Eritrea - Demographic and Health Survey - 2003

Publication date: 2003

Eritrea Demographic and Health Survey 2002 E r i t r e a 2 0 0 2 D e m o g r a p h i c a n d H e a l t h S u r v e y World Summit for Children Indicators World Summit for Children Indicators by zoba, Eritrea 2002 Zoba Total Debubawi Keih Bahri Maekel Semenawi Keih Bahri Anseba Gash- Barka Debub Childhood mortality Infant mortality rate (per 1,000 live births) 48 122 39 77 37 66 58 Under-five mortality rate (per 1,000 live births) 93 187 60 154 73 123 111 Percent stunted (children under 5 years) 37.6 37.4 23.0 41.9 40.5 44.8 38.7 Childhood undernutrition Percent wasted (children under 5 years) 12.6 13.8 6.1 18.0 15.6 16.9 9.8 Percent underweight (children under 5 years) 39.6 41.1 23.4 51.2 46.7 49.6 34.6 Clean water supply Percent of households within 15 minutes of safe water supply1 67.4 83.7 91.5 62.6 56.3 70.3 51.9 Sanitary excreta disposal Percent of households with flush toilet, pit toilet/latrine2 25.6 56.7 58.4 24.1 19.2 10.3 10.0 Basic education Proportion entering primary school3 14.4 14.4 39.5 9.2 9.5 7.7 9.4 Net primary school attendance rate3 61.2 52.7 87.5 42.7 53.3 40.4 71.1 Children in especially difficult situations Percent of children who do not live with either biological parent3 5.7 6.6 6.6 4.3 5.3 5.4 5.9 Percent of children with at least one parent dead3 9.8 12.0 11.7 9.8 8.1 12.2 8.0 Percent of children age 10-14 that are working 2.2 9.9 0.8 2.2 1.4 4.3 1.7 Family planning Contraceptive prevalence rate (any method, currently married women) 8.0 7.1 19.6 5.1 4.4 1.9 7.9 Contraceptive prevalence rate (any method, all women) 5.8 6.2 10.5 4.0 3.2 1.8 5.7 Antenatal care Percent of women who received antenatal care from a health professional4 70.4 68.0 89.1 74.1 68.6 64.0 62.1 Delivery care Percent of births in the 5 years preceding the survey attended by a health professional 28.3 41.9 71.9 22.5 15.4 11.0 20.5 Low birth weight Percent of births in the 5 years preceding the survey at low birth weight5 11.3 17.1 9.8 16.4 12.4 7.5 4.8 Iodized salt intake Percent of households that use iodized salt6 68.0 51.0 79.1 48.7 70.2 57.1 75.6 Vitamin A supplements Percent of children age 6-59 months who received a vitamin A dose in the 6 months preceding the survey 38.0 22.1 51.7 36.0 37.3 32.2 35.8 Percent of women age 15-49 who received a vitamin A dose in the 2 months after delivery4 13.4 10.7 25.8 12.7 12.7 11.4 8.0 Night blindness Percent of women age 15-49 who suffered from night blindness during pregnancy4, 7 11.6 19.2 3.4 11.9 9.9 13.7 15.4 Exclusive breastfeeding Percent of children under 6 months who are exclusively breastfed 52.0 26.1 55.7 44.9 58.3 48.8 54.4 Continued breastfeeding Percent of all children age 12-15 months still breastfeeding 91.0 77.3 (85.6) 89.3 90.3 91.6 97.6 Percent of all children age 20-23 months still breastfeeding 58.0 (28.5) (58.7) (54.9) 53.4 (65.2) 60.8 (Continued on inside back cover) World Summit for Children Indicators (Continued from inside front cover) Zoba Total Debubawi Keih Bahri Maekel Semenawi Keih Bahri Anseba Gash- Barka Debub Timely complementary feeding Percent of children age 6-9 months receiving breast milk and complementary foods 42.5 28.2 62.5 38.3 39.9 34.4 42.8 Vaccinations Percent of children whose mothers received at least 2 tetanus toxoid vaccinations4 34.6 50.0 40.7 37.1 34.6 32.7 29.3 Percent of children age 12-23 months with at least 3 DPT vaccinations 82.8 76.5 95.0 78.8 94.8 73.5 75.8 Percent of children age 12-23 months with at least 3 polio vaccinations 83.3 75.6 91.9 79.8 93.0 75.6 79.0 Percent of children age 12-23 months with measles vaccination 84.2 70.2 96.1 80.3 93.8 75.7 78.7 Percent of children age 12-23 months with BCG vaccination 91.4 90.8 97.9 89.1 97.9 87.1 86.8 Diarrhea control Percent of children with diarrhea in preceding 2 weeks who received ORS or RHF 55.7 47.1 75.8 64.4 51.3 57.7 47.1 Home management of diarrhea Percent of children age 0-59 months with diarrhea in the past 2 weeks who took more fluids than usual and continued eating somewhat less, the same, or more food 30.4 27.1 41.3 29.4 39.9 42.5 20.1 Treatment of ARI Percent of children age 0-59 months with acute respiratory infection (ARI) in past 2 weeks who were taken to a health facility or provider 43.6 41.1 61.5 40.3 32.7 57.2 36.0 Malaria control Percent of children age 0-59 months who slept under an insecticide-treated mosquito net on the previous night8 4.2 2.1 0.7 8.1 4.5 3.0 5.4 Percent of children age 0-59 months with fever in the past 2 weeks who were treated with antimalarial drugs 3.6 0.0 5.8 0.7 4.4 5.6 2.8 HIV/AIDS Percent of women age 15-49 who correctly state two ways of avoiding HIV infection9 51.5 46.3 71.2 29.2 42.4 31.0 61.3 Percent of women age 15-49 who correctly identify two misconceptions about AIDS10 46.3 36.5 72.4 30.8 42.3 24.2 45.9 Percent of women age 15-49 who believe that AIDS can be transmitted from mother to child during pregnancy, delivery, and breastfeeding 60.2 57.8 63.7 54.1 65.9 44.1 67.7 Note: Figures in parentheses are based on 25-49 unweighted cases. 1 Piped water or protected well water from covered well or tanker 2 In household or shared with others 3 Based on de jure children 4 For the last live birth in the five years preceding the survey 5 For children without a reported birth weight, the proportion with low birth weight is assumed to be the same as the proportion with low birth weight in each birth size category among children who have a reported birth weight 6 15 parts per million or more 7 Includes women who report night blindness and difficulty with vision during the day 8 Mosquito net bought or treated with insecticide within 6 months before the interview 9 Having sex with only one partner who has no other partners and using a condom every time they have sex 10 They said that AIDS cannot be transmitted through mosquito bites and that a healthy-looking person can have the AIDS virus Eritrea Demographic and Health Survey 2002 National Statistics and Evaluation Office Asmara, Eritrea ORC Macro Calverton, Maryland, USA May 2003 National Statistics and Evaluation Office ORC Macro This report summarizes the findings of the 2002 Eritrea Demographic and Health Survey (EDHS) carried out by the National Statistics and Evaluation Office. Financial support for the survey was provided by the U.S. Agency for International Development (USAID) and the Ministry of Health through the Technical Assistance and Support Contract (TASC) with John Snow, Inc. ORC Macro provided technical assistance for the survey through the USAID-funded MEASURE DHS+ project, which is designed to assist developing countries to collect data on fertility, family planning, and maternal and child health. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the U.S. Agency for International Development. Additional information about the EDHS may be obtained from the National Statistics and Evaluation Office P.O. Box 5838, Asmara, Eritrea (telephone: 291-1-202940/119507; e-mail: seo12@eol.com.er). Additional information about the MEASURE DHS+ project may be obtained by contacting: MEASURE DHS+, ORC Macro, 11785 Beltsville Drive, Suite 300, Calverton, MD 20705 (telephone: 301-572-0200; fax: 301-572-0999; e-mail: reports@orcmacro.com; internet: www.measuredhs.com). Suggested citation: National Statistics and Evaluation Office (NSEO) [Eritrea] and ORC Macro. 2003. Eritrea Demographic and Health Survey 2002. Calverton, Maryland, USA: National Statistics and Evaluation Office and ORC Macro. Contents | iii CONTENTS Contents. iii Tables and Figures . vii Preface . xiii Summary of Findings . xv Map of Eritrea. xxii CHAPTER 1 INTRODUCTION 1.1 Geography, History, and the Economy.1 1.2 Population.2 1.3 Health Services and Programs.3 1.4 Objectives of the Survey .5 1.5 Organization of the Survey .5 1.6 Sample Design.5 1.7 Questionnaires .6 1.9 Data Processing .7 1.10 Coverage and Response Rates.7 CHAPTER 2 CHARACTERISTICS OF HOUSEHOLDS AND HOUSEHOLD MEMBERS 2.1 Household Population by Age, Residence, and Sex .9 2.2 Household Composition .11 2.3 Fosterhood And Orphanhood.12 2.4 Education Levels of the Household Population .14 2.5 Marital Status.20 2.6 Employment Status of Household Population .22 2.7 Housing Characteristics.24 2.8 Household Possessions .28 2.9 Mosquito Nets .29 CHAPTER 3 WOMEN’S CHARACTERISTICS AND STATUS 3.1 Characteristics of Survey Respondents .31 3.2 Women’s Migration .33 3.3 Educational Attainment by Background Characteristics .36 3.4 Reasons for Leaving School.39 3.5 Access to Mass Media .40 3.6 Employment Status .42 3.7 Occupation .44 3.8 Earnings, Employers and Continuity of Employment.44 3.9 Child Care While Working.48 3.10 Decision on Use of Earnings .49 3.11 Measures of Women’s Empowerment.51 iv | Contents CHAPTER 4 FERTILITY 4.1 Current Fertility .55 4.2 Fertility Differentials.58 4.3 Fertility Trends.59 4.4 Children Ever Born and Living .61 4.5 Birth Intervals .63 4.6 Age at First Birth .65 4.7 Adolescent Fertility .66 CHAPTER 5 FERTILITY REGULATION 5.1 Knowledge of Contraceptive Methods and Sources.71 5.2 Exposure to Family Planning Information .75 5.3 Acceptability of Use of Electronic Media to Disseminate Family Planning Messages .77 5.4 Interpersonal Communication About Family Planning.79 5.5 Attitudes of Couples Toward Family Planning .80 5.6 Ever Use of Contraceptive Methods .83 5.7 Current Use of Contraceptive Methods.84 5.8 Source of Modern Family Planning Methods.89 5.9 Reasons for Nonuse of Contraception .90 5.10 Intention to Use Family Planning Among Nonusers .92 5.11 Reasons for Not Intending to Use a Contraceptive Method in the Future .92 5.12 Preferred Method of Contraception for Future Use .93 5.13 Contact of Nonusers with Health Care Providers.94 CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY 6.1 Current Marital Status .97 6.2 Polygyny.98 6.3 Age at First Marriage . 100 6.4 Median Age at First Marriage . 101 6.5 Age at First Sexual Intercourse . 102 6.6 Median Age at First Intercourse. 102 6.7 Recent Sexual Activity. 103 6.8 Postpartum Amenorrhea, Abstinence, and Insusceptibility . 105 6.9 Median Duration of Postpartum Insusceptibility by Background Characteristics. 106 6.10 Menopause . 108 CHAPTER 7 FERTILITY PREFERENCES AND UNMET NEED FOR FAMILY PLANNING 7.1 Reproductive Preferences . 109 7.2 Desire To Limit Childbearing by Background Characteristics . 110 7.3 Need for Family Planning Services . 111 7.4 Ideal Family Size. 113 7.5 Ideal Family Size, Unmet Need, and Status of Women . 115 7.6 Fertility Planning . 116 Contents | v 7.7 Attitudes toward Unplanned Pregnancy. 119 CHAPTER 8 INFANT AND CHILD MORTALITY 8.1 Assessment of Data Quality. 121 8.2 Early Childhood Mortality Rates: Levels and Trends . 122 8.3 Differentials in Mortality . 123 8.4 Early Childhood Mortality by Women’s Status. 127 8.5 High-Risk Fertility Behavior. 128 CHAPTER 9 MATERNAL AND CHILD HEALTH 9.1 Pregnancy Care . 131 9.2 Delivery Care . 136 9.3 Postnatal Care . 142 9.4 Reproductive Health Care by Women’s Status. 142 9.5 Use of Mosquito Nets by Women. 144 9.6 Childhood Vaccination . 146 9.7 Acute Respiratory Infections . 149 9.8 Fever . 151 9.9 Diarrheal Diseases . 151 9.10 Women’s Status and Child Health Care . 156 9.11 Use of Mosquito Nets by Children . 158 9.12 Women’s Perception of Problems in Accessing Health Care. 158 CHAPTER 10 INFANT FEEDING AND NUTRITIONAL STATUS OF CHILDREN AND WOMEN 10.1 Breastfeeding and Complementary Feeding . 161 10.2 Age Pattern of Breastfeeding . 163 10.3 Duration and Frequency of Breastfeeding . 164 10.4 Types of Complementary Foods Consumed. 166 10.5 Frequency of Foods Consumed by Children in the Past Day and Night . 167 10.6 Frequency of Foods Consumed by Children in the Past Seven Days. 169 10.7 Micronutrient Supplementation . 171 10.8 Nutritional Status of Children under Age Five. 176 10.9 Nutritional Status of Women . 182 CHAPTER 11 HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS 11.1 Knowledge of HIV/AIDS and Its Prevention. 186 11.2 Knowledge of Other AIDS-Related Issues. 189 11.3 Social Aspects of HIV/AIDS Prevention and Mitigation . 191 11.4 Knowledge of Signs and Symptoms of Sexually Transmitted Infections . 194 11.5 Knowledge of Source and Use of Condoms . 195 CHAPTER 12 FEMALE CIRCUMCISION 12.1 Circumcision of EDHS Respondents. 197 vi | Contents 12.2 Circumcision Experience of Daughters. 201 12.3 Objections to Daughter’s Circumcision . 204 12.4 Attitudes Toward Female Circumcision . 206 12.5 Women’s Perceptions of Their Husband’s Attitude Toward Female Circumcision . 208 12.6 Perceived Benefits of Female Circumcision . 208 12.7 Perceived Benefits of Girls Not Being Circumcised. 211 12.8 Beliefs about Circumcision. 213 12.9 Problems Associated with Female Circumcision . 214 References . 217 Appendix A SAMPLE DESIGN . 219 Appendix B SAMPLING ERRORS . 225 Appendix C DATA QUALITY TABLES . 239 Appendix D SURVEY PERSONNEL. 245 Appendix E QUESTIONNAIRES . 251 Tables and Figures | vii TABLES AND FIGURES CHAPTER 1 INTRODUCTION Table 1.1 Results of the household and individual interviews and response rates.7 Table 1.2 Sample implementation.8 CHAPTER 2 CHARACTERISTICS OF HOUSEHOLDS AND HOUSEHOLD MEMBERS Table 2.1 Household population by age, residence and sex .10 Table 2.2 Household composition according to residence and zoba.12 Table 2.3 Children’s living arrangements and orphanhood .13 Table 2.4 Educational attainment of the household population .15 Table 2.5.1 Primary school attendance ratios .16 Table 2.5.2 Middle school attendance ratios .17 Table 2.5.3 Secondary school attendance ratios .18 Table 2.6 Marital status of the de facto household population .21 Table 2.7.1 Employment status: women.22 Table 2.7.2 Employment status: men .23 Table 2.8 Household characteristics .25 Table 2.9 Household durable goods.28 Table 2.10 Household ownership of a house, animals and cropland.29 Table 2.11 Household possession of mosquito nets .30 Figure 2.1 Population Pyramid .10 Figure 2.2 Distribution of DeFacto Household Population by Single Year of Age and Sex .11 Figure 2.3 Age Specific Attendance Rates .19 Figure 2.4 Access to Clean Water .27 CHAPTER 3 WOMEN’S CHARACTERISTICS AND STATUS Table 3.1 Background characteristics of respondents .32 Table 3.2 Reasons for migration by background characteristics .34 Table 3.3 Reasons for migration by type of migration .35 Table 3.4 Zoba in-migration and out-migration, and immigration from abroad.35 Table 3.5 Educational attainment by background characteristics.37 Table 3.6 Reason for leaving school by zoba .39 Table 3.7 Exposure to mass media .41 Table 3.8 Employment status.43 Table 3.9 Occupation .45 Table 3.10 Employment characteristics.46 Table 3.11 Childcare while working .48 Table 3.12 Decision on use of earnings .50 Table 3.13 Women’s participation in decisionmaking .51 Table 3.14 Women’s participation in decisionmaking by background characteristics .52 Table 3.15 Women’s attitude toward wife beating .54 viii | Tables and Figures Figure 3.1 In-Migration and Out-Migration by Zoba .36 Figure 3.2 Employment Status of Women.42 Figure 3.3 Type of Earnings Among Employed Women .47 Figure 3.4 Type of Employer Among Employed Women .47 CHAPTER 4 FERTILITY Table 4.1 Current fertility .56 Table 4.2 Fertility by background characteristics.58 Table 4.3 Trends in fertility.60 Table 4.4 Trends in age-specific fertility rates .61 Table 4.5 Children ever born and living.62 Table 4.6 Birth intervals.64 Table 4.7 Age at first birth .65 Table 4.8 Median age at first birth by background characteristics.66 Table 4.9 Teenage pregnancy and motherhood .68 Figure 4.1 Total Fertility Rates, Etritrea Compared with Other Sub-Saharan Countries .56 Figure 4.2 Age-Specific Fertility Rates by Residence.57 Figure 4.3 Total Fertility Rates by Background Characteristics .59 Figure 4.4 Trends in Age-Specific Fertility Rates.60 Figure 4.5 Trends in Adolescent Fertility by Age and Residence.69 CHAPTER 5 FERTILITY REGULATION Table 5.1 Knowledge of contraceptive methods .72 Table 5.2 Knowledge of fertile period.73 Table 5.3 Knowledge of contraceptive methods by background characteristics.74 Table 5.4 Exposure to family planning messages.76 Table 5.5 Acceptability of media messages on family planning .78 Table 5.6 Discussion of family planning with husband.80 Table 5.7 Discussion of family planning with persons other than husband .81 Table 5.8 Attitudes toward family planning.82 Table 5.9 Ever use of contraception .84 Table 5.10 Current use of contraception .85 Table 5.11 Current use of contraception by background characteristics .86 Table 5.12 Current use of contraception by women's status.88 Table 5.13 Number of children at first use of contraception .88 Table 5.14 Source of contraception.90 Table 5.15 Reasons for not using family planning .91 Table 5.16 Future use of contraception .92 Table 5.17 Reasons for not intending to use contraception in the future.93 Table 5.18 Preferred method of contraception for future use .94 Table 5.19 Contact of nonusers with family planning providers .95 Figure 5.1 Trends in Knowledge of Family Planning Methods Among Currently Married Women, 1995 EDHS and 2002 EDHS.73 Tables and Figures | ix Figure 5.2 Exposure to Family Planning Messages on Radio, Women Age 15-49, 1995 EDHS and 2002 EDHS .77 Figure 5.3 Trends in Acceptability of Family Planning Messages on Radio, Women Age 15-49 Years, 1995 EDHS and 2002 EDHS.79 Figure 5.4 Trends in Approval of Family Planning, Women Age 15-49, 1995 EDHS and 2002 EDHS .83 Figure 5.5 Contraceptive Use by Background Characteristics, Currently Married Women 15-49 .87 Figure 5.6 Distribution of Current Users of Modern Contraceptive Methods by Source of Supply .89 CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY Table 6.1 Current marital status.97 Table 6.2 Number of co-wives .99 Table 6.3 Age at first marriage . 100 Table 6.4 Median age at first marriage. 101 Table 6.5 Age at first sexual intercourse. 102 Table 6.6 Median age at first sexual intercourse . 103 Table 6.7 Recent sexual activity. 104 Table 6.8 Postpartum amenorrhea, abstinence and insusceptibility . 106 Table 6.9 Median duration of postpartum insusceptibility by background characteristics . 107 Table 6.10 Menopause . 108 Figure 6.1 Current Marital Status .98 Figure 6.2 Median Duration of Postpartum Insusceptibility by Background Characteristics. 108 CHAPTER 7 FERTILITY PREFERENCES AND UNMET NEED FOR FAMILY PLANNING Table 7.1 Fertility preferences by number of living children. 109 Table 7.2 Desire to limit childbearing by background characteristics . 111 Table 7.3 Need for family planning . 112 Table 7.4 Ideal number of children . 114 Table 7.5 Mean ideal number of children by background characteristics . 115 Table 7.6 Ideal number of children and unmet need by women’s status. 116 Table 7.7 Fertility planning status . 117 Table 7.8 Wanted fertility rates . 118 Table 7.9 Attitudes of nonusers toward mistimed and unwanted pregnancies. 120 Figure 7.1 Fertility Preferences of Currently Married Women . 110 CHAPTER 8 INFANT AND CHILD MORTALITY Table 8.1 Early childhood mortality rates. 123 Table 8.2 Early childhood mortality rates by socioeconomic characteristics . 125 Table 8.3 Early childhood mortality rates by demographic characteristics . 126 Table 8.4 Early childhood mortality rates by women’s status indicators. 128 Table 8.5 High-risk fertility behavior. 129 x | Tables and Figures Figure 8.1 Trends in Childhood Mortality . 124 Figure 8.2 Under-five Mortality by Background Characteristics . 125 CHAPTER 9 MATERNAL AND CHILD HEALTH Table 9.1 Antenatal care . 132 Table 9.2 Number of antenatal care visits and timing of first visit . 134 Table 9.3 Components of antenatal care . 135 Table 9.4 Tetanus toxoid injections . 137 Table 9.5 Place of delivery . 139 Table 9.6 Assistance during delivery . 140 Table 9.7 Delivery characteristics . 141 Table 9.8 Postnatal care by background characteristics. 143 Table 9.9 Reproductive health care by women’s status. 144 Table 9.10 Use of mosquito nets by all women and pregnant women . 145 Table 9.11 Vaccinations by source of information . 147 Table 9.12 Vaccinations by background characteristics. 148 Table 9.13 Prevalence and treatment of symptoms of acute respiratory infection (ARI) . 150 Table 9.14 Prevalence and treatment of fever . 152 Table 9.15 Prevalence of diarrhea . 153 Table 9.16 Knowledge of ORS packets . 154 Table 9.17 Diarrhea treatment . 155 Table 9.18 Children’s health care by women’s status. 157 Table 9.19 Use of mosquito nets by children. 158 Table 9.20 Problems in accessing health care . 159 Figure 9.1 Percentage of Children Age 12-23 Months Who Have Received Specific Vaccinations, 1995 EDHS and 2002 EDHS. 147 Figure 9.2 Feeding Practices During Diarrhea Compared to Normal Practice. 156 CHAPTER 10 INFANT FEEDING AND NUTRITIONAL STATUS OF CHILDREN AND WOMEN Table 10.1 Initial breastfeeding . 162 Table 10.2 Breastfeeding status by child’s age . 164 Table 10.3 Median duration of breastfeeding . 165 Table 10.4 Foods consumed by children in the day or night preceding the interview . 166 Table 10.5 Frequency of foods consumed by children in the day and night preceding the interview . 168 Table 10.6 Frequency of foods consumed by children in preceding seven days . 170 Table 10.7 Iodization of household salt . 172 Table 10.8 Micronutrient intake among children . 173 Table 10.9 Micronutrient intake among mothers . 175 Table 10.10 Nutritional status of children by child’s characteristics . 179 Table 10.11 Nutritional status of children by mother’s characteristics . 180 Table 10.12 Nutritional status of women by background characteristics. 183 Tables and Figures | xi Figure 10.1 Frequency of Meals Consumed by Children Under 36 Months of Age Living with Their Mother. 169 Figure 10.2 Nutritional Status of Children Under Age Five. 178 Figure 10.3 Percentage of Children Under Age Five that Are Underweight (weight-for-age below -2 SD) by Background Characteristics . 181 Figure 10.4 Trends in Levels of Undernutrition among Children Under Age Three, 1995 and 2002. 182 Figure 10.5 Percentage of Women Age 15-49 with Low Body Mass Index (BMI < 18.5) by Background Characteristics . 184 CHAPTER 11 HIV/AIDS AND OTHER SEXUALLY TRANSMITTED INFECTIONS Table 11.1 Knowledge of HIV/AIDS . 186 Table 11.2 Knowledge of ways to avoid HIV/AIDS . 187 Table 11.3 Knowledge of programmatically important ways to avoid HIV/AIDS. 188 Table 11.4 Knowledge of HIV/AIDS-related issues. 190 Table 11.5 Discussion of HIV/AIDS with partner . 192 Table 11.6 Social aspects of HIV/AIDS . 193 Table 11.7 Knowledge of symptoms of STIs. 195 Table 11.8 Knowledge of source and use of condoms . 196 Figure 11.1 Percentage of Women Who Know at Least Two Programatically Important Ways to Avoid HIV/AIDS, by Zoba and Education . 189 Figure 11.2 Percentage of Women Who Know at Least One Symptom of Sexually Transmitted Infections (STIs) in Men . 194 CHAPTER 12 FEMALE CIRCUMCISION Table 12.1 Knowledge and prevalence of female circumcision . 198 Table 12.2 Age at circumcision . 200 Table 12.3 Person who performed female circumcision . 201 Table 12.4 Daughter’s circumcision experience and type of circumcision. 202 Table 12.5 Person who performed daughter’s circumcision. 204 Table 12.6 Objections to daughter’s circumcision . 205 Table 12.7 Attitudes toward female circumcision by background characteristics . 207 Table 12.8 Women’s perception of their husband’s attitude toward circumcision. 209 Table 12.9 Perceived benefits of female circumcision. 210 Table 12.10 Perceived benefits of not undergoing female circumcision . 212 Table 12.11 Beliefs about female circumcision . 214 Table 12.12 Problems associated with female circumcision . 215 Figure 12.1 Distribution of Circumcised Women by Type of Circumcision . 199 Figure 12.2 Daughter’s Age at Circumcision . 203 Figure 12.3 Perceived Benefits of Female Circumcision . 211 Figure 12.4 Perceived Benefits of Not Undergoing Female Circumcision . 213 xii | Tables and Figures APPENDIX A SAMPLE DESIGN Table A.1 Proportional and square root allocations of clusters. 220 Table A.2 Expected number of selected households to reach the target of completed interviews . 220 Table A.3 Final allocation of women 15-49 with completed interviews and clusters in each zoba. 220 Table A.4 Sample implementation. 223 APPENDIX B SAMPLING ERRORS Table B.1 List of selected variables for sampling errors . 227 Table B.2 Sampling errors for selected variables, total sample . 228 Table B.3 Sampling errors for selected variables, urban sample. 229 Table B.4 Sampling errors for selected variables, Asmara sample . 230 Table B.5 Sampling errors for selected variables, other towns sample . 231 Table B.6 Sampling errors for selected variables, rural sample. 232 Table B.7 Sampling errors for selected variables, zoba Debubawi Keih Bahri sample . 233 Table B.8 Sampling errors for selected variables, zoba Maekel sample . 234 Table B.9 Sampling errors for selected variables, Zoba Semenawi Keih Bahri sample. 235 Table B.10 Sampling errors for selected variables, zoba Anseba sample . 236 Table B.11 Sampling errors for selected variables, zoba Gash-Barka sample. 237 Table B.12 Sampling errors for selected variables, zoba Debub sample. 238 APPENDIX C DATA QUALITY TABLES Table C.1 Household age distribution. 239 Table C.2 Age distribution of eligible and interviewed women. 240 Table C.3 Completeness of reporting . 240 Table C.4 Births by calendar years . 241 Table C.5 Reporting of age at death in days . 242 Table C.6 Reporting of age at death in months . 243 Preface | xiii PREFACE The 2002 Eritrea Demographic and Health Survey (EDHS) is the second National Demographic and Health Survey (DHS) in the series that started in 1995. The National Statistics and Evaluation Office (NSEO), Office of the President conducted the survey under the aegis of the Ministry of Health (MOH). ORC Macro furnished technical assistance to the survey as part of the MEASURE DHS+ program, while funding was provided by the U.S Agency for International Development (USAID). The United Nations Population Fund (UNFPA) and the Canada International Development Agency (CIDA) supported the survey by supplying 20 field vehicles. The fieldwork for the 2002 EDHS was carried out between the last week of March and the first week of July 2002. The major objective of this survey, similar to the first survey, was to collect and analyze data on fertility, mortality, family planning, and health. Compared with the 1995 EDHS, the present survey was expanded in scope to include a malaria module and questions on gender issues. Moreover, geographic coordinates were taken for the selected sample points to allow analysis based on the geographic information system (GIS). Thus, the 2002 EDHS will not only update the information from the 1995 EDHS, but also will provide findings on some new topics of interest. The findings of the 2002 EDHS presented in this report provide up-to-date and reliable information on a number of key topics of interest to planners, policymakers, program managers, and researchers that will guide the planning, implementation, monitoring, and evaluation of population and health programs in Eritrea. In addition to the estimates at the national level, estimates for key indicators relating to fertility, mortality, and health are provided for all six zobas and for urban and rural areas. The 2002 EDHS results present evidence of a decline in fertility and early childhood mortality as well as a substantial increase in the level of child immunization coverage since the 1995 EDHS survey. Knowledge of HIV/AIDS remains high in Eritrea. There is, however, still a wide gap between knowledge and use of family planning. The National Statistics and Evaluation Office (NSEO) acknowledges the efforts of a number of organizations and individuals who contributed immensely to the successful completion of the 2002 EDHS and the timely publication of this report. NSEO is particularly thankful to USAID for funding the survey, to ORC Macro for providing technical assistance, and to UNFPA and CIDA for supporting field vehicles. The office would like to express its gratitude to the Ministry of Health (MOH) for close cooperation in the whole operation and for their significant technical and logistical inputs. The office is grateful for the endeavors of government officials at all levels of administration that supported the survey. High appreciation and commendation go to all the 2002 EDHS field personnel for commitment to high-quality work in difficult working conditions. We acknowledge with gratitude the NSEO staff, who made the survey successful through commitment and a spirit of team work. Last but not least, special gratitude goes to all of the respondents who generously gave their valuable time to provide information that forms the basis of this report Dr. Georgis Teclemichael National Statistics and Evaluation Office (Head) May 2003 Summary of Findings | xv SUMMARY OF FINDINGS The 2002 Eritrea Demographic and Health Sur- vey (2002 EDHS) is a nationally representative sample survey covering 9,389 households and 8,754 women age 15-49. The survey provides up-to-date information on fertility, early childhood mortality, fertility pref- erences, knowledge and use of family planning, maternal and child health and nutrition, aware- ness and behavior regarding HIV/AIDS and other sexually transmitted infections, malaria control program indicators, and female genital cutting (female circumcision). It was designed as follow- on to the 1995 EDHS survey. As most of the in- formation collected in the two surveys is similar, it is possible to examine trends in the different indicators over the intervening period of six and a half years. The major findings are considered at the national level, by urban-rural residence, and by region (the six zobas). The National Statistics and Evaluation Office (NSEO) was responsible for implementing the survey. Fourteen survey teams conducted inter- views from the last week of March to the first week of July 2002. FERTILITY Fertility Trends: Fertility has declined sharply since 1995; the total fertility rate has dropped from 6.1 children per woman to 4.8 children, a decline of 21 percent. Because of this decline, at current fertility levels, the average Eritrean woman will give birth to five children instead of six children by the end of her reproductive years. The decline is more rapid among rural women and younger women (below age 35), and is most notable among adolescents (15-19). Fertility Differentials: Similar to the pattern that exists in all sub-Saharan countries, fertility among urban women in Eritrea is substantially lower than fertility among rural women. The total fertility rate among rural women is 5.7 children per women, compared with 3.2 children in urban areas. By zoba, fertility ranges from a high of 5.7 children per woman in zoba Debub to a low of 3.4 children in zoba Maekel. Fertility levels are related to various socioeco- nomic characteristics of women. Education, for example, has a negative relationship with fertil- ity. The total fertility rate decreases from 5.5 children among women with no education to 3.1 children among women who have at least some secondary education. Birth Intervals: The length of interval between births influences overall fertility, as well as the health status of mother and child. The interval between births in Eritrea has increased from 31.3 months in 1995 to 33.6 months in 2002. The op- timal interval between births is at least 36 months. In Eritrea, 43 percent of births occur with the optimal birth interval, compared with 35 percent in 1995. Nuptiality: Women’s age at marriage has been increasing. For example, the proportion of women age 15-19 still single has increased from 62 percent in1995, to 69 percent in 2002. In 1995, almost six in ten women were married by age 18, compared with less than half in 2002. These results indicate that the rising age at mar- riage is an important factor in fertility decline in Ertirea. The proportion of never-married women who reported that they had sex in the year before the survey is less than 3 percent. Childbearing at Young Ages: Fourteen percent of adolescent women (15-19) are either already mothers (11 percent) or are currently pregnant with their first child (3 percent). The rate for ado- lescent women has declined substantially since 1995 (23 percent). The decline is mainly attribut- able to lower teenage childbearing among rural women. In 1995, one in three rural teenagers had started childbearing, compared with one in five in 2002, a decline of more than 40 percent. xvi | Summary of Findings Unplanned Fertility: The 2002 EDHS data indi- cate that one-fourth of all births in the five years preceding the survey were unplanned; 6 percent were unwanted and 20 percent were mistimed (wanted later). The proportion of mistimed births has increased from 14 percent in the 1995 EDHS to 20 percent in 2002, while the proportion of unwanted births increased only slightly from 5 percent to 6 percent. If all births associated with unwanted pregnancy were avoided, the total fer- tility rate in Eritrea would be 4.4 children per woman, which is roughly one-half child lower than the observed total fertility rate. Ideal Family Size: Eritrean women want to have large families; the mean ideal number of children for all women is 5.8. Overall, only one in ten women wants less than four children, while more than one-fourth want seven or more. One in ten women considers 10 or more children to be the ideal family size. FAMILY PLANNING Knowledge of Family Planning Methods: Al- most nine in ten women know of at least one modern method of family planning. The pill, male condoms, and injectables are the most widely known modern methods among all sub- groups. Knowledge of family planning methods has increased since 1995. The mean number of methods known by all women increased by al- most two methods from 2.6 in 1995 to 4.4. in 2002. Mass media are important sources of information on family planning. A majority of women (55 percent) heard or saw a family planning message on the radio, on television, in a newspaper/ magazine, or on a poster in the 12 months before the survey. Half of all women have heard a fam- ily planning message on the radio, which is the major medium for all subgroups. Women’s expo- sure to all other media is much lower. Nineteen percent of women reported seeing a family plan- ning message on television, and the same propor- tion saw a family planning message on a poster. Only 16 percent saw a family planning message in newspapers or magazines. Trends in Contraceptive Use: Contraceptive use remains low in Eritrea; there has been no increase since 1995. The 2002 EDHS results show that only 8 percent of currently married women re- ported using contraception at the time of the sur- vey, with 5 percent depending on modern meth- ods and 3 percent relying on traditional methods. Currently, the most widely used methods among married women are injectables (3 percent), lacta- tional amenorrhea method (LAM) (2 percent), and the pill (1 percent). Differentials in Family Planning Use: There are marked differences by background characteristics in current use of family planning methods among currently married women. Urban women are more than four times as likely to use a method of contraception as rural women (17 versus 4 per- cent). Among zobas, use of contraception is high- est in zoba Maekel (20 percent) and lowest in zoba Gash-Barka (2 percent). One-fifth of women with some secondary education reported using a method, compared with only 4 percent of women with no education. Source of Family Planning Methods: The sur- vey results show that public facilities remain the major source for modern contraceptive methods in Eritrea, providing family planning methods to nearly three-fourths (74 percent) of current users. Fifteen percent of users get their methods from private medical sources, and 8 percent get their methods from other private sources (mainly shops). As in 1995, three-fourth of pill users and more than 90 percent of users of injectables rely on the public sector. The Family Reproductive Health Association of Eritrea (previously the Planned Parenthood Federation of Eritrea) remains the major source for pills, while government hospi- tals are the predominant source for injectables users. Unmet Need for Family Planning: Currently married women who either do not want any more children or want to wait two or more years before having another child, and are not using contra- ception, are considered to have an unmet need for family planning. The total unmet need for family planning in Eritrea is 27 percent — 21 percent for Summary of Findings | xvii spacing and 6 percent for limiting births. Because unmet need has remained unchanged since 1995, no progress has been made in satisfying women’s need for family planning. Among currently mar- ried women, less than one-fourth of the total de- mand for family planning is being satisfied. CHILD HEALTH AND SURVIVAL Early Childhood Mortality: The 2002 EDHS data indicate that early childhood mortality in Eritrea has declined sharply since 1995. The in- fant mortality rate has declined from 72 per 1000 live births in the 1995 EDHS survey (1991-1995) to 48 in the 2002 EDHS survey (1997-2001). The under-five mortality rate was 136 per 1000 live births in the period 1991-1995, compared with 93 per 1000 for the period 1997-2001. Factors that have contributed to the decline in child mortality are increasing urbanization, major gains in child immunization, improved nutrition and increasing education among women. Marked differentials in early childhood mortality exist in Eritrea. Infant mortality ranges from a low of 37 deaths per 1,000 live births in zoba An- seba to a high of 122 in zoba Debubawi Keih Bahri. Living in rural areas, low maternal educa- tion, and young age of mothers at birth are factors associated with higher infant and childhood mor- tality. Vaccination Coverage: The 2002 EDHS results show that three-fourths of children age 12-23 months are fully vacinated. This represents a sub- stantial increase from the 41 percent fully vacci- nated in 1995. Although urban children are more likely to be fully vaccinated, the urban-rural gap has narrowed. It is encouraging to note that the proportion of fully vaccinated children among uneducated mothers has doubled since 1995. Zoba Anseba (92 percent) has the highest propor- tion of children fully immunized and zoba De- bubawi Keih Bahri has the lowest (60 percent). Childhood Illnesses: The survey provides data on some of the more common childhood illnesses and their treatment. One in five children under five had a cough accompanied by short, rapid breathing—signs of acute respiratory infection (ARI)—in the two weeks before the survey. Of these, 44 percent were taken to a health facility for treatment. Thirteen percent of children under age five were reported to had experienced diar- rhea some time in the two weeks preceding the survey. Overall, more than two-thirds of these children received some type of oral rehydration therapy, i.e., solution prepared from packets of oral rehydration salts (ORS), homemade sugar- salt water solution, or increased fluids. Although almost all mothers who had a birth in the five years preceding the survey reported knowing about ORS packets, only 45 percent of children with diarrhea received ORS. Breastfeeding Practices: The 2002 EDHS data indicate that almost all children under one year of age are breastfed. Despite the universal preva- lence of breastfeeding of newborns in Eritrea, the majority of infants are not fed in compliance with WHO/UNICEF recommendations. Exclusive breastfeeding is common but not universal in early infancy in Eritrea. The prevalence of exclu- sive breastfeeding would be higher except for the early supplementation of breast milk with plain water. Overall, the median duration of any breast- feeding is 22 months; the median duration of ex- clusive breastfeeding is 2.5 months. Patterns of Feeding in Early Childhood: Dur- ing the period when complementary foods should be introduced, at age 6-9 months, only 54 percent of Eritrean infants in this age group received solid or semi-solid foods the day and night pre- ceding the survey and the variety of foods given was limited. These children mainly received foods made from grain and milk, (cheese or yo- gurt), and to a lesser extent received animal prod- ucts (meats, poultry, fish, or eggs), and fruits and vegetables, and infant formula. Micronutrient Supplements: The 2002 EDHS data show that only 38 percent of children age 6- 59 months received a vitamin A supplement in the six months preceding the survey. The survey also measured the iodine content of salt used in the household. The results show that over two- thirds (68 percent) of children under age five live in households that use adequately iodized salt. Nutritional Status of Children: Overall, 38 per- cent of children under age five are chronically xviii | Summary of Findings malnourished or stunted (short for their age), 13 percent are wasted (thin for their height), and 40 percent are underweight (low weight-for-age). Rural children are more than one and a half times as likely to be stunted and wasted as urban chil- dren. Among zobas, malnutrition is more preva- lent in Gash-Barka, Anseba, and Semenawi Keih Bahri than in other zobas. The prevalence of se- vere malnutrition among children in these zobas is also higher than in other zobas. A comparison of children under three years in 1995 and 2002 indicates a slight improvement in the nutritional status. WOMEN’S HEALTH Maternal Health: The 2002 EDHS findings in- dicate that there has been a substantial improve- ment in antenatal care coverage since 1995. Seven in ten women with births in the five years before the survey received antenatal care services for the last birth from a health professional (doc- tor, trained nurse, midwife or auxiliary midwife), compared with only half of mothers in 1995. Forty-one percent of women with a birth in the five years preceding the survey had four or more antenatal care visit, though only 22 percent made the first visit in the first trimester. Half of women who had a live birth in the five years preceding the survey received at least one tetanus toxoid injection during pregnancy for the most recent birth; 32 percent received multivitamin or vita- min C tablets. Four in ten mothers received iron tablets for the last birth in the five years preced- ing the survey but almost all took the tablets for less than 60 days. Delivery under hygienic conditions and where medical assistance is available decreases the risk of maternal morbidity and mortality. Overall, one-fourth of births—compared with 17 percent in 1995—occurred in health facilities, almost all of them public facilities. More than nine in ten women with deliveries outside health facilities do not receive any postnatal checkup. Three percent of births in the five years preceding the survey were delivered by caesarean section (C-section), indicating a slight increase from 1995. A C-section rate below 5 percent is gener- ally thought to be a reflection of limited access to maternal health services and potentially life- saving emergency obstetrical care. Female Genital Cutting: Results from the 2002 EDHS show that knowledge of female circumci- sion is universal among Eritrean women, with almost all respondents (99 percent) having heard of female genital cutting. Nine in ten women (89 percent) reported that they had been circumcised, indicating a slight decline in the proportion of women circumcised in 1995 (95 percent). Among circumcised women, 39 percent had their vaginal area sewn closed (the most severe form of cir- cumcision), 4 percent had some flesh removed, and 46 percent were nicked and no flesh was re- moved. Younger women (age 15-19) are less likely to be circumcised than older women. Sixty- three percent of women with living daughters indicated that at least one daughter was circum- cised. Attitudes of Eritrean women toward female cir- cumcision are evenly divided: the proportion of women who support continuation of the practice is the same as the proportion who want it to be discontinued (49 percent). As expected, women who are not circumcised are more likely to want the practice discontinued (86 percent) than those who are circumcised (44 percent). Seven percent of circumcised women say they have had prob- lems during sexual relations; one in ten reported having problems during delivery and one in twenty-five reported problems during both sexual relations and delivery. Constraints to Use of Health Services: Many different factors can be barriers to women seek- ing health care for themselves. Seventy-two per- cent of women reported at least one issue or cir- cumstance they regarded as a big problem in seeking health care. The major constraints to women’s access to health services are lack of money, distance to health facilities, and having to take transportation. Almost four in ten women mentioned the problem of waiting in line at the health facility as a big problem. Eleven percent of women in Eritrea do not know where to go for health care. Nutritional Status of Women: The 2002 EDHS collected information on the height and weight of Summary of Findings | xix all women age 15-49. Overall, 2 percent of women are shorter than 145 cm, the cutoff point below which a woman is identified as at risk of delivering a baby with low birth weight. The findings also indicate that more than half of women age 15-49 have a body mass index (BMI)—a measure of a woman’s weight relative to her height—in the normal range, and 37 per- cent have a low BMI (less than 18.5), indicating chronic energy deficiency. Rural women and women with no education are more likely to have a low BMI than urban women and women with some education. In addition, 9 percent of Eritrean women are overweight, including 2 percent that are severely overweight or obese. WOMEN’S CHARACTERISTICS AND STATUS Residence and Education: Almost six in ten (57 percent) of the survey respondents live in rural areas. Over half of women age six and over have never been to school. Women’s Migration: More than half of women in Eritrea can be considered migrants because they are not living in the area in which they were born. Women’s Status and Empowerment: Only one in five women is currently working. Two-thirds (65 percent) of these women work for cash. Nearly three-fourths (73 percent) of working women who receive cash earnings report that they are solely responsible for decisions on the use of their earnings. To assess women’s attitudes toward wife beating, women interviewed in the EDHS were asked whether a husband would be justified in beating his wife for specific reasons. Seven in ten women believe that a husband is justified in beating his wife for at least one of the reasons. MALARIA CONTROL PROGRAM INDICATORS Mosquito nets: The use of insecticide-treated mosquito nets has been proven to reduce malaria transmission. The 2002 EDHS found that 34 per- cent of households owned at least one mosquito net. Possession of mosquito nets is more common in rural areas (37 percent) than urban areas (28 percent), but it is most common in small towns (45 percent). Mosquito nets are least prevalent in zoba Maekel, where malaria prevalence is low. Women: Seven percent of all women and preg- nant women slept under a mosquito net the night before the interview; however, only 3 percent used an insecticide-treated net. Use of antimalari- als by pregnant women is low. Only five percent of women who had at least one birth in the five years preceding the survey reported that they re- ceived antimalarial treatment for the last birth. Children: Twelve percent of children under five slept under a mosquito net the night before the interview. However, only 4 percent of children under five slept under an insecticide-treated net. (Note: the survey was conducted in the dry sea- son, when mosquito net use is lower than aver- age). Fever is a major manifestation of malaria in chil- dren. Thirty percent of children under five had a fever in the two weeks preceding the survey. Fe- ver was most prevalent among children age 6-23 months. Among febrile children, only 4 percent were treated with antimalarial medication, mostly chloroquine. HIV/AIDS AND OTHER STIS Knowledge of HIV/AIDS and Prevention Methods: The 2002 EDHS results indicate that awareness of HIV/AIDS is nearly universal among women in Eritrea, with 96 percent of women reporting that they have heard of AIDS. The ways to prevent HIV/AIDS mentioned most frequently by respondents were staying faithful to one partner (72 percent), using condoms (54 per- cent), and abstaining (47 percent). Almost eight in ten women know two or more programmati- cally important ways to avoid getting infected with HIV. Knowledge of ways that HIV can be transmitted is important in preventing the spread of the dis- ease. More than seven in ten women recognize that the HIV virus can be transmitted from mother to child during pregnancy (80 percent), xx | Summary of Findings during delivery (72 percent), and through breast- feeding (70 percent). Three-fourths of women know that a healthy-looking person can have the AIDS virus. Knowledge of Condoms and Use of Condoms: One of the main objectives of the National HIV/ AIDS Control Programme is to encourage consis- tent and correct use of condoms, especially among high-risk groups. The 2002 EDHS data show that 54 percent of women know a source for condoms. However, use of condoms is negligible, with only 2 percent of women having used con- doms during the last sexual intercourse in the past year. Social Aspects of HIV/AIDS Prevention and Mitigation: Discussion of HIV/AIDS with a with spouse or partner is an important first step in pre- vention of HIV/AIDS and the control of the epi- demic. The 2002 EDHS survey results show that only 37 percent of women have had such discus- sions with their partners. One-fourth of women say that they would not be willing to take care of a relative who had HIV/AIDS Knowledge of Signs and Symptoms of Sexually Transmitted Infections (STIs): Sexually trans- mitted infections (STIs) are believed to be impor- tant predisposing factors in HIV/AIDS transmis- sion. Fifty-eight percent of women in Eritrea have no knowledge of STIs other than HIV. Among those who have heard of STIs, one in ten women was unable to mention any symptoms of STIs in a man and a woman. ERITREA xxii | Map of Eritrea DEBUBAWI KEIH BAHRI SEMENAWI KEIH BAHRI ANSEBA GASH-BARKA DEBUB MAEKEL Asmara Ethiopia Djibouti Sudan R E D S E A Saudi Arabia Republic of Yemen Note: This is not the official and political map of Eritrea. Introduction | 1 INTRODUCTION 1 1.1 GEOGRAPHY, HISTORY, AND THE ECONOMY Geography Eritrea is situated in the Horn of Africa and lies north of the equator between latitudes 12o22' N and 18o02' N, and longitudes 36o26'21" E and 43o13' E. It has an area of 122,000 square kilometers. To the east, the country is bordered by the Red Sea, extending about 1,212 kilometers from Ras Kasar in the north to Dar Elwa in the southeast. Djibouti borders Eritrea in the southeast, Ethiopia in the south, and the Sudan in the north and west. Administratively, the country is divided into six zobas (regions): Anseba, Debub, Debubawi Keih Bahri, Gash Barka, Maekel, and Semenawi Keih Bahri (see map). Eritrea is a land of contrasts with land rising from below sea level to 3,000 meters above sea level. There are three major physiographic zones: the Western Lowlands, the Central and Northern Highlands, and the Eastern Lowlands (also referred to as the Coastal Plains). Temperature varies with altitude: the mean annual temperature ranges from 16o-18oC in the Highlands to 28oC in the Lowlands to more than 30oC in the Coastal Plains (Ministry of Land, Water and Environment, 1997). Most of the Western Lowlands and Coastal Plains are associated with hot and dry climatic conditions, while the Highlands are relatively cool. The presence of flat land, relatively fertile soil, and a milder climate makes the Central Highlands a center of rain-fed agricultural activity. Several of the major urban centers of Eritrea, including the capital city, Asmara, are located in the Central Highlands zone. During good rains the Western Lowlands have a potential for cultivation and agro-pastoralism. The Coastal Plains is the location of the two major port towns of Eritrea, Massawa and Assab. In general, the Central Highlands is the most densely populated part of the country, while the Lowlands are sparsely populated. Rainfall in Eritrea ranges from less than 200 mm per annum in the Eastern Lowlands to about 1,000 mm per annum in a small pocket of the Escarpment; the annual rainfall in the Highlands ranges from 450 mm to 600 mm. The southern part of the Western Lowlands receives 600-800 mm per annum, but rainfall decreases substantially as one moves northward. The extremely low rainfall in the Eastern Lowlands causes aridity and a hostile environment for agriculture, grazing, and industry. There are two major periods of precipitation in Eritrea. One, from June to September, covers both the Western Lowlands and the Highlands. The second comes between October and March and covers the Eastern Lowlands. History Because of Eritrea’s strategic position on the Red Sea, it has fallen victim to many invaders and colonizers. The Ottoman Turks controlled the northern and coastal areas from the middle of the sixteenth century to the second half of the nineteenth century, when Egypt evicted them from their last stronghold, Massawa, in 1872. With the opening of the Suez Canal in 1869, the European colonizers became interested in the Red Sea and Horn of Africa. Italy, after establishing a foothold at Assab through a maritime company, Compagnia Maritimma Rubattino, extended its control, and declared Eritrea its first African colony in 1890. In 1941, Italy was defeated by the Allied forces, and Britain took over the administration of Eritrea. In 1952, after 10 years of British colonial rule, Eritrea was federated with Ethiopia by the United Nations against the will of the Eritrean people. A decade later, Ethiopia abrogated the federal arrangement of the United Nations and annexed Eritrea as one of its provinces. This led to the Eritrean struggle for self-determination, which resulted in a destructive war lasting from 1961 to 1991. 2 | Introduction Two years after the end of the war, a United Nations supervised referendum was held to determine Eritrea’s political status; 99.8 percent of the voters chose independence in that referendum. Independence was formally declared in May 1993. Thereafter, Eritrea became a member of the United Nations and many other international and regional organizations. Economy Agriculture and pastoralism are the main sources of livelihood for about 80 percent of Eritrea’s population. The agricultural sector depends mainly on rain, with less than 10 percent of the arable land currently irrigated. Consequently, productivity is low and the agricultural sector, including livestock and fisheries, accounts for only one-fifth of the gross domestic product (GDP). Eritrea is one of the poorest countries in the world, with GDP per capita of about US$ 200, well below the average US$ 270 for less developed countries (UNDP, 2001). The war for liberation destroyed most of Eritrea’s infrastructure and devastated its economy and environment. This compelled Eritrea to reconstruct its social, economic and physical infrastructure entirely. In an effort to place the economy on a path of sustainable development, the government had targeted the period 1998-2000 to complete the transitional phase of rehabilitation and reconstruction. Nonetheless, in May 1998, under the pretext of a border dispute, Ethiopia declared war against Eritrea and occupied some parts of zobas Gash Barka and Debub. As a result of this war, Eritrean villages, towns, bridges, power plants and public and private buildings were destroyed systematically through aerial and artillery bombardment. The impact of the war on the economy of Eritrea is more visible in the destruction of infrastructure, which had been painfully built in the seven years of peace. Although growth in GDP had reached about 7 percent over the period 1994-1997 (University of Asmara, 2000), it fell to about 3 percent in 1999 due to the border conflict. Government development efforts not only concentrated on rebuilding and rehabilitating war- damaged and destroyed economic and social infrastructures, but also on formulating numerous national economic and social development strategies and policies. Among these was the Macro Policy of 1994, which mapped out short-, medium-, and long-term reconstruction and development programs. In the Macro Policy, human capital formation through education and health was identified as the main strategy for long-term national development. Eritrea’s Macro Policy advocated adequate and sustainable economic growth and social development to reduce poverty and create a basis for all of Eritrea’s citizens to provide a better life for themselves and their children. Eritrea has abundant natural resources including arable land (26 percent of the total area) of which only about 4 percent is under cultivation (World Food Programme, 2002). Although surface water is inadequate in Eritrea, there are adequate supplies of ground water, particularly in the Western Lowlands and in some parts of the Coastal Plains, that can be used for both household and industrial purposes. Eritrea is also believed to have varied and extensive mineral resources including copper, gold, iron, nickel, silica, sulfur and potash. Good quality marble and granite also exist in large quantities (Ministry of Land, Water and Environment, 1997). The Red Sea offers opportunities for the fishing industry, for expanding salt extraction industry, tourism, and possibly extraction of oil and gas. At present, most of these natural resources have not been fully exploited. 1.2 POPULATION No population census has ever been carried out in Eritrea. As a result, there are no reliable estimates of the population currently residing in Eritrea or the population of Eritreans living abroad, many of whom are potential returnees. However, based on a population count, the Ministry of Local Government estimated the total population of Eritrea to be about 3.2 million as of 2001. As there is no Introduction | 3 reliable information about population size, the population growth rate is not known with precision. The population is essentially rural with about 80 percent of the people living in the countryside. The urban population is characterized by rapid growth, partly as the result of returning refugees from the neighboring and other countries, and partly due to high rural-urban migration. The population of Eritrea is not uniformly distributed throughout the country. About 50-60 percent of the population lives in the Highlands. The age distribution is typical of high fertility regimes in which a larger proportion of the population is to be found in the younger age groups than in the older age groups. Eritrea is a multi-ethnic society with nine different ethnic groups speaking nine different languages and professing two major religions, namely, Christianity and Islam. Great efforts have been made by the National Statistics and Evaluation Office (NSEO) to collect demographic, health, and socioeconomic information through surveys. The first nationally representative survey conducted by the NSEO was the 1995 Eritrea Demographic and Health Survey (1995 EDHS) (National Statistics Office and Macro International, 1997). The 2002 Eritrea Demographic and Health Survey (2002 EDHS) was carried out by the same office. These surveys provide detailed information on fertility, infant and child mortality, health and nutritional status of women and children, breastfeeding, and contraceptive use, among other topics. 1.3 HEALTH SERVICES AND PROGRAMS The introduction of modern health services into Eritrea is relatively recent. The first hospital was established in Asmara by the Italians at the end of the nineteenth century. In the period prior to federation with Ethiopia, Eritrea had a relatively advanced health care system at least by the standards of the time. However, during the three decades of the war for independence, almost all existing health facilities were destroyed, medical supplies were disrupted, and health professionals abandoned their posts. Since independence, the Ministry of Health (MOH) has made significant progress in ensuring access to health care services through restoration of health facilities damaged during the war, the provision of adequate supplies of drugs and equipment, the expansion of available health services to communities where they are lacking, through the construction of new facilities and the training of qualified health personnel. Health services in Eritrea focus on primary health care (PHC) and are available to everyone. The PHC strategy emphasizes the development of basic health services at the local level to reach more people and to strengthen preventive public health activities including the prevention and control of endemic diseases such as HIV/AIDS, malaria, tuberculosis, and sexually transmitted infections (STIs). The major objectives of the PHC program are to: • Reduce infant and maternal mortality and increase life expectancy through the provision of adequate and equitable maternal and child health services, promotion of adequate nutrition, and control of communicable diseases, • Ensure that health services are available and accessible to all urban and rural communities, • Sensitize the community to common preventable health problems and design appropriate activities through genuine community involvement, • Promote awareness among the relevant offices and the community at large that health problems can only be solved through multi-sectoral cooperation, • Create awareness among the community that responsibility for one’s health rests with the individual, as an integral part of the family, and 4 | Introduction • Move towards self-sufficiency in manpower by training cadres required at all levels (WHO, 2002a). Since effective implementation of PHC depends on approaches that coordinate and make use of various sectors, and not simply health care activities, the MOH has put more emphasis on an integrated program of PHC that incorporates cross-cutting issues. This is because the causes of ill health are related to both health factors and non-health factors. The important cross-cutting issues include community participation, intersectoral collaboration, decentralization of health services, information, education and communication (IEC), monitoring and supervision of programs and capacity-building (mainly research and training). Currently, the MOH is operating 23 hospitals, 52 health centers, and 225 health stations, most of which are government owned (WHO, 2002a). When compared with the data at independence, these figures indicate a significant increase in health services; the number of hospitals grew by about 50 percent, while health stations and health centers grew by more than 100 percent. The substantial growth in the number of health stations and health centers indicates a great effort on the part of MOH to develop and expand basic health care services at the local level, particularly to people living in rural areas. In terms of health manpower, significant improvements have been made in both recruitment and training. For example, between 1995 and 2000, the number of physicians and nurses increased by 60 percent and 107 percent, respectively. Another area of concern to MOH since independence is maternal and child health and family planning (MCH/FP). Before 1992, family planning services were provided at locations where MCH services were delivered. In 1992, the Planned Parenthood Association of Eritrea (PPAE) was established to promote family planning services, particularly among women and youth. About seven years later, the name of the association was changed to Family Reproductive Health Association of Eritrea (FRHAE), to encompass a broader area of activities. The FRHAE has the following objectives (FRHAE, 2000): • To contribute to the advancement of family welfare by establishing health facilities, social services and other delivery systems for the purpose of advising and counseling couples, youth, and interested individuals regarding responsible parenthood, • To assist families to solve problems of infertility and sub-fertility by providing them with appropriate preventive and remedial social and psychological services, • To promote public awareness and understanding about the marriage relationship, sexual life, reproductive health, and related matters through educational programs, and • To conduct research on and compile and disseminate information about child feeding and rearing practices, quality of life, and reproductive and sexual activity. Although significant efforts have been made to improve the health care system since independence, there remain some deficiencies both in coverage and quality. Health care services are still not adequate for the population, a problem common to most African countries. There is, for example, a shortage of skilled medical personnel, medications, and equipment. In 2000, the ratio of population per physician was 13,144, while the ratio of population per nurse was 2,804 (WHO, 2002a). Another problem is the uneven distribution of medical facilities. There is a high concentration of health facilities in urban areas, especially in the capital city, Asmara. Traditional healers are still consulted in Eritrea, especially in the rural areas. In this respect, although the MOH has made efforts to improve the health situation through educational campaigns directed to eradicate harmful traditional practices, such as female circumcision, it Introduction | 5 appears that there are still problems in this area. Also, the health system of Eritrea provides only limited services on reproductive health and family planning. 1.4 OBJECTIVES OF THE SURVEY The major aim of the 2002 EDHS was to provide up-to-date information on: fertility and childhood mortality levels, fertility preferences, awareness and use of family planning methods, use of maternal and child health services, breastfeeding practices, nutritional status of mothers and young children, and awareness and behavior regarding HIV/AIDS and other sexually transmitted infections. It was designed as a follow-on to the 1995 EDHS survey. However, compared with the 1995 survey, the 2002 EDHS is significantly expanded in scope and coverage. More specifically, the 2002 EDHS survey was designed to: • Collect data at the national level that allow the calculation of demographic rates, particularly fertility and childhood mortality rates; • Assess the health status of mothers and children under age five in Eritrea, including nutritional status, use of antenatal and maternity services, treatment of recent episodes of childhood illness, use of immunization services, and malaria prevention activities; • Measure the levels and patterns of knowledge and behavior of women about sexually transmitted infections, HIV/AIDS, and female circumcision; • Provide information on changes in fertility and contraceptive prevalence and the factors that have contributed to these changes, such as marriage patterns, desire for children, availability of contraception, breastfeeding practices, and other important socioeconomic factors; and • Assess gender issues. 1.5 ORGANIZATION OF THE SURVEY The 2002 EDHS survey is a comprehensive survey that involved several agencies. The NSEO, which is a part of the Office of the President, had the major responsibility for conducting this survey. The various departments of the Ministry of Health collaborated with NSEO in all phases of the survey and provided valuable technical help. Financial support for the survey was provided by the U.S. Agency for International Development (USAID) and the Ministry of Health through the Technical Assistance and Support Contract (TASC) with John Snow, Inc. The United Nations Population Fund and the Canadian International Development Agency supported the 2002 EDHS by supplying all the field vehicles. Technical assistance was provided by ORC Macro. 1.6 SAMPLE DESIGN The objectives of the 2002 Eritrea survey are similar to those of the 1995 EDHS survey, with major findings considered at the national level, by urban-rural residence, and by region (the six zobas). The sample for the 2002 EDHS survey is a nationally representative sample of households and is self-weighted in each of the six zobas but not proportionally distributed among the zobas. The sample was designed using information provided by the Ministry of Local Government on the total number of households in various administrative units, mainly villages (in rural areas) and towns (in urban areas). It is a two-stage cluster design in rural areas and a three-stage cluster design in urban areas. 6 | Introduction A national sample of 368 clusters was selected, with 249 in rural areas and 119 in urban areas. A complete household listing operation was carried out in all the selected clusters to provide a frame for the final systematic selection of households. Twenty-five households were selected from each cluster in urban and rural areas in all zobas except one. In zoba Debubawi Keih Bahri, 40 households were selected in each cluster because this zoba contains less than 4 percent of the national population, and has transportation problems, so it was decided to select fewer, larger clusters in this zoba. Around 9,800 households were selected from the 368 clusters to provide an expected sample of 8,500 eligible women. A detailed sample design description is presented in Appendix A. 1.7 QUESTIONNAIRES Two kinds of questionnaires were used in the 2002 EDHS survey: the Household Questionnaire and the Women’s Questionnaire. The contents of the questionnaires were based on the MEASURE DHS+ Model “B”, which was developed for countries with low levels of contraceptive use. The NSEO held several meetings with experts and professionals from partner ministries, most importantly the Ministry of Health, to discuss the questionnaires. The MOH, the Ministry of Education, the Ministry of Labor and Human Welfare, and other concerned institutions in Eritrea actively participated in reviewing and modifying the questionnaires to address Eritrean concerns. Both questionnaires, which were originally prepared in English, were translated into and printed in seven local languages: Tigrigna, Tigre, Bilen, Saho, Afar, Kunama, and Nara. A pretest of the questionnaires was conducted in December 2002. The Household Questionnaire was used to list all of the usual members and visitors who spent the night before the interview in the selected households. Basic background information on each listed person was collected, including age, sex, marital status, educational level attained, occupation, and relationship to the head of the household. The information on age was used to identify women eligible for the individual interview and children less than five years of age whose height and weight would be measured. The Household Questionnaire also obtained information on selected socioeconomic indicators such as number of rooms in the dwelling, type of floor material, source of drinking water, type of toilet facilities, and ownership of various durable goods. Information on the household’s possession of mosquito nets was collected, and a test was conducted by interviewers to assess whether the household used cooking salt fortified with iodine. The Women’s Questionnaire was used to collect information from all women age 15-49. Respondents were asked questions on the following topics: background characteristics; reproductive history; contraceptive knowledge and use; antenatal, delivery and postnatal care; infant feeding practices; child immunization, health and nutrition; marriage and sexual activity; and fertility preferences. In addition, respondents were asked questions about their husband’s background characteristics. Data on female circumcision and on knowledge, attitudes and behavior related to HIV/AIDS and other sexually transmitted infections were collected. Training and Fieldwork Training of the field staff, namely interviewers, supervisors and field editors for the main survey was conducted over a three-week period from February to March 2002. The training was conducted following the standard DHS training procedures, including class presentations, mock interviews, field practice and tests. There was a detailed review of items on the questionnaires and interviewer instructions, and the trainees practiced weighing and measuring women and children. The trainers included NSEO staff, guest lecturers from various departments of the Ministry of Health and the ORC Macro country manager. Introduction | 7 A total of 123 female field staff were trained, of which 98 with good performance were selected to form 14 teams for the fieldwork. The remaining 25 trainees were assigned as data processing staff. Following the training, the fieldwork for the survey was conducted from the last week of March to the first week of July 2002. 1.9 DATA PROCESSING All completed questionnaires for the EDHS survey were brought to the NSEO in Asmara for data processing, which consisted of office editing, coding of open-ended questions, data entry, and secondary editing. A team of 14 data entry clerks, one questionnaire administrator, 14 office editors, two data entry supervisors, six secondary editors, and two data processing experts from ORC Macro were involved in the data processing. Data entry and editing were completed between April 16 and July 26, 2002. 1.10 COVERAGE AND RESPONSE RATES Table 1.1 presents the results of household and individual interviews and response rates for Eritrea as a whole and by urban-rural residence. A total of 9,824 households were selected in the sample, of which 9,512 households were occupied. Of the total occupied households, 9,389 were interviewed successfully, giving a household response rate of 99 percent. In general, response rates for households were not influenced by urban-rural residence. As Table 1.2 indicates, the major reason for not completing household interviews was that no competent respondent was found at home1 (1 percent). Table 1.1 Results of the household and individual interviews and response rates Number of households and interviews and response rates, according to residence, Eritrea 2002 —————————————————————————————————————————————— Urban ———————————————— Result Asmara Other towns Total Rural Total —————————————————————————————————————————————— Household interviews Households selected 1,076 2,169 3,245 6,579 9,824 Households occupied 1,043 2,134 3,177 6,335 9,512 Households interviewed 1,023 2,104 3,127 6,262 9,389 Household response rate 98.1 98.6 98.4 98.8 98.7 Individual interviews Number of eligible women 1,205 2,138 3,343 5,753 9,096 Number of eligible women interviewed 1,123 2,057 3,180 5,574 8,754 Eligible woman response rate 93.2 96.2 95.1 96.9 96.2 From the interviewed households, 9,096 women eligible were identified for the individual interview, of whom 8,754 were successfully interviewed. The women’s response rate for the 2002 EDHS was 96 percent (Table 1.1). Nonresponse among women was mainly due to the absence of women at home at the time of interview, despite repeated visits to the household. The women’s response rate is higher in rural areas than in urban areas (Table 1.2). Details of the fieldwork and sample design are presented in Appendix A. 1An absent household is considered not occupied. 8 | Introduction Table 1.2 Sample implementation Percent distribution of households and eligible women by results of the household and individual interviews, and household and eligible women response rates, according to residence, Eritrea 2002 —————————————————————————————————————————————— Urban ———————————————— Result Asmara Other towns Total Rural Total —————————————————————————————————————————————— Selected households Completed 95.1 97.0 96.4 95.2 95.6 Household present but no competent respondent at home 1.7 1.3 1.4 1.1 1.2 Refused 0.2 0.1 0.1 0.0 0.0 Household absent 2.0 1.2 1.5 3.1 2.6 Dwelling vacant/address not a dwelling 0.9 0.3 0.5 0.4 0.4 Dwelling destroyed 0.1 0.1 0.1 0.2 0.1 Total 100.0 100.0 100.0 100.0 100.0 Number of sampled households 1,076 2,169 3,245 6,579 9,824 Household response rate 98.1 98.6 98.4 98.8 98.7 Eligible women Completed 93.2 96.2 95.1 96.9 96.2 Not at home 3.9 2.3 2.9 1.8 2.2 Postponed 0.2 0.0 0.1 0.1 0.1 Refused 0.4 0.4 0.4 0.1 0.2 Partly completed 0.1 0.1 0.1 0.1 0.1 Incapacitated 0.8 0.7 0.7 1.0 0.9 Other 1.4 0.1 0.6 0.1 0.3 Total 100.0 100.0 100.0 100.0 100.0 Number of women 1,205 2,138 3,343 5,753 9,096 Eligible woman response rate 93.2 96.2 95.1 96.9 96.2 Characteristics of Households and Household Members | 9 CHARACTERISTICS OF HOUSEHOLDS AND HOUSEHOLD MEMBERS 2 The purpose of this chapter is to provide a descriptive summary of some socioeconomic and demographic characteristics of the population in sampled households. These characteristics include age, sex, place of residence, educational status, marital status, household economic status (the wealth index), and children’s living arrangements. The chapter also discusses household facilities and housing characteristics such as source of drinking water, electricity, sanitation facilities, flooring materials, and ownership of household durable goods. Information on the characteristics of the surveyed population is essential because it provides a more complete picture of the household population and gives a wider perspective for interpreting the survey findings in subsequent chapters. For the purpose of the 2002 EDHS survey, a household is defined as a person or a group of related or unrelated persons who usually live in the same dwelling unit and who have common cooking and eating arrangements. A member of the household is any person who usually lives in the household and a visitor is someone who is not a member of the household, but who stayed in the household the night preceding the interview. The Household Questionnaire in the survey collected information from all usual residents of the selected household (de jure population) and visitors who stayed in the selected household the night before the interview. The de facto population includes all persons who stayed in the household the night before the interview. The inclusion of both populations in the household survey allows the analysis of either the de jure or the de facto population. 2.1 HOUSEHOLD POPULATION BY AGE, RESIDENCE, AND SEX The percent distribution of the de facto household population in the 2002 EDHS is shown in Table 2.1 by five-year age groups, according to sex and residence. Of the total household population sampled, 62 percent were living in rural areas and 38 percent in urban areas. Forty-five percent of the household population were males and 55 percent were females. The proportion of males in the sampled households is slightly lower than in 1995. Overall, the age distribution in Table 2.1 shows the expected pattern. The proportion in each five-year age group generally decreases with increasing age. An important exception is the age group 0-4 years, in which the proportions are lower than the next age group (i.e., 5- 9). The lower proportions at age 0-4 years are partly due to a recent decline in fertility (see Chapter 3). Figure 2.1 shows the age-sex structure of the household population more clearly in a population pyramid. The pyramid is broad at the base with the next adjacent bar slightly wider. This is a pattern of a youthful population with high but recently declining fertility. The distribution of the male and female household population by single year of age is presented in Figure 2.2. The figure shows noticeable heaping at ages ending with 0 and 5 for both sexes. Ages ending with 1 and 9 are underreported. 10 | Characteristics of Households and Household Members Table 2.1 Household population by age, residence and sex Percent distribution of the de facto household population by five-year age group, according to sex and residence, Eritrea 2002 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Urban Rural Total ––––––––––––––––––––– –––––––––––––––––––– ––––––––––––––––––––– Age Male Female Total Male Female Total Male Female Total –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– <5 14.8 11.8 13.1 18.2 14.5 16.2 17.0 13.4 15.0 5-9 17.5 12.5 14.7 20.4 17.4 18.7 19.3 15.5 17.2 10-14 15.7 13.6 14.5 17.7 14.7 16.0 16.9 14.2 15.5 15-19 13.7 11.7 12.6 10.4 8.6 9.5 11.6 9.8 10.6 20-24 4.8 7.9 6.5 3.8 6.4 5.2 4.2 7.0 5.7 25-29 4.3 8.9 6.9 2.2 6.5 4.5 3.0 7.5 5.4 30-34 3.7 5.3 4.6 2.3 5.1 3.8 2.8 5.2 4.1 35-39 2.8 5.7 4.5 2.2 4.7 3.5 2.4 5.1 3.9 40-44 3.2 3.7 3.5 2.9 4.0 3.5 3.0 3.9 3.5 45-49 3.2 3.3 3.3 2.3 3.6 3.0 2.6 3.5 3.1 50-54 3.6 4.3 4.0 3.6 3.0 3.3 3.6 3.5 3.5 55-59 2.7 3.0 2.9 2.7 2.8 2.7 2.7 2.8 2.8 60-64 3.4 2.9 3.1 3.4 3.3 3.3 3.4 3.2 3.3 65-69 2.3 1.7 2.0 2.3 1.8 2.1 2.3 1.8 2.0 70-74 1.7 1.7 1.7 2.4 1.9 2.1 2.1 1.8 2.0 75-79 1.3 0.8 1.0 1.3 0.6 0.9 1.3 0.7 1.0 80 + 1.2 1.2 1.2 1.9 1.1 1.4 1.6 1.1 1.4 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number 6,504 8,423 14,929 11,362 13,281 24,644 17,865 21,703 39,573 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Totals include a small number of people with age or sex not known. EDHS 2002 Figure 2.1 Population Pyramid 85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 Age 0 2 4 6 8 10-2-4-6-8-10 Percent Male Female Characteristics of Households and Household Members | 11 EDHS 2002 Figure 2.2 Distribution of the De Facto Household Population by Single Year of Age and Sex 0 20 40 60 80 100 Age 0 1 2 3 4 5 Pe rc e n t Male Female 2.2 HOUSEHOLD COMPOSITION Table 2.2 presents the distribution of de jure households in the 2002 EDHS sample by sex of head of household and by number of household members. These characteristics are important because they are often associated with socioeconomic differences between households. In addition, the size and composition of households affect the allocation of financial and other resources among household members, which in turn influences the well-being of these individuals. Household size is related to crowding, which can lead to unfavorable health conditions. Since 1995, the proportion of households in Eritrea headed by females has increased. Slightly more than half (53 percent) of household heads are males, indicating a substantial decrease since 1995 (69 percent). The proportion of female-headed households is higher in urban areas (52 percent) than in rural areas (43 percent). All zobas except zoba Debub, have predominantly male-headed households. Forty-three percent of households have 2-4 members. Large households (9 or more members) account for 8 percent of all households and single-person households account for 7 percent. The proportion of single- person households is higher in urban areas (9 percent) than in rural areas (6 percent). Large households are most common in rural areas. The average household size is 4.8 persons, which is larger than the household size observed in both urban areas and rural areas in 1995 (4.4). Since 1995, the mean household size has increased more in rural areas (4.9) than in urban areas (4.7). In the 2002 EDHS, information was collected on the displacement status of household members due to the recent war between Eritrea and Ethiopia. Respondents to the Household Questionnaire were asked whether there were any members in the household who had been displaced from their usual place of residence due to the recent war. According to Table 2.2, 7 percent of households have at least one displaced person—11 percent of urban households and 4 percent of rural households. By zoba, the proportion of households with displaced persons is higher in zobas Maekel (11 percent) and Gash-Barka (8 percent) than in other zobas. The average number of displaced persons (in households with displaced persons) is 3.5. Zoba Gash-Barka has the highest mean number of displaced persons (4.6). 12 | Characteristics of Households and Household Members Table 2.2 Household composition according to residence and zoba Percent distribution of households by sex of head of household and household size, and percentage of households with displaced persons, according to residence and zoba, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Zoba ––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Debubawi Semenawi –––––––––––– Keih Keih Gash- Characteristic Urban Rural Bahri Maekel Bahri Anseba Barka Debub Total ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Sex of head of household Male 47.8 56.8 54.5 50.6 61.6 59.8 59.3 45.1 53.3 Female 52.2 43.2 45.5 49.4 38.4 40.2 40.7 54.9 46.7 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of usual members 1 8.8 6.2 9.2 8.8 6.0 4.8 6.8 7.6 7.2 2 11.9 12.3 17.1 12.3 13.3 10.2 13.8 10.8 12.2 3 14.8 15.1 18.4 13.2 15.4 14.5 17.8 14.1 15.0 4 16.9 15.1 16.1 16.3 15.8 16.0 15.1 15.6 15.8 5 13.7 13.3 13.8 11.7 15.2 12.8 14.4 13.6 13.4 6 11.9 12.9 10.8 11.9 12.7 13.3 11.8 13.3 12.5 7 8.6 9.8 6.4 9.7 9.6 9.8 8.5 9.8 9.4 8 5.8 6.8 4.4 6.5 5.7 8.9 5.8 6.3 6.4 9+ 7.6 8.5 3.7 9.7 6.3 9.8 6.0 9.0 8.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Mean size 4.7 4.9 4.1 4.9 4.7 5.1 4.6 4.9 4.8 Percentage of households with displaced persons 10.6 4.0 3.4 10.9 0.9 1.2 8.1 7.4 6.6 Number of households 3,634 5,755 328 2,122 1,195 1,181 1,800 2,763 9,389 Mean number of displaced persons per household1 3.4 3.5 2.6 3.2 * * 4.6 3.1 3.5 Number of households with displaced persons 384 225 11 227 10 15 144 203 610 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Based on households with displaced persons 2.3 FOSTERHOOD AND ORPHANHOOD Foster children are children under 15 years of age who are not living with either of their biological parents. Orphaned children are children under 15 years of age who have lost one or both of their biological parents. To measure the prevalence of child fostering and orphanhood, four questions were asked in the Household Questionnaire on the survival status and residence of the parents of children under 15 years of age. Information on children’s living arrangements and orphanhood is presented in Table 2.3. In Eritrea, 76 percent of children under age 15 live with both parents. The proportion of children living with both parents decreases with increasing age. Rural children are more likely to live with both parents than urban children. By residence, the percentage of children who live with both parents is lowest in Asmara and, among zobas, in zoba Maekel. Eighteen percent of children live with only one parent— Characteristics of Households and Household Members | 13 15 percent with their mothers and 3 percent with their fathers. Seven percent of children live with only one parent because the other parent is dead. The proportion of children living with their father only because their mother is dead is higher in zoba Gash-Barka than in other zobas. Foster children—children not living with either parent—account for 6 percent of children under age 15 and orphaned children— children who have lost one or both parents—account for 10 percent. Among children age 10-14, one in six is an orphan. A comparison of the last two rows in Table 2.3 shows that the proportion of children under 15 years who live with both of their parents has increased from 72 percent in 1995 to 76 percent in 2002. The proportion who live with their mothers only declined from 18 to 15 percent, and those who live with their fathers only decreased from 4 to 3 percent. The proportion of orphaned children decreased from 12 percent to 10 percent. Table 2.3 Children’s living arrangements and orphanhood Percent distribution of de jure children under age 15 by children’s living arrangements and survival status of parents, according to background characteristics, Eritrea 2002 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Living Living with mother with father Not living with but not father but not mother either parent Missing Living –––––––––––––– ––––––––––––––– ––––––––––––––––––––––––– informa- with Only Only tion on Number Background both Father Father Mother Mother Both father mother Both father/ of characteristic parents alive dead alive dead alive alive alive dead mother Total children –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age <2 84.9 13.4 0.8 0.0 0.1 0.4 0.1 0.0 0.0 0.3 100.0 2,274 2-4 82.7 11.8 1.9 0.2 0.6 1.3 0.9 0.1 0.1 0.4 100.0 3,790 5-9 77.3 9.9 4.0 0.8 1.9 3.0 1.6 0.4 0.7 0.5 100.0 7,026 10-14 67.3 8.4 10.2 1.2 3.0 4.2 1.8 1.5 1.6 0.9 100.0 6,343 Sex Male 76.7 10.3 5.0 0.7 1.8 2.5 1.2 0.5 0.8 0.5 100.0 9,849 Female 75.2 10.1 5.4 0.7 1.8 3.0 1.5 0.7 0.8 0.7 100.0 9,582 Residence Total urban 67.6 16.1 6.2 1.2 1.3 3.5 1.2 1.1 1.0 0.9 100.0 6,462 Asmara 63.9 16.7 7.9 1.2 1.8 3.3 1.2 1.5 1.0 1.5 100.0 2,594 Other towns 70.1 15.6 5.0 1.2 1.0 3.7 1.2 0.8 1.0 0.4 100.0 3,868 Rural 80.1 7.3 4.8 0.5 2.1 2.4 1.4 0.4 0.6 0.5 100.0 12,970 Zoba Debubawi Keih Bahri 71.3 11.7 7.1 1.1 1.8 3.5 1.2 0.9 1.0 0.5 100.0 550 Maekel 69.1 13.5 7.2 1.1 1.4 3.3 1.0 1.2 0.8 1.4 100.0 3,654 Semenawi Keih Bahri 78.4 9.4 5.0 0.6 1.9 1.5 1.7 0.5 0.6 0.3 100.0 2,527 Anseba 82.4 6.2 3.2 0.5 2.3 2.7 1.5 0.5 0.6 0.1 100.0 2,836 Gash-Barka 77.1 8.0 5.9 0.5 2.8 1.9 2.3 0.2 1.0 0.2 100.0 3,626 Debub 75.8 11.5 4.5 0.8 1.2 3.4 0.9 0.6 0.7 0.6 100.0 6,241 Total 2002 76.0 10.2 5.2 0.7 1.8 2.8 1.4 0.6 0.8 0.6 100.0 19,433 Total 1995 71.8 11.8 6.4 1.0 2.7 2.8 1.1 0.8 0.7 0.9 100.0 11,269 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Total includes two children with missing information on sex. 14 | Characteristics of Households and Household Members 2.4 EDUCATION LEVELS OF THE HOUSEHOLD POPULATION Education is a key determinant of the lifestyle and status an individual enjoys in society. It affects many aspects of life, including health, employment, marriage, and demographic behaviors. Studies have consistently shown that education has a strong effect on reproductive behavior, fertility, childhood mortality, morbidity, and contraceptive use, as well as attitudes and awareness related to family health and hygiene. Educational Attainment of the Household Population In the 2002 EDHS survey, information on educational attainment was collected for every member of the household age six years and above. Primary education in Eritrea starts at 7 years of age and continues until age 11; it is followed by two years for middle school, and an additional four years for secondary education. Table 2.4 shows the distribution of the de facto male and female household populations age six years and over by educational level, according to age, residence, and zoba. Educational attainment at each age is higher for males than for females. Fifty-two percent of female household members have never attended school, compared with 39 percent of males. However, among the population with any schooling, about one-fourth of males as well females have completed at least primary school. The median number of years of schooling is 0.7 for males and 0.0 for females because the majority of women have never attended school. Rapid increases in educational attainment for both sexes can be seen from the declining proportion without any formal education in successively younger age groups. For example, the proportion of women with no education decreases from 95 percent at age 65 and above to 21 percent at age 10-14. The higher proportions uneducated among those age 6-9 years for both sexes (51 percent and 54 percent for boys and girls, respectively) is mostly due to the inclusion of children age six in the age group; those children have not yet attended school. Officially, the minimum age for attending school in Eritrea is 7 years. There have been marked improvements since the 1995 EDHS in educational attainment among both males and females, but the differentials in 2002 show the same patterns by zoba, residence, and sex as in the past. For example, in 1995, the proportions of boys and girls age 10-14 who had never attended school were 32 percent and 40 percent, respectively, compared with 15 percent and 21 percent, respectively, in 2002. Urban areas have a wide lead over rural areas in level of education attained. For example, 82 percent of males and 70 percent of females in urban areas have some education, compared with less than half of males (48 percent) and one-third of females in rural areas. Asmara, the most urbanized area in the country, has the highest proportion of males and females with some education (88 percent and 77 percent, respectively). The median number of years of schooling for urban males and urban females is 4.1 and 2.6, respectively, and 0.0 for both males and females in rural areas. By residence, the difference in the median number of years of schooling between males and females is highest in other towns (the median is 2.8 years for males and 1.1 years for females). Educational attainment varies widely among zobas. The proportion of males and females with some education is lowest in zoba Gash-Barka (38 and 26 percent, respectively) and highest in zoba Maekel (86 and 76 percent, respectively). The median number of years of schooling for males is 4.7 years in zoba Maekel, much lower in zobas Debubawi Keih Bahri and Debub, and 0.0 in all other zobas. The median number of years for schooling is one year lower for females (3.7 years) than for males in zoba Maekel, and is 0.0 for females in all other zobas. To determine the literacy level in the country, for each person age six and above, the question was asked if the person could read and write in any language without difficulty. More than half Characteristics of Households and Household Members | 15 Table 2.4 Educational attainment of the household population Percent distribution of the de facto household populations age six and over by highest level of education attended or completed, median number of years of schooling, and percentage literate, by sex, according to background characteristics, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Highest level of schooling attended or completed Median ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– number More of years Some than Don’t of Percent- Background No Some Completed second- Completed second- know/ school- age characteristic education primary primary1 ary secondary2 ary missing Total Number ing literate ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– MALE ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 6-9 50.8 47.7 0.0 0.0 0.0 0.0 1.5 100.0 2,940 0.0 31.5 10-14 14.7 80.6 1.1 3.4 0.0 0.1 0.1 100.0 3,024 2.0 79.5 15-19 12.3 47.4 3.2 33.7 1.9 1.4 0.1 100.0 2,072 5.3 86.7 20-24 20.1 27.1 3.8 30.2 9.5 8.5 0.7 100.0 751 6.3 81.4 25-29 19.7 25.1 1.5 21.0 19.7 12.3 0.7 100.0 528 7.0 81.4 30-34 37.8 21.0 2.9 11.6 17.5 8.4 0.8 100.0 503 3.9 67.1 35-39 47.0 22.3 3.0 10.5 10.8 6.2 0.2 100.0 430 1.6 60.8 40-44 54.5 20.6 1.9 7.3 7.6 7.1 1.0 100.0 536 0.0 54.7 45-49 49.6 25.3 3.0 7.6 7.2 6.6 0.7 100.0 473 0.0 59.6 50-54 58.8 20.3 2.2 6.9 4.8 5.6 1.4 100.0 648 0.0 49.6 55-59 63.1 19.5 1.3 5.5 4.2 5.3 1.0 100.0 480 0.0 46.3 60-64 74.2 15.8 1.5 2.2 3.1 1.7 1.6 100.0 605 0.0 34.5 65+ 82.4 12.9 0.3 1.1 0.8 0.7 1.7 100.0 1,319 0.0 31.4 Residence Total urban 18.2 45.4 2.8 18.0 8.1 6.3 1.3 100.0 5,370 4.1 80.7 Asmara 10.4 42.2 2.6 18.9 12.3 11.5 2.1 100.0 2,420 5.5 88.9 Other towns 24.6 48.1 2.9 17.2 4.6 2.0 0.6 100.0 2,950 2.8 73.9 Rural 51.6 40.7 0.8 5.0 0.8 0.5 0.6 100.0 8,951 0.0 46.7 Zoba Debubawi Keih Bahri 37.6 37.8 2.8 9.8 8.4 2.5 1.0 100.0 410 1.7 60.0 Maekel 13.8 45.3 2.4 18.0 9.6 9.0 2.0 100.0 3,186 4.7 85.0 Semenawi Keih Bahri 52.7 37.6 2.2 4.7 1.4 0.8 0.7 100.0 1,893 0.0 48.1 Anseba 45.7 44.2 1.3 5.6 2.5 0.4 0.4 100.0 2,028 0.0 52.3 Gash-Barka 61.7 30.4 1.2 4.7 0.8 0.6 0.5 100.0 2,700 0.0 37.5 Debub 34.4 50.1 0.8 11.6 1.6 1.0 0.4 100.0 4,105 0.7 62.8 Total 39.1 42.5 1.6 9.9 3.5 2.7 0.8 100.0 14,321 0.7 59.4 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– FEMALE ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 6-9 53.8 44.6 0.1 0.0 0.0 0.0 1.5 100.0 2,825 0.0 28.7 10-14 21.3 74.0 1.1 3.5 0.0 0.0 0.2 100.0 3,092 1.9 73.4 15-19 21.5 47.2 2.7 24.4 3.0 1.0 0.1 100.0 2,136 4.6 77.1 20-24 41.5 27.9 3.0 16.4 8.8 2.1 0.2 100.0 1,515 2.1 57.9 25-29 46.4 26.3 1.8 12.9 9.7 2.7 0.2 100.0 1,618 1.2 53.5 30-34 65.7 19.1 0.9 5.4 7.4 1.2 0.4 100.0 1,130 0.0 35.6 35-39 65.5 20.4 1.2 4.8 6.3 1.7 0.1 100.0 1,105 0.0 34.4 40-44 72.8 15.7 1.1 3.7 3.8 2.7 0.3 100.0 845 0.0 27.0 45-49 79.5 14.9 1.4 1.5 1.7 0.5 0.5 100.0 753 0.0 20.5 50-54 78.7 12.7 0.5 1.6 1.2 1.3 4.0 100.0 750 0.0 19.6 55-59 85.4 10.0 0.0 1.7 0.5 0.4 2.0 100.0 616 0.0 12.1 60-64 91.0 4.7 0.2 0.9 0.0 0.3 2.9 100.0 684 0.0 5.9 65+ 95.0 2.1 0.3 0.2 0.2 0.0 2.3 100.0 1,178 0.0 3.3 Residence Total urban 30.2 41.8 2.3 14.7 7.3 2.3 1.4 100.0 7,259 2.6 65.6 Asmara 20.6 38.3 2.7 20.7 11.7 3.6 2.3 100.0 3,525 4.7 75.3 Other towns 39.2 45.1 1.9 9.0 3.2 1.0 0.6 100.0 3,734 1.1 56.4 Rural 67.0 29.8 0.5 1.9 0.3 0.0 0.5 100.0 10,994 0.0 28.9 Zoba Debubawi Keih Bahri 54.8 28.9 2.5 8.3 4.1 0.4 1.0 100.0 567 0.0 41.6 Maekel 23.9 41.0 2.5 18.1 9.3 2.9 2.3 100.0 4,506 3.7 72.0 Semenawi Keih Bahri 69.2 26.4 1.0 1.9 1.1 0.1 0.3 100.0 2,216 0.0 28.0 Anseba 60.2 34.2 0.7 3.5 1.0 0.0 0.5 100.0 2,368 0.0 36.6 Gash-Barka 74.2 23.1 0.6 1.5 0.4 0.1 0.1 100.0 3,179 0.0 22.0 Debub 52.7 40.0 0.7 4.5 1.1 0.6 0.5 100.0 5,417 0.0 41.9 Total 52.4 34.5 1.2 7.0 3.1 0.9 0.9 100.0 18,253 0.0 43.5 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Total includes 8 females and 13 males with missing information on age, who are not shown separately. 1 Completed 5 grade at the primary level 2 Completed 11 grades at the secondary level 16 | Characteristics of Households and Household Members (51 percent) of the population are literate. There is a significant difference in the literacy level by sex. Overall, 59 percent of males and 44 percent of females are literate. There are marked differentials in the literacy level by residence. Eight in ten males and almost two-thirds of females in urban areas are literate, compared with less than half (47 percent) of males and less than one-third (29 percent) of females in rural areas. School Attendance Ratios Information on the net attendance ratio (NAR), gross attendance ratio (GAR), and gender parity index (GPI) by school level, according to sex, residence, zoba, and wealth index is shown in Tables 2.5.1- 2.5.3. The NAR indicates participation in primary schooling for the population age 7-11, in middle schooling for the population age 12-13, and in secondary schooling for the population age 14-17. The GAR measures participation at each level of schooling among population age 6-24. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100 percent. The GPI at a given school level is defined as the ratio of the GAR for females to the GAR for males, and indicates the magnitude of the gender gap in attendance ratios. If there is no gender difference, the GPI will be equal to 1, whereas the wider the disparity in favor of males, the closer the gap will be to zero. If the gender gap favors females, the GPI exceeds 1. Table 2.5.1 Primary school attendance ratios Primary school net attendance ratios (NAR), gross attendance ratios (GAR), and the gender parity index for the de jure household population age 7-11, by sex, according to background characteristics, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Net attendance ratio 1 Gross attendance ratio 2 Gender Background –––––––––––––––––––––––––– ––––––––––––––––––––––––– parity characteristic Male Female Total Male Female Total index 3 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Total urban 79.4 80.6 80.0 112.3 121.4 116.6 1.08 Asmara 86.9 89.3 88.1 114.7 119.2 116.9 1.04 Other towns 75.1 75.0 75.1 110.9 122.9 116.5 1.11 Rural 54.7 49.7 52.3 103.0 82.3 92.9 0.80 Zoba Debubawi Keih Bahri 57.2 47.7 52.7 84.0 71.0 77.9 0.84 Maekel 85.4 89.6 87.5 117.8 121.5 119.7 1.03 Semenawi Keih Bahri 46.7 38.3 42.7 89.2 69.2 79.6 0.78 Anseba 57.2 49.3 53.3 111.9 85.7 98.8 0.77 Gash-Barka 42.7 37.8 40.4 84.7 70.9 78.1 0.84 Debub 72.4 69.8 71.1 118.9 110.3 114.8 0.93 Wealth index Lowest 43.6 33.8 39.0 93.6 63.9 79.4 0.68 Second 52.8 46.6 49.8 96.4 79.7 88.4 0.83 Middle 64.1 64.9 64.5 114.3 104.9 109.6 0.92 Fourth 81.9 81.6 81.7 120.9 120.2 120.6 0.99 Highest 85.3 86.4 85.8 113.5 121.3 117.0 1.07 Total 62.8 59.4 61.2 106.1 94.6 100.5 0.89 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Percentage of the primary-school-age (7-11 years) population that is attending primary school 2 Total number of primary school students, expressed as a percentage of the official primary-school-age population. 3 The gender parity index for primary school is the ratio of the primary school GAR for females to the GAR for males. Characteristics of Households and Household Members | 17 Table 2.5.2 Middle school attendance ratios Middle school net attendance ratios (NAR), gross attendance ratios (GAR), and the gender parity index for the de jure household population age 12-13, by sex, according to background characteristics, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Net attendance ratio1 Gross attendance ratio 2 Gender Background –––––––––––––––––––––––––– ––––––––––––––––––––––––– parity characteristic Male Female Total Male Female Total index 3 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Total urban 40.0 38.1 39.0 116.2 106.6 111.0 0.92 Asmara 49.6 54.7 52.3 121.1 133.6 127.7 1.10 Other towns 33.1 27.1 29.8 112.7 88.8 99.5 0.79 Rural 13.6 9.1 11.2 58.9 34.0 45.9 0.58 Zoba Debubawi Keih Bahri 31.8 28.1 29.8 76.3 63.7 69.5 0.84 Maekel 48.4 49.0 48.7 115.9 121.5 118.8 1.05 Semenawi Keih Bahri 14.3 10.7 12.3 92.4 29.9 57.0 0.32 Anseba 15.2 12.0 13.5 64.7 42.5 53.2 0.66 Gash-Barka 6.4 1.9 4.0 35.6 17.6 25.9 0.50 Debub 20.6 17.4 19.0 79.6 67.2 73.2 0.84 Wealth index Lowest 4.6 4.2 4.4 38.6 18.5 27.6 0.48 Second 9.4 5.5 7.4 59.4 30.5 44.3 0.51 Middle 19.8 12.2 15.8 83.4 42.3 61.6 0.51 Fourth 34.3 32.1 33.2 95.0 106.9 101.2 1.12 Highest 51.5 52.2 51.9 129.0 124.4 126.6 0.96 Total 22.7 19.6 21.1 78.6 60.4 68.9 0.77 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Percentage of the middle-school-age (12-13 years) population that is attending middle school 2 Total number of middle school students, expressed as a percentage of the official middle-school-age population. 3 The gender parity index for middle school is the ratio of the middle school GAR for females to the GAR for males. Table 2.5.1 shows that more than six in ten (61 percent) primary-school-age children are currently attending primary school. Only one in five (21 percent) middle-school-age children is attending middle school (Table 2.5.2), while one in four (23 percent) secondary-school-age youths is attending secondary school (Table 2.5.3). The NAR is slightly higher among males than among females at each level. Attendance ratios are much lower in rural areas than in urban areas at all three levels of schooling. Regarding variations by zoba, the NAR in zoba Maekel is the same for boys and girls at the middle-school level and the secondary-school level, but higher for girls than for boys at the primary- school level. In the other zobas, it is consistently higher for boys than for girls at each level. Net attendance ratios are lowest in zoba Gash-Barka and highest in zoba Maekel, followed by zoba Debub. There is a positive correlation between the wealth index1 and attendance ratios for both sexes at each school level. The GAR has a pattern similar to that of the NAR. The GAR is higher among males than females, at 106 and 95, respectively, at the primary level; 79 and 60, respectively, at the middle-school level; and 1 The wealth index used in this analysis is discussed on page 19. 18 | Characteristics of Households and Household Members 50 and 35, respectively, at the secondary-school level. The GPI for these levels is 0.89, 0.77, and 0.71, respectively, indicating that the deficit of females increases with level of education. Table 2.5.3 Secondary school attendance ratios Secondary school net attendance ratios (NAR), gross attendance ratios (GAR), and the gender parity index for the de jure household population age 14-17, by sex, according to background characteristics, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Net attendance ratio 1 Gross attendance ratio 2 Gender Background –––––––––––––––––––––––––– ––––––––––––––––––––––––– parity characteristic Male Female Total Male Female Total Index 3 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Total urban 44.4 36.6 40.4 87.1 61.1 73.6 0.70 Asmara 48.3 45.4 46.6 86.5 80.7 83.2 0.93 Other towns 41.9 28.0 35.3 87.4 42.0 65.9 0.48 Rural 13.4 8.4 11.3 27.2 12.4 20.9 0.46 Zoba Debubawi Keih Bahri 42.5 24.3 33.7 57.7 37.8 48.1 0.66 Maekel 42.6 42.6 42.6 78.6 72.3 75.2 0.92 Semenawi Keih Bahri 14.2 8.4 11.9 27.1 13.7 21.9 0.51 Anseba 16.1 13.2 15.0 33.8 21.5 28.8 0.64 Gash-Barka 9.4 4.8 7.4 29.3 7.2 19.9 0.25 Debub 28.6 16.3 22.9 56.5 24.3 41.7 0.43 Wealth index Lowest 7.0 2.0 5.1 14.5 4.4 10.7 0.30 Second 8.4 4.9 6.9 22.1 6.4 15.2 0.29 Middle 18.2 11.6 15.2 36.2 15.0 26.7 0.41 Fourth 45.2 29.4 37.4 91.9 46.5 69.4 0.51 Highest 47.5 45.2 46.3 85.4 78.3 81.6 0.92 Total 25.1 21.6 23.5 49.7 35.3 43.0 0.71 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Percentage of the secondary-school-age (14-17 years) population that is attending secondary school 2 Total number of secondary school students, expressed as a percentage of the official secondary-school- population. 3 The gender parity index for secondary school is the ratio of the secondary school GAR for females to the GAR for males. The differentials in GAR and GPI by residence and zoba are small at the primary school level but become more pronounced as the level of education increases. At the middle school level, the total GAR is lower in rural areas than in urban areas and in zobas Semenawi Keih Bahri, Anseba, and Gash Barka than in other zobas. The lowest GAR is in zoba Gash-Barka (26). The GPI at the middle-school level ranges from 0.32 in zoba Semenawi Keih Bahri to 1.10 in Asmara, indicating that there is a huge deficit of females in the zoba, while females have a slight edge in school attendance in Asmara. The GAR and GPI at the secondary-school level are generally lower than at the middle-school level. The GPI is lowest for zoba Gash-Barka (0.25) and deficit of females is evident for all subgroups. The female deficit observed at the secondary-school level could be partly due to young women getting married and dropping out of school, especially in rural areas. At the primary school level, for different levels of the wealth index the GAR varies from 79 to 117 and the GPI varies from 0.68 to 1.07. The differences by sex are small at the primary-school level. At higher levels of schooling, there is greater variation in the GAR and the GPI by wealth index. At the middle-school level, the total GAR increases from 28 to 127 going from the lowest to the highest quintile. The GPI is around 0.50 for the three lowest quintiles of the wealth index. Females from households in the Characteristics of Households and Household Members | 19 fourth quintile of the wealth index have a slight edge over males, and the deficit of females at the secondary-school level is even greater for the three lowest quintiles. The wealth index used here is one recently developed and tested in a large number of countries in relation to inequities in household income, use of health services, and health outcomes (Rutstein, Johnson, and Gwatkin, 2000). It is an indicator of wealth that is consistent with expenditure and income measures (Rutstein, 1999). The wealth index was constructed using household asset data (including country-specific assets) and principal components analysis. The asset information was collected through the 2002 EDHS Household Questionnaire, and covers information on household ownership of a number of consumer items ranging from a television to a bicycle or car, as well as dwelling characteristics such as source of drinking water, sanitation facilities, and type of material used in flooring. Each asset was assigned a weight (factor score) generated through principal components analysis, and the resulting asset scores were standardized in relation to a standard normal distribution with a mean of zero and a standard deviation of one (Gwatkin et al., 2000). Each household was then assigned a score for each asset, and the scores were summed for each household; individuals were ranked according to the total score of the household in which they resided. The sample was then divided into population quintiles; each quintile was designated a rank, from one (lowest) to five (highest). Current School Attendance The age-specific attendance rates (ASARs) for the population age 6-24 by single year and sex are shown in Figure 2.3. The ASAR indicates school attendance at any level, from primary to higher levels of education. Although the minimum age for schooling in Eritrea is 7 years, there are some children attending school at younger ages. A majority of children are not attending school at age 7. The peak attendance is at age 11 when 86 percent of boys and 82 percent of girls are currently attending school. The male-female disparity in attending school is small at younger ages (in favor of males). However, EDHS 2002 Figure 2.3 Age-Specific Attendance Rates Note: Figure shows percentage of the de jure house- hold population age 6-24 years attending school. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Age 0 20 40 60 80 100 Percent Male Female 20 | Characteristics of Households and Household Members differentials by sex in school attendance become wider beginning at age 17. For example, one in five males age 24 is attending school, compared with only one in 50 females. 2.5 MARITAL STATUS The 2002 EDHS includes information on the marital status of all household members age 15 and above. Table 2.6 shows the current marital status of the de facto household population by age, sex, and residence. In this report, ‘‘marriage’’ refers to both formal and informal unions. An informal union is one in which the man and woman live together for some time, intending to have a lasting relationship, but do not have a formal civil, cultural or religious marriage ceremony. Among females age 15 and above, 62 percent are currently married and 19 percent have never been married. The proportion never married is much higher among males (39 percent) than among females (19 percent), and is higher in urban areas (46 percent for males and 28 percent for females) than in rural areas (34 percent for males and 12 percent for females). Percentages currently divorced and separated are generally small, regardless of age, sex, and place of residence. One in eight women age 15 and above in urban areas and rural areas is currently widowed, compared with 2-3 percent of men. By age group, the percentage of women widowed is small except at older ages (age 40 and above). For example, among women age 50 and above in both urban areas and rural areas, more than two in ten women are widowed. The higher percentage of older woman than men who are widowed reflects sex differentials in age at marriage, longevity, and remarriage rates. A discussion of marital patterns among women age 15-49 is contained in Chapter 6. Characteristics of Households and Household Members | 21 Table 2.6 Marital status of the de facto household population Percent distribution of the de facto household population age 15 and above by marital status, according to age, residence and sex, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Current marital status –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Number Never Living Not living of Characteristic married Married together Widowed Divorced together Missing Total women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– URBAN ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Male 15-19 98.0 0.5 0.0 0.0 0.0 0.0 1.5 100.0 889 20-24 92.4 3.7 1.2 0.0 1.0 0.0 1.7 100.0 315 25-29 73.0 24.1 1.8 0.0 1.0 0.0 0.0 100.0 277 30-34 38.7 55.6 3.9 0.0 0.8 0.0 1.0 100.0 243 35-39 21.0 70.8 4.1 0.8 2.2 1.1 0.0 100.0 184 40-44 8.1 85.0 3.1 2.4 0.7 0.1 0.5 100.0 209 45-49 4.4 90.3 3.0 1.0 1.4 0.0 0.0 100.0 207 50+ 1.6 90.6 1.6 2.1 2.3 0.0 1.7 100.0 240 Total 45.6 48.8 1.4 1.8 1.3 0.2 0.9 100.0 3,386 Female 15-19 88.5 10.0 0.5 0.0 0.7 0.2 0.1 100.0 988 20-24 48.9 42.0 3.1 0.4 3.4 2.1 0.0 100.0 662 25-29 21.8 63.3 5.0 2.4 5.5 1.8 0.2 100.0 749 30-34 9.2 68.3 4.5 4.5 9.1 3.7 0.7 100.0 447 35-39 4.4 76.1 3.5 4.2 9.4 2.1 0.2 100.0 481 40-44 2.5 71.6 2.6 12.1 5.1 6.2 0.0 100.0 313 45-49 1.5 61.1 4.5 14.8 15.0 2.7 0.4 100.0 280 50+ 4.2 59.0 0.5 21.1 13.1 1.7 0.3 100.0 360 Total 28.0 48.7 2.5 12.0 6.4 2.0 0.4 100.0 5,234 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– RURAL ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Male 15-19 96.3 2.3 0.1 0.1 0.2 0.0 1.0 100.0 1,183 20-24 80.4 17.9 0.0 0.4 0.7 0.0 0.6 100.0 436 25-29 47.8 47.3 2.1 0.9 0.9 0.5 0.4 100.0 250 30-34 12.1 82.1 1.3 1.2 3.3 0.0 0.0 100.0 260 35-39 7.0 86.3 2.0 1.2 2.9 0.0 0.5 100.0 245 40-44 2.5 92.3 0.0 2.3 2.0 0.0 1.0 100.0 326 45-49 2.6 91.5 0.5 3.8 1.6 0.0 0.0 100.0 266 50+ 1.0 93.2 0.7 3.0 2.1 0.1 0.0 100.0 415 Total 33.9 60.6 0.6 3.1 1.3 0.1 0.4 100.0 4,971 Female 15-19 52.7 43.5 0.5 0.0 2.1 0.4 0.8 100.0 1,148 20-24 14.2 77.4 0.9 1.0 4.5 1.5 0.5 100.0 853 25-29 4.9 83.2 1.8 0.9 7.7 1.0 0.4 100.0 868 30-34 2.2 85.9 1.6 3.3 5.7 1.3 0.0 100.0 682 35-39 1.6 83.0 2.9 5.1 5.7 1.8 0.0 100.0 624 40-44 0.4 84.8 0.9 9.4 4.1 0.4 0.0 100.0 532 45-49 0.6 79.0 1.8 10.9 6.4 1.3 0.0 100.0 473 50+ 0.8 67.9 0.8 22.3 7.4 0.3 0.5 100.0 394 Total 11.5 68.2 1.1 12.8 5.2 0.9 0.3 100.0 7,103 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– TOTAL ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Male 15-19 97.0 1.5 0.1 0.1 0.1 0.0 1.2 100.0 2,072 20-24 85.4 11.9 0.5 0.2 0.9 0.0 1.0 100.0 751 25-29 61.1 35.1 2.0 0.4 1.0 0.2 0.2 100.0 528 30-34 25.0 69.3 2.6 0.6 2.1 0.0 0.5 100.0 503 35-39 13.0 79.7 2.9 1.0 2.6 0.5 0.3 100.0 430 40-44 4.7 89.4 1.2 2.4 1.5 0.0 0.8 100.0 536 45-49 3.4 91.0 1.6 2.6 1.5 0.0 0.0 100.0 473 50+ 1.2 92.2 1.0 2.7 2.2 0.0 0.6 100.0 655 Total 38.6 55.8 0.9 2.6 1.3 0.1 0.6 100.0 8,357 Female 15-19 69.3 28.0 0.5 0.0 1.4 0.3 0.5 100.0 2,136 20-24 29.4 61.9 1.9 0.7 4.1 1.7 0.3 100.0 1,515 25-29 12.8 74.0 3.3 1.6 6.7 1.4 0.3 100.0 1,618 30-34 5.0 79.0 2.7 3.7 7.0 2.3 0.3 100.0 1,130 35-39 2.8 80.0 3.2 4.7 7.3 1.9 0.1 100.0 1,105 40-44 1.2 79.9 1.5 10.4 4.5 2.5 0.0 100.0 845 45-49 1.0 72.4 2.8 12.4 9.6 1.8 0.1 100.0 753 50+ 2.4 63.7 0.7 21.7 10.1 1.0 0.4 100.0 754 Total 18.5 59.9 1.7 12.5 5.7 1.4 0.4 100.0 12,337 22 | Characteristics of Households and Household Members 2.6 EMPLOYMENT STATUS OF HOUSEHOLD POPULATION Tables 2.7.1 and 2.7.2 show the distribution of household populations of females and males age 10 and above by employment status and type of earnings, according to background characteristics. Sixty- nine percent of males and 16 percent of females age 15 years and above were employed in the month before the survey and are considered currently employed. The proportions for males and females age 15- 64 employed are 72 percent and 17 percent, respectively. The proportion currently employed peaks at age 30-34 for males (93 percent) and at age 25-29 for females (26 percent). For both sexes, there is a moderate decline in employment at age 60 and above. However, remarkably, almost half of males age 65 and above were employed the month before the survey. Tables 2.7.1 and 2.7.2 show that overall, the vast majority of children age 10-14 attend school, and only a small proportion were employed in the month before the survey. Children’s employment varies by sex; boys are more likely to be employed than girls (4 percent and 1 percent, respectively). Around four in ten persons age 10-14 are not paid for their work. Table 2.7.1 Employment status: women Percent distribution of the de jure female household population age 10 and over by employment status and type of earnings, according to background charac- teristics, Eritrea 2002 Employment status Type of earnings Background characteristic Not em- ployed, in school Not em- ployed in past month Employed in past month Missing Total Number of women Cash In-kind Both cash and in-kind Not paid Missing Total Total employed women Age 10-14 69.7 24.2 1.3 4.9 100.0 3,185 40.5 7.0 2.3 39.4 10.8 100.0 41 15-19 43.2 47.0 9.1 0.7 100.0 2,247 80.1 3.6 0.7 12.9 2.7 100.0 205 20-24 7.2 69.5 22.7 0.6 100.0 1,660 86.0 1.4 0.7 11.0 0.8 100.0 377 25-29 0.0 73.5 25.7 0.8 100.0 1,719 86.6 1.1 1.0 8.6 2.7 100.0 442 30-34 0.0 80.8 18.7 0.4 100.0 1,172 81.8 2.4 2.5 12.2 1.2 100.0 220 35-39 0.0 77.8 21.7 0.5 100.0 1,135 81.7 3.5 4.5 10.2 0.0 100.0 247 40-44 0.0 82.8 16.8 0.3 100.0 878 81.2 3.4 2.2 9.5 3.7 100.0 148 45-49 0.0 80.8 19.0 0.2 100.0 783 76.7 3.2 7.0 13.0 0.0 100.0 149 50-54 0.0 83.3 16.2 0.5 100.0 796 79.9 5.7 4.4 8.9 1.0 100.0 129 55-59 0.0 88.5 10.5 1.0 100.0 650 78.3 6.3 5.8 9.7 0.0 100.0 68 60-64 0.0 92.5 5.9 1.6 100.0 715 75.0 2.7 5.3 17.0 0.0 100.0 42 65+ 0.0 93.4 5.4 1.2 100.0 1,220 75.8 8.5 5.6 8.5 1.6 100.0 66 Residence1 Urban 14.1 57.5 27.5 0.9 100.0 5,072 89.5 1.6 0.6 6.8 1.4 100.0 1,394 Asmara 13.7 52.7 32.3 1.3 100.0 2,596 90.4 0.6 0.1 7.2 1.6 100.0 840 Other towns 14.5 62.6 22.4 0.6 100.0 2,476 88.1 3.2 1.4 6.2 1.1 100.0 554 Rural 5.7 84.4 9.5 0.4 100.0 6,684 67.7 4.9 6.6 19.2 1.6 100.0 634 Zoba1 Debubawi Keih Bahri 7.4 58.1 34.4 0.2 100.0 409 58.8 0.6 0.3 40.2 0.1 100.0 141 Maekel 13.6 55.3 30.0 1.1 100.0 3,202 89.0 1.2 0.3 7.5 1.9 100.0 961 Semenawi Keih Bahri 5.5 84.1 9.4 0.9 100.0 1,458 84.4 4.5 1.3 9.8 0.0 100.0 138 Anseba 10.8 82.2 6.9 0.1 100.0 1,421 76.8 4.0 13.3 4.9 1.0 100.0 98 Gash-Barka 3.5 83.9 11.9 0.7 100.0 2,012 81.9 1.6 5.2 9.1 2.3 100.0 239 Debub 9.9 76.0 13.8 0.3 100.0 3,255 77.6 6.1 4.5 10.6 1.1 100.0 451 Population age 10+ 20.5 64.8 13.2 1.5 100.0 16,170 81.6 2.9 2.6 11.2 1.7 100.0 2,134 Population age 15+ 8.4 74.8 16.1 0.7 100.0 12,986 82.4 2.9 2.6 10.6 1.5 100.0 2,093 Population age 10-64 22.1 62.5 13.8 1.6 100.0 14,941 81.8 2.8 2.5 11.3 1.7 100.0 2,068 Population age 15-64 9.3 72.8 17.2 0.6 100.0 11,756 82.7 2.7 2.5 10.7 1.5 100.0 2,028 Note: The populations age 10 and over and age 15 and over include 9 women with missing information on age. 1 Based on women age 15-64 Characteristics of Households and Household Members | 23 Table 2.7.2 Employment status: men Percent distribution of the de jure male household population age 10 and over by employment status and type of earnings, according to background charac- teristics, Eritrea 2002 Employment status Type of earnings Background characteristic Not em- ployed, in school Not em- ployed in past month Employed in past month Missing Total Number of men Cash In-kind Both cash and in-kind Not paid Missing Total Total employed men Age 10-14 76.7 15.5 3.9 3.9 100.0 3,158 31.2 13.1 7.8 43.8 4.1 100.0 122 15-19 63.2 13.4 23.0 0.5 100.0 2,416 60.4 5.1 11.8 21.2 1.5 100.0 555 20-24 19.7 11.4 68.5 0.4 100.0 1,539 76.9 1.1 6.0 13.3 2.8 100.0 1,054 25-29 0.0 10.5 89.2 0.3 100.0 1,424 77.4 1.3 4.5 14.3 2.5 100.0 1,270 30-34 0.0 6.7 93.2 0.1 100.0 1,166 79.2 1.4 8.4 9.8 1.2 100.0 1,087 35-39 0.0 8.0 91.9 0.1 100.0 910 79.6 1.5 9.6 8.3 1.0 100.0 836 40-44 0.0 8.5 91.4 0.1 100.0 898 72.2 4.5 12.7 8.4 2.1 100.0 821 45-49 0.0 10.0 90.0 0.0 100.0 704 71.9 5.3 13.3 8.3 1.2 100.0 633 50-54 0.0 12.9 87.1 0.0 100.0 814 61.8 7.3 21.3 8.3 1.4 100.0 709 55-59 0.0 13.9 86.1 0.0 100.0 567 54.3 11.2 21.8 11.6 1.0 100.0 489 60-64 0.0 24.8 75.2 0.0 100.0 673 47.0 11.3 27.7 11.9 2.1 100.0 506 65+ 0.0 52.2 47.5 0.3 100.0 1,427 36.3 14.9 32.2 13.7 2.8 100.0 678 Residence1 Urban 19.2 10.9 69.6 0.3 100.0 4,568 85.0 0.9 1.3 11.0 1.7 100.0 3,179 Asmara 14.6 12.2 72.7 0.5 100.0 2,217 82.2 0.3 0.0 14.9 2.6 100.0 1,613 Other towns 23.5 9.6 66.6 0.2 100.0 2,352 88.0 1.5 2.7 7.1 0.7 100.0 1,566 Rural 14.6 12.2 73.1 0.1 100.0 6,542 61.5 6.0 18.8 11.7 1.9 100.0 4,781 Zoba1 Debubawi Keih Bahri 10.7 11.9 77.2 0.2 100.0 345 77.7 0.1 0.2 21.4 0.7 100.0 266 Maekel 16.2 12.1 71.4 0.4 100.0 2,810 80.4 0.9 0.4 15.4 2.9 100.0 2,005 Semenawi Keih Bahri 16.5 12.9 70.3 0.3 100.0 1,327 67.7 6.1 15.9 8.7 1.6 100.0 933 Anseba 18.5 11.0 70.5 0.0 100.0 1,436 64.7 0.8 30.3 3.1 1.1 100.0 1,013 Gash-Barka 11.5 13.3 74.9 0.2 100.0 2,150 59.1 5.7 22.9 10.1 2.1 100.0 1,611 Debub 19.9 9.9 70.1 0.2 100.0 3,042 74.5 6.6 5.2 12.7 1.0 100.0 2,131 Population age 10+ 27.1 16.2 55.8 1.0 100.0 15,710 67.7 5.0 13.4 12.1 1.9 100.0 8,765 Population age 15+ 14.6 16.3 68.9 0.2 100.0 12,552 68.2 4.8 13.5 11.6 1.9 100.0 8,642 Population age 10-64 29.8 12.5 56.6 1.0 100.0 14,268 70.3 4.1 11.8 11.9 1.8 100.0 8,082 Population age 15-64 16.5 11.7 71.6 0.2 100.0 11,110 70.9 4.0 11.9 11.5 1.8 100.0 7,960 Note: The populations age 10 and over and age 15 and over include 15 men with missing information on age. 1 Based on men age 15-64 Differentials in employment status by residence and zoba are examined for persons age 15-64, the age considered economically active in Eritrea. There is a slight difference in the level of current employment for males by urban-rural residence, with rural males more likely to be employed than urban males. However, rural males and males living in Asmara have the same level of employment (73 percent). In contrast, females are almost three times as likely to be employed in urban areas as in rural areas. However, females are also most likely to be employed in Asmara than in other areas. By zoba, the highest levels of both female and male employment are in zoba Debubawi Keih Bahri (34 percent and 77 percent, respectively). The differentials by zoba in male employment are small; at least 70 percent of males are employed in all zobas. The differentials in female employment are marked: one-third of females in Debubawi Keih Bahri are currently employed, compared with only 7 percent in Anseba. A substantial majority of employed females and males age 15-64 reported that they earn only cash (83 percent and 71 percent, respectively), and 3 percent of females and 12 percent of males reported that they receive cash 24 | Characteristics of Households and Household Members plus some payment in kind. Men and women employed in rural areas and in zobas Anseba and Gash- Barka are more likely to be paid in cash and in-kind than other men and women. Thus, there are only small differences in the proportion of employed persons receiving some cash by residence and zoba. 2.7 HOUSING CHARACTERISTICS In the Household Questionnaire, respondents were asked about characteristics of their households, including access to electricity, source of drinking water, time to water source, time at water source, type of toilet facilities, fuel used for cooking, main flooring material, and number of rooms used for sleeping. Table 2.8 summarizes this information by residence. In Eritrea, 32 percent of the households have electricity, a substantial increase from 23 percent in 1995. However, there has been almost no increase in households with electricity in rural areas. Only 3 percent of rural households have electricity, compared with 78 percent of urban households—almost all households in Asmara and 61 percent of households in other towns. Information on a household’s source of drinking water is important because potentially fatal diseases including typhoid, cholera, and dysentery are prevalent in unprotected water sources. Sources of water expected to be relatively free of these diseases are piped water, water drawn from protected wells, and water delivered by tanker trucks. Piped water is mainly accessible in urban areas; seven in ten households in Asmara, more than six in ten in other towns, and 18 percent (all from public tap) in rural areas use piped water. Around one-fourth of households in Asmara and other towns depend on tanker trucks to deliver water. More than half of households in rural areas have access to public wells (half of them protected and the other half unprotected) and 17 percent use spring water. Overall, half of rural households have access to clean water. The accessibility to water is reflected by the time required to get to the water source. At least 50 percent of urban households have water available in the dwelling or yard and 69 percent are within 15 minutes of a water source. In contrast, only 8 percent of rural households are within 15 minutes to a water source, and more than half spend at least an hour to reach water. Respondents were asked about the waiting time at the source of water, excluding the time to go to and come back from the water source. For 57 percent of households there is no wait at the water source. But one in nine households in urban areas and almost one in four households in rural areas wait at least an hour at the water source. Access to adequate sanitation facilities is an important determinant of health conditions. Three- fourths of households in Eritrea, and almost all households in rural areas (96 percent) have no toilet facility. Half of the households in other towns and slightly more than one-fourth of those in Asmara also do not have any toilet facility. Figure 2.4 shows that since 1995 access to flush toilets in Eritrea has increased from 12 percent to 17 percent, mainly because of better toilet facilities in other towns. Several types of fuel are used for cooking in Eritrea. More than half of the households (59 percent) use wood or straw for cooking, 28 percent use kerosene, and 5 percent each depend on animal dung cakes and gas. Regarding urban-rural variation, wood or straw is more commonly used for cooking in rural areas (82 percent) than in urban areas (23 percent). In Asmara, most households use either kerosene (70 percent) or gas (22 percent) as fuel for cooking. The type of material used for flooring is an indicator of the economic standing of the household as well as the potential exposure of household members to disease-causing agent. According to Table 2.8, two-thirds of households in Eritrea live in structures with floors made of earth, sand or dung, 20 percent have floors made of cement, and 13 percent have ceramic tile floors. The flooring material differs considerably by place of residence. Rural houses have poorer quality floors than urban houses (89 percent Characteristics of Households and Household Members | 25 Table 2.8 Household characteristics Percent distribution of households by household characteristics, according to resi- dence, Eritrea 2002 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Urban –––––––––––––––––––––– Total Other Characteristic urban Asmara towns Rural Total –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Electricity Yes 78.3 98.7 60.9 3.0 32.2 No 21.7 1.3 39.1 96.9 67.8 Total 100.0 100.0 100.0 100.0 100.0 Source of drinking water Piped into residence/yard/plot 41.9 56.9 29.0 0.1 16.3 Public tap 25.1 15.1 33.8 18.1 20.8 Unprotected well in dwelling/ yard/plot 0.1 0.0 0.2 0.6 0.4 Unprotected public well 2.1 0.0 3.9 24.7 15.9 Protected well in dwelling/ yard/plot 0.3 0.0 0.5 0.4 0.4 Protected public well 4.2 0.2 7.6 26.3 17.8 Spring 0.3 0.0 0.6 17.2 10.7 River, stream 0.2 0.0 0.3 4.8 3.0 Pond, lake 0.1 0.0 0.1 1.4 0.9 Dam 0.1 0.0 0.2 2.3 1.5 Tanker truck 25.5 27.7 23.6 3.8 12.2 Total 100.0 100.0 100.0 100.0 100.0 Time to water source Percentage <15 minutes 68.7 80.9 58.3 8.2 31.6 Median time to source 0.0 0.0 0.0 59.7 29.9 Normal wait at water source None 72.5 81.1 65.2 47.9 57.4 <5 min 0.4 0.6 0.3 0.0 0.2 5-14 min 3.7 2.7 4.7 4.2 4.0 15-29 min 5.4 3.1 7.5 7.8 6.9 30-44 min 6.3 4.1 8.1 15.4 11.9 45-59 min 0.6 0.4 0.7 0.7 0.7 60+ min 11.1 8.1 13.6 23.8 18.9 Total 100.0 100.0 100.0 100.0 100.0 Sanitation facility Own flush toilet 23.0 32.2 15.1 0.4 9.1 Shared flush toilet 18.8 29.6 9.5 0.3 7.5 Traditional pit toilet 15.6 8.4 21.7 1.3 6.8 Ventilated improved pit latrine 3.2 2.7 3.6 1.5 2.2 No facility, bush, field 39.4 27.0 50.1 96.4 74.3 Other 0.0 0.0 0.1 0.0 0.0 Total 100.0 100.0 100.0 100.0 100.0 Fuel used for cooking Gas 11.9 21.9 3.3 0.2 4.7 Electricity 1.6 3.0 0.4 0.0 0.6 Kerosene 58.2 70.3 47.9 8.9 28.0 Charcoal/coal 3.0 0.4 5.2 0.9 1.7 Wood, straw 23.4 3.0 41.0 82.1 59.4 Animal dung cakes 1.2 0.8 1.5 7.7 5.2 Other 0.5 0.4 0.6 0.1 0.2 Missing 0.2 0.3 0.1 0.1 0.1 Total 100.0 100.0 100.0 100.0 100.0 continued 26 | Characteristics of Households and Household Members Table 2.8 Household characteristics (cont.) Percent distribution of households by household characteristics, according to resi- dence, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Urban –––––––––––––––––––––– Total Other Characteristic urban Asmara towns Rural Total ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Flooring material Earth, sand 31.6 12.6 47.9 75.4 58.5 Dung 1.3 0.3 2.1 13.5 8.7 Wood planks 0.1 0.1 0.0 0.0 0.0 Parquet, polished wood 0.1 0.1 0.0 0.0 0.0 Vinyl, asphalt strips 0.6 1.2 0.2 0.0 0.2 Ceramic tiles 30.6 50.1 13.9 1.2 12.6 Cement 35.3 35.3 35.4 9.8 19.7 Carpet 0.4 0.3 0.5 0.1 0.2 Total 100.0 100.0 100.0 100.0 100.0 Persons per room <3 40.8 46.5 36.0 26.0 31.7 3-4 32.7 28.6 36.3 33.8 33.4 5-6 16.7 15.1 18.1 22.5 20.3 7+ 9.7 9.8 9.6 17.7 14.6 Total 100.0 100.0 100.0 100.0 100.0 Mean number of persons per room 3.4 3.2 3.5 4.2 3.9 Persons per sleeping room <3 31.8 36.3 27.9 21.8 25.7 3-4 36.5 34.6 38.2 33.3 34.6 5-6 20.0 18.0 21.8 24.4 22.7 7+ 11.7 11.2 12.1 20.4 17.0 Total 100.0 100.0 100.0 100.0 100.0 Mean number of persons per sleeping room 3.8 3.6 3.9 4.5 4.2 Farm animals in living area 1.1 0.7 1.4 5.9 4.1 Wealth index Lowest 0.8 0.0 1.4 26.1 16.3 Second 3.2 0.0 5.9 31.3 20.4 Middle 9.6 0.1 17.7 29.4 21.7 Fourth 35.3 25.9 43.4 12.6 21.4 Highest 51.1 74.0 31.6 0.5 20.1 Total 100.0 100.0 100.0 100.0 100.0 Number of households 3,634 1,678 1,956 5,755 9,389 Characteristics of Households and Household Members | 27 EDHS 2002 Figure 2.4 Access to Clean Water and Flush Toilet 22 12 37 17 Clean water supply (piped) Flush toilet 0 10 20 30 40 50 Percentage of households 1995 2002 EDHS 1995 and EDHS 2002 of rural households have earth, sand or dung floors, while 66 percent of urban houses have cement or ceramic tile floors). In Asmara, floors in half the households are made of ceramic tiles, one-third have cement floors, and one in ten has flooring made of lesser quality materials. Compared with the quality of flooring in 1995, some improvement is evident. For example, the proportion of households with floors made of earth or sand decreased from 69 to 59 percent, the proportion of households with floors made of ceramic tiles increased from 9 to 13 percent, and the proportion of households with cement floors more than doubled from 9 percent to 20 percent. The increase in households with floors made of cement is almost entirely due to improvement in housing in rural areas. Information on the total number of rooms (excluding toilets and kitchens) and sleeping rooms was collected to measure household crowding. Overall, one-third of households have less than 3 persons per room and the same proportion have 3-4 persons per room. Crowding is more common in rural areas than urban areas. For example, 10 percent of the households in urban areas have 7 or more persons per room, compared with 18 percent in rural areas. The mean number of persons per room and per sleeping room in rural areas is 4.2 and 4.5, respectively; in urban areas, it is 3.4 and 3.8, respectively. The presence of farm animals in the living area increases crowding, pollutes the living area, and exposes household members to disease-causing agents. In Eritrea, farm animals in the living area are not common; only 4 percent of households have farm animals in their living areas. The problem is more common among rural households (6 percent) than urban households (1 percent). The wealth index is discussed in Section 2.4 (page 19). Table 2.8 shows that the proportion of households in the lowest quintile is 16 percent and the proportion of households in the other quintiles is nearly the same, 20-22 percent. Regarding differences by residence, more than half of urban households (51 percent) are in the highest quintile of the wealth index, compared with only 1 percent of rural households. This difference in wealth is a result of rural areas not having access to many of the amenities common in urban areas, such as electricity and piped water. In contrast, only 4 percent of urban households are in the two lowest quintiles of the wealth index. All households in Asmara are in the higher quintiles of the wealth indexthree-fourths in the highest quintile and the remaining in the fourth 28 | Characteristics of Households and Household Members quintile. This is not surprising because of the concentration of amenities in the city (Table 2.8). Households in Asmara are also most likely to own various durable goods and transportation vehicles (Table 2.9). 2.8 HOUSEHOLD POSSESSIONS Information on household possession of durable goods and means of transportation is presented in Table 2.9. Combined with other indicators, information on ownership of durable goods can be used to generate a wealth index that acts as a proxy estimate for the socioeconomic status of a household. Ownership of a radio or television is a measure of access to mass media; telephone ownership measures access to efficient communications; refrigerator ownership indicates a capacity for more hygienic storage. Bicycle, motorcycle, car, and donkey cart ownership reflects access to means of transportation. In general, ownership of these items has a bearing on the households’ access to health information and services. Possession of the durable goods mentioned above is not common in Eritrea. Six in ten households in Eritrea own a radio–81 percent of urban households and 43 percent of rural households. Radio ownership is almost universal in Asmara and very high in zoba Maekel. Less than half the households in zobas Anseba, Gash-Barka, and Semenawi Keih Bahri have radios. A household in zoba Gash-Barka is even less likely to have a radio than a household in rural areas. Basically, television is only in urban areas (34 percent), and zobas Maekel (46 percent) and Debubawi Keih Bahri (18 percent). Fifty-seven percent of households in Asmara have television. Overall, four in ten households in Eritrea have no television or radio. Four percent of households have a telephone and 7 percent own a refrigerator. These amenities are almost exclusively in urban areas and zobas Maekel and Debubawi Keih Bahri. Regarding ownership of any means of transportation, 87 percent of the households do not own any means of transportation. Table 2.9 Household durable goods Percentage of households possessing various durable consumer goods and transport vehicles, by residence and zoba, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Zoba –––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––––––––––– Debubawi Semenawi Durable Total Other Keih Keih Gash- goods/vehicles urban Asmara towns Rural Bahri Maekel Bahri Anseba Barka Debub Total ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Durable consumer goods Radio 81.3 93.4 71.0 42.9 50.5 89.3 43.8 46.7 36.7 58.8 57.8 Television 33.6 57.4 13.2 0.3 17.6 46.2 4.5 4.6 0.6 3.0 13.2 Telephone 11.3 18.5 5.1 0.1 4.6 14.7 1.6 3.1 0.3 1.0 4.4 Refrigerator 18.2 25.7 11.8 0.1 35.2 20.4 4.5 2.5 0.8 0.9 7.1 No mass media1 18.1 6.0 28.6 57.1 47.9 10.1 56.0 53.2 63.2 41.2 42.0 Transport vehicles Donkey cart 1.9 1.4 2.3 0.4 0.6 1.6 0.2 0.2 2.4 0.3 1.0 Bicycle 19.4 29.0 11.2 4.9 6.2 29.6 2.4 3.8 2.4 8.0 10.5 Motorcycle 0.5 0.8 0.2 0.0 0.0 0.7 0.1 0.0 0.0 0.1 0.2 Car/truck 7.9 14.5 2.3 0.4 3.0 11.8 1.8 0.8 0.4 0.6 3.3 None of the above 73.9 60.7 85.2 94.6 90.6 62.0 95.9 95.6 95.7 91.3 86.6 Total 3,634 1,678 1,956 5,755 328 2,122 1,195 1,181 1,800 2,763 9,389 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 No radio or television Characteristics of Households and Household Members | 29 Bicycles are the most common means of transportation; one in ten households owns a bicycle. Only 3 percent of households own a car or a truck. Not surprisingly, households in urban areas, in Asmara, and zoba Maekel are more likely to own durable consumer goods and means of transportation. Ownership of durable consumer goods and means of transportation has increased since 1995. For example, the proportion of households with radios has increased from 40 to 58 percent and the proportion of households that have a bicycle has increased from 7 to 11 percent. Respondents to the Household Questionnaire were asked whether they owned the house they lived in, whether they owned animals and cropland, and whether they grew cash crops. Seven in ten households own a house, 56 percent own cropland, and almost half of the households own animals (Table 2.10). Possession of livestock, a house, and cropland is more concentrated in rural areas than urban areas. For example, nine in ten rural households own a house, compared with only two in five urban households. Two-thirds of rural households own animals, half own horses, mules, or donkeys, four in ten own sheep or goats, and the same proportion own cattle or camels. Four percent of households in rural areas and 2 percent in other towns grow cash crop. Table 2.10 Household ownership of a house, animals and cropland Percentage of households owning a house, animals, and cropland, and percentage of households that grow cash crops, by residence, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Total Other Ownership urban Asmara towns Rural Total ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– House 42.2 28.8 53.7 88.2 70.4 Any animals 12.6 1.2 22.4 68.8 47.0 Cattle or camel 5.2 0.9 9.0 41.6 27.5 Horse, mule, or donkey 7.4 0.8 13.0 49.5 33.2 Sheep or goat 6.9 0.3 12.6 38.9 26.6 Cropland 17.6 4.4 28.9 80.8 56.4 Grow cash crops 1.1 0.2 1.8 3.8 2.7 Total 3,634 1,678 1,956 5,755 9,389 2.9 MOSQUITO NETS Malaria is endemic and is a major public health problem in Eritrea. Use of mosquito nets is one of the methods to prevent malaria. The global Roll Back Malaria (RBM) movement, which Eritrea endorsed, has set the framework within which the country is implementing malaria control. In the 2002 EDHS, information on the possession of mosquito nets by households was collected in the Household Questionnaire. Table 2.11 shows the distribution of households by number of mosquito nets, according to household characteristics. One-third of households reported owning at least one mosquito net. The likelihood of possessing at least two mosquito nets increases with household size. For example, one-fifth of large households (nine members or more) have at least two mosquito nets, compared with only 8 percent of households with three members. 30 | Characteristics of Households and Household Members Table 2.11 Household possession of mosquito nets Percent distribution of households by number of mosquito nets present in household, percentage with at least one net, and mean number of nets per household, by household size, residence, and zoba, Eritrea 2002 Number of mosquito nets in household Household characteristic None One Two Three or more Total Number of households Percentage with at least one net Mean number of mosquito nets per household (for households with mosquito nets) Household size 1 80.9 17.4 1.7 0.0 100.0 676 19.1 1.1 2 75.6 18.2 5.7 0.5 100.0 1,144 24.4 1.3 3 66.3 25.3 7.1 1.3 100.0 1,407 33.7 1.3 4 63.3 23.4 10.9 2.5 100.0 1,480 36.7 1.4 5 61.1 21.2 13.8 3.9 100.0 1,259 38.6 1.6 6 61.2 21.0 12.0 5.8 100.0 1,176 38.8 1.7 7 63.6 15.9 12.6 8.0 100.0 880 36.4 1.9 8 63.8 17.6 10.4 8.2 100.0 603 36.2 1.9 9+ 64.9 16.2 10.9 8.0 100.0 763 35.1 2.0 Residence Urban 71.7 15.7 8.7 3.9 100.0 3,634 28.3 1.7 Asmara 91.2 6.5 1.9 0.3 100.0 1,678 8.8 1.3 Other towns 54.9 23.6 14.5 7.0 100.0 1,956 45.1 1.7 Rural 62.6 23.3 10.3 3.8 100.0 5,755 37.3 1.5 Zoba Debubawi Keih Bahri 71.4 19.5 6.8 2.3 100.0 328 28.6 1.4 Maekel 91.3 6.5 2.0 0.3 100.0 2,122 8.7 1.3 Semenawi Keih Bahri 57.3 23.0 13.3 6.5 100.0 1,195 42.6 1.7 Anseba 55.3 25.1 15.2 4.4 100.0 1,181 44.6 1.6 Gash-Barka 46.8 27.5 15.9 9.7 100.0 1,800 53.1 1.8 Debub 67.2 23.3 7.9 1.5 100.0 2,763 32.7 1.3 Total 66.1 20.3 9.7 3.8 100.0 9,389 33.8 1.6 Possession of mosquito nets is more common in rural areas (37 percent) than urban areas (28 percent), but it is most common in small towns (45 percent). Mosquito nets are less likely to be available in households in zoba Maekel than in the other zobas, probably because it is not a high-risk malaria area. Households in zobas Gash-Barka, Anseba, and Semenawi Keih Bahri are more likely to own at least one mosquito net than households in the other two zobas. Smaller households with one or two members (19-24 percent) are less likely to possess a mosquito net than larger households (34-39 percent). Among households with mosquito nets, the mean number of nets is 1.6. Although crowding is greater in rural areas (Table 2.2), the mean number of mosquito nets in rural households is smaller than in urban areas. The use of mosquito nets by women age 15-49 and by their children under age five is discussed in Chapter 9. Chapter 9 also discusses intermittent treatment for malaria among women age 15-49 during the last pregnancy ending in a live birth. Women’s Characteristics and Status | 31 WOMEN’S CHARACTERISTICS AND STATUS 3 This chapter provides a demographic and socioeconomic profile of women of reproductive age who were interviewed in the 2002 EDHS. The information is essential for the interpretation of findings later in the report. The chapter starts by presenting a number of basic characteristics of women including age, marital status, residence, educational level, religion, ethnicity, and wealth status. Next, information on women’s migration status, and more detailed information on educational attainment, literacy status, and the extent of exposure to mass media are provided. Finally, factors that enhance women’s empowerment are explored, including employment status, occupation, earnings, and continuity of employment as well as women’s participation in household decisionmaking and their attitudes toward wife beating. 3.1 CHARACTERISTICS OF SURVEY RESPONDENTS Background characteristics of all women and currently married women age 15-49 interviewed in the 2002 EDHS are presented in Table 3.1. Reflecting the results of high fertility levels in the past, there are proportionally more younger than older women and the proportion of respondents in each age group generally declines as age increases for all women. Sixty-two percent of all women were currently married at the time of the survey, with an additional 4 percent in informal marriages (“living together”). About one-fourth of women age 15-49 have never married. Seven percent of women are divorced or separated, while 4 percent are widowed. In all other tables in this report, the categories “married” and “living together” are combined and referred to collectively as “currently married.” As expected, most women reside in rural areas (57 percent of all women and 66 percent of currently married women). Just over one-fifth of all women reside in Asmara, with the same proportion residing in other towns. The largest proportions of women live in three zobas: Debub (27 percent), Maekel (26 percent), and Gash-Barka (17 percent). Only 4 percent live in zoba Debubawi Keih Bahri. Similar distribution patterns by residence and zoba are observed for currently married women. Table 3.1 shows that half of all women 15-49 have never attended school, while one-fifth have attained primary school only, one-tenth have attained middle school only, and one-fifth have been to secondary school or higher. As expected, currently married women are less likely to have attended school and less likely to have attained higher levels of education than the broader category of all women. Improvements in female education are reflected at all levels of education. For example, the proportion of women age 15-49 who have attended secondary school doubled from 10 percent in 1995 to 20 percent in 2002. Similarly, the proportion of women with no education declined from 66 to 50 percent in the same period. As regards religious affiliation, almost six in ten women (58 percent) are Orthodox, 37 percent are Muslim, and 5 percent are Catholic. Respondents are predominantly Tigrigna (62 percent of all women), followed by Tigre (22 percent). Since the wealth index classifies households into quintiles according to their assets and other economic characteristics, by definition there are roughly equal proportions of women falling into each category of the wealth index. 32 | Women’s Characteristics and Status Table 3.1 Background characteristics of respondents Percent distribution of all women and currently married women by background characteristics, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– All women Currently married women –––––––––––––––––––––––––––––––––– –––––––––––––––––––––––––––––––––––– Number of women Number of women ––––––––––––––––––––– ––––––––––––––––––––– Background Weighted Un- Weighted Un- characteristic percent Weighted weighted percent Weighted weighted ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 22.9 2,001 1,861 10.1 580 552 20-24 16.6 1,454 1,386 16.6 950 956 25-29 17.6 1,543 1,558 21.1 1,212 1,252 30-34 12.7 1,109 1,175 15.8 904 992 35-39 12.4 1,085 1,129 15.7 899 946 40-44 9.5 827 876 11.6 663 711 45-49 8.4 734 769 9.2 526 561 Marital status Never married 23.3 2,044 1,851 na na na Married 61.8 5,409 5,682 94.4 5,409 5,682 Living together 3.7 324 288 5.6 324 288 Divorced/separated 7.4 650 592 na na na Widowed 3.7 328 341 na na na Residence Total urban 43.0 3,767 3,180 34.3 1,967 1,719 Asmara 21.7 1,899 1,123 15.1 868 505 Other towns 21.3 1,868 2,057 19.2 1,099 1,214 Rural 57.0 4,987 5,574 65.7 3,766 4,251 Zoba Debubawi Keih Bahri 3.7 324 1,470 3.7 210 1,005 Maekel 25.9 2,264 1,404 19.2 1,103 689 Semenawi Keih Bahri 13.1 1,148 1,416 14.3 817 1,027 Anseba 12.9 1,130 1,418 13.7 784 1,003 Gash-Barka 17.1 1,500 1,414 19.9 1,142 1,072 Debub 27.3 2,388 1,632 29.3 1,677 1,174 Education No education 50.1 4,384 5,098 61.9 3,549 4,126 Primary 18.7 1,637 1,506 18.8 1,075 961 Middle 11.1 974 831 7.0 400 340 Secondary + 20.1 1,760 1,319 12.4 709 543 Religion Orthodox 57.7 5,048 3,946 52.5 3,009 2,393 Catholic 4.6 400 390 4.0 228 228 Protestant 0.7 60 45 0.5 27 22 Muslim 36.5 3,198 4,319 42.6 2,443 3,293 Traditional believer 0.4 33 42 0.4 23 31 Other 0.1 12 8 0.0 0 0 Missing 0.1 5 4 0.0 3 3 Ethnicity Afar 2.9 254 1,033 3.0 174 752 Bilen 2.7 233 285 2.5 145 179 Hedarib 2.1 187 292 2.6 151 228 Kunama 1.5 132 135 1.3 77 80 Nara 2.0 174 142 2.2 124 101 Rashaida 0.5 47 72 0.6 36 55 Saho 3.6 313 324 4.5 257 266 Tigre 22.2 1,940 2,129 26.7 1,533 1,677 Tigrigna 61.9 5,422 4,218 55.9 3,206 2,546 Amhara 0.4 36 97 0.4 23 69 Other 0.2 17 27 0.1 9 17 Wealth index Lowest 16.8 1,472 1,709 20.3 1,161 1,342 Second 18.6 1,626 2,000 21.2 1,215 1,513 Middle 19.1 1,674 1,815 21.4 1,224 1,344 Fourth 20.9 1,833 1,404 18.8 1,079 832 Highest 24.6 2,149 1,826 18.4 1,053 939 Total 100.0 8,754 8,754 100.0 5,733 5,970 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Education categories refer to the highest level of education attended, whether or not that level was completed. na=Not applicable Women’s Characteristics and Status | 33 3.2 WOMEN’S MIGRATION In the 2002 EDHS, the migration status of women age 15-49 was determined on the basis of duration of continuous residence. Information on continuous residence was obtained by asking each woman the number of years she continuously lived in the place where she was living at the time of the survey. The duration of stay was recorded in completed years. From this information, it is possible to classify women as migrants or non-migrants. All women except those who have lived at the place of interview continuously since birth are considered migrants. Migrant women were asked whether they had lived in a city, town, or village just before they moved to the current place of residence and in which zoba they lived just before moving to the place of interview. Finally, they were asked the main reason for their move. Table 3.2 shows that 54 percent of women can be considered migrants. As might be expected, older women are more likely to have moved than younger women. The percentage of migrants is higher among urban women (63 percent) than rural women (47 percent), though Asmara has a lower proportion of migrant women than other towns (56 vs. 70 percent). By zoba, the highest percentage of migrants is in zoba Debub (61 percent) and the lowest is in zoba Semenawi Keih Bahri (43 percent). Women with no education or only primary school are somewhat more likely to have moved than those with more education, most probably because they tend to be older. Women in the higher quintiles of the wealth index are generally more likely to have moved than women who are in the lower quintiles. Table 3.2 indicates that the major reason for women’s migration is marriage (41 percent). This reason is most common among migrant women who reside in rural areas (60 percent) and zoba Debub (61 percent), as well as those with no formal education (54 percent) and those who fall in the two lower wealth quintiles (60-61 percent). War-related reasons (war, insecurity, deportation, and internal displacement) are the next most frequently cited reason (14 percent) for migration, followed by employment (13 percent) and housing (11 percent). War-related reasons for moving are more commonly cited by teenage women, women in Gash-Barka, and those who have some secondary education. Employment is mentioned as the main reason for moving among urban women, women in zoba Debubawi Keih Bahri and women in the highest wealth quintile. Not surprisingly, the proportion of those migrating because of education is highest among migrants who are young (21 percent), those with secondary or higher education (18 percent), and those who moved to Asmara (11 percent) and zoba Maekel (10 percent). The first column of Table 3.3 shows that the major type of female migration in Eritrea is rural- rural migration, which constitutes 40 percent of total migration. The next most common type of migration is urban-urban migration (28 percent). Surprisingly, rural-urban migration—the major form of migration in most developing countries—accounts for only one-fifth of total female migration in Eritrea. With the exception of urban-urban migration, marriage is the predominant reason for all forms of migration (Table 3.3), particularly for rural-rural migration. While rural women mainly migrate to urban areas for reasons relating to marriage, employment, and education, those who move from one urban area to another tend to do so for a broader variety of reasons, including almost equally war-related reasons, liberation, a better home, employment, and marriage. Information on migration streams both within and between zobas is presented in Table 3.4. Migration from one place to another within the same zoba (shown in bold figures in Table 3.4) is the major form of migration in all zobas except zoba Debubawi Keih Bahri. This intra-zoba migration is particularly pronounced in zoba Debub, where nearly four in five female migrants came from other areas within the zoba. 34 | Women’s Characteristics and Status Table 3.2 Reasons for migration by background characteristics Percentage of all women who have ever moved from their place of birth and percent distribution of these migrants by the main reason for migrating, according to background characteristics, Eritrea 2002 Migration Reason for migration Background characteristics Per- centage who mig- rated Number of women Libera- tion War- related reasons Drought, deforest- ation, famine Employ- ment Edu- cation Mar- riage Better home Other Missing Total Number of women migrants Age 15-19 36.8 2,001 13.4 22.1 0.6 9.5 21.4 17.1 13.3 2.3 0.3 100.0 737 20-24 51.2 1,454 9.2 16.8 1.2 12.0 4.9 42.0 10.2 3.3 0.3 100.0 744 25-29 56.3 1,543 7.1 12.5 1.5 16.2 3.7 45.3 11.9 1.7 0.2 100.0 869 30-34 59.9 1,109 12.0 11.1 2.1 13.0 2.0 47.2 9.8 2.7 0.2 100.0 664 35-39 66.2 1,085 12.3 12.7 1.9 13.0 3.0 42.6 12.0 2.2 0.2 100.0 719 40-44 62.3 827 12.1 11.4 2.3 14.5 3.3 45.3 9.8 1.1 0.0 100.0 515 45-49 65.1 734 6.7 12.8 2.9 13.2 1.5 49.4 12.5 0.9 0.0 100.0 478 Residence Urban 62.8 3,767 14.3 16.6 1.3 20.5 9.4 21.5 13.6 2.5 0.3 100.0 2,364 Asmara 55.9 1,899 12.3 17.8 1.0 19.2 11.1 18.8 17.4 1.8 0.4 100.0 1,062 Other towns 69.7 1,868 16.0 15.5 1.6 21.6 8.0 23.6 10.4 3.0 0.2 100.0 1,302 Rural 47.4 4,987 6.5 12.3 2.0 5.6 2.7 59.9 9.3 1.7 0.1 100.0 2,363 Zoba Debubawi Keih Bahri 43.7 324 7.1 10.7 0.7 37.2 7.1 23.4 5.7 8.2 0.0 100.0 142 Maekel 55.2 2,264 10.7 16.3 1.1 16.4 10.3 25.8 16.8 2.0 0.5 100.0 1,250 Semenawi Keih Bahri 42.9 1,148 15.5 12.1 3.7 16.0 4.5 33.4 12.9 2.0 0.0 100.0 493 Anseba 46.5 1,130 10.9 6.9 2.0 8.9 4.5 53.8 11.1 1.9 0.0 100.0 526 Gash-Barka 57.1 1,500 20.2 23.2 3.5 11.1 3.9 27.3 9.7 1.1 0.0 100.0 857 Debub 61.1 2,388 2.8 11.5 0.5 9.5 4.6 60.6 8.0 2.3 0.1 100.0 1,460 Education No education 55.8 4,384 8.0 12.3 2.8 10.1 1.7 54.1 9.4 1.6 0.0 100.0 2,448 Primary 59.1 1,637 11.6 12.2 0.9 19.3 3.7 37.7 12.4 2.0 0.2 100.0 968 Middle 45.7 974 16.3 17.8 0.3 9.3 11.4 24.6 14.9 4.7 0.7 100.0 445 Secondary + 49.2 1,760 12.9 21.3 0.2 16.3 18.3 14.1 14.2 2.4 0.4 100.0 866 Wealth index Lowest 40.1 1,472 8.2 12.2 3.6 2.5 2.7 60.4 9.1 1.2 0.0 100.0 590 Second 46.5 1,626 8.2 11.8 2.6 3.4 2.4 61.2 9.7 0.7 0.0 100.0 756 Middle 53.6 1,674 11.8 13.4 1.4 6.9 2.3 54.5 7.7 1.8 0.2 100.0 897 Fourth 69.0 1,833 9.1 15.2 1.7 17.8 9.1 29.4 14.2 3.4 0.2 100.0 1,265 Highest 56.8 2,149 13.1 17.0 0.5 23.8 9.5 19.8 13.4 2.5 0.4 100.0 1,220 Total 54.0 8,754 10.4 14.4 1.7 13.1 6.0 40.7 11.4 2.1 0.2 100.0 4,727 Note: Migration is defined as not having always lived in the place of residence at the time of the survey. It is based on the de jure population. Women’s Characteristics and Status | 35 Table 3.3 Reasons for migration by type of migration Percent distribution of female migrants by main reason for migrating, according to type of migration, Eritrea 2002 Reason for migration Type of migration Total Libera- tion War and war-related reasons Drought, deforesta- tion, famine Employ- ment Edu- cation Mar- riage Better home Other Missing Total Number of women migrants Urban-urban 28.0 17.8 21.1 0.7 17.1 4.8 17.1 18.1 2.8 0.4 100.0 1,324 Urban-rural 9.1 16.6 14.7 1.0 11.6 2.7 32.5 16.5 4.5 0.0 100.0 429 Rural- rural 40.0 4.0 11.9 2.3 4.3 2.7 66.1 7.5 1.1 0.1 100.0 1,892 Rural-urban 21.3 9.2 11.1 2.2 25.2 15.3 26.7 8.0 2.2 0.0 100.0 1,006 Abroad/missing 1.6 21.4 4.2 0.5 7.8 5.8 48.9 8.2 1.8 1.4 100.0 77 Total 100.0 10.4 14.4 1.7 13.1 6.0 40.7 11.4 2.1 0.2 100.0 4,727 Table 3.4 Zoba in-migration and out-migration, and immigration from abroad Percent distribution of female migrants by zoba of origin or country of origin, according to zoba of destination, Eritrea 2002 Zoba of destination Zoba/country of origin Debubawi Keih Bahri Maekel Semenawi Keih Bahri Anseba Gash-Barka Debub Total Debubawi Keih Bahri 17.5 1.8 1.6 0.4 0.1 1.1 1.6 Maekel 18.8 40.6 9.2 6.3 2.7 5.3 15.1 Semenawi Keih Bahri 5.1 4.2 48.3 5.0 0.8 3.8 8.2 Anseba 0.9 4.1 6.6 67.9 3.6 0.4 10.1 Gash-Barka 1.3 3.5 1.2 5.6 64.2 1.8 13.9 Debub 19.3 20.7 10.9 2.2 3.8 78.5 32.4 Ethiopia 33.1 19.1 2.7 0.9 2.6 7.7 9.3 Sudan 0.2 2.5 18.2 11.5 21.6 0.7 8.0 Other Africa/Middle East 3.4 1.9 1.2 0.2 0.5 0.4 0.9 Other/missing 0.4 1.6 0.2 0.0 0.0 0.3 0.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of women 142 1,250 493 526 857 1,460 4,727 Percentage of in-migrants 3.0 26.4 10.4 11.1 18.1 30.9 100.0 In-migrants from other zobas 64 429 145 103 95 180 1,016 Percent distribution 6.3 42.2 14.3 10.1 9.4 17.7 100.0 Out-migrants into other zobas 49 206 148 122 107 384 1,016 Percent distribution 4.8 20.3 14.6 12.0 10.5 37.8 100.0 Net number of migrants 15 223 -3 -19 -12 -204 0 Immigrants (returnees from abroad) 53 314 110 66 212 132 887 Percent distribution immigrants 6.0 35.4 12.4 7.4 23.9 14.9 100.0 36 | Women’s Characteristics and Status EDHS 2002 Figure 3.1 In-migration and Out-migration by Zoba Debubawi Keih Bahri 6% Maekel 42% Semenawi Keih Bahri 14% Anseba 10% Gash-Barka 9% Debub 18% Debubawi Keih Bahri 5% Maekel 20% Semenawi Keih Bahri 15% Anseba 12% Gash-Barka 11% Debub 38% In-migration Out-migration Migration between zobas is dominated by a major flow originating from zoba Debub (accounting for 38 percent of all out-migrants), followed by zoba Maekel (20 percent) and zoba Semenawi Keih Bahri (15 percent) (Figure 3.1). Zoba Maekel is the most favored zoba for in-migrants from other zobas (42 percent), followed by zoba Debub (18 percent) and zoba Semenawi Keih Bahri (14 percent). The least favored zoba is Debubawi Keih Bahri, receiving only 6 percent of all in-migrants. Comparing the number of internal in- and out-migrants, zoba Maekel experienced the largest net gain due to female migration and zoba Debub experienced the largest net decline. Table 3.4 also shows that nearly one-fifth (18 percent) of female migrants were from abroad, with the largest number coming from Ethiopia (9 percent) and the Sudan (8 percent). Zoba Maekel and zoba Gash-Barka were the most common destinations for migrants from abroad, accounting for 35 percent and 24 percent of international immigrants, respectively. One-third and one-fifth of the total migrants into zoba Debubawi Keih Bahri and zoba Maekel, respectively, were from Ethiopia. Immigrants from the Sudan constituted roughly one-fifth of the total migrants into zoba Gash-Barka and zoba Semenawi Keih Bahri. 3.3 EDUCATIONAL ATTAINMENT BY BACKGROUND CHARACTERISTICS Table 3.5 shows the percent distribution of respondents by highest level of schooling attended, according to background characteristics. As mentioned previously, about half of the respondents have never attended school and 16 percent have had only some primary schooling. While one-third of Eritrean women 15-49 have completed primary school, only 8 percent have completed secondary education. Younger women are more likely to be educated and to reach higher levels of education than older women. The proportion of women who have never attended school rises rapidly with increasing age. Only one in five women age 15-19 has no formal education, compared with more than three-fourths of women age 45-49. Similarly, 29 percent of women age 15-19 have some secondary or higher education, compared with only 4 percent of women age 45-49. Women’s Characteristics and Status | 37 Table 3.5 Educational attainment by background characteristics Percent distribution of women by highest level of schooling attended or completed, median number of years of schooling, and percent literate, according to background characteristics, Eritrea 2002 Highest level of schooling attended or completed Background characteristic No edu- cation Some primary Com- pleted primary1 Some middle Com- pleted middle2 Some secon- dary Com- pleted secon- dary3 More than secon- dary Total Number of women Median years of schooling Percent literate Age 15-19 21.2 20.8 3.6 22.3 3.2 25.2 3.2 0.6 100.0 2,001 4.6 77.1 20-24 42.2 17.1 2.8 8.3 3.2 15.6 8.8 1.9 100.0 1,454 2.0 56.4 25-29 47.3 16.9 2.7 6.3 2.1 12.7 10.2 1.8 100.0 1,543 0.8 51.7 30-34 65.0 12.8 1.9 4.3 1.2 5.2 7.6 2.1 100.0 1,109 0.0 36.5 35-39 65.4 15.7 1.2 3.6 1.1 4.5 7.5 1.1 100.0 1,085 0.0 34.5 40-44 73.0 12.0 1.4 3.0 1.1 3.6 3.1 2.9 100.0 827 0.0 26.5 45-49 79.3 12.5 1.2 1.8 1.3 1.6 2.1 0.3 100.0 734 0.0 19.4 Residence Total urban 22.7 16.5 3.0 13.0 3.6 24.0 13.9 3.3 100.0 3,767 5.4 76.0 Asmara 11.0 12.9 2.6 11.5 3.9 31.3 21.2 5.4 100.0 1,899 7.3 88.0 Other towns 34.5 20.1 3.4 14.6 3.2 16.5 6.6 1.0 100.0 1,868 3.3 63.7 Rural 70.8 16.2 1.9 5.9 1.1 3.4 0.6 0.1 100.0 4,987 0.0 28.9 Zoba Debubawi Keih Bahri 51.7 11.8 3.6 8.3 3.8 13.0 7.1 0.6 100.0 324 0.0 45.5 Maekel 14.3 14.4 2.9 12.5 3.9 29.2 18.1 4.7 100.0 2,264 6.7 85.0 Semenawi Keih Bahri 71.8 14.1 1.8 4.8 1.8 3.6 1.9 0.2 100.0 1,148 0.0 26.7 Anseba 59.5 18.8 1.4 10.2 1.4 6.8 1.9 0.0 100.0 1,130 0.0 40.4 Gash-Barka 77.3 13.6 1.2 3.3 1.2 2.4 0.7 0.2 100.0 1,500 0.0 21.2 Debub 51.7 20.4 3.2 10.7 1.4 9.0 2.9 0.7 100.0 2,388 0.0 48.1 Wealth Index Lowest 83.0 10.7 0.7 3.8 0.9 0.8 0.0 0.0 100.0 1,472 0.0 17.2 Second 77.5 13.1 1.1 5.3 0.5 2.2 0.2 0.0 100.0 1,626 0.0 21.2 Middle 65.3 20.1 2.2 7.2 1.1 3.6 0.4 0.1 100.0 1,674 0.0 33.6 Fourth 31.0 23.4 4.4 14.3 3.9 17.3 4.8 0.9 100.0 1,833 3.4 68.6 Highest 11.2 13.6 2.9 12.2 3.6 30.2 21.3 5.1 100.0 2,149 7.2 87.6 Total 50.1 16.3 2.4 9.0 2.1 12.3 6.4 1.5 100.0 8,754 0.0 49.1 1 Completed 5 grades in primary level 2 Completed 7 grades in middle level 3 Completed 11 grades in secondary level 38 | Women’s Characteristics and Status The level of education also varies greatly by residence. Women in rural areas are far less likely to be educated than their urban counterparts. Nearly three-fourths (71 percent) of rural women have not attended school, more than three times the proportion of urban women (23 percent). The urban-rural difference is more pronounced at the secondary-school level or higher. Only 4 percent of women in rural areas have attended secondary school, compared with 41 percent of women in urban areas. As expected, women who reside in Asmara have higher levels of educational attainment, especially at the secondary- school level or higher; 58 percent of women in Asmara have some secondary education. By zoba, the proportion of women with no formal education ranges from a high of 77 percent in zoba Gash-Barka to a low of 14 percent in zoba Maekel. Similarly, some secondary education is most common (52 percent) for women who reside in zoba Maekel and least common (3 percent) for women in zoba Gash-Barka. The wealth index exhibits a positive association with women’s educational attainment. Whereas 83 percent of the women in the lowest quintile of the wealth index have never been to school, the proportion for women in the highest quintile is only 11 percent. Less than 1 percent of women in the lowest quintile have at least some secondary education, compared with 57 percent of women in highest quintile. The median number of years of schooling is shown in Table 3.5 for the various subgroups. The figures confirm the above findings: younger women, those living in urban areas, those living in zoba Maekel, and those in the highest quintile of the wealth index have had more years of schooling. Table 3.5 also shows the percentage of women who are literate. Literacy is widely acknowledged as benefiting both the individual and the society and is associated with a number of positive outcomes for health and nutrition. Knowing the distribution of the literate population can help planners—especially in the areas of health and family planning—reach women with their messages. Literacy is increasingly important for taking advantage of day-to-day opportunities. In the 2002 EDHS, literacy was determined by asking respondents if they could read and write in any language without difficulty. This question was asked only to respondents who had never attended school or had attended primary school only; those who had attended middle school or above were assumed to be literate. This approach to measuring literacy is subjective, since no test of ability to read or write was administered. Overall, nearly half of Eritrean women are literate. The level of literacy is much higher for younger women than older women, ranging from a high of 77 percent for women age 15-19 to a low of 19 percent for women age 45-49. Urban women have a higher level of literacy (76 percent) than rural women (29 percent). Literacy levels also vary widely among zobas, with the percent literate more than four times higher in zoba Maekel (85 percent) than in zoba Gash-Barka (21 percent). There are also marked differences in literacy levels by women’s wealth status, ranging from 17 percent of women in the lowest wealth quintile to 88 percent of those in the highest quintile. Women’s Characteristics and Status | 39 3.4 REASONS FOR LEAVING SCHOOL Knowledge of the reasons for leaving school can guide policies aimed at enhancing women’s status in general and the level of women’s educational attainment in particular. Table 3.6 presents the percent distribution of women age 15-24 years who ever attended school but are not currently attending, by their reason for leaving school. Table 3.6 Reason for leaving school by zoba Percent distribution of women age 15-24 who have ever attended school but are not currently attending school by reason for leaving school, according to zoba, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Debubawi Semenawi Keih Keih Gash- Reason Bahri Maekel Bahri Anseba Barka Debub Total ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Got pregnant 4.8 1.8 0.9 1.4 3.6 1.3 1.8 Got married 27.8 19.3 25.3 43.7 41.4 60.9 38.1 Care for younger children 4.0 4.8 10.3 5.2 4.0 3.6 4.8 Family needed help 3.5 4.0 5.8 9.6 7.3 6.1 5.8 Could not pay school fees 2.1 2.8 2.2 0.7 2.7 1.9 2.2 Needed to earn money 7.2 4.8 3.7 2.2 6.0 1.8 3.7 Finished schooling 13.6 18.1 8.0 1.5 1.8 3.7 9.0 Did not pass entrance exam 13.8 19.8 2.8 3.2 1.1 3.3 9.1 Did not like school 5.5 7.5 6.9 6.5 6.4 2.7 5.7 School too far 2.7 2.1 6.5 1.8 9.6 3.1 3.6 Illness 11.1 12.4 26.2 20.0 11.9 10.9 14.0 Other 3.8 2.6 1.5 4.2 4.1 0.6 2.3 Missing/Don't know 0.0 0.2 0.0 0.0 0.0 0.0 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number not attending 33 489 123 156 153 427 1,381 Marriage is the single most important reason for leaving school among Eritrean women age 15- 24. Thirty-eight percent of women in this age group reported marriage as their major reason for leaving school. The next most frequently cited reason was illness (14 percent). Nine percent of women said they left school because they did not pass the entrance exams required to continue, while another 9 percent said they left school because they “finished” schooling. Other reasons cited for leaving school are: family needed help (6 percent), did not like school (6 percent), care for young children (5 percent), and school too far away (4 percent). It is interesting to note that inability to pay school fees and pregnancy are the two least common reasons for leaving school in Eritrea. Marriage is the main reason for leaving school in all zobas, except in zoba Semenawi Keih Bahri and zoba Maekel where “illness” and “did not pass entrance exams,” respectively, are cited more frequently. Sixty-one percent of women who reside in zoba Debub reported that they stopped schooling because they got married, compared with 44 percent of women in zoba Anseba, 41 percent in zoba Gash- Barka, and 28 percent in zoba Debubawi Keih Bahri. The proportion is relatively lower for zobas Maekel and Semenawi Keih Bahri (19 and 25 percent, respectively). Similar to the nation as a whole, illness is the second most frequently cited reason for leaving school in zoba Debub (11 percent), zoba Gash-Barka (12 percent) and zoba Anseba (20 percent). In zobas Debubawi Keih Bahri and Maekel, “finished schooling” and “did not pass entrance exam” are among the important reasons for leaving school. Twenty percent of women in zoba Maekel mentioned that they left school because they were not able to pass the entrance exams, while 18 percent said they left because they had finished schooling. In zoba 40 | Women’s Characteristics and Status Semenawi Keih Bahri, the need to care for younger children, and in zoba Anseba, that the family needed help, are cited fairly frequently. In zoba Gash-Barka, the third most important reason for girls leaving school is that the school is too far away. 3.5 ACCESS TO MASS MEDIA The 2002 EDHS collected information on the exposure of women to broadcast and print media by asking respondents if they usually read newspapers, listen to the radio, or watch television at least once a week. These data are important because they provide an indication of the extent to which Eritrean women are regularly exposed to the mass media, which are extensively used in Eritrea to disseminate reproductive health and other messages to the population. Table 3.7 shows the percentage of women exposed to different types of mass media by selected background characteristics. Overall, 18 percent of women usually access all three media at least once a week. Radio is the most popular medium; nearly three-fourths of women listen to the radio at least once a week, while much smaller proportions read newspapers (28 percent) or watch television (28 percent) weekly. More than one-fourth (26 percent) of women are not regularly exposed to any of these mass media. Access to the three media has increased since the previous EDHS. The proportion of women who listen to a radio at least once a week has increased by one-third from 53 percent in 1995 to 71 percent in 2002. Exposure to newspapers or magazines and to television has also increased over the same period, from 20 to 28 percent for newspapers/magazines and from 18 to 28 percent for television. The proportion of women who are exposed to any media at least once a week declines with age. As expected, women living in urban areas are much more likely to be exposed to the mass media, particularly newspapers/magazines and television, than rural women. Overall, more than one-third of urban women are exposed to all three media at least once a week, compared with only 2 percent of rural women. Among the zobas, exposure to all three types of media is greatest among women who reside in zoba Maekel (48 percent) and least among women in zoba Gash-Barka (3 percent). As expected, there is a positive association between the level of education and exposure to mass media; as the education level of respondents increases, the proportion who report exposure to each of the three mass media increases, especially the print media and television. Fifty-nine percent of women with some secondary education have access to all three media, compared with less than 1 percent of women with no formal education. Women’s economic status also reflects a positive relationship with access to mass media. Access to all three media ranges from a low of less than 1 percent among women in the two lowest quintiles of the wealth index to a high of 55 percent among women in the highest quintile of the wealth index. The differential is most pronounced for exposure to television: 2 percent for women in the lowest quintile compared with 82 percent for women in the highest quintile of the wealth index. Women’s Characteristics and Status | 41 Table 3.7 Exposure to mass media Percentage of women who usually read a newspaper at least once a week, watch television at least once a week, and listen to the radio at least once a week, by background characteristics, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Type of mass media exposure –––––––––––––––––––––––––––––––––– Reads a Watches Listens to newspaper television the radio at least at least at least All No Number Background once once once three mass of characteristic a week a week a week media media women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 45.2 35.5 81.9 24.8 14.8 2,001 20-24 32.6 31.0 72.3 21.6 25.0 1,454 25-29 29.3 29.6 70.7 19.1 27.6 1,543 30-34 21.3 22.4 66.8 14.5 31.4 1,109 35-39 18.1 25.7 69.9 13.8 28.7 1,085 40-44 14.1 20.6 61.8 9.1 36.1 827 45-49 9.3 20.2 61.6 6.4 36.4 734 Residence Total urban 50.4 60.6 88.6 38.4 7.6 3,767 Asmara 64.0 81.0 93.3 55.5 2.7 1,899 Other towns 36.7 39.8 83.8 21.0 12.6 1,868 Rural 11.0 3.7 58.3 1.8 40.7 4,987 Zoba Debubawi Keih Bahri 24.1 35.3 49.3 16.4 43.0 324 Maekel 58.8 70.6 92.2 47.8 4.0 2,264 Semenawi Keih Bahri 15.0 14.9 57.1 6.1 40.7 1,148 Anseba 19.9 14.7 66.5 8.2 31.4 1,130 Gash-Barka 11.0 4.8 58.4 2.7 41.1 1,500 Debub 19.9 14.4 71.7 8.3 27.0 2,388 Education No education 1.4 6.0 52.0 0.4 47.1 4,384 Primary 35.6 26.9 84.5 13.0 10.8 1,637 Middle 52.3 43.3 92.6 26.9 4.5 974 Secondary + 73.5 76.1 95.4 59.3 1.6 1,760 Wealth index Lowest 7.1 1.6 44.1 0.6 54.8 1,472 Second 8.4 2.4 54.6 0.9 44.4 1,626 Middle 13.3 3.8 67.2 1.8 31.6 1,674 Fourth 34.5 31.4 87.9 16.4 10.1 1,833 Highest 62.9 82.2 91.7 55.1 3.2 2,149 Total 2002 28.0 28.2 71.3 17.6 26.4 8,754 Total 1995 20.2 17.5 52.6 11.0 45.5 5,054 42 | Women’s Characteristics and Status 3.6 EMPLOYMENT STATUS In the 2002 EDHS, respondents were asked a series of questions about their employment, including whether they were currently working and, if not, whether they had worked in the 12 months before the survey. Table 3.8 and Figure 3.2 show the percent distribution of women age 15-49 by employment status, according to background characteristics. Overall, the majority of women (76 percent) did not work at all in the 12 months preceding the survey. Only one in five women reported being currently employed and 4 percent of women worked during the 12 months prior to the survey but were not currently employed. The current employment level has declined from 25 percent in 1995 to 20 percent in 2002 (Table 3.8). Older women are generally more likely to be employed than younger women. Women who are divorced, separated, or widowed are the most likely to be employed (43 percent), followed by those who have not married (24 percent); currently married women are the least likely to be employed (15 percent). Women with five or more children are less likely to be working at the time of the survey than women with fewer children or no children at all. The current employment level is higher for women in urban areas than in rural areas. By zoba, the highest proportion currently employed (35 percent) is in zoba Debubawi Keih Bahri, followed by zoba Maekel (31 percent), and the lowest is in zoba Anseba, at 9 percent. Education generally has a positive association with the level of current employment; the proportion of women who are currently employed ranges from 14 percent among uneducated women to 34 percent among women with at least some secondary education. The employment level has a positive correlation with women’s wealth status. Among women in the highest quintile of the wealth index, 33 percent are currently employed, compared with only 8 percent among women in the lowest quintile. EDHS 2002 Figure 3.2 Employment Status of Women Employed in last 12 months, currently employed 20% Employed in last 12 months, not currently employed 4% Not employed in last 12 months 76% Women’s Characteristics and Status | 43 Table 3.8 Employment status Percent distribution of women by employment status, according to background characteristics, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Employed in the 12 months Not preceding the survey employed ––––––––––––––––––––– in the 12 Not months Number Background Currently currently preceding of characteristic employed employed the survey Missing Total women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 10.1 2.8 87.1 0.1 100.0 2,001 20-24 18.5 4.3 77.2 0.0 100.0 1,454 25-29 25.0 3.2 71.8 0.1 100.0 1,543 30-34 21.3 5.3 73.3 0.0 100.0 1,109 35-39 24.9 4.1 71.0 0.0 100.0 1,085 40-44 23.3 4.5 72.1 0.0 100.0 827 45-49 24.4 5.7 69.8 0.2 100.0 734 Marital status Never married 23.5 2.8 73.6 0.0 100.0 2,044 Married or living together 14.5 3.9 81.6 0.0 100.0 5,733 Divorced/separated/widowed 43.3 7.1 49.5 0.2 100.0 977 Number of living children 0 20.4 2.7 76.8 0.0 100.0 3,019 1-2 22.2 5.0 72.7 0.1 100.0 2,287 3-4 21.6 5.0 73.4 0.0 100.0 1,772 5+ 13.6 3.9 82.5 0.0 100.0 1,677 Residence Total urban 28.6 3.5 67.7 0.1 100.0 3,767 Asmara 33.9 3.9 62.1 0.2 100.0 1,899 Other towns 23.3 3.2 73.5 0.1 100.0 1,868 Rural 13.2 4.3 82.5 0.0 100.0 4,987 Zoba Debubawi Keih Bahri 35.2 2.1 62.6 0.1 100.0 324 Maekel 30.8 3.5 65.6 0.2 100.0 2,264 Semenawi Keih Bahri 10.0 1.0 89.0 0.0 100.0 1,148 Anseba 9.4 2.1 88.5 0.0 100.0 1,130 Gash-Barka 14.9 5.2 79.9 0.0 100.0 1,500 Debub 20.0 6.3 73.6 0.0 100.0 2,388 Education No education 13.7 4.1 82.2 0.0 100.0 4,384 Primary 21.9 4.9 73.2 0.0 100.0 1,637 Middle 17.5 3.8 78.6 0.1 100.0 974 Secondary + 34.4 3.0 62.5 0.2 100.0 1,760 Wealth index Lowest 7.6 1.9 90.5 0.0 100.0 1,472 Second 13.0 4.2 82.7 0.0 100.0 1,626 Middle 14.0 7.1 78.9 0.0 100.0 1,674 Fourth 26.0 3.7 70.2 0.1 100.0 1,833 Highest 32.5 3.1 64.2 0.1 100.0 2,149 Total 2002 19.8 4.0 76.1 0.0 100.0 8,754 Total 1995 25.0 1.8 73.0 1.4 100.0 5,054 44 | Women’s Characteristics and Status 3.7 OCCUPATION Respondents who were currently employed or had worked within the year before the survey were asked to state their occupation; results are shown in Table 3.9. The agricultural sector employs 30 percent of currently working women, a far lower proportion than in 1995 (55 percent). In 2002, almost one-fourth of working women were employed in sales and service occupations (24 percent), followed by domestic service (17 percent), and skilled manual jobs (12 percent). Ten percent of employed women work in professional, technical, and managerial occupations. The occupational pattern of women who work varies by age. Women in all age groups except those in their twenties are most likely to be engaged in agricultural work. Those age 20-29 are most likely to be working in sales and service occupations. More than one-fourth (27 percent) of women age 15-19 are domestic-service workers. Currently married women who are working tend to be employed in agricultural work (41 percent), whereas never-married women and those who are divorced, separated or widowed tend to work in either sales and service jobs or in domestic service. The large majority (63 percent) of employed rural women work in agriculture. Working women who reside in urban areas, particularly in Asmara, are almost exclusively employed in non-agricultural occupations; 29 percent of employed urban women work in sales and service jobs and nearly one-fourth (23 percent) work in domestic service. Women are most likely to be employed in agricultural activities in all zobas except zoba Maekel and zoba Semenawi Keih Bahri, where sales and services and domestic service are the predominant occupations. Education is strongly related to the type of occupation. Over half (55 percent) of women who are employed and have never attended school work in agriculture. Working women with primary and middle education are about as likely to be employed in agriculture as in sales and service occupations, in domestic service, and in skilled manual jobs. Women who have at least some secondary education are most likely to be employed in sales and services (29 percent), followed closely by professional, managerial, or technical jobs (28 percent), and clerical occupations (18 percent). Agriculture is by far the major occupation of working women in the lower quintiles of the wealth index, while sales and services account for the largest proportion of women in the fourth and highest quintiles (29 and 28 percent, respectively). Nearly one-fourth of women in the fourth and highest quintile are employed in domestic service. 3.8 EARNINGS, EMPLOYERS AND CONTINUITY OF EMPLOYMENT Table 3.10 shows the percent distribution of women employed in the 12 months preceding the survey by type of earnings, type of employer, and continuity of employment, according to whether they work in agricultural or non-agricultural jobs. Almost two-thirds (65 percent) of employed women receive payments in cash only, while 15 percent do not receive any form of payment for their work, 13 percent receive payment in kind only, and 8 percent receive both cash and in-kind payments (Figure 3.3). Women who are engaged in nonagricultural jobs are more than five times as likely to be paid in cash only as those who work in agricultural jobs. On the other hand, women employed in the agricultural sector are much more likely to receive payment in kind or no payment than those who work in nonagricultural jobs (Table 3.10). Data on type of employer in Table 3.10 indicate that over half (53 percent) of working women are employed by someone outside the family, while 39 percent are self-employed, and 8 percent work for a family member. These results are also displayed graphically in Figure 3.4. Women engaged in agricultural occupations are predominantly self-employed (68 percent); the majority of women involved in nonagricultural activities are employed by nonfamily members (68 percent). Women’s Characteristics and Status | 45 Table 3.9 Occupation Percent distribution of women employed in the 12 months preceding the survey by occupation, according to background characteristics, Eritrea 2002 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Professional/ Sales Un- Number Background technical/ and Skilled skilled Domestic Agri- of characteristic managerial Clerical services manual manual service culture Missing Total women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 4.2 3.0 13.6 15.0 0.1 26.6 37.6 0.0 100.0 258 20-24 14.9 9.3 25.7 10.7 0.3 15.2 23.9 0.1 100.0 331 25-29 9.2 7.9 33.8 12.0 0.3 13.9 21.5 1.4 100.0 434 30-34 12.9 9.8 23.9 10.0 0.3 11.3 31.2 0.5 100.0 296 35-39 10.7 8.0 20.8 14.3 0.5 21.3 22.9 1.4 100.0 314 40-44 13.3 4.4 16.4 7.1 1.3 16.7 39.5 1.4 100.0 230 45-49 3.9 1.5 21.8 15.6 0.9 13.4 41.6 1.2 100.0 220 Marital status Never married 13.6 9.4 26.5 13.0 0.3 21.9 15.3 0.0 100.0 538 Married or living together 11.2 7.0 21.6 8.9 0.6 9.1 40.6 1.0 100.0 1,054 Divorced/separated/widowed 4.1 3.4 24.0 17.8 0.4 27.3 21.4 1.6 100.0 492 Number of living children 0 12.7 9.1 26.1 14.1 0.2 18.5 18.9 0.3 100.0 699 1-2 11.1 7.6 22.9 12.8 0.2 19.3 24.4 1.8 100.0 621 3-4 8.7 4.7 22.9 10.4 1.6 15.6 35.3 1.0 100.0 471 5+ 4.4 2.5 19.2 8.3 0.0 8.6 56.8 0.1 100.0 293 Residence Total urban 15.1 10.8 28.5 14.6 0.6 23.2 5.8 1.5 100.0 1,211 Asmara 17.5 13.5 27.6 15.2 0.6 23.3 1.3 1.1 100.0 717 Other towns 11.7 6.8 29.8 13.8 0.5 23.1 12.2 2.0 100.0 494 Rural 3.2 1.1 16.4 8.5 0.3 7.7 62.6 0.1 100.0 873 Zoba Debubawi Keih Bahri 3.3 9.3 21.1 4.5 0.5 25.0 34.6 1.6 100.0 121 Maekel 16.4 12.8 27.3 15.1 0.6 22.3 4.6 1.0 100.0 775 Semenawi Keih Bahri 7.8 4.8 20.7 12.9 2.0 33.4 18.4 0.0 100.0 126 Anseba 10.9 6.1 16.8 5.0 0.0 15.9 45.4 0.0 100.0 130 Gash-Barka 4.0 2.7 26.4 14.0 0.8 8.9 42.5 0.7 100.0 302 Debub 7.0 1.2 19.7 10.1 0.0 8.8 52.1 1.1 100.0 629 Education No education 0.5 0.0 18.8 9.7 0.7 14.6 55.2 0.5 100.0 780 Primary 1.9 1.4 22.7 18.1 0.0 26.8 28.3 0.7 100.0 439 Middle 6.9 6.8 22.2 16.0 0.1 26.7 18.9 2.3 100.0 207 Secondary + 28.1 18.2 29.8 9.6 0.7 9.3 3.3 1.0 100.0 657 Wealth index Lowest 0.7 0.0 18.0 7.0 0.6 1.7 72.1 0.0 100.0 140 Second 2.5 1.1 13.1 5.2 0.8 3.6 73.3 0.3 100.0 280 Middle 2.5 0.8 14.3 9.7 0.0 10.7 61.7 0.3 100.0 352 Fourth 8.5 3.9 29.4 19.2 0.4 23.1 15.1 0.5 100.0 544 Highest 19.4 14.8 28.2 11.5 0.6 22.4 1.2 1.8 100.0 766 Total 2002 10.1 6.7 23.5 12.1 0.5 16.7 29.6 0.9 100.0 2,084 Total 1995 10.2 na 8.8 12.1 na 13.2 55.4 0.3 100.0 1,265 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– na = Not applicable 46 | Women’s Characteristics and Status Table 3.10 Employment characteristics Percent distribution of women employed in the 12 months preceding the survey by type of earnings, type of employer and continuity of employment, according to type of employment (agricultural or nonagricultural), Eritrea 2002 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Type of employment ––––––––––––––––––– Agri- Nonagri- cultural cultural Characteristic work work

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