IRAQMultiple Indicator Cluster survey MICS4

Launch of the Final Report

Baghdad, 12 December 2012

2

MICS Iraq – Overview

Iraq Multiple Indicator Cluster Survey (MICS) in Iraq– MICS1 1996 / MICS2, 2000 / MICS3, 2006 / MICS4, 2011

MICS-4– Implementing partners

• Central Statistics Organization (CSO) • Kurdistan Region Statistics Organization (KRSO).

– Financial support from Iraq Trust Fund and United Nations Children’s Fund (UNICEF).

– Technical support from UNICEF, MoH, MoE, WHO.

3

MICS4 Iraq Phases

Oct. 2009 - Apr. 2010

•Planning•Sample Design•Questionnaires adaptation and translation•Supplies

May 2010 – Nov. 2011

• Training for data processing• Training for data collection• Interviewing• Data processing• Data validation

Nov.2011Jan-Mar.2012

Nov-Apr.2012

•Weighting• Indicators definition• Tabulation• Estimating precision

May 2012 Aug. 2012Oct. 2012

•Preliminary Findings & Final Report•Information products•Further Analysis: Equity, Gov.Prof.

TIME PHASES QUALITY CONTROL

Planning & Design

Data collection & Processing

Analysis

Dissemination

•ICO, RO, HQ and partners•Partners, HQ•ICO, RO•ICO, RO

•ICO, RO•ICO, HQ•ICO, RO *•ICO, RO , HQ•ICO, RO, HQ

•ICO, RO, HQ•ICO, RO, JQ•ICO, HQ•ICO, RO, HQ

•ICO, RO, HQ, partners

4

Planning & DesignSample Design

• New sample frame from Census 2009 available• Sample coverage: all governorates (18), all districts (118)• Estimates with acceptable margin of error at district level, minimum at

governorate level, and high accuracy at urban/rural and national levels• Sample size: 36,580 households; 3,658 clusters, 10 HH/cluster• Interview mother/caretaker of all children U5, and all women 15-49 years

Interviewing• 35,701 households interviewed

• 55,194 women 15-49 years old interviewed• 36,307 children under five (mother/caretaker interviewed)

5

Planning & DesignQuestionnaires

Adaptations of standard questionnaires:• Household assets added to capture particular assets from poorer households, to improve

wealth index validity• FGM/C module added (shortened) / Water chlorine test and coverage of vaccination campaigns

included / Reverse Osmosis option added in Water sources questions

Household Questionnaire

Questionnaire for Individual Women (age 15-49)

Questionnaire for Children under Five

Household Listing FormEducation

Water and SanitationHousehold Characteristics

Child LabourChild DisciplineHandwashingSalt IodizationWater Chlorine

Woman’s BackgroundChild Mortality

Desire for Last Birth Maternal and New-born Health

Illness Symptoms Contraception Unmet Needs

Female Genital Mutilation/CuttingAttitudes Toward Domestic Violence

Marriage/UnionHIV/AIDS

Age Birth Registration

Early Childhood DevelopmentBreastfeedingCare of Illness Immunization

Anthropometry

6

Data Collection & ProcessingTraining

• Data Processing Training, May 2010• Translation of Questionnaires and Manuals, May 2010• Training of Trainers, June 2010• Postponment due to Census implementation• Training of Trainers refresher, January 2011• Updating budgets and Time Table, December 2010 – January 2011

Data collection, entry and cleaning• March 2011 – October 2011 (February 2012 for minor issues)

Validation• Overall data validation: November 2011, Final data validation: July 2012• Analysis: December 2011 – April 2012

Children and Women in Iraq

8

Infant Mortality:

32

U5 Mortality:

37

Mortality

Deaths per 1,000 live births

20

12

5

Iraq Mortality Rates, 2011

9

Mortality

Under-5 Infant Neonatal

32

28

21

37

32

20

38

33

20

Mortality Rates, 2011

Kurdistan Region Iraq Center-South

Dea

ths p

er 1

,000

live

birt

hs

10

Determinants of MortalityM

ale

Fem

ale

Urb

an

Rura

l

Non

e

Prim

ary

Seco

ndar

y+

Sex Residence Mother's Edu-cation

0

15

30

45

Deat

hs p

er 1

,000

live

birt

hs

Mal

e

Fem

ale

Urb

an

Rura

l

Non

e

Prim

ary

Seco

ndar

y+

Sex Residence Mother's Edu-cation

0

15

30

45

Deat

hs p

er 1

,000

live

birt

hs

Infant Mortality Children Under 5 Mortality

Mortality by GovernoratesMortality Rates, 2011

SuleimaniaWasit

BaghdadBasrah

KarbalaNajaf

AnbarSalahaddin

DiyalaBabil

20 25 30 35 40 45 50 55 60

Infant Mortality RateUnder-5 Mortality Rate

12

Nutrition0-

1

2-3

4-5

6-7

8-9

10-1

1

12-1

3

14-1

5

16-1

7

18-1

9

20-2

1

22-2

30%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Breastfeeding, Iraq 2011

Not breastfed

Breastfed and other foods

Breastfed and other milk/ formula

Breastfed and non-milk liquids

Breastfed and plain water only

Exclusively breastfed

Age in months

• A chronic restriction of vertical growth indicated by a low height for age

Stunting

• Acute weight loss indicated by a low weight for heightWasting

Stunting & Wasting Begin Early in Childhood

14

Kurd

istan

Iraq

Cent

er-S

outh

Kurd

istan

Iraq

Cent

er-S

outh

Kurd

istan

Iraq

Cent

er-S

outh

Underweight Stunted Wasted

0

10

20

30

40

7 8 915.4

22.6 23.6

5 7.4 7.7

Undernourishment, 2011

Perc

enta

geNutrition

15

Nutrition

Underweight Stunted Wasted0

5

10

15

20

25

9

23

7

4

10

4

Undernourishment, Iraq 2011

Moderate & Severe Severe only

Perc

ent

SulimaniaBabil

MisanThiqarDuhuk

AlbasrahNainwa

SalahaladinDiala

Anbar

0 5 10 15 20 25 30 35 40

WastedStuntedUnderweight

Undernourishment by Governorate

Kirkuk

Erbil

Dohuk

Ninewa

Diyala

16

Children and Mother’s Health

All vaccinations

Measles/MMR

Polio3Polio2Polio1

DPT3DPT2DPT1

HepB3HepB2HepB1

BCG

0 20 40 60 80 100

50.7

76.7

70.483.2

90.2

65.177.4

85.8

60.280.7

89.1

91.2

Children aged 18-29 months vaccinated by first birthday (by 18 months for Measles/MMR)

Percent

Immunization, vaccines

More than 500,000 children 18-29 months have not received all recommended vaccinations

18

Tetanus Immunization

About 45% (more

than 500,000)

pregnant women are

not protected against

neonatal tetanus

KarbalaSulimaniaAlbasrah

KakukBaghdad

BabilNajaf

MisanQadisya

IRAQKR

DuhukDiala

AlmuthanaNainwa

ThiqarArbil

AnbarSalahaladin

Wasit

0 10 20 30 40 50 60 70 80 90 100

Percentage of women age 15-49 years with a live birth in the last 2 years protected against neonatal tetanus

Percent

Kirkuk

Erbil

Dohuk

Ninewa

Diyala

19

Child Health

Urban

Rural

IRAQ

KR

0 20 40 60 80 100

27

24

26

30

26

27

26

25

Treatment for Children Under 5 who had di-arrhoea

No treatment or drug ORT with continued feeding

Percent

Urban Rural IRAQ KR0%

20%

40%

60%

80%

100%

Children U5 with suspected pneumonia that were treated with antibiotics

Not Treated

Treated

20

Maternal Health

At least 4 times by any provider

At least once by skilled personnel

0 50 100

50

78

Antenatal care coverage, Iraq, 2011

Percent

Institutional deliveries

Skilled attendant at delivery

0 50 100

77

91

Delivery care, Iraq, 2011

Percent

About 250,000 women deliver at home every year

21

Water and Sanitation

22

Water and Sanitation

AlbasrahDuhuk

NajafArbil

KRBaghdad

SulimaniaKakukMisanIRAQ

AnbarKarbala

ThiqarQadisyaNainwa

BabilAlmuthana

WasitSalahaladin

0% 20% 40% 60% 80% 100%

Percentage of household members using improved water sources

Not Im-provedImproved

Urban Rural IRAQ KR0

25

50

75

100 98

77

9197

Percentage of household members us-ing improved sources of drinking water,

Iraq, 2011

Perc

ent

23

Water and Sanitation

Baghdad

Karbala

Qadisy

aWasi

tKak

uk

Almuthan

aDial

aNaja

fBab

il

Nainwa

IRAQ

Salah

aladin

DuhukArbil KR

Misan

Sulim

aniaTh

iqarAnbar

Albasrah

0

20

40

60

80

100Households Levels of Water Chlorine (Parts per million)

More than 1

0.5 - 1

Less than 0.5

Percent of households with no chlorine

Perc

ent

24

Education

25

Education

GPI (primary) GPI (secondary)0.00

0.20

0.40

0.60

0.80

1.00

0.94

0.85

Gender parity index (GPI) in primary and secondary school

Ratio

Every year 365,000 children with Primary school completion age (11 years) do notcomplete Primary education or do not complete it in time

MisanNainwaQadisya

DialaDuhuk

30 40 50 60 70 80 90 100

SecondaryPrimary

Net School Attendance Ratio

Kirkuk

ErbilDohuk

Ninewa

Diyala

26

Education

Poorest Second Middle Fourth Richest Country 0

20

40

60

80

100

36

59

70

82

92

69

Literacy rates, young women age 15-24 years, by wealth quintiles

Perc

ent

27

Iraq

Urb

an

Rura

l

Kurd

istan

Re.

..

Cent

re/S

outh

Mal

e

Fem

ale

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

48.624895481178255.510630579197

33.9065414057338

71.8806432664759

44.441326388383152.4673407602683

44.58780813697

13.737052327809112.7224546261163

15.9057689579255

9.91831146554504

14.4240208309189

18.3766276564797

8.8624556891008

37.638052191012631.7669147946867

50.1876896363407

18.2010452679791

41.13465278069829.1560315832521

46.5497361739292

Education attendance among secondary age children (12-17 years)

Out of school

Attending Primary

Secondary attendance (NAR)

Education

28

Child Protection

29

Child Protection

Urban Rural KR IRAQ0

2

4

6

8

10

12

5

10

2

6

Percentage of children age 5-14 years who are involved in child labour

Perc

ent

Males Females KR IRAQ0

20

40

60

80

100

8177

7079

31 2523

28

Percentage of children age 2-14 years who experience violent discipline, by sex

Any Violent Discipline MethodSevere Physical Punishment

Perc

ent

9,6 million children 2-14 years suffer from any violent discipline method;one third of them (3.3m) suffer from severe physical punishment

30

Protection

None Primary Secondary+

 

 

 

FGM and Education

FGM/C among

women Approval for

FGM/C

Approval0

5

10

15

20

8 5

Perc

ent

1,3 million women 15-49 years suffer from any form of FGM

ErbilSuleimania

KRKakukIRAQ

DuhukSalahaladin

QadisyaNajaf

AlmuthanaBabil

WasitDiala

KarbalaNainwa

BaghdadAnbarThiqarMisan

0 25 50 75 100

5855

4320

82

Prevalence of FGM/C among women 15-49 years in each Governorate

Percent

Kirkuk

Dohuk

Ninewa

Diyala

31

Protection

Urban Rural KR IRAQ

20

40

60

80

100

51

69

30

56

Percentage of women age 15-49 years who be-lieve a husband is justified beating his wife

Perc

ent

32

Thank You.

Thank you