Kenya - Multiple Indicator Cluster Survey - 2000

Publication date: 2000

- I I I ·I II I :I il I I I ~ I I I I II 11 I I II ·I I unicef~ KENYA MULTIPLE INDICATOR CLUSTER SURVEY 2000 PRELIMINARY REPORT CENTRAL BUREAU OF STATISTICS MINISTRY OF FINANCE AND PLANNING December 2000. -- 1 II il II i• II I II I II I II :I i II II ~ I CONTENTS Page Acknowledgement . iii I. Background . 1 Introduction . 1 Survey Objectives . . 1 II. Sample and Survey Methodology . 2 Sample Design . . . 2 Questionnaires . 2 Fieldwork and Processing . . . 2 Sample Coverage . 3 III. Results . 4 Primary School Attendance . 4 Water and Sanitation . . . 4 Nutritional Status . . . 6 Vitamin A Supplementation . . . 8 Salt lodization . . . 8 Immunization Coverage . . . . . . . . . . . . . 9 Knowledge of HIV I AIDS Transmission . . . 10 Assistance at Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Birth Registration . . . . . . . . . 11 1 I I LIST OF TABLES I I Table 1: Percent distribution of households by background characteristics . 12 I Table 2: Percent distribution of women 15-49 by background characteristics . 13 Table 3: Percent distribution of children under 5 by background characteristics . 14 I Table 4: Percentage of children of primary school age attending primary school . 15 Table 5: Percentage of children entering first class of primary school and reaching . 16 I Table 6: Percentage of the population using improved drinking water sources . 17 I Table 7: Percentage of the population using sanitary means of excreta disposal. . 18 Table 8: Percentage of under-five children who are severely or moderately undernourished . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 I Table 9: Percent of living children by breastfeeding status . 20 I Table 10: Percent distribution of children aged 6-59 months by whether they received a high dose of Vitamin A supplement in the last 6 months . 21 Table 11: Percentage of households consuming adequately iodized salt . 22 I Table 12: Percentage of children 12-23 months immunized against childhood diseases at any time before the survey . 23 I Table 13: Percentage of women aged 15-49 who know the main ways of preventing HIV transmission . 24 I Table 14: Percentage of women aged 15-49 who correctly identify misconceptions about HIV I AIDS . 25 I Table 15: Percent distribution of women aged 15-49 with a birth in the last year by type of personnel delivering antenatal care . . . . . . . . . . . . . . . . . . . . . . . . 26 I Table 16: Percent distribution of children aged 0-59 months by whether birth is registered and reasons for non-registration . 27 I I I I I ii I I I I I I I I I ~ I I ~I I I II :I I I I I I Acknowledgement This preliminary report presents selected results on some of the principal topics covered in the Kenya Multiple Cluster Indicator Survey (MICS) undertaken in all districts of Kenya during the months of September and October 2000. This report only analyses a subset of indicators while a comprehensive report covering all indictors is scheduled for publication in mid-2001. The main objective of the MICS was to provide up-to-date information for assessing the situation of children and women in Kenya at the end of the decade, with a view to monitoring progress toward goals established at the World Summit for Children. The survey collected a wide range of information that would be extremely useful for the implementation of poverty reduction strategies in Kenya. In addition, it provides indicators and benchmarks that would greatly augment the process of monitoring and evaluation of poverty related indicators. This report is therefore highly recommended as a working document for the Poverty Reduction Strategy Paper (PRSP) currently under preparation. Experiences gained during this survey will no doubt contribute to the strengthening of technical expertise in the design, implementation, and analysis of such surveys in the future. While it is not possible to thank every body who directly and indirectly supported us in this process, the Kenya Government is highly indebted to UNICEF Country office for extending both technical and financial assistance during the planning and execution phases of the survey. UNICEF funded planning of the survey, developing and printing of survey instruments, training, and data collection activities. It also provided technical assistance by providing model survey instruments and standard data processing software. The Government looks forward to UNICEF's continued support in future data collection activities. I take this opportunity to sincerely thank UNICEF staff, especially Samuel Momanyi, Dr .Abel Mugenda and Ms Susan Kinyua for their efforts in seeing that the survey was undertaken as scheduled. I would also like to thank members of different households who participated in the survey by providing information that has given content to this report. Their cooperation, especially in areas of fairly close personal concern, was vital to the success of the MICS. All are assured that their personal details collected by the survey will be treated in strict confidence. The MICS Ministerial Steering Committee needs special mention for providing the overall co-ordination of MICS activities. I must commend CBS officers, especially the Technical Working Group comprising of Messrs Joseph Mukui, Anthony Muchanga, Jimmie Katabwa, Samuel Kipruto, Sammy Oyombe, Walter Ogwindo and Joshua Musyimi for their dedication in ensuring that each phase of the survey work was successfully concluded. Ill I I I I I I I I I I I I I I I I I I I I I I. Background Introduction At the World Summit for Children held in New York in 1990, the government of Kenya committed itself to a Declaration and Plan of Action for Children. Subsequently, Kenya developed the National Programme of Action (NPA) for Children in 1992. The NPA marked a major step forward in Kenya's continued effort to articulate and address the concerns of children and women in Kenya, and presented targets for reaching summit goals for children by the year 2000. The global Plan of Action also called for the establishment of mechanisms for monitoring progress toward the goals and objectives set for the year 2000. Toward this end, UNICEF, in collaboration with WHO, UNESCO and others, has developed a core set of 75 indicators of specific aspects of the situation of children. The 2000 Kenya Multiple Indicator Cluster (MICS) survey has been conducted in order to provide end- decade information on many of these indicators. The Central Bureau of Statistics (CBS) conducted the Kenya MICS. The UNICEF Kenya Country office provided funding. The Technical Working Group (TWG) comprising mainly CBS staff, and the MICS Steering Committee (MSC) constituted the core institutional arrangement for the management of Kenya MICS 2000. The fieldwork was carried out by CBS field enumerators who are based in the districts under supervision of respective District Statistical Officers (DSOs). In addition, district co- ordinators were constituted to coordinate MICS activities in the districts. This preliminary report presents selected results on some of the principal topics covered in the survey and on a subset of indicators. A comprehensive full report is scheduled for publication in mid-2001. Survey Objectives The 2000 Kenya Multiple Indicator Cluster Survey has as its primary objectives: • • • • To provide up-to-date information for assessing the situation of children and women in Kenya at the end of the decade and for looking forward to the next decade; To furnish data needed for monitoring progress toward goals established at the World Summit for Children and as a basis for future action; To facilitate informed decision-making in operationalising the Poverty Reduction Strategy Paper (PRSP) by providing data for monitoring and evaluation of strategies and programmes aimed at alleviating poverty; To contribute to the improvement of data and monitoring systems in Kenya and to strengthen technical expertise in the design, implementation, and analysis of such systems. 1 I I I I I I I I I I I I I I I I I I I I I II. Sample and Survey Methodology Sample Design The sample for the Kenya Multiple Indicator Cluster Survey (MICS) 2000 was designed to provide estimates of health indicators at the national level, urban and rural areas and for the seven provinces: Nairobi, Central, Coast, Eastern, Nyanza, Rift Valley and Western. Estimates for the eighth province (North Eastern) refer only to urban areas because there are no rural clusters in the province due to nomadic lifestyle of the inhabitants. The sample was selected in two stages. At the first stage, 900 clusters were selected with probability proportional to size. After a household listing was carried out within the selected clusters, a systematic sample of 9,540 households was drawn. Because the sample was stratified by region, it is not self-weighting. For reporting national level results, sample weights are used. Questionnaires In addition to a household questionnaire, questionnaires were administered to each household for women aged 15-49 and children under age five. The questionnaires are based on the MICS model questionnaire with the exclusion of the Contraceptive use module. The model MICS questionnaire was modified into a tabular format to accommodate maximum of 12 members of a household. The questionnaire was not translated into local languages, but unfamiliar terms and concepts were explained and verbally translated into local languages during the training of enumerators. The questionnaires were pre-tested in each province during the months of July and August 2000. Based on the results of the pre-test, modifications were made on the paper size from size A4 to legal size. Also, the wording and sequencing of the questions were modified. Consequently, the enumerator's instructions manual were revised accordingly. Fieldwork and Processing Training for field staff was undertaken in two tier: 6 days training of trainers, and one week's training of enumerators in 8 training venues. The fieldwork for the Kenya MICS 2000 was undertaken in 21 consecutive days during the months of September and October. About 270 enumerators who are permanent employees of CBS based in each of the surveyed districts collected the data. The Director of Statistics provided the overall co-ordination. District Statistical Officers (DSOs) supervised data collection at district level. In addition, district co-ordinators were constituted to coordinate MICS survey in each of the districts. Data were entered on twenty microcomputers using the IMPS software. The analysis was done using SPSS software. All questionnaires were double entered and internal consistency checks performed, using programs developed under MICS data processing system and adapted to the revised questionnaire. Data processing began in the month of September alongside the data collection and completed in the month of November 2000. 2 I I I I I I I I I I I I I I I I I I I I I Sample Coverage Of the 9,285 households selected for the sample, 9,115 were found to be occupied. Of these, 9,045 were successfully interviewed for a household response rate of 98 percent. In the interviewed households, 11,244 eligible women (age 15-49) were identified. Of these, 10,537 were successfully interviewed, yielding a response rate of 94 percent. In addition, 8,700 children under age five were listed in the household questionnaire. Of these, questionnaires were completed for 8,161 for a response rate of 94 percent. Characteristics of the Respondents Table 1 presents the percent distribution of households in the sample by background characteristics. About 25 percent of the households (2,257 households) are urban and 75 percent (6,787 households) are rural. Rift Valley province has the largest share of households among the eight provinces, with 21 percent of households while Nyanza is next largest with a share of 16 percent. The remaining provinces each contain between 7 and 15 percent of households. Most of the households have between four and five members. About 64 percent of the households contain at least one child under age five, and 97 percent contain at least one woman age 15-49. Women aged 15-19 comprise the greatest percentage of the sample at 22 percent (Table 2). This percentage declines steadily across age groups until age 45-49 where it is 5 percent. This pattern is typical of countries in the region. About 75 percent of women aged 15 - 49 have ever had a birth. The majority of women have had at least some primary education while 16 percent have had no education. Table 3 shows the characteristics of children under age five. There is near parity in sex ratio. Approximately 18 percent of mothers of children under age five have no education, a percentage that is slightly above the 16 percent overall percentage of women with no education in the sample. Note that, for children whose mothers did not live in the household, the education of the child's caretaker is used. The number of children rises with age to peak at the age 24 -35 months and then declines gradually to 14.3 percent for 48 -59 months olds. 3 -- 1 I I I I I I I I I I I I I I I I I I I I III. Results Primary School Attendance Universal access to basic education and the achievement of primary education by the world's children is one of the most important goals of the World Summit for Children. Education is a vital prerequisite for combating poverty, empowering women, protecting children from hazardous and exploitative labour and sexual exploitation, promoting human rights and democracy, protecting the environment, and influencing population growth. Overall, 74 percent of children of primary school aged 6-13 in Kenya are attending primary school (Table 4). However, there exist notable regional variations. School attendance in the coast province is significantly lower than in the rest of the country at 57 percent. At the national level, female primary school attendance is slightly higher than that of males. Similarly, urban primary school attendance is marginally higher than that of rural. More than four fifths (87 percent) of the children who enter the first grade of primary school eventually reach grade five (Table 5). However, there exist significance regional disparities in the achievement of grade five. In Western and Coast provinces eight in ten who enter grade one reach grade five, while in Nairobi and Rift Valley provinces nine in ten will reach grade five. Although the rate of school entrance is nearly the same for boys as for girls, girl pupils are more likely to reach grade five than boys are, although the difference is marginal. Water and Sanitation Safe drinking water is a basic necessity for good health. Unsafe drinking water can be a significant carrier of diseases such as trachoma, cholera, typhoid, and schistosomiasis. Drinking water can also be tainted with chemical, physical and radiological contaminants with harmful effects on human health. In addition to its association with disease, access to drinking water may be particularly important for women and children, particularly in rural areas, who bear the primary responsibility for carrying water, often for long distances. The distribution of the overall population by source of drinking water is shown in Figure 1. Majority of the population being rural based, over a quarter of the population uses drinking water from river, stream or pond. Water piped into dwelling units and public tap are also important sources of drinking water, contributing 12 percent each. The source of drinking water for the population varies strongly by region (Table 6). About 87 of the urban populations use piped drinking water, either piped into dwelling, piped into plot, or public tap. On the other extreme, 82 percent of the rural population do not have access to piped water. In Nairobi province 94 percent of the population uses drinking water that is piped into their dwelling or into their yard or plot. About 51 percent of the population in Coast province use piped water, mainly from public tap. In contrast, the main source drinking water in Nyanza province is river or stream water 4 I I I I I II I I I I I I I I I I I (an unsafe source), and only 11 percent of those residing in the province use piped water. The population using safe drinking water sources are those who may use any of the following types of supply: water piped into either the dwelling or yard, public tap, borehole/tubewell, protected well, protected spring or rain water. About 56 percent of the surveyed population had access to safe drinking water, 88 percent in urban areas and 46 percent rural areas. The situation in Eastern province is considerably worse than other regions, with only 37 percent of the population getting drinking water from a safe source. Figure 1: Percent distribution of the population by source of drinking water Pond, river or stream 29% Unprotected 11% Other Tanker truck vendor 2% 0% Rainwater collection 1% Protected spring 8% Piped into dwelling Protected dug well 6% Piped into yard or plot 11% ictap pump 7% Inadequate disposal of human excreta and personal hygiene is associated with a range of diseases including diarrhoea diseases and polio. Sanitary means of excreta disposal include: flush toilets connected to sewage system or septic tank, pour flush toilets, improved pit latrines and traditional pit latrines. Table 7 shows that 80 percent of the population of Kenya is living in households with sanitary means of excreta disposal. Ninety three percent of the urban and 76 percent of the rural populations have means of excreta disposal. Residents of Coast province are much less likely than others to use sanitary means of excreta disposal. Most of this population uses bush, fields or has no facility. In contrast, the most common facilities in rural areas are traditional pit latrines, while flush toilets with connection to a sewage system or septic tank are highly used in urban areas. 5 I I I I I I I I I I I I I I I I I I I I I Nutritional Status Children's nutritional status is a reflection of their overall health. When children have access to an adequate food supply, are not exposed to repeated illness, and are well cared for, they reach their growth potential and are considered well nourished. In a well-nourished population, there is a standard distribution of height and weight for children under age five. Undernourishment in a population can be gauged by comparing children to this standard distribution. The standard or reference population used here is the NCHS standard, which is recommended for use by UNICEF and the World Health Organization. Each of the three nutritional status indicators is expressed in standard deviation units (z-scores) from the median of this reference population. Weight for age is a measure of both acute and chronic malnutrition. Children whose weight for age is more than two standard deviations below the median of the reference population are considered moderately or severely underweight while those whose weight for age is more than three standard deviations below the median are classified as severely underweight. Height for age is a measure of linear growth. Children whose height for age is more than two standard deviations below the median of the reference population are considered short for their age and are classified as moderately or severely stunted. Those with height for age more than three standard deviations below the median are classified as severely stunted. Stunting is a reflection of chronic malnutrition as a result of failure to receive adequate nutrition over a long period and recurrent or chronic illness. Finally, children whose weight for height is more than two standard deviations below the median of the reference population are classified as moderately or severely wasted, while those who fall more than three standard deviations below the median are severely wasted. Wasting is usually the result of a recent nutritional deficiency. The indicator may exhibit significant seasonal shifts associated with changes in the availability of food or disease prevalence. In Table 8, children who were not weighed and measured and children whose measurements are outside a plausible range are excluded. Also excluded is a small number of children whose birth dates are not known. Almost 23 percent of children under age five in Kenya are underweight and 6.5 percent are classified as severely underweight (Table 8). Thirty seven percent of children are stunted or too short for their age and six percent are wasted or too thin for their height. Children in Eastern province are more likely to be underweight and stunted than other children. Also, Eastern and Coast provinces have the highest rate of severe wasting with 8 percent each. Children whose mothers have had secondary or over level of education seem to be better nourished than those of primary or no education. Boys appear to be slightly more underweight, stunted and wasted than girls. The age pattern shows that a higher percentage of children aged 12 - 23 months are undernourished according to all the three indices in comparison to children who are younger and older 6 I I I I I I I I I I I I I I I I I I I I I (Figure 2). This pattern is expected and is related to the age at which many children cease to be breast-fed and are exposed to contamination in water, food, and environment. 60 50 - r::: Gl 30 u . Gl Q. 20 10 0 <6 Figure 2: Distribution of under-five children who are severely or moderately undernourished, 2000 -+-Stunted -Underweight -It-Wasted 6_11 12_23 24_35 36_47 48_59 Age Group (Months) Breastfeeding Breastfeeding for the first few years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. However, many mothers stop breastfeeding too soon, and there are often pressures to switch to infant formula, which can contribute to growth faltering and micronutrient malnutrition and is unsafe if clean water is not readily available. The World Summit for Children goal states that children should be exclusively breastfed for four to six months, and that breastfeeding should continue with complementary food, well into the second year of life. Many countries have adopted the recommendation of exclusive breastfeeding for about six months. In Table 9, breastfeeding status is based on women's reports of children's consumption in the 24 hours prior to the interview. Exclusive breastfeeding refers to children who receive only breast milk and vitamins, mineral supplements, or medicine. Complementary feeding refers to children who receive breast milk and solid or semi- solid food. The last two columns of the table include children who are continuing to be breastfed at one and at two years of age. Due to small sample sizes, percentages according to region should be interpreted with caution. Approximately 16 percent of children aged less than four months are exclusively breastfed, a level considerably lower than recommended. At age 6-9 months, 67 percent of children are who are still breastfeding receiving solid or semi-solid foods. By age 12-15 months, 80 percent of children are still being breastfed, but the proportion declines to 54 percent by age of 20-23 months. Boys are more likely to be exclusively breastfed than girls are. Over 90 percent of children in Nyanza, Coast and Eastern regions are introduced to supplementary feeding before they reach their fourth month. Children in urban areas are more likely to be exclusively breastfed for the first three months than their rural counterparts. The level of education of the mother seems to influence the duration of 7 I I I I I I I I I I I I I I I I I I I I I exclusive breastfeeding since more educated mothers exclusively breastfeed their children for relatively longer periods. Vitamin A Supplementation Vitamin A Deficiency (VAD) impairs children's immune systems, increasing their chances of dying of common childhood diseases and undermines the health of pregnant and lactating women. It can also cause eye damage and blindness in children. Yet it can be easily be prevented by vitamin A supplementation or food fortification. UNICEF and WHO recommend that all countries with an under five mortality rate exceeding 70 per 1000 live births, or where vitamin A deficiency is a public health problem, should put in place a programme for control of vitamin A deficiency. Based on UNICEF/WHO guidelines, the Ministry of Health in Kenya recommends that children aged 6-12 months be given one dose of vitamin A capsule of 100,000 IU every six months, and children older than one year be given one high dose of 200,000 IU every six months. Within the six months prior to the MICS, 41 percent of children aged 6-59 months received the high dose Vitamin A supplement (Table 10). About 4 percent of they mothers/caretakers were not sure whether the children had received the vitamin A supplementation. Vitamin A coverage is lower in Central province than other provinces The age pattern in the last six months shows that vitamin A supplementation coverage increases moderately from 34 percent to 45 percent among children aged 6-11 and 12- 23 months respectively, then drops to below 40 percent for children aged 36-47 months but picks up slightly for children aged 48-59 months Mother's level of education seem to influence the child's vitamin A intake. The percentage receiving supplement in the last six months increases from 35 percent for mothers with no education to 43 percent for mother with primary education, albeit a slight drop to 42 percent for mothers with secondary or higher education. Salt lodization Deficiency of iodine in the diet is the world's single greatest cause of preventable mental retardation and can lower the average intelligence quotient (IQ) of a population by as much as thirteen points. Salt iodization is an effective, low-cost way of preventing iodine deficiency disorders (IDD). Adequately iodized salt contains 15 ppm (parts per million) of iodine or more. In MICS, interviewers tested household salt for iodine levels by means of a testing kit. Approximately 96 percent of households had salt, which was tested during the MICS (Table 11). Among households in which salt was tested, 91 percent had adequately iodized salt. The usage of adequately iodized salt ranges from 82 percent in Central region to 97 percent in Rift valley. Ninety one percent of urban households have adequately iodized salt compared to 88 percent of rural households. 8 I I I I I I I I I I I I I I I I I I I I ·I Immunization Coverage According to UNICEF and WHO guidelines, a child should receive a BCG vaccination to protect against tuberculosis, three doses of DPT to protect against diptheria, pertussis, and tetanus, three doses of polio vaccine, and a measles vaccination by the age of 12 months. In Kenya, a child is considered to be fully immunised if the child has received the following vaccination; a BCG vaccination to protect the child against tuberculosis, three doses of DPT to protect against Diptheria, Pertussis (Whooping cough), and Tetanus, three doses of Polio to protect against poliomyelitis, and a Measles vaccination before their first birthday as stipulated by the Kenya Expanded Programme on Immunization (KEPI). In MICS, mothers were asked to provide vaccination cards (or other vaccination records) for children under the age of five. Interviewers copied vaccination information from these documents onto the MICS questionnaire. Overall, 70 percent of children had vaccination documents. If the child did not have a card, the mother was asked to recall whether or not the child had received each of the vaccinations and for DPT and Polio, how many times. 100 90 80 70 60 c Q) 50 ~ Q) a. 40 30 20 10 0 Figure 3: Percentage of children 12-23 months who received immunization by age 12 57.9 BCG OPT POLIO MEASLES I• BCG • OPT c POLIO J ALL Table 12 shows the percentage of children aged 12 to 23 months who received each of the vaccinations. The denominator for the table is comprised of children aged 12-23 months so that only children who are old enough to be fully vaccinated are counted. In the top panel, the numerator includes all children who were vaccinated at any time before the survey according to the vaccination card or the mother's report. In the bottom panel, only those who were vaccinated before their first birthday are included. For children without vaccination cards, the proportion of vaccinations given before the first birthday is assumed to be the same as for children with vaccination cards. 9 I I I I I I I I I I I I I I I I I I I I I Approximately 93 percent of children aged 12-23 months received a BCG vaccination by the age of 12 months and the first dose of DPT was given to 92 percent. The percentage declines for subsequent doses of DPT to 86 percent for the second dose, and 79 percent for the third dose (Figure 3). Similarly, 91 percent of children received Polio 1 by age 12 months and this declines to 77 percent by the third dose. The coverage for measles vaccine by 12 months is slightly lower than for the other vaccines at 71 percent, 52 percent of the cases being recorded into vaccination cards. The percentage of children who had all eight recommended vaccinations by their first birthday is 58 percent. Knowledge of HIV I AIDS Transmission One of the most important strategies for reducing the rate of HIV I AIDS infection is the promotion of accurate knowledge of how AIDS is transmitted and how to prevent transmission. Among women aged 15-49 in Kenya, 92 percent have ever heard of HIVIAIDS (Table 13). The high level of knowledge persists irrespective of age, urban- rural residence, education level and province of residence. Women in the MICS were read several statements about means of HIVIAIDS transmission and asked to state whether they believed the statements were true. Over three quarters (79 percent) believe that having only one uninfected sexual partner can prevent HIV transmission. About a half (52 percent) believe using a condom every time one has sex can prevent HIV transmission and three quarters (75 percent) agreed that abstaining from sex prevents transmission. Overall, less than half of the women ( 46 percent) knew all the three ways and 83 percent were aware of at least one of the mechanisms of preventing transmission. Accurate knowledge of means of HIV I AIDS transmission is significantly less among women in North Eastern and Nyanza provinces than among other women. Also, education level is an important factor in AIDS knowledge. The percentage who know all the three means of preventing transmission is more than one and a half times greater among women with secondary or more education compared to women with no education. Women residing in the urban are more likely to know all the three routes of transmission. Differences across age groups are significantly large; percentage of women who know all three means ranges from 36 percent among 45-49 year olds to 51 percent among 20-24 year olds. Over three-quarters (79 percent) correctly mentioned that HIV can not be transmitted by supernatural means while about a half (46 percent) stated that AIDS can not be transmitted by mosquito bites (Table 14). More than seven in ten women correctly cited that a healthy looking person could be infected. Women in Nairobi province are most likely to recognise all the three misconceptions. Still, less than half (44 percent) of women interviewed correctly identified all the three misconceptions. Assistance at Delivery The provision of delivery assistance by skilled attendants can greatly improve outcomes for mothers and children by the use of technically appropriate procedures, and accurate 10 I I I I I I I I I I I I I I I I I I I I I and speedy diagnosis and treatment of complications. Skilled assistance at delivery is defined as assistance provided by a doctor, nurse, or midwife. Skilled personnel (Table 15) delivered about 76 percent of births occurring in the year prior to the MICS survey. This percentage is highest in Eastern province at 85 percent and lowest in the urban stratum of North Eastern province at only 16 percent. The more educated a woman is, the more likely she is to have delivered with the assistance of a skilled person. In most cases nurses and midwife assisted in the delivery of births in the year prior to the MICS survey (six out of every ten births). Doctors assist with the delivery of 15 percent of births, mainly in urban areas (27 percent). Traditional birth attendants assist in delivering babies in Western province more than in other provinces. In the other regions, most of the births are delivered with the assistance of nurses and midwives. Birth Registration The International Convention on the Rights of the Child states that every child has the right to a name and a nationality and the right to protection from being deprived of his or her identity. Birth registration is a fundamental means of securing these rights of children. The births of 63 percent of children under five years in Kenya were officially reported and issued with a birth notification form within the registration process (Table 16). However, only 13 percent of the children under five years were issued their birth certificates, the main reasons being cost, travel distance, and lack of knowledge. There are variations in birth registration across regions, where Central province had the highest births registered at 90.0 percent while Nyanza province had the lowest with 42 percent. Similarly, there was higher registration of births in urban areas compared to rural areas. Also, educated mothers registered more births than less educated mothers. There are no significant variations in birth registration across sex and age. 11 I I I I I I I I I !I I I I ~I ' I Table 1: Percent distribution of households by background characteristics Province Rural/Urban Number of HH members Total Nairobi Central Coast Eastern North Eastern(Urban) Nyanza Rift valley Western Rural Urban 1 2-3 4-5 6-7 8-9 10+ At least one child age < 15 At least one child age < 5 At least one woman age 15-49 12 Percent Weighted 14.4 13.8 7.9 14.9 1.0 16.2 21.0 10.8 75.0 25.0 4.2 22.7 37.1 22.9 9.5 3.7 89.9 63.9 96.9 100 1,299 1,253 710 1,348 90 1,468 1,899 978 6,787 2,257 377 2,055 3,356 2,068 857 331 9,045 9,045 9,045 9,045 Unweighted 373 1,329 1,055 1,164 100 1,556 2,581 874 7,178 1,854 417 1,968 3,273 2,094 905 375 9,032 9,032 9,032 9,032 I I I I 'I I I I I I I I I I I I I I Table 2: Percent distribution of women 15-49 by background characteristics Percent Weighted Unweighted Province Nairobi 16.2 1,705 496 Central 12.6 1,326 1,401 Coast 8.8 931 1,359 Eastern 15.4 1,622 1,398 North Eastern(Urban) 0.9 100 113 Nyanza 15.6 1,642 1,792 Rift Valley 20.2 2,127 2,983 Western 10.4 1,092 995 Rural/Urban Rural 72.9 7,684 8,234 Urban 27.1 2,862 2,303 Age 15-19 22.1 2,331 2,341 20-24 20.7 2,178 2,127 25-29 17.8 1,876 1,813 30-34 13.8 1,456 1,473 35-39 11 .8 1,241 1,281 40-44 8.5 901 917 45-49 5.3 563 585 Ever given birth Ever gave birth 75.4 7,956 7,928 Never gave birth 24.5 2,589 2,609 Woman's education level None 15.8 1,667 1,828 Primary 57.1 6,019 6,074 Secondary+ 27.1 2,859 2,635 Total 100.0 10,545 10,537 13 I I I I I I I I I I I I I I I I I I I Table 3: Percent distribution of children under 5 by background characteristics Percent Number Unweighted Sex Male 50.1 4,132 4,167 Female 49.9 4,113 4,093 Province Nairobi 14.6 1,208 334 Central 10.3 853 893 Coast 9.1 750 1,052 Eastern 14.0 1,153 992 North Eastern(Urban) 1.1 87 78 Nyanza 16.7 1,380 1,426 Rift valley 22.8 1,876 2,629 Western 11.4 939 856 Rural/Urban Rural 75.3 6,206 6,705 Urban 24.7 2,040 1,555 Age < 6 months 10.8 889 855 6-11 months 14.4 1,185 1,168 12-23 months 20.0 1,650 1,675 24-35 months 20.5 1,689 1,664 36-4 7 months 20.0 1,652 1,654 48-59 months 14.3 1,181 1,244 Woman's education level None 18.4 1,516 1,653 Primary 56.4 4,648 4,651 Secondary+ 25.2 2,082 1,956 Total 100.0 8,246 8,260 14 I I I I I I I I I I I I I I I I I I I I I Table 4: Percentage of children of primary school age attending primary school Male Female Total Attending Number Attending Number Attending Number Province Nairobi 68.9 492 79.9 451 74.2 943 Central 82.1 663 83.5 607 82.7 1,270 Coast 59.7 502 54.6 464 57.3 966 Eastern 71 .2 890 77.9 968 74.7 1,857 North Eastern(Urban) 61 .6 35 58.7 45 60.0 80 Nyanza 75.8 890 74.4 922 75.1 1,812 Rift Valley 73.1 1,254 75.0 1,303 74.1 2,557 Western 72.9 694 73.6 672 73.2 1,366 Rural/Urban Rural 72.6 4,499 74.2 4,531 73.4 9,030 Urban 72.7 920 77.2 901 74.9 1,821 Age 6 29.8 728 33.7 680 31 .7 1,407 7 57.2 681 57.4 685 57.3 1,366 8 72.0 743 76.3 755 74.1 1,499 9 83.5 623 82.7 666 83.1 1,290 10 84.3 703 87.4 730 85.9 1,434 11 86.7 619 88.8 609 87.7 1,228 12 86.8 699 87.5 673 87.1 1,372 13 86.4 622 85.5 633 85.9 1,255 Total 72.6 5,419 74.7 5,431 73.7 10,851 World Summit for Children Goal => Number 6 15 I I I I I I I I I I I I I I I I I I I I I Table 5: Percentage of children entering first class of primary school who eventually reach std 5 Percent who Percent in std Percent in std Percent in std Percent in std reach std 5 of 1 reaching 2 reaching 3 reaching 4 reaching those who std 2 std 3 std 4 std 5 enter std 1 Sex Male 95.9 96.7 96.2 95.4 85.0 Female 97.3 97.4 97.1 95.5 88.0 Province Nairobi 97.5 100.0 94.0 100.0 91 .7 Central 96.7 95.9 97.5 96.7 87.4 Coast 95.7 94.8 96.7 89.5 78.5 Eastern 96.1 97.4 98.3 95.7 88.1 North Eastern(Urban) 100.0 100.0 100.0 89.1 89.1 Nyanza 95.2 97.7 97.3 94.1 85.1 Rift Valley 98.6 97.2 97.3 96.5 90.0 Western 95.1 95.9 93.4 93.8 79.9 Rural/Urban Rural 96.4 97.0 96.9 95.3 86.4 Urban 97.3 97.4 95.0 96.3 86.7 Total 96.6 97.0 96.7 95.5 86.5 World Summit for Children Goal => Number 6 16 - - - - - - - - - - - - - - - - - - - - - Table 6: Percentage of the population using improved drinking water sources, 2000 Main source of water Unprotect Tubewell/ ed dug Total with Piped into borehole weii/Unpr Pond, Tanker safe Number Piped into yard or with Protected Protected Rainwater Bottled otected river or truck drinking of dwelling plot Public tap pump dug well spring collection water spring stream vendor Other water persons Province Nairobi 31.7 30.8 31.4 0.2 0.0 0.0 0.0 0.0 0.0 0.7 3.9 1.2 92.2 5,790 Central 15.4 14.1 3.7 3.2 6.1 5.8 1.8 0.1 7.1 41.5 0.7 0.4 49.5 5,449 Coast 11.9 2.6 36.3 10.2 2.3 0.2 3.9 0.0 5.4 20.6 5.8 0.7 66.6 3,934 Eastern 6.1 9.8 10.7 5.5 3.0 1.4 0.7 0.1 20.3 39.0 1.5 2.0 36.6 7,143 North Eastern(Urban) 9.0 49.7 1.6 3.4 10.9 0.0 0.0 0.0 8.1 1.6 6.4 9.3 68.0 394 Nyanza 3.7 1.8 5.9 12.1 2.8 15.7 1.9 0.0 16.5 37.8 1.2 0.5 43.5 7,315 Rift valley 9.9 8.2 7.3 4.5 12.3 5.8 1.6 0.1 11.5 34.6 2.5 1.7 48.7 9,729 Western 5.8 3.5 4.8 15.0 16.2 26.1 0.4 0.1 17.1 9.7 0.5 0.9 70.9 5,306 Rural/Urban Rural 6.0 5.8 6.4 8.7 8.1 10.0 1.7 0.1 15.0 36.5 0.8 1.1 45.9 34,992 Urban 29.8 26.4 31.1 0.6 1.0 0.5 0.5 0.0 0.8 1 4 6.4 1.5 88.0 10,070 Total 11.9 10.9 12.5 6.7 6.3 76 1.4 0.1 11.5 27.8 2.2 1.2 56.4 45,061 World Summit for Children Goal => Number 4 17 - - - - - - - - - - - - - - - - - - - - -· Table 7: Percentage of the population using sanitary means of excreta disposal Type of toilet facility Total with Flush to sanitary sewage Pour Traditiona No means of Number system/se flush Improved I pit facilities/ excreta of ptic tank latrine pit latrine latrine Open pit Bucket Other bush/field Total disposal persons Province Nairobi 42.0 6.0 6.5 41.1 2.5 0.5 0.0 1.4 100.0 93.7 5,790 Central 10.6 0.3 6.9 80.2 1.9 0.0 0.1 0.0 100.0 96.7 5,449 Coast 12.3 2.4 4.4 49.3 4.6 0.0 0.1 26.9 100.0 67.4 3,934 Eastern 7.0 0.1 9.1 59.7 10.2 0.0 0.1 13.9 100.0 74.7 7,143 North Eastern(Urban) 25.3 1.6 3.1 49.2 10.9 8.4 1.6 0.0 100.0 72.1 394 Nyanza 5.7 0.6 4.3 59.3 3.5 0.0 0.1 26.5 100.0 69.2 7,315 Rift valley 10.5 0.7 7.7 53.3 8.0 0.2 0.3 19.3 100.0 70.8 9,729 Western 9.3 0.7 5.1 76.5 3.3 0.0 0.0 5.1 100.0 90.5 5,306 Rural/Urban Rural 5.9 0.4 6.3 64.0 6.1 0.0 0.1 17.3 100.0 75.5 34,992 Urban 38.1 4.7 6.9 45.4 2.6 0.8 0.3 1.3 100.0 93.0 10,070 Total 13.8 1.4 6.5 59.4 5.2 0.2 0.1 13.3 100.0 79.9 45,061 World Summit for Children Goal => Number 5 18 -------- --------------------- Table 8: Percentage of under-five children who are severely or moderately undernourished Weight for Weight for Height for Height for Weight for Weight for Number of age: -2 SO age: -3 SO age: -2 SO age: -3 SO height: -2 SO height: -3 SO children Sex Male 23.6 7.8 39.7 18.4 6.8 1.8 3,295 Female 21.7 5.2 34.7 16.8 5.8 0.9 3,294 Province Nairobi 13.1 2.2 29.3 12.2 3.0 0.4 789 Central 18.8 4.5 30.3 13.8 5.6 1.2 675 Coast 25.6 5.9 38.5 18.8 7.8 1.7 609 Eastern 29.3 7.6 44.3 21.6 7.9 1.3 979 North Eastern (Urban) 13.0 5.4 34.4 16.6 4.8 0.0 68 Nyanza 21.4 6.9 37.9 18.9 5.8 2.0 1 '119 Rift valley 25.5 7.8 37.9 17.5 7.4 1.4 1,583 Western 22.1 8.4 39.2 18.7 5.5 1.5 768 Rural/Urban Rural 25.2 7.6 40.1 19.1 7.1 1.6 5,110 Urban 13.8 2.6 27.5 12.4 3.6 0.5 1,479 Age < 6 months 1.8 0.4 12.3 2.6 2.8 0.8 367 6-11 months 12.4 3.5 19.8 4.9 3.4 0.7 406 12-23 months 34.1 12.3 52.5 29.9 9.4 2.1 1,670 24-35 months 23.1 6.1 33.7 13.2 7.0 1.6 1,419 36-4 7 months 19.5 4.6 35.6 16.2 5.5 1.4 1,495 48-59 months 20.2 4.1 35.9 16.4 4.2 0.5 1,232 Woman's education level None 26.9 8.5 39.6 20.1 8.2 2.3 1,194 Primary 25.1 7.5 41.0 19.5 6.6 1.4 3,735 Secondary+ 14.2 2.6 27.1 11.5 4.1 0.6 1,661 Total 22.7 6.5 37.2 17.6 6.3 1.4 6,590 World Summit for Children Goal => Number 3, 9 19 --------------------- Table 9: Percent of living children by breastfeeding status Exclusive breastfeeding Solid foods Breastfed Breastfed Children 0-3 Number of Children 6-9 Number of Children 12-15 Number of Children 20-23 Number of months children months children months children months children Sex Male 16.2 310 67.5 454 80.7 331 24.3 226 Female 14.8 282 66.7 479 80.9 308 22.7 212 Province Nairobi 24.4 113 74.1 176 63.6 88 12.5 47 Central 11.0 50 76.1 101 77.5 63 10.4 55 Coast 8.2 53 71.5 77 86.5 69 26.3 39 Eastern 9.5 58 72.6 97 87.1 73 32.5 59 North Eastern (Urban) 25.0 5 52.6 5 80.5 13 79.6 6 Nyanza 7.3 108 57.4 164 87.2 117 27.5 83 Rift valley 14.7 124 73.6 210 80.3 142 25.6 95 Western 28.1 75 39.4 96 83.9 66 17.8 47 Rural/Urban Rural 13.8 429 65.7 670 84.9 478 23.1 331 Urban 20.1 164 70.6 263 68.5 161 25.0 107 Woman's education level None 13.2 76 66.2 139 83.4 95 29.9 96 Primary 15.0 366 66.6 535 82.4 382 20.9 238 Secondary+ 18.1 150 68.6 260 75.3 162 23.7 104 Total 15.5 593 67.1 933 80.8 639 23.5 438 World Summit for Children Goal => Number 16 20 I I I I I I I I I I I I I I I I I I I I I Table 10: Percent distribution of children aged 6-59 months by whether they received a high dose of Vitamin A supplement in the last 6 months Received: Vitamin A Total within last Not sure if Not Number of 6 months received received Total children Sex Male 41.9 4.0 54.1 100.0 3,670 Female 40.0 4.4 55.7 100.0 3,687 Province Nairobi 31.9 4.5 63.5 100.0 1,044 Central 31.7 4.3 64.0 100.0 764 Coast 39.9 4.0 56.0 100.0 662 Eastern 35.3 3.0 61.7 100.0 1,002 North Eastern (Urban) 47.8 10.7 41.5 100.0 79 Nyanza 53.9 2.7 43.4 100.0 1,214 Rift valley 41.5 5.0 53.5 100.0 1,698 Western 48.4 4.7 46.9 100.0 803 Rural/Urban Rural 42.7 3.6 53.7 100.0 5,563 Urban 35.4 5.9 58.7 100.0 1,794 Age 6-11 months 33.7 2.0 64.3 100.0 1,185 12-23 months 44.7 3.9 51.5 100.0 1,650 24-35 months 43.1 4.9 52.0 100.0 1,689 36-4 7 months 39.6 4.3 56.1 100.0 1,652 48-59 months 41.5 5.6 52.8 100.0 1,181 Woman's education level None 34.6 8.3 57.1 100.0 1,386 Primary 42.6 3.4 54.0 100.0 4,107 Secondary+ 41.8 2.9 55.2 100.0 1,864 Total 40.9 4.2 54.9 100.0 7,357 World Summit for Children Goal => Number 15 21 I I I I I I I I I I I I I I I I I I I I I Table 11: Percentage of households consuming adeuqately iodized salt Percent of Percent of households households in which salt with no salt was tested Result of test < 15 PPM 15+ PPM Province Nairobi 3.3 93.3 15.8 84.2 Central 1.8 96.5 17.9 82.1 Coast 1.2 97.2 5.9 94.1 Eastern 2.0 96.9 11.9 88.1 North Eastern (Urban) 11.7 78.1 14.5 85.5 Nyanza 2.2 96.2 7.3 92.7 Rift valley 2.8 95.2 3.2 96.8 Western 3.3 95.3 3.8 96.2 Rural/Urban Rural 2.4 96.1 8.6 91.4 Urban 3.0 93.9 11.9 88.1 Total 2.5 95.5 9.4 90.6 World Summit for Children Goal => Number 14 22 Number of households interviewed 1,299 1,253 710 1,348 90 1,468 1,899 978 6,787 2,257 9,045 --------------------- Table 12: Percentage of children 12-23 months immunized against childhood diseases at any time before the survey Percentage of children who received: Number of BCG DPT1 DPT2 DPT3 Polio 0 Polio 1 Polio 2 Polio 3 Measles All None Children Vaccination Card 68.4 68.6 65.9 63.0 60.2 69.0 66.2 61.9 52.0 49.7 0.1 1,365 Mother's Report 25.8 24.2 20.5 16.5 5.3 22.7 21.5 15.8 22.5 12.2 4.5 478 Not vaccinated 5.8 7.2 13.5 20.5 34.5 8.3 12.4 22.3 25.5 38.1 95.4 236 Either 94.2 92.8 86.5 79.5 65.5 91.7 87.6 77.7 74.5 61.9 4.6 2,079 Vaccinated by 12 months of age 93.8 92.2 85.9 78.7 65.2 91.0 86.8 76.7 71.4 57.9 2,079 23 --------------------- Table 13: Percentage of women aged 15-49 who know the main ways of preventing HIV transmission Percent who know transmission can be prevented by: Have only one faithful Using a Knows at Doesn't Heard of uninfected sex condom Abstaining Knows all least one know any Number of AIDS partner every time from sex three ways way way women Province Nairobi 95.9 78.4 61.4 78.1 54.1 85.4 14.6 1,705 Central 90.1 82.3 56.2 78.5 53.1 83.7 16.3 1,326 Coast 94.5 77.4 55.7 75.1 51.9 80.9 19.1 931 Eastern 91.9 81.6 47.2 77.1 42.4 84.4 15.6 1,622 North Eastern (Urban) 72.2 50.7 29.8 49.6 29.3 51.4 48.8 100 Nyanza 93.9 77.6 46.1 71.5 36.9 84.8 15.2 1,642 Rift Valley 91.4 79.4 51.9 72.6 45.9 82.4 17.6 2,127 Western 90.0 75.8 50.5 71.2 44.0 81.2 18.8 1,092 Rural/Urban Rural 92.0 79.0 49.9 73.6 43.9 82.9 17.1 7,684 Urban 93.5 78.5 58.9 77.4 52.8 84.1 15.9 2,862 Age 15-19 87.6 70.7 47.9 66.6 40.9 75.9 24.1 2,331 20-24 92.9 79.9 57.4 76.9 51.3 84.7 15.3 2,178 25-29 95.0 83.1 57.5 77.8 50.1 87.6 12.4 1,876 30-34 93.4 80.4 53.2 76.9 48.1 85.0 15.0 1,456 35-39 93.5 80.9 48.1 75.5 43.6 83.6 16.4 1,241 40-44 94.1 81.5 53.0 78.2 48.1 85.8 14.2 901 45-49 92.9 79.1 38.9 73.1 35.6 81.7 18.3 563 Woman's education level None 89.6 68.0 39.4 64.0 35.3 71.8 28.2 1,667 Primary 92.4 78.4 51.1 73.2 44.1 83.1 16.9 6,019 Secondary+ 93.9 86.0 62.4 83.7 57.5 89.9 10.1 2,859 Total 92.4 78.8 52.3 74.6 46.4 83.2 16.8 10,545 Monitoring HIV/AIDS Indicator 24 --------------------- Table 14: Percentage of women aged 15-49 who correctly identify misconceptions about HIVIAIDS Percent who know that: AIDS cannot be transmitted by: Knows all Knows at A healthy three least one Doesn't correctly Heard of supernatural mosquito looking person misconcepti misconcepti identify any Number of AIDS means bites can be infected ons on misconception women Province Nairobi 95.9 74.9 62.3 83.1 52.9 96.6 9.4 1,705 Central 90.1 81 .1 56.7 78.6 47.4 88.9 11 .1 1,326 Coast 94.5 83.7 64.2 73.3 47.7 92.1 7.9 931 Eastern 91 .9 82.8 55.7 84.0 49.1 90.1 9.9 1,622 North Eastern (Urban) 72.2 57.0 46.0 40.3 17.0 68.5 31.5 100 Nyanza 93.9 77.7 53.6 80.5 40.9 92.1 7.9 1,642 Rift Valley 91.4 76.9 50.9 72.8 38.4 87.4 12.6 2,127 Western 90.0 76.7 48.2 74.9 36.3 88.1 11.9 1,092 Rural/Urban Rural 92.0 79.1 53.2 77.1 41 .6 89.5 10.5 7,684 Urban 93.5 76.9 61 .6 80.7 51 .5 89.8 10.2 2,862 Age 15-19 87.6 71.3 49.8 69.7 38.9 83.0 17.0 2,331 20-24 92.9 80.8 60.6 79.6 49.1 90.6 9.4 2,178 25-29 95.0 82.9 58.0 83.5 47.6 93.3 6.7 1,876 30-34 93.4 78.7 57.1 81.5 45.6 91.7 8.3 1,456 35-39 93.5 80.1 53.4 79.6 43.4 90.6 9.4 1,241 40-44 94.1 78.3 53.6 77.9 41.4 91.0 9.0 901 45-49 92.9 79.9 52.7 75.4 40.5 89.0 11 .0 563 Woman's education level None 89.6 73.2 49.4 64.7 32.2 84.3 15.7 1,667 Primary 92.4 78.0 52.6 78.0 41 .8 89.6 10.4 6,019 Secondary+ 93.9 82.7 65.0 86.0 56.7 92.5 7.5 2,859 Total 92.4 78.5 55.5 78.1 44.3 89.6 10.4 10,545 Monitoring HIV/AIDS Indicator 25 --------------------- Table 15: Percent distribution of women aged 15-49 with a birth in the last year by type of personnel delivering antenatal care Person delivering antenatal care No Traditiona antenatal Any Nurse/mid Auxiliary I birth Other/mis care skilled Number of Doctor wife midwife attendant sing received Total personnel women Province Nairobi 31.5 49.3 0.0 3.0 14.6 1.6 100.0 80.8 354 Central 15.5 65.0 3.2 0.0 13.5 2.8 100.0 83.7 183 Coast 12.5 55.4 4.2 8.5 13.4 5.9 100.0 72.2 165 Eastern 8.6 75.7 0.8 1.6 10.2 3.1 100.0 85.2 206 North Eastern(Urban) 4.4 11.3 0.0 0.0 84.3 0.0 100.0 15.7 19 Nyanza 5.6 66.8 0.2 9.1 13.3 5.0 100.0 72.6 338 Rift Valley 16.0 58.5 1.0 7.1 13.5 3.8 100.0 75.6 382 Western 7.2 59.0 1.1 17.3 10.9 4.5 100.0 67.3 216 Rural/Urban Rural 9.8 63.2 1.4 8.4 12.9 4.3 100.0 74.4 1,337 Urban 27.3 52.2 0.4 2.2 15.7 2.1 100.0 80.0 526 Woman's education level None 7.5 49.7 1.8 10.4 23.2 7.4 100.0 59.0 245 Primary 11.3 63.1 1.1 7.4 13.3 3.7 100.0 75.5 1,132 Secondary+ 26.4 58.2 1.1 2.8 10.0 1.5 100.0 85.7 486 Total 14.8 60.1 1.2 6.6 13.7 3.7 100.0 76.0 1,863 World Summit for Children Goals => Numbers 9, 11 26 --------------------- Table 16: Percent distribution of children aged 0-59 months by whether birth is registered and reasons for non-registration Sex Province Rural/Urban Age Woman's education level Total Male Female Nairobi Central Coast Eastern North Eastern Nyanza Rift valley Western Rural Urban < 6 months 6-11 months 12-23 months 24-35 months 36-4 7 months 48-59 months None Primary Secondary+ Monitoring Children's Rights Indicator Birth is not registered because: Doesn't Costs Must Didn't know Late & know Birth DK if birth too travel it should be didn't want where to registered registered much too far registered to pay fine register 62.1 2.2 1.3 63.0 2.0 1.6 82.7 90.0 64.4 67.0 80.8 41.8 51.7 56.5 56.5 80.9 60.9 63.2 61.6 65.3 61.2 62.3 49.6 58.1 81 .9 62.5 5.4 0.8 0.6 1.1 0.6 2.1 1.4 3.1 1.6 3.6 2.0 1.2 1.4 1.8 3.8 2.1 2.2 2.5 1.2 2.1 0.0 0.5 1.2 2.1 0.0 2.6 1.7 1.6 1.8 0.5 1.9 2.4 0.7 1.3 1.4 1.6 1.3 1.7 0.9 1.4 4.5 14.5 3.9 4.2 3.8 15.4 3.9 3.2 1.1 1.0 4.9 4.4 2.5 6.4 6.1 3.0 5.1 1.3 4.1 3.5 4.0 3.8 4.7 4.6 5.9 4.5 2.1 4.1 27 6.7 3.4 15.9 14.0 0.9 24.5 20.2 13.0 17.3 7.7 15.6 16.1 15.2 13.5 15.1 14.8 23.7 16.3 5.5 15.0 1.1 0.6 3.4 3.3 8.3 7.6 3.7 5.5 4.7 1.7 3.0 3.5 3.9 5.3 3.5 3.9 4.3 4.4 2.7 3.9 1.3 1.5 2.3 3.4 0.0 6.5 5.0 4.0 4.5 1.4 4.0 3.7 4.6 2.7 3.5 3.9 4.4 4.6 1.1 3.7 Birth Reason DK certificate Other or Missing issued Total Number of children 2.9 4.4 12.5 100.0 4,132 4,113 2.6 0.8 0.9 3.3 1.2 1.4 2.9 3.6 5.9 3.3 1.3 5.2 2.5 3.1 2.7 2.1 1.8 3.1 3.1 1.8 2.8 4.5 0.9 1.4 4.1 3.5 5.5 5.6 6.5 7.2 5.3 1.6 3.3 3.9 5.4 3.6 4.7 5.1 5.5 4.8 2.7 4.4 14.3 100.0 26.3 100.0 1 ,207 15.9 100.0 843 13.0 8.0 65.1 10.7 9.7 8.3 100.0 100.0 100.0 100.0 100.0 100.0 749 1,104 87 1,374 1,867 914 8.6 100.0 6,206 28.1 100.0 2,040 6.1 100.0 889 11.3 100.0 1,185 11.0 100.0 1,650 16.0 100.0 1 ,689 16.0 100.0 1 ,652 17.0 100.0 1,181 10.1 100.0 1,516 9.8 100.0 4,648 23.8 100.0 2,082 13.4 100.0 8,246

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