Multi Indicator Cluster Survey (MICS) 2005

November 30, 2007

What Is MICS ?Multiple Indicator Cluster Survey

Household survey developed by UNICEF in 1990’s.

It assists countries in filling data gaps for monitoring human development, especially the situation of women and children.

What is MICS Cont’d

Many countries were involved in each round,

using common questionnaire modules.

Facilitates the production of comparable estimates of indicators.

It uses international definitions of indicators.

What is MICS Cont’d

Jamaica is among :

the 191 signatories to the Millennium Development Goals (MDG).

the 189 member states who adopted the Plan of Action of A World Fit For Children.

What is MICS Cont’d

Round 1 - 1995 No Jamaica

Round 2 - 2000 Jamaica but no official report

Round 3 - 2005 Jamaica and here we are!

OBJECTIVES

To provide up-to-date information for assessing the situation of children and women in Jamaica;To furnish data for monitoring progress toward goals established by the MDG, A World Fit For Children (WFFC), and other internationally agreed upon goals;To contribute to the improvement of data and monitoring systems in Jamaica

Survey Management

A Steering Committee was formed with representatives from:

UNICEF UNFPA UNAIDS STATIN

UNDP PAHO PIOJ ECC Cabinet Office

MOH MOEY SALISES CCDC

Survey Management cont’d

Survey coordination and implementation was done by STATIN through the Special Projects

and Field Services Divisions.

Questionnaires

The survey instrument consisted of three questionnaires:

HouseholdWoman (15-49 yrs)Child (0-4 yrs) .

Household Questionnaire

Modules included:– Household Information Panel– Household Listing– Education– Child Labour– Orphaned and Vulnerable Children– Water and Sanitation– Child Discipline– Child Disability– Salt Iodization

Women’s Questionnaire

Modules Included:– Basic Characteristics– Child Mortality– Tetanus Toxoid immunisation– Maternal and Newborn Health– Marriage/Common-law unions– Attitudes Toward Domestic Violence– HIV/AIDS

Child Questionnaire

Modules included:– Information Panel– Birth Registration and Early Learning– Child Development– Breastfeeding– Occurrence and treatment of Illness– Immunization

Sample SelectionParish No. of

PSU No. of

dwellings Kingston 20 360 St. Andrew 110 990 St. Thomas 20 360 Portland 16 336 St. Mary 22 330 St. Ann 30 360 Trelawny 14 336 St. James 34 408 Hanover 14 336 Westmoreland 28 336 St. Elizabeth 28 336 Manchester 36 432 Clarendon 44 528 St. Catherine 92 828 Total 508 6,276

Training of Field Staff

Training included: interviewing techniques the questionnaires mock interviews between trainees interviewing practice. These practice interviews were

conducted in areas close to the training centres. Trainees were tested, and based on the test results, observation and participation in the training sessions,83 persons were offered employment on the project.

Field Work

Field work began October 10, 200513 Supervisors 70 Interviewers and Field Editors

Problems during field work

Adverse weatherViolence in some sections of Kingston, St. Andrew and St. Catherine. Interviewers were forced to leave some EDs.Vacant dwellingsUpper income communities that have gated communities and to which access was not granted by security personnel.

Data Processing

Data was manually edited and keyed into the computer using the CSPro software

7 Data Entry Operators 2 Data Entry Supervisors

Computer edits were doneProcess lasted from November 2005 – March 2006

Data analysis

Done in SPSS ver. 14.0 by STATIN

Using syntaxes prepared by UNICEF

Rigorous process

Response Rate Total

Number of households Sampled 6250 Occupied 5604 Interviewed 4767 Response rate 85.1 Number of women Eligible 3777 Interviewed 3647 Response rate 96.6 Overall response rate 82.1 Number of children under 5 Eligible 1444 Mother/Caretaker interviewed 1427 Response rate 98.8

FINDINGS

Child mortality

The infant mortality rate is the probability of dying before the first birthday. The under-five mortality rate is the probability of dying before the fifth birthday.

Based on an indirect estimation technique known as the Brass method

Child mortality

Infant mortality – 26 per 1000

Under 5 mortality – 31 per 1000

Mortality higher among children of women with low levels of education

Trend in Under-5 Mortality Rates,

Jamaica, 2005

05

101520

253035

4045

1982 1986 1990 1994 1998 2002 2006

Year

Per

1,0

00

MICS2000 MICS2005

Breastfeeding

Exclusive breastfeeding 0-5mths 15.2%

Complementary feeding at6-9mths.

35.6%

Continued breastfeeding at12-15mths

49.1%

Continued breastfeeding at 20-23mths.

24.0%

Percent distribution of children aged under 3 years by feeding pattern by age group, Jamaica, 2005

0

10

20

30

40

50

60

70

80

90

100

0-1

2-3

4-5

6-7

8-9

10-1

1

12-1

3

14-1

5

16-1

7

18-1

9

20-2

1

22-2

3

24-2

5

26-2

7

28-2

9

30-3

1

32-3

3

34-3

5

Age (in Months)

Per

cen

t

Weaned (not breastfed)

Breastfed and complementaryfoodsBreastfed and other milk/ formula

Breastfed and non-milk liquids

Breastfed and plain water only

Exclusively breastfed

Breastfeeding cont’dFigure NU.1

Percentage of mothers who started breastfeeding within one hour and within one day of birth, Jamaica, 2005

82.287.4

83.4 8587.9

81.7

91.9

84.3 83.1

61.965.9 66.4

57.2

67.5 65.2

58.1

73.3

62.6 60.1

41.6

0

10

20

30

40

50

60

70

80

90

100

KMA OtherUrban

Rural < 6 months 6-11 months 12-23months

Primary Secondary Higher Non-standardcurriculum

Per

cent

Within one day Within one hour

Birth Weight

Majority of birth occur in hospitals

97% of babies were weighed at birth

Approx 12% weighed less than 2500 gms

Immunization

Overall, more than 70 % of children had immunization cards.

If the child did not have a card, the mother was asked to recall whether or not the child had received BCG, Polio, DPT or measles vaccination .

Percentage of children aged 18-29 months who received the recommended vaccinations by 12 months (and by 18 months for

measles), Jamaica, 2005

94.3 91.4 90.9

81.5

95.7 93.1

80.186.8

62.9

0

10

20

30

40

50

60

70

80

90

100

BCG DPT1 DPT2 DPT3 Polio1Polio2Polio3 Measles All

Per

cen

t

CHILD HEALTH

During the two weeks preceding the survey2.4% had diarrhoea6.5% had symptoms of pneumonia75% were taken to an appropriate provider Amoxil was the antibiotic of choice

23% of women knew of the two danger signs of pneumonia

Water and Sanitation

Water Use of improved drinking water sourcesUse of adequate water treatment methodTime to source of drinking waterPerson collecting drinking water

Sanitation Use of improved sanitation facilitiesSanitary disposal of child’s faeces

Water and Sanitation

Use of improved drinking water sources - 93.5%

97 % in urban areas88 % in rural areas

53% used water treatment method

.

Water and Sanitation cont’dPercentage distribution of household members by source of drinking

water Jamaica, 2005

68%8%

1%

16%

3%

1%

3%

Piped into dwelling, yardor plotPublic tap/standpipe

Protected well/spring

Other improved

Unprotected well or spring

Surface water

Other unimproved

Water and Sanitation cont’d

97% live in households using improved sanitation facilities

Flush toilets most common in urban areas

Pit latrines most common in rural areas

Water and Sanitation cont’d

36% of children diapers were properly disposed.

56% thrown directly into garbage.

Reproductive Health

91% of women received antenatal care from skilled personnel at least once during pregnancy

The doctor was the main provider (57.8%)Then Nurse / midwife (32.7%)

Over 95% of women had blood and urine samples taken during pregnancy

Reproductive Health cont’d

97% of births were delivered by skill personnel

56% assisted by nurse / midwife

41% assisted by doctors

Child Development

86% of children under 5 had an adult household member who engaged in activities that promote learning and school readiness

Fathers involvement was only 41%

51% of children were living without their fathers

Child Development cont’d

3% of children age 0 – 59 months were left in care of other children under 10 yrs

1% of children were left alone

Education

Pre-school Attendance 86% of children attended pre-school 89% urban 81% from rural areas

94% of children 48 - 59 months attended pre-school.

Education cont’d

97.4% attended primary school

Attendance increased with age from 89.7% among children 6 years to 99.3% among 11 year oldTransition to secondary school almost universal

Education cont’d

At the secondary levelAttendance was lower among boys (89 %) than

among girls (93 %).

Higher levels of attendance among children whose mothers have a higher level of education.

Education - Distance from school

Primary 97% lived less than 5 miles 68% lived within a mile

Secondary 86% lived less than 5 miles 42% lived within a mile

11 % of rural lived within one mile 4 % in KMA lived within one mile

Child Protection

Birth Registration 89% of children under 5 were registeredOf those not registered 57% owed hospital fees 32% said too costly to register

Child Labour - Definition

Ages 5-11: at least one hour of economic work or 28 hours of domestic work per week.

Ages 12-14: at least 14 hours of economic work or 28 hours of domestic work per week.

Child Labour

Children 5 -11 yrs - 7.9%

Children 12-14 yrs - 2.3%

More males -7 % than females - 5 %

Child Discipline

Psychological aggression -If child was shouted, yelled or screamed at and/or called dumb, lazy or other such nameMinor physical punishment – If child was shaken, spanked, hit or slapped on bottom with bare hand and/or hit anywhere on the body with a hard instrument and/or hit/slapped on arm, leg or handSevere physical punishment - If child is hit/slapped on the face, head or ears and/or beat with an instrument over and over as hard as one could.

Child Discipline

87% of children 2 – 14 were subjected to at least one form of psychological or physical punishment

8% were subjected to severe physical punishment

Women with higher educational levels used non-violent discipline and less to psychological and minor physical punishment than women with lower levels education.

Child Discipline (cont.d)

Minor Severe

Males 75 10

Females 71 5

Domestic Violence

6.1% of women felt that a husband or male partner was justified in beating his wife for at least one reason

The most popular reason was if the woman neglected her children

Child Disability - 2-9 years

Most Common Disabilities Reported. Not understanding instructions - 4.9% Dull or slow - 4.7% Not Speaking - 3.9%

HIV/AIDS, and orphaned and vulnerable children

69% of women knew three main ways of preventing HIV 83% knew about one faithful partner 89% knew about using a condom 87% knew about abstaining

HIV cont’dPercent of women who have comprehensive knowledge of HIV/AIDS

transmission, Jamaica, 2005

65

7580

75

51

72

57

74

35

57

6758

0

10

20

30

40

50

60

70

80

90

Primary Secondary Higher Jamaica

Perc

ent

Knows 2 ways to prevent HIV Identify 3 misconceptions Comprehensive knowledge

HIV cont’d

During Antenatal Care 83% received information about HIV

prevention 90% have tested for HIV 84% have received result

Conclusion

Health status of women and children good

Need to improve vital registration especially for infant and young child deaths

Young children need to be protected from child labour whether inside or outside the home

Need to decrease the levels of social inequality as measured by the educational levels of women as these influence attitudes and behaviours e.g. child discipline, domestic violence