1. Multi Indicator Cluster Survey (MICS) 2005 November 30, 2007

2. What Is MICS ? Multiple Indicator Cluster Survey Household survey developed by UNICEF in 1990s. It assists countries in filling data gaps for monitoring human development, especially the situation of women and children.

3. What is MICS Contd Many countries were involved in each round, using common questionnaire modules. Facilitates the production of comparable estimates of indicators. It uses international definitions of indicators.

4. What is MICS Contd Jamaica is among : the 191 signatories to the Millennium Development Goals (MDG). the 189 member states who adopted the Plan of Action of A World Fit For Children.

5. What is MICS Contd Round 1 - 1995 No Jamaica Round 2 - 2000 Jamaica but no official report Round 3 - 2005 Jamaica and here we are!

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

7. Survey Management A Steering Committee was formed with representatives from: UNICEF UNFPA UNAIDS STATIN UNDP PAHO PIOJ ECC Cabinet Office MOH MOEY SALISES CCDC

8. Survey Management contd Survey coordination and implementation was done by STATIN through the Special Projects and Field Services Divisions.

9. Questionnaires The survey instrument consisted of three questionnaires: Household Woman (15-49 yrs) Child (0-4 yrs).

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

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

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

13. Sample Selection

14. Training of Field Staff Training included: interviewing techniques the questionnaires mock interviews between trainees interviewing practice. These practice interviews were conducted in areas close to the training centres. Trainees were tested, and based on the test results, observation and participation in the training sessions, 83 persons were offered employment on the project.

15. Field Work Field work began October 10, 2005 13 Supervisors 70 Interviewers and Field Editors

16. Problems during field work Adverse weather Violence in some sections of Kingston, St. Andrew and St. Catherine. Interviewers were forced to leave some EDs. Vacant dwellings Upper income communities that have gated communities and to which access was not granted by security personnel.

17. Data Processing Data was manually edited and keyed into the computer using the CSPro software 7 Data Entry Operators 2 Data Entry Supervisors Computer edits were done Process lasted from November 2005 – March 2006

18. Data analysis Done in SPSS ver. 14.0 by STATIN Using syntaxes prepared by UNICEF Rigorous process

19. Response Rate

20. FINDINGS

21. Child mortality The infant mortality rate is the probability of dying before the first birthday. The under-five mortality rate is the probability of dying before the fifth birthday. Based on an indirect estimation technique known as the Brass method

22. Child mortality Infant mortality – 26 per 1000 Under 5 mortality – 31 per 1000 Mortality higher among children of women with low levels of education

24. Breastfeeding Exclusive breastfeeding 0-5mths 15.2% Complementary feeding at 6-9mths. 35.6% Continued breastfeeding at 12-15mths 49.1% Continued breastfeeding at 20-23mths. 24.0%

26. Breastfeeding contd

27. Birth Weight Majority of birth occur in hospitals 97% of babies were weighed at birth Approx 12% weighed less than 2500 gms

28. Immunization Overall, more than 70 % of children had immunization cards. If the child did not have a card, the mother was asked to recall whether or not the child had received BCG, Polio, DPT or measles vaccination.

30. CHILD HEALTH During the two weeks preceding the survey 2.4% had diarrhoea 6.5% had symptoms of pneumonia 75% were taken to an appropriate provider Amoxil was the antibiotic of choice 23% of women knew of the two danger signs of pneumonia

31. Water and Sanitation Water Use of improved drinking water sources Use of adequate water treatment method Time to source of drinking water Person collecting drinking water Sanitation Use of improved sanitation facilities Sanitary disposal of childs faeces

32. Water and Sanitation Use of improved drinking water sources - 93.5% 97 % in urban areas 88 % in rural areas 53% used water treatment method.

33. Water and Sanitation contd

34. 97% live in households using improved sanitation facilities Flush toilets most common in urban areas Pit latrines most common in rural areas

35. Water and Sanitation contd 36% of children diapers were properly disposed. 56% thrown directly into garbage.

36. Reproductive Health 91% of women received antenatal care from skilled personnel at least once during pregnancy The doctor was the main provider (57.8%) Then Nurse / midwife (32.7%) Over 95% of women had blood and urine samples taken during pregnancy

37. Reproductive Health contd 97% of births were delivered by skill personnel 56% assisted by nurse / midwife 41% assisted by doctors

38. Child Development 86% of children under 5 had an adult household member who engaged in activities that promote learning and school readiness Fathers involvement was only 41% 51% of children were living without their fathers

39. Child Development contd 3% of children age 0 – 59 months were left in care of other children under 10 yrs 1% of children were left alone

40. Education Pre-school Attendance 86% of children attended pre-school 89% urban 81% from rural areas 94% of children 48 - 59 months attended pre-school.

41. Education contd 97.4% attended primary school Attendance increased with age from 89.7% among children 6 years to 99.3% among 11 year old Transition to secondary school almost universal

42. Education contd At the secondary level Attendance was lower among boys (89 %) than among girls (93 %). Higher levels of attendance among children whose mothers have a higher level of education.

43. Education - Distance from school Primary 97% lived less than 5 miles 68% lived within a mile Secondary 86% lived less than 5 miles 42% lived within a mile 11 % of rural lived within one mile 4 % in KMA lived within one mile

44. Child Protection Birth Registration 89% of children under 5 were registered Of those not registered 57% owed hospital fees 32% said too costly to register

45. Child Labour - Definition Ages 5-11: at least one hour of economic work or 28 hours of domestic work per week. Ages 12-14: at least 14 hours of economic work or 28 hours of domestic work per week.

46. Child Labour Children 5 -11 yrs - 7.9% Children 12-14 yrs - 2.3% More males -7 % than females - 5 %

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

48. Child Discipline 87% of children 2 – 14 were subjected to at least one form of psychological or physical punishment 8% were subjected to severe physical punishment Women with higher educational levels used non-violent discipline and less to psychological and minor physical punishment than women with lower levels education.

49. Child Discipline (cont.d) MinorSevere Males 7510 Females 715

50. Domestic Violence 6.1% of women felt that a husband or male partner was justified in beating his wife for at least one reason The most popular reason was if the woman neglected her children

51. Child Disability - 2-9 years Most Common Disabilities Reported. Not understanding instructions - 4.9% Dull or slow - 4.7% Not Speaking - 3.9%

52. HIV/AIDS, and orphaned and vulnerable children 69% of women knew three main ways of preventing HIV 83% knew about one faithful partner 89% knew about using a condom 87% knew about abstaining

53. HIV contd

54. During Antenatal Care 83% received information about HIV prevention 90% have tested for HIV 84% have received result

55. Conclusion Health status of women and children good Need to improve vital registration especially for infant and young child deaths Young children need to be protected from child labour whether inside or outside the home Need to decrease the levels of social inequality as measured by the educational levels of women as these influence attitudes and behaviours e.g. child discipline, domestic violence