39468 SOCIO-ECONOMIC DIFFERENCES IN HEALTH, NUTRITION, AND POPULATION COLOMBIA 1995, 2000, 2005 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, 2005 1 A. Total Population 3 B. Female and Male Populations 9 C. Rural and Urban Populations 13 Part II. Basic Tables, 2000 19 A. Total Population 21 B. Female and Male Populations 27 C. Rural and Urban Populations 31 Part III. Basic Tables, 1995 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, 2005 81 A. Sample Sizes 83 B. Standard Errors 89 C. Asset Distribution and Weights 95 Part VI. Supporting Tables, 2000 97 A. Sample Sizes 99 B. Standard Errors 105 C. Asset Distribution and Weights 111 Part VII. Supporting Tables, 1995 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, 2005 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. Colombia 2005 - 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 32.0 23.8 20.9 14.2 14.4 22.1 2.23 17.64 -0.1646 0.0339 Under-five mortality rate 39.1 27.3 24.0 15.9 15.9 25.7 2.47 23.24 -0.1828 0.0379 Prevalence of fever 27.1 25.3 22.5 23.4 22.3 24.4 1.22 4.82 -0.0507 0.0092 Prevalence of diarrhea 17.5 17.1 13.3 11.4 9.0 14.4 1.95 8.54 -0.1390 0.0126 Prevalence of acute respiratory 10.2 9.5 8.9 10.3 9.2 9.6 1.11 1.02 -0.0452 0.0160 infection (ARI) B. Fertility Total fertility rate 4.1 2.8 2.4 1.8 1.4 2.4 2.92 2.67 -0.2004 0.0458 Adolescent fertility rate 155.0 118.2 96.9 60.5 37.4 90.4 4.14 117.55 -0.2513 0.0631 C. Nutritional status (%) Children: Moderate stunting 15.4 10.1 9.0 5.4 2.2 9.5 6.95 13.16 -0.2871 0.0165 Severe stunting 4.4 2.4 0.8 0.7 0.6 2.1 7.33 3.76 -0.5156 0.0459 Moderate underweight 10.6 6.0 5.5 3.6 3.0 6.3 3.57 7.65 -0.2950 0.0226 Severe underweight 1.0 0.8 0.3 0.2 0.1 0.6 7.80 0.89 -0.4978 0.0901 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 5.9 5.8 5.3 5.3 4.4 5.3 1.35 1.55 -0.0328 0.0138 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 5.5 4.9 5.3 4.6 3.9 4.8 1.43 1.67 -0.0697 0.0137 Men na na na na na na na na na na Prevalence of genital ulcer: Women 0.6 0.7 0.7 0.6 0.7 0.7 0.81 0.13 0.0045 0.0380 Men na na na na na na na na na na - 3 - Colombia 2005 - 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 93.1 98.4 98.8 98.7 99.8 97.3 0.93 6.76 0.0139 0.0024 Measles coverage 70.3 83.9 87.2 89.0 90.8 82.7 0.77 20.46 0.0502 0.0053 DPT coverage 72.8 80.5 89.5 84.2 90.8 82.3 0.80 17.94 0.0479 0.0057 Full basic coverage 48.2 56.0 66.8 61.8 73.5 59.3 0.66 25.36 0.0630 0.0093 No basic coverage 2.2 0.2 0.0 0.7 0.1 0.7 40.71 2.15 -0.7728 0.2116 Hepatitis B coverage 67.7 71.4 82.0 72.3 84.2 74.4 0.80 16.50 0.0380 0.0068 Yellow fever coverage 52.4 63.4 59.5 64.6 53.1 58.8 0.99 0.67 0.0263 0.0093 B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 41.3 47.2 44.9 40.4 34.9 42.6 1.18 6.42 0.0008 0.0125 Treatment in a public facility 38.3 44.2 38.7 27.9 25.7 36.7 1.49 12.62 -0.0494 0.0140 Treatment in a private facility 3.0 3.1 6.3 12.5 9.2 5.9 0.33 6.20 0.3126 0.0431 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 48.9 63.0 62.7 70.2 71.6 61.6 0.68 22.69 0.0809 0.0130 Treatment in a public facility 45.2 59.9 57.2 56.3 64.8 55.5 0.70 19.56 0.0576 0.0148 Treatment in a private facility 3.7 3.1 5.5 13.9 6.9 6.1 0.54 3.13 0.2913 0.0623 Treatment of diarrhea: Use of oral rehydration therapy 65.0 70.8 70.5 78.5 71.4 70.1 0.91 6.38 0.0399 0.0093 Medical treatment of diarrhea 29.7 34.1 30.2 26.2 26.8 30.4 1.11 2.90 0.0222 0.0213 Treatment in a public facility 28.1 32.6 24.3 19.3 16.1 26.5 1.74 11.98 -0.0310 0.0232 Treatment in a private facility 1.6 1.5 5.9 6.9 10.7 3.9 0.15 9.08 0.3879 0.0763 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 83.7 92.7 96.9 97.5 99.1 93.5 0.84 15.40 0.0429 0.0018 To a doctor 73.1 85.3 90.8 92.3 95.8 86.7 0.76 22.71 0.0628 0.0024 To a nurse or trained midwife 10.6 7.4 6.1 5.2 3.3 6.8 3.22 7.31 -0.2105 0.0216 Multiple visits to a medically-trained person 75.9 86.8 92.1 94.4 96.3 88.4 0.79 20.45 0.0594 0.0023 Antenatal care content: Tetanus toxoid 82.8 86.0 87.5 86.3 84.5 85.5 0.98 1.70 0.0108 0.0024 Prophylactic antimalarial treatment 2.0 0.7 0.4 0.4 0.0 0.8 na 1.98 -0.6142 0.0830 Iron supplementation 61.6 73.2 81.6 81.7 85.4 75.9 0.72 23.72 0.0699 0.0032 Delivery attendance: By a medically-trained person 72.0 94.0 97.3 98.9 99.3 90.7 0.72 27.35 0.0752 0.0021 By a doctor 66.2 90.3 94.8 97.4 98.4 87.5 0.67 32.18 0.0906 0.0023 By a nurse or trained midwife 5.8 3.7 2.5 1.5 0.9 3.2 6.16 4.83 -0.3383 0.0293 In a public facility 72.0 91.1 93.5 93.0 91.6 88.0 0.79 19.56 0.0548 0.0025 In a private facility 1.0 2.9 4.1 6.1 7.6 4.0 0.13 6.62 0.3347 0.0283 At home 26.7 5.8 2.1 0.9 0.5 7.8 52.78 26.21 -0.7833 0.0243 D. Contraceptive services Contraceptive prevalence: Women 60.4 66.6 69.3 71.7 71.8 68.2 0.84 11.41 0.0409 0.0031 Men na na na na na na na na na na - 4 - Colombia 2005 - 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 61.2 48.9 41.8 34.5 31.9 42.7 1.92 29.26 -0.1239 0.0060 Men na na na na na na na na na na Source of contraception - private sector: Women 38.4 50.2 57.5 64.4 67.1 56.5 0.57 28.69 0.0934 0.0045 Men na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 4.7 4.6 5.0 4.1 3.8 4.4 1.25 0.93 -0.0388 0.0144 Men na na na na na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women 4.7 4.6 5.0 4.1 3.8 4.4 1.25 0.93 -0.0388 0.0144 Men na na na na na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 9.4 16.8 19.6 19.7 21.8 18.1 0.43 12.41 0.1165 0.0066 Men na na na na na na na na na na - 5 - Colombia 2005 - 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 33.9 60.2 61.7 63.4 61.6 55.7 0.55 27.74 0.1056 0.0055 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 85.2 78.6 77.1 72.6 73.4 79.2 1.16 11.77 -0.0466 0.0052 By pregnant women na na na na na na na na na na C. Breastfeeding Exclusive breastfeeding 59.7 52.3 61.8 61.4 64.4 59.3 0.93 4.72 -0.0017 0.0171 Timely complementary feeding 68.4 59.7 60.6 60.6 41.6 60.1 1.64 26.82 -0.0734 0.0154 Bottle-feeding 45.3 51.9 47.3 56.2 61.5 51.1 0.74 16.20 0.0684 0.0110 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 4.3 5.6 4.8 4.8 4.7 4.9 0.90 0.46 -0.0031 0.0153 Men na na na na na na na na na na Condom usage with non-regular partner: Women 26.4 38.2 45.4 54.0 60.5 46.4 0.44 34.07 0.1348 0.0169 Men na na na na na na na na na na G. Domestic violence Ever experienced violence 41.9 47.7 46.0 43.8 37.3 43.5 1.12 4.58 -0.0326 0.0044 Experienced violence in past year na na na na na na na na na na - 6 - Colombia 2005 - 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 55.9 76.6 87.3 92.4 96.6 83.9 0.58 40.62 0.0889 0.0013 Men 52.4 73.6 85.1 91.0 96.3 80.2 0.54 43.90 0.1046 0.0015 School participation: Girls 91.5 93.9 96.6 97.0 96.6 94.9 0.95 5.10 0.0181 0.0019 Boys 89.4 92.6 92.9 95.5 96.1 93.0 0.93 6.73 0.0217 0.0020 B. Exposure to mass media Newspaper readership: Women na na na na na na na na na na Men na na na na na na na na na na Radio listenership: Women na na na na na na na na na na Men na na na na na na na na na na Television viewership: Women na na na na na na na na na na Men na na na na na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 67.9 80.6 84.9 86.6 88.8 82.8 0.76 20.89 0.0523 0.0015 Men na na na na na na na na \ na na Knowledge about mother-to-child transmission of HIV/AIDS: Women 74.6 86.7 90.5 92.6 93.5 88.6 0.80 18.96 0.0420 0.0013 Men na na na na na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care 58.3 68.7 73.2 74.7 76.3 71.2 0.76 17.97 0.0452 0.0020 Can seek children's health care 96.5 98.3 98.1 98.6 98.7 98.0 0.98 2.21 0.0071 0.0011 Can make daily household purchases 55.4 65.0 65.7 64.0 59.2 62.2 0.94 3.79 0.0086 0.0025 Can make large household purchases 49.8 59.8 62.0 61.4 57.0 58.5 0.87 7.26 0.0236 0.0027 Can make meal-related decisions 58.8 58.9 54.7 50.1 44.7 52.8 1.32 14.10 -0.0498 0.0029 Freedom of movement: Can travel to visit family, relatives 31.3 42.5 43.4 41.5 36.7 39.5 0.85 5.44 0.0299 0.0039 Other decisionmaking, attitudes: Can decide how to spend own money 87.2 89.7 91.7 91.3 90.3 90.3 0.97 3.10 0.0059 0.0012 Can decide whether to have sex 97.5 99.1 99.3 99.6 99.4 99.1 0.98 1.96 0.0044 0.0004 Justifies domestic violence na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 4.8 5.7 4.9 4.5 3.8 4.8 1.27 1.01 -0.0304 0.0132 Maternal orphan prevalence 1.1 1.0 1.1 0.8 0.9 1.0 1.25 0.22 -0.0718 0.0317 Double orphan prevalence 0.2 0.2 0.3 0.1 0.1 0.2 3.60 0.18 -0.0932 0.0670 - 7 - Colombia 2005 - 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 25.6 21.3 15.6 12.8 9.5 18.0 38.4 26.3 25.9 15.5 19.3 26.2 Under-five mortality rate 34.4 23.7 17.9 13.2 10.9 21.3 43.8 30.7 29.7 18.4 20.8 30.0 Prevalence of fever 26.9 26.4 21.7 22.1 19.8 24.0 27.2 24.2 23.2 24.8 24.7 24.9 Prevalence of diarrhea 17.2 15.6 14.0 10.3 7.5 13.7 17.9 18.4 12.6 12.6 10.4 15.0 Prevalence of acute respiratory 9.5 9.5 9.2 9.1 8.5 9.3 10.9 9.5 8.6 11.5 9.9 10.0 infection (ARI) B. Nutritional status Children: Moderate stunting 13.6 9.9 8.5 5.0 2.1 8.8 17.2 10.2 9.4 5.9 2.3 10.2 Severe stunting 4.1 2.6 0.9 1.0 0.1 2.0 4.6 2.2 0.6 0.4 1.0 2.1 Moderate underweight 11.5 5.8 5.3 2.6 1.7 6.1 9.8 6.0 5.6 4.8 4.2 6.5 Severe underweight 1.1 0.8 0.4 0.1 0.1 0.6 0.9 0.8 0.2 0.2 0.1 0.5 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 C. Sexually transmitted disease Prevalence of genital discharge: Women 5.0 4.5 4.9 4.3 3.6 4.4 Men na na na na na na Prevalence of genital ulcer: Women 0.5 0.6 0.7 0.6 0.7 0.6 Men na na na na na na - 9 - Colombia 2005 - 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 92.1 97.9 98.7 98.2 99.9 96.7 94.0 98.9 98.9 99.3 99.8 97.9 Measles coverage 69.4 82.7 87.4 90.2 96.8 82.5 71.2 85.0 87.1 87.6 87.3 82.9 DPT coverage 72.3 78.3 89.6 79.9 94.5 80.8 73.3 82.4 89.4 88.8 88.6 83.5 Full basic coverage 48.0 53.8 63.3 61.5 84.6 58.2 48.4 58.0 70.1 62.0 67.1 60.2 No basic coverage 2.8 0.3 0.0 1.4 0.1 1.1 1.6 0.1 0.0 0.0 0.0 0.4 Hepatitis B coverage 65.6 71.4 81.5 62.5 88.6 72.1 69.9 71.4 82.4 82.6 81.6 76.4 Yellow fever coverage 51.2 59.5 61.1 69.0 63.5 59.4 53.8 66.8 58.2 59.9 47.0 58.2 B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 42.8 45.2 49.1 39.0 29.3 42.7 39.8 49.6 41.2 41.7 39.1 42.7 Treatment in a public facility 39.5 42.6 43.3 29.0 22.1 37.6 37.0 46.1 34.6 26.9 28.4 36.0 Treatment in a private facility 3.3 2.6 5.8 10.0 7.3 5.1 2.7 3.5 6.6 14.8 10.7 6.7 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 53.2 65.0 65.3 69.3 77.5 64.2 45.4 61.7 60.1 70.9 66.8 59.4 Treatment in a public facility 49.7 62.4 59.8 55.1 69.5 58.2 41.5 58.1 54.6 57.3 60.8 53.3 Treatment in a private facility 3.5 2.6 5.5 14.2 8.0 6.0 3.9 3.6 5.5 13.6 5.9 6.2 Treatment of diarrhea: Use of oral rehydration therapy na na na na na na na na na na na na Medical treatment of diarrhea 29.1 36.4 27.5 25.7 21.1 29.7 30.2 32.1 33.1 26.5 30.8 30.9 Treatment in a public facility 27.3 35.4 22.5 24.0 13.7 27.1 28.8 30.4 26.2 15.3 17.8 26.0 Treatment in a private facility 1.8 1.1 5.0 1.7 7.4 2.7 1.4 1.8 7.0 11.2 13.0 4.9 C. Contraceptive services Contraceptive prevalence: Women 60.3 66.4 69.3 71.7 71.8 68.1 Men na na na na na na Source of contraception - public sector: Women 61.1 48.8 41.7 34.5 31.9 42.6 Men na na na na na na Source of contraception - private sector: Women 38.4 50.2 57.5 64.4 67.1 56.5 Men na na na na na na D. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 4.2 4.2 4.6 3.9 3.5 4.1 Men na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women 4.2 4.2 4.6 3.9 3.5 4.1 Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 8.5 15.7 18.4 18.6 20.5 16.9 Men na na na na na na - 10 - Colombia 2005 - 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 33.9 60.2 61.7 63.4 61.6 55.7 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 85.2 78.6 77.1 72.6 73.4 79.2 C. Breastfeeding Exclusive breastfeeding 62.1 59.8 61.9 55.6 66.3 60.9 55.8 47.7 62.7 68.4 62.7 58.1 Timely complementary feeding 70.5 63.9 63.0 62.0 39.4 62.2 66.1 54.2 58.3 59.3 43.7 57.8 Bottle-feeding 41.2 46.9 44.4 57.1 61.0 48.2 50.2 55.8 50.4 55.5 62.0 54.0 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 4.3 5.7 4.8 4.9 4.7 4.9 Men na na na na na na Condom usage with non-regular partner: Women 26.0 38.4 45.5 53.5 60.5 46.2 Men na na na na na na - 11 - Colombia 2005 - 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 55.9 76.6 87.3 92.4 96.6 83.9 Men 52.4 73.6 85.1 91.0 96.3 80.2 School participation: Girls 91.5 93.9 96.6 97.0 96.6 94.9 Boys 89.4 92.6 92.9 95.5 96.1 93.0 B. Exposure to mass media Newspaper readership: Women na na na na na na Men na na na na na na Radio listenership: Women na na na na na na Men na na na na na na Television viewership: Women na na na na na na Men na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 67.9 80.6 84.9 86.6 88.8 82.8 Men na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women 74.6 86.7 90.5 92.6 93.5 88.6 Men na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Orphanhood Paternal orphan prevalence 4.6 5.9 4.9 4.3 3.5 4.7 4.9 5.5 4.9 4.8 4.0 4.9 Maternal orphan prevalence 1.0 1.0 1.0 0.6 0.6 0.9 1.2 1.1 1.2 0.9 1.1 1.1 Double orphan prevalence 0.2 0.3 0.3 0.1 0.1 0.2 0.3 0.1 0.4 0.1 0.1 0.2 - 12 - Colombia 2005 - 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 30.9 19.1 6.8 9.4 24.8 26.1 40.3 26.2 22.2 14.3 14.3 20.3 Under-five mortality rate 38.0 24.3 10.2 14.2 73.9 32.8 47.1 28.7 25.3 15.9 15.0 22.6 Prevalence of fever 26.7 23.9 18.2 19.6 11.6 25.4 30.0 25.9 22.9 23.5 22.4 24.0 Prevalence of diarrhea 16.9 15.5 14.8 16.8 0.0 16.4 21.9 17.8 13.1 11.2 9.1 13.5 Prevalence of acute respiratory infection 10.1 10.3 6.5 1.7 10.7 9.9 10.9 9.1 9.1 10.5 9.2 9.5 B. Fertility Total fertility rate 4.1 2.6 2.2 1.5 1.4 3.4 4.1 3.0 2.5 1.8 1.4 2.1 Adolescent fertility rate 150.8 100.5 85.4 52.5 81.7 128.4 177.2 126.2 97.9 60.7 36.9 79.3 C. Nutritional status Children: Moderate stunting 15.8 8.2 4.9 9.3 8.2 13.3 12.6 10.9 9.3 5.3 2.1 7.7 Severe stunting 4.6 2.0 0.4 0.0 0.0 3.7 2.5 2.6 0.8 0.7 0.6 1.3 Moderate underweight 10.7 5.5 2.5 11.3 0.8 9.0 9.8 6.1 5.7 3.5 3.0 5.0 Severe underweight 1.0 0.8 0.0 0.0 0.0 0.9 1.3 0.9 0.3 0.2 0.1 0.4 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 Women: Malnutrition 5.2 5.0 4.1 3.8 3.6 5.0 10.8 6.2 5.4 5.4 4.4 5.4 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 D. Female circumcision Prevalence of circumcision: Girls na na na na na na na na na na na na Women na na na na na na na na na na na na Prevalence of occlusion: Girls na na na na na na na na na na na na Women na na na na na na na na na na na na E. Sexually transmitted disease Prevalence of genital discharge: Women 5.5 4.1 4.1 4.4 0.1 4.8 6.0 5.3 5.4 4.6 3.9 4.7 Men na na na na na na na na na na na na Prevalence of genital ulcer: Women 0.5 0.7 0.2 0.0 0.1 0.5 0.9 0.7 0.8 0.6 0.7 0.7 Men na na na na na na na na na na na na - 13 - Colombia 2005 - 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 92.8 98.2 100.0 100.0 100.0 94.7 94.7 98.5 98.7 98.7 99.8 98.7 Measles coverage 71.8 86.1 88.5 87.8 100.0 76.6 60.1 82.7 87.1 89.0 90.7 85.7 DPT coverage 72.7 81.6 90.0 100.0 100.0 76.2 74.0 80.0 89.4 84.0 90.7 85.3 Full basic coverage 48.5 58.5 56.4 78.6 100.0 51.9 45.9 54.8 67.7 61.5 73.4 62.9 No basic coverage 2.5 0.0 0.0 0.0 0.0 1.7 0.1 0.2 0.0 0.7 0.1 0.2 Hepatitis B coverage 67.3 71.6 74.7 60.6 100.0 68.9 70.4 71.3 82.5 72.5 84.1 77.2 Yellow fever coverage 53.4 71.9 70.2 75.8 100.0 59.5 45.2 58.9 58.7 64.4 52.9 58.4 B. Treatment of childhood diseases Treatment of fever: Medical treatment of fever 40.7 49.8 44.1 48.4 0.0 42.9 44.9 46.2 45.0 40.2 35.1 42.5 Treatment in a public facility 37.9 47.8 44.1 27.9 0.0 40.2 40.6 42.7 38.3 27.9 25.8 35.1 Treatment in a private facility 2.8 2.0 0.0 20.5 0.0 2.7 4.2 3.5 6.7 12.3 9.3 7.4 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 47.0 63.5 65.2 100.0 32.0 51.8 61.5 62.7 62.6 70.1 72.1 66.2 Treatment in a public facility 43.1 62.0 58.1 100.0 32.0 48.4 58.5 58.8 57.2 56.1 65.2 58.8 Treatment in a private facility 3.8 1.5 7.1 0.0 0.0 3.4 3.0 3.9 5.4 13.9 6.9 7.4 Treatment of diarrhea: Use of oral rehydration therapy 63.9 71.7 80.7 63.2 na 66.5 71.0 70.4 69.4 79.1 71.4 72.0 Medical treatment of diarrhea 29.1 39.8 32.0 10.2 na 31.4 32.8 31.9 30.0 26.8 26.8 29.8 Treatment in a public facility 27.7 39.2 32.0 10.2 na 30.2 30.6 30.1 23.5 19.6 16.1 24.5 Treatment in a private facility 1.5 0.5 0.0 0.0 na 1.2 2.2 1.8 6.5 7.1 10.7 5.3 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 83.4 94.7 96.7 98.4 91.4 87.5 85.9 91.8 96.9 97.4 99.2 95.8 To a doctor 72.7 88.0 91.5 95.6 91.4 78.4 76.0 84.1 90.7 92.2 95.9 89.9 To a nurse or trained midwife 10.7 6.7 5.2 2.8 0.0 9.1 9.8 7.7 6.2 5.3 3.3 5.9 Multiple visits to a medically-trained person 75.7 90.4 94.1 95.6 84.0 81.1 76.9 85.2 92.0 94.3 96.5 91.3 Antenatal care content: Tetanus toxoid 81.9 86.8 89.3 81.3 75.3 83.6 88.9 85.7 87.4 86.4 84.7 86.3 Prophylactic antimalarial treatment 2.0 0.9 0.1 0.0 0.0 1.6 1.6 0.7 0.4 0.5 0.0 0.4 Iron supplementation 60.1 74.0 79.6 78.6 61.6 65.3 71.4 72.8 81.8 81.8 85.7 80.0 Delivery attendance: By a medically-trained person 69.8 90.9 96.2 100.0 100.0 76.8 86.9 95.3 97.4 98.9 99.3 97.1 By a doctor 63.7 86.1 92.9 97.0 100.0 71.2 83.5 92.1 95.0 97.4 98.4 94.9 By a nurse or trained midwife 6.1 4.8 3.3 3.0 0.0 5.6 3.3 3.3 2.4 1.5 0.9 2.2 In a public facility 70.0 86.6 93.1 97.8 95.9 76.4 85.5 93.1 93.6 92.9 91.5 92.6 In a private facility 0.9 3.2 2.7 2.2 4.1 1.6 1.5 2.8 4.2 6.2 7.6 4.9 28.8 9.9 4.2 0.0 0.0 21.6 12.9 3.9 1.9 0.9 0.5 2.3 D. Contraceptive services Contraceptive prevalence: Women 61.1 71.0 74.3 75.8 74.4 65.6 55.5 63.9 68.8 71.5 71.8 69.1 Men na na na na na na na na na na na na - 14 - Colombia 2005 - 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 62.0 51.9 47.3 31.8 31.0 56.1 54.1 46.7 41.1 34.6 31.9 37.9 Men 0.0 0.0 0.0 0.0 0.0 0.0 na na na na na na Source of contraception - private sector: Women 37.6 47.7 52.7 67.6 69.0 43.5 45.2 52.0 58.1 64.3 67.0 61.1 Men 0.0 0.0 0.0 0.0 0.0 0.0 na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 4.5 3.7 4.0 2.5 0.0 4.1 5.9 5.0 5.1 4.2 3.8 4.5 Men na na na na na na na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women 4.5 3.7 4.0 2.5 0.0 4.1 5.9 5.0 5.1 4.2 3.8 4.5 Men na na na na na na na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 20.3 8.4 13.2 13.9 13.1 16.1 10.6 15.8 18.7 20.2 19.9 21.9 Men na na na na na na na na na na na na - 15 - Colombia 2005 - 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 44.7 56.5 50.7 47.2 82.9 48.0 48.3 50.1 47.1 56.6 60.9 52.6 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 84.4 77.2 81.4 76.3 76.0 82.6 90.7 79.4 76.5 72.4 73.4 76.8 By pregnant women na na na na na na na na na na na na C. Breastfeeding Exclusive breastfeeding 60.3 48.8 50.9 100.0 0.0 57.1 56.9 53.8 62.3 60.8 64.9 60.2 Timely complementary feeding 66.3 65.0 20.6 84.0 100.0 64.2 79.4 57.8 64.1 59.7 40.9 58.3 Bottle-feeding 44.7 56.5 50.7 47.2 82.9 48.0 48.3 50.1 47.1 56.6 60.9 52.6 D. Micronutrient consumption Iodized salt: Availability of iodized salt na na na na na na na na na na na na in household Vitamin A: Children 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 4.0 3.5 2.9 2.7 2.1 3.7 6.0 6.7 4.9 4.9 4.8 5.2 Men na na na na na na na na na na na na Condom usage with non-regular partner: Women 22.7 39.3 42.3 1.8 91.8 28.8 42.4 37.9 45.6 54.9 60.3 50.1 Men na na na na na na na na na na na na G. Domestic violence Ever experienced violence 44.0 41.3 43.1 43.3 37.1 37.4 41.8 45.9 50.1 46.3 44.0 37.3 Experienced violence in past year na na na na na na na na na na na na - 16 - Colombia 2005 - 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 54.1 72.3 82.5 86.4 94.6 63.5 67.5 78.8 87.8 92.6 96.6 89.7 Men 51.1 67.8 79.6 88.6 97.0 59.1 62.3 76.9 85.6 91.1 96.3 87.8 School participation: Girls 90.8 95.5 97.3 94.6 100.0 92.5 96.3 93.0 96.6 97.1 96.5 96.0 Boys 89.2 95.1 96.9 95.6 82.6 91.3 90.9 91.1 92.5 95.5 96.4 93.8 B. Exposure to mass media Newspaper readership: 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 Radio listenership: 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 Television viewership: 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 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 66.6 79.5 82.9 86.4 82.4 72.7 75.6 81.2 85.1 86.6 88.8 85.7 Men na na na na na na na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women 73.0 85.5 87.8 89.5 96.6 78.8 84.3 87.4 90.8 92.7 93.5 91.4 Men na na na na na na na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care 74.1 56.8 63.9 69.6 73.0 83.2 60.8 68.0 71.2 73.5 74.8 76.2 Can seek children's health care 98.4 96.4 97.8 99.3 98.4 100.0 97.0 97.7 98.5 98.0 98.6 98.7 Can make daily household purchases 63.4 54.4 61.9 64.4 66.6 67.4 58.0 62.1 66.6 65.9 64.0 59.1 Can make large household purchases 60.1 49.1 56.5 61.6 60.9 67.9 53.0 53.9 61.5 62.1 61.4 56.9 Can make meal-related decisions 50.7 59.7 62.1 62.3 56.7 46.6 60.4 53.0 57.2 54.0 49.8 44.7 Freedom of movement: Can travel to visit family, relatives 41.4 29.5 34.7 41.5 47.7 37.8 32.8 42.5 46.6 43.5 41.3 36.7 Other decisionmaking, attitudes: Can decide how to spend own money 91.2 86.3 86.3 88.9 87.9 88.1 86.6 91.7 91.3 91.9 91.4 90.3 Can decide whether to have sex 99.4 97.3 99.1 98.9 99.2 100.0 98.0 98.9 99.1 99.4 99.6 99.4 Justifies domestic violence na na na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 5.0 4.5 4.3 3.5 2.9 0.4 4.3 6.8 6.4 5.0 4.6 3.8 Maternal orphan prevalence 1.0 1.0 0.7 1.0 0.3 1.4 0.9 1.6 1.2 1.1 0.8 0.9 Double orphan prevalence 0.2 0.2 0.2 0.3 0.0 0.0 0.2 0.6 0.2 0.3 0.1 0.1 - 17 - PART II. BASIC TABLES, 2000 A. TOTAL POPULATION B. FEMALE AND MALE POPULATIONS C. RURAL AND URBAN POPULATIONS Notes: ­ Each of the three sections referred to above consists of four divisions, presenting data for: I) hnp status; II) hnp service use; III) hnp-related individual and household behavior; and IV) other, underlying determinants of hnp status. ­ Full definitions of all indicators covered in the tables are provided in section A of the technical notes found in part II. ­ "na" appears in the table cells when data are not available, usually because the DHS survey concerned did not collect information about the indicator(s) in question. ­ Figures in the tables shown within parentheses indicate the absence of adequate observations to produce acceptably reliable values. Asterisks appear when the number of observations was too small to justify the presentation even of figures within parentheses. (For further information, see the section on "Sampling Errors" in the presentation of data and methods in part II.B.) Asterisks also will be found in columns showing statistical indices of inequality when the amount of quintile-specific information available is inadequate to permit computation of the value for the index concerned. ­ Female/male tables include only indicators relevant for both sexes; those pertaining to only one sex (e.g., fertility, women's nutritional status, antenatal care, attended deliveries) have been omitted. Colombia 2000 - TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood illness and mortality Infant mortality rate 32.0 31.6 22.0 11.9 17.6 24.4 1.82 14.40 -0.1602 0.0013 Under-five mortality rate 39.1 34.7 24.1 14.2 20.2 28.0 1.94 18.90 -0.1710 0.0012 Prevalence of fever 23.9 25.8 25.2 26.4 26.8 25.5 0.89 2.90 0.0216 0.0150 Prevalence of diarrhea 17.5 15.9 12.9 10.4 10.2 13.9 1.72 7.30 -0.1200 0.0215 Prevalence of acute respiratory 16.5 17.8 14.5 14.5 13.3 15.6 1.24 3.20 -0.0555 0.0200 infection (ARI) B. Fertility Total fertility rate 4.4 3.3 2.4 1.9 1.8 2.6 2.44 2.60 -0.1844 0.0005 Adolescent fertility rate 155.0 133.0 90.0 45.0 34.0 85.0 4.56 121.00 -0.2999 0.0016 C. Nutritional status (%) Children: Moderate stunting 17.3 12.6 9.0 5.6 4.6 10.7 3.76 12.70 -0.2616 0.0267 Severe stunting 4.6 3.8 2.4 1.5 0.5 2.8 9.20 4.10 -0.2876 0.0523 Moderate underweight 7.8 8.4 4.7 4.1 2.8 6.0 2.79 5.00 -0.2063 0.0366 Severe underweight 1.5 0.6 0.9 0.3 0.2 0.8 7.50 1.30 -0.3437 0.1101 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 3.2 4.2 2.5 2.6 3.0 3.2 1.07 0.20 -0.1210 0.0572 Mild anemia na na na na na na na na na na Moderate anemia na na na na na na na na na na Severe anemia na na na na na na na na na na D. Female circumcision (%) Prevalence of circumcision: Girls na na na na na na na na na na Women na na na na na na na na na na Prevalence of occlusion: Girls * * * * * * * * * * Women * * * * * * * * * * E. Sexually transmitted disease Prevalence of genital discharge: Women 25.3 29.2 29.9 27.9 23.6 27.2 1.07 1.70 -0.0101 0.0097 Men na na na na na na na na na na Prevalence of genital ulcer: Women 0.9 1.3 1.2 0.9 0.8 1.1 1.13 0.10 -0.0399 0.0543 Men na na na na na na na na na na - 21 - Colombia 2000 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Childhood immunization BCG coverage 89.0 96.0 98.0 97.1 93.6 94.5 0.95 4.60 0.0155 0.0054 Measles coverage 74.2 80.7 85.4 93.1 85.3 82.7 0.87 11.10 0.0366 0.0088 DPT coverage 72.9 76.8 85.0 87.9 86.6 80.7 0.84 13.70 0.0482 0.0102 Full basic coverage 50.0 59.7 69.7 72.8 65.4 62.2 0.76 15.40 0.0783 0.0147 No basic coverage 1.8 0.9 0.5 0.8 0.0 0.9 na 1.80 -0.3744 0.2194 Hepatitis B coverage 67.9 75.4 80.5 92.8 84.5 78.7 0.80 16.60 0.0573 0.0104 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 31.2 40.1 48.7 55.1 59.1 45.4 0.53 27.90 0.1356 0.0180 Treatment in a public facility 24.4 27.6 29.5 23.7 20.6 25.6 1.18 3.80 -0.0025 0.0274 Treatment in a private facility 6.8 12.2 19.2 30.9 38.5 19.6 0.18 31.70 0.3119 0.0333 Treatment of acute respiratory infection (ARI): Medical treatment of ARI * * * * * * * * * * 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 52.7 60.5 65.0 59.0 78.1 60.8 0.67 25.40 0.0475 0.0185 Medical treatment of diarrhea 24.3 22.7 36.8 31.1 39.3 28.8 0.62 15.00 0.1015 0.0361 Treatment in a public facility 20.2 16.1 25.7 12.4 13.7 18.5 1.47 6.50 -0.0319 0.0439 Treatment in a private facility 4.2 6.6 11.1 18.7 25.6 10.3 0.16 21.40 0.3389 0.0735 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 80.1 88.2 94.4 97.7 96.5 90.8 0.83 16.40 0.0419 0.0034 To a doctor 73.5 85.1 90.2 94.6 94.3 86.9 0.78 20.80 0.0520 0.0040 To a nurse or trained midwife 6.5 3.1 4.2 3.1 2.2 3.9 2.95 4.30 -0.1869 0.0497 Multiple visits to a medically-trained person 68.7 83.0 90.8 94.4 93.7 85.4 0.73 25.00 0.0635 0.0043 Antenatal care content: Tetanus toxoid 84.8 83.4 83.2 85.3 77.7 83.1 1.09 7.10 -0.0006 0.0044 Prophylactic antimalarial treatment 1.5 1.3 0.5 0.1 0.0 0.8 na 1.50 -0.4462 0.1077 Iron supplementation 58.3 69.3 74.3 79.5 82.9 72.0 0.70 24.60 0.0655 0.0061 Delivery attendance: By a medically-trained person 64.3 85.6 94.7 98.6 98.6 86.4 0.65 34.30 0.0862 0.0037 By a doctor 57.9 81.6 91.2 96.2 97.8 82.7 0.59 39.90 0.1008 0.0041 By a nurse or trained midwife 6.3 4.0 3.5 2.4 0.8 3.7 7.88 5.50 -0.2425 0.0435 In a public facility 41.9 52.5 58.1 55.4 48.1 51.0 0.87 6.20 0.0436 0.0084 In a private facility 3.0 11.7 18.0 27.0 36.9 17.1 0.08 33.90 0.3764 0.0184 At home 24.2 10.5 4.1 1.1 1.2 9.6 20.17 23.00 -0.5207 0.0279 D. Contraceptive services Contraceptive prevalence: Women 53.8 61.6 67.2 70.1 66.4 64.0 0.81 12.60 0.0450 0.0055 Men na na na na na na na na na na - 22 - Colombia 2000 - TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors D. Contraceptive services (cont.) Source of contraception - public sector: Women 46.1 35.1 27.9 25.1 20.9 30.2 2.21 25.20 -0.1472 0.0142 Men na na na na na na na na na na Source of contraception - private sector: Women 48.0 62.1 68.8 71.8 76.0 66.3 0.63 28.00 0.0728 0.0067 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 3.0 6.4 9.4 11.4 14.5 9.5 0.21 11.50 0.2295 0.0162 Men na na na na na na na na na na - 23 - Colombia 2000 - TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Hygienic practices Disposal of children's stools: Sanitary disposal 33.0 56.1 63.1 61.8 57.5 53.9 0.57 24.50 0.0985 0.0093 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 0.7 0.6 0.5 0.3 0.2 0.4 3.50 0.50 -0.2762 0.0809 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 35.2 43.1 34.2 (26.6) (24.0) 33.5 1.47 59.20 -0.1039 0.0494 Timely complementary feeding 72.6 61.2 52.8 (56.2) (52.4) 59.8 1.39 125.00 -0.0625 0.0248 Bottle-feeding 56.9 41.2 45.0 50.0 46.1 47.7 1.23 10.80 -0.0125 0.0186 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 2.6 4.3 3.8 4.3 4.0 3.9 0.65 1.40 0.0611 0.0263 Men na na na na na na na na na na Condom usage with non-regular partner: Women (20.1) 24.2 29.5 34.3 44.0 32.1 0.46 64.10 0.1428 0.0385 Men na na na na na na na na na na G. Domestic violence Ever experienced violence 30.2 34.7 34.6 26.3 21.1 29.0 1.43 9.10 -0.0884 0.0084 Experienced violence in past year na na na na na na na na na na - 24 - Colombia 2000 - TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low/High Low-High Concentration Index Ratio Diff. Value Standard Low 2nd 3rd 4th High Avg. (Abs. Val.) Errors A. Education School completion: Women 43.5 71.3 84.4 91.8 94.5 79.9 0.46 51.00 0.1146 0.0026 Men 45.5 71.4 83.9 93.5 95.7 78.1 0.48 50.20 0.1330 0.0028 School participation: Girls 88.0 92.3 93.1 97.3 97.7 93.2 0.90 9.70 0.0225 0.0032 Boys 85.3 91.1 92.4 95.9 95.8 91.7 0.89 10.50 0.0267 0.0038 B. Exposure to mass media Newspaper readership: Women na na na na na na na na na na Men na na na na na na na na na na Radio listenership: Women na na na na na na na na na na Men na na na na na na na na na na Television viewership: Women na na na na na na na na na na Men na na na na na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 54.6 71.2 76.6 79.1 79.2 73.5 0.69 24.60 0.0588 0.0034 Men na na na na na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women 88.6 86.3 90.6 91.9 91.4 87.9 0.97 2.80 0.0325 0.0022 Men na na na na na na na na na na Attitudes toward HIV/AIDS: Women 13.3 15.0 11.8 10.4 9.8 12.0 1.36 3.50 -0.0839 0.0149 Men na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care 53.3 60.0 67.4 69.6 71.6 65.4 0.74 18.30 0.0537 0.0039 Can seek children's health care 96.3 97.5 99.1 98.0 98.6 97.9 0.98 2.30 0.0055 0.0015 Can make daily household purchases 56.3 63.3 64.8 61.6 57.4 60.8 0.98 1.10 0.0018 0.0044 Can make large household purchases 50.5 58.6 61.4 58.4 55.4 57.2 0.91 4.90 0.0144 0.0048 Can make meal-related decisions 60.3 58.8 54.2 48.1 45.1 52.5 1.34 15.20 -0.0599 0.0051 Freedom of movement: Can travel to visit family, relatives 30.1 38.1 43.6 44.6 39.8 39.9 0.76 9.70 0.0496 0.0067 Other decisionmaking, attitudes: Can decide how to spend own money 83.6 87.3 88.4 89.1 90.2 88.4 0.93 6.60 0.0104 0.0026 Can decide whether to have sex 98.0 99.0 99.7 99.6 99.5 99.2 0.98 1.50 0.0026 0.0006 Justifies domestic violence na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 5.0 4.6 4.3 4.7 4.0 4.6 1.25 1.00 -0.0142 0.0227 Maternal orphan prevalence 1.0 0.9 0.8 1.0 1.3 1.0 0.77 0.30 0.0551 0.0515 Double orphan prevalence 0.2 0.2 0.1 0.1 0.2 0.2 1.00 0.00 0.0103 0.1186 - 25 - Colombia 2000 - FEMALE / MALE POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood mortality and morbidity Infant mortality rate 26.2 22.2 21.8 7.9 17.8 20.1 38.0 40.8 22.2 15.7 17.5 28.5 Under-five mortality rate 32.0 23.7 23.6 12.6 20.6 23.4 46.2 45.4 24.6 15.7 19.7 32.4 Prevalence of fever 21.7 25.1 23.7 27.9 26.9 24.7 26.1 26.5 26.4 24.9 26.7 26.2 Prevalence of diarrhea 15.6 14.3 12.5 10.1 8.6 12.7 19.6 17.5 13.3 10.6 11.8 15.1 Prevalence of acute respiratory 14.1 18.7 11.8 12.7 16.3 14.9 19.0 17.0 16.8 16.3 10.4 16.3 infection (ARI) B. Nutritional status Children: Moderate stunting 16.8 12.3 7.8 5.9 6.0 10.7 17.9 12.8 10.0 5.4 3.1 10.7 Severe stunting 4.5 4.1 2.1 1.6 0.0 2.8 4.8 3.4 2.7 1.4 1.0 2.9 Moderate underweight 8.2 8.4 4.4 4.7 3.2 6.2 7.4 8.4 4.9 3.5 2.5 5.7 Severe underweight 1.2 0.4 1.0 0.3 0.0 0.6 1.8 0.8 0.9 0.2 0.4 0.9 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 25.3 29.2 29.9 27.9 23.6 27.2 Men na na na na na na Prevalence of genital ulcer: Women 0.9 1.3 1.2 0.9 0.8 1.1 Men na na na na na na - 27 - Colombia 2000 - FEMALE / MALE POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 86.5 96.3 97.6 97.0 89.3 93.0 91.7 95.7 98.2 97.2 98.7 96.0 Measles coverage 71.1 76.7 85.1 92.5 82.0 80.1 77.5 84.1 85.6 93.6 89.1 85.2 DPT coverage 73.0 77.2 85.0 89.4 84.6 80.7 72.8 76.5 85.0 86.5 88.8 80.7 Full basic coverage 48.7 53.1 66.4 73.0 60.1 58.7 51.4 65.4 72.7 72.6 71.5 65.7 No basic coverage 3.5 1.0 0.0 1.7 0.0 1.4 0.0 0.7 1.0 0.0 0.0 0.4 Hepatitis B coverage 67.0 73.3 86.5 92.7 84.3 78.9 69.0 77.2 75.1 93.0 84.7 78.5 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 28.0 41.6 41.3 52.9 58.7 43.4 34.0 38.8 54.1 57.5 59.4 47.1 Treatment in a public facility 24.5 28.3 26.8 23.7 20.8 25.1 24.4 26.9 31.6 23.7 20.4 26.0 Treatment in a private facility 3.5 12.5 14.6 28.2 37.9 17.9 9.6 11.9 22.5 33.9 39.0 21.2 Treatment of acute respiratory infection (ARI): Medical treatment of ARI * * * * * * * * * * * * 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 52.6 64.6 64.3 (47.3) (77.2) 59.9 52.8 57.4 65.5 (69.9) (78.7) 61.5 Medical treatment of diarrhea 26.1 21.5 29.5 (24.7) (43.4) 27.1 22.8 23.7 42.4 (37.2) (36.4) 30.2 Treatment in a public facility 21.8 15.5 19.4 (11.1) (10.9) 17.2 18.8 16.5 30.5 (13.7) (15.6) 19.6 Treatment in a private facility 4.3 6.0 10.1 (13.6) (32.5) 9.9 4.0 7.2 11.9 (23.5) (20.7) 10.6 C. Contraceptive services Contraceptive prevalence: Women 53.8 61.6 67.2 70.1 66.4 64.0 Men na na na na na na Source of contraception - public sector: Women 46.1 35.1 27.9 25.1 20.9 30.2 Men na na na na na na Source of contraception - private sector: Women 48.0 62.1 68.8 71.8 76.0 66.3 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 3.0 6.4 9.4 11.4 14.5 9.5 Men na na na na na na - 28 - Colombia 2000 - FEMALE / MALE POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal 33.0 56.1 63.1 61.8 57.5 53.9 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 (35.2) (40.0) * * * 33.7 (35.1) (45.1) (43.2) * * 33.3 Timely complementary feeding (70.9) (62.7) (59.3) * * 60.0 (74.1) (60.0) (47.0) (56.1) (60.6) 59.7 Bottle-feeding 59.3 34.9 47.9 45.3 42.3 46.8 54.1 46.1 42.6 54.4 49.1 48.6 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 2.6 4.3 3.8 4.3 4.0 3.9 Men na na na na na na Condom usage with non-regular partner: Women (20.1) 24.2 29.5 34.3 44.0 32.1 Men na na na na na na - 29 - Colombia 2000 - FEMALE / MALE POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 43.5 71.3 84.4 91.8 94.5 79.9 Men 45.5 71.4 83.9 93.5 95.7 78.1 School participation: Girls 88.0 92.3 93.1 97.3 97.7 93.2 Boys 85.3 91.1 92.4 95.9 95.8 91.7 B. Exposure to mass media Newspaper readership: Women na na na na na na Men na na na na na na Radio listenership: Women na na na na na na Men na na na na na na Television viewership: Women na na na na na na Men na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 54.6 71.2 76.6 79.1 79.2 73.5 Men na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women 88.6 86.3 90.6 91.9 91.4 87.9 Men na na na na na na Attitudes toward HIV/AIDS: Women 13.3 15.0 11.8 10.4 9.8 12.0 Men na na na na na na D. Orphanhood Paternal orphan prevalence 4.8 4.3 5.1 5.6 4.2 4.8 5.2 4.9 3.7 3.9 3.7 4.3 Maternal orphan prevalence 0.8 0.9 0.7 1.1 1.7 1.0 1.2 0.8 0.9 0.9 0.9 0.9 Double orphan prevalence 0.3 0.2 0.1 0.1 0.5 0.2 0.1 0.2 0.1 0.2 0.0 0.1 - 30 - Colombia 2000 - RURAL / URBAN POPULATIONS Part I: HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 32.6 28.9 * * * 31.1 * 33.2 21.6 11.4 17.9 21.3 Under-five mortality rate 40.4 28.9 * * * 36.2 * 38.0 23.8 13.8 20.5 24.1 Prevalence of fever 21.5 21.8 25.8 * * 21.6 41.4 27.9 25.1 27.0 26.8 27.2 Prevalence of diarrhea 16.6 14.2 10.1 * * 15.6 24.5 16.8 13.1 10.4 10.3 13.2 Prevalence of acute respiratory infection 15.3 15.2 9.9 * * 14.9 25.5 19.2 14.9 14.8 13.3 15.9 B. Fertility Total fertility rate 4.3 (3.1) * * * 3.8 * 3.3 2.4 1.9 1.8 2.3 Adolescent fertility rate 150.0 (115.0) * * * 134.4 * 142.0 87.0 45.0 34.0 71.1 C. Nutritional status Children: Moderate stunting 17.6 11.1 10.9 * * 15.3 15.2 13.4 8.9 5.6 4.6 8.6 Severe stunting 4.9 2.2 5.2 * * 4.1 2.6 4.6 2.2 1.5 0.5 2.3 Moderate underweight 7.8 7.3 13.2 * * 7.7 7.5 9.0 4.1 4.2 2.9 5.1 Severe underweight 1.4 0.7 0.0 * * 1.1 2.0 0.5 1.0 0.3 0.2 0.6 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 3.1 2.8 (6.6) * * 3.1 4.0 4.9 2.3 2.7 3.1 3.2 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 24.4 23.7 21.9 34.9 (30.9) 24.4 32.9 32.4 30.4 27.7 23.5 28.1 Men na na na na na na na na na na na na Prevalence of genital ulcer: Women 1.0 0.9 0.5 0.0 0.0 0.9 0.6 1.6 1.3 1.0 0.8 1.1 Men na na na na na na na na na na na na - 31 - Colombia 2000 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 89.8 98.0 * * * 91.9 (82.3) 95.0 98.4 97.0 94.2 95.7 Measles coverage 74.9 90.5 * * * 79.9 (68.2) 76.0 85.0 92.8 85.7 84.0 DPT coverage 74.8 91.2 * * * 79.7 (57.5) 69.9 85.0 87.5 87.0 81.2 Full basic coverage 52.2 68.7 * * * 57.5 (32.4) 55.4 69.6 72.7 65.5 64.4 No basic coverage 2.0 0.0 * * * 1.7 0.0 1.3 0.0 0.8 0.0 0.5 Hepatitis B coverage 70.1 86.3 * * * 74.6 (50.5) 70.2 80.9 93.0 84.9 80.6 Yellow fever coverage na na na na na na na na na na na na B. Treatment of childhood diseases Treatment of fever: Medical treatment of fever 25.7 40.1 * * * 31.0 52.7 40.2 48.5 55.1 59.4 50.6 Treatment in a public facility 19.2 30.7 * * * 23.1 45.0 26.3 29.1 23.9 20.4 26.4 Treatment in a private facility 6.5 9.4 * * * 7.9 7.8 13.3 19.4 30.8 39.0 23.9 Treatment of acute respiratory infection (ARI): Medical treatment of ARI * * * * * * * * * * * * 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 50.9 51.0 * * * 50.9 (62.2) 64.7 64.5 60.7 79.0 66.1 Medical treatment of diarrhea 20.7 23.3 * * * 22.2 (43.1) 22.5 35.5 32.0 39.7 32.3 Treatment in a public facility 16.1 20.2 * * * 17.9 (41.2) 14.3 24.3 12.8 13.8 18.9 Treatment in a private facility 4.6 3.0 * * * 4.4 (1.9) 8.2 11.1 19.2 25.9 13.4 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 80.3 91.7 89.2 * * 84.3 78.1 86.4 94.7 97.8 96.5 93.5 To a doctor 73.4 86.3 78.9 * * 77.4 75.0 84.5 91.0 95.2 94.3 90.8 To a nurse or trained midwife 7.0 5.4 10.3 * * 6.8 3.1 1.9 3.7 2.6 2.2 2.7 Multiple visits to a medically-trained person 68.9 87.2 87.5 * * 75.6 66.8 80.8 91.1 94.3 93.6 89.4 Antenatal care content: Tetanus toxoid 84.0 81.9 81.8 * * 83.5 90.6 84.1 83.3 85.3 77.4 82.9 Prophylactic antimalarial treatment 1.1 1.0 2.0 * * 1.1 4.6 1.4 0.4 0.1 0.0 0.6 Iron supplementation 57.6 64.9 68.6 * * 60.5 63.7 71.6 74.7 79.6 83.2 76.7 Delivery attendance: By a medically-trained person 63.2 82.2 83.9 (100.0) * 69.8 72.6 87.4 95.5 98.5 98.6 94.0 By a doctor 56.7 77.2 77.1 (86.0) * 63.6 67.4 83.8 92.2 96.5 97.8 91.4 By a nurse or trained midwife 6.5 4.9 6.8 (14.0) * 6.2 5.2 3.6 3.2 2.0 0.8 2.6 In a public facility 41.1 50.9 58.3 (77.6) * 45.2 47.8 53.3 58.1 54.7 47.8 53.6 In a private facility 2.8 11.2 7.8 (8.7) * 5.4 4.1 11.9 18.7 27.5 37.2 22.4 At home 25.1 13.6 11.4 0.0 * 20.9 17.8 8.9 3.5 1.2 1.2 4.3 D. Contraceptive services Contraceptive prevalence: Women 54.3 62.7 64.4 (91.3) * 58.4 47.8 60.8 67.4 69.6 66.4 66.2 Men na na na na na na na na na na na na - 32 - Colombia 2000 - RURAL / URBAN POPULATIONS Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - public sector: Women 46.4 38.9 34.4 (36.2) * 42.5 (42.1) 32.4 27.3 24.7 20.9 25.9 Men na na na na na na na na na na na na Source of contraception - private sector: Women 47.9 57.8 64.1 (61.5) * 53.1 (48.7) 65.3 69.2 72.2 76.0 70.9 Men na na na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na na na na na na na Men 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 2.7 4.6 4.3 6.1 (13.8) 3.6 5.8 7.5 9.8 11.6 14.5 11.3 Men na na na na na na na na na na na na - 33 - Colombia 2000 - RURAL / URBAN POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na na na na na na na Handwashing facilities in household na na na na na na na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na na na na na na na Treated bednet ownership 0.6 0.4 1.9 0.0 0.0 0.6 1.3 0.7 0.4 0.3 0.2 0.4 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 39.8 (57.2) * * * 42.1 * (32.7) 35.4 (27.7) (24.8) 29.1 Timely complementary feeding 69.6 (67.8) * * * 68.2 * 57.6 53.6 (53.5) (53.3) 55.9 Bottle-feeding 53.4 37.4 * * * 48.3 * 43.1 45.3 49.4 47.3 47.5 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 2.3 2.5 3.7 0.0 (3.6) 2.4 5.5 5.4 3.8 4.4 4.0 4.3 Men na na na na na na na na na na na na Condom usage with non-regular partner: Women (22.7) * * 0.0 * 24.0 * 24.9 28.4 34.3 44.5 33.3 Men na na na na na na na na na na na na G. Domestic violence Ever experienced violence 29.1 29.0 24.7 28.4 (27.5) 28.8 40.2 38.1 35.3 26.2 21.0 29.1 Experienced violence in past year na na na na na na na na na na na na - 34 - Colombia 2000 - RURAL / URBAN POPULATIONS Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles - Rural Wealth Quintiles - Urban Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Education School completion: Women 42.3 64.7 74.9 83.8 (87.4) 52.9 54.4 75.3 85.1 92.1 94.6 87.8 Men 44.7 65.2 70.9 88.6 (96.6) 53.2 55.7 75.8 84.9 93.6 95.7 88.0 School participation: Girls 88.3 95.4 (94.4) (100.0) * 91.1 85.5 90.2 93.0 97.1 97.7 94.2 Boys 85.5 94.9 (94.8) * * 88.9 (83.2) 88.3 92.2 95.7 95.7 93.0 B. Exposure to mass media Newspaper readership: 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 Radio listenership: 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 Television viewership: 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 C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 54.1 72.8 73.3 79.5 (79.1) 62.0 58.7 70.3 76.8 79.1 79.2 76.8 Men na na na na na na na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women 74.1 87.9 85.5 88.4 (94.7) 79.6 79.6 85.3 90.9 92.0 91.3 90.3 Men na na na na na na na na na na na na Attitudes toward HIV/AIDS: Women 14.3 17.7 11.4 8.4 (5.3) 14.9 13.6 13.4 11.8 10.5 9.9 11.1 Men na na na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care 52.3 52.6 57.6 60.3 (64.0) 53.1 62.8 64.4 68.0 69.9 71.7 69.0 Can seek children's health care 96.1 97.5 100.0 * * 96.8 97.8 97.5 99.0 97.9 98.6 98.3 Can make daily household purchases 55.4 58.5 61.3 62.1 (56.0) 56.9 64.4 66.0 65.1 61.6 57.4 62.0 Can make large household purchases 50.0 54.3 55.8 57.1 (57.6) 51.9 55.4 61.2 61.8 58.5 55.4 58.8 Can make meal-related decisions 61.2 61.0 60.5 65.8 (46.7) 61.0 52.5 57.5 53.8 47.6 45.1 50.0 Freedom of movement: Can travel to visit family, relatives 29.1 27.4 35.5 55.3 (40.6) 29.8 38.6 44.4 44.2 44.3 39.8 42.9 Other decisionmaking, attitudes: Can decide how to spend own money 83.1 84.0 89.2 (86.9) * 84.2 86.6 88.6 88.4 89.2 90.2 89.2 Can decide whether to have sex 97.8 98.6 99.6 100.0 (100.0) 98.2 100.0 99.3 99.7 99.6 99.5 99.5 Justifies domestic violence na na na na na na na na na na na na E. Orphanhood Paternal orphan prevalence 5.1 4.8 3.3 13.0 (4.9) 5.1 4.3 4.4 4.4 4.4 3.9 4.3 Maternal orphan prevalence 1.0 0.7 0.8 1.0 (2.4) 0.9 0.9 0.9 0.8 1.0 1.3 1.0 Double orphan prevalence 0.2 0.2 0.0 0.0 (2.4) 0.2 0.0 0.2 0.1 0.1 0.2 0.2 - 35 - PART III. BASIC TABLES, 1995 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. Colombia 1995 - 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 40.8 31.4 27.0 31.5 16.2 30.8 2.52 24.60 -0.1205 0.0015 Under-five mortality rate 52.1 37.1 30.7 34.9 23.6 37.4 2.21 28.50 -0.1309 0.0012 Prevalence of fever 27.6 28.4 28.0 29.1 25.9 27.9 1.07 1.70 -0.0002 0.0135 Prevalence of diarrhea 18.4 19.8 16.8 14.9 10.0 16.7 1.84 8.40 -0.0879 0.0179 Prevalence of acute respiratory 27.4 22.4 22.0 23.4 26.3 24.3 1.04 1.10 -0.0279 0.0154 infection (ARI) B. Fertility Total fertility rate 5.2 3.7 2.8 2.3 1.7 3.0 3.06 3.50 -0.2100 0.0006 Adolescent fertility rate 180.0 126.0 93.0 65.0 24.0 89.0 7.50 156.00 -0.3196 0.0027 C. Nutritional status (%) Children: Moderate stunting 16.7 13.0 11.2 6.6 4.5 11.5 3.71 12.20 -0.2272 0.0235 Severe stunting 6.9 3.7 2.2 1.1 1.4 3.5 4.93 5.50 -0.3454 0.0484 Moderate underweight 12.7 8.7 5.9 3.1 2.7 7.5 4.70 10.00 -0.2944 0.0306 Severe underweight 2.0 0.7 0.9 0.1 0.3 0.9 6.67 1.70 -0.3993 0.1021 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 5.9 4.0 3.7 3.6 1.2 3.8 4.92 4.70 -0.1775 0.0509 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 - 39 - Colombia 1995 - 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 88.9 92.8 95.9 96.0 93.1 93.1 0.95 4.20 0.0202 0.0055 Measles coverage 81.7 87.4 89.6 93.4 96.5 88.6 0.85 14.80 0.0340 0.0065 DPT coverage 66.3 80.2 75.7 87.5 89.5 78.1 0.74 23.20 0.0658 0.0093 Full basic coverage 57.7 69.7 68.8 75.2 77.3 68.3 0.75 19.60 0.0677 0.0125 No basic coverage 3.5 2.2 0.0 0.5 0.0 1.5 na 3.50 -0.5941 0.1743 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 22.6 29.5 31.8 35.3 54.2 32.3 0.42 31.60 0.1417 0.0231 Treatment in a public facility 13.9 17.7 21.2 20.8 14.4 17.7 0.97 0.50 0.0551 0.0314 Treatment in a private facility 8.7 11.6 10.6 14.5 38.9 14.5 0.22 30.20 0.2523 0.0418 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 34.3 50.5 49.4 53.7 68.0 48.7 0.50 33.70 0.1159 0.0169 Treatment in a public facility 21.8 30.7 28.8 29.0 12.6 24.9 1.73 9.20 -0.0161 0.0279 Treatment in a private facility 12.6 19.5 20.0 24.7 54.1 23.4 0.23 41.50 0.2672 0.0325 Treatment of diarrhea: Use of oral rehydration therapy 58.1 66.4 72.1 80.8 70.8 67.9 0.82 12.70 0.0607 0.0142 Medical treatment of diarrhea 22.4 32.8 37.2 45.5 39.0 33.3 0.57 16.60 0.1346 0.0273 Treatment in a public facility 12.6 18.2 22.6 22.4 18.0 18.2 0.70 5.40 0.1229 0.0415 Treatment in a private facility 9.8 14.6 13.6 23.1 21.0 14.9 0.47 11.20 0.1506 0.0464 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 65.7 83.3 90.9 95.8 97.7 85.8 0.67 32.00 0.0789 0.0040 To a doctor 60.9 79.9 88.5 92.7 96.1 82.7 0.63 35.20 0.0868 0.0043 To a nurse or trained midwife 4.7 3.4 2.4 3.2 1.6 3.1 2.94 3.10 -0.1276 0.0517 Multiple visits to a medically-trained person 56.2 78.3 87.9 93.4 96.2 81.3 0.58 40.00 0.1022 0.0044 Antenatal care content: Tetanus toxoid 83.2 85.4 82.7 77.6 69.7 80.4 1.19 13.50 -0.0237 0.0048 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 60.6 85.2 92.8 98.9 98.1 84.5 0.62 37.50 0.1028 0.0039 By a doctor 41.1 71.7 84.7 94.3 96.5 73.8 0.43 55.40 0.1630 0.0045 By a nurse or trained midwife 19.4 13.5 8.1 4.6 1.6 10.8 12.13 17.80 -0.3041 0.0235 In a public facility 42.7 71.8 76.8 75.3 60.6 64.5 0.70 17.90 0.0909 0.0067 In a private facility 2.4 4.2 10.8 20.9 36.7 12.3 0.07 34.30 0.4635 0.0235 At home 53.8 23.3 11.9 3.8 1.9 22.6 28.32 51.90 -0.4952 0.0143 D. Contraceptive services Contraceptive prevalence: Women 42.2 59.6 62.7 64.2 65.7 59.3 0.64 23.50 0.0665 0.0061 Men na na na na na na na na na na - 40 - Colombia 1995 - 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 44.3 34.9 26.0 24.1 18.2 27.9 2.43 26.10 -0.1519 0.0153 Men na na na na na na na na na na Source of contraception - private sector: Women 54.7 64.7 73.8 75.2 81.3 71.5 0.67 26.60 0.0609 0.0061 Men na na na na na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na na na na na Men na na na na na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na na na na na Men na na na na na na na na na na Voluntary counseling and testing for HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na - 41 - Colombia 1995 - 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 11.0 9.9 15.0 (29.4) (17.0) 15.7 (0.65) 28.00 0.1394 0.0820 Timely complementary feeding 81.4 56.3 58.2 44.3 (59.6) 61.9 (1.37) 141.00 -0.0968 0.0248 Bottle-feeding 67.0 81.5 79.7 74.4 76.8 75.7 0.87 9.80 0.0257 0.0114 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 na na na na na na na na na na Men na na na na na na na na na na Condom usage with non-regular partner: Women na na na na na na na na na na Men na na na na na na na na na na G. Domestic violence Ever experienced violence na na na na na na na na na na Experienced violence in past year na na na na na na na na na na - 42 - Colombia 1995 - 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 34.3 60.6 80.1 90.4 93.6 75.5 0.37 59.30 0.1478 0.0029 Men 33.8 59.5 80.6 90.9 95.8 73.0 0.35 62.00 0.1752 0.0030 School participation: Girls 80.7 90.9 95.6 97.1 98.5 91.5 0.82 17.80 0.0384 0.0038 Boys 79.4 87.9 92.0 97.2 98.9 89.7 0.80 19.50 0.0451 0.0040 B. Exposure to mass media Newspaper readership: Women 40.6 60.4 69.8 75.6 82.0 68.1 0.50 41.40 0.1098 0.0037 Men na na na na na na na na na na Radio listenership: Women 69.3 79.4 81.2 86.0 85.3 81.2 0.81 16.00 0.0385 0.0029 Men na na na na na na na na na na Television viewership: Women 46.3 82.9 89.2 90.1 92.0 82.6 0.50 45.70 0.0858 0.0030 Men na na na na na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 59.2 82.6 88.6 93.0 94.7 85.7 63.00 35.51 0.0709 0.0025 Men na na na na na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na na na na na Men na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na Can seek children's health care na na na na na na na na na na Can make daily household purchases na na na na na na na na na na Can make large household purchases na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money 66.9 75.5 77.1 79.2 81.7 77.7 0.82 14.84 0.0252 0.0041 Can decide whether to have sex na na na na na na na na na na Justifies domestic violence na na na na na na na na na na E. Orphanhood Paternal orphan prevalence na na na na na na na na na na Maternal orphan prevalence 1.4 1.1 1.0 1.0 1.1 1.1 1.27 0.30 -0.0445 0.0459 Double orphan prevalence na na na na na na na na na na - 43 - Colombia 1995 - 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 40.2 22.8 17.0 31.5 14.7 26.5 41.3 39.5 36.5 31.4 17.6 34.9 Under-five mortality rate 51.6 29.4 20.7 37.2 16.5 32.8 52.6 44.4 40.2 32.6 30.1 41.7 Prevalence of fever 29.4 27.6 30.0 28.5 30.4 29.1 25.7 29.1 26.2 29.7 21.9 26.8 Prevalence of diarrhea 16.5 19.8 15.4 12.6 12.2 15.8 20.3 19.8 18.1 17.1 8.1 17.5 Prevalence of acute respiratory 26.8 23.2 23.4 23.2 28.1 24.8 28.1 21.5 20.7 23.6 24.8 23.8 infection (ARI) B. Nutritional status Children: Moderate stunting 15.7 12.8 9.0 5.2 3.0 10.3 17.8 13.3 13.2 8.0 5.9 12.5 Severe stunting 5.9 4.0 1.6 0.7 2.6 3.3 8.0 3.4 2.7 1.4 0.3 3.7 Moderate underweight 11.3 8.7 5.2 2.4 2.5 6.9 14.2 8.8 6.4 3.7 2.8 8.0 Severe underweight 1.7 0.5 0.2 0.3 0.7 0.7 2.3 0.9 1.4 0.0 0.0 1.1 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 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 - 45 - Colombia 1995 - 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 87.9 90.2 96.7 94.6 92.5 92.0 89.9 95.2 95.2 97.3 93.6 94.0 Measles coverage 78.8 87.1 86.5 94.8 100.0 87.7 84.4 87.7 92.4 92.2 93.4 89.4 DPT coverage 59.3 80.4 77.4 89.6 92.8 77.3 72.8 80.1 74.3 85.6 86.4 78.8 Full basic coverage 50.8 70.7 70.8 75.3 83.5 67.8 64.1 68.7 66.9 75.1 71.7 68.7 No basic coverage 5.3 2.5 0.0 0.0 0.0 1.9 1.9 2.0 0.0 0.9 0.0 1.1 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 illnesses Treatment of fever: Medical treatment of fever 20.3 26.0 29.9 33.0 51.3 29.8 25.3 32.9 33.7 37.4 57.7 34.9 Treatment in a public facility 13.6 16.1 18.2 18.7 10.9 15.7 14.2 19.2 24.3 22.8 18.8 19.7 Treatment in a private facility 6.6 9.9 11.7 14.3 38.8 14.0 11.1 13.2 9.5 14.6 38.9 15.0 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 28.8 47.9 46.4 52.8 66.4 45.7 39.7 53.3 52.4 54.6 69.5 51.6 Treatment in a public facility 18.8 29.2 26.5 30.5 14.4 23.8 24.6 32.4 31.1 27.7 10.7 26.0 Treatment in a private facility 9.9 18.8 19.9 22.3 50.3 21.6 15.1 20.2 20.0 26.9 57.9 25.2 Treatment of diarrhea: Use of oral rehydration therapy 61.7 65.3 70.8 78.9 (76.4) 68.4 55.1 67.5 73.2 82.1 (63.3) 67.5 Medical treatment of diarrhea 20.5 30.2 31.6 44.8 (38.4) 30.7 23.8 35.4 41.4 45.9 (39.9) 35.5 Treatment in a public facility 10.6 16.3 19.1 17.8 (19.9) 15.8 14.2 20.1 25.2 25.6 (15.4) 20.2 Treatment in a private facility 10.0 13.9 12.5 27.0 (18.5) 14.9 9.6 15.4 14.3 20.3 (24.5) 14.9 C. Contraceptive services Contraceptive prevalence: Women 42.2 59.6 62.7 64.2 65.7 59.3 Men na na na na na na Source of contraception - public sector: Women 44.3 34.9 26.0 24.1 18.2 27.9 Men na na na na na na Source of contraception - private sector: Women 54.7 64.7 73.8 75.2 81.3 71.5 Men na na na na na na D. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na Men na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men na na na na na na - 46 - Colombia 1995 - FEMALE / MALE POPULATIONS Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles - Female Wealth Quintiles - Male Low 2nd 3rd 4th High Avg. Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet use: By children na na na na na na C. Breastfeeding Exclusive breastfeeding (8.6) (13.6) (13.6) * * 15.2 (13.1) (6.2) (16.2) (25.4) (21.3) 16.2 Timely complementary feeding (72.1) (56.0) (50.7) * (58.4) 57.0 (91.0) (56.5) (65.2) (52.1) * 66.7 Bottle-feeding 64.7 80.6 78.8 71.5 75.9 74.1 69.3 82.3 80.5 77.0 77.5 77.2 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 na na na na na na Men na na na na na na Condom usage with non-regular partner: Women na na na na na na Men na na na na na na - 47 - Colombia 1995 - 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 34.3 60.6 80.1 90.4 93.6 75.5 Men 33.8 59.5 80.6 90.9 95.8 73.0 School participation: Girls 80.7 90.9 95.6 97.1 98.5 91.5 Boys 79.4 87.9 92.0 97.2 98.9 89.7 B. Exposure to mass media Newspaper readership: Women 40.6 60.4 69.8 75.6 82.0 68.1 Men na na na na na na Radio listenership: Women 69.3 79.4 81.2 86.0 85.3 81.2 Men na na na na na na Television viewership: Women 46.3 82.9 89.2 90.1 92.0 82.6 Men na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 59.2 82.6 88.6 93.0 94.7 85.7 Men na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na Men na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Orphanhood Paternal orphan prevalence na na na na na na na na na na na na Maternal orphan prevalence 1.9 1.0 1.3 0.9 1.3 1.3 0.9 1.2 0.7 1.1 0.9 1.0 Double orphan prevalence na na na na na na na na na na na na - 48 - Colombia 1995 - 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 39.6 28.2 * * * 35.2 (48.0) 34.6 27.3 31.4 15.7 28.3 Under-five mortality rate 50.0 31.9 * * * 43.2 (65.6) 42.5 30.6 34.8 22.7 34.1 Prevalence of fever 26.7 24.9 29.5 * * 26.3 32.9 31.5 27.8 29.2 26.0 28.7 Prevalence of diarrhea 18.0 16.2 17.2 * * 17.2 21.3 23.1 16.8 15.0 10.1 16.4 Prevalence of acute respiratory infection 26.3 20.5 25.0 * * 24.3 34.7 24.1 21.6 23.5 26.6 24.3 B. Fertility Total fertility rate 5.3 3.6 * * * 4.3 * 3.7 2.8 2.3 1.7 2.5 Adolescent fertility rate 182.0 93.0 * * * 136.7 * 156.0 94.0 65.0 23.0 73.9 C. Nutritional status Children: Moderate stunting 15.9 10.7 11.3 * * 13.9 22.3 15.3 11.2 6.5 4.5 10.1 Severe stunting 7.0 2.4 3.6 * * 5.3 6.5 5.0 2.0 1.1 1.5 2.4 Moderate underweight 12.5 6.9 3.4 * * 10.1 14.2 10.5 6.2 3.0 2.8 5.9 Severe underweight 1.9 0.5 1.2 * * 1.4 2.4 0.9 0.8 0.1 0.3 0.6 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 5.2 2.7 0.8 * * 3.9 10.1 5.3 4.1 3.6 1.2 3.8 Mild anemia na na na na na na na na na na na na Moderate anemia na na na na na na na na na na na na Severe anemia na na na na na na na na na na na na D. Female circumcision Prevalence of circumcision: Girls na na na na na na na na na na na na Women na na na na na na na na na na na na Prevalence of occlusion: Girls na na na na na na na na na na na na Women na na na na na na na na na na na na E. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na na na na na na na Men 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 - 49 - Colombia 1995 - 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 87.5 91.3 * * * 89.4 (97.8) 94.4 95.7 96.0 93.0 95.2 Measles coverage 80.8 85.6 * * * 83.7 (87.1) 89.4 88.3 93.3 96.5 91.5 DPT coverage 65.4 78.0 * * * 71.1 (71.4) 82.8 74.3 87.3 89.4 82.2 Full basic coverage 56.5 68.9 * * * 62.3 (65.2) 70.6 66.9 75.2 77.1 71.8 No basic coverage 3.7 4.2 * * * 3.6 (2.2) 0.0 0.0 0.5 0.0 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 19.5 21.6 (41.4) * * 22.2 38.4 35.2 30.5 34.8 54.9 37.5 Treatment in a public facility 12.9 13.3 (26.4) * * 14.3 19.1 20.9 20.5 20.1 14.8 19.4 Treatment in a private facility 6.7 8.3 (15.0) * * 7.9 19.3 13.9 10.0 14.7 39.2 17.9 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 30.1 44.1 (51.5) * * 35.4 54.9 55.5 49.1 53.7 68.2 56.1 Treatment in a public facility 19.4 26.5 (31.0) * * 22.1 33.1 34.0 28.5 28.7 12.8 26.5 Treatment in a private facility 10.6 17.6 (20.5) * * 13.4 21.8 20.9 19.9 24.9 54.1 29.0 Treatment of diarrhea: Use of oral rehydration therapy 56.2 60.2 * * * 58.1 (68.2) 70.3 73.1 80.6 71.1 73.7 Medical treatment of diarrhea 22.1 32.8 * * * 27.4 (23.5) 32.8 35.6 44.8 38.7 36.7 Treatment in a public facility 12.5 19.4 * * * 16.1 (13.1) 17.4 21.6 21.5 17.3 19.4 Treatment in a private facility 9.7 13.4 * * * 11.3 (10.4) 15.4 12.8 23.3 21.4 17.0 C. Antenatal and delivery care Antenatal care visits: To a medically-trained person 65.1 82.7 89.9 * * 73.3 69.2 83.8 91.0 95.8 98.0 91.8 To a doctor 59.9 79.0 85.9 * * 68.8 67.3 80.7 88.8 92.5 96.4 89.3 To a nurse or trained midwife 5.2 3.7 4.0 * * 4.5 1.9 3.1 2.2 3.2 1.6 2.5 Multiple visits to a medically-trained person 54.7 78.0 88.1 * * 65.7 65.7 78.6 87.9 93.3 96.5 88.8 Antenatal care content: Tetanus toxoid 82.0 83.5 81.8 * * 82.7 90.5 87.2 82.8 77.3 69.3 79.3 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 59.2 84.6 94.6 * * 69.7 68.8 85.7 92.6 98.9 98.3 92.8 By a doctor 38.4 69.1 84.7 * * 51.5 58.3 74.2 84.7 94.2 96.7 86.2 By a nurse or trained midwife 20.8 15.6 9.8 * * 18.2 10.5 11.5 7.9 4.7 1.6 6.6 In a public facility 40.8 70.2 73.0 * * 52.2 54.5 73.2 77.3 75.3 60.4 71.4 In a private facility 2.0 4.1 14.0 * * 3.8 5.2 4.2 10.4 20.9 37.1 17.1 At home 56.4 24.4 13.0 * * 43.0 38.0 22.3 11.8 3.8 2.0 11.1 D. Contraceptive services Contraceptive prevalence: Women 42.4 61.4 65.8 (59.1) (51.5) 51.6 40.3 57.5 62.3 64.3 66.0 62.6 Men na na na na na na na na na na na na - 50 - Colombia 1995 - 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 46.8 40.8 26.7 * * 41.2 24.5 26.9 25.9 24.3 18.2 23.2 Men na na na na na na na na na na na na Source of contraception - private sector: Women 52.3 58.9 73.3 * * 58.3 73.7 72.6 73.8 74.9 81.3 76.3 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 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 - 51 - Colombia 1995 - 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 10.4 * * 0.0 0.0 11.4 * (9.2) 13.9 (29.4) (17.0) 18.1 Timely complementary feeding 84.0 (48.5) * * * 71.9 * 61.8 57.1 46.4 (56.4) 55.6 Bottle-feeding 68.0 85.8 * * * 72.7 (60.0) 78.5 81.9 74.6 76.3 77.3 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 na na na na na na na na na na na na Men na na na na na na na na na na na na Condom usage with non-regular partner: Women na na na na na na na na na na na na Men na na na na na na na na na na na na G. Domestic violence Ever experienced violence na na na na na na na na na na na na Experienced violence in past year na na na na na na na na na na na na - 52 - Colombia 1995 - 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 32.3 56.1 72.4 88.1 91.6 47.1 46.9 65.6 81.1 90.4 93.7 85.2 Men 31.8 52.0 77.3 93.1 97.1 44.6 48.7 69.1 81.1 90.8 95.7 85.8 School participation: Girls 81.0 91.8 100.0 * * 86.0 78.9 89.8 95.0 97.2 98.5 94.7 Boys 79.4 88.2 91.1 * * 83.4 79.5 87.3 92.1 97.2 98.9 93.7 B. Exposure to mass media Newspaper readership: Women 38.8 57.2 69.3 74.6 77.6 49.9 51.4 63.9 69.9 75.6 82.1 74.3 Men na na na na na na na na na na na na Radio listenership: Women 70.0 83.7 87.0 83.6 79.2 77.1 65.0 74.6 80.5 86.1 85.4 82.6 Men na na na na na na na na na na na na Television viewership: Women 42.8 86.7 90.6 94.7 93.3 65.4 67.9 78.7 89.0 90.0 91.9 88.5 Men na na na na na na na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 61.2 83.7 93.3 96.7 97.8 73.9 72.9 85.5 89.0 93.8 95.6 91.7 Men na na na na na na na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na na na na na na na Men na na na na na na na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na na na na na na na Can seek children's health care na na na na na na na na na na na na Can make daily household purchases na na na na na na na na na na na na Can make large household purchases na na na na na na na na na na na na Can make meal-related decisions na na na na na na na na na na na na Freedom of movement: Can travel to visit family, relatives na na na na na na na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money 49.9 59.5 72.4 (65.5) 81.5 57.0 69.3 76.6 74.2 76.1 79.5 76.7 Can decide whether to have sex na na na na na na na na na na na na Justifies domestic violence na na na na na na na na na na na na E. Orphanhood Paternal orphan prevalence na na na na na na na na na na na na Maternal orphan prevalence 1.2 1.7 4.7 0.0 0.0 1.6 2.4 0.5 0.5 1.0 1.2 0.9 Double orphan prevalence na na na na na na na na na na na na - 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, 2005 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Colombia 2005 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 28,953 30,555 31,068 30,989 31,248 152,812 Urban 3,730 19,674 28,241 29,977 30,894 112,517 Rural 25,222 10,881 2,826 1,012 354 40,295 Female 13,945 15,496 16,416 16,751 17,006 79,614 Male 15,007 15,059 14,651 14,238 14,242 73,197 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 6,733 6,659 5,975 4,983 3,906 28,257 Urban 841 4,457 5,467 4,837 3,851 19,453 Rural 5,892 2,203 508 147 55 8,804 Female 3,352 3,245 2,903 2,455 1,956 13,911 Male 3,381 3,414 3,072 2,528 1,950 14,346 Prevalence of fever, diarrhea, acute respiratory infection All 3,315 3,278 2,951 2,248 1,717 13,509 Urban 421 2,291 2,713 2,192 1,698 9,315 Rural 2,893 987 238 56 19 4,194 Female 1,672 1,601 1,450 1,140 842 6,705 Male 1,646 1,687 1,507 1,109 875 6,823 Total fertility rate All 6,316 7,987 8,659 9,095 9,286 41,344 Urban 866 5,233 7,883 8,804 9,178 31,963 Rural 5,451 2,755 776 291 109 9,381 Age-specific fertility rate 15-19 All 1,243 1,401 1,387 1,457 1,415 6,902 Urban 202 946 1,273 1,411 1,398 5,228 Rural 1,041 455 114 46 17 1,674 Children's nutritional status All 2,931 2,832 2,504 1,924 1,351 11,542 Urban 368 1,949 2,303 1,877 1,334 7,830 Rural 2,563 883 201 47 17 3,711 Female 1,478 1,371 1,233 1,001 661 5,744 Male 1,454 1,471 1,274 923 690 5,811 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 - 83 - Colombia 2005 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All 5,374 7,000 7,462 7,793 7,453 35,082 Urban 741 4,562 6,767 7,532 7,364 26,966 Rural 4,633 2,437 695 261 89 8,116 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 5,662 7,362 8,055 8,539 8,701 38,319 Urban Female 778 4,830 7,328 8,258 8,601 29,795 Rural Female 4,884 2,532 728 281 99 8,524 Male na na na na na na Urban Male na na na na na na Rural Male 0 0 0 0 0 0 - 84 - Colombia 2005 - 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 674 686 596 391 290 2,637 Urban 83 448 552 384 289 1,755 Rural 591 239 44 7 1 882 Female 345 321 282 200 107 1,256 Male 329 367 313 191 183 1,383 Treatment of fever All 898 828 664 526 382 3,299 Urban 126 592 621 515 380 2,235 Rural 772 235 43 11 2 1,064 Female 450 423 315 252 166 1,606 Male 448 409 349 275 216 1,697 Treatment of acute respiratory infection All 339 311 263 231 158 1,302 Urban 46 209 247 231 156 889 Rural 293 102 15 1 2 413 Female 160 153 133 104 72 621 Male 180 161 130 127 86 685 Treatment of diarrhea All 569 547 385 254 152 1,907 Urban 89 396 350 245 152 1,232 Rural 479 151 35 9 na 675 Female 281 243 200 116 62 903 Male 288 305 185 138 90 1,005 Antenatal and delivery care All 3,409 3,351 3,011 2,275 1,733 13,779 Urban 433 2,343 2,770 2,218 1,711 9,475 Rural 2,976 1,009 241 56 22 4,304 Contraceptive prevalence Female 3,572 4,066 4,114 4,085 3,925 19,762 Urban Female 420 2,493 3,691 3,930 3,865 14,398 Rural Female 3,153 1,573 423 155 60 5,364 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Contraceptive source Female 2,159 2,710 2,852 2,927 2,820 13,468 Urban Female 233 1,593 2,538 2,810 2,775 9,949 Rural Female 1,926 1,117 314 118 45 3,519 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 5,670 7,377 8,056 8,548 8,703 38,355 Urban Female 780 4,841 7,329 8,267 8,604 29,821 Rural Female 4,890 2,536 728 281 99 8,534 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 85 - Colombia 2005 - 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 2,261 2,513 2,357 1,956 1,517 10,605 Urban 299 1,721 2,156 1,903 1,499 7,577 Rural 1,962 793 201 53 18 3,028 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 1,573 1,075 873 609 475 4,605 Urban 185 653 765 585 472 2,660 Rural 1,388 422 109 25 3 1,946 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 187 195 194 129 104 809 Urban 30 136 186 127 103 582 Rural 157 59 8 2 1 227 Female 111 90 85 73 50 409 Male 78 111 112 56 54 412 Timely complementary breastfeeding All 243 180 182 167 113 885 Urban 40 132 167 161 112 611 Rural 204 48 15 6 1 273 Female 129 94 89 84 55 451 Male 115 87 93 83 58 435 Bottle-feeding All 674 614 578 436 338 2,641 Urban 103 443 535 419 330 1,830 Rural 571 171 43 18 9 811 Female 366 294 298 218 172 1,349 Male 311 327 285 219 166 1,308 - 86 - Colombia 2005 - 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 na na na na na na Urban Female na na na na na na Rural Female na na na na na na Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Domestic violence All 4,114 5,176 5,392 5,294 4,930 24,906 Urban 574 3,381 4,897 5,118 4,862 18,833 Rural 3,540 1,794 496 175 68 6,073 - 87 - Colombia 2005 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 6,313 8,138 8,944 9,383 9,895 42,673 Urban female 859 5,342 8,117 9,072 9,784 33,174 Rural female 5,454 2,797 827 311 110 9,499 Male 7,148 7,643 7,709 7,739 7,895 38,135 Urban male 868 4,881 6,996 7,466 7,792 28,002 Rural male 6,281 2,762 713 274 103 10,133 School participation Female 1,919 1,764 1,624 1,525 1,209 8,041 Urban female 226 1,116 1,483 1,472 1,193 5,490 Rural female 1,693 647 141 53 16 2,550 Male 1,924 1,787 1,701 1,546 1,302 8,260 Urban male 241 1,108 1,540 1,492 1,278 5,660 Rural male 1,683 679 161 54 24 2,600 Mass media exposure 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 Knowledge of HIV/AIDS prevention Female 5,670 7,377 8,056 8,548 8,703 38,355 Urban female 780 4,841 7,329 8,267 8,604 29,821 Rural female 4,890 2,536 728 281 99 8,534 Male na na na na na na Urban male na na na na na na Rural male na na na na na na Household decisionmaking and justification of violence All na na na na na na Urban na na na na na na Rural na na na na na na Orphanhood All 11,439 10,715 10,014 8,660 6,973 47,800 Urban 1,459 6,950 9,136 8,405 6,875 32,825 Rural 9,980 3,765 878 255 98 14,975 Female 5,635 5,228 4,921 4,321 3,472 23,577 Male 5,804 5,487 5,092 4,339 3,501 24,223 - 88 - Colombia 2005 - 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 2.93 2.48 2.43 2.89 3.24 1.25 Under-five mortality rate 3.25 2.60 2.49 2.93 3.33 1.35 Prevalence of fever 1.08 0.96 1.18 1.44 1.76 0.55 Prevalence of diarrhea 0.92 0.84 0.86 1.01 1.03 0.44 Prevalence of acute respiratory infection 0.70 0.60 0.75 1.12 1.14 0.37 B. Fertility Total fertility rate 0.21 0.13 0.12 0.09 0.09 0.06 Adolescent fertility rate 11.55 8.47 9.36 6.09 4.93 3.85 C. Nutritional status Children: Moderate stunting 0.87 0.76 0.81 0.74 0.56 0.39 Severe stunting 0.47 0.37 0.20 0.25 0.40 0.17 Moderate underweight 0.69 0.57 0.58 0.59 0.89 0.30 Severe underweight 0.19 0.18 0.12 0.09 0.09 0.08 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 0.40 0.34 0.32 0.36 0.36 0.17 Mild anemia na na na na na na Moderate anemia na na na na na na Severe anemia na na na na na na D. Female circumcision Prevalence of circumcision: Girls na na na na na na Women na na na na na na Prevalence of occlusion: Girls na na na na na na Women na na na na na na E. Sexually transmitted disease Prevalence of genital discharge: Women 0.39 0.31 0.39 0.32 0.36 0.16 Men na na na na na na Prevalence of genital ulcer: Women 0.12 0.11 0.12 0.11 0.14 0.05 Men na na na na na na - 89 - Colombia 2005 - 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 1.18 0.47 0.41 0.64 0.13 0.38 Measles coverage 2.19 1.63 1.72 2.03 2.48 0.94 DPT coverage 2.17 1.94 1.48 2.82 2.15 0.98 Full basic coverage 2.52 2.35 2.62 3.44 3.51 1.28 No basic coverage 0.59 0.13 0.00 0.55 0.05 0.18 Hepatitis B coverage 2.23 2.25 2.05 3.38 2.83 1.14 Yellow fever coverage 2.47 2.22 3.12 3.30 4.16 1.33 B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 2.08 2.11 3.00 3.28 4.56 1.26 Treatment in a public facility 2.04 2.10 2.90 2.98 4.59 1.22 Treatment in a private facility 0.71 0.70 1.16 2.88 2.23 0.66 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 3.24 3.32 4.21 4.14 5.35 1.81 Treatment in a public facility 3.10 3.36 4.31 5.75 5.69 1.95 Treatment in a private facility 1.20 1.06 1.43 4.05 2.47 0.98 Treatment of diarrhea: Use of oral rehydration therapy 2.40 2.67 3.06 3.67 5.35 1.35 Medical treatment of diarrhea 2.52 2.87 3.16 4.23 4.90 1.47 Treatment in a public facility 2.49 2.86 2.94 3.62 3.81 1.41 Treatment in a private facility 0.58 0.57 1.45 2.91 3.57 0.62 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically-trained person 1.00 0.64 0.43 0.57 0.27 0.33 To a doctor 1.24 0.88 0.77 0.89 0.76 0.47 To a nurse or trained midwife 0.74 0.64 0.68 0.73 0.72 0.32 Multiple visits to a medically-trained person 1.17 0.86 0.76 0.74 0.65 0.43 Antenatal care content: Tetanus toxoid 0.91 0.86 0.87 1.19 1.54 0.47 Prophylactic antimalarial treatment 0.34 0.19 0.14 0.22 0.00 0.10 Iron supplementation 1.21 1.15 1.06 1.34 1.45 0.59 Delivery attendance: By a medically-trained person 1.50 0.50 0.37 0.28 0.23 0.51 By a doctor 1.55 0.63 0.54 0.43 0.38 0.57 By a nurse or trained midwife 0.53 0.40 0.39 0.33 0.30 0.21 In a public facility 1.42 0.64 0.55 0.77 1.03 0.47 In a private facility 0.22 0.42 0.46 0.73 1.00 0.25 At home 1.40 0.50 0.31 0.26 0.20 0.41 D. Contraceptive services Contraceptive prevalence: Women 1.07 0.87 0.97 0.94 1.17 0.46 Men na na na na na na Source of contraception - public sector: Women 1.47 1.21 1.27 1.27 1.39 0.66 Men na na na na na na - 90 - Colombia 2005 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - private sector: Women 1.47 1.20 1.27 1.28 1.41 0.65 Men na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women 0.35 0.29 0.33 0.30 0.35 0.15 Men na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women 0.35 0.29 0.33 0.30 0.35 0.15 Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 0.49 0.59 0.63 0.65 0.77 0.32 Men na na na na na na - 91 - Colombia 2005 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal 1.51 1.27 1.37 1.57 2.00 0.72 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 1.86 1.77 1.90 3.07 3.25 1.02 By pregnant women na na na na na na C. Breastfeeding Exclusive breastfeeding 4.02 4.02 4.88 6.87 7.85 2.35 Timely complementary feeding 4.12 7.58 4.42 5.44 6.50 2.52 Bottle-feeding 2.32 2.89 2.90 3.59 4.16 1.39 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 0.43 0.42 0.37 0.38 0.45 0.19 Men na na na na na na Condom usage with non-regular partner: Women 3.91 3.63 3.75 4.00 5.22 1.94 Men na na na na na na G. Domestic violence Ever experienced violence 1.03 0.94 0.97 1.03 1.14 0.48 Experienced violence in past year na na na na na na - 92 - Colombia 2005 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Education School completion: Women 0.93 0.67 0.47 0.37 0.32 0.37 Men 1.04 0.74 0.55 0.49 0.30 0.46 School participation: Girls 0.83 0.67 0.62 0.65 0.78 0.34 Boys 0.88 0.88 0.97 0.79 0.85 0.41 B. Exposure to mass media Newspaper readership: Women na na na na na na Men na na na na na na Radio listenership: Women na na na na na na Men na na na na na na Television viewership: Women na na na na na na Men na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 1.02 0.63 0.58 0.60 0.62 0.35 Men na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women 0.86 0.51 0.42 0.38 0.54 0.27 Men na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Status of women Household decisionmaking: Can seek own health care 0.86 0.73 0.65 0.66 0.93 0.39 Can seek children's health care 0.43 0.30 0.36 0.36 0.45 0.17 Can make daily household purchases 0.90 0.75 0.70 0.70 0.90 0.38 Can make large household purchases 0.91 0.77 0.71 0.70 0.92 0.39 Can make meal-related decisions 0.85 0.76 0.72 0.77 0.96 0.41 Freedom of movement: Can travel to visit family/relatives 0.83 0.79 0.80 0.83 0.94 0.41 Other decisionmaking, attitudes: Can decide how to spend own money 0.66 0.58 0.44 0.49 0.60 0.26 Can decide whether to have sex 0.25 0.13 0.13 0.09 0.18 0.07 Justifies domestic violence na na na na na na E. Orphanhood Paternal orphan prevalence 0.32 0.35 0.37 0.36 0.38 0.17 Maternal orphan prevalence 0.14 0.14 0.17 0.14 0.21 0.07 Double orphan prevalence 0.07 0.06 0.08 0.03 0.06 0.03 - 93 - Colombia 2005 - 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 telephone 0.473 0.499 3.4% 17.2% 41.2% 77.4% 95.7% 47.0% 0.07184 Has radio 0.666 0.472 51.2% 54.6% 63.0% 76.1% 87.2% 66.4% 0.03078 Has television 0.822 0.382 47.8% 77.7% 92.8% 98.7% 99.8% 83.4% 0.06005 Has refrigerator 0.649 0.477 16.6% 48.2% 71.9% 93.1% 99.1% 65.8% 0.06936 Has blender 0.682 0.466 26.5% 54.4% 74.8% 93.3% 99.3% 69.7% 0.06496 Has stereo 0.393 0.488 7.3% 19.9% 31.0% 56.1% 87.2% 40.3% 0.06020 Has washing machine 0.217 0.412 1.6% 5.4% 9.0% 22.8% 74.6% 22.7% 0.05810 Has DVD 0.109 0.312 0.6% 2.4% 5.0% 10.2% 39.2% 11.5% 0.04121 Has computer 0.092 0.289 0.1% 0.4% 1.3% 5.4% 41.8% 9.8% 0.04751 Has internet 0.041 0.199 0.1% 0.4% 0.5% 0.9% 20.5% 4.5% 0.03586 Has gas or electric range (cooktop) 0.824 0.381 29.1% 85.4% 97.1% 98.8% 99.6% 82.0% 0.06921 Has gas or electric oven 0.203 0.402 1.2% 6.7% 12.0% 24.5% 61.8% 21.3% 0.05138 Has microwave 0.056 0.230 0.0% 0.4% 0.7% 2.3% 26.2% 5.9% 0.03894 Has vacuum or buffer 0.035 0.185 0.0% 0.1% 0.2% 1.0% 18.2% 3.9% 0.03411 Has hot water heater 0.067 0.251 0.1% 0.7% 1.3% 4.2% 27.7% 6.8% 0.03758 Has air conditioning 0.019 0.135 0.0% 0.1% 0.3% 1.0% 8.0% 1.9% 0.02203 Has VCR 0.075 0.263 0.1% 1.0% 2.1% 4.9% 31.1% 7.9% 0.03998 Has motorcycle or scooter 0.120 0.325 2.2% 7.1% 10.8% 15.8% 24.1% 12.0% 0.02487 Has car or truck 0.081 0.273 0.6% 2.2% 3.1% 5.8% 31.5% 8.7% 0.03755 Has fan 0.424 0.494 25.2% 45.4% 50.4% 48.2% 48.4% 43.5% 0.01901 Has a shower 0.712 0.453 17.1% 51.5% 78.1% 94.0% 98.6% 67.9% 0.06892 Has a domestic worker not related to household head 0.014 0.116 0.1% 0.5% 0.8% 1.2% 6.2% 1.8% 0.01431 Uses water piped from public system 0.646 0.478 15.1% 49.4% 75.3% 86.5% 89.5% 63.2% 0.05937 Uses water piped from rural aquaduct 0.106 0.308 30.3% 20.4% 5.3% 1.4% 0.2% 11.5% -0.03825 Uses water from a public standpipe 0.002 0.042 0.5% 0.3% 0.1% 0.0% 0.0% 0.2% -0.00427 Uses water from well with pump 0.045 0.207 4.8% 7.3% 6.2% 2.9% 1.4% 4.5% -0.00605 Uses water from well without pump 0.025 0.157 13.2% 2.6% 0.5% 0.1% 0.0% 3.3% -0.03047 Uses water from river, stream, pond, lake, or spring 0.037 0.188 16.9% 3.2% 0.3% 0.2% 0.0% 4.1% -0.03388 Uses water from tanker truck 0.002 0.044 0.6% 0.5% 0.2% 0.0% 0.0% 0.3% -0.00334 Uses water from aguatero 0.008 0.089 0.9% 1.3% 1.1% 0.6% 0.3% 0.9% -0.00259 Uses bottled drinking water 0.070 0.254 1.0% 5.2% 7.6% 7.2% 8.1% 5.8% 0.01108 Uses rainwater for drinking 0.051 0.220 14.2% 8.8% 3.2% 1.0% 0.3% 5.5% -0.02479 Uses water from other source 0.008 0.087 2.4% 1.0% 0.2% 0.1% 0.1% 0.8% -0.01124 Uses toilet connected to sewer 0.570 0.495 5.1% 31.9% 64.7% 87.8% 96.3% 57.1% 0.07267 Uses shared toilet connected to sewer 0.117 0.321 1.9% 16.4% 17.2% 6.3% 1.8% 8.7% -0.00366 Uses own toilet connected to septic system 0.158 0.365 33.1% 32.2% 13.1% 5.0% 1.7% 17.0% -0.03196 Uses shared toilet connected to septic system 0.022 0.146 3.5% 4.3% 1.3% 0.2% 0.0% 1.9% -0.01307 Uses own unconnnected flush toilet 0.020 0.139 4.3% 4.6% 1.5% 0.3% 0.1% 2.2% -0.01271 Uses shared unconnnected flush toilet 0.004 0.059 0.6% 0.8% 0.2% 0.0% 0.0% 0.3% -0.00583 Uses own pit latrine 0.014 0.119 6.5% 2.2% 0.3% 0.0% 0.0% 1.8% -0.01810 Uses shared pit latrine 0.002 0.045 0.6% 0.3% 0.0% 0.0% 0.0% 0.2% -0.00610 Uses own bajamar 0.010 0.101 1.2% 2.4% 1.3% 0.4% 0.1% 1.1% -0.00627 Uses shared bajamar 0.001 0.034 0.1% 0.2% 0.1% 0.0% 0.0% 0.1% -0.00275 Uses bush or field as latrine 0.080 0.271 42.7% 4.2% 0.2% 0.0% 0.0% 9.4% -0.05841 Uses other type of latrine 0.001 0.038 0.2% 0.4% 0.1% 0.0% 0.0% 0.1% -0.00270 Lives in a separate house 0.826 0.379 98.3% 91.3% 86.3% 83.0% 71.2% 86.0% -0.02634 Lives in an apartment 0.127 0.333 0.3% 2.5% 8.4% 15.6% 28.6% 11.1% 0.03400 Rents room in someone's home 0.032 0.176 0.5% 4.8% 3.7% 0.7% 0.1% 2.0% -0.00494 - 95 - Colombia 2005 - 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 Rents room in some other type of building 0.015 0.121 0.8% 1.4% 1.6% 0.7% 0.1% 0.9% -0.00371 Lives in other type of dwelling 0.000 0.010 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% -0.00154 Has parquet or polished wood flooring 0.009 0.092 0.0% 0.1% 0.6% 0.8% 3.1% 0.9% 0.01089 Has carpeted flooring 0.004 0.066 0.0% 0.0% 0.1% 0.2% 2.2% 0.5% 0.01117 Has tile flooring 0.372 0.483 1.4% 8.1% 22.8% 57.4% 85.3% 35.0% 0.06579 Has wood plank flooring 0.067 0.250 16.1% 8.7% 4.5% 2.7% 2.1% 6.8% -0.02362 Has cement flooring 0.460 0.498 39.6% 74.0% 70.4% 38.6% 7.3% 46.0% -0.02435 Has earth, mud, dung, or sand flooring 0.089 0.284 42.9% 9.2% 1.6% 0.2% 0.0% 10.8% -0.05449 Has flooring made of other materials 0.000 0.010 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.00010 Has walls made of adobe 0.030 0.169 5.9% 4.1% 2.4% 1.1% 0.7% 2.8% -0.01342 Has bahareque revocado walls 0.056 0.231 19.4% 7.2% 3.5% 0.8% 0.3% 6.2% -0.03088 Has walls made of rough wood 0.087 0.282 32.2% 13.8% 2.4% 0.5% 0.1% 9.8% -0.04381 Has walls made of cane 0.014 0.116 6.2% 1.0% 0.3% 0.1% 0.0% 1.5% -0.02056 Has walls made of brick, block, or finished wood 0.792 0.406 29.9% 70.8% 90.3% 97.3% 98.8% 77.4% 0.06564 Has walls made of pressed dirt 0.016 0.126 5.0% 2.1% 0.9% 0.3% 0.2% 1.7% -0.01438 Has wall made of flimsy materials 0.005 0.067 1.3% 1.0% 0.1% 0.0% 0.0% 0.5% -0.00922 Uses natural gas for cooking 0.303 0.460 1.3% 15.2% 33.0% 48.7% 61.5% 31.9% 0.04825 Uses propane for cooking 0.425 0.494 9.8% 52.6% 59.2% 46.1% 31.7% 39.9% 0.01719 Uses kerosene for cooking 0.012 0.109 1.4% 3.0% 0.8% 0.1% 0.1% 1.1% -0.00794 Uses electricity for cooking 0.048 0.214 2.3% 5.9% 4.2% 4.4% 6.5% 4.7% 0.00659 Uses wood or charcoal for cooking 0.176 0.381 83.1% 19.8% 1.6% 0.2% 0.0% 21.0% -0.07662 Uses coal for cooking 0.004 0.060 1.0% 0.6% 0.2% 0.2% 0.0% 0.4% -0.00543 Uses discarded material for cooking 0.000 0.007 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% -0.00108 Uses other fuel for cooking 0.000 0.005 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% -0.00050 Does not cook 0.032 0.175 1.1% 2.8% 1.0% 0.3% 0.2% 1.1% -0.00989 Waste collected by the government 0.756 0.430 11.2% 63.6% 92.0% 96.7% 98.8% 72.5% 0.07630 Waste burned 0.124 0.329 49.3% 18.5% 2.7% 0.4% 0.1% 14.2% -0.05395 Waste buried 0.015 0.121 5.0% 2.3% 0.4% 0.2% 0.0% 1.6% -0.01579 Waste dumped in waterways 0.020 0.141 8.2% 3.3% 0.5% 0.1% 0.0% 2.4% -0.02185 Waste dumped in compound or yard 0.060 0.238 24.9% 7.4% 0.8% 0.2% 0.0% 6.6% -0.04092 Waste collected informally 0.024 0.152 0.9% 4.4% 3.5% 2.4% 1.0% 2.4% -0.00064 Waste disposed some other way 0.002 0.044 0.5% 0.4% 0.1% 0.0% 0.0% 0.2% -0.00507 Number of members per sleeping room 2.239 1.417 3.7 3.1 2.7 2.1 1.6 2.6 -0.04241 - 96 - PART VI. SUPPORTING TABLES, 2000 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Colombia 2000 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 9,169 9,169 9,152 9,099 9,254 45,844 Urban 826 5,483 8,515 8,830 9,118 32,772 Rural 8,343 3,686 637 269 136 13,071 Female 4,365 4,578 4,708 4,923 5,067 23,642 Male 4,804 4,591 4,444 4,177 4,186 22,201 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 2,184 2,209 1,995 1,485 1,358 9,230 Urban 236 1,410 1,860 1,430 1,336 6,272 Rural 1,947 799 135 55 22 2,957 Female 1,108 1,090 927 720 668 4,514 Male 1,075 1,118 1,068 764 690 4,716 Prevalence of fever, diarrhea, acute respiratory infection All 1,065 1,067 959 716 654 4,462 Urban 125 703 898 696 645 3,067 Rural 941 364 61 20 9 1,395 Female 550 519 430 358 324 2,181 Male 515 548 529 359 330 2,281 Total fertility rate All 4,817 6,021 6,941 7,454 7,519 32,752 Urban 471 3,803 6,491 7,249 7,424 25,438 Rural 4,346 2,218 450 205 94 7,313 Age-specific fertility rate 15-19 All 1,002 1,306 1,427 1,546 1,547 6,827 Urban 114 859 1,344 1,508 1,529 5,354 Rural 888 446 83 38 18 1,473 Children's nutritional status All 970 978 881 648 583 4,060 Urban 117 638 828 628 574 2,785 Rural 853 341 53 20 9 1,276 Female 519 475 395 311 287 1,987 Male 451 503 486 337 295 2,072 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 - Colombia 2000 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All 629 696 681 549 514 3,070 Urban 74 457 640 532 507 2,210 Rural 555 240 41 17 7 860 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 1,448 1,810 2,058 2,117 2,126 9,559 Urban Female 145 1,151 1,924 2,062 2,100 7,382 Rural Female 1,303 659 135 55 26 2,178 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 100 - Colombia 2000 - SAMPLE SIZES Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Immunization coverage All 211 217 171 138 129 866 Urban 23 147 160 133 127 590 Rural 188 71 11 5 2 277 Female 110 101 81 66 70 428 Male 101 116 91 72 59 439 Treatment of fever All 254 276 241 189 175 1,136 Urban 52 196 226 188 173 835 Rural 203 79 16 1 2 301 Female 135 145 139 89 88 596 Male 119 130 102 100 87 538 Treatment of acute respiratory infection 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 Treatment of diarrhea All 187 170 124 74 67 622 Urban 31 118 118 72 66 405 Rural 156 52 6 2 1 217 Female 86 74 54 36 28 278 Male 101 96 70 38 39 344 Antenatal and delivery care All 759 819 782 611 576 3,547 Urban 89 540 732 592 568 2,521 Rural 670 280 50 19 8 1,027 Contraceptive prevalence Female 1,083 1,265 1,274 1,202 1,111 5,935 Urban Female 87 740 1,175 1,169 1,098 4,269 Rural Female 996 525 99 32 13 1,665 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Contraceptive source Female 583 779 856 843 738 3,798 Urban Female 42 449 792 813 729 2,826 Rural Female 541 329 64 30 9 972 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Treatment of genital discharge, ulcer, sore Female na na na na na na Urban Female na na na na na na Rural Female na na na na na na Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 101 - Colombia 2000 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Sanitary disposal of stools All na na na na na na Urban na na na na na na Rural na na na na na na Wash hands prior to preparing food All na na na na na na Urban na na na na na na Rural na na na na na na Handwashing facilities in household? All na na na na na na Urban na na na na na na Rural na na na na na na Bednet ownership All na na na na na na Urban na na na na na na Rural na na na na na na Bednet use by children All na na na na na na Urban na na na na na na Rural na na na na na na Bednet use by pregnant women All na na na na na na Urban na na na na na na Rural na na na na na na Exclusive breastfeeding All 65 62 62 39 50 278 Urban 8 35 56 37 49 185 Rural 58 26 6 2 2 94 Female 29 38 41 21 24 153 Male 36 24 21 18 26 125 Timely complementary breastfeeding All 80 73 84 49 49 335 Urban 8 47 80 46 48 229 Rural 72 26 4 3 1 106 Female 43 39 45 26 29 182 Male 37 34 39 22 20 152 Bottle-feeding All 215 227 216 146 138 942 Urban 20 149 204 141 134 648 Rural 195 78 12 5 3 293 Female 100 128 120 76 78 502 Male 115 99 95 70 60 439 - 102 - Colombia 2000 - SAMPLE SIZES Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Iodized salt in household All 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 1,731 2,143 2,449 2,618 2,644 11,585 Urban Female 173 1,347 2,291 2,548 2,611 8,970 Rural Female 1,558 796 157 70 33 2,614 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Domestic violence All 1,731 2,143 2,449 2,618 2,644 11,585 Urban 173 1,347 2,291 2,548 2,611 8,970 Rural 1,558 796 157 70 33 2,615 - 103 - Colombia 2000 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 1,852 2,286 2,626 2,821 2,867 12,452 Urban female 184 1,427 2,456 2,745 2,830 9,641 Rural female 1,668 858 171 76 37 2,810 Male 2,223 2,351 2,289 2,242 2,276 11,381 Urban male 178 1,373 2,132 2,190 2,247 8,119 Rural male 2,046 978 157 52 29 3,262 School participation Female 547 563 517 409 370 2,406 Urban female 54 337 488 385 363 1,627 Rural female 493 226 30 24 7 779 Male 559 545 527 423 407 2,461 Urban male 42 314 490 408 404 1,658 Rural male 517 230 37 15 3 803 Mass media exposure Female 1,731 2,143 2,449 2,618 2,644 11,585 Urban female 173 1,347 2,291 2,548 2,611 8,970 Rural female 1,558 796 157 70 33 2,615 Male na na na na na na Urban male na na na na na na Rural male na na na na na na Knowledge of HIV/AIDS prevention Female 4,592 2,143 2,449 2,618 2,644 14,446 Urban female 173 1,347 2,291 2,548 2,611 8,970 Rural female 1,558 796 157 70 33 2,614 Male na na na na na na Urban male na na na na na na Rural male na na na na na na Household decisionmaking and justification of violence All 1,731 2,143 2,449 2,618 2,644 11,585 Urban 173 1,347 2,291 2,548 2,611 8,970 Rural 1,558 796 157 70 33 2,615 Orphanhood All 3,345 3,272 3,048 2,472 2,248 14,385 Urban 315 1,970 2,842 2,378 2,208 9,714 Rural 3,030 1,302 206 93 40 4,672 Female 1,669 1,619 1,411 1,211 1,113 7,022 Male 1,676 1,652 1,638 1,261 1,136 7,363 - 104 - Colombia 2000 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part I: HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood illness and mortality Infant mortality rate 4.12 3.98 4.05 3.20 3.72 1.79 Under-five mortality rate 4.69 4.15 4.18 3.37 3.95 1.92 Prevalence of fever 1.69 1.50 1.61 1.85 1.76 0.78 Prevalence of diarrhea 1.53 1.31 1.15 1.22 1.31 0.62 Prevalence of acute respiratory infection 1.47 1.30 1.20 1.42 1.43 0.62 B. Fertility Total fertility rate 0.18 0.15 0.10 0.09 0.09 0.06 Adolescent fertility rate 12.00 10.00 9.00 6.00 5.00 4.00 C. Nutritional status Children: Moderate stunting 1.37 1.09 0.96 0.94 1.04 0.53 Severe stunting 0.79 0.64 0.54 0.49 0.27 0.29 Moderate underweight 0.91 1.06 0.80 0.90 0.77 0.43 Severe underweight 0.36 0.22 0.32 0.20 0.18 0.13 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 0.80 0.76 0.63 0.68 0.88 0.34 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 1.22 1.37 1.26 1.18 1.33 0.64 Men na na na na na na Prevalence of genital ulcer: Women 0.27 0.30 0.23 0.22 0.21 0.11 Men na na na na na na - 105 - Colombia 2000 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Childhood immunization BCG coverage 2.30 1.40 0.97 1.45 2.21 0.80 Measles coverage 3.43 3.06 2.87 2.20 3.33 1.40 DPT coverage 3.29 3.01 3.58 3.07 3.30 1.61 Full basic coverage 4.24 3.57 3.99 3.96 4.59 1.82 No basic coverage 0.98 0.66 0.52 0.81 0.00 0.33 Hepatitis B coverage 3.47 3.03 3.75 2.24 3.25 1.41 Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 3.83 3.49 3.56 4.49 4.00 1.73 Treatment in a public facility 3.68 2.97 3.40 3.25 3.27 1.58 Treatment in a private facility 1.81 2.36 3.06 3.98 4.37 1.43 Treatment of acute respiratory infection (ARI): Medical treatment of ARI * * * * * * 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 4.58 4.02 4.39 6.49 4.99 2.28 Medical treatment of diarrhea 3.95 3.38 5.00 5.61 7.18 2.16 Treatment in a public facility 3.81 3.01 4.63 3.90 5.54 2.06 Treatment in a private facility 1.68 1.70 2.94 4.60 6.07 1.35 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically-trained person 1.65 1.22 0.94 0.61 0.76 0.60 To a doctor 1.73 1.30 1.19 1.06 0.97 0.63 To a nurse or trained midwife 1.00 0.62 0.79 0.89 0.66 0.37 Multiple visits to a medically-trained person 1.93 1.38 1.04 0.95 1.03 0.69 Antenatal care content: Tetanus toxoid 1.27 1.39 1.47 1.61 1.99 0.66 Prophylactic antimalarial treatment 0.61 0.42 0.25 0.13 0.00 0.17 Iron supplementation 2.10 1.73 1.53 1.69 1.83 0.85 Delivery attendance: By a medically-trained person 2.21 1.47 0.94 0.47 0.49 0.81 By a doctor 2.36 1.57 1.09 0.74 0.61 0.89 By a nurse or trained midwife 1.07 0.63 0.65 0.61 0.37 0.36 In a public facility 1.81 1.65 1.44 1.95 2.27 0.85 In a private facility 0.51 1.24 1.31 1.84 2.23 0.69 At home 1.58 0.94 0.68 0.42 0.44 0.54 D. Contraceptive services Contraceptive prevalence: Women 1.89 1.52 1.40 1.38 1.56 0.73 Men na na na na na na Source of contraception - public sector: Women 2.02 2.07 1.58 1.64 1.66 0.88 Men na na na na na na - 106 - Colombia 2000 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part II: Intermediate Determinants of HNP Status - HNP SERVICE USE (Cont.) Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. D. Contraceptive services (cont.) Source of contraception - private sector: Women 2.14 2.02 1.60 1.63 1.74 0.89 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 1.22 1.37 1.26 1.18 1.33 0.64 Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women 0.42 0.57 0.61 0.72 0.83 0.33 Men na na na na na na - 107 - Colombia 2000 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal 2.14 1.95 1.84 2.23 2.11 0.98 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: na na na na na na Bednet ownership 0.21 0.17 0.15 0.11 0.12 0.07 Treated bednet ownership Bednet use: By children na na na na na na By pregnant women na na na na na na C. Breastfeeding Exclusive breastfeeding 6.41 6.48 5.92 7.54 5.54 3.04 Timely complementary feeding 5.26 5.98 5.66 7.78 7.73 2.67 Bottle-feeding 3.64 3.31 3.35 4.10 4.63 1.71 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 0.42 0.47 0.43 0.47 0.45 0.21 Men na na na na na na Condom usage with non-regular partner: Women 6.19 5.06 4.88 5.40 5.22 2.58 Men na na na na na na G. Domestic violence Ever experienced violence 1.30 1.22 1.01 0.90 0.85 0.51 Experienced violence in past year na na na na na na - 108 - Colombia 2000 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Education School completion: Women 1.52 1.17 0.81 0.56 0.45 0.53 Men 1.48 1.20 0.99 0.58 0.45 0.65 School participation: Girls 1.42 1.32 1.12 0.82 0.77 0.55 Boys 1.61 1.26 1.19 1.01 1.08 0.59 B. Exposure to mass media Newspaper readership: Women na na na na na na Men na na na na na na Radio listenership: Women na na na na na na Men na na na na na na Television viewership: Women na na na na na na Men na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 1.48 1.19 0.98 0.90 0.94 0.52 Men na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women 1.26 0.96 0.62 0.58 0.69 0.39 Men na na na na na na Attitudes toward HIV/AIDS: Women 0.95 0.84 0.73 0.65 0.64 0.33 Men na na na na na na D. Status of women Household decisionmaking: Can seek own health care 1.44 1.12 1.14 1.05 0.99 0.58 Can seek children's health care 0.68 0.57 0.27 0.65 0.47 0.25 Can make daily household purchases 1.40 1.05 0.99 1.10 1.12 0.53 Can make large household purchases 1.49 1.15 1.09 1.13 1.13 0.56 Can make meal-related decisions 1.27 1.32 1.02 1.06 1.08 0.57 Freedom of movement: Can travel to visit family/relatives 1.20 1.30 1.26 1.26 1.21 0.65 Other decisionmaking, attitudes: Can decide how to spend own money 1.68 1.05 0.94 0.99 0.80 0.48 Can decide whether to have sex 0.36 0.22 0.11 0.13 0.14 0.09 Justifies domestic violence na na na na na na E. Orphanhood Paternal orphan prevalence 0.61 0.53 0.51 0.55 0.55 0.26 Maternal orphan prevalence 0.19 0.18 0.21 0.23 0.27 0.10 Double orphan prevalence 0.07 0.07 0.07 0.07 0.11 0.04 - 109 - Colombia 2000 - 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 0.950 0.217 76.6% 98.7% 100.0% 100.0% 100.0% 95.1% 0.09606 Has radio 0.866 0.341 71.8% 79.1% 89.1% 97.5% 100.0% 87.5% 0.06285 Has television 0.823 0.382 49.8% 78.9% 94.0% 99.4% 100.0% 84.4% 0.10865 Has refrigerator 0.625 0.484 17.0% 45.2% 67.0% 94.0% 100.0% 64.7% 0.11719 Has telephone 0.493 0.500 1.6% 13.8% 48.6% 89.6% 100.0% 50.7% 0.12762 Uses water from public aqueduct 0.780 0.414 17.1% 71.7% 94.9% 100.0% 100.0% 76.8% 0.13927 Uses water from a private aqueduct 0.066 0.248 21.3% 13.0% 2.9% 0.0% 0.0% 7.4% -0.05260 Uses water from a piped public source 0.001 0.036 0.3% 0.2% 0.0% 0.0% 0.0% 0.1% -0.00781 Uses water from a well 0.060 0.238 20.5% 8.5% 1.6% 0.0% 0.0% 6.1% -0.06349 Uses water from a river, canal, or surface water 0.068 0.251 31.9% 4.1% 0.1% 0.0% 0.0% 7.2% -0.09050 Uses rainwater for drinking 0.016 0.126 5.8% 1.4% 0.2% 0.0% 0.0% 1.5% -0.03502 Uses water from tanker truck 0.004 0.063 1.7% 0.4% 0.0% 0.0% 0.0% 0.4% -0.01659 Uses water from other source 0.004 0.066 1.2% 0.5% 0.2% 0.0% 0.0% 0.4% -0.01442 Uses flush toilet connected to a sewer 0.547 0.498 1.6% 22.0% 64.9% 90.6% 100.0% 55.8% 0.13051 Uses flush toilet connected to a pit 0.109 0.312 24.7% 29.1% 5.3% 0.0% 0.0% 11.8% -0.05263 Uses flush toilet connected to a creek or open space 0.033 0.180 9.4% 8.5% 1.5% 0.0% 0.0% 3.9% -0.03064 Uses pit latrine 0.053 0.224 17.2% 8.5% 1.3% 0.0% 0.0% 5.4% -0.05050 Uses shared flush toilet connected to a sewer 0.142 0.349 1.5% 21.1% 26.5% 9.4% 0.0% 11.7% 0.00919 Uses shared flush toilet connected to a pit 0.015 0.120 2.8% 3.4% 0.3% 0.0% 0.0% 1.3% -0.01919 Uses shared flush toilet connected to a creek or open space 0.004 0.065 0.5% 1.2% 0.0% 0.0% 0.0% 0.3% -0.00715 Uses shared pit latrine 0.007 0.081 0.7% 1.9% 0.1% 0.0% 0.0% 0.6% -0.01082 Uses bush or field as latrine 0.089 0.285 41.5% 4.2% 0.1% 0.0% 0.0% 9.2% -0.10943 Uses other type of latrine 0.000 0.010 0.0% 0.0% 0.1% 0.0% 0.0% 0.0% 0.00092 Has dirt, sand, or dung as principal flooring 0.094 0.291 40.8% 6.3% 0.9% 0.0% 0.0% 9.6% -0.10614 Has wood or plank as principal flooring 0.041 0.199 10.5% 6.1% 2.7% 2.1% 0.0% 4.3% -0.02913 Has carpet as principal flooring 0.015 0.121 0.0% 0.1% 0.4% 2.7% 3.4% 1.3% 0.01802 Has brick as principal flooring 0.004 0.061 0.2% 0.2% 0.6% 1.1% 0.0% 0.4% 0.00387 Has tile as principal flooring 0.377 0.485 2.7% 12.3% 28.4% 49.8% 93.0% 37.3% 0.10126 Has cement as principal flooring 0.414 0.493 44.4% 72.9% 61.7% 31.6% 0.0% 42.0% -0.03937 Has parquet or polished wood as principal flooring 0.042 0.200 1.2% 2.1% 4.6% 11.1% 0.0% 3.8% 0.01470 Has marble or ceramic tile as principal flooring 0.004 0.065 0.0% 0.0% 0.3% 0.6% 1.1% 0.4% 0.00940 Has vinyl or asphalt strip as principal flooring 0.009 0.095 0.0% 0.1% 0.5% 1.0% 2.5% 0.8% 0.01283 Has other type of flooring 0.000 0.014 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% -0.00781 Uses electricity for cooking 0.131 0.337 3.6% 11.0% 17.6% 28.2% 0.0% 12.0% 0.02577 Uses gas for cooking 0.649 0.477 9.2% 67.6% 79.2% 71.0% 100.0% 65.5% 0.10563 Uses kerosene for cooking 0.008 0.087 1.2% 1.8% 0.2% 0.1% 0.0% 0.7% -0.01347 Uses charcoal for cooking 0.007 0.086 2.3% 2.0% 0.3% 0.1% 0.0% 0.9% -0.01330 Uses wood for cooking 0.177 0.381 82.6% 13.3% 0.5% 0.0% 0.0% 19.3% -0.14420 Uses gasoline for cooking 0.011 0.103 0.6% 2.9% 1.3% 0.3% 0.0% 1.0% -0.00554 Uses concinol for cooking 0.000 0.021 0.0% 0.1% 0.2% 0.0% 0.0% 0.1% -0.00031 Uses other cooking fuel 0.000 0.014 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% -0.00026 Does not cook 0.016 0.125 0.3% 1.2% 0.5% 0.2% 0.0% 0.5% -0.00861 - 111 - PART VII. SUPPORTING TABLES, 1995 A. SAMPLE SIZES B. STANDARD ERRORS C. ASSET DISTRIBUTION AND WEIGHTS Colombia 1995 - SAMPLE SIZES TOTAL SAMPLE Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Number of household members All 8,963 8,951 8,988 8,608 9,336 44,846 Urban 1,095 4,080 7,855 8,424 9,146 30,599 Rural 7,868 4,871 1,133 184 190 14,247 Female 4,269 4,414 4,698 4,672 5,082 23,135 Male 4,695 4,537 4,290 3,935 4,254 21,710 Part I: HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Mortality rates All 2,513 2,168 2,087 1,717 1,333 9,817 Urban 341 1,090 1,859 1,689 1,301 6,281 Rural 2,171 1,078 228 28 31 3,536 Female 1,232 1,057 1,016 833 641 4,779 Male 1,280 1,111 1,071 883 692 5,038 Prevalence of fever, diarrhea, acute respiratory infection All 1,249 1,101 1,037 865 639 4,891 Urban 170 576 921 851 621 3,139 Rural 1,079 525 116 13 18 1,751 Female 625 557 488 422 301 2,393 Male 624 544 549 443 338 2,498 Total fertility rate All 4,556 5,467 6,563 7,032 7,596 31,214 Urban 630 2,594 5,797 6,873 7,439 23,333 Rural 3,926 2,873 765 159 157 7,880 Age-specific fertility rate 15-19 All 899 1,101 1,265 1,337 1,441 6,043 Urban 143 572 1,123 1,326 1,418 4,582 Rural 756 529 142 11 23 1,461 Children's nutritional status All 1,157 1,011 939 770 532 4,409 Urban 155 512 834 760 515 2,776 Rural 1,002 499 104 10 16 1,631 Female 590 512 442 377 255 2,176 Male 568 499 496 392 276 2,231 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 - Colombia 1995 - SAMPLE SIZES Part I: HNP STATUS (Cont.) Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total Women's nutritional status All 671 680 711 643 452 3,157 Urban 95 341 624 633 439 2,132 Rural 576 339 86 10 13 1,024 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 - 116 - Colombia 1995 - 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 265 213 211 189 123 1,001 Urban 37 100 188 186 121 632 Rural 228 113 23 3 1 368 Female 128 104 100 88 58 478 Male 137 109 111 101 64 522 Treatment of fever All 344 312 290 252 166 1,364 Urban 56 181 256 248 161 902 Rural 288 131 34 4 4 461 Female 160 158 144 132 74 668 Male 184 154 146 120 91 695 Treatment of acute respiratory infection All 342 246 228 202 168 1,186 Urban 59 139 199 200 165 762 Rural 283 108 29 2 3 425 Female 167 129 114 98 85 593 Male 175 117 114 105 84 595 Treatment of diarrhea All 230 218 175 129 64 816 Urban 36 133 155 127 63 514 Rural 194 85 20 1 1 301 Female 103 110 75 53 37 378 Male 127 107 99 76 27 436 Antenatal and delivery care All 816 810 822 763 560 3,771 Urban 114 417 725 751 546 2,553 Rural 703 394 97 12 14 1,220 Contraceptive prevalence Female 1,096 1,202 1,284 1,285 1,230 6,097 Urban Female 130 529 1,134 1,252 1,209 4,254 Rural Female 967 673 149 32 21 1,842 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Contraceptive source Female 462 717 805 824 808 3,617 Urban Female 52 304 706 805 797 2,665 Rural Female 410 413 98 19 11 951 Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Treatment of genital discharge, ulcer, sore Female na na na na na na Urban Female na na na na na na Rural Female na na na na na na Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na - 117 - Colombia 1995 - 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 73 52 57 48 35 265 Urban 7 30 52 48 35 172 Rural 67 22 5 0 0 94 Female 39 26 29 25 28 147 Male 35 26 27 23 7 118 Timely complementary breastfeeding All 88 84 61 52 40 325 Urban 9 49 52 50 37 197 Rural 78 35 8 2 3 126 Female 43 44 31 34 14 166 Male 44 40 29 18 27 158 Bottle-feeding All 239 225 212 157 126 959 Urban 29 133 190 153 123 628 Rural 210 92 22 3 3 330 Female 121 110 110 83 72 496 Male 118 115 102 73 54 462 - 118 - Colombia 1995 - 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 na na na na na na Urban Female na na na na na na Rural Female na na na na na na Male na na na na na na Urban Male na na na na na na Rural Male na na na na na na Domestic violence All na na na na na na Urban na na na na na na Rural na na na na na na - 119 - Colombia 1995 - SAMPLE SIZES Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Pop. Low 2nd 3rd 4th High Total School completion (Grade 5) Female 1,782 2,106 2,518 2,679 2,962 12,047 Urban female 247 1,004 2,220 2,618 2,899 8,989 Rural female 1,535 1,102 298 61 63 3,058 Male 2,031 2,200 2,219 2,122 2,388 10,961 Urban male 234 960 1,936 2,076 2,342 7,549 Rural male 1,797 1,240 283 46 46 3,412 School participation Female 634 546 553 411 385 2,528 Urban female 85 254 486 402 379 1,605 Rural female 549 292 67 9 6 923 Male 644 581 513 427 360 2,524 Urban male 77 246 452 421 355 1,550 Rural male 567 335 61 6 5 974 Mass media exposure Female 1,643 1,957 2,350 2,495 2,696 11,140 Urban female 224 929 2,076 2,441 2,639 8,310 Rural female 1,419 1,027 273 54 56 2,830 Male na na na na na na Urban male na na na na na na Rural male na na na na na na Knowledge of HIV/AIDS prevention Female 4,307 1,957 2,350 2,495 2,696 13,805 Urban female 224 929 2,076 2,441 2,639 8,309 Rural female 1,419 1,027 273 54 56 2,829 Male na na na na na na Urban male na na na na na na Rural male na na na na na na Household decisionmaking and justification of violence All 1,643 1,957 2,350 2,495 2,696 11,140 Urban 224 929 2,076 2,441 2,639 8,310 Rural 1,419 1,027 273 54 56 2,830 Orphanhood All 3,787 3,416 3,173 2,656 2,270 15,302 Urban 496 1,597 2,801 2,607 2,220 9,721 Rural 3,291 1,819 372 49 50 5,581 Female 1,728 1,669 1,660 1,496 1,320 7,874 Male 2,053 1,748 1,511 1,158 950 7,419 - 120 - Colombia 1995 - 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 4.70 4.27 3.57 5.10 3.35 2.08 Under-five mortality rate 5.30 4.51 3.74 5.30 4.37 2.24 Prevalence of fever 1.70 1.51 1.62 1.59 1.95 0.75 Prevalence of diarrhea 1.31 1.43 1.21 1.19 1.27 0.60 Prevalence of acute respiratory infection 1.46 1.46 1.45 1.49 1.96 0.72 B. Fertility Total fertility rate 0.19 0.15 0.11 0.09 0.09 0.06 Adolescent fertility rate 15.00 12.00 8.00 8.00 5.00 4.00 C. Nutritional status Children: Moderate stunting 1.19 1.12 1.05 0.98 1.02 0.54 Severe stunting 0.85 0.58 0.49 0.41 0.49 0.32 Moderate underweight 1.19 0.93 0.78 0.65 0.79 0.46 Severe underweight 0.43 0.25 0.29 0.14 0.26 0.15 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 0.93 0.70 0.67 0.69 0.54 0.34 Mild anemia na na na na na na Moderate anemia na na na na na na Severe anemia na na na na na na D. Female circumcision Prevalence of circumcision: Girls na na na na na na Women na na na na na na Prevalence of occlusion: Girls na na na na na na Women na na na na na na E. Sexually transmitted disease Prevalence of genital discharge: Women na na na na na na Men na na na na na na Prevalence of genital ulcer: Women na na na na na na Men na na na na na na - 121 - Colombia 1995 - 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 2.11 1.81 1.76 1.45 2.83 0.89 Measles coverage 2.90 2.61 2.18 1.93 2.01 1.18 DPT coverage 3.23 2.78 3.18 2.27 3.25 1.45 Full basic coverage 3.32 3.15 3.38 2.92 3.89 1.54 No basic coverage 1.11 1.32 0.00 0.51 0.00 0.40 Hepatitis B coverage na na na na na na Yellow fever coverage na na na na na na B. Treatment of childhood illnesses Treatment of fever: Medical treatment of fever 2.63 2.72 3.11 3.24 4.27 1.42 Treatment in a public facility 2.02 2.20 2.88 2.56 2.82 1.17 Treatment in a private facility 1.76 2.28 1.72 2.59 4.03 1.09 Treatment of acute respiratory infection (ARI): Medical treatment of ARI 2.81 3.49 3.66 3.63 4.03 1.64 Treatment in a public facility 2.60 3.30 3.18 3.40 2.73 1.36 Treatment in a private facility 1.97 3.04 2.75 3.59 4.55 1.45 Treatment of diarrhea: Use of oral rehydration therapy 3.67 3.96 3.54 3.51 6.05 1.88 Medical treatment of diarrhea 3.05 3.72 3.93 4.75 6.72 1.91 Treatment in a public facility 2.38 2.72 3.35 3.96 5.29 1.42 Treatment in a private facility 2.08 2.99 2.88 4.10 5.36 1.43 C. Antenatal and delivery care Antenatal care (ANC) visits: To a medically-trained person 2.12 1.54 1.04 0.76 0.59 0.79 To a doctor 2.00 1.56 1.09 0.94 0.83 0.71 To a nurse or trained midwife 0.72 0.62 0.51 0.67 0.54 0.29 Multiple visits to a medically-trained person 2.00 1.65 1.17 0.93 0.84 0.76 Antenatal care content: Tetanus toxoid 1.39 1.30 1.49 1.56 2.30 0.73 Prophylactic antimalarial treatment na na na na na na Iron supplementation na na na na na na Delivery attendance: By a medically-trained person 2.01 1.37 1.06 0.36 0.57 0.80 By a doctor 2.17 1.84 1.41 0.91 0.79 0.99 By a nurse or trained midwife 1.55 1.28 1.05 0.85 0.49 0.59 In a public facility 2.11 1.83 1.57 1.59 2.33 1.00 In a private facility 0.59 0.63 1.14 1.48 2.23 0.57 At home 2.21 1.82 1.34 0.75 0.57 0.97 D. Contraceptive services Contraceptive prevalence: Women 1.69 1.47 1.32 1.37 1.61 0.68 Men na na na na na na Source of contraception - public sector: Women 2.56 2.02 1.62 1.53 1.76 0.86 Men na na na na na na - 122 - Colombia 1995 - 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 2.52 2.03 1.62 1.55 1.77 0.87 Men na na na na na na E. Treatment of adult illnesses Treatment of genital discharge, ulcer, sore: Women na na na na na na Men na na na na na na Treatment of genital discharge, ulcer, sore in public facilities: Women na na na na na na Men na na na na na na Voluntary counseling and testing for HIV/AIDS: Women na na na na na na Men na na na na na na - 123 - Colombia 1995 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part III: Intermediate Determinants of HNP Status - INDIVIDUAL AND HOUSEHOLD BEHAVIOR Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Hygienic practices Disposal of children's stools: Sanitary disposal na na na na na na Handwashing: Wash hands prior to preparing food na na na na na na Handwashing facilities in household na na na na na na B. Bednet ownership and use Bednet ownership: Bednet ownership na na na na na na Treated bednet ownership na na na na na na Bednet use: By children na na na na na na By pregnant women na na na na na na C. Breastfeeding Exclusive breastfeeding 3.07 3.84 4.76 6.86 5.10 2.08 Timely complementary feeding 3.89 5.74 6.47 7.35 6.87 2.86 Bottle-feeding 3.39 2.44 2.67 3.53 3.98 1.41 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 na na na na na na Men na na na na na na Condom usage with non-regular partner: Women na na na na na na Men na na na na na na G. Domestic violence Ever experienced violence na na na na na na Experienced violence in past year na na na na na na - 124 - Colombia 1995 - STANDARD ERRORS OF QUINTILE ESTIMATES FOR TOTAL POPULATION Part IV: UNDERLYING DETERMINANTS OF HNP STATUS Indicator Wealth Quintiles Low 2nd 3rd 4th High Avg. A. Education School completion: Women 1.39 1.19 0.90 0.61 0.50 0.59 Men 1.56 1.27 1.02 0.64 0.44 0.67 School participation: Girls 2.05 1.34 0.94 0.81 0.62 0.72 Boys 1.89 1.69 1.32 0.76 0.52 0.72 B. Exposure to mass media Newspaper readership: Women 1.40 1.26 1.13 0.98 0.95 0.70 Men na na na na na na Radio listenership: Women 1.50 1.15 0.93 0.78 0.86 0.50 Men na na na na na na Television viewership: Women 2.10 1.04 0.67 0.62 0.60 0.63 Men na na na na na na C. Knowledge and attitudes about HIV/AIDS Knowledge about sexual transmission of HIV/AIDS: Women 1.59 0.92 0.81 0.55 0.53 0.54 Men na na na na na na Knowledge about mother-to-child transmission of HIV/AIDS: Women na na na na na na Men na na na na na na Attitudes toward HIV/AIDS: Women na na na na na na Men na na na na na na D. Status of women Household decisionmaking: Can seek own health care na na na na na na Can seek children's health care na na na na na na Can make daily household purchases na na na na na na Can make large household purchases na na na na na na Can make meal-related decisions na na na na na na Freedom of movement: Can travel to visit family/relatives na na na na na na Other decisionmaking, attitudes: Can decide how to spend own money 1.87 1.74 1.29 1.14 1.11 0.65 Can decide whether to have sex na na na na na na Justifies domestic violence na na na na na na E. Orphanhood Paternal orphan prevalence na na na na na na Maternal orphan prevalence 0.31 0.25 0.44 0.23 0.25 0.14 Double orphan prevalence na na na na na na - 125 - Colombia 1995 - ASSET DISTRIBUTION AND WEIGHTS (FACTOR SCORE) Asset Variable Unweighted Wealth Quintiles Factor Low 2nd 3rd 4th High Avg. Score Mean Std. Percentage of Population Devia- tion Has electricity 0.914 0.280 54.6% 99.2% 99.8% 100.0% 100.0% 90.7% 0.09775 Has radio 0.871 0.335 68.3% 82.4% 91.5% 98.1% 99.9% 88.1% 0.06295 Has television 0.808 0.394 33.3% 82.7% 96.1% 99.5% 100.0% 82.3% 0.10477 Has refrigerator 0.587 0.492 4.5% 38.7% 63.2% 91.6% 100.0% 59.7% 0.10581 Has bicycle 0.411 0.492 26.1% 39.6% 46.4% 48.3% 67.7% 45.8% 0.04094 Has motorcycle 0.072 0.259 1.2% 3.6% 4.6% 9.8% 18.4% 7.6% 0.02891 Has car 0.114 0.318 0.2% 2.1% 3.9% 8.9% 45.6% 12.4% 0.05024 Has telephone 0.343 0.475 0.3% 2.5% 13.6% 54.0% 96.5% 33.7% 0.09225 Has iron 0.806 0.395 26.4% 82.5% 97.7% 99.8% 100.0% 81.3% 0.11074 Has blender 0.715 0.451 15.1% 65.9% 86.3% 98.4% 100.0% 73.2% 0.10997 Has tractor 0.002 0.046 0.1% 0.6% 0.4% 0.0% 0.0% 0.2% -0.00305 Works own or family's agricultural land 0.081 0.273 32.1% 13.8% 3.1% 2.7% 0.4% 10.4% -0.05534 Uses piped water 0.053 0.224 18.4% 11.1% 1.5% 0.1% 0.0% 6.2% -0.04222 Uses water from a well 0.067 0.249 29.0% 8.2% 0.2% 0.1% 0.0% 7.5% -0.06459 Uses water from river, canal, or surface 0.045 0.207 17.5% 6.0% 0.0% 0.0% 0.0% 4.7% -0.05239 Uses water from another source 0.006 0.076 1.8% 0.8% 0.0% 0.0% 0.0% 0.5% -0.01683 Uses water from a public aqueduct 0.701 0.458 6.1% 2.6% 0.3% 0.0% 0.0% 1.8% 0.11756 Uses rainwater for drinking 0.019 0.138 2.1% 0.6% 0.0% 0.0% 0.0% 0.5% -0.02939 Uses water from a piped public source 0.005 0.072 12.6% 10.0% 1.4% 0.1% 0.0% 4.8% -0.01472 Uses water from a rural/private aqueduct 0.093 0.290 15.1% 23.7% 8.7% 0.8% 0.0% 9.6% -0.03311 Uses water from a tanker truck 0.009 0.096 1.8% 2.8% 0.5% 0.0% 0.0% 1.0% -0.01173 Uses flush toilet connected to a sewer 0.667 0.471 1.5% 33.1% 86.5% 98.7% 100.0% 64.0% 0.12170 Uses flush toilet connected to a pit 0.102 0.302 13.9% 30.1% 10.0% 1.0% 0.0% 11.0% -0.03024 Uses flush toilet connected to another location 0.038 0.192 5.4% 11.9% 1.8% 0.2% 0.0% 3.9% -0.01956 Uses pit toilet 0.045 0.206 0.3% 2.8% 5.7% 11.7% 5.0% 5.0% -0.03527 Uses bush or field as latrine 0.143 0.350 65.6% 13.1% 0.1% 0.0% 0.0% 15.8% -0.10415 Has dirt, sand, or dung as principal flooring 0.116 0.320 55.6% 7.7% 0.7% 0.0% 0.0% 12.8% -0.09547 Has wood plank as principal flooring 0.048 0.215 10.4% 8.0% 2.9% 0.9% 0.0% 4.4% -0.03086 Has cement as principal flooring 0.375 0.484 32.3% 70.7% 65.1% 24.4% 0.7% 38.5% -0.02512 Has other material as principal flooring 0.005 0.072 0.1% 0.1% 0.3% 0.6% 1.5% 0.5% 0.00809 Has bricks as principal flooring 0.003 0.059 7.8% 43.7% 88.8% 99.0% 100.0% 67.9% -0.00076 Has parquet or polished wood as principal flooring 0.057 0.231 0.4% 0.6% 0.3% 0.1% 0.3% 0.3% 0.01929 Has tile as principal flooring 0.375 0.484 0.8% 10.1% 24.7% 60.4% 83.1% 36.0% 0.08581 Has carpet as principal flooring 0.020 0.139 0.0% 0.0% 0.3% 1.9% 9.4% 2.4% 0.02040 Number of members per sleeping room 2.128 1.568 3.7 2.9 2.7 1.9 1.2 2.5 -0.06149 - 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 - Colombia 2005 - ASSET QUESTIONNAIRE Question Score if Score if Item "Yes" "No" Score 1. In your household, is/are there? One or more telephones 0.07578 -0.06811 One or more radios 0.02180 -0.04348 One or more televisions 0.02791 -0.12918 One or more refrigerators 0.05096 -0.09441 One or more blenders 0.04436 -0.09511 One or more stereos 0.07478 -0.04846 One or more washing machines 0.11039 -0.03058 One or more DVDs 0.11780 -0.01442 One or more computers 0.14905 -0.01514 Internet 0.17252 -0.00745 One or more gas, electric ranges (cooktop) 0.03198 -0.14979 One or more gas, electric ovens 0.10189 -0.02591 One or more microwave ovens 0.15991 -0.00948 One or more vacuums, buffers 0.17781 -0.00654 One or more hot water heaters 0.13992 -0.01009 One or more air conditioners 0.15986 -0.00304 One or more VCRs 0.14052 -0.01137 One or more motorcycles, scooters 0.06723 -0.00920 One or more cars, trucks 0.12658 -0.01114 One or more fans 0.02216 -0.01630 One or more showers 0.04386 -0.10828 2. What is the principal source of drinking water for your household? Piped water from public system 0.04391 -0.08029 Piped water from rural aquaduct -0.11083 0.01320 Public standpipel -0.10212 0.00018 Well with pump -0.02786 0.00131 Well without pump -0.18934 0.00490 River, stream, pond, lake, spring -0.17334 0.00662 Tanker truck -0.07654 0.00015 Aguatero -0.02884 0.00023 Bottled water 0.04052 -0.00303 Rainwater -0.10677 0.00576 Other -0.12813 0.00099 3. What is the principal type of fuel for cooking used by your household? Natural gas 0.07309 -0.03185 Propane 0.01999 -0.01479 Kerosene -0.07171 0.00088 Electricity 0.02935 -0.00148 Wood, charcoal -0.16594 0.03538 Coal -0.09080 0.00032 Discarded materials -0.14851 0.00001 Does not cook -0.05464 0.00179 Other -0.09632 0.00000 4. What is the principal type of toilet facility used by your household? Private flush toilet connected to sewer 0.06310 -0.08369 Shared flush toilet connected to sewer -0.01005 0.00133 Private flush toilet connected to septic system -0.07366 0.01387 - 137 - Colombia 2005 - ASSET QUESTIONNAIRE (Cont.) Question Score if Score if Item "Yes" "No" Score 4. What is the principal type of toilet facility used by your household? (Cont.) Shared flush toilet connected to septic system -0.08770 0.00195 Private flush toilet not connected to sewer -0.08944 0.00180 Shared flush toilet not connected to sewer -0.09824 0.00035 Private pit latrine -0.14981 0.00219 Shared pit latrine -0.13423 0.00028 Private bajamar -0.06111 0.00064 Shared bajamar -0.07966 0.00009 Field, bush as latrine -0.19808 0.01722 Other -0.07076 0.00010 5. What is the principal material used for the floors in your household? Earth, mud, dung, sand -0.17462 0.01700 Cement -0.02641 0.02245 Parquet, polished wood 0.11684 -0.00101 Carpeted 0.16828 -0.00074 Tile 0.08554 -0.05059 Wood plank -0.08812 0.00633 Linoleum or vinyl floor 0.00951 0.00000 6. What is the principal material used for the walls of your household? Adobe -0.07685 0.00234 Bahareque revocado -0.12632 0.00755 Rough wood -0.14175 0.01354 Cane -0.17489 0.00242 Brick, block, finished wood 0.03362 -0.12818 Pressed dirt walls -0.11263 0.00183 Flimsy materials -0.13653 0.00062 7. How does your household dispose of solid waste? Collected by the government 0.04340 -0.13416 Collected informally -0.00410 0.00010 Burned -0.14370 0.02025 Buried -0.12814 0.00194 Dumped in waterways -0.15226 0.00314 Dumped in compound or yard -0.16162 0.01036 Disposed of in some other fashion -0.11617 0.00022 8. In what type of dwelling does your household live? Separate house -0.01207 0.05745 Apartment 0.08922 -0.01295 Rents room in someone's home -0.02724 0.00090 Rents room in some other type of building -0.03014 0.00046 Other -0.15024 0.00002 9. How many people are there for each sleeping room in your household? people-13.36x- 0.006 9.94 Total Household Asset Score (sum of individual item scores) - 138 - Colombia 2005 - QUINTILE CUT-OFF POINTS Asset Index Value Wealth Quintile Bottom Cut-Off Top Cut-Off Low Low -0.84159 Second -0.84159 0.05383 Third 0.05383 0.56359 Fourth 0.56359 0.99968 High 0.99968 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 -