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©Bangladesh Bureau of Statistics (BBS) and United Nations Children’s Fund (UNICEF) March, 2017

All UNICEF materials are protected by copyright, including text, photographs, images and videotapes.

Permission is required to reproduce any part of this publication. Permission will be freely granted to educational or non-profit organizations. Please contact:

Bangladesh Bureau of Statistics (BBS)Statistics and Informatics Division, Ministry of PlanningGovernment of the People’s Republic of BangladeshDhaka, Bangladeshwww.bbs.gov.bd

Social Policy, Evaluation, Analytics and Research Section (SPEAR)United Nations Children’s Fund (UNICEF)BSL Office Complex1, Minto Road, Dhaka-1000, Bangladesh

Telephone: (880-2) 55668088Email: [email protected]

Child Well-Being Survey 2016 (CWS 2016) was conducted to measure the level of child well-being in urban areas of Bangladesh in terms of nutrition, health, education, protection and access to water and sanitation.

As consequence of rapid urbanization, urban cities are experiencing extreme pressure on housing, growth of slums and pressure on urban services. It is known that one-third of the City Corporations’ population lives in slums, which are areas of dense concentration of people and of conditions that affect health negatively. It is, therefore, of a great concern to know the situation of urban children and their mothers, especially those living in slums. To understand the situation of children and women in urban context Bangladesh Bureau of Statistics (BBS) with support from UNICEF, commissioned this CWS 2016. Associates for Community and Population Research (ACPR) implemented the survey.

Results presented in this report are not expected to change and are considered final unless otherwise mentioned. For electronic copy of the report please go to bbs.gov.bd and unicef.org/Bangladesh.

Suggested citation:Child Well-Being Survey 2016, Final Report.Bangladesh Bureau of Statistics and UNICEF Bangladesh 2016, Dhaka, Bangladesh

ISBN: 978-984-8969-26-7

Cover photo: ©UNICEF/BANA2015/Kiron

Design and Layout: Expressions Ltd

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CHILD WELL-BEING SURVEYIN URBAN AREAS OF BANGLADESH

2016Final Report

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Summary Table of Survey Implementation and the Survey PopulationChild Well-Being Survey in Urban Areas of Bangladesh

SURVEY IMPLEMENTATION

Sample frame Population and Housing Census, 2011, and Slum Census 2013

Questionnaires HouseholdWomen (age 15-49)Children under five

Interviewer training January 21 – February 3, 2016 Fieldwork February – April 2016

Survey sample

HouseholdsSampledOccupiedInterviewedResponse rate (Per cent)

20,13419,18718,887

98.4

Children under fiveEligibleMothers/caretakers interviewedResponse rate (Per cent)

7,7367,52197.2

WomenEligible for interviewsInterviewedResponse rate (Per cent)

20, 63219, 632

95.2

Strata/domainsAll urban

City Corporation SlumCity Corporation Non-slumOther Municipalities/Urban areas

19577

SURVEY POPULATION

Average household sizeAll urban

Percentage of population under:All urban

Age 5 Age 18

Percentage of women age 15-49 years with at least one live birth in the last 2 years

All UrbanCity Corporation SlumCity Corporation Non-slumOther Municipalities/Urban

4.3

9.335.6

14.715.713.615.1

Percentage of population with source of livelihood

All UrbanSelf-employmentManufacturing sectorService sectorRemittanceFrom rentOther

Proportion of household having at least one member employed in garment sector

All UrbanCity Corporation SlumCity Corporation Non-SlumOther Municipalities/Urban

38.211.142.36.02.00.3

8.627.29.57.0

HOUSING CHARACTERISTICS HOUSEHOLD OR PERSONAL ASSETS

Percentage of households withElectricityFinished floorFinished roofingFinished walls

Mean number of persons per room used for sleepingAll UrbanCity Corporation SlumCity Corporation Non-slumOther Municipalities/Urban

95.272.799.564.8

2.53.32.72.4

Percentage of households that own A televisionA refrigeratorElectric fan Almirah / WardrobeAgricultural landFarm animals/livestockPercentage of households where at least a member has or owns aWatchMobile phoneBicycleComputer Car or truck

72.245.292.558.432.426.9

42.597.420.711.41.2

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Summary Table of Findings1

Child Well-Being Survey in Urban Areas of Bangladesh 2016

Serial number Indicators Description

Area

All

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NUTRITION

1a. Underweight prevalence (Moderate and severe)

Percentage of children under age 5 who fall below minus two standard deviation of the median weight for age (moderate and severe, WHO standard)

20.4 30.8 17.7 20.9

1b. Underweight prevalence (Severe)

Percentage of children under age 5 who fall below minus three standard deviations (severe) of the median weight for age of the WHO standard

4.0 7.9 2.7 4.3

2a. Stunting prevalence (Moderate and severe)

Percentage of children under age 5 who fall below minus two standard deviation of the median height for age (moderate and severe, WHO standard)

26.3 40.4 25.2 25.9

2b. Stunting prevalence (Severe)

Percentage of children under age 5 who fall below minus three standard deviations (severe) of the median height for age of the WHO standard

7.8 15.4 7.3 7.5

3a. Wasting prevalence (Moderate and severe)

Percentage of children under age 5 who fall below minus two standard deviation of the median weight for height (moderate and severe, WHO standard)

9.9 11.6 7.3 11.0

3b. Wasting prevalence (Severe)

Percentage of children under age 5 who fall below minus three standard deviations (severe) of the median weight for height of the WHO standard

2.2 2.1 2.1 2.3

1 See Appendix B for a detailed description of indicators

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4 Overweight prevalence (+2SD)

Percentage of children under age 5 who fall equal or above plus two standard deviation of the median weight for height of the WHO standard

2.7 2.7 4.1 2.1

5 Children ever breastfed Percentage of women with a live birth in the last 2 years who breastfed their last live-born child at any time

98.2 97.8 97.2 98.7

6 Early initiation of breastfeeding

Percentage of women with a live birth in the last 2 years who put their last new-born to the breast within one hour of birth

63.3 66.9 58.2 65.2

7 Exclusive breastfeeding under 6 months

Percentage of infants under 6 months of age who are exclusively breastfeeding

52.7 62.3 57.5 50.0

8 Predominant breastfeeding under 6 months

Percentage of infants under 6 months of age who received breast milk as the predominant source of nourishment during the previous day (plain water & non-milk liquids)

72.5 83.0 72.0 72.1

9 Continued breastfeeding at 1 year

Percentage of children age 12-15 months who received breast milk during the previous day

96.9 92.3 98.7 96.4

10 Continued breastfeeding at 2 years

Percentage of children age 20-23 months who received breast milk during the previous day

87.0 90.7 80.3 89.7

11 Age appropriate breastfeeding

Percentage of children age 0-23 months appropriately fed during the previous day (exclusive breastfeeding 0-5 months, currently breastfeeding and solid/semisolids or soft foods for 6-23 months)

60.3 60.2 59.8 60.5

12 Introduction of solid, semi-solid or soft foods (6-8 months)

Percentage of infants age 6-8 months who received solid, semi-solid or soft foods during the previous day

75.7 75.1 68.1 78.4

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13 Milk feeding frequency for non-breastfed children (6-23 months)

Milk feeding frequency for non-breastfed children (6-23 months) during the previous day

2.9 2.7 2.5 3.1

14 Minimum meal frequency (6-23 months)

Percentage of children age 6-23 months who received appropriate liquids and solid, semisolids or soft foods the minimum number of times or more during the previous day

72.2 64.5 76.2 71.0

15 Minimum dietary diversity (6-23 months)

Percentage of children age 6-23 months who received from food 4 or more groups among 7 food groups during the previous day

45.1 34.9 51.6 43.0

16 Minimum acceptable diet (6-23 months)

Percentage of children age 6-23 months with minimum dietary diversity and minimum meal frequency (breastfed children) and minimum dietary diversity (excluding milk feeds and minimum meal frequency (Non-breastfed children))

38.0 29.7 44.4 36.0

17 Bottle feeding Percentage of children age 0-23 months who were fed with a bottle during the previous day

21.4 20.6 26.3 19.4

18 Low-birth weight infants Percentage of most recent live births in the last 2 years weighing below 2,500 grams at birth

13.7 15.8 11.1 15.1

19 Infants weighed at birth Percentage of most recent live births in the last 2 years who were weighed at birth

64.6 60.5 78.7 59.0

CHILD HEALTH

1 Neonatal tetanus protection

Percentage of women age 15-49 years with a live birth in the last 2 years who received at least two doses of tetanus toxoid vaccine during last pregnancy; 2 doses the last within prior 3 years; 3 doses the last within prior 5 years; 4 doses the last within prior 10 years; or 5 doses during lifetime

86.8 83.4 83.6 88.3

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2 Episode of diarrhea Percentage of children under age 5 with diarrhoea in the last 2 weeks who had an episode of diarrhoea

6.1 9.2 5.9 6.0

3 Diarrhea treatment with oral rehydration therapy (ORT) and continued feeding (0-59 months)

Percentage of children under age 5 with diarrhoea in the last 2 weeks who received ORT (ORS packet, pre-packaged ORS fluid, recommended homemade fluid or increased fluids) and continued feeding during the episode of diarrhoea

70.0 60.9 72.8 69.6

4 Children with ARI symptoms

Percentage of children under age 5 with ARI symptoms in the last 2 weeks

7.1 7.5 6.7 7.2

5 Care-seeking for children with ARI symptoms

Percentage of children under age 5 with ARI symptoms in the last 2 weeks for whom advice or treatment was sought from a health facility or provider

81.2 78.5 79.4 82.1

6 Antibiotic treatment for children with ARI symptoms

Percentage of children under age 5 with ARI symptoms in the last 2 weeks who received antibiotics

80.7 76.8 79.2 81.5

7 Use of solid fuels for cooking

Percentage of household members using solid fuels for cooking (wood, charcoal, agricultural crop residue, straw/shrubs/grass, animals dug etc.)

48.6 44.5 15.2 64.3

8 Measles immunization coverage (MR)

Percentage of children age 12-23 months who received the coverage of measles immunization

89.7 76.3 92.6 89.3

9 Full immunization coverage

Percentage of children age 12-23 months who received the coverage of full immunization

88.0 72.1 92.1 87.3

REPRODUCTIVE HEALTH

1 Adolescent birth Percentage of women age 15-19 years who have had a live birth

13.3 29.9 10.4 13.4

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2 Early childbearing Percentage of women age 20-24 years who have had at least one live birth before age 18 years

22.9 31.9 17.1 24.9

3 Contraceptive prevalence rate

Percentage of currently married women age 15-49 years who are using (or whose partner is using) a modern or traditional contraceptive method

67.3 73.8 66.6 67.2

4 Unmet need Percentage of women age 15-49 years who are currently married or in union who are fecund and want to space their births or limit the number of children they have and who are not currently using contraception

7.8 5.9 7.8 7.9

5 Antenatal care coverage: At least once by skilled health personnel

Percentage of women age 15-49 years with a live birth in the last 2 years who received during their last pregnancy at least one check up by skilled health personnel

81.1 67.7 84.1 80.7

6 Antenatal care coverage: At least four times by any provider

Percentage of women age 15-49 years with a live birth in the last 2 years who received during their last pregnancy at least four check up by any provider

45.9 35.8 60.8 40.4

7 Content of antenatal care Percentage of women age 15-49 years with a live birth in the last 2 years who received during their last pregnancy antenatal care with BP measured, Urine and Blood sample taken

62.9 52.2 76.8 57.9

8 Skilled attendant at delivery

Percentage of women age 15-49 years with a live birth in the last 2 years who were attended by skilled health personnel during their most recent live birth

64.2 55.5 73.4 60.9

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9 Institutional deliveries Percentage of women age 15-49 years with a live birth in the last 2 years whose most recent live birth was delivered in a health facility

62.0 57.1 75.5 56.7

10 Caesarean section Percentage of women age 15-49 years whose most recent live birth in the last 2 years was delivered by caesarean section

39.9 23.9 46.6 38.1

11 Post-partum stay in health facility (12 hour or more)

Percentage of women age 15-49 years who stayed in the health facility for 12 hours or more after the delivery of their most recent live birth in the last 2 years

84.4 70.9 83.3 86.0

12 Post-natal health check for the newborn within 2 days

Percentage of last live births in the last 2 years who received a health check while in facility or at home following delivery, or a post-natal care visit within 2 days after delivery

79.9 64.8 83.9 79.2

13 Post-natal health check for the mother within 2 days

Percentage of women age 15-49 years who received a health check while in facility or at home following delivery, or a post-natal care visit within 2 days after delivery of their most recent live birth in the last 2 years

77.5 61.4 80.3 77.4

WATER AND SANITATION

1 Use of improved drinking water sources

Percentage of household members using improved sources of drinking water

99.2 98.0 99.0 99.3

2 Water treatment Percentage of household members in households using unimproved drinking water who use an appropriate treatment method

39.7 25.9 25.6 51.4

3 Use of improved sanitation

Percentage of household members using improved sanitation facilities which are not shared

57.3 18.9 51.3 62.4

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4 Safe disposal of child’s faces

Percentage of children age 0-2 years whose last stools were disposed off safely

66.2 58.0 81.9 60.2

5 Place for handwashing Percentage of households with a specific place for handwashing

91.9 88.2 92.2 92.0

6 Availability of soap or other cleansing agent

Percentage of households having specific place for handwashing with soap or other cleansing agent

55.4 35.4 67.1 51.1

LITERACY AND EDUCATION

1 Attendance to early childhood education

Percentage of children age 36-59 months who are attending an early childhood education programme

26.2 23.8 30.4 24.2

2 Literacy rate Percentage of women aged 15-24 who are literate

82.6 59.0 83.7 83.8

3 School readiness Percentage of children in first grade of primary school regardless of age who attended pre-school during the previous school year

68.0 56.1 59.1 72.7

4 Net intake rate in primary education

Percentage of children of school-entry age who enter the first grade of primary school

62.2 40.5 66.9 61.5

5 Primary school net attendance ratio (adjusted)

Percentage of children of primary school age currently attending primary or secondary school

85.5 69.4 85.0 86.8

6 Secondary school net attendance ratio (adjusted)

Percentage of children of secondary school age currently attending secondary school or higher

63.1 33.3 62.0 65.3

7 Children reaching last grade of primary

Percentage of children entering the first grade of primary school who eventually reach last grade

94.7 82.6 92.4 96.3

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8 Primary completion rate Percentage of primary school completion age (age appropriate to final grade of primary school) who were attending the last grade of primary school (excluding repeaters)

87.5 73.1 77.4 92.8

9 Transition rate to secondary school

Percentage of children attending the last grade of primary school during the previous school year who are in the first grade of secondary school during the current school year

97.2 92.5 98.5 96.8

10 Gender parity index (GPI) – Primary Education

Ratio of female to male attending primary school

1.05 1.01 1.05 1.06

11 Gender parity index (GPI) – Secondary Education

Ratio of female to male attending secondary school

1.18 1.14 1.22 1.17

PROTECTION

1 Birth registration Percentage of children under age 5 whose births are reported registered

29.3 32.9 33.2 27.2

2 Violent discipline (1-14 years)

Percentage of children age 1-14 years who experienced psychological aggression or physical punishment during the last one month

82.4 84.9 81.9 82.5

3 Child labour (5-14 years) Percentage of children age 5-11 years who are involved more than 1 hour per week and more than 14 hours for 12-14 years in economic activities and more than 28 hours in household chores for both groups

8.1 14.3 7.0 8.2

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4 Child labour (5-17 years) Percentage of children age 5-11 years who are involved more than 1 hour per week and more than 14 hours for 12-14 years in economic activities and more than 28 hours in household chores for both groups and more than 43 hours for 15-17 years involved in economic activities and household chores

12.5 23.1 12.0 12.6

5 Women 15-49, marrying before age 15

Percentage of women age 15-49 years who were first married or in union before age 15

22.5 28.1 20.0 23.4

6 Women 20-49, marrying before age 18

Percentage of women age 20-49 years who were first married or in union before age 18

59.7 66.4 53.3 62.3

7 Young women age 15-19 years currently married or in union

Percentage of young women age 15-19 years who are married or in union

32.9 34.8 32.9 32.7

8 Polygyny Percentage of young women age 15-49 years who are in a polygynous union

2.8 4.4 2.4 3.0

9 Children’s living with neither biological parent (0-17 yrs)

Percentage of children age 0-17 years living with neither biological parent

4.7 4.4 4.4 4.9

10 Children with one or both parents dead (0-17 yrs)

Percentage of children age 0-17 years with one or both parents dead

4.1 6.2 4.8 3.7

11 Children with at least one parent living abroad (0-17 yrs)

Percentage of children age 0-17 years with at least one parent living abroad

4.9 1.1 3.1 5.9

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Summary Table of Survey Implementation and the Survey Population ...................... iii

Summary Table of Findings ............................................................................................................................. iv

List of Tables ............................................................................................................................................................. xvi

List of Figures ............................................................................................................................................................. xviii

List of Abbreviations .............................................................................................................................................. xx

Messages ........................................................................................................................................................... xxi

Foreword ............................................................................................................................................................. xxiv

Executive Summary ............................................................................................................................................... 1

Chapter 1 Introduction and Methodology ................................................................................. 8

1.1 Background ................................................................................................................................................... 8

1.2 Survey Objectives ................................................................................................................................. 9

1.3 Sample Design .......................................................................................................................................... 9

1.4 Survey Implementation .................................................................................................................. 11

1.4.1 Questionnaires .................................................................................................................... 11

1.4.2 Training, Fieldwork and Data Processing ............................................. 12

1.5 Survey Sample and Response Rates .............................................................................. 12

1.6 Challenges Faced ................................................................................................................................... 14

Chapter 2 Household Population and Housing Characteristics .................................. 16

2.1 Characteristics of Household Population ................................................................... 16

2.1.1 Age and Sex Composition ..................................................................................... 16

2.1.2 Household Composition .......................................................................................... 18

2.2 Background Characteristics of Women and Under Five Children ..... 19

2.3 Housing Characteristics .................................................................................................................. 22

2.4 Household and Personal Assets ........................................................................................... 25

2.5 Socio-Economic Index: Wealth Quintiles ................................................................... 27

2.6 Livelihood Status and Employment in Garments Sector ........................ 28

Chapter 3 Nutritional Status of Children and Infant Feeding ...................................... 32

3.1 Child’s Weight and Size at Birth ........................................................................................... 33

3.2 Nutritional Status of Children .................................................................................................. 35

3.3 Breastfeeding ............................................................................................................................................. 38

3.3.1 Initial Breastfeeding ...................................................................................................... 38

3.3.2 Exclusive and Continued Breastfeeding ................................................ 40

3.3.3 Age-Appropriate Breastfeeding ....................................................................... 42

3.4 Introduction of Solid, Semi-Solid or Soft Food ................................................... 43

TABLE OF CONTENTSTA

BLE

OF C

ONTE

NTS

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3.5 Infant and Young Child Feeding (IYCF) Practices ............................................. 44

3.5.1 Minimum Dietary Diversity ................................................................................... 46

3.5.2 Minimum Meal Frequency .................................................................................... 47

3.5.3 Minimum Acceptable Diet ..................................................................................... 47

3.5.4 Bottle Feeding ...................................................................................................................... 48

Chapter 4 Child Heath ............................................................................................................................ 50

4.1 Childhood Vaccination ..................................................................................................................... 51

4.1.1 Vaccination Coverage ................................................................................................. 51

4.1.2 Differentials in Vaccination Coverage ...................................................... 53

4.2 Neonatal Tetanus Protection .................................................................................................... 54

4.3 Childhood Illness and Treatment ........................................................................................ 56

4.3.1 Childhood Diarrhoea .................................................................................................... 58

4.3.2 Treatment of Childhood Diarrhoea .............................................................. 59

4.3.3 Feeding Practices during Diarrhoea ........................................................... 61

4.3.4 Acute Respiratory Infection (ARI) .................................................................. 63

4.4 Solid Fuel Use ............................................................................................................................................ 67

Chapter 5 Reproductive Health ........................................................................................................ 70

5.1 Fertility Rates .............................................................................................................................................. 71

5.1.1 Age at First Marriage ................................................................................................... 71

5.1.2 Age at First Birth ............................................................................................................... 73

5.2 Early Childbearing and Adolescent Birth Rate ..................................................... 73

5.3 Contraception ............................................................................................................................................. 77

5.4 Unmet Need ................................................................................................................................................. 77

5.5 Antenatal Care ........................................................................................................................................... 80

5.5.1 Antenatal Care Coverage ........................................................................................ 81

5.5.2 Number of Antenatal Care Visits .................................................................... 83

5.5.3 Component of Antenatal Care ........................................................................... 83

5.6 Delivery Care ............................................................................................................................................... 85

5.6.1 Assistance during Delivery ................................................................................... 85

5.6.2 Place of Delivery ................................................................................................................ 88

5.7 Postnatal Care ............................................................................................................................................ 88

5.7.1 Postpartum Stay in Health Facility ............................................................... 88

5.7.2 Postnatal Checkup for Newborn ..................................................................... 90

5.7.3 Postnatal Checkup for Mothers ........................................................................ 94

5.7.4 Postnatal Health Checks for Mothers and Newborns ............. 98

Chapter 6 Water and Sanitation ...................................................................................................... 100

6.1 Use of Improved Water Sources .......................................................................................... 100

6.2 Use of Improved Sanitation ....................................................................................................... 104

6.3 Disposal of Child’s Faeces ........................................................................................................... 108

6.4 Handwashing Practices ................................................................................................................... 110TABL

E O

F CO

NTE

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Chapter 7 Child Development, Literacy and Education ................................................... 114

7.1 Attendance in Early Childhood Education ................................................................ 115

7.2 Literacy among Young Women ............................................................................................ 117

7.3 School Readiness .................................................................................................................................. 118

7.4 Primary and Secondary School Participation ....................................................... 119

7.4.1 Net Intake Rate in Primary School ................................................................ 119

7.4.2 Primary School Net Attendance Ratio ..................................................... 120

7.4.3 Secondary School Net Attendance Ratio ............................................. 122

7.4.4 Children Reaching the Last Grade of Primary School ........... 124

7.4.5 Primary School Completion and Transition to Secondary School ....... 126

7.4.6 Education Gender Parity .......................................................................................... 127

7.4.7 Out of School Gender Parity ............................................................................... 129

Chapter 8 Child Protection .................................................................................................................. 132

8.1 Birth Registration ................................................................................................................................... 133

8.2 Child Discipline ......................................................................................................................................... 135

8.3 Attitude towards Physical Punishment ......................................................................... 136

8.4 Child Labour ................................................................................................................................................ 138

8.4.1 Children’s Involvement in Economic Activities ............................. 139

8.4.2 Children’s Involvement in Household Chores ................................ 141

8.4.3 Total Child Labour ........................................................................................................... 142

8.5 Early Marriage and Polygamy ................................................................................................. 145

8.6 Child’s Living Arrangement and Orphanhood ..................................................... 149

References ................................................................................................................................... 152

Appendix ........................................................................................................................................................ xxv

Appendix A Sample Design and Estimates of Sampling Errors ......................................... xxvi

Appendix B CWS 2016 Indicators: Numerators and Denominators .............................. xli

Appendix C Questionnaires .......................................................................................................................................... xlv

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Table 1.2 Results of household, women’s, and under-5 interviews ................................ 13

Table 1.2a Results of household, women’s, and under-5 interviews by survey areas ...... 14

Table 2.1 Age distribution of household population by sex .................................................... 17

Table 2.2 Household composition .......................................................................................................................... 19

Table 2.3 Background characteristics of women ................................................................................... 20

Table 2.4 Under-5’s background characteristics .................................................................................... 21

Table 2.5 Housing characteristics ........................................................................................................................... 23

Table 2.5a Housing characteristics by CC slum and CC non-slum areas ...................... 24

Table 2.6 Household and personal assets ..................................................................................................... 25

Table 2.6a Housing and personal assets by slum and CC non-slum areas ................ 26

Table 2.7 Socio Economic Status Index (SES): Wealth Quintile .......................................... 28

Table 2.8 Livelihood status ............................................................................................................................................. 29

Table 3.1 Low birth weight infants ........................................................................................................................ 34

Table 3.2 Nutritional status of children ............................................................................................................ 36

Table 3.3 Initial breastfeeding ..................................................................................................................................... 39

Table 3.4 Exclusive and continued breastfeeding ................................................................................ 41

Table 3.5 Age-appropriate breastfeeding ...................................................................................................... 42

Table 3.6 Introduction of solid, semi-solid, or soft foods ............................................................ 43

Table 3.7 Infant and young child feeding (IYCF) practices ......................................................... 45

Table 3.8 Bottle feeding ...................................................................................................................................................... 48

Table 4.1 Vaccinations in the first years of life ........................................................................................ 52

Table 4.2 Vaccination by background characteristics ...................................................................... 53

Table 4.3 Neonatal Tetanus protection ............................................................................................................. 55

Table 4.4 Reported disease episodes ................................................................................................................. 57

Table 4.5 Treatment/care- seeking for diarrhea ...................................................................................... 58

Table 4.6 Feeding practices during diarrhoea .......................................................................................... 59

Table 4.7 Oral rehydration solutions, recommended homemade fluids, and zinc ............ 61

Table 4.8 Oral rehydration therapy with continued feeding and other treatments ........... 63

Table 4.9 Care-seeking for ARI ................................................................................................................................... 65

Table 4.10 Care seeking for ARI/ suspected pneumonia and antibiotic use during suspected pneumonia (ARI) ........................................................................................... 66

Table 4.11 Solid fuel use ....................................................................................................................................................... 67

Table 4.12 Solid fuel use by place of cooking .............................................................................................. 68

Table 5.1 Age at first marriage and age at first child birth ......................................................... 71

Table 5.2 Early childbearing .......................................................................................................................................... 72

Table 5.3 Trends in early childbearing .............................................................................................................. 75

Table 5.4 Use of contraception .................................................................................................................................. 76

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Table 5.6 Antenatal care coverage ......................................................................................................................... 80

Table 5.7 Number of antenatal care visits and timing of first visit ................................... 81

Table 5.8 Content of antenatal care ...................................................................................................................... 84

Table 5.9 Assistance during delivery and caesarian section ................................................... 85

Table 5.10 Place of delivery ............................................................................................................................................... 87

Table 5.11 Post-partum stay in health facility .............................................................................................. 89

Table 5.12 Post-natal health checks for newborns ................................................................................. 91

Table 5.13 Post-natal care visits for newborns within one week of birth ..................... 93

Table 5.14 Post-natal health checks for mothers ...................................................................................... 94

Table 5.15 Post-natal care visits for mothers within one week of birth .......................... 96

Table 5.16 Post-natal health checks for mothers and newborns ............................................ 97

Table 6.1 Use of improved water sources ..................................................................................................... 101

Table 6.2 Household water treatment ................................................................................................................ 103

Table 6.3 Types of sanitation facilities .............................................................................................................. 104

Table 6.4 Use and sharing of sanitation facilities ................................................................................. 105

Table 6.5 Drinking water and sanitation ladders ................................................................................... 106

Table 6.6 Disposal of child’s faeces ...................................................................................................................... 109

Table 6.7 Water and soap at place for handwashing ....................................................................... 111

Table 6.8 Availability of soap or other cleansing agent ................................................................ 112

Table 7.1 Attendance to Early Childhood Education ......................................................................... 116

Table 7.2 Literacy rate among young women .......................................................................................... 117

Table 7.3 School readiness ............................................................................................................................................. 118

Table 7.4 Net intake rate in primary education ....................................................................................... 120

Table 7.5 Primary school attendance and out of school children ...................................... 121

Table 7.6 Secondary school attendance and out of school children .............................. 122

Table 7.7 Children reaching last grade of primary school .......................................................... 125

Table 7.8 Primary school completion and transition to secondary school ............. 127

Table 7.9 Education gender parity ......................................................................................................................... 128

Table 7.10 Out of school gender parity ................................................................................................................ 129

Table 8.1 Birth registration ............................................................................................................................................. 133

Table 8.2 Child discipline .................................................................................................................................................. 135

Table 8.3 Attitudes toward physical punishment ................................................................................. 137

Table 8.4 Children’s involvement in economic activities ............................................................. 140

Table 8.5 Children’s involvement in household chores ................................................................ 141

Table 8.6 Child labour (5-17 years) ........................................................................................................................ 142

Table 8.6a Child labour (5-14 years) ........................................................................................................................ 144

Table 8.7 Early marriage and polygyny (women) ................................................................................ 145

Table 8.8 Trends in early marriage (women) ............................................................................................. 148

Table 8.9 Children’s living arrangements and orphanhood ..................................................... 149

Table 8.10 Children with parents living abroad ......................................................................................... 150

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Figure 2.1 Age distribution of household population, CWS 2016 ........................................ 18

Figure 2.2 Socio-economic status by areas, CWS 2016 ................................................................... 27

Figure 2.3 Proportion of households with one or more members employed in Garments Sector by divisions, CWS 2016 .................................................................. 30

Figure 3.1 Nutritional status by areas, CWS 2016 .................................................................................. 37

Figure 3.2 Underweight, stunted, wasted and overweight children under age 5 (moderate and severe), Bangladesh, CWS 2016 ....................................... 37

Figure 3.3 Initiation of breasfeeding within one day of birth by areas, CWS 2016 .............. 39

Figure 3.4 Percentage fed according to minimum standard of acceptable feeding practices, CWS 2016 ............................................................................................................. 46

Figure 3.5 IYCF Indicators on breastfeeding status, CWS 2016 .............................................. 47

Figure 4.1 Full vaccination coverage by areas, CWS 2016 ........................................................... 52

Figure 4.2 Vaccination coverage by division, CWS 2016 ................................................................ 53

Figure 4.3 Percentage of women age 15-49 years with a live birth in the last 2 years protected against tetanus by background characteristics, CWS 2016 .................. 56

Figure 4.4 Percentage of children under 5 with diarrhoea who received oral rehydration therapy (ORT) and continued feeding, CWS 2016 ................. 63

Figure 5.1 Trend in early childbearing before age 18, CWS 2016 ........................................ 74

Figure 5.2 Women age 15-49 years currently married with unmet need for contraception by age, CWS 2016 ................................................................................................. 79

Figure 5.3 ANC by skilled provider by areas, CWS 2016 ................................................................ 82

Figure 5.4 ANC received 4 or more visits by areas, CWS 2016 ............................................... 83

Figure 5.5 Person assisted at delivery, CWS 2016 ................................................................................. 86

Figure 5.6 Place of delivery by areas, CWS 2016 ..................................................................................... 88

Figure 5.7 Post natal health checks for the newborn by areas, CWS 2016 ................ 90

Figure 5.8 Post natal checks for the mother by areas, CWS 2016 ........................................ 95

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Figure 6.1 Percentage of using improve source of drinking water by areas, CWS 2016 ........ 102

Figure 6.2 Water treatment method used in the household, CWS 2016 ...................... 102

Figure 6.3 Percentage of users of improved sanitation facilities (not shared) by areas, CWS 2016 ................................................................................................. 105

Figure 6.4 Use of improved drinking water sources and improved sanitation by division, CWS 2016 .............................................................................................................................. 108

Figure 6.5 Percentage of children whose last stools were disposed of safely by areas, CWS 2016 ........................................................................................................... 108

Figure 6.6 Percentage of households with a specific place for handwashing where water and soap or other cleansing agent are present, CWS 2016 .......... 110

Figure 7.1 Percentage of children age 36-59 months attending early childhood education, CWS 2016 ................................................................................................................................. 115

Figure 7.2 School readiness by areas, CWS 2016 ................................................................................... 118

Figure 7.3 Primary and Secondary School Net Attendance Ratio (adjusted) by areas, CWS 2016 ....................................................................................... 124

Figure 7.4 Primary school completion and transition to secondary school by areas, CWS 2016 ................................................................................................................. 126

Figure 7.5 Out of School Gender Parity by areas, CWS 2016 .................................................... 129

Figure 8.1 Percentage of children under age five whose births are registered, CWS 2016 ..... 134

Figure 8.2 Percentage of child disciplining methods by areas, CWS 2016 ................ 136

Figure 8.3 Percentage of respondents to the child discipline module who believe that physical punishment is needed by division, CWS 2016 ...................... 137

Figure 8.4 Percentage engaged in child labour by areas, CWS 2016 ............................... 144

Figure 8.5 Early marriage before age 15 among women age 15-49, and 15-19 by areas, CWS 2016 .................................................................................................................... 147

Figure 8.6 Early marriage before age 18 among women age 20-49 by areas, CWS 2016 ........ 147

Figure 8.7 Trend in early marriage (before age 18) by age group, CWS 2016 ....... 148

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ACPR Associates for Community and Population Research

AIDS Acquired Immune Deficiency Syndrome

ANC Antenatal Care

ARI Acute Respiratory Infection

BBS Bangladesh Bureau of Statistics

BCG Bacille Calmetto-Guerin

BDHS Bangladesh Demographic and Health Survey

CC City Corporation

CPR Contraceptive Prevalence Rate

CSPro Census and Survey Processing System

CWS Child Well-being Survey

DPT Diphtheria, Pertussis, and Tetanus Vaccine

ECE Early Childhood Education

ECCE Early Childhood Care and Education

EPI Expanded Program on Immunization

FP Family Planning

GPI Gender Parity Index

HIV Human Immunodeficiency Virus

HPNSDP Health, Population and Nutrition Sector Development Programme

IUD Intrauterine Device

IYCF Infant and Young Child Feeding

LAM Lactational Amenorrhea Method

MDG Millennium Development Goals

MICS Multiple Indicator Cluster Survey

MR Measles-Rubella

MSD Measles Second Dose

NAR Net Attendance Ratio

OPV Oral Polio Vaccine

ORS Oral Rehydration Salt

ORT Oral Rehydration Therapy

PNC Postnatal Care

PSCR Primary School Completion Rate

PSU Primary Sampling Unit

SPSS Statistical Package for Social Sciences

TT Tetanus Toxoid

UHC Bangladesh Urban Health Survey

UNAIDS United Nations Programme on HIV/AIDS

UNDP United Nations Development Programme

UNFPA United Nations Population Fund

UNICEF United Nations Children’s Fund

WHO World Health Organization

LIST OF ABBREVIATIONSLIS

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LIST OF ABBREVIATIONS

It is my pleasure to compliment the Bangladesh Bureau of Statistics (BBS) on issuing the results of the Child Well-being Survey in Urban areas of the country conducted during 2016. I am particularly pleased that the Key findings of this survey was published within the same calendar year of undertaking the field work under the guidance of BBS with UNICEF support.

The survey report provides detailed information and analysis on the situation of children and women of Bangladesh in relation to indicators on health, nutrition, water and sanitation, education and child protection in the urban settings. The report also includes evidence on a wide range of other issues concerning the Well-being of children and women in urban areas in general and in the slum and non-slum areas within the City Corporations of the country.

Therefore, I hope that policy-makers, planners, researchers, development partners and NGOs from all sectors will use the findings to inform the formulation of appropriate strategies for their programmes. The findings of the survey will also contribute to provide baseline information for reporting and monitoring the Sustainable Development Goals (SDGs) of Bangladesh.

I would like to congratulate officials of the Statistice and informatics Division (SID) and BBS on the completion of this important report. My sincere thanks goes to UNICEF Bangladesh for their continuous support at all stages of conducting the survey and publishing the report.

Dhaka, June 2017 AHM Mustafa Kamal, FCA, MP

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MinisterGovernment of the People’s Republic

of BangladeshMinister of Planning

Where you have a dream

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I would like to congratulate the Bangladesh Bureau of Statistics for leading the implementation of the Child Well-being Survey in urban areas of the country (CWS-U 2016), with the support of UNICEF. CWS-U 2016 covers the entire urban area of the country and provides estimates at the national, divisional levels with disaggregation for slum and non-slum areas within the City Corporations of the country.

The report presents the situation of children in Bangladesh in urban settings based on 72 indicators and its findings will provide useful information for setting the baseline for many important indicators for the Sustainable Development Goals (SDGs) and help its monitoring.

The present report is yet another example of the commendable and continued cooperation between BBS and UNICEF since 1994. I thank UNICEF for extending its support to conducting this survey to generate important evidence. I also thank Associates for Communities and Population Research (ACPR), a well-known national survey research agency, for their support in this activity.

My sincere thanks to the Secretary, Statistics and Informatics Division, Ministry of Planning for giving his valuable strategic support and guidance for publishing the report.

I would like to extend my sincere thanks to the Director General of BBS, Project Focal Point of the Monitoring the Situation of Children and Women Project together with the team of BBS officials for issuing this report.

Dhaka, June 2017 M. A. Mannan MP

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State MinisterMinistry of Finance

andMinistry of Planning

Government of the People’s Republic of Bangladesh

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The Bangladesh Bureau of Statistics (BBS) has recently completed the report on the Child Well-being Survey in urban areas of Bangladesh (CWS-U 2016) to provide information on the situation of children and women in the urban settings of the country. The fieldwork for the survey was undertaken during February – April 2016. It involved the collection of information on 72 indicators related to children and women in the urban areas. The report provides baseline estimates for many of the SDG indicators and will be helpful in their monitoring and reporting.

I would like to thank Director General, Bangladesh Bureau of Statistics for taking the lead in this important evidence generation and successfully and publishing the report. The survey also makes special efforts in providing disaggregated estimates for children and women living in slums and non-slum areas of City Corporations in the country. I would like to congratulate BBS on successfully accomplishing this task by the officials associated with Monitoring the Situation of Children and Women (MSCW) Project. I take this opportunity all to thank the Project Focal Point officer and the entire team for providing guidance in undertaking the survey and preparation of the report.

In conclusion, I believe the results of Bangladesh CWS-U 2016 will be useful to policy-makers, researchers, planners and programme implementation managers in understanding and formulating strategies to improve the lives of the children and women in urban areas of Bangladesh.

Dhaka, June 2017 K M Mozammel Hoq

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SecretaryStatistics and Informatics Division (SID)

Ministry of PlanningGovernment of the People’s Republic

of Bangladesh

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We are very pleased that the Bangladesh Bureau of Statistics (BBS) through a longstanding partnership with the UNICEF has successfully lead the completion of the Child Well-being Survey in Urban areas of the country (CWS-U 2016) for which data collection was undertaken during 2016. The survey was conducted with the objective of generating information on the situation of children and women in the urban areas of the country for effective use by planners, policymakers, researchers and programme implementers at the rntional, regional and global levels.

The CWS-U 2016 focused on indicators related to child nutrition and breastfeeding, child health, reproductive health, access to improved drinking water and improved sanitation, child development, literacy and education and child protection. It provides estimates at national level with disaggregated data by division, slum and non-slum areas within the city corporatons and other municipalities within the division. Disaggregated estmates are also available by sex, age, education and wealth quintile.

CWS, 2016, inform a wide range of Sustainable Development Goal (SDG) indiators and provides a robust baseline estimate for the SDGs in the urban settings. Among SDG indicators covered in this report most important are nutritional status of children, improved sanitation, handwashing facility at households, skilled attendant at birth, school attendance ratio for girls, birth registration and early marriage.

The field work, data analysis and report writing was undertaken by the Associates for Communities and Population Research (ACPR), a well-known survey research agency, commissioned by the BBS and UNICEF.

We would like to express our sincere thanks to the Secretary of the Statistics and Informatics Division, Ministry of Planning for providing guidance and valuable support for completing this technical report within a very short time, while the Key Results for the survey were published within the same calendar year as of the data collection for the survey.

Furthermore, we express our sincere appreciation to all officials of BBS associated with the Monitoring the Situation of Children and Women (MSCW) project under the able leadership of Mr. Ashraful Haque, Joint Director and the Focal Point for this project, for their valuable guidance in completing the survey and preparing this report. Dr. M. Sekander Hayat Khan, Mr. A.P.M. Shafiur Rahman and Ms. Tauhida Nasrin from ACPR, deserve special mention for completing the data collection, analysis and drafting of the report.

Mr. Carlos Acosta, Chief of Social Policy, Evaluation, Analytics and Research, Mr. Shantanu Gupta, Statistics and Monitoring Specialist, Mr. Mashiur Rahman Khan, Statistics and Monitoring Officer, all of UNICEF Bangladesh, provided valuable support at all stages of the survey. Prof. Muhammad Shuaib, Institute of Statistical Research and Training (ISRT), University of Dhaka, supported development of the sampling design for the survey.

We hope that the report will prove useful to policy makers, planners, researchers, development partners and NGOs in formulating programmes and strategies for the urban areas of the country and help in determining the baseline estimates for the SDGs progress report of Bangladesh.

Edouard Beigbeder Md. Amir Hossain Representative (Additional Secretary) UNICEF Bangladesh Director General Bangladesh Bureau of Statistics (BBS)

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EXECUTIVE SUMMARY

The Child Well-being Survey in urban areas of Bangladesh, 2016 (CWS 2016) was conducted to understand the situation of children and women in urban context of Bangladesh. The survey measured the level of child well-being in urban areas of Bangladesh in terms of nutrition, health, education, protection and access to water and sanitation.

The Child Well-being Survey 2016 covered entire urban population of Bangladesh. It was based on representative samples of households drawn independently from 19 strata or domains viz., (i) City Corporation Non-Slum, City Corporation CC slum, and Other Municipalities/Urban areas (or Other urban areas) in 5 divisions of Chittagong, Dhaka, Khulna, Rajshahi and Rangpur; and (ii) City Corporations and Other Municipalities/Urban areas in the remaining two divisions – Barisal and Sylhet, since the proportion of CC slum population in urban areas of these two divisions was very low. Sample was drawn from 700 CC non-slum and 220 CC slum Primary Sampling Units (PSUs). A PSU was a Mauza/Mahalla for CC non-slum areas. It was a CC slum (a segment in case of a large CC slum) in case of City Corporation slum stratum/domain. In total, 18,400 households from 920 clusters (a cluster is a randomly selected segment of a PSU) were planned to be included in the sample. For ensuring adequate level of response to the survey, 10 per cent additional households were surveyed through this survey. Information was collected from knowledgeable person of a household, women aged 15-49 years living in the sample households, and mothers/primary caregivers of children under five years of age.

Based on the survey data the key findings on the status of child well-being are collated below.

Background Characteristics

In the overall urban population, the number of male exceeded the number of female, but male-female ratio was found to be almost equal in CC slum and other municipality/urban areas. Nine of ten persons were Muslims (90.5 per cent), and the remainder were mostly Hindus.

Nearly two in three (66.2 per cent) of urban population were in the working age group (age 15-64 years), and one in three (35.6 per cent) were children age 0-17 years, and three in ten (29.6 per cent) were in the age group 0-14 years. The overall dependency ratio was 51.1 per cent.

The estimated average household size was 4.3 members, which is slightly smaller than the MICS 2012-2013 estimated urban household size (4.6 members).

Women in CC slums were younger than those in CC non-slums; 26.4 per cent in CC slums were aged under 25 years, compared to 22.6 per cent in CC non-slums. The proportion of women in the middle reproductive age (age 25-34 years) was also higher in CC slums.

Only a small proportion of households (12.0 per cent) were headed by a female.

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As regards education, CC slum people are in disadvantageous position. The proportion of ever-married women aged 15-49 years without any formal education was more than two times higher in CC slums (35.8 per cent) than in CC non-slums (15.5 per cent) and other urban areas (16.6 per cent).

Access to electricity was quite high and nearly equal in all urban domains. More than nine in ten of urban households had electricity (95.2 per cent), with some variation by CC non-slum (99.4 per cent), CC slum (96.4 per cent), and other urban/municipality areas (93.2 per cent).

Overall 8.6 per cent of urban households had at least one household member employed in Garments Sector, with 27.3 per cent in CC slums, 9.4 per cent in CC non-slums and 7.0 per cent in other municipal areas.

Nutritional Status of Children

Size and weight at birth, stunting, wasting and under-weight are important indicators of nutritional status of newborn and under five children. The survey interviewed mothers and measured height and weight of under-five children. According to mothers’ assessment of size at birth, 16.1 per cent of last live-born children in the last two years were either smaller than average, or very small in size at birth. Sixty-five per cent of births occurring in the last two years preceding the survey were reported to have weighed at birth and 13.7 per cent of those live births were underweight (weight at birth below 2,500 grams).

Overall prevalence of stunting (moderate or severe) among urban children age below five was quite high at 26.3 per cent. This was more pronounced among children who lived in CC slums (40.4 per cent) compared to those in CC non-slum (25.2 per cent) and other urban/municipal areas (25.9 per cent). Among the divisions, Sylhet had the highest rate of stunting (35.5 per cent). Bangladesh Urban Health Survey 2013 (UHS 20132) reported somewhat higher prevalence of stunting with 49.6 per cent in CC slums, 33.4 per cent in CC non-slums and 36.8 per cent in other urban areas.

About one in ten of urban children were moderately or severely wasted (9.9 per cent), with 7.3 per cent in CC non-slums, 11.6 per cent in CC slums and 11.0 per cent in other urban areas. Prevalence of wasting was the highest in urban areas of Sylhet division (11.6 per cent).

One of five of urban children aged below five years were either moderately or severely underweight (20.4 per cent). This prevalence was three in ten among children of CC slum areas (30.8 per cent), while it was only about half (17.7 per cent) in CC non-slums and 20.9 per cent in other urban areas.

Overweight prevalence among under five urban children was recorded at 2.7 per cent, with 4.1 per cent in CC non-slums, 2.7 per cent in CC slums, and 2.1 per cent in other urban areas.

Infant Feeding Practices

Breastfeeding, exclusive breastfeeding and timely introduction of solid or semi-solid food are important for childhood nutrition. According to the survey results, more than 6 in 10 of urban children age 0-23 months were put to the breast within one hour of birth (63.3 per cent).

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2 National Institute of Population Research and Training (NIPORT), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), and MEASURE Evaluation. Bangladesh Urban Health Survey 2013. Final Report. Dhaka, Bangladesh and Chapel Hill, North Carolina, (USA): NIPORT, icddr,b, and MEASURE Evaluation.

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Although ever breastfeeding was universal, prevalence of exclusive breastfeeding among urban children age 0-5 months was 52.7 per cent, with 62.3 per cent in CC slums, 57.5 per cent in CC non-slums and 50.0 per cent in other urban areas. Approximately 72.5 per cent of urban children age less than six months were predominantly breastfed. Marked variation was observed between divisions and also by CC slum and CC non-slum areas.

Prevalence of continued breastfeeding at 1 year among children age 12-15 months was almost universal (96.9 per cent). Continued breastfeeding at 2 years among 20-23 months’ children was 87.0 per cent with some variations by divisions and urban domains.

Approximately six in ten of urban children age 0-23 months received age-appropriate feeding (60.3 per cent), with some variation by CC slums (60.2 per cent), CC non-slums (59.8 per cent) and other urban areas (60.5 per cent)

According to recall data of last 24 hours preceding the survey, three-fourths (75.7 per cent) of non-breastfed children age 6-8 months were fed with solid, semi-solid or soft foods in the last 24 hours. Less than half (45.1 per cent) of 6-23 months’ children had received food with minimum diversity. Minimum dietary diversity was significantly higher among CC non-slums children (51.6 per cent) than among CC slums (34.9 per cent) and other urban children (43.0 per cent).

The average milk feeding frequency for non-breastfed children age 6-23 months during the previous day of the survey was 2.9 times, and about three-fourths (72.2 per cent) were fed the minimum required number of times. Receiving minimum required number of meals varied by divisions and urban domains.

Survey data showed that majority of urban children are deprived of minimum acceptable diet. Only 38.0 per cent of children age 6-23 months had received minimum acceptable diet, with 44.4 per cent in CC non-slums, 29.7 per cent in CC slums and 36.0 per cent in other urban areas.

Child Health

As reported in other studies, coverage with full immunization (BCG, 3 doses of Pentavalent, 3 doses of OPV and MR at 9 months) among children age 12-23 months was quite high at 88.0 per cent. About 86.4 per cent were fully vaccinated by 12 months of age. Coverage with full vaccination was relatively low in CC slums (72.1 per cent) than CC non-slums (92.1 per cent) and other urban areas (87.3 per cent). Nine in ten had received measles and rubella (MR) vaccine (89.7 per cent).

Nearly seven of ten children age 15-23 months received measles second dose (68.5 per cent), supposed to be administered at or after 15 months of age.

About 86.8 per cent of women who had a live birth in the last two years were protected against neonatal/maternal tetanus. Women of CC non-slum and CC slum areas were less likely to be protected against tetanus (83.6 per cent in CC non-slums and 83.4 per cent in CC slum areas) than women of other urban areas (88.3 per cent). Protection status was the highest in Chittagong (93.7 per cent), and lowest in Dhaka division (83.6 per cent).

More than half (59.4 per cent) of urban children under age five with diarrhea in the last two weeks had received care/treatment either at a health facility or from a health provider. Also 88.8 per cent with diarrhea received any ORS fluid, and 36.1 per cent children with diarrhea received oral rehydration salt (ORS) and Zinc.

Seven of ten (70.0 per cent) received diarrhea treatment with oral rehydration therapy (ORT) – ORS packets, pre-packaged ORS fluid, homemade fluid or increased fluids – and continued feeding. E

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More than eight in ten of under five children with ARI symptoms in the last two weeks preceding the survey sought advice or treatment for ARI from a health facility or provider (81.2 per cent). Children of CC non-slum areas were more likely to seek advice or treatment (79.4 per cent) than children of CC slums (78.5 per cent).

Eight of ten children with ARI symptoms received treatment with antibiotics (80.7 per cent).

Overall 48.6 per cent of urban households rely on solid fuel for cooking, with 64.3 per cent in other urban areas, 44.5 per cent in CC slums and 15.2 per cent in CC non-slums areas. Households/members of the lowest quintile mostly (67.5 per cent) use solid fuel and thus are exposed to higher health risks.

Reproductive Health

The CWS focused mainly on certain aspects of reproductive health such as fertility and maternal care. According to the survey results, the median age at first marriage among urban women of reproductive age (15-49 years) was 16.1 years, with somewhat higher in CC non-slums areas (17.0 years). The median age at first child birth was three years more than the median age at first marriage (19.0 years).

Early childbearing (either have had a live birth or are pregnant with the first child) among women age 15-19 years persists high at 18.6 per cent, with 14.8 per cent in CC non-slums, 35.8 per cent in CC slums and 19.1 per cent in other urban areas. However, among the adolescent women age 15-19, only 0.5 per cent have had a live birth before age 15.

Nearly one in four women (22.9 per cent) age 20-24 years have had a live birth before the age of 18. This percentage was 33.0 per cent among women age 20-49 years. The percentage of women age15- 49 who have had a live birth before age 15 was 5.3 per cent.

Two-thirds (67.3 per cent) of currently married urban women aged 15-49 use some method of contraception, with 73.8 per cent in CC slums, 67.2 per cent in other urban, and 66.6 per cent in CC non-slum areas. The total unmet need for contraception was 7.8 per cent.

Eight of ten women age 15-49 who gave birth in the two years preceding the survey received antenatal care from skilled health provider at least once (81.1 per cent), and 45.9 per cent had the recommended four or more antenatal care (ANC) visits by any provider. Six of ten of CC non-slum women received 4 or more ANC visits, compared to one-third (35.8 per cent) in CC slums, and four of ten (40.4 per cent) in other urban areas.

Sixty-two per cent of all deliveries in urban areas took place in health facilities, and 64.2 per cent of deliveries were attended by skilled health provider during their most recent live births. Delivery at health facility was the highest in Khulna urban areas (76.9 per cent), and lowest in Chittagong Division (48.1 per cent).

Of all births, 39.9 per cent of women had delivery by Caesarean Section, with very high prevalence in CC non-slum areas (46.6 per cent).

About 84.4 per cent of women age 15-49 years with a live birth in the last two years who had their last delivery in a health facility stayed in the health facility for 12 hours or more after the last delivery.

Four in five (79.7 per cent) of newborns received postnatal health checks within two days of birth.

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Water and Sanitation

Access to safe water and sanitation are basic determinants of better health. Survey data showed that use of drinking water from improved water sources was almost universal among urban households (99.2 per cent). Among those who do not use improved drinking water sources, 39.7 per cent reported of using an appropriate treatment method to make water safe for drinking.

About 57.3 per cent of urban population are using improved sanitation facilities which are not shared with members of other households. It varied by urban domains with 51.3 per cent in CC non-slums, 18.9 per cent in CC slums which was very low and 62.4 per cent in other urban areas. Use of improved sanitation facilities which are not shared was the highest in Barisal (80.7 per cent), and lowest in Dhaka (47.1 per cent).

Overall 56.7 per cent of urban population use both improved drinking water source and improved sanitation facility. This percentage was very low in CC slums (18.2 per cent) compared to CC non-slums (50.5 per cent) and other urban areas (61.9 per cent).

For 66.2 per cent of children age 0-2 years, the stool was disposed of safely the last time they passed stool. This percentage was much higher in CC non-slums (81.9 per cent) than CC slums (58.0 per cent) and other urban areas (60.2 per cent).

More than half of urban households (55.4 per cent) had specific place for handwashing with water and soap available, while the corresponding estimates for CC non-slums, CC slums and other urban areas were 67.1, 35.4, and 51.1 per cent, respectively.

Child Development, Literacy and Education

According to the Education Policy of Bangladesh, children age 36-59 months are expected to attend pre-school for early childhood development and education. Survey data showed that only 26.2 per cent of urban children age 36-59 months were attending an early childhood education (ECE) programme or pre-school, with about 30.4 per cent in CC non-slums, 24.2 per cent in other urban areas and 23.8 per cent in CC slum areas.

Attendance to an ECE programme was 9.4 per cent among children age 36-47 months, while

this was 41.7 per cent in the age group 48-59 months.

The CWS 2016 collected information on education of all sampled household members aged three years or above. Based on this data, status of literacy of young women age 15-24 years and a number of indicators related to school readiness, participation in primary and secondary education, gender parity in education, etc. were assessed.

Overall literacy among urban young women age 15-24 years was found to be quite high at 82.6 per cent, with 83.8 per cent in other urban areas, 83.7 per cent in CC non-slums and 59.0 per cent in CC slum areas.

Sixty-eight per cent of the urban children who were currently attending the first grade of primary school had attended pre-school the previous year. Attendance to pre-school was substantially low in CC slums (56.1 per cent), CC non-slums (59.1 per cent) and compared to other urban areas (72.7 per cent). Among the divisions, it was the highest in Khulna (86.9 per cent), and lowest in Rangpur (61.5 per cent).

Net intake rate in primary school was found to be 62.2 per cent with 66.9 per cent in CC non-slums, 61.5 per cent in other urban areas, and considerably low in CC slum areas at 40.5 per cent.

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The primary school adjusted net attendance ratio (NAR) was 85.5 per cent. It was 85.0 per cent in CC non-slums, 86.8 per cent in other urban, and 69.4 per cent in CC slum areas. The NAR was 4 percentage points higher among female (87.8 per cent) than among male (83.3 per cent).

The secondary school adjusted net attendance ratio was 63.1 per cent, which is 22 percentage points lower than the primary school NAR. The secondary school NAR was substantially low in CC slums (33.3 per cent) compared to CC non-slums (62.0 per cent) and other urban areas (65.5 per cent). It was the highest in Barisal (74.4 per cent), and lowest in Dhaka division (59.4 per cent).

The effective transition rate to secondary school was 97.3 per cent, with little variation by urban domains and divisions.

Girls are in advantage in both primary school and secondary school attendance. The Gender Parity Index (GPI), defined as the ratio of girls to boys attending primary or secondary education, was 1.05 for primary and 1.18 for secondary education. The advantage of girls though noticed for all categories of children, was particularly pronounced in children with no/less educated mothers and children of lower quintiles.

Child Protection

Child protection refers to the protection of children from violence, exploitation, abuse and neglect. To see the status of urban children in relation to child protection, the survey tried to assess certain aspects such as birth registration, child discipline, attitude towards physical punishment, involvement of children in economic and household activities, child labour, orphan-hood, early marriage, and some other related issues.

Though almost all the mothers or caretakers of children under age five whose births have not been registered were found aware of how to register a birth (99.7 per cent), registration of birth was not widely practiced with only 29.3 per cent of births registered. A huge gap between knowledge and practice persists across all domains irrespective of background characteristics in relation to registration of births.

While violent methods (psychological or physical punishment) were common forms of discipline applied by household members for child discipline (82.4 per cent), only 35.4 per cent women actually approved physical punishment to bring, raise or educate a child properly.

Overall, 12.9 per cent of urban children age 5-17 years were in child Labour, with 12.0 per cent in CC non-slums, 23.1 per cent in CC slums, and 12.6 per cent in other urban areas. It was the highest in Rangpur (15.4 per cent), and lowest in Barisal Division (8.1 per cent). As expected, proportion of children in child labour were higher as the age increased. Prevalence of child labour among children age 5-14 years was 8.1 per cent, with 7.0 per cent in CC non-slums, 14.3 per cent in CC slums, and 8.2 per cent in other urban areas.

More than one of five women (22.5 per cent) of age 15-49 years were (first) married before the age of 15, with some variation by CC non-slum (20.0 per cent), CC slums (28.1 per cent) and other urban areas (23.4 per cent). Among the women aged 20-49 years, the proportion who married before the age of 18 was 59.7 per cent, with 53.3 per cent in CC non-slums, 66.4 per cent in CC slums, and 62.3 per cent in other urban areas.

Polygyny is not common among urban women of Bangladesh. Overall, 2.8 per cent of women aged 15-49 years were in polygynous union. Only 1.0 per cent of the young women aged 15-19 were in polygynous union as compared to 4.8 per cent of the old (aged 45-49).

About one in twenty (4.7 per cent) of urban children age 0-17 years were living with neither of biological parents, with 4.4 per cent in CC non-slums, 4.4 per cent in CC slums and 4.9 per cent in other urban areas.

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1 INTRODUCTION AND METHODOLOGYUNICEF/NYHQ2013-0380/Noorani

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1.1 Background Bangladesh has been experiencing rapid urbanization since 1980s, partly due to lack of work opportunities in rural areas and availability of livelihood opportunities in urban areas. It has close link with development of garment industry and rapid expansion of the service sector in urban areas. Bangladesh Population and Housing Census 2011 reported that the urban population of Bangladesh rose to 41.9 million in 2011 from 28.6 million in 2001. According to a recent report published by the United Nations Department of Economic and Social Affairs, Population Division (2014), while the rural population is expected to peak at 105 million people in 2016 and then decline, the urban population will grow from its current (2015) level of 54 million people to 81.4 million in 2029, an increase of 50 per cent in 14 years. From being a largely rural country now (66.5 per cent of the population lives in rural areas in 2015), Bangladesh will be an urban country by 2039 when majority of the people will live in urban areas.

As consequence of rapid urbanization, urban cities are experiencing extreme pressure on housing, growth of slums and pressure on urban services. What is more of a concern is the fact that the number of hardcore poor has gone up in urban cities. Urban cities are now characterized by large inequalities in health-related conditions. In cities, well-developed areas co-exist with slums, which are areas of dense concentration of people and of conditions that affect health negatively. It is estimated that one-third of the city corporations’ population lives in City Corporation (CC) slums3.

In recent years, a number of large-scale surveys have taken place in Bangladesh, providing partial data on the situation of children living in urban areas. The Bangladesh Urban Health Surveys published by NIPORT in 2013 and 2006 indicate that large inequalities exist in the socio-economic conditions and health care-seeking behaviour in urban areas of Bangladesh. The Multiple Indicators Cluster Survey (MICS) 2012-20134 conducted by Bangladesh Bureau of Statistics (BBS) with support from UNICEF and BDHS 20145 provided estimates for a good number of indicators for urban areas. However, none of these studies provided data on disparities/inequalities that exist within urban areas, e.g. on the conditions of children in urban CC slums vs CC non-slum areas. With the increasing influx of population migrating from rural to urban areas, it is important for the planners, researchers and programme manages to understand the prevailing situation of children (and women) in urban areas stratified by CC slum and CC non-slum areas. To understand the present situation of children and women in urban context, Bangladesh Bureau of Statistics (BBS), with support from UNICEF, Commissioned a Child Well-being Survey in urban areas of Bangladesh.

This report presents main findings of the Child Well-being Survey in urban areas of Bangladesh (CWS 2016).

1 INTRODUCTION AND METHODOLOGY

3 Centre for Urban Studies, et al., 2006

4 Bangladesh Bureau of Statistics (BBS) and UNICEF, 2014. Bangladesh Multiple Indicator Cluster Survey 2012-2013, Progotirpathey: Final Report, Dhaka, Bangladesh.

5 National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. 2013. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International.

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1.2 Survey ObjectivesThe main objective of the CWS 2016 was to measure the level of child well-being in urban areas of Bangladesh in terms of nutrition, health, education, protection and access to water and sanitation. In addition, the survey also aimed to gauge the knowledge, attitude and practices of mothers/caregivers in some key areas that affect healthy growth of children in urban areas.

The specific objectives were to:

� Measure a set of indicators related to child nutrition, health, education, protection, child discipline, and access to water and sanitation.

� Identify urban areas that are most vulnerable for child’s living and identifying the vulnerability.

� Assess condition of children and women by wealth/socio-economic status of households and other equity stratifies.

� Assess level of disparities that exist in urban CC slum areas of big cities across the country

1.3 Sample DesignThe sample for the CWS 2016 is nationally representative and covers entire urban population residing in non-institutional dwelling units in urban areas. The survey is based on a two-stage stratified cluster sample of households, stratified by 19 strata or domains. The strata/domains are – (i) City Corporation non-slum, City Corporation slum, and other Municipalities/Urban areas in Dhaka, Chittagong, Khulna, Rajshahi and Rangpur divisions; and (ii) City Corporations and Other Municipalities/Urban areas in the remaining two divisions - Barisal and Sylhet – since the population content of the slum areas in these division was relatively small. A stratum/domain is considered as an independent stratum/domain.

In the first stage of sampling, from each stratum/domain, mauza/mahallas (slum in the City Corporation slum stratum/domain) were selected randomly as Primary Sampling Units (PSUs) using probability proportional to size (PPS), size being the number of households in the PSU. In total, 920 PSUs were selected, taking 50 PSUs from each stratum/domain except three stratum/domains of City Corporation slums of Rajshahi, Khulna and Rangpur, from each of which 40 PSUs were selected.

Using 2011 Census list of Mauzas/Mahalla as sampling frame, BBS selected 700 CC non-slum urban PSUs, while Urban Slum Census 2014 data were used to select 220 CC slum PSUs from five City Corporation slum domains. Necessary adjustments were made in the population estimates in the two sampling frames prior to selection of PSUs.

In the second stage, for PSUs with large number of households, segments of equal size of around 100 households were created for each PSU through a physical mapping exercise in each selected PSU, and then one of the segments was selected randomly. Segmant was not done for smaller PSU's. A randomly selected segment of a PSU is referred to as a cluster. A household listing operation was conducted in each cluster using a structured enumeration form. In total, 18,400 households from 920 clusters were planned to be included in the sample taking 20 households from each cluster following systematic random sampling procedure. This sample size was expected to provide estimates with at most 12 per cent margin of error at 95% level of confidence. For ensuring adequate level of response to the survey, 10 per cent additional households were surveyed through this survey.

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Survey could not be conducted in 4 preselected clusters due to eviction of slums and other reasons. Ultimately, a total of 20,134 households from 916 clusters were attempted to interview.

The following table presents the sample sizes, number of clusters and cluster size per domain.

Table 1.1: Sample size

Number of clusters and households included in the sample by division (Dhaka, Chittagong, Rajshahi, Khulna, Rangpur, Barisal and Sylhet), and areas (City Corporation slum, City Corporation non-slum and other municipalities/urban areas), Child Well-being survey in urban areas, Bangladesh, CWS 2016.

Division Area/DomainNumber of clusters

Number of Households

Dhaka City Corporation slum 48 1,056

City Corporation non-slum 50 1,100

Other municipalities/urban 50 1,100

Chittagong City Corporation slum 50 1,097

City Corporation non-slum 50 1,100

Other municipalities/urban 50 1,100

Rajshahi City Corporation slum 40 877

City Corporation non-slum 49 1,078

Other municipalities/urban 50 1,100

Khulna City Corporation slum 39 848

City Corporation non-slum 50 1,100

Other municipalities/urban 50 1,100

Rangpur City Corporation slum 40 880

City Corporation non-slum 50 1,100

Other municipalities/urban 50 1,100

Sylhet City Corporation 50 1,100

Other municipalities/urban 50 1,100

Barisal City Corporation 50 1,098

Other municipalities/urban 50 1,100

Total 19 916 20,134

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1.4 Survey Implementation

1.4.1 Questionnaires

The CWS 2016 used three questionnaires:

� Households Questionnaire � Women Questionnaire (for women 15-49 years), and � Under-five Questionnaire

The Household Questionnaire was administered to a knowledgeable person, in most cases a woman, of a sample household and was used to list all the usual members in the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education, etc. The questionnaire included the following modules:

� Household information � Household characteristics � Participation in garment industry � Education � Water and sanitation � Handwashing � Child labour � Child discipline

The Women Questionnaire was administered to all ever married women aged 15-49 years living in the households. It was used to collect information on the following topics:

� Individual Background Characteristics � Maternal and Newborn Health (Antenatal, Delivery and Newborn Care) � Breastfeeding and IYCF � Postnatal Health Checks � Immunization � Contraception � Unmet Need

The Questionnaire for Children Under-Five was administered to mothers or primary caregivers of children under 5 years of age living in the households. The questionnaire included the following variables and modules:

� Birth Registration � Care for illness � Anthropometry

The questionnaires were developed in English based on the questionnaires used in the MICS-2012-2013 and other relevant surveys. The questionnaires were then translated into Bangla, pre-tested in parallel urban households and then administered to sample households and individuals.

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1.4.2 Training, Fieldwork and Data Processing

Training and Fieldwork

Fifty-four enumerators were trained to carry out the listing of households and to delineate the clusters. The training lasted a total of three days including one day of field practice from December 27 to 29, 2015. A household listing operation was carried out in all selected clusters from December 30, 2015 to March 13, 2016 in three phases, each about three weeks in duration. Initially, 25 two-member teams were deployed to carry out the listing of households. The number of teams was reduced to 18 in the final phase.

The instruments were pre-tested on January 25, 2016. Training for the fieldworkers of the main survey was conducted from January 20 to February 3, 2016. A total of 94 fieldworkers were recruited based on their educational level, prior experience with surveys and willingness to spend up to four months on the project. Training included lectures, how to complete the questionnaires, mock interviews between participants and field practice. The BBS and UNICEF personnel monitored the training activities.

Fieldwork for the CWS 2016 was carried out by interviewing teams, each consisting of one male supervisor, four female interviewers and one anthropometric expert. Data collection was implemented in three phases, starting on February 4, 2016 and ending on April 30, 2016. The number of teams declined with each subsequent phase, starting with 15 teams in the first phase and ending with 12 teams by the end of data collection.

Data Processing

Data processing commenced on February 24, 2016 and was completed on June 15, 2016. The data processing operations consisted to office editing, coding, data entry and editing inconsistencies found by computer programs. Data were processed on 11 microcomputers, carried out by 11 data entry operators and a data entry supervisor. Data entry and editing were done using CSPro software. To minimize error, a double data entry procedure was followed.

1.5 Survey Sample and Response Rates

Table 1.2 and Table 1.2a show household, eligible women and children under 5 response rates by division and area of residence. The household response rates were similar across divisions and areas of residence (98 per cent). The response rates of women and children under 5 showed similar pattern, but somewhat low at 94 per cent and 96 per cent, respectively. However, this was in line with other survey results in urban areas.

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Table 1.2: Results of household, women’s, and under-5 interviews

Number of households, women, and children under 5 by results of the household, women’s, and under-5’s interviews, and household, women’s, and under-5’s response rates, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

AllDivision

Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet

Households

Sampled 20,134 2,198 3,297 3,256 3,048 3,055 3,080 2,200

Occupied 19,187 2,088 3,115 3,081 2,971 2,926 2,928 2,078

Interviewed 18,887 2,076 3,063 3,001 2,900 2,909 2,903 2,035

Household response rate 98.4 99.4 98.3 97.4 97.6 99.4 99.1 97.9

Women

Eligible 20,632 2,246 3,456 3,124 3,199 3,191 3,183 2,233

Interviewed 19,632 2,136 3,239 2,997 3,048 3,090 2,991 2,131

Women’s response rate 95.2 95.1 93.7 95.9 95.3 96.8 94.0 95.4

Women’s overall response rate 93.7 94.6 92.2 93.4 93.0 96.3 93.2 93.5

Children under 5

Eligible 7,736 871 1,397 1,226 1,014 1,001 1,167 1,060

Mothers/caretakers interviewed 7,521 844 1,360 1,193 983 976 1,138 1,027

Under-5’s response rate 97.2 96.9 97.4 97.3 96.9 97.5 97.5 96.9

Under-5’s overall response rate 95.7 96.3 95.7 94.8 94.6 96.9 96.7 94.9

Table 1.2a: Results of household, women’s, and under-5 interviews by survey areas

Number of households, women, and children under 5 by results of the household, women’s, and under-5’s interviews, and household, women’s, and under-5’s response rates, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

All

Area

City Corporation slum

City Corporation non-slum

Other municipalities/urban

Households

Sampled 20,134 4,758 7,676 7,700

Occupied 19,187 4,533 7,301 7,353

Interviewed 18,887 4,457 7,151 7,279

Household response rate 98.4 98.3 97.9 99.0

Women

Eligible 20,632 4,883 7,729 8,020

Interviewed 19,632 4,659 7,379 7,594

Women’s response rate 95.2 95.4 95.5 94.7

Women’s overall response rate 93.7 93.8 93.5 93.7

Children under 5

Eligible 7,736 1,853 2,784 3,099

Mothers/caretakers interviewed 7,521 1,805 2,720 2,996

Under-5’s response rate 97.2 97.4 97.7 96.7

Under-5’s overall response rate 95.7 95.8 95.7 95.7

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1.6 Challenges FacedThe CWS 2016 encountered a number of challenges that might have increased sampling and non-sampling errors:

� For drawing sample from CC slum and CC non-slum populations, the first challenge was to make adjustments in the population estimates as the available source populations were from two different time points. The 2011 Bangladesh National Census provided Mauza/Mahalla list with households without demarcating CC slum households, while CC Slum Census was conducted in 2014. However, BBS successfully made necessary adjustments in the two populations to prepare the sampling frame of PSUs, for selecting PSUs (Mauza/Mahalla for CC non-slum and slum/segment of a slum for slum areas) and final sample.

� Survey could not be conducted in four pre-selected clusters because of non-existence of these clusters at the time of the survey due to eviction.

� Though many large scale surveys like the Bangladesh Demographic and Health Survey (BDHS), Multiple Indicator Cluster Survey (MICS), etc. provide estimates of indicators related to child Well-being for the urban areas, the results obtained in this survey are not strictly comparable for trend analysis owing to differences in the method of drawing samples and use of sampling frames. However, comparisons are provided in the text of the report, wherever possible.

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2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS

UNICEF/NYHQ2013-0378/Noorani

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Key Findings:

� Nearly two-thirds (66.2 per cent) of urban population are reported to be in the working age group (15-64 years), 35.6 per cent are children age 0-17 years, and 29.6 per cent are in the age group 0-14 years. The overall dependency ratio is 51.1 per cent.

� The estimated average household size was 4.3 members, which is slightly smaller than the MICS 2012-2013 estimate of 4.6 but comparable to the BDHS 2014 estimate of 4.4 members.

� Women in CC slums were younger than those in CC non-slums; 26.4 per cent in CC slums were aged under 25 years, compared to 22.6 per cent in CC non-slums.

� Only 12.0 per cent households were headed by females.

� The proportion of ever-married women aged 15-49 years without any formal education was more than two times higher in CC slums (35.8 per cent) than in CC non-slums (15.5 per cent) and other urban areas (16.6 per cent).

� As high as 95.2 per cent of urban households have electricity connection, with 99.4 per cent in CC non-slums, 96.4 per cent in CC slums, and 93.2 per cent in other urban/municipal areas.

� About 8.6 per cent of urban households had at least one household member employed in Garments Sector. This was much higher in CC slums (27.2 per cent) and relatively lower, 9.5 per cent, in CC non-slums and 7.0 per cent in other municipal areas.

This chapter presents information on certain characteristics of the household population, selected features of the sampled households, and socio-economic aspects of households. More specifically, main focus was on composition of household population, socio-economic and livelihood status, and certain physical features known to influence health of urban population. The purpose was to compare the population and housing profiles of CC slums, CC non-slums and other urban households. Information on characteristics such as water use, sanitation and handwashing practices were available, analysis of which is presented in a separate chapter.

2.1 Characteristics of Household PopulationThe 2016 Child Well-being Survey defines a household as a person or group of persons, regardless of age or relationship, who usually live in the same dwelling, share common cooking and eating arrangements and can identify one member as the head of household. Interviews were completed for a total of 7,151 households in CC non-slums, 4,457 in CC slums, and 7,279 in other urban areas, giving a total of 18,887 urban households in the sample.

2.1.1 Age and Sex Composition

Table 2.1 gives age distribution of household population by five-year age groups, and sex, and also by dependency age groups, children (0-17 years) and adult age (18 years or above),

2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS

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according to area of residence. In the 18,887 successfully interviewed households, 82,228 household members were listed. Overall, the number of men exceeded the number of women. This pattern prevailed in CC non-slum, but male-female ratio was almost equal in CC slums and other urban areas.

Table 2.1: Age distribution of household population by sex

Per cent distribution of household population by five years age groups, and sex and by dependency age group, child (0-17 years) and adults populations (age 18 or more), according to areas (City Corporation slum, City Corporation non-slum and other urban areas), Child Well-being survey in urban areas, Bangladesh, CWS 2016

Age group(years)

AllCity Corporation slum City Corporation non-slum Other municipalities/urban

Total Male Female Total Male Female Total Male Female

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

0-4 9.3 10.4 10.6 10.1 9.2 9.1 9.3 9.4 9.5 9.3

5-9 10.0 11.0 11.3 10.6 9.4 9.3 9.5 10.2 10.3 10.0

10-14 10.3 10.7 10.8 10.5 9.8 9.8 9.8 10.4 10.7 10.2

15-19 10.5 11.8 11.1 12.6 10.1 9.2 11.0 10.7 10.4 11.0

20-24 9.0 9.6 8.5 10.7 9.9 9.3 10.5 8.6 7.7 9.5

25-29 9.9 10.5 9.6 11.3 10.3 9.6 11.1 9.6 9.2 10.1

30-34 8.3 8.8 8.2 9.4 8.9 9.2 8.6 7.9 7.6 8.2

35-39 7.6 7.9 8.4 7.5 7.9 8.1 7.6 7.5 7.6 7.4

40-44 5.9 5.1 5.9 4.3 6.4 6.6 6.1 5.7 6.0 5.3

45-49 6.2 5.1 4.6 5.6 6.2 6.0 6.5 6.3 5.3 7.3

50-54 3.0 2.7 3.8 1.6 3.3 4.2 2.3 2.8 4.0 1.6

55-59 3.3 2.2 2.3 2.0 3.1 3.5 2.7 3.4 3.7 3.2

60-64 2.5 1.8 2.1 1.5 2.2 2.6 1.8 2.7 2.9 2.5

65-69 1.6 0.8 0.9 0.8 1.3 1.6 1.1 1.8 2.0 1.7

70-74 1.2 0.8 0.9 0.8 0.9 0.9 1.0 1.3 1.5 1.1

75-79 0.6 0.3 0.4 0.3 0.6 0.5 0.7 0.6 0.8 0.5

80-84 0.4 0.3 0.3 0.2 0.3 0.3 0.3 0.5 0.4 0.6

85+ 0.4 0.2 0.3 0.2 0.2 0.2 0.2 0.5 0.5 0.6

Dependency age groups

0-14 29.6 32.0 32.8 31.3 28.4 28.2 28.6 30.0 30.5 29.5

15-64 66.2 65.5 64.4 66.5 68.3 68.4 68.2 65.3 64.5 66.0

65+ 4.2 2.5 2.8 2.2 3.3 3.4 3.2 4.8 5.0 4.5

Child and adult populations

Children age 0-17 years 35.6 38.4 38.9 37.9 33.9 33.6 34.2 36.2 36.7 35.7

Adults age 18+ years 64.4 61.6 61.1 62.1 66.1 66.4 65.8 63.8 63.3 64.3

Number of household member 82,228 3,302 1,648 1,654 25,015 12,526 12,489 53,911 26,942 26,969

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The proportions of child (0-14 years), working age (15-64 years) and old age groups (65 years and over) were 29.6, 66.2 and 4.2 per cent respectively. These figures are similar to those recorded in the recent MICS 2012-2013. The proportion of children age 0-14 years was 3.6 Percentage points higher in the city corporation slums (32.0 per cent) than CC non-slums (28.4 per cent), and the corresponding figure for other urban areas was 30.0 per cent.

The overall dependency ratio was 51.1 per cent. This was lower in CC non-slums (46.4 per cent), compared to CC slums (52.7 per cent). Dependency ratio was 53.3 per cent in other urban/municipality areas.

The age-pyramid of male and female (Fig 2.1) show a clear tilt towards males at higher age groups in urban areas, as obtained from the survey.

Fig 2.1: Age distribution of household population, Bangladesh, CWS 2016

Note: # household members with missing age and/or sex are excluded

2.1.2 Household Composition

Table 2.2 shows that a small proportion of households (12.0 per cent) were headed by females. Overall, 64.7 per cent of the urban households were in other urban areas, 31.1 per cent in CC non-slums, and 4.2 per cent in CC slum areas. Dhaka Division had the largest share of households (49.0 per cent), and Sylhet (3.5 per cent) and Barisal (4.0 per cent) had very small share of households. Only 1.9 per cent of the households were single-member households, and 77.8 per cent were 2-5 member households. The average household size was 4.3 members, which is somewhat smaller than MICS 2012-2013 estimated size (4.6 members).

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Table 2.2: Household composition

Per cent and frequency distribution of households by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Weighted per cent

Number of households

Weighted Unweighted

Total 100.0 18,887 18,887

Sex of household head

Male 88.0 16,618 16,679

Female 12.0 2,269 2,208

Area

City Corporation slum 4.2 784 4,457

City Corporation non-slum 31.1 5,874 7,151

Other municipalities/urban 64.7 12,229 7,279

Division

Barisal 4.0 749 2,076

Chittagong 17.7 3,334 3,063

Dhaka 49.0 9,263 3,001

Khulna 8.8 1,657 2,900

Rajshahi 10.5 1,988 2,909

Rangpur 6.6 1,238 2,903

Sylhet 3.5 658 2,035

Number of household members

1 1.9 361 382

2 9.9 1,878 1,743

3 21.0 3,963 3,846

4 27.7 5,235 5,302

5 19.2 3,631 3,555

6 10.2 1,933 1,965

7 4.7 897 927

8 2.4 444 519

9 1.3 240 282

10+ 1.6 306 366

Mean household size 4.3

2.2 Background Characteristics of Women and Under Five ChildrenTable 2.3 provides information on selected background characteristics of ever married women age 15-49 years by CC slum, CC non-slum and other urban areas, and also by division. Background characteristics considered were age, current marital status, education, socio-economic status: wealth quintiles and religion.

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Table 2.3: Background Characteristics of Women

Per cent distribution of ever married women age 15-49 years by selected background characteristics, according to domains (City Corporation slum, City Corporation non-slum and other urban areas), Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Background characteristicsType of area

AllCity Corporation

slumCity Corporation

non-slumOther municipalities/

urban

Total 100.0 100.0 100.0 100.0

Age

15-24 22.9 26.4 22.6 22.8

25-34 36.4 39.1 36.8 36.1

35-49 40.7 34.5 40.6 41.2

Division

Barisal 4.0 0.0 2.8 4.8

Chittagong 18.7 39.3 16.3 18.5

Dhaka 47.4 50.3 64.2 39.5

Khulna 9.1 4.4 5.9 10.9

Rajshahi 10.6 3.7 4.0 14.0

Rangpur 6.6 2.4 3.0 8.6

Sylhet 3.6 0.0 3.8 3.7

Marital status

Currently married 93.0 89.8 92.2 93.5

Widowed 4.0 4.6 4.2 3.8

Divorced 1.1 1.2 1.3 1.0

Separated 2.0 4.4 2.3 1.6

Wealth Index quintile

Lowest 17.8 45.3 11.2 19.1

Second 19.3 29.9 20.1 18.2

Middle 20.3 11.7 15.2 23.2

Fourth 21.6 8.7 22.1 22.2

Highest 21.1 4.3 31.4 17.4

Highest education

No education 17.0 35.8 15.5 16.6

Primary incomplete 15.9 24.5 14.5 15.9

Primary complete 10.4 11.6 9.0 11.0

Secondary incomplete 42.0 25.2 40.9 43.6

Secondary complete or higher 14.7 2.8 20.1 12.9

Reading skill

Can’t read at all 8.4 18.6 7.8 8.2

Can read some words 12.8 22.5 10.7 13.4

Can read the whole sentence 78.8 58.9 81.5 78.4

Religion

Islam 90.5 92.5 91.1 90.1

Hindu 8.8 7.0 8.2 9.2

Buddhist 0.4 0.2 0.1 0.6

Christian 0.3 0.3 0.6 0.2

Number of women 19,632 814 5,973 12,845

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Women in CC slums were younger than those in CC non-slums; one in every four women (26.4 per cent) in CC slums were aged under 25 years, compared to about 23 per cent in CC non-slums and in other urban areas. Proportion of women in middle reproductive age (age 25-34 years) was also higher in CC slums (39.1 per cent in CC slums against 36.8 per cent in CC non-slums).

Nearly two-thirds of CC non-slums (64.2 per cent) and half of CC slums (50.3 per cent) women and over one-third (39.5 per cent) of other urban women were from Dhaka division, and the rests were from other divisions. Across three domains, most of the women were currently married (89.8 to 93.5 per cent).

As expected, a large proportion of women in the CC slums are from the poorest, with 45.3 per cent in the lowest wealth quintile, against only 11.2 per cent in CC non-slums and 19.1 per cent in other urban areas. About three in every four (75.2 per cent) CC slums women were in the lowest two quintiles.

Thirty six per cent (35.8 per cent) of CC slums women against 15.5 per cent of CC non-slums and 16.6 per cent of other urban women had no formal education. Obviously, reading skill was also low among women who lived in CC slum areas.

Table 2.4: Under-5’s background characteristics

Per cent and frequency distribution of children under five years of age by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Characteristics Weighted per centNumber of under-5 children

Weighted Unweighted

Total 100.0 7,521 7,521

Sex

Boy 50.3 3,783 3,768

Girl 49.7 3,738 3,753

Area

City Corporation slum 4.5 336 1,805

City Corporation non-slum 29.8 2,242 2,720

Other municipalities/urban 65.7 4,943 2,996

Division

Barisal 4.2 318 844

Chittagong 20.8 1,562 1,360

Dhaka 47.6 3,580 1,193

Khulna 7.2 542 983

Rajshahi 9.2 695 976

Rangpur 6.5 487 1,138

Sylhet 4.5 337 1,027

Age

0-5 months 8.4 631 684

6-11 months 10.0 751 771

12-23 months 20.2 1,521 1,472

24-35 months 20.4 1,534 1,514

36-47 months 20.1 1,511 1,485

48-59 months 20.9 1,573 1,595

Respondent to the under-5 questionnaire

Mother 98.8 7,430 7,421

Other primary caretaker 1.2 91 100

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Table 2.4: continued

Characteristics Weighted per centNumber of under-5 children

Weighted UnweightedMother’s education*

No education 9.2 693 872

Primary incomplete 14.3 1,077 1,083

Primary complete 10.0 751 876

Secondary incomplete 48.9 3,677 3,446

Secondary complete or higher 17.6 1,324 1,244

Wealth index quintile

Lowest 20.8 1,563 1,890

Second 18.5 1,388 1,410

Middle 19.6 1,474 1,343

Fourth 22.4 1,686 1,519

Highest 18.8 1,410 1,359

Religion

Islam 91.9 6,909 6,789

Hindu 7.4 558 696

Buddhist (*) 33 16

Christian (*) 21 20

* In this table and throughout the report, mother’s education refers to educational attainment of mothers as well as caretakers

of children under 5, who are the respondents to the under-5 questionnaire if the mother is deceased or is living elsewhere.

(*) Figures that are based on fewer than 25 unweighted cases

The background characteristic of children under-5 years of age are presented in Table 2.4. These include the distribution of children by several attributes, such as age, sex, areas of residence, division, mothers’ education and socioeconomic status. Proportion of boys (50.3 per cent) and girls (49.7 per cent) are almost at the same level. Nearly two-thirds (65.7 per cent) of children were from other urban areas, 29.8 per cent from CC non-slums and 4.5 per cent from CC slum areas. About 47.6 per cent were from Dhaka, 20.8 per cent from Chittagong, and the rest were from other divisions.

Age distribution of children age 0-59 months showed that proportions of children in the younger age groups were significantly lower than those in the higher age groups.

2.3 Housing Characteristics Tables 2.5, 2.5a, 2.6 and 2.6a provide housing characteristics disaggregated by urban domains and divisions. The main characteristics considered were whether the dwelling had electricity, main materials of the floor, roof, and exterior walls as well as the number of rooms used for sleeping.

Tables 2.5 show that 95.2 per cent of dwelling houses were connected to supply of electricity, 72.7 per cent had finished floor with cement or tiles; 68.3 per cent had tin/metal roof and 30.7 per cent had cement roofing; and 59.6 per cent had finished exterior walls with cement.

This situation varied by division, CC slum, CC non-slum and other urban areas (Table 2.5a). Seventy-one per cent of CC slum households had a single room for sleeping of all household members, while 55.9 per cent of CC non-slums and 68.5 per cent of other urban households had 2 or more rooms for sleeping. On average, in CC slum areas 3.3 persons shared a room for sleeping; the corresponding average was 2.7 in CC non-slums and 2.4 in other urban areas.

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Table 2.5: Housing characteristicsPer cent distribution of households by selected housing characteristics, according to area of residence and regions, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

DivisionAll Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

ElectricityYes 95.2 92.3 94.2 98.2 94.5 88.8 89.0 95.3No 4.8 7.7 5.8 1.8 5.5 11.2 11.0 4.7

FloorNatural floorEarth/sand 26.9 49.3 32.3 14.4 32.8 45.2 51.8 32.3Dung 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1Rudimentary floorWood plank 0.4 1.0 0.2 0.6 0.0 0.1 0.0 0.0Palm/ bamboo 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0Finished floorFinished floor parquet/polished wood 0.0 0.1 0.1 0.0 0.0 0.0 0.0 0.0Wood plank covered with tar 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0Ceramic tiles/mosaics 7.4 2.9 6.5 9.0 8.5 4.1 2.0 11.1Cement 64.6 46.2 58.8 75.5 58.5 50.0 46.0 56.1Carpet/ mat 0.7 0.3 2.0 0.5 0.1 0.6 0.1 0.5

RoofNatural roofingStraw/palm leaf 0.4 0.0 0.7 0.0 2.5 0.0 0.5 0.1Rudimentary roofingVillage mat 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0Bamboo/palm tree 0.1 0.0 0.3 0.0 0.1 0.0 0.0 0.1Finished roofingTin/metal 68.3 81.9 73.7 61.8 58.3 78.2 90.9 68.9Wood 0.1 0.0 0.0 0.1 0.0 0.0 0.0 0.0Cement fiber 0.1 0.0 0.1 0.1 0.1 0.2 0.0 0.0Ceramic tiles 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0Cement 30.7 18.0 25.1 37.8 35.5 21.2 8.5 31.0Tally 0.3 0.0 0.1 0.0 3.1 0.3 0.1 0.0Others 0.0 0.0 0.1 0.0 0.2 0.0 0.0 0.0

Exterior wallsNatural wallsNo wall 0.0 0.1 0.0 0.0 0.1 0.0 0.0 0.1Cane/jute stick/palm tree/trunk/ chatai/hogla 1.1 0.7 3.0 0.1 2.3 1.4 1.7 0.7Mud 3.0 0.0 3.4 0.8 2.9 12.8 5.2 0.8Rudimentary wallsBamboo with mud/bamboo 2.7 0.2 9.4 0.2 4.6 2.2 2.4 5.4Stone with mud 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0Uncovered (sunburn bricks) 0.0 0.0 0.1 0.1 0.0 0.0 0.0 0.0Cardboard 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0Reused wood 0.0 0.2 0.1 0.0 0.1 0.0 0.0 0.0Tin 28.3 56.4 27.7 29.7 12.3 21.3 37.9 22.4Finished wallsCement 59.6 37.6 54.2 67.2 60.5 47.3 45.3 67.9Cement/stone with lime mortar 0.4 0.1 0.1 0.7 0.2 0.0 0.0 0.0Bricks 4.1 1.7 1.7 1.0 12.9 14.9 7.4 2.6Block made by cement 0.2 0.1 0.0 0.3 0.2 0.0 0.0 0.0Plank/joint plank 0.5 2.9 0.2 0.0 3.6 0.0 0.0 0.0Others 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.0

Rooms used for sleeping1 37.1 17.3 28.1 47.9 25.2 27.1 29.5 26.42 38.0 37.7 40.1 34.8 42.6 44.2 40.6 37.73 or more 24.9 45.1 31.8 17.2 32.2 28.7 29.9 35.9

Mean number of persons per room used for sleeping 2.5 2.0 2.5 2.7 2.2 2.2 2.4 2.6Number of households 18,887 749 3,334 9263 1,657 1,988 1,238 658

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Table 2.5a: Housing characteristics by CC slum and CC non-slum areasPer cent distribution by selected characteristics, according of City Corporation slum, City Corporation non-slum, and other municipalities/urban areas, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

AllArea

City Corporation slum

City Corporation non-slum

Other municipalities/urban

Total 100.0 100.0 100.0 100.0

ElectricityYes 95.2 96.4 99.4 93.2No 4.8 3.6 .6 6.8

FloorNatural floorEarth/sand 26.9 15.2 5.0 38.1Dung 0.0 0.0 0.0 0.0Rudimentary floorWood plank 0.4 3.7 0.2 0.3Finished floorFinished floor parquet/polished wood 0.0 0.0 0.0 0.0Ceramic tiles/mosaics 7.4 1.3 14.5 4.4Cement 64.6 79.0 79.6 56.4Carpet/ mat 0.7 0.5 0.6 0.7Others 0.0 0.2 0.0 0.0

RoofNatural roofingStraw/palm leaf 0.4 0.6 0.2 0.4Grass/ Peat 0.0 0.1 0.0 0.0Rudimentary roofingVillage mat 0.0 0.1 0.0 0.0Bamboo/ palm tree 0.1 0.5 0.1 0.1Plank 0.0 0.3 0.0 0.0Finished roofingTin/ metal 68.3 86.5 43.0 79.2Wood 0.1 0.6 0.1 0.0Cement fiber 0.1 0.0 0.2 0.0Ceramic tiles 0.0 0.0 0.1 0.0Cement 30.7 10.9 56.1 19.7Tally 0.3 0.0 0.0 0.5Others 0.0 0.3 0.0 0.0

Exterior wallsNatural wallsNo wall 0.0 0.0 0.0 0.0Cane/jute stick/palm tree/trunk/ chatai/hogla 1.1 1.4 0.6 1.3Mud 3.0 0.7 0.1 4.5Rudimentary wallsBamboo with mud/ bamboo 2.7 6.9 1.7 3.0Stone with mud 0.0 0.0 0.0 0.0Uncovered (sunburn bricks) 0.0 0.0 0.0 0.1Cardboard 0.0 0.0 0.1 0.0Reused wood 0.0 0.1 0.0 0.1Tin 28.3 43.3 9.0 36.6Finished wallsCement 59.6 43.3 85.5 48.3Cement/ stone with lime mortar 0.4 0.1 1.1 0.1Bricks 4.1 3.5 1.3 5.5Block made by cement 0.2 0.1 0.4 0.0Plank/ joint plank 0.5 0.3 0.1 0.7Others 0.0 0.2 0.0 0.0

Rooms used for sleeping1 37.1 70.9 44.1 31.52 38.0 22.6 36.4 39.83 or more 24.9 6.5 19.5 28.7

Mean number of persons per room used for sleeping 2.5 3.3 2.7 2.4Number of households 18,887 784 5,874 12,229

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2.4 Household and Personal Asset Table 2.6 and Table 2.6a provide information on ownership of household and personal assets by divisions, and CC slums, CC non-slum and other urban areas.

Table 2.6: Household and personal assets

Percentage of households by ownership of selected household and personal assets, and per cent distribution by ownership of dwelling, according to area of residence and regions, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

AllDivision

Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet

Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0

Percentage of households that own a

Radio 1.1 0.9 0.6 1.4 1.4 0.6 0.5 0.5

Television 72.2 63.0 68.1 77.3 69.6 69.4 63.4 63.3

Non-mobile telephone 2.0 1.0 1.4 2.5 1.8 1.7 1.0 3.6

Refrigerator 45.2 39.6 43.0 51.5 41.4 35.8 27.5 44.6

Electric fan 92.5 88.8 90.1 96.2 92.4 86.7 83.7 89.7

Cot/Bed 97.5 99.1 95.5 97.1 98.8 99.3 98.8 98.9

Table 75.8 90.3 75.9 68.7 79.9 89.2 89.1 81.1

Almirah/Wardrobe 58.4 58.6 62.2 61.6 53.4 49.3 45.3 58.0

Sofa set 24.4 22.5 31.5 21.8 23.8 23.3 21.4 38.0

Water dispenser 17.9 10.4 23.5 18.4 17.6 11.2 5.8 34.5

Water pump 11.2 8.7 12.6 10.0 15.1 12.3 10.3 12.2

Households that own

Agricultural land 32.4 33.1 26.3 33.8 36.6 32.9 32.0 32.2

Farm animals/Livestock 26.9 36.1 28.9 16.3 38.5 44.9 52.0 25.3

Households where at least one member owns or has a

Watch 42.5 39.9 38.4 45.0 45.4 39.9 37.5 41.7

Mobile telephone 97.4 97.8 98.4 98.1 97.3 94.6 93.9 96.7

Bicycle 20.7 19.6 14.2 13.9 41.9 36.4 38.4 16.2

Motorcycle or scooter 8.7 9.6 5.2 6.5 15.4 14.0 15.3 11.3

Animal-drawn cart 0.1 0.1 0.0 0.1 0.3 0.1 0.1 0.0

Car or truck 1.2 0.3 0.8 1.5 1.4 0.8 0.8 1.7

Boat with motor 0.2 0.4 0.1 0.1 0.2 0.3 0.2 0.2

Rickshaw/Van 4.2 3.9 3.6 3.8 6.2 5.6 4.9 3.8

Nasiman/Kariman/Votbati 0.3 1.1 0.3 0.1 0.6 0.3 0.3 0.4

Easy bike/Auto bike (battery driven) 1.5 1.6 1.5 1.3 1.5 2.3 1.8 0.9

Computer 11.4 9.9 8.8 12.7 13.7 11.1 7.7 10.5

Bank Account 45.7 46.1 45.0 48.1 52.3 39.4 30.6 44.7

Ownership of dwelling

Owned by a household member 53.2 69.8 59.1 37.5 66.6 80.9 81.5 54.2

Not owned 46.8 30.2 40.9 62.5 33.4 19.1 18.5 45.8

Rented 42.4 27.0 38.9 57.2 28.6 15.2 12.1 41.9

Other 4.4 3.1 2.0 5.2 4.8 3.8 6.4 3.9

Number of households 18,887 749 3,334 9,263 1,657 1,988 1,238 658

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Higher proportion of CC non-slum households or members owned television, refrigerator, sofa set, non-mobile telephone, and bank account, compared to CC slums and other urban households. Fifty three per cent of dwellings owned by a member of household. Living in owned household highest in Rangpur division (81.5 per cent) and lowest in Dhaka division 37.5 per cent. This is also the case for Dhaka division where people living in rented house much higher than other divisions (57.2 per cent).

Table 2.6a: Housing and personal assets by CC slum and CC non-slum areas

Per cent distribution by selected characteristics, according of City Corporation slum, City Corporation non-slum, and other municipalities/urban areas, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

AllArea

City Corporation slum

City Corporation non-slum

Other municipalities/urban

Total 100.0 100.0 100.0 100.0

Percentage of households that own a

Radio 1.1 0.5 1.9 0.7

Television 72.2 61.9 82.0 68.2

Non-mobile telephone 2.0 0.4 4.6 0.9

Refrigerator 45.2 19.6 60.7 39.4

Electric fan 92.5 90.1 97.3 90.3

Cot/Bed 97.5 91.3 97.4 97.9

Table 75.8 42.4 69.7 80.8

Almirah/Wardrobe 58.4 36.8 71.0 53.7

Sofa set 24.4 6.0 31.3 22.3

Water dispenser 17.9 8.4 26.6 14.3

Water pump 11.2 1.1 10.2 12.4

Households that own

Agricultural land 32.4 19.0 30.2 34.4

Farm animals/Livestock 26.9 10.3 6.3 37.9

Households where at least one member owns or has a

Watch 42.5 29.5 51.5 39.0

Mobile telephone 97.4 95.4 98.8 96.8

Bicycle 20.7 9.1 13.8 24.8

Motorcycle or scooter 8.7 1.3 7.1 10.0

Animal-drawn cart 0.1 0.1 0.1 0.1

Car or truck 1.2 0.4 2.5 0.6

Boat with motor 0.2 0.3 0.1 0.2

Rickshaw/Van 4.2 7.3 3.3 4.5

Nasiman/Kariman/Votbati 0.3 0.1 0.2 0.3

Easy bike/Auto bike (battery driven) 1.5 0.5 0.7 1.9

Computer 11.4 2.7 18.1 8.8

Bank Account 45.7 23.0 51.9 44.2

Ownership of dwelling

Owned by a household member 53.2 13.9 24.7 69.4

Not owned 46.8 86.1 75.3 30.6

Rented 42.4 68.2 69.2 27.9

Other 4.4 17.9 6.2 2.7

Number of households 18,887 784 5,874 12,229

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Ownership of dwelling was much higher in other urban areas (69.4 per cent) than among CC non-slums (24.7 per cent) and CC slum (13.9 per cent) areas. At least one member of 97.4 per cent households owned a mobile phone, and this was almost identical in CC slums, CC non-slums and in-other urban areas. Ownership pattern of durable household goods was almost identical across divisions.

2.5 Socio-Economic Index: Wealth QuintilesHouseholds across all the survey domains and areas were categorized using an index based primarily on dwelling characteristics (e.g. presence of electricity, type of water source, type of toilet, and floor, roof and wall materials, etc.), household ownership of assets and durable goods, (television, non-mobile phone, refrigerator, sofa set, etc.) and ownership of homestead or land. Using a common scale to classify households across all domains and areas, attempt was made to observe variation in socio-economic status (SES) by constructing SES index quintile. The procedure assigns each variable a factor score or weight, and then index is constructed as a weighted sum of these variables using principal component analysis. The index is then used to rank and classify households into quintiles referred to as household asset quintiles or wealth index: quintiles.

Fig 2.2: Socio-economic status by areas, Bangladesh, CWS 2016

Table 2.7 presents information on the distribution of households by wealth quintiles by CC slums, CC non-slums and other urban areas, as well as across divisions. Higher proportion of CC slum households were poorer than CC non-slum households. Three of four (78.4 Per cent) of the CC slum households were in the lowest two wealth quintiles, compared with one in three (33.0 per cent) in CC non-slum areas. Fifty-two per cent of CC non-slum households were in the two highest wealth quintiles, compared with 10.5 per cent in CC slums.

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Table 2.7: Socio Economic Status Index (SES): Wealth Quintiles

Per cent distribution of the household by wealth quintiles index, according to area of residence and divisions, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Wealth quintiles index

TotalNumber of householdsLowest Second Middle Fourth Highest

Total 20.0 20.0 20.0 20.0 20.0 100.0 18,887

Area

City Corporation slum 48.5 29.9 11.1 7.4 3.1 100.0 784

City Corporation non-slum 12.1 20.9 15.3 20.9 30.8 100.0 5,874

Other municipalities/urban 22.0 18.8 22.9 20.4 16.0 100.0 12,229

Division

Barisal 15.6 16.3 28.4 23.9 15.9 100.0 749

Chittagong 20.9 16.2 20.2 22.8 19.9 100.0 3,334

Dhaka 19.3 23.4 18.4 18.2 20.6 100.0 9,263

Khulna 17.6 15.3 21.0 23.1 23.1 100.0 1,657

Rajshahi 21.3 17.7 22.8 20.4 17.9 100.0 1,988

Rangpur 25.9 19.2 22.4 19.6 12.9 100.0 1,238

Sylhet 20.8 14.1 16.2 18.7 30.2 100.0 658

The distribution of wealth among urban population by division showed almost even pattern except Sylhet, and Rangpur divisions. In Sylhet division, proportion of wealthy people was higher than other divisions and proportion of poor people was higher in Rangpur division.

2.6 Livelihood Status and Employment in Garments SectorHousehold interviews (with either the head of households or with a competent member of a household) collected information on the main sources of household income. Information was also collected on whether any household member was involved in garments sector. Results are presented in Table 2.8.

Thirty eight per cent of urban households derived their income mainly from self-employment, while 42.3 per cent were involved in service sector and 11.1 per cent in manufacturing sector for income generation, 6.0 per cent relied on remittances and 2.0 per cent derived income mainly from rents.

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Table 2.8: Livelihood status

Percentage of household employed in garments sector by selected background characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Main Source of HH Income

Total

Number of

house-hold

member

Proportion employed in garments sector

Total

Number of

house-holds

Self-employ-

ment

Manu-facturing

sector

Service sector

Remittance Rentals Others 0 1 2 3+

Total 38.2 11.1 42.3 6.0 2.0 0.3 100.0 82,228 91.4 5.9 2.3 0.4 100.0 18,887

Sex

Male 40.4 11.4 43.0 3.4 1.7 0.2 100.0 73,979 91.8 5.7 2.1 0.4 100.0 16,618

Female 19.0 9.0 36.3 29.6 5.3 0.9 100.0 8,249 88.2 7.5 3.7 0.6 100.0 2,269

Area

City Corporation slum 32.7 13.6 50.8 1.4 1.2 0.2 100.0 3,302 72.8 19.4 6.5 1.4 100.0 784

City Corporation

non-slum 33.5 9.5 50.2 2.8 3.8 0.3 100.0 25,015 90.5 6.6 2.4 0.4 100.0 5,874

Other municipalities/

urban 40.8 11.7 38.2 7.8 1.3 0.2 100.0 53,911 93.0 4.6 2.0 0.3 100.0 12,229

Division

Barisal 43.9 6.3 42.3 6.5 0.8 0.4 100.0 3,343 99.6 0.3 0.1 0.0 100.0 749

Chittagong 33.5 10.1 42.6 12.0 1.6 0.2 100.0 16,019 88.6 7.6 3.1 0.8 100.0 3,334

Dhaka 35.4 11.7 45.7 4.2 2.9 0.2 100.0 38,509 87.0 8.8 3.6 0.5 100.0 9,263

Khulna 40.6 14.1 39.5 4.1 1.0 0.6 100.0 6,988 99.8 0.2 0.0 0.0 100.0 1,657

Rajshahi 52.8 9.0 31.8 5.0 1.2 0.2 100.0 8,430 99.2 0.8 0.0 0.0 100.0 1,988

Rangpur 40.4 12.7 43.1 2.8 0.8 0.3 100.0 5,554 98.5 1.4 0.2 0.0 100.0 1,238

Sylhet 42.7 11.1 33.9 9.9 2.2 0.2 100.0 3,385 99.7 0.2 0.2 0.0 100.0 658

Age

15-19 9.8 30.1 42.0 9.6 8.4 0.0 100.0 277 73.2 6.2 15.8 4.8 100.0 109

20-24 22.0 20.6 51.4 4.4 1.4 0.1 100.0 1,938 74.0 16.0 7.5 2.6 100.0 612

25-29 29.4 11.8 50.4 7.3 1.0 0.0 100.0 6,081 85.0 10.5 4.4 0.2 100.0 1,800

30-34 34.6 11.7 46.4 5.7 1.3 0.2 100.0 10,018 89.7 6.8 3.0 0.5 100.0 2,484

35-39 39.0 11.8 42.6 4.8 1.3 0.4 100.0 12,446 91.8 6.5 1.4 0.3 100.0 2,983

40-44 43.7 9.3 41.2 4.5 1.2 0.1 100.0 11,338 92.7 4.8 2.0 0.5 100.0 2,504

45+ 39.6 10.6 39.9 6.7 2.8 0.3 100.0 40,130 94.3 4.0 1.5 0.2 100.0 8,395

Education

No education 42.5 13.2 38.2 4.0 1.9 0.2 100.0 19,159 88.7 7.8 2.9 0.7 100.0 4,202

Primary incomplete 42.7 13.7 36.0 6.0 1.3 0.3 100.0 13,377 88.7 8.0 2.9 0.4 100.0 3,050

Primary complete 42.7 11.2 35.9 7.7 2.3 0.2 100.0 9,033 90.9 6.5 2.4 0.2 100.0 1,985

Secondary

incomplete 38.6 10.8 39.9 8.0 2.3 0.4 100.0 24,583 91.7 5.3 2.6 0.5 100.0 5,788

Secondary

complete or higher 25.9 6.7 60.3 4.5 2.3 0.2 100.0 15,715 96.6 2.4 0.8 0.1 100.0 3,793

Missing/DK 39.2 14.9 43.9 0.5 1.4 0.0 100.0 360 79.9 14.5 5.6 0.0 100.0 69

Wealth index quintile

Lowest 37.9 14.5 43.1 2.6 1.4 0.4 100.0 13,990 85.2 9.4 4.9 0.5 100.0 3,777

Second 37.1 16.0 42.3 3.5 1.0 0.1 100.0 15,216 81.7 12.9 4.8 0.6 100.0 3,766

Middle 41.1 12.0 40.2 5.6 0.8 0.2 100.0 17,034 94.4 4.2 0.8 0.6 100.0 3,778

Fourth 40.2 9.1 40.3 8.6 1.6 0.2 100.0 17,824 96.2 2.4 1.1 0.2 100.0 3,781

Highest 34.7 5.6 45.7 8.6 5.0 0.5 100.0 18,163 99.5 0.4 0.0 0.0 100.0 3,785

Religion of household head

Islam 37.4 11.2 42.6 6.3 2.2 0.3 100.0 74,338 91.1 6.0 2.4 0.4 100.0 17,108

Hindu 46.7 10.0 39.5 3.2 0.4 0.2 100.0 7,253 93.8 4.6 1.4 0.1 100.0 1,631

Buddhist 29.9 21.8 48.4 0.0 0.0 0.0 100.0 358 97.5 (2.1) (0.4) (0.0) 100.0 84

Christian 34.9 6.9 55.8 1.8 0.6 0.0 100.0 258 99.3 0.7 0.0 0.0 100.0 60

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About 8.6 per cent of households had at least one member employed in garments sector. Majority of the garments workers were female. Women/household members, those who lived in CC slums were more likely to be employed in garments sector. Twenty seven per cent of CC slums households against 9.4 per cent of CC non-slums and 7.0 per cent of other urban had at least one household member employed in garment sector.

Fig 2.3: Proportion of households with one or more members employed in Garments Sector by divisions, Bangladesh, CWS 2016

The proportion of households with at least one members employed in garments sector was higher in Dhaka (13.0 per cent) and Chittagong (11.4 per cent) divisions, compared with other divisions (also see Fig. 2.3). Higher proportion of younger age group (age 15-24 years) and those belonging to the lowest two quintiles were more likely to work in garments sector. Women were more likely to work in garments sector than men (11.8 per cent female vs. 8.2 per cent male).

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3 NUTRITIONAL STATUS OF CHILDREN AND INFANT FEEDING

UNICEF/BANA2014-00711/Paul

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Key Findings:

� Only sixty five per cent of births occurring in the last two years preceding the survey were reported to be weighed at birth and 13.7 per cent of those live births had low birth (weight at birth below 2,500 grams).

� Overall prevalence of stunting (moderate or severe) among urban children age below five was quite high at 26.3 per cent. This was more pronounced among children who lived in CC slums (40.4 per cent) compared to 25.2 per cent among CC non-slum and 25.9 per cent among children of other urban/municipal areas.

� Overall 9.9 per cent of under-5 urban children, with 7.3 per cent in CC non-slums, 11.6 per cent in CC slums and 11.0 per cent in other urban areas were moderately or severely wasted.

� Overweight prevalence among under-5 urban children was recorded at 2.7 per cent, with 4.1 per cent in CC non-slums, 2.7 per cent in CC slums, and 2.1 per cent in other urban areas.

� About 20.4 per cent of urban children aged below five years were either moderately or severely underweight. This prevalence was 30.8 per cent among CC slum area children, while it was only about half (17.7 per cent) in CC non-slums and 20.9 per cent in other urban areas.

� Overall, 63.3 per cent of urban children age 0-23 months were put to the breast within one hour of birth.

� Overall prevalence of exclusive breastfeeding among urban children age 0-5 months was 52.7 per cent, with considerably high proportions (62.3 per cent) in CC slums, 57.5 per cent in CC non-slums and 50.0 per cent in other urban areas.

� Approximately 72.5 per cent of urban children age less than six months were predominantly breastfed. Marked variation was observed by division and also by CC slum and CC non-slum areas.

� Prevalence of continued breastfeeding at 1 year among children age 12-15 months was almost universal (96.9 per cent). Continued breastfeeding at 2 years (among 20-23 months children) was 87.0 per cent with some variations by divisions and urban domains.

� Approximately 60.3 per cent of urban children age 0-23 months received age-appropriate feeding, with no marked difference between CC slums, CC non-slums and other urban areas.

� About 75.7 per cent of urban children age 6-8 months were fed with solid semi-solid or soft foods in the last 24 hours preceding the survey.

� Less than half (45.1 per cent) of urban children age 6-23 months had received food with minimum diversity in the 24 hours preceding the survey. Minimum dietary diversity was significantly higher among CC non-slums children (51.6 per cent) than among CC slums (34.9 per cent) and other urban children (43.0 per cent).

� About 72.2 per cent of urban children age 6-23 months were fed the minimum required number of times. Receiving minimum required number of meals varied by divisions and urban domains.

� Overall 38.0 per cent of urban children age 6-23 months had received minimum acceptable diet, with 44.4 per cent in CC non-slums, 29.7 per cent in CC slums and 36.0 per cent in other urban areas.

3 NUTRITIONAL STATUS OF CHILDREN AND INFANT FEEDING

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Malnutrition among children is a serious health problem in many countries. Persistently high rates of under-lnutrition remain a very important health problem for Bangladesh. Inadequate or inappropriate feeding is the most obvious contributing factor for under-nutrition. Under-lnutrition caused by protein-energy and micronutrient deficiencies seriously affect physical growth, health and development. Undernourished children are more likely to die from common childhood ailments.

The CWS 2016 collected data on the nutritional status of urban children by measuring the height and weight of all children under age 5 years in the selected households. The survey also collected information on birth weight, feeding practices for infants and young children, including breastfeeding, feeding of solid and semi-solid foods, diversity of foods, and frequency of feeding. This chapter presents the findings on birth weight, infant feeding practices and nutritional status of children.

3.1 Child’s Weight and Size at BirthWeight at birth is a good indicator not only of a mother’s health and nutritional status but also the newborn’s chances for survival, growth, long-term health and psychosocial development. Low birth weight (defined as less than 2,500 grams) carries a range of grave health risks for children. Babies who were undernourished in the womb face a greatly increased risk of dying during their early days, months and years. Those who survive may have impaired immune function and increased risk of disease; they are likely to remain undernourished, with reduced muscle strength, throughout their lives, and suffer a higher incidence of diabetes and heart disease in later life. Children born with low birth weight also risk a lower IQ and cognitive disabilities, affecting their performance in school and their job opportunities as adults.

In the developing world, low birth weight stems primarily from the mother’s poor health and nutrition. Three factors have most impact: the mother’s poor nutritional status before conception, short stature (due mostly to under nutrition and infections during her childhood), and poor nutrition during pregnancy. Inadequate weight gain during pregnancy is particularly important since it accounts for a large proportion of foetal growth retardation. Moreover, diseases such as diarrhoea and malaria, which are common in many developing countries, can significantly impair foetal growth if the mother becomes infected while pregnant.

One of the major challenges in measuring the incidence of low birth weight is that more than half of infants in the developing world are not weighed at birth. In the past, most estimates of low birth weight for developing countries were based on data compiled from health facilities. However, these estimates are biased for most developing countries because the majority of newborns are not delivered in facilities, and those who are represent only a selected sample of all births. Because many infants are not weighed at birth and those who are weighed may be a biased sample of all births, the reported birth weights usually cannot be used to estimate the prevalence of low birth weight among all children. Therefore, the Percentage of births weighing below 2500 grams is estimated from two items in the questionnaire: the mother’s assessment of the child’s size at birth (i.e., very small, smaller than average, average, larger than average, very large) and the mother’s recall of the child’s weight or the weight as recorded on a health card if the child was weighed at birth6.

Overall, 4.8 per cent of children were considered by their mothers to be very small in size at birth, 11.3 per cent smaller than average, and 83.8 per cent average or larger in size.

Table 3.1 also provides information of last live-born children in the last two years preceding the survey on the Percentage of live births weighed at birth and Percentage of having low birth weight.

6 For a detailed description of the methodology, see Boerma, J. T., Weinstein, K. I., Rutstein, S.O., and Sommerfelt, A. E., 1996. Data on Birth Weight in Developing Countries: Can Surveys Help? Bulletin of the World Health Organization, 74(2), 209-16

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Sixty five per cent (64.6 per cent) of births were reported to be weighed at birth and 13.7 per cent of those live births weighed below 2,500 grams at births. Prevalence of low birth weight (weight at birth below 2,500 grams) appeared to be associated with mother’s age at birth, area of residence, mother’s level of education, and household wealth quintiles. Mothers who lived in CC slums, having no or lower level of education and belonging to lower wealth quintiles were more likely to have low birth weight child.

Table 3.1: Low birth weight infantsPercentage of last live-born children in the last two years preceding the survey that are estimated to have weighed below 2,500 grams at birth and Percentage of live births weighed at birth, according to selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Per cent distribution of births by mother’s assessment of size at birth

Total Percentage of children who have weighed

at birth

Number of last live-born

children in the last two

years

Percentage of children who had weight below 2,500

grams

Number of last live-born

children in the last two years who were weighted

Very small

Smaller than

average

Average Larger than average or very large

DK

Total 4.8 11.3 70.3 13.5 0.0 100.0 64.6 2,882 13.7 1,862

Mother’s age at birthLess than 20 years 6.0 10.5 69.2 14.3 0.0 100.0 59.4 1,545 14.0 91820-34 years 3.4 12.3 71.5 12.8 0.0 100.0 70.6 1,328 13.4 93735-49 years (*) (*) (*) (*) (*) 100.0 (*) 9 (*) 6

Birth order1 4.4 11.3 71.1 13.3 0.0 100.0 70.0 1,202 13.3 8422-3 4.8 12.0 69.8 13.5 0.0 100.0 63.1 1,477 14.7 9324-5 8.0 7.7 68.2 16.1 0.0 100.0 41.9 177 9.0 746+ (3.0) (3.8) (82.1) (11.1) (0.0) 100.0 (52.3) 27 (*) 14

AreaCity Corporation slum 5.2 16.9 61.7 16.2 0.0 100.0 60.5 127 15.8 77City Corporation non-slum 3.8 11.7 70.3 14.3 0.0 100.0 78.7 811 11.1 638Other municipalities/urban 5.2 10.8 70.9 13.1 0.0 100.0 59.0 1,944 15.1 1,147

DivisionBarisal 3.4 7.2 79.7 9.7 0.0 100.0 63.1 120 11.7 76Chittagong 8.5 17.8 64.9 8.8 0.0 100.0 49.9 651 16.5 325Dhaka 2.9 8.3 74.0 14.8 0.0 100.0 70.6 1,320 13.0 932Khulna 6.5 11.0 64.9 17.5 0.0 100.0 72.5 193 14.5 140Rajshahi 5.2 11.6 64.8 18.3 0.0 100.0 68.1 272 12.0 185Rangpur 2.5 11.2 69.8 16.6 0.0 100.0 71.4 198 13.9 141Sylhet 6.3 14.0 72.1 7.6 0.0 100.0 49.0 128 14.9 63

Mother’s educationNo education 5.3 23.2 60.7 10.8 0.0 100.0 42.2 237 17.2 100Primary incomplete 3.8 12.0 73.4 10.8 0.0 100.0 44.2 423 17.5 187Primary complete 5.4 11.4 70.7 12.5 0.0 100.0 48.0 294 11.7 141Secondary incomplete 4.9 10.1 71.1 13.9 0.0 100.0 69.5 1,378 14.7 958Secondary complete or above 4.6 8.7 70.0 16.6 0.0 100.0 86.6 549 10.1 476

Wealth index quintileLowest 5.2 17.4 68.8 8.6 0.0 100.0 40.3 633 16.0 255Second 3.7 11.5 71.5 13.3 0.0 100.0 55.9 520 13.4 291Middle 5.0 8.1 71.5 15.3 0.0 100.0 63.5 594 12.2 378Fourth 6.1 7.7 70.1 16.1 0.0 100.0 79.9 634 12.1 507Highest 3.3 12.0 69.8 14.8 0.0 100.0 86.2 500 15.8 431

Religion*Islam 4.0.8 11.1 70.6 13.4 0.0 100.0 63.7 2,629 14.3 1,674Hindu 5.0.0 15.9 64.4 14.7 0.0 100.0 78.3 220 9.9 172

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted casesDK: Don’t know

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3.2 Nutritional Status of ChildrenThe standard indices of physical growth that describes the nutritional status of children are:

� Height-for-age (stunting); � Weight-for-height (wasting); and � Weight-for-age (underweight).

Using height and weight data of children age below 5 years, nutritional status were assessed. The nutritional measurements were evaluated against the WHO standard growth curves (WHO 2006). Specifically, the nutritional indicators are expressed in standard deviations (z-scores) from the mean of the standard/reference population. Children with measurements between less than -2 and -3 Z-scores were considered to have moderate stunting, wasting or underweight, while those below -3 Z-score have exhibited severe stunting, wasting or underweight.

Height-for-age (Stunting):

Height-for-age measures linear growth and measures a chronic nutrition status. A child who is more than two standard deviations below (-2 SD) the median of the WHO reference population in terms of height-for-age is considered short for her/his age and classified as moderately or severely stunted. This reflects the effect of chronic malnutrition. If a child is below three standard deviation (-3SD) from the reference median, then s/he is considered to be severely stunted. The survey collected data on height and weight of under 5 children (age 0-59 months).

Results in Table 3.2 show that prevalence of stunting (moderate or severe) among urban children age below 5 was quite high (26.3 per cent). This was more pronounced among children who lived in CC slums (40.4 per cent). Prevalence of moderately or severely stunting among CC non-slums and other urban children were 25.2 and 25.9 per cents respectively. Among the divisions, Sylhet had the highest rate of stunting (35.5 per cent), while it was lowest among the under five children of Khulna division (20.5 per cent). The UHS 2013 reported somewhat higher prevalence of stunting with 49.6 per cent in CC slums, 33.4 per cent in CC non-slums and 36.8 per cent in other urban areas.

Prevalence of stunting (moderate or severe) was found to be negatively associated with mother’s level of education and household wealth quintiles. For example, 36.6 per cent children of the lowest wealth quintile were stunted, while this was only 14.5 per cent among children of the highest quintile. Stunting was 42.6 per cent among children with mothers having no education and this prevalence was 15.0 per cent among those with mother’s having secondary or higher level of education. (These results are similar to those reported in MICS 2012-2013 and BDHS 2014.)

Weight-for-height (Wasting):

Weight-for-height describes current nutritional status. Children whose weight-for-height is more than two standard deviation below (-2SD) the median of the reference population are considered to be too thin for their weight and classified as moderately or severely wasted, while those who fall more than three standard deviations below the median are classified as severely wasted. Wasting is usually the result of a recent nutritional deficiency and this may exhibit significant seasonal shifts associated with changes in the availability of food or disease prevalence.

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A child is considered overweight if her/his weight-for-height is more than two standard deviation above (+2SD) the median.

Table 3.2: Nutritional status of children

Percentage of children under age 5 years by nutritional status according to three anthropometric indices: weight for age, height for age, and weight for height by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Weight for age Number of

children under age 5

Height for age Number of

children under age 5

Weight for height Number of

children under age 5

Underweight Mean Z-Score

(SD)

Stunted Mean Z-Score

(SD)

Wasted Overweight Mean Z-Score

(SD)Per cent below Per cent below Per cent below Per cent

above- 2 SD - 3 SD - 2 SD - 3 SD - 2 SD - 3 SD + 2 SD

Total 20.4 4.0 -1.1 6,888 26.3 7.8 -1.2 6,888 9.9 2.2 2.7 -0.6 6,888

Sex

Boy 21.1 4.3 -1.1 3,438 27.3 8.6 -1.2 3,438 11.2 3.0 3.3 -0.6 3,438

Girl 19.8 3.6 -1.1 3,451 25.3 6.9 -1.2 3,451 8.6 1.4 2.2 -0.6 3,451Area

City Corporation slum 30.8 7.9 -1.4 311 40.4 15.4 -1.7 311 11.6 2.1 2.7 -0.6 311

City Corporation non-slum 17.7 2.7 -0.9 2,042 25.2 7.3 -1.1 2,042 7.3 2.1 4.1 -0.4 2,042

Other municipalities/urban 20.9 4.3 -1.1 4,536 25.9 7.5 -1.2 4,536 11.0 2.3 2.1 -0.6 4,536Division

Barisal 18.7 3.6 -1.0 291 25.6 7.5 -1.1 291 8.2 1.8 2.0 -0.6 291

Chittagong 23.7 5.3 -1.2 1,410 30.4 8.6 -1.3 1,410 10.6 2.7 1.9 -0.7 1,410

Dhaka 18.8 3.3 -1.0 3,289 24.5 7.6 -1.1 3,289 9.4 2.1 3.3 -0.5 3,289

Khulna 21.0 3.4 -1.0 502 20.5 5.1 -1.0 502 10.2 2.4 3.2 -0.6 502

Rajshahi 21.5 4.6 -1.2 641 27.1 7.6 -1.3 641 10.7 1.2 2.2 -0.7 641

Rangpur 17.5 2.8 -1.1 445 26.1 6.1 -1.2 445 9.4 2.0 1.8 -0.6 445

Sylhet 25.8 6.1 -1.2 309 35.5 13.3 -1.4 309 11.6 2.7 3.1 -0.6 309Age

0-5 months 20.9 5.4 -1.0 552 15.5 5.6 -0.6 552 16.8 6.7 2.0 -0.6 552

6-11 months 12.9 1.6 -0.7 700 13.9 2.9 -0.7 700 5.6 1.4 3.1 -0.3 700

12-17 months 15.0 1.3 -0.9 736 24.3 4.3 -1.1 736 8.3 1.5 2.4 -0.5 736

18-23 months 17.6 4.6 -0.9 681 32.0 10.5 -1.4 681 8.5 1.7 4.6 -0.4 681

24-35 months 24.8 4.1 -1.2 1,416 32.6 10.4 -1.4 1,416 8.8 1.4 2.5 -0.6 1,416

36-47 months 21.8 4.4 -1.2 1,391 29.6 8.9 -1.3 1,391 10.3 2.0 1.8 -0.7 1,391

48-59 months 22.4 5.0 -1.3 1,412 25.5 7.9 -1.3 1,412 11.6 2.4 3.3 -0.8 1,412Mother’s education

No education 34.2 8.7 -1.5 641 42.6 16.0 -1.7 641 12.2 4.4 2.1 -0.8 641

Primary incomplete 24.6 4.7 -1.4 1,021 33.3 9.9 -1.5 1,021 10.0 2.4 1.6 -0.7 1,021

Primary complete 25.2 4.0 -1.3 703 32.1 12.0 -1.5 703 7.6 2.5 1.6 -0.7 703

Secondary incomplete 19.4 3.6 -1.0 3,325 23.9 6.0 -1.1 3,325 11.4 1.7 2.8 -0.6 3,325

Secondary complete or above 9.6 1.8 -0.5 1,198 15.0 4.1 -0.7 1,198 5.7 1.9 4.6 -0.3 1,198Wealth index quintile

Lowest 29.1 5.7 -1.4 1,459 36.6 11.5 -1.6 1,459 11.2 2.5 2.7 -0.7 1,459

Second 23.4 3.7 -1.3 1,285 31.9 10.5 -1.4 1,285 7.7 1.4 1.3 -0.7 1,285

Middle 23.7 6.3 -1.2 1,358 27.6 8.4 -1.2 1,358 11.9 3.3 2.0 -0.7 1,358

Fourth 16.0 2.3 -1.0 1,515 20.3 4.3 -1.0 1,515 11.0 2.1 2.4 -0.5 1,515

Highest 9.4 1.6 -0.5 1,272 14.6 4.2 -0.6 1,272 7.2 1.4 5.4 -0.3 1,272Religion*

Islam 20.8 3.9 -1.1 6,324 26.8 8.0 -1.2 6,324 9.8 2.2 2.7 -0.6 6,324

Hindu 16.2 4.2 -0.8 515 21.3 5.4 -1.0 515 10.4 1.8 4.1 -0.4 515

*Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

Table 3.2 also shows that overall 9.9 per cent of the urban children were either moderately or severely wasted. This prevalence was 7.3 per cent in CC non-slums, 11.6 per cent in CC slums and 11.0 per cent in other urban areas. Prevalence of wasting (either moderately or severely) was the highest in Sylhet (11.6 per cent) and lowest in Barisal (8.2 per cent) division. Wasting among urban children was more pronounced among boys, and in the lowest wealth quintile.

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Fig 3.1: Nutritional status by areas, Bangladesh, CWS 2016

Overweight prevalence among urban children age under 5 was recorded at 2.7 per cent, with 4.1 per cent in CC non-slums, 2.7 per cent in CC slums and 2.1 per cent in other urban areas. Overweight prevalence was higher among male, and among children of the highest wealth quintile.

Weight-for-age (underweight):

Weight-for-age is a composite index of weight-for-height and height-for-age. It does not distinguish between acute malnutrition (wasting) and chronic malnutrition (stunting). A child can be underweight for her/his age because s/he is stunted, because s/he is wasted, or both. Underweight indicates severe presence of malnutrition. A child whose weight-for-age is more than two standard deviation below (-2SD) the median of the reference population is considered moderately or severely underweight, while if her/his weight-for-age is more than three standard deviation below (-3SD) the median is classified as severely underweight.

Fig 3.2: Underweight, stunt ed, wasted and overweight children under age 5 (moderate and severe), Bangladesh, CWS 2016

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Results showed that 20.4 per cent of urban children aged below five years were either moderately or severely underweight. Prevalence of underweight was 30.8 per cent among children of CC slum areas, while it was only about half (17.7 per cent) in CC non-slums and 20.9 per cent in other urban areas. Again, underweight prevalence was the highest in Sylhet (25.8 per cent), and lowest in Rangpur division (17.5 per cent). It was negatively associated with mother’s education and household wealth quintiles.

The levels of stunting, wasting, under-weight and overweight for different age-groups of under-5 children are shown in Figure 3.2. It shows how the nutrition level deteriorates with the age of the child, in general.

3.3 Breastfeeding

Feeding practices, especially breastfeeding practices play a pivotal role in deterring the optimal growth and development of infants. Poor breastfeeding and infant feeding practices have adverse consequences for the health and nutrient status of children.

It is recommended (UNICEF & WHO) that children should be exclusively breastfed (that is, given no other liquid or solid food or plain water) for first six months of life and that children be given solid or semi-solid complementary food at six completed months. It is also recommended that breastfeeding should continue throughout the second year of life. The usual indicator for exclusive breastfeeding is the Percentage of children under age 6 months who are exclusively breastfeed. The indicator for early initiation of breastfeeding is the Percentage of newborn who are put to the mother’s breast within one hour of birth. The indicator for timely complementary feed is the Percentage of children age 6-8 months who receive solid, semi-solid or soft food in the last 24 hours.

3.3.1 Initial Breastfeeding

Early initiation of breastfeeding is important for both the mother and the child. The first breastmilk contains colostrum which is highly nutritious and has antibodies that protect the newborn from disease. The CWS 2016 collected information, for last-born children in the last two years preceding the survey, on ever breastfeeding, initiation of breastfeeding within one hour and one day of birth, and whether any prelacteal food was given.

Results on initiation of breastfeeding for children born in the last two years are given in Table 3.3. It can be seen that percentage of children born in the last two years were ever breastfeed was 98.2 per cent. Overall, 63.3 per cent of urban children age 0-23 months were put to the breast within one hour of birth and 89.5 per cent were breastfed within one day after birth.

Table 3.3 indicates no marked differences in the timing of initial breastfeeding within one hour of birth, either by divisions, mother’s education, socio-economic status or by place of delivery. Notable variation, however, can be seen by CC non-slum and CC slum areas of residence. The proportion of children breastfed within one hour of birth was lowest in CC non-slums (58.2 per cent).

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Fig 3.3: Initiation of breasfeeding within one day of birth by areas, Bangladesh, CWS 2016

Prelacteal feeding is the practice of giving any liquids other than breastmilk to a child during the first three days of life. Twenty nine per cent of urban children received prelacteal feed. Receiving prelacteal feed was more in CC slums (31.1 per cent) than in CC non-slums areas (27.5 per cent). Prelacteal feeding was more common in Rajshahi, Dhaka, and Khulna divisions than Sylhet, Rangpur and other divisions.

Table 3.3: Initial breastfeeding

Percentage of last live-born children in the last two years preceding the survey, who were ever breastfed, breastfed within one hour of birth, and within one day of birth, and Percentage who received a pre-lacteal feed, according to selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Percentage who were

ever breastfed

Percentage who were first breastfed:

Percentage who received a pre-lacteal

feed

Number of last live-born

children in the last two years

Within one hour of birth2

Within one day of birth

Total 98.2 63.3 89.5 28.6 2,882

AreaCity Corporation slum 97.8 66.9 90.0 31.1 127City Corporation non-slum 97.2 58.2 89.0 27.5 811Other municipalities/urban 98.7 65.2 89.6 29.0 1,944

DivisionBarisal 99.2 71.1 89.7 23.1 120Chittagong 98.6 57.5 90.4 23.2 651Dhaka 97.3 63.2 88.3 32.1 1,320Khulna 99.6 62.3 88.5 33.7 193Rajshahi 99.2 64.0 86.7 37.5 272Rangpur 99.4 71.4 94.5 20.3 198Sylhet 99.2 73.4 95.9 12.1 128

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Table 3.3: continued Percentage

who were ever breastfed

Percentage who were first breastfed:

Percentage who received a pre-lacteal

feed

Number of last live-born

children in the last two years

Within one hour of birth2

Within one day of birth

Months since last birth

0-11 months 97.5 64.0 90.6 26.8 1,380

12-23 months 98.9 62.7 88.4 30.5 1,495

Assistance at delivery

Skilled attendant 98.2 53.8 87.4 28.2 1,851

Traditional birth attendant 98.6 82.3 93.5 28.3 241

Others 98.3 79.6 93.0 30.0 788

Place of delivery

Home 98.5 79.6 92.8 28.3 1,093

Health facility

Public 97.9 57.4 87.8 27.5 506

Private 98.2 51.6 87.3 29.5 1,281

Mother’s education

No education 99.6 63.0 87.7 28.5 237

Primary incomplete 99.9 73.2 95.4 35.0 423

Primary complete 97.8 62.9 94.1 26.6 294

Secondary incomplete 97.8 60.8 88.0 27.8 1,378

Secondary complete or higher 97.7 62.1 86.8 27.2 549

Wealth index quintile

Lowest 98.3 70.2 91.5 29.9 633

Second 97.7 64.4 87.6 27.9 520

Middle 98.4 62.2 87.8 31.2 594

Fourth 98.9 62.7 90.6 29.7 634

Highest 97.7 55.4 89.3 23.5 500

Religion*

Islam 98.1 63.5 89.2 29.1 2,629

Hindu 99.8 60.9 91.4 26.1 220

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

3.3.2 Exclusive and Continued Breastfeeding

Exclusive breastfeeding was defined as proportion of infants age 0-5 months who received only breast milk during the previous 24 hours preceding the survey. Exclusive breastfeeding allows the inclusion of ORS (oral rehydration salt), vitamins and/or mineral supplements. Table 3.4 shows that prevalence of exclusive breastfeeding among 0-5 months’ children in CC slums, and other urban areas were 62.3and 50.0 per cent, respectively. Overall over half of the children (0-5 months) were exclusively breastfed (52.7 per cent). The UHS 2013 reported similar results (for CC slums 59.2 per cent, CC non-slums 57.7 per cent and for other urban 66.1 per cent).

Results indicate marked differences in exclusive breastfeeding by divisions. Barisal at 64.2 per cent and Khulna (32.7 per cent) division, were the best and worst divisions. It was positively associated with mother’s education and household wealth quintiles.

Over seven in every ten (72.5 per cent) children aged less than six months in urban areas of Bangladesh were predominantly breastfed.

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Continued breastfeeding at 1 year and continued breastfeeding at 2 years are defined respectively as Percentages of children age 12-15 months and of age 20-23 months who received breastmilk during the previous day. Table 3.4 also shows almost universal (96.9 per cent) prevalence of continued breastfeeding at 1 year, while practice of continued breastfeeding at 2 years was 87.0 per cent. Variations in continued breastfeeding by area of residence, division and wealth quintiles were minimal.

Table 3.4: Exclusive and continued breastfeeding

Percentage of last-born children age under 6 months who were exclusively breastfed, predominantly breastfed, Percentage of 12-15 months and 20-23 months children who received breast milk during the previous day (continued breastfeeding at 1 year and at 2 year) by selected background characteristics, Child Well-being survey in urban areas, Bangladesh, CWS 2016

Children age 0-5 months Children age 12-15 months Children age 20-23 months

Per cent exclusively breastfed

Per cent predominantly

breastfed

Number of

children

Per cent breastfed (Continued

breastfeeding at 1 year)

Number of

children

Per cent breastfed (Continued

breastfeeding at 2 years)

Number of

children

Total 52.7 72.5 662 96.9 519 87.0 459

Sex

Boy 50.6 67.8 333 98.4 254 86.7 256

Girl 54.8 77.3 329 95.6 265 87.4 202

Area

City Corporation slum 62.3 83.0 28 92.3 19 90.7 18

City Corporation non-slum 57.5 72.0 188 98.7 152 80.3 134

Other municipalities/urban 50.0 72.1 446 96.4 347 89.7 307

Division

Barisal 64.2 77.1 35 98.0 24 (95.8) 18

Chittagong 62.0 78.4 132 98.2 102 89.8 97

Dhaka 49.4 66.9 300 97.8 241 83.7 239

Khulna 32.7 63.0 48 91.6 34 (91.3) 26

Rajshahi 43.6 74.3 60 94.0 59 88.2 32

Rangpur 66.4 86.9 55 96.7 33 93.4 32

Sylhet 56.1 82.9 32 96.7 26 89.2 16

Mother’s education

No education 36.5 73.2 58 98.4 41 (87.4) 34

Primary incomplete 53.5 81.0 109 99.0 77 90.0 62

Primary complete 44.4 71.4 64 100.0 48 (100.0) 41

Secondary incomplete 52.4 67.8 311 96.5 283 90.4 206

Secondary complete or higher 65.0 77.6 120 93.7 70 74.6 115

Wealth index quintile

Lowest 46.5 73.6 141 99.1 122 88.0 87

Second 52.9 75.3 102 100.0 111 93.7 96

Middle 47.6 74.0 168 95.6 102 97.8 91

Fourth 56.7 68.8 155 91.8 101 87.8 96

Highest 64.1 71.6 95 97.7 83 66.8 88

Religion*

Islam 54.0 72.8 603 96.7 466 86.5 424

Hindu 39.1 69.6 50 98.9 48 (92.7) 33

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

( ) Figures that are based on 25-49 unweighted cases

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3.3.3 Age-Appropriate Breastfeeding

The age appropriate breastfeeding of children under age 24 months is provided in Table 3.6. It is defined as the Percentage of children age 0-23 months who were appropriately breastfed during the previous day, preceding the survey. This means, children age 0-5 months who are exclusively breastfed, and children age 6-23 months who received solid, semi-solid or soft food along with breastmilk are considered as age-appropriately breastfed.

Results in Table 3.5 show that 60.3 per cent of urban children age 0-23 months received age-appropriate breastfeeding. Some variations were found in the age-appropriate feeding practices by urban CC slums (60.2 per cent), CC non-slums (59.8 per cent) and other urban areas (60.5 per cent), though not very marked. Wide variation was observed across divisions, with Sylhet showing the highest prevalence (72.2 per cent) and Rajshahi the lowest (51.7 per cent). Male children were less likely to receive age-appropriate breastfeeding (58.4 per cent) than females (62.3 per cent). Age-appropriate breastfeeding was found to be positively associated with mother’s education though the association was not very strong with the socio-economic status.

Table 3.5: Age-appropriate breastfeeding

Percentage of children age 0-23 months who were appropriately breastfed during the previous day, preceding the survey by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Children age 0-5 months Children age 6-23 months Children age 0-23 months

Per cent exclusively breastfed

Number of

children

Per cent currently breastfeeding and

receiving solid, semi-solid or soft foods

Number of

children

Per cent appropriately

breastfed

Number of

children

Total 52.7 662 62.5 2136 60.3 2805

Sex

Male 50.6 333 60.5 1,055 58.4 1,396

Female 54.8 329 64.5 1,080 62.3 1,409

Area

City Corporation slum 62.3 28 59.6 94 60.2 123

City Corporation non-slum 57.5 188 60.0 595 59.8 790

Other municipalities/urban 50.0 446 63.8 1,447 60.5 1,892

Division

Barisal 64.2 35 73.8 84 71.0 119

Chittagong 62.0 132 68.1 503 66.8 635

Dhaka 49.4 300 57.3 970 55.7 1278

Khulna 32.7 48 64.4 139 56.2 187

Rajshahi 43.6 60 54.1 209 51.7 269

Rangpur 66.4 55 72.8 140 71.0 195

Sylhet 56.1 32 77.8 91 72.2 123

Mother’s education

No education 36.5 58 59.0 174 54.1 236

Primary incomplete 53.5 109 58.2 303 57.0 412

Primary complete 44.4 64 66.5 224 61.6 287

Secondary incomplete 52.4 311 62.8 1,019 60.4 1,334

Secondary complete or higher 65.0 120 64.5 416 64.6 536

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Table 3.5: continued

Children age 0-5 months Children age 6-23 months Children age 0-23 months

Per cent exclusively breastfed

Number of

children

Per cent currently breastfeeding and

receiving solid, semi-solid or soft foods

Number of

children

Per cent appropriately

breastfed

Number of

children

Wealth index quintile

Lowest 46.5 141 62.4 460 59.0 605

Second 52.9 102 63.4 397 61.5 503

Middle 47.6 168 62.9 418 58.5 586

Fourth 56.7 155 61.9 471 60.6 627

Highest 64.1 95 62.2 389 62.6 484

Religion*

Islam 54.0 603 61.8 1,945 60.1 2,556

Hindu 39.1 50 65.9 168 59.7 218

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

3.4 Introduction of Solid, Semi-Solid or Soft FoodIt is recommended that complementary feeding (giving solid, semi-solid or soft food to infants in addition to breast milk) should start at age six months, because at this age breast milk is no longer-sufficient to maintain the child’s growth (WHO 2008). The complementary feeding indicator measures the proportion of infants age 6-8 months who receive solid, semi-solid, or soft food along with or without breastmilk.

The CWS 2016 collected information from mothers/caregivers on the types of liquids and food the children had consumed during the day or night preceding the interview. Based on 24 hours recall data, results obtained on complementary feeding as presented in Table 3.6 show that three in every four children (75.7 per cent) of urban children age 6-8 months received solid, semi-solid, or soft food. Differences in receiving complementary feeding by areas of residence was quite high - with 75.1 per cent in CC slums, 68.1 per cent in CC non-slums and 78.4 per cent in other urban areas. Among the divisions, it was the highest in Khulna (92.0 per cent), and lowest in Sylhet (66.3 per cent).

Table 3.6: Introduction of solid, semi-solid, or soft foods

Percentage of infants age 6-8 months who received solid, semi-solid, or soft foods during the previous day, preceding the survey by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Currently breastfeeding Currently not breastfeeding All

Per cent receiving solid, semi-solid or

soft foods

Number of children age 6-8 months

Per cent receiving solid, semi-solid or

soft foods

Number of children age 6-8 months

Per cent receiving solid, semi-solid or

soft foods

Number of children age 6-8 months

Total 78.8 371 (*) 19 75.7 390

Sex

Male 74.9 162 (*) 4 73.2 166

Female 81.9 209 (*) 3 82.0 212

Area

City Corporation slum 76.9 19 (*) 1 75.1 20

City Corporation non-slum 73.1 90 (*) 7 68.1 97

Other municipalities/urban 80.9 262 (*) 11 78.4 273

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Table 3.6: continued Currently breastfeeding Currently not breastfeeding All

Per cent receiving solid, semi-solid or

soft foods

Number of children age 6-8 months

Per cent receiving solid, semi-solid or

soft foods

Number of children age 6-8 months

Per cent receiving solid, semi-solid or

soft foods

Number of children age 6-8 months

Division

Barisal (78.1) 14 (*) (78.3) 14

Chittagong 82.0 109 (*) 5 78.7 114

Dhaka 76.7 138 (*) 9 72.2 147

Khulna (92.0) 29 (*) (92.0) 29

Rajshahi 76.8 39 (*) 2 77.8 40

Rangpur 70.8 26 (*) 1 67.2 28

Sylhet 71.4 17 (*) 2 66.3 19

Mother’s education

No education (65.2) 23 (*) 1 (65.0) 24

Primary incomplete 63.6 63 (*) 2 64.1 65

Primary complete (76.5) 39 (*) 2 (74.7) 40

Secondary incomplete 80.2 159 (*) 11 75.0 170

Secondary complete or higher 92.0 87 (*) 4 88.6 91

Wealth index quintile

Lowest 76.0 94 (*) 4 74.6 98

Second 71.2 73 (*) 6 67.2 79

Middle 79.5 60 (*) 4 74.1 64

Fourth 92.7 62 (*) 4 87.7 66

Highest 77.9 83 (*) 1 76.7 84

Religion*

Islam 77.5 334 (*) 16 74.7 350

Hindu (89.2) 30 (*) 1 87.7 31

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted cases

3.5 Infant and Young Child Feeding (IYCF) PracticesInfant and young child feeding (IYCF) practices include initiating timely feeding of solid or semi-solid foods at age 6 completed months and increasing the amount and variety of foods and frequency of feeding as the child gets older, while maintaining frequent breastfeeding.

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Table 3.7: Infant and young child feeding (IYCF) practices

Percentage of children age 6-23 months who received appropriate liquids and solid, semi-solid, or soft foods the minimum number of times or more during the previous day, by breastfeeding status, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Currently breastfeeding Currently not breastfeeding AllPer cent of children who

received: Number of

children age 6-23 months

Per cent of children who received:Number

of children age 6-23 months

Per cent of children who received: Number

of children age 6-23 months

aMini-mum

dietary diversity

bMini-mum meal fre-

quency

cMini-mum

accep-table diet

aMini-mum

dietary diversity

bMini-mum meal fre-

quency

cMini-mum acce-ptable

diet

At least

2 milk feeds

aMini-mum

dietary diversity

bMini-mum meal fre-

quency

cMini-mum acce-ptable

diet

Total 45.1 72.9 39.6 1,997 43.3 62.9 17.9 43.3 157 45.1 72.2 38.0 2,188

Sex

Male 47.7 74.4 41.5 992 41.2 82.3 34.4 61.6 56 47.3 74.8 41.2 1,055

Female 42.6 71.4 37.6 1,006 (44.9) (73.5) 12.4 (46.6) 72 42.8 71.6 35.9 1,080

Age

6-8 months 22.7 76.1 22.2 371 (*) (*) (*) (*) 7 22.3 75.3 21.9 390

9-11 months 34.4 68.2 29.6 281 (*) (*) (*) (*) 17 35.9 69.4 31.1 304

12-17 months 50.7 74.4 44.9 745 (45.5) (55.0) (4.9) (29.0) 45 50.6 73.3 42.6 792

18-23 months 57.0 71.3 48.3 601 40.0 64.1 18.5 42.5 88 55.3 70.4 44.5 702

Area

City Corporation slum 36.3 65.7 32.3 86 (20.5) (54.7) (7.5) (41.9) 10 34.9 64.5 29.7 97

City Corporation non-slum 52.0 75.5 45.9 540 (48.4) (84.3) (27.7) (56.9) 49 51.6 76.2 44.4 609

Other municipalities/urban 43.0 72.3 37.5 1,372 42.7 53.2 14.1 36.6 98 43.0 71.0 36.0 1,482

Division

Barisal 52.4 70.7 45.6 83 (*) (*) (*) (*) 2 53.2 70.8 45.3 85

Chittagong 41.1 55.7 32.4 484 (*) (*) (*) (*) 26 41.4 54.5 31.7 515

Dhaka 49.1 83.0 45.7 884 (38.9) (71.0) (13.7) (45.5) 88 48.3 81.9 42.8 998

Khulna 41.9 86.2 39.3 131 (33.6) (64.5) (18.5) (48.4) 12 41.5 84.3 37.5 143

Rajshahi 36.1 64.8 27.5 193 (*) (*) (*) (*) 16 39.0 66.4 29.4 211

Rangpur 47.0 74.1 40.8 135 (*) (*) (*) (*) 7 45.9 73.5 38.8 143

Sylhet 41.6 63.8 36.6 87 (*) (*) (*) (*) 7 40.8 61.0 34.3 95

Mother’s education

No education 31.8 55.4 25.7 162 (*) (*) (*) (*) 13 32.2 56.2 26.0 175

Primary incomplete 34.8 62.7 30.3 286 (40.3) (46.6) (7.6) (22.4) 22 35.1 61.5 28.7 308

Primary complete 42.8 75.8 39.6 219 (*) (*) (*) (*) 6 43.7 75.9 38.7 231

Secondary incomplete 46.8 72.9 39.8 959 43.0 54.8 16.4 44.5 74 46.5 71.6 38.2 1,047

Secondary complete or higher 55.8 86.7 52.0 372 (41.8) (82.1) (23.7) (53.5) 43 54.9 86.2 49.1 428

Wealth index quintile

Lowest 33.8 62.4 27.8 441 (13.8) (23.5) (6.0) (19.0) 33 33.3 59.7 26.3 482

Second 37.8 68.7 33.2 382 (84.8) (20.1) (13.3) (15.8) 20 39.5 66.2 32.2 409

Middle 48.7 75.6 42.8 394 (*) (*) (*) (*) 24 47.5 75.6 41.3 422

Fourth 52.8 79.6 46.6 429 (54.6) (85.1) (24.7) (43.2) 40 53.3 80.0 44.8 476

highest 53.9 79.5 48.9 351 (*) (*) (*) (*) 39 52.1 80.4 46.4 399

Religion*

Islam 44.1 72.3 38.5 1,820 40.5 61.5 14.4 40.0 140 43.9 71.6 36.8 1,994

Hindu 51.2 78.4 48.2 155 (*) (*) (*) (*) 14 52.4 79.2 48.7 170

a Minimum dietary diversity is defined as receiving foods from at least 4 of 7 food groups: 1) Grains, roots and tubers, 2) legumes and nuts, 3) dairy products (milk, yogurt, cheese), 4) flesh foods (meat, fish, poultry and liver/organ meats), 5) eggs, 6) vitamin-A rich fruits and vegetables, and 7) other fruits and vegetables.

b Minimum meal frequency: Children age 6-23 months who received solid, semi-solid or soft food (plain milk feeds for non-breastfed children) the minimum of 7 (or more) times

c Minimum acceptable diet: Children age 6-23 months with minimum dietary diversity and minimum meal frequency (Breastfed children) and minimum dietary diversity (excluding milk feeds and minimum meal frequency, Non-breastfed children).

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

(*) Figures that are based on fewer than 25 unweighted cases

( ) Figures that are based on 25-49 unweighted cases

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3.5.1 Minimum Dietary Diversity

As per guidelines established for IYCF practices for children age 6-23 months (WHO 2008), minimum dietary diversity means feeding the child food from at least four food groups out of seven food groups: grains, roots and tubers; legumes and nuts; dairy products (milk, yogurt, cheese); flesh foods (meat, fish, poultry, and liver/organ meat); eggs; vitamin A-rich fruits and vegetables; and other fruit and vegetables. Consumption of food from at least four food groups means that the child has a high likelihood of consuming at least one animal source of food and at least one fruit or vegetables in addition to a staple food (grains, roots, or tubers) (WHO 2008). This cut-off was selected because it is associated with better-quality diets for both breastfed and non-breastfed children. It is recommended that meat, poultry, fish or eggs be eaten daily or as often as possible. Vegetarian diets may not meet children’s nutrient requirements unless supplements or fortified products are used. Vitamin A-rich fruits and vegetables should be consumed daily. Children’s diets should include an adequate fat content, including fats that provide essential fatty acids. Fat facilitates adsorption of fat-soluble vitamins (such as Vitamin A), and enhances dietary energy density and palatability.

Minimum dietary diversity is defined as the proportion of children age 6-23 months who consume foods from 4 or more food groups. Based on the recall data on the consumption of foods by children age 6-23 months in the last 24 hours preceding interview, prevalence of dietary diversity was estimated. Table 3.7 shows that 45.1 per cent of urban children age 6-23 months had received food with minimum diversity. Prevalence of minimum dietary diversity was significantly higher among children of CC non-slum areas (51.6 per cent), compared to CC slums (34.9 per cent) and other urban children (43.0 per cent). Wide variation was also observed by divisions, with the highest prevalence in Barisal (53.2 per cent) and lowest in Rajshahi (39.0 per cent). Children of higher age groups, higher level of mother’s education and belonging to higher wealth quintiles were more likely to consume food with minimum dietary diversity.

Fig 3.4: Percentage of children of age 6-8 months fed according to minimum standard of acceptable feeding practices, Bangladesh, CWS 2016

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3.5.2 Minimum Meal Frequency

The minimum meal frequency or the minimum number of meals consumed by a child during the last 24 hours is a proxy for adequate energy intake from complementary food. In CWS 2016, prevalence of minimum meal frequency is defined as percentage of children age 6-23 months who received solid, semi-solid or soft food (plain milk feeds for non-breastfed children) the minimum of 7 (or more) times in last 24 hours preceding the survey.

Results (in Table 3.7) show that, overall 72.2 per cent of urban children age 6-23 months (both breastfed and non-breastfed) were fed the minimum number of times.

Receiving minimum meal frequency was relatively higher for children age 6-23 months in CC non-slums(76.2 per cent) than CC slums (64.5 per cent) and other urban areas (71.0 per cent) received minimum number of meals (7 or more) in the 24 hours preceding interviews.

Receiving minimum number of meals varied substantially by division, with highest proportion in Khulna (84.3 per cent), and lowest in Sylhet division (61.0 per cent). Receiving minimum number of meals were positively associated with mother’s education and household wealth levels.

3.5.3 Minimum Acceptable Diet

Minimum acceptable diet is a composite indicator. It is defined as the proportion of 6-23 months breastfed children who had at least minimum dietary diversity and minimum meal frequency during the previous day and 6-23 months non-breastfed children who had at least the minimum dietary diversity excluding milk feeds and had minimum meal frequency.

Fig 3.5: IYCF Indicators on breastfeeding status, Bangladesh, CWS 2016

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Overall, 38.0 per cent of urban children received minimum acceptable diet. Coverage with minimum acceptable diet among 6-23 months children (both breastfed and non-breastfed) was significantly higher among CC non-slums children (44.4 per cent) than among CC slums (29.7 per cent) and other urban children (36.0 per cent). Children with higher level of mother’s education and children from higher household wealth quintiles were more likely to receive minimum acceptable diet.

3.5.4 Bottle Feeding

Results presented in Table 3.8 show that more than half of (53.1 per cent) of non-breastfed children age 6-23 months were bottle-fed with two milk feedings during the previous day. Results also show that 21.4 per cent of children age 0-23 months were fed with a bottle with a nipple.

Table 3.8: Bottle feeding

Percentage of children age 0-23 months who were bottle fed during the previous day preceding the survey by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Characteristics

Non-breastfed children 6-23 month who received 2 milk feeding

Number

Children 0-23 months who were fed with a bottle a nipple

PercentageMean number of

milk feedinga Percentage Number

Total 53.1 2.9 128 21.4 2,797

AreaCity Corporation slum 51.8 (2.7) 8 20.6 123City Corporation non-slum 59.3 (2.5) 47 26.3 783Other municipalities/urban 49.3 (3.1) 73 19.4 1,892

DivisionBarisal 41.6 (*) 2 18.7 119Chittagong 37.2 (*) 18 12.9 635Dhaka 51.6 (2.8) 78 28.3 1,270Khulna 74.2 (*) 8 20.8 187Rajshahi 86.3 (*) 14 23.5 269Rangpur 20.9 (*) 5 9.6 195Sylhet 46.6 (*) 3 11.7 123

Mother’s education (*)No education 55.5 (*) 12 14.9 232Primary incomplete 29.2 (*) 17 16.1 412Primary complete 12.5 (*) 5 19.8 287Secondary incomplete 60.8 (3.6) 54 21.6 1,330Secondary complete or higher 57.0 (2.6) 40 28.5 536

Wealth index quintileLowest 36.3 1.9 17 12.9 601Second 21.7 (*) 15 13.4 499Middle 64.7 (*) 20 23.9 586Fourth 46.3 (*) 37 29.7 627Highest 73.7 (*) 38 26.5 484

Religion* (*)Islam 48.7 (*) 115 20.8 2,549Hindu 94.0 (*) 12 31.5 218

a Mean number of milk feeding in the last 24 hours

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

(*) Figures that are based on fewer than 25 unweighted cases

( ) Figures that are based on 25-49 unweighted cases

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4 CHILD HEALTHUNICEF/BANA2013-00462/Haque

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Key Findings:

� Coverage with full immunization (BCG, 3 doses of Pentavalent, 3 doses of OPV and MR at 9 months) among children age 12-23 months was 88.0 per cent. About 86.4 per cent were fully vaccinated by 12 months of age. Coverage with full vaccination was relatively low in CC slums (72.1 per cent) than CC non-slums (92.1 per cent) and other urban areas (87.3 per cent).

� About 89.7 per cent of children had received measles and rubella (MR) vaccine. Only about 68.5 per cent of children age 15-23 months received measles second dose, supposed to be administered at or after 15 months of age.

� About 86.8 per cent of women who had a live birth in the last two years were protected against neonatal/maternal tetanus. Women of CC non-slum and CC slum areas were less likely to be protected against tetanus (83.6 per cent in CC non-slums and 83.4 per cent in CC slums) than women of other urban areas (88.3 per cent). Protection status was the highest in Rajshahi (93.7 per cent), and lowest in Dhaka division (83.6 per cent).

� More than half (59.4 per cent) of urban children under age 5 with diarrhea in the last two weeks (6.1 per cent) had received advice/treatment either at a health facility or from a health provider.

� About 88.8 per cent of under five children with diarrhea received any ORS fluid.

� Overall, 36.1 per cent of urban children with diarrhea received oral rehydration salt (ORS) and Zinc.

� Seventy per cent (70.0 per cent) received diarrhea treatment with oral rehydration therapy (ORT) – ORS packets, pre-packaged ORS fluid, homemade fluid or increased fluids – and continued feeding.

� More than eighty per cent (81.2 per cent) of children under age 5 with ARI symptoms in the last two weeks (7.1 per cent) preceding the survey sought advice or treatment for ARI from a health facility or provider. There was no marked difference between children of CC non-slum areas (79.4 per cent) and children of CC slums (78.5 per cent).

� About eighty one per cent of children with ARI symptoms received treatment with antibiotics.

� Overall 48.6 per cent of urban households rely on solid fuel for cooking, with 64.3 per cent in other urban areas, 44.5 per cent in CC slums and 15.2 per cent in CC non-slums areas. Households/members of the lowest quintile mostly (67.5 per cent) use solid fuel and thus exposed to higher health risks.

This chapter presents findings on the overall health and care seeking patterns, vaccination coverage and neonatal tetanus protection of under-five children in the three urban domains and all divisions. The presentation of information on vaccination coverage focused on the age groups 12-23 months. Overall coverage level at the time of the survey and by age 12 months are shown for this group of children.

Information on the prevalence and treatment of important childhood illness – diarrhea, and acute respiratory infection (ARI) are discussed in details. Results are presented by urban domains, divisions as well as by selected characteristics.

4 CHILD HEALTH

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4.1 Childhood VaccinationUniversal immunization of children against the major vaccine-preventable diseases (tuberculosis, diphtheria, pertussis, tetanus, hepatitis, haemophiles influenza type B, poliomyelitis, pneumonia, measles and rubella) is globally recognized as one of the most cost-effective programmes to reduce infant and child morbidity and mortality. Bangladesh initiated the Expanded Programme on Immunization (EPI) in 1979 against six preventable diseases (tuberculosis, diphtheria, pertussis, tetanus, polio and measles) which was intensified after 1985, and modified in phases in 2004 and 2012. The EPI is a priority programme for the government of Bangladesh. It follows the international guidelines recommended by the World Health Organization (WHO).

At present, the full course of Childhood Vaccines under Expanded Programme of Immunization (EPI) in Bangladesh consists of three doses of Pentavalent Vaccine (diphtherias, pertussis, tetanus, hepatitis B, and Haemophiles influenza type B), four doses of oral polio vaccines (OPV), one dose of Bacille Calmetto-Guerin (BCG) vaccine against tuberculosis. One dose of measles-rubella (MR) and a measles second dose (MSD) vaccine. Moreover, EPI Bangladesh included TT Vaccination for 15-49 years-old women and MR vaccine for 16-17 year old adolescent girls.

According to EPI programme, a child should be vaccinated with all eligible antigens before first birthday. The BCG vaccine, given at birth or at first contact with the health worker, provides protection against childhood tuberculosis. The oral Polio Vaccine (OPV) provides protection against Poliomyelitis; the pentavalent (DPT+Hep-B+Hib) provides protection against Diphtheria, Pertussis, Tetanus, Hepatitis B, and Hemophilus influenza type B; and the Measles and Rubella (MR) vaccine given soon after 9 months of age, provides protection against Measles and Rubella. A Measles Second dose is given at or after 15 months of age. The Current Children Vaccination schedule under EPI in Bangladesh with number, doses and minimum time-interval is given below:

EPI Childhood Vaccination Schedule:

Name of Vaccination Doses Minimum interval between doses Starting age

BCG 1 - At birth

Pentavalent 3 4 weeks 6 weeks

OPV 4* 4 weeks 6 weeks

MR 1 - 9 months

Measles second dose (MSD) 1 - 15 months

* The 4th dose of OPV is given with MR Vaccine.

4.1.1 Vaccination Coverage

The CWS 2016 collected data on Childhood Vaccination for all surviving children born during the last two years preceding the survey. For each child, mothers were asked whether they had the vaccination card, if so, to show the card to the interviewer. If the mother was able to show the vaccination card, the dates of vaccines were recorded on the survey questionnaire. If the vaccination card was not available, mothers were asked to recall whether the child had received any vaccination. Since OPV 4th dose was introduced very recently and for comparability with other survey results on vaccination coverage, the analysis is done with 3 doses of Polio vaccination along with other vaccinations.

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Table 4.1: Vaccinations in the first years of life

Percentage of children age 12-23 months vaccinated against vaccine preventable childhood diseases at any time before the survey and by their first birthday, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Background characteristics BCG

Pentavalent OPVMR at 9 months

Full vaccinationa

No vaccinations

Number of

children

Children age 15-23 months

1 2 3 1 2 3 Measles at 15 months

Number of children

Vaccinated at any time before the survey

Vaccination card 71.4 71.8 71.4 69.9 71.8 71.7 69.9 65.5 65.0 - 1,059 50.5 752

Mother’s report 25.2 25.6 25.3 24.8 25.9 25.7 24.4 24.2 23.1 2.1 413 17.9 331

Either source 96.6 97.4 96.7 94.7 97.7 97.4 94.3 89.7 88.0 2.1 1,472 68.5 1,083

Vaccinated by 12 months of ageb 96.6 97.4 96.6 94.0 97.3 97.0 93.6 88.9 86.4 - 1,472

a BCG, measles, and three doses each of pentavalent and polio vaccine (excluding polio vaccine given at birth and polio 4)

b For children whose information is based on the mother’s report, the proportion of vaccinations given during the first year of life is assumed to be the same as for children with a written record of vaccination.

Table 4.1 provides vaccination coverage according to source of information. The data were for children age 12-23 months. According to information from both vaccination cards and mother’s report, 88.0 per cent of children age 12-23 months were fully vaccinated. The level of coverage with BCG, three doses of Pentavalent, and three doses of Polio Vaccine (OPV) was 94.0 per cent or higher. Coverage with MR vaccines was slightly lower at 89.7 per cent. Coverage of pentavalent and Polio/OPV vaccines declined with the doses, from 97.4 per cent for the first dose of pentavalent to 94.7 per cent for the third dose and from 97.7 for the first dose of polio/OPV to 94.3 per cent for the third dose. Only 2.1 per cent did not receive any vaccinations.

Fig 4.1: Full vaccination coverage by areas, Bangladesh, CWS 2016

In line with the WHO guidelines, childhood vaccinations with eligible antigens should be completed as per schedule of immunization by 12 months of age. Overall, 86.4 per cent of children age 12-23 months had received all the recommended vaccines before their first birth day.

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Fig 4.2: Vaccination coverage by division, Bangladesh, CWS 2016

As per vaccination schedule, measles second dose (MSD) is to be given at or after 15 months of age. About 68.5 per cent of children age 15-23 months received MSD.

4.1.2 Differentials in Vaccination Coverage

Table 4.2 provides coverage of vaccination by selected background characteristics. Vaccination coverage did not vary by sex of the child. Among the urban domains, lowest vaccination coverage (full) was seen in CC slums (72.1 per cent), compared with CC non-slums (92.1 per cent) and other urban areas (87.3 per cent). Vaccination coverage by divisions showed that Sylhet had the lowest coverage (80.3 per cent), and it was highest in Khulna (93.7 per cent). As expected, full vaccination by 12 months of age was found to be positively associated with mother’s education and household wealth index quintile/socio-economic status.

Table 4.2: Vaccination by background characteristics

Percentage of children age 12-23 months who received specific vaccines at any time before the survey (vaccination card or mother’s report, and vaccination card seen), by specific background characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016.

Background characteristics

BCG Pentavalent OPVMR at 9 months

Full None

Percen-tage with

vaccina-tion card

seen

Num-ber of chil-dren

Percentage of children age 15-23 months who

received measles at 15 months

1 2 3 1 2 3Measles

at 15 months

Number of

children

Total 96.6 97.4 96.7 94.7 97.7 97.4 94.3 89.7 88.0 2.1 71.9 1,472 68.5 1,083

Sex

Male 95.2 96.5 95.6 93.4 96.5 96.4 93.3 89.7 87.8 3.2 69.6 731 67.2 552

Female 98.1 98.4 97.8 95.9 98.9 98.4 95.3 89.6 88.1 1.1 75.3 731 69.3 521

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Table 4.2: continued

Background characteristics

BCG Pentavalent OPVMR at 9 months

Full None

Percen-tage with

vaccina-tion card

seen

Num-ber of chil-dren

Percentage of children age 15-23 months who

received measles at 15 months

1 2 3 1 2 3Measles

at 15 months

Number of

children

Area

City Corporation slum 92.9 92.6 90.7 83.4 93.2 91.3 82.9 76.3 72.1 6.7 57.8 61 50.6 47

City Corporation non-slum 96.5 96.5 96.1 94.4 97.4 97.2 94.2 92.6 92.1 2.6 65.9 425 71.4 310

Other municipalities/urban 96.9 98.1 97.4 95.5 98.1 97.9 95.1 89.3 87.3 1.6 75.4 986 68.4 726

Division

Barisal 99.0 98.1 97.8 94.9 98.1 97.8 95.9 90.0 88.0 1.0 75.5 60 76.2 41

Chittagong 98.1 99.5 98.4 96.2 99.5 98.6 95.8 91.7 89.4 0.5 72.1 316 72.8 241

Dhaka 94.4 95.7 95.0 92.7 96.3 96.3 92.0 88.3 86.0 3.7 67.4 696 64.4 509

Khulna 99.6 99.6 99.4 99.2 99.6 99.4 99.2 93.8 93.7 0.4 79.5 95 71.6 72

Rajshahi 99.8 98.7 98.7 98.5 98.7 98.7 98.5 91.5 91.5 0.2 76.8 141 70.1 98

Rangpur 99.8 99.8 99.6 98.4 99.8 99.6 98.4 92.9 92.7 0.2 85.6 100 76.0 77

Sylhet 95.6 95.6 93.9 87.5 95.6 93.9 87.5 81.0 80.3 4.4 73.9 64 62.6 44

Mother’s education

No education 93.7 94.0 92.8 88.5 94.0 93.5 84.2 84.2 78.9 6.0 64.8 118 56.0 86

Primary incomplete 86.3 89.6 87.9 81.9 91.7 90.1 81.9 73.3 69.2 8.2 64.2 199 59.0 138

Primary complete 99.6 99.6 99.6 96.0 99.6 99.6 96.3 88.0 87.7 0.4 77.6 166 59.4 128

Secondary incomplete 98.1 98.7 98.0 97.4 98.7 98.6 97.2 92.9 91.6 1.0 75.7 723 67.0 520

Secondary complete or above 99.9 99.9 99.9 98.8 99.9 99.9 98.8 96.9 96.7 0.1 67.2 267 88.7 212

Wealth index quintile

Lowest 90.0 92.4 92.1 87.3 93.6 93.3 87.3 81.3 77.4 5.9 66.8 328 55.3 235

Second 97.2 97.9 96.0 95.4 98.0 97.8 93.7 83.8 81.3 2.0 73.4 295 58.5 213

Middle 99.0 99.6 98.5 97.6 99.6 98.8 97.6 94.9 93.7 0.2 76.8 285 67.4 210

Fourth 99.8 99.8 99.7 96.7 99.8 99.7 96.9 93.9 93.9 0.2 71.1 321 78.2 245

Highest 97.9 97.9 97.8 97.7 97.9 97.8 97.3 96.7 96.1 2.1 72.4 243 85.4 179

Religion*

Islam 96.3 97.2 96.5 94.3 97.6 97.2 93.9 89.0 87.2 2.3 71.3 1,346 67.7 994

Hindu 99.8 99.3 99.3 98.3 99.3 99.3 98.9 97.6 97.0 0.2 77.5 110 78.4 75

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases.

4.2 Neonatal Tetanus ProtectionIn order to reduce maternal mortality and morbidity, it is essential to eliminate maternal tetanus. For preventing maternal and neonatal tetanus, all pregnant women should receive at least two doses of tetanus toxoid (TT) vaccine. If a woman has not received at least two doses of TT during a particular pregnancy, she and her child will be protected against tetanus if the women:

� Received at least two doses of TT vaccine, the last within the previous 3 years; � Received at least 3 doses, the last within the previous 5 years; � Received at least 4 doses, the last within the previous 10 years; � Received 5 or more doses any time during her life time

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To assess the tetanus vaccination coverage, women who had a live birth in the last two years preceding the interview were asked if they had received any TT injections during the pregnancy for their recent birth, and if they did, how many. Women who did not receive two or more doses of TT injections during their most recent pregnancy were then asked about TT vaccinations they might have previously received. Interviewers also asked them to show their vaccination card, if available, for recording the date and vaccination received.

Table 4.3: Neonatal tetanus protection

Percentage of woman age 15-49 years with a live birth in the last two years preceding the survey who were protected against neo natal tetanus by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016.

Percentage of women who received at

least 2 doses during last pregnancy

Percentage of women who did not receive two or more doses during last pregnancy but received:

Protected against tetanus

Number of women with a live

birth in the last 2

years

2 doses, the last within

prior 3 years

3 doses, the last within prior 5 years

4 doses, the last within

prior 10 years

5 or more doses during

lifetime

Total 30.5 0.9 4.2 6.1 45.0 86.8 2,882

Area

City Corporation slum 39.8 1.9 2.6 4.7 34.3 83.4 127

City Corporation non-slum 31.8 1.2 4.6 5.7 40.4 83.6 811

Other municipalities/urban 29.3 0.7 4.2 6.4 47.7 88.3 1,944

Division

Barisal 35.4 0.0 2.2 8.6 44.3 90.5 120

Chittagong 32.1 0.4 2.9 7.2 48.0 90.6 651

Dhaka 34.6 1.4 4.4 4.4 38.9 83.6 1,320

Khulna 22.0 1.5 10.6 8.8 42.3 85.1 193

Rajshahi 22.7 0.1 4.9 9.7 56.4 93.7 272

Rangpur 21.8 0.6 1.6 5.1 57.1 86.3 198

Sylhet 17.4 0.2 4.8 6.1 55.8 84.2 128

Mother’ education

No education 36.4 0.6 7.9 1.3 26.6 72.8 237

Primary incomplete 31.5 2.6 1.1 5.0 36.4 76.6 423

Primary complete 30.3 0.3 6.6 8.1 44.9 90.1 294

Secondary incomplete 29.7 0.6 4.8 6.7 47.3 89.0 1,378

Secondary complete or above 29.2 0.8 2.3 6.8 54.2 93.2 549

Wealth index quintile

Lowest 32.4 1.6 6.2 7.2 37.7 85.1 633

Second 41.8 1.1 3.3 3.8 37.3 87.2 520

Middle 24.4 0.9 1.8 9.9 51.1 88.0 594

Fourth 23.7 0.6 4.9 5.3 50.9 85.4 634

Highest 32.1 0.0 4.8 3.9 47.8 88.7 500

Religion*

Islam 31.4 0.9 4.5 5.9 44.0 86.7 2,629

Hindu 18.1 0.5 1.4 10.4 57.2 87.5 220

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

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Table 4.3 gives the protection status from tetanus of women who have had a live birth in the last two years preceding the survey. Results show that 86.8 per cent of women were protected against tetanus. Only 30.5 per cent women received 2 or more doses of TT vaccines during their last pregnancy and 45.0 per cent reported receiving of 5 or more doses during life time.

Fig 4.3: Percentage of women age 15-49 years with a live birth in the last 2 years protected against tetanus by background characteristics, Bangladesh, CWS 2016

Women of other urban areas were more likely to receive protection against tetanus (88.3 per cent) than women of CC slums (83.4 per cent) and CC non-slum areas (83.6 per cent).

Among the divisions, protection status was the highest in Rajshahi (93.7 per cent) and lowest in Sylhet division (84.2 per cent). Protection status against neonatal/maternal tetanus was found to be positively associated with mother’s education and socioeconomic status of women. For example, only 72.8 per cent women who had no formal education were protected against tetanus, while it was 93.2 per cent of those who had secondary or higher education. About 85.1 per cent women of the lowest quintile against 88.7 per cent of the highest quintile were found to be protected against tetanus. The MICS 2012-2013 reported protection status from tetanus of urban women at 81.8 per cent.

4.3 Childhood Illness and Treatment

This section discusses two illnesses that are major contributors to childhood morbidity and mortality in Bangladesh: diarrhea and acute respiratory infection (ARI). Estimates of the prevalence of these illnesses are presented as well as care seeking behavior and feeding practices during diarrhea. It should be noted here that seasonal changes affect greatly the prevalence of these illnesses.

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Table 4.4: Reported disease episodes

Percentage of children age 0-59 months for whom mother/ caretaker reported an episode of diarrhea and/ or symptoms of acute respiratory infection (ARI) and/or fever in the last two weeks prior to the survey by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

CharacteristicsHad an episode of

diarrheaSymptoms of ARI Number of children

Total 6.1 7.1 7,521

Sex

Male 5.7 8.0 3,783

Female 6.5 6.2 3,738

Area

City Corporation slum 9.2 7.5 336

City Corporation non-slum 5.9 6.7 2,242

Other municipalities/urban 6.0 7.2 4,943

Division

Barisal 5.0 8.0 318

Chittagong 9.1 6.1 1,562

Dhaka 5.1 6.8 3,580

Khulna 5.7 8.3 542

Rajshahi 6.2 10.2 695

Rangpur 5.9 6.6 487

Sylhet 4.7 6.2 337

Age

0-11 months 7.1 11.0 1,382

12-23 months 10.2 6.9 1,521

24-35 months 6.3 7.0 1,534

36-47 months 4.1 6.4 1,511

48-59 months 3.0 4.6 1,573

Mother’s education

No education 7.0 9.8 693

Primary incomplete 8.9 9.0 1,077

Primary complete 6.4 8.1 751

Secondary incomplete 5.7 7.1 3,677

Secondary complete or higher 4.3 3.5 1,324

Wealth index quintile

Lowest 7.7 7.7 1,563

Second 6.7 9.0 1,388

Middle 5.4 9.6 1,474

Fourth 5.9 6.3 1,686

Highest 4.8 2.9 1,410

Religion*

Islam 6.1 7.2 6,909

Hindu 5.7 6.6 558

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

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4.3.1 Childhood Diarrhea

Diarrhea remains a leading cause of childhood morbidity and mortality in developing countries. Dehydration from diarrhea has been an important contributing cause of childhood mortality. The administration of oral rehydration therapy (ORT) is a simple means of countering the effects of dehydration. During diarrhea, a child may be given a solution prepared either by mixing water with a commercially prepared oral rehydration salts packet (ORS) – also called Khabar or packet saline in Bangladesh or by making a homemade solution of sugar, salt and water, also called laban gur.

In CWS 2016, respondents were asked if their children under age 5 had experienced an episode of diarrhea in the two weeks before the survey. Table 4.4 shows that 6.1 per cent of children under age 5 were reported to have had diarrhea. The prevalence of diarrhea was higher in CC slum areas. It was also higher at age 12-23 months, a period during which solid foods are introduced into the child’s diet.

Table 4.5: Treatment/care- seeking for diarrhea

Percentage of children age 0-59 months with diarrhea in the last 2 weeks preceding the survey for whom treatment or advice was sought from health provider/ facility, Percentage who received ORS and Zinc and Percentage who received ORT (ORS packet, pre-packaged ORS fluid, recommended homemade fluid or increased fluids) and continued feeding during episode of diarrhea by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Characteristics

Had diarrhea in the last 2

weeks

Number of children under

5 years with diarrhea

Percentage who received

Advice/ treatment from provider/ facility

ORS and Zinc

ORT and Continued

feeding

Total 6.1 459 59.4 36.1 70.0

Sex

Male 5.7 217 61.3 42.0 72.3

Female 6.5 242 57.7 30.8 67.9

Area

City Corporation slum 9.2 31 59.6 32.8 60.9

City Corporation non-slum 5.9 132 49.0 39.1 72.8

Other municipalities/urban 6.0 296 64.0 35.1 69.6

Division

Barisal (5.0) 16 (54.0) (42.4) (62.8)

Chittagong 9.1 142 56.5 44.8 70.1

Dhaka 5.1 183 58.5 37.0 71.7

Khulna (5.7) 31 (44.2) (21.2) (68.5)

Rajshahi 6.2 43 77.0 27.0 74.6

Rangpur 5.9 29 68.2 17.9 51.0

Sylhet 4.7 16 66.6 27.5 79.2

Mother’s education

No education 7.0 48 63.8 39.0 75.7

Primary incomplete 8.9 96 51.4 30.7 57.6

Primary complete 6.4 48 61.1 49.0 88.3

Secondary incomplete 5.7 210 58.4 27.9 66.3

Secondary complete or higher 4.3 57 71.2 62.3 83.8

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Table 4.5: continued

Characteristics

Had diarrhea in the last 2

weeks

Number of children under

5 years with diarrhea

Percentage who received

Advice/ treatment from provider/ facility

ORS and Zinc

ORT and Continued

feeding

Wealth index quintile

Lowest 7.7 120 49.2 27.7 61.1

Second 6.7 93 65.7 36.2 74.9

Middle 5.4 79 57.9 41.9 73.9

Fourth 5.9 99 61.3 33.7 70.2

Highest 4.8 68 67.8 47.6 73.8

Religion*

Islam 6.1 423 59.8 36.4 69.6

Hindu (5.7) 32 (56.8) (28.4) (70.9)

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

( ) Figures that are based on 25-49 unweighted cases

4.3.2 Treatment of Childhood Diarrhea

For children under age 5 with diarrhea in the two weeks before the survey, mothers were asked what they did to treat their diarrhea. Because the prevalence of diarrhea varies seasonally, the survey results pertain only to the period from February to April, 2016 when the fieldwork took place. Table 4.5 shows that 59.4 per cent of urban children under age 5 with diarrhea were taken to a health facility or provider for advice or treatment. Overall, 36.1 per cent of children with diarrhea received oral rehydration salt (ORS) and Zinc, and 70.0 per cent received oral rehydration therapy (ORT) – ORS packet, prepackaged ORS fluid, recommended homemade fluid or increased fluids – and continued feedings.

Receiving advice/treatment for diarrhea from a health facility or provider was higher in other urban areas, compared to CC non-slums and CC slum areas. Children of higher wealth quintiles were more likely to receive treatment/advice from health facility or providers. These results should be taken with some caution as the sample sizes from which these were estimated were small.

Table 4.6: Feeding practices during diarrhea

Percentage of children age 0-59 months with diarrhoea in the last two weeks preceding the survey by amount of liquids and food given during episode of diarrhoea, by selected characteristics Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Drinking practices during diarrhoea Eating practices during diarrhoea Number of children age 0-59

months with diarrhoea in the last two

weeks

Child was given to drink: Total Child was given to eat: Total

Much less

Some what less

About the

same

More Noth-ing

Missing/DK

Much less

Some what less

About the

same

More Noth-ing

Missing/DK

Total 8.3 28.3 30.4 31.9 0.8 0.2 100.0 19.7 31.7 31.6 15.6 1.3 0.2 100.0 459

Sex

Male 8.0 24.8 33.0 32.9 0.8 0.4 100.0 17.6 35.4 28.5 16.7 1.3 0.5 100.0 217

Female 8.5 31.6 28.0 31.1 0.9 0.0 100.0 21.5 28.3 34.3 14.6 1.3 0.0 100.0 242

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Table 4.6: continued Drinking practices during diarrhoea Eating practices during diarrhoea Number

of children age 0-59

months with diarrhoea in the last two

weeks

Child was given to drink: Total Child was given to eat: Total

Much less

Some what less

About the

same

More Noth-ing

Missing/DK

Much less

Some what less

About the

same

More Noth-ing

Missing/DK

Area

City Corporation slum 15.8 32.1 30.1 21.9 0.1 0.0 100.0 21.0 39.8 25.6 13.6 0.1 0.0 100.0 31

City Corporation non-slum 4.5 26.3 34.3 32.9 1.3 0.7 100.0 17.8 29.8 34.3 16.0 1.3 0.8 100.0 132

Other municipalities/urban 9.2 28.9 28.6 32.6 0.7 0.0 100.0 20.4 31.6 31.0 15.6 1.4 0.0 100.0 296

Division

Barisal (9.2) (21.5) (40.9) (28.5) 0.0 0.0 100.0 (24.5) (44.4) (22.0) (8.2) 0.0 (1.0) 100.0 16

Chittagong 15.3 41.2 25.1 16.5 1.3 0.6 100.0 21.1 38.5 23.6 14.9 1.3 0.6 100.0 142

Dhaka 1.9 24.5 30.4 43.3 0.0 0.0 100.0 21.6 27.8 34.9 15.6 0.0 0.0 100.0 183

Khulna (1.1) (14.3) (31.7) (52.9) 0.0 0.0 100.0 (4.0) (30.9) (46.4) (18.6) 0.0 0.0 100.0 31

Rajshahi 13.2 17.6 41.6 27.6 0.0 0.0 100.0 13.2 26.0 38.3 22.5 0.0 0.0 100.0 43

Rangpur 14.9 18.3 30.8 28.7 7.3 0.0 100.0 26.8 19.1 27.1 12.5 14.5 0.0 100.0 29

Sylhet (8.3) (38.9) (33.4) (19.4) 0.0 0.0 100.0 (13.9) (41.7) (34.8) (9.6) 0.0 0.0 100.0 16

Age

0-11 months 7.1 26.1 38.8 24.1 3.0 0.9 100.0 7.1 26.5 43.5 16.9 4.9 1.1 100.0 98

12-23 months 11.6 32.0 23.3 33.2 0.0 0.0 100.0 24.9 32.4 28.5 13.6 0.7 0.0 100.0 156

24-35 months 6.3 27.7 32.3 33.7 0.0 0.0 100.0 21.6 28.4 36.1 13.9 0.0 0.0 100.0 96

36-47 months 4.8 29.2 31.1 33.5 1.4 0.0 100.0 20.4 39.5 18.2 21.9 0.0 0.0 100.0 62

48-59 months 8.9 21.3 31.3 38.6 0.0 0.0 100.0 23.7 36.2 25.5 14.7 0.0 0.0 100.0 47

Mother’s education

No education 12.8 43.5 23.2 18.6 1.8 0.0 100.0 17.6 37.6 22.0 22.8 0.0 0.0 100.0 48

Primary incomplete 2.7 32.5 33.9 30.9 0.0 0.0 100.0 22.0 34.8 31.8 11.4 0.0 0.0 100.0 96

Primary complete 0.4 17.8 32.7 45.0 4.0 0.0 100.0 7.3 39.2 19.5 30.1 4.0 0.0 100.0 48

Secondary incomplete 12.2 25.5 29.1 32.2 0.5 0.4 100.0 24.9 27.0 32.8 13.0 1.9 0.4 100.0 210

Secondary complete or higher 6.3 27.7 33.0 33.0 0.0 0.0 100.0 8.6 32.2 45.0 13.9 0.0 0.3 100.0 57

Wealth index quintile

Lowest 7.5 35.9 24.1 31.1 1.5 0.0 100.0 20.1 32.1 25.1 21.1 1.6 0.0 100.0 120

Second 8.1 44.0 28.4 19.5 0.0 0.0 100.0 20.1 41.1 28.2 10.6 0.0 0.0 100.0 93

Middle 8.6 32.4 25.7 32.0 1.3 0.0 100.0 20.5 27.4 33.7 17.2 1.3 0.0 100.0 79

Fourth 7.0 9.7 38.6 43.8 0.0 0.9 100.0 18.7 31.2 36.8 11.5 0.9 0.9 100.0 99

Highest 11.6 15.9 37.6 33.3 1.5 0.0 100.0 18.7 23.5 37.7 16.8 3.1 0.2 100.0 68

Religion*

Islam 7.8 29.1 29.7 32.3 0.9 0.2 100.0 19.3 32.9 29.7 16.4 1.4 0.2 100.0 423

Hindu (16.0) (14.6) (42.1) (27.3) 0.0 0.0 100.0 (26.3) (8.8) (59.5) (5.4) 0.0 0.0 100.0 32

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

( ) Figures that are based on 25-49 unweighted cases

DK Don't know

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4.3.3 Feeding Practices during Diarrhea

Table 4.6 provides statistics on drinking and feeding practices during diarrhea. About one-third (31.9 per cent) of children under age 5 with diarrhea were given more than the usual amount to drink, while 30.4 per cent children were given the same amount. Three in every ten children were given less than usual amount to drink during the episode of diarrhea. Among the children of different age groups, the youngest of age 0-11 months were least likely to be given more than usual amount to drink (24.1 per cent).

About one in three (31.7 per cent) with diarrhea were given somewhat less to eat than normal, with another 19.7 per cent given much less or nothing to eat. Only 31.6 per cent children with diarrhea were given about the same amount to eat during diarrhea.

Table 4.7: Oral rehydration solutions, recommended homemade fluids, and zinc

Percentage of children age 0-59 months with diarrhoea in the last two weeks, and treatment with oral rehydration salts (ORS), recommended homemade fluids, and zinc, by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Percentage of children with diarrhoea who received: Number of

children age 0-59 months

with diarrhoea

in the last two weeks

Oral rehydration salts (ORS)

Recommended homemade fluids ORS or any

recomm-ended home-made fluid

Zinc ORS and zincFluid

from packet

Pre-packa-

ged fluid

Any ORS

Sugar and salt

solu-tion

Green coco-nut

water

Chira water

Rice starch

Any recomm-

ended home-made fluid

Syrup Tablet Any zinc

Total 88.1 10.9 88.8 6.6 12.4 13.3 12.5 32.6 90.3 31.0 11.2 38.4 36.1 459

Sex

Male 90.0 12.4 90.7 9.7 13.0 17.8 13.6 37.6 91.6 38.1 13.1 44.0 42.0 217

Female 86.4 9.5 87.1 3.8 11.9 9.3 11.4 28.1 89.1 24.7 9.6 33.3 30.8 242

Area

City Corporation slum 80.2 17.3 83.9 6.6 11.5 9.8 11.6 30.4 84.2 29.9 9.6 32.9 32.8 31

City Corporation non-slum 89.9 12.0 90.5 7.2 13.1 9.9 14.0 33.1 90.8 26.2 15.0 39.5 39.1 132

Other municipalities/urban 88.1 9.7 88.5 6.3 12.2 15.2 11.9 32.6 90.7 33.3 9.7 38.4 35.1 296

Division

Barisal (88.3) (18.4) (88.3) (24.6) (26.5) (15.3) (29.7) (57.2) (88.3) (38.8) (8.2) (42.4) (42.4) 16

Chittagong 91.2 6.3 91.4 3.8 14.4 12.4 6.9 26.2 92.9 42.1 12.1 46.3 44.8 142

Dhaka 90.5 11.3 91.0 7.4 10.2 13.1 20.7 36.3 91.0 25.4 14.7 37.0 37.0 183

Khulna (68.4) (22.5) (73.5) (1.1) (17.6) (21.8) (10.2) (44.3) (73.6) (25.2) (4.0) (29.2) (21.2) 31

Rajshahi 82.8 20.5 83.9 8.2 11.1 1.1 1.1 19.3 91.7 27.5 8.3 35.3 27.0 43

Rangpur 87.3 3.6 87.3 9.5 8.9 31.6 1.7 41.1 88.5 19.0 3.7 22.6 17.9 29

Sylhet (86.1) (4.1) (86.1) (5.6) (5.6) (5.5) (4.2) (20.9) (91.7) (31.8) (1.4) (33.1) (27.5) 16

Age

0-11 months 75.1 14.7 75.7 4.6 5.8 7.2 1.0 16.4 77.8 36.8 2.4 36.8 29.2 98

12-23 months 88.4 6.4 90.1 2.2 8.8 9.0 15.3 29.6 90.5 27.4 10.8 35.5 35.1 156

24-35 months 92.5 13.8 92.5 15.9 11.1 14.8 12.7 38.6 96.5 36.6 9.4 41.7 39.3 96

36-47 months 93.7 9.7 93.7 11.0 23.7 27.4 21.2 53.0 93.7 27.8 34.1 50.3 50.3 62

48-59 months (98.0) (13.7) (98.0) (0.3) (26.2) (18.4) (14.9) (37.5) (98.0) (23.9) (4.5) (28.4) (28.4) 47

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Table 4.7: continued Percentage of children with diarrhoea who received: Number

of children age 0-59 months

with diarrhoea

in the last two weeks

Oral rehydration salts (ORS)

Recommended homemade fluids ORS or any

recomm-ended home-made fluid

Zinc ORS and zincFluid

from packet

Pre-packa-

ged fluid

Any ORS

Sugar and salt

solu-tion

Green coco-nut

water

Chira water

Rice starch

Any recomm-

ended home-made fluid

Syrup Tablet Any zinc

Mother’s education

No education 88.5 14.4 90.3 2.4 8.4 27.2 17.0 44.0 90.3 34.6 10.4 39.0 39.0 48

Primary incomplete 71.5 10.7 72.8 3.7 10.6 13.8 10.2 26.8 75.0 25.6 12.8 35.7 30.7 96

Primary complete 93.5 13.0 93.5 12.4 26.2 16.0 18.8 49.2 96.9 34.8 30.2 51.2 49.0 48

Secondary incomplete 93.2 6.3 93.7 4.5 10.8 8.0 12.8 27.6 95.0 25.9 6.4 30.0 27.9 210

Secondary complete or higher 92.4 23.6 92.4 17.9 13.2 17.8 5.6 37.5 92.7 52.8 11.2 62.6 62.3 57

Wealth index quintile

Lowest 75.2 12.4 77.1 10.5 7.9 13.8 7.9 29.7 80.6 27.6 10.5 33.3 27.7 120

Second 95.1 5.9 95.1 3.0 10.3 15.7 8.1 31.6 95.2 28.7 8.2 36.2 36.2 93

Middle 93.4 9.5 93.8 3.8 21.2 15.2 25.9 42.2 96.2 41.5 12.0 43.7 41.9 79

Fourth 88.0 7.5 88.3 3.2 10.9 8.4 15.0 27.1 88.7 22.7 15.1 35.8 33.7 99

Highest 95.2 21.7 95.6 12.8 15.1 13.9 7.0 36.2 95.8 40.3 10.1 47.9 47.6 68

Religion*

Islam 87.5 11.0 88.1 6.9 12.8 13.6 13.0 33.5 89.6 31.0 11.8 38.8 36.4 423

Hindu (94.9) (9.5) (96.6) (1.4) (8.6) (10.3) (7.2) (23.9) (97.1) (27.7) (5.0) (29.0) (28.4) 32

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases( ) Figures that are based on 25-49 unweighted cases

Table 4.7 gives Percentage of urban children with diarrhea who received various types of recommended fluids during their recent (last two weeks) episodes of diarrhea. Mothers provided multiple responses (more than one type) on type of liquids given and thus Percentages do not necessary add up to 100 per cent. More than eight in every ten (88.8 per cent) children with diarrhea had received ORS packets or pre-packaged ORS fluids, and 90.3 per cent children with diarrhea received ORS or any recommended homemade fluids.

About one third (38.4 per cent) of urban children with diarrhea had received Zinc syrup or tablet during recent episode of diarrhea: Children of urban CC non-slum areas and children of higher wealth quintiles were more likely to receive Zinc during their recent episode of diarrhea.

Nearly 36.1 per cent of urban children had received ORS and Zinc during their recent episode of diarrhea. This Percentage was 39.1 per cent in CC non-slums, 32.8 per cent in CC slums, and 35.1 per cent in other urban areas. Administration of ORS with Zinc was the highest in Chittagong (44.8 per cent), and lowest in Rangpur (17.9 per cent).

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Fig 4.4: Percentage of children under 5 with diarrhoea who received oral rehydration therapy (ORT) and continued feeding, Bangladesh, CWS 2016

4.3.4 Acute Respiratory Infection (ARI) The CWS 2016 collected symptoms of ARI that prevailed among children under five years of age during the last two weeks preceding the survey. Acute respiratory infections (ARI), primarily pneumonia, is a leading cause of childhood morbidity and mortality throughout the world. Early diagnosis and treatment with antibiotics can reduce the number of deaths caused by ARI, particularly deaths from pneumonia. ARI symptoms include cough accompanied by short, rapid breathing or difficulty in breathing.

Table 4.8: Oral rehydration therapy with continued feeding and other treatments

Percentage of children age 0-59 months with diarrhoea in the last two weeks who received oral rehydration therapy with continued feeding, and Percentage of children with diarrhoea who received other treatments, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Children with diarrhoea who received: Other treatment: Not

given any

treat-ment

or drug

Num-ber of

children aged 0-59

months with diarr-hoea

ORS or increa-

sed fluids

ORT (ORS or recomm-

ended homemade

fluids or increased

fluids)

ORT with

conti-nued

feeding

Pill or syrup:

Antibio-tic

Pill or syrup:

Antimo-tility

Pill or syrup: Zinc

Pill or syrup: Other

Pill or syrup:

Un-known

Injec-tion:

Antibio-tic

Injec-tion: Non-

antibio-tic

Injection: Unknown

Home remedy /Herbal medi-cine

Other

Total 70.4 71.7 70.0 32.4 0.2 11.2 8.3 15.3 0.8 1.1 1.3 0.6 1.9 5.3 459

Sex

Male 72.9 73.7 72.3 39.3 0.3 14.2 5.9 19.0 1.3 0.2 1.3 0.7 0.4 4.3 217

Female 68.1 69.9 67.9 26.3 0.2 8.5 10.6 11.9 0.4 2.0 1.2 0.4 3.2 6.3 242

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Table 4.8: continued

Children with diarrhoea who received: Other treatment: Not

given any

treat-ment

or drug

Num-ber of

children aged 0-59

months with diarr-hoea

ORS or increa-

sed fluids

ORT (ORS or recomm-

ended homemade

fluids or increased

fluids)

ORT with

conti-nued

feeding

Pill or syrup:

Antibio-tic

Pill or syrup:

Antimo-tility

Pill or syrup: Zinc

Pill or syrup: Other

Pill or syrup:

Un-known

Injec-tion:

Antibio-tic

Injec-tion: Non-

antibio-tic

Injection: Unknown

Home remedy /Herbal medi-cine

Other

Area

City Corporation slum 64.3 64.6 60.9 12.3 2.9 13.1 8.5 19.2 1.4 0.0 0.0 0.1 0.9 6.9 31

City Corporation non-slum 73.1 73.2 72.8 33.7 0.1 14.1 10.7 14.3 0.2 0.0 0.3 0.6 4.4 3.3 132

Other municipalities/urban 69.8 71.8 69.6 34.0 0.0 9.6 7.3 15.3 1.0 1.8 1.8 0.6 0.9 6.1 296

Division

Barisal (66.4) (66.4) (62.8) (20.4) (1.0) (32.7) (4.6) (29.1) 0.0 0.0 (3.6) (3.6) (1.0) (7.2) 16

Chittagong 70.3 71.8 70.1 27.4 0.0 12.5 3.6 15.9 1.5 0.0 1.5 0.0 0.8 4.8 142

Dhaka 72.2 72.2 71.7 42.4 0.5 9.7 10.4 11.3 0.2 2.6 0.0 0.0 2.1 5.7 183

Khulna (69.5) (69.6) (68.5) (11.6) (0.1) (6.1) (15.3) (17.4) 0.0 0.0 0.0 (5.1) (6.1) (9.2) 31

Rajshahi 70.7 78.5 74.6 26.5 0.0 5.7 8.3 20.4 0.0 0.0 4.4 1.1 0.0 3.9 43

Rangpur 57.5 58.1 51.0 32.6 0.0 8.3 14.3 11.0 3.6 0.0 3.6 0.0 4.1 3.7 29

Sylhet (77.8) (80.6) (79.2) (30.6) 0.0 (23.5) (7.0) (30.6) (1.4) (2.8) (1.4) 0.0 (2.8) (2.7) 16

Age

0-11 months 66.9 68.5 67.4 24.7 0.4 9.8 3.3 16.0 2.1 0.4 2.7 0.2 2.3 6.7 98

12-23 months 68.3 68.8 64.5 29.3 0.3 10.5 10.4 16.0 0.0 3.1 0.0 0.4 1.0 8.1 156

24-35 months 71.9 75.8 75.8 41.4 0.0 13.4 9.4 15.3 0.2 0.0 0.8 1.6 5.0 1.9 96

36-47 months 75.6 75.6 75.6 37.8 0.0 14.0 7.3 13.3 0.7 0.0 3.4 0.4 0.0 5.0 62

48-59 months (74.4) (74.4) (73.9) (33.6) (0.3) (7.8) (11.4) (13.7) (2.2) 0.0 (0.5) (0.1) (0.3) (0.7) 47

Mother’s education Mother’s education

No education 76.9 76.9 75.7 11.6 0.0 11.7 3.0 24.8 0.0 0.9 0.4 0.0 0.0 2.3 48

Primary incomplete 55.8 58.0 57.6 13.6 0.4 9.2 10.9 20.5 1.1 0.0 1.7 0.2 1.6 16.1 96

Primary complete 84.8 88.3 88.3 32.9 0.0 15.9 1.6 12.3 0.0 0.0 6.5 3.1 0.0 0.5 48

Secondary incomplete 68.1 69.2 66.3 38.5 0.3 10.2 10.3 12.3 1.3 2.3 0.4 0.4 3.4 2.3 210

Secondary complete or higher 85.6 85.6 83.8 59.3 0.0 13.4 6.9 11.8 0.0 0.0 0.0 0.0 0.0 5.1 57

Wealth index quintile Wealth index quintile

Lowest 60.6 64.1 61.1 20.8 0.4 12.7 2.8 17.2 0.0 0.0 0.2 1.0 1.8 14.4 120

Second 76.8 76.8 74.9 23.9 0.5 6.9 15.8 9.4 0.5 0.5 4.0 0.4 5.3 2.2 93

Middle 73.7 76.0 73.9 41.7 0.2 15.4 10.0 12.4 1.3 0.0 2.0 1.3 1.7 0.3 79

Fourth 70.2 70.2 70.2 28.1 0.0 7.0 8.7 26.5 0.0 4.9 0.2 0.0 0.0 3.2 99

Highest 75.3 75.3 73.8 60.5 0.0 15.4 5.4 6.8 3.4 0.0 0.0 0.0 0.5 2.7 68

Religion*

Islam 70.1 71.5 69.6 29.8 0.2 11.2 7.9 15.9 0.9 1.2 1.4 0.6 1.8 5.8 423

Hindu (70.9) (70.9) (70.9) (60.1) 0.0 (11.5) (15.6) (8.9) 0.0 0.0 0.0 0.0 (3.2) 0.0 32

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases( ) Figures that are based on 25-49 unweighted cases

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Table 4.9: Care-seeking for ARI

Percentage of children age 0-59 months with ARI symptoms in the last 2 weeks preceding the survey for whom advice/ treatment was sought from a facility/ provider and Percentage who received antibiotics by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

CharacteristicsHad ARI

symptomsNumber of children

under 5 years with ARI

Percentage who

Sought advice/ treatment from facility/ provider

Received antibiotics

Total 7.1 533 81.2 80.7

Sex

Male 8.0 303 79.3 78.4

Female 6.2 230 83.6 83.6Area

City Corporation slum 7.5 25 78.5 76.8

City Corporation non-slum 6.7 151 79.4 79.2

Other municipalities/urban 7.2 357 82.1 81.5Division

Barisal 8.0 25 86.9 86.9

Chittagong 6.1 96 75.9 73.7

Dhaka 6.8 243 80.6 80.4

Khulna 8.3 45 79.4 79.4

Rajshahi 10.2 71 89.5 89.5

Rangpur 6.6 32 81.7 81.7

Sylhet 6.2 21 80.2 79.2Mother’s education

No education 9.8 68 76.4 76.4

Primary incomplete 9.0 97 81.9 81.9

Primary complete 8.1 61 85.2 85.2

Secondary incomplete 7.1 262 78.3 77.4

Secondary complete or higher 3.5 46 97.6 97.2Wealth index quintile

Lowest 7.7 120 70.3 70.3

Second 9.0 125 79.0 79.0

Middle 9.6 141 93.5 91.7

Fourth 6.3 106 76.1 76.1

Highest 2.9 40 90.7 90.2Religion*

Islam 7.2 496 81.1 80.6

Hindu (6.6) 37 (82.2) (82.2)

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

( ) Figures that are based on 25-49 unweighted cases

Table 4.9 shows that 7.1 per cent of the children under age 5 had symptoms of an ARI, that is, cough accompanied by short, rapid breathing and/or by difficult breathing which was chest related, at some time in the two weeks preceding the survey. Among those who had symptoms of ARI, 81.2 per cent sought treatment or advice from health facility or a provider. Nearly 80.7 per cent of the ARI infected children had received treatment with antibiotics. Receiving treatment with antibiotics for ARI was somewhat less prevalent in CC slums (76.8 per cent) than CC non-slums (79.2 per cent) and other urban areas (81.5 per cent). Treatment for ARI with antibiotics varied by divisions with the highest in Rajshahi (89.5 per cent) and lowest in Chittagong (73.7 per cent).

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Tab

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4.4 Solid Fuel UseSolid fuels include biomass fuels such as wood, charcoal, crops or other agricultural wastes, and animal dung. Cooking and heating with solid fuels leads to high levels of indoor smoke which contains a complex mix of health damaging pollutants. Use of solid fuels increases the risk of causing acute respiratory illness (ARI), pneumonia, lung disease, cancer, asthma, and other diseases and may contribute to low birth weight babies.

Table 4.11: Solid fuel use

Per cent distribution of household members according to type of cooking fuel mainly used by the household, and Percentage of household members living in households using solid fuels for cooking, Child Well-being Survey in Urban Areas, Bangladesh, CWS, 2016

Percentage of household members in households mainly using:

Number of

house-hold

mem-bers

Electri-city

Lique-fied

Petro-leum Gas

(LPG)Natural

GasBio-gas

Kero-sene

Solid fuels

Other fuel

No food cook-ed in

the HH Total

Solid fuels for

cook-ing

Coal/ Lignite

Char- coal Wood

Straw/ Shrubs/ Grass

Animal dung

Agricul-tural crop

residue

Total 1.0 5.2 44.9 0.1 0.2 0.0 0.2 44.7 0.8 0.9 2.0 0.0 0.1 100.0 48.6 82,228

AreaCity Corporation slum 3.4 1.6 47.5 0.0 2.5 0.0 0.4 42.4 1.0 0.5 0.3 0.1 0.4 100.0 44.5 3,302

City Corporation non-slum 1.1 4.7 78.7 0.1 0.1 0.0 0.2 14.2 0.4 0.2 0.3 0.0 0.1 100.0 15.2 25,015

Other municipalities/urban 0.8 5.6 29.0 0.1 0.1 0.0 0.1 59.0 1.0 1.2 2.9 0.1 0.1 100.0 64.3 53,911

DivisionBarisal 0.6 16.2 0.2 0.0 0.0 0.0 0.2 79.1 1.4 0.2 2.1 0.0 0.0 100.0 82.9 3,343

Chittagong 0.0 5.3 49.3 0.0 0.1 0.0 0.1 44.7 0.3 0.0 0.1 0.0 0.1 100.0 45.2 16,019

Dhaka 0.5 2.0 67.9 0.1 0.3 0.0 0.0 26.8 0.8 0.1 1.5 0.0 0.1 100.0 29.1 38,509

Khulna 2.9 17.6 0.2 0.0 0.2 0.1 0.6 65.3 2.5 4.4 6.2 0.0 0.1 100.0 79.1 6,988

Rajshahi 1.9 5.7 12.9 0.2 0.2 0.0 0.1 67.9 0.9 4.3 5.7 0.2 0.1 100.0 78.9 8,430

Rangpur 4.0 6.3 0.4 0.3 0.0 0.0 0.7 87.0 0.3 0.1 0.7 0.0 0.1 100.0 88.9 5,554

Sylhet 0.0 1.2 50.8 0.2 0.0 0.0 0.1 45.3 0.7 0.6 1.0 0.0 0.1 100.0 47.7 3,385

Education of household headNo education 0.6 0.8 37.0 0.1 0.3 0.0 0.1 56.8 0.7 1.4 2.2 0.0 0.1 100.0 61.1 19,159

Primary incomplete 0.6 1.2 41.8 0.1 0.2 0.0 0.2 48.2 1.4 1.4 4.7 0.1 0.1 100.0 56.0 13,377

Primary complete 0.3 2.9 38.8 0.1 0.1 0.0 0.2 54.0 0.9 1.0 1.5 0.0 0.1 100.0 57.6 9,033

Secondary incomplete 0.7 5.7 46.4 0.1 0.1 0.0 0.3 43.5 0.9 0.6 1.6 0.1 0.1 100.0 46.9 24,583

Secondary complete or above 2.3 14.5 57.9 0.1 0.2 0.0 0.0 24.0 0.3 0.2 0.3 0.0 0.1 100.0 24.9 15,715

Missing/DK 4.6 0.6 61.1 0.2 0.0 0.0 0.0 31.1 0.0 0.0 2.3 0.0 0.0 100.0 33.4 360

Wealth Index quintileLowest 0.4 0.5 30.9 0.1 0.1 0.0 0.2 61.1 1.1 1.2 4.1 0.1 0.4 100.0 67.5 13,990

Second 0.4 0.9 48.1 0.0 0.3 0.0 0.2 45.3 1.0 1.3 2.2 0.1 0.1 100.0 50.0 15,216

Middle 0.5 2.1 32.6 0.1 0.3 0.0 0.2 58.5 1.1 1.5 2.9 0.0 0.0 100.0 64.3 17,034

Fourth 1.5 6.8 45.8 0.0 0.2 0.0 0.2 43.0 0.9 0.5 1.0 0.0 0.0 100.0 45.7 17,824

Highest 1.7 13.7 63.4 0.2 0.1 0.0 0.0 20.5 0.1 0.1 0.3 0.0 0.0 100.0 20.9 18,163

Religion*Islam

Hiundu

Table 4.11 gives Percentage of household members by types of cooking fuel mainly used by the households. Results presented in Table 4.11 show that the majority of urban households use natural gas or liquified petroleum gas LPG (50.1 per cent), others depend on wood (44.7

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per cent), and agricultural crop residue (2.0 per cent) as fuel for cooking. About 83.4 per cent of CC non-slums households use gas (natural or LPG), this is 49.1 per cent in CC slums and 34.6 per cent in other urban areas.

About 48.6 per cent of the urban population relied on solid fuels for cooking. Use of solid fuels was very high in other urban households (64.3 per cent), compared with 44.5 per cent in CC slums and 15.2 per cent in CC non-slum households. Prevalence of use of solid fuels was the highest in urban households of Rangpur division (88.9 per cent), and lowest in Dhaka (29.1 per cent). Households/members belonging to the lower wealth quintiles were more likely to use solid fuel.

Table 4.12: Solid fuel use by place of cookingPer cent distribution of household members in households using solid fuels by place of cooking, Child Well-being Survey in Urban Areas, CWS 2016

Place of cooking: Number of household

members in households using solid

fuels for cooking

In the house

In a separate building Outdoors

Other place Total

In a separate room used as kitchen

Elsewhere in the house

Total 18.5 9.4 57.2 14.9 0.0 100.0 39,952

AreaCity Corporation slum 23.9 21.0 33.2 21.7 0.2 100.0 1,470 City Corporation non-slum 25.3 14.4 46.9 13.4 0.0 100.0 3,808 Other municipalities/urban 17.5 8.3 59.4 14.8 0.0 100.0 34,674

DivisionBarisal 24.9 21.0 42.1 12.0 0.0 100.0 2,773 Chittagong 34.4 11.4 47.4 6.8 0.0 100.0 7,245 Dhaka 11.6 3.6 68.2 16.6 0.0 100.0 11,200 Khulna 19.9 3.6 68.8 7.7 0.0 100.0 5,526 Rajshahi 10.5 11.4 49.6 28.5 0.0 100.0 6,653 Rangpur 9.4 12.4 62.7 15.5 0.0 100.0 4,940 Sylhet 39.8 22.2 25.7 12.1 0.2 100.0 1,615

Education of household headNo education 15.6 11.6 52.0 20.8 0.0 100.0 11,708 Primary incomplete 17.7 8.2 56.8 17.3 0.0 100.0 7,484 Primary complete 20.5 10.3 52.3 16.8 0.0 100.0 5,201 Secondary incomplete 19.2 8.5 62.2 10.1 0.0 100.0 11,524 Secondary complete or higher 24.4 6.1 65.4 4.1 0.0 100.0 3,913 Missing/DK 1.4 12.2 57.7 28.7 0.0 100.0 120

Wealth index quintileLowest 13.0 13.4 48.3 25.2 0.0 100.0 9,447 Second 17.7 9.0 54.8 18.6 0.0 100.0 7,611 Middle 16.8 8.6 61.2 13.5 0.0 100.0 10,950 Fourth 22.9 6.5 63.9 6.8 0.0 100.0 8,141 Highest 29.3 8.5 58.6 3.7 0.0 100.0 3,803

ReligionIslam 18.1 9.2 57.6 15.2 0.0 100.0 35,232 Hindu 20.5 10.9 55.2 13.4 0.0 100.0 4,305 Buddhist 36.5 9.1 42.5 11.8 0.0 100.0 271

Christian 12.2 15.4 64.1 8.3 0.0 100.0 122

Table 4.12 presents information on the household members who use solid fuel by place of cooking. Among those who were using solid fuels for cooking, 27.9 per cent had cooking place inside the house, either in a separate room or elsewhere in the house. This was more common among CC slum households (44.9 per cent), compared to 39.7 per cent of CC non-slums and 25.8 per cent in other urban households. Cooking place in a separate building or in outdoor places was the highest (74.2 per cent) in the other urban areas and lowest in CC slum (54.9 per cent) areas.

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5 REPRODUCTIVE HEALTH©UNICEF/UNI111360/Siddique

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Key Findings:

� The median age at first marriage among urban women of reproductive age (15-49 years) was found to be 16.1 years, with somewhat higher in CC non-slums areas (17 years).

� The median age at first child birth among urban women aged 15-49 was three years more than the median age at first marriage (19.0 years).

� Early childbearing among women age 15-19 years persists high at 18.6 per cent, with 14.8 per cent in CC non-slums, 35.8 per cent in CC slums and 19.1 per cent in other urban areas.

� More than one-fifth of women (22.9 per cent) of age 20-24 have had a live birth before the age of 18. This Percentage was 33.0 per cent among women age 20-49 years.

� The Percentage of women age15-49 who have had a live birth before age 15 is 5.3 per cent.

� About 67.3 per cent of urban currently married women aged 15-49 use some method of contraception, with 73.8 per cent of CC slums, 67.2 per cent of other urban, and 66.6 per cent of CC non-slum areas. The total unmet need was 7.8 per cent.

� About 81.1 per cent of women age 15-49 who gave birth in the two years, preceding the survey received antenatal care from skilled health provider at least once, and 45.9 per cent had the recommended four or more antenatal care (ANC) visits by any provider. Sixty one per cent of those women living in CC non-slums received 4 or more ANC visits, compared to 35.8 per cent in CC slums, and 40.4 per cent in other urban areas.

� Sixty two per cent of all deliveries in urban areas took place in health facilities, and 64.2 per cent of deliveries were attended by skilled health provider during their most recent live births. Delivery at health facility was the highest in Khulna urban areas (76.9 per cent), and lowest in Chittagong (48.1 per cent).

� Of all births, 39.9 per cent of women had delivery by Caesarean Section.

� About 84.4 per cent of women age 15-49 years with a live birth in the last two years who had their last delivery in a health facility stayed in the health facility for 12 hours or more after the last delivery.

� Three-fourths (79.9 per cent) of both mothers age 15-49 years and their newborns received postnatal health checks within two days of birth.

This chapter provides information from the CWS 2016 on two important aspects of reproductive health: Fertility and Maternal Care. It focuses mainly on certain aspects of fertility such as age at first marriage, age at first childbearing, early childbearing and adolescent births, fertility regulation, use and unmet need for contraception, antenatal care, delivery and postnatal care.

5 REPRODUCTIVE HEALTH

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5.1 FertilityFertility is an important component of population dynamics that determines the size, structure and composition of the population in any country. The CWS 2016 did not collect birth history data and therefore it was not possible to estimate age-specific fertility or total fertility rate. However, using the available data it was possible to estimate certain indicators related to adolescent birth and early childbearing.

5.1.1 Age at First Marriage

Age at marriage has a direct effect on fertility. Early marriage lengthens the effective reproductive period and subsequently increases fertility. An increase in the age at marriage can contribute to overall fertility decline. Table 5.1 provides data on age at first marriage.

Table 5.1: Age at first marriage and age at first child birth

Percentage of women aged 15-19 years by median age at first marriage and age at first child birth, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Median age at first marriage

Number of women

Median age at first child birth

Number of women who have had a live birth

Total 16.1 19,632 19.0 17,494

Age

15-19 17.0 1,520 16.9 202

20-24 17.2 2,967 19.2 2,632

25-29 16.8 3,835 19.1 3,595

30-34 16.0 3,317 18.9 3,240

35-39 16.0 2,970 19.0 2,917

40-44 15.7 2,213 19.1 2,159

45-49 15.0 2,810 19.0 2,749

Area

City Corporation slum 16.0 814 18.4 726

City Corporation non-slum 17.0 ,973 19.4 5,244

Other municipalities/urban 16.0 12,845 18.9 11,524

Division

Barisal 16.0 787 19.0 715

Chittagong 16.6 3,668 19.0 3,302

Dhaka 16.1 9,313 19.1 8,214

Khulna 15.8 1,788 18.8 1,585

Rajshahi 16.1 2,076 19.0 1,874

Rangpur 16.0 1,301 18.8 1,178

Sylhet 18.0 698 20.0 627

Education

No education 15.0 3,341 18.0 3,203

Primary incomplete 15.0 3,113 18.1 2,891

Primary complete 15.3 2,045 18.2 1,889

Secondary incomplete 16.7 8,253 19.0 7,176

Secondary complete or higher 19.6 2,880 22.6 2,336

Rep

rod

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ive

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Table 5.1: continued Median age at first

marriageNumber of

womenMedian age at first

child birthNumber of women who

have had a live birth

Wealth index quintile

Poorest 16.0 3,488 18.7 3,093

Second 16.0 3,783 18.6 3,354

Middle 16.0 3,979 18.8 3,601

Fourth 16.7 4,238 19.3 3,781

Richest 17.7 4,144 20.0 3,666

Religion

Islam 16.0 17,761 19.0 15,793

Hindu 17.2 1,725 19.8 1,564

Buddhist (19.2) 85 (22.4) 81

Christian 18.7 61 21.3 57

( ) Figures that are based on 25-49 unweighted cases

Overall, the median age at first marriage was 16.1 year. This means, half of the urban women get married by age 16.1 years. The median age at first marriage was recorded at 17 years among women of CC non-slum areas. Median age at first marriage by current age of women, across division and by socio economic status are also presented in Table 5.1. Older women, women from the lowest wealth quintile and with no education were more likely to get married at an early age. The median age at first marriage was 17.0 years in the age group 15-19 years, which was 15.0 years in age group 45-49 years. It was 15.0 years among the women having no education, against 19.6 years among those with secondary or higher education. Khulna had the least median age at marriage (15.8 per cent) and Sylhet had the highest (18 per cent) among divisions.

Table 5.2: Early childbearing

Percentage of women age 15-19 years who have had a live birth, are pregnant with the first child, have begun childbearing, and who have had a live birth before age 15, and Percentage of women age 20-24 years who have had a live birth before age 18, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Percentage of women age 15-19 who: Number of women

age 15-19

Percentage of women age 20-24 who

have had a live birth before

age 18

Number of

women age

20-24

Have had

a live birth

Are pregnant with first

child

Have begun childbearing

Have had a live birth before age

15

Total 13.3 5.3 18.6 0.5 1,520 22.9 2,967

Area

City Corporation slum 29.9 5.9 35.8 1.5 76 31.9 139

City Corporation non-slum 10.4 4.3 14.8 0.4 460 17.1 887

Other municipalities/urban 13.4 5.7 19.1 0.4 984 24.9 1,942

Division

Barisal 16.0 5.9 22.0 0.0 57 23.1 122

Chittagong 10.6 9.0 19.6 0.7 229 24.2 644

Dhaka 11.2 4.9 16.0 0.1 796 20.7 1,398

Khulna 16.3 4.8 21.1 1.6 162 27.0 228

Rajshahi 18.6 2.8 21.4 1.5 156 25.7 266

Rangpur 19.9 4.8 24.8 0.0 84 27.6 210

Sylhet 22.1 5.4 27.5 1.2 36 19.0 99

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Table 5.2: continued

Percentage of women age 15-19 who: Number of women

age 15-19

Percentage of women age 20-24 who

have had a live birth before

age 18

Number of

women age

20-24

Have had

a live birth

Are pregnant with first

child

Have begun childbearing

Have had a live birth before age

15

Education

No education 21.9 0.6 22.5 0.4 57 34.3 157

Primary incomplete 14.9 2.2 17.2 1.3 166 25.8 395

Primary complete 24.9 8.9 33.8 1.2 107 21.6 273

Secondary incomplete 14.9 5.8 20.7 0.4 912 24.4 1,719

Secondary complete or higher 1.1 5.1 6.2 0.0 279 10.9 424

Wealth index quintile

Poorest 13.3 5.6 18.9 1.1 318 29.3 736

Second 17.0 4.4 21.4 0.1 351 26.4 669

Middle 13.0 2.8 15.7 0.2 269 21.3 574

Fourth 11.1 7.1 18.2 0.5 329 20.2 539

Richest 11.5 6.5 18.0 0.5 253 12.6 448

Religion*

Islam 13.3 5.3 18.6 0.5 1,408 23.5 2,749

Hindu 13.2 5.3 18.5 0.0 112 16.7 203

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

5.1.2 Age at First Birth

Age at first birth is an important determinant of fertility. The proportion of women who become mothers before age 20 is also a measure of the magnitude of adolescent fertility, which is a major health and social concern. Table 5.1 also provides information on median age at first child birth. Overall, median age at first child birth in urban areas was 19.0 years, which was roughly three years more than the median age at first marriage. Median age at first child birth was lower in CC slums (18.4 years) than in other urban and CC non-slum areas (18.9 years) than in CC non-slum areas (19.4 years). Education appeared to be the most significant determinant of age at first child birth; Median age at first child birth was 18.0 years among those with no education, and 22.6 years among those with secondary or higher education.

5.2 Early Childbearing and Adolescent Birth Rate

Childbearing during adolescence (before 20 years of age) had serious consequences on maternal health. Bearing children at a young age involves substantial risks to the health of both the mother and child. It has direct effect on fertility. Early childbearing also tends to restrict educational and economic opportunities for women.

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Table 5.2 presents the Percentage of women age 15-19 years who have had a live birth or were pregnant with the first child. It shows that 18.6 per cent of adolescents age 15-19 years in urban areas of Bangladesh had begun childbearing; 13.3 per cent have had a live birth and another 5.3 per cent were found currently pregnant. Early childbearing among CC slum women age 15-19 years was much higher (35.8 per cent), than to the CC non-slum (14.8 per cent) and other urban women (19.1 per cent).

Delayed childbearing was strongly related to education among women age 15-19 years. About 6.2 per cent of women who completed secondary or higher education in urban areas had begun childbearing compared with 22.5 per cent of those with no education. Childbearing began early in the lower wealth quintile.

Fig 5.1: Trend in early childbearing before age 18, Bangladesh, CWS 2016

Table 5.2 also provides information on the Percentage of women age 15-19 years who have had a live birth by age 15. Overall, 0.5 per cent of the teenage women have had a live birth before age 15. Teenage motherhood was more pronounced among women of CC slums (1.5 per cent) than those in CC non-slums (0.4 per cent) and other urban areas (0.4 per cent). These results compare well with surveys, MICS 2012-2013 and UHC 2013 results.

It was also evident that about 23 per cent women of age 20-24 years have had a live birth before age 18. This proportion was very high among CC slums women (31.9 per cent) followed by other urban women (24.9 per cent) and CC non-slums (17.1 per cent) and.

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Tab

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of

wo

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wh

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ave

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nd

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by

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cor

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Num

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Num

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Num

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Num

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Num

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Tota

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781

439

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Wea

lth in

dex

quin

tile

Poor

est

5.6

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39.4

329

6.9

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38.4

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urth

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est

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.91,

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Relig

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na:

Not

app

licab

le*

Figu

res

for B

uddh

ist a

nd C

hris

tian

relig

ion

have

bee

n su

ppre

ssed

from

the

tabl

e du

e to

a s

mal

l num

ber o

f unw

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ted

case

s

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Tab

le 5

.4: U

se o

f co

ntra

cept

ion

Per

cen

tag

e o

f w

om

en a

ge

15-4

9 ye

ars

curr

entl

y m

arri

ed o

r in

un

ion

wh

o a

re u

sin

g (

or

wh

ose

par

tner

is u

sin

g)

a co

ntr

acep

tive

met

ho

d b

y se

lect

ed c

har

acte

rist

ics,

Ch

ild W

ell-

bei

ng

S

urv

ey in

Urb

an A

reas

, Ban

gla

des

h, C

WS

201

6

No

met

hod

Fem

ale

ster

ili-

zatio

n

Mal

e st

erili

- za

tion

IUD

Inje

c-ta

bles

Impl

-an

tsPi

llM

ale

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omFe

mal

e co

ndom

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hrag

m/

Foam

/Jel

lyLA

MPe

riodi

c ab

sti-

nenc

e

With

-dr

awal

Oth

er M

iss-

ing

Any

mod

ern

met

hod

Any

tradi

-tio

nal

met

hod

Any

met

hod

Num

ber o

f wom

en

age

15-4

9 ye

ars

curr

ently

mar

ried

or

in u

nion

Tota

l32

.74.

00.

80.

510

.81.

429

.011

.70.

00.

00.

17.

91.

00.

10.

058

.48.

967

.318

,252

Are

a City

Cor

pora

tion

slum

26.2

5.0

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0.5

20.1

2.2

30.0

6.8

0.1

0.0

0.2

6.6

0.7

0.0

0.0

66.4

7.3

73.8

731

City

Cor

pora

tion

non-

slum

33.4

4.0

0.8

0.5

10.2

1.6

25.4

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ther

mun

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32

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80.

510

.41.

330

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18.

70.

90.

10.

057

.59.

767

.212

,016

Div

isio

nBa

risal

28.9

3.3

0.9

0.7

11.5

1.5

33.3

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0.1

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na30

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.113

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hahi

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27.8

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0.5

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0.0

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3.8

48.6

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820

-24

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0.4

2.9

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325

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035

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140

-44

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1,98

845

-49

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65.1

15,4

581

18.2

0.0

0.0

0.4

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1.5

38.9

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0.0

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1.0

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1.6

0.0

0.0

74.4

7.4

81.8

1,16

02

24.1

1.7

0.0

0.8

17.0

1.3

35.8

13.6

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945

318

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077

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14+

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4.8

0.0

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76.3

198

Educ

atio

nN

o ed

ucat

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37.1

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23.9

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lth in

dex

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tile

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est

29.7

4.0

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hest

35.3

5.3

0.4

0.6

3.3

0.7

21.2

22.2

0.1

0.0

0.1

9.8

1.0

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5Re

ligio

n*Is

lam

33.3

3.9

0.8

0.6

11.5

1.4

28.1

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0.0

0.0

0.1

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1.0

0.1

0.0

58.1

8.6

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16,5

20H

indu

26.9

5.0

0.3

0.1

3.8

1.6

38.6

11.4

0.1

0.0

0.1

11.3

0.9

0.0

0.0

60.9

12.2

73.1

1,60

3

* Fi

gure

s fo

r Bud

dhis

t and

Chr

istia

n re

ligio

n ha

ve b

een

supp

ress

ed fr

om th

e ta

ble

due

to a

sm

all n

umbe

r of u

nwei

ghte

d ca

ses

( )

Figu

res

that

are

bas

ed o

n 25

-49

unw

eigh

ted

case

s

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Results presented in Table 5.3 suggest that early childbearing has gradually declined over the years. The Percentage of women with a live birth before age 15 had dropped from 6.5 (for age groups 25-29) to 0.5 (for age 15-19) during the last 10 years in urban areas. Similarly, Percentage of women with a live birth before age 18 has dropped from 37.1 (for age 30-34) to 22.9 (for age 20-24) during the same length of period.

5.3 ContraceptionFertility regulation is an important proximate determinant of fertility. Currently married women aged 15-49 years were asked whether they were currently using any family planning (FP) or contraceptive method. These data were used to indicate overall and method specific prevalence of contraceptive use by these women or their husband.

Table 5.4 presents data on the proportion of currently married women who reported that they were using a contraceptive method. Contraceptive prevalence rate (CPR) was high in all urban domains. The overall CPR in urban areas was 67.3 per cent, the highest being in the CC slums (73.8 per cent).

The majority of women were ‘modern’ methods users (54.4 per cent). Use of traditional methods was 8.9 per cent with the highest in the other urban areas (9.7 per cent). Among the divisions, use of any method of contraception was the highest in Rajshahi (73.0 per cent), and lowest in Sylhet (59.3 per cent).

Among the modern methods, oral pill was the most popular method (29.0 per cent) and it was almost equally popular in all the urban domains. Approximately one in four currently married women from CC non-slum (25.4 per cent), and three in ten women of CC slum and other urban areas were using pills. The same pattern prevailed in all divisions. Injectables was the second most popular method in CC slums (20.1 per cent) while male condoms were the second most popular method in CC non-slums (16.3 per cent).

Long-acting (IUD, implant) and permanent (female sterilization and NSV) method (LAPM) use was low in CC slums, CC non-slums and other urban areas.

Contraceptive use by background characteristics such as age, number of living children, education, and household wealth quintile can also be seen in Table 5.4. Contraceptive use increased with age, reaching a high of 77.9 per cent in ages 35-39, then declined. Similarly, it increased with the number of living children.

5.4 Unmet NeedUnmet need for contraception refers to fecund women who are married or in union and are not using any method of contraception but who wish to postpone the next birth (spacing) or who wish to stop childbearing altogether (limiting). In CWS 2016, unmet need was identified by using a set of questions eliciting current behavior and preferences pertaining to contraceptive use, fecund-ability, and fertility preferences.

Table 5.5 shows the levels of met need for contraception, unmet need, and the demand for contraception satisfied.

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Table 5.5: Unmet need for contraception

Percentage of women age 15-49 years currently married or in union with an unmet need for family planning and Percentage of demand for contraception satisfied by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Met need for contraception Unmet need for contraception

Number of women currently

married or in union

Percentage of demand for

contraception satisfied

Number of women currently

married or in union with need for contraception

For spacing

For limiting

Total For spacing

For limiting

Total

Total 22.1 45.1 67.3 3.2 4.6 7.8 18,252 89.6 13,696

Area

City Corporation slum 26.6 47.1 73.8 2.2 3.7 5.9 731 92.6 582

City Corporation non-slum 23.4 43.2 66.6 2.9 4.9 7.8 5,505 89.6 4,093

Other municipalities/urban 21.3 45.9 67.2 3.4 4.5 7.9 12,016 89.5 9,022

Division

Barisal 23.2 47.9 71.1 2.0 3.0 5.1 751 93.4 572

Chittagong 19.4 45.2 64.7 3.8 7.8 11.5 3,383 84.9 2,577

Dhaka 23.6 43.0 66.6 3.6 4.3 7.9 8,639 89.4 6,438

Khulna 21.8 47.6 69.3 2.5 3.0 5.6 1,685 92.6 1,262

Rajshahi 22.7 50.2 73.0 1.9 2.6 4.6 1,953 94.1 1,514

Rangpur 21.6 47.4 69.0 2.1 3.2 5.3 1,210 92.8 899

Sylhet 15.5 43.8 59.3 3.8 5.7 9.5 632 86.2 435

Age

15-19 47.3 1.3 48.6 10.0 0.0 10.1 1,508 82.9 884

20-24 56.8 14.1 70.9 6.0 1.5 7.4 2,853 90.5 2,234

25-29 30.4 41.3 71.7 4.3 3.0 7.3 3,704 90.7 2,927

30-34 13.8 63.2 76.9 2.1 5.5 7.7 3,170 90.9 2,682

35-39 4.4 73.5 77.9 1.1 6.8 7.9 2,721 90.8 2,333

40-44 1.0 66.6 67.6 0.2 10.3 10.6 1,988 86.5 1,554

45-49 0.3 41.5 41.8 0.0 5.1 5.1 2,308 89.2 1,081

Education

No education 7.1 55.7 62.9 0.9 4.9 5.8 2,808 91.5 1,928

Primary incomplete 16.3 51.7 68.0 2.0 5.3 7.3 2,841 90.3 2,138

Primary complete 20.6 51.4 72.0 1.8 4.4 6.2 1,896 92.1 1,483

Secondary incomplete 26.7 40.6 67.3 4.2 4.5 8.7 7,896 88.5 6,005

Secondary complete or higher 31.1 36.5 67.6 4.7 3.9 8.6 2,812 88.7 2,143

Wealth index quintile

Lowest 25.9 44.4 70.3 2.4 3.3 5.7 3,130 92.5 2,378

Second 24.8 43.8 68.6 3.0 2.7 5.6 3,480 92.4 2,584

Middle 20.2 49.1 69.3 2.8 3.3 6.2 3,732 91.8 2,819

Fourth 21.7 42.6 64.2 4.0 6.7 10.7 3,985 85.8 2,984

Highest 19.1 45.6 64.7 3.5 6.4 9.9 3,925 86.7 2,930

Religion

Islam 22.1 44.6 66.7 3.4 4.7 8.0 16,520 89.2 12,350

Hindu 22.6 50.5 73.1 1.7 3.1 4.8 1,603 93.8 1,249

Buddhist (13.2) (49.1) (62.3) (0.0) (5.0) (5.0) 77 (92.5) 52

Christian 28.9 42.2 71.1 0.0 17.5 17.5 52 80.3 46

( ) Figures that are based on 25-49 unweighted cases

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Unmet need for spacing is defined as the Percentage of women who are married or in union and are not using a method of contraception AND

� are not pregnant, and not postpartum amenorrheic, and fecund and say they want to wait two or more years for their next births OR

� are not pregnant, and not postpartum amenorrheic, and are fecund, and unsure whether they wanted another child, OR

� are pregnant, and say that pregnancy was mistimed: would have wanted to wait OR � are postpartum amenorrheic, and say that birth was mistimed: would have wanted to wait.

Unmet need for limiting is defined as the Percentage of women who are married or in union and are not using a method of contraception AND

� are not pregnant, and not postpartum amenorrheic, and are fecund and say they do not want any more child OR

� are pregnant, and say they did not want to have a child OR � are postpartum amenorrheic, and say that they did not want the birth.

Total unmet need for contraception is the sum of unmet need for spacing and unmet need for limiting.

About 3.2 Percentage of 15-49 year old women who were married had an unmet need for contraception for spacing, and 4.6 per cent for limiting children. The total unmet need for contraception was 7.8 per cent. As expected, the unmet need for spacing was higher among younger women, and for limiting among the women of older age.

Fig 5.2: Women age 15-49 years currently married with unmet need for contraception by age, Bangladesh, CWS 2016

Met need for limiting includes women married or in union who are using (or whose partner is using) a contraceptive method, and who want no more children, are using male or female sterilization, or declare themselves as infecund. Met need for spacing includes women who are using (or whose partner is using) a contraceptive method, and who want to have another child, or are undecided whether to have another child. The total of met need for ‘spacing’ and ‘Limiting’ adds upto the total met need for contraception.

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In Bangladesh, the total Percentage of women whose contraceptive needs are met was 67.3 per cent. The met need for contraception for spacing was higher among younger women, particularly those aged 20-24 years (56.8 Per cent), while the met need for limiting was higher among women aged 35-39 years (73.5 per cent). Results also show that met need was higher among women of CC slum areas than in CC non-slums and other urban areas.

5.5 Antenatal CareThe reproductive health care services that a mother receives during her pregnancy and at the time of delivery are important for the well-being of the mother and her child. Antenatal checkup facilitates detection and treatment of possible complications during pregnancy. Antenatal Care (ANC) can be assessed according to the type of service provider, number of visits made, content of antenatal care, the stage of pregnancy at the time of first ANC visit and consumption of iron folic acid tablets.

Table 5.6: Antenatal care coverage

Per cent distribution of women age 15-49 years with a live birth in the last two years preceding the survey by antenatal care provider during the pregnancy for the last birth, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Provider of antenatal carea

No antenatal

care Total

Any skilled

provider

Number of women with a live birth in the

last two years

Medical doctor

Nurse/ Midwife

Auxi-liary mid-wife

Comm-unity

skilled birth

attendant

Comm-unity

health worker Other

Total 75.6 4.9 0.6 0.0 0.2 9.5 9.3 100.0 81.1 2,882

AreaCity Corporation slum 59.5 7.0 1.2 0.0 2.5 13.8 16.1 100.0 67.7 127City Corporation non-slum 80.4 3.1 0.5 0.0 0.0 8.4 7.5 100.0 84.1 811Other municipalities/urban 74.7 5.5 0.6 0.0 0.1 9.7 9.5 100.0 80.7 1,944

DivisionBarisal 71.4 5.8 1.1 0.0 0.1 7.4 14.2 100.0 78.3 120Chittagong 71.0 4.2 0.4 0.0 0.1 11.1 13.2 100.0 75.6 651Dhaka 79.8 3.8 0.4 0.0 0.2 8.9 7.0 100.0 83.9 1,320Khulna 82.1 4.4 0.7 0.0 0.0 5.9 7.0 100.0 87.2 193Rajshahi 69.9 8.6 1.8 0.0 0.0 13.1 6.5 100.0 80.4 272Rangpur 73.7 9.3 0.0 0.0 0.5 8.5 7.9 100.0 83.0 198Sylhet 65.4 5.5 1.2 0.2 0.0 8.5 19.3 100.0 72.0 128

Mother’s age at birthLess than 20 71.1 4.9 0.6 0.0 0.2 11.8 11.3 100.0 76.7 1,54520-34 80.7 4.9 0.5 0.0 0.1 6.9 6.9 100.0 86.2 1,32835-49 (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 9

EducationNo education 49.6 10.1 0.9 0.0 0.2 16.4 22.7 100.0 60.7 237Primary incomplete 59.8 7.8 1.1 0.1 0.2 14.1 17.0 100.0 68.6 423Primary complete 66.6 5.4 0.1 0.0 0.1 14.9 13.0 100.0 72.1 294Secondary incomplete 80.4 3.6 0.7 0.0 0.2 8.7 6.4 100.0 84.7 1,378Secondary complete or higher 91.8 3.4 0.0 0.0 0.0 2.1 2.7 100.0 95.2 549

Wealth index quintileLowest 56.3 5.5 1.0 0.0 0.2 16.1 20.8 100.0 62.8 633Second 66.1 5.3 0.2 0.0 0.2 18.1 10.2 100.0 71.5 520Middle 76.5 6.8 0.5 0.0 0.2 9.0 7.0 100.0 83.7 594Fourth 88.0 3.9 0.4 0.0 0.0 3.0 4.7 100.0 92.3 634Highest 93.3 2.8 0.8 0.0 0.0 0.9 2.1 100.0 96.9 500

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Table 5.6: continued

Provider of antenatal carea

No antenatal

care Total

Any skilled

provider

Number of women with a live birth in the

last two years

Medical doctor

Nurse/ Midwife

Auxi-liary mid-wife

Comm-unity

skilled birth

attendant

Comm-unity

health worker Other

Religion*

Islam 74.3 4.9 0.6 0.0 0.2 10.1 9.9 100.0 79.8 2,629

Hindu 88.2 5.2 0.2 0.0 0.1 3.1 3.2 100.0 93.6 220

a Only the most qualified provider is considered in cases where more than one provider was reported.* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted casesNote: Medical Doctor (MN2, A = Qualified Doctor); Nurse/Midwife (MN2, B= Nurse/Midwife/Paramedic); Auxiliary Midwife (MN2, C = FWV); Community Skilled Birth Attendant (MN, J = Trained Traditional Birth Attendant (TTBA)); Community Health Worker (N2, F = Community Health Provider); Other (MN2, G = Health Assistant (HA)/H= Family Welfare Assistant (FWA)/I= NGO Worker/K= Untrained Traditional Birth Attendant

(UTBA)/L- Quack/X = Other); Any Skilled Provider = Medical Doctor/Nurse/Midwife/Paramedic/Auxiliary Midwife.

5.5.1 Antenatal Care Coverage

Table 5.6 shows that the overall use of ANC from any provider at least once during the last pregnancy was 90.7 per cent in urban areas of Bangladesh. The overall use of any ANC was higher among CC non-slums women (92.5 per cent) than in CC slums (83.9 per cent) or in other urban areas (90.5 per cent). The recent BDHS also reported use of any ANC among urban women of the same level.

Table 5.7: Number of antenatal care visits and timing of first visit

Per cent distribution of women age 15-49 years with a live birth in the last two years by number of antenatal care visits by any provider and by the timing of first antenatal care visits, Child Well-being Survey in Urban Areas, Bangladesh, 2016

Percentage of women who had:

Total

Number of women with a live birth in the last two years

Number of women with a live

birth in the last two years who had at least one

ANC visit

No antenatal care visits

One visit

Two visits

Three visits

4 or more visits

Total 9.3 10.4 16.7 17.7 45.9 100.0 2,882 2,615

Area

City Corporation slum 16.1 11.8 19.1 17.3 35.8 100.0 127 107

City Corporation non-slum 7.5 4.4 12.1 15.2 60.8 100.0 811 750

Other municipalities/urban 9.5 12.8 18.4 18.8 40.4 100.0 1,944 1,759 Division

Barisal 14.2 5.9 18.2 24.4 37.3 100.0 120 103

Chittagong 13.2 15.5 20.0 15.7 35.5 100.0 651 565

Dhaka 7.0 8.5 15.2 17.3 52.0 100.0 1,320 1,228

Khulna 7.0 9.4 14.5 15.0 54.1 100.0 193 180

Rajshahi 6.5 11.8 19.2 16.8 45.8 100.0 272 255

Rangpur 7.9 5.2 12.4 26.1 48.3 100.0 198 182

Sylhet 19.3 15.7 17.2 18.9 28.9 100.0 128 103

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Table 5.7: continued

Percentage of women who had:

Total

Number of women with a live birth in the last two years

Number of women with a live

birth in the last two years who had at least one

ANC visit

No antenatal care visits

One visit

Two visits

Three visits

4 or more visits

Mother’s age at birth

Less than 20 11.3 11.4 16.9 17.1 43.2 100.0 1,545 1,370

20-34 6.9 9.4 16.5 17.9 49.3 100.0 1,328 1,237

35-49 (*) (*) (*) (*) (*) 100.0 (*) 9 Education

No education 22.7 14.5 15.8 23.4 23.6 100.0 237 183

Primary incomplete 17.0 12.3 26.5 14.0 30.3 100.0 423 351

Primary complete 13.0 20.6 13.7 15.8 37.0 100.0 294 256

Secondary incomplete 6.4 9.2 16.4 19.6 48.4 100.0 1,378 1,290

Secondary complete or higher 2.7 4.8 11.8 14.4 66.3 100.0 549 535 Wealth index quintile

Lowest 20.8 17.1 18.2 15.6 28.3 100.0 633 501

Second 10.2 14.5 23.4 20.5 31.3 100.0 520 467

Middle 7.0 11.7 19.0 21.0 41.3 100.0 594 553

Fourth 4.7 4.1 11.6 15.5 64.1 100.0 634 604

Highest 2.1 4.2 11.3 16.4 65.9 100.0 500 489 Religion*

Islam 9.9 10.9 16.9 17.6 44.7 100.0 2,629 2,369

Hindu 3.2 6.8 14.8 18.3 56.9 100.0 220 213

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases

Coverage with at least one ANC from a skilled provider was 81.1 per cent, and this was significantly higher among women of CC non-slum areas (84.1 per cent) than among CC slums women (67.7 per cent). A substantial difference was noticed in the type of ANC provider used by area of residences. Women in the CC non-slum areas were almost one and half time as likely as women in CC slums to go to a qualified doctor for ANC (80.4 versus 59.5 per cent). About 16.3 per cent women living in CC slums received ANC from a non-medically trained provider, against only 8.4 per cent women of CC non-slums.

Fig 5.3: ANC by skilled provider by areas, Bangladesh, CWS 2016

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There were sharp differences in ANC coverage by background characteristics. Across all urban areas and divisions, similar pattern exist where medically trained providers were more likely to be used for ANC for older women, more educated women, and women in higher wealth quintiles (Table 5.6).

5.5.2 Number of Antenatal Care Visits

The Bangladesh Maternal Health Strategy recommends at last four ANC visits during a pregnancy. The coverage of the recommended four or more ANC visits varied widely by CC slums, CC non-slums and other urban areas. As shown in Table 5.7, overall 45.9 per cent received 4 or more ANC visits during last pregnancy. Women living in CC non-slums were more likely to have received four or more ANC visits compared to in the other two urban areas. Sixty one per cent of women living in CC non-slums received at least four ANC visits during their last pregnancy, compared to 35.8 per cent in CC slums and 40.4 per cent in other urban areas (Figure 5.4).

Fig 5.4: ANC received 4 or more visits by areas, Bangladesh, CWS 2016

Coverage with four or more ANC visits was highest in Khulna (54.1 per cent) and lowest in Sylhet (28.9 per cent). A substantial difference was noticed in the coverage with four or more ANC visits by mother’s age at the time of birth, education and household wealth. Women of age at birth 20-34 years, those with secondary or higher level of education and those in the highest wealth quintiles were most likely to receive four or more ANC visits.

5.5.3 Components of Antenatal Care

The content of antenatal care is an essential component of ANC service quality. Table 5.8 shows that 87.6 per cent of women receiving ANC had their blood pressure checked, urine sample was taken for 69.5 per cent, blood sample was taken for 66.9 per cent, and all these components done for 62.9 per cent women. All the three components was done in most cases for women of CC non-slum areas (76.8 per cent). Women living in CC slums and other urban

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areas were less likely to receive ANC care covering all these three components in 52.2 per cent in CC slums and 57.9 per cent women in other urban areas. Receiving this care was highest in Dhaka (69.3 per cent), and lowest in Rajshahi division (50.3 per cent).

Table 5.8: Content of antenatal care

Percentage of women age 15-49 years with a live birth in the last two years preceding the survey who, at least once, had their blood pressure measured, urine sample taken, and blood sample taken as part of antenatal care, during the pregnancy for the last birth, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Percentage of women who, during the pregnancy of their last birth, had:

Number of women with a live birth in the last two yearsBlood

pressure measured

Urine sample taken

Blood sample taken

Blood pressure measured, urine and blood sample taken1

Total 87.6 69.5 66.9 62.9 2,882

Area

City Corporation slum 79.3 59.1 55.4 52.2 127

City Corporation non-slum 91.4 79.6 79.5 76.8 811

Other municipalities/urban 86.6 66.0 62.4 57.9 1,944

Division

Barisal 82.7 71.0 62.5 62.3 120

Chittagong 79.2 64.4 62.1 57.4 651

Dhaka 92.1 74.7 73.6 69.3 1,320

Khulna 89.8 69.0 69.5 63.9 193

Rajshahi 89.2 61.3 53.7 50.3 272

Rangpur 90.3 64.1 62.1 59.6 198

Sylhet 77.0 67.7 58.2 56.3 128

Mother’s age at birth

Less than 20 85.2 66.4 63.2 59.7 1,545

20-34 90.3 73.1 71.3 66.7 1,328

35-49 (*) (*) (*) (*) 9

Education

No education 67.6 44.7 41.3 35.9 237

Primary incomplete 80.5 52.4 46.8 41.2 423

Primary complete 81.9 55.5 50.6 47.2 294

Secondary incomplete 90.9 73.6 72.7 68.6 1,378

Secondary complete or higher 96.5 90.8 87.7 85.6 549

Wealth index quintile

Lowest 74.3 52.7 46.3 43.2 633

Second 84.2 54.5 50.7 43.2 520

Middle 89.8 65.7 63.8 60.0 594

Fourth 94.6 84.7 84.1 80.9 634

Highest 96.5 91.7 91.9 89.4 500

Religion*

Islam 86.8 68.4 65.9 61.7 2,629

Hindu 94.8 82.4 78.3 77.3 220

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases

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5.6 Delivery CareDelivery care is an important component of maternal and newborn care. Proper medical attention and hygienic condition during delivery can reduce the risk of complications and infections. Place of delivery and the provider who conducts or assists in the delivery are very important.

5.6.1 Assistance during Delivery

Assistance during delivery influences the delivery outcome and the health of the mother and the child. Table 5.9 shows that among the women who had a live birth in the last two years, 64.2 per cent were assisted during delivery by a skilled attendant. Skilled birth attendants include qualified medical doctors, nurses, and midwives.

Table 5.9: Assistance during delivery and caesarian section

Per cent distribution of women age 15-49 years with a live birth in the last two years by person providing assistance at delivery, and Percentage of births delivered by C-section, Child Well-being Survey in Urban Areas, Bangladesh, 2016

Person assisting at delivery No atten-dant

Total Delivery assisted by any skilled attendant

Per cent delivered

by C-section

Number of women who had a live birth in the last two

years

Medical doctor

Nurse/ Mid-wife

FWV HA/ FWA

NGO worker

TTBA UTBA Unquali-fied

doctor

Relative/ friends

Total 48.1 16.0 0.1 0.5 2.5 8.4 21.1 0.6 2.6 0.1 100.0 64.2 39.9 2,882

AreaCity Corporation slum 34.6 20.5 0.4 0.0 4.4 11.7 22.3 1.3 4.8 0.0 100.0 55.5 23.9 127City Corporation non-slum 59.4 14.2 0.0 0.5 2.8 8.5 13.8 0.0 0.7 0.0 100.0 73.6 46.6 811Other municipalities/urban 44.3 16.4 0.2 0.5 2.2 8.1 24.1 0.8 3.3 0.1 100.0 60.9 38.1 1,944

DivisionBarisal 47.7 20.6 0.0 0.0 0.5 7.0 23.1 1.0 0.3 0.0 100.0 68.2 39.5 120Chittagong 36.3 17.5 0.3 0.3 1.4 11.0 27.8 1.2 3.9 0.3 100.0 54.2 26.1 651Dhaka 52.8 13.9 0.0 0.7 4.1 7.1 19.6 0.0 1.8 0.0 100.0 66.8 44.5 1,320Khulna 58.5 21.7 0.0 0.0 0.3 9.6 8.4 0.8 0.6 0.0 100.0 80.3 57.2 193Rajshahi 51.3 13.6 0.6 1.2 1.4 8.8 17.3 1.2 4.6 0.0 100.0 65.5 40.8 272Rangpur 50.6 18.7 0.0 0.0 1.3 5.5 18.9 1.6 3.5 0.0 100.0 69.3 43.9 198Sylhet 34.0 16.9 0.0 0.3 0.7 11.4 32.1 0.3 4.3 0.0 100.0 50.9 28.2 128

Mother’s age at birthLess than 20 41.5 17.5 0.3 0.7 3.2 9.5 23.4 0.7 3.1 0.1 100.0 59.3 32.1 1,54520-34 55.8 14.1 0.0 0.3 1.7 7.1 18.4 0.5 2.0 0.0 100.0 69.9 48.8 1,32835-49 (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) (*) 9

Place of deliveryHome 1.0 8.8 0.0 1.3 3.1 21.6 55.7 1.6 6.7 0.2 100.0 9.8 0.0 1,093Health facility

Public 64.8 34.4 0.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 42.4 506Private 81.8 14.8 0.0 0.0 2.9 0.4 0.0 0.0 0.0 0.0 100.0 96.6 73.0 1,281

EducationNo education 25.9 12.8 0.2 0.0 8.4 9.1 37.1 2.0 4.5 0.0 100.0 38.9 24.4 237Primary incomplete 26.6 16.4 0.0 0.0 2.3 8.7 40.1 0.7 4.6 0.5 100.0 43.1 18.2 423Primary complete 30.7 19.3 0.0 1.3 5.6 9.0 30.9 0.4 2.8 0.0 100.0 50.0 20.3 294Secondary incomplete 51.9 16.4 0.3 0.5 1.7 9.3 16.8 0.5 2.6 0.0 100.0 68.6 43.6 1,378Secondary complete or higher 74.1 14.1 0.0 0.7 0.4 5.0 5.3 0.4 0.0 0.0 100.0 88.2 64.4 549

Wealth index quintileLowest 20.7 16.0 0.0 0.8 5.5 10.1 41.6 1.1 4.2 0.0 100.0 36.7 17.3 633Second 37.8 13.6 0.1 0.0 4.3 12.7 27.8 0.3 3.5 0.0 100.0 51.5 28.6 520Middle 46.9 16.9 0.6 0.0 1.9 7.5 22.3 0.3 3.3 0.4 100.0 64.5 38.7 594Fourth 64.2 17.4 0.0 1.1 0.5 5.4 9.2 0.8 1.4 0.0 100.0 81.6 50.9 634Highest 74.6 15.5 0.0 0.5 0.1 6.3 2.0 0.5 0.5 0.0 100.0 90.1 67.7 500

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Table 5.9: continued Person assisting at delivery No

atten-dant

Total Delivery assisted by any skilled attendant

Per cent delivered

by C-section

Number of women who had a live birth in the last two

years

Medical doctor

Nurse/ Mid-wife

FWV HA/ FWA

NGO worker

TTBA UTBA Unquali-fied

doctor

Relative/ friends

Religion*

Islam 46.5 16.0 0.2 0.6 2.7 8.7 22.3 0.5 2.6 0.1 100.0 62.6 38.3 2,629

Hindu 71.0 13.2 0.0 0.0 0.0 4.5 7.7 1.4 2.1 0.0 100.0 84.2 62.3 220

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted casesNote: Medical Doctor (MN17, A= Qualified Doctor); Nurse/Midwife (MN17, B= Nurse/Midwife/Paramedic); FWV (MN17, C= FWV); HA/FWA (MN17,

G= Health Assistant (HA)/H= Family Welfare Assistant (FWA)); NGO Worker (MN17, I= NGO Worker); TTBA (MN17, J= Trained Traditional Birth Attendant (TTBA)); UTBA (MN17, K= Untrained Traditional Birth Attendant (UTBA); Unqualified Doctor (MN17, L= Quack);

Relative/friends (MN17, M= Relatives/ N= Neighbour/friends); Other (MN17, X= Other); No Attendant (MN17, Y= No one). Deliver assisted by any Skilled Attendant= Medical Doctor/Nurse/Midwife/Paramedic/ FWV.

Large variation was observed in the use of skilled provider for delivery by place of residence and divisions. Three-fourths (73.6 per cent) of deliveries among women of CC non-slum areas were assisted by skilled attendants, while 55.5 per cent of CC slums women received skilled assistance. Deliveries assisted by skilled attendants was the highest in Khulna (80.3 per cent), and lowest in Sylhet division (50.9 per cent). Women with secondary or higher level of education (88.2 per cent), and women of highest wealth quintile (90.1 per cent) were most likely to receive skilled assistance during delivery. Among those deliveries occurring at home only 9.8 per cent deliveries were assisted by skilled personnel (Table 5.9).

Fig 5.5: Person assisting during delivery, Bangladesh, CWS 2016

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Table 5.10: Place of delivery

Percentage of women age 15-49 years with a live birth in the last two years preceding the survey by place of delivery of their last birth by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Place of delivery

Total Delivered in health facility

Number of women with a live birth in the last two years

Health facility Home Other

Public sector

Private sector

Total 17.6 44.5 37.9 0.1 100.0 62.0 2,882

Area

City Corporation slum 20.5 36.7 42.9 0.0 100.0 57.1 127

City Corporation non-slum 20.5 55.0 24.5 0.0 100.0 75.5 811

Other municipalities/urban 16.1 40.6 43.2 0.1 100.0 56.7 1,944

Division

Barisal 22.3 41.0 36.8 0.0 100.0 63.2 120

Chittagong 14.1 34.1 51.9 0.0 100.0 48.1 651

Dhaka 17.1 49.4 33.5 0.0 100.0 66.5 1,320

Khulna 17.7 59.1 23.1 0.0 100.0 76.9 193

Rajshahi 25.1 38.9 36.1 0.0 100.0 63.9 272

Rangpur 19.5 47.9 31.6 1.1 100.0 67.4 198

Sylhet 16.7 33.5 49.8 0.0 100.0 50.2 128

Mother’s age at birth

Less than 20 16.4 40.4 43.0 0.1 100.0 56.9 1,545

20-34 18.9 49.0 32.1 0.0 100.0 67.9 1,328

35-49 (*) (*) (*) (*) 100.0 (*) 9

Number of antenatal care visits

None 4.4 14.2 81.5 0.0 100.0 18.5 267

1-3 visits 18.2 36.8 45.0 0.0 100.0 55.0 1,291

4+ visits 19.6 58.0 22.2 0.2 100.0 77.6 1,324

Education

No education 14.2 29.9 56.0 0.0 100.0 44.0 237

Primary incomplete 17.0 24.2 58.8 0.0 100.0 41.2 423

Primary complete 20.4 26.8 52.8 0.0 100.0 47.2 294

Secondary incomplete 17.5 48.4 34.0 0.2 100.0 65.9 1,378

Secondary complete or higher 18.3 65.8 15.9 0.0 100.0 84.1 549

Wealth index quintile

Lowest 11.8 27.0 61.1 0.0 100.0 38.9 633

Second 13.6 34.7 51.7 0.0 100.0 48.3 520

Middle 23.3 38.9 37.8 0.0 100.0 62.2 594

Fourth 22.4 55.3 22.3 0.0 100.0 77.7 634

Highest 16.0 69.5 14.0 0.4 100.0 85.6 500

Religion*

Islam 16.6 43.8 39.4 0.1 100.0 60.5 2,629

Hindu 27.2 54.4 18.4 0.0 100.0 81.6 220

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases

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Of all births, 39.9 per cent of women had delivery by caesarian section, with 46.6 per cent in CC non-slums, 23.9 per cent in CC slums and 38.1 per cent in other urban areas.

5.6.2 Place of delivery

Table 5.10 gives percentage of women age 15-49 years with a live birth in the last two years preceding the survey by place of delivery of their last birth by selected characteristics. It shows that a high proportion of births in urban areas occurred at home (37.9 per cent). Sixty two per cent of births occurred at a health facility. Overall, 44.5 per cent of births were delivered in private health facility, and 17.6 per cent in public health facility.

Delivery in a health facility varied widely by area of residence, divisions, age of mother, number of ANC visits made, education and wealth quintile. Three-fourths (75.5 per cent) of last births in CC non-slum areas occurred at a health facility, while this prevalence was 57.1 per cent in CC slums, and 56.7 per cent in other urban areas. Delivery at health facility was the highest in Khulna (76.9 per cent), and lowest in Chittagong division (48.1 per cent). Women who made 4 or more ANC visits (77.6 per cent), or with secondary complete or higher level of education (84.1 per cent), and those in the highest wealth quintile (85.6 per cent) were more likely to have delivery at a health facility.

Fig 5.6: Place of delivery by areas, Bangladesh, CWS 2016

5.7 Postnatal CareWomen may experience problems in the postpartum/postnatal period, the six weeks or 42 days following delivery. Such problems can be detected and treated through proper follow-up visits for women in the postpartum period. Postnatal care, care or check-up during postpartum period, and postpartum stay in health facility are important for women.

5.7.1 Postpartum Stay in Health Facility

In the survey, women age 15-49 years with a live birth in the last two years preceding the survey who had their last birth delivered in a health facility were asked how long they stayed

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in the health facility after birth. Table 5.11 shows that 84.4 per cent of all women who had their last delivery in a health facility stayed in the health facility 12 hours or more after delivery. Proportion who stayed 12 hour or more in health facility after delivery was the highest among women of other urban areas (86.0 per cent), followed by CC non-slum (83.3 per cent) and CC slums (70.9 per cent). The MICS 2012-2013 reported this prevalence at 82.8 per cent, which is slightly lower than the estimate obtained in this survey.

Table 5.11: Post-partum stay in health facility

Percentage of women age 15-49 years with a live birth in the last two years preceding the survey who had their last birth delivered in a health facility by duration of stay in health facility according to selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Duration of stay in health facility Total 12 hours or more

Number of women who had their last birth delivered in a health facility in the

last 2 years

Less than 6 hours

6-11 hours

12-23 hours

1-2 days

3 days or

more

DK/ Missing

Total 9.5 6.0 2.8 16.0 65.7 0.1 100.0 84.4 1788

Area

City Corporation slum 19.4 9.7 5.3 23.9 41.6 0.0 100.0 70.9 73

City Corporation non-slum 8.6 8.1 2.0 17.7 63.6 0.0 100.0 83.3 612

Other municipalities/urban 9.4 4.5 3.0 14.5 68.4 0.1 100.0 86.0 1,102

Division

Barisal 5.6 6.1 2.9 17.5 67.9 0.0 100.0 88.3 76

Chittagong 8.2 5.6 4.1 24.4 57.7 0.0 100.0 86.2 313

Dhaka 11.0 5.5 2.2 14.1 67.2 0.0 100.0 83.5 878

Khulna 5.4 6.4 2.7 11.8 73.8 0.0 100.0 88.2 149

Rajshahi 11.6 7.0 5.0 13.4 62.1 0.9 100.0 80.5 174

Rangpur 6.8 7.7 0.8 13.2 71.6 0.0 100.0 85.6 133

Sylhet 9.8 6.8 2.7 20.7 59.7 0.3 100.0 83.1 64

Mother’s age at birth

Less than 20 13.7 8.2 2.9 16.6 58.4 0.2 100.0 77.9 878

20-34 5.5 3.7 2.8 15.4 72.7 0.0 100.0 90.8 903

35-49 (*) (*) (*) (*) (*) (*) 100.0 (*) 7

Type of health facility

Public 13.1 6.8 4.6 26.0 49.2 0.3 100.0 79.8 506

Private 8.1 5.6 2.1 12.0 72.2 0.0 100.0 86.2 1,281

Type of delivery

Vaginal birth 25.9 16.4 7.1 39.1 11.5 0.0 100.0 57.7 638

C-section 0.4 0.2 0.4 3.1 95.7 0.1 100.0 99.3 1,150

Education

No education 17.7 18.0 2.8 6.5 55.0 0.0 100.0 64.3 105

Primary incomplete 16.0 13.6 1.3 18.6 50.4 0.1 100.0 70.3 174

Primary complete 27.2 5.0 3.7 18.6 45.6 0.0 100.0 67.9 139

Secondary incomplete 7.5 5.4 3.0 16.2 67.7 0.2 100.0 86.9 908

Secondary complete or higher 3.9 1.7 2.7 15.8 75.9 0.0 100.0 94.4 462

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Table 5.11: continued Duration of stay in health facility Total 12 hours

or moreNumber of women who had their last birth delivered in a health facility in the

last 2 years

Less than 6 hours

6-11 hours

12-23 hours

1-2 days

3 days or

more

DK/ Missing

Wealth index quintile

Lowest 20.8 14.1 3.0 15.8 46.3 0.1 100.0 65.0 246

Second 13.3 8.3 1.7 15.7 61.0 0.0 100.0 78.4 251

Middle 8.3 6.0 4.4 17.2 64.1 0.0 100.0 85.7 370

Fourth 9.6 3.7 3.0 14.4 69.2 0.0 100.0 86.7 493

Highest 1.8 2.5 1.7 16.9 76.8 0.4 100.0 95.4 428

Religion*

Islam 10.3 6.4 2.9 15.8 64.6 0.0 100.0 83.3 1,590

Hindu 2.5 2.5 0.6 15.8 77.7 0.9 100.0 94.1 180

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases

5.7.2 Postnatal Checkup for Newborn

Postnatal Health Checks:

Table 5.12 shows that 79.9 per cent of the newborns received health checks by any health provider following birth while in health facility or at home following home birth before departure of provider from home. This proportion was low among newborns of CC slums (64.8 per cent) than those living in CC non-slums (83.9 per cent) and other urban areas (79.2 per cent)

Fig 5.7: Post natal health checks for the newborn by areas, Bangladesh, CWS 2016

Table 5.12 also provides Percentage of the newborns born in the last two years who received postnatal care visits from any health provider after birth. It should be noted that health checks following birth while in facility or at home refers to checks provided by any health provider regardless of timing (column 1), whereas postnatal care visits refers to a separate visit to

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check on the health of the newborn and provide preventive care services and therefore do not include health checks following birth while in facility or at home. Postnatal health checks include any health check performed while in the health facility or at home following birth, as well as postnatal care (PNC) visits within two days of delivery.

With regard to PNC visits, these were infrequent and predominantly occurred on the same day or after three days of birth (12.2 per cent and 4.0 per cent respectively). As a result, a total of 79.4 per cent of all newborns received a postnatal health check. Similar variations in PNC checks were observed by area, division and selected background characteristics as observed for health checks following births.

Table 5.12: Post-natal health checks for newborns

Percentage of women age 15-49 years with a live birth in the last two years preceding the survey whose last live birth received health checks while in facility or at home following birth, Percentage whose last live birth received post-natal care (PNC) visits from any health provider after birth, by timing of visit, and Percentage who received post natal health checks by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Health check

following birth

while in facility or at homea

PNC visit for newbornsb Post-natal

health check for the new-born c

Number of last

live births in the

last two years

Same day

1 day follow-

ing birth

2 days follow-

ing birth

3-6 days

follow-ing

birth

After the first

week follow-

ing birth

No post-natal care visit

Miss-ing/DK

Total

Total 79.4 12.2 0.9 0.1 1.3 2.7 82.8 0.1 100.0 79.9 2,882

Area

City Corporation slum 64.1 8.7 0.4 0.8 2.3 1.7 86.1 0.0 100.0 64.8 127

City Corporation non-slum 83.8 12.5 1.3 0.0 2.9 6.3 76.9 0.0 100.0 83.9 811

Other municipalities/urban 78.6 12.3 0.7 0.0 0.6 1.2 85.0 0.1 100.0 79.2 1,944

Division

Barisal 93.3 16.1 1.7 0.0 1.0 0.0 81.3 0.0 100.0 93.3 120

Chittagong 73.4 9.5 0.5 0.1 0.0 0.9 89.0 0.0 100.0 73.4 651

Dhaka 78.5 10.0 1.0 0.0 2.7 4.8 81.5 0.0 100.0 79.3 1,320

Khulna 95.2 17.2 0.2 0.0 0.6 0.7 80.6 0.6 100.0 95.2 193

Rajshahi 82.1 19.5 1.8 0.0 0.1 0.6 77.9 0.1 100.0 82.8 272

Rangpur 85.3 17.0 0.2 0.1 0.0 2.1 80.7 0.0 100.0 85.4 198

Sylhet 68.5 14.1 1.2 0.5 0.2 1.2 82.8 0.0 100.0 69.3 128

Mother’s age at birth

Less than 20 77.4 9.2 1.4 0.0 1.4 1.7 86.1 0.1 100.0 77.8 1,545

20-34 81.7 15.7 0.3 0.1 1.2 3.8 78.8 0.0 100.0 82.3 1,328

35-49 (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 9

Place of delivery

Home 54.0 0.9 0.6 0.0 0.8 0.5 97.1 0.0 100.0 54.6 1,093

Health facility 95.1 19.1 1.0 0.1 1.7 4.0 74.0 0.1 100.0 95.5 1,788

Public 93.2 15.1 0.3 0.1 1.2 2.9 80.3 0.0 100.0 93.3 506

Private 95.9 20.7 1.3 0.1 1.8 4.4 71.6 0.1 100.0 96.3 1,281

Other/DK/Missing (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 2

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Table 5.12: continued

Health check

following birth

while in facility or at homea

PNC visit for newbornsb Post-natal

health check for the new-born c

Number of last

live births in the

last two years

Same day

1 day follow-

ing birth

2 days follow-

ing birth

3-6 days

follow-ing

birth

After the first

week follow-

ing birth

No post-natal care visit

Miss-ing/DK

Total

Education

No education 63.0 7.1 0.8 0.2 0.7 2.5 88.7 0.0 100.0 65.2 237

Primary incomplete 69.4 8.2 0.0 0.0 1.2 0.4 90.2 0.0 100.0 69.5 423

Primary complete 69.6 5.0 0.3 0.1 0.0 3.2 91.4 0.0 100.0 69.6 294

Secondary incomplete 81.9 12.1 1.4 0.1 1.3 2.0 82.9 0.1 100.0 82.4 1,378

Secondary complete or higher 93.5 21.6 0.5 0.0 2.6 5.8 69.5 0.0 100.0 93.5 549

Wealth index quintile

Lowest 64.1 7.4 0.4 0.1 0.7 0.4 91.0 0.0 100.0 65.1 633

Second 76.9 7.2 0.9 0.1 2.0 1.9 87.8 0.0 100.0 77.9 520

Middle 80.4 11.7 0.9 0.1 0.7 1.8 84.8 0.0 100.0 80.7 594

Fourth 87.3 12.6 0.6 0.0 0.7 7.5 78.4 0.2 100.0 87.3 634

Highest 90.5 23.6 1.7 0.0 3.0 1.3 70.3 0.0 100.0 90.5 500

Religion*

Islam 78.4 11.5 0.9 0.1 1.5 2.9 83.1 0.1 100.0 78.9 2,629

Hindu 92.9 18.6 1.1 0.1 0.0 0.5 79.7 0.0 100.0 93.0 220

a Health checks by any health provider following facility births (before discharge from facility) or following home births (before departure of provider from home).

b Post-natal care visits (PNC) refer to a separate visit by any health provider to check on the health of the newborn and provide preventive care services. PNC visits do not include health checks following birth while in facility or at home (see note "a" above).

c Post-natal health checks include any health check performed while in the health facility or at home following birth (see note "a" above), as well as PNC visits (see note "b" above) within two days of delivery.

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases

Postnatal Care Visits for Newborns within one week of Birth:

Table 5.13 presents Percentage of women age 15-49 years with a live birth in the last two years preceding the survey whose last birth received a postnatal care (PNC) visit within one week of birth, by location and provider of first PNC visit. Among those newborns who received any PNC visits, 21.6 per cent received their first PNC visit at home, majority (60.8 per cent) received at private sector health facility, while 17.6 per cent received at public sector health facility. One-fourth of CC slums and other urban areas of newborn received PNC visits at home, while receiving PNC visits at home was only 12.9 per cent in CC non-slums areas. For births occurred at home mostly received first PNC visits within one week of births at home (84.1 per cent).

Three-fourths of the first PNC visits within a week (76.0 per cent) for the newborns were provided by either a doctor/nurse/midwife or an auxiliary midwife in urban areas of Bangladesh. However, differences exist in the first PNC visits for the newborns provided by doctor, nurse, or midwife by area, division and selected background characteristics. For example, 84.6 per cent of newborns of CC non-slum areas received first PNC visits by doctor, nurse and midwife, while this was 67.1 per cent in CC slums and 72.7 per cent in other urban areas. Interestingly, this prevalence was the highest in Sylhet (83.9 per cent), and lowest in Barisal (70.9 per cent).

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Table 5.13: Post-natal care visits for newborns within one week of birth

Percentage of women age 15-49 years with a live birth in the last two years preceding the survey whose last live birth received a post-natal care (PNC) visit within one week of birth, by location and provider of the first PNC visit, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Location of first PNC visit for newborns

Total

Provider of first PNC visit for newborns

Total

Number of last live births in the last two years

with a PNC visit within the first

week of life

Home Public Sector

Private sector

Other loca-tion

Doctor/ nurse/

midwife

Auxiliary midwife

Comm-unity

health worker

Tradi-tional birth

attendant

Other

Total 21.6 17.6 60.8 0.1 100.0 76.0 0.0 0.1 5.5 18.4 100.0 548

Area

City Corporation slum 26.4 22.3 50.0 1.4 100.0 67.1 0.2 3.3 3.6 25.7 100.0 22

City Corporation non-slum 12.9 14.2 72.9 0.0 100.0 84.6 0.0 0.0 1.4 14.0 100.0 161

Other municipalities/urban 25.1 18.9 56.1 0.0 100.0 72.7 0.0 0.0 7.5 19.8 100.0 366

Division

Barisal 32.2 13.0 54.8 0.0 100.0 70.9 0.0 0.0 9.0 20.1 100.0 32

Chittagong 28.5 19.8 51.4 0.3 100.0 74.0 0.0 0.3 6.6 19.1 100.0 89

Dhaka 17.9 17.5 64.6 0.0 100.0 74.4 0.0 0.2 3.9 21.4 100.0 243

Khulna 24.9 10.9 64.2 0.0 100.0 76.4 0.0 0.0 14.5 9.2 100.0 46

Rajshahi 21.4 13.2 65.4 0.0 100.0 80.1 0.0 0.0 4.6 15.2 100.0 73

Rangpur 20.5 25.4 54.1 0.0 100.0 80.7 0.1 0.0 3.4 15.9 100.0 42

Sylhet 15.2 29.6 55.2 0.0 100.0 83.9 0.0 0.0 2.7 13.4 100.0 24

Mother’s age at birth

Less than 20 25.9 13.8 60.2 0.1 100.0 66.8 0.0 0.1 6.8 26.3 100.0 279

20-34 17.1 21.6 61.3 0.0 100.0 85.4 0.0 0.2 4.3 10.1 100.0 269

35-49 (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) (*)

Place of delivery

Home 84.1 10.8 4.8 0.2 100.0 21.5 0.0 0.0 24.3 54.2 100.0 121

Health facility 3.8 19.6 76.6 0.0 100.0 91.4 0.0 0.2 0.2 8.2 100.0 427

Public 4.6 88.4 7.0 0.0 100.0 90.3 0.0 0.0 0.0 9.7 100.0 94

Private 3.6 0.1 96.3 0.0 100.0 91.8 0.0 0.2 0.3 7.8 100.0 333

Education

No education 24.9 34.7 40.3 0.0 100.0 77.5 0.2 0.0 0.4 21.9 100.0 27

Primary incomplete 36.0 26.0 37.5 0.4 100.0 57.3 0.0 0.0 10.4 32.3 100.0 70

Primary complete 56.8 19.8 23.4 0.0 100.0 43.5 0.0 0.8 4.0 51.7 100.0 36

Secondary incomplete 20.2 14.4 65.5 0.0 100.0 74.3 0.0 0.2 7.7 17.9 100.0 276

Secondary complete or higher 7.6 16.1 76.3 0.0 100.0 96.6 0.0 0.0 0.2 3.3 100.0 140

Wealth index quintile

Lowest 42.0 22.1 35.9 0.0 100.0 56.0 0.1 0.8 10.3 32.9 100.0 96

Second 11.7 25.5 62.4 0.4 100.0 78.9 0.0 0.0 0.1 20.9 100.0 67

Middle 32.2 18.3 49.5 0.0 100.0 62.1 0.0 0.0 11.6 26.4 100.0 128

Fourth 15.0 14.5 70.5 0.0 100.0 80.3 0.0 0.0 5.0 14.7 100.0 110

Highest 8.4 12.9 78.7 0.0 100.0 96.5 0.0 0.0 0.0 3.5 100.0 147

Religion*

Islam 22.1 17.1 60.7 0.1 100.0 74.9 0.0 0.1 5.7 19.2 100.0 488

Hindu 19.6 20.3 60.1 0.0 100.0 82.2 0.0 0.0 4.3 13.6 100.0 53

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases

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5.7.3 Postnatal Checkup for Mothers

Postnatal Health Check

Table 5.14 shows that 77.3 per cent of women age 15-49 years with a live birth in the last two years preceding the survey received their health checks by any health provider following birth while in the facility (before discharge from facility) or at home (before departure of provider from home). With regard to PNC visits, only 16.7 per cent received PNC visits and 12.7 per cent took place on the same day, but 83.3 per cent did not receive any PNC visits. Overall, 77.5 per cent of mothers received postnatal health check.

Table 5.14: Post-natal health checks for mothers

Percentage of women age 15-49 years with a live birth in the last two years preceding the survey who received health checks while in facility or at home following birth, per cent distribution who received post-natal care (PNC) visits from any health provider after birth at the time of last birth, by timing of visit, and Percentage who received post-natal health checks, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Health check

following birth while in facility

or at homea

PNC visit for mothersb Post-natal

health check for the

motherc

Number of women with a live

birth in the last

two years

Same day

1 day follow-

ing birth

2 days follow-

ing birth

3-6 days

follow-ing

birth

After the first

week follow-

ing birth

No post-natal care visit

Miss-ing /DK

Total

Total 77.3 12.7 0.8 0.1 0.5 2.6 83.3 0.0 100.0 77.5 2882

Area

City Corporation slum 60.3 8.4 0.3 0.6 1.2 2.4 86.9 0.0 100.0 61.4 127

City Corporation non-slum 80.2 13.7 1.3 0.2 1.1 6.5 77.2 0.0 100.0 80.3 811

Other municipalities/urban 77.1 12.5 0.6 0.0 0.2 0.9 85.6 0.1 100.0 77.4 1944

Division

Barisal 88.5 12.2 1.6 0.0 0.0 0.0 86.2 0.0 100.0 88.5 120

Chittagong 72.8 12.6 1.1 0.2 0.2 0.0 85.8 0.0 100.0 72.9 651

Dhaka 75.8 11.9 0.6 0.0 1.0 5.1 81.3 0.0 100.0 76.2 1320

Khulna 96.0 17.3 0.5 0.0 0.0 0.6 81.6 0.0 100.0 96.0 193

Rajshahi 78.7 14.6 1.2 0.0 0.0 0.0 84.2 0.0 100.0 78.8 272

Rangpur 82.5 12.0 0.2 0.2 0.1 1.8 85.2 0.5 100.0 82.5 198

Sylhet 64.9 11.9 0.5 0.3 0.0 1.0 86.2 0.0 100.0 65.4 128

Mother’s age at birth

Less than 20 75.0 9.9 1.0 0.1 0.6 1.4 87.0 0.0 100.0 75.1 1545

20-34 79.7 15.9 0.5 0.1 0.5 3.9 79.0 0.1 100.0 80.2 1328

35-49 (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 9

Place of delivery

Home 50.5 1.0 0.6 0.0 0.0 0.6 97.8 0.0 100.0 50.6 1093

Health facility 93.7 19.8 0.9 0.1 0.8 3.8 74.5 0.1 100.0 94.1 1788

Public 90.7 15.6 0.1 0.1 0.1 1.9 82.1 0.0 100.0 90.7 506

Private 94.9 21.5 1.2 0.1 1.1 4.6 71.4 0.1 100.0 95.4 1281

Other/DK/Missing (*) (*) (*) (*) (*) (*) 100.0 (*) 100.0 (*) 2

Type of delivery

Vaginal birth 63.8 6.3 0.4 0.1 0.0 0.8 92.5 0.0 100.0 63.9 1733

C-section 97.5 22.4 1.4 0.1 1.2 5.2 69.5 0.1 100.0 98.0 1150

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Table 5.14: continued Health

check following

birth while in facility

or at homea

PNC visit for mothersb Post-natal

health check for the

motherc

Number of women with a live

birth in the last

two years

Same day

1 day follow-

ing birth

2 days follow-

ing birth

3-6 days

follow-ing

birth

After the first

week follow-

ing birth

No post-natal care visit

Miss-ing /DK

Total

EducationNo education 60.9 5.3 0.9 0.2 0.0 1.1 92.6 0.0 100.0 63.1 237Primary incomplete 65.8 7.8 0.0 0.0 0.1 0.1 92.0 0.0 100.0 65.9 423Primary complete 66.4 6.8 0.1 0.1 0.1 2.9 90.0 0.0 100.0 66.5 294Secondary incomplete 80.6 13.4 0.7 0.1 0.3 2.9 82.4 0.0 100.0 80.7 1378Secondary complete or higher 90.7 20.9 1.9 0.0 1.8 4.0 71.2 0.2 100.0 90.7 549

Wealth index quintileLowest 62.5 6.1 0.5 0.1 0.0 0.4 92.9 0.0 100.0 63.4 633Second 71.8 7.6 0.0 0.0 0.2 4.4 87.5 0.2 100.0 71.9 520Middle 79.0 13.8 0.2 0.1 0.2 0.8 85.0 0.0 100.0 79.0 594Fourth 86.2 14.3 0.5 0.2 0.6 4.0 80.4 0.0 100.0 86.3 634Highest 88.3 22.9 3.1 0.0 1.9 3.6 68.5 0.0 100.0 88.3 500

Religion*Islam 76.3 12.1 0.8 0.1 0.6 2.8 83.6 0.0 100.0 76.6 2629Hindu 90.4 17.7 1.1 0.0 0.0 0.3 80.9 0.0 100.0 90.5 220

a Health checks by any health provider following facility births (before discharge from facility) or following home births (before departure of provider from home).

b Post-natal care visits (PNC) refer to a separate visit by any health provider to check on the health of the newborn and provide preventive care services. PNC visits do not include health checks following birth while in facility or at home (see note "a" above).

c Post-natal health checks include any health check performed while in the health facility or at home following birth (see note "a" above), as well as PNC visits (see note "b" above) within two days of delivery.

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

(*) Figures that are based on fewer than 25 unweighted cases

Proportion of women who received health check following birth varied by area of residence; 80.2 per cent of mothers who lived in CC non-slum areas received health check following births, while this Percentage was 60.3 per cent for CC slum women and 77.1 per cent for women of other urban areas. Some variation was observed by divisions, with highest in Khulna (96.0 per cent) and lowest in Sylhet (64.9 per cent). Similar variation was observed in the postnatal health check for the mothers by education and socioeconomic status.

Fig 5.8: Post natal checks for the mother by areas, Bangladesh, CWS 2016

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Table 5.15: Post-natal care visits for mothers within one week of birth

Percentage of women age 15-49 years with a live birth in the last two years preceding the survey who received a post-natal care (PNC) visit within one week of birth, by location and provider of the first PNC visit, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Location of first PNC visit for mothers

Total

Provider of first PNC visit for mothers

Total

Number of women with a live birth in the last two years

who received a PNC visit within

one week of birth

Home Public Sector

Pri-vate

sector

Other locat-

ion

Doctor/ nurse/

midwife

Auxi-liary mid-wife

Comm-unity

health worker

Tradi-tional birth atten-dant

Other

Total 20.8 16.7 62.6 0.0 100.0 79.8 0.0 0.2 5.9 14.1 100.0 507

Area

City Corporation slum 39.6 16.1 44.3 0.0 100.0 59.3 0.1 5.6 6.5 28.5 100.0 21

City Corporation non-slum 15.2 14.3 70.5 0.0 100.0 84.6 0.0 0.0 1.3 14.1 100.0 156

Other municipalities/urban 22.2 17.8 60.0 0.0 100.0 78.8 0.0 0.0 8.0 13.2 100.0 330

Division

Barisal 36.0 7.7 56.3 0.0 100.0 65.7 0.0 0.0 11.4 23.0 100.0 25

Chittagong 23.4 20.4 56.3 0.0 100.0 81.6 0.0 0.3 8.8 9.3 100.0 112

Dhaka 19.4 16.0 64.6 0.0 100.0 78.3 0.0 0.4 4.6 16.8 100.0 228

Khulna 12.6 11.7 75.6 0.0 100.0 88.9 0.0 0.0 7.4 3.7 100.0 39

Rajshahi 23.1 16.2 60.7 0.0 100.0 78.9 0.0 0.0 3.1 18.0 100.0 55

Rangpur 18.3 14.7 67.0 0.0 100.0 82.2 0.1 0.0 4.8 12.9 100.0 30

Sylhet 15.2 29.2 55.7 0.0 100.0 87.2 0.0 0.0 2.3 10.5 100.0 19

Mother’s age at birth

Less than 20 26.4 12.2 61.3 0.0 100.0 70.8 0.0 0.3 7.4 21.5 100.0 252

20-34 15.2 21.1 63.7 0.0 100.0 88.8 0.0 0.2 4.3 6.8 100.0 254

35-49 (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0

Place of delivery

Home 90.5 3.1 6.4 0.0 100.0 19.4 0.0 0.0 32.0 48.6 100.0 93

Health facility 5.2 19.7 75.1 0.0 100.0 93.4 0.0 0.3 0.0 6.4 100.0 414

Public 5.5 87.8 6.7 0.0 100.0 89.2 0.0 0.0 0.0 10.8 100.0 91

Private 5.1 0.6 94.4 0.0 100.0 94.5 0.0 0.4 0.0 5.1 100.0 323

Type of delivery

Vaginal birth 46.1 17.4 36.4 0.0 100.0 55.1 0.0 0.6 14.2 30.1 100.0 209

C-section 3.0 16.1 80.9 0.0 100.0 97.2 0.0 0.0 0.0 2.8 100.0 298

Education

No education (39.9) (30.1) (30.1) (0.0) 100.0 63.8 (0.1) (0.0) (11.5) (24.6) 100.0 24

Primary incomplete 29.7 20.4 49.9 0.0 100.0 62.2 0.0 0.0 11.7 26.2 100.0 54

Primary complete 44.5 31.4 24.1 0.0 100.0 57.2 0.0 0.8 0.0 42.0 100.0 36

Secondary incomplete 23.4 13.3 63.2 0.0 100.0 78.0 0.0 0.3 8.0 13.7 100.0 257

Secondary complete or higher 2.6 15.2 82.1 0.0 100.0 99.0 0.0 0.0 0.2 0.9 100.0 136

Wealth index quintile

Lowest 42.4 18.6 39.0 0.0 100.0 55.4 0.0 1.0 11.0 32.6 100.0 75

Second 18.5 24.9 56.7 0.0 100.0 84.4 0.0 0.0 2.4 13.2 100.0 48

Middle 32.8 11.1 56.1 0.0 100.0 64.5 0.0 .3 11.3 23.8 100.0 130

Fourth 15.3 22.1 62.5 0.0 100.0 87.9 0.0 0.0 4.9 7.2 100.0 113

Highest 3.3 13.6 83.1 0.0 100.0 99.0 0.0 0.0 0.0 1.0 100.0 141

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Table 5.15: continued Location of first PNC visit for mothers

Total

Provider of first PNC visit for mothers

Total

Number of women with a live birth in the last two years

who received a PNC visit within

one week of birth

Home Public Sector

Pri-vate

sector

Other locat-

ion

Doctor/ nurse/

midwife

Auxi-liary mid-wife

Comm-unity

health worker

Tradi-tional birth atten-dant

Other

Religion*

Islam 21.0 16.3 62.8 0.0 100.0 79.4 0.0 0.3 5.9 14.4 100.0 448

Hindu 22.0 17.9 60.1 0.0 100.0 80.3 0.0 0.0 6.6 13.1 100.0 52

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases

Postnatal Care Visits within One Week of Birth:

Table 5.15 deals with postnatal care visits for mothers within one week of birth by location of PNC visits and providers who provided the first PNC visit for mothers. Results show that among those women who received their first PNC visits within one week of birth, more than three-fourths (79.3 per cent) received at health facility, either of private sector (62.6 per cent) or of public sector (16.7 per cent). Only a fifth (20.8 per cent) of mothers received at home. Mother’s first PNC visit at health facility was the highest in CC non-slums (84.8 per cent), and lowest in CC slums (60.4 per cent). Mother’s first PNC visit at home within one week of birth was the lowest in Khulna (12.6 per cent), and highest in Barisal division (36.0 per cent).

Results on the provider of first PNC visit for mothers, as presented in Table 5.15, show that more than three-fourths of the first PNC visits were provided by doctor/Nurse/midwife (79.8 per cent). This Percentage was significantly high in CC non-slums (84.6 per cent) compared to CC slums (59.3 per cent) and other urban areas (78.8 per cent). Some variation was observed by division, with highest in Sylhet (87.2 per cent) and lowest in Barisal (65.7 per cent). Mothers whose birth occurred in a health facility, delivery with C-section and those in the higher wealth quintiles were more likely to receive first PNC visit within one week of birth by doctor/nurse/midwife (Table 5.15).

Table 5.16: Post-natal health checks for mothers and newborns

Percentage of women age 15-49 years with a live birth in the last two years preceding the survey by post-natal health checks for the mother and newborn, within two days of the most recent birth, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Post-natal health checks within two days of birth for: DK/Missing

Total Number of women with a live birth in the last two years

Both mothers and

newborns

Mothers only

Newborns only

Neither mother

nor newborn

Total 76.2 1.3 3.7 18.8 0.0 100.0 2882

Area

City Corporation slum 57.9 3.1 6.6 32.4 0.0 100.0 127

City Corporation non-slum 78.3 2.1 5.6 14.0 0.0 100.0 811

Other municipalities/urban 76.6 0.8 2.7 19.9 0.0 100.0 1,944

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Table 5.16: continued Post-natal health checks within two days of birth for: DK/

MissingTotal Number of

women with a live birth in the last two years

Both mothers and

newborns

Mothers only

Newborns only

Neither mother

nor newbornDivision

Barisal 88.5 0.0 4.8 6.7 0.0 100.0 120

Chittagong 71.4 1.5 2.0 25.1 0.0 100.0 651

Dhaka 74.4 1.8 4.8 19.0 0.0 100.0 1,320

Khulna 95.0 1.0 0.2 3.8 0.0 100.0 193

Rajshahi 78.8 0.0 4.0 17.2 0.0 100.0 272

Rangpur 81.9 0.5 3.4 14.1 0.0 100.0 198

Sylhet 64.7 0.7 4.6 30.0 0.0 100.0 128

Mother’s age at birth

Less than 20 73.5 1.6 4.2 20.7 0.0 100.0 1,545

20-34 79.2 1.0 3.1 16.8 0.0 100.0 1,328

35-49 (*) (*) (*) (*) (*) 100.0 9

Place of delivery

Home 49.9 0.7 4.7 44.7 0.0 100.0 1,093

Health facility 92.4 1.6 3.1 2.9 0.0 100.0 1,788

Public 88.6 2.1 4.6 4.7 0.0 100.0 506

Private 93.9 1.5 2.4 2.2 0.0 100.0 1,281

Other/DK/Missing 0.0 0.0 0.0 100.0 0.0 100.0 2

Type of delivery

Vaginal birth 63.1 0.8 5.2 30.8 0.0 100.0 1,733

C-section 96.0 2.0 1.3 0.7 0.0 100.0 1,150

Education

No education 61.1 1.9 4.0 32.9 0.0 100.0 237

Primary incomplete 65.3 0.5 4.1 30.0 0.0 100.0 423

Primary complete 65.3 1.3 4.4 29.1 0.0 100.0 294

Secondary incomplete 79.0 1.6 3.4 16.0 0.0 100.0 1,378

Secondary complete or higher 90.0 0.7 3.5 5.8 0.0 100.0 549

Wealth index quintile

Lowest 62.3 1.0 2.7 34.0 0.0 100.0 633

Second 71.3 0.6 6.6 21.5 0.0 100.0 520

Middle 77.2 1.8 3.5 17.5 0.0 100.0 594

Fourth 84.7 1.6 2.6 11.1 0.0 100.0 634

Highest 86.9 1.5 3.6 8.1 0.0 100.0 500

Religion*

Islam 75.2 1.3 3.7 19.8 0.0 100.0 2,629

Hindu 89.4 1.2 3.6 5.8 0.0 100.0 220

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases

5.7.4 Postnatal Health Checks for Mothers and Newborns

Table 5.16 presents data on the postnatal health checks for the mother and newborn, within two days of most recent birth. Overall, 76.2 per cent of both mothers and their newborns received postnatal health checks within two days of birth, while 18.8 per cent of neither mother nor newborn received this PNC checks. This PNC check for both mothers and newborns was the least prevalent in CC slums (57.9 per cent), and in Sylhet divisions (64.7 per cent).

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6 WATER AND SANITATIONUNICEF/BANA2014-004717/Mawa

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Key Findings:

� Use of drinking water from improved water sources was almost universal among urban households (99.2 per cent). Among those who do not use improved drinking water sources, 39.7 per cent reported of using an appropriate treatment method to make water safe for drinking.

� About 57.3 per cent of urban population are using improved sanitation facilities which are not shared with members of other household. It varied by type of urban areas, with 51.3 per cent in CC non-slums, 18.9 per cent in CC slums and 62.4 per cent in other urban areas. Use of improved sanitation facilities which are not shared was the highest in Barisal (80.7 per cent), and lowest in Dhaka (47.1 per cent).

� Overall 56.7 per cent of urban population use both improved drinking water source and improved sanitation facility. This Percentage was very low in CC slums (18.2 per cent compared to CC non-slums (50.5 per cent) and other urban areas (61.9 per cent).

� For 66.2 per cent of children age 0-2 years, the stool were disposed of safely the last time they passed stool. This Percentage was much higher in CC non-slums (81.9 per cent) than CC slums (58.0 per cent) and other urban areas (60.2 per cent).

� Overall, 55.4 per cent of households had specific place for handwashing with water and soap available, with 67.1 per cent in CC non-slums, 35.4 per cent in CC slums, and 51.1 per cent in other urban areas.

Safe drinking water is a basic necessity for good health. Access to safe water and sanitation are basic determinants of better health. Limited access to safe drinking water and sanitation facilities and poor hygiene are associated with skin diseases, acute respiratory infections (ARIs), and diarrheal diseases. The CWS 2016 collected information on the primary sources of drinking water, whether water is treated to make it safe, type of toilet facility used, whether sanitation facility is shared, place of disposal of child faeces, and handwashing practices. The main results are stated below.

6.1 Use of Improved Water SourcesThe distribution of household population by main sources of drinking water is given in Table 6.1. The population using improved sources of drinking water are those using any of the following types of supply: piped water (into dwelling, compound, yard or plot, to neighbor, public tap/standpipe), tubewell/borehole, protected well, protected spring, and rain water collection. Bottle water can be considered as an improved water source only if the household is using an improved water source for handwashing and cooking. The table shows that 99.2 per cent of urban population of Bangladesh were using drinking water from an improved source – with no marked difference between the three areas of CC slums, CC non slums and other urban areas. Differences between divisions were not pronounced and the Percentage also varied little by background characteristics.

6 WATER AND SANITATION

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Table 6.1: Use of improved water sources

Per cent distribution of households population according to main source of drinking water and Percentage of household population using improved drinking water sources, by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Main source of drinking water Total Percen-tage using

improved sources

of drinking

water

Number of house-

hold mem-bers

Improved sources Unimproved sources

Piped water Tube-well/ bore-hole

Pro-tected well

Pro-tected spring

Rain-water collec-

tion

Bottled watera

Unpro-tected well

Tanker trere-uck

Cart with tank/ drum

Sur-face

water

Bottled watera

Other

Into dwelling

Into yard/ plot

To neigh-bour

Public tap/

stand-pipe

Total 21.2 18.3 1.6 3.4 54.2 0.1 0.0 0.1 0.3 0.0 0.1 0.4 0.3 0.0 0.0 100.0 99.2 82,228

Area

City Corporation slum 9.3 36.0 4.6 10.7 37.0 0.0 0.1 0.0 0.3 0.0 0.0 1.9 0.0 0.1 0.0 100.0 98.0 3,302

City Corporation non-slum 43.8 24.6 1.6 6.1 22.2 0.1 0.0 0.0 0.8 0.0 0.2 0.8 0.0 0.0 0.0 100.0 99.0 25,015

Other municipalities/urban 11.4 14.3 1.4 1.7 70.1 0.1 0.0 0.2 0.1 0.0 0.0 0.2 0.4 0.0 0.0 100.0 99.3 53,911

Division

Barisal 3.1 2.9 0.6 0.2 91.7 0.0 0.0 0.4 0.0 0.0 0.0 0.5 0.6 0.1 0.0 100.0 98.8 3,343

Chittagong 18.7 16.7 3.8 4.6 54.8 0.0 0.1 0.0 0.5 0.1 0.0 0.8 0.1 0.0 0.0 100.0 99.0 16,019

Dhaka 31.2 28.1 1.3 4.3 34.1 0.2 0.0 0.0 0.4 0.0 0.1 0.3 0.0 0.0 0.0 100.0 99.6 38,509

Khulna 6.2 6.0 2.2 2.8 78.1 0.1 0.0 1.4 0.3 0.0 0.1 1.4 1.4 0.1 0.0 100.0 97.0 6,988

Rajshahi 7.9 7.1 0.2 1.8 83.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 8,430

Rangpur 4.9 1.8 0.1 0.6 92.5 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 100.0 99.9 5,554

Sylhet 27.9 9.6 0.2 1.0 58.1 0.0 0.0 0.0 0.0 0.0 0.0 0.1 3.0 0.1 0.0 100.0 96.8 3,385

Education of household head

No education 8.9 22.1 2.8 3.6 61.4 0.0 0.1 0.0 0.2 0.1 0.0 0.5 0.3 0.0 0.0 100.0 99.1 19,159

Primary incomplete 13.3 22.3 1.7 3.6 57.8 0.0 0.0 0.2 0.4 0.0 0.0 0.4 0.2 0.0 0.0 100.0 99.3 13,377

Primary complete 14.0 17.3 1.6 2.5 63.1 0.3 0.0 0.0 0.0 0.0 0.0 0.8 0.4 0.0 0.0 100.0 98.8 9,033

Secondary incomplete 22.7 18.0 1.3 3.6 53.1 0.1 0.0 0.2 0.3 0.0 0.2 0.4 0.2 0.0 0.0 100.0 99.2 24,583

Secondary complete or higher 44.7 10.7 0.5 3.3 39.1 0.1 0.0 0.1 0.6 0.0 0.0 0.4 0.3 0.0 0.0 100.0 99.2 15,715

Missing/DK 19.8 36.8 0.0 1.0 42.1 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.0 0.0 100.0 99.6 360

Wealth index quintile

Lowest 1.6 25.6 3.9 3.0 65.0 0.0 0.1 0.0 0.1 0.1 0.0 0.3 0.3 0.0 0.0 100.0 99.3 13,990

Second 6.1 32.3 2.1 5.1 53.3 0.0 0.0 0.1 0.0 0.0 0.0 0.5 0.3 0.0 0.0 100.0 99.2 15,216

Middle 10.4 16.6 1.3 1.9 68.5 0.0 0.0 0.4 0.1 0.0 0.0 0.4 0.3 0.0 0.0 100.0 99.2 17,034

Fourth 27.1 12.1 0.9 5.0 53.1 0.3 0.0 0.1 0.7 0.0 0.0 0.4 0.3 0.0 0.0 100.0 99.2 17,824

Highest 53.2 8.5 0.3 2.2 34.1 0.1 0.0 0.1 0.6 0.0 0.2 0.6 0.2 0.0 0.0 100.0 99.0 18,163

Religion

Islam 21.6 18.7 1.5 3.4 53.6 0.1 0.0 0.1 0.3 0.0 0.1 0.4 0.2 0.0 0.0 100.0 99.3 74,338

Hindu 16.7 14.0 1.5 3.7 61.2 0.3 0.0 0.8 0.2 0.0 0.0 0.7 0.8 0.1 0.0 100.0 98.4 7,253

Buddhist 14.1 27.0 12.7 6.9 39.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 358

Christian 39.4 12.6 0.0 0.5 45.1 0.0 0.0 0.0 0.0 0.0 0.0 2.4 0.0 0.0 0.0 100.0 97.6 258

The prime source of drinking water for the urban population was tubewell/ borehole (54.2 per cent). Another 44.5 per cent was using piped drinking water. About three-fourths (76.1 per cent) of CC non-slum households were using pipe water for drinking and this was 60.6 per cent in CC slums, and as low as 28.8 per cent in other urban areas. Overall use of tubewell water for drinking was 54.2 per cent, with maximum in other urban areas (70.1 per cent), and minimum in CC non-slums (22.2 per cent). W

ater

an

d S

anit

atio

n

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Fig 6.1: Percentage of using improve source of drinking water by areas, Bangladesh, CWS 2016

Households where an unimproved drinking water source is used (about 1 per cent) were asked about the method they use for treating water to make it safe. Table 6.2 shows that 68.2 per cent do not treat water to make it safe, but those who use some method the commonly used techniques were: straining through a filter (14.5 per cent), and boiling (22.8 per cent) (Figure 6.2).

Among the population in households who were using unimproved drinking water source, only two-fifths (39.7 per cent) reported of using an appropriate treatment method to make water safe. This practice appeared to be higher in other urban areas (51.4 per cent) than in CC non-slums (25.6 per cent) and CC slum areas (25.9 per cent). This practice was the highest in Khulna (56.7 per cent). These estimate are similar to those reported in MICS 2012-2013.

Fig 6.2: Water treatment method used in the household, Bangladesh, CWS 2016

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Table 6.2: Household water treatment

Per cent of household population by drinking water treatment method used in the household, and for household members living in households where an unimproved drinking water source is used, the Percentage who are using an appropriate treatment method, by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Water treatment method used in the household Number of

house-hold

mem-bers

Percentage of household members in

households using unimproved

drinking water sources and using

an appropriate water treatment

method

Number of household

members in households

using unimproved

drinking water

sources

None Boil Add bleach/ chlorine

Strain through a cloth

Use water filter

Solar dis-

infec-tion

Let it stand and

settle

Other Missing/DK

Total 68.2 22.8 0.3 3.3 14.5 0.0 0.2 0.7 0.0 82,228 39.7 683

Area

City Corporation slum 73.0 20.5 0.1 1.8 7.6 0.0 0.3 0.9 0.0 3,302 25.9 65

City Corporation non-slum 38.2 52.8 0.6 7.4 22.5 0.0 0.2 1.1 0.0 25,015 25.6 245

Other municipalities/urban 81.8 9.0 0.2 1.5 11.2 0.0 0.3 0.5 0.0 53,911 51.4 372

Division

Barisal 90.1 1.6 0.4 0.4 6.1 0.0 0.3 2.1 0.0 3,343 45.8 40

Chittagong 70.3 18.2 0.5 0.5 16.7 0.0 0.1 2.1 0.0 16,019 37.7 157

Dhaka 53.8 39.3 0.2 6.6 16.3 0.0 0.3 0.3 0.0 38,509 16.1 168

Khulna 86.1 .9 0.8 0.2 11.7 0.0 0.2 0.1 0.0 6,988 56.7 206

Rajshahi 90.0 1.6 0.0 0.8 8.3 0.0 0.3 0.0 0.0 8,430 na na

Rangpur 95.8 .8 0.1 0.0 3.3 0.0 0.1 0.0 0.0 5,554 (*) 4

Sylhet 64.4 12.8 0.0 0.4 31.1 0.0 0.4 0.3 0.0 3,385 46.1 107

Main source of drinking water

Improved 68.3 22.9 0.3 3.3 14.4 0.0 0.2 0.7 0.0 81,545 - -

Unimproved 57.4 15.0 5.7 0.2 23.4 0.0 1.3 0.6 0.0 683 39.7 683

Education of household head

No education 82.4 14.1 0.1 2.4 5.6 0.0 0.2 0.4 0.0 19,159 20.0 166

Primary incomplete 73.4 19.9 0.2 3.0 8.0 0.0 0.3 0.9 0.0 13,377 34.6 87

Primary complete 75.8 16.8 0.5 3.5 8.7 0.0 0.4 0.5 0.0 9,033 53.8 107

Secondary incomplete 65.8 24.6 0.3 3.4 15.1 0.0 0.3 0.9 0.0 24,583 37.8 194

Secondary complete or higher 46.6 35.8 0.5 4.1 33.3 0.0 0.1 0.6 0.0 15,715 60.1 128

Missing/DK 40.7 54.5 0.0 17.4 4.0 0.0 0.0 0.8 0.0 360 (*) 1

Wealth index quintile

Lowest 87.4 10.2 0.3 2.0 1.4 0.0 0.4 0.4 0.0 13,990 18.2 101

Second 75.8 20.9 0.2 3.5 3.7 0.0 0.2 0.3 0.0 15,216 32.9 129

Middle 77.0 17.1 0.2 2.5 7.7 0.0 0.1 0.8 0.0 17,034 45.8 133

Fourth 65.6 24.0 0.2 3.0 14.5 0.0 0.2 0.8 0.0 17,824 48.4 137

Highest 41.4 38.2 0.7 5.2 39.8 0.0 0.2 1.0 0.0 18,163 45.3 184

Religion

Islam 68.1 23.5 0.3 3.5 14.0 0.0 0.2 0.7 0.0 74,338 34.9 555

Hindu 70.5 15.1 0.4 1.4 17.3 0.0 0.2 0.7 0.0 7,253 58.0 117

Buddhist 66.1 12.3 0.0 0.0 28.7 0.0 0.0 0.0 0.0 358 na na

Christian 32.6 43.5 2.4 12.0 42.8 0.0 0.0 0.0 0.0 258 (*) 6

na: not applicable(*) Figures that are based on fewer than 25 unweighted cases

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Table 6.3: Types of sanitation facilities

Perc ent distribution of household population according to type of toilet facility used by the household, by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Type of toilet facility used by household Open defecation

(no facility, bush, field)

Total Number of households members

Improved sanitation facility Unimproved sanitation facility

Flush/Pour flush to: Ventilated improved pit latrine

Pit latrine with slab

Compos-ting toilet

Flush/Pour flush to

somewhere else

Pit latrine without slab/

open pit

Bucket Hang-ing

toilet/ latrine

Missing/ DkPiped

sewer system

Septic tank

Pit latrine

Total 7.0 15.8 2.5 24.6 38.9 0.0 3.2 2.9 0.0 0.3 4.6 0.2 100.0 82,228

AreaCity Corporation slum 6.2 12.1 1.5 17.3 44.6 0.0 4.6 5.3 0.0 1.3 6.8 0.1 100.0 3,302City Corporation non-slum 18.4 20.3 2.4 15.9 23.0 0.0 7.5 0.8 0.0 0.0 11.7 0.0 100.0 25,015Other municipalities/urban 1.7 13.9 2.6 29.1 45.9 0.0 1.1 3.8 0.0 0.4 1.2 0.3 100.0 53,911

DivisionBarisal 0.1 17.3 1.2 32.4 47.4 0.0 0.4 0.5 0.1 0.2 0.3 0.0 100.0 3,343Chittagong 2.0 25.2 3.7 13.9 44.5 0.0 3.2 4.5 0.0 0.2 2.5 0.2 100.0 16,019Dhaka 13.2 11.3 2.1 25.1 33.6 0.0 4.7 1.4 0.0 0.2 8.4 0.0 100.0 38,509Khulna 0.1 21.8 0.7 36.7 29.8 0.2 1.4 8.3 0.0 0.0 0.9 0.0 100.0 6,988Rajshahi 1.2 17.2 5.3 29.4 42.5 0.0 0.5 2.6 0.0 0.5 0.7 0.0 100.0 8,430Rangpur 0.5 7.1 1.4 23.0 61.8 0.0 0.2 3.1 0.1 0.6 0.4 1.9 100.0 5,554Sylhet 5.5 18.5 1.3 26.9 36.8 0.1 3.8 4.9 0.0 1.5 0.7 0.1 100.0 3,385

Education of household headNo education 3.5 5.4 1.3 22.8 52.5 0.1 2.4 6.0 0.0 0.8 4.9 0.4 100.0 19,159Primary incomplete 6.1 9.1 2.1 25.9 45.2 0.0 2.5 3.3 0.0 0.3 5.2 0.4 100.0 13,377Primary complete 4.8 11.5 2.6 25.5 45.2 0.0 2.7 3.1 0.0 0.3 4.1 0.1 100.0 9,033Secondary incomplete 6.3 18.9 3.2 25.9 36.0 0.0 2.9 2.0 0.0 0.1 4.6 0.0 100.0 24,583Secondary complete or higher 14.5 31.8 3.1 23.5 18.3 0.0 5.1 0.2 0.0 0.0 3.3 0.0 100.0 15,715Missing/DK 0.0 13.1 0.3 14.7 17.2 0.0 11.0 2.7 0.0 0.5 40.6 0.0 100.0 360

Wealth index quintileLowest 0.9 3.3 1.2 22.0 56.9 0.0 1.3 7.3 0.0 1.4 4.7 1.1 100.0 13,990Second 3.0 6.7 1.9 25.1 49.3 0.1 2.5 4.0 0.0 0.2 7.2 0.0 100.0 15,216Middle 4.2 6.1 2.6 26.0 51.2 0.0 1.8 3.9 0.0 0.1 4.2 0.0 100.0 17,034Fourth 7.7 16.7 3.7 32.2 32.2 0.0 3.1 0.7 0.0 0.0 3.8 0.0 100.0 17,824Highest 16.9 41.2 2.8 17.5 11.4 0.0 6.5 0.1 0.0 0.0 3.7 0.0 100.0 18,163

ReligionIslam 7.1 15.5 2.5 24.0 39.1 0.0 3.2 3.0 0.0 0.3 5.0 0.2 100.0 74,338Hindu 4.7 18.6 2.1 30.8 36.2 0.0 2.8 2.8 0.0 0.2 1.7 0.1 100.0 7,253Buddhist 4.3 14.9 4.0 13.7 58.4 0.0 4.6 0.0 0.0 0.0 0.0 0.0 100.0 358Christian 28.4 10.7 0.7 29.2 28.3 0.0 1.4 0.4 0.0 0.1 0.8 0.0 100.0 258

6.2 Use of Improved SanitationAn improved sanitation facility is defined as the one that hygienically separates human excreta from human contact. Access to improved sanitation facilities is a determinant of health and environmental safety. Improved sanitation facilities for excreta disposal include flush/pour flush to a piped sewer system, septic tank, or pit latrine; ventilated improved pit latrine, pit latrine with slab, and use of a composting toilet. Table 6.3 provides Percentage of household population, according to types of toilet facility used by them.

Eighty two per cent of urban household population in Bangladesh were using improved sanitation facilities (Table 6.3), which include shared latrine. This Percentage was higher in other urban areas (93.2 Percentage) than in CC’s (around 81 per cent) by division was not significant.

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Fig 6.3: Percentage of users of improved sanitation facilities (not shared) by areas, Bangladesh, CWS 2016

About 31.5 per cent users of improved sanitation facilities were reported to be sharing sanitation facilities with members of other households; 28.5 per cent shared a facility by 10 households or less and another 2.5 per cent shared an improved sanitation facility by more than 10 households. About eleven per cent of urban household population were using unimproved sanitation facility, with 5.5 per cent did not share with other households and 4.7 per cent shared by 10 or less households (Table 6.4).

Table 6.4: Use and sharing of sanitation facilities

Per cent distribution of household population by use of private and public sanitation facilities and use of shared facilities, by users of improved and unimproved sanitation facilities, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Users of improved sanitation facilities Users of unimproved sanitation facilities Open defeca-tion (no facility, bush, field)

Total Number of

house-hold

mem-bers

Not shared1

Public facility

Shared by Miss-ing/DK

Not shared

Public facility

Shared by

10 house-holds or

less

More than 10 house-holds

10 households

or less

More than 10

households

Total 57.3 0.5 28.5 2.5 0.0 5.5 0.1 4.7 0.7 0.2 100.0 82,228

AreaCity Corporation slum 18.9 8.4 37.0 17.5 0.0 3.5 0.5 9.3 4.8 0.1 100.0 3,302 City Corporation non-slum 51.3 0.1 26.0 2.6 0.0 9.3 0.1 9.6 0.9 0.0 100.0 25,015 Other municipalities/urban 62.4 0.2 29.2 1.5 0.0 3.9 0.0 2.2 0.4 0.3 100.0 53,911

DivisionBarisal 80.7 0.1 17.3 0.3 0.0 1.0 0.0 .6 0.0 0.0 100.0 3,343 Chittagong 63.6 0.5 22.0 3.2 0.0 5.5 0.0 4.0 0.9 0.2 100.0 16,019 Dhaka 47.1 0.7 34.0 3.5 0.0 6.7 0.1 6.8 1.1 0.0 100.0 38,509 Khulna 65.2 0.0 23.3 0.8 0.0 6.6 0.1 3.8 0.1 0.0 100.0 6,988 Rajshahi 66.5 0.3 28.9 0.0 0.0 2.5 0.0 1.7 0.0 0.0 100.0 8,430 Rangpur 65.4 0.3 27.6 0.5 0.0 2.3 0.0 2.0 0.0 1.9 100.0 5,554 Sylhet 66.7 0.1 19.1 3.1 0.0 7.8 0.0 2.9 0.2 0.1 100.0 3,385

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Table 6.4: continued Users of improved sanitation facilities Users of unimproved sanitation facilities Open

defeca-tion (no facility, bush, field)

Total Number of

house-hold

mem-bers

Not shared1

Public facility

Shared by Miss-ing/DK

Not shared

Public facility

Shared by

10 house-holds or

less

More than 10 house-holds

10 households

or less

More than 10

households

Education of household headNo education 43.7 1.1 35.1 5.5 0.0 5.3 0.2 7.7 0.9 0.4 100.0 19,159 Primary incomplete 44.7 0.4 40.1 3.0 0.0 4.6 0.0 6.1 0.6 0.4 100.0 13,377 Primary complete 55.5 0.3 32.2 1.7 0.0 4.2 0.0 5.2 0.8 0.1 100.0 9,033 Secondary incomplete 62.1 0.3 26.4 1.6 0.0 5.7 0.1 3.2 0.7 0.0 100.0 24,583 Secondary complete or higher 78.8 0.2 12.0 0.2 0.0 6.8 0.0 1.7 0.2 0.0 100.0 15,715 Missing/DK 19.4 0.0 24.8 0.9 0.0 23.4 0.0 16.3 15.1 0.0 100.0 360

Wealth index quintilePoorest 5.6 1.4 67.7 9.5 0.0 1.6 0.1 10.8 2.1 1.1 100.0 13,990 Second 22.4 1.0 58.5 4.1 0.0 2.5 0.2 10.1 1.1 0.0 100.0 15,216 Middle 63.9 0.2 25.6 0.4 0.0 5.0 0.0 4.3 0.6 0.0 100.0 17,034 Fourth 88.5 0.2 3.7 0.0 0.0 6.8 0.2 0.6 0.0 0.0 100.0 17,824 Richest 89.4 0.0 .3 0.0 0.0 10.3 0.0 0.0 0.0 0.0 100.0 18,163

ReligionIslam 56.1 0.5 29.1 2.7 0.0 5.6 0.1 5.0 0.7 0.2 100.0 74,338 Hindu 68.5 0.3 22.7 0.9 0.0 4.9 0.1 2.1 0.4 0.1 100.0 7,253 Buddhist 58.5 1.7 35.2 0.0 0.0 4.6 0.0 0.0 0.0 0.0 100.0 358 Christian 67.7 0.0 29.7 0.0 0.0 2.3 0.0 0.3 0.0 0.0 100.0 258

Table 6.4 also show that 57.3 per cent of urban household population use improved sanitation facilities which are not shared with members of other households. This Percentage was very low in CC slums (18.9 per cent) compared to CC non-slums (51.3 per cent) and other urban areas (62.4 per cent), implying that most of the CC slum dwellers used shared facility even if it is an improved facility. This is also shown in Figure 6.3.

Table 6.5: Drinking water and sanitation ladders

Percentage of household population by drinking water and sanitation ladders, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Percentage of household population using: Number of

house-hold

mem-bers

Improved drinking water a

Unim-proved drinking

water

Total Improved sanitation

Unimproved sanitation Total Improved drinking

water sources

and improved sanitation

Piped into

dwelling, plot or yard

Other improved

Shared improved facilities

Unim-proved

facilities

Open defeca-

tion

Total 39.7 59.5 0.8 100.0 57.3 31.5 11.0 0.2 100.0 56.7 82,228

Area

City Corporation slum 45.5 52.6 2.0 100.0 18.9 62.9 18.1 0.1 100.0 18.2 3,302

City Corporation non-slum 69.0 30.0 1.0 100.0 51.3 28.7 20.0 0.0 100.0 50.5 25,015

Other municipalities/urban 25.8 73.5 0.7 100.0 62.4 30.9 6.5 0.3 100.0 61.9 53,911

Division

Barisal 6.0 92.8 1.2 100.0 80.7 17.7 1.6 0.0 100.0 79.6 3,343

Chittagong 35.7 63.4 1.0 100.0 63.6 25.7 10.4 0.2 100.0 63.1 16,019

Dhaka 59.6 39.9 0.4 100.0 47.1 38.2 14.7 0.0 100.0 46.8 38,509

Khulna 12.4 84.7 3.0 100.0 65.2 24.2 10.6 0.0 100.0 62.9 6,988

Rajshahi 15.1 84.9 0.0 100.0 66.5 29.2 4.2 0.0 100.0 66.5 8,430

Rangpur 6.8 93.2 0.1 100.0 65.4 28.4 4.3 1.9 100.0 65.4 5,554

Sylhet 37.5 59.4 3.2 100.0 66.7 22.4 10.9 0.1 100.0 64.6 3,385

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Table 6.5: continued Percentage of household population using: Number

of house-hold

mem-bers

Improved drinking water a

Unim-proved drinking

water

Total Improved sanitation

Unimproved sanitation Total Improved drinking

water sources

and improved sanitation

Piped into

dwelling, plot or yard

Other improved

Shared improved facilities

Unim-proved

facilities

Open defeca-

tion

Education of household head

No education 31.1 68.0 0.9 100.0 43.7 41.8 14.1 0.4 100.0 43.3 19,159

Primary incomplete 36.0 63.3 0.7 100.0 44.7 43.5 11.3 0.4 100.0 44.4 13,377

Primary complete 31.3 67.5 1.2 100.0 55.5 34.2 10.2 0.1 100.0 54.7 9,033

Secondary incomplete 40.9 58.3 0.8 100.0 62.1 28.2 9.7 0.0 100.0 61.5 24,583

Secondary complete or higher 56.0 43.2 0.8 100.0 78.8 12.4 8.7 0.0 100.0 78.1 15,715

Missing/DK 56.6 43.1 0.4 100.0 19.4 25.8 54.8 0.0 100.0 19.4 360

Wealth index quintile

Lowest 27.2 72.0 0.7 100.0 5.6 78.6 14.7 1.1 100.0 5.6 13,990

Second 38.5 60.7 0.8 100.0 22.4 63.6 14.0 0.0 100.0 22.1 15,216

Middle 27.1 72.1 0.8 100.0 63.9 26.2 10.0 0.0 100.0 63.2 17,034

Fourth 39.7 59.5 0.8 100.0 88.5 4.0 7.5 0.0 100.0 87.8 17,824

Highest 62.2 36.8 1.0 100.0 89.4 .3 10.3 0.0 100.0 88.5 18,163

Religion

Islam 40.5 58.7 0.7 100.0 56.1 32.2 11.5 0.2 100.0 55.6 74,338

Hindu 30.7 67.6 1.6 100.0 68.5 23.8 7.5 0.1 100.0 67.3 7,253

Buddhist 41.1 58.9 0.0 100.0 58.5 36.9 4.6 0.0 100.0 58.5 358

Christian 52.1 45.6 2.4 100.0 67.7 29.7 2.6 0.0 100.0 65.3 258

a Those indicating bottled water as the main source of drinking water are distributed according to the water source used for other purposes such as cooking and handwashing.

Having access to both an improved drinking water source and an improved sanitation facility bring huge public health benefits. Table 6.5 presents Percentages of household population by drinking water and sanitation ladders. It also shows the Percentage of household members using both improved sources of drinking water and an improved sanitation means of excreta disposal. The table shows that overall 56.7 per cent of urban household members had an improved drinking water source as well as improved sanitation. This Percentage was very low in CC slums (18.2 per cent) compared to CC non-slums (50.5 per cent) and the situation was the best in other urban areas (61.9 per cent). This prevalence varied by division with the highest prevalence in Barisal (79.6 per cent) and lowest in Dhaka (46.8 per cent). Education of household head and wealth level appeared to have positive impact on use of improved drinking water sources and improved sanitation.

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Fig 6.4 : Use of improved drinking water sources and improved sanitation by division, Bangladesh, CWS 2016

6.3 Disposal of Child’s FaecesSafe disposal of a child’s faeces is disposing of the stool by the child using a toilet or by rinsing the stool into a toilet or latrine. Disposal of faeces of children age 0-2 years is presented in Table 6.6.

Fig 6.5: Percentage of children whose last stools were disposed of safely by areas, Bangladesh, CWS 2016

Table 6.6 (and Figure 6.5) shows that in urban areas of Bangladesh, for 66.2 per cent children of age 0-2 years, the stools were disposed of safely the last time they passed stools. This Percentage was much higher in CC non-slum areas (81.9 per cent) than in other urban (60.2 per cent) and CC slum areas (58.0 per cent).

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Significant differences were observed in this practice in different divisions. The lowest in Rajshahi (43.7 per cent), and the highest was in Dhaka (76.6 per cent)). Safe disposal of child’s faeces were found to be positively associated with mother’s education and household wealth quintile – from 55.1 per cent when mothers have no education to 83.1 per cent for mothers with secondary or higher education. Safe disposal of stools was as low as 43.9 per cent among the poorest households as compared to 82.2 per cent among the richest.

By place of disposal, the most common practice in urban areas was put/rinsed child’s faeces into a toilet or latrine. This safe practice was observed for 63.3 per cent of children age 0-2 years. Other disposal methods was to put/rinsed into drain or ditch (17.1 per cent) and throwing into garbage (12.1 per cent).

Table 6.6: Disposal of child’s faeces

Per cent distribution of children age 0-2 years according to place of disposal of child’s faeces, and the Percentage of children age 0-2 years whose stools were disposed of safely the last time the child passed stools, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Place of disposal of child’s faeces Percentage of children whose last stools were

disposed of safely

Number of

children age 0-2 years

Child used toilet/latrine

Put/rinsed into toilet or latrine

Put/rinsed into drain or ditch

Thrown into

garbage

Buried Left in the open

Other Total

Total 2.9 63.3 17.1 12.1 0.2 4.1 0.2 100.0 66.2 2,805Type of sanitation facility used by household members

Improved 2.9 63.8 16.7 12.2 0.2 4.0 0.2 100.0 66.7 2,499Unimproved 2.3 60.0 20.7 11.7 0.4 4.4 0.6 100.0 62.3 299Open defecation (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 7

AreaCity Corporation slum 1.2 56.8 27.9 10.2 0.1 3.8 0.0 100.0 58.0 123City Corporation non-slum 5.3 76.6 10.5 6.8 .0 0.8 0.0 100.0 81.9 790Other municipalities/urban 1.9 58.2 19.2 14.5 0.4 5.5 0.3 100.0 60.2 1,892

DivisionBarisal 0.6 56.9 22.0 16.5 0.0 4.0 0.0 100.0 57.5 119Chittagong 1.2 60.5 20.2 12.9 0.7 4.5 0.0 100.0 61.7 635Dhaka 4.0 72.7 11.6 8.5 0.0 3.2 0.0 100.0 76.7 1,278Khulna 5.0 57.7 17.6 14.7 0.7 3.6 0.7 100.0 62.8 187Rajshahi 1.5 42.2 27.3 21.3 0.0 5.9 1.8 100.0 43.7 269Rangpur 2.5 53.8 25.0 10.9 0.6 7.2 0.0 100.0 56.3 195Sylhet 2.1 56.0 18.8 19.3 0.0 3.4 0.4 100.0 58.2 123

Mother’s educationNo education 3.1 52.1 23.9 17.9 0.0 3.0 0.0 100.0 55.1 236Primary incomplete 0.4 56.1 21.5 13.3 0.3 7.9 0.5 100.0 56.5 412Primary complete 7.0 52.8 15.0 18.9 0.0 5.9 0.4 100.0 59.7 287Secondary incomplete 2.4 63.3 19.1 10.9 0.3 3.8 0.2 100.0 65.7 1,334Secondary complete or higher 3.6 79.5 7.2 7.9 0.4 1.3 0.0 100.0 83.1 536

Wealth index quintileLowest 1.6 42.4 25.8 22.8 0.0 6.9 0.5 100.0 43.9 605Second 2.2 63.4 19.5 12.5 0.3 2.1 0.0 100.0 65.6 503Middle 2.6 58.9 20.0 10.6 0.5 7.1 0.3 100.0 61.4 586Fourth 4.1 76.1 10.6 6.1 0.0 2.8 0.3 100.0 80.2 627Highest 4.0 78.3 8.9 7.9 0.5 0.5 0.0 100.0 82.2 484

Religion*Islam 2.8 63.3 17.2 12.1 0.2 4.2 0.3 100.0 66.1 2,556Hindu 4.0 64.9 15.4 11.7 1.0 3.0 0.0 100.0 68.9 218

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases

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6.4 Handwashing PracticesHandwashing with water and soap is essential and hygienic before and after meals, before preparing food and feeding the child and after toilet use. In urban areas, in 91.9 per cent of households a specific place for handwashing was observed, while 8.0 per cent households did not have a specific place for handwashing of household members. Some variations were observed by area and divisions. The results are shown in Table 6.7.

Fig 6.6: Percentage of households with a specific place for handwashing where water and soap or other cleansing agent are present, Bangladesh, CWS 2016

Among the places observed, 55.1 per cent of households had water and soap available in the dwelling for handwashing. This varied greatly by area of residence; 67.0 per cent of CC non-slums households against only 35.0 per cent in CC slums and 50.7 per cent in other urban areas. Variation by division was not much.

It was evident that 55.4 per cent of urban households had a specific place for handwashing with water and cleansing agent available. This proportion was the highest in CC non-slums (67.1 per cent), and lowest in CC slums (35.4 per cent). Variations by division was not much.

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The Percentage of households by availability of soap or other cleansing agent anywhere in the households can be seen in Table 6.8. It shows that 97.3 per cent of urban households had soap or other cleansing agent available somewhere in the households.

Table 6.8: Availability of soap or other cleansing agent

Per cent distribution of households by availability of soap or other cleansing agent in the dwelling, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Place for handwashing observed Place for handwashing not observed

Total Percentage of households with soap or other

cleansing agent

anywhere in the dwelling

Number of house-

holdsSoap or other

cleans-ing

agent obser-

ved

Soap or other cleansing agent not observed at place for handwashing

Soap or other

cleans-ing

agent shown

No soap or other cleans-

ing agent in house-hold

Not able/Does not want to

show soap or other

cleansing agent

Soap or other

cleansing agent shown

No soap or other

cleansing agent in

household

Not able/Does not want to

show soap or other cleansing

agent

Total 55.7 34.3 1.7 0.1 7.3 0.8 0.0 100.0 97.3 18,887

Area

City Corporation slum 36.2 48.1 3.8 0.1 9.6 2.3 0.0 100.0 93.9 784

City Corporation non-slum 67.4 22.7 2.0 0.1 6.3 1.5 0.1 100.0 96.4 5,874

Other municipalities/urban 51.3 39.0 1.5 0.1 7.6 0.4 0.0 100.0 98.0 12,229

Division

Barisal 44.0 37.0 0.4 0.1 18.0 0.3 0.0 100.0 99.1 749

Chittagong 54.2 38.7 1.7 0.1 4.7 0.6 0.0 100.0 97.6 3,334

Dhaka 55.6 32.7 2.1 0.1 8.4 1.1 0.0 100.0 96.7 9,263

Khulna 58.0 35.1 1.1 0.5 4.1 1.3 0.0 100.0 97.2 1,657

Rajshahi 62.0 29.6 0.3 0.3 7.5 0.3 0.0 100.0 99.1 1,988

Rangpur 54.7 40.9 2.3 0.0 2.1 0.0 0.0 100.0 97.7 1,238

Sylhet 54.9 32.1 3.3 0.0 9.3 0.5 0.0 100.0 96.2 658

Education of household head

No education 34.6 47.8 4.2 0.1 11.7 1.5 0.1 100.0 94.1 4,202

Primary incomplete 39.9 45.3 1.6 0.2 11.9 1.1 0.0 100.0 97.1 3,050

Primary complete 50.1 41.4 0.7 0.1 7.3 0.4 0.0 100.0 98.7 1,985

Secondary incomplete 60.4 31.8 1.4 0.2 5.5 0.7 0.0 100.0 97.7 5,788

Secondary complete or higher 87.4 10.9 0.2 0.0 1.4 0.1 0.0 100.0 99.7 3,793

Missing/DK 58.4 29.4 0.4 0.0 11.7 0.0 0.0 100.0 99.6 69

Wealth index quintile

Lowest 19.6 59.2 4.3 0.3 14.8 1.7 0.1 100.0 93.6 3,777

Second 31.8 52.0 3.3 0.1 11.2 1.6 0.0 100.0 95.0 3,766

Middle 48.7 43.0 0.7 0.1 7.1 0.4 0.0 100.0 98.8 3,778

Fourth 81.5 14.8 0.2 0.1 2.9 0.4 0.0 100.0 99.3 3,781

Highest 96.6 2.7 0.2 0.0 0.5 0.0 0.0 100.0 99.8 3,785

Religion

Islam 55.0 34.6 1.8 0.1 7.6 0.8 0.0 100.0 97.3 17,108

Hindu 61.4 32.4 0.9 0.2 4.0 0.8 0.2 100.0 97.8 1,631

Buddhist (66.9) (20.8) (4.9) 0.0 (4.9) (2.4) 0.0 100.0 (92.7) 84

Christian 71.9 25.3 2.4 0.0 0.4 0.0 0.0 100.0 97.6 60

( ) Figures that are based on 25-49 unweighted case

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7 CHILD DEVELOPMENT, LITERACY AND EDUCATION

UNICEF/BANA2014-00171/Kiron

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Key Findings:

� Only 26.2 per cent of urban children age 36-59 months were attending an early childhood education (ECE) programme or pre-school, with about 30.4 per cent in CC non-slums, 24.2 per cent in other urban areas and 23.8 per cent in CC slums.

� Attendance to an ECE programme was 9.4 per cent among children age 36-47 months, while this was 41.7 per cent in the age group 48-59 months.

� Overall literacy among urban young women age 15-24 years is high at 82.6 per cent, with higher (about 84 per cent) in other urban areas and CC non-slums and low at 59.0 per cent in CC slum areas.

� Sixty-eight per cent of the urban children who were currently attending the first grade of primary school had attended pre-school the previous year. Attendance to pre-school was substantially low in CC slums (56.1 per cent) compared to CC non-slums (59.1 per cent) and other urban areas (72.7 per cent). Among the divisions, it was the highest in Khulna (86.9 per cent), and lowest in Sylhet (61.5 per cent).

� Net intake rate in primary school was found to be 62.2 per cent with a high of 66.9 per cent in CC non-slums compared to 40.5 per cent in CC slum areas.

� The primary school adjusted net attendance ratio (NAR) was 85.5 per cent. It was very low at 69.4 per cent in CC slum areas as compared to other areas.

� The secondary school adjusted net attendance ratio was 63.1 per cent, which is 22 Percentage points lower than the primary school NAR. The secondary school NAR was substantially low in CC slums (33.3 per cent) compared to CC non-slums (62.0 per cent) and other urban areas (65.5 per cent). It was the highest in Barisal (74.4 per cent), and lowest in Dhaka division (59.4 per cent).

� The effective transition rate to secondary school was 97.3 per cent, with little variation by domains and divisions.

� Girls are in advantage in both primary school and secondary school attendance. The Gender Parity Index (GPI), defined as the ratio of girls to boys attending primary or secondary education, was 1.05 for primary and 1.18 for secondary education. The advantage of girls was noticed for all categories of children, and was particularly pronounced in children with no/less educated mothers and children of lower quintiles.

Readiness of children for primary school can be improved through attendance to early childhood education programme or through pre-school attendance. Early childhood education programmes include programmes for children that have organized learning components as opposed to baby-sitting and day-care where do not typically have organized education and learning. In Bangladesh, Early Childhood Care and Education (ECCE) models have been developed, piloted and are being implemented. The Education Policy encourages two years of early education for children age below five years. For children age 36-59 months are expected to attend pre-school as part of organized early childhood education programme. The survey collected information from mothers/caregivers of 36-59 months old children on whether they were attending an organized early childhood education programme.

7 CHILD DEVELOPMENT, LITERACY AND EDUCATION

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Education influences a person’s behavior and attitude. Education is often seen as a proxy measure of social progress and economic development. In line with the UN Child Rights Convention, primary education is mandatory in Bangladesh (Primary Education Law 1990). In addition to Primary and Secondary education, the government of Bangladesh has initiated opening up non-grade-level schools for pre-primary/preschool education. The CWS 2016 collected information from household level on education of all household members aged 3 years and above. Based on this data, status of literacy among young women age 15-24 years and a number of indicators relating to school readiness, participation of school going children in primary and secondary education, gender parity in primary and secondary education, etc. were assessed. The data here refers to the age at the beginning of the school year 2016. The year 2016 refers to the current academic year, and previous year refers to the 2015 academic year, since January to December period is the academic year in Bangladesh for secondary education or below.

7.1 Attendance in Early Childhood EducationTable 7.1 provides Percentage of urban children age 36-59 months attending an organized early childhood education (ECE) programme. It shows that only 26.2 per cent of urban children age 36-59 months in Bangladesh were attending pre-school as part of organized early childhood education programme. Male children and children of younger age group were less likely to attend early childhood education program. Twenty four per cent of male against 28.2 per cent of female, and 9.4 per cent of children age 36-47 months against 41.7 per cent in the age group 48-59 months reported to be attending an organized early childhood education programme.

Fig 7.1: Percentage of children age 36-59 months attending early childhood education, Bangladesh, CWS 2016

Attendance in an early childhood education programme also varied by area of residence, divisions, mother’s education and socio-economic status of households in which the children were growing. Attendance was high among children of CC non-slum areas (30.4 per cent) compared to those of CC slums (23.8 per cent) and other urban areas (24.2 per cent). As regards divisions, attendance was the highest in Khulna (31.5 per cent), and lowest in Sylhet division (20.1 per cent). C

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About 17.6 per cent of children age 36-59 months whose mothers had no formal education reported to be attending an ECE programme, and this prevalence was 37.0 per cent among those with secondary or higher level educated mothers. Similarly, 19.3 per cent children of the lowest wealth quintile against 38.4 per cent of the highest quintile have been attending an ECE programme.

Table 7.1: Attendance to Early Childhood Education

Percentage of children age 36-59 months who are attending an organized early childhood education programme by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Percentage of children age 36-59 months attending early childhood education

Number of children age 36-59 months

Total 26.2 3137

Sex

Male 24.2 1609

Female 28.2 1528

Area

City Corporation slum 23.8 150

City Corporation non-slum 30.4 989

Other municipalities/urban 24.2 1999

Division

Barisal 23.8 129

Chittagong 23.9 603

Dhaka 27.7 1599

Khulna 31.5 225

Rajshahi 21.7 260

Rangpur 26.7 181

Sylhet 20.1 140

Age of child

36-47 months 9.4 1526

48-59 months 41.7 1577

Mother’s education

No education 17.6 348

Primary incomplete 24.2 495

Primary complete 19.9 320

Secondary incomplete 26.7 1509

Secondary complete or higher 37.0 464

Missing/DK 100.0 1

Wealth index quintile

Lowest 19.3 644

Second 21.6 641

Middle 25.3 585

Fourth 27.9 725

Highest 38.4 541

Religion

Islam 24.8 2887

Hindu 39.8 233

Buddhist 31.8 6

Christian 90.0 10

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7.2 Literacy among Young WomenIn the CWS 2016, if a person was able to read a short simple statement about every day of life or attended secondary or higher education was classified as literate. Using this definition, literacy rate among young women age 15-24 was estimated. The Youth Literacy Rate (literacy among youths age 15-24 years) reflects the outcome of primary education over the previous 10 years or so. As a measure of effectiveness of the primary education system, it is often seen as a proxy measure of social progress and achievements.

Table 7.2 provides Percentage of young women age 15-24 years who are literate. It indicated that 82.6 per cent of urban young women of Bangladesh aged 15-24 years were literate. Literacy varied by area of residence; it was higher in other urban areas (83.8 per cent), and CC non-slums (83.7 per cent), compared to CC slum areas (59.0 per cent). It did not vary greatly by divisions (the highest in Khulna (91.8 per cent), and lowest in Sylhet (76.8 per cent)).

Socio-economic Status had positive impact on literacy; over three in five of the young women from the poorest quintile (61.9 per cent) were literate, whereas among those in the highest wealth quintile nearly all were literate (98.3 per cent). These results are in conformity with the results from recent surveys collecting such information.

Table 7.2: Literacy rate among young women

Percentage of women age 15-24 years who are literate by selected background characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Percentage literate Percentage not known Number of women

Total 82.6 8.5 4488

AreaCity Corporation slum 59.0 24.9 215City Corporation non-slum 83.7 9.9 1,347Other municipalities/urban 83.8 6.6 2,926

DivisionBarisal 87.6 5.8 179Chittagong 79.8 10.5 873Dhaka 80.9 9.1 2,194Khulna 91.8 3.4 390Rajshahi 88.8 6.2 423Rangpur 81.9 8.5 294Sylhet 76.8 11.1 135

EducationNo education 0.0 95.7 213Primary incomplete 22.9 28.6 560Primary complete 64.3 4.1 379Secondary incomplete 100.0 0.0 2,632Secondary complete or higher 100.0 0.0 703

Age15-19 85.5 6.1 1,52020-24 81.1 9.7 2,967

Wealth index quintileLowest 61.9 21.9 1,054Second 77.5 8.2 1,020Middle 89.2 4.3 843Fourth 94.7 2.2 869Highest 98.3 1.5 702

Religion*Islam 82.1 8.6 4,157Hindu 89.1 6.3 315

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

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7.3 School ReadinessPre-school or pre-primary education is important for the readiness of children for primary education. Table 7.3 shows the proportion of children in the first grade of primary school in 2016 (regardless of age) who attended pre-school the previous year (year 2015). In urban areas of Bangladesh, 68.0 per cent of the children who were currently attending the first grade of primary school attended pre-schools the previous year. Attendance to pre-school was substantially low in CC slum areas (56.1 per cent) compared to CC non-slums (59.1 per cent) and it was most common in other urban areas (72.7 per cent).

Fig 7.2: School readiness by areas, Bangladesh, CWS 2016

Attendance to pre-school education varied by divisions; it was the highest in Khulna (86.9 per cent), and lowest in Dhaka (60.2 per cent). Male first graders were somewhat less likely to attend pre-school (67.8 per cent) than females (68.1 per cent). Mother’s education and attendance to pre-school education appeared to be highly correlated; only 59.6 per cent of first grade children with attended pre-school the previous academic year when their mothers had no formal education, against 66.6 per cent when their mothers were secondary or higher educated. Readiness of children for primary education were positively associated with wealth (Table 7.3).

Table 7.3: School readiness

Percentage of children attending first grade of primary school (in 2016) who attended pre-school the previous year (2015) by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

CharacteristicsPercentage of children attending first grade

who attended preschool in previous yearNumber of children attending first grade of primary school

Total 68.0 1,927

Area

City Corporation slum 56.1 85

City Corporation non-slum 59.1 570

Other municipalities/urban 72.7 1,272

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Table 7.3: continued

CharacteristicsPercentage of children attending first grade

who attended preschool in previous yearNumber of children attending first grade of primary school

Division

Barisal 64.3 81

Chittagong 80.5 371

Dhaka 60.2 929

Khulna 86.9 134

Rajshahi 73.7 202

Rangpur 65.6 118

Sylhet 61.5 92

Sex

Male 67.8 965

Female 68.1 962

Mother’s education

No education 59.6 315

Primary incomplete 60.3 338

Primary complete 70.3 257

Secondary incomplete 74.2 780

Secondary complete or higher 66.6 234

Wealth index quintile

Lowest 64.9 447

Second 64.6 394

Middle 72.3 423

Fourth 75.4 365

Highest 61.6 298

Religion*

Islam 67.7 1,793

Hindu 73.4 127

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

7.4 Primary and Secondary School ParticipationBasic Education for all is one of the goals set in the education policy of Bangladesh. In Bangladesh, children enter primary school at age 6 and enter secondary school at age 11. There are five grades in primary school and five grades in secondary school. In primary schools, grades are referred to as year 1 to year 5 or class I to Class V. For secondary schools, the grades are referred to as class VI to class X (or grade 6 to grade 10). The school year typically runs from January to December of a year.

7.4.1 Net Intake Rate in Primary School

Table 7.4 provides `net intake rate’ in primary school. It is defined as the proportion of children of primary school entry age of six entering Grade 1. Table 8.3 shows that among the children in urban areas of Bangladesh who are of primary school entry age of six, 62.2 per cent were attending the first grade of primary school (Table 7.4). This proportion was much higher in CC non-slums (66.9 per cent) and other urban areas (61.5 per cent) than CC slum areas (40.5 per cent). Sex differential was not significant; however, notable differences exist by divisions. Children of Sylhet division were better off at 70.5 per cent to enter primary grade 1 at age six, and they were least likely Khulna division (57.1 per cent).

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Table 7.4: Net intake rate in primary education

Percentage of children of primary school entry age of six entering Grade 1, (net intake rate) by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

CharacteristicsPercentage of primary school entry age

children entering grade 1Number of children of

primary school entry age

Total 62.2 1459

Area

City Corporation slum 40.5 69

City Corporation non-slum 66.9 448

Other municipalities/urban 61.5 942

Division

Barisal 68.7 61

Chittagong 57.5 323

Dhaka 65.2 666

Khulna 57.1 99

Rajshahi 58.6 157

Rangpur 57.6 85

Sylhet 70.5 69

Sex

Male 60.4 712

Female 63.9 747

Mother’s education

No education 44.7 220

Primary incomplete 68.4 219

Primary complete 60.7 177

Secondary incomplete 66.1 620

Secondary complete or higher 63.3 221

Wealth index quintile

Lowest 57.9 308

Second 55.5 303

Middle 71.3 274

Fourth 69.4 281

Highest 58.1 292

Religion*

Islam 61.7 1319

Hindu 70.5 126

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

7.4.2 Primary School Net Attendance Ratio

Primary school net attendance ratio (adjusted) is defined as the proportion of children of primary school age 6 to 10 years (as of the beginning of school year) who are attending primary or secondary school. The term adjusted is used since not only primary school attendance, but also secondary school attendance are included in the number.

Table 7.5 presents the Percentage of children of primary school age 6 to 10 years who are attending primary or secondary school and those who are out of school. Results show that 85.5 per cent of the children were attending school and 11.5 per cent were out of school. Attendance rate was very low for children age 6 who appeared to be starting late in school (64.0 per cent), as seen by a relatively higher Percentage attending preschool (29.6 per cent).

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The adjusted primary school net attendance ratio (NAR) for children of CC non-slums and other urban areas was 85.0 per cent and 86.8 per cent respectively, while it was 69.4 per cent in CC slums. The NAR varied little by division, but some variations were observed by mother’s education and socio-economic status. The NAR was 4 Percentage points higher among female (87.8 per cent) than male (83.3 per cent).

7.4.3 Secondary School Net Attendance Ratio

Secondary school net attendance ratio (adjusted) is defined as the Percentage of children of secondary school age 11 to 15 years who are attending secondary school or higher. The secondary school adjusted net attendance ratio (NAR) for urban children of Bangladesh is presented in Table 7.6. Among the urban children of secondary school age, 63.1 per cent were attending secondary school or higher. The NAR at secondary level is significantly lower than primary school net attendance ratio (85.5 per cent).

Table 7.6: Secondary school attendance and out of school children

Percentage of children of secondary school age attending secondary school or higher (adjusted net attendance ratio), Percentage attending primary school, and Percentage out of school, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Male Female Total

Net attendance

ratio (adjusted)

Percentage of children:

Number of

children

Net atten-dance ratio

(adjusted)

Percentage of children:

Number of

children

Net atten-dance ratio

(adjusted)

Percentage of children:

Number of

childrenAttending primary school

Out of schoola

Attending primary school

Out of schoola

Attending primary school

Out of schoola

Total 57.9 15.7 23.1 5,797 68.4 12.4 17.8 5,807 63.1 14.0 20.5 11,604

Area

City Corporation slum 31.1 20.8 38.9 237 35.5 17.4 41.8 246 33.3 19.1 40.4 483

City Corporation non-slum 55.9 15.7 22.3 1,630 67.9 11.3 18.8 1,694 62.0 13.4 20.5 3,324

Other municipalities /urban 60.3 15.4 22.6 3,930 70.8 12.6 15.9 3,867 65.5 14.0 19.3 7,797

Division

Barisal 70.8 11.8 16.9 231 77.9 9.7 12.1 232 74.4 10.7 14.5 463

Chittagong 55.5 14.8 26.4 1,182 65.9 14.9 17.1 1,255 60.9 14.9 21.6 2,437

Dhaka 53.1 17.3 25.3 2,670 65.7 10.9 22.2 2,707 59.4 14.1 23.7 5,377

Khulna 69.1 13.1 17.3 491 73.9 13.1 11.9 446 71.4 13.1 14.7 937

Rajshahi 65.4 14.1 17.4 553 75.4 12.0 12.0 528 70.3 13.1 14.8 1,081

Rangpur 63.8 14.9 19.7 397 75.1 14.5 8.8 374 69.3 14.7 14.4 771

Sylhet 60.0 15.7 20.6 274 66.9 14.6 16.4 264 63.4 15.1 18.5 538

Age at beginning of school year

11 36.0 51.5 11.2 850 51.6 43.1 4.7 851 43.8 47.3 8.0 1,701

12 52.7 32.0 12.8 913 70.8 22.5 5.5 931 61.8 27.2 9.1 1,845

13 69.8 12.8 14.5 809 79.4 11.3 7.6 784 74.5 12.0 11.1 1,593

14 63.2 6.6 26.7 772 79.8 3.7 14.8 747 71.4 5.2 20.8 1,519

15 67.3 2.5 26.2 855 68.8 2.6 26.4 821 68.0 2.6 26.3 1,677

16 60.8 0.4 35.8 865 71.3 0.5 26.3 891 66.1 .5 31.0 1,757

17 56.5 0.0 37.3 732 58.3 0.0 41.4 781 57.4 0.0 39.4 1,513

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Table 7.6: continued Male Female Total

Net attendance

ratio (adjusted)

Percentage of children:

Number of

children

Net atten-dance ratio

(adjusted)

Percentage of children:

Number of

children

Net atten-dance ratio

(adjusted)

Percentage of children:

Number of

childrenAttending primary school

Out of schoola

Attending primary school

Out of schoola

Attending primary school

Out of schoola

Mother’s education

No education 34.6 29.2 29.7 813 51.0 33.6 12.9 720 42.3 31.2 21.8 1,533

Primary incomplete 42.8 31.4 24.5 654 63.4 23.4 12.8 658 53.1 27.4 18.7 1,311

Primary complete 52.6 30.3 15.1 374 70.5 21.7 6.9 402 61.9 25.8 10.8 776

Secondary incomplete 67.4 24.6 6.4 1,156 81.9 14.5 2.7 1,153 74.7 19.6 4.6 2,309

Secondary complete or higher 86.8 12.4 0.8 343 79.7 11.7 7.1 370 83.1 12.0 4.1 713

Wealth index quintile

Lowest 34.0 16.2 40.8 944 37.5 21.8 38.5 887 35.7 18.9 39.7 1,831

Second 36.8 20.4 37.7 1,134 55.9 15.8 26.1 1,111 46.3 18.1 32.0 2,245

Middle 57.3 17.3 24.1 1,403 75.3 11.1 13.1 1,272 65.9 14.4 18.9 2,675

Fourth 75.5 12.0 11.1 1,194 79.6 9.0 10.5 1,252 77.6 10.5 10.8 2,446

Highest 81.1 12.3 5.3 1,122 82.8 7.6 8.2 1,285 82.0 9.8 6.8 2,407

Religion

Islam 56.6 16.1 24.0 5,311 67.9 12.5 18.3 5,352 62.3 14.3 21.1 10,663

Hindu 70.6 11.9 14.8 460 74.0 11.5 13.5 411 72.2 11.7 14.2 871

Buddhist (*) (*) (*) 18 (*) (*) (*) 21 (*) (*) (*) 39

Christian (*) (*) (*) 8 (*) (*) (*) 20 (73.6) (9.4) (4.0) 28

a The percentage of children of primary school age out of school are those not attending school and those attending preschoolNote: Due to 3 unweighted cases, ‘Missing/DK’ category under ‘education’ is not shown(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted cases

Results also show that a high proportion (20.5 per cent) of secondary school age children were out of school, which includes 14.0 per cent who were still attending primary school. This was also evident from the NAR for children of secondary school entry age of 11 years, among whom NAR is 43.8 per cent, and 47.3 per cent were still attending primary schools.

As observed in Primary school net attendance ratio, Secondary school NAR was considerably low among male than female secondary school age children. It was 10 Percentage points higher for female children (68.4 per cent) than male (57.9 per cent). The secondary school NAR varied significantly by urban domains: it was only 33.3 per cent in CC slum areas, against 62.0 per cent in CC non-slums and 65.5 per cent in other urban areas. NAR at secondary was highest in Barisal (74.4 per cent), and lowest in Dhaka division (59.4 per cent).

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Fig 7.3: Primary and Secondary School Net Attendance Ratio (adjusted) by areas, Bangladesh, CWS 2016

7.4.4 Children Reaching the Last Grade of Primary School

Children reaching the last grade of primary school, also known as the survival rate to the last grade of primary school, is defined as the Percentage of children attending the first grade of primary school who would be expected to reach the last grade of primary school, if current rates of transition from one grade of primary school to the next are applicable. In Bangladesh context, where primary school consists of 5 grades, this is calculated as the product of the following probabilities;

� The probability that a child completes the first grade and enters the second grade. � The probability that a child completes the second grade and enters the third grade. � The probability that a child completes the third grade and enters the fourth grade. � The probability that a child completes the fourth grade and enters the fifth grade

Using the information on the attendance to primary school for two school years (year 2016 and previous year 2015), calculation were carried out on the basis of a hypothetical cohort that is assumed to experience transition rates during the previous and current school year.

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Table 7.7: Children reaching last grade of primary school

Percentage of children entering first grade of primary school who eventually reach the last grade of primary school (Survival rate to last grade of primary school), Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Per cent attending grade

1 last school year who are in grade 2 this

school year

Per cent attending grade 2 last

school year who are attending grade 3 this school year

Per cent attending grade 3 last school

year who are attending grade 4 this school year

Per cent attending grade 4 last

school year who are attending grade 5 this school year

Per cent who reach grade 5 of those who enter grade

Total 98.8 99.0 98.4 98.4 94.7

Area

City Corporation slum 96.6 95.3 94.0 95.5 82.6

City Corporation non-slum 97.3 99.6 98.9 96.4 92.4

Other municipalities/urban 99.6 99.0 98.4 99.3 96.3

Division

Barisal 99.2 99.6 99.1 97.4 95.4

Chittagong 99.1 99.7 99.7 99.2 97.7

Dhaka 98.0 99.0 97.5 97.3 92.1

Khulna 100.0 98.8 99.5 99.7 98.0

Rajshahi 100.0 97.2 100.0 100.0 97.1

Rangpur 99.7 98.0 97.0 98.9 93.8

Sylhet 100.0 100.0 99.1 99.4 98.6

Sex

Male 98.2 98.2 98.0 98.2 92.8

Female 99.6 99.8 98.8 98.6 96.8

Mother’s education

No education 97.5 96.8 98.8 99.2 92.6

Primary incomplete 98.8 98.3 98.1 94.8 90.3

Primary complete 97.6 99.8 97.4 99.3 94.3

Secondary incomplete 99.5 99.7 99.1 99.6 97.9

Secondary complete or higher 100.0 100.0 100.0 100.0 100.0

Missing/DK 100.0

Wealth index quintile

Lowest 96.9 97.7 96.8 95.1 87.2

Second 98.8 97.8 98.2 98.0 92.9

Middle 100.0 99.7 98.4 98.3 96.5

Fourth 98.8 99.5 99.9 99.9 98.0

Highest 100.0 100.0 98.6 100.0 98.5

Religion

Islam 98.7 98.9 98.3 98.3 94.3

Hindu 100.0 100.0 99.7 99.6 99.3

Buddhist 100.0 100.0 100.0 100.0 100.0

Christian 100.0 100.0 100.0 98.4 98.4

Table 7.7 presents the Percentage of children entering first grade who eventually reach the last grade of primary school. It shows that of all urban children starting grade one, most of them (94.7 per cent) will eventually reach the last grade. Differentials by divisions and other characteristics were not significant, but variation by CC slums and CC non-slums areas was quite high (92.4 per cent in CC non-slums vs. 82.6 per cent in CC slums).

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7.4.5 Primary School Completion and Transition to Secondary School

The primary school completion rate and transition rate to secondary education are presented in Table 7.8. The primary school completion rate is the ratio of the total number of students, regardless of age, entering the last grade of primary school (Class V in Bangladesh) for the first time, to the number of children of the primary graduation age (age 11 year) at the beginning of the current year school year (year 2016).

The transition rate to secondary education is the Percentage of children who were in the last grade of primary school during the previous year and who are attending the first grade of secondary school in the current year. The effective transition rate is similar to the transition rate, except that the denominator excludes repeaters.

Table 7.8 shows that the primary school completion rate was 87.5 per cent. More than nine in ten (97.2 per cent) of the children who were attending the last grade of primary in the previous year were found to be attending the first grade of secondary school in the current year (year 2016). The table also provides “effective” transition rate which takes account of the presence of repeaters in the final grade of primary school. The effective transition rate to secondary school was 97.3 per cent.

Fig 7.4: Primary school completion and transition to secondary school of those who completed primary by areas, Bangladesh, CWS 2016

Primary School Completion Rate (PSCR) was found to be significantly higher in other urban areas (92.8 per cent) compared to city corporation CC non-slums (77.4 per cent) and CC slums areas (73.1 per cent). The PSCR was the highest in Rajshahi division (99.4 per cent), and lowest in Dhaka (81.8 per cent). It was positively associated with Mother’s education and socio-economic status. Similar trend was noticed in the transition rate to secondary school, and also in the effective transition rate.

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Table 7.8: Primary school completion and transition to secondary school

Primary school completion rates and transition and effective transition rates to secondary school, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Primary school

completion rate

Number of children of primary

school completion

age

Transition rate to

secondary school

Number of children who were in the

last grade of primary school

the previous year

Effective transition

rate to secondary

school

No. of children who were in the last grade of primary school the

previous year and are not repeating that grade in the current

school year

Total 87.5 1,782 97.2 1,466 97.3 1,465

Area

City Corporation slum 73.1 77 92.5 41 92.5 41

City Corporation non-slum 77.4 513 98.5 394 98.5 394

Other municipalities/urban 92.8 1,191 96.8 1032 97.0 1,031

Division

Barisal 86.2 74 99.3 78 99.3 78

Chittagong 94.4 355 98.5 329 98.5 329

Dhaka 81.8 839 95.8 618 95.8 618

Khulna 88.8 153 95.2 129 96.1 128

Rajshahi 99.4 160 99.8 133 99.8 133

Rangpur 86.9 120 98.0 113 98.0 113

Sylhet 92.5 81 98.4 67 98.4 67

Sex

Male 83.7 943 96.0 675 96.0 675

Female 91.9 839 98.2 792 98.4 791

Mother’s education

No education 68.5 390 94.0 260 94.4 259

Primary incomplete 77.6 360 95.3 244 95.3 244

Primary complete 89.2 236 97.9 179 97.9 179

Secondary incomplete 100.0 594 99.6 514 99.6 514

Secondary complete or higher 81.4 201 99.0 186 99.0 186

Wealth index quintile

Lowest 66.9 366 93.7 191 93.7 191

Second 81.7 396 95.9 276 95.9 276

Middle 98.2 353 96.7 342 97.0 341

Fourth 84.5 374 99.2 355 99.2 355

Highest 100.0 293 98.7 303 98.7 303

Religion*

Islam 86.8 1,661 97.0 1,361 97.0 1,360

Hindu 100.0 106 100.0 96 100.0 96

Note: Due to 1 unweighted cases, ‘Missing/DK’ category under ‘education’ is not shown* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

7.4.6 Education Gender Parity

The ratio of girls to boys attending primary and secondary education is known as the Gender parity Index (GPI). The ratio of girls to boys attending primary and secondary education is provided in Table 7.9. The ratios included here are obtained from net attendance ratios rather than gross attendance ratios.

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The table shows that gender parity for primary school adjusted NAR (net attendance ratio) was 1.05 indicating an advantage in the attendance of girls over boys in primary school or higher. The index rises even higher to 1.18 for secondary education. The advantage of girls was obvious in almost all categories of children, and was particularly pronounced in children with less educated mothers and children from poorer households (lower quintiles).

Table 7.9: Education gender parity

Ratio of adjusted net attendance ratios of girls to boys, in primary and secondary school by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Primary school Secondary schoolPrimary school

adjusted net attendance ratio (NAR),

girls

Primary school

adjusted net attendance ratio (NAR),

boys

Gender parity index (GPI) for primary school adjusted NAR

Secondary school

adjusted net attendance ratio (NAR),

girls

Secondary school

adjusted net attendance ratio (NAR),

boys

Gender parity index (GPI)

for secondary school adjusted

NAR

Total 87.8 83.3 1.05 68.3 57.8 1.18

Area

City Corporation slum 69.7 69.2 1.01 35.5 31.1 1.14

City Corporation non-slum 86.9 83.0 1.05 67.9 55.8 1.22

Other municipalities/urban 89.4 84.3 1.06 70.6 60.2 1.17

Division

Barisal 93.9 85.2 1.10 77.9 70.8 1.10

Chittagong 86.7 79.3 1.09 65.9 55.5 1.19

Dhaka 87.0 82.5 1.06 65.6 52.9 1.24

Khulna 88.9 91.0 .98 73.9 69.0 1.07

Rajshahi 91.0 86.1 1.06 75.3 65.4 1.15

Rangpur 85.9 84.7 1.01 75.1 63.8 1.18

Sylhet 88.8 87.1 1.02 66.6 59.8 1.11

Mother’s education

No education 80.3 67.9 1.18 51.0 34.6 1.47

Primary incomplete 88.4 84.1 1.05 63.4 42.8 1.48

Primary complete 90.0 82.6 1.09 70.5 52.6 1.34

Secondary incomplete 90.4 88.1 1.03 81.9 67.4 1.21

Secondary complete or higher 87.7 88.0 1.00 79.7 86.8 0.92

Cannot be determineda na 100.0 na 100.0 0.0 na

Wealth index quintile

Lowest 82.5 72.7 1.13 37.5 34.0 1.10

Second 86.3 79.6 1.08 55.9 36.8 1.52

Middle 92.3 88.3 1.04 75.3 57.3 1.31

Fourth 92.9 88.5 1.05 79.6 75.1 1.06

Highest 84.9 86.7 0.98 82.4 81.1 1.02

Religion

Islam 87.5 82.6 1.06 67.8 56.5 1.20

Hindu 94.3 89.3 1.06 74.0 70.6 1.05

Buddhist 100.0 100.0 1.00 90.2 98.1 0.92

Christian 50.7 97.5 0.52 68.5 83.6 0.82

a Information on education of the mother’s/caretaker’s education was not collected for all children age 15 and abovena= Not available

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7.4.7 Out of School Gender Parity

Table 7.10 gives the Percentage of girls in the total out of school population, in both primary and secondary school. It shows that at the primary level girls account for 41.4 per cent of the out-of-school population; and the corresponding Percentage for secondary level was 43.6 per cent, showing that ‘Girls’ share increased by 2.3 Percentage point from primary to secondary school out of school population and that boys form the major share of the out of school children at both the levels.

Fig 7.5: Out of School Gender Parity by areas, Bangladesh, CWS 2016

Table 7.10: Out of school gender parity

Percentage of girls in the total out of school population, in primary and secondary school, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Primary school Secondary schoolPercen-tage of out of school

children

Number of

children of

primary school

age

Percen-tage of

girls in the total out of school

population of primary school age

Number of

children of

primary school

age out of school

Percen-tage of out of school

children

Number of

children of

secondary school

age

Percentage of girls in

the total out of school

population of secondary school age

Number of children of secondary

school age out of

school

Total 11.5 8,436 41.4 972 20.5 11,604 43.6 2378

AreaCity Corporation slum 20.2 375 50.5 76 40.4 483 52.6 195City Corporation non-slum 11.5 2,452 42.6 281 20.5 3,324 46.7 680Other municipalities/urban 11.0 5,610 39.7 615 19.3 7,797 41.0 1502

DivisionBarisal 8.2 344 26.9 28 14.5 463 41.9 67Chittagong 12.4 1,710 34.6 212 21.6 2,437 40.8 526Dhaka 12.6 4,031 41.7 506 23.7 5,377 47.1 1,276Khulna 8.5 646 58.0 55 14.7 937 38.5 138Rajshahi 10.1 794 41.7 80 14.8 1,081 39.6 160Rangpur 11.3 539 52.7 61 14.4 771 29.6 111Sylhet 7.7 372 42.9 29 18.5 538 43.3 100

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Table 7.10: continued Primary school Secondary school

Percen-tage of out of school

children

Number of

children of

primary school

age

Percen-tage of

girls in the total out of school

population of primary school age

Number of

children of

primary school

age out of school

Percen-tage of out of school

children

Number of

children of

secondary school

age

Percentage of girls in

the total out of school

population of secondary school age

Number of children of secondary

school age out of

school

Mother’s education

No education 17.0 1,493 35.9 254 21.8 1,533 27.7 334

Primary incomplete 10.3 1,481 46.4 152 18.7 1,311 34.4 245

Primary complete 11.2 1,007 39.4 113 10.8 776 32.8 84

Secondary incomplete 10.0 3,323 42.5 331 4.6 2,309 29.5 105

Secondary complete or higher 10.8 1,123 45.2 121 4.1 713 (90.1) 29

Wealth index quintile

Lowest 15.7 1,643 41.5 258 39.7 1,831 47.0 727

Second 12.7 1,725 35.1 218 32.0 2,245 40.5 717

Middle 8.6 1,750 42.0 150 18.9 2,675 33.1 505

Fourth 8.0 1,671 39.4 134 10.8 2,446 49.9 264

Highest 12.8 1,647 48.5 211 6.8 2,407 64.1 165

Religion

Islam 11.9 7757 41.7 919 21.1 10,663 43.5 2,253

Hindu 7.6 614 27.6 47 14.2 871 44.9 123

Buddhist (*) 32 na na (*) 39 (*) na

Christian (17.7) 29 (*) 5 (4.0) 28 (*) 1

Note: Due to 3 unweighted cases, ‘Missing/DK’ category under ‘education’ is not shown(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted casesna= Not available

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8 CHILD PROTECTIONUNICEF/UNI77811/Khatun

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Key Findings:

� Almost all the mothers or caretakers of children under the age of 5 whose births have not been registered were aware of how to register a birth (99.7 per cent), but registration of birth is still not widely practiced with only 29.3 per cent of births registered. A huge gap between knowledge and practice persists across all domain irrespective of background characteristics in relation to registration of births.

� While violent methods (psychological or physical punishment) were common forms of discipline applied by household members for child discipline (82.4 per cent), only 35.4 per cent women actually approved physical punishment to bring, raise or educate a child properly.

� Overall, 12.4 per cent of urban children age 5-17 years were in child Labour, with 11.3 per cent in CC non-slums, 22.9 per cent in CC slums, and 9.7 per cent in other urban areas. It was the highest in Rangpur (15.3 per cent), and lowest in Barisal (7.7 per cent). As expected, proportion of children in child labour were higher as the age increased.

� Prevalence of Child Labour among children age 5-14 years was 8.1 per cent, with 7.0 per cent in non CC slums, 14.3 per cent in CC slums, and 8.2 per cent in other urban areas.

� About 22.5 per cent of women age 15-49 years were (first) married before the age of 15, with 20.0 per cent in CC non-slums, 28.1 per cent in CC slums and 23.4 per cent in other urban areas. Among the women aged 20-49 years, the proportion who married before the age of 18 was 59.7 per cent, with 53.3 per cent in CC non-slums, 66.4 per cent in CC slums, and 62.3 per cent in other urban areas.

� Polygamy is not common among urban women of Bangladesh. Overall, 2.8 per cent of women aged 15-49 years were in polygynous union. Only 1.0 per cent of the youngest women aged 15-19 were in polygynous union as compared to 4.8 per cent of the oldest (aged 45-49).

� About 4.7 per cent of urban children age 0-17 years were living with neither of biological parents, with 4.4 per cent in CC non-slums, 4.4 per cent in CC slums and 4.9 per cent in other urban areas.

Child protection refers to the protection of children from violence, exploitation, abuse and neglect. UNICEF defines a “Child Protection System” as: the set of laws, policies, regulation and services needed across all social sectors ---- especially social welfare, education, health, security and justice --- to support prevention and response to protection related risks.

This section discusses certain issues which are important for the protection of children and for ensuring their universally accepted rights. The issues/topics considered are birth registration, child discipline, attitude towards physical punishment, involvement of children in economic and household activities, child labour, living arrangement, orphanhood, early marriage and other related issues.

8 CHILD PROTECTION

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8.1 Birth RegistrationTo make every girls and boy visible in the eyes of the law is to provide them with a first form of legal identity, a birth certificate. A birth certificate is a proof of age to access services like issuance of passport, admission into school, receiving social or other benefits and marriage registration. Unfortunately, 230 million children around the world have not had their births registered, while more than 100 developing countries don’t have well-functioning system in place to register key events, like births, deaths and marriages. In Bangladesh, the Birth and Death Registration Act 2004 provides a legal basis for mandatory birth registration. Local government administrations facilitates births and deaths registration. An online Birth Registration Information System (BRIS) had been introduced in 2009, which allows local registrar nationwide and Embassies abroad to register births and deaths and issue official certificates through a wave-based application.

Table 8.1: Birth registration

Percentage of children under age 5 by whether birth is registered and Percentage of children not registered whose mothers/caretakers know how to register birth by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Children under age 5 whose birth is registered with civil authorities

Number of

children under age 5

Children under age 5 whose birth is not registered

Has birth certificate No birth certificate

Total regis-tered

Per cent of children whose mother/caretaker knows

how to register birth

Number of children under age 5 without

birth registrationSeen Not seen

Total 15.3 13.1 0.9 29.3 7,521 99.7 5,320

AreaCity Corporation slum 13.0 18.5 1.4 32.9 336 100.0 225City Corporation non-slum 14.1 18.1 1.1 33.2 2,242 99.7 1,497Other municipalities/urban 16.0 10.4 0.7 27.2 4,943 99.7 3,598

DivisionBarisal 15.4 10.6 0.2 26.3 318 99.4 234Chittagong 19.5 14.1 0.7 34.3 1,562 99.4 1,026Dhaka 13.3 15.0 1.0 29.3 3,580 99.8 2,530Khulna 14.1 9.6 0.9 24.5 542 99.7 409Rajshahi 16.3 7.3 0.8 24.5 695 100.0 525Rangpur 13.8 11.0 0.5 25.3 487 99.6 364Sylhet 19.5 10.8 0.7 31.0 337 99.6 232

SexMale 15.6 12.7 1.1 29.4 3,783 99.9 2,671Female 15.1 13.5 0.6 29.1 3,738 99.5 2,649

Age0-11 months 6.0 7.8 0.8 14.6 1,382 99.5 1,18012-23 months 10.0 11.8 0.2 22.0 1,521 99.8 1,18724-35 months 17.7 13.3 0.4 31.4 1,534 100.0 1,05236-47 months 17.4 16.5 1.1 34.9 1,511 99.6 98448-59 months 24.4 15.5 1.8 41.7 1,573 99.7 917

Mother’s educationNo education 13.5 13.4 0.3 27.1 693 100.0 505Primary incomplete 11.0 11.7 1.2 23.9 1,077 100.0 819Primary complete 15.1 10.7 1.0 26.8 751 99.5 550Secondary incomplete 16.4 13.4 0.9 30.7 3,677 99.6 2,547Secondary complete or higher 16.8 14.7 0.6 32.1 1,324 99.7 899

Wealth index quintileLowest 11.2 14.7 0.5 26.3 1,563 99.9 1,151Second 11.9 12.3 0.8 25.1 1,388 99.9 1,040Middle 16.9 9.3 0.8 26.9 1,474 99.3 1,077Fourth 17.2 15.2 0.8 33.2 1,686 99.9 1,126Highest 19.4 13.5 1.5 34.4 1,410 99.4 925

Religion*Islam 15.2 12.9 0.8 29.0 6,909 99.7 4,905Hindu 16.1 14.7 1.4 32.2 558 99.9 378

* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases

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Based on the data collected in the CWS 2016, Percentage of urban children under age 5 by whether birth was registered, and Percentage of non-registered children whose mothers/caretakers knew how to register births were calculated and presented in Table 8.1. It shows that about three in ten (29.3 per cent) births of children under 5 years of age in urban areas of Bangladesh had been registered. Overall, 28.4 per cent of the children possessed a birth certificate, though the certificate could be seen for only 15.3 per cent. Birth registration was almost at the same level in CC non-slums (33.2 per cent) and CC slums (32.9 per cent) and was lower in other urban areas (27.2 per cent). This prevalence was highest in Chittagong (34.3 per cent), and lowest in Rajshahi division (24.5 per cent). Registration of births becomes more likely as a child grows older, and peaks at age 4 to 41.7 per cent.

Lack of knowledge about how and where birth should be registered may hamper the fulfillment of a child’s right to identity. Data in Table 8.1 also shows that almost all of mothers/caretakers (99.7 per cent) of unregistered children were aware of how to register births. Prevalence of this awareness/knowledge was almost identical in all the areas and divisions, irrespective of education and socio-economic status of mothers/caretakers. This shows a huge gap between level of awareness/knowledge and putting knowledge into practice in relation to birth registration.

Fig 8.1: Percentage of children under age five whose births are registered, Bangladesh, CWS 2016

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8.2 Child DisciplineEvery parent wants their children to be happy, respectful, respected by others, and able to find their place in the society as well-behaved adults when they grow up. But sometimes these goals remain miles away for child’s behavior. Child discipline is the process of teaching a child what type of behavior is acceptable and what type is not acceptable. In other words, discipline teaches a child to follow rules. Loving and supportive family environment enhance discipline. Sometimes, punishment may be an effective tool, but that does not mean that good discipline is mostly about punishments. Research shows that exposing children to violent discipline have harmful consequences. Violence hampers children’s development, learning attitude and school performance.

Table 8.2: Child discipline

Percentage of children age 1-14 years by child disciplining methods experienced during the last one month by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Percentage of children age 1-14 years who experienced: Number of children age 1-14 years

Only non-violent discipline

Psychological aggression

Physical punishment Any violent discipline methodAny Severe

Total 13.1 72.1 55.9 17.6 82.4 21,038

AreaCity Corporation slum 10.4 74.2 62.6 23.3 84.9 888City Corporation non-slum 13.6 67.4 59.1 18.9 81.9 6,249Other municipalities/urban 13.0 74.1 54.0 16.7 82.5 13,901

DivisionBarisal 15.2 75.1 50.9 15.3 80.6 883Chittagong 12.7 75.5 55.7 18.6 83.6 4,246Dhaka 13.1 67.9 58.2 18.7 81.6 10,051Khulna 11.1 76.0 52.6 16.2 83.3 1,600Rajshahi 11.9 79.5 57.3 18.6 85.6 1,962Rangpur 16.8 72.0 43.2 7.6 80.0 1,356Sylhet 13.5 76.2 58.4 18.6 82.9 940

SexMale 11.5 74.4 58.8 19.5 84.0 10,532Female 14.6 69.7 53.1 15.7 80.8 10,506

Age1-2 13.7 57.8 49.1 11.2 71.9 2,7063-4 9.2 72.5 68.1 22.3 86.2 3,1565-9 10.2 77.2 63.9 20.2 87.9 7,50210-14 17.3 72.0 45.5 15.4 79.1 7,675

Education of household headNo education 9.5 74.1 67.1 22.3 86.8 5,373Primary incomplete 11.4 76.7 60.9 19.9 86.8 8,544Primary complete 11.8 68.8 20.9 7.0 73.9 120Secondary incomplete 20.4 69.4 37.2 11.5 75.2 4,286Secondary complete or higher (*) (*) (*) (*) (*) 5

Wealth index quintileLowest 8.7 77.3 63.5 23.7 86.3 3,992Second 11.8 73.8 59.6 20.1 84.0 4,200Middle 10.3 76.5 59.4 17.1 86.5 4,345Fourth 14.6 69.6 55.0 17.6 81.6 4,373Highest 20.0 63.3 42.1 9.9 73.5 4,129

ReligionIslam 12.8 72.3 56.2 17.9 82.7 19,299Hindu 15.0 70.1 53.1 13.8 79.3 1,583Buddhist (41.6) (58.0) (32.5) (6.6) (58.0) 81Christian 10.9 72.9 64.0 25.9 88.7 65

Note: Due to 1 unweighted cases, ‘Missing/DK’ category under ‘education’ is not shown(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted cases

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In the CWS 2016, respondents were asked a series of questions on the methods adults in the household used to discipline a (randomly selected) child of the household age 1-14 years during the past month preceding the survey. Results in Table 8.2 show that more than four in every five (82.4 per cent) children age 1-14 years were subjected to at least one form of psychological or physical punishments by household members during the past month. This matches closely with findings from other surveys.

A combination of disciplinary practices were prevalent, while 72.1 per cent of children experienced psychological aggression, 55.9 per cent experienced physical punishment of any form, and about one-fifth (17.6 per cent) faced severe physical punishment. Severe form of physical punishment included hitting the child on the head, ears, face, or hitting the child hard and repeatedly. Practice of only non-violent discipline was very low (13.1 per cent).

Fig 8.2: Percentage of child disciplining methods by areas, Bangladesh, CWS 2016

Boys and girls of all urban domains (slums, CC non-slums, and other urban areas), divisions and wealth quintiles, irrespective of mothers’ education level, experienced virtually the same level of violent discipline. Children in the age groups 5-9 and 3-4 years were most likely to experience violent discipline (87.9 and 86.2 per cent, respectively).

8.3 Attitude towards Physical PunishmentThe survey also collected information regarding attitude of women towards physical punishment as a method of child discipline. Table 8.3 presents Percentage of women who believe that physical punishment is needed to bring up, raise, or educate a child properly by selected background characteristics. Figure 8.3 shows the rates for the different divisions.

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Fig 8.3: Percentage of respondents to the child discipline module who believe that physical punishment is needed by division, Bangladesh, CWS 2016

Table 8.3: Attitudes toward physical punishment

Percentage of respondents to the child discipline module who believe that physical punishment is needed to bring up, raise, or educate a child properly by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Respondent believes that a child needs to be physically punished

Number of respondents to the child discipline module

Total 35.4 12,167

Area

City Corporation slum 37.8 495

City Corporation non-slum 34.4 3,679

Other municipalities/urban 35.7 7,993

Division

Barisal 33.5 512

Chittagong 23.9 2,230

Dhaka 41.1 5,878

Khulna 36.7 1,064

Rajshahi 43.7 1,250

Rangpur 12.1 789

Sylhet 34.4 444

Sex

Male 28.1 629

Female 35.8 11,538

Age

<25 33.0 1,837

25-39 37.1 7,483

40-59 32.7 2,591

60+ 30.5 257

Respondent’s relationship to selected child

Mother 30.7 475

Father 36.2 9,996

Other 32.2 1,696

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Table 8.3: continued Respondent believes that a child needs to

be physically punishedNumber of respondents to the child discipline

module

Respondent’s education

No education 40.8 2,068

Primary incomplete 43.4 2,002

Primary complete 37.6 1,278

Secondary incomplete 34.9 5,004

Secondary complete or higher 20.4 1,815

Wealth index quintile

Lowest 41.0 2,279

Second 39.3 2,488

Middle 38.8 2,490

Fourth 33.2 2,509

Highest 24.9 2,403

Religion

Islam 36.1 11,057

Hindu 29.4 1,002

Buddhist (19.8) 55

Christian 29.9 49

Note: Due to 2 unweighted cases, ‘Missing/DK’ category under ‘education’ is not shown ( ) Figures that are based on 25-49 unweighted cases

Table 8.3 shows that, while violent methods were common forms of discipline applied by household members for child discipline (82.4 per cent), only 35.4 per cent respondents actually approved physical punishment to bring, raise or educate a child properly. This attitude prevailed almost equally in CC non-slums, CC slums or in other urban areas, but varied greatly by division, mother’s education and socio-economic status of respondents. More fathers (36.2 per cent) than mothers (30.7 per cent) approved of physical punishment. About 43.7 per cent women of Rajshahi division were in favour of physical punishment, against only 12.1 per cent of Rangpur division. Women with a higher level of education were less likely to be in favour of physical punishment. For example, 20.4 per cent of women with secondary or higher level of education favoured it, against 40.8 per cent among those who did not have any education. This approval rate was 24.9 per cent among women of highest wealth quintile versus 41.0 per cent of lowest quintile.

8.4 Child LabourChild labour is, generally speaking, work by children that hampers them or exploits them in some way (physically, mentally, morally or by blocking their access to education).

There is no universally accepted definition of child labour. `Child and Childhood’ are defined differently by different culture. Children age 5-17 are not expected to work, rather this is the age for developing and preparing themselves for work in the future through education. Unfortunately, according to International Labour Organization (ILO), worldwide 215 million children age below 18 work, many fulltime. In sub Saharan Africa, 1 in 4 children aged 5-17 work, compared to 1 in 8 in Asia Pacific, and 1 in 10 in Latin America. Child Labour also prevails in Bangladesh.

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In the CWS 2016, a child labour module was administered for children aged 5-17 years and information was collected about their involvement and extent of involvement in economic activities, household chores, and work in hazardous conditions. Economic activity was defined as any of the following activities: work in agriculture, gardening, taking care of domestic animals, assisting in business (own or relative), production or sale of handicrafts, cloths, food or agriculture items and other such items or goods.

Household chores was defined as any of the following: collection of water and fuel for household, household purchase, repair of household items, cooking and cleaning of utensils and house, washing of clothes, child care, care for elderly household members and such other household works.

For assessing child labour the following three age-specific thresholds for the number of hours a child can perform economic activity without it being classified as Child Labour were used. A child that performed economic activities during the last one week for more than the age specific number of hours was classified as in child labour:

For age 5-11 years : 1 hour or more

For age 12-14 years : 14 hours or more and

For age 15-17 years : 43 hours or more

Similarly, child labour used two age-specific thresholds for the number of hours a child can perform household chores without being classified as Child Labour. A child that performed household chores during the last week for more than the age-specific number of hours was classified as in child labour:

For age 5-11 and age 12-14 years : 28 hours or more

And for age 15-17 years : 43 hours or more

Besides, if a child works under hazardous condition, it falls in child labour.

8.4.1 Children’s Involvement in economic activities

Table 8.4 gives Percentage of children age 5-11years, 12-14 years, and 15-17 years by their involvement in economic activities in hours during the last one week. Among the children as young as 5-11 years of age, 7.1 per cent were involved in economic activity for at least one hour in the last one week. Children of CC non-slum areas were less likely to be involved in economic activities for at least one hour (4.9 per cent) than children of CC slum areas (8.7 per cent). This varied greatly by divisions; 9.5 per cent of 5-11 years old children of Khulna division, 9.4 per cent in Rajshahi were at the higher end against 4.7 per cent of Barisal as per their involvement in economic activities.

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Table 8.4: Children’s involvement in economic activities

Percentage of children by involvement in economic activities during the last week, according to age groups by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Percentage of children age 5-11 years involved in economic

activity for at least one hour

Num-ber of

children age 5-11

years

Percentage of children age 12-14 years involved in:

Num-ber of

children age 12-14 years

Percentage of children age 15-17 years involved in:

Num-ber of

children age 15-17 years

Economic activity less

than 14 hours

Economic activity for 14 hours or

more

Economic activity less

than 43 hours

Economic activity for 43 hours or

more

Total 7.1 8,065 11.0 8.1 2,783 17.5 9.4 3,027

AreaCity Corporation slum 8.7 328 13.2 23.0 108 23.5 20.7 128City Corporation non-slum 4.9 2,363 8.8 8.5 837 16.9 10.8 831Other municipalities/urban 8.0 5,375 11.9 7.1 1,838 17.4 8.1 2,068

DivisionBarisal 4.7 357 7.2 3.8 121 17.5 2.9 115Chittagong 5.5 1,540 9.1 6.2 553 13.0 10.0 612Dhaka 7.3 3,895 10.5 10.5 1,260 16.2 12.2 1,416Khulna 9.5 658 15.7 4.1 245 24.4 4.6 264Rajshahi 7.4 796 12.2 6.8 285 24.5 5.7 306Rangpur 9.4 496 14.0 8.3 197 21.1 4.5 192Sylhet 6.3 322 12.4 8.0 121 18.0 6.0 122

SexMale 7.9 4,077 11.5 12.0 1,450 20.4 12.4 1,514Female 6.4 3,988 10.5 3.9 1,333 14.7 6.3 1,513

School attendanceYes 7.1 6,521 10.8 2.4 2,398 14.7 1.8 2,090No 7.3 1,544 12.3 43.6 385 23.7 26.2 937

Mother’s educationNo education 5.0 1,643 23.1 27.3 78 8.6 38.9 64Primary incomplete 7.4 5,571 11.1 22.8 604 28.9 34.9 279Primary complete 76.3 30 18.3 33.2 51 37.1 23.0 120Secondary incomplete 6.9 821 10.4 2.4 2,041 15.4 3.1 1,989Secondary complete or higher na na (0.0) (8.1) 5 (14.5) (3.7) 33

Wealth index quintileLowest 10.6 1,534 16.8 19.5 441 21.2 16.7 439Second 9.5 1,759 10.0 13.8 479 22.7 22.0 571Middle 6.5 1,702 17.1 5.3 609 20.0 8.5 711Fourth 5.8 1,551 9.3 2.6 615 15.9 3.3 628Highest 2.9 1,519 3.7 4.0 639 9.6 0.5 678

ReligionIslam 6.8 7,348 11.2 8.3 2,518 17.5 9.6 2,752Hindu 8.6 633 9.2 7.0 246 18.4 7.6 257Buddhist (*) 40 (*) (*) 13 (*) (*) 13Christian (42.0) 38 (*) (*) 7 (*) (*) 5

(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted casesna= not available

As expected, proportions of children involved in economic activities were higher as the age increased. About 8.1 per cent of children age 12-14 years were involved in economic activities for 14 hours or more and therefore in Child labour. Proportion in child labour among 12-14 years old children was very high in CC slums (23.0 per cent), compared to CC non-slums (8.5 per cent) and other municipal areas (7.1 per cent). Again, this was highest in Dhaka (10.5 per cent), and lowest in Barisal (3.8 per cent). It was higher among male (12.0 per cent) than among female (3.9 per cent); primarily among those not attending school (43.6 per cent) than

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those who are in school (2.4 per cent); and also among those in lowest wealth quintile (19.5 per cent) compared to those in the richest households (4.0 per cent in highest quintile).

Overall, 9.4 per cent of children age 15-17 years were involved for more than 43 hours in the last week in economic activities and, therefore, one in ten children (9.4 per cent) were in child labour. Again, this varied greatly by urban domains, division, sex of children, schooling status, mother’s education, and socio economic status. It was very high in CC slums (20.7 per cent) compared to CC non-slums (10.8 per cent) and other urban areas (8.1 per cent). Among the divisions, this was highest in Dhaka (12.2 per cent), and lowest in Barisal (2.9 per cent). About 12.4 per cent of male against 6.3 per cent of female, 26.2 per cent of not in school children against only 1.8 per cent of those attending school, and 16.7 per cent in the lowest quintile against only 0.5 per cent in the richest quintile worked for 43 or more hours for earning income or benefits.

8.4.2 Children’s Involvement in Household Chores

Table 8.5 provides Percentage of children age 5-11years, age 12-14 years and age 15-17 years by their involvement in household chores during the last one week, according to age groups and hours of involvement by selected characteristics. It shows that, child labour, as per thresholds described above for child labour on account of involvement (with duration) in household chores, was negligible across all age groups: 5-11, 12-14 and 15-17 years of age.

Table 8.5: Children’s involvement in household chores

Percentage of children by involvement in household chores during the last week, according to age groups by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Percentage of children age 5-11 years involved in:

Number of

children age 5-11

years

Percentage of children age 12-14 years involved in:

Number of

children age 12-14

years

Percentage of children age 15-17 years involved in:

Number of

children age 15-17

years

House-hold

chores less than 28 hours

House-hold

chores for 28

hours or more

House-hold

chores less than 28 hours

House-hold

chores for 28

hours or more

House-hold

chores less than 43 hours

House-hold

chores for 43

hours or more

Total 52.9 0.4 8,065 72.4 1.7 2,783 77.6 1.3 3,027

Area

City Corporation slum 60.5 1.2 328 77.1 3.1 108 80.2 2.7 128

City Corporation non-slum 45.9 0.5 2,363 60.7 2.7 837 75.8 2.6 831

Other municipalities/urban 55.5 0.3 5,375 77.5 1.2 1,838 78.2 0.7 2,068

Division

Barisal 46.5 0.2 357 79.3 0.5 121 77.4 0.6 115

Chittagong 53.0 0.7 1,540 75.9 0.7 553 75.1 1.1 612

Dhaka 49.9 0.5 3,895 66.4 2.6 1,260 76.0 1.3 1,416

Khulna 72.6 0.0 658 88.6 1.5 245 89.2 2.4 264

Rajshahi 58.9 0.0 796 74.1 1.4 285 76.5 1.5 306

Rangpur 50.4 0.0 496 75.8 0.0 197 81.4 1.4 192

Sylhet 44.2 0.5 322 70.4 2.8 121 81.3 1.2 122

Sex

Male 47.1 0.1 4,077 65.0 0.5 1,450 66.1 0.4 1,514

Female 58.7 0.7 3,988 80.6 3.1 1,333 89.1 2.3 1,513

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Table 8.5: continued

Percentage of children age 5-11 years involved in:

Number of

children age 5-11

years

Percentage of children age 12-14 years involved in:

Number of

children age 12-14

years

Percentage of children age 15-17 years involved in:

Number of

children age 15-17

years

House-hold

chores less than 28 hours

House-hold

chores for 28

hours or more

House-hold

chores less than 28 hours

House-hold

chores for 28

hours or more

House-hold

chores less than 43 hours

House-hold

chores for 43

hours or more

School attendanceYes 56.7 0.2 6,521 74.6 0.9 2,398 76.8 0.3 2,090No 36.5 1.3 1,544 59.1 7.2 385 79.4 3.6 937

Mother’s educationNo education 34.9 0.4 1,643 29.9 13.9 78 46.5 0.9 64Primary incomplete 56.9 0.5 5,571 74.0 2.1 604 83.2 1.4 279Primary complete (*) (*) 30 61.0 15.4 51 83.5 0.6 120Secondary incomplete 62.7 0.0 821 73.9 0.8 2,041 75.6 0.3 1,989Secondary complete or higher Na Na na (*) (*) 5 (49.9) (0.0) 33

Wealth index quintileLowest 60.2 0.7 1,534 79.7 1.0 441 83.5 1.0 439Second 53.8 0.5 1,759 71.4 2.2 479 79.9 2.1 571Middle 55.0 0.1 1,702 80.5 1.8 609 81.1 1.2 711Fourth 52.3 0.1 1,551 70.8 0.5 615 77.0 1.2 628Highest 42.5 0.7 1,519 62.0 3.1 639 68.7 1.1 678

ReligionIslam 53.0 0.4 7,348 71.8 1.9 2,518 77.4 1.4 2,752Hindu 50.4 0.0 633 77.5 0.0 246 78.8 0.8 257Buddhist (*) (*) 40 (*) (*) 13 (*) (*) 13Christian (62.5) (62.5) 38 (*) (*) 7 (*) (*) 5

(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted casesna= not available

8.4.3 Total Child Labour

According to the definition of `Child Labour’ as stated earlier and considering their involvement and extent in economic activity, household chores, and work under hazardous condition, total child labour was estimated.

Table 8.6: Child labour

Percentage of children age 5-17 years by involvement in economic activities or household chores during the last week, Percentage working under hazardous conditions during the last week, and Percentage engaged in child labour during the last week according to selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Children involved in economic activities for a total number of

hours during last week:

Children involved in household chores for a total number of

hours during last week:

Children working under

hazardous conditions

Total child

labour

Number of children age 5-17

yearsBelow the age specific threshold

At or above the age specific

threshold

Below the age specific threshold

At or above the age specific

threshold

Total 7.7 8.5 63.6 0.8 9.8 12.9 19,370

AreaCity Corporation slum 10.3 15.1 69.1 2.1 19.2 23.1 833City Corporation non-slum 6.1 8.3 55.8 1.3 8.6 12.0 5,541Other municipalities/urban 8.1 8.1 66.5 0.5 9.7 12.6 12,996

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Table 8.6: continued Children involved in economic

activities for a total number of hours during last week:

Children involved in household chores for a total number of

hours during last week:

Children working under

hazardous conditions

Total child

labour

Number of children age 5-17

yearsBelow the age specific threshold

At or above the age specific

threshold

Below the age specific threshold

At or above the age specific

threshold

Division

Barisal 5.8 5.0 60.3 0.3 5.2 8.1 801

Chittagong 5.9 6.8 65.3 0.6 9.3 11.3 3,987

Dhaka 7.1 10.1 59.7 1.1 10.6 14.0 9,028

Khulna 11.5 7.3 81.1 0.7 8.3 12.8 1,562

Rajshahi 9.4 7.2 66.8 0.7 8.6 11.5 1,871

Rangpur 10.5 8.7 64.1 0.2 12.1 15.4 1,245

Sylhet 8.4 6.8 60.2 1.1 9.4 12.0 877

Sex

Male 8.0 10.9 55.4 0.3 12.4 15.3 9,768

Female 7.3 6.0 72.0 1.3 7.1 10.4 9,602

Age

5-11 1.3 7.5 53.1 0.4 4.3 7.9 10,161

12-14 11.5 9.0 73.0 1.5 12.8 15.0 4,693

15-17 18.1 10.2 77.5 1.2 19.0 21.8 4,516

School attendance

Yes 6.8 5.0 65.8 0.3 5.3 8.1 15,359

No 10.8 21.9 55.3 2.7 27.0 31.2 4,011

Mother’s education

No education 2.8 9.7 35.7 1.2 9.0 11.7 2,292

Primary incomplete 3.9 11.2 60.6 0.6 9.6 13.5 8,612

Primary complete 29.4 32.4 71.1 4.6 50.2 59.9 306

Secondary incomplete 11.7 3.6 73.4 0.4 7.5 9.1 7,470

Secondary complete or above 12.3 3.5 54.8 0.0 3.3 5.9 47

Wealth index quintile

Lowest 9.6 14.5 69.3 0.8 17.9 20.6 3,381

Second 8.3 14.2 63.9 1.2 14.7 19.5 3,870

Middle 10.1 7.4 68.0 0.6 9.0 12.6 4,269

Fourth 6.4 4.9 62.4 0.3 5.6 8.4 3,935

Highest 3.9 2.4 54.7 1.2 3.0 4.4 3,915

Religion

Islam 7.8 8.4 63.5 .9 10.0 12.9 17,724

Hindu 6.8 8.4 64.5 .2 7.8 11.8 1,502

Buddhist (7.8) (5.2) (67.0) (0.0) (7.8) (13.0) 79

Christian 0.1 31.0 70.1 0.0 .3 31.1 57

( ) Figures that are based on 25-49 unweighted cases

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Table 8.6a: Child labour

Percentage of children age 5-14 years by involvement in economic activities or household chores during the last week, and Percentage engaged in child labour during the last week according to selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

All Survey areas Number of children (5-14) years agedCity Corporation slum City Corporation non-

slumOther municipalities/urban

Total 8.1 14.3 7.0 8.2 13,316

Division

Barisal 5.4 3.3 5.9 576

Chittagong 6.1 10.8 5.1 5.9 2,653

Dhaka 9.3 17.6 8.1 9.5 6,294

Khulna 7.7 10.3 2.5 9.0 1,056

Rajshahi 7.0 6.8 5.6 7.1 1,301

Rangpur 9.9 9.9 4.4 10.7 848

Sylhet 7.5 0.0 10.2 6.2 588

Table 8.6 gives Percentage of children age 5-17 years by their involvement in economic activities or in household chores during the last week, Percentage working under hazardous conditions during the last week, and Percentage engaged in child labour during the last week, according to selected characteristics. Overall, 8.5 per cent of children age 5-17 years were involved in economic activities for a total number of hours during the last week at or above the age specific thresholds (for child labour), and only 0.8 per cent for involvement in household chores. About 9.8 per cent of 5-17 years old children reported of working under hazardous conditions in the last week preceding the survey.

Fig 8.4: Percentage engaged in child labour by areas, Bangladesh, CWS 2016

Considering involvement of children age 5-17 years in economic activities, household chores and work under hazardous condition, the total child labour was estimated at 12.9 per cent. As expected, this was more prevalent in CC slums (23.1 per cent) than other areas. Among divisions it was most prevalent in Rangpur division (15.4 per cent). The proportions in the age

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group 15-17 years was more (21.8 per cent). Child labour more common among children 5-17 years that were not attending school (31.2 per cent) than those attending. Children from the lowest or poorest wealth quintile were more into child labour (20.6 per cent) than those from the richest (4.4 per cent).

Considering involvement of children age 5-14 years in economic activities and household chores in the last week at or above the age specific thresholds (for child labour), Table 8.6a shows that prevalence of child labour was 8.1 per cent, with 7.0 per cent in CC non-slums as compared to 14.3 per cent in CC slums. Figure 8.4 shows prevalence of child labour among children age 5-14 years and age 5-17 years.

8.5 Early marriage and PolygamyMarriage before the age of 18 years for girls is considered as early marriage or child marriage. The legal minimum age at marriage for girls is also 18 years in Bangladesh. However, for various reasons, a high proportion of girls get married in their childhood, and this is common in many countries including Bangladesh. Child marriage (or early marriage) is a violation of human rights, compromising the development, education, and skills of girls for self-reliance. Early marriage often results in early pregnancy that may contribute in high maternal deaths.

Information about early marriage in urban areas of Bangladesh is provided in Table 8.7. It gives proportion of women age 15-49 years who first married or entered a marital union before their 15th birthday, proportion of women age 20-49 years who first married or entered a marital union before their 15th and 18th birth days, Percentage of women age 15-19 years currently married or in union, and the Percentage of women who are in a polygynous marriage or union by selected characteristics.

Table 8.7: Early marriage and polygyny (women)

Percentage of women age 15-49 years who first married or entered a marital union before their 15th birthday, Percentages of women age 20-49 years who first married or entered a marital union before their 15th and 18th birthdays, Percentage of women age 15-19 years currently married or in union, and the Percentage of women who are in a polygynous marriage or union by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Women age 15-49 years

Women age 20-49 years Women age 15-19 years

Women age 15-49 years

Percen-tage

married before age 15

Number of women age 15-49

years

Percen-tage

married before age 15

Percen-tage

married before age 18

Number of women age 20-49

years

Percen-tage

currently married/in union

Number of women age 15-19

years

Percen-tage in polygy-

nous marriage/

union

Number of women age 15-49 years

currently married/in

union

Total 22.5 24525 26.7 59.7 19983 32.9 4542 2.8 20359

AreaCity Corporation slum 28.1 1015 33.2 66.4 807 34.8 208 4.4 844City Corporation non-slum 20.0 7658 23.8 53.3 6286 32.9 1372 2.4 6194Other municipalities/urban 23.4 15853 27.7 62.3 12890 32.7 2962 3.0 13320

DivisionBarisal 22.7 959 26.9 61.9 788 31.9 172 1.8 817Chittagong 18.7 4742 22.7 56.2 3813 23.5 929 1.8 3804Dhaka 22.6 11544 26.7 60.3 9383 36.4 2161 3.3 9658Khulna 30.2 2158 35.6 65.9 1771 40.9 387 3.0 1855Rajshahi 25.0 2513 28.9 62.6 2098 37.6 415 3.2 2152Rangpur 25.3 1637 29.9 61.8 1354 29.0 283 2.3 1350Sylhet 12.3 971 14.9 40.4 777 18.1 195 2.7 724

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Table 8.7: continued Women age 15-49

yearsWomen age 20-49 years Women age 15-19

yearsWomen age 15-49 years

Percen-tage

married before age 15

Number of women age 15-49

years

Percen-tage

married before age 15

Percen-tage

married before age 18

Number of women age 20-49

years

Percen-tage

currently married/in union

Number of women age 15-19

years

Percen-tage in polygy-

nous marriage/

union

Number of women age 15-49 years

currently married/in

union

Age

15-19 4.0 4542 na na na 32.9 4542 1.0 1640

20-24 12.2 4048 12.2 41.8 4048 na na 1.5 3162

25-29 24.3 4290 24.3 54.7 4290 na na 2.2 4030

30-34 29.2 3448 29.2 64.1 3448 na na 3.0 3380

35-39 30.4 3062 30.4 65.5 3062 na na 3.6 3034

40-44 34.3 2262 34.3 68.8 2262 na na 3.5 2247

45-49 38.1 2874 38.1 73.5 2874 na na 4.8 2867

Education

No education 40.8 3570 42.2 77.8 3427 38.5 143 8.0 3428

Primary incomplete 34.1 3521 38.4 73.5 3081 36.2 440 4.5 3189

Primary complete 33.7 2279 37.0 72.0 2044 44.7 236 1.9 2106

Secondary incomplete 17.4 11057 22.7 60.8 7879 28.2 3178 1.3 8572

Secondary complete or higher 4.1 4095 4.7 20.6 3550 50.7 545 0.2 3061

Wealth index quintile

Lowest 27.2 4102 31.9 69.2 3345 41.4 756 6.5 3597

Second 27.3 4543 32.8 67.2 3683 40.4 861 3.8 3929

Middle 26.1 4894 31.0 66.4 4015 29.7 879 2.1 4096

Fourth 19.5 5341 23.1 56.7 4313 31.3 1028 1.4 4407

Highest 15.0 5645 17.9 43.7 4627 24.5 1018 1.1 4330

Religion

Islam 23.3 22158 27.7 61.0 18012 33.4 4145 3.1 18417

Hindu 16.0 2156 18.6 48.8 1794 30.4 362 0.2 1788

Buddhist 1.8 111 2.1 26.2 97 (*) 14 (0.0) 86

Christian 7.3 95 8.8 32.1 76 2.0 19 6.1 64

Note: Due to 5 unweighted cases, ‘Other/DK/missing’ category under ‘education’ is not shown(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted casesna= not available

Among the adolescent girls age 15-19 years, 32.9 per cent were found currently married. This proportion was not very different for different areas within urban areas viz., CC slums, CC non-slums and other urban areas. Differentials by division, education of women and socio-economic status were however quite high.

Among the urban women age 15-49 years, 22.5 per cent were (first) married before age 15 (see Figure 8.5). While, among women age 20-49 years, 26.7 per cent got married before age 15 years, and 59.7 per cent women were married before age 18 (Figure-8.6).

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Fig 8.5: Early marriage before age 15 among women age 15-49, Bangladesh, CWS 2016

About 22.5 per cent of women age 15-49 were first married by age 15, while this was only 4.0 per cent of women age 15-19, 12.2 per cent in the age group 20-24, 24.3 per cent in age group 25-29 and as high as 38.1 per cent among women of age 45-49 years. Nearly 59.7 per cent of women age 20-49 years married before age 18, while this was 41.8 per cent among women age 20-24 years, and 73.5 per cent among women age 45-49.

Fig 8.6: Early marriage before age 18 among women age 20-49 by areas, Bangladesh, CWS 2016

Table 8.7 shows a strong negative correlation between early marriage and education. Women were much more likely to be subjected to early marriage (before age 18) if they had no education (77.8 per cent) as compared to those having secondary or higher education (20.6 per cent).

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Fig 8.7: Trend in early marriage (before age 18) by age group, Bangladesh, CWS 2016

It was also evident that 2.8 per cent of women aged 15-49 years in urban areas were in polygynous marriage/union, with some difference by CC slums (4.4 per cent), CC non-slums (2.4 per cent) and other urban areas (3.0 per cent). This prevalence was the highest in Dhaka (3.3 per cent) and Rajshahi (3.2 per cent), and lowest in Barisal and Chittagong (1.8 per cent). Only 1.0 per cent of the youngest women (aged 15-19) were in polygynous union as compared to 4.8 per cent of the oldest (aged 45-49).

Figure 8.7 shows trend in early marriage (marriage before age 18 years) by age groups. It is evident that early marriage declined over time. This is also shown in table 8.8.

Table 8.8: Trends in early marriage (women)

Percentage of women who were first married or entered into a marital union before age 15 and 18, by area and age groups by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

City corporation slum City corporation non-slum Other municipalities/Urban All

Percen-tage of women married before age 15

Number of

women age

15-49 years

Percen-tage of women married before age 18

Number of

women age

20-49 years

Percen-tage of women married before age 15

Number of

women age

15-49 years

Percen-tage of women married before age 18

Number of

women age

20-49 years

Percen-tage of women married before age 15

Number of

women age

15-49 years

Percen-tage of women married before age 18

Number of

women age

20-49 years

Percen-tage of women married before age 15

Number of

women age

15-49 years

Percen-tage of women married before age 18

Number of

women age

20-49 years

Total 28.1 1,015 66.4 807 20.0 7,658 53.3 6,286 23.4 15,853 62.3 12,890 22.5 24,525 59.7 19,983

Age

15-19 8.5 208 na na 2.5 1,372 na na 4.4 2,962 Na na 4.0 4,542 na na

20-24 16.9 177 53.0 177 10.6 1,310 37.3 1,310 12.6 2,560 43.3 2,560 12.2 4,048 41.8 4,048

25-29 32.2 187 60.1 187 23.0 1,384 49.5 1,384 24.4 2,718 56.9 2,718 24.3 4,290 54.7 4,290

30-34 39.9 155 70.8 155 25.8 1,069 55.2 1,069 30.1 2,224 68.0 2,224 29.2 3,448 64.1 3,448

35-39 40.6 123 80.0 123 26.0 953 57.7 953 31.9 1,986 68.3 1,986 30.4 3,062 65.5 3,062

40-44 38.3 71 73.9 71 30.1 758 61.0 758 36.2 1,433 72.7 1,433 34.3 2,262 68.8 2,262

45-49 41.2 93 73.4 93 35.3 811 71.1 811 39.1 1,970 74.5 1,970 38.1 2,874 73.5 2,874

na= Not available

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8.6 Child’s Living Arrangements and OrphanhoodFor proper development of personality, a child needs to grow up in a family environment, in an atmosphere of happiness, love and understanding. There is no equal substitute of parents for proper care of children. Unfortunately, many children grow up without the care of their parents for various reasons, such as premature death of parents, migration of parents for work, separation and others. In these situations, children are cared by other family members, or grow up in other families as adapted child, domestic worker, or as a street child.

This survey (the CWS 2016) collected information for urban children age 0-17 years on their living arrangements: whether living with both parents, living with mothers only, living with fathers only, or living with neither of biological parents. Results as presented in Table 8.9 shows that 84.3 per cent of urban children aged 0-17 years were living with both parents, while 4.7 per cent were living with neither of biological parents. Percentage of children living with both parents was nearly the same in all urban domains, and divisions, but the proportion decreased as age of the child increased. About 7.2 per cent of urban children were living with mothers only when their fathers are alive, and 0.4 per cent with fathers only even when mothers are alive.

The Percentage of children with one or both parents dead was 4.1 per cent. This ‘orphanhood’ varied little between CC slums, CC non-slums or other urban areas, but variation by division was prominent. Orphanhood was the highest in Sylhet (6.3 per cent) and lowest in Rajshahi (3.1 per cent).

Table 8.9: Children’s living arrangements and orphanhood

Per cent distribution of children age 0-17 years according to living arrangements, Percentage of children age 0-17 years not living with a biological parent and Percentage of children who have one or both parents dead, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Living with both

parents

Living with neither biological parent

Living with mother only

Living with father only

Missing informa-tion on father/ mother

Total

Living with neither

biological parent

One or both pare-nts

dead

Number of

children age 0-17

years

Only father alive

Only mother

alive

Both alive

Both dead

Father alive

Father dead

Mother alive

Mother dead

Total 84.3 0.0 0.0 3.9 0.0 7.2 0.0 0.4 0.0 4.2 100.0 4.7 4.1 2,9267

Area

City Corporation slum 84.2 0.0 0.0 3.1 0.0 5.6 0.0 0.8 0.0 6.3 100.0 4.4 6.2 1,267

City Corporation non-slum 85.8 0.0 0.0 3.2 0.0 5.7 0.0 0.4 0.0 4.9 100.0 4.4 4.8 8,482

Other municipalities/urban 83.7 0.0 0.0 4.2 0.0 7.9 0.0 0.4 0.0 3.8 100.0 4.9 3.7 19,518

Division

Barisal 83.9 0.0 0.0 4.5 0.0 6.8 0.0 0.7 0.0 4.1 100.0 5.5 4.1 1,199

Chittagong 81.4 0.0 0.0 1.9 0.0 11.7 0.0 0.2 0.0 4.9 100.0 2.5 4.7 6,077

Dhaka 84.6 0.0 0.0 4.1 0.0 6.7 0.0 0.4 0.0 4.1 100.0 5.2 4.0 13,754

Khulna 86.4 0.0 0.0 4.8 0.0 5.0 0.0 0.6 0.0 3.2 100.0 5.2 3.2 2,266

Rajshahi 86.7 0.0 0.0 5.2 0.0 4.2 0.0 0.7 0.0 3.2 100.0 5.9 3.1 2,747

Rangpur 87.3 0.0 0.0 5.3 0.0 2.7 0.0 0.5 0.0 4.2 100.0 6.1 4.2 1,900

Sylhet 82.9 0.0 0.0 3.2 0.0 7.2 0.0 0.3 0.0 6.3 100.0 4.2 6.3 1,324

Sex

Male 85.8 0.0 0.0 2.4 0.0 7.4 0.0 0.4 0.0 4.1 100.0 3.0 3.9 1,4734

Female 82.9 0.0 0.0 5.4 0.0 6.9 0.0 0.5 0.0 4.4 100.0 6.5 4.3 1,4533

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Table 8.9: continued Living

with both

parents

Living with neither biological parent

Living with mother only

Living with father only

Missing informa-tion on father/ mother

Total

Living with neither

biological parent

One or both pare-nts

dead

Number of

children age 0-17

years

Only father alive

Only mother

alive

Both alive

Both dead

Father alive

Father dead

Mother alive

Mother dead

Age

0-4 90.5 0.0 0.0 0.7 0.0 7.7 0.0 0.2 0.0 0.8 100.0 0.9 0.8 7,686

5-9 87.0 0.0 0.0 2.2 0.0 7.6 0.0 0.4 0.0 2.9 100.0 2.7 2.7 8,195

10-14 83.4 0.0 0.0 3.5 0.0 7.2 0.0 0.5 0.0 5.3 100.0 4.5 5.3 8,440

15-17 72.0 0.0 0.0 12.1 0.0 5.4 0.0 0.6 0.0 9.8 100.0 14.5 9.7 4,946

Wealth index quintile

Lowest 84.4 0.0 0.0 4.0 0.0 5.8 0.0 0.6 0.0 5.1 100.0 5.1 5.0 5,383

Second 85.1 0.0 0.0 4.1 0.0 6.1 0.0 0.3 0.0 4.5 100.0 5.2 4.4 5,716

Middle 86.1 0.0 0.0 3.9 0.0 5.4 0.0 0.5 0.0 4.1 100.0 4.4 4.0 6,215

Fourth 83.4 0.0 0.0 4.1 0.0 8.6 0.0 0.4 0.0 3.5 100.0 4.7 3.4 6,140

Highest 82.7 0.0 0.0 3.3 0.0 9.7 0.0 0.3 0.0 4.1 100.0 4.3 4.0 5,813

Religion

Islam 84.0 0.0 0.0 3.9 0.0 7.5 0.0 0.4 0.0 4.2 100.0 4.8 4.1 2,6840

Hindu 88.5 0.0 0.0 3.5 0.0 3.4 0.0 0.3 0.0 4.3 100.0 3.9 4.3 2,208

Buddhist 90.7 0.0 0.0 5.1 0.0 3.4 0.0 0.0 0.0 0.7 100.0 5.1 0.7 120

Christian 74.6 0.0 0.0 10.9 0.0 10.3 0.0 0.0 0.0 4.2 100.0 10.9 4.2 87

Table 8.10 shows that for about one in twenty children (4.9 per cent) of age 0-17 years, either of the parents (father or mother) was living abroad. This was the highest for Chittagong division (9.2 per cent) and lowest for Rangpur (0.7 per cent). The proportion was very small when only mother was living abroad.

Table 8.10: Children with parents living abroad

Per cent distribution of children age 0-17 years by residence of parents in another country, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016

Per cent distribution of children age 0-17 years: Percentage of children age 0-17 years with at least one parent living

abroad

Number of children age 0-17

years

With at least one parent living abroad With neither parent living

abroad

Total

Only mother abroad

Only father abroad

Both mother and father abroad

Total 0.2 4.7 0.1 95.1 100.0 4.9 29,267

Area

City Corporation slum 0.4 .7 0.0 98.9 100.0 1.1 1,267

City Corporation non-slum 0.3 2.7 0.1 96.9 100.0 3.1 8,482

Other municipalities/urban 0.1 5.8 0.0 94.1 100.0 5.9 19,518

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Table 8.10: continued Per cent distribution of children age 0-17 years: Percentage of

children age 0-17 years with at least one parent living

abroad

Number of children age 0-17

years

With at least one parent living abroad With neither parent living

abroad

Total

Only mother abroad

Only father abroad

Both mother and father abroad

Division

Barisal 0.2 3.5 0.0 96.3 100.0 3.7 1,199

Chittagong 0.1 9.1 0.0 90.8 100.0 9.2 6,077

Dhaka 0.2 3.9 0.1 95.8 100.0 4.2 13,754

Khulna 0.1 3.4 0.1 96.4 100.0 3.6 2,266

Rajshahi 0.2 2.6 0.0 97.2 100.0 2.8 2,747

Rangpur 0.1 .5 0.1 99.3 100.0 .7 1,900

Sylhet 0.2 5.6 0.1 94.2 100.0 5.8 1,324

Sex

Male 0.1 4.6 0.1 95.2 100.0 4.8 14,734

Female 0.2 4.7 0.0 95.1 100.0 4.9 14,533

Age group

0-4 0.0 4.9 0.1 95.0 100.0 5.0 7,686

5-9 0.2 5.6 0.1 94.1 100.0 5.9 8,195

10-14 0.2 4.3 0.1 95.4 100.0 4.6 8,440

15-17 0.3 3.3 0.0 96.3 100.0 3.7 4,946

Wealth index quintile

Lowest 0.1 1.1 0.0 98.8 100.0 1.2 5,383

Second 0.4 2.8 0.0 96.9 100.0 3.1 5,716

Middle 0.1 3.8 0.1 96.0 100.0 4.0 6,215

Fourth 0.1 7.1 0.2 92.5 100.0 7.5 6,140

Highest 0.1 8.1 0.0 91.8 100.0 8.2 5,813

Religion

Islam 0.2 4.9 0.1 94.9 100.0 5.1 26,840

Hindu 0.0 2.0 0.0 98.0 100.0 2.0 2,208

Buddhist 0.0 0.0 0.0 100.0 100.0 0.0 120

Christian 0.0 4.4 0.0 95.6 100.0 4.4 87

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Bangladesh Bureau of Statistics (BBS) and UNICEF, 2014. Bangladesh Multiple Indicator Cluster Survey 2012-2013, Progotir Pathey: Final Report, Dhaka, Bangladesh.

Government of Bangladesh (GOB). 2011. Health, Population and Nutrition Development Programme 2011-16: Programme Implementation Plan, Vol. 1. Dhaka, Bangladesh: Ministry of Health and Family Welfare.

National Institute of Population Research and Training (NIPORT), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), and MEASURE Evaluation. Bangladesh Urban Health Survey 2013 (UHS 2013). Final Report. Dhaka, Bangladesh and Chapel Hill, North Carolina, (USA): NIPORT, icddr,b, and MEASURE Evaluation.

National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. 2013. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International.

Pan American Health Organization (PAHO), and World Health Organization (WHO). 2003. Guiding Principles for Complementary Feeding of the Breastfed Child. Washington, D.C., USA, and Geneva, Switzerland: WHO.

World Health Organization (WHO). 2003. The management of nutrition in major emergencies. Geneva, Switzerland: WHO.

World Health Organization (WHO). 2005. Guiding Principles for Feeding Non-breastfed Children 6 to 24 Months of Age. Geneva, Switzerland: WHO.

World Health Organization (WHO). 2006. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: WHO.

World Health Organization (WHO). 2008. Indicators for Assessing Infant and Young Child Feeding Practices: Conclusions of Consensus Meeting Held 6-8 November 2007 in Washington D.C., USA, Geneva, Switzerland: WHO.

REFERENCES

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Appendix A

UNICEF/BANA2016_00298/Haque

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The main features of the sampling design of the Child Well-being Survey (CWS) in Urban Areas of Bangladesh include estimation of sample size, stratification, sampling frame, sample allocation for the different domains (strata), and sample selection and calculation of sampling weights. The sampling design followed had the following details.

Sample sizeSample size was estimated based on vaccination coverage among children age 12-23 months. Considering the predicted value of the indicator of immunization of 12-23 months’ children with marginal error of 12 per cent the sample size was estimated at 996 rounded to 1000 households using the standard statistical formula and with a confidence level of 95%. The sample size was adjusted by design effect and the possible non-responses. To ensure equal precision at the domain level estimates, equal sample size was taken for all domains except for city-slums of Khulna, Rajshahi and Rangpur because of very small populations in these domains. Separate domains of city slums for Sylhet and Barisal were not considered as the slum population for these divisions was very small. It may be noted that domain level estimates may not be available for some smaller target groups, e.g., exclusive breastfeeding of 0-5 month children, for which divisional level and overall estimates will be available.

Sample DesignThe sample for the CWS was nationally representative and covers entire urban population residing in non-institutional dwelling units in urban areas of Bangladesh. The sample of households was drawn using two-stage stratified cluster sampling method, stratified by 19 strata or domains. The strata/domains were; (i) City Corporation Non-slum, City Corporation Slum, and other Municipalities/Urban areas in Dhaka, Chittagong, Khulna, Rajshahi and Rangpur divisions; and (ii) City Corporations and Other Municipalities/Urban areas in the remaining two divisions - Barisal and Sylhet. A stratum/domain is considered as an independent stratum/domain.

In the first stage of sampling, from each stratum/domain, Mauza/Mahallas (slum in the City Corporation slum stratum/domain) were selected randomly as Primary Sampling Units (PSUs) using probability proportional to size (PPS), size being the number of households in the PSU. In total, 920 PSUs were selected, taking 50 PSUs from each stratum/domain except three stratum/domains of City Corporation slums of Rajshahi, Khulna and Rangpur, from each of which 40 PSUs were selected.

Using Population census (2011) list of Mauzas/Mahalla as sampling frame, BBS selected 700 non-slum urban PSUs, while Urban Slum Census (2014) data were used to select 220 slum PSUs from five City Corporation slum domains. Necessary adjustments were made in the population estimates in the two sampling frames prior to selection of PSUs to bring them to a reference of 2014.

In Mouzas/Mohallas, for the second stage, segments of equal size of around 100 households were created for each PSU through a physical mapping exercise in each selected PSU, and then one of the segments was selected randomly. A segment was randomly selected and

Appendix A

SAMPLE DESIGN AND ESTIMATES OF SAMPLING ERRORS

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is referred to as a cluster. Segment was not done for smaller PSU's. A household listing operation was conducted in each cluster using a structured enumeration form. A sample of 20 households were planned to be selected from each such cluster following systematic random sampling procedure, resulting into a planned total selection of 18,400 households from 920 clusters. This sample size is expected to provide estimates with at most 12 percent margin of error at 95% level of confidence. Since the availability of household members during a survey is sometimes not ensured in urban areas, a 10 per cent oversampling of households at the cluster level was done, leading to a selection of 22 households from each cluster.

Survey could not be conducted in 4 preselected clusters due to eviction of slums and other reasons. Ultimately, a total of 20,134 households from 916 clusters were attempted for interview.

The following table presents the sample sizes, number of clusters and cluster size per domain.

Sample size

Number of clusters and households included in the sample by division (Dhaka, Chittagong, Rajshahi, Khulna, Rangpur, Barisal and Sylhet), and areas (City Corporation slum, City Corporation non-slum and other municipalities/urban areas), Child Well-being survey in urban areas, Bangladesh, CWS 2016.

Division Area/DomainNumber of clusters

Number of Households @22 HHs/Cluster

Dhaka City Corporation non-slum 50 1,100

City Corporation slum 48 1,056

Other municipalities/urban 50 1,100

Chittagong City Corporation non-slum 50 1,100

City Corporation slum 50 1,097

Other municipalities/urban 50 1,100

Rajshahi City Corporation non-slum 49 1,078

City Corporation slum 40 877

Other municipalities/urban 50 1,100

Khulna City Corporation non-slum 50 1,100

City Corporation slum 39 848

Other municipalities/urban 50 1,100

Rangpur City Corporation non-slum 50 1,100

City Corporation slum 40 880

Other municipalities/urban 50 1,100

Sylhet City Corporation non-slum 50 1,100

Other municipalities/urban 50 1,100

Barisal City Corporation non-slum 50 1,098

Other municipalities/urban 50 1,100

Total 19 916 20,134

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Weight calculationWeighting was not needed in producing the estimates for each domain since the sample was self-weighted within it. However, appropriate weights were needed to produce the combined estimates.

We use the following notations:

P1hi: first-stage sampling probability of the ith cluster in stratum h

P2hi: second -stage sampling probability within the ith cluster (households)

Let ah be the number of PSUs selected in stratum/domain h, Mhi the number of households according to the sampling frame in the ith PSU, and ∑ Mhi the total number of households in the stratum. The probability of selecting the ith EA is calculated as follows:

ah Mhi

∑ Mhi

Let bhi be the proportion of households in the selected cluster compared to the total number of households in PSUi in stratum h if the PSU is segmented, otherwise bhi = 1. Then the probability of selecting cluster i in the sample is:

P1hi =ah Mhi x bhi∑ Mhi

Let Lhi be the number of households listed in the household listing operation in cluster i in stratum h, let ghi be the number of households selected in the cluster. The second stage’s selection probability for each household in the cluster is calculated as follows:

P2hi =ghi

Lhi

The overall selection probability of each household in cluster i of stratum h is therefore the product of the two stages selection probabilities:

Phi = P1hi x P2hi

The sampling weight (Design weight) for each household in cluster i of stratum h is the inverse of its overall selection probability:

Whi = 1/Phi

Estimates of Sampling ErrorsSampling errors are measures of variability in the estimates. The extent of variability is not known exactly, but can be estimated statistically from the survey data.

The following sampling error measures are presented for each of the selected indicators;

� Standard error (se): Standard error is the square root of the variance of the estimate, and is a measure of the sampling error. For survey indicators that are means, proportions or ratios, the Taylor series linearization method is used for the estimation of standard errors.

� Coefficient of variation (se/r): Coefficient of variation is the ratio of the standard error to the mean value (r) of the indicator, and is a measure of the relative sampling error.

� Design effect (deff): Design effect is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption

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of simple random sampling based on the same sample size. The square root of the design effect (deff) is used to show the efficiency of the sample design in relation to the precision. A deff value of 1.0 indicates that the sample design of the survey is as efficient as a simple random sample for a particular indicator, while a deff value above 1.0 indicates an increase in the standard error due to use of a more complex sample design.

� Confidence limits: Confidence limits are calculated to show the interval within which the true value for the population can be reasonably assumed to fall, with a specified level of confidence. For any given statistic calculated from the survey, the value of that statistic will fall within a range of plus or minus two times the standard error (r+2.se or r–2.se) of the statistic in 95 per cent of all possible samples of identical size and design.

For the calculation of sampling errors from the CWS data, programs developed in CSPro Version 4.1, SPSS Version 23.0 Complex Samples module have been used.

The results are shown in the tables that follow. In addition to the sampling error measures described above, the tables also include weighted and unweighted counts of denominators for each indicator. Given the use of normalized weights, by comparing the weighted and unweighted counts it is possible to determine whether a particular domain has been under-sampled or over-sampled compared to the average sampling rate. If the weighted counts is smaller than the unweighted counts, this means that the particular domain had been over-sampled.

Sampling errors are calculated for indicators of primary interest, for the urban Bangladesh level, for urban domains, and for all divisions.

Table SE.1: Indicators selected for sampling error calculations

List of indicators selected for sampling error calculations, and base populations (denominators) for each indicator, Child Well-being survey in urban areas, Bangladesh, CWS 2016.

Indicator Base PopulationHousehold members

Use of improved drinking water sources All household membersa

Use of improved sanitation All household membersa

Primary school net attendance ratio (adjusted)Secondary school net attendance ratio (adjusted)

Children of primary school ageChildren of secondary school age

WomenUnmet need Women age 15-49 years who are

currently married or in unionAntenatal care coverage (1+ times, skilled provider) Women age 15-49 years with a live birth

in the last 2 yearsAntenatal care coverage (4+ times, any provider) Women age 15-49 years with a live birth

in the last 2 yearsSkilled attendant at delivery Women age 15-49 years with a live birth

in the last 2 yearsPost-natal health check for the newborn Women age 15-49 years with a live birth

in the last 2 yearsLiteracy rate (young women) Women age 15-24 yearsKnowledge about HIV prevention (young women) Women age 15-24 years

Under-5sBirth registration Children under age 5 yearsExclusive breastfeeding Children under 6 months of ageUnderweight prevalence (moderate and severe) Children under age 5 yearsUnderweight prevalence (severe) Children under age 5 yearsStunting (moderate and severe) Children under age 5 yearsStunting (severe) Children under age 5 yearsWasting (moderate and severe) Children under age 5 yearsWasting (severe) Children under age 5 years

a To calculate the weighted results of Indicators ‘use of improved drinking water sources’ and ‘use of improved sanitation’ the household weight is multiplied by the number of household members in each household. Therefore the unweighted base population presented in the SE tables reflect the unweighted number of households, whereas the weighted numbers reflect the household population.

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Table SE.02: Sampling Errors: all urban sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 0.9917 0.00130 0.001 3.589 1.894 82,228 18,887 0.989 0.994

Use of improved sanitation 0.5727 0.01130 0.020 9.855 3.139 82,228 18,887 0.550 0.595

Primary school net attendance ratio (adjusted) 0.8550 0.00880 0.010 5.262 2.294 8,436 8,462 0.837 0.873

Secondary school net attendance ratio (adjusted) 0.6315 0.01040 0.016 5.448 2.334 11,604 11,802 0.611 0.652

Women

Contraceptive prevalence 0.6726 0.00710 0.010 4.073 2.018 18,252 18,029 0.659 0.687

Unmet need 0.0778 0.00340 0.044 2.906 1.705 18,252 18,029 0.071 0.085

Antenatal care coverage (1+ times, skilled provider) 0.8109 0.01110 0.014 2.289 1.513 2,882 2,850 0.789 0.833

Antenatal care coverage (4+ times, any provider) 0.4594 0.01630 0.035 3.036 1.742 2,882 2,850 0.427 0.492

Skilled attendant at delivery 0.6423 0.01740 0.027 3.761 1.939 2,882 2,850 0.607 0.677

Literacy rate (young women) 0.8260 0.01060 0.013 3.496 1.870 4,488 4,454 0.805 0.847

Post-natal health check for the newborn 0.7991 0.01420 0.018 3.556 1.886 2,882 2,850 0.771 0.827

Post-natal health check for the mother 0.7751 0.01400 0.018 3.181 1.783 2,882 2,850 0.747 0.803

Under-5s

Birth registration 0.2926 0.01050 0.036 4.015 2.004 7,521 7,521 0.272 0.314

Exclusive breastfeeding (under 6 months of age) 0.5267 0.01820 0.035 0.921 0.960 662 696 0.490 0.563

Underweight prevalence (moderate and severe) 0.2043 0.00770 0.038 2.516 1.586 6,888 6,928 0.189 0.220

Underweight prevalence (severe) 0.0395 0.00370 0.093 2.474 1.573 6,888 6,928 0.032 0.047

Stunting prevalence (moderate and severe) 0.2631 0.01030 0.039 3.762 1.940 6,888 6,928 0.243 0.284

Stunting prevalence (severe) 0.0779 0.00580 0.074 3.216 1.793 6,888 6,928 0.066 0.089

Wasting prevalence (moderate and severe) 0.0990 0.00550 0.056 2.350 1.533 6,888 6,928 0.088 0.110

Wasting prevalence (severe) 0.0219 0.00280 0.128 2.558 1.599 6,888 6,928 0.016 0.028

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Table SE.03: Sampling Errors: city corporation slum sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 0.9802 0.00864 0.009 17.128 4.139 3,302 4,457 0.963 0.997

Use of improved sanitation 0.1890 0.01849 0.098 9.944 3.153 3,302

4,457 0.152 0.226

Primary school net attendance ratio (adjusted) 0.6945 0.01975 0.028 3.721 1.929 375 2,025 0.655 0.734

Secondary school net attendance ratio (adjusted) 0.3331 0.01636 0.049 3.327 1.824 483 2,764 0.300 0.366

Women

Contraceptive prevalence 0.7376 0.01118 0.015 2.682 1.638 731 4,155 0.715 0.760

Unmet need 0.0587 0.00457 0.078 1.573 1.254 731 4,155 0.050 0.068

Antenatal care coverage (1+ times, skilled provider) 0.6767 0.02431 0.036 1.831 1.353 127 679 0.628 0.725

Antenatal care coverage (4+ times, any provider) 0.3582 0.02536 0.071 1.897 1.377

127 679 0.307 0.409

Skilled attendant at delivery 0.5546 0.03021 0.054 2.506 1.583

127 679 0.494 0.615

Literacy rate (young women) 0.5900 0.02562 0.043 3.343 1.828

215 1,233 0.539 0.641

Post-natal health check for the newborn 0.6485 0.03002 0.046 2.681 1.637

127 679 0.588 0.709

Post-natal health check for the mother 0.6141 0.02716 0.044 2.111 1.453

127 679 0.560 0.668

Under-5s

Birth registration 0.3292 0.01866 0.057 2.846 1.687 336 1,805 0.292 0.367

Exclusive breastfeeding (under 6 months of age) 0.6235 0.03155 0.051 0.661 0.813

28 157 0.560 0.687

Underweight prevalence (moderate and severe) 0.3076 0.01496 0.049 1.775 1.332 311 1,689 0.278 0.338

Underweight prevalence (severe) 0.0793 0.00947 0.119 2.073 1.440 311 1,689 0.060 0.098

Stunting prevalence (moderate and severe) 0.4035 0.01745 0.043 2.134 1.461 311 1,689 0.369 0.438

Stunting prevalence (severe) 0.1538 0.01565 0.102 3.178 1.783 311 1,689 0.123 0.185

Wasting prevalence (moderate and severe) 0.1163 0.01088 0.094 1.943 1.394 311 1,689 0.095 0.138

Wasting prevalence (severe) 0.0209 0.00547 0.262 2.468 1.571 311 1,689 0.010 0.032

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Table SE.04: Sampling Errors: city corporation non-slum sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 0.9902 0.00244 0.002 4.371 2.091

25,015 7,151 0.985 0.995

Use of improved sanitation 0.5127 0.02785 0.054 22.204 4.712

25,015 7,151 0.457 0.568

Primary school net attendance ratio (adjusted) 0.8497 0.01707 0.020 6.918 2.630

2,452 3,031 0.816 0.884

Secondary school net attendance ratio (adjusted) 0.6198 0.02006 0.032 7.205 2.684

3,324 4,220 0.580 0.660

Women

Contraceptive prevalence 0.6659 0.01238 0.019 4.659 2.159

5,505 6,765 0.641 0.691

Unmet need 0.0775 0.00491 0.063 2.281 1.510 5,505 6,765 0.068 0.087

Antenatal care coverage (1+ times, skilled provider) 0.8406 0.01934 0.023 2.811 1.677

811 1,008 0.802 0.879

Antenatal care coverage (4+ times, any provider) 0.6082 0.02726 0.045 3.140 1.772

811 1,008 0.554 0.663

Skilled attendant at delivery 0.7365 0.02905 0.039 4.377 2.092

811 1,008 0.678 0.795

Literacy rate (young women) 0.8369 0.01455 0.017 2.377 1.542

1,347 1,535 0.808 0.866

Post-natal health check for the newborn 0.8391 0.02467 0.029 4.539 2.130

811 1,008 0.790 0.888

Post-natal health check for the mother 0.8033 0.02436 0.030 3.781 1.944

811 1,008 0.755 0.852

Under-5s

Birth registration 0.3325 0.02091 0.063 5.357 2.314 2,242 2,720 0.291 0.374

Exclusive breastfeeding (under 6 months of age) 0.5754 0.03182 0.055 1.057 1.028

188 256 0.512 0.639

Underweight prevalence (moderate and severe) 0.1772 0.01614 0.091 4.463 2.113

2,042 2,499 0.145 0.209

Underweight prevalence (severe) 0.0266 0.00582 0.219 3.266 1.807

2,042 2,499 0.015 0.038

Stunting prevalence (moderate and severe) 0.2519 0.02410 0.096 7.701 2.775

2,042 2,499 0.204 0.300

Stunting prevalence (severe) 0.0730 0.01239 0.170 5.662 2.379

2,042 2,499 0.048 0.098

Wasting prevalence (moderate and severe) 0.0727 0.00842 0.116 2.626 1.621

2,042 2,499 0.056 0.090

Wasting prevalence (severe) 0.0206 0.00408 0.198 2.067 1.438

2,042 2,499 0.012 0.029

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Table SE.05: Sampling Errors: other municipalities/urban sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 0.9931

0.00144 0.001 2.205 1.485

53,911 7,279 0.990 0.996

Use of improved sanitation 0.6241

0.01125 0.018 3.927 1.982

53,911 7,279 0.602 0.647

Primary school net attendance ratio (adjusted) 0.8680

0.01086 0.013 3.505 1.872

5,610 3,406 0.846 0.890

Secondary school net attendance ratio (adjusted) 0.6550

0.01288 0.020 3.536 1.880

7,797 4,818 0.629 0.681

Women

Contraceptive prevalence 0.6717 0.00905 0.013 2.639 1.625 12,016 7,109 0.654 0.690

Unmet need 0.0791 0.00464 0.059 2.102 1.450 12,016 7,109 0.070 0.088

Antenatal care coverage (1+ times, skilled provider) 0.8074

0.01422 0.018 1.510 1.229

1,944 1,163 0.779 0.836

Antenatal care coverage (4+ times, any provider) 0.4040

0.02095 0.052 2.117 1.455

1,944 1,163 0.362 0.446

Skilled attendant at delivery 0.6088

0.02277 0.037 2.530 1.591

1,944 1,163 0.563 0.654

Literacy rate (young women) 0.8384

0.01475 0.018 2.705 1.645

2,926 1,686 0.809 0.868

Post-natal health check for the newborn 0.7924

0.01817 0.023 2.330 1.527

1,944 1,163 0.756 0.829

Post-natal health check for the mother 0.7739

0.01792 0.023 2.134 1.461

1,944 1,163 0.738 0.810

Under-5s

Birth registration 0.2721 0.01289 0.047 2.513 1.585 4,943 2,996 0.246 0.298

Exclusive breastfeeding (under 6 months of age) 0.5001

0.02317 0.046 0.606 0.778

446 283 0.454 0.546

Underweight prevalence (moderate and severe) 0.2094

0.00901 0.043 1.342 1.158

4,536 2,740 0.191 0.227

Underweight prevalence (severe) 0.0426

0.00489 0.115 1.606 1.267

4,536 2,740 0.033 0.052

Stunting prevalence (moderate and severe) 0.2586

0.01107 0.043 1.751 1.323

4,536 2,740 0.236 0.281

Stunting prevalence (severe) 0.0749

0.00667 0.089 1.758 1.326

4,536 2,740 0.062 0.088

Wasting prevalence (moderate and severe) 0.1096

0.00744 0.068 1.555 1.247

4,536 2,740 0.095 0.124

Wasting prevalence (severe) 0.0226

0.00384 0.170 1.830 1.353

4,536 2,740 0.015 0.030

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Table SE.06: Sampling Errors: barial division sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 0.9879 0.00732 0.007 9.317 3.052

3,343 2,076 0.973 1.003

Use of improved sanitation 0.8072 0.01353 0.017 2.441 1.562 3,343 2,076 0.780 0.834

Primary school net attendance ratio (adjusted) 0.8973 0.01197 0.013 1.474 1.214

344 950 0.873 0.921

Secondary school net attendance ratio (adjusted) 0.7437 0.01890 0.025 2.316 1.522

463 1,237 0.706 0.782

Women

Contraceptive prevalence 0.7110 0.01166 0.016 1.341 1.158 751 2,029 0.688 0.734

Unmet need 0.0506 0.00519 0.103 1.137 1.066 751 2,029 0.040 0.061

Antenatal care coverage (1+ times, skilled provider) 0.7828 0.02862 0.037 1.479 1.216

120 308 0.726 0.840

Antenatal care coverage (4+ times, any provider) 0.3728 0.02871 0.077 1.083 1.040

120 308 0.315 0.430

Skilled attendant at delivery 0.6821 0.03308 0.048 1.549 1.245

120 308 0.616 0.748

Literacy rate (young women) 0.8764 0.02039 0.023 1.731 1.316

179 452 0.836 0.917

Post-natal health check for the newborn 0.9327 0.01725 0.018 1.456 1.206

120 308 0.898 0.967

Post-natal health check for the mother 0.8850 0.02258 0.026 1.538 1.240

120 308 0.840 0.930

Under-5s

Birth registration 0.2626 0.02468 0.094 2.653 1.629 318 844 0.213 0.312

Exclusive breastfeeding (under 6 months of age) 0.6418 0.03377 0.053 0.407 0.638

35 83 0.574 0.709

Underweight prevalence (moderate and severe) 0.1871 0.02423 0.129 2.990 1.729

291 776 0.139 0.236

Underweight prevalence (severe) 0.0360 0.01026 0.285 2.350 1.533

291 776 0.015 0.057

Stunting prevalence (moderate and severe) 0.2560 0.02175 0.085 1.926 1.388

291 776 0.213 0.300

Stunting prevalence (severe) 0.0752 0.01303 0.173 1.892 1.375

291 776 0.049 0.101

Wasting prevalence (moderate and severe) 0.0815 0.01307 0.160 1.768 1.330

291 776 0.055 0.108

Wasting prevalence (severe) 0.0175 0.00440 0.251 0.870 0.933 291 776 0.009 0.026

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Table SE.07: Sampling Errors: chittagong division sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 0.9902 0.00258 0.003 2.111 1.453 16,019 3,063 0.985 0.995

Use of improved sanitation 0.6363 0.01687 0.027 3.765 1.940

16,019 3,063 0.603 0.670

Primary school net attendance ratio (adjusted) 0.8288 0.01503 0.018 2.388 1.545

1,710 1,501 0.799 0.859

Secondary school net attendance ratio (adjusted) 0.6088 0.01829 0.030 2.878 1.696

2,437 2,050 0.572 0.645

Women

Contraceptive prevalence 0.6468 0.01368 0.021 2.424 1.557 3,383 2,960 0.619 0.674

Unmet need 0.1151 0.00952 0.083 2.636 1.624 3,383 2,960 0.096 0.134

Antenatal care coverage (1+ times, skilled provider) 0.7562 0.02476 0.033 1.772 1.331

651 534 0.707 0.806

Antenatal care coverage (4+ times, any provider) 0.3551 0.03029 0.085 2.135 1.461

651 534 0.295 0.416

Skilled attendant at delivery 0.5416 0.03720 0.069 2.971 1.724

651 534 0.467 0.616

Literacy rate (young women) 0.7978 0.01759 0.022 1.532 1.238

873 800 0.763 0.833

Post-natal health check for the newborn 0.7338 0.03167 0.043 2.738 1.655

651 534 0.670 0.797

Post-natal health check for the mother 0.729 0.02918 0.040 2.296 1.515

651 534 0.671 0.787

Under-5s

Birth registration 0.3433 0.02250 0.066 3.052 1.747 1,562 1,360 0.298 0.388

Exclusive breastfeeding (under 6 months of age) 0.6199 0.02278 0.037 0.249 0.499

132 114 0.574 0.665

Underweight prevalence (moderate and severe) 0.2374 0.01536 0.065 1.611 1.269

1,410 1,237 0.207 0.268

Underweight prevalence (severe) 0.0529 0.00674 0.127 1.121 1.059

1,410 1,237 0.039 0.066

Stunting prevalence (moderate and severe) 0.3036 0.01549 0.051 1.402 1.184

1,410 1,237 0.273 0.335

Stunting prevalence (severe) 0.0859 0.01055 0.123 1.752 1.324

1,410 1,237 0.065 0.107

Wasting prevalence (moderate and severe) 0.1064 0.00964 0.091 1.207 1.099

1,410 1,237 0.087 0.126

Wasting prevalence (severe) 0.0272 0.00570 0.210 1.519 1.232

1,410 1,237 0.016 0.039

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Table SE.08: Sampling Errors: dhaka division sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 0.9956 0.00146 0.001 1.467 1.211

38,509 3,001 0.993 0.999

Use of improved sanitation 0.4713 0.02264 0.048 6.173 2.484

38,509 3,001 0.426 0.517

Primary school net attendance ratio (adjusted) 0.8469 0.01656 0.020 2.861 1.692

4,031 1,354 0.814 0.880

Secondary school net attendance ratio (adjusted) 0.5944 0.01946 0.033 2.826 1.681

5,377 1,799 0.555 0.633

Women

Contraceptive prevalence 0.6659 0.01313 0.020 2.130 1.459 8,639 2,751 0.640 0.692

Unmet need 0.0793 0.00545 0.069 1.119 1.058 8,639 2,751 0.068 0.090

Antenatal care coverage (1+ times, skilled provider) 0.839 0.01900 0.023 1.184 1.088

1,320 444 0.801 0.877

Antenatal care coverage (4+ times, any provider) 0.5201 0.02764 0.053 1.355 1.164

1,320 444 0.465 0.575

Skilled attendant at delivery 0.6677 0.03010 0.045 1.809 1.345

1,320 444 0.608 0.728

Literacy rate (young women) 0.8094 0.01982 0.024 1.854 1.361

2,194 729 0.770 0.849

Post-natal health check for the newborn 0.7928 0.02498 0.032 1.683 1.297

1,320 444 0.743 0.843

Post-natal health check for the mother 0.7624 0.02497 0.033 1.525 1.235

1,320 444 0.712 0.812

Under-5s

Birth registration 0.2934 0.01870 0.064 2.010 1.418 3,580 1,193 0.256 0.331

Exclusive breastfeeding (under 6 months of age) 0.4938 0.03567 0.072 0.504 0.710

300 100 0.422 0.565

Underweight prevalence (moderate and severe) 0.1875 0.01334 0.071 1.280 1.131

3,289 1,096 0.161 0.214

Underweight prevalence (severe) 0.0333 0.00662 0.199 1.492 1.221

3,289 1,096 0.020 0.047

Stunting prevalence (moderate and severe) 0.2453 0.01917 0.078 2.174 1.474

3,289 1,096 0.207 0.284

Stunting prevalence (severe) 0.0763 0.01070 0.140 1.779 1.334

3,289 1,096 0.055 0.098

Wasting prevalence (moderate and severe) 0.0943 0.00979 0.104 1.229 1.109

3,289 1,096 0.075 0.114

Wasting prevalence (severe) 0.0214 0.00505 0.236 1.336 1.156

3,289 1,096 0.011 0.032

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Table SE.09: Sampling Errors: khulna division sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 0.9705 0.00783 0.008 6.206 2.491

6,988 2,900 0.955 0.986

Use of improved sanitation 0.6518 0.01674 0.026 3.581 1.892

6,988 2,900 0.618 0.685

Primary school net attendance ratio (adjusted) 0.8998 0.01275 0.014 2.009 1.417

646 1,115 0.874 0.925

Secondary school net attendance ratio (adjusted) 0.7135 0.02392 0.034 4.775 2.185

937 1,707 0.666 0.761

Women

Contraceptive prevalence 0.6931 0.01346 0.019 2.388 1.545

1,685 2,805 0.666 0.720

Unmet need 0.0556 0.00643 0.116 2.210 1.487 1,685 2,805 0.043 0.068

Antenatal care coverage (1+ times, skilled provider) 0.8717 0.02601 0.030 2.153 1.467

193 357 0.820 0.924

Antenatal care coverage (4+ times, any provider) 0.5412 0.04323 0.080 2.679 1.637

193 357 0.455 0.628

Skilled attendant at delivery 0.8028 0.03248 0.040 2.372 1.540

193 357 0.738 0.868

Literacy rate (young women) 0.9178 0.01344 0.015 1.615 1.271

390 675 0.891 0.945

Post-natal health check for the newborn 0.9524 0.01228 0.013 1.183 1.088

193 357 0.928 0.977

Post-natal health check for the mother 0.9602 0.00987 0.010 0.909 0.953

193 357 0.940 0.980

Under-5s

Birth registration 0.2451 0.02128 0.087 2.404 1.550 542 983 0.203 0.288

Exclusive breastfeeding (under 6 months of age) 0.3267 0.04657 0.143 0.887 0.942

48 91 0.234 0.420

Underweight prevalence (moderate and severe) 0.2104 0.01869 0.089 1.919 1.385

502 914 0.173 0.248

Underweight prevalence (severe) 0.034 0.00733 0.215 1.492 1.221

502 914 0.019 0.049

Stunting prevalence (moderate and severe) 0.2049 0.01844 0.090 1.906 1.381

502 914 0.168 0.242

Stunting prevalence (severe) 0.0508 0.00924 0.182 1.617 1.272

502 914 0.032 0.069

Wasting prevalence (moderate and severe) 0.1022 0.01097 0.107 1.196 1.094

502 914 0.080 0.124

Wasting prevalence (severe) 0.0242 0.00606 0.251 1.422 1.193

502 914 0.012 0.036

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Table SE.10: Sampling Errors: rajshahi division sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 1.0000 0.00000 0.000 - -

8,430 2,909 1.000 1.000

Use of improved sanitation 0.6651 0.01587 0.024 3.290 1.814 8,430 2,909 0.633 0.697

Primary school net attendance ratio (adjusted) 0.887 0.01470 0.017 2.438 1.562

794 1,132 0.858 0.916

Secondary school net attendance ratio (adjusted) 0.703 0.02550 0.036 4.998 2.236

1,081 1,606 0.652 0.754

Women

Contraceptive prevalence 0.7296 0.01306 0.018 2.446 1.564 1,953 2,831 0.703 0.756

Unmet need 0.0457 0.00977 0.214 6.198 2.490 1,953 2,831 0.026 0.065

Antenatal care coverage (1+ times, skilled provider) 0.8039 0.02283 0.028 1.240 1.114

272 376 0.758 0.850

Antenatal care coverage (4+ times, any provider) 0.4578 0.04826 0.105 3.519 1.876

272 376 0.361 0.554

Skilled attendant at delivery 0.6546 0.04480 0.068 3.329 1.825

272 376 0.565 0.744

Literacy rate (young women) 0.8882 0.01349 0.015 1.248 1.117

423 682 0.861 0.915

Post-natal health check for the newborn 0.8281 0.03220 0.039 2.730 1.652

272 376 0.764 0.893

Post-natal health check for the mother 0.7881 0.03553 0.045 2.836 1.684

272 376 0.717 0.859

Under-5s

Birth registration 0.2446 0.02035 0.083 2.186 1.478 695 976 0.204 0.285

Exclusive breastfeeding (under 6 months of age) 0.4361 0.04833 0.111 0.798 0.893

60 85 0.339 0.533

Underweight prevalence (moderate and severe) 0.2153 0.01674 0.078 1.511 1.229

641 912 0.182 0.249

Underweight prevalence (severe) 0.0457 0.00889 0.194 1.649 1.284

641 912 0.028 0.063

Stunting prevalence (moderate and severe) 0.2714 0.01874 0.069 1.618 1.272

641 912 0.234 0.309

Stunting prevalence (severe) 0.0756 0.00838 0.111 0.917 0.957

641 912 0.059 0.092

Wasting prevalence (moderate and severe) 0.1066 0.01599 0.150 2.446 1.564

641 912 0.075 0.139

Wasting prevalence (severe) 0.0122 0.00615 0.504 2.861 1.692

641 912 0.000 0.025

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Table SE.11: Sampling Errors: rangpur division sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 0.9992 0.00074 0.001 2.078 1.442

5,554 2,903 0.998 1.001

Use of improved sanitation 0.6544 0.01820 0.028 4.249 2.061

5,554 2,903 0.618 0.691

Primary school net attendance ratio (adjusted) 0.8533 0.01804 0.021 3.319 1.822

539 1,278 0.817 0.889

Secondary school net attendance ratio (adjusted) 0.6930 0.01588 0.023 2.125 1.458

771 1,793 0.661 0.725

Women

Contraceptive prevalence 0.6897 0.01264 0.018 2.032 1.425 1,210 2,724 0.664 0.715

Unmet need 0.0534 0.00675 0.126 2.455 1.567 1,210 2,724 0.040 0.067

Antenatal care coverage (1+ times, skilled provider) 0.8300 0.03227 0.039 3.232 1.798

198 439 0.765 0.895

Antenatal care coverage (4+ times, any provider) 0.4834 0.04305 0.089 3.250 1.803

198 439 0.397 0.570

Skilled attendant at delivery 0.6928 0.04293 0.062 3.793 1.948

198 439 0.607 0.779

Literacy rate (young women) 0.819 0.02661 0.032 3.345 1.829

294 701 0.766 0.872

Post-natal health check for the newborn 0.8535 0.02706 0.032 2.566 1.602

198 439 0.799 0.908

Post-natal health check for the mother 0.8247 0.02856 0.035 2.471 1.572

198 439 0.768 0.882

Under-5s

Birth registration 0.2535 0.01900 0.075 2.170 1.473 487 1,138 0.216 0.292

Exclusive breastfeeding (under 6 months of age) 0.6641 0.03359 0.051 0.637 0.798

55 127 0.597 0.731

Underweight prevalence (moderate and severe) 0.1745 0.02008 0.115 2.922 1.709

445 1,045 0.134 0.215

Underweight prevalence (severe) 0.0278 0.00803 0.289 2.491 1.578

445 1,045 0.012 0.044

Stunting prevalence (moderate and severe) 0.2613 0.02699 0.103 3.940 1.985

445 1,045 0.207 0.315

Stunting prevalence (severe) 0.0610 0.01378 0.226 3.461 1.860

445 1,045 0.033 0.089

Wasting prevalence (moderate and severe) 0.0945 0.01615 0.171 3.182 1.784

445 1,045 0.062 0.127

Wasting prevalence (severe) 0.0204 0.00574 0.282 1.726 1.314

445 1,045 0.009 0.032

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Table SE.12: Sampling Errors: sylhet division sample Value (r) Standard

error (se)Coefficient of variation

(se/r)

Design effect (deff)

Square root of design

effect (deft)

Weighted count

Unweighted count

Confidence limits

Lower bound r - 2se

Upper bound r + 2se

Household members

Use of improved drinking water sources 0.9684 0.01370 0.014 12.468 3.531

3,385 2,035 0.941 0.996

Use of improved sanitation 0.6666 0.01956 0.029 3.502 1.871

3,385 2,035 0.627 0.706

Primary school net attendance ratio (adjusted) 0.8796 0.01170 0.013 1.461 1.209

372 1,132 0.856 0.903

Secondary school net attendance ratio (adjusted) 0.6336 0.02363 0.037 3.870 1.967

538 1,610 0.586 0.681

Women

Contraceptive prevalence 0.5934 0.01265 0.021 1.280 1.131 632 1,929 0.568 0.619

Unmet need 0.0949 0.00920 0.097 1.899 1.378 632 1,929 0.077 0.113

Antenatal care coverage (1+ times, skilled provider) 0.7203 0.02267 0.031 0.997 0.999

128 392 0.675 0.766

Antenatal care coverage (4+ times, any provider) 0.2891 0.02304 0.080 1.009 1.005

128 392 0.243 0.335

Skilled attendant at delivery 0.5088 0.03300 0.065 1.704 1.305

128 392 0.443 0.575

Literacy rate (young women) 0.7685 0.02197 0.029 1.123 1.060

135 415 0.725 0.812

Post-natal health check for the newborn 0.6932 0.02794 0.040 1.435 1.198

128 392 0.637 0.749

Post-natal health check for the mother 0.654 0.02999 0.046 1.554 1.247

128 392 0.594 0.714

Under-5s

Birth registration 0.3102 0.02173 0.070 2.264 1.505 337 1,027 0.267 0.354

Exclusive breastfeeding (under 6 months of age) 0.5615 0.05830 0.104 1.311 1.145

32 96 0.445 0.678

Underweight prevalence (moderate and severe) 0.2581 0.01837 0.071 1.669 1.292

309 948 0.221 0.295

Underweight prevalence (severe) 0.0608 0.00874 0.144 1.269 1.126

309 948 0.043 0.078

Stunting prevalence (moderate and severe) 0.3549 0.02062 0.058 1.759 1.326

309 948 0.314 0.396

Stunting prevalence (severe) 0.133 0.01119 0.084 1.028 1.014

309 948 0.111 0.155

Wasting prevalence (moderate and severe) 0.1159 0.01170 0.101 1.266 1.125

309 948 0.093 0.139

Wasting prevalence (severe) 0.0268 0.00548 0.204 1.090 1.044

309 948 0.016 0.038

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NUTRITION1.1a

1.1b

Underweight prevalence

AN Number of children under age 5 who fall below

(a) minus two standard deviations (moderate and severe)

(b) minus three standard deviations (severe) of the median weight for age of the WHO standard

Total number of children under age 5

2.2a

2.2b

Stunting prevalence AN Number of children under age 5 who fall below

(a) minus two standard deviations (moderate and severe)

(b) below minus three standard deviations (severe) of the median height for age of the WHO standard

Total number of children under age 5

2.3a

2.3b

Wasting prevalence AN Number of children under age 5 who fall below

(a) minus two standard deviations (moderate and severe)

(b) minus three standard deviations (severe) of the median weight for height of the WHO standard

Total number of children under age 5

2.4 Overweight prevalence AN Number of children under age 5 who are above two standard deviations of the median weight for height of the WHO standard

Total number of children under age 5

2.5 Children ever breastfed MN Number of women with a live birth in the last 2 years who breastfed their last live-born child at any time

Total number of women with a live birth in the last 2 years

2.6 Early initiation of breastfeeding

MN Number of women with a live birth in the last 2 years who put their last newborn to the breast within one hour of birth

Total number of women with a live birth in the last 2 years

2.7 Exclusive breastfeeding under 6 months

BD Number of infants under 6 months of age who are exclusively breastfed

Total number of infants under 6 months of age

2.8 Predominant breastfeeding under 6 months

BD Number of infants under 6 months of age who received breast milk as the predominant source of nourishment during the previous day

Total number of infants under 6 months of age

2.9 Continued breastfeeding at 1 year

BD Number of children age 12-15 months who received breast milk during the previous day

Total number of children age 12-15 months

2.10 Continued breastfeeding at 2 years

BD Number of children age 20-23 months who received breast milk during the previous day

Total number of children age 20-23 months

2.11 Age-appropriate breastfeeding

BD Number of children age 0-23 months appropriately fed during the previous day

Total number of children age 0-23 months

2.12 Introduction of solid, semi-solid or soft foods

BD Number of infants age 6-8 months who received solid, semi-solid or soft foods during the previous day

Total number of infants age 6-8 months

2.13 Milk feeding frequency for non-breastfed children

BD Number of non-breastfed children age 6-23 months who received at least 2 milk feedings during the previous day

Total number of non-breastfed children age 6-23 months

2.14 Minimum meal frequency

BD Number of children age 6-23 months who received solid, semi-solid and soft foods (plus milk feeds for non-breastfed children) the minimum number of times1 or more during the previous day

Total number of children age 6-23 months

Appendix B

CWS 2016 INDICATORS: NUMERATORS AND DENOMINATORS

1 Breastfeeding children: Solid, semi-solid, or soft foods, two times for infants age 6-8 months, and three times for children 9-23 months; Non-breastfeeding children: Solid, semi-solid, or soft foods, or milk feeds, four times for children age 6-23 months

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2.15 Minimum dietary diversity

BD Number of children age 6–23 months who received foods from 4 or more food groups2 during the previous day

Total number of children age 6–23 months

2.16 Minimum acceptable diet

BD (a) Number of breastfed children age 6–23 months who had at least the minimum dietary diversity and the minimum meal frequency during the previous day

(b) Number of non-breastfed children age 6–23 months who received at least 2 milk feedings and had at least the minimum dietary diversity not including milk feeds and the minimum meal frequency during the previous day

(a) Number of breastfed children age 6–23 months

(b) Number of non-breastfed children age 6–23 months

2.17 Bottle feeding BD Number of children age 0-23 months who were fed with a bottle during the previous day

Total number of children age 0-23 months

2.18 Low-birthweight infants MN Number of most recent live births in the last 2 years weighing below 2,500 grams at birth

Total number of most recent live births in the last 2 years

2.19 Infants weighed at birth MN Number of most recent live births in the last 2 years who were weighed at birth

Total number of most recent live births in the last 2 years

CHILD HEALTH3.1 Neonatal tetanus

protection MN Number of women age 15-49 years with a live

birth in the last 2 years who were given at least two doses of tetanus toxoid vaccine within the appropriate interval prior to the most recent birth or 5 doses during lifetime

Total number of women age 15-49 years with a live birth in the last 2 years

3.2 Children with diarrhea Number of children under age 5 with diarrhoea in the last 2 weeks

Total number of under 5 children

3.3 Diarrhoea treatment with oral rehydration therapy (ORT) and continued feeding

CA Number of children under age 5 with diarrhoea in the last 2 weeks who received ORT (ORS packet, pre-packaged ORS fluid, recommended homemade fluid or increased fluids) and continued feeding during the episode of diarrhoea

Total number of children under age 5 with diarrhoea in the last 2 weeks

3.4 Children with ARI symptoms

CA Number of children under age 5 with ARI symptoms in the last 2 weeks

Total number of under 5 children

3.5 Care-seeking for children with acute respiratory infection (ARI) symptoms

CA Number of children under age 5 with ARI symptoms in the last 2 weeks for whom advice or treatment was sought from a health facility or provider

Total number of children under age 5 with ARI symptoms in the last 2 weeks

3.6 Antibiotic treatment for children with ARI symptoms

CA Number of children under age 5 with ARI symptoms in the last 2 weeks who received antibiotics

Total number of children under age 5 with ARI symptoms in the last 2 weeks

3.7 Use of solid fuels for cooking

HC Number of household members in households that use solid fuels as the primary source of domestic energy to cook

Total number of household members

3.8 Measles immunization coverage

IM Number of children age 12-23 months who received all vaccinations recommended in the national immunization schedule by their first birthday

Total number of children age 12-23 months

WATER AND SANITATION4.1 Use of improved

drinking water sourcesWS Number of household members using improved

sources of drinking waterTotal number of household members

4.2 Water treatment WS Number of household members in households using unimproved drinking water who use an appropriate treatment method

Total number of household members in households using unimproved drinking water sources

2 The indicator is based on consumption of any amount of food from at least 4 out of the 7 following food groups: 1) grains, roots and tubers, 2) legumes and nuts, 3) dairy products (milk, yogurt, cheese), 4) flesh foods (meat, fish, poultry and liver/organ meats), 5) eggs, 6) vitamin-A rich fruits and vegetables, and 7) other fruits and vegetables

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CWS 2016 Indicators Module Numerator Denominator

4.3 Use of improved sanitation

WS Number of household members using improved sanitation facilities which are not shared

Total number of household members

4.4 Safe disposal of child’s faeces

CA Number of children age 0-2 years whose last stools were disposed of safely

Total number of children age 0-2 years

4.5 Place for handwashing HW Number of households with a specific place for handwashing where water and soap or other cleansing agent are present

Total number of households

4.6 Availability of soap or other cleansing agent

HW Number of households with soap or other cleansing agent

Total number of households

REPRODUCTIVE HEALTH5.1 Adolescent birth CM - BH Women age 15-19 years who have had a live birth

5.2 Early childbearing CM - BH Number of women age 20-24 years who had at least one live birth before age 18

Total number of women age 20-24 years

5.3 Contraceptive prevalence rate

CP Number of women age 15-49 years currently married or in union who are using (or whose partner is using) a (modern or traditional) contraceptive method

Total number of women age 15-49 years who are currently married or in union

5.4 Unmet need UN Number of women age 15-49 years who are currently married or in union who are fecund and want to space their births or limit the number of children they have and who are not currently using contraception

Total number of women age 15-49 years who are currently married or in union

5.6

5.6

Antenatal care coverage

MN Number of women age 15-49 years with a live birth in the last 2 years who were attended during their last pregnancy that led to a live birth(a) at least once by skilled health personnel(b) at least four times by any provider

Total number of women age 15-49 years with a live birth in the last 2 years

5.7 Content of antenatal care

MN Number of women age 15-49 years with a live birth in the last 2 years who had their blood pressure measured and gave urine and blood samples during the last pregnancy that led to a live birth

Total number of women age 15-49 years with a live birth in the last 2 years

5.8 Skilled attendant at delivery

MN Number of women age 15-49 years with a live birth in the last 2 years who were attended by skilled health personnel during their most recent live birth

Total number of women age 15-49 years with a live birth in the last 2 years

5.9 Institutional deliveries MN Number of women age 15-49 years with a live birth in the last 2 years whose most recent live birth was delivered in a health facility

Total number of women age 15-49 years with a live birth in the last 2 years

5.10 Caesarean section MN Number of women age 15-49 years whose most recent live birth in the last 2 years was delivered by caesarean section

Total number of women age 15-49 years with a live birth in the last 2 years

5.11 Post-partum stay in health facility

PN Number of women age 15-49 years who stayed in the health facility for 12 hours or more after the delivery of their most recent live birth in the last 2 years

Total number of women age 15-49 years with a live birth in the last 2 years

5.12 Post-natal health check for the newborn

PN Number of last live births in the last 2 years who received a health check while in facility or at home following delivery, or a post-natal care visit within 2 days after delivery

Total number of last live births in the last 2 years

5.13 Post-natal health check for the mother

PN Number of women age 15-49 years who received a health check while in facility or at home following delivery, or a post-natal care visit within 2 days after delivery of their most recent live birth in the last 2 years

Total number of women age 15-49 years with a live birth in the last 2 years

LITERACY AND EDUCATION6.1 Attendance to early

childhood educationEC Number of children age 36-59 months who are

attending an early childhood education programmeTotal number of children age 36-59 months

6.2 Literacy rate among young women

WB Number of women age 15-24 years who are able to read a short simple statement about everyday life or who attended secondary or higher education

Total number of women age 15-24 years

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CWS 2016 Indicators Module Numerator Denominator

6.3 School readiness ED Number of children in first grade of primary school who attended pre-school during the previous school year

Total number of children attending the first grade of primary school

6.4 Net intake rate in primary education

ED Number of children of school-entry age who enter the first grade of primary school

Total number of children of school-entry age

6.5 Primary school net attendance ratio (adjusted)

ED Number of children of primary school age currently attending primary or secondary school

Total number of children of primary school age

6.6 Secondary school net attendance ratio (adjusted)

ED Number of children of secondary school age currently attending secondary school or higher

Total number of children of secondary school age

6.7 Children reaching last grade of primary

ED Proportion of children entering the first grade of primary school who eventually reach last grade

6.8 Primary completion rate

ED Number of children attending the last grade of primary school (excluding repeaters)

Total number of children of primary school completion age (age appropriate to final grade of primary school)

6.9 Transition rate to secondary school

ED Number of children attending the last grade of primary school during the previous school year who are in the first grade of secondary school during the current school year

Total number of children attending the last grade of primary school during the previous school year

6.10 Gender parity index (primary school)

ED Primary school net attendance ratio (adjusted) for girls

Primary school net attendance ratio (adjusted) for boys

6.11 Gender parity index (secondary school)

ED Secondary school net attendance ratio (adjusted) for girls

Secondary school net attendance ratio (adjusted) for boys

CHILD PROTECTION7.1 Birth registration BR Number of children under age 5 whose births are

reported registeredTotal number of children under age 5

7.2 Violent discipline CD Number of children age 1-14 years who experienced psychological aggression or physical punishment during the last one month

Total number of children age 1-14 years

7.3 Child labour (5-14 years)

CL Number of children age 5-11 years who are involved more than 1 hour per week and more than 14 hours for 12-14 years in economic activities and more than 28 hours in household chores for both groups

Total number of children age 1-14 years

7.4 Child labour (5-17 years)

Number of children age 5-11 years who are involved more than 1 hour per week and more than 14 hours for 12-14 years in economic activities and more than 28 hours in household chores for both groups and more than 43 hours for 15-17 years involved in economic activities and household chores

Total number of children age 1-17 years

7.5 Marriage before age 15 MA Number of women age 15-49 years who were first married or in union before age 15

Total number of women age 15-49 years

7.6 Marriage before age 18 MA Number of women age 20-49 years who were first married or in union before age 18

Total number of women age 20-49 years

7.7 Young women age 15-19 years currently married or in union

MA Number of women age 15-19 years who are married or in union

Total number of women age 15-19 years

7.8 Polygyny MA Number of women age 15-49 years who are in a polygynous union

Total number of women age 15-49 years who are married or in union

7.9 Children’s living arrangements

HL Number of children age 0-17 years living with neither biological parent

Total number of children age 0-17 years

7.10 Prevalence of children with one or both parents dead

HL Number of children age 0-17 years with one or both biological parents dead

Total number of children age 0-17 years

7.11 Children with at least one parent living abroad

HL Number of children 0-17 years with at least one biological parent living abroad

Total number of children 0-17 years

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CHILD WELL-BEING SURVEY IN URBAN AREAS OF BANGLADESH

QUESTIONNAIRE

Appendix C

QUESTIONNAIRES

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HOUSEHOLD (HH) QUESTIONNAIRE

Household Information

HH1. Cluster number: HH2. Household number:

HH3. Interviewer name and code:

Name: ...................................................................................

HH4. Supervisor name and code:

Name: ..................................................................................

HH5. Day/Month/Year of Interview:

HH7. Division:

Barisal ........................................................................................................... 10

Chittagong ................................................................................................ 20

Dhaka ............................................................................................................ 30

Khulna .......................................................................................................... 40

Rajshahi ...................................................................................................... 50

Rangpur ...................................................................................................... 55

Sylhet ............................................................................................................ 60

HH6. Type of Domain:

City Corporation non-slum .................................................... 1

City Corporation slum ................................................................ 2

Other Municipalities/Urban ................................................... 3

HH7A. District name and code:

Name: ...................................................................................

Informed Consent:

We are from Associates for Community and Population Research (ACPR). We are collecting information on behalf of a project of Bangladesh Government and UNICEF on HH information, maternal and child health, education, and child labour. I would like to talk to you about these subjects. The interview will take about 30 minutes. All the information we obtain will remain strictly confidential and your answers will never be shared with anyone other than our project team.

May I start now?

Yes, permission is given Go to HH18 to record the time and then begin the interview.

No, permission is not given Circle 04 in HH9. Discuss this result with your supervisor.

After all questionnaire for the HH have been completed, fill in the following information:

HH8. Name of head of household:

...........................................................................................................................................

HH10. Respondent to household questionnaire:

Name & line #: ............................................................................................

HH9. Result of household interview:

Completed ...................................................................................................... 01

No HH member or no competent respondent at home at time of visit .............................................................................................. 02

Enter HH absent for extended period of time ................. 03

Refused ............................................................................................................. 04

Dwelling vacant/address not a dwelling .............................. 05

Dwelling destroyed ................................................................................. 06

Dwelling not found ................................................................................. 07

Other (specify) ............................................................................................. 96

HH11. Total number of HH members:

HH12. No. of ever married women age 15-49 years: .

HH13.# of women’s questionnaire completed:

HH14. Number of under 5 years child:

HH14A. Number of under 2 years child:

HH16. Field editor name & code:

............................................................................

HH17. Data entry clerk (1st) name & code:

............................................................................

HH17A. Data entry clerk (2nd) name & code:

............................................................................

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HO

USEH

OLD

LIS

TIN

G F

ORM

H

L

HH

18. R

eco

rd t

he

tim

e:

H

ou

rs

M

inu

tes

FIR

ST

, PLE

AS

E T

ELL

ME

TH

E N

AM

E O

F E

AC

H P

ER

SO

N W

HO

US

UA

LLY

LIV

ES

HE

RE

, ST

AR

TIN

G W

ITH

TH

E H

EA

D O

F T

HE

HO

US

EH

OLD

.In

stru

ctio

n: L

ist t

he

hea

d o

f th

e h

ou

seh

old

in li

ne

01. L

ist a

ll h

ou

seh

old

mem

ber

s (H

L2),

thei

r re

lati

on

ship

to th

e h

ou

seh

old

hea

d (H

L3),

an

d

thei

r s

ex (

HL4

). T

hen

ask

: AR

E T

HE

RE

AN

Y O

TH

ER

S W

HO

LIV

E H

ER

E, E

VE

N IF

TH

EY

AR

E N

OT

AT

HO

ME

NO

W?

If y

es, c

om

ple

te li

stin

g f

or

qu

esti

on

s H

L2-H

L4.T

hen

ask

qu

esti

on

s st

arti

ng

wit

h H

L5 f

or

each

per

son

at

a ti

me.

Use

an

ad

dit

ion

al q

ues

tio

nn

aire

if a

ll ro

ws

in t

he

ho

use

ho

ld li

stin

g f

orm

hav

e b

een

use

d.

HL1

Li

ne

no.

HL2

N

ame

HL3

Wha

t is

the

rela

tions

hip

of (n

ame)

to

the

head

of

hous

ehol

d?

HL4

Is (n

ame)

m

ale

or

fem

ale?

HL5

Wha

t is

(nam

e)’s

dat

e of

birt

h?D

K-M

onth

=98,

D

K-Ye

ar=9

998

HL6

How

old

is

(nam

e)?

Reco

rd in

co

mpl

eted

yea

rs.

If ag

e is

95

or

abov

e, re

cord

95.

If le

ss th

an 1

ye

ar w

rite

‘00’

For H

H

mem

ber a

ge

15 a

nd a

bove

For W

omen

ag

e 15

-49

For c

hild

ren

age

5-14

Fo

r chi

ldre

n un

der a

ge 5

For c

hild

ren

ag

e 0-

17

year

Fo

r chi

ldre

n a

ge 0

-17

year

HL6

AIs

(nam

e)

ever

mar

ried?

HL7

Circ

le

line

no o

f w

oman

ag

ed 1

5-49

(HL4

=2,

HL6

=15-

49,

HL6

=1)

HL8

W

ho is

the

mot

her o

r pr

imar

y ca

reta

ker

of th

is c

hild

?Re

cord

line

no

. of

mot

her/

care

take

r

HL9

W

ho is

the

mot

her o

r pr

imar

y ca

reta

ker

of t

his

child

?Re

cord

line

no

. of

mot

her/

care

take

r

HL.

11

Is (n

ame)

’s

natu

ral

mot

her

aliv

e?

HL.

12

Does

(nam

e)’s

na

tura

l mot

her

live

in th

is

hous

ehol

d?

Reco

rd

mot

her’s

line

nu

mbe

r & if

no

circ

le 0

0.

HL.

12A

Whe

re d

oes

(nam

e)’s

na

tura

l m

othe

r liv

e?

HL.

13Is

(nam

e)’s

na

tura

l fa

ther

aliv

e?

HL.

14Do

es (n

ame)

’s

natu

ral f

athe

r liv

e in

this

ho

useh

old?

Re

cord

fa

ther

’s li

ne

num

ber &

if

no c

ircle

00.

HL.

14A

Whe

re d

oes

(nam

e)’s

na

tura

l fa

ther

live

?

Line

Nam

eRe

latio

n*Se

xM

onth

&

Year

Age

Mar

riage

15-4

9M

othe

r/ Ca

reta

ker

Mot

her/

Care

take

rM

othe

r aliv

eM

othe

r’s

line

#M

othe

r liv

e in

Fath

er a

live

Fath

er’s

lin

e #

Fath

er li

ve

in

01

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

01

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

02

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

02

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

03

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

03

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

04

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

04

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Page 202: 1* 6859(< ,1 85%$1 $5($6 2) %$1*/$'(6+ - UNICEF

Ch

ild W

ell-

bei

ng

Su

rvey

in U

rban

Are

as o

f B

ang

lad

esh

xlviii

HL1

Li

ne

no.

HL2

N

ame

HL3

Wha

t is

the

rela

tions

hip

of (n

ame)

to

the

head

of

hous

ehol

d?

HL4

Is (n

ame)

m

ale

or

fem

ale?

HL5

Wha

t is

(nam

e)’s

dat

e of

birt

h?D

K-M

onth

=98,

D

K-Ye

ar=9

998

HL6

How

old

is

(nam

e)?

Reco

rd in

co

mpl

eted

yea

rs.

If ag

e is

95

or

abov

e, re

cord

95.

If le

ss th

an 1

ye

ar w

rite

‘00’

For H

H

mem

ber a

ge

15 a

nd a

bove

For W

omen

ag

e 15

-49

For c

hild

ren

age

5-14

Fo

r chi

ldre

n un

der a

ge 5

For c

hild

ren

ag

e 0-

17

year

Fo

r chi

ldre

n a

ge 0

-17

year

HL6

AIs

(nam

e)

ever

mar

ried?

HL7

Circ

le

line

no o

f w

oman

ag

ed 1

5-49

(HL4

=2,

HL6

=15-

49,

HL6

=1)

HL8

W

ho is

the

mot

her o

r pr

imar

y ca

reta

ker

of th

is c

hild

?Re

cord

line

no

. of

mot

her/

care

take

r

HL9

W

ho is

the

mot

her o

r pr

imar

y ca

reta

ker

of t

his

child

?Re

cord

line

no

. of

mot

her/

care

take

r

HL.

11

Is (n

ame)

’s

natu

ral

mot

her

aliv

e?

HL.

12

Does

(nam

e)’s

na

tura

l mot

her

live

in th

is

hous

ehol

d?

Reco

rd

mot

her’s

line

nu

mbe

r & if

no

circ

le 0

0.

HL.

12A

Whe

re d

oes

(nam

e)’s

na

tura

l m

othe

r liv

e?

HL.

13Is

(nam

e)’s

na

tura

l fa

ther

aliv

e?

HL.

14Do

es (n

ame)

’s

natu

ral f

athe

r liv

e in

this

ho

useh

old?

Re

cord

fa

ther

’s li

ne

num

ber &

if

no c

ircle

00.

HL.

14A

Whe

re d

oes

(nam

e)’s

na

tura

l fa

ther

live

?

Line

Nam

eRe

latio

n*Se

xM

onth

&

Year

Age

Mar

riage

15-4

9M

othe

r/ Ca

reta

ker

Mot

her/

Care

take

rM

othe

r aliv

eM

othe

r’s

line

#M

othe

r liv

e in

Fath

er a

live

Fath

er’s

lin

e #

Fath

er li

ve

in

05

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

05

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

06

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

06

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

07

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

07

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

08

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

08

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

09

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

09

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Page 203: 1* 6859(< ,1 85%$1 $5($6 2) %$1*/$'(6+ - UNICEF

xlix

Ap

pen

dix

C :

Qu

esti

on

nai

res

HL1

Li

ne

no.

HL2

N

ame

HL3

Wha

t is

the

rela

tions

hip

of (n

ame)

to

the

head

of

hous

ehol

d?

HL4

Is (n

ame)

m

ale

or

fem

ale?

HL5

Wha

t is

(nam

e)’s

dat

e of

birt

h?D

K-M

onth

=98,

D

K-Ye

ar=9

998

HL6

How

old

is

(nam

e)?

Reco

rd in

co

mpl

eted

yea

rs.

If ag

e is

95

or

abov

e, re

cord

95.

If le

ss th

an 1

ye

ar w

rite

‘00’

For H

H

mem

ber a

ge

15 a

nd a

bove

For W

omen

ag

e 15

-49

For c

hild

ren

age

5-14

Fo

r chi

ldre

n un

der a

ge 5

For c

hild

ren

ag

e 0-

17

year

Fo

r chi

ldre

n a

ge 0

-17

year

HL6

AIs

(nam

e)

ever

mar

ried?

HL7

Circ

le

line

no o

f w

oman

ag

ed 1

5-49

(HL4

=2,

HL6

=15-

49,

HL6

=1)

HL8

W

ho is

the

mot

her o

r pr

imar

y ca

reta

ker

of th

is c

hild

?Re

cord

line

no

. of

mot

her/

care

take

r

HL9

W

ho is

the

mot

her o

r pr

imar

y ca

reta

ker

of t

his

child

?Re

cord

line

no

. of

mot

her/

care

take

r

HL.

11

Is (n

ame)

’s

natu

ral

mot

her

aliv

e?

HL.

12

Does

(nam

e)’s

na

tura

l mot

her

live

in th

is

hous

ehol

d?

Reco

rd

mot

her’s

line

nu

mbe

r & if

no

circ

le 0

0.

HL.

12A

Whe

re d

oes

(nam

e)’s

na

tura

l m

othe

r liv

e?

HL.

13Is

(nam

e)’s

na

tura

l fa

ther

aliv

e?

HL.

14Do

es (n

ame)

’s

natu

ral f

athe

r liv

e in

this

ho

useh

old?

Re

cord

fa

ther

’s li

ne

num

ber &

if

no c

ircle

00.

HL.

14A

Whe

re d

oes

(nam

e)’s

na

tura

l fa

ther

live

?

Line

Nam

eRe

latio

n*Se

xM

onth

&

Year

Age

Mar

riage

15-4

9M

othe

r/ Ca

reta

ker

Mot

her/

Care

take

rM

othe

r aliv

eM

othe

r’s

line

#M

othe

r liv

e in

Fath

er a

live

Fath

er’s

lin

e #

Fath

er li

ve

in

10

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

10

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

11

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

11

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

12

Mal

e ...

.... 1

Fem

ale

.. 2

Mon

th

Year

Ye

ars

Yes

.....

. 1

No

......

.. 2

HL1

1

12

Yes

......

.1

No .

......

..2

NA

.....

...8

HL1

3

HL1

3N

o ...

......

.. 00

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Yes

......

.1

No .

......

..2

NA

.....

...8

Nex

t row

Nex

t row

No .

......

....0

0

In a

noth

erH

H in

this

coun

try

....

1A

broa

d ...

.. 2

Inst

itutio

n/H

oste

l ....

... 3

DK

......

......

.. 8

Tic

k he

re if

add

ition

al q

uest

ionn

aire

use

d

Prob

e fo

r ad

ditio

nal H

H m

embe

rs:

Pro

be

esp

ecia

lly f

or

any

infa

nts

or

smal

l ch

ildre

n n

ot

liste

d, a

nd

oth

ers

wh

o m

ay n

ot

be

mem

ber

s o

f th

e fa

mily

(su

ch a

s se

rvan

ts, f

rien

ds)

bu

t w

ho

usu

ally

live

in t

he

ho

use

ho

ld. I

nse

rt

nam

es o

f ad

dit

ion

al m

emb

ers

in t

he

ho

use

ho

ld li

st a

nd

co

mp

lete

fo

rm a

cco

rdin

gly

.

* C

odes

for

HL3

: Rel

atio

nshi

p to

hea

d of

hou

seho

ld:

01 H

ead

02 W

ife/

hu

sban

d

03 S

on

/Dau

gh

ter

04 S

on

-in

- La

w/ D

aug

hte

r-in

- La

w

05 G

ran

dch

ild

06 P

aren

t

07 P

aren

t-in

-Law

08 B

roth

er/S

iste

r

09 B

roth

er-i

n-

Law

/Sis

ter-

in-L

aw

10 U

ncl

e/A

un

t

11 N

iece

/Nep

hew

12 O

ther

rel

ativ

e

13 A

do

pte

d/F

ost

er/S

tep

child

14 N

ot

rela

ted

98 D

on

’t k

no

w

Page 204: 1* 6859(< ,1 85%$1 $5($6 2) %$1*/$'(6+ - UNICEF

Ch

ild W

ell-

bei

ng

Su

rvey

in U

rban

Are

as o

f B

ang

lad

esh

l

PARTICIPATION IN GARMENT INDUSTRY PG

PG1. What is the main source of livelihood for your household

Self-employment .................................................... 1

Manufacturing sector ........................................ 2

Service sector ............................................................. 3

Remittance ................................................................... 4

From rent ......................................................................... 5

Other ..................................................................................... 6

(Specify)

PG2. Whether any member works in the garments industry as wage earner?

Yes ........................................................................................... 1

No ............................................................................................. 2 ED1

PG3. How many members work in garment industry as wage earner?

One ......................................................................................... 1

Two ......................................................................................... 2

Three or more ............................................................ 3 PG4.1

PG4.2

PG4. PLEASE TELL ME the NAME OF member WHO IS working in the garment industry:

NAME: ......................................................................................................

(WRITE THE LINE NUMBER FROM HL1 & AGE FROM HL 6 IN APPROPRIATE BOX)

Line number Age ED1

PG4.1 PLEASE TELL ME the NAME OF memberS WHO IS working in the garment industry:

NAME: ......................................................................................................

NAME: ......................................................................................................

(WRITE THE LINE NUMBER FROM HL1 & AGE FROM HL 6 IN APPROPRIATE BOX)

1. Line number Age

2. Line number Age

ED1

ED1

PG4.2 PLEASE TELL ME the NAME OF memberS WHO IS working in the garment industry:

NAME: ......................................................................................................

NAME: ......................................................................................................

NAME: ......................................................................................................

(WRITE THE LINE NUMBER FROM HL1 & AGE FROM HL 6 IN APPROPRIATE BOX) (Consider three youngest members by age)

1. Line number Age

2. Line number Age

3. Line number Age

Page 205: 1* 6859(< ,1 85%$1 $5($6 2) %$1*/$'(6+ - UNICEF

li

Ap

pen

dix

C :

Qu

esti

on

nai

res

EDU

CA

TIO

NED

For h

ouse

hold

mem

bers

age

3 y

ears

and

abo

ve

For h

ouse

hold

mem

bers

age

3-2

4 ye

ars

ED1L

ine

num

ber

ED2

Nam

e an

d ag

e

Copy

from

Hou

seho

ld L

istin

g Fo

rm, H

L2 &

HL6

.

ED3

Has

(nam

e)

ever

atte

nded

pr

esch

ool,

prim

ary

scho

ol, s

econ

dary

sc

hool

, col

lege

or

uni

vers

ity,

mad

rash

a?

ED4A

Wha

t is

the

high

est l

evel

of

scho

ol (n

ame)

ha

s at

tend

ed?

ED4B

Wha

t is

the

high

est g

rade

(n

ame)

com

plet

ed

at th

is le

vel?

If

less

tha

n 1

grad

e, e

nter

00,

G

rade

: 98

DK

ED5

Dur

ing

the

2016

sch

ool

year

, did

(nam

e) a

ttend

pr

e-sc

hool

, prim

ary

scho

ol, s

econ

dary

sc

hool

, col

lege

or

univ

ersi

ty, m

adra

sha

at

any

time?

ED6

Dur

ing

this

sch

ool y

ear,

whi

ch

leve

l & g

rade

is/w

as (n

ame)

at

tend

ing?

ED7

Dur

ing

the

prev

ious

sc

hool

yea

r, th

at is

20

15 d

id (n

ame)

atte

nd

pres

choo

l, pr

imar

y sc

hool

, se

cond

ary

scho

ol, c

olle

ge

or u

nive

rsity

, mad

rash

a at

an

y tim

e?

ED8

Dur

ing

that

pre

viou

s sc

hool

yea

r, w

hich

leve

l & g

rade

did

(nam

e)

atte

nd?

Line

Nam

eA

geYe

s/N

oLe

vel

Gra

deYe

s/N

oLe

vel

Gra

deYe

s/N

o/D

KLe

vel

Gra

de

01

In y

ears

Yes

......

......

1

No

......

......

.. 2

Nex

t row

Pres

choo

l ....

0(S

kip

to E

D.5

)Pr

imar

y ..

......

1Se

cond

ary/

high

er

seco

ndar

y ...

2H

ighe

r ...

......

.. 3

DK

......

......

......

.. 8

DK

......

......

.... 9

8

Yes

......

......

..1

No .

......

......

...2

G

o to

ED

7

Pres

choo

l ....

0(S

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t row

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choo

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......

......

......

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......

......

. 98

03

In y

ears

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1

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......

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t row

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choo

l ....

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kip

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D.5

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imar

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......

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er

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ndar

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ighe

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......

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......

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......

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8

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......

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o to

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7

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......

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......

. 98

Page 206: 1* 6859(< ,1 85%$1 $5($6 2) %$1*/$'(6+ - UNICEF

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as o

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t is

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plet

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n 1

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nter

00,

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rade

: 98

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ED5

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e) a

ttend

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, prim

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ol, s

econ

dary

sc

hool

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lege

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ersi

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sha

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Dur

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this

sch

ool y

ear,

whi

ch

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l & g

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as (n

ame)

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tend

ing?

ED7

Dur

ing

the

prev

ious

sc

hool

yea

r, th

at is

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15 d

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ame)

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nd

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choo

l, pr

imar

y sc

hool

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......

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......

. 98

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In y

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......

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choo

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......

......

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......

......

. 98

06

In y

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......

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t row

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choo

l ....

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kip

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......

......

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......

......

. 98

Page 207: 1* 6859(< ,1 85%$1 $5($6 2) %$1*/$'(6+ - UNICEF

liii

Ap

pen

dix

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esch

ool,

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ary

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ol, s

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dary

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hool

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lege

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uni

vers

ity,

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rash

a?

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Wha

t is

the

high

est l

evel

of

scho

ol (n

ame)

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s at

tend

ed?

ED4B

Wha

t is

the

high

est g

rade

(n

ame)

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plet

ed

at th

is le

vel?

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less

tha

n 1

grad

e, e

nter

00,

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rade

: 98

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ED5

Dur

ing

the

2016

sch

ool

year

, did

(nam

e) a

ttend

pr

e-sc

hool

, prim

ary

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ol, s

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dary

sc

hool

, col

lege

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ersi

ty, m

adra

sha

at

any

time?

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Dur

ing

this

sch

ool y

ear,

whi

ch

leve

l & g

rade

is/w

as (n

ame)

at

tend

ing?

ED7

Dur

ing

the

prev

ious

sc

hool

yea

r, th

at is

20

15 d

id (n

ame)

atte

nd

pres

choo

l, pr

imar

y sc

hool

, se

cond

ary

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ol, c

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ge

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kip

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7

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......

......

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sD

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......

......

. 98

08

In y

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......

......

1

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......

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Nex

t row

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choo

l ....

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kip

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D.5

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imar

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......

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DK

......

......

......

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DK

......

......

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8

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......

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7

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kip

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......

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DK

......

......

......

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DK

......

......

.... 9

8

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......

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......

......

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......

......

...8

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kip

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kip

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ighe

r ...

......

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DK

......

......

......

.. 8

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sD

K ...

......

......

. 98

09

In y

ears

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......

......

1

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......

......

.. 2

Nex

t row

Pres

choo

l ....

0(S

kip

to E

D.5

)Pr

imar

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......

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er

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ndar

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ighe

r ...

......

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DK

......

......

......

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......

......

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8

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......

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......

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o to

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7

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choo

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kip

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D.7

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imar

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ndar

y ...

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ighe

r ...

......

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DK

......

......

......

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DK

......

......

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8

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......

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......

......

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......

......

...8

(S

kip

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......

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DK

......

......

......

.. 8

Clas

sD

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......

......

. 98

Page 208: 1* 6859(< ,1 85%$1 $5($6 2) %$1*/$'(6+ - UNICEF

Ch

ild W

ell-

bei

ng

Su

rvey

in U

rban

Are

as o

f B

ang

lad

esh

liv

For h

ouse

hold

mem

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age

3 y

ears

and

abo

ve

For h

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mem

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age

3-2

4 ye

ars

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num

ber

ED2

Nam

e an

d ag

e

Copy

from

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seho

ld L

istin

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rm, H

L2 &

HL6

.

ED3

Has

(nam

e)

ever

atte

nded

pr

esch

ool,

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ary

scho

ol, s

econ

dary

sc

hool

, col

lege

or

uni

vers

ity,

mad

rash

a?

ED4A

Wha

t is

the

high

est l

evel

of

scho

ol (n

ame)

ha

s at

tend

ed?

ED4B

Wha

t is

the

high

est g

rade

(n

ame)

com

plet

ed

at th

is le

vel?

If

less

tha

n 1

grad

e, e

nter

00,

G

rade

: 98

DK

ED5

Dur

ing

the

2016

sch

ool

year

, did

(nam

e) a

ttend

pr

e-sc

hool

, prim

ary

scho

ol, s

econ

dary

sc

hool

, col

lege

or

univ

ersi

ty, m

adra

sha

at

any

time?

ED6

Dur

ing

this

sch

ool y

ear,

whi

ch

leve

l & g

rade

is/w

as (n

ame)

at

tend

ing?

ED7

Dur

ing

the

prev

ious

sc

hool

yea

r, th

at is

20

15 d

id (n

ame)

atte

nd

pres

choo

l, pr

imar

y sc

hool

, se

cond

ary

scho

ol, c

olle

ge

or u

nive

rsity

, mad

rash

a at

an

y tim

e?

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Dur

ing

that

pre

viou

s sc

hool

yea

r, w

hich

leve

l & g

rade

did

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e)

atte

nd?

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eA

geYe

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vel

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deYe

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deYe

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KLe

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1

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Nex

t row

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choo

l ....

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kip

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D.5

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DK

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DK

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8

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......

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7

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kip

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D.7

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DK

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......

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DK

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8

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......

......

...8

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ighe

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......

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DK

......

......

......

.. 8

Clas

sD

K ...

......

......

. 98

11

In y

ears

Yes

......

......

1

No

......

......

.. 2

Nex

t row

Pres

choo

l ....

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kip

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D.5

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imar

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......

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ary/

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er

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ndar

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ighe

r ...

......

.. 3

DK

......

......

......

.. 8

DK

......

......

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8

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......

..1

No .

......

......

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o to

ED

7

Pres

choo

l ....

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kip

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D.7

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imar

y ..

......

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er

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ndar

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ighe

r ...

......

.. 3

DK

......

......

......

.. 8

DK

......

......

.... 9

8

Yes

......

......

..1

No .

......

......

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WATER AND SANITATION WSWS1 What is the main source of drinking water for

members of your household?PIPED WATER

Piped into dwelling .................... 11 Piped into compound,

yard or plot ................................. 12

Piped to neighbour .................... 13

Public tap/standpipe .................. 14

Tube well, borehole ........................ 21

DUG WELL

Protected well ............................ 31 Unprotected well ....................... 32

WATER FROM SPRING

Protected spring ......................... 41

Unprotected spring .................... 42

Rainwater collection ....................... 51

Tanker-truck .................................... 61

Cart with small tank/drum .............. 71

Surface water (River, stream,

dam, lake, pond, canal,

irrigation channel) ..................... 81

Bottled water ................................... 91 Other ................................................ 96

(Specify)

WS6

WS6

WS2 WHAT IS THE MAIN SOURCE OF WATER USED BY YOUR HOUSEHOLD FOR OTHER PURPOSES SUCH AS COOKING AND HANDWASHING

PIPED WATER Piped into dwelling .................... 11 Piped into compound, yard or plot ................................. 12 Piped to neighbour .................... 13 Public tap/standpipe .................. 14Tube well, borehole ........................ 21DUG WELL Protected well ............................ 31 Unprotected well ....................... 32WATER FROM SPRING Protected spring ......................... 41 Unprotected spring .................... 42Rainwater collection ....................... 51Tanker-truck .................................... 61Cart with small tank/drum .............. 71 Surface water (River, stream, dam, lake, pond, canal, irrigation channel) ..................... 81Other ................................................ 96

(Specify)

WS6 Do you do anything to the water to make it safer to drink?

Yes ..................................................... 1

No ....................................................... 2 Don’t know ........................................ 8

WS8

WS7 What do you usually do to make the water safer to drink?

Probe:

Anything else?

Record all items mentioned.

Boil ..................................................... A

Add bleach/chlorine .......................... B

Strain through a cloth ...................... C

Use water filter (ceramic,

sand, composite, etc.) ...................... D

Solar disinfection .............................. E

Let it stand and settle ....................... F

Use purify tablet ............................... G

Other (Specify) .................................. X

Don’t know ........................................ Z

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WS8 What kind of toilet facility do members of your household usually use?

If “flush” or “pour flush”, probe: where does it flush to?

If necessary, ask permission to observe the facility.

Flush or pour flush toilet

Flush to piped sewer system ........... 11

Flush to septic tank .................... 12

Flush to pit (latrine) ................... 13

Flush to somewhere else .......... 14

Flush to unknown place/

not sure/don’t know where ........ 15

Pit latrine

Ventilated improved pit latrine ........ 21

Pit latrine with slab .................... 22

Pit latrine without slab/open pit ........ 23

Composting toilet ........................... 31

Bucket .............................................. 41

Hanging toilet, Hanging latrine ........... 51

No facility, bush, field ..................... 95 Other ................................................ 96

(Specify)

HC1A

WS9 Do you share this facility with others who are not members of your households?

Yes ..................................................... 1

No ....................................................... 2 HC1A

WS10 Do you share this facility only with members of other households that you know, or is the facility open to the use of the general public?

Other households only

(not public) ........................................ 1

Public facility ..................................... 2 HC1A

WS11 How many households in total use this toilet facility, including your own household?

Number of households (if less than 10) ........................... 0

Ten or more households ................ 10

Don’t know ...................................... 98

HOUSEHOLD CHARACTERISTICS HCHC1A What is the religion of the head of this

household?Islam ...................................................................................................... 1

Hinduism ........................................................................................ 2

Buddhism ...................................................................................... 3

Christianity .................................................................................. 4

Other religion ......................................................................... 6

(Specify)

No religion ................................................................................... 7

HC2 HOW MANY ROOMS IN THIS HOUSEHOLD ARE USED FOR SLEEPING?

Number of rooms ................................................

HC3 Main material of the dwelling floor:

RECORD OBSERVATION

Natural floor

Earth/Sand ..................................................................... 11

Dung ........................................................................................ 12

Rudimentary floor

Wood planks .............................................................. 21

Palm/Bamboo ........................................................... 22

Finished floor

Parquet or polished

wood ........................................................................................ 31

Vinyl or asphalt strips ................................. 32

Ceramic tiles/Mosaic .................................... 33

Cement ................................................................................ 34

Carpet .................................................................................... 35

Other ................................................................................................. 96

(specify)

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HC4. Main material of the roof:

RECORD OBSERVATION

Natural roofing

No Roof ............................................................................... 11

Thatch/Palm leaf .................................................. 12

Sod ............................................................................................. 13

Rudimentary Roofing

Rustic mat ....................................................................... 21

Palm/Bamboo ........................................................... 22

Wood planks .............................................................. 23

Cardboard ....................................................................... 24

Finished roofing

Metal/Tin ........................................................................... 31

Wood ...................................................................................... 32

Calamine/Cement fiber ............................. 33

Ceramic tiles ............................................................... 34

Cement ................................................................................ 35

Roofing shingles .................................................. 36

Other ............................................................................................. 96

(Specify)

HC5. Main material of the exterior walls:

RECORD OBSERVATION

Natural walls

No walls ............................................................................. 11

Cane/Palm/Trunks ............................................. 12

Dirt .............................................................................................. 13

Rudimentary walls

Bamboo with mud ............................................ 21

Stone with mud .................................................... 22

Uncovered adobe .............................................. 23

Plywood ............................................................................. 24

Cardboard ....................................................................... 25

Reused wood ............................................................ 26

Tin ................................................................................................ 27

Finished walls

Cement ................................................................................ 31

Stone with lime/cement .......................... 32

Bricks ...................................................................................... 33

Cement blocks ......................................................... 34

Covered adobe ....................................................... 35

Wood planks/shingles ................................ 36

Other ............................................................................................... 96

(Specify)

HC6. What type of fuel does your household mainly use for cooking?

Electricity ................................................................................... 01

Liquefied Petroleum Gas (LPG) ...................... 02

Natural gas ............................................................................. 03

Biogas ............................................................................................. 04

Kerosene ..................................................................................... 05

Coal/lignite .............................................................................. 06

Charcoal ....................................................................................... 07

Wood ................................................................................................ 08

Straw/Shrubs/Grass ................................................. 09

Animal dung ......................................................................... 10

Agricultural crop residue ................................ 11

No food cooked in household .......................... 95 Other ................................................................................................. 96

(Specify)

HC8

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HC7 IS THE COOKING USUALLY DONE IN THE HOUSE, IN A SEPARATE BUILDING, OR OUTDOORS?

If ‘In the house’, probe: IS IT DONE IN A SEPARATE ROOM USED AS A KITCHEN?

In the house

In a separate room used as

Kitchen ............................................................................................... 1

Elsewhere in the house ......................................... 2

In a separate building ............................................... 3

Outdoors ......................................................................................... 4

Other (specify) ....................................................................... 6

HC8. Does your household have:

READ OUTYes No

A. Electricity 1 2

B. Radio 1 2

C. Television 1 2

D. Non-mobile telephone 1 2

E. Refrigerator 1 2

F. Electric fan 1 2

G. Cot/Bed 1 2

H. Table 1 2

I. Almirah/wardrobe 1 2

J. Sofa set 1 2

K. Water dispenser 1 2

L. Water pump 1 2

HC9. Does any member of your household own:

READ OUTYes No

A. Watch 1 2

B. Mobile telephone 1 2

C. Bicycle 1 2

D. Motorcycle/Scooter 1 2

E. Animal drawn-cart 1 2

F. Car/Truck 1 2

G. Boat with motor 1 2

H. Rickshaw/van 1 2

I. NNasiman/ Kariman/ Votbati

1 2

J. Easy bike/Auto bike (Battery driven)

1 2

K. Computer 1 2

HC10. Do you or someone living in this household own this dwelling?

If ‘no’ then ask: Do you rent this dwelling from someone not living in this households?

Own ......................................................................................................... 1

Rent ......................................................................................................... 2

Other (Not owned or rented) ........................ 6

HC11 Does any member of this household own any land that can be used for agriculture?

Yes ............................................................................................................ 1

No ............................................................................................................... 2 C13

HC12 How many acres of agricultural land do members of this household own?

If less than1, record ‘00’, If 95 or more, record ‘95’ If unknown, record ‘98’.

Acres .........................................................................................

HC13 DOES THIS HOUSEHOLD OWN ANY LIVESTOCK, HERDS, OTHER FARM ANIMALS, OR POULTRY?

Yes ............................................................................................................ 1

No ............................................................................................................... 2 HC15

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HC14 HOW MANY OF THE FOLLOWING ANIMALS DOES THIS HOUSEHOLD HAVE? (READ OUT)

[A] CATTLE, MILK COWS, OR BULLS?

[B] HORSES, DONKEYS, OR MULES?

[C] GOATS?

[D] SHEEP?

[E] CHICKEN/DUCKS?

[F] PIGS?

If none, record ‘00’.

If 95 or more, record ‘95’.

If unknown, record ‘98’.

Cattle, milk cows, or bulls ........................

Horses, donkeys, or mules ......................

Goats ............................................................................................

Sheep ........................................................................................

Chicken/Ducks ..............................................................

Pigs .................................................................................................

HC15 DOES ANY MEMBER OF THIS HOUSEHOLD HAVE A BANK ACCOUNT?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

HC16 DO YOU DO ANYTHING TO GET PROTECTION FROM MOSQUITO BITES?

Yes ............................................................................................................ 1

No ............................................................................................................... 2 Dk ................................................................................................................ 3

SL1

HC17 WHAT ARE YOU DOING TO GET PROTECTION FROM MOSQUITO BITES?

Circle all that apply.

Mosquito net .......................................................................... A

Coil .......................................................................................................... B

Spray .................................................................................................... C

Electric mat ................................................................................ D

Other (specify) .................................................................... X

DK ............................................................................................................... Z

SELECTION OF ONE CHILD FOR CHILD LABOUR/CHILD DISCIPLINESL1 Check HL6 in the list of household members and

write the total number of children age 1-17 years.Number ......................................................................................... No children age 1-17 years .............................. 0 HW1

SL2 Check the number of children age 1-17 years in SL1and tick in appropriate box. One Go to SL9 and record the rank number as’1’, enter the line number, child’s name and

age. Two or more Continue with SL2A

SL2A List each of the children aged 1-17 years below in the order they appear in the List of Household Members. Do not include other household members outside of the age rang 5-17 years. Record the line number, name, sex, and age for each child.

SL3Rank

Number

SL4Line number

from HL1

SL5Name from HL2

SL6Sex from HL4

SL7Age from

HL6

Rank Line Name Male Female Age

1 Male .................. 1 Female .......... 2 2 Male .................. 1 Female .......... 2 3 Male .................. 1 Female .......... 2 4 Male .................. 1 Female .......... 2 5 Male .................. 1 Female .......... 2 6 Male .................. 1 Female .......... 2 7 Male .................. 1 Female .......... 2 8 Male .................. 1 Female .......... 2

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SL8 � Check the last digit of the household number (HH2) from the cover page. This is the number of the row you should go to in the table below.

� Check the total number of children age 1-17 in SL1 above. This is the number of the column you should go to in the table below.

� Find the box where the row and the column meet and circle the number that appears in the box. This is the rank number (SL3) of the selected child.

Last digit of household number (from HH2)

Total number of Eligible Children in the Household (from SL1)2 3 4 5 6 7 8+

0 2 2 4 3 6 5 4

1 1 3 1 4 1 6 5

2 2 1 2 5 2 7 6

3 1 2 3 1 3 1 7

4 2 3 4 2 4 2 8

5 1 1 1 3 5 3 1

6 2 2 2 4 6 4 2

7 1 3 3 5 1 5 3

8 2 1 4 1 2 6 4

9 1 2 1 2 3 7 5

SL9 Record the rank number (SL3), line number (SL4), name (SL5) and age (SL7) of the selected child.

Rank number ....................................................................... Line number .................................................................

Name: ........................................................................................................

Age ...............................................................................................

CHILD LABOUR CLCL1 Check the age of child in SL9 and tick an

appropriate box.Age 01-04 years .............................................................. Age 05-17 years ..............................................................

CD1

CL2 Now I would like to ask about any work children in this household may do.

Since last (day of the week), did (name) do any of the following activities, even for only one hour?

[A] Did (name) do any work or help on his/her own or the household’s plot/ farm/food garden or looked after animals?

For example, growing firm produce, harvesting, or feeding, grazing, milking animals?

[B] Did (name) help in family business or relative’s business with or without pay, or run his/her own business?

[C] Did (name) produce or sell articles, handicrafts, clothes, food or agricultural products?

[D] Since last (day of the week), did (name) engage in any other activity in return for income in cash or in kind,

even for only one hour?

If ‘No’, probe:

Please include any activity (name) performed as a regular or casual employee, self-employed or employer: or as an unpaid family worker helping out in household business or farm

Yes No

Work on plot/farm/food garden/looked after animals .. 1 2

Helped in family/relative’s business/ran own business ...... 1 2

Produce/sell articles/handicrafts/ clothes/food or agriculture products ............................. 1 2

Any other activity ...................................... 1 2

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CL3 Check CL2A-CL2D and tick in appropriate box. At least one code 1 is circled .................... All code 2 is circled ...................................................

CL8

CL4 Since last (day of the week), about how many hours did (name) engage in this activity/these activities, in total?

Number of hours ..................................................

CL5 Does the activity/Do these activities require carrying heavy loads?

Yes ............................................................................................................ 1 No ............................................................................................................... 2

CL8

CL6 Does the activity/Do these activities require working with dangerous tools (knives etc.) or operating heavy machinery?

Yes ............................................................................................................ 1 No ............................................................................................................... 2

CL8

CL7 How would you describe the work environment of (name)?

[A] Is (name) exposed to dust, fumes or gas? Yes ............................................................................................................ 1

No ............................................................................................................... 2

[B] Is (name) exposed to extreme cold, heat or humidity?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

[C] Is (name) exposed to loud noise or vibration? Yes ............................................................................................................ 1

No ............................................................................................................... 2

[D] Is (name) required to work at heights? Yes ............................................................................................................ 1

No ............................................................................................................... 2

[E] Is (name) required to work with chemicals (pesticides, glues, etc.) or explosives?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

[F] Is (name) exposed to other things, processes or conditions bad for (name)’s health or safety?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

CL8 Since last (day of the week), did (name) fetch water or collect firewood for household use?

Yes ............................................................................................................ 1

No ............................................................................................................... 2 CL10

CL9 In total, how many hours did (name) spend on fetching water or collecting firewood for household use, since last (day of the week)?

If less than one hour, record ‘0’.

Number of hours ..........................................................

CL10 Since last (day of the week), did (name) do any of the following for this household?

[A] Shopping for household?

[B] Repair any household equipment?

[C] Cooking or cleaning utensils or the house?

[D] Washing clothes?

[E] Caring for children?

[F] Caring for the old or sick?

[G] Other household tasks?

Yes No

Shopping for household ....................... 1 2

Repair any household equipment .............................................................

1 2

Cooking or cleaning utensils or the house ................................................................

1 2

Washing clothes ......................................... 1 2

Caring for children .................................. 1 2

Caring for the old or sick ...................... 1 2

Other household tasks ..................... 1 2

CL11 Check CL10A-CL10G and tick in appropriate box. At least one code 1 is circled .................... All code 2 is circled ...................................................

CD1

CL12 Since last (day of the week), about how many hours did (name) engage in this activity/these activities, in total?

If less than one hour, record ‘00’.

Number of hours ..................................................

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CHILD DISCIPLINE CDCD1 Check the age of child in SL9 and tick an appropriate

box.Age 01-14 years ..............................................................

Age 15-17 years .............................................................. HW1

CD2 Write the line number (SL4) and name (SL5) of the child selected.

Line number .................................................................

Name: ........................................................................................................

CD3 Adults use certain ways to teach children the right behavior or to address a behavior problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month?

[A] Took away privileges, forbade something (name) liked or did not allow him/her to leave house.

[B] Explained why (name)’s behavior was wrong.

[C] Shook him/her.

[D] Shouted, yelled at or screamed at him/her.

[E] Gave him/her something else to do.

[F] Spanked, hit or slapped him/her on the bottom with bare hand.

[G] Hit him/her on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object.

[H] Called him/her dumb, lazy, or another name like that.

[I] Hit or slapped him/her on the face, head or ears.

[J] Hit or slapped him/her on the hand, arm or leg.

[K] Beat him/her up, that is hit him/her over and over as hard as one could

Yes No

Took away privileges ................................. 1 2

Explained wrong behavior ................. 1 2

Shook him/her ................................................. 1 2

Shouted, yelled, screamed ................ 1 2

Gave something else to do ................ 1 2

Spanked, hit, slapped on bottom with bare hand .............................................. 1 2

Hit with belt, hairbrush, stick or other hard object ....................................... 1 2

Called dumb, lazy, or another name ............................................................................... 1 2

Hit/slapped on the face, head or ears ................................................................................... 1 2

Hit/slapped on the hand, arm or leg ....................................................................................... 1 2

Beat up, hit over and over as hard as one could ...................................................... 1 2

CD4 Do you believe that in order to bring up, raise, or educate a child properly, the child needs to be physically punished?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

Don’t know/No opinion .......................................... 8

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HANDWASHING HWHW1 Please show me where members of your

household most often wash their hands.Observed ........................................................................................ 1

Not observed

Not in dwelling/plot/yard .......................... 2

No permission to see ...................................... 3

Other reason .................................................................. 6

(Specify)

HW4

HW2 OBSERVATION ONLY:

OBSERVE PRESENCE OF WATER AT THE

SPECIFIC PLACE FOR HANDWASHING.

VERIFY BY CHECKING THE TAP/PUMP, OR BASIN, BUCKET, WATER CONTAINER OR SIMILAR OBJECTS FOR PRESENCE OF WATER.

WATER IS AVAILABLE ............................................ 1

WATER IS NOT AVAILABLE ........................... 2

HW3 OBSERVATION ONLY:

RECORD IF SOAP OR DETERGENT IS PRESENT AT THE SPECIFIC PLACE FOR HANDWASHING

Circle all that apply

Bar Soap ........................................................................................ A

Detergent (powder/liquid/paste) ...................... B

Liquid soap ................................................................................ C

Ash/mud/sand ...................................................................... D

None ..................................................................................................... Y

HH19

HW4 Do you have any soap or detergent in your household for washing hands?

Yes ............................................................................................................ 1

No ............................................................................................................... 2 HH19

HW5 Can you please show it to me?

RECORD OBSERVATION.

Circle all that apply

Bar Soap ...................................................................................... A

Detergent (powder/liquid/paste) ...................... B

Liquid soap .............................................................................. C

Ash/mud/sand ...................................................................... D

Not able/Does not want to show ..................... Y

HH19 Record the time

Hour and minutes .......................... : HH20 Thanks for the respondent for his/her cooperation and check the household questionnaire:

Return to the cover page and make sure that all information is entered, including the number of eligible women (HH12), under 2 children (HH14A) and under 5 children (HH14).

Make arrangement for individual women questionnaire has been issued for each married woman aged 15-49 years in the Household List (HL7).

Important instruction Check HH14 and HH14A. If there is no eligible woman aged 15-49 years in the HH, then ask the Immunization, For children under 5 and Anthropometry module to the caretakers, if the under 5 and under 2 child in the HH.

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QUESTIONNAIRE FOR INDIVIDUAL WOMAN

Woman’s InformationThis questionnaire is to be administered to all married women age 15 through 49 (see Household listing Form,

column HL7). A separate questionnaire should be used for each eligible woman.

WM1. Cluster number: WM2. Household number:

WM3. Woman’s name

Name: ..................................................................................................................................................................

WM4. Woman’s line number:

WM5. Interviewer name and code:

Name: .................................................................................................................................................

WM6. Day/Month/Year of Interview:

Informed Consent

Repeat greeting if not already read to this woman: If greeting at the beginning of the household questionnaire has already been read to this woman, then read the following:

We are from Associates for Community and Population Research (ACPR). We are collecting information on behalf of a project of Bangladesh Government and UNICEF on HH information, maternal and child health, education, and child labour. I would like to talk to you about these subjects. The interview will take about 40 minutes. All the information we obtain will remain strictly confidential and your answers will never be shared with anyone other than our project team.

Now I would like to talk to you more about your & your child’s health and other topics. This interview will take about 40 minutes. Again, all the information we obtain will remain strictly confidential and your answers will never be shared with anyone other than our project team.

May I start now?

Yes, permission is given Go to WM10 to record the time and then begin the interview.

No, permission is not given Circle 03 in WM7. Discuss this result with your supervisor.

WM7. Result of woman’s interview: Completed ......................................................................................................................................... 01

Not at home .................................................................................................................................... 02

Refused ................................................................................................................................................... 03

Partly completed ..................................................................................................................... 04

Incapacited ........................................................................................................................................ 05

Other (specify) ............................................................................................................................. 96

WM8. Field editor name & code:

............................................................................

WM9. Data entry clerk (1st) name & code:

............................................................................

WM9A. Data entry clerk (2nd) name & code:

............................................................................

WM10. Interview starting time Hours ..................................................................................................................

Minutes ...........................................................................................................

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WOMAN’S BACKGROUND WBWB1. In what month and year were you born? Date of birth

Month ......................................................................................

DK month ................................................................................... 98

Year ...........................................................................

DK year ................................................................................... 9998

WB2. How old are you?

Probe: How old were you at your last birthday?

Compare and correct WB1 and/or WB2 if inconsistent

Age (in completed years) .......................

WB3. Have you ever attended pre-primary school, primary school, secondary school, college or university, madrasha?

Yes ............................................................................................................. 1

No ................................................................................................................ 2 WB7

WB4. What is the highest level of pre-primary school, primary school, secondary school, college or university, madrasha you attended?

Preschool ........................................................................................ 0 Primary ............................................................................................... 1

Secondary/Higher secondary ....................... 2

Higher ................................................................................................... 3

WB7

WB5. What is the highest grade you completed at the level of pre-primary school, primary school, secondary school, college or university, madrasha?

If less than 1 grade, enter ‘00’

Grade ........................................................................................

WB6. Check WB4 (Highest level) and circle in appropriate code.

Code 2 or 3 (secondary/higher)

is circled ....................................................................................... Code 1(primary) is circled ..............................

MA6

WB7. Now I would like you to read this sentence to me.

Show sentence on the card to the respondent. If respondent cannot read whole sentence, probe:

Can you read part of the sentence to me?

Cannot read at all .............................................................. 1

Able to read only parts of sentence .................. 2

Able to read whole sentence ......................... 3

No sentence in required

language .......................................................................................... 4

(Specify language)

Blind/visually impaired ............................................ 5

MARRIAGE MAMA6. What is your marital status now: Are you currently

married, widowed, divorced, separated or never married?

Currently married ............................................................. 1

Widowed ......................................................................................... 2

Divorced ........................................................................................... 3

Separated ....................................................................................... 4

Never married ........................................................................ 5

AN7

MA7. Have you been married only once or more than once?

Only once ....................................................................................... 1

More than once .................................................................... 2

MA8. In what month and year did you start living with your (first) husband? Month ......................................................................................

DK month ................................................................................... 98

Year .......................................................................... DK year ................................................................................... 9998

BH1

MA9 How old were you when you started living with your (First) Husband?

Age

(in completed years) ....................................... BH1. Now I would like to ask about the birth you have

had during your life.

Have you ever given birth?

Yes ............................................................................................................. 1

No ................................................................................................................ 2 CP0

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BH2. What was the date of your first birth?

I mean the very first time you gave birth, even if the child is no longer living, or whose father is not your current husband.

Day ...............................................................................................

DK day ............................................................................................. 98

Month ......................................................................................

DK month ................................................................................... 98

Year .......................................................................... DK year ................................................................................... 9998

BH4

BH3. How many years ago did you have your first birth? Years ago

(in completed years) ..................................... BH4. How many live birth you have had during your

life?One ............................................................................................................ 1

More than one ................................................................... BH6

BH5. Check BH2 & BH3: Birth occurred within the last 2 years, that is, since (day and month of interview) in 2014/2015.

No live birth in last 2 years

(Februay 2014) ................................................................ Live birth in last 2 years

(February 2014) .............................................................

CP0

BH8

BH6. What was the date of your last birth (even if he or she has died)?

Month and year must be recorded.

Day ...............................................................................................

DK day ............................................................................................. 98

Month ......................................................................................

Year ...........................................................................

BH7. Check BH6: Last birth occurred within the last 2 years, that is, since (day and month of interview) in 2014/2015.

No live birth in last 2 years

(February 2014) ...........................................................

One or more live birth in last 2 years (February 2014) ..........................................

CP0

BH8. Ask for the name of the child whose birth occurred within the last 2 years.

If child has died, take special care when referring to this child by name in the following modules.

Name of last born child:

...............................................................................................................................

BH9. Is the youngest child is alive? If alive, whether he/she is living in this household?

Yes alive, live in the household ........................... 1

Yes alive, not live in the household ................. 2

Dead ........................................................................................................ 3

MATERNAL AND NEWBORN HEALTH MNMN0 This module is to be administered to all women with a live birth in the 2 years preceding the date of

interview.

Check BH8 and record name of (last born) child here. Name: ....................................... Use this child’s name in the following questions, where indicated.

MN1. Did you see anyone for antenatal care during your pregnancy with (name)?

Yes ............................................................................................................. 1

No ................................................................................................................ 2 MN5

MN2. Whom did you see?

Probe:

Anyone else?

PROBE FOR THE TYPE OF PERSON SEEN AND CIRCLE ALL ANSWERS GIVEN.

Health Professional

Qualified Doctor ...................................................... A

Nurse/Midwife/Paramedic ...................... B

FWV .............................................................................................. C

Community skilled birth

attendant (CSBA) ................................................. D

MAS/SACMO ................................................................. E

Community Health Provider .......................... F

Health Assistant (HA) ..................................... G

Family Welfare Assistant (FWA) ................... H

NGO worker ...................................................................... I

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Other Professional

Trained Traditional birth

attendant(TTBA) ....................................................... J

Untrained Traditional birth

attendant(UTBA) ..................................................... K

Quack .......................................................................................... L

Other ..................................................................................................... X

(Specify)

MN3. How many times did you receive antenatal care during this pregnancy?

Number of times ...................................................

DK ............................................................................................................ 98

MN4. As part of your antenatal care during this pregnancy, were any of the following done at least once: Read out

Yes No

[A] Was your blood pressure measured? Blood pressure ........................................... 1 2

[B] Did you give a urine sample? Urine sample ................................................. 1 2

[C] Did yo give a blood sample? Blood sample ................................................ 1 2

MN5. Do you have a card or other document with your own immunizations listed?

MAY I SEE IT PLEASE?

If a card is presented, use it to assist with answers to the following questions.

Yes (card seen) ...................................................................... 1

Yes (card not seen) ........................................................ 2

No ................................................................................................................ 3

DK ................................................................................................................ 8

MN6. When you were pregnant with (name), Did you receive any injection in the arm or shoulder to prevent the baby from getting tetanus,that is convulsions after birth?

Yes ............................................................................................................. 1

No ................................................................................................................ 2

DK ................................................................................................................ 8

MN9

MN9

MN7. How many times did you receive this tetanus injection during your last pregnancy with (name)?

If 7 or more times, record ‘7’Number of times ............................................................

DK ................................................................................................................ 8 MN9

MN8. How many tetanus injections during last pregnancy were reported in MN7?

At least 2 tetanus injection during last pregnancy ..............................................

Only one tetanus injection during last pregnancy ..............................................

MN17

MN9.

Did you receive any tetanus injection at any time before your pregnancy with (name), either to protect yourself or another baby?

Yes ............................................................................................................. 1

No ................................................................................................................ 2

DK ................................................................................................................ 8

MN17

MN17

MN10. How many times did you receive a tetanus injection before your pregnancy with (name)?

If 7 or more times, record ‘7’Number of times ............................................................

DK ................................................................................................................ 8 MN17

MN11. How many years ago did you receive the last tetanus injection before your pregnancy with (name)?

Years ago ...........................................................................

MN17. Who assisted with the delivery of (Name)?

Probe:

Anyone else?

Probe for the type of person assisting and circle all answers given.

If respondent says no one assisted, probe to determine whether any adults were present at the delivery.

Health Professional

Qualified Doctor ...................................................... A

Nurse/Midwife/Paramedic ...................... B

FWV .............................................................................................. C

Community skilled birth

attendant (CSBA) ................................................. D

MA/SACMO ...................................................................... E

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Community Health Provider .......................... F

Health Assistant (HA) ..................................... G

Family Welfare Assistant (FWA) ...................... H

NGO worker ...................................................................... I

Other Professional

Trained Traditional birth

attendant(TTBA) ....................................................... J

Untrained Traditional birth

attendant(UTBA) ..................................................... K

Quack .......................................................................................... L

Relatives ............................................................................. M

Neighbour/friends ................................................ N

Other ..................................................................................................... X

(Specify)

No one ................................................................................................ Y

MN18. Where did you give birth to (Name)?

Probe to identify the type of source.

If unable to determine whether public or private, write the name of the place.

............................................................................................................

(Name of place)

Home

Respondent’s home ....................................... 11

Other home .................................................................. 12

Public sector

Govt. hospital ........................................................... 21

Govt. clinic/health centre ...................... 22

Govt. health post ................................................ 23

Other public ................................................................. 26

(Specify)

Private Medical sector

Private hospital ...................................................... 31

Private clinic ................................................................ 32

Private maternity home ........................... 33

NGO clinic/hospital ......................................... 34

Other private medical ................................. 36

(Specify)

Other .................................................................................................. 96

(Specify)

MN20

MN20

MN20

MN19. Was (name) Delivered by caesarean section? That is, Did they cut your belly open to take the baby out?

Yes ............................................................................................................. 1

No ................................................................................................................ 2

MN20 WHEN (name) WAS BORN, WAS HE/SHE VERY LARGE, LARGER THAN AVERAGE, AVERAGE, SMALLER THAN AVERAGE, OR VERY SMALL?

Very large ....................................................................................... 1

Larger than average ..................................................... 2

Average ............................................................................................. 3

Smaller than average ................................................. 4

Very small ...................................................................................... 5

DK .............................................................................................................. 8

MN21. Was (name) weighed at birth? Yes ............................................................................................................. 1

No ................................................................................................................ 2

DK ................................................................................................................ 8

MN24

MN24

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MN22. How much did (name) weigh?

Record weight from health card, if available.

Kg

From card .............................................. 1 .

From recall .......................................... 2 .

Don’t know ................................................................... 99998

MN24. Did you ever breastfeed (name)? Yes ............................................................................................................. 1

No ................................................................................................................ 2

BF2A

MN25. How long after birth did you first put (name) to the breast?

If less than 1 hour, record ‘00’ hours.

If less than 24 hours, record hours.

Otherwise, record days.

Immediately ....................................................................... 000

Hours .................................................................................. 1

Days ...................................................................................... 2

Don’t know/remember ..................................... 998

MN26. In the first three days after delivery, was (name) given anything to drink other than breast milk?

Yes ............................................................................................................. 1

No ................................................................................................................ 2 BF2

MN27. What was (name) given to drink?

Probe:

Anything else?

Milk (Other than breast milk) ....................... A

Plain water ................................................................................... B

Sugar or glucose water ......................................... C

Gripe water ................................................................................. D

Sugar-salt-water solution .................................... E

Fruit juice ........................................................................................ F

Infant formula ........................................................................ G

Tea/Infusions ........................................................................... H

Honey ...................................................................................................... I

Other ..................................................................................................... X

(Specify)

BF2. Is (name) still being breastfed? Yes ............................................................................................................. 1

No ................................................................................................................ 2

DHS558

DHS459A For how many months did you breastfeed (Name)?

Months ...................................................................................

Don’t know ............................................................................... 98

BF2A. Check BH9 and circle in appropriate code. Yes alive, live in the household ........................... 1

Yes alive, not live in the household ........................ 2

Dead ....................................................................................................... 3

PN0

PN0

DHS558 Now I would like to ask you about liquids or foods that (NAME) had yesterday during the day or at night. I am interested in whether your child had the item I mention even if it was combined with other foods.

Did (NAME) (drink/eat):

Liquids/foods Yes No DK

a. Plain water? 1 2 8

b. Juice or juice drinks? 1 2 8

c. Milk such as tinned, powdered, or fresh animal milk?

1 2 8

IF YES: How many times did (NAME) drink milk?

IF 7 OR MORE TIMES, RECORD ‘7’.

Number of times

drank milk

d. Infant formula like Lactogen? 1 2 8

IF YES: How many times did (NAME) drink infant formula?

IF 7 OR MORE TIMES, RECORD ‘7’.

Number of times

drank formula

e. Any other liquids? 1 2 8

f. Yogurt? 1 2 8

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IF YES: How many times did (NAME) eat yogurt?

IF 7 OR MORE TIMES, RECORD ‘7’.

Number of times ate

yogurt

g. Any commercially fortified baby food like Cerelac?

1 2 8

h. Bread, rice, noodles, porridge, or other foods made from grains?

1 2 8

i. Pumpkin, carrots, squash or sweet potatoes that are yellow or orange inside?

1 2 8

j. White potatoes, white yams, manioc, cassava, or any other foods made from roots?

1 2 8

k. Any dark green, leafy vegetables like spinach, poi sag, methi, kolmi, kochu, palong?

1 2 8

l. Ripe mangoes, papayas, ripe kathal, bangi or other Vitamin A rich fruits?

1 2 8

m. Any other fruits like banana, grapes, apple, guava or other vegetables like cabbage, patal, kopi?

1 2 8

n. Liver, kidney, heart or other organ meats? 1 2 8

o. Any meat, such as beef, pork, lamb, goat, chicken, or duck?

1 2 8

p. Eggs? 1 2 8

q. Fish, shrimps or crab? 1 2 8

r. Any foods made from beans, peas, lentils, or nuts?

1 2 8

s. Cheese or other food made from milk like paneer?

1 2 8

t. Drink clear broth/clear soup? 1 2 8

u. Drink or eat vitamin or mineral supplements or any medicines?

1 2 8

v. Drink ORS (Oral Rehydration Solution)? 1 2 8

DHS559 Check DHS558: Any yes code from g to v is circled.

No 1 (yes) code is circled .................................

One or more than one 1(yes) code is circled .................................................................... BF17

BF16 Did (name) eat solid or semi-solid (soft mushy) food yesterday, during the day or night?

Yes ............................................................................................................. 1

No ................................................................................................................ 2

DK ................................................................................................................ 8

BF18

BF18

BF17 How many times did (name) eat solid or semi-solid (soft mushy) food yesterday, during the day or night?

Number of times ...................................................

BF18. Yesterday, during the day and night, did (name) drink anything from a bottle with a nipple ?

Yes ............................................................................................................. 1

No ................................................................................................................ 2

Don’t know ................................................................................... 8

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POST-NATAL HEALTH CHECKS PNPN0. This module is to be administered to all women with a live birth in the 2 years preceding the date

of interview. Record name of last born child from BH8.

Name: ........................................................................................................ . Use this child’s name in the following questions, where indicated.

PN1. Check MN18. Was the child delivered in a health facility?

Yes, child was delivered in a health facility (code21-26 or31-36 is circled) ..............................

No, child was no delivered in a health facility (code 11,12 or 96 is circled) ................................................. PN6

PN2. Now I would like to ask you some questions about what happened in the hours and days after the birth of (name).

You have said that you gave birth in (name of facility in MN18). How long did you stay there after the delivery?

If less than one day, record hours.

If less than one week, record days.

Otherwise, record weeks.

Hours ................................................................................. 1

Days ..................................................................................... 2

Weeks ............................................................................... 3

Don’t know/remember .................................... 998

PN3. I would like to talk to you about checks on (name)’s health after delivery for example, someone examining (name), checking the cord, or seeing if (name) is OK.

Before you left the (name of facility in MN18), Did anyone check on (name)’s health?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

PN4. And what about checks on your health – I mean, someone assessing your health, for example asking questions about your health or examining you.

Did anyone check on your health before you left (name or type or facility in MN18)?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

PN5. Now I would like to talk to you about what happened after you left (name or type or facility in MN18).

Did anyone check on (name)’s health after you left (name or type or facility in MN18)?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

PN11

PN16

PN6 Check MN17. Did a health professional, traditional birth attendant, or community health worker assist with the delivery?

Yes, delivery assisted by a health professional, TBA, or community health worker (code A-K is circled) ..........................................

No, delivery not assisted by a health professional, TBA, or community health worker (code A-K is not circled) ..............................

PN10

PN7 You have already said that (person or persons in MN17) assisted with the birth. Now I would like to talk to you about checks on (name)’s health after delivery, for example examining (name), checking the cord, or seeing if (name) is OK.

After the delivery was over and before (person or persons in MN17) left you, did

(person or persons in MN17) check on (name)’s health?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

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PN8. And did (person or persons in MN17) Check on your health before leaving?

By check on your health, I mean assessing your heatlh, for example asking questions about your health or examining you.

Yes ............................................................................................................ 1

No ............................................................................................................... 2

PN9. After the (person or persons in MN17) left you, did anyone check on the health of (name)?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

PN11

PN18

PN10. I would like to talk to you about checks on (name)’s health after delivery -- for example, someone examining (name), checking the cord, or seeing if the baby is OK.

After (name) was delivered, did anyone check on his/her health?

Yes ............................................................................................................ 1

No ............................................................................................................... 2 PN19

PN11. Did such a check happen only once or more than once?

Once ....................................................................................................... 1

More than once ................................................................... 2 PN12B

PN12A How long after delivery did that check happen?

If less than one day, record hours.

If less than one week, record days.

Otherwise, record weeks.

Hours ................................................................................ 1

Days .................................................................................... 2

Weeks .............................................................................. 3

Don’t know/remember .................................... 998

PN13

PN12B How long after delivery did the first of these checks happen?

If less than one day, record hours.

If less than one week, record days.

Otherwise, record weeks.

Hours .................................................................................................... 1

Days ........................................................................................................ 2

Weeks .................................................................................................. 3

Don’t know/remember .................................... 998

PN13 Who checked on (name)’s health at that time? Health Professional

Qualified Doctor ................................................... 11

Nurse/Midwife/Paramedic ................... 12

FWV ........................................................................................... 13

Community skilled birth

attendant (CSBA) .............................................. 14

MA/SACMO .................................................................. 15

Community Health Provider ...................... 16

Health Assistant (HA) .................................. 17

Family Welfare Assistant (FWA) ............ 18

NGO worker ................................................................ 21

Other Professional

Trained Traditional birth

attendant(TTBA) ................................................... 31

Untrained Traditional birth

attendant(UTBA) .................................................. 32

Quack ...................................................................................... 33

Other ................................................................................................. 96

(Specify)

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PN14. Where did this check take place?

Probe to identify the type of source.

If unable to determine whether public or private, write the name of the place.

.............................................................................................................

(Name of place)

Home

Respondent’s home ....................................... 11

Other home .................................................................. 12

Public sector

Govt. hospital ........................................................... 21

Govt. clinic/health centre ...................... 22

Govt. health post ................................................ 23

Other public ................................................................. 26

(Specify)

Private Medical sector

Private hospital ...................................................... 31

Private clinic ................................................................ 32

Private maternity home ........................... 33

NGO clinic/hospital ......................................... 34

Other private medical ................................. 36

(Specify)

Other ................................................................................................. 96

(Specify)

PN15. Check MN18: Was the child delivered in a health facility?

Yes, child was delivered in a health facility(code21-26 or31-36 is circled) ....................................... No, child was not delivered in a health facility (code 11,12 or 96 is circled) ....................... PN17

PN16. After you left (name or type of facility in MN18), did anyone check on your health?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

PN20

CA15

PN17. Check MN17: Did a health professional, traditional birth attendant, or community health worker assist with the delivery?

Yes, delivery assisted by a health professional, TBA, or community health worker (code A-K is circled) ..........................................

No, delivery not assisted by a health professional, TBA, or community health worker (code A-K is not circled) .............................. PN19

PN18. After the delivery was over and (person or persons in MN17) left, did anyone check on your health?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

PN20

CA15

PN19. After the birth of (name), did anyone check on you health?

I mean someone assessing your health, for example asking questions about your health or examining you.

Yes ............................................................................................................ 1

No ............................................................................................................... 2

CA15

PN20. Did such a check happen only once or more than once?

Once ....................................................................................................... 1

More than once ................................................................... 2 PN21B

PN21A. How long after delivery did that check happen?

If less than one day, record hours.

If less than one week, record days.

Otherwise, record weeks.

Hours ................................................................................ 1

Days .................................................................................... 2 Weeks ............................................................................... 3

Don’t know/remember .................................... 998

PN22

PN21B. How long after delivery did the first of these checks happen?

If less than one day, record hours.

If less than one week, record days.

Otherwise, record weeks.

Hours ................................................................................. 1

Days ..................................................................................... 2

Weeks ............................................................................... 3

Don’t know/remember .................................... 998

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PN22. Who checked on your health at that time? Health Professional

Qualified Doctor ................................................... 11

Nurse/Midwife/Paramedic ................... 12

FWV ........................................................................................... 13

Community skilled birth

attendant (CSBA) ................................................ 14

MA/SACMO .................................................................. 15

Community Health Provider ...................... 16

Health Assistant (HA) .................................. 17

Family Welfare Assistant (FWA) ............... 18

NGO worker ................................................................ 21

Other Professional

Trained Traditional birth

attendant(TTBA) ................................................... 31

Untrained Traditional birth

attendant(UTBA) .................................................. 32

Quack ...................................................................................... 33

Other ................................................................................................. 96

(Specify)

PN23. Where did this check take place?

Probe to identify the type of source.

If unable to determine whether public or private, write the name of the place.

.............................................................................................................

(Name of place)

Home

Respondent’s home ....................................... 11

Other home .................................................................. 12

Public sector

Govt. hospital ........................................................... 21

Govt. clinic/health centre ...................... 22

Govt. health post ................................................ 23

Other public ........................................................................... 26

(Specify)

Private medical sector

Private hospital ...................................................... 31

Private clinic ................................................................ 32

Private maternity home ........................... 33

NGO clinic/hospital ......................................... 34

Other private medical ................................. 36

(Specify)

Other ................................................................................................. 96

(Specify)

CA15. The last time (name) passed stools, what was done to dispose of the stools?

Child used toilet/latrine ...................................... 01

Put/rinsed into toilet/latrine ........................ 02

Put/rinsed into drain or ditch ................... 03

Thrown into garbage (solid waste) ................. 04

Buried .............................................................................................. 05

Left in the open ............................................................... 06

Other ................................................................................................. 96

(Specify)

Don’t know .............................................................................. 98

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IMMUNIZATION IMIM0. Check BH9 and circle in appropriate code. Yes alive, live in the household .................................... 1

Yes alive, not live in the household .......................... 2

Dead ....................................................................................................... 3 CP0

IM1 Do you have a card where (name)’s vaccinations are written down?

IF YES, May I see it please?

Yes, seen ........................................................................................ 1

Yes, not seen ........................................................................... 2

No card .............................................................................................. 3

IM3

IM6

IM2 Did you ever have a vaccination (child health) card for (name)?

Yes ............................................................................................................ 1 No ............................................................................................................... 2

IM6

IM3 a) Copy dates for each vaccination from the card.

b) Write “44” in day column if card shows that vaccination was given but no date is recorded.

Date of immunization

DAY MON YEAR

Copy date of birth if written on card.

BCG BCG

PENTAVELENT 1 PENTA 1

PENTAVELENT 2 PENTA 2

PENTAVELENT 3 PENTA 3

OPV 1 OPV 1

OPV 2 OPV 2

OPV 3 OPV 3

OPV 4 OPV 4

MR at 9 months MR 9

Measles at 15 months M 15

IM4. Check IM3.Are all vaccines (BCG to measles at 15 months) recorded?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

IM19

IM5. In addition to what is recorded on this card, did (name) receive any other vaccinations- including vaccinations received in campaigns or immunization days?

Yes ............................................................................................................ 1

(GO BACK TO IM3 AND PROBE FOR THESE

VACCINATIONS AND WRITE “66” IN THE

CORRESPONDING DAY COLUMN FOR EACH

VACCINE MENTIONED. WHEN FINISHED, SKIP

TO IM19)

No ............................................................................................................... 2

Don’t know .................................................................................. 8

IM19

IM6 Has (name) ever received any vaccinations to prevent him/her from getting diseases, including vaccinations received in a campaign or immunization day?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

Don’t know .................................................................................. 8 IM19

IM7 Has (name) ever received a BCG vaccination against tuberculosis -- that is, an injection in the left shoulder that usually caused a scar?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

Don’t know .................................................................................. 8

IM8 Has (name) ever received any vaccination drops in the mouth to protect him/her from Polio?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

Don’t know .................................................................................. 8 IM11

IM9 Was the first polio vaccine received in the first two weeks after birth or later?

First 2 weeks ............................................................................. 1

Later ....................................................................................................... 2

IM10 How many times was the polio vaccine received?Number of times ...........................................................

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IM11 Has (name) ever received a Penta vaccination -- that is, an injection in the thigh to prevent him/her from getting tetanus, whooping cough, or diphtheria?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

Don’t know .................................................................................. 8 IM13

IM12 How many times was the Penta vaccine received?Number of times ...........................................................

IM13 A measles injection or and measles and rubella (MR) injection – that is, a shot in the arm at the age of 9 months or older – to prevent him/her from getting measles?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

Don’t know .................................................................................. 8 IM19

IM14 A measles injection – that is, a shot in the arm at the age of 15 months or older – to prevent him/her from getting measles?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

Don’t know .................................................................................. 8

IM19 Did (name) receive any polio vaccine from the National Immunization Days (NID)?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

Don’t know .................................................................................. 8 CP0

IM19A Please tell me if (name) has participated in any of the following campaigns, national immunization days and/or Vitamin A or child health days:

Yes No DK

Immunization day-1 .............

(Polio/Nov, 2015)

1 2 8

Immunization day-2 .............

(Polio/Apr, 2015) ......................

1 2 8

Immunization day-3 .............

(Polio/Nov, 2014) ....................

1 2 8

CONTRACEPTION CPCP0. Check MA6 (Marital status) and circle in

appropriate code.Currently married ............................................................ 1Widowed ........................................................................................ 2 Divorced .......................................................................................... 3 Separated ...................................................................................... 4Never married ....................................................................... 5

UF0

CP1. I would like to talk with you about another subject – family planning.

Are you pregnant now?

Yes, currently pregnant ......................................... 1

No ............................................................................................................... 2

Unsure/DK .................................................................................... 8

CP2A

CP2. Couples use various ways or methods to delay or avoid a pregnancy.

Are you or your husband currently doing something or using any method to delay or avoid getting pregnant?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

CP3

CP2A Have you or your husband ever done something or used any method to delay or avoid getting pregnant?

Yes ............................................................................................................ 1 No ............................................................................................................... 2

UN1

CP3. What are you or your husband doing to delay or avoid a pregnancy?

Do not prompt.

If more than one method is mentioned, circle each one.

Female sterilization ...................................................... AMale sterilization .............................................................. BIUD ........................................................................................................... CInjectables ................................................................................... DImplants ........................................................................................... EPill .............................................................................................................. FMale condom ......................................................................... GFemale condom ................................................................. HDiaphragm ..................................................................................... IFoam/Jelly ................................................................................... JLactational amenorrhoea method (LAM) ................................................................................................... KPeriodic abstinence/Rhythm ......................... LWithdrawal .............................................................................. MOther .................................................................................................... X

(Specify)

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UNMET NEED UNUN1 Interviewer: Check CP1 (Current pregnancy status)

and circle in appropriate code.Yes, currently pregnant ......................................... 1

No ............................................................................................................... 2

Unsure or DK ........................................................................... 8 UN5

UN2 Now I would like to talk to you about your current pregnancy.

When you got pregnant, did you want to get pregnant at that time?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

UN4

UN3 Did you want to have a baby later on or did you not want any (more) children?

Later ....................................................................................................... 1

No more ........................................................................................... 2

UN4 Now I would like to ask some questions about the future.

After the child you are now expecting, would you like to have another child, or would you prefer not to have any more children?

Have another child ......................................................... 1

No more/None ...................................................................... 2

Undecided/Don’t know ........................................... 8

UN7

UN13

UN13

UN5 Interviewer: Check CP3 (Currently using female sterilization) and circle in appropriate code.

Code A is circled ................................................................ 1

Code A is not circled ................................................... 2

UN13

UN6 Now I would like to ask you some questions about the future.

Would you like to have (a/another) child, or would you prefer not to have any (more) children?

Have (a/another) child .............................................. 1

No more/None ...................................................................... 2

Says she cannot get pregnant ................... 3

Undecided/Don’t know ........................................... 8

UN9

UN11

UN9

UN7 How long would you like to wait before the birth of (a/another) child?

Months ............................................................................ 1

Years .................................................................................. 2

Soon/Now ............................................................................. 993

Says she cannot get pregnant ...................... 994

After marriage ............................................................... 995

Other ............................................................................................. 996

Don’t know .......................................................................... 998

UN11

UN8 Interviewer: Check CP1 (Current pregnancy status) and circle in appropriate code.

Yes, currently pregnant ......................................... 1

No ............................................................................................................... 2

Unsure or DK ........................................................................... 8

UN13

UN9 Interviewer: Check CP2 (Currently using a method) and circle in appropriate code.

Code 1 is circled ................................................................. 1

Code 1 is not circled .................................................... 2

UN13

UN10 Do you think you are physically able to get pregnant at this time?

Yes ............................................................................................................ 1

No ............................................................................................................... 2

DK ............................................................................................................... 8

UN13

UN13

UN11 Why do you think you are not physically able to get pregnant?

Infrequent sex/No sex ............................................. A

Menopausal .............................................................................. B

Never menstruated ...................................................... C Hysterectomy (surgical removal

of uterus) ....................................................................................... D

Has been trying to get pregnant for

2 years or more without result .................. E

Postpartum amenorrheic .................................... F

Breastfeeding ........................................................................ G

Too old .............................................................................................. H

Fatalistic ............................................................................................. I

Other .................................................................................................... X

(Specify)

Don’t know .................................................................................. Z

UF0

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UN13 When did your last menstrual period start?

Record the answer using the same unit stated by the respondent.

Days ago ...................................................................... 1

Weeks ago ................................................................ 2

Months ago ............................................................. 3

Years ago .................................................................... 4

In menopause/has had hysterectomy .................. 994

Before last birth .......................................................... 995

For Children Under 5

UF0 Check household listing form column HL 6 and write the number of under 5 children in the household.

Number of under 5 children ...

No under 5 child ...................... 0 Go to CA14A & write the finishing time and thanks to responders and end interview

UF00 Interviewer: Have you collected the information of under 5 from another respondent?

Yes .................................................... 1

No ..................................................... 2

Go to CA14A & write the finishing time and thanks to responders and end interview

UF0A ENTER THE LINE NUMBER AND NAME IN THE TABLE FROM HOUSEHOLD LIST FORM COLUMN HL1 AND HL2 SINCE FEBRUARY 2011 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE CHILDREN. BEGIN WITH THE YOUNGEST CHILD. (IF THERE ARE MORE THAN 2 CHILDREN, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRE.)

UF0B Write the line number from HL1, name from HL2 and identify mother/caretaker from HL9.

Child name & line number:

......................................................

Mother/Caretaker name

& line number: ..................

Child name & line number:

......................................................

Mother/Caretaker name

& line number: .................. BR1 Does (name) have a birth

certificate?

If yes, ask: May I see it?

Yes, seen ...................................... 1

Yes, not seen ............................. 2

Skip to BR2A

No ..................................................... 3

DK ..................................................... 8

Yes, seen ...................................... 1

Yes, not seen ............................. 2

Skip to BR2A

No ..................................................... 3

DK ..................................................... 8BR2 Has (name)’s birth been registered

with the civil authorities?Yes .................................................... 1

No ..................................................... 2

DK ..................................................... 8

Yes .................................................... 1

No ..................................................... 2

DK ..................................................... 8BR2A Check HL6 and circle in

appropriate code.Age is 03 or 04 years ........... 1

Age is 00 or 01 or 02 years ...... 2

(Skip to CA1)

Age is 03 or 04 years ............. 1

Age is 00 or 01 or 02 years ...... 2

(Skip to CA1)

EC5. Does (name) attend any organized learning or early childhood education programme, such as a Government or private facility, including kindergarten or community child care or madrasha?

Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA1)

Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA1)

EC6 Within the last seven days, about how many hours did (name) attend? Number of hours ............. Number of hours .............

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CARE OF ILLNESSCA1. In the last two weeks, has (name)

had diarrhoea?Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA7)

Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA7)

CA2. I would like to know how much (name) was given to drink during the diarrhoea (including breastmilk).

During the time (name) had diarrhoea, was he/she given less than usual to drink, about the same amount, or more than usual to drink?

If less, probe:

Was he/she given much less than usual to drink, or somewhat less?

Much less ..................................... 1

Somewhat less ......................... 2

About the same ........................ 3

More ................................................ 4

Nothing to drink ....................... 5

Don’t know .................................. 8

Much less ..................................... 1

Somewhat less ......................... 2

About the same ........................ 3

More ................................................ 4

Nothing to drink ....................... 5

Don’t know .................................. 8

CA3 During the time (name) had diarrhoea, was he/she given less than usual to eat, about the same amount, more than usual, or nothing to eat?

If less, probe: Was he/she given much less than usual to eat or somewhat less?

Much less ..................................... 1

Somewhat less ......................... 2

About the same ........................ 3

More ................................................ 4

Stopped food ............................. 5

Never gave food ...................... 6

Don’t know .................................. 8

Much less ..................................... 1

Somewhat less ......................... 2

About the same ........................ 3

More ................................................ 4

Stopped food ............................. 5

Never gave food ...................... 6

Don’t know .................................. 8CA10A Did you seek advice or treatment

for the illness from any source?Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA4)

Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA4)

CA11A From where did you seek advice or treatment?

Probe: Anywhere else?

Circle all providers mentioned, but do not prompt with any suggestions.

Probe to identify each type of source.

If unable to determine if public or private sector, write the name of the place

....................................................................

(Name of places)

Public sector

Govt. hospital ..................... A Govt. health center ........... B Govt. health post ............... C Village health worker ..... D Mobile/outreach clinic .... EOther public ............................... H

(specify)

Private medical sector

Private hospital/clinic ........ I Private physician ............... J Private pharmacy .............. K Mobile clinic ......................... L NGO clinic/hospital ........ MOther private medical .......... O

(specify)

Other source

Relative/friend ..................... P Shop ......................................... Q Traditional practitioner .. ROther .............................................. X

(specify)

Public sector

Govt. hospital ..................... A Govt. health center ........... B Govt. health post ............... C Village health worker ..... D Mobile/outreach clinic .... EOther public ............................... H

(specify)

Private medical sector

Private hospital/clinic ........ I Private physician ............... J Private pharmacy .............. K Mobile clinic ......................... L NGO clinic/hospital ........ MOther private medical .......... O

(specify)

Other source

Relative/friend ..................... P Shop ......................................... Q Traditional practitioner .. ROther .............................................. X

(specify)

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CA4 During the episode of diarrhea, was (name) given to drink any of the following:

Read each item aloud and record response before proceeding to the next item.

[A] A fluid made from a special

saline packet called PACKET

SALINE (for example OR saline)?

[B] Rice based ORS packet for

diarrhea?

[C] Sugar and salt solution?

[D] Green coconut water?

[E] Rice water?

[F] Boiled rice water?

[G] Zinc syrup?

[H] Zinc tablets?

Yes No DK

Fluid from ORS

packet

1 2 8

Rice-based ORS

packet

1 2 8

Suger & salt

sulation

1 2 8

Green coconut

water

1 2 8

Rice water 1 2 8

Boiled rice water 1 2 8

Zinc syrup 1 2 8

Zinc tablets 1 2 8

Yes No DK

Fluid from ORS

packet

1 2 8

Rice-based ORS

packet

1 2 8

Suger & salt

sulation

1 2 8

Green coconut

water

1 2 8

Rice water 1 2 8

Boiled rice water 1 2 8

Zinc syrup 1 2 8

Zinc tablets 1 2 8

CA5 Was anything (else) given to treat the diarrhea?

Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA7)

Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA7)

CA6 What (else) was given to treat the diarrhea?

Probe: Anything else?

Record all treatment given. Write brand name(s) of all medicines mentioned.

....................................................................

(Name of medicine)

Pill/Syrup Antibiotic ............................... A Antimotility ........................... B Zinc ............................................ C Other pill or syrup (Not antibiotic, antimotility or zinc) .................................... G Unknown pill or syrup ... HInjection Antibiotic ................................ L Non-antibiotic .................... M Unknown injection ......... NIntravenous ................................ OHome remedy/herbal medicine ...................................... QOther .............................................. X (Specify)

Pill/Syrup Antibiotic ............................... A Antimotility ........................... B Zinc ............................................ C Other pill or syrup (Not antibiotic, antimotility or zinc) .................................... G Unknown pill or syrup ... HInjection Antibiotic ................................ L Non-antibiotic .................... M Unknown injection ......... NIntravenous ................................ OHome remedy/herbal medicine ...................................... QOther .............................................. X

(Specify)

CA7 At any time in the last 2 weeks, has (name) had an illness with a cough?

Yes .................................................... 1No ..................................................... 2 Don’t know .................................. 8

(Skip to CA14)

Yes .................................................... 1No ..................................................... 2 Don’t know .................................. 8

(Skip to CA14)

CA8 When (name) had an illness with a cough, did he/she breathe faster than usual with short, rapid breaths or have difficulty breathing?

Yes .................................................... 1No ..................................................... 2 Don’t know .................................. 8

(Skip to CA14)

Yes .................................................... 1No ..................................................... 2 Don’t know .................................. 8

(Skip to CA14)

CA9 Was the fast or difficult breathing due to a problem in the chest or to a blocked or runny nose?

Problem in chest only ........... 1Blocked or runny nose only .... 2

(Skip to CA14)Both ................................................. 3Other ............................................... 6

(Specify)(Skip to CA14)

Don’t know .................................. 8

Problem in chest only ........... 1Blocked or runny nose only .... 2

(Skip to CA14)Both ................................................. 3Other ............................................... 6

(Specify)(Skip to CA14)

Don’t know .................................. 8

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CA10 Did you seek advice or treatment for the illness from any source?

Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA12)

Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA12)

CA11 From where did you seek advice or treatment?

Probe: Anywhere else?

Circle all providers mentioned, but do not prompt with any suggestions.

Probe to identify each type of source.

If unable to determine if public or private sector, write the name of the place

....................................................................

(Name of places)

Public sector

Govt. hospital ..................... A Govt. health center ........... B Govt. health post ............... C Village health worker ..... D Mobile/outreach clinic .... EOther public ............................... H

(specify)

Private medical sector

Private hospital/clinic ........ I Private physician ............... J Private pharmacy .............. K Mobile clinic ......................... L NGO clinic/hospital ........ MOther private medical ........ O

(specify)

Other source

Relative/friend ..................... P Shop ......................................... Q Traditional practitioner .. ROther .............................................. X

(specify)

Public sector

Govt. hospital ..................... A Govt. health center ........... B Govt. health post ............... C Village health worker ..... D Mobile/outreach clinic .... EOther public ............................... H

(specify)

Private medical sector

Private hospital/clinic ........ I Private physician ............... J Private pharmacy .............. K Mobile clinic ......................... L NGO clinic/hospital ........ MOther private medical ........ O

(specify)

Other source

Relative/friend ..................... P Shop ......................................... Q Traditional practitioner .. ROther .............................................. X

(specify)

CA12 Was (name) given any medicine to treat this illness?

Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA14)

Yes .................................................... 1

No ..................................................... 2

Don’t know .................................. 8

(Skip to CA14)

CA13 What medicine was (name) given?

Probe: Any other medicine?

Circle all medicines given. Write brand name(s) of all medicines mentioned.

....................................................................

(Name of medicines)

Antibiotic

Pill/Syrup ............................... A Injection .................................. BAnti-malarials .......................... MParacetamol/panadol/

acetaminophen ......................... PAspirin ........................................... QIbuprofen ...................................... ROther .............................................. X

(Specify)

Don’t know .................................. Z

Antibiotic

Pill/Syrup ............................... A Injection .................................. BAnti-malarials .......................... MParacetamol/panadol/

acetaminophen ......................... PAspirin ........................................... QIbuprofen ...................................... ROther .............................................. X

(Specify)

Don’t know .................................. ZCA14 Go back to UF0B in next column;

or if no more birth, write the finishing time and go to AN0.

Go back to UF0B and use last column of additional sheet; or if no more birth, write the finishing time and go to AN0.

CA14A Hour Minute

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ANTHROPOMETRY

After questionnaires for all children are complete, the measurer weighs and measures each child. Record weight and length/height below, taking care to record the measurements on the correct questionnaire for each child. Check the child’s name and line number on the household listing before recording measurements.

AN0. Write the child’s line number from HL1 and name from HL2. Name: ..................................... Name: .....................................

AN0A Starting time: Hour Minute Hour Minute

AN1. Measurer’s name and code:Name: ............................... Name: ...............................

AN2 Result of height/length and weight measurement.

Either or both measured ..... 1

Child not present ..................... 2

Child or mother/caretaker refused ........................................... 3

Other ............................................... 6

(Specify)(Skip to AN6)

Either or both measured ..... 1

Child not present ..................... 2

Child or mother/caretaker refused ........................................... 3

Other ............................................... 6

(Specify)(Skip to AN6)

AN3 Child’s weight (in kilogram)Record in appropriate box.

Kilograms (kg) ......... .

Weight not measured .... 99.9

Kilograms (kg) ......... .

Weight not measured .... 99.9

AN4 Child’s length or height (in centimeter).Record in appropriate box. Child under 2 years old Measure length (lying down) Child aged 2 or more years Measure height (standing up)

Length (cm)Lying down ........ 1 .

Height (cm)Standing up ....... 2 .

Length/height not measured ......................................... 9999.9

Length (cm)Lying down ......... 1 .

Height (cm)Standing up ........ 2 .

Length/height not measured ............................................ 9999.9

AN6 Is there another child in the household who is eligible for measurement

Yes .................................................

Write the ending time then Measurement for next child

No ..................................................

Yes .................................................

Write the ending time then Measurement for next child

No ..................................................

AN7 Ending time Hour Minute Hour Minute

CHECK THAT ALL QUESTIONS ARE COMPLETED AND THANK RESPONDENT.

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Interviewer’s Observations

Field Editor’s Observations

Supervisor’s Observations

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Page 239: 1* 6859(< ,1 85%$1 $5($6 2) %$1*/$'(6+ - UNICEF

The Coverage Report is jointly produced by Implementing, Monitoring and Evaluation Division, Ministry of Planning, Bangladesh Bureau of Statistics (BBS); Bangladesh Institute of Development Studies (BIDS); and UNICEF under a Memorandum of Understanding between IMED and BIDS. Many people from the following organizations contributed to the assignment in conceptualizing, analyzing and preparing the report:

Implementing, Monitoring and Evaluation (IMED)

Md. Mofizul Islam, Secretary in Charge, IMED; Kazi Jahangir Alam, former Director General, Education and Social Sector, IMED.

Bangladesh Bureau of Statistics (BBS)

Md. Amir Hossain, Director General, Bangladesh Bureau of Statistics (BBS); AKM Ashraful Haque, Project Director, SVRS, BBS.

Bangladesh Institute of Development Studies (BIDS)

Mohammad Yunus, Senior Research Fellow; Md. Mainul Haque, Research Fellow.

General Economic Division

Professor Shamsul Alam, Member, General Economic Division (GED), Planning Commission, Government of Bangladesh.

UNICEF Bangladesh

Carlos Acosta Bermúdez, Chief, Social Policy, Evaluation Analytics and Research (SPEAR) Section; Shantanu Gupta, Monitoring and Evaluation Specialist; Md. Azizur Rahman, Social Policy Specialist, Mashiur Rahman Khan, Knowledge Management Officer.

AC

KN

OW

LED

GEM

ENT

S ACKNOWLEDGEMENTS

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ТАНИЛЦУУЛГА 1 - UNICEF

ТАНИЛЦУУЛГА 1 - UNICEF

STANDARD OPERATING PROCEDURE - UNICEF - UNICEF Home

STANDARD OPERATING PROCEDURE - UNICEF - UNICEF Home

$66(660(17 2) 352)(66,21$/ &203(7(1&( %8,/',1* 6859(

$66(660(17 2) 352)(66,21$/ &203(7(1&( %8,/',1* 6859(

No. 1, 2012 - Unicef

No. 1, 2012 - Unicef

Oct 23 CCYHC Symposium - UNICEF document 1

Oct 23 CCYHC Symposium - UNICEF document 1

South Sudan - UNICEF · UNICEFWFP CLEUP NURIION PLN 1 YER REPORT OUH UDN UNICEF . WFP JULY 2015. 1. unite for children. South Sudan. UNICEF and …

South Sudan - UNICEF · UNICEFWFP CLEUP NURIION PLN 1 YER REPORT OUH UDN UNICEF . WFP JULY 2015. 1. unite for children. South Sudan. UNICEF and …

6859(< 21 7+( 86( 2) *(2 7$**(' 3+2726 ,1 &DWDORQLD (6 · 6859(

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UNICEF ျမန္မာျပည္မွ unicef

UNICEF ျမန္မာျပည္မွ unicef

Dr. Robert M. Mark Bmark.blackdiamond@tmo.blackberry 925 299 6859

Dr. Robert M. Mark [email protected] 925 299 6859

5$',2 0$5.(7 6859(< 3238/$7,21 5$1.,1*6 ,1)250$7,21 · 2020. 4. 22. · 5$',2 0$5.(7 6859(< 3238/$7,21 5$1.,1*6 ,1)250$7,21²635,1* &rs\uljkw 7kh 1lhovhq &rpsdq\ 86 //& $oo uljkwv

5$',2 0$5.(7 6859(< 3238/$7,21 5$1.,1*6 ,1)250$7,21 · 2020. 4. 22. · 5$',2 0$5.(7 6859(< 3238/$7,21 5$1.,1*6 ,1)250$7,21²635,1* &rs\uljkw 7kh 1lhovhq &rpsdq\ 86 //& $oo uljkwv

Module 1 UNICEF Principles for the Planning, Contracting andUNICEF/Skat Foundation (2018) Module 1: UNICEF Principles for Planning, Contracting and the Management of Boreholes In UNICEF/Skat

Module 1 UNICEF Principles for the Planning, Contracting andUNICEF/Skat Foundation (2018) Module 1: UNICEF Principles for Planning, Contracting and the Management of Boreholes In UNICEF/Skat

5 7 7 , 1 0 8 - UNICEF

5 7 7 , 1 0 8 - UNICEF

UNICEF Authorization for Direct Deposit · UNICEF Authorization for Direct Deposit of MPO Form UNICEF (12/11) 1. I hereby advise UNICEF of my banking preferences and currency distribution.

UNICEF Authorization for Direct Deposit · UNICEF Authorization for Direct Deposit of MPO Form UNICEF (12/11) 1. I hereby advise UNICEF of my banking preferences and currency distribution.

KUWAIT - UNICEF - UNICEF Home

KUWAIT - UNICEF - UNICEF Home

Hotel Directory 2010 - UNICEF - UNICEF Home

Hotel Directory 2010 - UNICEF - UNICEF Home

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21*,78',1$/ 60$// %86,1(66 6859(

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GENDER MAINSTREAMING SELF-ASSESSMENT - UNICEF - UNICEF Home

GENDER MAINSTREAMING SELF-ASSESSMENT - UNICEF - UNICEF Home

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UNICEF COOPERATION IN INDIA DR.S.K. CHATURVEDI UNICEF.

UNICEF COOPERATION IN INDIA DR.S.K. CHATURVEDI UNICEF.