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

Publication date: 2013

Indonesia SELECTED DISTRICTS OF WEST PAPUA PROVINCE Multiple Indicator Cluster Survey 2011 Monitoring the situation of children and women The Selected Districts of West 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 West 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 West Papua Province Multiple Indicator Cluster Survey 2011, Final Report. Jakarta, Indonesia: BPS. March, 2013 Indonesia SELECTED DISTRICTS OF WEST PAPUA PROVINCE Multiple Indicator Cluster Survey 2011 Monitoring the situation of children and women MULTIPLE INDICATOR CLUSTER SURVEY 2011 iii Multiple Indicator Cluster Surveys (MICS) and Millennium Development Goals (MDGs) Indicators, Selected Districts of West 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 4.1 4.2 4.1 4.2 4.3 6.7 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) 65 50 91.3 22.7 (41.3) (75.0) (65.5) (46.1) 25.2 43.9 45.9 41.3 71.2 51.1 12.0 47.3 79.2 38.4 33.1 53.6 31.9 62.4 53.0 37.2 46.6 36.1 81 60 90.9 23.2 (18.6) (*) (54.7) (30.6) 21.6 43.6 59.3 38.9 (86.2) 47.1 15.3 70.0 68.1 50.8 38.8 61.0 29.2 56.5 45.9 31.8 40.9 25.2 54 42 92.8 27.2 (43.9) (74.2) (*) (51.2) 22.5 41.9 62.7 46.4 (93.5) 70.4 14.4 63.3 95.9 87.0 69.9 88.9 67.6 76.4 52.0 44.0 64.3 45.6 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 Child mortality Breastfeeding and infant feeding Vitamin A Low birth weight Vaccinations Tetanus toxoid Solid fuel use Malaria Topic Indicator Kaimana Manokwari Sorong Value CHILD MORTALITY NUTRITION CHILD HEALTH SUMMARY TABLE OF FINDINGS MICS4 Indicator Number MDGs Indicator Number MULTIPLE INDICATOR CLUSTER SURVEY 2011iv 1 Results for child labour for age group 5-17 can be found in the report in Table CP.2 3.16 3.17 3.18 4.1 4.2 4.3 8.2 8.3 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 5.1 5.2 5.3 5.5a 5.5b 5.6 5.7 5.8 6.8 7.8 7.9 2.3 2.1 2.2 5.4 5.3 5.5 5.2 Malaria diagnostics usage Antimalarial treatment of children under 5 the same or next day Antimalarial treatment of children under age 5 Use of improved drinking water sources Water treatment Use of improved sanitation Birth registration Child labour School attendance among child labourers 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) 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 40.3 20.0 33.5 66.4 75.6 43.6 46.2 26.9 89.5 73.7 73.1 27.8 77.0 93.6 48.0 96.3 88.8 (80.7) 1.02 1.32 66 15.5 30.1 14.7 83.7 53.7 29.6 57.7 33.4 48.4 47.2 55.7 69.0 88.0 56.3 50.1 20.1 88.0 87.5 89.2 42.2 76.6 94.0 77.9 98.8 114.4 95.3 1.01 0.98 44 15.2 53.9 9.7 85.8 66.5 19.4 75.5 54.4 15.0 12.9 14.1 79.9 92.3 48.7 51.2 22.0 92.4 95.2 89.7 40.1 69.6 95.8 77.1 96.3 112.6 100.0 1.01 1.07 53 16.8 53.7 10.9 91.2 72.5 16.6 75.3 21.8 per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent ratio ratio per 1,000 per cent per cent per cent per cent per cent per cent per cent per cent Water and sanitation Birth registration Child labour (age 5-14)1 Literacy and education Contraception Maternal and newborn health Kaimana Manokwari Sorong Value WATER AND SANITATION CHILD PROTECTION EDUCATION REPRODUCTIVE HEALTH Topic IndicatorMICS4 Indicator Number MDGs Indicator Number MULTIPLE INDICATOR CLUSTER SURVEY 2011 v 8.4 8.5 8.6 8.7 8.8 8.10b 8.14 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.10 6.3 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 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 29.0 86.4 5.0 1.5 21.5 4.5 13.0 0.6 5.4 36.0 48.1 17.9 12.1 16.3 8.7 50.5 65.8 6.2 6.8 22.6 21.2 0.6 2.0 0.0 1.1 91.3 73.2 23.1 83.7 9.6 2.8 30.1 8.0 21.7 6.6 9.9 40.7 28.2 24.9 26.1 27.1 29.7 61.7 57.8 13.4 14.6 31.1 36.4 0.8 2.8 0.0 5.6 94.3 79.7 23.8 89.9 8.1 0.9 34.7 5.1 15.4 1.2 19.2 32.6 20.1 22.7 25.1 36.8 27.7 59.5 67.2 21.1 17.0 19.5 20.1 0.8 0.8 1.2 (2.2) 96.2 92.3 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 per cent per cent per cent per cent Child discipline Early marriage Domestic violence HIV/AIDS knowledge and attitudes Sexual behaviour Kaimana Manokwari Sorong Value HIV/AIDS, SEXUAL BEHAVIOUR, AND ORPHANED Topic IndicatorMICS4 Indicator Number MDGs Indicator Number MULTIPLE INDICATOR CLUSTER SURVEY 2011vi 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 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 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 3.6 3.7 6.3 5.5 0.4 6.4 20.1 3.6 58.9 5.8 7.7 41.4 0.5 21.5 0.5 5.9 6.6 4.6 15.0 1.5 0.2 4.5 27.9 4.0 38.3 9.6 7.3 47.3 2.4 19.4 1.9 9.4 2.8 1.1 26.4 (0.0) 0.1 1.9 (*) 4.2 (48.9) 6.6 5.5 68.4 0.2 10.1 0.0 3.8 per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent per cent Orphaned children Male circumcision Alcohol use Kaimana Manokwari Sorong Value ACOHOL USE Topic IndicatorMICS4 Indicator Number MDGs Indicator Number (*) Figures that are based on fewer than 25 unweighted cases MULTIPLE INDICATOR CLUSTER SURVEY 2011 vii 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 xiv xv 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 viii 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 2011 ix 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011x 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 and among women Table CP.5M: Early marriage and 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 Table HA.5: Knowledge of a place for HIV testing among women Table HA.5M: Knowledge of a place for HIV testing among men 80 81 83 85 86 87 88 89 91 92 93 94 95 96 98 101 104 106 109 110 112 113 114 116 118 119 123 124 125 126 128 129 130 131 133 134 MULTIPLE INDICATOR CLUSTER SURVEY 2011 xi 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: Kaimana District Table SE.3: Sampling errors: Manokwari District Table SE.4: Sampling errors: Sorong District 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: Per centage 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 aged 15-49 years married before their 15th birthday, percentage of women 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 2011 xiii AIDS BAPPENAS BCG BPS CDC CEDAW CRC DPT GPI Hep B HIV IUD LAM MDG MICS MICS4 MMR MoH NAR NCHS PPS PSU SD SPSS TFR UNFPA UNICEF WFFC WHO Acquired Immune Deficiency Syndrome Badan Perencanaan Pembangunan Nasional Bacillis-Cereus-Geuerin (Tuberculosis) Badan Pusat Statistik Center for Disease Control Convention on the Elimination of All Forms of Discrimination against Women Convention on the Rights of the Child Diptheria, Pertussis, and Tetanus Gender Parity Index Hepatitis B Human Immunodeficiency Virus Intrauterine Device Lactational Amenorrhea Method Millennium Development Goals Multiple Indicator Cluster Survey The fourth round of the Multiple Indicator Cluster Survey Measles, Mumps, and Rubella Ministry of Health Net Attendance Rate National Center for Health Statistics (USA) Probability Proportional to Size Primary Sampling Unit Standard Deviation Statistical Package for Social Sciences Total Fertility Rate United Nations Population Fund United Nations Children’s Fund World Fit For Children World Health Organization LIST OF ABBREVIATIONS MULTIPLE INDICATOR CLUSTER SURVEY 2011xiv MULTIPLE INDICATOR CLUSTER SURVEY 2011 xv The Selected Districts of West Papua Province Multiple Indicator Cluster Survey 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 Papua Province. The Selected Districts of West Papua Province Multiple Indicator Cluster Survey 2011 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 Kaimana, Manokwari and Sorong. 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, conducting 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 was 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 committment 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 West Papua Province Papua Province SIX SELECTED MICS DISTRICTS IN PAPUA AND WEST PAPUA PROVINCES MULTIPLE INDICATOR CLUSTER SURVEY 2011 xvii The Selected Districts of West Papua Province Multiple Indicator Cluster Survey (MICS) is a sample survey of households, women, men and children covering the districts of Kaimana, Manokwari and Sorong. 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 50, 60 and 42 per thousand in the districts of Kaimana, Manokwari and Sorong respectively. The probabilities of dying under age 5 (U5MR) are 65, 81 and 54 per thousand in the districts of Kaimana, Manokwari and Sorong respectively. NUTRITION Breastfeeding. Women in Kaimana were the least likely to start breastfeeding within one day (45 per cent) compared with women in Manokwari (69 per cent) and Sorong (51 per cent) (Figure NU.1). Breastfeeding within one hour was higher in Sorong District (27 per cent) than in Kaimana and Manokwari (23 per cent for each). Exclusive and predominant breast feeding is higher in Sorong District (44 and 51 per cent respectively) compared with the other two districts (Kaimana: 41 and 46 respectively; Manokwari: 19 and 31 respectively). Appropriate feeding among children aged 6-23 months is highest in Sorong District (47 per cent) compared with Manokwari (39 per cent) and Kaimana (41 per cent) districts. There are more children age 6-23 months in Sorong (52 per cent) and Manokwari (45 per cent) districts were receiving solid, semi-solid and soft foods the minimum number of times compared with those in Kaimana (46 per cent). About 44 per cent of children under 6 months are fed using a bottle with a nipple each in Kaimana and Manokwari districts compared with 42 per cent in Sorong District. Vitamin A supplements. Vitamin A supplementation coverage, within the six months prior to the survey, was considerable lower in Manokwari District (47 per cent) and Kaimana District (51 per cent) compared with Sorong District (71 per cent). Low birth weight. The lowest estimated percentage of infants weighing less than 2,500 grams at birth was in Kaimana (12 per cent) compared with 14 per cent in Sorong and 15 per cent in Manokwari districts. EXECUTIVE SUMMARY MULTIPLE INDICATOR CLUSTER SURVEY 2011xviii CHILD HEALTH Immunization. Manokwari District tended to have low coverage for most of the vaccinations with full vaccination coverage at any time up to the date of the survey being 20 per cent. Levels of full vaccination coverage in Kaimana and Sorong districts were 22 and 46 per cent respectively. Tetanus toxoid. Tetanus toxoid coverage among women age 15-49 years with a live birth in the last 2 years is lowest in Manokwari District (Kaimana, 62 per cent; Manokwari, 57 per cent; Sorong, 76 per cent). Solid fuel use. Use of solid fuels generally does not vary much among districts (Kaimana, 53 per cent; Manokwari, 46 per cent; Sorong, 52 per cent). Almost all solid fuel use in each district is from wood. Malaria. Differentials exist in the households availability of ITNs among districts where the availability is lowest in Manokwari District (32 per cent) and highest in Sorong District (44 per cent). The percentage of this indicator is 37 per cent in Kaimana 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 lower in Manokwari District (41 and 25 per cent respectively). These percentages are 47 per cent and 36 per cent for Kaimana and 64 per cent and 46 per cent for Sorong District. Compared with Manokwari District, Kaimana and Sorong districts were lacking anti- malarial treatment. The percentages of children receiving any anti-malarial drug on the same or next day in Kaimana and Sorong (20 and 13 per cent respectively) were about half that observed in Manokwari District (47 per cent). 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 lowest in Sorong District (15 per cent) compared with 40 per cent in Kaimana and 48 per cent in Manokwari District. WATER AND SANITATION Water. The situation in Sorong District is better than in other districts; 80 per cent of the population in this district gets its drinking water from an improved source, mostly from rainwater collection (48 per cent) and bottled water (18 per cent). The percentage of population getting its drinking water from improved sources in Manokwari and Kaimana districts are 69 and 66 per cent respectively. Although Kaimana District shows the lowest percentage of people using an improved source of drinking water, the district has the highest percentage of households where people drink water that is piped into their dwelling or into their yard or plot (20 per cent). These percentages are nine and two per cent for Manokwari and Sorong respectively. In Manokwari District, the most common improved sources of drinking water are bottled water (19 per cent), tube well or borehole (14 per cent) and protected well (13 per cent). Household members in Kaimana District show 76 per cent use of appropriate water treatment methods while this percentage is 88 and 92 per cent in Manokwari and Sorong districts respectively. MULTIPLE INDICATOR CLUSTER SURVEY 2011 xix Time and person to obtain water. Most of the households in Sorong have an improved drinking water source on the premises (75 per cent). This is higher than households in Kaimana and Manokwari (57 per cent each). For household users of unimproved drinking water sources it takes more than 30 minutes to get to the water source and bring water for six per cent of households in Kaimana District. Lower percentages in this indicator were observed in Manokwari (1 per cent) and Sorong (3 per cent) districts. More adult women in Manokwari (60 per cent) and Sorong (56 per cent) districts collect water than adult men and children. In Kaimana District slightly more men (52 per cent) than adult women (44 per cent) collect water. Collection of water by children is not common. Sanitation. About one-fourth of the population Kaimana District has no facility or uses bushes or fields (25 per cent). No facility or use of bushes or fields is much less common in Manokwari (13 per cent) and Sorong (5 per cent). About 68, 73 and 69 per cent of the population in Kaimana, Manokwari and Sorong districts respectively use facilities that flush to a septic tank or pit (latrines). About 56 per cent of the household population in Manokwari District is using an improved sanitation facility which is not shared; higher than in Sorong District (49 per cent) and higher than in Kaimana (44 per cent). REPRODUCTIVE HEALTH Fertility. TFR is highest in Kaimana District (3.2 children per woman) and lowest in Sorong District (2.8 children per woman). TFR in Manokwari District is 3.1 children per woman. The adolescent birth rate is higher in Kaimana District (66 births per 1,000 women) than in Sorong (53 births per 1,000 women) and Manokwari (44 births per 1,000 women). Early childbearing. The percentage of women aged 20-24 years who gave birth before age 18 did not vary much among districts (Kaimana, 16 per cent; Manokwari, 15 per cent; Sorong, 17 per cent). Contraception. The lowest current usage was seen in Kaimana District (30 per cent), (mostly modern methods) compared with 54 per cent each in Manokwari and Sorong districts, where women are also mostly using modern methods. The most popular methods in Kaimana District are IUD (18 per cent) and implants (9 per cent). The most popular methods in Manokwari are IUD (29 per cent) and implants (11 per cent). The most popular methods in Sorong are IUD (31 per cent) and implants (14 per cent). Antenatal care. Coverage of antenatal care (by a doctor, nurse or midwife) is higher in Sorong District (91 per cent) than Manokwari District (86 per cent) and Kaimana District (84 per cent). Within Kaimana and Sorong districts, antenatal care is provided mostly by midwives, while in Manokwari antenatal care is provided mostly by doctors. The percentage of mothers who received antenatal care at least four times was 54, 67 and 73 per cent in Kaimana, Manokwari and Sorong districts respectively. MULTIPLE INDICATOR CLUSTER SURVEY 2011xx Women living in Manokwari (19 per cent) and Sorong (17 per cent) districts were less likely to have all three tests made than those living in Kaimana District (30 per cent). These tests are: taking blood sample, checking blood pressure and taking urine specimen. Assistance at delivery. The percentages of babies who were delivered by skilled personnel were 58, 76 and 75 per cent in Kaimana, Manokwari and Sorong districts respectively. These deliveries were mostly assisted by midwives. Delivery in a health facility. The percentages of babies delivered in a health facility were 33, 54 and 22 per cent in Kaimana, Manokwari and Sorong districts respectively. LITERACY AND EDUCATION Literacy among young women and men. The lowest literacy rate among women was found in Kaimana District (74 per cent), compared with 88 per cent in Manokwari and 95 per cent in Sorong districts. For men, literacy rates among the three were similar to those among women, except that in Sorong District (89 per cent) slightly fewer men are literate than women (95 per cent). School readiness. About 42 per cent of children in Manokwari who are currently attending the first grade of primary school were attending pre-school the previous year. This compares with 40 per cent in Sorong and 28 per cent in Kaimana. Net intake rate in primary education. Of children who are of primary school entry age (age 7), 77 per cent are attending the first grade of primary school in Kaimana and Manokwari districts. This indicator is 70 per cent in Sorong District. Net primary school attendance rate. The majority of children of primary school age in Kaimana (94 per cent), Manokwari (94 per cent) and Sorong (96 per cent) are attending primary school or secondary school. Net secondary school attendance rate. The survey ranks the secondary school net attendance ratio in Kaimana as the lowest and shows a striking 48 per cent of children of secondary school age who are out of school. 24 per cent are still in primary school, while 28 per cent are out of school. Net secondary school attendance rates are 77 and 78 per cent in Sorong and Manokwari districts respectively. 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 in Kaimana (88 per cent) with the highest rates in Manokwari (114 per cent). The primary completion rate in Sorong is 113 per cent. Transition rate to secondary school. High percentages of children that completed successfully the last grade of primary school were found at the moment the survey to be attending the first grade of secondary school (Kaimana, 81 per cent; Manokwari, 95 per cent; Sorong, 100 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 2011 xxi Gender parity index. The gender parity for primary school is 1.02, 1.01 and 1.01 in Kaimana, Manokwari and Sorong districts respectively, i.e. girls and boys similarly attend primary school. The gender parity for secondary school is 1.34, 0.99 and 1.05 in Kaimana, Manokwari and Sorong districts respectively. This shows that far more girls in Kaimana attend secondary school. CHILD PROTECTION Birth registration. Birth registration is generally slightly lower in Kaimana District (46 per cent) compared with Manokwari (51 per cent) and Sorong (50 per cent) districts. Child labour. Child labour is 24, 22 and 22 per cent in Kaimana, Manokwari and Sorong districts respectively. 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 (Kaimana, 86 per cent; Manokwari, 84 per cent; Sorong, 90 per cent). More importantly, 23 per cent of children were subjected to severe physical punishment (Kaimana, 31 per cent; Manokwari, 23 per cent; Sorong, 18 per cent). Early marriage. The percentage of women age 15-19 years who are currently married or in union is higher in Manokwari (22 per cent) and lower in Kaimana District (13 per cent). In Sorong District, 15 per cent of women 15-19 are currently married or in union. The percentage of women aged 20-49 years married before age 18 was higher in Sorong District (35 per cent) than Kaimana District (22 per cent) and Manokwari District (30 per cent). Among men, marriage/union before age 18 is not common, but it is higher in Manokwari District (8 per cent) than in Kaimana and Sorong districts (5 per cent each). About 19 per cent of women age 20-24 in Sorong District are currently married to a man who is older by ten years or more. This compares with much lower percentages in Manokwari (10 per cent) and Kaimana districts (5 per cent). Domestic Violence. Differences in the percentage of women who believe that a husband is justified to beat his wife were clear among districts. 41 per cent of women in Manokwari District accept this type of violence. This percentage is reduced in Sorong and Kaimana districts to 33 and 36 per cent respectively. Domestic violence is lower among men in Manokwari (28 per cent) than among women (41 per cent) and higher among men in Kaimana (48 per cent) than among women (36 per cent). In Sorong, more women justify domestic violence (33 per cent) than men (20 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 2011xxii HIV/AIDS, SEXUAL BEHAVIOUR AND ORPHANS Knowledge of HIV transmission. Lower percentages of the interviewed women have heard of AIDS in Kaimana District than in the other two districts (Kaimana, 64 per cent; Manokwari, 84 per cent; Sorong, 72 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 much lower in Kaimana District (18 per cent) than in Manokwari (25 per cent) and Sorong (23 per cent). Comprehensive knowledge among men age 15-49 is lower in Kaimana District (12 per cent) compared than in Manokwari (26 per cent) and Sorong (25 per cent) districts. Knowledge of mother-to-child transmission of HIV. Knowledge of mother-to-child HIV transmission among women was highest in Manokwari (62 per cent) and lowest in Kaimana (51 per cent). This indicator was 60 per cent in Sorong District. Knowledge of mother-to-child HIV transmission from mother to child was generally higher among men than women. Attitudes toward people living with HIV. The percentage of women agreeing to all accepting attitudes is highest in Sorong District (21 per cent) compared with Manokwari District (13 per cent) and Kaimana District (6 per cent). Accepting attitudes toward people living with HIV/AIDS were generally similar among men. Knowledge of where to be tested for HIV. Very small numbers of women age 15-49 have been tested and told their result in Kaimana (0.6 per cent), Manokwari and Sorong (0.8 per cent each). The percentages of men who have been tested and told their result were slightly higher (Kaimana, 2 per cent; Manokwari, 3 per cent; Sorong, 1 per cent). Very small numbers of young women, were tested in the last 12 months and have been told their result. Among young men, a higher percentage of men have been tested in the last 12 months and told their result in Manokwari District (6 per cent) than in the other two districts. Sexual Behaviour Related to HIV Transmission. About seven per cent of never-married women age 15-24 years in Manokwari District had sex before age 15. This compares with to lower percentages in Kaimana (4 per cent) and Sorong districts (3 per cent). About five per cent of men in Manokwari District had sex before age 15. This compares to with lower percentages in Kaimana (4 per cent) and Sorong districts (1 per cent). Sex with multiple partners. Sex with multiple partners is higher among men than among women in the same age category. A Negligible number of women 15-49 in each of the three districts reported having sex with more than one partner in last 12 months. Six, five and two per cent of men 15-49 in Kaimana, Manokwari and Sorong respectively reported having sex with more than one partner in last 12 months. Results among men age 15-24 years men were higher than those among men 15-49 years. MULTIPLE 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 a non-marital, non-cohabiting partner in the last 12 months among women 15-24 is similar among the three districts (4 per cent each). This indicator is considerably higher among men than among women where 59 per cent of young men age 15-24 years in Kaimana had sex with a non-marital, non-cohabiting partner in the last 12 months, compared with 38 per cent in Manokwari District and 49 per cent in Sorong District. Orphaned Children.2 Higher percentages of orphans were found in Kaimana (8 per cent) and Manokwari (7 per cent) districts than in Sorong District (6 per cent). Male circumcision. Circumcision is more prevalent in Sorong District (68 per cent) than in Manokwari (47 per cent) and Kaimana districts (41 per cent). In each district, most circumcision was performed at home by a health worker/professional. Alcohol use. About two per cent of women age 15-49 years in the district of Manokwari had at least one drink of alcohol on one or more days during the last one month. This is compared with less than one per cent each in the districts of Kaimana (0.5 per cent) and Sorong (0.2 per cent). Alcohol use is considerably higher among men in the same age group with about one fifth of men age 15-49 years in Kaimana District (22 per cent) reporting having at least one drink of alcohol on one or more days during the last one month. This compares with percentages of 19 and 10 in Manokwari and Sorong districts respectively. MULTIPLE INDICATOR CLUSTER SURVEY 2011xxiv MULTIPLE INDICATOR CLUSTER SURVEY 2011 1 1 INTRODUCTION 1.1. BACKGROUND This report is based on the Selected Districts of West 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 West Papua Province: Kaimana, Manokwari and Sorong, 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 West 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 the 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) MULTIPLE INDICATOR CLUSTER SURVEY 20112 “…We will conduct periodic reviews at the national and subnational levels of progress in order to address obstacles more effectively and accelerate actions.…” (A World Fit for Children, paragraph 61) The Plan of Action (paragraph 61) also calls for the specific involvement of UNICEF in the preparation of periodic progress reports: “… As the world’s lead agency for children, the United Nations Children’s Fund is requested to continue to prepare and disseminate, in close collaboration with Governments, relevant funds, programmes and the specialized agencies of the United Nations system, and all other relevant actors, as appropriate, information on the progress made in the implementation of the Declaration and the Plan of Action.” Similarly, the Millennium Declaration (paragraph 31) calls for periodic reporting on progress: “…We request the General Assembly to review on a regular basis the progress made in implementing the provisions of this Declaration, and ask the Secretary- General to issue periodic reports for consideration by the General Assembly and as a basis for further action.” This final report presents the results of the indicators and topics covered in the survey. 1.2. SURVEY OBJECTIVES The 2011 Selected Districts of West 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 West 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011 3 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 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 5 2 SAMPLE AND SURVEY METHODOLOGY 2.1. SAMPLE DESIGN The sample for the 2011 Selected Districts of West 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 Kaimana, Manokwari and Sorong 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 20116 • 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 West Papua Province MICS questionnaires is provided in Appendix F. 2.3. TRAINING AND FIELDWORK Training of trainers for the field was conduct for 12 days during 4-15 July 2011 in Bogor. Enumerators training was conducted in Jayapura 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 a half days in practice interviewing in Manokwari District. The data were 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 2011 7 2.4. DATA PROCESSING Data was entered using the CSPro software. The data was entered on 12 microcomputers and 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 programs developed under the global MICS4 programme and adapted to the Selected Districts of West Papua Province 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 9 3 SAMPLE COVERAGE AND THE CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS 3.1. SAMPLE COVERAGE Of the 2,913 households selected for the three districts sample, 2,843 were found to be occupied. Of these, 2,816 were successfully interviewed for a household response rate of 99.1 per cent. In the interviewed households, 2,853 women (age 15-49 years) were identified. Of these, 2,715 were successfully interviewed, yielding a response rate of 95.2 per cent within interviewed households. In addition, 2,917 men (age 15-49 years) were listed in the household questionnaire. Questionnaires were completed for 2,736 of eligible men, a response rate of 93.8 per cent within interviewed households. There were 1,394 children under age five listed in the household questionnaire. Questionnaires were completed for 1,354 of these children, a response rate of 97.1 per cent within interviewed households. Overall response rates of 94.3, 92.9 and 96.2 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 Kaimana, Manokwari and Sorong, whereas the women, men and children response rates were generally lower in the district of Manokwari. Households Sampled Occupied Interviewed Household response rate Women Eligible Interviewed Women’s response rate Women’s overall response rate Men Men Eligible Men 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 873 851 840 98.7 936 891 95.2 94.0 952 877 92.1 90.9 394 383 97.2 96.0 2,040 1,992 1,976 99.2 1,917 1,824 95.1 94.4 1,965 1,859 94.6 93.8 1,000 971 97.1 96.3 990 961 943 98.1 959 922 96.1 94.3 999 955 95.6 93.8 533 527 98.9 97.0 923 896 889 99.2 946 868 91.8 91.0 961 876 91.2 90.4 418 391 93.5 92.8 1,000 986 984 99.8 948 925 97.6 97.4 957 905 94.6 94.4 443 436 98.4 98.2 2,913 2,843 2,816 99.1 2,853 2,715 95.2 94.3 2,917 2,736 93.8 92.9 1,394 1,354 97.1 96.2 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Area Urban Rural Kaimana Sorong TotalManokwari District MULTIPLE INDICATOR CLUSTER SURVEY 201110 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 3.2. CHARACTERISTICS OF HOUSEHOLDS The age and sex distribution of the three districts survey population is provided in Table HH.2. In the 2,816 households successfully interviewed in the survey, 11,667 household members were listed. Of these, 5,990 were males and 5,659 were females. The age structure of the selected three districts of West Papua is experiencing substantial 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 43 per cent of the population in the three districts is comprised of children 0-17 years. 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 1,342 1,542 1,456 1,007 769 926 982 875 747 595 521 346 233 138 93 52 33 10 4,340 7,001 326 4,962 6,706 11,667 8 5 3 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 17 0 2 17 2 19 658 758 676 491 418 490 473 427 334 279 245 156 110 63 46 23 7 4 2,092 3,424 142 2,386 3,273 5,659 676 779 777 516 352 436 508 448 413 316 275 190 124 75 48 29 24 6 2,231 3,577 182 2,559 3,431 5,990 11.5 13.2 12.5 8.6 6.6 7.9 8.4 7.5 6.4 5.1 4.5 3.0 2.0 1.2 0.8 0.4 0.3 0.1 37.2 60.0 2.8 42.5 57.5 100.0 44.6 27.0 17.5 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 10.9 0.0 89.1 0.0 10.9 89.1 10.9 100.0 11.6 13.4 11.9 8.7 7.4 8.7 8.4 7.5 5.9 4.9 4.3 2.8 1.9 1.1 0.8 0.4 0.1 0.1 37.0 60.5 2.5 42.2 57.8 100.0 11.3 13.0 13.0 8.6 5.9 7.3 8.5 7.5 6.9 5.3 4.6 3.2 2.1 1.3 0.8 0.5 0.4 0.1 37.3 59.7 3.0 42.7 57.3 100.0 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 TotalMissingFemaleMale Per centPer centPer centPer cent NumberNumberNumberNumber MULTIPLE INDICATOR CLUSTER SURVEY 2011 11 District Kaimana Manokwari Sorong 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 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 943 889 984 2,478 338 840 1,976 240 377 556 622 427 281 158 57 45 53 220 982 1,253 359 2 1,265 828 352 253 111 7 2,816 2,816 2,816 2,816 2,816 2,816 15.9 58.2 25.9 88.2 11.8 24.7 75.3 8.5 13.7 19.2 21.2 15.9 9.6 5.8 2.2 1.7 2.2 7.4 33.7 44.2 14.6 0.0 43.7 33.3 12.1 6.2 4.4 0.3 100.0 36.8 74.3 81.1 79.0 4.1 448 1,638 730 2,485 331 697 2,119 238 387 540 597 449 271 163 63 47 61 208 950 1,245 412 1 1,231 937 342 174 124 9 2,816 2,816 2,816 2,816 2,816 2,816 Table HH.3: Household composition Per cent and frequency distribution of households by selected characteristics, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of households Weighted per cent Weighted Unweighted 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, region, 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. MULTIPLE INDICATOR CLUSTER SURVEY 201112 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. 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 16 per cent of the three districts West Papua sample resides in Kaimana, 58 per cent reside in Manokwari and 26 per cent reside in Sorong. Most of the households consisted of 4 members (21 per cent) and the mean household size is four members. About 44 per cent of the survey sample consisted of households with Papuan heads, followed by Javanese heads of households, who accounted for about one third of the survey sample (33 per cent). The remaining 23 per cent of the survey sample was headed by other ethnic groups from: Sulawesi, Maluku and others. Thirty-seven per cent of the households contained at least one child under-five years of age, 81 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. There seems to be oversampling in Kaimana and Sorong districts and some undersampling in Manokwari District. 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 un-weighted 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 of residence, age, marital status, motherhood status, births in last two years, education,5 wealth index quintiles6 and ethnicity of the household head. MULTIPLE INDICATOR CLUSTER SURVEY 2011 13 Table HH.4: Women’s background characteristics Per cent and frequency distribution of women age 15-49 years by selected background characteristics, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong 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 Missing Total for 3 districts 922 868 925 891 1,824 437 377 495 435 392 326 253 1,998 61 43 41 572 1,988 727 519 2,196 150 836 1,364 365 580 540 484 559 552 1,216 760 340 289 106 4 2,715 15.6 60.3 24.1 28.1 71.9 17.1 14.6 17.0 16.3 14.2 11.2 9.5 73.2 1.8 1.3 1.8 21.9 72.2 27.8 18.0 82.0 4.9 28.1 51.6 15.3 17.2 18.5 18.2 23.6 22.6 44.6 31.7 12.3 7.2 4.0 0.2 100.0 423 1,638 654 763 1,952 465 395 462 443 387 305 259 1,987 50 35 49 594 1,959 756 489 2,226 134 764 1,402 415 467 502 493 640 614 1,212 860 333 197 107 7 2,715 Number of women Weighted per cent Weighted Unweighted MULTIPLE INDICATOR CLUSTER SURVEY 201114 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 of residence, age, marital status, motherhood status, births in last two years, education, wealth index quintiles and ethnicity of the household head. About 15 per cent of female respondents 15-49 years of age live in Kaimana, 60 per cent in Manokwari and 24 per cent in Sorong. About 28 per cent of these women live in urban areas while the remaining 72 per cent live in rural areas. Of the 2,715 successfully interviewed women, 1,987 women (73 per cent) were currently married or in union, 594 women (22 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 had give birth while 28 per cent never had. To assess their education, women were asked about the highest level of school they had reached. About five per cent of all women had never attended any form of education. The majority (42 per cent) of all women have junior or senior secondary (SMP/SM) education, 28 per cent have primary education and only 15 per cent have higher than secondary education. Weighted and un-weighted number of cases were generally similar except for districts. 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 of residence, 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 (33 per cent) whereas almost all of the remaining survey sample were currently married or in union (65 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 similar to that of female children (50 per cent and 49 per cent respectively). About one per cent of responses did not list the child’s sex. About one-fifth of children were under one year of age (20 per cent), 19 per cent were 12-23 months, 22 per cent were 24-35 months, 21 per cent were 36-47 months and 19 per cent were 48-59 months. The majority (76 per cent) of these children reside in rural areas whereas 24 per cent reside in urban areas. Six per cent of children’s mothers or care takers were uneducated, 30 per cent had primary education, 53 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 2011 15 Table HH.4M: Men’s background characteristics Per cent and frequency distribution of men age 15-49 years by selected background characteristics, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong 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 955 876 905 877 1,859 453 322 409 467 404 383 298 1,776 26 22 29 883 85 702 1,560 389 623 528 533 530 522 1,207 787 365 263 109 5 2,736 16.0 60.2 23.8 26.7 73.3 17.4 11.6 14.2 17.5 15.0 13.7 10.6 64.6 0.6 0.7 1.1 33.0 2.7 22.9 57.6 16.8 18.2 18.3 21.6 21.1 20.9 43.4 33.1 12.2 6.2 4.7 0.3 100.0 437 1,647 652 732 2,004 477 317 388 479 410 374 291 1,767 17 20 31 902 74 625 1,576 460 498 499 591 576 571 1,189 906 333 171 129 9 2,736 Number of men Weighted per cent Weighted Unweighted MULTIPLE INDICATOR CLUSTER SURVEY 201116 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong 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 Missing/DK Total for 3 districts 527 391 436 693 653 383 971 115 135 273 290 291 250 94 438 683 139 406 288 247 209 204 741 280 137 145 49 2 1,354 19.4 56.1 24.5 50.2 49.2 24.3 75.7 8.9 10.6 19.0 21.5 20.6 19.3 6.3 30.0 52.6 11.0 23.5 20.1 20.4 17.2 18.7 53.7 24.6 10.5 7.2 3.7 0.3 100.0 262 760 332 679 666 329 1,025 121 143 257 292 280 261 85 407 713 150 319 272 277 234 253 727 333 142 98 50 4 1,354 Number of under-5 children Weighted per cent Weighted Unweighted * Mother’s education refers to educational attainment of mothers and caretakers of children under 5. MULTIPLE INDICATOR CLUSTER SURVEY 2011 17 4 CHILD MORTALITY 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. 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 of 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 estimateds should be undertaken with caution. Table CM.2 provides estimates of child mortality. The infant mortality rates are estimated at 50, 60 and 42 per thousand in the districts of Kaimana, Manokwari and Sorong respectively. The probabilities of dying under age 5 (U5MR) are 65, 81 and 45 per thousand in the districts of Kaimana, Manokwari and Sorong 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 clear a disadvantage in Manokwari District compared with Kaimana and Sorong. The overall combined three districts infant and under- five mortality rates were 54 and 72 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 Papua Province for the 10-year period preceding the survey using the direct method of mortality estimation. MULTIPLE INDICATOR CLUSTER SURVEY 201118 Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total for 3 districts 0.136 0.868 1.863 2.602 3.231 3.830 3.988 2.161 0.133 0.786 1.754 2.394 2.980 3.524 3.588 1.988 63 343 860 1,152 1,249 1,168 1,032 5,867 62 311 810 1,060 1,152 1,075 929 5,398 0.023 0.094 0.058 0.080 0.077 0.080 0.100 0.080 465 395 462 443 387 305 259 2,715 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 Kaimana, Manokwari and Sorong, Papua, Indonesia, 2011 Children ever born Total TotalMean Mean Children surviving Proportion dead Number of women District Kaimana Manokwari Sorong 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 50 60 42 65 43 46 57 55 70 47 29 74 57 22 61 44 70 35 54 65 81 54 86 57 59 76 73 96 61 36 103 76 28 82 57 96 43 72 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 Table CM.2: Child mortality Infant and under-five mortality rates, West Model, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 MULTIPLE 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 higher in rural areas compared with urban. As expected, a sharp negative association between mortality and education is observed; for example the under-five mortality rate decreased from 73 per thousand for children with uneducated mothers to 36 per thousand for children with mothers with higher education. Similarly under-five mortality rate decreased sharply from 103 per thousand among children living in the poorest households to 57 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest Ethnicity Papuan Other 0 40 8020 60 100 120 Per 1,000 live births 65 54 59 76 76 82 73 96 61 36 28 96 57 43 103 81 MULTIPLE INDICATOR CLUSTER SURVEY 201120 MULTIPLE INDICATOR CLUSTER SURVEY 2011 21 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 folowing 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 23 per cent of babies in the three selected districts of West Papua were breastfed for the first time within one hour of birth, while 61 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 day of birth. Women in Kaimana were the least likely to start breastfeeding within one day (45 per cent), compared with women in Manokwari (69 per cent) and Sorong (51 per cent) (Figure NU.1). MULTIPLE INDICATOR CLUSTER SURVEY 201122 Breastfeeding within one hour was highest in Sorong District (27 per cent) than in Kaimana and Manokwari (23 per cent for each). Children born in private hospitals (29 per cent) were more likely to be initially breastfed appropriately within one hour compared with those born in public sector hospitals (20 per cent) and those born at home (26 per cent). Children born to mothers with no education were more likely to be initially breastfed within one hour compared with children born to mothers with higher education. Figure NU.1: Percentage of mothers who started breastfeeding within one hour and within one day of birth, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 100 90 80 70 60 50 40 30 20 10 0 Within one hourWithin one day P er c en t Three districts SorongManokwariKaimana RuralUrban In Table NU.2, breastfeeding status is based on the reports of mothers/caretakers of children’s consumption of food and fluids during the previous day or night prior to the interview. Exclusively breastfed refers to infants who received only breast milk (and vitamins, mineral supplements, or medicine). The table shows exclusive breastfeeding of infants during the first six months of life, as well as continued breastfeeding of children at 12-15 and 20-23 months of age. For the three districts of West Papua, only 28 per cent of children aged less than six months are exclusively breastfed and 37 per cent are predominantly breastfed. Exclusive and predominant breast feeding are higher in Sorong District (44 and 51 per cent respectively) compared with the other two districts (Kaimana: 41 and 46 respectively; Manokwari: 19 and 31 respectively). At age 12-15 months, 62 per cent of the children are breastfed, while this percentage is 55 per cent for children aged 20-23 months. It should be noted that these figures should be treated with caution due to the small number of cases observed. Continued breastfeeding indicators by background characteristics are not reported due to the 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, about half a month for exclusive breastfeeding and about half a month for predominant breastfeeding. Results show that the median duration of breastfeeding was lowest in Kaimana District (25 months) compared with Manokwari (22 months) and Sorong (23 months) districts. The median duration of breastfeeding showed a negative correlation with mothers’ education, being considerably lower among mothers with higher education (10 months), 45 69 59 61 60 23 24 2727 2323 51 MULTIPLE INDICATOR CLUSTER SURVEY 2011 23 District Kaimana Manokwari Sorong 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 Other/Missing 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 91.3 90.9 92.8 83.5 94.1 94.5 87.5 93.0 96.0 98.4 (*) 92.1 (100.0) 94.8 (*) 96.4 88.7 91.8 93.4 95.3 90.1 91.8 92.5 86.3 94.3 90.5 85.1 83.8 (*) 91.4 22.7 23.2 27.2 27.0 22.9 21.3 25.0 24.2 15.1 31.5 (*) 19.8 (29.4) 25.9 (*) 46.5 24.4 22.7 20.5 24.1 24.3 26.0 22.0 22.9 24.0 25.8 19.3 17.7 (*) 23.9 44.5 69.4 51.0 59.2 60.9 60.1 59.9 60.3 54.3 75.3 (*) 61.9 (55.7) 62.6 (*) 78.2 49.3 64.8 58.4 58.6 63.5 54.9 64.2 62.2 67.6 55.0 51.5 44.5 (*) 60.5 99 287 102 124 365 255 223 351 49 68 21 173 38 254 23 23 128 272 67 109 96 103 93 87 251 128 59 34 15 489 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 * 2 cases 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 201124 while that median was 25 months among women with no education. A similar negative correlation was also observed between duration of breastfeeding and wealth. The adequacy of infant feeding in children under 24 months is provided in Table NU.4. Different criteria of feeding are used depending on the age of the child. For infants aged 0-5 months, exclusive breastfeeding is considered as age-appropriate feeding, while infants aged 6-23 months are considered to be appropriately fed if they are receiving breastmilk and solid, semi-solid or soft food. As a result of these feeding patterns, fewer than half of the children aged 6-23 months are being appropriately fed (45 per cent). The level of age-appropriate feeding is highest in Sorong District (47 per cent), compared with Manokwari (46 per cent) and Kaimana (41 per cent) districts. Appropriate feeding was higher among children residing in rural areas (46 per cent) compared with urban areas (42 per cent). Appropriate feeding varied unsystematically according to mother education and wealth (Figure NU.2). Similar patterns were observed for children age 0-23 months. District Kaimana Manokwari Sorong Sex Male Female Area Urban Rural Total for 3 districts (41.3) (18.6) (43.9) 35.9 18.4 (21.1) 28.9 27.5 (46.1) (30.6) (51.2) 48.0 25.9 (21.1) 40.7 37.2 (75.0) (*) (74.2) (59.2) (68.7) (53.3) 66.2 62.2 (65.5) (54.7) (*) (65.4) (45.8) (20.1) 66.9 54.9 25 76 21 60 60 21 100 121 19 36 18 47 26 23 50 73 16 56 18 42 48 23 67 90 Table NU.2: Breastfeeding Percentage of living children according to breastfeeding status at selected age groups, Districts of Kaimana, Manokwari and Sorong, West 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 * 2 cases 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 2.6 2 MICS indicator 2.9 3 MICS indicator 2.7 4 MICS indicator 2.8 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 breastmilk 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011 25 District Kaimana Manokwari Sorong 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) 25.2 21.6 22.5 23.3 20.7 9.9 23.5 23.7 23.4 22.6 9.7 25.3 27.8 22.1 16.2 15.1 23.5 19.9 7.9 23.8 (*) 22.4 19.7 0.7 0.5 0.7 0.7 0.5 0.5 0.6 2.2 0.5 0.6 0.5 2.5 0.6 0.5 0.4 0.5 0.6 0.4 1.6 0.7 (*) 0.6 1.8 2.1 0.5 1.7 0.7 0.5 0.5 0.6 2.2 0.5 0.6 0.5 3.2 0.6 0.5 0.4 0.5 0.6 0.4 2.0 0.7 (*) 0.6 3.2 162 466 185 392 415 208 606 51 240 427 95 188 158 170 143 155 447 198 86 58 22 813 813 Table NU.3: Duration of breastfeeding Median duration of any breastfeeding, exclusive breastfeeding, and predominant breastfeeding among children age 0-35 months, Districts of Kaimana, Manokwari and Sorong, West 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 fewer than 25 unweighted cases 1 MICS indicator 2.10 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. Overall, 51 per cent of infants age 6-8 received solid, semi-solid, or soft foods (Table NU.5). Among currently breastfeeding infants this percentage is 41, while it is 87 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, more than half of the children age 6-23 months (57 per cent) were receiving solid, semi-solid and soft foods the minimum number of times (Kaimana, 44 per cent; Manokwari, 44 per cent; Sorong, 42 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 201126 Table NU.4: Age-appropriate breastfeeding Percentage of children age 0-23 months who were appropriately breastfed during the previous day, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 * 2 cases 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 2.6 2 MICS indicator 2.14 District Kaimana Manokwari Sorong 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 (41.3) (18.6) (43.9) 35.9 18.4 (21.1) 28.9 (*) (39.2) 20.2 (*) (50.5) (*) (*) (*) (*) 28.0 (*) (*) (*) 27.5 25 76 21 60 60 21 100 11 27 68 16 28 22 22 23 25 77 20 18 6 121 41.3 38.9 46.4 46.1 36.3 38.0 41.9 (54.1) 39.9 43.1 25.2 48.7 36.6 46.6 34.7 34.1 43.2 40.8 28.4 49.6 (*) 40.9 41.3 45.6 47.0 49.4 41.5 41.5 46.2 (*) 40.0 50.3 (24.5) 48.2 39.1 52.3 42.7 40.2 48.7 43.2 (33.2) (50.2) (*) 45.0 83 230 87 191 206 105 296 26 114 215 45 103 85 85 63 65 213 111 37 27 10 401 108 306 107 252 266 126 395 37 141 283 61 131 107 107 86 91 290 131 55 34 10 522 Children age 0-5 months Children age 6-23 months Children age 0-23 months Per cent exclusively breastfed1 Per cent currently breastfeeding and receiving solid, semi-solid or soft foods Per cent appropriately breastfed2 Number of children Number of children Number of children The continued practice of bottle-feeding is a concern due to possible contamination due to by unsafe water and lack of hygiene in preparation. Table NU.7 shows that 43 per cent of children under 6 months are fed using a bottle with a nipple (Kaimana, 44 per cent; Manokwari, 44 per cent; Sorong, 42 per cent). Bottle feeding is higher among female children, in urban areas, among children of the more educated, and of the richest women. MULTIPLE INDICATOR CLUSTER SURVEY 2011 27 Sex Male Female Area Urban Rural Total for 3 districts (46.2) (35.9) (*) 34.6 40.5 (56.6) (45.9) (75.2) 42.3 50.9 (*) (*) (*) (*) (*) 33 42 15 61 75 13 9 11 11 22 46 51 26 72 97 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 Kaimana, Manokwari and Sorong, West 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 100 90 80 70 60 50 40 30 20 10 0 P er c en t Mother’s education Wealth index None PoorestSMP/SM MiddlePrimary SecondHigher Fourth Richest 58 50 24 48 39 52 43 4040 MULTIPLE INDICATOR CLUSTER SURVEY 201128 District Kaimana Manokwari Sorong 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 37.4 44.7 51.8 53.9 37.0 36.4 (27.8) 51.0 54.0 54.1 42.3 (*) 39.0 44.9 (*) 38.9 34.4 49.2 (55.1) (57.8) 39.5 50.1 (*) (42.9) (*) 44.7 24 81 25 64 65 22 10 45 52 49 81 8 33 63 25 21 26 25 25 33 48 41 23 8 7 130 71.2 (86.2) (93.5) 83.5 85.9 (*) (*) 83.3 76.6 89.9 81.6 (*) (73.0) 91.1 (*) (*) (76.2) (82.9) (*) (93.2) (80.1) (94.3) (*) (*) (*) 84.8 59 149 62 127 141 75 35 87 73 56 215 18 81 152 20 82 59 60 37 33 164 70 14 19 3 271 66.7 (86.1) (90.4) 82.6 84.0 (*) (*) 80.7 80.3 91.2 78.6 (*) (71.4) 91.2 (*) (*) (84.7) (84.6) (*) (90.8) (77.8) (94.3) (*) (*) (*) 83.3 45.9 59.3 62.7 63.5 51.9 50.7 (38.6) 61.2 65.0 71.5 52.2 (*) 48.4 58.6 (68.6) 41.9 49.6 59.7 71.7 74.3 48.2 66.5 (80.2) (56.2) (*) 57.2 83 230 87 191 206 97 46 132 125 105 296 26 114 215 45 103 85 85 63 65 213 111 37 27 10 401 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 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 * 2 cases with missing “Ethnicity of household head” and 3 cases with missing “Sex” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 2.15 2 MICS indicator 2.13 MULTIPLE INDICATOR CLUSTER SURVEY 2011 29 District Kaimana Manokwari Sorong Sex* Male Female Age 0-5 months 6-11 months 12-13 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 43.9 43.6 41.9 39.1 46.8 38.6 44.3 45.0 63.4 36.9 18.7 31.2 46.5 71.5 25.4 32.1 37.1 72.4 62.2 36.2 53.7 56.0 37.7 (*) 43.3 108 306 107 252 266 121 143 257 126 395 37 141 283 61 131 107 107 86 91 290 131 55 34 10 522 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 Kaimana, Manokwari and Sorong, West 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 * 2 cases with missing “Ethnicity of household head” and 4 cases with missing “Sex”not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 2.11 MULTIPLE INDICATOR CLUSTER SURVEY 201130 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 programs, the definition of the indicator is the per cent 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 throughout two National Campaigns held in February and August. Indonesian post-partum women also receive one Vitamin A capsule within eight weeks of delivery, though 2011 WHO Guidelines no longer recommend this. Within the six months prior to the Selected Districts of West Papua Province MICS, 54 per cent of children aged 6-59 months received a high-dose Vitamin A supplement (Table NU.8). About 53 per cent of children received a high dose vitamin A supplement according to mothers’ reports. Vitamin A supplementation coverage is considerable lower in Manokwari District (47 per cent) and Kaimana District (51 per cent) than in Sorong (71 per cent). The age pattern of Vitamin A supplementation shows that supplementation in the last six months rises from 35 per cent among children aged 6-11 months to 61 per cent among children aged 12-23 months, then declines to 60, 54 and 49 per cent among children 24-35, 36-47 and 48-59 months respectively. MULTIPLE 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 31 per cent among children whose mothers have no education, to 48 per cent of those whose mothers have primary education, to 58 per cent of those whose mothers have secondary education and to 59 per cent among children of mothers with higher education. 9.0 8.0 17.4 12.6 8.5 14.3 9.3 17.4 17.6 9.3 7.9 4.1 4.9 6.9 13.0 12.1 2.7 11.2 15.1 11.8 13.6 4.6 23.9 11.5 9.2 9.0 10.6 50.5 46.0 69.3 53.5 51.5 47.4 54.6 33.5 58.5 59.9 53.7 48.7 30.6 48.4 57.2 56.6 44.1 59.4 58.1 59.0 44.9 49.2 61.2 46.4 61.8 57.4 52.8 51.1 47.1 70.4 54.1 52.7 48.7 55.4 35.1 61.4 60.2 54.0 48.7 30.6 48.4 58.4 59.0 44.4 59.9 58.7 60.1 47.4 49.3 64.6 46.7 61.8 57.4 53.7 237 685 311 619 606 307 926 143 257 292 280 261 75 379 645 134 291 250 254 210 227 650 313 124 92 50 1,233 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 Kaimana, Manokwari and Sorong, West 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 * 4 cases with missing “Ethnicity of household head” and 8 cases with missing “Sex” not shown 1 MICS indicator 2.17 District Kaimana Manokwari Sorong 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 MULTIPLE INDICATOR CLUSTER SURVEY 201132 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 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 babies weighing below 2,500 grams at birth 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 West 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 based only on the mother’s recall of the child’s weight, or on the weight as recorded on a health card if the child was weighed at birth.8 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 2011 33 District Kaimana Manokwari Sorong 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 12.0 15.3 14.4 9.3 16.8 (0.0) 31.6 12.9 2.7 41.2 13.6 14.3 11.9 5.5 20.5 13.5 8.2 12.3 (*) 14.6 47.3 70.0 63.6 73.7 60.8 (17.1) 45.9 73.7 75.3 34.5 53.9 66.8 81.1 90.8 45.4 89.5 79.5 72.7 58.8 64.0 99 287 102 124 365 23 128 272 67 109 96 103 93 87 251 128 59 34 15 489 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 Kaimana, Manokwari and Sorong, West 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 * 2 cases 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 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, 64 per cent of babies were weighed at birth, with approximately 15 per cent of infants estimated to weigh less than 2,500 grams at birth (Table NU.9). There are great variations by districts. The lowest estimated percentage of infants weighing less than 2500 grams at birth was found in Kaimana (12 per cent), compared with 14 per cent in Sorong and 15 per cent in Manokwari District. MULTIPLE INDICATOR CLUSTER SURVEY 201134 MULTIPLE INDICATOR CLUSTER SURVEY 2011 35 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 West 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 MULTIPLE INDICATOR CLUSTER SURVEY 201136 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 44.0 15.8 38.8 30.6 27.5 41.8 36.0 12.9 35.4 13.4 41.2 33.5 8.6 34.5 29.2 12.5 1.3 17.0 257 32.8 32.9 32.5 31.4 28.1 34.3 32.4 31.5 29.9 6.1 33.1 31.3 29.7 20.3 19.1 17.7 25.1 0.0 257 76.8 48.7 71.3 62.0 55.7 76.1 68.4 44.4 65.4 19.5 74.3 64.8 38.3 54.8 48.3 30.2 26.4 17.0 257 76.0 48.3 70.5 61.4 54.5 76.1 68.4 44.4 61.2 19.5 74.3 64.8 38.1 53.9 47.0 30.2 20.7 17.0 257 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Vaccinated by 12 months of ageChild health book/ vaccination card Mother’s report Either Vaccinated at any time before the survey according to 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 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 West Papua, approximately 76 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 76 per cent. The percentage declines for subsequent doses of DPT, to 68 per cent for the second dose and 44 per cent for the third dose (Figure CH.1). Similarly, 48 per cent of children received Polio 1 by age 12 months. And this increased to 71 per cent for the second dose and then declineds to 55 per cent by the fourth dose. The coverage for measles/ MMR vaccine by 12 months is 61 per cent. There is also a decline in the Hepatitis B vaccination, from 74 per cent for the first dose to 65 per cent for the second dose and 38 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, only 21 per cent. MULTIPLE INDICATOR CLUSTER SURVEY 2011 37 Figure CH.1: Percentage of children aged 12-23 months who received the recommended vaccinations by 12 months, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 100 90 80 70 60 50 40 30 20 10 0 P er c en t B C G D P T 1 P o lio 1 H ep B 0 D P T 2 P o lio 2 H ep B 1 D P T 3 P o lio 3 H ep B 2 P o lio 4 H ep B 3 A ll M ea sl es 76 76 71 74 61 61 21 65 54 68 44 48 38 19 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 36 per cent of children (Kaimana, 28 per cent; Manokwari, 32 per cent; Sorong, 54 per cent). Out of all selected districts, the survey results show that Kaimana District tended to have low coverage for most of the vaccinations with full vaccination coverage of only 22 per cent of children. The full vaccination coverage in Manokwari and Sorong districts was 20 and 46 per cent respectively. Often given to infants at the time of birth, BCG vaccine and DPT 1 (77 and 76 per cent respectively) 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 3 and DPT 3 are considerably lagging behind in Kaimana. HepB at birth has low coverage both overall and among the districts (Kaimana, 15 per cent; Manokwari, 22 per cent; Sorong, 20 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 201138 * 2 ca se s 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 ” an d 1 c as e w it h m is si n g “ S ex ” 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 79 .2 68 .1 95 .9 73 .4 79 .9 86 .6 73 .4 ( *) 77 .0 78 .2 ( *) 62 .4 78 .9 80 .3 ( 90 .9 ) ( 79 .6 ) 64 .3 91 .9 79 .1 92 .3 ( *) 76 .8 40 .9 48 .3 58 .5 50 .7 46 .9 68 .7 41 .8 ( *) 47 .9 51 .6 ( *) 29 .9 46 .4 53 .0 ( 63 .3 ) ( 63 .9 ) 30 .6 72 .8 71 .6 52 .7 ( *) 48 .7 43 .6 58 .9 90 .3 59 .3 64 .8 73 .7 58 .0 ( *) 61 .1 64 .7 ( *) 47 .6 57 .4 69 .6 ( 72 .6 ) ( 72 .1 ) 45 .7 80 .4 80 .0 64 .1 ( *) 62 .0 38 .4 50 .8 87 .0 54 .2 57 .1 70 .1 50 .7 ( *) 57 .7 56 .7 ( *) 39 .9 53 .5 60 .1 ( 69 .4 ) ( 66 .0 ) 38 .9 74 .1 71 .7 61 .1 ( *) 55 .7 75 .7 68 .4 95 .9 68 .8 82 .9 83 .1 73 .7 ( *) 71 .8 79 .6 ( *) 60 .4 72 .0 81 .2 ( 92 .7 ) ( 85 .0 ) 62 .3 91 .9 87 .3 83 .2 ( *) 76 .1 61 .5 61 .0 94 .5 62 .2 74 .1 75 .7 65 .9 ( *) 65 .3 73 .9 ( *) 45 .3 67 .4 78 .7 ( 84 .1 ) ( 80 .0 ) 49 .7 89 .3 87 .3 74 .5 ( *) 68 .4 61 .7 66 .8 93 .1 67 .7 74 .5 79 .5 68 .4 ( *) 73 .4 72 .3 ( *) 58 .7 70 .3 75 .9 ( 80 .9 ) ( 78 .0 ) 61 .1 83 .7 82 .2 68 .9 ( *) 71 .3 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 T o ta l f o r 3 d is tr ic ts 33 .1 38 .8 69 .9 39 .9 48 .8 65 .8 37 .1 ( *) 42 .1 48 .7 ( *) 20 .8 41 .1 51 .4 ( 59 .4 ) ( 65 .6 ) 21 .4 74 .6 66 .5 57 .7 ( *) 44 .4 P er ce n ta g e o f ch ild re n w h o r ec ei ve d : P o lio D P T B C G A t b ir th A t b ir th 1 1 1 2 2 2 3 3 3 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 M ea sl es N o n e A ll Pe rc en ta ge w it h va cc in at io n ca rd s ee n N um be r of ch ild re n ag e 12 -2 3 m on th s 53 .6 61 .0 88 .9 57 .8 72 .1 70 .3 63 .6 ( *) 63 .8 68 .9 ( *) 47 .1 66 .8 80 .3 ( 74 .2 ) ( 66 .1 ) 48 .4 85 .3 75 .5 77 .5 ( *) 65 .4 14 .6 21 .6 19 .5 16 .2 22 .4 25 .6 17 .3 ( *) 16 .6 23 .7 ( *) 4. 5 23 .0 22 .4 ( 21 .8 ) ( 33 .8 ) 12 .9 26 .9 34 .6 8. 9 ( *) 19 .5 73 .8 66 .5 94 .5 68 .0 80 .0 87 .3 69 .8 ( *) 70 .6 77 .9 ( *) 54 .1 72 .7 79 .8 ( 92 .8 ) ( 85 .0 ) 62 .6 85 .5 87 .3 83 .2 ( *) 74 .3 59 .6 55 .8 93 .1 57 .9 71 .2 75 .9 61 .0 ( *) 58 .3 71 .8 ( *) 39 .5 68 .0 68 .0 ( 84 .3 ) ( 80 .0 ) 46 .5 82 .9 87 .3 72 .5 ( *) 64 .8 31 .9 29 .2 67 .6 33 .2 43 .2 60 .1 30 .6 ( *) 40 .9 38 .9 ( *) 14 .4 31 .2 54 .2 ( 45 .1 ) ( 60 .0 ) 17 .5 67 .2 55 .0 46 .7 ( *) 38 .3 17 .4 22 .5 2. 7 19 .9 14 .4 9. 6 19 .6 ( *) 14 .7 15 .9 ( *) 29 .6 19 .4 7. 4 (7 .2 ) ( 15 .0 ) 27 .1 4. 6 12 .7 7. 7 ( *) 17 .0 21 .8 20 .4 46 .3 25 .9 26 .7 45 .5 19 .9 ( *) 25 .8 28 .2 ( *) 7. 3 27 .5 33 .1 ( 25 .5 ) ( 49 .6 ) 9. 9 52 .0 32 .6 35 .3 ( *) 26 .4 28 .2 31 .6 54 .1 38 .4 32 .8 59 .8 27 .3 ( *) 32 .6 37 .7 ( *) 16 .0 28 .6 48 .0 ( 38 .3 ) ( 58 .9 ) 15 .1 64 .2 51 .4 48 .6 ( *) 35 .5 61 14 2 55 12 3 13 3 65 19 2 15 83 13 8 22 68 56 56 40 39 13 1 74 26 18 6 25 7 H ep B MULTIPLE 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. 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 women: • 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 her life. To assess the status of tetanus vaccination coverage, women who gave birth during the two years before the survey were asked if they had received tetanus toxoid injections during the pregnancy for their most recent birth, and if so, how many. Women who did not receive two or more tetanus toxoid vaccinations during this pregnancy were then asked about tetanus toxoid vaccinations they may have received prior to this pregnancy. Interviewers also asked women to present their vaccination card, on which dates of tetanus toxoid are recorded and referred to information from the cards when available. Figure CH.2: Percentage of women with a live birth in the last 12 months who are protected against neonatal tetanus, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest 0 40 8020 60 100 Per cent 62 76 56 64 52 62 34 55 67 65 65 80 52 57 MULTIPLE INDICATOR CLUSTER SURVEY 201140 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 West Papua is at 62 per cent and lowest in Manokwari District (Kaimana, 62 per cent; Manokwari, 57 per cent; Sorong, 76 per cent). It is worth noting that tetanus toxoid protection is much lower among the poorest households (52 per cent) than the richest households (80 per cent). Similarly, tetanus toxoid protection increases from 34 per cent among women with no education to 62 per cent among women with higher education. District Kaimana Manokwari Sorong 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 4.5 5.7 7.3 8.2 5.0 (2.3) 7.1 4.8 8.4 2.6 4.7 4.2 8.2 10.3 5.6 6.9 4.3 6.6 (*) 5.8 0.0 0.0 0.6 0.5 0.0 (0.0) 0.0 0.0 0.8 0.0 0.0 0.0 0.0 0.6 0.0 0.4 0.0 0.0 (*) 0.1 0.0 0.6 0.0 0.0 0.5 (0.0) 0.0 0.0 2.7 0.0 0.0 0.0 0.0 2.1 0.0 0.0 3.1 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 (*) 0.0 99 287 102 124 365 23 128 272 67 109 96 103 93 87 251 128 59 34 15 489 57.9 50.2 68.6 47.7 58.3 (31.4) 48.0 62.6 50.1 49.6 47.6 60.8 54.3 67.4 52.1 60.7 57.8 50.3 (*) 55.6 62.4 56.5 76.4 56.3 63.8 (33.7) 55.0 67.4 62.0 52.2 52.3 65.0 62.4 80.4 57.7 68.1 65.2 56.9 (*) 61.9 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of women with a live birth in the last 2 years Percentage of women who received at least 2 doses during last pregnancy Protected against tetanus1 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 Percentage of women who did not receive two or more doses during last pregnancy but received: ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 3.7 MULTIPLE 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 monoxide, 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 of babies born to pregnant women exposed to smoke. The primary indicator for monitoring use of solid fuels is the proportion of the population using solid fuels as the primary source of domestic energy for cooking. Table CH.4 shows that solid fuel use is common in the three selected districts of West Papua Province, where about half of households are using solid fuel for cooking (49 per cent). Almost all of the remaining half is using kerosene (49 per cent). The findings show that use of solid fuels generally does not vary much between districts (Kaimana, 53 per cent; Manokwari, 46 per cent; Sorong, 52 per cent). Almost all solid fuel use in each district is from wood. Use of solid fuels is considerably lower in urban areas (13 per cent) than in rural areas (61 per cent). Differentials with respect to household wealth and the educational level of the household head are also greatly significant. The findings show that use of solid fuels is more common among households whose household heads are Papuan than in 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, and types of fuel used. Most people sampled cooks in a separate room used as a kitchen (77 per cent), eight per cent cook elsewhere in the house, 12 per cent cook in a separate building and about two per cent cook outdoors. The percentages of households that cook in a separate building are generally similar between districts (Kaimana, 77 per cent; Manokwari, 76 per cent; Sorong, 80 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 201142 T ab 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 s o lid f u el s fo r co o ki n g , D is tr ic ts o f K ai m an a, M an o kw ar i a n d S o ro n g , W es t 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 1 M IC S in d ic at o r 3. 11 0. 1 0. 6 0. 1 0. 7 0. 3 0. 0 0. 6 0. 5 0. 0 ( *) 0. 0 0. 0 1. 0 0. 8 0. 3 0. 4 0. 2 1. 7 0. 1 0. 0 (0 .0 ) 0. 4 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 : E le ct ri ci ty Li qu efi ed Pe tr ol eu m G as (L PG ) K er o se n e N at u ra l G as B io g as D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 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 M is si n g /D K T o ta l f o r 3 d is tr ic ts 0. 5 0. 4 0. 0 0. 7 0. 1 0. 0 0. 1 0. 3 0. 8 ( *) 0. 0 0. 1 0. 6 0. 5 0. 3 0. 0 0. 6 1. 0 0. 2 0. 0 (0 .0 ) 0. 3 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 (* ) 0. 1 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 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 10 0. 0 10 0. 0 53 .0 45 .9 52 .0 12 .5 61 .2 86 .9 67 .6 37 .8 18 .1 ( *) 98 .7 86 .3 44 .0 12 .6 1. 1 66 .3 38 .2 14 .1 28 .1 26 .9 ( 65 .8 ) 48 .5 1, 85 8 6, 91 2 2, 89 8 3, 03 6 8, 63 1 76 5 3, 96 8 5, 36 9 1, 56 1 4 2, 33 3 2, 33 7 2, 32 6 2, 33 7 2, 33 4 5, 79 0 3, 37 8 1, 28 0 72 0 46 2 37 11 ,6 67 S o lid f u el s S tr aw , s hr ub s, gr as s N o fo od co ok ed in th e ho us e- ho ld W o o d M is si n g C h ar co al C oa l, lig ni te T o ta l S ol id fu el s fo r co ok in g1 N um be r of h ou se - ho ld m em be rs 0. 1 0. 0 0. 1 0. 1 0. 0 0. 0 0. 0 0. 0 0. 1 ( *) 0. 0 0. 0 0. 0 0. 0 0. 2 0. 0 0. 1 0. 2 0. 0 0. 0 (0 .0 ) 0. 0 0. 0 0. 1 0. 1 0. 1 0. 1 0. 0 0. 2 0. 0 0. 2 ( *) 0. 0 0. 0 0. 0 0. 4 0. 1 0. 0 0. 4 0. 0 0. 0 0. 0 (0 .0 ) 0. 1 0. 6 1. 2 1. 5 2. 2 0. 8 0. 0 0. 2 1. 1 4. 5 ( *) 0. 0 0. 0 0. 0 0. 5 5. 4 0. 2 2. 4 1. 7 0. 0 4. 1 (0 .0 ) 1. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 ( *) 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 (0 .0 ) 0. 0 45 .7 51 .8 46 .2 83 .5 37 .4 13 .1 31 .1 60 .3 76 .2 ( *) 1. 2 13 .6 54 .5 85 .1 92 .6 33 .0 58 .2 81 .2 71 .7 69 .0 ( 34 .2 ) 49 .4 0. 1 0. 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 0. 0 0. 0 0. 0 0. 0 (0 .0 ) 0. 0 52 .9 45 .7 52 .0 12 .5 61 .1 86 .9 67 .6 37 .7 18 .0 ( *) 98 .6 85 .9 44 .0 12 .6 1. 1 66 .3 37 .9 14 .1 28 .1 26 .9 ( 65 .8 ) 48 .4 0. 0 0. 1 0. 0 0. 0 0. 1 0. 0 0. 0 0. 2 0. 0 ( *) 0. 0 0. 4 0. 0 0. 0 0. 0 0. 0 0. 2 0. 0 0. 0 0. 0 (0 .0 ) 0. 1 MULTIPLE INDICATOR CLUSTER SURVEY 2011 43 District Kaimana Manokwari Sorong 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 Missing/DK Total for 3 districts 76.9 75.8 79.8 55.7 78.6 74.5 78.9 76.6 69.3 71.8 79.5 82.0 83.0 (*) 72.0 93.2 78.8 70.2 68.8 (*) 77.1 6.5 11.6 0.7 8.2 7.8 11.2 5.1 9.6 13.2 11.2 5.3 4.9 9.0 (*) 9.9 1.5 8.0 5.7 13.5 (*) 7.8 0.0 0.2 0.0 1.6 0.0 0.0 0.2 0.0 0.0 0.0 0.0 0.6 0.0 (*) 0.0 0.0 0.0 3.0 0.0 (*) 0.1 12.4 10.1 15.4 27.7 10.8 11.6 13.3 10.7 8.1 13.0 12.0 10.7 8.0 (*) 14.4 4.9 8.3 13.2 14.1 (*) 11.9 2.5 0.9 0.6 0.0 1.2 2.3 1.3 0.6 0.0 1.8 0.7 0.7 0.0 (*) 1.4 0.0 2.3 3.1 0.0 (*) 1.1 1.7 1.4 3.5 6.8 1.6 0.4 1.2 2.6 9.4 2.3 2.4 1.1 0.0 (*) 2.3 0.5 2.5 4.8 2.6 (*) 2.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 984 3,171 1,507 381 5,281 665 2,684 2,030 283 2,303 2,017 1,023 295 25 3,840 1,290 181 202 125 24 5,662 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of household members in households using solid fuels for cooking In a separate room used as kitchen Elsewhere in the house At another place In a separate building MissingOutdoors Total for 3 districts Place of cooking: (*) Figures that are based on fewer than 25 unweighted cases MULTIPLE INDICATOR CLUSTER SURVEY 201144 6.4. MALARIA Malaria is a leading cause of death of children under age five in West Papua. 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 mosquitoes and other insects. The use of ITNs is one of the main health interventions applied to reduce malaria transmission in West 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 West Papua Province MICS results indicate that 36 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 58 per cent and the percentage of households with at least one long-lasting treated net is 36 per cent. Differentials exist in the availability of ITNs among districts where the availability is the lowest in Manokwari District (32 per cent) and highest in Sorong District (44 per cent). The percentage of this indicator is 37 per cent in Kaimana. Availability of at least one ITN was positively associated with education and wealth. This percentage is higher among households with Papuan heads (43 per cent) than among households with Javanese heads (28 per cent). Results indicate that 48 per cent of children under the age of five slept under any mosquito net the night prior to the survey and 32 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 lower in Manokwari District (41 and 25 per cent respectively). These percentages are 47 per cent and 36 per cent for Kaimana and 64 per cent and 46 per cent for Sorong District. Slightly more male children slept under any net or an insecticide-treated net (50 and 34 respectively) than females (45 and 30 per cent respectively). 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. Questions on the prevalence and treatment of fever were asked for all children under age five. Slightly fewer than one in three (29 per cent) of children under five were ill with fever in the two weeks prior to the survey (Table CH.8) (Kaimana, 22 per cent; Manokwari, 35 per cent; Sorong, 18 per cent). Fever prevalence slightly declined with age. There was no clear trend linking this indicator with mother’s education or wealth. MULTIPLE INDICATOR CLUSTER SURVEY 2011 45 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 * 9 cases with missing “Ethnicity of household head” and 1 case with missing “Education of household head” not shown 1 MICS indicator 3.12 37.1 31.6 44.0 29.5 37.8 39.9 39.3 33.9 30.7 47.2 46.8 35.5 26.5 22.7 43.2 28.3 31.2 35.7 31.2 35.7 37.2 31.8 44.0 29.6 37.9 39.9 39.5 33.9 30.7 47.5 46.9 35.5 26.5 22.7 43.4 28.4 31.2 35.7 31.2 35.8 50.2 55.5 69.8 43.7 63.2 59.7 67.4 55.6 45.1 63.0 75.8 64.6 51.5 36.4 59.9 61.1 52.6 47.4 58.5 58.4 District Kaimana Manokwari Sorong 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 448 1,638 730 697 2,119 208 950 1,245 412 568 550 565 602 532 1,231 937 342 174 124 2,816 Percentage of households with at least one mosquito net Percentage of households with at least one ITN1 Percentage of households with at least one long- lasting treated net Number of households MULTIPLE INDICATOR CLUSTER SURVEY 201146 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 * 4 cases with missing “Ethnicity of household head” and 7 cases with missing “Sex” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted case 1 MICS indicator 3.14, 2 MICS indicator 3.15; MDG indicator 6.7 98.7 98.7 98.1 98.2 98.9 98.6 98.6 99.8 99.5 99.0 97.5 97.0 97.5 99.2 98.9 96.1 98.9 99.1 98.7 97.5 98.4 99.4 97.5 99.6 96.0 (100.0) 98.6 46.6 40.9 64.3 50.0 44.7 29.6 53.5 48.6 50.6 45.9 49.2 44.3 44.5 53.7 47.3 34.9 54.2 71.1 49.7 39.5 19.4 47.2 57.1 32.8 40.9 (50.4) 47.7 36.1 25.2 45.6 34.1 30.3 21.5 35.8 34.3 37.1 32.0 31.4 26.8 35.2 37.5 29.6 29.2 44.7 44.0 30.4 21.7 15.7 37.1 29.1 20.2 25.9 25.4 32.3 259 751 325 667 659 324 1,011 264 256 289 273 254 83 403 704 144 315 270 273 228 249 722 324 142 94 48 1,335 70.0 54.0 79.8 64.3 64.4 51.1 67.8 70.7 67.9 61.0 64.4 57.6 78.9 65.8 62.9 59.2 80.8 75.0 59.1 49.0 40.8 71.0 61.1 42.3 51.7 (*) 64.4 262 760 332 679 666 329 1,025 264 257 292 280 261 85 407 713 150 319 272 277 234 253 727 333 142 98 50 1,354 District Kaimana Manokwari Sorong 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 133 351 186 354 310 136 534 128 140 151 133 118 37 230 332 71 175 158 141 101 96 377 154 68 47 20 670 Percentage of children who:Percentage of children age 0-59 who stayed in the household the previous night Number of children age 0-59 months Number of children age 0-59 months who slept in the household the previous night Slept under any mosquito net1 Percentage of children who slept under an ITN living in households with at least one ITN Slept under an insecticide- treated net2 Number of children age 0-59 living in households with at least one ITN MULTIPLE INDICATOR CLUSTER SURVEY 2011 47 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 * 4 cases with missing “Ethnicity of household head” and 9 cases with missing “Sex” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted case 1 MICS indicator 3.18; MDG indicator 6.8 22.4 35.3 18.1 26.9 29.7 29.2 28.4 30.9 31.9 30.1 25.7 24.4 29.4 27.4 29.3 27.9 20.9 30.1 33.0 29.9 30.5 26.9 32.2 30.4 23.6 31.8 28.6 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 0.0 (0.0) 0.0 0.0 0.0 0.0 0.0 0.0 0.0 (0.0) (0.0) (*) 0.0 5.1 7.3 2.6 6.0 5.7 14.2 3.6 2.8 0.0 6.0 12.4 11.8 0.0 6.1 8.0 (1.5) 6.5 3.6 11.1 0.9 7.7 10.7 2.9 (0.0) (0.0) (*) 6.2 10.4 14.2 0.0 9.7 11.3 8.8 12.3 10.7 12.8 12.5 16.3 3.5 9.5 10.7 11.3 (14.7) 7.9 12.1 16.8 10.5 8.1 15.1 9.0 (6.3) (1.8) (*) 11.4 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 0.0 0.0 0.0 0.0 0.0 (0.0) (0.0) (*) 0.0 262 760 332 679 666 329 1025 264 257 292 280 261 85 407 713 150 319 272 277 234 253 727 333 142 98 50 1354 District Kaimana Manokwari Sorong 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 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) (*) 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) (0.0) (*) 0.0 19.7 35.0 14.1 30.4 28.3 33.8 28.0 42.4 30.8 21.4 24.5 27.5 12.0 34.2 30.2 (23.2) 11.8 24.5 36.2 34.8 37.0 26.7 34.1 (36.1) (23.8) (*) 29.4 33.5 55.7 16.7 45.8 45.0 55.0 43.4 55.4 42.9 39.9 53.2 40.1 21.5 50.5 48.4 (39.4) 24.7 40.3 62.2 46.2 52.7 51.3 45.9 (41.1) (25.5) (*) 46.3 Children with a fever in the last two weeks who were treated with: Anti-malarials: Had a fever in last two weeks Num- ber of children age 0-59 months Anti malari- als/SP/ Fansidar Anti ma- larials/ Artesdia- quine Anti ma- larials/ Chloro- quine Anti ma- larials/ Arsua- mon Anti ma- larials/ Other Anti- malarial Anti ma- larials/ Quinine/ Kina Anti malari- als/ Ar- terakin/ Artekin Anti ma- larials/ Any anti- malarial drug1 MULTIPLE INDICATOR CLUSTER SURVEY 201148 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 * 4 cases with missing “Ethnicity of household head” and 9 cases with missing “Sex” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted case 2 MICS indicator 3.18; MDG indicator 3.17 District Kaimana Manokwari Sorong 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 30.9 15.9 19.1 21.6 15.4 23.5 17.1 18.0 21.2 17.0 25.9 10.4 2.2 13.2 24.2 (15.6) 11.6 25.6 16.5 12.6 25.4 21.6 8.1 (17.6) (30.3) (*) 18.7 0.8 1.5 0.0 2.1 0.2 1.9 0.9 0.0 0.0 4.5 0.6 0.0 0.0 2.3 0.9 (0.0) 0.0 0.0 2.8 2.6 0.0 2.0 0.0 (0.0) (2.0) (*) 1.1 47.5 53.5 72.4 54.4 55.0 78.4 48.0 61.5 57.6 54.8 48.9 53.4 38.6 52.9 56.9 (65.5) 30.2 59.7 57.6 58.6 67.4 48.2 69.6 (57.7) (61.4) (*) 55.5 1.0 2.1 0.0 2.2 1.1 1.7 1.6 0.0 0.0 6.5 0.0 0.9 0.0 3.4 1.2 (0.0) 0.0 0.7 4.1 0.0 2.5 1.1 0.0 (4.4) (7.2) (*) 1.6 0.0 2.8 1.4 3.0 1.4 3.5 1.7 1.0 5.0 0.0 2.4 2.6 0.0 2.2 2.8 (0.0) 2.5 1.0 2.1 0.0 5.1 2.2 2.0 (0.0) (0.0) (*) 2.2 14.1 43.6 46.0 38.9 39.3 38.7 39.8 36.5 39.5 45.9 32.4 42.3 30.7 36.8 39.9 (49.8) 24.9 39.9 37.9 61.1 33.9 34.4 50.2 (43.7) (30.5) (*) 39.5 0.0 4.6 0.9 2.5 4.2 1.9 3.8 3.2 5.4 4.5 0.0 3.0 8.4 3.9 3.1 (0.0) 9.7 5.6 0.0 0.0 2.4 5.3 2.4 (0.0) (0.0) (*) 3.3 20.0 47.2 12.9 34.7 38.6 40.7 36.8 49.2 38.0 32.5 36.3 31.7 21.5 36.2 41.6 (32.8) 17.2 27.9 50.6 42.0 47.1 37.5 42.3 (39.8) (23.1) (*) 37.8 59 268 60 183 198 96 291 82 82 88 72 64 25 112 208 42 67 82 91 70 77 196 107 43 23 16 387 Other medications: Other medica- tions: Antibiotic injection Other medica- tions: Other Other medications: Paracetamol/ Panadol/ Acetamino- phan OtherOther medica- tions: Ibupro- fen Other medica- tions: Aspirin DK Percent- age who took an anti- malarial drug same or next day2 Num- ber of children with fever in last two weeks Children with a fever in the last two weeks who were treated with: MULTIPLE INDICATOR CLUSTER SURVEY 2011 49 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 36 per cent of children with fever in the last two weeks were treated with an “appropriate” anti-malarial drug and 28 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 Manokwari District, Kaimana and Sorong districts were lacking anti- malarial treatment. The percentage of children receiving any anti-malarial drug on the same or next day in Kaimana and Sorong (15 and 13 per cent respectively) was about half that observed in Manokwari District (34 per cent). Overall across the three districts, six per cent of children with fever were given chloroquine, and none were given SP/ Fansidar. None received quinine/ kina, artesdiaquine or arsuamon and most of the children who were given an anti-malarial drug were given another anti-malarial drug (29 per cent). A large number of children were given other types of medicines that are not anti-malarial, including paracetamol, panadol, acetaminophen (56 per cent) and antibiotic pills or syrups (19 per cent). Urban children (64 per cent) are more often treated appropriately than rural children (36 per cent). Children 24-35 and 36-47 months and children from the poorest households were disadvantaged in receiving appropriate ant-malarial drugs. Girls (29 per cent) were more likely to receive appropriate anti-malarial drugs than boys (26 per cent). 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, 42 per cent of children with a fever in the last two weeks had a finger or heel stick. Sorong District revealed the lowest value for this indicator (15 per cent), compared with 40 per cent in Kaimana and 48 per cent in Manokwari District. Having a finger or heel stick for malaria testing is more common in urban areas (60 per cent) than in rural areas (36 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 100 90 80 70 60 50 40 30 20 10 0 P er c en t None PoorestSecondary MiddlePrimary SecondHigher Fourth Richest 22 45 56 21 37 54 45 50 35 Mother’s education Wealth index MULTIPLE INDICATOR CLUSTER SURVEY 201150 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 * 2 cases with missing “Ethnicity of household head” and 6 cases with missing “Sex” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 3.16 40.3 48.4 15.0 39.8 42.1 60.8 35.8 55.8 38.6 43.3 43.6 25.0 (*) 34.9 45.5 (55.9) 20.6 37.0 53.6 44.8 49.5 43.8 41.0 (34.3) (54.1) (*) 42.0 District Kaimana Manokwari Sorong Sex* Male Female Area Urban Rural Age 0-11 12-23 24-35 36-47 48-59 Mother’sEducation 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 59 268 60 183 198 96 291 82 82 88 72 64 25 112 208 42 67 82 91 70 77 196 107 43 23 16 387 Had a finger or heel stick1 Number of children age 0-59 months with fever in the last two weeks This indicator increases according to mother’s education; from 22 per cent among children of uneducated women to 56 per cent among children with higher education. A similar pattern is seen according to 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 21 per cent for children living in the poorest households to 50 per cent for those living in the richest (Figure CH.3). MULTIPLE INDICATOR CLUSTER SURVEY 2011 51 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 MULTIPLE INDICATOR CLUSTER SURVEY 201152 Overall, 71 per cent of the population in the three districts is using an improved source of drinking water–86 per cent in urban areas and 66 per cent in rural areas. The situation in Sorong District is better than in other districts; 80 per cent of the population in this district gets its drinking water from an improved source, mostly from rainwater collection (48 per cent) and bottled water (18 per cent). The percentage of the population getting their drinking water from an improved source in Manokwari and Kaimana districts is 69 and 66 per cent respectively. The source of drinking water for the population varies strongly by district (Table WS.1). Although Kaimana District had the lowest percentage of people using an improved source of drinking water, the district had the highest percentage of households that drink water that is piped into their dwelling or into their yard or plot (20 per cent). These percentages are nine and two per cent for Manokwari and Sorong respectively. In Manokwari District, the most common improved sources of drinking water are bottled water (19 per cent), tube well or borehole (14 per cent) and protected well (13 per cent). Figure WS.1: Per cent distribution of household members by source of drinking water, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Piped into dwelling, yard, plot or neighbour 10% Public tap/standpipe 5% Tubewell/borehole 10% Unprotected well or spring 22% Bottled water 21% Surface water 3% Other unimproved 0% Rain-water collection 16% Protected well or spring 13% MULTIPLE INDICATOR CLUSTER SURVEY 2011 53 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 11.8 7.7 1.8 14.7 4.2 0.6 2.8 8.6 14.2 0.3 1.9 6.0 10.9 15.6 7.1 5.8 7.5 10.0 2.1 (0.0) 6.9 2.6 0.7 0.1 2.0 0.4 0.6 1.6 0.6 0.1 1.0 0.4 1.9 1.0 0.0 1.2 0.3 0.4 1.8 0.0 (0.0) 0.9 1.2 7.6 0.7 4.2 5.1 14.5 5.6 3.3 3.6 6.3 8.8 4.7 2.8 1.7 8.9 0.5 1.4 1.9 0.0 (3.4) 4.9 0.7 14.3 6.7 15.5 8.3 3.3 9.2 11.4 12.3 0.4 3.4 11.3 17.3 18.7 7.8 12.7 14.0 10.0 9.8 31.5 10.2 9.1 12.8 3.9 8.6 10.5 14.5 11.6 9.4 6.0 8.3 14.1 14.9 8.9 3.8 11.7 9.9 5.2 7.3 7.7 (0.0) 10.0 5.0 3.5 0.5 2.1 3.3 4.2 3.2 2.9 2.3 3.5 4.0 3.3 2.7 1.4 4.3 1.5 1.7 1.3 3.8 (0.0) 3.0 15.6 1.4 48.4 6.6 18.4 17.9 18.6 15.0 7.2 16.6 25.0 17.8 12.3 5.1 11.1 22.8 10.8 20.5 20.4 (0.0) 15.4 8.9 1.7 0.0 2.0 2.6 5.2 3.1 1.8 1.4 6.3 1.2 2.4 1.2 1.0 4.3 0.1 1.1 2.2 0.0 (0.0) 2.4 District Kaimana Manokwari Sorong 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 Missing/DK Total for 3 districts 11.6 19.3 17.7 29.6 13.5 2.2 9.7 20.9 34.4 0.1 2.1 11.0 29.5 45.7 6.3 25.3 42.5 22.5 29.4 (15.2) 17.7 Main source of drinking water Improved sources Piped water Into dwelling Into yard/ plot Protected well Rain- water collection Bottled water* To neigh- bour Public tap/ stand- pipe Tube- well/ bore- hole Protected spring * 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. ** 4 cases with missing “Education of household head” not shown ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 4.1; MDG indicator 7.8 MULTIPLE INDICATOR CLUSTER SURVEY 201154 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong 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 Missing/DK Total for 3 districts 9.0 17.9 13.6 6.2 18.6 14.8 18.5 15.4 7.8 24.0 28.7 18.6 5.1 0.6 20.0 12.9 3.5 12.5 14.0 (2.8) 15.4 0.8 0.2 0.0 0.9 0.0 0.0 0.1 0.1 1.1 0.0 0.1 0.3 0.1 0.5 0.3 0.0 0.0 0.8 0.7 (0.0) 0.2 0.2 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 (0.0) 0.0 6.0 2.8 2.7 0.1 4.4 10.8 4.1 2.6 0.0 14.0 1.8 0.1 0.5 0.0 6.5 0.1 0.1 0.5 0.0 (0.0) 3.3 7.0 3.0 1.8 5.5 2.5 0.4 2.2 3.9 5.8 0.2 1.4 3.6 5.7 5.6 1.1 4.2 9.0 4.6 7.4 (0.0) 3.3 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) 0.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 66.4 69.0 79.9 85.5 66.3 62.9 65.3 73.9 81.5 42.8 60.8 73.2 86.7 92.9 62.7 79.0 84.6 77.5 77.4 (50.1) 71.3 10.6 7.2 2.1 1.9 8.1 11.0 9.8 4.1 4.0 18.8 7.2 4.1 2.0 0.3 9.4 3.9 2.8 4.0 0.5 (47.1) 6.5 1,858 6,912 2,898 3,036 8,631 765 3,968 5,369 1,561 2,333 2,337 2,326 2,337 2,334 5,790 3,378 1,280 720 462 37 11,667 Main source of drinking water Unimproved sources Unpro- tected well Unpro- tected spring Bottled water* Percent- age using im- proved sources of drinking water1 Total for 3 districts Num- ber of house- hold mem- bers Tank- er truck Cart with tank/ drum Surface water Other * 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. ** 4 cases with missing “Education of household head” not shown ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 4.1; MDG indicator 7.8 MULTIPLE 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 87 per cent of households in the selected districts of West Papua use appropriate water treatment for unimproved drinking water sources and 17 per cent do not use any method for water treatment. The most common method of water treatment is boiling (82 per cent). There exist some differentials in the use of appropriate water treatment between districts. Household members in Kaimana District show 17 per cent use of appropriate water treatment methods, while this percentage is 88 and 92 per cent in Manokwari and Sorong districts respectively. It was also observed that appropriate water treatment use is greater in rural areas and among less educated women. The amount of time it takes to obtain water is presented in Table WS.3 and the person who usually collects 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 one third of household members who use an improved source of drinking water, the source is on the premises (61 per cent). For eight per cent, it takes less than 30 minutes to get to the water source and bring water, while two per cent of household members spend 30 minutes or more for this purpose. For users of unimproved drinking water sources, water is on the premises for 16 per cent of household members. One tenth of household members take less than 30 minutes to get to the water source and bring water (10 per cent), and for two 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. MULTIPLE INDICATOR CLUSTER SURVEY 201156 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 M is si n g /D K T o ta l f o r 3 d is tr ic ts * 4 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 ” 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 4. 2 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 17 .1 17 .8 16 .1 27 .2 13 .8 19 .5 11 .9 11 .9 11 .5 18 .8 29 .5 7. 7 3. 0 11 .6 27 .6 36 .5 8. 1 21 .4 39 .4 22 .6 32 .8 (3 .4 ) 17 .3 0. 5 2. 1 0. 1 1. 8 1. 2 0. 9 2. 4 0. 9 1. 3 1. 4 1. 4 2. 3 1. 0 1. 7 1. 2 0. 4 2. 2 0. 3 0. 7 0. 8 0. 8 (0 .0 ) 1. 3 22 .6 46 .4 6. 9 38 .6 30 .8 30 .2 39 .3 30 .1 30 .5 34 .0 36 .1 28 .0 36 .7 37 .7 34 .2 27 .6 44 .6 19 .3 20 .8 24 .3 27 .6 ( 78 .6 ) 32 .8 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. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 (0 .0 ) 0. 0 32 .4 25 .0 4. 2 24 .2 19 .8 17 .6 29 .5 23 .3 19 .9 22 .0 19 .4 25 .7 25 .0 20 .8 14 .8 18 .6 29 .2 11 .9 18 .6 10 .4 8. 6 (0 .0 ) 21 .0 0. 2 0. 0 0. 1 0. 1 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 2 0. 0 0. 0 0. 0 0. 0 0. 2 0. 0 0. 2 0. 0 0. 0 0. 0 (0 .0 ) 0. 0 75 .6 88 .0 92 .3 67 .2 89 .4 n a 86 .5 82 .8 89 .8 85 .7 77 .5 89 .3 94 .9 86 .3 68 .6 50 .5 91 .6 85 .4 46 .2 80 .6 70 .5 (* ) 86 .5 0. 1 0. 3 0. 7 0. 6 0. 3 0. 4 0. 3 0. 0 0. 1 0. 7 0. 1 0. 7 0. 2 0. 1 0. 3 0. 5 0. 4 0. 2 1. 1 0. 0 0. 0 (0 .0 ) 0. 4 80 .9 81 .0 83 .5 70 .7 85 .4 79 .7 86 .3 87 .8 88 .0 79 .4 69 .9 90 .7 96 .6 86 .7 71 .9 62 .1 90 .4 77 .7 59 .7 77 .4 65 .9 ( 96 .6 ) 81 .6 1, 85 8 6, 91 2 2, 89 8 3, 03 6 8, 63 1 8, 31 6 3, 35 1 76 5 3, 96 8 5, 36 9 1, 56 1 2, 33 3 2, 33 7 2, 32 6 2, 33 7 2, 33 4 5, 79 0 3, 37 8 1, 28 0 72 0 46 2 37 11 ,6 67 62 4 2, 14 3 58 4 44 0 2, 91 1 n a 3, 35 1 28 4 1, 37 8 1, 40 0 28 9 1, 33 5 91 6 62 3 31 2 16 5 2, 15 8 71 1 19 7 16 2 10 4 19 3, 35 1 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 B o il S o la r d is in fe c- ti o n Le t it st an d a n d se tt le N u m b er o f h o u se h o ld m em b er s Pe rc en ta ge o f h ou se ho ld m em be rs in h ou se ho ld s us in g un im pr ov ed d ri nk in g w at er so ur ce s an d us in g an a pp ro pr i- at e w at er t re at m en t m et ho d1 N um be r of h ou se - ho ld m em be rs in ho us eh ol d us in g un im pr ov ed d ri nk - in g w at er s ou rc es A d d b le ac h / ch lo ri n e S tr ai n th ro ug h a cl ot h U se w at er fi lt er O th er MULTIPLE INDICATOR CLUSTER SURVEY 2011 57 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 56.8 56.8 74.5 72.0 57.4 43.4 53.7 64.8 76.2 32.8 (47.0) 57.8 78.9 89.5 48.6 72.6 79.2 70.5 71.6 (50.1) 61.2 2.1 2.4 0.7 4.5 1.1 5.8 2.5 1.5 0.4 2.1 2.0 2.8 2.3 0.5 3.3 0.6 1.3 0.4 0.0 (0.0) 2.0 0.4 0.3 0.3 0.5 0.2 1.0 0.6 0.0 0.0 0.4 0.5 0.6 0.0 0.0 0.2 0.1 0.5 1.2 0.0 (0.0) 0.3 12.9 19.7 10.3 7.6 19.4 11.1 17.7 16.9 13.3 22.0 22.0 21.5 10.3 5.6 17.8 16.5 12.1 12.8 14.0 (2.8) 16.3 14.0 9.7 6.9 5.8 11.1 20.6 14.4 6.4 3.9 26.7 15.0 4.1 2.5 0.4 15.4 3.3 1.9 7.8 6.9 (47.1) 9.7 6.1 1.2 3.0 1.0 2.9 4.5 2.5 2.7 0.3 8.2 2.1 1.0 0.5 0.3 3.9 0.8 1.0 1.0 1.6 (0.0) 2.4 0.6 0.4 0.0 0.2 0.3 0.9 0.1 0.1 1.0 0.3 0.2 0.2 0.0 0.8 0.1 0.5 0.4 0.9 0.0 (0.0) 0.3 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 1,858 6,912 2,898 3,036 8,631 765 3,968 5,369 1,561 2,333 2,337 2,326 2,337 2,334 5,790 3,378 1,280 720 462 37 11,667 7.1 9.5 4.3 8.5 7.6 12.8 8.5 7.5 4.9 7.4 11.3 12.1 5.5 2.9 10.6 5.6 3.6 5.4 5.9 (0.0) 7.8 District Kaimana Manokwari Sorong 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 Missing/DK Total for 3 districts Time to source of drinking water Users of improved drinking water sources Users of unimproved drinking water sources Water on premises Water on premises 30 min- utes or more 30 min- utes or more Less than 30 minutes Less than 30 minutes Missing/ DK Missing/ DK Number of house- hold members Total * 4 cases with missing “Education of household head” not shown ( ) Figures that are based on 25-49 unweighted cases MULTIPLE INDICATOR CLUSTER SURVEY 201158 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 30.0 22.8 14.1 18.2 22.9 44.8 26.7 17.3 12.0 44.5 29.0 20.0 10.7 4.2 35.5 10.4 9.2 14.2 15.2 21.7 43.6 59.7 55.9 50.4 56.9 57.0 56.9 53.0 (57.1) 63.6 54.6 44.6 48.5 (*) 60.5 42.7 (30.3) (37.0) (*) 55.5 52.1 36.5 38.4 44.6 39.1 35.6 38.5 43.8 (42.3) 32.6 40.9 50.4 49.0 (*) 35.4 55.5 (62.7) (46.3) (*) 40.2 1.2 1.9 2.3 0.0 2.3 0.6 2.6 1.7 (0.0) 2.3 2.7 0.0 1.3 (*) 2.3 0.0 (0.0) (3.3) (*) 1.8 1.1 1.6 1.5 2.1 1.3 6.2 0.4 1.1 (0.0) 1.3 0.2 3.2 0.0 (*) 1.3 0.0 (5.4) (6.1) (*) 1.5 0.4 0.0 0.0 0.5 0.0 0.0 0.0 0.1 (0.6) 0.0 0.0 0.0 0.4 (*) 0.1 0.0 (0.0) (1.2) (*) 0.1 1.5 0.4 1.8 2.4 0.5 0.6 1.7 0.2 (0.0) 0.2 1.5 1.8 0.8 (*) 0.3 1.9 (1.6) (6.2) (*) 0.9 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 134 374 103 127 485 93 254 215 50 253 160 113 64 22 437 98 32 25 19 611 448 1638 730 697 2119 208 950 1245 412 568 550 565 602 532 1231 937 342 174 124 2816 District Kaimana Manokwari Sorong 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 Person usually collecting drinking water Percent- age of house- holds without drinking water on premises Female child under age 15 Adult woman Missing Num- ber of house- holds Male child under age 15 Adult man DK Number of house- holds without drinking water on premises Total * 2 cases with missing “Ethnicity of household head” and 1 case with missing “Education of household head” not shown ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases Table WS.4 shows that for 56 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 40 per cent of cases, while for the rest of the households, female (2 per cent) or male children (2 per cent) under age 15 collect water. MULTIPLE 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. Seventy-one per cent of the population of the three selected districts of West Papua Province is living in households that use improved sanitation facilities that flush to septic tank (59 per cent) or use pit latrine with slab (13 per cent) (Table WS.5). About 13 per cent of the population have no facility or use bushes or fields. MULTIPLE INDICATOR CLUSTER SURVEY 201160 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , In d o n es ia , 2 01 1 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 (0 .0 ) 0. 0 0. 4 0. 2 0. 0 0. 3 0. 2 0. 0 0. 0 0. 4 0. 2 0. 0 0. 0 0. 7 0. 2 0. 1 0. 1 (0 .1 ) 0. 0 0. 2 2. 7 (0 .0 ) 0. 2 0. 1 0. 3 1. 7 0. 0 0. 8 1. 6 0. 5 0. 5 0. 8 0. 7 1. 2 0. 7 0. 3 0. 0 0. 5 1. 0 0. 5 0. 0 0. 0 (0 .0 ) 0. 6 0. 1 0. 0 0. 5 0. 0 0. 2 0. 4 0. 2 0. 1 0. 0 0. 0 0. 1 0. 1 0. 3 0. 2 0. 0 0. 4 0. 1 0. 0 0. 0 (0 .0 ) 0. 1 31 .9 9. 9 6. 4 21 .9 9. 2 8. 9 13 .7 13 .4 8. 3 11 .2 17 .9 14 .7 12 .1 6. 6 13 .3 8. 3 16 .0 19 .1 13 .5 (0 .0 ) 12 .5 36 .0 62 .7 62 .8 65 .1 56 .1 33 .1 45 .5 65 .0 81 .2 16 .2 36 .0 66 .9 81 .5 91 .6 48 .0 68 .0 74 .5 64 .2 67 .3 ( 49 .5 ) 58 .5 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 (0 .0 ) 0. 0 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 * 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 M is si n g /D K T o ta l f o r 3 d is tr ic ts T yp e o f to ile t fa ci lit y u se d b y h o u se h o ld Fl u sh to p it (l at ri n e) Fl u sh t o se p ti c ta n k 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 Fl u sh t o p ip ed se w er sy st em Fl us h to un kn ow n pl ac e/ N ot su re /D K w he re C o m - p o st in g to ile t P it la tr in e w it h sl ab V en ti - la te d Im - p ro ve d P it la tr in e (V IP ) P it la tr in e w it h o u t sl ab / o p en p it U n m p ro ve d s an it at io n f ac ili ty Fl u sh / p o u r fl u sh t o so m e- w h er e el se B u ck et H an g in g to ile t/ h an g in g la tr in e M is si n g O th er N u m - b er o f h o u se - h o ld m em - b er s T o ta l O p en d ef ec a- ti o n ( n o fa ci lit y, b u sh , fi el d ) * 4 ca se 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 ” 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 0. 4 1. 0 0. 7 2. 4 0. 2 0. 0 1. 2 0. 8 0. 3 0. 0 0. 6 0. 6 1. 8 1. 1 1. 0 0. 6 0. 7 0. 9 0. 0 (0 .0 ) 0. 8 2. 1 5. 6 3. 0 5. 8 3. 9 6. 5 6. 6 3. 3 1. 4 6. 6 11 .1 2. 9 1. 2 0. 0 7. 1 0. 9 1. 7 5. 3 1. 9 (0 .0 ) 4. 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 10 0. 0 25 .2 12 .5 4. 6 1. 3 16 .5 23 .7 18 .3 9. 1 4. 6 43 .7 12 .8 5. 4 1. 0 0. 0 21 .3 3. 8 1. 6 6. 6 4. 5 ( 47 .1 ) 12 .6 0. 5 0. 8 0. 1 0. 3 0. 7 1. 7 0. 9 0. 3 0. 0 1. 5 1. 0 0. 4 0. 0 0. 0 1. 0 0. 3 0. 1 0. 1 0. 0 (0 .0 ) 0. 6 0. 3 0. 1 0. 3 0. 2 0. 2 0. 0 0. 1 0. 3 0. 3 0. 2 0. 2 0. 4 0. 1 0. 2 0. 3 0. 2 0. 0 0. 0 0. 0 (0 .0 ) 0. 2 0. 0 0. 1 0. 1 0. 0 0. 1 0. 6 0. 0 0. 1 0. 1 0. 5 0. 0 0. 0 0. 0 0. 0 0. 2 0. 1 0. 0 0. 0 0. 0 (0 .0 ) 0. 1 3. 1 6. 9 19 .6 2. 6 11 .8 23 .6 13 .0 6. 7 3. 0 19 .0 19 .1 7. 2 1. 7 0. 2 7. 2 16 .3 4. 7 3. 6 10 .1 (3 .4 ) 9. 4 1, 85 8 6, 91 2 2, 89 8 3, 03 6 8, 63 1 76 5 3, 96 8 5, 36 9 1, 56 1 2, 33 3 2, 33 7 2, 32 6 2, 33 7 2, 33 4 5, 79 0 3, 37 8 1, 28 0 72 0 46 2 37 11 ,6 67 MULTIPLE INDICATOR CLUSTER SURVEY 2011 61 T ab 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 f ac ili ti es , D is tr ic ts o f K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 M is si n g /D K T o ta l f o r 3 d is tr ic ts U se rs o f i m pr ov ed s an ita tio n fa ci lit ie s S ha re d by N ot sh ar ed 1 5 ho us e- ho ld s or le ss Pu bl ic fa ci lit y M or e th an 5 ho us e- ho ld s M is si ng / D K U se rs o f u ni m pr ov ed s an ita tio n fa ci lit ie s S ha re d by N ot sh ar ed 1 5 ho us e- ho ld s or le ss Pu bl ic fa ci lit y M or e th an 5 ho us e- ho ld s M is si ng / D K O pe n de f- ec at io n (n o fa ci l- ity , b us h, fie ld ) To ta l N um be r of h ou se - ho ld m em be rs * 4 ca se 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 ” 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 1 M IC S in d ic at o r 4. 3; M D G in d ic at o r 7. 9 43 .6 56 .3 48 .7 63 .0 48 .7 25 .8 40 .8 58 .5 74 .0 11 .3 31 .6 57 .7 72 .3 89 .2 40 .9 62 .4 68 .3 63 .2 65 .0 ( 30 .5 ) 52 .4 10 .7 10 .8 12 .0 16 .6 9. 2 5. 9 8. 8 13 .7 10 .9 5. 2 12 .2 16 .1 15 .6 6. 4 10 .0 11 .9 14 .1 13 .1 9. 0 (0 .0 ) 11 .1 3. 5 2. 5 0. 6 3. 8 1. 6 0. 6 2. 1 2. 4 2. 4 0. 6 1. 5 3. 8 3. 2 1. 9 1. 4 2. 3 4. 3 3. 4 2. 7 ( 19 .0 ) 2. 2 0. 5 1. 0 0. 4 1. 4 0. 6 0. 0 1. 0 0. 6 1. 1 0. 3 0. 2 0. 4 1. 8 1. 0 0. 3 0. 7 1. 2 0. 8 5. 1 (0 .0 ) 0. 8 10 .3 2. 4 9. 8 2. 5 6. 5 11 .7 7. 2 4. 2 2. 1 11 .0 9. 8 5. 2 1. 4 0. 0 9. 4 0. 6 3. 3 3. 0 1. 8 (0 .0 ) 5. 5 2. 8 8. 8 17 .8 5. 8 11 .6 18 .8 15 .1 7. 0 3. 7 16 .4 22 .0 8. 0 3. 6 0. 5 9. 2 15 .1 4. 6 3. 5 10 .6 (3 .4 ) 10 .1 1. 4 2. 1 4. 3 2. 8 2. 4 7. 7 2. 3 2. 5 0. 7 4. 1 4. 5 2. 8 0. 3 1. 0 2. 8 2. 8 0. 6 3. 4 1. 1 (0 .0 ) 2. 5 25 .2 12 .5 4. 6 1. 3 16 .5 23 .7 18 .3 9. 1 4. 6 43 .7 12 .8 5. 4 1. 0 0. 0 21 .3 3. 8 1. 6 6. 6 4. 5 ( 47 .1 ) 12 .6 0. 7 0. 1 0. 0 0. 4 0. 1 0. 9 0. 1 0. 1 0. 1 0. 4 0. 4 0. 1 0. 0 0. 0 0. 2 0. 0 0. 2 1. 0 0. 0 (0 .0 ) 0. 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 0. 0 0. 2 0. 2 0. 3 0. 1 0. 2 0. 2 0. 1 0. 0 0. 2 0. 0 0. 3 0. 1 0. 0 0. 3 0. 0 0. 0 0. 0 0. 0 (0 .0 ) 0. 1 1, 85 8 6, 91 2 2, 89 8 3, 03 6 8, 63 1 76 5 3, 96 8 5, 36 9 1, 56 1 2, 33 3 2, 33 7 2, 32 6 2, 33 7 2, 33 4 5, 79 0 3, 37 8 1, 28 0 72 0 46 2 37 11 ,6 67 1. 5 3. 2 1. 7 2. 1 2. 7 4. 7 4. 1 1. 7 0. 5 6. 8 5. 1 0. 3 0. 7 0. 0 4. 3 0. 4 1. 8 2. 0 0. 3 (0 .0 ) 2. 6 MULTIPLE INDICATOR CLUSTER SURVEY 201162 About one-fourth of the population Kaimana District has no facility or use bushes or fields (25 per cent). No facility or use of bushes or fields is much less common in Manokwari (13 per cent) and Sorong (5 per cent). About 69, 73 and 69 per cent of the population in Kaimana, Manokwari and Sorong districts respectively use facilities that flush to a septic tank or pit (latrines). As expected, the percentage of population that have no facility or use bushes or fields is higher in rural areas (17 per cent) than urban areas (1 per cent). The table indicates that no facility or use of bushes or fields is strongly correlated with both education level 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, 52 per cent of the household population is using an improved sanitation facility (Kaimana, 44 per cent; Manokwari, 56 per cent; Sorong, 49 per cent). About 19 per cent of the household population are using an improved sanitation facility shared with others. As expected, use of improved sanitation facilitiesy 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 11 per cent among the poorest household population to 89 per cent for the richest. Figure WS.2: Percentage of household population using improved (not shared) sanitation facilities, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest 0 40 8020 60 100 Per cent 44 49 49 63 32 72 26 41 59 74 58 89 11 56 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011 63 gives an understanding of the proportion of population with no sanitation facilities at all, of those reliant on technologies defined by JMP as “unimproved,” of those sharing sanitation facilities of otherwise acceptable technology, and those using “improved” sanitation facilities. 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 43 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: Higher percentages of household populations using both improved drinking sources and sanitation were seen in Manokwari and Sorong (45 per cent each) than in Kaimana (32 per cent). Urban areas exhibit a higher use of both improved drinking sources and sanitation (56 per cent) than rural (38 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest 0 40 8020 60 100 Per cent 32 45 45 38 56 24 62 20 32 49 61 39 84 4 MULTIPLE INDICATOR CLUSTER SURVEY 201164 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 25 .4 15 .2 3. 1 25 .9 9. 6 5. 8 6. 8 16 .7 25 .4 6. 6 3. 1 10 .2 18 .7 30 .4 13 .0 12 .0 20 .0 18 .8 13 .4 (0 .0 ) 13 .8 33 .6 31 .0 20 .1 14 .5 33 .7 37 .1 34 .7 26 .1 18 .5 57 .2 39 .2 26 .8 13 .3 7. 1 37 .3 21 .0 15 .4 22 .5 22 .6 ( 49 .9 ) 28 .7 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 43 .6 56 .3 48 .7 63 .0 48 .7 25 .8 40 .8 58 .5 74 .0 11 .3 31 .6 57 .7 72 .3 89 .2 40 .9 62 .4 68 .3 63 .2 65 .0 ( 30 .5 ) 52 .4 24 .9 16 .7 22 .9 24 .3 17 .8 18 .2 19 .1 20 .9 16 .5 17 .1 23 .7 25 .5 22 .0 9. 3 21 .1 15 .5 22 .9 20 .3 18 .6 ( 19 .0 ) 19 .5 6. 4 14 .5 23 .9 11 .3 17 .0 32 .3 21 .8 11 .5 5. 0 27 .9 32 .0 11 .4 4. 7 1. 5 16 .8 18 .3 7. 2 9. 9 12 .0 (3 .4 ) 15 .5 25 .2 12 .5 4. 6 1. 3 16 .5 23 .7 18 .3 9. 1 4. 6 43 .7 12 .8 5. 4 1. 0 0. 0 21 .3 3. 8 1. 6 6. 6 4. 5 ( 47 .1 ) 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 31 .7 44 .6 44 .9 56 .5 37 .7 19 .5 31 .6 48 .8 60 .8 4. 5 23 .6 39 .5 61 .8 83 .6 31 .2 52 .0 60 .7 52 .4 53 .4 ( 27 .7 ) 42 .6 1, 85 8 6, 91 2 2, 89 8 3, 03 6 8, 63 1 76 5 3, 96 8 5, 36 9 1, 56 1 2, 33 3 2, 33 7 2, 32 6 2, 33 7 2, 33 4 5, 79 0 3, 37 8 1, 28 0 72 0 46 2 37 11 ,6 67 41 .1 53 .8 76 .7 59 .6 56 .7 57 .1 58 .5 57 .2 56 .1 36 .1 57 .7 63 .0 67 .9 62 .5 49 .7 67 .0 64 .6 58 .7 64 .0 ( 50 .1 ) 57 .5 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 M is si n g /D K T o ta l f o r 3 d is tr ic ts 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 d ri n ki n g w at er Im pr ov ed d rin ki ng w at er 1 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 O p en d ef ec at io n P ip ed in to d w el lin g , p lo t o r ya rd U n im - p ro ve d d ri n ki n g w at er T o ta l Im p ro ve d s an i- ta ti o n 2 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 T o ta l Im p ro ve d d ri n ki n g w at er so u rc es a n d im p ro ve d sa n it at io n * 4 ca se 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 ” 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 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 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 46 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 28 per cent did not know how great the distance was. By district the proportion of households reporting water sources 10 or more metres away from the closest excreta place was 52, 40 and 35 per cent in Manokwari, Kaimana and Sorong respectively. In Sorong District 58 per cent of households did not know the distance between their water source and the closest excreta disposal place (Table WS.8) compared with 20 and 17 per cent in Kaimana and Manokwari. District Kaimana Manokwari Sorong 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 Missing/DK Total for 3 districts 28.4 20.1 6.0 26.2 15.0 9.2 16.0 19.6 21.3 6.5 15.8 21.5 28.4 17.4 14.6 19.0 25.1 25.2 33.2 15.3 17.9 39.9 52.1 35.0 40.4 47.9 48.6 51.3 42.4 43.0 53.1 51.6 44.0 39.3 41.6 51.1 40.6 42.7 36.3 89.2 53.8 45.9 20.2 16.8 57.7 25.1 28.4 27.8 25.7 29.4 25.5 25.6 27.6 28.1 25.5 30.8 23.0 35.5 23.5 31.6 58.4 27.6 27.5 11.6 10.9 1.3 8.3 8.8 14.4 7.1 8.5 10.2 14.7 5.0 6.4 6.8 10.3 11.4 4.9 8.8 6.9 9.1 3.4 8.6 1,858 6,912 2,898 3,036 8,631 765 3,968 5,369 1,561 2,333 2,337 2,326 2,337 2,334 5,790 3,378 1,280 720 462 37 11,667 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of household members Total less than 10 meters 10 meters or more DK Missing * 4 case with missing “Education of household head” not shown MULTIPLE INDICATOR CLUSTER SURVEY 201166 MULTIPLE INDICATOR CLUSTER SURVEY 2011 67 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 16 14 12 10 8 6 4 2 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 10 12 0 0 11 5 15 13 13 2 1 2 Kaimana SorongManokwari MULTIPLE INDICATOR CLUSTER SURVEY 201168 The TFR in the three selected districts of West Papua for the one-year period preceding the survey is 3 children per woman. TFR is highest in Kaimana District (3.2 children per woman) and lowest in Sorong District (2.8 children per woman). TFR in Manokwari District is 3.1 children per woman. Table RH.1 also shows differentials in fertility by area of 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 Papuans compared with others. The adolescent birth rate (Age-specific fertility rate for women age 15-19) is 49 births per 1,000 women. The adolescent birth rate is higher in Kaimana District (66 births per 1,000 women) than in Sorong (53 births per 1,000 women) and Manokwari (44 births per 1,000 women). The birth rate is highest among rural adolescents, the poorest adolescents, 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, 11 per cent of women age 15-19 have already given birth, four per cent are District Kaimana Manokwari Sorong 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 66 44 53 18 63 0 164 32 25 101 45 55 36 19 53 45 45 3.2 3.1 2.8 2.7 3.2 4.2 3.1 3.2 3.2 3.6 3.1 3.5 2.6 2.5 3.7 2.5 3.0 Table RH.1: Adolescent birth rate and total fertility rate Adolescent birth rates and total fertility rates, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Total fertility rate Adolescent birth rate1 (Age-specific fertility rate for women age 15-19) 1 MICS indicator 5.1; MDG indicator 5.4 MULTIPLE INDICATOR CLUSTER SURVEY 2011 69 pregnant with their first child, 15 per cent have begun childbearing and one per cent has gave birth before age 15. More women have begun childbearing in Manokwari District than in other districts (Figure RH.1). Sixteen per cent of women aged 20-24 years gave birth before reaching 18 years of age. The percentage of women giving birth before age 18 in this age group did not vary much among districts (Kaimana, 16 per cent; Manokwari, 15 per cent; Sorong, 17 per cent). 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 12.2 10.3 10.8 10.0 10.9 (*) 28.7 7.3 11.1 20.1 9.2 8.2 9.4 6.8 14.8 5.9 (8.8) (4.8) (*) 10.7 0.4 5.1 2.1 4.4 3.6 (*) 8.0 3.8 0.0 2.5 6.7 6.5 1.7 3.1 3.2 3.9 (9.3) (0.9) (*) 3.8 12.6 15.4 13.0 14.4 14.5 (*) 36.8 11.1 11.1 22.5 15.9 14.6 11.1 9.9 18.0 9.9 (18.1) (5.7) (*) 14.5 0.0 1.6 1.1 1.5 1.2 (*) 1.8 1.4 0.0 2.3 0.0 0.0 1.6 2.0 1.6 0.0 (4.4) (0.0) (*) 1.3 63 301 101 138 327 6 62 342 56 86 96 70 124 88 248 130 41 33 13 465 15.5 15.2 16.8 5.2 19.8 (*) 30.3 15.8 1.3 38.7 21.4 13.8 9.0 0.0 19.0 18.1 2.1 (5.3) (*) 15.5 58 265 72 116 279 7 79 201 108 74 68 74 89 90 193 117 51 27 7 395 District Kaimana Manokwari Sorong 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 Have had a live birth Are preg- nant with first child Have begun childbear- ing 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 Percentage of women age 15-19 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 5.2 MULTIPLE INDICATOR CLUSTER SURVEY 201170 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 1. 5 0. 0 1. 5 0. 4 0. 0 2. 3 2. 1 1. 0 13 8 11 6 15 3 11 4 97 76 69 76 3 n a 5. 2 13 .8 14 .3 9. 3 19 .3 20 .2 13 .0 n a 27 9 30 8 32 9 29 0 22 9 19 0 1, 62 4 n a 11 6 15 3 11 4 97 76 69 62 6 1. 3 3. 5 2. 9 2. 3 2. 4 6. 4 3. 4 3. 0 1. 2 4. 9 3. 6 2. 9 3. 2 7. 8 3. 8 3. 7 46 5 39 5 46 2 44 3 38 7 30 5 25 9 2, 71 5 32 7 27 9 30 8 32 9 29 0 22 9 19 0 1, 95 2 n a 15 .5 17 .1 16 .1 16 .4 20 .4 25 .2 17 .9 n a 19 .8 18 .7 16 .7 18 .8 20 .8 27 .0 19 .8 n a 39 5 46 2 44 3 38 7 30 5 25 9 2, 25 0 A g e 15 -1 9 20 -2 4 25 -2 9 30 -3 4 35 -3 9 40 -4 4 45 -4 9 T o ta l f o r 3 d is tr ic ts 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 a g 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 18 N u m b er o f w o m en a g e 20 -4 9 U rb an 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 a g 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 18 N u m b er o f w o m en a g e 20 -4 9 R u ra l 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 a g 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 18 N u m b er o f w o m en a g e 20 -4 9 A ll MULTIPLE 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 West Papua was reported by half of women currently married (50 per cent) (Table RH.4). The lowest current use was seen in Kaimana District (30 per cent), mostly modern methods, compared with 54 per cent each in Manokwari and Sorong districts with women also mostly using modern methods (Figure RH.2). Figure RH.2: Percentage of currently married women aged 15-49 years using contraceptive methods, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 100 90 80 70 60 50 40 30 20 10 0 P er c en t Kaimana Manokwari Sorong Traditional Method No MethodModern Method 28 2 2 1 70 46 52 53 46 The most popular methods in Kaimana District are injectables (18 per cent) and the pill (9 per cent). The most popular methods in Manokwari are injectables (29 per cent) and the pill (11 per cent). The most popular methods in Sorong are injectables (31 per cent) and the pill (14 per cent). Only about 21 per cent of women aged 15-19 currently use a method of contraception compared 58 per cent for women aged 35-39. Women’s education levels are associated with contraceptive prevalence. The percentage of women using any method of contraception rises from 23 per cent among those with no education to 47 per cent among women with primary education, to 57 per cent among women with secondary education and drops to 44 per cent among women with higher education. The method mix did not vary by education. Contraceptive users among the different education categories were mostly using injectables and the pill. Use of any contraceptive method did not show clearly the expected positive association between contraceptive use and number of living children a woman had. MULTIPLE INDICATOR CLUSTER SURVEY 201172 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 30 4 1, 17 6 50 7 49 2 1, 49 5 89 24 0 38 2 40 9 36 4 26 6 23 7 18 0 40 9 53 9 36 2 49 7 1 M IC S in d ic at o r 5. 3; M D G in d ic at o r 5. 3 69 .9 46 .1 46 .3 49 .2 50 .0 78 .8 49 .6 45 .2 48 .2 41 .7 48 .1 63 .4 96 .2 51 .4 42 .8 37 .1 48 .4 0. 0 0. 0 0. 2 0. 0 0. 1 0. 0 0. 0 0. 0 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 9. 2 10 .6 14 .1 10 .2 11 .6 3. 8 10 .8 8. 2 12 .0 17 .3 13 .9 6. 1 1. 0 9. 9 14 .7 15 .0 9. 7 0. 3 1. 0 1. 0 1. 3 0. 8 1. 9 1. 2 0. 0 1. 5 0. 4 0. 4 1. 9 0. 0 1. 0 1. 0 1. 7 0. 5 17 .7 28 .8 30 .6 24 .9 28 .5 15 .5 33 .2 39 .1 31 .6 26 .9 20 .4 10 .2 2. 8 31 .5 33 .0 31 .4 24 .6 0. 3 4. 2 4. 2 2. 2 4. 1 0. 0 3. 8 3. 7 3. 9 5. 8 1. 2 3. 2 0. 0 3. 4 4. 0 4. 9 3. 7 0. 3 2. 3 0. 3 3. 5 0. 8 0. 0 1. 5 1. 7 0. 4 1. 6 3. 6 0. 8 0. 0 1. 8 1. 0 2. 6 1. 3 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. 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. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 28 .5 51 .9 52 .5 47 .9 48 .7 21 .2 50 .4 53 .4 50 .9 55 .2 47 .5 35 .4 3. 8 47 .7 55 .4 60 .9 48 .8 0. 6 1. 1 0. 5 1. 1 0. 8 0. 0 0. 0 0. 4 0. 3 1. 2 4. 0 0. 0 0. 0 0. 9 1. 2 0. 6 1. 1 0. 2 0. 6 0. 1 1. 0 0. 2 0. 0 0. 0 0. 9 0. 0 0. 6 0. 0 1. 0 0. 0 0. 0 0. 6 0. 0 0. 9 0. 8 0. 3 0. 5 0. 8 0. 3 0. 0 0. 0 0. 1 0. 6 1. 3 0. 4 0. 2 0. 0 0. 1 0. 0 1. 3 0. 8 1. 7 2. 0 1. 2 2. 9 1. 4 0. 0 0. 0 1. 4 0. 9 3. 1 4. 4 1. 2 0. 0 1. 0 1. 8 2. 0 2. 8 30 .1 53 .9 53 .7 50 .8 50 .0 21 .2 50 .4 54 .8 51 .8 58 .3 51 .9 36 .6 3. 8 48 .6 57 .2 62 .9 51 .6 MULTIPLE INDICATOR CLUSTER SURVEY 2011 73 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t 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 T o 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 76 .7 53 .1 43 .1 56 .2 67 .4 50 .0 48 .6 40 .3 45 .9 63 .8 35 .0 43 .2 56 .8 36 .8 49 .8 1. 2 4. 4 3. 6 2. 3 1. 8 4. 4 0. 2 5. 3 5. 9 3. 7 3. 1 5. 7 2. 3 3. 3 3. 6 3. 9 11 .1 12 .8 8. 7 5. 7 9. 3 12 .6 13 .7 14 .0 3. 9 17 .3 12 .5 11 .4 30 .4 11 .3 1. 0 0. 7 0. 8 2. 0 0. 3 0. 6 1. 8 0. 1 1. 6 0. 7 1. 2 1. 3 0. 4 0. 0 0. 9 15 .8 24 .5 31 .9 23 .5 22 .1 31 .2 28 .4 30 .4 25 .3 23 .5 34 .0 29 .1 22 .6 21 .0 27 .6 1. 4 4. 3 3. 4 3. 6 1. 7 3. 2 5. 8 4. 0 3. 1 2. 1 6. 2 2. 6 2. 0 2. 9 3. 6 0. 0 0. 4 2. 1 2. 6 0. 0 0. 2 0. 4 4. 7 1. 4 0. 9 1. 6 3. 2 2. 1 0. 0 1. 5 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. 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. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 23 .3 45 .6 54 .6 42 .6 31 .6 48 .9 49 .4 58 .2 51 .2 34 .9 63 .4 54 .7 40 .9 57 .6 48 .5 0. 0 0. 1 1. 5 1. 2 0. 2 0. 1 1. 4 0. 7 1. 9 0. 2 1. 2 1. 2 1. 4 3. 0 0. 9 0. 0 0. 7 0. 3 0. 0 0. 2 0. 6 0. 4 0. 8 0. 0 0. 5 0. 3 0. 0 0. 0 2. 0 0. 4 0. 0 0. 6 0. 5 0. 0 0. 6 0. 4 0. 3 0. 1 0. 9 0. 5 0. 1 0. 9 0. 9 0. 5 0. 4 0. 0 1. 3 2. 3 1. 2 1. 0 1. 1 2. 0 1. 6 2. 9 1. 3 1. 6 2. 1 2. 3 5. 5 1. 7 23 .3 46 .9 56 .9 43 .8 32 .6 50 .0 51 .4 59 .7 54 .1 36 .2 65 .0 56 .8 43 .2 63 .2 50 .2 11 1 66 1 99 5 22 0 35 0 37 8 38 9 43 7 43 4 82 6 68 5 24 7 13 4 89 1, 98 7 *6 c as es 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 5. 3; M D G in d ic at o r 5. 3 MULTIPLE INDICATOR CLUSTER SURVEY 201174 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 11 per cent, i.e. one in 10 women are not using contraceptives but wish to stop having children (limit) or postpone the next pregnancy for at least two years (space) (Table RH.4A). Slightly less women are in unmet need for limiting for contraception (5 per cent) than in unmet need in for spacing for contraception (6 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 a 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 2011 75 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 22.4 23.0 26.9 23.5 24.1 17.5 44.9 36.0 30.0 14.7 10.1 4.8 7.2 19.4 27.5 29.8 14.0 25.1 28.3 25.6 25.3 17.0 32.4 25.3 22.6 22.1 23.9 8.5 31.0 26.8 27.3 26.2 3.9 5.7 18.9 22.0 43.7 41.8 32.2 16.1 28.0 29.4 14.0 19.3 25.0 23.1 34.1 28.8 19.5 32.6 31.4 20.6 41.1 26.5 30.9 54.0 53.7 50.8 50.2 21.5 50.7 54.9 51.9 58.3 51.9 37.0 23.3 47.4 56.9 43.8 33.3 50.1 51.4 59.7 54.1 36.5 65.0 56.8 43.2 63.2 50.4 9.5 5.4 5.7 5.8 6.2 23.1 7.2 8.5 8.0 2.6 2.7 0.7 9.2 5.7 5.6 8.2 9.9 6.5 5.2 4.4 5.3 9.0 3.2 6.2 4.6 4.4 6.1 5.2 4.3 5.2 4.5 4.7 0.0 0.5 4.0 4.7 5.4 7.6 7.0 7.7 6.5 3.7 2.2 6.0 5.1 5.3 2.6 4.6 5.4 3.5 3.8 10.7 0.0 4.7 14.7 9.7 10.9 10.3 10.9 23.1 7.8 12.5 12.7 8.0 10.4 7.8 16.9 12.1 9.3 10.4 16.0 11.6 10.5 7.0 9.9 14.4 6.7 10.0 15.4 4.4 10.8 304 1,176 507 492 1,495 89 240 382 409 364 266 237 111 661 995 220 350 378 389 437 434 826 685 247 134 89 1,987 67.7 84.8 83.1 83.2 82.1 48.2 86.7 81.5 80.3 88.0 83.3 82.7 58.0 79.6 86.0 80.8 67.6 81.2 83.0 89.5 84.5 71.7 90.6 85.1 73.8 93.5 82.4 139 749 328 301 915 40 140 258 265 241 166 106 45 393 658 119 172 233 241 292 278 421 491 165 79 60 1,215 District Kaimana Manokwari Sorong 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 Number of women currently married or in union Percentage of demand for con- traception satisfied Number of women cur- rently married or in union with need for contraception For spacing For spacing For limiting For limiting Total Total Met need for contraception Unmet need for contraception MULTIPLE INDICATOR CLUSTER SURVEY 201176 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 anemia • Weight/height measurement (optional) The type of personnel providing antenatal care to women aged 15-49 years who gave birth in the two years preceding the survey is presented in Table RH.5. Coverage of antenatal care (by a doctor, nurse or midwife) is higher in Sorong District (91 per cent) than in Manokwari District (86 per cent) or Kaimana District (84 per cent). Within Kaimana and Sorong districts, antenatal care is provided mostly by midwifves, while in Manokwari antenatal care is provided mostly by doctors. Antenatal care coverage is higher in urban areas (88 per cent) than in rural (82 per cent). Most women who sought antenatal care were age 20-34 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 87 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 54, 67 and 73 per cent in Kaimana, Manokwari and Sorong 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, 22 per cent of the women living in the poorest households reported four or more antenatal care visits compared with 83 per cent among those living in richest households. MULTIPLE 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 recieved antenatal care at least once by skilled personnel, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong Area Urban Rural Age Less than 20 20-34 35-49 Education None Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest 74 86 88 84 91 86 88 82 85 92 57 76 92 93 90 94 75 0 40 8020 60 100 Per cent 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, 40 per cent reported that a blood sample was taken during antenatal care visits, 79 per cent reported that their blood pressure was checked, 32 per cent that a urine specimen was taken and 21 per cent that all three tests were made. Women living in Manokwari (19 per cent) and Sorong (17 per cent) districts were less likely to have all three tests made than those living in Kaimana District (30 per cent). Similarly, women with no education, the poorest women, younger women (age less than 20 years) and older women (35-49 years) were also less likely to receive all tests. MULTIPLE INDICATOR CLUSTER SURVEY 201178 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 15 .3 50 .9 25 .5 42 .3 37 .0 20 .1 42 .0 33 .2 (9 .9 ) 20 .4 44 .1 58 .8 16 .0 29 .7 39 .1 44 .7 68 .2 32 .1 40 .3 63 .5 23 .8 ( *) 38 .4 55 .7 31 .8 61 .0 39 .2 44 .0 46 .3 41 .5 46 .6 ( 26 .2 ) 45 .5 45 .4 32 .2 47 .3 48 .1 45 .4 45 .3 25 .4 40 .2 51 .8 28 .9 55 .9 ( *) 42 .8 12 .7 3. 1 4. 7 0. 4 7. 1 7. 5 4. 9 6. 1 ( 20 .7 ) 9. 9 2. 8 2. 2 11 .2 6. 7 5. 5 2. 0 0. 0 7. 3 2. 9 0. 8 9. 3 ( *) 5. 4 1. 4 0. 0 0. 0 0. 3 0. 3 1. 8 0. 1 0. 0 (0 .0 ) 1. 1 0. 0 0. 0 0. 8 0. 5 0. 0 0. 0 0. 0 0. 5 0. 0 0. 0 0. 0 ( *) 0. 3 83 .7 85 .8 91 .2 82 .0 88 .1 73 .9 88 .5 86 .0 ( 56 .8 ) 75 .8 92 .3 93 .3 74 .5 84 .6 90 .1 92 .0 93 .6 79 .6 95 .0 93 .3 89 .0 ( *) 86 .5 0. 5 0. 0 0. 6 0. 5 0. 1 0. 0 0. 1 0. 9 (2 .6 ) 0. 4 0. 0 0. 0 0. 4 0. 0 0. 6 0. 0 0. 0 0. 4 0. 0 0. 0 0. 0 ( *) 0. 2 14 .5 14 .2 8. 2 17 .3 11 .5 24 .2 11 .3 13 .2 ( 40 .6 ) 22 .7 7. 7 6. 7 24 .2 14 .9 9. 3 8. 0 6. 4 19 .4 5. 0 6. 7 11 .0 ( *) 13 .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 99 28 7 10 2 12 4 36 5 54 36 7 68 23 12 8 27 2 67 10 9 96 10 3 93 87 25 1 12 8 59 34 15 48 9 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 T o ta l f o r 3 d is tr ic ts D o ct o r M id w if e 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 re ce iv ed N u rs e T o ta l T ra d it io n al b ir th at te n d an t 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 t h e p re ce d in g t w o ye ar s P er so n p ro vi d in g a n te n at al c ar e * 2 ca se s 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 5. 5a ; M D G in d ic at o r 5. 5 MULTIPLE INDICATOR CLUSTER SURVEY 2011 79 T ab 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 K ai m an a, M an o kw ar i an d S o ro n g , W es t 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 1 V is it 4 o r m o re vi si ts 1 M is si n g /D K 2 V is it s T o ta l 3 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 P er c en t d is tr ib u ti o n o f w o m en w h o h ad : 14 .5 14 .2 8. 2 17 .3 11 .5 24 .2 11 .3 13 .2 ( 40 .6 ) 22 .7 7. 7 6. 7 24 .2 14 .9 9. 3 8. 0 6. 4 19 .4 5. 0 6. 7 11 .0 ( *) 13 .0 5. 3 5. 0 5. 1 7. 5 4. 3 6. 1 5. 1 4. 5 ( 11 .3 ) 6. 9 4. 5 2. 0 7. 3 6. 7 2. 8 5. 0 3. 5 7. 7 1. 6 3. 4 4. 5 ( *) 5. 1 12 .5 6. 3 3. 5 4. 4 7. 9 8. 1 6. 7 7. 7 ( 14 .3 ) 11 .7 4. 3 6. 6 12 .5 6. 8 8. 7 1. 1 4. 5 9. 9 5. 3 1. 0 5. 5 ( *) 7. 0 13 .1 8. 0 10 .6 2. 1 12 .1 13 .2 9. 5 6. 8 ( 12 .0 ) 13 .1 7. 5 10 .4 14 .6 13 .2 6. 4 10 .1 2. 3 14 .1 3. 9 5. 6 8. 5 ( *) 9. 6 53 .7 66 .5 72 .5 68 .3 64 .1 47 .4 67 .3 67 .9 ( 21 .8 ) 45 .6 75 .7 74 .3 40 .9 58 .3 72 .4 75 .9 83 .2 48 .6 84 .3 82 .5 70 .5 ( *) 65 .2 0. 9 0. 0 0. 0 0. 3 0. 1 0. 9 0. 1 0. 0 (0 .0 ) 0. 0 0. 3 0. 0 0. 4 0. 0 0. 4 0. 0 0. 0 0. 2 0. 0 0. 7 0. 0 ( *) 0. 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 99 28 7 10 2 12 4 36 5 54 36 7 68 23 12 8 27 2 67 10 9 96 10 3 93 87 25 1 12 8 59 34 15 48 9 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 T o ta l f o r 3 d is tr ic ts * 2 ca se s 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 5. 5a ; M D G in d ic at o r 5. 5 MULTIPLE INDICATOR CLUSTER SURVEY 201180 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 79 .6 77 .2 81 .5 78 .2 78 .7 68 .5 80 .1 78 .4 ( 48 .5 ) 66 .1 85 .6 84 .2 62 .1 70 .4 81 .5 92 .0 90 .5 67 .9 91 .1 87 .2 86 .7 ( *) 78 .6 38 .4 33 .2 21 .5 40 .1 29 .0 15 .4 32 .9 39 .2 ( 13 .2 ) 26 .5 34 .2 38 .4 13 .9 21 .0 43 .0 36 .6 47 .7 21 .7 39 .2 47 .5 45 .5 ( *) 31 .8 29 .6 19 .4 16 .6 26 .2 19 .1 14 .3 21 .9 20 .9 (6 .2 ) 17 .6 23 .9 20 .0 10 .5 15 .1 32 .8 21 .8 25 .4 17 .7 22 .7 17 .9 39 .9 ( *) 20 .9 55 .4 30 .3 52 .8 40 .6 39 .9 41 .9 40 .3 37 .7 ( 22 .9 ) 34 .8 44 .1 39 .6 31 .5 40 .1 48 .1 41 .8 39 .6 37 .9 39 .7 36 .0 62 .8 ( *) 40 .1 99 28 7 10 2 12 4 36 5 54 36 7 68 23 12 8 27 2 67 10 9 96 10 3 93 87 25 1 12 8 59 34 15 48 9 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 T o ta l f o r 3 d is tr ic ts 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 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 B lo o d s am p le t ak en 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 P er ce n ta g e o f p re g n an t w o m en w h o h ad : * 2 ca se s 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 5. 6 MULTIPLE 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 12 http://www.who.int/features/2003/04b/en/ 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 received a test for malaria during pregnancy at any antenatal care visit by malaria test result Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 45.4 46.0 53.9 43.4 48.9 (13.6) 43.7 51.6 49.4 44.0 54.3 51.3 54.2 32.6 46.0 51.6 33.8 62.4 (*) 47.5 30.8 56.8 61.3 40.4 56.5 (45.4) 51.6 52.6 56.1 53.9 52.5 68.0 43.8 43.6 56.2 53.0 46.9 36.9 (*) 52.7 0.0 0.0 17.2 1.5 4.9 (*) 5.4 3.5 (2.4) 1.6 12.4 2.8 (0.0) (2.8) 1.4 9.6 (*) 0.0 (*) 4.1 99 287 102 124 365 23 128 272 67 109 96 103 93 87 251 128 59 34 15 489 13.5 48.0 17.1 24.3 36.9 (*) 29.0 36.2 (33.8) 27.1 26.7 48.1 (33.3) (34.1) 35.4 40.0 (*) 18.8 (*) 34.0 86.5 52.0 65.7 74.2 58.2 (*) 65.6 60.4 (63.8) 71.3 60.9 49.1 (66.7) (63.1) 63.3 50.4 (*) 81.2 (*) 61.9 45 132 55 54 178 3 56 140 33 48 52 53 51 28 115 66 20 21 7 232 District Kaimana Manokwari Sorong 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 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 an- tenatal care (ANC) and had malaria blood test Percentage of women who received an ITN during antenatal visit Number of women who had a live birth in the two years pre- ceeding the survey Positive (malaria present) Nega- tive (no malaria) DK Percentage of pregnant women whose malaria test was: * 2 cases 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 201182 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 drugs are given to those pregnant mothers with positive malaria blood test results. At the request of the Ministry of Health, MICS in Selected Districts of West Papua incorporated additional questions designed to assess the implementation of this policy. Table RH.8 shows that 48 per cent of women in the three selected districts of West Papua Province who received antenatal care had a malaria blood test. By district, the percentages are 54, 46 and 45 per cent in Sorong, Manokwari and Kaimana respectively. About half of the women (48 per cent) who received the malaria test in Manokwari District had malaria, compared with 17 and 14 per cent in Sorong and Kaimana districts. 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 an antenatal visit in the three selected districts of West Papua was reported as 53 per cent. The percentage was the highest in Sorong District (61 per cent), followed by Manokwari (57 per cent) and Kaimana (31 per cent). Table RH.9 shows that of those women whose blood tested positive for malaria, 15 per cent were given any anti-malarial drug in the three selected districts. By district the percentages are: 21, 9 and 5 per cent in Manokwari, Sorong and Kaimana respectively. MULTIPLE INDICATOR CLUSTER SURVEY 2011 83 T ab 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 , r ec ei ve d a n te n at al c ar e (A N C ) an d h ad m al ar ia b lo o d ed t es t, w h o h ad a p o si ti ve 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 T o ta l f o r 3 d is tr ic ts 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 ) A n y an ti - m al ar ia l d ru g s if m al ar ia p o si ti ve d u ri n g A N C ca re /v is it A rs ua m on A n ti b io ti c: In je ct io n C hl or oq ui ne O th er a n ti - m al ar ia l P ar ac et am o l/ P an ad o l/ A ce ta m in o - p h en Q ui ni ne /K in a A n ti b io ti c: P ill /S yr u p O th er N um be r of w om en w ho ha d a liv e bi rt h in t he tw o ye ar s pr ec ee di ng th e su rv ey P er ce n ta g e o f p re g n an t w o m en w h o t o o k: 83 .7 85 .8 91 .2 82 .0 88 .1 ( 56 .8 ) 75 .8 92 .3 93 .3 74 .5 84 .6 90 .1 92 .0 93 .6 79 .6 95 .0 93 .3 89 .0 ( *) 86 .5 4. 9 20 .7 8. 7 9. 5 16 .8 (3 .6 ) 12 .7 17 .4 13 .0 11 .5 12 .5 24 .1 17 .5 8. 5 14 .5 20 .2 8. 5 9. 6 ( *) 14 .9 2. 6 4. 8 3. 7 2. 3 4. 7 (3 .6 ) 4. 0 4. 1 4. 3 1. 4 7. 5 7. 3 1. 9 2. 3 5. 5 4. 5 0. 6 - - 4. 1 1. 0 4. 4 0. 6 1. 9 3. 2 - 1. 8 3. 5 3. 4 2. 0 1. 0 3. 9 2. 4 5. 3 3. 4 1. 7 5. 0 - (* ) 2. 9 0. 5 - - - 0. 1 - - 0. 2 - - 0. 6 - - - - - - 1. 6 - 0. 1 0. 4 5. 5 - - 4. 4 - 1. 4 3. 8 6. 1 2. 4 4. 1 3. 2 6. 7 - 4. 7 3. 5 - - - 3. 3 0. 3 6. 1 0. 8 3. 2 4. 0 - 3. 2 4. 3 4. 2 4. 1 0. 3 7. 8 5. 3 0. 9 2. 2 7. 0 2. 9 0. 8 (* ) 3. 8 0. 8 1. 4 - 0. 6 1. 1 - - 1. 8 - - 2. 6 2. 3 - - 1. 9 - - - - 1. 0 0. 9 6. 0 1. 4 1. 3 4. 9 - 0. 3 5. 9 4. 4 2. 9 3. 5 2. 9 8. 7 1. 9 2. 5 10 .1 - - - 4. 0 0. 5 0. 3 - - 0. 4 - - 0. 5 - - 0. 6 0. 8 - - 0. 3 - - 1. 6 - 0. 3 99 28 7 10 2 12 4 36 5 23 12 8 27 2 67 10 9 96 10 3 93 87 25 1 12 8 59 34 15 48 9 * 2 ca se s 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 201184 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 72 per cent of births occurring in the two years preceding the MICS survey were delivered by skilled personnel (Doctor, 22 per cent; Midwife, 45 per cent; Nurse, 5 per cent) (Table RH.10). The percentages of babies who were delivered by skilled personnel were 58, 76 and 75 per cent in Kaimana, Manokwari and Sorong districts respectively. These deliveries were mostly assisted by midwives. Delivery by skilled personnel is higher among women who delivered in public and private sector health facilities (100 per cent each) than among women who delivered at home (54 per cent). Rural women, uneducated women, the 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.9 presents the per cent 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 West Papua are delivered in a health facility. The percentages of babies who were delivered in a health facility were 33, 54 and 22 per cent in Kaimana, Manokwari and Sorong districts respectively. Delivery in a health facility is highest among women who had four or more visits (50 per cent) compared with only 14 per cent among women with no education. Rural women, uneducated women, the poorest women and women from households with Papuan heads are less likely to delivered in a health facility. MULTIPLE INDICATOR CLUSTER SURVEY 2011 85 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 T o ta l f o r 3 d is tr ic ts D o ct o r M id w if e C om m un it y he al th w or ke r R el at iv e/ Fr ie n d O th er / m is si n g N u rs e T o ta l N o at te n d an t Tr ad it io na l bi rt h at te nd an t D el iv er y as si st ed b y an y sk ill ed a t- 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 y ea rs P er so n a ss is ti n g a t d el iv er y 7. 5 29 .2 18 .0 35 .4 18 .0 8. 1 22 .6 32 .8 49 .8 ( 54 .2 ) 0. 3 ( *) (0 .0 ) 12 .8 25 .0 37 .9 3. 6 12 .8 17 .6 31 .1 53 .2 14 .1 26 .4 39 .6 31 .6 ( *) 22 .4 39 .5 43 .5 52 .1 45 .0 44 .3 48 .2 45 .3 36 .8 44 .2 ( 40 .2 ) 48 .9 ( *) ( 22 .6 ) 34 .4 51 .5 42 .6 32 .0 48 .3 54 .6 50 .7 37 .2 38 .3 56 .9 45 .0 37 .0 ( *) 44 .5 10 .6 2. 8 5. 2 4. 2 5. 1 6. 6 5. 0 3. 0 6. 0 (5 .6 ) 4. 5 ( *) (4 .5 ) 9. 5 3. 0 4. 2 5. 8 5. 9 7. 1 3. 4 1. 7 4. 6 4. 6 2. 9 12 .7 ( *) 4. 9 25 .6 4. 2 10 .9 5. 6 11 .5 10 .3 9. 6 11 .6 0. 0 (0 .0 ) 19 .2 ( *) ( 12 .8 ) 19 .2 7. 5 1. 6 17 .7 15 .3 5. 4 9. 1 0. 7 14 .1 7. 1 4. 0 4. 6 ( *) 10 .0 0. 9 0. 0 0. 0 0. 0 0. 2 0. 0 0. 1 0. 6 0. 0 (0 .0 ) 0. 3 ( *) (0 .0 ) 0. 7 0. 0 0. 0 0. 8 0. 0 0. 0 0. 0 0. 0 0. 3 0. 0 0. 0 0. 0 ( *) 0. 2 57 .7 75 .5 75 .3 84 .6 67 .5 62 .9 73 .0 72 .6 1 00 .0 (1 00 .0 ) 53 .7 ( *) ( 27 .1 ) 56 .7 79 .5 84 .7 41 .4 67 .0 79 .2 85 .2 92 .2 57 .0 87 .9 87 .4 81 .3 ( *) 71 .8 14 .7 13 .7 13 .0 2. 4 17 .6 17 .6 14 .0 9. 7 0. 0 (0 .0 ) 24 .9 ( *) ( 53 .7 ) 20 .1 9. 0 7. 9 33 .1 17 .7 12 .2 1. 2 0. 6 24 .0 1. 7 2. 6 9. 5 ( *) 13 .8 1. 1 5. 5 0. 7 7. 4 2. 3 7. 5 2. 7 5. 6 0. 0 (0 .0 ) 1. 4 ( *) (2 .4 ) 2. 5 3. 7 5. 8 4. 2 0. 0 3. 2 4. 5 6. 4 3. 4 3. 3 6. 0 4. 5 ( *) 3. 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 10 0. 0 0. 0 1. 1 0. 0 0. 0 0. 8 1. 6 0. 6 0. 0 0. 0 (0 .0 ) 0. 5 ( *) (3 .9 ) 0. 8 0. 4 0. 0 2. 8 0. 0 0. 0 0. 0 0. 0 1. 2 0. 0 0. 0 0. 0 ( *) 0. 6 99 28 7 10 2 12 4 36 5 54 36 7 68 17 3 38 25 4 7 23 12 8 27 2 67 10 9 96 10 3 93 87 25 1 12 8 59 34 15 48 9 * 2 ca se s 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 ” an d 1 6 ca se s w it h m is si n g “ P la ce o f d el iv er y” 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 ; ( *) F ig 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 (* ) 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. 7; M D G in d ic at o r 5. 2 MULTIPLE INDICATOR CLUSTER SURVEY 201186 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 30.8 43.4 17.8 60.7 26.9 26.3 35.7 41.9 14.1 35.5 39.7 (9.1) 26.3 39.1 47.4 14.1 28.1 38.9 45.4 55.9 33.8 31.7 38.9 47.1 (*) 35.5 65.5 38.4 77.4 23.8 61.7 58.5 53.0 42.2 61.3 55.5 49.1 (87.3) 67.0 48.1 27.9 79.6 70.4 52.5 37.5 12.4 60.0 52.4 30.4 41.5 (*) 52.1 2.6 10.9 4.0 8.1 7.7 5.2 7.7 10.3 0.0 4.1 10.6 (0.0) 3.2 9.2 13.5 0.0 0.6 5.4 12.6 23.2 1.6 11.3 24.8 6.9 (*) 7.8 0.0 2.0 0.8 0.0 1.8 3.0 1.4 0.0 2.3 3.3 0.6 (3.6) 1.4 (0.9) 2.7 3.7 0.8 0.0 0.0 2.0 1.9 1.4 0.0 0.0 (*) 1.4 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 33.4 54.4 21.8 68.8 34.6 31.5 43.4 52.2 14.1 39.6 50.3 (9.1) 29.5 48.3 60.9 14.1 28.7 44.3 58.0 79.1 35.4 43.0 63.7 54.0 (*) 43.3 1.1 5.2 0.0 7.4 1.9 7.0 2.3 5.6 22.4 1.7 0.0 (0.0) 2.1 2.8 8.5 2.7 0.0 3.2 4.5 6.4 2.7 3.3 6.0 4.5 (*) 3.3 99 287 102 124 365 54 367 68 63 106 318 23 128 272 67 109 96 103 93 87 251 128 59 34 15 489 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Public sector health facility Private sector health facility Home Delivered in health facility1Other Missing/ DK Number of women who had a live birth in pre- ceding two years TotalPlace of delivery * 2 case with missing “Ethnicity of household head” and 1 case with “Number of antenatal care visits” not shown ( ) 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 2011 87 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 percentages of people who are literate are presented in Table ED.1. District Kaimana Manokwari Sorong Area Urban Rural Education None Primary SMP/SM Higher Age 15-19 20-24 Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 73.7 87.5 95.2 96.3 83.2 (*) 50.4 94.8 100.0 88.6 85.3 60.0 82.2 93.7 97.5 98.1 76.6 98.5 98.6 96.1 (*) 87.1 121 566 173 254 606 13 141 543 163 465 395 160 164 144 213 179 441 247 92 60 19 860 Table ED.1: Literacy among young women Percentage of women age 15-24 years who are literate, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of women age 15-24 yearsPercentage literate1 * 1 case with missing “Ethnicity of household head” not shown (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 7.1; MDG indicator 2.3 MULTIPLE INDICATOR CLUSTER SURVEY 201188 Table ED.1 indicates that 87 per cent of women age 15-24 in the three districts of West Papua are literate with the lowest percentage in Kaimana District (74 per cent), compared with 88 per cent in Manokwari and 95 per cent in Sorong districts. Literacy status varies greatly by place of residence (Urban, 96 per cent; Rural, 83 per cent). Of women who stated that primary school was their highest level of education, only 50 per cent were actually able to read the statement shown to them. Fifteen 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. with Only 60 per cent of women living in the poorest households are literate, compared with 98 per cent of women living in the richest ones. Literacy rate was lower among women who live in households with Papuan heads of households. Table ED.1M shows that literacy among men 15-24 (84 per cent) is slightly lower than literacy among women (87 per cent). Literacy rates among the three districts are similar to those among women, except that in Sorong District (89 per cent) slightly fewer men are literate than women (95 per cent). More men (87 per cent) than women (50 per cent) who stated that primary school was their highest levels of education were actually able to read the statement shown to them. District Kaimana Manokwari Sorong Area Urban Rural Education None Primary SMP/SM Higher Age 15-19 20-24 Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 73.1 89.2 89.7 94.2 83.7 (*) 55.3 94.3 100.0 87.9 85.2 55.8 86.2 92.6 99.3 98.1 76.6 96.9 97.3 95.1 (*) 86.8 121 499 174 240 554 10 144 522 118 477 317 150 153 178 173 140 395 235 77 44 37 794 Table ED.1M: Literacy among young men Percentage of men age 15-24 years who are literate, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of men age 15-24 yearsPercentage literate1 * 7 cases with missing “Ethnicity of household head” not shown (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 7.1; MDG indicator 2.3 MULTIPLE INDICATOR CLUSTER SURVEY 2011 89 District Kaimana Manokwari Sorong 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 27.8 42.4 40.1 40.0 37.9 63.9 32.8 13.9 34.4 47.8 62.8 14.5 31.2 48.0 62.2 75.2 33.3 55.6 (60.0) (33.2) (*) 38.9 83 232 91 198 208 80 326 54 160 159 31 125 94 77 70 40 266 65 31 33 11 406 Table ED.2: School readiness Percentage of children attending first grade of primary school who attended pre-school the previous year, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 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 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 7.2 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, 39 per cent of children who are currently attending the first grade of primary school were attending pre-school the previous year (Kaimana, 28 per cent; Manokwari, 42 per cent; Sorong, 40 per cent). School readiness was higher in urban areas (64 per cent) than in rural areas (33 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 and were attending pre-school the previous year is 75 per cent while the indicator is only 15 per cent among the poorest households. There was also a clear trend linking pre-school attendance with mother’s education (No education, 14 per cent; Primary, 34 per cent; Secondary, 48 per cent, Higher, 63 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 201190 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 West Papua, 75 per cent are attending the first grade of primary school (Table ED.3) with more females attending (79 per cent) compared to males (71 per cent). Significant differentials are present by districts and area of residence. Attendance is highest in Kaimana and Manokwari districts (77 per cent each) compared to a lower percentage in Sorong (69 per cent). Children’s participation to primary school is higher in rural areas (77 per cent) than in urban areas (68 per cent). A positive correlation with mother’s education and socioeconomic status is observed; for children age 7 whose mothers have higher education, 67 per cent were attending the first grade, were attending the first grade, compared to 60 for children whose mothers have no education. However, there is no significant difference in this percentage between the richest households (71 per cent) and the poorest households (72 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 2011 91 Table ED.3: Primary school entry Percentage of children of primary school entry age entering grade 1 (net intake rate), Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of children of primary school entry age Percentage of children of primary school entry age entering grade 11 District Kaimana Manokwari Sorong 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 77.0 76.6 69.6 71.1 79.2 67.7 77.0 59.8 80.4 74.8 67.2 71.7 80.1 74.2 78.1 71.0 73.7 73.1 79.4 83.3 79.3 75.0 60 204 81 183 160 74 272 28 138 144 36 82 64 69 76 55 183 90 33 24 15 346 * 2 cases with missing “Ethnicity of household head” not shown 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 (94 per cent) (Kaimana, 94 per cent; Manokwari, 94 per cent; Sorong, 96 per cent). However, six 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 86 per cent for mothers with no education to 93 per cent for mothers with primary education, to 96 per cent for those who have secondary education and to 100 per cent for those with higher education. Urban and rural primary school net attendance ratios are similar (94 per cent each). The secondary school net attendance ratio is presented in Table ED.5. Only 74 per cent of children of secondary school age (13 to 18 years) are attending secondary school. MULTIPLE INDICATOR CLUSTER SURVEY 201192 District Kaimana Manokwari Sorong 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 92.8 93.4 95.2 93.5 93.8 88.1 96.2 92.1 97.0 96.3 93.5 82.7 91.7 96.9 100.0 83.3 94.1 97.7 97.5 98.0 90.8 99.6 93.2 98.3 95.5 93.8 142 493 216 220 631 160 147 126 163 131 123 98 299 376 78 202 170 143 153 183 471 206 91 49 30 851 157 533 228 216 703 183 150 142 154 169 119 90 358 386 83 206 186 193 167 166 518 205 87 71 38 918 93.6 94.0 95.8 94.1 94.4 91.0 94.6 93.1 96.0 97.1 94.7 85.9 93.3 96.1 100.0 85.3 94.8 97.1 97.6 98.8 91.0 99.7 96.6 98.6 97.5 94.4 94.4 94.5 96.4 94.7 95.1 94.3 92.8 94.1 94.9 98.2 95.8 88.9 95.2 95.3 100.0 87.4 95.6 96.2 97.7 99.6 91.2 99.8 99.8 99.0 (*) 95.0 301 1,030 445 437 1,339 346 299 269 318 301 242 189 659 764 163 408 356 336 325 350 989 413 182 120 67 1,775 Table ED.4: Primary school attendance Percentage of children of primary school age attending primary or secondary school (adjusted net attendance ratio), Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Total*Male Net attendance ratio (adjusted) Net attendance ratio (adjusted) Net attendance ratio (adjusted)1 Female Number of children Number of children Number of children * 4 cases with missing “Ethnicity of household head” not shown (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 7.4; MDG indicator 2.1 MULTIPLE INDICATOR CLUSTER SURVEY 2011 93 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 T o ta l M al e Fe m al e 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 et a tt en d an ce ra ti o ( ad ju st ed )1 N et a tt en d an ce ra ti o ( ad ju st ed )1 N et a tt en d an ce ra ti o ( ad ju st ed )1 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 41 .8 78 .5 74 .9 81 .5 69 .3 71 .0 75 .5 79 .0 68 .6 70 .0 69 .9 56 .5 63 .2 85 .8 ( 87 .5 ) 67 .9 29 .7 73 .0 75 .9 90 .1 90 .0 61 .8 79 .0 94 .7 80 .1 ( 94 .4 ) 72 .5 30 .8 7. 1 10 .6 4. 2 13 .8 24 .1 16 .1 8. 6 8. 2 0. 7 0. 5 25 .5 20 .3 5. 6 (1 .5 ) 0. 4 34 .1 12 .5 5. 0 6. 5 0. 4 19 .9 2. 2 0. 6 3. 8 (0 .0 ) 11 .3 55 .2 77 .1 79 .9 82 .6 72 .0 72 .6 75 .0 88 .0 79 .5 68 .3 65 .1 53 .6 69 .3 92 .0 ( 84 .3 ) 61 .4 38 .7 72 .2 79 .7 91 .7 88 .7 64 .3 92 .2 83 .3 87 .2 ( *) 74 .8 89 42 0 15 2 17 4 48 7 13 5 12 4 10 6 10 1 88 10 7 68 19 9 22 9 35 13 0 12 0 15 2 12 0 13 7 13 1 37 7 16 3 55 40 25 66 1 48 .0 77 .9 77 .1 82 .0 70 .6 71 .7 75 .5 83 .3 73 .6 69 .2 67 .5 55 .1 66 .1 88 .7 86 .0 64 .6 34 .0 72 .6 77 .5 90 .9 89 .3 63 .0 85 .0 89 .9 83 .6 89 .0 73 .6 24 .0 6. 6 9. 5 4. 0 11 .7 23 .9 14 .7 5. 0 5. 3 0. 4 0. 6 23 .8 17 .9 3. 6 5. 5 0. 5 28 .0 11 .6 6. 4 3. 5 0. 3 16 .6 1. 4 0. 6 3. 4 0. 0 9. 7 19 3 87 9 34 3 37 4 1, 04 1 28 9 29 1 21 9 22 0 18 3 21 2 14 3 44 6 49 2 76 25 7 25 4 31 2 28 6 29 1 27 1 76 9 36 4 12 7 79 71 1, 41 4 10 4 45 7 19 1 19 9 55 2 15 4 16 5 11 3 11 8 95 10 5 74 24 5 26 3 41 12 8 13 4 16 0 16 5 15 2 14 0 39 3 20 0 71 40 46 75 1 16 .0 6. 1 8. 0 3. 7 9. 4 23 .7 13 .1 1. 1 2. 0 0. 0 0. 6 22 .0 15 .1 1. 3 ( 10 .1 ) 0. 5 21 .1 10 .6 8. 2 0. 3 0. 2 13 .3 0. 5 0. 5 3. 0 ( *) 7. 9 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 y ea r 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 T o ta l f o r 3 d is tr ic ts * 4 ca se s 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 ( ) 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 7. 5 MULTIPLE INDICATOR CLUSTER SURVEY 201194 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 99.7 100.0 100.0 100.0 99.9 100.0 99.8 100.0 100.0 99.9 100.0 100.0 100.0 100.0 99.7 100.0 100.0 100.0 100.0 100.0 99.0 100.0 99.9 98.9 100.0 98.3 99.6 98.9 100.0 100.0 99.1 100.0 99.4 99.4 100.0 98.1 100.0 100.0 98.9 100.0 99.2 100.0 100.0 100.0 92.3 99.3 98.9 98.8 98.9 99.0 98.7 100.0 97.8 99.3 97.8 98.2 100.0 100.0 93.7 100.0 100.0 100.0 100.0 98.3 98.7 100.0 100.0 100.0 98.9 100.0 100.0 99.1 99.5 100.0 100.0 100.0 99.7 100.0 99.4 100.0 100.0 100.0 98.9 100.0 100.0 100.0 100.0 98.8 100.0 100.0 100.0 99.7 98.7 100.0 100.0 100.0 99.5 100.0 100.0 99.7 97.5 100.0 100.0 100.0 99.0 100.0 100.0 100.0 100.0 99.6 100.0 100.0 100.0 100.0 99.8 96.3 98.8 96.3 98.1 97.1 100.0 97.6 97.8 95.4 96.9 99.4 100.0 91.0 98.9 99.7 98.9 100.0 97.1 97.6 100.0 99.0 92.3 97.7 District Kaimana Manokwari Sorong 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 Per cent attending grade 1 last year who are in grade 2 this year Per cent attending grade 2 last year who are attending grade 3 this year Per cent attending grade 3 last year who are attending grade 4 this year Per cent attending grade 4 last year who are attending grade 5 this year Per cent a ttending grade 5 last year who are attending grade 6 this year Per cent who reach grade 6 of those who enter grade1 1 MICS ndicator 7.6; MDG indicator 2.2 The results show a clear association between mothers’ education and wealth and secondary school net attendance ratio. For the three selected districts, this ratio is 55 per cent for children with uneducated mothers and increases to 86 per cent for children whose mothers’ education is higher than secondary. Moreover, secondary school net attendance ratio increased from 34 per cent in the poorest households to 89 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 (99 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 the poorest households are less likely to eventually reach the last grade of primary school. MULTIPLE INDICATOR CLUSTER SURVEY 2011 95 District Kaimana Manokwari Sorong 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 88.8 114.4 112.6 109.1 108.2 134.5 100.7 (77.6) 100.9 118.8 (*) 89.7 (127.1) (72.2) (117.6) (142.9) 105.5 98.0 (150.2) (93.6) (*) 108.8 (80.7) 95.3 100.0 96.5 93.7 98.1 94.3 (*) 95.6 99.3 (*) 65.2 (99.0) (94.6) (100.0) (100.0) 90.9 100.0 (100.0) (*) (*) 95.2 22 168 63 132 121 61 193 21 86 117 20 25 52 58 58 61 130 77 24 14 8 253 49 128 66 119 123 58 184 29 94 99 21 50 44 54 43 51 122 68 27 19 6 242 Table ED.7: Primary school completion and transition to secondary school Primary school completion rates and transition rate to secondary school, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of children who were in the last grade of primary school the previous year Number of children of primary school completion age Primary school completion rate1 Transition rate to secondary school2 ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 7.7 2 MICS indicator 7.8 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 109 per cent. Large differences were observed in the primary completion rates of districts, with the lowest rates found in Kaimana (88 per cent) and the highest rates in Manokwari (114 per cent). The primary completion rate was lower in rural areas (101 per cent) compared with urban (135 per cent). About 95 per cent of the 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 (Kaimana, 81 per cent; Manokwari, 95 per cent; Sorong, 100). The transition rate in rural areas (94 per cent) was lower than in urban areas (98 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 201196 Table ED.8: Education gender parity Ratio of adjusted net attendance ratios of girls to boys, in primary and secondary school, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 94.4 94.3 96.2 94.7 94.9 88.9 95.0 95.2 100.0 na 87.4 95.3 96.2 97.2 99.6 91.1 99.4 99.8 99.0 100.0 94.8 1.02 1.01 1.01 1.01 1.01 1.08 1.04 0.98 1.00 na 1.05 1.01 .98 1.00 1.02 1.00 1.00 1.07 1.01 1.05 1.01 41.8 78.5 74.9 81.5 69.3 56.5 63.2 85.8 87.5 67.9 29.7 73.0 75.9 90.1 90.0 61.8 79.0 94.7 80.1 94.4 72.5 92.8 93.4 95.2 93.5 93.8 82.7 91.7 96.9 100.0 na 83.3 94.1 97.7 97.5 98.0 90.8 99.6 93.2 98.3 95.5 93.8 55.2 77.1 79.9 82.6 72.0 53.6 69.3 92.0 84.3 61.4 38.7 72.2 79.7 91.7 88.7 64.3 92.2 83.3 87.2 78.9 74.8 1.32 0.98 1.07 1.01 1.04 0.95 1.10 1.07 0.96 0.90 1.30 0.99 1.05 1.02 0.99 1.04 1.17 0.88 1.09 0.84 1.03 District Kaimana Manokwari Sorong 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 Primary school adjusted net attendance ratio (NAR), girls Primary school adjusted net attendance ratio (NAR), boys Gender parity index (GPI) for primary school ad- justed NAR1 Second- ary school adjusted net attendance ratio (NAR), girls Second- ary school adjusted net attendance ratio (NAR), boys Gender parity index (GPI) for secondary school ad- justed NAR2 1 MICS indicator 7.9; MDG indicator 3.1 2 MICS indicator 7.10; MDG indicator 3.1 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 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 (Kaimana, 1.02 per cent; Manokwari, 1.01 per cent; Sorong, 1.01). The indicator did not vary greatly by background characteristics. The gender parity for secondary school is 1.34, 0.99 and 1.05 in Kaimana, Manokwari and Sorong districts respectively. GPI for secondary school was markedly higher for children whose mothers have no or primary education. MULTIPLE INDICATOR CLUSTER SURVEY 2011 97 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 of developing 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 half the children under-five years in the three selected districts have been registered (50 per cent) (Table CP.1). Birth registration is generally similar among districts and area of residence but it is positively associated with education and wealth (Figure CP.1). Among children whose birth was not registered, only 42 per cent know how to register birth. Knowledge of how to register birth is lowest in Kaimana District, where only 35 per cent of mothers/caretakers know how to register birth. These percentages are 42 and 47 per cent respectively in Manokwari and Sorong districts. Figure CP.1: Percentage of children under age 5 whose birth is registered, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest 0 40 8020 60 100 Per cent 46 51 49 51 41 64 16 38 56 71 49 74 28 50 MULTIPLE INDICATOR CLUSTER SURVEY 201198 District Kaimana Manokwari Sorong 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 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 19.2 16.3 30.4 18.3 22.7 24.5 19.0 6.8 17.9 17.9 27.7 31.1 4.8 14.1 23.4 31.5 8.2 14.3 21.0 24.1 37.9 8.1 38.5 33.0 25.9 31.6 20.3 14.6 29.0 15.2 22.6 22.3 21.7 23.2 18.8 17.9 20.2 26.1 31.3 7.1 16.0 26.0 35.5 13.8 18.9 20.4 32.1 32.6 18.1 28.7 32.0 18.5 37.1 22.8 46.2 50.1 51.2 48.6 50.0 51.4 49.1 33.1 42.0 45.8 60.6 66.4 16.3 38.2 55.6 71.0 28.1 41.2 49.0 63.5 73.6 33.0 73.3 68.6 55.8 72.0 49.6 35.0 42.0 47.1 42.5 41.0 42.1 41.6 39.1 45.9 41.6 43.5 38.0 16.6 37.3 50.6 (44.1) 24.0 41.6 46.9 63.2 (64.9) 34.5 72.7 (56.4) 33.7 (*) 41.8 141 379 162 349 333 160 522 177 149 158 110 88 71 251 316 43 229 160 141 85 67 487 89 45 43 14 682 12.4 4.8 5.6 7.7 5.0 5.1 6.9 7.5 6.2 7.7 6.8 4.0 4.3 8.2 6.3 4.0 6.1 8.1 7.7 7.3 3.1 6.8 6.1 3.6 11.4 3.3 6.5 262 760 332 679 666 329 1025 264 257 292 280 261 85 407 713 150 319 272 277 234 253 727 333 142 98 50 1,354 Children under age 5 whose birth is not registered * 9 cases with missing “sex” and 4 cases 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 8.1 Not seenSeen No birth certificate Has birth certificate Total registered1 Number of children Per cent of children whose moth- er/caretaker knows how to register birth Number of children without birth registration Children under age 5 whose birth is registered with civil authorities MULTIPLE 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 West Papua 2011 MICS questionnaire, a number of questions addressed the issue of child labour, that is, children 5-1713 years of age involved in labour activities. A child is considered to be involved in child labour activities at the moment of the survey if during the week preceding the survey: • Ages 5-11: at least one hour of economic work or 28 hours of domestic work per week. • Ages 12-14: at least 14 hours of economic work or 28 hours of domestic work per week. • 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 lower 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 District Kaimana Manokwari Sorong Area Urban Rural Mother’s Education No education Primary Secondary Higher Wealth quintiles Poorest Second Middle Fourth Richest 0 40 8020 60 100 Per cent 24 22 24 19 29 13 37 26 18 10 21 10 36 22 MULTIPLE INDICATOR CLUSTER SURVEY 2011100 Table CP.2 presents the results of child labour by the type of work. The Selected Districts of West Papua Province 2011 MICS survey estimates that about one in four children aged 5-17 years are involved in child labour (23 per cent). Child labour is 24, 22 and 22 per cent in Kaimana, Manokwari and Sorong districts respectively. 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 reveal slightly higher percentages of child labour (24 per cent) compared with those who go to school (22 per cent). Variations in child labour also exist by other background characteristics, with a clear sharp negative association with mothers’ education and wealth (Figure CP.2). Child labour rates are lower among the age group 12-17 years (13 per cent) than among the younger age group 5-11 years (30 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 2011 101 T ab 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 ch ild la b o u r, D is tr ic ts o f K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 Y es 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 T o ta l f o r 3 d is tr ic ts P ai d w o rk U n p ai d w o rk W o rk in g o u ts id e h o u se h o ld H o u se h o ld ch o re s le ss t h an 28 h o u rs W o rk in g f o r fa m ily b u si n es s H o u se h o ld ch o re s fo r 28 h o u rs o r m o re E co n o m ic ac ti vi ty f o r at le as t o n e h o u r C h ild la b o u r N u m b er o f ch ild re n a g e 5- 11 P er ce n ta g e o f ch ild re n a g e 5- 11 in vo lv ed in E co n o m ic a ct iv it y 2. 9 3. 5 7. 5 4. 2 4. 5 5. 6 4. 0 4. 8 2. 1 5. 1 4. 1 5. 0 1. 5 5. 1 5. 5 5. 0 2. 4 3. 4 4. 8 2. 3 3. 5 7. 5 6. 2 4. 4 8. 1 1. 2 8. 0 4. 2 4. 0 2. 3 4. 7 4. 4 2. 3 3. 9 5. 2 3. 7 1. 7 6. 0 4. 8 3. 4 3. 2 2. 3 4. 2 3. 3 5. 0 5. 9 1. 4 4. 1 32 .7 26 .1 20 .8 25 .5 26 .4 21 .3 27 .4 26 .9 20 .4 49 .2 31 .5 19 .8 8. 4 41 .4 35 .0 24 .2 12 .8 9. 7 34 .4 10 .4 21 .6 17 .5 15 .7 25 .9 36 .5 27 .1 30 .2 28 .8 30 .2 24 .3 31 .1 30 .7 22 .3 51 .7 34 .8 24 .0 10 .4 45 .3 37 .9 28 .3 16 .5 12 .7 36 .7 14 .3 27 .4 26 .5 18 .3 29 .5 36 .5 27 .1 29 .9 28 .8 30 .1 24 .1 31 .1 30 .6 22 .3 51 .7 34 .8 23 .9 10 .4 45 .3 37 .9 28 .0 16 .5 12 .7 36 .7 14 .1 27 .4 26 .5 18 .3 29 .4 36 .8 43 .2 46 .0 32 .9 53 .2 46 .5 41 .6 47 .0 17 .5 43 .8 42 .4 40 .8 52 .7 39 .2 44 .6 36 .9 47 .3 46 .7 42 .5 44 .5 45 .7 37 .5 41 .9 42 .8 0. 0 0. 0 0. 4 0. 0 0. 2 0. 2 0. 0 0. 1 0. 0 0. 0 0. 1 0. 1 0. 0 0. 0 0. 0 0. 5 0. 0 0. 0 0. 0 0. 3 0. 0 0. 6 0. 0 0. 1 37 1 1, 23 7 52 9 1, 09 1 1, 03 9 50 8 1, 62 9 1, 82 8 30 9 21 3 78 5 94 1 19 8 51 3 45 8 39 1 38 8 38 8 1, 21 2 47 2 21 8 14 6 84 2, 13 7 * 8 ca se s w it h m is si n g “ se x” , 1 c as e w it h m is si n g “ M o th er ’s e d u ca ti o n ”, 9 c as es 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 1 M IC S in d ic at o r 8. 2 MULTIPLE INDICATOR CLUSTER SURVEY 2011102 T ab 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 ch ild la b o u r, D is tr ic ts o f K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 Y es 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 T o ta l f o r 3 d is tr ic ts P ai d w o rk U n p ai d w o rk W o rk in g o u ts id e h o u se h o ld H o u se h o ld ch o re s le ss th an 2 8 h o u rs W o rk in g f o r fa m ily b u si n es s H o u se h o ld ch o re s fo r 28 h o u rs o r m o re E co n o m ic ac ti vi ty le ss th an 1 4 h o u rs C h ild la b o u r T o ta l ch ild la b o u r P er ce n ta g e o f ch ild re n a g e 12 -1 4 in vo lv ed in E co n o m ic a ct iv it y * 8 ca se s w it h m is si n g “ se x” , 1 c as e w it h m is si n g “ M o th er ’s e d u ca ti o n ”, 9 c as es 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 1 M IC S in d ic at o r 8. 2 E co n o m ic ac ti vi ty f o r 14 h o u rs o r m o re N u m b er o f ch ild re n a g e 12 -1 4 3. 5 9. 7 8. 4 10 .7 5. 6 9. 3 8. 1 8. 0 13 .6 9. 9 7. 7 9. 5 1. 8 6. 0 10 .0 14 .9 3. 7 5. 7 8. 0 10 .0 3. 6 4. 0 ( 20 .1 ) 8. 3 19 .4 4. 8 10 .4 10 .2 6. 6 4. 8 9. 6 8. 4 11 .3 14 .4 11 .2 4. 6 8. 4 17 .7 8. 6 6. 4 5. 8 4. 1 11 .8 3. 3 6. 1 6. 5 (4 .4 ) 8. 5 60 .6 51 .9 49 .4 52 .2 53 .5 35 .6 57 .6 51 .6 70 .1 77 .1 56 .0 45 .4 35 .8 73 .9 69 .4 55 .9 32 .5 26 .9 63 .6 34 .7 32 .1 44 .8 ( 69 .0 ) 52 .7 23 .1 16 .5 18 .6 17 .5 18 .8 14 .8 19 .2 18 .5 15 .7 29 .3 21 .3 14 .8 6. 8 30 .9 23 .2 17 .1 9. 7 7. 3 23 .0 8. 3 17 .1 17 .5 12 6 18 .1 6. 7 1. 2 2. 0 2. 5 2. 0 0. 0 2. 9 2. 2 3. 1 9. 9 2. 5 0. 2 0. 0 6. 5 4. 3 0. 3 0. 0 0. 0 3. 9 0. 0 0. 0 0. 0 (2 .1 ) 2. 3 0. 7 2. 0 1. 9 1. 5 2. 1 1. 0 2. 0 1. 8 1. 4 4. 4 2. 6 0. 5 0. 0 3. 9 1. 9 2. 7 0. 0 0. 0 2. 6 1. 0 1. 0 0. 0 (0 .0 ) 1. 8 63 .3 76 .4 86 .0 65 .0 90 .8 70 .4 78 .5 76 .4 81 .0 73 .2 76 .5 78 .7 70 .3 72 .9 80 .6 77 .2 75 .0 77 .1 73 .6 88 .2 67 .3 71 .5 ( 80 .3 ) 76 .7 0. 6 0. 8 0. 4 1. 1 0. 2 1. 4 0. 5 0. 7 0. 0 0. 0 0. 4 1. 2 0. 0 0. 0 0. 5 1. 4 1. 5 0. 0 0. 0 0. 0 0. 8 2. 1 ( 10 .7 ) 0. 7 1. 3 2. 8 2. 3 2. 6 2. 3 2. 5 2. 4 2. 5 1. 4 4. 4 3. 0 1. 7 0. 0 3. 9 2. 4 4. 0 1. 5 0. 0 2. 6 1. 0 1. 8 2. 1 ( 10 .7 ) 2. 4 14 0 50 4 21 8 46 5 39 5 19 3 66 8 81 2 49 10 4 33 2 37 1 55 16 9 18 5 19 1 15 6 16 1 47 8 20 6 92 44 39 86 1 MULTIPLE INDICATOR CLUSTER SURVEY 2011 103 T ab 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 ch ild la b o u r, D is tr ic ts o f K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 Y es 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 T o ta l f o r 3 d is tr ic ts P ai d w o rk U n p ai d w o rk W o rk in g o u ts id e h o u se h o ld H o u se h o ld ch o re s le ss th an 2 8 h o u rs W o rk in g f o r fa m ily b u si n es s H o u se h o ld ch o re s fo r 28 h o u rs o r m o re E co n o m ic ac ti vi ty le ss th an 1 4 h o u rs C h ild la b o u r T o ta l ch ild la b o u r P er ce n ta g e o f ch ild re n a g e 15 -1 7 in vo lv ed in E co n o m ic a ct iv it y * 8 ca se s w it h m is si n g “ se x” , 1 c as e w it h m is si n g “ M o th er ’s e d u ca ti o n ”, 9 c as es 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 8. 2E co n o m ic ac ti vi ty f o r 14 h o u rs o r m o re N u m b er o f ch ild re n ag e 15 -1 7 N u m b er o f ch ild re n ag e 5- 17 ye ar s 5. 0 14 .1 9. 8 13 .9 9. 5 9. 9 12 .6 10 .2 19 .5 4. 0 11 .7 16 .6 0. 0 0. 0 8. 7 11 .9 28 .4 6. 9 4. 1 6. 9 18 .7 ( 12 .2 ) 5. 8 ( *) 11 .8 19 .9 5. 8 10 .5 9. 6 8. 1 4. 6 10 .7 8. 2 12 .2 17 .0 12 .4 4. 9 0. 0 0. 0 26 .9 12 .2 2. 8 4. 2 2. 4 13 .1 1. 9 (3 .7 ) 16 .9 ( *) 8. 9 60 .0 55 .8 48 .9 57 .0 52 .1 38 .8 61 .2 52 .7 64 .2 75 .2 60 .8 51 .4 11 .3 0. 0 77 .3 66 .9 65 .4 45 .7 24 .8 61 .1 46 .1 ( 50 .5 ) 45 .2 ( *) 54 .7 0. 5 0. 6 1. 6 0. 9 0. 7 1. 1 0. 7 0. 3 3. 4 1. 1 1. 8 0. 0 0. 0 0. 0 3. 2 0. 0 1. 6 0. 0 0. 0 0. 3 1. 1 (1 .3 ) 3. 4 ( *) 0. 8 10 .3 5. 8 3. 7 6. 7 5. 0 2. 2 7. 4 5. 5 7. 9 9. 2 8. 6 3. 5 0. 0 0. 0 15 .4 8. 6 6. 0 0. 9 1. 3 8. 6 3. 4 (4 .8 ) 0. 0 ( *) 5. 9 0. 5 0. 4 1. 6 0. 9 0. 4 1. 1 0. 5 0. 1 3. 4 0. 0 1. 8 0. 0 0. 0 0. 0 2. 4 0. 0 1. 6 0. 0 0. 0 0. 0 1. 1 (1 .3 ) 3. 4 ( *) 0. 7 62 .2 78 .3 82 .3 64 .6 91 .1 74 .0 78 .4 80 .1 63 .1 79 .4 77 .4 79 .6 59 .2 1 00 .0 71 .3 72 .7 81 .0 84 .1 74 .5 72 .4 82 .4 ( 73 .5 ) 80 .4 ( *) 77 .1 0. 0 0. 2 0. 0 0. 0 0. 3 0. 0 0. 2 0. 2 0. 0 1. 1 0. 0 0. 0 0. 0 0. 0 0. 8 0. 0 0. 0 0. 0 0. 0 0. 3 0. 0 (0 .0 ) 0. 0 ( *) 0. 1 59 6 2, 12 6 89 7 1, 88 4 1, 72 8 88 3 2, 73 7 3, 15 3 46 7 39 4 1, 35 5 1, 56 7 30 2 1 78 4 76 7 70 3 68 8 67 7 1, 99 3 86 4 36 5 23 5 15 5 3, 62 0 23 .1 16 .5 18 .6 17 .5 18 .8 14 .8 19 .2 18 .5 15 .7 29 .3 21 .3 14 .8 6. 8 0. 0 30 .9 23 .2 17 .1 9. 7 7. 3 23 .0 8. 3 17 .1 17 .5 12 .6 18 .1 85 38 6 15 1 32 8 29 3 18 2 44 0 51 3 10 8 77 23 8 25 6 50 1 10 3 12 4 12 1 14 5 12 9 30 3 18 6 54 45 32 62 1 MULTIPLE INDICATOR CLUSTER SURVEY 2011104 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 81.4 87.5 90.1 86.5 87.7 90.5 86.0 85.6 89.4 76.1 84.3 91.1 93.6 72.2 86.3 90.2 93.8 95.2 81.8 93.8 93.2 94.1 92.0 87.1 24.0 22.2 22.2 22.4 22.6 19.3 23.6 29.5 12.5 36.6 26.3 18.2 9.7 35.8 29.0 21.5 13.2 10.4 27.7 13.7 20.4 18.9 14.7 22.5 88.5 84.2 89.2 85.5 86.9 89.5 85.3 89.1 76.4 78.2 84.5 93.2 78.1 78.9 88.9 89.6 93.3 90.5 84.8 84.8 94.2 93.1 (*) 86.2 143 472 199 422 391 170 645 630 185 144 356 285 29 281 222 151 91 70 552 118 74 44 23 815 26.1 21.4 22.0 22.1 22.4 19.1 23.4 30.7 10.7 37.6 26.3 18.6 8.1 39.1 29.8 21.3 13.2 9.9 28.7 12.4 20.6 18.7 13.6 22.3 596 2,126 897 1,884 1,728 883 2,737 2,137 1,483 394 1,355 1,567 302 784 767 703 688 677 1,993 864 365 235 155 3,620 485 1,860 808 1,630 1,515 799 2,354 1,828 1,325 300 1,142 1,428 283 566 662 635 645 645 1,631 810 340 221 142 3,153 District Kaimana Manokwari Sorong 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 Percentage of children involved in child labour Number of children age 5-17 years Percentage of children attending school Number of children age 5-17 years involved in child labour Percent- age of child labourers who are attending school Number of children age 5-17 years attending school Percentage of children attending school who are involved in child labour * 8 cases with missing “sex”, 1 case with missing “Mother’s education”, 9 cases 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 Table CP.3 presents the percentage of children age 5-17 years involved in child labour who are attending school and the percentage of children age 5-17 years attending school who are involved in child labour. Of the 87 per cent of children 5-17 years of age attending school, 22 per cent are also involved in child labour activities. On the other hand, of the 23 per cent of the children who are involved in child labour, 86 per cent were attending school. The percentage of child labourers who are attending school MULTIPLE INDICATOR CLUSTER SURVEY 2011 105 in Manokwari is lower than the other in the two districts. The percentage of children attending school who are involved in child labour in Kaimana is higher than in the two other districts. Results for children 5-14 years as per the definition of the MICS indicator are presented in the summary table of findings. 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 of West Papua Province MICS survey, mothers/caretakers of children age 2-14 years were asked a series of questions on the ways parents tend 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 West Papua, 86 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 (Kaimana, 89 per cent; Manokwari, 84 per cent; Sorong, 90 per cent) (Table CP.4). More importantly, 23 per cent of children were subjected to severe physical punishment (Kaimana, 31 per cent; Manokwari, 23 per cent; Sorong, 18 per cent). Children age 2-4 (84 per cent) and age 10-14 (84 per cent) were subjected to at least one psychological or physical punishment less than children age 5-9 (89 per cent). Generally, education was not clearly associated with child discipline. It is of importance also to indicate that only one fifth of parents/caretakers believe that in order to raise their children properly, they need to physically punish them (20 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011106 Table CP.4: Child discipline Percentage of children age 2-14 years according to method of disciplining the child, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 9.3 12.9 8.2 12.2 9.8 12.5 10.7 10.2 8.9 13.8 10.5 6.0 12.3 19.7 na na na na 3.9 7.6 10.5 14.0 22.0 6.3 18.8 15.5 8.5 22.7 11.1 80.4 78.8 83.7 80.7 80.1 76.1 81.6 77.4 84.9 77.5 84.5 86.3 79.5 66.4 na na na na 88.5 86.4 79.8 76.5 67.5 87.6 66.7 73.9 85.4 64.5 80.3 74.1 60.9 69.5 65.9 65.0 67.9 64.6 65.9 67.3 63.0 67.5 71.6 62.9 57.8 na na na na 74.7 75.7 60.3 57.1 55.3 74.8 47.0 57.8 73.6 43.5 65.3 306 1058 490 950 895 431 1423 441 711 702 na na na na 110 590 919 235 383 371 362 369 369 866 578 201 121 84 1,854 86.4 83.7 89.9 84.4 87.3 85.2 85.9 83.9 88.6 83.9 85.3 90.2 85.0 77.2 na na na na 90.8 90.9 86.2 82.3 76.2 91.6 74.7 82.3 88.4 70.6 85.7 30.9 22.6 18.4 24.8 21.2 19.5 24.1 14.9 26.2 24.6 36.3 26.1 21.7 14.0 na na na na 34.5 29.9 18.2 18.0 10.9 33.1 5.1 10.6 26.9 12.3 23.0 661 2,190 965 2,006 1,793 900 2,915 872 1,459 1,484 225 1,241 1,855 493 231 1,230 1,904 451 864 813 747 688 703 2,129 874 393 251 158 3,815 14.4 21.6 21.6 21.4 19.7 13.1 22.7 19.4 20.1 21.4 na na na na 34.0 26.4 16.8 13.3 36.6 28.5 17.6 11.3 7.6 30.8 9.5 14.0 16.7 10.3 20.4 District Kaimana Manokwari Sorong 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 Any Severe Respon- dent be- lieves that the child needs to be physically punished Respon- dents to the child discipline module Physical punishment Any violent disci- pline method1 Only non- violent discipline Psycho- logical aggres- sion Number of children age 2-14 years Percentage of children age 2-14 years who experienced: * 15 cases with missing “sex” and 5 cases with missing “Ethnicity of household head” not shown 1 MICS indicator 8.5 MULTIPLE INDICATOR CLUSTER SURVEY 2011 107 marriage is recognized in the Universal Declaration of Human Rights–with the recognition that consent cannot be ‘free and full’ when one of the parties involved is not sufficiently mature to make an informed decision about a life partner. The Convention on the Elimination of all Forms of Discrimination against Women mentions the right to protection from child marriage in article 16, which states: “The betrothal and the marriage of a child shall have no legal effect, and all necessary action, including legislation, shall be taken to specify a minimum age for marriage.” While marriage is not considered directly in the Convention on the Rights of the Child, child marriage is linked to other rights–such as the right to express 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 young wives to reproduce and the power imbalance resulting from the age differential lead to very low condom use among such couples. MULTIPLE INDICATOR CLUSTER SURVEY 2011108 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 (19 per cent) (Table CP.5). This percentage is higher in Manokwari (22 per cent) and lower in Kaimana District (13 per cent). In Sorong District, 15 percentage of women 15-19 are currently married or in union. This indicator is strongly related to wealth. It decreases from 30 per cent among the poorest women to only 12 per cent among the richest women. The percentage of men married at various ages is provided in Table CP.5M. Nine per cent of women aged 15-49 years were married before age 15 while 30 per cent of women aged 20-49 years were married before age 18. The percentage of women married before age 18 was higher in Sorong District (35 per cent) compared with Kaimana District (22 per cent) and Manokwari District (30 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 2011 109 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 423 1,638 654 763 1,952 465 395 462 443 387 305 259 134 764 1,402 415 467 502 493 640 614 1,212 860 333 197 107 2,715 5.0 9.6 8.1 5.2 9.8 3.6 7.1 8.2 8.3 8.0 14.1 14.4 16.4 18.2 4.8 0.5 13.9 9.6 10.6 6.2 4.1 9.5 10.7 4.2 2.7 4.4 8.5 21.5 30.1 34.7 22.6 32.7 na 27.0 29.1 28.3 26.9 34.3 37.4 43.8 47.0 25.9 3.1 39.2 36.1 37.6 26.3 15.6 29.7 38.8 20.0 13.6 19.2 29.9 360 1,337 553 626 1,624 na 395 462 443 387 305 259 128 702 1,060 359 381 406 423 515 525 964 730 292 164 95 2,250 13.0 21.7 15.4 13.3 21.6 19.1 na na na na na na 58.5 48.3 14.1 (13.6) 29.7 24.9 19.2 12.3 12.2 22.8 13.6 (24.4) (5.7) (*) 19.1 5.4 10.9 8.8 5.8 10.9 na 7.1 8.2 8.3 8.0 14.1 14.4 17.1 18.4 5.7 0.6 15.5 10.4 11.9 7.7 4.3 10.5 12.6 3.9 3.2 5.0 9.5 63 301 101 138 327 465 na na na na na na 6 62 342 56 86 96 70 124 88 248 130 41 33 13 465 District Kaimana Manokwari Sorong 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 Percentage married before age 151 Percentage married be- fore age 15 Number of women age 15-49 years Number of women age 20-49 years Percentage married before age 182 Number of women age 15-19 years Percentage of women 15-19 years currently married/in union3 * 9 cases 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 8.6 2 MICS indicator 8.7 3 MICS indicator 8.8 MULTIPLE INDICATOR CLUSTER SURVEY 2011110 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 437 1,647 652 732 2,004 477 317 388 479 410 374 291 74 625 1,576 460 498 499 591 576 571 1,189 906 333 171 129 2,736 1.5 2.8 0.9 0.6 2.7 0.9 3.3 3.5 3.6 1.3 0.8 1.6 4.1 3.2 1.5 2.4 4.7 2.5 2.8 0.0 1.1 3.9 1.0 0.5 0.6 0.0 2.1 4.5 8.0 5.1 3.0 8.1 na 8.0 6.8 9.1 4.7 4.9 6.7 13.2 10.4 5.9 3.3 13.9 8.6 6.2 3.7 2.6 10.8 3.7 4.6 4.1 1.6 6.7 375 1,344 540 595 1,664 na 317 388 479 410 374 291 69 553 1,212 426 418 398 486 480 477 957 763 292 142 100 2,259 0.6 6.6 1.2 5.2 4.2 4.5 na na na na na na (*) 7.6 3.5 (9.2) 8.6 3.9 1.9 5.0 4.2 7.9 2.2 (0.0) (0.0) (0.0) 4.5 1.8 3.0 1.1 0.2 3.2 na 3.3 3.5 3.6 1.3 0.8 1.6 4.4 3.6 1.6 2.6 5.3 2.8 3.4 0.0 0.9 4.5 1.2 0.0 0.7 0.0 2.4 62 303 112 136 341 477 na na na na na na 6 73 364 35 80 101 105 97 94 232 143 41 29 29 477 District Kaimana Manokwari Sorong 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 Percentage married before age 151 Percentage married be- fore age 15 Number of men age 15-49 years Number of men age 20-49 years Percentage married before age 182 Number of men age 15-19 years Percentage of men 15-19 years currently married/in union3 * 9 cases 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 8.6 2 MICS indicator 8.7 3 MICS indicator 8.8 MULTIPLE 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; 37 per cent of women aged 45-49 years were married before their 18th birthday compared with 27 per cent of women aged 20-24 years. The percentage of women who were first married before age 15 and 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. MULTIPLE INDICATOR CLUSTER SURVEY 2011112 T ab 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 re si d en ce a n d a g e g ro u p s, D is tr ic ts o f K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 A ge 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 or 3 d is tr ic ts Pe rc en ta ge of w om en m ar ri ed be fo re a ge 15 Pe rc en ta ge of w om en m ar ri ed be fo re a ge 15 Pe rc en ta ge of w om en m ar ri ed be fo re a ge 15 Pe rc en ta ge of w om en m ar ri ed be fo re a ge 18 Pe rc en ta ge of w om en m ar ri ed be fo re a ge 18 Pe rc en ta ge of w om en m ar ri ed be fo re a ge 18 N um be r of w om en a ge 15 -4 9 N um be r of w om en a ge 15 -4 9 N um be r of w om en a ge 15 -4 9 N um be r of w om en a ge 20 -4 9 N um be r of w om en a ge 20 -4 9 N um be r of w om en a ge 20 -4 9 U rb an R u ra l A ll 2. 0 3. 5 7. 8 4. 2 2. 5 10 .5 7. 6 5. 2 4. 3 8. 6 8. 4 9. 8 9. 8 15 .3 16 .8 9. 8 3. 6 7. 1 8. 2 8. 3 8. 0 14 .1 14 .4 8. 5 n a 12 .6 22 .9 25 .1 14 .9 28 .7 38 .4 22 .6 n a 33 .0 32 .2 29 .4 30 .9 36 .2 37 .0 32 .7 n a 27 .0 29 .1 28 .3 26 .9 34 .3 37 .4 29 .9 13 8 11 6 15 3 11 4 97 76 69 76 3 32 7 27 9 30 8 32 9 29 0 22 9 19 0 1, 95 2 46 5 39 5 46 2 44 3 38 7 30 5 25 9 2, 71 5 n a 11 6 15 3 11 4 97 76 69 62 6 n a 27 9 30 8 32 9 29 0 22 9 19 0 1, 62 4 n a 39 5 46 2 44 3 38 7 30 5 25 9 2, 25 0 MULTIPLE INDICATOR CLUSTER SURVEY 2011 113 T ab le C P .6 M : 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 re si d en ce a n d a g e g ro u p s, D is tr ic ts o f K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 A g e 15 -1 9 20 -2 4 25 -2 9 30 -3 4 35 -3 9 40 -4 4 45 -4 9 T o ta l f o r 3 d is tr ic ts P er ce n ta g e o f m en m ar ri ed b ef o re a g e 15 P er ce n ta g e o f m en m ar ri ed b ef o re a g e 15 P er ce n ta g e o f m en m ar ri ed b ef o re a g e 15 P er ce n ta g e o f m en m ar ri ed b ef o re a g e 18 P er ce n ta g e o f m en m ar ri ed b ef o re a g e 18 P er ce n ta g e o f m en m ar ri ed b ef o re a g e 18 N u m b er o f m en a g e 15 -4 9 N u m b er o f m en a g e 15 -4 9 N u m b er o f m en a g e 15 -4 9 N u m b er o f m en a g e 20 -4 9 N u m b er o f m en a g e 20 -4 9 N u m b er o f m en a g e 20 -4 9 U rb an R u ra l A ll 2. 5 0. 0 0. 7 0. 0 0. 0 0. 4 0. 0 0. 6 0. 3 4. 9 4. 5 4. 9 1. 7 0. 9 2. 0 2. 7 0. 9 3. 3 3. 5 3. 6 1. 3 0. 8 1. 6 2. 1 n a 3. 0 1. 7 4. 0 3. 8 1. 5 3. 6 3. 0 n a 10 .4 8. 7 11 .0 5. 0 6. 0 7. 5 8. 1 n a 8. 0 6. 8 9. 1 4. 7 4. 9 6. 7 6. 7 13 6 10 3 10 6 12 7 11 3 88 58 73 2 34 1 21 4 28 3 35 1 29 8 28 5 23 3 2, 00 4 47 7 31 7 38 8 47 9 41 0 37 4 29 1 2, 73 6 n a 10 3 10 6 12 7 11 3 88 58 59 5 n a 21 4 28 3 35 1 29 8 28 5 23 3 1, 66 4 n a 31 7 38 8 47 9 41 0 37 4 29 1 2, 25 9 MULTIPLE INDICATOR CLUSTER SURVEY 2011114 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 45.8 37.5 39.3 45.6 37.2 na 39.1 (*) 58.3 31.9 (*) 51.7 32.3 (35.9) (28.9) (44.1) 46.4 29.3 (38.3) (*) (*) 39.1 9.6 7.1 3.2 19.2 3.0 na 6.7 (*) 2.8 7.2 (*) 3.0 9.5 (1.5) (12.3) (9.1) 10.4 3.6 (0.0) (*) (*) 6.7 5.4 9.9 19.2 7.7 12.1 na 11.1 (*) 12.9 10.1 (*) 8.5 11.1 (18.7) (11.6) (4.8) 4.1 18.5 (8.4) (*) (*) 11.1 2.7 2.0 0.0 0.0 2.3 na 1.7 (*) 0.4 2.6 (*) 6.9 1.0 (0.0) (0.0) (0.0) 3.7 0.0 (0.0) (*) (*) 1.7 100.0 100.0 100.0 100.0 100.0 na 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 36.5 43.4 38.4 27.6 45.5 na 41.4 (*) 25.6 48.2 (*) 30.0 46.2 (43.9) (47.2) (42.1) 35.3 48.6 (53.4) (*) (*) 41.4 35 158 47 55 185 na 240 6 62 148 24 54 50 52 39 44 112 91 22 11 3 240 District Kaimana Manokwari Sorong 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 Younger 5-9 years older 0-4 years older Percentage of currently married/in union women age 20-24 years whose husband or partner is: Husband/ partner’s age unknown 10+ years older1 Number of women age 20-24 years currently married/ in union Total for 3 districts ( ) 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 West Papua. MULTIPLE INDICATOR CLUSTER SURVEY 2011 115 About 11 per cent of women age 20-24 are currently married to a man who is older by ten years or more and 19 percent14 of women age 15-19 are currently married to men who are older by ten years or more (data not shown). 10.5. TYPE OF MARRIAGE REGISTRATION Marriage is considered official if it is registered through 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 registered 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 West 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 74 per cent (78, 77 and 55 per cent in Sorong, Manokwari and Kaimana districts respectively). Figure CP.3 Percentage of women aged 15-49 years married before their 15th birthday, percentage of women aged 20-49 years married before their 18th birthday, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 50 45 40 35 30 25 20 15 10 5 0 P er c en t Age (in years) Married before 15 0 2015 4035105 3025 5045 Married before 18 14 MICS Indicator 8.10a MULTIPLE INDICATOR CLUSTER SURVEY 2011116 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 90.5 89.4 63.5 78.0 83.9 63.5 76.3 84.1 82.1 86.2 84.0 84.1 86.9 81.3 83.1 81.1 82.9 84.5 79.4 84.2 81.5 83.1 78.4 87.3 88.0 86.8 100.0 82.5 55.0 77.0 78.3 77.4 72.9 48.6 68.5 75.2 73.2 75.3 77.2 79.9 41.1 68.7 78.5 84.9 36.5 63.7 76.4 88.4 91.6 44.9 98.0 90.0 76.3 67.5 69.8 74.0 29.8 81.1 14.8 58.6 54.1 76.5 55.0 48.7 56.2 53.2 53.6 61.6 49.5 51.7 56.6 61.3 46.9 42.8 50.2 64.1 65.7 59.0 50.5 63.9 40.9 56.0 70.0 55.1 277 1,048 501 442 1,384 64 205 334 385 350 257 232 93 613 913 208 291 332 360 421 422 684 683 243 124 87 6 1,826 37.7 48.9 18.3 50.2 35.2 58.1 38.1 35.6 44.1 34.4 37.2 38.5 48.9 33.7 39.3 47.2 45.4 28.8 33.1 39.5 46.5 50.5 25.5 45.9 25.9 48.0 70.0 38.8 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Missing/DK Total for 3 districts Religious ceremony Civil registration Type of marriage registration Community acceptance Traditional ceremony Number of women age 15-49 years currently married/ in union MULTIPLE 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 Tables CP.9 and CP.9M. Overall, 40 per cent of women feel that their husband has a right to hit or beat them for at least one of a variety of reasons. In most cases, women who approve their husband’s violence agree with and justify violence in instances when they neglect the children (25 per cent), or if they demonstrate their autonomy, e.g. go out without telling their husbands (20 per cent) or argue with them (23 per cent). Around 14 per cent of women believe that their partner has a right to hit or beat them if they refuse to have sex with him, if they burn the food (10 per cent) or if they argue with the in-laws (21 per cent). Differences in this indicator were clear among districts, where 41 per cent of women in Manokwari District accept this type of violence. This percentage is reduced in Sorong and Kaimana districts to 33 and 36 per cent respectively. Association of domestic violence with education and wealth did not show a clear trend, but acceptance is more present among those living in the poorest households (40 per cent) than in the richest households (31 per cent). Results on domestic violence for men are presented in Table CP.8M. Overall, 32 per cent of men feel that a husband has a right to hit or beat his wife for at least one of a variety of reasons, a percentage lower than that expressed by women (40 per cent). In most cases, men who approve of husband violence agree with and justify violence in instances when wives argue with their husbands (17 per cent) or she neglects the children (16 per cent). Differences in this indicator were clear among districts where 51 per cent of women in Kaimana District accept this type of violence. This percentage is reduced in Manokwari and Sorong districts to 31 and 23 per cent respectively. MULTIPLE INDICATOR CLUSTER SURVEY 2011118 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 22.4 19.5 17.9 20.0 19.4 22.6 19.6 21.2 19.9 15.7 20.8 14.7 19.3 22.9 19.7 20.8 22.8 19.2 14.3 25.2 25.3 18.1 15.8 15.6 26.4 13.1 14.5 18.1 13.0 19.5 19.1 26.9 23.9 23.5 25.5 31.6 25.5 27.0 22.6 21.4 21.5 22.1 24.2 25.5 27.3 19.2 25.9 26.7 19.1 27.4 28.5 25.3 24.2 20.8 31.0 23.1 15.1 19.1 15.2 25.0 9.9 15.1 11.9 8.3 15.6 14.6 13.0 15.8 13.8 10.8 12.7 12.6 13.9 11.0 12.8 17.3 18.3 12.8 6.0 17.0 16.7 14.1 11.8 9.5 16.2 12.6 9.9 10.5 8.1 13.5 36.0 40.7 32.6 38.4 37.9 45.3 35.6 40.3 36.9 34.1 35.9 34.7 37.6 42.0 38.7 30.4 41.1 39.1 31.0 40.2 40.9 40.2 38.9 31.4 44.4 35.2 29.9 34.8 22.5 38.0 38.3 43.7 33.4 41.3 40.0 48.2 38.1 42.5 37.6 36.0 41.0 36.5 39.8 45.1 41.4 33.7 43.8 41.4 32.9 42.3 44.0 41.6 42.0 33.3 46.8 37.6 32.1 35.4 26.3 40.4 18.9 25.7 19.9 22.9 23.4 30.6 21.7 24.2 23.0 20.4 18.4 21.0 22.6 24.2 25.2 23.9 25.8 24.1 15.4 25.5 27.0 26.4 21.5 17.7 29.4 19.5 17.7 18.5 11.1 23.2 9.7 10.9 7.9 8.7 10.5 11.6 10.7 12.5 11.2 4.8 7.7 10.1 9.6 15.9 10.0 15.9 13.4 9.4 3.8 17.2 16.2 9.9 5.8 3.9 17.4 3.1 4.8 5.6 5.9 10.0 18.6 23.2 14.8 18.3 21.3 28.3 19.0 21.0 19.8 14.5 21.2 17.2 19.5 23.7 23.3 24.4 23.2 21.2 11.7 26.6 24.3 20.0 19.7 13.9 27.2 16.7 13.9 10.7 15.2 20.5 423 1,638 654 763 1,952 465 395 462 443 387 305 259 1,987 134 594 134 764 1,402 415 467 502 493 640 614 1,212 860 333 197 107 2,715 District Kaimana Manokwari Sorong 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 If she goes out without telling him If she neglects the children If she burns the food Percentage of women age 15-49 years who believe a husband is justified in beating his wife/partner: If she refuses sex with him If she argues with parent- in-law If she argues with him For any of these reasons1 Number of women age 15-49 years For any of the 6 reasons * 7 cases with missing “Ethnicity of household head” not shown 1 MICS indicator 8.14 MULTIPLE INDICATOR CLUSTER SURVEY 2011 119 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 30.2 12.5 8.2 9.8 15.9 13.9 17.2 15.8 14.5 16.1 12.7 8.8 14.2 18.9 14.0 36.7 17.4 12.9 11.1 27.7 21.9 12.5 6.8 5.4 24.1 5.1 6.0 15.9 20.0 14.3 26.8 14.3 10.9 10.1 17.5 20.5 19.8 17.1 13.2 13.5 12.8 10.6 13.4 18.9 19.3 27.0 16.8 15.2 12.8 26.1 22.0 12.3 9.6 9.7 23.1 8.8 9.2 12.2 20.0 15.5 15.0 7.9 5.4 7.2 8.9 11.4 9.9 7.8 9.4 7.7 6.7 4.2 7.3 11.4 10.4 7.4 9.3 8.9 5.9 14.6 12.8 7.1 4.6 4.4 13.3 3.5 4.1 8.0 0.0 8.4 48.1 28.2 20.1 24.4 31.3 36.3 32.1 30.0 29.9 28.2 27.8 17.5 26.6 41.7 34.0 51.8 34.1 28.4 23.1 49.0 37.4 27.1 19.7 17.7 43.8 17.0 15.4 27.5 20.0 29.4 51.4 30.5 22.8 27.0 33.8 40.6 37.6 32.8 30.6 30.0 29.7 18.7 28.3 44.2 38.3 55.5 37.0 30.6 26.4 53.2 39.4 30.1 21.6 19.6 47.3 18.4 17.6 31.9 39.9 32.0 33.0 14.8 10.3 13.9 17.6 20.7 19.2 17.4 16.5 16.6 14.2 9.6 14.8 21.3 19.9 30.2 21.4 14.9 13.8 32.6 21.9 14.2 9.4 7.9 28.7 5.7 6.3 13.1 0.0 16.6 12.3 2.9 4.4 3.4 5.2 4.6 7.6 5.8 3.7 4.5 4.0 3.5 4.2 9.3 5.4 7.0 7.7 4.2 2.2 12.7 6.3 2.7 2.7 0.6 8.7 1.6 1.4 3.4 0.0 4.7 36.0 13.3 11.8 11.5 18.4 22.0 23.6 19.5 12.4 14.5 14.1 8.9 13.6 19.9 22.1 32.7 21.9 14.7 13.3 33.4 21.0 14.7 9.1 7.6 27.6 6.8 7.5 13.6 39.9 16.6 437 1,647 652 732 2,004 477 317 388 479 410 374 291 1,767 68 902 74 625 1,576 460 498 499 591 576 571 1,189 906 333 171 129 2,736 District Kaimana Manokwari Sorong 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 If she goes out without telling him If she neglects the children If she burns the food Percentage of men age 15-49 years who believe a husband is justified in beating his wife/partner: If she refuses sex with him If she argues with parent- in-law If she argues with him For any of these reasons1 Number of men age 15-49 years For any of the 6 reasons * 9 cases with missing “Ethnicity of household head” not shown 1 MICS indicator 8.14 MULTIPLE INDICATOR CLUSTER SURVEY 2011120 MULTIPLE INDICATOR CLUSTER SURVEY 2011 121 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 percentage of young women who have comprehensive and correct knowledge of HIV prevention and transmission. In MICS conducted in three districts in West Papua all women who had 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 West Papua, about 78 per cent of the interviewed women have heard of AIDS with clear differentials among districts (Kaimana, 64 per cent; Manokwari, 84 per cent; Sorong, 72 per cent). The percentage of women who know of both main ways of preventing HIV transmission is only 43 per cent. Sixty per cent of women know of having one faithful uninfected sex partner and 50 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 lowest level of knowledge in Kaimana District (34 per cent) compared with 39 and 47 per cent in Sorong and Manokwari 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 83 per cent and the percentage of women who MULTIPLE INDICATOR CLUSTER SURVEY 2011122 know of both main ways of preventing HIV transmission is almost the same for this age group (49 per cent) as for the age group 15-49 (50 per cent). Differentials of these indicators are generally similar to those for age group 15-49. Table HA.1 and HA.2 also present the percentage 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 West Papua, 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, 34 per cent reject the two most common misconceptions and know that a healthy-looking person can be infected. Sixty-three per cent of women know that HIV cannot be transmitted by supernatural means, and 45 per cent of women know that HIV cannot be transmitted by sharing food with someone with AIDS, while 64 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 23 per cent of women age 15-49 were found to have comprehensive knowledge, which was higher in urban areas (29 per cent) compared with rural (11 per cent). Comprehensive knowledge is much lower in Kaimana District (18 per cent) than in Manokwari (25 per cent) and Sorong (23 per cent). As expected, the percentage of women with comprehensive knowledge increases with the woman’s education level (Figure HA.1). Comprehensive knowledge was lowest among women with no education (less than one per cent) and increased to 46 per cent among women with higher education. Women residing in the poorest households show only 15 per cent comprehensive knowledge compared with 41 per cent in the richest households. Women living in households with Javanese heads show higher 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 Kaimana, Manokwari and Sorong, West 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 42 6766 46 27 50 8 13 24 11 3 1 MULTIPLE INDICATOR CLUSTER SURVEY 2011 123 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 H av in g on ly on e fa it hf ul un in fe ct ed se x pa rt ne r U si ng a co nd om ev er y ti m e M os qu it o bi te s Pe rc en ta ge of w om en w ho k no w bo th w ay s S up er na tu ra l m ea ns S ha rin g fo od w ith s om e- on e w ith A ID S Pe rc en ta ge w ho k no w th at a h ea lth y lo ok in g pe rs on ca n ha ve th e A ID S v iru s Pe rc en ta ge w ho re je ct th e tw o m os t co m m on m is co nc ep - tio ns a nd k no w th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ith c om - pr eh en si ve kn ow le dg e1 N u m b er o f w o m en Pe rc en t- ag e w ho ha ve he ar d of A ID S Pe rc en ta ge w ho k no w t ra ns - m is si on c an b e pr ev en te d by : P er ce n ta g e w h o k n o w t h at H IV c an n o t b e tr an sm it te d b y: D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 T o ta l f o r 3 d is tr ic ts 63 .7 83 .8 71 .9 87 .9 73 .8 82 .9 80 .0 79 .3 66 .0 75 .3 86 .6 26 .4 56 .7 87 .8 99 .3 45 .4 65 .0 83 .9 90 .8 94 .4 67 .9 84 .4 89 .7 84 .4 90 .2 77 .8 43 .2 65 .2 57 .0 67 .5 56 .8 66 .2 61 .6 60 .3 47 .9 56 .8 70 .5 15 .3 38 .0 67 .7 87 .5 30 .0 47 .7 61 .7 72 .6 77 .6 50 .1 67 .0 71 .1 68 .4 62 .0 59 .8 42 .8 54 .1 43 .7 57 .1 47 .0 56 .0 50 .7 49 .8 39 .9 47 .8 57 .1 14 .4 29 .1 58 .7 69 .7 23 .2 41 .6 52 .7 60 .9 63 .1 42 .9 53 .5 61 .1 59 .0 49 .0 49 .9 54 .5 66 .3 58 .1 72 .2 58 .7 69 .2 63 .6 63 .6 49 .6 58 .7 76 .1 16 .5 37 .5 73 .0 87 .6 31 .4 47 .4 61 .0 78 .0 83 .4 50 .9 70 .9 73 .6 73 .8 73 .2 62 .5 34 .1 47 .4 39 .2 47 .6 41 .7 49 .2 43 .6 43 .7 33 .5 41 .2 51 .0 10 .8 23 .9 50 .4 65 .7 19 .1 35 .5 44 .2 53 .3 57 .0 36 .1 47 .5 54 .4 53 .8 38 .7 43 .3 44 .2 71 .9 56 .2 75 .5 59 .2 69 .5 68 .1 63 .3 52 .1 60 .7 74 .6 14 .9 37 .5 73 .9 93 .8 26 .9 52 .5 66 .7 79 .1 82 .6 54 .0 70 .3 74 .6 71 .6 75 .6 63 .8 38 .4 43 .4 39 .9 52 .6 37 .6 51 .6 41 .6 39 .9 29 .7 37 .5 57 .0 7. 9 22 .5 48 .7 64 .7 18 .1 30 .1 43 .4 52 .4 57 .0 32 .2 45 .9 57 .7 52 .2 48 .9 41 .8 38 .5 47 .7 43 .9 59 .3 39 .9 52 .0 44 .7 45 .8 35 .1 42 .1 57 .1 4. 2 21 .4 54 .2 72 .6 18 .3 27 .9 44 .3 60 .0 65 .6 34 .0 53 .8 56 .4 55 .7 53 .2 45 .3 27 .4 38 .9 33 .4 46 .7 31 .5 42 .0 34 .4 35 .6 27 .6 32 .2 48 .4 2. 5 13 .1 42 .0 67 .1 10 .8 19 .6 31 .1 51 .7 55 .1 24 .4 45 .4 45 .5 45 .0 40 .0 35 .8 17 .9 24 .9 22 .7 29 .0 21 .1 27 .6 23 .2 23 .0 17 .3 21 .4 30 .3 0. 5 7. 9 27 .1 46 .3 5. 7 14 .0 20 .5 33 .8 35 .7 15 .1 30 .0 31 .2 32 .0 21 .9 23 .3 42 3 1, 63 8 65 4 76 3 1, 95 2 86 0 46 2 82 9 56 4 2, 12 1 59 4 13 4 76 4 1, 40 2 41 5 46 7 50 2 49 3 64 0 61 4 1, 21 2 86 0 33 3 19 7 10 7 2, 71 5 * 7 ca se s w it h m is si n g /D K “ 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011124 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 H av in g on ly on e fa it hf ul un in fe ct ed se x pa rt ne r U si ng a co nd om ev er y ti m e M os qu it o bi te s Pe rc en ta ge of m en w ho kn ow b ot h w ay s S up er na tu ra l m ea ns S ha rin g fo od w ith s om e- on e w ith A ID S Pe rc en ta ge w ho k no w th at a h ea lth y lo ok in g pe rs on ca n ha ve th e A ID S v iru s Pe rc en ta ge w ho re je ct th e tw o m os t co m m on m is co nc ep - tio ns a nd k no w th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ith c om - pr eh en si ve kn ow le dg e1 N u m b er o f m en Pe rc en t- ag e w ho ha ve he ar d of A ID S Pe rc en ta ge w ho k no w t ra ns - m is si on c an b e pr ev en te d by : P er ce n ta g e w h o k n o w t h at H IV c an n o t b e tr an sm it te d b y: D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 T o ta l f o r 3 d is tr ic ts 85 .3 92 .9 89 .1 93 .5 89 .8 89 .6 94 .0 91 .9 88 .9 91 .4 89 .5 62 .2 79 .5 94 .4 98 .4 75 .1 89 .9 93 .4 96 .3 96 .9 86 .8 93 .1 95 .8 93 .1 95 .8 90 .8 53 .4 66 .9 73 .5 61 .0 68 .3 64 .5 69 .8 67 .1 65 .5 66 .9 65 .2 32 .3 54 .9 71 .2 70 .9 52 .3 64 .6 67 .6 71 .2 73 .9 60 .0 73 .6 65 .8 65 .2 76 .5 66 .3 57 .1 69 .6 59 .7 71 .4 63 .0 66 .9 68 .3 65 .4 61 .2 64 .9 65 .9 35 .6 46 .0 70 .4 78 .6 46 .3 63 .3 65 .6 73 .9 74 .4 59 .3 71 .3 65 .3 65 .7 75 .6 65 .2 71 .2 80 .3 76 .8 82 .6 76 .3 77 .7 80 .7 78 .5 76 .1 78 .1 77 .8 44 .0 62 .2 82 .7 88 .9 58 .6 75 .7 75 .5 85 .8 91 .8 69 .4 85 .0 85 .8 81 .7 84 .7 78 .0 40 .5 54 .0 54 .2 50 .7 52 .3 52 .6 53 .9 52 .6 48 .9 51 .9 51 .8 20 .8 37 .1 57 .1 59 .2 37 .5 49 .5 52 .5 58 .7 59 .0 45 .9 59 .2 49 .2 49 .8 84 .7 51 .9 54 .7 71 .4 57 .1 67 .9 64 .4 65 .7 67 .6 66 .7 61 .7 65 .4 65 .1 32 .5 47 .7 70 .1 78 .3 42 .2 60 .4 65 .3 73 .7 81 .4 59 .2 72 .5 70 .1 60 .3 69 .0 65 .3 43 .5 48 .5 45 .0 49 .2 46 .0 50 .2 46 .1 47 .9 41 .9 44 .9 50 .8 25 .3 33 .3 49 .5 59 .7 27 .9 44 .9 46 .2 51 .9 60 .7 40 .5 54 .9 48 .8 39 .5 50 .9 46 .9 36 .7 56 .7 52 .4 57 .7 50 .6 55 .9 54 .9 51 .3 48 .6 49 .9 57 .7 14 .0 30 .7 56 .4 75 .1 25 .2 43 .3 54 .1 61 .8 73 .4 44 .0 60 .8 59 .3 48 .0 62 .6 52 .5 25 .0 41 .5 34 .7 40 .9 35 .9 39 .9 38 .2 37 .7 33 .0 35 .3 41 .3 6. 1 18 .4 40 .1 58 .3 12 .3 28 .3 33 .9 44 .9 62 .6 27 .7 48 .0 45 .4 31 .0 39 .0 37 .3 12 .1 26 .1 25 .1 24 .0 23 .5 26 .1 25 .0 23 .7 19 .8 22 .1 26 .7 0. 9 9. 4 27 .1 34 .7 8. 9 18 .4 21 .8 27 .1 39 .4 15 .8 33 .4 26 .7 18 .7 26 .9 23 .6 43 7 1, 64 7 65 2 73 2 2, 00 4 79 4 38 8 88 9 66 5 1, 83 4 90 2 74 62 5 1, 57 6 46 0 49 8 49 9 59 1 57 6 57 1 1, 18 9 90 6 33 3 17 1 12 9 2, 73 6 * 9 ca se s w it h m is si n g /D K “ 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011 125 T ab 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 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 H av in g on ly on e fa it hf ul un in fe ct ed se x pa rt ne r U si ng a co nd om ev er y ti m e M os qu it o bi te s Pe rc en ta ge of w om en w ho k no w bo th w ay s S up er na tu ra l m ea ns S ha rin g fo od w ith s om e- on e w ith A ID S Pe rc en ta ge w ho k no w th at a h ea lth y lo ok in g pe rs on ca n ha ve th e A ID S v iru s Pe rc en ta ge w ho re je ct th e tw o m os t co m m on m is co nc ep - tio ns a nd k no w th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ith c om - pr eh en si ve kn ow le dg e1 N u m b er o f w o m en ag e 15 -2 4 Pe rc en t- ag e w ho ha ve he ar d of A ID S Pe rc en ta ge w ho k no w t ra ns - m is si on c an b e pr ev en te d by : P er ce n ta g e w h o k n o w t h at H IV c an n o t b e tr an sm it te d b y: D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 T o ta l f o r 3 d is tr ic ts 63 .1 87 .1 83 .2 91 .9 79 .1 84 .3 81 .3 76 .5 87 .2 (* ) 43 .7 89 .6 99 .6 49 .2 76 .6 91 .5 95 .0 97 .4 72 .6 95 .6 91 .2 89 .3 (* ) 82 .9 44 .0 69 .6 70 .3 73 .6 63 .0 66 .8 65 .4 58 .6 71 .3 (* ) 29 .2 70 .3 88 .2 39 .1 58 .1 69 .1 81 .4 77 .2 55 .5 82 .1 73 .2 75 .2 (* ) 66 .2 44 .2 58 .3 56 .7 62 .6 53 .2 54 .9 57 .2 50 .8 59 .4 (* ) 19 .2 61 .8 72 .1 25 .3 51 .1 69 .1 65 .0 66 .5 47 .4 65 .5 65 .8 70 .6 (* ) 56 .0 52 .5 71 .5 73 .3 76 .7 66 .0 72 .1 65 .7 58 .3 76 .5 (* ) 28 .9 75 .1 88 .2 36 .3 60 .8 74 .0 85 .4 83 .1 57 .3 86 .2 72 .3 77 .2 (* ) 69 .2 36 .3 51 .5 50 .8 53 .7 47 .3 48 .6 49 .9 43 .6 53 .0 (* ) 17 .3 53 .1 67 .3 22 .9 43 .2 57 .1 59 .8 59 .3 40 .3 60 .1 58 .7 63 .6 (* ) 49 .2 43 .1 74 .6 71 .3 79 .2 65 .5 69 .2 69 .9 60 .7 75 .5 (* ) 28 .0 74 .4 94 .6 29 .2 62 .4 78 .0 85 .7 86 .1 57 .4 86 .5 77 .6 74 .6 (* ) 69 .5 42 .4 50 .9 60 .2 62 .5 47 .0 53 .5 49 .3 43 .5 57 .0 (* ) 21 .6 56 .4 65 .6 20 .6 46 .4 58 .9 61 .1 67 .0 37 .2 65 .6 70 .3 63 .9 (* ) 51 .6 39 .2 51 .9 61 .2 65 .9 46 .1 52 .1 51 .8 43 .5 57 .7 (* ) 17 .5 55 .5 74 .0 21 .8 38 .1 53 .6 68 .6 70 .5 38 .4 68 .1 63 .4 65 .5 (* ) 52 .0 25 .4 43 .0 50 .4 52 .5 37 .6 41 .8 42 .3 31 .7 48 .9 (* ) 9. 3 43 .7 67 .9 13 .2 28 .7 41 .9 60 .0 58 .5 28 .5 61 .6 48 .5 54 .7 (* ) 42 .0 16 .3 27 .1 36 .8 33 .7 25 .0 26 .8 28 .5 22 .1 31 .3 (* ) 3. 4 28 .6 47 .1 6. 8 20 .2 30 .2 39 .5 36 .5 18 .1 41 .2 32 .9 39 .1 (* ) 27 .6 12 1 56 6 17 3 25 4 60 6 46 5 39 5 34 6 51 4 13 14 1 54 3 16 3 16 0 16 4 14 4 21 3 17 9 44 1 24 7 92 60 19 86 0 * 1 ca se w it h m is si n g / D K “ 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 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 9. 2; M D G in d ic at o r 6. 3 MULTIPLE INDICATOR CLUSTER SURVEY 2011126 T ab 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 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 H av in g on ly on e fa it hf ul un in fe ct ed se x pa rt ne r U si ng a co nd om ev er y ti m e M os qu it o bi te s Pe rc en ta ge of m en w ho kn ow b ot h w ay s S up er na tu ra l m ea ns S ha rin g fo od w ith s om e- on e w ith A ID S Pe rc en ta ge w ho k no w th at a h ea lth y lo ok in g pe rs on ca n ha ve th e A ID S v iru s Pe rc en ta ge w ho re je ct th e tw o m os t co m m on m is co nc ep - tio ns a nd k no w th at a he al th y lo ok in g pe rs on c an h av e th e A ID S v iru s Pe rc en ta ge w ith c om - pr eh en si ve kn ow le dg e1 N u m b er o f m en ag e 15 -2 4 Pe rc en t- ag e w ho ha ve he ar d of A ID S Pe rc en ta ge w ho k no w t ra ns - m is si on c an b e pr ev en te d by : P er ce n ta g e w h o k n o w t h at H IV c an n o t b e tr an sm it te d b y: D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 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 T o ta l f o r 3 d is tr ic ts 79 .0 92 .8 88 .1 94 .0 87 .8 88 .7 91 .1 91 .2 89 .3 (* ) 72 .0 93 .2 99 .2 66 .8 88 .3 97 .4 96 .9 96 .7 84 .1 97 .2 95 .5 88 .5 (* ) 89 .6 47 .3 67 .8 66 .9 59 .9 66 .4 65 .8 62 .5 63 .5 64 .7 (* ) 49 .6 69 .1 65 .7 48 .5 58 .1 70 .0 67 .9 77 .2 56 .7 76 .1 64 .1 59 .9 (* ) 64 .5 50 .6 74 .9 55 .4 72 .6 64 .5 64 .2 71 .0 72 .1 65 .9 (* ) 44 .7 71 .1 80 .2 45 .9 65 .8 70 .1 72 .2 80 .1 59 .3 76 .5 73 .7 64 .9 (* ) 66 .9 66 .2 80 .1 79 .0 82 .5 75 .7 76 .2 80 .0 80 .0 77 .3 (* ) 55 .9 82 .5 87 .9 53 .7 74 .7 79 .2 87 .9 92 .4 67 .7 92 .6 90 .0 74 .2 (* ) 77 .7 35 .2 58 .3 48 .4 52 .7 52 .5 50 .9 55 .1 54 .6 52 .2 (* ) 35 .3 57 .5 56 .1 38 .7 44 .6 56 .3 58 .3 64 .4 44 .6 63 .5 54 .3 49 .8 (* ) 52 .6 44 .7 72 .4 61 .0 62 .6 67 .0 65 .3 66 .2 66 .9 65 .4 (* ) 47 .0 69 .1 77 .9 38 .0 63 .5 71 .6 75 .0 78 .7 59 .2 80 .1 69 .8 42 .5 (* ) 65 .7 39 .7 52 .3 51 .6 48 .8 50 .8 54 .1 44 .3 40 .6 52 .2 (* ) 33 .1 53 .4 60 .7 27 .1 51 .4 49 .7 54 .1 69 .6 39 .0 69 .5 51 .5 45 .4 (* ) 50 .2 30 .8 60 .4 60 .7 55 .0 56 .3 55 .6 56 .4 46 .8 57 .8 (* ) 26 .7 58 .8 82 .7 25 .7 50 .9 57 .9 66 .3 78 .5 44 .5 66 .9 78 .2 58 .7 (* ) 55 .9 19 .2 43 .8 43 .1 35 .6 41 .8 40 .4 39 .2 36 .1 40 .7 (* ) 17 .5 42 .9 57 .5 13 .6 35 .9 38 .8 47 .0 65 .1 29 .6 54 .6 58 .6 32 .1 (* ) 39 .9 8. 7 29 .7 27 .7 23 .0 27 .4 28 .1 23 .0 22 .7 26 .8 (* ) 10 .0 29 .8 31 .5 9. 7 20 .7 26 .4 29 .2 45 .1 16 .9 38 .2 41 .3 16 .9 (* ) 26 .1 12 1 49 9 17 4 24 0 55 4 47 7 31 7 13 3 66 1 10 14 4 52 2 11 8 15 0 15 3 17 8 17 3 14 0 39 5 23 5 77 44 37 79 4 * 7 ca se w it h m is si n g /D K “ 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 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 9. 2; M D G in d ic at o r 6. 3 MULTIPLE 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 similar among men age 15-49 (24 per cent) compared with women (23 per cent). Similar trends were observed in variations by background characteristic in comprehensive knowledge for men as were observed among women. Unlike women, comprehensive knowledge was lower among men in the younger age group 15-24 (19 per cent) than among men age 15-49 (24 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, 70 per cent during pregnancy, 63 per cent during delivery and 67 per cent by breastfeeding. The percentage of women who know all three ways of mother-to-child transmission is 60 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 Manokwari (62 per cent) and the lowest in Kaimana (51 per cent) The impact of education on the knowledge is also clear. Knowledge among women with no education stands at 15 per cent, rising to 37 per cent among women who have primary education, to 69 per cent among women with secondary education and rising to reach the maximum of 82 per cent among women who higher education. Wealth index is positively correlated with knowledge of the transmission from mother to child, amounting to 29 per cent of women in the poorest 20 per cent of households and rising gradually to reach 78 per cent for women in the richest 20 per cent of households. Knowledge of mother-to-child HIV transmission is higher among men (83 per cent) than women (72 per cent). About 78 per cent of men know that HIV can be transmitted during pregnancy, 70 per cent during delivery and 74 per cent by breastfeeding. The percentage of men who know all three ways of mother-to-child transmission is 10 per cent, while six per cent of men did not know of any specific way. MULTIPLE INDICATOR CLUSTER SURVEY 2011128 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 57.6 78.3 65.9 84.5 67.2 77.8 78.7 76.7 74.7 73.0 59.9 69.0 83.1 23.9 48.0 82.3 97.4 36.7 58.7 76.8 86.4 91.1 62.9 76.8 86.2 79.4 82.2 72.1 54.2 71.7 62.7 78.6 62.1 73.4 74.9 71.5 68.5 66.7 55.4 63.6 78.1 20.3 45.2 76.2 89.6 34.0 55.1 72.3 79.0 84.0 58.6 70.7 78.9 75.7 75.1 66.8 55.4 75.8 65.1 81.6 65.5 75.5 76.1 74.8 72.5 71.1 58.1 66.8 81.5 22.4 44.8 80.5 96.5 34.5 57.1 74.7 83.2 90.2 60.9 74.9 82.7 78.4 82.2 70.0 54.3 66.5 61.5 75.7 58.6 68.6 70.0 67.0 63.6 64.1 54.1 60.6 73.3 15.9 40.0 73.1 88.8 30.4 52.6 65.5 74.9 83.5 54.3 67.1 76.9 74.9 74.7 63.4 50.5 61.7 59.5 71.0 54.9 65.9 68.0 63.4 59.7 59.0 50.1 56.4 70.5 15.2 37.2 69.2 81.8 29.1 49.7 62.9 69.3 77.5 51.8 62.7 69.6 71.8 67.6 59.5 6.1 5.5 6.0 3.3 6.6 5.1 5.6 4.6 5.3 6.3 6.1 6.3 3.5 2.4 8.7 5.5 1.8 8.7 6.3 7.1 4.4 3.3 5.0 7.6 3.4 5.0 8.0 5.7 423 1,638 654 763 1,952 860 465 395 462 829 564 2,121 594 134 764 1,402 415 467 502 493 640 614 1,212 860 333 197 107 2,715 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts During pregnancy During delivery By breast- feeding All three means1 Does not know any of the specific means Number of women Percentage who know HIV can be transmit- ted from mother to child Per cent who know HIV can be transmitted: * 7 cases with missing/DK “Ethnicity of household head” not shown 1 MICS indicator 9.3 MULTIPLE INDICATOR CLUSTER SURVEY 2011 129 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 78.1 86.5 78.3 87.7 81.6 83.7 82.8 85.1 86.8 84.4 78.8 82.8 84.0 52.7 65.9 87.6 96.5 64.5 79.7 85.3 89.1 94.4 83.2 74.5 73.5 73.5 77.1 72.5 72.9 71.0 75.8 80.3 74.6 69.6 74.1 72.9 48.1 60.7 77.0 84.0 59.5 72.2 76.0 77.9 80.8 73.7 73.0 80.1 74.6 83.1 75.6 77.8 75.2 81.7 79.9 79.8 73.1 77.8 77.2 47.9 60.8 81.2 92.9 59.7 73.7 78.6 84.9 88.4 77.6 69.9 68.7 72.0 75.4 67.6 69.2 68.1 70.8 70.0 72.0 66.9 69.8 69.5 33.7 55.7 74.1 79.3 53.1 65.0 72.1 74.8 80.5 69.7 65.8 57.8 67.2 67.0 59.2 60.1 57.3 64.4 65.1 62.6 58.7 62.3 59.3 28.9 50.3 64.8 69.4 48.4 57.8 63.8 65.7 68.6 61.3 7.2 6.4 10.8 5.8 8.2 6.0 5.9 6.1 7.1 7.4 10.1 8.6 5.5 9.5 13.7 6.8 1.8 10.7 10.2 8.1 7.2 2.5 7.6 437 1,647 652 732 2,004 794 477 317 388 889 665 1,834 902 74 625 1,576 460 498 499 591 576 571 2,736 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Total for 3 districts During pregnancy During delivery By breastfeeding All three means1 Does not know any of the specific means Number of men Percentage who know HIV can be transmitted from mother to child Per cent who know HIV can be transmitted: 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 West Papua, 14 per cent of women who have heard of AIDS agree with all four accepting attitudes. The most common accepting attitude is willingness to care for a family member with the AIDS virus in own home (65 per cent), followed by belief that a female teacher with the AIDS virus and is not sick should be allowed to continue (57 per cent), followed by not wanting to keep secret that a family member got infected with the AIDS virus (51 per cent) and lastly buying fresh vegetables from a shopkeeper or vendor who has the AIDS virus (43 per cent). MULTIPLE INDICATOR CLUSTER SURVEY 2011130 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 31.7 68.7 71.9 62.8 65.5 69.1 69.0 69.3 61.5 66.0 56.8 63.3 68.9 (36.2) 50.1 66.7 76.3 40.7 58.7 67.2 67.5 72.1 51.7 78.1 72.6 62.8 51.7 64.7 74.7 45.4 52.5 48.6 51.7 42.0 43.0 40.7 54.4 54.0 57.9 53.5 42.0 (67.5) 51.2 53.9 39.3 55.5 55.2 (54.7) 48.8 45.4 49.4 48.1 56.7 57.9 49.3 50.7 34.1 42.4 48.4 44.7 41.7 43.6 42.5 44.9 43.1 45.1 35.9 41.9 44.8 (10.4) 27.5 43.9 57.4 24.6 32.4 39.9 47.8 51.7 34.0 50.4 45.0 44.8 45.6 42.6 45.9 56.8 64.5 60.3 55.7 60.2 57.2 63.7 57.8 60.3 45.2 55.1 63.4 (12.5) 35.7 59.4 76.8 33.3 46.7 56.7 59.5 69.7 49.5 63.9 59.1 59.4 60.3 57.1 93.0 90.0 91.3 90.9 90.5 90.2 90.0 90.5 93.3 91.8 86.8 90.3 91.7 (78.9) 84.1 91.5 95.9 82.0 90.0 91.6 91.7 92.4 86.2 92.7 95.1 95.4 91.8 90.7 6.2 13.4 21.1 13.7 14.4 13.9 15.6 11.8 12.1 16.8 12.3 14.4 13.6 (1.5) 6.9 16.5 16.1 6.0 9.5 15.4 14.8 18.4 9.7 17.7 19.2 12.3 11.7 14.2 270 1,372 470 671 1,441 713 392 321 369 657 372 1,598 514 35 433 1,231 412 212 326 414 581 579 823 725 298 166 97 2,112 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Would buy fresh veg- etables from a shopkeep- er or vendor who has the AIDS virus Believe that a female teacher with the AIDS vi- rus and is not sick should be allowed to continue teaching Would not want to keep secret that a fam- ily member got in- fected with the AIDS virus 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 mem- ber with the AIDS virus in own home Percentage of women who: * 3 cases with missing/DK “Ethnicity of household head” not shown ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 9.4 MULTIPLE INDICATOR CLUSTER SURVEY 2011 131 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 36.6 78.6 77.1 68.7 73.2 74.8 76.5 72.2 72.0 71.6 69.1 69.7 76.7 (58.1) 60.1 74.4 78.3 52.9 65.2 74.9 76.8 82.5 61.2 86.0 73.0 58.3 78.4 72.0 69.2 48.3 56.4 45.9 56.2 41.9 40.7 43.7 52.4 56.6 63.2 58.2 43.3 (66.1) 58.5 54.3 43.2 58.1 57.0 55.1 50.3 48.4 51.0 55.7 50.6 57.7 57.2 53.3 24.6 45.1 51.0 47.6 41.8 42.4 44.7 39.0 45.7 46.1 39.6 41.9 46.7 (17.4) 25.5 46.4 55.8 21.1 35.1 44.5 47.0 60.6 32.0 56.7 49.6 33.8 45.6 43.4 30.9 60.1 49.1 57.8 51.4 56.9 59.6 53.0 55.6 52.4 48.1 51.4 56.7 (33.5) 35.0 54.7 70.1 30.7 43.0 51.4 58.0 73.5 44.6 65.6 57.1 30.5 58.4 53.2 88.0 94.8 96.5 91.8 95.1 92.4 91.7 93.4 95.9 94.8 94.4 94.4 93.7 (89.4) 89.1 95.4 96.2 88.5 94.1 94.4 94.8 97.2 91.0 97.8 94.4 92.8 97.4 94.2 6.8 14.6 17.0 13.0 14.4 10.5 10.6 10.3 14.8 16.9 13.7 15.1 11.8 (3.5) 8.2 14.5 19.9 5.5 10.8 13.3 15.4 21.7 9.5 20.8 13.2 6.8 16.2 14.0 373 1,531 580 684 1,800 712 423 289 365 817 591 1,677 807 46 497 1,487 453 374 449 552 555 554 1,032 844 319 159 123 2,484 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Would buy fresh veg- etables from a shopkeep- er or vendor who has the AIDS virus Believe that a female teacher with the AIDS vi- rus and is not sick should be allowed to continue teaching Would not want to keep secret that a fam- ily member got in- fected with the AIDS virus 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 mem- ber with the AIDS virus in own home Percentage of men who: * 7 cases with missing/DK “Ethnicity of household head” not shown ( ) Figures that are based on 25-49 unweighted cases 1 MICS indicator 9.4 MULTIPLE INDICATOR CLUSTER SURVEY 2011132 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 one’s own status is also a critical factor in the decision to seek treatment. Questions related to knowledge among men of a facility for HIV testing and whether they have ever been tested is presented in Table HA.5. Twenty-seven per cent of women knew where to be tested, while five per cent have actually been tested. Of these, one per cent have been tested within the last 12 months, and less than one per cent have been told the result within the last 12 months. Kaimana District generally lagged behind in these indicators. It should be noted that these results do not include women with birth delivered by health professional. Thirty per cent of men knew where to be tested, while nine per cent have actually been tested (Table HA.5M). Of these, three per cent have been tested within the last 12 months, and two per cent have been tested and told the result within the last 12 months. Knowledge of a place to get tested and the percentage of those who have been tested in the last 12 months and have been told the result are lower in Sorong District than in Kaimana and Manokwari districts. The percentage of women agreeing to all accepting attitudes is highest in Sorong District (21 per cent) compared with Manokwari District (13 per cent) and Kaimana District (6 per cent). And as expected; accepting attitudes increase with women’ education. Accepting Attitudes toward People Living with HIV/AIDS is similar among men (14 per cent) and women (14 per cent) (Table HA4.M) with similar trends by background characteristics. MULTIPLE INDICATOR CLUSTER SURVEY 2011 133 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 2.7 5.7 5.6 9.7 3.5 5.3 3.7 7.2 5.9 6.8 2.1 5.0 6.2 0.0 2.1 5.3 12.4 1.2 2.4 6.3 7.1 7.7 5.5 4.4 6.5 5.4 4.2 5.2 22.6 31.1 19.5 42.6 20.9 26.1 22.6 30.2 26.8 31.5 22.0 25.2 33.4 1.9 9.7 27.7 64.6 6.4 12.3 24.9 34.9 48.2 25.0 23.2 36.7 33.4 37.9 27.0 0.9 1.1 0.8 2.4 0.5 1.2 1.0 1.5 0.7 1.3 0.6 0.8 1.7 0.0 0.5 0.8 2.9 0.0 1.2 1.6 0.6 1.7 1.2 0.8 1.5 0.7 1.1 1.0 0.6 0.8 0.8 1.6 0.5 0.6 0.3 1.0 0.7 1.3 0.5 0.8 0.8 0.0 0.5 0.5 2.4 0.0 0.9 1.2 0.6 1.3 0.7 0.7 1.4 0.7 1.1 0.8 423 1,638 654 763 1,952 860 465 395 462 829 564 2,121 594 134 764 1,402 415 467 502 493 640 614 1,212 860 333 197 107 2,715 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Know a place to get tested1 Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result2 Num- ber of women Percentage of women who: * 7 cases with missing/DK “Ethnicity of household head” not shown 1 MICS indicator 9.5 2 MICS indicator 9.6 MULTIPLE INDICATOR CLUSTER SURVEY 2011134 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 8.7 9.3 7.0 14.5 6.5 5.9 4.9 7.5 12.0 8.9 9.7 9.4 7.2 0.0 3.4 8.9 16.5 4.4 5.2 7.1 9.6 16.2 8.8 6.9 12.4 10.4 8.1 8.7 21.2 36.4 20.1 46.0 24.3 27.3 24.6 31.2 33.2 32.5 28.3 30.1 30.1 1.7 10.7 31.1 57.6 8.9 20.7 30.7 36.5 49.7 29.9 27.4 36.3 31.4 30.4 30.1 2.4 3.7 1.5 5.5 2.0 2.5 1.9 3.2 3.6 3.1 3.0 3.1 2.7 0.0 1.9 2.6 6.2 2.0 1.4 3.3 3.4 4.4 2.9 2.5 3.9 4.1 3.0 3.0 2.0 2.8 0.8 4.3 1.5 1.9 1.8 2.1 3.4 2.2 1.8 2.4 1.9 0.0 1.2 1.9 5.0 1.3 0.9 2.3 2.9 3.4 2.3 1.8 2.2 3.7 2.5 2.2 437 1,647 652 732 2,004 794 477 317 388 889 665 1,834 902 74 625 1,576 460 498 499 591 576 571 1,189 906 333 171 129 2,736 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Know a place to get tested1 Have ever been tested Have been tested in the last 12 months Have been tested in the last 12 months and have been told result2 Number of men Percentage of men who: * 9 cases with missing/DK “Ethnicity of household head” not shown 1 MICS indicator 9.5 2 MICS indicator 9.6 Table HA.6 and HA.6M present 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 2011 135 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 121 566 173 254 606 465 395 346 514 13 141 543 163 160 164 144 213 179 441 247 92 60 19 860 37.2 40.1 36.4 32.0 41.9 19.9 61.4 93.6 2.1 (*) 62.6 36.8 23.8 46.0 46.1 47.5 26.7 33.9 39.6 44.2 35.1 22.0 (*) 39.0 13.8 23.7 14.2 34.8 16.0 18.8 21.2 19.8 (*) (*) 9.8 22.1 (41.4) 10.0 9.6 28.4 (28.0) (31.2) 22.2 17.4 (16.3) (*) (*) 20.6 0.0 0.0 1.2 0.0 0.3 0.9 0.0 0.2 (*) (*) 0.0 0.4 (0.0) 0.0 0.0 0.0 (0.0) (1.3) 0.0 0.7 (0.0) (*) (*) 0.2 2.5 5.7 4.5 4.7 5.2 3.4 5.7 4.7 (*) (*) 1.4 6.1 (9.2) 1.7 0.9 8.1 (10.5) (5.8) 5.2 3.1 (7.1) (*) (*) 5.1 0.0 0.0 1.2 0.0 0.3 0.9 0.0 0.2 (*) (*) 0.0 0.4 (0.0) 0.0 0.0 0.0 (0.0) (1.3) 0.0 0.7 (0.0) (*) (*) 0.2 45 227 63 81 254 93 243 324 11 8 88 200 39 74 76 69 57 61 175 109 32 13 6 335 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Know a place to get tested Percentage who have had sex in the last 12 months Number of women age 15-24 years Have ever been tested Number of women age 15-24 years who have had sex in the last 12 months Have been tested in the last 12 months and have been told result 1 Have been tested in the last 12 months Percentage of women who: ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.7 About 39 per cent of women had sex in the last 12 months. Among these, 21 per cent know a place to get tested, five per cent have been tested, less than one per cent have been tested in the last 12 months, and less than one 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, 27 per cent know a place to get tested, 10 per cent have been tested, five per cent have been tested in the last 12 months and none have been tested in the last 12 months and have been told result. MULTIPLE INDICATOR CLUSTER SURVEY 2011136 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 121 499 174 240 554 477 317 133 661 10 144 522 118 150 153 178 173 140 395 235 77 44 37 794 34.7 26.6 13.2 25.6 24.6 10.8 46.2 92.5 11.3 14.7 33.2 22.5 26.5 34.5 26.4 19.5 24.5 20.3 32.5 14.8 27.8 24.3 (*) 24.9 17.4 29.4 (26.6) 35.4 22.5 (19.9) 28.8 22.5 33.1 0.0 17.5 21.6 (*) 7.2 (31.5) (18.9) (34.8) (*) 22.3 (*) (*) (*) (*) 26.5 1.1 5.6 (2.2) 9.4 1.9 (8.1) 2.9 4.3 4.1 0.0 7.7 0.8 (*) 1.0 (4.2) (7.4) (8.5) (*) 4.5 (*) (*) (*) (*) 4.2 4.8 11.2 (11.0) 18.1 6.1 (9.4) 10.0 7.2 14.1 0.0 7.7 6.9 (*) 2.3 (9.0) (14.3) (16.3) (*) 8.9 (*) (*) (*) (*) 9.8 1.1 7.1 (2.2) 12.7 1.9 (8.1) 4.3 4.3 6.8 0.0 7.7 0.8 (*) 1.0 (4.2) (7.4) (13.3) (*) 4.5 (*) (*) (*) (*) 5.3 42 133 23 61 136 51 146 123 74 2 48 117 31 52 40 35 42 29 128 35 21 11 3 198 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Percentage who have had sex in the last 12 months Number of men age 15-24 years Number of men age 15-24 years who have had sex in the last 12 months Percentage of men who: * 7 cases with missing/DK “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 9.7 Know a place to get tested Have ever been tested Have been tested in the last 12 months and have been told result 1 Have been tested in the last 12 months MULTIPLE 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 94 per cent of never-married women age 15-24 have never had sex, five per cent had sex before age 15 and 16 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 by district with about seven per cent of men in Manokwari District having sex before age 15. This compares with lower percentages in Kaimana (4 per cent) and Sorong districts (3 per cent). This indicator shows strong association with 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 (82 per cent) was lower than for women (94 per cent). Slightly fewer men than women had sex before age 15 (Men, 4 per cent, Women 5 per cent) and considerably fewer men had sex in the last 12 months with a woman 10 or more years older (2 per cent) than women had sex in the last 12 months with a man 10 or more years older (16 per cent). The percentage of men age 15-24 years who had sex before age 15 varied by district with about five per cent of women in Manokwari District having sex before age 15. This compares to with lower percentages in Kaimana (4 per cent) and Sorong districts (1 per cent). Contrary to results of women where this indicator is higher in rural areas, the results show that the indicator is higher among men living in urban area. MULTIPLE INDICATOR CLUSTER SURVEY 2011138 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 75 331 108 174 339 370 144 na 514 4 44 336 130 71 88 76 157 122 259 135 60 47 12 514 91.3 94.3 96.2 90.6 96.1 97.6 85.7 na 94.3 72.3 93.7 96.7 88.7 97.7 98.1 94.3 92.7 91.4 90.2 98.0 99.3 97.6 100.0 94.3 3.6 6.6 2.8 2.9 6.5 3.7 7.4 13.1 0.2 (*) 16.5 3.8 0.0 16.7 5.4 1.4 2.3 2.3 8.6 1.1 3.1 1.1 (*) 5.4 6.3 15.0 26.4 6.1 19.1 20.0 14.5 16.5 (*) (*) 16.6 17.7 (7.3) 10.7 19.9 24.4 (13.6) (10.3) 9.1 26.9 (11.4) (*) (*) 16.0 121 566 173 254 606 465 395 346 514 13 141 543 163 160 164 144 213 179 441 247 92 60 19 860 45 227 63 81 254 93 243 324 11 8 88 200 39 74 76 69 57 61 175 109 32 13 6 335 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Percentage of never-mar- ried women age 15-24 years who have never had sex1 Number of never-mar- ried 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 who had sex in the 12 months preceding the survey 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 * 1 case with missing/DK “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 9.10 2 MICS indicator 9.11 3 MICS indicator 9.12 MULTIPLE INDICATOR CLUSTER SURVEY 2011 139 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 man 10 or more years older during the last 12 months, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 101 400 160 205 455 451 209 na 661 9 110 443 98 110 123 157 150 121 310 211 60 39 34 661 73.2 79.7 92.3 73.4 85.5 89.4 65.1 na 81.7 93.1 79.5 84.9 68.9 83.0 83.1 80.8 78.6 84.3 73.3 91.8 77.3 81.6 (*) 81.7 3.7 4.6 1.1 5.7 2.8 3.7 3.7 13.2 1.8 (*) 3.8 4.3 1.5 4.6 8.0 3.9 0.3 1.9 5.8 1.0 2.2 5.4 (*) 3.7 5.5 1.5 (0.0) 5.4 0.7 (1.0) 2.6 2.7 1.3 (*) 6.2 1.1 (*) 1.9 (1.2) (1.0) (4.7) (*) 1.4 (*) (*) (*) (*) 2.2 121 499 174 240 554 477 317 133 661 10 144 522 118 150 153 178 173 140 395 235 77 44 37 794 42 133 23 61 136 51 146 123 74 2 48 117 31 52 40 35 42 29 128 35 21 11 3 198 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Percentage of never- married men age 15-24 years who have never had sex1 Number of never-mar- ried 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 who had sex in the 12 months preceding the survey Percentage of men age 15-24 years who had sex in the last 12 months with a woman 10 or more years older3 Number of men age 15-24 years * 7 case with missing/DK “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 9.10 2 MICS indicator 9.11 3 MICS indicator 9.12 MULTIPLE INDICATOR CLUSTER SURVEY 2011140 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 (0.2 per cent) and 15-24 (0.3 per cent) years of age report having sex with more than one partner. Results of sexual behaviour among all men and men age 15-24 years are presented in Tables HA.8M and HA.9M. Sex with multiple partners is higher among men than among women where about four per cent of men 15- 49 years of age report having sex with more than one partner in the last 12 months. 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 80.4 78.0 83.2 74.9 81.5 43.5 22.3 68.4 89.3 98.0 99.8 99.9 7.2 96.5 93.1 75.8 62.6 82.8 81.8 84.7 74.1 77.2 77.9 84.0 77.6 71.8 84.3 79.6 0.4 0.2 0.1 0.4 0.1 0.3 0.1 0.5 0.0 0.0 0.5 0.3 0.0 0.0 0.4 0.2 0.0 0.4 0.2 0.6 0.0 0.0 0.3 0.1 0.0 0.0 0.0 0.2 70.7 71.2 76.0 64.9 75.1 39.0 19.9 61.4 83.0 92.4 84.6 91.8 2.5 78.5 83.2 70.8 55.0 71.9 73.6 78.0 68.2 71.0 67.6 78.9 72.1 65.7 83.1 72.3 423 1,638 654 763 1,952 860 465 395 462 829 564 2,121 594 134 764 1,402 415 467 502 493 640 614 1,212 860 333 197 107 2,715 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Ever had sex Had sex in the last 12 months Percentage of women who: Number of women age 15-49 years Had sex with more than one partner in last 12 months1 * 7 cases with missing/DK “Ethnicity of household head” not shown 1 MICS indicator 9.13 MULTIPLE INDICATOR CLUSTER SURVEY 2011 141 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 81.1 76.2 71.9 75.5 76.1 32.0 15.5 56.9 82.3 95.0 99.2 100.0 27.0 82.0 82.7 71.8 80.0 76.8 76.2 74.3 76.6 76.0 78.2 71.5 80.7 80.8 71.1 75.9 6.4 4.5 1.9 7.3 3.1 5.0 3.0 8.0 5.7 3.8 3.0 3.3 6.1 0.5 3.5 4.3 5.4 3.4 4.7 3.4 4.6 4.9 5.3 2.3 3.5 6.4 6.4 4.2 73.9 69.1 66.7 66.7 70.2 24.9 10.8 46.2 70.8 89.5 94.4 95.9 15.0 73.5 76.9 66.3 68.4 69.2 70.0 69.0 70.3 67.9 70.1 66.5 72.8 76.7 64.6 69.3 437 1,647 652 732 2,004 794 477 317 388 889 665 1,834 902 74 625 1,576 460 498 499 591 576 571 1,189 906 333 171 129 2,736 20.1 (27.9) (*) 31.6 18.6 (24.3) (*) (23.9) (*) (25.6) (*) 11.9 38.6 (*) (9.6) 28.4 (*) (*) 16.3 (*) (*) (30.0) 20.6 (*) (*) (*) (*) 24.7 28 74 12 53 61 39 14 25 22 33 20 60 55 22 68 25 17 24 20 26 28 63 20 12 11 8 115 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts 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 * 9 cases with missing/DK “Ethnicity of household head” not shown (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.13 2 MICS indicator 9.14 Percentage of men who: Ever had sex Had sex in the last 12 months Number of men age 15-49 years Had sex with more than one partner in last 12 months1 Of those men, only 25 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 (5 per cent) and of those men age 15-24 only 24 per cent report using a condom when they had sex the last time (data not shown). MULTIPLE INDICATOR CLUSTER SURVEY 2011142 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 43.2 44.5 40.3 37.8 45.8 22.3 68.4 99.4 5.7 (*) 69.6 40.1 29.4 55.7 47.6 50.0 31.6 37.7 46.6 46.5 35.5 23.6 (*) 43.5 0.0 0.3 0.4 0.0 0.4 0.1 0.5 0.7 0.0 (*) 0.4 0.3 0.0 0.0 0.4 1.2 0.0 0.0 0.5 0.0 0.0 0.0 (*) 0.3 37.2 40.1 36.4 32.0 41.9 19.9 61.4 93.6 2.1 (*) 62.6 36.8 23.8 46.0 46.1 47.5 26.7 33.9 39.6 44.2 35.1 22.0 (*) 39.0 121 566 173 254 606 465 395 346 514 13 141 543 163 160 164 144 213 179 441 247 92 60 19 860 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Ever had sex Had sex in the last 12 months Percentage of women age 15-24 years who: Number of women age 15-24 years Had sex with more than one partner in last 12 months * 1 case with missing/DK “Ethnicity of household head” not shown (*) Figures that are based on fewer than 25 unweighted cases MULTIPLE INDICATOR CLUSTER SURVEY 2011 143 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 39.3 36.1 15.3 37.1 29.8 15.5 56.9 100.0 18.3 (*) 39.2 27.9 42.5 39.3 33.3 28.6 31.6 27.6 42.5 17.5 39.7 27.7 (7.1) 32.0 8.2 5.0 2.6 8.9 3.2 3.0 8.0 7.5 4.5 (*) 3.1 5.2 6.6 4.5 5.4 4.1 6.3 4.4 6.9 3.3 0.4 9.4 (0.0) 5.0 34.7 26.6 13.2 25.6 24.6 10.8 46.2 92.5 11.3 (*) 33.2 22.5 26.5 34.5 26.4 19.5 24.5 20.3 32.5 14.8 27.8 24.3 (7.1) 24.9 121 499 174 240 554 477 317 133 661 10 144 522 118 150 153 178 173 140 395 235 77 44 31 794 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Ever had sex Had sex in the last 12 months Percentage of men age 15-24 years who: Number of men age 15- 24 years Had sex with more than one partner in last 12 months * 7 case with missing/DK “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 Tables HA.10 presents the percentages of women age 15-24 years who have 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 and, among those, who had sex with a non-marital, non-cohabiting partner. About 44 per cent of women age 15-24 years have ever had sex and 39 per cent of women had sex in the last 12 months. About four per cent of women had sex with a non-marital, non-cohabiting partner in the last 12 months and among those who had sex with a non- marital, non-cohabiting partner. This percentage was generally similar among districts. Sex with non-marital, non-cohabiting partner in the last 12 months is considerably higher among men (44 per cent) (Table HA.10M) than among women (4 per cent) (Table HA.10). MULTIPLE INDICATOR CLUSTER SURVEY 2011144 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 43.2 44.5 40.3 37.8 45.8 22.3 68.4 99.4 5.7 (*) 69.6 40.1 29.4 55.7 47.6 50.0 31.6 37.7 46.6 46.5 35.5 23.6 (*) 43.5 3.6 4.0 4.2 8.8 2.4 5.2 3.5 0.7 (*) (*) 1.4 1.7 (22.2) 2.3 1.6 5.0 (4.9) (6.9) 6.9 0.6 (0.0) (*) (*) 4.0 37.2 40.1 36.4 32.0 41.9 19.9 61.4 93.6 2.1 (*) 62.6 36.8 23.8 46.0 46.1 47.5 26.7 33.9 39.6 44.2 35.1 22.0 (*) 39.0 121 566 173 254 606 465 395 346 514 13 141 543 163 160 164 144 213 179 441 247 92 60 19 860 45 227 63 81 254 93 243 324 11 8 88 200 39 74 76 69 57 61 175 109 32 13 6 335 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Ever had sex Had sex in the last 12 months Number of women age 15-24 years who had sex in the last 12 months Percentage who had sex with a non-marital, non-cohabiting partner in the last 12 months1 Number of women age 15-24 years * 1 case with missing/DK “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 9.15 Percentage of women age 15-24 years who: MULTIPLE INDICATOR CLUSTER SURVEY 2011 145 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 39.3 36.1 15.3 37.1 29.8 15.5 56.9 100.0 18.3 (*) 39.2 27.9 42.5 39.3 33.3 28.6 31.6 27.6 42.5 17.5 39.7 27.7 (7.1) 32.0 58.9 38.3 (48.9) 59.0 37.1 (63.0) 37.2 10.6 99.3 (*) 31.8 49.7 (*) 28.5 (43.0) (59.0) (47.1) (*) 45.3 (*) (*) (*) (*) 43.9 34.7 26.6 13.2 25.6 24.6 10.8 46.2 92.5 11.3 (*) 33.2 22.5 26.5 34.5 26.4 19.5 24.5 20.3 32.5 14.8 27.8 24.3 (7.1) 24.9 121 499 174 240 554 477 317 133 661 10 144 522 118 150 153 178 173 140 395 235 77 44 37 794 42 133 23 61 136 51 146 123 74 2 48 117 31 52 40 35 42 29 128 35 21 11 3 198 District Kaimana Manokwari Sorong 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 quintile Poorest Second Middle Fourth Richest Ethnicity of household head* Papua Jawa Sulawesi Maluku Others Total for 3 districts Ever had sex Had sex in the last 12 months Number of men age 15-24 years who had sex in the last 12 months Percentage who had sex with a non-marital, non-cohabiting partner in the last 12 months1 Number of men age 15-24 years * 7 case with missing/DK “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 9.15 Percentage of men age 15-24 years who: 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 West Papua, about seven per MULTIPLE INDICATOR CLUSTER SURVEY 2011146 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 81 .0 79 .1 84 .3 81 .6 79 .7 78 .6 81 .4 87 .8 84 .4 77 .8 63 .4 82 .3 81 .1 74 .6 83 .1 82 .5 78 .6 80 .9 89 .0 83 .9 81 .6 80 .7 4. 8 6. 5 4. 9 5. 4 6. 2 5. 6 5. 9 3. 0 4. 1 7. 2 13 .1 3. 9 4. 6 9. 1 6. 9 4. 9 5. 0 7. 3 3. 5 7. 3 11 .6 5. 8 0. 2 0. 7 0. 7 0. 7 0. 5 0. 8 0. 5 0. 1 0. 5 0. 6 2. 0 0. 4 0. 8 0. 2 1. 0 0. 6 0. 6 1. 0 0. 2 0. 0 0. 0 0. 6 0. 4 1. 3 0. 4 0. 8 1. 1 1. 2 0. 8 0. 0 0. 7 1. 1 3. 1 0. 0 1. 1 1. 9 1. 2 0. 5 0. 9 1. 2 0. 6 0. 4 1. 6 0. 9 0. 4 1. 1 0. 7 0. 9 0. 8 1. 3 0. 7 0. 2 0. 6 1. 5 1. 6 0. 9 1. 2 0. 5 1. 1 0. 6 0. 9 1. 1 0. 2 0. 0 2. 2 0. 9 4. 5 3. 9 4. 2 4. 1 4. 1 6. 4 3. 3 6. 2 3. 6 3. 3 2. 3 3. 5 4. 3 4. 0 2. 6 6. 1 4. 7 3. 8 3. 4 2. 8 1. 6 4. 1 3. 4 2. 6 2. 3 2. 3 3. 1 1. 9 2. 9 0. 7 2. 2 3. 8 5. 3 5. 1 2. 5 2. 9 1. 1 1. 1 3. 7 1. 7 1. 0 1. 6 0. 3 2. 6 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 T o ta l f o r 3 d is tr ic ts Li vi n g w it h b o th p ar en ts 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 O n ly fa th er al iv e Fa th er al iv e Fa th er d ea d O n ly m o th er al iv e B o th a re al iv e B o th a re d ea d Im p o ss ib le to d et er m in e T o ta l N o t liv in g w it h a b io lo g ic al p ar en t1 O n e o r b o th p ar en ts d ea d 2 N u m b er o f ch ild re n ag e 0- 17 ye ar s Li vi n g w it h fa th er o n ly M o th er al iv e M o th er d ea d 1. 8 2. 5 0. 5 1. 8 1. 9 1. 7 1. 9 1. 4 1. 2 0. 9 6. 8 1. 1 1. 8 2. 3 1. 2 3. 1 1. 8 2. 1 1. 9 2. 4 1. 1 1. 9 7. 7 7. 3 5. 5 6. 5 7. 4 7. 3 6. 8 1. 5 6. 1 9. 8 13 .9 9. 0 7. 9 8. 2 5. 9 3. 1 9. 3 5. 2 2. 0 3. 1 4. 1 6. 9 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 5. 8 9. 6 6. 6 7. 8 8. 7 8. 8 8. 0 3. 2 5. 8 10 .3 19 .8 5. 3 7. 7 11 .7 10 .2 6. 5 7. 4 10 .6 4. 4 7. 8 15 .4 8. 2 85 5 2, 88 2 1, 22 5 2, 55 9 2, 38 6 1, 21 2 3, 74 9 1, 34 2 1, 54 2 1, 45 6 62 1 1, 09 7 1, 04 2 97 8 91 6 92 9 2, 72 7 1, 18 4 50 5 32 9 20 2 4, 96 2 0. 3 0. 8 0. 6 0. 6 0. 7 0. 6 0. 6 0. 2 0. 6 1. 1 0. 5 0. 2 0. 4 2. 0 0. 4 0. 3 0. 7 0. 7 0. 3 0. 6 0. 0 0. 6 3. 1 1. 6 1. 5 1. 8 1. 9 2. 0 1. 8 0. 5 2. 1 2. 8 1. 9 2. 6 2. 2 2. 6 1. 4 0. 2 3. 1 0. 2 0. 0 0. 9 0. 0 1. 8 * 14 c as es w it h m is si n g / D K “ E th n ic it y o f h o u se h o ld h ea d ” an d 1 7 ca se s w it h “ S ex ” n o t sh o w n 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 2011 147 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. 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 but it is also often performed as part of local traditional practice, although this 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 51 per cent of men aged 15-49 are circumcised. The prevalence is highest in the older age groups and does not show differences according to area of residence (51 urban, 52 rural). Circumcision is more prevalent in Sorong District (68 per cent) than in Manokwari (47 per cent) and Kaimana districts (41 per cent). The majority of circumcised men went through the procedure at the age groups 5-11 years (59 per cent) and 12-17 years (36 per cent). Table HA.13 shows the provider and location of circumcision. Most circumcision was performed by health worker/professional (73 per cent) while traditional practitioners/ family/friends performed 23 per cent of the circumcisions. About 6 per cent were performed by others. Most of the circumcisions were performed at home (62 per cent) while 17 per cent were performed in a health facility. 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. cent of children aged 0-17 years have lost one or both parents and about eight per cent are not living with a biological parent and 81 per cent of children live with both parents. Higher percentages of orphans were found in the older age group 15-17, in Kaimana and Manokwari districts, in urban areas, in the poorest quintile and living in households whose heads are Papuan. MULTIPLE INDICATOR CLUSTER SURVEY 2011148 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 41.4 47.3 68.4 51.0 51.6 45.8 45.6 46.1 55.2 52.0 55.1 18.5 46.9 57.2 42.8 18.1 41.5 57.6 65.5 68.4 8.8 98.7 83.2 40.8 47.2 51.4 7.6 3.8 2.6 5.9 3.2 3.4 3.3 3.6 4.5 3.4 4.8 (*) 3.3 3.9 4.6 4.7 4.9 3.1 4.0 3.8 7.9 2.8 4.7 6.4 7.6 3.9 437 1,647 652 732 2,004 794 477 317 388 889 665 74 625 1,576 460 498 499 591 576 571 1,189 906 333 171 129 2,736 18.1 37.5 39.3 30.0 37.6 30.9 30.6 31.2 34.1 35.2 41.5 (*) 34.8 34.2 41.2 38.2 33.9 32.2 34.0 40.4 28.3 40.5 28.6 19.0 27.3 35.6 1.6 0.9 2.4 0.9 1.7 0.4 0.0 1.0 2.1 1.9 1.6 (*) 2.0 1.3 1.8 6.0 2.1 0.7 0.7 1.5 5.7 0.4 0.0 6.8 10.3 1.5 71.9 57.3 55.4 62.7 57.1 65.1 66.0 63.9 59.1 58.9 51.3 (*) 59.3 60.1 52.4 51.1 58.1 63.6 61.2 53.6 57.3 56.2 65.5 67.9 53.6 58.6 0.9 0.5 0.3 0.4 0.5 0.2 0.1 0.4 0.2 0.6 0.7 (*) 0.7 0.5 0.0 0.0 1.0 0.5 0.0 0.7 0.8 0.2 1.2 0.0 1.2 0.5 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 181 780 446 373 1,034 364 218 146 214 462 367 14 293 902 197 90 207 341 378 391 105 894 277 70 61 1,406 District Kaimana Manokwari Sorong Area Urban Rural Age 15-24 15-19 20-24 25-29 30-39 40-49 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 * 7 cases with missing/DK “Ethnicity of household head” not shown (*) Figures that are based on fewer than 25 unweighted cases 1 MICS indicator 9.21 Number of men age 15- 49 years Per cent circum- cised1 Age at circumcision: 1-4 years Number of men circum- cised 5-11 years 12-17 years 18+ years TotalDon't Know/ Missing MULTIPLE INDICATOR CLUSTER SURVEY 2011 149 T ab 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 rm 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 23 .2 17 .2 24 .8 17 .5 21 .4 10 .3 6. 8 15 .7 16 .4 19 .5 33 .8 (* ) 28 .3 19 .0 13 .2 38 .9 29 .4 21 .0 18 .0 13 .0 23 .4 20 .0 18 .0 30 .6 19 .3 20 .4 8. 0 2. 8 4. 6 2. 8 4. 5 3. 5 2. 5 5. 0 3. 7 3. 1 6. 1 (* ) 5. 2 3. 7 2. 6 12 .3 4. 9 4. 1 1. 6 4. 1 12 .3 2. 5 7. 2 2. 3 0. 0 4. 1 68 .3 79 .4 70 .6 79 .7 73 .5 86 .0 90 .8 79 .0 78 .8 77 .3 59 .6 (* ) 65 .0 77 .3 84 .1 48 .2 64 .4 74 .3 80 .4 82 .9 63 .3 77 .0 74 .8 67 .0 80 .7 75 .2 0. 6 0. 6 0. 0 0. 0 0. 5 0. 1 0. 0 0. 4 1. 1 0. 1 0. 6 (* ) 1. 5 0. 1 0. 0 0. 6 1. 4 0. 6 0. 0 0. 0 1. 0 0. 5 0. 0 0. 0 0. 0 0. 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 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 10 0. 0 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 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 T o ta l f o r 3 d is tr ic ts P er so n p er fo rm in g c ir cu m ci si o n : T ra d it io n al p ra ct it io - n er /f am ily / fr ie n d D o n ’t kn o w / M is si n g T o ta l H ea lt h w o rk er /p ro - fe ss io n al O th er P la ce o f ci rc u m ci si o n : H ea lt h fa ci lit y R it u al s it e O th er h o m e/ p la ce T o ta l N u m b er o f m en ci rc u m - ci se d H o m e o f a h ea lt h w o rk er / p ro fe ss io n al A t h o m e 22 .6 14 .0 16 .1 18 .8 14 .7 14 .7 19 .3 7. 7 9. 1 17 .7 18 .3 (* ) 10 .5 17 .0 17 .0 3. 9 12 .3 17 .1 16 .9 18 .0 14 .0 15 .0 18 .0 9. 9 26 .9 15 .7 63 .0 60 .0 63 .1 56 .3 63 .2 61 .0 59 .2 63 .6 62 .9 61 .2 61 .2 (* ) 67 .9 60 .1 57 .6 74 .9 63 .1 62 .1 59 .6 58 .4 66 .6 60 .7 60 .1 72 .2 55 .5 61 .4 3. 2 17 .5 11 .3 14 .7 13 .3 11 .5 7. 5 17 .4 22 .3 13 .3 11 .4 (* ) 12 .9 12 .6 20 .8 6. 8 10 .1 12 .3 15 .2 17 .0 6. 1 16 .2 11 .8 5. 3 9. 1 13 .7 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 7. 5 0. 5 1. 2 3. 0 1. 1 1. 3 1. 3 1. 3 1. 5 1. 3 2. 4 (* ) 1. 6 1. 6 1. 1 5. 3 1. 4 1. 0 2. 0 1. 0 3. 7 0. 5 3. 5 1. 6 5. 8 1. 6 3. 7 8. 0 8. 3 7. 2 7. 6 11 .6 12 .7 10 .0 4. 2 6. 5 6. 7 (* ) 7. 1 8. 6 3. 5 9. 1 13 .2 7. 4 6. 2 5. 5 9. 6 7. 6 6. 7 11 .0 2. 7 7. 5 18 1 78 0 44 6 37 3 1, 03 4 36 4 21 8 14 6 21 4 46 2 36 7 14 29 3 90 2 19 7 90 20 7 34 1 37 8 39 1 10 5 89 4 27 7 70 61 1, 40 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011150 MULTIPLE INDICATOR CLUSTER SURVEY 2011 151 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 one per cent of women of the same age group first drank alcohol before the age of 15 while 85 per cent of women had never had one drink of alcohol. In urban areas, the proportion of women who had at least one drink of alcohol before age 15 and the proportion of women who had at least one drink of alcohol on one or more days during the last one month is higher than in rural areas. The proportion of men who consume alcohol is much higher than the proportion of women that consume alcohol (Table TA.1M). Eighteen 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 (Eight per cent of men age 15-49 years drank alcohol before age 15, compared with one per cent of women). The highest proportion of alcohol use by men is found in Kaimana District (22 per cent). The use of alcohol by men varies according to education where alcohol use is more common among more educated men compared with those who are less educated. 16 US Centers for Disease Control and Prevention, http://www.cdc.gov/ MULTIPLE INDICATOR CLUSTER SURVEY 2011152 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of women age 15-49 years Never had one drink of alcohol Had at least one drink of alcohol before age 151 Had at least one drink of alcohol drink on one or more days during the last one month2 Percentage of women who: District Kaimana Manokwari Sorong 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 95.1 77.8 97.1 92.1 82.1 84.7 83.7 82.3 84.4 86.0 75.0 89.1 86.9 88.9 84.6 79.6 87.9 86.7 84.0 85.3 82.6 75.9 97.4 86.7 90.3 79.9 85.2 0.5 2.4 0.2 1.3 1.1 1.5 2.5 2.1 1.2 1.0 3.6 0.8 0.4 1.6 1.3 3.0 1.0 0.8 1.7 2.8 1.4 2.9 0.1 1.2 0.2 2.0 1.6 0.5 1.9 0.0 1.1 2.4 1.1 1.9 1.1 0.5 0.0 1.7 1.1 0.0 0.4 1.6 2.0 1.3 0.9 1.0 1.6 1.5 1.5 0.2 0.9 2.0 6.0 1.3 423 1,638 654 465 395 462 443 387 305 259 763 1,952 134 764 1,402 415 467 502 493 640 614 1,212 860 333 197 107 2,715 * 7 cases with missing/DK “Ethnicity of household head” not shown 1 MICS indicator TA.3 2 MICS indicator TA.4 MULTIPLE INDICATOR CLUSTER SURVEY 2011 153 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of men age 15-49 years Never had one drink of alcohol Had at least one drink of alcohol before age 151 Had at least one drink of alcohol drink on one or more days during the last one month2 Percentage of men who: District Kaimana Manokwari Sorong 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 28.5 31.5 40.3 68.0 28.3 17.6 22.4 24.9 31.1 33.7 28.3 34.9 30.0 33.3 33.7 31.5 32.1 34.1 33.8 31.8 33.8 28.8 43.6 24.1 26.0 28.8 33.1 21.5 19.4 10.1 7.6 22.5 28.4 19.9 21.5 12.1 11.1 25.3 14.6 11.0 17.1 16.2 23.5 16.6 16.5 16.5 18.8 18.8 24.3 8.5 16.2 20.6 18.7 17.5 5.9 9.4 3.8 9.9 11.3 7.9 8.6 6.5 4.0 3.1 7.7 7.4 4.5 9.6 7.2 6.1 8.3 10.0 6.3 6.8 6.7 8.9 4.8 10.8 7.8 4.9 7.5 437 1,647 652 477 317 388 479 410 374 291 732 2,004 74 625 1,576 460 498 499 591 576 571 1,189 906 333 171 129 2,736 * 9 cases with missing/DK “Ethnicity of household head” not shown 1 MICS indicator TA.3 2 MICS indicator TA.4 MULTIPLE INDICATOR CLUSTER SURVEY 2011154 MULTIPLE INDICATOR CLUSTER SURVEY 2011 155 13 MIGRATION Table MI.1 shows that heads of households of about two-third of households in Sorong were not born in West Papua (63 per cent) with a mean number of 24 years since they moved to West Papua. The main reason for migration was transmigration. About 39 per cent of heads of households in Kaimana were not born in West Papua. The main reason for migration to West Papua was looking for a job. The percentage of heads of households in Manokwari who were not born in West Papua was 47 per cent with a mean number of 21 years since they moved to West Papua. The main reason for migration to West Papua in Manokwari was looking for a job. MULTIPLE INDICATOR CLUSTER SURVEY 2011156 T ab 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 W es t 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 W es t P ap u a, D is tr ic ts o f K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 D is tr ic t K ai m an a M an o kw ar i S o ro n g 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 /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 M is si n g /D K T o ta l f o r 3 d is tr ic ts H ea d o f h o u se h o ld n o t b o rn in W es t P ap u a T ra n sf er in g o ve rn m en t jo b T ra n sf er in p ri va te jo b Lo o ki n g f o r a jo b Fa m ily re as o n M ed ic al re as o n O th er s N u m b er o f h o u se h o ld T ra n sm ig ra - ti o n 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 W es t 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 W es t P ap u a 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 W es t P ap u a 38 .6 46 .9 62 .9 52 .9 48 .7 26 .6 49 .1 56 .7 41 .9 45 .5 15 .4 40 .7 57 .1 66 .0 69 .6 0. 8 91 .6 86 .2 79 .2 80 .9 8. 8 49 .8 44 8 1, 63 8 73 0 69 7 2, 11 9 20 8 95 0 1, 24 5 41 2 1 56 8 55 0 56 5 60 2 53 2 1, 23 1 93 7 34 2 17 4 12 4 9 2, 81 6 3. 6 4. 0 1. 2 2. 3 3. 3 6. 4 1. 9 3. 1 5. 1 0. 0 0. 0 0. 5 2. 7 4. 4 4. 1 0. 0 3. 3 2. 1 2. 8 4. 4 0. 0 3. 0 0. 8 23 .1 54 .7 9. 9 38 .2 63 .2 51 .9 18 .6 13 .0 0. 0 57 .5 45 .0 36 .6 24 .7 17 .2 8. 1 48 .2 0. 4 0. 0 15 .0 0. 0 30 .7 74 .5 40 .5 36 .0 65 .3 35 .3 20 .5 35 .7 52 .0 34 .7 10 0. 0 30 .1 40 .0 43 .0 48 .3 43 .1 76 .5 29 .3 64 .7 66 .1 65 .2 0. 0 43 .2 0. 3 0. 0 0. 0 0. 0 0. 1 0. 0 0. 0 0. 1 0. 0 0. 0 0. 0 0. 0 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 4 0. 0 0. 0 0. 0 5. 3 5. 8 1. 5 5. 6 3. 9 1. 5 0. 1 3. 8 19 .1 0. 0 0. 0 0. 9 1. 0 4. 2 10 .6 0. 0 4. 9 2. 6 3. 8 5. 8 0. 0 4. 4 13 .5 25 .7 6. 3 16 .1 18 .4 8. 4 10 .3 21 .6 25 .4 0. 0 11 .8 13 .3 15 .6 17 .4 24 .2 15 .4 13 .9 29 .0 23 .7 9. 6 10 0. 0 17 .8 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 17 3 76 9 46 0 36 8 1, 03 3 55 46 6 70 6 17 3 87 22 4 32 3 39 7 37 0 10 85 8 29 5 13 8 10 0 1 1, 40 1 13 .6 20 .6 23 .7 17 .4 22 .0 27 .1 22 .7 19 .6 18 .2 16 .0 21 .7 22 .3 20 .3 18 .5 22 .5 18 .6 22 .2 18 .5 18 .2 18 .8 24 .0 20 .8 MULTIPLE INDICATOR CLUSTER SURVEY 2011 157 14 FLOOR AREA PER PERSON In the Selected Districts of West Papua Province MICS survey, head of households were asked a question on the floor area in square meters to determine the indicator of floor area per person, which is defined as the median floor area of housing unit devided by the average household size. 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 three selected districts of West Papua, the floor area per person was 13 square meters (Kaimana, 12 square meters; Manokwari, 13 square meters; Sorong, 14 square meters) (Table FA.1). Female-headed households averaged a higher floor area per person than male-headed households, but there is was no difference between urban and rural households. 17 United Nations (1996). Indicators of Sustainable Development: Framework and Methodologies. Sales No. E.96.II.A.16 Table FA.1: Floor area per person Median floor area per person by selected characteristics, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of householdMedian floor area per person District Kaimana Manokwari Sorong Sex Male Female Area Urban Rural Education None Primary SMP/SM Higher Missing/DK Ethnicity of household head Papua Jawa Sulawesi Maluku Others Total for 3 districts 12.0 12.6 13.5 12.0 15.0 12.6 12.5 15.0 12.5 12.0 16.0 7.0 11.4 14.4 12.6 12.0 14.4 28.0 12.6 448 1,638 730 2,485 331 697 2,119 208 950 1,245 412 1 1,231 937 342 174 124 9 2,816 MULTIPLE INDICATOR CLUSTER SURVEY 2011158 MULTIPLE INDICATOR CLUSTER SURVEY 2011 159 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 West Papua Multiple Indicator Cluster Survey was to produce statistically reliable district level estimates of most indicators, in three selected districts (Kaimana, Manokwari and Sorong districts) of West Papua Province, for urban and rural areas. The districts were selected purposively by considering topographic areas in West 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 West 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 is the average household size (number of persons per household). [4(r)(l-r)(f)(1.1)] [(0.12r)2(p)(n)] n = MULTIPLE INDICATOR CLUSTER SURVEY 2011160 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, n (average household size) was taken as 4.5 households, and the response rate is assumed to be 90%. 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 of West 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 West Papua Province. Topographic area in West Papua No of selected households No of selected clusters District Hard to access lowland Easily accessible lowland Total for 3 districts 1,000 1,000 1,000 3,000 40 40 40 120 1. Kaimana 2. Manokwari 3. Sorong 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 is complemented with the information on the number of household 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 from an updated listing of 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 up-date the existing information based on Population Census in all the sample enumeration areas prior to the selection of households. MULTIPLE 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 West 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): 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 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: fhi = p1hi x p2hi x p3hi 1 fhi Whi = MULTIPLE INDICATOR CLUSTER SURVEY 2011162 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 West Papua Multiple Indicator Cluster Survey are shown in Table HH.1 in this report. Similarly, the adjustment for non-response at the individual level (women and under-5 children) 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 2011 163 Appendix B. LIST OF PERSONNEL INVOLVED IN THE SURVEY 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 West Papua Province BPS of West 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 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. Tanda Sirait, MM Ratna MH. Gusti 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 Steering Team Questionnaire Customization Survey Manager Master Trainer NameResponsibility Institution MULTIPLE INDICATOR CLUSTER SURVEY 2011164 Local Trainer Questionnaire Administrator Suprevisor Editor Enumerator 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 West Papua Province West Papua Province West Papua Province West Papua Province BPS of Kaimana District BPS of Kaimana District BPS of Kaimana District BPS of Kaimana District BPS of Kaimana District BPS of Kaimana District BPS of Sorong District BPS of Sorong District BPS of Sorong District BPS of Sorong District BPS of Manokwari District BPS of Manokwari District BPS of Manokwari District BPS of Manokwari District BPS of Kaimana District BPS of Kaimana District BPS of Kaimana District BPS of Kaimana District BPS of Sorong District BPS of Sorong District BPS of Sorong District BPS of Sorong District BPS of Manokwari District BPS of Manokwari District BPS of Manokwari District BPS of Manokwari District Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Kaimana Sorong Sorong Sorong Sorong Sorong Sorong Sorong Maria Ulfa, SST Djoko Prijadi Hardianto, SE Ferandya Yoedhiandito Sapta Hastho Ponco Kadarmanto, MA. P.Hd. Heriminto Widodo Suryana, M.Si Henny Wulandari, SSt Anita Rokmah Cahyo Kristiono, M. Stat Jefry Patikayhatu Semuel A. Gosal Udin Rumuar,S.Sos Miraham Ayudin,SSt Kristian Yoris Waromi, SE Crist Mora Ikbal Ismail, A.Md Bhara Yudhiantara, S.ST Hardi Saputra, S.ST Darwin Bonga, S Alamsyah Anton Sihotang Sugiarto Eka Kristanto, S.Si Abd. Gafur Arey Rika Verlita,Sst Roby Viny Ody Saputra Pasali M. Arifin Jaya M. Ali Jumati M.Arpin Romel Oktavia Tuuk Irwansah Gatot Prayitno Tajudin Farawowan Taufiqurohman Hakim Fimbay Sahrun Suprianto Harida Tappa Yati S Rumasukun Julius Papilaya Hendrik W. Nega Siti Laputi Kasriana Suparman Jofan Sohilau M. Irsan Hendrika Batlayeri Suraida Candra Maipauw Rifai Hadi Manaf Hasna Laipari Rahmawati Rumbara Wardoyo Abdur Rohman Henni Lanteng Anita Sari M. Saiful Syamsul Alam Rostiana Tandirerung Name Institution MULTIPLE INDICATOR CLUSTER SURVEY 2011 165 Sorong Sorong Sorong Sorong Sorong Sorong Sorong Sorong Sorong Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari Manokwari 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 Mahyunita Abd. Gafur, S.P Dortheus Yable Hermansyah Azwaty, S.Si Ipa Fatma Alhamid, SIP Michael L. Haurissa Antonius Jhoni M. Palungan Kristina Demotekay Novelist F. Tuharea, S.P Mokhamad Qusrin Gunawan Riskianto Lufy Wahyuni Hana Fadhila Muh. Husein Frenki Samori Orpa Rosmina, SP Dedeh Sadiah Muhammad Idam Hidayat Abdullah Vonice M. K. Wabiser Siti Rahayu Sermias Towansiba Marthen Mandowen Blandina Theodora Rumsayor Anastasia W. Leisubun Drs. Sukarma Amransyah Fanny Srie Indrianti Gantjang Amannullah, MA Nona Iriana, S.Si. M.Si Dr. I Made Arcana Name Institution Administrator Support MULTIPLE INDICATOR CLUSTER SURVEY 2011166 MULTIPLE INDICATOR CLUSTER SURVEY 2011 167 Appendix C. DATA QUALITY TABLES 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+ Miss- ing Total 133 120 139 153 130 167 138 168 157 149 151 161 139 157 169 106 126 96 100 88 83 69 68 68 64 99 86 85 81 85 113 100 117 77 100 130 81 80 73 84 87 100 88 68 69 74 76 60 63 43 47 73 48 57 51 42 45 33 38 33 33 20 34 24 13 17 19 5 17 17 10 12 13 9 4 10 3 1 9 6 30 0 5,990 127 142 142 131 117 139 155 163 175 125 136 145 129 117 149 94 109 91 99 99 85 85 65 79 103 99 92 103 104 92 88 99 105 91 90 104 82 76 93 71 63 59 78 63 71 59 79 40 56 46 69 54 40 38 44 45 34 34 17 27 31 22 24 15 17 25 18 6 9 5 21 6 7 5 7 9 5 0 9 0 10 0 5,659 3 2 1 2 0 0 0 4 1 1 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 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 19 2.2 2 2.3 2.6 2.2 2.8 2.3 2.8 2.6 2.5 2.5 2.7 2.3 2.6 2.8 1.8 2.1 1.6 1.7 1.5 1.4 1.1 1.1 1.1 1.1 1.7 1.4 1.4 1.4 1.4 1.9 1.7 2 1.3 1.7 2.2 1.4 1.3 1.2 1.4 1.5 1.7 1.5 1.1 1.2 1.2 1.3 1 1.1 0.7 0.8 1.2 0.8 0.9 0.8 0.7 0.7 0.5 0.6 0.5 0.5 0.3 0.6 0.4 0.2 0.3 0.3 0.1 0.3 0.3 0.2 0.2 0.2 0.2 0.1 0.2 0.1 0 0.1 0.1 0.5 0 100.0 2.2 2.5 2.5 2.3 2.1 2.5 2.7 2.9 3.1 2.2 2.4 2.6 2.3 2.1 2.6 1.7 1.9 1.6 1.8 1.7 1.5 1.5 1.2 1.4 1.8 1.8 1.6 1.8 1.8 1.6 1.6 1.7 1.9 1.6 1.6 1.8 1.4 1.3 1.6 1.3 1.1 1 1.4 1.1 1.2 1 1.4 0.7 1 0.8 1.2 0.9 0.7 0.7 0.8 0.8 0.6 0.6 0.3 0.5 0.6 0.4 0.4 0.3 0.3 0.4 0.3 0.1 0.2 0.1 0.4 0.1 0.1 0.1 0.1 0.2 0.1 0 0.2 0 0.2 0 100.0 17 1.9 11.7 5.3 8.7 0 0 0 22.6 4.4 4.7 1.9 0 0 10.9 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.9 0 100.0 Table DQ.1: Age distribution of household population Single-year age distribution of household population by sex, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Males Number NumberNumber NumberNumber NumberPer cent Per centPer cent Per centPer cent Per cent Males Age Age Females FemalesMissing Missing MULTIPLE INDICATOR CLUSTER SURVEY 2011168 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 45-49 676 491 418 490 473 427 334 279 245 2,913 777 516 352 436 508 448 413 316 275 2,988 na 17.1 14.5 17 16.3 14.2 11.3 9.6 na 100.0 na 17.4 11.6 14.2 17.5 15 13.7 10.6 na 100.0 na 95.1 95 95.1 94.3 91.3 92.4 93.6 na 93.9 0.88 na 93.3 90.9 90.2 95 92.5 91.6 93.1 na 92.5 0.87 na 467 397 466 446 390 308 261 na 2,736 na 481 320 393 483 414 378 294 na 2,763 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 Kaimana, Manokwari and Sorong, West 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Percentage of eligible women interviewed (Completion rate) Percentage of eligible men interviewed (Completion rate) Household population of women age 10-54 years Household population of men age 10-54 years Interviewed women age 15-49 years Interviewed men age 15-49 years Number Number Number Number Per cent Per cent MULTIPLE INDICATOR CLUSTER SURVEY 2011 169 Age 0 1 2 3 4 5 6 7 Total (0-4) Ratio of 5 to 4 263 262 283 285 249 306 293 331 1,342 20 19.3 21.4 20.4 18.8 na na na 100.0 97.4 94.4 96.8 91.8 96.9 na na na 95.4 1.23 256 248 274 261 241 na na na 1,281 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Percentage of eligible under-5s interviewed (Completion rate) Household population of children age 0-7 years Interviewed under-5 children NumberNumber Per cent District Kaimana Manokwari Sorong Area Urban Rural Household size 1-3 4-6 7+ Education of household head None Primary SMP/SM Higher Missing/DK Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Missing/DK Total for 3 districts 455 1,756 702 819 2,094 754 1,559 599 173 910 1,373 456 1 519 549 527 665 653 1,352 885 353 204 112 7 2,913 16.0 59.0 25.1 28.1 71.9 26.3 53.8 19.9 5.9 30.8 47.6 15.7 0.0 17.3 18.6 18.2 23.4 22.5 44.5 31.8 12.2 7.3 4.0 0.2 100.0 15.6 60.3 24.1 28.1 71.9 25.9 53.5 20.6 5.9 31.2 47.1 15.7 0.0 17.8 18.8 18.1 22.8 22.4 46.4 30.4 12.1 7.0 3.9 0.3 100.0 96.0 91.9 97.7 93.8 94.0 95.4 94.4 90.9 93.0 92.8 94.8 94.0 45.5 91.3 92.7 94.4 96.5 94.2 90.1 98.2 94.8 98.4 96.2 89.3 93.9 437 1,614 686 768 1,969 720 1,472 545 161 844 1,302 429 473 509 497 642 615 1,218 869 334 201 108 7 2,736 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Percentage of eligible women interviewed (Completion rate) Household population of women age 15-49 years Interviewed women age 15-49 years NumberNumber Per centPer cent MULTIPLE INDICATOR CLUSTER SURVEY 2011170 District Kaimana Manokwari Sorong Area Urban Rural Household size 1-3 4-6 7+ Education of household head None Primary SMP/SM Higher Missing/DK Wealth index quintile Poorest Second Middle Fourth Richest Ethnicity of household head Papua Jawa Sulawesi Maluku Others Missing/DK Total for 3 districts 477 1,800 711 837 2,151 787 1,555 647 164 957 1,433 432 3 531 545 647 638 627 1,346 961 357 183 132 10 2,988 16.5 59.2 24.3 26.8 73.2 27.2 52.6 20.3 5.6 31.8 48.2 14.3 0.0 18.3 18.3 21.5 21.0 20.8 43.4 33.1 12.2 6.3 4.7 0.3 100.0 16.0 60.3 23.8 28.0 72.0 26.3 52.0 21.6 5.5 32.0 48.0 14.4 0.1 17.8 18.2 21.7 21.3 21.0 45.0 32.2 11.9 6.1 4.4 0.3 100.0 95.5 90.9 94.5 88.4 94.1 95.4 93.4 86.6 94.5 91.8 93.0 91.8 40.7 95.5 92.8 92.0 91.0 91.7 89.1 95.1 94.3 95.5 98.0 91.7 92.5 455 1,636 671 740 2,023 751 1,452 560 155 878 1,333 396 1 507 506 595 580 575 1,200 914 336 175 129 9 2,763 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Percentage of eligible men interviewed (Completion rate) Household population of men age 15-49 years Interviewed men age 15-49 years NumberNumber Per centPer cent MULTIPLE INDICATOR CLUSTER SURVEY 2011 171 District Kaimana Manokwari Sorong Area Urban Rural Household size 1-3 4-6 7+ 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 Missing/DK Total for 3 districts 259 756 327 330 1,012 182 771 389 69 402 684 187 313 275 274 228 252 735 320 140 95 48 5 1,342 20.0 54.8 25.2 24.3 75.7 13.7 58.2 28.1 5.4 29.6 50.7 14.3 23.8 20.2 20.4 17.2 18.5 53.6 24.6 10.5 7.4 3.7 0.3 100.0 19.3 56.3 24.4 24.6 75.4 13.5 57.5 29.0 5.1 30.0 51.0 13.9 23.3 20.5 20.4 17.0 18.7 54.7 23.8 10.5 7.0 3.5 0.4 100.0 98.8 92.9 98.5 94.3 95.8 96.7 96.6 92.5 100.0 94.2 94.9 98.3 97.3 94.2 95.1 96.2 94.2 93.5 98.3 95.5 99.5 100.0 68.9 95.4 256 702 322 311 970 176 745 360 69 379 650 184 304 259 261 220 237 687 315 134 94 48 4 1,281 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Per cent of eligible under-5s with completed under-5 questionnaires (Completion rate) Household population of under-5 children Interviewed under-5 children NumberNumber Per centPer cent MULTIPLE INDICATOR CLUSTER SURVEY 2011172 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 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 0.0 0.3 0.2 3.8 1.3 5.7 1.3 0.0 2.9 0.5 27.8 7.2 0.0 0.0 0.5 0.7 0.2 3.3 0.9 27.7 8.7 0.0 0.0 0.0 0.5 0.2 1 0 0.5 0.5 11,533 2,816 2,816 2,715 2,715 1,959 1,959 27 1,959 1,959 2,121 2,121 2,121 374 374 2,715 2,715 2,736 2,736 1,834 1,834 1,834 254 254 2,736 2,736 1,354 1,354 1,354 1,354 Table DQ.6: Completeness of reporting Percentage of observations that are missing information for selected questions and indicators, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Per cent with missing/ incomplete information* Number of class Questionnaire and type of missing information Reference Group MULTIPLE INDICATOR CLUSTER SURVEY 2011 173 District Kaimana Manokwari Sorong Area Urban Rural Wealth index quintile Poorest Second Middle Fourth Richest Total for 3 districts 52.3 38.1 54.4 47.3 49.3 50.2 58.0 52.3 34.1 39.0 48.9 826 890 1,211 666 2,261 656 798 664 501 308 2,927 Table DQ.7: Observation of bednets Percentage of bednets in all households interviewed observed by the interviewer, Districts of Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Percentage of bednets observed by interviewer Total number of bednets District Kaimana Manokwari Sorong Area Urban Rural Wealth index quintile Poorest Second Middle Fourth Richest Total for 3 districts 215 159 145 155 364 149 110 102 81 77 519 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 35.3 45.3 37.9 54.2 32.7 28.2 34.5 37.3 51.9 55.8 39.1 17.4 31.4 50.5 22.9 40.2 22.2 36.7 47.2 27.6 32.8 34.1 0.9 5.0 1.4 3.2 1.9 2.0 1.8 2.0 2.5 3.9 2.3 56.3 28.9 22.1 26.5 43.4 61.7 43.6 27.5 25.9 13.0 38.3 7.4 20.8 38.6 16.1 22.0 8.1 20.0 33.3 19.8 27.3 20.2 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of women with a live birth in the last two years Total Seen by the interviewer (1) Not seen by the interviewer (2) Per cent of health cards seen by the interviewer (1)/(1+2)*100 Missing/ DK Woman does not have health card Woman has health card MULTIPLE INDICATOR CLUSTER SURVEY 2011174 District Kaimana Manokwari Sorong Area Urban Rural Child’s age 0 1 2 3 4 Total for 3 districts District Kaimana Manokwari Sorong Area Urban Rural Child’s age 0 1 2 3 4 Total for 3 districts 527 391 436 383 971 255 279 286 291 243 1,354 527 391 436 383 971 255 279 286 291 243 1,354 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 14.8 27.1 14.9 17.5 18.7 14.1 15.1 17.1 22.0 23.9 18.4 36.8 35.0 54.8 31.9 46.1 23.1 36.2 47.6 48.1 55.1 42.1 29.6 24.3 10.8 9.7 26.9 30.6 22.6 21.0 18.2 18.1 22.0 57.1 34.6 67.2 64.7 48.3 40.0 53.3 54.2 57.0 57.4 54.1 37.8 44.1 37.3 55.8 32.3 64.9 49.8 33.3 31.0 17.3 39.2 0.2 0.3 0.0 0.0 0.2 0.0 0.0 0.3 0.0 0.4 0.1 0.8 0.0 0.2 0.0 0.5 0.4 0.7 0.3 0.3 0.0 0.4 65.3 58.3 54.6 50.4 63.5 76.5 67.7 62.2 48.8 43.6 59.8 19.7 14.3 30.5 32.1 17.5 9.4 17.2 20.3 29.2 32.1 21.6 22.4 27.6 32.6 40.2 22.0 42.7 35.8 23.8 21.6 11.5 27.2 10.4 13.0 1.6 18.3 4.4 3.1 4.7 7.3 11.7 15.2 8.3 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Number of children under age 5 Number of children under age 5 Total Total Seen by the interviewer (1) Seen by the interviewer (1) Had vaccination card previously Not seen by the interviewer (2) Not seen by the interviewer (2) Never had vaccination card Per cent of bitrh certificate seen by the interviewer (1)/(1+2)*100 Per cent of vaccination card seen by the interviewer (1)/(1+2)*100 Missing/ DK Missing/ DK Child does not have birth certificate Child has birth certificate Child does not have vaccination card Child has vaccination card MULTIPLE INDICATOR CLUSTER SURVEY 2011 175 Age 0 1 2 3 4 Total for 3 districts District Kaimana Manokwari Sorong Area Urban Rural Number of children age 12-14 years 2 3 4 5+ Total for 3 districts 95.2 94.7 95.8 95.5 93.7 95.0 4.8 5.0 3.9 4.4 5.0 4.6 0.0 0.2 0.0 0.2 1.1 0.3 0.0 0.0 0.3 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.3 0.0 85.3 87.9 95.2 87.4 90.2 93.0 86.6 83.9 84.3 89.4 100.0 100.0 100.0 100.0 100.0 100.0 263 262 283 285 249 1,342 400 338 377 309 806 585 298 149 83 1,115 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Total Number of children under-5 Number of households with 2 or more children age 2-14 years Mother in the household Per cent of households where correct selection was performed Mother not in the household Mother interviewed Other adult female interviewed Father interviewed Other person interviewed Other adult male interviewed MULTIPLE INDICATOR CLUSTER SURVEY 2011176 T ab 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 K ai m an a, M an o kw ar i a n d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 42 .9 17 .1 6. 5 4. 9 5. 5 4. 0 2. 9 4. 5 4. 3 9. 6 11 .7 21 .1 30 .5 45 .6 57 .6 68 .5 74 .2 76 .9 84 .3 88 .2 0. 0 1. 1 13 .8 40 .1 22 .5 11 .0 7. 7 6. 5 4. 1 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 21 .1 58 .3 22 .3 16 .7 3. 7 3. 5 2. 7 1. 4 0. 9 0. 7 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 12 .4 33 .7 21 .1 6. 5 5. 0 5. 0 1. 1 2. 0 0. 4 0. 3 0. 3 0. 0 0. 0 0. 0 0. 0 0. 0 33 .2 4. 1 1. 9 0. 4 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 0. 7 2. 2 12 .8 43 .6 19 .9 13 .0 5. 3 2. 5 1. 7 1. 0 0. 5 0. 0 0. 0 0. 4 0. 0 0. 0 0. 5 0. 0 0. 0 2. 3 18 .5 52 .8 25 .0 9. 7 4. 6 3. 0 3. 1 1. 1 0. 8 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 1. 2 23 .3 30 .1 15 .0 10 .3 6. 5 2. 8 2. 9 0. 0 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 N ot at te nd in g sc ho ol A ge a t th e be gi nn in g of sc ho ol y ea r Pr e- sc ho ol C u rr en tl y at te n d in g S D 1 1 3 3 5 2 2 4 6 D K N u m b er o f h o u se h o ld m em b er s To ta l 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 2. 0 19 .2 26 .4 22 .1 9. 0 4. 5 1. 2 0. 7 0. 3 1. 2 1. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 2 0. 2 3. 8 16 .3 47 .9 56 .1 57 .3 26 .8 8. 7 6. 1 2. 3 0. 5 2. 2 1. 4 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 8 16 .8 30 .0 21 .2 11 .4 2. 5 2. 5 4. 5 0. 8 1. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 17 .5 36 .7 24 .7 7. 1 5. 3 1. 2 1. 3 0. 2 0. 0 0. 4 0. 0 0. 0 0. 0 1. 5 0. 2 0. 0 0. 5 0. 0 1. 3 0. 0 0. 0 0. 8 0. 0 0. 2 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 4 0. 0 0. 0 1. 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 30 7 30 7 34 6 29 9 26 9 31 8 30 1 24 2 28 9 29 1 21 9 22 0 18 3 21 2 16 7 16 8 15 8 13 5 14 4 19 2 S M P S M U ni ve r- si ty D K 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 0 0. 3 6. 9 23 .6 28 .3 23 .0 19 .7 22 .1 13 .5 7. 1 MULTIPLE INDICATOR CLUSTER SURVEY 2011 177 Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Total for 3 districts 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 Kaimana, Manokwari and Sorong, West Papua Province, Indonesia, 2011 Children Ever Born Children Deceased Number of Women Children Living Number of sons ever born Number of sons living Number of deceased sons Sex ratio at birth Sex ratio Sex ratioNumber of daughters ever born Number of daughters living Number of deceased daughters 40 158 478 600 688 654 526 3,144 38 143 445 550 628 597 478 2,879 2 15 33 50 60 57 48 265 26 179 447 534 601 614 483 2,884 26 166 429 499 554 568 435 2,677 0 13 18 35 47 46 48 207 1.54 0.88 1.07 1.12 1.14 1.07 1.09 1.13 1.46 0.86 1.04 1.10 1.13 1.05 1.10 1.11 1.15 1.83 1.43 1.28 1.24 1.00 1.32 437 377 495 435 392 326 253 2,715 MULTIPLE INDICATOR CLUSTER SURVEY 2011178 MULTIPLE INDICATOR CLUSTER SURVEY 2011 179 Appendix D. ESTIMATES OF SAMPLING ERRORS The sample of respondents selected in Selected Districts of West 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: Kaimana, Manokwari and Sorong. 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. MULTIPLE INDICATOR CLUSTER SURVEY 2011180 T ab 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 W es t 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 4. 1 4. 3 7. 4 7. 5 8. 2 9. 18 8. 5 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 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 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 5. 2 5. 3 5. 5a 5. 5b 5. 7 5. 8 7. 1 8. 7 9. 2 9. 3 9. 4 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 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 W O M E N 7. 1 8. 7 9. 2 9. 3 9. 4 9. 11 9. 21 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 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 M E N 2. 6 2. 14 3. 1 3. 2 3. 3 3. 4 3. 5 3. 15 3. 18 8. 1 T o 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 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 T u 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 U N D E R 5 s MULTIPLE INDICATOR CLUSTER SURVEY 2011 181 T ab le S E .2 : S am p lin g e rr o rs : K ai m an a 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 K ai m an a, M an o kw ar i an d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 H O U S E H O LD M E M B E R S 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 M IC S in di ca to r nu m be r r - 2s e r + 2s e W ie g h te d co u n t U nw ie gh te d co un t C o n fi d en ce li m it V al u e (r ) S ta n d ar d er ro r (s e) D es ig n ef fe ct (d ef f) C oe ffi ci en t of v ar ia tio n (s e/ r) S qu ar e ro ot of d es ig n ef fe ct (d ef t) 4. 1 4. 3 7. 4 7. 5 8. 2 9. 18 8. 5 0. 66 41 0. 43 58 0. 93 57 0. 47 97 0. 23 12 0. 07 73 0. 86 38 0. 04 65 0 0. 02 98 1 0. 01 34 1 0. 03 82 6 0. 01 00 4 0. 01 12 5 0. 01 86 9 0. 07 0 0. 06 8 0. 01 4 0. 08 0 0. 04 3 0. 14 6 0. 02 2 1, 85 8 1, 85 8 30 1 19 3 59 6 85 5 66 1 94 3 94 3 63 2 40 3 1, 24 8 1, 78 1 63 9 0. 57 1 0. 37 6 0. 90 9 0. 40 3 0. 21 1 0. 05 5 0. 82 6 0. 75 7 0. 49 5 0. 96 3 0. 55 6 0. 25 1 0. 10 0 0. 90 1 9. 13 0 3. 40 5 1. 88 5 2. 35 8 0. 70 7 3. 16 1 1. 89 5 3. 02 2 1. 84 5 1. 37 3 1. 53 6 0. 84 1 1. 77 8 1. 37 6 5. 2 5. 5 5. 5a 5. 5b 5. 7 5. 8 7. 1 8. 7 9. 2 9. 3 9. 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 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 0. 15 50 0. 30 14 0. 83 68 0. 53 73 0. 57 66 0. 33 39 0. 73 75 0. 21 51 0. 16 30 0. 50 49 0. 06 23 0. 04 66 5 0. 02 21 1 0. 03 50 9 0. 04 14 0 0. 05 73 9 0. 05 11 0 0. 04 04 3 0. 01 38 7 0. 03 22 6 0. 02 90 8 0. 01 00 8 0. 30 1 0. 07 3 0. 04 2 0. 07 7 0. 10 0 0. 15 3 0. 05 5 0. 06 4 0. 19 8 0. 05 8 0. 16 2 58 30 4 99 99 99 99 12 1 36 0 12 1 42 3 27 0 12 8 66 4 21 5 21 5 21 5 21 5 26 3 78 7 26 3 92 2 59 2 0. 06 2 0. 25 7 0. 76 7 0. 45 4 0. 46 2 0. 23 2 0. 65 7 0. 18 7 0. 09 8 0. 44 7 0. 04 2 0. 24 8 0. 34 6 0. 90 7 0. 62 0 0. 69 1 0. 43 6 0. 81 8 0. 24 3 0. 22 8 0. 56 3 0. 08 2 2. 11 0 1. 53 9 1. 93 0 1. 47 5 2. 88 7 2. 51 3 2. 21 1 0. 89 6 1. 99 9 3. 11 6 1. 02 8 1. 45 3 1. 24 0 1. 38 9 1. 21 5 1. 69 9 1. 58 5 1. 48 7 0. 94 6 1. 41 4 1. 76 5 1. 01 4 W O M E N 7. 1 8. 7 9. 2 9. 3 9. 4 9. 11 9. 21 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 0. 73 14 0. 04 47 0. 08 69 0. 65 82 0. 06 84 0. 03 74 0. 41 39 0. 04 55 0 0. 00 87 5 0. 01 44 2 0. 02 51 8 0. 01 07 3 0. 01 05 7 0. 05 05 1 0. 06 2 0. 19 5 0. 16 6 0. 03 8 0. 15 7 0. 28 3 0. 12 2 12 1 37 5 12 1 43 7 37 3 12 1 43 7 26 1 81 9 26 1 95 5 81 4 26 1 95 5 0. 64 0 0. 02 7 0. 05 8 0. 60 8 0. 04 7 0. 01 6 0. 31 3 0. 82 2 0. 06 2 0. 11 6 0. 70 9 0. 09 0 0. 05 9 0. 51 5 2. 74 0 1. 46 4 0. 68 1 2. 68 8 1. 46 9 0. 80 7 10 .0 34 1. 65 5 1. 21 0 0. 82 5 1. 64 0 1. 21 2 0. 89 9 3. 16 8 M E N 2. 6 2. 14 3. 1 3. 2 3. 3 3. 4 3. 5 3. 15 3. 18 8. 1 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 T u 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 0. 41 26 0. 41 28 0. 79 20 0. 43 60 0. 33 07 0. 53 62 0. 31 93 0. 36 08 0. 20 00 0. 46 20 0. 06 95 1 0. 02 86 3 0. 04 16 8 0. 04 58 1 0. 04 56 3 0. 05 61 9 0. 04 05 3 0. 03 04 0 0. 04 59 1 0. 04 04 1 0. 16 8 0. 06 9 0. 05 3 0. 10 5 0. 13 8 0. 10 5 0. 12 7 0. 08 4 0. 22 9 0. 08 7 25 10 8 61 61 58 60 57 25 9 59 26 2 49 22 2 12 6 12 6 12 1 12 5 11 9 52 0 11 9 52 7 0. 27 4 0. 35 6 0. 70 9 0. 34 4 0. 23 9 0. 42 4 0. 23 8 0. 30 0 0. 10 8 0. 38 1 0. 55 2 0. 47 0 0. 87 5 0. 52 8 0. 42 2 0. 64 9 0. 40 0 0. 42 2 0. 29 2 0. 54 3 0. 95 7 0. 74 8 1. 31 8 1. 06 7 1. 12 9 1. 57 4 0. 89 2 2. 08 0 1. 55 4 3. 45 6 0. 97 8 0. 86 5 1. 14 8 1. 03 3 1. 06 2 1. 25 5 0. 94 4 1. 44 2 1. 24 7 1. 85 9 U N D E R 5 s MULTIPLE INDICATOR CLUSTER SURVEY 2011182 T ab le S E .3 : S am p lin g e rr o rs : M an o kw ar i 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 K ai m an a, M an o kw ar i an d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 H O U S E H O LD M E M B E R S 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 M IC S in di ca to r nu m be r r - 2s e r + 2s e W ie g h te d co u n t U nw ie gh te d co un t C o n fi d en ce li m it V al u e (r ) S ta n d ar d er ro r (s e) D es ig n ef fe ct (d ef f) C oe ffi ci en t of v ar ia tio n (s e/ r) S qu ar e ro ot of d es ig n ef fe ct (d ef t) 4. 1 4. 3 7. 4 7. 5 8. 2 9. 18 8. 5 0. 68 99 0. 56 34 0. 93 95 0. 77 89 0. 16 54 0. 07 27 0. 83 66 0. 04 83 4 0. 04 11 9 0. 01 31 8 0. 02 23 9 0. 02 06 2 0. 00 90 7 0. 02 02 9 0. 07 0 0. 07 3 0. 01 4 0. 02 9 0. 12 5 0. 12 5 0. 02 4 6, 91 2 6, 91 2 1, 03 0 87 9 2, 12 6 2, 88 2 2, 19 0 88 9 88 9 55 6 47 0 1, 13 2 1, 55 0 56 5 0. 59 3 0. 48 1 0. 91 3 0. 73 4 0. 12 4 0. 05 5 0. 79 6 0. 78 7 0. 64 6 0. 96 6 0. 82 4 0. 20 7 0. 09 1 0. 87 7 9. 70 1 6. 12 5 1. 69 8 1. 36 5 3. 48 5 1. 89 2 1. 69 8 3. 11 5 2. 47 5 1. 30 3 1. 16 8 1. 86 7 1. 37 6 1. 30 3 5. 2 5. 5 5. 5a 5. 5b 5. 7 5. 8 7. 1 8. 7 9. 2 9. 3 9. 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 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 0. 15 18 0. 53 99 0. 85 85 0. 66 52 0. 75 45 0. 54 35 0. 87 48 0. 30 12 0. 27 14 0. 61 75 0. 13 43 0. 03 77 8 0. 02 38 7 0. 03 03 9 0. 04 03 6 0. 04 39 0 0. 04 28 3 0. 02 07 2 0. 02 34 5 0. 04 12 7 0. 02 87 7 0. 02 07 3 0. 24 9 0. 04 4 0. 03 5 0. 06 1 0. 05 8 0. 07 9 0. 02 4 0. 07 8 0. 15 2 0. 04 7 0. 15 4 26 5 1, 17 6 28 7 28 7 28 7 28 7 56 6 1, 33 7 56 6 1, 63 8 1, 37 2 14 7 61 9 15 9 15 9 15 9 15 9 30 7 70 8 30 7 86 8 70 7 0. 07 6 0. 49 2 0. 79 8 0. 58 4 0. 66 7 0. 45 8 0. 83 3 0. 25 4 0. 18 9 0. 56 0 0. 09 3 0. 22 7 0. 58 8 0. 91 9 0. 74 6 0. 84 2 0. 62 9 0. 91 6 0. 34 8 0. 35 4 0. 67 5 0. 17 6 1. 61 9 1. 41 8 1. 20 1 1. 15 6 1. 64 4 1. 16 8 1. 20 0 1. 84 7 2. 63 5 3. 03 8 2. 60 9 1. 27 2 1. 19 1 1. 09 6 1. 07 5 1. 28 2 1. 08 1 1. 09 5 1. 35 9 1. 62 3 1. 74 3 1. 61 5 W O M E N 7. 1 8. 7 9. 2 9. 3 9. 4 9. 11 9. 21 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 0. 89 19 0. 08 02 0. 29 74 0. 57 77 0. 14 64 0. 04 62 0. 47 33 0. 03 22 0 0. 01 23 8 0. 02 83 1 0. 01 97 9 0. 01 24 9 0. 01 14 3 0. 05 27 0 0. 03 6 0. 15 4 0. 09 5 0. 03 4 0. 08 5 0. 24 7 0. 11 1 49 9 1, 34 4 49 9 1, 64 7 1, 53 1 49 9 1, 64 7 27 3 71 3 27 3 87 6 80 4 27 3 87 6 0. 82 7 0. 05 5 0. 24 1 0. 53 8 0. 12 1 0. 02 3 0. 36 8 0. 95 6 0. 10 5 0. 35 4 0. 61 7 0. 17 1 0. 06 9 0. 57 9 2. 92 5 1. 47 8 1. 04 4 1. 40 5 1. 00 2 0. 80 7 9. 74 9 1. 71 0 1. 21 6 1. 02 2 1. 18 5 1. 00 1 0. 89 8 3. 12 2 M E N 2. 6 2. 14 3. 1 3. 2 3. 3 3. 4 3. 5 3. 15 3. 18 8. 1 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 T u 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 0. 18 57 0. 38 90 0. 68 12 0. 58 89 0. 38 82 0. 61 01 0. 29 17 0. 25 24 0. 47 22 0. 50 12 0. 05 29 0 0. 03 79 7 0. 04 20 0 0. 04 98 1 0. 05 51 3 0. 05 66 5 0. 05 94 5 0. 02 18 0 0. 04 09 6 0. 03 15 5 0. 28 5 0. 09 8 0. 06 2 0. 08 5 0. 14 2 0. 09 3 0. 20 4 0. 08 6 0. 08 7 0. 06 3 76 30 6 13 7 13 7 13 3 13 5 13 5 75 1 26 8 76 0 39 16 0 72 72 69 71 70 38 7 13 8 39 1 0. 08 0 0. 31 3 0. 59 7 0. 48 9 0. 27 8 0. 49 7 0. 17 3 0. 20 9 0. 39 0 0. 43 8 0. 29 1 0. 46 5 0. 76 5 0. 68 9 0. 49 8 0. 72 3 0. 41 1 0. 29 6 0. 55 4 0. 56 4 0. 70 3 0. 96 5 0. 57 7 0. 72 8 0. 87 0 0. 94 4 1. 18 1 0. 97 2 0. 92 2 1. 55 3 0. 83 9 0. 98 2 0. 75 9 0. 85 3 0. 93 3 0. 97 2 1. 08 7 0. 98 6 0. 96 0 1. 24 6 U N D E R 5 s MULTIPLE INDICATOR CLUSTER SURVEY 2011 183 T ab le S E .4 : S am p lin g e rr o rs : S o ro n g 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 K ai m an a, M an o kw ar i an d S o ro n g , W es t P ap u a P ro vi n ce , I n d o n es ia , 2 01 1 H O U S E H O LD M E M B E R S 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 M IC S in di ca to r nu m be r r - 2s e r + 2s e W ie g h te d co u n t U nw ie gh te d co un t C o n fi d en ce li m it V al u e (r ) S ta n d ar d er ro r (s e) D es ig n ef fe ct (d ef f) C oe ffi ci en t of v ar ia tio n (s e/ r) S qu ar e ro ot of d es ig n ef fe ct (d ef t) 4. 1 4. 3 7. 4 7. 5 8. 2 9. 18 8. 5 0. 79 86 0. 48 66 0. 95 84 0. 77 13 0. 18 61 0. 05 51 0. 89 86 0. 04 07 3 0. 03 41 0 0. 00 88 5 0. 03 73 8 0. 01 35 9 0. 00 94 0 0. 01 67 5 0. 05 1 0. 07 0 0. 00 9 0. 04 8 0. 07 3 0. 17 1 0. 01 9 2, 89 8 2, 89 8 44 5 34 3 89 7 1, 22 5 96 5 98 4 98 4 60 6 45 8 1, 21 9 1, 66 2 66 1 0. 71 7 0. 41 8 0. 94 1 0. 69 7 0. 15 9 0. 03 6 0. 86 5 0. 88 0 0. 55 5 0. 97 6 0. 84 6 0. 21 3 0. 07 4 0. 93 2 10 .1 39 4. 57 6 1. 18 8 3. 61 9 1. 48 5 2. 81 7 2. 03 3 3. 18 4 2. 13 9 1. 09 0 1. 90 2 1. 21 8 1. 67 8 1. 42 6 9. 2 9. 3 9. 4 5. 2 5. 5 5. 5a 5. 5b 5. 7 5. 8 7. 1 8. 7 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 0. 16 84 0. 53 72 0. 91 17 0. 72 55 0. 75 34 0. 21 79 0. 95 16 0. 34 71 0. 36 80 0. 59 50 0. 21 06 0. 03 44 2 0. 02 34 5 0. 02 14 2 0. 05 15 2 0. 05 03 3 0. 04 04 2 0. 01 11 4 0. 02 85 2 0. 03 72 8 0. 02 84 4 0. 01 87 0 0. 20 4 0. 04 4 0. 02 3 0. 07 1 0. 06 7 0. 18 5 0. 01 2 0. 08 2 0. 10 1 0. 04 8 0. 08 9 72 50 7 10 2 10 2 10 2 10 2 17 3 55 3 17 3 65 4 47 0 10 2 71 5 14 5 14 5 14 5 14 5 24 4 78 3 24 4 92 5 66 6 0. 10 0 0. 49 0 0. 86 9 0. 62 2 0. 65 3 0. 13 7 0. 92 9 0. 29 0 0. 29 3 0. 53 8 0. 17 3 0. 23 7 0. 58 4 0. 95 5 0. 82 9 0. 85 4 0. 29 9 0. 97 4 0. 40 4 0. 44 3 0. 65 2 0. 24 8 0. 85 5 1. 58 0 0. 82 1 1. 91 9 1. 96 3 1. 38 0 0. 65 5 2. 80 7 1. 45 2 3. 10 1 1. 39 9 0. 92 4 1. 25 7 0. 90 6 1. 38 5 1. 40 1 1. 17 5 0. 80 9 1. 67 5 1. 20 5 1. 76 1 1. 18 3 W O M E N 7. 1 8. 7 9. 2 9. 3 9. 4 9. 11 9. 21 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 0. 89 65 0. 05 14 0. 27 67 0. 67 23 0. 17 00 0. 01 07 0. 68 43 0. 02 24 3 0. 00 89 4 0. 02 56 2 0. 01 33 6 0. 01 37 9 0. 01 06 4 0. 05 33 4 0. 02 5 0. 17 4 0. 09 3 0. 02 0 0. 08 1 0. 99 4 0. 07 8 17 4 54 0 17 4 65 2 58 0 17 4 65 2 24 1 75 1 24 1 90 5 80 3 24 1 90 5 0. 85 2 0. 03 4 0. 22 6 0. 64 6 0. 14 2 0. 00 0 0. 57 8 0. 94 1 0. 06 9 0. 32 8 0. 69 9 0. 19 8 0. 03 2 0. 79 1 1. 30 1 1. 22 9 0. 78 7 0. 73 2 1. 08 1 2. 56 6 11 .9 07 1. 14 1 1. 10 9 0. 88 7 0. 85 6 1. 04 0 1. 60 2 3. 45 1 M E N 2. 6 2. 14 3. 1 3. 2 3. 3 3. 4 3. 5 3. 15 3. 18 8. 1 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 T u 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 * 0. 46 38 0. 95 87 0. 90 29 0. 69 90 0. 88 94 0. 67 58 0. 45 60 0. 12 91 0. 51 20 * 0. 03 93 6 0. 01 78 1 0. 02 77 4 0. 05 45 5 0. 02 41 4 0. 05 49 1 0. 02 63 1 0. 02 67 9 0. 04 06 5 * 0. 08 5 0. 01 9 0. 03 1 0. 07 8 0. 02 7 0. 08 1 0. 05 8 0. 20 8 0. 07 9 21 10 7 55 55 55 55 55 32 5 60 33 2 27 14 1 73 73 73 73 73 42 8 76 43 6 * 0. 38 5 0. 92 3 0. 84 7 0. 59 0 0. 84 1 0. 56 6 0. 40 3 0. 07 5 0. 43 1 * 0. 54 2 0. 99 4 0. 95 8 0. 80 8 0. 93 8 0. 78 6 0. 50 9 0. 18 3 0. 59 3 * 0. 87 2 0. 57 7 0. 63 2 1. 01 8 0. 42 7 0. 99 1 1. 19 1 0. 47 9 2. 87 7 * 0. 93 4 0. 75 9 0. 79 5 1. 00 9 0. 65 3 0. 99 5 1. 09 1 0. 69 2 1. 69 6 U N D E R 5 s MULTIPLE INDICATOR CLUSTER SURVEY 2011184 MULTIPLE INDICATOR CLUSTER SURVEY 2011 185 Appendix E. MICS INDICATORS: NUMERATORS AND DENOMINATOR 1.1 1.2 2.4 2.5 2.6 2.7 2.8 2.9 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 MDG 4.1 MDG 4.2 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 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 MICS4 Indicator[M] Module18 Numerator Denominator MDG19 01. CHILD MORTALITY 02. 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) MULTIPLE INDICATOR CLUSTER SURVEY 2011186 2.10 2.11 2.12 2.13 2.14 2.15 2.17 2.18 2.19 3.1 3.2 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 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 Module18 Numerator Denominator MDG19 03. CHILD HEALTH24 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 The age in months when 50 per cent of children age 0-35 months did not receive breast milk during the previous day MICS4 Indicator[M] MULTIPLE INDICATOR CLUSTER SURVEY 2011 187 3.3 3.4 3.5 3.7 3.11 3.12 3.14 3.15 3.16 3.17 IM IM IM MN HC TN TN TN ML ML 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 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 Module18 Numerator Denominator MDG19 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 MDG 4.3 MDG 6.7 MICS4 Indicator[M] MULTIPLE INDICATOR CLUSTER SURVEY 2011188 3.18 ML Number of children under age 5 reported to have had fever in the previous 2 weeks who received any antimalarial treatment Total number of children under age 5 reported to have had fever in the previous 2 weeks Anti-malarial treatment of children under age 5 Module18 Numerator Denominator MDG19 MDG 6.8 4.1 4.2 4.3 WS WS WS 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 Total number of household members Total number of household members in households using unimproved drinking water sources Total number of household members Use of improved drinking water sources Water treatment Use of improved sanitation 04. WATER AND SANITATION MDG 7.8 MDG 7.9 5.1 5.2 5.3 5.4 5.5a 5.5b CM - BH CM - BH CP UN MN 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 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 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 Adolescent birth rate27 Early childbearing Contraceptive prevalence rate Unmet need28 (Indonesia specific) Antenatal care coverage 05. REPRODUCTIVE HEALTH MDG 5.4 MDG 5.3 MDG 5.6 MDG 5.5 Age-specific fertility rate for women age 15-19 years for the one year period preceding the survey 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 MICS4 Indicator[M] MULTIPLE INDICATOR CLUSTER SURVEY 2011 189 Module18 Numerator Denominator MDG19 5.6a 5.7 5.8 MN MN MN 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 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 Content of antenatal care Skilled attendant at delivery Institutional deliveries MDG 5.2 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 WB ED ED ED ED ED ED ED 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 15-24 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 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 07. LITERACY AND EDUCATION MDG 2.3 MDG 2.1 MDG 2.2Proportion of children entering the first grade of primary school who eventually reach last grade MICS4 Indicator[M] MULTIPLE INDICATOR CLUSTER SURVEY 2011190 7.9 7.10 ED ED Primary school net attendance ratio (adjusted) for girls Secondary school net attendance ratio (adjusted) for girls Primary school net attendance ratio (adjusted) for boys Secondary school net attendance ratio (adjusted) for boys Gender parity index (primary school) Gender parity index (secondary school) Module18 MDG 3.1 MDG 3.1 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.10 b 8.14 BR CL ED - CL ED - CL CD MA MA MA MA DV 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 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 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] 08. CHILD PROTECTION Numerator Denominator MDG19MICS4 Indicator[M] MULTIPLE INDICATOR CLUSTER SURVEY 2011 191 Module18 29 Using condoms 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 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.10 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 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] MDG 6.3 09. HIV/AIDS, SEXUAL BEHAVIOUR AND ORPHANS MICS4 Indicator[M] Numerator Denominator MDG19 MULTIPLE INDICATOR CLUSTER SURVEY 2011192 9.11 9.12 9.13 9.14 9.15 9.17 9.18 9.21 SB SB SB SB SB HL HL MMC 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 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 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[M] partnersonly for men Sex with non- regular partners[M] Children’s living arrangements Prevalence of children with one or both parents dead Male circumcision Module17 TA.3 TA.4 TA TA 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 15-49 years Total number of women age 15-49 years Alcohol use[M] Use of alcohol before age 15[M] 12. ALCOHOL USE Numerator Denominator MDG19MICS4 Indicator[M] MULTIPLE INDICATOR CLUSTER SURVEY 2011 193 1 2a 2b 2c 3 4a 4b 5 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 test was positive Number of women age 15-19 years who are married through civil registration Number of heads of household who were born in West Papua Median floor area of housing unit 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 care 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 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 head of households born in West Papua Mean number of years head of household has been residing in Papua Median floor area per person (Indonesia specific) Indicator Numerator Denominator WEST 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 195 Appendix F. QUESTIONNAIRES     INDONESIA  2011       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: __________________________________________ 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 HH10. Respondent to household questionnaire: Name: ____________________________________ Line Number: ___ ___ 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 ___________________________ ___ ___ MULTIPLE INDICATOR CLUSTER SURVEY 2011196     H H 18 . Re co rd th e tim e. H ou r . . . . . _ _ __ M in ut es . . . _ _ __   H O U SE H O LD  L IS TI N G  F O RM   H L   FI R S T, P LE A S E T E LL 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 LL Y L IV E S H E R E , S TA R TI N G W IT H T H E H EA D O F TH E H O U S E H O LD . Li st th e he ad o f t he h ou se ho ld in li ne 0 1. L is t a ll ho us eh ol d m em be rs (H L2 ), th ei r r el at io ns hi p to th e ho us eh ol d he ad (H L3 ), an d th ei r s ex (H L4 ) Th en a sk : A R E T H E R E A N Y O TH E R S W H O L IV E H E R E , E V E N IF T H E Y A R E N O T A T H O M E N O W ? If ye s, co m pl et e lis tin g fo r q ue st io ns H L2 -H L4 . T he n, a sk q ue st io ns st ar tin g w ith H L5 fo r e ac h pe rs on a t a ti m e. U se a n ad di tio na l q ue st io nn ai re if a ll ro w s i n th e ho us eh ol d lis tin g fo rm h av e be en u se d. Fo r w om en ag e 15 -4 9 Fo r m en ag e 15 -4 9 Fo r ch ild re n ag e 5- 17 Fo r ch ild re n un de r a ge 5 Fo r a ll ho us eh ol d m em be rs Fo r c hi ld re n ag e 0- 17 y ea rs H L1 . Li ne N o H L2 . N am e H L3 . W H A T IS TH E R E LA TI O N - S H IP O F (n am e) T O TH E H E A D O F H O U S E - H O LD ? H L4 . IS (n am e) M A LE O R FE M A LE ? 1 M al e 2 Fe m al e H L5 . W H A T IS (n am e) ’S D A TE O F B IR TH ? H L6 . H O W O LD IS (n am e) ? Re co rd in co m pl et ed ye ar s. If ag e is 9 5 or ab ov e, re co rd ‘9 5’ H L7 . C ir cl e lin e no . if w om an is a ge 15 -4 9 H L7 A . C ir cl e lin e no . if m an is ag e 15 -4 9 H L8 . W H O IS TH E M O TH E R O R P R IM A R Y C A R E TA K E R O F TH IS C H IL D ? Re co rd lin e no . o f m ot he r/ ca re ta ke r H L9 . W H O IS TH E M O TH E R O R P R IM A R Y C A R E TA K E R O F TH IS C H IL D ? Re co rd lin e no . o f m ot he r/ ca re ta ke r H L1 0. D ID (n am e) S TA Y H E R E LA S T N IG H T? 1 Y es 2 N o H L1 1. IS (n am e) ’S N A TU R A L M O TH E R A LI V E ? 1 Y es 2 N o H L1 3 8 D K  H L1 3 H L1 2. D O E S (n am e) ’S N A TU R A L M O TH E R LI V E IN T H IS H O U S E - H O LD ? Re co rd lin e no . o f m ot he r o r 00 fo r “N o” H L1 3. IS (n am e) ’ S N A TU R A L FA TH E R A LI V E ? 1 Y es 2 N o N ex t L in e 8 D K  N ex t L in e H L1 4. D O E S (n am e) ’S N A TU R A L FA TH E R LI V E IN T H IS H O U S E - H O LD ? Re co rd lin e no . o f fa th er o r 00 fo r “N o” 98 D K 99 98 D K Li ne N am e R el at io n* M F M on th Y ea r A ge 15 -4 9 15 -4 9 M ot he r M ot he r Y N Y N D K M ot he r Y N D K Fa th er 01 0 1 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 01 01 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 02 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 02 02 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 03 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 03 03 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 04 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 04 04 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 05 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 05 05 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 06 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 06 06 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 07 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 07 07 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 08 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 08 08 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 09 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 09 09 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 10 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 10 10 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 11 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 11 11 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ MULTIPLE INDICATOR CLUSTER SURVEY 2011 197 H L5 . W H A T IS (n am e) ’S D A TE O F B IR TH ? H L1 . Li ne N o H L2 . N am e H L3 . W H A T IS TH E R E LA TI O N - S H IP O F (n am e) T O TH E H E A D O F H O U S E - H O LD ? H L4 . I S (n am e) M A LE O R FE M A LE ? 1 M al e 2 Fe m al e 98 D K 99 98 D K H L6 . H O W O LD IS (n am e) ? Re co rd in co m pl et ed ye ar s. If ag e is 9 5 or ab ov e, re co rd ‘9 5’ H L7 . C ir cl e lin e no . if w om an is a ge 15 -4 9 H L7 A . C ir cl e lin e no . if m an is ag e 15 -4 9 H L8 . W H O IS TH E M O TH E R O R P R IM A R Y C A R E TA K E R O F TH IS C H IL D ? Re co rd lin e no . o f m ot he r/ ca re ta ke r H L9 . W H O IS TH E M O TH E R O R P R IM A R Y C A R E TA K E R O F TH IS C H IL D ? Re co rd lin e no . o f m ot he r/ ca re ta ke r H L1 0. D ID (n am e) S TA Y H E R E LA S T N IG H T ? 1 Y es 2 N o H L1 1. I S (n am e) ’S N A TU R A L M O TH E R A LI V E ? 1 Y es 2 N o H L1 3 8 D K H L1 3 H L1 2. D O E S (n am e) ’S N A TU R A L M O TH E R LI V E IN T H IS H O U S E - H O LD ? Re co rd lin e no . o f m ot he r o r 00 fo r “N o” H L1 3. I S (n am e) ’ S N A TU R A L FA TH E R A LI V E ? 1 Y es 2 N o N ex t L in e 8 D K N ex t L in e H L1 4. D O E S (n am e) ’S N A TU R A L FA TH E R LI V E IN T H IS H O U S E - H O LD ? Re co rd lin e no . o f fa th er o r 00 fo r “N o” Li ne N am e R el at io n* M F M on th Y ea r A ge 15 -4 9 15 -4 9 M ot he r M ot he r Y N Y N D K M ot he r Y N D K Fa th er 12 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 12 12 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 13 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 13 13 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 14 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 14 14 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ 15 __ _ _ __ 1 2 __ _ _ __ _ _ __ _ _ __ _ _ __ 15 15 __ _ _ __ __ _ _ __ 1 2 1 2 8 __ _ _ __ 1 2 8 __ _ _ __ Ti ck h er e if ad di tio na l q ue st io nn ai re u se d P ro be fo r a dd iti on al h ou se ho ld m em be rs . Pr ob e es pe ci al ly fo r a ny in fa nt s o r s m al l c hi ld re n no t l is te d, a nd o th er s w ho m ay n ot b e m em be rs o f t he fa m ily (s uc h as se rv an ts , f ri en ds ) b ut w ho u su al ly li ve in th e ho us eh ol d. In se rt n am es o f a dd iti on al m em be rs in th e ho us eh ol d lis t a nd c om pl et e fo rm a cc or di ng ly . N ow fo r e ac h w om an a ge 1 5- 49 y ea rs , w ri te h er n am e an d lin e nu m be r a nd o th er id en tif yi ng in fo rm at io n in th e in fo rm at io n pa ne l o f a se pa ra te In di vi du al W om en ’s Q ue st io nn ai re . Fo r e ac h m an a ge 1 5- 49 y ea rs , w ri te h is n am e an d lin e nu m be r a nd o th er id en tif yi ng in fo rm at io n in th e in fo rm at io n pa ne l o f a se pa ra te In di vi du al M an ’s Q ue st io nn ai re . Fo r e ac h ch ild u nd er a ge 5 , w ri te h is /h er n am e an d lin e nu m be r A N D th e lin e nu m be r o f h is /h er m ot he r o r c ar et ak er in th e in fo rm at io n pa ne l o f a se pa ra te U nd er -5 Q ue st io nn ai re . Yo u sh ou ld n ow h av e a se pa ra te q ue st io nn ai re fo r e ac h el ig ib le w om an , e ac h el ig ib le m an , a nd e ac h ch ild u nd er fi ve in th e ho us eh ol d. * C od es fo r H L3 : R el at io ns hi p to h ea d of h ou se ho ld : 01 H ea d 02 W ife / H us ba nd 03 S on / D au gh te r 04 S on -In -L aw / D au gh te r- In -L aw 05 G ra nd ch ild 06 P ar en t 07 P ar en t-I n- La w 08 B ro th er / S is te r 09 B ro th er -In -L aw / S is te r- In -L aw 10 U nc le / A un t 11 N ie ce / N ep he w 12 O th er re la tiv e 13 A do pt ed / Fo st er / S te pc hi ld 14 N ot re la te d 98 D on 't kn ow MULTIPLE INDICATOR CLUSTER SURVEY 2011198 ED U CA TI O N 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 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 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 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 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 ? E D 2A E D 2B ED 6A ED 6B ED 8A ED 8B 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 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011200     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 2011 201 HOUSEHOLD 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 PAPUAWEST ? 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011202     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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011204     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 2011 205     IN SE CT IC ID E   TR EA TE D  N ET S                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   TN   TN 1. D O E S Y O U R H O U S E H O LD H A V E A N Y M O S Q U IT O N E TS T H A T C A N B E U S E D W H IL E S LE E P IN G ? Y es . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 N o . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 2 IR M od ul e TN 2. H O W M A N Y M O S Q U IT O N E TS D O E S Y O U R H O U S E H O LD H A V E ? N um be r o f n et s . . . . . . . . . . . . . . . . . . _ __ _ __ TN 3. A sk th e re sp on de nt to sh ow y ou th e ne ts in th e ho us eh ol d. If m or e th an 6 n et s, us e ad di tio na l q ue st io nn ai re (s ). 1s t N et 2n d N et 3r d N et 4t h N et 5t h N et 6t h N et TN 4. M os qu ito n et o bs er ve d? O bs er ve d . . . . . . . . 1 N ot o bs er ve d . . . . . 2 O bs er ve d . . . . . . . . 1 N ot o bs er ve d . . . . . 2 O bs er ve d . . . . . . . . 1 N ot o bs er ve d . . . . . 2 O bs er ve d . . . . . . . . 1 N ot o bs er ve d . . . . . 2 O bs er ve d . . . . . . . . 1 N ot o bs er ve d . . . . . 2 O bs er ve d . . . . . . . . 1 N ot o bs er ve d . . . . . 2 TN 5. O bs er ve o r a sk th e br an d/ ty pe o f m os qu ito n et . If br an d is u nk no w n an d yo u ca nn ot o bs er ve th e ne t, sh ow pi ct ur es o f t yp ic al n et ty pe s/ br an ds to re sp on de nt . Lo ng -la st in g tre at ed ne ts O ly se t N et . . . . . . 1 1 P er m an et . . . . . . 12 O th er (s pe ci fy )_ __ __ __ __ __ 16 D K b ra nd . . . . . . 18 P re -tr ea te d ne ts (A ny br an d) . . . . . . . 21 O th er n et ( sp ec ify ) _ __ __ __ __ __ 3 1 D K b ra nd / ty pe . . . 98 Lo ng -la st in g tre at ed ne ts O ly se t N et . . . . . . 1 1 P er m an et . . . . . . 12 O th er (s pe ci fy )_ __ __ __ __ __ 16 D K b ra nd . . . . . . 18 P re -tr ea te d ne ts (A ny br an d) . . . . . . . 21 O th er n et ( sp ec ify ) _ __ __ __ __ __ 3 1 D K b ra nd / ty pe . . . 98 Lo ng -la st in g tre at ed ne ts O ly se t N et . . . . . . 1 1 P er m an et . . . . . . 12 O th er (s pe ci fy )_ __ __ __ __ __ 16 D K b ra nd . . . . . . . 1 8 P re -tr ea te d ne ts (A ny br an d) . . . . . . . 21 O th er n et ( sp ec ify ) _ __ __ __ __ __ 3 1 D K b ra nd / ty pe . . . . 9 8 Lo ng -la st in g tre at ed ne ts O ly se t N et . . . . . . 1 1 P er m an et . . . . . . 12 O th er (s pe ci fy )_ __ __ __ __ __ 16 D K b ra nd . . . . . . 18 P re -tr ea te d ne ts (A ny br an d) . . . . . . . 21 O th er n et ( sp ec ify ) _ __ __ __ __ __ 3 1 D K b ra nd / ty pe . . . 98 Lo ng -la st in g tre at ed ne ts O ly se t N et . . . . . . 1 1 P er m an et . . . . . . 12 O th er (s pe ci fy )_ __ __ __ __ __ 16 D K b ra nd . . . . . . 18 P re -tr ea te d ne ts (A ny br an d) . . . . . . . 21 O th er n et ( sp ec ify ) _ __ __ __ __ __ 3 1 D K b ra nd / ty pe . . . 98 Lo ng -la st in g tre at ed ne ts O ly se t N et . . . . . . 1 1 P er m an et . . . . . . 12 O th er (s pe ci fy )_ __ __ __ __ __ 16 D K b ra nd . . . . . . 18 P re -tr ea te d ne ts (A ny br an d) . . . . . . . 21 O th er n et ( sp ec ify ) _ __ __ __ __ __ 3 1 D K b ra nd / ty pe . . . 98 TN 6. H O W M A N Y M O N TH S A G O D ID Y O U R H O U S E H O LD G E T TH E M O S Q U IT O N E T? If le ss th an o ne m on th , r ec or d “0 0” M on th s ag o . . _ __ _ __ M or e th an 3 6 m o. ag o . . . . . . . . . 95 D K / N ot s ur e . . . . 9 8 M on th s ag o . . _ __ _ __ M or e th an 3 6 m o. ag o . . . . . . . . . 95 D K / N ot s ur e . . . . 9 8 M on th s ag o . . _ __ _ __ M or e th an 3 6 m o. ag o . . . . . . . . . 95 D K / N ot s ur e . . . . 9 8 M on th s ag o . . _ __ _ __ M or e th an 3 6 m o. ag o . . . . . . . . . 95 D K / N ot s ur e . . . . 9 8 M on th s ag o . . _ __ _ __ M or e th an 3 6 m o. ag o . . . . . . . . . 95 D K / N ot s ur e . . . . 9 8 M on th s ag o . . _ __ _ __ M or e th an 3 6 m o. ag o . . . . . . . . . 95 D K / N ot s ur e . . . . 9 8 TN 7. C he ck T N 5 fo r t yp e of n et  L on g- la st in g (1 1- 18 )  T N1 1  P re -tr ea te d (2 1)  T N9  E ls e C on tin ue  L on g- la st in g (1 1- 18 )  T N1 1  P re -tr ea te d (2 1)  T N9  E ls e C on tin ue  L on g- la st in g (1 1- 18 )  T N1 1  P re -tr ea te d (2 1)  T N9  E ls e C on tin ue  L on g- la st in g (1 1- 18 )  T N1 1  P re -tr ea te d (2 1)  T N9  E ls e C on tin ue  L on g- la st in g (1 1- 18 )  T N1 1  P re -tr ea te d (2 1)  T N9  E ls e C on tin ue  L on g- la st in g (1 1- 18 )  T N1 1  P re -tr ea te d (2 1)  T N9  E ls e C on tin ue MULTIPLE INDICATOR CLUSTER SURVEY 2011206     TN 8. W H E N Y O U G O T TH E N E T, W A S IT A LR E A D Y T R E A TE D W IT H A N IN S E C TI C ID E T O K IL L O R R E P E L M O S Q U IT O E S ? Y es . . . . . . . . . . 1 N o . . . . . . . . . . . . 2 D K / N ot s ur e . . . . . 8 Y es . . . . . . . . . . 1 N o . . . . . . . . . . . . 2 D K / N ot s ur e . . . . . 8 Y es . . . . . . . . . . 1 N o . . . . . . . . . . . . 2 D K / N ot s ur e . . . . . 8 Y es . . . . . . . . . . 1 N o . . . . . . . . . . . . 2 D K / N ot s ur e . . . . . 8 Y es . . . . . . . . . . 1 N o . . . . . . . . . . . . 2 D K / N ot s ur e . . . . . 8 Y es . . . . . . . . . . 1 N o . . . . . . . . . . . . 2 D K / N ot s ur e . . . . . 8 TN 9. S IN C E Y O U G O T TH E N E T, W A S IT 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 es . . . . . . . 1 N o . . . . . . . . 2  TN 11 D K / N ot s ur e . 8  TN 11 Y es . . . . . . . 1 N o . . . . . . . . 2  TN 11 D K / N ot s ur e . 8  TN 11 Y es . . . . . . . 1 N o . . . . . . . . 2  TN 11 D K / N ot s ur e . 8  TN 11 Y es . . . . . . . 1 N o . . . . . . . . 2  TN 11 D K / N ot s ur e . 8  TN 11 Y es . . . . . . . 1 N o . . . . . . . . 2  TN 11 D K / N ot s ur e . 8  TN 11 Y es . . . . . . . 1 N o . . . . . . . . 2  TN 11 D K / N ot s ur e . 8  TN 11 TN 10 . H O W M A N Y M O N TH S A G O W A S T H E N E T LA S T S O A K E D O R D IP P E D ? If le ss th an o ne m on th , r ec or d “0 0” M on th s ag o . . __ _ __ _ M or e th an 2 4 m o. ag o . . . . . . . . . . 9 5 D K / N ot s ur e . . . . . 9 8 M on th s ag o . . __ _ __ _ M or e th an 2 4 m o. ag o . . . . . . . . . . 9 5 D K / N ot s ur e . . . . . 9 8 M on th s ag o . . __ _ __ _ M or e th an 2 4 m o. ag o . . . . . . . . . . 9 5 D K / N ot s ur e . . . . 98 M on th s ag o . . __ _ __ _ M or e th an 2 4 m o. ag o . . . . . . . . . . 9 5 D K / N ot s ur e . . . . . 9 8 M on th s ag o . . __ _ __ _ M or e th an 2 4 m o. ag o . . . . . . . . . . 9 5 D K / N ot s ur e . . . . . 9 8 M on th s ag o . . __ _ __ _ M or e th an 2 4 m o. ag o . . . . . . . . . . 9 5 D K / N ot s ur e . . . . . 9 8 TN 11 . D ID A N Y O N E S LE E P U N D E R T H IS M O S Q U IT O N E T LA S T N IG H T? Ye s . . . . . . . 1 N o . . . . . . . . 2  TN 13 D K / N ot s ur e . . 8  TN 13 Ye s . . . . . . . 1 N o . . . . . . . . 2  TN 13 D K / N ot s ur e . . 8  TN 13 Ye s . . . . . . . 1 N o . . . . . . . . 2  TN 13 D K / N ot s ur e . 8  TN 13 Ye s . . . . . . . 1 N o . . . . . . . . 2  TN 13 D K / N ot s ur e . . 8  TN 13 Ye s . . . . . . . 1 N o . . . . . . . . 2  TN 13 D K / N ot s ur e . . 8  TN 13 Ye s . . . . . . . 1 N o . . . . . . . . 2  TN 13 D K / N ot s ur e . . 8  TN 13 TN 12 . W H O S LE P T U N D E R T H IS M O S Q U IT O N E T LA S T N IG H T? Re co rd th e pe rs on ’s li ne n um be r fr om th e ho us eh ol d lis tin g fo rm If so m eo ne n ot in th e ho us eh ol d lis t s le pt u nd er th e m os qu ito n et , re co rd “ 00 ” N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ N am e __ __ __ __ __ __ __ __ __ Li ne n um be r . . _ __ _ __ TN 13 . G o ba ck to T N 4 fo r n ex t ne t. If no m or e ne ts , g o to n ex t m od ul e G o ba ck to T N 4 fo r n ex t ne t. If no m or e ne ts , g o to n ex t m od ul e G o ba ck to T N 4 fo r n ex t ne t. If no m or e ne ts , g o to n ex t m od ul e G o ba ck to T N 4 fo r n ex t ne t. If no m or e ne ts , g o to n ex t m od ul e G o ba ck to T N 4 fo r n ex t ne t. If no m or e ne ts , g o to n ex t m od ul e G o ba ck to T N 4 in fi rs t co lu m n of a n ew qu es tio nn ai re fo r n ex t ne t. If no m or e ne ts , g o to n ex t m od ul e Ti ck h er e if ad di tio na l qu es tio nn ai re u se d  MULTIPLE INDICATOR CLUSTER SURVEY 2011 207     CH IL D  L A BO U R   CL   To b e ad m in is te re d fo r c hi ld re n in th e ho us eh ol d ag e 5- 17 y ea rs . F or h ou se ho ld m em be rs b el ow a ge 5 o r a bo ve a ge 1 7, le av e ro w s b la nk . N O W I W O U LD 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 IN T H IS H O U S E H O LD M A Y D O . C L1 . Li ne nu m be r C L2 . N am e an d Ag e C op y fr om H ou se ho ld L is tin g Fo rm , H L2 a nd H L6 C L3 . D U R IN G T H E P A S T W E E K , D ID (n am 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 IS N O T A M E M B E R O F TH IS H O U S E H O LD ? If ye s: F O R P A Y IN C A S H O R K IN D ? 1 Y es , f or p ay (c as h or k in d) 2 Y es , u np ai d 3 N o  C L5 C L4 . S IN C E L A S T (d ay o f t he 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 IS N O T A M E M B E R O F TH IS H O U S E H O LD ? If m or e th an o ne jo b, in cl ud e al l ho ur s a t a ll jo bs . C L5 . D U R IN G T H E P A S T W E E K , D ID (n am e) FE TC H W A TE R O R C O LL E C T FI R E W O O D F O R H O U S E H O LD U S E ? 1 Y es 2 N o  C L7 C L6 . S IN C E L A S T (d ay o f t he 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 FE TC H W A TE R O R C O LL E C T FI R E W O O D F O R H O U S E H O LD U S E ? C L7 . D U R IN G T H E P A S T W E E K , D ID (n am 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 FA R M O R IN A F A M IL Y B U S IN E S S O R S E LL IN G G O O D S IN T H E S TR E E T? In cl ud e w or k fo r a b us in es s ru n by th e ch ild , a lo ne o r w ith o ne o r m or e pa rt ne rs . 1 Y es 2 N o  C L9 C L8 . S IN C E L A S T (d ay o f t he 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 TH IS W O R K FO R H IS /H E R FA M IL Y O R H IM S E LF / H E R S E LF ? C L9 . D U R IN G T H E P A S T W E E K , D ID (n am e) H E LP W IT H H O U S E H O LD C H O R E S S U C H A S S H O P P IN G , C LE A N IN G , W A S H IN G C LO TH 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 LD O R S IC K P E O P LE ? 1 Y es 2 N o  N ex t L in e C L1 0. S IN C E L A S T (d ay o f t he 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 TH E S E C H O R E S ? Y es N o N um be r N um be r N um be r N um be r Li ne N am e A ge P ai d U np ai d of h ou rs Y es N o of h ou rs Y es N o of h ou rs Y es N o of h ou rs 01 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 02 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 03 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 04 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 05 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 06 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 07 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 08 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 09 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 10 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 11 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 12 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 13 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 14 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 15 __ __ 1 2 3 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ 1 2 __ __ __ __ MULTIPLE INDICATOR CLUSTER SURVEY 2011208 
 
 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011210 
 
 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 2011 211 INDONESIA 2011 INDONESIA MULTIPLE INDICATOR CLUSTER SURVEY PAPUA AND WEST PAPUA PROVINCE QUESTIONNAIRE FOR INDIVIDUAL WOMEN CONFIDENTIAL WOMAN’S 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 greeting and introduce 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 __________________________ ___ ___ MULTIPLE INDICATOR CLUSTER SURVEY 2011212 
 
 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 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 .__ __ MULTIPLE INDICATOR CLUSTER SURVEY 2011214 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011216 
 
 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011218 
 
 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011220 
 
 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011222 
 
 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011224 
 
 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011226 
 
 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 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. MULTIPLE INDICATOR CLUSTER SURVEY 2011228 INDONESIA 2011 INDONESIA MULTIPLE INDICATOR CLUSTER SURVEY PAPUA AND WEST PAPUA PROVINCE QUESTIONNAIRE FOR INDIVIDUAL MEN CONFIDENTIAL MAN’S INFORMATION PANEL 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011230 
 
 ATTITUDES
TOWARD
DOMESTIC
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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011232 
 
 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011234 
 
 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 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. MULTIPLE INDICATOR CLUSTER SURVEY 2011236 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011238 
 
 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011240 
 
 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011242 
 
 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 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 MULTIPLE INDICATOR CLUSTER SURVEY 2011244 
 
 is sometimes given at the same time as Polio and DPT vaccines 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. INDONESIA: SELECTED DISTRICTS OF WEST PAPUA PROVINCE MULTIPLE INDICATOR CLUSTER SURVEY 2011

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