Serbia - Multiple Indicator Cluster Survey - 2014

Publication date: 2014

SERBIA MULTIPLE INDICATOR CLUSTER SURVEY 2014 AND SERBIA ROMA SETTLEMENTS MULTIPLE INDICATOR CLUSTER SURVEY 2014 FINAL REPORTS December, 2014 The 2014 Serbia Multiple Indicator Cluster Survey (MICS) and 2014 Serbia Roma Settlements Multiple Indicator Cluster Survey were carried out in 2014 by the Statistical Office of the Republic of Serbia as part of the global MICS programme. Technical and financial support was provided by the United Nations Children’s Fund (UNICEF). The global MICS programme was developed by UNICEF in the 1990s as an international household survey programme to support countries in the collection of internationally comparable data on a wide range of indicators on the situation of children and women. MICS surveys measure key indicators that allow countries to generate data for use in policies and programmes, and to monitor progress towards the Millennium Development Goals (MDGs) and other internationally agreed upon commitments. Suggested citation Statistical Office of the Republic of Serbia and UNICEF. 2014. Serbia Multiple Indicator Cluster Survey and Serbia Roma Settlements Multiple Indicator Cluster Survey, 2014, Final Reports. Belgrade, Serbia: Statistical Office of the Republic of Serbia and UNICEF. Publisher UNICEF Belgrade For publisher Michel Saint-Lot Representative Proofreading Chris Prickett Design Rastko Toholj Cover photo ©UNICEF SERBIA/Shubuckl Printed by Radunic, Belgrade Print run 300 ISBN 978-86-82471-96-7 Published in December, 2014 Revised in May, 2015 Monitoring the situation of children and women i Summary Table of Survey Implementation and the Survey Population 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS Survey implementation Sample frame Updated Population census 2011 October 2013 Questionnaires Household Women (age 15-49) Children under five Questionnaire for Vaccination Records at Health Facility Interviewer training January 2014 Fieldwork February — April 2014 Survey sample — Serbia Survey sample — Serbia Roma Settlements Households Sampled Occupied Interviewed Response rate (Percent) 7351 6959 6191 89.0 Households Sampled Occupied Interviewed Response rate (Percent) 1976 1803 1743 96.7 Women Eligible for interviews Interviewed Response rate (Percent) 4997 4713 94.3 Women Eligible for interviews Interviewed Response rate (Percent) 2162 2081 96.3 Children under five Eligible Mothers/caretakers interviewed Response rate (Percent) 2773 2720 98.1 Children under five Eligible Mothers/caretakers interviewed Response rate (Percent) 1556 1515 97.4 Survey population Serbia Serbia Roma Settlements Average household size 3.1 Average household size 4.9 Percentage of population under Age 5 Age 18 4.7 18.1 Percentage of population under Age 5 Age 18 12.5 40.2 Percentage of women age 15-49 years with at least one live birth in the last 2 years 8.2 Percentage of women age 15-49 years with at least one live birth in the last 2 years 19.4 Percentage of population living in Urban areas Other areas1 Belgrade Vojvodina Sumadija and Western Serbia Southern and Eastern Serbia 59.0 41.0 22.6 26.6 27.5 23.3 Percentage of population living in Urban areas Other areas 73.7 26.3 1 Official statistics in Serbia do not include a specific definition for rural settlements. Instead, an “administrative-legal” criteria is applied that designates settlements as either “Urban” or “Other”. Urban settlements are recognised as such by an act of the local self-government, with all other settlements falling into the category of “Other”. ii Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Housing characteristics Serbia Serbia Roma Settlements Percentage of households with Electricity Finished floor Finished roofing Finished walls 99.7 99.0 98.8 98.2 Percentage of households with Electricity Finished floor Finished roofing Finished walls 89.7 96.4 93.3 95.7 Mean number of persons per room used for sleeping 1.62 Mean number of persons per room used for sleeping 2.97 Household or personal assets Serbia Serbia Roma Settlements Percentage of households that own A refrigerator An electrical stove Washing machine PC/Laptop Internet Agricultural land Farm animals/livestock 98.3 95.3 93.6 63.6 57.5 41.3 26.8 Percentage of households that own A refrigerator An electrical stove Washing machine PC/Laptop Internet Agricultural land Farm animals/livestock 75.2 60.2 57.6 42.1 34.8 2.6 9.3 Percentage of households where at least a member has or owns a Mobile phone Car Bank account 90.7 59.9 83.0 Percentage of households where at least a member has or owns a Mobile phone Car Bank account 80.9 22.3 25.7 Monitoring the situation of children and women iii Summary Table of Findings2 Multiple Indicator Cluster Surveys (MICS) and Millennium Development Goals (MDG) Indicators, 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS Child mortality Early childhood mortalityA MICS Indicator Indicator Description Serbia RomaSettlementsB 1.2 MDG 4.2 Infant mortality rate Probability of dying between birth and the first birthday 12.8 1.5 MDG 4.1 Under-five mortality rate Probability of dying between birth and the fifth birthday 14.4 A Child mortality was calculated only for the 2014 Serbia Roma Settlements MICS. Rates refer approximately to the first quarter of 2012. The East Model was assumed to approximate the age pattern of mortality in the 2014 Serbia Roma Settlements MICS. B Indicator values are per 1000 live births and refer to the one-year period before the survey Nutrition Nutritional status MICS Indicator Indicator Description Serbia Serbia Roma Settlements 2.1a 2.1b MDG 1.8 Underweight prevalence (a) Moderate and severe (b) Severe Percentage of children under age 5 who fall below (a) minus two standard deviations (moderate and severe) (b) minus three standard deviations (severe) of the median weight for age of the WHO standard 1.8 0.2 9.5 1.9 2.2a 2.2b Stunting prevalence (a) Moderate and severe (b) Severe Percentage of children under age 5 who fall below (a) minus two standard deviations (moderate and severe) (b) minus three standard deviations (severe) of the median height for age of the WHO standard 6.0 2.3 18.5 5.3 2.3a 2.3b Wasting prevalence (a) Moderate and severe (b) Severe Percentage of children under age 5 who fall below (a) minus two standard deviations (moderate and severe) (b) minus three standard deviations (severe) of the median weight for height of the WHO standard 3.9 1.1 4.8 1.9 2.4 Overweight prevalence Percentage of children under age 5 who are above two standard deviations of the median weight for height of the WHO standard 13.9 5.1 Breastfeeding and infant feeding 2.5 Children ever breastfed Percentage of women with a live birth in the last 2 years who breastfed their last live-born child at any time 90.4 94.4 2.6 Early initiation of breastfeeding Percentage of women with a live birth in the last 2 years who put their last newborn to the breast within one hour of birth 50.8 69.1 2.7 Exclusive breastfeeding under 6 months Percentage of infants under 6 months of age who are exclusively breastfed 12.8 13.0 2.8 Predominant breastfeeding under 6 months Percentage of infants under 6 months of age who received breast milk as the predominant source of nourishment during the previous day 47.2 60.6 2 See Appendix E for a detailed description of MICS indicators iv Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 2.9 Continued breastfeeding at 1 year Percentage of children age 12-15 months who received breast milk during the previous day 24.6 62.0 2.10 Continued breastfeeding at 2 years Percentage of children age 20-23 months who received breast milk during the previous day 8.9 33.3 2.11 Median duration of breastfeeding The age in months when 50 percent of children age 0-35 months did not receive breast milk during the previous day 10.5 15.7 2.12 Age-appropriate breastfeeding Percentage of children age 0-23 months appropriately fed during the previous day 23.4 42.9 2.13 Introduction of solid, semi-solid or soft foods Percentage of infants age 6-8 months who received solid, semi-solid or soft foods during the previous day 96.6 89.6 2.14 Milk feeding frequency for non- breastfed children Percentage of non-breastfed children age 6-23 months who received at least 2 milk feedings during the previous day 84.3 62.1 2.15 Minimum meal frequency Percentage of children age 6-23 months who received solid, semi-solid and soft foods (plus milk feeds for non-breastfed children) the minimum number of times or more during the previous day 94.4 71.7 2.16 Minimum dietary diversity Percentage of children age 6-23 months who received foods from 4 or more food groups during the previous day 89.6 51.3 2.17a 2.17b Minimum acceptable diet (a) Percentage of breastfed children age 6-23 months who had at least the minimum dietary diversity and the minimum meal frequency during the previous day (b) Percentage of non-breastfed children age 6-23 months who received at least 2 milk feedings and had at least the minimum dietary diversity not including milk feeds and the minimum meal frequency during the previous day 68.9 73.0 26.8 36.5 2.18 Bottle feeding Percentage of children age 0-23 months who were fed with a bottle during the previous day 83.1 72.0 Low-birthweight 2.20 Low-birthweight infants Percentage of most recent live births in the last 2 years weighing below 2500 grams at birth 5.1 14.7 2.21 Infants weighed at birth Percentage of most recent live births in the last 2 years who were weighed at birth 98.7 98.6 Child health Vaccinations MICS Indicator Indicator Description Serbia Serbia Roma Settlements 3.1 Tuberculosis immunization coverage Percentage of children age 12-23 months who received BCG vaccine by their first birthday 98.0 94.3 3.2 Polio immunization coverage Percentage of children age 12-23 months who received the third dose of OPV vaccine (OPV3) by their first birthday 86.4 61.0 3.3 Diphtheria, pertussis and tetanus (DPT) immunization coverage Percentage of children age 12-23 months who received the third dose of DPT vaccine (DPT3) by their first birthday 87.4 64.5 3.4 MDG 4.3 Measles immunization coverage Percentage of children age 24-35 months who received measles vaccine by their second birthday 93.4 63.3 3.5 Hepatitis B immunization coverage Percentage of children age 12-23 months who received the third dose of Hepatitis B vaccine (HepB3) by their first birthday 91.3 67.8 3.6 Haemophilus influenzae type B (Hib) immunization coverage Percentage of children age 12-23 months who received the third dose of Hib vaccine (Hib3) by their first birthday 80.4 49.6 3.8 Full immunization coverage Percentage of children age 24-35 months who received all vaccinations recommended in the national immunization schedule by their first birthday (by their second birthday for measles) 70.5 12.7 - Full immunization coverage at any time before the survey Percentage of children age 24-35 months who received all vaccinations recommended in the national immunization schedule at any time before the survey 80.6 44.1 Solid fuel use 3.15 Use of solid fuels for cooking Percentage of household members in households that use solid fuels as the primary source of domestic energy to cook 34.2 81.9 Monitoring the situation of children and women v Water and sanitation MICS Indicator Indicator Description Serbia Serbia Roma Settlements 4.1 MDG 7.8 Use of improved drinking water sources Percentage of household members using improved sources of drinking water 99.5 97.7 4.2 Water treatment Percentage of household members in households using unimproved drinking water who use an appropriate treatment method 3.3 4.1 4.3 MDG 7.9 Use of improved sanitation Percentage of household members using improved sanitation facilities which are not shared 96.9 72.9 Reproductive health Contraception and unmet need MICS Indicator Indicator Description Serbia Serbia Roma Settlements - Total fertility rate Total fertility rate for women age 15-49 years 1.6 (3.1) 5.1 MDG 5.4 Adolescent birth rate Age-specific fertility rate for women age 15-19 years 22 157 5.2 Early childbearing Percentage of women age 20-24 years who had at least one live birth before age 18 1.4 38.3 5.3 MDG 5.3 Contraceptive prevalence rate Percentage of women age 15-49 years currently married or in union who are using (or whose partner is using) a (modern or traditional) contraceptive method 58.4 61.2 5.4 MDG 5.6 Unmet need Percentage of women age 15-49 years who are currently married or in union who are fecund and want to space their births or limit the number of children they have and who are not currently using contraception 14.9 13.9 SS3 Lifetime experience with abortion Percentage of women age 15-49 years who had at least one induced abortion 14.6 30.6 Maternal and newborn health 5.5a 5.5b MDG 5.5 MDG 5.5 Antenatal care coverage Percentage of women age 15-49 years with a live birth in the last 2 years who were attended during their last pregnancy that led to a live birth (a) at least once by skilled health personnel (b) at least four times by any provider 98.3 93.9 95.5 74.4 5.6 Content of antenatal care Percentage of women age 15-49 years with a live birth in the last 2 years who had their blood pressure measured and gave urine and blood samples during the last pregnancy that led to a live birth 93.6 86.9 5.7 MDG 5.2 Skilled attendant at delivery Percentage of women age 15-49 years with a live birth in the last 2 years who were attended by skilled health personnel during their most recent live birth 98.4 98.6 5.8 Institutional deliveries Percentage of women age 15-49 years with a live birth in the last 2 years whose most recent live birth was delivered in a health facility 98.3 98.5 5.9 Caesarean section Percentage of women age 15-49 years whose most recent live birth in the last 2 years was delivered by caesarean section 28.8 12.6 ( ) Figures that are based on 125-249 unweighted person-years of exposure. Child development MICS Indicator Indicator Description Serbia Serbia Roma Settlement 6.1 Attendance to early childhood education Percentage of children age 36-59 months who are attending an early childhood education programme 50.2 5.7 6.2 Support for learning Percentage of children age 36-59 months with whom an adult has engaged in four or more activities to promote learning and school readiness in the last 3 days 95.5 68.0 6.3 Father’s support for learning Percentage of children age 36-59 months whose biological father has engaged in four or more activities to promote learning and school readiness in the last 3 days 36.5 17.3 6.4 Mother’s support for learning Percentage of children age 36-59 months whose biological mother has engaged in four or more activities to promote learning and school readiness in the last 3 days 89.6 48.3 6.5 Availability of children’s books Percentage of children under age 5 who have three or more children’s books 71.9 11.9 6.6 Availability of playthings Percentage of children under age 5 who play with two or more types of playthings 75.0 53.2 3 SS (survey-specific) denotes an indicator calculated by introduction of a non-standard module or question(s) to this survey or by applying a non-standard calculation method. vi Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Child development MICS Indicator Indicator Description Serbia Serbia Roma Settlement 6.7 Inadequate care Percentage of children under age 5 left alone or in the care of another child younger than 10 years of age for more than one hour at least once in the last week 1.3 3.6 6.8 Early child development index Percentage of children age 36-59 months who are developmentally on track in at least three of the following four domains: literacy-numeracy, physical, social-emotional, and learning 95.1 83.3 Literacy and education MICS Indicator Indicator Description Serbia Serbia Roma Settlements 7.1 MDG 2.3 Literacy rate among young women Percentage of young women age 15-24 years who are able to read a short simple statement about everyday life or who attended secondary or higher education 99.1 80.1 7.2 School readiness Percentage of children in first grade of primary school who attended pre-school during the previous school year 98.1 79.9 7.3 Net intake rate in primary education Percentage of children of school-entry age who enter the first grade of primary school 97.0 69.1 Indicators according to the ISCED classification4 7.4 MDG 2.1 Primary school net attendance ratio (adjusted) Percentage of children of primary school age currently attending primary or secondary school 98.8 85.8 7.5 Secondary school net attendance ratio (adjusted) Percentage of children of secondary school age currently attending secondary school or higher 93.5 51.2 SS Lower secondary school net attendance ratio (adjusted) Percentage of children of lower secondary school age currently attending lower secondary school or higher 96.2 67.1 SS Upper secondary school net attendance ratio (adjusted) Percentage of children of upper secondary school age currently attending upper secondary school or higher 89.1 21.6 7.6 MDG 2.2 Children reaching last grade of primary Percentage of children entering the first grade of primary school who eventually reach last grade 99.8 96.5 7.7 Primary completion rate Number of children attending the last grade of primary school (excluding repeaters) divided by number of children of primary school completion age (age appropriate to final grade of primary school) 92.4 115.7 7.8 Transition rate to secondary school Number of children attending the last grade of primary school during the previous school year who are in the first grade of secondary school during the current school year divided by number of children attending the last grade of primary school during the previous school year 99.6 92.6 7.9 MDG 3.1 Gender parity index (primary school) Primary school net attendance ratio (adjusted) for girls divided by primary school net attendance ratio (adjusted) for boys 1.00 1.03 7.10 MDG 3.1 Gender parity index (secondary school) Secondary school net attendance ratio (adjusted) for girls divided by secondary school net attendance ratio (adjusted) for boys 1.04 0.87 SS Gender parity index (lower secondary school) Lower secondary school net attendance ratio (adjusted) for girls divided by lower secondary school net attendance ratio (adjusted) for boys 0.99 1.00 SS Gender parity index (upper secondary school) Upper secondary school net attendance ratio (adjusted) for girls divided by upper secondary school net attendance ratio (adjusted) for boys 1.08 0.53 Indicators according to the national education system classification5 7.S4 Primary school net attendance ratio (adjusted) Percentage of children of primary school age currently attending primary or secondary school 98.5 84.9 7.S5 Secondary school net attendance ratio (adjusted) Percentage of children of secondary school age currently attending secondary school or higher 89.1 21.6 4 The classification of primary school and secondary school education in the Republic of Serbia according to ISCED 2011 comprises the following: (i) ISCED 1 — primary school, corresponding to grades 1-4 of primary school (typically for ages 6-9 years); (ii) ISCED 2 — lower secondary school, corresponding to grades 5-8 of primary school within the national education system (typically for ages 10-13 years); and (iii) ISCED 3 — upper secondary school, corresponding to grades 1-4 of secondary school within the national education system (typically for ages 14-18 years). For global reporting purposes, lower secondary school and upper secondary school are combined as secondary school education. Age is adjusted to take into account age eligibility criteria for starting primary school. Since age eligibility criteria for starting primary school changed in Serbia in 2006, separate calculations were applied for children born in 1998 or earlier and those born afterwards. For the first group, the appropriate age at the start of primary school refers to the age in the 2013 calendar year, while for the second group, adjusted age is the age of the child (in completed years) at the end of February 2013. 5 The national education system classification comprises 8 grades of obligatory primary school education (typically for ages 6-13 years; children who turn 6 by the end of February of the current school year are required to enrol in first grade of primary school), and 4 grades of secondary school education (typically for ages 14-18 years). Age is adjusted to take into account age eligibility criteria for starting primary school. Since age eligibility criteria for starting primary school changed in Serbia in 2006, separate calculations were applied for children born in 1998 or earlier and those born afterwards. For the first group, the appropriate age at the start of primary school refers to the age in the 2013 calendar year, while for the second group, adjusted age is the age of the child (in completed years) at the end of February 2013. Monitoring the situation of children and women vii 7.S6 Children reaching last grade of primary Percentage of children entering the first grade of primary school who eventually reach last grade 97.9 77.0 7.S7 Primary completion rate Number of children attending the last grade of primary school (excluding repeaters) divided by number of children of primary school completion age (age appropriate to final grade of primary school) 93.4 64.0 7.S8 Transition rate to secondary school Number of children attending the last grade of primary school during the previous school year who are in the first grade of secondary school during the current school year divided by number of children attending the last grade of primary school during the previous school year 96.3 58.7 7.S9 Gender parity index (primary school) Primary school net attendance ratio (adjusted) for girls divided by primary school net attendance ratio (adjusted) for boys 0.99 1.01 7.S10 Gender parity index (secondary school) Secondary school net attendance ratio (adjusted) for girls divided by secondary school net attendance ratio (adjusted) for boys 1.08 0.53 Child protection Birth registration MICS Indicator Indicator Description Serbia Serbia Roma Settlements 8.1 Birth registration Percentage of children under age 5 whose births are reported registered 99.4 95.3 Child labour 8.2 Child labour Percentage of children age 5-17 years who are involved in child labour 9.5 4.7 Child discipline 8.3 Violent discipline Percentage of children age 1-14 years who experienced psychological aggression or physical punishment during the last one month 43.1 65.9 Early marriage 8.4 Marriage before age 15 Percentage of women age 15-49 years who were first married or in union before age 15 0.8 16.9 8.5 Marriage before age 18 Percentage of women age 20-49 years who were first married or in union before age 18 6.8 57.0 8.6 Young women age 15-19 years currently married or in union Percentage of young women age 15-19 years who are married or in union 3.5 42.7 8.8a 8.8b Spousal age difference Percentage of young women who are married or in union and whose spouse is 10 or more years older, (a) among women age 15-19 years, (b) among women age 20-24 years (9.1) 10.3 6.3 2.6 Attitudes towards domestic violence 8.12 Attitudes towards domestic violence Percentage of women age 15-49 years who state that a husband is justified in hitting or beating his wife in at least one of the following circumstances: (1) she goes out without telling him, (2) she neglects the children, (3) she argues with him, (4) she refuses sex with him, (5) she burns the food 3.8 37.0 Children’s living arrangements 8.13 Children’s living arrangements Percentage of children age 0-17 years living with neither biological parent 0.7 3.4 8.14 Prevalence of children with one or both parents dead Percentage of children age 0-17 years with one or both biological parents dead 1.7 2.3 8.15 Children with at least one parent living abroad Percentage of children 0-17 years with at least one biological parent living abroad 1.2 1.8 ( ) Figures that are based on 25-49 unweighted cases Subjective well-being MICS Indicator Indicator Description Serbia Serbia Roma Settlements 11.1 Life satisfaction Percentage of young women age 15-24 years who are very or somewhat satisfied with their life, overall 93.1 82.4 11.2 Happiness Percentage of young women age 15-24 years who are very or somewhat happy 93.6 86.7 11.3 Perception of a better life Percentage of young women age 15-24 years whose life improved during the last one year, and who expect that their life will be better after one year 29.1 27.4 viii Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 TABLE OF TABLE OF CONTENTSCONTENTS Summary Table of Survey Implementation and the Survey Population, 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS . . . . . . . . . . . . . . . . . . . . . . . . . . i Summary Table of Findings . . . . . . . . . . . . . . . . . . . iii Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . viii List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . .x List of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . xiv List of Abbreviations . . . . . . . . . . . . . . . . . . . . . . . xv Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . xvi Executive Summary . . . . . . . . . . . . . . . . . . . . . . . xvii I. Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Survey Objectives . . . . . . . . . . . . . . . . . . . . . . . .3 II. Sample and Survey Methodology . . . . . . . . . . . . . . . . 4 Sample Design for the 2014 Serbia MICS . . . . . . . . . .4 Sample Design for the 2014 Serbia Roma Settlements MICS. . . . . . . . . . . . . . . . . . . . . . . .4 Questionnaires . . . . . . . . . . . . . . . . . . . . . . . . .4 Training and Fieldwork. . . . . . . . . . . . . . . . . . . . .6 Data Processing . . . . . . . . . . . . . . . . . . . . . . . . .6 The Report Structure . . . . . . . . . . . . . . . . . . . . . .6 How to Read the Tables. . . . . . . . . . . . . . . . . . . . .7 III. Sample Coverage and the Characteristics of Households and Respondents . . . . . . . . . . . . . . . . . 8 Sample Coverage and the Characteristics of Households and Respondents for Serbia . . . . . . . . .8 Sample Coverage . . . . . . . . . . . . . . . . . . . . . . . . . 8 Characteristics of Households . . . . . . . . . . . . . . . . . 9 Characteristics of Female Respondents and Children Under 5 . . . . . . . . . . . . . . . . . . . . . 12 Housing Characteristics, Asset Ownership, and Wealth Quintiles . . . . . . . . . . . . . . . . . . . . . 15 Sample Coverage and the Characteristics of Households and Respondents for Roma Settlements. . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Sample Coverage . . . . . . . . . . . . . . . . . . . . . . . . 19 Characteristics of Households . . . . . . . . . . . . . . . . 19 Characteristics of Female Respondents and Children Under 5 . . . . . . . . . . . . . . . . . . . . . 22 Housing Characteristics, Asset Ownership, and Wealth Quintiles . . . . . . . . . . . . . . . . . . . . . 25 IV. Child Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 V. Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Low Birth Weight . . . . . . . . . . . . . . . . . . . . . . . 29 Low Birth Weight in Roma Settlements . . . . . . . . . . 31 Nutritional Status . . . . . . . . . . . . . . . . . . . . . . . 32 Nutritional Status in Roma Settlements . . . . . . . . . . 35 Breastfeeding and Infant and Young Child Feeding . . . 37 Breastfeeding and Infant and Young Child Feeding in Roma Settlements . . . . . . . . . . . . . . . . . . . . . 47 VI. Child Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Vaccinations in Roma Settlements . . . . . . . . . . . . . 60 Health Insurance . . . . . . . . . . . . . . . . . . . . . . . 65 Health Insurance in Roma Settlements . . . . . . . . . . 66 Care-seeking Behaviour for Acute Respiratory Infections. . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Care-seeking Behaviour for Acute Respiratory Infections in Roma Settlements . . . . . . . . . . . . . . . 69 Solid Fuel Use . . . . . . . . . . . . . . . . . . . . . . . . . 70 Solid Fuel Use in Roma Settlements . . . . . . . . . . . . 73 VII. Water and Sanitation . . . . . . . . . . . . . . . . . . . . . . . 75 Use of Improved Water Sources. . . . . . . . . . . . . . . 75 Use of Improved Water Sources in Roma Settlements . . 82 Use of Improved Sanitation . . . . . . . . . . . . . . . . . 87 Use of Improved Sanitation in Roma Settlements . . . . 92 VIII. Reproductive Health . . . . . . . . . . . . . . . . . . . . . . . 97 Fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Fertility in Roma Settlements . . . . . . . . . . . . . . . 101 Contraception . . . . . . . . . . . . . . . . . . . . . . . . 103 Contraception in Roma Settlements . . . . . . . . . . . 108 Unmet Need . . . . . . . . . . . . . . . . . . . . . . . . . 114 Unmet Need in Roma Settlements . . . . . . . . . . . . 117 Antenatal Care . . . . . . . . . . . . . . . . . . . . . . . 119 Antenatal Care in Roma Settlements . . . . . . . . . . 126 Assistance at Delivery . . . . . . . . . . . . . . . . . . . 132 Assistance at Delivery in Roma Settlements . . . . . . 135 Place of Delivery. . . . . . . . . . . . . . . . . . . . . . . 137 Place of Delivery in Roma Settlements . . . . . . . . . . 140 Abortions . . . . . . . . . . . . . . . . . . . . . . . . . . 142 Abortions in Roma Settlements. . . . . . . . . . . . . . 144 IX. Early Childhood Development . . . . . . . . . . . . . . . . . . 145 Early Childhood Care and Education. . . . . . . . . . . 145 Early Childhood Care and Education in Roma Settlements. . . . . . . . . . . . . . . . . . . . . . . . . . 148 Quality of Care . . . . . . . . . . . . . . . . . . . . . . . 150 Quality of Care in Roma Settlements. . . . . . . . . . . 157 Developmental Status of Children . . . . . . . . . . . . 162 Developmental Status of Children in Roma Settlements. . . . . . . . . . . . . . . . . . . . . . . . . . 164 Monitoring the situation of children and women ix X. Literacy and Education . . . . . . . . . . . . . . . . . . . . . . 165 Literacy among Young Women . . . . . . . . . . . . . . 165 Literacy among Young Women in Roma Settlements. . . . . . . . . . . . . . . . . . . . . . . . . . 166 School Readiness . . . . . . . . . . . . . . . . . . . . . . 167 School Readiness in Roma Settlements . . . . . . . . . 172 Primary and Secondary School Participation . . . . . . 178 Primary and Secondary School Participation in Roma Settlements . . . . . . . . . . . . . . . . . . . . 189 XI. Child Protection. . . . . . . . . . . . . . . . . . . . . . . . . . 198 Birth Registration . . . . . . . . . . . . . . . . . . . . . 198 Birth Registration in Roma Settlements. . . . . . . . . 200 Child Labour . . . . . . . . . . . . . . . . . . . . . . . . 201 Child Labour in Roma Settlements . . . . . . . . . . . 206 Child Discipline . . . . . . . . . . . . . . . . . . . . . . 209 Child Discipline in Roma Settlements. . . . . . . . . . 212 Early Marriage . . . . . . . . . . . . . . . . . . . . . . . 214 Early Marriage in Roma Settlements . . . . . . . . . . 218 Attitudes toward Domestic Violence . . . . . . . . . . 221 Attitudes toward Domestic Violence in Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . 223 Children’s Living Arrangements and Orphanhood . . 224 Children’s Living Arrangements and Orphanhood in Roma Settlements . . . . . . . . . . . . . . . . . . . . 226 Attitudes toward Children with Disabilities . . . . . . 228 Attitudes toward Children with Disabilities in Roma Settlements . . . . . . . . . . . . . . . . . . . . 232 XII. Social Protection . . . . . . . . . . . . . . . . . . . . . . . . .234 Cash Benefit Programmes. . . . . . . . . . . . . . . . . 234 Cash Benefit Programmes in Roma Settlements. . . . 236 Financial Social Assistance . . . . . . . . . . . . . . . . 237 Financial Social Assistance in Roma Settlements . . . 240 Child Allowance . . . . . . . . . . . . . . . . . . . . . . 242 Child Allowance in Roma Settlements . . . . . . . . . 244 Birth Grant . . . . . . . . . . . . . . . . . . . . . . . . . 246 Birth Grant in Roma Settlements . . . . . . . . . . . . 248 XIII. Subjective Well-being . . . . . . . . . . . . . . . . . . . . . . 250 Subjective Well-being in Serbia. . . . . . . . . . . . . . 250 Subjective Well-being in Roma Settlements . . . . . . 255 Appendices Appendix A. Sample Design . . . . . . . . . . . . . . . . . . . . . 260 Sample Design for the 2014 Serbia MICS Sample . . . . . . 260 Target Population and Survey Population . . . . . . . . . . . 260 Survey Domains and Stratification . . . . . . . . . . . . . . . 260 Sampling Procedure . . . . . . . . . . . . . . . . . . . . . . . 260 Sample Size and Sample Allocation . . . . . . . . . . . . . . 260 Sampling Frame and Selection of Clusters . . . . . . . . . . 262 Listing Activities . . . . . . . . . . . . . . . . . . . . . . . . . 262 Selection of Households . . . . . . . . . . . . . . . . . . . . . 263 Calculation of Sample Weights . . . . . . . . . . . . . . . . . 263 Sample Design for the 2014 Serbia Roma Settlements MICS Sample. . . . . . . . . . . . . . . . . . . . . . . . . . . 266 Target Population and Survey Population . . . . . . . . . . . 266 Survey Domains and Stratification . . . . . . . . . . . . . . . 266 Sampling Procedure . . . . . . . . . . . . . . . . . . . . . . . 266 Sample Size and Sample Allocation . . . . . . . . . . . . . . 266 Sampling Frame and Selection of Clusters . . . . . . . . . . 268 Listing Activities . . . . . . . . . . . . . . . . . . . . . . . . . 268 Selection of Households . . . . . . . . . . . . . . . . . . . . . 268 Calculation of Sample Weights . . . . . . . . . . . . . . . . 268 Appendix B. List of Personnel Involved in the Surveys . . . . . 271 Appendix C. Estimates of Sampling Errors for the Serbia Sample . . . . . . . . . . . . . . . . . . . . . . . . . 273 Estimates of Sampling Errors for the 2014 Serbia MICS Sample . . . . . . . . . . . . . . . . . . 273 Estimates of Sampling Errors for the 2014 Serbia Roma Settlements MICS Sample . . . . . . . 282 Appendix D. Data Quality Tables . . . . . . . . . . . . . . . . . . 287 Data Quality Tables for the 2014 Serbia MICS . . . . . . 287 Data Quality Tables for the 2014 Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . 298 Appendix E. 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS Indicators: Numerators and Denominators . . . . . . . . . . . . . . . . . . . . . . . . . . . 308 Appendix F. 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS Questionnaires . . . . . . . . . . . . . 315 Appendix G. Education according to the International Standard Classification (ISCED). . . . . . . . . . . . . . . . . . . 379 Education in Serbia according to ISCED 2011 . . . . . . 379 Education in Roma Settlements according to ISCED 2011 . . . . . . . . . . . . . . . . . . 388 x Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 List of Tables Table HH.1: Results of household, women’s and under-5 interviews, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Table HH.2: Household age distribution by sex, Serbia . . . . . 9 Table HH.3: Household composition, Serbia . . . . . . . . . . 11 Table HH.4: Women’s background characteristics, Serbia . . 13 Table HH.5: Under-5’s background characteristics, Serbia . . 14 Table HH.6: Housing characteristics, Serbia . . . . . . . . . . 15 Table HH.7: Household and personal assets, Serbia . . . . . . 16 Table HH.8: Wealth quintiles, Serbia . . . . . . . . . . . . . . . 17 Table HH.1R: Results of household, women’s and under-5 interviews, Serbia Roma Settlements . . . . . . . . . . . . . 19 Table HH.2R: Household age distribution by sex, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 20 Table HH.3R: Household composition, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 21 Table HH.4R: Women’s background characteristics, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 23 Table HH.5R: Under-5’s background characteristics, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 24 Table HH.6R: Housing characteristics, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 25 Table HH.7R: Household and personal assets, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 26 Table HH.8R: Wealth quintiles, Serbia Roma Settlements . . 27 Table NU.1: Low birth weight infants, Serbia . . . . . . . . . . 30 Table NU.1R: Low birth weight infants, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 31 Table NU.2: Nutritional status of children, Serbia . . . . . . . 33 Table NU.2R: Nutritional status of children, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 35 Table NU.3: Initial breastfeeding, Serbia. . . . . . . . . . . . . 38 Table NU.4: Breastfeeding, Serbia . . . . . . . . . . . . . . . . 40 Table NU.5: Duration of breastfeeding, Serbia . . . . . . . . . 41 Table NU.6: Age-appropriate breastfeeding, Serbia . . . . . . 42 Table NU.7: Introduction of solid, semi-solid, or soft foods, Serbia . . . . . . . . . . . . . . . . . . . . . . . 43 Table NU.8: Infant and young child feeding (IYCF) practices, Serbia . . . . . . . . . . . . . . . . . . . . . 44 Table NU.9: Bottle feeding, Serbia . . . . . . . . . . . . . . . . 46 Table NU.3R: Initial breastfeeding, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 47 Table NU.4R: Breastfeeding, Serbia Roma Settlements . . . . 48 Table NU.5R: Duration of breastfeeding, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 50 Table NU.6R: Age-appropriate breastfeeding, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 51 Table NU.7R: Introduction of solid, semi-solid, or soft foods, Serbia Roma Settlements . . . . . . . . . . . . 51 Table NU.8R: Infant and young child feeding (IYCF) practices, Serbia Roma Settlements . . . . . . . . . . 52 Table NU.9R: Bottle feeding, Serbia Roma Settlements . . . . 54 Table CH.1: Vaccinations in the first years of life, Serbia . . . 56 Table CH.2: Vaccinations by background characteristics, Serbia . . . . . . . . . . . . . . . . . . . . . . 57 Table CH.2A: Coverage of the pentavalent DPT-IPV-Hib combination vaccine and timeliness of polio and measles vaccines, Serbia . . . . . . . . . . . . . 59 Table CH.1R: Vaccinations in the first years of life, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 60 Table CH.2R: Vaccinations by background characteristics, Serbia Roma Settlements . . . . . . . . . . . 62 Table CH.2A.R: Coverage of the pentavalent DPT-IPV-Hib combination vaccine and timeliness of polio and measles vaccines, Serbia Roma Settlements . . . 64 Table CH.3A: Health insurance card, Serbia . . . . . . . . . . 65 Table CH.3A.R: Health insurance card, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 66 Table CH.4: Knowledge of the two danger signs of pneumonia, Serbia . . . . . . . . . . . . . . . . . . . . . . . 67 Table CH.4R: Knowledge of the two danger signs of pneumonia, Serbia Roma Settlements . . . . . . . . . . . 69 Table CH.5: Solid fuel use, Serbia . . . . . . . . . . . . . . . . . 70 Table CH.6: Solid fuel use by place of cooking, Serbia . . . . . 72 Table CH.5R: Solid fuel use, Serbia Roma Settlements. . . . . 73 Table CH.6R: Solid fuel use by place of cooking, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 74 Table WS.1: Use of improved water sources, Serbia . . . . . . 76 Table WS.2: Household water treatment, Serbia . . . . . . . . 79 Table WS.3: Time to source of drinking water, Serbia . . . . . 80 Table WS.4: Person collecting water, Serbia . . . . . . . . . . . 81 Table WS.1R: Use of improved water sources, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 82 Table WS.2R: Household water treatment, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 84 Table WS.3R: Time to source of drinking water, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 85 Table WS.4R: Person collecting water, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 86 Table WS.5: Types of sanitation facilities, Serbia . . . . . . . . 87 Table WS.6: Use and sharing of sanitation facilities, Serbia. . . 88 Table WS.7: Drinking water and sanitation ladders, Serbia . . 90 Table WS.5R: Types of sanitation facilities, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 92 Table WS.6R: Use and sharing of sanitation facilities, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 94 Table WS.7R: Drinking water and sanitation ladders, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 94 Table RH.1: Fertility rates, Serbia . . . . . . . . . . . . . . . . . 97 Table RH.2: Early childbearing, Serbia . . . . . . . . . . . . . . 99 Table RH.3: Trends in early childbearing, Serbia . . . . . . . . 100 Table RH.1R: Fertility rates, Serbia Roma Settlements. . . . . 101 Monitoring the situation of children and women xi Table RH.2R: Early childbearing, Serbia Roma Settlements . . 102 Table RH.3R: Trends in early childbearing, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 102 Table RH.3A: Knowledge of specific contraceptive methods, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Table RH.3B: Knowledge of contraceptive methods, Serbia. . 104 Table RH.4: Use of contraception, Serbia . . . . . . . . . . . . 105 Table RH.4A: Reasons for never using any methods of contraception to avoid or delay pregnancy, Serbia . . . . 107 Table RH.3A.R: Knowledge of specific contraceptive methods, Serbia Roma Settlements . . . . . . . . . . . . . . 108 Table RH.3B.R: Knowledge of contraceptive methods, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 109 Table RH.4R: Use of contraception, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 110 Table RH.4A.R: Reasons for never using any methods to avoid or delay pregnancy, Serbia Roma Settlements . . . 113 Table RH.5: Unmet need for contraception, Serbia . . . . . . . 115 Table RH.5R: Unmet need for contraception, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 117 Table RH.6: Antenatal care coverage, Serbia . . . . . . . . . .120 Table RH.7: Number of antenatal care visits and timing of first visit, Serbia . . . . . . . . . . . . . . . . . 121 Table RH.8: Content of antenatal care, Serbia. . . . . . . . . . 122 Table RH.8A: Antenatal and post-natal home visits, Serbia . . 123 Table RH.8B: Counselling during childbirth preparation programme, Serbia . . . . . . . . . . . . . . . . 124 Table RH.8C: Reasons for not attending childbirth preparation programme, Serbia . . . . . . . . . . . . . . . . 125 Table RH.6R: Antenatal care coverage, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 126 Table RH.7R: Number of antenatal care visits and timing of first visit, Serbia Roma Settlements . . . . . . . . 127 Table RH.8R: Content of antenatal care, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 128 Table RH.8A.R: Antenatal and post-natal home visits, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 129 Table RH.8B.R: Counselling during childbirth preparation programme, Serbia Roma Settlements . . . . .130 Table RH.8C.R: Reasons for not attending childbirth preparation programme, Serbia Roma Settlements . . . . . 131 Table RH.9: Assistance during delivery and caesarean section, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Table RH.9R: Assistance during delivery and caesarian section, Serbia Roma Settlements . . . . . . . . . . . . . . . 135 Table RH.10: Place of delivery, Serbia. . . . . . . . . . . . . . . 137 Table RH.10A: Use of baby-friendly services, Serbia . . . . . . 138 Table RH.10R: Place of delivery, Serbia Roma Settlements . . 140 Table RH.10A.R: Use of baby-friendly services, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 141 Table RH.11: Lifetime experience with wasted pregnancies, Serbia . . . . . . . . . . . . . . . . . . . . . . . . 142 Table RH.11R: Lifetime experience with wasted pregnancies, Serbia Roma Settlements . . . . . . . . . . . . 144 Table CD.1: Early childhood education, Serbia . . . . . . . . . 146 Table CD.1A: Early child development, Serbia . . . . . . . . . 147 Table CD.1R: Early childhood education, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 148 Table CD.1A.R: Early child development, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 149 Table CD.2: Support for learning, Serbia. . . . . . . . . . . . . 151 Table CD.2A: Support for learning for children age 12-35 months, Serbia . . . . . . . . . . . . . . . . . . . . 153 Table CD.3: Learning materials, Serbia . . . . . . . . . . . . . 155 Table CD.4: Inadequate care, Serbia . . . . . . . . . . . . . . . 156 Table CD.2R: Support for learning, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 157 Table CD.2A.R: Support for learning for children age 12-35 months, Serbia Roma Settlements . . . . . . . . . 158 Table CD.3R: Learning materials, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 160 Table CD.4R: Inadequate care, Serbia Roma Settlements . . . 161 Table CD.5: Early child development index, Serbia . . . . . . . 163 Table CD.5R: Early child development index, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 164 Table ED.1: Literacy (young women), Serbia . . . . . . . . . . . 165 Table ED.1R: Literacy (young women), Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 166 Table ED.2: School readiness, Serbia . . . . . . . . . . . . . . . 167 Table ED.2A: Preschool Preparation Programme (PPP) attendance, Serbia . . . . . . . . . . . . . . . . . . . . . 168 Table ED.2B: Methods of going to PPP and average distance to the facility, Serbia . . . . . . . . . . . . . . . . . . 170 Table ED.2C: Children attending PPP and living more than 2 km away from the PPP facility, Serbia . . . . . 171 Table ED.2R: School readiness, Serbia Roma Settlements . . . 172 Table ED.2A.R: Preschool Preparation Programme (PPP) attendance, Serbia Roma Settlements . . . . . . . . . 173 Table ED.2B.R: Methods of going to PPP and average distance to the facility, Serbia Roma Settlements . . . . . . 174 Table ED.2C.R: Children attending PPP and living more than 2 km away from the PPP facility, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 175 Table ED.2D.R: Reasons for non-attendance to the preparatory preschool programme (PPP), Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 176 Table ED.3: Primary school entry, Serbia . . . . . . . . . . . . 178 Table ED.4: Primary school attendance and out of school children, Serbia . . . . . . . . . . . . . . . . . . . . 179 Table ED.5: Secondary school attendance and out of school children, Serbia . . . . . . . . . . . . . . . . . . . . 181 Table ED.6: Children reaching last grade of primary school, Serbia . . . . . . . . . . . . . . . . . . . . 182 Table ED.7: Primary school completion and transition to secondary school, Serbia . . . . . . . . . . . . . . . . . . . 184 xii Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Table ED.8: Education gender parity, Serbia . . . . . . . . . . . 185 Table ED.9: Out of school gender parity, Serbia . . . . . . . . . 186 Table ED.10 ISCED: Summary of education indicators (ISCED), Serbia . . . . . . . . . . . . . . . . . . . . 188 Table ED.3R: Primary school entry, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 189 Table ED.4R: Primary school attendance and out of school children, Serbia Roma Settlements . . . . . . . . . 190 Table ED.5R: Secondary school attendance and out of school children, Serbia Roma Settlements . . . . . . . . . 192 Table ED.6R: Children reaching last grade of primary school, Serbia Roma Settlements . . . . . . . . . 193 Table ED.7R: Primary school completion and transition to secondary school, Serbia Roma Settlements . . . . . . . . 194 Table ED.8R: Education gender parity, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 195 Table ED.9R: Out of school gender parity, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 196 Table ED.10R ISCED: Summary of education indicators (ISCED), Serbia Roma Settlements . . . . . . . . 197 Table CP.1: Birth registration, Serbia . . . . . . . . . . . . . . . 198 Table CP.1R: Birth registration, Serbia Roma Settlements . . .200 Table CP.2: Children’s involvement in economic activities, Serbia. . . . . . . . . . . . . . . . . . . . . . . . . .202 Table CP.3: Children’s involvement in household chores, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . .203 Table CP.4: Child labour, Serbia . . . . . . . . . . . . . . . . . .204 Table CP.2R: Children’s involvement in economic activities, Serbia Roma Settlements . . . . . . . . . . . . . .206 Table CP.3R: Children’s involvement in household chores, Serbia Roma Settlements . . . . . . . . . . . . . . . .207 Table CP.4R: Child labour, Serbia Roma Settlements . . . . .208 Table CP.5: Child discipline, Serbia . . . . . . . . . . . . . . . .209 Table CP.6: Attitudes toward physical punishment, Serbia . . . 211 Table CP.5R: Child discipline, Serbia Roma Settlements . . . 212 Table CP.6R: Attitudes toward physical punishment, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 213 Table CP.7: Early marriage, Serbia. . . . . . . . . . . . . . . . . 215 Table CP.8: Trends in early marriage, Serbia . . . . . . . . . . 216 Table CP.9: Spousal age difference, Serbia . . . . . . . . . . . . 217 Table CP.7R: Early marriage, Serbia Roma Settlements . . . . 218 Table CP.8R: Trends in early marriage, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 219 Table CP.9R: Spousal age difference, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .220 Table CP.10: Attitudes toward domestic violence, Serbia . . . 221 Table CP.10R: Attitudes toward domestic violence, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 223 Table CP.11: Children’s living arrangements and orphanhood, Serbia . . . . . . . . . . . . . . . . . . . . . 224 Table CP.12: Children with parents living abroad, Serbia . . .225 Table CP.11R: Children’s living arrangements and orphanhood, Serbia Roma Settlements. . . . . . . . . .226 Table CP.12R: Children with parents living abroad, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 227 Table CP.13: Attitudes toward children with disabilities, Serbia. . . . . . . . . . . . . . . . . . . . . . . . .230 Table CP.13R: Attitudes toward children with disabilities, Serbia Roma Settlements . . . . . . . . . . . . . 232 Table SP.1: Cash benefit programmes, Serbia . . . . . . . . . .234 Table SP.1R: Cash benefit programmes, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .236 Table SP.2: Financial social assistance (FSA), Serbia . . . . . .238 Table SP.2R: Financial social assistance (FSA), Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .240 Table SP.3: Child allowance (CA), Serbia. . . . . . . . . . . . .243 Table SP.3R: Child allowance (CA), Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .244 Table SP.4: Birth grant, Serbia . . . . . . . . . . . . . . . . . . . 247 Table SP.4R: Birth grant, Serbia Roma Settlements. . . . . . .248 Table SW.1: Domains of life satisfaction, Serbia . . . . . . . . . 251 Table SW.2: Overall life satisfaction and happiness, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253 Table SW.3: Perception of a better life, Serbia . . . . . . . . . .254 Table SW.1R: Domains of life satisfaction, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .256 Table SW.2R: Overall life satisfaction and happiness, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .258 Table SW.3R: Perception of a better life, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 259 Table SD.1: Allocation of sample clusters (primary sampling units) to sampling strata, Serbia . . . . . . . . . . 262 Table SD.1R: Allocation of sample clusters (primary sampling units) to sampling strata, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .267 Table SE.1: Indicators selected for sampling error calculations, Serbia . . . . . . . . . . . . . . . . . . . . . . . . 274 Table SE.2: Sampling errors: Total sample, Serbia . . . . . . . 275 Table SE.3: Sampling errors: Urban, Serbia . . . . . . . . . . . 276 Table SE.4: Sampling errors: Other, Serbia . . . . . . . . . . . 277 Table SE.5: Sampling errors: Belgrade, Serbia . . . . . . . . . . 278 Table SE.6: Sampling errors: Vojvodina, Serbia . . . . . . . . . 279 Table SE.7: Sampling errors: Sumadija and Western Serbia, Serbia . . . . . . . . . . . . . . . . . . .280 Table SE.8: Sampling errors: Southern and Eastern Serbia, Serbia . . . . . . . . . . . . . . . . . . . . 281 Table SE.1R: Indicators selected for sampling error calculations, Serbia Roma Settlements . . . . . . . . . . . .283 Table SE.2R: Sampling errors: Total sample, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .284 Table SE.3R: Sampling errors: Urban, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .285 Table SE.4R: Sampling errors: Other, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .286 Table DQ.1: Age distribution of household population, Serbia . . . . . . . . . . . . . . . . . . . . . . . . 287 Monitoring the situation of children and women xiii Table DQ.2: Age distribution of eligible and interviewed women, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . .288 Table DQ.3: Age distribution of children in household and under-5 questionnaires, Serbia . . . . . . . . . . . . . . 289 Table DQ.4: Birth date reporting: Household population, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 Table DQ.5: Birth date and age reporting: Women, Serbia . .290 Table DQ.6: Birth date and age reporting: Under-5s, Serbia . .290 Table DQ.7: Birth date reporting: Children, adolescents and young people, Serbia . . . . . . . . . . . . . . . . . . . .290 Table DQ.8: Birth date reporting: First and last births, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 Table DQ.9: Completeness of reporting, Serbia . . . . . . . . . 291 Table DQ.10: Completeness of information for anthropometric indicators: Underweight, Serbia . . . . . . 292 Table DQ.11: Completeness of information for anthropometric indicators: Stunting, Serbia . . . . . . . . . 292 Table DQ.12: Completeness of information for anthropometric indicators: Wasting, Serbia . . . . . . . . . 293 Table DQ.13: Heaping in anthropometric measurements, Serbia . . . . . . . . . . . . . . . . . . . . . . 293 Table DQ.14: Observation of birth certificates, Serbia . . . . .294 Table DQ.15: Observation of vaccination cards, Serbia . . . . 295 Table DQ.16: Presence of mother in the household and the person interviewed for the under-5 questionnaire, Serbia . . . . . . . . . . . . . . . . . . . . . . . 295 Table DQ.17: Selection of children age 1-17 years for the child labour and child discipline modules, Serbia . . . . . .296 Table DQ.18: School attendance by single age, Serbia . . . . .296 Table DQ.19: Sex ratio at birth among children ever born and living, Serbia . . . . . . . . . . . . . . . . . . . 297 Table DQ.1R: Age distribution of household population, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 298 Table DQ.2R: Age distribution of eligible and interviewed women, Serbia Roma Settlements . . . . . . . . . . . . . . .299 Table DQ.3R: Age distribution of children in household and under-5 questionnaires, Serbia Roma Settlements . . .300 Table DQ.4R: Birth date reporting: Household population, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .300 Table DQ.5R: Birth date and age reporting: Women, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 301 Table DQ.6R: Birth date and age reporting: Under-5s, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 301 Table DQ.7R: Birth date reporting: Children, adolescents and young people, Serbia Roma Settlements . . . . . . . . . 301 Table DQ.8R: Birth date reporting: First and last births, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 301 Table DQ.9R: Completeness of reporting, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .302 Table DQ.10R: Completeness of information for anthropometric indicators: Underweight, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .302 Table DQ.11R: Completeness of information for anthropometric indicators: Stunting, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .303 Table DQ.12R: Completeness of information for anthropometric indicators: Wasting, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .303 Table DQ.13R: Heaping in anthropometric measurements, Serbia Roma Settlements . . . . . . . . . . .304 Table DQ.14R: Observation of birth certificates, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .305 Table DQ.15R: Observation of vaccination cards, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .305 Table DQ.16R: Presence of mother in the household and the person interviewed for the under-5 questionnaire, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .306 Table DQ.17R: Selection of children age 1-17 years for the child labour and child discipline modules, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .306 Table DQ.18R: School attendance by single age, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .307 Table DQ.19R: Sex ratio at birth among children ever born and living, Serbia Roma Settlements. . . . . . . .307 Table ED.4 ISCED: Primary school attendance and out of school children, Serbia . . . . . . . . . . . . . . .380 Table ED.5 ISCED: Secondary school attendance and out of school children, Serbia . . . . . . . . . . . . . . . 381 Table ED.5A ISCED: Lower secondary school attendance and out of school children, Serbia . . . . . . . . 382 Table ED.5B ISCED: Upper secondary school attendance and out of school children, Serbia . . . . . . . .383 Table ED.6 ISCED: Children reaching last grade of primary school, Serbia . . . . . . . . . . . . . . . . . . . .384 Table ED.7 ISCED: Primary school completion and transition to secondary school, Serbia . . . . . . . . . .385 Table ED.8 ISCED: Education gender parity, Serbia . . . . . .386 Table ED.9 ISCED: Out of school gender parity, Serbia . . . . 387 Table ED.4R ISCED: Primary school attendance and out of school children, Serbia Roma Settlements. . . . . . .388 Table ED.5R ISCED: Secondary school attendance and out of school children, Serbia Roma Settlements. . . . . . . 389 Table ED.5A.R ISCED: Lower secondary school attendance and out of school children, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . .390 Table ED.5B.R ISCED: Upper secondary school attendance and out of school children, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 391 Table ED.6R ISCED: Children reaching last grade of primary school, Serbia Roma Settlements . . . . . . . . . 392 Table ED.7R ISCED: Primary school completion and transition to secondary school, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 393 Table ED.8R ISCED: Education gender parity, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 394 Table ED.9R ISCED: Out of school gender parity, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . 395 xiv Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 List of Figures Figure HH.1: Age and sex distribution of household population, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Figure HH.1R: Age and sex distribution of household population, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . 21 Figure NU.1: Underweight, stunted, wasted and overweight children under age 5 (moderate and severe), Serbia . . . . . . . . . . . . 34 Figure NU.1R: Underweight, stunted, wasted and overweight children under age 5 (moderate and severe), Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Figure NU.2: Initiation of breastfeeding, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Figure NU.3: Infant feeding patterns by age, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Figure NU.2R: Initiation of breastfeeding, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Figure NU.3R: Infant feeding patterns by age, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Figure CH.1: Vaccinations by age 12 months (measles by 24 months), Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Figure CH.1R: Vaccinations by age 12 months (measles by 24 months), Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . 61 Figure WS.1: Percent distribution of household members by source of drinking water, Serbia . . . . . . . . . . . . . . . . . . . . . . . 78 Figure WS.1R: Percent distribution of household members by source of drinking water, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Figure WS.2: Percent distribution of household members by use and sharing of sanitation facilities, Serbia . . . . . . . . . . . . . . . 89 Figure WS.3: Percentages of household members using improved drinking water sources and improved sanitation, by wealth, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Figure WS.2R: Percent distribution of household members by use and sharing of sanitation facilities, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Figure WS.3R: Percentages of household members using improved drinking water sources and improved sanitation, by wealth, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 Figure RH.1: Age-specific fertility rates by area, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Figure RH.2: Differentials in contraceptive use, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Figure RH.1R: Differentials in contraceptive use, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112 Figure RH.3: Person assisting at delivery, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 Figure RH.2R: Person assisting at delivery, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 Figure ED.1: Education indicators by sex, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 Figure ED.1R: Education indicators by sex, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196 Figure CP.1: Child disciplining methods, children age 1-14 years, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210 Figure CP.1R: Child disciplining methods, children age 1-14 years, Serbia Roma Settlements. . . . . . . . . . . . . . . . . . . . . . . . 213 Figure CP.2: Early marriage among women, Serbia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216 Figure CP.2R: Early marriage among women, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 Figure DQ.1: Household population by single ages, Serbia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288 Figure DQ.2: Weight and height/length measurements by digits reported for the decimal points, Serbia . . . . . . . . . . . . . . . . . 294 Figure DQ.1R: Household population by single ages, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299 Figure DQ.2R: Weight and height/length measurements by digits reported for the decimal points, Serbia Roma Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .304 Monitoring the situation of children and women xv List of Abbreviations ARI Acute respiratory infections BCG Bacillus Calmette-Guérin (Tuberculosis) CA Child Allowances CBR Crude Birth Rate CHERG Child Health Epidemiology Reference Group CRC Convention on the Rights of the Child CSPro Census and Survey Processing System deff Design effect deft Square root of the design effect DHS Demographic and Health Survey DPT Diphteria Pertussis Tetanus ECD Early Childhood Development ECDI Early Childhood Development Index ECE Early Childhood Education EPI Expanded Programme on Immunization EU European Union FSA Financial Social Assistance GFR General Fertility Rate GPI Gender Parity Index GVAP Global Vaccine Action Plan HepB Hepatitis B Hib Haemophilus influenzae type b HIV Human Immunodeficiency Virus IPV Inactivated polio vaccine ISCED International Standard Classification of Education IUD Intrauterine Device IYCF Infant and young child feeding JMP Joint Monitoring Programme LAM Lactational Amenorrhea Method LSMS Living Standards Measurement Survey MDG Millennium Development Goals MICS Multiple Indicator Cluster Survey MICS2 Second global round of Multiple Indicator Clusters Surveys programme MICS3 Third global round of Multiple Indicator Clusters Surveys programme MICS4 Fourth global round of Multiple Indicator Clusters Surveys programme MICS5 Fifth global round of Multiple Indicator Clusters Surveys programme MMR Measles, mumps and rubella NAR Net Attendance Rate NPA National Plan of Action for Children OPV Oral polio vaccine PAHO Pan American Health Organization PC Personal computer PPP Preschool Preparatory Programme PPS Probability proportional to size PSU Primary Sampling Unit QFIVE United Nations Program for Child Mortality Estimation RME Relative margin of error RR Response rate SIPRU Social Inclusion and Poverty Reduction Unit SORS Statistical Office of the Republic of Serbia SPSS Statistical Package for Social Sciences STI Sexually transmitted infection TFR Total Fertility Rate U5MR Under-five mortality rate UNCRPD UN Convention on the Rights of Persons with Disabilities UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund WHO World Health Organization xvi Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Acknowledgements The implementation of the 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS surveys and this report are the result of a joint effort by a number of individuals, institutions and organisations that have contributed, with their professional knowledge and commitment. The United Nation Children’s Fund (UNICEF) provided financial support, which made the implementation of the surveys possible. Special thanks are owed to the staff and consultants of the UNICEF Serbia Office, UNICEF CEE/CIS Regional Office in Geneva and the global MICS team in UNICEF New York for their professional contribution and assistance in the preparation of the surveys. The UNICEF Serbia team, led by Judita Reichenberg, Michel Saint-Lot and Lesley Miller, provided their expertise and support during the implementation phase. Project consultant Tatjana Karaulac assisted during all phases of the surveys, and preparation of the final report, while the overall country-level coordination of the surveys was successfully managed by Aleksandra Jovic. Special thanks go to Siraj Mahmudlu, UNICEF Regional MICS Coordinator, and the members of the UNICEF Regional team, in particular to Ana Abdelbasit, Hans Pettersson and Aleksandar Zoric, whose continuous technical and logistical support was of vital importance. We express our sincere gratitude to the global MICS Team, especially Attila Hancioglu, David Megill, Ivana Bjelic, Yadigar Coskun and Turgay Unalan, who supported data processing and analysis. Thank you to a number of local and international experts who provided critical support and input in the data collection process and during the preparation of the report. Members of the MICS Steering Committee provided important advice and comments during the preparation of the surveys, the development of the questionnaires, and the drafting of the report. Particularly valuable was the support of experts in the domains of immunization and nutrition from the Institute of Public Health of Serbia who participated in all stages of MICS5. Marko Milanovic provided valuable contributions to the new module on attitudes towards children with disability. The hard work and commitment of the staff in the Statistical Office of the Republic of Serbia (SORS) greatly contributed to the successful implementation of the surveys. Special recognition goes to the MICS project manager, Professor Dragan Vukmirovic, PhD, for his leadership, the coordinators in SORS, the data processing staff, sampling expert, interviewers, measurers, editors, supervisors, listing experts, and data entry staff. We express our genuine gratitude to all the individuals and households of Serbia, including those living in Roma settlements, who generously opened the doors of their homes and gave their time to the realisation of these surveys. Without their collaboration and contribution, the implementation of these surveys would not have been possible. We hope that this report will help to improve the living conditions of all children and women in Serbia. Monitoring the situation of children and women xvii EXECUTIVE SUMMARYEXECUTIVE SUMMARY This report is based on the 2014 Serbia Multiple Indicator Cluster Survey (MICS) and 2014 Serbia Roma Settlements MICS surveys, conducted in 2014 by the Statistical Office of the Republic of Serbia with technical and financial support from UNICEF. Both MICS surveys were carried out in 2014 in Serbia on two independent samples — Serbia MICS on the nationally representative sample and Serbia Roma Settlements MICS on the sample of the population living in Roma settlements6. 6 2014 Serbia MICS, the nationally representative survey, also included some households whose head of households self-declared as Roma (data presented through the background characteristic “Ethnicity”). However, as these findings are based on the nationally representative sample they are different from the findings of the 2014 Serbia Roma Settlements MICS that is based on the sample of population living in Roma settlements. The surveys provide statistically sound and internationally comparable data essential for developing evidence-based policies and programmes, and for monitoring progress toward national goals and global commitments. Among these global commitments are those emanating from the World Fit for Children Declaration and Plan of Action, the Education for All Declaration and the Millennium Development Goals (MDGs). Survey findings from both samples are presented jointly in this report. The findings pertain, unless stated otherwise, to February-April 2014, when the fieldwork was conducted. Child Mortality Child mortality indicators were calculated on the basis of the MICS data only for the Roma settlements. The infant mortality rate among children in Roma settlements is estimated at 13 per thousand live births, while the probability of dying under the age of 5 is around 14 per thousand live births. When compared to the national average on the basis of data from the vital registration system it is almost twice as high. Low Birth WeightLow Birth Weight 99 percent of all newborns were weighed at birth while 5 percent of all births were below 2500 grams. In the Roma settlements, 99 percent of live births were weighed. 15 percent of all newborns had low birth weight at birth. Nutritional StatusNutritional Status The prevalence of child malnourishment (moderate and severe) in Serbia is relatively low: the prevalence of underweight is nearly 2 percent, close to 6 percent of children are stunted (too short for their age), and 4 percent are wasted (too thin for their height). About 14 percent of children are overweight. The prevalence of stunting is 14 percent among the children from the poorest quintile. The nutritional status found among children living in Roma settlements reveals a more unfavourable situation — the prevalence of malnourishment is several times higher than the national average (around 10 percent of children are underweight and around 19 percent are stunted). The prevalence of obesity is lower than in the national sample — 5 percent. The prevalence of stunting is the highest among the children from the poorest quintile, at 28 percent. xviii Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Breastfeeding and Infant and Young Child Feeding Although breastfeeding was initiated for 90 percent of children in Serbia, only 13 percent of children are exclusively breastfed until the sixth month of age while 47 percent of children 0-5 months old are predominantly breastfed. The median duration of exclusive breastfeeding of children 0-35 months old in Serbia is 0.5 months while for any breastfeeding it is 10.5 months. 94 percent of all children age 6-23 months in Serbia were receiving solid, semi-solid and soft foods the recommended minimum number of times. 90 percent of children had minimal dietary diversity while 72 percent were benefiting from a diet sufficient in both diversity and frequency. Only 84 percent of the non-breastfed children 6-23 months received at least 2 milk feeds during the day while this percentage drops to 56 percent among the children living in the poorest households. The situation of children in Roma settlements is similar, where 94 percent of children are ever breastfed, 13 percent are exclusively breastfed until the sixth month and 61 percent of children age 0-5 months are predominantly breastfed. Median duration of any breastfeeding for children 0-35 months from Roma settlements is 15.7 months. 72 percent of all children age 6-23 months were receiving solid, semi-solid and soft foods the recommended minimum number of times. The overall assessment using the indicator of minimum acceptable diet revealed that only 31 percent were benefiting from a diet sufficient in both diversity and frequency. For the minimum acceptable diet indicator, corresponding percentages by wealth index quintile range from 14 percent of children in the poorest wealth index quintile to 53 percent of children in the richest quintile. Vaccinations 81 percent of children 24-35 months old received all recommended vaccines (at any time before the survey date) while 71 percent received all vaccines on time (by their second birthday for measles and by their first birthday for all other vaccinations). The coverage for the first and the second doses of all individual vaccines, except the Hib, is above 90 percent and then declines for the third dose but not below 85 percent. About half of all children age 12-23 months received the Polio 3 vaccine before 6 months of age, which is considered timely as per the national calendar of immunization, with notable regional differences — 41 percent in Vojvodina compared with 64 percent in Southern and Eastern Serbia. The timely immunization rates with Polio 3 are the lowest among children whose mothers have only primary education (42 percent) and from the poorest households (35 percent). Overall, only 65 percent of children age 24-35 months received the measles vaccine by 15 months of age with notable regional differences (28 percent in Belgrade vs. 79 percent in Southern and Eastern Serbia). In Roma settlements, 44 percent of children 24-35 months old received all recommended vaccines (at any time before the survey date) while only 13 percent received all vaccines on time (by their second birthday for measles and by their first birthday for all other vaccinations). The coverage for individual vaccines, except for BCG and HepB, is below 90 percent and is declining for the second and the third dose. For example, coverage for the first dose of Polio is 87 percent while it is 61 percent for the third dose. The coverage is lowest for the measles vaccine as only 63 percent of children 24-35 months old received it by 24 months. Full immunization coverage is even lower for children whose mothers have no education (33 percent) and those from the poorest households (32 percent). 45 percent of all children age 12-23 months have received the Polio 3 vaccine before 6 months of age while 53 percent of children age 24-35 months received the measles vaccine before 15 months of age, which is considered timely as per the national calendar of immunization. Monitoring the situation of children and women xix Water and sanitation Overall, almost 100 percent of the population uses an improved source of drinking water — 100 percent in urban areas and 99 percent in other areas. In Vojvodina, 70 percent of the population uses drinking water that is piped into their dwelling or into their yard or plot while this is the case for 88 percent of population in Southern and Eastern Serbia. The second most important source of drinking water in Vojvodina is bottled water (22 percent) as is the case in Belgrade (11 percent). 97 percent of the population of Serbia lives in households using improved sanitation facilities that are not shared. In other areas, the population mostly uses flush to septic tank (65 percent). In contrast, the most common facilities in urban areas are flush toilets with connection to a sewage system (83 percent). 98 percent of the population in Roma settlements uses an improved source of drinking water — 100 percent in urban areas and 92 percent in other areas. The proportion of the population in Roma settlements using drinking water piped into their dwelling is 75 percent. 73 percent of the population in Roma settlements lives in households using improved sanitation facilities that are not shared. 77 percent of households use improved sanitation in urban areas and 61 percent in other areas. In other areas, the population mostly uses pit latrines with slabs (30 percent). In contrast, the most common facility in urban areas is a pour flush to a piped sewer system (51 percent). 42 percent of the population in the poorest households use a pit latrine with slab, and 35 percent of them use a pit latrine without slab/open pit, while 11 percent does not have facilities. Fertility The TFR for the one year preceding the 2014 Serbia MICS survey is 1.6 births per woman. The adolescent birth rate in Serbia is 22. Only 3 percent of the women age 15-19 have begun childbearing, and almost none of the woman age 15- 19 have had a live birth before age 15. Furthermore, only 1 percent of women aged 20-24 have had a live birth before the age of 18. The TFR for the one year preceding the 2014 Serbia Roma Settlements MICS survey is 3.1 births per woman. The adolescent birth rate in Roma settlements in Serbia is 157. About one quarter of woman aged 15-19 years have already had a birth. 9 percent of the women of this age are pregnant with their first child, and 4 percent have had a live birth before age 15. Furthermore, 38 percent of women aged 20-24 have had a live birth before the age of 18. The percentage of women age 20-49 years who have had a live birth before 18 is the same. xx Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Contraception The data show that almost all women have heard of some type of contraceptive method and the mean number of methods known by women is 11 (of 14 methods). Current use of contraception was reported by 58 percent of women who are married or in union. Traditional methods are dominant and are used by 40 percent of women, while modern methods are used by 18 percent of women. The most popular method is withdrawal which is used by 35 percent of married women in Serbia, followed by male condom, which is used by 12 percent of women. Contraceptive prevalence ranges from 45 percent in the Belgrade region to 71 percent in Southern and Eastern Serbia. Prevalence of any modern method rises with the level of education and wealth. Only 9 percent of women with primary education use any modern method compared with 28 percent of women with higher education. Only 10 percent of women living in the poorest households use modern methods, compared to the richest households where every fourth woman uses a modern method. 95 percent of all women in Roma settlements have heard of some type of contraceptive method and the mean number of methods known by women is 6 (of 14 methods). 12 percent of women with no education and 14 percent of women in the poorest households had not heard of any modern methods. Current use of contraception was reported by 61 percent of women currently married or in union. Any modern methods are used by only 7 percent, while traditional methods are used by 54 percent. The most popular method is withdrawal which is used by 52 percent of married women followed by the male condom, used by 3 percent of married women. The percentage of married women using any method of contraception varies from 59 percent among those with no education and 61 percent with primary education to 71 percent among those with secondary or higher education. Antenatal care 98 percent of women aged 15-49 years in Serbia who had a live birth during the two years preceding the survey received antenatal care, provided by medical doctors in almost all cases. 97 percent of women have received antenatal care more than once, and 94 percent of mothers have received it at least four times. Overall, 94 percent of women with a live birth in the last two years had their first antenatal care visit during the first trimester of their last pregnancy, with a median of 1.2 months of pregnancy at the first visit. Women from the poorest households tend to have their first antenatal visit later as a lower percentage of them (84 percent) had their first visit during the first trimester. 90 percent of women received the recommended content of antenatal care. The percentage of those who received a home visit by a patronage nurse during pregnancy is low with only 29 percent of women receiving it. The lowest coverage of women is in the Belgrade region (9 percent) while the highest is in Southern and Eastern Serbia (53 percent). Much more importance is given to postnatal home visits, where 94 percent of women were visited by a patronage nurse within a week after delivery. The average number of postnatal visits by a patronage nurse after birth is 4.3. 96 percent of women aged 15-49 years from Roma settlements who had a live birth during the two years preceding the survey received antenatal care, provided by medical doctors in 95 percent of cases. 91 percent of mothers received antenatal care more than once and 74 percent received antenatal care at least four times. 60 percent of mothers from the poorest households received antenatal care four or more times, compared with 89 percent among those living in the richest households. Overall, 81 percent of women with a live birth in the last two years from Roma settlements had their first antenatal care visit during the first trimester of their last pregnancy, with a median of 2.0 months of pregnancy. There are some differences by socio- economic status as only 63 percent of women from the poorest households had their first visit during the first trimester of their last pregnancy while this was the case for 91 percent of women from the richest households. 79 percent of women received the recommended content of antenatal care. Monitoring the situation of children and women xxi Assistance at delivery Overall, 98 percent of births were delivered by skilled personnel. 29 percent of women had a C-section; for 20 percent of women, the decision was taken before the onset of labour pains and for 9 percent after the onset of labour pains. The highest percent of births by caesarean section are among women age 35-49 years (37 percent). 98 percent of all births in Serbia were delivered in a health facility. 99 percent of births of women from Roma settlements were delivered by skilled personnel. In total, 13 percent of women had a C-section; for 6 percent of women, the decision was taken before the onset of labour pains and for the same percent after. There is a higher percent of births by caesarean section among women age 20-34 years (14 percent) and from the poorest quintiles (18 percent). 99 percent of all births of women from Roma settlements were delivered in a health facility. Only 14 percent of women with live births in the last two years attended a childbirth preparation programme in primary health facilities. The main reasons for low utilization were: 51 percent of women stated they did not need it, 20 percent reported that no such programme was organized in their neighborhood, 13 percent had no time and 9 percent did not know that such programme existed. 22 percent of women were visited by a patronage nurse during pregnancy while 88 percent were visited by a patronage nurse within a week after returning home following delivery. In average, they were visited 3.5 times. The percentage of women in Roma settlements with live births in the two years preceding the survey that attended a childbirth preparation programme is very low, at 3 percent. Abortions In Serbia, overall, 15 percent of women have had at least one induced abortion. Abortion is more widespread among women with primary education (28 percent) and among those living in the poorest households (21 percent). The percentage of women who had an experience of abortion rises with age and is highest among older women 45-49 years (32 percent). There are differences by regions, and the percentage of women with reported induced abortions ranges from 8 percent in the Belgrade region to 19 percent in Southern and Eastern Serbia. Out of all women age 15-49 years who had an abortion, 55 percent had one abortion, 38 percent had 2 or 3 and 8 percent had four or more abortions. In total, 31 percent of women from Roma settlements have had at least one induced abortion. Abortion is more widespread among women with primary education (34 percent) and among those living in the richest households (35 percent). The percentage of women who had an experience of abortion rises with age and is highest among older women 45-49 years (56 percent). Among women age 15-49 years who have had an abortion, 29 percent had one abortion, 41 percent had 2 or 3 and 30 percent had four or more abortions. xxii Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Early Childhood Care and Education In Serbia, 50 percent of children age 3-4 years attend an organised early childhood education. The figure is as high as 63 percent in urban areas, compared to 27 percent in other areas. 82 percent of children living in the richest households attend such programmes, while the figure drops to 9 percent in the poorest households. The proportion of children attending early childhood education programmes at ages 36-47 months is 44 percent while attendance among the older age group of 48-59 months is 56 percent. The main reason for non-attendance to early childhood education programmes is that there is someone who can take care of the child at home (66 percent) while access issues are reasons for non-attendance of 38 percent of children. Costly services present an obstacle mainly for children from the Belgrade region (34 percent) and urban areas (21 percent) while overcrowded facilities are more frequent reasons for children from Vojvodina (21 percent) and those from the poorest households (17 percent). Only 6 percent of children age 3-4 years from Roma settlements attend an organised early childhood education programme with somewhat higher attendance in urban (6 percent) than in other areas (3 percent). 28 percent of children whose mothers have secondary or higher education attend such programmes, while the figure drops to 2 percent for children of mothers who have only primary education. The attendance of early childhood education programmes is higher among the older age group of children 48-59 months old (10 percent) than among smaller children of 36-47 months old (2 percent). The main reason for non-attendance to early childhood education programmes is that there is someone who can take care of the child at home (44 percent). Access issues are reasons for non-attendance of 43 percent of children where costly services (24 percent) and other too high expenses (22 percent) related to preschool programme attendance present the main obstacles. Quality of Care For 96 percent of children age 36-59 months, an adult household member engaged in four or more activities that promote learning and school readiness during the 3 days preceding the survey. More children benefited from mothers’ engagement (90 percent) than fathers’ (37 percent). Fathers were more engaged in activities with male children (41 percent) compared to female children (32 percent). For 91 percent of children age 12-35 months, adults engaged in four or more activities, with a similarly higher engagement of mothers (83 percent) than fathers (34 percent). Both parents are less engaged in at least four activities that promote learning with younger children 12-23 months old than with children aged 24-35 months old. For 68 percent of children 36-59 months old, an adult household member engaged in four or more early learning activities; mothers engaged in such activities with 48 percent of children while fathers engaged in activities of 17 percent of children. Adults engaged with female children more (75 percent) than with boys (62 percent). Adult engagement in activities with children was greatest with children whose mothers have higher education (96 percent) and lowest for children whose mothers are without education (49 percent). Engagement of adults in the early learning activities of smaller children (12-35 months) is almost at the same level as with the older children. Monitoring the situation of children and women xxiii 72 percent of children under five live in households where at least 3 children’s books are present while the proportion of children with 10 or more books declines to 55 percent. Only 44 percent of children from the poorest households have 3 or more books compared with 83 percent of children from the richest households. 75 percent of children age 0-59 months have 2 or more types of playthings to play with in their homes. 1 percent of children had been left with inadequate care during the previous week, either by being left alone or in the care of another child. In Roma settlements in Serbia, only 12 percent of children under five live in households where at least 3 children’s books are present while the proportion of children with 10 or more books declines to 2 percent. Some 4 percent of children from the poorest households have at least 3 books compared to 24 percent for children from the richest households. 53 percent of children age 0-59 months had 2 or more types of playthings to play with in their homes. 4 percent of children were left with inadequate care during the week preceding the survey, either by being left alone or in the care of another child. Developmental Status of Children In Serbia, 95 percent of children aged 36-59 months are developmentally on track. The analysis of the four domains of child development shows that 98 percent of children are on track in the learning domain, 99 percent in the physical domain and 95 percent in the social-emotional domain. Many fewer are on track (35 percent) in the literacy- numeracy domain. In Roma settlements, 83 percent of children aged 36-59 months are developmentally on track. Children living in poorest households have lower ECDI (77 percent) compared to children living in richest households (90 percent). The analysis of the four domains of child development shows that 95 percent of children are on track in the learning domain and 96 percent in the physical domain, somewhat less in the socio-emotional domain (83 percent) and many fewer are on track in the literacy- numeracy (16 percent) domain. Literacy among young women 99 percent of young women in Serbia are literate and the literacy status varies only for those women with only primary education and who are from the poorest households. Of women who stated that primary school was their highest level of education, 90 percent were actually able to read the statement shown to them, and this was the case for 94 percent of women from the poorest households. 80 percent of young women in Roma settlements in Serbia are literate. Of women who stated that primary school was their highest level of education, 88 percent were actually able to read the statement shown to them. Socioeconomic status is positively correlated with the literacy rate as 51 percent of the poorest women are literate compared to 98 percent of the richest. xxiv Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 School Readiness Overall, 98 percent of children who are currently attending the first grade of primary school attended pre-school the previous year, with lower values only for children from the poorest households (92 percent). 98 percent of children of the PPP age attend or attended the PPP at the appropriate age — 81 percent of children attend PPP in the public preschool facilities and 19 percent attend PPP in public schools. About 80 percent of children who are currently attending the first grade of primary school attended pre-school the previous year. 63 percent of children of PPP age from Roma settlements attend or attended PPP at the appropriate age. There is a notable difference in the percentage of children attending PPP as per socioeconomic status; PPP is attended by 59 percent of children living in households in the bottom three wealth quintiles in comparison with 72 percent of children living in households in the top two wealth quintiles. Birth Registration The births of 99 percent of children under-five in Serbia have been registered. There are no significant variations in birth registration across different background characteristics apart from ethnicity where Roma have the lowest birth registration rate (94 percent). The births of 95 percent of children under five years in Roma settlements have been registered. Birth registration rate is lower among the children age 0-5 months (83 percent) and among children from the poorest wealth quintile (89 percent). Primary and Secondary School Participation 97 percent of children who are of primary school entry age (who turn 6 by 1st March 2013) attend the first grade of primary school, while this is the case for 91 percent among children in the poorest wealth quintile. 99 percent of children of primary school age (age 6-13 years) attend primary school, while secondary school, which is not compulsory in Serbia, is attended by 89 percent of children (age 14-18 years). 11 percent of children of secondary school age are not attending secondary school: 3 percent attend primary school, while the remaining 8 percent are not attending school at all. In the richest households the proportion of children attending secondary education is around 97 percent, while it is 74 percent among children living in the poorest households. The primary school completion rate is 93 percent and the transition rate to secondary school is 96 percent. Gender parity is 0.99 for primary school and 1.08 for secondary school. Only 69 percent of children from Roma settlements who are of primary school entry age attend the first grade of primary school (82 percent in other and 65 percent in urban areas). 85 percent of children of primary school age (age 6-13 years) attend primary school and 15 percent are out of school. Primary school attendance is lower among Roma children living in households within the poorest quintile (66 percent) compared to children living in the richest households (97 percent). 22 percent of secondary school age children (age 14- 18 years) attend secondary school, 14 percent are still in primary school while 64 percent do not attend any school. There are notable differences in secondary school attendance between girls (15 percent) and boys (28 percent) as well as between children from the poorest households (5 percent) and the richest (40 percent). The primary school completion rate is 64 percent and the secondary school transition rate is 59 percent. Gender parity for primary school is 1.01 while it drops to 0.53 for secondary education. Monitoring the situation of children and women xxv Child Labour In Serbia, children’s engagement in economic activities was such that 12 percent of children age 5-11 year and 2 percent of children age 12-14 years were engaged for the number of hours that would classify their work as child labour (1 hour or more for children 5-11 years old and 14 hours or more for children 12-14 years old). The engagement of children age 15-17 in economic activities was below the threshold (43 hours or more) that would classify it as child labour among all children in this age group. Boys, children from other residence areas and the poorest children are more likely to be involved in economic activities. The percentage of children in household chores for a number of hours that would define it as child labour is negligible. In total, 10 percent of children are involved in child labour including 3 percent who are working under hazardous conditions. In Roma settlements, children’s engagement in economic activities was such that 4 percent of children age 5-11 year and below 1 percent of children age 12-14 years and age 15-17 were engaged for the number of hours that would classify their work as child labour (1 hour or more for children 5-11 years old, 14 hours or more for children 12-14 years old and 43 hours or more for children 15-17 years old). Boys and children from other residence areas are far more likely to be involved in economic activities. 2 percent of children 12-14 years old and 1 percent of children 15-17 years old were engaged in household chores for the number of hours that would classify their work as child labour (28 hours or more for children 12-14 years old and 43 hours or more for children 15-17 years old). In total, 5 percent of children are involved in child labour including 4 percent who are working under hazardous conditions. Child Discipline In Serbia, 43 percent of children aged between 1 and 14 years old were subjected to at least one form of psychological or physical punishment by household members. While 39 percent of children experienced psychological aggression, about 17 percent experienced physical punishment. The most severe forms of physical punishment were experienced by 1 percent of children. Younger children were more exposed to some form of physical disciplining than older children. 25 percent of children age 1-2 years were physically punished while this was the case for 8 percent of children age 10-14 years. 7 percent of respondents to the household questionnaires believe physical punishment is necessary to properly raise a child. In Roma settlements, 66 percent of children aged 1-14 years were subjected to at least one form of psychological or physical punishment by their household members. While 63 percent of children experienced psychological aggression, about 35 percent experienced physical punishment. 8 percent of children, girls more than boys, were subjected to severe punishment. Physical punishment is the most prevalent among children age 3-4 years. 14 percent were the subject of severe punishment and 47 percent were the subject to some form of physical punishment. 11 percent of respondents to the household questionnaires believe physical punishment is necessary to properly raise a child. Early Marriage Around 4 percent of young women aged 15 to 19 are currently married or in union but this rises to 9 percent among those from the poorest households. Among women age 20-49 years, 7 percent were married before the age of 18. 43 percent of young women age 15-19 years from Roma settlements are currently married but this rises to 52 percent of those from the poorest households and with primary education. 17 percent of girls and women age 15-49 were married before the age of 15 while 57 percent of women age 20-49 were married before the age of 18 years. xxvi Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Attitudes toward Domestic Violence 4 percent of women in Serbia feel that a husband/partner has the right to hit or beat his wife or partner for at least one of a variety of reasons. In most cases, women can justify husband/partner violence when women neglect the children (3 percent), or if women demonstrate their autonomy, e.g. go out without telling their husbands or argue with them (both 1 percent). Domestic violence is more likely to be justified by women from Roma settlements (37 percent). The most common reasons given are the same: when they neglect the children (30 percent) or demonstrate their autonomy, e.g. argue with their husband (21 percent) or go out without telling him (19 percent). Attitudes toward Children with Disability 87 percent of the respondents in Serbia believe that it is better for a child with physical or sensory disabilities to live in the family rather than in a specialized child care institution. Furthermore, 62 percent of them think that children with physical and sensory disabilities attending mainstream schools do not have a negative impact on the work of other students. Only 35 percent of respondents express positive attitudes toward children with physical and sensory disabilities on all five statements used to define common attitudes. 79 percent of the respondents in Serbia believe that it is better for a child with intellectual disabilities to live in the family rather than in a specialized child care institution. Only 32 percent of respondents believe that it is better for children with intellectual disabilities to attend mainstream schools than special schools. Overall, 20 percent of respondents express positive attitudes toward children with intellectual disabilities on all five statements used to define common attitudes. 92 percent of the respondents in Roma settlements believe that it is better for a child with physical or sensory disabilities to live in a family rather than in a specialized child care institution. A smaller percent of respondents (73 percent) believe that it is better for children with physical or sensory disabilities to attend mainstream schools than special schools. 55 percent of respondents express positive attitudes toward children with physical and sensory disabilities on all five statements. 81 percent of the respondents believe that it is better for a child with intellectual disabilities to live in a family rather than in a specialized child care institution and 55 percent of respondents believe that it is better for children with intellectual disabilities to attend mainstream schools than special schools. 38 percent of respondents express positive attitudes toward children with intellectual disabilities on all five statements. Financial Social Assistance (FSA) In Serbia, 4 percent of households received FSA. There are differences regarding almost all background characteristics. Data show that this cash benefit is received by 11 percent of households from the poorest quintile compared to zero percent from the richest quintile. Regarding the ethnicity of the head of household, the highest percent receiving FSA is among the households whose head of household self- declared as Roma (38 percent). In Roma settlements, 49 percent of households received FSA. There are differences regarding the education of the head of household and socioeconomic status. 65 percent of households whose head of households is without education received FSA compared to less than 32 percent of households whose head of household has secondary or higher education. Also, 64 percent of households from the poorest quintile received FSA compared to 28 percent from the richest quintile. Monitoring the situation of children and women xxvii The highest percent of those who did not apply for FSA, have not applied because they know that they did not meet the conditions. One quarter of the households from the poorest quintile did not apply because they were unaware of the programme (7 percent), didn’t know how to apply (14 percent) or because procedures were too complicated (4 percent). The highest percent of those who did not apply for FSA have not applied because they know that they did not meet the conditions (32 percent) and because they were discouraged from applying by being told that they do not meet the conditions (31 percent). As high as 41 percent of the poorest households didn’t apply because they found procedures too complicated (26 percent) and too expensive (15 percent). Child Allowance (CA) Overall, 27 percent of children in Serbia received CA and 25 percent have been receiving CA for at least 12 months. The child allowance is received by 9 percent of all children from the Belgrade region and around 30 percent of children from other regions. As expected, receiving CA is correlated with socioeconomic status; 48 percent of children that live in households from the poorest quintile received CA compared with 11 percent of children living in the richest households. 56 percent of those who didn’t apply for this benefit stated that they knew that they did not meet the conditions while 14 percent was discouraged from applying by being told that they do not meet the conditions. As much as 28 percent of the poorest was told that they did not meet the conditions, while for 17 percent of them administrative procedures were too complicated. 60 percent of children from Roma settlements received CA and 56 percent have been receiving CA for at least 12 months. 45 percent of children that live in households from the poorest quintile received CA compared with 72 percent of children from the fourth quintile. The main reasons why households from the poorest quintile didn’t apply relate to the fact that they thought they did not meet the conditions (33 percent), 23 percent was told that they did not meet the conditions and 28 percent found the administrative procedures to be too complicated or costly. The coverage with CA is the lowest among the oldest age group of children age 15-18 years (29 percent). Birth Grant 89 percent of children under five in Serbia received the birth grant. 86 percent of children in Sumadija and Western Serbia received the birth grant compared to 94 percent in Southern and Eastern Serbia. Only 54 percent of children whose mother is without education received the birth grant compared with 91 and 88 percent of children whose mothers have secondary and higher education, respectively. For the majority of children whose mothers did not apply for this benefit, the main reason was that the mothers knew they did not meet the conditions (38 percent). Other reasons given were that there was still time and they would apply (19 percent), they found the administrative procedure to be too complicated (8 percent) or they didn’t need this benefit (5 percent). The complicated administrative procedure was an obstacle for applying for 18 percent of mothers from the poorest households. Overall, 76 percent of children from Roma settlements received the birth grant. There are some differences regarding the mother’s education since 63 percent of children whose mother is without education received the birth grant compared to 90 percent of children whose mothers have secondary or higher education. 36 percent of mothers who did not submit an application for the birth grant knew that they did not meet the conditions while 18 percent stated that the administrative procedure was too complicated, followed by 9 percent of those who didn’t know how to apply and 8 percent who thought that it was too costly to apply. For 22 percent of mothers from the poorest households, the procedures are too complicated, for 15 percent it is too expensive to apply and 8 percent didn’t know how to apply. xxviii Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Subjective Well-being 95 percent of young women age 15-24 years are the most satisfied with their health, 93 percent with their family life and 92 percent with their friendships. Among the domains, young women are the least satisfied with their current income, with 74 percent of young women not having an income at all. In total, 93 percent of 15-24 year old women are satisfied with their life while 94 percent are very or somewhat happy. Comparing 15-19 year old women to 20-24 year old women, the proportion of women who are very or somewhat happy is 97 and 91 percent, respectively. The proportion of women age 15-24 years who think that their lives have improved during the last one year and who expect that their lives will get better after one year is 29 percent. 90 percent of young women age 15-24 years from Roma settlements are the most satisfied with their family life and the same percent with their health while 86 percent are the most satisfied with the way they look. Among the domains, young women are the least satisfied with their current income, with 83 percent of young women not having an income at all. It is notable that young women living in the poorest households are least satisfied in all selected domains. The lowest satisfaction is with their living environment, where only about half of them are satisfied. In total, 82 percent of 15-24 year old women from Roma settlements are satisfied with their life overall — the figure ranges from 65 percent for women living in the poorest households to 93 percent among those living in the richest households. 87 percent of women age 15-24 years are very or somewhat happy. The proportion of women age 15-24 years who think that their lives have improved during the last one year and who expect that their lives will get better after one year is only 27 percent. Monitoring the situation of children and women 1 I INTRODUCTION INTRODUCTION Background This report is based on the 2014 Serbia Multiple Indicator Cluster Survey (MICS) and 2014 Serbia Roma Settlements MICS, conducted in 2014 by the Statistical Office of the Republic of Serbia with technical and financial support from UNICEF. The surveys provide statistically sound and internationally comparable data essential for developing evidence- based policies and programmes, and for monitoring progress toward national goals and global commitments. Among these global commitments are those emanating from the World Fit for Children Declaration and Plan of Action, the Education for All Declaration and the Millennium Development Goals (MDGs). A Commitment to Action: National and International Reporting Responsibilities The governments that signed the Millennium Declaration and the World Fit for Children Declaration and Plan of Action also committed themselves to monitoring progress towards the goals and objectives they contained: “We will monitor regularly at the national level and, where appropriate, at the regional level and assess progress towards the goals and targets of the present Plan of Action at the national, regional and global levels. Accordingly, we will strengthen our national statistical capacity to collect, analyse and disaggregate data, including by sex, age and other relevant factors that may lead to disparities, and support a wide range of child-focused research. We will enhance international cooperation to support statistical capacity-building efforts and build community capacity for monitoring, assessment and planning.” (A World Fit for Children, paragraph 60) “…We will conduct periodic reviews at the national and subnational levels of progress in order to address obstacles more effectively and accelerate actions…” (A World Fit for Children, paragraph 61) The Plan of Action of the World Fit for Children (paragraph 61) also calls for the specific involvement of UNICEF in the preparation of periodic progress reports: “…As the world’s lead agency for children, the United Nations Children’s Fund is requested to continue to prepare and disseminate, in close collaboration with Governments, relevant funds, programmes and the specialized agencies of the United Nations system, and all other relevant actors, as appropriate, information on the progress made in the implementation of the Declaration and the Plan of Action.” Similarly, the Millennium Declaration (paragraph 31) calls for periodic reporting on progress: “…We request the General Assembly to review on a regular basis the progress made in implementing the provisions of this Declaration, and ask the Secretary-General to issue periodic reports for consideration by the General Assembly and as a basis for further action.” 2 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Serbia is an upper-middle income country that has made significant progress on a wide-ranging reform agenda. Studies, evaluations and research carried out over the past 3 years, show that much progress has been made towards achieving Serbia’s national Millennium Development Goals, particularly in the areas of health, reform of social services, and education. The prospect of EU integration is driving the comprehensive reforms of the economic and social sectors. Serbia became a candidate for European Union (EU) membership in 2012, and started negotiations for membership in January 2014. Over the past 5 years, the country has continued to revise its normative framework and established a number of institutions to strengthen accountability and guarantee respect for rights and the full implementation of the legal framework, without discrimination. The most important reform processes related to children and supported by UNICEF in Serbia are in the areas of child protection, education and health. In the area of child protection the main focus is on de-institutionalization, prevention of family separation through development of community based services and strengthening of social protection programmes. In the area of education, efforts are being made to fully implement inclusive legal provisions on education to enable equal access and the right to quality education for all children. The main focus in the area of health is support to early childhood development services and Roma health. Serbia is one of the few countries in which all four previous rounds of MICS were implemented. This occurred, however, under three different states. The first MICS was conducted in 1996 while Serbia was a part of the Federal Republic of Yugoslavia in order to review progress towards the World Summit for Children with the 2000 Federal Republic of Yugoslavia MICS (MICS2) conducted as a follow-up in 2000. The 2005 Serbia MICS (MICS3) came in time to show progress in meeting “A World Fit for Children Declaration” but also in the implementation of the National Plan of Action for Children (NPA) and the Poverty Reduction Strategy of Serbia. Serbia was then part of the State Union of Serbia and Montenegro which ceased to exist in 2006 when Serbia became independent. The MICS survey implemented in 2005 and the MICS survey implemented in late 2010 (as part of the MICS4 round), were conducted on Roma settlements samples as well, to close the data gap for this very vulnerable population group, as is the case with this round of MICS. MICS data have been and continue to be an important source of information on the situation of vulnerable children and their families. The MICS surveys implemented in 2005 and 2010 proved to be sensitive enough to measure disparities and bring a wealth of data about groups that are difficult to reach and have remained the only source for many indicators that reveal the status of Roma children and women, as well as inter-linkages stemming from the different background characteristics of children and their parents. Bearing in mind the ongoing process of reforms, having reliable and recent data on the general population but even more importantly on socially excluded and deprived groups will be the key precondition for development of new adequate social inclusion policies. The 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS provide up-to-date and comparable data that will enable decision makers within the Government and all other stakeholders to critically assess progress made and to put additional efforts in areas that require more attention. The findings of the 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS will be critically important for final MDG reporting in 2015, and are expected to form part of the baseline data for the post-2015 era. The 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS is expected to contribute to the evidence base of several other important initiatives, including Committing to Child Survival: A Promise Renewed, a global movement to end child deaths from preventable causes, and the accountability framework proposed by the Commission on Information and Accountability for the Global Strategy for Women’s and Children’s Health. This final report presents the results of the indicators and topics covered in both surveys. Monitoring the situation of children and women 3 Survey Objectives The 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS have as their primary objectives:  To provide up-to-date information for assessing the situation of children and women in Serbia;  To generate data for the critical assessment of the progress made in various areas, and to put additional efforts in those areas that require more attention;  To furnish data needed for monitoring progress toward goals established in the Millennium Declaration and other internationally agreed upon goals, as a basis for future action;  To collect disaggregated data for the identification of disparities, to allow for evidence based policy-making aimed at social inclusion of the most vulnerable;  To contribute to the generation of baseline data for the post-2015 agenda;  To validate data from other sources and the results of focused interventions. 4 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 IIII SAMPLE AND SURVEY SAMPLE AND SURVEY METHODOLOGYMETHODOLOGY In 2014, two MICS surveys were carried out in Serbia using two different samples — the 2014 Serbia MICS and the 2014 Serbia Roma Settlements MICS. The 2014 Serbia MICS was carried out based on a national sample representative of the whole population of Serbia. The 2014 Serbia Roma Settlements MICS was carried out based on a Roma settlements sample representative of the population living in Roma settlements in Serbia. Individual samples and their technical characteristics will be described separately in the relevant parts of the report. Elements of the survey methodology that were common for both samples, as well as survey findings will be presented jointly to avoid repetition. Sample Design for the 2014 Serbia MICS The national sample for the 2014 Serbia Multiple Indicator Cluster Survey was designed to provide estimates for a large number of indicators on the situation of children and women at the national level, for urban and other7 areas, and for 4 regions: Belgrade, Vojvodina, Sumadija and Western Serbia, and Southern and Eastern Serbia. The urban and other domains within 25 Areas were identified as the main sampling strata and the sample was selected in two stages. Within each stratum, a specified number of census enumeration areas was selected systematically with probability proportional to size. After a household listing was carried out within the selected enumeration areas, the listed households were divided into households with and without children under 5, and a separate systematic sample of households was selected for each group. At the national level a total of 7351 households were selected: 2921 households with children and 4430 households without children. The 2014 Serbia MICS sample is not self-weighting. For reporting of the national level results, sample weights were used. A more detailed description of the 2014 Serbia MICS sample design can be found in Appendix A. Sample Design for the 2014 Serbia Roma Settlements MICS The sample for the 2014 Serbia Roma Settlements MICS was designed to provide estimates for a large number of indicators on the situation of children and women in Roma settlements, at the Serbia level and for urban and other areas. The urban and other areas within four regions were identified as the main sampling strata and the sample was selected in two stages. Within each stratum, a specified number of enumeration areas were selected systematically with probability proportional to size. After a household listing was carried out within the selected enumeration areas, the listed households were divided into households with and without children under 5, and a separate systematic sample of households was selected for each group. A total of 1976 Roma households were selected: 1187 households with children and 789 households without children. The 2014 Serbia Roma Settlements Multiple Indicator Cluster Survey sample is not self-weighting. For the reporting of the results, sample weights were used. A more detailed description of the sample design can be found in Appendix A. Questionnaires Four sets of questionnaires were used in the survey: 1) a household questionnaire which was used to collect basic demographic information on all de jure household members (usual residents), the household, and the dwelling; 2) a questionnaire for 7 Official statistics in Serbia do not include a specific definition for rural settlements. Instead, an “administrative-legal” criteria is applied that designates settlements as either “Urban” or “Other”. Urban settlements are recognised as such by an act of the local self-government, with all other settlements falling into the category of “Other”. Monitoring the situation of children and women 5 individual women administered in each household to all women age 15-49 years; 3) an under-5 questionnaire, administered to mothers (or caretakers) for all children under 5 living in the household; and 4) a questionnaire for vaccination records at the health facility. The questionnaires included the following modules: The Household Questionnaire included the following modules:  List of Household Members  Education8  Child Labour  Child Discipline  Attitudes Toward Children with Disabilities9  Household Characteristics  Cash Benefit10  Water and Sanitation The Questionnaire for Individual Women was administered to all women age 15-49 years living in the households, and included the following modules:  Woman’s Background  Fertility11  Desire for Last Birth  Maternal and Newborn Health12  Illness Symptoms  Contraception13  Unmet Need  Attitudes Toward Domestic Violence  Marriage/Union  Life Satisfaction The Questionnaire for Children Under Five was administered to mothers (or caretakers) of children under 5 years of age14 living in the households. Normally, the questionnaire was administered to mothers of under-5 children; in cases when the mother was not listed in the household roster, a primary caretaker for the child was identified and interviewed. The questionnaire included the following modules:  Age  Birth Registration  Birth Grant15  Early Childhood Development16  Breastfeeding and Dietary Intake  Immunization  Anthropometry 8 This module included survey-specific questions about age at the start of primary school and attendance in the compulsory preparatory preschool program (PPP). 9 Module Attitudes toward Children with Disabilities is a survey-specific module that includes questions on different attitudes toward children with disabilities. 10 Module Cash Benefit is a survey-specific module that includes questions on key child-related cash benefits in Serbia. 11 This module included survey-specific questions about wasted pregnancies. 12 This module included survey-specific questions about visits conducted at home by auxiliary (patronage) nurses, attendance to childbirth preparation programmes and stay of the child and mother in the same room after birth. 13 This module included survey-specific questions about knowledge of contraceptive methods and the use of methods to delay or avoid pregnancy. 14 The terms “children under 5”, “children age 0-4 years”, and “children age 0-59 months” are used interchangeably in this report. 15 The module Birth Grant is a survey-specific module related to the country-specific cash benefit programme. 16 This module included survey-specific questions on the type of facility in which the child attends an ECE programme, and the reasons for non-attendance. The age group for the MICS question on engagement of adults with children in activities that promote learning and school readiness was broadened from 3-4 years to 1-4 years. 6 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 The questionnaires are based on the MICS5 model questionnaires17. From the English version of the MICS5 model, the questionnaires were customised and translated into Serbian and were pre-tested in Zrenjanin during November 2013. Based on the results of the pre-test, modifications were made to the wording and translation of the questionnaires. A copy of the 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS questionnaires is provided in Appendix F18. In addition to the administration of questionnaires, fieldwork teams visited health facilities to collect immunization records of children age under 3 years and measured the weights and heights of children age under 5 years. Details and findings of these observations and measurements are provided in the respective section of the report. Training and Fieldwork Training for the fieldwork was conducted for 14 days in January 2014 for both surveys. Training included lectures on interviewing techniques and the contents of the questionnaires, and mock interviews between trainees to gain practice in asking questions. Towards the end of the training period, trainees spent 2 days in practice interviewing in Zrenjanin in both urban and other areas. Trainees also practiced measuring the weights and heights of children in 5 kindergartens in Zrenjanin. The data were collected by 11 teams — 8 teams for the general population and 3 teams for Roma settlements; each team was comprised of 4 interviewers, one editor, one measurer and a supervisor (the editor or supervisor was also the driver). Fieldwork began on 1 February 2014 and concluded on 30 April 2014 for the 2014 Serbia MICS and on 15 April 2014 for the 2014 Serbia Roma Settlements MICS. Data Processing Data were entered using CSPro software, Version 5.0. The data entry was carried out by 8 data entry operators using 8 microcomputers, with support of 1 data entry supervisor. For quality assurance purposes, all questionnaires were double- entered and internal consistency checks were performed. Procedures and standard programmes developed under the global MICS programme and adapted to the 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS questionnaires were used throughout. Data processing began simultaneously with data collection in February 2014 and was completed in May 2014 for both surveys. Data were analysed using the Statistical Package for Social Sciences (SPSS) software, Version 21. Model syntax and tabulation plans developed by UNICEF were customized and used for the standard MICS modules while new syntaxes and tabulation plans were developed for non-standard MICS modules and questions. The Report Structure As noted before, this report presents findings from the 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS. Although they are two independent surveys, the decision was made to present findings in a joint report to facilitate the use and comparability of data. Each subchapter starts with a common introduction. After that, there are explanations that refer to the 2014 Serbia MICS and 2014 Serbia Roma Settlements MICS findings, respectively. In order to visually differentiate findings coming from the two surveys, the parts of the report that describe findings from the 2014 Serbia Roma Settlements MICS are shaded in a different colour. 17 The model MICS5 questionnaires can be found at http://www.childinfo.org/mics5_questionnaire.html 18 The same questionnaires were used for both surveys. Monitoring the situation of children and women 7 How to Read the Tables It should be noted that when education is used as a background characteristic in the tables, primary and secondary education levels are defined in line with the national education system classification (eight grades of primary school and four grades of secondary school). The ethnicity background characteristic is presented only in tables with findings from the 2014 MICS Serbia. However, this background characteristic is not presented where data for all ethnic groups apart from one (mostly Serbian) are based on less than 25 unweighted cases. The findings related to the education category “Higher” within the 2014 Serbia Roma Settlements MICS, are mainly based on less than 25 unweighted cases and are therefore too small to be reported separately. As such, the category “Higher” has been combined with the category “Secondary” and presented as “Secondary or higher”. Age groups presented in this report also include those persons who had reached the full age indicated by the upper limit for an age group, for instance, respondents aged 15-49 include persons who had reached a full 49 years of age, while the age group of children aged 20-23 months includes those who had reached a full 23 months. Tables also contain particular marking that is used consistently to indicate the following:  (*) — an asterisk in tables indicate that the percentage or proportion is based on less than 25 unweighted cases and are therefore too small to be reported  (number) — a figure in parenthesis indicates that the percentage or proportion is based on 25 to 49 unweighted cases and should be treated with caution  (R) — the letter R after a table/figure code indicates that it refers to the Roma settlements sample 8 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 IIIIII SAMPLE COVERAGE AND SAMPLE COVERAGE AND THE CHARACTERISTICS THE CHARACTERISTICS OF HOUSEHOLDS AND OF HOUSEHOLDS AND RESPONDENTSRESPONDENTS Sample Coverage and the Characteristics of Households and Respondents for Serbia Sample Coverage Of the 7351 households selected for the sample, 6959 were found to be occupied. Of these, 6191 were successfully interviewed for a household response rate of 89 percent. In the interviewed households, 4997 women (age 15-49 years) were identified. Of these, 4713 were successfully interviewed, yielding a women’s response rate of 94 percent within the interviewed households. There were 2773 children under age five listed in the household questionnaires. Questionnaires were completed for 2720 of these children, which corresponds to a response rate of 98 percent within interviewed households. Overall response rates of 84 and 87 percent were calculated for the completion of the women and children under five questionnaires, respectively (Table HH.1). Table HH.1: Results of household, women’s and under-5 interviews Number of households, women and children under 5 by results of the household, women’s and under-5’s interview results, and household, women’s and under-5’s response rates, Serbia, 2014   Total Area Region Urban Other Belgrade Vojvodina Sumadija and Western Serbia Southern and Eastern Serbia Households  Sampled 7351 4617 2734 1863 1976 1886 1626 Occupied 6959 4329 2630 1700 1888 1809 1562 Interviewed 6191 3702 2489 1317 1701 1704 1469 Household response rate 89.0 85.5 94.6 77.5 90.1 94.2 94.0 Women   Eligible 4997 2967 2030 1070 1311 1403 1213 Interviewed 4713 2831 1882 1025 1241 1336 1111 Women’s response rate 94.3 95.4 92.7 95.8 94.7 95.2 91.6 Women’s overall response rate 83.9 81.6 87.7 74.2 85.3 89.7 86.1 Children under 5  Eligible 2773 1739 1034 662 734 752 625 Mothers/caretakers interviewed 2720 1710 1010 642 726 746 606 Under-5’s response rate 98.1 98.3 97.7 97.0 98.9 99.2 97.0 Under-5’s overall response rate 87.3 84.1 92.4 75.1 89.1 93.4 91.2 Monitoring the situation of children and women 9 Response rates across regions and areas were, as expected, characterised by lower response rates in urban areas (about 86 percent compared with 95 percent in other areas). Response was also lower in the Belgrade region (about 78 percent) and the results for this region should be interpreted with some caution, as the response rate is lower than 85 percent. Characteristics of Households The weighted age and sex distribution of the survey populations are provided in Table HH.2. The distribution is also used to produce the population pyramid in Figure HH.1. In the 6191 households successfully interviewed in the survey, 19212 household members were listed. Of these, 9380 were males, and 9832 were females. Table HH.2: Household age distribution by sex Percent and frequency distribution of the household population by five-years age groups, dependency age groups, and by child (age 0-17 years) and adult populations (age 18 or more), by sex, Serbia, 2014 Total Males Females Number Percent Number Percent Number Percent Total 19212 100.0 9380 100.0 9832 100.0 Age  0-4 897 4.7 459 4.9 438 4.5 5-9 995 5.2 478 5.1 517 5.3 10-14 959 5.0 476 5.1 483 4.9 15-19 1085 5.6 606 6.5 480 4.9 20-24 1111 5.8 569 6.1 542 5.5 25-29 1170 6.1 566 6.0 604 6.1 30-34 1281 6.7 646 6.9 635 6.5 35-39 1335 6.9 668 7.1 667 6.8 40-44 1299 6.8 650 6.9 649 6.6 45-49 1303 6.8 635 6.8 668 6.8 50-54 1349 7.0 647 6.9 701 7.1 55-59 1467 7.6 723 7.7 744 7.6 60-64 1572 8.2 764 8.1 808 8.2 65-69 1080 5.6 509 5.4 571 5.8 70-74 855 4.4 380 4.1 475 4.8 75-79 766 4.0 337 3.6 429 4.4 80-84 421 2.2 182 1.9 239 2.4 85+ 265 1.4 86 0.9 179 1.8 Missing/DK 2 0.0 0 0.0 2 0.0 Dependency age groups  0-14 2851 14.8 1413 15.1 1438 14.6 15-64 12971 67.5 6473 69.0 6499 66.1 65+ 3387 17.6 1494 15.9 1893 19.3 Missing/DK 2 0.0 0 0.0 2 0.0 Child and adult populations  Children age 0-17 years 3471 18.1 1767 18.8 1704 17.3 Adults age 18+ years 15739 81.9 7613 81.2 8127 82.7 Missing/DK 2 0.0 0 0.0 2 0.0 10 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 The age and sex distribution of the 2014 Serbia MICS survey by 5-year-groups is in accordance with demographic data from the 2011 Census. The age distribution indicates negative population growth, with a low proportion of children aged under five and a high proportion of the elderly. The proportion of children age 0-14 years in the overall population is 15 percent and is lower by 3 percentage points than the proportion of the population age 65+ that has a share of 18 percent. Children up to 18 years of age constitute 18 percent of the population. The largest two 5-year groups are 55-59 and 60-64 age-groups (8 percent). The male-female ratio shows some variations and after 60 years of life the number of women exceeds that of men. Figure HH.1: Age and sex distribution of household population, Serbia, 2014 Tables HH.3, HH.4 and HH.5 provide basic information on the households, female respondents age 15-49 years and children under 5. Both unweighted and weighted numbers are presented. Such information is essential for the interpretation of findings presented later in the report and provides background information on the representativeness of the survey sample. The remaining tables in this report are presented only with weighted numbers19. Table HH.3 provides basic background information on the households, including region, area, number of household members as well as sex, education and ethnicity20 of the head of household as shown in the table. These background characteristics are used in subsequent tables in this report; the figures in the table are also intended to show the numbers of observations by major categories of analysis in the report. The weighted and unweighted total number of households are equal, since sample weights were normalized. The gender structure for heads of households is almost the same, when comparing the 2011 Census and 2014 Serbia MICS data. Namely, 30 percent of heads of household in the 2011 Census and 29 percent in the 2014 Serbia MICS, are female. About 62 percent of households are urban, while the rest are other. The regional distribution is very similar to the Census data. The Vojvodina region comprises the largest number of households (29 percent), while the smallest number of households is in Southern and Eastern Serbia (21 percent). 19 See Appendix A: Sample Design, for more details on sample weights. 20 This was determined by asking “To what ethnic group does the head of this household belong?” Please refer to the Household Questionnaire in Appendix F for a detailed view of the questions. 5 4 3 2 1 0 1 2 3 4 5 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 80-84 85+ Percent Age Males Females Note: 2 household members with missing age and/or sex are excluded Monitoring the situation of children and women 11 Table HH.3: Household composition Percent and frequency distribution of households by selected characteristics, Serbia, 2014   Weighted percent Number of households Weighted Unweighted Total 100.0 6191 6191 Sex of household head  Male 71.5 4428 4684 Female 28.5 1763 1507 Region  Belgrade 23.5 1458 1317 Vojvodina 28.8 1785 1701 Sumadija and Western Serbia 26.6 1645 1704 Southern and Eastern Serbia 21.1 1303 1469 Area  Urban 61.6 3816 3702 Other 38.4 2375 2489 Number of household members  1 18.9 1167 850 2 24.2 1497 1100 3 18.9 1167 1175 4 19.0 1175 1325 5 10.4 644 832 6 5.4 333 520 7 1.8 113 220 8 0.7 44 85 9 0.3 20 39 10+ 0.5 30 45 Education of household head  None 2.0 125 108 Primary 26.6 1645 1582 Secondary 48.0 2970 3044 Higher 23.3 1445 1450 Missing/DK 0.1 6 7 Ethnicity of household head  Serbian 86.7 5365 5384 Hungarian 4.7 289 261 Bosnian 1.1 70 86 Roma 1.6 98 129 Other 4.8 294 270 Does not want to declare 1.2 72 58 Missing/DK 0.0 3 3 Mean household size 3.1 6191 6191 The table also shows the weighted average household size in Serbia estimated by the survey which is 3.1 members per household. 2011 Census data shows that the average household size in Serbia was 2.9. There are some differences in the proportion of households with 5 members (10.4 from the survey and 7.9 from the 2011 Census), and 6+ members (8.7 from the survey and 6.7 from the 2011 Census). The majority of households have two to four members (62 percent). 12 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Characteristics of Female Respondents and Children Under 5 Tables HH.4 and HH.5 provide information on the background characteristics of female respondents 15-49 years of age and of children under age 5. In these tables, the total numbers of weighted and unweighted observations are equal, since sample weights have been normalized (standardized)21. In addition to providing useful information on the background characteristics of women and children under age 5, the tables are also intended to show the numbers of observations in each background category. These categories are used in the subsequent tabulations of this report. Table HH.4 provides background characteristics of female respondents 15-49 years old. The table includes information on the distribution of women according to region, area, age, marital/union status, motherhood status, births in last two years, education22, wealth index quintiles23, 24, and ethnicity of the head of household. In the tables where denominators for wealth index quintiles are too small, data are merged into two groups — the poorest 60 percent (bottom three wealth quintiles) and the richest 40 percent (top two wealth quintiles) — in order to allow for the presentation of data by wealth status. Approximately 27 percent of interviewed eligible women live in Sumadija and Western Serbia and a similar percentage lives in Vojvodina (26 percent). The distribution among the Belgrade region and Southern and Eastern Serbia is almost equal, 23 percent. This pattern was expected and similar to the data from the 2011 Census. The proportion of younger women is lower, with 11 percent in the 15-19 years age group. Around 60 percent of all women in this sample are currently married, while 32 percent have never been married. Distribution by motherhood status is similar: 61 percent of women have given birth, compared to 39 percent that have never given birth. The majority of interviewed women have secondary education (55 percent), while the proportion of women with no education is less than 1 percent and with primary education is 10 percent. Those with higher education constitute approximately 34 percent. These data do not correspond to the 2011 Census data due to the different methodology. Unlike the 2011 Census, MICS records the highest level of education ever attended, irrespective of whether that level was completed. As far as wealth index quintiles are concerned, fewer women live in households within the poorest quintile — about 13 percent — while 20 to 23 percent of women live in the households within the remaining wealth quintiles. Background characteristics of children under 5 are presented in Table HH.5. These include the distribution of children by several attributes: sex, region and area, age in months, respondent type, mother’s (or caretaker’s) education, wealth index, and ethnicity. The proportion of male and female children in the under-5 sample is almost the same, 51 and 49 percent respectively. The majority of children under 5 in Serbia live in urban areas (about 63 percent). The proportion of children in Southern and Eastern Serbia is smaller than in other regions (about 19 percent) which is expected due to the concentration of the population in big and more developed cities. The majority of children under 5 (51 percent) have a mother with secondary education. 21 See Appendix A: Sample Design, for more details on sample weights. 22 Throughout this report, unless otherwise stated, “education” refers to highest educational level ever attended by the respondent when it is used as a background characteristic. 23 The wealth index is a composite indicator of wealth. To construct the wealth index, principal components analysis is performed by using information on the ownership of consumer goods, dwelling characteristics, water and sanitation, and other characteristics that are related to the household’s wealth to generate weights (factor scores) for each of the household items used. First, initial factor scores are calculated for the total sample. Then, separate factor scores are calculated for households in urban and other (rural) areas. Finally, the urban and other factor scores are regressed on the initial factor scores to obtain the combined, final factor scores for the total sample. This is carried out to minimize the urban bias in the wealth index values. Each household in the total sample is then assigned a wealth score based on the assets owned by that household and on the final factor scores obtained as described above. The survey household population is then ranked according to the wealth score of the household they are living in, and is finally divided into 5 equal parts (quintiles) from lowest (poorest) to highest (richest). In the 2014 Serbia MICS, the following assets were used in these calculations: source of drinking water; location of water source; type of sanitation facility; sharing of sanitation facilities; number of rooms used for sleeping; main material of dwelling floor, roof and exterior walls; type of household fuel; presence in the household of electricity, a television, radio, non-mobile phone, refrigerator, wardrobe, table with chairs, bed, iron, hair dryer, water heater, vacuum cleaner, freezer, electric stove, personal washing machine, drying machine, dishwashing machine, microwave, Cable TV/total TV, PC/ laptop, Internet connection, air conditioner, presence in the household of a watch, mobile phone, bicycle, motorcycle/scooter, car, truck, tractor; possession of a bank account; ownership of dwelling; land ownership; ownership of livestock: cattle, milk cows or bulls, goats, sheep, chickens, other poultry, pigs and bees; and applying for financial social assistance. The wealth index is assumed to capture the underlying long-term wealth through information on the household assets, and is intended to produce a ranking of households by wealth, from poorest to richest. The wealth index does not provide information on absolute poverty, current income or expenditure levels. The wealth scores calculated are applicable for only the particular data set they are based on. Further information on the construction of the wealth index can be found in Filmer, D. and Pritchett, L., 2001. “Estimating wealth effects without expenditure data — or tears: An application to educational enrolments in states of India”. Demography 38(1): 115-132. Rutstein, S. O. and Johnson, K., 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, Maryland: ORC Macro and Rutstein, S. O., 2008. The DHS Wealth Index: Approaches for Rural and Urban Areas. DHS Working Papers No. 60. Calverton, Maryland: Macro International Inc. 24 When describing survey results by wealth quintiles, appropriate terminology is used when referring to individual household members, such as for instance “women in the richest household population”, which is used interchangeably with “women in the wealthiest survey population” and similar. Monitoring the situation of children and women 13 Table HH.4: Women’s background characteristics Percent and frequency distribution of women age 15-49 years by selected background characteristics, Serbia, 2014   Weighted percent Number of women Weighted Unweighted Total 100.0 4713 4713 Region  Belgrade 23.4 1105 1025 Vojvodina 26.3 1238 1241 Sumadija and Western Serbia 27.4 1293 1336 Southern and Eastern Serbia 22.9 1077 1111 Area  Urban 60.9 2870 2831 Other 39.1 1843 1882 Age  15-19 10.9 515 388 20-24 11.9 562 489 25-29 14.2 667 865 30-34 14.9 704 1065 35-39 16.1 758 813 40-44 15.8 745 570 45-49 16.2 763 523 Marital/Union status  Currently married/in union 60.4 2846 3436 Widowed 1.3 60 45 Divorced 4.3 201 159 Separated 1.8 86 98 Never married/in union 32.3 1520 975 Motherhood and recent births  Never gave birth 38.8 1827 1136 Ever gave birth 61.2 2886 3577 Gave birth in last two years 8.2 384 959 No birth in last two years 53.1 2502 2618 Education  None 0.4 20 32 Primary 10.0 473 521 Secondary 55.2 2604 2572 Higher 34.3 1616 1587 Missing/DK 0.0 0 1 Wealth index quintile  Poorest 12.7 600 662 Second 20.2 954 897 Middle 21.8 1025 1001 Fourth 22.0 1035 995 Richest 23.3 1099 1158 Ethnicity of household head  Serbian 87.6 4131 4107 Hungarian 3.6 172 160 Bosnian 1.7 80 91 Roma 2.2 102 142 Other 3.6 170 167 Does not want to declare 1.2 54 42 Missing/DK 0.1 4 4 14 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Table HH.5: Under-5’s background characteristics Percent and frequency distribution of children under five years of age by selected characteristics, Serbia, 2014   Weighted percent Number of under-5 children Weighted Unweighted Total 100.0 2720 2720 Sex  Male 51.5 1400 1367 Female 48.5 1320 1353 Region  Belgrade 26.9 733 642 Vojvodina 27.7 753 726 Sumadija and Western Serbia 25.9 706 746 Southern and Eastern Serbia 19.4 528 606 Area  Urban 63.3 1722 1710 Other 36.7 998 1010 Age  0-5 months 11.8 321 169 6-11 months 9.0 245 271 12-23 months 18.0 489 524 24-35 months 17.1 465 545 36-47 months 20.0 545 582 48-59 months 24.1 655 629 Respondent to the under-5 questionnaire  Mother 97.3 2645 2679 Other primary caretaker 2.7 75 41 Mother’s educationa  None 1.2 32 32 Primary 11.4 309 285 Secondary 50.7 1380 1405 Higher 36.7 999 998 Wealth index quintile  Poorest 15.1 411 394 Second 15.6 425 457 Middle 19.2 522 544 Fourth 22.4 609 583 Richest 27.7 752 742 Ethnicity of household head  Serbian 84.8 2306 2348 Hungarian 3.0 83 89 Bosnian 2.2 61 67 Roma 3.4 91 98 Other 5.1 138 99 Does not want to declare 1.5 40 18 Missing/DK 0.0 1 1 a In this table and throughout the report, mother’s education refers to educational attainment of mothers as well as caretakers of children under 5, who are the respondents to the under-5 questionnaire if the mother is deceased or is living elsewhere. Monitoring the situation of children and women 15 Housing Characteristics, Asset Ownership, and Wealth Quintiles Tables HH.6, HH.7 and HH.8 provide further details on household level characteristics. Table HH.6 presents characteristics of housing, disaggregated by area and region, distributed by whether the dwelling has electricity, the main materials of the flooring, roof, and exterior walls, as well as the number of rooms used for sleeping. All household in Serbia have electricity. There are no differences by area or by region. The majority of households have a finished floor (99 percent), a finished roof (99 percent) and finished exterior walls (98 percent). There are no differentials by area or region. The mean number of persons per room used for sleeping in Serbia is 1.62 with minimal regional variations. Table HH.6: Housing characteristics Percent distribution of households by selected housing characteristics, according to area of residence and regions, Serbia, 2014   Total Area Region Urban Other Belgrade Vojvodina Sumadija and Western Serbia Southern and Eastern Serbia Electricity  Yes 99.7 99.8 99.4 99.7 99.6 99.6 99.8 No 0.3 0.2 0.6 0.3 0.4 0.4 0.2 Missing/DK 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Flooring  Natural floor 0.4 0.1 1.0 0.1 0.7 0.2 0.7 Rudimentary floor 0.6 0.3 1.1 0.1 0.7 0.8 0.7 Finished floor 99.0 99.6 97.9 99.8 98.6 99.0 98.5 Other 0.0 0.0 0.0 0.0 0.0 0.0 0.1 Missing/DK 0.0 0.0 0.0 0.1 0.0 0.0 0.0 Roof  Natural roofing 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Rudimentary roofing 0.0 0.0 0.1 0.1 0.0 0.0 0.2 Finished roofing 98.8 98.2 99.6 98.9 97.6 99.2 99.6 Other 1.0 1.5 0.4 0.5 2.3 0.8 0.2 Missing/DK 0.1 0.2 0.0 0.5 0.1 0.0 0.0 Exterior walls  Natural walls 0.2 0.0 0.4 0.0 0.0 0.0 0.8 Rudimentary walls 1.3 0.5 2.6 0.4 2.5 0.4 1.8 Finished walls 98.2 99.1 96.8 99.0 97.1 99.5 97.3 Other 0.1 0.1 0.2 0.1 0.4 0.1 0.0 Missing/DK 0.2 0.3 0.0 0.6 0.0 0.1 0.1 Rooms used for sleeping  1 37.1 38.8 34.3 37.2 43.4 36.2 29.3 2 37.4 40.3 32.9 42.0 34.1 35.6 39.3 3 or more 25.4 20.8 32.8 20.7 22.4 28.1 31.4 Missing/DK 0.1 0.1 0.1 0.1 0.1 0.2 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of households 6191 3816 2375 1458 1785 1645 1303 Mean number of persons per room used for sleeping 1.62 1.63 1.59 1.60 1.59 1.64 1.63 16 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 In Table HH.7 households are distributed according to ownership of assets by households and by individual household members. This also includes ownership of a dwelling. Table HH.7: Household and personal assets Percentage of households by ownership of selected household and personal assets, and percent distribution by ownership of dwelling, according to area of residence and regions, Serbia, 2014   Total Area Region Urban Other Belgrade Vojvodina Sumadija and Western Serbia Southern and Eastern Serbia Percentage of households that own a  Radio 77.7 78.4 76.7 80.6 79.8 77.5 71.9 Television 98.6 99.1 97.9 98.9 97.9 99.1 98.8 Non-mobile telephone 88.9 91.2 85.2 92.3 86.7 91.0 85.5 Refrigerator 98.3 99.2 96.8 99.4 98.1 98.6 97.1 Wardrobe 99.1 99.4 98.6 99.5 99.4 98.7 98.8 Table with chairs 99.2 99.3 99.1 99.2 99.6 99.1 99.0 Bed 99.9 99.9 100.0 99.7 100.0 100.0 100.0 Iron 95.7 97.7 92.5 98.6 95.1 95.6 93.4 Hair dryer 89.7 92.9 84.6 95.9 89.1 89.4 83.9 Water heater 94.9 96.8 91.7 97.2 94.5 95.0 92.5 Vacuum cleaner 93.8 96.4 89.6 96.9 92.2 94.7 91.3 Freezer 83.6 78.9 91.2 66.9 89.1 89.1 88.0 Electrical stove 95.3 98.3 90.5 98.4 95.3 93.9 93.5 Washing machine 93.6 96.6 88.8 97.4 93.6 93.2 89.9 Drying machine 7.2 8.2 5.6 6.9 11.0 5.8 3.9 Dishwasher 19.1 23.4 12.2 32.1 14.9 16.7 13.5 Microwave 35.5 39.9 28.5 39.0 40.6 32.0 29.0 Cable/Total TV 61.7 76.2 38.5 83.8 60.7 52.8 49.6 PC/Laptop 63.6 70.4 52.8 72.9 62.6 57.7 62.2 Internet 57.5 66.0 43.8 70.1 57.5 49.6 53.3 Air conditioner 33.4 44.2 16.0 58.9 35.0 20.3 19.3 Percentage of households that own  Agricultural land 41.3 24.8 68.0 20.6 43.7 47.9 53.0 Farm animals/Livestock 26.8 9.4 54.8 9.6 28.7 34.1 34.4 Percentage of households where at least one member owns or has a  Watch 68.9 72.9 62.6 73.0 64.5 72.1 66.5 Mobile telephone 90.7 93.5 86.2 95.0 87.8 90.8 89.7 Bicycle 56.1 53.2 60.7 38.4 79.5 45.5 57.2 Motorcycle or scooter 11.5 9.4 14.9 6.5 15.5 10.3 13.3 Animal-drawn cart 1.1 0.2 2.7 0.4 0.8 1.1 2.5 Car 59.9 59.8 60.1 62.4 53.9 63.7 60.5 Truck 2.2 1.4 3.5 0.8 3.0 2.7 2.1 Tractor 16.2 3.9 35.9 4.2 13.6 22.8 24.7 Bank account 83.0 88.0 74.9 87.1 86.5 79.1 78.4 Ownership of dwelling  Owned by a household member 86.9 84.7 90.4 85.8 86.8 89.5 85.0 Not owned 13.1 15.3 9.6 14.2 13.2 10.5 15.0 Rented 4.3 5.8 1.9 6.4 4.3 4.2 2.1 Other 8.8 9.5 7.8 7.8 8.9 6.4 12.9 Missing/DK 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of households 6191 3816 2375 1458 1785 1645 1303 Monitoring the situation of children and women 17 99 percent of households own a television, a wardrobe, a table with a chair and 100 percent own a bed. Similarly, over 90 percent of households own a refrigerator, an iron, a water heater, a vacuum cleaner, an electrical stove and a washing machine, and 78 percent of households own a radio. There are no notable differences by area and region. Some differences between regions and urban/other areas are observed related to the ownership of a drying machine and a dishwasher. 64 percent of households in Serbia own a PC or a laptop, and 58 percent have access to the Internet. There are differences by area and region related to access to the Internet with higher access observed in urban areas and in the Belgrade region. 41 percent of households own agricultural land and 27 percent own farm animals/livestock. The majority of households (87 percent) inhabit a dwelling owned by a household member and 4 percent of households inhabit dwelling that are rented. In 91 percent of households in Serbia at least one member has a mobile telephone. In 60 percent at least one member owns a car, and in 83 percent at least one member has a bank account. Table HH.8 shows how the household populations in areas and regions are distributed according to household wealth quintiles as well as the household population distribution by sex, education and ethnicity of the head of household. Table HH.8: Wealth quintiles Percent distribution of the household population by wealth index quintiles, according to area of residence, region, and sex, education and ethnicity of household head, Serbia, 2014   Wealth index quintiles Total Number of household membersPoorest Second Middle Fourth Richest Total 20.0 20.0 20.0 20.1 20.0 100.0 19212 Area  Urban 10.0 14.4 20.4 26.7 28.6 100.0 11345 Other 34.5 28.1 19.5 10.5 7.5 100.0 7867 Region  Belgrade 8.7 13.1 18.7 25.6 33.9 100.0 4345 Vojvodina 19.5 21.7 20.2 21.1 17.5 100.0 5113 Sumadija and Western Serbia 22.9 22.1 22.3 16.6 16.0 100.0 5284 Southern and Eastern Serbia 28.1 22.2 18.3 17.6 13.9 100.0 4470 Sex of household head  Male 19.2 19.7 20.1 20.2 20.8 100.0 15150 Female 23.1 20.9 19.5 19.7 16.9 100.0 4062 Education of household head  None 58.5 22.7 4.4 13.3 1.1 100.0 352 Primary 43.4 23.9 16.9 10.7 5.2 100.0 4906 Secondary 14.1 21.6 22.9 22.6 18.8 100.0 9740 Higher 3.2 11.6 18.3 25.4 41.5 100.0 4185 Missing/DK 5.4 0.0 21.2 65.3 8.1 100.0 30 Ethnicity of household head  Serbian 18.2 19.5 20.6 21.0 20.8 100.0 16761 Hungarian 24.6 25.9 18.9 19.3 11.3 100.0 746 Bosnian 39.5 37.2 12.2 4.9 6.1 100.0 290 Roma 74.3 11.2 3.7 6.7 4.1 100.0 426 Other 21.0 24.8 21.1 15.9 17.2 100.0 779 Does not want to declare 7.1 14.4 18.6 15.7 44.2 100.0 201 Missing/DK 0.0 0.0 0.0 0.0 100.0 100.0 8 18 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 The share of the household population living in the poorest wealth quintile is higher in other areas (35 percent) than in urban (10 percent) and is the highest in Southern and Eastern Serbia (28 percent) compared to 9 percent in the Belgrade region. There is a positive correlation between the education of the head of household and the wealth index. The household population where the head of household has no education or has only primary education has the highest share in the poorest wealth quintile (59 and 43 percent respectively). The majority of the household population where the head of household has declared as Roma live in the poorest wealth quintile (74 percent). Monitoring the situation of children and women 19Monitoring the situation of children and women 19 Sample Coverage and the Characteristics of Households and Respondents for Roma Settlements Sample Coverage Of the 1976 households selected for the sample, 1803 were found to be occupied. Of these, 1743 were successfully interviewed for a household response rate of 97 percent. In the interviewed households, 2162 women (age 15-49 years) were identified. Of these, 2081 were successfully interviewed, yielding a response rate of 96 percent within interviewed households. There were 1556 children under age five listed in the household questionnaire. Questionnaires were completed for 1515 of these children, which corresponds to a response rate of 97 percent within interviewed households. Overall response rates of 93 and 94 are calculated for individual interviews of women and under-5’s, respectively (Table HH.1R). Table HH.1R: Results of household, women’s and under-5 interviews Number of households, women and children under 5 by results of the household, women’s and under-5’s interviews, and household, women’s and under-5’s response rates, Serbia Roma Settlements, 2014   Total Area Urban Other Households  Sampled 1976 1277 699 Occupied 1803 1167 636 Interviewed 1743 1134 609 Household response rate 96.7 97.2 95.8 Women  Eligible 2162 1481 681 Interviewed 2081 1424 657 Women’s response rate 96.3 96.2 96.5 Women’s overall response rate 93.1 93.4 92.4 Children under 5  Eligible 1556 1091 465 Mothers/caretakers interviewed 1515 1065 450 Under-5’s response rate 97.4 97.6 96.8 Under-5’s overall response rate 94.1 94.9 92.7 Response rates across areas were, as expected, characterised by similarly high response rates in urban and other areas (97 and 96 percent respectively). A similar pattern exists for women and children under 5. Characteristics of Households The weighted age and sex distribution of the survey populations are provided in Table HH.2R. The distribution is also used to produce the population pyramid in Figure HH.1R. In the 1976 households successfully interviewed in the survey, 8595 household members were listed. Of these, 4286 were males, and 4309 were females. 20 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 201420 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Table HH.2R: Household age distribution by sex Percent and frequency distribution of the household population by five-years age groups, dependency age groups, and by child (age 0-17 years) and adult populations (age 18 or more), by sex, Serbia Roma Settlements, 2014   Total Males Females Number Percent Number Percent Number Percent Total 8595 100.0 4286 100.0 4309 100.0 Age  0-4 1076 12.5 564 13.2 512 11.9 5-9 1011 11.8 466 10.9 545 12.7 10-14 904 10.5 435 10.1 469 10.9 15-19 788 9.2 401 9.4 387 9.0 20-24 752 8.8 371 8.7 381 8.8 25-29 632 7.4 343 8.0 289 6.7 30-34 539 6.3 250 5.8 288 6.7 35-39 539 6.3 266 6.2 273 6.3 40-44 513 6.0 261 6.1 252 5.9 45-49 478 5.6 248 5.8 231 5.4 50-54 397 4.6 210 4.9 187 4.3 55-59 310 3.6 146 3.4 164 3.8 60-64 310 3.6 161 3.8 149 3.4 65-69 161 1.9 70 1.6 91 2.1 70-74 105 1.2 48 1.1 56 1.3 75-79 54 0.6 32 0.7 23 0.5 80-84 13 0.1 9 0.2 4 0.1 85+ 8 0.1 3 0.1 5 0.1 Missing/DK 5 0.1 2 0.1 3 0.1 Dependency age groups  0-14 2991 34.8 1464 34.2 1526 35.4 15-64 5259 61.2 2658 62.0 2601 60.4 65+ 341 4.0 162 3.8 179 4.2 Missing/DK 5 0.1 2 0.1 3 0.1 Child and adult populations  Children age 0-17 years 3460 40.2 1718 40.1 1742 40.4 Adults age 18+ years 5130 59.7 2566 59.9 2564 59.5 Missing/DK 5 0.1 2 0.1 3 0.1 The age distribution of the 2014 Serbia Roma Settlements MICS indicates that the proportion of children under the age of 5 is highest (about 13 percent), and then in each subsequent age group the proportion of the population decreases. Children up to 17 years of age constitute about 40 percent of the population, while only 4 percent belong to the group over 65 years of age. There was almost no difference between the male and female distribution in the broad age groups, i.e. 0-14 years, 15-64 years and 65 years and above. Monitoring the situation of children and women 21Monitoring the situation of children and women 21 Figure HH.1R: Age and sex distribution of household population, Serbia Roma Settlements, 2014 Table HH.3R: Household composition Percent and frequency distribution of households by selected characteristics, Serbia Roma Settlements, 2014   Weighted percent Number of households Weighted Unweighted Total 100.0 1743 1743 Sex of household head  Male 82.4 1437 1439 Female 17.6 306 304 Area  Urban 70.3 1225 1134 Other 29.7 518 609 Number of household members  1 5.4 94 80 2 14.7 256 192 3 11.0 192 172 4 14.7 256 280 5 16.6 289 300 6 14.4 250 281 7 9.8 171 176 8 5.2 90 109 9 3.6 63 64 10+ 4.7 82 89 Education of household head  None 16.2 282 279 Primary 69.4 1209 1228 Secondary or higher 14.4 250 234 Missing/DK 0.1 1 2 Mean household size 4.9 1743 1743 Males Females 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 80-84 85+ Percent Note: 5 household members with missing age and/or sex are excluded 22 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 201422 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Tables HH.3R, HH.4R and HH.5R provide basic information on the households, female respondents aged 15-49 and children under 5. Both unweighted and weighted numbers are presented. Such information is essential for the interpretation of findings presented later in the report and provide background information on the representativeness of the survey sample. The remaining tables in this report are presented only with weighted numbers25. Table HH.3R provides basic background information on the households, including the sex of the head of household, area, and number of household members and education of the head of household as shown in the table. These background characteristics are used in subsequent tables in this report. The figures in the table are also intended to show the numbers of observations by major categories of analysis in the report. The weighted and unweighted total number of households are equal, since sample weights were normalized. The table shows the weighted mean household size estimated by the survey. Gender structure for the heads of households indicates that 82 percent are men. About 70 percent of households are urban, while the rest are other. The majority of households (about 57 percent) have three to six members and about 69 percent of households have a household head with primary education. The survey estimated the average household size at 4.9 persons. Characteristics of Female Respondents and Children Under 5 Tables HH.4R and HH.5R provide information on the background characteristics of the female respondents 15-49 years of age and of children under age 5. In these tables, the total numbers of weighted and unweighted observations are equal, since sample weights have been normalized (standardized)25. In addition to providing useful information on the background characteristics of women and children under age five, the tables are also intended to show the numbers of observations in each background category. These categories are used in the subsequent tabulations of this report. Table HH.4R provides background characteristics of female respondents, age 15-49 years. The table includes information on the distribution of women according to area, age, marital/union status, motherhood status, births in the last two years preceding the survey, education26 and wealth index quintiles27, 28 or wealth index. In the tables where denominators for wealth index quintiles are too small, data are merged into two groups — the poorest 60 percent (bottom three wealth quintiles) and the richest 40 percent (top two wealth quintiles) — in order to allow for the presentation of data by wealth status. 25 See Appendix A: Sample Design, for more details on sample weights. 26 Throughout this report, unless otherwise stated, “education” refers to highest educational level ever attended by the respondent when it is used as a background characteristic. 27 The wealth index is a composite indicator of wealth. To construct the wealth index, principal components analysis is performed by using information on the ownership of consumer goods, dwelling characteristics, water and sanitation, and other characteristics that are related to the household’s wealth, to generate weights (factor scores) for each of the items used. In 2014 Serbia Roma Settlements MICS final factor scores are calculated for the total sample, without separate factor scores for households in urban and other areas. Each household in the total sample is then assigned a wealth score based on the assets owned by that household and on the final factor scores obtained as described above. The survey household population is then ranked according to the wealth score of the household they are living in, and is finally divided into 5 equal parts (quintiles) from lowest (poorest) to highest (richest). In 2014 Serbia Roma Settlements MICS, the following assets were used in these calculations: source of drinking water; location of water source; type of sanitation facility; sharing of sanitation facilities; number of rooms used for sleeping; main material of dwelling floor, roof and exterior walls; type of household fuel; presence in the household of electricity, a television, radio, non-mobile phone, refrigerator, wardrobe, table with chairs, bed, iron, hair dryer, water heater, vacuum cleaner, freezer, electric stove, washing machine, drying machine, dishwashing machine, microwave, Cable TV/total TV, PC/laptop, Internet connection, air conditioner, presence in the household of a watch, mobile phone, bicycle, motorcycle/scooter, car, truck; possession of a bank account; ownership of dwelling; ownership of agricultural land; and applying for financial social assistance. The wealth index is assumed to capture underlying long-term wealth through information on household assets and is intended to produce a ranking of households by wealth, from poorest to richest. The wealth index does not provide information on absolute poverty, current income or expenditure levels. The wealth scores calculated are applicable for only the particular data set they are based on. Further information on the construction of the wealth index can be found in Filmer, D. and Pritchett, L., 2001. “Estimating wealth effects without expenditure data — or tears: An application to educational enrolments in states of India”. Demography 38(1): 115-132. Rutstein, S. O. and Johnson, K., 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, Maryland: ORC Macro and Rutstein, S. O., 2008. The DHS Wealth Index: Approaches for Rural and Urban Areas. DHS Working Papers No. 60. Calverton, Maryland: Macro International Inc. 28 When describing survey results by wealth quintiles, appropriate terminology is used when referring to individual household members, such as for instance “women in the richest household population”, which is used interchangeably with “women in the wealthiest survey population” and similar. Monitoring the situation of children and women 23Monitoring the situation of children and women 23 Table HH.4R: Women’s background characteristics Percent and frequency distribution of women age 15-49 years by selected background characteristics, Serbia Roma Settlements, 2014   Weighted percent Number of women Weighted Unweighted Total 100.0 2081 2081 Area  Urban 74.2 1544 1424 Other 25.8 537 657 Age  15-19 18.3 382 377 20-24 18.1 377 440 25-29 13.7 284 350 30-34 13.8 288 276 35-39 12.9 267 229 40-44 12.2 254 217 45-49 11.0 229 192 Marital/Union status  Currently married/in union 73.7 1533 1573 Widowed 1.5 32 28 Divorced 1.7 36 31 Separated 7.0 145 162 Never married/in union 16.1 335 286 Missing 0.0 0 1 Motherhood and recent births  Never gave birth 21.2 442 375 Ever gave birth 78.8 1639 1706 Gave birth in last two years 19.4 405 567 No birth in last two years 59.3 1234 1139 Education  None 21.0 436 420 Primary 66.4 1381 1428 Secondary or higher 12.6 263 230 Missing/DK 0.1 1 3 Wealth index quintile  Poorest 19.1 397 461 Second 19.3 402 430 Middle 19.4 405 420 Fourth 19.8 413 375 Richest 22.3 464 395 Wealth index  Poorest 60 percent 57.9 1204 1311 Richest 40 percent 42.1 877 770 Approximately 74 percent of interviewed eligible women live in urban areas. Almost 74 percent of all women in this sample are married, while 16 percent have never been married. Distribution by motherhood is similar to marital status: 79 percent of women have given birth. The majority of interviewed women have primary education (66 percent), while the proportion of women with no education is 21 percent. Overall, 13 percent of women age 15-49 have secondary or higher education. As far as wealth index quintiles are concerned, women are almost equally distributed across the first four quintiles (about 19 percent in each quintile), while there is only a slightly higher percentage of women who live in households within the richest quintile (about 22 percent of women). 24 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 201424 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Background characteristics of children under 5 are presented in Table HH.5R. These include the distribution of children by several attributes: sex, area, age in months, mother’s (or caretaker’s) education and wealth index. The proportion of male and female children in the under-5 sample is almost the same, 52 and 48 percent respectively. The majority of children under 5 in Roma settlements live in urban areas (about 75 percent). Age distribution shows that about 18 percent of children are under one year of age, while the remaining one-year categories range between 19 and 21 percent. The majority of children under 5 (68 percent) have a mother with primary education. As for the wealth index quintiles, a higher percentage of children under 5 from Roma settlements live in households within the poorest quintile (29 percent) than in the richest quintile (14 percent). Table HH.5R: Under-5’s background characteristics Percent and frequency distribution of children under five years of age by selected characteristics, Serbia Roma Settlements, 2014   Weighted percent Number of under-5 children Weighted Unweighted Total 100.0 1515 1515 Sex  Male 51.9 787 796 Female 48.1 728 719 Area  Urban 74.9 1135 1065 Other 25.1 380 450 Age  0-5 months 9.6 146 117 6-11 months 8.6 130 147 12-23 months 21.0 318 323 24-35 months 18.5 281 271 36-47 months 21.4 324 328 48-59 months 20.9 316 329 Respondent to the under-5 questionnaire  Mother 96.7 1465 1464 Other primary caretaker 3.3 50 51 Mother’s educationa None 23.8 361 329 Primary 68.1 1031 1069 Secondary or higher 8.1 123 117 Wealth index quintile  Poorest 28.8 436 455 Second 20.9 317 346 Middle 19.8 300 290 Fourth 16.8 254 215 Richest 13.7 208 209 Wealth index  Poorest 60 percent 69.5 1053 1091 Richest 40 percent 30.5 462 424 a In this table and throughout the report, mother’s education refers to educational attainment of mothers as well as caretakers of children under 5, who are the respondents to the under-5 questionnaire if the mother is deceased or is living elsewhere. Monitoring the situation of children and women 25Monitoring the situation of children and women 25 Housing Characteristics, Asset Ownership, and Wealth Quintiles Tables HH.6R, HH.7R and HH.8R provide further details on household level characteristics. Table HH.6R presents characteristics of housing, disaggregated by area and distributed by whether the dwelling has electricity, the main materials of the flooring, roof, and exterior walls, as well as the number of rooms used for sleeping. The majority of households have a finished floor (96 percent) and finished roof (93 percent) without differences by the area of residence. As regards exterior walls, 96 percent of households have finished exterior walls, 97 percent in urban and 93 percent in other areas. The mean number of persons per room used for sleeping in Roma settlements is 2.97. Table HH.6R: Housing characteristics Percent distribution of households by selected housing characteristics, according to area of residence, Serbia Roma Settlements, 2014   Total Area Urban Other Electricity  Yes 89.7 90.7 87.2 No 10.3 9.3 12.8 Missing/DK 0.0 0.0 0.0 Flooring  Natural floor 2.8 2.0 4.8 Rudimentary floor 0.7 0.9 0.2 Finished floor 96.4 97.0 95.0 Other 0.0 0.1 0.0 Missing/DK 0.0 0.0 0.0 Roof  Natural roofing 0.4 0.4 0.3 Rudimentary roofing 2.0 2.2 1.6 Finished roofing 93.3 92.9 94.2 Other 4.0 4.3 3.4 Missing/DK 0.3 0.2 0.5 Exterior walls  Natural walls 0.9 0.6 1.8 Rudimentary walls 2.8 2.0 4.8 Finished walls 95.7 96.9 92.7 Other 0.4 0.4 0.4 Missing/DK 0.2 0.1 0.2 Rooms used for sleeping  1 41.7 37.7 51.0 2 38.0 39.7 34.0 3 or more 19.3 21.5 14.3 Missing/DK 1.0 1.1 0.8 Total 100.0 100.0 100.0 Number of households 1743 1225 518 Mean number of persons per room used for sleeping 2.97 3.00 2.92 26 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 201426 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 In Table HH.7R households in Roma settlements are distributed according to ownership of assets by households and by individual household members. This also includes ownership of a dwelling. Table HH.7R: Household and personal assets Percentage of households by ownership of selected household and personal assets, and percent distribution by ownership of dwelling, according to area of residence, Serbia Roma Settlements, 2014   Total Area Urban Other Percentage of households that own a  Radio 41.0 42.9 36.7 Television 90.3 91.4 87.8 Non-mobile telephone 32.1 34.8 25.7 Refrigerator 75.2 78.3 67.8 Wardrobe 79.9 81.1 76.9 Table with chairs 76.2 74.4 80.4 Bed 95.5 95.1 96.4 Iron 56.6 60.0 48.5 Hair dryer 41.6 45.2 33.0 Water heater 57.0 63.9 40.8 Vacuum cleaner 49.2 55.1 35.4 Freezer 58.7 61.3 52.4 Electrical stove 60.2 67.2 43.4 Washing machine 57.6 63.8 42.9 Drying machine 1.4 1.3 1.7 Dishwasher 1.8 1.8 1.7 Microwave 12.8 15.0 7.5 Cable/Total TV 18.9 21.2 13.6 PC/Laptop 42.1 49.1 25.6 Internet 34.8 42.8 16.0 Air conditioner 6.3 6.9 4.9 Percentage of households that own  Agricultural land 2.6 0.8 6.8 Farm animals/Livestock 9.3 5.2 18.9 Percentage of households where at least one member owns or has a  Watch 32.5 33.6 30.1 Mobile telephone 80.9 80.7 81.3 Bicycle 35.9 35.4 37.2 Motorcycle or scooter 4.3 4.0 4.8 Animal-drawn cart 2.2 1.4 4.0 Car 22.3 22.3 22.5 Truck 2.8 2.3 4.0 Tractor 1.3 1.4 1.3 Bank account 25.7 29.6 16.5 Ownership of dwelling  Owned by a household member 81.1 80.2 83.4 Not owned 18.7 19.7 16.4 Rented 2.9 3.1 2.5 Other 15.8 16.6 13.9 Missing/DK 0.2 0.2 0.2 Total 100.0 100.0 100.0 Number of households 1743 1225 518 Monitoring the situation of children and women 27Monitoring the situation of children and women 27 96 percent of households own a bed and 90 percent own a television. Between 75 and 80 percent of households own a refrigerator, a wardrobe and a table with chairs. About 60 percent of households own an electrical stove and about 58 percent own a freezer and a washing machine, while 32 percent own a non-mobile telephone. About 42 percent of households in Roma settlements own a PC or a laptop, while one-third have access to Internet (35 percent). There are large differences by area: in other areas 26 percent of households own a PC or a laptop and 16 percent have Internet, compared with 49 and 43 percent in urban areas respectively. 3 percent of households from Roma settlements own agricultural land and 9 percent own farm animals/livestock. 81 percent of households inhabit a dwelling owned by a household member and 3 percent of households inhabit a rented dwelling. Table HH.8R shows how the household population is distributed according to household wealth quintiles, by area, sex and education of the household head. 29 percent of the household population from other areas live in the poorest households. There are differences by education of the head of household — 40 percent of the household population whose head of household is without education live in the poorest households. Table HH.8R: Wealth quintiles Percent distribution of the household population by wealth index quintiles, according to area of residence, and the sex and education level of the household head, Serbia Roma Settlements, 2014   Wealth index quintiles Total Number of household membersPoorest Second Middle Fourth Richest Total 20.0 20.1 19.9 20.0 20.0 100.0 8595 Area  Urban 16.9 17.5 21.3 22.4 21.9 100.0 6337 Other 28.7 27.3 16.0 13.4 14.6 100.0 2259 Sex of household head  Male 18.4 20.2 19.5 21.0 20.8 100.0 7249 Female 28.6 19.2 22.2 14.6 15.4 100.0 1347 Education of household head  None 40.4 22.4 18.5 15.3 3.4 100.0 1344 Primary 18.6 21.0 21.2 19.4 19.9 100.0 6070 Secondary or higher 4.2 13.0 15.1 28.4 39.3 100.0 1175 Missing/DK 0.0 0.0 0.0 60.0 40.0 100.0 7 28 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 IVIV CHILD MORTALITY CHILD MORTALITY One of the overarching goals of the Millennium Development Goals (MDGs) is the reduction of infant and under-five mortality. Specifically, the MDGs call for the reduction in under-five mortality by two-thirds between 1990 and 2015. Monitoring progress towards this goal is an important but difficult objective. The infant mortality rate is the probability of dying before the first birthday, while the under-five mortality rate is the probability of dying before the fifth birthday. Even though the fertility module was included in the questionnaires for the 2014 Serbia MICS, there was a deliberate decision not to calculate mortality rates for this survey considering low mortality and fertility rates in general. The data from the module was used for calculation of fertility-related indicators. The mortality indicators were calculated only for the population of children from the Roma settlements in the 2014 Serbia Roma Settlements MICS because there are no data coming from regular statistics for this population group while other estimates indicate that values are higher than the national averages. In the 2014 Serbia Roma Settlements MICS, an indirect method, known as the Brass method29, was used. Robust estimates of the aforementioned indicators are produced by this indirect method, and are comparable with those obtained by applying direct methods. The data used by the indirect methods are: the mean number of children ever born for five-year time-since-first-birth groups of women age 15 to 49 years, and the proportion of these children who are deceased, also for five-year time-since- first-birth groups of women. The technique converts the proportions dead among children of women in each time-since- first-birth group into probabilities of dying by taking into account the approximate length of exposure of children to the risk of dying, assuming a particular model age pattern of mortality. Based on previous information on mortality in Serbia, the East model life table was selected as the most appropriate. To obtain the most recent single estimates of the two indicators, estimates based on the time since first birth group 0-4 are used. The infant mortality rate is estimated at 12.8 per thousand live births, while the probability of dying under age 5 (U5MR) is around 14.4 per thousand live births. The reference period is the first quarter of 2012. Due to the small number of unweighted cases, data by background characteristics in this chapter are not shown. 29 United Nations, 1983. Manual X: Indirect Techniques for Demographic Estimation (United Nations publication, Sales No. E.83.XIII.2). United Nations, 1990a. QFIVE, United Nations Program for Child Mortality Estimation. New York, UN Pop Division. United Nations, 1990b. Step-by-step Guide to the Estimation of Child Mortality. New York, UN. International Union for the Scientific Study of Population, 2013. Tools for Demographic Estimation. Paris, UNFPA. Monitoring the situation of children and women 29 V NUTRITION NUTRITION Low Birth Weight Weight at birth is a good indicator not only of a mother’s health and nutritional status but also the newborn’s chances for survival, growth, long-term health and psychosocial development. Low birth weight (defined as less than 2500 grams) carries a range of grave health risks for children. Babies who were undernourished in the womb face a greatly increased risk of dying during their early days, months and years. Those who survive may have impaired immune function and increased risk of disease; they are likely to remain undernourished, with reduced muscle strength, throughout their lives, and suffer a higher incidence of diabetes and heart disease in later life. Children born with low birth weight also risk a lower IQ and cognitive disabilities, affecting their performance in school and their job opportunities as adults. In the developing world, low birth weight stems primarily from the mother’s poor health and nutrition. Three factors have most impact: the mother’s poor nutritional status before conception, short stature (due mostly to under nutrition and infections during her childhood), and poor nutrition during pregnancy. Inadequate weight gain during pregnancy is particularly important since it accounts for a large proportion of foetal growth retardation. Moreover, diseases such as diarrhoea and malaria, which are common in many developing countries, can significantly impair foetal growth if the mother becomes infected while pregnant. In the industrialized world, cigarette smoking during pregnancy is the leading cause of low birth weight. In developed and developing countries alike, teenagers who give birth when their own bodies have yet to finish growing run a higher risk of bearing low birth weight babies. The percentage of births weighing below 2500 grams is estimated from two items in the questionnaire: the mother’s assessment of the child’s size at birth (i.e., very small, smaller than average, average, larger than average, very large) and the mother’s recall of the child’s weight or the weight as recorded on a health card if the child was weighed at birth.30 Overall, almost all (99 percent) of births in Serbia were weighed at birth and approximately 5 percent of infants are estimated to weigh less than 2500 grams (Table NU.1). The prevalence of low birth weight does not vary much by region or by urban and other area. As for mother’s education, there are 16 percent of infants with low birth weight whose mothers have primary school compared to 4 percent for infants whose mothers have secondary or higher education. 30 For a detailed description of the methodology, see Boerma, J. T., Weinstein, K. I., Rutstein, S. O., and Sommerfelt, A. E., 1996. Data on Birth Weight in Developing Countries: Can Surveys Help? Bulletin of the World Health Organization, 74(2), 209-16 30 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Table NU.1: Low birth weight infants Percentage of last live-born children in the last two years that are estimated to have weighed below 2500 grams at birth and percentage of live births weighed at birth, Serbia, 2014 Percent distribution of births by mother’s assessment of size at birth Total Percentage of live births: Number of last live-born children in the last two years Very small Smaller than average Average Larger than average or very large DK Below 2500 grams1 Weighed at birth2 Total 2.4 7.6 71.9 16.8 1.3 100.0 5.1 98.7 384 Mother’s age at birth  Less than 20 years (1.9) (14.6) (46.4) (37.1) (0.0) 100.0 (6.7) (100.0) 16 20-34 years 2.6 7.0 73.4 15.5 1.5 100.0 5.1 98.5 320 35-49 years 1.9 8.9 70.6 18.5 0.2 100.0 5.0 99.8 48 Birth order  1 1.5 7.7 74.5 16.2 0.1 100.0 4.4 99.9 161 2-3 3.2 7.4 70.2 17.0 2.2 100.0 5.7 97.8 207 4-5 (3.1) (4.3) (71.4) (21.2) (0.0) 100.0 (4.5) (100.0) 14 6+ (*) (*) (*) (*) (*) 100.0 (*) (*) 3 Region  Belgrade 2.0 4.5 76.2 12.1 5.1 100.0 3.9 94.9 91 Vojvodina 0.8 10.8 70.5 17.8 0.0 100.0 4.8 99.8 112 Sumadija and Western Serbia 5.4 4.7 72.8 17.1 0.0 100.0 6.5 100.0 102 Southern and Eastern Serbia 1.4 10.3 67.8 20.3 0.2 100.0 5.1 99.8 78 Area  Urban 1.2 8.2 71.9 16.6 2.1 100.0 4.4 97.9 229 Other 4.3 6.7 71.9 17.1 0.0 100.0 6.2 99.9 155 Mother’s education  None (*) (*) (*) (*) (*) 100.0 (*) (*) 4 Primary 13.7 12.5 52.0 21.7 0.0 100.0 15.6 100.0 41 Secondary 1.5 6.4 75.0 16.9 0.1 100.0 4.0 99.9 194 Higher 0.5 7.2 73.7 15.4 3.2 100.0 3.5 96.8 145 Missing/DK (*) (*) (*) (*) (*) 100.0 (*) (*) 0 Wealth index quintile  Poorest 3.5 8.9 72.9 14.7 0.0 100.0 6.4 99.6 52 Second 8.0 7.3 64.3 20.3 0.0 100.0 9.4 100.0 63 Middle 0.6 9.9 71.4 18.1 0.0 100.0 4.3 100.0 83 Fourth 0.6 9.5 73.8 15.9 0.2 100.0 4.3 99.8 84 Richest 1.5 3.6 75.0 15.3 4.6 100.0 3.1 95.4 102 Ethnicity of household head  Serbian 1.3 6.7 73.0 17.7 1.4 100.0 3.9 98.6 325 Hungarian (0.0) (12.9) (77.7) (9.5) (0.0) 100.0 (4.9) (100.0) 14 Bosnian (0.0) (0.0) (80.7) (19.3) (0.0) 100.0 (0.6) (100.0) 9 Roma (4.8) (22.1) (65.4) (7.7) (0.0) 100.0 (11.8) (98.1) 12 Other (20.6) (13.5) (50.6) (15.3) (0.0) 100.0 (21.5) (100.0) 22 Does not want to declare (*) (*) (*) (*) (*) 100.0 (*) (*) 3 Missing/DK (*) (*) (*) (*) (*) 100.0 - - 0 1 MICS indicator 2.20 — Low-birthweight infants 2 MICS indicator 2.21 — Infants weighed at birth ( ) Figures that are based on 25-49 unweighted cases  (*) Figures that are based on less than 25 unweighted cases “-” denotes 0 unweighted cases in that cell Monitoring the situation of children and women 31Monitoring the situation of children and women 31 Low Birth Weight in Roma Settlements Almost all (99 percent) of births in Roma settlements were weighed at birth and approximately 15 percent of infants are estimated to weigh less than 2500 grams (Table NU.1R). There are no notable variations by background characteristics: area, mother’s education and wealth. Table NU.1R: Low birth weight infants Percentage of last live-born children in the last two years that are estimated to have weighed below 2500 grams at birth and percentage of live births weighed at birth, Serbia Roma Settlements, 2014   Percent distribution of births by mother’s assessment of size at birth Total Percentage of live births Number of last live-born children in the last two years Very small Smaller than average Average Larger than average or very large DK Below 2500 grams1 Weighed at birth2 Total 4.5 9.6 72.6 12.9 0.4 100.0 14.7 98.6 405 Mother’s age at birth  Less than 20 years 1.1 8.5 77.7 12.8 0.0 100.0 11.7 98.7 113 20-34 years 4.3 10.1 73.0 12.0 0.6 100.0 14.7 98.9 271 35-49 years (*) (*) (*) (*) (*) 100.0 (*) (*) 20 Birth order  1 2.4 13.4 70.1 14.1 0.0 100.0 14.6 99.2 105 2-3 3.8 7.6 77.4 10.7 0.5 100.0 13.4 98.9 212 4-5 12.0 5.2 62.6 20.1 0.0 100.0 18.3 98.4 62 6+ (1.1) (21.0) (66.4) (9.7) (1.8) 100.0 (16.5) (93.9) 27 Area  Urban 4.7 9.8 72.5 12.5 0.5 100.0 14.9 99.1 306 Other 3.9 9.0 72.8 14.3 0.0 100.0 13.9 97.2 99 Mother’s education  None 2.1 11.9 77.2 8.2 0.6 100.0 13.8 97.0 80 Primary 5.1 9.3 71.5 14.1 0.0 100.0 14.9 99.3 292 Secondary or higher (5.4) (7.0) (70.3) (14.0) (3.3) 100.0 (14.3) (96.7) 32 Missing/DK (*) (*) (*) (*) (*) 100.0 (*) (*) 0 Wealth index quintile  Poorest 3.3 10.9 76.4 9.0 0.5 100.0 14.3 96.8 104 Second 3.5 6.9 76.2 12.9 0.5 100.0 12.9 98.9 96 Middle 9.1 9.3 67.0 14.7 0.0 100.0 17.7 99.1 85 Fourth 1.2 8.2 82.1 7.5 1.0 100.0 11.9 99.0 52 Richest 4.5 13.3 61.0 21.2 0.0 100.0 15.9 100.0 67 Wealth index   Poorest 60 percent 5.1 9.0 73.5 12.0 0.3 100.0 14.9 98.2 286 Richest 40 percent 3.1 11.1 70.3 15.2 0.4 100.0 14.2 99.6 119 1 MICS indicator 2.20 — Low-birthweight infants 2 MICS indicator 2.21 — Infants weighed at birth ( ) Figures that are based on 25-49 unweighted cases  (*) Figures that are based on less than 25 unweighted cases 32 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 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. Under nutrition is associated with more than half of all child deaths worldwide. Undernourished children are more likely to die from common childhood ailments, and for those who survive, have recurring sicknesses and faltering growth. Three- quarters of children who die from causes related to malnutrition were only mildly or moderately malnourished — showing no outward sign of their vulnerability. The Millennium Development Goal target is to reduce by half the proportion of people who suffer from hunger between 1990 and 2015. A reduction in the prevalence of malnutrition will also assist in the goal to reduce child mortality. In a well-nourished population, there is a reference distribution of height and weight for children under age five. Under- nourishment in a population can be gauged by comparing children to a reference population. The reference population used in this report is based on the WHO growth standards31. Each of the three nutritional status indicators — weight-for- age, height-for-age, and weight-for-height — can be expressed in standard deviation units (z-scores) from the median of the 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 whose height-for-age is 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. Weight-for-height can be used to assess wasting and overweight status. 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 classified as severely wasted. Wasting is usually the result of a recent nutritional deficiency. The indicator of wasting may exhibit significant seasonal shifts associated with changes in the availability of food or disease prevalence. Children whose weight-for-height is more than two standard deviations above the median reference population are classified as moderately or severely overweight. In MICS, weights and heights of all children under 5 years of age were measured using the anthropometric equipment recommended32 by UNICEF. Findings in this section are based on the results of these measurements. Table NU.2 shows percentages of children classified into each of the above described categories, based on the anthropometric measurements that were taken during the fieldwork. Additionally, the table includes mean z-scores for the three key anthropometric indicators. 31 http://www.who.int/childgrowth/standards/technical_report 32 See MICS Supply Procurement Instructions here: http://www.childinfo.org/mics5_planning.html Monitoring the situation of children and women 33 Table NU.2: Nutritional status of children Percentage of children under age 5 by nutritional status according to three anthropometric indices: weight for age, height for age, and weight for height, Serbia, 2014   Weight for age Number of children under age 5 Height for age Number of children under age 5 Weight for height Number of children under age 5 Underweight Mean Z-Score (SD) Stunted Mean Z-Score (SD) Wasted Overweight Mean Z-Score (SD) Percent below Percent below Percent below Percent above – 2 SD1 – 3 SD2 – 2 SD3 – 3 SD4 – 2 SD5 – 3 SD6 + 2 SD7 Total 1.8 0.2 0.6 2353 6.0 2.3 0.4 2337 3.9 1.1 13.9 0.5 2270 Sex  Male 1.8 0.1 0.7 1239 6.8 2.4 0.5 1232 4.2 1.0 15.6 0.6 1185 Female 1.7 0.2 0.5 1114 5.1 2.1 0.3 1105 3.6 1.2 12.0 0.4 1085 Region  Belgrade 1.9 0.1 0.7 489 4.2 2.9 0.9 482 8.1 1.6 13.6 0.4 438 Vojvodina 3.6 0.3 0.4 709 8.8 2.7 0.1 706 2.7 0.4 12.2 0.5 703 Sumadija and Western Serbia 0.5 0.1 0.8 655 5.7 2.4 0.6 652 3.2 1.0 15.8 0.7 637 Southern and Eastern Serbia 0.8 0.0 0.5 499 4.2 0.8 0.3 497 2.8 1.7 14.0 0.4 492 Area  Urban 2.3 0.3 0.6 1450 6.5 2.7 0.5 1440 4.5 1.3 14.3 0.5 1388 Other 0.9 0.0 0.6 903 5.2 1.6 0.3 897 2.9 0.8 13.2 0.6 882 Age  0-5 months 4.6 0.0 -0.2 270 8.8 1.6 -0.1 270 8.3 0.3 5.2 -0.2 270 6-11 months 1.3 0.0 0.5 209 8.9 5.1 0.6 203 6.0 1.5 12.2 0.3 204 12-17 months 0.6 0.0 0.8 196 8.6 3.4 0.3 195 2.6 0.0 17.8 0.9 196 18-23 months 1.4 0.3 1.1 233 7.0 4.3 0.3 230 1.4 1.1 28.0 1.3 231 24-35 months 2.0 0.0 0.8 419 9.6 3.0 0.3 414 2.2 1.6 15.9 0.7 414 36-47 months 1.5 0.2 0.5 458 2.8 1.0 0.4 457 4.8 1.2 12.0 0.4 449 48-59 months 1.2 0.4 0.7 568 2.1 0.8 0.8 568 2.9 1.2 11.3 0.4 506 Mother’s education  None (7.2) (2.5) -(0.5) 28 (31.4) (14.2) -(1.0) 28 (5.2) (0.0) (5.8) (0.1) 28 Primary 4.3 0.2 0.3 295 13.4 2.8 -0.2 296 3.8 0.2 12.7 0.5 292 Secondary 1.4 0.2 0.7 1231 4.3 1.4 0.5 1221 3.5 1.2 14.5 0.5 1193 Higher 1.3 0.1 0.6 799 4.9 3.0 0.6 792 4.5 1.3 13.7 0.5 758 Wealth index quintile  Poorest 4.9 0.4 0.4 376 13.6 3.9 -0.1 376 1.3 0.3 16.4 0.6 373 Second 0.3 0.0 0.8 407 3.6 1.1 0.5 402 2.4 1.1 17.2 0.7 390 Middle 2.5 0.2 0.6 474 7.2 2.6 0.4 470 4.4 1.4 12.8 0.6 460 Fourth 0.8 0.1 0.5 548 3.3 1.5 0.5 544 5.0 0.4 11.7 0.3 515 Richest 1.1 0.2 0.7 548 4.1 2.5 0.7 545 5.2 2.0 12.8 0.5 533 Ethnicity of household head  Serbian 1.1 0.1 0.7 1993 4.4 2.1 0.5 1979 3.9 1.2 14.3 0.5 1918 Hungarian 0.9 0.0 0.2 78 5.7 1.8 0.0 77 5.5 0.0 10.5 0.3 77 Bosnian 1.4 0.0 1.3 61 5.3 1.7 1.1 61 3.4 3.4 27.4 0.9 59 Roma 12.2 0.8 -0.4 84 21.9 8.1 -0.8 83 2.7 0.0 6.3 0.1 81 Other 6.4 0.0 0.1 130 20.2 1.8 -0.2 130 3.2 0.0 8.3 0.3 128 Does not want to declare (*) (*) (*) 7 (*) (*) (*) 7 (*) (*) (*) (*) 7 1 MICS indicator 2.1a and MDG indicator 1.8 — Underweight prevalence (moderate and severe) 2 MICS indicator 2.1b — Underweight prevalence (severe) 3 MICS indicator 2.2a — Stunting prevalence (moderate and severe) 4 MICS indicator 2.2b — Stunting prevalence (severe) 5 MICS indicator 2.3a — Wasting prevalence (moderate and severe) 6 MICS indicator 2.3b — Wasting prevalence (severe) 7 MICS indicator 2.4 — Overweight prevalence ( ) Figures that are based on 25-49 unweighted cases  (*) Figures that are based on less than 25 unweighted cases 34 Serbia Multiple Indicator Cluster Survey 2014 and Serbia Roma Settlements Multiple Indicator Cluster Survey 2014 Children whose full birth date (month and year) were not obtained and children whose measurements are outside a plausible range are excluded from Table NU.2. Children are excluded from one or more of the anthropometric indicators when their weights and heights have not been measured, whichever applicable. For example, if a child has been weighed but his/her height has not been measured, the child is included in underweight calculations, but not in the calculations for stunting and wasting. Percentages of children by age and reasons for exclusion are shown in the data quality Tables DQ.10, DQ.11 and DQ.12 in Appendix D. Overall, 87 percent of children h

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