39471 SOCIO-ECONOMIC DIFFERENCES IN HEALTH, NUTRITION, AND POPULATION TANZANIA 1996, 1999, 2004 Davidson R. Gwatkin, Shea Rutstein, Kiersten Johnson, Eldaw Suliman, Adam Wagstaff, and Agbessi Amouzou TABLE OF CONTENTS Foreword I Introduction III Part I. Basic Tables, 2004 1 A. Total Population 3 B. Female and Male Populations 9 C. Rural and Urban Populations 13 Part II. Basic Tables, 1999 19 A. Total Population 21 B. Female and Male Populations 27 C. Rural and Urban Populations 31 Part III. Basic Tables, 1996 37 A. Total Population 39 B. Female and Male Populations 45 C. Rural and Urban Populations 49 Part IV. Technical Notes 55 A. Indicator Definitions 57 B. Data and Methods 71 C. Discussion 75 Part V. Supporting Tables, 2004 81 A. Sample Sizes 83 B. Standard Errors 89 C. Asset Distribution and Weights 95 Part VI. Supporting Tables, 1999 97 A. Sample Sizes 99 B. Standard Errors 105 C. Asset Distribution and Weights 111 Part VII. Supporting Tables, 1996 113 A. Sample Sizes 115 B. Standard Errors 121 C. Asset Distribution and Weights 127 Part VIII. Annexes 129 A. Sources of Additional Information 131 B. Use of Information from this 133 Report to Monitor the Economic Status of People Served by HNP Programs C. Countries Covered by the 141 HNP-Poverty Report Project FOREWORD The World Bank shares the desire of its member states and client countries to ensure that the poor partake fully in the health gains that the countries achieve. To assist in this, the Bank, in cooperation with the Dutch and Swedish Governments, has sponsored the set of reports providing basic information about health inequalities within countries to which this document belongs. The information shows clearly that disparities in both health conditions and health service use are unacceptably large. As countries and the Bank work to reduce important inequalities among regions and countries, there is a clear need for equally vigorous efforts to lessen the inequity represented by intra-country differences among socio-economic groups. My colleagues and I hope that all concerned with equity in health will find this information useful in making the case for effective actions to improve the health of the poor, and in designing programs to achieve this crucial objective. Joy Phumaphi Vice President Human Development Network The World Bank - I - INTRODUCTION This report is one in a series that provides basic information about health, nutrition, and population (hnp) inequalities within fifty-six developing countries. The series to which the report belongs is an expanded and updated version of a set covering forty- five countries that was published in 2000. The fifty-six reports in the current series cover almost all DHS surveys undertaken during the period beginning in 1990 and ending with the date of the last survey for which data were publicly available as of June 2006.1 The report's contents are intended to facilitate preparation of country analyses and the development of activities to benefit poor people. To this end, the report presents data about hnp status, service use, and related matters among individuals belonging to different socio-economic classes. The principal focus is on differences among groups of individuals defined in terms of the wealth or assets of the households where they reside. The source of data is the Demographic and Health Survey (DHS) program, a large, multi-country household survey project. The figures in this and the other reports in the series draw on responses to questions about household wealth or assets included in the DHS questionnaire, which were similar for all the surveys covered. These responses served as the basis for the construction of a wealth index, which was used to rank individuals according to the index value for the household to which they belonged. The individuals were then divided into quintiles, and the mean value for each of up to approximately 120 indicators was calculated for each quintile. The report is organized in four principal parts: · Parts one, two, and three, which constitute the report's core, consist of tables presenting quintile-specific data for each hnp indicator covered from the two most recent DHS surveys available at the time of the report's publication. In each part there are three sets of tables: the first provides quintile-specific information for the total population; the second presents data separately for quintiles of females and males; the third features quintile-specific information presented separately for rural and urban residents. Each of these sets is divided into four sections: one dealing with hnp status, the second with the use of hnp services, the third with hnp-related behavior, and the fourth with other hnp status determinants. · Part four provides supplementary technical information designed to help readers understand the data presented in the three previous parts. This information deals with such issues as how the covered hnp indicators were defined and how the quintile-specific estimates were derived. · Parts five, six, and seven present supporting tables that deal with three of the technical matters covered in part four: the size of the sample for each indicator covered; the 1The average interval of approximately two years between data collection and availability means that the latest surveys covered were conducted in 2005. III standard error for each quintile-specific estimate in the total population; and the items used in constructing the wealth index, along with the weight assigned to each. An additional, eighth part consists of three annexes, for readers interested in applying the approach used in the report or in learning more about the other reports in this series. The first annex is an annotated bibliography containing further information about the technical issues concerning the approach used in the report, and about employing that approach to examine additional issues using DHS or other data sets. The second shows how the report's approach can be applied to monitor the distribution of benefits from other hnp programs, and provides a tool for doing so. The third annex is a list of all fifty-six countries for which reports are available, along with an indication of how to obtain copies of the reports dealing with them. ********************************* The authors thank the Dutch and Swedish Governments for the generous support that made production of this report possible. IV PART I. BASIC TABLES, 2004 A. TOTAL POPULATION B. FEMALE AND MALE POPULATIONS C. RURAL AND URBAN POPULATIONS Notes: ­ Each of the three sections referred to above consists of four divisions, presenting data for: I) hnp status; II) hnp service use; III) hnp-related individual and household behavior; and IV) other, underlying determinants of hnp status. ­ Full definitions of all indicators covered in the tables are provided in section A of the technical notes found in part II. ­ "na" appears in the table cells when data are not available, usually because the DHS survey concerned did not collect information about the indicator(s) in question. ­ Figures in the tables shown within parentheses indicate the absence of adequate observations to produce acceptably reliable values. Asterisks appear when the number of observations was too small to justify the presentation even of figures within parentheses. (For further information, see the section on "Sampling Errors" in the presentation of data and methods in part II.B.) Asterisks also will be found in columns showing statistical indices of inequality when the amount of quintile-specific information available is inadequate to permit computation of the value for the index concerned. ­ Female/male tables include only indicators relevant for both sexes; those pertaining to only one sex (e.g., fertility, women's nutritional status, antenatal care, attended deliveries) have been omitted. Tanzania 2004 - TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood illness and mortality Infant mortality rate 88.0 97.1 87.8 69.8 64.2 82.5 1.37 23.76 -0.0674 0.0267 Under-five mortality rate 137.3 156.0 146.8 117.4 93.3 132.2 1.47 43.96 -0.0673 0.0405 Prevalence of fever 25.8 25.7 23.5 24.2 22.5 24.5 1.15 3.28 -0.0252 0.0122 Prevalence of diarrhea 13.3 14.2 12.1 13.2 9.4 12.6 1.41 3.89 -0.0487 0.0174 Prevalence of acute respiratory 8.9 7.5 8.3 8.3 7.3 8.1 1.23 1.65 -0.0196 0.0229 infection (ARI) B. Fertility Total fertility rate 7.3 6.7 6.6 5.3 3.3 5.7 2.23 4.05 -0.1435 0.0511 Adolescent fertility rate 172.5 159.2 163.8 129.2 71.4 132.5 2.42 101.18 -0.1597 0.0611 C. Nutritional status (%) Children: Moderate stunting 27.7 26.9 27.3 26.5 11.4 24.8 2.43 16.32 -0.0954 0.0113 Severe stunting 17.2 14.7 12.5 10.3 3.7 12.3 4.70 13.57 -0.2150 0.0178 Moderate underweight 20.3 20.8 18.5 16.8 10.9 17.9 1.86 9.42 -0.1006 0.0146 Severe underweight 5.0 5.0 3.9 2.9 0.6 3.7 8.09 4.40 -0.2466 0.0336 Mild anemia 22.0 25.4 22.8 26.7 27.2 24.6 0.81 5.14 0.0459 0.0127 Moderate anemia 50.0 44.4 44.5 37.3 32.6 42.5 1.53 17.34 -0.0639 0.0082 Severe anemia 5.3 5.0 4.3 2.6 2.4 4.0 2.24 2.92 -0.1668 0.0310 Women: Malnutrition 11.3 10.8 10.0 8.7 7.2 9.4 1.57 4.13 -0.0830 0.0195 Mild anemia 36.5 35.5 31.8 28.4 29.6 32.1 1.23 6.91 -0.0276 0.0087 Moderate anemia 14.0 14.2 13.3 12.6 15.3 14.0 0.91 1.32 0.0028 0.0143 Severe anemia 1.6 1.3 0.9 0.6 1.2 1.1 1.32 0.38 -0.0659 0.0581 D. Female circumcision (%) Prevalence of circumcision: Girls 10.8 9.3 5.9 4.0 1.1 5.7 10.28 9.76 -0.4096 0.0370 Women 20.5 18.4 16.3 12.8 7.8 14.6 2.63 12.68 -0.2163 0.0143 Prevalence of occlusion: Girls 1.6 0.0 (5.4) 0.0 * 2.4 * * * * Women 1.0 1.2 1.8 1.8 5.4 2.0 0.19 4.39 0.2160 0.1143 E. Sexually transmitted disease Prevalence of genital discharge: Women 3.3 2.6 3.3 3.4 3.8 3.3 0.86 0.53 -0.0184 0.0294 Men 1.7 2.8 1.5 3.8 0.8 2.1 1.98 0.83 -0.0918 0.0671 Prevalence of genital ulcer: Women 1.9 2.0 1.7 1.8 1.5 1.8 1.24 0.37 -0.0879 0.0400 Men 1.8 2.4 4.7 4.2 1.2 2.8 1.57 0.67 -0.0476 0.0501 - 3 - Tanzania 2004 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood immunization BCG coverage 86.7 90.4 91.2 93.7 96.8 91.2 0.89 10.18 0.0207 0.0042 Measles coverage 64.6 78.7 81.1 89.6 90.8 79.7 0.71 26.14 0.0588 0.0071 DPT coverage 33.6 35.2 33.9 36.9 36.5 35.1 0.92 2.90 -0.0176 0.0191 Full basic coverage 26.6 30.3 29.6 31.7 29.3 29.4 0.91 2.68 -0.0049 0.0213 No basic coverage 7.7 5.1 3.8 2.3 2.4 4.5 3.20 5.28 -0.2309 0.0656 Hepatitis B coverage na na na na na na na na na na Yellow fever coverage na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 51.0 59.5 53.4 54.2 76.3 57.6 0.67 25.30 0.0682 0.0117 Treatment in a public facility 46.9 53.9 44.9 46.2 54.2 48.9 0.87 7.30 0.0217 0.0147 Treatment in a private facility 4.0 5.6 8.6 8.1 22.1 8.7 0.18 18.01 0.3305 0.0513 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 52.3 61.0 65.2 55.3 67.1 59.4 0.78 14.81 0.0543 0.0189 Treatment in a public facility 45.6 60.1 55.9 49.7 50.6 52.1 0.90 5.01 0.0288 0.0226 Treatment in a private facility 6.7 0.9 9.2 5.6 16.5 7.3 0.41 9.81 0.2365 0.0933 Treatment of diarrhea: Use of oral rehydration therapy 65.6 70.6 71.4 67.5 80.1 70.0 0.82 14.42 0.0141 0.0127 Medical treatment of diarrhea 45.3 52.8 47.8 37.1 54.9 47.0 0.83 9.55 -0.0055 0.0197 Treatment in a public facility 40.7 47.8 37.9 31.2 34.7 39.2 1.17 6.01 -0.0459 0.0226 Treatment in a private facility 3.1 3.7 9.3 3.7 20.2 6.6 0.15 17.11 0.2724 0.0735 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 90.6 93.8 95.4 95.3 96.7 94.3 0.94 6.03 0.0151 0.0019 To a doctor 1.1 1.3 1.3 2.1 5.2 2.1 0.21 4.08 0.3288 0.0621 To a nurse or trained midwife 89.6 92.6 94.1 93.2 91.5 92.2 0.98 1.95 0.0078 0.0024 Multiple visits to a medically-trained person 80.2 85.5 85.3 88.3 91.3 86.0 0.88 11.09 0.0275 0.0031 Antenatal care content: Tetanus toxoid 78.0 78.5 75.2 81.6 86.1 79.7 0.91 8.09 0.0076 0.0039 Prophylactic antimalarial treatment 44.7 44.9 46.2 53.9 56.5 49.0 0.79 11.86 0.0273 0.0076 Iron supplementation 59.3 64.3 58.5 59.5 64.1 61.1 0.93 4.76 -0.0005 0.0062 Delivery attendance: By a medically-trained person 31.0 35.7 37.6 53.4 86.8 46.3 0.36 55.78 0.1884 0.0067 By a doctor 1.4 2.3 2.9 3.9 11.3 3.9 0.12 9.95 0.2629 0.0335 By a nurse or trained midwife 29.6 33.4 34.7 49.5 75.5 42.4 0.39 45.83 0.1816 0.0074 In a public facility 25.6 30.1 28.7 42.6 73.0 37.8 0.35 47.44 0.1986 0.0083 In a private facility 6.5 6.6 10.2 11.3 13.4 9.3 0.48 6.89 0.0923 0.0195 At home 67.5 63.1 61.1 46.1 13.3 52.7 5.08 54.26 -0.1582 0.0060 D. Contraceptive services Contraceptive prevalence: Women 10.7 12.8 15.6 24.1 36.0 20.0 0.30 25.31 0.1856 0.0136 Men 17.3 23.4 22.7 29.8 36.3 25.7 0.48 19.05 0.0908 0.0241 - 4 - Tanzania 2004 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors D. Contraceptive services (cont.) Source of contraception - public sector: Women 78.1 79.6 75.5 73.7 67.0 72.7 1.17 11.08 -0.0255 0.0091 Men na na na na na na na na na na Source of contraception - private sector: Women 14.9 15.5 22.6 22.4 31.8 24.3 0.47 16.87 0.1075 0.0258 Men na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 57.1 48.3 65.6 64.6 60.3 59.5 0.95 3.20 0.0283 0.0211 Men na na na na na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women 43.3 43.3 49.1 47.9 40.1 44.4 1.08 3.16 -0.0039 0.0300 Men na na na na na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 5.7 6.4 8.0 13.1 29.4 13.7 0.19 23.72 0.2803 0.0144 Men 8.1 8.2 10.9 14.6 23.9 13.6 0.34 15.82 0.2205 0.0309 - 5 - Tanzania 2004 - TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Hygienic practices Disposal of children's stools: Sanitary disposal 56.5 70.3 72.2 84.9 92.3 74.6 0.61 35.72 0.0853 0.0045 Handwashing: Wash hands prior to preparing food na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership 26.7 31.5 37.0 50.1 81.8 46.4 0.33 55.14 0.2346 0.0055 Treated bednet ownership 2.5 4.9 9.0 13.6 40.4 14.2 0.06 37.97 0.4000 0.0077 Bednet use: By children 17.8 24.1 28.2 40.0 71.3 33.9 0.25 53.52 0.2730 0.0092 By pregnant women 12.8 20.0 26.1 39.3 72.2 32.2 0.18 59.35 0.2974 0.0227 C. Breastfeeding Exclusive breastfeeding 57.6 58.4 51.1 54.2 54.8 55.0 1.05 2.73 -0.0403 0.0226 Timely complementary feeding 89.0 86.2 81.1 92.0 95.2 88.0 0.93 6.24 0.0099 0.0076 Bottle-feeding 1.6 1.4 2.6 2.1 17.0 4.2 0.10 15.39 0.8777 0.1027 D. Micronutrient consumption Iodized salt: Availability of iodized salt 24.8 28.4 33.3 48.1 76.5 43.1 0.32 51.69 0.1718 0.0066 in household Vitamin A: Children 36.1 42.2 44.8 52.2 56.5 45.6 0.64 20.38 0.0542 0.0080 Women 11.3 14.5 16.3 24.0 37.1 20.2 0.31 25.77 0.1931 0.0155 E. Tobacco and alcohol use Tobacco: Women 3.7 1.9 1.8 0.3 0.3 1.5 13.45 3.45 -0.5426 0.0534 Men 26.7 24.1 24.5 20.8 15.6 22.0 1.71 11.12 -0.1017 0.0220 Alcohol: Women na na na na na na na na na na Men na na na na na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 1.6 1.9 2.2 2.6 2.9 2.3 0.54 1.35 0.0248 0.0383 Men 20.1 23.0 19.1 25.4 23.7 22.3 0.85 3.57 -0.0313 0.0228 Condom usage with non-regular partner: Women * (33.2) (31.7) (36.8) 68.8 44.1 * * * * Men 35.5 47.7 66.6 62.0 89.7 62.4 0.40 54.21 0.1382 0.0186 G. Domestic violence Ever experienced violence na na na na na na na na na na Experienced violence in past year na na na na na na na na na na - 6 - Tanzania 2004 - TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Education School completion: Women 40.5 47.9 60.0 75.1 87.2 64.1 0.46 46.66 0.1580 0.0037 Men 48.5 60.9 70.9 80.9 92.0 72.5 0.53 43.56 0.1214 0.0034 School participation: Girls 46.1 53.8 62.8 79.2 89.3 65.4 0.52 43.29 0.1192 0.0069 Boys 41.8 44.8 60.4 72.1 83.7 59.3 0.50 41.90 0.1229 0.0076 B. Exposure to mass media Newspaper readership: Women 4.9 7.6 11.5 23.0 46.1 20.5 0.11 41.13 0.3806 0.0111 Men 20.0 20.9 24.8 37.2 69.3 36.0 0.29 49.25 0.2453 0.0148 Radio listenership: Women 26.3 56.0 60.1 74.7 84.5 62.3 0.31 58.15 0.1831 0.0040 Men 56.1 78.3 80.5 89.8 90.8 79.8 0.62 34.62 0.00 0.0757 0.0061 Television viewership: Women 1.5 3.4 4.3 10.2 53.1 17.1 0.03 51.59 0.6301 0.0145 Men 6.1 9.3 12.7 23.8 65.5 25.3 0.09 59.45 0.4684 0.0193 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 89.3 93.5 94.8 96.9 98.7 95.0 0.90 9.39 0.0178 0.0015 Men 93.0 94.3 97.7 96.8 97.9 96.1 0.95 4.85 0.0125 0.0029 Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na na na na na Men 84.4 87.7 92.0 92.7 95.1 90.6 0.89 10.73 0.0253 0.0038 Attitudes toward HIV/AIDS: Women 78.7 80.8 84.3 87.2 93.9 85.7 0.84 15.13 0.0405 0.0024 Men 72.6 77.3 77.3 82.4 91.4 80.8 0.79 18.82 0.0384 0.0054 D. Status of women Household decisionmaking: Can seek own health care 38.4 37.6 42.1 43.4 50.6 43.0 0.76 12.21 0.0462 0.0068 Can seek children's health care 91.3 92.3 96.0 96.8 97.2 94.7 0.94 5.95 0.0154 0.0017 Can make daily household purchases 41.9 39.8 40.3 48.0 48.4 44.0 0.86 6.56 -0.0043 0.0066 Can make large household purchases 31.7 30.0 31.2 35.3 36.0 33.0 0.88 4.35 -0.0079 0.0082 Can make meal-related decisions 57.3 57.3 54.5 57.4 54.3 56.0 1.05 2.95 -0.0374 0.0052 Freedom of movement: Can travel to visit family, relatives 17.1 14.8 16.0 18.8 24.1 18.6 0.71 6.95 0.0574 0.0126 Other decisionmaking, attitudes: Can decide how to spend own money 34.2 34.3 47.5 61.8 78.6 61.6 0.44 44.40 0.1462 0.0087 Can decide whether to have sex 92.4 94.0 94.1 93.7 95.6 94.1 0.97 3.22 0.0056 0.0015 Justifies domestic violence 65.3 65.4 62.6 59.1 49.3 59.6 1.32 15.97 -0.0738 0.0049 E. Orphanhood Paternal orphan prevalence 6.9 5.4 6.1 5.6 6.9 6.2 1.00 0.03 -0.0138 0.0169 Maternal orphan prevalence 2.5 2.5 3.3 3.6 4.6 3.3 0.53 2.19 0.0560 0.0211 Double orphan prevalence 0.5 0.3 0.7 1.1 2.1 0.9 0.26 1.53 0.1922 0.0397 - 7 - Tanzania 2004 - FEMALE / MALE POPULATION Part I: HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood mortality and morbidity Infant mortality rate 96.5 98.4 89.2 64.5 50.9 82.0 79.7 95.9 86.5 74.7 77.2 83.0 Under-five mortality rate 140.4 159.5 152.7 105.1 75.0 129.8 134.1 152.5 141.1 128.9 111.1 134.6 Prevalence of fever 24.4 25.4 23.0 21.8 23.2 23.6 27.1 26.0 24.0 26.6 21.8 25.3 Prevalence of diarrhea 11.7 13.3 11.3 12.3 9.2 11.7 14.9 15.1 12.8 14.0 9.7 13.5 Prevalence of acute respiratory 7.3 7.7 8.5 7.9 7.4 7.7 10.6 7.3 8.1 8.8 7.2 8.5 infection (ARI) B. Nutritional status Children: Moderate stunting 29.0 27.1 25.1 25.1 12.3 24.4 26.5 26.7 29.5 27.9 10.5 25.2 Severe stunting 18.1 12.4 11.7 9.8 3.0 11.6 16.3 17.1 13.3 10.8 4.4 13.0 Moderate underweight 22.0 18.2 18.6 16.6 10.6 17.7 18.7 23.5 18.4 17.0 11.2 18.2 Severe underweight 5.1 4.4 4.4 2.5 0.3 3.5 5.0 5.6 3.5 3.3 1.0 3.8 Mild anemia 22.4 26.7 24.3 27.3 27.1 25.4 21.6 24.0 21.4 26.2 27.2 23.8 Moderate anemia 50.8 41.8 42.0 38.2 32.9 41.8 49.1 47.1 47.0 36.3 32.3 43.2 Severe anemia 4.8 4.4 4.3 2.3 2.0 3.7 5.7 5.6 4.4 2.8 2.7 4.4 C. Sexually transmitted disease Prevalence of genital discharge: Women 3.3 2.6 3.3 3.4 3.8 3.3 Men 1.7 2.8 1.5 3.8 0.8 2.1 Prevalence of genital ulcer: Women 1.9 2.0 1.7 1.8 1.5 1.8 Men 1.8 2.4 4.7 4.2 1.2 2.8 - 9 - Tanzania 2004 - FEMALE / MALE POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 84.8 90.1 88.0 97.3 96.5 90.6 88.8 90.6 93.9 90.4 97.2 91.8 Measles coverage 66.1 77.2 81.1 91.4 90.9 79.7 63.0 80.2 81.1 87.9 90.7 79.6 DPT coverage 32.2 30.1 30.6 39.3 35.1 33.3 35.2 39.9 36.6 34.6 37.8 36.8 Full basic coverage 25.8 27.4 27.0 34.9 29.8 28.7 27.6 33.1 31.8 28.7 28.8 30.1 No basic coverage 9.2 2.5 4.3 0.9 1.9 4.2 5.9 7.6 3.4 3.6 2.8 4.8 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 48.8 59.8 52.6 48.3 75.7 56.2 52.9 59.2 54.2 59.2 77.0 58.9 Treatment in a public facility 45.2 54.4 46.6 43.2 53.1 48.5 48.4 53.3 43.3 48.7 55.5 49.4 Treatment in a private facility 3.6 5.4 5.9 5.1 22.6 7.8 4.4 5.9 10.9 10.5 21.5 9.5 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 52.9 63.6 58.3 47.4 59.8 56.3 51.9 58.1 71.8 62.6 75.2 62.3 Treatment in a public facility 46.0 61.9 54.7 42.4 42.8 50.0 45.3 58.1 57.1 56.4 59.2 54.0 Treatment in a private facility 6.9 1.7 3.6 5.0 17.0 6.3 6.6 0.0 14.7 6.1 16.0 8.3 Treatment of diarrhea: Use of oral rehydration therapy na na na na na na na na na na na na Medical treatment of diarrhea 46.8 51.6 40.9 32.1 54.5 44.7 44.2 53.9 53.4 41.5 55.3 49.0 Treatment in a public facility 40.5 47.5 34.0 25.0 37.3 37.3 40.9 48.1 41.1 36.6 32.1 40.8 Treatment in a private facility 4.2 2.2 6.8 3.6 17.2 5.8 2.2 5.1 11.3 3.7 23.2 7.3 C. Contraceptive services Contraceptive prevalence: Women 10.7 12.8 15.6 24.1 36.0 20.0 Men 17.3 23.4 22.7 29.8 36.3 25.7 Source of contraception - public sector: Women 78.1 79.6 75.5 73.7 67.0 72.7 Men na na na na na na Source of contraception - private sector: Women 14.9 15.5 22.6 22.4 31.8 24.3 Men na na na na na na D. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 57.1 48.3 65.6 64.6 60.3 59.5 Men na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women 43.3 43.3 49.1 47.9 40.1 44.4 Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 5.7 6.4 8.0 13.1 29.4 13.7 Men 8.1 8.2 10.9 14.6 23.9 13.6 - 10 - Tanzania 2004 - FEMALE / MALE POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal 56.5 70.3 72.2 84.9 92.3 74.6 Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet use: By children 17.8 24.1 28.2 40.0 71.3 33.9 C. Breastfeeding Exclusive breastfeeding 48.5 61.0 49.7 56.0 51.1 53.4 65.2 54.8 52.2 51.9 60.8 56.8 Timely complementary feeding 89.7 86.8 80.8 95.2 96.4 89.3 88.2 85.6 81.3 88.4 93.9 86.7 Bottle-feeding 1.2 1.9 1.3 2.6 15.8 4.1 2.0 0.8 3.8 1.4 18.5 4.4 D. Micronutrient consumption Vitamin A: Children 38.6 40.6 46.6 54.1 57.9 46.8 33.6 43.8 43.0 50.4 55.1 44.3 E. Tobacco and alcohol use Tobacco: Women 3.7 1.9 1.8 0.3 0.3 1.5 Men 26.7 24.1 24.5 20.8 15.6 22.0 Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 1.6 1.9 2.2 2.6 2.9 2.3 Men 20.1 23.0 19.1 25.4 23.7 22.3 Condom usage with non-regular partner: Women 27.3 33.2 31.7 36.8 68.8 44.1 Men 35.5 47.7 66.6 62.0 89.7 62.4 - 11 - Tanzania 2004 - FEMALE / MALE POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 40.5 47.9 60.0 75.1 87.2 64.1 Men 48.5 60.9 70.9 80.9 92.0 72.5 School participation: Girls 46.1 53.8 62.8 79.2 89.3 65.4 Boys 41.8 44.8 60.4 72.1 83.7 59.3 B. Exposure to mass media Newspaper readership: Women 4.9 7.6 11.5 23.0 46.1 20.5 Men 20.0 20.9 24.8 37.2 69.3 36.0 Radio listenership: Women 26.3 56.0 60.1 74.7 84.5 62.3 Men 56.1 78.3 80.5 89.8 90.8 79.8 Television viewership: Women 1.5 3.4 4.3 10.2 53.1 17.1 Men 6.1 9.3 12.7 23.8 65.5 25.3 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 89.3 93.5 94.8 96.9 98.7 95.0 Men 93.0 94.3 97.7 96.8 97.9 96.1 Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na Men 84.4 87.7 92.0 92.7 95.1 90.6 Attitudes toward HIV/AIDS: Women 78.7 80.8 84.3 87.2 93.9 85.7 Men 72.6 77.3 77.3 82.4 91.4 80.8 D. Orphanhood Paternal orphan prevalence 6.9 4.9 6.7 5.6 6.8 6.2 6.8 5.9 5.5 5.6 7.0 6.1 Maternal orphan prevalence 2.2 2.8 3.3 3.8 4.3 3.2 2.7 2.2 3.4 3.5 5.0 3.3 Double orphan prevalence 0.4 0.3 0.8 1.2 2.2 1.0 0.6 0.3 0.6 1.0 1.9 0.9 - 12 - Tanzania 2004 - RURAL / URBAN POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 87.8 98.4 85.2 64.6 76.3 84.9 95.5 61.6 120.0 86.2 60.5 72.5 Under-five mortality rate 137.0 156.1 145.2 115.0 107.6 138.3 145.2 152.0 166.9 125.1 88.9 107.8 Prevalence of fever 25.9 25.5 23.5 24.4 25.6 24.9 22.4 32.3 23.5 23.4 21.6 22.5 Prevalence of diarrhea 13.4 14.3 12.3 13.1 12.0 13.2 11.0 11.9 9.2 13.5 8.6 10.0 Prevalence of acute respiratory infection 8.9 7.3 8.8 9.1 7.0 8.4 9.1 13.7 2.1 6.0 7.4 6.9 B. Fertility Total fertility rate 7.3 6.8 6.7 5.4 4.6 6.5 7.7 5.2 5.4 5.0 3.0 3.6 Adolescent fertility rate 170.7 158.2 163.2 126.1 84.8 151.1 225.5 176.3 169.8 139.4 68.4 89.7 C. Nutritional status Children: Moderate stunting 27.5 27.1 27.8 25.8 8.5 26.3 38.4 21.1 20.8 28.7 12.4 18.3 Severe stunting 17.0 14.7 12.7 10.4 1.2 13.4 26.9 13.2 10.0 10.1 4.5 7.3 Moderate underweight 20.2 20.9 19.0 15.7 9.3 18.7 26.2 15.2 11.3 20.3 11.4 14.3 Severe underweight 5.0 4.9 4.0 2.6 0.1 4.0 8.1 6.3 3.4 4.0 0.8 2.2 Mild anemia 22.4 25.5 22.3 26.4 24.8 24.0 9.9 20.6 30.6 27.6 27.9 27.2 Moderate anemia 49.6 44.5 45.2 36.7 31.9 44.1 62.4 39.9 34.0 39.0 32.8 35.8 Severe anemia 5.3 4.7 4.3 2.8 0.7 4.2 3.8 13.9 4.9 1.8 2.9 3.1 Women: Malnutrition 11.3 10.9 10.0 9.1 7.1 10.2 14.2 8.4 9.3 7.5 7.2 7.6 Mild anemia 36.2 35.6 32.2 28.6 28.1 33.0 44.2 33.0 28.1 27.9 29.9 29.8 Moderate anemia 14.1 14.0 13.8 12.9 12.9 13.6 12.3 19.3 8.6 11.7 15.9 14.8 Severe anemia 1.6 1.2 0.9 0.6 0.9 1.1 0.0 4.4 0.5 0.6 1.3 1.2 D. Female circumcision Prevalence of circumcision: Girls 10.8 9.3 5.9 4.4 1.6 7.2 11.2 9.6 5.5 2.9 0.9 2.0 Women 20.9 19.3 16.7 14.4 11.9 17.6 6.9 1.4 11.5 8.2 6.9 7.2 Prevalence of occlusion: Girls 1.7 0.0 5.9 0.0 0.0 1.7 na na na na na na Women 1.0 1.2 1.9 2.2 0.0 1.4 0.0 0.0 0.0 0.0 7.5 5.2 E. Sexually transmitted disease Prevalence of genital discharge: Women 3.3 2.5 3.2 2.8 2.1 2.9 2.9 3.4 3.7 5.1 4.2 4.3 Men 1.7 3.0 1.6 4.4 0.0 2.4 0.0 0.0 0.0 2.0 1.0 1.1 Prevalence of genital ulcer: Women 2.0 2.0 1.8 1.7 2.4 1.9 0.0 1.0 0.5 2.1 1.3 1.4 Men 1.9 2.4 4.9 4.3 1.3 3.2 0.0 2.4 2.2 3.9 1.1 1.7 - 13 - Tanzania 2004 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 86.3 90.9 91.1 92.7 97.6 90.2 100.0 80.2 93.8 98.1 96.6 96.0 Measles coverage 63.7 78.7 80.8 90.0 91.7 77.5 100.0 80.2 86.1 87.7 90.5 89.4 DPT coverage 33.3 36.1 34.2 37.1 36.1 35.0 45.5 15.4 28.7 36.2 36.6 35.2 Full basic coverage 26.1 31.3 30.1 31.9 23.3 29.4 45.5 10.8 20.1 31.0 30.7 29.5 No basic coverage 7.9 4.4 4.0 2.7 0.0 4.8 0.0 19.8 0.6 0.3 3.0 3.1 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood diseases Treatment of fever: Medical treatment of fever 50.4 58.8 52.7 51.6 66.2 54.0 74.5 76.1 62.8 62.9 79.9 73.9 Treatment in a public facility 46.2 53.0 44.1 43.7 54.6 47.4 74.5 76.1 55.0 54.4 54.1 55.9 Treatment in a private facility 4.1 5.8 8.6 8.0 11.6 6.6 0.0 0.0 7.7 8.4 25.9 17.9 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 51.7 60.4 64.7 52.9 66.7 57.7 72.5 69.8 87.6 66.9 67.2 68.0 Treatment in a public facility 44.8 59.5 55.3 47.0 51.5 51.4 72.5 69.8 87.6 62.4 50.3 56.0 Treatment in a private facility 6.9 0.9 9.4 5.8 15.2 6.4 0.0 0.0 0.0 4.5 16.9 12.1 Treatment of diarrhea: Use of oral rehydration therapy 65.2 70.7 71.5 66.1 71.9 68.6 83.6 64.4 69.4 71.9 83.6 78.0 Medical treatment of diarrhea 45.1 52.5 48.1 37.7 60.7 47.1 54.7 64.4 42.0 35.2 52.4 46.6 Treatment in a public facility 40.4 47.4 38.4 29.8 43.8 40.1 54.7 64.4 30.1 35.2 30.8 34.3 Treatment in a private facility 3.1 3.8 9.2 4.9 16.9 5.6 0.0 0.0 12.0 0.0 21.6 12.2 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 90.4 93.6 95.6 95.1 94.3 93.6 96.8 100.0 92.4 96.1 97.3 96.8 To a doctor 1.1 1.3 1.4 1.6 4.1 1.5 0.0 0.0 1.1 3.6 5.5 4.4 To a nurse or trained midwife 89.3 92.3 94.3 93.4 90.3 92.1 96.8 100.0 91.2 92.5 91.9 92.4 Multiple visits to a medically-trained person 79.8 85.2 85.3 88.9 90.5 84.8 92.2 94.0 85.3 86.5 91.5 90.1 Antenatal care content: Tetanus toxoid 77.7 78.2 75.4 79.7 82.7 77.9 86.1 88.2 72.9 87.2 87.0 86.1 Prophylactic antimalarial treatment 44.4 44.6 45.9 52.3 57.5 47.0 55.1 53.9 49.5 58.4 56.3 56.2 Iron supplementation 59.2 64.0 59.0 59.2 60.7 60.4 65.3 75.2 52.2 60.1 65.1 63.4 Delivery attendance: By a medically-trained person 30.3 34.8 35.7 48.9 71.6 38.0 57.6 63.8 60.5 66.9 91.5 80.9 By a doctor 1.3 2.1 2.4 3.7 7.4 2.5 3.8 9.2 9.2 4.6 12.5 9.9 By a nurse or trained midwife 29.0 32.7 33.3 45.3 64.1 35.5 53.8 54.6 51.3 62.3 79.0 71.0 In a public facility 24.8 29.2 26.7 36.9 49.3 29.7 54.7 57.8 53.0 59.8 80.4 71.5 In a private facility 6.6 6.7 10.3 12.2 22.0 9.2 2.8 5.9 8.1 8.4 10.6 9.5 At home 68.2 64.0 62.9 50.8 27.9 60.9 42.4 36.2 38.8 31.8 8.7 18.9 D. Contraceptive services Contraceptive prevalence: Women 10.4 12.5 14.6 22.2 31.9 15.5 24.4 19.1 27.2 30.3 37.2 34.3 Men 17.1 23.6 23.1 31.8 27.1 23.5 28.4 19.8 16.1 23.7 38.5 33.3 - 14 - Tanzania 2004 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - public sector: Women 77.0 80.6 74.4 74.6 67.6 75.4 100.0 67.2 82.6 71.2 66.9 68.8 Men na na na na na na na na na na na na Source of contraception - private sector: Women 15.7 15.2 23.4 21.6 28.0 20.5 0.0 19.3 17.4 24.3 32.7 29.8 Men na na na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 56.2 48.9 63.6 68.9 64.6 59.2 100.0 35.1 88.6 56.7 59.5 60.1 Men na na na na na na na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women 42.0 43.7 45.7 51.4 29.0 44.2 100.0 35.1 88.6 41.5 42.3 44.8 Men na na na na na na na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 5.7 5.4 7.5 11.1 25.9 8.5 5.1 25.1 13.5 19.2 30.2 26.8 Men 8.0 8.5 11.0 15.2 24.2 11.2 12.3 3.9 8.5 12.7 23.9 20.1 - 15 - Tanzania 2004 - RURAL / URBAN POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal 55.9 70.1 71.6 85.0 85.5 70.3 80.7 75.7 79.5 84.9 94.2 90.1 Handwashing: Wash hands prior to preparing food na na na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership 26.7 30.6 35.8 48.3 67.5 36.4 26.4 47.9 49.9 54.9 85.1 74.1 Treated bednet ownership 2.5 4.8 8.7 11.7 27.1 7.8 3.0 7.7 12.2 19.5 44.0 34.6 Bednet use: By children 17.9 23.7 26.8 37.8 57.4 27.0 11.0 35.6 46.0 46.6 75.6 62.7 By pregnant women 12.6 19.4 25.9 36.6 44.7 23.7 16.7 60.8 29.0 48.5 80.4 67.0 C. Breastfeeding Exclusive breastfeeding 57.6 57.0 53.1 56.3 56.9 56.0 100.0 31.7 46.8 53.9 na 50.7 Timely complementary feeding 88.8 85.8 80.5 88.3 98.9 86.0 100.0 100.0 90.8 99.5 94.2 95.9 Bottle-feeding 1.7 1.4 2.8 2.2 14.7 2.6 0.0 0.0 0.4 1.7 17.8 10.8 D. Micronutrient consumption Iodized salt: Availability of iodized salt 24.8 27.8 32.6 43.7 64.4 33.5 26.4 40.9 41.4 60.5 79.4 70.7 in household Vitamin A: Children 36.0 41.9 44.7 51.9 57.6 43.5 41.6 50.3 46.1 53.3 56.2 54.1 Women 10.7 14.3 15.9 23.5 28.7 16.2 32.1 21.3 20.5 25.5 39.5 34.3 E. Tobacco and alcohol use Tobacco: Women 3.6 1.9 1.3 0.4 0.6 1.8 6.5 1.0 7.4 0.2 0.2 0.7 Men 26.7 24.1 24.3 19.2 12.4 23.2 28.6 24.0 27.2 25.3 16.2 18.9 Alcohol: Women na na na na na na na na na na na na Men na na na na na na na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 1.5 1.9 2.2 2.5 0.6 1.9 2.5 0.8 1.3 2.8 3.4 3.1 Men 20.0 23.9 19.6 28.3 17.7 22.4 28.1 7.2 11.3 16.1 24.8 22.2 Condom usage with non-regular partner: Women 28.5 34.1 33.4 34.2 100.0 34.0 0.0 0.0 0.0 43.9 67.7 60.6 Men 35.2 46.8 66.5 58.0 80.1 52.8 44.9 100.0 70.6 84.3 91.0 89.0 G. Domestic violence Ever experienced violence na na na na na na na na na na na na Experienced violence in past year na na na na na na na na na na na na - 16 - Tanzania 2004 - RURAL / URBAN POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 40.8 47.9 60.2 74.3 88.7 57.2 33.2 48.0 57.1 77.5 86.9 81.5 Men 48.3 61.6 71.1 81.3 91.1 67.0 53.3 49.9 68.7 79.7 92.3 86.6 School participation: Girls 45.5 53.6 61.3 79.8 86.6 60.5 69.5 56.2 80.9 76.9 90.2 84.4 Boys 41.4 44.6 59.4 72.4 76.2 54.4 58.6 49.6 71.2 70.9 86.0 78.9 B. Exposure to mass media Newspaper readership: Women 4.8 7.4 11.3 18.9 32.7 11.7 10.6 11.8 13.5 35.5 49.0 42.8 Men 20.2 19.7 25.1 37.7 57.5 26.8 11.2 39.4 19.9 35.7 71.6 60.5 Radio listenership: Women 26.1 55.0 59.7 75.0 85.0 55.2 33.2 73.5 63.9 74.0 84.4 80.2 Men 56.1 78.2 80.2 91.0 90.2 76.5 56.3 80.0 85.0 86.4 90.9 88.9 Television viewership: Women 1.3 3.0 4.0 7.6 32.7 5.7 8.0 10.9 7.8 18.2 57.7 45.8 Men 5.8 7.8 10.5 19.3 49.4 12.5 19.0 32.8 44.8 37.2 68.7 59.6 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 89.1 93.4 94.5 96.6 98.0 93.6 97.5 96.5 97.9 97.8 98.9 98.5 Men 93.3 94.2 97.6 96.1 99.6 95.5 78.7 96.6 99.1 98.9 97.5 97.5 Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na na na na na na na Men 84.5 86.9 91.6 91.5 95.4 88.9 80.0 100.0 97.4 96.1 95.0 95.4 Attitudes toward HIV/AIDS: Women 78.4 80.6 84.2 86.1 92.4 82.8 91.4 83.6 84.5 90.6 94.2 92.7 Men 72.6 76.5 76.6 82.6 92.9 77.7 70.7 89.7 87.9 81.8 91.1 88.9 D. Status of women Household decisionmaking: Can seek own health care 38.5 37.5 42.0 42.3 50.7 40.6 34.7 40.5 43.3 46.6 50.6 48.9 Can seek children's health care 91.1 92.0 95.9 96.2 98.2 93.9 100.0 98.5 96.5 98.7 97.0 97.4 Can make daily household purchases 41.6 39.6 39.8 46.1 43.7 41.7 50.7 43.9 46.0 53.9 49.5 49.9 Can make large household purchases 31.4 29.8 30.6 33.2 32.1 31.2 41.1 33.9 37.5 41.6 36.9 37.7 Can make meal-related decisions 57.6 57.4 55.0 56.6 51.6 56.3 48.1 56.1 49.5 59.7 55.0 55.4 Freedom of movement: Can travel to visit family, relatives 17.0 14.3 15.5 16.1 16.2 15.7 22.4 23.3 21.5 26.9 25.8 25.6 Other decisionmaking, attitudes: Can decide how to spend own money 33.5 33.5 42.4 54.1 68.4 44.7 51.1 40.1 81.8 73.8 80.3 78.0 Can decide whether to have sex 92.2 93.8 94.1 93.9 93.8 93.5 98.2 97.2 93.9 92.8 96.0 95.4 Justifies domestic violence 65.4 65.6 62.3 59.3 50.5 62.5 58.9 62.0 65.8 58.6 49.0 52.2 E. Orphanhood Paternal orphan prevalence 6.6 5.1 6.2 4.5 4.5 5.6 16.4 11.3 4.3 9.3 7.6 8.2 Maternal orphan prevalence 2.4 2.3 3.5 3.7 3.5 2.9 5.7 5.8 1.6 3.5 5.0 4.5 Double orphan prevalence 0.5 0.3 0.7 1.1 0.8 0.6 2.6 0.4 0.7 1.3 2.4 2.0 - 17 - PART II. BASIC TABLES, 1999 A. TOTAL POPULATION B. FEMALE AND MALE POPULATIONS C. RURAL AND URBAN POPULATIONS Notes: ­ Each of the three sections referred to above consists of four divisions, presenting data for: I) hnp status; II) hnp service use; III) hnp-related individual and household behavior; and IV) other, underlying determinants of hnp status. ­ Full definitions of all indicators covered in the tables are provided in section A of the technical notes found in part II. ­ "na" appears in the table cells when data are not available, usually because the DHS survey concerned did not collect information about the indicator(s) in question. ­ Figures in the tables shown within parentheses indicate the absence of adequate observations to produce acceptably reliable values. Asterisks appear when the number of observations was too small to justify the presentation even of figures within parentheses. (For further information, see the section on "Sampling Errors" in the presentation of data and methods in part II.B.) Asterisks also will be found in columns showing statistical indices of inequality when the amount of quintile-specific information available is inadequate to permit computation of the value for the index concerned. ­ Female/male tables include only indicators relevant for both sexes; those pertaining to only one sex (e.g., fertility, women's nutritional status, antenatal care, attended deliveries) have been omitted. Tanzania 1999 - TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood illness and mortality Infant mortality rate 114.8 107.5 115.4 106.8 91.9 107.8 1.25 22.90 -0.0323 0.0010 Under-five mortality rate 160.0 159.3 192.7 155.0 135.2 161.1 1.18 24.80 -0.0221 0.0010 Prevalence of fever 35.4 38.2 31.4 37.1 33.4 35.1 1.06 2.00 -0.0451 0.0137 Prevalence of diarrhea 11.7 12.2 14.1 15.2 8.5 12.4 1.38 3.20 -0.0301 0.0258 Prevalence of acute respiratory 13.6 12.9 11.5 18.8 13.1 13.9 1.04 0.50 -0.0202 0.0254 infection (ARI) B. Fertility Total fertility rate 7.8 6.4 6.1 5.0 3.4 5.6 2.29 4.40 -0.1518 0.0010 Adolescent fertility rate 196.0 141.0 178.0 117.0 81.0 138.0 2.42 115.00 -0.1520 0.0030 C. Nutritional status (%) Children: Moderate stunting 28.5 30.6 27.9 24.6 16.3 26.2 1.75 12.20 -0.1022 0.0168 Severe stunting 21.0 21.9 17.1 12.0 7.1 16.5 2.96 13.90 -0.1855 0.0215 Moderate underweight 23.6 27.9 23.5 18.3 17.7 22.5 1.33 5.90 -0.0913 0.0183 Severe underweight 8.6 7.2 5.3 5.6 4.0 6.3 2.15 4.60 -0.1572 0.0386 Mild anemia na na na na na na na na na na Moderate anemia na na na na na na na na na na Severe anemia na na na na na na na na na na Women: Malnutrition na na na na na na na na na na Mild anemia na na na na na na na na na na Moderate anemia na na na na na na na na na na Severe anemia na na na na na na na na na na D. Female circumcision (%) Prevalence of circumcision: Girls na na na na na na na na na na Women na na na na na na na na na na Prevalence of occlusion: Girls na na na na na na na na na na Women na na na na na na na na na na E. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na na na na na Men na na na na na na na na na na Prevalence of genital ulcer: Women na na na na na na na na na na Men na na na na na na na na na na - 21 - Tanzania 1999 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood immunization BCG coverage 88.8 96.9 87.3 93.7 99.9 92.7 0.89 11.10 0.0163 0.0053 Measles coverage 63.4 84.2 72.2 88.4 89.0 78.1 0.71 25.60 0.0614 0.0117 DPT coverage 66.2 86.1 78.5 91.1 88.7 81.0 0.75 22.50 0.0604 0.0110 Full basic coverage 53.1 74.3 61.7 80.8 78.4 68.3 0.68 25.30 0.0787 0.0148 No basic coverage 9.1 2.6 8.1 4.4 0.1 5.3 91.00 9.00 -0.1965 0.0815 Hepatitis B coverage na na na na na na na na na na Yellow fever coverage na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever na na na na na na na na na na Treatment in a public facility na na na na na na na na na na Treatment in a private facility na na na na na na na na na na Treatment of acute respiratory infection (ARI): Medical treatment of ARI na na na na na na na na na na Treatment in a public facility na na na na na na na na na na Treatment in a private facility na na na na na na na na na na Treatment of diarrhea: Use of oral rehydration therapy 58.0 69.1 70.3 72.0 71.5 67.8 0.81 13.50 0.0067 0.0208 Medical treatment of diarrhea na na na na na na na na na na Treatment in a public facility na na na na na na na na na na Treatment in a private facility na na na na na na na na na na C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 88.8 90.8 91.5 94.2 97.3 92.5 0.91 8.50 0.0099 0.0026 To a doctor 3.6 3.2 2.1 2.4 17.1 5.7 0.21 13.50 0.4009 0.0596 To a nurse or trained midwife 85.2 87.7 89.4 91.8 80.1 86.8 1.06 5.10 -0.0156 0.0046 Multiple visits to a medically-trained person 82.0 84.4 83.0 89.0 92.5 86.1 0.89 10.50 0.0141 0.0041 Antenatal care content: Tetanus toxoid 76.0 80.2 82.5 86.8 88.6 82.7 0.86 12.60 0.0194 0.0053 Prophylactic antimalarial treatment 26.8 31.1 27.5 33.9 43.4 32.4 0.62 16.60 0.0791 0.0169 Iron supplementation 37.9 41.2 42.4 48.4 53.0 44.4 0.72 15.10 0.0641 0.0126 Delivery attendance: By a medically-trained person 28.9 35.0 33.3 48.4 82.8 43.8 0.35 53.90 0.2134 0.0097 By a doctor 3.2 7.4 3.8 7.1 17.8 7.4 0.18 14.60 0.2270 0.0324 By a nurse or trained midwife 25.7 27.6 29.5 41.3 65.1 36.4 0.39 39.40 0.2108 0.0121 In a public facility 22.6 28.0 28.4 39.4 74.9 37.0 0.30 52.30 0.2515 0.0116 In a private facility 5.3 5.6 5.4 10.1 7.2 6.6 0.74 1.90 0.0109 0.0305 At home 71.8 66.3 65.9 50.4 17.4 56.3 4.13 54.40 -0.1657 0.0076 D. Contraceptive services Contraceptive prevalence: Women 5.6 12.8 11.8 20.4 32.1 16.9 0.17 26.50 0.2736 0.0217 Men 10.5 18.1 22.5 25.3 34.9 23.0 0.30 24.40 0.1935 0.0203 - 22 - Tanzania 1999 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors D. Contraceptive services (cont.) Source of contraception - public sector: Women (77.0) (73.0) 69.7 91.0 64.2 73.4 1.20 141.20 -0.0431 0.0156 Men na na na na na na na na na na Source of contraception - private sector: Women (23.0) (27.0) 28.7 9.0 35.2 26.1 0.65 58.20 0.1130 0.0447 Men na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na na na na na Men na na na na na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na Men na na na na na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 3.1 4.9 3.1 7.1 12.5 6.5 0.25 9.40 0.3141 0.0334 Men 7.2 11.7 8.5 13.2 18.3 12.2 0.39 11.10 0.1497 0.0246 - 23 - Tanzania 1999 - TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership 10.2 17.0 19.2 36.8 63.8 30.7 0.16 53.60 0.3669 0.0127 Treated bednet ownership 0.6 0.2 0.7 1.0 2.3 1.0 0.26 1.70 0.4561 0.1038 Bednet use: By children 9.4 12.1 12.2 27.8 52.2 22.3 0.18 42.80 0.4005 0.0230 By pregnant women 4.6 12.3 11.9 22.1 61.0 19.7 0.08 56.40 0.4317 0.0528 C. Breastfeeding Exclusive breastfeeding 53.2 * (34.3) (56.5) 28.3 39.7 * * * * Timely complementary feeding (59.5) (55.0) (68.3) (75.4) (64.5) 63.8 0.92 5.00 0.0358 0.0277 Bottle-feeding 6.8 4.3 5.7 5.5 24.6 8.6 0.28 17.80 0.3417 0.0886 D. Micronutrient consumption Iodized salt: Availability of iodized salt 52.1 60.0 61.7 71.3 86.0 66.9 0.61 33.90 0.0739 0.0068 in household Vitamin A: Children 7.9 13.1 9.7 12.8 20.9 12.5 0.38 13.00 0.3305 0.0364 Women 7.9 11.8 9.7 11.1 14.3 10.9 0.55 6.40 0.0424 0.0304 E. Tobacco and alcohol use Tobacco: Women na na na na na na na na na na Men na na na na na na na na na na Alcohol: Women na na na na na na na na na na Men na na na na na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 9.1 10.8 14.4 12.5 17.7 13.3 0.51 8.60 0.0319 0.0183 Men 32.7 30.6 31.5 32.0 32.2 31.8 1.02 0.50 -0.0114 0.0125 Condom usage with non-regular partner: Women 21.8 14.0 15.4 16.1 36.0 22.8 0.61 14.20 0.2274 0.0475 Men 21.4 27.6 25.7 33.8 62.3 36.0 0.34 40.90 0.2001 0.0227 G. Domestic violence Ever experienced violence na na na na na na na na na na Experienced violence in past year na na na na na na na na na na - 24 - Tanzania 1999 - TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Education School completion: Women 44.2 48.6 50.4 64.7 82.3 59.5 0.54 38.10 0.1451 0.0060 Men 59.7 60.9 64.3 74.4 84.7 69.9 0.70 25.00 0.0888 0.0054 School participation: Girls 27.3 29.1 23.5 47.2 72.6 38.9 0.38 45.30 0.2224 0.0163 Boys 16.5 20.2 23.1 36.9 66.7 31.4 0.25 50.20 0.2918 0.0203 B. Exposure to mass media Newspaper readership: Women 1.2 1.2 1.1 3.5 15.7 5.2 0.08 14.50 0.6589 0.0470 Men 4.6 5.5 4.7 10.4 35.7 13.6 0.13 31.10 0.4664 0.0260 Radio listenership: Women 4.8 17.6 13.8 40.7 51.5 27.5 0.09 46.70 0.3334 0.0139 Men 18.5 39.4 33.2 59.4 65.5 45.2 0.28 47.00 0.1722 0.0097 Television viewership: Women 0.8 0.4 1.2 1.8 14.0 4.3 0.06 13.20 1.4145 0.0771 Men 3.3 3.9 3.1 5.9 26.3 9.5 0.13 23.00 0.7597 0.0402 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 70.2 75.1 73.1 84.5 90.0 79.4 0.78 19.80 0.0551 0.0043 Men 85.1 87.0 86.7 92.9 95.3 89.9 0.89 10.20 0.0201 0.0029 Knowledge about mother-to-child transmission of HIV/AIDS: Women 72.7 71.1 74.1 84.7 90.1 78.9 0.81 17.40 0.0496 0.0038 Men 77.0 76.1 77.7 84.9 88.4 80.7 0.87 11.40 0.0303 0.0043 Attitudes toward HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na Can seek children's health care na na na na na na na na na na Can make daily household purchases na na na na na na na na na na Can make large household purchases na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na na na na na Can decide whether to have sex na na na na na na na na na na Justifies domestic violence na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 7.3 6.1 7.7 5.3 5.3 6.4 1.38 2.00 -0.0172 0.0223 Maternal orphan prevalence 3.9 2.7 3.5 3.4 4.2 3.5 0.93 0.30 -0.0049 0.0280 Double orphan prevalence 1.1 1.0 1.0 0.7 1.4 1.0 0.79 0.30 0.0626 0.0501 - 25 - Tanzania 1999 - FEMALE / MALE POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood mortality and morbidity Infant mortality rate 100.9 (92.9) 99.2 (110.8) 80.4 97.2 126.7 (122.8) (131.9) (102.9) 102.4 118.0 Under-five mortality rate (151.0) (145.3) (173.1) (149.9) 125.9 149.8 167.7 (174.2) (212.6) (160.1) 143.9 171.8 Prevalence of fever 35.0 36.1 27.9 38.4 31.5 33.7 35.9 40.6 35.1 36.0 35.1 36.5 Prevalence of diarrhea 10.0 11.2 10.6 16.6 7.5 11.1 13.1 13.4 17.7 13.8 9.3 13.5 Prevalence of acute respiratory 14.4 13.7 6.5 21.0 12.8 13.4 12.9 12.1 16.9 16.8 13.4 14.4 infection (ARI) B. Nutritional status Children: Moderate stunting 27.1 27.7 26.7 24.3 12.9 24.5 29.9 33.9 29.1 24.9 19.3 27.8 Severe stunting 19.5 25.2 18.8 8.2 9.3 17.0 22.4 18.2 15.3 15.7 5.1 16.0 Moderate underweight 24.5 32.4 25.8 18.0 12.0 23.5 22.8 22.8 21.0 18.5 22.6 21.6 Severe underweight 7.5 7.2 7.1 5.0 6.6 6.8 9.6 7.2 3.5 6.2 1.8 5.9 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na C. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na Men na na na na na na Prevalence of genital ulcer: Women na na na na na na Men na na na na na na - 27 - Tanzania 1999 - FEMALE / MALE POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 87.7 (98.3) 92.1 (93.8) 99.7 94.0 89.5 (95.0) (81.8) 93.6 100.0 91.7 Measles coverage 56.0 (86.5) 72.6 (89.2) 78.6 76.0 67.6 (81.1) (71.8) 88.0 94.8 79.8 DPT coverage 57.9 (84.6) 78.6 (88.0) 85.2 78.2 71.0 (88.0) (78.3) 92.8 90.6 83.1 Full basic coverage 44.4 (69.4) 66.4 (81.5) 76.6 66.5 58.1 (80.9) (56.3) 80.4 79.4 69.8 No basic coverage 7.7 (1.7) 5.5 (6.2) 0.3 4.5 9.9 (3.7) (11.0) 3.4 0.0 6.0 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever na na na na na na na na na na na na Treatment in a public facility na na na na na na na na na na na na Treatment in a private facility na na na na na na na na na na na na Treatment of acute respiratory infection (ARI): Medical treatment of ARI na na na na na na na na na na na na Treatment in a public facility na na na na na na na na na na na na Treatment in a private facility na na na na na na na na na na na na Treatment of diarrhea: Use of oral rehydration therapy (64.0) (75.7) (69.2) (62.0) (55.6) 66.2 (53.7) (62.9) (71.0) (82.8) (83.0) 69.1 Medical treatment of diarrhea na na na na na na na na na na na na Treatment in a public facility na na na na na na na na na na na na Treatment in a private facility na na na na na na na na na na na na C. Contraceptive services Contraceptive prevalence: Women 5.6 12.8 11.8 20.4 32.1 16.9 Men 10.5 18.1 22.5 25.3 34.9 23.0 Source of contraception - public sector: Women (77.0) (73.0) 69.7 91.0 64.2 73.4 Men na na na na na na Source of contraception - private sector: Women (23.0) (27.0) 28.7 9.0 35.2 26.1 Men na na na na na na D. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na Men na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 3.1 4.9 3.1 7.1 12.5 6.5 Men 7.2 11.7 8.5 13.2 18.3 12.2 - 28 - Tanzania 1999 - FEMALE / MALE POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet use: By children 9.4 12.1 12.2 27.8 52.2 22.3 C. Breastfeeding Exclusive breastfeeding (48.6) * * * * 44.8 * * * * (8.2) 34.5 Timely complementary feeding (46.6) * * * (80.2) 63.6 * * * * * 64.1 Bottle-feeding 3.1 (3.8) 6.9 1.2 30.7 8.7 12.1 (4.9) 4.6 (9.1) 15.8 8.4 D. Micronutrient consumption Vitamin A: Children 9.6 17.4 10.4 13.3 19.0 13.7 6.5 8.0 8.8 12.4 22.4 11.3 E. Tobacco and alcohol use Tobacco: Women na na na na na na Men na na na na na na Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 9.1 10.8 14.4 12.5 17.7 13.3 Men 32.7 30.6 31.5 32.0 32.2 31.8 Condom usage with non-regular partner: Women 21.8 14.0 15.4 16.1 36.0 22.8 Men 21.4 27.6 25.7 33.8 62.3 36.0 - 29 - Tanzania 1999 - FEMALE / MALE POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 44.2 48.6 50.4 64.7 82.3 59.5 Men 59.7 60.9 64.3 74.4 84.7 69.9 School participation: Girls 27.3 29.1 23.5 47.2 72.6 38.9 Boys 16.5 20.2 23.1 36.9 66.7 31.4 B. Exposure to mass media Newspaper readership: Women 1.2 1.2 1.1 3.5 15.7 5.2 Men 4.6 5.5 4.7 10.4 35.7 13.6 Radio listenership: Women 4.8 17.6 13.8 40.7 51.5 27.5 Men 18.5 39.4 33.2 59.4 65.5 45.2 Television viewership: Women 0.8 0.4 1.2 1.8 14.0 4.3 Men 3.3 3.9 3.1 5.9 26.3 9.5 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 70.2 75.1 73.1 84.5 90.0 79.4 Men 85.1 87.0 86.7 92.9 95.3 89.9 Knowledge about mother-to-child transmission of HIV/AIDS: Women 72.7 71.1 74.1 84.7 90.1 78.9 Men 77.0 76.1 77.7 84.9 88.4 80.7 Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Orphanhood Paternal orphan prevalence 7.1 6.3 8.0 5.3 4.3 6.4 7.5 5.9 7.3 5.2 6.2 6.5 Maternal orphan prevalence 2.4 2.3 4.1 3.7 4.7 3.4 5.2 3.1 2.9 3.1 3.7 3.6 Double orphan prevalence 0.3 0.4 1.3 0.8 0.4 0.7 1.7 1.5 0.7 0.6 2.2 1.3 - 30 - Tanzania 1999 - RURAL / URBAN POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 116.3 106.7 119.1 121.1 (75.4) 113.0 * * * * 97.8 87.3 Under-five mortality rate 162.3 157.0 200.0 159.1 (109.1) 165.9 * * * * 144.5 141.6 Prevalence of fever 35.2 38.2 30.4 39.2 36.7 35.5 * * (47.6) 30.1 32.1 33.4 Prevalence of diarrhea 11.6 12.2 13.4 16.9 9.0 12.9 * * (24.0) 9.1 8.3 9.8 Prevalence of acute respiratory infection 13.6 13.2 11.9 20.1 15.1 14.3 * * (6.6) 14.2 12.4 12.2 B. Fertility Total fertility rate (7.9) (6.4) 6.5 (5.9) * 6.5 * * * * 3.0 3.2 Adolescent fertility rate (203.0) (135.0) 175.0 (123.0) * 154.5 * * * * 80.0 94.8 C. Nutritional status Children: Moderate stunting 28.6 31.1 28.4 24.8 20.1 28.0 * * (19.4) 23.9 14.7 17.3 Severe stunting 21.1 22.5 17.7 13.5 6.9 18.5 * * (7.4) 6.5 7.2 7.2 Moderate underweight 23.7 28.2 24.6 19.4 21.6 24.1 * * (5.3) 13.9 16.0 14.9 Severe underweight 8.6 7.4 5.4 5.6 3.3 6.7 * * (5.3) 5.5 4.3 4.5 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na Women: Malnutrition na na na na na na na na na na na na Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na D. Female circumcision Prevalence of circumcision: Girls na na na na na na na na na na na na Women na na na na na na na na na na na na Prevalence of occlusion: Girls * * * * * * * * * * * * Women * * * * * * * * * * * * E. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Prevalence of genital ulcer: Women na na na na na na na na na na na na Men na na na na na na na na na na na na - 31 - Tanzania 1999 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 88.7 96.8 86.6 92.2 (99.5) 91.0 * * * * 100.0 100.0 Measles coverage 63.3 83.6 70.7 85.9 (96.5) 75.3 * * * * 86.9 90.3 DPT coverage 65.8 85.6 77.3 89.2 (98.9) 78.9 * * * * 85.8 89.9 Full basic coverage 53.2 73.4 59.9 77.2 (90.8) 65.5 * * * * 74.9 80.5 No basic coverage 9.2 2.6 8.5 5.4 (0.5) 6.5 na na na na na na Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood diseases Treatment of fever: Medical treatment of fever na na na na na na na na na na na na Treatment in a public facility na na na na na na na na na na na na Treatment in a private facility na na na na na na na na na na na na Treatment of acute respiratory infection (ARI): Medical treatment of ARI na na na na na na na na na na na na Treatment in a public facility na na na na na na na na na na na na Treatment in a private facility na na na na na na na na na na na na Treatment of diarrhea: Use of oral rehydration therapy 57.9 69.5 73.2 68.6 * 68.3 * * * * 61.5 65.0 Medical treatment of diarrhea na na na na na na na na na na na na Treatment in a public facility na na na na na na na na na na na na Treatment in a private facility na na na na na na na na na na na na C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 88.6 90.5 91.0 92.4 95.1 90.7 * * (98.5) 99.0 97.9 98.3 To a doctor 3.7 3.1 2.1 2.1 2.4 2.8 * * (1.9) 3.1 21.5 15.3 To a nurse or trained midwife 85.0 87.4 88.8 90.3 92.7 87.9 * * (96.6) 95.9 76.4 83.0 Multiple visits to a medically-trained person 81.7 84.1 82.0 87.2 89.9 83.8 * * (94.1) 93.6 93.3 93.5 Antenatal care content: Tetanus toxoid 75.9 79.9 81.5 84.1 82.0 80.1 * * (94.4) 93.9 90.6 91.4 Prophylactic antimalarial treatment 26.8 32.1 26.0 30.9 42.5 29.6 * * (45.0) 41.9 43.6 41.9 Iron supplementation 37.6 40.8 41.3 53.6 49.9 42.8 * * (55.3) 34.6 54.0 49.8 Delivery attendance: By a medically-trained person 28.7 34.5 30.9 40.6 64.7 34.8 * * (69.9) 77.2 89.3 83.3 By a doctor 3.3 7.3 4.1 4.8 13.2 5.3 * * 0.0 15.6 19.4 16.6 By a nurse or trained midwife 25.4 27.2 26.9 35.8 51.6 29.4 * * (69.9) 61.6 69.9 66.7 In a public facility 22.3 27.4 26.7 34.5 58.7 28.8 * * (55.5) 57.4 80.7 72.5 In a private facility 5.3 5.8 4.8 7.2 6.5 5.7 * * (14.0) 21.1 7.4 10.3 At home 72.0 66.8 68.2 58.3 33.0 65.3 * * (30.4) 21.4 11.8 17.2 D. Contraceptive services Contraceptive prevalence: Women 5.4 12.2 10.4 14.9 30.1 12.0 * * (29.5) 37.0 32.8 32.8 Men 10.8 17.9 22.6 23.4 32.2 19.9 * * (22.3) 31.7 35.8 32.7 - 32 - Tanzania 1999 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - public sector: Women (75.4) (70.9) (65.2) (89.5) (65.5) 73.6 * * * (92.9) 63.8 73.2 Men (100.0) (100.0) 100.0 100.0 (100.0) 100.0 * * * * 100.0 100.0 Source of contraception - private sector: Women (24.6) (29.1) (32.8) (10.5) (34.5) 26.0 * * * (7.1) 35.5 26.3 Men na na na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 3.1 4.6 2.9 5.3 7.9 4.2 (3.0) (12.2) 5.3 11.7 13.8 12.5 Men 6.3 11.5 8.2 11.7 13.8 9.8 * (16.1) 11.4 17.9 19.8 18.9 - 33 - Tanzania 1999 - RURAL / URBAN POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership 9.9 16.4 18.6 35.6 47.4 20.9 (19.6) (29.4) 24.0 39.9 68.8 56.9 Treated bednet ownership 0.6 0.2 0.8 1.1 2.9 0.8 0.0 0.0 0.0 0.7 2.1 1.6 Bednet use: By children 9.5 11.6 12.3 25.2 38.1 15.4 * * (11.5) 35.2 57.0 45.9 By pregnant women 4.0 (10.3) 11.6 (15.2) (63.4) 12.5 * * * * 60.2 54.5 C. Breastfeeding Exclusive breastfeeding 53.2 * (33.3) (58.5) * 40.0 * * * * (38.0) (38.1) Timely complementary feeding (59.5) (56.0) (68.3) * * 63.3 * * * * (61.2) (66.3) Bottle-feeding 6.8 3.8 4.9 6.3 (18.8) 6.1 * * * * 26.8 20.2 D. Micronutrient consumption Iodized salt: Availability of iodized salt 51.4 59.4 60.6 66.9 74.5 60.0 (78.3) * 69.5 82.9 89.5 85.7 in household Vitamin A: Children 8.1 13.5 9.5 15.9 13.0 11.4 * * (13.6) 2.3 23.7 17.1 Women 8.0 11.8 9.5 12.8 6.3 10.1 * * (13.1) 6.5 16.7 13.7 E. Tobacco and alcohol use Tobacco: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Alcohol: Women na na na na na na na na na na na na Men na na na na na na na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 9.1 10.6 13.3 10.4 12.0 11.0 (10.4) (16.8) 24.3 17.8 19.2 19.1 Men 32.7 29.7 29.9 32.3 30.1 31.0 * (45.8) 46.3 31.2 32.9 34.2 Condom usage with non-regular partner: Women 22.6 (11.5) 14.4 (19.7) * 17.2 * * * (10.6) 37.7 31.2 Men 21.1 27.3 22.4 32.0 54.0 28.0 * (31.3) 44.6 39.9 64.9 56.2 G. Domestic violence Ever experienced violence na na na na na na na na na na na na Experienced violence in past year na na na na na na na na na na na na - 34 - Tanzania 1999 - RURAL / URBAN POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 44.3 48.1 50.1 63.4 76.2 52.8 (41.9) (59.2) 54.1 68.1 83.9 77.3 Men 60.3 61.1 64.2 75.2 82.8 66.4 * (57.2) 64.4 71.9 85.2 79.3 School participation: Girls 28.0 28.7 22.6 44.4 57.4 32.1 * * (30.9) 55.5 79.6 64.4 Boys 16.2 20.4 25.0 37.2 61.9 26.5 * * (5.5) 35.4 68.9 52.3 B. Exposure to mass media Newspaper readership: Women 1.2 1.2 1.2 2.6 4.7 1.7 * 0.0 0.0 6.0 18.8 14.2 Men 4.6 5.7 3.9 6.3 16.7 6.1 * (1.5) 11.6 23.4 42.4 34.3 Radio listenership: Women 4.9 17.5 14.5 39.9 50.8 20.7 * (18.3) 7.1 42.7 51.7 45.1 Men 18.9 39.0 32.8 60.5 63.4 39.8 * (48.0) 36.8 56.1 66.2 60.1 Television viewership: Women 0.6 0.2 1.1 1.3 5.4 1.1 * (5.4) 1.7 3.1 16.4 12.4 Men 3.2 3.5 1.9 4.7 11.3 3.9 * (10.9) 14.1 9.6 31.5 24.9 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 69.7 74.8 72.0 81.1 86.0 75.0 (86.2) (85.1) 83.2 93.3 91.1 90.7 Men 84.8 87.0 86.7 92.4 95.2 88.3 * (88.1) 86.7 94.7 95.3 94.2 Knowledge about mother-to-child transmission of HIV/AIDS: Women 69.4 70.8 73.0 82.7 85.6 74.5 (88.2) (78.2) 84.5 90.2 91.3 90.2 Men 72.9 75.5 78.3 82.6 87.0 78.2 * (87.0) 72.8 92.3 88.9 87.7 Attitudes toward HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na na na Can seek children's health care na na na na na na na na na na na na Can make daily household purchases na na na na na na na na na na na na Can make large household purchases na na na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na na na na na na na Can decide whether to have sex na na na na na na na na na na na na Justifies domestic violence na na na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 7.2 6.2 7.8 4.9 3.7 6.4 12.4 1.6 6.7 6.7 6.0 6.3 Maternal orphan prevalence 3.9 2.5 3.5 3.4 4.3 3.4 3.7 10.9 3.8 3.5 4.1 4.1 Double orphan prevalence 1.1 1.0 1.0 0.7 1.8 1.0 0.0 0.0 1.0 0.6 1.1 0.9 - 35 - PART III. BASIC TABLES, 1996 A. TOTAL POPULATION B. FEMALE AND MALE POPULATIONS C. RURAL AND URBAN POPULATIONS Notes: ­ Each of the three sections referred to above consists of four divisions, presenting data for: I) hnp status; II) hnp service use; III) hnp-related individual and household behavior; and IV) other, underlying determinants of hnp status. ­ Full definitions of all indicators covered in the tables are provided in section A of the technical notes found in part II. ­ "na" appears in the table cells when data are not available, usually because the DHS survey concerned did not collect information about the indicator(s) in question. ­ Figures in the tables shown within parentheses indicate the absence of adequate observations to produce acceptably reliable values. Asterisks appear when the number of observations was too small to justify the presentation even of figures within parentheses. (For further information, see the section on "Sampling Errors" in the presentation of data and methods in part II.B.) Asterisks also will be found in columns showing statistical indices of inequality when the amount of quintile-specific information available is inadequate to permit computation of the value for the index concerned. ­ Female/male tables include only indicators relevant for both sexes; those pertaining to only one sex (e.g., fertility, women's nutritional status, antenatal care, attended deliveries) have been omitted. Tanzania 1996 - TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood illness and mortality Infant mortality rate 87.3 118.0 95.6 102.1 64.8 94.1 1.35 22.50 -0.0403 0.0012 Under-five mortality rate 140.1 179.8 148.0 152.8 97.5 144.8 1.44 42.60 -0.0513 0.0011 Prevalence of fever 29.2 28.2 31.7 34.0 28.1 30.3 1.04 1.10 0.0100 0.0115 Prevalence of diarrhea 13.7 11.7 14.8 15.4 12.3 13.7 1.11 1.40 0.0059 0.0183 Prevalence of acute respiratory 11.6 12.9 14.2 13.9 12.3 13.0 0.94 0.70 0.0014 0.0190 infection (ARI) B. Fertility Total fertility rate 7.8 6.0 6.4 5.4 3.9 5.8 2.00 3.90 -0.1189 0.0006 Adolescent fertility rate 151.0 130.0 165.0 160.0 93.0 135.0 1.62 58.00 -0.0716 0.0018 C. Nutritional status (%) Children: Moderate stunting 27.8 26.6 27.6 25.1 19.6 25.6 1.42 8.20 -0.0709 0.0133 Severe stunting 22.6 20.3 19.2 16.1 9.3 17.8 2.43 13.30 -0.1300 0.0167 Moderate underweight 28.2 25.4 23.1 20.6 15.4 22.9 1.83 12.80 -0.1005 0.0143 Severe underweight 11.6 8.0 8.5 6.6 2.8 7.8 4.14 8.80 -0.2002 0.0275 Mild anemia na na na na na na na na na na Moderate anemia na na na na na na na na na na Severe anemia na na na na na na na na na na Women: Malnutrition 12.2 7.7 9.3 9.1 7.1 9.2 1.72 5.10 -0.1129 0.0312 Mild anemia na na na na na na na na na na Moderate anemia na na na na na na na na na na Severe anemia na na na na na na na na na na D. Female circumcision (%) Prevalence of circumcision: Girls 11.6 5.7 7.8 6.5 2.4 6.8 4.83 9.20 -0.2507 0.0320 Women 31.7 16.0 17.4 15.6 10.6 17.7 2.99 21.10 -0.1666 0.0147 Prevalence of occlusion: Girls na na na na na na na na na na Women 8.7 3.2 6.4 3.1 1.9 5.3 4.58 6.80 -0.4074 0.0789 E. Sexually transmitted disease Prevalence of genital discharge: Women 2.2 1.5 1.8 1.3 1.5 1.6 1.47 0.70 -0.0590 0.0526 Men 5.7 7.8 8.6 6.3 6.8 7.1 0.84 1.10 -0.0189 0.0470 Prevalence of genital ulcer: Women 1.1 0.8 0.6 0.4 0.5 0.7 2.20 0.60 -0.1933 0.0856 Men 2.5 6.0 4.2 3.7 2.7 3.8 0.93 0.20 -0.1013 0.0624 - 39 - Tanzania 1996 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood immunization BCG coverage 91.3 96.4 95.7 98.9 99.6 96.2 0.92 8.30 0.0175 0.0035 Measles coverage 66.9 79.9 76.4 89.0 94.9 80.9 0.70 28.00 0.0585 0.0079 DPT coverage 74.6 84.6 83.2 91.4 94.3 85.2 0.79 19.70 0.0424 0.0065 Full basic coverage 57.3 68.8 66.9 79.3 82.5 70.5 0.69 25.20 0.0614 0.0107 No basic coverage 6.9 3.6 4.3 0.6 0.4 3.3 17.25 6.50 -0.4684 0.0958 Hepatitis B coverage na na na na na na na na na na Yellow fever coverage na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 32.2 40.0 39.7 41.6 45.3 39.4 0.71 13.10 0.0607 0.0164 Treatment in a public facility 29.5 35.9 36.6 36.9 39.1 35.4 0.75 9.60 0.0497 0.0177 Treatment in a private facility 1.8 3.0 2.0 4.4 5.5 3.2 0.33 3.70 0.1347 0.0677 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 61.8 65.0 74.8 69.7 77.0 69.6 0.80 15.20 0.0469 0.0135 Treatment in a public facility 54.6 61.8 66.8 61.3 67.7 62.3 0.81 13.10 0.0437 0.0156 Treatment in a private facility 6.2 2.1 4.1 8.4 7.1 5.6 0.87 0.90 0.0783 0.0759 Treatment of diarrhea: Use of oral rehydration therapy 69.0 71.2 70.7 76.2 83.9 73.7 0.82 14.90 0.0378 0.0121 Medical treatment of diarrhea 44.3 60.6 56.0 59.0 66.1 56.3 0.67 21.80 0.0588 0.0176 Treatment in a public facility 41.4 51.0 51.4 55.2 52.9 50.1 0.78 11.50 0.0436 0.0198 Treatment in a private facility 2.1 7.7 4.3 2.9 10.0 4.9 0.21 7.90 0.2366 0.0827 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 82.2 90.1 88.4 93.1 96.6 89.9 0.85 14.40 0.0277 0.0029 To a doctor 5.3 5.1 5.4 8.3 13.4 7.4 0.40 8.10 0.2197 0.0328 To a nurse or trained midwife 76.9 85.0 83.0 84.9 83.2 82.5 0.92 6.30 0.0101 0.0041 Multiple visits to a medically-trained person 81.0 88.2 89.5 88.7 90.5 87.5 0.90 9.50 0.0163 0.0035 Antenatal care content: Tetanus toxoid 87.0 90.6 92.7 94.3 96.4 92.1 0.90 9.40 0.0202 0.0027 Prophylactic antimalarial treatment na na na na na na na na na na Iron supplementation na na na na na na na na na na Delivery attendance: By a medically-trained person 26.7 40.4 41.2 51.8 80.9 46.7 0.33 54.20 0.2006 0.0069 By a doctor 3.0 5.2 5.3 5.3 11.1 5.7 0.27 8.10 0.2135 0.0308 By a nurse or trained midwife 23.7 35.2 35.9 46.6 69.8 40.9 0.34 46.10 0.1988 0.0080 In a public facility 24.7 37.0 38.6 48.7 74.0 43.2 0.33 49.30 0.1994 0.0075 In a private facility 2.3 2.9 3.3 3.7 4.7 3.3 0.49 2.40 0.1230 0.0389 At home 68.0 55.0 54.0 44.9 18.9 49.5 3.60 49.10 -0.1714 0.0066 D. Contraceptive services Contraceptive prevalence: Women 4.9 7.2 10.0 14.1 28.9 13.3 0.17 24.00 0.3319 0.0208 Men 7.9 8.7 13.7 16.4 30.3 15.9 0.26 22.40 0.2843 0.0393 - 40 - Tanzania 1996 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors D. Contraceptive services (cont.) Source of contraception - public sector: Women 84.1 81.5 84.4 80.2 71.9 77.5 1.17 12.20 -0.0489 0.0112 Men na na na na na na na na na na Source of contraception - private sector: Women 8.5 16.0 13.0 15.4 25.1 19.0 0.34 16.60 0.2007 0.0450 Men na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women (51.0) (52.8) (50.5) (48.6) (49.8) 50.6 1.02 1.20 -0.0072 0.0435 Men * (58.5) (61.9) (70.5) 62.5 64.6 * * * * Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na Men * (72.9) (72.1) (70.0) 47.9 68.9 * * * * Voluntary counseling and testing for HIV/AIDS: Women 2.0 2.4 2.9 3.7 7.8 4.0 0.26 5.80 0.3229 0.0347 Men 6.4 8.3 7.0 13.8 17.3 11.2 0.37 10.90 0.2421 0.0372 - 41 - Tanzania 1996 - TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na na na na na Treated bednet ownership na na na na na na na na na na Bednet use: By children na na na na na na na na na na By pregnant women na na na na na na na na na na C. Breastfeeding Exclusive breastfeeding 46.9 48.2 38.6 41.6 24.2 40.5 1.94 22.70 -0.0977 0.0331 Timely complementary feeding 85.8 91.6 78.9 94.4 91.6 87.9 0.94 5.80 0.0044 0.0107 Bottle-feeding 7.5 7.0 8.0 8.4 12.5 8.5 0.60 5.00 0.1012 0.0544 D. Micronutrient consumption Iodized salt: Availability of iodized salt na na na na na na na na na na in household Vitamin A: Children na na na na na na na na na na Women na na na na na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na na na na na Men na na na na na na na na na na Alcohol: Women na na na na na na na na na na Men na na na na na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 11.1 12.9 13.6 11.8 16.4 13.3 0.68 5.30 0.0452 0.0164 Men 24.8 26.7 26.2 27.7 35.5 28.6 0.70 10.70 0.0714 0.0192 Condom usage with non-regular partner: Women 7.3 11.7 13.0 13.1 30.5 17.1 0.24 23.20 0.2529 0.0414 Men 20.2 16.4 17.7 24.5 34.4 24.2 0.59 14.20 0.1778 0.0407 G. Domestic violence Ever experienced violence na na na na na na na na na na Experienced violence in past year na na na na na na na na na na - 42 - Tanzania 1996 - TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Education School completion: Women 40.8 47.1 53.9 61.0 81.4 58.1 0.50 40.60 0.1401 0.0049 Men 51.8 61.1 66.1 72.6 85.9 69.1 0.60 34.10 0.0965 0.0042 School participation: Girls 16.1 25.0 26.8 35.4 48.7 29.5 0.33 32.60 0.2028 0.0160 Boys 15.4 21.5 21.3 25.5 44.9 25.0 0.34 29.50 0.2105 0.0183 B. Exposure to mass media Newspaper readership: Women 1.3 2.8 4.8 8.4 41.0 13.1 0.03 39.70 0.6201 0.0195 Men 5.8 12.9 16.2 19.0 64.8 26.1 0.09 59.00 0.4595 0.0187 Radio listenership: Women 3.4 5.5 23.3 50.5 68.7 32.6 0.05 65.30 0.4624 0.0079 Men 16.2 20.8 47.0 71.0 85.5 52.2 0.19 69.30 0.2973 0.0092 Television viewership: Women 0.8 1.7 3.5 5.4 28.0 8.8 0.03 27.20 0.7344 0.0281 Men 5.6 8.5 7.6 13.0 47.0 18.0 0.12 41.40 0.5321 0.0282 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 77.8 85.1 86.1 91.3 95.0 87.6 0.82 17.20 0.0361 0.0025 Men 86.9 89.8 93.7 90.1 96.9 91.9 0.90 10.00 0.0206 0.0037 Knowledge about mother-to-child transmission of HIV/AIDS: Women 69.8 68.9 70.7 77.4 84.7 73.0 0.82 14.90 0.0706 0.0038 Men 74.9 73.1 76.5 78.1 85.6 76.2 0.88 10.70 0.0568 0.0071 Attitudes toward HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na Can seek children's health care na na na na na na na na na na Can make daily household purchases na na na na na na na na na na Can make large household purchases na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money * * * * * * * * * * Can decide whether to have sex na na na na na na na na na na Justifies domestic violence na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 6.6 7.5 5.4 4.8 6.4 6.2 1.03 0.20 -0.0628 0.0173 Maternal orphan prevalence 2.7 3.7 2.2 2.5 3.6 2.9 0.75 0.90 0.0233 0.0249 Double orphan prevalence 0.2 1.0 0.3 0.5 1.0 0.6 0.20 0.80 0.1610 0.0562 - 43 - Tanzania 1996 - FEMALE / MALE POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood mortality and morbidity Infant mortality rate 82.4 114.8 84.8 87.5 63.0 87.1 92.0 121.1 105.6 117.2 66.4 100.8 Under-five mortality rate 135.7 174.4 133.4 131.9 92.9 134.9 144.2 184.9 161.7 174.4 101.6 154.2 Prevalence of fever 30.0 26.3 33.1 32.4 25.6 29.7 28.4 30.1 30.4 35.8 30.4 30.9 Prevalence of diarrhea 14.6 11.8 15.3 13.2 10.1 13.2 12.9 11.7 14.2 17.8 14.3 14.2 Prevalence of acute respiratory 11.8 13.1 15.5 12.8 11.4 12.9 11.3 12.7 12.9 15.1 13.1 13.0 infection (ARI) B. Nutritional status Children: Moderate stunting 27.8 23.6 27.0 25.0 19.4 24.9 27.8 29.7 28.1 25.2 19.8 26.3 Severe stunting 21.5 18.6 18.6 14.9 10.2 17.1 23.6 21.9 19.7 17.4 8.4 18.6 Moderate underweight 29.4 26.8 22.6 20.6 15.6 23.3 27.1 24.0 23.6 20.6 15.3 22.5 Severe underweight 11.1 5.7 7.8 7.0 2.7 7.1 12.1 10.3 9.3 6.2 2.9 8.4 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na C. Sexually transmitted disease Prevalence of genital discharge: Women 2.2 1.5 1.8 1.3 1.5 1.6 Men 5.7 7.8 8.6 6.3 6.8 7.1 Prevalence of genital ulcer: Women 1.1 0.8 0.6 0.4 0.5 0.7 Men 2.5 6.0 4.2 3.7 2.7 3.8 - 45 - Tanzania 1996 - FEMALE / MALE POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 87.5 94.1 95.9 98.8 99.3 95.1 94.5 98.6 95.5 98.9 100.0 97.3 Measles coverage 67.2 81.1 75.6 87.8 95.3 81.0 66.6 78.8 77.2 90.1 94.5 80.7 DPT coverage 72.1 84.3 86.5 89.4 92.8 84.8 76.7 84.9 79.6 93.4 95.8 85.6 Full basic coverage 59.6 67.0 65.7 76.7 79.4 69.4 55.3 70.6 68.1 82.0 85.5 71.5 No basic coverage 8.6 5.9 4.1 0.0 0.7 3.9 5.5 1.4 4.5 1.1 0.0 2.7 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 32.4 40.1 42.5 40.4 48.3 40.2 32.1 39.8 36.7 42.7 43.1 38.7 Treatment in a public facility 29.4 38.4 38.6 35.8 42.5 36.4 29.6 33.7 34.6 38.0 36.6 34.5 Treatment in a private facility 1.8 1.8 1.8 4.4 4.5 2.8 1.9 4.1 2.1 4.4 6.3 3.7 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 64.9 64.1 72.6 71.7 70.9 69.0 58.7 65.9 77.4 68.0 81.7 70.2 Treatment in a public facility 58.6 63.1 63.1 64.3 63.7 62.5 50.7 60.4 71.2 58.6 70.7 62.2 Treatment in a private facility 6.2 1.1 4.0 7.4 4.3 4.7 6.1 3.2 4.3 9.4 9.3 6.6 Treatment of diarrhea: Use of oral rehydration therapy 64.2 63.1 67.3 84.9 87.7 72.2 74.1 79.6 74.1 69.3 81.5 75.1 Medical treatment of diarrhea 37.7 52.3 59.2 60.6 64.6 53.7 51.3 69.1 52.7 57.7 67.1 58.7 Treatment in a public facility 34.2 44.0 53.6 56.5 52.5 47.6 49.0 58.1 49.0 54.1 53.1 52.4 Treatment in a private facility 1.9 4.4 4.9 4.1 10.2 4.6 2.3 10.9 3.7 2.0 9.9 5.2 C. Contraceptive services Contraceptive prevalence: Women 4.9 7.2 10.0 14.1 28.9 13.3 Men 7.9 8.7 13.7 16.4 30.3 15.9 Source of contraception - public sector: Women 84.1 81.5 84.4 80.2 71.9 77.5 Men na na na na na na Source of contraception - private sector: Women 8.5 16.0 13.0 15.4 25.1 19.0 Men na na na na na na D. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women (51.0) (52.8) (50.5) (48.6) (49.8) 50.6 Men * (58.5) (61.9) (70.5) 62.5 na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 2.0 2.4 2.9 3.7 7.8 4.0 Men 6.4 8.3 7.0 13.8 17.3 11.2 - 46 - Tanzania 1996 - FEMALE / MALE POPULATIONS Part III: Intermediate Determinants of HNP Status - HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet use: By children na na na na na na C. Breastfeeding Exclusive breastfeeding (39.5) (48.9) (25.9) (51.7) (25.0) 39.4 (54.4) (47.5) 47.0 (32.6) (23.7) 41.5 Timely complementary feeding 85.9 (87.7) 80.1 93.7 (93.1) 87.4 85.6 (95.3) (77.1) (95.3) (90.6) 88.5 Bottle-feeding 6.7 2.8 9.2 8.1 9.9 7.2 8.4 12.2 6.9 8.7 14.6 9.9 D. Micronutrient consumption Vitamin A: Children na na na na na na na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na Men na na na na na na Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 11.1 12.9 13.6 11.8 16.4 13.3 Men 24.8 26.7 26.2 27.7 35.5 28.6 Condom usage with non-regular partner: Women 7.3 11.7 13.0 13.1 30.5 17.1 Men 20.2 16.4 17.7 24.5 34.4 24.2 - 47 - Tanzania 1996 - FEMALE / MALE POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 40.8 47.1 53.9 61.0 81.4 58.1 Men 51.8 61.1 66.1 72.6 85.9 69.1 School participation: Girls 16.1 25.0 26.8 35.4 48.7 29.5 Boys 15.4 21.5 21.3 25.5 44.9 25.0 B. Exposure to mass media Newspaper readership: Women 1.3 2.8 4.8 8.4 41.0 13.1 Men 5.8 12.9 16.2 19.0 64.8 26.1 Radio listenership: Women 3.4 5.5 23.3 50.5 68.7 32.6 Men 16.2 20.8 47.0 71.0 85.5 52.2 Television viewership: Women 0.8 1.7 3.5 5.4 28.0 8.8 Men 5.6 8.5 7.6 13.0 47.0 18.0 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 77.8 85.1 86.1 91.3 95.0 87.6 Men 86.9 89.8 93.7 90.1 96.9 91.9 Knowledge about mother-to-child transmission of HIV/AIDS: Women 69.8 68.9 70.7 77.4 84.7 73.0 Men 74.9 73.1 76.5 78.1 85.6 76.2 Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Orphanhood Paternal orphan prevalence 6.8 6.8 5.1 5.3 7.2 6.2 6.5 8.2 5.7 4.2 5.6 6.1 Maternal orphan prevalence 2.5 3.5 2.4 2.1 3.7 2.8 2.9 3.8 2.1 3.0 3.4 3.0 Double orphan prevalence 0.2 0.9 0.3 0.3 1.1 0.5 0.2 1.1 0.3 0.7 0.8 0.6 - 48 - Tanzania 1996 - RURAL / URBAN POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 87.5 118.4 93.2 100.5 68.7 96.8 * * (116.7) (109.5) 62.5 81.7 Under-five mortality rate 139.7 182.2 142.7 152.3 109.6 150.0 * * * (155.0) 90.2 120.3 Prevalence of fever 29.1 28.0 31.2 33.2 30.1 30.3 * 31.0 36.3 38.4 27.0 30.5 Prevalence of diarrhea 13.7 12.0 15.3 15.9 11.5 14.0 * 7.7 10.2 13.2 12.8 12.3 Prevalence of acute respiratory infection 11.6 12.9 14.6 14.4 12.5 13.2 * 12.9 10.9 11.4 12.2 11.9 B. Fertility Total fertility rate 7.8 6.1 6.5 5.7 (4.5) 6.3 * * * * 3.5 4.1 Adolescent fertility rate 150.0 127.0 165.0 153.0 (95.0) 142.6 * * * * 92.0 115.2 C. Nutritional status Children: Moderate stunting 27.9 26.9 27.8 25.6 20.8 26.7 * 23.0 25.3 22.4 18.9 20.6 Severe stunting 22.8 20.8 18.9 17.1 8.1 19.1 * 12.6 22.1 11.1 9.9 11.8 Moderate underweight 28.2 25.8 24.2 21.7 16.2 24.5 * 20.3 13.9 14.8 15.0 15.5 Severe underweight 11.8 8.1 8.1 7.0 3.6 8.5 * 6.2 12.8 4.4 2.3 4.1 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na Women: Malnutrition 12.1 7.5 9.9 8.7 7.0 9.5 * (11.6) 4.3 11.0 7.2 8.0 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na D. Female circumcision Prevalence of circumcision: Girls 11.8 6.0 7.9 7.4 3.4 7.9 * 2.7 7.2 2.2 1.9 2.6 Women 31.9 16.6 17.6 17.6 12.3 20.1 * 6.0 15.5 6.9 9.9 9.8 Prevalence of occlusion: Girls na na na na na na * * * * * * Women 8.8 3.2 7.1 3.3 0.0 5.8 * * * * 3.1 2.1 E. Sexually transmitted disease Prevalence of genital discharge: Women 2.1 1.6 1.9 1.4 1.3 1.7 * 0.0 1.1 1.1 1.6 1.4 Men 5.8 7.3 7.5 5.4 2.8 6.1 * * 15.7 10.0 8.8 10.1 Prevalence of genital ulcer: Women 1.1 0.8 0.7 0.3 0.5 0.7 * 0.0 0.0 0.9 0.5 0.5 Men 2.6 5.6 4.0 3.1 1.0 3.6 * * 5.4 6.4 3.5 4.6 - 49 - Tanzania 1996 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 91.1 96.1 95.3 98.6 100.0 95.4 * * * 100.0 99.5 99.7 Measles coverage 66.4 78.2 75.0 88.7 94.4 77.7 * * * 90.5 95.2 94.4 DPT coverage 74.2 84.4 82.3 90.1 94.6 83.1 * * * 97.4 94.2 94.2 Full basic coverage 56.6 67.8 66.9 78.6 85.6 68.2 * * * 82.8 81.0 80.4 No basic coverage 7.0 3.9 4.7 0.7 0.0 4.0 * * * 0.0 0.5 0.3 Hepatitis B coverage na na na na na na na na na na na na Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood diseases Treatment of fever: Medical treatment of fever 32.4 39.9 39.2 39.8 35.0 37.3 * * (43.7) 49.3 51.7 48.8 Treatment in a public facility 29.7 36.3 36.4 35.1 33.0 34.0 * * (38.4) 45.0 42.9 41.5 Treatment in a private facility 1.8 2.6 1.5 4.5 2.0 2.5 * * (5.3) 3.7 7.7 6.3 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 61.5 65.3 74.0 69.2 63.0 67.3 * * * (73.0) 84.8 81.0 Treatment in a public facility 54.4 63.1 66.5 60.1 63.0 61.1 * * * (69.3) 70.3 68.3 Treatment in a private facility 6.2 1.0 3.9 9.2 0.0 4.8 * * * (3.6) 11.1 9.7 Treatment of diarrhea: Use of oral rehydration therapy 68.5 70.9 71.2 74.5 (85.0) 72.1 * * * (87.1) 83.3 82.3 Medical treatment of diarrhea 44.5 59.8 56.6 55.5 (63.7) 54.1 * * * (80.5) 67.3 67.8 Treatment in a public facility 41.5 49.8 51.6 51.9 (55.6) 48.8 * * * (75.6) 51.6 56.7 Treatment in a private facility 2.1 8.0 4.6 2.6 (5.9) 4.1 * * * (4.9) 12.0 8.8 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 82.0 89.6 87.8 92.5 94.4 88.2 * 98.3 92.7 96.2 97.7 96.9 To a doctor 5.1 4.8 4.7 6.8 7.8 5.5 * 9.9 10.5 15.0 16.2 15.0 To a nurse or trained midwife 76.8 84.8 83.1 85.7 86.6 82.7 * 88.4 82.2 81.2 81.5 82.0 Multiple visits to a medically-trained person 80.9 87.6 89.5 88.8 92.3 86.9 * 96.8 89.6 88.2 89.5 89.7 Antenatal care content: Tetanus toxoid 86.8 90.3 92.3 93.9 96.1 91.1 * 93.8 95.5 96.3 96.6 96.3 Prophylactic antimalarial treatment na na na na na na na na na na na na Iron supplementation na na na na na na na na na na na na Delivery attendance: By a medically-trained person 26.3 38.8 37.8 47.7 71.1 39.4 * 64.6 69.7 73.5 86.3 80.1 By a doctor 2.8 4.7 4.6 4.9 8.3 4.5 * 12.5 10.9 7.1 12.7 11.6 By a nurse or trained midwife 23.6 34.1 33.2 42.8 62.8 34.9 * 52.1 58.8 66.4 73.7 68.5 In a public facility 24.3 35.4 35.3 44.9 62.9 36.4 * 60.3 66.0 68.7 80.2 74.8 In a private facility 2.3 3.0 3.0 3.4 5.5 3.1 * 1.2 5.9 5.1 4.2 4.3 At home 68.6 56.5 57.4 48.5 28.0 56.2 * 33.1 25.9 25.4 13.8 18.7 D. Contraceptive services Contraceptive prevalence: Women 4.9 6.6 9.3 12.1 26.3 9.8 * 16.5 16.9 23.1 30.3 26.6 Men 8.2 9.1 12.6 15.0 30.3 13.1 * * (23.2) (22.9) 30.3 26.3 - 50 - Tanzania 1996 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - public sector: Women 83.6 82.4 82.1 83.1 77.9 81.6 * * * 73.4 69.2 71.8 Men * * (100.0) (100.0) (100.0) 100.0 0.0 0.0 * * 100.0 100.0 Source of contraception - private sector: Women 8.8 15.7 14.7 12.9 18.2 14.5 * * * 21.7 28.3 25.3 Men na na na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women (51.6) (52.8) (47.8) * * 50.1 * 0.0 * * (47.8) (52.6) Men * (58.5) (70.2) (67.3) * 66.2 0.0 * * * (62.8) 61.4 Treatment of genital discharge, ulcer, sore in public facilities: Women 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Men * (73.7) (73.8) (66.7) * 73.3 0.0 * * * (49.7) 59.2 Voluntary counseling and testing for HIV/AIDS: Women 2.1 2.1 2.9 3.6 6.5 3.0 * 7.5 3.2 4.2 8.5 7.1 Men na na na na na na na na na na na na - 51 - Tanzania 1996 - RURAL / URBAN POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na na na na na na na Treated bednet ownership na na na na na na na na na na na na Bednet use: By children na na na na na na na na na na na na By pregnant women na na na na na na na na na na na na C. Breastfeeding Exclusive breastfeeding 47.3 50.1 39.4 43.3 (32.6) 43.9 * * * * (17.6) 24.1 Timely complementary feeding 85.5 91.1 77.3 93.9 * 87.0 * * * * 91.0 92.3 Bottle-feeding 7.5 5.4 8.6 7.9 12.1 7.8 * * (3.0) 10.9 12.8 12.1 D. Micronutrient consumption Iodized salt: Availability of iodized salt na na na na na na na na na na na na in household Vitamin A: Children na na na na na na na na na na na na Women na na na na na na na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Alcohol: Women na na na na na na na na na na na na Men na na na na na na na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 11.2 11.9 12.3 10.0 13.0 11.5 * 26.4 23.5 19.7 18.1 19.1 Men na na na na na na na na na na na na Condom usage with non-regular partner: Women 7.4 11.7 9.9 10.3 20.2 11.0 * (12.0) (25.1) 19.4 34.1 28.9 Men 20.4 16.1 16.5 26.3 33.1 21.7 * * 24.6 16.8 35.1 30.8 G. Domestic violence Ever experienced violence na na na na na na na na na na na na Experienced violence in past year na na na na na na na na na na na na - 52 - Tanzania 1996 - RURAL / URBAN POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 40.9 46.7 52.6 60.1 79.0 52.7 * 52.5 63.7 64.9 82.6 75.9 Men 51.9 61.5 65.5 72.3 82.7 65.0 * 56.0 70.5 74.0 87.3 81.8 School participation: Girls 15.9 24.9 24.7 33.4 49.7 26.0 * (27.1) 45.1 48.0 48.1 46.3 Boys 15.4 21.0 21.2 26.2 47.0 22.8 * (30.9) 22.6 21.7 43.4 36.2 B. Exposure to mass media Newspaper readership: Women 1.4 2.7 3.2 6.4 22.0 5.2 * 3.9 16.9 17.0 50.1 38.6 Men 5.1 12.3 12.8 13.3 40.5 14.3 * * 40.4 42.5 77.3 64.0 Radio listenership: Women 3.4 5.4 23.5 49.7 63.2 24.3 * 7.6 21.6 53.9 71.3 59.7 Men 16.2 18.8 47.4 70.7 83.4 44.4 * * 44.8 72.4 86.5 77.3 Television viewership: Women 0.8 1.6 2.7 2.7 14.4 3.2 * 3.4 9.7 16.7 34.6 27.3 Men 5.7 7.9 5.8 9.8 27.7 9.5 * * 20.5 26.1 57.0 45.0 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 77.7 84.7 85.8 90.3 93.9 85.5 * 89.9 88.5 95.6 95.5 94.5 Men na na na na na na na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women 58.8 68.0 70.1 76.2 83.8 69.7 * 82.4 74.6 82.8 85.1 83.6 Men 61.1 72.3 76.4 78.2 86.9 74.2 * * 77.8 77.7 84.9 82.7 Attitudes toward HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na na na Can seek children's health care na na na na na na na na na na na na Can make daily household purchases na na na na na na na na na na na na Can make large household purchases na na na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money * * * * * * * * * * * * Can decide whether to have sex na na na na na na na na na na na na Justifies domestic violence na na na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 6.6 7.7 5.0 5.0 7.2 6.2 (6.0) 4.3 9.6 3.3 5.9 5.7 Maternal orphan prevalence 2.7 3.7 2.1 2.7 3.5 2.9 0.0 3.2 3.2 1.3 3.6 3.1 Double orphan prevalence 0.2 1.1 0.3 0.5 0.7 0.5 0.0 0.0 0.7 0.4 1.1 0.9 - 53 - PART IV. TECHNICAL NOTES A. INDICATOR DEFINITIONS B. DATA AND METHODS C. DISCUSSION INDICATOR DEFINITIONS Part I: HNP STATUS A. CHILDHOOD MORTALITY AND ILLNESS 2 Infant mortality rate: number of deaths to children under 12 months of age per 1,000 live births, based on experience during the ten years preceding the survey. Under-five mortality rate: number of deaths to children under five years of age per 1,000 live births, based on experience during the ten years preceding the survey. Prevalence of fever: percent of children who had fever, whether or not accompanied by cough or rapid breathing, in the two weeks before the survey. Prevalence of diarrhea: percent of children who had diarrhea in the two weeks before the survey. Prevalence of acute respiratory infection: percent of children who had a cough accompanied by rapid or difficult breathing in the two weeks before the survey. B. FERTILITY Total fertility rate (TFR): average number of births a woman could expect to have during her lifetime if she followed the levels of fertility currently observed at every age. The TFR is calculated as the sum of average annual age-specific fertility rates for all reproductive age groups (usually 15-49 years) in the three years before the survey. Adolescent fertility rate: age-specific fertility rate for women 15-19 years of age. This is the average number of births among women aged 15-19 years per 1,000 women in that age group, based on births in the three years before the survey and expressed as annual averages. 2Figures for the prevalence of fever, diarrhea, and acute respiratory infection refer to percent of children under three, four, or five years of age, depending upon the country. (The specific ages covered for in particular country may be determined by consulting the full report on that country's DHS, which may be found at: www.measuredhs.com/countries.) - 57 - C. NUTRITIONAL STATUS Children 3, 4, 5 Moderate stunting (height-for-age): percent of children with a height-for-age Z-score of between ­2 and ­3 standard deviations of the median reference standard for their age (as defined in fn. 4). Severe stunting (height-for-age): percent of children with a height-for-age Z-score of below ­3 standard deviations of the median reference standard for their age (as defined in fn. 4). Moderate underweight (weight-for-age): percent of children with a weight-for-age Z-score of between ­2 and ­3 standard deviations of the median reference standard for their age (as defined in fn. 4). Severe underweight (weight-for-age): percent of children with a weight-for-age Z-score of below ­3 standard deviations of the median reference standard for their age (as defined in fn. 4). Mild anemia: percent of children with a hemoglobin level of between 10.0g/dl and 10.9 g/dl, the World Health Organization criterion for mild anemia. Moderate anemia: percent of children with a hemoglobin level of between 7.0g/dl and 9.9g/dl, the World Health Organization criterion for moderate anemia. Severe anemia: percent of children with a hemoglobin level of below 7.0g/dl, the World Health Organization criterion for severe anemia. Women 6, 7 Malnutrition: percent of women aged 15-49 years with a Body Mass Index (BMI) of less than 18.5, where BMI ­ commonly used to indicate adult nutritional status ­ is defined as weight in kilograms divided by the square of height in meters. Mild anemia: percent of women aged 15-49 years with a hemoglobin level of between 10.0g/dl and 10.9g/dl for pregnant women and between 10.0g/dl and 11.9g/dl for non-pregnant women, the World Health Organization criterion for mild anemia. Moderate anemia: percent of women aged 15-49 years with a hemoglobin level of between 7.0g/dl and 9.9g/dl, the World Health Organization criterion for moderate anemia. Severe anemia: percent of women aged 15-49 years with a hemoglobin level of less than 7.0g/dl, the World Health Organization criterion for severe anemia. 3 All figures related to children's nutrition status refer to children under three, four, or five years of age, depending upon the country. (The specific ages covered for in particular country may be determined by consulting the full report on the DHS of the country concerned, which is available at: www.measuredhs.com/countries.) 4 The reference standards used for stunting and underweight are those established in the 1970s by the World Health Organization, the U.S. Centers for Disease Control, and the U.S. National Center for Health Statistics. Updated stunting and underweight figures based on the recently-released, 2006 World Health Organization reference standards are currently under preparation. When complete, they will be available at: www.worldbank.org/povertyandhealth/ countrydata. 5The anemia figures for children living at an altitude above 1,000 meters have been adjusted to reflect the higher level of hemoglobin required. 6In some countries, the BMI is presented for all women; in others, the figure is available only for mothers of children under five years of age. The reference population for any given country can be determined by consulting the full report on the DHS for the country concerned. An electronic version of this report is located at: www.measuredhs.com/ countries. 7 Anemia cut-off points for respondents who live at an altitude above 1,000 meters and/or who smoke have been adjusted to account for their higher hemoglobin requirements. - 58 - D. FEMALE CIRCUMCISION Prevalence of Circumcision Girls: percent of women aged 15-49 years with one or more daughters, at least one of whom had been circumcised. Women: percent of women aged 15-49 years who had been circumcised. Prevalence of Occlusion Girls: percent of women aged 15-49 years with one or more daughters, at least one of whom had been circumcised with the vaginal area sewn closed. Women: percent of women aged 15-49 years whose vaginal area had been sewn closed. E. SEXUALLY TRANSMITTED DISEASES Prevalence of Genital Discharge Women: percent of women aged 15-49 years who had had abnormal genital discharge in the twelve months before the survey. Men: percent of men aged 15-54 years who had had abnormal genital discharge in the twelve months before the survey. Prevalence of Genital Ulcer or Sore Women: percent of women aged 15-49 years who had had a genital ulcer or sore in the twelve months before the survey. Men: percent of men aged 15-54 years who had had a genital ulcer or sore in the twelve months before the survey. - 59 - Part II: INTERMEDIATE DETERMINANTS OF HNP STATUS ­ HEALTH SERVICE USE A. CHILDHOOD IMMUNIZATION 8 BCG coverage: percent of children who had received a dose of BCG vaccine by the time of the survey. Measles coverage: percent of children who had received a dose of measles vaccine by the time of the survey. DPT coverage: percent of children who had received three doses of DPT vaccine by the time of the survey. Full basic coverage: percent of children who had received a dose of BCG vaccine, measles vaccine, and three doses of DPT and polio vaccines by the time of the survey, excluding polio vaccine given at birth. No basic coverage: percent of children who had received no vaccination against the six early- childhood diseases (TB, measles, polio, diphtheria, pertusis, and tetanus) by the time of the survey. Hepatitis B coverage: percent of children who had received three doses of hepatitis B vaccine by the time of the survey. Yellow fever coverage: percent of children who had received a dose of yellow fever vaccine by the time of the survey. B. TREATMENT OF CHILDHOOD ILLNESSES 9 Treatment of Fever Medical treatment of fever: percent of children with fever, with or without cough or rapid breathing, in the two weeks before the survey who had sought medical advice for fever from any health facility or health provider, whether public or private. Treatment in a public facility: percent of children with fever, with or without cough or rapid breathing, in the two weeks before the survey who had sought medical advice for fever from a public-sector health facility or provider (as defined in fn. 9). Treatment in a private facility: percent of children with fever, with or without cough or rapid breathing, in the two weeks before the survey who had sought medical advice for fever from a private-sector health facility or provider (as defined in fn. 9). 8Childhood immunization figures refer to rates among children 12-23 months of age in all countries except those in Latin America and the Caribbean. There, the figures refer to rates among children 18-29 months of age. All figures are based on information recorded on the child's vaccination card; or, in cases where a card was not seen by the interviewer, on the mother's report. 9Figures for illness treatment in a public facility refer to treatment in government hospitals, health centers, health posts, or dispensaries; or in facilities operated by government-affiliated social securing programs. Figures for treatment in private facilities cover treatment in private hospitals or clinics, in private doctors' offices, or in facilities operated by other private medical providers (such as non-governmental organizations) as defined in the country concerned; but exclude treatment obtained in private pharmacies or shops. - 60 - Treatment of Acute Respiratory Infection (ARI) Medical treatment of ARI: percent of children with a cough and rapid breathing in the two weeks before the survey who had been taken for treatment at any medical facility or provider, whether public or private. Treatment in a public facility: percent of children with a cough and rapid breathing in the two weeks before the survey who had been taken for treatment at a public-sector health facility or provider (as defined in fn. 9). Treatment in a private facility: percent of children with a cough and rapid breathing in the two weeks before the survey who had been taken for treatment at a private-sector health facility or provider (as defined in fn. 9). Treatment of Diarrhea Use of oral rehydration therapy: percent of children with diarrhea in the two weeks before the survey who had received oral rehydration therapy (ORT) (defined as including consumption of oral rehydration salts, other recommended home fluids, or other increased liquids). Medical treatment of diarrhea: percent of children with diarrhea in the two weeks before the survey who had been taken for treatment at any medical facility or provider, whether public or private. Treatment in a public facility: percent of children with diarrhea in the two weeks before the survey who had been taken for treatment at a public-sector health facility or provider (as defined in fn. 9). Treatment in a private facility: percent of children with diarrhea in the two weeks before the survey who had been taken for treatment at a private-sector health facility or provider (as defined in fn. 9). C. ANTENATAL AND DELIVERY CARE 10 Antenatal Care (ANC) Visits To a medically-trained person: percent of women with one or more births in the five years before the survey who had received at least one antenatal care consultation from a medically- trained person (as defined in fn. 10) before her most recent birth. To a doctor: percent of women with one or more births in the five years before the survey who had received at least one antenatal care consultation from a doctor before her most recent birth. To a nurse or trained midwife: percent of women with one or more births in the five years before the survey who had received at least one antenatal care consultation from a nurse or trained midwife (as defined in fn. 10) before her most recent birth. Multiple visits to a medically-trained person: percent of women with one or more births in the five years before the survey who had received at least three antenatal care consultations from any medically-trained provider (as defined in fn. 10) before her most recent birth. 10When speaking of antenatal and delivery care, medically-trained persons are defined as doctors, nurses, and trained midwives. The definition excludes traditional midwives or other traditional birth attendants, whether trained or untrained. - 61 - Antenatal Care (ANC) Content Tetanus toxoid: percent of women with one or more births in the five years before the survey who had received at least one tetanus toxoid injection during her most recent pregnancy. Prophylactic antimalarial treatment: percent of women with one or more births in the five years before the survey who had received prophylactic treatment with any anti-malarial drug during her most recent pregnancy. Iron supplementation: percent of women with one or more births in the five years before the survey who had taken iron tablets during her most recent pregnancy. Delivery Attendance By a medically-trained person: percent of births in the five years before the survey attended by a medically-trained person (as defined in fn. 10). By a doctor: percent of births in the five years before the survey attended by a doctor. By a nurse or trained midwife: percent of births in the five years before the survey attended to by a nurse or a trained midwife (as defined in fn. 10). In a public facility: percent of all deliveries in the five years before the survey occurring in a public-sector health facility (as defined in fn. 9). In a private facility: percent of all deliveries in the five years before the survey occurring in a private-sector health facility (as defined in fn. 9). At home: percent of all deliveries in the five years before the survey occurring at home (defined as the woman's own or any other home). D. CONTRACEPTIVE SERVICES Contraceptive Prevalence 11 Women: percent of married or in-union women aged 15-49 years who used any modern means of contraception (as defined in fn. 11). Men: percent of married or in-union men aged 15-54 years who used any modern means of contraception (as defined in fn. 11). Source of Contraception - Public Sector Women: percent of married women who obtained their current method of contraception from a public-sector health facility or provider (as defined in fn. 9). Men: percent of married men who obtained their current method of contraception from a public- sector health facility or provider (as defined in fn. 9). Source of Contraception - Private Sector Women: percent of married women who obtained their current method of contraception from a private-sector health facility or provider (as defined in fn. 9, except that private pharmacies and shops are included rather than excluded). 11Figures refer to use of modern means of contraception, defined as male/female sterilization, oral contraceptive pill, contraceptive injection, intrauterine device, male/female condom, diaphragm, cervical cap, contraceptive jelly or foam, implant, or some country-specific modern method. - 62 - Men: percent of married women who obtained their current method of contraception from a private-sector health facility or provider (as defined in fn. 9, except that private pharmacies and shops are included rather than excluded). E. TREATMENT OF ADULT ILLNESSES Treatment of Genital Discharge, Ulcer, or Sore Women: percent of women with genital discharge, ulcer, or sore who sought any medical treatment for resulting symptoms. Men: percent of men with genital discharge, ulcer, or sore who sought any medical treatment for resulting symptoms. Treatment of Genital Discharge, Ulcer, or Sore in a Public Facility Women: percent of women with genital discharge, ulcer, or sore who sought treatment from a public-sector health facility or provider (as defined in fn. 9). Men: percent of men with genital discharge, ulcer, or sore who sought treatment from a public- sector health facility or provider (as defined in fn. 9). Voluntary Counseling and Testing for HIV/AIDS Women: percent of women aged 15-49 years who had been tested for HIV at any time before the survey. Men: percent of men aged 15-54 years who had been tested for HIV at any time before the survey. - 63 - Part III: INTERMEDIATE DETERMINANTS OF HNP STATUS ­ INDIVIDUAL AND HOUSEHOLD BEHAVIOR A. HYGIENIC PRACTICES Disposal of Children's Stools Sanitary disposal: percent of mothers with at least one child under five years of age who disposed of the stools of their youngest child in a sanitary manner (defined as dropping stool into a latrine, burying it, or using disposable diapers). Handwashing Wash hands prior to preparing food: percent of women aged 15-49 years preparing meals who washed hands before handling food. Handwashing facilities in household: percent of households that had hand-washing materials or facilities, as determined by direct observation of interviewers. B. BEDNET OWNERSHIP AND USE Bednet Ownership Bednet ownership: percent of households owning one or more bednets. Treated bednet ownership: percent of households owning one or more bednets that had recently been treated with insecticides. Bednet Use By children: percent of households with at least one child under five years of age, some or all of whom had slept under a bednet the night before the survey. By pregnant women: percent of currently pregnant women who had slept under a bednet the night before the survey. C. BREASTFEEDING Exclusive breastfeeding: percent of children 0-3 months of age who had received only breast milk in the 24 hours before the survey. Timely complementary feeding: percent of children 6-9 months of age who had received breast milk and solid or semi-solid foods in the twenty-four hours before the survey. Bottle-feeding: percent of children under 12 months of age who had received any food or drink from a bottle with a nipple in the twenty-four hours before the survey. - 64 - D. MICRONUTRIENT CONSUMPTION Iodized Salt Availability of iodized salt in household: percent of households with cooking salt testing positive for iodine/iodate at the recommended level of 15 or 25 parts per million or more (depending on the country). 12 Vitamin A Children: percent of children13 who had received at least one dose of vitamin A in the six months before the survey, as reported by the mothers. Women: percent of women who had received a dose of vitamin A within two months of the last birth, in the five years before the survey. E. TOBACCO AND ALCOHOL USE Tobacco 14 Women: percent of women aged 15-49 years who currently were smoking or chewing tobacco products. Men: percent of men aged 15-54 years who currently were smoking or chewing tobacco products. Alcohol Women: percent of women aged 15-49 years who had gotten intoxicated due to excessive consumption of alcohol in the three months before the survey. Men: percent of men aged 15-54 years who had gotten intoxicated due to excessive consumption of alcohol in the three months before the survey. F. SEXUAL PRACTICES Non-Regular Sexual Partnerships Women: percent of women aged 15-49 years who had had sex with a non-regular partner at least once in the twelve months before the survey. Men: percent of men aged 15-54 years who had had sex with a non-regular partner at least once in the twelve months before the survey. 12Which of these two levels is recommended in any particular country may be determined by consulting the full report on that country's DHS, which may be found at: www.measuredhs.com/countries. 13Figures refer to children over six months of age and under three, four, or five years of age, depending upon the country. (The specific ages covered for in a particular country may be determined by consulting the full report on that country's DHS, which is available at: www.measuredhs.com/countries.) 14Tobacco products include cigarettes, pipes, cigars, leaves, etc. - 65 - Condom Usage with Non-Regular Partner Women: percent of women aged 15-49 years with non-regular sexual partner who had used a condom in the last sexual intercourse with such a partner in the twelve months before the survey. Men: percent of men aged 15-54 years with non-regular sexual partner who had used a condom in the last sexual intercourse with such a partner in the twelve months before the survey. G. DOMESTIC VIOLENCE Ever experienced violence: percent of women aged 15-49 years who had ever been hit or beaten by current or former husband/partner. Experienced violence in past year: percent of women aged 15-49 years who had been hit or beaten by current or former husband/partner in the twelve months before the survey. - 66 - Part IV: UNDERLYING DETERMINANTS OF HNP STATUS A. EDUCATION School Completion Women: percent of women aged 15-49 years who had completed the fifth grade. Men: percent of men aged 15-54 years who had completed the fifth grade. School Participation Girls: percent of girls aged 6-10 years who were attending school at the time of the survey. Boys: percent of boys aged 6-10 years who were attending school at the time of the survey. B. EXPOSURE TO MASS MEDIA Newspaper Readership Women: percent of women aged 15-49 years who read a newspaper at least once a week. Men: percent of men aged 15-54 years who read a newspaper at least once a week. Radio Listenership Women: percent of women aged 15-49 years who listened to radio at least once a week. Men: percent of men aged 15-54 years who listened to radio at least once a week. Television Viewership Women: percent of women aged 15-49 years who watched television at least once a week. Men: percent of men aged 15-54 years who watched television at least once a week. C. KNOWLEDGE AND ATTITUDES ABOUT HIV/AIDS Knowledge about Sexual Transmission of HIV/AIDS 15 Women: percent of women aged 15-49 years who knew of HIV/AIDS and of at least one of the following ways to avoid it through interruption of its sexual transmission route: abstinence; using a condom; avoiding multiple sex partners, sex with prostitutes, and unprotected homosexual sex. Men: percent of men aged 15-54 years who knew of HIV/AIDS and of at least one of the ways to avoid HIV/AIDS referred to in the preceding definition. Knowledge about Mother-to-Child Transmission of HIV/AIDS 15In most countries, the survey sample included both married and unmarried individuals. Where this was the case, all respondents, regardless of marital status, were asked the question covered in this section. Where the survey covered only individuals who were or had been married, the data pertain only to individuals who had ever been married. (The marital status of people covered for in particular country is indicated in the full report on that country's DHS, which is located at: www.measuredhs.com/countries.) - 67 - Women: percent of women aged 15-49 years who knew of at least one way HIV/AIDS can be transmitted from mother to child during pregnancy, delivery, or breastfeeding. Men: percent of men aged 15-54 years who knew of at least one way HIV/AIDS can be transmitted from mother to child during pregnancy, delivery, or breastfeeding. Attitudes toward HIV/AIDS Women: percent of women aged 15-49 years who believed that people with HIV/AIDS should be allowed to continue working or that HIV test results should remain confidential. Men: percent of men aged 15-54 years who believed that people with HIV/AIDS should be allowed to continue working or that HIV test results should remain confidential. D. STATUS OF WOMEN Household Decisionmaking Can seek own health care: percent of women age 15-49 years who could decide by themselves to seek their own health care. Can seek children's health care: percent of women aged 15-49 years, whose children live with them, who could decide by themselves to seek health care for their children. Can make daily household purchases: percent of women aged 15-49 years who could decide by themselves or jointly with others to make daily household purchases. Can make large household purchases: percent of women aged 15-49 years who could decide by themselves or jointly with others to make large household purchases. Can make meal-related decisions: percent of women aged 15-49 years who could decide by themselves what food to cook daily. Freedom of Movement Can travel to visit family, relatives: percent of women aged 15-49 years who could decide by themselves to visit family and relatives. Other Decisionmaking, Attitudes Can decide how to spend own money: percent of women aged 15-49 years who work for cash who could decide by themselves on how to use the money they earn. Can decide whether to have sex: percent of women aged 15-49 years agreeing that they can refuse to have sex with their husband for at least one of the following reasons: he has a sexually- transmitted disease; he has had sexual relations with another woman; or the woman is tired, not in mood, or recently has given birth. Justify domestic violence: percent of women aged 15-49 years believing that a husband/male partner would be justified in beating his wife/female partner for at least one of the following reasons: he suspects her of being unfaithful; she argues with him; she goes out without telling him; she neglects the children; she burns the food; or other, country-specific reasons (for example, she shows disrespect for her in-laws or her family does not give the expected dowry). - 68 - E. ORPHANHOOD Maternal orphan prevalence: percent of children under 15 years of age whose natural mother had died before the survey. Paternal orphan prevalence: percent of children under 15 years of age whose natural father had died before the survey. Double orphan prevalence: percent of children under 15 years of age both of whose natural parents had died before the survey. - 69 - DATA AND METHODS Any assessment of the figures featured in this report requires an appreciation of how they were prepared. The first need is to understand the basic features of the data and methods employed. A. SOURCE OF FIGURES The figures appearing in this report are all derived from data collected under the Demographic and Health Surveys (DHS) program conducted by ORC Macro, with support from the U.S. Agency for International Development and other external assistance organizations. Large DHS household surveys have been carried out, usually at periodic intervals, in approximately seventy- five countries across Africa, Asia, Latin America, the Middle East, and the former Soviet Union.16 This series of reports covers the fifty-six of those countries that had one or more DHS surveys undertaken since 1990, for which data were publicly available as of June 2006. (Annex C is a list of the countries for which reports have been prepared.) In each country, the DHS program has gathered information on a large number of indicators about health, nutrition, and population (hnp) status and service use; about relevant behaviors of household members; and about household characteristics like those described below. It has done this through a set of questionnaires, similar in all countries, to collect data at the individual, household, and community levels. The data presented here draw on responses to the individual and household questionnaires. In most cases, they are based on responses from women or other family members interviewed. The principal exceptions concern nutritional status, which is based on anthropometric measurement; immunization, which typically relies to the extent possible on record cards maintained at the household level; and those other items where a source other than interviewer response is specifically identified. B. MEASUREMENT OF ECONOMIC STATUS Wealth or Asset Approach Economic status has been expressed in terms of wealth or assets: specifically, on the basis of information about household characteristics gathered through the DHS household questionnaire. (Such information was normally provided for at least 25-30, and often many more, characteristics like the presence, availability, or use of a fan, radio receiver, or automobile; housing materials like wood or concrete flooring, tile or tin roofing, or cement block walls; superior sources of water like piped or a protected well; and other attributes related to economic status.) 16Further information about the DHS program is available at the program's website: www.measuredhs.com. - 71 - Index Construction A single, consolidated index of living standards17 was constructed by using principal components analysis (PCA) to generate a weight for each household item with available information. A wealth index score was calculated for each household by weighting the response with respect to each item pertaining to that household by the coefficient of the first principal component as determined by application of principal components analysis, and summing the results. The resulting household scores were standardized in relation to a standard normal distribution with a mean of zero and a standard deviation of one. All individuals usually present in each household were assigned the household's standardized wealth index score, and all individuals in the sample population were ranked according to that score. The sample population was then divided into quintiles of individuals, with all individuals in a single household being assigned to the same quintile. The same standardized household wealth index scores originally derived for the total population sample, as just described, were also used in preparing the disaggregated estimates for female and male members of the sample population, and for rural and urban residents. In preparing those disaggregated estimates, the entire population sample was divided into quintiles of individuals; the females and males, and the rural and urban residents in each quintile of the entire sample were then separated from one another; and the mean for each of the ten resulting subgroups (five female, five male; or five rural, five urban) was calculated. This procedure was carried out separately for each of the surveys covered. C. CALCULATION AND PRESENTATION OF RATES Use of Sampling Weights Rates for all health, nutrition, and population indicators are calculated after applying the DHS sampling weights. (DHS surveys often over-sample certain small subgroups of interest ­ residents of a particular geographic area, for example ­ in order to get sample sizes large enough to produce statistically-significant results. The DHS sampling weights are used to compensate for such over-sampling in order to ensure that the results are representative of the population as a whole and not just of the DHS sample.) Calculation of Total Population Averages The average for the total population presented alongside the quintile-specific rates for each indicator is calculated without reference to quintile divisions. It thus equals the weighted mean of the quintile rates, with the weight assigned to each quintile rate being the proportion of the number of individuals at risk (as defined on p. 77) for the indicator concerned. Sampling Errors Information needed to assess the statistical significance of differences among the quintile-specific rates is presented in three ways: · First, in all the basic tables presented in part I, rates are shown in parentheses or replaced by asterisks in cases where the standard error is likely to be unacceptably high because 17 Such an index is usually referred to as either an "asset index" or a "wealth index." The two expressions are used interchangeably in this report; for ease of communication, "wealth index" appears more frequently despite the inexact correspondence between the items included in the index's construction and those appearing in more conventional, financially-based definitions of wealth. - 72 - of small sample size. The number of observations used to determine how to present the data for the different indicators covered were as follows: Indicator Unit of measure Number of observations used to determine how quintile-specific rate was presented Without With Replaced by parentheses parentheses asterisk Infant and child Number of deaths >500 250-499 <250 mortality Total and adolescent Number of births >250 125-249 <125 fertility All other indicators Number of >50 25-49 <25 individuals · Second, the standard error for each quintile-specific rate (except for any rate replaced by an asterisk) appearing in the total population table is provided in part III.B. (Standard errors for the quintile-specific rates presented in the female-male and rural-urban tables are not available.) · Third, the right-hand column of the total population table provides the standard error for the concentration index, one of the measures of inequality shown, as indicated below. D. MEASUREMENT OF INEQUALITY Accompanying each of the indicators presented in the total population table are the values for three statistical measures of inequality: · Low/High Quintile Ratio: the ratio between the rate prevailing in the lowest (poorest) population quintile and that found in the highest (least poor) quintile. · Low-High Quintile Difference: the value of the lowest quintile minus the value of the highest, expressed as an absolute value. · Concentration Index: twice the area in a Lorenz-type diagram between the line of equality and the concentration curve for the indicator in question, the curve being the graph of the cumulative share of the indicator against the cumulative share in the asset distribution. (The value, which can range from -1 to +1, is negative when the hnp indicator is higher among the poor (e.g., fertility), positive when it is higher among the better-off (e.g., modern contraceptive use), and zero when on balance the indicator shows no systematic relationship with wealth.)18 18Adam Wagstaff, Pierella Paci, and Eddy van Doorslaer, "On the Measurement of Inequalities of Health," Social Science and Medicine 33 (1991): 545-57. (See also chapter eight in the volume by O'Donnell, van Doorslaer, Wagstaff, and Lindelow described in the annotated bibliography that constitutes annex A.) - 73 - DISCUSSION While a basic understanding of the data and methods employed is necessary to adequately appreciate the figures appearing in this report, it is not sufficient. For the application of the approach taken involves many subtleties that also need to be understood. Among the more important are: A. DESCRIPTIVE NATURE OF THE RELATIONSHIPS The hnp-poverty relationships shown in this report are no more than descriptive. They should not be taken to imply any direct causal relationships, for several reasons. One reason is the possibility that it is not wealth or asset possession per se that determine a person's health condition. Rather, the determining factors could be other characteristics (such as education or ethnic background) that are simultaneously associated with both asset ownership and health status. It is also possible that the health-poverty relationships shown are driven primarily by particular items included in the index (e.g., water and sanitation). Should this be the case, improvements in health conditions among the poor might be more effectively brought about by focusing on changing those particular components of the wealth index rather than by a general effort to increase economic status as measured by the index as a whole. B. IMPLICATIONS OF A WEALTH/ASSET APPROACH Wealth or Assets as a Measure of Economic Status Reliance on a wealth index to measure economic status is a rather recent development in research on economic disparities, where such status traditionally has been defined in terms of consumption or income. The principal reason for the choice of the wealth index is pragmatic rather than conceptual: the DHS surveys, which are of interest because of the plethora of hnp information that they contain, do not collect consumption or income data; but they do have detailed information on households' physical characteristics, and on the household-level presence of and access to a wide range of goods and services. While there is some disagreement about the relative merits of using such wealth/asset information or consumption data to measure economic status, several recent studies suggest that the asset-consumption relationship is quite close.19 To the extent this is the case, an index of wealth or asset possession/availability can be taken as a 19See, for example, Deon Filmer and Lant H. Pritchett, "Estimating Wealth Effects without Expenditure ­ or Tears: An Application to Educational Enrollments in States of India," Demography 38, no. 1 (February 2001): 115-32; Shea Rutstein and Kiersten Johnson, The DHS Wealth Index, DHS Comparative Reports No. 6 (Calverton, Maryland, USA: ORC Macro, August 2004) esp. 10-14; Adam Wagstaff and Naoko Watanabe, "What Difference Does the Choice of SES Make in Health Inequality Measurement?" Health Economics 12 (2003): 885-90. - 75 - reasonably satisfactory proxy for consumption, rather than or in addition to serving as an indicator of economic status in its own right. C. ECONOMIC STATUS AS A MEASURE OF SOCIO-ECONOMIC WELL-BEING Like consumption or income, a wealth index defines disparities that are primarily economic. This is by no means the only way to define inter-group inequalities that are of potential concern. Other possibilities include gender, place of residence, education, ethnic background, or other factors associated with social exclusion. Thus the economic perspective provides only a partial view of the multidimensional concepts of poverty, inequality, and inequity. By including tables on female-male and rural-urban inequalities, this report pays adequate attention to two of inequality's other important dimensions to justify the use of the term "socio- economic" rather than simply "economic" in its title. However, the centrality of tabulations based on the wealth index means that the primary focus is on the economic dimension. The justification for this lies not in the greater importance of economic considerations, but rather in the recently-improved ability to analyze and thus begin dealing with them. Until the development of the wealth/asset approach, the assessment of economic status had been based on consumption, expenditures, or income, all of which are far more difficult to measure than such other, non- economic dimensions of inequality as gender, ethnic identity, educational level, and place of residence. As a result, assessments of health inequalities by economic status had lagged well behind measurements in terms of these other dimensions, especially gender and education. The focus on inequality's economic aspect applied here represents an effort to redress this imbalance. D. INDEX CONSTRUCTION Choice of Items Use of a wealth index requires decisions about which items to include in it. In the case of secondary analyses like the one featured in this report, the choice is limited to those items included in the data sets being used. But even with this constraint, there nonetheless remains considerable room for choice, given the large number of items for which information is collected by the DHS. The decision made in preparing this report was to include all items in each DHS household questionnaire that relate to ownership of household goods; to dwelling unit construction and characteristics; and to access to services and resources like electricity, water, and sanitation facilities. Also included were other potential indicators of wealth, such as live-in domestic servants. This decision, admittedly somewhat arbitrary, has both advantages and disadvantages. The principal advantage is practical: use of a large number of assets increases the degree of variation across household asset scores and facilitates a more regular distribution of individuals across quintiles. It also reduces the possibility of subjectivity in selecting only some of the variables for inclusion on some a priori basis; and it may increase a wealth index's accuracy as a proxy for consumption. However, including all variables is far from satisfying conceptually. For example, it means failing to discriminate with respect to the items' differing natures. It is not clear, for instance, whether access to water, sanitation, electricity, or other publicly-provided resources should be included in an index that purports to measure private household wealth. Further, many items that are candidates for inclusion in a DHS-based wealth index might be seen as directly influencing health status: water and sanitation for infant and child mortality, for - 76 - example. It would be desirable to include quintile-specific estimates for such items; but to the extent that such items have large index coefficients, any estimates for those items would be suspect. Such items appear to be relatively few and of limited statistical significance in the index used here. However, for the sake of caution, quintile-specific estimates for items appearing in the index have nonetheless been excluded from the basic tables and appear only in supporting table III.C Additional issues arise when comparing the findings for two different points in time covered in the basic tables. Because the nature and number of asset questions included in DHS surveys has been evolving, the items included in the wealth index differ somewhat for each of the surveys reported upon. As such, the results presented in the basic tables might differ to some extent from findings produced by some other approach, such as including in the index only those items appearing in each survey covered. Weighting of Items A further decision required in construction of an index concerns the weight to attach to each of the respective items. As noted earlier, the method used in this report is principal components analysis (PCA). Adoption of this method was based on the findings, referred to earlier, that its use resulted in outcomes that approximated reasonably well those produced by taking a consumption or expenditure approach. Further, it often provides greater discrimination in economic status than does the use of consumption/expenditures. It has also emerged as the standard approach for use in analyses of the sort presented here, so that its adoption is largely non-controversial. Yet this choice, too, is not without an arbitrary aspect; for alternative plausible methods exist. Examples include the "inverse possession" approach, which gives more weight to items possessed by only a few and less to those possessed by many;20 or, perhaps, the common practice of simply assigning the same weight to each index item. Also, the weights for any particular item vary from survey to survey, since the weights were determined separately for the population of each survey included in the basic tables. The results thus produced can be expected to differ from those generated in some other manner, such as generating common weights for all the surveys covered by pooling the data sets. Use of Principal Components Analysis with Dichotomous Variables An additional issue concerns the use of a technique like PCA, developed for use with continuous variables, in the construction of an index based primarily on dichotomous variables. While legitimate in principle, any reservations in this regard are of limited practical consequence, since the considerable experimentation undertaken in preparation for the tabulations presented here indicated that any inaccuracy introduced by applying PCA to the analysis of the dichotomous values used is minimal. Economies of Scale Calculating the values for a household wealth index also requires a decision concerning economies of scale that exist in the households covered. The calculations presented here assume complete economies of scale. The implicit assumption is that additional members do not add to household expenses on items included in the index. 20Saul S. Morris et al., "Validity of Rapid Estimates of Household Wealth and Income for Health Surveys in Rural Africa," Journal of Epidemiology and Community Health 54 (2000): 381-87. - 77 - E. DEFINITION OF QUINTILES Quintiles of Individuals As noted earlier, the quintile-specific figures presented in this report refer to quintiles of individuals in the household population. Such quintiles need to be distinguished from quintiles of households or quintiles of only those people in the population who are "at risk": that is, subject to the particular condition, eligible for the particular service, or capable of behaving in a particular way (children born alive for infant and under-five mortality, for example; or adult men and women for condom use or non-regular sexual partnerships). The expression of findings in terms of quintiles of individuals has several implications: · Because fertility is often higher in lower economic households than among better-off ones, the number of individuals per household will frequently be larger among the poor than among higher-income groups. In such cases, the number of households will vary systematically across quintiles of individuals, and the results expressed in terms of quintiles of households can differ significantly from those presented here. · The proportion of individuals "at risk" with regard to a particular indicator is also likely to vary across quintiles in many cases. (For example, in cases where fertility is higher among poor people, a higher-than-average proportion of poor populations will consist of newborns at risk from infant mortality, young children subject to malnutrition, and pregnant women for whom antenatal care is relevant.) To facilitate the work of any investigators wishing to undertake calculations based on people at risk, the number of such people in each quintile of individuals is shown in part III.A. · As previously indicated, the population average figure provided for each indicator is equivalent to the weighted sum of the quintile rates for that indicator, where the weight assigned to each quintile rate is the number of people at risk in each quintile as presented in part III.A. As a result of this weighting, the population average will usually differ from a simple mean of the population quintile estimates. Quintiles of Males and Females, of Rural and Urban Residents As also reported in the data and methods section, the tables on rural and urban residents and on men and women were prepared using the same asset scores as for the total population; and rural- urban residents and females-males were separated from one another only after the entire sample had been disaggregated into quintiles of individuals. This means that the figures given in the rural-urban and female-male tables refer to females-males and rural-urban residents belonging to each quintile of individuals in the total population, as distinct from quintiles of females, of males, of rural residents, or of urban residents alone. The consequence of this distinction is particularly evident with regard to rural and urban residents. Since rural residents tend to be poorer than urban dwellers, they normally form a considerably higher proportion of individuals in the lower economic quintiles of the total population than in the higher ones. Conversely, urban residents tend to be concentrated in the higher economic groups. As a result, the number of individuals in each of the urban and rural quintiles usually varies greatly and systematically; and when this is the case, the figures presented in the rural-urban tables can differ significantly from those produced by a computation procedure that places the same number of rural and urban residents in each rural quintile or each urban quintile. (The results may also differ significantly from application of an approach featuring the separate calculation of index values for urban and for rural groups. While such separate index values may well be preferable conceptually, their calculation involves complexities that prevented their preparation for this report.) - 78 - F. COMPARISON OF QUINTILES ACROSS COUNTRIES Reliance on population quintiles as basic presentational format for the data appearing in this report implicitly incorporates a relative concept of poverty. This differs from an absolute concept of poverty under which the population would be divided into groups of different sizes according to some absolute standard of living (such as people earning less than one dollar a day, between one and two dollars a day, and more than two dollars a day). This means that, when comparing values of an indicator among people in a given quintile across countries, the comparison is between groups of people whose economic status can be quite different. The lowest quintile of a Latin American population, for example, will usually be considerably better-off than the lowest quintile in an African country. G. COMPARISON OF QUINTILES OVER TIME Another implication is that the wealth status of any given quintile within a particular country is likely to change over time. For instance, when a country is progressing economically, the wealth of the households in the population will tend to increase. This will raise the average asset score in most, possibly all population quintiles. As a result, the living standard enjoyed by individuals in any quintile covered by a recent survey is likely to be higher than that of individuals in that same quintile as measured in a prior survey. H. STATISTICAL INDICATORS OF INEQUALITY The available statistical indicators of inequality are far too numerous to permit use of more than a small proportion of them in presenting the findings featured in this report. The three indicators employed have been selected to provide a wide range of perspectives. Two are designed for ease of understanding, the third for greater technical accuracy. The low/high quintile ratio and low-high quintile difference are the two presented for ease of understanding. The former is a relative measure, the latter an absolute measure that can produce a significantly different impression from that provided by the former. The concentration index is provided for the benefit of technical specialists wishing greater accuracy. It measures the degree of inequality in an hnp indicator across the full wealth index distribution, rather than differences between only two of the five quintiles, and also reflects the relative size of the different asset-based divisions of the study population. I. COMPARABILITY WITH OTHER REPORTS Tabulations similar to those presented here can also be found in the initial series of hnp/poverty country reports, issued in 2000, and in the recent country reports issued by the DHS program. The figures presented in those reports normally resemble quite closely those appearing here for any given indicator; but there are often slight differences for one or more of several reasons. The most common is a difference in the definition of the indicator in question. (These differences are usually small and subtle. But there is one important exception: the definition of moderate malnutrition among children. In the 2000 reports, this was defined as second and third degree malnutrition taken together. Here, it is defined as second degree malnutrition alone.) Another reason, with respect to infant and child mortality, is that the figures in the DHS documents are typically based on experience during the five years before the survey in question, rather than - 79 - during the ten previous years as in this report. A further frequent reason is the use of an improved computational technique. In addition, asset-based, quintile-specific tabulations of hnp indicators have begun to appear in an increasing number of other documents. Given the basic similarity of approach, such tabulations usually produce results that are generally congruent with those shown in part I of this report. However, significant divergences have occasionally been reported; and the absence of adequately detailed information about data and methods often prevents any fully-satisfying understanding of the approaches used. As a result, occasional doubts and frequent uncertainties about approach comparability remain. - 80 - PART V. SUPPORTING TABLES, 2004 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Tanzania 2004 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 9,467 9,475 9,470 9,468 9,475 47,356 Urban 271 446 736 2,253 7,495 11,201 Rural 9,197 9,029 8,734 7,215 1,979 36,154 Female 4,846 4,792 4,831 4,734 4,881 24,084 Male 4,621 4,683 4,639 4,735 4,594 23,272 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 3,601 3,397 3,372 3,208 2,506 16,084 Urban 87 119 250 779 1,909 3,144 Rural 3,514 3,278 3,122 2,429 597 12,940 Female 1,779 1,705 1,665 1,556 1,241 7,945 Male 1,823 1,692 1,707 1,652 1,265 8,139 Prevalence of fever, diarrhea, acute respiratory infection All 1,812 1,664 1,685 1,560 1,250 7,970 Urban 50 52 121 378 957 1,558 Rural 1,762 1,612 1,564 1,182 293 6,413 Female 897 848 809 787 648 3,989 Male 915 816 876 773 603 3,982 Total fertility rate All 1,840 1,944 1,943 2,004 2,597 10,329 Urban 54 99 158 500 2,123 2,935 Rural 1,786 1,845 1,785 1,504 474 7,394 Age-specific fertility rate 15-19 All 355 449 412 391 638 2,245 Urban 14 29 34 86 507 670 Rural 341 419 378 305 131 1,575 Children's nutritional status All 1,651 1,502 1,574 1,451 1,087 7,264 Urban 39 47 106 358 820 1,371 Rural 1,612 1,455 1,467 1,093 267 5,893 Female 815 766 766 726 560 3,633 Male 836 736 808 726 527 3,631 Children's anemia status All 1,493 1,384 1,391 1,311 964 6,542 Urban 41 40 86 322 738 1,228 Rural 1,451 1,344 1,305 988 226 5,315 Female 742 694 679 650 481 3,246 Male 751 690 712 661 483 3,296 - 83 - Tanzania 2004 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All 1,826 1,930 1,931 1,989 2,564 10,240 Urban 54 99 157 490 2,090 2,891 Rural 1,772 1,830 1,774 1,498 474 7,348 Women's anemia status All 1,815 1,928 1,913 1,983 2,500 10,139 Urban 54 98 157 490 2,031 2,830 Rural 1,761 1,830 1,756 1,493 469 7,309 Girls' circumcision All 772 776 798 985 1,165 4,497 Urban 22 34 74 273 915 1,319 Rural 750 742 724 711 250 3,178 Women's circumcision All 377 357 316 256 202 1,507 Urban 4 1 18 41 146 210 Rural 373 356 298 215 57 1,298 Prevalence of genital discharge, ulcer, sore Female 1,835 1,942 1,943 2,004 2,595 10,319 Urban Female 54 99 158 500 2,121 2,933 Rural Female 1,781 1,842 1,785 1,504 474 7,386 Male 476 500 515 512 606 2,610 Urban Male 10 32 32 131 508 712 Rural Male 467 468 482 382 98 1,897 - 84 - Tanzania 2004 - SAMPLE SIZES Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Immunization coverage All 399 348 323 323 238 1,631 Urban 10 16 17 61 193 297 Rural 389 331 306 262 45 1,334 Female 214 170 148 157 116 805 Male 185 178 175 166 123 827 Treatment of fever All 467 428 396 377 281 1,949 Urban 11 17 28 89 206 351 Rural 456 411 368 288 75 1,598 Female 219 216 186 171 150 942 Male 248 212 210 206 131 1,007 Treatment of acute respiratory infection All 162 124 140 130 91 648 Urban 5 7 3 23 71 108 Rural 157 117 137 108 21 540 Female 65 65 69 62 48 309 Male 97 59 71 68 43 339 Treatment of diarrhea All 241 236 204 206 118 1,004 Urban 5 6 11 51 83 156 Rural 236 230 193 154 35 848 Female 105 113 91 97 60 466 Male 136 123 112 108 58 538 Antenatal and delivery care All 1,974 1,857 1,866 1,681 1,347 8,725 Urban 53 57 140 416 1,025 1,691 Rural 1,921 1,799 1,726 1,265 322 7,034 Contraceptive prevalence Female 1,341 1,424 1,380 1,365 1,440 6,950 Urban Female 28 69 103 309 1,137 1,647 Rural Female 1,313 1,355 1,277 1,056 303 5,303 Male 281 294 292 261 272 1,401 Urban Male 3 18 16 65 221 322 Rural Male 278 276 277 196 52 1,078 Contraceptive source Female 144 183 215 328 519 1,389 Urban Female 7 13 28 94 422 564 Rural Female 137 170 187 235 97 825 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Treatment of genital discharge, ulcer, sore Female 73 75 82 84 122 436 Urban Female 2 3 7 29 102 143 Rural Female 72 72 75 54 20 293 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 85 - Tanzania 2004 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Sanitary disposal of stools All 1,143 1,082 1,085 1,057 950 5,317 Urban 31 39 79 262 736 1,148 Rural 1,111 1,044 1,006 794 214 4,170 Wash hands prior to preparing food All na na na na na na Urban na na na na na na Rural na na na na na na Handwashing facilities in household? All na na na na na na Urban na na na na na na Rural na na na na na na Bednet ownership All 1,837 1,928 1,919 1,913 2,135 9,733 Urban 62 93 160 516 1,739 2,569 Rural 1,775 1,835 1,759 1,398 396 7,163 Bednet use by children All 1,974 1,857 1,866 1,681 1,347 8,725 Urban 53 57 140 416 1,025 1,691 Rural 1,921 1,799 1,726 1,265 322 7,034 Bednet use by pregnant women All 235 239 216 218 180 1,088 Urban 9 4 11 50 138 213 Rural 226 236 205 168 42 875 Exclusive breastfeeding All 121 101 134 114 89 559 Urban 3 13 25 60 na 102 Rural 121 98 122 88 29 458 Female 55 59 60 63 55 291 Male 66 42 75 51 34 268 Timely complementary breastfeeding All 114 141 141 117 91 604 Urban 2 4 8 39 71 125 Rural 112 137 133 78 20 480 Female 61 69 67 62 48 308 Male 53 72 74 55 43 296 Bottle-feeding All 358 384 398 332 268 1,739 Urban 6 12 35 92 198 343 Rural 352 372 363 240 69 1,396 Female 175 205 190 178 148 896 Male 182 179 208 154 120 843 - 86 - Tanzania 2004 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Iodized salt in household All 1,700 1,794 1,792 1,809 1,985 9,080 Urban 55 83 144 473 1,606 2,361 Rural 1,645 1,712 1,648 1,336 379 6,719 Vitamin A supplementation All 1,624 1,501 1,478 1,403 1,112 7,118 Urban 49 45 97 342 862 1,395 Rural 1,575 1,456 1,381 1,061 250 5,723 Female 807 755 717 698 569 3,547 Male 816 746 761 705 543 3,571 Tobacco and alcohol use, casual sexual partners, condom use for casual sex Female 1,840 1,944 1,943 2,003 2,594 10,325 Urban Female 54 99 158 500 2,120 2,931 Rural Female 1,786 1,844 1,785 1,504 474 7,393 Male 484 504 516 517 615 2,635 Urban Male 10 32 32 131 512 716 Rural Male 474 473 483 386 103 1,919 Domestic violence All na na na na na na Urban na na na na na na Rural na na na na na na - 87 - Tanzania 2004 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 1,987 2,106 2,089 2,152 2,854 11,187 Urban female 59 106 169 533 2,334 3,200 Rural female 1,928 2,000 1,920 1,619 520 7,987 Male 1,708 1,928 1,843 2,058 2,520 10,056 Urban male 43 116 135 492 2,041 2,827 Rural male 1,665 1,811 1,708 1,565 479 7,229 School participation Female 732 696 709 704 606 3,447 Urban female 16 40 52 150 458 715 Rural female 716 657 656 554 148 2,732 Male 801 755 757 782 579 3,675 Urban male 18 27 62 187 443 737 Rural male 783 728 695 595 136 2,938 Mass media exposure Female 1,840 1,944 1,943 2,004 2,597 10,329 Urban female 54 99 158 500 2,123 2,935 Rural female 1,786 1,845 1,785 1,504 474 7,394 Male 484 504 516 517 615 2,635 Urban male 10 32 32 131 512 716 Rural male 474 473 483 386 103 1,919 Knowledge of HIV/AIDS prevention Female 1,840 1,944 1,943 2,004 2,597 10,329 Urban female 54 99 158 500 2,123 2,935 Rural female 1,786 1,845 1,785 1,504 474 7,394 Male 484 504 516 517 615 2,635 Urban male 10 32 32 131 512 716 Rural male 474 473 483 386 103 1,919 Household decisionmaking and justification of violence All 1,840 1,944 1,943 2,004 2,597 10,329 Urban 54 99 158 500 2,123 2,935 Rural 1,786 1,845 1,785 1,504 474 7,394 Orphanhood All 4,856 4,538 4,664 4,570 3,818 22,447 Urban 126 194 338 1,054 2,909 4,621 Rural 4,730 4,345 4,327 3,516 909 17,826 Female 2,363 2,221 2,282 2,262 1,968 11,097 Male 2,493 2,317 2,382 2,308 1,850 11,350 - 88 - Tanzania 2004 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 5.45 7.12 6.58 5.56 8.04 3.11 Under-five mortality rate 6.77 8.71 8.83 7.16 9.00 4.12 Prevalence of fever 1.89 1.96 1.60 1.55 1.65 1.04 Prevalence of diarrhea 1.07 1.12 1.17 1.10 1.06 0.57 Prevalence of acute respiratory infection 0.89 0.97 0.93 0.99 1.07 0.51 B. Fertility Total fertility rate 0.21 0.23 0.20 0.17 0.13 0.14 Adolescent fertility rate 12.34 9.28 11.45 9.98 8.89 5.55 C. Nutritional status Children: Moderate stunting 1.35 1.47 1.48 1.45 1.18 0.70 Severe stunting 1.45 1.38 1.31 1.13 0.83 0.69 Moderate underweight 1.50 1.56 1.29 1.17 1.38 0.69 Severe underweight 0.67 0.77 0.64 0.71 0.33 0.36 Mild anemia 1.21 1.36 1.43 1.52 1.74 0.73 Moderate anemia 1.59 1.71 2.01 1.83 1.95 1.03 Severe anemia 0.68 0.72 0.67 0.62 0.87 0.34 Women: Malnutrition 1.00 0.83 0.79 0.75 0.88 0.42 Mild anemia 1.23 1.52 1.34 1.39 1.41 0.76 Moderate anemia 0.95 1.24 1.10 1.02 1.23 0.59 Severe anemia 0.32 0.31 0.24 0.24 0.25 0.13 D. Female circumcision Prevalence of circumcision: Girls 1.70 1.63 1.16 0.85 0.35 0.69 Women 2.91 2.21 2.03 1.65 1.09 1.33 Prevalence of occlusion: Girls 1.56 0.00 3.44 0.00 * 1.15 Women 0.62 0.62 0.85 0.86 2.59 0.48 E. Sexually transmitted disease Prevalence of genital discharge: Women 0.51 0.40 0.47 0.53 0.55 0.24 Men 0.62 0.94 0.73 1.02 0.50 0.39 Prevalence of genital ulcer: Women 0.37 0.37 0.35 0.39 0.34 0.17 Men 0.66 0.92 1.05 1.26 0.57 0.46 - 89 - Tanzania 2004 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 2.43 2.13 2.15 1.56 1.65 1.12 Measles coverage 4.00 3.01 3.32 1.97 2.44 1.92 DPT coverage 3.32 3.56 3.96 4.37 4.69 2.12 Full basic coverage 3.21 3.44 3.93 4.15 4.21 2.07 No basic coverage 2.15 1.89 1.45 0.92 1.59 0.86 Hepatitis B coverage na na na na na na Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 3.56 3.20 3.66 3.42 3.89 1.91 Treatment in a public facility 3.49 3.55 3.57 3.53 4.82 2.01 Treatment in a private facility 1.08 1.50 1.67 1.95 3.35 0.93 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 5.01 5.96 5.25 5.67 6.97 2.82 Treatment in a public facility 5.09 5.94 5.91 5.55 6.80 2.91 Treatment in a private facility 2.60 0.87 2.48 2.45 4.59 1.21 Treatment of diarrhea: Use of oral rehydration therapy 3.60 3.54 4.18 3.68 4.33 1.95 Medical treatment of diarrhea 3.50 4.38 5.03 4.11 6.21 2.24 Treatment in a public facility 3.52 4.58 4.83 4.06 6.67 2.32 Treatment in a private facility 1.40 1.34 3.82 1.51 4.99 1.15 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically-trained person 1.74 0.95 0.85 1.05 1.20 0.65 To a doctor 0.31 0.42 0.53 0.53 0.95 0.29 To a nurse or trained midwife 1.81 1.01 1.04 1.20 1.56 0.73 Multiple visits to a medically-trained person 1.77 1.25 1.36 1.43 1.57 0.79 Antenatal care content: Tetanus toxoid 1.82 1.39 1.64 1.50 1.37 0.83 Prophylactic antimalarial treatment 2.39 2.11 2.09 2.07 1.89 1.19 Iron supplementation 1.91 1.87 2.17 1.99 2.24 1.09 Delivery attendance: By a medically-trained person 2.13 1.87 2.23 2.35 1.34 1.64 By a doctor 0.33 0.45 0.57 0.55 1.31 0.37 By a nurse or trained midwife 1.97 1.76 2.16 2.29 1.68 1.48 In a public facility 2.02 1.95 1.98 2.29 2.13 1.54 In a private facility 1.10 1.13 1.28 1.78 1.79 0.89 At home 2.34 1.98 2.33 2.36 1.35 1.66 D. Contraceptive services Contraceptive prevalence: Women 1.18 1.34 1.37 1.73 1.92 1.02 Men 2.54 3.10 2.82 3.35 4.21 1.57 Source of contraception - public sector: Women 4.09 3.90 3.62 3.09 3.33 1.97 Men na na na na na na - 90 - Tanzania 2004 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - private sector: Women 3.57 3.25 3.42 2.97 3.32 1.91 Men na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 6.84 6.30 5.73 6.24 5.26 2.78 Men na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women 7.32 6.21 6.04 7.40 5.80 3.13 Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 0.66 0.86 0.78 1.09 1.24 0.79 Men 1.21 1.42 1.67 1.89 2.36 0.92 - 91 - Tanzania 2004 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal 3.25 2.90 2.25 1.46 1.42 1.70 Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership 2.04 2.11 2.26 2.55 1.65 1.73 Treated bednet ownership 0.36 0.60 1.06 1.23 1.89 0.99 Bednet use: By children 2.17 2.71 2.64 2.68 2.61 1.84 By pregnant women 2.49 3.38 4.23 4.19 3.93 2.24 C. Breastfeeding Exclusive breastfeeding 5.59 5.26 4.94 5.67 7.99 2.85 Timely complementary feeding 3.05 3.40 4.45 2.92 2.67 1.62 Bottle-feeding 0.95 0.66 0.91 0.63 3.16 0.65 D. Micronutrient consumption Iodized salt: Availability of iodized salt in household 2.15 1.89 2.21 2.68 2.00 1.83 Vitamin A: Children 2.54 2.52 2.00 2.19 2.70 1.54 Women 1.29 1.27 1.48 1.55 2.22 1.01 E. Tobacco and alcohol use Tobacco: Women 0.69 0.42 0.45 0.12 0.16 0.19 Men 2.45 2.48 2.55 2.34 2.20 1.19 Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 0.38 0.46 0.53 0.59 0.56 0.25 Men 2.21 2.46 2.47 2.95 2.57 1.19 Condom usage with non-regular partner: Women * 10.37 10.39 10.55 9.06 5.40 Men 7.48 6.21 8.14 6.00 3.52 3.34 G. Domestic violence Ever experienced violence na na na na na na Experienced violence in past year na na na na na na - 92 - Tanzania 2004 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Education School completion: Women 2.33 1.69 1.72 1.39 1.09 1.43 Men 2.19 1.68 1.65 1.34 0.84 1.23 School participation: Girls 3.19 2.57 2.39 2.02 2.22 1.79 Boys 3.20 2.57 2.55 2.01 2.72 1.87 B. Exposure to mass media Newspaper readership: Women 0.61 0.83 1.02 1.42 1.66 1.18 Men 2.33 2.38 2.54 2.74 2.90 1.71 Radio listenership: Women 1.67 2.02 1.73 1.27 1.17 1.29 Men 3.16 2.37 2.70 1.57 1.67 1.27 Television viewership: Women 0.33 0.49 0.60 1.05 2.17 1.43 Men 1.19 1.60 1.93 2.61 3.16 1.82 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 1.84 1.23 0.96 0.48 0.28 0.65 Men 1.59 1.09 0.69 0.94 1.09 0.54 Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na Men 2.50 1.81 1.71 1.75 1.15 0.91 Attitudes toward HIV/AIDS: Women 1.79 1.21 1.22 0.90 0.68 0.76 Men 2.12 2.41 2.58 2.05 1.59 1.16 D. Status of women Household decisionmaking: Can seek own health care 2.25 2.52 2.13 1.92 1.74 1.33 Can seek children's health care 1.41 1.03 0.67 0.52 0.69 0.49 Can make daily household purchases 1.67 1.69 1.60 1.69 1.53 0.96 Can make large household purchases 1.70 1.54 1.55 1.50 1.45 0.87 Can make meal-related decisions 1.73 1.54 1.55 1.38 1.47 0.79 Freedom of movement: Can travel to visit family/relatives 1.25 1.00 1.09 1.43 1.41 0.72 Other decisionmaking, attitudes: Can decide how to spend own money 3.73 4.05 3.98 2.95 1.58 2.04 Can decide whether to have sex 1.13 0.77 0.76 0.90 0.69 0.50 Justifies domestic violence 1.99 2.02 1.88 1.71 1.80 1.13 E. Orphanhood Paternal orphan prevalence 0.66 0.58 0.63 0.57 0.65 0.31 Maternal orphan prevalence 0.36 0.40 0.45 0.44 0.54 0.21 Double orphan prevalence 0.14 0.10 0.20 0.23 0.35 0.10 - 93 - Tanzania 2004 - ASSET DISTRIBUTION AND WEIGHTS (FACTOR SCORE) Asset Variable Unweighted Wealth Quintiles Factor Low 2nd 3rd 4th High Avg. Score Mean Std. Percentage of Population Devia- tion Has radio 0.608 0.488 18.0% 64.2% 61.1% 77.6% 88.3% 61.8% 0.03263 Has television 0.063 0.243 0.0% 0.0% 0.1% 0.3% 32.2% 6.5% 0.06091 Has refrigerator 0.040 0.197 0.0% 0.0% 0.0% 0.0% 21.0% 4.2% 0.02671 Has bicycle 0.403 0.491 37.3% 52.5% 51.7% 54.2% 37.8% 46.7% -0.00858 Has motorcycle or scooter 0.019 0.137 0.0% 0.1% 0.3% 1.1% 5.8% 1.5% 0.03015 Has car or truck 0.013 0.115 0.0% 0.0% 0.0% 0.8% 9.7% 2.1% 0.00225 Has phone 0.094 0.292 0.0% 0.0% 0.3% 3.3% 45.0% 9.7% -0.03536 Has an iron 0.212 0.408 0.0% 2.8% 14.8% 38.8% 68.3% 25.0% -0.00103 Has a bank account 0.070 0.256 0.0% 0.0% 0.5% 6.4% 33.0% 8.0% 0.01400 Has a domestic worker not related to household head 0.009 0.093 0.0% 0.0% 0.0% 0.0% 7.8% 1.6% 0.01289 Uses piped water in residence 0.066 0.249 0.0% 0.0% 0.1% 1.3% 18.6% 4.0% -0.01274 Uses piped water in compound or plot 0.043 0.202 0.0% 0.1% 0.7% 3.8% 12.3% 3.4% -0.01178 Uses water from piped public source 0.207 0.405 9.0% 15.9% 18.5% 22.9% 11.0% 15.4% -0.02451 Uses water from neighbor's tap 0.096 0.295 0.0% 2.0% 4.6% 12.6% 29.6% 9.8% 0.01818 Uses water from own private open well 0.008 0.087 0.5% 1.3% 0.6% 1.2% 0.9% 0.9% 0.04896 Uses water from a public open well 0.237 0.425 47.6% 29.2% 26.0% 16.6% 3.9% 24.7% 0.02535 Uses water from neighbor's open well 0.012 0.107 0.9% 2.8% 1.0% 1.4% 1.0% 1.4% -0.02269 Uses bottled water 0.002 0.042 0.0% 0.0% 0.0% 0.0% 0.6% 0.1% 0.01609 Uses water from a protected well in own or neighbor's yard or 0.009 0.092 0.0% 0.3% 0.9% 0.7% 4.6% 1.3% 0.03480 Uses water from a protected public well 0.105 0.306 9.8% 18.0% 15.8% 14.1% 5.6% 12.7% 0.02454 Uses water from a spring 0.055 0.228 7.2% 7.0% 7.2% 6.2% 1.8% 5.9% -0.03386 Uses water from river, stream, pond, lake or dam 0.144 0.351 25.2% 23.0% 23.9% 17.3% 3.2% 18.5% 0.04771 Uses water from other source 0.018 0.131 0.0% 0.3% 0.7% 1.8% 7.0% 2.0% 0.08085 Uses own flush toilet 0.021 0.143 0.0% 0.0% 0.0% 0.6% 9.9% 2.1% 0.07179 Uses shared flush toilet 0.008 0.089 0.0% 0.0% 0.0% 0.0% 3.1% 0.6% 0.00722 Uses own pit latrine 0.540 0.498 55.1% 65.4% 68.8% 68.8% 34.0% 58.4% 0.03403 Uses shared pit latrine 0.208 0.406 4.5% 21.3% 17.6% 23.6% 34.7% 20.3% 0.03987 Uses own VIP latrine 0.023 0.150 0.0% 0.0% 0.2% 0.6% 10.4% 2.2% 0.08082 Uses shared VIP latrine 0.015 0.120 0.0% 0.0% 0.0% 0.5% 6.4% 1.4% 0.07248 Uses bush or field as latrine 0.180 0.384 40.2% 12.8% 12.6% 5.2% 0.7% 14.3% 0.06268 Has earth, mud, dung, or sand flooring 0.712 0.453 100.0% 99.4% 98.6% 69.9% 4.2% 74.4% -0.09911 Has floor made of dung 0.005 0.069 0.0% 0.5% 0.6% 0.8% 0.0% 0.4% -0.00216 Has finished wood, vinyl, or tile flooring 0.002 0.049 0.0% 0.0% 0.0% 0.0% 1.8% 0.4% 0.02026 Has cement flooring 0.278 0.448 0.0% 0.0% 0.4% 28.6% 94.0% 24.6% 0.09829 Has roof made of grass, leaves, or mud 0.504 0.500 100.0% 99.9% 42.8% 8.3% 0.5% 50.3% -0.08229 Has roof made of corrugated iron 0.485 0.500 0.0% 0.0% 56.6% 91.2% 95.9% 48.7% 0.07753 Has roof made of tile 0.005 0.068 0.0% 0.0% 0.0% 0.2% 2.3% 0.5% 0.01781 Has roof made of other materials 0.006 0.078 0.0% 0.0% 0.4% 0.3% 1.3% 0.4% 0.01559 Has walls made of grass 0.012 0.107 1.9% 1.1% 0.6% 0.2% 0.0% 0.8% -0.00946 Has walls made of pole and mud 0.395 0.489 63.7% 37.9% 35.5% 21.7% 4.1% 32.6% -0.04820 Has walls made of sundried 0.246 0.431 32.5% 46.4% 44.0% 36.8% 10.5% 34.1% -0.02364 Has walls made of baked brick 0.141 0.348 0.7% 13.3% 18.2% 32.4% 17.0% 16.4% 0.00661 Has walls made of timber 0.009 0.093 0.5% 0.8% 0.7% 1.5% 0.3% 0.8% -0.00221 Has walls made of cement brick 0.149 0.356 0.0% 0.0% 0.1% 5.9% 66.3% 14.5% 0.08459 Has walls made of stone 0.046 0.210 0.0% 0.1% 0.6% 1.5% 1.8% 0.8% 0.01288 Has walls made of other materials 0.002 0.049 0.6% 0.2% 0.2% 0.0% 0.0% 0.2% -0.00453 - 95 - Tanzania 2004 - ASSET DISTRIBUTION AND WEIGHTS (Cont.) (FACTOR SCORE) Asset Variable Unweighted Wealth Quintiles Factor Low 2nd 3rd 4th High Avg. Score Mean Std. Percentage of Population Devia- tion Uses electricity for cooking 0.004 0.060 0.0% 0.0% 0.0% 0.0% 1.2% 0.2% 0.02324 Uses kerosene for cooking 0.020 0.142 0.0% 0.0% 0.0% 1.1% 5.1% 1.2% 0.02425 Uses charcoal for cooking 0.153 0.360 0.0% 0.0% 0.9% 14.3% 72.3% 17.5% 0.08264 Uses wood, straw, dung, or crop residue for cooking 0.819 0.385 100.0% 100.0% 99.1% 84.5% 20.6% 80.8% -0.09132 Uses other fuel for cooking 0.003 0.059 0.0% 0.0% 0.0% 0.1% 0.7% 0.2% 0.00937 Uses electricity for lighting 0.106 0.308 0.0% 0.0% 0.0% 0.9% 51.2% 10.4% 0.09262 Uses paraffin - hurricane lamp for lighting 0.228 0.420 0.0% 2.6% 20.2% 52.2% 40.6% 23.1% 0.02594 Uses paraffin - pressure lamp for lighting 0.022 0.146 0.1% 2.8% 2.3% 3.3% 0.9% 1.9% -0.00402 Uses paraffin - wick lamp for lighting 0.608 0.488 93.9% 87.9% 76.0% 42.7% 6.3% 61.3% -0.07510 Uses firewood for lighting 0.030 0.172 6.0% 6.3% 1.2% 0.6% 0.0% 2.8% -0.01494 Uses candles for lighting 0.004 0.062 0.0% 0.0% 0.1% 0.2% 0.9% 0.2% 0.00818 Acres of land for farming 3.353 26.248 470.1% 532.7% 543.3% 667.4% 240.8% 490.8% -0.00274 Acres of land for grazing 0.134 1.681 25.8% 20.7% 58.9% 28.5% 20.1% 30.8% -0.00172 Number of members per sleeping room 2.401 1.317 3.5 2.8 2.7 2.6 2.5 2.8 -0.01482 - 96 - PART VI. SUPPORTING TABLES, 1999 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Tanzania 1999 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 3,482 3,484 4,080 3,468 3,619 18,133 Urban 94 124 407 786 2,645 4,057 Rural 3,388 3,360 3,673 2,682 975 14,077 Female 1,754 1,812 2,153 1,776 1,834 9,329 Male 1,728 1,672 1,927 1,692 1,786 8,805 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 1,372 1,305 1,257 1,166 1,096 6,195 Urban 35 37 91 276 807 1,245 Rural 1,337 1,267 1,166 890 289 4,949 Female 637 669 635 567 521 3,029 Male 735 636 621 599 575 3,166 Prevalence of fever, diarrhea, acute respiratory infection All 678 599 601 519 502 2,898 Urban 11 19 37 115 364 546 Rural 667 580 564 404 138 2,353 Female 326 316 309 247 238 1,436 Male 352 283 292 271 264 1,462 Total fertility rate All 1,877 2,016 2,287 2,153 2,775 11,109 Urban 61 74 229 621 2,188 3,173 Rural 1,816 1,942 2,059 1,531 587 7,935 Age-specific fertility rate 15-19 All 387 437 559 519 639 2,541 Urban 13 21 44 118 523 719 Rural 374 415 515 401 116 1,821 Children's nutritional status All 615 532 548 473 414 2,582 Urban 11 19 32 100 290 452 Rural 604 514 516 373 124 2,131 Female 295 281 278 231 193 1,278 Male 320 252 270 242 221 1,305 Children's anemia status All na na na na na na Urban na na na na na na Rural na na na na na na Female na na na na na na Male na na na na na na - 99 - Tanzania 1999 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All na na na na na na Urban na na na na na na Rural na na na na na na Women's anemia status All na na na na na na Urban na na na na na na Rural na na na na na na Girls' circumcision All na na na na na na Urban na na na na na na Rural na na na na na na Women's circumcision All na na na na na na Urban na na na na na na Rural na na na na na na Prevalence of genital discharge, ulcer, sore Female na na na na na na Urban Female na na na na na na Rural Female na na na na na na Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 100 - Tanzania 1999 - SAMPLE SIZES Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Immunization coverage All 144 105 131 114 100 593 Urban 2 4 7 21 78 112 Rural 142 101 124 92 22 481 Female 52 60 70 41 36 259 Male 91 45 61 72 64 333 Treatment of fever All 240 229 189 193 167 1,018 Urban 5 7 18 34 117 181 Rural 235 221 171 158 51 836 Female 126 115 103 98 93 535 Male 114 114 86 95 75 484 Treatment of acute respiratory infection All 92 78 69 98 66 403 Urban 2 1 2 16 45 66 Rural 91 76 67 81 21 336 Female 47 43 20 52 30 192 Male 45 34 49 46 35 209 Treatment of diarrhea All 79 73 85 79 42 358 Urban 1 3 9 10 30 53 Rural 78 71 76 68 12 305 Female 33 36 33 41 18 161 Male 46 38 52 38 25 199 Antenatal and delivery care All 456 436 458 399 435 2,183 Urban 9 15 35 109 334 502 Rural 447 421 422 290 100 1,680 Contraceptive prevalence Female 488 531 552 516 565 2,653 Urban Female 15 17 42 128 420 622 Rural Female 473 515 510 388 145 2,031 Male 349 361 443 464 446 2,063 Urban Male 12 17 37 109 328 503 Rural Male 337 344 406 355 117 1,559 Contraceptive source Female 28 68 65 105 182 447 Urban Female 2 5 12 47 138 204 Rural Female 26 63 53 58 44 243 Male 349 361 443 464 446 2,063 Urban Male 12 17 37 109 328 503 Rural Male 337 344 406 355 117 1,559 Treatment of genital discharge, ulcer, sore Female na na na na na na Urban Female na na na na na na Rural Female na na na na na na Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 101 - Tanzania 1999 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Sanitary disposal of stools All na na na na na na Urban na na na na na na Rural na na na na na na Wash hands prior to preparing food All na na na na na na Urban na na na na na na Rural na na na na na na Handwashing facilities in household? All na na na na na na Urban na na na na na na Rural na na na na na na Bednet ownership All 714 627 782 656 852 3,631 Urban 21 26 91 192 655 985 Rural 693 601 690 464 197 2,645 Bednet use by children All 434 387 458 394 403 2,076 Urban 12 16 41 104 300 473 Rural 422 371 416 290 103 1,602 Bednet use by pregnant women All 86 68 97 71 57 379 Urban 2 2 5 14 42 65 Rural 84 66 91 57 16 314 Exclusive breastfeeding All 51 42 56 35 36 220 Urban 0 0 8 2 22 32 Rural 51 42 48 32 14 187 Female 19 21 27 23 19 109 Male 32 21 29 12 17 111 Timely complementary breastfeeding All 42 50 51 33 29 205 Urban 0 1 0 13 25 39 Rural 42 49 51 19 4 165 Female 15 24 26 13 13 91 Male 27 26 25 19 17 114 Bottle-feeding All 139 130 161 107 100 637 Urban 1 2 15 23 73 114 Rural 138 128 146 84 27 523 Female 57 63 84 59 41 304 Male 82 67 77 48 59 333 - 102 - Tanzania 1999 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Iodized salt in household All 700 609 749 627 823 3,508 Urban 19 25 88 175 632 939 Rural 681 583 660 452 191 2,567 Vitamin A supplementation All 597 541 528 464 442 2,572 Urban 11 18 27 105 326 487 Rural 586 522 501 359 117 2,085 Female 320 251 256 234 239 1,300 Male 276 289 272 230 203 1,270 Tobacco and alcohol use, casual sexual partners, condom use for casual sex Female 680 725 843 788 992 4,028 Urban Female 21 26 80 217 778 1,122 Rural Female 659 699 763 572 214 2,907 Male 569 620 756 733 863 3,541 Urban Male 19 31 77 174 640 941 Rural Male 550 589 679 559 223 2,600 Domestic violence All na na na na na na Urban na na na na na na Rural na na na na na na - 103 - Tanzania 1999 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 709 735 887 816 1,008 4,156 Urban female 22 29 83 221 794 1,149 Rural female 687 707 804 595 213 3,007 Male 600 605 780 685 870 3,540 Urban male 16 30 93 163 659 961 Rural male 585 575 687 522 211 2,579 School participation Female 236 257 333 299 233 1,358 Urban female 6 7 37 77 159 286 Rural female 230 251 296 222 73 1,072 Male 304 315 304 276 260 1,459 Urban male 12 7 30 52 177 278 Rural male 292 308 274 224 83 1,181 Mass media exposure Female 680 725 843 788 992 4,029 Urban female 21 26 80 217 778 1,122 Rural female 659 699 763 572 214 2,907 Male 569 620 756 733 863 3,542 Urban male 19 31 77 174 640 941 Rural male 550 589 679 559 223 2,601 Knowledge of HIV/AIDS prevention Female 1,569 725 843 788 992 4,917 Urban female 21 26 80 217 778 1,122 Rural female 659 699 763 572 214 2,907 Male 569 620 756 733 863 3,542 Urban male 19 31 77 174 640 941 Rural male 550 589 679 559 223 2,600 Household decisionmaking and justification of violence All 680 725 843 788 992 4,029 Urban 21 26 80 217 778 1,122 Rural 659 699 763 572 214 2,907 Orphanhood All 1,674 1,691 1,869 1,572 1,430 8,237 Urban 47 44 170 320 983 1,564 Rural 1,628 1,646 1,699 1,252 447 6,672 Female 780 845 981 784 693 4,084 Male 894 845 888 788 737 4,152 - 104 - Tanzania 1999 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 13.62 11.17 16.54 14.50 11.13 6.66 Under-five mortality rate 13.97 13.65 23.17 17.26 12.89 8.78 Prevalence of fever 3.13 2.69 3.26 3.58 4.10 1.73 Prevalence of diarrhea 1.78 2.12 1.80 2.44 1.41 0.91 Prevalence of acute respiratory infection 2.29 1.91 1.73 2.68 1.70 0.82 B. Fertility Total fertility rate 0.39 0.33 0.45 0.42 0.29 0.26 Adolescent fertility rate 31.00 22.00 26.00 21.00 17.00 11.00 C. Nutritional status Children: Moderate stunting 1.93 2.71 2.28 2.15 2.52 1.12 Severe stunting 1.77 3.16 2.20 1.85 1.60 1.11 Moderate underweight 2.02 3.15 2.22 2.57 3.28 1.29 Severe underweight 2.70 1.44 1.11 1.39 1.34 0.72 Mild anemia na na na na na na Moderate anemia na na na na na na Severe anemia na na na na na na Women: Malnutrition na na na na na na Mild anemia na na na na na na Moderate anemia na na na na na na Severe anemia na na na na na na D. Female circumcision Prevalence of circumcision: Girls na na na na na na Women na na na na na na Prevalence of occlusion: Girls * * * * * * Women * * * * * * E. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na Men na na na na na na Prevalence of genital ulcer: Women na na na na na na Men na na na na na na - 105 - Tanzania 1999 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 3.29 1.92 4.80 3.24 0.12 1.52 Measles coverage 5.55 5.83 5.58 3.58 3.00 3.04 DPT coverage 6.04 5.77 6.18 3.49 6.57 3.51 Full basic coverage 5.98 7.23 5.84 4.51 5.64 3.42 No basic coverage 3.21 1.82 4.60 2.68 0.12 1.55 Hepatitis B coverage na na na na na na Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever na na na na na na Treatment in a public facility na na na na na na Treatment in a private facility na na na na na na Treatment of acute respiratory infection (ARI): Medical treatment of ARI na na na na na na Treatment in a public facility na na na na na na Treatment in a private facility na na na na na na Treatment of diarrhea: Use of oral rehydration therapy 8.02 5.64 7.12 6.46 7.98 3.22 Medical treatment of diarrhea na na na na na na Treatment in a public facility na na na na na na Treatment in a private facility na na na na na na C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically-trained person 4.14 3.37 2.63 1.96 1.06 2.03 To a doctor 1.26 1.08 0.76 0.97 3.96 0.97 To a nurse or trained midwife 5.25 3.03 2.60 1.83 3.92 2.19 Multiple visits to a medically-trained person 5.21 4.93 3.46 2.55 1.56 2.74 Antenatal care content: Tetanus toxoid 4.67 4.42 2.89 2.43 1.90 2.30 Prophylactic antimalarial treatment 3.81 3.48 3.31 3.36 4.20 1.98 Iron supplementation 3.78 3.74 4.21 4.61 4.49 2.55 Delivery attendance: By a medically-trained person 3.43 3.76 3.98 4.88 2.74 2.85 By a doctor 0.98 2.57 1.18 1.34 2.27 0.77 By a nurse or trained midwife 3.15 3.54 3.93 4.60 3.33 2.72 In a public facility 2.83 3.78 3.64 4.76 3.37 2.46 In a private facility 1.68 1.54 1.59 4.20 3.25 1.61 At home 3.39 3.79 3.97 4.81 2.92 2.86 D. Contraceptive services Contraceptive prevalence: Women 1.40 2.88 2.19 4.21 2.41 1.72 Men 1.91 3.02 2.64 4.19 3.36 1.96 Source of contraception - public sector: Women 9.16 8.91 7.95 2.89 4.44 3.18 Men na na na na na na - 106 - Tanzania 1999 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - private sector: Women 9.69 8.68 7.76 3.74 4.47 3.20 Men na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na Men na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 0.81 1.03 0.74 1.58 1.68 0.73 Men 1.44 2.23 1.26 1.76 2.08 0.86 - 107 - Tanzania 1999 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership 1.76 2.71 2.82 4.41 2.56 1.89 Treated bednet ownership 0.38 0.18 0.34 0.44 0.63 0.21 Bednet use: By children 2.22 2.48 2.41 4.84 3.44 1.75 By pregnant women 2.02 4.57 3.31 7.36 5.92 2.34 C. Breastfeeding Exclusive breastfeeding 9.60 * 9.56 8.92 11.56 5.68 Timely complementary feeding 8.72 10.20 9.19 9.38 17.32 5.99 Bottle-feeding 3.15 1.93 2.09 4.52 6.08 1.52 D. Micronutrient consumption Iodized salt: Availability of iodized salt in household 4.60 3.66 3.89 4.06 2.06 2.65 Vitamin A: Children 1.59 3.56 1.96 2.47 2.93 1.47 Women 1.93 2.83 1.82 2.25 1.81 1.02 E. Tobacco and alcohol use Tobacco: Women na na na na na na Men na na na na na na Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 1.52 1.78 1.88 1.88 2.21 1.10 Men 3.39 3.97 2.44 2.90 2.64 1.29 Condom usage with non-regular partner: Women 8.60 5.82 4.04 5.16 6.24 3.36 Men 4.15 7.84 3.19 5.12 4.02 2.68 G. Domestic violence Ever experienced violence na na na na na na Experienced violence in past year na na na na na na - 108 - Tanzania 1999 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Education School completion: Women 3.07 3.38 3.16 2.95 1.52 2.04 Men 4.43 2.81 2.14 1.93 2.74 1.49 School participation: Girls 4.26 4.42 4.07 4.50 3.72 2.53 Boys 2.73 3.69 2.86 5.06 4.55 2.07 B. Exposure to mass media Newspaper readership: Women 0.45 0.53 0.38 1.01 1.95 0.76 Men 1.10 1.65 1.03 2.44 2.27 1.35 Radio listenership: Women 0.86 2.90 1.71 3.15 1.67 1.38 Men 2.52 4.76 2.57 3.68 1.94 1.69 Television viewership: Women 0.38 0.18 0.50 0.45 2.21 0.59 Men 0.89 0.92 0.82 1.35 2.09 0.75 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 2.96 3.81 3.64 1.96 1.04 1.86 Men 2.80 3.82 2.54 1.38 0.94 1.02 Knowledge about mother-to-child transmission of HIV/AIDS: Women 3.43 3.05 3.84 2.04 1.19 1.89 Men 3.11 4.66 2.53 1.64 1.34 1.18 Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na Can seek children's health care na na na na na na Can make daily household purchases na na na na na na Can make large household purchases na na na na na na Can make meal-related decisions na na na na na na Freedom of movement: Can travel to visit family/relatives na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money na na na na na na Can decide whether to have sex na na na na na na Justifies domestic violence na na na na na na E. Orphanhood Paternal orphan prevalence 1.37 1.11 1.34 0.95 0.76 0.64 Maternal orphan prevalence 0.95 0.60 0.58 0.72 0.63 0.38 Double orphan prevalence 0.66 0.36 0.36 0.24 0.44 0.20 - 109 - Tanzania 1999 - ASSET DISTRIBUTION AND WEIGHTS (FACTOR SCORES) Asset Variable Unweighted Wealth Quintiles Factor Low 2nd 3rd 4th High Avg. Score Mean Std. Percentage of Population Devia- tion Has electricity 0.142 0.350 0.0% 0.0% 0.0% 0.2% 36.2% 7.3% 0.17362 Has radio 0.504 0.500 6.1% 36.7% 26.8% 84.9% 80.1% 46.5% 0.09736 Has television 0.061 0.240 0.0% 0.0% 0.0% 0.0% 14.8% 3.0% 0.14903 Has refrigerator 0.051 0.220 0.0% 0.0% 0.0% 0.0% 12.2% 2.4% 0.14498 Has bicycle 0.368 0.482 35.9% 35.0% 42.0% 50.2% 39.1% 40.5% 0.00817 Has motorcycle 0.016 0.126 0.0% 0.0% 0.0% 0.0% 4.6% 0.9% 0.06619 Has car 0.021 0.143 0.0% 0.0% 0.0% 0.0% 6.8% 1.4% 0.09356 Uses water piped into residence 0.094 0.292 0.0% 0.0% 0.0% 0.7% 14.5% 3.0% 0.12941 Uses water from river, canal or surface 0.180 0.384 36.1% 48.6% 27.0% 3.8% 5.9% 24.3% -0.05776 Uses rain water for drinking 0.001 0.029 0.0% 0.0% 0.0% 0.0% 0.3% 0.1% 0.00612 Uses water from a piped public source 0.192 0.394 6.2% 0.0% 31.8% 40.5% 21.6% 20.4% -0.02068 Uses water from borehole or tubewell 0.123 0.328 8.3% 23.4% 19.3% 23.1% 5.1% 15.9% -0.03183 Uses water piped into yard 0.153 0.360 0.0% 0.0% 0.6% 13.2% 40.5% 10.8% 0.07339 Uses water from an unprotected well 0.165 0.371 49.4% 19.1% 3.2% 1.4% 1.6% 14.5% -0.06098 Uses water from a protected dug well 0.165 0.371 49.4% 19.1% 3.2% 1.4% 1.6% 14.5% -0.06098 Uses water from unprotected spring 0.030 0.172 8.9% 1.2% 5.5% 0.0% 2.3% 3.6% -0.01977 Uses water from a protected spring for drinking 0.049 0.216 18.6% 15.2% 0.5% 0.9% 0.7% 6.9% -0.03344 Uses water from tanker truck 0.009 0.094 0.0% 0.0% 0.0% 0.0% 2.8% 0.6% 0.03227 Uses bottled water for drinking 0.001 0.029 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.00867 Uses own flush toilet 0.037 0.190 0.0% 0.0% 0.0% 0.6% 7.7% 1.7% 0.11044 Uses bush or field as latrine 0.178 0.382 45.5% 11.4% 4.9% 1.3% 0.4% 12.4% -0.06990 Uses shared flush toilet 0.252 0.434 12.0% 1.3% 26.8% 26.6% 46.5% 23.0% 0.05115 Uses pit toilet 0.768 0.422 54.5% 88.3% 95.1% 98.1% 87.2% 85.0% -0.00125 Uses a VIP latrine 0.016 0.126 0.0% 0.0% 0.0% 0.0% 4.7% 0.9% 0.05055 Has dirt, sand, dung as principal flooring 0.700 0.458 100.0% 100.0% 100.0% 97.9% 8.3% 81.3% -0.17443 Has wood plank as principal flooring 0.001 0.033 0.0% 0.0% 0.0% 0.0% 0.3% 0.1% 0.00218 Has cement as principal flooring 0.296 0.457 0.0% 0.0% 0.0% 2.0% 91.0% 18.5% 0.17155 Has other type of flooring 0.000 0.017 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.00253 Has parquet or polished wood as principal flooring 0.000 0.017 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.01639 Has tile as principal flooring 0.001 0.037 0.0% 0.0% 0.0% 0.0% 0.4% 0.1% 0.03260 - 111 - PART VII. SUPPORTING TABLES, 1996 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Tanzania 1996 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 7,750 7,923 7,713 7,857 7,761 39,003 Urban 105 484 829 1,336 4,958 7,712 Rural 7,645 7,439 6,883 6,522 2,802 31,292 Female 4,007 4,058 3,941 3,974 3,901 19,880 Male 3,740 3,862 3,771 3,883 3,860 19,116 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 3,015 2,533 2,719 2,616 2,231 13,115 Urban 34 162 280 436 1,398 2,310 Rural 2,981 2,371 2,439 2,180 833 10,804 Female 1,474 1,238 1,310 1,330 1,038 6,389 Male 1,541 1,295 1,410 1,286 1,193 6,725 Prevalence of fever, diarrhea, acute respiratory infection All 1,429 1,129 1,279 1,259 1,091 6,188 Urban 17 76 129 205 705 1,132 Rural 1,412 1,053 1,151 1,054 386 5,056 Female 691 569 627 650 514 3,051 Male 738 561 652 609 577 3,137 Total fertility rate All 4,048 4,355 4,292 4,707 5,355 22,757 Urban 49 289 516 897 3,653 5,404 Rural 3,999 4,066 3,776 3,811 1,702 17,354 Age-specific fertility rate 15-19 All 855 929 946 1,127 1,480 5,337 Urban 6 48 105 203 1,040 1,402 Rural 850 880 840 924 440 3,934 Children's nutritional status All 1,247 966 1,117 1,087 926 5,344 Urban 17 65 113 172 584 951 Rural 1,231 901 1,004 915 343 4,394 Female 594 482 543 557 441 2,617 Male 654 484 574 530 485 2,727 Children's anemia status All na na na na na na Urban na na na na na na Rural na na na na na na Female na na na na na na Male na na na na na na - 115 - Tanzania 1996 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All 793 657 715 736 727 3,629 Urban 11 45 77 130 485 748 Rural 782 612 639 607 242 2,882 Women's anemia status All na na na na na na Urban na na na na na na Rural na na na na na na Girls' circumcision All 944 906 949 974 910 4,683 Urban 12 65 111 176 589 954 Rural 932 841 838 798 321 3,730 Women's circumcision All 1,437 1,566 1,530 1,673 1,913 8,120 Urban 19 101 179 315 1,293 1,906 Rural 1,418 1,465 1,351 1,358 620 6,214 Prevalence of genital discharge, ulcer, sore Female 1,293 1,362 1,344 1,473 1,600 7,072 Urban Female 17 97 166 291 1,086 1,657 Rural Female 1,275 1,265 1,178 1,181 514 5,413 Male 264 366 373 455 452 1,910 Urban Male 5 15 52 90 299 461 Rural Male 259 350 320 365 152 1,446 - 116 - Tanzania 1996 - SAMPLE SIZES Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Immunization coverage All 293 251 275 284 232 1,335 Urban 4 19 23 50 155 251 Rural 289 232 252 234 76 1,083 Female 134 124 142 142 113 655 Male 159 127 133 142 118 679 Treatment of fever All 417 318 406 428 307 1,876 Urban 6 24 47 79 190 346 Rural 411 294 359 350 116 1,530 Female 209 169 198 218 175 969 Male 207 150 208 210 131 906 Treatment of acute respiratory infection All 165 146 182 175 134 802 Urban 1 10 14 24 86 135 Rural 164 136 167 152 48 667 Female 81 75 97 83 58 394 Male 84 71 84 92 75 406 Treatment of diarrhea All 196 133 189 194 135 846 Urban 3 6 13 27 90 139 Rural 193 127 176 167 44 707 Female 101 67 96 86 52 402 Male 95 65 93 108 83 444 Antenatal and delivery care All 973 872 920 939 874 4,577 Urban 12 56 106 164 578 916 Rural 961 816 814 774 296 3,661 Contraceptive prevalence Female 1,019 1,044 1,041 1,190 1,118 5,411 Urban Female 16 65 104 210 735 1,130 Rural Female 1,003 978 937 980 383 4,281 Male 201 246 256 324 261 1,288 Urban Male 5 10 27 54 173 269 Rural Male 196 236 229 270 88 1,019 Contraceptive source Female 50 75 104 167 323 720 Urban Female 2 11 18 49 222 301 Rural Female 49 64 87 119 101 419 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Treatment of genital discharge, ulcer, sore Female 47 31 35 27 38 178 Urban Female 1 0 2 7 29 39 Rural Female 46 31 34 19 9 139 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 117 - Tanzania 1996 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Sanitary disposal of stools All na na na na na na Urban na na na na na na Rural na na na na na na Wash hands prior to preparing food All na na na na na na Urban na na na na na na Rural na na na na na na Handwashing facilities in household? All na na na na na na Urban na na na na na na Rural na na na na na na Bednet ownership All na na na na na na Urban na na na na na na Rural na na na na na na Bednet use by children All na na na na na na Urban na na na na na na Rural na na na na na na Bednet use by pregnant women All na na na na na na Urban na na na na na na Rural na na na na na na Exclusive breastfeeding All 93 85 97 87 70 432 Urban 1 8 12 14 39 74 Rural 92 77 85 73 31 358 Female 46 37 59 46 41 229 Male 47 47 39 41 30 204 Timely complementary breastfeeding All 130 76 94 87 74 461 Urban 2 5 12 7 53 79 Rural 128 72 82 80 21 383 Female 58 39 39 37 43 216 Male 72 37 56 51 31 247 Bottle-feeding All 339 241 279 278 238 1,375 Urban 3 17 31 43 156 250 Rural 336 224 248 235 82 1,125 Female 158 108 148 134 135 683 Male 180 133 132 144 103 692 - 118 - Tanzania 1996 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Iodized salt in household All na na na na na na Urban na na na na na na Rural na na na na na na Vitamin A supplementation All na na na na na na Urban na na na na na na Rural na na na na na na Female na na na na na na Male na na na na na na Tobacco and alcohol use, casual sexual partners, condom use for casual sex Female 1,437 1,566 1,530 1,673 1,913 8,119 Urban Female 19 101 179 315 1,293 1,907 Rural Female 1,418 1,465 1,351 1,358 620 6,212 Male 321 436 442 530 526 2,255 Urban Male 6 23 55 103 347 534 Rural Male 315 412 387 428 179 1,721 Domestic violence All na na na na na na Urban na na na na na na Rural na na na na na na - 119 - Tanzania 1996 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 1,548 1,647 1,610 1,735 2,009 8,549 Urban female 20 104 188 330 1,359 2,002 Rural female 1,528 1,543 1,422 1,405 649 6,547 Male 1,283 1,431 1,440 1,673 1,915 7,742 Urban male 16 86 159 331 1,311 1,904 Rural male 1,268 1,345 1,281 1,342 603 5,838 School participation Female 726 564 618 587 549 3,044 Urban female 8 31 65 80 347 531 Rural female 719 533 552 507 202 2,513 Male 682 620 671 584 545 3,102 Urban male 9 33 52 86 327 507 Rural male 673 587 619 498 218 2,595 Mass media exposure Female 1,437 1,566 1,530 1,673 1,913 8,120 Urban female 19 101 179 315 1,293 1,906 Rural female 1,418 1,465 1,351 1,358 620 6,214 Male 321 436 442 530 526 2,256 Urban male 6 23 55 103 347 535 Rural male 315 412 387 428 179 1,721 Knowledge of HIV/AIDS prevention Female 3,096 1,566 1,530 1,673 1,913 9,778 Urban female 19 101 179 315 1,293 1,907 Rural female 1,418 1,465 1,351 1,358 620 6,212 Male 321 436 442 530 526 2,256 Urban male 6 23 55 103 347 534 Rural male 315 412 387 428 179 1,721 Household decisionmaking and justification of violence All 1,437 1,566 1,530 1,673 1,913 8,120 Urban 19 101 179 315 1,293 1,906 Rural 1,418 1,465 1,351 1,358 620 6,214 Orphanhood All 4,067 3,554 3,673 3,566 3,203 18,064 Urban 51 207 358 541 1,953 3,111 Rural 4,016 3,347 3,315 3,025 1,250 14,953 Female 2,025 1,710 1,826 1,810 1,593 8,964 Male 2,040 1,843 1,847 1,756 1,610 9,096 - 120 - Tanzania 1996 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 8.54 9.04 6.80 7.79 5.26 4.21 Under-five mortality rate 9.19 10.74 9.68 9.42 6.54 5.17 Prevalence of fever 1.65 1.80 1.69 1.71 1.70 0.82 Prevalence of diarrhea 1.11 1.09 1.07 1.31 1.10 0.53 Prevalence of acute respiratory infection 1.12 1.29 1.44 1.30 1.05 0.61 B. Fertility Total fertility rate 0.28 0.20 0.21 0.18 0.16 0.13 Adolescent fertility rate 14.00 12.00 13.00 10.00 8.00 6.00 C. Nutritional status Children: Moderate stunting 1.68 1.68 1.39 1.50 1.37 0.75 Severe stunting 1.52 1.55 1.36 1.35 1.11 0.65 Moderate underweight 1.35 1.58 1.43 1.26 1.42 0.70 Severe underweight 1.26 0.92 0.92 0.79 0.54 0.49 Mild anemia na na na na na na Moderate anemia na na na na na na Severe anemia na na na na na na Women: Malnutrition 1.70 1.08 1.19 1.32 1.11 0.61 Mild anemia na na na na na na Moderate anemia na na na na na na Severe anemia na na na na na na D. Female circumcision Prevalence of circumcision: Girls 1.42 0.84 1.25 1.08 0.62 0.59 Women 5.46 1.98 2.42 2.38 2.08 2.00 Prevalence of occlusion: Girls na na na na na na Women 0.93 0.18 0.36 0.22 0.09 0.21 E. Sexually transmitted disease Prevalence of genital discharge: Women 0.47 0.32 0.44 0.33 0.40 0.19 Men 1.67 1.60 1.53 1.26 1.25 0.66 Prevalence of genital ulcer: Women 0.31 0.29 0.22 0.18 0.17 0.11 Men 0.97 1.68 1.12 0.87 0.67 0.49 - 121 - Tanzania 1996 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 1.87 1.79 1.52 0.70 0.36 0.77 Measles coverage 4.10 2.68 3.37 1.94 1.39 1.55 DPT coverage 3.53 3.03 2.98 1.83 1.57 1.45 Full basic coverage 4.06 3.66 3.67 2.51 2.82 1.76 No basic coverage 1.77 1.79 1.52 0.41 0.36 0.76 Hepatitis B coverage na na na na na na Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 3.04 3.29 2.90 2.71 2.93 1.50 Treatment in a public facility 2.80 3.40 2.94 2.76 3.01 1.47 Treatment in a private facility 0.89 1.45 1.11 1.17 1.70 0.60 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 4.91 4.81 4.33 4.16 3.90 2.28 Treatment in a public facility 4.81 4.84 4.71 4.24 4.58 2.21 Treatment in a private facility 2.19 1.34 2.67 2.34 3.22 1.14 Treatment of diarrhea: Use of oral rehydration therapy 4.03 4.89 3.38 4.05 3.41 2.07 Medical treatment of diarrhea 4.36 4.99 3.86 3.80 4.02 2.10 Treatment in a public facility 4.36 4.88 3.90 3.90 4.33 2.13 Treatment in a private facility 1.32 2.78 1.81 1.31 3.13 0.89 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically-trained person 2.55 1.42 1.26 0.96 0.82 0.89 To a doctor 0.98 0.85 0.91 0.95 1.26 0.51 To a nurse or trained midwife 2.91 1.59 1.37 1.33 1.37 0.90 Multiple visits to a medically-trained person 2.54 1.43 1.07 1.12 0.97 0.82 Antenatal care content: Tetanus toxoid 1.92 1.22 1.04 0.76 0.77 0.68 Prophylactic antimalarial treatment na na na na na na Iron supplementation na na na na na na Delivery attendance: By a medically-trained person 2.19 2.45 2.05 2.16 1.69 1.64 By a doctor 0.59 0.80 0.71 0.70 0.93 0.40 By a nurse or trained midwife 1.92 2.32 2.02 2.09 1.89 1.51 In a public facility 1.96 2.36 2.07 2.15 1.72 1.49 In a private facility 0.81 0.63 0.76 0.63 1.00 0.43 At home 2.34 2.42 2.14 2.12 1.69 1.58 D. Contraceptive services Contraceptive prevalence: Women 0.86 1.00 1.15 1.29 1.49 0.75 Men 1.84 1.61 2.25 2.39 3.17 1.19 Source of contraception - public sector: Women 4.91 4.94 4.15 3.36 2.80 1.92 Men na na na na na na - 122 - Tanzania 1996 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - private sector: Women 3.93 4.81 3.77 3.07 2.35 1.67 Men na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 7.57 10.23 10.64 9.25 8.71 4.08 Men * 6.20 8.12 7.09 6.77 3.39 Treatment of genital discharge, ulcer, sore in public facilities: Women 0.47 0.32 0.44 0.33 0.40 0.19 Men * 2.09 1.86 1.39 1.16 0.75 Voluntary counseling and testing for HIV/AIDS: Women 0.51 0.43 0.45 0.50 0.70 0.27 Men 1.52 1.37 1.29 1.80 1.56 0.79 - 123 - Tanzania 1996 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na Treated bednet ownership na na na na na na Bednet use: By children na na na na na na By pregnant women na na na na na na C. Breastfeeding Exclusive breastfeeding 6.19 5.40 5.48 6.31 5.16 2.56 Timely complementary feeding 3.81 4.09 3.95 2.05 2.93 1.66 Bottle-feeding 1.72 2.08 1.83 1.89 2.41 0.93 D. Micronutrient consumption Iodized salt: Availability of iodized salt in household na na na na na na Vitamin A: Children na na na na na na Women na na na na na na E. Tobacco and alcohol use Tobacco: Women na na na na na na Men na na na na na na Alcohol: Women na na na na na na Men na na na na na na F. Sexual practices Non-regular sexual partnerships: Women 1.11 0.98 1.05 0.94 1.11 0.55 Men 2.56 2.65 2.60 2.41 1.92 1.13 Condom usage with non-regular partner: Women 2.95 2.30 2.47 2.30 3.16 1.32 Men 5.17 3.85 3.46 3.95 3.85 1.79 G. Domestic violence Ever experienced violence na na na na na na Experienced violence in past year na na na na na na - 124 - Tanzania 1996 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Education School completion: Women 2.87 1.48 1.39 1.43 1.22 1.16 Men 2.58 1.62 1.60 1.47 1.16 1.02 School participation: Girls 1.65 2.34 2.48 2.21 2.73 1.26 Boys 1.54 2.06 1.86 2.13 2.17 1.06 B. Exposure to mass media Newspaper readership: Women 0.32 0.43 0.54 0.75 1.92 0.86 Men 1.60 1.96 2.08 2.25 2.92 1.73 Radio listenership: Women 0.59 0.68 1.74 1.65 1.63 1.10 Men 2.56 2.15 3.31 2.69 1.56 1.60 Television viewership: Women 0.23 0.31 0.58 0.61 1.64 0.57 Men 1.46 1.40 1.46 1.69 2.98 1.24 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 1.65 1.15 1.08 0.84 0.60 0.58 Men 2.37 1.53 1.44 1.80 0.62 0.69 Knowledge about mother-to-child transmission of HIV/AIDS: Women 2.44 1.48 1.29 1.40 1.02 0.86 Men 3.53 2.71 2.43 2.16 1.15 1.03 Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na Can seek children's health care na na na na na na Can make daily household purchases na na na na na na Can make large household purchases na na na na na na Can make meal-related decisions na na na na na na Freedom of movement: Can travel to visit family/relatives na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money * * * * * * Can decide whether to have sex na na na na na na Justifies domestic violence na na na na na na E. Orphanhood Paternal orphan prevalence 0.70 0.83 0.72 0.60 0.73 0.34 Maternal orphan prevalence 0.44 0.65 0.40 0.32 0.40 0.21 Double orphan prevalence 0.08 0.35 0.12 0.15 0.21 0.09 - 125 - Tanzania 1996 - ASSET DISTRIBUTION AND WEIGHTS (FACTOR SCORE) Asset Variable Unweighted Wealth Quintiles Factor Low 2nd 3rd 4th High Avg. Score Mean Std. Percentage of Population Devia- tion Has electricity 0.099 0.299 0.0% 0.0% 0.0% 0.8% 44.0% 8.9% 0.18787 Has radio 0.428 0.495 0.4% 3.2% 43.3% 86.7% 86.7% 44.0% 0.11666 Has television 0.020 0.139 0.0% 0.0% 0.0% 0.0% 10.4% 2.1% 0.14727 Has refrigerator 0.023 0.150 0.0% 0.0% 0.0% 0.0% 12.2% 2.4% 0.15469 Has bicycle 0.305 0.460 26.5% 31.5% 36.4% 56.3% 38.1% 37.8% 0.00947 Has motorcycle 0.009 0.093 0.0% 0.0% 0.0% 0.6% 5.1% 1.1% 0.05301 Has car 0.015 0.123 0.0% 0.0% 0.0% 0.0% 8.9% 1.8% 0.12196 Uses water water piped into residence 0.097 0.296 0.0% 0.0% 0.0% 5.7% 35.4% 8.2% 0.16172 Uses water from a well in residence 0.013 0.115 0.0% 0.0% 0.6% 3.4% 2.5% 1.3% 0.01071 Uses rainwater for drinking 0.001 0.027 0.0% 0.0% 0.0% 0.1% 0.3% 0.1% 0.01139 Uses water from a piped public source 0.299 0.458 0.7% 6.4% 51.9% 36.8% 36.6% 26.4% 0.01280 Uses water from a traditional public well 0.277 0.448 33.6% 48.4% 15.5% 32.7% 12.4% 28.6% -0.05243 Uses water from river, canal, or surface water 0.303 0.460 65.0% 45.2% 31.6% 19.4% 11.6% 34.6% -0.07092 Uses water from another source 0.003 0.054 0.0% 0.0% 0.0% 0.1% 1.1% 0.2% 0.01621 Uses own flush toilet 0.014 0.116 0.0% 0.0% 0.0% 0.0% 7.3% 1.5% 0.10531 Uses shared flush toilet 0.005 0.072 0.0% 0.0% 0.1% 0.8% 1.1% 0.4% 0.02053 Uses bush or field as latrine 0.132 0.338 45.4% 6.5% 8.8% 3.1% 1.0% 12.9% -0.05430 Uses pit toilet 0.830 0.376 54.0% 92.9% 90.8% 93.5% 85.7% 83.5% -0.00650 Uses VIP latrine 0.012 0.109 0.0% 0.0% 0.0% 0.5% 4.6% 1.0% 0.06620 Has dirt, sand, or dung as principal flooring 0.762 0.426 100.0% 100.0% 100.0% 92.1% 3.1% 79.1% -0.19168 Has wood plank as principal flooring 0.001 0.037 0.0% 0.0% 0.0% 0.6% 0.0% 0.1% -0.00001 Has cement as principal flooring 0.229 0.420 0.0% 0.0% 0.0% 4.4% 96.3% 20.0% 0.19152 Has parquet or polished wood as principal flooring 0.000 0.011 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.01599 Has tile as principal flooring 0.001 0.022 0.0% 0.0% 0.0% 0.0% 0.4% 0.1% 0.03818 Has other type of flooring 0.000 0.016 0.0% 0.0% 0.0% 0.0% 0.1% 0.0% 0.00261 Number of members per sleeping room 2.429 1.696 4.7 2.5 3.1 2.4 2.4 3.0 -0.03617 - 127 - PART VIII. ANNEXES A. SOURCES OF ADDITIONAL INFORMATION B. USE OF INFORMATION FROM THIS REPORT TO MONITOR THE ECONOMIC STATUS OF PEOPLE SERVED BY HNP PROGRAMS C. COUNTRIES COVERED BY THE HNP- POVERTY REPORT PROJECT ANNEX A. SOURCES OF ADDITIONAL INFORMATION ADDITIONAL INEQUALITY DATA World Bank HNP/Poverty Country Report Website: http://www.worldbank.org/hnp/povertyandhealth/countrydata. This World Bank website provides the full texts and tables for all fifty-six countries covered by the HNP/Poverty Country Report Project. (A list of the countries covered appears in annex C, at the end of this report.) Also available at the site are summary tables, organized by indicator, designed to facilitate cross-country comparisons in inequality with respect to particular indicators. DHS Country Reports: http://www.measuredhs.com/countries. All DHS final country reports produced since 2003 include quintile-specific tabulations in approximately 50-100 of the reports' HNP indicator tables. The tables deal with some of the indicators covered in this volume, and with many that are not. UNICEF Multi-Indicator Cluster Survey Website: http://www.childinfo.org/MICS2/natlMICSrepz/MICSnatrep.htm. The UNICEF Multi-Indicator Cluster Survey (MICS) project is generally similar to the DHS program, but covers a somewhat different set of countries and indicators. The "standard tables" section for each country listed at the MICS website provides wealth- based, quintile-specific information in around 40-45 of the tables related to hnp, education, and child labor. In deriving these quintile-specific estimates, the MICS investigators have employed a wealth index similar to the one used here. World Health Organization World Health Survey Website: http://www.who.int/healthinfo/survey/en/index.html. The World Health Organization's World Health Survey (WHS) includes such issues as self-assessed adult health status; coverage of interventions against adult chronic diseases and against maternal and child health problems; household health expenditures; insurance coverage; and health system responsiveness. Approximately seventy countries ­ developed as well as developing ­ have been covered thus far. Household wealth information has been collected and used to prepare quintile-specific estimates for many of the indicators appearing in the reports on these countries. - 131 - METHODS AND RESOURCES FOR FURTHER INEQUALITY ANALYSIS Shea Oscar Rutstein and Kiersten Johnson, The DHS Wealth Index, DHS Comparative Reports No. 6 (Calverton, Maryland, USA: ORC Macro, August 2004) (Available at: http://www.measuredhs.com/pubs/pub_details.cfm?ID =470&srchTp=type). This DHS publication, by two of the co-authors of the current report, describes in detail the construction of the wealth index that underlies the data presented in the basic tables. Deon Filmer and Lant H. Pritchett, "Estimating Wealth Effects without Expenditure Data ­ or Tears: An Application to Education Enrollments in States in India," Demography 38, no.1 (February 2001): 115-132. This seminal piece gave birth to the wealth index procedure used in the current volume. It also includes three of the previously-cited country case studies demonstrating the close relationship between results produced using wealth and those based on consumption as an indicator of household economic status. Owen O'Donnell, Eddy van Doorslaer, Adam Wagstaff, and Magnus Lindelow. Quantitative Techniques for Health Equity Analysis. Washington D.C.: The World Bank, forthcoming. Among the topics covered in this comprehensive overview of available quantitative techniques are the measurement of living standards using a wealth index and other approaches (chapter 6) and the concentration index as a measure of inequality (chapter 8). DHS Country Data Sets: http://www.measuredhs.com/accesssurveys/search. The data sets for all DHS surveys undertaken since 2003 include two pieces of information for each household that are designed to help investigators prepare quintile- specific tabulations for any indicator. These are: 1) the household wealth score; and 2) the economic quintile to which individuals in the household belong. Any tabulation using these pieces of information will be comparable to the figures appearing here. - 132 - ANNEX B. USE OF INFORMATION FROM THIS REPORT TO MONITOR THE ECONOMIC STATUS OF PEOPLE SERVED BY HNP PROGRAMS The wealth or asset approach employed in this report can be used to monitor the economic status of people served by health, nutrition, and population (hnp) programs in two ways. The first, simpler way is suitable for monitoring nationwide, facility-based programs. A second, fuller version can also be employed for other types of programs, such as initiatives undertaken only in some parts of a country, or activities like mass education or outreach programs that do not operate through facilities. BASIC MONITORING OF NATIONWIDE FACILITY-BASED PROGRAMS The economic distribution of patients in a nationwide, facility-based program (say, a network of rural health posts, antenatal care clinics, emergency obstetrical facilities, or hospitals) can be determined through an exit survey of facility patients, using the wealth questionnaire and the set of quintile cut-off points that immediately follow this text, and which have been created using the information presented in part III.C. The questionnaire can be employed to measure the economic status of any individual responding to the questions on it. The set of cut-off points can serve to compare the distribution of the respondents' economic status with that of the nationally- representative sample of people interviewed by the DHS survey on which the present report is based. The first step is to use the questionnaire in interviewing an adequately-large sample of patients attending the facility-based services of interest. The wealth score for each patient can then be calculated by multiplying the response to each question by the item scores also provided on the questionnaire, and summing the results. After this has been done, the quintile cut-off points can be used to place each individual in the economic quintile to which (s)he belongs. The number of patients and percentage of total patients in each quintile can then be calculated. Since each quintile defined by the cut-off points contains 20 percent of the individuals in the nationally-representative DHS sample, the patients belonging to any such quintile containing significantly more (or less) than 20 percent of the total are over- (under-) represented relative to the national population. When the percentage of patients in each of the five quintiles is viewed as a whole, the result is a frequency distribution that indicates the spread of service beneficiaries across economic classes of individuals.21 For example: 21That is, across economic classes of all individuals in the sample population. Estimates pertaining to quintiles of only those individuals needing services require adjusting the results of the procedure described here through application of the relevant quintile-specific, sample-size figures presented in part III.A. - 133 - · A service that favors the poorest people would have substantially more than 20 percent of its patients in each of the lowest one or two economic quintiles; considerably less than 20 percent of its patients in each of the highest quintiles. · A service that reaches all economic classes equally would draw roughly the same proportion of total patients from the lower and upper quintiles. · A service that favors the least poor population groups would have well over 20 percent of its patients in each of the highest one or two quintiles, considerably less than 20 percent of its patients in each of the lowest quintiles. FULLER MONITORING OF FACILITY-BASED AND OF OTHER PROGRAMS While capable of providing far more information than currently exists about the distribution of a program's beneficiaries, the approach just described has important limitations. For example, it cannot deal with the many important types of health programs that do not deliver services primarily through facilities ­ mass media health education, household visits by health workers, and many social marketing initiatives, for example. It is also limited in its ability to assess programs working only with certain areas within a country: it can compare the economic status of the programs' beneficiaries with that of the national population, but not with that of the specific sub-national areas where the programs are active. Further, it focuses primarily on only one of the two important dimensions of monitoring the distribution of program beneficiaries: that is, incidence or focus ­ the percentage of program benefits that flow to the poor. It cannot deal nearly so well with the second dimension, which concerns coverage, or the percentage of the poor that the program reaches. These limitations can be overcome by a modified version of the approach described above that relies on a household- rather than facility-based survey. A household survey can generate a set of data containing the full range of information needed to produce an equity assessment by collecting two types of information: first, about the household's wealth or assets, using the questions in the left-hand column of the attached questionnaire;22 and second, about the household members' use of or exposure to the services provided by the program(s) of interest. The collected data can be analyzed in either (or both) of two ways, depending on the type of information desired: · One way would be to use only data from the household survey. The procedure would be analogous to that for a DHS survey employed in this report: ­ Asset information from the survey-generated data set would be used as the basis for the construction of a wealth index, weighting the individual items using some method like principal components analysis. ­ The individuals in the sample would be ranked in order of the index values for their households, then divided into groups like quintiles. ­ The coverage rates in each quintile for the service of interest would be calculated. 22Or, if one is willing to forego the benefits of the second analytical approach described below, using any of several other asset questionnaires that exist. Examples include the INDEPTH health equity survey tool (available at: www.indepth-network.org/core_documents/indepthtools.htm) or the model questionnaire developed by M. Mahood Khan and David Hotchkiss of the PHR Plus project (which can be found at: www.phrplus.org). - 134 - · A second approach would be to use the weights for each item appearing on the attached questionnaire in determining the wealth of each individual, instead of calculating the weights from the new household data set. Once the individuals' wealth is determined, the individuals would be ranked, divided into quintiles, and the coverage rate in each quintile would be calculated. In the case of programs undertaken in only one region of the country, it would provide a comparison of the economic status of the people served with that of the entire country rather than of only the region where the programs are active;23 in the case of nationwide as well as regional programs, it would permit a comparison with the other service programs covered in this report. 23This additional perspective could be particularly helpful in an assessment of a program seeking to reach the poor by focusing on especially backward districts. A report presenting only a finding that the program was reaching the better- off people in those districts could produce an impression that it had failed to reach its intended beneficiaries. But a comparison between the economic status of the program's beneficiaries with that of the national population might well reveal that most of the beneficiaries were poor by national standards and that the program was thus considerably more successful than otherwise thought. - 135 - Tanzania 2004 - ASSET QUESTIONNAIRE Question Score if Score if Item "Yes" "No" Score 1. In your household, is/are there? One or more radios 0.02621 -0.04062 One or more televisons 0.23514 -0.01577 One or more refrigerators 0.13037 -0.00547 One or more bicycles -0.01044 0.00705 One or more motorcycles, scooters 0.21603 -0.00421 One or more cars, trucks 0.01934 -0.00026 One or more phones -0.10990 0.01137 One or more irons -0.00199 0.00054 One or more bank accounts 0.05083 -0.00385 2. Does your household have a domestic worker not related to head? 0.13738 -0.00121 3. What is the principal source of drinking water for your household? Piped water in residence -0.04773 0.00340 Piped water in compound, plot -0.05583 0.00249 Piped water in public tap -0.04798 0.01251 Piped water from neighbor's tap 0.05571 -0.00593 Protected well in own or neighbor's residence, yard 0.37529 -0.00323 Protected public well 0.07168 -0.00840 Open private well 0.55935 -0.00428 Open public well 0.04551 -0.01412 Neighbor's open well -0.20939 0.00246 Bottled water 0.38464 -0.00067 Springwater -0.14028 0.00817 River, stream, pond, lake, dam 0.11641 -0.01955 Other 0.60458 -0.01081 4. What is the principal type of fuel for cooking used by your household? Electricity 0.38684 -0.00140 Kerosene 0.16789 -0.00350 Charcoal 0.19424 -0.03516 Wood, straw, dung, crop residual -0.04294 0.19418 Other 0.15828 -0.00055 5. What is the principal type of toilet facility used by your household? Private flush toilet 0.49189 -0.01048 Shared flush toilet 0.08085 -0.00064 Private pit latrine 0.03142 -0.03685 Shared pit latrine 0.07776 -0.02044 Private VIP latrine 0.52778 -0.01237 Shared VIP latrine 0.59356 -0.00885 Bush, field as latrine 0.13375 -0.02937 6. What is the principal material used for the floors in your household? Earth, mud, dung, sand -0.06295 0.15600 Dung -0.03098 0.00015 Finished wood, vinyl, tile 0.41622 -0.00099 Cement 0.15828 -0.06103 - 137 - Tanzania 2004 - ASSET QUESTIONNAIRE (Cont.) Question Score if Score if Item "Yes" "No" Score 7. What is the principal material used for the walls of your household? Grass -0.08766 0.00102 Pole, mud -0.05966 0.03893 Sundried brick -0.04140 0.01349 Baked brick 0.01633 -0.00268 Timber -0.02353 0.00021 Cement brick 0.20194 -0.03543 Stone 0.05843 -0.00284 Other -0.09316 0.00022 8. What is the principal material used for the roof of your household? Grass, leaves, mud -0.08161 0.08298 Corrugated iron 0.07993 -0.07520 Tile 0.26127 -0.00121 Other 0.19962 -0.00122 9. What is the principal means of lighting in your household? Electricity 0.26910 -0.03188 Paraffin - hurricane lamp 0.04770 -0.01410 Paraffin - pressure lamp -0.02686 0.00060 Paraffin - wick lamp -0.06031 0.09351 Firewood -0.08438 0.00265 Candles 0.13250 -0.00051 10. How many acres of land does your household use for farming? # people-3.35× -0.003 26.25 11. How many acres of land does your household use for grazing? # people- 0.13×-0.002 1.68 12. How many people are there for each sleeping room in your household? # people- 2.40× -0.015 1.32 Total Household Asset Score (sum of individual item scores) - 138 - Tanzania 2004 - QUINTILE CUT-OFF POINTS Asset Index Value Wealth Quintile Bottom Cut-Off Top Cut-Off Low Low -0.75954 Second -0.75954 -0.59044 Third -0.59044 -0.26838 Fourth -0.26838 0.70258 High 0.70258 High - 139 - ANNEX C. COUNTRIES COVERED BY THE HNP - POVERTY REPORT PROJECT* East Asia and Pacific Sub-Saharan Africa Cambodia 2000 Benin 1996, 2001 Indonesia 1997, 2002-03 Burkina Faso 1992-3, 1998-9, 2003 Philippines 1998, 2003 Cameroon 1991, 1998, 2004 Vietnam 1997, 2002 Central African Rep. 1994-95 Chad 1996-97, 2004 Europe and Central Asia Comoros 1996 Armenia 2000 Cote d'Ivoire 1994 Kazakhstan 1995, 1999 Eritrea 1995 Kyrgyz Rep. 1997 Ethiopia 2000 Turkey 1993, 1998 Gabon 2000 Turkmenistan 2000 Ghana 1993, 1998, 2003 Uzbekistan 1996 Guinea 1999 Kenya 1993, 1998, 2003 Latin America and the Caribbean Madagascar 1997 Bolivia 1998, 2003 Malawi 1992, 2000 Brazil 1996 Mali 1995-96, 2001 Colombia 1995, 2000, 2005 Mauritania 2000-01 Dominican Rep. 1996, 2002 Mozambique 1997, 2003 Guatemala 1995, 1998-99 Namibia 1992, 2000 Haiti 1994-95, 2000 Niger 1998 Nicaragua 1997- 98, 2001 Nigeria 1990, 2003 Paraguay 1990 Rwanda 2000 Peru 1996, 2000 Senegal 1997 South Africa 1998 Middle East and North Africa Tanzania 1996, 1999, 2004 Egypt 1995, 2000 Togo 1998 Jordan 1997 Uganda 1995, 2000-01 Morocco 1992, 2003-04 Zambia 1996, 2001-02 Yemen 1997 Zimbabwe 1994, 1999 South Asia * Note: electronic versions of reports for all countries Bangladesh 1996-97, 1999-2000, 2004 are currently available at: www.worldbank.org/ povertyandhealth/countrydata. While supplies last, India 1992-93, 1998-99 paper copies may be obtained at no charge by sending Nepal 1996, 2001 a request to the World Bank's health advisory service: healthpop@worldbank.org. Pakistan 1990-91 - 141 -