39446 SOCIO-ECONOMIC DIFFERENCES IN HEALTH, NUTRITION, AND POPULATION HAITI 1994/95, 2000 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, 2000 1 A. Total Population 3 B. Female and Male Populations 9 C. Rural and Urban Populations 13 Part II. Basic Tables, 1994 /95 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, 2000 63 A. Sample Sizes 65 B. Standard Errors 71 C. Asset Distribution and Weights 77 Part V. Supporting Tables, 1994 /95 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, 2000 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. Haiti 2000 - 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 99.5 70.0 93.4 88.4 97.2 89.4 1.02 2.30 0.0068 0.0009 Under-five mortality rate 163.9 143.6 140.6 119.7 108.7 137.7 1.51 55.20 -0.0758 0.0006 Prevalence of fever 47.8 47.6 39.3 35.9 28.2 40.6 1.70 19.60 -0.0715 0.0092 Prevalence of diarrhea 27.0 24.4 29.9 26.1 20.2 25.7 1.34 6.80 -0.0318 0.0127 Prevalence of acute respiratory 46.7 44.9 37.9 36.0 27.4 39.3 1.70 19.30 -0.0910 0.0096 infection (ARI) B. Fertility Total fertility rate 6.8 6.0 5.0 4.4 2.7 4.7 2.52 4.10 -0.1701 0.0006 Adolescent fertility rate 101.0 95.0 120.0 91.0 54.0 86.0 1.87 47.00 -0.1227 0.0017 C. Nutritional status (%) Children: Moderate stunting 18.2 16.5 17.3 12.3 5.1 14.5 3.57 13.10 -0.1651 0.0185 Severe stunting 12.6 9.3 7.3 3.7 2.3 7.5 5.48 10.30 -0.2797 0.0273 Moderate underweight 17.7 13.5 15.4 10.9 6.4 13.3 2.77 11.30 -0.1681 0.0202 Severe underweight 5.9 3.8 3.6 2.1 1.3 3.5 4.54 4.60 -0.2618 0.0433 Mild anemia 30.6 31.2 27.3 29.5 28.2 29.6 1.09 2.40 0.0141 0.0185 Moderate anemia 31.0 35.3 41.3 36.7 26.9 34.5 1.15 4.10 0.0138 0.0158 Severe anemia 1.2 0.7 2.3 3.6 1.0 1.7 1.20 0.20 0.0742 0.0787 Women: Malnutrition 17.3 12.6 13.4 9.6 8.1 11.5 2.14 9.20 -0.1948 0.0174 Mild anemia 36.0 34.3 35.8 39.4 35.6 36.3 1.01 0.40 0.0016 0.0112 Moderate anemia 13.6 17.8 13.4 17.4 16.1 15.8 0.84 2.50 0.0121 0.0187 Severe anemia 3.0 2.6 2.8 3.6 3.0 3.0 1.00 0.00 0.0223 0.0437 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 7.7 7.0 6.6 7.8 6.4 7.1 1.20 1.30 -0.0301 0.0235 Men 5.6 10.3 9.1 5.5 2.7 6.6 2.07 2.90 -0.0666 0.0391 Prevalence of genital ulcer: Women 2.8 2.3 2.5 1.6 1.7 2.1 1.65 1.10 -0.0903 0.0461 Men 6.4 6.1 4.4 1.6 1.3 4.0 4.92 5.10 -0.1283 0.0527 - 3 - Haiti 2000 - 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 55.4 64.5 75.1 78.6 85.5 71.0 0.65 30.10 0.0906 0.0101 Measles coverage 42.9 49.1 58.4 58.6 63.3 53.9 0.68 20.40 0.0882 0.0153 DPT coverage 31.1 36.8 48.3 44.9 57.6 42.9 0.54 26.50 0.1295 0.0192 Full basic coverage 25.4 30.3 41.1 31.7 42.3 33.5 0.60 16.90 0.1156 0.0244 No basic coverage 25.8 24.5 13.7 8.7 7.4 16.7 3.51 18.43 -0.2348 0.0331 Hepatitis B coverage na na na na na na na na na na Yellow fever coverage na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 32.1 35.2 44.5 43.7 57.6 40.2 0.56 25.50 0.1148 0.0143 Treatment in a public facility 21.6 27.5 26.7 29.5 37.3 27.2 0.58 15.70 0.0866 0.0197 Treatment in a private facility 10.0 6.0 17.5 14.2 19.9 12.2 0.50 9.90 0.1672 0.0311 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 31.7 34.5 42.5 38.5 47.4 37.4 0.67 15.70 0.0987 0.0158 Treatment in a public facility 21.5 26.2 28.2 27.6 28.4 25.9 0.76 6.90 0.0757 0.0206 Treatment in a private facility 9.5 6.5 14.1 10.9 18.6 10.9 0.51 9.10 0.1408 0.0349 Treatment of diarrhea: Use of oral rehydration therapy 49.1 48.7 56.6 57.4 68.8 54.9 0.71 19.70 0.0507 0.0137 Medical treatment of diarrhea 18.4 18.6 25.2 28.1 35.2 24.1 0.52 16.80 0.1182 0.0278 Treatment in a public facility 13.5 13.0 20.6 19.1 18.6 16.8 0.73 5.10 0.0723 0.0331 Treatment in a private facility 4.9 4.9 4.6 9.1 16.6 7.2 0.30 11.70 0.2214 0.0620 C. Antenatal and delivery care Antenatal care visits: To a medically trained person 65.4 74.4 82.4 89.2 90.7 80.3 0.72 25.30 0.0702 0.0043 To a doctor 24.6 35.4 41.4 63.0 71.8 46.9 0.34 47.20 0.2189 0.0087 To a nurse or trained midwife 40.7 39.0 40.9 26.2 18.9 33.4 2.15 21.80 -0.1382 0.0120 Multiple visits to a medically trained person 41.0 52.0 62.5 70.3 82.0 61.1 0.50 41.00 0.1321 0.0067 Antenatal care content: Tetanus toxoid 63.2 63.7 72.6 77.9 76.8 70.8 0.82 13.60 0.0363 0.0059 Prophylactic antimalarial treatment na na na na na na na na na na Iron supplementation 42.2 46.8 61.6 63.1 74.0 57.1 0.57 31.80 0.1108 0.0074 Delivery attendance: By a medically trained person 4.1 9.4 13.5 37.9 70.0 24.2 0.06 65.90 0.4570 0.0123 By a doctor 1.8 4.5 4.9 19.2 51.2 14.1 0.04 49.40 0.5205 0.0202 By a nurse or trained midwife 2.3 4.9 8.5 18.7 18.8 10.1 0.12 16.50 0.3683 0.0224 In a public facility 2.5 5.6 7.8 20.1 34.0 12.7 0.07 31.50 0.5027 0.0212 In a private facility 0.4 0.7 3.3 4.3 15.5 4.1 0.03 15.10 0.6063 0.0468 At home 95.9 91.8 86.4 62.3 31.4 76.3 3.05 64.50 -0.1423 0.0039 D. Contraceptive services Contraceptive prevalence: Women 17.4 22.2 25.7 24.2 24.2 22.8 0.72 6.80 0.1009 0.0139 Men 22.0 28.9 22.2 21.3 20.8 23.5 1.06 1.20 na na - 4 - Haiti 2000 - 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 42.9 24.8 24.0 24.8 16.5 25.4 2.60 26.40 -0.1328 0.0281 Men na na na na na na na na na na Source of contraception - private sector: Women 55.9 73.3 75.0 72.1 81.8 72.8 0.68 25.90 0.0457 0.0099 Men na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 34.1 29.9 44.3 44.6 55.4 43.1 0.62 21.30 0.1056 0.0266 Men 27.8 (76.7) (70.9) (52.0) * 57.0 * * * * Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na Men 100.0 (100.0) (100.0) (100.0) * 100.0 * * * * Voluntary counseling and testing for HIV/AIDS: Women 0.0 0.2 0.5 2.3 4.3 1.8 0.00 4.30 0.5325 0.1541 Men 2.1 1.2 4.8 9.2 12.1 5.9 0.17 10.00 0.3573 0.0440 - 5 - Haiti 2000 - 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 40.2 36.1 28.5 30.6 (15.4) 31.7 2.61 55.60 -0.0004 0.0494 Timely complementary feeding 80.0 68.4 79.4 88.8 59.7 74.1 1.34 20.30 -0.0427 0.0172 Bottle-feeding 14.2 21.6 21.8 39.1 65.9 29.9 0.22 51.70 0.2642 0.0256 D. Micronutrient consumption Iodized salt: Availability of iodized salt 8.7 14.9 15.4 12.7 7.8 11.9 1.12 0.90 -0.0336 0.0870 in household Vitamin A: Children 25.5 34.1 34.0 35.4 27.3 31.4 0.93 1.80 0.0755 0.0127 Women 18.3 22.2 24.3 26.3 32.1 24.5 0.57 13.80 0.1735 0.0165 E. Tobacco and alcohol use Tobacco: Women 8.3 3.5 5.2 3.7 2.8 4.4 2.96 5.50 -0.2371 0.0303 Men 18.0 20.1 19.9 11.4 11.6 16.1 18.0 6.40 -0.1340 0.0239 Alcohol: Women 4.4 2.0 1.9 1.1 1.1 1.9 4.00 3.30 -0.3140 0.0483 Men 5.8 2.9 2.1 2.8 3.6 3.5 1.61 2.20 -0.0756 0.0675 F. Sexual practices Non-regular sexual partnerships: Women 0.6 1.0 2.3 1.4 0.7 1.2 0.86 0.10 0.1071 0.0481 Men 14.9 17.8 19.0 18.5 21.6 18.3 0.69 6.70 0.1122 0.0227 Condom usage with non-regular partner: Women * * * (32.2) * 18.3 * * * * Men 21.3 36.5 28.6 54.7 70.1 44.5 0.30 48.80 0.2518 0.0243 G. Domestic violence Ever experienced violence 20.9 22.1 25.8 19.6 13.9 19.8 1.50 7.00 -0.0694 0.0185 Experienced violence in past year 17.4 16.0 21.9 15.4 6.3 14.5 2.76 11.10 -0.0795 0.0216 - 6 - Haiti 2000 - 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 9.8 17.7 29.5 52.3 72.4 41.0 0.14 62.60 0.3363 0.0055 Men 20.5 29.0 39.7 66.6 85.3 51.0 0.24 64.80 0.2782 0.0045 School participation: Girls 66.5 79.4 87.2 78.8 77.5 77.7 0.86 11.00 0.0549 0.0057 Boys 63.3 71.5 81.1 73.3 85.5 73.9 0.74 22.20 0.0800 0.0058 B. Exposure to mass media Newspaper readership: Women 11.0 14.5 18.1 29.7 44.6 26.2 0.25 33.60 0.3200 0.0097 Men 10.9 20.3 19.5 41.6 54.9 29.9 0.20 44.00 0.2830 0.0146 Radio listenership: Women 31.2 37.9 52.8 74.7 89.9 61.9 0.35 58.70 0.2204 0.0039 Men 42.2 50.5 66.9 86.3 91.2 67.6 0.46 49.00 0.1665 0.0064 Television viewership: Women 0.9 2.0 4.5 36.3 80.3 31.3 0.01 79.40 0.4949 0.0072 Men 3.1 9.1 6.7 43.5 77.7 29.1 0.04 74.60 0.4814 0.0136 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 31.8 45.6 49.0 66.7 80.4 58.2 0.92 48.63 0.1644 0.0062 Men 65.2 78.1 82.3 88.0 94.1 81.3 0.69 28.90 0.0657 0.0051 Knowledge about mother-to-child transmission of HIV/AIDS: Women 33.5 31.7 35.2 40.0 42.3 36.6 0.79 8.80 0.0818 0.0081 Men 63.4 60.3 67.2 78.5 81.3 70.3 0.78 17.90 0.0675 0.0066 Attitudes toward HIV/AIDS: Women 74.3 77.7 71.0 65.8 63.2 69.8 1.18 11.10 -0.0526 0.0056 Men 68.3 71.8 64.1 61.9 50.9 63.9 1.34 17.40 -0.0500 0.0082 D. Status of women Household decisionmaking: Can seek own health care 32.9 33.3 36.1 33.4 28.9 32.6 1.14 4.00 -0.0323 0.0085 Can seek children's health care 94.0 93.3 94.3 97.4 94.9 94.8 0.99 0.90 0.0062 0.0023 Can make daily household purchases 30.2 32.0 32.4 30.6 23.8 29.2 1.27 6.40 -0.0621 0.0089 Can make large household purchases 28.3 29.0 28.7 25.9 21.8 26.2 1.30 6.50 -0.0663 0.0097 Can make meal-related decisions 29.4 29.5 32.1 28.6 22.2 27.7 1.32 7.20 -0.0650 0.0092 Freedom of movement: Can travel to visit family, relatives 23.0 20.7 21.4 28.6 24.9 24.1 0.92 1.90 0.0363 0.0106 Other decisionmaking, attitudes: Can decide how to spend own money 80.4 84.0 81.4 90.4 88.0 85.3 0.91 7.60 0.0224 0.0035 Can decide whether to have sex 87.2 83.9 90.8 95.0 96.8 91.6 0.90 9.60 0.0138 0.0017 Justifies domestic violence 52.4 46.9 46.6 39.5 24.1 39.9 2.17 28.30 -0.1409 0.0069 E. Orphanhood Paternal orphan prevalence 6.8 6.4 5.8 9.1 7.8 7.1 0.87 1.00 0.0870 0.0167 Maternal orphan prevalence 3.3 3.0 5.7 3.4 3.8 3.8 0.87 0.50 0.1109 0.0220 Double orphan prevalence 0.6 0.6 0.7 1.1 1.3 0.8 0.46 0.70 0.3044 0.0591 - 7 - Haiti 2000 - FEMALE / MALE POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood mortality and morbidity Infant mortality rate 90.6 74.5 84.5 77.7 85.9 82.6 107.8 66.8 102.4 100.8 109.2 96.5 Under-five mortality rate 161.2 162.6 119.1 108.5 94.9 132.3 166.4 124.1 161.9 132.8 123.3 143.3 Prevalence of fever 46.2 48.4 36.5 37.1 28.6 40.0 49.3 46.8 42.2 34.6 27.8 41.2 Prevalence of diarrhea 26.8 23.2 30.1 22.3 19.7 24.5 27.3 25.7 29.6 30.4 20.6 27.0 Prevalence of acute respiratory 45.2 44.6 39.0 36.3 25.8 38.8 48.0 45.3 36.8 35.7 29.2 39.9 infection (ARI) B. Nutritional status Children: Moderate stunting 17.4 16.2 12.0 12.1 2.0 12.5 18.8 16.8 22.7 12.6 8.6 16.5 Severe stunting 11.4 8.9 5.7 2.9 3.2 6.6 13.7 9.7 8.9 4.5 1.4 8.3 Moderate underweight 16.3 14.5 13.9 10.3 6.9 12.7 19.0 12.5 17.1 11.6 5.8 13.9 Severe underweight 6.3 3.1 3.7 1.5 1.0 3.2 5.6 4.5 3.5 2.6 1.7 3.8 Mild anemia 33.1 31.5 27.1 31.2 33.8 31.4 28.4 30.8 27.6 27.1 18.8 27.5 Moderate anemia 27.6 31.0 41.1 36.3 23.0 31.9 34.1 39.8 41.6 37.3 33.5 37.5 Severe anemia 0.5 0.2 1.1 3.7 0.7 1.3 1.8 1.2 3.8 3.4 1.5 2.3 C. Sexually transmitted disease Prevalence of genital discharge: Women 7.7 7.0 6.6 7.8 6.4 7.1 Men 5.6 10.3 9.1 5.5 2.7 6.6 Prevalence of genital ulcer: Women 2.8 2.3 2.5 1.6 1.7 2.1 Men 6.4 6.1 4.4 1.6 1.3 4.0 - 9 - Haiti 2000 - 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 56.3 66.3 71.8 81.8 83.5 71.5 54.6 61.8 78.7 75.5 88.4 70.4 Measles coverage 43.4 54.1 55.0 55.8 60.5 53.6 42.3 42.0 62.2 61.3 67.0 54.2 DPT coverage 35.1 39.5 42.5 50.9 48.6 43.1 27.3 32.8 54.6 39.1 69.8 42.6 Full basic coverage 28.0 31.7 38.0 36.0 37.6 34.0 22.9 28.2 44.5 27.7 48.7 32.9 No basic coverage 26.0 22.0 12.9 8.3 1.0 14.6 23.6 29.0 14.8 10.8 2.6 16.7 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 31.4 29.4 48.5 36.8 51.1 37.2 32.8 41.7 41.0 51.9 65.1 43.2 Treatment in a public facility 21.8 20.2 31.2 26.0 32.3 25.1 21.3 35.6 22.7 33.6 43.1 29.4 Treatment in a private facility 9.6 6.3 17.1 10.7 18.8 11.3 10.3 5.6 17.8 18.3 21.2 13.1 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 33.8 30.9 42.8 34.5 48.7 36.5 29.8 38.4 42.1 43.0 46.0 38.3 Treatment in a public facility 23.7 21.2 30.4 26.7 31.3 25.8 19.6 31.5 25.8 28.7 25.6 25.9 Treatment in a private facility 10.1 6.5 12.3 7.8 17.5 9.9 9.1 6.4 16.1 14.4 19.7 11.8 Treatment of diarrhea: Use of oral rehydration therapy 46.2 53.1 58.1 62.2 68.9 56.6 51.6 44.4 55.0 53.5 68.7 53.2 Medical treatment of diarrhea 19.9 19.0 27.9 26.4 42.5 25.8 17.0 18.2 22.4 29.5 27.2 22.5 Treatment in a public facility 14.6 9.5 24.8 21.7 25.5 18.8 12.6 16.5 16.2 17.0 11.0 15.0 Treatment in a private facility 5.3 9.5 3.1 4.8 17.0 7.1 4.5 0.5 6.2 12.5 16.2 7.2 C. Contraceptive services Contraceptive prevalence: Women 17.4 22.2 25.7 24.2 24.2 22.8 Men 22.0 28.9 22.2 21.3 20.8 23.5 Source of contraception - public sector: Women 42.9 24.8 24.0 24.8 16.5 25.4 Men na na na na na na Source of contraception - private sector: Women 55.9 73.3 75.0 72.1 81.8 72.8 Men na na na na na na D. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 34.1 29.9 44.3 44.6 55.4 43.1 Men 27.8 (76.7) (70.9) (52.0) * na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men na na na na na 100.0 Voluntary counseling and testing for HIV/AIDS: Women 0.0 0.2 0.5 2.3 4.3 1.8 Men 2.1 1.2 4.8 9.2 12.1 5.9 - 10 - Haiti 2000 - 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 (36.1) (29.5) (41.3) (34.9) * 34.4 42.5 (40.6) (21.1) (26.4) * 30.0 Timely complementary feeding 80.1 73.9 74.3 (90.8) * 74.1 79.8 (62.2) (84.5) (85.6) (69.2) 74.0 Bottle-feeding 13.6 17.9 14.3 29.5 61.7 24.1 14.6 24.8 28.7 51.4 68.3 34.9 D. Micronutrient consumption Vitamin A: Children 25.0 35.0 36.6 34.8 28.4 32.1 26.0 33.1 31.2 36.0 26.1 30.6 E. Tobacco and alcohol use Tobacco: Women 8.3 3.5 5.2 3.7 2.8 4.4 Men 18.0 20.1 19.9 11.4 11.6 16.1 Alcohol: Women 4.4 2.0 1.9 1.1 1.1 1.9 Men 5.8 2.9 2.1 2.8 3.6 3.5 F. Sexual practices Non-regular sexual partnerships: Women 0.6 1.0 2.3 1.4 0.7 1.2 Men 14.9 17.8 19.0 18.5 21.6 18.3 Condom usage with non-regular partner: Women * * * (32.2) * 18.3 Men 21.3 36.5 28.6 54.7 70.1 44.5 - 11 - Haiti 2000 - 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 9.8 17.7 29.5 52.3 72.4 41.0 Men 20.5 29.0 39.7 66.6 85.3 51.0 School participation: Girls 66.5 79.4 87.2 78.8 77.5 77.7 Boys 63.3 71.5 81.1 73.3 85.5 73.9 B. Exposure to mass media Newspaper readership: Women 11.0 14.5 18.1 29.7 44.6 26.2 Men 10.9 20.3 19.5 41.6 54.9 29.9 Radio listenership: Women 31.2 37.9 52.8 74.7 89.9 61.9 Men 42.2 50.5 66.9 86.3 91.2 67.6 Television viewership: Women 0.9 2.0 4.5 36.3 80.3 31.3 Men 3.1 9.1 6.7 43.5 77.7 29.1 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 31.8 45.6 49.0 66.7 80.4 58.2 Men 65.2 78.1 82.3 88.0 94.1 81.3 Knowledge about mother-to-child transmission of HIV/AIDS: Women 33.5 31.7 35.2 40.0 42.3 36.6 Men 63.4 60.3 67.2 78.5 81.3 70.3 Attitudes toward HIV/AIDS: Women 74.3 77.7 71.0 65.8 63.2 69.8 Men 68.3 71.8 64.1 61.9 50.9 63.9 D. Orphanhood Paternal orphan prevalence 6.4 6.4 5.1 9.5 8.5 7.2 7.1 6.4 6.3 8.6 6.9 7.0 Maternal orphan prevalence 3.4 2.7 4.8 3.6 3.9 3.6 3.3 3.2 6.4 3.2 3.6 4.0 Double orphan prevalence 0.4 0.5 0.9 1.2 1.3 0.9 0.8 0.7 0.6 0.9 1.2 0.8 - 12 - Haiti 2000 - 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 99.8 69.0 95.9 115.1 * 90.5 * * 78.6 77.6 97.7 87.0 Under-five mortality rate 164.6 142.0 140.5 156.2 * 149.4 * * (146.8) 104.8 109.9 111.7 Prevalence of fever 47.9 47.5 38.8 42.8 44.9 45.0 * 52.9 43.2 33.4 26.9 31.6 Prevalence of diarrhea 27.0 24.4 29.9 22.8 27.7 26.6 * 25.8 29.4 27.3 19.6 24.1 Prevalence of acute respiratory infection 46.7 44.8 37.7 40.9 23.3 42.9 * 50.9 39.5 34.2 27.7 32.1 B. Fertility Total fertility rate 6.8 6.0 5.1 (4.9) * 5.8 * * * 4.2 2.7 3.4 Adolescent fertility rate 101.0 96.0 124.0 (131.0) * 107.6 * * * 82.0 54.0 66.1 C. Nutritional status Children: Moderate stunting 18.2 16.7 17.7 19.2 4.3 17.5 * (8.5) 13.6 9.3 5.1 7.7 Severe stunting 12.7 9.3 7.2 2.2 0.0 9.1 * (9.0) 7.8 4.3 2.5 3.8 Moderate underweight 17.7 13.7 15.5 10.8 2.8 15.0 * (8.0) 15.0 11.0 6.7 9.3 Severe underweight 5.9 3.7 3.8 0.3 0.0 4.1 * (5.3) 2.3 2.8 1.5 2.2 Mild anemia 30.7 31.0 26.9 29.9 (20.9) 29.7 * * 30.8 29.3 28.8 29.2 Moderate anemia 31.0 35.2 42.0 35.7 (44.7) 35.7 * * 36.1 37.2 25.5 31.8 Severe anemia 1.2 0.6 2.4 0.3 (6.6) 1.3 * * 1.8 5.1 0.6 2.7 Women: Malnutrition 17.4 12.6 13.0 6.7 7.0 13.4 * 12.4 16.5 10.4 8.2 9.4 Mild anemia 36.1 34.2 35.8 47.4 39.2 36.6 * 36.9 36.1 37.0 35.4 36.0 Moderate anemia 13.5 18.0 13.1 15.8 17.2 15.1 * 11.8 16.4 17.8 16.1 16.7 Severe anemia 3.0 2.6 2.8 3.1 0.0 2.8 * 1.8 2.6 3.8 3.1 3.3 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 7.6 6.9 6.7 8.6 6.7 7.2 (16.1) 8.6 5.9 7.5 6.4 6.9 Men 5.6 10.5 9.6 9.7 1.8 8.4 * (5.2) 6.1 3.9 2.8 3.4 Prevalence of genital ulcer: Women 2.8 2.3 2.3 2.2 0.8 2.4 0.0 0.9 3.7 1.4 1.7 1.7 Men 6.5 6.2 4.5 0.0 1.8 5.3 * (2.7) 3.3 2.3 1.3 1.8 - 13 - Haiti 2000 - 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 55.4 63.8 74.1 74.4 * 65.1 * * (85.9) 79.9 84.6 82.5 Measles coverage 42.8 48.7 58.7 49.5 * 50.2 * * (54.6) 61.5 60.8 60.9 DPT coverage 30.8 36.0 48.6 50.1 * 39.7 * * (45.1) 43.3 54.5 49.0 Full basic coverage 25.3 29.7 41.8 41.1 * 33.5 * * (33.4) 28.8 37.9 33.6 No basic coverage 24.8 25.3 14.1 18.3 * 21.3 * * (10.4) 6.9 1.4 4.5 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood diseases Treatment of fever: Medical treatment of fever 32.2 35.6 44.1 49.6 (47.7) 37.6 * (22.3) 47.9 41.0 58.8 47.7 Treatment in a public facility 21.6 27.9 24.7 32.9 (38.5) 25.6 * (13.8) 41.6 27.9 37.1 32.0 Treatment in a private facility 9.9 6.0 19.3 16.6 (6.2) 11.2 * (5.9) 4.1 13.1 21.8 15.3 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 31.7 34.7 42.1 52.1 * 36.8 * (28.4) 46.0 32.7 47.9 39.3 Treatment in a public facility 21.6 26.5 26.5 37.8 * 25.6 * (16.6) 41.6 23.3 28.9 26.5 Treatment in a private facility 9.5 6.4 15.6 14.3 * 10.3 * (9.1) 2.7 9.4 19.0 12.5 Treatment of diarrhea: Use of oral rehydration therapy 49.1 48.9 57.3 42.5 * 51.3 * * 50.6 61.9 68.9 63.1 Medical treatment of diarrhea 18.4 19.1 24.6 28.1 * 21.2 * * 30.6 28.1 36.2 30.6 Treatment in a public facility 13.6 13.4 20.1 16.9 * 15.8 * * 25.1 19.7 18.2 19.1 Treatment in a private facility 4.8 5.1 4.5 11.2 * 5.2 * * 5.5 8.4 18.0 11.5 C. Antenatal and delivery care Antenatal care visits: To a medically trained person 65.2 74.1 81.8 87.4 96.1 75.0 * 85.9 87.8 89.9 90.4 89.9 To a doctor 24.6 35.2 41.1 51.8 77.2 35.8 * 43.3 44.2 67.3 71.4 67.3 To a nurse or trained midwife 40.7 38.9 40.6 35.6 18.8 39.3 * 42.5 43.6 22.6 18.9 22.6 Multiple visits to a medically trained person 40.9 51.2 61.7 64.4 87.3 52.7 * 78.2 69.5 72.6 81.7 76.6 Antenatal care content: Tetanus toxoid 63.0 63.3 72.2 72.1 82.6 66.7 * 80.1 76.1 80.1 76.4 78.2 Prophylactic antimalarial treatment na na na na na na na na na na na na Iron supplementation 41.9 46.1 61.7 56.1 84.4 50.6 * 69.7 60.5 65.8 73.2 69.0 Delivery attendance: By a medically trained person 4.1 9.2 12.9 26.1 69.6 11.0 * 15.4 17.8 42.5 70.1 52.3 By a doctor 1.8 4.5 4.2 11.8 44.9 4.9 * 4.7 10.8 22.0 51.7 33.8 By a nurse or trained midwife 2.3 4.7 8.7 14.3 24.7 6.1 * 10.7 7.0 20.5 18.4 18.4 In a public facility 2.6 5.6 8.0 13.5 30.4 6.3 * 2.7 6.3 22.7 34.3 26.2 In a private facility 0.4 0.5 3.1 3.4 5.5 1.5 * 6.3 5.2 4.7 16.3 9.8 At home 95.9 92.0 86.7 74.0 33.9 89.4 * 86.5 83.4 57.8 31.2 48.6 D. Contraceptive services Contraceptive prevalence: Women 17.2 22.3 25.7 33.4 31.5 23.0 * 18.3 25.8 20.9 23.7 22.6 Men 21.7 29.3 22.7 18.5 (28.2) 24.5 * * 19.0 22.7 20.2 21.1 - 14 - Haiti 2000 - 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 43.3 24.8 22.8 22.3 (24.0) 27.9 * * 34.0 26.2 15.8 21.2 Men na na na na na na na na na na na na Source of contraception - private sector: Women 55.5 73.3 76.0 75.6 (72.9) 70.5 * * 66.0 70.2 82.7 76.6 Men na na na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 34.6 29.0 43.4 (37.8) * 36.8 * * (51.5) 47.1 54.1 50.9 Men 28.0 (77.4) (74.2) * * 62.0 * * * (31.7) * 36.3 Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na na na Men 100.0 (100.0) (100.0) * * 100.0 0.0 * * (100.0) * 100.0 Voluntary counseling and testing for HIV/AIDS: Women 0.0 0.2 0.3 1.3 6.6 0.4 0.0 2.6 2.1 2.7 4.2 3.5 Men na na na na na na na na na na na na - 15 - Haiti 2000 - 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 40.2 35.2 28.0 * * 35.8 0.0 * * 24.6 (11.6) 21.6 Timely complementary feeding 80.0 67.9 79.0 * * 73.4 0.0 * * 88.7 (65.7) 75.5 Bottle-feeding 14.2 22.1 21.4 32.3 * 20.4 * * 26.6 41.6 70.2 52.4 D. Micronutrient consumption Iodized salt: Availability of iodized salt 8.7 14.7 14.9 19.3 30.1 13.5 (15.5) 23.3 19.4 10.3 6.8 9.1 in household Vitamin A: Children 25.4 34.0 33.3 45.9 45.6 32.3 * 36.1 39.5 31.6 25.9 29.7 Women 18.1 22.2 21.9 25.4 41.6 21.5 * 24.1 44.9 26.6 31.5 30.0 E. Tobacco and alcohol use Tobacco: Women 8.4 3.5 5.1 3.7 3.5 5.4 (2.9) 3.8 5.7 3.7 2.8 3.3 Men 18.1 20.1 20.5 21.3 14.0 19.4 * (20.9) 16.2 7.8 11.4 10.4 Alcohol: Women 4.4 2.0 1.7 1.5 2.6 2.6 (2.1) 2.1 3.5 1.0 1.0 1.1 Men 5.8 2.9 2.2 2.5 3.4 3.7 * (3.3) 1.3 2.9 3.6 3.2 F. Sexual practices Non-regular sexual partnerships: Women 0.6 1.0 2.3 1.4 0.9 1.3 0.0 1.4 1.7 1.4 0.7 1.0 Men na na na na na na na na na na na na Condom usage with non-regular partner: Women * * * * * 7.6 0.0 * * (31.5) * 34.5 Men 20.9 36.2 29.9 33.8 27.6 29.6 * (57.8) 23.7 60.3 75.3 65.5 G. Domestic violence Ever experienced violence 20.9 22.1 25.6 17.5 11.3 22.0 * (22.3) 27.2 20.2 14.1 17.1 Experienced violence in past year 17.3 16.2 22.2 14.5 9.9 17.9 * (12.7) 19.6 15.7 6.1 10.5 - 16 - Haiti 2000 - 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 9.5 17.2 28.7 43.3 72.3 22.1 (47.3) 31.6 35.7 54.9 72.4 63.6 Men 20.3 28.8 38.5 52.7 85.2 32.8 (47.5) 34.6 51.0 72.1 85.4 78.1 School participation: Girls 66.0 79.1 86.6 90.5 86.8 77.9 (100.0) (92.2) 93.0 75.2 76.7 77.4 Boys 63.1 71.7 80.7 90.9 (100.0) 73.2 * 66.9 85.9 64.1 84.9 75.7 B. Exposure to mass media Newspaper readership: Women 10.6 14.2 17.0 28.0 53.2 16.4 * 22.3 26.0 30.2 44.1 37.8 Men 10.7 20.0 19.1 35.4 68.0 19.2 * (32.7) 22.9 44.1 54.0 48.3 Radio listenership: Women 31.0 37.5 52.8 66.6 86.8 44.1 * 48.0 52.8 77.2 90.1 82.9 Men 41.9 50.3 66.3 76.9 90.8 55.0 * (57.0) 71.2 90.0 91.2 89.2 Television viewership: Women 0.8 1.9 4.4 13.2 65.8 5.1 * 2.7 5.5 43.1 81.2 62.2 Men 3.1 9.2 5.6 21.6 50.8 8.3 * (8.3) 15.7 52.3 79.6 64.9 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 86.9 90.1 90.9 95.9 95.9 90.1 (89.2) 94.8 93.2 96.4 94.8 95.4 Men na na na na na na na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women 28.5 31.4 35.6 38.3 39.0 32.6 (39.8) 40.9 32.5 40.6 42.5 41.3 Men 64.0 60.1 65.7 62.0 65.0 63.0 * (68.5) 76.7 84.7 82.6 82.8 Attitudes toward HIV/AIDS: Women 77.3 78.3 70.9 65.7 51.2 73.9 * 62.4 71.7 65.8 63.8 64.9 Men 71.6 71.3 65.9 67.8 72.8 69.9 * (87.8) 52.4 59.7 49.1 53.8 D. Status of women Household decisionmaking: Can seek own health care 32.9 33.5 36.5 34.3 28.1 34.1 (27.0) 29.5 33.1 33.2 29.0 30.8 Can seek children's health care 94.0 93.1 94.5 96.9 (98.0) 94.2 * 100.0 92.9 97.6 94.7 96.0 Can make daily household purchases 30.2 32.1 32.9 31.9 21.5 31.5 (27.9) 26.5 28.7 30.2 24.0 26.6 Can make large household purchases 28.4 29.2 29.3 27.5 19.5 28.6 (21.9) 22.6 24.7 25.4 21.9 23.4 Can make meal-related decisions 29.4 29.7 32.5 31.0 21.7 30.3 (24.0) 24.7 28.9 27.9 22.2 24.7 Freedom of movement: Can travel to visit family, relatives 23.1 20.6 21.0 27.5 27.9 22.3 (9.8) 22.2 24.4 29.0 24.7 26.3 Other decisionmaking, attitudes: Can decide how to spend own money 80.4 83.7 80.7 84.4 81.8 81.9 * 95.1 87.5 92.4 88.4 90.0 Can decide whether to have sex 87.3 83.9 91.2 93.4 90.7 88.0 (80.8) 83.6 87.7 95.4 97.1 95.9 Justifies domestic violence 52.4 47.2 46.8 42.7 22.5 47.5 (52.5) 38.9 45.6 38.6 24.2 30.9 E. Orphanhood Paternal orphan prevalence 6.8 6.3 5.5 6.2 4.9 6.2 6.4 10.4 9.0 10.3 8.0 9.1 Maternal orphan prevalence 3.3 2.9 5.8 2.9 5.0 3.9 5.5 4.7 5.2 3.6 3.7 3.8 Double orphan prevalence 0.6 0.6 0.6 0.4 1.4 0.6 5.5 1.3 1.9 1.4 1.2 1.4 - 17 - . PART II. BASIC TABLES, 1994 / 95 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. Haiti 1994 / 95 - 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 93.7 93.6 85.6 81.7 74.3 87.1 1.26 19.40 -0.0431 0.0008 Under-five mortality rate 163.3 150.1 137.1 130.6 105.6 140.6 1.55 57.70 -0.0709 0.0009 Prevalence of fever 46.2 43.6 35.6 39.0 29.9 39.8 1.55 16.30 -0.0659 0.0124 Prevalence of diarrhea 30.9 27.1 24.4 31.6 20.4 27.4 1.51 10.50 -0.0430 0.0168 Prevalence of acute respiratory 20.6 21.7 20.2 21.1 15.3 20.2 1.35 5.30 -0.0425 0.0199 infection (ARI) B. Fertility Total fertility rate 7.0 6.2 5.5 4.0 2.3 4.8 3.04 4.70 -0.2102 0.0043 Adolescent fertility rate 105.0 99.0 92.0 93.0 25.0 76.0 4.20 80.00 -0.2019 0.0011 C. Nutritional status (%) Children: Moderate stunting 20.1 15.9 19.9 16.2 8.4 16.9 2.39 11.70 -0.0875 0.0239 Severe stunting 25.4 17.1 12.4 9.0 4.3 14.9 5.91 21.10 -0.2751 0.0264 Moderate underweight 25.6 21.3 19.1 16.7 8.6 19.4 2.98 17.00 -0.1357 0.0222 Severe underweight 13.3 8.4 7.8 5.5 1.6 8.1 8.31 11.70 -0.2603 0.0372 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 24.9 23.6 18.7 15.1 9.3 18.7 2.68 15.60 -0.1617 0.0262 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 0.8 0.8 1.2 1.8 2.6 1.5 0.31 1.80 0.2546 0.0744 Men 2.3 6.1 9.8 7.9 5.7 6.6 0.40 3.40 0.0656 0.0509 Prevalence of genital ulcer: Women 0.0 0.0 0.0 0.1 0.0 0.0 na 0.00 0.4067 0.4069 Men 1.1 1.7 1.6 2.5 2.1 1.8 0.52 1.00 0.1063 0.1155 - 21 - Haiti 1994 / 95 - 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 56.4 65.1 76.4 84.8 90.6 73.4 0.62 34.20 0.0971 0.0125 Measles coverage 40.1 38.8 49.2 53.6 64.7 47.9 0.62 24.60 0.1097 0.0234 DPT coverage 29.4 29.8 44.3 53.4 56.2 41.4 0.52 26.80 0.1450 0.0270 Full basic coverage 18.8 20.1 35.3 37.9 44.1 30.2 0.43 25.30 0.1795 0.0362 No basic coverage 31.3 29.2 18.1 9.1 4.2 19.6 7.45 27.10 -0.2954 0.0419 Hepatitis B coverage na na na na na na na na na na Yellow fever coverage na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 16.3 22.1 23.8 33.4 35.3 24.3 0.46 19.00 0.1570 0.0288 Treatment in a public facility 3.8 7.9 10.7 11.3 9.7 8.2 0.39 5.90 0.1975 0.0506 Treatment in a private facility 3.2 4.0 4.1 7.6 21.1 6.2 0.15 17.90 0.3765 0.0802 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 17.7 26.8 23.8 35.7 40.4 27.2 0.44 22.70 0.1523 0.0384 Treatment in a public facility 4.3 8.5 10.2 13.8 9.8 9.1 0.44 5.50 0.1882 0.0691 Treatment in a private facility 4.3 6.0 3.5 8.3 26.4 7.6 0.16 22.10 0.3550 0.0990 Treatment of diarrhea: Use of oral rehydration therapy 42.7 53.1 63.4 66.7 71.6 57.2 0.60 28.90 0.1026 0.0161 Medical treatment of diarrhea 16.0 16.5 26.2 30.2 43.2 23.9 0.37 27.20 0.1884 0.0354 Treatment in a public facility 4.3 7.6 9.2 13.4 13.1 8.9 0.33 8.80 0.2156 0.0625 Treatment in a private facility 2.4 2.6 3.2 5.8 19.9 5.1 0.12 17.50 0.4445 0.1100 C. Antenatal and delivery care Antenatal care visits: To a medically trained person 45.9 60.0 73.7 84.0 92.0 69.6 0.50 46.10 0.1326 0.0076 To a doctor 20.1 26.5 39.7 61.5 84.5 43.9 0.24 64.40 0.2952 0.0114 To a nurse or trained midwife 25.8 33.5 33.9 22.5 7.6 25.7 3.39 18.20 -0.1279 0.0192 Multiple visits to a medically trained person 26.4 38.5 52.7 68.8 81.6 51.6 0.32 55.20 0.2198 0.0102 Antenatal care content: Tetanus toxoid 50.5 64.4 69.5 77.4 70.0 65.9 0.72 19.50 0.0689 0.0091 Prophylactic antimalarial treatment na na na na na na na na na na Iron supplementation na na na na na na na na na na Delivery attendance: By a medically trained person 24.0 37.3 47.4 60.7 78.2 46.3 0.31 54.20 0.2240 0.0096 By a doctor 1.4 2.9 8.5 22.3 54.1 14.2 0.03 52.70 0.6252 0.0277 By a nurse or trained midwife 22.5 34.4 38.9 38.4 24.1 32.1 0.93 1.60 0.0522 0.0142 In a public facility 1.8 4.2 11.7 22.4 34.1 12.7 0.05 32.30 0.5082 0.0272 In a private facility 0.0 0.6 0.9 2.9 21.7 3.7 0.00 21.70 0.7978 0.0760 At home 97.5 94.1 84.4 66.3 35.8 79.8 2.72 61.70 -0.1367 0.0048 D. Contraceptive services Contraceptive prevalence: Women 4.9 7.4 12.7 20.4 20.9 13.2 0.23 16.00 0.2905 0.0258 Men 6.6 12.2 19.5 21.7 27.3 16.9 0.24 20.70 0.2251 0.0437 - 22 - Haiti 1994 / 95 - TOTAL POPULATION (Cont.) Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors D. Contraceptive services (cont.) Source of contraception - public sector: Women (59.3) (70.9) 59.8 59.3 45.1 56.5 1.31 104.40 -0.0905 0.0258 Men na na na na na na na na na na Source of contraception - private sector: Women (40.7) (29.1) 38.8 38.5 52.7 41.9 (0.77) 93.40 0.1217 0.0354 Men na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women * * * * (85.9) 76.3 * * * * Men * * (18.6) (26.3) * 25.8 * * * * 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 - Haiti 1994 / 95 - 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 7.5 4.8 0.0 0.0 0.0 3.3 na 7.50 -0.5014 0.2052 Timely complementary feeding 91.7 86.4 (84.5) (89.0) * 84.8 * * * * Bottle-feeding 11.8 19.7 20.2 30.2 48.6 22.8 0.24 36.80 0.2531 0.0422 D. Micronutrient consumption Iodized salt: Availability of iodized salt na na na na na na na na na na in household Vitamin A: Children 13.3 9.6 11.0 14.2 13.6 12.2 0.98 0.30 0.0366 0.0315 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 7.5 10.5 16.3 15.3 12.4 12.6 0.60 4.90 0.0992 0.0355 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 - Haiti 1994 / 95 - 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 4.9 11.1 27.2 41.8 65.4 33.8 0.07 60.50 0.3863 0.0087 Men 9.0 17.9 36.5 53.9 77.4 41.6 0.12 68.40 0.3552 0.0072 School participation: Girls 35.8 60.0 78.5 84.4 90.1 68.7 0.40 54.30 0.1579 0.0084 Boys 35.9 58.5 75.9 86.7 92.7 67.6 0.39 56.80 0.1704 0.0088 B. Exposure to mass media Newspaper readership: Women 5.6 10.7 21.6 30.8 52.2 26.9 0.11 46.60 0.3587 0.0122 Men 15.9 21.6 40.8 59.9 77.5 43.4 0.21 61.60 0.3065 0.0142 Radio listenership: Women 15.7 38.3 54.1 77.0 91.3 59.8 0.17 75.60 0.2402 0.0059 Men 29.0 47.0 71.9 86.7 97.4 67.3 0.30 68.40 0.2082 0.0081 Television viewership: Women 2.1 2.9 8.9 35.6 81.5 31.2 0.03 79.40 0.5687 0.0099 Men 1.8 3.6 12.7 41.9 88.0 29.5 0.02 86.20 0.6043 0.0183 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 94.8 96.9 97.3 97.5 98.1 97.1 0.97 3.30 0.0054 0.0015 Men 93.4 95.7 97.9 98.5 98.4 96.9 0.95 5.00 0.0096 0.0028 Knowledge about mother-to-child transmission of HIV/AIDS: Women 66.5 60.6 72.4 82.5 90.3 73.5 0.74 23.80 0.1112 0.0045 Men 65.7 62.6 69.8 83.4 91.7 73.4 0.72 26.00 0.0977 0.0079 Attitudes toward HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na Can seek children's health care na na na na na na na na na na Can make daily household purchases na na na na na na na na na na Can make large household purchases na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na na na na na Can decide whether to have sex na na na na na na na na na na Justifies domestic violence na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 5.5 6.5 7.7 9.3 10.8 7.8 0.51 5.30 0.1470 0.0208 Maternal orphan prevalence 4.1 4.9 3.7 4.6 6.4 4.7 0.64 2.30 0.0640 0.0276 Double orphan prevalence 1.0 1.0 1.2 1.5 2.4 1.4 0.42 1.40 0.2010 0.0538 - 25 - Haiti 1994 / 95 - 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 97.2 64.7 71.5 80.1 (60.2) 76.2 90.2 120.8 99.2 83.3 (86.8) 97.7 Under-five mortality rate 162.6 118.6 129.0 (128.1) (94.5) 129.7 164.0 180.0 144.7 (133.2) (115.4) 151.2 Prevalence of fever 42.8 46.4 36.5 38.0 29.3 39.7 49.9 41.0 34.8 39.9 30.4 39.9 Prevalence of diarrhea 28.6 23.4 25.9 29.9 20.2 26.1 33.4 30.6 23.0 33.3 20.5 28.6 Prevalence of acute respiratory 20.7 22.9 21.4 20.4 13.3 20.4 20.6 20.5 19.1 21.8 17.0 19.9 infection (ARI) B. Nutritional status Children: Moderate stunting 18.8 16.8 21.3 14.0 6.5 16.6 21.5 15.1 18.6 18.7 9.9 17.2 Severe stunting 24.7 17.4 12.0 11.1 4.0 15.3 26.1 16.9 12.8 6.7 4.5 14.6 Moderate underweight 25.7 21.5 20.7 16.2 6.5 19.7 25.5 21.1 17.5 17.3 10.1 19.1 Severe underweight 11.7 9.7 7.9 6.3 2.1 8.3 15.1 7.3 7.6 4.6 1.3 7.8 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na C. Sexually transmitted disease Prevalence of genital discharge: Women 0.8 0.8 1.2 1.8 2.6 1.5 Men 2.3 6.1 9.8 7.9 5.7 6.6 Prevalence of genital ulcer: Women na na na na na na Men 1.1 1.7 1.6 2.5 2.1 1.8 - 27 - Haiti 1994 / 95 - 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 66.8 61.8 79.7 85.0 (90.1) 75.5 47.4 68.1 72.4 84.6 90.9 71.3 Measles coverage 52.7 40.8 54.6 53.3 (68.6) 52.6 29.1 36.9 43.0 53.9 61.6 43.6 DPT coverage 33.4 26.4 50.3 61.6 (62.3) 45.3 26.0 32.9 37.4 46.1 51.2 37.7 Full basic coverage 22.8 15.9 40.7 42.1 (47.3) 32.8 15.3 23.9 28.9 34.2 41.5 27.8 No basic coverage 20.9 32.2 16.4 10.1 (2.5) 17.9 40.4 26.6 20.1 8.1 5.5 21.3 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 16.5 17.7 22.2 32.8 31.3 22.4 16.2 26.8 25.3 34.0 38.3 26.2 Treatment in a public facility 6.0 5.6 10.6 10.5 7.1 7.7 1.8 10.4 10.7 12.2 11.7 8.6 Treatment in a private facility 2.7 2.6 4.3 7.6 19.2 5.3 3.6 5.4 3.8 7.7 22.5 6.9 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 16.4 20.3 25.4 33.4 (41.4) 24.7 19.1 33.6 22.1 37.9 (39.8) 29.6 Treatment in a public facility 5.5 3.5 12.5 14.2 (3.9) 8.2 2.9 13.7 7.8 13.4 (13.5) 10.0 Treatment in a private facility 2.7 2.6 5.8 5.4 (34.4) 6.4 5.9 9.5 1.1 11.2 (21.4) 8.8 Treatment of diarrhea: Use of oral rehydration therapy 49.5 53.4 65.8 65.9 (75.0) 59.8 36.5 53.0 60.9 67.4 68.9 54.9 Medical treatment of diarrhea 19.7 15.2 26.6 29.4 (52.9) 25.5 12.6 17.3 25.7 31.0 35.6 22.4 Treatment in a public facility 5.0 6.3 12.6 13.6 (17.6) 10.0 3.6 8.5 5.6 13.2 9.6 7.9 Treatment in a private facility 4.0 1.3 0.0 3.9 (29.9) 5.0 0.9 3.6 6.5 7.6 12.1 5.2 C. Contraceptive services Contraceptive prevalence: Women 4.9 7.4 12.7 20.4 20.9 13.2 Men 6.6 12.2 19.5 21.7 27.3 16.9 Source of contraception - public sector: Women (59.3) (70.9) 59.8 59.3 45.1 56.5 Men na na na na na na Source of contraception - private sector: Women (40.7) (29.1) 38.8 38.5 52.7 41.9 Men na na na na na na D. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women * * * * (85.9) 76.3 Men * * (18.6) (26.3) * 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 - Haiti 1994 / 95 - 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 (6.3) * * * * 3.9 * (2.9) 0.0 * * 2.8 Timely complementary feeding (93.3) * * * * 84.0 (90.0) (91.5) * (89.5) * 85.4 Bottle-feeding 14.1 14.7 19.5 32.0 (47.7) 21.9 9.0 23.4 20.7 28.6 (49.3) 23.6 D. Micronutrient consumption Vitamin A: Children 12.9 10.2 12.4 12.9 12.5 12.1 13.6 9.1 9.6 15.5 14.5 12.2 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 7.5 10.5 16.3 15.3 12.4 12.6 Condom usage with non-regular partner: Women na na na na na na Men na na na na na na - 29 - Haiti 1994 / 95 - 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 4.9 11.1 27.2 41.8 65.4 33.8 Men 9.0 17.9 36.5 53.9 77.4 41.6 School participation: Girls 35.8 60.0 78.5 84.4 90.1 68.7 Boys 35.9 58.5 75.9 86.7 92.7 67.6 B. Exposure to mass media Newspaper readership: Women 5.6 10.7 21.6 30.8 52.2 26.9 Men 15.9 21.6 40.8 59.9 77.5 43.4 Radio listenership: Women 15.7 38.3 54.1 77.0 91.3 59.8 Men 29.0 47.0 71.9 86.7 97.4 67.3 Television viewership: Women 2.1 2.9 8.9 35.6 81.5 31.2 Men 1.8 3.6 12.7 41.9 88.0 29.5 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 94.8 96.9 97.3 97.5 98.1 97.1 Men 93.4 95.7 97.9 98.5 98.4 96.9 Knowledge about mother-to-child transmission of HIV/AIDS: Women 66.5 60.6 72.4 82.5 90.3 73.5 Men 65.7 62.6 69.8 83.4 91.7 73.4 Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Orphanhood Paternal orphan prevalence 5.7 6.4 7.8 10.6 11.4 8.3 5.3 6.7 7.6 8.1 9.9 7.3 Maternal orphan prevalence 4.8 5.0 3.7 3.8 6.4 4.8 3.5 4.8 3.7 5.3 6.4 4.6 Double orphan prevalence 1.3 1.1 1.2 1.1 2.4 1.4 0.7 0.9 1.2 1.9 2.5 1.3 - 30 - Haiti 1994 / 95 - 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 92.8 96.7 79.0 (71.2) * 88.9 * * (109.1) 87.2 71.8 83.2 Under-five mortality rate 161.8 153.0 128.0 (96.6) * 144.3 * * (168.8) 149.3 103.6 132.7 Prevalence of fever 46.0 43.4 35.9 36.8 * 41.5 * 45.4 34.6 40.1 30.8 36.2 Prevalence of diarrhea 30.8 27.4 23.7 28.5 * 27.6 * 23.9 27.3 33.1 20.6 27.0 Prevalence of acute respiratory infection 20.6 21.5 20.5 21.2 * 20.8 * 23.9 19.2 21.0 15.8 18.9 B. Fertility Total fertility rate (7.0) 6.2 5.5 (3.9) * 5.9 * * * 4.0 2.3 3.3 Adolescent fertility rate (106.0) 99.0 89.0 (67.0) * 91.7 * * * 107.0 22.0 58.2 C. Nutritional status Children: Moderate stunting 19.9 15.8 17.8 13.8 * 17.4 * 16.7 28.9 17.5 8.6 15.8 Severe stunting 25.3 17.4 13.0 5.4 * 17.7 * 13.6 9.7 10.9 3.9 8.4 Moderate underweight 25.6 21.0 17.4 9.6 * 20.5 * 24.9 26.3 20.6 8.3 17.0 Severe underweight 13.0 8.7 7.9 3.0 * 9.3 * 5.4 7.1 6.8 1.7 5.1 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 24.7 22.8 19.9 14.0 * 21.7 * (30.9) 15.0 15.6 9.0 13.7 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na 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 0.8 0.6 1.1 1.8 (2.3) 1.0 * 2.5 1.4 1.8 2.6 2.2 Men 2.3 5.7 10.4 7.5 * 6.2 * (12.0) 7.8 8.1 6.0 7.2 Prevalence of genital ulcer: Women 0.0 0.0 0.0 0.0 0.0 0.0 * 0.0 0.0 0.2 0.0 0.1 Men 1.1 1.8 1.6 2.8 * 1.8 * 0.0 1.3 2.3 1.7 1.8 - 31 - Haiti 1994 / 95 - 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 57.5 64.4 74.1 (88.9) * 67.8 * * (85.8) 83.0 89.8 84.7 Measles coverage 40.8 39.4 46.6 (47.2) * 42.7 * * (60.4) 56.3 65.9 58.6 DPT coverage 30.0 30.3 43.1 (58.3) * 36.8 * * (49.5) 51.4 55.4 50.7 Full basic coverage 19.2 20.5 34.5 (36.1) * 25.6 * * (38.6) 38.7 44.9 39.5 No basic coverage 30.0 29.5 19.8 (5.6) * 24.4 * * (10.9) 10.5 4.5 10.0 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood diseases Treatment of fever: Medical treatment of fever 16.1 22.7 22.0 25.4 * 20.2 * (15.8) 31.0 37.2 36.5 34.4 Treatment in a public facility 3.9 7.9 9.9 9.9 * 7.0 * (7.9) 13.7 12.0 10.1 11.1 Treatment in a private facility 3.2 4.3 3.3 2.8 * 3.6 * 0.0 7.1 9.9 21.8 12.6 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 18.0 27.0 21.2 (29.3) * 22.7 * * (34.8) 38.9 41.8 37.7 Treatment in a public facility 4.3 7.3 9.6 (12.2) * 7.3 * * (12.8) 14.6 10.2 13.2 Treatment in a private facility 4.3 6.6 1.9 (7.3) * 4.7 * * (10.0) 8.9 27.3 14.2 Treatment of diarrhea: Use of oral rehydration therapy 42.3 52.6 63.3 61.8 * 52.0 * * (63.8) 68.7 72.7 68.7 Medical treatment of diarrhea 15.9 16.6 24.2 29.1 * 19.4 * * (32.8) 30.7 42.8 33.6 Treatment in a public facility 4.3 7.4 7.5 12.7 * 6.8 * * (14.8) 13.7 13.8 13.5 Treatment in a private facility 2.4 2.9 3.3 1.8 * 2.7 * * (2.5) 7.6 20.9 10.3 C. Antenatal and delivery care Antenatal care visits: To a medically trained person 45.9 57.8 73.6 90.1 * 61.5 * 83.6 74.0 80.9 91.9 84.4 To a doctor 20.3 25.5 37.7 57.0 * 30.7 * 37.6 46.3 63.6 84.5 68.1 To a nurse or trained midwife 25.6 32.3 35.9 33.1 * 30.7 * 45.9 27.7 17.3 7.4 16.3 Multiple visits to a medically trained person 26.5 37.5 52.0 72.5 * 41.7 * 49.5 54.8 67.0 81.2 69.9 Antenatal care content: Tetanus toxoid 50.6 63.4 68.7 81.7 * 62.6 * 74.2 71.9 75.4 69.2 72.1 Prophylactic antimalarial treatment na na na na na na na na na na na na Iron supplementation na na na na na na na na na na na na Delivery attendance: By a medically trained person 23.4 34.8 46.7 57.0 (73.1) 36.4 * 65.6 49.7 62.5 78.5 66.9 By a doctor 1.5 2.7 7.8 17.9 (42.3) 5.4 * 5.6 10.9 24.4 54.8 32.6 By a nurse or trained midwife 22.0 32.1 38.9 39.1 (30.8) 31.0 * 60.1 38.8 38.0 23.7 34.2 In a public facility 1.9 3.7 11.6 18.8 (19.2) 6.6 * 10.0 12.0 24.0 35.0 25.4 In a private facility 0.0 0.4 0.5 3.4 (19.2) 0.8 * 2.2 2.0 2.6 21.8 9.8 At home 97.5 95.1 86.1 72.0 (46.2) 91.0 * 83.3 78.6 63.6 35.2 56.6 D. Contraceptive services Contraceptive prevalence: Women 5.0 7.0 11.6 20.1 (34.5) 9.5 * 11.6 17.0 20.6 20.1 19.5 Men 6.7 12.3 19.3 27.3 * 14.7 * * (20.3) 18.8 25.0 21.0 - 32 - Haiti 1994 / 95 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - public sector: Women (59.3) (66.7) 53.8 (67.4) * 60.2 * * (76.0) 54.8 45.5 53.3 Men na na na na na na na na na na na na Source of contraception - private sector: Women (40.7) (33.3) 44.2 (30.2) * 38.6 * * (24.0) 43.1 52.0 44.6 Men na na na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women * * * * * * * * * * (85.3) (80.3) Men * * * * * 24.1 * * * * * (28.0) 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 - Haiti 1994 / 95 - 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 7.5 3.8 0.0 * * 3.9 * * * * * 1.4 Timely complementary feeding 91.7 85.7 (82.9) * * 87.3 * * * (87.9) * 77.9 Bottle-feeding 11.9 19.4 18.4 (31.6) * 17.6 * * (27.8) 29.5 50.0 36.4 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 13.3 10.0 10.6 10.9 * 11.3 * 5.4 12.5 15.8 14.1 14.0 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 - Haiti 1994 / 95 - 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 4.9 10.6 27.0 42.6 72.9 19.1 * 16.7 27.7 41.4 65.1 52.2 Men 8.8 17.2 33.7 52.5 58.4 25.1 * 28.9 48.4 54.8 78.8 66.5 School participation: Girls 35.8 59.9 79.1 83.2 * 60.5 * (61.1) 76.2 85.3 89.7 84.5 Boys 36.0 56.9 75.9 89.6 * 59.5 * (79.1) 75.9 84.1 92.9 86.7 B. Exposure to mass media Newspaper readership: Women 5.6 9.9 21.4 29.3 41.0 15.2 * 19.1 22.7 31.7 52.8 41.9 Men 16.0 22.0 40.3 62.7 * 30.7 * (15.3) 42.9 58.2 79.0 64.7 Radio listenership: Women 15.7 37.5 53.9 72.8 91.8 42.1 * 47.5 54.9 79.4 91.3 82.5 Men 28.9 45.7 71.5 87.3 * 53.8 * (66.3) 73.4 86.4 98.4 89.9 Television viewership: Women 1.9 2.4 7.7 14.5 54.1 6.5 * 8.0 13.9 47.4 83.0 62.6 Men 1.8 2.9 8.1 16.7 * 6.2 * (15.3) 29.6 57.4 90.3 68.5 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 94.8 97.2 96.9 97.5 100.0 96.6 * 92.6 98.6 97.6 98.0 97.8 Men 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Knowledge about mother-to-child transmission of HIV/AIDS: Women 49.3 59.5 70.3 76.8 93.4 62.8 * 72.2 81.0 85.7 90.1 87.1 Men 58.2 62.0 67.4 83.3 * 65.5 * (71.5) 78.5 83.4 92.4 86.7 Attitudes toward HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na na na Can seek children's health care na na na na na na na na na na na na Can make daily household purchases na na na na na na na na na na na na Can make large household purchases na na na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na na na na na na na Can decide whether to have sex na na na na na na na na na na na na Justifies domestic violence na na na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 5.4 6.2 7.1 5.4 8.9 6.1 (6.7) 11.1 10.3 12.3 10.9 11.2 Maternal orphan prevalence 4.0 4.8 3.7 5.0 6.7 4.4 (16.6) 5.1 3.5 4.2 6.4 5.3 Double orphan prevalence 1.0 1.0 1.0 0.5 2.2 0.9 (3.3) 1.0 1.9 2.3 2.4 2.2 - 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, 2000 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Haiti 2000 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 9,004 9,013 9,005 9,005 9,008 45,034 Urban 70 277 930 6,537 8,480 16,294 Rural 8,934 8,736 8,075 2,468 527 28,740 Female 4,306 4,585 4,417 4,914 4,918 23,139 Male 4,698 4,428 4,588 4,091 4,090 21,895 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 2,902 2,827 2,682 2,674 1,917 13,007 Urban 19 85 274 1,906 1,788 4,072 Rural 2,883 2,742 2,412 768 130 8,935 Female 1,397 1,460 1,345 1,438 986 6,626 Male 1,505 1,372 1,337 1,236 931 6,381 Prevalence of fever, diarrhea, acute respiratory infection All 1,296 1,286 1,134 1,254 909 5,879 Urban 6 34 123 921 843 1,927 Rural 1,290 1,252 1,011 333 67 3,953 Female 616 666 573 658 485 2,998 Male 679 620 561 596 424 2,880 Total fertility rate All 4,531 4,912 4,983 6,411 7,635 28,477 Urban 36 165 558 4,958 7,204 12,921 Rural 4,496 4,747 4,428 1,455 431 15,557 Age-specific fertility rate 15-19 All 999 1,046 1,103 1,682 2,129 6,959 Urban 9 46 126 1,362 2,033 3,576 Rural 991 1,000 977 320 96 3,384 Children's nutritional status All 1,202 1,204 1,053 1,050 810 5,321 Urban 6 33 113 734 747 1,633 Rural 1,197 1,171 941 317 64 3,690 Female 557 626 535 557 436 2,711 Male 646 578 518 493 374 2,609 Children's anemia status All 514 566 432 470 352 2,333 Urban 3 11 52 322 327 715 Rural 511 555 380 148 25 1,619 Female 274 274 203 198 131 1,080 Male 240 292 228 272 221 1,253 - 65 - Haiti 2000 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All 1,360 1,521 1,538 2,054 2,615 9,090 Urban 11 52 175 1,608 2,474 4,320 Rural 1,349 1,470 1,363 446 141 4,769 Women's anemia status All 778 835 865 1,088 1,269 4,836 Urban 7 31 95 836 1,206 2,175 Rural 771 803 770 252 63 2,659 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 1,298 1,403 1,471 1,806 2,000 7,978 Urban Female 10 46 157 1,374 1,881 3,468 Rural Female 1,288 1,356 1,314 431 118 4,507 Male 556 581 439 481 604 2,661 Urban Male 3 16 64 342 559 984 Rural Male 553 565 375 140 45 1,678 - 66 - Haiti 2000 - 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 274 257 225 262 207 1,225 Urban 1 6 19 200 190 416 Rural 273 252 206 62 17 810 Female 133 153 118 128 120 652 Male 141 105 107 134 87 574 Treatment of fever All 620 612 446 450 257 2,385 Urban 2 18 53 308 227 608 Rural 618 594 393 142 30 1,777 Female 335 290 237 206 118 1,186 Male 285 322 209 244 139 1,199 Treatment of acute respiratory infection All 605 578 430 451 249 2,312 Urban 3 17 49 315 234 618 Rural 602 560 381 136 16 1,695 Female 279 297 223 239 125 1,163 Male 326 281 206 213 124 1,150 Treatment of diarrhea All 350 314 339 328 183 1,514 Urban 2 9 36 252 165 464 Rural 348 305 302 76 18 1,049 Female 165 155 173 147 96 736 Male 185 159 166 181 88 779 Antenatal and delivery care All 866 868 826 951 742 4,254 Urban 6 25 87 689 694 1,501 Rural 859 843 739 262 48 2,751 Contraceptive prevalence Female 1,114 1,170 1,200 1,286 1,187 5,958 Urban Female 9 35 120 951 1,108 2,223 Rural Female 1,105 1,134 1,080 336 79 3,734 Male 373 390 277 250 257 1,548 Urban Male 2 10 37 171 238 458 Rural Male 372 379 240 79 19 1,089 Contraceptive source Female 194 260 309 311 288 1,361 Urban Female 3 6 31 199 263 502 Rural Female 190 253 278 112 25 859 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 108 106 106 151 163 634 Urban Female 2 4 12 110 154 282 Rural Female 107 102 94 41 10 354 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 67 - Haiti 2000 - 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 80 62 87 69 36 334 Urban 0 2 8 52 33 95 Rural 80 59 79 17 2 237 Female 51 37 55 35 23 201 Male 28 25 32 34 13 132 Timely complementary breastfeeding All 90 118 73 78 98 457 Urban 0 3 7 55 83 148 Rural 90 115 66 23 14 308 Female 46 55 36 30 69 236 Male 44 63 37 49 29 222 Bottle-feeding All 270 252 268 228 177 1,195 Urban 0 8 23 166 156 353 Rural 270 244 245 62 20 841 Female 156 135 140 100 111 642 Male 114 117 128 128 65 552 - 68 - Haiti 2000 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Iodized salt in household All 1,686 1,747 1,706 1,798 1,873 8,810 Urban 11 46 191 1,306 1,793 3,347 Rural 1,675 1,700 1,515 492 80 5,462 Vitamin A supplementation All 1,167 1,186 983 1,145 857 5,338 Urban 6 31 111 843 796 1,787 Rural 1,161 1,155 871 303 62 3,552 Female 598 563 477 540 397 2,575 Male 569 623 506 605 461 2,764 Tobacco and alcohol use, casual sexual partners, condom use for casual sex Female 1,606 1,738 1,751 2,296 2,766 10,157 Urban Female 13 59 199 1,773 2,615 4,659 Rural Female 1,592 1,680 1,552 523 151 5,498 Male 687 672 527 594 689 3,169 Urban Male 4 18 72 433 638 1,165 Rural Male 683 654 456 160 51 2,004 Domestic violence All 1,606 1,738 1,751 2,296 2,766 10,159 Urban 13 59 199 1,773 2,615 4,660 Rural 1,592 1,680 1,552 523 151 5,499 - 69 - Haiti 2000 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 1,647 1,806 1,773 2,314 2,802 10,342 Urban female 13 58 205 1,785 2,651 4,713 Rural female 1,634 1,748 1,568 529 151 5,629 Male 1,724 1,740 1,912 1,991 2,369 9,735 Urban male 12 51 188 1,428 2,231 3,910 Rural male 1,712 1,689 1,724 563 138 5,826 School participation Female 689 629 641 687 498 3,143 Urban female 11 18 62 527 458 1,075 Rural female 678 612 579 160 40 2,068 Male 798 636 757 548 409 3,149 Urban male 8 25 69 362 393 857 Rural male 790 611 688 187 16 2,292 Mass media exposure Female 1,606 1,738 1,751 2,296 2,766 10,159 Urban female 13 59 199 1,773 2,615 4,660 Rural female 1,592 1,680 1,552 523 151 5,499 Male 647 641 584 592 706 3,171 Urban male 5 17 63 422 660 1,166 Rural male 642 624 522 170 47 2,005 Knowledge of HIV/AIDS prevention Female 3,490 1,738 1,751 2,296 2,766 12,041 Urban female 13 59 199 1,773 2,615 4,659 Rural female 1,592 1,680 1,552 523 151 5,498 Male 687 672 527 594 689 3,171 Urban male 4 18 72 433 638 1,165 Rural male 683 654 456 160 51 2,004 Household decisionmaking and justification of violence All 1,606 1,738 1,751 2,296 2,766 10,159 Urban 13 59 199 1,773 2,615 4,660 Rural 1,592 1,680 1,552 523 151 5,499 Orphanhood All 4,159 3,967 3,919 3,700 2,880 18,630 Urban 35 129 384 2,613 2,685 5,847 Rural 4,124 3,838 3,535 1,087 195 12,783 Female 1,796 1,762 1,698 1,918 1,545 8,723 Male 2,363 2,206 2,221 1,782 1,335 9,907 - 70 - Haiti 2000 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 7.11 9.76 8.30 8.32 15.29 4.23 Under-five mortality rate 8.50 12.62 10.27 11.13 12.75 5.47 Prevalence of fever 1.70 2.25 3.08 1.64 1.80 1.25 Prevalence of diarrhea 1.50 3.74 1.55 3.04 1.95 1.13 Prevalence of acute respiratory infection 2.02 2.09 3.06 1.95 3.41 1.24 B. Fertility Total fertility rate 0.21 0.37 0.48 0.24 0.23 0.20 Adolescent fertility rate 14.00 13.00 15.00 8.00 11.00 5.00 C. Nutritional status Children: Moderate stunting 1.35 2.49 1.97 2.13 0.83 1.13 Severe stunting 1.20 1.40 1.15 0.83 0.95 0.69 Moderate underweight 1.33 1.42 1.57 1.75 1.03 0.81 Severe underweight 0.78 1.02 1.13 0.66 0.57 0.50 Mild anemia 1.86 3.08 2.92 4.16 2.44 1.09 Moderate anemia 2.28 2.35 3.61 2.49 2.87 1.15 Severe anemia 0.43 0.34 1.20 1.78 0.67 0.49 Women: Malnutrition na na na na na na Mild anemia 2.15 2.76 1.41 1.92 1.47 0.84 Moderate anemia 1.59 2.12 2.05 1.24 2.89 1.11 Severe anemia 0.90 0.92 0.93 0.68 0.59 0.30 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 0.90 0.96 0.98 0.93 0.67 0.45 Men 1.04 3.82 3.65 1.54 1.03 1.54 Prevalence of genital ulcer: Women 0.59 0.89 0.60 0.49 0.43 0.29 Men 2.86 1.84 1.25 0.92 0.50 1.06 - 71 - Haiti 2000 - 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 5.22 7.10 4.92 4.57 4.69 3.28 Measles coverage 4.03 6.16 5.50 4.67 7.38 3.20 DPT coverage 4.24 4.47 6.56 4.32 12.17 3.23 Full basic coverage 3.95 4.14 6.74 3.93 9.69 3.03 No basic coverage 3.69 6.33 3.13 3.06 5.28 2.38 Hepatitis B coverage na na na na na na Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 2.62 3.21 3.08 3.94 4.48 1.26 Treatment in a public facility 2.11 3.57 2.88 3.05 4.87 1.26 Treatment in a private facility 2.33 1.81 3.87 2.50 5.30 1.21 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 2.40 3.26 3.03 6.42 6.04 1.85 Treatment in a public facility 2.32 3.82 3.12 5.16 3.13 1.36 Treatment in a private facility 2.28 1.90 3.81 2.26 7.03 1.29 Treatment of diarrhea: Use of oral rehydration therapy 3.02 5.09 4.70 7.04 5.52 3.00 Medical treatment of diarrhea 2.19 2.76 5.61 2.53 4.25 1.70 Treatment in a public facility 1.93 1.84 5.41 3.88 4.09 1.92 Treatment in a private facility 1.35 2.22 1.32 2.73 4.92 1.10 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically trained person 2.82 3.05 1.98 2.01 1.82 1.59 To a doctor 2.13 3.02 3.02 3.17 2.22 2.06 To a nurse or trained midwife 2.24 2.10 2.98 2.32 1.88 1.35 Multiple visits to a medically trained person 2.40 4.20 3.98 3.00 3.52 2.14 Antenatal care content: Tetanus toxoid 2.35 4.87 2.44 3.24 2.78 1.96 Prophylactic antimalarial treatment na na na na na na Iron supplementation 2.51 3.02 3.24 3.05 3.21 2.00 Delivery attendance: By a medically trained person 0.60 1.77 1.64 2.50 2.46 2.49 By a doctor 0.48 0.94 1.03 2.30 2.19 1.19 By a nurse or trained midwife 0.47 1.13 1.29 3.61 2.11 1.51 In a public facility 0.54 1.95 1.52 1.86 3.67 1.00 In a private facility 0.20 0.23 1.06 0.78 3.69 0.48 At home 0.58 1.74 1.53 3.12 2.23 2.51 D. Contraceptive services Contraceptive prevalence: Women 1.75 1.75 2.87 2.00 2.95 1.26 Men na na na na na na Source of contraception - public sector: Women 6.08 6.96 6.28 5.04 3.60 3.71 Men na na na na na na - 72 - Haiti 2000 - 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 5.36 7.46 6.97 4.61 3.27 3.91 Men na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 5.78 5.96 6.66 3.61 4.34 2.69 Men 9.46 12.49 10.76 13.38 * 5.66 Treatment of genital discharge, ulcer, sore in public facilities: Women 0.90 0.96 0.98 0.93 0.67 0.45 Men 2.84 3.63 3.61 1.62 * 2.02 Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men 0.78 0.72 1.47 3.51 1.66 1.01 - 73 - Haiti 2000 - 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 7.25 7.33 10.07 7.44 7.72 4.71 Timely complementary feeding 5.22 5.86 4.89 4.08 11.81 3.94 Bottle-feeding 2.18 3.78 3.45 4.83 7.36 2.08 D. Micronutrient consumption Iodized salt: Availability of iodized salt in household 1.26 2.89 2.01 2.04 1.53 1.41 Vitamin A: Children 2.33 3.68 3.50 4.31 6.39 2.36 Women 2.73 3.26 1.97 2.07 2.14 1.32 E. Tobacco and alcohol use Tobacco: Women 0.84 0.77 0.94 0.49 0.64 0.38 Men 1.89 2.51 2.40 1.96 2.01 1.01 Alcohol: Women 0.76 0.50 0.66 0.29 0.29 0.27 Men 0.97 0.96 0.57 0.71 1.15 0.48 F. Sexual practices Non-regular sexual partnerships: Women 0.24 0.36 0.80 0.31 0.23 0.18 Men 2.29 4.16 2.81 2.25 4.62 1.41 Condom usage with non-regular partner: Women * * * 7.82 * 4.64 Men 5.89 6.62 3.99 6.87 5.49 2.82 G. Domestic violence Ever experienced violence 1.72 2.69 2.30 2.58 1.94 1.07 Experienced violence in past year 1.89 2.25 2.63 2.29 2.21 0.96 - 74 - Haiti 2000 - 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 1.04 2.59 2.53 1.35 2.17 2.32 Men 1.82 3.72 1.84 2.18 1.18 2.42 School participation: Girls 3.19 2.83 2.71 2.44 1.81 1.74 Boys 2.68 3.82 2.86 5.82 3.41 1.88 B. Exposure to mass media Newspaper readership: Women 1.19 1.69 1.89 1.95 2.82 1.34 Men 1.96 2.85 2.20 3.93 3.79 2.66 Radio listenership: Women 1.91 2.55 2.84 1.52 0.76 2.32 Men 3.24 3.77 4.54 2.47 2.43 2.19 Television viewership: Women 0.22 0.58 0.77 3.04 1.63 3.70 Men 1.56 2.90 1.71 4.22 3.89 3.41 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 3.15 2.58 2.81 2.89 0.90 2.41 Men 3.66 2.66 2.29 1.86 1.50 1.51 Knowledge about mother-to-child transmission of HIV/AIDS: Women 1.83 1.44 2.01 2.61 1.17 0.73 Men 2.87 5.11 3.00 2.50 4.38 1.95 Attitudes toward HIV/AIDS: Women 2.07 3.17 2.70 1.92 2.92 1.19 Men 2.65 3.47 4.84 3.64 3.33 2.25 D. Status of women Household decisionmaking: Can seek own health care 1.35 1.25 3.38 1.56 1.20 0.75 Can seek children's health care 0.93 1.65 1.32 0.64 1.35 0.56 Can make daily household purchases 1.24 1.38 2.72 0.93 1.41 0.67 Can make large household purchases 1.12 1.20 2.30 1.61 1.32 0.67 Can make meal-related decisions 1.33 1.53 3.69 1.09 1.70 0.75 Freedom of movement: Can travel to visit family/relatives 1.65 1.35 1.33 2.35 1.07 0.85 Other decisionmaking, attitudes: Can decide how to spend own money 2.23 3.15 3.18 1.23 1.95 1.20 Can decide whether to have sex 2.45 4.97 1.27 0.99 0.78 1.41 Justifies domestic violence 2.17 3.72 1.90 1.31 1.19 1.24 E. Orphanhood Paternal orphan prevalence 0.84 0.86 0.69 1.05 1.15 0.39 Maternal orphan prevalence 0.38 0.54 1.94 0.64 1.00 0.47 Double orphan prevalence 0.13 0.18 0.18 0.28 0.46 0.12 - 75 - Haiti 1995 - 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 0.264 0.441 0.0% 0.3% 4.3% 64.4% 98.8% 33.6% 0.11511 Has radio 0.454 0.498 15.9% 24.8% 47.0% 66.6% 92.9% 49.4% 0.07603 Has television 0.161 0.367 0.0% 0.1% 0.3% 27.9% 89.2% 23.5% 0.10210 Has refrigerator 0.077 0.267 0.0% 0.0% 0.0% 2.3% 46.3% 9.7% 0.08179 Has bicycle 0.157 0.364 3.3% 10.1% 23.5% 21.9% 22.2% 16.2% 0.03443 Has motorcycle/scooter 0.016 0.125 0.0% 0.1% 1.5% 2.1% 3.8% 1.5% 0.02192 Has car/truck 0.031 0.174 0.0% 0.0% 0.4% 1.6% 15.9% 3.6% 0.05518 Has telephone 0.034 0.182 0.0% 0.0% 0.0% 0.0% 21.9% 4.4% 0.06236 Has electricity from EDH 0.257 0.437 0.0% 0.2% 4.0% 62.9% 97.9% 33.0% 0.11388 Has electricity from other source 0.021 0.142 0.0% 0.1% 0.3% 1.8% 6.5% 1.7% 0.03741 Owns Furnace 0.977 0.150 99.4% 99.5% 98.9% 99.0% 99.6% 99.3% -0.00162 Owns a Bed 0.962 0.192 91.7% 96.2% 96.7% 98.5% 100.0% 96.6% 0.01886 Owns Horse, mule 0.154 0.361 18.8% 23.1% 28.0% 8.5% 1.0% 15.9% -0.02587 Works own or family's agric. land 0.107 0.309 26.2% 12.9% 10.9% 1.8% 0.1% 10.4% -0.03515 Uses water piped into residence for drinking 0.105 0.307 0.0% 1.8% 5.4% 12.1% 34.3% 10.7% 0.06403 Uses water from a public faucet (piped) for drinking 0.361 0.480 4.3% 37.9% 49.0% 65.7% 51.9% 41.8% 0.03609 Uses water from own open well in residence for drinking 0.015 0.120 0.1% 4.1% 3.4% 2.5% 0.4% 2.1% 0.00167 Uses water from a public open well in residence 0.030 0.171 0.3% 3.4% 5.1% 4.4% 1.9% 3.0% 0.00115 Uses water from a public covered well for drinking 0.053 0.224 2.2% 3.8% 8.2% 4.8% 1.3% 4.1% 0.00002 Uses water from own covered well for drinking 0.012 0.107 0.0% 0.8% 1.0% 2.6% 0.5% 1.0% 0.00688 Uses water from river, canal or surface for drinking 0.391 0.488 91.3% 45.8% 25.5% 5.3% 0.2% 33.6% -0.08481 Uses protected surface water for drinking 0.073 0.260 20.0% 9.0% 3.6% 1.1% 0.1% 6.8% -0.03076 Uses rain water for drinking 0.015 0.121 1.7% 2.2% 2.2% 1.1% 0.2% 1.5% -0.00647 Uses water from tanker truck for drinking 0.003 0.052 0.0% 0.0% 0.1% 0.4% 1.4% 0.4% 0.00772 Uses bottled water for drinking 0.009 0.092 0.0% 0.0% 0.0% 0.1% 3.3% 0.7% 0.02923 Uses water from vendor truck for drinking 0.007 0.081 0.0% 0.1% 0.1% 1.1% 4.5% 1.1% 0.01191 Uses a flush toilet in residence/private 0.027 0.163 0.0% 0.0% 0.0% 0.6% 15.0% 3.1% 0.05532 Uses a pit latrine 0.082 0.274 7.0% 10.9% 11.3% 4.7% 2.8% 7.4% -0.01238 Uses a VIP latrine 0.195 0.396 5.0% 14.9% 20.9% 26.0% 27.6% 18.9% 0.02321 Uses a shared flush toilet in residence/private 0.003 0.054 0.0% 0.0% 0.0% 0.0% 1.4% 0.3% 0.01324 Uses a shared pit latrine 0.086 0.280 2.7% 9.5% 11.0% 11.7% 10.3% 9.0% 0.01263 Uses a shared VIP latrine 0.193 0.395 1.3% 7.7% 16.6% 43.9% 40.7% 22.0% 0.04730 Uses bush,field as latrine 0.413 0.492 84.0% 57.0% 40.2% 13.1% 2.1% 39.3% -0.07672 Has dirt, sand, dung as principal floor material in dwelling 0.486 0.500 97.1% 78.2% 41.2% 15.7% 0.8% 46.6% -0.09206 Has wood, plank as principal floor material in dwelling 0.009 0.093 0.9% 0.4% 0.3% 0.2% 0.6% 0.5% -0.00265 Has tiles as principal floor material in dwelling 0.030 0.171 0.0% 0.0% 0.1% 0.7% 18.0% 3.8% 0.05344 Has cement as principal floor material in dwelling 0.473 0.499 1.9% 21.2% 58.3% 83.4% 80.6% 49.1% 0.07445 Has parquet or polished wood as principal floor material in dw 0.001 0.023 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% -0.00175 Has other type of floor material in dwelling 0.000 0.014 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% -0.00050 Uses electricity as cooking fuel 0.000 0.018 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.00239 Uses gas as cooking fuel 0.011 0.102 0.0% 0.0% 0.0% 0.4% 5.0% 1.1% 0.03288 Uses biogas as cooking fuel 0.008 0.088 0.0% 0.0% 0.0% 0.2% 3.5% 0.7% 0.02778 Uses kerosene as cooking fuel 0.009 0.096 0.0% 0.0% 0.0% 0.7% 4.9% 1.1% 0.02294 Uses charcoal for cooking 0.383 0.486 0.0% 5.8% 26.8% 87.5% 85.8% 41.2% 0.09274 Uses wood as cooking fuel 0.572 0.495 99.9% 94.0% 71.7% 10.2% 0.3% 55.2% -0.10906 Uses other cooking fuel 0.016 0.124 0.1% 0.2% 1.4% 0.8% 0.3% 0.5% 0.00657 Owns dwelling 0.743 0.437 98.3% 90.2% 83.2% 61.5% 35.5% 73.8% -0.07028 Rents dwelling 0.199 0.399 0.2% 2.4% 9.3% 30.5% 61.2% 20.7% 0.07340 Work provided dwelling 0.001 0.037 0.0% 0.0% 0.0% 0.1% 0.5% 0.1% 0.00481 Free lodging 0.056 0.230 1.5% 7.3% 7.4% 7.8% 2.8% 5.4% 0.00537 - 77 - PART V. SUPPORTING TABLES, 1994 / 95 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Haiti 1994 / 95 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 4,226 5,452 4,806 4,827 4,831 24,143 Urban 51 364 931 2,870 4,544 8,759 Rural 4,175 5,088 3,876 1,957 287 15,383 Female 2,140 2,711 2,421 2,591 2,645 12,508 Male 2,086 2,741 2,385 2,236 2,186 11,635 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 1,594 1,638 1,467 1,277 960 6,936 Urban 21 141 321 839 900 2,222 Rural 1,573 1,497 1,146 438 60 4,714 Female 825 792 717 641 449 3,424 Male 769 846 750 636 511 3,512 Prevalence of fever, diarrhea, acute respiratory infection 746 760 697 630 432 3,265 All 9 64 144 419 405 1,041 Urban 738 696 553 211 26 2,224 Rural 385 368 338 321 191 1,603 Female 361 392 358 309 241 1,661 Male Total fertility rate All 2,319 2,736 2,725 3,285 3,718 14,783 Urban 29 230 569 2,116 3,534 6,478 Rural 2,290 2,506 2,156 1,169 184 8,305 Age-specific fertility rate 15-19 All 465 605 626 903 1,065 3,665 Urban 3 41 110 595 1,001 1,750 Rural 463 564 516 309 64 1,916 Children's nutritional status All 655 669 610 518 342 2,794 Urban 7 56 115 335 325 838 Rural 648 613 495 182 17 1,955 Female 336 324 297 270 145 1,372 Male 319 346 313 248 198 1,424 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 - Haiti 1994 / 95 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All 389 383 356 387 301 1,816 Urban 5 38 88 263 286 680 Rural 384 345 268 124 15 1,136 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 681 776 755 911 927 4,050 Urban Female 9 70 168 609 880 1,736 Rural Female 672 706 587 302 47 2,314 Male 191 326 254 318 260 1,349 Urban Male 2 21 58 203 247 531 Rural Male 190 305 196 115 13 819 - 82 - Haiti 1994 / 95 - 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 133 154 157 132 90 667 Urban 3 10 30 93 84 220 Rural 131 144 127 39 7 448 Female 62 73 85 63 40 323 Male 71 81 72 69 50 343 Treatment of fever All 345 331 248 245 129 1,299 Urban 6 29 50 168 125 378 Rural 339 302 199 77 4 921 Female 180 161 125 123 73 662 Male 165 170 123 122 56 636 Treatment of acute respiratory infection All 154 165 141 133 66 659 Urban 2 15 28 88 64 197 Rural 152 149 113 45 2 461 Female 80 84 72 65 25 326 Male 74 80 69 67 41 331 Treatment of diarrhea All 231 206 170 199 88 894 Urban 4 15 39 139 84 281 Rural 227 191 131 60 4 613 Female 110 86 88 96 38 418 Male 121 120 82 103 49 475 Antenatal and delivery care All 500 506 470 470 356 2,302 Urban 6 43 111 315 336 811 Rural 494 463 359 155 20 1,491 Contraceptive prevalence Female 602 658 613 645 595 3,113 Urban Female 7 53 124 412 564 1,160 Rural Female 595 606 489 233 32 1,955 Male 146 216 159 170 119 809 Urban Male 2 15 36 111 113 277 Rural Male 144 201 123 59 6 533 Contraceptive source Female 29 49 78 132 124 412 Urban Female 0 6 21 85 113 225 Rural Female 29 43 57 47 11 187 Male 146 216 159 170 119 809 Urban Male 2 15 36 111 113 277 Rural Male 144 201 123 59 6 533 Treatment of genital discharge, ulcer, sore Female 5 7 9 18 28 67 Urban Female 0 2 2 12 27 43 Rural Female 5 5 7 7 1 25 Male 5 22 27 28 19 101 Urban Male 0 3 5 18 18 44 Rural Male 5 19 23 10 1 58 - 83 - Haiti 1994 / 95 - 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 58 62 44 32 25 221 Urban 0 4 9 19 22 54 Rural 58 58 35 13 3 167 Female 23 38 26 14 16 117 Male 35 24 18 18 10 105 Timely complementary breastfeeding All 65 64 47 44 24 244 Urban 0 3 9 31 21 64 Rural 65 61 38 13 2 179 Female 33 38 24 26 12 133 Male 33 26 23 18 12 112 Bottle-feeding All 185 170 133 116 78 682 Urban 2 13 26 74 72 187 Rural 183 157 107 41 7 495 Female 84 98 73 61 44 360 Male 100 72 60 55 34 321 - 84 - Haiti 1994 / 95 - 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 656 676 635 579 390 2,936 Urban 9 57 130 388 368 952 Rural 647 620 505 191 22 1,985 Female 325 343 324 286 217 1,495 Male 330 333 311 294 173 1,441 Tobacco and alcohol use, casual sexual partners, condom use for casual sex Female 825 993 981 1,195 1,361 5,355 Urban Female 10 82 200 766 1,295 2,353 Rural Female 815 911 781 429 67 3,003 Male 244 402 302 357 305 1,610 Urban Male 2 25 64 221 291 603 Rural Male 242 377 238 136 14 1,007 Domestic violence All na na na na na na Urban na na na na na na Rural na na na na na na - 85 - Haiti 1994 / 95 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 865 1,064 1,030 1,266 1,453 5,679 Urban female 10 86 221 824 1,388 2,529 Rural female 854 978 809 443 65 3,150 Male 784 1,075 1,001 1,064 1,200 5,124 Urban male 6 62 189 671 1,115 2,043 Rural male 778 1,013 811 393 85 3,081 School participation Female 355 402 364 315 314 1,750 Urban female 6 33 73 183 302 598 Rural female 349 369 290 131 12 1,151 Male 375 407 355 306 267 1,710 Urban male 1 30 76 158 244 509 Rural male 374 376 279 148 23 1,201 Mass media exposure Female 825 993 981 1,195 1,361 5,356 Urban female 10 82 200 766 1,295 2,353 Rural female 815 911 781 429 67 3,003 Male 244 402 302 357 305 1,610 Urban male 2 25 64 221 291 603 Rural male 242 377 238 136 14 1,007 Knowledge of HIV/AIDS prevention Female 1,974 993 981 1,195 1,361 6,504 Urban female 10 82 200 766 1,295 2,353 Rural female 815 911 781 429 67 3,003 Male 244 402 302 357 305 1,610 Urban male 2 25 64 221 291 603 Rural male 242 377 238 136 14 1,007 Household decisionmaking and justification of violence All na na na na na na Urban na na na na na na Rural na na na na na na Orphanhood All 2,112 2,362 2,087 1,891 1,667 10,117 Urban 23 176 405 1,074 1,567 3,245 Rural 2,089 2,186 1,681 817 99 6,872 Female 929 1,136 934 908 931 4,838 Male 1,183 1,226 1,153 982 736 5,279 - 86 - Haiti 1994 / 95 - 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 8.11 10.35 9.54 9.10 11.61 4.55 Under-five mortality rate 10.21 14.37 11.99 12.66 13.43 6.46 Prevalence of fever 2.70 2.16 2.09 2.25 2.63 1.18 Prevalence of diarrhea 1.80 2.04 1.86 2.22 2.28 1.13 Prevalence of acute respiratory infection 2.24 2.08 1.82 1.99 1.85 1.06 B. Fertility Total fertility rate 0.31 0.26 0.24 0.23 0.18 0.17 Adolescent fertility rate 15.00 16.00 12.00 15.00 5.00 6.00 C. Nutritional status Children: Moderate stunting 1.77 1.80 1.50 1.65 1.66 0.76 Severe stunting 1.54 2.17 1.64 1.36 1.24 0.95 Moderate underweight 1.73 1.72 1.80 1.64 1.65 0.81 Severe underweight 1.38 1.53 1.28 1.02 0.64 0.73 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 2.35 2.18 2.30 1.81 1.70 1.03 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 0.36 0.32 0.39 0.45 0.42 0.20 Men 1.34 1.55 1.98 1.63 1.25 0.83 Prevalence of genital ulcer: Women 0.00 0.00 0.00 0.11 0.00 0.02 Men 0.80 0.71 0.76 0.81 1.03 0.37 - 87 - Haiti 1994 / 95 - 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 6.23 4.72 4.24 3.79 2.91 2.64 Measles coverage 5.37 4.66 4.63 4.49 5.47 2.57 DPT coverage 5.59 3.75 4.65 5.46 4.93 2.68 Full basic coverage 4.80 3.44 4.34 4.06 5.48 2.28 No basic coverage 5.96 4.49 3.50 2.61 1.82 2.36 Hepatitis B coverage na na na na na na Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 2.56 3.44 3.15 3.45 4.52 1.65 Treatment in a public facility 1.35 2.18 2.13 2.41 2.73 0.96 Treatment in a private facility 1.28 2.63 1.26 1.89 3.86 0.97 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 4.22 4.04 3.97 4.25 4.96 1.99 Treatment in a public facility 1.88 2.55 2.65 3.83 3.99 1.37 Treatment in a private facility 1.94 3.38 1.49 2.41 4.51 1.24 Treatment of diarrhea: Use of oral rehydration therapy 4.01 3.39 4.07 3.50 4.08 2.23 Medical treatment of diarrhea 2.86 3.71 4.15 3.55 5.52 1.91 Treatment in a public facility 1.36 2.60 2.29 2.65 5.14 1.25 Treatment in a private facility 1.84 1.27 1.47 1.70 3.95 0.86 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically trained person 3.50 3.02 2.15 1.87 1.41 1.73 To a doctor 2.88 3.00 2.53 2.88 1.61 1.86 To a nurse or trained midwife 2.99 2.89 3.17 2.70 1.28 1.67 Multiple visits to a medically trained person 3.06 2.35 2.20 2.57 1.88 1.73 Antenatal care content: Tetanus toxoid 3.32 2.45 2.44 2.13 2.32 1.48 Prophylactic antimalarial treatment na na na na na na Iron supplementation na na na na na na Delivery attendance: By a medically trained person 3.10 3.38 2.71 2.30 2.37 2.28 By a doctor 0.51 0.69 1.36 1.79 2.77 0.89 By a nurse or trained midwife 2.98 3.32 2.63 2.32 2.36 1.84 In a public facility 0.54 0.89 1.64 2.01 2.41 0.90 In a private facility 0.00 0.29 0.31 0.85 2.59 0.36 At home 0.58 1.07 1.77 2.35 2.65 1.21 D. Contraceptive services Contraceptive prevalence: Women 1.37 1.43 1.73 2.11 2.21 0.94 Men 2.89 2.56 3.22 3.50 4.61 1.79 Source of contraception - public sector: Women 14.78 9.23 6.09 5.78 4.62 3.68 Men na na na na na na - 88 - Haiti 1994 / 95 - 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 14.19 8.78 6.46 5.36 4.77 3.61 Men na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women * * * * 5.88 5.20 Men * * 8.02 7.96 * 4.43 Treatment of genital discharge, ulcer, sore in public facilities: Women 0.36 0.32 0.39 0.45 0.42 0.20 Men 1.45 1.65 2.04 1.67 1.48 0.88 Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men na na na na na na - 89 - Haiti 1994 / 95 - 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 3.14 2.37 0.00 0.00 0.00 1.18 Timely complementary feeding 3.40 5.33 5.13 4.36 * 2.66 Bottle-feeding 2.45 2.93 3.55 4.69 6.81 1.54 D. Micronutrient consumption Iodized salt: na na na na na na Availability of iodized salt in household Vitamin A: Children 2.51 1.92 1.83 2.39 3.38 1.37 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 1.83 2.02 2.34 2.23 1.79 1.12 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 - Haiti 1994 / 95 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Education School completion: Women 0.92 1.17 1.68 1.72 1.49 1.16 Men 1.33 1.63 2.09 1.84 1.74 1.38 School participation: Girls 3.55 3.90 2.44 2.03 1.55 2.01 Boys 3.47 3.28 2.98 2.32 1.76 2.01 B. Exposure to mass media Newspaper readership: Women 1.17 1.36 1.73 1.38 1.53 0.93 Men 2.91 2.39 3.77 3.08 3.47 1.87 Radio listenership: Women 2.43 2.89 2.36 1.48 1.12 1.54 Men 4.45 4.37 3.61 2.31 1.05 2.44 Television viewership: Women 0.77 0.69 1.18 2.70 1.57 1.38 Men 0.77 0.69 1.18 2.70 1.57 1.38 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 1.27 0.71 0.63 0.64 0.36 0.37 Men 1.86 1.44 0.75 0.60 0.83 0.64 Knowledge about mother-to-child transmission of HIV/AIDS: Women 2.77 2.31 1.85 1.55 0.82 1.20 Men 5.27 4.02 3.49 2.29 1.38 1.83 Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na Can seek children's health care na na na na na na Can make daily household purchases na na na na na na Can make large household purchases na na na na na na Can make meal-related decisions na na na na na na Freedom of movement: Can travel to visit family/relatives na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na Can decide whether to have sex na na na na na na Justifies domestic violence na na na na na na E. Orphanhood Paternal orphan prevalence 0.91 0.70 0.90 0.94 0.93 0.45 Maternal orphan prevalence 0.81 0.71 0.65 0.66 0.68 0.33 Double orphan prevalence 0.26 0.24 0.32 0.37 0.46 0.16 - 91 - Haiti 1994 / 95 - 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 0.348 0.476 0.0% 0.1% 5.3% 51.7% 98.1% 31.0% 0.15525 Has radio 0.417 0.493 0.4% 18.6% 35.1% 58.7% 96.6% 42.3% 0.12659 Has television 0.186 0.389 0.0% 0.0% 0.1% 7.6% 84.3% 18.4% 0.14172 Has refrigerator 0.092 0.289 0.0% 0.0% 0.0% 0.7% 45.8% 9.3% 0.11792 Has bicycle 0.099 0.298 0.2% 2.8% 8.7% 20.6% 20.7% 10.7% 0.04909 Has motorcycle 0.011 0.102 0.0% 0.0% 0.4% 1.7% 4.1% 1.2% 0.02224 Has car 0.036 0.187 0.0% 0.0% 0.0% 0.2% 17.6% 3.6% 0.08268 Works own or family's agric. land 0.216 0.412 60.3% 40.9% 29.5% 10.6% 3.7% 28.5% -0.07364 Uses water piped into residence for drinking 0.134 0.341 0.0% 0.0% 1.8% 10.4% 48.2% 12.1% 0.10159 Uses water from public tap for drinking 0.245 0.430 1.8% 28.3% 38.5% 36.6% 10.9% 23.9% -0.00905 Uses water from inside well for drinking 0.035 0.185 0.0% 2.7% 5.0% 5.5% 2.6% 3.2% 0.00445 Uses water from river, canal or surface for drinking 0.364 0.481 96.6% 58.8% 39.1% 12.8% 1.5% 40.8% -0.11679 Uses rain water for drinking 0.008 0.090 1.4% 1.1% 0.8% 0.4% 0.6% 0.9% -0.00616 Uses water from a public well for drinking 0.066 0.248 0.2% 7.5% 10.9% 9.6% 3.6% 6.5% -0.00245 Uses water from a vendor for drinking 0.109 0.311 0.0% 1.0% 2.9% 20.4% 21.8% 9.2% 0.05372 Uses water from a tanker truck for drinking 0.012 0.111 0.0% 0.0% 0.0% 0.6% 5.5% 1.2% 0.03786 Uses bottled water for drinking 0.004 0.059 0.0% 0.0% 0.0% 0.0% 1.5% 0.3% 0.03053 Uses water from other source for drinking 0.023 0.151 0.0% 0.5% 1.1% 3.7% 3.8% 1.8% 0.02076 Uses own flush toilet 0.041 0.198 0.0% 0.0% 0.0% 0.0% 19.7% 3.9% 0.08622 Uses shared flush toilet 0.007 0.082 0.0% 0.0% 0.0% 1.0% 1.8% 0.6% 0.01517 Uses own VIP latrine 0.215 0.411 0.0% 7.5% 25.0% 39.4% 45.1% 23.6% 0.06066 Uses a shared VIP latrine 0.247 0.431 0.0% 3.5% 18.5% 44.0% 30.8% 19.4% 0.06076 Uses a shared traditional pit latrine 0.035 0.183 0.3% 4.0% 4.6% 3.9% 1.6% 2.9% -0.00172 Uses bush,field as latrine 0.397 0.489 99.7% 75.4% 35.6% 5.4% 0.2% 42.7% -0.13469 Uses other type of latrine 0.004 0.061 0.0% 0.2% 0.5% 0.4% 0.2% 0.3% 0.00283 Has sand as principal floor material in dwelling 0.439 0.496 100.0% 93.3% 38.5% 5.3% 1.1% 47.5% -0.14371 Has wood, plank as principal floor material in dwelling 0.007 0.084 0.0% 0.5% 0.6% 0.8% 0.9% 0.6% 0.00580 Has cement as principal floor material in dwelling 0.492 0.500 0.0% 6.2% 59.5% 92.2% 71.9% 46.1% 0.09913 Has tile as principal floor material in dwelling 0.059 0.236 0.0% 0.0% 1.0% 1.5% 25.5% 5.6% 0.08877 Has other type of floor material in dwelling 0.001 0.029 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.00524 Has parquet or polished wood as principal floor material in dw 0.002 0.041 0.0% 0.0% 0.4% 0.0% 0.5% 0.2% 0.00539 Number of members per sleeping room 2.877 1.803 4.3 3.2 3.2 3.4 3.0 3.4 -0.02553 - 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 - Haiti 2000 - ASSET QUESTIONNAIRE Question Score if Score if Item "Yes" "No" Score 1. In your household, is/are there? Electricity 0.19199 -0.06901 Electricity from EDH 0.19375 -0.06697 Electricity from other source 0.25769 -0.00545 One or more radios 0.08343 -0.06928 One or more televisions 0.23313 -0.04471 One or more refrigerators 0.28269 -0.02366 One or more bicycles 0.07974 -0.01487 One or more motorcycles 0.17216 -0.00279 One or more cars 0.30715 -0.00991 One or more telephones 0.33039 -0.01177 One or more furnaces -0.00025 0.01054 One or more beds 0.00376 -0.09470 One or more horses, mules -0.06057 0.01105 2. Do the members of your household work their own or family's agricultural land? -0.10148 0.01218 3. What is the principal source of drinking water for your household? Piped water in residence 0.18667 -0.02196 Piped water in public faucet 0.04803 -0.02711 Covered well in residence 0.06334 -0.00075 Open well in residence 0.01375 -0.00020 Public covered well 0.00008 0.00000 Public open well 0.00650 -0.00020 River, canal, surface water -0.10578 0.06799 Protected surface water -0.10989 0.00861 Rainwater -0.05260 0.00080 Tanker truck 0.14816 -0.00040 Bottled water 0.31486 -0.00271 Vendor truck 0.14644 -0.00097 4. What is the principal type of fuel for cooking used by your household? Electricity 0.13521 -0.00004 Gas 0.31872 -0.00339 Biogas 0.31296 -0.00247 Kerosene 0.23711 -0.00222 Charcoal 0.11760 -0.07313 Wood -0.09432 0.12609 Other 0.05232 -0.00083 5. What is the principal type of toilet facility used by your household? Private flush toilet in residence 0.33017 -0.00927 Shared flush toilet in residence 0.24480 -0.00072 Private VIP latrine 0.04716 -0.01142 Shared VIP latrine 0.09657 -0.02316 Pit latrine -0.04141 0.00370 Shared pit latrine 0.04120 -0.00387 Bush, field as latrine -0.09142 0.06438 - 103 - Haiti 2000 - ASSET QUESTIONNAIRE (Cont.) Question Score if Score if Item "Yes" "No" Score 6. What is the principal material used for the floors in your household? Dirt, sand, dung -0.09460 0.08959 Cement 0.07856 -0.07056 Wood plank -0.02841 0.00025 Parquet, polished wood -0.07652 0.00004 Tiles 0.30270 -0.00943 Other -0.03460 0.00001 7. What type of tenant is your household? Owns dwelling -0.04131 0.11955 Rents dwelling 0.14726 -0.03658 Work-provided dwelling 0.13054 -0.00018 Free lodging 0.02204 -0.00131 Total Household Asset Score (sum of individual item scores) 2000 - QUINTILE CUT-OFF POINTS Asset Index Value Wealth Quintile Bottom Cut-Off Top Cut-Off Low Low -0.83131 Second -0.83131 -0.51207 Third -0.51207 0.09925 Fourth 0.09925 1.22483 High 1.22483 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 -