Guyana - Demographic and Health Survey - 2010

Publication date: 2010

Guyana Demographic and Health Survey 2009 G uyana 2009 D em ographic and H ealth Survey Guyana Demographic and Health Survey 2009 Ministry of Health Georgetown, Guyana Bureau of Statistics Georgetown, Guyana ICF Macro (Technical Assistance) October 2010 Ministry of Health This report summarizes the results of the 2009 Guyana Demographic and Health Survey (2009 GDHS), implemented by the Ministry of Health (MOH) and the Bureau of Statistics (BOS), with technical assistance from ICF Macro. Funds for the survey were provided in their entirety by the local mission of the United States Agency for International Development (USAID/Guyana) under the MEASURE DHS program. The 2009 GDHS is part of the worldwide MEASURE DHS program, which is designed to assist developing countries to collect, analyze, and disseminate data on fertility, family planning, and maternal and child health. Additional information about the 2009 GDHS may be obtained from Bureau of Statistics (BOS) Avenue of the Republic and Brickdam, Stabroek Georgetown, Guyana Telephone: 592 225 6150 Fax: 592 226 2036 Web site: www.statisticsguyana.gov.gy Additional information about the Demographic and Health Surveys program may be obtained from MEASURE DHS, ICF Macro 11785 Beltsville Drive, Suite 300 Calverton, MD 20705 USA Telephone: 301-572-0200; fax: 301-572-0999 Email: reports@measuredhs.com Web site: www.measuredhs.com Suggested citation: Ministry of Health (MOH), Bureau of Statistics (BOS), and ICF Macro. 2010. Guyana Demographic and Health Survey 2009. Georgetown, Guyana: MOH, BOS, and ICF Macro. Contents | iii CONTENTS Páge TABLES AND FIGURES . ix FOREWORD .xvii SUMMARY OF FINDINGS . xix BASIC INDICATORS . xxix MAP OF GUYANA . xxx CHAPTER 1 INTRODUCTION 1.1 Overview . 1 1.2 Objectives. 1 1.3 Sample Design. 1 1.4 Questionnaires . 2 1.5 Pretest Activities, Training, and Fieldwork. 3 1.6 Data Processing . 3 1.7 Response Rates. 3 1.8 Contents of the Report. 5 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS 2.1 Characteristics of the Population. 9 2.1.1 Age-Sex Structure . 9 2.1.2 Household Composition . 11 2.1.3 Children’s Living Arrangements and Orphanhood . 12 2.1.4 Educational Attainment. 14 2.1.5 School Attendance. 17 2.2 Housing Characteristics. 20 2.2.1 Drinking Water and Housing Characteristics. 20 2.2.2 Sanitation Facilities . 24 2.2.3 Household Possessions. 25 2.3 Wealth Quintiles. 26 2.4 Birth Registration . 27 CHAPTER 3 CHARACTERISTICS OF SURVEY RESPONDENTS 3.1 Background Characteristics of Survey Respondents. 29 3.2 Educational Attainment of Respondents . 31 3.3 Literacy. 33 3.4 Exposure and Access to Mass Media . 36 3.5 Employment Status and Type of Occupation. 38 3.6 Health Insurance Coverage . 44 iv │ Contents 3.7 Knowledge and Attitudes Concerning Tuberculosis . 47 3.8 Smoking . 50 CHAPTER 4 FERTILITY 4.1 Current Fertility. 53 4.2 Fertility Differentials. 55 4.3 Fertility Trends. 56 4.4 Children Ever Born and Living . 57 4.5 Birth Intervals. 58 4.6 Age at First Birth. 60 4.7 Teenage Pregnancy and Motherhood . 62 CHAPTER 5 FAMILY PLANNING 5.1 Knowledge of Contraceptive Methods. 65 5.2 Knowledge of Contraception by Background Characteristics . 67 5.3 Ever Use of Contraceptive Methods . 67 5.4 Current Use of Contraception. 69 5.5 Differentials in Current Use . 71 5.6 Number of Children at First Use of Contraception . 73 5.7 Use of Social Marketing of Brands of Pills and Condoms. 74 5.8 Sources for Family Planning Methods and Informed Choice . 75 5.9 Contraceptive Discontinuation . 78 5.10 Intention to Use Family Planning Among Non-users . 78 5.11 Exposure to Family Planning in the Mass Media. 81 5.12 Contact of Non-users with Family Planning Providers . 83 5.13 Husband/Partner's Knowledge of Women's Use of Contraception . 84 CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY 6.1 Current Marital Status . 85 6.2 Age at First Union . 87 6.3 Age at First Sexual Intercourse . 90 6.4 Recent Sexual Activity. 93 6.5 Postpartum Amenorrhea, Abstinence, and Insusceptibility. 96 6.6 Termination of Exposure to Pregnancy. 98 CHAPTER 7 FERTILITY PREFERENCES 7.1 Desire for More Children . 101 7.2 Desire to Limit Childbearing by Background Characteristics. 104 7.3 Need and Demand for Family Planning Services. 106 7.4 Ideal Family Size. 110 7.5 Fertility Planning Status . 111 7.6 Wanted Fertility Rates. 112 CHAPTER 8 INFANT AND CHILD MORTALITY 8.1 Definition, Data Quality, and Methodology. 115 8.2 Current Estimates of Infant and Child Mortality. 116 Contents | v 8.3 Differentials in Infant and Child Mortality . 117 8.4 Perinatal Mortality. 120 8.5 High-Risk Fertility Behavior. 122 CHAPTER 9 REPRODUCTIVE HEALTH 9.1 Antenatal Care. 125 9.1.1 Content of Antenatal Care. 128 9.1.2 Tetanus Toxoid Injections . 129 9.2 Delivery Care . 131 9.3 Postnatal Care. 135 9.4 Problems in Accessing Health Care . 139 CHAPTER 10 CHILD HEALTH 10.1 Child’s Size at Birth . 141 10.2 Vaccination of Children . 143 10.2.1 Vaccination at Any Time before the Survey . 143 10.2.2 Trends in Vaccination Coverage . 146 10.3 Acute Respiratory Infection . 147 10.4 Fever. 149 10.5 Diarrhea: Prevalence and Treatment . 151 10.5.1 Prevalence of Diarrhea . 151 10.5.2 Treatment of Diarrhea . 153 10.5.3 Feeding Practices during Diarrhea . 154 10.5.4 Knowledge of ORS Packets . 155 10.5.5 Disposal of Stools. 156 CHAPTER 11 NUTRITION OF CHILDREN AND ADULTS 11.1 Nutritional Status of Young Children . 159 11.2 Breastfeeding. 165 11.2.1 Initial Breastfeeding . 165 11.2.2 Breastfeeding Status by Age . 167 11.2.3 Duration and Frequency of Breastfeeding. 169 11.3 Complementary Foods . 170 11.4 Appropriate Infant and Young Child Feeding (IYCF) . 172 11.5 Anemia in Children . 175 11.6 Micronutrient Intake among Children . 177 11.7 Presence of Iodized Salt in Households . 180 11.8 Nutritional Status of Women and Men. 181 11.9 Foods Consumed by Mothers. 184 11.10 Anemia in Women and Men . 186 11.11 Micronutrient Intake among Mothers. 189 vi │ Contents CHAPTER 12 MALARIA 12.1 Ownership of Mosquito Nets . 191 12.2 Use of Mosquito Nets by Children. 193 12.3 Use of Mosquito Nets by Women . 195 12.4 Malaria during Pregnancy . 197 12.5 Prevalence and Management of Childhood Malaria . 199 CHAPTER 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR 13.1 Knowledge of AIDS. 201 13.2 Knowledge of HIV Prevention Methods. 203 13.3 Beliefs about AIDS . 206 13.4 Knowledge of Prevention of Mother-to-Child Transmission of HIV . 210 13.5 Stigma Associated with AIDS and Attitudes Related to HIV/AIDS. 212 13.6 Attitudes toward Negotiating Safer Sex . 215 13.7 Attitudes toward Condom Education for Youth. 217 13.8 Higher-Risk Sex . 218 13.8.1 Multiple Partners and Condom Use . 218 13.8.2 Transactional Sex . 222 13.9 Coverage of Prior HIV Testing . 222 13.9.1 HIV Testing during Antenatal Care . 226 13.10 Male Circumcision . 228 13.11 Self-Reporting of Sexually Transmitted Infections. 229 13.12 Prevalence of Medical Injections . 231 13.13 HIV/AIDS-Related Knowledge and Sexual Behavior among Young Adults . 234 13.13.1 HIV/AIDS-Related Knowledge among Young Adults . 234 13.13.2 Age at First Sex . 236 13.13.3 Condom Use at First Sex. 238 13.13.4 Abstinence and Premarital Sex. 240 13.13.5 Higher-Risk Sex and Condom Use among Young Adults . 242 13.13.6 Age Mixing in Sexual Relationships among Women . 244 13.13.7 Drunkenness during Sex among Young Adults . 246 13.13.8 Recent HIV Testing among Youth. 248 CHAPTER 14 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH OUTCOMES 14.1 Employment and Forms of Earnings. 251 14.2 Control over Women’s and Men’s Earnings . 252 14.3 Women’s Participation in Household Decision-Making. 257 14.4 Attitudes toward Wife Beating. 262 14.5 Attitudes toward Refusing Sex with Husband. 266 14.6 Women’s Empowerment Indicators . 271 14.7 Current Use of Contraception by Women’s Status . 272 14.8 Ideal Family Size and Unmet Need by Women’s Status . 273 14.9 Reproductive Health Care and Women’s Empowerment Status. 274 Contents | vii REFERENCES . 277 APPENDIX A SAMPLE DESIGN. 279 A.1 Sample Frame . 279 A.2 Sample Selection . 279 A.3 Sample Allocation . 280 A.4 Response Rates. 281 APPENDIX B ESTIMATES OF SAMPLING ERRORS . 285 APPENDIX C DATA QUALITY TABLES. 309 APPENDIX D SURVEY PERSONNEL . 315 APPENDIX E QUESTIONNAIRES . 317 Tables and Figures | ix TABLES AND FIGURES Page CHAPTER 1 INTRODUCTION Table 1.1 Results of the household and individual interviews .4 Table 1.2 Number of women and men interviewed by residence and region.5 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS Table 2.1 Household population by age, sex, and residence .10 Table 2.2 Household composition .11 Table 2.3 Children’s living arrangements and orphanhood.13 Table 2.4.1 Educational attainment of the female household population.15 Table 2.4.2 Educational attainment of the male household population.16 Table 2.5 School attendance ratios .18 Table 2.6 Household drinking water.21 Table 2.7 Housing characteristics.23 Table 2.8 Sanitation facilities .24 Table 2.9 Durable goods.25 Table 2.10 Wealth quintiles .27 Table 2.11 Birth registration of children under age 5.28 Figure 2.1 Population Pyramid .10 Figure 2.2 Percentage of Female-Headed Households by Residence.12 Figure 2.3 Age-Specific School Attendance Rates, by Sex .19 CHAPTER 3 CHARACTERISTICS OF SURVEY RESPONDENTS Table 3.1 Background characteristics of respondents.29 Table 3.2.1 Educational attainment of respondents: Women .30 Table 3.2.2 Educational attainment of respondents: Men.32 Table 3.3.1 Literacy: Women .34 Table 3.3.2 Literacy: Men .35 Table 3.4.1 Exposure to mass media: Women.36 Table 3.4.2 Exposure to mass media: Men.37 Table 3.5 Employment status .39 Table 3.6.1 Occupation: Women .42 Table 3.6.2 Occupation: Men .43 Table 3.7 Type of employment.44 Table 3.8.1 Health insurance coverage: Women .45 Table 3.8.2 Health insurance coverage: Men .46 Table 3.9.1 Knowledge and attitudes concerning tuberculosis: Women.48 Table 3.9.2 Knowledge and attitudes concerning tuberculosis: Men .49 Table 3.10.1 Use of tobacco: Women .51 Table 3.10.2 Use of tobacco: Men.52 x | Tables and Figures Figure 3.1 Respondents Completing Secondary or Higher Education, by Residence and Wealth Quintile.33 Figure 3.2 Respondents Currently Employed, by Residence and Education.41 CHAPTER 4 FERTILITY Table 4.1 Current fertility .54 Table 4.2 Fertility by background characteristics.55 Table 4.3 Trends in age-specific fertility rates .56 Table 4.4 Children ever born and living .57 Table 4.5 Birth intervals .59 Table 4.6 Age at first birth.61 Table 4.7 Median age at first birth by background characteristics .62 Table 4.8 Teenage pregnancy and motherhood .63 Figure 4.1 Total Fertility Rates for the Three Years Preceding the Survey, by Residence.54 Figure 4.2 Births with a Birth Interval of Less than 24 Months, by Residence and Wealth Quintile.60 CHAPTER 5 FAMILY PLANNING Table 5.1 Knowledge of contraceptive methods .66 Table 5.2 Knowledge of contraceptive methods by selected background characteristics .67 Table 5.3 Ever use of contraception by age: Women .68 Table 5.4 Ever use of contraception by age: Men .69 Table 5.5 Current use of contraception by age .70 Table 5.6 Current use of contraception by background characteristics .72 Table 5.7 Number of children at first use of contraception .74 Table 5.8.1 Brand of pills .74 Table 5.8.2 Brand of condoms.75 Table 5.9 Source of modern contraception methods .76 Table 5.10 Informed choice.77 Table 5.11 First-year contraceptive discontinuation rates .78 Table 5.12 Future use of contraception among non-users .79 Table 5.13.1 Reasons for not intending to use contraception .80 Table 5.13.2 Preferred method of contraception for future use.81 Table 5.14 Exposure to family planning messages.82 Table 5.15 Contact of non-users with family planning providers .83 Figure 5.1 Contraceptive Use among Currently Married Women, by Region.73 CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY Table 6.1 Current marital status by age and sex .86 Table 6.2 Current marital status by background characteristics .87 Table 6.3 Age at first union .88 Table 6.4 Median age at first union by background characteristics .89 Table 6.5.1 Age at first sexual intercourse: Women.91 Table 6.5.2 Age at first sexual intercourse: Men.91 Table 6.6.1 Median age at first sexual intercourse, by background characteristics: Women .92 Table 6.6.2 Median age at first sexual intercourse, by background characteristics: Men .93 Table 6.7.1 Recent sexual activity: Women .94 Tables and Figures | xi Table 6.7.2 Recent sexual activity: Men.94 Table 6.8 Postpartum amenorrhea, abstinence and insusceptibility .97 Table 6.9 Median duration of postpartum insusceptibility by background characteristics.98 Table 6.10 Menopause.99 Figure 6.1 Median Age at First Sexual Intercourse by Region.92 CHAPTER 7 FERTILITY PREFERENCES Table 7.1.1 Fertility preferences by number of living children .102 Table 7.1.2 Fertility preferences by background characteristics .103 Table 7.2 Desire to limit childbearing by background characteristics.105 Table 7.3 Need and demand for family planning .108 Table 7.4 Ideal number of children.111 Table 7.5 Fertility planning status .112 Table 7.6 Wanted fertility rates .113 Figure 7.1 Fertility Practices of Women in Union.104 Firuge 7.2 Desire for No More Children by Region .106 Figure 7.3 Components of the Unmet Need for Family Planning .109 Figure 7.4 Women with Unmet Need and Demand Satisfied, by Region.109 CHAPTER 8 INFANT AND CHILD MORTALITY Table 8.1 Early childhood mortality rates .117 Table 8.2 Early childhood mortality rates by socioeconomic characteristics.118 Table 8.3 Early childhood mortality rates by demographic characteristics.119 Table 8.4 Perinatal mortality .121 Table 8.5 High-risk fertility behavior .123 Figure 8.1 Infant Mortality Rates for the 10-Year Period Preceding the Survey, by Residence and Wealth Quintile .119 Figure 8.2 Births in the Last Five Years and Women in Categories of High-risk Fertility Behavior.124 CHAPTER 9 REPRODUCTIVE HEALTH Table 9.1 Antenatal care .126 Table 9.2 Number of antenatal care visits and timing of first visit.127 Table 9.3 Components of antenatal care.129 Table 9.4 Tetanus toxoid injections.130 Table 9.5 Place of delivery .133 Table 9.6 Assistance during delivery.134 Table 9.7 Timing of postnatal care .137 Table 9.8 Type of provider of first postnatal checkup.138 Table 9.9 Problems in accessing health care .140 Figure 9.1 Two Tetanus Vaccinations during Last Pregnancy and Births Protected against Neonatal Tetanus, by Residence .131 xii | Tables and Figures CHAPTER 10 CHILD HEALTH Table 10.1 Child’s weight and size at birth .142 Table 10.2 Vaccinations by source of information.143 Table 10.3 Vaccinations by background characteristics.144 Table 10.4 Vaccinations in the first 18 months of life.147 Table 10.5 Prevalence and treatment of symptoms of acute respiratory infection (ARI).148 Table 10.6 Prevalence and treatment of fever .150 Table 10.7 Prevalence of diarrhea .152 Table 10.8 Diarrhea treatment .154 Table 10.9 Feeding practices during diarrhea.155 Table 10.10 Knowledge of ORS packets or pre-packaged ORS liquid.156 Table 10.11 Disposal of children's stools .157 Figure 10.1 Vaccination Coverage at Any Time before the Survey among Children 18-29 Months.145 Figure 10.2 Children Age 18-29 Months with All Vaccines at Any Time before the Survey, by Residence .145 CHAPTER 11 NUTRITION OF CHILDREN AND ADULTS Table 11.1.1 Nutritional status of children by demographic characteristics.162 Table 11.1.2 Nutritional status of children by socioeconomic characteristics .164 Table 11.2 Initial breastfeeding .166 Table 11.3 Breastfeeding status by child’s age.168 Table 11.4 Median duration and frequency of breastfeeding .170 Table 11.5 Foods consumed by children in the day or night preceding the interview .171 Table 11.6 Infant and young child feeding (IYCF) practices .174 Table 11.7 Prevalence of anemia in children.176 Table 11.8 Micronutrient intake among children .179 Table 11.9 Presence of iodized salt in the household .180 Table 11.10.1 Nutritional status by background characteristics: Women .182 Table 11.10.2 Nutritional status by background characteristics: Men.183 Table 11.11 Foods consumed by mothers in the day or night preceding the interview.185 Table 11.12.1 Prevalence of anemia: Women .187 Table 11.12.2 Prevalence of anemia: Men .188 Table 11.13 Micronutrient intake among mothers.190 Figure 11.1 Nutritional Status of Children under Age 5 .153 Figure 11.2 Children under Five Stunted and Underweight, by Residence .165 Figure 11.3 Infant Feeding Practices by Age.169 CHAPTER 12 MALARIA Table 12.1 Household possession of mosquito nets .192 Table 12.2 Use of mosquito nets by children .194 Table 12.3.1 Use of mosquito nets by women.196 Table 12.3.2 Use of mosquito nets by pregnant women.198 Table 12.4 Prevalence and prompt treatment of children with fever.200 Tables and Figures | xiii CHAPTER 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR Table 13.1 Knowledge of AIDS .202 Table 13.2 Knowledge of HIV prevention methods.204 Table 13.3.1 Comprehensive knowledge about AIDS: Women.208 Table 13,3,2 Comprehensive knowledge about AIDS: Men .209 Table 13.4 Knowledge of prevention of mother-to-child transmission of HIV.211 Table 13.5.1 Accepting attitudes toward those living with HIV: Women.213 Table 13.5.2 Accepting attitudes toward those living with HIV: Men.214 Table 13.6 Attitudes toward negotiating safer sex with husband .216 Table 13.7 Adult support of education about condom use to prevent AIDS.217 Table 13.8.1 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months: Women.220 Table 13.8.2 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months: Men .221 Table 13.9.1 Coverage of prior HIV testing: Women .224 Table 13.9.2 Coverage of prior HIV testing: Men.225 Table 13.10 Pregnant women counseled and tested for HIV.227 Table 13.11 Male circumcision .228 Table 13.12 Self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms.230 Table 13.13 Prevalence of medical injections .232 Table 13.14 Comprehensive knowledge about AIDS and of a source for condoms among youth .235 Table 13.15 Age at first sexual intercourse among youth .237 Table 13.16 Condom use at first sexual intercourse among youth .239 Table 13.17 Premarital sexual intercourse in the past year and condom use during premarital sexual intercourse among youth .241 Table 13.18 Higher-risk sexual intercourse among youth and condom use at last higher-risk intercourse in the past 12 months .243 Table 13.19 Age mixing in sexual relationships among women age 15-19 .245 Table 13.20 Drunkenness during sexual intercourse among youth .247 Table 13.21 Recent HIV tests among youth .249 Figure 13.1 Knowledge of Two HIV Prevention Methods (Using Condoms and Limiting Sexual Intercourse to One Uninfected Faithful Partner), by Residence and Education .206 Figure 13.2 Comprehensive Knowledge about AIDS, by Residence and Education .210 Figure 13.3 Women and Men Seeking Treatment for STIs .231 Figure 13.4 Type of Facility Where Last Medical Injection Was Received.233 Figure 13.5 Abstinence, Being Faithful, and Condom Use (ABC) among Young Women and Men Age 15-24 .244 CHAPTER 14 WOMEN’S EMPOWERMENT AND DEMOGRAPHIC AND HEALTH OUTCOMES Table 14.1 Employment and cash earnings of currently married women and men.252 Table 14.2.1 Control over women's cash earnings and relative magnitude of women's earnings: Women.253 Table 14.2.2 Control over men's cash earnings .255 Table 14.3 Women's control over her own earnings and over those of her husband.256 xiv | Tables and Figures Table 14.4.1 Women's participation in decision making.257 Table 14.4.2 Women's participation in decision making according to men .258 Table 14.5.1 Women's participation in decision-making by background characteristics.259 Table 14.5.2 Men's attitude toward wives' participation in decision making .261 Table 14.6.1 Attitude toward wife beating: Women .264 Table 14.6.2 Attitude toward wife beating: Men.265 Table 14.7.1 Attitude toward refusing sexual intercourse with husband: Women .267 Table 14.7.2 Attitude toward refusing sexual intercourse with husband: Men .268 Table 14.7.3 Men's attitude toward a husband's rights when his wife refuses to have sexual intercourse .270 Table 14.8 Indicators of women's empowerment .272 Table 14.9 Current use of contraception by women's status.273 Table 14.10 Women's empowerment and ideal number of children and unmet need for family planning.274 Table 14.11 Reproductive health care by women's empowerment.275 Figure 14.1 Number of Decisions in Which Currently Married Women Participate.262 APPENDIX A SAMPLE DESIGN Table A.1 Sample allocation .281 Table A.2.1 Sample implementation by residence .282 Table A.2.2 Sample implementation by region .283 APPENDIX B ESTIMATES OF SAMPLING ERRORS Table B.1 List of selected variables for sampling errors.287 Table B.2.1 Sampling errors for the total sample.288 Table B.2.2 Sampling errors for the Urban sample.289 Table B.2.3 Sampling errors for the Georgetown urban sample .290 Table B.2.4 Sampling errors for the rest of urban sample (other than Georgetown urban) .291 Table B.2.5 Sampling errors for the Rural sample .292 Table B.2.6 Sampling errors for the Coastal total sample.293 Table B.2.7 Sampling errors for the Coastal urban sample.294 Table B.2.8 Sampling errors for the Coastal rural sample .295 Table B.2.9 Sampling errors for the Interior sample.296 Table B.2.10 Sampling errors for the Region 1 sample .297 Table B.2.11 Sampling errors for the Region 2 sample .298 Table B.2.12 Sampling errors for the Region 3 sample .299 Table B.2.13 Sampling errors for the Region 4 sample .300 Table B.2.14 Sampling errors for the Region 5 sample .301 Table B.2.15 Sampling errors for the Region 6 sample .302 Table B.2.16 Sampling errors for the Region 7 sample .303 Table B.2.17 Sampling errors for the Region 8 sample .304 Table B.2.18 Sampling errors for the Region 9 sample .305 Table B.2.19 Sampling errors for the Region 10 sample .306 Table B.3 Sampling errors for fertility rates for the three-year period before the survey.307 Table B.4.1 Sampling errors for mortality rates for the five-year period preceding the survey and for the infant mortality rates by five-year periods.307 Table B.4.2 Sampling errors for mortality for the ten-year period preceding the survey .308 Tables and Figures | xv APPENDIX C DATA QUALITY TABLES Table C.1 Household age distribution .310 Table C.2.1 Age distribution of eligible and interviewed women.311 Table C.2.2 Age distribution of eligible and interviewed men .311 Table C.3 Completeness of reporting.311 Table C.4 Births by calendar years.312 Table C.5 Reporting of age at death in days .312 Table C.6 Reporting of age at death in months .312 Table C.7.1 Nutritional status of children by NCHS/CDC/WHO International Reference Population according to demographic characteristics .313 Table C.7.2 Nutritional status of children by NCHS/CDC/WHO International Reference Population according to socioeconomic characteristics .314 Foreword | xvii FOREWORD Guyana is increasing efforts to put together a comprehensive set of tools for the monitoring and evaluation of health and the social determinants of health under a new paradigm. The Ministry of Health (MoH) is demonstrating that information and statistics are important ingredients for the strengthening of health systems and the improvement of services. I am therefore happy to introduce Guyana’s first Demographic and Health Survey (GDHS), conducted in 2009 by the Ministry in collaboration with the Bureau of Statistics of Guyana and with technical assistance from ICF MACRO. The GDHS was designed to provide nationally representative data on housing and household characteristics in areas of education; maternal and child health; nutrition; family planning; gender; and knowledge, attitudes, and behaviors concerning HIV and other risk factors. The survey has provided valuable and timely data to go along with other indicators for the Government of Guyana (GoG) and its many partners in health care−the Pan American Health Organization/World Health Organization (PAHO/WHO), the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS, the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), and the President’s Emergency Plan for AIDS Relief (PEPFAR), among others. The 2009 GDHS sampled about 6,000 households and completed interviews with 4,996 womenand 3,522 men, age 15-49. Information was also collected on all children of the women in the sample. All households successfully enrolled in the study were asked questions regarding the physical dwelling, ownership of various durable goods, and characteristics of usual residents of the household. In-depth individual interviews were used to collect information from women and men age 15- 49 on smoking, diet, and sexual activity and practices, as well as knowledge of HIV/AIDS, experience with HIV testing, and attitudes regarding people living with HIV/AIDS. It is hoped that the data collected through the GDHS will inform our efforts to develop the policies and programs to respond to the health needs of all Guyanese. The survey information can complement other survey data and national data in informing us of the health of the people. I would like to express my gratitude to the GDHS technical and managerial staff at the Ministry of Health, whose efforts made this report possible. I would also like to thank the Guyana Bureau of Statistics, the agency asked to conduct this survey. Finally, I would like to thank ICF Macro for their technical assistance to the project under the MEASURE DHS program and the U.S. Agency for International Development (USAID) for their financial support. Dr. Leslie Ramsammy Minister of Health Summary of Findings | xix SUMMARY OF FINDINGS This document contains the main results of the 2009 Guyana Demographic and Health Survey (2009 GDHS). The 2009 GDHS is the first household-based, comprehensive survey on demographics and health (especially maternal and child health) to be carried out in Guyana. The survey was conducted by the Bureau of Statistics (BOS) and the Ministry of Health (MOH) of Guyana. ICF Macro of Calverton, Maryland, provided technical assistance to the project through its contract with the U.S. Agency for International Development (USAID). Funding to cover technical assistance by ICF Macro and local costs was provided in its entirety by the USAID Mission in Georgetown, Guyana. The primary objective of the 2009 GDHS was to collect information on characteristics of the households and their members, including exposure to malaria and tuberculosis; infant and child mortality; fertility and family planning; pregnancy and postnatal care; childhood immunization, health, and nutrition; marriage and sexual activity; and HIV/AIDS indicators. Other objectives of the 2009 GDHS included (1) supporting the dissemination and utilization of the results in planning, managing, and improving family planning and health services in the country and (2) enhancing the survey capabilities of the institutions involved to facilitate surveys of this type in the future. The 2009 GDHS sampled 5,632 households and completed interviews with 4,996 women age 15-49 and 3,522 men age 15-49. Three questionnaires were used for the 2009 GDHS: the Household Questionnaire, the Women’s Questionnaire, and the Men’s Questionnaire. The content of these questionnaires was based on the model questionnaires developed by the MEASURE DHS program of ICF Macro. FERTILITY Fertility Levels and Differentials If fertility were to remain constant in Guyana, women would bear, on average, 2.8 children by the end of their reproductive lifespan. The total fertility rate (TFR) is close to replacement level in urban areas (2.1 children per woman), and higher in the rural areas (3.0 children per woman). The TFR in the Interior area (6.0 children) is more than twice as high as the TFR in the Coastal area (2.4 children per woman) and is three times the fertility in the Georgetown (urban) area (2.0 children). The TFRs for women in the Interior area are significantly higher for all age groups. The TFR is extremely high in some regions of Guyana: 6.9 children per woman in Region 1, 6.1 children per woman in Region 8, and 5.7 children per woman in Region 9. Region 1 also has the highest percentage of women currently pregnant (15 percent), which is several times the national average of 4 percent. Fertility decreases rapidly with increasing education of women and increasing socioeconomic status of the household. The TFR for women with more than secondary education (1.7 children per woman) clearly indicates very low fertility among highly educated women. On the other hand, the TFR for women with primary education (3.8 children) exceeds the fertility rate of women with higher xx | Summary of Findings education by over two children. Fertility decreases with wealth; the TFR for women in the poorest quintile is very high (4.9 children), 2.5 times the level of fertility for women in the highest quintile (1.9 children). Fertility Preferences Fifty-six percent of currently married women reported that they don’t want to have a/another child, and five percent are already sterilized. The figures for men are 51 and 1 percent, respectively. The desire to stop childbearing increases rapidly as the number of children increases. Among respondents with one child, around one in five wants no more children. Among those with three children, about eight in ten women and seven in ten men want no more children. Among women who want to have a child or another child (32 percent), half (16 percent) want to delay the birth for two or more years. Thirty-five percent of men want to have a/another child, but less than half of them (14 percent) want to wait two or more years. Currently married women in urban areas are somewhat less likely than those in rural areas to want to limit childbearing (58 percent versus 62 percent). Additionally, currently married women in the Coastal area (61 percent) are less likely than women in the Interior area (67 percent) to want no more children. Close to seven in ten currently married women in Regions 1, 2, 6, and 9 are either sterilized or want no more children compared with 55 percent in Region 3 and 57 percent in Region 4. The largest differences in the desire for no more children among currently married women are observed by educational level. Seventy-six percent of women with no education or primary education want no more children compared with 48 percent of women with more than secondary education. The percentage of women who want to limit childbearing decreases as the wealth quintile increases, from 68 percent of women in the lowest quintile to 58 percent of women in the highest two wealth quintiles. FAMILY PLANNING Use of Contraception Forty-three percent of women who are currently married or in union are currently using a contraceptive method, mainly a modern method (40 percent). The methods most commonly used by currently married women are the male condom (13 percent), the pill (9 percent), and the IUD (7 percent). Female sterilization and injectables are each used by 5 percent of women. The 2009 GDHS prevalence rate of 43 percent represents an increase of 8 percentage points since the 2005 GAIS (35 percent). Most of the increase was in condom use, injectables, and female sterilization. The level of contraceptive use increases with the level of education, from 22 percent among women with no education to 46 percent among women with more than secondary education. The level of contraceptive use increases with the number of living children (up to 4 children), from 16 percent of women with no children to 51 percent of those with 3 to 4 children, after which it decreases to 46 percent for women with 5 or more children. Similarly, the percentage of women currently using contraception increases with women’s age, from 30 percent among women age 15-19 to 50 percent among women age 30-34, after which it decreases to reach 33 percent among women age 45-49. The current use of contraception is similar for women in Urban, Rural, and Coastal areas (42-44 percent), but it is much lower among women in the Interior area (31 percent). The method mix among women in the Urban and Rural areas is slightly different: Rural area women are more likely to use the condom, the pill, and the IUD, while Urban area women are more likely to use the condom, the IUD, and female sterilization. Summary of Findings | xxi Unmet Need for Family Planning Twenty-nine percent of currently married women have an unmet need for family planning, mostly for limiting births (19 percent) compared with spacing (10 percent). Because 43 percent of married women are currently using a contraceptive method (met need), the total demand for family planning is estimated at 71 percent of married women (22 percent for spacing, 49 percent for limiting). As a result, only 60 percent of the total demand for family planning is met. The unmet need for family planning is highest among youngest women age 15-19 (35 percent, mostly for spacing) and declines with age to 26 to 28 percent among women age 40-49 (mostly for limiting). In Urban, Rural, and Coastal areas, 27 to 29 percent of women have an unmet need, compared with 37 percent in the Interior area. By region, unmet need ranges from 26 percent in Regions 3 and 10 to 46 percent in Region 1. Unmet need for spacing increases steadily with education while unmet need for limiting declines with education. As a result, unmet need remains relatively constant among educational groups (28 to 31 percent), with the exception of women with no education who have a much higher percentage of unmet need (41 percent). Both unmet need for spacing and unmet need for limiting are highest for women in the lowest wealth quintile, and they tend to decline with increasing socioeconomic status of the household. Overall, 38 percent of women in the lowest wealth quintile have unmet need for family planning compared with 24 percent of women in the highest quintile. MATERNAL HEALTH Antenatal Care Among women who had a birth in the five years preceding the survey, 92 percent received antenatal care (ANC) from a skilled health provider for their most recent birth (51 percent from a nurse/midwife and 35 percent from a doctor). Older mothers (35-49 years) are less likely to receive antenatal care by a skilled health provider than younger mothers. Eighty-six percent of women with no education received ANC from a skilled health provider compared with 95 percent of women with more than secondary education. Urban women are more likely than Rural area women to have received antenatal care from a skilled health provider (98 and 90 percent, respectively). The lowest percentage of women who received antenatal care from a skilled health provider is in the Interior area (78 percent). Antenatal care from a skilled health provider is almost universal in Regions 3, 4, 5, 6, and 10, compared with only 35 percent of women in Region 9. Forty-two percent of women in Region 9 received ANC by a community health worker for their most recent birth. Nurses/midwives provide antenatal care for a large proportion of women in Region 6 (79 percent) and in Region 1 (70 percent). On the other hand, a large percentage, more than half (53 percent) of women in Region 4 receive ANC from a doctor. Antenatal care is more beneficial in preventing adverse outcomes when it is sought early in the pregnancy and is continued through to delivery. Under normal circumstances, the World Health Organization (WHO) recommends that a woman without complications have at least four antenatal care visits, the first of which should take place during the first trimester. Almost eight in ten women (79 percent) with a live birth in the five years preceding the survey had four or more antenatal care visits, as recommended. Almost half of the visits (49 percent) took place during the first trimester, ranging from a low of 42 percent in the Interior area to 67 percent in the Georgetown (urban) area. The median number of months pregnant at the first visit for women who received ANC was 4 months. xxii | Summary of Findings Delivery Care Overall, 92 percent of births in the five years preceding the survey were assisted by a skilled birth provider, mainly by a nurse or midwife (56 percent), followed by a doctor (31 percent). Births to mothers under age 35 and lower order births are more likely to have assistance at delivery by a skilled provider than births to older mothers and higher order births. By residence, births in Urban areas are more likely than those in Rural areas, and births in the Coastal area are more likely than births in the Interior area, to be assisted by a skilled health provider. The percentage of births assisted by a skilled provider ranges from a low of 57 percent in Region 9 to a high of 98 percent in Region 4. Births to mothers who have more education and births in the higher wealth quintiles are more likely to be assisted by a skilled provider than other births. Almost all births to mothers with more than secondary education (98 percent) are assisted by a skilled provider compared with 71 percent of births to mothers with no education. Caesarean section One in eight births (13 percent) in the five years preceding the survey was delivered by caesarean section. The prevalence of C-section delivery increases steadily with mother’s age and decreases with birth order. Regions 1, 6, 7, and 9 have the lowest levels of deliveries by C-section (2-5 percent) and Region 3 has the highest level (23 percent). The percentage of births delivered by C-section increases with a mother’s education and generally increases with her wealth. CHILD HEALTH Infant and Child Mortality Childhood mortality rates in Guyana are relatively low. For every 1,000 live births, 38 children die during the first year of life (infant mortality), and 40 children die during the first five years (under-age 5 mortality). Almost two-thirds of deaths in the first five years (25 deaths per 1,000 live births) take place during the neonatal period (the first month of life). The mortality rate after the first year of life up to age 5 (child mortality) is also very low at 3 deaths per 1,000 live births. The 2009 GDHS mortality data do not show any clear trends over time. However, mortality data have to be interpreted with caution because sampling errors associated with mortality estimates are large. All indicators of childhood mortality are higher in Urban than in Rural areas. For example, infant mortality is 45 deaths per 1,000 live births in Urban areas and 32 deaths per 1,000 live births in Rural areas. Childhood mortality is higher in the Coastal than in the Interior area for most indicators. The infant mortality rate is 37 deaths per 1,000 live births in the Coastal area compared with 27 deaths per 1,000 live births in the Interior area. Early childhood mortality is generally lower among children in the poorer quintiles and higher among children in the wealthiest quintiles. For example, children in the wealthiest quintile are more likely to die during the first year of life (44 deaths per 1,000 live births) than children in poor households (25 deaths per 1,000 live births). The patterns in childhood mortality by mother’s education are not clear due to the small number of cases under each education category. Mortality rates among children born to the oldest mothers (age 30-39) are almost twice as high as mortality rates among children born to the youngest mothers. Furthermore, higher-parity children (parity 7 or higher) have higher childhood mortality rates than children of birth orders 2 through 6. Short birth intervals (i.e., less than two years) are clearly associated with higher mortality both during and after infancy, supporting the importance of child spacing for child survival. Almost half the children in Guyana (48 percent) are in so-called avoidable high-risk categories, although mostly in single high-risk categories, because they were born of birth order 4 or higher (13 percent); born after a short birth interval of less than 24 months (9 percent); or born to mothers less than 18 years old and, thus, considered very young (9 percent) or to mothers age 35 or older (4 percent). Summary of Findings | xxiii Fourteen percent of children in an avoidable high-risk category are classified in the multiple high- risk category, mostly because the mother is 35 years or older and the birth order is high (6 percent); and also because of a short birth interval and a high birth order (5 percent). The latter group of children is of particular concern because they are almost five times more likely to die than children who are not in any high-risk category (the risk ratio is 4.5). Vaccination Coverage Overall, 63 percent of Guyanese children age 18-29 months are fully immunized, and only 5 percent of the children received no vaccinations at all. Looking at coverage for specific vaccines, 94 percent of children received the BCG vaccination, 92 percent received the first dose of pentavalent vaccine, and 78 percent received the first polio dose (Polio 1). Coverage for the pentavalent and polio vaccinations declines with subsequent doses; 85 percent of children received the recommended three doses of pentavalent vaccine, and 70 percent received three doses of polio. These figures reflect dropout rates of 8 percent for the pentavalent vaccine and 11 percent for polio; the dropout rate represents the proportion of children who received the first dose of a vaccine but who did not get the third dose. Eighty-two percent of children are vaccinated against measles, and 79 percent of children have been vaccinated against yellow fever. Full vaccination coverage is lower for first- and sixth- or higher-order births (56 and 50 percent, respectively). Full vaccination coverage decreases with an increase in mother’s education, and it is lowest for children in the lowest and highest wealth quintiles. There are no major variations in vaccination coverage by residence. However, children in the Interior area are somewhat less likely to be vaccinated than other children. This is especially true when looking at specific vaccines, indicating a need for scaling up efforts in the Interior area to reach more children and to improve the quality of vaccination services, including recording and monitoring systems. Illnesses and Treatment Acute Respiratory Infections (ARI) Five percent of children under age 5 had symptoms of acute respiratory infection (ARI) in the two weeks preceding the survey. Among children with symptoms of ARI, advice or treatment was sought from a health facility or provider for 65 percent, and antibiotics were prescribed as treatment for 18 percent (data not shown). Fever Fever was found to be moderately frequent in children under age 5 in Guyana (20 percent), ranging from 17 percent in children under 6 months to about 26 percent in children 12–17 months. Most of the children under age 5 with fever (59 percent) were taken to a health facility or a health provider for their most recent episode of fever. Overall, about one in five children with fever (21 percent) received antibiotics, and 6 percent received antimalarial drugs. Diarrhea Overall, about 10 percent of children were reported to have diarrhea in the two weeks immediately before the survey, with just 1 percent reporting bloody diarrhea. Overall, about six in ten children under age 5 with diarrhea (59 percent) were taken to a health facility or health provider for advice or treatment. Male children (55 percent) are less likely than female children (63 percent) to be taken for treatment or advice to a health facility or provider. Additionally, children living in the Coastal area are much less likely to be taken for treatment or advice (50 percent) than children in the Interior area (79 percent). Oral rehydration therapy (ORT) was given to almost six in ten children (59 percent), half of the children (50 percent) received ORS packets or pre-packaged liquid, and one in six (16 percent) received xxiv | Summary of Findings recommended home fluid (RHF). In total, 64 percent of children with diarrhea received ORT or increased fluids. Antibiotics are generally not recommended to treat non-bloody diarrhea in young children. Twelve percent of children with diarrhea received antibiotics, even though only 1 percent of children under age 5 had a bloody diarrhea. Four percent of children received antimotility drugs, and 1 percent received zinc supplements. One in four children (25 percent) received home or other remedies for their diarrhea. About one in five children with diarrhea (18 percent) did not receive any treatment at all. Urban children are more than twice as likely as rural children (36 versus 15 percent) and children living in the Coastal area are almost five times as likely as children in the Interior area (24 percent versus 5 percent) to receive no treatment at all for their diarrhea. NUTRITION OF CHILDREN Height and Weight Almost one in five children (18 percent) under age 5 is short for age or stunted, and one in twenty (5 percent) is severely stunted. As expected, stunting, which reflects chronic malnutrition, rises with age during the first year. Stunting is lower among children whose mothers have more than secondary education (16 percent). Children in Rural areas are almost twice as likely to be stunted as children in Urban areas (20 and 11 percent, respectively). The highest levels of stunting are found among children in the Interior area (35 percent). Based on the weight-for-age index, 11 percent of children (over one in ten) in Guyana are underweight, and about 2 percent are severely underweight. Boys are somewhat more likely to be underweight than girls (12 and 9 percent, respectively), and children in Rural areas are more likely to be underweight than children in Urban areas (12 and 7 percent, respectively). Based on the weight-for-height index, 5 percent of children under age 5 are considered wasted, and just 1 percent are severely wasted. Anemia Overall, about four in ten (39 percent) children age 6-59 months have some level of anemia, in- cluding 23 percent of children who are mildly anemic, 15 percent who are moderately anemic, and less than 1 percent with severe anemia. Prevalence of any anemia is highest for children 9-11 months (74 percent) and lowest for those 36-59 months (25 to 28 percent). More than half of children in Region 1 are anemic (51 percent) compared with three in ten (30 percent) in Region 8. The percentage of children with anemia is lowest among children of mothers with secondary or higher education (38-40 percent) and among children of mothers in the highest wealth quintile (32 percent). Malaria Eighty-nine percent of households own a mosquito net, whether treated or untreated, and 66 percent of households own more than one net. Rural households are more likely to own at least one net than urban households (90 percent versus 85 percent). About nine in ten households (89 percent) in the malaria-endemic regions (Regions 1, 7, 8, and 9) have at least one mosquito net. About three in ten households (29 percent) own at least one ever-treated net, and more than one in four (26 percent) households owns an insecticide-treated net. Rural area households are more than twice Summary of Findings | xxv as likely as Urban area households to own an ITN (31 percent versus 13 percent), and households in the Interior area are more likely than those in the Coastal area to own at least one ITN (34 percent versus 25 percent). About four in ten households in the malaria-endemic regions (38 percent) have at least one ITN. The percentage of households with at least one ITN is lowest for households in the highest wealth quintile (17 percent) compared with other households (25 to 29 percent). The average number of mosquito nets per household is two. Eight in ten children under age 5 in all households in Guyana slept under a mosquito net (treated or untreated) the night before the survey; about three in ten (29 percent) slept under an ever-treated net; and about one in four (24 percent) slept under an ITN. In households that own at least one ITN, a substantially larger proportion of children under age 5 slept under an ITN the night before the survey (81 percent). HIV/AIDS Knowledge of HIV Prevention Methods Knowledge of AIDS is almost universal in Guyana—97 percent of women and men have heard of AIDS. There are minor variations in knowledge of AIDS by age, marital status, or residence. The only exception is the level of knowledge in the Interior area, which is the lowest for both women (89 percent) and men (95 percent). More than eight in ten respondents age 15-49 know that consistent use of condoms is a means of preventing the spread of HIV (81 percent of women and 84 percent of men) and that limiting sexual intercourse to one HIV-negative and faithful partner can reduce the chances of contracting HIV (82 percent of women and 85 percent of men). A smaller proportion of respondents (73 percent of women and 77 percent of men) reported that both methods—using condoms and limiting sexual intercourse to one HIV-negative partner who has no other partners—are ways of avoiding HIV transmission. Thus, knowledge is higher among men than women for each of the three specified prevention methods. An equal proportion of women and men age 15-49 (78 percent, each) know that abstinence is a way to reduce risk of getting HIV. Beliefs about AIDS About nine in ten Guyanese adults know that a healthy-looking person can have the AIDS virus (87 percent of women and men) or that AIDS cannot be transmitted by supernatural means (87 percent of women and 88 percent of men). About three-quarters of women (73 percent) and two-thirds of men (65 percent) are aware that the AIDS virus cannot be transmitted through mosquito bites. Furthermore, 84 percent of women and 79 percent of men know that the AIDS virus cannot be contracted by sharing food with a person who has AIDS. These findings show that the two most common local misconceptions are that the HIV virus can be transmitted (1) by mosquito bites and (2) by sharing food with someone with AIDS. Overall, more than half of women (53 percent) and more than four in ten men (46 percent) in Guyana have a comprehensive knowledge of HIV/AIDS transmission and prevention methods, i.e., they know that condom use and limiting sex to one uninfected partner are HIV prevention methods; they are aware that a healthy looking person can have the AIDS virus; and they reject the two most common local xxvi | Summary of Findings misconceptions (that AIDS can be transmitted by mosquito bites and by sharing food with someone with AIDS). Younger women are somewhat more likely to have a comprehensive knowledge about AIDS than older women, while among men there is no major difference by age. Respondents who have ever had sex have a much higher level of comprehensive knowledge than those who have never had sex. Currently married women (48 percent) are less likely than never married women (61 percent) or formerly married women (60 percent) to have a comprehensive knowledge of AIDS, while among men the variation is not pronounced. Urban respondents and those living in the Coastal area are much more likely to have comprehensive knowledge about AIDS than respondents in the Rural and Interior areas. For example, 70 percent of women in Urban areas have comprehensive knowledge about AIDS compared with 46 percent of women in Rural areas; and 54 percent in the Coastal area have such knowledge compared with 41 percent of women in the Interior area. For women, the lowest percentage of comprehensive knowledge about AIDS is in Region 9 (31 percent) and the highest is in Region 10 (63 percent), while for men it ranges from 26 percent in Region 5 to 64 percent in Region 10. Education and wealth status have a strong positive correlation with the likelihood of having a comprehensive knowledge of AIDS. The percentage with comprehensive knowledge increases from 20 percent among women and 11 percent among men with no education to 78 and 75 percent, respectively, among women and men with secondary or higher education. Similar patterns are observed in the variation of this indicator by wealth. Thirty-two percent of women and 28 percent of men in the lowest wealth quintile have a comprehensive knowledge of AIDS compared with 68 percent of women and 65 percent of men in the highest wealth quintile. Mother-to-Child Transmission About eight in ten women (79 percent) and seven in ten men (67 percent) know that HIV can be transmitted by breastfeeding. Sixty-eight percent of women and 54 percent of men are aware that the risk of mother-to-child transmission (MTCT) can be reduced by the mother taking drugs during pregnancy. Overall, 60 percent of women and 43 percent of men know both facts: (1) HIV can be transmitted through breastfeeding and (2) the risk of MTCT can be reduced by the mother taking special drugs during pregnancy. Both individual indicators, as well as the combination indicator (knowledge that HIV can be transmitted by breastfeeding and knowledge that the risk of MTCT can be reduced by the mother taking special drungs during pregnancy), have shown significant improvement over the same period. For women, knowledge of the combination indicator has increased from 39 percent in 2005 to 60 percent in 2009, and for men it has increased from 28 percent in 2005 to 43 percent in 2009. Attitudes toward Negotiating Safer Sex Almost nine in ten respondents (89 percent of women and 88 percent of men) feel that a wife is justified in refusing to have sexual intercourse with her husband if she knows that he has a sexually transmitted disease. Ninety-six percent of women and men agree that a woman is justified in either refusing sexual intercourse with her husband or in asking him to use a condom if she knows that he has an STI. Attitudes toward Educating Children on Condom Use Overall, more than eight in ten women (81 percent) and men (86 percent) age 18-49 agree that children age 12-14 should be taught to use condoms to avoid AIDS. Older respondents age 40-49 are Summary of Findings | xxvii slightly less likely than younger respondents to support education of children age 12-14 about condom use to prevent AIDS. Women and men living in the Coastal area (82 and 86 percent, respectively) are more likely than women and men living in the Interior area (73 and 82 percent, respectively) to agree about education on condom use of children age 12-14. Fifty-eight percent of women and 61 percent of men with no education agree on instructing children age 12-14 about condoms, compared with 85 percent of women and 86 percent of men with more than secondary education. For women, the percentage who agree that children age 12-14 should be taught about condoms increases from 72 percent among those in the lowest wealth quintile to 85 percent among women in the highest wealth quintile. Among men, there is no clear pattern in the variation of this indicator by wealth. Higher-risk Sex A larger proportion of men (10 percent) than women (1 percent) reported having had more than one sexual partner in the 12 months preceding the survey. Additionally, a higher percentage of men (30 percent) than women (17 percent) reported having had sex with a person who was neither their spouse nor their cohabiting partner (higher-risk sex) in the year before the survey. Among respondents who reported having had higher-risk intercourse (with a person who was neither their husband nor who lived with them) in the past 12 months, about half of women (52 percent) and seven in ten men (72 percent) used a condom at the last higher-risk sex. The smaller proportions of women with multiple partners, higher-risk sexual intercourse, and condom use, compared with men, may accurately reflect the context, but it may also reflect a bias from some women being hesitant to report behavior that may not be widely accepted. Condom use in the past 12 months by respondents who had higher-risk sexual intercourse is more likely among young people age 15-19, never married respondents, respondents living in an Urban area, women living in the Coastal area, and respondents in Region 10. Condom use during last higher-risk sexual intercourse is higher among men with more than secondary education. For both women and men, it is highest among those in the highest wealth quintile. HIV/AIDS-Related Knowledge and Sexual Behavior among Young Adults About half of respondents age 15-24 (54 percent of women and 47 percent of men) have a comprehensive knowledge of AIDS (i.e., they know that people can reduce their chances of getting the AIDS virus by having sex with only one uninfected, faithful partner and by using condoms consistently; know that a healthy-looking person can have the AIDS virus; and know that HIV cannot be transmitted by mosquito bites or by supernatural means). Overall, about four in ten women age 15-24 (41 percent) and men age 15-24 (39 percent) in Guyana have never had sex, and an additional 6 percent of women and 9 percent of men have had sex but not in the 12 months before the survey. Furthermore, the proportion of young people who had multiple sexual partners in the past 12 months is not large—1 percent of women and 12 percent of men. Less than 1 percent of young women and 3 percent of young men who had sex with more than one partner in the past 12 months did not use a condom the last time they had sex. One in ten women (10 percent) age 15-24 and one in five men (19 percent) age 15-24 had sex by age 15, up from 9 and 13 percent, respectively, in the 2005 GAIS. The percentage of respondents age 18- 24 who had sex before exact age 18 increases rapidly to 46 percent for women and 60 percent for men, a decrease from 59 percent for women and 68 percent for men in the 2005 GAIS. xxviii | Summary of Findings Condom use at first sex is not very common in Guyana. Among young adults age 15-24 who have ever had sexual intercourse, only 46 percent of females and 54 percent of males used a condom the first time they had sex. Never-married women and men (63 and 59 percent, respectively) are much more likely to use a condom at first sex than those who have been married (34 and 35 percent, respectively). Use is also markedly higher among respondents who know where to obtain a condom (49 percent of women and 55 percent of men) than among those who do not have such knowledge (27 percent of women and 25 percent of men). Young women and men who live in Urban areas and in the Coastal area, and those who live in Region 10, are more likely to use a condom at first sex than other young adults. As expected, young women and men with more than secondary education (68 and 58 percent, respectively) and in the highest wealth quintiles (64 and 58 percent, respectively) are the most likely to use a condom at first sex compared with those who have less or no education or are in the lowest wealth quintiles. Among youth who had sexual intercourse in the past 12 months, higher-risk sex is more common among young men (80 percent) than among young women (42 percent). Condom use at last higher-risk sexual intercourse is also higher among young men (78 percent) than young women (56 percent). Higher- risk sex is more prevalent among younger respondents and among those who have never married. Urban respondents age 15-24 and those living in the Coastal area are more likely to have higher-risk sexual intercourse than rural respondents and those living in the Interior area. The variation is more pronounced among women than men. The proportion of youth age 15-24 who reported higher-risk sexual intercourse in the 12 months preceding the survey increases with level of education and wealth quintile. Condom use at the last higher-risk sex generally follows the same patterns. Basic Indicators | xxix BASIC INDICATORS Fertility Levels and Preferences Total fertility rate for three years preceding the survey (average number of children at end of reproductive life) . 2.8 Percentage of women who want no more children (includes sterilized women).61.2 Percentage of women who want more children soon.14.0 Percentage of women who want more children later .15.5 Mortality in the Five-Year Period Preceding the Survey (deaths per 1,000 births) Infant mortality rate (deaths in the first year per 1,000 births). 38 Under-5 mortality rate (deaths in the first five years of life per 1,000 births). 40 Contraceptive Knowledge and Use among All Women and Currently Married Women Percentage of currently married women using any method .42.5 Percentage of currently married women using modern methods .40.0 Antenatal and Delivery Care for Women with Births in the Five Years Preceding the Survey Percentage of women who received an antenatal checkup from a health professional .92.1 Percentage of women whose last birth was protected against neonatal tetanus1 .34.5 Percentage of live births in the five years preceding the survey delivered by a skilled provider .91.9 Percentage of live births in the five years preceding the survey delivered in a health facility .89.0 Vaccinations at Any Time (from health card and mother’s report) Percentage of children age 18-29 months who received BCG vaccine at any time.94.1 Percentage of children age 18-29 months who received pentavalent 3 vaccine at any time.84.7 Percentage of children age 12-29 months who received polio 3 vaccine at any time.70.0 Percentage of children age 12-29 months who received MMR vaccine at any time .66.6 Percentage of children age 12-29 months who received yellow fever vaccine at any time.79.0 Percentage of children age12-29 months who received all basic vaccines at any time2.63.4 Treatment for Children under Age 5 with Symptoms of Acute Respiratory Infection (ARI) and Diarrhea in Two Weeks Preceding the Survey Percentage of children with symptoms of ARI for whom treatment was sought from a health facility or provider.65.3 Percentage of children with fever for whom treatment was sought from a health facility or provider.59.0 Percentage of children with diarrhea for whom treatment was sought from a health facility or provider .58.8 Percentage of children with diarrhea who were given a solution made from packets of oral rehydration salts (ORS) .49.8 Children with diarrhea who received oral rehydration therapy (ORT)3 .59.0 Infant Feeding and Nutritional Status Percentage of children under age 4 months exclusively breastfeeding .42.4 Percentage of children under age 4 months breastfeeding and consuming plain water only. 1.5 Percentage of children under age 4 months using a bottle with a nipple.33.7 Percentage of children under age 5 years stunted (short for their age).18.2 Percentage of children under age 5 years severely stunted . 5.3 Percentage of children under age 5 years underweight .10.5 Percentage of children under age 5 years severely underweight . 1.6 Percentage of children age 6-59 months with anemia.39.3 Percentage of households with adequately iodized salt4 .10.5 Malaria Indicators Percentage of households with at least one Insecticide Treated Net (ITN) .25.6 Percentage of children under 5 who slept under an ITN the night before the interview.24.4 Percentage of pregnant women age 15-49 who slept under an ITN the night before the interview .30.1 Among children under age 5 with fever in the two weeks preceding the survey, percentage who took antimalarial drugs .6.4 Among children under age 5 with fever in the two weeks preceding the survey, percentage who took antimalarial drugs the same day/next day after developing fever . 4.3 AIDS-Related Knowledge and Attitudes Women Men Total Percentage of respondents age 15-49: Who have heard of AIDS . 97.0 .97.4. 97.2 With knowledge of using condoms as a specific way to avoid AIDS. 81.3 .83.9. 82.4 With knowledge of limiting sexual intercourse to one uninfected partner who has no other partners . 82.3 .84.7. 83.3 With knowledge of abstaining from sexual intercourse as a specific way to avoid AIDS . 78.2 .77.8. 78.0 Who had higher-risk sexual intercourse in the last 12 months4. 16.7 .29.2. 21.9 Using condoms at high-risk sexual intercourse in the last 12 months (among married respondents)5 . 52.2 .71.5. 62.9 __________________________________ 1 Includes mothers with two injections during the pregnancy of her last birth (19 percent), or two or more injections (the last within 3 years of the last live birth), or three or more injections (the last within five years of the last birth), or four or more injections (the last within ten years of the last live birth), or five or more injections prior to the last birth 2 Measles and three doses each of pentavalent and polio vaccines 3 ORS packets, pre-packaged liquid, or recommended home fluids 4 Salt containing 15 part per million (ppm) of iodine or more. Excludes households where salt was not tested. 5 Sexual intercourse with a partner who was neither a spouse nor who lived with the respondent, among those who had sexual intercourse xxx | Map of Guyana GUYANA Introduction | 1 INTRODUCTION 1 1.1 OVERVIEW The 2009 Guyana Demographic and Health Survey (2009 GDHS) is a nationally representative sample survey of women, men, and children. The survey is designed to obtain information on fertility and family planning, sexual activity and awareness of HIV and other infections, infant and child mortality, and the health and nutritional status of mothers and children. The survey was conducted in Guyana by the Bureau of Statistics (BOS) and the Ministry of Health (MOH). ICF Macro of Calverton, Maryland, provided technical assistance to the project through its contract with the U.S. Agency for International Development (USAID). Funding to cover technical assistance by ICF Macro and local costs was provided entirely by the USAID mission in Georgetown, Guyana. 1.2 OBJECTIVES The primary objective of the 2009 GDHS was to collect information on the following topics: • Characteristics of households and household members • Fertility and reproductive preferences, infant and child mortality, and family planning • Health-related matters, such as breastfeeding, antenatal care, children’s immunizations, and childhood diseases • Marriage, sexual activity, and awareness and behavior regarding HIV and other sexually transmitted infections (STIs) • The nutritional status of mothers and children, including anthropometry measurements and anemia testing Other complementary objectives of the 2009 GDHS were: • To support dissemination and utilization of the results in planning, managing, and improving family planning and health services in the country • To enhance the survey capabilities of the institutions involved to facilitate their use of surveys of this type in the future 1.3 SAMPLE DESIGN The 2009 GDHS utilized a two-stage sample design. The 2002 Population and Housing Census served as the master sample for the GDHS survey. In 2000, the Guyana BOS, in collaboration with the U.S. Census Bureau, designed a sampling frame from the census master sample. In the same year, BOS updated the geographical location and household listing of each primary sampling unit included in the master sample; this work was supported in part by USAID. In the first stage, 330 clusters, or enumeration districts (EDs), were selected from the master sample. In the second stage, 25 households were selected by systematic random sampling from the updated household listing of the selected EDs. Administratively, Guyana is divided into 10 regions, with 71 percent of the population dispersed in rural areas. The rural areas of Regions 3, 4, and 6 are the most densely populated. Regions 1, 7, 8, and 9 each account for less than 4 percent of the rural population, and Region 5 accounts for 10 percent. 2 | Introduction Region 4 includes almost two-thirds (64 percent) of the urban population. Because of these variations in population density, the sample was not allocated by region according to the actual distribution of the population. A minimum of 400 households were allocated to each region. The largest numbers of households were allocated to Regions 4 (1,600 households) and 6 (1,000 households). Around 600 to 650 households were allocated to each of Regions 2, 3, and 10. Table 1.1 shows the number of households and clusters allocated by region and by the main sample domains—Coastal (urban), Coastal (rural), and Interior. Additional details on how the sample was allocated by domains and procedures are included in Appendix A. All women and men age 15-49 who were either permanent residents or visitors present in the selected households the night before the interview were eligible to be interviewed in the survey. 1.4 QUESTIONNAIRES Three questionnaires were used for the 2009 GDHS: the Household Questionnaire, the Women’s Questionnaire, and the Men’s Questionnaire. The contents of these questionnaires were based on the model questionnaires developed by the MEASURE DHS program. In consultation with USAID/Guyana, technical institutions, and local and international organizations, the contents of the model questionnaires were modified to reflect relevant issues in population, family planning, and other health issues in Guyana. The Household Questionnaire was used to list all the usual members and visitors in the selected households. The following basic information was collected: • Characteristics of each person listed, including age, sex, education, and relationship to the head of the household. As a result, women and men who would be eligible for a subsequent individual interview could be identified. • Characteristics of the household’s dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor of the house, ownership of various durable goods, and ownership and use of mosquito nets. • Height and weight measurements of women age 15-49 and children under age 6, as well as the results of anemia testing. The Women’s Questionnaire was used to collect information from all women age 15-49. Eligible women were asked questions on the following topics: • Background characteristics (e.g., education, residential history, media exposure) • Birth history and childhood mortality • Knowledge and use of family planning methods • Fertility preferences • Antenatal and delivery care for children born after January 2004 • Breastfeeding and infant feeding practices • Vaccinations and illnesses for children born after January 2004 • Marriage and sexual activity • Woman’s work and husband’s background characteristics • Awareness and behavior regarding AIDS and other STIs The Men’s Questionnaire was administered to all men age 15-49 living in households included in the 2009 GDHS sample. The Men’s Questionnaire collected information similar to that of the Women’s Questionnaire but was shorter because it did not include a reproductive history or questions on maternal and child health and nutrition. The following topics were addressed: • Background characteristics (e.g., education, residential history, media exposure) Introduction | 3 • Reproductive history and basic health questions about last birth • Knowledge and use of family planning methods • Fertility preferences • Marriage and sexual activity • Employment and gender roles • Awareness and behavior regarding AIDS and other sexually transmitted infections (STIs) 1.5 PRETEST ACTIVITIES, TRAINING, AND FIELDWORK A training of trainers took place in early December 2008. One hundred and twelve candidates (50 men and 62 women) participated in the main survey training of interviewers, supervisors, and field editors, which took place on December 9-19, 2008, and January 12-22, 2009. Special parallel training sessions for supervisors and editors were conducted on January 19-21. All participants received training in interviewing techniques and became acquainted with the contents of the survey questionnaires. The training was conducted following standard DHS procedures and included class presentations, mock interviews, and tests in which the actual 2009 GDHS questionnaires were used. During the last week of January 2009, the editors of each team received training and instruction on how to use measuring boards and scales to conduct anthropometric measurements (height and weight) of women and young children and on how to conduct anemia testing. Because the beginning of fieldwork was delayed, a refresher training course was conducted on February 24-26, 2009. Data collection for the 2009 GDHS took place over a five-month period from March 1 through late July 2009 and was carried out by 16 interviewing teams. Each team consisted of one team supervisor, one field editor, two female and two male interviewers, and one driver. In total, 96 fieldworkers completed work first in the Coastal enumeration districts (Regions 2, 3, 4, 5, and 10). At a later stage, 60 fieldworkers were selected to work in the Interior districts (Regions 1, 7, 8, 9, and 10). Staff from the Bureau of Statistics was responsible for coordinating and supervising fieldwork activities. Two nurses supervised the anthropometry and anemia testing. ICF Macro staff participated in the survey, assisting with questionnaire design, training for data collection, data processing and tabulation, field supervision of interviews, and training in anthropometry and anemia testing. 1.6 DATA PROCESSING The processing of the 2009 GDHS questionnaires began on March 16, 2009, shortly after fieldwork commenced. Completed questionnaires were submitted periodically to BOS offices in Georgetown, where they were edited by data processing personnel who had been trained specifically for this task by ICF Macro staff. Data processing was done concurrently with fieldwork using CSPro, a program specially developed for use in complex surveys. The concurrent processing of the data was an advantage because field check tables were produced periodically to advise field teams of any problems that were detected during data processing. Data processing was completed in late August 2009. 1.7 RESPONSE RATES Table 1.1 shows the number of households selected and interviewed, numbers of women and men eligible for individual interviews, and their response rates (percentage of interviews), according to residence and region. • Of the 6,376 selected households, 6,042 households were occupied, and a total of 5,632 households were interviewed, yielding a household response rate of 93 percent. By residence, the household response rate is lowest in urban areas (91 percent), especially in Georgetown (86 percent), and highest in Interior areas of the country (96 percent). By region, the household response rate ranges from 89 percent in Region 4 to 99 percent in Region 8. 4 | Introduction • In the households interviewed, a total of 5,547 eligible women were identified. Interviews were completed with 4,996 of these women, yielding a response rate for women of 90 percent. The women’s response rates were lowest in the Interior areas (86 percent) and in Region 1 (83 percent) and highest in the Coastal areas (92 percent) and Region 2 (95 percent). • Of the 4,553 eligible men identified in the same interviewed households, a total of 4,553 men were identified. Interviews were conducted with only 3,522 men, yielding a response rate for men of 77 percent. Men from the Interior area (70 percent) and from Region 1 (62 percent) have the lowest response rates, while men in Urban and Coastal (urban) areas (82 percent, each) have the highest response rates. • The primary reason for non-response among eligible women and men was the failure to find individuals at home despite repeated visits to the household. The substantially lower response rate for men reflects the more frequent and longer absences of men from the household, principally related to employment and lifestyle activities (data not shown). Table 1.1 Results of the household and individual interviews Number of households and individual interviews, and response rates (percentage of interviews), according to residence and region, Guyana 2009 Households Women Men Residence and region Number of households selected Number of households occupied Number of households interviewed Household response rate Number of eligible women Number of eligible women interviewed Women response rate Number of eligible men Number of eligible men interviewed Men response rate Residence Total Urban 1,779 1,670 1,518 90.9 1,558 1,420 91.1 1,230 1,013 82.4 Georgetown (urban) 760 694 598 86.2 614 554 90.2 485 394 81.2 Other (urban) 1,019 976 920 94.3 944 866 91.7 745 619 83.1 Total Rural 4,597 4,372 4,114 94.1 3,989 3,576 89.6 3,323 2,509 75.5 Total Coastal 4,714 4,477 4,123 92.1 4,078 3,738 91.7 3,378 2,697 79.8 Coastal(urban) 1,779 1,670 1,518 90.9 1,558 1,420 91.1 1,230 1,013 82.4 Coastal (rural) 2,935 2,807 2,605 92.8 2,520 2,318 92.0 2,148 1,684 78.4 Total Interior 1,662 1,565 1,509 96.4 1,469 1,258 85.6 1,175 825 70.2 Region 1 387 383 370 96.6 345 287 83.2 288 179 62.2 2 623 605 574 94.9 534 505 94.6 438 386 88.1 3 645 609 565 92.8 564 520 92.2 423 326 77.1 4 1,600 1,491 1,319 88.5 1,314 1,179 89.7 1,111 861 77.5 5 489 479 452 94.4 431 404 93.7 393 319 81.2 6 977 937 881 94.0 881 817 92.7 771 614 79.6 7 367 351 334 95.2 330 290 87.9 221 165 74.7 8 308 304 302 99.3 302 256 84.8 248 169 68.1 9 382 335 322 96.1 317 280 88.3 261 195 74.7 10 598 548 513 93.6 529 458 86.6 399 308 77.2 Total 6,376 6,042 5,632 93.2 5,547 4,996 90.1 4,553 3,522 77.4 The weighted and unweighted numbers of women and men in the 2009 GDHS are shown in Table 1.2. The weighted numbers are shown because weighting is necessary for the calculation of most indicators—percent distributions, percentages, and rates. This is because the sample was not allocated by region according to the actual distribution of the population. Instead, the sample was allocated to provide a sufficient number of respondents for each region to allow calculation of most survey variables at the regional level. The unweighted numbers are the actual numbers of interviews. Some subgroups shown may include comparatively small numbers of respondents (e.g., respondents with no education and those in some religious and ethnic groups). In some tables in this report, estimates for these subgroups are not shown if the unweighted number of cases is fewer than 25. Also, estimates based on 25 to 49 unweighted cases are shown enclosed in parentheses. • Although only 1,179 women were interviewed in Region 4 (24 percent of the total unweighted number of all women), the weighted number is 2,168 women (43 percent of the total weighted Introduction | 5 number of women). On the other hand, 280 women were interviewed in Region 9 (6 percent of the total unweighted number of all women), and the weighted number is 78 women (2 percent of the total weighted number of women). • The regional distribution of the population shows no marked differences by sex, with around three in ten women (30 percent) and men (27 percent) living in Urban areas, with two-thirds of these living in Georgetown. Approximately nine in ten respondents of both sexes (90 percent of women and 89 percent of men) live in the Coastal areas, with the majority (60 percent of women and 62 percent of men) living in the Coastal (rural) areas. Only one-tenth of the respondents (10 percent of women and 11 percent of men) live in the Interior areas of the country. Table 1.2 Number of women and men interviewed by residence and region Percent distribution of women age 15-49 and men age 15-49, by residence and region, Guyana 2009 Women Men Residence and region Weighted percent Weighted number Unweighted number Weighted percent Weighted number Unweighted number Residence Total Urban 29.5 1,475 1,420 27.0 949 1,013 Georgetown (urban) 19.4 967 554 17.6 619 394 Other (urban) 10.2 508 866 9.4 330 619 Total Rural 70.5 3,521 3,576 73.0 2,573 2,509 Total Coastal 90.0 4,495 3,738 88.7 3,126 2,697 Coastal (urban) 29.5 1,475 1,420 27.0 949 1,013 Coastal (rural) 60.4 3,019 2,318 61.8 2,176 1,684 Total Interior 10.0 501 1,258 11.3 396 825 Region Region 1 3.2 162 287 4.5 160 179 Region 2 5.9 293 505 5.1 179 386 Region 3 13.8 687 520 11.9 420 326 Region 4 43.4 2,168 1,179 43.7 1,540 861 Region 5 7.1 353 404 7.7 271 319 Region 6 15.6 780 817 16.7 587 614 Region 7 2.1 104 290 1.7 61 165 Region 8 1.9 95 256 1.9 68 169 Region 9 1.6 78 280 1.6 57 195 Region 10 5.6 277 458 5.1 178 308 Total 100.0 4,996 4,996 100.0 3,522 3,522 1.8 CONTENTS OF THE REPORT Chapter 1, which is introductory, includes a description of the country and its population history, selected health and demographic characteristics, and an overview of the health care system. It also includes the 2009 GDHS objectives, a brief summary of the survey design and implementation, the sample design, and data on the numbers of households and individuals selected for interview and corresponding response rates. Chapter 2 describes the background characteristics of the household population and its dwelling conditions. Chapter 3 contains information on the basic characteristics of the eligible respondents, including their educational level, work status, and occupation. Chapter 4 describes the current and past fertility of the population. The chapter also presents information on the beginning of a woman's childbearing years, including the age when she first gives birth, as well as her current level of fertility. 6 | Introduction Chapter 5 includes information on one of the main determinants of fertility, use of family planning. Information on the current and ever use of specific methods by age and background characteristics is included here. Chapter 6 includes factors other than contraception that regulate the level of fertility, such as marriage patterns and sexual activity. Chapter 7 discusses fertility preferences, the desire to limit childbearing, the ideal number of children, and the unmet need for contraception. Chapter 8 describes the current and past levels of infant and child mortality, as well as differentials in childhood mortality, by demographic and background characteristics. Also included is information on the extra risk in infant and child mortality incurred by certain reproductive behaviors. Chapter 9 presents findings from areas important to reproductive and women’s health (i.e., antenatal, delivery, and postnatal care), as well as general access to health services. Chapter 10 presents the impact on child health indicators of children being born in the five years preceding the survey, including weight and size at birth, vaccination status as children, and history of childhood illnesses (acute respiratory infection, fever, and diarrhea, for example) and their treatment. Chapter 11 presents data on the nutritional status of children and adults. The section on childhood nutrition covers anthropometric assessment of the nutritional status of children under age 5; infant and young child feeding practices, including breastfeeding and feeding with solid/semi-solid foods; diversity of foods being fed; frequency of feeding; micronutrient status; supplementation and fortification; and anemia. The section on adult nutrition covers the nutritional status of women and men age 15-49; the diversity of foods eaten by mothers of children under age 3; micronutrient status, supplementation and fortification; and presence of anemia. Chapter 12 describes the availability and use of preventive measures for malaria among women and children, as well as access to early diagnosis and prompt treatment. This chapter also describes knowledge about tuberculosis (TB) and its mode of transmission, diagnosis, and treatment among men and women. Chapter 13 presents information collected from the HIV/AIDS module, including knowledge of HIV/AIDS, attitudes about HIV/AIDS, and behavior among adults and youth at risk for HIV/AIDS. Chapter 14 presents indicators of women’s empowerment, such as receipt of cash earnings, the magnitude of a woman’s earnings relative to those of her husband, and control over the use of woman’s earnings and the earnings of her husband. Three separate indices of empowerment are developed that are based on the number of household decisions in which the respondent participates, her opinion on the number of reasons that justify wife beating, and her opinion on the number of circumstances for which a woman is justified in refusing to have sexual intercourse with her husband. The sample design is described in Appendix A, and the estimates of sampling errors are covered in Appendix B. Appendix C contains several tables that may be of use in examining the quality of some data collected in the 2009 GDHS: single-year age distribution of the de facto household population by sex; age distribution of the eligible respondents; completeness of reporting of basic indicators; distribution of births by calendar years; reporting of age at death in days, and reporting of age at death in months. Appendix C also includes tables showing the percentage of children under age 5 who are classified as malnourished according to three anthropometric indices of nutritional status―height-for-age, weight-for-height, and weight-for-age―based on the former NCHS/CDC/WHO International Reference Introduction | 7 Population. Shown for comparative purposes, is the vaccination coverage for children following the DHS program schedule, which includes neither yellow fever nor measles, mumps, rubella (MMR) vaccine (only measles). Full immunization in Guyana includes BCG, MMR, yellow fever, and three doses each of pentavalent and polio vaccines. Finally, the survey personnel are listed in Appendix D, and the questionnaires are included in Appendix E. Household Population and Housing Characteristics | 9 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS 2 This chapter summarizes demographic and socioeconomic characteristics of the household popu- lation, including age, sex, place of residence, educational status, and household characteristics. Informa- tion collected on the characteristics of the households and individual respondents in the survey helps one to understand and interpret the findings of the survey and also provides some indication of the repre- sentativeness of the survey. A household is defined as a person or group of related and unrelated persons who (1) live together in the same dwelling unit(s) or in connected premises, (2) acknowledge one adult member as head of the household, and (3) have common arrangements for cooking and eating their food. The questionnaire for the 2009 GDHS distinguishes between the de jure population (persons who usually live in a selected household) and the de facto population (persons who stayed the night before the interview in the household). According to the 2009 GDHS data, the differences between these populations are small. Tabulations for the household data presented in this chapter are primarily based on the de facto population. The number of cases in some regions may appear small. This is because they have been weighted to make the regional distribution appear nationally representative. Throughout this report, numbers in the tables reflect weighted numbers. To ensure statistical reliability, percentages based on 25 to 49 un- weighted cases are shown within parentheses, and percentages based on fewer than 25 unweighted cases are suppressed. 2.1 CHARACTERISTICS OF THE POPULATION 2.1.1 Age-Sex Structure Age and sex are important demographic variables. They serve as the primary basis for demographic classification in vital statistics, censuses, and surveys. Age and sex are also important variables in the study of mortality, fertility, and nuptiality. Table 2.1 presents the percent distribution of the de facto population by five-year age groups, according to Urban-Rural residence and sex. The data are used to construct the population pyramid shown in Figure 2.1. • Guyana has a larger proportion of its population in younger age groups than in older age groups (65+). One third (34 percent) of the population is under age 15 (36 percent male and 31 percent female) compared with only 5 percent of males and 6 percent of females age 65 and older. • Sixty-one percent of the household population (59 percent of males and 62 percent of females), however, are in the economically productive age range (age 15-64). 10 | Household Population and Housing Characteristics Table 2.1 Household population by age, sex, and residence Percent distribution of the de facto household population by five-year age group, according to sex and residence, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Urban Rural Total –––––––––––––––––––––– –––––––––––––––––––––– –––––––––––––––––––––– Age Male Female Total Male Female Total Male Female Total ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– <5 8.7 7.6 8.1 11.0 10.2 10.6 10.4 9.4 9.9 5-9 10.7 9.1 9.8 13.0 11.2 12.0 12.4 10.6 11.4 10-14 13.6 9.8 11.6 13.2 12.1 12.6 13.3 11.4 12.3 15-19 10.5 10.7 10.6 8.8 10.1 9.4 9.2 10.3 9.8 20-24 7.7 7.8 7.7 6.6 8.1 7.4 6.9 8.0 7.5 25-29 7.3 6.2 6.7 6.0 6.9 6.5 6.3 6.7 6.5 30-34 5.9 6.6 6.3 6.7 6.5 6.6 6.5 6.5 6.5 35-39 5.4 7.7 6.7 6.5 6.6 6.6 6.2 6.9 6.6 40-44 6.0 6.4 6.2 6.2 5.9 6.0 6.1 6.0 6.1 45-49 4.6 6.6 5.7 5.3 5.7 5.5 5.1 6.0 5.6 50-54 5.6 5.6 5.6 5.1 5.2 5.1 5.2 5.3 5.3 55-59 4.7 4.3 4.5 4.0 3.9 4.0 4.2 4.0 4.1 60-64 3.0 3.0 3.0 2.8 2.3 2.5 2.8 2.5 2.7 65-69 2.4 2.7 2.6 2.1 1.9 2.0 2.2 2.1 2.2 70-74 1.8 1.9 1.8 1.4 1.4 1.4 1.5 1.6 1.5 75-79 1.1 1.8 1.5 0.6 1.0 0.8 0.8 1.2 1.0 80 + 1.0 2.0 1.5 0.6 1.0 0.8 0.7 1.3 1.0 Don't know/missing 0.2 0.2 0.2 0.2 0.1 0.2 0.2 0.1 0.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number 2,647 3,143 5,790 7,277 7,849 15,126 9,924 10,992 20,916 Figure 2.1 Population Pyramid 8 6 4 2 0 2 4 6 8 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80+ A ge Percentage of population Male Female Household Population and Housing Characteristics | 11 2.1.2 Household Composition The size and composition of the household usually affect the allocation of financial and other resources available to its members. In cases where women are heads of household, financial resources are typically limited. Similarly, the size and composition of the household affect the well-being of its members. If the household is large, crowding can lead to health problems. Table 2.2 presents the percent distribution of households by sex of head of the household and by number of residents, according to Urban-Rural residence. The percentage of households with a female as head is presented in Figure 2.2 by residence. Table 2.2 also presents the mean number of members of the households and the percentage of households with orphans and foster children under age 18. Table 2.2 Household composition Percent distribution of households by sex of head of household and by household size; mean size of household, and percentage of households with orphans and foster children under 18, according to residence, Guyana 2009 Urban-Rural residence Coastal-Interior residence Urban Coastal Characteristic Total Urban Georgetown (urban) Other (urban) Total Rural Total Coastal Coastal (urban) Coastal (rural) Total Interior Total Household headship Male 55.9 53.2 61.2 70.6 65.3 55.9 69.7 76.3 66.5 Female 44.1 46.8 38.8 29.4 34.7 44.1 30.3 23.7 33.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of usual members 0 0.3 0.4 0.1 0.3 0.3 0.3 0.3 0.0 0.3 1 13.5 13.4 13.8 12.6 13.0 13.5 12.8 11.3 12.8 2 21.0 23.4 16.5 17.0 18.9 21.0 17.9 11.6 18.2 3 18.8 18.3 19.9 18.3 18.9 18.8 19.0 14.1 18.4 4 16.8 16.6 17.2 18.1 17.9 16.8 18.4 16.3 17.7 5 12.4 11.4 14.4 15.0 14.4 12.4 15.4 12.9 14.3 6 7.3 7.3 7.2 8.5 7.7 7.3 7.9 11.7 8.1 7 4.8 4.9 4.5 4.8 4.3 4.8 4.1 9.2 4.8 8 2.3 2.0 2.8 2.6 2.2 2.3 2.2 5.3 2.5 9+ 2.8 2.4 3.6 2.9 2.3 2.8 2.1 7.5 2.9 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Mean size of households 3.7 3.6 3.8 3.8 3.7 3.7 3.7 4.6 3.8 Percentage of households with orphans and foster children under 18 Foster children1 12.6 10.9 15.8 12.0 12.1 12.6 11.8 13.0 12.2 Double orphans 0.3 0.3 0.4 0.5 0.5 0.3 0.6 0.3 0.5 Single orphans 6.7 7.0 6.0 5.2 5.5 6.7 4.9 7.2 5.7 Foster and/or orphan children 16.3 14.8 19.2 14.6 14.9 16.3 14.2 17.3 15.1 Number of households 1,603 1,053 550 4,029 5,052 1,603 3,449 580 5,632 Note: Table is based on de jure household members, i.e., usual residents. 1 Foster children are those under age 18 years of age living in households where neither their mother nor their father is a de jure resident. . • Women head one-third of Guyanese households (34 percent). Households with a female head are more common in the urban areas, with 44 percent in Total Urban, consisting of 47 percent in Georgetown (urban), and 39 percent in Other (urban). The average household size is 3.8 persons, with little difference attributable to Urban or Rural area residence or residence within the Coastal area. The average household in the Interior area is larger in comparison, however, with 4.6 members. 12 | Household Population and Housing Characteristics • More than four in five households (82 percent) have five or fewer members, and one in eight (13 percent) is a single-person household. Generally, there are no significant urban- rural differences in the household composition. The only urban-rural difference is the percentage of households with two members: 21 percent in Urban areas compared with 17 percent in Rural areas. More than one-third (34 percent) of households in the Interior area have 6 or more members compared with fewer than one in five in other areas. As a result, the mean size of a household in the Interior area is 4.6. 2.1.3 Children’s Living Arrangements and Orphanhood Table 2.3 shows information relevant to living arrangements and orphanhood for children less than 18 years of age. The table also includes the percentage of children living in a household where neither parent is present (foster children) and the percentage of children who are orphans (children with the father dead, the mother dead, both parents dead, or one parent dead but with missing information on survival status of the other parent). No distinction is made between long-term and short-term fostering. 34 44 47 39 29 Total Guyana Total Urban Georgetown (Urban) Other Urban Total Rural 0 10 20 30 40 50 Percentage of households GDHS 2009 Figure 2.2 Percentage of Female-Headed Households, by Residence Household Population and Housing Characteristics | 13 • Twelve percent of Guyanese children under age 18 live in households with neither their mother nor their father (they are foster children), and 7 percent have lost at least one biological parent (they are orphan children). These percentages are similar to those reported in the 2005 Guyana AIS (11 percent and 7 percent, respectively). • The percentages of both foster children and orphans increase steadily with the children’s age, and they are higher in urban areas (15 percent and 9 percent, respectively) than in rural Table 2.3 Children’s living arrangements and orphanhood Percent distribution of de jure children under age 18 by living arrangements and survival status of parents, according to background characteristics, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 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 Percent- Percent- Number Background both Father Father Mother Mother Both father mother Both father/ age age of characteristic parents alive dead alive dead alive alive alive dead mother Total foster1 orphan2 children ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 0-4 65.9 25.4 0.6 1.6 0.1 4.3 0.3 0.2 0.0 1.6 100.0 4.8 1.2 2,053 <2 68.2 26.2 0.5 0.9 0.0 2.0 0.2 0.1 0.0 1.9 100.0 2.3 0.9 825 2-4 64.3 25.0 0.7 2.0 0.1 5.8 0.4 0.2 0.0 1.5 100.0 6.4 1.4 1,228 5-9 56.1 24.6 3.0 2.5 0.5 8.6 1.5 1.0 0.2 1.9 100.0 11.3 6.3 2,403 10-14 52.1 22.4 4.3 2.4 1.4 12.4 1.4 0.9 0.6 2.0 100.0 15.3 8.8 2,603 15-17 45.5 22.6 6.7 3.0 0.5 12.2 3.1 1.1 0.9 4.4 100.0 17.2 12.4 1,292 Sex Male 56.0 23.4 3.2 2.8 0.5 9.2 1.4 0.7 0.3 2.4 100.0 11.6 6.3 4,217 Female 55.3 24.3 3.6 1.8 0.8 9.4 1.5 0.9 0.4 2.0 100.0 12.2 7.3 4,134 Residence Total Urban 40.1 34.2 5.0 3.5 0.6 11.7 1.8 0.7 0.3 2.1 100.0 14.5 8.5 2,097 Urban (Georgetown) 36.7 37.6 6.1 4.2 0.8 10.3 2.3 0.5 0.2 1.3 100.0 13.3 10.1 1,257 Urban (other) 45.4 29.0 3.2 2.5 0.3 13.8 1.1 1.0 0.3 3.4 100.0 16.2 6.0 839 Total Rural 60.8 20.4 2.9 2.0 0.7 8.5 1.3 0.8 0.4 2.3 100.0 11.0 6.2 6,254 Total Coastal 54.4 24.4 3.4 2.4 0.7 9.8 1.5 0.8 0.4 2.3 100.0 12.5 6.8 6,986 Coastal (urban) 40.1 34.2 5.0 3.5 0.6 11.7 1.8 0.7 0.3 2.1 100.0 14.5 8.5 2,097 Coastal (rural) 60.5 20.2 2.7 1.9 0.7 9.1 1.3 0.8 0.5 2.4 100.0 11.7 6.1 4,889 Total Interior 62.2 21.1 3.7 2.1 0.5 6.5 1.0 0.9 0.2 1.9 100.0 8.6 6.3 1,365 Region Region 1 58.6 25.6 2.3 3.0 0.6 5.8 0.9 0.8 0.4 2.2 100.0 7.8 5.0 488 Region 2 64.6 16.2 3.0 1.5 0.4 9.4 0.5 0.3 0.8 3.2 100.0 11.0 5.1 541 Region 3 59.5 21.4 3.1 2.0 0.0 9.5 1.5 0.9 0.3 1.8 100.0 12.2 6.0 1,078 Region 4 47.4 28.8 3.9 3.2 1.3 9.6 2.2 0.6 0.4 2.6 100.0 12.8 8.5 3,037 Region 5 56.8 23.1 2.7 1.4 0.4 12.2 1.0 1.0 0.6 0.8 100.0 14.8 5.8 616 Region 6 65.7 16.5 2.8 2.0 0.3 8.9 0.6 1.0 0.3 1.8 100.0 10.9 5.0 1,325 Region 7 56.8 25.5 3.2 1.6 0.1 6.3 2.7 1.5 0.1 2.1 100.0 10.6 7.6 249 Region 8 65.9 16.5 5.0 0.2 0.8 8.6 0.6 0.4 0.1 2.0 100.0 9.7 6.8 230 Region 9 76.9 9.7 2.1 2.8 0.5 6.1 0.2 0.0 0.0 1.7 100.0 6.3 2.8 236 Region 10 42.6 33.7 5.0 1.6 0.2 10.9 1.2 1.4 0.2 3.3 100.0 13.6 8.1 550 Wealth quintile Lowest 62.0 20.1 4.0 1.8 0.3 7.6 0.8 0.8 0.4 2.2 100.0 9.6 6.3 2,036 Second 54.7 25.9 3.3 2.1 0.2 8.6 1.6 0.9 0.3 2.3 100.0 11.4 6.6 1,806 Middle 52.7 24.9 3.2 2.7 2.1 10.4 1.0 0.6 0.3 2.2 100.0 12.2 7.2 1,609 Fourth 52.8 23.3 3.2 2.7 0.5 11.3 2.7 0.8 0.4 2.5 100.0 15.2 7.6 1,522 Highest 54.0 26.1 3.2 2.8 0.2 9.2 1.2 0.9 0.6 1.9 100.0 11.9 6.2 1,378 Total <15 57.5 24.1 2.8 2.2 0.7 8.8 1.1 0.7 0.3 1.8 100.0 10.9 5.7 7,059 Total <18 2009 55.6 23.8 3.4 2.3 0.7 9.3 1.4 0.8 0.4 2.2 100.0 11.9 6.8 8,351 2005 59.7 21.1 4.0 2.4 0.4 7.7 1.0 0.9 1.0 1.8 100.0 10.6 7.3 4,324 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Table is based on de jure members, i.e., usual residents. 1 Foster children are those under age 18 living in households with neither their mother nor their father present. 2 Includes children with father dead, mother dead, both dead, and one parent dead but information missing on survival status of the other parent. 14 | Household Population and Housing Characteristics areas (11 percent and 6 percent, respectively). The percentage of foster children ranges from 6 percent in Region 9 to 15 percent in Region 5, while the percentage of orphan children ranges from 3 percent in Region 9 to 9 percent in Region 4. • Fifty-six percent of children under age 18 live with both parents, 27 percent live with their mothers but not with their fathers; 3 percent live with their fathers but not with their mothers; and 12 percent live with neither of their natural parents. There has been a slight decrease since the 2005 Guyana AIS (GAIS) in the percentage of children under age 18 who live with both their parents, which has dropped from 60 percent in 2005 to 56 percent to 2009. • The proportion of children living with both parents decreases with age; younger children are more likely than older children to live with both natural parents. More than six in ten children under age 18 in Rural areas (61 percent in Coastal [rural] and 62 percent in the Interior area) live with both parents compared with four in ten children in the Urban areas. • Region 9 has the highest percentage of children living with both parents (77 percent), and Region 10 has the lowest percentage (43 percent), mostly due to the high percentage of children (34 percent) who live with the mother despite the fact that the father is alive. 2.1.4 Educational Attainment The educational level of household members is perhaps their most important demographic characteristic. Many phenomena—reproductive behavior, use of contraception, health of children, and proper hygienic habits— are affected by the education of the household members. Tables 2.4.1 and 2.4.2, respectively, show the percent distribution of the de facto female and male household populations, age 6 and over, by highest level of schooling attended or completed, and median number of years completed. Schooling in Guyana starts at the nursery school level, which is available to children for two years, beginning at age four. Children begin primary school at age 6. Primary school has six grades: Preparatory A and B and Standards I through IV. Entry into secondary education is based on students' performance in a placement examination, the Secondary School Entrance Examination (SSEE) administered to 11-year-old students. For students who score poorly on the SSEE, a continuation of primary education for three to four years is also available in the senior department of the primary school, also known as the all-age school (or the primary-top). Thus, students who complete primary school and pass the SSEE placement test or students who complete all-age school are eligible to continue in secondary school. There are three different kinds of secondary school in Guyana for students who have passed the SSEE: the general secondary school, the multilateral school, and the community high school. The general secondary school consists of Forms I-VI (Form VI being the equivalent of the senior year of high school in the United States). At the end of their secondary education, students can take the Secondary School Proficiency Examination to be admitted into the trade school. Or they can take the General Certificate of Education (GCE) Advanced Level examination or the Caribbean Examination Council examination to be admitted into the university. The multilateral school, established in 1974, consists of Forms I-V for students age 10-18 years. The community high school provides on-the-job training to students over age 12. Students who complete a full secondary education may enroll in the university. Household Population and Housing Characteristics | 15 Table 2.4.1 Educational attainment of the female household population Percent distribution of the de facto female household population age 6 and over by highest level of schooling attended or completed, and median number of years completed, according to background characteristics, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Highest level of schooling ––––––––––––––––––––––––––––––––––––––––––––––––––– Median More number Some than Don’t Number of years Background No Some Completed secon- Completed secon- know/ of of characteristic education primary primary1 dary secondary2 dary missing Total women schooling3 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 6-9 11.8 86.6 0.2 0.5 0.2 0.0 0.8 100.0 985 1.2 10-14 0.9 39.8 12.2 46.2 0.3 0.2 0.5 100.0 1,258 5.5 15-19 1.4 4.6 2.7 60.6 26.7 3.4 0.6 100.0 1,127 9.1 20-24 1.1 6.3 4.8 28.9 45.9 11.7 1.2 100.0 879 10.2 25-29 1.6 10.0 6.8 34.0 35.2 11.6 0.9 100.0 736 9.8 30-34 1.9 12.0 7.4 38.3 26.7 11.2 2.6 100.0 720 9.3 35-39 1.7 9.4 11.9 41.0 26.0 7.7 2.2 100.0 761 9.1 40-44 1.7 20.0 11.5 35.6 22.8 4.8 3.8 100.0 663 8.3 45-49 2.2 18.4 12.4 33.9 20.8 7.1 5.2 100.0 658 8.0 50-54 2.6 21.6 19.4 28.0 17.0 6.0 5.4 100.0 582 6.5 55-59 2.0 31.3 18.6 20.6 15.8 6.4 5.3 100.0 440 5.7 60-64 2.8 29.7 32.0 13.0 11.5 4.5 6.6 100.0 275 5.5 65+ 7.3 30.7 28.8 11.4 6.8 4.4 10.6 100.0 678 5.3 Residence Total Urban 1.8 17.7 9.1 31.8 24.6 10.8 4.3 100.0 2,861 8.9 Georgetown (urban) 1.3 15.8 8.7 30.3 27.1 11.7 5.2 100.0 1,874 9.3 Other (urban) 2.8 21.2 9.7 34.6 20.0 9.1 2.5 100.0 987 8.1 Total Rural 3.5 28.8 11.6 32.9 17.2 3.5 2.4 100.0 6,918 6.7 Total Coastal 2.6 24.7 10.9 32.6 20.3 6.1 2.9 100.0 8,718 7.6 Coastal (urban) 1.8 17.7 9.1 31.8 24.6 10.8 4.3 100.0 2,861 8.9 Coastal (rural) 3.0 28.1 11.8 32.9 18.2 3.8 2.3 100.0 5,857 6.9 Total Interior 6.8 32.9 10.1 33.0 11.6 2.1 3.4 100.0 1,061 5.7 Region Region 1 11.7 42.9 10.2 24.8 5.3 1.7 3.4 100.0 367 4.3 Region 2 4.9 30.2 16.3 29.0 13.5 3.7 2.4 100.0 608 5.7 Region 3 3.5 27.6 8.1 35.9 19.5 3.6 1.8 100.0 1,327 7.3 Region 4 2.0 21.7 9.8 31.6 23.0 7.7 4.2 100.0 4,139 8.3 Region 5 2.0 28.6 15.1 28.7 18.2 5.5 1.9 100.0 698 6.5 Region 6 2.9 28.2 13.8 33.0 17.9 3.3 1.1 100.0 1,537 6.6 Region 7 4.2 26.4 10.7 35.2 17.3 3.1 3.0 100.0 228 7.0 Region 8 2.8 22.8 10.9 41.9 14.6 2.1 4.9 100.0 166 7.5 Region 9 5.5 35.7 10.1 31.9 12.6 0.8 3.4 100.0 170 5.6 Region 10 2.8 18.9 5.6 41.9 17.6 10.5 2.6 100.0 537 8.4 Wealth quintile Lowest 7.2 38.2 12.8 29.2 7.7 1.0 3.9 100.0 1,726 5.2 Second 3.7 29.4 13.2 35.6 13.7 2.0 2.5 100.0 1,955 6.3 Middle 1.6 24.6 10.9 36.8 20.3 3.0 2.8 100.0 1,926 7.7 Fourth 1.8 22.7 10.5 33.4 22.7 6.2 2.9 100.0 2,086 8.0 Highest 1.6 15.3 7.2 27.9 30.3 14.8 2.8 100.0 2,086 9.6 Total 2009 3.0 25.6 10.8 32.6 19.4 5.6 3.0 100.0 9,778 7.4 Total 2005 3.5 27.1 13.3 35.1 12.8 6.2 2.1 100.0 4,446 8.6 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Total includes 15 females with information missing on age who are not shown separately. 1 Completed 6th grade at the primary level 2 Completed 5th grade at the secondary level 3 The median number of years is the midpoint of the distribution of the population by number of years of education. 16 | Household Population and Housing Characteristics Table 2.4.2 Educational attainment of the male household population Percent distribution of the de facto male household populations age 6 and over by highest level of education attended or completed and median number of years completed, according to background characteristics, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Highest level of schooling ––––––––––––––––––––––––––––––––––––––––––––––––––– Median More number Some than Don’t Number of years Background No Some Completed secon- Completed secon- know/ of of characteristic education primary primary1 dary secondary2 dary missing Total men schooling3 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 6-9 16.9 82.1 0.0 0.2 0.0 0.0 0.8 100.0 1,013 0.8 10-14 0.5 37.8 10.7 50.5 0.0 0.0 0.5 100.0 1,322 5.5 15-19 0.6 4.8 3.7 67.7 17.1 5.1 1.0 100.0 915 8.7 20-24 0.9 8.7 4.6 38.1 31.3 13.6 2.7 100.0 682 9.8 25-29 2.1 9.1 8.0 38.3 26.9 9.6 6.1 100.0 628 9.3 30-34 1.8 15.7 10.2 37.3 20.4 9.4 5.3 100.0 643 8.7 35-39 1.5 18.9 10.0 39.0 20.7 5.8 4.1 100.0 618 8.6 40-44 1.3 20.3 12.5 36.0 18.8 5.6 5.5 100.0 607 8.2 45-49 1.6 21.5 13.3 35.7 13.8 7.0 7.1 100.0 506 7.6 50-54 1.3 21.1 17.3 26.6 16.6 6.9 10.2 100.0 518 7.4 55-59 2.6 26.1 10.9 24.6 16.8 7.9 11.1 100.0 418 7.1 60-64 1.0 23.7 32.0 14.7 15.6 7.6 5.5 100.0 281 5.8 65+ 4.1 27.2 29.8 12.2 10.6 7.4 8.6 100.0 510 5.5 Residence Total Urban 1.9 19.1 8.6 35.7 19.4 10.8 4.4 100.0 2,379 8.2 Georgetown (urban) 1.3 16.9 8.9 33.9 22.1 12.0 4.9 100.0 1,537 8.7 Other (urban) 2.9 23.2 8.1 39.1 14.3 8.7 3.5 100.0 842 7.4 Total Rural 3.8 30.3 11.1 34.3 12.4 3.7 4.4 100.0 6,301 6.2 Total Coastal 2.8 26.2 10.4 35.4 15.0 6.2 4.1 100.0 7,670 7.0 Coastal (urban) 1.9 19.1 8.6 35.7 19.4 10.8 4.4 100.0 2,379 8.2 Coastal (rural) 3.3 29.3 11.1 35.2 13.1 4.0 3.9 100.0 5,290 6.4 Total Interior 6.3 35.7 11.0 29.9 8.5 2.0 6.7 100.0 1,010 5.4 Region Region 1 10.4 39.6 11.3 25.0 5.6 0.7 7.5 100.0 367 4.5 Region 2 3.6 34.4 14.0 31.6 11.3 2.8 2.4 100.0 522 5.8 Region 3 4.3 31.4 7.9 36.0 11.8 3.8 4.7 100.0 1,076 6.5 Region 4 1.9 22.8 8.5 35.8 18.2 7.6 5.2 100.0 3,607 7.8 Region 5 2.4 30.8 14.1 34.1 11.6 4.8 2.2 100.0 663 6.0 Region 6 4.1 26.3 15.2 33.5 14.1 4.5 2.2 100.0 1,471 6.3 Region 7 4.1 31.1 13.7 32.4 11.8 3.5 3.4 100.0 170 6.0 Region 8 3.3 31.9 12.0 32.1 8.2 0.4 12.1 100.0 183 5.7 Region 9 5.7 37.5 7.7 33.3 9.1 2.6 4.0 100.0 165 5.5 Region 10 2.6 25.6 5.1 41.5 9.3 11.3 4.5 100.0 456 7.4 Wealth quintile Lowest 6.5 40.2 11.4 29.3 5.9 1.1 5.7 100.0 1,693 5.1 Second 4.1 32.3 11.9 36.9 9.4 1.9 3.5 100.0 1,708 5.8 Middle 2.1 26.0 10.9 40.4 13.3 3.6 3.7 100.0 1,784 7.1 Fourth 2.3 21.9 10.2 36.6 16.8 7.1 5.1 100.0 1,734 7.8 Highest 1.4 16.5 7.8 30.3 25.5 14.5 4.0 100.0 1,762 9.2 Total 2009 3.2 27.3 10.4 34.7 14.3 5.7 4.4 100.0 8,680 6.8 Total 2005 3.2 24.7 13.2 35.7 16.0 5.6 1.5 100.0 4,814 9.2 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Total includes 19 males with information missing on age who are not shown separately. 1 Completed 6th grade at the primary level 2 Completed 5th grade at the secondary level 3 The median number of years is the midpoint of the distribution of the population by number of years of education. Household Population and Housing Characteristics | 17 • Over two-thirds of the household population (68 percent of females and 65 percent of males) have completed primary school or higher. Only 3 percent of the population age 6 and over have never attended school, and about one in four people (26 to 27 percent) have attended only some primary school. • There is no significant gap in educational attainment between females and males except for the percentages who have completed secondary school (19 and 14 percent, respectively). • The median number of years of schooling is slightly higher for females than for males: 7.4 years versus 6.8 years. The median number of years of schooling are two years higher among both Urban area females and males (8.9 years and 8.2 years, respectively) compared with their Rural area counterparts (6.7 and 6.2 years, respectively). • The most substantial variation in educational attainment among household members is evident across wealth quintiles and regions for both females and males. Seventeen percent of females and 18 percent of males from the wealthiest households have never been to school or have just attended some primary school, compared with 45 percent of females and 47 percent of males from the poorest households. • Regarding regions, 55 percent of females and 50 percent of males in Region 1 have never been to school or have just attended some primary school, compared with 22 percent of females in Region 10 and 25 percent of males in Region 4. 2.1.5 School Attendance Table 2.5 provides net and gross attendance ratios by school level, sex, and residence. The net attendance ratio (NAR) is an indicator of participation in schooling among the population of official school age, while the gross attendance ratio (GAR) is an indicator of participation in schooling among those of any age between 5 and 24 years. The difference between the ratios indicates the incidence of over-age and under-age attendance. The GAR is nearly always higher than the NAR for the same level because the GAR includes participation by those who may be older or younger than the official age range for that level.1 A NAR of 100 percent would indicate that all children in the official age range for the level are attending education at that level. The GAR can exceed 100 percent if there is significant over- age or under-age participation at a given level of schooling. Children are considered to be attending school currently if they attended at any point during the current school year. Figure 2.3 presents the age-specific attendance ratios (ASAR) for the population age 5-24 by sex. The ASAR indicates participation in schooling at any level, from primary through higher education. The closer the ASAR is to 100 percent, the higher is the proportion of a given age attending school. The Gender Parity Index (GPI), or the ratio of the female to the male GAR at the general basic and general secondary levels, is also included in Table 2.5. The GPI indicates the magnitude of the gender gap in attendance ratios. If there is no gender difference, the GPI will be equal to 1. The GPI will be closer to 0 if the disparity is in favor of males. If the gender gap favors females, the GPI will exceed 1. 1 Students who are over-age for a given level of schooling may have started school over-age, may have repeated one or more grades in school, or may have dropped out of school and later returned. 18 | Household Population and Housing Characteristics Table 2.5 School attendance ratios Net attendance ratios (NAR) and gross attendance ratios (GAR) for the de jure household population by sex and grade; and the Gender Parity Index (GPI), according to background characteristics, Guyana 2009 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Net attendance ratio1 Gross attendance ratio2 Background –––––––––––––––––––––––––––––––––– –––––––––––––––––––––––––––––––––– characteristic Male Female Total GPI3 Male Female Total GPI3 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– PRIMARY SCHOOL ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Total Urban 94.9 92.8 93.9 0.98 97.7 95.3 96.5 0.98 Georgetown (urban) 96.2 95.5 95.8 0.99 99.5 97.8 98.6 0.98 Other (urban) 93.1 88.7 90.9 0.95 95.1 91.6 93.3 0.96 Total Rural 91.3 93.3 92.3 1.02 96.9 98.4 97.6 1.01 Total Coastal 93.1 93.8 93.4 1.01 96.9 96.8 96.8 1.00 Coastal (urban) 94.9 92.8 93.9 0.98 97.7 95.3 96.5 0.98 Coastal (rural) 92.3 94.2 93.2 1.02 96.5 97.4 96.9 1.01 Total Interior 88.2 90.0 89.1 1.02 98.3 101.9 100.0 1.04 Wealth quintile Lowest 88.3 90.4 89.3 1.02 97.2 98.7 97.9 1.02 Second 94.6 92.4 93.5 0.98 100.6 97.0 98.8 0.96 Middle 92.5 95.2 93.9 1.03 95.5 98.4 97.0 1.03 Fourth 89.8 95.6 92.9 1.07 93.1 97.3 95.3 1.05 Highest 97.6 93.3 95.5 0.96 98.3 96.3 97.3 0.98 Total 2009 92.2 93.2 92.7 1.01 97.1 97.6 97.4 1.01 Total 2005 90.1 91.2 90.6 na 100.3 101.0 100.6 1.01 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– SECONDARY SCHOOL –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Total Urban 87.1 91.5 89.2 1.05 96.6 111.1 103.5 1.15 Georgetown urban 88.4 92.8 90.4 1.05 98.6 113.9 105.7 1.16 Other urban 85.2 89.7 87.4 1.05 93.5 107.0 100.2 1.14 Total Rural 76.4 77.8 77.1 1.02 86.1 87.0 86.5 1.01 Total Coastal 80.8 83.5 82.1 1.03 90.5 95.9 93.1 1.06 Coastal urban 87.1 91.5 89.2 1.05 96.6 111.1 103.5 1.15 Coastal rural 77.7 79.9 78.8 1.03 87.5 89.0 88.2 1.02 Total Interior 69.5 67.9 68.7 0.98 78.4 77.3 77.8 0.99 Wealth quintile Lowest 64.6 61.5 63.0 0.95 68.8 69.6 69.2 1.01 Second 72.5 77.6 75.1 1.07 82.3 88.7 85.5 1.08 Middle 77.3 86.2 81.3 1.12 85.5 96.5 90.4 1.13 Fourth 87.5 91.3 89.4 1.04 102.2 105.4 103.7 1.03 Highest 97.5 92.3 94.8 0.95 108.8 109.1 109.0 1.00 Total 2009 79.5 81.6 80.5 1.03 89.2 93.6 91.3 1.05 Total 2005 69.9 78.1 74.0 na 87.1 95.5 91.3 1.10 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– na = Not available 1 The net attendance ratio (NAR) for primary school is the percentage of the primary-school-age (6-11 years) population that is attending primary school. The NAR for secondary school is the percentage of the secondary school-age (12-17 years) population that is attending secondary school. By definition the NAR cannot exceed 100 percent. 2 The gross attendance ratio (GAR) for primary school is the total number of primary school students, expressed as a percentage of the official primary-school-age population. The GAR for secondary school is the total number of secondary school students, expressed as a percentage of the official secondary-school-age population. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100 percent. 3 The gender parity index (GPI) for primary school is the ratio of the primary school GAR for females to the GAR for males. The GPI for secondary school is the ratio of the secondary school GAR for females to the GAR for males. Household Population and Housing Characteristics | 19 • More than nine in ten of the primary school-age children (age 6-11) in Guyana attend primary school; males (92 percent) are about as likely as females (93 percent) to attend primary school. • About eight in ten secondary school-age children (age 12-17) attend secondary school (80 percent of males and 82 percent of females). • Although the urban-rural difference in primary school NAR is negligible (94 and 92 percent, respectively), there is a 12 percentage point difference in the NAR for secondary school (89 and 77 percent, respectively). The gap in the secondary school NAR between the Coastal and the Interior areas is slightly larger: 82 and 69 percent, respectively. • Although there is little variation in the primary school NAR, according to the wealth index, secondary school-age children from the wealthiest households are significantly more likely to attend school than those in the least wealthy households (95 and 63 percent, respectively). 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 0 20 40 60 80 100 Percentage of the population Female Male GDHS 2009 Figure 2.3 Age-Specific School Attendance Rates, by Sex A ge 3 8 2 6 6 8 5 9 12 17 9 19 21 17 42 68 58 88 47 92 85 81 96 9590 82 95 96 96 97 99 98 98 98 98 99 97 98 20 | Household Population and Housing Characteristics • An important proportion of primary school students fall outside the official age range for primary schooling: whereas the primary school NAR is 93, the GAR is 97, indicating that for every 93 students age 6-11, there are four primary school students who are either younger than age 6 or older than age 11. In secondary school, the NAR is 81, while the GAR is 91, indicating that for every 81 students age 12-17, there are 10 who are either younger than age 12 or older than age 17. • The gross atendance ratios at the primary and secondary levels are slightly higher for females than for males, resulting in a Gender Parity Index of 1.01 for primary school and 1.05 for secondary school. • As shown on Figure 2.3, similar proportions of female and male youth attend school between 7 and 14 years. Attendance rates peak around age 7-13 (close to 100 percent) and decrease rapidly after age 15. At age 15 and age 16, greater proportions of female than male youth attend school, while between age 17 and age 24 male youths are generally more likely to attend school. 2.2 HOUSING CHARACTERISTICS To assess the socioeconomic conditions under which the population lives, respondents were asked to give specific information about their household environment. Type of water source, sanitation facilities, and floor material are characteristics that affect the health status of household members and, in particular, children. They also indicate the socioeconomic status of households. Table 2.6 shows the percentage of households with drinking water by Urban-Rural and Coastal-Interior residence. Major housing characteristics are presented in Table 2.7, and sanitation facilities are described in Table 2.8. 2.2.1 Drinking Water and Housing Characteristics Table 2.6 presents several indicators relating to household access to improved drinking water. The source of drinking water is an indicator of whether or not it is suitable for drinking. Sources that are considered likely to be of suitable quality are listed under “Improved source,” and sources that may not be of suitable quality are listed under “Non-improved source.” The categorization by improved and non- improved sources is proposed by WHO, UNICEF, and the Joint Monitoring Program for Water and Sanitation (WHO, UNICEF, and JMP, 2004). Information is also provided on the time to obtain drinking water, the age and sex of the person who usually collects the drinking water, and the treatment given to water used for drinking. Water may be treated in several ways by a household, so water treatment is given as the percentage of households using the treatment rather than as a distribution. The results for the de jure population are also included.2 2 The information for the de jure population is shown, given that UNICEF tabulates statistics by population rather than by household. Household Population and Housing Characteristics | 21 Table 2.6 Household drinking water Percent distribution of households and de jure population by source, time to collect, and person who usually collects drinking water; and percentage by treatment of drinking water, according to residence, Guyana 2009 Urban-rural residence Coastal-Interior residence Urban Coastal Characteristic Total urban Georgetown urban Other urban Total rural Total Coastal Coastal urban Coastal rural Total Interior Total percentage of households Total percentage of population Source of drinking water Improved source 44.7 25.8 80.8 69.5 61.7 44.7 69.6 69.4 62.5 62.8 Piped into dwelling/yard/plot 28.5 14.5 55.4 33.9 34.9 28.5 37.9 10.5 32.4 32.5 Public tap/standpipe 0.4 0.0 1.3 1.3 0.9 0.4 1.1 2.3 1.1 1.1 Tube well or borehole 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.0 Protected dug well 0.0 0.0 0.1 2.0 0.7 0.0 0.9 8.6 1.5 1.7 Protected spring 0.7 0.0 2.1 0.3 0.3 0.7 0.1 1.3 0.4 0.5 Rainwater 14.9 11.3 21.9 31.9 24.9 14.9 29.5 46.5 27.1 27.0 Non-improved source 0.6 0.0 1.8 6.3 2.3 0.6 3.1 25.5 4.7 5.9 Unprotected dug well 0.0 0.0 0.0 0.7 0.0 0.0 0.0 4.3 0.5 0.7 Unprotected spring 0.4 0.0 1.3 0.6 0.3 0.4 0.2 2.8 0.5 0.6 Tanker truck/cart with small tank 0.0 0.0 0.1 0.2 0.1 0.0 0.2 0.4 0.2 0.2 Surface water 0.1 0.0 0.4 4.9 1.9 0.1 2.7 17.9 3.5 4.3 Bottled water1 54.2 73.6 17.1 23.4 35.3 54.2 26.6 4.7 32.1 30.6 Improved source 53.8 73.3 16.4 22.8 34.7 53.8 25.9 4.7 31.6 30.1 Non-improved source 0.4 0.3 0.7 0.6 0.6 0.4 0.7 0.0 0.5 0.5 Other sources 0.5 0.5 0.3 0.7 0.7 0.5 0.8 0.3 0.6 0.7 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Percentage using any improved source of drinking water 98.5 99.1 97.1 92.3 96.4 98.5 95.4 74.0 94.1 93.0 Time to obtain drinking water (round trip) Water on premises 97.4 99.3 93.9 90.7 94.8 97.4 93.6 73.3 92.6 91.7 Less than 30 minutes 2.1 0.6 5.1 7.1 3.5 2.1 4.2 24.5 5.7 6.7 30 minutes or longer 0.3 0.0 0.9 1.6 1.3 0.3 1.7 0.8 1.2 1.2 Don't know/missing 0.1 0.1 0.2 0.6 0.3 0.1 0.4 1.3 0.5 0.4 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Person who usually collects drinking water Adult female 15+ 0.2 0.0 0.6 2.6 1.3 0.2 1.9 7.0 1.9 2.3 Adult male 15+ 1.8 0.6 4.2 5.3 3.2 1.8 3.8 13.9 4.3 4.4 Female child under age 15 0.1 0.0 0.4 0.1 0.1 0.1 0.0 0.5 0.1 0.1 Male child under age 15 0.3 0.0 0.8 0.5 0.3 0.3 0.3 1.6 0.4 0.7 Other 0.0 0.0 0.1 0.7 0.2 0.0 0.2 3.3 0.5 0.7 Water on premises 97.4 99.3 93.9 90.7 94.8 97.4 93.6 73.3 92.6 91.7 Missing 0.1 0.1 0.1 0.2 0.1 0.1 0.1 0.4 0.2 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Water treatment prior to drinking2 Boiled 14.3 10.9 20.9 8.0 9.9 14.3 7.8 8.7 9.8 9.8 Bleach/chlorine 32.6 27.0 43.4 39.0 38.8 32.6 41.6 23.4 37.2 38.9 Strained through cloth 0.1 0.0 0.4 0.8 0.5 0.1 0.7 1.6 0.6 0.6 Ceramic, sand or other filter 0.6 0.6 0.7 0.8 0.8 0.6 0.8 0.5 0.7 0.7 Other 1.6 0.9 2.7 1.9 1.7 1.6 1.8 2.5 1.8 1.7 No treatment 56.3 64.9 39.6 52.1 52.0 56.3 50.0 65.1 53.3 51.9 Percentage using an appro- priate treatment method3 42.1 34.0 57.7 46.5 46.7 42.1 48.9 32.4 45.3 46.7 Number 1,603 1,053 550 4,029 5,052 1,603 3,449 580 5,632 21,317 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Because the quality of bottled water is not known, households using bottled water for drinking are classified as using an improved or non- improved source according to their water source for cooking and washing. 2 Respondents may report multiple treatment methods, so the sum of treatment may exceed 100 percent. 3 Appropriate water treatment methods include boiling, bleaching, straining through cloth, filtering, and solar disinfecting. 22 | Household Population and Housing Characteristics • Although the majority of Guyanese households (94 percent) have access to clean water sources, 27 percent rely on rainwater and 32 percent rely on bottled water. For 33 percent of households, the water is piped into the dwelling, yard, or plot. • Access to an improved source of drinking water is similar for Urban, Rural, and Coastal area residences (92 to 99 percent). However, for residences in the Interior area, only 74 percent of households have access to an improved source of drinking water, where the main sources of drinking water are rainwater and surface water (47 and 18 percent, respectively). The drinking water is piped into the dwelling, yard, or plot for only 11 percent of house- holds in the Interior area. • Overall, 93 percent of Guyanese households have drinking water on their premises. In the Interior area, however, only 73 percent of households have drinking water on their premi- ses, with the majority of the remaining households (25 percent) reporting that it takes less than 30 minutes to obtain the water. In the Interior area, men over age 15 usually collect the water (14 percent) followed by women over age 15 (7 percent). • More than half of the households (53 percent) reported no water treatment prior to drinking, including almost two-thirds (65 percent) in the Interior and in the Urban (Georgetown) areas. Only 45 percent of households use an appropriate treatment method (i.e., boiling, bleaching, straining through cloth, filtering, or solar disinfecting). The principal water treatment is bleach or chlorine (37 percent) followed by boiling (10 percent). Table 2.7 shows information on basic housing characteristics by residence, including access to electricity, type of flooring material, number of rooms used for sleeping, place for cooking, and type of cooking fuel. • As many as 78 percent of Guyanese households have electricity, 91 percent in Urban areas compared with 72 percent in Rural areas. In the Interior area, only 40 percent of households have electricity. • Many households (38 percent) have wood or planks as flooring material, and 16 percent each have vinyl/asphalt strips or cement. • The number of rooms used for sleeping indicates the extent of crowding in households. Overcrowding increases the risk of infectious diseases, including acute respiratory infections and skin diseases, which particularly affect children. About one-third of households in rural areas (32 percent) use only one room for sleeping, and about one-fourth (24 percent) use three or more rooms for sleeping, compared with 21 percent and 36 percent, respectively, in urban areas. • Overall, in 86 percent of the households in Guyana cooking is done in the house. The only exception is the Interior area where 31 percent of households cook outdoors or in a separate building. • More than half of the households (56 percent) use LPG/natural gas/biogas as cooking fuel, and more than one-third (34 percent) use kerosene. In the Urban (Georgetown) area, however, the corresponding figures are 84 and 15 percent, respectively. • Solid fuel (coal/lignite, charcoal, wood, and straw/shrubs/grass) is used in only 8 percent of households for cooking. In the Interior area, however, more than one-third of households (35 percent) use solid fuel, compared with virtually 0 percent in the Urban (Georgetown) area. These Interior-area households use either fire-side (65 percent) or “open fire/stove without chimney or hood” (31 percent), with little difference by residence (data not shown). Household Population and Housing Characteristics | 23 Table 2.7 Housing characteristics Percent distribution of households and de jure population by housing characteristics and percentage using solid fuel for cooking; and among those using solid fuels, percent distribution by type of fire/stove, according to residence, Guyana 2009 Urban-Rural residence Coastal-Interior residence Urban Coastal Characteristic Total Urban Georgetown (urban) Other (urban) Total Rural Total Coastal Coastal (urban) Coastal (rural) Total Interior Total percentage of households Total percentage of population Electricity 90.9 91.8 89.3 72.3 81.9 90.9 77.7 40.3 77.6 75.9 Flooring material Earth, sand 0.1 0.2 0.0 3.1 0.8 0.1 1.1 14.9 2.3 2.9 Dung 0.0 0.0 0.0 0.4 0.1 0.0 0.2 1.4 0.3 0.3 Wood/planks 25.3 22.7 30.3 43.1 37.1 25.3 42.6 45.6 38.0 38.2 Palm/bamboo 0.0 0.0 0.1 0.4 0.2 0.0 0.3 0.8 0.3 0.2 Parquet or polished wood 16.6 19.1 11.9 9.3 11.2 16.6 8.7 13.2 11.4 10.7 Vinyl or asphalt strips 21.5 22.5 19.5 13.5 16.1 21.5 13.7 12.3 15.7 15.9 Ceramic tiles 7.7 9.1 5.1 4.1 5.6 7.7 4.6 1.3 5.2 4.9 Cement 13.1 9.2 20.5 16.9 16.7 13.1 18.4 8.1 15.8 16.2 Carpet 14.9 16.4 11.9 8.8 11.4 14.9 9.9 2.3 10.5 10.1 Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.0 0.1 0.1 Missing 0.7 0.7 0.5 0.4 0.5 0.7 0.4 0.3 0.5 0.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Rooms used for sleeping One 21.0 20.1 22.7 31.7 27.4 21.0 30.3 39.6 28.6 20.9 Two 40.6 41.8 38.1 39.7 40.5 40.6 40.5 34.9 40.0 41.1 Three or more 35.9 35.6 36.3 23.9 28.8 35.9 25.5 14.4 27.3 33.8 Missing 2.6 2.4 2.9 4.7 3.3 2.6 3.6 11.2 4.1 4.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Place for cooking In the house 95.9 98.3 91.2 82.7 88.5 95.9 85.1 67.9 86.4 85.5 In a separate building 1.0 0.3 2.1 7.3 4.4 1.0 6.1 14.5 5.5 6.3 Outdoors 2.2 0.7 5.2 8.9 5.9 2.2 7.5 16.7 7.0 7.6 Missing 0.9 0.6 1.5 1.2 1.1 0.9 1.2 0.8 1.1 0.6 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Cooking fuel Electricity 3.8 0.1 11.0 0.6 1.4 3.8 0.3 2.3 1.5 1.5 LPG/natural gas/biogas 71.6 84.0 47.7 49.1 57.9 71.6 51.5 34.5 55.5 54.9 Kerosene 22.2 15.2 35.6 38.6 34.7 22.2 40.6 27.2 34.0 33.5 Coal/lignite 0.3 0.0 0.9 0.2 0.2 0.3 0.2 0.2 0.2 0.2 Charcoal 0.1 0.0 0.3 0.2 0.1 0.1 0.2 0.6 0.2 0.2 Wood 1.2 0.0 3.4 10.2 4.6 1.2 6.2 34.1 7.7 9.1 Straw/shrubs/grass 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.0 No food cooked in household 0.7 0.6 0.9 0.9 0.9 0.7 1.0 0.3 0.8 0.3 Other 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.2 0.0 0.1 Missing 0.1 0.0 0.3 0.1 0.1 0.1 0.1 0.3 0.1 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Percentage using solid fuel for cooking1 1.6 0.0 4.5 10.7 5.0 1.6 6.5 35.1 8.1 9.5 Number of households 1,603 1,053 550 4,029 5,052 1,603 3,449 580 5,632 21,317 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– LPG = Liquid petroleum gas 1 Includes coal/lignite, charcoal, wood, and straw/shrubs/grass. 24 | Household Population and Housing Characteristics 2.2.2 Sanitation Facilities Table 2.8 shows the proportions of households and of the de jure population that have access to hygienic sanitation facilities. Hygienic status is determined on the basis of type of facility used and whether or not it is a shared facility. A household’s toilet/latrine facility is classified as hygienic if it is used only by household members (i.e., not shared) and if the type of facility effectively separates human waste from human contact. The types of facilities that are most likely to accomplish this are flush or pour flush into a piped sewer system, septic tank, or pit latrine; a ventilated, improved pit (VIP) latrine; and a pit latrine with a slab. A household’s sanitation facility is classified as unhygienic if it is shared with other households or if it does not effectively separate human waste from human contact. • With regard to sanitation facilities, 48 percent of households use septic tank toilets, 24 percent use a pit latrine with slab, and 7 percent use a ventilated improved pit latrine. Only 1 percent of households have no sanitation facilities. • In urban areas, the most common type of toilet facility is a septic tank (69 percent), while only 11 percent of households are connected to a piped sewer system. In Rural areas, 40 percent of households have septic tanks, and 31 percent have pit latrines with a slab. Sharing a toilet facility with other households is also more common in Rural areas (10 percent of households) compared with Urban areas (6 percent of households). Table 2.8 Sanitation facilities Percent distribution of households and de jure population by type of toilet/latrine facilities, according to residence, Guyana 2009 Urban-Rural residence Coastal-Interior residence Urban Coastal Type of toilet/latrine facility Total Urban Georgetown (urban) Other (urban) Total Rural Total Coastal Coastal (urban) Coastal (rural) Total Interior Total percentage of households Total percentage of population Improved, not shared facility Flush/pour flush to piped sewer system 11.3 16.4 1.5 1.1 4.3 11.3 1.1 1.4 4.0 4.0 Flush/pour flush to septic tank 68.6 72.1 61.7 39.8 51.9 68.6 44.2 13.3 48.0 45.9 Flush/pour flush to pit latrine 0.1 0.2 0.0 0.3 0.2 0.1 0.2 1.0 0.2 0.4 Ventilated improved pit (VIP) latrine 3.5 2.5 5.5 9.0 6.9 3.5 8.5 11.5 7.4 8.3 Pit latrine with slab 6.6 1.6 16.2 31.2 23.1 6.6 30.8 33.8 24.2 25.4 Non-improved facility Any facility shared with other households 5.9 4.7 8.3 10.4 8.7 5.9 10.0 13.0 9.1 8.3 Flush/pour flush not to sewer/septic tank/pit latrine 0.1 0.2 0.0 0.3 0.2 0.1 0.3 0.3 0.2 0.2 Pit latrine without slab/open pit 3.3 1.8 6.1 5.5 3.5 3.3 3.5 17.3 4.9 5.5 Hanging toilet/hanging latrine 0.0 0.0 0.1 0.9 0.7 0.0 1.0 0.7 0.7 0.7 No facility/bush/field 0.3 0.2 0.5 1.3 0.3 0.3 0.3 7.1 1.0 1.0 Missing 0.3 0.3 0.1 0.1 0.1 0.3 0.1 0.4 0.1 0.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number 1,603 1,053 550 4,029 5,052 1,603 3,449 580 5,632 21,317 Household Population and Housing Characteristics | 25 2.2.3 Household Possessions The availability of durable goods is a proximate measure of household socioeconomic status. Moreover, goods have specific benefits. Having access to a radio or a television exposes household members to innovative ideas; a refrigerator prolongs the wholesomeness of foods; and a means of transport, such as a bicycle, motorcycle, or car, allows access to many services available outside the local area. In the 2009 GDHS, respondents were asked about ownership of particular household goods. Table 2.9 provides information on household ownership of durable goods (radios, televisions, telephones, refrigerators, and other items) and modes of transportation (bicycles, motorcycles, and automobiles). • Nationally, the most commonly owned items among those investigated are the television (81 percent of households) and the mobile telephone (80 percent). The ownership of these two items is high in all areas, except for households in the Interior area, where ownership of television and mobile telephones is relatively low (45 and 55 percent, respectively). • Refrigerators and radios are the next most popular household items (62 and 59 percent, respectively). Over half of Guyanese households own a land-line telephone (54 percent) and a bicycle (52 percent), but only 17 percent own a car or a truck. • As expected, for most items ownership is much higher in Urban than in Rural areas, especially for non-mobile telephones (78 percent compared with 45 percent) and refrigerators (80 percent compared with 55 percent). Table 2.9 Durable goods Percentage of households and de jure population possessing various household effects, means of transportation, agricultural land, and livestock/farm animals, by residence, Guyana 2009 Urban-Rural residence Coastal-Interior residence Urban Coastal Characteristic Total Urban Georgetown (urban) Other (urban) Total Rural Total Coastal Coastal (urban) Coastal (rural) Total Interior Total percentage of households Total percentage of population Radio 70.8 75.9 61.2 54.4 62.0 70.8 57.9 33.7 59.1 58.7 Television 90.4 91.2 89.1 76.5 84.6 90.4 81.8 44.8 80.5 81.8 Mobile telephone 87.2 87.3 87.0 76.8 82.6 87.2 80.5 54.9 79.7 82.9 Non-mobile telephone 77.9 86.9 60.9 44.7 59.6 77.9 51.1 6.8 54.2 53.2 Refrigerator 79.5 83.6 71.5 54.9 66.4 79.5 60.3 22.8 61.9 61.7 Bicycle 47.8 39.2 64.2 53.8 54.7 47.8 57.9 29.3 52.1 57.2 Animal-drawn cart 0.9 0.7 1.2 1.2 1.1 0.9 1.3 0.8 1.1 1.2 Motorcycle/scooter 14.6 16.0 11.7 6.6 9.4 14.6 7.0 4.6 8.9 9.8 Car/truck 22.8 26.3 16.2 15.0 18.5 22.8 16.5 5.9 17.2 17.6 Boat with a motor 0.6 0.0 1.8 5.0 3.2 0.6 4.4 8.8 3.7 4.4 Ownership of agricultural land 5.9 2.5 12.3 18.5 11.8 5.9 14.6 42.1 14.9 16.4 Ownership of farm animals1 11.7 6.4 21.7 27.8 22.4 11.7 27.4 30.5 23.2 26.4 Number 1,603 1,053 550 4,029 5,052 1,603 3,449 580 5,632 21,317 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Cattle, cows, bulls, horses, donkeys, goats, sheep, or chickens 26 | Household Population and Housing Characteristics 2.3 WEALTH QUINTILES In addition to standard background characteristics, most of the results in this report are shown by wealth quintiles, an indicator of the economic status of households. Although surveys under the DHS program do not collect data on consumption or income, they do collect detailed information on dwelling and household characteristics and access to a variety of consumer goods, services, and assets. The wealth index is a measure that has been tested in a number of countries in relation to inequities in household income, use of health services, and health outcomes. The wealth index is constructed by assigning a weight or factor score to each household asset through principal components analysis. The resulting asset scores are standardized in relation to a standard normal distribution with a mean of zero and standard deviation of one. These scores are summed by household, and individuals are ranked according to the total score of the household in which they reside. The sample is then divided into population quintiles— five groups with the same number of individuals in each. At the national level, approximately 20 percent of the population is in each wealth quintile (Gwatkin et al, 2000). Asset information was collected in the 2009 GDHS 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, type of sanitation facilities, and type of material used in flooring (see Tables 2.7.1 through 2.9). Table 2.10 shows the distribution of the population across the five wealth quintiles, by areas of residence (Urban or Rural; Coastal or Interior) and by region. These distributions indicate the degree to which wealth is evenly (or unevenly) distributed by geographic areas. Also included in Table 2.10 is the Gini coefficient, which indicates the level of concentration of wealth, with 0 being an equal distribution and 1 a totally unequal distribution, although the coefficient is expressed as a percentage in the table. • Around two-thirds of households in Urban areas are in the two highest wealth quintiles compared with about one-third in Rural areas. In contrast, households in Rural areas are five times as likely as those in Urban areas to be in the poorest wealth quintile (26 percent versus 5 percent). • Fifty percent of the Urban (Georgetown) households are in the wealthiest quintile, com- pared with only 24 percent in Urban (other) areas in the country and 12 percent in Rural areas. • Two-thirds of households (66 percent) in the Interior area are in the lowest quintile, and 83 percent are in the two poorest quintiles. Regions 1, 8, and 9 have most of their households in the lowest quintile (72, 74, and 84 percent, respectively), while Regions 4 and 10 have a significant percentage of households in the wealthiest quintile (32 and 24 percent, respectively). Household Population and Housing Characteristics | 27 2.4 BIRTH REGISTRATION The registration of births is the inscription of the facts of the birth into an official log kept at the registrar’s office. A birth certificate is issued at the time of registration or later as proof of the registration of the birth. In the 2009 GDHS, for all children born since January 2004, mothers were asked if their child’s birth had been registered. Table 2.11 shows the percentage of children under age 5 whose births were officially registered and the percentage that had a birth certificate at the time of the survey. Not all children who are registered may have a birth certificate since some certificates may have been lost or were never issued. However, all children with a certificate have been registered. • A total of 88 percent of Guyanese children under age 5 have been registered with the civil authority. There are no substantial variations by background characteristics in the per- centage of chidlren whose births are registered, except for regions. The total percentage of registered births ranges from 83 percent in Region 1 to 96 percent in Region 5. • More variation is observed in the proportion of children with a birth certificate available at the time of the survey. Overall, 73 percent of children under age 5 had a birth certificate at the time of the survey. Children in Urban areas are slightly more likely than those in Rural areas to have a birth certificate available (81 and 70 percent, respectively). Only 61 percent of children under age 5 in the Interior area had a birth certificate at the time of the survey. • The likelihood of having a birth certificate at the time of the survey is 21 percentage points lower for children in the poorest wealth quintile compared with those in the highest wealth quintile (63 percent versus 84 percent). Table 2.10 Wealth quintiles Percent distribution of the de jure population by wealth quintiles, according to residence and region, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Wealth quintile Number of –––––––––––––––––––––––––––––––––––––––––––– de jure Gini Residence/region Lowest Second Middle Fourth Highest Total population coefficient ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Residence Total Urban 5.1 12.2 17.4 24.8 40.5 100.0 5,870 7.8 Urban (Georgetown) 3.4 9.7 12.9 24.3 49.7 100.0 3,774 5.6 Urban (other) 8.2 16.7 25.5 25.7 24.0 100.0 2,096 9.0 Total Rural 25.7 23.0 21.0 18.1 12.2 100.0 15,448 18.8 Total Coastal 13.5 20.4 21.7 22.0 22.4 100.0 18,649 12.1 Coastal (urban) 5.1 12.2 17.4 24.8 40.5 100.0 5,870 7.8 Coastal (rural) 17.3 24.1 23.7 20.8 14.1 100.0 12,780 12.6 Total Interior 65.6 17.4 8.1 5.6 3.4 100.0 2,668 40.1 Region Region 1 72.0 20.1 4.2 2.1 1.6 100.0 934 33.8 Region 2 38.0 21.6 17.7 14.2 8.5 100.0 1,312 21.5 Region 3 15.5 22.9 28.2 18.9 14.5 100.0 2,842 10.5 Region 4 9.4 17.6 18.7 22.7 31.6 100.0 8,678 10.2 Region 5 15.8 30.4 22.0 20.1 11.5 100.0 1,567 9.7 Region 6 13.9 22.5 23.6 26.0 14.0 100.0 3,357 12.5 Region 7 53.8 14.6 11.8 12.4 7.3 100.0 508 39.7 Region 8 74.0 12.9 9.6 2.6 0.9 100.0 465 43.5 Region 9 84.4 6.8 3.7 3.0 2.1 100.0 439 51.3 Region 10 10.8 17.9 25.2 22.4 23.8 100.0 1,215 12.8 Total 20.0 20.0 20.0 20.0 20.0 100.0 21,317 16.9 28 | Household Population and Housing Characteristics Table 2.11 Birth registration of children under age 5 Percentage of de jure children under age 5 whose births are registered with the civil authorities, according to background characteristics, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Percentage of children whose births are registered: –––––––––––––––––––––––––––––– Had Didn’t have Number Background a birth a birth Total of characteristic certificate certificate registered children ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age <2 58.8 28.4 87.2 825 2-4 82.1 6.3 88.4 1,228 Sex Male 71.6 16.7 88.2 1,023 Female 73.9 13.8 87.6 1,030 Residence Total Urban 81.2 9.9 91.1 464 Urban (Georgetown) 83.9 7.6 91.5 286 Urban (other) 77.0 13.5 90.4 178 Total Rural 70.2 16.8 87.0 1,589 Total Coastal 75.9 12.5 88.3 1,623 Coastal (urban) 81.2 9.9 91.1 464 Coastal (rural) 73.7 13.5 87.2 1,158 Total Interior 60.8 25.5 86.3 430 Region Region 1 56.1 26.8 83.0 162 Region 2 70.0 16.7 86.6 123 Region 3 73.9 15.0 88.9 269 Region 4 78.8 9.2 87.9 727 Region 5 81.2 14.6 95.8 144 Region 6 69.3 15.9 85.2 272 Region 7 73.6 15.5 89.2 73 Region 8 56.4 34.0 90.4 76 Region 9 59.4 24.5 83.9 72 Region 10 73.9 16.2 90.1 133 Wealth quintile Lowest 63.3 20.9 84.3 595 Second 74.5 15.4 89.8 438 Middle 72.6 15.5 88.2 374 Fourth 76.7 11.2 87.9 339 Highest 84.1 7.9 92.0 307 Total 2009 72.7 15.2 87.9 2,053 Total 2005 77.5 17.3 94.8 1,006 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Table is based on de jure household members, i.e., usual household members. Characteristics of Survey Respondents | 29 CHARACTERISTICS OF SURVEY RESPONDENTS 3 This chapter provides a brief description of demographic and socioeconomic characteristics of the survey respondents, specifically their age, sex, residence, education, economic status, employment, and marital status. Examination of these characteristics not only helps one to gauge the accuracy of the survey data but also provides a look at trends in these characteristics over time. Most important, they provide a basis for the analysis of how these characteristics relate to the other issues investigated in the survey. 3.1 BACKGROUND CHARACTERISTICS OF SURVEY RESPONDENTS A description of the basic characteristics of the 4,996 women and 3,522 men interviewed in the 2009 GDHS is essential as background for interpreting findings presented later in the report. Table 3.1 provides the percent distribution of respondents by age, marital status, level of education, wealth quintile, religion, and ethnicity. Information on both the weighted and unweighted numbers is included. To determine their age, respondents were asked two questions in the individual interview: “In what month and year were you born?” and “How old were you at your last birthday?” The interviewers were trained to use probing techniques for situations in which respondents did not know their age or date of birth, and as a last resort, they were instructed to record their best estimate of the respondent's age. Highlights of basic background characteristics of the respondents are the following: • The percentage of each age group decreases with age for both women and men, reflecting the predominantly youthful age structure of the population of Guyana. Respondents age 15-19 represent the highest percentage—20 percent— or one-fifth of the total population age 15-49. • About one-third of women (34 percent) and men (31 percent) are currently married. An additional one in four women (25 percent) and one in five men (22 percent) are in “informal” unions. All together, 59 percent of women and 52 percent of men are currently in a union. Eleven percent of women and 9 percent of men are divorced, separated, or widowed. The proportion that has never married is higher for men (39 percent) than for women (31 percent). • About one-fifth of women (19 percent) and men (20 percent) attended or completed primary school. Seven in ten respondents have attended or completed secondary school, and 8 percent each of women and men have more than a secondary education. • The male population is more evenly distributed among wealth quintiles (19-21 percent each) than the female population (which increases steadily from 16 percent in the lowest quintile to 23 percent in the highest quintile). • The majority of respondents (66 percent of women and 56 percent of men) are Christian, followed by Hindu (26 percent of women and 31 percent of men). Another 6 percent of women and 8 percent of men are Muslim. • The largest ethnic group in Guyana is Indian: 43 percent of women and 50 percent of men are of Indian descent. More than one-quarter of respondents are in the African ethnic group (30 percent of women and 27 percent of men), and slightly less than one-tenth of respondents (9 percent of women and 8 percent of men) report that they are Amerindian. • Eighteen percent of women and 14 percent of men say they are of mixed ethnic background. 30 | Characteristics of Survey Respondents Table 3.1 Background characteristics of respondents Percent distribution of women and men age 15-49, by background characteristics, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Women Men –––––––––––––––––––––––––––––––––– –––––––––––––––––––––––––––––––––––– Background Weighted Weighted Unweighted Weighted Weighted Unweighted characteristic percent number number percent number number ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 20.3 1,016 1,016 19.6 689 720 20-24 15.4 767 775 14.5 511 497 25-29 13.2 658 658 13.1 462 460 30-34 12.9 643 661 14.8 521 487 35-39 14.0 699 697 13.3 470 482 40-44 12.5 624 624 13.0 457 463 45-49 11.8 589 565 11.7 413 413 Marital status Never married 30.8 1,540 1,512 39.2 1,382 1,377 Married 33.8 1,687 1,803 30.6 1,078 1,159 Living together 24.7 1,233 1,203 21.5 757 725 Divorced/separated 9.1 454 398 8.3 291 247 Widowed 1.6 82 80 0.4 14 14 Education No education 1.4 68 81 1.7 60 56 Primary 19.1 952 1,042 20.2 711 741 Secondary 71.4 3,568 3,500 69.8 2,459 2,451 More than secondary 8.2 409 373 8.3 292 274 Wealth quintile Lowest 15.6 779 1,254 18.8 663 900 Second 19.2 957 899 19.3 679 675 Middle 20.5 1,025 936 20.5 723 667 Fourth 21.7 1,084 984 21.3 751 695 Highest 23.0 1,151 923 20.0 705 585 Religion Christian 66.2 3,306 3,520 55.5 1,956 2,095 Hindu 26.2 1,307 1,137 31.4 1,106 981 Muslim 6.1 306 271 8.0 282 262 Rastafarian 0.2 12 7 1.2 42 38 Not religious 1.1 53 48 3.5 123 131 Other 0.1 4 6 0.3 11 12 Missing 0.1 6 7 0.1 3 3 Ethnic group African 29.5 1,475 1,242 26.5 933 848 Indian 43.4 2,168 1,847 49.6 1,748 1,557 Amerindian 9.0 449 932 8.2 291 561 Portuguese 0.1 5 7 1.1 38 26 Chinese 0.0 2 3 0.1 2 3 Mixed 17.9 892 959 14.3 504 520 Other 0.1 3 2 0.1 4 6 Missing 0.0 2 4 0.0 2 1 Total 100.0 4,996 4,996 100.0 3,522 3,522 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Unweighted numbers refer to the number of interviews actually completed. Education categories refer to the highest level of education attended, whether or not that level was completed. Characteristics of Survey Respondents | 31 3.2 EDUCATIONAL ATTAINMENT OF RESPONDENTS Tables 3.2.1 and 3.2.2 show the percent distribution of women and men age 15-49, respectively, by highest level of schooling attended or completed and median number of years completed, according to background characteristics. Furthermore, Figure 3.1 shows the gender differentials in educational attain- ment, by place of residence and by wealth index. Table 3.2.1 Educational attainment of respondents: Women Percent distribution of women age 15-49 by highest level of schooling attended or completed and median number of years completed, according to background characteristics, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Highest level of schooling –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Median Some More than years Number Background No Some Completed secon- Completed secon- of of characteristic education primary primary1 dary secondary2 dary Total schooling3 women ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-24 0.8 6.2 3.5 47.8 34.3 7.5 100.0 9.6 1,783 15-19 0.8 5.5 2.4 61.5 26.4 3.5 100.0 9.1 1,016 20-24 0.8 7.0 4.9 29.7 44.8 12.8 100.0 10.2 767 25-29 1.8 9.8 8.1 35.8 32.6 11.9 100.0 9.6 658 30-34 1.9 11.8 6.9 41.8 26.4 11.2 100.0 9.2 643 35-39 1.9 11.7 10.7 46.2 22.5 7.0 100.0 8.9 699 40-44 1.1 17.9 13.1 39.6 23.3 4.9 100.0 8.4 624 45-49 1.6 20.7 12.0 37.7 20.3 7.7 100.0 8.1 589 Residence Total Urban 0.6 4.8 2.5 43.8 32.7 15.6 100.0 9.9 1,475 Georgetown (urban) 0.6 3.0 1.2 44.5 34.3 16.4 100.0 10.0 967 Other (urban) 0.6 8.2 4.9 42.5 29.6 14.2 100.0 9.6 508 Total Rural 1.7 14.1 9.9 42.7 26.6 5.1 100.0 8.8 3,521 Total Coastal 1.0 10.6 7.5 42.9 29.2 8.7 100.0 9.3 4,495 Coastal (urban) 0.6 4.8 2.5 43.8 32.7 15.6 100.0 9.9 1,475 Coastal (rural) 1.2 13.5 9.9 42.5 27.5 5.4 100.0 8.8 3,019 Total Interior 4.5 17.5 9.9 44.0 21.1 3.1 100.0 8.3 501 Region Region 1 10.8 36.7 8.7 31.0 9.9 2.8 100.0 5.4 162 Region 2 2.8 11.8 13.3 45.4 21.1 5.6 100.0 8.3 293 Region 3 1.2 15.3 7.0 40.2 29.7 6.5 100.0 8.9 687 Region 4 0.9 7.8 4.4 45.3 31.0 10.6 100.0 9.6 2,168 Region 5 1.6 12.5 16.6 34.6 29.0 5.6 100.0 9.1 353 Region 6 0.5 15.2 11.6 39.9 27.5 5.3 100.0 8.6 780 Region 7 1.3 6.5 9.1 44.7 33.7 4.6 100.0 9.5 104 Region 8 0.4 8.3 9.5 61.0 19.1 1.7 100.0 9.0 95 Region 9 2.3 11.5 15.1 41.0 28.4 1.7 100.0 8.7 78 Region 10 0.5 4.5 3.1 49.8 25.8 16.3 100.0 9.6 277 Wealth quintile Lowest 6.0 23.9 13.9 40.9 14.4 1.0 100.0 7.0 779 Second 0.9 13.9 9.3 52.0 21.3 2.5 100.0 8.5 957 Middle 0.5 10.2 8.1 47.7 28.7 4.8 100.0 9.2 1,025 Fourth 0.4 8.1 7.0 43.0 32.3 9.2 100.0 9.5 1,084 Highest 0.3 4.7 2.6 32.7 39.8 19.9 100.0 10.2 1,151 Total 2009 1.4 11.3 7.7 43.0 28.4 8.2 100.0 9.2 4,996 Total 2005 1.0 12.1 8.0 47.9 23.1 7.9 100.0 12.1 2,425 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Completed 6 grades at the primary level 2 Completed 5 grades at the secondary level 3 The median is the midpoint of the distribution of the population by number of years of education. 32 | Characteristics of Survey Respondents • Only 1 percent of women and 2 percent of men have never attended school. Respondents in the Interior area (5 percent of women and 6 percent of men) and in Region 1 (11 percent of women and 12 percent of men) are more likely than other respondents to have no education. • Eighty percent of women and 78 percent of men have attended secondary school or higher, the percentage being significantly higher for younger age groups. An Urban-Rural differential exists, with Urban respondents being much more likely to have attended secondary or higher education than Rural respondents. Ninety-two percent of Urban Table 3.2.2 Educational attainment of respondents: Men Percent distribution of men age 15-49 by highest level of schooling attended or completed and median number of years completed, according to background characteristics, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Highest level of schooling –––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Median Some More than years Number Background No Some Completed secon- Completed secon- of of characteristic education primary primary1 dary secondary2 dary Total schooling3 men ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-24 1.1 6.0 2.9 57.7 23.0 9.2 100.0 9.1 1,200 15-19 0.3 4.7 2.2 69.6 17.9 5.1 100.0 8.8 689 20-24 2.2 7.7 3.8 41.7 29.9 14.7 100.0 9.7 511 25-29 2.1 7.7 6.1 45.5 28.1 10.5 100.0 9.4 462 30-34 1.4 15.6 8.8 46.9 18.1 9.2 100.0 8.5 521 35-39 1.9 18.1 9.3 44.4 19.8 6.5 100.0 8.6 470 40-44 1.3 20.0 11.9 44.5 17.2 5.0 100.0 8.1 457 45-49 3.5 22.5 11.3 43.8 11.2 7.8 100.0 8.1 413 Residence Total Urban 0.4 4.7 4.1 47.0 28.8 15.1 100.0 9.6 949 Georgetown (urban) 0.3 4.0 4.2 42.4 33.0 16.2 100.0 10.0 619 Other (urban) 0.5 5.9 3.9 55.7 21.1 12.9 100.0 9.1 330 Total Rural 2.2 16.0 8.4 50.3 17.3 5.8 100.0 8.5 2,573 Total Coastal 1.2 12.9 6.7 49.2 21.1 8.8 100.0 8.9 3,126 Coastal (urban) 0.4 4.7 4.1 47.0 28.8 15.1 100.0 9.6 949 Coastal (rural) 1.6 16.5 7.9 50.2 17.8 6.1 100.0 8.6 2,176 Total Interior 5.6 13.8 11.0 50.8 14.8 4.0 100.0 8.0 396 Region Region 1 12.1 16.2 10.7 46.6 11.8 2.6 100.0 6.5 160 Region 2 1.3 16.4 15.5 44.6 18.5 3.8 100.0 8.1 179 Region 3 1.7 12.8 4.5 58.8 15.8 6.4 100.0 8.8 420 Region 4 0.9 13.1 4.1 46.1 25.7 10.1 100.0 9.2 1,540 Region 5 1.4 16.5 9.0 51.0 14.5 7.5 100.0 8.3 271 Region 6 1.7 12.0 12.9 47.6 18.8 7.0 100.0 8.5 587 Region 7 0.4 9.9 18.4 45.8 20.3 5.2 100.0 8.8 61 Region 8 2.7 7.0 16.0 55.8 17.7 0.8 100.0 8.5 68 Region 9 0.5 21.8 4.5 56.3 13.3 3.6 100.0 8.4 57 Region 10 0.3 4.4 1.8 62.9 12.5 18.0 100.0 9.0 178 Wealth quintile Lowest 4.2 23.4 12.9 49.6 7.7 2.2 100.0 6.7 663 Second 2.6 18.0 7.2 54.4 14.2 3.5 100.0 8.2 679 Middle 1.1 12.7 6.9 55.5 17.4 6.3 100.0 8.8 723 Fourth 0.7 8.5 6.2 50.7 25.4 8.6 100.0 9.2 751 Highest 0.2 3.3 3.3 36.7 36.1 20.4 100.0 10.2 705 Total 2009 1.7 13.0 7.2 49.4 20.4 8.3 100.0 8.8 3,522 Total 2005 1.6 11.6 10.1 49.2 19.1 8.5 100.0 11.8 1,875 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Completed 6 grades at the primary level 2 Completed 5 grades at the secondary level 3 The median is the midpoint of the distribution of the population by number of years of education. Characteristics of Survey Respondents | 33 women and 91 percent of Urban men have secondary or higher education compared with 74 percent of Rural women and 73 percent of Rural men. Only 68 percent of women and 70 percent of men in the Interior area have secondary or higher education. • Respondents in the higher wealth quintiles are much more likely to be educated than respondents in the lower wealth quintiles. The percentage of respondents who have secondary or higher education increases rapidly with wealth. For women, it increases from 56 percent in the lowest wealth quintile to 92 percent in the highest quintile, while for men it increases from 60 percent to 93 percent. • The median years of schooling, indicating the number of years spent in school by half the population, is 9.2 years for women and 8.8 years for men. The median is about one year higher for young respondents, those age 15-24, than for those age 45-49. Respondents in the highest wealth quintile have at least three more years of schooling than those in the lowest wealth quintile (3.2 more years for women and 3.5 more years for men). 3.3 LITERACY The ability to read and write is an important personal asset, offering individuals increased opportunities in life. Knowing the distribution of the literate population can help program managers— especially those concerned with health and family planning—reach women and men with their messages. The 2009 GDHS assessed respondents’ ability to read by asking them to read a simple sentence. Only women and men who had never attended school and who had attended only primary school were asked to read the sentence; it was assumed that everyone with secondary or higher education was literate. Literacy was measured by whether the respondent could read none, part, or all of the sentence. Individuals who were blind or visually impaired were excluded. Figure 3.1 Respondents Completing Secondary or Higher Education, by Residence and Wealth Quintile 37 48 51 44 32 15 24 34 42 60 29 44 49 34 23 10 18 24 34 57 Total RESIDENCE Total Urban Georgetown (urban) Other (urban) Total Rural WEALTH QUINTILE Lowest Second Middle Fourth Highest 0 20 40 60 80 Percentage of respondents Women Men GDHS 2009 34 | Characteristics of Survey Respondents The following sentences were included in the 2009 GDHS: • The child is reading a book. • The rains came late this year. • Parents must care for their children. • Farming is hard work. Tables 3.3.1 and 3.3.2 show the percent distributions of women and men, respectively, by level of schooling attended, by level of literacy, and by percentage literate, according to background character- istics. Table 3.3.1 Literacy: Women Percent distribution of women by level of schooling attended, by level of literacy, and by percentage literate, according to background characteristics, Guyana 2009 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– No schooling or primary school –––––––––––––––––––––––––––––––––––––– Secondary Can Can No card school read read Cannot with Blind/ Don't Number Background or whole part of read required visually know/ Percentage of characteristic higher sentence sentence at all language impaired missing Total literate1 women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 91.3 4.3 1.6 2.4 0.0 0.0 0.3 100.0 97.3 1,016 20-24 87.4 4.9 3.6 4.1 0.1 0.0 0.0 100.0 95.9 767 25-29 80.4 9.2 3.9 6.6 0.0 0.0 0.0 100.0 93.4 658 30-34 79.4 8.9 4.4 6.9 0.3 0.0 0.1 100.0 92.7 643 35-39 75.6 12.1 5.3 5.9 0.0 0.0 1.0 100.0 93.1 699 40-44 67.8 19.7 5.6 6.3 0.0 0.1 0.5 100.0 93.1 624 45-49 65.8 21.3 6.2 5.8 0.0 0.6 0.3 100.0 93.3 589 Residence Total Urban 92.2 4.6 1.2 1.7 0.1 0.0 0.2 100.0 97.9 1,475 Georgetown (urban) 95.2 2.9 0.7 0.8 0.2 0.0 0.2 100.0 98.8 967 Other (urban) 86.3 7.9 2.0 3.4 0.0 0.0 0.3 100.0 96.2 508 Total Rural 74.3 13.2 5.4 6.6 0.0 0.1 0.4 100.0 92.9 3,521 Total Coastal 80.9 10.1 3.8 4.7 0.0 0.1 0.3 100.0 94.8 4,495 Coastal (urban) 92.2 4.6 1.2 1.7 0.1 0.0 0.2 100.0 97.9 1,475 Coastal(rural) 75.4 12.8 5.1 6.2 0.0 0.1 0.3 100.0 93.3 3,019 Total Interior 68.2 15.2 7.0 9.0 0.1 0.0 0.6 100.0 90.4 501 Region Region 1 43.7 20.7 13.8 21.3 0.2 0.0 0.2 100.0 78.2 162 Region 2 72.1 12.6 4.2 10.0 0.0 0.3 0.8 100.0 88.9 293 Region 3 76.4 14.8 3.7 4.7 0.0 0.0 0.4 100.0 94.9 687 Region 4 86.9 6.9 2.6 3.2 0.1 0.1 0.3 100.0 96.4 2,168 Region 5 69.3 17.6 6.4 6.3 0.0 0.4 0.0 100.0 93.2 353 Region 6 72.7 12.4 6.8 7.7 0.0 0.0 0.4 100.0 91.9 780 Region 7 83.0 9.7 4.1 2.0 0.0 0.0 1.1 100.0 96.9 104 Region 8 81.8 10.7 4.5 1.6 0.0 0.0 1.4 100.0 97.0 95 Region 9 71.1 20.1 3.7 5.1 0.0 0.0 0.0 100.0 94.9 78 Region 10 91.9 5.8 0.9 1.4 0.0 0.0 0.0 100.0 98.6 277 Wealth quintile Lowest 56.2 18.6 8.5 16.4 0.0 0.0 0.3 100.0 83.2 779 Second 75.9 11.2 5.7 6.6 0.0 0.2 0.4 100.0 92.8 957 Middle 81.2 10.1 5.5 3.0 0.0 0.3 0.1 100.0 96.7 1,025 Fourth 84.6 10.6 2.0 2.4 0.0 0.0 0.4 100.0 97.2 1,084 Highest 92.4 5.4 0.7 0.9 0.2 0.0 0.4 100.0 98.5 1,151 Total 79.6 10.6 4.1 5.2 0.0 0.1 0.3 100.0 94.4 4,996 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Refers to respondents who attended secondary school or higher level and respondents who can read a whole sentence or part of a sentence. The calculation excludes from the denominator respondents for whom no card in the required language was available and respondents who were blind/visually impaired (their literacy could not be gauged). Characteristics of Survey Respondents | 35 • Overall, 94 percent of women and 91 percent of men age 15-49 are literate. Only 5 percent of women and 8 percent of men age 15-49 cannot read at all. The figures for respondents in Region 1 are much higher, 21 percent for women and 19 percent for men. • Literacy levels among men have increased over the years, from 88 percent for men age 45- 49 to 96 percent for those age 15-19. This pattern is less pronounced among women as literacy in all age groups is 93 percent or higher. • As expected, literacy levels in urban areas are higher than in rural areas (98 percent versus 93 percent for women; 97 percent versus 89 percent for men). The lowest literacy levels occur in Region 1 (78 percent for women and 80 percent for men). Table 3.3.2 Literacy: Men Percent distribution of men by level of schooling attended, by level of literacy, and by percentage literate, according to background characteristics, Guyana 2009 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– No schooling or primary school –––––––––––––––––––––––––––––––––––––– Secondary Can Can No card school read read Cannot with Blind/ Don't Number Background or whole part of read required visually know/ Percentage of characteristic higher sentence sentence at all language impaired missing Total literate1 men –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 92.7 1.8 1.3 4.0 0.0 0.0 0.2 100.0 95.8 689 20-24 86.3 3.9 3.5 6.0 0.0 0.0 0.3 100.0 93.6 511 25-29 84.2 4.4 3.2 8.0 0.1 0.0 0.2 100.0 91.7 462 30-34 74.2 11.6 3.5 10.1 0.0 0.0 0.6 100.0 89.3 521 35-39 70.8 9.0 7.9 10.4 0.2 0.4 1.4 100.0 87.6 470 40-44 66.7 14.7 9.1 8.2 0.0 0.0 1.2 100.0 90.5 457 45-49 62.8 19.2 6.4 10.2 0.2 0.6 0.6 100.0 88.3 413 Residence Total Urban 90.9 4.0 1.9 2.4 0.0 0.2 0.7 100.0 96.7 949 Georgetown (urban) 91.5 4.1 2.2 1.3 0.0 0.2 0.7 100.0 97.8 619 Other (urban) 89.7 3.7 1.3 4.4 0.0 0.2 0.7 100.0 94.7 330 Total Rural 73.4 10.3 5.7 9.9 0.1 0.1 0.6 100.0 89.3 2,573 Total Coastal 79.2 8.1 4.4 7.6 0.0 0.1 0.6 100.0 91.7 3,126 Coastal (urban) 90.9 4.0 1.9 2.4 0.0 0.2 0.7 100.0 96.7 949 Coastal (rural) 74.1 9.9 5.5 9.8 0.0 0.1 0.6 100.0 89.5 2,176 Total Interior 69.6 12.1 6.9 10.2 0.6 0.1 0.4 100.0 88.7 396 Region Region 1 61.1 11.8 6.9 18.6 1.3 0.0 0.3 100.0 79.8 160 Region 2 66.8 17.3 8.7 7.1 0.0 0.0 0.0 100.0 92.9 179 Region 3 81.0 8.1 4.8 5.3 0.0 0.3 0.5 100.0 94.0 420 Region 4 81.9 7.1 4.6 5.6 0.0 0.1 0.6 100.0 93.7 1,540 Region 5 73.0 11.4 1.9 13.2 0.0 0.4 0.0 100.0 86.4 271 Region 6 73.4 7.9 4.0 13.5 0.0 0.0 1.2 100.0 85.3 587 Region 7 71.3 17.8 5.5 4.0 0.0 0.0 1.2 100.0 94.7 61 Region 8 74.3 11.3 8.6 5.6 0.3 0.0 0.0 100.0 94.1 68 Region 9 73.2 16.1 4.5 5.1 0.4 0.6 0.0 100.0 93.8 57 Region 10 93.4 1.2 3.1 0.8 0.0 0.4 1.0 100.0 97.8 178 Wealth quintile Lowest 59.5 13.1 10.2 15.8 0.3 0.1 0.9 100.0 82.8 663 Second 72.2 9.4 6.9 10.8 0.1 0.3 0.3 100.0 88.5 679 Middle 79.2 8.9 4.0 7.2 0.0 0.0 0.8 100.0 92.0 723 Fourth 84.6 7.7 1.7 5.1 0.0 0.2 0.7 100.0 94.0 751 Highest 93.2 4.1 1.1 1.2 0.0 0.0 0.4 100.0 98.4 705 Total 15-49 78.1 8.6 4.7 7.9 0.1 0.1 0.6 100.0 91.3 3,522 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 1 Refers to respondents who attended secondary school or higher and respondents who can read a whole sentence or part of a sentence. The calculation excludes from the denominator respondents for whom no card with the required language is avail- able and respondents who are blind/visually impaired, since their literacy cannot be gauged. 36 | Characteristics of Survey Respondents • Literacy among respondents in the highest wealth quintile is almost universal (99 percent for women and 98 percent for men), but only 83 percent of women and men in the lowest wealth quintile are literate. 3.4 EXPOSURE AND ACCESS TO MASS MEDIA Respondents were asked in the 2009 GDHS how frequently they read a newspaper or watch television and how frequently they listen to a radio. This information is important to program planners seeking to reach women and men through the media with family planning and health messages. The percentages of women and men who were exposed to specific mass media on a weekly basis are presented in Tables 3.4.1 (for women) and 3.4.2 (for men), by background characteristics. Table 3.4.1 Exposure to mass media: Women Percentage of women age 15-49 who are exposed to specific media on a weekly basis, by background characteristics, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 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 70.6 85.4 52.4 38.3 6.1 1,016 20-24 71.0 83.6 47.0 35.9 8.2 767 25-29 66.7 83.3 43.9 32.0 8.6 658 30-34 69.8 85.4 51.2 38.5 5.3 643 35-39 67.4 84.5 47.5 35.8 8.2 699 40-44 65.4 82.5 46.1 33.7 7.6 624 45-49 62.4 83.4 44.2 28.1 8.7 589 Residence Total Urban 79.9 90.6 61.9 50.1 2.4 1,475 Georgetown (urban) 82.9 92.2 69.3 57.1 2.0 967 Other (urban) 74.3 87.5 47.8 36.7 3.2 508 Total Rural 63.0 81.4 42.0 28.7 9.5 3,521 Total Coastal 70.9 88.1 50.7 37.8 4.4 4,495 Coastal (urban) 79.9 90.6 61.9 50.1 2.4 1,475 Coastal (rural) 66.5 86.9 45.2 31.9 5.4 3,019 Total Interior 41.4 48.5 22.4 9.6 34.6 501 Region Region 1 35.3 42.9 18.2 6.4 40.7 162 Region 2 60.0 75.0 47.0 28.3 9.9 293 Region 3 70.7 90.4 46.0 34.2 4.3 687 Region 4 76.5 89.7 57.7 45.1 3.2 2,168 Region 5 58.2 82.2 40.4 25.7 6.2 353 Region 6 63.9 90.2 41.9 30.3 5.3 780 Region 7 50.0 57.1 34.0 21.8 29.5 104 Region 8 40.5 45.2 13.3 3.9 36.3 95 Region 9 31.5 30.6 20.8 3.0 45.2 78 Region 10 72.4 82.7 44.3 31.4 5.2 277 Education No education 5.4 37.6 16.3 0.3 50.6 68 Primary 42.7 74.0 35.4 16.5 15.7 952 Secondary 73.6 87.0 50.2 38.4 4.9 3,568 More than secondary 87.8 90.5 62.2 53.8 3.2 409 Wealth quintile Lowest 37.6 37.0 32.2 9.0 35.3 779 Second 59.5 86.0 41.9 25.8 5.3 957 Middle 70.9 92.6 46.5 34.2 2.2 1,025 Fourth 75.7 96.0 49.9 40.2 1.6 1,084 Highest 85.7 95.7 62.8 56.1 0.7 1,151 Total 2009 68.0 84.1 47.9 35.0 7.4 4,996 Total 2005 69.6 82.9 60.3 41.2 5.5 2,425 Characteristics of Survey Respondents | 37 • Only 7 percent of women and 9 percent of men are not exposed to any of the specified media. • More than eight in ten respondents (84 percent of women and 83 percent of men) watch television, the most common type of mass media in Guyana, at least once a week. More than two-thirds of women (68 percent) and six in ten men (62 percent) read a newspaper. About half (48 percent of women and 55 percent of men) listen to the radio at least once a Table 3.4.2 Exposure to mass media: Men Percentage of men age 15-49 who are exposed to specific media on a weekly basis, by background characteristics, Guyana 2009 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– 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 men –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 62.9 88.2 50.9 33.6 6.2 689 20-24 60.4 82.5 54.5 36.1 10.6 511 25-29 65.7 86.5 58.9 44.9 8.4 462 30-34 58.9 83.7 55.5 37.2 9.2 521 35-39 58.4 80.9 53.1 33.7 7.7 470 40-44 66.2 79.1 54.0 39.5 11.6 457 45-49 58.1 77.3 57.9 35.2 11.3 413 Residence Total Urban 75.6 92.4 63.4 49.6 2.5 949 Georgetown (urban) 78.6 93.0 68.9 56.1 2.4 619 Other (urban) 69.8 91.3 53.0 37.5 2.5 330 Total Rural 56.4 79.6 51.4 32.3 11.5 2,573 Total Coastal 65.0 87.5 57.5 40.0 5.6 3,126 Coastal (urban) 75.6 92.4 63.4 49.6 2.5 949 Coastal (rural) 60.3 85.3 54.9 35.8 7.0 2,176 Total Interior 34.8 48.3 32.4 12.8 36.3 396 Region Region 1 27.7 47.8 31.6 11.6 41.2 160 Region 2 60.1 84.5 64.6 38.4 6.5 179 Region 3 60.8 89.2 46.4 28.9 5.0 420 Region 4 70.7 88.2 62.4 48.0 5.5 1,540 Region 5 51.8 77.5 47.7 26.6 8.7 271 Region 6 58.4 89.0 56.2 34.1 5.1 587 Region 7 52.5 61.1 47.5 32.0 29.0 61 Region 8 34.4 37.7 18.1 2.1 40.8 68 Region 9 35.4 34.0 36.8 9.5 36.8 57 Region 10 63.5 83.3 45.4 30.4 8.5 178 Education No education 3.2 64.4 29.2 1.4 32.1 60 Primary 33.3 72.0 47.6 19.0 18.6 711 Secondary 67.9 85.6 56.7 41.3 6.6 2,459 More than secondary 88.6 92.0 59.7 51.1 1.6 292 Wealth quintile Lowest 34.9 43.1 42.3 13.6 33.4 663 Second 48.7 84.1 50.2 25.6 6.3 679 Middle 64.3 93.3 56.1 39.1 3.9 723 Fourth 73.0 95.6 59.4 48.6 1.9 751 Highest 84.0 95.8 64.0 55.3 1.7 705 Total 2009 61.6 83.0 54.7 36.9 9.1 3,522 Total 2005 64.1 85.5 67.0 44.0 4.8 1,875 38 | Characteristics of Survey Respondents week. Slightly over one-third of women and men (35 and 37 percent, respectively) have exposure to all three media on a weekly basis. • As expected, women and men living in urban areas are more likely than those living in rural areas to be exposed to mass media. Half of urban women and men are exposed to all three forms of media. On the other hand, only 29 percent of rural women and 32 percent of rural men are exposed to all three media weekly. • The exposure to all three forms of mass media is relatively low in Region 8 (4 percent of women and 2 percent of men), Region 9 (3 percent of women and 10 percent of men), and Region 1 (6 percent of women and 12 percent of men). Additionally, the likelihood of having exposure to any mass media strongly correlates with the person’s education and wealth status. 3.5 EMPLOYMENT STATUS AND TYPE OF OCCUPATION Male and female respondents age 15 and older were asked if they were employed at the time of the survey and, if not, if they were employed in the 12 months preceding the survey. The measurement of employment, however, is difficult because some work, especially work on family farms, in family businesses, or in the informal sector, is often not perceived as employment and hence not reported as such. To avoid underestimating respondent’s employment, the DHS questionnaire asks respondents several questions to probe for their employment status and to ensure complete coverage of employment in both the formal and informal sectors. Respondents are considered “employed” if they are currently working (i.e., worked in the past seven days) or if they worked at any time during the 12 months preceding the survey. Table 3.5 shows the percent distribution of respondents by employment status, according to background characteristics, while Figure 3.2 presents the percentage of currently employed respondents by residence and education. Tables 3.6.1 and 3.6.2 present the distribution of currently employed women and men, respectively, by type of occupation, according to background characteristics. Table 3.7 shows the percentage 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). Characteristics of Survey Respondents | 39 Table 3.5 Employment status Percent distribution of women and men by employment status, according to background characteristics, Guyana 2009 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Women Men ––––––––––––––––––––––––––––––––––––––––––– ––––––––––––––––––––––––––––––––––––––––––––– Employed Employed in the 12 months in the 12 months preceding the survey Not preceding the survey Not ––––––––––––––––––– employed ––––––––––––––––––– employed Not in the Number Not in the Number Background Currently currently last 12 of Currently currently last 12 of characteristic employed1 employed months Total women employed1 employed months Total men ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 13.9 3.9 82.2 100.0 1,016 44.7 6.1 49.0 100.0 689 20-24 38.6 3.8 57.6 100.0 767 85.2 6.9 7.9 100.0 511 25-29 41.4 5.1 53.1 100.0 658 93.6 3.9 2.5 100.0 462 30-34 40.2 3.3 56.3 100.0 643 96.1 2.4 1.4 100.0 521 35-39 43.3 2.9 53.6 100.0 699 92.7 4.9 2.2 100.0 470 40-44 45.5 3.3 50.9 100.0 624 93.9 3.5 2.5 100.0 457 45-49 43.6 2.6 52.9 100.0 589 89.4 4.7 5.7 100.0 413 Marital status Never married 35.4 4.6 59.7 100.0 1,540 64.0 6.8 29.0 100.0 1,382 Married or living together 32.5 3.0 64.2 100.0 2,920 95.3 3.1 1.6 100.0 1,835 Formerly married 59.2 3.9 36.9 100.0 536 90.7 5.0 4.2 100.0 305 Number of living children 0 31.1 4.3 64.6 100.0 1,598 68.9 5.9 25.1 100.0 1,621 1-2 40.6 2.6 56.4 100.0 1,773 93.1 4.8 2.1 100.0 978 3-4 34.8 3.9 61.2 100.0 1,147 95.8 2.6 1.5 100.0 662 5+ 41.2 4.5 54.0 100.0 478 95.5 2.6 1.9 100.0 260 Residence Total Urban 48.0 4.1 47.7 100.0 1,475 77.1 5.9 17.1 100.0 949 Georgetown (urban) 50.5 4.1 45.4 100.0 967 77.8 4.3 17.8 100.0 619 Other (urban) 43.3 4.1 52.0 100.0 508 75.7 8.7 15.6 100.0 330 Total Rural 31.4 3.4 65.0 100.0 3,521 84.7 4.3 10.9 100.0 2,573 Total Coastal 36.6 3.5 59.6 100.0 4,495 82.3 4.8 12.8 100.0 3,126 Coastal (urban) 48.0 4.1 47.7 100.0 1,475 77.1 5.9 17.1 100.0 949 Coastal (rural) 31.0 3.3 65.4 100.0 3,019 84.6 4.4 11.0 100.0 2,176 Total Interior 33.4 4.1 62.4 100.0 501 85.3 4.0 10.6 100.0 396 Region Region 1 23.9 6.9 69.2 100.0 162 84.4 3.1 12.5 100.0 160 Region 2 28.5 2.0 69.3 100.0 293 88.0 3.2 8.8 100.0 179 Region 3 36.7 1.5 61.8 100.0 687 85.9 4.7 9.3 100.0 420 Region 4 41.5 5.1 53.1 100.0 2,168 82.6 3.5 13.9 100.0 1,540 Region 5 31.4 2.0 66.6 100.0 353 82.9 7.4 9.4 100.0 271 Region 6 24.0 1.3 74.2 100.0 780 80.6 5.9 13.6 100.0 587 Region 7 37.5 1.3 61.3 100.0 104 90.5 3.4 6.0 100.0 61 Region 8 38.5 3.0 58.3 100.0 95 85.0 4.9 10.0 100.0 68 Region 9 37.4 1.1 60.7 100.0 78 79.9 6.2 13.4 100.0 57 Region 10 49.1 6.7 44.1 100.0 277 72.0 10.8 17.2 100.0 178 Education No education 23.8 0.0 76.2 100.0 68 77.9 3.7 18.4 100.0 60 Primary 26.9 2.3 70.5 100.0 952 90.1 5.4 4.5 100.0 711 Secondary 34.4 4.0 61.3 100.0 3,568 80.7 4.5 14.7 100.0 2,459 More than secondary 76.3 3.5 20.0 100.0 409 81.4 5.2 12.9 100.0 292 Wealth quintile Lowest 27.9 3.6 68.0 100.0 779 86.0 4.9 9.0 100.0 663 Second 31.4 4.3 64.2 100.0 957 83.4 5.9 10.5 100.0 679 Middle 34.8 3.9 61.0 100.0 1,025 81.7 4.3 14.0 100.0 723 Fourth 35.3 3.5 60.9 100.0 1,084 80.9 5.0 13.9 100.0 751 Highest 48.2 2.9 48.9 100.0 1,151 81.5 3.6 14.9 100.0 705 Total 36.3 3.6 59.9 100.0 4,996 82.6 4.7 12.6 100.0 3,522 ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: The total includes cases with missing data on employment (0.1 percent for women and 0.2 percent for men), which are not shown separately. 1 “Currently employed” is defined as having done work in the past seven days. Includes persons who did not work in the past seven days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reason. 40 | Characteristics of Survey Respondents • The level of current employment for women stands at 36 percent, with an additional 4 percent who worked in the 12 months preceding the survey. As a result, a total of four in ten women were employed in the 12 months preceding the survey. The corresponding proportions for men are twice as high: 83 percent of men are currently employed and 5 percent were employed in the last 12 months, putting the total level of employment for men in the last 12 months at 88 percent. • The proportion of women and men who are currently employed is lowest in the age 15-19 group (14 percent for women and 45 percent for men), compared with 39-46 percent of women and 85-96 percent of men age 20 or older. • There are some variations in employment by residence. Current employment for women in urban areas is higher than in rural areas (48 and 31 percent, respectively), while for men the reverse is true: 77 percent of men are currently employed in urban areas compared with 85 percent in rural areas. By region, currently employment for women varies from 24 percent in Regions 1 and 6 to 49 percent in Region 10. Among men, the lowest level of current employment is in Region 10 (72 percent), and the highest is in Region 7 (91 percent). • Women with the most education and in the highest wealth quintile are most likely to be currently employed, while there is little variation among men. • Among women, the two most common occupations are sales and services (36 percent) and professional/technical/managerial occupations (22 percent). Among men, the most common occupations are skilled/manual jobs (42 percent), agriculture (17 percent), and unskilled manual jobs (14 percent). • Analysis by age does not suggest an important variation by occupational categories, with few exceptions. For both men and women, the proportions working in most occupations decrease with age, except for agricultural employment for both women and men, domestic services for women, and professional, technical, or managerial jobs for women. • Region 9 has the highest percentage of both women and men working in agriculture: 39 percent of women and 47 percent of men. • As expected, women and men with higher education are most likely to be employed in a professional, technical, or managerial job. • Ninety-two percent of women receive cash only for their work. As expected, women working in nonagricultural jobs are much more likely to be paid in cash (95 percent) than women who do agricultural work (60 percent). It is noteworthy that about three in ten women who work in agriculture (29 percent) are not paid at all. • Sixty-three percent of women are employed by a nonfamily member, 25 percent are self- employed, and 12 percent work for a family member. Characteristics of Survey Respondents | 41 Figure 3.2 Respondents Currently Employed, by Residence and Education 36 48 51 43 31 24 27 34 76 83 77 78 76 85 78 90 81 81 Total RESIDENCE Total Urban Georgetown (urban) Other (urban) Total Rural EDUCATION No education Primary Secondary Higher 0 20 40 60 80 100 Percentage of respondents currently employed Women Men GDHS 2009 42 | Characteristics of Survey Respondents Table 3.6.1 Occupation: Women Percent distribution of women age 15-49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Guyana 2009 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Professional/ Sales Un- Don’t Number Background technical/ and Skilled skilled Domestic know/ of characteristic managerial Clerical services manual manual service Agriculture missing Total women –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 13.2 26.2 44.1 3.8 0.4 3.9 5.3 3.1 100.0 181 20-24 27.1 25.3 34.3 3.6 0.5 1.3 3.2 4.6 100.0 325 25-29 27.8 16.4 31.3 6.0 2.4 6.3 6.7 3.1 100.0 306 30-34 24.2 11.9 35.2 3.6 2.7 9.1 6.7 6.6 100.0 280 35-39 21.1 11.8 37.3 5.9 2.1 9.5 7.6 4.7 100.0 323 40-44 14.7 4.5 39.4 8.2 4.4 18.0 6.9 4.0 100.0 304 45-49 21.3 6.5 30.7 5.7 4.1 17.9 10.3 3.5 100.0 272 Marital status Never married 27.9 24.2 33.3 4.5 0.7 5.1 1.6 2.8 100.0 616 Currently in union 18.8 10.6 33.9 6.6 2.7 11.5 11.0 4.9 100.0 1,038 Formerly in union 20.4 7.2 45.2 3.3 4.7 11.8 2.5 5.0 100.0 338 Number of living children 0 29.7 25.7 31.9 4.0 0.4 3.7 1.0 3.5 100.0 565 1-2 23.9 14.7 33.7 6.0 1.8 9.2 6.0 4.6 100.0 765 3-4 14.2 4.1 45.5 4.0 4.0 12.8 9.5 5.9 100.0 444 5+ 10.1 3.0 31.7 9.2 6.6 19.2 18.1 2.1 100.0 219 Residence Total Urban 25.9 16.9 38.0 5.2 1.5 8.4 0.4 3.7 100.0 769 Georgetown (urban) 26.0 19.6 35.3 4.6 1.8 9.2 0.0 3.5 100.0 528 Other (urban) 25.6 10.8 43.9 6.5 0.7 6.8 1.2 4.3 100.0 241 Rural 19.3 12.5 34.1 5.5 3.0 10.3 10.6 4.6 100.0 1,223 Total Coastal 22.0 15.3 35.2 5.6 2.5 9.8 5.1 4.4 100.0 1,804 Coastal (urban) 25.9 16.9 38.0 5.2 1.5 8.4 0.4 3.7 100.0 769 Coastal (rural) 19.2 14.1 33.1 5.9 3.3 10.8 8.7 4.9 100.0 1,036 Total Interior 20.2 3.9 39.5 3.3 1.3 7.5 21.3 3.0 100.0 188 Region Region 1 18.6 0.7 43.9 0.1 0.5 8.7 24.4 3.1 100.0 50 Region 2 20.1 10.6 23.6 8.4 4.3 11.1 20.9 1.0 100.0 89 Region 3 24.2 13.0 32.6 5.9 3.6 10.9 5.2 4.6 100.0 263 Region 4 21.7 19.5 34.2 5.2 2.9 10.6 2.7 3.2 100.0 1,011 Region 5 19.3 7.2 30.9 4.4 0.9 5.4 18.0 13.9 100.0 118 Region 6 19.9 5.2 45.5 7.5 0.6 9.4 6.1 5.8 100.0 197 Region 7 20.3 7.1 52.5 1.5 0.5 7.4 9.3 1.3 100.0 40 Region 8 21.7 5.5 30.7 8.9 1.0 6.1 21.5 4.5 100.0 39 Region 9 24.4 4.4 16.0 5.7 0.0 6.1 38.5 4.9 100.0 30 Region 10 25.5 10.7 45.7 3.3 1.9 5.5 2.7 4.6 100.0 155 Education No education * * * * * * * * * 16 Primary 2.4 2.1 42.6 6.4 4.0 19.0 17.9 5.6 100.0 278 Secondary 16.8 16.1 40.4 5.5 2.6 9.5 5.3 3.7 100.0 1,372 More than secondary 61.1 17.0 10.1 4.4 0.0 1.4 0.4 5.7 100.0 326 Wealth quintile Lowest 12.1 3.7 30.0 4.0 6.4 13.6 27.2 3.0 100.0 245 Second 9.7 8.7 41.8 8.9 3.3 14.4 9.4 3.9 100.0 343 Middle 15.2 14.7 38.3 6.4 2.7 13.0 3.7 6.1 100.0 396 Fourth 23.2 17.1 39.1 3.9 2.2 7.1 3.6 3.7 100.0 421 Highest 36.6 19.3 30.0 4.3 0.3 4.5 0.7 4.3 100.0 588 Total 21.9 14.2 35.6 5.4 2.4 9.6 6.7 4.3 100.0 1,992 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Note: Currently in union includes respondents in consensual union (living together). Formerly in union includes divorced/separated/widowed. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Characteristics of Survey Respondents | 43 Table 3.6.2 Occupation: Men Percent distribution of men age 15-49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Guyana 2009 –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Professional/ Sales Un- Don’t Number Background technical/ and Skilled skilled Domestic know/ of characteristic managerial Clerical services manual manual service Agriculture missing Total men –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Age 15-19 6.9 4.4 10.9 43.5 17.8 0.7 11.2 4.6 100.0 350 20-24 11.0 6.0 11.8 43.4 14.0 0.0 11.1 2.8 100.0 471 25-29 10.3 4.3 12.0 47.1 9.9 0.0 14.6 1.7 100.0 450 30-34 10.1 0.9 9.3 45.4 13.6 0.2 17.3 3.2 100.0 513 35-39 8.3 1.3 9.4 41.5 15.4 0.2 20.4 3.5 100.0 458 40-44 8.7 0.8 12.9 37.7 15.3 0.6 21.9 2.2 100.0 446 45-49 6.7 0.2 16.1 35.5 11.7 0.9 25.3 3.6 100.0 389 Marital status Never married 10.0 5.7 13.8 41.0 15.2 0.3 10.3 3.8 100.0 979 Currently in

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