contrary, only about one-tenth of heads of households in Jayawijaya were not born in Papua. The main reason for migration to Papua was looking for a job. The percentage of heads of households in Biak Numfor who were not born in Papua was 27 per cent, with a mean number of 20 years since moving to Papua. The main reason for migration to Papua in Biak Numfor was looking for a job. MULTIPLE INDICATOR CLUSTER SURVEY 2011156 MULTIPLE INDICATOR CLUSTER SURVEY 2011 D is tr ic t M er au ke Ja ya w ija ya B ia k N u m fo r A re a U rb an R u ra l E d u ca ti o n N o n e P ri m ar y S M P /S M H ig h er M is si n g W ea lt h in d ex q u in ti le s P o o re st S ec o n d M id d le Fo u rt h R ic h es t E th n ic it y o f h o u se h o ld h ea d * P ap u a Ja w a S u la w es i M al u ku O th er s To ta l f o r 3 d is tr ic ts 68 .3 10 .9 26 .9 50 .3 34 .0 18 .6 45 .6 43 .8 38 .4 65 .4 2. 6 38 .9 41 .2 59 .7 64 .7 0. 4 90 .3 88 .2 69 .9 94 .7 40 .5 20 .5 14 .1 20 .0 17 .4 22 .4 23 .5 22 .1 18 .5 17 .4 24 .0 18 .5 20 .8 21 .7 19 .1 19 .3 26 .2 20 .4 19 .3 19 .3 19 .5 20 .0 1, 24 8 79 9 81 9 1, 13 2 1, 73 4 36 2 94 0 1, 15 9 40 2 2 63 9 55 7 53 3 56 5 57 2 1, 56 1 74 1 26 9 12 9 16 5 2, 86 6 57 .0 1. 7 0. 4 14 .2 69 .0 71 .2 70 .6 25 .1 5. 6 10 0. 0 87 .9 86 .5 65 .9 32 .5 8. 7 21 .5 61 .7 1. 5 0. 0 45 .0 42 .1 5. 3 9. 0 10 .2 11 .7 1. 4 0. 0 0. 3 10 .7 12 .6 0. 0 0. 0 0. 0 0. 0 2. 1 18 .4 12 .1 5. 7 5. 8 16 .9 4. 9 6. 5 1. 9 2. 8 8. 0 4. 3 2. 0 0. 0 0. 7 2. 9 12 .2 0. 0 0. 0 1. 4 0. 0 3. 8 5. 5 0. 0 2. 8 2. 5 9. 8 1. 7 3. 1 22 .3 65 .2 59 .2 47 .0 18 .4 23 .4 22 .0 42 .0 34 .7 0. 0 8. 7 9. 6 23 .0 42 .5 43 .5 27 .3 18 .6 67 .8 44 .4 31 .8 32 .5 12 .7 10 .6 19 .6 19 .0 8. 8 5. 4 5. 7 17 .7 27 .1 0. 0 3. 4 2. 6 10 .8 16 .2 20 .5 25 .3 10 .7 19 .7 24 .5 11 .8 13 .8 0. 9 9. 3 2. 7 3. 7 0. 1 0. 0 0. 7 1. 3 7. 8 0. 0 0. 0 0. 0 0. 3 2. 9 3. 1 13 .8 0. 6 2. 7 4. 3 4. 2 1. 9 0. 0 1. 5 0. 0 0. 0 0. 2 0. 0 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 3 13 .8 2. 7 4. 3 4. 2 0. 8 0. 1 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 85 3 87 22 0 57 0 59 0 68 42 8 50 8 15 5 1 16 21 7 21 9 33 7 37 0 7 66 9 23 7 90 1, 16 0 Ta b le M I.1 : M ig ra ti o n P er c en t d is tr ib u ti o n o f h o u se h o ld s ac co rd in g t o b ir th , m ea n n u m b er o f ye ar s m o ve d t o P ap u a an d m ai n r ea so n w h y h ea d o f h o u se h o ld m o ve d t o P ap u a, D is tr ic ts o f M er au ke , Ja ya w ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 H ea d o f h o u se h o ld n o t b o rn in P ap u a Tr an sm i- g ra ti o n Lo o ki n g fo r a jo b M ai n r ea so n w h y h ea d o f h o u se h o ld m o ve d t o P ap u a: M ea n n u m b er o f ye ar h ea d m o ve d t o P ap u a Tr an sf er in g o ve rn m en t jo b Fa m ily re as o n s D o n ’t kn o w / M is si n g To ta l N u m b er o f h o u se h o ld s w it h h ea d n o t b o rn in P ap u a N u m b er o f h o u se h o ld Tr an sf er in p ri va te jo b O th er *1 c as e w it h m is si n g “ E th n ic it y o f h o u se h o ld h ea d ” n o t sh o w n MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 157MULTIPLE INDICATOR CLUSTER SURVEY 2011 This indicator measures the adequacy of living space per person in a dwelling. Reduced space per person can be associated with certain health risks.17 In the Selected Districts of Papua Province MICS survey, heads of households were asked a question on the floor area in square meters to determine floor area per person. In the three selected districts of Papua Province, the floor area per person was 11 square meters (Merauke, 14 square meters; Jayawijaya, 8 square meters; Biak Numfor, 11 square meters) (Table FA.1). Female-headed households had higher floor areas per person compared with with male- headed households, but there was no significant difference between urban and rural areas. District Merauke Jayawijaya Biak Numfor Sex Male Female Area Urban Rural Education None Primary SMP/SM Higher Missing/DK Ethnicity of households head Papua Jawa Sulawesi Maluku Others Missing/DK Total for 3 districts 13.5 8.0 10.5 10.5 15.0 11.4 10.5 10.0 10.5 10.5 13.3 14.0 8.4 16.0 12.0 12.0 13.5 25.0 10.8 1,248 799 819 2,555 311 1,132 1,734 362 940 1,159 402 2 1,561 741 269 129 165 1 2,866 Table FA.1: Floor area per person Median floor area per person by selected characteristics, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Median floor area per person Number of household 17 United Nations (1996). Indicators of Sustainable Development: Framework and Methodologies. Sales No. E.96.II.A.16 14 FLOOR AREA PER PERSON MULTIPLE INDICATOR CLUSTER SURVEY 2011158 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 159MULTIPLE INDICATOR CLUSTER SURVEY 2011 APPENDIX A. SAMPLE DESIGN The major features of the sample design are described in this appendix. Sample design features include target sample size, sample allocation, sampling frame and listing, choice of domains, sampling stages, stratification, and the calculation of sample weights. The primary objective of the sample design for the Papua Multiple Indicator Cluster Survey was to produce statistically reliable district level estimates of most indicators, in three selected districts (Merauke, Jayawijaya and Biak Numfor districts) of Papua Province, for urban and rural areas. The districts were selected purposively by considering topographic areas in Papua Province. 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 Papua MICS was calculated as 1,000 households for each selected district. For the calculation of the sample size, the following formula was used to estimate the required sample size for this indicator: where • n is the required sample size, expressed as number of households • 4 is a factor to achieve the 95 per cent level of confidence • r is the predicted or anticipated value of the indicator, expressed in the form of a proportion • 1.1 is the factor necessary to raise the sample size by 10 per cent for the expected non-response [the actual factor was based on the non-response level experienced in previous surveys in the country] • f is the shortened symbol for deff (design effect) • 0.12r is the margin of error to be tolerated at the 95 per cent level of confidence, defined as 12 per cent of r (relative margin of error of r) • p is the proportion of the total population upon which the indicator, r, is based • n the average household size (number of persons per household). For the calculation, r was assumed to be 0.5 per cent. The value of deff (design effect) was taken as 2 based on estimates from previous surveys, p (percentage of children aged 0-4 years in the total population) was taken as 18 per cent, (average household size) was taken as 4.5 households, and the response rate is assumed to be 90%. [4(r)(1-r)(f)(1.1)] [(0.12r)2(p)(n)] n = 160 MULTIPLE INDICATOR CLUSTER SURVEY 2011 The resulting number of households from this exercise was 1,000 households per selected district which is the sample size needed in each districts – thus yielding about 3,000 in total in the three districts in Papua province. The average number of households selected per cluster for each selected district was determined as 25 households, based on a number of considerations, including the design effect, the budget available, and the time that would be needed per team to complete one cluster. Dividing the total number of households by the number of sample households per cluster, it was calculated that 40 sample clusters would need to be selected in each selected district. The table below shows the sample size in each selected district of Papua Province. SAMPLING FRAME, SELECTION OF CLUSTERS AND HOUSEHOLDS Since a two-stage, stratified cluster sampling approach was used for the selection of the survey sample, two sampling frames were used for each stage • For the first stage, the recent master list of Census Blocks, dated 5 May 2010. The list includes information on the number of households resulted from listing of 2010 population census, number of HH in each block census, information on the difficulty of the area, and urban/rural classification. Forty census blocks were selected according to probability proportional to size (pps), while the size is number of households in each districts based on the listing of 2010 Population Census. • For the second stage, a list of households resulting from the updated listing of the 2010 Population Census. Twenty-five households in each block census were selected using systematic random sampling. LISTING ACTIVITIES Since the sampling frame (the 2010 Population Census) was not up-to-date, a listing of households was conducted in each cluster by all enumeration teams to update the existing information based on Population Census in all the sample enumeration areas prior to the selection of households. Topographic area in Papua Easily accessible lowland Highland Easily accessible lowland Total for 3 districts District 1. Merauke 2. Jayawijaya 3. Biak Numfor No of selected households 1,000 1,000 1,000 3,000 No of selected clusters 40 40 40 120 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 161 SELECTION OF HOUSEHOLDS Lists of households were prepared by the enumeration team 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) at the Central Statistical Office, where the selection of 25 households in each enumeration area was carried out by the supervisor using random systematic selection procedures. CALCULATION OF SAMPLE WEIGHTS The Papua Multiple Indicator Cluster Survey sample is not self-weighting. Essentially, by allocating equal numbers of households to each of the regions, different sampling fractions were used in each region since the size of the regions varied. For this reason, sample weights were calculated and these were used in the subsequent analyses of the survey data. The major component of the weight is the reciprocal of the sampling fraction employed in selecting the number of sample households in that particular sampling stratum (h) and PSU (i): The term fhi , the sampling fraction for the i-th sample PSU in the h-th stratum, is the product of probabilities of selection at every stage in each sampling stratum: where pshi is the probability of selection of the sampling unit at stage s for the i-th sample PSU in the h-th sampling stratum. Since the estimated number of households in each enumeration area (PSU) in the sampling frame used for the first stage selection and the updated number of households in the enumeration area from the updated listing were different, individual sampling fractions for households in each sample enumeration area (cluster) were calculated. The sampling fractions for households in each enumeration area (cluster) therefore included the first stage probability of selection of the enumeration area in that particular sampling stratum and the second stage probability of selection of a household in the sample enumeration area (cluster). A second component in the calculation of sample weights takes into account the level of non-response for the household and individual interviews. The adjustment for household non-response is equal to the inverse value of: RRh = Number of interviewed households in stratum h/ Number of occupied households listed in stratum h After the completion of fieldwork, response rates were calculated for each sampling stratum. These were used to adjust the sample weights calculated for each cluster. Response rates in the Papua Multiple Indicator Cluster Survey are shown in Table HH.1 in this report. fhi = p1hi x p2hi x p3hi Whi = 1 fhi MULTIPLE INDICATOR CLUSTER SURVEY 2011162 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Similarly, the adjustment for non-response at the individual level (women and under-5 children) for each stratum is equal to the inverse value of: RRh = Completed women’s (or under-5’s) questionnaires in stratum h / Eligible women (or under-5s) in stratum h The non-response adjustment factors for women’s and under-5’s questionnaires are applied to the adjusted household weights. Numbers of eligible women and under-5 children were obtained from the roster of household members in the Household Questionnaire for households where interviews were completed. The design weights for the households were calculated by multiplying the above factors for each enumeration area. These weights were then standardized (or normalized), one purpose of which is to make the weighted sum of the interviewed sample units equal the total sample size at the national level. Normalization is performed by dividing the aforementioned design weights by the average design weight at the national level. The average design weight is calculated as the sum of the design weights divided by the unweighted total). A similar standardization procedure was followed in obtaining standardized weights for the women’s and under-5’s questionnaires. Adjusted (normalized) weights varied between 0.188711 and 3.175026 in the 120 sample enumeration areas (clusters). Sample weights were appended to all data sets and analyses were performed by weighting each household, woman, men or under-5 with these sample weights. MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 163MULTIPLE INDICATOR CLUSTER SURVEY 2011 APPENDIX B. LIST OF PERSONNEL INVOLVED IN THE SURVEY Responsibility Steering Team Questionnaire Customization Survey Manager Master Trainer Name Drs. Wynandin Imawan, M.Sc S. Happy Hardjo, SE, M.Ec. Dr. Hamonangan Ritonga, M.Sc Ir. Toman Pardosi, SE. M.Si Dra. Nina Sardjunani, MA Dr. Arum Atmawikarta Dr. Hadiat, MA Deqa Ibrahim Musa Bheta Arsyad Erlangga A. Landiyanto Wuriyanto Nugroho Yosi D. Tresna Binar Ginting Zamzani B. Rahmat Santoso Prihyugiarto Julianti Pradono Lukas CH Bastari Siti Sofiah Lies Rosdianty Ir. JA Djarot Soetanto, MM Suntono Ir. Aryago Mulia, M.Si Ir. Purwanto Ruslam Ahmad Azhari, S.Si Ida Eridawati, S.Si Krido Saptono, S.Si, M.Si Raden Sinang, SST, M.Si Budi Santoso, SST, M.Si. Ahmad M. Saleh, SE Yaya Setyadi, MM Satriana Yasmuarto, MM Gaib Hakiki, SE Sumardiyanto, SE Tini Suhartini, S.Si Ofi Ana Sari, SST Maria Ulfa, SST Institution National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Development Planning Agency - BAPPENAS National Development Planning Agency - BAPPENAS National Development Planning Agency - BAPPENAS UNICEF UNICEF UNICEF UNICEF National Development Planning Agency - BAPPENAS Directorate General for Regional Development Ministry of Home Affair Directorate General for Regional Development Ministry of Home Affair National Family Planning Coordinating Board - BKKBN National Family Planning Coordinating Board - BKKBN Ministry of Health Ministry of Health Ministry of Education and Culture Ministry of Education and Culture Ministry of Women Empowerment and Child Protection - KPPPA BPS of Papua Province BPS of Papua Province National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat 164 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Responsibility Name Institution Local Trainer Questionnaire Administrator Supervisor Editor Enumerator Djoko Prijadi Hardianto, SE Ferandya Yoedhiandito Sapta Hastho Ponco Kadarmanto, MA. P.Hd. Heriminto Widodo Hendra Wijaya, M.Si Markus Tuange, SST Agung Budi Prasetyo, A.Md Japisser Sinaga, SST Rizka Ayu Oktaviani, SST Bagus Setyawan Wijaya, S.ST Isnaeni Noviyanti, S.ST Tigon Manurung Abdul Majid, S.Sos Naftaly Tombi Layuk S.Sos Senly Glorian Polii Geminda Prihatma Hamdani Hans W Rumaropen Iis Pebriyanti Rahmatullah Thamrin Inosensius Renyaan, S.Sos Ikfina Chairani, S.ST Jianto, SE Theo Polii Sumarni Salam, S.Si Bahtiar, S.E Alfonsina Yumame, S.E Paskalinus M. Asyerem Peri Tangke Datu Alexander Patibang Yuliana Harianja Haris Fajar Furqoni Dedi Satibi Limbong Tandilolo Maximus Araweng Eka Putra Setiawan, S.E Wiwik Andianti Matuan, S.Si Maria Endina Ohoitimur, S.E Alexander Bano, S.T Semuel Kogoya Cyntia Pinontoan, S.E Trisnawati, S.E Pietein Raubaba Isayas Kosay Deki Kapisa Waege Yogobi Niel Jigibalom Piter Tabuni Norton Marpaung Novalisa Kamarea Nurhaeda O.S.A.N. Jani Ode Tanda Harry Saputra Elsron Bontong Aloisius Dinaulik Silva Regiriana Sophan Z. Kamal Fremelina A. Pattiwael National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat Papua Province Papua Province Papua Province Papua Province Papua Province BPS of Jayawijaya District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Biak Numfor District BPS of Biak Numfor District BPS of Biak Numfor District BPS of Biak Numfor District BPS of Merauke District BPS of Merauke District BPS of Merauke District BPS of Merauke District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Biak Numfor District BPS of Biak Numfor District BPS of Biak Numfor District BPS of Biak Numfor District BPS of Merauke District BPS of Merauke District BPS of Merauke District BPS of Merauke District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Jayawijaya District BPS of Tolikara district BPS of Tolikara district Regional planning body of Jayawijaya Regional planning body of Jayawijaya Education office of Jayawijaya District Education office of Jayawijaya District Health office of Jayawijaya District Health office of Jayawijaya District BPS partner BPS partner BPS partner Merauke Merauke Merauke Merauke Merauke Merauke Merauke MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 165 Responsibility Name Institution Administrative Support Yakobus V. Yawima Helen LK Butarbutar Levidones Worumi Novianti Rante Manik Robertus Kandika Ahcmad Sodiq Dedi Irama Olivia Kahol Nur Eni Wulandari Endang Budi Rahayu Endang Sulistyorini Hans Luther Burdam Irene Samberi Julius Sitandung Marice F D Sanggenafa Martinus Rummar Meyke Engka Mince Tikubane Ritha Pasang Ruslan Saenal Arifin Sherly Johanis Yoseph Marini Yulianus Tonapa Sudarpo Drs. Sukarma Amransyah Fanny Srie Indrianti Gantjang Amannullah, MA Nona Iriana, S.Si. M.Si Dr. I Made Arcana Merauke Merauke Merauke Merauke Merauke Merauke Merauke Merauke Merauke Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor Biak Numfor National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat National Statistics Office – BPS Pusat MULTIPLE INDICATOR CLUSTER SURVEY 2011166 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 167MULTIPLE INDICATOR CLUSTER SURVEY 2011 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80+ DK/Missing Total Number 165 152 183 155 161 142 180 167 171 150 156 149 147 130 146 102 117 109 93 101 80 95 79 74 81 90 104 86 108 96 93 88 79 94 75 98 81 100 95 70 85 92 101 72 60 Number 57 89 80 62 65 56 54 67 54 44 47 46 43 43 32 34 31 22 16 25 27 19 10 23 7 9 6 8 4 6 6 8 1 1 5 20 0 6,182 Per cent 2.7 2.5 3 2.5 2.6 2.3 2.9 2.7 2.8 2.4 2.5 2.4 2.4 2.1 2.4 1.6 1.9 1.8 1.5 1.6 1.3 1.5 1.3 1.2 1.3 1.5 1.7 1.4 1.7 1.6 1.5 1.4 1.3 1.5 1.2 1.6 1.3 1.6 1.5 1.1 1.4 1.5 1.6 1.2 1 Per cent 0.9 1.4 1.3 1 1 0.9 0.9 1.1 0.9 0.7 0.8 0.7 0.7 0.7 0.5 0.5 0.5 0.4 0.3 0.4 0.4 0.3 0.2 0.4 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0 0 0.1 0.3 0 100.0 Number 134 128 125 167 144 146 157 161 160 141 131 140 152 105 141 112 107 101 104 99 75 101 91 96 94 83 118 112 100 127 87 110 96 81 78 103 85 89 86 93 60 70 61 54 60 Number 62 80 60 66 47 56 71 69 53 52 45 43 38 33 25 31 31 19 19 7 14 11 9 11 10 7 4 5 5 3 8 5 4 5 2 13 0 5,888 Per cent 2.3 2.2 2.1 2.8 2.5 2.5 2.7 2.7 2.7 2.4 2.2 2.4 2.6 1.8 2.4 1.9 1.8 1.7 1.8 1.7 1.3 1.7 1.5 1.6 1.6 1.4 2 1.9 1.7 2.2 1.5 1.9 1.6 1.4 1.3 1.7 1.4 1.5 1.5 1.6 1 1.2 1 0.9 1 Per cent 1.1 1.4 1 1.1 0.8 1 1.2 1.2 0.9 0.9 0.8 0.7 0.6 0.6 0.4 0.5 0.5 0.3 0.3 0.1 0.2 0.2 0.2 0.2 0.2 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0 0.2 0 100.0 Table DQ.1: Age distribution of household population Single-year age distribution of household population by sex, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 APPENDIX C. DATA QUALITY TABLES Males Age MalesFemales Females Age 168 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Age 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 Total (15-49) Ratio of 50-54 to 45-49 Age 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 Total (15-49) Ratio of 50-54 to 45-49 Number 669 522 456 540 453 457 304 316 302 3,048 Number 728 522 407 485 430 444 410 353 276 3,051 Number na 467 403 509 418 422 289 291 na 2,799 Number na 425 329 400 364 383 345 310 2,556 Per cent na 16.7 14.4 18.2 14.9 15.1 10.3 10.4 na 100.0 Per cent na 16.6 12.9 15.6 14.2 15 13.5 12.1 100.0 Percentage of eligible women interviewed (Completion rate) na 89.4 88.4 94.2 92.3 92.5 94.9 92 na 91.8 0.95 Percentage of eligible men interviewed (Completion rate) na 81.5 80.7 82.5 84.6 86.3 84.1 87.7 83.8 0.78 Table DQ.2: Age distribution of eligible and interviewed women Household population of women age 10-54, interviewed women age 15-49, and percentage of eligible women who were interviewed, by five-year age groups, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Table DQ.2M: Age distribution of eligible and interviewed men Household population of men age 10-54, interviewed men age 15-49, and percentage of eligible men who were interviewed, by five-year age groups, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Interviewed women age 15-49 years Interviewed men age 15-49 years Household population of women age 10-54 years Household population of men age 10-54 years MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 169 Age 0 1 2 3 4 5 6 7 Total (0-4) Ratio of 5 to 4 Number 299 280 308 322 306 288 337 328 1,515 Number 291 270 300 308 294 na na na 1,462 Per cent 19.9 18.4 20.5 21.1 20.1 na na na 100.0 Percentage of eligible under- 5s interviewed (Completion rate) 97.4 96.3 97.3 95.5 96.1 na na na 96.5 0.94 Table DQ.3: Age distribution of under-5s in household and under-5 questionnaires Household population of children age 0-7, children age 0-4 whose mothers/caretakers were interviewed, and percentage of under-5 children whose mothers/caretakers were interviewed, by single ages, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Interviewed under-5 children Household population of children 0-7 years District Merauke Jayawijaya Biak Numfor Area Urban Rural Household size 1-3 4-6 7+ Education of household head None Primary SMP/SM Higher Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts Number 1,146 761 892 1,182 1,617 728 1,449 622 250 890 1,218 438 542 504 529 598 626 1,533 665 304 143 154 2,799 Number 1,292 825 931 1,332 1,716 778 1,549 722 265 984 1,313 482 590 554 564 641 700 1,682 701 329 160 176 3,048 Per cent 40.9 27.2 31.9 42.2 57.8 26.0 51.8 22.2 8.9 31.8 43.5 15.6 19.4 18.0 18.9 21.4 22.4 54.8 23.8 10.8 5.1 5.5 100.0 Per cent 42.4 27.1 30.6 43.7 56.3 25.5 50.8 23.7 8.7 32.3 43.1 15.8 19.3 18.2 18.5 21.0 23.0 55.2 23.0 10.8 5.2 5.8 100.0 Per cent of eligible women interviewed (Completion rates) 88.7 92.3 95.8 88.7 94.2 93.5 93.6 86.3 94.3 90.4 92.8 90.7 91.9 91.0 93.9 93.3 89.4 91.2 94.9 92.1 89.5 87.3 91.8 Table DQ.4: Women’s completion rates by socio-economic characteristics of households Household population of women age 15-49, interviewed women age 15-49, and percentage of eligible women who were interviewed, by selected social and economic characteristics of the household, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Interviewed women age 15-49 years Household population of women age 15-49 years 170 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Household size 1-3 4-6 7+ Education of household head None Primary SMP/SM Higher Missing/DK Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Missing/DK Total for 3 districts Number 1,039 637 880 1,148 1,408 698 1,305 553 201 808 1,113 430 2 486 437 496 573 564 1,402 637 253 119 144 1 2,556 Number 1,369 757 925 1,442 1,610 782 1,574 696 226 973 1,328 522 2 537 549 606 674 686 1,643 751 317 140 200 1 3,051 Per cent 40.6 24.9 34.4 44.9 55.1 27.3 51.0 21.6 7.9 31.6 43.6 16.8 0.1 19.0 17.1 19.4 22.4 22.0 54.8 24.9 9.9 4.7 5.6 0.0 100.0 Per cent 44.9 24.8 30.3 47.2 52.8 25.6 51.6 22.8 7.4 31.9 43.5 17.1 0.1 17.6 18.0 19.8 22.1 22.5 53.9 24.6 10.4 4.6 6.5 0.0 100.0 Per cent of eligible men interviewed (Completion rates) 75.9 84.2 95.1 79.6 87.5 89.3 82.9 79.5 89.0 83.1 83.8 82.5 100.0 90.4 79.6 81.9 85.1 82.2 85.3 84.8 79.8 85.5 72.1 100.0 83.8 Table DQ.4M: Men’s completion rates by socio-economic characteristics of households Household population of men age 15-49, interviewed men age 15-49, and percentage of eligible men who were interviewed, by selected social and economic characteristics of the household, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Interviewed men age 15-49 years Household population of men age 15-49 years MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 171 District Merauke Jayawijaya Biak Numfor Area Urban Rural Household size 1-3 4-6 7+ Education of household head None Primary SMP/SM Higher Missing/DK Wealth index quintiles Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts Number 547 412 503 563 899 176 852 433 115 447 680 218 1 325 291 297 287 261 909 264 141 58 149 1,462 Number 577 424 514 596 918 182 885 448 119 463 701 230 1 332 308 305 299 271 946 269 144 63 93 1,515 Per cent 37.4 28.2 34.4 38.5 61.5 12.0 58.3 29.6 7.9 30.6 46.5 14.9 0.1 22.2 19.9 20.4 19.6 17.8 62.2 18.0 9.6 4.0 10.2 100.0 Per cent 38.1 28.0 34.0 39.4 60.6 12.0 58.4 29.6 7.9 30.6 46.3 15.2 0.1 21.9 20.4 20.1 19.7 17.9 62.5 17.7 9.5 4.2 6.1 100.0 Per cent of eligible under-5s with completed under-5 questionnaires (Completion rates) 94.8 97.3 97.7 94.4 97.9 96.8 96.3 96.8 96.8 96.4 97.0 94.9 100.0 98.1 94.4 97.5 96.1 96.3 96.0 98.1 97.8 91.8 95.5 96.5 Table DQ.5: Completion rates for under-5 questionnaires by socio-economic characteristics of households Household population of under-5 children, under-5 questionnaires completed, and percentage of under-5 children for whom interviews were completed, by selected socio-economic characteristics of the household, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Interviewed under-5 children Household population of under-5 children 172 MULTIPLE INDICATOR CLUSTER SURVEY 2011 Questionnaire and type of missing information Household Age Starting time of interview Ending time of interview Women Woman’s date of birth • Only month • Both month and year Date of first birth • Only month • Both month and year Completed years since first birth Date of last birth • Only month • Both month and year Date of first marriage/union • Only month • Both month and year Age at first marriage/union Age at first intercourse Time since last intercourse Starting time of interview Ending time of interview Men Man’s date of birth • Only month • Both month and year Date of first marriage/union • Only month • Both month and year Age at first marriage/union Age at first intercourse Time since last intercourse Starting time of interview Ending time of interview Under-5 Date of birth • Only month • Both month and year Starting time of interview Ending time of interview Reference group All household members All households interviewed All households interviewed All women age 15-49 All women age 15-49 with at least one live birth All women age 15-49 with at least one live birth with year of first birth unknown All women age 15-49 with a live birth in last 2 years All ever married women age 15-49 All ever married women age 15-49 with year of first marriage not known All women age 15-24 who have ever had sex All women age 15-24 who have ever had sex All women interviewed All women interviewed All men age 15-49 All ever married men age 15-49 All ever married men age 15-49 with year of first marriage not known All men age 15-24 who have ever had sex All men age 15-24 who have ever had sex All men interviewed All men interviewed All under-5 children All under-5 children All under-5 children Per cent with missing/ incomplete information* 0.0 0.2 0.2 3.1 13.0 4.7 7.7 0.0 1.7 0.6 23.9 20.5 0.0 0.0 0.0 0.4 0.6 3.8 8.6 21.6 19.3 0.0 0.0 0.0 0.3 0.3 0.6 0.0 0.3 0.5 Number of cases 12,112 2,866 2,866 2,784 2,784 2,006 2,006 161 2,006 2,006 2,233 2,233 2,233 459 459 2,784 2,784 2,568 2,568 1,743 1,743 1,743 267 267 2,568 2,568 1,511 1,511 1,511 1,511 Table DQ.6: Completeness of reporting Percentage of observations that are missing information for selected questions and indicators, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 173 District Merauke Jayawijaya Biak Numfor Area Urban Rural Wealth index quintiles Poorest Second Middle Fourth Richest Total for 3 districts District Merauke Jayawijaya Biak Numfor Area Urban Rural Wealth index quintiles Poorest Second Middle Fourth Richest Total for 3 districts Per centage of bednets observed by interviewer 53.9 55 50.7 28.5 62.8 52.3 69.3 55.1 42 28.6 52.8 Woman does not have health card 23.5 48.3 25.1 28.8 35.9 57.5 28.1 17.5 26.0 19.1 33.3 Seen by the interviewer (1) 50.3 15.6 24.2 34.4 24.0 8.0 31.3 33.0 42.3 39.4 27.8 Not seen by the interviewer (2) 26.2 35.5 50.7 36.8 39.8 33.9 40.6 49.5 31.7 41.5 38.7 Missing/ DK 0.0 0.5 0.0 0.0 0.3 0.6 0.0 0.0 0.0 0.0 0.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Per cent of health cards seen by the interviewer (1)/(1+2)*100 65.8 30.6 32.3 48.3 37.6 19.2 43.5 40.0 57.1 48.7 41.8 Number of women with a live birth in the last two years 149 211 211 212 359 174 96 103 104 94 571 Total number of bednets 1,376 318 1,076 810 1,960 266 775 790 617 322 2,770 Table DQ.7: Observation of bednets Percentage of bednets in all households interviewed observed by the interviewer, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Table DQ.8: Observation of women’s health cards Per cent distribution of women with a live birth in the last 2 years by presence of a health card, and the percentage of health cards seen by the interviewers, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Woman has health card 174 MULTIPLE INDICATOR CLUSTER SURVEY 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Child’s age 0 1 2 3 4 Total for 3 districts Child does not have birth certificate 49.0 83.7 75.5 47.8 82.8 80.2 73.4 69.8 65.4 65.6 70.8 Seen by the interviewer (1) 32.4 7.7 12.2 30.6 9.0 10.6 14.9 16.9 18.8 20.4 16.3 Not seen by the interviewer (2) 18.3 6.3 12.0 21.1 7.1 8.6 10.6 12.0 14.5 13.6 11.9 Don’t know/ Missing 0.2 2.2 0.3 0.6 1.1 0.7 1.1 1.3 1.2 0.3 0.9 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Per cent of birth certificates seen by the interviewer (1)/ (1+2)*100 63.8 55.1 50.3 59.2 55.6 55.2 58.3 58.4 56.5 60.0 57.8 Number of children under age 5 420 492 599 517 994 303 282 308 324 294 1,511 Table DQ.9: Observation of under-5s birth certificates Per cent distribution of children under 5 by presence of birth certificates, and percentage of birth calendar seen, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Child has birth certificate District Merauke Jayawijaya Biak Numfor Area Urban Rural Child’s age 0 1 2 3 4 Total for 3 districts Had vaccination card previously 13.6 0.8 5.7 13.2 2.7 1.7 3.5 6.2 10.2 9.5 6.3 Never had vaccination card 9.5 48.2 13.2 11.2 30.0 26.7 20.2 23.1 23.8 23.8 23.6 Seen by the interviewer (1) 44.5 11.4 28.4 36.4 22.6 45.5 33.3 25.6 17.0 16.0 27.3 Not seen by the interviewer (2) 32.4 39.6 52.8 39.3 44.7 26.1 42.9 45.1 49.1 50.7 42.8 Don’t know/ Missing 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Per cent of vaccination cards seen by the interviewer (1)/(1+2)*100 57.9 22.3 35.0 48.1 33.6 63.6 43.7 36.2 25.7 24.0 39.0 Number of children under age 5 420 492 599 517 994 303 282 308 324 294 1,511 Table DQ.10: Observation of vaccination cards Per cent distribution of children under 5 by presence of a vaccination card, and the percentage of vaccination cards seen by the interviewers, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Child does not have vaccination card Child has vaccination card MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 175 Age 0 1 2 3 4 Total for 3 districts Mother interviewed 95.2 94.5 91.8 92.4 89.6 92.7 Father interviewed 0.0 0.7 0.5 0.6 0.3 0.4 Other adult female interviewed 1.2 0.3 0.8 0.9 1.5 1.0 Other adult female interviewed 3.6 4.6 6.9 6.0 8.6 6.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of children under 5 299 280 308 322 306 1,515 Table DQ.11: 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, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 District Merauke Jayawijaya Biak Numfor Area Urban Rural Number of children age 2-14 years 2 3 4 5+ Total for 3 districts Per cet of households where correct selection was performed 84.7 88.8 92.1 90.3 88.1 91.5 88.6 85.8 77.0 88.9 Number of households with 2 or more children age 2-14 years 333 392 433 382 776 599 317 155 87 1,158 Table DQ.12: Selection of children age 2-14 years for the child discipline module Per cent of households with at least two children age 2-14 years where correct selection of one child for the child discipline module was performed, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Mother in the household Mother not in the household 176 MULTIPLE INDICATOR CLUSTER SURVEY 2011 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 40 .2 21 .5 10 .9 6. 2 7. 4 6. 8 5. 8 8. 2 12 .8 17 .4 20 .6 28 .4 35 .8 53 .4 65 .8 71 .0 75 .3 83 .5 90 .5 87 .6 27 .4 5. 5 0. 5 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1 30 .1 53 .2 29 .9 12 .1 4. 2 2. 1 0. 1 0. 5 0. 0 0. 0 0. 0 1. 4 0. 7 0. 0 0. 7 1. 2 0. 7 0. 0 0. 0 0. 0 2 2. 2 18 .3 41 .3 25 .1 8. 4 4. 5 3. 1 0. 5 0. 6 0. 7 0. 4 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 3 0. 0 1. 3 15 .9 36 .7 30 .4 14 .8 9. 1 2. 5 0. 6 0. 5 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 4 0. 0 0. 2 1. 5 17 .5 37 .5 27 .6 11 .2 8. 3 2. 0 1. 4 0. 5 0. 5 0. 0 0. 4 0. 0 0. 4 0. 0 0. 0 1. 8 0. 0 D K 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 5 0. 0 0. 0 0. 0 2. 3 11 .4 29 .7 24 .3 10 .3 3. 7 2. 5 1. 4 1. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1 0. 0 0. 0 0. 0 0. 0 0. 0 1. 1 11 .4 30 .4 27 .7 10 .9 8. 4 3. 2 0. 7 0. 6 0. 5 0. 5 0. 0 0. 0 0. 0 1. 0 6 0. 0 0. 0 0. 0 0. 0 0. 6 13 .1 33 .9 24 .0 9. 2 6. 1 3. 3 0. 7 0. 7 0. 6 0. 7 0. 0 0. 0 0. 0 0. 0 0. 0 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 8 13 .9 29 .5 23 .2 10 .8 1. 8 3. 4 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 3 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 0. 2 1. 5 13 .3 25 .3 18 .4 8. 7 5. 7 1. 1 1. 3 0. 0 0. 8 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 6 12 .0 36 .1 53 .8 49 .6 38 .0 18 .4 7. 7 6. 4 0. 6 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 3. 5 5. 2 12 .0 19 .1 16 .9 16 .0 7. 7 11 .5 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 7 0. 7 0. 0 0. 0 0. 0 0. 0 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 29 7 33 8 31 4 32 6 27 3 28 9 32 1 27 0 25 4 26 8 21 8 21 9 21 2 18 1 19 0 17 3 19 1 16 1 16 4 18 5 Ta b le D Q .1 3: S ch o o l a tt en d an ce b y si n g le a g e D is tr ib u ti o n o f h o u se h o ld p o p u la ti o n a g e 5- 24 b y ed u ca ti o n al le ve l a n d e d u ca ti o n al le ve l a n d g ra d e at te n d ed in t h e cu rr en t (o r m o st r ec en t) s ch o o l y ea r, D is tr ic ts o f M er au ke , Ja ya w ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 A g e at b eg in n in g o f sc h o o l ye ar S D S M P S M U n iv er si ty C u rr en tl y at te n d in g D K N u m b er o f h o u se h o ld m em b er s To ta l N o t at te n d in g sc h o o l P re sc h o o l MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 177 Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total for 3 districts 45 228 514 583 745 545 583 3,243 1.16 1.33 1.17 1.01 1.07 0.97 0.98 1.10 40 167 450 551 678 543 574 3,003 8 26 41 68 94 69 83 389 1.13 1.37 1.14 1.06 1.10 1.00 1.02 1.12 8 15 47 41 70 53 64 298 37 202 473 515 651 476 500 2,854 1.00 1.73 0.87 1.66 1.34 1.30 1.30 1.32 32 152 403 510 608 490 510 2,705 465 399 504 432 421 289 274 2,784 Number of sons ever born Number of daughters ever born Number of women Sex ratio Sex ratio Number of deceased daughters Number of daughters living Number of deceased sons Number of sons living Sex ratio at birth Table DQ.14: Sex ratio at birth among children ever born and living Sex ratio (number of males per 100 females) among children ever born (at birth), children living, and deceased children, by age of women, Districts of Merauke, Jayawijaya and Biak Numfor, Papua Province, Indonesia, 2011 Children Ever Born Children Living Children Deceased MULTIPLE INDICATOR CLUSTER SURVEY 2011178 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 179MULTIPLE INDICATOR CLUSTER SURVEY 2011 APPENDIX D. ESTIMATES OF SAMPLING ERRORS The sample of respondents selected in Selected Districts of Papua Province Multiple Indicator Cluster Survey (MICS) is only one of the samples that could have been selected from the same population, using the same design and size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between the estimates from all possible samples. The extent of variability is not known exactly, but can be estimated statistically from the survey data. The following sampling error measures are presented in this appendix for each of the selected indicators: • Standard error (se): Sampling errors are usually measured in terms of standard errors for particular indicators (means, proportions etc). Standard error is the square root of the variance of the estimate. The Taylor linearization method is used for the estimation of standard errors. • Coefficient of variation (se/r) is the ratio of the standard error to the value of the indicator, and is a measure of the relative sampling error. • Design effect (deff) is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption of simple random sampling. The square root of the design effect (deft) is used to show the efficiency of the sample design in relation to the precision. A deft value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a deft value above 1.0 indicates an increase in the standard error due to the use of a more complex sample design. • Confidence limits are calculated to show the interval within which the true value for the population can be reasonably assumed to fall, with a specified level of confidence. For any given statistic calculated from the survey, the value of that statistic will fall within a range of plus or minus two times the standard error (r + 2.se or r – 2.se) of the statistic in 95 per cent of all possible samples of identical size and design. For the calculation of sampling errors from MICS data, SPSS Version 18 Complex Samples module has been used. The results are shown in the tables that follow. In addition to the sampling error measures described above, the tables also include weighted and unweighted counts of denominators for each indicator. Sampling errors are calculated for indicators of primary interest for each district: Merauke, Jayawijaya and Biak Numfor. Seven are based on household members, 11 are based on women, 7 are based on men and 10 are based on children under 5. All indicators presented here are in the form of proportions. Table SE.1 shows the list of indicators for which sampling errors are calculated, including the base population (denominator) for each indicator. Tables SE.2 to SE.4 show the calculated sampling errors for selected domains. 180 MULTIPLE INDICATOR CLUSTER SURVEY 2011 4. 1 4. 3 7. 4 7. 5 8. 2 9. 18 8. 5 5. 2 5. 3 5. 5a 5. 5b 5. 7 5. 8 7. 1 8. 7 9. 2 9. 3 9. 4 7. 1 8. 7 9. 2 9. 3 9. 4 9. 11 9. 21 2. 6 2. 14 3. 1 3. 2 3. 3 3. 4 3. 5 3. 15 3. 18 8. 1 U se o f im p ro ve d d ri n ki n g w at er s o u rc es U se o f im p ro ve d s an it at io n P ri m ar y sc h o o l n et a tt en d an ce r at io ( ad ju st ed ) S ec o n d ar y sc h o o l n et a tt en d an ce r at io ( ad ju st ed ) C h ild la b o u r P re va le n ce o f ch ild re n w it h o n e o r b o th p ar en ts d ea d V io le n t d is ci p lin e E ar ly c h ild b ea ri n g C o n tr ac ep ti ve p re va le n ce A n te n at al c ar e co ve ra g e - at le as t o n ce b y sk ill ed p er so n n el A n te n at al c ar e co ve ra g e – at le as t fo u r ti m es b y an y p ro vi d er S ki lle d a tt en d an t at d el iv er y In st it u ti o n al d el iv er ie s Li te ra cy r at e am o n g y o u n g w o m en M ar ri ag e b ef o re a g e 18 C o m p re h en si ve k n o w le d g e ab o u t H IV p re ve n ti o n a m o n g y o u n g p eo p le K n o w le d g e o f m o th er - to -c h ild t ra n sm is si o n o f H IV A cc ep ti n g a tt it u d es t o w ar d s p eo p le li vi n g w it h H IV Li te ra cy r at e am o n g y o u n g m en M ar ri ag e b ef o re a g e 18 C o m p re h en si ve k n o w le d g e ab o u t H IV p re ve n ti o n a m o n g y o u n g p eo p le K n o w le d g e o f m o th er - to -c h ild t ra n sm is si o n o f H IV A cc ep ti n g a tt it u d es t o w ar d s p eo p le li vi n g w it h H IV S ex b ef o re a g e 15 a m o n g y o u n g m en M al e ci rc u m ci si o n E xc lu si ve b re as tf ee d in g u n d er 6 m o n th s A g e- ap p ro p ri at e b re as tf ee d in g Tu b er cu lo si s im m u n iz at io n c o ve ra g e R ec ei ve d p o lio im m u n iz at io n R ec ei ve d D P T im m u n iz at io n R ec ei ve d m ea sl es im m u n iz at io n R ec ei ve d H ep at it is B im m u n iz at io n S le ep in g u n d er in se ct ic id e- tr ea te d n et s (I T N s) A n ti -m al ar ia l t re at m en t B ir th r eg is tr at io n A ll h o u se h o ld m em b er s A ll h o u se h o ld m em b er s C h ild re n o f se co n d ar y sc h o o l a g e C h ild re n o f se co n d ar y sc h o o l a g e C h ild re n a g e 5- 14 y ea rs C h ild re n a g e 0- 17 y ea rs C h ild re n a g e 2- 14 y ea rs W o m en a g e 20 -2 4 ye ar s W o m en a g e 15 -4 9 ye ar s w h o a re c u rr en tl y m ar ri ed o r in u n io n W o m en a g e 15 -4 9 ye ar s w it h a li ve b ir th in t h e 2 ye ar s p re ce d in g t h e su rv ey W o m en a g e 15 -4 9 ye ar s w it h a li ve b ir th in t h e 2 ye ar s p re ce d in g t h e su rv ey W o m en a g e 15 -4 9 ye ar s w it h a li ve b ir th in t h e 2 ye ar s p re ce d in g t h e su rv ey W o m en a g e 15 -4 9 ye ar s w it h a li ve b ir th in t h e 2 ye ar s p re ce d in g t h e su rv ey W o m en a g e 15 -2 4 ye ar s W o m en a g e 20 -4 9 ye ar s W o m en a g e 15 -2 4 ye ar s W o m en a g e 15 -4 9 ye ar s W o m en a g e 15 -4 9 ye ar s w h o h av e h ea rd o f H IV M en a g e 15 -2 4 ye ar s M en a g e 20 -4 9 ye ar s M en a g e 15 -2 4 ye ar s M en a g e 15 -4 9 ye ar s M en a g e 15 -4 9 ye ar s w h o h av e h ea rd o f H IV M en a g e 15 -2 4 ye ar s M en a g e 15 -4 9 ye ar s To ta l n u m b er o f in fa n ts u n d er 6 m o n th s o f ag e C h ild re n a g e 0- 23 m o n th s C h ild re n a g e 12 -2 3 m o n th s C h ild re n a g e 12 -2 3 m o n th s C h ild re n a g e 12 -2 3 m o n th s C h ild re n a g e 12 -2 3 m o n th s C h ild re n a g e 12 -2 3 m o n th s C h ild re n u n d er a g e 5 C h ild re n u n d er a g e 5 re p o rt ed t o h av e h ad f ev er in t h e p re vi o u s 2 w ee ks C h ild re n u n d er a g e 5 Ta b le S E .1 : I n d ic at o rs s el ec te d f o r sa m p lin g e rr o r ca lc u la ti o n s Li st o f in d ic at o rs s el ec te d f o r sa m p lin g e rr o r ca lc u la ti o n s, a n d b as e p o p u la ti o n s (d en o m in at o rs ) fo r ea ch in d ic at o r, S el ec te d D is tr ic ts o f P ap u a P ro vi n ce M u lt ip le In d ic at o r C lu st er S u rv ey ( M IC S ), 2 01 1 M IC S 4 In d ic at o r B as e P o p u la ti o n H O U S E H O LD M E M B E R S W O M E N M E N U N D E R -5 s MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 181 U se o f im p ro ve d d ri n ki n g w at er s o u rc es U se o f im p ro ve d s an it at io n P ri m ar y sc h o o l n et a tt en d an ce r at io ( ad ju st ed ) S ec o n d ar y sc h o o l n et a tt en d an ce r at io ( ad ju st ed ) C h ild la b o u r P re va le n ce o f ch ild re n w it h a t le as t o n e p ar en t d ea d C h ild d is ci p lin e 4. 1 4. 3 7. 4 7. 5 8. 2 9. 18 8. 5 7. 1 8. 7 9. 2 9. 3 9. 4 9. 11 9. 21 2. 6 2. 14 3. 1 3. 2 3. 3 3. 4 3. 5 3. 15 3. 18 8. 1 5. 2 5. 3 5. 5a 5. 5b 5. 7 5. 8 7. 1 8. 7 9. 2 9. 3 9. 4 0. 54 30 0. 64 00 0. 96 53 0. 70 51 0. 20 37 0. 07 02 0. 86 52 0. 92 37 0. 03 38 0. 14 59 0. 53 68 0. 22 15 0. 02 49 0. 63 04 0. 23 30 0. 41 58 0. 96 26 0. 81 40 0. 70 05 0. 92 23 0. 69 18 0. 41 70 0. 06 68 0. 65 93 0. 11 13 0. 51 80 0. 96 36 0. 89 63 0. 85 73 0. 61 13 0. 90 21 0. 34 14 0. 30 23 0. 59 70 0. 21 52 0. 04 63 1 0. 04 16 7 0. 01 09 8 0. 03 77 7 0. 02 40 8 0. 00 96 4 0. 01 28 1 0. 01 77 2 0. 00 63 3 0. 02 44 9 0. 02 65 9 0. 02 03 4 0. 01 24 7 0. 05 32 2 0. 03 15 8 0. 05 51 0 0. 02 46 2 0. 05 17 5 0. 05 16 7 0. 01 89 7 0. 04 53 4 0. 04 13 8 0. 02 96 3 0. 04 81 3 0. 03 58 8 0. 02 59 2 0. 02 11 6 0. 03 46 2 0. 03 70 0 0. 05 36 4 0. 02 71 5 0. 03 32 4 0. 03 74 3 0. 02 51 3 0. 02 16 6 0. 08 5 0. 06 5 0. 01 1 0. 05 4 0. 11 8 0. 13 7 0. 01 5 0. 01 9 0. 18 7 0. 16 8 0. 05 0 0. 09 2 0. 50 0 0. 08 4 0. 13 6 0. 13 3 0. 02 6 0. 06 4 0. 07 4 0. 02 1 0. 06 6 0. 09 9 0. 44 4 0. 07 3 0. 32 2 0. 05 0 0. 02 2 0. 03 9 0. 04 3 0. 08 8 0. 03 0 0. 09 7 0. 12 4 0. 04 2 0. 10 1 7. 89 0 6. 88 2 1. 96 0 2. 77 3 3. 86 8 2. 17 4 0. 85 0 0. 98 0 0. 78 6 1. 05 9 2. 16 7 1. 65 6 1. 40 6 9. 26 2 0. 17 9 1. 86 2 1. 21 1 1. 27 3 0. 89 1 0. 35 2 0. 67 5 2. 88 1 1. 67 6 4. 32 2 1. 76 9 1. 76 5 1. 88 7 1. 91 0 1. 65 6 1. 79 2 2. 14 5 3. 53 3 1. 70 7 2. 20 4 1. 95 0 2. 80 9 2. 62 3 1. 40 0 1. 66 5 1. 96 7 1. 47 4 0. 92 2 0. 99 0 0. 88 7 1. 02 9 1. 47 2 1. 28 7 1. 18 6 3. 04 3 0. 42 3 1. 36 5 1. 10 1 1. 12 8 0. 94 4 0. 59 3 0. 82 1 1. 69 7 1. 29 5 2. 07 9 1. 33 0 1. 32 8 1. 37 4 1. 38 2 1. 28 7 1. 33 9 1. 46 5 1. 88 0 1. 30 7 1. 48 5 1. 39 6 5, 05 0 5, 05 0 71 6 53 4 1, 41 9 1, 99 5 1, 52 1 32 7 98 9 32 7 1, 16 1 1, 05 6 32 7 1, 16 1 46 20 6 10 3 10 3 99 10 0 99 56 2 15 8 57 6 19 3 93 6 20 4 20 4 20 4 20 4 36 5 1, 01 7 36 5 1, 18 9 1, 00 4 91 4 91 4 54 6 40 5 1, 08 3 1, 52 6 60 5 22 1 64 3 22 1 76 3 69 1 22 1 76 3 33 15 0 73 73 71 71 71 41 0 12 0 42 0 13 7 65 7 14 9 14 9 14 9 14 9 25 8 72 0 25 8 84 1 70 3 0. 45 0 0. 55 7 0. 94 3 0. 63 0 0. 15 6 0. 05 1 0. 84 0 0. 88 8 0. 02 1 0. 09 7 0. 48 4 0. 18 1 0. 00 0 0. 52 4 0. 17 0 0. 30 6 0. 91 3 0. 71 0 0. 59 7 0. 88 4 0. 60 1 0. 33 4 0. 00 8 0. 56 3 0. 04 0 0. 46 6 0. 92 1 0. 82 7 0. 78 3 0. 50 4 0. 84 8 0. 27 5 0. 22 7 0. 54 7 0. 17 2 0. 63 6 0. 72 3 0. 98 7 0. 78 1 0. 25 2 0. 08 9 0. 89 1 0. 95 9 0. 04 6 0. 19 5 0. 59 0 0. 26 2 0. 05 0 0. 73 7 0. 29 6 0. 52 6 1. 00 0 0. 91 7 0. 80 4 0. 96 0 0. 78 2 0. 50 0 0. 12 6 0. 75 6 0. 18 3 0. 57 0 1. 00 0 0. 96 6 0. 93 1 0. 71 9 0. 95 6 0. 40 8 0. 37 7 0. 64 7 0. 25 9 E ar ly c h ild b ea ri n g C o n tr ac ep ti ve p re va le n ce A n te n at al c ar e co ve ra g e at le as t o n e b y sk ill ed p er so n n el A n te n at al c ar e co ve ra g e at le as t fo u r b y sk ill ed p er so n n el S ki lle d a tt en d an t at d el iv er y In st it u ti o n al d el iv er ie s Li te ra cy a m o n g y o u n g w o m en M ar ri ag e b ef o re a g e 18 C o m p re h en si ve k n o w le d g e ab o u t H IV p re ve n ti o n a m o n g y o u n g p eo p le K n o w le d g e o f m o th er -t o -c h ild t ra n sm is si o n o f H IV A cc ep ti n g a tt it u d es t o w ar d s p eo p le li vi n g w it h H IV Li te ra cy a m o n g y o u n g m en M ar ri ag e b ef o re a g e 18 C o m p re h en si ve k n o w le d g e ab o u t H IV p re ve n ti o n a m o n g y o u n g p eo p le K n o w le d g e o f m o th er -t o -c h ild t ra n sm is si o n o f H IV A cc ep ti n g a tt it u d es t o w ar d s p eo p le li vi n g w it h H IV S ex b ef o re a g e 15 a m o n g y o u n g m en M al e ci rc u m ci si o n E xc lu si ve b re as tf ee d in g u n d er 6 m o n th s A g e- ap p ro p ri at e b re as tf ee d in g Tu b er cu lo si s im m u n iz at io n c o ve ra g e P o lio im m u n iz at io n c o ve ra g e Im m u n iz at io n c o ve ra g e fo r D P T M ea sl es im m u n iz at io n c o ve ra g e H ep at it is B im m u n iz at io n S le ep in g u n d er in se ct ic id e- tr ea te d n et s (I T N s) A n ti -m al ar ia l t re at m en t B ir th r eg is tr at io n Ta b le S E .2 : S am p lin g e rr o rs : M er au ke D is tr ic t S ta n d ar d e rr o rs , c o ef fi ci en ts o f va ri at io n , d es ig n e ff ec ts ( d ef f) , s q u ar e ro o t o f d es ig n e ff ec ts ( d ef t) a n d c o n fi d en ce in te rv al s fo r se le ct ed in d ic at o rs , D is tr ic ts o f M er au ke , Ja ya w ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 M IC S in d ic at o r n u m b er S ta n d ar d er ro r (s e) C o ef fi ci en t o f va ri at io n (s e/ r) D es ig n ef fe ct (d ef f) S q u ar e ro o t o f d es ig n e ff ec t (d ef t) W ei g h te d co u n t U n w ei g h te d co u n t r - 2s e r + 2s e C o n fi d en ce li m it s V al u e (r ) H O U S E H O LD M E M B E R S W O M E N M E N U N D E R -5 s 182 MULTIPLE INDICATOR CLUSTER SURVEY 2011 U se o f im p ro ve d d ri n ki n g w at er s o u rc es U se o f im p ro ve d s an it at io n f ac ili ti es P ri m ar y sc h o o l n et a tt en d an ce r at io ( ad ju st ed ) S ec o n d ar y sc h o o l n et a tt en d an ce r at io ( ad ju st ed ) C h ild la b o u r P re va le n ce o f ch ild re n w it h a t le as t o n e p ar en t d ea d V io le n t d is ci p lin e 4. 1 4. 3 7. 4 7. 5 8. 2 9. 18 8. 5 7. 1 8. 7 9. 2 9. 3 9. 4 9. 11 9. 21 2. 6 2. 14 3. 1 3. 2 3. 3 3. 4 3. 5 3. 15 3. 18 8. 1 5. 2 5. 3 5. 5a 5. 5b 5. 7 5. 8 7. 1 8. 7 9. 2 9. 3 9. 4 0. 34 91 0. 23 60 0. 81 73 0. 54 08 0. 36 24 0. 09 22 0. 92 07 0. 71 84 0. 11 01 0. 13 84 0. 58 40 0. 10 76 0. 07 51 0. 11 77 0. 54 97 0. 68 80 0. 62 72 0. 43 17 0. 30 90 0. 43 83 0. 32 19 0. 08 89 0. 00 17 0. 19 73 0. 36 92 0. 33 69 0. 57 06 0. 36 00 0. 35 64 0. 27 62 0. 60 18 0. 46 80 0. 14 13 0. 41 01 0. 08 17 0. 04 47 0 0. 03 80 9 0. 03 90 3 0. 05 49 8 0. 02 54 5 0. 01 28 9 0. 01 13 5 0. 04 44 9 0. 01 19 1 0. 04 53 7 0. 03 60 0 0. 01 77 1 0. 02 58 2 0. 02 62 2 0. 09 69 7 0. 04 74 8 0. 06 05 7 0. 06 61 3 0. 06 64 3 0. 07 52 4 0. 06 65 2 0. 02 39 1 0. 00 16 7 0. 03 27 9 0. 04 33 5 0. 01 88 1 0. 04 96 4 0. 05 47 6 0. 04 79 4 0. 04 37 2 0. 06 20 0 0. 03 40 9 0. 02 73 5 0. 04 03 0 0. 01 35 8 0. 12 8 0. 16 1 0. 04 8 0. 10 2 0. 07 0 0. 14 0 0. 01 2 0. 06 2 0. 10 8 0. 32 8 0. 06 2 0. 16 5 0. 34 4 0. 22 3 0. 17 6 0. 06 9 0. 09 7 0. 15 3 0. 21 5 0. 17 2 0. 20 7 0. 26 9 1. 00 6 0. 16 6 0. 11 7 0. 05 6 0. 08 7 0. 15 2 0. 13 5 0. 15 8 0. 10 3 0. 07 3 0. 19 4 0. 09 8 0. 16 6 8. 48 7 7. 76 6 6. 14 0 4. 57 6 3. 25 1 3. 30 8 1. 12 2 1. 75 1 0. 94 2 3. 09 1 3. 96 9 1. 99 5 1. 71 9 4. 92 6 2. 05 1 2. 04 8 1. 36 5 1. 55 1 1. 55 0 1. 93 1 1. 52 0 3. 41 7 0. 23 1 3. 33 3 0. 96 8 1. 17 1 2. 11 2 2. 73 3 2. 10 4 2. 00 8 4. 09 0 3. 50 0 1. 57 3 5. 94 2 1. 28 0 2. 91 3 2. 78 7 2. 47 8 2. 13 9 1. 80 3 1. 81 9 1. 05 9 1. 32 3 .9 70 1. 75 8 1. 99 2 1. 41 3 1. 31 1 2. 22 0 1. 43 2 1. 43 1 1. 16 8 1. 24 5 1. 24 5 1. 39 0 1. 23 3 1. 84 8 0. 48 1 1. 82 6 0. 98 4 1. 08 2 1. 45 3 1. 65 3 1. 45 1 1. 41 7 2. 02 2 1. 87 1 1. 25 4 2. 43 8 1. 13 1 31 92 31 92 49 5 33 0 98 3 14 06 11 04 14 6 55 0 14 6 62 7 52 1 14 6 62 7 48 16 9 74 74 65 72 65 41 7 13 3 42 497 61 5 17 4 17 4 17 4 17 4 21 7 62 8 21 7 74 8 47 2 96 6 96 6 60 3 37 7 11 61 16 68 63 7 18 0 65 2 18 0 74 5 61 2 18 0 74 5 55 19 6 88 88 76 85 76 48 5 13 8 49 2 12 1 74 1 21 1 21 1 21 1 21 1 25 6 75 1 25 6 88 6 52 2 0. 26 0 0. 16 0 0. 73 9 0. 43 1 0. 31 2 0. 06 6 0. 89 8 0. 62 9 0. 08 6 0. 04 8 0. 51 2 0. 07 2 0. 02 3 0. 06 5 0. 35 6 0. 59 3 0. 50 6 0. 29 9 0. 17 6 0. 28 8 0. 18 9 0. 04 1 0. 00 0 0. 13 2 0. 28 2 0. 29 9 0. 47 1 0. 25 1 0. 26 0 0. 18 9 0. 47 8 0. 40 0 0. 08 7 0. 32 9 0. 05 5 0. 43 9 0. 31 2 0. 89 5 0. 65 1 0. 41 3 0. 11 8 0. 94 3 0. 80 7 0. 13 4 0. 22 9 0. 65 6 0. 14 3 0. 12 7 0. 17 0 0. 74 4 0. 78 3 0. 74 8 0. 56 4 0. 44 2 0. 58 9 0. 45 5 0. 13 7 0. 00 5 0. 26 3 0. 45 6 0. 37 5 0. 67 0 0. 47 0 0. 45 2 0. 36 4 0. 72 6 0. 53 6 0. 19 6 0. 49 1 0. 10 9 E ar ly c h ild b ea ri n g C o n tr ac ep ti ve p re va le n ce A n te n at al c ar e co ve ra g e at le as t o n e b y sk ill ed p er so n n el A n te n at al c ar e co ve ra g e at le as t fo u r b y sk ill ed p er so n n el S ki lle d a tt en d an t at d el iv er y In st it u ti o n al d el iv er ie s Li te ra cy a m o n g y o u n g w o m en M ar ri ag e b ef o re a g e 18 C o m p re h en si ve k n o w le d g e ab o u t H IV p re ve n ti o n a m o n g y o u n g p eo p le K n o w le d g e o f m o th er -t o -c h ild t ra n sm is si o n o f H IV A cc ep ti n g a tt it u d es t o w ar d s p eo p le li vi n g w it h H IV Li te ra cy a m o n g y o u n g m en M ar ri ag e b ef o re a g e 18 C o m p re h en si ve k n o w le d g e ab o u t H IV p re ve n ti o n a m o n g y o u n g p eo p le K n o w le d g e o f m o th er -t o -c h ild t ra n sm is si o n o f H IV A cc ep ti n g a tt it u d es t o w ar d s p eo p le li vi n g w it h H IV S ex b ef o re a g e 15 a m o n g y o u n g m en M al e ci rc u m ci si o n E xc lu si ve b re as tf ee d in g u n d er 6 m o n th s A g e- ap p ro p ri at e b re as tf ee d in g Tu b er cu lo si s im m u n iz at io n c o ve ra g e P o lio im m u n iz at io n c o ve ra g e Im m u n iz at io n c o ve ra g e fo r D P T M ea sl es im m u n iz at io n c o ve ra g e H ep at it is B im m u n iz at io n S le ep in g u n d er in se ct ic id e- tr ea te d n et s (I T N s) A n ti -m al ar ia l t re at m en t B ir th r eg is tr at io n Ta b le S E .3 : S am p lin g e rr o rs : J ay aw ija ya D is tr ic t S ta n d ar d e rr o rs , c o ef fi ci en ts o f va ri at io n , d es ig n e ff ec ts ( d ef f) , s q u ar e ro o t o f d es ig n e ff ec ts ( d ef t) a n d c o n fi d en ce in te rv al s fo r se le ct ed in d ic at o rs , D is tr ic ts o f M er au ke , Ja ya w ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 M IC S in d ic at o r n u m b er S ta n d ar d er ro r (s e) C o ef fi ci en t o f va ri at io n (s e/ r) D es ig n ef fe ct (d ef f) S q u ar e ro o t o f d es ig n e ff ec t (d ef t) W ei g h te d co u n t U n w ei g h te d co u n t r - 2s e r + 2s e C o n fi d en ce li m it s V al u e (r ) H O U S E H O LD M E M B E R S W O M E N M E N U N D E R -5 s MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 183 U se o f im p ro ve d d ri n ki n g w at er s o u rc es U se o f im p ro ve d s an it at io n f ac ili ti es P ri m ar y sc h o o l n et a tt en d an ce r at io ( ad ju st ed ) S ec o n d ar y sc h o o l n et a tt en d an ce r at io ( ad ju st ed ) C h ild la b o u r P re va le n ce o f ch ild re n w it h a t le as t o n e p ar en t d ea d V io le n t d is ci p lin e 4. 1 4. 3 7. 4 7. 5 8. 2 9. 18 8. 5 7. 1 8. 7 9. 2 9. 3 9. 4 9. 11 9. 21 2. 6 2. 14 3. 1 3. 2 3. 3 3. 4 3. 5 3. 15 3. 18 8. 1 5. 2 5. 3 5. 5a 5. 5b 5. 7 5. 8 7. 1 8. 7 9. 2 9. 3 9. 4 0. 87 02 0. 74 46 0. 96 45 0. 75 40 0. 22 01 0. 07 54 0. 91 46 0. 92 15 0. 03 86 0. 26 17 0. 65 10 0. 11 39 0. 00 75 0. 24 58 0. 38 25 0. 39 68 0. 90 76 0. 63 90 0. 57 35 0. 86 03 0. 48 70 0. 41 92 0. 35 92 0. 32 66 0. 10 21 0. 42 52 0. 90 08 0. 65 69 0. 77 34 0. 42 57 0. 90 32 0. 20 20 0. 24 70 0. 69 39 0. 13 92 0. 03 61 5 0. 03 48 5 0. 01 14 8 0. 02 32 8 0. 01 85 2 0. 00 89 6 0. 01 36 6 0. 01 09 3 0. 00 76 7 0. 02 78 6 0. 02 02 5 0. 01 20 4 0. 00 42 9 0. 04 18 4 0. 07 96 8 0. 03 84 5 0. 02 04 8 0. 03 85 8 0. 04 99 2 0. 02 63 9 0. 04 37 7 0. 03 81 7 0. 03 96 5 0. 04 11 3 0. 01 50 1 0. 02 37 1 0. 02 11 9 0. 02 90 3 0. 03 92 2 0. 03 40 8 0. 02 58 7 0. 01 52 2 0. 02 96 9 0. 02 72 3 0. 01 72 9 0. 04 2 0. 04 7 0. 01 2 0. 03 1 0. 08 4 0. 11 9 0. 01 5 0. 01 2 0. 19 9 0. 10 6 0. 03 1 0. 10 6 0. 57 4 0. 17 0 0. 20 8 0. 09 7 0. 02 3 0. 06 0 0. 08 7 0. 03 1 0. 09 0 0. 09 1 0. 11 0 0. 12 6 0. 14 7 0. 05 6 0. 02 4 0. 04 4 0. 05 1 0. 08 0 0. 02 9 0. 07 5 0. 12 0 0. 03 9 0. 12 4 11 .3 92 6. 29 0 2. 66 2 1. 66 9 2. 89 0 2. 37 1 1. 64 4 0. 61 6 1. 31 6 1. 49 9 1. 91 1 1. 44 3 0. 92 4 10 .0 01 1. 34 4 1. 40 2 0. 58 0 0. 75 5 1. 14 1 0. 67 2 0. 87 4 3. 51 9 1. 29 1 4. 60 0 0. 34 4 1. 58 0 1. 05 6 0. 78 5 1. 84 3 0. 99 8 2. 67 3 1. 21 7 1. 65 4 3. 68 7 2. 51 7 3. 37 5 2. 50 8 1. 63 2 1. 29 2 1. 70 0 1. 54 0 1. 28 2 0. 78 5 1. 14 7 1. 22 4 1. 38 3 1. 20 1 0. 96 1 3. 16 2 1. 15 9 1. 18 4 0. 76 2 0. 86 9 1. 06 8 0. 82 0 0. 93 5 1. 87 6 1. 13 6 2. 14 5 0. 58 7 1. 25 7 1. 02 7 0. 88 6 1. 35 8 0. 99 9 1. 63 5 1. 10 3 1. 28 6 1. 92 0 1. 58 7 3, 82 8 3, 82 8 58 3 48 7 1, 21 7 1, 73 1 1, 28 3 27 8 60 9 27 8 78 0 74 2 27 8 78 0 44 19 4 99 10 0 96 99 98 50 4 15 9 51 2 11 3 54 6 16 7 16 7 16 7 16 7 28 3 67 7 28 3 84 8 81 1 98 6 98 6 69 4 57 2 1, 44 8 2, 05 9 68 9 37 4 83 0 37 4 1, 06 0 1, 00 6 37 4 1, 06 0 51 22 8 11 7 11 8 11 3 11 7 11 5 58 9 19 0 59 9 14 1 68 8 21 1 21 1 21 1 21 1 35 0 84 8 35 0 1, 05 7 1, 01 0 0. 79 8 0. 67 5 0. 94 2 0. 70 7 0. 18 3 0. 05 8 0. 88 7 0. 90 0 0. 02 3 0. 20 6 0. 61 0 0. 09 0 0. 00 0 0. 16 2 0. 22 3 0. 32 0 0. 86 7 0. 56 2 0. 47 4 0. 80 8 0. 39 9 0. 34 3 0. 28 0 0. 24 4 0. 07 2 0. 37 8 0. 85 8 0. 59 9 0. 69 5 0. 35 8 0. 85 1 0. 17 2 0. 18 8 0. 63 9 0. 10 5 0. 94 2 0. 81 4 0. 98 7 0. 80 1 0. 25 7 0. 09 3 0. 94 2 0. 94 3 0. 05 4 0. 31 7 0. 69 1 0. 13 8 0. 01 6 0. 32 9 0. 54 2 0. 47 4 0. 94 9 0. 71 6 0. 67 3 0. 91 3 0. 57 5 0. 49 6 0. 43 8 0. 40 9 0. 13 2 0. 47 3 0. 94 3 0. 71 5 0. 85 2 0. 49 4 0. 95 5 0. 23 2 0. 30 6 0. 74 8 0. 17 4 E ar ly c h ild b ea ri n g C o n tr ac ep ti ve p re va le n ce A n te n at al c ar e co ve ra g e at le as t o n e b y sk ill ed p er so n n el A n te n at al c ar e co ve ra g e at le as t fo u r b y sk ill ed p er so n n el S ki lle d a tt en d an t at d el iv er y In st it u ti o n al d el iv er ie s Li te ra cy a m o n g y o u n g w o m en M ar ri ag e b ef o re a g e 18 C o m p re h en si ve k n o w le d g e ab o u t H IV p re ve n ti o n a m o n g y o u n g p eo p le K n o w le d g e o f m o th er -t o -c h ild t ra n sm is si o n o f H IV A cc ep ti n g a tt it u d es t o w ar d s p eo p le li vi n g w it h H IV Li te ra cy a m o n g y o u n g m en M ar ri ag e b ef o re a g e 18 C o m p re h en si ve k n o w le d g e ab o u t H IV p re ve n ti o n a m o n g y o u n g p eo p le K n o w le d g e o f m o th er -t o -c h ild t ra n sm is si o n o f H IV A cc ep ti n g a tt it u d es t o w ar d s p eo p le li vi n g w it h H IV S ex b ef o re a g e 15 a m o n g y o u n g m en M al e ci rc u m ci si o n E xc lu si ve b re as tf ee d in g u n d er 6 m o n th s A g e- ap p ro p ri at e b re as tf ee d in g Tu b er cu lo si s im m u n iz at io n c o ve ra g e P o lio im m u n iz at io n c o ve ra g e Im m u n iz at io n c o ve ra g e fo r D P T M ea sl es im m u n iz at io n c o ve ra g e H ep at it is B im m u n iz at io n S le ep in g u n d er in se ct ic id e- tr ea te d n et s (I T N s) A n ti -m al ar ia l t re at m en t B ir th r eg is tr at io n Ta b le S E .4 : S am p lin g e rr o rs : B ia k N u m fo r D is tr ic t S ta n d ar d e rr o rs , c o ef fi ci en ts o f va ri at io n , d es ig n e ff ec ts ( d ef f) , s q u ar e ro o t o f d es ig n e ff ec ts ( d ef t) a n d c o n fi d en ce in te rv al s fo r se le ct ed in d ic at o rs , D is tr ic ts o f M er au ke , J ay aw ija ya a n d B ia k N u m fo r, P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 M IC S in d ic at o r n u m b er S ta n d ar d er ro r (s e) C o ef fi ci en t o f va ri at io n (s e/ r) D es ig n ef fe ct (d ef f) S q u ar e ro o t o f d es ig n e ff ec t (d ef t) W ei g h te d co u n t U n w ei g h te d co u n t r - 2s e r + 2s e C o n fi d en ce li m it s V al u e (r ) H O U S E H O LD M E M B E R S W O M E N M E N U N D E R -5 s MULTIPLE INDICATOR CLUSTER SURVEY 2011184 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 185MULTIPLE INDICATOR CLUSTER SURVEY 2011 APPENDIX E MICS INDICATORS: NUMERATORS AND DENOMINATOR 1.1 1.2 2.4 2.5 2.6 2.7 2.8 2.9 Under-five mortality rate Infant mortality rate Children ever breastfed Early initiation of breastfeeding Exclusive breastfeeding under 6 months Continued breastfeeding at 1 year Continued breastfeeding at 2 years Predominant breastfeeding under 6 months CM CM MN MN BF BF BF BF Probability of dying by exact age 5 years Probability of dying by exact age 1 year Number of women with a live birth in the 2 years preceding the survey who breastfed the child at any time Number of women with a live birth in the 2 years preceding the survey who put the newborn infant to the breast within 1 hour of birth Number of infants under 6 months of age who are exclusively breastfed20 Number of children age 12-15 months who are currently breastfeeding Number of children age 20-23 months who are currently breastfeeding Number of infants under 6 months of age who received breast milk as the predominant source of nourishment21 during the previous day Total number of women with a live birth in the 2 years preceding the survey Total number of women with a live birth in the 2 years preceding the survey Total number of infants under 6 months of age Total number of children age 12-15 months Total number of children age 20-23 months Total number of infants under 6 months of age MDG 4.1 MDG 4.2 MICS4 Indicator [M] Module18 Numerator Denominator MDG 19 1. MORTALITY 2. NUTRITION [M] Indicates that the indicator is also calculated for men, for the same age group, in surveys where the Questionnaire for Individual Men has been included. Calculations are carried out by using modules in the Men’s Questionnaire 18 Some indicators are constructed by using questions in several modules. In such cases, only the module(s) which contains most of the necessary information is indicated. 19 MDG indicators as of February 2010 20 Infants receiving breast milk, and not receiving any other fluids or foods, with the exception of oral rehydration solution, vitamins, mineral supplements and medicines 21 Infants who receive breast milk and certain fluids (water and water-based drinks, fruit juice, ritual fluids, oral rehydration solution, drops, vitamins, minerals, and medicines), but do not receive anything else (in particular, non-human milk and food-based fluids) 186 MULTIPLE INDICATOR CLUSTER SURVEY 2011 3. CHILD HEALTH24 MICS4 Indicator [M] Module18 Numerator Denominator MDG 19 22 Breastfeeding children: Solid, semi-solid, or soft foods, two times for infants age 6-8 months, 3 times for children 9-23 months; Non-breastfeeding children: Solid, semi-solid, or soft foods, or milk feeds, four times for children age 6-23 months 23 Infants age 0-5 who are exclusively breastfed, and children age 6-23 months who are breastfed and ate solid, semi-solid or soft foods 24 Indicators 3.1, 3.2, 3.3, 3.4, 3.5 and 3.6 may be calculated for an older age group, such as 15-26 months or 18-29 months, depending on the immunization schedule 2.10 2.11 2.12 2.13 2.14 2.15 2.17 2.18 2.19 3.1 3.2 Duration of breastfeeding Bottle feeding Introduction of solid, semi-solid or soft foods Minimum meal frequency Age-appropriate breastfeeding Milk feeding frequency for non- breastfed children Vitamin A supplementation (children under age 5) Low-birthweight infants Infants weighed at birth Tuberculosis immunization coverage Polio immunization coverage BF BF BF BF BF BF IM MN MN IM IM Number of children age 0-23 months who were fed with a bottle during the previous day Number of infants age 6-8 months who received solid, semi-solid or soft foods during the previous day Number of children age 6-23 months receiving solid, semi- solid and soft foods (plus milk feeds for non-breastfed children) the minimum times22 or more, according to breastfeeding status, during the previous day Number of children age 0-23 months appropriately fed23 during the previous day Number of non-breastfed children age 6-23 months who received at least 2 milk feedings during the previous day Number of children age 6-59 months who received at least one high-dose vitamin A supplement in the 6 months preceding the survey Number of last live births in the 2 years preceding the survey weighing below 2,500 grams at birth Number of last live births in the 2 years preceding the survey who were weighed at birth Number of children age 12-23 months who received BCG vaccine before their first birthday Number of children age 12-23 months who received OPV3 vaccine before their first birthday Total number of children age 0-23 months Total number of infants age 6-8 months Total number of children age 6-23 months Total number of children age 0-23 months Total number of non- breastfed children age 6-23 months Total number of children age 6-59 months Total number of last live births in the 2 years preceding the survey Total number of last live births in the 2 years preceding the survey Total number of children age 12-23 months Total number of children age 12-23 months The age in months when 50 per cent of children age 0-35 months did not receive breast milk during the previous day MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 187 MICS4 Indicator [M] Module18 Numerator Denominator MDG 19 3.3 3.4 3.5 3.7 3.11 3.12 3.14 3.15 3.16 3.17 Immunization coverage for diphtheria, pertussis and tetanus (DPT) Measles immunization coverage Hepatitis B immunization coverage Neonatal tetanus protection Solid fuels Household availability of insecticide-treated nets (ITNs)26 Children under age 5 sleeping under any type of mosquito net Children under age 5 sleeping under insecticide-treated nets (ITNs) Malaria diagnostics usage Anti-malarial treatment of children under age 5 the same or next day IM IM IM MN HC TN TN TN ML ML MDG 4.3 MDG 6.7 Number of children age 12-23 months who received DPT3 vaccine before their first birthday Number of children age 12-23 months who received measles vaccine before their first birthday Number of children age 12-23 months who received the third dose of Hepatitis B vaccine before their first birthday Number of women age 15-49 years with a live birth in the 2 years preceding the survey who were given at least two doses of tetanus toxoid vaccine within the appropriate interval25 prior to giving birth Number of household members in households that use solid fuels as the primary source of domestic energy to cook Number of households with at least one insecticide- treated net (ITN) Number of children under age 5 who slept under any type of mosquito net the previous night Number of children under age 5 who slept under an insecticide-treated mosquito net (ITN) the previous night Number of children under age 5 reported to have had fever in the previous 2 weeks who had a finger or heel stick for malaria testing Number of children under age 5 reported to have had fever in the previous 2 weeks who were treated with any anti-malarial drug within the same or next day of onset of symptoms Total number of children age 12-23 months Total number of children age 12-23 months Total number of children age 12-23 months Total number of women age 15-49 years with a live birth in the 2 years preceding the survey Total number of household members Total number of households Total number of children under age 5 Total number of children under age 5 Total number of children under age 5 reported to have had fever in the previous 2 weeks Total number of children under age 5 reported to have had fever in the previous 2 weeks 25 See MICS4 manual for a detailed description 26 An ITN is (a) a factory treated net which does not require any treatment, (b) a pretreated net obtained within the past 12 months, or (c) a net that has been soaked with or dipped in insecticide within the past 12 months 188 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MICS4 Indicator [M] Module18 Numerator Denominator MDG 19 3.18 3.19 4.1 4.2 4.3 5.1 5.2 5.3 5.4 5.5a 5.5b Anti-malarial treatment of children under age 5 Pregnant women sleeping under insecticide-treated nets (ITNs) Use of improved drinking water sources Water treatment Use of improved sanitation Adolescent birth rate27 Early childbearing Contraceptive prevalence rate Unmet need28 (Indonesia specific) Antenatal care coverage ML TN WS WS WS CM - BH CM - BH CP UN MN Number of children under age 5 reported to have had fever in the previous 2 weeks who received any antimalarial treatment Number of pregnant women who slept under an insecticide-treated net (ITN) the previous night Number of household members using improved sources of drinking water Number of household members using unimproved drinking water who use an appropriate treatment method Number of household members using improved sanitation facilities which are not shared Number of women age 20-24 years who had at least one live birth before age 18 Number of women age 15- 49 years currently married or in union who are using (or whose partner is using) a (modern or traditional) contraceptive method Number of women age 15- 49 years who are currently married or in union who are fecund and want to space their births or limit the number of children they have and who are not currently using contraception Number of women age 15-49 years who were attended during pregnancy in the 2 years preceding the survey (a) at least once by skilled personnel (b) at least four times by any provider Total number of children under age 5 reported to have had fever in the previous 2 weeks Total number of pregnant women Total number of household members Total number of household members in households using unimproved drinking water sources Total number of household members Total number of women age 20-24 years Total number of women age 15-49 years who are currently married or in union Total number of women age 15-49 years who are currently married or in union Total number of women age 15-49 years with a live birth in the 2 years preceding the survey MDG 6.8 MDG 7.8 MDG 7.9 MDG 5.4 MDG 5.3 MDG 5.6 MDG 5.5 27 Indicator is defined as “Age-specific fertility rate for women age 15-19 years, for the 3-year period preceding the survey” when estimated from the birth history 28 See MICS4 manual for a detailed description 4. WATER AND SANITATION 5. REPRODUCTIVE HEALTH Age-specific fertility rate for women age 15-19 years for the one year period preceding the survey MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 189 MICS4 Indicator [M] Module18 Numerator Denominator MDG 19 5.6 5.7 5.8 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 Content of antenatal care Skilled attendant at delivery Institutional deliveries Literacy rate among young women[M] School readiness Net intake rate in primary education Primary school net attendance ratio (adjusted) Secondary school net attendance ratio (adjusted) Children reaching last grade of primary Primary completion rate Transition rate to secondary school MN MN MN WB ED ED ED ED ED ED ED Number of women age 15-49 years with a live birth in the 2 years preceding the survey who had their blood pressure measured and gave urine and blood samples during the last pregnancy Number of women age 15-49 years with a live birth in the 2 years preceding the survey who were attended during childbirth by skilled health personnel Number of women age 15-49 years with a live birth in the 2 years preceding the survey who delivered in a health facility Number of women age 15-24 years who are able to read a short simple statement about everyday life or who attended senior secondary or higher education Number of children in first grade of primary school who attended pre-school during the previous school year Number of children of school-entry age who enter the first grade of primary school Number of children of primary school age (7-12 years) currently attending primary or secondary school Number of children of secondary school age currently attending secondary school or higher Number of children attending the last grade of primary school (excluding repeaters) Number of children attending the last grade of primary school during the previous school year who are in the first grade of secondary school during the current school year Total number of women age 15-49 years with a live birth in the 2 years preceding the survey Total number of women age 15-49 years with a live birth in the 2 years preceding the survey Total number of women age 15-49 years with a live birth in the 2 years preceding the survey Total number of women age 15-24 years Total number of children attending the first grade of primary school Total number of children of school-entry age Total number of children of primary school age Total number of children of secondary school age Total number of children of primary school completion age (age appropriate to final grade of primary school) Total number of children attending the last grade of primary school during the previous school year MDG 5.2 MDG 2.3 MDG 2.1 MDG 2.2 7. LITERACY AND EDUCATION Proportion of children entering the first grade of primary school who eventually reach last grade 190 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MICS4 Indicator [M] Module18 Numerator Denominator MDG 19 7.9 7.10 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.10b 8.14 Gender parity index (primary school) Gender parity index (secondary school) Birth registration Child labour School attendance among child labourers Child labour among students Violent discipline Marriage before age 15 [M] Marriage before age 18 [M] Young women age 15-19 years currently married or in union [M] Spousal age difference Attitudes towards domestic violence[M] ED ED BR CL ED - CL ED - CL CD MA MA MA MA DV Primary school net attendance ratio (adjusted) for girls Secondary school net attendance ratio (adjusted) for girls Number of children under age 5 whose births are reported registered Number of children age 5-14 years who are involved in child labour Number of children age 5-14 years who are involved in child labour and are currently attending school Number of children age 5-14 years who are involved in child labour and are currently attending school Number of children age 2-14 years who experienced psychological aggression or physical punishment during the past month Number of women age 15-49 years who were first married or in union by the exact age of 15 Number of women age 20-49 years who were first married or in union by the exact age of 18 Number of women age 15- 19 years who are currently married or in union Number of women currently married or in union whose spouse is 10 or more years older, (b) for women age 20-24 years Number of women who state that a husband/partner is justified in hitting or beating his wife in at least one of the following circumstances: (1) she goes out without telling him, (2) she neglects the children, (3) she argues with him, (4) she refuses sex with him, (5) she burns the food Primary school net attendance ratio (adjusted) for boys Secondary school net attendance ratio (adjusted) for boys Total number of children under age 5 Total number of children age 5-14 years Total number of children age 5-14 years involved in child labour Total number of children age 5-14 years attending school Total number of children age 2-14 years Total number of women age 15-49 years Total number of women age 20-49 years Total number of women age 15-19 years Total number of women currently married or in union (b) age 20-24 years Total number of women age 15-49 years MDG 3.1 MDG 3.1 8. CHILD PROTECTION MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 191 MICS4 indicator [M] Module18 Numerator Denominator MDG 19 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.10 Comprehensive knowledge about HIV prevention [M] Comprehensive knowledge about HIV prevention among young people [M] Knowledge of mother-to-child transmission of HIV [M] Accepting attitudes towards people living with HIV [M] Women who know where to be tested for HIV [M] Women who have been tested for HIV and know the results [M] Sexually active young women who have been tested for HIV and know the results [M] Young women who have never had sex [M] HA HA HA HA HA HA HA SB Number of women age 15-49 years who correctly identify two ways of preventing HIV infection,29 know that a healthy looking person can have HIV, and reject the two most common misconceptions about HIV transmission Number of women age 15-24 years who correctly identify two ways of preventing HIV infection, know that a healthy looking person can have HIV, and reject the two most common misconceptions about HIV transmission Number of women age 15-49 years who correctly identify all three means30 of mother-to-child transmission of HIV Number of women age 15-49 years expressing accepting attitudes on all four questions31 toward people living with HIV Number of women age 15-49 years who state knowledge of a place to be tested for HIV health profession was deleted Number of women age 15-49 years who have been tested for HIV in the 12 months preceding the survey and who know their results Number of women age 15-24 years who have had sex in the 12 months preceding the survey, who have been tested for HIV in the 12 months preceding the survey and who know their results Number of never married women age 15-24 years who have never had sex Total number of women age 15-49 years Total number of women age 15-24 years Total number of women age 15-49 years Total number of women age 15-49 years who have heard of HIV Total number of women age 15-49 years Total number of women age 15-49 years Total number of women age 15-24 years who have had sex in the 12 months preceding the survey Total number of never married women age 15-24 years MDG 6.3 9. HIV/AIDS, SEXUAL BEHAVIOUR AND ORPHANS 29 Using condom and limiting sex to one faithful, uninfected partner 30 Transmission during pregnancy, during delivery, and by breastfeeding 31 Women (1) who think that a female teacher with the AIDS virus should be allowed to teach in school, (2) who would buy fresh vegetables from a shopkeeper or vendor who has the AIDS virus, (3) who would not want to keep it as a secret if a family member became infected with the AIDS virus, and (4) who would be willing to care for a family member who became sick with the AIDS virus 192 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MICS4 Indicator [M] Module18 Numerator Denominator MDG 19 9.11 9.12 9.13 9.14 9.15 9.17 9.18 9.21 TA.3 TA.4 Sex before age 15 among young women [M] Age-mixing among sexual partners [M] Sex with multiple partners [M] Condom use during sex with multiple partners [M] only for men Sex with non- regular partners[M] Children’s living arrangements Prevalence of children with one or both parents dead Male circumcision Alcohol use [M] Use of alcohol before age 15 [M] SB SB SB SB SB HL HL MMC TA TA Number of women age 15-24 years who have had sexual intercourse before age 15 Number of women age 15-24 years who had sex in the 12 months preceding the survey with a partner who was 10 or more years older Number of women age 15-49 years who have had sexual intercourse with more than one partner in the 12 months preceding the survey Number of men age 15-49 years who report having had more than one sexual partner in the 12 months preceding the survey who also reported that a condom was used the last time they had sex Number of sexually active women age 15-24 years who have had sex with a non- marital, non-cohabitating partner in the 12 months preceding the survey Number of children age 0-17 years not living with a biological parent Number of children age 0-17 years with one or both parents dead Number of men age 15-49 years who report having been circumcised Number of women age 15- 49 years who had at least one alcoholic drink on one or more days during the last one month Number of women age 15- 49 years who had at least one alcoholic drink before age 15 Total number of women age 15-24 years Total number of women age 15-24 years who have had sex in the 12 months preceding the survey Total number of women age 15-49 years Total number of men age 15-49 years who reported having had more than one sexual partner in the 12 months preceding the survey Total number of women age 15-24 years who have had sex in the 12 months preceding the survey Total number of children age 0-17 years Total number of children age 0-17 years Total number of men age 15-49 years Total number of women age 15-49 years Total number of women age 15-49 years 12. ALCOHOL USE MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 193 1 2a 2b 2c 3 4a 4b 5 Indicator Safe distance between water source and closest excreta disposal place Malaria screening during antenatal care ITN given to women during antenatal care Anti-malarial treatment of women during antenatal care Percentage of women age 15-49 who were officially married (registered in civil registration) Percentage of heads of households born in Papua Mean number of years head of household has been residing in Papua Median floor area per person (Indonesia specific) Numerator Number of household members whose water source for drinking or other use is 10 or more meters distance away from closest excreta disposal place Number of women age 15-49 years with a live birth in the 2 years preceding the survey who had blood screening test for malaria Number of women age 15-49 years who had antenatal visit during pregnancy in the 2 years preceding the survey and who received an ITN to prevent from malaria. Number of women age 15-49 years who had antenatal visit during pregnancy in the 2 years preceding the survey and who had blood screening test and were treated with any anti-malarial drug if malaria was positive. Number of women age 15-19 years who are married through civil registration Number of heads of household who were born in Papua Median floor area of housing unit Denominator Total number of household members Total number of women age 15- 49 years with a live birth in the 2 years preceding the survey Total number of women age 15- 49 years with a live birth in the 2 years preceding the survey who had antenatal visit during pregnancy Total number of women age 15-49 years with a live birth in the 2 years preceding the survey and who received ANC and received malaria test that tested positive Total number of women age 15-49 years Total number of household heads Average household size PAPUA SURVEY-SPECIFIC INDICATORS Mean number of years head of household has been residing in Papua MULTIPLE INDICATOR CLUSTER SURVEY 2011194 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 195MULTIPLE INDICATOR CLUSTER SURVEY 2011 APPENDIX F. QUESTIONNAIRES INDONESIA
2011
 
 Appendix
F.
 Questionnaires
 
 INDONESIA MULTIPLE INDICATOR CLUSTER SURVEY PAPUA AND WEST PAPUA PROVINCE HOUSEHOLD QUESTIONNAIRE CONFIDENTIAL HOUSEHOLD
INFORMATION
PANEL
 HH
 HH1. Cluster number: ____ ___ ___ ___ HH2. Household number: ___ ___ HH3. Interviewer name and number: HH4. Supervisor name and number: Name _________________________ ___ ___ Name__________________________ ___ ___ HH5. Day / Month / Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ HH7 Province: .___ ___ HH7A District: . ___ ___ Copy from Sample List of Block Census provided. WE ARE FROM LOCAL GOVERNMENT/BPS & WOULD LIKE TO INTERVIEW YOU ABOUT HEALTH AND EDUCATION. THE INTERVIEW WILL TAKE ABOUT 40 MINUTES. ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE SHARED WITH ANYONE OTHER THAN OUR PROJECT TEAM. MAY I START NOW?  Yes, permission is given  Go to HH18 to record the time and then begin the interview.  No, permission is not given  Complete HH9. Discuss this result with your supervisor. After all questionnaires for the household have been completed, fill in the following information: HH8. Name of head of household: __________________________________________ HH10. Respondent to household questionnaire: Name: ____________________________________ Line Number: ___ ___ HH9. Result of household interview: Completed. 01 No household member or no competent respondent at home at time of visit . 02 Entire household absent for extended period of time . 03 Refused. 04 Dwelling vacant / Address not a dwelling. 05 Dwelling destroyed. 06 Dwelling not found . 07 Other (specify)________________________ 96 HH11. Total number of household members: ___ ___ HH12. Number of women age 15-49 years: ___ ___ HH13. Number of woman’s questionnaires completed: ___ ___ HH13A. Number of men age 15-49 years: ___ ___ HH13B. Number of man’s questionnaires completed: ___ ___ HH14. Number of children under age 5: ___ ___ HH15. Number of under-5 questionnaires completed: ___ ___ HH16. Field edited by (Name and number): Name _________________________ ___ ___ HH17. Data entry clerk (Name and number): Name ___________________________ ___ ___ 196 MULTIPLE INDICATOR CLUSTER SURVEY 2011 H O U SE H O LD 
L IS TI N G 
F O R M 
 H L
 
 F IR S T , P L E A S E T E L L M E T H E N A M E O F E A C H P E R S O N W H O U S U A L L Y L IV E S H E R E , S T A R T IN G W IT H T H E H E A D O F T H E H O U S E H O L D . L is t th e h ea d o f th e h o u se h o ld i n l in e 0 1 . L is t a ll h o u se h o ld m em b er s (H L 2 ), t h ei r re la ti o n sh ip t o t h e h o u se h o ld h ea d ( H L 3 ), a n d t h ei r se x (H L 4 ) T h en a sk : A R E T H E R E A N Y O T H E R S W H O L IV E H E R E , E V E N I F T H E Y A R E N O T A T H O M E N O W ? If y es , co m p le te l is ti n g f o r q u es ti o n s H L 2 -H L 4 . T h en , a sk q u es ti o n s st a rt in g w it h H L 5 f o r ea ch p er so n a t a t im e. U se a n a d d it io n a l q u es ti o n n a ir e if a ll r o w s in t h e h o u se h o ld l is ti n g f o rm h a ve b ee n u se d . H H 1 8 . R ec o rd t h e ti m e. H o u r. . . . . . _ _ _ _ M in u te s . . . _ _ _ _ F o r w o m en a g e 1 5 -4 9 F o r m en a g e 1 5 -4 9 F o r ch il d re n a g e 5 -1 7 F o r ch il d re n u n d er a g e 5 F o r a ll h o u se h o ld m em b er s F o r ch il d re n a g e 0 -1 7 y ea rs H L 5 . W H A T I S ( n a m e) ’S D A T E O F B IR T H ? H L 1 . L in e N o H L 2 . N a m e H L 3 . W H A T I S T H E R E L A T IO N - S H IP O F (n a m e) T O T H E H E A D O F H O U S E - H O L D ? H L 4 . I S ( n a m e) M A L E O R F E M A L E ? 1 M a le 2 F e m a le 9 8 D K 9 9 9 8 D K H L 6 . H O W O L D IS ( n a m e) ? R ec o rd i n co m p le te d ye a rs . If a g e is 9 5 o r a b o ve , re co rd ‘ 9 5 ’ H L 7 . C ir cl e li n e n o . if w o m a n is a g e 1 5 -4 9 H L 7 A . C ir cl e li n e n o . if m a n i s a g e 1 5 -4 9 H L 8 . W H O I S T H E M O T H E R O R P R IM A R Y C A R E T A K E R O F T H IS C H IL D ? R ec o rd li n e n o . o f m o th er / ca re ta ke r H L 9 . W H O I S T H E M O T H E R O R P R IM A R Y C A R E T A K E R O F T H IS C H IL D ? R ec o rd li n e n o . o f m o th er / ca re ta ke r H L 1 0 . D ID ( n a m e) S T A Y H E R E L A S T N IG H T ? 1 Y e s 2 N o H L 1 1 . I S (n a m e) ’S N A T U R A L M O T H E R A L IV E ? 1 Y e s 2 N o  H L 1 3 8 D K  H L 1 3 H L 1 2 . D O E S (n a m e) ’S N A T U R A L M O T H E R L IV E I N T H IS H O U S E - H O L D ? R ec o rd li n e n o . o f m o th er o r 0 0 f o r “ N o ” H L 1 3 . I S (n a m e) ’ S N A T U R A L F A T H E R A L IV E ? 1 Y e s 2 N o  N e x t L in e 8 D K  N e x t L in e H L 1 4 . D O E S (n a m e) ’S N A T U R A L F A T H E R L IV E I N T H IS H O U S E - H O L D ? R ec o rd li n e n o . o f fa th er o r 0 0 f o r “ N o ” L in e N a m e R e la ti o n * M F M o n th Y e a r A g e 1 5 -4 9 1 5 -4 9 M o th e r M o th e r Y N Y N D K M o th e r Y N D K F a th e r 0 1 0 1 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 1 0 1 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 0 2 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 2 0 2 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 0 3 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 3 0 3 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 0 4 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 4 0 4 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 0 5 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 5 0 5 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 0 6 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 6 0 6 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 0 7 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 7 0 7 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 0 8 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 8 0 8 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 0 9 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 9 0 9 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 1 0 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 0 1 0 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 1 1 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 1 1 1 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 197 H L 5 . W H A T I S ( n a m e )’ S D A T E O F B IR T H ? H L 1 . L in e N o H L 2 . N a m e H L 3 . W H A T I S T H E R E L A T IO N - S H IP O F (n a m e ) T O T H E H E A D O F H O U S E - H O L D ? H L 4 . IS ( n a m e ) M A L E O R F E M A L E ? 1 M a le 2 F e m a le 9 8 D K 9 9 9 8 D K H L 6 . H O W O L D IS ( n a m e )? R e c o rd i n c o m p le te d y e a rs . If a g e i s 9 5 o r a b o v e , re c o rd ‘ 9 5 ’ H L 7 . C ir c le li n e n o . if w o m a n is a g e 1 5 - 4 9 H L 7 A . C ir c le li n e n o . if m a n i s a g e 1 5 - 4 9 H L 8 . W H O I S T H E M O T H E R O R P R IM A R Y C A R E T A K E R O F T H IS C H IL D ? R e c o rd li n e n o . o f m o th e r/ c a re ta k e r H L 9 . W H O I S T H E M O T H E R O R P R IM A R Y C A R E T A K E R O F T H IS C H IL D ? R e c o rd li n e n o . o f m o th e r/ c a re ta k e r H L 1 0 . D ID ( n a m e ) S T A Y H E R E L A S T N IG H T ? 1 Y e s 2 N o H L 1 1 . IS (n a m e )’ S N A T U R A L M O T H E R A L IV E ? 1 Y e s 2 N o  H L 1 3 8 D K  H L 1 3 H L 1 2 . D O E S (n a m e )’ S N A T U R A L M O T H E R L IV E I N T H IS H O U S E - H O L D ? R e c o rd li n e n o . o f m o th e r o r 0 0 f o r “ N o ” H L 1 3 . IS (n a m e )’ S N A T U R A L F A T H E R A L IV E ? 1 Y e s 2 N o  N e x t L in e 8 D K  N e x t L in e H L 1 4 . D O E S (n a m e )’ S N A T U R A L F A T H E R L IV E I N T H IS H O U S E - H O L D ? R e c o rd li n e n o . o f fa th e r o r 0 0 f o r “ N o ” L in e N a m e R e la ti o n * M F M o n th Y e a r A g e 1 5 -4 9 1 5 -4 9 M o th e r M o th e r Y N Y N D K M o th e r Y N D K F a th e r 1 2 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 1 3 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 3 1 3 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 1 4 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 4 1 4 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ 1 5 _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1 5 1 5 _ _ _ _ _ _ _ _ _ _ _ _ 1 2 1 2 8 _ _ _ _ _ _ 1 2 8 _ _ _ _ _ _ T ic k h e re i f a d d it io n a l q u e st io n n a ir e u se d  P ro b e f o r a d d it io n a l h o u se h o ld m e m b e rs . P ro b e e sp e c ia ll y f o r a n y i n fa n ts o r sm a ll c h il d re n n o t li st e d , a n d o th e rs w h o m a y n o t b e m e m b e rs o f th e f a m il y ( su c h a s se rv a n ts , fr ie n d s) b u t w h o u su a ll y l iv e i n t h e h o u se h o ld . In se rt n a m e s o f a d d it io n a l m e m b e rs i n t h e h o u se h o ld l is t a n d c o m p le te f o rm a c c o rd in g ly . N o w f o r e a c h w o m a n a g e 1 5 -4 9 y e a rs , w ri te h e r n a m e a n d l in e n u m b e r a n d o th e r id e n ti fy in g i n fo rm a ti o n i n t h e i n fo rm a ti o n p a n e l o f a s e p a ra te I n d iv id u a l W o m e n ’s Q u e st io n n a ir e . F o r e a c h m a n a g e 1 5 -4 9 y e a rs , w ri te h is n a m e a n d l in e n u m b e r a n d o th e r id e n ti fy in g i n fo rm a ti o n i n t h e i n fo rm a ti o n p a n e l o f a s e p a ra te I n d iv id u a l M a n ’s Q u e st io n n a ir e . F o r e a c h c h il d u n d e r a g e 5 , w ri te h is /h e r n a m e a n d l in e n u m b e r A N D t h e l in e n u m b e r o f h is /h e r m o th e r o r c a re ta k e r in t h e i n fo rm a ti o n p a n e l o f a s e p a ra te U n d e r- 5 Q u e st io n n a ir e . Y o u s h o u ld n o w h a v e a s e p a ra te q u e st io n n a ir e f o r e a c h e li g ib le w o m a n , e a c h e li g ib le m a n , a n d e a c h c h il d u n d e r fi v e i n t h e h o u se h o ld . * C o d e s f o r H L 3 : R e la ti o n s h ip t o h e a d o f h o u s e h o ld : 0 1 H e a d 0 2 W if e / H u s b a n d 0 3 S o n / D a u g h te r 0 4 S o n -I n -L a w / D a u g h te r- In -L a w 0 5 G ra n d c h ild 0 6 P a re n t 0 7 P a re n t- In -L a w 0 8 B ro th e r / S is te r 0 9 B ro th e r- In -L a w / S is te r- In -L a w 1 0 U n c le / A u n t 1 1 N ie c e / N e p h e w 1 2 O th e r re la ti v e 1 3 A d o p te d / F o s te r / S te p c h ild 1 4 N o t re la te d 9 8 D o n 't k n o w 198 MULTIPLE INDICATOR CLUSTER SURVEY 2011 ED U CA TI O N ED ED Fo r h ou se ho ld m em be rs a ge 5 a nd a bo ve Fo r h ou se ho ld m em be rs a ge 5 -2 4 ye ar s E D 1 . Li ne nu m be r E D 2. N am e an d ag e C op y fr om H ou se ho ld Li st in g Fo rm , H L2 a nd H L6 E D 6. D U R IN G T H IS / T H A T S C H O O L Y E A R , W H IC H L E V E L A N D G R A D E IS /W A S (n am e) A TT E N D IN G ? E D 8. D U R IN G T H A T P R E V IO U S S C H O O L Y E A R , W H IC H L E V E L A N D G R A D E D ID (n am e) A TT E N D ? ED 6A ED 6B ED 8A ED 8B E D 2A E D 2B E D 3. H A S (n am e) E V E R A TT E N D E D S C H O O L O R P R E - S C H O O L ? 1 Y es 2 N O  N ex t Li ne E D 4A . W H A T IS T H E H IG H E S T LE V E L O F S C H O O L (n am e) H A S A TT E N D E D ? Le ve l: 0 P re sc ho ol 1 P rim ar y 2 Ju ni or S ec on da ry 3 S en io r H ig h 4 U ni ve rs ity 8 D K If le ve l= 0, sk ip to E D 5 E D 4B . W H A T IS T H E H IG H E S T G R A D E (n am e) C O M P LE TE D A T TH IS L E V E L? G ra de : 8 D K If le ss th an 1 gr ad e, e nt er 0 . E D 5. D U R IN G T H E (2 01 1- 20 12 ) S C H O O L Y E A R , D ID (n am e) A TT E N D S C H O O L O R P R E S C H O O L A T A N Y T IM E ? 1 Y es 2 N o  E D 7 Le ve l: 0 P re sc ho ol 1 P rim ar y 2 Ju ni or S ec on da ry 3 S en io r H ig h 4 U ni ve rs ity 8 D K If le ve l= 0, sk ip to E D 7 G ra de : 8 D K E D 7. D U R IN G T H E P R E V IO U S S C H O O L Y E A R , TH A T IS (2 01 0- 20 11 ), D ID (n am e) A TT E N D S C H O O L O R P R E S C H O O L A T A N Y T IM E ? 1 Y es 2 N o  N ex t L in e 8 D K  N ex t L in e Le ve l: 0 P re sc ho ol 1 P rim ar y 2 Ju ni or S ec on da ry 3 S en io r H ig h 4 U ni ve rs ity 8 D K If le ve l= 0, g o to ne xt p er so n G ra de : 8 D K Li ne N am e A ge Y es N o Le ve l G ra de Y es N o Le ve l G ra de Y N D K Le ve l G ra de 01 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 02 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 03 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 04 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 05 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 06 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 07 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 08 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 09 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 10 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 11 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 12 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 13 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 14 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ 15 __ _ __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 0 1 2 3 4 8 __ _ 1 2 8 0 1 2 3 4 8 __ _ MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 199 WATER
AND
SANITATION
 WS
 WS1. WHAT IS THE MAIN SOURCE OF DRINKING WATER FOR MEMBERS OF YOUR HOUSEHOLD? Piped water Piped into dwelling. 11 Piped into compound, yard or plot. 12 Piped to neighbour . 13 Public tap / standpipe . 14 Tube Well, Borehole . 21 Dug well Protected well . 31 Unprotected well . 32 Water from spring Protected spring . 41 Unprotected spring . 42 Rainwater collection . 51 Tanker-truck . 61 Cart with small tank / drum. 71 Surface water (river, stream, dam, lake, pond, canal , irrigation channel) . 81 Bottled water . 91 Other (specify) _____________________ 96 11WS6 12WS6 13WS6 14WS3 14WS3 31WS3 32WS3 41WS3 42WS3 51WS3 61WS3 71WS3 81WS3 96WS3 WS2. WHAT IS THE MAIN SOURCE OF WATER USED BY YOUR HOUSEHOLD FOR OTHER PURPOSES SUCH AS COOKING AND HANDWASHING? Piped water Piped into dwelling. 11 Piped into compound, yard or plot. 12 Piped to neighbour . 13 Public tap / standpipe . 14 Tube Well, Borehole . 21 Dug well Protected well . 31 Unprotected well . 32 Water from spring Protected spring . 41 Unprotected spring . 42 Rainwater collection . 51 Tanker-truck . 61 Cart with small tank / drum. 71 Surface water (river, stream, dam, lake, pond, canal, irrigation channel) . 81 Other (specify) _____________________ 96 11WS6 12WS6 13WS6 WS3. WHERE IS THAT WATER SOURCE LOCATED? In own dwelling . 1 In own yard /plot . 2 Elsewhere. 3 1WS6 2WS6 WS4. HOW LONG DOES IT TAKE TO GO THERE, GET WATER, AND COME BACK? Number of minutes . __ __ __ DK. 998 WS5. WHO USUALLY GOES TO THIS SOURCE TO COLLECT THE WATER FOR YOUR HOUSEHOLD? PROBE: IS THIS PERSON UNDER AGE 15? WHAT SEX? Adult woman (age 15+ years) . 1 Adult man (age 15+ years) . 2 Female child (under 15) . 3 Male child (under 15). 4 DK. 8 200 MULTIPLE INDICATOR CLUSTER SURVEY 2011 WS6. DO YOU DO ANYTHING TO THE WATER TO MAKE IT SAFER TO DRINK? Yes .1 No.2 DK .8 2WS8 8WS8 WS7. WHAT DO YOU USUALLY DO TO MAKE THE WATER SAFER TO DRINK? Probe: ANYTHING ELSE? Record all items mentioned. Boil . A Add bleach / chlorine. B Strain it through a cloth . C Use water filter (ceramic, sand, composite, etc.) . D Solar disinfection . E Let it stand and settle . F Other (specify) ______________________ X DK . Z WS8. WHAT KIND OF TOILET FACILITY DO MEMBERS OF YOUR HOUSEHOLD USUALLY USE? If “flush” or “pour flush”, probe: WHERE DOES IT FLUSH TO? If necessary, ask permission to observe the facility. Flush / Pour flush Flush to piped sewer system.11 Flush to septic tank .12 Flush to pit (latrine).13 Flush to somewhere else .14 Flush to unknown place / Not sure / DK where.15 Pit latrine Ventilated Improved Pit latrine (VIP) .21 Pit latrine with slab .22 Pit latrine without slab / Open pit.23 Composting toilet .31 Bucket . .41 Hanging toilet, Hanging latrine .51 No facility, Bush, Field.95 Other (specify) _____________________ 96 95Next Module WS9. DO YOU SHARE THIS FACILITY WITH OTHERS WHO ARE NOT MEMBERS OF YOUR HOUSEHOLD? Yes .1 No.2 2Next Module WS10. DO YOU SHARE THIS FACILITY ONLY WITH MEMBERS OF OTHER HOUSEHOLDS THAT YOU KNOW, OR IS THE FACILITY OPEN TO THE USE OF THE GENERAL PUBLIC? Other households only (not public) .1 Public facility .2 2Next Module WS11. HOW MANY HOUSEHOLDS IN TOTAL USE THIS TOILET FACILITY, INCLUDING YOUR OWN HOUSEHOLD? Number of households (if less than 10) 0 __ Ten or more households .10 DK .98 WS11A. The distance between the water source and the closest excreta disposal place? Record Observation Less than 10 meters.1 10 meters or more.2 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 201 HOUSEHOLD CHARACTER CHARACTERISTICS HC HC1A. WHAT IS THE RELIGION OF THE HEAD OF THIS HOUSEHOLD? Islam . 1 Kristen Protestan . 2 Kristen Katolik . 3 Hindu . 4 Budha . 5 Other (specify) _____________________ 6 No religion. 7 HC1C. TO WHAT ETHNIC GROUP DOES THE HEAD OF THIS HOUSEHOLD BELONG? Papuan ……………….………………….….01 Javanesse. 02 Sumatran . 03 Kalimantan. 04 Sulawesi . 05 Molucas . . 06 Bali, NTT, NTB. 06 Other (specify) _____________________96 HC1D. WAS THE HEAD OF THIS HOUSEHOLD BORN IN PAPUA OR Yes. 1 No . 2 1  HC2 HC1E. HOW MANY YEARS AGO DID THE HEAD OF THIS HOUSEHOLD MOVE TO PAPUA/WEST PAPUA? If less than 1 year, record “00”. If unknown, record “98”. Do not count short visit away from Papua/West Papua. Number of years ……………………. __ __ DK … …………………………………. 98 HC1F. WHAT WAS THE MAIN REASON WHY THE HEAD OF THIS HOUSEHOLD MOVED TO PAPUA/WEST PAPUA? If a person says He/she moved to Papua for a job, probe to find out if it is government or private job Transmigration. 1 Transfer in government job. 2 Transfer in private job . 3 Looking for a job . 4 Family reasons ……………………………….5 Medical reasons …………………………….6 Other (specify) ______________________6 HC2. HOW MANY ROOMS IN THIS HOUSEHOLD ARE USED FOR SLEEPING? Number of rooms . __ __ HC3. Main material of the dwelling floor. Record observation. 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 HC3A. WHAT IS THE FLOOR AREA OF THIS DWELLING? If less than 1, record “000”. If unknown, record ‘998’. Square meters . __ __ __ DK………………………………………….998 WEST PAPUA? 202 MULTIPLE INDICATOR CLUSTER SURVEY 2011 HC4. Main material of the roof. Record observation. Natural roofing No Roof .11 Thatch / Palm leaf .12 Sod.13 Rudimentary Roofing Rustic mat .21 Palm / Bamboo.22 Wood planks .23 Cardboard .24 Finished roofing Metal .31 Wood.32 Calamine / Cement fibre .33 Ceramic tiles .34 Cement.35 Roofing shingles.36 Other (specify) _____________________ 96 HC5. Main material of the exterior walls. Record observation. Natural walls No walls.11 Cane / Palm / Trunks .12 Dirt.13 Bark.14 Rudimentary walls Bamboo with mud .21 Stone with mud .22 Uncovered adobe.23 Plywood.24 Cardboard .25 Reused wood .26 Finished walls Cement.31 Stone with lime / cement .32 Bricks .33 Cement blocks .34 Covered adobe.35 Wood planks / shingles .36 Other (specify) _____________________ 96 HC6. WHAT TYPE OF FUEL DOES YOUR HOUSEHOLD MAINLY USE FOR COOKING? Electricity.01 Liquefied Petroleum 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 No food cooked in household .95 Other (specify) _____________________ 96 01HC8 02HC8 03HC8 04HC8 05HC8 95HC8 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 203 HC7. IS THE COOKING USUALLY DONE IN THE HOUSE, IN A SEPARATE BUILDING, OR OUTDOORS? If ‘In the house’, probe: IS IT DONE IN A SEPARATE ROOM USED AS A KITCHEN? In the house In a separate room used as kitchen .1 Elsewhere in the house.2 In a separate building.3 Outdoors .4 Other (specify) ______________________ 6 HC8. DOES YOUR HOUSEHOLD HAVE: [A] ELECTRICITY? [B] A RADIO? [C] A TELEVISION? [D] A NON-MOBILE TELEPHONE? [E] A REFRIGERATOR? Yes No Electricity.1 2 Radio.1 2 Television.1 2 Non-mobile telephone.1 2 Refrigerator .1 2 HC9. DOES ANY MEMBER OF YOUR HOUSEHOLD OWN: [A] A WATCH? [B] A MOBILE TELEPHONE? [C] A BICYCLE? [D] A MOTORCYCLE OR SCOOTER? [E] AN ANIMAL-DRAWN CART? [F] A CAR OR TRUCK? [G] A BOAT WITH A MOTOR? Yes No Watch. 1 2 Mobile telephone. 1 2 Bicycle. 1 2 Motorcycle / Scooter . 1 2 Animal drawn-cart . 1 2 Car / Truck . 1 2 Boat with motor . 1 2 HC10. DO YOU OR SOMEONE LIVING IN THIS HOUSEHOLD OWN THIS DWELLING? If “No”, then ask: DO YOU RENT THIS DWELLING FROM SOMEONE NOT LIVING IN THIS HOUSEHOLD? If “Rented from someone else”, circle “2”. For other responses, circle “6”. Own.1 Rent .2 Other (Not owned or rented) .6 HC11. DOES ANY MEMBER OF THIS HOUSEHOLD OWN ANY LAND THAT CAN BE USED FOR AGRICULTURE? Yes.1 No .2 2HC13 HC12. HOW MANY HECTARES OF AGRICULTURAL LAND DO MEMBERS OF THIS HOUSEHOLD OWN? If less than 1, record “00”. If 95 or more, record ‘95’. If unknown, record ‘98’. Hectares.___ ___ HC13. DOES THIS HOUSEHOLD OWN ANY LIVESTOCK, HERDS, OTHER FARM ANIMALS, OR POULTRY? Yes.1 No .2 2HC15 204 MULTIPLE INDICATOR CLUSTER SURVEY 2011 HC14. HOW MANY OF THE FOLLOWING ANIMALS DOES THIS HOUSEHOLD HAVE? [A] CATTLE, MILK COWS, OR BULLS? [B] HORSES, DONKEYS, OR MULES? [C] GOATS? [D] SHEEP? [E] CHICKENS? [F] PIGS? [G] CROCODILES? [H] DEER? [I] KASUARI (BIRDS)? If none, record ‘00’. If 95 or more, record ‘95’. If unknown, record ‘98’. Cattle, milk cows, or bulls .___ ___ Horses, donkeys, or mules .___ ___ Goats .___ ___ Sheep.___ ___ Chickens .___ ___ Pigs .___ ___ Crocodiles .___ ___ Deer .___ ___ Kasuari (birds). .___ ___ HC15. DOES ANY MEMBER OF THIS HOUSEHOLD HAVE A BANK ACCOUNT? Yes.1 No .2 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 205 IN SE CT IC ID E
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 T N 1 . D O E S Y O U R H O U S E H O L D H A V E A N Y M O S Q U IT O N E T S T H A T C A N B E U S E D W H IL E S L E E P IN G ? Y e s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 N o . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2  IR M o d u le T N 2 . H O W M A N Y M O S Q U IT O N E T S D O E S Y O U R H O U S E H O L D H A V E ? N u m b e r o f n e ts . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ _ _ _ _ T N 3 . A sk t h e re sp o n d en t to s h o w y o u t h e n et s in t h e h o u se h o ld . If m o re t h a n 6 n et s, u se a d d it io n a l q u es ti o n n a ir e( s) . 1 s t N e t 2 n d N e t 3 rd N e t 4 th N e t 5 th N e t 6 th N e t T N 4 . M o sq u it o n et o b se rv ed ? O b s e rv e d . . . . . . . . . . .1 N o t o b s e rv e d . . . . . . . .2 O b s e rv e d . . . . . . . . . .1 N o t o b s e rv e d . . . . . . .2 O b s e rv e d . . . . . . . . . .1 N o t o b s e rv e d . . . . . . .2 O b s e rv e d . . . . . . . . . .1 N o t o b s e rv e d . . . . . . .2 O b s e rv e d . . . . . . . . . .1 N o t o b s e rv e d . . . . . . .2 O b s e rv e d . . . . . . . . . .1 N o t o b s e rv e d . . . . . . .2 T N 5 . O b se rv e o r a sk t h e b ra n d /t yp e o f m o sq u it o n et . If b ra n d i s u n kn o w n a n d y o u ca n n o t o b se rv e th e n et , sh o w p ic tu re s o f ty p ic a l n et ty p es /b ra n d s to r es p o n d en t. L o n g -l a s ti n g t re a te d n e ts O ly s e t N e t. . . . . . . . .1 1 P e rm a n e t. . . . . . . . . 1 2 O th e r (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 1 6 D K b ra n d . . . . . . . . . 1 8 P re -t re a te d n e ts ( A n y b ra n d ) . . . . . . . . . .2 1 O th e r n e t (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 3 1 D K b ra n d / t y p e . . . . .9 8 L o n g -l a s ti n g t re a te d n e ts O ly s e t N e t. . . . . . . . .1 1 P e rm a n e t. . . . . . . . . 1 2 O th e r (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 1 6 D K b ra n d . . . . . . . . . 1 8 P re -t re a te d n e ts ( A n y b ra n d ) . . . . . . . . . .2 1 O th e r n e t (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 3 1 D K b ra n d / t y p e . . . . .9 8 L o n g -l a s ti n g t re a te d n e ts O ly s e t N e t. . . . . . . . .1 1 P e rm a n e t. . . . . . . . . 1 2 O th e r (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 1 6 D K b ra n d . . . . . . . . . 1 8 P re -t re a te d n e ts ( A n y b ra n d ) . . . . . . . . . .2 1 O th e r n e t (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 3 1 D K b ra n d / t y p e . . . . .9 8 L o n g -l a s ti n g t re a te d n e ts O ly s e t N e t. . . . . . . . .1 1 P e rm a n e t. . . . . . . . . 1 2 O th e r (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 1 6 D K b ra n d . . . . . . . . . 1 8 P re -t re a te d n e ts ( A n y b ra n d ) . . . . . . . . . .2 1 O th e r n e t (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 3 1 D K b ra n d / t y p e . . . . .9 8 L o n g -l a s ti n g t re a te d n e ts O ly s e t N e t. . . . . . . . .1 1 P e rm a n e t. . . . . . . . . 1 2 O th e r (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 1 6 D K b ra n d . . . . . . . . . 1 8 P re -t re a te d n e ts ( A n y b ra n d ) . . . . . . . . . .2 1 O th e r n e t (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 3 1 D K b ra n d / t y p e . . . . .9 8 L o n g -l a s ti n g t re a te d n e ts O ly s e t N e t. . . . . . . . .1 1 P e rm a n e t. . . . . . . . . 1 2 O th e r (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 1 6 D K b ra n d . . . . . . . . . 1 8 P re -t re a te d n e ts ( A n y b ra n d ) . . . . . . . . . .2 1 O th e r n e t (s p ec if y) _ _ _ _ _ _ _ _ _ _ _ 3 1 D K b ra n d / t y p e . . . . .9 8 T N 6 . H O W M A N Y M O N T H S A G O D ID Y O U R H O U S E H O L D G E T T H E M O S Q U IT O N E T ? If l es s th a n o n e m o n th , re co rd “ 0 0 ” M o n th s a g o . . _ _ _ _ _ _ M o re t h a n 3 6 m o . a g o . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . 9 8 M o n th s a g o . . _ _ _ _ _ _ M o re t h a n 3 6 m o . a g o . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . 9 8 M o n th s a g o . . _ _ _ _ _ _ M o re t h a n 3 6 m o . a g o . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . 9 8 M o n th s a g o . . _ _ _ _ _ _ M o re t h a n 3 6 m o . a g o . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . 9 8 M o n th s a g o . . _ _ _ _ _ _ M o re t h a n 3 6 m o . a g o . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . 9 8 M o n th s a g o . . _ _ _ _ _ _ M o re t h a n 3 6 m o . a g o . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . 9 8 T N 7 . C h ec k T N 5 f o r ty p e o f n et  L o n g -l a st in g ( 1 1 -1 8 )  T N 1 1  P re -t re a te d ( 2 1 )  T N 9  E ls e C o n ti n u e  L o n g -l a st in g ( 1 1 -1 8 )  T N 1 1  P re -t re a te d ( 2 1 )  T N 9  E ls e C o n ti n u e  L o n g -l a st in g ( 1 1 -1 8 )  T N 1 1  P re -t re a te d ( 2 1 )  T N 9  E ls e C o n ti n u e  L o n g -l a st in g ( 1 1 -1 8 )  T N 1 1  P re -t re a te d ( 2 1 )  T N 9  E ls e C o n ti n u e  L o n g -l a st in g ( 1 1 -1 8 )  T N 1 1  P re -t re a te d ( 2 1 )  T N 9  E ls e C o n ti n u e  L o n g -l a st in g ( 1 1 -1 8 )  T N 1 1  P re -t re a te d ( 2 1 )  T N 9  E ls e C o n ti n u e 206 MULTIPLE INDICATOR CLUSTER SURVEY 2011 T N 8. W H E N Y O U G O T T H E N E T , W A S I T A L R E A D Y T R E A T E D W IT H A N I N S E C T IC ID E T O K IL L O R R E P E L M O S Q U IT O E S ? Y e s . . . . . . . . . . . . . . . .1 N o . . . . . . . . . . . . . . . . 2 D K / N o t s u re . . . . . . .8 Y e s . . . . . . . . . . . . . . . .1 N o . . . . . . . . . . . . . . . . 2 D K / N o t s u re . . . . . . .8 Y e s . . . . . . . . . . . . . . . .1 N o . . . . . . . . . . . . . . . . 2 D K / N o t s u re . . . . . . .8 Y e s . . . . . . . . . . . . . . . .1 N o . . . . . . . . . . . . . . . . 2 D K / N o t s u re . . . . . . .8 Y e s . . . . . . . . . . . . . . . .1 N o . . . . . . . . . . . . . . . . 2 D K / N o t s u re . . . . . . .8 Y e s . . . . . . . . . . . . . . . .1 N o . . . . . . . . . . . . . . . . 2 D K / N o t s u re . . . . . . .8 T N 9 . S IN C E Y O U G O T T H E N E T , W A S I T E V E R S O A K E D O R D IP P E D IN A L IQ U ID T O K IL L O R R E P E L M O S Q U IT O E S ? Y e s . . . . . . . . . . 1 N o . . . . . . . . . . 2  T N 1 1 D K / N o t s u re .8  T N 1 1 Y e s . . . . . . . . . . 1 N o . . . . . . . . . . 2  T N 1 1 D K / N o t s u re .8  T N 1 1 Y e s . . . . . . . . . . 1 N o . . . . . . . . . . 2  T N 1 1 D K / N o t s u re .8  T N 1 1 Y e s . . . . . . . . . . 1 N o . . . . . . . . . . 2  T N 1 1 D K / N o t s u re .8  T N 1 1 Y e s . . . . . . . . . . 1 N o . . . . . . . . . . 2  T N 1 1 D K / N o t s u re .8  T N 1 1 Y e s . . . . . . . . . . 1 N o . . . . . . . . . . 2  T N 1 1 D K / N o t s u re .8  T N 1 1 T N 1 0 . H O W M A N Y M O N T H S A G O W A S T H E N E T L A S T S O A K E D O R D IP P E D ? If l es s th a n o n e m o n th , re co rd “ 0 0 ” M o n th s a g o . . . _ _ _ _ _ _ M o re t h a n 2 4 m o . a g o . . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . .9 8 M o n th s a g o . . . _ _ _ _ _ _ M o re t h a n 2 4 m o . a g o . . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . .9 8 M o n th s a g o . . . _ _ _ _ _ _ M o re t h a n 2 4 m o . a g o . . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . .9 8 M o n th s a g o . . . _ _ _ _ _ _ M o re t h a n 2 4 m o . a g o . . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . .9 8 M o n th s a g o . . . _ _ _ _ _ _ M o re t h a n 2 4 m o . a g o . . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . .9 8 M o n th s a g o . . . _ _ _ _ _ _ M o re t h a n 2 4 m o . a g o . . . . . . . . . . . . . . .9 5 D K / N o t s u re . . . . . .9 8 T N 1 1 . D ID A N Y O N E S L E E P U N D E R T H IS M O S Q U IT O N E T L A S T N IG H T ? Y e s . . . . . . . . . .1 N o . . . . . . . . . . 2  T N 1 3 D K / N o t s u re .8  T N 1 3 Y e s . . . . . . . . . .1 N o . . . . . . . . . . 2  T N 1 3 D K / N o t s u re .8  T N 1 3 Y e s . . . . . . . . . .1 N o . . . . . . . . . . 2  T N 1 3 D K / N o t s u re .8  T N 1 3 Y e s . . . . . . . . . .1 N o . . . . . . . . . . 2  T N 1 3 D K / N o t s u re .8  T N 1 3 Y e s . . . . . . . . . .1 N o . . . . . . . . . . 2  T N 1 3 D K / N o t s u re .8  T N 1 3 Y e s . . . . . . . . . .1 N o . . . . . . . . . . 2  T N 1 3 D K / N o t s u re .8  T N 1 3 T N 1 2 . W H O S L E P T U N D E R T H IS M O S Q U IT O N E T L A S T N IG H T ? R ec o rd t h e p er so n ’s l in e n u m b er fr o m t h e h o u se h o ld l is ti n g f o rm If s o m eo n e n o t in t h e h o u se h o ld li st s le p t u n d er t h e m o sq u it o n et , re co rd “ 0 0 ” N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ L in e n u m b e r . ._ _ _ _ _ _ T N 1 3 . G o b a ck t o T N 4 f o r n ex t n et . If n o m o re n et s, g o to n ex t m o d u le G o b a ck t o T N 4 f o r n ex t n et . If n o m o re n et s, g o to n ex t m o d u le G o b a ck t o T N 4 f o r n ex t n et . If n o m o re n et s, g o to n ex t m o d u le G o b a ck t o T N 4 f o r n ex t n et . If n o m o re n et s, g o to n ex t m o d u le G o b a ck t o T N 4 f o r n ex t n et . If n o m o re n et s, g o to n ex t m o d u le G o b a ck t o T N 4 i n f ir st co lu m n o f a n ew q u es ti o n n a ir e fo r n ex t n et . If n o m o re n et s, g o to n ex t m o d u le T ic k h er e if a d d it io n a l q u es ti o n n a ir e u se d  MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 207 CH IL D 
L A B O U R 
 CL 
 T o b e a d m in is te re d f o r ch il d re n i n t h e h o u se h o ld a g e 5 -1 7 y e a rs . F o r h o u se h o ld m em b er s b el o w a g e 5 o r a b o ve a g e 1 7 , le a ve r o w s b la n k. N O W I W O U L D L IK E T O A S K A B O U T A N Y W O R K C H IL D R E N I N T H IS H O U S E H O L D M A Y D O . C L 1 . L in e n u m b er C L 2 . N a m e a n d A g e C o p y fr o m H o u se h o ld L is ti n g F o rm , H L 2 a n d H L 6 C L 3 . D U R IN G T H E P A S T W E E K , D ID ( n a m e) D O A N Y K IN D O F W O R K F O R S O M E O N E W H O I S N O T A M E M B E R O F T H IS H O U S E H O L D ? If y es : F O R P A Y I N C A S H O R K IN D ? 1 Y e s , fo r p a y ( c a s h o r k in d ) 2 Y e s , u n p a id 3 N o  C L 5 C L 4 . S IN C E L A S T (d a y o f th e w ee k) , A B O U T H O W M A N Y H O U R S D ID H E /S H E D O T H IS W O R K F O R S O M E O N E W H O I S N O T A M E M B E R O F T H IS H O U S E H O L D ? If m o re t h a n o n e jo b , in cl u d e a ll h o u rs a t a ll j o b s. C L 5 . D U R IN G T H E P A S T W E E K , D ID ( n a m e) F E T C H W A T E R O R C O L L E C T F IR E W O O D F O R H O U S E H O L D U S E ? 1 Y e s 2 N o  C L 7 C L 6 . S IN C E L A S T (d a y o f th e w ee k) , A B O U T H O W M A N Y H O U R S D ID H E /S H E F E T C H W A T E R O R C O L L E C T F IR E W O O D F O R H O U S E H O L D U S E ? C L 7 . D U R IN G T H E P A S T W E E K , D ID ( n a m e) D O A N Y P A ID O R U N P A ID W O R K O N A F A M IL Y F A R M O R I N A F A M IL Y B U S IN E S S O R S E L L IN G G O O D S I N T H E S T R E E T ? In cl u d e w o rk f o r a b u si n es s ru n b y th e ch il d , a lo n e o r w it h o n e o r m o re p a rt n er s. 1 Y e s 2 N o  C L 9 C L 8 . S IN C E L A S T (d a y o f th e w ee k) , A B O U T H O W M A N Y H O U R S D ID H E /S H E D O T H IS W O R K F O R H IS /H E R F A M IL Y O R H IM S E L F / H E R S E L F ? C L 9 . D U R IN G T H E P A S T W E E K , D ID ( n a m e) H E L P W IT H H O U S E H O L D C H O R E S S U C H A S S H O P P IN G , C L E A N IN G , W A S H IN G C L O T H E S , C O O K IN G ; O R C A R IN G F O R C H IL D R E N , O L D O R S IC K P E O P L E ? 1 Y e s 2 N o  N e x t L in e C L 1 0 . S IN C E L A S T (d a y o f th e w ee k) , A B O U T H O W M A N Y H O U R S D ID H E /S H E S P E N D D O IN G T H E S E C H O R E S ? Y e s N o N u m b e r N u m b e r N u m b e r N u m b e r L in e N a m e A g e P a id U n p a id o f h o u rs Y e s N o o f h o u rs Y e s N o o f h o u rs Y e s N o o f h o u rs 0 1 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 0 2 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 0 3 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 0 4 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 0 5 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 0 6 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 0 7 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 0 8 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 0 9 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 0 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 1 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 3 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 4 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 5 _ _ _ _ 1 2 3 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 1 2 _ _ _ _ _ _ _ _ 208 MULTIPLE INDICATOR CLUSTER SURVEY 2011 CHILD
DISCIPLINE
 CD
 Table 1: Children Aged 2-14 Years Eligible for Child Discipline Questions o List each of the children aged 2-14 years below in the order they appear in the Household Listing Form. Do not include other household members outside of the age range 2-14 years. o Record the line number, name, sex, and age for each child. o Then record the total number of children aged 2-14 in the box provided (CD6). CD1. Rank number CD2. Line number from HL1 CD3. Name from HL2 CD4. Sex from HL4 CD5. Age from HL6 Rank Line Name M F Age 1 __ __ 1 2 ___ ___ 2 __ __ 1 2 ___ ___ 3 __ __ 1 2 ___ ___ 4 __ __ 1 2 ___ ___ 5 __ __ 1 2 ___ ___ 6 __ __ 1 2 ___ ___ 7 __ __ 1 2 ___ ___ 8 __ __ 1 2 ___ ___ CD6. Total children age 2-14 years ___ ___ o If there is only one child age 2-14 years in the household, then skip table 2 and go to CD8; write down’1’ and continue with CD9 
 Table 2: Selection of Random Child for Child Discipline Questions o Use Table 2 to select one child between the ages of 2 and 2-14 years, if there is more than one child in that age range in the household. o Check the last digit of the household number (HH2) from the cover page. This is the number of the row you should go to in the table below. o Check the total number of eligible children (2-14) in CD6 above. This is the number of the column you should go to. o 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 (CD1) about whom the questions will be asked. CD7. Total Number of Eligible Children in the Household (CD6) Last digit of household number (HH2) 1 2 3 4 5 6 7 8+ 0 1 2 2 4 3 6 5 4 1 1 1 3 1 4 1 6 5 2 1 2 1 2 5 2 7 6 3 1 1 2 3 1 3 1 7 4 1 2 3 4 2 4 2 8 5 1 1 1 1 3 5 3 1 6 1 2 2 2 4 6 4 2 7 1 1 3 3 5 1 5 3 8 1 2 1 4 1 2 6 4 9 1 1 2 1 2 3 7 5 CD8. Record the rank number of the selected child. ___ MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 209 CD9. Write the name and line number of the child selected for the module from CD3 and CD2, based on the rank number in CD8. Name _____________________________ Line number . __ __ CD10. 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. CD11. TOOK AWAY PRIVILEGES, FORBADE SOMETHING (name) LIKED OR DID NOT ALLOW HIM/HER TO LEAVE HOUSE. Yes . 1 No . 2 CD12. EXPLAINED WHY (name)’S BEHAVIOR WAS WRONG. Yes . 1 No . 2 CD13. SHOOK HIM/HER. Yes . 1 No . 2 CD14. SHOUTED, YELLED AT OR SCREAMED AT HIM/HER. Yes . 1 No . 2 CD15. GAVE HIM/HER SOMETHING ELSE TO DO. Yes . 1 No . 2 CD16. SPANKED, HIT OR SLAPPED HIM/HER ON THE BOTTOM WITH BARE HAND. Yes . 1 No . 2 CD17. HIT HIM/HER ON THE BOTTOM OR ELSEWHERE ON THE BODY WITH SOMETHING LIKE A BELT, HAIRBRUSH, STICK OR OTHER HARD OBJECT. Yes . 1 No . 2 CD18. CALLED HIM/HER DUMB, LAZY, OR ANOTHER NAME LIKE THAT. Yes . 1 No . 2 CD19. HIT OR SLAPPED HIM/HER ON THE FACE, HEAD OR EARS. Yes . 1 No . 2 CD20. HIT OR SLAPPED HIM/HER ON THE HAND, ARM, OR LEG. Yes . 1 No . 2 CD21. BEAT HIM/HER UP, THAT IS HIT HIM/HER OVER AND OVER AS HARD AS ONE COULD. Yes . 1 No . 2 CD22. DO YOU BELIEVE THAT IN ORDER TO BRING UP, RAISE, OR EDUCATE A CHILD PROPERLY, THE CHILD NEEDS TO BE PHYSICALLY PUNISHED? Yes . 1 No . 2 Don’t know / No opinion. 8 210 MULTIPLE INDICATOR CLUSTER SURVEY 2011 HH19. Record the time. Hour and minutes.__ __ : __ __ HH20. Thank the respondent for his/her cooperation and check the Household Listing Form:  A separate Questionnaire for Individual Women has been issued for each woman age 15-49 years in the household list (HL7)  A separate Questionnaire for Individual Men has been issued for each man age 15-49 years in the household list (HL7A)  A separate Questionnaire for Children Under Five has been issued for each child under age 5 years in the household list (HL9) Return to the cover page and make sure that all information is entered, including the number of eligible women (HH12), men (HH12A) and under-5s (HH14) Make arrangements for the administration of the remaining questionnaire(s) in this household. ___ __ MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 211 INDONESIA 2011 INDONESIA MULTIPLE INDICATOR CLUSTER SURVEY PAPUA AND WEST PAPUA PROVINCE QUESTIONNAIRE FOR INDIVIDUAL WOMEN CONFIDENTIAL WOMAN’S INFORMATION INFORMATION PANEL WM This questionnaire is to be administered to all women age 15 through 49 (see Household Listing Form, column HL7). A separate questionnaire should be used for each eligible woman. WM1. Cluster number: WM2. Household number: ___ ___ ___ ___ ___ ___ WM3. Woman’s name: WM4. Woman’s line number: Name ___ ___ WM5. Interviewer name and number: Name ___ ___ WM6. Day / Month / Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ Repeat greetin g a n d i ntroduce yourself if you never met with this respondent (woman), and read the following: WE ARE FROM LOCAL GOVERNMENT/BPS WOULD LIKE TO TALK TO YOU ABOUT HEALTH AND EDUCATION. THE INTERVIEW WILL TAKE ABOUT 35 MINUTES. ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE SHARED WITH ANYONE OTHER THAN OUR PROJECT TEAM. If greeting at the beginning of the household questionnaire has already been read to this woman, then read the following: NOW I WOULD LIKE TO TALK TO YOU MORE ABOUT YOUR HEALTH AND OTHER TOPICS. THIS INTERVIEW WILL TAKE ABOUT 35 MINUTES. AGAIN, ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE SHARED WITH ANYONE OTHER THAN OUR PROJECT TEAM. MAY I START NOW?  Yes, permission is given  Go to WM10 to record the time and then begin the interview.  No, permission is not given  Complete WM7. Discuss this result with your supervisor. WM7. Result of woman’s interview Completed . 01 Not at home . 02 Refused . 03 Partly completed. . 04 Incapacitated . 05 Other (specify) ___________________________ 96 WM8. Field edited by (Name and number): Name _________________________ ___ ___ WM9. Data entry clerk (Name and number): Name __________________________ ___ ___ 212 MULTIPLE INDICATOR CLUSTER SURVEY 2011 WM10. Record the time. Hour and minutes.__ __ : __ __ 
 WOMAN’S
BACKGROUND
 WB
 WB1. IN WHAT MONTH AND YEAR WERE YOU BORN? Date of birth Month .__ __ DK month .98 Year .__ __ __ __ DK year .9998 WB2. HOW OLD ARE YOU? Probe: HOW OLD WERE YOU AT YOUR LAST BIRTHDAY? Compare and correct WB1 and/or WB2 if inconsistent Age (in completed years) .__ __ WB3. HAVE YOU EVER ATTENDED SCHOOL OR PRESCHOOL? Yes .1 No.2 2WB7 WB4. WHAT IS THE HIGHEST LEVEL OF SCHOOL YOU ATTENDED? Preschool .0 Primary.1 Junior Secondary .2 Senior High .3 University .4 DK . .8 0WB7 WB5. WHAT IS THE HIGHEST GRADE YOU COMPLETED AT THAT LEVEL? If less than 1 grade, enter “00” Grade . __ WB6. Check WB4:  Senior High or University  Go to CM Module  Primary or Junior Secondary  Continue with WB7 WB7. NOW I WOULD LIKE YOU TO READ THIS SENTENCE TO ME. Show sentence on the card to the respondent. If respondent cannot read whole sentence, probe: CAN YOU READ PART OF THE SENTENCE TO ME? 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 213   CHILD  MORTALITY  MODULE   CM   This module is to be administered to all women age 15-49. All questions refer only to LIVE births. CM1. NOW I WOULD LIKE TO ASK ABOUT ALL THE BIRTHS YOU HAVE HAD DURING YOUR LIFE. HAVE YOU EVER GIVEN BIRTH? Yes . 1 No. 2 2CM8 CM2. 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 CM4 ONLY IF YEAR OF FIRST BIRTH IS GIVEN. OTHERWISE, CONTINUE WITH CM3. Date of first birth Day . __ __ DK day. 98 Month . __ __ DK month . 98 Year . __ __ __ __ DK year . 9998 CM4 CM3. HOW MANY YEARS AGO DID YOU HAVE YOUR FIRST BIRTH? Completed years since first birth . __ __ CM4. DO YOU HAVE ANY SONS OR DAUGHTERS TO WHOM YOU HAVE GIVEN BIRTH WHO ARE NOW LIVING WITH YOU? Yes . 1 No. 2 2CM6 CM5. HOW MANY SONS LIVE WITH YOU? HOW MANY DAUGHTERS LIVE WITH YOU? Sons at home . __ __ Daughters at home. __ __ CM6. DO YOU HAVE ANY SONS OR DAUGHTERS TO WHOM YOU HAVE GIVEN BIRTH WHO ARE ALIVE BUT DO NOT LIVE WITH YOU? Yes . 1 No. 2 2CM8 CM7. HOW MANY SONS ARE ALIVE BUT DO NOT LIVE WITH YOU? HOW MANY DAUGHTERS ARE ALIVE BUT DO NOT LIVE WITH YOU? if none, record ‘00’ Sons elsewhere . __ __ Daughters elsewhere . __ __ CM8. HAVE YOU EVER GIVEN BIRTH TO A BOY OR GIRL WHO WAS BORN ALIVE BUT LATER DIED? If “No” probe by asking: I MEAN, TO A CHILD WHO EVER BREATHED OR CRIED OR SHOWED OTHER SIGNS OF LIFE – EVEN IF HE OR SHE LIVED ONLY A FEW MINUTES OR HOURS? Yes . 1 No. 2 2CM10 CM9. HOW MANY BOYS HAVE DIED? HOW MANY GIRLS HAVE DIED? if none, record ‘00’ Boys dead . __ __ Girls dead . __ __ CM10. Sum answers to CM5, CM7, and CM9. Sum . __ __ 214 MULTIPLE INDICATOR CLUSTER SURVEY 2011 CM11. JUST TO MAKE SURE THAT I HAVE THIS RIGHT, YOU HAVE HAD IN TOTAL (total number) BIRTHS DURING YOUR LIFE. IS THIS CORRECT?  Yes. Check below:  No live births  Go to Contraception module  One or more live births  continue with CM12  No.  Check responses to CM1-CM10 and make corrections as necessary before proceeding to CM12 CM12. OF THESE (total number in CM10) BIRTHS YOU HAVE HAD, WHEN DID YOU DELIVER THE LAST ONE (EVEN IF HE OR SHE HAS DIED)? Month and year must be recorded Date of last birth Day .__ __ DK day.98 Month .__ __ Year. .__ __ __ __ CM13. Check CM12: Last birth occurred within the last 2 years, that is, since (day and month of interview) in 2009  No live birth in last 2 years.  Go to Attitudes toward domestic violence module.  One or more live births in last 2 years  Ask for the name of the child Name of child_______________________ If child has died, take special care when referring to this child by name in the following modules. Continue with the next module (DB). MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 215 DESIRE
FOR
LAST
BIRTH
 DB
 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 CM13 and record name of last-born child here _____________________. Use this child’s name in the following questions, where indicated. DB1. WHEN YOU GOT PREGNANT WITH (name), DID YOU WANT TO GET PREGNANT AT THAT TIME? Yes .1 No.2 1Next Module DB2. DID YOU WANT TO HAVE A BABY LATER ON, OR DID YOU NOT WANT ANY (MORE) CHILDREN? Later .1 No more.2 2Next Module DB3. HOW MUCH LONGER DID YOU WANT TO WAIT? Months.1 __ __ Years .2 __ __ DK .998 216 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MATERNAL
AND
NEWBORN
HEALTH
 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 CM13 and record name of last-born child here _____________________. Use this child’s name in the following questions, where indicated. MN1. DID YOU SEE ANYONE FOR ANTENATAL CARE DURING YOUR PREGNANCY WITH (name)? Yes .1 No.2 2MN5 MN2. WHOM DID YOU SEE? Probe: ANYONE ELSE? Probe for the type of person seen and circle all answers given. Health professional: Doctor. A Midwife . B Nurse. D Other person Traditional birth attendant. F Community health worker (cadre) .G Other (specify) ______________________ X MN3. HOW MANY TIMES DID YOU RECEIVE ANTENATAL CARE DURING THIS PREGNANCY? Number of times .__ __ Don’t know (DK) .98 MN4. AS PART OF YOUR ANTENATAL CARE DURING THIS PREGNANCY, WERE ANY OF THE FOLLOWING DONE AT LEAST ONCE: [A] WAS YOUR BLOOD PRESSURE MEASURED? [B] DID YOU GIVE A URINE SAMPLE? [C] DID YOU GIVE A BLOOD SAMPLE? Yes No Blood pressure . 1 2 Urine sample . 1 2 Blood sample . 1 2 MN5. DO YOU HAVE A CARD OR OTHER DOCUMENT WITH YOUR OWN IMMUNIZATIONS LISTED? MAY I SEE IT PLEASE? If a card is presented, use it to assist with answers to the following questions. Yes (card seen).1 Yes (card not seen).2 No.3 DK . .8 MN6. WHEN YOU WERE PREGNANT WITH (name), DID YOU RECEIVE ANY INJECTION IN THE ARM OR SHOULDER TO PREVENT THE BABY FROM GETTING TETANUS, THAT IS CONVULSIONS AFTER BIRTH? Yes .1 No.2 DK .8 2MN9 8MN9 MN7. HOW MANY TIMES DID YOU RECEIVE THIS TETANUS INJECTION DURING YOUR PREGNANCY WITH (name)? If 7 or more times, record ‘7’. Number of times.__ DK .8 8MN9 MN8. How many tetanus injections during last pregnancy were reported in MN7?  At least two tetanus injections during last pregnancy.  Go to MN12  Only one tetanus injection during last pregnancy.  Continue with MN9 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 217 MN9. DID YOU RECEIVE ANY TETANUS INJECTION AT ANY TIME BEFORE YOUR PREGNANCY WITH (name), EITHER TO PROTECT YOURSELF OR ANOTHER BABY? Yes .1 No.2 DK .8 2MN12 8MN12 MN10. HOW MANY TIMES DID YOU RECEIVE A TETANUS INJECTION BEFORE YOUR PREGNANCY WITH (name)? If 7 or more times, record ‘7’. Number of times.__ DK .8 8MN12 MN11. HOW MANY YEARS AGO DID YOU RECEIVE THE LAST TETANUS INJECTION BEFORE YOUR PREGNANCY WITH (name)? Years ago.__ __ MN12. Check MN1 for presence of antenatal care during this pregnancy:  Yes, antenatal care received. Continue with MN13A  No antenatal care received  Go to MN17 MN13A. DURING ANY OF THESE ANTENATAL VISITS FOR THE PREGNANCY, DID YOU GET THE BLOOD SCREENING TEST FOR MALARIA? Yes .1 No.2 DK .8 2MN13E 8MN13E MN13B. WHAT WAS THE RESULT OF THE BLOOD SCREENING TEST? Positive (malaria present) .1 Negative (no malaria) .2 DK .8 2MN13E MN13C. WERE YOU GIVEN ANY MEDICINE FOR MALARIA DURING ANY OF THESE ANTENATAL VISITS FOR THE PREGNANCY? Yes .1 No.2 DK .8 2MN13E 8MN13E MN13D. WHAT MEDICINE WERE YOU GIVEN? Probe: ANY OTHER MEDICINE? Circle all medicines mentioned. Write brand name(s) of all medicines, if given. (Name) . Anti-malarials: SP / Fansidar. A Chloroquine . B Quinine / Kina. C Artesdiaquine . D Arsuamon . E Arterakin/Artekin. F Other anti-malarial (specify)_______________________ G Antibiotic drugs Pill / Syrup .I Injection .J Other medications: Paracetamol/ Panadol /Acetaminophen . P Aspirin .Q Ibuprofen . R Other (specify) ______________________ X DK . . Z MN13E. DURING ANY OF THESE ANTENATAL VISITS FOR THE PREGNANCY, WERE YOU GIVEN A INSECTICIDE TREATED NET? Yes .1 No.2 DK .8 218 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MN17. WHO ASSISTED WITH THE DELIVERY OF (name)? Probe: ANYONE ELSE? Probe for the type of person assisting and circle all answers given. If respondent says no one assisted, probe to determine whether any adults were present at the delivery. Health professional: Doctor. A Midwife . B Nurse. D Other person Traditional birth attendant. F Community health worker.G Relative / Friend . H Other (specify) ______________________ X No one. Y MN18. WHERE DID YOU GIVE BIRTH TO (name)? Probe to identify the type of source. If unable to determine whether public or private, write the name of the place. (Name of place) Home Your home.11 Other home .12 Public sector Govt. hospital .21 Govt. clinic / health centre .22 Govt. health post .23 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 MN21. WAS (name) WEIGHED AT BIRTH? Yes .1 No.2 DK .8 2MN24 8MN24 MN22. HOW MUCH DID (name) WEIGH? Record weight from health card, if available. From card . 1 (kg) __ . __ __ __ From recall . 2 (kg) __ . __ __ __ DK .99998 MN24. DID YOU EVER BREASTFEED (name)? Yes .1 No.2 2CP Module MN25. HOW LONG AFTER BIRTH DID YOU FIRST PUT (name) TO THE BREAST? If less than 1 hour, record ‘00’ hours. If less than 24 hours, record hours. Otherwise, record days. Immediately .000 Hours . 1 __ __ Days . 2 __ __ Don’t know / remember .998 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 219 CONTRACEPTION




















































































































































 







CP
 CP1. I WOULD LIKE TO TALK WITH YOU ABOUT ANOTHER SUBJECT – FAMILY PLANNING. ARE YOU PREGNANT NOW? Yes, currently pregnant. 1 No . 2 Unsure or DK . 8 1UN Module CP1A. COUPLES USE VARIOUS WAYS OR METHODS TO DELAY OR AVOID A PREGNANCY. DID YOU EVER DO SOMETHING OR USED ANY METHOD TO DELAY OR AVOID GETTING PREGNANT? Yes. 1 No . 2 CP2. ARE YOU CURRENTLY DOING SOMETHING OR USING ANY METHOD TO DELAY OR AVOID GETTING PREGNANT? Yes. 1 No . 2 2UN Module CP3. WHAT ARE YOU DOING TO DELAY OR AVOID A PREGNANCY? Do not prompt. If more than one method is mentioned, circle each one. Female sterilization.A Male sterilization .B IUD.C Injectables.D Implants . .E Pill .F Male condom . G Female condom .H Diaphragm . I Foam / Jelly . J Lactational amenorrhoea method (LAM) . .K Periodic abstinence / Rhythm . L Withdrawal . M Other (specify) ______________________ X 220 MULTIPLE INDICATOR CLUSTER SURVEY 2011 UNMET
NEED
 UN
 UN1. Check CP1. Currently pregnant?  Yes, currently pregnant  Continue with UN2  No, unsure or DK  Go to UN5 UN2. NOW I WOULD LIKE TO TALK TO YOU ABOUT YOUR CURRENT PREGNANCY. WHEN YOU GOT PREGNANT, DID YOU WANT TO GET PREGNANT AT THAT TIME? Yes. 1 No . 2 1UN4 UN3. DID YOU WANT TO HAVE A BABY LATER ON OR DID YOU NOT WANT ANY (MORE) CHILDREN? Later. 1 No more . 2 UN4. NOW I WOULD LIKE TO ASK SOME QUESTIONS ABOUT THE FUTURE. AFTER THE CHILD YOU ARE NOW EXPECTING, WOULD YOU LIKE TO HAVE ANOTHER CHILD, OR WOULD YOU PREFER NOT TO HAVE ANY MORE CHILDREN? Have another child . 1 No more / None . 2 Undecided / Don’t know. 8 1UN7 2UN 13 8UN 13 UN5. Check CP3. Currently using “Female sterilization”?  Yes  Go to UN13  No  Continue with UN6 UN6. NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE FUTURE. WOULD YOU LIKE TO HAVE (A/ANOTHER) CHILD, OR WOULD YOU PREFER NOT TO HAVE ANY (MORE) CHILDREN? Have (a/another) child . 1 No more / None . 2 Says she cannot get pregnant . 3 Undecided / Don’t know. 8 2 UN9 3UN11 8 UN9 UN7. HOW LONG WOULD YOU LIKE TO WAIT BEFORE THE BIRTH OF (A/ANOTHER) CHILD? Months . 1 __ __ Years . 2 __ __ Soon / Now . 993 Says she cannot get pregnant . 994 After marriage . 995 Other . . 996 Don’t know . 998 994 UN11 UN8. Check CP1. Currently pregnant?  Yes, currently pregnant  Go to UN13  No, unsure or DK  Continue with UN9 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 221 UN9. Check CP2. Currently using a method?  Yes  Go to UN13  No  Continue with UN10 UN10. DO YOU THINK YOU ARE PHYSICALLY ABLE TO GET PREGNANT AT THIS TIME? YES …………………………………………. 1 1 UN13 No . 2 DK ……… . ……. 8  UN13 UN11. WHY DO YOU THINK YOU ARE NOT PHYSICALLY ABLE TO GET PREGNANT? Infrequent sex / No sex.A Menopausal .B Never menstruated . C Hysterectomy (surgical removal of uterus). D Has been trying to get pregnant for 2 years or more without result .E Postpartum amenorrheic .F Breastfeeding. G Too old . H Fatalistic. I Other (specify)_______________________X Don’t know .Z UN12. Check UN11. “Never menstruated” mentioned?  Mentioned  Go to Next Module  Not mentioned  Continue with UN13 UN13. WHEN DID YOUR LAST MENSTRUAL PERIOD START? Days ago. 1 __ __ Weeks ago. 2 __ __ Months ago . 3 __ __ Years ago . 4 __ __ In menopause / Has had hysterectomy . 994 Before last birth. . 995 Never menstruated . 996 222 MULTIPLE INDICATOR CLUSTER SURVEY 2011 ATTITUDES
TOWARD
DOMESTIC
VIOLENCE
 DV
 DV1. SOMETIMES A HUSBAND IS ANNOYED OR ANGERED BY THINGS THAT HIS WIFE DOES. IN YOUR OPINION, IS A HUSBAND JUSTIFIED IN HITTING OR BEATING HIS WIFE IN THE FOLLOWING SITUATIONS: [A] IF SHE GOES OUT WITHOUT TELLING HIM? [B] IF SHE NEGLECTS THE CHILDREN? [C] IF SHE ARGUES WITH HIM? [D] IF SHE REFUSES TO HAVE SEX WITH HIM? [E] IF SHE BURNS THE FOOD? [F] IF SHE ARGUES WITH THE PARENTS-IN- LAW? Yes No DK Goes out without telling . 1 2 8 Neglects children. 1 2 8 Argues with him. 1 2 8 Refuses sex. 1 2 8 Burns food . 1 2 8 Argues with the parents-in-law . 1 2 8 
 MARRIAGE/UNION













































































































































































































MA MA1. ARE YOU CURRENTLY MARRIED OR LIVING TOGETHER WITH A MAN AS IF MARRIED? Yes, currently married. 1 Yes, living with a man . 2 No, not in union. 3 2 MA2 3 MA5 MA1A. ARE YOU MARRIED THROUGH: [A] CIVIL REGISTRATION? [B] RELIGIOUS CEREMONY? [C] TRADITIONAL CEREMONY? [D] COMMUNITY ACCEPTANCE? Yes No DK Civil registration .1 2 8 Religious ceremony .1 2 8 Traditional ceremony .1 2 8 Community acceptance .1 2 8 MA2. HOW OLD IS YOUR HUSBAND/PARTNER? PROBE: HOW OLD WAS YOUR HUSBAND/PARTNER ON HIS LAST BIRTHDAY? Age in years . __ __ DK . 98 MA7 98MA7 MA5. HAVE YOU EVER BEEN MARRIED OR LIVED TOGETHER WITH A MAN AS IF MARRIED? Yes, formerly married. 1 Yes, formerly lived with a man . 2 No . 3 3 Next Module MA6. WHAT IS YOUR MARITAL STATUS NOW: ARE YOU WIDOWED, DIVORCED OR SEPARATED? Widowed . 1 Divorced. 2 Separated . 3 MA7. HAVE YOU BEEN MARRIED OR LIVED WITH A MAN ONLY ONCE OR MORE THAN ONCE? Only once. 1 More than once . 2 MA8. IN WHAT MONTH AND YEAR DID YOU FIRST MARRY OR START LIVING WITH A MAN AS IF MARRIED? Date of first marriage Month . __ __ DK month . 98 Year . __ __ __ __ DK year . 9998 Next Module MA9. HOW OLD WERE YOU WHEN YOU STARTED LIVING WITH YOUR FIRST HUSBAND/PARTNER? Age in years . __ __ MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 223 SEXUAL
BEHAVIOUR
 SB
 Check for the presence of others. Before continuing, ensure privacy. SB1. NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT SEXUAL ACTIVITY IN ORDER TO GAIN A BETTER UNDERSTANDING OF SOME IMPORTANT LIFE ISSUES. THE INFORMATION YOU SUPPLY WILL REMAIN STRICTLY CONFIDENTIAL. HOW OLD WERE YOU WHEN YOU HAD SEXUAL INTERCOURSE FOR THE VERY FIRST TIME? Never had intercourse . 00 Age in years. __ __ First time when started living with (first) husband/partner. 95 00Next Module SB2. THE FIRST TIME YOU HAD SEXUAL INTERCOURSE, WAS A CONDOM USED? Yes . 1 No . 2 DK / Don’t remember . 8 SB3. WHEN WAS THE LAST TIME YOU HAD SEXUAL INTERCOURSE? Record ‘years ago’ only if last intercourse was one or more years ago. If 12 months or more the answer must be recorded in years. Days ago . 1 __ __ Weeks ago. 2 __ __ Months ago. 3 __ __ Years ago . . 4 __ __ 4SB15 SB4. THE LAST TIME YOU HAD SEXUAL INTERCOURSE, WAS A CONDOM USED? Yes . 1 No . 2 SB5. WHAT WAS YOUR RELATIONSHIP TO THIS PERSON WITH WHOM YOU LAST HAD SEXUAL INTERCOURSE? Probe to ensure that the response refers to the relationship at the time of sexual intercourse If ‘boyfriend’, then ask: WERE YOU LIVING TOGETHER AS IF MARRIED? If ‘yes’, circle ‘2’. If ‘no’, circle‘3’. Husband . 1 Cohabiting partner . 2 Boyfriend . 3 Casual acquaintance . 4 Other (specify) ______________________ 6 3SB7 4SB7 6SB7 SB6. Check MA1:  Currently married or living with a man (MA1 = 1 or 2)  Go to SB8  Not married / Not in union (MA1 = 3)  Continue with SB7 SB7. HOW OLD IS THIS PERSON? If response is DK, probe: ABOUT HOW OLD IS THIS PERSON? Age of sexual partner . __ __ DK. 98 SB8. HAVE YOU HAD SEXUAL INTERCOURSE WITH ANY OTHER PERSON IN THE LAST 12 MONTHS? Yes . 1 No . 2 2SB15 SB9. THE LAST TIME YOU HAD SEXUAL INTERCOURSE WITH THIS OTHER PERSON, WAS A CONDOM USED? Yes . 1 No . 2 224 MULTIPLE INDICATOR CLUSTER SURVEY 2011 SB10. WHAT WAS YOUR RELATIONSHIP TO THIS PERSON? Probe to ensure that the response refers to the relationship at the time of sexual intercourse If ‘boyfriend’ then ask: WERE YOU LIVING TOGETHER AS IF MARRIED? If ‘yes’, circle ‘2’. If ‘no’, circle’ 3’. Husband . 1 Cohabiting partner . 2 Boyfriend . 3 Casual acquaintance . 4 Other (specify) ______________________ 6 3SB12 4SB12 6SB12 SB11. Check MA1 and MA7:  Currently married or living with a man (MA1 = 1 or 2) AND Married only once or lived with a man only once (MA7 = 1)  Go to SB13  Else  Continue with SB12 SB12. HOW OLD IS THIS PERSON? If response is DK, probe: ABOUT HOW OLD IS THIS PERSON? Age of sexual partner . __ __ DK. 98 SB13. OTHER THAN THESE TWO PERSONS, HAVE YOU HAD SEXUAL INTERCOURSE WITH ANY OTHER PERSON IN THE LAST 12 MONTHS? Yes . 1 No . 2 2SB15 SB14. IN TOTAL, WITH HOW MANY DIFFERENT PEOPLE HAVE YOU HAD SEXUAL INTERCOURSE IN THE LAST 12 MONTHS? Number of partners. __ __ SB15. IN TOTAL, WITH HOW MANY DIFFERENT PEOPLE HAVE YOU HAD SEXUAL INTERCOURSE IN YOUR LIFETIME? If a non-numeric answer is given, probe to get an estimate. If number of partners is 95 or more, write ‘95’. Number of lifetime partners . __ __ DK. 98 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 225 HIV/AIDS
 HA
 HA1. NOW I WOULD LIKE TO TALK WITH YOU ABOUT SOMETHING ELSE. HAVE YOU EVER HEARD OF AN ILLNESS CALLED AIDS? Yes .1 No.2 2Next Module HA2. CAN PEOPLE REDUCE THEIR CHANCE OF GETTING THE AIDS VIRUS BY HAVING JUST ONE UNINFECTED SEX PARTNER WHO HAS NO OTHER SEX PARTNERS? Yes .1 No.2 DK .8 HA3. CAN PEOPLE GET THE AIDS VIRUS BECAUSE OF WITCHCRAFT OR OTHER SUPERNATURAL MEANS? Yes .1 No.2 DK .8 HA4. CAN PEOPLE REDUCE THEIR CHANCE OF GETTING THE AIDS VIRUS BY USING A CONDOM EVERY TIME THEY HAVE SEX? Yes .1 No.2 DK .8 HA5. CAN PEOPLE GET THE AIDS VIRUS FROM MOSQUITO BITES? Yes .1 No.2 DK .8 HA6. CAN PEOPLE GET THE AIDS VIRUS BY SHARING FOOD WITH A PERSON WHO HAS THE AIDS VIRUS? Yes .1 No.2 DK .8 HA7. IS IT POSSIBLE FOR A HEALTHY-LOOKING PERSON TO HAVE THE AIDS VIRUS? Yes .1 No.2 DK .8 HA8. CAN THE VIRUS THAT CAUSES AIDS BE TRANSMITTED FROM A MOTHER TO HER BABY: [A] DURING PREGNANCY? [B] DURING DELIVERY? [C] BY BREASTFEEDING? Yes No DK During pregnancy.1 2 8 During delivery .1 2 8 By breastfeeding .1 2 8 HA9. IN YOUR OPINION, IF A FEMALE TEACHER HAS THE AIDS VIRUS BUT IS NOT SICK, SHOULD SHE BE ALLOWED TO CONTINUE TEACHING IN SCHOOL? Yes .1 No.2 DK / Not sure / Depends .8 HA10. WOULD YOU BUY FRESH VEGETABLES FROM A SHOPKEEPER OR VENDOR IF YOU KNEW THAT THIS PERSON HAD THE AIDS VIRUS? Yes .1 No.2 DK / Not sure / Depends .8 HA11. IF A MEMBER OF YOUR FAMILY GOT INFECTED WITH THE AIDS VIRUS, WOULD YOU WANT IT TO REMAIN A SECRET? Yes .1 No.2 DK / Not sure / Depends .8 HA12. IF A MEMBER OF YOUR FAMILY BECAME SICK WITH AIDS, WOULD YOU BE WILLING TO CARE FOR HER OR HIM IN YOUR OWN HOUSEHOLD? Yes .1 No.2 DK / Not sure / Depends .8 226 MULTIPLE INDICATOR CLUSTER SURVEY 2011 HA13. Check CM13: Any live birth in last 2 years?  No live birth in last 2 years  Go to HA24  One or more live births in last 2 years  Continue with HA14 HA14. Check MN1: Received antenatal care?  Received antenatal care  Continue with HA15  Did not receive antenatal care  Go to HA24 HA15. DURING ANY OF THE ANTENATAL VISITS FOR YOUR PREGNANCY WITH (name), WERE YOU GIVEN ANY INFORMATION ABOUT HIV/AIDS Yes .1 No.2 DK .8 HA16. I DON’T WANT TO KNOW THE RESULT, BUT WERE YOU TESTED FOR THE AIDS VIRUS AS PART OF YOUR ANTENATAL CARE? Yes .1 No.2 DK .8 2HA24 8HA24 HA17. I DON’T WANT TO KNOW THE RESULT, BUT DID YOU GET THE RESULTS OF THE TEST? Yes .1 No.2 DK .8 2HA24 8HA24 HA18. REGARDLESS OF THE RESULT, ALL WOMEN WHO ARE TESTED ARE SUPPOSED TO RECEIVE COUNSELLING AFTER GETTING THE RESULT. AFTER YOU WERE TESTED, DID YOU RECEIVE COUNSELLING? Yes .1 No.2 DK .8 HA24. I DON’T WANT TO KNOW THE RESULTS, BUT HAVE YOU EVER BEEN TESTED TO SEE IF YOU HAVE THE AIDS VIRUS? Yes .1 No.2 2HA27 HA25. WHEN WAS THE MOST RECENT TIME YOU WERE TESTED? Less than 12 months ago.1 12-23 months ago .2 2 or more years ago .3 HA26. I DON’T WANT TO KNOW THE RESULTS, BUT DID YOU GET THE RESULTS OF THE TEST? Yes .1 No.2 DK .8 1 Next Module 2 Next Module 8 Next Module HA27. DO YOU KNOW OF A PLACE WHERE PEOPLE CAN GO TO GET TESTED FOR THE AIDS VIRUS? Yes .1 No.2 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 227 ALCOHOL
USE
 TA
 TA14. NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT DRINKING ALCOHOL. HAVE YOU EVER DRUNK ALCOHOL? Yes . 1 No . 2 2WM11 TA15. WHICH IS CONSIDERED ONE DRINK OF ALCOHOL IS ONE CAN OR BOTTLE OF BEER, ONE GLASS OF WINE, OR ONE SHOT OF COGNAC, VODKA, WHISKEY, RUM, SAGUER, PERMIPAN, BOBO, CAP TIKUS, SOFI, OR SBY. HOW OLD WERE YOU WHEN YOU HAD YOUR FIRST DRINK OF ALCOHOL, OTHER THAN A FEW SIPS? Never had one drink of alcohol. 00 Age . ___ ___ 00WM11 TA16. DURING THE LAST ONE MONTH, ON HOW MANY DAYS DID YOU HAVE AT LEAST ONE DRINK OF ALCOHOL? If respondent did not drink, circle “00”. If less than 10 days, record the number of days. If 10 days or more but less than a month, circle “10”. If “everyday” or “almost every day”, circle “30” Did not have one drink in last one month . 00 Number of days . 0 ___ 10 days or more but less than a month . 10 Everyday / Almost every day . 30 00WM11 TA17. IN THE LAST ONE MONTH, ON THE DAYS THAT YOU DRANK ALCOHOL, HOW MANY CAN/BOTTLE/GLASS/SHOT OF DRINKS DID YOU USUALLY HAVE? Number of can/bottle/glass/shot . ___ ___ WM11. Record the time. Hour and minutes . __ __ : __ __ WM12. Check Household Listing Form, column HL9. Is the respondent the mother or caretaker of any child age 0-4 living in this household?  Yes  Go to QUESTIONNAIRE FOR CHILDREN UNDER FIVE for that child and start the interview with this respondent.  No  End the interview with this respondent by thanking her for her cooperation. Check for the presence of any other eligible woman, man or child under-5 in the household. 228 MULTIPLE INDICATOR CLUSTER SURVEY 2011 INDONESIA 2011 INDONESIA MULTIPLE INDICATOR CLUSTER SURVEY PAPUA AND WEST PAPUA PROVINCE QUESTIONNAIRE FOR INDIVIDUAL MEN CONFIDENTIAL MAN’S INFORMATION PA INFORMATION PA NEL MWM This questionnaire is to be administered to all men age 15 through 49 (see Household Listing Form, column HL7A). A separate questionnaire should be used for each eligible man. MWM1. Cluster number: MWM2. Household number: ___ ___ ___ ___ ___ ___ MWM3. Man’s name: MWM4. Man’s line number: Name. ___ ___ MWM5. Interviewer name and number: Name . ___ ___ MWM6. Day / Month / Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ Repeat greeting and introduce yourself if you never met with this respondent (man), and read the following: WE ARE FROM LOCAL GOVERNMENT/BPS WOULD LIKE TO TALK TO YOU ABOUT HEALTH AND EDUCATION. THE INTERVIEW WILL TAKE ABOUT 20 MINUTES. ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE SHARED WITH ANYONE OTHER THAN OUR PROJECT TEAM. If greeting at the beginning of the household questionnaire has already been read to this man, then read the following: NOW I WOULD LIKE TO TALK TO YOU MORE ABOUT YOUR HEALTH AND OTHER TOPICS. THIS INTERVIEW WILL TAKE ABOUT 20 MINUTES. AGAIN, ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE SHARED WITH ANYONE OTHER THAN OUR PROJECT TEAM. MAY I START NOW?  Yes, permission is given  Go to MWM10 to record the time and then begin the interview.  No, permission is not given  Complete MWM7. Discuss this result with your supervisor MWM7. Result of man’s interview Completed . 01 Not at home . 02 Refused . 03 Partly completed. . 04 Incapacitated . 05 Other (specify) ___________________________ 96 MWM8. Field edited by (Name and number): Name _________________________ ___ ___ MWM9. Data entry clerk (Name and number): Name __________________________ ___ ___ MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 229 MWM10. Record the time. Hour and minutes . __ __ : __ __ MAN’S
BACKGROUND
 MWB
 MWB1. IN WHAT MONTH AND YEAR WERE YOU BORN? Date of birth Month. __ __ DK month. 98 Year . __ __ __ __ DK year. 9998 MWB2. HOW OLD ARE YOU? Probe: HOW OLD WERE YOU AT YOUR LAST BIRTHDAY? Compare and correct MWB1 and/or MWB2 if inconsistent Age (in completed years). __ __ MWB3. HAVE YOU EVER ATTENDED SCHOOL OR PRESCHOOL? Yes . 1 No . 2 2MWB7 MWB4. WHAT IS THE HIGHEST LEVEL OF SCHOOL YOU ATTENDED? Preschool. 0 Primary . 1 Junior Secondary . 2 Senior High . 3 University. 4 DK. . 5 0MWB7 MWB5. WHAT IS THE HIGHEST GRADE YOU COMPLETED AT THAT LEVEL? If less than 1 grade, enter “0” Grade. ___ MWB6. Check MWB4:  Senior High or University  Go to MDV  Primary or Junior secondary  Continue with MWB7 MWB7. NOW I WOULD LIKE YOU TO READ THIS SENTENCE TO ME. Show sentence on the card to the respondent. If respondent cannot read whole sentence, probe: CAN YOU READ PART OF THE SENTENCE TO ME? 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 . 5 230 MULTIPLE INDICATOR CLUSTER SURVEY 2011 ATTITUDES TOWARD DOM ESTIC VIOLENCE MDV MDV1. 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: [A] IF SHE GOES OUT WITHOUT TELLING HIM? [B] IF SHE NEGLECTS THE CHILDREN? [C] IF SHE ARGUES WITH HIM? [D] IF SHE REFUSES TO HAVE SEX WITH HIM? [E] IF SHE BURNS THE FOOD? [F] IF SHE ARGUES WITH PARENTS-IN-LAW? Yes No DK Goes out without telling . 1 2 8 Neglects children. 1 2 8 Argues with him. 1 2 8 Refuses sex. 1 2 8 Burns food . 1 2 8 Argues with parents-in-law . 1 2 8 MARRIAGE/UNION MMA MMA1. ARE YOU CURRENTLY MARRIED OR LIVING TOGETHER WITH A WOMAN AS IF MARRIED? Yes, currently married. 1 Yes, living with a woman. 2 No, not in union. 3 2MMA2 3MMA5 MMA1A. ARE YOU MARRIED THROUGH: [A] CIVIL REGISTRATION? [B] RELIGIOUS CEREMONY? [C] TRADITIONAL CEREMONY? [D] COMMUNITY ACCEPTANCE? Yes No DK Civil registration .1 2 8 Religious ceremony .1 2 8 Traditional ceremony .1 2 8 Community acceptance .1 2 8 MMA2. HOW OLD IS YOUR WIFE/PARTNER? PROBE: HOW OLD WAS YOUR WIFE/PARTNER ON HIS LAST BIRTHDAY? Age in years . __ __ DK . 98 MMA7 98MMA7 MMA5. HAVE YOU EVER BEEN MARRIED OR LIVED TOGETHER WITH A WOMAN AS IF MARRIED? Yes, formerly married. 1 Yes, formerly lived with a man . 2 No . 3 3 Next Module MMA6. WHAT IS YOUR MARITAL STATUS NOW: ARE YOU WIDOWED, DIVORCED OR SEPARATED? Widowed . 1 Divorced. 2 Separated . 3 MMA7. HAVE YOU BEEN MARRIED OR LIVED WITH A WOMAN ONLY ONCE OR MORE THAN ONCE? Only once. 1 More than once . 2 MMA8. IN WHAT MONTH AND YEAR DID YOU FIRST MARRY OR START LIVING WITH A WOMAN AS IF MARRIED? Date of first marriage Month . __ __ DK month . 98 Year . __ __ __ __ DK year . 9998 Next Module MMA9. HOW OLD WERE YOU WHEN YOU STARTED LIVING WITH YOUR FIRST WIFE/PARTNER? Age in years . __ __ MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 231 SEXUAL
BEHAVIOUR
 MSB
 Check for the presence of others. Before continuing, ensure privacy. MSB1. NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT SEXUAL ACTIVITY IN ORDER TO GAIN A BETTER UNDERSTANDING OF SOME IMPORTANT LIFE ISSUES. THE INFORMATION YOU SUPPLY WILL REMAIN STRICTLY CONFIDENTIAL. HOW OLD WERE YOU WHEN YOU HAD SEXUAL INTERCOURSE FOR THE VERY FIRST TIME? Never had intercourse. 00 Age in years . __ __ First time when started living with (first) wife/partner . 95 00Next Module MSB2. THE FIRST TIME YOU HAD SEXUAL INTERCOURSE, WAS A CONDOM USED? Yes. 1 No . 2 DK / Don’t remember . 8 MSB3. WHEN WAS THE LAST TIME YOU HAD SEXUAL INTERCOURSE? Record ‘years ago’ only if last intercourse was one or more years ago. If 12 months or more the answer must be recorded in years. Days ago. 1 __ __ Weeks ago . 2 __ __ Months ago . 3 __ __ Years ago. . 4 __ __ 4MSB15 MSB4. THE LAST TIME YOU HAD SEXUAL INTERCOURSE, WAS A CONDOM USED? Yes. 1 No . 2 MSB5. WHAT WAS YOUR RELATIONSHIP TO THIS PERSON WITH WHOM YOU LAST HAD SEXUAL INTERCOURSE? Probe to ensure that the response refers to the relationship at the time of sexual intercourse If ‘girlfriend’, then ask: WERE YOU LIVING TOGETHER AS IF MARRIED? If ‘yes’, circle ‘2’. If ‘no’, circle‘3’. Wife. 1 Cohabiting partner . 2 Girlfriend . 3 Casual acquaintance . 4 Prostitute. 5 Other (specify) ______________________ 6 3MSB7 4MSB7 4MSB7 6MSB7 MSB6. Check MMA1:  Currently married or living with a woman (MMA1 = 1 or 2)  Go to MSB8  Not married / Not in union (MMA1 = 3)  Continue with MSB7 MSB7. HOW OLD IS THIS PERSON? If response is DK, probe: ABOUT HOW OLD IS THIS PERSON? Age of sexual partner. __ __ DK . 98 MSB8. HAVE YOU HAD SEXUAL INTERCOURSE WITH ANY OTHER PERSON IN THE LAST 12 MONTHS? Yes. 1 No . 2 2MSB15 MSB9. THE LAST TIME YOU HAD SEXUAL INTERCOURSE WITH THIS OTHER PERSON, WAS A CONDOM USED? Yes. 1 No . 2 232 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MSB10. WHAT WAS YOUR RELATIONSHIP TO THIS PERSON? Probe to ensure that the response refers to the relationship at the time of sexual intercourse If ‘girlfriend’ then ask: WERE YOU LIVING TOGETHER AS IF MARRIED? If ‘yes’, circle ‘2’. If ‘no’, circle’ 3’. Wife. 1 Cohabiting partner . 2 Girlfriend . 3 Casual acquaintance . 4 Prostitute. 5 Other (specify) ______________________ 6 3MSB12 4MSB12 4MSB12 6MSB12 MSB11. Check MMA1:  Currently married or living with a woman (MMA1 = 1 or 2) AND Married only once or lived with a woman only once (MMA7 = 1)  Go to MSB13  Else  Continue with MSB12 MSB12. HOW OLD IS THIS PERSON? If response is DK, probe: ABOUT HOW OLD IS THIS PERSON? Age of sexual partner. __ __ DK . 98 MSB13. OTHER THAN THESE TWO PERSONS, HAVE YOU HAD SEXUAL INTERCOURSE WITH ANY OTHER PERSON IN THE LAST 12 MONTHS? Yes. 1 No . 2 2MSB15 MSB14. IN TOTAL, WITH HOW MANY DIFFERENT PEOPLE HAVE YOU HAD SEXUAL INTERCOURSE IN THE LAST 12 MONTHS? Number of partners . __ __ MSB15. IN TOTAL, WITH HOW MANY DIFFERENT PEOPLE HAVE YOU HAD SEXUAL INTERCOURSE IN YOUR LIFETIME? If a non-numeric answer is given, probe to get an estimate. If number of partners is 95 or more, write ‘95’. Number of lifetime partners. __ __ DK . 98 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 233 HIV/AIDS
 MHA
 MHA1. NOW I WOULD LIKE TO TALK WITH YOU ABOUT SOMETHING ELSE. HAVE YOU EVER HEARD OF AN ILLNESS CALLED AIDS? Yes. 1 No . 2 2 Next Module MHA2. CAN PEOPLE REDUCE THEIR CHANCE OF GETTING THE AIDS VIRUS BY HAVING JUST ONE UNINFECTED SEX PARTNER WHO HAS NO OTHER SEX PARTNERS? Yes. 1 No . 2 DK. 8 MHA3. CAN PEOPLE GET THE AIDS VIRUS BECAUSE OF WITCHCRAFT OR OTHER SUPERNATURAL MEANS? Yes. 1 No . 2 DK. 8 MHA4. CAN PEOPLE REDUCE THEIR CHANCE OF GETTING THE AIDS VIRUS BY USING A CONDOM EVERY TIME THEY HAVE SEX? Yes. 1 No . 2 DK. 8 MHA5. CAN PEOPLE GET THE AIDS VIRUS FROM MOSQUITO BITES? Yes. 1 No . 2 DK. 8 MHA6. CAN PEOPLE GET THE AIDS VIRUS BY SHARING FOOD WITH A PERSON WHO HAS THE AIDS VIRUS? Yes. 1 No . 2 DK. 8 MHA7. IS IT POSSIBLE FOR A HEALTHY-LOOKING PERSON TO HAVE THE AIDS VIRUS? Yes. 1 No . 2 DK. 8 MHA8. CAN THE VIRUS THAT CAUSES AIDS BE TRANSMITTED FROM A MOTHER TO HER BABY: [A] DURING PREGNANCY? [B] DURING DELIVERY? [C] BY BREASTFEEDING? Yes No DK During pregnancy . 1 2 8 During delivery. 1 2 8 By breastfeeding. 1 2 8 MHA9. IN YOUR OPINION, IF A FEMALE TEACHER HAS THE AIDS VIRUS BUT IS NOT SICK, SHOULD SHE BE ALLOWED TO CONTINUE TEACHING IN SCHOOL? Yes. 1 No . 2 DK / Not sure / Depends. 8 MHA10. WOULD YOU BUY FRESH VEGETABLES FROM A SHOPKEEPER OR VENDOR IF YOU KNEW THAT THIS PERSON HAD THE AIDS VIRUS? Yes. 1 No . 2 DK / Not sure / Depends. 8 MHA11. IF A MEMBER OF YOUR FAMILY GOT INFECTED WITH THE AIDS VIRUS, WOULD YOU WANT IT TO REMAIN A SECRET? Yes. 1 No . 2 DK / Not sure / Depends. 8 MHA12. IF A MEMBER OF YOUR FAMILY BECAME SICK WITH AIDS, WOULD YOU BE WILLING TO CARE FOR HER OR HIM IN YOUR OWN HOUSEHOLD? Yes. 1 No . 2 DK / Not sure / Depends. 8 234 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MHA24. I DON’T WANT TO KNOW THE RESULTS, BUT HAVE YOU EVER BEEN TESTED TO SEE IF YOU HAVE THE AIDS VIRUS? Yes. 1 No . 2 2MHA27 MHA25. WHEN WAS THE MOST RECENT TIME YOU WERE TESTED? Less than 12 months ago . 1 12-23 months ago. 2 2 or more years ago. 3 MHA26. I DON’T WANT TO KNOW THE RESULTS, BUT DID YOU GET THE RESULTS OF THE TEST? Yes. 1 No . 2 DK. 8 1Next Module 2Next Module 8Next Module MHA27. DO YOU KNOW OF A PLACE WHERE PEOPLE CAN GO TO GET TESTED FOR THE AIDS VIRUS? Yes. 1 No . 2 
 CIRCUMCISION
 































































































































MNC MNC1. SOME MEN ARE CIRCUMCISED, THAT IS, THE FORESKIN IS COMPLETELY REMOVED FROM THE PENIS. ARE YOU CIRCUMCISED? Yes. 1 No . 2 2Next Module MNC2. HOW OLD WERE YOU GOT CIRCUMCISED? Age in completed years . __ __ DK. 98 MNC3. WHO DID THE CIRCUMCISION? Traditional practitioner/family/friend. 1 Health worker/Professional. 2 Other (specify) ______________________ 6 DK. 8 MNC4. WHERE WAS IT DONE? Health facility . 1 Home of a health worker/professional . 2 Circumcision done at home . 3 Ritual site . 4 Other home/place (specify)_____________ 6 DK. 8 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 235 ALCOHOL
USE
 MTA
 MTA14. NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT DRINKING ALCOHOL. HAVE YOU EVER DRUNK ALCOHOL? Yes.1 No .2 2 MWM11 MTA15. WE COUNT ONE DRINK OF ALCOHOL AS ONE CAN OR BOTTLE OF BEER, ONE GLASS OF WINE, OR ONE SHOT OF COGNAC, VODKA, WHISKEY, SAGUER, PERMIPAN, BOBO, CAP TIKUS, SOFI, OR SBY. HOW OLD WERE YOU WHEN YOU HAD YOUR FIRST DRINK OF ALCOHOL, OTHER THAN A FEW SIPS? Never had one drink of alcohol .00 Age.___ ___ 00 MWM11 MTA16. DURING THE LAST ONE MONTH, ON HOW MANY DAYS DID YOU HAVE AT LEAST ONE DRINK OF ALCOHOL? If respondent did not drink, circle “00”. If less than 10 days, record the number of days. If 10 days or more but less than a month, circle “10”. If “everyday” or “almost every day”, circle “30” Did not have one drink in last one month.00 Number of days.0 ___ 10 days or more but less than a month.10 Everyday / Almost every day .30 00 MWM11 MTA17. IN THE LAST ONE MONTH, ON THE DAYS THAT YOU DRANK ALCOHOL, HOW MANY CAN/BOTTLE/GLASS/SHOT OF DRINKS DID YOU USUALLY HAVE? Number of can/bottle/glass/shot .___ ___ MWM11. Record the time. Hour and minutes . __ __ : __ __ MWM12. Check Household Listing Form, column HL9. Is the respondent the caretaker of any child age 0-4 living in this household?  Yes  Go to QUESTIONNAIRE FOR CHILDREN UNDER FIVE for that child and start the interview with this respondent.  No  End the interview with this respondent by thanking him for his cooperation. Check for the presence of any other eligible man in the household. 236 MULTIPLE INDICATOR CLUSTER SURVEY 2011 INDONESIA
2011
 INDONESIA MULTIPLE INDICATOR CLUSTER SURVEY PAPUA AND WEST PAPUA PROVINCE QUESTIONNAIRE FOR CHILDREN UNDER FIVE CONFIDENTIAL UNDER‐FIVE
CHILD
INFORMATION
PANEL
 UF
 This questionnaire is to be administered to all mothers or caretakers (see Household Listing Form, column HL9) who care for a child that lives with them and is under the age of 5 years (see Household Listing Form, column HL6). A separate questionnaire should be used for each eligible child. UF1. Cluster number: ___ ____ ___ ___ ___ UF2. Household number: ___ ___ ___ UF3. Child’s name: UF4. Child’s line number: _ ----- ------- Name UF5. Mother’s / Caretaker’s name: UF6. Mother’s / Caretaker’s line number: Name ___ ___ UF7. Interviewer name and number: Name . ___ ___ UF8. Day / Month / Year of interview: ___ ___ / ___ ___ / ___ ___ ___ ___ Repeat greeting if not already read to this respondent: WE ARE FROM LOCAL GOVERNMENT/BPS WOULD LIKE TO TALK TO YOU ABOUT (name)’S HEALTH AND WELL-BEING. THE INTERVIEW WILL TAKE ABOUT 20 MINUTES. ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE SHARED WITH ANYONE OTHER THAN OUR PROJECT TEAM. If greeting at the beginning of the household questionnaire has already been read to this woman, then read the following: NOW I WOULD LIKE TO TALK TO YOU MORE ABOUT (child’s name from UF3)’S HEALTH AND OTHER TOPICS. THIS INTERVIEW WILL TAKE ABOUT 20 MINUTES. AGAIN, ALL THE INFORMATION WE OBTAIN WILL REMAIN STRICTLY CONFIDENTIAL AND YOUR ANSWERS WILL NEVER BE SHARED WITH ANYONE OTHER THAN OUR PROJECT TEAM. MAY I START NOW?  Yes, permission is given  Go to UF12 to record the time and then begin the interview.  No, permission is not given  Complete UF9. Discuss this result with your supervisor UF9. Result of interview for children under 5 Codes refer to mother/caretaker. Completed . 01 Not at home . 02 Refused . 03 Partly completed. 04 Incapacitated . 05 Other (specify) ___________________________ 96 UF10. Field edited by (Name and number): Name __________________________ ___ ___ UF11. Data entry clerk (Name and number): Name __________________________ ___ ___ MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 237 UF12. Record the time. Hour and minutes.__ __ : __ __ AGE
 AG
 AG1. NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE HEALTH OF (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 Month and year must be recorded. Date of birth Day .__ __ DK day.98 Month .__ __ Year.__ __ __ __ AG2. HOW OLD IS (name)? Probe: HOW OLD WAS (name) AT HIS / HER LAST BIRTHDAY? Record age in completed years. Record ‘0’ if less than 1 year. Compare and correct AG1 and/or AG2 if inconsistent. Age (in completed years) .__ BIRTH
REGISTRATION
 BR
 BR1. DOES (name) HAVE A BIRTH CERTIFICATE? If yes, ask: MAY I SEE IT? Yes, seen .1 Yes, not seen .2 No.3 DK .8 1Next Module 2Next Module BR2. HAS (name)’S BIRTH BEEN REGISTERED WITH THE CIVIL AUTHORITIES? Yes .1 No.2 DK .8 1Next Module BR3. DO YOU KNOW HOW TO REGISTER YOUR CHILD’S BIRTH? Yes .1 No.2 238 MULTIPLE INDICATOR CLUSTER SURVEY 2011 BREASTFEEDING

 BF
 BF1. HAS (name) EVER BEEN BREASTFED? Yes .1 No.2 DK .8 2BF3 8BF3 BF2. IS HE/SHE STILL BEING BREASTFED? Yes .1 No.2 DK .8 BF3. I WOULD LIKE TO ASK YOU ABOUT LIQUIDS THAT (name) MAY HAVE HAD YESTERDAY DURING THE DAY OR THE NIGHT. I AM INTERESTED IN WHETHER (name) HAD THE ITEM EVEN IF IT WAS COMBINED WITH OTHER FOODS. DID (name) DRINK PLAIN WATER YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 BF4. DID (name) DRINK INFANT FORMULA YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 2BF6 8BF6 BF5. HOW MANY TIMES DID (name) DRINK INFANT FORMULA? Number of times.__ __ BF6. DID (name) DRINK MILK, SUCH AS TINNED, POWDERED OR FRESH ANIMAL MILK YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 2BF8 8BF8 BF7. HOW MANY TIMES DID (name) DRINK TINNED, POWDERED OR FRESH ANIMAL MILK? Number of times.__ __ BF8. DID (name) DRINK JUICE OR JUICE DRINKS YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 BF9. DID (name) DRINK CLEAR BROTH/CLEAR SOUP YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 BF10. DID (name) DRINK OR EAT VITAMIN OR MINERAL SUPPLEMENTS OR ANY MEDICINES YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 BF11. DID (name) DRINK ORALIT (SUGAR SALT SOLUTION) YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 239 BF12. DID (name) DRINK ANY OTHER LIQUIDS YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 BF13. DID (name) DRINK OR EAT YOGURT YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 2BF15 8BF15 BF14. HOW MANY TIMES DID (name) DRINK OR EAT YOGURT YESTERDAY, DURING THE DAY OR NIGHT? Number of times.__ __ BF15. DID (name) EAT THIN PORRIDGE YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 BF16. DID (name) EAT SOLID OR SEMI-SOLID (SOFT, MUSHY) FOOD YESTERDAY, DURING THE DAY OR NIGHT? Yes .1 No.2 DK .8 2BF18 8BF18 BF17. HOW MANY TIMES DID (name) EAT SOLID OR SEMI-SOLID (SOFT, MUSHY) FOOD YESTERDAY, DURING THE DAY OR NIGHT? Number of times.__ __ BF18. YESTERDAY, DURING THE DAY OR NIGHT, DID (name) DRINK ANYTHING FROM A BOTTLE WITH A NIPPLE? Yes .1 No.2 DK .8 240 MULTIPLE INDICATOR CLUSTER SURVEY 2011 MALARIA
 ML
 ML1. IN THE LAST TWO WEEKS, HAS (name) BEEN ILL WITH A FEVER AT ANY TIME? Yes .1 No.2 DK .8 2Next Module 8Next Module ML2. AT ANY TIME DURING THE ILLNESS, DID (name) HAVE BLOOD TAKEN FROM HIS/HER FINGER OR HEEL FOR TESTING? Yes .1 No.2 DK .8 ML3. DID YOU SEEK ANY ADVICE OR TREATMENT FOR THE ILLNESS FROM ANY SOURCE? Yes .1 No.2 DK .8 2ML8 8ML8 ML4. WAS (name) TAKEN TO A HEALTH FACILITY DURING THIS ILLNESS? Yes .1 No.2 DK .8 2ML8 8ML8 ML5. WAS (name) GIVEN ANY MEDICINE FOR FEVER OR MALARIA AT THE HEALTH FACILITY? Yes .1 No.2 DK .8 2ML7 8ML7 ML6. WHAT MEDICINE WAS (name) GIVEN? Probe: ANY OTHER MEDICINE? Circle all medicines mentioned. Write brand name(s) of all medicines, if given. (Name) Anti-malarials: SP / Fansidar. A Chloroquine . B Quinine / Kina. D Artesdiaquine . E Arsuamon.F Arterakin/Artekin.G Other anti-malarial (specify)_______________________ H Antibiotic drugs Pill / Syrup .I Injection . J Other medications: Paracetamol/ Panadol /Acetaminophen. P Aspirin .Q Ibuprofen . R Other (specify)______________________ X DK . .Z ML7. WAS (name) GIVEN ANY MEDICINE FOR THE FEVER OR MALARIA BEFORE BEING TAKEN TO THE HEALTH FACILITY? Yes .1 No.2 DK .8 1ML9 2ML10 8ML10 ML8. WAS (name) GIVEN ANY MEDICINE FOR FEVER OR MALARIA DURING THIS ILLNESS? Yes .1 No.2 DK .8 2ML10 8ML10 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 241 ML9. WHAT MEDICINE WAS (name) GIVEN? Probe: ANY OTHER MEDICINE? Circle all medicines mentioned. Write brand name(s) of all medicines, if given. (Name) . Anti-malarials: SP / Fansidar. A Chloroquine . B Quinine / Kina. D Artesdiaquine . E Arsuamon.F Arterakin/Artekin.G Other anti-malarial (speci fy)_______________________ H Antibiotic drugs Pill / Syrup .I Injection . J Other medications: Paracetamol/ Panadol /Acetaminophen. P Aspirin .Q Ibuprofen . R Other (specify)______________________ X DK . .Z ML10. Check ML6 and ML9: Anti-malarial mentioned (codes A - H)?  Yes  Continue with ML11  No  Go to Next Module ML11. HOW LONG AFTER THE FEVER STARTED DID (name) FIRST TAKE (name of anti-malarial from ML6 or ML9)? If multiple anti-malarials mentioned in ML6 or ML9, name all anti-malarial medicines mentioned. 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 .8 242 MULTIPLE INDICATOR CLUSTER SURVEY 2011 IMMUNIZATION
 IM
 If an immunization card is available, copy the dates in IM3 for each type of immunization recorded on the card. IM6- IM17 are for registering vaccinations that are not recorded on the card. IM6-IM17 will only be asked when a card is not available. IM1. DO YOU HAVE A CARD WHERE (name)’S VACCINATIONS ARE WRITTEN DOWN? (If yes) MAY I SEE IT PLEASE? Yes, seen .1 Yes, not seen .2 No card .3 1IM3 2IM6 IM2. DID YOU EVER HAVE A VACCINATION CARD FOR (name)? Yes.1 No .2 1IM6 2IM6 IM3. (a) Copy dates for each vaccination from the card. (b) Write ‘44’ in day column if card shows that vaccination was given but no date recorded. Date of Immunization Day Month Year BCG BCG POLIO 1 OPV1 POLIO 2 OPV2 POLIO 3 OPV3 POLIO 4 OPV4 DPT/HB 1 DPT/HB 1 DPT/HB 2 DPT/HB 2 DPT/HB 3 DPT/HB 3 DPT1 DPT1 DPT2 DPT2 DPT3 DPT3 HEPB AT BIRTH H0 HEPB1 H1 HEPB2 H2 HEPB3 H3 MEASLES (OR MMR) MEASLES VITAMIN A (MOST RECENT) VITA IM4. Check IM3. Are all vaccines (BCG to Measles) recorded?  Yes Go to IM18  No  Continue with IM5 MULTIPLE INDICATOR CLUSTER SURVEY 2011MULTIPLE INDICATOR CLUSTER SURVEY 2011 243 IM5. IN ADDITION TO WHAT IS RECORDED ON THIS CARD, DID (name) RECEIVE ANY OTHER VACCINATIONS – INCLUDING VACCINATIONS RECEIVED IN CAMPAIGNS OR IMMUNIZATION DAYS? Record ‘Yes’ only if respondent mentions vaccines shown in the table above. Yes .1 (Probe for vaccinations and write ‘66’ in the corresponding day column for each vaccine mentioned. Then skip to IM18) No .2 DK .8 2IM18 8IM18 IM6. HAS (name) EVER RECEIVED ANY VACCINATIONS TO PREVENT HIM/HER FROM GETTING DISEASES, INCLUDING VACCINATIONS RECEIVED IN A CAMPAIGN OR IMMUNIZATION DAY? Yes.1 No .2 DK .8 2IM18 8IM18 IM7. HAS (name) EVER RECEIVED A BCG VACCINATION AGAINST TUBERCULOSIS – THAT IS, AN INJECTION IN THE ARM OR SHOULDER THAT USUALLY CAUSES A SCAR? Yes.1 No .2 DK .8 IM8. HAS (name) EVER RECEIVED ANY “VACCINATION DROPS IN THE MOUTH” TO PROTECT HIM/HER FROM GETTING DISEASES – THAT IS, POLIO? Yes.1 No .2 DK .8 2IM11 8IM11 IM9. WAS THE FIRST POLIO VACCINE RECEIVED IN THE FIRST MONTH AFTER BIRTH OR LATER? First two weeks .1 Later .2 IM10. HOW MANY TIMES WAS THE POLIO VACCINE RECEIVED? Number of times.__ IM10A. HAS (name) EVER RECEIVED A COMBO VACCINATION (COMBINATION OF DPT AND HEPATITIS B VACCINES) – THAT IS, AN INJECTION IN THE THIGH OR BUTTOCKS – TO PREVENT HIM/HER FROM GETTING TETANUS, WHOOPING COUGH, DIPHTHERIA AND HEPATITIS B? Probe by indicating that the Combo vaccine is sometimes given at the same time as Polio vaccines Yes .1 No .2 DK .8 2IM11 8IM11 IM10B. HOW MANY TIMES WAS A COMBO VACCINE (COMBINATION OF DPT AND HEPATITIS B VACCINES) RECEIVED? Number of times.__ IM11. HAS (name) EVER RECEIVED A DPT VACCINATION – THAT IS, AN INJECTION IN THE THIGH OR BUTTOCKS – TO PREVENT HIM/HER FROM GETTING TETANUS, WHOOPING COUGH, OR DIPHTHERIA? Probe by indicating that DPT vaccination is sometimes given at the same time as Polio Yes .1 No .2 DK .8 2IM13 8IM13 IM12. HOW MANY TIMES WAS A DPT VACCINE RECEIVED? Number of times.__ IM13. HAS (name) EVER BEEN GIVEN A HEPATITIS B VACCINATION – THAT IS, AN INJECTION IN THE THIGH OR BUTTOCKS – TO PREVENT HIM/HER FROM GETTING HEPATITIS B? Probe by indicating that the Hepatitis B vaccine is sometimes given at the same time as Polio and DPT vaccines Yes .1 No . 2 DK .8 2IM16 8IM16 244 MULTIPLE INDICATOR CLUSTER SURVEY 2011 IM14. WAS THE FIRST HEPATITIS B VACCINE RECEIVED WITHIN 24 HOURS AFTER BIRTH, OR LATER? Within 24 hours .1 Later .2 IM15. HOW MANY TIMES WAS A HEPATITIS B VACCINE RECEIVED? Number of times.__ IM16. HAS (name) EVER RECEIVED A MEASLES INJECTION OR AN MMR INJECTION – THAT IS, A SHOT IN THE ARM AT THE AGE OF 9 MONTHS OR OLDER - TO PREVENT HIM/HER FROM GETTING MEASLES? Yes.1 No .2 DK .8 IM18. HAS (name) RECEIVED A VITAMIN A DOSE LIKE (THIS/ANY OF THESE) WITHIN THE LAST 6 MONTHS? Show common types of ampules / capsules / syrups Yes .1 No .2 DK .8 IM19. PLEASE TELL ME IF (name) HAS PARTICIPATED IN ANY OF THE FOLLOWING CAMPAIGNS, NATIONAL IMMUNIZATION DAYS AND/OR VITAMIN A OR CHILD HEALTH DAYS: [A] POLIO AND MEASLES CAMPAIGN, DURING JULY-AUGUST 2011 Y N DK Polio and Measles campaign .1 2 8 UF13. Record the time. Hour and minutes.__ __ : __ __ UF14. Is the respondent the mother or caretaker of another child age 0-4 living in this household?  Yes  Indicate to the respondent that you will need to measure the weight and height of the child later. Go to the next QUESTIONNAIRE FOR CHILDREN UNDER FIVE to be administered to the same respondent  No  End the interview with this respondent by thanking him/her for his/her cooperation and tell her/him that you will need to measure the weight and height of the child Check to see if there are other woman’s, man’s or under-5 questionnaires to be administered in this household. Move to another woman’s, man’s or under-5 questionnaire, or start making arrangements for anthropometric measurements of all eligible children in the household. AN6. Is there another child in the household who is eligible for measurement?  Yes  Record measurements for next child.  No  Check if there are any other individual questionnaires to be completed in the household. 
 
 MULTIPLE INDICATOR CLUSTER SURVEY 2011 INDONESIA: SELECTED DISTRICTS OF PAPUA PROVINCE MULTIPLE INDICATOR CLUSTER SURVEY 2011

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