39466 SOCIO-ECONOMIC DIFFERENCES IN HEALTH, NUTRITION, AND POPULATIO BURKINA FASO 1992/93, 1998/99, 2003 Davidson R. Gwatkin, Shea Rutstein, Kiersten Johnson, Eldaw Suliman, Adam Wagstaff, and Agbessi Amouzou TABLE OF CONTENTS Foreword I Introduction III Part I. Basic Tables, 2003 1 A. Total Population 3 B. Female and Male Populations 9 C. Rural and Urban Populations 13 Part II. Basic Tables, 1998 / 1999 19 A. Total Population 21 B. Female and Male Populations 27 C. Rural and Urban Populations 31 Part III. Basic Tables, 1992 / 1993 37 A. Total Population 39 B. Female and Male Populations 45 C. Rural and Urban Populations 49 Part IV. Technical Notes 55 A. Indicator Definitions 57 B. Data and Methods 71 C. Discussion 75 Part V. Supporting Tables, 2003 81 A. Sample Sizes 83 B. Standard Errors 89 C. Asset Distribution and Weights 95 Part VI. Supporting Tables, 1998 / 1999 97 A. Sample Sizes 99 B. Standard Errors 105 C. Asset Distribution and Weights 111 Part VII. Supporting Tables, 1992 / 1993 113 A. Sample Sizes 115 B. Standard Errors 121 C. Asset Distribution and Weights 127 Part VIII. Annexes 129 A. Sources of Additional Information 131 B. Use of Information from this 133 Report to Monitor the Economic Status of People Served by HNP Programs C. Countries Covered by the 139 HNP-Poverty Report Project FOREWORD The World Bank shares the desire of its member states and client countries to ensure that the poor partake fully in the health gains that the countries achieve. To assist in this, the Bank, in cooperation with the Dutch and Swedish Governments, has sponsored the set of reports providing basic information about health inequalities within countries to which this document belongs. The information shows clearly that disparities in both health conditions and health service use are unacceptably large. As countries and the Bank work to reduce important inequalities among regions and countries, there is a clear need for equally vigorous efforts to lessen the inequity represented by intra-country differences among socio-economic groups. My colleagues and I hope that all concerned with equity in health will find this information useful in making the case for effective actions to improve the health of the poor, and in designing programs to achieve this crucial objective. Joy Phumaphi Vice President Human Development Network The World Bank - I - INTRODUCTION This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty- five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006.1 The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. The figures in this and the other reports in the series draw on responses to questions about household wealth or assets included in the DHS questionnaire, which were similar for all the surveys covered. These responses served as the basis for the construction of a wealth index, which was used to rank individuals according to the index value for the household to which they belonged. The individuals were then divided into quintiles, and the mean value for each of up to approximately 120 indicators was calculated for each quintile. The report is organized in four principal parts: · Parts one, two, and three, which constitute the report's core, consist of tables presenting quintile-specific data for each hnp indicator covered from the two most recent DHS surveys available at the time of the report's publication. In each part there are three sets of tables: the first provides quintile-specific information for the total population; the second presents data separately for quintiles of females and males; the third features quintile-specific information presented separately for rural and urban residents. Each of these sets is divided into four sections: one dealing with hnp status, the second with the use of hnp services, the third with hnp-related behavior, and the fourth with other hnp status determinants. · Part four provides supplementary technical information designed to help readers understand the data presented in the three previous parts. This information deals with such issues as how the covered hnp indicators were defined and how the quintile-specific estimates were derived. · Parts five, six, and seven present supporting tables that deal with three of the technical matters covered in part four: the size of the sample for each indicator covered; the 1The average interval of approximately two years between data collection and availability means that the latest surveys covered were conducted in 2005. III standard error for each quintile-specific estimate in the total population; and the items used in constructing the wealth index, along with the weight assigned to each. An additional, eighth part consists of three annexes, for readers interested in applying the approach used in the report or in learning more about the other reports in this series. The first annex is an annotated bibliography containing further information about the technical issues concerning the approach used in the report, and about employing that approach to examine additional issues using DHS or other data sets. The second shows how the report's approach can be applied to monitor the distribution of benefits from other hnp programs, and provides a tool for doing so. The third annex is a list of all fifty-six countries for which reports are available, along with an indication of how to obtain copies of the reports dealing with them. ********************************* The authors thank the Dutch and Swedish Governments for the generous support that made production of this report possible. IV PART I. BASIC TABLES, 2003 A. TOTAL POPULATION B. FEMALE AND MALE POPULATIONS C. RURAL AND URBAN POPULATIONS Notes: ­ Each of the three sections referred to above consists of four divisions, presenting data for: I) hnp status; II) hnp service use; III) hnp-related individual and household behavior; and IV) other, underlying determinants of hnp status. ­ Full definitions of all indicators covered in the tables are provided in section A of the technical notes found in part II. ­ "na" appears in the table cells when data are not available, usually because the DHS survey concerned did not collect information about the indicator(s) in question. ­ Figures in the tables shown within parentheses indicate the absence of adequate observations to produce acceptably reliable values. Asterisks appear when the number of observations was too small to justify the presentation even of figures within parentheses. (For further information, see the section on "Sampling Errors" in the presentation of data and methods in part II.B.) Asterisks also will be found in columns showing statistical indices of inequality when the amount of quintile-specific information available is inadequate to permit computation of the value for the index concerned. ­ Female/male tables include only indicators relevant for both sexes; those pertaining to only one sex (e.g., fertility, women's nutritional status, antenatal care, attended deliveries) have been omitted. Bukina Faso 2003 - TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood illness and mortality Infant mortality rate 97.1 108.4 81.9 94.1 77.9 92.1 1.25 19.15 -0.0431 0.0195 Under-five mortality rate 206.3 213.1 195.7 192.5 144.1 193.2 1.43 62.20 -0.0510 0.0308 Prevalence of fever 37.3 36.5 39.6 37.7 30.1 36.7 1.24 7.15 -0.0066 0.0079 Prevalence of diarrhea 20.7 22.1 21.2 19.8 21.5 21.1 0.96 0.81 -0.0092 0.0115 Prevalence of acute respiratory 8.2 8.8 9.1 8.8 7.5 8.6 1.10 0.74 0.0026 0.0196 infection (ARI) B. Fertility Total fertility rate 6.6 6.8 6.4 6.5 3.6 5.9 1.84 3.02 -0.0973 0.0579 Adolescent fertility rate 142.3 161.9 138.7 132.6 61.1 119.2 2.33 81.16 -0.1581 0.0730 C. Nutritional status (%) Children: Moderate stunting 19.5 20.2 20.4 20.5 13.5 19.2 1.44 6.01 -0.0375 0.0125 Severe stunting 26.5 21.5 21.0 17.5 7.1 19.4 3.75 19.41 -0.1612 0.0126 Moderate underweight 25.9 25.1 25.5 24.9 16.0 24.0 1.61 9.85 -0.0620 0.0110 Severe underweight 16.4 14.9 15.0 13.6 6.3 13.7 2.61 10.14 -0.1170 0.0153 Mild anemia 20.6 16.4 16.2 19.0 21.6 18.3 0.95 0.99 0.0216 0.0247 Moderate anemia 61.5 63.8 62.2 57.8 51.5 60.1 1.20 10.04 -0.0349 0.0093 Severe anemia 10.7 14.6 14.2 17.2 7.2 13.2 1.48 3.47 0.0071 0.0269 Women: Malnutrition 24.3 23.4 23.2 19.4 8.9 19.5 2.74 15.44 -0.1435 0.0102 Mild anemia 17.8 14.9 16.1 17.3 14.7 16.0 1.21 3.09 -0.0153 0.0203 Moderate anemia 15.4 15.1 14.5 17.8 12.0 14.7 1.27 3.30 -0.0118 0.0209 Severe anemia 1.7 0.7 1.3 1.5 0.6 1.1 2.99 1.13 -0.1271 0.0812 D. Female circumcision (%) Prevalence of circumcision: Girls na na na na na na na na na na Women 77.3 80.1 80.6 81.7 76.9 79.2 1.01 0.40 0.0012 0.0030 Prevalence of occlusion: Girls 3.8 3.3 5.6 2.3 2.1 3.6 1.80 1.71 -0.0712 0.0548 Women 2.1 2.7 2.0 1.6 1.7 2.0 1.25 0.42 -0.0729 0.0395 E. Sexually transmitted disease Prevalence of genital discharge: Women 1.2 1.4 1.7 2.1 9.1 3.4 0.13 7.89 0.4609 0.0327 Men 1.4 0.4 1.6 2.5 2.0 1.6 0.67 0.66 0.1639 0.0722 Prevalence of genital ulcer: Women 0.2 0.3 0.3 0.5 2.5 0.9 0.09 2.28 0.5449 0.0688 Men 0.5 1.1 0.8 1.6 1.7 1.2 0.29 1.20 0.0970 0.0799 - 3 - Bukina Faso 2003 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood immunization BCG coverage 71.6 77.1 79.8 84.6 94.3 80.9 0.76 22.75 0.0485 0.0056 Measles coverage 48.0 54.6 53.9 54.9 70.9 55.8 0.68 22.91 0.0658 0.0117 DPT coverage 45.4 50.6 57.5 61.3 73.0 57.0 0.62 27.59 0.0971 0.0111 Full basic coverage 33.4 41.1 41.5 45.9 61.4 43.9 0.54 27.99 0.1029 0.0151 No basic coverage 10.7 12.3 12.1 4.6 4.4 9.2 2.45 6.32 -0.2013 0.0371 Hepatitis B coverage na na na na na na na na na na Yellow fever coverage na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 23.5 24.2 33.9 35.0 57.1 33.0 0.41 33.55 0.1705 0.0144 Treatment in a public facility 22.3 22.9 33.3 34.1 54.4 31.8 0.41 32.08 0.1715 0.0145 Treatment in a private facility 1.3 1.3 0.7 0.9 2.7 1.2 0.46 1.47 0.1703 0.1146 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 24.8 23.2 35.4 35.3 73.4 35.9 0.34 48.57 0.2088 0.0268 Treatment in a public facility 24.2 19.6 34.5 33.2 66.3 33.4 0.36 42.17 0.1990 0.0300 Treatment in a private facility 0.6 3.6 0.9 2.1 7.0 2.5 0.09 6.40 0.3511 0.1497 Treatment of diarrhea: Use of oral rehydration therapy 56.9 58.0 64.0 64.6 72.7 62.8 0.78 15.73 0.0445 0.0102 Medical treatment of diarrhea 8.8 15.0 19.3 12.9 31.4 17.2 0.28 22.56 0.2044 0.0285 Treatment in a public facility 8.1 14.3 19.3 12.1 29.4 16.4 0.27 21.34 0.1982 0.0296 Treatment in a private facility 0.8 0.8 0.0 0.8 2.0 0.7 0.38 1.22 0.3619 0.1880 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 56.3 62.2 72.9 81.0 95.8 72.8 0.59 39.43 0.1037 0.0037 To a doctor 1.6 1.5 0.8 2.1 8.1 2.5 0.20 6.53 0.2982 0.0527 To a nurse or trained midwife 54.7 60.7 72.1 78.8 87.7 70.3 0.62 32.90 0.0966 0.0042 Multiple visits to a medically-trained person 32.5 34.7 45.9 50.8 74.5 46.7 0.44 42.00 0.1694 0.0068 Antenatal care content: Tetanus toxoid 54.2 57.8 64.1 67.6 81.8 64.5 0.66 27.61 0.0785 0.0048 Prophylactic antimalarial treatment 48.4 53.2 62.9 69.1 87.4 63.3 0.55 39.00 0.1124 0.0046 Iron supplementation 55.5 60.4 70.5 74.5 88.4 69.3 0.63 32.97 0.0953 0.0042 Delivery attendance: By a medically-trained person 18.7 24.3 31.8 45.3 84.5 37.8 0.22 65.72 0.2956 0.0066 By a doctor 0.3 0.9 0.6 1.1 5.2 1.4 0.07 4.83 0.4080 0.0605 By a nurse or trained midwife 18.4 23.4 31.2 44.2 79.3 36.5 0.23 60.90 0.2916 0.0069 In a public facility 19.6 25.3 32.6 45.0 79.7 37.6 0.25 60.10 0.2789 0.0068 In a private facility 0.0 0.0 0.1 0.6 4.8 0.8 0.00 4.84 0.6286 0.0819 At home 80.2 74.6 67.2 54.1 15.3 61.3 5.23 64.87 -0.1798 0.0041 D. Contraceptive services Contraceptive prevalence: Women 1.8 4.5 6.2 6.9 26.8 8.8 0.07 24.99 0.4861 0.0223 Men na na na na na na na na na na - 4 - Bukina Faso 2003 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors D. Contraceptive services (cont.) Source of contraception - public sector: Women (65.2) 64.0 73.7 80.0 67.7 70.0 0.96 132.99 -0.0301 0.0147 Men na na na na na na na na na na Source of contraception - private sector: Women (28.3) 32.2 22.4 17.2 29.9 26.9 0.95 58.22 0.1073 0.0357 Men na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women (31.1) (41.0) 23.7 42.8 74.6 60.4 0.42 105.67 0.2077 0.0182 Men * * * * (32.6) 32.0 * * * * Treatment of genital discharge, ulcer, sore in public facilities: Women (31.1) (41.0) 23.7 42.8 74.6 60.4 0.42 105.67 0.2080 0.0183 Men * * * * (32.6) 32.0 * * * * Voluntary counseling and testing for HIV/AIDS: Women na na na na na na na na na na Men 1.8 1.6 3.6 6.7 17.2 7.1 0.10 15.49 0.4254 0.0400 - 5 - Bukina Faso 2003 - TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Hygienic practices Disposal of children's stools: Sanitary disposal 4.4 4.0 7.5 20.8 76.7 19.8 0.06 72.34 0.5935 0.0153 Handwashing: Wash hands prior to preparing food 96.7 97.0 97.2 97.3 96.1 96.8 1.01 0.60 0.0005 0.0010 Handwashing facilities in household 0.5 1.8 2.1 7.2 19.5 6.3 0.03 18.96 0.6422 0.0289 B. Bednet ownership and use Bednet ownership: Bednet ownership 34.1 39.7 37.3 38.6 51.5 40.4 0.66 17.38 0.1057 0.0074 Treated bednet ownership na na na na na na na na na na Bednet use: By children 25.0 22.1 21.3 20.5 30.1 23.3 0.83 5.16 0.0476 0.0110 By pregnant women 32.0 24.8 23.8 28.6 29.2 27.2 1.10 2.85 0.0374 0.0262 C. Breastfeeding Exclusive breastfeeding 16.6 20.6 18.3 23.2 27.7 20.3 0.60 11.03 0.0782 0.0437 Timely complementary feeding na na na na na na na na na na Bottle-feeding 0.4 0.2 0.9 0.6 6.8 1.3 0.06 6.39 0.6516 0.1542 D. Micronutrient consumption Iodized salt: Availability of iodized salt 35.8 40.4 45.5 52.7 64.3 47.5 0.56 28.46 0.1170 0.0062 in household Vitamin A: Children 23.4 28.9 29.6 36.4 47.6 32.2 0.49 24.28 0.1200 0.0090 Women 9.4 15.6 16.3 16.5 26.0 16.5 0.36 16.52 0.1701 0.0154 E. Tobacco and alcohol use Tobacco: Women 8.6 7.6 6.8 5.1 1.4 5.7 5.95 7.12 -0.2945 0.0210 Men na na na na na na na na na na Alcohol: Women 2.1 1.7 1.8 1.2 0.9 1.5 2.35 1.22 -0.2318 0.0448 Men 3.2 3.8 3.2 1.6 4.8 3.5 0.67 1.58 -0.0410 0.0526 F. Sexual practices Non-regular sexual partnerships: Women 0.2 0.4 0.3 0.6 1.0 0.5 0.17 0.86 0.2889 0.0751 Men 2.1 4.0 4.5 4.1 13.4 6.4 0.16 11.28 0.3240 0.0399 Condom usage with non-regular partner: Women * * * * (80.0) 61.1 * * * * Men * (53.2) (67.3) * 96.1 82.2 * * * * G. Domestic violence Ever experienced violence na na na na na na na na na na Experienced violence in past year na na na na na na na na na na - 6 - Bukina Faso 2003 - TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Education School completion: Women 2.8 3.4 5.8 8.7 46.3 15.1 0.06 43.50 0.5783 0.0131 Men 7.0 9.6 13.1 19.6 61.2 25.8 0.12 54.16 0.4431 0.0088 School participation: Girls 10.5 14.6 19.7 20.4 63.3 24.3 0.17 52.82 0.3481 0.0144 Boys 21.7 29.7 35.9 43.5 80.5 42.6 0.27 58.87 0.2687 0.0072 B. Exposure to mass media Newspaper readership: Women 0.5 0.5 0.8 2.5 20.5 5.7 0.03 19.91 0.6736 0.0285 Men 0.5 2.3 3.3 7.0 31.3 10.8 0.01 30.84 0.5968 0.0327 Radio listenership: Women 21.6 48.8 47.0 56.2 75.0 51.0 0.29 53.32 0.1935 0.0046 Men 37.9 68.7 72.2 76.7 89.9 71.6 0.42 52.02 0.1235 0.0057 Television viewership: Women 2.8 3.9 5.6 12.3 68.6 20.9 0.04 65.83 0.6321 0.0107 Men 4.9 7.3 15.7 23.0 77.3 30.2 0.06 72.40 0.5065 0.0121 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 60.2 62.9 62.4 66.2 84.4 68.0 0.71 24.24 0.0785 0.0034 Men 76.5 75.6 78.5 80.5 93.6 82.0 0.82 17.11 0.0473 0.0043 Knowledge about mother-to-child transmission of HIV/AIDS: Women 49.2 53.3 56.3 60.4 80.3 60.9 0.61 31.08 0.1060 0.0039 Men 63.8 63.7 68.1 72.5 90.6 73.3 0.70 26.83 0.0804 0.0054 Attitudes toward HIV/AIDS: Women 49.5 47.5 52.5 52.6 61.7 53.4 0.80 12.27 0.0538 0.0050 Men 64.1 64.1 62.9 66.8 83.4 69.6 0.77 19.38 0.0661 0.0063 D. Status of women Household decisionmaking: Can seek own health care 7.5 5.7 6.7 8.6 21.9 10.6 0.34 14.37 0.1964 0.0162 Can seek children's health care 71.4 71.5 75.4 78.7 85.7 76.4 0.83 14.32 0.0426 0.0033 Can make daily household purchases 35.8 33.8 34.8 31.9 33.2 33.9 1.08 2.61 -0.0348 0.0073 Can make large household purchases 24.2 21.6 20.8 17.5 23.9 21.7 1.01 0.31 -0.0384 0.0101 Can make meal-related decisions 56.0 56.3 53.4 51.3 40.7 51.0 1.38 15.31 -0.0684 0.0051 Freedom of movement: Can travel to visit family, relatives 16.1 15.8 14.3 13.6 24.5 17.2 0.66 8.43 0.0508 0.0121 Other decisionmaking, attitudes: Can decide how to spend own money 90.4 84.9 85.9 89.6 86.5 87.0 1.05 3.94 0.0006 0.0046 Can decide whether to have sex 92.1 93.4 92.2 93.5 91.8 92.5 1.00 0.30 -0.0018 0.0015 Justifies domestic violence 71.9 71.0 74.9 78.3 61.8 71.1 1.16 10.17 -0.0243 0.0035 E. Orphanhood Paternal orphan prevalence 5.5 4.9 3.8 5.0 7.6 5.2 0.72 2.17 0.0573 0.0162 Maternal orphan prevalence 2.3 2.9 2.4 2.2 3.5 2.7 0.66 1.19 0.0442 0.0216 Double orphan prevalence 0.4 0.8 0.6 0.6 1.5 0.8 0.25 1.17 0.2151 0.0422 - 7 - Bukina Faso 2003 - FEMALE / MALE POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood mortality and morbidity Infant mortality rate 90.0 109.9 80.1 89.7 70.1 88.6 103.7 106.9 83.8 98.3 85.8 95.5 Under-five mortality rate 194.9 215.7 200.9 188.9 140.7 191.7 217.1 210.4 190.9 196.0 147.5 194.7 Prevalence of fever 37.5 36.5 38.6 36.5 30.4 36.3 37.1 36.5 40.5 38.8 29.9 37.1 Prevalence of diarrhea 20.0 17.5 21.5 19.2 20.8 19.9 21.4 26.2 20.9 20.4 22.2 22.2 Prevalence of acute respiratory 8.0 8.1 8.1 8.4 7.3 8.0 8.5 9.3 10.0 9.1 7.7 9.1 infection (ARI) B. Nutritional status Children: Moderate stunting 18.1 18.3 19.9 19.4 13.6 18.2 21.0 21.9 20.8 21.6 13.5 20.1 Severe stunting 27.4 18.9 20.8 16.3 6.3 18.7 25.5 23.8 21.2 18.7 7.8 20.1 Moderate underweight 24.1 24.0 24.8 26.8 14.9 23.4 27.7 26.1 26.1 23.1 17.2 24.5 Severe underweight 18.5 13.9 15.0 12.3 6.4 13.7 14.3 15.8 15.0 14.8 6.2 13.7 Mild anemia 21.1 17.4 16.1 24.1 24.0 19.9 20.0 15.5 16.3 14.7 19.1 16.8 Moderate anemia 61.1 62.9 63.6 57.5 46.0 59.3 61.9 64.6 60.9 58.1 57.1 60.8 Severe anemia 11.7 15.3 12.2 11.9 9.4 12.4 9.4 14.0 16.1 21.7 5.0 14.1 C. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na Men 1.1 0.7 1.3 1.3 1.3 1.1 Prevalence of genital ulcer: Women na na na na na na Men 0.8 0.7 0.4 1.6 1.1 0.9 - 9 - Bukina Faso 2003 - FEMALE / MALE POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 75.6 76.0 79.6 81.8 91.9 80.5 67.8 78.0 80.0 87.3 96.7 81.4 Measles coverage 51.7 53.1 55.6 60.4 73.4 58.1 44.4 55.8 52.0 49.3 68.4 53.5 DPT coverage 49.7 49.1 57.4 57.9 72.7 56.9 41.2 51.9 57.5 64.7 73.2 57.2 Full basic coverage 35.6 40.5 44.8 47.1 63.1 45.6 31.3 41.6 37.7 44.7 59.8 42.2 No basic coverage 9.8 12.5 12.5 3.8 5.4 9.2 11.5 12.2 11.6 5.4 3.3 9.3 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 20.2 21.5 28.2 37.5 52.7 30.1 26.9 26.6 39.1 32.7 61.6 35.6 Treatment in a public facility 18.8 20.3 27.6 36.4 49.6 28.8 25.8 25.2 38.3 32.1 59.3 34.5 Treatment in a private facility 1.4 1.2 0.6 1.1 3.2 1.3 1.1 1.3 0.8 0.7 2.3 1.1 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 25.0 20.8 34.9 32.7 80.5 36.2 24.6 25.1 35.8 37.6 66.5 35.6 Treatment in a public facility 23.7 17.9 33.9 28.9 68.4 32.6 24.6 20.9 35.0 37.0 64.4 34.1 Treatment in a private facility 1.3 2.9 1.0 3.7 12.1 3.5 0.0 4.2 0.8 0.6 2.1 1.5 Treatment of diarrhea: Use of oral rehydration therapy 57.2 60.1 63.4 60.9 70.9 62.4 56.7 56.8 64.5 68.0 74.3 63.2 Medical treatment of diarrhea 7.1 9.9 22.6 11.2 29.0 16.3 10.5 18.0 16.2 14.5 33.7 17.9 Treatment in a public facility 6.6 9.9 22.6 10.8 27.0 15.8 9.5 16.8 16.2 13.3 31.7 16.9 Treatment in a private facility 0.5 0.0 0.0 0.4 2.0 0.5 1.0 1.2 0.0 1.1 2.0 1.0 C. Contraceptive services Contraceptive prevalence: Women 22.5 27.7 31.5 41.8 49.3 34.9 Men 14.6 17.7 26.5 40.2 38.0 27.3 Source of contraception - public sector: Women 73.0 71.1 58.2 50.1 40.5 54.9 Men na na na na na na Source of contraception - private sector: Women 7.8 18.5 32.6 42.7 55.1 36.4 Men na na na na na na D. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na Men * * * (72.0) (72.0) 62.1 Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men * * * (72.0) (72.0) 62.1 Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men 0.4 1.0 2.9 6.3 13.7 5.3 - 10 - Bukina Faso 2003 - FEMALE / MALE POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal 4.4 4.0 7.5 20.8 76.7 19.8 Handwashing: Wash hands prior to preparing food 96.7 97.0 97.2 97.3 96.1 96.8 Handwashing facilities in household 0.5 1.8 2.1 7.2 19.5 6.3 B. Bednet ownership and use Bednet use: By children 25.0 22.1 21.3 20.5 30.1 23.3 C. Breastfeeding Exclusive breastfeeding 7.0 20.7 16.7 (18.4) (39.5) 18.5 25.3 20.6 20.3 26.6 (15.0) 22.1 Timely complementary feeding na na na na na na na na na na na na Bottle-feeding 0.0 0.3 1.2 1.1 4.8 1.2 0.8 0.1 0.5 0.2 8.7 1.4 D. Micronutrient consumption Vitamin A: Children 24.5 30.7 29.4 39.1 50.5 33.7 22.1 27.3 29.9 33.8 44.8 30.8 E. Tobacco and alcohol use Tobacco: Women na na na na na na Men na na na na na na Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 1.3 0.8 0.8 0.9 1.2 1.0 Men 4.7 7.3 6.1 8.1 12.7 8.0 Condom usage with non-regular partner: Women (2.4) (9.1) (16.4) (15.4) 35.6 18.2 Men (15.9) 26.3 29.5 48.8 47.6 38.4 - 11 - Bukina Faso 2003 - FEMALE / MALE POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 36.4 57.1 73.5 84.6 93.3 72.6 Men 60.5 78.5 88.0 93.1 97.9 85.2 School participation: Girls 41.9 39.5 58.7 77.4 85.4 57.1 Boys 86.0 82.9 88.0 96.0 97.4 89.3 B. Exposure to mass media Newspaper readership: Women 6.4 20.8 38.7 53.6 71.5 42.4 Men 11.6 32.1 56.9 67.4 83.4 53.0 Radio listenership: Women 62.0 82.5 85.6 89.7 91.0 83.8 Men 78.0 91.4 92.5 94.1 90.9 89.9 Television viewership: Women 6.5 41.8 83.7 94.0 98.3 71.0 Men 10.6 49.7 86.0 95.3 98.5 71.4 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 60.2 62.9 62.4 66.2 84.4 68.0 Men 76.5 75.6 78.5 80.5 93.6 82.0 Knowledge about mother-to-child transmission of HIV/AIDS: Women 49.2 53.3 56.3 60.4 80.3 60.9 Men 63.8 63.7 68.1 72.5 90.6 73.3 Attitudes toward HIV/AIDS: Women 49.5 47.5 52.5 52.6 61.7 53.4 Men 64.1 64.1 62.9 66.8 83.4 69.6 D. Orphanhood Paternal orphan prevalence 5.1 4.9 4.0 4.2 8.3 5.2 5.8 4.9 3.7 5.7 6.9 5.2 Maternal orphan prevalence 2.5 2.8 2.3 1.1 4.1 2.5 2.2 3.1 2.6 3.2 3.0 2.8 Double orphan prevalence 0.5 0.9 0.7 0.3 2.0 0.9 0.3 0.7 0.5 0.9 1.0 0.7 - 12 - Bukina Faso 2003 - RURAL / URBAN POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 97.3 108.6 81.9 96.1 98.7 95.3 50.5 65.8 81.4 75.4 69.2 70.2 Under-five mortality rate 206.2 213.8 196.0 194.8 179.4 201.5 220.8 103.1 169.6 171.6 129.3 136.4 Prevalence of fever 37.4 36.5 39.5 38.7 36.4 38.0 * * (48.9) 29.2 27.7 28.5 Prevalence of diarrhea 20.7 22.2 21.2 19.6 19.8 21.0 * * (18.6) 21.8 22.1 21.9 Prevalence of acute respiratory infection 8.2 8.8 9.1 8.6 6.9 8.6 * * (7.5) 9.9 7.7 8.0 B. Fertility Total fertility rate 6.6 6.8 6.4 6.5 5.6 6.5 6.6 6.0 6.2 5.9 3.0 3.4 Adolescent fertility rate 142.3 162.6 138.2 138.5 98.6 142.6 139.9 169.8 100.4 54.9 59.9 0.0 C. Nutritional status Children: Moderate stunting 19.5 20.1 20.4 21.0 17.3 20.1 * * * 16.7 12.1 13.2 Severe stunting 26.5 21.6 21.1 18.0 11.8 21.3 * * * 13.5 5.3 6.7 Moderate underweight 26.0 25.1 25.5 26.0 20.9 25.4 * * * 15.0 14.3 14.7 Severe underweight 16.4 14.9 15.1 13.7 11.4 14.9 * * * 13.2 4.4 5.8 Mild anemia 20.4 16.5 16.1 18.9 11.8 17.4 * * * (19.8) 26.4 25.5 Moderate anemia 61.7 63.8 62.2 57.8 69.1 62.0 * * * (57.6) 42.7 45.3 Severe anemia 10.7 14.6 14.3 18.2 12.4 14.3 * * * (7.5) 4.7 5.3 Women: Malnutrition 24.4 23.4 23.2 20.1 14.4 22.4 * * (21.4) 13.5 7.5 8.3 Mild anemia 17.8 14.8 16.3 17.1 17.7 16.5 * * * 19.5 13.9 14.4 Moderate anemia 15.4 15.1 14.4 17.0 11.2 15.1 * * * 23.9 12.3 13.4 Severe anemia 1.7 0.8 1.3 1.5 1.0 1.3 * * * 1.1 0.5 0.6 D. Female circumcision Prevalence of circumcision: Girls na na na na na na na na na na na na Women 77.2 80.4 80.7 82.1 81.2 80.2 * * (75.2) 78.4 75.8 75.9 Prevalence of occlusion: Girls 3.8 3.3 5.7 2.5 3.6 3.9 * * * 0.0 1.5 1.3 Women 2.1 2.7 2.0 1.5 1.5 2.0 * * (1.4) 2.2 1.7 1.7 E. Sexually transmitted disease Prevalence of genital discharge: Women 1.2 1.4 1.7 1.8 4.2 1.7 * * (3.4) 4.8 10.2 9.5 Men 1.4 0.4 1.6 2.8 0.0 1.4 * * * 0.0 2.5 2.3 Prevalence of genital ulcer: Women 0.2 0.3 0.3 0.3 0.5 0.3 * * (1.5) 1.7 3.0 2.8 Men 0.5 1.1 0.9 1.8 0.0 1.0 * * * 0.0 2.1 1.9 - 13 - Bukina Faso 2003 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 71.5 77.0 79.8 83.1 89.3 78.7 * * * (99.1) 96.9 96.5 Measles coverage 47.9 54.4 53.7 54.1 62.7 53.4 * * * (62.0) 75.0 72.7 DPT coverage 45.5 50.4 57.5 60.9 67.8 54.7 * * * (65.4) 75.5 73.0 Full basic coverage 33.5 40.9 41.5 45.8 51.1 41.2 * * * (46.2) 66.5 62.5 No basic coverage 10.7 12.3 12.1 5.0 6.8 10.1 * * * (0.9) 3.1 3.2 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood diseases Treatment of fever: Medical treatment of fever 23.4 24.2 33.9 34.2 54.7 30.5 * * * 43.2 58.3 54.8 Treatment in a public facility 22.1 22.9 33.3 33.6 54.2 29.6 * * * 40.2 54.4 51.0 Treatment in a private facility 1.3 1.3 0.6 0.7 0.4 0.9 * * * 3.0 3.9 3.8 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 24.5 23.0 35.6 33.8 (81.7) 31.7 * * * * 70.5 65.4 Treatment in a public facility 23.8 19.3 34.8 31.4 (81.7) 29.9 * * * * 61.0 57.9 Treatment in a private facility 0.6 3.6 0.9 2.4 0.0 1.7 * * * * 9.5 7.5 Treatment of diarrhea: Use of oral rehydration therapy 57.1 57.9 64.2 64.8 71.0 61.5 * * * (63.0) 73.2 70.9 Medical treatment of diarrhea 8.9 14.9 19.4 13.0 19.2 14.9 * * * (12.2) 35.7 31.7 Treatment in a public facility 8.1 14.2 19.4 12.3 19.2 14.4 * * * (10.6) 33.0 29.2 Treatment in a private facility 0.8 0.8 0.0 0.7 0.0 0.5 * * * (1.7) 2.7 2.5 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 56.2 62.1 72.8 79.5 91.9 68.9 * * * 95.0 97.2 96.4 To a doctor 1.6 1.5 0.8 1.6 2.9 1.4 * * * 6.8 10.0 9.4 To a nurse or trained midwife 54.6 60.6 72.0 77.8 88.9 67.5 * * * 88.1 87.2 87.1 Multiple visits to a medically-trained person 32.4 34.8 45.8 49.4 62.3 41.8 * * * 63.9 78.9 76.1 Antenatal care content: Tetanus toxoid 54.2 57.7 64.0 66.8 77.9 61.6 * * * 74.7 83.3 81.8 Prophylactic antimalarial treatment 48.3 53.1 62.8 67.6 84.0 59.4 * * * 82.5 88.6 87.2 Iron supplementation 55.4 60.4 70.5 74.2 84.8 66.3 * * * 77.3 89.8 87.7 Delivery attendance: By a medically-trained person 18.6 24.2 31.6 42.4 63.6 30.5 * * (52.1) 70.5 92.7 87.7 By a doctor 0.3 0.9 0.6 0.7 0.0 0.6 * * (3.0) 4.4 7.2 6.6 By a nurse or trained midwife 18.3 23.4 31.0 41.7 63.6 29.9 * * (49.1) 66.1 85.5 81.1 In a public facility 19.5 25.2 32.3 42.4 64.5 31.2 * * (54.2) 67.3 85.7 81.6 In a private facility 0.0 0.0 0.1 0.3 0.5 0.1 * * 0.0 2.4 6.6 5.7 At home 80.3 74.6 67.4 57.0 35.0 68.5 * * (45.8) 29.2 7.5 12.4 D. Contraceptive services Contraceptive prevalence: Women 1.8 4.5 6.1 6.2 14.5 5.2 * * (13.0) 14.0 31.0 28.5 Men na na na na na na na na na na na na - 14 - Bukina Faso 2003 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - public sector: Women (64.6) 63.5 73.0 79.0 87.1 73.8 * * * * 64.6 66.2 Men na na na na na na na na na na na na Source of contraception - private sector: Women (28.9) 32.6 23.0 18.6 9.6 22.4 * * * * 33.2 31.6 Men na na na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women (31.1) (41.0) 22.6 (29.5) (82.2) 37.7 * * 73.9 * * 74.0 Men * * * * * 31.0 (33.4) * * * * (33.4) Treatment of genital discharge, ulcer, sore in public facilities: Women (31.1) (41.0) 22.6 (29.5) (82.2) 37.7 * * 73.9 na na 74.0 Men * * * * * 31.0 (33.4) * * * * (33.4) Voluntary counseling and testing for HIV/AIDS: Women na na na na na na na na na na na na Men 1.8 1.6 3.7 6.4 10.4 3.7 * * * 9.7 18.8 17.9 - 15 - Bukina Faso 2003 - RURAL / URBAN POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal 4.4 4.0 7.4 17.9 43.3 9.8 * * * 47.7 89.4 81.5 Handwashing: Wash hands prior to preparing food 96.7 97.0 97.2 97.4 96.9 97.1 * * (96.5) 96.7 95.9 96.0 Handwashing facilities in household 0.5 1.8 2.0 6.1 5.8 2.5 * * (6.7) 14.5 22.6 21.3 B. Bednet ownership and use Bednet ownership: Bednet ownership 34.0 39.7 37.5 40.6 61.4 38.8 * * (24.6) 25.1 49.2 46.4 Treated bednet ownership na na na na na na na na na na na na Bednet use: By children 24.8 22.0 21.4 20.9 37.3 23.0 * * (12.4) 16.4 27.3 25.6 By pregnant women 32.2 24.7 24.0 28.6 25.8 26.8 * * * * 30.7 29.7 C. Breastfeeding Exclusive breastfeeding 16.8 20.7 18.4 20.8 (34.6) 19.6 * * * * 24.6 26.4 Timely complementary feeding na na na na na na na na na na na na Bottle-feeding 0.4 0.2 0.9 0.1 4.0 0.6 * * * (4.6) 7.9 7.1 D. Micronutrient consumption Iodized salt: Availability of iodized salt 35.8 40.4 45.2 51.4 52.3 42.9 * * (68.8) 63.1 67.1 66.4 in household Vitamin A: Children 23.3 28.9 29.6 36.1 39.2 29.8 * * (36.1) 39.1 51.0 48.6 Women 9.4 15.5 16.4 15.6 23.6 14.9 * * * 24.1 26.8 26.1 E. Tobacco and alcohol use Tobacco: Women 8.6 7.6 6.9 5.4 3.1 6.9 * * (1.4) 3.0 1.0 1.2 Men na na na na na na na na na na na na Alcohol: Women 2.1 1.7 1.8 1.2 0.6 1.7 * * (1.5) 1.6 1.0 1.0 Men 3.3 3.8 3.3 1.8 3.2 3.1 * * * 0.0 5.2 4.7 F. Sexual practices Non-regular sexual partnerships: Women 0.2 0.4 0.3 0.4 0.0 0.3 * * 0.0 1.8 1.3 1.3 Men 2.2 4.0 4.5 3.9 7.3 4.0 * * * 5.8 14.8 13.9 Condom usage with non-regular partner: Women * * * * na (43.7) * * (80.0) na na (76.3) Men * (53.2) (67.3) * * 65.9 * 96.8 na na na 96.9 G. Domestic violence Ever experienced violence na na na na na na na na na na na na Experienced violence in past year na na na na na na na na na na na na - 16 - Bukina Faso 2003 - RURAL / URBAN POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 2.8 3.3 5.6 6.6 24.0 5.8 * * (15.4) 25.3 51.7 48.4 Men 7.0 9.3 12.9 17.6 45.7 13.8 * * (26.8) 35.7 64.7 61.7 School participation: Girls 10.4 14.5 19.3 17.8 50.1 17.6 * * * 46.5 68.4 65.0 Boys 21.5 29.6 35.5 40.2 64.4 33.9 * * (58.6) 70.4 86.6 83.7 B. Exposure to mass media Newspaper readership: Women 0.5 0.5 0.9 1.8 8.6 1.3 * * (0.3) 7.8 23.3 21.4 Men 0.5 2.3 3.2 6.5 13.0 3.7 * * * 11.2 35.5 33.3 Radio listenership: Women 21.6 48.6 46.7 54.8 63.9 44.1 * * (63.7) 66.8 77.6 76.3 Men 37.8 68.7 72.1 75.6 81.4 65.4 * * * 85.5 91.8 91.2 Television viewership: Women 2.7 3.8 5.6 9.7 39.3 7.3 * * (11.3) 32.7 75.6 70.2 Men 4.9 7.2 15.7 21.8 53.4 14.9 * * * 32.7 82.8 78.2 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 60.2 62.8 62.3 65.0 73.3 63.1 * * (74.5) 75.1 87.1 85.7 Men 76.6 75.7 78.6 79.6 92.5 78.5 * * * 87.8 93.9 93.1 Knowledge about mother-to-child transmission of HIV/AIDS: Women 49.2 53.2 56.1 58.6 67.1 55.0 * * (70.5) 74.6 83.5 82.3 Men 63.8 63.6 67.8 71.2 85.7 67.7 * * * 83.3 91.7 90.9 Attitudes toward HIV/AIDS: Women 49.5 47.6 52.4 51.9 61.6 51.1 * * (56.0) 57.7 61.8 61.2 Men 64.2 64.2 62.8 66.2 69.5 64.6 * * * 71.6 86.6 85.0 D. Status of women Household decisionmaking: Can seek own health care 7.4 5.7 6.6 6.2 8.9 6.6 * * (10.2) 26.8 25.0 24.8 Can seek children's health care 71.5 71.5 75.4 77.8 79.8 74.3 * * (76.2) 86.5 87.7 87.1 Can make daily household purchases 35.8 33.9 34.8 30.6 35.6 34.1 * * (38.6) 41.6 32.6 33.5 Can make large household purchases 24.1 21.6 20.9 15.9 20.6 20.8 * * (17.7) 29.4 24.6 24.9 Can make meal-related decisions 55.9 56.2 53.4 51.2 47.9 53.9 * * (55.4) 51.8 38.9 40.6 Freedom of movement: Can travel to visit family, relatives 16.0 15.8 14.3 11.7 16.3 14.7 * * (10.4) 28.1 26.5 26.4 Other decisionmaking, attitudes: Can decide how to spend own money 90.3 84.9 86.0 87.7 83.4 86.6 * * * 94.1 86.9 87.5 Can decide whether to have sex 92.0 93.4 92.2 93.4 92.0 92.7 * * (96.7) 94.5 91.7 92.1 Justifies domestic violence 71.8 71.0 75.0 78.4 75.0 74.0 * * (71.8) 77.5 58.6 60.7 E. Orphanhood Paternal orphan prevalence 5.4 4.7 3.8 4.6 4.1 4.5 (14.2) (19.6) 4.9 9.3 9.1 9.1 Maternal orphan prevalence 2.4 2.9 2.4 2.2 3.0 2.5 0.0 (4.2) 2.5 2.0 3.7 3.5 Double orphan prevalence 0.4 0.8 0.6 0.6 1.4 0.6 0.0 0.0 0.2 0.9 1.6 1.5 - 17 - PART II. BASIC TABLES, 1998 / 1999 A. TOTAL POPULATION B. FEMALE AND MALE POPULATIONS C. RURAL AND URBAN POPULATIONS Notes: ­ Each of the three sections referred to above consists of four divisions, presenting data for: I) hnp status; II) hnp service use; III) hnp-related individual and household behavior; and IV) other, underlying determinants of hnp status. ­ Full definitions of all indicators covered in the tables are provided in section A of the technical notes found in part II. ­ "na" appears in the table cells when data are not available, usually because the DHS survey concerned did not collect information about the indicator(s) in question. ­ Figures in the tables shown within parentheses indicate the absence of adequate observations to produce acceptably reliable values. Asterisks appear when the number of observations was too small to justify the presentation even of figures within parentheses. (For further information, see the section on "Sampling Errors" in the presentation of data and methods in part II.B.) Asterisks also will be found in columns showing statistical indices of inequality when the amount of quintile-specific information available is inadequate to permit computation of the value for the index concerned. ­ Female/male tables include only indicators relevant for both sexes; those pertaining to only one sex (e.g., fertility, women's nutritional status, antenatal care, attended deliveries) have been omitted. Bukina Faso 1998 / 99 - TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood illness and mortality Infant mortality rate 106.2 118.5 118.0 116.5 76.7 108.6 1.38 29.50 -0.0311 0.0010 Under-five mortality rate 239.2 250.1 220.1 232.2 154.5 224.1 1.55 84.70 -0.0574 0.0009 Prevalence of fever 35.0 38.1 36.5 35.4 33.6 35.8 1.04 1.40 -0.0179 0.0104 Prevalence of diarrhea 17.8 19.1 20.4 21.5 22.0 20.0 0.81 4.20 0.0342 0.0154 Prevalence of acute respiratory 14.2 15.6 13.5 12.1 11.3 13.5 1.26 2.90 -0.0579 0.0197 infection (ARI) B. Fertility Total fertility rate 7.2 6.9 6.8 7.0 4.5 6.4 1.60 2.70 -0.0700 0.0007 Adolescent fertility rate 168.0 129.0 148.0 148.0 90.0 131.0 1.87 78.00 -0.0926 0.0019 C. Nutritional status (%) Children: Moderate stunting 20.9 21.1 20.1 23.2 15.0 20.2 1.39 5.90 -0.0476 0.0179 Severe stunting 20.9 18.3 16.1 16.2 11.2 16.6 1.87 9.70 -0.1183 0.0199 Moderate underweight 23.0 24.7 23.6 22.3 18.8 22.6 1.22 4.17 -0.0443 0.0168 Severe underweight 15.6 13.5 12.1 11.1 5.8 11.8 2.68 9.75 -0.1627 0.0245 Mild anemia na na na na na na na na na na Moderate anemia na na na na na na na na na na Severe anemia na na na na na na na na na na Women: Malnutrition 15.6 15.5 14.1 11.0 9.2 13.3 1.70 6.40 -0.1119 0.0248 Mild anemia na na na na na na na na na na Moderate anemia na na na na na na na na na na Severe anemia na na na na na na na na na na D. Female circumcision (%) Prevalence of circumcision: Girls 28.2 26.6 24.8 23.7 20.2 24.7 1.40 8.00 -0.0865 0.0117 Women 64.9 69.4 70.6 72.3 80.3 71.6 0.81 15.40 0.0342 0.0047 Prevalence of occlusion: Girls na na na na na na na na na na Women 0.1 0.2 0.0 0.4 0.6 0.3 0.17 0.50 0.3498 0.1813 E. Sexually transmitted disease Prevalence of genital discharge: Women 0.0 0.2 0.0 0.1 0.6 0.2 0.00 0.60 0.7777 0.2471 Men 0.0 1.7 2.0 1.5 3.4 1.9 0.00 3.40 0.3126 0.0906 Prevalence of genital ulcer: Women 0.0 0.0 0.0 0.0 0.1 0.0 0.00 0.10 1.4666 1.0380 Men 0.0 0.5 0.3 0.2 1.9 0.7 0.00 1.90 0.6775 0.1898 - 21 - Bukina Faso 1998 / 99 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood immunization BCG coverage 61.1 72.5 67.4 73.6 90.5 72.3 0.68 29.40 0.0743 0.0101 Measles coverage 33.2 41.7 42.6 47.8 69.3 45.8 0.48 36.10 0.1557 0.0185 DPT coverage 28.3 38.4 33.9 44.3 64.9 41.0 0.44 36.64 0.1778 0.0205 Full basic coverage 21.4 24.3 21.7 32.1 52.1 29.3 0.41 30.70 0.2137 0.0278 No basic coverage 17.1 16.5 11.7 10.9 2.2 12.3 7.77 14.90 -0.2483 0.0425 Hepatitis B coverage na na na na na na na na na na Yellow fever coverage 23.1 31.6 30.8 37.6 59.7 35.4 0.39 36.60 0.2014 0.0244 B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 8.9 8.8 14.7 11.8 31.8 14.0 0.28 22.90 0.2924 0.0366 Treatment in a public facility 8.3 8.8 14.4 11.6 30.8 13.6 0.27 22.50 0.2931 0.0372 Treatment in a private facility 0.5 0.0 0.4 0.2 0.9 0.4 0.56 0.40 0.3714 0.2589 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 13.8 12.5 23.0 24.9 49.7 21.9 0.28 35.90 0.3174 0.0453 Treatment in a public facility 13.2 12.5 22.0 24.2 46.2 21.0 0.29 33.00 0.3084 0.0463 Treatment in a private facility 0.7 0.0 1.0 0.6 1.8 0.7 0.39 1.10 0.8456 0.3637 Treatment of diarrhea: Use of oral rehydration therapy 44.8 39.3 40.3 46.1 60.5 46.0 0.74 15.74 0.0737 0.0254 Medical treatment of diarrhea 14.7 12.8 19.4 16.2 34.2 18.9 0.43 19.50 0.2007 0.0401 Treatment in a public facility 13.2 11.8 19.4 16.2 33.2 18.2 0.40 20.00 0.2132 0.0404 Treatment in a private facility 1.1 1.0 0.0 0.0 1.0 0.6 1.10 0.10 -0.2698 0.2640 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 50.0 55.1 58.8 67.6 89.7 63.0 0.56 39.70 0.1164 0.0079 To a doctor 0.3 0.3 0.6 3.4 6.4 2.0 0.05 6.10 0.7597 0.0920 To a nurse or trained midwife 49.7 54.7 58.1 64.1 83.2 60.9 0.60 33.50 0.1064 0.0069 Multiple visits to a medically-trained person 35.5 38.0 39.7 48.0 71.4 45.4 0.50 35.90 0.1601 0.0095 Antenatal care content: Tetanus toxoid 45.1 53.7 50.7 54.9 78.9 55.8 0.57 33.79 0.1133 0.0074 Prophylactic antimalarial treatment na na na na na na na na na na Iron supplementation na na na na na na na na na na Delivery attendance: By a medically-trained person 17.9 20.8 21.9 32.4 75.0 30.9 0.24 57.10 0.3538 0.0111 By a doctor 0.2 0.6 0.3 0.4 2.9 0.8 0.07 2.70 0.7559 0.1259 By a nurse or trained midwife 17.7 20.2 21.6 31.9 72.1 30.2 0.25 54.40 0.3437 0.0114 In a public facility 19.6 23.1 22.8 31.7 71.5 31.4 0.27 51.90 0.3062 0.0110 In a private facility 0.1 0.0 0.0 0.3 4.4 0.7 0.02 4.30 1.3870 0.1690 At home 79.9 76.3 76.9 67.7 23.4 67.4 3.41 56.50 -0.1568 0.0051 D. Contraceptive services Contraceptive prevalence: Women 1.8 2.6 2.9 2.4 16.0 4.8 0.11 14.20 0.5747 0.0434 Men 4.8 8.4 11.9 11.2 30.1 13.5 0.16 25.30 0.3993 0.0405 - 22 - Bukina Faso 1998 / 99 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors D. Contraceptive services (cont.) Source of contraception - public sector: Women * (59.1) * * 71.6 70.7 * * * * Men na na na na na na na na na na Source of contraception - private sector: Women * (40.9) * * 25.3 26.0 * * * * Men na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women * * * * (71.9) 45.1 * * * * Men * * * * (54.1) 43.1 * * * * Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na Men * * * * (84.2) 82.5 * * * * Voluntary counseling and testing for HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na - 23 - Bukina Faso 1998 / 99 - TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na na na na na Treated bednet ownership na na na na na na na na na na Bednet use: By children na na na na na na na na na na By pregnant women na na na na na na na na na na C. Breastfeeding Exclusive breastfeeding 0.7 2.7 8.0 4.7 15.8 5.3 0.04 15.10 0.5498 0.1253 Timely complementary feeding 36.0 42.8 49.3 58.4 70.3 49.8 0.51 34.30 0.1375 0.0272 Bottle-feeding 0.0 0.4 0.0 1.1 4.5 1.0 0.00 4.50 0.9529 0.2606 D. Micronutrient consumption Iodized salt: Availability of iodized salt na na na na na na na na na na in household Vitamin A: Children na na na na na na na na na na Women na na na na na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na na na na na Men na na na na na na na 0.00 na na na Alcohol: Women na na na na na na na na na na Men na na na na na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 1.2 1.6 1.2 1.1 1.9 1.4 0.63 0.70 0.0595 0.0588 Men 8.1 16.5 17.7 20.7 32.9 20.7 0.25 24.80 0.2693 0.0221 Condom usage with non-regular partner: Women * * * * (39.3) 22.7 * * * * Men 17.6 10.8 14.2 6.0 10.8 10.9 1.63 6.80 -0.0287 0.0706 G. Domestic violence Ever experienced violence na na na na na na na na na na Experienced violence in past year na na na na na na na na na na - 24 - Bukina Faso 1998 / 99 - TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Education School completion: Women 1.1 1.6 2.5 4.8 35.9 9.6 0.03 34.80 0.8639 0.0269 Men 4.0 7.0 8.3 12.8 49.5 19.5 0.08 45.50 0.5906 0.0156 School participation: Girls 7.3 11.7 13.3 18.9 56.2 20.6 0.13 48.90 0.4845 0.0228 Boys 17.2 20.7 25.6 28.7 58.3 28.7 0.30 41.10 0.3012 0.0172 B. Exposure to mass media Newspaper readership: Women 0.1 0.4 0.2 0.8 14.0 3.3 0.01 13.90 1.0665 0.0606 Men 0.7 0.3 0.5 1.7 29.0 8.6 0.02 28.30 0.9250 0.0506 Radio listenership: Women 27.2 47.5 57.6 53.3 74.7 52.2 0.36 47.50 0.1715 0.0064 Men 43.7 66.2 73.1 74.0 89.0 71.5 0.49 45.30 0.1158 0.0067 Television viewership: Women 0.9 2.0 3.0 5.1 48.2 12.6 0.02 47.30 0.8976 0.0237 Men 3.5 5.8 7.2 11.7 60.6 22.0 0.06 57.10 0.6661 0.0209 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 65.5 73.5 68.2 72.8 90.6 74.5 0.72 25.14 0.0701 0.0037 Men 85.6 90.4 90.5 88.7 96.8 91.1 0.88 11.25 0.0239 0.0032 Knowledge about mother-to-child transmission of HIV/AIDS: Women 40.1 40.1 40.0 47.0 78.3 48.2 0.51 38.20 0.2059 0.0065 Men 54.0 52.3 56.1 59.4 84.5 62.3 0.64 30.50 0.1345 0.0078 Attitudes toward HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na Can seek children's health care na na na na na na na na na na Can make daily household purchases na na na na na na na na na na Can make large household purchases na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na na na na na Can decide whether to have sex na na na na na na na na na na Justifies domestic violence na na na na na na na na na na E. Orphanhood Paternal orphan prevalence na na na na na na na na na na Maternal orphan prevalence na na na na na na na na na na Double orphan prevalence na na na na na na na na na na - 25 - Bukina Faso 1998 / 99 - FEMALE / MALE POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood mortality and morbidity Infant mortality rate 107.0 108.4 95.4 108.8 76.2 100.9 105.3 128.3 138.3 124.1 77.2 116.1 Under-five mortality rate 231.2 247.7 205.8 223.0 147.8 216.1 246.9 252.5 232.9 241.4 161.0 231.8 Prevalence of fever 34.8 36.4 36.5 33.9 30.3 34.5 35.2 39.7 36.5 36.9 36.9 37.1 Prevalence of diarrhea 16.8 17.3 18.5 23.1 22.9 19.5 19.0 20.6 22.0 19.9 21.0 20.4 Prevalence of acute respiratory 13.4 14.8 15.7 12.6 11.0 13.5 15.0 16.4 11.7 11.6 11.7 13.5 infection (ARI) B. Nutritional status Children: Moderate stunting 17.5 21.9 20.4 23.6 13.0 19.4 24.6 20.2 19.8 22.8 16.9 20.9 Severe stunting 18.9 14.8 17.1 15.9 10.5 15.5 23.2 21.6 15.2 16.4 11.9 17.8 Moderate underweight 21.4 26.8 30.7 22.0 19.0 23.9 22.6 22.4 20.0 21.1 19.9 21.2 Severe underweight 14.4 10.8 11.1 12.1 7.1 11.2 16.8 16.5 11.6 10.3 5.9 12.4 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na C. Sexually transmitted disease Prevalence of genital discharge: Women 0.0 0.2 0.0 0.1 0.6 0.2 Men 0.0 1.7 2.0 1.5 3.4 1.9 Prevalence of genital ulcer: Women 0.0 0.0 0.0 0.0 0.1 0.0 Men 0.0 0.5 0.3 0.2 1.9 0.7 - 27 - Bukina Faso 1998 / 99 - FEMALE / MALE POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 57.3 68.7 67.1 73.4 90.1 70.1 65.9 76.3 67.8 73.7 90.9 74.7 Measles coverage 32.3 42.8 45.2 46.2 60.9 44.3 34.3 40.6 39.4 49.5 77.8 47.4 DPT coverage 27.9 37.2 34.2 46.8 69.0 41.4 39.2 35.1 29.4 40.9 60.1 40.5 Full basic coverage 17.1 27.2 22.8 33.7 48.4 28.6 26.7 21.4 20.2 30.4 55.8 30.1 No basic coverage 15.8 17.3 11.8 8.5 1.4 11.7 18.8 15.7 11.6 13.3 3.2 13.0 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage 20.5 31.0 31.5 40.6 53.4 34.1 26.3 32.3 29.8 34.5 66.1 36.9 B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 7.7 9.0 11.5 9.6 35.7 13.1 10.1 8.6 17.6 13.8 28.5 14.7 Treatment in a public facility 7.2 9.0 10.7 9.1 34.7 12.6 9.5 8.6 17.6 13.8 27.4 14.4 Treatment in a private facility 0.5 0.0 0.8 0.5 1.0 0.5 0.6 0.0 0.0 0.0 0.7 0.2 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 12.3 14.5 26.3 15.9 51.9 21.6 15.3 10.8 19.2 34.4 47.5 22.3 Treatment in a public facility 12.3 14.5 24.4 14.7 49.5 20.7 14.0 10.8 19.2 34.4 42.9 21.3 Treatment in a private facility 0.0 0.0 1.9 1.3 2.4 0.9 1.3 0.0 0.0 0.0 1.1 0.5 Treatment of diarrhea: Use of oral rehydration therapy 37.3 44.0 43.3 52.7 62.0 48.0 37.4 40.9 46.0 47.4 60.8 45.7 Medical treatment of diarrhea 11.3 11.6 21.4 12.7 35.1 17.9 18.1 13.7 18.0 20.1 33.2 19.9 Treatment in a public facility 11.3 11.6 21.4 12.7 33.2 17.6 15.0 11.9 18.0 20.1 33.2 18.8 Treatment in a private facility 0.0 0.0 0.0 0.0 1.9 0.4 2.1 1.8 0.0 0.0 0.0 0.9 C. Contraceptive services Contraceptive prevalence: Women 1.8 2.6 2.9 2.4 16.0 4.8 Men 4.8 8.4 11.9 11.2 30.1 13.5 Source of contraception - public sector: Women * (59.1) * * 71.6 70.7 Men na na na na na na Source of contraception - private sector: Women * (40.9) * * 25.3 26.0 Men na na na na na na D. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women * * * * (71.9) 45.1 Men * * * * (54.1) 43.1 Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men na na na na na na - 28 - Bukina Faso 1998 / 99 - FEMALE / MALE POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet use: By children na na na na na na C. Breastfeeding Exclusive breastfeeding 1.3 0.0 (9.2) (2.0) (10.3) 3.6 0.0 (5.1) (6.8) (6.9) (20.8) 7.0 Timely complementary feeding (31.1) (37.2) (52.5) (62.1) (75.8) 49.6 (41.2) (48.1) (46.9) (54.0) (65.4) 50.0 Bottle-feeding 0.0 0.0 0.0 1.7 5.2 1.2 0.0 0.8 0.0 0.6 3.8 0.9 D. Micronutrient consumption Vitamin A: Children na na na na na na na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na Men na na na na na na Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 1.2 1.6 1.2 1.1 1.9 1.4 Men 8.1 16.5 17.7 20.7 32.9 20.7 Condom usage with non-regular partner: Women * * * * (39.3) 22.7 Men 17.6 10.8 14.2 6.0 10.8 10.9 - 29 - Bukina Faso 1998 / 99 - FEMALE / MALE POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 1.1 1.6 2.5 4.8 35.9 9.6 Men 4.0 7.0 8.3 12.8 49.5 19.5 School participation: Girls 7.3 11.7 13.3 18.9 56.2 20.6 Boys 17.2 20.7 25.6 28.7 58.3 28.7 B. Exposure to mass media Newspaper readership: Women 0.1 0.4 0.2 0.8 14.0 3.3 Men 0.7 0.3 0.5 1.7 29.0 8.6 Radio listenership: Women 27.2 47.5 57.6 53.3 74.7 52.2 Men 43.7 66.2 73.1 74.0 89.0 71.5 Television viewership: Women 0.9 2.0 3.0 5.1 48.2 12.6 Men 3.5 5.8 7.2 11.7 60.6 22.0 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 65.5 73.5 68.2 72.8 90.6 74.5 Men 85.6 90.4 90.5 88.7 96.8 91.1 Knowledge about mother-to-child transmission of HIV/AIDS: Women 40.1 40.1 40.0 47.0 78.3 48.2 Men 54.0 52.3 56.1 59.4 84.5 62.3 Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Orphanhood Paternal orphan prevalence na na na na na na na na na na na na Maternal orphan prevalence na na na na na na na na na na na na Double orphan prevalence na na na na na na na na na na na na - 30 - Bukina Faso 1998 / 99 - RURAL / URBAN POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 106.2 118.7 118.7 117.8 89.4 113.2 * * * * 68.1 67.4 Under-five mortality rate 239.4 250.5 221.1 234.8 (192.6) 234.7 * * * * 129.1 129.1 Prevalence of fever 35.1 38.2 36.4 35.4 39.4 36.5 * * * (35.0) 29.7 30.1 Prevalence of diarrhea 17.9 19.1 20.5 21.2 26.4 20.0 * * * (31.0) 19.0 19.2 Prevalence of acute respiratory infection 14.2 15.7 13.3 11.8 14.7 13.9 * * * (21.5) 9.1 10.1 B. Fertility Total fertility rate 7.2 6.9 6.8 7.1 * 6.9 * * * * 3.8 3.9 Adolescent fertility rate 168.0 129.0 149.0 152.0 * 148.0 * * * * 74.0 71.8 C. Nutritional status Children: Moderate stunting 21.0 21.1 20.2 23.4 15.6 21.0 * * * (16.5) 14.6 14.4 Severe stunting 20.9 18.3 16.2 16.1 16.6 17.8 * * * (17.1) 7.9 8.4 Moderate underweight 22.0 24.7 24.6 21.1 24.4 23.2 * * * (33.8) 16.4 17.7 Severe underweight 15.5 13.7 11.5 11.4 10.0 12.8 * * * (6.7) 4.3 4.5 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na Women: Malnutrition 15.5 15.5 14.3 10.7 10.4 13.9 * * * * 8.5 9.0 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na D. Female circumcision Prevalence of circumcision: Girls 28.3 26.7 24.7 23.4 25.5 25.9 * * * 31.1 18.3 18.9 Women 64.9 69.4 70.4 71.6 76.8 69.5 * * * 89.9 81.6 81.8 Prevalence of occlusion: Girls 0.0 0.0 0.0 0.0 0.0 0.0 * * * * 0.0 0.0 Women 0.1 0.2 0.0 0.4 1.1 0.3 * * * 0.0 0.4 0.4 E. Sexually transmitted disease Prevalence of genital discharge: Women 0.0 0.2 0.0 0.1 0.3 0.1 * * * 0.0 0.8 0.7 Men 0.0 1.7 2.0 1.2 4.0 1.5 * * * * 3.2 3.4 Prevalence of genital ulcer: Women 0.0 0.0 0.0 0.0 0.0 0.0 * * * 0.0 0.1 0.1 Men 0.0 0.5 0.3 0.2 0.0 0.2 * * * * 2.4 2.3 - 31 - Bukina Faso 1998 / 99 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 61.3 72.4 67.1 72.9 81.6 69.5 * * * * 97.4 96.4 Measles coverage 33.3 41.5 42.2 47.5 59.1 42.3 * * * * 77.1 75.5 DPT coverage 33.1 36.0 31.6 44.2 49.7 37.2 * * * * 76.0 73.3 Full basic coverage 21.4 24.1 21.1 31.9 40.8 25.9 * * * * 60.8 59.5 No basic coverage 16.9 16.6 11.8 11.3 4.2 13.6 * * * * 0.7 1.3 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage 23.2 31.7 30.3 37.0 47.0 31.7 * * * * 69.4 67.9 B. Treatment of childhood diseases Treatment of fever: Medical treatment of fever 8.9 8.8 14.5 11.6 26.8 11.9 * * * * 36.2 35.0 Treatment in a public facility 8.3 8.8 14.5 11.4 26.8 11.7 * * * * 34.2 32.4 Treatment in a private facility 0.5 0.0 0.0 0.2 0.0 0.2 * * * * 1.6 2.3 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 13.8 12.5 21.4 24.0 (37.4) 18.5 * * * * 62.7 62.0 Treatment in a public facility 13.2 12.5 21.4 23.3 (37.4) 18.2 * * * * 55.5 53.6 Treatment in a private facility 0.7 0.0 0.0 0.7 0.0 0.3 * * * * 3.6 5.4 Treatment of diarrhea: Use of oral rehydration therapy 37.4 42.2 44.8 50.4 54.8 44.7 * * * * 67.5 65.7 Medical treatment of diarrhea 14.7 12.8 19.4 15.9 26.7 16.6 * * * * 41.1 39.5 Treatment in a public facility 13.2 11.8 19.4 15.9 26.7 16.0 * * * * 39.1 37.7 Treatment in a private facility 1.1 1.0 0.0 0.0 0.0 0.5 * * * * 1.9 1.8 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 50.0 54.9 58.5 67.1 78.4 58.7 * * * (84.0) 96.4 95.6 To a doctor 0.3 0.3 0.6 3.5 2.7 1.2 * * * 0.0 8.7 8.1 To a nurse or trained midwife 49.7 54.6 57.9 63.6 75.7 57.5 * * * (84.0) 87.7 87.5 Multiple visits to a medically-trained person 35.4 37.8 39.7 47.6 58.5 41.2 * * * (61.7) 79.2 77.8 Antenatal care content: Tetanus toxoid 47.9 48.9 49.9 54.9 65.9 51.4 * * * (73.8) 81.8 81.1 Prophylactic antimalarial treatment na na na na na na na na na na na na Iron supplementation na na na na na na na na na na na na Delivery attendance: By a medically-trained person 17.8 20.8 21.8 31.0 50.6 24.5 * * * (81.5) 91.8 90.2 By a doctor 0.2 0.6 0.3 0.3 0.8 0.4 * * * (5.9) 4.4 4.4 By a nurse or trained midwife 17.6 20.2 21.5 30.7 49.7 24.1 * * * (75.6) 87.4 85.8 In a public facility 19.5 23.1 22.5 30.7 52.9 25.8 * * * (68.1) 84.4 82.8 In a private facility 0.1 0.0 0.0 0.1 0.0 0.0 * * * (7.0) 7.4 7.2 At home 80.0 76.3 77.2 68.8 46.5 73.8 * * * (24.9) 7.5 9.3 D. Contraceptive services Contraceptive prevalence: Women 1.8 2.6 2.7 2.3 6.2 2.6 * * * (3.8) 21.2 20.1 Men 4.8 8.4 11.5 11.0 28.8 10.4 * * * * 30.6 30.0 - 32 - Bukina Faso 1998 / 99 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - public sector: Women * (59.1) * * * 71.9 * * * * 69.7 69.7 Men na na na na na na na na na na na na Source of contraception - private sector: Women * (40.9) * * * 25.8 * * * * 26.8 26.3 Men na na na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women * * * * * * * * * * (75.3) (75.3) Men * * * * * (32.2) * * * * (58.5) (58.0) Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na na na Men * * * * * (71.5) * * * * (90.5) (91.0) Voluntary counseling and testing for HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na - 33 - Bukina Faso 1998 / 99 - RURAL / URBAN POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na na na na na na na Treated bednet ownership na na na na na na na na na na na na Bednet use: By children na na na na na na na na na na na na By pregnant women na na na na na na na na na na na na C. Breastfeeding Exclusive breastfeeding 0.7 2.7 8.0 4.8 * 3.7 * * * * 20.0 19.3 Timely complementary feeding 36.0 42.8 49.8 57.4 * 46.7 * * * * (80.7) 80.0 Bottle-feeding 0.0 0.4 0.0 1.1 0.0 0.4 * * * * 6.8 6.3 D. Micronutrient consumption Iodized salt: Availability of iodized salt na na na na na na na na na na na na in household Vitamin A: Children na na na na na na na na na na na na Women na na na na na na na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Alcohol: Women na na na na na na na na na na na na Men na na na na na na na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 1.2 1.6 1.2 1.0 1.5 1.3 * * * 1.6 2.1 2.0 Men 8.1 16.6 17.7 21.0 21.7 16.5 * * * * 36.6 35.5 Condom usage with non-regular partner: Women * * * * * 18.0 * * * * (39.1) (37.9) Men 17.6 10.8 14.3 6.1 11.0 11.1 * * * * 10.7 10.6 G. Domestic violence Ever experienced violence na na na na na na na na na na na na Experienced violence in past year na na na na na na na na na na na na - 34 - Bukina Faso 1998 / 99 - RURAL / URBAN POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 1.1 1.6 2.4 4.3 10.1 2.8 * * * 17.7 46.2 44.5 Men 4.0 7.0 8.3 12.1 26.4 9.4 * * * 25.5 57.3 55.6 School participation: Girls 7.1 11.7 13.1 17.7 32.6 13.7 * * * (43.3) 68.8 67.0 Boys 17.2 20.6 25.7 26.9 36.0 23.4 * * * (69.9) 73.4 72.2 B. Exposure to mass media Newspaper readership: Women 0.1 0.4 0.1 0.8 2.8 0.5 * * * (1.6) 18.1 17.3 Men 0.7 0.3 0.5 1.5 7.4 1.3 * * * * 36.0 34.7 Radio listenership: Women 27.1 47.4 57.5 52.9 58.4 46.6 * * * (63.6) 80.7 80.0 Men 43.6 66.2 73.0 73.3 81.9 66.1 * * * * 91.3 91.0 Television viewership: Women 0.9 1.9 3.0 4.8 16.0 3.5 * * * (12.5) 60.0 57.5 Men 3.5 5.8 7.1 10.0 30.7 8.7 * * * * 70.4 69.1 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 80.1 83.1 82.8 79.8 88.9 82.0 * * * 94.3 94.8 94.7 Men 93.6 95.2 97.0 95.9 99.1 95.8 * * * * 99.1 99.1 Knowledge about mother-to-child transmission of HIV/AIDS: Women 32.4 40.0 39.6 45.8 57.6 40.6 * * * 78.8 86.0 85.7 Men 46.6 52.2 56.0 58.7 69.6 54.8 * * * * 89.4 88.8 Attitudes toward HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na na na Can seek children's health care na na na na na na na na na na na na Can make daily household purchases na na na na na na na na na na na na Can make large household purchases na na na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na na na na na na na Can decide whether to have sex na na na na na na na na na na na na Justifies domestic violence na na na na na na na na na na na na E. Orphanhood Paternal orphan prevalence na na na na na na na na na na na na Maternal orphan prevalence na na na na na na na na na na na na Double orphan prevalence na na na na na na na na na na na na - 35 - PART III. BASIC TABLES, 1992 / 93 A. TOTAL POPULATION B. FEMALE AND MALE POPULATIONS C. RURAL AND URBAN POPULATIONS Notes: ­ Each of the three sections referred to above consists of four divisions, presenting data for: I) hnp status; II) hnp service use; III) hnp-related individual and household behavior; and IV) other, underlying determinants of hnp status. ­ Full definitions of all indicators covered in the tables are provided in section A of the technical notes found in part II. ­ "na" appears in the table cells when data are not available, usually because the DHS survey concerned did not collect information about the indicator(s) in question. ­ Figures in the tables shown within parentheses indicate the absence of adequate observations to produce acceptably reliable values. Asterisks appear when the number of observations was too small to justify the presentation even of figures within parentheses. (For further information, see the section on "Sampling Errors" in the presentation of data and methods in part II.B.) Asterisks also will be found in columns showing statistical indices of inequality when the amount of quintile-specific information available is inadequate to permit computation of the value for the index concerned. ­ Female/male tables include only indicators relevant for both sexes; those pertaining to only one sex (e.g., fertility, women's nutritional status, antenatal care, attended deliveries) have been omitted. Bukina Faso 1992 / 93 - TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood illness and mortality Infant mortality rate 112.5 119.5 120.8 99.7 80.9 107.6 1.39 31.56 -0.0584 0.0327 Under-five mortality rate 199.1 226.0 230.3 201.9 156.9 204.5 1.27 42.20 -0.0390 0.0376 Prevalence of fever 33.3 35.3 36.2 36.6 31.9 34.8 1.04 1.39 -0.0231 0.0104 Prevalence of diarrhea 13.8 10.8 12.5 11.9 11.0 12.0 1.25 2.78 -0.0269 0.0209 Prevalence of acute respiratory 4.0 5.1 4.7 4.3 4.6 4.5 0.86 0.63 0.0375 0.0363 infection (ARI) B. Fertility Total fertility rate 7.5 6.6 7.1 7.1 4.6 6.5 1.63 2.90 -0.0691 0.0430 Adolescent fertility rate 186.1 139.2 173.7 191.5 97.4 148.9 1.91 88.76 -0.0876 0.0639 C. Nutritional status (%) Children: Moderate stunting 20.1 22.1 22.9 21.0 14.6 20.3 1.37 5.46 -0.0896 0.0167 Severe stunting 15.5 15.2 14.3 12.6 7.1 13.0 2.20 8.46 -0.1672 0.0213 Moderate underweight 26.1 24.3 23.7 24.8 17.9 23.5 1.45 8.14 -0.0809 0.0153 Severe underweight 9.2 10.8 10.5 10.9 4.0 9.3 2.27 5.15 -0.1448 0.0235 Mild anemia na na na na na na na na na na Moderate anemia na na na na na na na na na na Severe anemia na na na na na na na na na na Women: Malnutrition 13.2 15.1 15.3 14.2 9.4 13.6 1.41 3.88 -0.0768 0.0194 Mild anemia na na na na na na na na na na Moderate anemia na na na na na na na na na na Severe anemia na na na na na na na na na na D. Female circumcision (%) Prevalence of circumcision: Girls na na na na na na na na na na Women na na na na na na na na na na Prevalence of occlusion: Girls na na na na na na na na na na Women na na na na na na na na na na E. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na na na na na Men na na na na na na na na na na Prevalence of genital ulcer: Women na na na na na na na na na na Men na na na na na na na na na na - 39 - Bukina Faso 1992 / 93 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood immunization BCG coverage 77.3 84.2 82.1 86.5 97.4 85.4 0.79 20.10 0.0454 0.0068 Measles coverage 46.0 61.4 54.4 60.9 75.3 59.6 0.61 29.33 0.1041 0.0137 DPT coverage 22.2 36.3 33.5 46.0 66.1 40.6 0.34 43.91 0.2364 0.0194 Full basic coverage 17.2 32.2 27.7 38.5 58.4 34.6 0.29 41.20 0.2646 0.0226 No basic coverage 20.6 14.0 17.3 10.9 2.1 13.1 9.84 18.50 -0.2774 0.0433 Hepatitis B coverage na na na na na na na na na na Yellow fever coverage na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 13.7 14.7 21.4 19.8 29.4 19.3 0.47 15.63 0.1927 0.0278 Treatment in a public facility 13.7 14.4 20.5 19.7 27.5 18.7 0.50 13.74 0.1752 0.0279 Treatment in a private facility 0.0 0.3 0.9 0.1 1.9 0.6 0.00 1.89 0.7390 0.2267 Treatment of acute respiratory infection (ARI): Medical treatment of ARI (6.8) 15.5 20.0 11.2 (39.8) 18.3 0.17 32.96 0.2853 0.0787 Treatment in a public facility (3.4) 15.5 20.0 9.3 (36.4) 16.8 0.09 33.04 0.2722 0.0776 Treatment in a private facility (3.4) 0.0 0.0 1.9 (3.3) 1.5 1.02 0.08 0.4378 0.4407 Treatment of diarrhea: Use of oral rehydration therapy 28.9 28.5 34.9 39.0 64.6 37.8 0.45 35.66 0.1932 0.0272 Medical treatment of diarrhea 13.8 16.4 14.5 10.2 27.8 15.9 0.50 14.00 0.1668 0.0572 Treatment in a public facility 11.8 15.4 14.5 9.5 24.1 14.6 0.49 12.22 0.1404 0.0571 Treatment in a private facility 2.0 1.0 0.0 0.7 3.8 1.4 0.53 1.78 0.4492 0.2754 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 42.6 48.3 48.9 69.0 94.2 60.0 0.45 51.59 0.1930 0.0063 To a doctor 0.4 0.8 2.0 1.5 6.9 2.2 0.05 6.49 0.7063 0.0806 To a nurse or trained midwife 42.2 47.4 46.9 67.6 87.3 57.8 0.48 45.10 0.1738 0.0068 Multiple visits to a medically-trained person 26.1 31.4 32.9 49.7 74.5 42.3 0.35 48.45 0.2649 0.0093 Antenatal care content: Tetanus toxoid 53.1 53.7 53.8 67.5 87.3 62.6 0.61 34.22 0.1285 0.0063 Prophylactic antimalarial treatment na na na na na na na na na na Iron supplementation na na na na na na na na na na Delivery attendance: By a medically-trained person 26.0 26.8 29.9 46.5 86.1 41.4 0.30 60.07 0.3274 0.0075 By a doctor 0.6 0.4 0.7 1.0 4.6 1.3 0.13 4.04 0.6291 0.0816 By a nurse or trained midwife 25.4 26.4 29.3 45.5 81.5 40.1 0.31 56.03 0.3176 0.0080 In a public facility 27.8 28.9 30.1 49.0 83.0 42.3 0.33 55.20 0.2905 0.0076 In a private facility 0.1 0.1 0.0 0.3 3.4 0.7 0.04 3.24 1.2513 0.1472 At home 71.7 70.3 68.9 49.9 12.7 56.3 5.64 59.02 -0.2338 0.0055 D. Contraceptive services Contraceptive prevalence: Women 0.8 0.3 1.0 2.5 16.4 4.2 0.05 15.67 0.9122 0.0492 Men 2.3 2.1 2.6 8.2 22.4 6.7 0.10 20.08 0.6955 0.0679 - 40 - Bukina Faso 1992 / 93 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors D. Contraceptive services (cont.) Source of contraception - public sector: Women * * * (81.8) 63.6 65.4 * * * * Men na na na na na na * * * * Source of contraception - private sector: Women * * * (14.6) 26.4 22.5 * * * * Men na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na na na na na Men na na na na na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na Men na na na na na na na na na na Voluntary counseling and testing for HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na - 41 - Bukina Faso 1992 / 93 - TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na na na na na Treated bednet ownership na na na na na na na na na na Bednet use: By children na na na na na na na na na na By pregnant women na na na na na na na na na na C. Breastfeeding Exclusive breastfeeding na na na na na na na na na na Timely complementary feeding na na na na na na na na na na Bottle-feeding 0.0 0.0 1.2 0.0 8.1 1.5 0.00 8.09 1.2121 0.2274 D. Micronutrient consumption Iodized salt: Availability of iodized salt na na na na na na na na na na in household Vitamin A: Children 5.0 5.5 4.2 6.2 19.7 7.8 0.25 14.72 0.4553 0.0521 Women na na na na na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na na na na na Men na na na na na na na na na na Alcohol: Women na na na na na na na na na na Men na na na na na na na na na na F. Sexual practices Non-regular sexual partnerships: Women na na na na na na na na na na Men na na na na na na na na na na Condom usage with non-regular partner: Women na na na na na na na na na na Men na na na na na na na na na na G. Domestic violence Ever experienced violence na na na na na na na na na na Experienced violence in past year na na na na na na na na na na - 42 - Bukina Faso 1992 / 93 - TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Education School completion: Women 2.2 2.9 3.0 7.0 37.4 11.5 0.06 35.28 0.8271 0.0223 Men 4.8 6.3 11.2 17.7 51.4 21.6 0.09 46.61 0.6196 0.0138 School participation: Girls 8.8 11.3 15.1 21.8 59.4 22.5 0.15 50.63 0.4895 0.0183 Boys 17.1 19.0 18.7 32.4 68.1 30.1 0.25 51.04 0.3583 0.0146 B. Exposure to mass media Newspaper readership: Women 0.7 1.2 1.0 3.7 26.7 7.5 0.03 25.99 0.9389 0.0319 Men na na na na na na na na na na Radio listenership: Women 17.0 35.0 32.3 42.1 74.5 42.1 0.23 57.46 0.2956 0.0069 Men na na na na na na na na na na Television viewership: Women 0.8 0.6 0.8 3.6 43.3 11.2 0.02 42.53 1.1085 0.0254 Men na na na na na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women na na na na na na na na na na Men 67.5 68.7 65.2 79.4 89.3 74.7 0.76 21.85 0.0759 0.0070 Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na Can seek children's health care na na na na na na na na na na Can make daily household purchases na na na na na na na na na na Can make large household purchases na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na na na na na Can decide whether to have sex na na na na na na na na na na Justifies domestic violence na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 3.0 6.1 4.7 6.8 7.0 5.6 0.43 3.96 0.1045 0.0168 Maternal orphan prevalence 1.8 3.1 4.3 3.4 3.4 3.2 0.54 1.55 0.0590 0.0216 Double orphan prevalence 0.4 1.1 1.0 1.0 1.6 1.0 0.22 1.27 0.1469 0.0396 - 43 - Bukina Faso 1992 / 93 - FEMALE / MALE POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood mortality and morbidity Infant mortality rate 102.8 120.9 119.0 78.9 73.2 100.3 122.0 118.2 122.6 119.1 87.9 114.5 Under-five mortality rate 187.5 235.0 223.1 189.9 149.2 199.5 210.6 217.4 237.2 212.8 163.9 209.3 Prevalence of fever 31.2 35.6 33.7 36.5 29.2 33.5 35.4 35.0 38.8 36.7 34.6 36.1 Prevalence of diarrhea 14.3 12.0 13.9 11.3 10.1 12.3 13.2 9.8 11.1 12.4 11.9 11.6 Prevalence of acute respiratory 4.3 4.5 3.4 4.9 3.9 4.2 3.6 5.7 6.0 3.7 5.2 4.8 infection (ARI) B. Nutritional status Children: Moderate stunting 20.0 23.1 21.7 18.8 13.9 19.7 20.1 21.2 24.1 23.1 15.3 20.9 Severe stunting 16.0 12.3 15.1 11.5 7.4 12.4 15.0 17.9 13.6 13.6 6.7 13.6 Moderate underweight 26.0 25.2 24.5 22.1 17.2 23.1 26.2 23.4 22.8 27.3 18.7 23.8 Severe underweight 8.4 7.9 12.7 11.4 4.8 9.1 10.0 13.4 8.3 10.5 3.3 9.4 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na C. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na Men na na na na na na Prevalence of genital ulcer: Women na na na na na na Men na na na na na na - 45 - Bukina Faso 1992 / 93 - FEMALE / MALE POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 77.2 87.8 88.4 87.0 96.1 87.4 77.4 80.9 74.2 86.1 98.7 83.5 Measles coverage 45.5 67.1 59.2 57.5 76.4 61.1 46.5 56.2 48.3 63.7 74.3 58.0 DPT coverage 21.3 40.2 38.6 45.4 64.5 41.8 23.0 32.6 27.3 46.5 67.6 39.5 Full basic coverage 15.6 36.6 32.9 33.3 59.6 35.4 18.6 28.1 21.1 42.9 57.2 33.8 No basic coverage 19.9 11.0 11.6 10.0 2.9 11.1 21.2 16.9 24.4 11.7 1.3 15.0 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 12.9 13.0 20.6 23.4 28.0 19.1 14.5 16.3 22.1 16.3 30.5 19.5 Treatment in a public facility 12.9 13.0 20.3 23.2 25.1 18.6 14.5 15.7 20.7 16.3 29.4 18.9 Treatment in a private facility 0.0 0.0 0.3 0.2 2.8 0.5 0.0 0.6 1.4 0.0 1.1 0.6 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 6.3 26.2 23.1 16.5 38.7 21.4 7.5 7.4 18.2 4.4 40.6 15.6 Treatment in a public facility 0.0 26.2 23.1 14.7 30.8 18.6 7.5 7.4 18.2 2.2 40.6 15.3 Treatment in a private facility 6.3 0.0 0.0 1.7 7.9 2.9 na na na na na na Treatment of diarrhea: Use of oral rehydration therapy 30.2 25.0 37.0 25.6 60.1 33.7 17.2 30.4 27.3 42.4 65.7 36.1 Medical treatment of diarrhea 11.3 13.7 16.2 13.9 25.9 15.5 16.6 19.6 12.4 7.0 29.4 16.5 Treatment in a public facility 11.3 13.7 16.2 13.2 21.7 14.7 12.4 17.4 12.4 6.3 25.9 14.4 Treatment in a private facility 0.0 0.0 0.0 0.8 4.2 0.7 4.1 2.2 0.0 0.6 3.4 2.1 C. Contraceptive services Contraceptive prevalence: Women 0.8 0.3 1.0 2.5 16.4 4.2 Men 2.3 2.1 2.6 8.2 22.4 6.7 Source of contraception - public sector: Women 80.0 66.7 42.9 81.8 63.6 65.4 Men na na na na na na Source of contraception - private sector: Women 0.0 0.0 0.0 14.6 26.4 22.5 Men na na na na na na D. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na Men na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men na na na na na na - 46 - Bukina Faso 1992 / 93 - FEMALE / MALE POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet use: By children na na na na na na C. Breastfeeding Exclusive breastfeeding na na na na na na na na na na na na Timely complementary feeding na na na na na na na na na na na na Bottle-feeding 0.0 0.0 2.3 0.0 8.4 1.8 0.0 0.0 0.0 0.0 7.8 1.1 D. Micronutrient consumption Vitamin A: Children 5.4 5.8 3.7 6.1 18.7 7.5 4.5 5.1 4.7 6.4 20.5 8.1 E. Tobacco and alcohol use Tobacco: Women na na na na na na Men na na na na na na Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women na na na na na na Men na na na na na na Condom usage with non-regular partner: Women na na na na na na Men na na na na na na - 47 - Bukina Faso 1992 / 93 - FEMALE / MALE POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 2.2 2.9 3.0 7.0 37.4 11.5 Men 4.8 6.3 11.2 17.7 51.4 21.6 School participation: Girls 8.8 11.3 15.1 21.8 59.4 22.5 Boys 17.1 19.0 18.7 32.4 68.1 30.1 B. Exposure to mass media Newspaper readership: Women 0.7 1.2 1.0 3.7 26.7 7.5 Men na na na na na na Radio listenership: Women 17.0 35.0 32.3 42.1 74.5 42.1 Men na na na na na na Television viewership: Women 0.8 0.6 0.8 3.6 43.3 11.2 Men na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women na na na na na na Men 67.5 68.7 65.2 79.4 89.3 74.7 Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na Men na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Orphanhood Paternal orphan prevalence 3.0 5.7 5.1 6.3 7.5 5.6 3.0 6.5 4.3 7.2 6.5 5.6 Maternal orphan prevalence 1.6 2.6 4.4 3.0 4.2 3.2 2.0 3.6 4.2 3.8 2.5 3.2 Double orphan prevalence 0.3 1.0 1.3 0.8 2.0 1.1 0.4 1.1 0.7 1.2 1.2 1.0 - 48 - Bukina Faso 1992 / 93 - RURAL / URBAN POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 112.7 119.9 120.9 102.2 93.0 113.0 75.0 64.1 115.0 72.5 76.0 76.4 Under-five mortality rate 199.4 226.4 230.4 204.9 192.3 214.4 157.3 182.6 220.9 169.1 142.8 148.4 Prevalence of fever 33.5 35.5 36.2 37.2 42.6 36.0 12.5 9.5 35.6 30.1 27.6 27.8 Prevalence of diarrhea 13.8 10.9 12.7 11.6 11.6 12.1 6.3 4.7 4.3 15.0 10.8 11.0 Prevalence of acute respiratory infection 3.9 5.1 4.8 4.3 2.0 4.4 6.3 4.7 0.0 4.3 5.6 5.3 B. Fertility Total fertility rate 7.5 6.6 7.1 7.3 5.3 7.0 4.6 4.5 6.4 5.7 4.4 4.6 Adolescent fertility rate 187.5 139.5 172.4 203.8 116.9 166.7 67.2 112.3 213.8 115.0 91.0 96.0 C. Nutritional status Children: Moderate stunting 20.0 22.0 22.8 21.4 19.6 21.5 28.6 31.1 24.9 17.7 12.6 13.9 Severe stunting 15.6 15.2 14.4 12.8 12.0 14.4 0.0 12.4 11.0 10.2 5.1 5.9 Moderate underweight 26.2 24.2 23.7 24.9 24.1 24.7 14.3 37.3 22.6 23.5 15.5 16.9 Severe underweight 9.3 10.8 10.6 11.2 7.0 10.3 0.0 6.2 8.2 8.5 2.9 3.7 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na Women: Malnutrition 13.1 15.2 15.4 14.5 10.9 14.4 27.1 6.2 11.0 11.0 8.8 9.2 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na D. Female circumcision Prevalence of circumcision: Girls na na na na na na na na na na na na Women na na na na na na na na na na na na Prevalence of occlusion: Girls na na na na na na na na na na na na Women na na na na na na na na na na na na E. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Prevalence of genital ulcer: Women na na na na na na na na na na na na Men na na na na na na na na na na na na - 49 - Bukina Faso 1992 / 93 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 77.2 84.2 82.3 86.0 97.8 83.6 100.0 67.5 90.7 97.3 na 95.8 Measles coverage 46.2 61.4 54.4 60.0 65.2 56.4 0.0 50.0 68.3 80.1 na 77.4 DPT coverage 22.1 36.3 33.5 44.0 47.8 35.1 50.0 33.7 62.9 74.7 na 72.1 Full basic coverage 17.2 32.2 27.8 36.0 39.1 29.3 0.0 16.3 59.1 67.4 na 64.9 No basic coverage 20.7 14.0 17.1 11.3 2.2 14.8 0.0 32.5 7.5 2.1 na 3.4 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood diseases Treatment of fever: Medical treatment of fever 13.8 14.6 20.8 20.2 17.9 17.4 0.0 50.0 46.7 14.0 36.6 33.8 Treatment in a public facility 13.8 14.3 20.1 20.2 17.9 17.1 0.0 50.0 40.9 12.4 33.5 30.9 Treatment in a private facility 0.0 0.3 0.8 0.0 0.0 0.2 0.0 0.0 5.8 1.6 3.1 3.0 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 6.9 14.9 20.0 9.1 75.0 14.9 0.0 100.0 33.9 34.6 na 34.9 Treatment in a public facility 3.4 14.9 20.0 9.1 75.0 14.2 0.0 100.0 11.3 30.8 na 29.3 Treatment in a private facility na na na na na na 0.0 0.0 22.6 3.8 na 5.6 Treatment of diarrhea: Use of oral rehydration therapy 28.7 28.3 35.2 36.4 59.1 33.4 100.0 100.0 0.0 61.5 67.0 65.7 Medical treatment of diarrhea 13.9 16.2 14.3 10.2 18.2 14.0 0.0 100.0 48.2 9.8 32.0 28.7 Treatment in a public facility 11.9 15.2 14.3 10.2 18.2 13.2 0.0 100.0 48.2 3.4 26.6 23.2 Treatment in a private facility 2.0 1.0 0.0 0.0 0.0 0.7 0.0 0.0 0.0 6.5 5.4 5.5 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 42.4 47.9 48.4 66.7 86.0 53.3 66.3 100.0 69.0 93.3 97.3 95.9 To a doctor 0.4 0.8 2.0 1.6 3.3 1.3 0.0 0.0 0.0 0.0 8.2 6.9 To a nurse or trained midwife 42.1 47.0 46.4 65.0 82.7 52.0 66.3 100.0 69.0 93.3 89.1 89.0 Multiple visits to a medically-trained person 26.0 31.1 32.7 47.7 61.3 35.9 41.4 69.0 46.0 69.2 79.6 77.1 Antenatal care content: Tetanus toxoid 52.9 53.4 53.6 65.9 79.3 57.7 75.2 93.8 63.3 83.6 90.3 88.8 Prophylactic antimalarial treatment na na na na na na na na na na na na Iron supplementation na na na na na na na na na na na na Delivery attendance: By a medically-trained person 25.9 26.4 29.2 42.6 68.6 33.0 46.9 79.3 66.3 89.7 93.4 91.6 By a doctor 0.6 0.4 0.7 0.9 5.8 0.9 0.0 0.0 0.0 2.1 4.1 3.7 By a nurse or trained midwife 25.3 26.0 28.5 41.7 62.8 32.1 46.9 79.3 66.3 87.6 89.2 87.9 In a public facility 27.7 28.5 29.3 45.6 72.2 34.9 46.9 87.6 68.1 86.3 87.5 86.5 In a private facility 0.1 0.1 0.0 0.1 0.0 0.1 0.0 0.0 0.0 2.6 4.7 4.2 At home 71.9 70.8 69.7 53.6 26.5 64.3 53.1 12.4 31.9 9.4 7.0 8.5 D. Contraceptive services Contraceptive prevalence: Women 0.8 0.3 1.0 2.1 8.8 1.5 0.0 0.0 0.0 6.3 19.2 17.1 Men 2.3 2.1 2.5 7.5 8.5 3.7 0.0 0.0 7.7 14.8 28.2 25.4 - 50 - Bukina Faso 1992 / 93 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - public sector: Women 80.0 66.7 42.9 85.7 88.9 78.7 69.5 59.4 na na na 59.8 Men na na na na na na na na na na na na Source of contraception - private sector: Women 0.0 0.0 0.0 14.3 0.0 4.3 15.8 30.8 na na na 30.2 Men na na na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Voluntary counseling and testing for HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na - 51 - Bukina Faso 1992 / 93 - RURAL / URBAN POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na na na na na na na Treated bednet ownership na na na na na na na na na na na na Bednet use: By children na na na na na na na na na na na na By pregnant women na na na na na na na na na na na na C. Breastfeeding Exclusive breastfeeding na na na na na na na na na na na na Timely complementary feeding na na na na na na na na na na na na Bottle-feeding 0.0 0.0 1.2 0.0 2.6 0.4 0.0 0.0 0.0 0.0 10.2 8.3 D. Micronutrient consumption Iodized salt: Availability of iodized salt na na na na na na na na na na na na in household Vitamin A: Children 5.0 5.5 4.1 5.9 12.0 5.6 0.0 0.0 10.9 10.1 23.7 21.3 Women na na na na na na na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Alcohol: Women na na na na na na na na na na na na Men na na na na na na na na na na na na F. Sexual practices Non-regular sexual partnerships: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Condom usage with non-regular partner: Women na na na na na na na na na na na na Men na na na na na na na na na na na na G. Domestic violence Ever experienced violence na na na na na na na na na na na na Experienced violence in past year na na na na na na na na na na na na - 52 - Bukina Faso 1992 / 93 - RURAL / URBAN POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 2.1 2.8 2.8 5.3 22.0 4.6 5.5 12.4 11.6 20.5 42.6 39.1 Men 4.8 6.0 10.8 16.0 39.8 11.5 0.0 35.0 24.7 27.5 54.2 50.4 School participation: Girls 8.7 11.2 14.6 19.6 44.4 15.5 18.2 30.7 41.1 46.7 66.2 62.5 Boys 17.2 18.7 18.1 31.3 58.5 23.5 0.0 53.7 62.3 43.8 71.9 67.2 B. Exposure to mass media Newspaper readership: Women 0.7 1.1 1.0 2.5 13.8 2.2 0.0 7.1 1.9 13.3 30.9 28.1 Men na na na na na na na na na na na na Radio listenership: Women 16.9 34.9 32.4 40.0 61.2 33.7 27.0 42.8 30.8 59.4 78.8 75.2 Men na na na na na na na na na na na na Television viewership: Women 0.8 0.6 0.8 1.6 3.5 1.1 0.0 3.8 3.5 19.7 56.4 50.7 Men na na na na na na na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women na na na na na na na na na na na na Men 67.4 68.9 65.0 78.8 85.9 71.1 100.0 33.3 72.2 83.7 90.3 88.7 Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na na na Can seek children's health care na na na na na na na na na na na na Can make daily household purchases na na na na na na na na na na na na Can make large household purchases na na na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na na na na na na na Can decide whether to have sex na na na na na na na na na na na na Justifies domestic violence na na na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 3.0 6.1 4.8 6.6 6.4 5.3 4.2 5.2 4.3 8.3 7.2 7.2 Maternal orphan prevalence 1.8 3.2 4.3 3.2 3.6 3.2 0.0 0.0 3.6 5.5 3.3 3.5 Double orphan prevalence 0.4 1.1 1.0 0.9 2.2 0.9 0.0 0.0 3.6 1.8 1.4 1.4 - 53 - PART IV. TECHNICAL NOTES A. INDICATOR DEFINITIONS B. DATA AND METHODS C. DISCUSSION INDICATOR DEFINITIONS Part I: HNP STATUS A. CHILDHOOD MORTALITY AND ILLNESS 2 Infant mortality rate: number of deaths to children under 12 months of age per 1,000 live births, based on experience during the ten years preceding the survey. Under-five mortality rate: number of deaths to children under five years of age per 1,000 live births, based on experience during the ten years preceding the survey. Prevalence of fever: percent of children who had fever, whether or not accompanied by cough or rapid breathing, in the two weeks before the survey. Prevalence of diarrhea: percent of children who had diarrhea in the two weeks before the survey. Prevalence of acute respiratory infection: percent of children who had a cough accompanied by rapid or difficult breathing in the two weeks before the survey. B. FERTILITY Total fertility rate (TFR): average number of births a woman could expect to have during her lifetime if she followed the levels of fertility currently observed at every age. The TFR is calculated as the sum of average annual age-specific fertility rates for all reproductive age groups (usually 15-49 years) in the three years before the survey. Adolescent fertility rate: age-specific fertility rate for women 15-19 years of age. This is the average number of births among women aged 15-19 years per 1,000 women in that age group, based on births in the three years before the survey and expressed as annual averages. 2Figures for the prevalence of fever, diarrhea, and acute respiratory infection refer to percent of children under three, four, or five years of age, depending upon the country. (The specific ages covered for in particular country may be determined by consulting the full report on that country's DHS, which may be found at: www.measuredhs.com/countries.) - 57 - C. NUTRITIONAL STATUS Children 3, 4, 5 Moderate stunting (height-for-age): percent of children with a height-for-age Z-score of between ­2 and ­3 standard deviations of the median reference standard for their age (as defined in fn. 4). Severe stunting (height-for-age): percent of children with a height-for-age Z-score of below ­3 standard deviations of the median reference standard for their age (as defined in fn. 4). Moderate underweight (weight-for-age): percent of children with a weight-for-age Z-score of between ­2 and ­3 standard deviations of the median reference standard for their age (as defined in fn. 4). Severe underweight (weight-for-age): percent of children with a weight-for-age Z-score of below ­3 standard deviations of the median reference standard for their age (as defined in fn. 4). Mild anemia: percent of children with a hemoglobin level of between 10.0g/dl and 10.9 g/dl, the World Health Organization criterion for mild anemia. Moderate anemia: percent of children with a hemoglobin level of between 7.0g/dl and 9.9g/dl, the World Health Organization criterion for moderate anemia. Severe anemia: percent of children with a hemoglobin level of below 7.0g/dl, the World Health Organization criterion for severe anemia. Women 6, 7 Malnutrition: percent of women aged 15-49 years with a Body Mass Index (BMI) of less than 18.5, where BMI ­ commonly used to indicate adult nutritional status ­ is defined as weight in kilograms divided by the square of height in meters. Mild anemia: percent of women aged 15-49 years with a hemoglobin level of between 10.0g/dl and 10.9g/dl for pregnant women and between 10.0g/dl and 11.9g/dl for non-pregnant women, the World Health Organization criterion for mild anemia. Moderate anemia: percent of women aged 15-49 years with a hemoglobin level of between 7.0g/dl and 9.9g/dl, the World Health Organization criterion for moderate anemia. Severe anemia: percent of women aged 15-49 years with a hemoglobin level of less than 7.0g/dl, the World Health Organization criterion for severe anemia. 3 All figures related to children's nutrition status refer to children under three, four, or five years of age, depending upon the country. (The specific ages covered for in particular country may be determined by consulting the full report on the DHS of the country concerned, which is available at: www.measuredhs.com/countries.) 4 The reference standards used for stunting and underweight are those established in the 1970s by the World Health Organization, the U.S. Centers for Disease Control, and the U.S. National Center for Health Statistics. Updated stunting and underweight figures based on the recently-released, 2006 World Health Organization reference standards are currently under preparation. When complete, they will be available at: www.worldbank.org/povertyandhealth/ countrydata. 5The anemia figures for children living at an altitude above 1,000 meters have been adjusted to reflect the higher level of hemoglobin required. 6In some countries, the BMI is presented for all women; in others, the figure is available only for mothers of children under five years of age. The reference population for any given country can be determined by consulting the full report on the DHS for the country concerned. An electronic version of this report is located at: www.measuredhs.com/ countries. 7 Anemia cut-off points for respondents who live at an altitude above 1,000 meters and/or who smoke have been adjusted to account for their higher hemoglobin requirements. - 58 - D. FEMALE CIRCUMCISION Prevalence of Circumcision Girls: percent of women aged 15-49 years with one or more daughters, at least one of whom had been circumcised. Women: percent of women aged 15-49 years who had been circumcised. Prevalence of Occlusion Girls: percent of women aged 15-49 years with one or more daughters, at least one of whom had been circumcised with the vaginal area sewn closed. Women: percent of women aged 15-49 years whose vaginal area had been sewn closed. E. SEXUALLY TRANSMITTED DISEASES Prevalence of Genital Discharge Women: percent of women aged 15-49 years who had had abnormal genital discharge in the twelve months before the survey. Men: percent of men aged 15-54 years who had had abnormal genital discharge in the twelve months before the survey. Prevalence of Genital Ulcer or Sore Women: percent of women aged 15-49 years who had had a genital ulcer or sore in the twelve months before the survey. Men: percent of men aged 15-54 years who had had a genital ulcer or sore in the twelve months before the survey. - 59 - Part II: INTERMEDIATE DETERMINANTS OF HNP STATUS ­ HEALTH SERVICE USE A. CHILDHOOD IMMUNIZATION 8 BCG coverage: percent of children who had received a dose of BCG vaccine by the time of the survey. Measles coverage: percent of children who had received a dose of measles vaccine by the time of the survey. DPT coverage: percent of children who had received three doses of DPT vaccine by the time of the survey. Full basic coverage: percent of children who had received a dose of BCG vaccine, measles vaccine, and three doses of DPT and polio vaccines by the time of the survey, excluding polio vaccine given at birth. No basic coverage: percent of children who had received no vaccination against the six early- childhood diseases (TB, measles, polio, diphtheria, pertusis, and tetanus) by the time of the survey. Hepatitis B coverage: percent of children who had received three doses of hepatitis B vaccine by the time of the survey. Yellow fever coverage: percent of children who had received a dose of yellow fever vaccine by the time of the survey. B. TREATMENT OF CHILDHOOD ILLNESSES 9 Treatment of Fever Medical treatment of fever: percent of children with fever, with or without cough or rapid breathing, in the two weeks before the survey who had sought medical advice for fever from any health facility or health provider, whether public or private. Treatment in a public facility: percent of children with fever, with or without cough or rapid breathing, in the two weeks before the survey who had sought medical advice for fever from a public-sector health facility or provider (as defined in fn. 9). Treatment in a private facility: percent of children with fever, with or without cough or rapid breathing, in the two weeks before the survey who had sought medical advice for fever from a private-sector health facility or provider (as defined in fn. 9). 8Childhood immunization figures refer to rates among children 12-23 months of age in all countries except those in Latin America and the Caribbean. There, the figures refer to rates among children 18-29 months of age. All figures are based on information recorded on the child's vaccination card; or, in cases where a card was not seen by the interviewer, on the mother's report. 9Figures for illness treatment in a public facility refer to treatment in government hospitals, health centers, health posts, or dispensaries; or in facilities operated by government-affiliated social securing programs. Figures for treatment in private facilities cover treatment in private hospitals or clinics, in private doctors' offices, or in facilities operated by other private medical providers (such as non-governmental organizations) as defined in the country concerned; but exclude treatment obtained in private pharmacies or shops. - 60 - Treatment of Acute Respiratory Infection (ARI) Medical treatment of ARI: percent of children with a cough and rapid breathing in the two weeks before the survey who had been taken for treatment at any medical facility or provider, whether public or private. Treatment in a public facility: percent of children with a cough and rapid breathing in the two weeks before the survey who had been taken for treatment at a public-sector health facility or provider (as defined in fn. 9). Treatment in a private facility: percent of children with a cough and rapid breathing in the two weeks before the survey who had been taken for treatment at a private-sector health facility or provider (as defined in fn. 9). Treatment of Diarrhea Use of oral rehydration therapy: percent of children with diarrhea in the two weeks before the survey who had received oral rehydration therapy (ORT) (defined as including consumption of oral rehydration salts, other recommended home fluids, or other increased liquids). Medical treatment of diarrhea: percent of children with diarrhea in the two weeks before the survey who had been taken for treatment at any medical facility or provider, whether public or private. Treatment in a public facility: percent of children with diarrhea in the two weeks before the survey who had been taken for treatment at a public-sector health facility or provider (as defined in fn. 9). Treatment in a private facility: percent of children with diarrhea in the two weeks before the survey who had been taken for treatment at a private-sector health facility or provider (as defined in fn. 9). C. ANTENATAL AND DELIVERY CARE 10 Antenatal Care (ANC) Visits To a medically-trained person: percent of women with one or more births in the five years before the survey who had received at least one antenatal care consultation from a medically- trained person (as defined in fn. 10) before her most recent birth. To a doctor: percent of women with one or more births in the five years before the survey who had received at least one antenatal care consultation from a doctor before her most recent birth. To a nurse or trained midwife: percent of women with one or more births in the five years before the survey who had received at least one antenatal care consultation from a nurse or trained midwife (as defined in fn. 10) before her most recent birth. Multiple visits to a medically-trained person: percent of women with one or more births in the five years before the survey who had received at least three antenatal care consultations from any medically-trained provider (as defined in fn. 10) before her most recent birth. 10When speaking of antenatal and delivery care, medically-trained persons are defined as doctors, nurses, and trained midwives. The definition excludes traditional midwives or other traditional birth attendants, whether trained or untrained. - 61 - Antenatal Care (ANC) Content Tetanus toxoid: percent of women with one or more births in the five years before the survey who had received at least one tetanus toxoid injection during her most recent pregnancy. Prophylactic antimalarial treatment: percent of women with one or more births in the five years before the survey who had received prophylactic treatment with any anti-malarial drug during her most recent pregnancy. Iron supplementation: percent of women with one or more births in the five years before the survey who had taken iron tablets during her most recent pregnancy. Delivery Attendance By a medically-trained person: percent of births in the five years before the survey attended by a medically-trained person (as defined in fn. 10). By a doctor: percent of births in the five years before the survey attended by a doctor. By a nurse or trained midwife: percent of births in the five years before the survey attended to by a nurse or a trained midwife (as defined in fn. 10). In a public facility: percent of all deliveries in the five years before the survey occurring in a public-sector health facility (as defined in fn. 9). In a private facility: percent of all deliveries in the five years before the survey occurring in a private-sector health facility (as defined in fn. 9). At home: percent of all deliveries in the five years before the survey occurring at home (defined as the woman's own or any other home). D. CONTRACEPTIVE SERVICES Contraceptive Prevalence 11 Women: percent of married or in-union women aged 15-49 years who used any modern means of contraception (as defined in fn. 11). Men: percent of married or in-union men aged 15-54 years who used any modern means of contraception (as defined in fn. 11). Source of Contraception - Public Sector Women: percent of married women who obtained their current method of contraception from a public-sector health facility or provider (as defined in fn. 9). Men: percent of married men who obtained their current method of contraception from a public- sector health facility or provider (as defined in fn. 9). Source of Contraception - Private Sector Women: percent of married women who obtained their current method of contraception from a private-sector health facility or provider (as defined in fn. 9, except that private pharmacies and shops are included rather than excluded). 11Figures refer to use of modern means of contraception, defined as male/female sterilization, oral contraceptive pill, contraceptive injection, intrauterine device, male/female condom, diaphragm, cervical cap, contraceptive jelly or foam, implant, or some country-specific modern method. - 62 - Men: percent of married women who obtained their current method of contraception from a private-sector health facility or provider (as defined in fn. 9, except that private pharmacies and shops are included rather than excluded). E. TREATMENT OF ADULT ILLNESSES Treatment of Genital Discharge, Ulcer, or Sore Women: percent of women with genital discharge, ulcer, or sore who sought any medical treatment for resulting symptoms. Men: percent of men with genital discharge, ulcer, or sore who sought any medical treatment for resulting symptoms. Treatment of Genital Discharge, Ulcer, or Sore in a Public Facility Women: percent of women with genital discharge, ulcer, or sore who sought treatment from a public-sector health facility or provider (as defined in fn. 9). Men: percent of men with genital discharge, ulcer, or sore who sought treatment from a public- sector health facility or provider (as defined in fn. 9). Voluntary Counseling and Testing for HIV/AIDS Women: percent of women aged 15-49 years who had been tested for HIV at any time before the survey. Men: percent of men aged 15-54 years who had been tested for HIV at any time before the survey. - 63 - Part III: INTERMEDIATE DETERMINANTS OF HNP STATUS ­ INDIVIDUAL AND HOUSEHOLD BEHAVIOR A. HYGIENIC PRACTICES Disposal of Children's Stools Sanitary disposal: percent of mothers with at least one child under five years of age who disposed of the stools of their youngest child in a sanitary manner (defined as dropping stool into a latrine, burying it, or using disposable diapers). Handwashing Wash hands prior to preparing food: percent of women aged 15-49 years preparing meals who washed hands before handling food. Handwashing facilities in household: percent of households that had hand-washing materials or facilities, as determined by direct observation of interviewers. B. BEDNET OWNERSHIP AND USE Bednet Ownership Bednet ownership: percent of households owning one or more bednets. Treated bednet ownership: percent of households owning one or more bednets that had recently been treated with insecticides. Bednet Use By children: percent of households with at least one child under five years of age, some or all of whom had slept under a bednet the night before the survey. By pregnant women: percent of currently pregnant women who had slept under a bednet the night before the survey. C. BREASTFEEDING Exclusive breastfeeding: percent of children 0-3 months of age who had received only breast milk in the 24 hours before the survey. Timely complementary feeding: percent of children 6-9 months of age who had received breast milk and solid or semi-solid foods in the twenty-four hours before the survey. Bottle-feeding: percent of children under 12 months of age who had received any food or drink from a bottle with a nipple in the twenty-four hours before the survey. - 64 - D. MICRONUTRIENT CONSUMPTION Iodized Salt Availability of iodized salt in household: percent of households with cooking salt testing positive for iodine/iodate at the recommended level of 15 or 25 parts per million or more (depending on the country). 12 Vitamin A Children: percent of children13 who had received at least one dose of vitamin A in the six months before the survey, as reported by the mothers. Women: percent of women who had received a dose of vitamin A within two months of the last birth, in the five years before the survey. E. TOBACCO AND ALCOHOL USE Tobacco 14 Women: percent of women aged 15-49 years who currently were smoking or chewing tobacco products. Men: percent of men aged 15-54 years who currently were smoking or chewing tobacco products. Alcohol Women: percent of women aged 15-49 years who had gotten intoxicated due to excessive consumption of alcohol in the three months before the survey. Men: percent of men aged 15-54 years who had gotten intoxicated due to excessive consumption of alcohol in the three months before the survey. F. SEXUAL PRACTICES Non-Regular Sexual Partnerships Women: percent of women aged 15-49 years who had had sex with a non-regular partner at least once in the twelve months before the survey. Men: percent of men aged 15-54 years who had had sex with a non-regular partner at least once in the twelve months before the survey. 12Which of these two levels is recommended in any particular country may be determined by consulting the full report on that country's DHS, which may be found at: www.measuredhs.com/countries. 13Figures refer to children over six months of age and under three, four, or five years of age, depending upon the country. (The specific ages covered for in a particular country may be determined by consulting the full report on that country's DHS, which is available at: www.measuredhs.com/countries.) 14Tobacco products include cigarettes, pipes, cigars, leaves, etc. - 65 - Condom Usage with Non-Regular Partner Women: percent of women aged 15-49 years with non-regular sexual partner who had used a condom in the last sexual intercourse with such a partner in the twelve months before the survey. Men: percent of men aged 15-54 years with non-regular sexual partner who had used a condom in the last sexual intercourse with such a partner in the twelve months before the survey. G. DOMESTIC VIOLENCE Ever experienced violence: percent of women aged 15-49 years who had ever been hit or beaten by current or former husband/partner. Experienced violence in past year: percent of women aged 15-49 years who had been hit or beaten by current or former husband/partner in the twelve months before the survey. - 66 - Part IV: UNDERLYING DETERMINANTS OF HNP STATUS A. EDUCATION School Completion Women: percent of women aged 15-49 years who had completed the fifth grade. Men: percent of men aged 15-54 years who had completed the fifth grade. School Participation Girls: percent of girls aged 6-10 years who were attending school at the time of the survey. Boys: percent of boys aged 6-10 years who were attending school at the time of the survey. B. EXPOSURE TO MASS MEDIA Newspaper Readership Women: percent of women aged 15-49 years who read a newspaper at least once a week. Men: percent of men aged 15-54 years who read a newspaper at least once a week. Radio Listenership Women: percent of women aged 15-49 years who listened to radio at least once a week. Men: percent of men aged 15-54 years who listened to radio at least once a week. Television Viewership Women: percent of women aged 15-49 years who watched television at least once a week. Men: percent of men aged 15-54 years who watched television at least once a week. C. KNOWLEDGE AND ATTITUDES ABOUT HIV/AIDS Knowledge about Sexual Transmission of HIV/AIDS 15 Women: percent of women aged 15-49 years who knew of HIV/AIDS and of at least one of the following ways to avoid it through interruption of its sexual transmission route: abstinence; using a condom; avoiding multiple sex partners, sex with prostitutes, and unprotected homosexual sex. Men: percent of men aged 15-54 years who knew of HIV/AIDS and of at least one of the ways to avoid HIV/AIDS referred to in the preceding definition. Knowledge about Mother-to-Child Transmission of HIV/AIDS 15In most countries, the survey sample included both married and unmarried individuals. Where this was the case, all respondents, regardless of marital status, were asked the question covered in this section. Where the survey covered only individuals who were or had been married, the data pertain only to individuals who had ever been married. (The marital status of people covered for in particular country is indicated in the full report on that country's DHS, which is located at: www.measuredhs.com/countries.) - 67 - Women: percent of women aged 15-49 years who knew of at least one way HIV/AIDS can be transmitted from mother to child during pregnancy, delivery, or breastfeeding. Men: percent of men aged 15-54 years who knew of at least one way HIV/AIDS can be transmitted from mother to child during pregnancy, delivery, or breastfeeding. Attitudes toward HIV/AIDS Women: percent of women aged 15-49 years who believed that people with HIV/AIDS should be allowed to continue working or that HIV test results should remain confidential. Men: percent of men aged 15-54 years who believed that people with HIV/AIDS should be allowed to continue working or that HIV test results should remain confidential. D. STATUS OF WOMEN Household Decisionmaking Can seek own health care: percent of women age 15-49 years who could decide by themselves to seek their own health care. Can seek children's health care: percent of women aged 15-49 years, whose children live with them, who could decide by themselves to seek health care for their children. Can make daily household purchases: percent of women aged 15-49 years who could decide by themselves or jointly with others to make daily household purchases. Can make large household purchases: percent of women aged 15-49 years who could decide by themselves or jointly with others to make large household purchases. Can make meal-related decisions: percent of women aged 15-49 years who could decide by themselves what food to cook daily. Freedom of Movement Can travel to visit family, relatives: percent of women aged 15-49 years who could decide by themselves to visit family and relatives. Other Decisionmaking, Attitudes Can decide how to spend own money: percent of women aged 15-49 years who work for cash who could decide by themselves on how to use the money they earn. Can decide whether to have sex: percent of women aged 15-49 years agreeing that they can refuse to have sex with their husband for at least one of the following reasons: he has a sexually- transmitted disease; he has had sexual relations with another woman; or the woman is tired, not in mood, or recently has given birth. Justify domestic violence: percent of women aged 15-49 years believing that a husband/male partner would be justified in beating his wife/female partner for at least one of the following reasons: he suspects her of being unfaithful; she argues with him; she goes out without telling him; she neglects the children; she burns the food; or other, country-specific reasons (for example, she shows disrespect for her in-laws or her family does not give the expected dowry). - 68 - E. ORPHANHOOD Maternal orphan prevalence: percent of children under 15 years of age whose natural mother had died before the survey. Paternal orphan prevalence: percent of children under 15 years of age whose natural father had died before the survey. Double orphan prevalence: percent of children under 15 years of age both of whose natural parents had died before the survey. - 69 - DATA AND METHODS Any assessment of the figures featured in this report requires an appreciation of how they were prepared. The first need is to understand the basic features of the data and methods employed. A. SOURCE OF FIGURES The figures appearing in this report are all derived from data collected under the Demographic and Health Surveys (DHS) program conducted by ORC Macro, with support from the U.S. Agency for International Development and other external assistance organizations. Large DHS household surveys have been carried out, usually at periodic intervals, in approximately seventy- five countries across Africa, Asia, Latin America, the Middle East, and the former Soviet Union.16 This series of reports covers the fifty-six of those countries that had one or more DHS surveys undertaken since 1990, for which data were publicly available as of June 2006. (Annex C is a list of the countries for which reports have been prepared.) In each country, the DHS program has gathered information on a large number of indicators about health, nutrition, and population (hnp) status and service use; about relevant behaviors of household members; and about household characteristics like those described below. It has done this through a set of questionnaires, similar in all countries, to collect data at the individual, household, and community levels. The data presented here draw on responses to the individual and household questionnaires. In most cases, they are based on responses from women or other family members interviewed. The principal exceptions concern nutritional status, which is based on anthropometric measurement; immunization, which typically relies to the extent possible on record cards maintained at the household level; and those other items where a source other than interviewer response is specifically identified. B. MEASUREMENT OF ECONOMIC STATUS Wealth or Asset Approach Economic status has been expressed in terms of wealth or assets: specifically, on the basis of information about household characteristics gathered through the DHS household questionnaire. (Such information was normally provided for at least 25-30, and often many more, characteristics like the presence, availability, or use of a fan, radio receiver, or automobile; housing materials like wood or concrete flooring, tile or tin roofing, or cement block walls; superior sources of water like piped or a protected well; and other attributes related to economic status.) 16Further information about the DHS program is available at the program's website: www.measuredhs.com. - 71 - Index Construction A single, consolidated index of living standards17 was constructed by using principal components analysis (PCA) to generate a weight for each household item with available information. A wealth index score was calculated for each household by weighting the response with respect to each item pertaining to that household by the coefficient of the first principal component as determined by application of principal components analysis, and summing the results. The resulting household scores were standardized in relation to a standard normal distribution with a mean of zero and a standard deviation of one. All individuals usually present in each household were assigned the household's standardized wealth index score, and all individuals in the sample population were ranked according to that score. The sample population was then divided into quintiles of individuals, with all individuals in a single household being assigned to the same quintile. The same standardized household wealth index scores originally derived for the total population sample, as just described, were also used in preparing the disaggregated estimates for female and male members of the sample population, and for rural and urban residents. In preparing those disaggregated estimates, the entire population sample was divided into quintiles of individuals; the females and males, and the rural and urban residents in each quintile of the entire sample were then separated from one another; and the mean for each of the ten resulting subgroups (five female, five male; or five rural, five urban) was calculated. This procedure was carried out separately for each of the surveys covered. C. CALCULATION AND PRESENTATION OF RATES Use of Sampling Weights Rates for all health, nutrition, and population indicators are calculated after applying the DHS sampling weights. (DHS surveys often over-sample certain small subgroups of interest ­ residents of a particular geographic area, for example ­ in order to get sample sizes large enough to produce statistically-significant results. The DHS sampling weights are used to compensate for such over-sampling in order to ensure that the results are representative of the population as a whole and not just of the DHS sample.) Calculation of Total Population Averages The average for the total population presented alongside the quintile-specific rates for each indicator is calculated without reference to quintile divisions. It thus equals the weighted mean of the quintile rates, with the weight assigned to each quintile rate being the proportion of the number of individuals at risk (as defined on p. 77) for the indicator concerned. Sampling Errors Information needed to assess the statistical significance of differences among the quintile-specific rates is presented in three ways: · First, in all the basic tables presented in part I, rates are shown in parentheses or replaced by asterisks in cases where the standard error is likely to be unacceptably high because 17 Such an index is usually referred to as either an "asset index" or a "wealth index." The two expressions are used interchangeably in this report; for ease of communication, "wealth index" appears more frequently despite the inexact correspondence between the items included in the index's construction and those appearing in more conventional, financially-based definitions of wealth. - 72 - of small sample size. The number of observations used to determine how to present the data for the different indicators covered were as follows: Indicator Unit of measure Number of observations used to determine how quintile-specific rate was presented Without With Replaced by parentheses parentheses asterisk Infant and child Number of deaths >500 250-499 <250 mortality Total and adolescent Number of births >250 125-249 <125 fertility All other indicators Number of >50 25-49 <25 individuals · Second, the standard error for each quintile-specific rate (except for any rate replaced by an asterisk) appearing in the total population table is provided in part III.B. (Standard errors for the quintile-specific rates presented in the female-male and rural-urban tables are not available.) · Third, the right-hand column of the total population table provides the standard error for the concentration index, one of the measures of inequality shown, as indicated below. D. MEASUREMENT OF INEQUALITY Accompanying each of the indicators presented in the total population table are the values for three statistical measures of inequality: · Low/High Quintile Ratio: the ratio between the rate prevailing in the lowest (poorest) population quintile and that found in the highest (least poor) quintile. · Low-High Quintile Difference: the value of the lowest quintile minus the value of the highest, expressed as an absolute value. · Concentration Index: twice the area in a Lorenz-type diagram between the line of equality and the concentration curve for the indicator in question, the curve being the graph of the cumulative share of the indicator against the cumulative share in the asset distribution. (The value, which can range from -1 to +1, is negative when the hnp indicator is higher among the poor (e.g., fertility), positive when it is higher among the better-off (e.g., modern contraceptive use), and zero when on balance the indicator shows no systematic relationship with wealth.)18 18Adam Wagstaff, Pierella Paci, and Eddy van Doorslaer, "On the Measurement of Inequalities of Health," Social Science and Medicine 33 (1991): 545-57. (See also chapter eight in the volume by O'Donnell, van Doorslaer, Wagstaff, and Lindelow described in the annotated bibliography that constitutes annex A.) - 73 - DISCUSSION While a basic understanding of the data and methods employed is necessary to adequately appreciate the figures appearing in this report, it is not sufficient. For the application of the approach taken involves many subtleties that also need to be understood. Among the more important are: A. DESCRIPTIVE NATURE OF THE RELATIONSHIPS The hnp-poverty relationships shown in this report are no more than descriptive. They should not be taken to imply any direct causal relationships, for several reasons. One reason is the possibility that it is not wealth or asset possession per se that determine a person's health condition. Rather, the determining factors could be other characteristics (such as education or ethnic background) that are simultaneously associated with both asset ownership and health status. It is also possible that the health-poverty relationships shown are driven primarily by particular items included in the index (e.g., water and sanitation). Should this be the case, improvements in health conditions among the poor might be more effectively brought about by focusing on changing those particular components of the wealth index rather than by a general effort to increase economic status as measured by the index as a whole. B. IMPLICATIONS OF A WEALTH/ASSET APPROACH Wealth or Assets as a Measure of Economic Status Reliance on a wealth index to measure economic status is a rather recent development in research on economic disparities, where such status traditionally has been defined in terms of consumption or income. The principal reason for the choice of the wealth index is pragmatic rather than conceptual: the DHS surveys, which are of interest because of the plethora of hnp information that they contain, do not collect consumption or income data; but they do have detailed information on households' physical characteristics, and on the household-level presence of and access to a wide range of goods and services. While there is some disagreement about the relative merits of using such wealth/asset information or consumption data to measure economic status, several recent studies suggest that the asset-consumption relationship is quite close.19 To the extent this is the case, an index of wealth or asset possession/availability can be taken as a 19See, for example, Deon Filmer and Lant H. Pritchett, "Estimating Wealth Effects without Expenditure ­ or Tears: An Application to Educational Enrollments in States of India," Demography 38, no. 1 (February 2001): 115-32; Shea Rutstein and Kiersten Johnson, The DHS Wealth Index, DHS Comparative Reports No. 6 (Calverton, Maryland, USA: ORC Macro, August 2004) esp. 10-14; Adam Wagstaff and Naoko Watanabe, "What Difference Does the Choice of SES Make in Health Inequality Measurement?" Health Economics 12 (2003): 885-90. - 75 - reasonably satisfactory proxy for consumption, rather than or in addition to serving as an indicator of economic status in its own right. C. ECONOMIC STATUS AS A MEASURE OF SOCIO-ECONOMIC WELL-BEING Like consumption or income, a wealth index defines disparities that are primarily economic. This is by no means the only way to define inter-group inequalities that are of potential concern. Other possibilities include gender, place of residence, education, ethnic background, or other factors associated with social exclusion. Thus the economic perspective provides only a partial view of the multidimensional concepts of poverty, inequality, and inequity. By including tables on female-male and rural-urban inequalities, this report pays adequate attention to two of inequality's other important dimensions to justify the use of the term "socio- economic" rather than simply "economic" in its title. However, the centrality of tabulations based on the wealth index means that the primary focus is on the economic dimension. The justification for this lies not in the greater importance of economic considerations, but rather in the recently-improved ability to analyze and thus begin dealing with them. Until the development of the wealth/asset approach, the assessment of economic status had been based on consumption, expenditures, or income, all of which are far more difficult to measure than such other, non- economic dimensions of inequality as gender, ethnic identity, educational level, and place of residence. As a result, assessments of health inequalities by economic status had lagged well behind measurements in terms of these other dimensions, especially gender and education. The focus on inequality's economic aspect applied here represents an effort to redress this imbalance. D. INDEX CONSTRUCTION Choice of Items Use of a wealth index requires decisions about which items to include in it. In the case of secondary analyses like the one featured in this report, the choice is limited to those items included in the data sets being used. But even with this constraint, there nonetheless remains considerable room for choice, given the large number of items for which information is collected by the DHS. The decision made in preparing this report was to include all items in each DHS household questionnaire that relate to ownership of household goods; to dwelling unit construction and characteristics; and to access to services and resources like electricity, water, and sanitation facilities. Also included were other potential indicators of wealth, such as live-in domestic servants. This decision, admittedly somewhat arbitrary, has both advantages and disadvantages. The principal advantage is practical: use of a large number of assets increases the degree of variation across household asset scores and facilitates a more regular distribution of individuals across quintiles. It also reduces the possibility of subjectivity in selecting only some of the variables for inclusion on some a priori basis; and it may increase a wealth index's accuracy as a proxy for consumption. However, including all variables is far from satisfying conceptually. For example, it means failing to discriminate with respect to the items' differing natures. It is not clear, for instance, whether access to water, sanitation, electricity, or other publicly-provided resources should be included in an index that purports to measure private household wealth. Further, many items that are candidates for inclusion in a DHS-based wealth index might be seen as directly influencing health status: water and sanitation for infant and child mortality, for - 76 - example. It would be desirable to include quintile-specific estimates for such items; but to the extent that such items have large index coefficients, any estimates for those items would be suspect. Such items appear to be relatively few and of limited statistical significance in the index used here. However, for the sake of caution, quintile-specific estimates for items appearing in the index have nonetheless been excluded from the basic tables and appear only in supporting table III.C Additional issues arise when comparing the findings for two different points in time covered in the basic tables. Because the nature and number of asset questions included in DHS surveys has been evolving, the items included in the wealth index differ somewhat for each of the surveys reported upon. As such, the results presented in the basic tables might differ to some extent from findings produced by some other approach, such as including in the index only those items appearing in each survey covered. Weighting of Items A further decision required in construction of an index concerns the weight to attach to each of the respective items. As noted earlier, the method used in this report is principal components analysis (PCA). Adoption of this method was based on the findings, referred to earlier, that its use resulted in outcomes that approximated reasonably well those produced by taking a consumption or expenditure approach. Further, it often provides greater discrimination in economic status than does the use of consumption/expenditures. It has also emerged as the standard approach for use in analyses of the sort presented here, so that its adoption is largely non-controversial. Yet this choice, too, is not without an arbitrary aspect; for alternative plausible methods exist. Examples include the "inverse possession" approach, which gives more weight to items possessed by only a few and less to those possessed by many;20 or, perhaps, the common practice of simply assigning the same weight to each index item. Also, the weights for any particular item vary from survey to survey, since the weights were determined separately for the population of each survey included in the basic tables. The results thus produced can be expected to differ from those generated in some other manner, such as generating common weights for all the surveys covered by pooling the data sets. Use of Principal Components Analysis with Dichotomous Variables An additional issue concerns the use of a technique like PCA, developed for use with continuous variables, in the construction of an index based primarily on dichotomous variables. While legitimate in principle, any reservations in this regard are of limited practical consequence, since the considerable experimentation undertaken in preparation for the tabulations presented here indicated that any inaccuracy introduced by applying PCA to the analysis of the dichotomous values used is minimal. Economies of Scale Calculating the values for a household wealth index also requires a decision concerning economies of scale that exist in the households covered. The calculations presented here assume complete economies of scale. The implicit assumption is that additional members do not add to household expenses on items included in the index. 20Saul S. Morris et al., "Validity of Rapid Estimates of Household Wealth and Income for Health Surveys in Rural Africa," Journal of Epidemiology and Community Health 54 (2000): 381-87. - 77 - E. DEFINITION OF QUINTILES Quintiles of Individuals As noted earlier, the quintile-specific figures presented in this report refer to quintiles of individuals in the household population. Such quintiles need to be distinguished from quintiles of households or quintiles of only those people in the population who are "at risk": that is, subject to the particular condition, eligible for the particular service, or capable of behaving in a particular way (children born alive for infant and under-five mortality, for example; or adult men and women for condom use or non-regular sexual partnerships). The expression of findings in terms of quintiles of individuals has several implications: · Because fertility is often higher in lower economic households than among better-off ones, the number of individuals per household will frequently be larger among the poor than among higher-income groups. In such cases, the number of households will vary systematically across quintiles of individuals, and the results expressed in terms of quintiles of households can differ significantly from those presented here. · The proportion of individuals "at risk" with regard to a particular indicator is also likely to vary across quintiles in many cases. (For example, in cases where fertility is higher among poor people, a higher-than-average proportion of poor populations will consist of newborns at risk from infant mortality, young children subject to malnutrition, and pregnant women for whom antenatal care is relevant.) To facilitate the work of any investigators wishing to undertake calculations based on people at risk, the number of such people in each quintile of individuals is shown in part III.A. · As previously indicated, the population average figure provided for each indicator is equivalent to the weighted sum of the quintile rates for that indicator, where the weight assigned to each quintile rate is the number of people at risk in each quintile as presented in part III.A. As a result of this weighting, the population average will usually differ from a simple mean of the population quintile estimates. Quintiles of Males and Females, of Rural and Urban Residents As also reported in the data and methods section, the tables on rural and urban residents and on men and women were prepared using the same asset scores as for the total population; and rural- urban residents and females-males were separated from one another only after the entire sample had been disaggregated into quintiles of individuals. This means that the figures given in the rural-urban and female-male tables refer to females-males and rural-urban residents belonging to each quintile of individuals in the total population, as distinct from quintiles of females, of males, of rural residents, or of urban residents alone. The consequence of this distinction is particularly evident with regard to rural and urban residents. Since rural residents tend to be poorer than urban dwellers, they normally form a considerably higher proportion of individuals in the lower economic quintiles of the total population than in the higher ones. Conversely, urban residents tend to be concentrated in the higher economic groups. As a result, the number of individuals in each of the urban and rural quintiles usually varies greatly and systematically; and when this is the case, the figures presented in the rural-urban tables can differ significantly from those produced by a computation procedure that places the same number of rural and urban residents in each rural quintile or each urban quintile. (The results may also differ significantly from application of an approach featuring the separate calculation of index values for urban and for rural groups. While such separate index values may well be preferable conceptually, their calculation involves complexities that prevented their preparation for this report.) - 78 - F. COMPARISON OF QUINTILES ACROSS COUNTRIES Reliance on population quintiles as basic presentational format for the data appearing in this report implicitly incorporates a relative concept of poverty. This differs from an absolute concept of poverty under which the population would be divided into groups of different sizes according to some absolute standard of living (such as people earning less than one dollar a day, between one and two dollars a day, and more than two dollars a day). This means that, when comparing values of an indicator among people in a given quintile across countries, the comparison is between groups of people whose economic status can be quite different. The lowest quintile of a Latin American population, for example, will usually be considerably better-off than the lowest quintile in an African country. G. COMPARISON OF QUINTILES OVER TIME Another implication is that the wealth status of any given quintile within a particular country is likely to change over time. For instance, when a country is progressing economically, the wealth of the households in the population will tend to increase. This will raise the average asset score in most, possibly all population quintiles. As a result, the living standard enjoyed by individuals in any quintile covered by a recent survey is likely to be higher than that of individuals in that same quintile as measured in a prior survey. H. STATISTICAL INDICATORS OF INEQUALITY The available statistical indicators of inequality are far too numerous to permit use of more than a small proportion of them in presenting the findings featured in this report. The three indicators employed have been selected to provide a wide range of perspectives. Two are designed for ease of understanding, the third for greater technical accuracy. The low/high quintile ratio and low-high quintile difference are the two presented for ease of understanding. The former is a relative measure, the latter an absolute measure that can produce a significantly different impression from that provided by the former. The concentration index is provided for the benefit of technical specialists wishing greater accuracy. It measures the degree of inequality in an hnp indicator across the full wealth index distribution, rather than differences between only two of the five quintiles, and also reflects the relative size of the different asset-based divisions of the study population. I. COMPARABILITY WITH OTHER REPORTS Tabulations similar to those presented here can also be found in the initial series of hnp/poverty country reports, issued in 2000, and in the recent country reports issued by the DHS program. The figures presented in those reports normally resemble quite closely those appearing here for any given indicator; but there are often slight differences for one or more of several reasons. The most common is a difference in the definition of the indicator in question. (These differences are usually small and subtle. But there is one important exception: the definition of moderate malnutrition among children. In the 2000 reports, this was defined as second and third degree malnutrition taken together. Here, it is defined as second degree malnutrition alone.) Another reason, with respect to infant and child mortality, is that the figures in the DHS documents are typically based on experience during the five years before the survey in question, rather than - 79 - during the ten previous years as in this report. A further frequent reason is the use of an improved computational technique. In addition, asset-based, quintile-specific tabulations of hnp indicators have begun to appear in an increasing number of other documents. Given the basic similarity of approach, such tabulations usually produce results that are generally congruent with those shown in part I of this report. However, significant divergences have occasionally been reported; and the absence of adequately detailed information about data and methods often prevents any fully-satisfying understanding of the approaches used. As a result, occasional doubts and frequent uncertainties about approach comparability remain. - 80 - PART V. SUPPORTING TABLES, 2003 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Bukina Faso 2003 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 10,963 11,036 14,331 9,858 11,548 57,737 Urban 55 89 205 1,008 8,888 10,244 Rural 10,908 10,947 14,127 8,851 2,660 47,493 Female 5,658 5,553 7,424 5,080 5,938 29,653 Male 5,305 5,480 6,907 4,779 5,610 28,081 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 4,250 4,684 5,804 3,912 3,185 21,834 Urban 23 25 69 386 2,247 2,750 Rural 4,227 4,659 5,734 3,526 938 19,084 Female 2,074 2,312 2,857 1,906 1,595 10,744 Male 2,176 2,372 2,947 2,006 1,589 11,090 Prevalence of fever, diarrhea, acute respiratory infection All 1,790 1,977 2,546 1,733 1,431 9,476 Urban 10 10 27 182 1,032 1,261 Rural 1,781 1,967 2,519 1,550 399 8,216 Female 900 927 1,236 847 721 4,630 Male 891 1,050 1,310 886 710 4,846 Total fertility rate All 2,190 2,290 2,972 2,058 2,967 12,477 Urban 11 15 42 236 2,393 2,697 Rural 2,179 2,275 2,930 1,822 574 9,780 Age-specific fertility rate 15-19 All 478 457 611 402 827 2,776 Urban 2 3 9 59 692 765 Rural 477 454 602 343 136 2,012 Children's nutritional status All 1,559 1,713 2,209 1,541 1,247 8,269 Urban 9 7 25 151 912 1,104 Rural 1,550 1,706 2,185 1,390 335 7,166 Female 787 808 1,061 748 614 4,018 Male 772 906 1,148 793 633 4,252 Children's anemia status All 465 597 706 486 381 2,634 Urban 2 3 8 44 254 311 Rural 463 594 698 442 126 2,324 Female 252 288 344 221 194 1,298 Male 213 309 362 265 187 1,336 - 83 - Bukina Faso 2003 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All 2,161 2,261 2,943 2,028 2,840 12,233 Urban 11 15 41 226 2,275 2,569 Rural 2,149 2,246 2,902 1,802 565 9,664 Women's anemia status All 714 832 1,022 716 987 4,271 Urban 3 3 14 79 767 866 Rural 711 828 1,008 638 220 3,404 Girls' circumcision All na na na na na na Urban na na na na na na Rural na na na na na na Women's circumcision All 2,074 2,194 2,859 2,004 2,928 12,059 Urban 11 15 41 234 2,368 2,669 Rural 2,062 2,179 2,818 1,771 560 9,389 Prevalence of genital discharge, ulcer, sore Female 2,190 2,290 2,971 2,058 2,965 12,474 Urban Female 11 15 42 236 2,391 2,695 Rural Female 2,179 2,275 2,929 1,822 574 9,778 Male 564 702 787 576 969 3,598 Urban Male 1 2 10 63 788 865 Rural Male 563 700 777 513 181 2,733 - 84 - Bukina Faso 2003 - SAMPLE SIZES Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Immunization coverage All 315 392 490 360 278 1,835 Urban 1 3 7 34 185 230 Rural 314 389 484 326 93 1,605 Female 154 179 258 180 137 909 Male 161 213 232 180 141 927 Treatment of fever All 668 722 1,007 653 431 3,481 Urban 2 4 13 53 286 359 Rural 666 717 994 600 145 3,122 Female 337 339 477 309 219 1,681 Male 330 383 530 344 212 1,800 Treatment of acute respiratory infection All 147 173 231 152 107 811 Urban 1 1 2 18 80 101 Rural 147 172 229 134 28 710 Female 72 75 100 71 53 370 Male 75 98 132 81 55 441 Treatment of diarrhea All 364 428 531 339 298 1,961 Urban 10 1 5 38 221 266 Rural 362 428 526 301 78 1,694 Female 176 158 260 160 144 898 Male 188 270 271 179 154 1,063 Antenatal and delivery care All 1,379 1,523 1,976 1,334 1,216 7,428 Urban 6 7 23 129 890 1,055 Rural 1,372 1,516 1,954 1,204 326 6,372 Contraceptive prevalence Female 1,826 1,959 2,476 1,699 1,694 9,655 Urban Female 9 11 31 156 1,262 1,468 Rural Female 1,817 1,949 2,445 1,544 432 8,187 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Contraceptive source Female 33 88 153 118 454 846 Urban Female 1 1 4 22 391 419 Rural Female 32 87 149 96 63 428 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Treatment of genital discharge, ulcer, sore Female 29 34 57 54 317 490 Urban Female 2 14 289 na na 305 Rural Female 29 34 55 40 28 184 Male 10 7 15 21 37 89 Urban Male 36 na na na na 36 Rural Male 10 7 15 21 1 54 - 85 - Bukina Faso 2003 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Sanitary disposal of stools All 1,286 1,411 1,857 1,263 1,117 6,933 Urban 6 6 20 123 811 967 Rural 1,280 1,405 1,837 1,140 306 5,967 Wash hands prior to preparing food All 2,190 2,290 2,972 2,058 2,967 12,477 Urban 11 15 42 236 2,393 2,697 Rural 2,179 2,275 2,930 1,822 574 9,780 Handwashing facilities in household? All 1,966 1,670 2,054 1,389 1,996 9,076 Urban 11 10 32 178 1,625 1,856 Rural 1,954 1,660 2,023 1,211 371 7,220 Bednet ownership All 1,970 1,673 2,058 1,392 2,000 9,093 Urban 11 10 32 178 1,629 1,860 Rural 1,959 1,663 2,026 1,214 371 7,233 Bednet use by children All 2,100 2,297 2,900 1,972 1,583 10,852 Urban 10 11 31 201 1,132 1,386 Rural 2,089 2,286 2,869 1,771 451 9,466 Bednet use by pregnant women All 222 283 351 234 219 1,310 Urban 1 1 5 18 152 176 Rural 1 1 5 18 152 176 Exclusive breastfeeding All 168 155 197 114 88 721 Urban 1 0 1 13 61 77 Rural 167 154 195 101 27 644 Female 79 77 112 48 45 361 Male 89 78 85 66 42 361 Timely complementary breastfeeding All na na na na na na Urban na na na na na na Rural na na na na na na Female na na na na na na Male na na na na na na Bottle-feeding All 453 456 565 375 265 2,113 Urban 3 1 4 43 190 241 Rural 450 455 562 331 75 1,872 Female 229 222 299 177 133 1,059 Male 224 234 266 198 132 1,054 - 86 - Bukina Faso 2003 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Iodized salt in household All 1,917 1,631 1,989 1,328 1,825 8,690 Urban 11 9 29 156 1,477 1,681 Rural 1,906 1,622 1,960 1,173 348 7,009 Vitamin A supplementation All 1,745 1,912 2,498 1,704 1,379 9,238 Urban 10 9 27 174 990 1,211 Rural 10 9 27 174 990 1,211 Female 861 1,011 1,281 870 692 4,714 Male 861 1,011 1,281 870 692 4,714 Tobacco and alcohol use, casual sexual partners, condom use for casual sex Female 2,190 2,289 2,972 2,058 2,963 12,472 Urban Female 11 15 42 236 2,389 2,693 Rural Female 2,178 2,275 2,930 1,822 574 9,779 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Domestic violence All na na na na na na Urban na na na na na na Rural na na na na na na - 87 - Bukina Faso 2003 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 2,346 2,411 3,176 2,261 3,267 13,461 Urban female 13 16 45 258 2,630 2,961 Rural female 2,333 2,396 3,131 2,003 637 10,500 Male 1,871 2,089 2,447 1,845 3,135 11,386 Urban male na na na na na na Rural male na na na na na na School participation Female 983 1,004 1,329 812 830 4,958 Urban female 4 9 16 72 599 701 Rural female 979 995 1,313 740 231 4,257 Male 1,168 1,179 1,657 1,064 1,309 6,376 Urban male na na na na na na Rural male na na na na na na Mass media exposure Female 2,190 2,290 2,972 2,058 2,967 12,477 Urban female 11 15 42 236 2,393 2,697 Rural female 2,179 2,275 2,930 1,822 574 9,780 Male 562 699 790 573 968 3,593 Urban male 1 2 10 63 788 865 Rural male 561 697 780 510 180 2,728 Knowledge of HIV/AIDS prevention Female 2,190 2,290 2,972 2,058 2,967 12,477 Urban female 11 15 42 236 2,393 2,697 Rural female 2,179 2,275 2,930 1,822 574 9,780 Male 565 702 791 576 971 3,605 Urban male 1 2 10 63 790 867 Rural male 564 700 781 513 181 2,738 Household decisionmaking and justification of violence All 2,190 2,290 2,972 2,058 2,967 12,477 Urban 11 15 42 236 2,393 2,697 Rural 11 15 42 236 2,393 2,697 Orphanhood All 5,407 5,560 7,473 5,014 4,756 28,210 Urban 27 42 94 455 3,388 4,006 Rural 5,380 5,518 7,378 4,559 1,369 24,205 Female 2,672 2,666 3,608 2,399 2,428 13,774 Male 2,735 2,889 3,864 2,615 2,328 14,432 - 88 - Bukina Faso 2003 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 7.34 6.09 4.83 6.79 7.85 3.10 Under-five mortality rate 11.02 9.19 8.07 10.69 9.99 5.20 Prevalence of fever 2.05 1.73 1.51 1.59 1.77 0.98 Prevalence of diarrhea 1.47 1.64 1.26 1.59 1.55 0.76 Prevalence of acute respiratory infection 0.86 0.87 0.88 1.14 0.99 0.46 B. Fertility Total fertility rate 0.21 0.20 0.15 0.23 0.21 0.14 Adolescent fertility rate 10.89 10.94 9.63 11.27 7.75 5.96 C. Nutritional status Children: Moderate stunting 1.16 1.17 1.12 1.00 1.18 0.52 Severe stunting 1.69 1.54 1.37 1.64 0.92 0.90 Moderate underweight 1.44 1.18 1.14 1.48 1.32 0.61 Severe underweight 1.26 1.09 1.02 1.22 0.89 0.64 Mild anemia 2.40 1.93 1.82 2.21 2.95 1.05 Moderate anemia 3.10 2.68 2.46 2.77 4.07 1.37 Severe anemia 1.69 1.95 1.57 2.07 1.79 0.94 Women: Malnutrition 1.46 1.32 1.19 1.44 0.76 0.81 Mild anemia 1.39 1.47 1.19 1.74 1.52 0.68 Moderate anemia 1.53 1.59 1.25 1.68 1.25 0.68 Severe anemia 0.54 0.34 0.39 0.57 0.26 0.19 D. Female circumcision Prevalence of circumcision: Girls na na na na na na Women 1.90 1.75 1.57 1.95 1.54 1.13 Prevalence of occlusion: Girls 1.00 0.98 1.13 0.97 0.75 0.46 Women 0.44 0.50 0.37 0.46 0.42 0.21 E. Sexually transmitted disease Prevalence of genital discharge: Women 0.28 0.30 0.34 0.43 0.79 0.31 Men 0.74 0.30 0.61 1.24 0.58 0.33 Prevalence of genital ulcer: Women 0.14 0.14 0.12 0.16 0.38 0.12 Men 0.29 0.51 0.50 0.79 0.74 0.32 - 89 - Bukina Faso 2003 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 3.52 3.43 2.78 6.23 2.11 2.20 Measles coverage 3.74 3.84 3.33 5.66 3.59 2.35 DPT coverage 3.69 3.87 3.17 5.61 3.30 2.41 Full basic coverage 3.49 3.60 3.23 4.94 3.61 2.19 No basic coverage 2.09 2.39 2.20 1.42 1.90 1.12 Hepatitis B coverage na na na na na na Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 2.71 2.29 1.99 2.74 2.96 1.52 Treatment in a public facility 2.61 2.24 1.97 2.72 3.00 1.49 Treatment in a private facility 0.55 0.58 0.29 0.36 0.76 0.22 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 4.63 4.47 3.78 5.76 5.03 2.37 Treatment in a public facility 4.59 4.01 3.80 5.66 5.23 2.28 Treatment in a private facility 0.63 1.91 0.56 1.26 2.78 0.62 Treatment of diarrhea: Use of oral rehydration therapy 3.13 3.92 2.81 3.88 3.29 1.89 Medical treatment of diarrhea 2.15 2.27 2.19 2.39 3.59 1.25 Treatment in a public facility 2.10 2.16 2.19 2.08 3.50 1.21 Treatment in a private facility 0.57 0.54 0.00 0.61 0.90 0.27 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically-trained person 2.76 2.45 2.02 2.24 0.87 1.64 To a doctor 0.38 0.34 0.20 0.53 1.38 0.32 To a nurse or trained midwife 2.72 2.43 2.01 2.19 1.37 1.59 Multiple visits to a medically-trained person 2.20 1.99 2.02 2.58 1.74 1.54 Antenatal care content: Tetanus toxoid 2.21 2.06 1.76 2.16 1.46 1.29 Prophylactic antimalarial treatment 2.58 2.25 1.93 2.23 1.14 1.56 Iron supplementation 2.58 2.27 1.86 2.05 1.24 1.42 Delivery attendance: By a medically-trained person 1.83 1.93 2.45 3.04 2.06 2.00 By a doctor 0.15 0.25 0.21 0.28 0.92 0.20 By a nurse or trained midwife 1.82 1.89 2.39 2.97 2.01 1.92 In a public facility 1.83 2.06 2.46 3.07 2.07 1.96 In a private facility 0.00 0.00 0.06 0.29 1.18 0.21 At home 1.84 2.06 2.46 3.09 2.06 2.01 D. Contraceptive services Contraceptive prevalence: Women 0.36 0.55 0.70 0.83 1.48 0.64 Men na na na na na na Source of contraception - public sector: Women 8.83 6.22 4.15 4.13 3.13 2.23 Men na na na na na na - 90 - Bukina Faso 2003 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - private sector: Women 9.03 6.35 4.01 3.94 2.74 2.06 Men na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 10.92 10.97 6.40 9.64 3.06 3.12 Men * * * * 10.99 6.04 Treatment of genital discharge, ulcer, sore in public facilities: Women 10.92 10.97 6.40 9.64 3.06 3.12 Men * * * * 10.99 6.04 Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men 0.52 0.62 0.74 1.21 1.74 0.72 - 91 - Bukina Faso 2003 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal 0.79 0.93 1.21 1.77 2.75 1.62 Handwashing: Wash hands prior to preparing food 0.51 0.53 0.41 0.40 0.46 0.27 Handwashing facilities in household 0.20 0.52 0.53 1.58 1.76 0.69 B. Bednet ownership and use Bednet ownership: Bednet ownership 3.26 2.60 2.30 2.48 1.85 1.57 Treated bednet ownership na na na na na na Bednet use: By children 3.49 2.45 2.15 2.34 2.50 1.66 By pregnant women 4.28 3.97 3.86 5.29 3.38 2.39 C. Breastfeeding Exclusive breastfeeding 3.98 3.91 3.32 5.53 6.00 2.07 Timely complementary feeding na na na na na na Bottle-feeding 0.28 0.16 0.41 0.54 1.82 0.29 D. Micronutrient consumption Iodized salt: Availability of iodized salt in household 2.04 2.48 2.34 2.49 2.22 1.69 Vitamin A: Children 1.68 1.84 1.55 2.05 2.01 1.11 Women 1.08 1.24 1.21 1.54 1.63 0.79 E. Tobacco and alcohol use Tobacco: Women 0.89 0.79 0.62 0.73 0.28 0.39 Men na na na na na na Alcohol: Women 0.44 0.34 0.33 0.30 0.32 0.18 Men 0.75 0.86 1.09 0.70 1.05 0.45 F. Sexual practices Non-regular sexual partnerships: Women 0.10 0.16 0.16 0.24 0.24 0.10 Men 0.64 1.05 0.87 1.16 2.02 0.75 Condom usage with non-regular partner: Women * * * * 8.79 8.68 Men * 8.52 8.74 * 1.74 3.31 G. Domestic violence Ever experienced violence na na na na na na Experienced violence in past year na na na na na na - 92 - Bukina Faso 2003 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Education School completion: Women 0.41 0.52 0.63 1.05 1.98 1.44 Men 0.86 0.91 1.04 1.90 1.85 1.82 School participation: Girls 1.33 1.59 1.84 2.28 2.82 1.54 Boys 2.07 2.16 2.34 2.66 2.04 1.85 B. Exposure to mass media Newspaper readership: Women 0.17 0.14 0.23 0.62 1.59 0.77 Men 0.23 0.64 0.76 2.04 2.21 1.18 Radio listenership: Women 1.75 1.96 1.71 2.45 1.38 1.48 Men 3.19 2.78 2.34 2.11 1.22 1.49 Television viewership: Women 0.60 0.69 0.89 1.75 1.91 2.00 Men 1.26 1.48 2.14 2.53 2.55 2.42 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 1.60 1.64 1.71 2.22 1.37 1.19 Men 2.27 2.07 1.83 2.05 1.21 1.04 Knowledge about mother-to-child transmission of HIV/AIDS: Women 1.68 1.79 1.54 2.81 1.50 1.28 Men 2.32 2.14 1.92 2.35 1.19 1.22 Attitudes toward HIV/AIDS: Women 2.19 1.83 1.87 1.82 1.66 1.07 Men 2.65 2.82 2.56 2.93 2.08 1.42 D. Status of women Household decisionmaking: Can seek own health care 0.72 0.80 0.72 1.11 1.83 0.87 Can seek children's health care 1.76 1.98 1.56 2.48 1.52 1.04 Can make daily household purchases 2.17 2.20 1.57 1.68 1.32 1.05 Can make large household purchases 2.02 1.76 1.40 1.44 1.39 0.96 Can make meal-related decisions 1.61 1.63 1.68 3.09 1.40 1.13 Freedom of movement: Can travel to visit family/relatives 1.35 1.53 1.07 1.36 2.08 0.98 Other decisionmaking, attitudes: Can decide how to spend own money 1.88 3.22 2.10 1.71 1.51 0.99 Can decide whether to have sex 0.91 0.77 0.71 0.85 0.65 0.42 Justifies domestic violence 2.08 1.79 1.43 1.34 2.23 1.13 E. Orphanhood Paternal orphan prevalence 0.68 0.53 0.44 0.56 0.73 0.29 Maternal orphan prevalence 0.32 0.43 0.27 0.42 0.51 0.17 Double orphan prevalence 0.11 0.23 0.13 0.15 0.27 0.08 - 93 - Bukina Faso 2003 - ASSET DISTRIBUTION AND WEIGHTS (FACTOR SCORE) Asset Variable Unweighted Wealth Quintiles Factor Low 2nd 3rd 4th High Avg. Score Mean Std. Percentage of Population Devia- tion Has electricity 0.123 0.329 0.0% 0.0% 0.3% 1.1% 51.3% 12.3% 0.13055 Has radio 0.641 0.480 0.0% 92.7% 67.8% 74.5% 88.4% 64.1% 0.05447 Has television 0.121 0.326 0.0% 0.0% 0.3% 3.1% 49.0% 12.1% 0.12302 Has refrigerator 0.046 0.209 0.0% 0.0% 0.0% 0.0% 19.5% 4.6% 0.10348 Has bicycle 0.770 0.421 67.4% 92.4% 85.1% 80.3% 64.0% 77.0% -0.02933 Has motorcycle or scooter 0.252 0.434 0.0% 0.0% 23.8% 33.6% 62.2% 25.2% 0.08924 Has car or truck 0.025 0.156 0.0% 0.0% 0.0% 0.5% 10.3% 2.5% 0.07631 Has telephone 0.033 0.178 0.0% 0.0% 0.0% 0.0% 13.9% 3.3% 0.09055 Has a domestic worker not related to household head 0.007 0.081 0.0% 0.0% 0.0% 0.1% 2.8% 0.7% 0.04432 Works own or family's agricultural land 0.819 0.385 79.0% 87.3% 85.6% 80.0% 78.0% 81.9% -0.00721 Uses water piped into residence 0.031 0.173 0.0% 0.0% 0.0% 0.1% 13.0% 3.1% 0.07568 Uses water piped into compound or plot 0.039 0.194 0.0% 0.0% 0.0% 0.1% 16.5% 3.9% 0.07408 Uses water piped from public system 0.158 0.365 0.0% 0.0% 6.1% 18.5% 49.3% 15.8% 0.06196 Uses water from an open well in yard or residence 0.035 0.185 0.0% 1.8% 4.9% 6.8% 4.5% 3.5% 0.00148 Uses water from a public open well 0.208 0.406 28.0% 30.4% 25.2% 20.3% 3.4% 20.8% -0.03703 Uses water from a protected well in yard or residence 0.121 0.326 9.3% 5.4% 19.0% 21.9% 6.4% 12.1% -0.01337 Uses water from a protected public well 0.269 0.443 32.7% 38.1% 34.8% 26.1% 6.2% 26.9% -0.03953 Uses water from a spring or collect rainwater for drinking 0.011 0.105 1.2% 1.8% 1.4% 1.4% 0.1% 1.1% -0.00773 Uses water from river, stream, pond, lake, dam, or other 0.128 0.334 28.8% 22.6% 8.7% 4.7% 0.6% 12.8% -0.03774 Uses own flush toilet 0.012 0.108 0.0% 0.0% 0.0% 0.1% 5.0% 1.2% 0.05712 Uses shared flush toilet 0.004 0.064 0.0% 0.0% 0.0% 0.4% 1.5% 0.4% 0.01284 Uses own pit latrine 0.038 0.190 0.0% 0.0% 5.1% 10.6% 4.1% 3.8% 0.00695 Uses a shared pit latrine 0.042 0.201 0.0% 0.0% 5.3% 8.7% 7.1% 4.2% 0.01226 Uses own VIP latrine 0.085 0.279 0.0% 0.0% 0.4% 7.8% 30.7% 8.5% 0.06739 Uses shared VIP latrine 0.129 0.335 0.0% 0.0% 0.7% 12.1% 46.0% 12.9% 0.07672 Uses bush or field as latrine 0.685 0.465 100.0% 100.0% 88.2% 59.0% 4.4% 68.5% -0.12041 Has raw natural material flooring 0.583 0.493 100.0% 100.0% 63.0% 31.7% 3.1% 58.3% -0.10826 Has parquet, vinyl, tile, or carpet as flooring 0.017 0.128 0.0% 0.0% 0.0% 0.6% 6.7% 1.7% 0.06487 Has cement as flooring 0.400 0.490 0.0% 0.0% 36.9% 67.5% 90.2% 40.0% 0.09204 Uses natural gas, biogas, or electricity for cooking 0.034 0.181 0.0% 0.0% 0.0% 0.1% 14.2% 3.4% 0.08029 Uses charcoal, lignite, coal, or kerosene for cooking 0.051 0.220 0.0% 0.0% 0.0% 6.2% 17.7% 5.1% 0.05426 Uses wood, straw, dung, or other materials for cooking 0.896 0.305 100.0% 100.0% 99.3% 90.6% 62.8% 89.6% -0.09462 Does not cook 0.018 0.133 0.0% 0.0% 0.5% 2.8% 5.3% 1.8% 0.01843 - 95 - PART VI. SUPPORTING TABLES, 1998 / 1999 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Bukina Faso 1998 / 99 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 6,427 6,976 6,370 6,131 6,459 32,363 Urban 10 12 43 254 4,285 4,605 Rural 6,417 6,963 6,327 5,877 2,174 27,758 Female 3,348 3,639 3,323 3,200 3,301 16,810 Male 3,078 3,337 3,048 2,931 3,158 15,551 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 2,947 2,873 2,218 2,343 1,878 12,260 Urban 4 6 14 68 1,126 1,218 Rural 2,943 2,867 2,205 2,275 752 11,042 Female 1,463 1,411 1,050 1,158 932 6,015 Male 1,485 1,462 1,168 1,185 946 6,245 Prevalence of fever, diarrhea, acute respiratory infection All 1,243 1,191 954 1,047 851 5,286 Urban 2 4 6 30 513 555 Rural 1,240 1,186 948 1,017 339 4,730 Female 645 567 445 518 429 2,604 Male 598 624 509 529 422 2,682 Total fertility rate All 3,642 4,006 3,097 3,310 3,860 17,915 Urban 4 9 24 126 2,798 2,961 Rural 3,638 3,997 3,073 3,184 1,062 14,954 Age-specific fertility rate 15-19 All 655 900 689 757 1,105 4,107 Urban 0 2 4 27 859 892 Rural 655 898 685 730 246 3,214 Children's nutritional status All 739 863 710 781 698 3,791 Urban 2 4 5 28 431 470 Rural 737 859 705 753 268 3,322 Female 387 426 322 387 350 1,872 Male 352 437 389 393 348 1,919 Children's anemia status All na na na na na na Urban na na na na na na Rural na na na na na na Female na na na na na na Male na na na na na na - 99 - Bukina Faso 1998 / 99 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All 731 746 590 623 587 3,279 Urban 1 2 6 20 376 405 Rural 730 744 584 604 212 2,874 Women's anemia status All na na na na na na Urban na na na na na na Rural na na na na na na Girls' circumcision All 1,292 1,444 1,122 1,180 1,408 6,445 Urban 1 3 8 45 1,028 1,086 Rural 1,290 1,441 1,113 1,135 380 5,359 Women's circumcision All 1,292 1,444 1,122 1,180 1,408 6,445 Urban 1 3 8 45 1,028 1,086 Rural 1,290 1,441 1,113 1,135 380 5,359 Prevalence of genital discharge, ulcer, sore Female 1,175 1,284 992 1,049 1,165 5,665 Urban Female 1 3 8 38 817 867 Rural Female 1,174 1,281 984 1,010 348 4,797 Male 323 434 370 353 577 2,057 Urban Male 2 2 4 12 440 460 Rural Male 322 433 367 341 137 1,600 - 100 - Bukina Faso 1998 / 99 - SAMPLE SIZES Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Immunization coverage All 229 248 186 206 172 1,041 Urban 1 1 1 7 97 107 Rural 228 248 184 199 75 934 Female 126 126 104 106 87 549 Male 103 123 82 100 86 494 Treatment of fever All 435 454 348 371 286 1,893 Urban 0 1 3 10 152 166 Rural 435 453 345 360 133 1,726 Female 210 247 186 195 156 994 Male 224 206 162 176 130 898 Treatment of acute respiratory infection All 176 186 129 126 97 714 Urban 0 0 3 6 47 56 Rural 176 186 127 120 50 659 Female 86 84 70 65 47 352 Male 90 102 59 61 49 361 Treatment of diarrhea All 222 227 194 225 187 1,055 Urban 0 0 0 9 98 107 Rural 222 227 194 216 89 948 Female 108 98 83 120 98 507 Male 113 129 112 105 89 548 Antenatal and delivery care All 924 927 747 797 703 4,099 Urban 1 3 6 21 439 470 Rural 923 924 741 776 264 3,628 Contraceptive prevalence Female 1,122 1,197 938 995 929 5,181 Urban Female 1 3 7 34 608 653 Rural Female 1,121 1,194 931 961 321 4,528 Male 290 340 290 259 326 1,505 Urban Male 2 2 3 9 226 242 Rural Male 288 338 287 251 100 1,264 Contraceptive source Female 20 31 27 24 149 250 Urban Female 0 0 1 1 129 131 Rural Female 20 31 26 23 20 119 Male 290 340 290 259 326 1,505 Urban Male 2 2 3 9 226 242 Rural Male 288 338 287 251 100 1,264 Treatment of genital discharge, ulcer, sore Female 2 4 5 6 27 44 Urban Female 0 0 0 0 22 22 Rural Female 2 4 5 6 4 21 Male 1 11 12 5 29 58 Urban Male 0 0 0 2 23 25 Rural Male 1 11 12 4 6 34 - 101 - Bukina Faso 1998 / 99 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Sanitary disposal of stools All na na na na na na Urban na na na na na na Rural na na na na na na Wash hands prior to preparing food All 1,292 1,444 1,122 1,180 1,408 6,446 Urban 1 3 8 45 1,028 1,085 Rural 1,290 1,441 1,113 1,135 380 5,359 Handwashing facilities in household? All 862 981 985 869 1,080 4,777 Urban 1 3 8 39 777 828 Rural 861 978 977 831 303 3,950 Bednet ownership All 862 981 985 869 1,080 4,777 Urban 1 3 8 39 777 828 Rural 861 978 977 831 303 3,950 Bednet use by children All 737 727 654 620 591 3,329 Urban 1 2 5 26 401 435 Rural 735 725 649 594 189 2,892 Bednet use by pregnant women All 146 153 134 146 109 688 Urban 0 1 0 3 61 65 Rural 146 152 134 142 48 622 Exclusive breastfeeding All 115 86 60 93 61 415 Urban 1 0 0 1 43 45 Rural 114 86 60 93 19 372 Female 51 46 29 52 32 210 Male 64 40 31 41 29 205 Timely complementary breastfeeding All 72 89 80 77 48 366 Urban 0 0 1 2 31 34 Rural 72 89 80 76 17 334 Female 35 46 45 36 25 187 Male 37 43 35 42 22 179 Bottle-feeding All 272 267 217 255 178 1,189 Urban 1 1 2 6 117 127 Rural 271 266 215 249 61 1,062 Female 130 139 125 136 89 619 Male 142 128 92 120 88 570 - 102 - Bukina Faso 1998 / 99 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Iodized salt in household All 862 981 985 869 1,080 4,777 Urban 1 3 8 39 777 828 Rural 861 978 977 831 303 3,950 Vitamin A supplementation All na na na na na na Urban na na na na na na Rural na na na na na na Female na na na na na na Male na na na na na na Tobacco and alcohol use, casual sexual partners, condom use for casual sex Female 1,292 1,444 1,122 1,180 1,408 6,446 Urban Female 1 3 8 45 1,028 1,085 Rural Female 1,290 1,441 1,113 1,135 380 5,359 Male 416 572 470 446 737 2,641 Urban Male 2 2 4 18 556 582 Rural Male 415 570 466 428 181 2,060 Domestic violence All 1,292 1,444 1,122 1,180 1,408 6,445 Urban 1 3 8 45 1,028 1,086 Rural 1,290 1,441 1,113 1,135 380 5,359 - 103 - Bukina Faso 1998 / 99 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 1,351 1,541 1,288 1,302 1,505 6,987 Urban female 2 3 9 50 1,075 1,140 Rural female 1,348 1,538 1,279 1,252 430 5,847 Male 968 1,079 969 977 1,536 5,530 Urban male 1 3 6 45 1,150 1,205 Rural male 967 1,077 964 932 386 4,325 School participation Female 562 614 526 508 493 2,703 Urban female 1 0 2 24 321 348 Rural female 561 614 524 484 172 2,355 Male 655 615 591 540 486 2,887 Urban male 2 1 2 22 290 316 Rural male 653 614 589 518 197 2,570 Mass media exposure Female 1,292 1,444 1,122 1,180 1,408 6,445 Urban female 1 3 8 45 1,028 1,086 Rural female 1,290 1,441 1,113 1,135 380 5,359 Male 416 572 470 446 737 2,641 Urban male 2 2 4 18 556 581 Rural male 415 570 466 428 181 2,060 Knowledge of HIV/AIDS prevention Female 2,565 1,444 1,122 1,180 1,408 7,719 Urban female 1 3 8 45 1,028 1,085 Rural female 1,290 1,441 1,113 1,135 380 5,359 Male 416 572 470 446 737 2,641 Urban male 2 2 4 18 556 582 Rural male 415 570 466 428 181 2,060 Household decisionmaking and justification of violence All 1,292 1,444 1,122 1,180 1,408 6,445 Urban 1 3 8 45 1,028 1,086 Rural 1,290 1,441 1,113 1,135 380 5,359 Orphanhood All 3,460 3,517 3,056 3,059 2,819 15,911 Urban 7 5 19 122 1,724 1,876 Rural 3,453 3,511 3,037 2,937 1,096 14,035 Female 1,702 1,704 1,465 1,497 1,458 7,825 Male 1,758 1,813 1,591 1,562 1,361 8,086 - 104 - Bukina Faso 1998 / 99 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 7.93 8.36 8.57 9.06 5.91 4.03 Under-five mortality rate 11.96 10.77 12.18 14.81 8.24 6.37 Prevalence of fever 1.61 1.98 2.11 1.71 2.02 0.98 Prevalence of diarrhea 1.30 1.65 1.55 1.56 1.66 0.78 Prevalence of acute respiratory infection 1.18 1.57 1.47 1.22 1.38 0.73 B. Fertility Total fertility rate 0.19 0.20 0.24 0.21 0.19 0.11 Adolescent fertility rate 18.00 13.00 13.00 12.00 8.00 6.00 C. Nutritional status Children: Moderate stunting 1.78 1.60 1.67 1.46 1.17 0.75 Severe stunting 1.99 1.40 1.57 1.54 1.23 0.80 Moderate underweight 1.40 1.33 1.74 1.48 1.30 0.67 Severe underweight 1.54 1.49 1.41 1.29 0.88 0.71 Mild anemia na na na na na na Moderate anemia na na na na na na Severe anemia na na na na na na Women: Malnutrition 1.85 1.43 1.65 1.35 1.02 0.82 Mild anemia na na na na na na Moderate anemia na na na na na na Severe anemia na na na na na na D. Female circumcision Prevalence of circumcision: Girls 1.86 1.68 1.77 1.68 1.24 0.96 Women 3.01 2.45 2.68 2.57 1.67 1.64 Prevalence of occlusion: Girls na na na na na na Women 0.09 0.10 0.00 0.15 0.15 0.05 E. Sexually transmitted disease Prevalence of genital discharge: Women 0.00 0.13 0.00 0.11 0.20 0.05 Men 0.00 0.73 0.77 0.65 0.67 0.31 Prevalence of genital ulcer: Women 0.00 0.00 0.00 0.00 0.07 0.01 Men 0.00 0.33 0.31 0.23 0.44 0.14 - 105 - Bukina Faso 1998 / 99 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 4.88 3.88 4.06 3.97 2.31 2.47 Measles coverage 3.78 4.28 3.88 4.69 4.14 2.32 DPT coverage 3.38 4.45 4.15 4.41 4.13 2.43 Full basic coverage 3.35 4.14 3.31 4.59 4.23 2.21 No basic coverage 3.06 2.89 3.00 2.88 1.16 1.63 Hepatitis B coverage na na na na na na Yellow fever coverage 3.53 3.21 3.74 4.18 4.15 2.18 B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 1.48 1.47 2.30 1.64 2.88 1.01 Treatment in a public facility 1.38 1.47 2.28 1.64 2.95 1.01 Treatment in a private facility 0.54 0.00 0.38 0.22 0.57 0.16 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 2.86 2.56 4.61 4.11 5.13 2.03 Treatment in a public facility 2.78 2.56 4.63 4.09 5.04 2.01 Treatment in a private facility 0.67 0.00 1.03 0.64 1.43 0.33 Treatment of diarrhea: Use of oral rehydration therapy 5.11 4.49 4.62 5.18 4.86 2.63 Medical treatment of diarrhea 2.30 2.36 3.45 2.86 3.23 1.31 Treatment in a public facility 2.15 1.97 3.45 2.86 3.31 1.27 Treatment in a private facility 0.92 1.02 0.00 0.00 0.79 0.33 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically-trained person 2.27 2.58 2.67 2.80 2.46 1.66 To a doctor 0.18 0.20 0.39 1.58 1.08 0.41 To a nurse or trained midwife 2.97 3.36 3.23 3.33 2.56 2.33 Multiple visits to a medically-trained person 2.92 2.96 2.81 2.69 2.55 1.99 Antenatal care content: Tetanus toxoid 3.18 3.46 3.35 3.54 2.08 2.46 Prophylactic antimalarial treatment na na na na na na Iron supplementation na na na na na na Delivery attendance: By a medically-trained person 1.58 1.91 2.40 3.70 3.07 1.88 By a doctor 0.11 0.29 0.23 0.21 0.48 0.12 By a nurse or trained midwife 1.57 1.86 2.40 3.64 3.05 1.85 In a public facility 2.01 2.50 2.47 3.92 3.03 2.07 In a private facility 0.08 0.00 0.00 0.20 0.86 0.15 At home 2.02 2.49 2.49 3.90 3.02 2.07 D. Contraceptive services Contraceptive prevalence: Women 0.67 0.79 0.89 0.76 1.52 0.55 Men 1.49 1.77 2.05 2.03 2.47 1.11 Source of contraception - public sector: Women * 8.11 * * 2.99 2.58 Men na na na na na na - 106 - Bukina Faso 1998 / 99 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - private sector: Women * 9.61 * * 2.99 2.64 Men na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women * * * * 7.55 6.47 Men * * * * 6.77 5.15 Treatment of genital discharge, ulcer, sore in public facilities: Women 0.00 0.13 0.00 0.11 0.20 0.05 Men * * * * 0.84 0.38 Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men na na na na na na - 107 - Bukina Faso 1998 / 99 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na Treated bednet ownership na na na na na na Bednet use: By children na na na na na na By pregnant women na na na na na na C. Breastfeeding Exclusive breastfeeding 0.70 1.92 3.64 2.93 3.85 1.18 Timely complementary feeding 5.36 5.64 4.96 5.59 6.81 2.84 Bottle-feeding 0.00 0.44 0.00 0.59 1.38 0.25 D. Micronutrient consumption Iodized salt: Availability of iodized salt in household na na na na na na Vitamin A: Children na na na na na na Women na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na Men na na na na na na Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 0.36 0.38 0.33 0.35 0.39 0.18 Men 1.60 2.08 1.97 2.27 1.92 1.05 Condom usage with non-regular partner: Women * * * * 8.75 4.76 Men 6.97 3.68 4.13 2.39 1.80 1.45 G. Domestic violence Ever experienced violence na na na na na na Experienced violence in past year na na na na na na - 108 - Bukina Faso 1998 / 99 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Education School completion: Women 0.30 0.41 0.43 0.74 2.23 0.59 Men 0.80 1.00 1.12 1.38 2.76 1.09 School participation: Girls 1.58 1.77 1.99 2.50 3.47 1.36 Boys 2.15 2.14 2.57 2.74 3.32 1.50 B. Exposure to mass media Newspaper readership: Women 0.09 0.16 0.12 0.32 1.14 0.27 Men 0.48 0.25 0.36 0.65 2.21 0.69 Radio listenership: Women 2.76 2.39 2.26 2.39 1.42 1.60 Men 3.73 3.13 2.84 2.69 1.72 1.75 Television viewership: Women 0.27 0.45 0.66 1.05 2.40 0.78 Men 1.58 1.64 1.55 2.00 2.61 1.30 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 2.74 1.79 2.20 2.07 1.04 1.33 Men 2.07 1.78 1.50 1.65 0.65 0.83 Knowledge about mother-to-child transmission of HIV/AIDS: Women 2.67 1.85 2.38 2.33 1.58 1.46 Men 3.17 2.82 2.99 2.89 1.70 1.54 Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na Can seek children's health care na na na na na na Can make daily household purchases na na na na na na Can make large household purchases na na na na na na Can make meal-related decisions na na na na na na Freedom of movement: Can travel to visit family/relatives na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na Can decide whether to have sex na na na na na na Justifies domestic violence na na na na na na E. Orphanhood Paternal orphan prevalence na na na na na na Maternal orphan prevalence na na na na na na Double orphan prevalence na na na na na na - 109 - Bukina Faso 1998 / 99 - ASSET DISTRIBUTION AND WEIGHTS (FACTOR SCORE) Asset Variable Unweighted Wealth Quintiles Factor Low 2nd 3rd 4th High Avg. Score Mean Std. Percentage of Population Devia- tion Has electricity 0.108 0.310 0% 0% 0% 0% 30% 6% 0.10530 Has radio 0.608 0.488 18% 59% 74% 71% 87% 62% 0.04837 Has television 0.100 0.299 0% 0% 0% 1% 31% 6% 0.09976 Has refrigerator 0.049 0.216 0% 0% 0% 0% 16% 3% 0.08691 Has bicycle 0.747 0.435 86% 85% 85% 91% 73% 84% -0.02923 Has motorcycle 0.267 0.443 0% 6% 37% 34% 65% 28% 0.06965 Has car 0.029 0.169 0% 0% 0% 0% 12% 2% 0.06454 Has telephone 0.028 0.165 0% 0% 0% 0% 9% 2% 0.07270 Has electric or gas stove 0.110 0.313 0% 0% 0% 2% 27% 6% 0.09358 Works own or family's agricultural land 0.549 0.498 98% 88% 64% 73% 31% 71% -0.07178 Uses filtered water 0.203 0.402 37% 22% 19% 22% 13% 22% -0.02593 Uses water piped in residence 0.068 0.252 0% 0% 0% 0% 18% 4% 0.09061 Uses water piped from public system 0.143 0.351 0% 0% 1% 4% 37% 8% 0.05555 Uses water from well in residence 0.052 0.221 0% 0% 6% 9% 12% 5% 0.00525 Uses water from a traditional public well 0.353 0.478 41% 51% 55% 40% 16% 41% -0.04662 Uses water from a borehole 0.323 0.468 51% 43% 34% 42% 11% 36% -0.04471 Uses water from a river, canal, or surface water 0.035 0.184 7% 5% 3% 3% 1% 4% -0.01472 Uses water from a spring 0.007 0.083 1% 1% 0% 2% 0% 1% -0.00533 Uses water from a vendor 0.017 0.129 0% 0% 0% 0% 4% 1% 0.02127 Uses bottled water 0.000 0.014 0% 0% 0% 0% 0% 0% 0.00286 Uses other source of water 0.001 0.032 0% 0% 0% 0% 0% 0% 0.00127 Uses a flush toilet in residence, private 0.009 0.096 0% 0% 0% 0% 2% 0% 0.04743 Uses a common flush toilet in residence, public 0.002 0.048 0% 0% 0% 0% 1% 0% 0.01284 Uses a pit latrine 0.307 0.461 0% 0% 0% 28% 84% 22% 0.09216 Uses a ventilated, improved latrine 0.003 0.056 0% 0% 0% 1% 1% 0% 0.01246 Uses bush or field as latrine 0.673 0.469 100% 100% 99% 70% 12% 77% -0.10326 Uses other type of latrine 0.002 0.050 0% 0% 0% 0% 0% 0% 0.00225 Has dirt, sand, dung as principal flooring 0.635 0.481 100% 100% 99% 53% 11% 73% -0.09901 Has vinyl or asphalt strips as flooring 0.002 0.050 0% 0% 0% 0% 0% 0% 0.01883 Has tiles as principal flooring 0.014 0.117 0% 0% 0% 0% 4% 1% 0.05156 Has cement as principal flooring 0.341 0.474 0% 0% 1% 46% 83% 25% 0.08426 Has carpeting as flooring 0.003 0.052 0% 0% 0% 0% 0% 0% 0.01363 Has other type of material as flooring 0.002 0.048 0% 0% 0% 0% 0% 0% -0.00031 Number of members per sleeping room 2.286 1.338 3.18 2.45 2.24 2.39 2.37 2.53 -0.01859 In rainy season: Uses water piped in residence 0.069 0.253 0% 0% 0% 0% 18% 4% 0.09044 Uses water piped from public system 0.139 0.346 0% 0% 0% 3% 37% 8% 0.05579 Uses water from well in residence 0.054 0.226 0% 0% 6% 10% 13% 6% 0.00521 Uses water from a borehole 0.263 0.440 37% 35% 28% 37% 10% 29% -0.03610 Uses water from a river, canal, or surface water 0.132 0.338 42% 16% 9% 7% 2% 15% -0.03403 Uses water from a spring 0.013 0.113 2% 2% 2% 2% 0% 2% -0.00851 Uses rainwater water for drinking 0.001 0.032 0% 0% 0% 0% 0% 0% 0.00008 Uses water from a vendor 0.017 0.129 0% 0% 0% 0% 4% 1% 0.02141 Uses bottled water 0.000 0.020 0% 0% 0% 0% 0% 0% 0.00580 Uses other source of water 0.001 0.032 0% 0% 0% 0% 0% 0% 0.00127 - 111 - PART VII. SUPPORTING TABLES, 1992 / 93 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Bukina Faso 1992 / 93 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 5,700 8,684 6,111 6,864 6,845 34,202 Urban 42 77 136 728 5,035 6,017 Rural 5,658 8,607 5,975 6,136 1,810 28,186 Female 2,944 4,496 3,244 3,519 3,410 17,613 Male 2,755 4,187 2,867 3,345 3,435 16,589 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 2,325 2,885 2,399 2,606 2,131 12,347 Urban 14 22 45 221 1,511 1,813 Rural 2,311 2,863 2,355 2,385 620 10,534 Female 1,157 1,430 1,197 1,250 1,016 6,050 Male 1,168 1,455 1,203 1,356 1,115 6,297 Prevalence of fever, diarrhea, acute respiratory infection All 1,041 1,305 1,043 1,182 955 5,526 Urban 7 10 22 101 679 818 Rural 1,034 1,296 1,021 1,081 276 4,708 Female 522 635 531 580 469 2,738 Male 519 670 512 602 485 2,788 Total fertility rate All 1,032 1,506 1,125 1,212 1,479 6,354 Urban 7 13 26 134 1,114 1,293 Rural 1,025 1,493 1,100 1,079 364 5,061 Age-specific fertility rate 15-19 All 195 302 227 240 409 1,373 Urban 2 4 7 31 312 356 Rural 193 298 220 209 97 1,017 Children's nutritional status All 777 992 784 947 778 4,278 Urban 6 7 16 82 557 669 Rural 770 985 768 866 221 3,610 Female 384 478 400 459 383 2,104 Male 393 514 384 488 395 2,175 Children's anemia status All na na na na na na Urban na na na na na na Rural na na na na na na Female na na na na na na Male na na na na na na - 115 - Bukina Faso 1992 / 93 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All 761 1,013 791 860 774 4,199 Urban 5 7 16 77 555 661 Rural 756 1,006 775 783 219 3,538 Women's anemia status All na na na na na na Urban na na na na na na Rural na na na na na na Girls' circumcision All na na na na na na Urban na na na na na na Rural na na na na na na Women's circumcision All na na na na na na Urban na na na na na na Rural na na na na na na Prevalence of genital discharge, ulcer, sore Female na na na na na na Urban Female na na na na na na Rural Female na na na na na na Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 116 - Bukina Faso 1992 / 93 - SAMPLE SIZES Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Immunization coverage All 204 240 224 235 201 1,104 Urban 1 3 25 137 na 166 Rural 203 240 221 210 64 938 Female 98 115 125 108 98 543 Male 106 125 99 127 104 561 Treatment of fever All 347 460 378 432 305 1,922 Urban 1 1 8 30 187 227 Rural 346 459 370 402 118 1,695 Female 163 226 179 212 137 916 Male 184 234 198 221 168 1,005 Treatment of acute respiratory infection All 41 66 49 51 44 251 Urban 0 0 4 38 na 43 Rural 41 66 49 46 6 207 Female 22 28 18 28 18 116 Male 19 38 31 22 25 135 Treatment of diarrhea All 142 139 128 138 102 649 Urban 0 0 1 14 71 87 Rural 141 139 127 123 31 562 Female 74 75 72 64 46 330 Male 68 64 57 74 56 319 Antenatal and delivery care All 1,187 1,519 1,236 1,360 1,064 6,366 Urban 8 11 26 113 751 909 Rural 1,179 1,509 1,210 1,247 312 5,457 Contraceptive prevalence Female 917 1,301 993 1,044 1,072 5,326 Urban Female 6 11 21 97 785 919 Rural Female 910 1,290 972 947 287 4,407 Male 239 387 229 262 217 1,334 Urban Male 0 2 6 25 152 186 Rural Male 238 385 223 237 64 1,148 Contraceptive source Female 7 4 10 26 176 223 Urban Female 6 151 na na na 157 Rural Female 7 4 10 20 25 66 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Treatment of genital discharge, ulcer, sore Female na na na na na na Urban Female na na na na na na Rural Female na na na na na na Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 117 - Bukina Faso 1992 / 93 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Sanitary disposal of stools All na na na na na na Urban na na na na na na Rural na na na na na na Wash hands prior to preparing food All na na na na na na Urban na na na na na na Rural na na na na na na Handwashing facilities in household? All na na na na na na Urban na na na na na na Rural na na na na na na Bednet ownership All na na na na na na Urban na na na na na na Rural na na na na na na Bednet use by children All na na na na na na Urban na na na na na na Rural na na na na na na Bednet use by pregnant women All na na na na na na Urban na na na na na na Rural na na na na na na Exclusive breastfeeding All na na na na na na Urban na na na na na na Rural na na na na na na Female na na na na na na Male na na na na na na Timely complementary breastfeeding All na na na na na na Urban na na na na na na Rural na na na na na na Female na na na na na na Male na na na na na na Bottle-feeding All 236 318 233 262 188 1,237 Urban 2 3 6 21 135 167 Rural 234 315 227 241 53 1,070 Female 114 167 121 115 96 613 Male 121 152 112 147 92 624 - 118 - Bukina Faso 1992 / 93 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Iodized salt in household All na na na na na na Urban na na na na na na Rural na na na na na na Vitamin A supplementation All 368 485 419 465 378 2,115 Urban 2 2 8 37 249 299 Rural 366 483 410 429 129 1,817 Female 181 239 200 238 169 1,027 Male 187 246 218 228 209 1,088 Tobacco and alcohol use, casual sexual partners, condom use for casual sex Female na na na na na na Urban Female na na na na na na Rural Female na na na na na na Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Domestic violence All na na na na na na Urban na na na na na na Rural na na na na na na - 119 - Bukina Faso 1992 / 93 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 1,157 1,763 1,280 1,378 1,645 7,223 Urban female 8 15 28 156 1,234 1,440 Rural female 1,148 1,749 1,252 1,222 411 5,783 Male 858 1,486 993 1,209 1,747 6,292 Urban male 7 17 28 176 1,405 1,633 Rural male 851 1,469 965 1,033 341 4,659 School participation Female 542 717 581 595 549 2,985 Urban female 5 6 10 49 376 447 Rural female 537 711 571 545 173 2,538 Male 577 695 538 677 522 3,008 Urban male 3 6 7 63 377 455 Rural male 574 689 530 614 145 2,553 Mass media exposure Female 1,032 1,506 1,125 1,212 1,479 6,354 Urban female 7 13 26 134 1,114 1,293 Rural female 1,025 1,493 1,100 1,079 364 5,061 Male na na na na na na Urban male na na na na na na Rural male na na na na na na Knowledge of HIV/AIDS prevention Female na na na na na na Urban female na na na na na na Rural female na na na na na na Male 265 500 287 366 400 1,818 Urban male 1 3 8 43 312 367 Rural male 264 497 278 323 88 1,451 Household decisionmaking and justification of violence All na na na na na na Urban na na na na na na Rural na na na na na na Orphanhood All 3,108 4,079 3,174 3,513 3,119 16,992 Urban 22 35 64 327 2,202 2,649 Rural 3,086 4,044 3,111 3,186 917 14,343 Female 1,519 2,027 1,634 1,702 1,582 8,464 Male 1,589 2,052 1,540 1,810 1,537 8,528 - 120 - Bukina Faso 1992 / 93 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 9.42 8.58 8.10 7.61 5.49 3.86 Under-five mortality rate 11.41 12.26 12.51 10.39 7.71 5.56 Prevalence of fever 2.24 2.06 2.07 2.13 1.60 1.18 Prevalence of diarrhea 1.26 1.12 1.52 1.28 0.80 0.59 Prevalence of acute respiratory infection 0.80 0.82 0.82 0.81 0.60 0.41 B. Fertility Total fertility rate 0.26 0.24 0.25 0.22 0.15 0.12 Adolescent fertility rate 15.77 12.92 18.45 14.73 8.78 7.21 C. Nutritional status Children: Moderate stunting 1.65 1.67 2.11 1.69 1.15 0.76 Severe stunting 1.48 1.59 1.90 1.41 1.04 0.75 Moderate underweight 1.93 1.62 1.92 1.73 1.03 0.75 Severe underweight 1.17 1.13 1.32 1.11 0.60 0.56 Mild anemia na na na na na na Moderate anemia na na na na na na Severe anemia na na na na na na Women: Malnutrition 1.31 1.26 1.63 1.44 0.92 0.65 Mild anemia na na na na na na Moderate anemia na na na na na na Severe anemia na na na na na na D. Female circumcision Prevalence of circumcision: Girls na na na na na na Women na na na na na na Prevalence of occlusion: Girls na na na na na na Women na na na na na na E. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na Men na na na na na na Prevalence of genital ulcer: Women na na na na na na Men na na na na na na - 121 - Bukina Faso 1992 / 93 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 4.43 2.77 3.47 2.86 0.93 1.65 Measles coverage 4.93 3.98 4.92 4.23 3.10 2.28 DPT coverage 4.35 5.13 4.33 4.40 3.64 2.89 Full basic coverage 3.67 4.75 4.32 4.57 3.30 2.68 No basic coverage 4.30 2.64 3.44 2.66 0.88 1.58 Hepatitis B coverage na na na na na na Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 2.68 2.59 3.59 2.91 2.57 1.59 Treatment in a public facility 2.68 2.59 3.56 2.91 2.52 1.58 Treatment in a private facility 0.00 0.30 0.54 0.11 0.62 0.20 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 4.28 4.87 8.19 6.19 6.18 3.15 Treatment in a public facility 3.29 4.87 8.19 5.94 6.01 3.06 Treatment in a private facility 3.17 0.00 0.00 1.94 2.39 0.81 Treatment of diarrhea: Use of oral rehydration therapy 4.06 5.24 5.25 5.13 4.39 2.66 Medical treatment of diarrhea 4.01 3.34 6.73 2.97 4.13 2.22 Treatment in a public facility 3.88 3.24 6.73 2.95 3.84 2.21 Treatment in a private facility 1.40 1.01 0.00 0.49 1.27 0.44 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically-trained person 4.20 3.69 3.95 3.93 1.30 3.00 To a doctor 0.26 0.59 0.98 0.61 0.85 0.43 To a nurse or trained midwife 4.21 3.63 3.83 4.01 1.51 2.94 Multiple visits to a medically-trained person 3.15 2.86 3.22 3.61 1.97 2.42 Antenatal care content: Tetanus toxoid 2.82 2.52 2.79 2.65 1.22 1.73 Prophylactic antimalarial treatment na na na na na na Iron supplementation na na na na na na Delivery attendance: By a medically-trained person 3.59 3.46 3.29 4.10 1.94 2.95 By a doctor 0.24 0.22 0.31 0.38 1.38 0.28 By a nurse or trained midwife 3.57 3.46 3.31 4.02 2.10 2.89 In a public facility 3.77 3.65 3.50 4.69 1.90 3.16 In a private facility 0.12 0.09 0.00 0.15 0.63 0.14 At home 3.83 3.66 3.50 4.66 1.84 3.18 D. Contraceptive services Contraceptive prevalence: Women 0.33 0.18 0.36 0.68 1.08 0.44 Men 1.39 0.85 1.18 2.09 2.29 0.81 Source of contraception - public sector: Women * * * 6.49 3.50 3.14 Men na na na na na na - 122 - Bukina Faso 1992 / 93 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - private sector: Women * * * 6.33 3.24 2.77 Men na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na Men na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men na na na na na na - 123 - Bukina Faso 1992 / 93 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na Treated bednet ownership na na na na na na Bednet use: By children na na na na na na By pregnant women na na na na na na C. Breastfeeding Exclusive breastfeeding na na na na na na Timely complementary feeding na na na na na na Bottle-feeding 0.00 0.00 0.85 0.00 1.62 0.33 D. Micronutrient consumption Iodized salt: Availability of iodized salt in household na na na na na na Vitamin A: Children 1.49 1.44 2.03 1.63 2.02 0.96 Women na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na Men na na na na na na Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women na na na na na na Men na na na na na na Condom usage with non-regular partner: Women na na na na na na Men na na na na na na G. Domestic violence Ever experienced violence na na na na na na Experienced violence in past year na na na na na na - 124 - Bukina Faso 1992 / 93 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Education School completion: Women 0.57 0.54 0.61 0.92 1.86 1.03 Men 0.98 0.91 1.29 1.89 1.88 1.48 School participation: Girls 1.92 1.58 2.09 2.46 2.28 1.56 Boys 2.08 2.36 2.29 2.59 2.42 1.71 B. Exposure to mass media Newspaper readership: Women 0.30 0.32 0.36 0.68 1.66 0.78 Men na na na na na na Radio listenership: Women 2.05 2.99 3.10 2.90 1.44 1.94 Men na na na na na na Television viewership: Women 0.33 0.22 0.31 0.63 3.20 1.32 Men na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women na na na na na na Men 3.43 3.20 3.90 2.76 1.61 1.70 Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na Men na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na Can seek children's health care na na na na na na Can make daily household purchases na na na na na na Can make large household purchases na na na na na na Can make meal-related decisions na na na na na na Freedom of movement: Can travel to visit family/relatives na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na Can decide whether to have sex na na na na na na Justifies domestic violence na na na na na na E. Orphanhood Paternal orphan prevalence 0.72 0.79 0.79 1.07 0.75 0.39 Maternal orphan prevalence 0.36 0.43 0.69 0.74 0.42 0.27 Double orphan prevalence 0.16 0.24 0.29 0.28 0.39 0.15 - 125 - Bukina Faso 1992 / 1993 - ASSET DISTRIBUTION AND WEIGHTS (FACTOR SCORE) This information is not available for the Burkina Faso 1992 / 1993 survey. - 127 - PART VIII. ANNEXES A. SOURCES OF ADDITIONAL INFORMATION B. USE OF INFORMATION FROM THIS REPORT TO MONITOR THE ECONOMIC STATUS OF PEOPLE SERVED BY HNP PROGRAMS C. COUNTRIES COVERED BY THE HNP- POVERTY REPORT PROJECT ANNEX A. SOURCES OF ADDITIONAL INFORMATION ADDITIONAL INEQUALITY DATA World Bank HNP/Poverty Country Report Website: http://www.worldbank.org/hnp/povertyandhealth/countrydata. This World Bank website provides the full texts and tables for all fifty-six countries covered by the HNP/Poverty Country Report Project. (A list of the countries covered appears in annex C, at the end of this report.) Also available at the site are summary tables, organized by indicator, designed to facilitate cross-country comparisons in inequality with respect to particular indicators. DHS Country Reports: http://www.measuredhs.com/countries. All DHS final country reports produced since 2003 include quintile-specific tabulations in approximately 50-100 of the reports' HNP indicator tables. The tables deal with some of the indicators covered in this volume, and with many that are not. UNICEF Multi-Indicator Cluster Survey Website: http://www.childinfo.org/MICS2/natlMICSrepz/MICSnatrep.htm. The UNICEF Multi-Indicator Cluster Survey (MICS) project is generally similar to the DHS program, but covers a somewhat different set of countries and indicators. The "standard tables" section for each country listed at the MICS website provides wealth- based, quintile-specific information in around 40-45 of the tables related to hnp, education, and child labor. In deriving these quintile-specific estimates, the MICS investigators have employed a wealth index similar to the one used here. World Health Organization World Health Survey Website: http://www.who.int/healthinfo/survey/en/index.html. The World Health Organization's World Health Survey (WHS) includes such issues as self-assessed adult health status; coverage of interventions against adult chronic diseases and against maternal and child health problems; household health expenditures; insurance coverage; and health system responsiveness. Approximately seventy countries ­ developed as well as developing ­ have been covered thus far. Household wealth information has been collected and used to prepare quintile-specific estimates for many of the indicators appearing in the reports on these countries. - 131 - METHODS AND RESOURCES FOR FURTHER INEQUALITY ANALYSIS Shea Oscar Rutstein and Kiersten Johnson, The DHS Wealth Index, DHS Comparative Reports No. 6 (Calverton, Maryland, USA: ORC Macro, August 2004) (Available at: http://www.measuredhs.com/pubs/pub_details.cfm?ID =470&srchTp=type). This DHS publication, by two of the co-authors of the current report, describes in detail the construction of the wealth index that underlies the data presented in the basic tables. Deon Filmer and Lant H. Pritchett, "Estimating Wealth Effects without Expenditure Data ­ or Tears: An Application to Education Enrollments in States in India," Demography 38, no.1 (February 2001): 115-132. This seminal piece gave birth to the wealth index procedure used in the current volume. It also includes three of the previously-cited country case studies demonstrating the close relationship between results produced using wealth and those based on consumption as an indicator of household economic status. Owen O'Donnell, Eddy van Doorslaer, Adam Wagstaff, and Magnus Lindelow. Quantitative Techniques for Health Equity Analysis. Washington D.C.: The World Bank, forthcoming. Among the topics covered in this comprehensive overview of available quantitative techniques are the measurement of living standards using a wealth index and other approaches (chapter 6) and the concentration index as a measure of inequality (chapter 8). DHS Country Data Sets: http://www.measuredhs.com/accesssurveys/search. The data sets for all DHS surveys undertaken since 2003 include two pieces of information for each household that are designed to help investigators prepare quintile- specific tabulations for any indicator. These are: 1) the household wealth score; and 2) the economic quintile to which individuals in the household belong. Any tabulation using these pieces of information will be comparable to the figures appearing here. - 132 - ANNEX B. USE OF INFORMATION FROM THIS REPORT TO MONITOR THE ECONOMIC STATUS OF PEOPLE SERVED BY HNP PROGRAMS The wealth or asset approach employed in this report can be used to monitor the economic status of people served by health, nutrition, and population (hnp) programs in two ways. The first, simpler way is suitable for monitoring nationwide, facility-based programs. A second, fuller version can also be employed for other types of programs, such as initiatives undertaken only in some parts of a country, or activities like mass education or outreach programs that do not operate through facilities. BASIC MONITORING OF NATIONWIDE FACILITY-BASED PROGRAMS The economic distribution of patients in a nationwide, facility-based program (say, a network of rural health posts, antenatal care clinics, emergency obstetrical facilities, or hospitals) can be determined through an exit survey of facility patients, using the wealth questionnaire and the set of quintile cut-off points that immediately follow this text, and which have been created using the information presented in part III.C. The questionnaire can be employed to measure the economic status of any individual responding to the questions on it. The set of cut-off points can serve to compare the distribution of the respondents' economic status with that of the nationally- representative sample of people interviewed by the DHS survey on which the present report is based. The first step is to use the questionnaire in interviewing an adequately-large sample of patients attending the facility-based services of interest. The wealth score for each patient can then be calculated by multiplying the response to each question by the item scores also provided on the questionnaire, and summing the results. After this has been done, the quintile cut-off points can be used to place each individual in the economic quintile to which (s)he belongs. The number of patients and percentage of total patients in each quintile can then be calculated. Since each quintile defined by the cut-off points contains 20 percent of the individuals in the nationally-representative DHS sample, the patients belonging to any such quintile containing significantly more (or less) than 20 percent of the total are over- (under-) represented relative to the national population. When the percentage of patients in each of the five quintiles is viewed as a whole, the result is a frequency distribution that indicates the spread of service beneficiaries across economic classes of individuals.21 For example: 21That is, across economic classes of all individuals in the sample population. Estimates pertaining to quintiles of only those individuals needing services require adjusting the results of the procedure described here through application of the relevant quintile-specific, sample-size figures presented in part III.A. - 133 - · A service that favors the poorest people would have substantially more than 20 percent of its patients in each of the lowest one or two economic quintiles; considerably less than 20 percent of its patients in each of the highest quintiles. · A service that reaches all economic classes equally would draw roughly the same proportion of total patients from the lower and upper quintiles. · A service that favors the least poor population groups would have well over 20 percent of its patients in each of the highest one or two quintiles, considerably less than 20 percent of its patients in each of the lowest quintiles. FULLER MONITORING OF FACILITY-BASED AND OF OTHER PROGRAMS While capable of providing far more information than currently exists about the distribution of a program's beneficiaries, the approach just described has important limitations. For example, it cannot deal with the many important types of health programs that do not deliver services primarily through facilities ­ mass media health education, household visits by health workers, and many social marketing initiatives, for example. It is also limited in its ability to assess programs working only with certain areas within a country: it can compare the economic status of the programs' beneficiaries with that of the national population, but not with that of the specific sub-national areas where the programs are active. Further, it focuses primarily on only one of the two important dimensions of monitoring the distribution of program beneficiaries: that is, incidence or focus ­ the percentage of program benefits that flow to the poor. It cannot deal nearly so well with the second dimension, which concerns coverage, or the percentage of the poor that the program reaches. These limitations can be overcome by a modified version of the approach described above that relies on a household- rather than facility-based survey. A household survey can generate a set of data containing the full range of information needed to produce an equity assessment by collecting two types of information: first, about the household's wealth or assets, using the questions in the left-hand column of the attached questionnaire;22 and second, about the household members' use of or exposure to the services provided by the program(s) of interest. The collected data can be analyzed in either (or both) of two ways, depending on the type of information desired: · One way would be to use only data from the household survey. The procedure would be analogous to that for a DHS survey employed in this report: ­ Asset information from the survey-generated data set would be used as the basis for the construction of a wealth index, weighting the individual items using some method like principal components analysis. ­ The individuals in the sample would be ranked in order of the index values for their households, then divided into groups like quintiles. ­ The coverage rates in each quintile for the service of interest would be calculated. 22Or, if one is willing to forego the benefits of the second analytical approach described below, using any of several other asset questionnaires that exist. Examples include the INDEPTH health equity survey tool (available at: www.indepth-network.org/core_documents/indepthtools.htm) or the model questionnaire developed by M. Mahood Khan and David Hotchkiss of the PHR Plus project (which can be found at: www.phrplus.org). - 134 - · A second approach would be to use the weights for each item appearing on the attached questionnaire in determining the wealth of each individual, instead of calculating the weights from the new household data set. Once the individuals' wealth is determined, the individuals would be ranked, divided into quintiles, and the coverage rate in each quintile would be calculated. In the case of programs undertaken in only one region of the country, it would provide a comparison of the economic status of the people served with that of the entire country rather than of only the region where the programs are active;23 in the case of nationwide as well as regional programs, it would permit a comparison with the other service programs covered in this report. 23This additional perspective could be particularly helpful in an assessment of a program seeking to reach the poor by focusing on especially backward districts. A report presenting only a finding that the program was reaching the better- off people in those districts could produce an impression that it had failed to reach its intended beneficiaries. But a comparison between the economic status of the program's beneficiaries with that of the national population might well reveal that most of the beneficiaries were poor by national standards and that the program was thus considerably more successful than otherwise thought. - 135 - Bukina Faso 2003 - ASSET QUESTIONNAIRE Question Score if Score if Item "Yes" "No" Score 1. In your household, is/are there? Electricity 0.34839 -0.04892 One or more radios 0.04080 -0.07273 One or more televisions 0.33168 -0.04562 One or more refrigerators 0.47150 -0.02271 One or more bicycles -0.01601 0.05372 One or more motorcycles, scooters 0.15376 -0.05179 One or more cars, trucks 0.47702 -0.01221 One or more telephones 0.49198 -0.01666 2. Does your household have a domestic worker not related to head? 0.54392 -0.00361 3. Do the members of your household work their own or family'sagricultural land? -0.00339 0.01532 4. What is the principal source of drinking water for your household? Piped water in residence 0.42468 -0.01349 Piped water in yard, plot 0.36706 -0.01495 Piped water in public tap 0.14286 -0.02687 Open well in residence or yard, plot 0.00771 -0.00028 Open public well -0.07226 0.01898 Protected well in residence or yard -0.03612 0.00495 Protected public well -0.06520 0.02396 Springwater or collected rainwater -0.07260 0.00082 River, stream, pond, lake, dam, other -0.09856 0.01445 5. What is the principal type of fuel for cooking used by your household? Natural gas, biogas, electricity 0.42961 -0.01500 Charcoal, lignite, coal, kerosene 0.23348 -0.01261 Wood, straw, dung, other -0.03223 0.27774 Does not cook 0.13601 -0.00250 6. What is the principal type of toilet facility used by your household? Private flush toilet 0.52105 -0.00626 Shared flush toilet 0.19818 -0.00083 Own pit latrine 0.03514 -0.00137 Shared pit latrine 0.05856 -0.00257 Own VIP latrine 0.22081 -0.02056 Shared VIP latrine 0.19958 -0.02949 Bush, field as latrine -0.08168 0.17748 7. What is the principal material used for the floors in your household? Raw natural materials -0.09157 0.12799 Some kind of applied flooring (parquet, vinyl, tile, carpet) 0.49760 -0.00846 Cement 0.11277 -0.07512 Total Household Asset Score (sum of individual item scores) - 137 - Bukina Faso 2003 - QUINTILE CUT-OFF POINTS Asset Index Value Wealth Quintile Bottom Cut-Off Top Cut-Off Low Low -0.06670 Second -0.06670 -0.05961 Third -0.05961 -0.02345 Fourth -0.02345 0.03219 High 0.03219 High - 138 - ANNEX C. COUNTRIES COVERED BY THE HNP - POVERTY REPORT PROJECT* East Asia and Pacific Sub-Saharan Africa Cambodia 2000 Benin 1996, 2001 Indonesia 1997, 2002-03 Burkina Faso 1992-3, 1998-9, 2003 Philippines 1998, 2003 Cameroon 1991, 1998, 2004 Vietnam 1997, 2002 Central African Rep. 1994-95 Chad 1996-97, 2004 Europe and Central Asia Comoros 1996 Armenia 2000 Cote d'Ivoire 1994 Kazakhstan 1995, 1999 Eritrea 1995 Kyrgyz Rep. 1997 Ethiopia 2000 Turkey 1993, 1998 Gabon 2000 Turkmenistan 2000 Ghana 1993, 1998, 2003 Uzbekistan 1996 Guinea 1999 Kenya 1993, 1998, 2003 Latin America and the Caribbean Madagascar 1997 Bolivia 1998, 2003 Malawi 1992, 2000 Brazil 1996 Mali 1995-96, 2001 Colombia 1995, 2000, 2005 Mauritania 2000-01 Dominican Rep. 1996, 2002 Mozambique 1997, 2003 Guatemala 1995, 1998-99 Namibia 1992, 2000 Haiti 1994-95, 2000 Niger 1998 Nicaragua 1997- 98, 2001 Nigeria 1990, 2003 Paraguay 1990 Rwanda 2000 Peru 1996, 2000 Senegal 1997 South Africa 1998 Middle East and North Africa Tanzania 1996, 1999, 2004 Egypt 1995, 2000 Togo 1998 Jordan 1997 Uganda 1995, 2000-01 Morocco 1992, 2003-04 Zambia 1996, 2001-02 Yemen 1997 Zimbabwe 1994, 1999 South Asia * Note: electronic versions of reports for all countries Bangladesh 1996-97, 1999-2000, 2004 are currently available at: www.worldbank.org/ povertyandhealth/countrydata. While supplies last, India 1992-93, 1998-99 paper copies may be obtained at no charge by sending Nepal 1996, 2001 a request to the World Bank's health advisory service: healthpop@worldbank.org. Pakistan 1990-91 - 139 -