39459 SOCIO-ECONOMIC DIFFERENCES IN HEALTH, NUTRITION, AND POPULATION PHILIPPINES 1998, 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 19 A. Total Population 21 B. Female and Male Populations 27 C. Rural and Urban Populations 31 Part III. Technical Notes 37 A. Indicator Definitions 39 B. Data and Methods 53 C. Discussion 57 Part IV. Supporting Tables, 2003 63 A. Sample Sizes 65 B. Standard Errors 71 C. Asset Distribution and Weights 77 Part V. Supporting Tables, 1998 79 A. Sample Sizes 81 B. Standard Errors 87 C. Asset Distribution and Weights 93 Part VI. Annexes 95 A. Sources of Additional Information 97 B. Use of Information from this 99 Report to Monitor the Economic Status of People Served by HNP Programs C. Countries Covered by the 105 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 and two, 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 three provides supplementary technical information designed to help readers understand the data presented in parts one and two. This information deals with such issues as how the covered hnp indicators were defined and how the quintile-specific estimates were derived. · Parts four and five present supporting tables that deal with three of the technical matters covered in part three: the size of the sample for each indicator covered; the standard error 1The average interval of approximately two years between data collection and availability means that the latest surveys covered were conducted in 2005. - III - 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, sixth 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. Philippines 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 42.0 32.2 25.8 22.2 19.5 30.0 2.16 22.52 -0.1538 0.0257 Under-five mortality rate 66.3 47.1 31.6 25.8 20.6 41.6 3.21 45.66 -0.2275 0.0387 Prevalence of fever 28.0 25.6 22.8 21.4 17.8 23.8 1.57 10.20 -0.0784 0.0128 Prevalence of diarrhea 13.1 11.2 9.4 9.2 9.4 10.8 1.39 3.66 -0.0803 0.0211 Prevalence of acute respiratory 14.6 11.0 9.0 7.6 5.8 10.2 2.50 8.79 -0.1745 0.0217 infection (ARI) B. Fertility Total fertility rate 5.9 4.6 3.5 2.8 2.0 3.5 2.95 3.88 -0.2102 0.0407 Adolescent fertility rate 133.7 84.1 51.7 32.3 15.8 52.5 8.45 117.90 -0.3902 0.0726 C. Nutritional status (%) Children: Moderate stunting na na na na na na na na na na Severe stunting na na na na na na na na na na Moderate underweight na na na na na na na na na na Severe underweight na na na na na na na na na na 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 na na na na na na na na na na 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 1.2 1.0 1.0 0.3 0.5 0.8 2.68 0.76 -0.1955 0.0958 Prevalence of genital ulcer: Women na na na na na na na na na na Men 0.5 1.1 0.6 0.7 0.2 0.6 2.42 0.31 -0.1618 0.0920 - 3 - Philippines 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 82.2 92.2 94.0 93.1 97.1 90.8 0.85 14.85 0.0373 0.0055 Measles coverage 69.7 81.6 83.4 80.2 89.4 79.7 0.78 19.67 0.0522 0.0080 DPT coverage 64.0 77.9 84.9 84.9 92.0 78.9 0.70 27.98 0.0760 0.0081 Full basic coverage 55.5 69.3 77.8 72.4 83.0 69.8 0.67 27.44 0.0814 0.0099 No basic coverage 15.1 5.9 5.0 3.9 2.2 7.3 6.76 12.88 -0.4223 0.0646 Hepatitis B coverage 30.6 43.7 51.9 49.5 60.5 45.3 0.51 29.85 0.1396 0.0158 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 44.9 42.0 50.0 45.3 55.4 46.3 0.81 10.54 0.0472 0.0164 Treatment in a public facility 38.7 34.3 37.6 16.3 11.6 31.1 3.34 27.09 -0.1349 0.0214 Treatment in a private facility 6.2 7.7 12.4 29.0 43.8 15.3 0.14 37.63 0.4183 0.0378 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 50.2 49.0 58.7 61.0 75.2 54.8 0.67 25.07 0.0903 0.0204 Treatment in a public facility 42.8 39.4 39.7 30.7 14.6 37.6 2.94 28.23 -0.0647 0.0297 Treatment in a private facility 7.4 9.6 19.0 30.3 60.7 17.2 0.12 53.30 0.4282 0.0516 Treatment of diarrhea: Use of oral rehydration therapy 73.0 81.7 82.6 80.8 84.8 79.3 0.86 11.75 0.0229 0.0112 Medical treatment of diarrhea 28.0 29.7 35.6 35.9 40.5 32.4 0.69 12.53 0.0833 0.0313 Treatment in a public facility 22.6 23.8 22.0 13.5 11.4 20.1 1.97 11.13 -0.0864 0.0415 Treatment in a private facility 5.4 5.9 13.6 22.4 29.1 12.4 0.19 23.66 0.3585 0.0607 C. Antenatal and delivery care Antenatal care visits: To a medically trained person 72.3 88.1 90.8 96.2 96.6 87.6 0.75 24.26 0.0649 0.0033 To a doctor 8.6 22.8 38.9 58.5 79.9 38.1 0.11 71.32 0.3757 0.0080 To a nurse or trained midwife 63.8 65.3 51.8 37.7 16.7 49.5 3.81 47.05 -0.1738 0.0079 Multiple visits to a medically trained person 71.1 79.6 84.7 91.4 93.3 82.8 0.76 22.18 0.0596 0.0037 Antenatal care content: Tetanus toxoid 61.6 73.2 76.1 74.5 70.2 70.7 0.88 8.57 0.0335 0.0055 Prophylactic antimalarial treatment na na na na na na na na na na Iron supplementation 64.7 75.3 80.6 82.2 86.9 76.8 0.74 22.20 0.0657 0.0044 Delivery attendance: By a medically trained person 25.1 51.4 72.4 84.4 92.3 59.8 0.27 67.26 0.2497 0.0044 By a doctor 8.6 21.0 37.4 52.6 73.2 33.6 0.12 64.59 0.3795 0.0082 By a nurse or trained midwife 16.5 30.4 35.0 31.8 19.1 26.2 0.86 2.67 0.0829 0.0111 In a public facility 9.2 20.5 32.3 37.6 31.6 24.2 0.29 22.38 0.2534 0.0119 In a private facility 1.2 4.4 11.1 22.2 45.5 13.7 0.03 44.32 0.5459 0.0197 At home 88.7 74.3 56.2 39.0 22.6 61.4 3.92 66.08 -0.2208 0.0045 D. Contraceptive services Contraceptive prevalence: Women 23.8 33.8 35.7 37.9 35.2 33.4 0.68 11.43 0.0719 0.0086 Men 21.4 29.4 36.0 34.4 31.5 30.5 0.70 10.10 0.0820 0.0157 - 4 - Philippines 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 83.4 77.8 72.0 63.9 43.2 66.9 1.93 40.23 -0.1133 0.0072 Men na na na na na na na na na na Source of contraception - private sector: Women 15.9 21.3 27.1 35.3 54.3 31.9 0.29 38.44 0.2281 0.0150 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 * * * * * 32.8 * * * * Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na Men * * * * * 32.8 * * * * Voluntary counseling and testing for HIV/AIDS: Women na na na na na na na na na na Men 1.2 1.8 2.3 4.9 7.6 3.6 0.16 6.35 0.3514 0.0449 - 5 - Philippines 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 43.0 63.9 74.6 84.3 92.9 69.2 0.46 49.85 0.1540 0.0051 Handwashing: Wash hands prior to preparing food 97.6 98.1 97.4 96.8 95.8 97.0 1.02 1.83 -0.0045 0.0009 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 60.3 47.4 34.6 32.7 20.1 42.2 2.99 40.12 -0.1853 0.0304 Timely complementary feeding 68.7 73.3 48.2 43.5 31.3 56.7 2.19 37.42 -0.1281 0.0210 Bottle-feeding 27.6 39.1 56.3 61.9 78.7 48.6 0.35 51.02 0.2062 0.0144 D. Micronutrient consumption Iodized salt: Availability of iodized salt na na na na na na na na na na in household Vitamin A: Children 65.0 73.6 80.5 84.5 87.3 76.5 0.74 22.36 0.0689 0.0043 Women 37.5 42.8 46.0 47.2 54.3 44.8 0.69 16.78 0.0744 0.0090 E. Tobacco and alcohol use Tobacco: Women 13.3 8.6 7.0 5.7 5.3 7.6 2.51 7.97 -0.1820 0.0184 Men 67.6 63.2 56.2 49.8 42.1 55.5 1.61 25.58 -0.0907 0.0074 Alcohol: Women na na na na na na na na na na Men 39.5 46.1 44.0 36.9 28.4 38.9 1.39 11.15 -0.0556 0.0105 F. Sexual practices Non-regular sexual partnerships: Women 0.0 0.0 0.1 0.0 0.0 0.0 0.00 0.05 0.6486 0.5565 Men 1.3 2.5 3.1 3.2 4.8 3.0 0.28 3.41 0.2482 0.0644 Condom usage with non-regular partner: Women na na na na na na na na na na Men * * * * * * * * * * 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 - Philippines 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 72.9 90.3 94.9 97.5 98.8 92.2 0.74 25.85 0.0504 0.0016 Men 62.1 84.4 93.2 96.5 99.0 87.8 0.63 36.89 0.0798 0.0018 School participation: Girls 82.3 93.3 94.6 97.4 98.0 92.0 0.84 15.68 0.0400 0.0031 Boys 79.3 91.1 94.5 97.0 97.7 90.8 0.81 18.41 0.0450 0.0033 B. Exposure to mass media Newspaper readership: Women 13.9 28.2 41.6 53.0 66.9 43.7 0.21 52.92 0.2480 0.0048 Men 19.4 35.5 52.1 57.7 67.9 47.2 0.29 48.46 0.2174 0.0079 Radio listenership: Women 59.4 75.8 78.1 82.7 86.6 77.9 0.69 27.19 0.0645 0.0028 Men 70.5 80.7 84.7 85.7 87.5 82.1 0.81 17.00 0.0441 0.0042 Television viewership: Women 34.5 69.3 89.2 95.3 97.2 80.4 0.36 62.68 0.1524 0.0025 Men 45.7 76.3 92.5 95.9 96.4 82.1 0.47 50.64 0.1290 0.0041 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 54.0 69.7 76.3 80.1 83.2 74.2 0.65 29.25 0.0716 0.0030 Men 66.4 80.5 84.0 87.8 92.9 82.7 0.71 26.50 0.0656 0.0040 Knowledge about mother-to-child transmission of HIV/AIDS: Women 60.2 71.7 77.3 80.2 81.6 75.3 0.74 21.41 0.0532 0.0029 Men 58.7 67.7 71.9 75.9 79.6 71.0 0.74 20.92 0.0623 0.0054 Attitudes toward HIV/AIDS: Women 26.4 24.7 27.5 30.8 38.0 30.3 0.70 11.53 0.0872 0.0078 Men 22.4 24.8 26.8 26.1 30.1 26.2 0.74 7.67 0.0575 0.0144 D. Status of women Household decisionmaking: Can seek own health care 69.4 73.5 72.2 73.6 77.1 73.5 0.90 7.68 0.0182 0.0030 Can seek children's health care 89.7 93.7 94.9 96.1 96.3 94.2 0.93 6.63 0.0165 0.0018 Can make daily household purchases 73.8 72.8 69.0 64.5 56.4 66.3 1.31 17.47 -0.0561 0.0035 Can make large household purchases 68.2 64.9 62.1 57.4 52.0 60.0 1.31 16.15 -0.0570 0.0040 Can make meal-related decisions 60.1 58.4 52.6 47.9 38.8 50.3 1.55 21.32 -0.0883 0.0048 Freedom of movement: Can travel to visit family, relatives 26.3 28.8 31.3 29.3 32.7 30.0 0.80 6.42 0.0443 0.0077 Other decisionmaking, attitudes: Can decide how to spend own money 60.9 68.2 70.7 71.6 78.9 71.9 0.77 17.99 0.0495 0.0046 Can decide whether to have sex 96.1 96.4 97.0 97.1 97.3 96.8 0.99 1.12 0.0019 0.0009 Justifies domestic violence 39.4 29.0 23.7 19.7 15.1 24.1 2.61 24.30 -0.1973 0.0090 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 - 7 - Philippines 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 30.4 31.2 22.1 17.6 18.2 25.0 52.7 33.0 29.2 26.4 20.7 34.5 Under-five mortality rate 49.9 43.2 24.4 22.2 18.9 34.2 81.5 50.7 38.0 29.0 22.2 48.4 Prevalence of fever 29.6 23.1 22.2 21.2 17.7 23.6 26.3 27.9 23.4 21.5 17.8 24.1 Prevalence of diarrhea 13.5 8.7 10.8 10.0 6.2 10.3 12.6 13.5 8.1 8.4 12.4 11.2 Prevalence of acute respiratory 16.4 10.7 8.9 7.4 5.9 10.6 12.9 11.2 9.2 7.8 5.8 9.9 infection (ARI) B. Nutritional status Children: Moderate stunting na na na na na na na na na na na na Severe stunting na na na na na na na na na na na na Moderate underweight na na na na na na na na na na na na Severe underweight na na na na na na na na na na na na 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 1.2 1.0 1.0 0.3 0.5 0.8 Prevalence of genital ulcer: Women na na na na na na Men 0.5 1.1 0.6 0.7 0.2 0.6 - 9 - Philippines 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 85.9 91.6 94.7 92.8 94.8 91.4 78.8 92.8 93.3 93.3 99.2 90.2 Measles coverage 74.0 81.2 82.2 85.7 86.7 81.2 65.7 82.0 84.6 74.3 91.9 78.3 DPT coverage 71.4 76.4 82.9 84.2 93.1 80.2 57.2 79.3 87.0 85.7 91.0 77.6 Full basic coverage 62.4 68.9 75.5 74.5 81.1 71.3 49.2 69.6 80.3 70.2 84.7 68.4 No basic coverage 12.5 6.6 3.9 4.2 3.7 6.7 17.6 5.2 6.1 3.6 0.8 7.8 Hepatitis B coverage 35.0 42.7 51.4 43.2 55.5 44.4 26.6 44.6 52.5 56.3 65.0 46.2 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 46.2 41.5 54.3 46.3 56.2 47.7 43.5 42.4 46.1 44.3 54.8 45.0 Treatment in a public facility 40.2 31.0 37.8 18.8 12.0 31.3 37.0 36.8 37.5 13.7 11.2 30.9 Treatment in a private facility 6.0 10.6 16.5 27.5 44.1 16.4 6.4 5.5 8.6 30.6 43.6 14.2 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 48.5 44.5 63.3 65.6 78.2 54.4 52.3 53.0 54.5 56.3 72.4 55.1 Treatment in a public facility 40.0 30.6 44.2 36.8 18.0 36.4 46.3 47.2 35.5 24.5 11.3 38.7 Treatment in a private facility 8.5 13.8 19.1 28.8 60.2 18.0 6.0 5.8 19.0 31.8 61.1 16.4 Treatment of diarrhea: Use of oral rehydration therapy na na na na na na na na na na na na Medical treatment of diarrhea 25.7 38.4 31.5 30.7 43.4 31.6 30.4 24.5 40.8 42.5 39.2 33.1 Treatment in a public facility 20.8 25.9 22.9 11.3 9.0 19.6 24.5 22.5 20.9 16.4 12.6 20.5 Treatment in a private facility 4.9 12.5 8.7 19.4 34.4 12.1 5.9 2.0 19.9 26.1 26.6 12.6 C. Contraceptive services Contraceptive prevalence: Women 23.8 33.8 35.7 37.9 35.2 33.4 Men 21.4 29.4 36.0 34.4 31.5 30.5 Source of contraception - public sector: Women 83.4 77.8 72.0 63.9 43.2 66.9 Men na na na na na na Source of contraception - private sector: Women 15.9 21.3 27.1 35.3 54.3 31.9 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 25.9 51.4 20.0 29.5 37.5 32.8 Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men 25.9 51.4 20.0 29.5 37.5 32.8 Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men 1.2 1.8 2.3 4.9 7.6 3.6 - 10 - Philippines 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 43.0 63.9 74.6 84.3 92.9 69.2 Handwashing: Wash hands prior to preparing food 97.6 98.1 97.4 96.8 95.8 97.0 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 58.2 47.3 34.1 38.3 24.2 43.1 62.4 47.5 35.0 27.1 16.1 41.3 Timely complementary feeding 71.0 74.9 46.3 40.9 20.2 54.8 67.0 71.6 50.4 48.4 39.8 58.8 Bottle-feeding 20.6 34.0 58.2 61.9 81.7 46.7 33.6 43.9 54.6 61.9 76.2 50.4 D. Micronutrient consumption Vitamin A: Children 64.1 73.8 80.0 82.7 88.7 76.1 65.9 73.3 81.0 86.3 86.1 76.9 E. Tobacco and alcohol use Tobacco: Women 13.3 8.6 7.0 5.7 5.3 7.6 Men 67.6 63.2 56.2 49.8 42.1 55.5 Alcohol: Women na na na na na na Men 39.5 46.1 44.0 36.9 28.4 38.9 F. Sexual practices Non-regular sexual partnerships: Women 0.0 0.0 0.1 0.0 0.0 0.0 Men 1.3 2.5 3.1 3.2 4.8 3.0 Condom usage with non-regular partner: Women na na na na na na Men 31.5 47.8 8.2 19.7 41.1 30.1 - 11 - Philippines 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 72.9 90.3 94.9 97.5 98.8 92.2 Men 62.1 84.4 93.2 96.5 99.0 87.8 School participation: Girls 82.3 93.3 94.6 97.4 98.0 92.0 Boys 79.3 91.1 94.5 97.0 97.7 90.8 B. Exposure to mass media Newspaper readership: Women 13.9 28.2 41.6 53.0 66.9 43.7 Men 19.4 35.5 52.1 57.7 67.9 47.2 Radio listenership: Women 59.4 75.8 78.1 82.7 86.6 77.9 Men 70.5 80.7 84.7 85.7 87.5 82.1 Television viewership: Women 34.5 69.3 89.2 95.3 97.2 80.4 Men 45.7 76.3 92.5 95.9 96.4 82.1 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 54.0 69.7 76.3 80.1 83.2 74.2 Men 66.4 80.5 84.0 87.8 92.9 82.7 Knowledge about mother-to-child transmission of HIV/AIDS: Women 60.2 71.7 77.3 80.2 81.6 75.3 Men 58.7 67.7 71.9 75.9 79.6 71.0 Attitudes toward HIV/AIDS: Women 26.4 24.7 27.5 30.8 38.0 30.3 Men 22.4 24.8 26.8 26.1 30.1 26.2 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 - 12 - Philippines 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 42.1 34.4 26.5 26.8 34.3 35.8 41.3 28.5 25.3 20.3 16.7 23.9 Under-five mortality rate 69.0 49.8 29.5 28.3 36.8 52.2 52.0 42.7 33.1 24.7 17.6 30.4 Prevalence of fever 28.4 24.8 24.9 20.4 21.6 25.8 25.7 26.7 21.7 21.7 17.1 21.8 Prevalence of diarrhea 12.4 10.4 9.1 7.3 7.1 10.7 16.2 12.3 9.6 10.0 9.8 10.8 Prevalence of acute respiratory infection 15.1 10.8 11.2 5.8 9.8 12.2 12.5 11.2 7.8 8.3 5.2 8.3 B. Fertility Total fertility rate 6.1 4.4 3.5 2.9 1.9 4.3 5.0 4.7 3.6 2.7 2.0 3.0 Adolescent fertility rate 137.0 77.8 46.1 41.3 10.8 73.8 122.3 92.4 54.9 28.7 16.8 39.9 C. Nutritional status Children: Moderate stunting na na na na na na na na na na na na Severe stunting na na na na na na na na na na na na Moderate underweight na na na na na na na na na na na na Severe underweight na na na na na na na na na na na na 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 na na na na na na na na na na na na 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 1.4 0.9 1.1 0.4 0.5 1.0 0.6 1.3 0.9 0.2 0.4 0.6 Prevalence of genital ulcer: Women na na na na na na na na na na na na Men 0.4 1.1 1.3 1.1 0.0 0.8 1.0 1.0 0.1 0.5 0.3 0.4 - 13 - Philippines 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 81.1 93.7 94.6 96.3 100.0 88.9 87.4 90.3 93.6 91.5 96.5 92.6 Measles coverage 68.9 84.5 83.2 83.0 88.9 77.5 73.3 77.8 83.5 78.8 89.5 81.8 DPT coverage 62.6 77.4 87.4 82.8 91.8 73.7 70.8 78.6 83.4 86.0 92.1 84.0 Full basic coverage 53.9 69.7 79.1 75.1 76.4 65.1 62.7 68.7 77.1 71.0 84.2 74.4 No basic coverage 16.3 3.6 2.5 1.4 0.0 8.5 9.8 9.0 6.4 5.1 2.7 6.0 Hepatitis B coverage 29.8 44.7 60.8 54.3 73.7 43.0 34.5 42.4 46.7 47.2 58.0 47.6 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 43.1 37.2 53.6 40.3 57.1 43.3 54.5 48.8 47.6 47.2 55.1 49.9 Treatment in a public facility 36.7 31.1 41.5 14.7 18.1 33.5 49.5 38.8 35.1 16.9 10.1 28.3 Treatment in a private facility 6.4 6.1 12.1 25.6 39.0 9.8 5.0 10.0 12.6 30.3 44.9 21.7 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 47.0 41.6 60.0 58.8 78.0 49.0 68.8 59.8 57.7 61.6 74.3 63.2 Treatment in a public facility 38.8 34.4 44.0 28.2 21.4 37.3 66.1 46.8 36.2 31.4 12.2 37.9 Treatment in a private facility 8.2 7.3 16.1 30.6 56.6 11.8 2.7 13.0 21.5 30.2 62.1 25.2 Treatment of diarrhea: Use of oral rehydration therapy 72.9 78.5 78.2 62.1 100.0 75.1 73.7 85.8 85.0 86.5 82.8 83.5 Medical treatment of diarrhea 28.0 25.5 28.8 33.4 54.8 28.6 27.8 35.1 39.4 36.7 38.7 36.2 Treatment in a public facility 22.8 18.9 14.6 16.3 17.6 20.1 21.9 30.2 26.1 12.7 10.6 20.0 Treatment in a private facility 5.3 6.7 14.2 17.2 37.3 8.5 5.9 4.9 13.3 24.0 28.0 16.2 C. Antenatal and delivery care Antenatal care visits: To a medically trained person 71.8 89.5 92.4 96.7 96.1 83.9 74.7 85.9 89.8 95.9 96.7 91.2 To a doctor 7.2 18.9 32.0 51.8 73.4 22.5 15.2 29.3 43.1 61.4 81.1 53.0 To a nurse or trained midwife 64.7 70.6 60.4 44.9 22.8 61.3 59.5 56.6 46.7 34.6 15.6 38.2 Multiple visits to a medically trained person 70.4 80.6 86.8 91.8 92.4 79.2 74.7 77.9 83.4 91.2 93.5 86.3 Antenatal care content: Tetanus toxoid 61.3 74.1 78.5 76.5 71.6 69.7 62.9 71.7 74.6 73.7 69.9 71.7 Prophylactic antimalarial treatment na na na na na na na na na na na na Iron supplementation 63.7 75.1 83.9 84.6 94.2 73.8 69.5 75.7 78.5 81.1 85.5 79.8 Delivery attendance: By a medically trained person 22.3 39.6 61.9 77.1 86.4 40.8 38.6 69.5 78.4 87.5 93.4 79.0 By a doctor 7.0 15.7 30.6 46.2 67.2 19.2 16.6 29.2 41.3 55.4 74.3 48.2 By a nurse or trained midwife 15.4 23.8 31.3 30.9 19.2 21.6 22.0 40.3 37.1 32.2 19.1 30.8 In a public facility 7.4 15.4 29.5 34.6 40.1 16.8 18.1 28.2 34.0 38.8 30.1 31.7 In a private facility 1.1 2.3 8.5 17.3 29.8 5.3 1.5 7.6 12.5 24.2 48.3 22.1 At home 90.6 81.4 61.7 46.8 29.2 77.0 79.3 63.3 53.1 35.7 21.5 45.5 D. Contraceptive services Contraceptive prevalence: Women 23.3 34.9 37.7 42.4 40.2 32.8 26.2 31.9 34.3 35.9 34.3 33.9 Men 22.3 32.5 36.9 36.1 40.9 30.6 17.3 24.1 35.4 33.7 29.7 30.4 - 14 - Philippines 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 83.5 80.1 74.7 68.7 51.7 75.5 82.9 73.5 70.0 61.4 41.2 59.8 Men na na na na na na na na na na na na Source of contraception - private sector: Women 15.9 19.4 23.9 30.2 45.2 23.5 16.0 24.8 29.4 37.9 56.4 38.9 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 30.8 41.0 15.2 48.1 0.0 31.2 0.0 67.4 27.7 11.1 42.7 35.3 Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na na na Men 30.8 41.0 15.2 48.1 0.0 31.2 0.0 67.4 27.7 11.1 42.7 35.3 Voluntary counseling and testing for HIV/AIDS: Women na na na na na na na na na na na na Men 1.2 1.4 1.3 3.2 8.7 2.1 1.5 2.7 2.9 5.6 7.3 4.9 - 15 - Philippines 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 43.6 62.4 70.4 80.5 90.9 59.3 40.6 66.4 77.1 86.0 93.3 78.7 Handwashing: Wash hands prior to preparing food 97.7 98.1 97.7 96.8 96.8 97.6 97.4 98.1 97.1 96.8 95.6 96.6 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 62.7 50.1 29.5 28.0 25.1 50.5 46.1 43.2 36.8 34.3 19.3 34.2 Timely complementary feeding 66.8 70.3 39.8 56.3 12.6 60.6 77.2 77.2 52.9 39.6 35.3 53.2 Bottle-feeding 26.4 32.5 49.1 52.0 80.8 36.4 34.1 48.4 60.2 65.3 78.1 60.6 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 64.5 73.9 82.9 81.6 92.9 72.7 67.1 73.1 79.1 85.7 86.3 80.4 Women 37.2 42.1 46.8 46.1 56.7 42.0 38.8 43.9 45.5 47.7 53.8 47.4 E. Tobacco and alcohol use Tobacco: Women 13.5 8.0 6.8 4.8 4.3 8.6 12.1 9.6 7.1 6.1 5.5 6.8 Men 67.0 61.5 55.4 47.9 43.7 58.9 70.6 66.4 56.7 50.6 41.7 52.4 Alcohol: Women na na na na na na na na na na na na Men 40.5 46.3 47.1 38.6 33.0 42.4 35.2 45.7 42.0 36.1 27.4 35.8 F. Sexual practices Non-regular sexual partnerships: Women na na na na na na 0.0 0.0 0.1 0.0 0.1 0.0 Men 1.4 2.8 2.5 4.2 4.2 2.5 1.2 1.9 3.5 2.8 4.9 3.4 Condom usage with non-regular partner: Women na na na na na na na na na na na na Men 37.2 50.4 0.0 16.8 20.5 28.6 0.0 41.3 12.0 21.8 44.8 31.0 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 - Philippines 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 71.7 89.3 94.4 96.5 99.3 87.1 78.7 91.9 95.2 97.9 98.7 96.0 Men 60.6 83.4 91.4 95.1 98.6 80.5 69.2 86.3 94.5 97.1 99.1 94.1 School participation: Girls 81.9 94.5 94.8 98.7 98.7 90.0 84.7 90.8 94.4 96.7 97.8 94.5 Boys 78.7 91.4 96.6 96.7 99.3 88.2 82.7 90.5 92.8 97.1 97.4 93.8 B. Exposure to mass media Newspaper readership: Women 12.9 24.2 32.6 41.2 53.3 27.7 18.6 34.9 47.4 58.1 69.5 55.3 Men 19.5 28.9 43.2 42.5 59.0 32.7 19.1 48.3 57.9 64.5 69.9 59.8 Radio listenership: Women 60.6 76.7 77.0 82.5 85.0 73.5 54.1 74.3 78.8 82.8 86.9 81.1 Men 71.4 82.7 87.6 86.4 82.8 80.4 66.3 76.6 82.9 85.4 88.5 83.5 Television viewership: Women 32.0 63.0 86.0 93.7 96.3 65.7 45.7 79.6 91.3 96.0 97.4 91.1 Men 43.9 73.0 91.5 94.2 93.1 71.2 54.0 82.7 93.1 96.6 97.1 91.5 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 53.7 69.1 74.5 78.3 81.5 68.0 55.3 70.9 77.5 80.9 83.5 78.7 Men 67.1 78.0 82.1 85.9 88.7 77.1 63.0 85.4 85.2 88.7 93.8 87.5 Knowledge about mother-to-child transmission of HIV/AIDS: Women 60.1 70.6 75.4 76.8 79.9 70.1 60.8 73.4 78.5 81.7 82.0 79.1 Men 59.5 63.5 71.9 76.0 85.3 67.2 54.7 76.0 71.8 75.9 78.3 74.4 Attitudes toward HIV/AIDS: Women 26.5 24.4 25.6 29.3 36.6 27.3 26.0 25.3 28.6 31.4 38.2 32.4 Men 21.8 25.3 25.5 21.6 26.9 23.9 25.4 23.9 27.7 28.1 30.8 28.2 D. Status of women Household decisionmaking: Can seek own health care 69.8 71.6 68.7 74.7 72.0 71.1 67.7 76.6 74.4 73.1 78.1 75.3 Can seek children's health care 89.9 93.2 95.7 94.9 95.2 92.9 88.7 94.5 94.5 96.7 96.6 95.3 Can make daily household purchases 74.4 73.1 68.5 63.5 55.3 69.4 71.4 72.4 69.3 64.9 56.6 64.0 Can make large household purchases 68.9 65.6 63.5 56.7 52.6 63.6 64.8 63.8 61.2 57.7 51.9 57.4 Can make meal-related decisions 60.9 57.6 51.6 46.2 40.0 54.1 56.5 59.7 53.3 48.7 38.6 47.6 Freedom of movement: Can travel to visit family, relatives 26.0 26.9 30.5 28.0 29.3 27.7 27.5 31.8 31.8 29.9 33.3 31.6 Other decisionmaking, attitudes: Can decide how to spend own money 60.4 66.0 64.5 71.4 70.1 65.7 62.9 71.3 74.1 71.6 80.5 75.5 Can decide whether to have sex 96.0 97.0 97.0 96.9 97.3 96.7 96.7 95.3 97.0 97.2 97.3 96.9 Justifies domestic violence 38.1 30.6 24.3 23.9 22.1 29.9 45.1 26.5 23.4 17.8 13.7 19.9 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 - 17 - . PART II. BASIC TABLES, 1998 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. Philippines 1998 - 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 48.8 39.2 33.7 24.9 20.9 36.0 2.33 27.90 -0.1566 0.0009 Under-five mortality rate 79.8 60.5 49.7 33.4 29.2 54.9 2.73 50.60 -0.1910 0.0009 Prevalence of fever 26.4 28.4 27.6 24.9 19.4 25.9 1.36 7.00 -0.0182 0.0111 Prevalence of diarrhea 8.8 7.7 7.7 6.2 4.9 7.4 1.80 3.90 -0.0839 0.0232 Prevalence of acute respiratory 15.3 13.4 13.6 12.6 9.1 13.3 1.68 6.20 -0.0734 0.0174 infection (ARI) B. Fertility Total fertility rate 6.5 4.7 3.6 2.9 2.1 3.7 3.10 4.40 -0.2221 0.0005 Adolescent fertility rate 130.0 90.0 32.0 29.0 12.0 46.0 10.83 118.00 -0.4426 0.0018 C. Nutritional status (%) Children: Moderate stunting na na na na na na na na na na Severe stunting na na na na na na na na na na Moderate underweight na na na na na na na na na na Severe underweight na na na na na na na na na na 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 na na na na na na na na na na 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 * * * * * * * * * * Women * * * * * * * * * * 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 - 21 - Philippines 1998 - 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 81.2 90.6 94.4 96.5 98.0 90.8 0.83 16.80 0.0463 0.0049 Measles coverage 67.6 77.1 83.4 84.3 92.2 78.9 0.73 24.60 0.0597 0.0073 DPT coverage 66.8 80.3 84.2 91.2 92.7 80.9 0.72 25.90 0.0715 0.0069 Full basic coverage 59.8 72.5 76.3 79.6 86.5 72.8 0.69 26.70 0.0712 0.0087 No basic coverage 16.4 8.7 3.6 2.4 1.0 7.7 16.40 15.40 -0.4830 0.0535 Hepatitis B coverage 48.1 51.0 51.3 66.7 67.5 55.1 0.71 19.40 0.0737 0.0130 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 32.4 37.6 44.6 51.6 41.7 40.3 0.78 9.30 0.0740 0.0165 Treatment in a public facility 25.6 26.9 21.9 15.5 5.4 21.5 4.74 20.20 -0.1244 0.0234 Treatment in a private facility 6.5 10.0 21.2 34.4 36.0 17.9 0.18 29.50 0.3161 0.0277 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 47.3 55.0 62.9 67.5 74.2 57.9 0.64 26.90 0.0735 0.0159 Treatment in a public facility 37.4 37.7 31.1 18.9 11.9 30.9 3.14 25.50 -0.1240 0.0252 Treatment in a private facility 9.4 15.7 28.9 45.0 60.8 25.1 0.15 51.40 0.3292 0.0299 Treatment of diarrhea: Use of oral rehydration therapy 74.7 64.4 78.8 77.4 (77.1) 73.7 0.97 151.80 0.0026 0.0140 Medical treatment of diarrhea 43.0 37.9 48.8 55.4 (33.4) 43.9 1.29 76.40 0.0331 0.0282 Treatment in a public facility 35.8 27.3 24.4 13.3 (3.4) 25.4 10.53 39.20 -0.1687 0.0390 Treatment in a private facility 6.9 9.6 23.8 38.9 (27.7) 17.3 0.25 34.60 0.3394 0.0535 C. Antenatal and delivery care Antenatal care visits: To a medically trained person 73.1 85.5 94.0 95.6 97.8 87.7 0.75 24.70 0.0701 0.0034 To a doctor 11.5 24.8 47.5 67.0 82.7 42.3 0.14 71.20 0.3426 0.0072 To a nurse or trained midwife 61.7 60.6 46.5 28.6 15.1 45.4 4.09 46.60 -0.1779 0.0083 Multiple visits to a medically trained person 64.1 74.0 83.9 89.1 92.8 79.0 0.69 28.70 0.0795 0.0040 Antenatal care content: Tetanus toxoid 62.7 71.1 75.7 68.2 60.1 67.6 1.04 2.60 0.0261 0.0059 Prophylactic antimalarial treatment na na na na na na na na na na Iron supplementation 59.4 72.8 81.2 84.0 89.9 75.6 0.66 30.50 0.0951 0.0044 Delivery attendance: By a medically trained person 21.2 45.9 72.8 83.9 91.9 56.4 0.23 70.70 0.2763 0.0044 By a doctor 7.1 16.5 35.7 50.2 75.8 30.9 0.09 68.70 0.4006 0.0085 By a nurse or trained midwife 14.1 29.3 37.1 33.8 16.0 25.5 0.88 1.90 0.1262 0.0106 In a public facility 7.1 16.0 28.7 29.3 26.3 19.5 0.27 19.20 0.2809 0.0130 In a private facility 1.6 4.1 11.8 25.5 52.5 14.8 0.03 50.90 0.5035 0.0172 At home 91.0 79.4 59.4 44.8 21.2 65.5 4.29 69.80 -0.1950 0.0040 D. Contraceptive services Contraceptive prevalence: Women 19.6 26.2 33.0 33.0 29.4 28.2 0.67 9.80 0.1146 0.0097 Men na na na na na na na na na na - 22 - Philippines 1998 - 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 90.4 85.1 79.8 63.8 44.7 71.5 2.02 45.70 -0.1156 0.0067 Men na na na na na na na na na na Source of contraception - private sector: Women 9.0 13.7 19.4 34.1 54.8 27.4 0.16 45.80 0.3198 0.0187 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 - 23 - Philippines 1998 - 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 68.4 54.2 38.6 28.6 37.4 47.9 1.83 31.00 -0.1652 0.0264 Timely complementary feeding 81.2 69.8 49.3 40.5 36.3 58.6 2.24 44.90 -0.1637 0.0205 Bottle-feeding 28.9 41.7 63.4 71.5 75.7 52.7 0.38 46.80 0.1788 0.0126 D. Micronutrient consumption Iodized salt: Availability of iodized salt 13.4 12.0 16.4 22.5 35.7 19.8 0.38 22.30 0.1991 0.0112 in household Vitamin A: Children 67.1 78.2 80.7 81.9 73.8 75.6 0.91 6.70 0.0445 0.0045 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 - 24 - Philippines 1998 - 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 71.2 88.6 95.6 97.3 98.0 91.6 0.73 26.80 0.0604 0.0018 Men 64.2 82.7 93.1 97.0 98.4 88.0 0.65 34.20 0.0852 0.0019 School participation: Girls 72.7 83.3 87.7 92.0 96.1 84.8 0.76 23.40 0.0630 0.0039 Boys 66.1 80.0 84.6 90.0 93.0 81.0 0.71 26.90 0.0750 0.0043 B. Exposure to mass media Newspaper readership: Women 32.0 51.8 63.9 71.3 81.4 63.0 0.39 49.40 0.1577 0.0036 Men na na na na na na na na na na Radio listenership: Women 67.0 79.0 81.4 82.2 83.9 79.6 0.80 16.90 0.0420 0.0029 Men na na na na na na na na na na Television viewership: Women 35.2 65.6 87.3 95.7 97.2 79.8 0.36 62.00 0.1631 0.0027 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 na na na na na na na na na na 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 42.1 54.7 61.5 63.2 70.3 61.1 0.60 28.20 0.0870 0.0053 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 - Philippines 1998 - 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 42.4 33.1 35.5 22.4 17.8 32.3 54.8 45.0 32.0 27.1 23.8 39.4 Under-five mortality rate 72.0 50.6 51.1 31.4 27.1 50.2 87.1 70.0 48.3 35.2 31.1 59.4 Prevalence of fever 27.5 27.0 28.3 23.5 18.7 25.7 25.4 29.7 26.8 26.0 20.1 26.1 Prevalence of diarrhea 8.2 7.1 8.3 5.4 4.9 7.1 9.4 8.4 7.2 6.8 4.9 7.7 Prevalence of acute respiratory 15.1 11.4 15.0 12.5 8.9 13.0 15.4 15.2 12.4 12.7 9.2 13.5 infection (ARI) B. Nutritional status Children: Moderate stunting na na na na na na na na na na na na Severe stunting na na na na na na na na na na na na Moderate underweight na na na na na na na na na na na na Severe underweight na na na na na na na na na na na na 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 - 27 - Philippines 1998 - 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 82.9 94.2 95.2 96.4 97.7 92.1 79.6 87.6 93.3 96.5 98.2 89.4 Measles coverage 69.8 80.1 79.8 85.8 86.8 79.0 65.5 74.7 88.1 83.0 96.5 78.8 DPT coverage 69.5 83.0 83.5 92.8 90.1 81.9 64.2 78.1 85.0 89.8 94.8 79.9 Full basic coverage 63.5 75.1 74.5 81.9 82.3 73.8 56.4 70.4 78.8 77.8 89.8 71.9 No basic coverage 14.3 5.2 2.6 1.9 2.3 6.2 18.3 11.6 4.8 2.8 0.0 9.1 Hepatitis B coverage 52.2 50.8 49.6 65.9 71.9 55.8 44.1 51.1 53.6 67.4 63.9 54.4 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 33.9 33.2 43.0 57.1 42.7 39.9 30.9 41.3 46.3 47.6 40.8 40.6 Treatment in a public facility 27.0 24.5 20.9 19.7 1.8 21.6 24.2 28.9 23.0 12.5 8.5 21.5 Treatment in a private facility 6.5 8.7 21.3 35.0 40.9 17.7 6.4 11.1 21.1 34.0 31.7 18.0 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 46.0 47.1 56.3 69.4 (70.5) 54.4 48.6 60.2 70.5 66.0 (77.5) 60.9 Treatment in a public facility 36.9 35.7 25.6 21.3 (8.7) 29.1 37.9 39.0 37.5 17.0 (14.8) 32.5 Treatment in a private facility 8.4 11.4 28.3 42.9 (61.9) 23.7 10.3 18.7 29.6 46.7 (59.8) 26.4 Treatment of diarrhea: Use of oral rehydration therapy 77.0 63.0 78.7 (81.2) * 74.1 72.8 65.5 79.0 (74.9) * 73.3 Medical treatment of diarrhea 43.9 37.6 47.7 (59.0) * 44.2 42.3 38.2 50.1 (53.2) * 43.6 Treatment in a public facility 33.3 26.7 24.3 (17.4) * 24.7 37.9 27.8 24.4 (10.6) * 26.0 Treatment in a private facility 9.9 8.6 22.1 (39.5) * 17.7 4.4 10.4 25.7 (38.6) * 17.0 C. Contraceptive services Contraceptive prevalence: Women 19.6 26.2 33.0 33.0 29.4 28.2 Men na na na na na na Source of contraception - public sector: Women 90.4 85.1 79.8 63.8 44.7 71.5 Men na na na na na na Source of contraception - private sector: Women 9.0 13.7 19.4 34.1 54.8 27.4 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 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 - 28 - Philippines 1998 - 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 67.3 52.1 (41.9) (32.3) * 50.8 69.7 56.0 (36.1) (26.5) (28.4) 45.3 Timely complementary feeding 81.6 73.2 (54.4) (47.0) * 61.6 80.8 66.6 (44.7) (35.2) (40.1) 56.0 Bottle-feeding 27.0 35.3 61.5 76.2 72.8 50.4 30.6 47.4 65.0 67.9 78.3 54.7 D. Micronutrient consumption Vitamin A: Children 65.6 79.0 82.8 81.8 74.3 75.8 68.5 77.5 78.6 82.0 73.4 75.5 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 - 29 - Philippines 1998 - 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 71.2 88.6 95.6 97.3 98.0 91.6 Men 64.2 82.7 93.1 97.0 98.4 88.0 School participation: Girls 72.7 83.3 87.7 92.0 96.1 84.8 Boys 66.1 80.0 84.6 90.0 93.0 81.0 B. Exposure to mass media Newspaper readership: Women 32.0 51.8 63.9 71.3 81.4 63.0 Men na na na na na na Radio listenership: Women 67.0 79.0 81.4 82.2 83.9 79.6 Men na na na na na na Television viewership: Women 35.2 65.6 87.3 95.7 97.2 79.8 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 na na na na na na 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 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 - Philippines 1998 - 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 48.7 38.7 28.4 25.1 (35.5) 40.2 49.7 40.1 37.6 24.8 17.7 30.9 Under-five mortality rate 81.2 59.2 38.8 33.7 (39.8) 62.5 70.5 62.9 57.9 33.2 26.9 45.8 Prevalence of fever 26.5 27.9 27.7 26.5 17.9 26.7 25.8 29.3 27.4 24.2 19.7 24.9 Prevalence of diarrhea 8.7 8.3 7.5 8.3 3.7 8.2 9.4 6.8 7.9 5.3 5.1 6.5 Prevalence of acute respiratory infection 15.8 12.9 15.6 14.3 8.5 14.6 11.6 14.4 12.3 11.9 9.2 11.7 B. Fertility Total fertility rate 6.5 4.8 3.7 (2.9) (2.6) 4.7 * (4.5) 3.6 2.9 2.0 3.0 Adolescent fertility rate 138.0 82.0 35.0 (28.0) (9.0) 69.3 * (102.0) 29.0 30.0 12.0 30.2 C. Nutritional status Children: Moderate stunting na na na na na na na na na na na na Severe stunting na na na na na na na na na na na na Moderate underweight na na na na na na na na na na na na Severe underweight na na na na na na na na na na na na 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 na na na na na na na na na na na na 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 * * * * * * * * * * * * Women * * * * * * * * * * * * 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 - 31 - Philippines 1998 - 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 80.1 88.4 94.1 96.2 (100.0) 86.9 87.4 94.1 94.6 96.6 97.6 95.0 Measles coverage 66.7 78.1 87.0 85.0 (97.9) 75.9 72.9 75.6 81.0 83.9 91.1 82.2 DPT coverage 65.6 81.2 86.8 89.4 (96.7) 76.7 73.4 79.0 82.4 92.0 91.9 85.5 Full basic coverage 58.6 73.9 81.6 80.6 (94.6) 69.8 66.5 70.3 72.9 79.2 84.9 76.1 No basic coverage 17.2 10.5 4.4 2.1 0.0 11.2 11.8 5.9 3.0 2.6 1.2 3.8 Hepatitis B coverage 45.3 51.9 51.2 65.6 (70.4) 51.1 63.1 49.5 51.4 67.2 66.9 59.5 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 30.7 35.1 38.8 49.4 (47.8) 35.4 44.0 42.0 48.8 52.6 40.6 46.4 Treatment in a public facility 23.6 23.3 18.1 13.3 (6.8) 21.3 39.1 33.1 24.6 16.6 5.2 21.8 Treatment in a private facility 6.7 11.2 18.8 33.8 (41.1) 13.3 4.9 7.9 22.9 34.7 35.1 23.6 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 46.5 53.0 61.0 71.8 * 53.3 (54.5) 58.2 64.6 65.3 74.5 64.5 Treatment in a public facility 36.7 35.0 20.1 20.5 * 31.9 (44.3) 41.9 40.9 18.1 9.5 29.5 Treatment in a private facility 9.3 16.8 36.5 47.6 * 19.7 (10.1) 14.0 22.2 43.6 64.2 33.1 Treatment of diarrhea: Use of oral rehydration therapy 74.5 65.9 (74.7) (69.5) * 71.6 (76.1) (61.3) 81.6 (82.7) (77.6) 76.7 Medical treatment of diarrhea 42.3 35.8 (40.3) (50.1) * 41.2 (47.5) (42.7) 54.5 (59.1) (30.3) 47.8 Treatment in a public facility 34.3 25.7 (22.2) (6.0) * 26.9 (45.1) (30.8) 25.8 (18.1) (3.9) 23.1 Treatment in a private facility 7.6 8.6 (18.2) (44.1) * 13.7 (2.5) (11.9) 27.6 (35.5) (23.7) 22.7 C. Antenatal and delivery care Antenatal care visits: To a medically trained person 71.8 83.9 91.2 96.2 95.9 81.8 81.5 88.3 96.0 95.4 98.2 94.2 To a doctor 9.9 20.8 36.7 66.7 73.1 26.0 21.8 32.2 55.1 67.1 84.7 60.0 To a nurse or trained midwife 62.0 63.1 54.4 29.5 22.8 55.8 59.7 56.1 40.9 28.3 13.6 34.1 Multiple visits to a medically trained person 63.0 71.4 81.9 86.8 89.2 72.0 70.7 78.7 85.3 90.0 93.5 86.6 Antenatal care content: Tetanus toxoid 61.7 71.4 78.8 70.8 59.9 67.8 69.1 70.5 73.5 67.1 60.1 67.5 Prophylactic antimalarial treatment na na na na na na na na na na na na Iron supplementation 58.3 71.7 79.2 84.5 86.7 69.2 66.4 74.8 82.6 83.8 90.5 82.6 Delivery attendance: By a medically trained person 18.9 37.6 59.5 78.2 78.6 37.7 36.1 60.9 82.2 86.4 94.5 78.6 By a doctor 6.6 13.0 25.9 47.3 54.1 16.8 10.4 23.0 42.6 51.4 80.1 47.6 By a nurse or trained midwife 12.3 24.6 33.6 30.9 24.5 20.9 25.7 37.9 39.5 35.0 14.4 30.9 In a public facility 6.2 12.3 20.7 30.2 23.9 12.9 12.6 22.8 34.2 28.9 26.7 27.2 In a private facility 1.5 3.4 9.9 21.0 33.1 6.3 2.1 5.5 13.1 27.5 56.4 24.8 At home 91.9 83.9 69.2 47.9 43.0 80.4 85.1 71.2 52.5 43.4 16.9 47.7 D. Contraceptive services Contraceptive prevalence: Women 19.3 24.6 30.6 31.1 30.5 25.0 21.7 29.2 34.9 33.9 29.1 31.3 Men na na na na na na na na na na na na - 32 - Philippines 1998 - 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 91.2 89.8 85.3 74.5 60.6 84.3 85.5 77.7 76.0 59.4 41.2 61.6 Men na na na na na na na na na na na na Source of contraception - private sector: Women 8.5 8.6 14.2 25.3 39.4 15.1 11.6 21.7 23.0 37.8 58.2 37.0 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 - 33 - Philippines 1998 - 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 68.0 61.5 (39.9) (43.0) * 58.2 * (34.0) (37.7) (22.2) (37.2) 34.8 Timely complementary feeding 85.0 75.9 (63.6) (51.1) * 73.3 * (57.5) (40.7) 36.1 (39.2) 42.8 Bottle-feeding 27.5 35.7 58.2 67.1 (72.5) 40.4 37.8 54.5 66.9 73.4 76.4 67.0 D. Micronutrient consumption Iodized salt: Availability of iodized salt 13.5 10.8 14.4 17.8 24.7 14.2 12.9 14.4 18.2 24.7 38.0 25.4 in household Vitamin A: Children 66.5 79.5 80.9 80.1 77.5 73.9 70.8 75.9 80.5 82.7 73.1 77.7 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 - 34 - Philippines 1998 - 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 70.5 87.3 95.5 96.6 97.7 86.2 74.9 91.1 95.7 97.5 98.0 95.8 Men 63.0 80.6 92.6 95.5 96.6 80.8 71.4 86.6 93.4 97.6 98.8 94.5 School participation: Girls 72.6 82.9 86.1 90.1 95.2 80.7 73.5 84.0 89.3 92.9 96.3 90.0 Boys 65.4 80.2 85.0 86.6 94.4 76.5 70.7 79.6 84.3 91.6 92.7 86.7 B. Exposure to mass media Newspaper readership: Women 30.9 48.0 58.1 67.5 75.2 50.1 38.6 58.5 68.4 73.0 82.5 72.9 Men na na na na na na na na na na na na Radio listenership: Women 67.2 81.5 84.2 86.3 83.7 78.5 65.7 74.4 79.2 80.5 83.9 80.3 Men na na na na na na na na na na na na Television viewership: Women 31.7 60.1 82.8 95.0 97.4 64.3 55.9 75.6 90.7 96.0 97.1 91.6 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 na na na na na na na na na na na na 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 39.5 50.8 57.2 58.9 64.4 51.5 57.0 61.2 64.4 64.9 71.1 67.0 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. 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.) - 39 - 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. - 40 - 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. - 41 - 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. - 42 - 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. - 43 - 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). 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. - 44 - 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). 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. - 45 - 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. - 46 - 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. - 47 - 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. - 48 - 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. 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.) - 49 - Knowledge about Mother-to-Child Transmission of HIV/AIDS 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). - 50 - 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. - 51 - 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. - 53 - 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. 59) 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. - 54 - 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.) - 55 - 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. - 57 - 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 - 58 - 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. - 59 - 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.) - 60 - 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 - 61 - 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. - 62 - PART IV. SUPPORTING TABLES, 2003 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Philippines 2003 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 12,121 12,127 12,116 12,099 12,126 60,589 Urban 1,983 4,306 6,902 8,165 9,979 31,336 Rural 10,137 7,821 5,214 3,935 2,147 29,253 Female 5,752 5,762 5,918 6,013 6,440 29,884 Male 6,368 6,365 6,198 6,087 5,686 30,705 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 3,686 3,165 2,750 2,326 2,015 13,943 Urban 597 1,198 1,665 1,638 1,697 6,795 Rural 3,088 1,967 1,085 688 319 7,148 Female 1,769 1,523 1,307 1,114 967 6,680 Male 1,917 1,642 1,443 1,213 1,048 7,262 Prevalence of fever, diarrhea, acute respiratory infection All 1,764 1,525 1,309 1,123 977 6,698 Urban 299 602 831 795 830 3,356 Rural 1,465 923 478 328 147 3,342 Female 879 733 643 576 472 3,303 Male 885 791 666 548 505 3,395 Total fertility rate All 2,161 2,412 2,682 2,940 3,438 13,633 Urban 396 917 1,632 2,055 2,878 7,877 Rural 1,765 1,495 1,050 885 560 5,756 Age-specific fertility rate 15-19 All 361 439 501 578 769 2,648 Urban 70 166 302 385 623 1,545 Rural 292 273 199 193 146 1,103 Children's nutritional 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 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 - 65 - Philippines 2003 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All na na na na na na Urban na na na na na na Rural na na na na na na 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 883 936 991 956 994 4,762 Urban Male 159 319 599 662 811 2,550 Rural Male 724 618 392 294 184 2,211 - 66 - Philippines 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 355 297 261 240 196 1,348 Urban 64 127 165 160 165 681 Rural 291 170 96 80 31 667 Female 171 140 135 124 94 664 Male 184 157 126 116 102 685 Treatment of fever All 493 390 299 240 173 1,596 Urban 77 161 180 173 142 732 Rural 416 229 119 67 32 863 Female 261 169 143 122 84 779 Male 233 221 156 118 90 817 Treatment of acute respiratory infection All 258 167 118 86 57 687 Urban 37 67 65 66 43 279 Rural 221 100 53 19 14 408 Female 145 79 57 43 28 351 Male 114 88 61 43 29 335 Treatment of diarrhea All 230 169 122 103 90 714 Urban 48 74 78 79 80 359 Rural 181 95 44 24 10 355 Female 119 63 69 57 28 336 Male 111 106 53 46 62 378 Antenatal and delivery care All 1,858 1,590 1,352 1,162 993 6,954 Urban 314 628 860 817 842 3,461 Rural 1,544 961 492 346 150 3,493 Contraceptive prevalence Female 1,677 1,767 1,776 1,755 1,697 8,671 Urban Female 289 652 1,058 1,226 1,418 4,643 Rural Female 1,388 1,114 717 529 279 4,028 Male 558 575 578 499 529 2,738 Urban Male 96 213 354 351 440 1,454 Rural Male 462 362 224 148 89 1,284 Contraceptive source Female 399 597 633 665 598 2,892 Urban Female 76 208 363 441 486 1,573 Rural Female 324 389 271 224 112 1,319 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 16 15 14 9 7 61 Urban Male 3 6 5 4 6 24 Rural Male 14 9 8 4 1 37 - 67 - Philippines 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 1,117 1,017 909 828 722 4,593 Urban 196 387 567 580 608 2,339 Rural 921 630 343 247 114 2,255 Wash hands prior to preparing food All 2,161 2,412 2,682 2,940 3,438 13,633 Urban 396 917 1,632 2,055 2,878 7,877 Rural 1,765 1,495 1,050 885 560 5,756 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 106 94 90 57 54 402 Urban 16 37 63 43 46 205 Rural 91 57 27 14 8 197 Female 53 47 39 29 27 196 Male 53 47 51 28 27 206 Timely complementary breastfeeding All 126 125 94 92 61 499 Urban 24 54 61 70 51 259 Rural 102 71 34 21 11 239 Female 55 64 51 59 27 256 Male 71 61 43 33 35 242 Bottle-feeding All 340 309 280 226 165 1,319 Urban 55 128 182 168 133 666 Rural 285 180 97 58 32 653 Female 157 149 136 121 74 636 Male 183 160 144 105 91 683 - 68 - Philippines 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 na na na na na na Urban na na na na na na Rural na na na na na na Vitamin A supplementation All 1,593 1,378 1,160 1,025 909 6,066 Urban 277 542 733 723 774 3,049 Rural 1,316 836 428 302 135 3,017 Female 797 664 573 530 439 3,002 Male 796 715 588 495 470 3,064 Tobacco and alcohol use, casual sexual partners, condom use for casual sex Female 2,161 2,412 2,681 2,939 3,438 13,630 Urban Female 396 917 1,632 2,054 2,878 7,876 Rural Female 1,765 1,494 1,049 885 560 5,754 Male 884 937 992 957 996 4,766 Urban Male 160 319 600 662 812 2,553 Rural Male 724 618 392 295 184 2,213 Domestic violence All na na na na na na Urban na na na na na na Rural na na na na na na - 69 - Philippines 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 2,353 2,635 2,954 3,234 3,754 14,930 Urban female 428 974 1,771 2,222 3,123 8,518 Rural female 1,925 1,661 1,183 1,012 631 6,412 Male 2,849 3,103 3,280 3,376 3,240 15,848 Urban male 489 1,126 1,922 2,332 2,638 8,507 Rural male 2,360 1,977 1,358 1,044 602 7,341 School participation Female 959 842 711 644 522 3,679 Urban female 139 281 404 435 434 1,692 Rural female 821 561 307 210 88 1,987 Male 992 881 801 689 591 3,954 Urban male 154 317 437 455 483 1,846 Rural male 838 565 363 234 108 2,109 Mass media exposure Female 2,161 2,412 2,682 2,940 3,438 13,633 Urban female 396 917 1,632 2,055 2,878 7,877 Rural female 1,765 1,495 1,050 885 560 5,756 Male 884 937 992 957 996 4,766 Urban male 160 319 600 662 812 2,553 Rural male 724 618 392 295 184 2,213 Knowledge of HIV/AIDS prevention Female 2,161 2,412 2,682 2,940 3,438 13,633 Urban female 396 917 1,632 2,055 2,878 7,877 Rural female 1,765 1,495 1,050 885 560 5,756 Male 884 937 992 957 996 4,766 Urban male 160 319 600 662 812 2,553 Rural male 724 618 392 295 184 2,213 Household decisionmaking and justification of violence All 2,161 2,412 2,682 2,940 3,438 13,633 Urban 396 917 1,632 2,055 2,878 7,877 Rural 1,765 1,495 1,050 885 560 5,756 Orphanhood 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 - 70 - Philippines 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 3.81 3.23 3.44 3.56 4.07 1.74 Under-five mortality rate 5.02 3.92 3.96 3.72 4.13 2.20 Prevalence of fever 1.18 1.27 1.36 1.49 1.51 0.67 Prevalence of diarrhea 0.89 0.94 0.96 0.94 1.10 0.47 Prevalence of acute respiratory infection 1.10 0.91 0.95 0.87 0.91 0.48 B. Fertility Total fertility rate 0.18 0.14 0.13 0.11 0.10 0.07 Adolescent fertility rate 12.42 8.63 6.65 4.67 3.03 2.94 C. Nutritional status Children: Moderate stunting na na na na na na Severe stunting na na na na na na Moderate underweight na na na na na na Severe underweight na na na na na na 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 na na na na na na 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 0.39 0.35 0.31 0.16 0.21 0.13 Prevalence of genital ulcer: Women na na na na na na Men 0.24 0.36 0.23 0.27 0.16 0.11 - 71 - Philippines 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 2.23 1.59 1.52 1.71 1.38 0.89 Measles coverage 2.47 2.27 2.45 2.81 2.60 1.15 DPT coverage 2.73 2.63 2.35 2.33 2.34 1.25 Full basic coverage 2.67 2.79 2.78 3.05 3.19 1.37 No basic coverage 2.13 1.43 1.41 1.28 1.22 0.80 Hepatitis B coverage 2.45 3.02 3.50 3.68 3.76 1.53 Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 2.74 2.78 3.55 3.66 4.60 1.48 Treatment in a public facility 2.76 2.78 3.33 2.59 3.12 1.49 Treatment in a private facility 1.12 1.33 2.09 3.31 4.81 1.12 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 3.50 4.46 5.62 5.58 6.15 2.16 Treatment in a public facility 3.46 4.50 5.49 5.31 4.87 2.14 Treatment in a private facility 1.68 2.20 4.39 5.60 7.50 1.71 Treatment of diarrhea: Use of oral rehydration therapy 3.13 2.85 3.93 4.02 4.13 1.62 Medical treatment of diarrhea 3.21 4.01 5.23 5.28 6.00 1.79 Treatment in a public facility 2.95 3.68 4.53 3.55 3.66 1.62 Treatment in a private facility 1.48 1.97 3.68 4.69 5.36 1.34 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically trained person 1.83 1.09 1.02 0.70 0.80 0.71 To a doctor 0.86 1.39 1.84 2.00 1.70 1.13 To a nurse or trained midwife 1.86 1.64 1.86 2.03 1.55 1.08 Multiple visits to a medically trained person 1.68 1.37 1.32 1.05 1.12 0.73 Antenatal care content: Tetanus toxoid 1.84 1.50 1.51 1.69 1.85 0.83 Prophylactic antimalarial treatment na na na na na na Iron supplementation 1.72 1.49 1.39 1.50 1.40 0.79 Delivery attendance: By a medically trained person 1.63 1.89 1.73 1.62 1.12 1.38 By a doctor 0.92 1.41 1.75 2.09 1.96 1.13 By a nurse or trained midwife 1.33 1.67 1.72 1.94 1.72 0.94 In a public facility 0.95 1.32 1.68 1.91 2.03 0.84 In a private facility 0.27 0.66 1.14 1.60 2.23 0.74 At home 1.03 1.50 1.81 2.09 1.89 1.20 D. Contraceptive services Contraceptive prevalence: Women 1.26 1.25 1.26 1.28 1.40 0.65 Men 1.72 1.88 2.11 2.26 2.27 0.99 Source of contraception - public sector: Women 1.93 1.88 1.95 2.03 2.36 1.13 Men na na na na na na - 72 - Philippines 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 1.86 1.85 1.92 2.04 2.34 1.12 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 * * * * * 6.44 Treatment of genital discharge, ulcer, sore in public facilities: na na na na na na Women * * * * * 6.44 Men Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men 0.37 0.43 0.51 0.77 0.97 0.31 - 73 - Philippines 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 1.62 1.57 1.60 1.37 0.99 0.93 Handwashing: Wash hands prior to preparing food 0.34 0.30 0.40 0.36 0.52 0.21 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 Bednet use: By children na na na na na na By pregnant women C. Breastfeeding Exclusive breastfeeding 4.46 5.10 5.79 6.33 5.40 2.54 Timely complementary feeding 4.16 3.98 5.47 5.49 6.50 2.24 Bottle-feeding 2.49 2.87 3.11 3.37 3.55 1.49 D. Micronutrient consumption Iodized salt: Availability of iodized salt in household na na na na na na Vitamin A: Children 1.75 1.47 1.56 1.29 1.40 0.84 Women 1.64 1.61 1.70 1.85 2.09 0.85 E. Tobacco and alcohol use Tobacco: Women 0.84 0.61 0.58 0.46 0.45 0.29 Men 1.66 1.68 1.89 1.82 1.79 0.86 Alcohol: Women na na na na na na Men 2.06 1.79 1.84 1.70 1.90 0.92 F. Sexual practices Non-regular sexual partnerships: Women 0.00 0.00 0.06 0.00 0.05 0.02 Men 0.47 0.63 0.73 0.85 0.97 0.34 Condom usage with non-regular partner: Women na na na na na na Men * * * * 9.15 5.14 G. Domestic violence Ever experienced violence na na na na na na Experienced violence in past year na na na na na na - 74 - Philippines 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 1.23 0.67 0.43 0.30 0.20 0.39 Men 1.31 0.79 0.50 0.36 0.19 0.55 School participation: Girls 1.50 0.96 0.89 0.78 0.66 0.59 Boys 1.49 1.03 0.85 0.71 0.63 0.58 B. Exposure to mass media Newspaper readership: Women 0.86 1.07 1.22 1.22 1.18 0.92 Men 1.52 2.04 1.89 2.10 2.22 1.20 Radio listenership: Women 1.33 1.08 1.01 0.88 0.76 0.54 Men 2.13 1.54 1.31 1.29 1.19 0.73 Television viewership: Women 1.77 1.19 0.78 0.47 0.31 0.86 Men 2.20 1.74 0.92 0.76 0.81 0.92 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 1.54 1.11 1.01 0.86 0.87 0.63 Men 2.23 1.47 1.46 1.25 1.07 0.79 Knowledge about mother-to-child transmission of HIV/AIDS: Women 1.35 1.07 1.01 0.91 0.91 0.60 Men 2.37 1.80 1.84 1.64 1.42 0.93 Attitudes toward HIV/AIDS: Women 1.21 0.99 1.05 1.02 1.19 0.59 Men 1.81 1.80 1.75 1.81 1.85 0.94 D. Status of women Household decisionmaking: Can seek own health care 1.54 1.18 1.15 1.08 1.06 0.72 Can seek children's health care 0.97 0.64 0.62 0.48 0.52 0.33 Can make daily household purchases 1.05 0.96 0.96 1.03 1.06 0.53 Can make large household purchases 1.10 1.10 1.04 1.00 0.97 0.53 Can make meal-related decisions 1.36 1.06 1.05 1.09 1.00 0.60 Freedom of movement: Can travel to visit family/relatives 1.12 1.04 1.08 0.99 1.12 0.56 Other decisionmaking, attitudes: Can decide how to spend own money 2.24 1.68 1.59 1.45 1.24 0.80 Can decide whether to have sex 0.52 0.44 0.38 0.40 0.34 0.21 Justifies domestic violence 1.64 1.16 1.02 0.93 0.88 0.67 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 - 75 - Philippines 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 0.742 0.438 14.4% 72.2% 97.2% 99.6% 100.0% 76.7% 0.09228 Has radio 0.702 0.457 46.3% 62.8% 73.9% 83.6% 94.2% 72.1% 0.05167 Has television 0.600 0.490 2.6% 37.7% 83.9% 97.3% 99.9% 64.3% 0.10216 Has refrigerator 0.359 0.480 0.0% 3.3% 21.4% 70.4% 97.4% 38.5% 0.10366 Has bicycle 0.188 0.391 7.3% 16.3% 22.5% 27.2% 34.5% 21.6% 0.03104 Has motorcycle/scooter 0.123 0.329 0.6% 4.6% 9.5% 21.4% 30.8% 13.4% 0.04483 Has car/truck 0.089 0.285 0.2% 0.5% 1.3% 5.4% 42.5% 10.0% 0.06452 Has telephone 0.108 0.310 0.0% 0.1% 0.9% 8.3% 53.6% 12.6% 0.07188 Has cellular phone 0.341 0.474 0.3% 6.1% 24.4% 60.1% 93.4% 36.9% 0.09596 Has washing machine 0.269 0.444 0.0% 1.0% 12.6% 49.3% 88.8% 30.4% 0.09498 Has CD/VCD/DVD player 0.329 0.470 0.1% 4.5% 23.7% 59.0% 92.6% 36.0% 0.09659 Has component/karaoke 0.260 0.439 1.1% 7.0% 18.2% 40.5% 76.6% 28.7% 0.08067 Has personal computer 0.059 0.236 0.0% 0.1% 0.1% 2.0% 33.4% 7.1% 0.05864 Has tractor 0.021 0.142 0.4% 1.1% 2.4% 3.1% 2.9% 2.0% 0.01105 Has motorized banca/boat 0.048 0.214 9.3% 6.5% 4.8% 3.3% 1.7% 5.1% -0.01621 Works own or family's agric. land 0.039 0.194 11.4% 4.3% 2.5% 1.4% 0.2% 4.0% -0.02477 Uses piped drinking water in residence 0.322 0.467 2.7% 15.0% 34.6% 51.1% 65.1% 33.7% 0.06467 Uses water from a tap in the yard 0.054 0.226 4.1% 8.5% 7.6% 4.7% 0.9% 5.2% -0.00817 Uses public tap water 0.138 0.344 21.4% 20.5% 14.4% 7.9% 3.1% 13.5% -0.02639 Uses water from an open well 0.049 0.217 17.9% 3.4% 1.1% 0.5% 0.0% 4.6% -0.03691 Uses water from a protected well 0.271 0.444 26.1% 39.2% 33.6% 25.3% 9.9% 26.8% -0.01825 Uses water from a tanker truck 0.016 0.127 0.9% 1.5% 1.3% 2.3% 1.4% 1.5% 0.00350 Uses surface water for drinking 0.009 0.097 2.8% 0.9% 0.4% 0.2% 0.2% 0.9% -0.01188 Uses water from a developed spring 0.048 0.213 10.8% 6.5% 2.6% 1.8% 0.2% 4.4% -0.02358 Uses bottled water for drinking water 0.052 0.222 0.0% 0.7% 2.9% 5.5% 19.0% 5.6% 0.03807 Uses rain for drinking water 0.005 0.069 0.9% 0.6% 0.4% 0.2% 0.0% 0.4% -0.00572 Uses water from a spring 0.035 0.184 12.3% 3.0% 1.0% 0.6% 0.0% 3.4% -0.02947 Uses own flush toilet 0.639 0.480 11.7% 53.4% 76.7% 92.1% 98.6% 66.5% 0.08683 Uses a shared flush toilet 0.133 0.339 12.0% 22.8% 16.9% 6.6% 1.2% 11.9% -0.02069 Uses a closed pit latrine 0.064 0.246 17.4% 9.4% 3.1% 0.9% 0.1% 6.2% -0.03340 Uses bush,field as latrine 0.100 0.299 37.2% 7.9% 1.8% 0.2% 0.0% 9.4% -0.05570 Uses a drop latrine 0.022 0.146 6.5% 2.9% 0.8% 0.1% 0.0% 2.0% -0.02151 Uses open pit latrine 0.041 0.199 14.9% 3.3% 0.9% 0.1% 0.1% 3.8% -0.03305 Has a dirt or sand floor 0.127 0.333 23.7% 23.9% 8.6% 4.4% 2.2% 12.6% -0.03586 Has cement floor (includes vinyl & other floor types) 0.514 0.500 2.8% 35.3% 74.5% 83.8% 68.4% 52.9% 0.07052 Has floor of ceramic tile (includes parquet floor) 0.040 0.196 0.0% 0.1% 0.7% 3.3% 17.7% 4.4% 0.04044 Has flooring made of palm or bamboo 0.148 0.355 52.5% 15.8% 3.1% 0.7% 0.0% 14.4% -0.06524 Has vinyl flooring 0.007 0.081 0.0% 0.0% 0.2% 1.0% 2.7% 0.8% 0.01384 Has parquet flooring 0.008 0.087 0.2% 1.1% 0.5% 0.6% 0.7% 0.6% 0.00091 Has marble flooring 0.013 0.112 0.0% 0.0% 0.2% 0.5% 7.1% 1.6% 0.02529 Has wood flooring 0.143 0.350 20.8% 23.5% 12.1% 5.6% 1.0% 12.6% -0.03454 Has concrete, brick or stone walls 0.379 0.485 0.4% 11.8% 41.1% 61.6% 83.8% 39.8% 0.08692 Has wood walls 0.206 0.404 27.2% 36.2% 22.2% 9.5% 2.4% 19.5% -0.03680 Has walls partly of concrete/brick/stone 0.171 0.376 2.1% 18.6% 27.6% 25.9% 13.0% 17.4% 0.01541 Has walls of galvanized iron/aluminum 0.012 0.107 0.7% 1.7% 1.3% 0.5% 0.1% 0.9% -0.00500 Has walls of bamboo/other natural materials 0.224 0.417 67.9% 29.6% 7.0% 2.3% 0.3% 21.4% -0.07640 Has walls makeshift or nonexistent 0.007 0.084 1.5% 1.7% 0.6% 0.2% 0.3% 0.9% -0.00682 - 77 - PART V. SUPPORTING TABLES, 1998 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Philippines 1998 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 12,581 12,593 12,607 12,378 12,773 62,932 Urban 1,713 4,192 6,644 8,318 10,638 31,505 Rural 10,868 8,401 5,963 4,060 2,135 31,427 Female 6,017 6,104 6,126 6,229 6,814 31,290 Male 6,565 6,487 6,481 6,149 5,959 31,640 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 4,199 3,478 2,818 2,582 1,999 15,075 Urban 550 1,234 1,621 1,799 1,642 6,847 Rural 3,649 2,244 1,197 782 357 8,228 Female 2,032 1,693 1,366 1,231 948 7,269 Male 2,167 1,786 1,452 1,351 1,051 7,807 Prevalence of fever, diarrhea, acute respiratory infection All 2,014 1,674 1,386 1,243 969 7,286 Urban 266 595 816 871 812 3,360 Rural 1,749 1,079 569 372 157 3,926 Female 982 787 674 557 463 3,463 Male 1,033 887 712 685 506 3,823 Total fertility rate All 6,155 6,742 7,643 8,392 10,182 39,113 Urban 879 2,401 4,349 5,861 8,704 22,194 Rural 5,276 4,341 3,294 2,531 1,477 16,919 Age-specific fertility rate 15-19 All 1,005 1,245 1,649 1,675 2,599 8,173 Urban 152 471 884 1,209 2,221 4,937 Rural 853 773 766 466 378 3,236 Children's nutritional 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 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 - 81 - Philippines 1998 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All na na na na na na Urban na na na na na na Rural na na na na na na 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 - 82 - Philippines 1998 - 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 400 344 285 260 185 1,474 Urban 61 134 172 177 155 699 Rural 339 210 113 83 30 775 Female 194 155 164 117 82 712 Male 206 189 122 143 102 762 Treatment of fever All 532 476 382 309 188 1,888 Urban 69 174 224 211 160 838 Rural 464 302 158 99 28 1,051 Female 262 263 191 179 102 997 Male 270 213 191 131 87 892 Treatment of acute respiratory infection All 308 225 189 157 88 966 Urban 31 85 100 104 74 394 Rural 277 139 89 53 13 571 Female 148 90 101 70 41 450 Male 159 135 88 87 47 516 Treatment of diarrhea All 178 130 107 77 48 539 Urban 25 40 64 46 42 217 Rural 152 89 43 31 6 321 Female 81 56 56 30 23 246 Male 97 74 51 47 25 294 Antenatal and delivery care All 1,258 1,091 957 912 750 4,968 Urban 169 384 561 641 625 2,380 Rural 1,089 707 395 271 125 2,587 Contraceptive prevalence Female 1,682 1,717 1,641 1,713 1,583 8,336 Urban Female 226 596 920 1,177 1,303 4,222 Rural Female 1,457 1,121 721 536 280 4,115 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 330 450 542 565 465 2,352 Urban Female 49 174 321 398 380 1,322 Rural Female 281 276 221 167 85 1,030 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 - 83 - Philippines 1998 - 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 113 108 83 77 71 452 Urban 12 29 47 53 58 199 Rural 101 80 35 24 13 253 Female 52 58 47 49 32 238 Male 60 50 35 28 38 211 Timely complementary breastfeeding All 132 107 97 101 65 502 Urban 19 35 61 71 57 243 Rural 113 71 36 30 9 259 Female 70 55 51 56 38 270 Male 62 52 46 46 28 234 Bottle-feeding All 391 336 287 264 216 1,494 Urban 52 108 169 183 178 690 Rural 339 228 118 80 39 804 Female 205 178 151 149 113 796 Male 186 158 135 114 103 696 - 84 - Philippines 1998 - 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 2,338 2,530 2,486 2,330 2,291 11,975 Urban 306 838 1,336 1,584 1,896 5,960 Rural 2,032 1,692 1,150 746 395 6,015 Vitamin A supplementation All 1,818 1,510 1,252 1,111 859 6,550 Urban 241 548 738 781 720 3,028 Rural 1,577 962 514 330 139 3,522 Female 931 802 637 603 454 3,427 Male 887 708 614 508 405 3,122 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 - 85 - Philippines 1998 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 2,413 2,647 3,051 3,310 4,057 15,478 Urban female 345 929 1,686 2,287 3,455 8,702 Rural female 2,069 1,718 1,365 1,022 601 6,776 Male 2,758 3,052 3,380 3,292 3,425 15,906 Urban male 400 1,054 1,880 2,233 2,856 8,423 Rural male 2,358 1,997 1,501 1,059 569 7,484 School participation Female 1,017 911 728 706 577 3,939 Urban female 133 296 368 468 463 1,727 Rural female 885 615 360 238 114 2,212 Male 1,045 903 820 697 605 4,070 Urban male 137 291 424 470 485 1,807 Rural male 908 613 396 227 120 2,263 Mass media exposure Female 2,192 2,402 2,741 2,998 3,650 13,983 Urban female 317 848 1,550 2,090 3,106 7,911 Rural female 1,876 1,554 1,191 908 544 6,072 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 na na na na na na Urban male na na na na na na Rural male na na na na na na Household decisionmaking and justification of violence All 2,192 2,402 2,741 2,998 3,650 13,983 Urban 317 848 1,550 2,090 3,106 7,911 Rural 1,876 1,554 1,191 908 544 6,072 Orphanhood All 5,984 5,194 4,454 4,125 3,451 23,207 Urban 774 1,712 2,335 2,765 2,814 10,400 Rural 5,210 3,482 2,119 1,360 636 12,807 Female 2,877 2,528 2,142 1,990 1,726 11,264 Male 3,107 2,663 2,312 2,134 1,724 11,941 - 86 - Philippines 1998 - 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 3.21 3.41 3.98 3.60 4.07 1.68 Under-five mortality rate 4.70 4.42 4.99 3.86 4.96 2.31 Prevalence of fever 1.30 1.27 1.52 1.77 1.78 0.72 Prevalence of diarrhea 0.66 0.72 0.82 0.80 0.83 0.34 Prevalence of acute respiratory infection 0.90 0.93 1.14 1.13 1.18 0.46 B. Fertility Total fertility rate 0.17 0.15 0.12 0.12 0.12 0.08 Adolescent fertility rate 13.00 9.00 5.00 5.00 2.00 3.00 C. Nutritional status Children: Moderate stunting na na na na na na Severe stunting na na na na na na Moderate underweight na na na na na na Severe underweight na na na na na na 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 na na na na na na 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 * * * * * * Women * * * * * * 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 - 87 - Philippines 1998 - 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 2.06 1.57 1.54 1.17 1.46 0.82 Measles coverage 2.54 2.27 2.49 2.65 2.30 1.22 DPT coverage 2.61 2.53 2.65 1.77 2.35 1.24 Full basic coverage 2.74 2.61 2.96 2.67 2.97 1.39 No basic coverage 1.99 1.52 1.20 0.98 1.03 0.76 Hepatitis B coverage 2.63 3.06 3.74 3.71 5.00 1.60 Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 2.54 2.31 3.30 3.71 4.73 1.41 Treatment in a public facility 2.37 2.17 2.75 2.77 1.98 1.20 Treatment in a private facility 1.08 1.56 2.70 3.62 4.62 1.19 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 3.09 3.59 4.45 4.90 5.57 1.94 Treatment in a public facility 3.13 3.52 4.69 4.02 4.18 1.89 Treatment in a private facility 1.59 2.72 3.73 5.01 6.50 1.67 Treatment of diarrhea: Use of oral rehydration therapy 3.39 4.30 4.18 5.12 6.94 2.05 Medical treatment of diarrhea 4.14 5.00 4.85 6.65 8.01 2.40 Treatment in a public facility 3.90 4.20 4.55 4.96 4.01 2.18 Treatment in a private facility 1.98 3.92 4.13 6.78 7.76 2.00 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically trained person 1.39 1.15 0.92 0.89 0.96 0.62 To a doctor 1.02 1.54 2.02 2.07 1.74 1.07 To a nurse or trained midwife 1.49 1.74 2.02 1.93 1.70 0.99 Multiple visits to a medically trained person 1.47 1.38 1.42 1.21 1.13 0.78 Antenatal care content: Tetanus toxoid 1.48 1.34 1.74 1.69 2.21 0.79 Prophylactic antimalarial treatment na na na na na na Iron supplementation 1.43 1.50 1.48 1.49 1.35 0.82 Delivery attendance: By a medically trained person 1.30 1.84 1.65 1.37 1.26 1.15 By a doctor 0.73 1.32 1.90 2.25 2.09 1.02 By a nurse or trained midwife 1.09 1.54 1.86 2.16 1.75 0.88 In a public facility 0.71 1.50 1.84 1.95 1.97 0.81 In a private facility 0.36 0.58 1.18 1.66 2.54 0.71 At home 0.81 1.63 1.99 2.18 1.99 1.05 D. Contraceptive services Contraceptive prevalence: Women 1.10 1.24 1.42 1.40 1.46 0.62 Men na na na na na na Source of contraception - public sector: Women 1.73 1.82 1.98 2.47 3.06 1.28 Men na na na na na na - 88 - Philippines 1998 - 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 1.54 1.67 1.92 2.42 3.08 1.25 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 - 89 - Philippines 1998 - 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 3.71 5.25 5.17 4.94 6.93 2.23 Timely complementary feeding 3.65 4.15 5.43 5.94 7.62 2.50 Bottle-feeding 2.37 2.78 3.07 3.31 3.22 1.37 D. Micronutrient consumption Iodized salt: Availability of iodized salt in household 0.85 0.71 0.91 1.08 1.52 0.53 Vitamin A: Children 1.50 1.30 1.48 1.52 2.37 0.78 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 - 90 - Philippines 1998 - 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 1.28 0.65 0.42 0.32 0.34 0.34 Men 1.37 0.82 0.51 0.37 0.34 0.43 School participation: Girls 1.51 1.31 1.33 1.18 0.90 0.64 Boys 1.77 1.46 1.44 1.24 1.21 0.78 B. Exposure to mass media Newspaper readership: Women 1.20 1.17 1.20 1.07 0.97 0.64 Men na na na na na na Radio listenership: Women 1.29 0.93 1.09 0.96 0.97 0.50 Men na na na na na na Television viewership: Women 1.54 1.42 0.86 0.55 0.81 0.69 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 na na na na na na 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 1.76 1.52 1.57 1.41 1.67 0.88 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 - 91 - Philippines 1998 - 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 0.651 0.476 6.9% 58.4% 94.1% 99.8% 100.0% 71.8% 0.14813 Has radio 0.771 0.420 53.6% 72.1% 86.7% 96.2% 99.5% 81.6% 0.09063 Has television 0.483 0.499 1.6% 24.8% 70.3% 96.7% 99.7% 58.6% 0.15718 Has refrigerator 0.321 0.466 0.0% 2.4% 21.3% 75.4% 98.4% 39.6% 0.15414 Has bicycle 0.225 0.418 7.6% 19.9% 25.8% 33.0% 45.5% 26.4% 0.06194 Has motorcycle 0.106 0.308 0.7% 3.6% 8.7% 18.6% 27.9% 11.9% 0.06762 Has car 0.082 0.274 0.1% 0.7% 1.2% 4.8% 51.7% 11.8% 0.09628 Has telephone 0.117 0.321 0.0% 0.1% 0.9% 10.1% 73.0% 17.0% 0.11651 Owns a boat 0.036 0.187 4.8% 3.8% 3.1% 2.5% 2.6% 3.3% -0.01335 Owns a tractor 0.016 0.125 0.1% 0.7% 1.4% 2.4% 2.8% 1.5% 0.01923 Works own or family's agricultural land 0.130 0.337 27.3% 11.1% 6.3% 4.5% 1.6% 10.1% -0.06165 Uses piped water in residence for drinking 0.260 0.439 0.9% 8.5% 24.2% 43.8% 76.3% 30.8% 0.11561 Uses water from public faucet (piped) for drinking 0.125 0.331 12.1% 20.3% 15.6% 8.2% 1.8% 11.6% -0.02252 Uses rain water for drinking 0.004 0.059 0.1% 0.4% 0.2% 0.1% 0.2% 0.2% -0.00014 Uses water piped into yard for drinking 0.063 0.244 3.2% 8.3% 9.8% 7.6% 3.1% 6.4% 0.00380 Uses water from river, canal or surface for drinking 0.120 0.325 29.8% 11.0% 3.8% 1.3% 0.2% 9.2% -0.07321 Uses water from a protected well for drinking 0.324 0.468 30.5% 42.9% 40.9% 34.9% 12.1% 32.2% -0.01395 Uses water from an unprotected well for drinking 0.081 0.272 21.7% 7.3% 2.9% 1.1% 0.3% 6.6% -0.05627 Uses water from a drop/overhang for drinking 0.032 0.175 7.1% 3.2% 0.9% 0.1% 0.0% 2.2% -0.03797 Uses bottled water for drinking 0.004 0.066 0.0% 0.0% 0.0% 0.3% 3.5% 0.8% 0.02255 Uses water from tanker truck/vendor for drinking 0.017 0.130 1.5% 1.0% 2.4% 2.6% 2.4% 2.0% -0.00067 Uses other source of water for drinking 0.002 0.039 0.1% 0.1% 0.2% 0.3% 0.2% 0.2% 0.00106 Uses own flush toilet 0.553 0.497 8.4% 41.9% 68.8% 86.3% 97.5% 60.6% 0.13089 Uses a shared flush toilet 0.137 0.344 12.7% 22.8% 18.9% 7.9% 1.7% 12.8% -0.02217 Uses a closed pit latrine 0.081 0.272 16.5% 10.2% 5.6% 4.0% 0.6% 7.4% -0.04247 Uses an open pit latrine 0.081 0.272 21.1% 6.4% 2.3% 1.1% 0.0% 6.2% -0.06445 Uses other type of latrine 0.001 0.024 0.1% 0.1% 0.0% 0.0% 0.0% 0.0% -0.00201 Has dirt, sand, dung as principal floor material in dwelling 0.090 0.286 15.9% 17.9% 7.9% 1.2% 0.1% 8.6% -0.03984 Has wood, plank as principal floor material in dwelling 0.187 0.390 21.0% 26.8% 15.5% 6.7% 2.1% 14.4% -0.04456 Has ceramic, marble as principal floor material in dwelling 0.021 0.144 0.0% 0.1% 0.8% 2.2% 12.3% 3.1% 0.04399 Has marble as principal floor material in dwelling 0.020 0.139 0.0% 0.1% 0.4% 1.4% 14.0% 3.2% 0.04670 Has cement as principal floor material in dwelling 0.435 0.496 2.2% 26.1% 64.9% 85.2% 67.7% 49.2% 0.11688 Has vinyl or asphalt strips as principal floor material in dwelli 0.006 0.080 0.0% 0.1% 0.5% 1.1% 3.1% 1.0% 0.01923 Has parquet or polished wood as principal floor material in dw 0.016 0.126 1.2% 1.9% 1.1% 0.8% 0.7% 1.1% -0.00611 Has bamboo as principal floor material in dwelling 0.222 0.416 59.7% 26.8% 8.5% 1.1% 0.0% 19.2% -0.10304 Number of members per sleeping room 3.140 1.884 4.6 3.7 3.3 2.8 2.0 3.3 -0.08870 - 93 - PART VI. 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. - 97 - 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. - 98 - 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: · 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. 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. - 99 - · 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. · 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 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). - 100 - 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. - 101 - Philippines 2003 - ASSET QUESTIONNAIRE Question Score if Score if Item "Yes" "No" Score 1. In your household, is/are there? Electricity 0.05448 -0.15630 One or more radios 0.03365 -0.07934 One or more televisions 0.08335 -0.12520 One or more refrigerators 0.13845 -0.07761 One or more bicycles 0.06448 -0.01494 One or more motorcycles, scooters 0.11966 -0.01679 One or more cars, trucks 0.20623 -0.02018 One or more telephones 0.20666 -0.02500 One or more cell phones 0.13347 -0.06899 One or more washing machines 0.15642 -0.05766 One or more CD/VCD/DVD players 0.13804 -0.06759 One or more components, karaokes 0.13609 -0.04781 One or more personal computers 0.23410 -0.01469 One or more tractors 0.07625 -0.00160 One or more motorized bancas, boats -0.07209 0.00365 2. Do the members of your household work their own or family's agricultural land? -0.12270 0.00500 3. What is the principal source of drinking water for you household? Piped water in residence 0.09385 -0.04456 Piped water in tap in yard, plot -0.03414 0.00196 Piped water in public tap -0.06608 0.01054 Protected well -0.02994 0.01113 Open well -0.16187 0.00842 Spring -0.15413 0.00564 Developed spring -0.10549 0.00527 Surface water -0.12156 0.00116 Rainwater -0.08261 0.00040 Tanker truck 0.02710 -0.00045 Bottled water 0.16276 -0.00891 4. What is the principal type of toilet facility used by your household? Private flush toilet 0.06525 -0.11555 Shared flush toilet -0.05289 0.00810 Closed pit latrine -0.12725 0.00876 Drop latrine -0.14391 0.00321 Open pit latrine -0.15952 0.00685 Bush, field as latrine -0.16750 0.01852 5. What is the principal material used for the floors in your household? Dirt, sand -0.09404 0.01368 Cement (includes other floor types) 0.06851 -0.07259 Ceramic tile 0.19842 -0.00824 Palm, bamboo -0.15631 0.02723 Wood plank -0.08472 0.01408 Parquet, polished wood 0.01038 -0.00008 Marble 0.22219 -0.00288 Vinyl 0.16987 -0.00113 - 103 - Philippines 2003 - ASSET QUESTIONNAIRE (Cont.) Question Score if Score if Item "Yes" "No" Score 6. What is the principal material of the walls in your household? Concrete, brick, stone 0.11126 -0.06790 Wood -0.07232 0.01873 Partly of concrete, brick, stone 0.03395 -0.00699 Galvanized iron, aluminum -0.04617 0.00054 Bamboo, other natural materials -0.14211 0.04107 Makeshift or nonexistent -0.08041 0.00058 Total Household Asset Score (sum of individual item scores) 2003 - QUINTILE CUT-OFF POINTS Asset Index Value Wealth Quintile Bottom Cut-Off Top Cut-Off Low Low -0.96996 Second -0.96996 -0.24199 Third -0.24199 0.39448 Fourth 0.39448 1.07489 High 1.07489 High - 104 - 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 - 105 -