1* 6859(< ,1 85%$1 $5($6 2) %$1*/$'(6+ - unicef
TRANSCRIPT
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
a
©Bangladesh Bureau of Statistics (BBS) and United Nations Children’s Fund (UNICEF) March, 2017
All UNICEF materials are protected by copyright, including text, photographs, images and videotapes.
Permission is required to reproduce any part of this publication. Permission will be freely granted to educational or non-profit organizations. Please contact:
Bangladesh Bureau of Statistics (BBS)Statistics and Informatics Division, Ministry of PlanningGovernment of the People’s Republic of BangladeshDhaka, Bangladeshwww.bbs.gov.bd
Social Policy, Evaluation, Analytics and Research Section (SPEAR)United Nations Children’s Fund (UNICEF)BSL Office Complex1, Minto Road, Dhaka-1000, Bangladesh
Telephone: (880-2) 55668088Email: [email protected]
Child Well-Being Survey 2016 (CWS 2016) was conducted to measure the level of child well-being in urban areas of Bangladesh in terms of nutrition, health, education, protection and access to water and sanitation.
As consequence of rapid urbanization, urban cities are experiencing extreme pressure on housing, growth of slums and pressure on urban services. It is known that one-third of the City Corporations’ population lives in slums, which are areas of dense concentration of people and of conditions that affect health negatively. It is, therefore, of a great concern to know the situation of urban children and their mothers, especially those living in slums. To understand the situation of children and women in urban context Bangladesh Bureau of Statistics (BBS) with support from UNICEF, commissioned this CWS 2016. Associates for Community and Population Research (ACPR) implemented the survey.
Results presented in this report are not expected to change and are considered final unless otherwise mentioned. For electronic copy of the report please go to bbs.gov.bd and unicef.org/Bangladesh.
Suggested citation:Child Well-Being Survey 2016, Final Report.Bangladesh Bureau of Statistics and UNICEF Bangladesh 2016, Dhaka, Bangladesh
ISBN: 978-984-8969-26-7
Cover photo: ©UNICEF/BANA2015/Kiron
Design and Layout: Expressions Ltd
CHILD WELL-BEING SURVEYIN URBAN AREAS OF BANGLADESH
2016Final Report
iii
Su
mm
ary
Tab
le o
f S
urv
ey
Summary Table of Survey Implementation and the Survey PopulationChild Well-Being Survey in Urban Areas of Bangladesh
SURVEY IMPLEMENTATION
Sample frame Population and Housing Census, 2011, and Slum Census 2013
Questionnaires HouseholdWomen (age 15-49)Children under five
Interviewer training January 21 – February 3, 2016 Fieldwork February – April 2016
Survey sample
HouseholdsSampledOccupiedInterviewedResponse rate (Per cent)
20,13419,18718,887
98.4
Children under fiveEligibleMothers/caretakers interviewedResponse rate (Per cent)
7,7367,52197.2
WomenEligible for interviewsInterviewedResponse rate (Per cent)
20, 63219, 632
95.2
Strata/domainsAll urban
City Corporation SlumCity Corporation Non-slumOther Municipalities/Urban areas
19577
SURVEY POPULATION
Average household sizeAll urban
Percentage of population under:All urban
Age 5 Age 18
Percentage of women age 15-49 years with at least one live birth in the last 2 years
All UrbanCity Corporation SlumCity Corporation Non-slumOther Municipalities/Urban
4.3
9.335.6
14.715.713.615.1
Percentage of population with source of livelihood
All UrbanSelf-employmentManufacturing sectorService sectorRemittanceFrom rentOther
Proportion of household having at least one member employed in garment sector
All UrbanCity Corporation SlumCity Corporation Non-SlumOther Municipalities/Urban
38.211.142.36.02.00.3
8.627.29.57.0
HOUSING CHARACTERISTICS HOUSEHOLD OR PERSONAL ASSETS
Percentage of households withElectricityFinished floorFinished roofingFinished walls
Mean number of persons per room used for sleepingAll UrbanCity Corporation SlumCity Corporation Non-slumOther Municipalities/Urban
95.272.799.564.8
2.53.32.72.4
Percentage of households that own A televisionA refrigeratorElectric fan Almirah / WardrobeAgricultural landFarm animals/livestockPercentage of households where at least a member has or owns aWatchMobile phoneBicycleComputer Car or truck
72.245.292.558.432.426.9
42.597.420.711.41.2
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
iv
Summary Table of Findings1
Child Well-Being Survey in Urban Areas of Bangladesh 2016
Serial number Indicators Description
Area
All
Urb
an
City
Cor
pora
tion
Slum
City
Cor
pora
tion
Non
-slu
m
Othe
r Mun
icip
aliti
es/
Urba
n
NUTRITION
1a. Underweight prevalence (Moderate and severe)
Percentage of children under age 5 who fall below minus two standard deviation of the median weight for age (moderate and severe, WHO standard)
20.4 30.8 17.7 20.9
1b. Underweight prevalence (Severe)
Percentage of children under age 5 who fall below minus three standard deviations (severe) of the median weight for age of the WHO standard
4.0 7.9 2.7 4.3
2a. Stunting prevalence (Moderate and severe)
Percentage of children under age 5 who fall below minus two standard deviation of the median height for age (moderate and severe, WHO standard)
26.3 40.4 25.2 25.9
2b. Stunting prevalence (Severe)
Percentage of children under age 5 who fall below minus three standard deviations (severe) of the median height for age of the WHO standard
7.8 15.4 7.3 7.5
3a. Wasting prevalence (Moderate and severe)
Percentage of children under age 5 who fall below minus two standard deviation of the median weight for height (moderate and severe, WHO standard)
9.9 11.6 7.3 11.0
3b. Wasting prevalence (Severe)
Percentage of children under age 5 who fall below minus three standard deviations (severe) of the median weight for height of the WHO standard
2.2 2.1 2.1 2.3
1 See Appendix B for a detailed description of indicators
v
Su
mm
ary
Tab
le o
f Fi
nd
ing
s
Serial number Indicators Description
Area
All
Urb
an
City
Cor
pora
tion
Slum
City
Cor
pora
tion
Non
-slu
m
Othe
r Mun
icip
aliti
es/
Urba
n
4 Overweight prevalence (+2SD)
Percentage of children under age 5 who fall equal or above plus two standard deviation of the median weight for height of the WHO standard
2.7 2.7 4.1 2.1
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
98.2 97.8 97.2 98.7
6 Early initiation of breastfeeding
Percentage of women with a live birth in the last 2 years who put their last new-born to the breast within one hour of birth
63.3 66.9 58.2 65.2
7 Exclusive breastfeeding under 6 months
Percentage of infants under 6 months of age who are exclusively breastfeeding
52.7 62.3 57.5 50.0
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 (plain water & non-milk liquids)
72.5 83.0 72.0 72.1
9 Continued breastfeeding at 1 year
Percentage of children age 12-15 months who received breast milk during the previous day
96.9 92.3 98.7 96.4
10 Continued breastfeeding at 2 years
Percentage of children age 20-23 months who received breast milk during the previous day
87.0 90.7 80.3 89.7
11 Age appropriate breastfeeding
Percentage of children age 0-23 months appropriately fed during the previous day (exclusive breastfeeding 0-5 months, currently breastfeeding and solid/semisolids or soft foods for 6-23 months)
60.3 60.2 59.8 60.5
12 Introduction of solid, semi-solid or soft foods (6-8 months)
Percentage of infants age 6-8 months who received solid, semi-solid or soft foods during the previous day
75.7 75.1 68.1 78.4
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
vi
Serial number Indicators Description
Area
All
Urb
an
City
Cor
pora
tion
Slum
City
Cor
pora
tion
Non
-slu
m
Othe
r Mun
icip
aliti
es/
Urba
n
13 Milk feeding frequency for non-breastfed children (6-23 months)
Milk feeding frequency for non-breastfed children (6-23 months) during the previous day
2.9 2.7 2.5 3.1
14 Minimum meal frequency (6-23 months)
Percentage of children age 6-23 months who received appropriate liquids and solid, semisolids or soft foods the minimum number of times or more during the previous day
72.2 64.5 76.2 71.0
15 Minimum dietary diversity (6-23 months)
Percentage of children age 6-23 months who received from food 4 or more groups among 7 food groups during the previous day
45.1 34.9 51.6 43.0
16 Minimum acceptable diet (6-23 months)
Percentage of children age 6-23 months with minimum dietary diversity and minimum meal frequency (breastfed children) and minimum dietary diversity (excluding milk feeds and minimum meal frequency (Non-breastfed children))
38.0 29.7 44.4 36.0
17 Bottle feeding Percentage of children age 0-23 months who were fed with a bottle during the previous day
21.4 20.6 26.3 19.4
18 Low-birth weight infants Percentage of most recent live births in the last 2 years weighing below 2,500 grams at birth
13.7 15.8 11.1 15.1
19 Infants weighed at birth Percentage of most recent live births in the last 2 years who were weighed at birth
64.6 60.5 78.7 59.0
CHILD HEALTH
1 Neonatal tetanus protection
Percentage of women age 15-49 years with a live birth in the last 2 years who received at least two doses of tetanus toxoid vaccine during last pregnancy; 2 doses the last within prior 3 years; 3 doses the last within prior 5 years; 4 doses the last within prior 10 years; or 5 doses during lifetime
86.8 83.4 83.6 88.3
vii
Su
mm
ary
Tab
le o
f Fi
nd
ing
s
Serial number Indicators Description
Area
All
Urb
an
City
Cor
pora
tion
Slum
City
Cor
pora
tion
Non
-slu
m
Othe
r Mun
icip
aliti
es/
Urba
n
2 Episode of diarrhea Percentage of children under age 5 with diarrhoea in the last 2 weeks who had an episode of diarrhoea
6.1 9.2 5.9 6.0
3 Diarrhea treatment with oral rehydration therapy (ORT) and continued feeding (0-59 months)
Percentage of children under age 5 with diarrhoea in the last 2 weeks who received ORT (ORS packet, pre-packaged ORS fluid, recommended homemade fluid or increased fluids) and continued feeding during the episode of diarrhoea
70.0 60.9 72.8 69.6
4 Children with ARI symptoms
Percentage of children under age 5 with ARI symptoms in the last 2 weeks
7.1 7.5 6.7 7.2
5 Care-seeking for children with ARI symptoms
Percentage of children under age 5 with ARI symptoms in the last 2 weeks for whom advice or treatment was sought from a health facility or provider
81.2 78.5 79.4 82.1
6 Antibiotic treatment for children with ARI symptoms
Percentage of children under age 5 with ARI symptoms in the last 2 weeks who received antibiotics
80.7 76.8 79.2 81.5
7 Use of solid fuels for cooking
Percentage of household members using solid fuels for cooking (wood, charcoal, agricultural crop residue, straw/shrubs/grass, animals dug etc.)
48.6 44.5 15.2 64.3
8 Measles immunization coverage (MR)
Percentage of children age 12-23 months who received the coverage of measles immunization
89.7 76.3 92.6 89.3
9 Full immunization coverage
Percentage of children age 12-23 months who received the coverage of full immunization
88.0 72.1 92.1 87.3
REPRODUCTIVE HEALTH
1 Adolescent birth Percentage of women age 15-19 years who have had a live birth
13.3 29.9 10.4 13.4
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
viii
Serial number Indicators Description
Area
All
Urb
an
City
Cor
pora
tion
Slum
City
Cor
pora
tion
Non
-slu
m
Othe
r Mun
icip
aliti
es/
Urba
n
2 Early childbearing Percentage of women age 20-24 years who have had at least one live birth before age 18 years
22.9 31.9 17.1 24.9
3 Contraceptive prevalence rate
Percentage of currently married women age 15-49 years who are using (or whose partner is using) a modern or traditional contraceptive method
67.3 73.8 66.6 67.2
4 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
7.8 5.9 7.8 7.9
5 Antenatal care coverage: At least once by skilled health personnel
Percentage of women age 15-49 years with a live birth in the last 2 years who received during their last pregnancy at least one check up by skilled health personnel
81.1 67.7 84.1 80.7
6 Antenatal care coverage: At least four times by any provider
Percentage of women age 15-49 years with a live birth in the last 2 years who received during their last pregnancy at least four check up by any provider
45.9 35.8 60.8 40.4
7 Content of antenatal care Percentage of women age 15-49 years with a live birth in the last 2 years who received during their last pregnancy antenatal care with BP measured, Urine and Blood sample taken
62.9 52.2 76.8 57.9
8 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
64.2 55.5 73.4 60.9
ix
Su
mm
ary
Tab
le o
f Fi
nd
ing
s
Serial number Indicators Description
Area
All
Urb
an
City
Cor
pora
tion
Slum
City
Cor
pora
tion
Non
-slu
m
Othe
r Mun
icip
aliti
es/
Urba
n
9 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
62.0 57.1 75.5 56.7
10 Caesarean section Percentage of women age 15-49 years whose most recent live birth in the last 2 years was delivered by caesarean section
39.9 23.9 46.6 38.1
11 Post-partum stay in health facility (12 hour or more)
Percentage of women age 15-49 years who stayed in the health facility for 12 hours or more after the delivery of their most recent live birth in the last 2 years
84.4 70.9 83.3 86.0
12 Post-natal health check for the newborn within 2 days
Percentage of last live births in the last 2 years who received a health check while in facility or at home following delivery, or a post-natal care visit within 2 days after delivery
79.9 64.8 83.9 79.2
13 Post-natal health check for the mother within 2 days
Percentage of women age 15-49 years who received a health check while in facility or at home following delivery, or a post-natal care visit within 2 days after delivery of their most recent live birth in the last 2 years
77.5 61.4 80.3 77.4
WATER AND SANITATION
1 Use of improved drinking water sources
Percentage of household members using improved sources of drinking water
99.2 98.0 99.0 99.3
2 Water treatment Percentage of household members in households using unimproved drinking water who use an appropriate treatment method
39.7 25.9 25.6 51.4
3 Use of improved sanitation
Percentage of household members using improved sanitation facilities which are not shared
57.3 18.9 51.3 62.4
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
x
Serial number Indicators Description
Area
All
Urb
an
City
Cor
pora
tion
Slum
City
Cor
pora
tion
Non
-slu
m
Othe
r Mun
icip
aliti
es/
Urba
n
4 Safe disposal of child’s faces
Percentage of children age 0-2 years whose last stools were disposed off safely
66.2 58.0 81.9 60.2
5 Place for handwashing Percentage of households with a specific place for handwashing
91.9 88.2 92.2 92.0
6 Availability of soap or other cleansing agent
Percentage of households having specific place for handwashing with soap or other cleansing agent
55.4 35.4 67.1 51.1
LITERACY AND EDUCATION
1 Attendance to early childhood education
Percentage of children age 36-59 months who are attending an early childhood education programme
26.2 23.8 30.4 24.2
2 Literacy rate Percentage of women aged 15-24 who are literate
82.6 59.0 83.7 83.8
3 School readiness Percentage of children in first grade of primary school regardless of age who attended pre-school during the previous school year
68.0 56.1 59.1 72.7
4 Net intake rate in primary education
Percentage of children of school-entry age who enter the first grade of primary school
62.2 40.5 66.9 61.5
5 Primary school net attendance ratio (adjusted)
Percentage of children of primary school age currently attending primary or secondary school
85.5 69.4 85.0 86.8
6 Secondary school net attendance ratio (adjusted)
Percentage of children of secondary school age currently attending secondary school or higher
63.1 33.3 62.0 65.3
7 Children reaching last grade of primary
Percentage of children entering the first grade of primary school who eventually reach last grade
94.7 82.6 92.4 96.3
xi
Su
mm
ary
Tab
le o
f Fi
nd
ing
s
Serial number Indicators Description
Area
All
Urb
an
City
Cor
pora
tion
Slum
City
Cor
pora
tion
Non
-slu
m
Othe
r Mun
icip
aliti
es/
Urba
n
8 Primary completion rate Percentage of primary school completion age (age appropriate to final grade of primary school) who were attending the last grade of primary school (excluding repeaters)
87.5 73.1 77.4 92.8
9 Transition rate to secondary school
Percentage 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
97.2 92.5 98.5 96.8
10 Gender parity index (GPI) – Primary Education
Ratio of female to male attending primary school
1.05 1.01 1.05 1.06
11 Gender parity index (GPI) – Secondary Education
Ratio of female to male attending secondary school
1.18 1.14 1.22 1.17
PROTECTION
1 Birth registration Percentage of children under age 5 whose births are reported registered
29.3 32.9 33.2 27.2
2 Violent discipline (1-14 years)
Percentage of children age 1-14 years who experienced psychological aggression or physical punishment during the last one month
82.4 84.9 81.9 82.5
3 Child labour (5-14 years) Percentage of children age 5-11 years who are involved more than 1 hour per week and more than 14 hours for 12-14 years in economic activities and more than 28 hours in household chores for both groups
8.1 14.3 7.0 8.2
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xii
Serial number Indicators Description
Area
All
Urb
an
City
Cor
pora
tion
Slum
City
Cor
pora
tion
Non
-slu
m
Othe
r Mun
icip
aliti
es/
Urba
n
4 Child labour (5-17 years) Percentage of children age 5-11 years who are involved more than 1 hour per week and more than 14 hours for 12-14 years in economic activities and more than 28 hours in household chores for both groups and more than 43 hours for 15-17 years involved in economic activities and household chores
12.5 23.1 12.0 12.6
5 Women 15-49, marrying before age 15
Percentage of women age 15-49 years who were first married or in union before age 15
22.5 28.1 20.0 23.4
6 Women 20-49, marrying before age 18
Percentage of women age 20-49 years who were first married or in union before age 18
59.7 66.4 53.3 62.3
7 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
32.9 34.8 32.9 32.7
8 Polygyny Percentage of young women age 15-49 years who are in a polygynous union
2.8 4.4 2.4 3.0
9 Children’s living with neither biological parent (0-17 yrs)
Percentage of children age 0-17 years living with neither biological parent
4.7 4.4 4.4 4.9
10 Children with one or both parents dead (0-17 yrs)
Percentage of children age 0-17 years with one or both parents dead
4.1 6.2 4.8 3.7
11 Children with at least one parent living abroad (0-17 yrs)
Percentage of children age 0-17 years with at least one parent living abroad
4.9 1.1 3.1 5.9
xiii
Summary Table of Survey Implementation and the Survey Population ...................... iii
Summary Table of Findings ............................................................................................................................. iv
List of Tables ............................................................................................................................................................. xvi
List of Figures ............................................................................................................................................................. xviii
List of Abbreviations .............................................................................................................................................. xx
Messages ........................................................................................................................................................... xxi
Foreword ............................................................................................................................................................. xxiv
Executive Summary ............................................................................................................................................... 1
Chapter 1 Introduction and Methodology ................................................................................. 8
1.1 Background ................................................................................................................................................... 8
1.2 Survey Objectives ................................................................................................................................. 9
1.3 Sample Design .......................................................................................................................................... 9
1.4 Survey Implementation .................................................................................................................. 11
1.4.1 Questionnaires .................................................................................................................... 11
1.4.2 Training, Fieldwork and Data Processing ............................................. 12
1.5 Survey Sample and Response Rates .............................................................................. 12
1.6 Challenges Faced ................................................................................................................................... 14
Chapter 2 Household Population and Housing Characteristics .................................. 16
2.1 Characteristics of Household Population ................................................................... 16
2.1.1 Age and Sex Composition ..................................................................................... 16
2.1.2 Household Composition .......................................................................................... 18
2.2 Background Characteristics of Women and Under Five Children ..... 19
2.3 Housing Characteristics .................................................................................................................. 22
2.4 Household and Personal Assets ........................................................................................... 25
2.5 Socio-Economic Index: Wealth Quintiles ................................................................... 27
2.6 Livelihood Status and Employment in Garments Sector ........................ 28
Chapter 3 Nutritional Status of Children and Infant Feeding ...................................... 32
3.1 Child’s Weight and Size at Birth ........................................................................................... 33
3.2 Nutritional Status of Children .................................................................................................. 35
3.3 Breastfeeding ............................................................................................................................................. 38
3.3.1 Initial Breastfeeding ...................................................................................................... 38
3.3.2 Exclusive and Continued Breastfeeding ................................................ 40
3.3.3 Age-Appropriate Breastfeeding ....................................................................... 42
3.4 Introduction of Solid, Semi-Solid or Soft Food ................................................... 43
TABLE OF CONTENTSTA
BLE
OF C
ONTE
NTS
xiv
3.5 Infant and Young Child Feeding (IYCF) Practices ............................................. 44
3.5.1 Minimum Dietary Diversity ................................................................................... 46
3.5.2 Minimum Meal Frequency .................................................................................... 47
3.5.3 Minimum Acceptable Diet ..................................................................................... 47
3.5.4 Bottle Feeding ...................................................................................................................... 48
Chapter 4 Child Heath ............................................................................................................................ 50
4.1 Childhood Vaccination ..................................................................................................................... 51
4.1.1 Vaccination Coverage ................................................................................................. 51
4.1.2 Differentials in Vaccination Coverage ...................................................... 53
4.2 Neonatal Tetanus Protection .................................................................................................... 54
4.3 Childhood Illness and Treatment ........................................................................................ 56
4.3.1 Childhood Diarrhoea .................................................................................................... 58
4.3.2 Treatment of Childhood Diarrhoea .............................................................. 59
4.3.3 Feeding Practices during Diarrhoea ........................................................... 61
4.3.4 Acute Respiratory Infection (ARI) .................................................................. 63
4.4 Solid Fuel Use ............................................................................................................................................ 67
Chapter 5 Reproductive Health ........................................................................................................ 70
5.1 Fertility Rates .............................................................................................................................................. 71
5.1.1 Age at First Marriage ................................................................................................... 71
5.1.2 Age at First Birth ............................................................................................................... 73
5.2 Early Childbearing and Adolescent Birth Rate ..................................................... 73
5.3 Contraception ............................................................................................................................................. 77
5.4 Unmet Need ................................................................................................................................................. 77
5.5 Antenatal Care ........................................................................................................................................... 80
5.5.1 Antenatal Care Coverage ........................................................................................ 81
5.5.2 Number of Antenatal Care Visits .................................................................... 83
5.5.3 Component of Antenatal Care ........................................................................... 83
5.6 Delivery Care ............................................................................................................................................... 85
5.6.1 Assistance during Delivery ................................................................................... 85
5.6.2 Place of Delivery ................................................................................................................ 88
5.7 Postnatal Care ............................................................................................................................................ 88
5.7.1 Postpartum Stay in Health Facility ............................................................... 88
5.7.2 Postnatal Checkup for Newborn ..................................................................... 90
5.7.3 Postnatal Checkup for Mothers ........................................................................ 94
5.7.4 Postnatal Health Checks for Mothers and Newborns ............. 98
Chapter 6 Water and Sanitation ...................................................................................................... 100
6.1 Use of Improved Water Sources .......................................................................................... 100
6.2 Use of Improved Sanitation ....................................................................................................... 104
6.3 Disposal of Child’s Faeces ........................................................................................................... 108
6.4 Handwashing Practices ................................................................................................................... 110TABL
E O
F CO
NTE
NTS
xv
Chapter 7 Child Development, Literacy and Education ................................................... 114
7.1 Attendance in Early Childhood Education ................................................................ 115
7.2 Literacy among Young Women ............................................................................................ 117
7.3 School Readiness .................................................................................................................................. 118
7.4 Primary and Secondary School Participation ....................................................... 119
7.4.1 Net Intake Rate in Primary School ................................................................ 119
7.4.2 Primary School Net Attendance Ratio ..................................................... 120
7.4.3 Secondary School Net Attendance Ratio ............................................. 122
7.4.4 Children Reaching the Last Grade of Primary School ........... 124
7.4.5 Primary School Completion and Transition to Secondary School ....... 126
7.4.6 Education Gender Parity .......................................................................................... 127
7.4.7 Out of School Gender Parity ............................................................................... 129
Chapter 8 Child Protection .................................................................................................................. 132
8.1 Birth Registration ................................................................................................................................... 133
8.2 Child Discipline ......................................................................................................................................... 135
8.3 Attitude towards Physical Punishment ......................................................................... 136
8.4 Child Labour ................................................................................................................................................ 138
8.4.1 Children’s Involvement in Economic Activities ............................. 139
8.4.2 Children’s Involvement in Household Chores ................................ 141
8.4.3 Total Child Labour ........................................................................................................... 142
8.5 Early Marriage and Polygamy ................................................................................................. 145
8.6 Child’s Living Arrangement and Orphanhood ..................................................... 149
References ................................................................................................................................... 152
Appendix ........................................................................................................................................................ xxv
Appendix A Sample Design and Estimates of Sampling Errors ......................................... xxvi
Appendix B CWS 2016 Indicators: Numerators and Denominators .............................. xli
Appendix C Questionnaires .......................................................................................................................................... xlv
TABL
E O
F CO
NTE
NTS
xvi
LIST OF TABLESLI
ST
OF
TA
BLE
S Table 1.1 Sample size ........................................................................................................................................................... 10
Table 1.2 Results of household, women’s, and under-5 interviews ................................ 13
Table 1.2a Results of household, women’s, and under-5 interviews by survey areas ...... 14
Table 2.1 Age distribution of household population by sex .................................................... 17
Table 2.2 Household composition .......................................................................................................................... 19
Table 2.3 Background characteristics of women ................................................................................... 20
Table 2.4 Under-5’s background characteristics .................................................................................... 21
Table 2.5 Housing characteristics ........................................................................................................................... 23
Table 2.5a Housing characteristics by CC slum and CC non-slum areas ...................... 24
Table 2.6 Household and personal assets ..................................................................................................... 25
Table 2.6a Housing and personal assets by slum and CC non-slum areas ................ 26
Table 2.7 Socio Economic Status Index (SES): Wealth Quintile .......................................... 28
Table 2.8 Livelihood status ............................................................................................................................................. 29
Table 3.1 Low birth weight infants ........................................................................................................................ 34
Table 3.2 Nutritional status of children ............................................................................................................ 36
Table 3.3 Initial breastfeeding ..................................................................................................................................... 39
Table 3.4 Exclusive and continued breastfeeding ................................................................................ 41
Table 3.5 Age-appropriate breastfeeding ...................................................................................................... 42
Table 3.6 Introduction of solid, semi-solid, or soft foods ............................................................ 43
Table 3.7 Infant and young child feeding (IYCF) practices ......................................................... 45
Table 3.8 Bottle feeding ...................................................................................................................................................... 48
Table 4.1 Vaccinations in the first years of life ........................................................................................ 52
Table 4.2 Vaccination by background characteristics ...................................................................... 53
Table 4.3 Neonatal Tetanus protection ............................................................................................................. 55
Table 4.4 Reported disease episodes ................................................................................................................. 57
Table 4.5 Treatment/care- seeking for diarrhea ...................................................................................... 58
Table 4.6 Feeding practices during diarrhoea .......................................................................................... 59
Table 4.7 Oral rehydration solutions, recommended homemade fluids, and zinc ............ 61
Table 4.8 Oral rehydration therapy with continued feeding and other treatments ........... 63
Table 4.9 Care-seeking for ARI ................................................................................................................................... 65
Table 4.10 Care seeking for ARI/ suspected pneumonia and antibiotic use during suspected pneumonia (ARI) ........................................................................................... 66
Table 4.11 Solid fuel use ....................................................................................................................................................... 67
Table 4.12 Solid fuel use by place of cooking .............................................................................................. 68
Table 5.1 Age at first marriage and age at first child birth ......................................................... 71
Table 5.2 Early childbearing .......................................................................................................................................... 72
Table 5.3 Trends in early childbearing .............................................................................................................. 75
Table 5.4 Use of contraception .................................................................................................................................. 76
xvii
LIS
T
OF
T
AB
LESLIST OF TABLES Table 5.5 Unmet need for contraception ........................................................................................................ 78
Table 5.6 Antenatal care coverage ......................................................................................................................... 80
Table 5.7 Number of antenatal care visits and timing of first visit ................................... 81
Table 5.8 Content of antenatal care ...................................................................................................................... 84
Table 5.9 Assistance during delivery and caesarian section ................................................... 85
Table 5.10 Place of delivery ............................................................................................................................................... 87
Table 5.11 Post-partum stay in health facility .............................................................................................. 89
Table 5.12 Post-natal health checks for newborns ................................................................................. 91
Table 5.13 Post-natal care visits for newborns within one week of birth ..................... 93
Table 5.14 Post-natal health checks for mothers ...................................................................................... 94
Table 5.15 Post-natal care visits for mothers within one week of birth .......................... 96
Table 5.16 Post-natal health checks for mothers and newborns ............................................ 97
Table 6.1 Use of improved water sources ..................................................................................................... 101
Table 6.2 Household water treatment ................................................................................................................ 103
Table 6.3 Types of sanitation facilities .............................................................................................................. 104
Table 6.4 Use and sharing of sanitation facilities ................................................................................. 105
Table 6.5 Drinking water and sanitation ladders ................................................................................... 106
Table 6.6 Disposal of child’s faeces ...................................................................................................................... 109
Table 6.7 Water and soap at place for handwashing ....................................................................... 111
Table 6.8 Availability of soap or other cleansing agent ................................................................ 112
Table 7.1 Attendance to Early Childhood Education ......................................................................... 116
Table 7.2 Literacy rate among young women .......................................................................................... 117
Table 7.3 School readiness ............................................................................................................................................. 118
Table 7.4 Net intake rate in primary education ....................................................................................... 120
Table 7.5 Primary school attendance and out of school children ...................................... 121
Table 7.6 Secondary school attendance and out of school children .............................. 122
Table 7.7 Children reaching last grade of primary school .......................................................... 125
Table 7.8 Primary school completion and transition to secondary school ............. 127
Table 7.9 Education gender parity ......................................................................................................................... 128
Table 7.10 Out of school gender parity ................................................................................................................ 129
Table 8.1 Birth registration ............................................................................................................................................. 133
Table 8.2 Child discipline .................................................................................................................................................. 135
Table 8.3 Attitudes toward physical punishment ................................................................................. 137
Table 8.4 Children’s involvement in economic activities ............................................................. 140
Table 8.5 Children’s involvement in household chores ................................................................ 141
Table 8.6 Child labour (5-17 years) ........................................................................................................................ 142
Table 8.6a Child labour (5-14 years) ........................................................................................................................ 144
Table 8.7 Early marriage and polygyny (women) ................................................................................ 145
Table 8.8 Trends in early marriage (women) ............................................................................................. 148
Table 8.9 Children’s living arrangements and orphanhood ..................................................... 149
Table 8.10 Children with parents living abroad ......................................................................................... 150
xviii
Figure 2.1 Age distribution of household population, CWS 2016 ........................................ 18
Figure 2.2 Socio-economic status by areas, CWS 2016 ................................................................... 27
Figure 2.3 Proportion of households with one or more members employed in Garments Sector by divisions, CWS 2016 .................................................................. 30
Figure 3.1 Nutritional status by areas, CWS 2016 .................................................................................. 37
Figure 3.2 Underweight, stunted, wasted and overweight children under age 5 (moderate and severe), Bangladesh, CWS 2016 ....................................... 37
Figure 3.3 Initiation of breasfeeding within one day of birth by areas, CWS 2016 .............. 39
Figure 3.4 Percentage fed according to minimum standard of acceptable feeding practices, CWS 2016 ............................................................................................................. 46
Figure 3.5 IYCF Indicators on breastfeeding status, CWS 2016 .............................................. 47
Figure 4.1 Full vaccination coverage by areas, CWS 2016 ........................................................... 52
Figure 4.2 Vaccination coverage by division, CWS 2016 ................................................................ 53
Figure 4.3 Percentage of women age 15-49 years with a live birth in the last 2 years protected against tetanus by background characteristics, CWS 2016 .................. 56
Figure 4.4 Percentage of children under 5 with diarrhoea who received oral rehydration therapy (ORT) and continued feeding, CWS 2016 ................. 63
Figure 5.1 Trend in early childbearing before age 18, CWS 2016 ........................................ 74
Figure 5.2 Women age 15-49 years currently married with unmet need for contraception by age, CWS 2016 ................................................................................................. 79
Figure 5.3 ANC by skilled provider by areas, CWS 2016 ................................................................ 82
Figure 5.4 ANC received 4 or more visits by areas, CWS 2016 ............................................... 83
Figure 5.5 Person assisted at delivery, CWS 2016 ................................................................................. 86
Figure 5.6 Place of delivery by areas, CWS 2016 ..................................................................................... 88
Figure 5.7 Post natal health checks for the newborn by areas, CWS 2016 ................ 90
Figure 5.8 Post natal checks for the mother by areas, CWS 2016 ........................................ 95
LIST OF FIGURESLI
ST
OF
FIG
UR
ES
xix
Figure 6.1 Percentage of using improve source of drinking water by areas, CWS 2016 ........ 102
Figure 6.2 Water treatment method used in the household, CWS 2016 ...................... 102
Figure 6.3 Percentage of users of improved sanitation facilities (not shared) by areas, CWS 2016 ................................................................................................. 105
Figure 6.4 Use of improved drinking water sources and improved sanitation by division, CWS 2016 .............................................................................................................................. 108
Figure 6.5 Percentage of children whose last stools were disposed of safely by areas, CWS 2016 ........................................................................................................... 108
Figure 6.6 Percentage of households with a specific place for handwashing where water and soap or other cleansing agent are present, CWS 2016 .......... 110
Figure 7.1 Percentage of children age 36-59 months attending early childhood education, CWS 2016 ................................................................................................................................. 115
Figure 7.2 School readiness by areas, CWS 2016 ................................................................................... 118
Figure 7.3 Primary and Secondary School Net Attendance Ratio (adjusted) by areas, CWS 2016 ....................................................................................... 124
Figure 7.4 Primary school completion and transition to secondary school by areas, CWS 2016 ................................................................................................................. 126
Figure 7.5 Out of School Gender Parity by areas, CWS 2016 .................................................... 129
Figure 8.1 Percentage of children under age five whose births are registered, CWS 2016 ..... 134
Figure 8.2 Percentage of child disciplining methods by areas, CWS 2016 ................ 136
Figure 8.3 Percentage of respondents to the child discipline module who believe that physical punishment is needed by division, CWS 2016 ...................... 137
Figure 8.4 Percentage engaged in child labour by areas, CWS 2016 ............................... 144
Figure 8.5 Early marriage before age 15 among women age 15-49, and 15-19 by areas, CWS 2016 .................................................................................................................... 147
Figure 8.6 Early marriage before age 18 among women age 20-49 by areas, CWS 2016 ........ 147
Figure 8.7 Trend in early marriage (before age 18) by age group, CWS 2016 ....... 148
LIST OF FIGURESLI
ST
OF
FIG
UR
ES
xx
ACPR Associates for Community and Population Research
AIDS Acquired Immune Deficiency Syndrome
ANC Antenatal Care
ARI Acute Respiratory Infection
BBS Bangladesh Bureau of Statistics
BCG Bacille Calmetto-Guerin
BDHS Bangladesh Demographic and Health Survey
CC City Corporation
CPR Contraceptive Prevalence Rate
CSPro Census and Survey Processing System
CWS Child Well-being Survey
DPT Diphtheria, Pertussis, and Tetanus Vaccine
ECE Early Childhood Education
ECCE Early Childhood Care and Education
EPI Expanded Program on Immunization
FP Family Planning
GPI Gender Parity Index
HIV Human Immunodeficiency Virus
HPNSDP Health, Population and Nutrition Sector Development Programme
IUD Intrauterine Device
IYCF Infant and Young Child Feeding
LAM Lactational Amenorrhea Method
MDG Millennium Development Goals
MICS Multiple Indicator Cluster Survey
MR Measles-Rubella
MSD Measles Second Dose
NAR Net Attendance Ratio
OPV Oral Polio Vaccine
ORS Oral Rehydration Salt
ORT Oral Rehydration Therapy
PNC Postnatal Care
PSCR Primary School Completion Rate
PSU Primary Sampling Unit
SPSS Statistical Package for Social Sciences
TT Tetanus Toxoid
UHC Bangladesh Urban Health Survey
UNAIDS United Nations Programme on HIV/AIDS
UNDP United Nations Development Programme
UNFPA United Nations Population Fund
UNICEF United Nations Children’s Fund
WHO World Health Organization
LIST OF ABBREVIATIONSLIS
T OF
ABB
REVI
ATIO
NS
xxi
LIST OF ABBREVIATIONS
It is my pleasure to compliment the Bangladesh Bureau of Statistics (BBS) on issuing the results of the Child Well-being Survey in Urban areas of the country conducted during 2016. I am particularly pleased that the Key findings of this survey was published within the same calendar year of undertaking the field work under the guidance of BBS with UNICEF support.
The survey report provides detailed information and analysis on the situation of children and women of Bangladesh in relation to indicators on health, nutrition, water and sanitation, education and child protection in the urban settings. The report also includes evidence on a wide range of other issues concerning the Well-being of children and women in urban areas in general and in the slum and non-slum areas within the City Corporations of the country.
Therefore, I hope that policy-makers, planners, researchers, development partners and NGOs from all sectors will use the findings to inform the formulation of appropriate strategies for their programmes. The findings of the survey will also contribute to provide baseline information for reporting and monitoring the Sustainable Development Goals (SDGs) of Bangladesh.
I would like to congratulate officials of the Statistice and informatics Division (SID) and BBS on the completion of this important report. My sincere thanks goes to UNICEF Bangladesh for their continuous support at all stages of conducting the survey and publishing the report.
Dhaka, June 2017 AHM Mustafa Kamal, FCA, MP
MESSAGE
ME
SS
AG
E
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxi
MinisterGovernment of the People’s Republic
of BangladeshMinister of Planning
Where you have a dream
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxii
I would like to congratulate the Bangladesh Bureau of Statistics for leading the implementation of the Child Well-being Survey in urban areas of the country (CWS-U 2016), with the support of UNICEF. CWS-U 2016 covers the entire urban area of the country and provides estimates at the national, divisional levels with disaggregation for slum and non-slum areas within the City Corporations of the country.
The report presents the situation of children in Bangladesh in urban settings based on 72 indicators and its findings will provide useful information for setting the baseline for many important indicators for the Sustainable Development Goals (SDGs) and help its monitoring.
The present report is yet another example of the commendable and continued cooperation between BBS and UNICEF since 1994. I thank UNICEF for extending its support to conducting this survey to generate important evidence. I also thank Associates for Communities and Population Research (ACPR), a well-known national survey research agency, for their support in this activity.
My sincere thanks to the Secretary, Statistics and Informatics Division, Ministry of Planning for giving his valuable strategic support and guidance for publishing the report.
I would like to extend my sincere thanks to the Director General of BBS, Project Focal Point of the Monitoring the Situation of Children and Women Project together with the team of BBS officials for issuing this report.
Dhaka, June 2017 M. A. Mannan MP
ME
SS
AG
EMESSAGE
State MinisterMinistry of Finance
andMinistry of Planning
Government of the People’s Republic of Bangladesh
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxiii
The Bangladesh Bureau of Statistics (BBS) has recently completed the report on the Child Well-being Survey in urban areas of Bangladesh (CWS-U 2016) to provide information on the situation of children and women in the urban settings of the country. The fieldwork for the survey was undertaken during February – April 2016. It involved the collection of information on 72 indicators related to children and women in the urban areas. The report provides baseline estimates for many of the SDG indicators and will be helpful in their monitoring and reporting.
I would like to thank Director General, Bangladesh Bureau of Statistics for taking the lead in this important evidence generation and successfully and publishing the report. The survey also makes special efforts in providing disaggregated estimates for children and women living in slums and non-slum areas of City Corporations in the country. I would like to congratulate BBS on successfully accomplishing this task by the officials associated with Monitoring the Situation of Children and Women (MSCW) Project. I take this opportunity all to thank the Project Focal Point officer and the entire team for providing guidance in undertaking the survey and preparation of the report.
In conclusion, I believe the results of Bangladesh CWS-U 2016 will be useful to policy-makers, researchers, planners and programme implementation managers in understanding and formulating strategies to improve the lives of the children and women in urban areas of Bangladesh.
Dhaka, June 2017 K M Mozammel Hoq
ME
SS
AG
E MESSAGE
SecretaryStatistics and Informatics Division (SID)
Ministry of PlanningGovernment of the People’s Republic
of Bangladesh
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxiv
We are very pleased that the Bangladesh Bureau of Statistics (BBS) through a longstanding partnership with the UNICEF has successfully lead the completion of the Child Well-being Survey in Urban areas of the country (CWS-U 2016) for which data collection was undertaken during 2016. The survey was conducted with the objective of generating information on the situation of children and women in the urban areas of the country for effective use by planners, policymakers, researchers and programme implementers at the rntional, regional and global levels.
The CWS-U 2016 focused on indicators related to child nutrition and breastfeeding, child health, reproductive health, access to improved drinking water and improved sanitation, child development, literacy and education and child protection. It provides estimates at national level with disaggregated data by division, slum and non-slum areas within the city corporatons and other municipalities within the division. Disaggregated estmates are also available by sex, age, education and wealth quintile.
CWS, 2016, inform a wide range of Sustainable Development Goal (SDG) indiators and provides a robust baseline estimate for the SDGs in the urban settings. Among SDG indicators covered in this report most important are nutritional status of children, improved sanitation, handwashing facility at households, skilled attendant at birth, school attendance ratio for girls, birth registration and early marriage.
The field work, data analysis and report writing was undertaken by the Associates for Communities and Population Research (ACPR), a well-known survey research agency, commissioned by the BBS and UNICEF.
We would like to express our sincere thanks to the Secretary of the Statistics and Informatics Division, Ministry of Planning for providing guidance and valuable support for completing this technical report within a very short time, while the Key Results for the survey were published within the same calendar year as of the data collection for the survey.
Furthermore, we express our sincere appreciation to all officials of BBS associated with the Monitoring the Situation of Children and Women (MSCW) project under the able leadership of Mr. Ashraful Haque, Joint Director and the Focal Point for this project, for their valuable guidance in completing the survey and preparing this report. Dr. M. Sekander Hayat Khan, Mr. A.P.M. Shafiur Rahman and Ms. Tauhida Nasrin from ACPR, deserve special mention for completing the data collection, analysis and drafting of the report.
Mr. Carlos Acosta, Chief of Social Policy, Evaluation, Analytics and Research, Mr. Shantanu Gupta, Statistics and Monitoring Specialist, Mr. Mashiur Rahman Khan, Statistics and Monitoring Officer, all of UNICEF Bangladesh, provided valuable support at all stages of the survey. Prof. Muhammad Shuaib, Institute of Statistical Research and Training (ISRT), University of Dhaka, supported development of the sampling design for the survey.
We hope that the report will prove useful to policy makers, planners, researchers, development partners and NGOs in formulating programmes and strategies for the urban areas of the country and help in determining the baseline estimates for the SDGs progress report of Bangladesh.
Edouard Beigbeder Md. Amir Hossain Representative (Additional Secretary) UNICEF Bangladesh Director General Bangladesh Bureau of Statistics (BBS)
FOREWORD
FO
RE
WO
RD
1
EXECUTIVE SUMMARY
The Child Well-being Survey in urban areas of Bangladesh, 2016 (CWS 2016) was conducted to understand the situation of children and women in urban context of Bangladesh. The survey measured the level of child well-being in urban areas of Bangladesh in terms of nutrition, health, education, protection and access to water and sanitation.
The Child Well-being Survey 2016 covered entire urban population of Bangladesh. It was based on representative samples of households drawn independently from 19 strata or domains viz., (i) City Corporation Non-Slum, City Corporation CC slum, and Other Municipalities/Urban areas (or Other urban areas) in 5 divisions of Chittagong, Dhaka, Khulna, Rajshahi and Rangpur; and (ii) City Corporations and Other Municipalities/Urban areas in the remaining two divisions – Barisal and Sylhet, since the proportion of CC slum population in urban areas of these two divisions was very low. Sample was drawn from 700 CC non-slum and 220 CC slum Primary Sampling Units (PSUs). A PSU was a Mauza/Mahalla for CC non-slum areas. It was a CC slum (a segment in case of a large CC slum) in case of City Corporation slum stratum/domain. In total, 18,400 households from 920 clusters (a cluster is a randomly selected segment of a PSU) were planned to be included in the sample. For ensuring adequate level of response to the survey, 10 per cent additional households were surveyed through this survey. Information was collected from knowledgeable person of a household, women aged 15-49 years living in the sample households, and mothers/primary caregivers of children under five years of age.
Based on the survey data the key findings on the status of child well-being are collated below.
Background Characteristics
In the overall urban population, the number of male exceeded the number of female, but male-female ratio was found to be almost equal in CC slum and other municipality/urban areas. Nine of ten persons were Muslims (90.5 per cent), and the remainder were mostly Hindus.
Nearly two in three (66.2 per cent) of urban population were in the working age group (age 15-64 years), and one in three (35.6 per cent) were children age 0-17 years, and three in ten (29.6 per cent) were in the age group 0-14 years. The overall dependency ratio was 51.1 per cent.
The estimated average household size was 4.3 members, which is slightly smaller than the MICS 2012-2013 estimated urban household size (4.6 members).
Women in CC slums were younger than those in CC non-slums; 26.4 per cent in CC slums were aged under 25 years, compared to 22.6 per cent in CC non-slums. The proportion of women in the middle reproductive age (age 25-34 years) was also higher in CC slums.
Only a small proportion of households (12.0 per cent) were headed by a female.
Exe
cuti
ve S
um
mar
y
1
2
As regards education, CC slum people are in disadvantageous position. The proportion of ever-married women aged 15-49 years without any formal education was more than two times higher in CC slums (35.8 per cent) than in CC non-slums (15.5 per cent) and other urban areas (16.6 per cent).
Access to electricity was quite high and nearly equal in all urban domains. More than nine in ten of urban households had electricity (95.2 per cent), with some variation by CC non-slum (99.4 per cent), CC slum (96.4 per cent), and other urban/municipality areas (93.2 per cent).
Overall 8.6 per cent of urban households had at least one household member employed in Garments Sector, with 27.3 per cent in CC slums, 9.4 per cent in CC non-slums and 7.0 per cent in other municipal areas.
Nutritional Status of Children
Size and weight at birth, stunting, wasting and under-weight are important indicators of nutritional status of newborn and under five children. The survey interviewed mothers and measured height and weight of under-five children. According to mothers’ assessment of size at birth, 16.1 per cent of last live-born children in the last two years were either smaller than average, or very small in size at birth. Sixty-five per cent of births occurring in the last two years preceding the survey were reported to have weighed at birth and 13.7 per cent of those live births were underweight (weight at birth below 2,500 grams).
Overall prevalence of stunting (moderate or severe) among urban children age below five was quite high at 26.3 per cent. This was more pronounced among children who lived in CC slums (40.4 per cent) compared to those in CC non-slum (25.2 per cent) and other urban/municipal areas (25.9 per cent). Among the divisions, Sylhet had the highest rate of stunting (35.5 per cent). Bangladesh Urban Health Survey 2013 (UHS 20132) reported somewhat higher prevalence of stunting with 49.6 per cent in CC slums, 33.4 per cent in CC non-slums and 36.8 per cent in other urban areas.
About one in ten of urban children were moderately or severely wasted (9.9 per cent), with 7.3 per cent in CC non-slums, 11.6 per cent in CC slums and 11.0 per cent in other urban areas. Prevalence of wasting was the highest in urban areas of Sylhet division (11.6 per cent).
One of five of urban children aged below five years were either moderately or severely underweight (20.4 per cent). This prevalence was three in ten among children of CC slum areas (30.8 per cent), while it was only about half (17.7 per cent) in CC non-slums and 20.9 per cent in other urban areas.
Overweight prevalence among under five urban children was recorded at 2.7 per cent, with 4.1 per cent in CC non-slums, 2.7 per cent in CC slums, and 2.1 per cent in other urban areas.
Infant Feeding Practices
Breastfeeding, exclusive breastfeeding and timely introduction of solid or semi-solid food are important for childhood nutrition. According to the survey results, more than 6 in 10 of urban children age 0-23 months were put to the breast within one hour of birth (63.3 per cent).
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
2
2 National Institute of Population Research and Training (NIPORT), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), and MEASURE Evaluation. Bangladesh Urban Health Survey 2013. Final Report. Dhaka, Bangladesh and Chapel Hill, North Carolina, (USA): NIPORT, icddr,b, and MEASURE Evaluation.
3
Although ever breastfeeding was universal, prevalence of exclusive breastfeeding among urban children age 0-5 months was 52.7 per cent, with 62.3 per cent in CC slums, 57.5 per cent in CC non-slums and 50.0 per cent in other urban areas. Approximately 72.5 per cent of urban children age less than six months were predominantly breastfed. Marked variation was observed between divisions and also by CC slum and CC non-slum areas.
Prevalence of continued breastfeeding at 1 year among children age 12-15 months was almost universal (96.9 per cent). Continued breastfeeding at 2 years among 20-23 months’ children was 87.0 per cent with some variations by divisions and urban domains.
Approximately six in ten of urban children age 0-23 months received age-appropriate feeding (60.3 per cent), with some variation by CC slums (60.2 per cent), CC non-slums (59.8 per cent) and other urban areas (60.5 per cent)
According to recall data of last 24 hours preceding the survey, three-fourths (75.7 per cent) of non-breastfed children age 6-8 months were fed with solid, semi-solid or soft foods in the last 24 hours. Less than half (45.1 per cent) of 6-23 months’ children had received food with minimum diversity. Minimum dietary diversity was significantly higher among CC non-slums children (51.6 per cent) than among CC slums (34.9 per cent) and other urban children (43.0 per cent).
The average milk feeding frequency for non-breastfed children age 6-23 months during the previous day of the survey was 2.9 times, and about three-fourths (72.2 per cent) were fed the minimum required number of times. Receiving minimum required number of meals varied by divisions and urban domains.
Survey data showed that majority of urban children are deprived of minimum acceptable diet. Only 38.0 per cent of children age 6-23 months had received minimum acceptable diet, with 44.4 per cent in CC non-slums, 29.7 per cent in CC slums and 36.0 per cent in other urban areas.
Child Health
As reported in other studies, coverage with full immunization (BCG, 3 doses of Pentavalent, 3 doses of OPV and MR at 9 months) among children age 12-23 months was quite high at 88.0 per cent. About 86.4 per cent were fully vaccinated by 12 months of age. Coverage with full vaccination was relatively low in CC slums (72.1 per cent) than CC non-slums (92.1 per cent) and other urban areas (87.3 per cent). Nine in ten had received measles and rubella (MR) vaccine (89.7 per cent).
Nearly seven of ten children age 15-23 months received measles second dose (68.5 per cent), supposed to be administered at or after 15 months of age.
About 86.8 per cent of women who had a live birth in the last two years were protected against neonatal/maternal tetanus. Women of CC non-slum and CC slum areas were less likely to be protected against tetanus (83.6 per cent in CC non-slums and 83.4 per cent in CC slum areas) than women of other urban areas (88.3 per cent). Protection status was the highest in Chittagong (93.7 per cent), and lowest in Dhaka division (83.6 per cent).
More than half (59.4 per cent) of urban children under age five with diarrhea in the last two weeks had received care/treatment either at a health facility or from a health provider. Also 88.8 per cent with diarrhea received any ORS fluid, and 36.1 per cent children with diarrhea received oral rehydration salt (ORS) and Zinc.
Seven of ten (70.0 per cent) received diarrhea treatment with oral rehydration therapy (ORT) – ORS packets, pre-packaged ORS fluid, homemade fluid or increased fluids – and continued feeding. E
xecu
tive
Su
mm
ary
3
4
More than eight in ten of under five children with ARI symptoms in the last two weeks preceding the survey sought advice or treatment for ARI from a health facility or provider (81.2 per cent). Children of CC non-slum areas were more likely to seek advice or treatment (79.4 per cent) than children of CC slums (78.5 per cent).
Eight of ten children with ARI symptoms received treatment with antibiotics (80.7 per cent).
Overall 48.6 per cent of urban households rely on solid fuel for cooking, with 64.3 per cent in other urban areas, 44.5 per cent in CC slums and 15.2 per cent in CC non-slums areas. Households/members of the lowest quintile mostly (67.5 per cent) use solid fuel and thus are exposed to higher health risks.
Reproductive Health
The CWS focused mainly on certain aspects of reproductive health such as fertility and maternal care. According to the survey results, the median age at first marriage among urban women of reproductive age (15-49 years) was 16.1 years, with somewhat higher in CC non-slums areas (17.0 years). The median age at first child birth was three years more than the median age at first marriage (19.0 years).
Early childbearing (either have had a live birth or are pregnant with the first child) among women age 15-19 years persists high at 18.6 per cent, with 14.8 per cent in CC non-slums, 35.8 per cent in CC slums and 19.1 per cent in other urban areas. However, among the adolescent women age 15-19, only 0.5 per cent have had a live birth before age 15.
Nearly one in four women (22.9 per cent) age 20-24 years have had a live birth before the age of 18. This percentage was 33.0 per cent among women age 20-49 years. The percentage of women age15- 49 who have had a live birth before age 15 was 5.3 per cent.
Two-thirds (67.3 per cent) of currently married urban women aged 15-49 use some method of contraception, with 73.8 per cent in CC slums, 67.2 per cent in other urban, and 66.6 per cent in CC non-slum areas. The total unmet need for contraception was 7.8 per cent.
Eight of ten women age 15-49 who gave birth in the two years preceding the survey received antenatal care from skilled health provider at least once (81.1 per cent), and 45.9 per cent had the recommended four or more antenatal care (ANC) visits by any provider. Six of ten of CC non-slum women received 4 or more ANC visits, compared to one-third (35.8 per cent) in CC slums, and four of ten (40.4 per cent) in other urban areas.
Sixty-two per cent of all deliveries in urban areas took place in health facilities, and 64.2 per cent of deliveries were attended by skilled health provider during their most recent live births. Delivery at health facility was the highest in Khulna urban areas (76.9 per cent), and lowest in Chittagong Division (48.1 per cent).
Of all births, 39.9 per cent of women had delivery by Caesarean Section, with very high prevalence in CC non-slum areas (46.6 per cent).
About 84.4 per cent of women age 15-49 years with a live birth in the last two years who had their last delivery in a health facility stayed in the health facility for 12 hours or more after the last delivery.
Four in five (79.7 per cent) of newborns received postnatal health checks within two days of birth.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
4
5
Water and Sanitation
Access to safe water and sanitation are basic determinants of better health. Survey data showed that use of drinking water from improved water sources was almost universal among urban households (99.2 per cent). Among those who do not use improved drinking water sources, 39.7 per cent reported of using an appropriate treatment method to make water safe for drinking.
About 57.3 per cent of urban population are using improved sanitation facilities which are not shared with members of other households. It varied by urban domains with 51.3 per cent in CC non-slums, 18.9 per cent in CC slums which was very low and 62.4 per cent in other urban areas. Use of improved sanitation facilities which are not shared was the highest in Barisal (80.7 per cent), and lowest in Dhaka (47.1 per cent).
Overall 56.7 per cent of urban population use both improved drinking water source and improved sanitation facility. This percentage was very low in CC slums (18.2 per cent) compared to CC non-slums (50.5 per cent) and other urban areas (61.9 per cent).
For 66.2 per cent of children age 0-2 years, the stool was disposed of safely the last time they passed stool. This percentage was much higher in CC non-slums (81.9 per cent) than CC slums (58.0 per cent) and other urban areas (60.2 per cent).
More than half of urban households (55.4 per cent) had specific place for handwashing with water and soap available, while the corresponding estimates for CC non-slums, CC slums and other urban areas were 67.1, 35.4, and 51.1 per cent, respectively.
Child Development, Literacy and Education
According to the Education Policy of Bangladesh, children age 36-59 months are expected to attend pre-school for early childhood development and education. Survey data showed that only 26.2 per cent of urban children age 36-59 months were attending an early childhood education (ECE) programme or pre-school, with about 30.4 per cent in CC non-slums, 24.2 per cent in other urban areas and 23.8 per cent in CC slum areas.
Attendance to an ECE programme was 9.4 per cent among children age 36-47 months, while
this was 41.7 per cent in the age group 48-59 months.
The CWS 2016 collected information on education of all sampled household members aged three years or above. Based on this data, status of literacy of young women age 15-24 years and a number of indicators related to school readiness, participation in primary and secondary education, gender parity in education, etc. were assessed.
Overall literacy among urban young women age 15-24 years was found to be quite high at 82.6 per cent, with 83.8 per cent in other urban areas, 83.7 per cent in CC non-slums and 59.0 per cent in CC slum areas.
Sixty-eight per cent of the urban children who were currently attending the first grade of primary school had attended pre-school the previous year. Attendance to pre-school was substantially low in CC slums (56.1 per cent), CC non-slums (59.1 per cent) and compared to other urban areas (72.7 per cent). Among the divisions, it was the highest in Khulna (86.9 per cent), and lowest in Rangpur (61.5 per cent).
Net intake rate in primary school was found to be 62.2 per cent with 66.9 per cent in CC non-slums, 61.5 per cent in other urban areas, and considerably low in CC slum areas at 40.5 per cent.
Exe
cuti
ve S
um
mar
y
5
6
The primary school adjusted net attendance ratio (NAR) was 85.5 per cent. It was 85.0 per cent in CC non-slums, 86.8 per cent in other urban, and 69.4 per cent in CC slum areas. The NAR was 4 percentage points higher among female (87.8 per cent) than among male (83.3 per cent).
The secondary school adjusted net attendance ratio was 63.1 per cent, which is 22 percentage points lower than the primary school NAR. The secondary school NAR was substantially low in CC slums (33.3 per cent) compared to CC non-slums (62.0 per cent) and other urban areas (65.5 per cent). It was the highest in Barisal (74.4 per cent), and lowest in Dhaka division (59.4 per cent).
The effective transition rate to secondary school was 97.3 per cent, with little variation by urban domains and divisions.
Girls are in advantage in both primary school and secondary school attendance. The Gender Parity Index (GPI), defined as the ratio of girls to boys attending primary or secondary education, was 1.05 for primary and 1.18 for secondary education. The advantage of girls though noticed for all categories of children, was particularly pronounced in children with no/less educated mothers and children of lower quintiles.
Child Protection
Child protection refers to the protection of children from violence, exploitation, abuse and neglect. To see the status of urban children in relation to child protection, the survey tried to assess certain aspects such as birth registration, child discipline, attitude towards physical punishment, involvement of children in economic and household activities, child labour, orphan-hood, early marriage, and some other related issues.
Though almost all the mothers or caretakers of children under age five whose births have not been registered were found aware of how to register a birth (99.7 per cent), registration of birth was not widely practiced with only 29.3 per cent of births registered. A huge gap between knowledge and practice persists across all domains irrespective of background characteristics in relation to registration of births.
While violent methods (psychological or physical punishment) were common forms of discipline applied by household members for child discipline (82.4 per cent), only 35.4 per cent women actually approved physical punishment to bring, raise or educate a child properly.
Overall, 12.9 per cent of urban children age 5-17 years were in child Labour, with 12.0 per cent in CC non-slums, 23.1 per cent in CC slums, and 12.6 per cent in other urban areas. It was the highest in Rangpur (15.4 per cent), and lowest in Barisal Division (8.1 per cent). As expected, proportion of children in child labour were higher as the age increased. Prevalence of child labour among children age 5-14 years was 8.1 per cent, with 7.0 per cent in CC non-slums, 14.3 per cent in CC slums, and 8.2 per cent in other urban areas.
More than one of five women (22.5 per cent) of age 15-49 years were (first) married before the age of 15, with some variation by CC non-slum (20.0 per cent), CC slums (28.1 per cent) and other urban areas (23.4 per cent). Among the women aged 20-49 years, the proportion who married before the age of 18 was 59.7 per cent, with 53.3 per cent in CC non-slums, 66.4 per cent in CC slums, and 62.3 per cent in other urban areas.
Polygyny is not common among urban women of Bangladesh. Overall, 2.8 per cent of women aged 15-49 years were in polygynous union. Only 1.0 per cent of the young women aged 15-19 were in polygynous union as compared to 4.8 per cent of the old (aged 45-49).
About one in twenty (4.7 per cent) of urban children age 0-17 years were living with neither of biological parents, with 4.4 per cent in CC non-slums, 4.4 per cent in CC slums and 4.9 per cent in other urban areas.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
6
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
7
1 INTRODUCTION AND METHODOLOGYUNICEF/NYHQ2013-0380/Noorani
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
8
1.1 Background Bangladesh has been experiencing rapid urbanization since 1980s, partly due to lack of work opportunities in rural areas and availability of livelihood opportunities in urban areas. It has close link with development of garment industry and rapid expansion of the service sector in urban areas. Bangladesh Population and Housing Census 2011 reported that the urban population of Bangladesh rose to 41.9 million in 2011 from 28.6 million in 2001. According to a recent report published by the United Nations Department of Economic and Social Affairs, Population Division (2014), while the rural population is expected to peak at 105 million people in 2016 and then decline, the urban population will grow from its current (2015) level of 54 million people to 81.4 million in 2029, an increase of 50 per cent in 14 years. From being a largely rural country now (66.5 per cent of the population lives in rural areas in 2015), Bangladesh will be an urban country by 2039 when majority of the people will live in urban areas.
As consequence of rapid urbanization, urban cities are experiencing extreme pressure on housing, growth of slums and pressure on urban services. What is more of a concern is the fact that the number of hardcore poor has gone up in urban cities. Urban cities are now characterized by large inequalities in health-related conditions. In cities, well-developed areas co-exist with slums, which are areas of dense concentration of people and of conditions that affect health negatively. It is estimated that one-third of the city corporations’ population lives in City Corporation (CC) slums3.
In recent years, a number of large-scale surveys have taken place in Bangladesh, providing partial data on the situation of children living in urban areas. The Bangladesh Urban Health Surveys published by NIPORT in 2013 and 2006 indicate that large inequalities exist in the socio-economic conditions and health care-seeking behaviour in urban areas of Bangladesh. The Multiple Indicators Cluster Survey (MICS) 2012-20134 conducted by Bangladesh Bureau of Statistics (BBS) with support from UNICEF and BDHS 20145 provided estimates for a good number of indicators for urban areas. However, none of these studies provided data on disparities/inequalities that exist within urban areas, e.g. on the conditions of children in urban CC slums vs CC non-slum areas. With the increasing influx of population migrating from rural to urban areas, it is important for the planners, researchers and programme manages to understand the prevailing situation of children (and women) in urban areas stratified by CC slum and CC non-slum areas. To understand the present situation of children and women in urban context, Bangladesh Bureau of Statistics (BBS), with support from UNICEF, Commissioned a Child Well-being Survey in urban areas of Bangladesh.
This report presents main findings of the Child Well-being Survey in urban areas of Bangladesh (CWS 2016).
1 INTRODUCTION AND METHODOLOGY
3 Centre for Urban Studies, et al., 2006
4 Bangladesh Bureau of Statistics (BBS) and UNICEF, 2014. Bangladesh Multiple Indicator Cluster Survey 2012-2013, Progotirpathey: Final Report, Dhaka, Bangladesh.
5 National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. 2013. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International.
9
Intr
od
uct
ion
an
d M
eth
od
olo
gy
1.2 Survey ObjectivesThe main objective of the CWS 2016 was to measure the level of child well-being in urban areas of Bangladesh in terms of nutrition, health, education, protection and access to water and sanitation. In addition, the survey also aimed to gauge the knowledge, attitude and practices of mothers/caregivers in some key areas that affect healthy growth of children in urban areas.
The specific objectives were to:
� Measure a set of indicators related to child nutrition, health, education, protection, child discipline, and access to water and sanitation.
� Identify urban areas that are most vulnerable for child’s living and identifying the vulnerability.
� Assess condition of children and women by wealth/socio-economic status of households and other equity stratifies.
� Assess level of disparities that exist in urban CC slum areas of big cities across the country
1.3 Sample DesignThe sample for the CWS 2016 is nationally representative and covers entire urban population residing in non-institutional dwelling units in urban areas. The survey is based on a two-stage stratified cluster sample of households, stratified by 19 strata or domains. The strata/domains are – (i) City Corporation non-slum, City Corporation slum, and other Municipalities/Urban areas in Dhaka, Chittagong, Khulna, Rajshahi and Rangpur divisions; and (ii) City Corporations and Other Municipalities/Urban areas in the remaining two divisions - Barisal and Sylhet – since the population content of the slum areas in these division was relatively small. A stratum/domain is considered as an independent stratum/domain.
In the first stage of sampling, from each stratum/domain, mauza/mahallas (slum in the City Corporation slum stratum/domain) were selected randomly as Primary Sampling Units (PSUs) using probability proportional to size (PPS), size being the number of households in the PSU. In total, 920 PSUs were selected, taking 50 PSUs from each stratum/domain except three stratum/domains of City Corporation slums of Rajshahi, Khulna and Rangpur, from each of which 40 PSUs were selected.
Using 2011 Census list of Mauzas/Mahalla as sampling frame, BBS selected 700 CC non-slum urban PSUs, while Urban Slum Census 2014 data were used to select 220 CC slum PSUs from five City Corporation slum domains. Necessary adjustments were made in the population estimates in the two sampling frames prior to selection of PSUs.
In the second stage, for PSUs with large number of households, segments of equal size of around 100 households were created for each PSU through a physical mapping exercise in each selected PSU, and then one of the segments was selected randomly. Segmant was not done for smaller PSU's. A randomly selected segment of a PSU is referred to as a cluster. A household listing operation was conducted in each cluster using a structured enumeration form. In total, 18,400 households from 920 clusters were planned to be included in the sample taking 20 households from each cluster following systematic random sampling procedure. This sample size was expected to provide estimates with at most 12 per cent margin of error at 95% level of confidence. For ensuring adequate level of response to the survey, 10 per cent additional households were surveyed through this survey.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
10
Survey could not be conducted in 4 preselected clusters due to eviction of slums and other reasons. Ultimately, a total of 20,134 households from 916 clusters were attempted to interview.
The following table presents the sample sizes, number of clusters and cluster size per domain.
Table 1.1: Sample size
Number of clusters and households included in the sample by division (Dhaka, Chittagong, Rajshahi, Khulna, Rangpur, Barisal and Sylhet), and areas (City Corporation slum, City Corporation non-slum and other municipalities/urban areas), Child Well-being survey in urban areas, Bangladesh, CWS 2016.
Division Area/DomainNumber of clusters
Number of Households
Dhaka City Corporation slum 48 1,056
City Corporation non-slum 50 1,100
Other municipalities/urban 50 1,100
Chittagong City Corporation slum 50 1,097
City Corporation non-slum 50 1,100
Other municipalities/urban 50 1,100
Rajshahi City Corporation slum 40 877
City Corporation non-slum 49 1,078
Other municipalities/urban 50 1,100
Khulna City Corporation slum 39 848
City Corporation non-slum 50 1,100
Other municipalities/urban 50 1,100
Rangpur City Corporation slum 40 880
City Corporation non-slum 50 1,100
Other municipalities/urban 50 1,100
Sylhet City Corporation 50 1,100
Other municipalities/urban 50 1,100
Barisal City Corporation 50 1,098
Other municipalities/urban 50 1,100
Total 19 916 20,134
11
Intr
od
uct
ion
an
d M
eth
od
olo
gy
1.4 Survey Implementation
1.4.1 Questionnaires
The CWS 2016 used three questionnaires:
� Households Questionnaire � Women Questionnaire (for women 15-49 years), and � Under-five Questionnaire
The Household Questionnaire was administered to a knowledgeable person, in most cases a woman, of a sample household and was used to list all the usual members in the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education, etc. The questionnaire included the following modules:
� Household information � Household characteristics � Participation in garment industry � Education � Water and sanitation � Handwashing � Child labour � Child discipline
The Women Questionnaire was administered to all ever married women aged 15-49 years living in the households. It was used to collect information on the following topics:
� Individual Background Characteristics � Maternal and Newborn Health (Antenatal, Delivery and Newborn Care) � Breastfeeding and IYCF � Postnatal Health Checks � Immunization � Contraception � Unmet Need
The Questionnaire for Children Under-Five was administered to mothers or primary caregivers of children under 5 years of age living in the households. The questionnaire included the following variables and modules:
� Birth Registration � Care for illness � Anthropometry
The questionnaires were developed in English based on the questionnaires used in the MICS-2012-2013 and other relevant surveys. The questionnaires were then translated into Bangla, pre-tested in parallel urban households and then administered to sample households and individuals.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
12
1.4.2 Training, Fieldwork and Data Processing
Training and Fieldwork
Fifty-four enumerators were trained to carry out the listing of households and to delineate the clusters. The training lasted a total of three days including one day of field practice from December 27 to 29, 2015. A household listing operation was carried out in all selected clusters from December 30, 2015 to March 13, 2016 in three phases, each about three weeks in duration. Initially, 25 two-member teams were deployed to carry out the listing of households. The number of teams was reduced to 18 in the final phase.
The instruments were pre-tested on January 25, 2016. Training for the fieldworkers of the main survey was conducted from January 20 to February 3, 2016. A total of 94 fieldworkers were recruited based on their educational level, prior experience with surveys and willingness to spend up to four months on the project. Training included lectures, how to complete the questionnaires, mock interviews between participants and field practice. The BBS and UNICEF personnel monitored the training activities.
Fieldwork for the CWS 2016 was carried out by interviewing teams, each consisting of one male supervisor, four female interviewers and one anthropometric expert. Data collection was implemented in three phases, starting on February 4, 2016 and ending on April 30, 2016. The number of teams declined with each subsequent phase, starting with 15 teams in the first phase and ending with 12 teams by the end of data collection.
Data Processing
Data processing commenced on February 24, 2016 and was completed on June 15, 2016. The data processing operations consisted to office editing, coding, data entry and editing inconsistencies found by computer programs. Data were processed on 11 microcomputers, carried out by 11 data entry operators and a data entry supervisor. Data entry and editing were done using CSPro software. To minimize error, a double data entry procedure was followed.
1.5 Survey Sample and Response Rates
Table 1.2 and Table 1.2a show household, eligible women and children under 5 response rates by division and area of residence. The household response rates were similar across divisions and areas of residence (98 per cent). The response rates of women and children under 5 showed similar pattern, but somewhat low at 94 per cent and 96 per cent, respectively. However, this was in line with other survey results in urban areas.
13
Intr
od
uct
ion
an
d M
eth
od
olo
gy
Table 1.2: 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, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
AllDivision
Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet
Households
Sampled 20,134 2,198 3,297 3,256 3,048 3,055 3,080 2,200
Occupied 19,187 2,088 3,115 3,081 2,971 2,926 2,928 2,078
Interviewed 18,887 2,076 3,063 3,001 2,900 2,909 2,903 2,035
Household response rate 98.4 99.4 98.3 97.4 97.6 99.4 99.1 97.9
Women
Eligible 20,632 2,246 3,456 3,124 3,199 3,191 3,183 2,233
Interviewed 19,632 2,136 3,239 2,997 3,048 3,090 2,991 2,131
Women’s response rate 95.2 95.1 93.7 95.9 95.3 96.8 94.0 95.4
Women’s overall response rate 93.7 94.6 92.2 93.4 93.0 96.3 93.2 93.5
Children under 5
Eligible 7,736 871 1,397 1,226 1,014 1,001 1,167 1,060
Mothers/caretakers interviewed 7,521 844 1,360 1,193 983 976 1,138 1,027
Under-5’s response rate 97.2 96.9 97.4 97.3 96.9 97.5 97.5 96.9
Under-5’s overall response rate 95.7 96.3 95.7 94.8 94.6 96.9 96.7 94.9
Table 1.2a: Results of household, women’s, and under-5 interviews by survey areas
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, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
All
Area
City Corporation slum
City Corporation non-slum
Other municipalities/urban
Households
Sampled 20,134 4,758 7,676 7,700
Occupied 19,187 4,533 7,301 7,353
Interviewed 18,887 4,457 7,151 7,279
Household response rate 98.4 98.3 97.9 99.0
Women
Eligible 20,632 4,883 7,729 8,020
Interviewed 19,632 4,659 7,379 7,594
Women’s response rate 95.2 95.4 95.5 94.7
Women’s overall response rate 93.7 93.8 93.5 93.7
Children under 5
Eligible 7,736 1,853 2,784 3,099
Mothers/caretakers interviewed 7,521 1,805 2,720 2,996
Under-5’s response rate 97.2 97.4 97.7 96.7
Under-5’s overall response rate 95.7 95.8 95.7 95.7
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
14
1.6 Challenges FacedThe CWS 2016 encountered a number of challenges that might have increased sampling and non-sampling errors:
� For drawing sample from CC slum and CC non-slum populations, the first challenge was to make adjustments in the population estimates as the available source populations were from two different time points. The 2011 Bangladesh National Census provided Mauza/Mahalla list with households without demarcating CC slum households, while CC Slum Census was conducted in 2014. However, BBS successfully made necessary adjustments in the two populations to prepare the sampling frame of PSUs, for selecting PSUs (Mauza/Mahalla for CC non-slum and slum/segment of a slum for slum areas) and final sample.
� Survey could not be conducted in four pre-selected clusters because of non-existence of these clusters at the time of the survey due to eviction.
� Though many large scale surveys like the Bangladesh Demographic and Health Survey (BDHS), Multiple Indicator Cluster Survey (MICS), etc. provide estimates of indicators related to child Well-being for the urban areas, the results obtained in this survey are not strictly comparable for trend analysis owing to differences in the method of drawing samples and use of sampling frames. However, comparisons are provided in the text of the report, wherever possible.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
15
2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
UNICEF/NYHQ2013-0378/Noorani
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
16
Key Findings:
� Nearly two-thirds (66.2 per cent) of urban population are reported to be in the working age group (15-64 years), 35.6 per cent are children age 0-17 years, and 29.6 per cent are in the age group 0-14 years. The overall dependency ratio is 51.1 per cent.
� The estimated average household size was 4.3 members, which is slightly smaller than the MICS 2012-2013 estimate of 4.6 but comparable to the BDHS 2014 estimate of 4.4 members.
� Women in CC slums were younger than those in CC non-slums; 26.4 per cent in CC slums were aged under 25 years, compared to 22.6 per cent in CC non-slums.
� Only 12.0 per cent households were headed by females.
� The proportion of ever-married women aged 15-49 years without any formal education was more than two times higher in CC slums (35.8 per cent) than in CC non-slums (15.5 per cent) and other urban areas (16.6 per cent).
� As high as 95.2 per cent of urban households have electricity connection, with 99.4 per cent in CC non-slums, 96.4 per cent in CC slums, and 93.2 per cent in other urban/municipal areas.
� About 8.6 per cent of urban households had at least one household member employed in Garments Sector. This was much higher in CC slums (27.2 per cent) and relatively lower, 9.5 per cent, in CC non-slums and 7.0 per cent in other municipal areas.
This chapter presents information on certain characteristics of the household population, selected features of the sampled households, and socio-economic aspects of households. More specifically, main focus was on composition of household population, socio-economic and livelihood status, and certain physical features known to influence health of urban population. The purpose was to compare the population and housing profiles of CC slums, CC non-slums and other urban households. Information on characteristics such as water use, sanitation and handwashing practices were available, analysis of which is presented in a separate chapter.
2.1 Characteristics of Household PopulationThe 2016 Child Well-being Survey defines a household as a person or group of persons, regardless of age or relationship, who usually live in the same dwelling, share common cooking and eating arrangements and can identify one member as the head of household. Interviews were completed for a total of 7,151 households in CC non-slums, 4,457 in CC slums, and 7,279 in other urban areas, giving a total of 18,887 urban households in the sample.
2.1.1 Age and Sex Composition
Table 2.1 gives age distribution of household population by five-year age groups, and sex, and also by dependency age groups, children (0-17 years) and adult age (18 years or above),
2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS
17
according to area of residence. In the 18,887 successfully interviewed households, 82,228 household members were listed. Overall, the number of men exceeded the number of women. This pattern prevailed in CC non-slum, but male-female ratio was almost equal in CC slums and other urban areas.
Table 2.1: Age distribution of household population by sex
Per cent distribution of household population by five years age groups, and sex and by dependency age group, child (0-17 years) and adults populations (age 18 or more), according to areas (City Corporation slum, City Corporation non-slum and other urban areas), Child Well-being survey in urban areas, Bangladesh, CWS 2016
Age group(years)
AllCity Corporation slum City Corporation non-slum Other municipalities/urban
Total Male Female Total Male Female Total Male Female
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
0-4 9.3 10.4 10.6 10.1 9.2 9.1 9.3 9.4 9.5 9.3
5-9 10.0 11.0 11.3 10.6 9.4 9.3 9.5 10.2 10.3 10.0
10-14 10.3 10.7 10.8 10.5 9.8 9.8 9.8 10.4 10.7 10.2
15-19 10.5 11.8 11.1 12.6 10.1 9.2 11.0 10.7 10.4 11.0
20-24 9.0 9.6 8.5 10.7 9.9 9.3 10.5 8.6 7.7 9.5
25-29 9.9 10.5 9.6 11.3 10.3 9.6 11.1 9.6 9.2 10.1
30-34 8.3 8.8 8.2 9.4 8.9 9.2 8.6 7.9 7.6 8.2
35-39 7.6 7.9 8.4 7.5 7.9 8.1 7.6 7.5 7.6 7.4
40-44 5.9 5.1 5.9 4.3 6.4 6.6 6.1 5.7 6.0 5.3
45-49 6.2 5.1 4.6 5.6 6.2 6.0 6.5 6.3 5.3 7.3
50-54 3.0 2.7 3.8 1.6 3.3 4.2 2.3 2.8 4.0 1.6
55-59 3.3 2.2 2.3 2.0 3.1 3.5 2.7 3.4 3.7 3.2
60-64 2.5 1.8 2.1 1.5 2.2 2.6 1.8 2.7 2.9 2.5
65-69 1.6 0.8 0.9 0.8 1.3 1.6 1.1 1.8 2.0 1.7
70-74 1.2 0.8 0.9 0.8 0.9 0.9 1.0 1.3 1.5 1.1
75-79 0.6 0.3 0.4 0.3 0.6 0.5 0.7 0.6 0.8 0.5
80-84 0.4 0.3 0.3 0.2 0.3 0.3 0.3 0.5 0.4 0.6
85+ 0.4 0.2 0.3 0.2 0.2 0.2 0.2 0.5 0.5 0.6
Dependency age groups
0-14 29.6 32.0 32.8 31.3 28.4 28.2 28.6 30.0 30.5 29.5
15-64 66.2 65.5 64.4 66.5 68.3 68.4 68.2 65.3 64.5 66.0
65+ 4.2 2.5 2.8 2.2 3.3 3.4 3.2 4.8 5.0 4.5
Child and adult populations
Children age 0-17 years 35.6 38.4 38.9 37.9 33.9 33.6 34.2 36.2 36.7 35.7
Adults age 18+ years 64.4 61.6 61.1 62.1 66.1 66.4 65.8 63.8 63.3 64.3
Number of household member 82,228 3,302 1,648 1,654 25,015 12,526 12,489 53,911 26,942 26,969
Ho
use
ho
ld P
op
ula
tio
n a
nd
Ho
usi
ng
Ch
arac
teri
stic
s
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
18
The proportions of child (0-14 years), working age (15-64 years) and old age groups (65 years and over) were 29.6, 66.2 and 4.2 per cent respectively. These figures are similar to those recorded in the recent MICS 2012-2013. The proportion of children age 0-14 years was 3.6 Percentage points higher in the city corporation slums (32.0 per cent) than CC non-slums (28.4 per cent), and the corresponding figure for other urban areas was 30.0 per cent.
The overall dependency ratio was 51.1 per cent. This was lower in CC non-slums (46.4 per cent), compared to CC slums (52.7 per cent). Dependency ratio was 53.3 per cent in other urban/municipality areas.
The age-pyramid of male and female (Fig 2.1) show a clear tilt towards males at higher age groups in urban areas, as obtained from the survey.
Fig 2.1: Age distribution of household population, Bangladesh, CWS 2016
Note: # household members with missing age and/or sex are excluded
2.1.2 Household Composition
Table 2.2 shows that a small proportion of households (12.0 per cent) were headed by females. Overall, 64.7 per cent of the urban households were in other urban areas, 31.1 per cent in CC non-slums, and 4.2 per cent in CC slum areas. Dhaka Division had the largest share of households (49.0 per cent), and Sylhet (3.5 per cent) and Barisal (4.0 per cent) had very small share of households. Only 1.9 per cent of the households were single-member households, and 77.8 per cent were 2-5 member households. The average household size was 4.3 members, which is somewhat smaller than MICS 2012-2013 estimated size (4.6 members).
19
Ho
use
ho
ld P
op
ula
tio
n a
nd
Ho
usi
ng
Ch
arac
teri
stic
s
Table 2.2: Household composition
Per cent and frequency distribution of households by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Weighted per cent
Number of households
Weighted Unweighted
Total 100.0 18,887 18,887
Sex of household head
Male 88.0 16,618 16,679
Female 12.0 2,269 2,208
Area
City Corporation slum 4.2 784 4,457
City Corporation non-slum 31.1 5,874 7,151
Other municipalities/urban 64.7 12,229 7,279
Division
Barisal 4.0 749 2,076
Chittagong 17.7 3,334 3,063
Dhaka 49.0 9,263 3,001
Khulna 8.8 1,657 2,900
Rajshahi 10.5 1,988 2,909
Rangpur 6.6 1,238 2,903
Sylhet 3.5 658 2,035
Number of household members
1 1.9 361 382
2 9.9 1,878 1,743
3 21.0 3,963 3,846
4 27.7 5,235 5,302
5 19.2 3,631 3,555
6 10.2 1,933 1,965
7 4.7 897 927
8 2.4 444 519
9 1.3 240 282
10+ 1.6 306 366
Mean household size 4.3
2.2 Background Characteristics of Women and Under Five ChildrenTable 2.3 provides information on selected background characteristics of ever married women age 15-49 years by CC slum, CC non-slum and other urban areas, and also by division. Background characteristics considered were age, current marital status, education, socio-economic status: wealth quintiles and religion.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
20
Table 2.3: Background Characteristics of Women
Per cent distribution of ever married women age 15-49 years by selected background characteristics, according to domains (City Corporation slum, City Corporation non-slum and other urban areas), Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Background characteristicsType of area
AllCity Corporation
slumCity Corporation
non-slumOther municipalities/
urban
Total 100.0 100.0 100.0 100.0
Age
15-24 22.9 26.4 22.6 22.8
25-34 36.4 39.1 36.8 36.1
35-49 40.7 34.5 40.6 41.2
Division
Barisal 4.0 0.0 2.8 4.8
Chittagong 18.7 39.3 16.3 18.5
Dhaka 47.4 50.3 64.2 39.5
Khulna 9.1 4.4 5.9 10.9
Rajshahi 10.6 3.7 4.0 14.0
Rangpur 6.6 2.4 3.0 8.6
Sylhet 3.6 0.0 3.8 3.7
Marital status
Currently married 93.0 89.8 92.2 93.5
Widowed 4.0 4.6 4.2 3.8
Divorced 1.1 1.2 1.3 1.0
Separated 2.0 4.4 2.3 1.6
Wealth Index quintile
Lowest 17.8 45.3 11.2 19.1
Second 19.3 29.9 20.1 18.2
Middle 20.3 11.7 15.2 23.2
Fourth 21.6 8.7 22.1 22.2
Highest 21.1 4.3 31.4 17.4
Highest education
No education 17.0 35.8 15.5 16.6
Primary incomplete 15.9 24.5 14.5 15.9
Primary complete 10.4 11.6 9.0 11.0
Secondary incomplete 42.0 25.2 40.9 43.6
Secondary complete or higher 14.7 2.8 20.1 12.9
Reading skill
Can’t read at all 8.4 18.6 7.8 8.2
Can read some words 12.8 22.5 10.7 13.4
Can read the whole sentence 78.8 58.9 81.5 78.4
Religion
Islam 90.5 92.5 91.1 90.1
Hindu 8.8 7.0 8.2 9.2
Buddhist 0.4 0.2 0.1 0.6
Christian 0.3 0.3 0.6 0.2
Number of women 19,632 814 5,973 12,845
21
Ho
use
ho
ld P
op
ula
tio
n a
nd
Ho
usi
ng
Ch
arac
teri
stic
s
Women in CC slums were younger than those in CC non-slums; one in every four women (26.4 per cent) in CC slums were aged under 25 years, compared to about 23 per cent in CC non-slums and in other urban areas. Proportion of women in middle reproductive age (age 25-34 years) was also higher in CC slums (39.1 per cent in CC slums against 36.8 per cent in CC non-slums).
Nearly two-thirds of CC non-slums (64.2 per cent) and half of CC slums (50.3 per cent) women and over one-third (39.5 per cent) of other urban women were from Dhaka division, and the rests were from other divisions. Across three domains, most of the women were currently married (89.8 to 93.5 per cent).
As expected, a large proportion of women in the CC slums are from the poorest, with 45.3 per cent in the lowest wealth quintile, against only 11.2 per cent in CC non-slums and 19.1 per cent in other urban areas. About three in every four (75.2 per cent) CC slums women were in the lowest two quintiles.
Thirty six per cent (35.8 per cent) of CC slums women against 15.5 per cent of CC non-slums and 16.6 per cent of other urban women had no formal education. Obviously, reading skill was also low among women who lived in CC slum areas.
Table 2.4: Under-5’s background characteristics
Per cent and frequency distribution of children under five years of age by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Characteristics Weighted per centNumber of under-5 children
Weighted Unweighted
Total 100.0 7,521 7,521
Sex
Boy 50.3 3,783 3,768
Girl 49.7 3,738 3,753
Area
City Corporation slum 4.5 336 1,805
City Corporation non-slum 29.8 2,242 2,720
Other municipalities/urban 65.7 4,943 2,996
Division
Barisal 4.2 318 844
Chittagong 20.8 1,562 1,360
Dhaka 47.6 3,580 1,193
Khulna 7.2 542 983
Rajshahi 9.2 695 976
Rangpur 6.5 487 1,138
Sylhet 4.5 337 1,027
Age
0-5 months 8.4 631 684
6-11 months 10.0 751 771
12-23 months 20.2 1,521 1,472
24-35 months 20.4 1,534 1,514
36-47 months 20.1 1,511 1,485
48-59 months 20.9 1,573 1,595
Respondent to the under-5 questionnaire
Mother 98.8 7,430 7,421
Other primary caretaker 1.2 91 100
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
22
Table 2.4: continued
Characteristics Weighted per centNumber of under-5 children
Weighted UnweightedMother’s education*
No education 9.2 693 872
Primary incomplete 14.3 1,077 1,083
Primary complete 10.0 751 876
Secondary incomplete 48.9 3,677 3,446
Secondary complete or higher 17.6 1,324 1,244
Wealth index quintile
Lowest 20.8 1,563 1,890
Second 18.5 1,388 1,410
Middle 19.6 1,474 1,343
Fourth 22.4 1,686 1,519
Highest 18.8 1,410 1,359
Religion
Islam 91.9 6,909 6,789
Hindu 7.4 558 696
Buddhist (*) 33 16
Christian (*) 21 20
* 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.
(*) Figures that are based on fewer than 25 unweighted cases
The background characteristic of children under-5 years of age are presented in Table 2.4. These include the distribution of children by several attributes, such as age, sex, areas of residence, division, mothers’ education and socioeconomic status. Proportion of boys (50.3 per cent) and girls (49.7 per cent) are almost at the same level. Nearly two-thirds (65.7 per cent) of children were from other urban areas, 29.8 per cent from CC non-slums and 4.5 per cent from CC slum areas. About 47.6 per cent were from Dhaka, 20.8 per cent from Chittagong, and the rest were from other divisions.
Age distribution of children age 0-59 months showed that proportions of children in the younger age groups were significantly lower than those in the higher age groups.
2.3 Housing Characteristics Tables 2.5, 2.5a, 2.6 and 2.6a provide housing characteristics disaggregated by urban domains and divisions. The main characteristics considered were whether the dwelling had electricity, main materials of the floor, roof, and exterior walls as well as the number of rooms used for sleeping.
Tables 2.5 show that 95.2 per cent of dwelling houses were connected to supply of electricity, 72.7 per cent had finished floor with cement or tiles; 68.3 per cent had tin/metal roof and 30.7 per cent had cement roofing; and 59.6 per cent had finished exterior walls with cement.
This situation varied by division, CC slum, CC non-slum and other urban areas (Table 2.5a). Seventy-one per cent of CC slum households had a single room for sleeping of all household members, while 55.9 per cent of CC non-slums and 68.5 per cent of other urban households had 2 or more rooms for sleeping. On average, in CC slum areas 3.3 persons shared a room for sleeping; the corresponding average was 2.7 in CC non-slums and 2.4 in other urban areas.
23
Ho
use
ho
ld P
op
ula
tio
n a
nd
Ho
usi
ng
Ch
arac
teri
stic
s
Table 2.5: Housing characteristicsPer cent distribution of households by selected housing characteristics, according to area of residence and regions, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
DivisionAll Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
ElectricityYes 95.2 92.3 94.2 98.2 94.5 88.8 89.0 95.3No 4.8 7.7 5.8 1.8 5.5 11.2 11.0 4.7
FloorNatural floorEarth/sand 26.9 49.3 32.3 14.4 32.8 45.2 51.8 32.3Dung 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.1Rudimentary floorWood plank 0.4 1.0 0.2 0.6 0.0 0.1 0.0 0.0Palm/ bamboo 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0Finished floorFinished floor parquet/polished wood 0.0 0.1 0.1 0.0 0.0 0.0 0.0 0.0Wood plank covered with tar 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0Ceramic tiles/mosaics 7.4 2.9 6.5 9.0 8.5 4.1 2.0 11.1Cement 64.6 46.2 58.8 75.5 58.5 50.0 46.0 56.1Carpet/ mat 0.7 0.3 2.0 0.5 0.1 0.6 0.1 0.5
RoofNatural roofingStraw/palm leaf 0.4 0.0 0.7 0.0 2.5 0.0 0.5 0.1Rudimentary roofingVillage mat 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0Bamboo/palm tree 0.1 0.0 0.3 0.0 0.1 0.0 0.0 0.1Finished roofingTin/metal 68.3 81.9 73.7 61.8 58.3 78.2 90.9 68.9Wood 0.1 0.0 0.0 0.1 0.0 0.0 0.0 0.0Cement fiber 0.1 0.0 0.1 0.1 0.1 0.2 0.0 0.0Ceramic tiles 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0Cement 30.7 18.0 25.1 37.8 35.5 21.2 8.5 31.0Tally 0.3 0.0 0.1 0.0 3.1 0.3 0.1 0.0Others 0.0 0.0 0.1 0.0 0.2 0.0 0.0 0.0
Exterior wallsNatural wallsNo wall 0.0 0.1 0.0 0.0 0.1 0.0 0.0 0.1Cane/jute stick/palm tree/trunk/ chatai/hogla 1.1 0.7 3.0 0.1 2.3 1.4 1.7 0.7Mud 3.0 0.0 3.4 0.8 2.9 12.8 5.2 0.8Rudimentary wallsBamboo with mud/bamboo 2.7 0.2 9.4 0.2 4.6 2.2 2.4 5.4Stone with mud 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0Uncovered (sunburn bricks) 0.0 0.0 0.1 0.1 0.0 0.0 0.0 0.0Cardboard 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0Reused wood 0.0 0.2 0.1 0.0 0.1 0.0 0.0 0.0Tin 28.3 56.4 27.7 29.7 12.3 21.3 37.9 22.4Finished wallsCement 59.6 37.6 54.2 67.2 60.5 47.3 45.3 67.9Cement/stone with lime mortar 0.4 0.1 0.1 0.7 0.2 0.0 0.0 0.0Bricks 4.1 1.7 1.7 1.0 12.9 14.9 7.4 2.6Block made by cement 0.2 0.1 0.0 0.3 0.2 0.0 0.0 0.0Plank/joint plank 0.5 2.9 0.2 0.0 3.6 0.0 0.0 0.0Others 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.0
Rooms used for sleeping1 37.1 17.3 28.1 47.9 25.2 27.1 29.5 26.42 38.0 37.7 40.1 34.8 42.6 44.2 40.6 37.73 or more 24.9 45.1 31.8 17.2 32.2 28.7 29.9 35.9
Mean number of persons per room used for sleeping 2.5 2.0 2.5 2.7 2.2 2.2 2.4 2.6Number of households 18,887 749 3,334 9263 1,657 1,988 1,238 658
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
24
Table 2.5a: Housing characteristics by CC slum and CC non-slum areasPer cent distribution by selected characteristics, according of City Corporation slum, City Corporation non-slum, and other municipalities/urban areas, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
AllArea
City Corporation slum
City Corporation non-slum
Other municipalities/urban
Total 100.0 100.0 100.0 100.0
ElectricityYes 95.2 96.4 99.4 93.2No 4.8 3.6 .6 6.8
FloorNatural floorEarth/sand 26.9 15.2 5.0 38.1Dung 0.0 0.0 0.0 0.0Rudimentary floorWood plank 0.4 3.7 0.2 0.3Finished floorFinished floor parquet/polished wood 0.0 0.0 0.0 0.0Ceramic tiles/mosaics 7.4 1.3 14.5 4.4Cement 64.6 79.0 79.6 56.4Carpet/ mat 0.7 0.5 0.6 0.7Others 0.0 0.2 0.0 0.0
RoofNatural roofingStraw/palm leaf 0.4 0.6 0.2 0.4Grass/ Peat 0.0 0.1 0.0 0.0Rudimentary roofingVillage mat 0.0 0.1 0.0 0.0Bamboo/ palm tree 0.1 0.5 0.1 0.1Plank 0.0 0.3 0.0 0.0Finished roofingTin/ metal 68.3 86.5 43.0 79.2Wood 0.1 0.6 0.1 0.0Cement fiber 0.1 0.0 0.2 0.0Ceramic tiles 0.0 0.0 0.1 0.0Cement 30.7 10.9 56.1 19.7Tally 0.3 0.0 0.0 0.5Others 0.0 0.3 0.0 0.0
Exterior wallsNatural wallsNo wall 0.0 0.0 0.0 0.0Cane/jute stick/palm tree/trunk/ chatai/hogla 1.1 1.4 0.6 1.3Mud 3.0 0.7 0.1 4.5Rudimentary wallsBamboo with mud/ bamboo 2.7 6.9 1.7 3.0Stone with mud 0.0 0.0 0.0 0.0Uncovered (sunburn bricks) 0.0 0.0 0.0 0.1Cardboard 0.0 0.0 0.1 0.0Reused wood 0.0 0.1 0.0 0.1Tin 28.3 43.3 9.0 36.6Finished wallsCement 59.6 43.3 85.5 48.3Cement/ stone with lime mortar 0.4 0.1 1.1 0.1Bricks 4.1 3.5 1.3 5.5Block made by cement 0.2 0.1 0.4 0.0Plank/ joint plank 0.5 0.3 0.1 0.7Others 0.0 0.2 0.0 0.0
Rooms used for sleeping1 37.1 70.9 44.1 31.52 38.0 22.6 36.4 39.83 or more 24.9 6.5 19.5 28.7
Mean number of persons per room used for sleeping 2.5 3.3 2.7 2.4Number of households 18,887 784 5,874 12,229
25
Ho
use
ho
ld P
op
ula
tio
n a
nd
Ho
usi
ng
Ch
arac
teri
stic
s
2.4 Household and Personal Asset Table 2.6 and Table 2.6a provide information on ownership of household and personal assets by divisions, and CC slums, CC non-slum and other urban areas.
Table 2.6: Household and personal assets
Percentage of households by ownership of selected household and personal assets, and per cent distribution by ownership of dwelling, according to area of residence and regions, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
AllDivision
Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Percentage of households that own a
Radio 1.1 0.9 0.6 1.4 1.4 0.6 0.5 0.5
Television 72.2 63.0 68.1 77.3 69.6 69.4 63.4 63.3
Non-mobile telephone 2.0 1.0 1.4 2.5 1.8 1.7 1.0 3.6
Refrigerator 45.2 39.6 43.0 51.5 41.4 35.8 27.5 44.6
Electric fan 92.5 88.8 90.1 96.2 92.4 86.7 83.7 89.7
Cot/Bed 97.5 99.1 95.5 97.1 98.8 99.3 98.8 98.9
Table 75.8 90.3 75.9 68.7 79.9 89.2 89.1 81.1
Almirah/Wardrobe 58.4 58.6 62.2 61.6 53.4 49.3 45.3 58.0
Sofa set 24.4 22.5 31.5 21.8 23.8 23.3 21.4 38.0
Water dispenser 17.9 10.4 23.5 18.4 17.6 11.2 5.8 34.5
Water pump 11.2 8.7 12.6 10.0 15.1 12.3 10.3 12.2
Households that own
Agricultural land 32.4 33.1 26.3 33.8 36.6 32.9 32.0 32.2
Farm animals/Livestock 26.9 36.1 28.9 16.3 38.5 44.9 52.0 25.3
Households where at least one member owns or has a
Watch 42.5 39.9 38.4 45.0 45.4 39.9 37.5 41.7
Mobile telephone 97.4 97.8 98.4 98.1 97.3 94.6 93.9 96.7
Bicycle 20.7 19.6 14.2 13.9 41.9 36.4 38.4 16.2
Motorcycle or scooter 8.7 9.6 5.2 6.5 15.4 14.0 15.3 11.3
Animal-drawn cart 0.1 0.1 0.0 0.1 0.3 0.1 0.1 0.0
Car or truck 1.2 0.3 0.8 1.5 1.4 0.8 0.8 1.7
Boat with motor 0.2 0.4 0.1 0.1 0.2 0.3 0.2 0.2
Rickshaw/Van 4.2 3.9 3.6 3.8 6.2 5.6 4.9 3.8
Nasiman/Kariman/Votbati 0.3 1.1 0.3 0.1 0.6 0.3 0.3 0.4
Easy bike/Auto bike (battery driven) 1.5 1.6 1.5 1.3 1.5 2.3 1.8 0.9
Computer 11.4 9.9 8.8 12.7 13.7 11.1 7.7 10.5
Bank Account 45.7 46.1 45.0 48.1 52.3 39.4 30.6 44.7
Ownership of dwelling
Owned by a household member 53.2 69.8 59.1 37.5 66.6 80.9 81.5 54.2
Not owned 46.8 30.2 40.9 62.5 33.4 19.1 18.5 45.8
Rented 42.4 27.0 38.9 57.2 28.6 15.2 12.1 41.9
Other 4.4 3.1 2.0 5.2 4.8 3.8 6.4 3.9
Number of households 18,887 749 3,334 9,263 1,657 1,988 1,238 658
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
26
Higher proportion of CC non-slum households or members owned television, refrigerator, sofa set, non-mobile telephone, and bank account, compared to CC slums and other urban households. Fifty three per cent of dwellings owned by a member of household. Living in owned household highest in Rangpur division (81.5 per cent) and lowest in Dhaka division 37.5 per cent. This is also the case for Dhaka division where people living in rented house much higher than other divisions (57.2 per cent).
Table 2.6a: Housing and personal assets by CC slum and CC non-slum areas
Per cent distribution by selected characteristics, according of City Corporation slum, City Corporation non-slum, and other municipalities/urban areas, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
AllArea
City Corporation slum
City Corporation non-slum
Other municipalities/urban
Total 100.0 100.0 100.0 100.0
Percentage of households that own a
Radio 1.1 0.5 1.9 0.7
Television 72.2 61.9 82.0 68.2
Non-mobile telephone 2.0 0.4 4.6 0.9
Refrigerator 45.2 19.6 60.7 39.4
Electric fan 92.5 90.1 97.3 90.3
Cot/Bed 97.5 91.3 97.4 97.9
Table 75.8 42.4 69.7 80.8
Almirah/Wardrobe 58.4 36.8 71.0 53.7
Sofa set 24.4 6.0 31.3 22.3
Water dispenser 17.9 8.4 26.6 14.3
Water pump 11.2 1.1 10.2 12.4
Households that own
Agricultural land 32.4 19.0 30.2 34.4
Farm animals/Livestock 26.9 10.3 6.3 37.9
Households where at least one member owns or has a
Watch 42.5 29.5 51.5 39.0
Mobile telephone 97.4 95.4 98.8 96.8
Bicycle 20.7 9.1 13.8 24.8
Motorcycle or scooter 8.7 1.3 7.1 10.0
Animal-drawn cart 0.1 0.1 0.1 0.1
Car or truck 1.2 0.4 2.5 0.6
Boat with motor 0.2 0.3 0.1 0.2
Rickshaw/Van 4.2 7.3 3.3 4.5
Nasiman/Kariman/Votbati 0.3 0.1 0.2 0.3
Easy bike/Auto bike (battery driven) 1.5 0.5 0.7 1.9
Computer 11.4 2.7 18.1 8.8
Bank Account 45.7 23.0 51.9 44.2
Ownership of dwelling
Owned by a household member 53.2 13.9 24.7 69.4
Not owned 46.8 86.1 75.3 30.6
Rented 42.4 68.2 69.2 27.9
Other 4.4 17.9 6.2 2.7
Number of households 18,887 784 5,874 12,229
27
Ho
use
ho
ld P
op
ula
tio
n a
nd
Ho
usi
ng
Ch
arac
teri
stic
s
Ownership of dwelling was much higher in other urban areas (69.4 per cent) than among CC non-slums (24.7 per cent) and CC slum (13.9 per cent) areas. At least one member of 97.4 per cent households owned a mobile phone, and this was almost identical in CC slums, CC non-slums and in-other urban areas. Ownership pattern of durable household goods was almost identical across divisions.
2.5 Socio-Economic Index: Wealth QuintilesHouseholds across all the survey domains and areas were categorized using an index based primarily on dwelling characteristics (e.g. presence of electricity, type of water source, type of toilet, and floor, roof and wall materials, etc.), household ownership of assets and durable goods, (television, non-mobile phone, refrigerator, sofa set, etc.) and ownership of homestead or land. Using a common scale to classify households across all domains and areas, attempt was made to observe variation in socio-economic status (SES) by constructing SES index quintile. The procedure assigns each variable a factor score or weight, and then index is constructed as a weighted sum of these variables using principal component analysis. The index is then used to rank and classify households into quintiles referred to as household asset quintiles or wealth index: quintiles.
Fig 2.2: Socio-economic status by areas, Bangladesh, CWS 2016
Table 2.7 presents information on the distribution of households by wealth quintiles by CC slums, CC non-slums and other urban areas, as well as across divisions. Higher proportion of CC slum households were poorer than CC non-slum households. Three of four (78.4 Per cent) of the CC slum households were in the lowest two wealth quintiles, compared with one in three (33.0 per cent) in CC non-slum areas. Fifty-two per cent of CC non-slum households were in the two highest wealth quintiles, compared with 10.5 per cent in CC slums.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
28
Table 2.7: Socio Economic Status Index (SES): Wealth Quintiles
Per cent distribution of the household by wealth quintiles index, according to area of residence and divisions, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Wealth quintiles index
TotalNumber of householdsLowest Second Middle Fourth Highest
Total 20.0 20.0 20.0 20.0 20.0 100.0 18,887
Area
City Corporation slum 48.5 29.9 11.1 7.4 3.1 100.0 784
City Corporation non-slum 12.1 20.9 15.3 20.9 30.8 100.0 5,874
Other municipalities/urban 22.0 18.8 22.9 20.4 16.0 100.0 12,229
Division
Barisal 15.6 16.3 28.4 23.9 15.9 100.0 749
Chittagong 20.9 16.2 20.2 22.8 19.9 100.0 3,334
Dhaka 19.3 23.4 18.4 18.2 20.6 100.0 9,263
Khulna 17.6 15.3 21.0 23.1 23.1 100.0 1,657
Rajshahi 21.3 17.7 22.8 20.4 17.9 100.0 1,988
Rangpur 25.9 19.2 22.4 19.6 12.9 100.0 1,238
Sylhet 20.8 14.1 16.2 18.7 30.2 100.0 658
The distribution of wealth among urban population by division showed almost even pattern except Sylhet, and Rangpur divisions. In Sylhet division, proportion of wealthy people was higher than other divisions and proportion of poor people was higher in Rangpur division.
2.6 Livelihood Status and Employment in Garments SectorHousehold interviews (with either the head of households or with a competent member of a household) collected information on the main sources of household income. Information was also collected on whether any household member was involved in garments sector. Results are presented in Table 2.8.
Thirty eight per cent of urban households derived their income mainly from self-employment, while 42.3 per cent were involved in service sector and 11.1 per cent in manufacturing sector for income generation, 6.0 per cent relied on remittances and 2.0 per cent derived income mainly from rents.
29
Ho
use
ho
ld P
op
ula
tio
n a
nd
Ho
usi
ng
Ch
arac
teri
stic
s
Table 2.8: Livelihood status
Percentage of household employed in garments sector by selected background characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Main Source of HH Income
Total
Number of
house-hold
member
Proportion employed in garments sector
Total
Number of
house-holds
Self-employ-
ment
Manu-facturing
sector
Service sector
Remittance Rentals Others 0 1 2 3+
Total 38.2 11.1 42.3 6.0 2.0 0.3 100.0 82,228 91.4 5.9 2.3 0.4 100.0 18,887
Sex
Male 40.4 11.4 43.0 3.4 1.7 0.2 100.0 73,979 91.8 5.7 2.1 0.4 100.0 16,618
Female 19.0 9.0 36.3 29.6 5.3 0.9 100.0 8,249 88.2 7.5 3.7 0.6 100.0 2,269
Area
City Corporation slum 32.7 13.6 50.8 1.4 1.2 0.2 100.0 3,302 72.8 19.4 6.5 1.4 100.0 784
City Corporation
non-slum 33.5 9.5 50.2 2.8 3.8 0.3 100.0 25,015 90.5 6.6 2.4 0.4 100.0 5,874
Other municipalities/
urban 40.8 11.7 38.2 7.8 1.3 0.2 100.0 53,911 93.0 4.6 2.0 0.3 100.0 12,229
Division
Barisal 43.9 6.3 42.3 6.5 0.8 0.4 100.0 3,343 99.6 0.3 0.1 0.0 100.0 749
Chittagong 33.5 10.1 42.6 12.0 1.6 0.2 100.0 16,019 88.6 7.6 3.1 0.8 100.0 3,334
Dhaka 35.4 11.7 45.7 4.2 2.9 0.2 100.0 38,509 87.0 8.8 3.6 0.5 100.0 9,263
Khulna 40.6 14.1 39.5 4.1 1.0 0.6 100.0 6,988 99.8 0.2 0.0 0.0 100.0 1,657
Rajshahi 52.8 9.0 31.8 5.0 1.2 0.2 100.0 8,430 99.2 0.8 0.0 0.0 100.0 1,988
Rangpur 40.4 12.7 43.1 2.8 0.8 0.3 100.0 5,554 98.5 1.4 0.2 0.0 100.0 1,238
Sylhet 42.7 11.1 33.9 9.9 2.2 0.2 100.0 3,385 99.7 0.2 0.2 0.0 100.0 658
Age
15-19 9.8 30.1 42.0 9.6 8.4 0.0 100.0 277 73.2 6.2 15.8 4.8 100.0 109
20-24 22.0 20.6 51.4 4.4 1.4 0.1 100.0 1,938 74.0 16.0 7.5 2.6 100.0 612
25-29 29.4 11.8 50.4 7.3 1.0 0.0 100.0 6,081 85.0 10.5 4.4 0.2 100.0 1,800
30-34 34.6 11.7 46.4 5.7 1.3 0.2 100.0 10,018 89.7 6.8 3.0 0.5 100.0 2,484
35-39 39.0 11.8 42.6 4.8 1.3 0.4 100.0 12,446 91.8 6.5 1.4 0.3 100.0 2,983
40-44 43.7 9.3 41.2 4.5 1.2 0.1 100.0 11,338 92.7 4.8 2.0 0.5 100.0 2,504
45+ 39.6 10.6 39.9 6.7 2.8 0.3 100.0 40,130 94.3 4.0 1.5 0.2 100.0 8,395
Education
No education 42.5 13.2 38.2 4.0 1.9 0.2 100.0 19,159 88.7 7.8 2.9 0.7 100.0 4,202
Primary incomplete 42.7 13.7 36.0 6.0 1.3 0.3 100.0 13,377 88.7 8.0 2.9 0.4 100.0 3,050
Primary complete 42.7 11.2 35.9 7.7 2.3 0.2 100.0 9,033 90.9 6.5 2.4 0.2 100.0 1,985
Secondary
incomplete 38.6 10.8 39.9 8.0 2.3 0.4 100.0 24,583 91.7 5.3 2.6 0.5 100.0 5,788
Secondary
complete or higher 25.9 6.7 60.3 4.5 2.3 0.2 100.0 15,715 96.6 2.4 0.8 0.1 100.0 3,793
Missing/DK 39.2 14.9 43.9 0.5 1.4 0.0 100.0 360 79.9 14.5 5.6 0.0 100.0 69
Wealth index quintile
Lowest 37.9 14.5 43.1 2.6 1.4 0.4 100.0 13,990 85.2 9.4 4.9 0.5 100.0 3,777
Second 37.1 16.0 42.3 3.5 1.0 0.1 100.0 15,216 81.7 12.9 4.8 0.6 100.0 3,766
Middle 41.1 12.0 40.2 5.6 0.8 0.2 100.0 17,034 94.4 4.2 0.8 0.6 100.0 3,778
Fourth 40.2 9.1 40.3 8.6 1.6 0.2 100.0 17,824 96.2 2.4 1.1 0.2 100.0 3,781
Highest 34.7 5.6 45.7 8.6 5.0 0.5 100.0 18,163 99.5 0.4 0.0 0.0 100.0 3,785
Religion of household head
Islam 37.4 11.2 42.6 6.3 2.2 0.3 100.0 74,338 91.1 6.0 2.4 0.4 100.0 17,108
Hindu 46.7 10.0 39.5 3.2 0.4 0.2 100.0 7,253 93.8 4.6 1.4 0.1 100.0 1,631
Buddhist 29.9 21.8 48.4 0.0 0.0 0.0 100.0 358 97.5 (2.1) (0.4) (0.0) 100.0 84
Christian 34.9 6.9 55.8 1.8 0.6 0.0 100.0 258 99.3 0.7 0.0 0.0 100.0 60
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
30
About 8.6 per cent of households had at least one member employed in garments sector. Majority of the garments workers were female. Women/household members, those who lived in CC slums were more likely to be employed in garments sector. Twenty seven per cent of CC slums households against 9.4 per cent of CC non-slums and 7.0 per cent of other urban had at least one household member employed in garment sector.
Fig 2.3: Proportion of households with one or more members employed in Garments Sector by divisions, Bangladesh, CWS 2016
The proportion of households with at least one members employed in garments sector was higher in Dhaka (13.0 per cent) and Chittagong (11.4 per cent) divisions, compared with other divisions (also see Fig. 2.3). Higher proportion of younger age group (age 15-24 years) and those belonging to the lowest two quintiles were more likely to work in garments sector. Women were more likely to work in garments sector than men (11.8 per cent female vs. 8.2 per cent male).
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
31
3 NUTRITIONAL STATUS OF CHILDREN AND INFANT FEEDING
UNICEF/BANA2014-00711/Paul
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
32
Key Findings:
� Only sixty five per cent of births occurring in the last two years preceding the survey were reported to be weighed at birth and 13.7 per cent of those live births had low birth (weight at birth below 2,500 grams).
� Overall prevalence of stunting (moderate or severe) among urban children age below five was quite high at 26.3 per cent. This was more pronounced among children who lived in CC slums (40.4 per cent) compared to 25.2 per cent among CC non-slum and 25.9 per cent among children of other urban/municipal areas.
� Overall 9.9 per cent of under-5 urban children, with 7.3 per cent in CC non-slums, 11.6 per cent in CC slums and 11.0 per cent in other urban areas were moderately or severely wasted.
� Overweight prevalence among under-5 urban children was recorded at 2.7 per cent, with 4.1 per cent in CC non-slums, 2.7 per cent in CC slums, and 2.1 per cent in other urban areas.
� About 20.4 per cent of urban children aged below five years were either moderately or severely underweight. This prevalence was 30.8 per cent among CC slum area children, while it was only about half (17.7 per cent) in CC non-slums and 20.9 per cent in other urban areas.
� Overall, 63.3 per cent of urban children age 0-23 months were put to the breast within one hour of birth.
� Overall prevalence of exclusive breastfeeding among urban children age 0-5 months was 52.7 per cent, with considerably high proportions (62.3 per cent) in CC slums, 57.5 per cent in CC non-slums and 50.0 per cent in other urban areas.
� Approximately 72.5 per cent of urban children age less than six months were predominantly breastfed. Marked variation was observed by division and also by CC slum and CC non-slum areas.
� Prevalence of continued breastfeeding at 1 year among children age 12-15 months was almost universal (96.9 per cent). Continued breastfeeding at 2 years (among 20-23 months children) was 87.0 per cent with some variations by divisions and urban domains.
� Approximately 60.3 per cent of urban children age 0-23 months received age-appropriate feeding, with no marked difference between CC slums, CC non-slums and other urban areas.
� About 75.7 per cent of urban children age 6-8 months were fed with solid semi-solid or soft foods in the last 24 hours preceding the survey.
� Less than half (45.1 per cent) of urban children age 6-23 months had received food with minimum diversity in the 24 hours preceding the survey. Minimum dietary diversity was significantly higher among CC non-slums children (51.6 per cent) than among CC slums (34.9 per cent) and other urban children (43.0 per cent).
� About 72.2 per cent of urban children age 6-23 months were fed the minimum required number of times. Receiving minimum required number of meals varied by divisions and urban domains.
� Overall 38.0 per cent of urban children age 6-23 months had received minimum acceptable diet, with 44.4 per cent in CC non-slums, 29.7 per cent in CC slums and 36.0 per cent in other urban areas.
3 NUTRITIONAL STATUS OF CHILDREN AND INFANT FEEDING
33
Nu
trit
ion
al S
tatu
s o
f C
hild
ren
an
d In
fan
t Fe
edin
g
Malnutrition among children is a serious health problem in many countries. Persistently high rates of under-lnutrition remain a very important health problem for Bangladesh. Inadequate or inappropriate feeding is the most obvious contributing factor for under-nutrition. Under-lnutrition caused by protein-energy and micronutrient deficiencies seriously affect physical growth, health and development. Undernourished children are more likely to die from common childhood ailments.
The CWS 2016 collected data on the nutritional status of urban children by measuring the height and weight of all children under age 5 years in the selected households. The survey also collected information on birth weight, feeding practices for infants and young children, including breastfeeding, feeding of solid and semi-solid foods, diversity of foods, and frequency of feeding. This chapter presents the findings on birth weight, infant feeding practices and nutritional status of children.
3.1 Child’s Weight and Size at BirthWeight 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 2,500 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.
One of the major challenges in measuring the incidence of low birth weight is that more than half of infants in the developing world are not weighed at birth. In the past, most estimates of low birth weight for developing countries were based on data compiled from health facilities. However, these estimates are biased for most developing countries because the majority of newborns are not delivered in facilities, and those who are represent only a selected sample of all births. Because many infants are not weighed at birth and those who are weighed may be a biased sample of all births, the reported birth weights usually cannot be used to estimate the prevalence of low birth weight among all children. Therefore, 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 birth6.
Overall, 4.8 per cent of children were considered by their mothers to be very small in size at birth, 11.3 per cent smaller than average, and 83.8 per cent average or larger in size.
Table 3.1 also provides information of last live-born children in the last two years preceding the survey on the Percentage of live births weighed at birth and Percentage of having low birth weight.
6 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
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
34
Sixty five per cent (64.6 per cent) of births were reported to be weighed at birth and 13.7 per cent of those live births weighed below 2,500 grams at births. Prevalence of low birth weight (weight at birth below 2,500 grams) appeared to be associated with mother’s age at birth, area of residence, mother’s level of education, and household wealth quintiles. Mothers who lived in CC slums, having no or lower level of education and belonging to lower wealth quintiles were more likely to have low birth weight child.
Table 3.1: Low birth weight infantsPercentage of last live-born children in the last two years preceding the survey that are estimated to have weighed below 2,500 grams at birth and Percentage of live births weighed at birth, according to selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Per cent distribution of births by mother’s assessment of size at birth
Total Percentage of children who have weighed
at birth
Number of last live-born
children in the last two
years
Percentage of children who had weight below 2,500
grams
Number of last live-born
children in the last two years who were weighted
Very small
Smaller than
average
Average Larger than average or very large
DK
Total 4.8 11.3 70.3 13.5 0.0 100.0 64.6 2,882 13.7 1,862
Mother’s age at birthLess than 20 years 6.0 10.5 69.2 14.3 0.0 100.0 59.4 1,545 14.0 91820-34 years 3.4 12.3 71.5 12.8 0.0 100.0 70.6 1,328 13.4 93735-49 years (*) (*) (*) (*) (*) 100.0 (*) 9 (*) 6
Birth order1 4.4 11.3 71.1 13.3 0.0 100.0 70.0 1,202 13.3 8422-3 4.8 12.0 69.8 13.5 0.0 100.0 63.1 1,477 14.7 9324-5 8.0 7.7 68.2 16.1 0.0 100.0 41.9 177 9.0 746+ (3.0) (3.8) (82.1) (11.1) (0.0) 100.0 (52.3) 27 (*) 14
AreaCity Corporation slum 5.2 16.9 61.7 16.2 0.0 100.0 60.5 127 15.8 77City Corporation non-slum 3.8 11.7 70.3 14.3 0.0 100.0 78.7 811 11.1 638Other municipalities/urban 5.2 10.8 70.9 13.1 0.0 100.0 59.0 1,944 15.1 1,147
DivisionBarisal 3.4 7.2 79.7 9.7 0.0 100.0 63.1 120 11.7 76Chittagong 8.5 17.8 64.9 8.8 0.0 100.0 49.9 651 16.5 325Dhaka 2.9 8.3 74.0 14.8 0.0 100.0 70.6 1,320 13.0 932Khulna 6.5 11.0 64.9 17.5 0.0 100.0 72.5 193 14.5 140Rajshahi 5.2 11.6 64.8 18.3 0.0 100.0 68.1 272 12.0 185Rangpur 2.5 11.2 69.8 16.6 0.0 100.0 71.4 198 13.9 141Sylhet 6.3 14.0 72.1 7.6 0.0 100.0 49.0 128 14.9 63
Mother’s educationNo education 5.3 23.2 60.7 10.8 0.0 100.0 42.2 237 17.2 100Primary incomplete 3.8 12.0 73.4 10.8 0.0 100.0 44.2 423 17.5 187Primary complete 5.4 11.4 70.7 12.5 0.0 100.0 48.0 294 11.7 141Secondary incomplete 4.9 10.1 71.1 13.9 0.0 100.0 69.5 1,378 14.7 958Secondary complete or above 4.6 8.7 70.0 16.6 0.0 100.0 86.6 549 10.1 476
Wealth index quintileLowest 5.2 17.4 68.8 8.6 0.0 100.0 40.3 633 16.0 255Second 3.7 11.5 71.5 13.3 0.0 100.0 55.9 520 13.4 291Middle 5.0 8.1 71.5 15.3 0.0 100.0 63.5 594 12.2 378Fourth 6.1 7.7 70.1 16.1 0.0 100.0 79.9 634 12.1 507Highest 3.3 12.0 69.8 14.8 0.0 100.0 86.2 500 15.8 431
Religion*Islam 4.0.8 11.1 70.6 13.4 0.0 100.0 63.7 2,629 14.3 1,674Hindu 5.0.0 15.9 64.4 14.7 0.0 100.0 78.3 220 9.9 172
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted casesDK: Don’t know
35
Nu
trit
ion
al S
tatu
s o
f C
hild
ren
an
d In
fan
t Fe
edin
g
3.2 Nutritional Status of ChildrenThe standard indices of physical growth that describes the nutritional status of children are:
� Height-for-age (stunting); � Weight-for-height (wasting); and � Weight-for-age (underweight).
Using height and weight data of children age below 5 years, nutritional status were assessed. The nutritional measurements were evaluated against the WHO standard growth curves (WHO 2006). Specifically, the nutritional indicators are expressed in standard deviations (z-scores) from the mean of the standard/reference population. Children with measurements between less than -2 and -3 Z-scores were considered to have moderate stunting, wasting or underweight, while those below -3 Z-score have exhibited severe stunting, wasting or underweight.
Height-for-age (Stunting):
Height-for-age measures linear growth and measures a chronic nutrition status. A child who is more than two standard deviations below (-2 SD) the median of the WHO reference population in terms of height-for-age is considered short for her/his age and classified as moderately or severely stunted. This reflects the effect of chronic malnutrition. If a child is below three standard deviation (-3SD) from the reference median, then s/he is considered to be severely stunted. The survey collected data on height and weight of under 5 children (age 0-59 months).
Results in Table 3.2 show that prevalence of stunting (moderate or severe) among urban children age below 5 was quite high (26.3 per cent). This was more pronounced among children who lived in CC slums (40.4 per cent). Prevalence of moderately or severely stunting among CC non-slums and other urban children were 25.2 and 25.9 per cents respectively. Among the divisions, Sylhet had the highest rate of stunting (35.5 per cent), while it was lowest among the under five children of Khulna division (20.5 per cent). The UHS 2013 reported somewhat higher prevalence of stunting with 49.6 per cent in CC slums, 33.4 per cent in CC non-slums and 36.8 per cent in other urban areas.
Prevalence of stunting (moderate or severe) was found to be negatively associated with mother’s level of education and household wealth quintiles. For example, 36.6 per cent children of the lowest wealth quintile were stunted, while this was only 14.5 per cent among children of the highest quintile. Stunting was 42.6 per cent among children with mothers having no education and this prevalence was 15.0 per cent among those with mother’s having secondary or higher level of education. (These results are similar to those reported in MICS 2012-2013 and BDHS 2014.)
Weight-for-height (Wasting):
Weight-for-height describes current nutritional status. Children whose weight-for-height is more than two standard deviation below (-2SD) the median of the reference population are considered to be too thin for their weight and 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 and this may exhibit significant seasonal shifts associated with changes in the availability of food or disease prevalence.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
36
A child is considered overweight if her/his weight-for-height is more than two standard deviation above (+2SD) the median.
Table 3.2: Nutritional status of children
Percentage of children under age 5 years by nutritional status according to three anthropometric indices: weight for age, height for age, and weight for height by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
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)Per cent below Per cent below Per cent below Per cent
above- 2 SD - 3 SD - 2 SD - 3 SD - 2 SD - 3 SD + 2 SD
Total 20.4 4.0 -1.1 6,888 26.3 7.8 -1.2 6,888 9.9 2.2 2.7 -0.6 6,888
Sex
Boy 21.1 4.3 -1.1 3,438 27.3 8.6 -1.2 3,438 11.2 3.0 3.3 -0.6 3,438
Girl 19.8 3.6 -1.1 3,451 25.3 6.9 -1.2 3,451 8.6 1.4 2.2 -0.6 3,451Area
City Corporation slum 30.8 7.9 -1.4 311 40.4 15.4 -1.7 311 11.6 2.1 2.7 -0.6 311
City Corporation non-slum 17.7 2.7 -0.9 2,042 25.2 7.3 -1.1 2,042 7.3 2.1 4.1 -0.4 2,042
Other municipalities/urban 20.9 4.3 -1.1 4,536 25.9 7.5 -1.2 4,536 11.0 2.3 2.1 -0.6 4,536Division
Barisal 18.7 3.6 -1.0 291 25.6 7.5 -1.1 291 8.2 1.8 2.0 -0.6 291
Chittagong 23.7 5.3 -1.2 1,410 30.4 8.6 -1.3 1,410 10.6 2.7 1.9 -0.7 1,410
Dhaka 18.8 3.3 -1.0 3,289 24.5 7.6 -1.1 3,289 9.4 2.1 3.3 -0.5 3,289
Khulna 21.0 3.4 -1.0 502 20.5 5.1 -1.0 502 10.2 2.4 3.2 -0.6 502
Rajshahi 21.5 4.6 -1.2 641 27.1 7.6 -1.3 641 10.7 1.2 2.2 -0.7 641
Rangpur 17.5 2.8 -1.1 445 26.1 6.1 -1.2 445 9.4 2.0 1.8 -0.6 445
Sylhet 25.8 6.1 -1.2 309 35.5 13.3 -1.4 309 11.6 2.7 3.1 -0.6 309Age
0-5 months 20.9 5.4 -1.0 552 15.5 5.6 -0.6 552 16.8 6.7 2.0 -0.6 552
6-11 months 12.9 1.6 -0.7 700 13.9 2.9 -0.7 700 5.6 1.4 3.1 -0.3 700
12-17 months 15.0 1.3 -0.9 736 24.3 4.3 -1.1 736 8.3 1.5 2.4 -0.5 736
18-23 months 17.6 4.6 -0.9 681 32.0 10.5 -1.4 681 8.5 1.7 4.6 -0.4 681
24-35 months 24.8 4.1 -1.2 1,416 32.6 10.4 -1.4 1,416 8.8 1.4 2.5 -0.6 1,416
36-47 months 21.8 4.4 -1.2 1,391 29.6 8.9 -1.3 1,391 10.3 2.0 1.8 -0.7 1,391
48-59 months 22.4 5.0 -1.3 1,412 25.5 7.9 -1.3 1,412 11.6 2.4 3.3 -0.8 1,412Mother’s education
No education 34.2 8.7 -1.5 641 42.6 16.0 -1.7 641 12.2 4.4 2.1 -0.8 641
Primary incomplete 24.6 4.7 -1.4 1,021 33.3 9.9 -1.5 1,021 10.0 2.4 1.6 -0.7 1,021
Primary complete 25.2 4.0 -1.3 703 32.1 12.0 -1.5 703 7.6 2.5 1.6 -0.7 703
Secondary incomplete 19.4 3.6 -1.0 3,325 23.9 6.0 -1.1 3,325 11.4 1.7 2.8 -0.6 3,325
Secondary complete or above 9.6 1.8 -0.5 1,198 15.0 4.1 -0.7 1,198 5.7 1.9 4.6 -0.3 1,198Wealth index quintile
Lowest 29.1 5.7 -1.4 1,459 36.6 11.5 -1.6 1,459 11.2 2.5 2.7 -0.7 1,459
Second 23.4 3.7 -1.3 1,285 31.9 10.5 -1.4 1,285 7.7 1.4 1.3 -0.7 1,285
Middle 23.7 6.3 -1.2 1,358 27.6 8.4 -1.2 1,358 11.9 3.3 2.0 -0.7 1,358
Fourth 16.0 2.3 -1.0 1,515 20.3 4.3 -1.0 1,515 11.0 2.1 2.4 -0.5 1,515
Highest 9.4 1.6 -0.5 1,272 14.6 4.2 -0.6 1,272 7.2 1.4 5.4 -0.3 1,272Religion*
Islam 20.8 3.9 -1.1 6,324 26.8 8.0 -1.2 6,324 9.8 2.2 2.7 -0.6 6,324
Hindu 16.2 4.2 -0.8 515 21.3 5.4 -1.0 515 10.4 1.8 4.1 -0.4 515
*Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
Table 3.2 also shows that overall 9.9 per cent of the urban children were either moderately or severely wasted. This prevalence was 7.3 per cent in CC non-slums, 11.6 per cent in CC slums and 11.0 per cent in other urban areas. Prevalence of wasting (either moderately or severely) was the highest in Sylhet (11.6 per cent) and lowest in Barisal (8.2 per cent) division. Wasting among urban children was more pronounced among boys, and in the lowest wealth quintile.
37
Nu
trit
ion
al S
tatu
s o
f C
hild
ren
an
d In
fan
t Fe
edin
g
Fig 3.1: Nutritional status by areas, Bangladesh, CWS 2016
Overweight prevalence among urban children age under 5 was recorded at 2.7 per cent, with 4.1 per cent in CC non-slums, 2.7 per cent in CC slums and 2.1 per cent in other urban areas. Overweight prevalence was higher among male, and among children of the highest wealth quintile.
Weight-for-age (underweight):
Weight-for-age is a composite index of weight-for-height and height-for-age. It does not distinguish between acute malnutrition (wasting) and chronic malnutrition (stunting). A child can be underweight for her/his age because s/he is stunted, because s/he is wasted, or both. Underweight indicates severe presence of malnutrition. A child whose weight-for-age is more than two standard deviation below (-2SD) the median of the reference population is considered moderately or severely underweight, while if her/his weight-for-age is more than three standard deviation below (-3SD) the median is classified as severely underweight.
Fig 3.2: Underweight, stunt ed, wasted and overweight children under age 5 (moderate and severe), Bangladesh, CWS 2016
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
38
Results showed that 20.4 per cent of urban children aged below five years were either moderately or severely underweight. Prevalence of underweight was 30.8 per cent among children of CC slum areas, while it was only about half (17.7 per cent) in CC non-slums and 20.9 per cent in other urban areas. Again, underweight prevalence was the highest in Sylhet (25.8 per cent), and lowest in Rangpur division (17.5 per cent). It was negatively associated with mother’s education and household wealth quintiles.
The levels of stunting, wasting, under-weight and overweight for different age-groups of under-5 children are shown in Figure 3.2. It shows how the nutrition level deteriorates with the age of the child, in general.
3.3 Breastfeeding
Feeding practices, especially breastfeeding practices play a pivotal role in deterring the optimal growth and development of infants. Poor breastfeeding and infant feeding practices have adverse consequences for the health and nutrient status of children.
It is recommended (UNICEF & WHO) that children should be exclusively breastfed (that is, given no other liquid or solid food or plain water) for first six months of life and that children be given solid or semi-solid complementary food at six completed months. It is also recommended that breastfeeding should continue throughout the second year of life. The usual indicator for exclusive breastfeeding is the Percentage of children under age 6 months who are exclusively breastfeed. The indicator for early initiation of breastfeeding is the Percentage of newborn who are put to the mother’s breast within one hour of birth. The indicator for timely complementary feed is the Percentage of children age 6-8 months who receive solid, semi-solid or soft food in the last 24 hours.
3.3.1 Initial Breastfeeding
Early initiation of breastfeeding is important for both the mother and the child. The first breastmilk contains colostrum which is highly nutritious and has antibodies that protect the newborn from disease. The CWS 2016 collected information, for last-born children in the last two years preceding the survey, on ever breastfeeding, initiation of breastfeeding within one hour and one day of birth, and whether any prelacteal food was given.
Results on initiation of breastfeeding for children born in the last two years are given in Table 3.3. It can be seen that percentage of children born in the last two years were ever breastfeed was 98.2 per cent. Overall, 63.3 per cent of urban children age 0-23 months were put to the breast within one hour of birth and 89.5 per cent were breastfed within one day after birth.
Table 3.3 indicates no marked differences in the timing of initial breastfeeding within one hour of birth, either by divisions, mother’s education, socio-economic status or by place of delivery. Notable variation, however, can be seen by CC non-slum and CC slum areas of residence. The proportion of children breastfed within one hour of birth was lowest in CC non-slums (58.2 per cent).
39
Nu
trit
ion
al S
tatu
s o
f C
hild
ren
an
d In
fan
t Fe
edin
g
Fig 3.3: Initiation of breasfeeding within one day of birth by areas, Bangladesh, CWS 2016
Prelacteal feeding is the practice of giving any liquids other than breastmilk to a child during the first three days of life. Twenty nine per cent of urban children received prelacteal feed. Receiving prelacteal feed was more in CC slums (31.1 per cent) than in CC non-slums areas (27.5 per cent). Prelacteal feeding was more common in Rajshahi, Dhaka, and Khulna divisions than Sylhet, Rangpur and other divisions.
Table 3.3: Initial breastfeeding
Percentage of last live-born children in the last two years preceding the survey, who were ever breastfed, breastfed within one hour of birth, and within one day of birth, and Percentage who received a pre-lacteal feed, according to selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Percentage who were
ever breastfed
Percentage who were first breastfed:
Percentage who received a pre-lacteal
feed
Number of last live-born
children in the last two years
Within one hour of birth2
Within one day of birth
Total 98.2 63.3 89.5 28.6 2,882
AreaCity Corporation slum 97.8 66.9 90.0 31.1 127City Corporation non-slum 97.2 58.2 89.0 27.5 811Other municipalities/urban 98.7 65.2 89.6 29.0 1,944
DivisionBarisal 99.2 71.1 89.7 23.1 120Chittagong 98.6 57.5 90.4 23.2 651Dhaka 97.3 63.2 88.3 32.1 1,320Khulna 99.6 62.3 88.5 33.7 193Rajshahi 99.2 64.0 86.7 37.5 272Rangpur 99.4 71.4 94.5 20.3 198Sylhet 99.2 73.4 95.9 12.1 128
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
40
Table 3.3: continued Percentage
who were ever breastfed
Percentage who were first breastfed:
Percentage who received a pre-lacteal
feed
Number of last live-born
children in the last two years
Within one hour of birth2
Within one day of birth
Months since last birth
0-11 months 97.5 64.0 90.6 26.8 1,380
12-23 months 98.9 62.7 88.4 30.5 1,495
Assistance at delivery
Skilled attendant 98.2 53.8 87.4 28.2 1,851
Traditional birth attendant 98.6 82.3 93.5 28.3 241
Others 98.3 79.6 93.0 30.0 788
Place of delivery
Home 98.5 79.6 92.8 28.3 1,093
Health facility
Public 97.9 57.4 87.8 27.5 506
Private 98.2 51.6 87.3 29.5 1,281
Mother’s education
No education 99.6 63.0 87.7 28.5 237
Primary incomplete 99.9 73.2 95.4 35.0 423
Primary complete 97.8 62.9 94.1 26.6 294
Secondary incomplete 97.8 60.8 88.0 27.8 1,378
Secondary complete or higher 97.7 62.1 86.8 27.2 549
Wealth index quintile
Lowest 98.3 70.2 91.5 29.9 633
Second 97.7 64.4 87.6 27.9 520
Middle 98.4 62.2 87.8 31.2 594
Fourth 98.9 62.7 90.6 29.7 634
Highest 97.7 55.4 89.3 23.5 500
Religion*
Islam 98.1 63.5 89.2 29.1 2,629
Hindu 99.8 60.9 91.4 26.1 220
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
3.3.2 Exclusive and Continued Breastfeeding
Exclusive breastfeeding was defined as proportion of infants age 0-5 months who received only breast milk during the previous 24 hours preceding the survey. Exclusive breastfeeding allows the inclusion of ORS (oral rehydration salt), vitamins and/or mineral supplements. Table 3.4 shows that prevalence of exclusive breastfeeding among 0-5 months’ children in CC slums, and other urban areas were 62.3and 50.0 per cent, respectively. Overall over half of the children (0-5 months) were exclusively breastfed (52.7 per cent). The UHS 2013 reported similar results (for CC slums 59.2 per cent, CC non-slums 57.7 per cent and for other urban 66.1 per cent).
Results indicate marked differences in exclusive breastfeeding by divisions. Barisal at 64.2 per cent and Khulna (32.7 per cent) division, were the best and worst divisions. It was positively associated with mother’s education and household wealth quintiles.
Over seven in every ten (72.5 per cent) children aged less than six months in urban areas of Bangladesh were predominantly breastfed.
41
Nu
trit
ion
al S
tatu
s o
f C
hild
ren
an
d In
fan
t Fe
edin
g
Continued breastfeeding at 1 year and continued breastfeeding at 2 years are defined respectively as Percentages of children age 12-15 months and of age 20-23 months who received breastmilk during the previous day. Table 3.4 also shows almost universal (96.9 per cent) prevalence of continued breastfeeding at 1 year, while practice of continued breastfeeding at 2 years was 87.0 per cent. Variations in continued breastfeeding by area of residence, division and wealth quintiles were minimal.
Table 3.4: Exclusive and continued breastfeeding
Percentage of last-born children age under 6 months who were exclusively breastfed, predominantly breastfed, Percentage of 12-15 months and 20-23 months children who received breast milk during the previous day (continued breastfeeding at 1 year and at 2 year) by selected background characteristics, Child Well-being survey in urban areas, Bangladesh, CWS 2016
Children age 0-5 months Children age 12-15 months Children age 20-23 months
Per cent exclusively breastfed
Per cent predominantly
breastfed
Number of
children
Per cent breastfed (Continued
breastfeeding at 1 year)
Number of
children
Per cent breastfed (Continued
breastfeeding at 2 years)
Number of
children
Total 52.7 72.5 662 96.9 519 87.0 459
Sex
Boy 50.6 67.8 333 98.4 254 86.7 256
Girl 54.8 77.3 329 95.6 265 87.4 202
Area
City Corporation slum 62.3 83.0 28 92.3 19 90.7 18
City Corporation non-slum 57.5 72.0 188 98.7 152 80.3 134
Other municipalities/urban 50.0 72.1 446 96.4 347 89.7 307
Division
Barisal 64.2 77.1 35 98.0 24 (95.8) 18
Chittagong 62.0 78.4 132 98.2 102 89.8 97
Dhaka 49.4 66.9 300 97.8 241 83.7 239
Khulna 32.7 63.0 48 91.6 34 (91.3) 26
Rajshahi 43.6 74.3 60 94.0 59 88.2 32
Rangpur 66.4 86.9 55 96.7 33 93.4 32
Sylhet 56.1 82.9 32 96.7 26 89.2 16
Mother’s education
No education 36.5 73.2 58 98.4 41 (87.4) 34
Primary incomplete 53.5 81.0 109 99.0 77 90.0 62
Primary complete 44.4 71.4 64 100.0 48 (100.0) 41
Secondary incomplete 52.4 67.8 311 96.5 283 90.4 206
Secondary complete or higher 65.0 77.6 120 93.7 70 74.6 115
Wealth index quintile
Lowest 46.5 73.6 141 99.1 122 88.0 87
Second 52.9 75.3 102 100.0 111 93.7 96
Middle 47.6 74.0 168 95.6 102 97.8 91
Fourth 56.7 68.8 155 91.8 101 87.8 96
Highest 64.1 71.6 95 97.7 83 66.8 88
Religion*
Islam 54.0 72.8 603 96.7 466 86.5 424
Hindu 39.1 69.6 50 98.9 48 (92.7) 33
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
( ) Figures that are based on 25-49 unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
42
3.3.3 Age-Appropriate Breastfeeding
The age appropriate breastfeeding of children under age 24 months is provided in Table 3.6. It is defined as the Percentage of children age 0-23 months who were appropriately breastfed during the previous day, preceding the survey. This means, children age 0-5 months who are exclusively breastfed, and children age 6-23 months who received solid, semi-solid or soft food along with breastmilk are considered as age-appropriately breastfed.
Results in Table 3.5 show that 60.3 per cent of urban children age 0-23 months received age-appropriate breastfeeding. Some variations were found in the age-appropriate feeding practices by urban CC slums (60.2 per cent), CC non-slums (59.8 per cent) and other urban areas (60.5 per cent), though not very marked. Wide variation was observed across divisions, with Sylhet showing the highest prevalence (72.2 per cent) and Rajshahi the lowest (51.7 per cent). Male children were less likely to receive age-appropriate breastfeeding (58.4 per cent) than females (62.3 per cent). Age-appropriate breastfeeding was found to be positively associated with mother’s education though the association was not very strong with the socio-economic status.
Table 3.5: Age-appropriate breastfeeding
Percentage of children age 0-23 months who were appropriately breastfed during the previous day, preceding the survey by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Children age 0-5 months Children age 6-23 months Children age 0-23 months
Per cent exclusively breastfed
Number of
children
Per cent currently breastfeeding and
receiving solid, semi-solid or soft foods
Number of
children
Per cent appropriately
breastfed
Number of
children
Total 52.7 662 62.5 2136 60.3 2805
Sex
Male 50.6 333 60.5 1,055 58.4 1,396
Female 54.8 329 64.5 1,080 62.3 1,409
Area
City Corporation slum 62.3 28 59.6 94 60.2 123
City Corporation non-slum 57.5 188 60.0 595 59.8 790
Other municipalities/urban 50.0 446 63.8 1,447 60.5 1,892
Division
Barisal 64.2 35 73.8 84 71.0 119
Chittagong 62.0 132 68.1 503 66.8 635
Dhaka 49.4 300 57.3 970 55.7 1278
Khulna 32.7 48 64.4 139 56.2 187
Rajshahi 43.6 60 54.1 209 51.7 269
Rangpur 66.4 55 72.8 140 71.0 195
Sylhet 56.1 32 77.8 91 72.2 123
Mother’s education
No education 36.5 58 59.0 174 54.1 236
Primary incomplete 53.5 109 58.2 303 57.0 412
Primary complete 44.4 64 66.5 224 61.6 287
Secondary incomplete 52.4 311 62.8 1,019 60.4 1,334
Secondary complete or higher 65.0 120 64.5 416 64.6 536
43
Nu
trit
ion
al S
tatu
s o
f C
hild
ren
an
d In
fan
t Fe
edin
g
Table 3.5: continued
Children age 0-5 months Children age 6-23 months Children age 0-23 months
Per cent exclusively breastfed
Number of
children
Per cent currently breastfeeding and
receiving solid, semi-solid or soft foods
Number of
children
Per cent appropriately
breastfed
Number of
children
Wealth index quintile
Lowest 46.5 141 62.4 460 59.0 605
Second 52.9 102 63.4 397 61.5 503
Middle 47.6 168 62.9 418 58.5 586
Fourth 56.7 155 61.9 471 60.6 627
Highest 64.1 95 62.2 389 62.6 484
Religion*
Islam 54.0 603 61.8 1,945 60.1 2,556
Hindu 39.1 50 65.9 168 59.7 218
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
3.4 Introduction of Solid, Semi-Solid or Soft FoodIt is recommended that complementary feeding (giving solid, semi-solid or soft food to infants in addition to breast milk) should start at age six months, because at this age breast milk is no longer-sufficient to maintain the child’s growth (WHO 2008). The complementary feeding indicator measures the proportion of infants age 6-8 months who receive solid, semi-solid, or soft food along with or without breastmilk.
The CWS 2016 collected information from mothers/caregivers on the types of liquids and food the children had consumed during the day or night preceding the interview. Based on 24 hours recall data, results obtained on complementary feeding as presented in Table 3.6 show that three in every four children (75.7 per cent) of urban children age 6-8 months received solid, semi-solid, or soft food. Differences in receiving complementary feeding by areas of residence was quite high - with 75.1 per cent in CC slums, 68.1 per cent in CC non-slums and 78.4 per cent in other urban areas. Among the divisions, it was the highest in Khulna (92.0 per cent), and lowest in Sylhet (66.3 per cent).
Table 3.6: 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, preceding the survey by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Currently breastfeeding Currently not breastfeeding All
Per cent receiving solid, semi-solid or
soft foods
Number of children age 6-8 months
Per cent receiving solid, semi-solid or
soft foods
Number of children age 6-8 months
Per cent receiving solid, semi-solid or
soft foods
Number of children age 6-8 months
Total 78.8 371 (*) 19 75.7 390
Sex
Male 74.9 162 (*) 4 73.2 166
Female 81.9 209 (*) 3 82.0 212
Area
City Corporation slum 76.9 19 (*) 1 75.1 20
City Corporation non-slum 73.1 90 (*) 7 68.1 97
Other municipalities/urban 80.9 262 (*) 11 78.4 273
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
44
Table 3.6: continued Currently breastfeeding Currently not breastfeeding All
Per cent receiving solid, semi-solid or
soft foods
Number of children age 6-8 months
Per cent receiving solid, semi-solid or
soft foods
Number of children age 6-8 months
Per cent receiving solid, semi-solid or
soft foods
Number of children age 6-8 months
Division
Barisal (78.1) 14 (*) (78.3) 14
Chittagong 82.0 109 (*) 5 78.7 114
Dhaka 76.7 138 (*) 9 72.2 147
Khulna (92.0) 29 (*) (92.0) 29
Rajshahi 76.8 39 (*) 2 77.8 40
Rangpur 70.8 26 (*) 1 67.2 28
Sylhet 71.4 17 (*) 2 66.3 19
Mother’s education
No education (65.2) 23 (*) 1 (65.0) 24
Primary incomplete 63.6 63 (*) 2 64.1 65
Primary complete (76.5) 39 (*) 2 (74.7) 40
Secondary incomplete 80.2 159 (*) 11 75.0 170
Secondary complete or higher 92.0 87 (*) 4 88.6 91
Wealth index quintile
Lowest 76.0 94 (*) 4 74.6 98
Second 71.2 73 (*) 6 67.2 79
Middle 79.5 60 (*) 4 74.1 64
Fourth 92.7 62 (*) 4 87.7 66
Highest 77.9 83 (*) 1 76.7 84
Religion*
Islam 77.5 334 (*) 16 74.7 350
Hindu (89.2) 30 (*) 1 87.7 31
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted cases
3.5 Infant and Young Child Feeding (IYCF) PracticesInfant and young child feeding (IYCF) practices include initiating timely feeding of solid or semi-solid foods at age 6 completed months and increasing the amount and variety of foods and frequency of feeding as the child gets older, while maintaining frequent breastfeeding.
45
Nu
trit
ion
al S
tatu
s o
f C
hild
ren
an
d In
fan
t Fe
edin
g
Table 3.7: Infant and young child feeding (IYCF) practices
Percentage of children age 6-23 months who received appropriate liquids and solid, semi-solid, or soft foods the minimum number of times or more during the previous day, by breastfeeding status, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Currently breastfeeding Currently not breastfeeding AllPer cent of children who
received: Number of
children age 6-23 months
Per cent of children who received:Number
of children age 6-23 months
Per cent of children who received: Number
of children age 6-23 months
aMini-mum
dietary diversity
bMini-mum meal fre-
quency
cMini-mum
accep-table diet
aMini-mum
dietary diversity
bMini-mum meal fre-
quency
cMini-mum acce-ptable
diet
At least
2 milk feeds
aMini-mum
dietary diversity
bMini-mum meal fre-
quency
cMini-mum acce-ptable
diet
Total 45.1 72.9 39.6 1,997 43.3 62.9 17.9 43.3 157 45.1 72.2 38.0 2,188
Sex
Male 47.7 74.4 41.5 992 41.2 82.3 34.4 61.6 56 47.3 74.8 41.2 1,055
Female 42.6 71.4 37.6 1,006 (44.9) (73.5) 12.4 (46.6) 72 42.8 71.6 35.9 1,080
Age
6-8 months 22.7 76.1 22.2 371 (*) (*) (*) (*) 7 22.3 75.3 21.9 390
9-11 months 34.4 68.2 29.6 281 (*) (*) (*) (*) 17 35.9 69.4 31.1 304
12-17 months 50.7 74.4 44.9 745 (45.5) (55.0) (4.9) (29.0) 45 50.6 73.3 42.6 792
18-23 months 57.0 71.3 48.3 601 40.0 64.1 18.5 42.5 88 55.3 70.4 44.5 702
Area
City Corporation slum 36.3 65.7 32.3 86 (20.5) (54.7) (7.5) (41.9) 10 34.9 64.5 29.7 97
City Corporation non-slum 52.0 75.5 45.9 540 (48.4) (84.3) (27.7) (56.9) 49 51.6 76.2 44.4 609
Other municipalities/urban 43.0 72.3 37.5 1,372 42.7 53.2 14.1 36.6 98 43.0 71.0 36.0 1,482
Division
Barisal 52.4 70.7 45.6 83 (*) (*) (*) (*) 2 53.2 70.8 45.3 85
Chittagong 41.1 55.7 32.4 484 (*) (*) (*) (*) 26 41.4 54.5 31.7 515
Dhaka 49.1 83.0 45.7 884 (38.9) (71.0) (13.7) (45.5) 88 48.3 81.9 42.8 998
Khulna 41.9 86.2 39.3 131 (33.6) (64.5) (18.5) (48.4) 12 41.5 84.3 37.5 143
Rajshahi 36.1 64.8 27.5 193 (*) (*) (*) (*) 16 39.0 66.4 29.4 211
Rangpur 47.0 74.1 40.8 135 (*) (*) (*) (*) 7 45.9 73.5 38.8 143
Sylhet 41.6 63.8 36.6 87 (*) (*) (*) (*) 7 40.8 61.0 34.3 95
Mother’s education
No education 31.8 55.4 25.7 162 (*) (*) (*) (*) 13 32.2 56.2 26.0 175
Primary incomplete 34.8 62.7 30.3 286 (40.3) (46.6) (7.6) (22.4) 22 35.1 61.5 28.7 308
Primary complete 42.8 75.8 39.6 219 (*) (*) (*) (*) 6 43.7 75.9 38.7 231
Secondary incomplete 46.8 72.9 39.8 959 43.0 54.8 16.4 44.5 74 46.5 71.6 38.2 1,047
Secondary complete or higher 55.8 86.7 52.0 372 (41.8) (82.1) (23.7) (53.5) 43 54.9 86.2 49.1 428
Wealth index quintile
Lowest 33.8 62.4 27.8 441 (13.8) (23.5) (6.0) (19.0) 33 33.3 59.7 26.3 482
Second 37.8 68.7 33.2 382 (84.8) (20.1) (13.3) (15.8) 20 39.5 66.2 32.2 409
Middle 48.7 75.6 42.8 394 (*) (*) (*) (*) 24 47.5 75.6 41.3 422
Fourth 52.8 79.6 46.6 429 (54.6) (85.1) (24.7) (43.2) 40 53.3 80.0 44.8 476
highest 53.9 79.5 48.9 351 (*) (*) (*) (*) 39 52.1 80.4 46.4 399
Religion*
Islam 44.1 72.3 38.5 1,820 40.5 61.5 14.4 40.0 140 43.9 71.6 36.8 1,994
Hindu 51.2 78.4 48.2 155 (*) (*) (*) (*) 14 52.4 79.2 48.7 170
a Minimum dietary diversity is defined as receiving foods from at least 4 of 7 food groups: 1) Grains, roots and tubers, 2) legumes and nuts, 3) dairy products (milk, yogurt, cheese), 4) flesh foods (meat, fish, poultry and liver/organ meats), 5) eggs, 6) vitamin-A rich fruits and vegetables, and 7) other fruits and vegetables.
b Minimum meal frequency: Children age 6-23 months who received solid, semi-solid or soft food (plain milk feeds for non-breastfed children) the minimum of 7 (or more) times
c Minimum acceptable diet: Children age 6-23 months with minimum dietary diversity and minimum meal frequency (Breastfed children) and minimum dietary diversity (excluding milk feeds and minimum meal frequency, Non-breastfed children).
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
(*) Figures that are based on fewer than 25 unweighted cases
( ) Figures that are based on 25-49 unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
46
3.5.1 Minimum Dietary Diversity
As per guidelines established for IYCF practices for children age 6-23 months (WHO 2008), minimum dietary diversity means feeding the child food from at least four food groups out of seven food groups: grains, roots and tubers; legumes and nuts; dairy products (milk, yogurt, cheese); flesh foods (meat, fish, poultry, and liver/organ meat); eggs; vitamin A-rich fruits and vegetables; and other fruit and vegetables. Consumption of food from at least four food groups means that the child has a high likelihood of consuming at least one animal source of food and at least one fruit or vegetables in addition to a staple food (grains, roots, or tubers) (WHO 2008). This cut-off was selected because it is associated with better-quality diets for both breastfed and non-breastfed children. It is recommended that meat, poultry, fish or eggs be eaten daily or as often as possible. Vegetarian diets may not meet children’s nutrient requirements unless supplements or fortified products are used. Vitamin A-rich fruits and vegetables should be consumed daily. Children’s diets should include an adequate fat content, including fats that provide essential fatty acids. Fat facilitates adsorption of fat-soluble vitamins (such as Vitamin A), and enhances dietary energy density and palatability.
Minimum dietary diversity is defined as the proportion of children age 6-23 months who consume foods from 4 or more food groups. Based on the recall data on the consumption of foods by children age 6-23 months in the last 24 hours preceding interview, prevalence of dietary diversity was estimated. Table 3.7 shows that 45.1 per cent of urban children age 6-23 months had received food with minimum diversity. Prevalence of minimum dietary diversity was significantly higher among children of CC non-slum areas (51.6 per cent), compared to CC slums (34.9 per cent) and other urban children (43.0 per cent). Wide variation was also observed by divisions, with the highest prevalence in Barisal (53.2 per cent) and lowest in Rajshahi (39.0 per cent). Children of higher age groups, higher level of mother’s education and belonging to higher wealth quintiles were more likely to consume food with minimum dietary diversity.
Fig 3.4: Percentage of children of age 6-8 months fed according to minimum standard of acceptable feeding practices, Bangladesh, CWS 2016
47
Nu
trit
ion
al S
tatu
s o
f C
hild
ren
an
d In
fan
t Fe
edin
g
3.5.2 Minimum Meal Frequency
The minimum meal frequency or the minimum number of meals consumed by a child during the last 24 hours is a proxy for adequate energy intake from complementary food. In CWS 2016, prevalence of minimum meal frequency is defined as percentage of children age 6-23 months who received solid, semi-solid or soft food (plain milk feeds for non-breastfed children) the minimum of 7 (or more) times in last 24 hours preceding the survey.
Results (in Table 3.7) show that, overall 72.2 per cent of urban children age 6-23 months (both breastfed and non-breastfed) were fed the minimum number of times.
Receiving minimum meal frequency was relatively higher for children age 6-23 months in CC non-slums(76.2 per cent) than CC slums (64.5 per cent) and other urban areas (71.0 per cent) received minimum number of meals (7 or more) in the 24 hours preceding interviews.
Receiving minimum number of meals varied substantially by division, with highest proportion in Khulna (84.3 per cent), and lowest in Sylhet division (61.0 per cent). Receiving minimum number of meals were positively associated with mother’s education and household wealth levels.
3.5.3 Minimum Acceptable Diet
Minimum acceptable diet is a composite indicator. It is defined as the proportion of 6-23 months breastfed children who had at least minimum dietary diversity and minimum meal frequency during the previous day and 6-23 months non-breastfed children who had at least the minimum dietary diversity excluding milk feeds and had minimum meal frequency.
Fig 3.5: IYCF Indicators on breastfeeding status, Bangladesh, CWS 2016
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
48
Overall, 38.0 per cent of urban children received minimum acceptable diet. Coverage with minimum acceptable diet among 6-23 months children (both breastfed and non-breastfed) was significantly higher among CC non-slums children (44.4 per cent) than among CC slums (29.7 per cent) and other urban children (36.0 per cent). Children with higher level of mother’s education and children from higher household wealth quintiles were more likely to receive minimum acceptable diet.
3.5.4 Bottle Feeding
Results presented in Table 3.8 show that more than half of (53.1 per cent) of non-breastfed children age 6-23 months were bottle-fed with two milk feedings during the previous day. Results also show that 21.4 per cent of children age 0-23 months were fed with a bottle with a nipple.
Table 3.8: Bottle feeding
Percentage of children age 0-23 months who were bottle fed during the previous day preceding the survey by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Characteristics
Non-breastfed children 6-23 month who received 2 milk feeding
Number
Children 0-23 months who were fed with a bottle a nipple
PercentageMean number of
milk feedinga Percentage Number
Total 53.1 2.9 128 21.4 2,797
AreaCity Corporation slum 51.8 (2.7) 8 20.6 123City Corporation non-slum 59.3 (2.5) 47 26.3 783Other municipalities/urban 49.3 (3.1) 73 19.4 1,892
DivisionBarisal 41.6 (*) 2 18.7 119Chittagong 37.2 (*) 18 12.9 635Dhaka 51.6 (2.8) 78 28.3 1,270Khulna 74.2 (*) 8 20.8 187Rajshahi 86.3 (*) 14 23.5 269Rangpur 20.9 (*) 5 9.6 195Sylhet 46.6 (*) 3 11.7 123
Mother’s education (*)No education 55.5 (*) 12 14.9 232Primary incomplete 29.2 (*) 17 16.1 412Primary complete 12.5 (*) 5 19.8 287Secondary incomplete 60.8 (3.6) 54 21.6 1,330Secondary complete or higher 57.0 (2.6) 40 28.5 536
Wealth index quintileLowest 36.3 1.9 17 12.9 601Second 21.7 (*) 15 13.4 499Middle 64.7 (*) 20 23.9 586Fourth 46.3 (*) 37 29.7 627Highest 73.7 (*) 38 26.5 484
Religion* (*)Islam 48.7 (*) 115 20.8 2,549Hindu 94.0 (*) 12 31.5 218
a Mean number of milk feeding in the last 24 hours
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
(*) Figures that are based on fewer than 25 unweighted cases
( ) Figures that are based on 25-49 unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
49
4 CHILD HEALTHUNICEF/BANA2013-00462/Haque
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
50
Key Findings:
� Coverage with full immunization (BCG, 3 doses of Pentavalent, 3 doses of OPV and MR at 9 months) among children age 12-23 months was 88.0 per cent. About 86.4 per cent were fully vaccinated by 12 months of age. Coverage with full vaccination was relatively low in CC slums (72.1 per cent) than CC non-slums (92.1 per cent) and other urban areas (87.3 per cent).
� About 89.7 per cent of children had received measles and rubella (MR) vaccine. Only about 68.5 per cent of children age 15-23 months received measles second dose, supposed to be administered at or after 15 months of age.
� About 86.8 per cent of women who had a live birth in the last two years were protected against neonatal/maternal tetanus. Women of CC non-slum and CC slum areas were less likely to be protected against tetanus (83.6 per cent in CC non-slums and 83.4 per cent in CC slums) than women of other urban areas (88.3 per cent). Protection status was the highest in Rajshahi (93.7 per cent), and lowest in Dhaka division (83.6 per cent).
� More than half (59.4 per cent) of urban children under age 5 with diarrhea in the last two weeks (6.1 per cent) had received advice/treatment either at a health facility or from a health provider.
� About 88.8 per cent of under five children with diarrhea received any ORS fluid.
� Overall, 36.1 per cent of urban children with diarrhea received oral rehydration salt (ORS) and Zinc.
� Seventy per cent (70.0 per cent) received diarrhea treatment with oral rehydration therapy (ORT) – ORS packets, pre-packaged ORS fluid, homemade fluid or increased fluids – and continued feeding.
� More than eighty per cent (81.2 per cent) of children under age 5 with ARI symptoms in the last two weeks (7.1 per cent) preceding the survey sought advice or treatment for ARI from a health facility or provider. There was no marked difference between children of CC non-slum areas (79.4 per cent) and children of CC slums (78.5 per cent).
� About eighty one per cent of children with ARI symptoms received treatment with antibiotics.
� Overall 48.6 per cent of urban households rely on solid fuel for cooking, with 64.3 per cent in other urban areas, 44.5 per cent in CC slums and 15.2 per cent in CC non-slums areas. Households/members of the lowest quintile mostly (67.5 per cent) use solid fuel and thus exposed to higher health risks.
This chapter presents findings on the overall health and care seeking patterns, vaccination coverage and neonatal tetanus protection of under-five children in the three urban domains and all divisions. The presentation of information on vaccination coverage focused on the age groups 12-23 months. Overall coverage level at the time of the survey and by age 12 months are shown for this group of children.
Information on the prevalence and treatment of important childhood illness – diarrhea, and acute respiratory infection (ARI) are discussed in details. Results are presented by urban domains, divisions as well as by selected characteristics.
4 CHILD HEALTH
51
4.1 Childhood VaccinationUniversal immunization of children against the major vaccine-preventable diseases (tuberculosis, diphtheria, pertussis, tetanus, hepatitis, haemophiles influenza type B, poliomyelitis, pneumonia, measles and rubella) is globally recognized as one of the most cost-effective programmes to reduce infant and child morbidity and mortality. Bangladesh initiated the Expanded Programme on Immunization (EPI) in 1979 against six preventable diseases (tuberculosis, diphtheria, pertussis, tetanus, polio and measles) which was intensified after 1985, and modified in phases in 2004 and 2012. The EPI is a priority programme for the government of Bangladesh. It follows the international guidelines recommended by the World Health Organization (WHO).
At present, the full course of Childhood Vaccines under Expanded Programme of Immunization (EPI) in Bangladesh consists of three doses of Pentavalent Vaccine (diphtherias, pertussis, tetanus, hepatitis B, and Haemophiles influenza type B), four doses of oral polio vaccines (OPV), one dose of Bacille Calmetto-Guerin (BCG) vaccine against tuberculosis. One dose of measles-rubella (MR) and a measles second dose (MSD) vaccine. Moreover, EPI Bangladesh included TT Vaccination for 15-49 years-old women and MR vaccine for 16-17 year old adolescent girls.
According to EPI programme, a child should be vaccinated with all eligible antigens before first birthday. The BCG vaccine, given at birth or at first contact with the health worker, provides protection against childhood tuberculosis. The oral Polio Vaccine (OPV) provides protection against Poliomyelitis; the pentavalent (DPT+Hep-B+Hib) provides protection against Diphtheria, Pertussis, Tetanus, Hepatitis B, and Hemophilus influenza type B; and the Measles and Rubella (MR) vaccine given soon after 9 months of age, provides protection against Measles and Rubella. A Measles Second dose is given at or after 15 months of age. The Current Children Vaccination schedule under EPI in Bangladesh with number, doses and minimum time-interval is given below:
EPI Childhood Vaccination Schedule:
Name of Vaccination Doses Minimum interval between doses Starting age
BCG 1 - At birth
Pentavalent 3 4 weeks 6 weeks
OPV 4* 4 weeks 6 weeks
MR 1 - 9 months
Measles second dose (MSD) 1 - 15 months
* The 4th dose of OPV is given with MR Vaccine.
4.1.1 Vaccination Coverage
The CWS 2016 collected data on Childhood Vaccination for all surviving children born during the last two years preceding the survey. For each child, mothers were asked whether they had the vaccination card, if so, to show the card to the interviewer. If the mother was able to show the vaccination card, the dates of vaccines were recorded on the survey questionnaire. If the vaccination card was not available, mothers were asked to recall whether the child had received any vaccination. Since OPV 4th dose was introduced very recently and for comparability with other survey results on vaccination coverage, the analysis is done with 3 doses of Polio vaccination along with other vaccinations.
Ch
ild H
ealt
h
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
52
Table 4.1: Vaccinations in the first years of life
Percentage of children age 12-23 months vaccinated against vaccine preventable childhood diseases at any time before the survey and by their first birthday, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Background characteristics BCG
Pentavalent OPVMR at 9 months
Full vaccinationa
No vaccinations
Number of
children
Children age 15-23 months
1 2 3 1 2 3 Measles at 15 months
Number of children
Vaccinated at any time before the survey
Vaccination card 71.4 71.8 71.4 69.9 71.8 71.7 69.9 65.5 65.0 - 1,059 50.5 752
Mother’s report 25.2 25.6 25.3 24.8 25.9 25.7 24.4 24.2 23.1 2.1 413 17.9 331
Either source 96.6 97.4 96.7 94.7 97.7 97.4 94.3 89.7 88.0 2.1 1,472 68.5 1,083
Vaccinated by 12 months of ageb 96.6 97.4 96.6 94.0 97.3 97.0 93.6 88.9 86.4 - 1,472
a BCG, measles, and three doses each of pentavalent and polio vaccine (excluding polio vaccine given at birth and polio 4)
b For children whose information is based on the mother’s report, the proportion of vaccinations given during the first year of life is assumed to be the same as for children with a written record of vaccination.
Table 4.1 provides vaccination coverage according to source of information. The data were for children age 12-23 months. According to information from both vaccination cards and mother’s report, 88.0 per cent of children age 12-23 months were fully vaccinated. The level of coverage with BCG, three doses of Pentavalent, and three doses of Polio Vaccine (OPV) was 94.0 per cent or higher. Coverage with MR vaccines was slightly lower at 89.7 per cent. Coverage of pentavalent and Polio/OPV vaccines declined with the doses, from 97.4 per cent for the first dose of pentavalent to 94.7 per cent for the third dose and from 97.7 for the first dose of polio/OPV to 94.3 per cent for the third dose. Only 2.1 per cent did not receive any vaccinations.
Fig 4.1: Full vaccination coverage by areas, Bangladesh, CWS 2016
In line with the WHO guidelines, childhood vaccinations with eligible antigens should be completed as per schedule of immunization by 12 months of age. Overall, 86.4 per cent of children age 12-23 months had received all the recommended vaccines before their first birth day.
53
Ch
ild H
ealt
h
Fig 4.2: Vaccination coverage by division, Bangladesh, CWS 2016
As per vaccination schedule, measles second dose (MSD) is to be given at or after 15 months of age. About 68.5 per cent of children age 15-23 months received MSD.
4.1.2 Differentials in Vaccination Coverage
Table 4.2 provides coverage of vaccination by selected background characteristics. Vaccination coverage did not vary by sex of the child. Among the urban domains, lowest vaccination coverage (full) was seen in CC slums (72.1 per cent), compared with CC non-slums (92.1 per cent) and other urban areas (87.3 per cent). Vaccination coverage by divisions showed that Sylhet had the lowest coverage (80.3 per cent), and it was highest in Khulna (93.7 per cent). As expected, full vaccination by 12 months of age was found to be positively associated with mother’s education and household wealth index quintile/socio-economic status.
Table 4.2: Vaccination by background characteristics
Percentage of children age 12-23 months who received specific vaccines at any time before the survey (vaccination card or mother’s report, and vaccination card seen), by specific background characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016.
Background characteristics
BCG Pentavalent OPVMR at 9 months
Full None
Percen-tage with
vaccina-tion card
seen
Num-ber of chil-dren
Percentage of children age 15-23 months who
received measles at 15 months
1 2 3 1 2 3Measles
at 15 months
Number of
children
Total 96.6 97.4 96.7 94.7 97.7 97.4 94.3 89.7 88.0 2.1 71.9 1,472 68.5 1,083
Sex
Male 95.2 96.5 95.6 93.4 96.5 96.4 93.3 89.7 87.8 3.2 69.6 731 67.2 552
Female 98.1 98.4 97.8 95.9 98.9 98.4 95.3 89.6 88.1 1.1 75.3 731 69.3 521
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
54
Table 4.2: continued
Background characteristics
BCG Pentavalent OPVMR at 9 months
Full None
Percen-tage with
vaccina-tion card
seen
Num-ber of chil-dren
Percentage of children age 15-23 months who
received measles at 15 months
1 2 3 1 2 3Measles
at 15 months
Number of
children
Area
City Corporation slum 92.9 92.6 90.7 83.4 93.2 91.3 82.9 76.3 72.1 6.7 57.8 61 50.6 47
City Corporation non-slum 96.5 96.5 96.1 94.4 97.4 97.2 94.2 92.6 92.1 2.6 65.9 425 71.4 310
Other municipalities/urban 96.9 98.1 97.4 95.5 98.1 97.9 95.1 89.3 87.3 1.6 75.4 986 68.4 726
Division
Barisal 99.0 98.1 97.8 94.9 98.1 97.8 95.9 90.0 88.0 1.0 75.5 60 76.2 41
Chittagong 98.1 99.5 98.4 96.2 99.5 98.6 95.8 91.7 89.4 0.5 72.1 316 72.8 241
Dhaka 94.4 95.7 95.0 92.7 96.3 96.3 92.0 88.3 86.0 3.7 67.4 696 64.4 509
Khulna 99.6 99.6 99.4 99.2 99.6 99.4 99.2 93.8 93.7 0.4 79.5 95 71.6 72
Rajshahi 99.8 98.7 98.7 98.5 98.7 98.7 98.5 91.5 91.5 0.2 76.8 141 70.1 98
Rangpur 99.8 99.8 99.6 98.4 99.8 99.6 98.4 92.9 92.7 0.2 85.6 100 76.0 77
Sylhet 95.6 95.6 93.9 87.5 95.6 93.9 87.5 81.0 80.3 4.4 73.9 64 62.6 44
Mother’s education
No education 93.7 94.0 92.8 88.5 94.0 93.5 84.2 84.2 78.9 6.0 64.8 118 56.0 86
Primary incomplete 86.3 89.6 87.9 81.9 91.7 90.1 81.9 73.3 69.2 8.2 64.2 199 59.0 138
Primary complete 99.6 99.6 99.6 96.0 99.6 99.6 96.3 88.0 87.7 0.4 77.6 166 59.4 128
Secondary incomplete 98.1 98.7 98.0 97.4 98.7 98.6 97.2 92.9 91.6 1.0 75.7 723 67.0 520
Secondary complete or above 99.9 99.9 99.9 98.8 99.9 99.9 98.8 96.9 96.7 0.1 67.2 267 88.7 212
Wealth index quintile
Lowest 90.0 92.4 92.1 87.3 93.6 93.3 87.3 81.3 77.4 5.9 66.8 328 55.3 235
Second 97.2 97.9 96.0 95.4 98.0 97.8 93.7 83.8 81.3 2.0 73.4 295 58.5 213
Middle 99.0 99.6 98.5 97.6 99.6 98.8 97.6 94.9 93.7 0.2 76.8 285 67.4 210
Fourth 99.8 99.8 99.7 96.7 99.8 99.7 96.9 93.9 93.9 0.2 71.1 321 78.2 245
Highest 97.9 97.9 97.8 97.7 97.9 97.8 97.3 96.7 96.1 2.1 72.4 243 85.4 179
Religion*
Islam 96.3 97.2 96.5 94.3 97.6 97.2 93.9 89.0 87.2 2.3 71.3 1,346 67.7 994
Hindu 99.8 99.3 99.3 98.3 99.3 99.3 98.9 97.6 97.0 0.2 77.5 110 78.4 75
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases.
4.2 Neonatal Tetanus ProtectionIn order to reduce maternal mortality and morbidity, it is essential to eliminate maternal tetanus. For preventing maternal and neonatal tetanus, all pregnant women should receive at least two doses of tetanus toxoid (TT) vaccine. If a woman has not received at least two doses of TT during a particular pregnancy, she and her child will be protected against tetanus if the women:
� Received at least two doses of TT vaccine, the last within the previous 3 years; � Received at least 3 doses, the last within the previous 5 years; � Received at least 4 doses, the last within the previous 10 years; � Received 5 or more doses any time during her life time
55
Ch
ild H
ealt
h
To assess the tetanus vaccination coverage, women who had a live birth in the last two years preceding the interview were asked if they had received any TT injections during the pregnancy for their recent birth, and if they did, how many. Women who did not receive two or more doses of TT injections during their most recent pregnancy were then asked about TT vaccinations they might have previously received. Interviewers also asked them to show their vaccination card, if available, for recording the date and vaccination received.
Table 4.3: Neonatal tetanus protection
Percentage of woman age 15-49 years with a live birth in the last two years preceding the survey who were protected against neo natal tetanus by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016.
Percentage of women who received at
least 2 doses during last pregnancy
Percentage of women who did not receive two or more doses during last pregnancy but received:
Protected against tetanus
Number of women with a live
birth in the last 2
years
2 doses, the last within
prior 3 years
3 doses, the last within prior 5 years
4 doses, the last within
prior 10 years
5 or more doses during
lifetime
Total 30.5 0.9 4.2 6.1 45.0 86.8 2,882
Area
City Corporation slum 39.8 1.9 2.6 4.7 34.3 83.4 127
City Corporation non-slum 31.8 1.2 4.6 5.7 40.4 83.6 811
Other municipalities/urban 29.3 0.7 4.2 6.4 47.7 88.3 1,944
Division
Barisal 35.4 0.0 2.2 8.6 44.3 90.5 120
Chittagong 32.1 0.4 2.9 7.2 48.0 90.6 651
Dhaka 34.6 1.4 4.4 4.4 38.9 83.6 1,320
Khulna 22.0 1.5 10.6 8.8 42.3 85.1 193
Rajshahi 22.7 0.1 4.9 9.7 56.4 93.7 272
Rangpur 21.8 0.6 1.6 5.1 57.1 86.3 198
Sylhet 17.4 0.2 4.8 6.1 55.8 84.2 128
Mother’ education
No education 36.4 0.6 7.9 1.3 26.6 72.8 237
Primary incomplete 31.5 2.6 1.1 5.0 36.4 76.6 423
Primary complete 30.3 0.3 6.6 8.1 44.9 90.1 294
Secondary incomplete 29.7 0.6 4.8 6.7 47.3 89.0 1,378
Secondary complete or above 29.2 0.8 2.3 6.8 54.2 93.2 549
Wealth index quintile
Lowest 32.4 1.6 6.2 7.2 37.7 85.1 633
Second 41.8 1.1 3.3 3.8 37.3 87.2 520
Middle 24.4 0.9 1.8 9.9 51.1 88.0 594
Fourth 23.7 0.6 4.9 5.3 50.9 85.4 634
Highest 32.1 0.0 4.8 3.9 47.8 88.7 500
Religion*
Islam 31.4 0.9 4.5 5.9 44.0 86.7 2,629
Hindu 18.1 0.5 1.4 10.4 57.2 87.5 220
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
56
Table 4.3 gives the protection status from tetanus of women who have had a live birth in the last two years preceding the survey. Results show that 86.8 per cent of women were protected against tetanus. Only 30.5 per cent women received 2 or more doses of TT vaccines during their last pregnancy and 45.0 per cent reported receiving of 5 or more doses during life time.
Fig 4.3: Percentage of women age 15-49 years with a live birth in the last 2 years protected against tetanus by background characteristics, Bangladesh, CWS 2016
Women of other urban areas were more likely to receive protection against tetanus (88.3 per cent) than women of CC slums (83.4 per cent) and CC non-slum areas (83.6 per cent).
Among the divisions, protection status was the highest in Rajshahi (93.7 per cent) and lowest in Sylhet division (84.2 per cent). Protection status against neonatal/maternal tetanus was found to be positively associated with mother’s education and socioeconomic status of women. For example, only 72.8 per cent women who had no formal education were protected against tetanus, while it was 93.2 per cent of those who had secondary or higher education. About 85.1 per cent women of the lowest quintile against 88.7 per cent of the highest quintile were found to be protected against tetanus. The MICS 2012-2013 reported protection status from tetanus of urban women at 81.8 per cent.
4.3 Childhood Illness and Treatment
This section discusses two illnesses that are major contributors to childhood morbidity and mortality in Bangladesh: diarrhea and acute respiratory infection (ARI). Estimates of the prevalence of these illnesses are presented as well as care seeking behavior and feeding practices during diarrhea. It should be noted here that seasonal changes affect greatly the prevalence of these illnesses.
57
Ch
ild H
ealt
h
Table 4.4: Reported disease episodes
Percentage of children age 0-59 months for whom mother/ caretaker reported an episode of diarrhea and/ or symptoms of acute respiratory infection (ARI) and/or fever in the last two weeks prior to the survey by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
CharacteristicsHad an episode of
diarrheaSymptoms of ARI Number of children
Total 6.1 7.1 7,521
Sex
Male 5.7 8.0 3,783
Female 6.5 6.2 3,738
Area
City Corporation slum 9.2 7.5 336
City Corporation non-slum 5.9 6.7 2,242
Other municipalities/urban 6.0 7.2 4,943
Division
Barisal 5.0 8.0 318
Chittagong 9.1 6.1 1,562
Dhaka 5.1 6.8 3,580
Khulna 5.7 8.3 542
Rajshahi 6.2 10.2 695
Rangpur 5.9 6.6 487
Sylhet 4.7 6.2 337
Age
0-11 months 7.1 11.0 1,382
12-23 months 10.2 6.9 1,521
24-35 months 6.3 7.0 1,534
36-47 months 4.1 6.4 1,511
48-59 months 3.0 4.6 1,573
Mother’s education
No education 7.0 9.8 693
Primary incomplete 8.9 9.0 1,077
Primary complete 6.4 8.1 751
Secondary incomplete 5.7 7.1 3,677
Secondary complete or higher 4.3 3.5 1,324
Wealth index quintile
Lowest 7.7 7.7 1,563
Second 6.7 9.0 1,388
Middle 5.4 9.6 1,474
Fourth 5.9 6.3 1,686
Highest 4.8 2.9 1,410
Religion*
Islam 6.1 7.2 6,909
Hindu 5.7 6.6 558
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
58
4.3.1 Childhood Diarrhea
Diarrhea remains a leading cause of childhood morbidity and mortality in developing countries. Dehydration from diarrhea has been an important contributing cause of childhood mortality. The administration of oral rehydration therapy (ORT) is a simple means of countering the effects of dehydration. During diarrhea, a child may be given a solution prepared either by mixing water with a commercially prepared oral rehydration salts packet (ORS) – also called Khabar or packet saline in Bangladesh or by making a homemade solution of sugar, salt and water, also called laban gur.
In CWS 2016, respondents were asked if their children under age 5 had experienced an episode of diarrhea in the two weeks before the survey. Table 4.4 shows that 6.1 per cent of children under age 5 were reported to have had diarrhea. The prevalence of diarrhea was higher in CC slum areas. It was also higher at age 12-23 months, a period during which solid foods are introduced into the child’s diet.
Table 4.5: Treatment/care- seeking for diarrhea
Percentage of children age 0-59 months with diarrhea in the last 2 weeks preceding the survey for whom treatment or advice was sought from health provider/ facility, Percentage who received ORS and Zinc and Percentage who received ORT (ORS packet, pre-packaged ORS fluid, recommended homemade fluid or increased fluids) and continued feeding during episode of diarrhea by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Characteristics
Had diarrhea in the last 2
weeks
Number of children under
5 years with diarrhea
Percentage who received
Advice/ treatment from provider/ facility
ORS and Zinc
ORT and Continued
feeding
Total 6.1 459 59.4 36.1 70.0
Sex
Male 5.7 217 61.3 42.0 72.3
Female 6.5 242 57.7 30.8 67.9
Area
City Corporation slum 9.2 31 59.6 32.8 60.9
City Corporation non-slum 5.9 132 49.0 39.1 72.8
Other municipalities/urban 6.0 296 64.0 35.1 69.6
Division
Barisal (5.0) 16 (54.0) (42.4) (62.8)
Chittagong 9.1 142 56.5 44.8 70.1
Dhaka 5.1 183 58.5 37.0 71.7
Khulna (5.7) 31 (44.2) (21.2) (68.5)
Rajshahi 6.2 43 77.0 27.0 74.6
Rangpur 5.9 29 68.2 17.9 51.0
Sylhet 4.7 16 66.6 27.5 79.2
Mother’s education
No education 7.0 48 63.8 39.0 75.7
Primary incomplete 8.9 96 51.4 30.7 57.6
Primary complete 6.4 48 61.1 49.0 88.3
Secondary incomplete 5.7 210 58.4 27.9 66.3
Secondary complete or higher 4.3 57 71.2 62.3 83.8
59
Ch
ild H
ealt
h
Table 4.5: continued
Characteristics
Had diarrhea in the last 2
weeks
Number of children under
5 years with diarrhea
Percentage who received
Advice/ treatment from provider/ facility
ORS and Zinc
ORT and Continued
feeding
Wealth index quintile
Lowest 7.7 120 49.2 27.7 61.1
Second 6.7 93 65.7 36.2 74.9
Middle 5.4 79 57.9 41.9 73.9
Fourth 5.9 99 61.3 33.7 70.2
Highest 4.8 68 67.8 47.6 73.8
Religion*
Islam 6.1 423 59.8 36.4 69.6
Hindu (5.7) 32 (56.8) (28.4) (70.9)
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
( ) Figures that are based on 25-49 unweighted cases
4.3.2 Treatment of Childhood Diarrhea
For children under age 5 with diarrhea in the two weeks before the survey, mothers were asked what they did to treat their diarrhea. Because the prevalence of diarrhea varies seasonally, the survey results pertain only to the period from February to April, 2016 when the fieldwork took place. Table 4.5 shows that 59.4 per cent of urban children under age 5 with diarrhea were taken to a health facility or provider for advice or treatment. Overall, 36.1 per cent of children with diarrhea received oral rehydration salt (ORS) and Zinc, and 70.0 per cent received oral rehydration therapy (ORT) – ORS packet, prepackaged ORS fluid, recommended homemade fluid or increased fluids – and continued feedings.
Receiving advice/treatment for diarrhea from a health facility or provider was higher in other urban areas, compared to CC non-slums and CC slum areas. Children of higher wealth quintiles were more likely to receive treatment/advice from health facility or providers. These results should be taken with some caution as the sample sizes from which these were estimated were small.
Table 4.6: Feeding practices during diarrhea
Percentage of children age 0-59 months with diarrhoea in the last two weeks preceding the survey by amount of liquids and food given during episode of diarrhoea, by selected characteristics Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Drinking practices during diarrhoea Eating practices during diarrhoea Number of children age 0-59
months with diarrhoea in the last two
weeks
Child was given to drink: Total Child was given to eat: Total
Much less
Some what less
About the
same
More Noth-ing
Missing/DK
Much less
Some what less
About the
same
More Noth-ing
Missing/DK
Total 8.3 28.3 30.4 31.9 0.8 0.2 100.0 19.7 31.7 31.6 15.6 1.3 0.2 100.0 459
Sex
Male 8.0 24.8 33.0 32.9 0.8 0.4 100.0 17.6 35.4 28.5 16.7 1.3 0.5 100.0 217
Female 8.5 31.6 28.0 31.1 0.9 0.0 100.0 21.5 28.3 34.3 14.6 1.3 0.0 100.0 242
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
60
Table 4.6: continued Drinking practices during diarrhoea Eating practices during diarrhoea Number
of children age 0-59
months with diarrhoea in the last two
weeks
Child was given to drink: Total Child was given to eat: Total
Much less
Some what less
About the
same
More Noth-ing
Missing/DK
Much less
Some what less
About the
same
More Noth-ing
Missing/DK
Area
City Corporation slum 15.8 32.1 30.1 21.9 0.1 0.0 100.0 21.0 39.8 25.6 13.6 0.1 0.0 100.0 31
City Corporation non-slum 4.5 26.3 34.3 32.9 1.3 0.7 100.0 17.8 29.8 34.3 16.0 1.3 0.8 100.0 132
Other municipalities/urban 9.2 28.9 28.6 32.6 0.7 0.0 100.0 20.4 31.6 31.0 15.6 1.4 0.0 100.0 296
Division
Barisal (9.2) (21.5) (40.9) (28.5) 0.0 0.0 100.0 (24.5) (44.4) (22.0) (8.2) 0.0 (1.0) 100.0 16
Chittagong 15.3 41.2 25.1 16.5 1.3 0.6 100.0 21.1 38.5 23.6 14.9 1.3 0.6 100.0 142
Dhaka 1.9 24.5 30.4 43.3 0.0 0.0 100.0 21.6 27.8 34.9 15.6 0.0 0.0 100.0 183
Khulna (1.1) (14.3) (31.7) (52.9) 0.0 0.0 100.0 (4.0) (30.9) (46.4) (18.6) 0.0 0.0 100.0 31
Rajshahi 13.2 17.6 41.6 27.6 0.0 0.0 100.0 13.2 26.0 38.3 22.5 0.0 0.0 100.0 43
Rangpur 14.9 18.3 30.8 28.7 7.3 0.0 100.0 26.8 19.1 27.1 12.5 14.5 0.0 100.0 29
Sylhet (8.3) (38.9) (33.4) (19.4) 0.0 0.0 100.0 (13.9) (41.7) (34.8) (9.6) 0.0 0.0 100.0 16
Age
0-11 months 7.1 26.1 38.8 24.1 3.0 0.9 100.0 7.1 26.5 43.5 16.9 4.9 1.1 100.0 98
12-23 months 11.6 32.0 23.3 33.2 0.0 0.0 100.0 24.9 32.4 28.5 13.6 0.7 0.0 100.0 156
24-35 months 6.3 27.7 32.3 33.7 0.0 0.0 100.0 21.6 28.4 36.1 13.9 0.0 0.0 100.0 96
36-47 months 4.8 29.2 31.1 33.5 1.4 0.0 100.0 20.4 39.5 18.2 21.9 0.0 0.0 100.0 62
48-59 months 8.9 21.3 31.3 38.6 0.0 0.0 100.0 23.7 36.2 25.5 14.7 0.0 0.0 100.0 47
Mother’s education
No education 12.8 43.5 23.2 18.6 1.8 0.0 100.0 17.6 37.6 22.0 22.8 0.0 0.0 100.0 48
Primary incomplete 2.7 32.5 33.9 30.9 0.0 0.0 100.0 22.0 34.8 31.8 11.4 0.0 0.0 100.0 96
Primary complete 0.4 17.8 32.7 45.0 4.0 0.0 100.0 7.3 39.2 19.5 30.1 4.0 0.0 100.0 48
Secondary incomplete 12.2 25.5 29.1 32.2 0.5 0.4 100.0 24.9 27.0 32.8 13.0 1.9 0.4 100.0 210
Secondary complete or higher 6.3 27.7 33.0 33.0 0.0 0.0 100.0 8.6 32.2 45.0 13.9 0.0 0.3 100.0 57
Wealth index quintile
Lowest 7.5 35.9 24.1 31.1 1.5 0.0 100.0 20.1 32.1 25.1 21.1 1.6 0.0 100.0 120
Second 8.1 44.0 28.4 19.5 0.0 0.0 100.0 20.1 41.1 28.2 10.6 0.0 0.0 100.0 93
Middle 8.6 32.4 25.7 32.0 1.3 0.0 100.0 20.5 27.4 33.7 17.2 1.3 0.0 100.0 79
Fourth 7.0 9.7 38.6 43.8 0.0 0.9 100.0 18.7 31.2 36.8 11.5 0.9 0.9 100.0 99
Highest 11.6 15.9 37.6 33.3 1.5 0.0 100.0 18.7 23.5 37.7 16.8 3.1 0.2 100.0 68
Religion*
Islam 7.8 29.1 29.7 32.3 0.9 0.2 100.0 19.3 32.9 29.7 16.4 1.4 0.2 100.0 423
Hindu (16.0) (14.6) (42.1) (27.3) 0.0 0.0 100.0 (26.3) (8.8) (59.5) (5.4) 0.0 0.0 100.0 32
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
( ) Figures that are based on 25-49 unweighted cases
DK Don't know
61
Ch
ild H
ealt
h
4.3.3 Feeding Practices during Diarrhea
Table 4.6 provides statistics on drinking and feeding practices during diarrhea. About one-third (31.9 per cent) of children under age 5 with diarrhea were given more than the usual amount to drink, while 30.4 per cent children were given the same amount. Three in every ten children were given less than usual amount to drink during the episode of diarrhea. Among the children of different age groups, the youngest of age 0-11 months were least likely to be given more than usual amount to drink (24.1 per cent).
About one in three (31.7 per cent) with diarrhea were given somewhat less to eat than normal, with another 19.7 per cent given much less or nothing to eat. Only 31.6 per cent children with diarrhea were given about the same amount to eat during diarrhea.
Table 4.7: Oral rehydration solutions, recommended homemade fluids, and zinc
Percentage of children age 0-59 months with diarrhoea in the last two weeks, and treatment with oral rehydration salts (ORS), recommended homemade fluids, and zinc, by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Percentage of children with diarrhoea who received: Number of
children age 0-59 months
with diarrhoea
in the last two weeks
Oral rehydration salts (ORS)
Recommended homemade fluids ORS or any
recomm-ended home-made fluid
Zinc ORS and zincFluid
from packet
Pre-packa-
ged fluid
Any ORS
Sugar and salt
solu-tion
Green coco-nut
water
Chira water
Rice starch
Any recomm-
ended home-made fluid
Syrup Tablet Any zinc
Total 88.1 10.9 88.8 6.6 12.4 13.3 12.5 32.6 90.3 31.0 11.2 38.4 36.1 459
Sex
Male 90.0 12.4 90.7 9.7 13.0 17.8 13.6 37.6 91.6 38.1 13.1 44.0 42.0 217
Female 86.4 9.5 87.1 3.8 11.9 9.3 11.4 28.1 89.1 24.7 9.6 33.3 30.8 242
Area
City Corporation slum 80.2 17.3 83.9 6.6 11.5 9.8 11.6 30.4 84.2 29.9 9.6 32.9 32.8 31
City Corporation non-slum 89.9 12.0 90.5 7.2 13.1 9.9 14.0 33.1 90.8 26.2 15.0 39.5 39.1 132
Other municipalities/urban 88.1 9.7 88.5 6.3 12.2 15.2 11.9 32.6 90.7 33.3 9.7 38.4 35.1 296
Division
Barisal (88.3) (18.4) (88.3) (24.6) (26.5) (15.3) (29.7) (57.2) (88.3) (38.8) (8.2) (42.4) (42.4) 16
Chittagong 91.2 6.3 91.4 3.8 14.4 12.4 6.9 26.2 92.9 42.1 12.1 46.3 44.8 142
Dhaka 90.5 11.3 91.0 7.4 10.2 13.1 20.7 36.3 91.0 25.4 14.7 37.0 37.0 183
Khulna (68.4) (22.5) (73.5) (1.1) (17.6) (21.8) (10.2) (44.3) (73.6) (25.2) (4.0) (29.2) (21.2) 31
Rajshahi 82.8 20.5 83.9 8.2 11.1 1.1 1.1 19.3 91.7 27.5 8.3 35.3 27.0 43
Rangpur 87.3 3.6 87.3 9.5 8.9 31.6 1.7 41.1 88.5 19.0 3.7 22.6 17.9 29
Sylhet (86.1) (4.1) (86.1) (5.6) (5.6) (5.5) (4.2) (20.9) (91.7) (31.8) (1.4) (33.1) (27.5) 16
Age
0-11 months 75.1 14.7 75.7 4.6 5.8 7.2 1.0 16.4 77.8 36.8 2.4 36.8 29.2 98
12-23 months 88.4 6.4 90.1 2.2 8.8 9.0 15.3 29.6 90.5 27.4 10.8 35.5 35.1 156
24-35 months 92.5 13.8 92.5 15.9 11.1 14.8 12.7 38.6 96.5 36.6 9.4 41.7 39.3 96
36-47 months 93.7 9.7 93.7 11.0 23.7 27.4 21.2 53.0 93.7 27.8 34.1 50.3 50.3 62
48-59 months (98.0) (13.7) (98.0) (0.3) (26.2) (18.4) (14.9) (37.5) (98.0) (23.9) (4.5) (28.4) (28.4) 47
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
62
Table 4.7: continued Percentage of children with diarrhoea who received: Number
of children age 0-59 months
with diarrhoea
in the last two weeks
Oral rehydration salts (ORS)
Recommended homemade fluids ORS or any
recomm-ended home-made fluid
Zinc ORS and zincFluid
from packet
Pre-packa-
ged fluid
Any ORS
Sugar and salt
solu-tion
Green coco-nut
water
Chira water
Rice starch
Any recomm-
ended home-made fluid
Syrup Tablet Any zinc
Mother’s education
No education 88.5 14.4 90.3 2.4 8.4 27.2 17.0 44.0 90.3 34.6 10.4 39.0 39.0 48
Primary incomplete 71.5 10.7 72.8 3.7 10.6 13.8 10.2 26.8 75.0 25.6 12.8 35.7 30.7 96
Primary complete 93.5 13.0 93.5 12.4 26.2 16.0 18.8 49.2 96.9 34.8 30.2 51.2 49.0 48
Secondary incomplete 93.2 6.3 93.7 4.5 10.8 8.0 12.8 27.6 95.0 25.9 6.4 30.0 27.9 210
Secondary complete or higher 92.4 23.6 92.4 17.9 13.2 17.8 5.6 37.5 92.7 52.8 11.2 62.6 62.3 57
Wealth index quintile
Lowest 75.2 12.4 77.1 10.5 7.9 13.8 7.9 29.7 80.6 27.6 10.5 33.3 27.7 120
Second 95.1 5.9 95.1 3.0 10.3 15.7 8.1 31.6 95.2 28.7 8.2 36.2 36.2 93
Middle 93.4 9.5 93.8 3.8 21.2 15.2 25.9 42.2 96.2 41.5 12.0 43.7 41.9 79
Fourth 88.0 7.5 88.3 3.2 10.9 8.4 15.0 27.1 88.7 22.7 15.1 35.8 33.7 99
Highest 95.2 21.7 95.6 12.8 15.1 13.9 7.0 36.2 95.8 40.3 10.1 47.9 47.6 68
Religion*
Islam 87.5 11.0 88.1 6.9 12.8 13.6 13.0 33.5 89.6 31.0 11.8 38.8 36.4 423
Hindu (94.9) (9.5) (96.6) (1.4) (8.6) (10.3) (7.2) (23.9) (97.1) (27.7) (5.0) (29.0) (28.4) 32
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases( ) Figures that are based on 25-49 unweighted cases
Table 4.7 gives Percentage of urban children with diarrhea who received various types of recommended fluids during their recent (last two weeks) episodes of diarrhea. Mothers provided multiple responses (more than one type) on type of liquids given and thus Percentages do not necessary add up to 100 per cent. More than eight in every ten (88.8 per cent) children with diarrhea had received ORS packets or pre-packaged ORS fluids, and 90.3 per cent children with diarrhea received ORS or any recommended homemade fluids.
About one third (38.4 per cent) of urban children with diarrhea had received Zinc syrup or tablet during recent episode of diarrhea: Children of urban CC non-slum areas and children of higher wealth quintiles were more likely to receive Zinc during their recent episode of diarrhea.
Nearly 36.1 per cent of urban children had received ORS and Zinc during their recent episode of diarrhea. This Percentage was 39.1 per cent in CC non-slums, 32.8 per cent in CC slums, and 35.1 per cent in other urban areas. Administration of ORS with Zinc was the highest in Chittagong (44.8 per cent), and lowest in Rangpur (17.9 per cent).
63
Ch
ild H
ealt
h
Fig 4.4: Percentage of children under 5 with diarrhoea who received oral rehydration therapy (ORT) and continued feeding, Bangladesh, CWS 2016
4.3.4 Acute Respiratory Infection (ARI) The CWS 2016 collected symptoms of ARI that prevailed among children under five years of age during the last two weeks preceding the survey. Acute respiratory infections (ARI), primarily pneumonia, is a leading cause of childhood morbidity and mortality throughout the world. Early diagnosis and treatment with antibiotics can reduce the number of deaths caused by ARI, particularly deaths from pneumonia. ARI symptoms include cough accompanied by short, rapid breathing or difficulty in breathing.
Table 4.8: Oral rehydration therapy with continued feeding and other treatments
Percentage of children age 0-59 months with diarrhoea in the last two weeks who received oral rehydration therapy with continued feeding, and Percentage of children with diarrhoea who received other treatments, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Children with diarrhoea who received: Other treatment: Not
given any
treat-ment
or drug
Num-ber of
children aged 0-59
months with diarr-hoea
ORS or increa-
sed fluids
ORT (ORS or recomm-
ended homemade
fluids or increased
fluids)
ORT with
conti-nued
feeding
Pill or syrup:
Antibio-tic
Pill or syrup:
Antimo-tility
Pill or syrup: Zinc
Pill or syrup: Other
Pill or syrup:
Un-known
Injec-tion:
Antibio-tic
Injec-tion: Non-
antibio-tic
Injection: Unknown
Home remedy /Herbal medi-cine
Other
Total 70.4 71.7 70.0 32.4 0.2 11.2 8.3 15.3 0.8 1.1 1.3 0.6 1.9 5.3 459
Sex
Male 72.9 73.7 72.3 39.3 0.3 14.2 5.9 19.0 1.3 0.2 1.3 0.7 0.4 4.3 217
Female 68.1 69.9 67.9 26.3 0.2 8.5 10.6 11.9 0.4 2.0 1.2 0.4 3.2 6.3 242
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
64
Table 4.8: continued
Children with diarrhoea who received: Other treatment: Not
given any
treat-ment
or drug
Num-ber of
children aged 0-59
months with diarr-hoea
ORS or increa-
sed fluids
ORT (ORS or recomm-
ended homemade
fluids or increased
fluids)
ORT with
conti-nued
feeding
Pill or syrup:
Antibio-tic
Pill or syrup:
Antimo-tility
Pill or syrup: Zinc
Pill or syrup: Other
Pill or syrup:
Un-known
Injec-tion:
Antibio-tic
Injec-tion: Non-
antibio-tic
Injection: Unknown
Home remedy /Herbal medi-cine
Other
Area
City Corporation slum 64.3 64.6 60.9 12.3 2.9 13.1 8.5 19.2 1.4 0.0 0.0 0.1 0.9 6.9 31
City Corporation non-slum 73.1 73.2 72.8 33.7 0.1 14.1 10.7 14.3 0.2 0.0 0.3 0.6 4.4 3.3 132
Other municipalities/urban 69.8 71.8 69.6 34.0 0.0 9.6 7.3 15.3 1.0 1.8 1.8 0.6 0.9 6.1 296
Division
Barisal (66.4) (66.4) (62.8) (20.4) (1.0) (32.7) (4.6) (29.1) 0.0 0.0 (3.6) (3.6) (1.0) (7.2) 16
Chittagong 70.3 71.8 70.1 27.4 0.0 12.5 3.6 15.9 1.5 0.0 1.5 0.0 0.8 4.8 142
Dhaka 72.2 72.2 71.7 42.4 0.5 9.7 10.4 11.3 0.2 2.6 0.0 0.0 2.1 5.7 183
Khulna (69.5) (69.6) (68.5) (11.6) (0.1) (6.1) (15.3) (17.4) 0.0 0.0 0.0 (5.1) (6.1) (9.2) 31
Rajshahi 70.7 78.5 74.6 26.5 0.0 5.7 8.3 20.4 0.0 0.0 4.4 1.1 0.0 3.9 43
Rangpur 57.5 58.1 51.0 32.6 0.0 8.3 14.3 11.0 3.6 0.0 3.6 0.0 4.1 3.7 29
Sylhet (77.8) (80.6) (79.2) (30.6) 0.0 (23.5) (7.0) (30.6) (1.4) (2.8) (1.4) 0.0 (2.8) (2.7) 16
Age
0-11 months 66.9 68.5 67.4 24.7 0.4 9.8 3.3 16.0 2.1 0.4 2.7 0.2 2.3 6.7 98
12-23 months 68.3 68.8 64.5 29.3 0.3 10.5 10.4 16.0 0.0 3.1 0.0 0.4 1.0 8.1 156
24-35 months 71.9 75.8 75.8 41.4 0.0 13.4 9.4 15.3 0.2 0.0 0.8 1.6 5.0 1.9 96
36-47 months 75.6 75.6 75.6 37.8 0.0 14.0 7.3 13.3 0.7 0.0 3.4 0.4 0.0 5.0 62
48-59 months (74.4) (74.4) (73.9) (33.6) (0.3) (7.8) (11.4) (13.7) (2.2) 0.0 (0.5) (0.1) (0.3) (0.7) 47
Mother’s education Mother’s education
No education 76.9 76.9 75.7 11.6 0.0 11.7 3.0 24.8 0.0 0.9 0.4 0.0 0.0 2.3 48
Primary incomplete 55.8 58.0 57.6 13.6 0.4 9.2 10.9 20.5 1.1 0.0 1.7 0.2 1.6 16.1 96
Primary complete 84.8 88.3 88.3 32.9 0.0 15.9 1.6 12.3 0.0 0.0 6.5 3.1 0.0 0.5 48
Secondary incomplete 68.1 69.2 66.3 38.5 0.3 10.2 10.3 12.3 1.3 2.3 0.4 0.4 3.4 2.3 210
Secondary complete or higher 85.6 85.6 83.8 59.3 0.0 13.4 6.9 11.8 0.0 0.0 0.0 0.0 0.0 5.1 57
Wealth index quintile Wealth index quintile
Lowest 60.6 64.1 61.1 20.8 0.4 12.7 2.8 17.2 0.0 0.0 0.2 1.0 1.8 14.4 120
Second 76.8 76.8 74.9 23.9 0.5 6.9 15.8 9.4 0.5 0.5 4.0 0.4 5.3 2.2 93
Middle 73.7 76.0 73.9 41.7 0.2 15.4 10.0 12.4 1.3 0.0 2.0 1.3 1.7 0.3 79
Fourth 70.2 70.2 70.2 28.1 0.0 7.0 8.7 26.5 0.0 4.9 0.2 0.0 0.0 3.2 99
Highest 75.3 75.3 73.8 60.5 0.0 15.4 5.4 6.8 3.4 0.0 0.0 0.0 0.5 2.7 68
Religion*
Islam 70.1 71.5 69.6 29.8 0.2 11.2 7.9 15.9 0.9 1.2 1.4 0.6 1.8 5.8 423
Hindu (70.9) (70.9) (70.9) (60.1) 0.0 (11.5) (15.6) (8.9) 0.0 0.0 0.0 0.0 (3.2) 0.0 32
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases( ) Figures that are based on 25-49 unweighted cases
65
Ch
ild H
ealt
h
Table 4.9: Care-seeking for ARI
Percentage of children age 0-59 months with ARI symptoms in the last 2 weeks preceding the survey for whom advice/ treatment was sought from a facility/ provider and Percentage who received antibiotics by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
CharacteristicsHad ARI
symptomsNumber of children
under 5 years with ARI
Percentage who
Sought advice/ treatment from facility/ provider
Received antibiotics
Total 7.1 533 81.2 80.7
Sex
Male 8.0 303 79.3 78.4
Female 6.2 230 83.6 83.6Area
City Corporation slum 7.5 25 78.5 76.8
City Corporation non-slum 6.7 151 79.4 79.2
Other municipalities/urban 7.2 357 82.1 81.5Division
Barisal 8.0 25 86.9 86.9
Chittagong 6.1 96 75.9 73.7
Dhaka 6.8 243 80.6 80.4
Khulna 8.3 45 79.4 79.4
Rajshahi 10.2 71 89.5 89.5
Rangpur 6.6 32 81.7 81.7
Sylhet 6.2 21 80.2 79.2Mother’s education
No education 9.8 68 76.4 76.4
Primary incomplete 9.0 97 81.9 81.9
Primary complete 8.1 61 85.2 85.2
Secondary incomplete 7.1 262 78.3 77.4
Secondary complete or higher 3.5 46 97.6 97.2Wealth index quintile
Lowest 7.7 120 70.3 70.3
Second 9.0 125 79.0 79.0
Middle 9.6 141 93.5 91.7
Fourth 6.3 106 76.1 76.1
Highest 2.9 40 90.7 90.2Religion*
Islam 7.2 496 81.1 80.6
Hindu (6.6) 37 (82.2) (82.2)
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
( ) Figures that are based on 25-49 unweighted cases
Table 4.9 shows that 7.1 per cent of the children under age 5 had symptoms of an ARI, that is, cough accompanied by short, rapid breathing and/or by difficult breathing which was chest related, at some time in the two weeks preceding the survey. Among those who had symptoms of ARI, 81.2 per cent sought treatment or advice from health facility or a provider. Nearly 80.7 per cent of the ARI infected children had received treatment with antibiotics. Receiving treatment with antibiotics for ARI was somewhat less prevalent in CC slums (76.8 per cent) than CC non-slums (79.2 per cent) and other urban areas (81.5 per cent). Treatment for ARI with antibiotics varied by divisions with the highest in Rajshahi (89.5 per cent) and lowest in Chittagong (73.7 per cent).
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
66
Tab
le 4
.10:
Car
e se
ekin
g fo
r A
RI/
susp
ecte
d pn
eum
onia
and
ant
ibio
tic u
se d
urin
g su
spec
ted
pneu
mon
ia (
ARI)
Per
cen
tag
e o
f ch
ildre
n a
ge
0-59
mo
nth
s w
ith
su
spec
ted
pn
eum
on
ia in
th
e la
st t
wo
wee
ks p
rece
din
g t
he
surv
ey w
ho
wer
e ta
ken
to
AR
I a h
ealt
h p
rovi
der
an
d P
erce
nta
ge
of
child
ren
w
ho
wer
e g
iven
an
tib
ioti
cs, C
hild
Wel
l-b
ein
g S
urv
ey in
Urb
an A
reas
, Ban
gla
des
h, C
WS
201
6
Had
susp
ecte
d pn
eum
onia
in
the
last
tw
o w
eeks
Num
ber
of
child
ren
age
0-59
m
onth
s
Child
ren
with
susp
ecte
d pn
eum
onia
who
wer
e ta
ken
to:
Any
appr
opria
te
prov
ider
Perc
enta
ge o
f ch
ildre
n w
ith
susp
ecte
d pn
eum
onia
who
re
ceiv
ed a
ntib
iotic
s in
ast
2 w
eeks
Num
ber
of ch
ildre
n ag
e 0-
59
mon
ths w
ith
susp
ecte
d pn
eum
onia
in
last
2 w
eeks
Pub
lic
sect
or:
Govt
. ho
spita
l
Publ
ic se
ctor
: Go
vt.
heal
th
cent
er
Publ
ic se
ctor
: Go
vt.
heal
th
post
Publ
ic se
ctor
: Vi
llage
he
alth
w
orke
r
Publ
ic se
ctor
: M
obile
/Ou
treac
h cli
nic
Priv
ate
hosp
ital
/ clin
icPr
ivat
e ph
ysici
anPr
ivat
e ph
arm
acy
NGO
Clin
ic/
hosp
ital
Othe
r pr
ivat
e m
edica
lRe
lativ
e /
Frie
ndSh
opTr
aditi
onal
pr
actit
ione
rOt
her
Tota
l7.
17,
521
20.0
1.8
0.0
0.4
0.0
12.8
14.6
34.4
2.7
0.0
0.0
2.5
9.1
3.3
81.2
80.7
533
Sex M
ale
8.0
3,78
324
.10.
40.
10.
00.
112
.816
.731
.81.
70.
10.
03.
68.
23.
479
.378
.530
3Fe
mal
e6.
23,
738
14.6
3.7
0.0
0.9
0.0
12.9
11.8
37.9
4.1
0.0
0.0
0.9
10.3
3.1
83.6
83.6
230
Are
a City
Cor
pora
tion
slum
7.5
336
10.3
1.2
0.0
0.0
0.0
10.3
15.1
42.2
3.5
0.0
0.2
1.2
7.5
3.5
78.5
76.8
25Ci
ty C
orpo
ratio
n no
n-sl
um6.
72,
242
22.7
0.0
0.2
0.0
0.2
22.5
14.9
23.1
3.4
0.1
0.0
6.5
4.6
0.6
79.4
79.4
151
Oth
er m
unic
ipal
ities
/urb
an7.
24,
943
19.5
2.6
0.0
0.6
0.0
8.9
14.4
38.7
2.4
0.0
0.0
0.9
11.1
4.4
82.1
81.5
357
Divi
sion
Baris
al8.
031
815
.40.
00.
00.
00.
05.
124
.741
.70.
00.
60.
02.
310
.90.
086
.986
.925
Chitt
agon
g6.
11,
562
32.2
2.5
0.0
2.2
0.0
8.7
13.0
16.4
0.9
0.0
0.0
2.2
15.2
0.0
75.9
73.7
96D
haka
6.8
3,58
010
.32.
00.
00.
00.
018
.112
.139
.83.
90.
00.
03.
26.
16.
380
.680
.424
3Kh
ulna
8.3
542
25.4
5.5
0.0
0.0
0.0
2.2
15.8
36.1
0.8
0.0
0.1
0.0
14.6
4.2
79.4
79.4
45Ra
jsha
hi10
.269
528
.10.
00.
30.
00.
312
.821
.841
.82.
30.
00.
00.
010
.20.
089
.589
.571
Rang
pur
6.6
487
25.4
0.0
0.0
0.0
0.0
8.9
12.8
28.8
6.3
0.0
0.0
6.8
6.6
0.0
81.7
81.7
32Sy
lhet
6.2
337
33.5
0.0
0.0
0.0
0.0
9.4
15.6
27.0
0.0
0.0
0.0
2.1
2.1
1.0
80.2
80.2
21A
ge0-
11 m
onth
s11
.01,
382
20.7
0.0
0.0
0.0
0.0
25.5
16.0
26.2
1.4
0.0
0.0
1.3
8.9
6.8
81.9
80.5
152
12-2
3 m
onth
s6.
91,
521
11.1
0.0
0.0
0.0
0.2
10.6
25.0
33.6
4.5
0.0
0.0
0.4
14.4
0.0
82.1
82.1
105
24-3
5 m
onth
s7.
01,
534
24.5
1.4
0.0
0.0
0.0
6.0
11.2
41.0
0.0
0.0
0.0
8.5
5.9
0.7
80.6
80.2
108
36-4
7 m
onth
s6.
41,
511
24.4
7.1
0.2
0.0
0.0
1.2
12.1
40.1
7.8
0.0
0.0
0.0
11.4
1.3
82.5
82.5
9748
-59
mon
ths
4.6
1,57
318
.71.
70.
02.
90.
015
.25.
135
.50.
00.
20.
02.
33.
67.
277
.477
.472
Mot
her’s
edu
catio
nN
o ed
ucat
ion
9.8
693
15.6
0.4
0.0
0.0
0.0
8.5
17.9
39.3
6.4
0.0
0.0
3.7
13.0
0.0
76.4
76.4
68Pr
imar
y in
com
plet
e9.
01,
077
22.9
0.0
0.0
0.0
0.2
13.6
9.5
36.8
2.1
0.0
0.0
5.4
9.6
2.1
81.9
81.9
97Pr
imar
y co
mpl
ete
8.1
751
15.7
3.4
0.0
0.0
0.0
13.0
9.8
45.5
8.0
0.0
0.0
1.5
9.2
0.5
85.2
85.2
61Se
cond
ary
inco
mpl
ete
7.1
3,67
721
.42.
80.
10.
80.
010
.114
.832
.01.
30.
10.
01.
79.
55.
878
.377
.426
2Se
cond
ary c
ompl
ete o
r hig
her
3.5
1,32
417
.90.
00.
00.
00.
033
.125
.721
.80.
00.
00.
00.
00.
10.
097
.697
.646
Wea
lth in
dex
quin
tile
Low
est
7.7
1,56
321
.22.
10.
00.
00.
27.
412
.133
.40.
40.
00.
01.
221
.50.
270
.370
.312
0Se
cond
9.0
1,38
813
.80.
20.
01.
70.
07.
513
.937
.45.
50.
00.
07.
711
.91.
979
.079
.012
5M
iddl
e9.
61,
474
23.6
1.5
0.2
0.0
0.0
16.0
12.4
39.2
4.5
0.1
0.0
0.7
1.9
0.2
93.5
91.7
141
Four
th6.
31,
686
21.4
4.5
0.0
0.0
0.0
16.8
16.6
26.7
0.8
0.0
0.0
0.8
4.6
13.7
76.1
76.1
106
Hig
hest
2.9
1,41
018
.90.
00.
00.
00.
023
.926
.931
.90.
00.
00.
00.
00.
80.
090
.790
.740
Relig
ion*
Isla
m7.
26,
909
20.8
1.6
0.0
0.4
0.0
13.8
14.3
33.3
2.9
0.0
0.0
2.6
9.7
2.3
81.1
80.6
496
Hin
du(6
.6)
558
(9.3
)(4
.1)
0.0
0.0
0.0
(0.1
)(1
9.4)
(49.
4)0.
00.
00.
00.
0(0
.8)
(16.
4)(8
2.2)
(82.
2)37
* Fi
gure
s fo
r Bud
dhis
t and
Chr
istia
n re
ligio
n ha
ve b
een
supp
ress
ed fr
om th
e ta
ble
due
to a
sm
all n
umbe
r of u
nwei
ghte
d ca
se( )
Fi
gure
s th
at a
re b
ased
on
25-4
9 un
wei
ghte
d ca
ses
67
Ch
ild H
ealt
h
4.4 Solid Fuel UseSolid fuels include biomass fuels such as wood, charcoal, crops or other agricultural wastes, and animal dung. Cooking and heating with solid fuels leads to high levels of indoor smoke which contains a complex mix of health damaging pollutants. Use of solid fuels increases the risk of causing acute respiratory illness (ARI), pneumonia, lung disease, cancer, asthma, and other diseases and may contribute to low birth weight babies.
Table 4.11: Solid fuel use
Per cent distribution of household members according to type of cooking fuel mainly used by the household, and Percentage of household members living in households using solid fuels for cooking, Child Well-being Survey in Urban Areas, Bangladesh, CWS, 2016
Percentage of household members in households mainly using:
Number of
house-hold
mem-bers
Electri-city
Lique-fied
Petro-leum Gas
(LPG)Natural
GasBio-gas
Kero-sene
Solid fuels
Other fuel
No food cook-ed in
the HH Total
Solid fuels for
cook-ing
Coal/ Lignite
Char- coal Wood
Straw/ Shrubs/ Grass
Animal dung
Agricul-tural crop
residue
Total 1.0 5.2 44.9 0.1 0.2 0.0 0.2 44.7 0.8 0.9 2.0 0.0 0.1 100.0 48.6 82,228
AreaCity Corporation slum 3.4 1.6 47.5 0.0 2.5 0.0 0.4 42.4 1.0 0.5 0.3 0.1 0.4 100.0 44.5 3,302
City Corporation non-slum 1.1 4.7 78.7 0.1 0.1 0.0 0.2 14.2 0.4 0.2 0.3 0.0 0.1 100.0 15.2 25,015
Other municipalities/urban 0.8 5.6 29.0 0.1 0.1 0.0 0.1 59.0 1.0 1.2 2.9 0.1 0.1 100.0 64.3 53,911
DivisionBarisal 0.6 16.2 0.2 0.0 0.0 0.0 0.2 79.1 1.4 0.2 2.1 0.0 0.0 100.0 82.9 3,343
Chittagong 0.0 5.3 49.3 0.0 0.1 0.0 0.1 44.7 0.3 0.0 0.1 0.0 0.1 100.0 45.2 16,019
Dhaka 0.5 2.0 67.9 0.1 0.3 0.0 0.0 26.8 0.8 0.1 1.5 0.0 0.1 100.0 29.1 38,509
Khulna 2.9 17.6 0.2 0.0 0.2 0.1 0.6 65.3 2.5 4.4 6.2 0.0 0.1 100.0 79.1 6,988
Rajshahi 1.9 5.7 12.9 0.2 0.2 0.0 0.1 67.9 0.9 4.3 5.7 0.2 0.1 100.0 78.9 8,430
Rangpur 4.0 6.3 0.4 0.3 0.0 0.0 0.7 87.0 0.3 0.1 0.7 0.0 0.1 100.0 88.9 5,554
Sylhet 0.0 1.2 50.8 0.2 0.0 0.0 0.1 45.3 0.7 0.6 1.0 0.0 0.1 100.0 47.7 3,385
Education of household headNo education 0.6 0.8 37.0 0.1 0.3 0.0 0.1 56.8 0.7 1.4 2.2 0.0 0.1 100.0 61.1 19,159
Primary incomplete 0.6 1.2 41.8 0.1 0.2 0.0 0.2 48.2 1.4 1.4 4.7 0.1 0.1 100.0 56.0 13,377
Primary complete 0.3 2.9 38.8 0.1 0.1 0.0 0.2 54.0 0.9 1.0 1.5 0.0 0.1 100.0 57.6 9,033
Secondary incomplete 0.7 5.7 46.4 0.1 0.1 0.0 0.3 43.5 0.9 0.6 1.6 0.1 0.1 100.0 46.9 24,583
Secondary complete or above 2.3 14.5 57.9 0.1 0.2 0.0 0.0 24.0 0.3 0.2 0.3 0.0 0.1 100.0 24.9 15,715
Missing/DK 4.6 0.6 61.1 0.2 0.0 0.0 0.0 31.1 0.0 0.0 2.3 0.0 0.0 100.0 33.4 360
Wealth Index quintileLowest 0.4 0.5 30.9 0.1 0.1 0.0 0.2 61.1 1.1 1.2 4.1 0.1 0.4 100.0 67.5 13,990
Second 0.4 0.9 48.1 0.0 0.3 0.0 0.2 45.3 1.0 1.3 2.2 0.1 0.1 100.0 50.0 15,216
Middle 0.5 2.1 32.6 0.1 0.3 0.0 0.2 58.5 1.1 1.5 2.9 0.0 0.0 100.0 64.3 17,034
Fourth 1.5 6.8 45.8 0.0 0.2 0.0 0.2 43.0 0.9 0.5 1.0 0.0 0.0 100.0 45.7 17,824
Highest 1.7 13.7 63.4 0.2 0.1 0.0 0.0 20.5 0.1 0.1 0.3 0.0 0.0 100.0 20.9 18,163
Religion*Islam
Hiundu
Table 4.11 gives Percentage of household members by types of cooking fuel mainly used by the households. Results presented in Table 4.11 show that the majority of urban households use natural gas or liquified petroleum gas LPG (50.1 per cent), others depend on wood (44.7
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
68
per cent), and agricultural crop residue (2.0 per cent) as fuel for cooking. About 83.4 per cent of CC non-slums households use gas (natural or LPG), this is 49.1 per cent in CC slums and 34.6 per cent in other urban areas.
About 48.6 per cent of the urban population relied on solid fuels for cooking. Use of solid fuels was very high in other urban households (64.3 per cent), compared with 44.5 per cent in CC slums and 15.2 per cent in CC non-slum households. Prevalence of use of solid fuels was the highest in urban households of Rangpur division (88.9 per cent), and lowest in Dhaka (29.1 per cent). Households/members belonging to the lower wealth quintiles were more likely to use solid fuel.
Table 4.12: Solid fuel use by place of cookingPer cent distribution of household members in households using solid fuels by place of cooking, Child Well-being Survey in Urban Areas, CWS 2016
Place of cooking: Number of household
members in households using solid
fuels for cooking
In the house
In a separate building Outdoors
Other place Total
In a separate room used as kitchen
Elsewhere in the house
Total 18.5 9.4 57.2 14.9 0.0 100.0 39,952
AreaCity Corporation slum 23.9 21.0 33.2 21.7 0.2 100.0 1,470 City Corporation non-slum 25.3 14.4 46.9 13.4 0.0 100.0 3,808 Other municipalities/urban 17.5 8.3 59.4 14.8 0.0 100.0 34,674
DivisionBarisal 24.9 21.0 42.1 12.0 0.0 100.0 2,773 Chittagong 34.4 11.4 47.4 6.8 0.0 100.0 7,245 Dhaka 11.6 3.6 68.2 16.6 0.0 100.0 11,200 Khulna 19.9 3.6 68.8 7.7 0.0 100.0 5,526 Rajshahi 10.5 11.4 49.6 28.5 0.0 100.0 6,653 Rangpur 9.4 12.4 62.7 15.5 0.0 100.0 4,940 Sylhet 39.8 22.2 25.7 12.1 0.2 100.0 1,615
Education of household headNo education 15.6 11.6 52.0 20.8 0.0 100.0 11,708 Primary incomplete 17.7 8.2 56.8 17.3 0.0 100.0 7,484 Primary complete 20.5 10.3 52.3 16.8 0.0 100.0 5,201 Secondary incomplete 19.2 8.5 62.2 10.1 0.0 100.0 11,524 Secondary complete or higher 24.4 6.1 65.4 4.1 0.0 100.0 3,913 Missing/DK 1.4 12.2 57.7 28.7 0.0 100.0 120
Wealth index quintileLowest 13.0 13.4 48.3 25.2 0.0 100.0 9,447 Second 17.7 9.0 54.8 18.6 0.0 100.0 7,611 Middle 16.8 8.6 61.2 13.5 0.0 100.0 10,950 Fourth 22.9 6.5 63.9 6.8 0.0 100.0 8,141 Highest 29.3 8.5 58.6 3.7 0.0 100.0 3,803
ReligionIslam 18.1 9.2 57.6 15.2 0.0 100.0 35,232 Hindu 20.5 10.9 55.2 13.4 0.0 100.0 4,305 Buddhist 36.5 9.1 42.5 11.8 0.0 100.0 271
Christian 12.2 15.4 64.1 8.3 0.0 100.0 122
Table 4.12 presents information on the household members who use solid fuel by place of cooking. Among those who were using solid fuels for cooking, 27.9 per cent had cooking place inside the house, either in a separate room or elsewhere in the house. This was more common among CC slum households (44.9 per cent), compared to 39.7 per cent of CC non-slums and 25.8 per cent in other urban households. Cooking place in a separate building or in outdoor places was the highest (74.2 per cent) in the other urban areas and lowest in CC slum (54.9 per cent) areas.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
69
5 REPRODUCTIVE HEALTH©UNICEF/UNI111360/Siddique
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
70
Key Findings:
� The median age at first marriage among urban women of reproductive age (15-49 years) was found to be 16.1 years, with somewhat higher in CC non-slums areas (17 years).
� The median age at first child birth among urban women aged 15-49 was three years more than the median age at first marriage (19.0 years).
� Early childbearing among women age 15-19 years persists high at 18.6 per cent, with 14.8 per cent in CC non-slums, 35.8 per cent in CC slums and 19.1 per cent in other urban areas.
� More than one-fifth of women (22.9 per cent) of age 20-24 have had a live birth before the age of 18. This Percentage was 33.0 per cent among women age 20-49 years.
� The Percentage of women age15-49 who have had a live birth before age 15 is 5.3 per cent.
� About 67.3 per cent of urban currently married women aged 15-49 use some method of contraception, with 73.8 per cent of CC slums, 67.2 per cent of other urban, and 66.6 per cent of CC non-slum areas. The total unmet need was 7.8 per cent.
� About 81.1 per cent of women age 15-49 who gave birth in the two years, preceding the survey received antenatal care from skilled health provider at least once, and 45.9 per cent had the recommended four or more antenatal care (ANC) visits by any provider. Sixty one per cent of those women living in CC non-slums received 4 or more ANC visits, compared to 35.8 per cent in CC slums, and 40.4 per cent in other urban areas.
� Sixty two per cent of all deliveries in urban areas took place in health facilities, and 64.2 per cent of deliveries were attended by skilled health provider during their most recent live births. Delivery at health facility was the highest in Khulna urban areas (76.9 per cent), and lowest in Chittagong (48.1 per cent).
� Of all births, 39.9 per cent of women had delivery by Caesarean Section.
� About 84.4 per cent of women age 15-49 years with a live birth in the last two years who had their last delivery in a health facility stayed in the health facility for 12 hours or more after the last delivery.
� Three-fourths (79.9 per cent) of both mothers age 15-49 years and their newborns received postnatal health checks within two days of birth.
This chapter provides information from the CWS 2016 on two important aspects of reproductive health: Fertility and Maternal Care. It focuses mainly on certain aspects of fertility such as age at first marriage, age at first childbearing, early childbearing and adolescent births, fertility regulation, use and unmet need for contraception, antenatal care, delivery and postnatal care.
5 REPRODUCTIVE HEALTH
71
5.1 FertilityFertility is an important component of population dynamics that determines the size, structure and composition of the population in any country. The CWS 2016 did not collect birth history data and therefore it was not possible to estimate age-specific fertility or total fertility rate. However, using the available data it was possible to estimate certain indicators related to adolescent birth and early childbearing.
5.1.1 Age at First Marriage
Age at marriage has a direct effect on fertility. Early marriage lengthens the effective reproductive period and subsequently increases fertility. An increase in the age at marriage can contribute to overall fertility decline. Table 5.1 provides data on age at first marriage.
Table 5.1: Age at first marriage and age at first child birth
Percentage of women aged 15-19 years by median age at first marriage and age at first child birth, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Median age at first marriage
Number of women
Median age at first child birth
Number of women who have had a live birth
Total 16.1 19,632 19.0 17,494
Age
15-19 17.0 1,520 16.9 202
20-24 17.2 2,967 19.2 2,632
25-29 16.8 3,835 19.1 3,595
30-34 16.0 3,317 18.9 3,240
35-39 16.0 2,970 19.0 2,917
40-44 15.7 2,213 19.1 2,159
45-49 15.0 2,810 19.0 2,749
Area
City Corporation slum 16.0 814 18.4 726
City Corporation non-slum 17.0 ,973 19.4 5,244
Other municipalities/urban 16.0 12,845 18.9 11,524
Division
Barisal 16.0 787 19.0 715
Chittagong 16.6 3,668 19.0 3,302
Dhaka 16.1 9,313 19.1 8,214
Khulna 15.8 1,788 18.8 1,585
Rajshahi 16.1 2,076 19.0 1,874
Rangpur 16.0 1,301 18.8 1,178
Sylhet 18.0 698 20.0 627
Education
No education 15.0 3,341 18.0 3,203
Primary incomplete 15.0 3,113 18.1 2,891
Primary complete 15.3 2,045 18.2 1,889
Secondary incomplete 16.7 8,253 19.0 7,176
Secondary complete or higher 19.6 2,880 22.6 2,336
Rep
rod
uct
ive
Hea
lth
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
72
Table 5.1: continued Median age at first
marriageNumber of
womenMedian age at first
child birthNumber of women who
have had a live birth
Wealth index quintile
Poorest 16.0 3,488 18.7 3,093
Second 16.0 3,783 18.6 3,354
Middle 16.0 3,979 18.8 3,601
Fourth 16.7 4,238 19.3 3,781
Richest 17.7 4,144 20.0 3,666
Religion
Islam 16.0 17,761 19.0 15,793
Hindu 17.2 1,725 19.8 1,564
Buddhist (19.2) 85 (22.4) 81
Christian 18.7 61 21.3 57
( ) Figures that are based on 25-49 unweighted cases
Overall, the median age at first marriage was 16.1 year. This means, half of the urban women get married by age 16.1 years. The median age at first marriage was recorded at 17 years among women of CC non-slum areas. Median age at first marriage by current age of women, across division and by socio economic status are also presented in Table 5.1. Older women, women from the lowest wealth quintile and with no education were more likely to get married at an early age. The median age at first marriage was 17.0 years in the age group 15-19 years, which was 15.0 years in age group 45-49 years. It was 15.0 years among the women having no education, against 19.6 years among those with secondary or higher education. Khulna had the least median age at marriage (15.8 per cent) and Sylhet had the highest (18 per cent) among divisions.
Table 5.2: Early childbearing
Percentage of women age 15-19 years who have had a live birth, are pregnant with the first child, have begun childbearing, and who have had a live birth before age 15, and Percentage of women age 20-24 years who have had a live birth before age 18, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Percentage of women age 15-19 who: Number of women
age 15-19
Percentage of women age 20-24 who
have had a live birth before
age 18
Number of
women age
20-24
Have had
a live birth
Are pregnant with first
child
Have begun childbearing
Have had a live birth before age
15
Total 13.3 5.3 18.6 0.5 1,520 22.9 2,967
Area
City Corporation slum 29.9 5.9 35.8 1.5 76 31.9 139
City Corporation non-slum 10.4 4.3 14.8 0.4 460 17.1 887
Other municipalities/urban 13.4 5.7 19.1 0.4 984 24.9 1,942
Division
Barisal 16.0 5.9 22.0 0.0 57 23.1 122
Chittagong 10.6 9.0 19.6 0.7 229 24.2 644
Dhaka 11.2 4.9 16.0 0.1 796 20.7 1,398
Khulna 16.3 4.8 21.1 1.6 162 27.0 228
Rajshahi 18.6 2.8 21.4 1.5 156 25.7 266
Rangpur 19.9 4.8 24.8 0.0 84 27.6 210
Sylhet 22.1 5.4 27.5 1.2 36 19.0 99
73
Rep
rod
uct
ive
Hea
lth
Table 5.2: continued
Percentage of women age 15-19 who: Number of women
age 15-19
Percentage of women age 20-24 who
have had a live birth before
age 18
Number of
women age
20-24
Have had
a live birth
Are pregnant with first
child
Have begun childbearing
Have had a live birth before age
15
Education
No education 21.9 0.6 22.5 0.4 57 34.3 157
Primary incomplete 14.9 2.2 17.2 1.3 166 25.8 395
Primary complete 24.9 8.9 33.8 1.2 107 21.6 273
Secondary incomplete 14.9 5.8 20.7 0.4 912 24.4 1,719
Secondary complete or higher 1.1 5.1 6.2 0.0 279 10.9 424
Wealth index quintile
Poorest 13.3 5.6 18.9 1.1 318 29.3 736
Second 17.0 4.4 21.4 0.1 351 26.4 669
Middle 13.0 2.8 15.7 0.2 269 21.3 574
Fourth 11.1 7.1 18.2 0.5 329 20.2 539
Richest 11.5 6.5 18.0 0.5 253 12.6 448
Religion*
Islam 13.3 5.3 18.6 0.5 1,408 23.5 2,749
Hindu 13.2 5.3 18.5 0.0 112 16.7 203
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
5.1.2 Age at First Birth
Age at first birth is an important determinant of fertility. The proportion of women who become mothers before age 20 is also a measure of the magnitude of adolescent fertility, which is a major health and social concern. Table 5.1 also provides information on median age at first child birth. Overall, median age at first child birth in urban areas was 19.0 years, which was roughly three years more than the median age at first marriage. Median age at first child birth was lower in CC slums (18.4 years) than in other urban and CC non-slum areas (18.9 years) than in CC non-slum areas (19.4 years). Education appeared to be the most significant determinant of age at first child birth; Median age at first child birth was 18.0 years among those with no education, and 22.6 years among those with secondary or higher education.
5.2 Early Childbearing and Adolescent Birth Rate
Childbearing during adolescence (before 20 years of age) had serious consequences on maternal health. Bearing children at a young age involves substantial risks to the health of both the mother and child. It has direct effect on fertility. Early childbearing also tends to restrict educational and economic opportunities for women.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
74
Table 5.2 presents the Percentage of women age 15-19 years who have had a live birth or were pregnant with the first child. It shows that 18.6 per cent of adolescents age 15-19 years in urban areas of Bangladesh had begun childbearing; 13.3 per cent have had a live birth and another 5.3 per cent were found currently pregnant. Early childbearing among CC slum women age 15-19 years was much higher (35.8 per cent), than to the CC non-slum (14.8 per cent) and other urban women (19.1 per cent).
Delayed childbearing was strongly related to education among women age 15-19 years. About 6.2 per cent of women who completed secondary or higher education in urban areas had begun childbearing compared with 22.5 per cent of those with no education. Childbearing began early in the lower wealth quintile.
Fig 5.1: Trend in early childbearing before age 18, Bangladesh, CWS 2016
Table 5.2 also provides information on the Percentage of women age 15-19 years who have had a live birth by age 15. Overall, 0.5 per cent of the teenage women have had a live birth before age 15. Teenage motherhood was more pronounced among women of CC slums (1.5 per cent) than those in CC non-slums (0.4 per cent) and other urban areas (0.4 per cent). These results compare well with surveys, MICS 2012-2013 and UHC 2013 results.
It was also evident that about 23 per cent women of age 20-24 years have had a live birth before age 18. This proportion was very high among CC slums women (31.9 per cent) followed by other urban women (24.9 per cent) and CC non-slums (17.1 per cent) and.
75
Rep
rod
uct
ive
Hea
lth
Tab
le 5
.3: Tre
nds
in e
arly
chi
ldbe
arin
gP
erce
nta
ge
of
wo
men
wh
o h
ave
had
a li
ve b
irth
, by
age
15 a
nd
18,
by
area
an
d a
ge
gro
up
, Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as, B
ang
lad
esh
, CW
S 2
016
City
cor
pora
tion
slum
City
cor
pora
tion
non-
slum
Oth
er m
unic
ipal
ities
/Urb
anA
ll
Perc
enta
ge
of w
omen
w
ith a
live
bi
rth b
efor
e ag
e 15
Num
ber
of
wom
en
age
15-4
9 ye
ars
Perc
enta
ge
of w
omen
w
ith a
live
bi
rth b
efor
e ag
e 18
Num
ber
of
wom
en
age
20-
49 y
ears
Perc
enta
ge
of w
omen
w
ith a
live
bi
rth b
efor
e ag
e 15
Num
ber
of
wom
en
age
15-
49 y
ears
Perc
enta
ge
of w
omen
w
ith a
live
bi
rth b
efor
e ag
e 18
Num
ber
of
wom
en
age
20-4
9 ye
ars
Perc
enta
ge
of w
omen
w
ith a
live
bi
rth b
efor
e ag
e 15
Num
ber
of w
omen
ag
e 15
-49
year
s
Perc
enta
ge
of w
omen
w
ith a
live
bi
rth b
efor
e ag
e 18
Num
ber
of
wom
en
age
20-4
9 ye
ars
Perc
enta
ge
of w
omen
w
ith a
live
bi
rth b
efor
e ag
e 15
Num
ber
of
wom
en
age
15-4
9 ye
ars
Perc
enta
ge
of w
omen
w
ith a
live
bi
rth b
efor
e ag
e 18
Num
ber
of w
omen
ag
e 20
-49
year
s
Tota
l6.
781
439
.673
85.
15,
973
28.9
5,51
35.
312
,845
34.5
11,8
615.
319
,632
33.0
18,1
12
Age
15-
191.
576
nana
0.4
460
nana
0.4
984
nana
0.5
1,52
0na
na 2
0-24
4.8
139
31.9
139
2.7
887
17.1
887
2.6
1,94
224
.91,
942
2.7
2,96
722
.92,
967
25-
299.
617
140
.817
17.
21,
198
32.7
1,19
86.
02,
465
34.6
2,46
56.
53,
835
34.3
3,83
5 3
0-34
9.6
147
46.5
147
6.2
1,00
231
.71,
002
8.6
2,16
838
.92,
168
7.9
3,31
737
.13,
317
35-
396.
812
245
.212
25.
590
929
.590
95.
81,
940
36.7
1,94
05.
82,
970
34.9
2,97
0 4
0-44
5.6
6938
.869
5.3
722
30.1
722
5.2
1,42
233
.41,
422
5.3
2,21
332
.52,
213
45-
494.
390
31.3
905.
179
530
.979
55.
51,
924
37.5
1,92
45.
32,
810
35.4
2,81
0D
ivis
ion
Baris
al0
04.
116
827
.315
84.
662
034
.757
34.
578
733
.173
1Ch
ittag
ong
5.9
319
35.3
291
5.7
971
30.5
906
4.9
2,37
734
.62,
242
5.2
3,66
833
.63,
439
Dha
ka6.
940
942
.237
14.
83,
834
27.9
3,52
64.
95,
070
34.2
4,62
04.
99,
313
32.0
8,51
7Kh
ulna
8.1
3641
.233
4.5
353
31.3
320
6.4
1,40
039
.61,
273
6.0
1,78
838
.01,
626
Rajs
hahi
9.3
3044
.427
8.6
242
36.7
221
5.9
1,80
431
.61,
671
6.3
2,07
632
.31,
919
Rang
pur
7.7
2047
.118
5.9
177
35.7
165
7.1
1,10
538
.51,
035
6.9
1,30
138
.31,
217
Sylh
et0
04.
822
922
.521
62.
847
023
.044
63.
569
822
.866
2Ed
ucat
ion
No
educ
atio
n7.
129
143
.528
28.
892
343
.690
17.
52,
126
42.5
2,10
07.
83,
341
42.9
3,28
4Pr
imar
y in
com
plet
e8.
020
043
.118
29.
186
642
.180
67.
52,
047
43.0
1,95
98.
03,
113
42.7
2,94
7Pr
imar
y co
mpl
ete
6.7
9538
.583
7.8
540
40.6
509
6.9
1,41
144
.71,
347
7.1
2,04
543
.41,
939
Seco
ndar
y in
com
plet
e5.
520
534
.317
03.
62,
443
26.1
2,20
74.
55,
605
32.8
4,96
44.
38,
253
30.8
7,34
1Se
cond
ary c
ompl
ete o
r hig
her
0.6
235.
121
1.0
1,20
17.
01,
089
1.2
1,65
68.
41,
490
1.1
2,88
07.
82,
601
Wea
lth in
dex
quin
tile
Poor
est
5.6
369
39.4
329
6.9
670
38.4
597
4.4
2,44
936
.42,
244
5.0
3,48
837
.13,
170
Seco
nd8.
224
343
.222
36.
11,
199
36.9
1,07
05.
92,
341
38.9
2,13
96.
13,
783
38.6
3,43
2M
iddl
e7.
995
36.4
876.
890
732
.385
87.
02,
976
37.3
2,76
57.
03,
979
36.1
3,71
0Fo
urth
8.1
7138
.765
4.4
1,31
826
.31,
212
5.0
2,84
832
.42,
631
4.9
4,23
830
.63,
908
Rich
est
1.5
3528
.234
3.4
1,87
820
.91,
775
3.7
2,23
026
.72,
082
3.6
4,14
424
.13,
891
Relig
ion*
Isla
m6.
875
340
.368
15.
25,
440
29.7
5,00
15.
611
,568
35.4
10,6
705.
517
,761
33.9
16,3
52H
indu
4.9
5733
.053
3.9
491
21.5
469
3.1
1,17
727
.81,
091
3.4
1,72
526
.11,
614
na:
Not
app
licab
le*
Figu
res
for B
uddh
ist a
nd C
hris
tian
relig
ion
have
bee
n su
ppre
ssed
from
the
tabl
e du
e to
a s
mal
l num
ber o
f unw
eigh
ted
case
s
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
76
Tab
le 5
.4: U
se o
f co
ntra
cept
ion
Per
cen
tag
e o
f w
om
en a
ge
15-4
9 ye
ars
curr
entl
y m
arri
ed o
r in
un
ion
wh
o a
re u
sin
g (
or
wh
ose
par
tner
is u
sin
g)
a co
ntr
acep
tive
met
ho
d b
y se
lect
ed c
har
acte
rist
ics,
Ch
ild W
ell-
bei
ng
S
urv
ey in
Urb
an A
reas
, Ban
gla
des
h, C
WS
201
6
No
met
hod
Fem
ale
ster
ili-
zatio
n
Mal
e st
erili
- za
tion
IUD
Inje
c-ta
bles
Impl
-an
tsPi
llM
ale
cond
omFe
mal
e co
ndom
Diap
hrag
m/
Foam
/Jel
lyLA
MPe
riodi
c ab
sti-
nenc
e
With
-dr
awal
Oth
er M
iss-
ing
Any
mod
ern
met
hod
Any
tradi
-tio
nal
met
hod
Any
met
hod
Num
ber o
f wom
en
age
15-4
9 ye
ars
curr
ently
mar
ried
or
in u
nion
Tota
l32
.74.
00.
80.
510
.81.
429
.011
.70.
00.
00.
17.
91.
00.
10.
058
.48.
967
.318
,252
Are
a City
Cor
pora
tion
slum
26.2
5.0
1.4
0.5
20.1
2.2
30.0
6.8
0.1
0.0
0.2
6.6
0.7
0.0
0.0
66.4
7.3
73.8
731
City
Cor
pora
tion
non-
slum
33.4
4.0
0.8
0.5
10.2
1.6
25.4
16.3
0.0
0.1
0.1
6.3
1.0
0.1
0.0
59.2
7.4
66.6
5,50
5O
ther
mun
icip
aliti
es/u
rban
32
.83.
90.
80.
510
.41.
330
.59.
90.
00.
00.
18.
70.
90.
10.
057
.59.
767
.212
,016
Div
isio
nBa
risal
28.9
3.3
0.9
0.7
11.5
1.5
33.3
8.7
0.1
0.0
0.2
9.1
1.9
0.1
0.0
60.1
11.0
71.1
751
Chitt
agon
g35
.34.
00.
50.
711
.01.
130
.87.
60.
00.
00.
28.
20.
50.
10.
055
.88.
964
.73,
383
Dha
ka33
.43.
50.
80.
411
.41.
329
.012
.30.
00.
00.
16.
41.
30.
00.
058
.87.
866
.68,
639
Khul
na30
.74.
70.
80.
58.
91.
423
.815
.80.
10.
00.
212
.11.
00.
10.
056
.113
.269
.31,
685
Rajs
hahi
27.0
5.8
1.1
1.0
10.5
2.1
27.8
14.4
0.0
0.0
0.0
9.7
0.3
0.0
0.0
62.9
10.1
73.0
1,95
3Ra
ngpu
r31
.03.
71.
30.
310
.92.
430
.611
.20.
00.
00.
18.
30.
20.
00.
060
.58.
569
.01,
210
Sylh
et40
.75.
11.
10.
35.
81.
927
.810
.10.
10.
00.
16.
30.
70.
10.
052
.37.
059
.363
2A
ge15
-19
51.4
0.0
0.0
0.0
3.3
0.3
24.2
16.8
0.1
0.0
0.0
3.3
0.5
0.0
0.0
44.8
3.8
48.6
1,50
820
-24
29.1
0.5
0.1
0.4
14.6
2.3
37.3
11.3
0.0
0.0
0.4
2.9
1.1
0.0
0.0
66.9
4.0
70.9
2,85
325
-29
28.3
1.9
0.2
0.9
14.3
2.3
32.8
13.4
0.0
0.1
0.1
5.1
0.6
0.0
0.0
66.0
5.7
71.7
3,70
430
-34
23.1
4.6
1.5
0.9
13.2
1.6
35.0
12.7
0.0
0.0
0.1
6.4
1.0
0.1
0.0
69.4
7.5
76.9
3,17
035
-39
22.1
7.3
1.5
0.4
10.3
1.2
31.7
13.5
0.0
0.0
0.0
10.5
1.5
0.0
0.0
65.8
12.1
77.9
2,72
140
-44
32.4
7.5
1.0
0.5
8.8
1.0
19.8
10.4
0.1
0.0
0.1
17.6
0.7
0.2
0.0
49.1
18.5
67.6
1,98
845
-49
58.2
6.6
1.2
0.2
4.1
0.3
12.1
3.9
0.0
0.0
0.0
11.9
1.2
0.2
0.0
28.5
13.2
41.8
2,30
8N
umbe
r of
livin
g ch
ildre
n0
34.9
4.3
0.9
0.5
9.8
1.4
27.6
11.1
0.0
0.0
0.0
8.4
0.9
0.1
0.0
55.7
9.4
65.1
15,4
581
18.2
0.0
0.0
0.4
14.2
1.5
38.9
18.4
0.0
0.0
1.0
5.8
1.6
0.0
0.0
74.4
7.4
81.8
1,16
02
24.1
1.7
0.0
0.8
17.0
1.3
35.8
13.6
0.0
0.0
0.5
4.2
0.9
0.0
0.0
70.8
5.1
75.9
945
318
.78.
60.
01.
017
.71.
735
.013
.20.
00.
00.
03.
90.
30.
00.
077
.14.
281
.349
14+
23.7
5.4
1.2
0.0
20.7
5.0
29.7
8.3
0.0
0.0
1.1
4.8
0.0
0.0
0.0
71.5
4.8
76.3
198
Educ
atio
nN
o ed
ucat
ion
37.1
6.4
2.0
0.8
14.0
1.8
23.9
3.7
0.0
0.0
0.1
9.5
0.5
0.1
0.0
52.7
10.1
62.9
2,80
8Pr
imar
y in
com
plet
e32
.06.
01.
50.
616
.22.
229
.64.
40.
00.
00.
06.
41.
00.
00.
060
.57.
468
.02,
841
Prim
ary
com
plet
e28
.04.
40.
30.
615
.51.
134
.06.
70.
00.
00.
18.
01.
20.
20.
062
.79.
372
.01,
896
Seco
ndar
y in
com
plet
e32
.72.
80.
50.
59.
11.
432
.012
.40.
00.
00.
17.
31.
20.
00.
058
.88.
567
.37,
896
Seco
ndar
y co
mpl
ete
or h
ighe
r32
.42.
90.
20.
53.
50.
621
.628
.30.
00.
00.
19.
10.
70.
00.
057
.89.
867
.62,
812
Wea
lth in
dex
quin
tile
Low
est
29.7
4.0
1.4
0.5
17.7
2.2
34.6
4.4
0.0
0.0
0.3
4.8
0.4
0.0
0.0
65.1
5.2
70.3
3,13
0Se
cond
31.4
3.7
1.1
0.5
14.3
2.1
32.4
6.6
0.0
0.1
0.1
6.5
1.2
0.1
0.0
60.8
7.8
68.6
3,48
0M
iddl
e30
.73.
61.
10.
612
.81.
430
.410
.00.
00.
00.
08.
01.
30.
10.
060
.09.
469
.33,
732
Four
th35
.83.
40.
10.
57.
61.
127
.913
.10.
00.
00.
19.
41.
00.
10.
053
.810
.464
.23,
985
Hig
hest
35.3
5.3
0.4
0.6
3.3
0.7
21.2
22.2
0.1
0.0
0.1
9.8
1.0
0.0
0.0
54.0
10.7
64.7
3,92
5Re
ligio
n*Is
lam
33.3
3.9
0.8
0.6
11.5
1.4
28.1
11.7
0.0
0.0
0.1
7.5
1.0
0.1
0.0
58.1
8.6
66.7
16,5
20H
indu
26.9
5.0
0.3
0.1
3.8
1.6
38.6
11.4
0.1
0.0
0.1
11.3
0.9
0.0
0.0
60.9
12.2
73.1
1,60
3
* Fi
gure
s fo
r Bud
dhis
t and
Chr
istia
n re
ligio
n ha
ve b
een
supp
ress
ed fr
om th
e ta
ble
due
to a
sm
all n
umbe
r of u
nwei
ghte
d ca
ses
( )
Figu
res
that
are
bas
ed o
n 25
-49
unw
eigh
ted
case
s
77
Rep
rod
uct
ive
Hea
lth
Results presented in Table 5.3 suggest that early childbearing has gradually declined over the years. The Percentage of women with a live birth before age 15 had dropped from 6.5 (for age groups 25-29) to 0.5 (for age 15-19) during the last 10 years in urban areas. Similarly, Percentage of women with a live birth before age 18 has dropped from 37.1 (for age 30-34) to 22.9 (for age 20-24) during the same length of period.
5.3 ContraceptionFertility regulation is an important proximate determinant of fertility. Currently married women aged 15-49 years were asked whether they were currently using any family planning (FP) or contraceptive method. These data were used to indicate overall and method specific prevalence of contraceptive use by these women or their husband.
Table 5.4 presents data on the proportion of currently married women who reported that they were using a contraceptive method. Contraceptive prevalence rate (CPR) was high in all urban domains. The overall CPR in urban areas was 67.3 per cent, the highest being in the CC slums (73.8 per cent).
The majority of women were ‘modern’ methods users (54.4 per cent). Use of traditional methods was 8.9 per cent with the highest in the other urban areas (9.7 per cent). Among the divisions, use of any method of contraception was the highest in Rajshahi (73.0 per cent), and lowest in Sylhet (59.3 per cent).
Among the modern methods, oral pill was the most popular method (29.0 per cent) and it was almost equally popular in all the urban domains. Approximately one in four currently married women from CC non-slum (25.4 per cent), and three in ten women of CC slum and other urban areas were using pills. The same pattern prevailed in all divisions. Injectables was the second most popular method in CC slums (20.1 per cent) while male condoms were the second most popular method in CC non-slums (16.3 per cent).
Long-acting (IUD, implant) and permanent (female sterilization and NSV) method (LAPM) use was low in CC slums, CC non-slums and other urban areas.
Contraceptive use by background characteristics such as age, number of living children, education, and household wealth quintile can also be seen in Table 5.4. Contraceptive use increased with age, reaching a high of 77.9 per cent in ages 35-39, then declined. Similarly, it increased with the number of living children.
5.4 Unmet NeedUnmet need for contraception refers to fecund women who are married or in union and are not using any method of contraception but who wish to postpone the next birth (spacing) or who wish to stop childbearing altogether (limiting). In CWS 2016, unmet need was identified by using a set of questions eliciting current behavior and preferences pertaining to contraceptive use, fecund-ability, and fertility preferences.
Table 5.5 shows the levels of met need for contraception, unmet need, and the demand for contraception satisfied.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
78
Table 5.5: Unmet need for contraception
Percentage of women age 15-49 years currently married or in union with an unmet need for family planning and Percentage of demand for contraception satisfied by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Met need for contraception Unmet need for contraception
Number of women currently
married or in union
Percentage of demand for
contraception satisfied
Number of women currently
married or in union with need for contraception
For spacing
For limiting
Total For spacing
For limiting
Total
Total 22.1 45.1 67.3 3.2 4.6 7.8 18,252 89.6 13,696
Area
City Corporation slum 26.6 47.1 73.8 2.2 3.7 5.9 731 92.6 582
City Corporation non-slum 23.4 43.2 66.6 2.9 4.9 7.8 5,505 89.6 4,093
Other municipalities/urban 21.3 45.9 67.2 3.4 4.5 7.9 12,016 89.5 9,022
Division
Barisal 23.2 47.9 71.1 2.0 3.0 5.1 751 93.4 572
Chittagong 19.4 45.2 64.7 3.8 7.8 11.5 3,383 84.9 2,577
Dhaka 23.6 43.0 66.6 3.6 4.3 7.9 8,639 89.4 6,438
Khulna 21.8 47.6 69.3 2.5 3.0 5.6 1,685 92.6 1,262
Rajshahi 22.7 50.2 73.0 1.9 2.6 4.6 1,953 94.1 1,514
Rangpur 21.6 47.4 69.0 2.1 3.2 5.3 1,210 92.8 899
Sylhet 15.5 43.8 59.3 3.8 5.7 9.5 632 86.2 435
Age
15-19 47.3 1.3 48.6 10.0 0.0 10.1 1,508 82.9 884
20-24 56.8 14.1 70.9 6.0 1.5 7.4 2,853 90.5 2,234
25-29 30.4 41.3 71.7 4.3 3.0 7.3 3,704 90.7 2,927
30-34 13.8 63.2 76.9 2.1 5.5 7.7 3,170 90.9 2,682
35-39 4.4 73.5 77.9 1.1 6.8 7.9 2,721 90.8 2,333
40-44 1.0 66.6 67.6 0.2 10.3 10.6 1,988 86.5 1,554
45-49 0.3 41.5 41.8 0.0 5.1 5.1 2,308 89.2 1,081
Education
No education 7.1 55.7 62.9 0.9 4.9 5.8 2,808 91.5 1,928
Primary incomplete 16.3 51.7 68.0 2.0 5.3 7.3 2,841 90.3 2,138
Primary complete 20.6 51.4 72.0 1.8 4.4 6.2 1,896 92.1 1,483
Secondary incomplete 26.7 40.6 67.3 4.2 4.5 8.7 7,896 88.5 6,005
Secondary complete or higher 31.1 36.5 67.6 4.7 3.9 8.6 2,812 88.7 2,143
Wealth index quintile
Lowest 25.9 44.4 70.3 2.4 3.3 5.7 3,130 92.5 2,378
Second 24.8 43.8 68.6 3.0 2.7 5.6 3,480 92.4 2,584
Middle 20.2 49.1 69.3 2.8 3.3 6.2 3,732 91.8 2,819
Fourth 21.7 42.6 64.2 4.0 6.7 10.7 3,985 85.8 2,984
Highest 19.1 45.6 64.7 3.5 6.4 9.9 3,925 86.7 2,930
Religion
Islam 22.1 44.6 66.7 3.4 4.7 8.0 16,520 89.2 12,350
Hindu 22.6 50.5 73.1 1.7 3.1 4.8 1,603 93.8 1,249
Buddhist (13.2) (49.1) (62.3) (0.0) (5.0) (5.0) 77 (92.5) 52
Christian 28.9 42.2 71.1 0.0 17.5 17.5 52 80.3 46
( ) Figures that are based on 25-49 unweighted cases
79
Rep
rod
uct
ive
Hea
lth
Unmet need for spacing is defined as the Percentage of women who are married or in union and are not using a method of contraception AND
� are not pregnant, and not postpartum amenorrheic, and fecund and say they want to wait two or more years for their next births OR
� are not pregnant, and not postpartum amenorrheic, and are fecund, and unsure whether they wanted another child, OR
� are pregnant, and say that pregnancy was mistimed: would have wanted to wait OR � are postpartum amenorrheic, and say that birth was mistimed: would have wanted to wait.
Unmet need for limiting is defined as the Percentage of women who are married or in union and are not using a method of contraception AND
� are not pregnant, and not postpartum amenorrheic, and are fecund and say they do not want any more child OR
� are pregnant, and say they did not want to have a child OR � are postpartum amenorrheic, and say that they did not want the birth.
Total unmet need for contraception is the sum of unmet need for spacing and unmet need for limiting.
About 3.2 Percentage of 15-49 year old women who were married had an unmet need for contraception for spacing, and 4.6 per cent for limiting children. The total unmet need for contraception was 7.8 per cent. As expected, the unmet need for spacing was higher among younger women, and for limiting among the women of older age.
Fig 5.2: Women age 15-49 years currently married with unmet need for contraception by age, Bangladesh, CWS 2016
Met need for limiting includes women married or in union who are using (or whose partner is using) a contraceptive method, and who want no more children, are using male or female sterilization, or declare themselves as infecund. Met need for spacing includes women who are using (or whose partner is using) a contraceptive method, and who want to have another child, or are undecided whether to have another child. The total of met need for ‘spacing’ and ‘Limiting’ adds upto the total met need for contraception.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
80
In Bangladesh, the total Percentage of women whose contraceptive needs are met was 67.3 per cent. The met need for contraception for spacing was higher among younger women, particularly those aged 20-24 years (56.8 Per cent), while the met need for limiting was higher among women aged 35-39 years (73.5 per cent). Results also show that met need was higher among women of CC slum areas than in CC non-slums and other urban areas.
5.5 Antenatal CareThe reproductive health care services that a mother receives during her pregnancy and at the time of delivery are important for the well-being of the mother and her child. Antenatal checkup facilitates detection and treatment of possible complications during pregnancy. Antenatal Care (ANC) can be assessed according to the type of service provider, number of visits made, content of antenatal care, the stage of pregnancy at the time of first ANC visit and consumption of iron folic acid tablets.
Table 5.6: Antenatal care coverage
Per cent distribution of women age 15-49 years with a live birth in the last two years preceding the survey by antenatal care provider during the pregnancy for the last birth, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Provider of antenatal carea
No antenatal
care Total
Any skilled
provider
Number of women with a live birth in the
last two years
Medical doctor
Nurse/ Midwife
Auxi-liary mid-wife
Comm-unity
skilled birth
attendant
Comm-unity
health worker Other
Total 75.6 4.9 0.6 0.0 0.2 9.5 9.3 100.0 81.1 2,882
AreaCity Corporation slum 59.5 7.0 1.2 0.0 2.5 13.8 16.1 100.0 67.7 127City Corporation non-slum 80.4 3.1 0.5 0.0 0.0 8.4 7.5 100.0 84.1 811Other municipalities/urban 74.7 5.5 0.6 0.0 0.1 9.7 9.5 100.0 80.7 1,944
DivisionBarisal 71.4 5.8 1.1 0.0 0.1 7.4 14.2 100.0 78.3 120Chittagong 71.0 4.2 0.4 0.0 0.1 11.1 13.2 100.0 75.6 651Dhaka 79.8 3.8 0.4 0.0 0.2 8.9 7.0 100.0 83.9 1,320Khulna 82.1 4.4 0.7 0.0 0.0 5.9 7.0 100.0 87.2 193Rajshahi 69.9 8.6 1.8 0.0 0.0 13.1 6.5 100.0 80.4 272Rangpur 73.7 9.3 0.0 0.0 0.5 8.5 7.9 100.0 83.0 198Sylhet 65.4 5.5 1.2 0.2 0.0 8.5 19.3 100.0 72.0 128
Mother’s age at birthLess than 20 71.1 4.9 0.6 0.0 0.2 11.8 11.3 100.0 76.7 1,54520-34 80.7 4.9 0.5 0.0 0.1 6.9 6.9 100.0 86.2 1,32835-49 (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 9
EducationNo education 49.6 10.1 0.9 0.0 0.2 16.4 22.7 100.0 60.7 237Primary incomplete 59.8 7.8 1.1 0.1 0.2 14.1 17.0 100.0 68.6 423Primary complete 66.6 5.4 0.1 0.0 0.1 14.9 13.0 100.0 72.1 294Secondary incomplete 80.4 3.6 0.7 0.0 0.2 8.7 6.4 100.0 84.7 1,378Secondary complete or higher 91.8 3.4 0.0 0.0 0.0 2.1 2.7 100.0 95.2 549
Wealth index quintileLowest 56.3 5.5 1.0 0.0 0.2 16.1 20.8 100.0 62.8 633Second 66.1 5.3 0.2 0.0 0.2 18.1 10.2 100.0 71.5 520Middle 76.5 6.8 0.5 0.0 0.2 9.0 7.0 100.0 83.7 594Fourth 88.0 3.9 0.4 0.0 0.0 3.0 4.7 100.0 92.3 634Highest 93.3 2.8 0.8 0.0 0.0 0.9 2.1 100.0 96.9 500
81
Rep
rod
uct
ive
Hea
lth
Table 5.6: continued
Provider of antenatal carea
No antenatal
care Total
Any skilled
provider
Number of women with a live birth in the
last two years
Medical doctor
Nurse/ Midwife
Auxi-liary mid-wife
Comm-unity
skilled birth
attendant
Comm-unity
health worker Other
Religion*
Islam 74.3 4.9 0.6 0.0 0.2 10.1 9.9 100.0 79.8 2,629
Hindu 88.2 5.2 0.2 0.0 0.1 3.1 3.2 100.0 93.6 220
a Only the most qualified provider is considered in cases where more than one provider was reported.* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted casesNote: Medical Doctor (MN2, A = Qualified Doctor); Nurse/Midwife (MN2, B= Nurse/Midwife/Paramedic); Auxiliary Midwife (MN2, C = FWV); Community Skilled Birth Attendant (MN, J = Trained Traditional Birth Attendant (TTBA)); Community Health Worker (N2, F = Community Health Provider); Other (MN2, G = Health Assistant (HA)/H= Family Welfare Assistant (FWA)/I= NGO Worker/K= Untrained Traditional Birth Attendant
(UTBA)/L- Quack/X = Other); Any Skilled Provider = Medical Doctor/Nurse/Midwife/Paramedic/Auxiliary Midwife.
5.5.1 Antenatal Care Coverage
Table 5.6 shows that the overall use of ANC from any provider at least once during the last pregnancy was 90.7 per cent in urban areas of Bangladesh. The overall use of any ANC was higher among CC non-slums women (92.5 per cent) than in CC slums (83.9 per cent) or in other urban areas (90.5 per cent). The recent BDHS also reported use of any ANC among urban women of the same level.
Table 5.7: Number of antenatal care visits and timing of first visit
Per cent distribution of women age 15-49 years with a live birth in the last two years by number of antenatal care visits by any provider and by the timing of first antenatal care visits, Child Well-being Survey in Urban Areas, Bangladesh, 2016
Percentage of women who had:
Total
Number of women with a live birth in the last two years
Number of women with a live
birth in the last two years who had at least one
ANC visit
No antenatal care visits
One visit
Two visits
Three visits
4 or more visits
Total 9.3 10.4 16.7 17.7 45.9 100.0 2,882 2,615
Area
City Corporation slum 16.1 11.8 19.1 17.3 35.8 100.0 127 107
City Corporation non-slum 7.5 4.4 12.1 15.2 60.8 100.0 811 750
Other municipalities/urban 9.5 12.8 18.4 18.8 40.4 100.0 1,944 1,759 Division
Barisal 14.2 5.9 18.2 24.4 37.3 100.0 120 103
Chittagong 13.2 15.5 20.0 15.7 35.5 100.0 651 565
Dhaka 7.0 8.5 15.2 17.3 52.0 100.0 1,320 1,228
Khulna 7.0 9.4 14.5 15.0 54.1 100.0 193 180
Rajshahi 6.5 11.8 19.2 16.8 45.8 100.0 272 255
Rangpur 7.9 5.2 12.4 26.1 48.3 100.0 198 182
Sylhet 19.3 15.7 17.2 18.9 28.9 100.0 128 103
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
82
Table 5.7: continued
Percentage of women who had:
Total
Number of women with a live birth in the last two years
Number of women with a live
birth in the last two years who had at least one
ANC visit
No antenatal care visits
One visit
Two visits
Three visits
4 or more visits
Mother’s age at birth
Less than 20 11.3 11.4 16.9 17.1 43.2 100.0 1,545 1,370
20-34 6.9 9.4 16.5 17.9 49.3 100.0 1,328 1,237
35-49 (*) (*) (*) (*) (*) 100.0 (*) 9 Education
No education 22.7 14.5 15.8 23.4 23.6 100.0 237 183
Primary incomplete 17.0 12.3 26.5 14.0 30.3 100.0 423 351
Primary complete 13.0 20.6 13.7 15.8 37.0 100.0 294 256
Secondary incomplete 6.4 9.2 16.4 19.6 48.4 100.0 1,378 1,290
Secondary complete or higher 2.7 4.8 11.8 14.4 66.3 100.0 549 535 Wealth index quintile
Lowest 20.8 17.1 18.2 15.6 28.3 100.0 633 501
Second 10.2 14.5 23.4 20.5 31.3 100.0 520 467
Middle 7.0 11.7 19.0 21.0 41.3 100.0 594 553
Fourth 4.7 4.1 11.6 15.5 64.1 100.0 634 604
Highest 2.1 4.2 11.3 16.4 65.9 100.0 500 489 Religion*
Islam 9.9 10.9 16.9 17.6 44.7 100.0 2,629 2,369
Hindu 3.2 6.8 14.8 18.3 56.9 100.0 220 213
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases
Coverage with at least one ANC from a skilled provider was 81.1 per cent, and this was significantly higher among women of CC non-slum areas (84.1 per cent) than among CC slums women (67.7 per cent). A substantial difference was noticed in the type of ANC provider used by area of residences. Women in the CC non-slum areas were almost one and half time as likely as women in CC slums to go to a qualified doctor for ANC (80.4 versus 59.5 per cent). About 16.3 per cent women living in CC slums received ANC from a non-medically trained provider, against only 8.4 per cent women of CC non-slums.
Fig 5.3: ANC by skilled provider by areas, Bangladesh, CWS 2016
83
Rep
rod
uct
ive
Hea
lth
There were sharp differences in ANC coverage by background characteristics. Across all urban areas and divisions, similar pattern exist where medically trained providers were more likely to be used for ANC for older women, more educated women, and women in higher wealth quintiles (Table 5.6).
5.5.2 Number of Antenatal Care Visits
The Bangladesh Maternal Health Strategy recommends at last four ANC visits during a pregnancy. The coverage of the recommended four or more ANC visits varied widely by CC slums, CC non-slums and other urban areas. As shown in Table 5.7, overall 45.9 per cent received 4 or more ANC visits during last pregnancy. Women living in CC non-slums were more likely to have received four or more ANC visits compared to in the other two urban areas. Sixty one per cent of women living in CC non-slums received at least four ANC visits during their last pregnancy, compared to 35.8 per cent in CC slums and 40.4 per cent in other urban areas (Figure 5.4).
Fig 5.4: ANC received 4 or more visits by areas, Bangladesh, CWS 2016
Coverage with four or more ANC visits was highest in Khulna (54.1 per cent) and lowest in Sylhet (28.9 per cent). A substantial difference was noticed in the coverage with four or more ANC visits by mother’s age at the time of birth, education and household wealth. Women of age at birth 20-34 years, those with secondary or higher level of education and those in the highest wealth quintiles were most likely to receive four or more ANC visits.
5.5.3 Components of Antenatal Care
The content of antenatal care is an essential component of ANC service quality. Table 5.8 shows that 87.6 per cent of women receiving ANC had their blood pressure checked, urine sample was taken for 69.5 per cent, blood sample was taken for 66.9 per cent, and all these components done for 62.9 per cent women. All the three components was done in most cases for women of CC non-slum areas (76.8 per cent). Women living in CC slums and other urban
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
84
areas were less likely to receive ANC care covering all these three components in 52.2 per cent in CC slums and 57.9 per cent women in other urban areas. Receiving this care was highest in Dhaka (69.3 per cent), and lowest in Rajshahi division (50.3 per cent).
Table 5.8: Content of antenatal care
Percentage of women age 15-49 years with a live birth in the last two years preceding the survey who, at least once, had their blood pressure measured, urine sample taken, and blood sample taken as part of antenatal care, during the pregnancy for the last birth, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Percentage of women who, during the pregnancy of their last birth, had:
Number of women with a live birth in the last two yearsBlood
pressure measured
Urine sample taken
Blood sample taken
Blood pressure measured, urine and blood sample taken1
Total 87.6 69.5 66.9 62.9 2,882
Area
City Corporation slum 79.3 59.1 55.4 52.2 127
City Corporation non-slum 91.4 79.6 79.5 76.8 811
Other municipalities/urban 86.6 66.0 62.4 57.9 1,944
Division
Barisal 82.7 71.0 62.5 62.3 120
Chittagong 79.2 64.4 62.1 57.4 651
Dhaka 92.1 74.7 73.6 69.3 1,320
Khulna 89.8 69.0 69.5 63.9 193
Rajshahi 89.2 61.3 53.7 50.3 272
Rangpur 90.3 64.1 62.1 59.6 198
Sylhet 77.0 67.7 58.2 56.3 128
Mother’s age at birth
Less than 20 85.2 66.4 63.2 59.7 1,545
20-34 90.3 73.1 71.3 66.7 1,328
35-49 (*) (*) (*) (*) 9
Education
No education 67.6 44.7 41.3 35.9 237
Primary incomplete 80.5 52.4 46.8 41.2 423
Primary complete 81.9 55.5 50.6 47.2 294
Secondary incomplete 90.9 73.6 72.7 68.6 1,378
Secondary complete or higher 96.5 90.8 87.7 85.6 549
Wealth index quintile
Lowest 74.3 52.7 46.3 43.2 633
Second 84.2 54.5 50.7 43.2 520
Middle 89.8 65.7 63.8 60.0 594
Fourth 94.6 84.7 84.1 80.9 634
Highest 96.5 91.7 91.9 89.4 500
Religion*
Islam 86.8 68.4 65.9 61.7 2,629
Hindu 94.8 82.4 78.3 77.3 220
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases
85
Rep
rod
uct
ive
Hea
lth
5.6 Delivery CareDelivery care is an important component of maternal and newborn care. Proper medical attention and hygienic condition during delivery can reduce the risk of complications and infections. Place of delivery and the provider who conducts or assists in the delivery are very important.
5.6.1 Assistance during Delivery
Assistance during delivery influences the delivery outcome and the health of the mother and the child. Table 5.9 shows that among the women who had a live birth in the last two years, 64.2 per cent were assisted during delivery by a skilled attendant. Skilled birth attendants include qualified medical doctors, nurses, and midwives.
Table 5.9: Assistance during delivery and caesarian section
Per cent distribution of women age 15-49 years with a live birth in the last two years by person providing assistance at delivery, and Percentage of births delivered by C-section, Child Well-being Survey in Urban Areas, Bangladesh, 2016
Person assisting at delivery No atten-dant
Total Delivery assisted by any skilled attendant
Per cent delivered
by C-section
Number of women who had a live birth in the last two
years
Medical doctor
Nurse/ Mid-wife
FWV HA/ FWA
NGO worker
TTBA UTBA Unquali-fied
doctor
Relative/ friends
Total 48.1 16.0 0.1 0.5 2.5 8.4 21.1 0.6 2.6 0.1 100.0 64.2 39.9 2,882
AreaCity Corporation slum 34.6 20.5 0.4 0.0 4.4 11.7 22.3 1.3 4.8 0.0 100.0 55.5 23.9 127City Corporation non-slum 59.4 14.2 0.0 0.5 2.8 8.5 13.8 0.0 0.7 0.0 100.0 73.6 46.6 811Other municipalities/urban 44.3 16.4 0.2 0.5 2.2 8.1 24.1 0.8 3.3 0.1 100.0 60.9 38.1 1,944
DivisionBarisal 47.7 20.6 0.0 0.0 0.5 7.0 23.1 1.0 0.3 0.0 100.0 68.2 39.5 120Chittagong 36.3 17.5 0.3 0.3 1.4 11.0 27.8 1.2 3.9 0.3 100.0 54.2 26.1 651Dhaka 52.8 13.9 0.0 0.7 4.1 7.1 19.6 0.0 1.8 0.0 100.0 66.8 44.5 1,320Khulna 58.5 21.7 0.0 0.0 0.3 9.6 8.4 0.8 0.6 0.0 100.0 80.3 57.2 193Rajshahi 51.3 13.6 0.6 1.2 1.4 8.8 17.3 1.2 4.6 0.0 100.0 65.5 40.8 272Rangpur 50.6 18.7 0.0 0.0 1.3 5.5 18.9 1.6 3.5 0.0 100.0 69.3 43.9 198Sylhet 34.0 16.9 0.0 0.3 0.7 11.4 32.1 0.3 4.3 0.0 100.0 50.9 28.2 128
Mother’s age at birthLess than 20 41.5 17.5 0.3 0.7 3.2 9.5 23.4 0.7 3.1 0.1 100.0 59.3 32.1 1,54520-34 55.8 14.1 0.0 0.3 1.7 7.1 18.4 0.5 2.0 0.0 100.0 69.9 48.8 1,32835-49 (*) (*) (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) (*) 9
Place of deliveryHome 1.0 8.8 0.0 1.3 3.1 21.6 55.7 1.6 6.7 0.2 100.0 9.8 0.0 1,093Health facility
Public 64.8 34.4 0.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 42.4 506Private 81.8 14.8 0.0 0.0 2.9 0.4 0.0 0.0 0.0 0.0 100.0 96.6 73.0 1,281
EducationNo education 25.9 12.8 0.2 0.0 8.4 9.1 37.1 2.0 4.5 0.0 100.0 38.9 24.4 237Primary incomplete 26.6 16.4 0.0 0.0 2.3 8.7 40.1 0.7 4.6 0.5 100.0 43.1 18.2 423Primary complete 30.7 19.3 0.0 1.3 5.6 9.0 30.9 0.4 2.8 0.0 100.0 50.0 20.3 294Secondary incomplete 51.9 16.4 0.3 0.5 1.7 9.3 16.8 0.5 2.6 0.0 100.0 68.6 43.6 1,378Secondary complete or higher 74.1 14.1 0.0 0.7 0.4 5.0 5.3 0.4 0.0 0.0 100.0 88.2 64.4 549
Wealth index quintileLowest 20.7 16.0 0.0 0.8 5.5 10.1 41.6 1.1 4.2 0.0 100.0 36.7 17.3 633Second 37.8 13.6 0.1 0.0 4.3 12.7 27.8 0.3 3.5 0.0 100.0 51.5 28.6 520Middle 46.9 16.9 0.6 0.0 1.9 7.5 22.3 0.3 3.3 0.4 100.0 64.5 38.7 594Fourth 64.2 17.4 0.0 1.1 0.5 5.4 9.2 0.8 1.4 0.0 100.0 81.6 50.9 634Highest 74.6 15.5 0.0 0.5 0.1 6.3 2.0 0.5 0.5 0.0 100.0 90.1 67.7 500
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
86
Table 5.9: continued Person assisting at delivery No
atten-dant
Total Delivery assisted by any skilled attendant
Per cent delivered
by C-section
Number of women who had a live birth in the last two
years
Medical doctor
Nurse/ Mid-wife
FWV HA/ FWA
NGO worker
TTBA UTBA Unquali-fied
doctor
Relative/ friends
Religion*
Islam 46.5 16.0 0.2 0.6 2.7 8.7 22.3 0.5 2.6 0.1 100.0 62.6 38.3 2,629
Hindu 71.0 13.2 0.0 0.0 0.0 4.5 7.7 1.4 2.1 0.0 100.0 84.2 62.3 220
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted casesNote: Medical Doctor (MN17, A= Qualified Doctor); Nurse/Midwife (MN17, B= Nurse/Midwife/Paramedic); FWV (MN17, C= FWV); HA/FWA (MN17,
G= Health Assistant (HA)/H= Family Welfare Assistant (FWA)); NGO Worker (MN17, I= NGO Worker); TTBA (MN17, J= Trained Traditional Birth Attendant (TTBA)); UTBA (MN17, K= Untrained Traditional Birth Attendant (UTBA); Unqualified Doctor (MN17, L= Quack);
Relative/friends (MN17, M= Relatives/ N= Neighbour/friends); Other (MN17, X= Other); No Attendant (MN17, Y= No one). Deliver assisted by any Skilled Attendant= Medical Doctor/Nurse/Midwife/Paramedic/ FWV.
Large variation was observed in the use of skilled provider for delivery by place of residence and divisions. Three-fourths (73.6 per cent) of deliveries among women of CC non-slum areas were assisted by skilled attendants, while 55.5 per cent of CC slums women received skilled assistance. Deliveries assisted by skilled attendants was the highest in Khulna (80.3 per cent), and lowest in Sylhet division (50.9 per cent). Women with secondary or higher level of education (88.2 per cent), and women of highest wealth quintile (90.1 per cent) were most likely to receive skilled assistance during delivery. Among those deliveries occurring at home only 9.8 per cent deliveries were assisted by skilled personnel (Table 5.9).
Fig 5.5: Person assisting during delivery, Bangladesh, CWS 2016
87
Rep
rod
uct
ive
Hea
lth
Table 5.10: Place of delivery
Percentage of women age 15-49 years with a live birth in the last two years preceding the survey by place of delivery of their last birth by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Place of delivery
Total Delivered in health facility
Number of women with a live birth in the last two years
Health facility Home Other
Public sector
Private sector
Total 17.6 44.5 37.9 0.1 100.0 62.0 2,882
Area
City Corporation slum 20.5 36.7 42.9 0.0 100.0 57.1 127
City Corporation non-slum 20.5 55.0 24.5 0.0 100.0 75.5 811
Other municipalities/urban 16.1 40.6 43.2 0.1 100.0 56.7 1,944
Division
Barisal 22.3 41.0 36.8 0.0 100.0 63.2 120
Chittagong 14.1 34.1 51.9 0.0 100.0 48.1 651
Dhaka 17.1 49.4 33.5 0.0 100.0 66.5 1,320
Khulna 17.7 59.1 23.1 0.0 100.0 76.9 193
Rajshahi 25.1 38.9 36.1 0.0 100.0 63.9 272
Rangpur 19.5 47.9 31.6 1.1 100.0 67.4 198
Sylhet 16.7 33.5 49.8 0.0 100.0 50.2 128
Mother’s age at birth
Less than 20 16.4 40.4 43.0 0.1 100.0 56.9 1,545
20-34 18.9 49.0 32.1 0.0 100.0 67.9 1,328
35-49 (*) (*) (*) (*) 100.0 (*) 9
Number of antenatal care visits
None 4.4 14.2 81.5 0.0 100.0 18.5 267
1-3 visits 18.2 36.8 45.0 0.0 100.0 55.0 1,291
4+ visits 19.6 58.0 22.2 0.2 100.0 77.6 1,324
Education
No education 14.2 29.9 56.0 0.0 100.0 44.0 237
Primary incomplete 17.0 24.2 58.8 0.0 100.0 41.2 423
Primary complete 20.4 26.8 52.8 0.0 100.0 47.2 294
Secondary incomplete 17.5 48.4 34.0 0.2 100.0 65.9 1,378
Secondary complete or higher 18.3 65.8 15.9 0.0 100.0 84.1 549
Wealth index quintile
Lowest 11.8 27.0 61.1 0.0 100.0 38.9 633
Second 13.6 34.7 51.7 0.0 100.0 48.3 520
Middle 23.3 38.9 37.8 0.0 100.0 62.2 594
Fourth 22.4 55.3 22.3 0.0 100.0 77.7 634
Highest 16.0 69.5 14.0 0.4 100.0 85.6 500
Religion*
Islam 16.6 43.8 39.4 0.1 100.0 60.5 2,629
Hindu 27.2 54.4 18.4 0.0 100.0 81.6 220
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
88
Of all births, 39.9 per cent of women had delivery by caesarian section, with 46.6 per cent in CC non-slums, 23.9 per cent in CC slums and 38.1 per cent in other urban areas.
5.6.2 Place of delivery
Table 5.10 gives percentage of women age 15-49 years with a live birth in the last two years preceding the survey by place of delivery of their last birth by selected characteristics. It shows that a high proportion of births in urban areas occurred at home (37.9 per cent). Sixty two per cent of births occurred at a health facility. Overall, 44.5 per cent of births were delivered in private health facility, and 17.6 per cent in public health facility.
Delivery in a health facility varied widely by area of residence, divisions, age of mother, number of ANC visits made, education and wealth quintile. Three-fourths (75.5 per cent) of last births in CC non-slum areas occurred at a health facility, while this prevalence was 57.1 per cent in CC slums, and 56.7 per cent in other urban areas. Delivery at health facility was the highest in Khulna (76.9 per cent), and lowest in Chittagong division (48.1 per cent). Women who made 4 or more ANC visits (77.6 per cent), or with secondary complete or higher level of education (84.1 per cent), and those in the highest wealth quintile (85.6 per cent) were more likely to have delivery at a health facility.
Fig 5.6: Place of delivery by areas, Bangladesh, CWS 2016
5.7 Postnatal CareWomen may experience problems in the postpartum/postnatal period, the six weeks or 42 days following delivery. Such problems can be detected and treated through proper follow-up visits for women in the postpartum period. Postnatal care, care or check-up during postpartum period, and postpartum stay in health facility are important for women.
5.7.1 Postpartum Stay in Health Facility
In the survey, women age 15-49 years with a live birth in the last two years preceding the survey who had their last birth delivered in a health facility were asked how long they stayed
89
Rep
rod
uct
ive
Hea
lth
in the health facility after birth. Table 5.11 shows that 84.4 per cent of all women who had their last delivery in a health facility stayed in the health facility 12 hours or more after delivery. Proportion who stayed 12 hour or more in health facility after delivery was the highest among women of other urban areas (86.0 per cent), followed by CC non-slum (83.3 per cent) and CC slums (70.9 per cent). The MICS 2012-2013 reported this prevalence at 82.8 per cent, which is slightly lower than the estimate obtained in this survey.
Table 5.11: Post-partum stay in health facility
Percentage of women age 15-49 years with a live birth in the last two years preceding the survey who had their last birth delivered in a health facility by duration of stay in health facility according to selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Duration of stay in health facility Total 12 hours or more
Number of women who had their last birth delivered in a health facility in the
last 2 years
Less than 6 hours
6-11 hours
12-23 hours
1-2 days
3 days or
more
DK/ Missing
Total 9.5 6.0 2.8 16.0 65.7 0.1 100.0 84.4 1788
Area
City Corporation slum 19.4 9.7 5.3 23.9 41.6 0.0 100.0 70.9 73
City Corporation non-slum 8.6 8.1 2.0 17.7 63.6 0.0 100.0 83.3 612
Other municipalities/urban 9.4 4.5 3.0 14.5 68.4 0.1 100.0 86.0 1,102
Division
Barisal 5.6 6.1 2.9 17.5 67.9 0.0 100.0 88.3 76
Chittagong 8.2 5.6 4.1 24.4 57.7 0.0 100.0 86.2 313
Dhaka 11.0 5.5 2.2 14.1 67.2 0.0 100.0 83.5 878
Khulna 5.4 6.4 2.7 11.8 73.8 0.0 100.0 88.2 149
Rajshahi 11.6 7.0 5.0 13.4 62.1 0.9 100.0 80.5 174
Rangpur 6.8 7.7 0.8 13.2 71.6 0.0 100.0 85.6 133
Sylhet 9.8 6.8 2.7 20.7 59.7 0.3 100.0 83.1 64
Mother’s age at birth
Less than 20 13.7 8.2 2.9 16.6 58.4 0.2 100.0 77.9 878
20-34 5.5 3.7 2.8 15.4 72.7 0.0 100.0 90.8 903
35-49 (*) (*) (*) (*) (*) (*) 100.0 (*) 7
Type of health facility
Public 13.1 6.8 4.6 26.0 49.2 0.3 100.0 79.8 506
Private 8.1 5.6 2.1 12.0 72.2 0.0 100.0 86.2 1,281
Type of delivery
Vaginal birth 25.9 16.4 7.1 39.1 11.5 0.0 100.0 57.7 638
C-section 0.4 0.2 0.4 3.1 95.7 0.1 100.0 99.3 1,150
Education
No education 17.7 18.0 2.8 6.5 55.0 0.0 100.0 64.3 105
Primary incomplete 16.0 13.6 1.3 18.6 50.4 0.1 100.0 70.3 174
Primary complete 27.2 5.0 3.7 18.6 45.6 0.0 100.0 67.9 139
Secondary incomplete 7.5 5.4 3.0 16.2 67.7 0.2 100.0 86.9 908
Secondary complete or higher 3.9 1.7 2.7 15.8 75.9 0.0 100.0 94.4 462
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
90
Table 5.11: continued Duration of stay in health facility Total 12 hours
or moreNumber of women who had their last birth delivered in a health facility in the
last 2 years
Less than 6 hours
6-11 hours
12-23 hours
1-2 days
3 days or
more
DK/ Missing
Wealth index quintile
Lowest 20.8 14.1 3.0 15.8 46.3 0.1 100.0 65.0 246
Second 13.3 8.3 1.7 15.7 61.0 0.0 100.0 78.4 251
Middle 8.3 6.0 4.4 17.2 64.1 0.0 100.0 85.7 370
Fourth 9.6 3.7 3.0 14.4 69.2 0.0 100.0 86.7 493
Highest 1.8 2.5 1.7 16.9 76.8 0.4 100.0 95.4 428
Religion*
Islam 10.3 6.4 2.9 15.8 64.6 0.0 100.0 83.3 1,590
Hindu 2.5 2.5 0.6 15.8 77.7 0.9 100.0 94.1 180
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases
5.7.2 Postnatal Checkup for Newborn
Postnatal Health Checks:
Table 5.12 shows that 79.9 per cent of the newborns received health checks by any health provider following birth while in health facility or at home following home birth before departure of provider from home. This proportion was low among newborns of CC slums (64.8 per cent) than those living in CC non-slums (83.9 per cent) and other urban areas (79.2 per cent)
Fig 5.7: Post natal health checks for the newborn by areas, Bangladesh, CWS 2016
Table 5.12 also provides Percentage of the newborns born in the last two years who received postnatal care visits from any health provider after birth. It should be noted that health checks following birth while in facility or at home refers to checks provided by any health provider regardless of timing (column 1), whereas postnatal care visits refers to a separate visit to
91
Rep
rod
uct
ive
Hea
lth
check on the health of the newborn and provide preventive care services and therefore do not include health checks following birth while in facility or at home. Postnatal health checks include any health check performed while in the health facility or at home following birth, as well as postnatal care (PNC) visits within two days of delivery.
With regard to PNC visits, these were infrequent and predominantly occurred on the same day or after three days of birth (12.2 per cent and 4.0 per cent respectively). As a result, a total of 79.4 per cent of all newborns received a postnatal health check. Similar variations in PNC checks were observed by area, division and selected background characteristics as observed for health checks following births.
Table 5.12: Post-natal health checks for newborns
Percentage of women age 15-49 years with a live birth in the last two years preceding the survey whose last live birth received health checks while in facility or at home following birth, Percentage whose last live birth received post-natal care (PNC) visits from any health provider after birth, by timing of visit, and Percentage who received post natal health checks by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Health check
following birth
while in facility or at homea
PNC visit for newbornsb Post-natal
health check for the new-born c
Number of last
live births in the
last two years
Same day
1 day follow-
ing birth
2 days follow-
ing birth
3-6 days
follow-ing
birth
After the first
week follow-
ing birth
No post-natal care visit
Miss-ing/DK
Total
Total 79.4 12.2 0.9 0.1 1.3 2.7 82.8 0.1 100.0 79.9 2,882
Area
City Corporation slum 64.1 8.7 0.4 0.8 2.3 1.7 86.1 0.0 100.0 64.8 127
City Corporation non-slum 83.8 12.5 1.3 0.0 2.9 6.3 76.9 0.0 100.0 83.9 811
Other municipalities/urban 78.6 12.3 0.7 0.0 0.6 1.2 85.0 0.1 100.0 79.2 1,944
Division
Barisal 93.3 16.1 1.7 0.0 1.0 0.0 81.3 0.0 100.0 93.3 120
Chittagong 73.4 9.5 0.5 0.1 0.0 0.9 89.0 0.0 100.0 73.4 651
Dhaka 78.5 10.0 1.0 0.0 2.7 4.8 81.5 0.0 100.0 79.3 1,320
Khulna 95.2 17.2 0.2 0.0 0.6 0.7 80.6 0.6 100.0 95.2 193
Rajshahi 82.1 19.5 1.8 0.0 0.1 0.6 77.9 0.1 100.0 82.8 272
Rangpur 85.3 17.0 0.2 0.1 0.0 2.1 80.7 0.0 100.0 85.4 198
Sylhet 68.5 14.1 1.2 0.5 0.2 1.2 82.8 0.0 100.0 69.3 128
Mother’s age at birth
Less than 20 77.4 9.2 1.4 0.0 1.4 1.7 86.1 0.1 100.0 77.8 1,545
20-34 81.7 15.7 0.3 0.1 1.2 3.8 78.8 0.0 100.0 82.3 1,328
35-49 (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 9
Place of delivery
Home 54.0 0.9 0.6 0.0 0.8 0.5 97.1 0.0 100.0 54.6 1,093
Health facility 95.1 19.1 1.0 0.1 1.7 4.0 74.0 0.1 100.0 95.5 1,788
Public 93.2 15.1 0.3 0.1 1.2 2.9 80.3 0.0 100.0 93.3 506
Private 95.9 20.7 1.3 0.1 1.8 4.4 71.6 0.1 100.0 96.3 1,281
Other/DK/Missing (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 2
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
92
Table 5.12: continued
Health check
following birth
while in facility or at homea
PNC visit for newbornsb Post-natal
health check for the new-born c
Number of last
live births in the
last two years
Same day
1 day follow-
ing birth
2 days follow-
ing birth
3-6 days
follow-ing
birth
After the first
week follow-
ing birth
No post-natal care visit
Miss-ing/DK
Total
Education
No education 63.0 7.1 0.8 0.2 0.7 2.5 88.7 0.0 100.0 65.2 237
Primary incomplete 69.4 8.2 0.0 0.0 1.2 0.4 90.2 0.0 100.0 69.5 423
Primary complete 69.6 5.0 0.3 0.1 0.0 3.2 91.4 0.0 100.0 69.6 294
Secondary incomplete 81.9 12.1 1.4 0.1 1.3 2.0 82.9 0.1 100.0 82.4 1,378
Secondary complete or higher 93.5 21.6 0.5 0.0 2.6 5.8 69.5 0.0 100.0 93.5 549
Wealth index quintile
Lowest 64.1 7.4 0.4 0.1 0.7 0.4 91.0 0.0 100.0 65.1 633
Second 76.9 7.2 0.9 0.1 2.0 1.9 87.8 0.0 100.0 77.9 520
Middle 80.4 11.7 0.9 0.1 0.7 1.8 84.8 0.0 100.0 80.7 594
Fourth 87.3 12.6 0.6 0.0 0.7 7.5 78.4 0.2 100.0 87.3 634
Highest 90.5 23.6 1.7 0.0 3.0 1.3 70.3 0.0 100.0 90.5 500
Religion*
Islam 78.4 11.5 0.9 0.1 1.5 2.9 83.1 0.1 100.0 78.9 2,629
Hindu 92.9 18.6 1.1 0.1 0.0 0.5 79.7 0.0 100.0 93.0 220
a Health checks by any health provider following facility births (before discharge from facility) or following home births (before departure of provider from home).
b Post-natal care visits (PNC) refer to a separate visit by any health provider to check on the health of the newborn and provide preventive care services. PNC visits do not include health checks following birth while in facility or at home (see note "a" above).
c Post-natal health checks include any health check performed while in the health facility or at home following birth (see note "a" above), as well as PNC visits (see note "b" above) within two days of delivery.
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases
Postnatal Care Visits for Newborns within one week of Birth:
Table 5.13 presents Percentage of women age 15-49 years with a live birth in the last two years preceding the survey whose last birth received a postnatal care (PNC) visit within one week of birth, by location and provider of first PNC visit. Among those newborns who received any PNC visits, 21.6 per cent received their first PNC visit at home, majority (60.8 per cent) received at private sector health facility, while 17.6 per cent received at public sector health facility. One-fourth of CC slums and other urban areas of newborn received PNC visits at home, while receiving PNC visits at home was only 12.9 per cent in CC non-slums areas. For births occurred at home mostly received first PNC visits within one week of births at home (84.1 per cent).
Three-fourths of the first PNC visits within a week (76.0 per cent) for the newborns were provided by either a doctor/nurse/midwife or an auxiliary midwife in urban areas of Bangladesh. However, differences exist in the first PNC visits for the newborns provided by doctor, nurse, or midwife by area, division and selected background characteristics. For example, 84.6 per cent of newborns of CC non-slum areas received first PNC visits by doctor, nurse and midwife, while this was 67.1 per cent in CC slums and 72.7 per cent in other urban areas. Interestingly, this prevalence was the highest in Sylhet (83.9 per cent), and lowest in Barisal (70.9 per cent).
93
Rep
rod
uct
ive
Hea
lth
Table 5.13: Post-natal care visits for newborns within one week of birth
Percentage of women age 15-49 years with a live birth in the last two years preceding the survey whose last live birth received a post-natal care (PNC) visit within one week of birth, by location and provider of the first PNC visit, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Location of first PNC visit for newborns
Total
Provider of first PNC visit for newborns
Total
Number of last live births in the last two years
with a PNC visit within the first
week of life
Home Public Sector
Private sector
Other loca-tion
Doctor/ nurse/
midwife
Auxiliary midwife
Comm-unity
health worker
Tradi-tional birth
attendant
Other
Total 21.6 17.6 60.8 0.1 100.0 76.0 0.0 0.1 5.5 18.4 100.0 548
Area
City Corporation slum 26.4 22.3 50.0 1.4 100.0 67.1 0.2 3.3 3.6 25.7 100.0 22
City Corporation non-slum 12.9 14.2 72.9 0.0 100.0 84.6 0.0 0.0 1.4 14.0 100.0 161
Other municipalities/urban 25.1 18.9 56.1 0.0 100.0 72.7 0.0 0.0 7.5 19.8 100.0 366
Division
Barisal 32.2 13.0 54.8 0.0 100.0 70.9 0.0 0.0 9.0 20.1 100.0 32
Chittagong 28.5 19.8 51.4 0.3 100.0 74.0 0.0 0.3 6.6 19.1 100.0 89
Dhaka 17.9 17.5 64.6 0.0 100.0 74.4 0.0 0.2 3.9 21.4 100.0 243
Khulna 24.9 10.9 64.2 0.0 100.0 76.4 0.0 0.0 14.5 9.2 100.0 46
Rajshahi 21.4 13.2 65.4 0.0 100.0 80.1 0.0 0.0 4.6 15.2 100.0 73
Rangpur 20.5 25.4 54.1 0.0 100.0 80.7 0.1 0.0 3.4 15.9 100.0 42
Sylhet 15.2 29.6 55.2 0.0 100.0 83.9 0.0 0.0 2.7 13.4 100.0 24
Mother’s age at birth
Less than 20 25.9 13.8 60.2 0.1 100.0 66.8 0.0 0.1 6.8 26.3 100.0 279
20-34 17.1 21.6 61.3 0.0 100.0 85.4 0.0 0.2 4.3 10.1 100.0 269
35-49 (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) (*)
Place of delivery
Home 84.1 10.8 4.8 0.2 100.0 21.5 0.0 0.0 24.3 54.2 100.0 121
Health facility 3.8 19.6 76.6 0.0 100.0 91.4 0.0 0.2 0.2 8.2 100.0 427
Public 4.6 88.4 7.0 0.0 100.0 90.3 0.0 0.0 0.0 9.7 100.0 94
Private 3.6 0.1 96.3 0.0 100.0 91.8 0.0 0.2 0.3 7.8 100.0 333
Education
No education 24.9 34.7 40.3 0.0 100.0 77.5 0.2 0.0 0.4 21.9 100.0 27
Primary incomplete 36.0 26.0 37.5 0.4 100.0 57.3 0.0 0.0 10.4 32.3 100.0 70
Primary complete 56.8 19.8 23.4 0.0 100.0 43.5 0.0 0.8 4.0 51.7 100.0 36
Secondary incomplete 20.2 14.4 65.5 0.0 100.0 74.3 0.0 0.2 7.7 17.9 100.0 276
Secondary complete or higher 7.6 16.1 76.3 0.0 100.0 96.6 0.0 0.0 0.2 3.3 100.0 140
Wealth index quintile
Lowest 42.0 22.1 35.9 0.0 100.0 56.0 0.1 0.8 10.3 32.9 100.0 96
Second 11.7 25.5 62.4 0.4 100.0 78.9 0.0 0.0 0.1 20.9 100.0 67
Middle 32.2 18.3 49.5 0.0 100.0 62.1 0.0 0.0 11.6 26.4 100.0 128
Fourth 15.0 14.5 70.5 0.0 100.0 80.3 0.0 0.0 5.0 14.7 100.0 110
Highest 8.4 12.9 78.7 0.0 100.0 96.5 0.0 0.0 0.0 3.5 100.0 147
Religion*
Islam 22.1 17.1 60.7 0.1 100.0 74.9 0.0 0.1 5.7 19.2 100.0 488
Hindu 19.6 20.3 60.1 0.0 100.0 82.2 0.0 0.0 4.3 13.6 100.0 53
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
94
5.7.3 Postnatal Checkup for Mothers
Postnatal Health Check
Table 5.14 shows that 77.3 per cent of women age 15-49 years with a live birth in the last two years preceding the survey received their health checks by any health provider following birth while in the facility (before discharge from facility) or at home (before departure of provider from home). With regard to PNC visits, only 16.7 per cent received PNC visits and 12.7 per cent took place on the same day, but 83.3 per cent did not receive any PNC visits. Overall, 77.5 per cent of mothers received postnatal health check.
Table 5.14: Post-natal health checks for mothers
Percentage of women age 15-49 years with a live birth in the last two years preceding the survey who received health checks while in facility or at home following birth, per cent distribution who received post-natal care (PNC) visits from any health provider after birth at the time of last birth, by timing of visit, and Percentage who received post-natal health checks, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Health check
following birth while in facility
or at homea
PNC visit for mothersb Post-natal
health check for the
motherc
Number of women with a live
birth in the last
two years
Same day
1 day follow-
ing birth
2 days follow-
ing birth
3-6 days
follow-ing
birth
After the first
week follow-
ing birth
No post-natal care visit
Miss-ing /DK
Total
Total 77.3 12.7 0.8 0.1 0.5 2.6 83.3 0.0 100.0 77.5 2882
Area
City Corporation slum 60.3 8.4 0.3 0.6 1.2 2.4 86.9 0.0 100.0 61.4 127
City Corporation non-slum 80.2 13.7 1.3 0.2 1.1 6.5 77.2 0.0 100.0 80.3 811
Other municipalities/urban 77.1 12.5 0.6 0.0 0.2 0.9 85.6 0.1 100.0 77.4 1944
Division
Barisal 88.5 12.2 1.6 0.0 0.0 0.0 86.2 0.0 100.0 88.5 120
Chittagong 72.8 12.6 1.1 0.2 0.2 0.0 85.8 0.0 100.0 72.9 651
Dhaka 75.8 11.9 0.6 0.0 1.0 5.1 81.3 0.0 100.0 76.2 1320
Khulna 96.0 17.3 0.5 0.0 0.0 0.6 81.6 0.0 100.0 96.0 193
Rajshahi 78.7 14.6 1.2 0.0 0.0 0.0 84.2 0.0 100.0 78.8 272
Rangpur 82.5 12.0 0.2 0.2 0.1 1.8 85.2 0.5 100.0 82.5 198
Sylhet 64.9 11.9 0.5 0.3 0.0 1.0 86.2 0.0 100.0 65.4 128
Mother’s age at birth
Less than 20 75.0 9.9 1.0 0.1 0.6 1.4 87.0 0.0 100.0 75.1 1545
20-34 79.7 15.9 0.5 0.1 0.5 3.9 79.0 0.1 100.0 80.2 1328
35-49 (*) (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 9
Place of delivery
Home 50.5 1.0 0.6 0.0 0.0 0.6 97.8 0.0 100.0 50.6 1093
Health facility 93.7 19.8 0.9 0.1 0.8 3.8 74.5 0.1 100.0 94.1 1788
Public 90.7 15.6 0.1 0.1 0.1 1.9 82.1 0.0 100.0 90.7 506
Private 94.9 21.5 1.2 0.1 1.1 4.6 71.4 0.1 100.0 95.4 1281
Other/DK/Missing (*) (*) (*) (*) (*) (*) 100.0 (*) 100.0 (*) 2
Type of delivery
Vaginal birth 63.8 6.3 0.4 0.1 0.0 0.8 92.5 0.0 100.0 63.9 1733
C-section 97.5 22.4 1.4 0.1 1.2 5.2 69.5 0.1 100.0 98.0 1150
95
Rep
rod
uct
ive
Hea
lth
Table 5.14: continued Health
check following
birth while in facility
or at homea
PNC visit for mothersb Post-natal
health check for the
motherc
Number of women with a live
birth in the last
two years
Same day
1 day follow-
ing birth
2 days follow-
ing birth
3-6 days
follow-ing
birth
After the first
week follow-
ing birth
No post-natal care visit
Miss-ing /DK
Total
EducationNo education 60.9 5.3 0.9 0.2 0.0 1.1 92.6 0.0 100.0 63.1 237Primary incomplete 65.8 7.8 0.0 0.0 0.1 0.1 92.0 0.0 100.0 65.9 423Primary complete 66.4 6.8 0.1 0.1 0.1 2.9 90.0 0.0 100.0 66.5 294Secondary incomplete 80.6 13.4 0.7 0.1 0.3 2.9 82.4 0.0 100.0 80.7 1378Secondary complete or higher 90.7 20.9 1.9 0.0 1.8 4.0 71.2 0.2 100.0 90.7 549
Wealth index quintileLowest 62.5 6.1 0.5 0.1 0.0 0.4 92.9 0.0 100.0 63.4 633Second 71.8 7.6 0.0 0.0 0.2 4.4 87.5 0.2 100.0 71.9 520Middle 79.0 13.8 0.2 0.1 0.2 0.8 85.0 0.0 100.0 79.0 594Fourth 86.2 14.3 0.5 0.2 0.6 4.0 80.4 0.0 100.0 86.3 634Highest 88.3 22.9 3.1 0.0 1.9 3.6 68.5 0.0 100.0 88.3 500
Religion*Islam 76.3 12.1 0.8 0.1 0.6 2.8 83.6 0.0 100.0 76.6 2629Hindu 90.4 17.7 1.1 0.0 0.0 0.3 80.9 0.0 100.0 90.5 220
a Health checks by any health provider following facility births (before discharge from facility) or following home births (before departure of provider from home).
b Post-natal care visits (PNC) refer to a separate visit by any health provider to check on the health of the newborn and provide preventive care services. PNC visits do not include health checks following birth while in facility or at home (see note "a" above).
c Post-natal health checks include any health check performed while in the health facility or at home following birth (see note "a" above), as well as PNC visits (see note "b" above) within two days of delivery.
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
(*) Figures that are based on fewer than 25 unweighted cases
Proportion of women who received health check following birth varied by area of residence; 80.2 per cent of mothers who lived in CC non-slum areas received health check following births, while this Percentage was 60.3 per cent for CC slum women and 77.1 per cent for women of other urban areas. Some variation was observed by divisions, with highest in Khulna (96.0 per cent) and lowest in Sylhet (64.9 per cent). Similar variation was observed in the postnatal health check for the mothers by education and socioeconomic status.
Fig 5.8: Post natal checks for the mother by areas, Bangladesh, CWS 2016
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
96
Table 5.15: Post-natal care visits for mothers within one week of birth
Percentage of women age 15-49 years with a live birth in the last two years preceding the survey who received a post-natal care (PNC) visit within one week of birth, by location and provider of the first PNC visit, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Location of first PNC visit for mothers
Total
Provider of first PNC visit for mothers
Total
Number of women with a live birth in the last two years
who received a PNC visit within
one week of birth
Home Public Sector
Pri-vate
sector
Other locat-
ion
Doctor/ nurse/
midwife
Auxi-liary mid-wife
Comm-unity
health worker
Tradi-tional birth atten-dant
Other
Total 20.8 16.7 62.6 0.0 100.0 79.8 0.0 0.2 5.9 14.1 100.0 507
Area
City Corporation slum 39.6 16.1 44.3 0.0 100.0 59.3 0.1 5.6 6.5 28.5 100.0 21
City Corporation non-slum 15.2 14.3 70.5 0.0 100.0 84.6 0.0 0.0 1.3 14.1 100.0 156
Other municipalities/urban 22.2 17.8 60.0 0.0 100.0 78.8 0.0 0.0 8.0 13.2 100.0 330
Division
Barisal 36.0 7.7 56.3 0.0 100.0 65.7 0.0 0.0 11.4 23.0 100.0 25
Chittagong 23.4 20.4 56.3 0.0 100.0 81.6 0.0 0.3 8.8 9.3 100.0 112
Dhaka 19.4 16.0 64.6 0.0 100.0 78.3 0.0 0.4 4.6 16.8 100.0 228
Khulna 12.6 11.7 75.6 0.0 100.0 88.9 0.0 0.0 7.4 3.7 100.0 39
Rajshahi 23.1 16.2 60.7 0.0 100.0 78.9 0.0 0.0 3.1 18.0 100.0 55
Rangpur 18.3 14.7 67.0 0.0 100.0 82.2 0.1 0.0 4.8 12.9 100.0 30
Sylhet 15.2 29.2 55.7 0.0 100.0 87.2 0.0 0.0 2.3 10.5 100.0 19
Mother’s age at birth
Less than 20 26.4 12.2 61.3 0.0 100.0 70.8 0.0 0.3 7.4 21.5 100.0 252
20-34 15.2 21.1 63.7 0.0 100.0 88.8 0.0 0.2 4.3 6.8 100.0 254
35-49 (*) (*) (*) (*) 100.0 (*) (*) (*) (*) (*) 100.0
Place of delivery
Home 90.5 3.1 6.4 0.0 100.0 19.4 0.0 0.0 32.0 48.6 100.0 93
Health facility 5.2 19.7 75.1 0.0 100.0 93.4 0.0 0.3 0.0 6.4 100.0 414
Public 5.5 87.8 6.7 0.0 100.0 89.2 0.0 0.0 0.0 10.8 100.0 91
Private 5.1 0.6 94.4 0.0 100.0 94.5 0.0 0.4 0.0 5.1 100.0 323
Type of delivery
Vaginal birth 46.1 17.4 36.4 0.0 100.0 55.1 0.0 0.6 14.2 30.1 100.0 209
C-section 3.0 16.1 80.9 0.0 100.0 97.2 0.0 0.0 0.0 2.8 100.0 298
Education
No education (39.9) (30.1) (30.1) (0.0) 100.0 63.8 (0.1) (0.0) (11.5) (24.6) 100.0 24
Primary incomplete 29.7 20.4 49.9 0.0 100.0 62.2 0.0 0.0 11.7 26.2 100.0 54
Primary complete 44.5 31.4 24.1 0.0 100.0 57.2 0.0 0.8 0.0 42.0 100.0 36
Secondary incomplete 23.4 13.3 63.2 0.0 100.0 78.0 0.0 0.3 8.0 13.7 100.0 257
Secondary complete or higher 2.6 15.2 82.1 0.0 100.0 99.0 0.0 0.0 0.2 0.9 100.0 136
Wealth index quintile
Lowest 42.4 18.6 39.0 0.0 100.0 55.4 0.0 1.0 11.0 32.6 100.0 75
Second 18.5 24.9 56.7 0.0 100.0 84.4 0.0 0.0 2.4 13.2 100.0 48
Middle 32.8 11.1 56.1 0.0 100.0 64.5 0.0 .3 11.3 23.8 100.0 130
Fourth 15.3 22.1 62.5 0.0 100.0 87.9 0.0 0.0 4.9 7.2 100.0 113
Highest 3.3 13.6 83.1 0.0 100.0 99.0 0.0 0.0 0.0 1.0 100.0 141
97
Rep
rod
uct
ive
Hea
lth
Table 5.15: continued Location of first PNC visit for mothers
Total
Provider of first PNC visit for mothers
Total
Number of women with a live birth in the last two years
who received a PNC visit within
one week of birth
Home Public Sector
Pri-vate
sector
Other locat-
ion
Doctor/ nurse/
midwife
Auxi-liary mid-wife
Comm-unity
health worker
Tradi-tional birth atten-dant
Other
Religion*
Islam 21.0 16.3 62.8 0.0 100.0 79.4 0.0 0.3 5.9 14.4 100.0 448
Hindu 22.0 17.9 60.1 0.0 100.0 80.3 0.0 0.0 6.6 13.1 100.0 52
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases
Postnatal Care Visits within One Week of Birth:
Table 5.15 deals with postnatal care visits for mothers within one week of birth by location of PNC visits and providers who provided the first PNC visit for mothers. Results show that among those women who received their first PNC visits within one week of birth, more than three-fourths (79.3 per cent) received at health facility, either of private sector (62.6 per cent) or of public sector (16.7 per cent). Only a fifth (20.8 per cent) of mothers received at home. Mother’s first PNC visit at health facility was the highest in CC non-slums (84.8 per cent), and lowest in CC slums (60.4 per cent). Mother’s first PNC visit at home within one week of birth was the lowest in Khulna (12.6 per cent), and highest in Barisal division (36.0 per cent).
Results on the provider of first PNC visit for mothers, as presented in Table 5.15, show that more than three-fourths of the first PNC visits were provided by doctor/Nurse/midwife (79.8 per cent). This Percentage was significantly high in CC non-slums (84.6 per cent) compared to CC slums (59.3 per cent) and other urban areas (78.8 per cent). Some variation was observed by division, with highest in Sylhet (87.2 per cent) and lowest in Barisal (65.7 per cent). Mothers whose birth occurred in a health facility, delivery with C-section and those in the higher wealth quintiles were more likely to receive first PNC visit within one week of birth by doctor/nurse/midwife (Table 5.15).
Table 5.16: Post-natal health checks for mothers and newborns
Percentage of women age 15-49 years with a live birth in the last two years preceding the survey by post-natal health checks for the mother and newborn, within two days of the most recent birth, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Post-natal health checks within two days of birth for: DK/Missing
Total Number of women with a live birth in the last two years
Both mothers and
newborns
Mothers only
Newborns only
Neither mother
nor newborn
Total 76.2 1.3 3.7 18.8 0.0 100.0 2882
Area
City Corporation slum 57.9 3.1 6.6 32.4 0.0 100.0 127
City Corporation non-slum 78.3 2.1 5.6 14.0 0.0 100.0 811
Other municipalities/urban 76.6 0.8 2.7 19.9 0.0 100.0 1,944
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
98
Table 5.16: continued Post-natal health checks within two days of birth for: DK/
MissingTotal Number of
women with a live birth in the last two years
Both mothers and
newborns
Mothers only
Newborns only
Neither mother
nor newbornDivision
Barisal 88.5 0.0 4.8 6.7 0.0 100.0 120
Chittagong 71.4 1.5 2.0 25.1 0.0 100.0 651
Dhaka 74.4 1.8 4.8 19.0 0.0 100.0 1,320
Khulna 95.0 1.0 0.2 3.8 0.0 100.0 193
Rajshahi 78.8 0.0 4.0 17.2 0.0 100.0 272
Rangpur 81.9 0.5 3.4 14.1 0.0 100.0 198
Sylhet 64.7 0.7 4.6 30.0 0.0 100.0 128
Mother’s age at birth
Less than 20 73.5 1.6 4.2 20.7 0.0 100.0 1,545
20-34 79.2 1.0 3.1 16.8 0.0 100.0 1,328
35-49 (*) (*) (*) (*) (*) 100.0 9
Place of delivery
Home 49.9 0.7 4.7 44.7 0.0 100.0 1,093
Health facility 92.4 1.6 3.1 2.9 0.0 100.0 1,788
Public 88.6 2.1 4.6 4.7 0.0 100.0 506
Private 93.9 1.5 2.4 2.2 0.0 100.0 1,281
Other/DK/Missing 0.0 0.0 0.0 100.0 0.0 100.0 2
Type of delivery
Vaginal birth 63.1 0.8 5.2 30.8 0.0 100.0 1,733
C-section 96.0 2.0 1.3 0.7 0.0 100.0 1,150
Education
No education 61.1 1.9 4.0 32.9 0.0 100.0 237
Primary incomplete 65.3 0.5 4.1 30.0 0.0 100.0 423
Primary complete 65.3 1.3 4.4 29.1 0.0 100.0 294
Secondary incomplete 79.0 1.6 3.4 16.0 0.0 100.0 1,378
Secondary complete or higher 90.0 0.7 3.5 5.8 0.0 100.0 549
Wealth index quintile
Lowest 62.3 1.0 2.7 34.0 0.0 100.0 633
Second 71.3 0.6 6.6 21.5 0.0 100.0 520
Middle 77.2 1.8 3.5 17.5 0.0 100.0 594
Fourth 84.7 1.6 2.6 11.1 0.0 100.0 634
Highest 86.9 1.5 3.6 8.1 0.0 100.0 500
Religion*
Islam 75.2 1.3 3.7 19.8 0.0 100.0 2,629
Hindu 89.4 1.2 3.6 5.8 0.0 100.0 220
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases
5.7.4 Postnatal Health Checks for Mothers and Newborns
Table 5.16 presents data on the postnatal health checks for the mother and newborn, within two days of most recent birth. Overall, 76.2 per cent of both mothers and their newborns received postnatal health checks within two days of birth, while 18.8 per cent of neither mother nor newborn received this PNC checks. This PNC check for both mothers and newborns was the least prevalent in CC slums (57.9 per cent), and in Sylhet divisions (64.7 per cent).
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
99
6 WATER AND SANITATIONUNICEF/BANA2014-004717/Mawa
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
100
Key Findings:
� Use of drinking water from improved water sources was almost universal among urban households (99.2 per cent). Among those who do not use improved drinking water sources, 39.7 per cent reported of using an appropriate treatment method to make water safe for drinking.
� About 57.3 per cent of urban population are using improved sanitation facilities which are not shared with members of other household. It varied by type of urban areas, with 51.3 per cent in CC non-slums, 18.9 per cent in CC slums and 62.4 per cent in other urban areas. Use of improved sanitation facilities which are not shared was the highest in Barisal (80.7 per cent), and lowest in Dhaka (47.1 per cent).
� Overall 56.7 per cent of urban population use both improved drinking water source and improved sanitation facility. This Percentage was very low in CC slums (18.2 per cent compared to CC non-slums (50.5 per cent) and other urban areas (61.9 per cent).
� For 66.2 per cent of children age 0-2 years, the stool were disposed of safely the last time they passed stool. This Percentage was much higher in CC non-slums (81.9 per cent) than CC slums (58.0 per cent) and other urban areas (60.2 per cent).
� Overall, 55.4 per cent of households had specific place for handwashing with water and soap available, with 67.1 per cent in CC non-slums, 35.4 per cent in CC slums, and 51.1 per cent in other urban areas.
Safe drinking water is a basic necessity for good health. Access to safe water and sanitation are basic determinants of better health. Limited access to safe drinking water and sanitation facilities and poor hygiene are associated with skin diseases, acute respiratory infections (ARIs), and diarrheal diseases. The CWS 2016 collected information on the primary sources of drinking water, whether water is treated to make it safe, type of toilet facility used, whether sanitation facility is shared, place of disposal of child faeces, and handwashing practices. The main results are stated below.
6.1 Use of Improved Water SourcesThe distribution of household population by main sources of drinking water is given in Table 6.1. The population using improved sources of drinking water are those using any of the following types of supply: piped water (into dwelling, compound, yard or plot, to neighbor, public tap/standpipe), tubewell/borehole, protected well, protected spring, and rain water collection. Bottle water can be considered as an improved water source only if the household is using an improved water source for handwashing and cooking. The table shows that 99.2 per cent of urban population of Bangladesh were using drinking water from an improved source – with no marked difference between the three areas of CC slums, CC non slums and other urban areas. Differences between divisions were not pronounced and the Percentage also varied little by background characteristics.
6 WATER AND SANITATION
101
Table 6.1: Use of improved water sources
Per cent distribution of households population according to main source of drinking water and Percentage of household population using improved drinking water sources, by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Main source of drinking water Total Percen-tage using
improved sources
of drinking
water
Number of house-
hold mem-bers
Improved sources Unimproved sources
Piped water Tube-well/ bore-hole
Pro-tected well
Pro-tected spring
Rain-water collec-
tion
Bottled watera
Unpro-tected well
Tanker trere-uck
Cart with tank/ drum
Sur-face
water
Bottled watera
Other
Into dwelling
Into yard/ plot
To neigh-bour
Public tap/
stand-pipe
Total 21.2 18.3 1.6 3.4 54.2 0.1 0.0 0.1 0.3 0.0 0.1 0.4 0.3 0.0 0.0 100.0 99.2 82,228
Area
City Corporation slum 9.3 36.0 4.6 10.7 37.0 0.0 0.1 0.0 0.3 0.0 0.0 1.9 0.0 0.1 0.0 100.0 98.0 3,302
City Corporation non-slum 43.8 24.6 1.6 6.1 22.2 0.1 0.0 0.0 0.8 0.0 0.2 0.8 0.0 0.0 0.0 100.0 99.0 25,015
Other municipalities/urban 11.4 14.3 1.4 1.7 70.1 0.1 0.0 0.2 0.1 0.0 0.0 0.2 0.4 0.0 0.0 100.0 99.3 53,911
Division
Barisal 3.1 2.9 0.6 0.2 91.7 0.0 0.0 0.4 0.0 0.0 0.0 0.5 0.6 0.1 0.0 100.0 98.8 3,343
Chittagong 18.7 16.7 3.8 4.6 54.8 0.0 0.1 0.0 0.5 0.1 0.0 0.8 0.1 0.0 0.0 100.0 99.0 16,019
Dhaka 31.2 28.1 1.3 4.3 34.1 0.2 0.0 0.0 0.4 0.0 0.1 0.3 0.0 0.0 0.0 100.0 99.6 38,509
Khulna 6.2 6.0 2.2 2.8 78.1 0.1 0.0 1.4 0.3 0.0 0.1 1.4 1.4 0.1 0.0 100.0 97.0 6,988
Rajshahi 7.9 7.1 0.2 1.8 83.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 8,430
Rangpur 4.9 1.8 0.1 0.6 92.5 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 100.0 99.9 5,554
Sylhet 27.9 9.6 0.2 1.0 58.1 0.0 0.0 0.0 0.0 0.0 0.0 0.1 3.0 0.1 0.0 100.0 96.8 3,385
Education of household head
No education 8.9 22.1 2.8 3.6 61.4 0.0 0.1 0.0 0.2 0.1 0.0 0.5 0.3 0.0 0.0 100.0 99.1 19,159
Primary incomplete 13.3 22.3 1.7 3.6 57.8 0.0 0.0 0.2 0.4 0.0 0.0 0.4 0.2 0.0 0.0 100.0 99.3 13,377
Primary complete 14.0 17.3 1.6 2.5 63.1 0.3 0.0 0.0 0.0 0.0 0.0 0.8 0.4 0.0 0.0 100.0 98.8 9,033
Secondary incomplete 22.7 18.0 1.3 3.6 53.1 0.1 0.0 0.2 0.3 0.0 0.2 0.4 0.2 0.0 0.0 100.0 99.2 24,583
Secondary complete or higher 44.7 10.7 0.5 3.3 39.1 0.1 0.0 0.1 0.6 0.0 0.0 0.4 0.3 0.0 0.0 100.0 99.2 15,715
Missing/DK 19.8 36.8 0.0 1.0 42.1 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.0 0.0 100.0 99.6 360
Wealth index quintile
Lowest 1.6 25.6 3.9 3.0 65.0 0.0 0.1 0.0 0.1 0.1 0.0 0.3 0.3 0.0 0.0 100.0 99.3 13,990
Second 6.1 32.3 2.1 5.1 53.3 0.0 0.0 0.1 0.0 0.0 0.0 0.5 0.3 0.0 0.0 100.0 99.2 15,216
Middle 10.4 16.6 1.3 1.9 68.5 0.0 0.0 0.4 0.1 0.0 0.0 0.4 0.3 0.0 0.0 100.0 99.2 17,034
Fourth 27.1 12.1 0.9 5.0 53.1 0.3 0.0 0.1 0.7 0.0 0.0 0.4 0.3 0.0 0.0 100.0 99.2 17,824
Highest 53.2 8.5 0.3 2.2 34.1 0.1 0.0 0.1 0.6 0.0 0.2 0.6 0.2 0.0 0.0 100.0 99.0 18,163
Religion
Islam 21.6 18.7 1.5 3.4 53.6 0.1 0.0 0.1 0.3 0.0 0.1 0.4 0.2 0.0 0.0 100.0 99.3 74,338
Hindu 16.7 14.0 1.5 3.7 61.2 0.3 0.0 0.8 0.2 0.0 0.0 0.7 0.8 0.1 0.0 100.0 98.4 7,253
Buddhist 14.1 27.0 12.7 6.9 39.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 358
Christian 39.4 12.6 0.0 0.5 45.1 0.0 0.0 0.0 0.0 0.0 0.0 2.4 0.0 0.0 0.0 100.0 97.6 258
The prime source of drinking water for the urban population was tubewell/ borehole (54.2 per cent). Another 44.5 per cent was using piped drinking water. About three-fourths (76.1 per cent) of CC non-slum households were using pipe water for drinking and this was 60.6 per cent in CC slums, and as low as 28.8 per cent in other urban areas. Overall use of tubewell water for drinking was 54.2 per cent, with maximum in other urban areas (70.1 per cent), and minimum in CC non-slums (22.2 per cent). W
ater
an
d S
anit
atio
n
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
102
Fig 6.1: Percentage of using improve source of drinking water by areas, Bangladesh, CWS 2016
Households where an unimproved drinking water source is used (about 1 per cent) were asked about the method they use for treating water to make it safe. Table 6.2 shows that 68.2 per cent do not treat water to make it safe, but those who use some method the commonly used techniques were: straining through a filter (14.5 per cent), and boiling (22.8 per cent) (Figure 6.2).
Among the population in households who were using unimproved drinking water source, only two-fifths (39.7 per cent) reported of using an appropriate treatment method to make water safe. This practice appeared to be higher in other urban areas (51.4 per cent) than in CC non-slums (25.6 per cent) and CC slum areas (25.9 per cent). This practice was the highest in Khulna (56.7 per cent). These estimate are similar to those reported in MICS 2012-2013.
Fig 6.2: Water treatment method used in the household, Bangladesh, CWS 2016
103
Wat
er a
nd
San
itat
ion
Table 6.2: Household water treatment
Per cent of household population by drinking water treatment method used in the household, and for household members living in households where an unimproved drinking water source is used, the Percentage who are using an appropriate treatment method, by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Water treatment method used in the household Number of
house-hold
mem-bers
Percentage of household members in
households using unimproved
drinking water sources and using
an appropriate water treatment
method
Number of household
members in households
using unimproved
drinking water
sources
None Boil Add bleach/ chlorine
Strain through a cloth
Use water filter
Solar dis-
infec-tion
Let it stand and
settle
Other Missing/DK
Total 68.2 22.8 0.3 3.3 14.5 0.0 0.2 0.7 0.0 82,228 39.7 683
Area
City Corporation slum 73.0 20.5 0.1 1.8 7.6 0.0 0.3 0.9 0.0 3,302 25.9 65
City Corporation non-slum 38.2 52.8 0.6 7.4 22.5 0.0 0.2 1.1 0.0 25,015 25.6 245
Other municipalities/urban 81.8 9.0 0.2 1.5 11.2 0.0 0.3 0.5 0.0 53,911 51.4 372
Division
Barisal 90.1 1.6 0.4 0.4 6.1 0.0 0.3 2.1 0.0 3,343 45.8 40
Chittagong 70.3 18.2 0.5 0.5 16.7 0.0 0.1 2.1 0.0 16,019 37.7 157
Dhaka 53.8 39.3 0.2 6.6 16.3 0.0 0.3 0.3 0.0 38,509 16.1 168
Khulna 86.1 .9 0.8 0.2 11.7 0.0 0.2 0.1 0.0 6,988 56.7 206
Rajshahi 90.0 1.6 0.0 0.8 8.3 0.0 0.3 0.0 0.0 8,430 na na
Rangpur 95.8 .8 0.1 0.0 3.3 0.0 0.1 0.0 0.0 5,554 (*) 4
Sylhet 64.4 12.8 0.0 0.4 31.1 0.0 0.4 0.3 0.0 3,385 46.1 107
Main source of drinking water
Improved 68.3 22.9 0.3 3.3 14.4 0.0 0.2 0.7 0.0 81,545 - -
Unimproved 57.4 15.0 5.7 0.2 23.4 0.0 1.3 0.6 0.0 683 39.7 683
Education of household head
No education 82.4 14.1 0.1 2.4 5.6 0.0 0.2 0.4 0.0 19,159 20.0 166
Primary incomplete 73.4 19.9 0.2 3.0 8.0 0.0 0.3 0.9 0.0 13,377 34.6 87
Primary complete 75.8 16.8 0.5 3.5 8.7 0.0 0.4 0.5 0.0 9,033 53.8 107
Secondary incomplete 65.8 24.6 0.3 3.4 15.1 0.0 0.3 0.9 0.0 24,583 37.8 194
Secondary complete or higher 46.6 35.8 0.5 4.1 33.3 0.0 0.1 0.6 0.0 15,715 60.1 128
Missing/DK 40.7 54.5 0.0 17.4 4.0 0.0 0.0 0.8 0.0 360 (*) 1
Wealth index quintile
Lowest 87.4 10.2 0.3 2.0 1.4 0.0 0.4 0.4 0.0 13,990 18.2 101
Second 75.8 20.9 0.2 3.5 3.7 0.0 0.2 0.3 0.0 15,216 32.9 129
Middle 77.0 17.1 0.2 2.5 7.7 0.0 0.1 0.8 0.0 17,034 45.8 133
Fourth 65.6 24.0 0.2 3.0 14.5 0.0 0.2 0.8 0.0 17,824 48.4 137
Highest 41.4 38.2 0.7 5.2 39.8 0.0 0.2 1.0 0.0 18,163 45.3 184
Religion
Islam 68.1 23.5 0.3 3.5 14.0 0.0 0.2 0.7 0.0 74,338 34.9 555
Hindu 70.5 15.1 0.4 1.4 17.3 0.0 0.2 0.7 0.0 7,253 58.0 117
Buddhist 66.1 12.3 0.0 0.0 28.7 0.0 0.0 0.0 0.0 358 na na
Christian 32.6 43.5 2.4 12.0 42.8 0.0 0.0 0.0 0.0 258 (*) 6
na: not applicable(*) Figures that are based on fewer than 25 unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
104
Table 6.3: Types of sanitation facilities
Perc ent distribution of household population according to type of toilet facility used by the household, by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Type of toilet facility used by household Open defecation
(no facility, bush, field)
Total Number of households members
Improved sanitation facility Unimproved sanitation facility
Flush/Pour flush to: Ventilated improved pit latrine
Pit latrine with slab
Compos-ting toilet
Flush/Pour flush to
somewhere else
Pit latrine without slab/
open pit
Bucket Hang-ing
toilet/ latrine
Missing/ DkPiped
sewer system
Septic tank
Pit latrine
Total 7.0 15.8 2.5 24.6 38.9 0.0 3.2 2.9 0.0 0.3 4.6 0.2 100.0 82,228
AreaCity Corporation slum 6.2 12.1 1.5 17.3 44.6 0.0 4.6 5.3 0.0 1.3 6.8 0.1 100.0 3,302City Corporation non-slum 18.4 20.3 2.4 15.9 23.0 0.0 7.5 0.8 0.0 0.0 11.7 0.0 100.0 25,015Other municipalities/urban 1.7 13.9 2.6 29.1 45.9 0.0 1.1 3.8 0.0 0.4 1.2 0.3 100.0 53,911
DivisionBarisal 0.1 17.3 1.2 32.4 47.4 0.0 0.4 0.5 0.1 0.2 0.3 0.0 100.0 3,343Chittagong 2.0 25.2 3.7 13.9 44.5 0.0 3.2 4.5 0.0 0.2 2.5 0.2 100.0 16,019Dhaka 13.2 11.3 2.1 25.1 33.6 0.0 4.7 1.4 0.0 0.2 8.4 0.0 100.0 38,509Khulna 0.1 21.8 0.7 36.7 29.8 0.2 1.4 8.3 0.0 0.0 0.9 0.0 100.0 6,988Rajshahi 1.2 17.2 5.3 29.4 42.5 0.0 0.5 2.6 0.0 0.5 0.7 0.0 100.0 8,430Rangpur 0.5 7.1 1.4 23.0 61.8 0.0 0.2 3.1 0.1 0.6 0.4 1.9 100.0 5,554Sylhet 5.5 18.5 1.3 26.9 36.8 0.1 3.8 4.9 0.0 1.5 0.7 0.1 100.0 3,385
Education of household headNo education 3.5 5.4 1.3 22.8 52.5 0.1 2.4 6.0 0.0 0.8 4.9 0.4 100.0 19,159Primary incomplete 6.1 9.1 2.1 25.9 45.2 0.0 2.5 3.3 0.0 0.3 5.2 0.4 100.0 13,377Primary complete 4.8 11.5 2.6 25.5 45.2 0.0 2.7 3.1 0.0 0.3 4.1 0.1 100.0 9,033Secondary incomplete 6.3 18.9 3.2 25.9 36.0 0.0 2.9 2.0 0.0 0.1 4.6 0.0 100.0 24,583Secondary complete or higher 14.5 31.8 3.1 23.5 18.3 0.0 5.1 0.2 0.0 0.0 3.3 0.0 100.0 15,715Missing/DK 0.0 13.1 0.3 14.7 17.2 0.0 11.0 2.7 0.0 0.5 40.6 0.0 100.0 360
Wealth index quintileLowest 0.9 3.3 1.2 22.0 56.9 0.0 1.3 7.3 0.0 1.4 4.7 1.1 100.0 13,990Second 3.0 6.7 1.9 25.1 49.3 0.1 2.5 4.0 0.0 0.2 7.2 0.0 100.0 15,216Middle 4.2 6.1 2.6 26.0 51.2 0.0 1.8 3.9 0.0 0.1 4.2 0.0 100.0 17,034Fourth 7.7 16.7 3.7 32.2 32.2 0.0 3.1 0.7 0.0 0.0 3.8 0.0 100.0 17,824Highest 16.9 41.2 2.8 17.5 11.4 0.0 6.5 0.1 0.0 0.0 3.7 0.0 100.0 18,163
ReligionIslam 7.1 15.5 2.5 24.0 39.1 0.0 3.2 3.0 0.0 0.3 5.0 0.2 100.0 74,338Hindu 4.7 18.6 2.1 30.8 36.2 0.0 2.8 2.8 0.0 0.2 1.7 0.1 100.0 7,253Buddhist 4.3 14.9 4.0 13.7 58.4 0.0 4.6 0.0 0.0 0.0 0.0 0.0 100.0 358Christian 28.4 10.7 0.7 29.2 28.3 0.0 1.4 0.4 0.0 0.1 0.8 0.0 100.0 258
6.2 Use of Improved SanitationAn improved sanitation facility is defined as the one that hygienically separates human excreta from human contact. Access to improved sanitation facilities is a determinant of health and environmental safety. Improved sanitation facilities for excreta disposal include flush/pour flush to a piped sewer system, septic tank, or pit latrine; ventilated improved pit latrine, pit latrine with slab, and use of a composting toilet. Table 6.3 provides Percentage of household population, according to types of toilet facility used by them.
Eighty two per cent of urban household population in Bangladesh were using improved sanitation facilities (Table 6.3), which include shared latrine. This Percentage was higher in other urban areas (93.2 Percentage) than in CC’s (around 81 per cent) by division was not significant.
105
Wat
er a
nd
San
itat
ion
Fig 6.3: Percentage of users of improved sanitation facilities (not shared) by areas, Bangladesh, CWS 2016
About 31.5 per cent users of improved sanitation facilities were reported to be sharing sanitation facilities with members of other households; 28.5 per cent shared a facility by 10 households or less and another 2.5 per cent shared an improved sanitation facility by more than 10 households. About eleven per cent of urban household population were using unimproved sanitation facility, with 5.5 per cent did not share with other households and 4.7 per cent shared by 10 or less households (Table 6.4).
Table 6.4: Use and sharing of sanitation facilities
Per cent distribution of household population by use of private and public sanitation facilities and use of shared facilities, by users of improved and unimproved sanitation facilities, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Users of improved sanitation facilities Users of unimproved sanitation facilities Open defeca-tion (no facility, bush, field)
Total Number of
house-hold
mem-bers
Not shared1
Public facility
Shared by Miss-ing/DK
Not shared
Public facility
Shared by
10 house-holds or
less
More than 10 house-holds
10 households
or less
More than 10
households
Total 57.3 0.5 28.5 2.5 0.0 5.5 0.1 4.7 0.7 0.2 100.0 82,228
AreaCity Corporation slum 18.9 8.4 37.0 17.5 0.0 3.5 0.5 9.3 4.8 0.1 100.0 3,302 City Corporation non-slum 51.3 0.1 26.0 2.6 0.0 9.3 0.1 9.6 0.9 0.0 100.0 25,015 Other municipalities/urban 62.4 0.2 29.2 1.5 0.0 3.9 0.0 2.2 0.4 0.3 100.0 53,911
DivisionBarisal 80.7 0.1 17.3 0.3 0.0 1.0 0.0 .6 0.0 0.0 100.0 3,343 Chittagong 63.6 0.5 22.0 3.2 0.0 5.5 0.0 4.0 0.9 0.2 100.0 16,019 Dhaka 47.1 0.7 34.0 3.5 0.0 6.7 0.1 6.8 1.1 0.0 100.0 38,509 Khulna 65.2 0.0 23.3 0.8 0.0 6.6 0.1 3.8 0.1 0.0 100.0 6,988 Rajshahi 66.5 0.3 28.9 0.0 0.0 2.5 0.0 1.7 0.0 0.0 100.0 8,430 Rangpur 65.4 0.3 27.6 0.5 0.0 2.3 0.0 2.0 0.0 1.9 100.0 5,554 Sylhet 66.7 0.1 19.1 3.1 0.0 7.8 0.0 2.9 0.2 0.1 100.0 3,385
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
106
Table 6.4: continued Users of improved sanitation facilities Users of unimproved sanitation facilities Open
defeca-tion (no facility, bush, field)
Total Number of
house-hold
mem-bers
Not shared1
Public facility
Shared by Miss-ing/DK
Not shared
Public facility
Shared by
10 house-holds or
less
More than 10 house-holds
10 households
or less
More than 10
households
Education of household headNo education 43.7 1.1 35.1 5.5 0.0 5.3 0.2 7.7 0.9 0.4 100.0 19,159 Primary incomplete 44.7 0.4 40.1 3.0 0.0 4.6 0.0 6.1 0.6 0.4 100.0 13,377 Primary complete 55.5 0.3 32.2 1.7 0.0 4.2 0.0 5.2 0.8 0.1 100.0 9,033 Secondary incomplete 62.1 0.3 26.4 1.6 0.0 5.7 0.1 3.2 0.7 0.0 100.0 24,583 Secondary complete or higher 78.8 0.2 12.0 0.2 0.0 6.8 0.0 1.7 0.2 0.0 100.0 15,715 Missing/DK 19.4 0.0 24.8 0.9 0.0 23.4 0.0 16.3 15.1 0.0 100.0 360
Wealth index quintilePoorest 5.6 1.4 67.7 9.5 0.0 1.6 0.1 10.8 2.1 1.1 100.0 13,990 Second 22.4 1.0 58.5 4.1 0.0 2.5 0.2 10.1 1.1 0.0 100.0 15,216 Middle 63.9 0.2 25.6 0.4 0.0 5.0 0.0 4.3 0.6 0.0 100.0 17,034 Fourth 88.5 0.2 3.7 0.0 0.0 6.8 0.2 0.6 0.0 0.0 100.0 17,824 Richest 89.4 0.0 .3 0.0 0.0 10.3 0.0 0.0 0.0 0.0 100.0 18,163
ReligionIslam 56.1 0.5 29.1 2.7 0.0 5.6 0.1 5.0 0.7 0.2 100.0 74,338 Hindu 68.5 0.3 22.7 0.9 0.0 4.9 0.1 2.1 0.4 0.1 100.0 7,253 Buddhist 58.5 1.7 35.2 0.0 0.0 4.6 0.0 0.0 0.0 0.0 100.0 358 Christian 67.7 0.0 29.7 0.0 0.0 2.3 0.0 0.3 0.0 0.0 100.0 258
Table 6.4 also show that 57.3 per cent of urban household population use improved sanitation facilities which are not shared with members of other households. This Percentage was very low in CC slums (18.9 per cent) compared to CC non-slums (51.3 per cent) and other urban areas (62.4 per cent), implying that most of the CC slum dwellers used shared facility even if it is an improved facility. This is also shown in Figure 6.3.
Table 6.5: Drinking water and sanitation ladders
Percentage of household population by drinking water and sanitation ladders, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Percentage of household population using: Number of
house-hold
mem-bers
Improved drinking water a
Unim-proved drinking
water
Total Improved sanitation
Unimproved sanitation Total Improved drinking
water sources
and improved sanitation
Piped into
dwelling, plot or yard
Other improved
Shared improved facilities
Unim-proved
facilities
Open defeca-
tion
Total 39.7 59.5 0.8 100.0 57.3 31.5 11.0 0.2 100.0 56.7 82,228
Area
City Corporation slum 45.5 52.6 2.0 100.0 18.9 62.9 18.1 0.1 100.0 18.2 3,302
City Corporation non-slum 69.0 30.0 1.0 100.0 51.3 28.7 20.0 0.0 100.0 50.5 25,015
Other municipalities/urban 25.8 73.5 0.7 100.0 62.4 30.9 6.5 0.3 100.0 61.9 53,911
Division
Barisal 6.0 92.8 1.2 100.0 80.7 17.7 1.6 0.0 100.0 79.6 3,343
Chittagong 35.7 63.4 1.0 100.0 63.6 25.7 10.4 0.2 100.0 63.1 16,019
Dhaka 59.6 39.9 0.4 100.0 47.1 38.2 14.7 0.0 100.0 46.8 38,509
Khulna 12.4 84.7 3.0 100.0 65.2 24.2 10.6 0.0 100.0 62.9 6,988
Rajshahi 15.1 84.9 0.0 100.0 66.5 29.2 4.2 0.0 100.0 66.5 8,430
Rangpur 6.8 93.2 0.1 100.0 65.4 28.4 4.3 1.9 100.0 65.4 5,554
Sylhet 37.5 59.4 3.2 100.0 66.7 22.4 10.9 0.1 100.0 64.6 3,385
107
Wat
er a
nd
San
itat
ion
Table 6.5: continued Percentage of household population using: Number
of house-hold
mem-bers
Improved drinking water a
Unim-proved drinking
water
Total Improved sanitation
Unimproved sanitation Total Improved drinking
water sources
and improved sanitation
Piped into
dwelling, plot or yard
Other improved
Shared improved facilities
Unim-proved
facilities
Open defeca-
tion
Education of household head
No education 31.1 68.0 0.9 100.0 43.7 41.8 14.1 0.4 100.0 43.3 19,159
Primary incomplete 36.0 63.3 0.7 100.0 44.7 43.5 11.3 0.4 100.0 44.4 13,377
Primary complete 31.3 67.5 1.2 100.0 55.5 34.2 10.2 0.1 100.0 54.7 9,033
Secondary incomplete 40.9 58.3 0.8 100.0 62.1 28.2 9.7 0.0 100.0 61.5 24,583
Secondary complete or higher 56.0 43.2 0.8 100.0 78.8 12.4 8.7 0.0 100.0 78.1 15,715
Missing/DK 56.6 43.1 0.4 100.0 19.4 25.8 54.8 0.0 100.0 19.4 360
Wealth index quintile
Lowest 27.2 72.0 0.7 100.0 5.6 78.6 14.7 1.1 100.0 5.6 13,990
Second 38.5 60.7 0.8 100.0 22.4 63.6 14.0 0.0 100.0 22.1 15,216
Middle 27.1 72.1 0.8 100.0 63.9 26.2 10.0 0.0 100.0 63.2 17,034
Fourth 39.7 59.5 0.8 100.0 88.5 4.0 7.5 0.0 100.0 87.8 17,824
Highest 62.2 36.8 1.0 100.0 89.4 .3 10.3 0.0 100.0 88.5 18,163
Religion
Islam 40.5 58.7 0.7 100.0 56.1 32.2 11.5 0.2 100.0 55.6 74,338
Hindu 30.7 67.6 1.6 100.0 68.5 23.8 7.5 0.1 100.0 67.3 7,253
Buddhist 41.1 58.9 0.0 100.0 58.5 36.9 4.6 0.0 100.0 58.5 358
Christian 52.1 45.6 2.4 100.0 67.7 29.7 2.6 0.0 100.0 65.3 258
a Those indicating bottled water as the main source of drinking water are distributed according to the water source used for other purposes such as cooking and handwashing.
Having access to both an improved drinking water source and an improved sanitation facility bring huge public health benefits. Table 6.5 presents Percentages of household population by drinking water and sanitation ladders. It also shows the Percentage of household members using both improved sources of drinking water and an improved sanitation means of excreta disposal. The table shows that overall 56.7 per cent of urban household members had an improved drinking water source as well as improved sanitation. This Percentage was very low in CC slums (18.2 per cent) compared to CC non-slums (50.5 per cent) and the situation was the best in other urban areas (61.9 per cent). This prevalence varied by division with the highest prevalence in Barisal (79.6 per cent) and lowest in Dhaka (46.8 per cent). Education of household head and wealth level appeared to have positive impact on use of improved drinking water sources and improved sanitation.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
108
Fig 6.4 : Use of improved drinking water sources and improved sanitation by division, Bangladesh, CWS 2016
6.3 Disposal of Child’s FaecesSafe disposal of a child’s faeces is disposing of the stool by the child using a toilet or by rinsing the stool into a toilet or latrine. Disposal of faeces of children age 0-2 years is presented in Table 6.6.
Fig 6.5: Percentage of children whose last stools were disposed of safely by areas, Bangladesh, CWS 2016
Table 6.6 (and Figure 6.5) shows that in urban areas of Bangladesh, for 66.2 per cent children of age 0-2 years, the stools were disposed of safely the last time they passed stools. This Percentage was much higher in CC non-slum areas (81.9 per cent) than in other urban (60.2 per cent) and CC slum areas (58.0 per cent).
109
Wat
er a
nd
San
itat
ion
Significant differences were observed in this practice in different divisions. The lowest in Rajshahi (43.7 per cent), and the highest was in Dhaka (76.6 per cent)). Safe disposal of child’s faeces were found to be positively associated with mother’s education and household wealth quintile – from 55.1 per cent when mothers have no education to 83.1 per cent for mothers with secondary or higher education. Safe disposal of stools was as low as 43.9 per cent among the poorest households as compared to 82.2 per cent among the richest.
By place of disposal, the most common practice in urban areas was put/rinsed child’s faeces into a toilet or latrine. This safe practice was observed for 63.3 per cent of children age 0-2 years. Other disposal methods was to put/rinsed into drain or ditch (17.1 per cent) and throwing into garbage (12.1 per cent).
Table 6.6: Disposal of child’s faeces
Per cent distribution of children age 0-2 years according to place of disposal of child’s faeces, and the Percentage of children age 0-2 years whose stools were disposed of safely the last time the child passed stools, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Place of disposal of child’s faeces Percentage of children whose last stools were
disposed of safely
Number of
children age 0-2 years
Child used toilet/latrine
Put/rinsed into toilet or latrine
Put/rinsed into drain or ditch
Thrown into
garbage
Buried Left in the open
Other Total
Total 2.9 63.3 17.1 12.1 0.2 4.1 0.2 100.0 66.2 2,805Type of sanitation facility used by household members
Improved 2.9 63.8 16.7 12.2 0.2 4.0 0.2 100.0 66.7 2,499Unimproved 2.3 60.0 20.7 11.7 0.4 4.4 0.6 100.0 62.3 299Open defecation (*) (*) (*) (*) (*) (*) (*) 100.0 (*) 7
AreaCity Corporation slum 1.2 56.8 27.9 10.2 0.1 3.8 0.0 100.0 58.0 123City Corporation non-slum 5.3 76.6 10.5 6.8 .0 0.8 0.0 100.0 81.9 790Other municipalities/urban 1.9 58.2 19.2 14.5 0.4 5.5 0.3 100.0 60.2 1,892
DivisionBarisal 0.6 56.9 22.0 16.5 0.0 4.0 0.0 100.0 57.5 119Chittagong 1.2 60.5 20.2 12.9 0.7 4.5 0.0 100.0 61.7 635Dhaka 4.0 72.7 11.6 8.5 0.0 3.2 0.0 100.0 76.7 1,278Khulna 5.0 57.7 17.6 14.7 0.7 3.6 0.7 100.0 62.8 187Rajshahi 1.5 42.2 27.3 21.3 0.0 5.9 1.8 100.0 43.7 269Rangpur 2.5 53.8 25.0 10.9 0.6 7.2 0.0 100.0 56.3 195Sylhet 2.1 56.0 18.8 19.3 0.0 3.4 0.4 100.0 58.2 123
Mother’s educationNo education 3.1 52.1 23.9 17.9 0.0 3.0 0.0 100.0 55.1 236Primary incomplete 0.4 56.1 21.5 13.3 0.3 7.9 0.5 100.0 56.5 412Primary complete 7.0 52.8 15.0 18.9 0.0 5.9 0.4 100.0 59.7 287Secondary incomplete 2.4 63.3 19.1 10.9 0.3 3.8 0.2 100.0 65.7 1,334Secondary complete or higher 3.6 79.5 7.2 7.9 0.4 1.3 0.0 100.0 83.1 536
Wealth index quintileLowest 1.6 42.4 25.8 22.8 0.0 6.9 0.5 100.0 43.9 605Second 2.2 63.4 19.5 12.5 0.3 2.1 0.0 100.0 65.6 503Middle 2.6 58.9 20.0 10.6 0.5 7.1 0.3 100.0 61.4 586Fourth 4.1 76.1 10.6 6.1 0.0 2.8 0.3 100.0 80.2 627Highest 4.0 78.3 8.9 7.9 0.5 0.5 0.0 100.0 82.2 484
Religion*Islam 2.8 63.3 17.2 12.1 0.2 4.2 0.3 100.0 66.1 2,556Hindu 4.0 64.9 15.4 11.7 1.0 3.0 0.0 100.0 68.9 218
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases(*) Figures that are based on fewer than 25 unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
110
6.4 Handwashing PracticesHandwashing with water and soap is essential and hygienic before and after meals, before preparing food and feeding the child and after toilet use. In urban areas, in 91.9 per cent of households a specific place for handwashing was observed, while 8.0 per cent households did not have a specific place for handwashing of household members. Some variations were observed by area and divisions. The results are shown in Table 6.7.
Fig 6.6: Percentage of households with a specific place for handwashing where water and soap or other cleansing agent are present, Bangladesh, CWS 2016
Among the places observed, 55.1 per cent of households had water and soap available in the dwelling for handwashing. This varied greatly by area of residence; 67.0 per cent of CC non-slums households against only 35.0 per cent in CC slums and 50.7 per cent in other urban areas. Variation by division was not much.
It was evident that 55.4 per cent of urban households had a specific place for handwashing with water and cleansing agent available. This proportion was the highest in CC non-slums (67.1 per cent), and lowest in CC slums (35.4 per cent). Variations by division was not much.
111
Wat
er a
nd
San
itat
ion
Tab
le 6
.7: W
ater
and
soa
p at
pla
ce f
or h
andw
ashi
ng
Per
cen
tag
e o
f h
ou
seh
old
s w
her
e p
lace
fo
r h
and
was
hin
g w
as o
bse
rved
, Per
cen
tag
e w
ith
no
sp
ecif
ic p
lace
fo
r h
and
was
hin
g, a
nd
per
cen
t d
istr
ibu
tio
n o
f h
ou
seh
old
s b
y av
aila
bili
ty
of
wat
er a
nd
so
ap a
t sp
ecif
ic p
lace
fo
r h
and
was
hin
g, C
hild
Wel
l-b
ein
g S
urv
ey in
Urb
an A
reas
, Ban
gla
des
h, C
WS
201
6
Pe
rcen
tage
of h
ouse
hold
s:
Num
-be
r of
hous
e-ho
lds
Plac
e fo
r han
dwas
hing
obs
erve
dN
o sp
ecifi
c pl
ace
for
hand
-w
ashi
ng in
th
e dw
ellin
g,
yard
, or p
lot
Tota
lPe
rcen
tage
of
hous
ehol
ds w
ith a
sp
ecifi
c pl
ace
for
hand
was
hing
whe
re
wat
er a
nd s
oap
or o
ther
cle
ansi
ng
agen
t are
pre
sent
Num
ber o
f hou
seho
lds
whe
re p
lace
for
hand
was
hing
was
ob
serv
ed o
r with
no
spe
cific
pla
ce fo
r ha
ndw
ashi
ng in
the
dwel
ling,
yar
d, o
r plo
t
Whe
re
plac
e fo
r ha
nd-
was
hing
w
as
obse
rved
With
no
spec
ific
plac
e fo
r han
d-w
ashi
ng in
the
dwel
ling,
yar
d,
or p
lot
Wat
er is
ava
ilabl
e an
d:
Wat
er is
not
ava
ilabl
e an
d:
Soap
pr
esen
tN
o so
ap:
Soap
pr
esen
tN
o so
ap:
Ash
, m
ud,
or s
and
pres
ent
No
othe
r cl
eans
-in
g ag
ent
pres
ent
Ash
, m
ud,
or s
and
pres
ent
No
othe
r cl
eans
-in
g ag
ent
pres
ent
Tota
l91
.98.
018
,887
55
.10.
334
.80.
30.
01.
58.
010
0.0
55.4
18,
858
Are
a City
Cor
pora
tion
slum
88.2
11.7
784
35
.00.
447
.70.
90.
14.
311
.710
0.0
35.4
783
Ci
ty C
orpo
ratio
n no
n-sl
um92
.27.
6 5
,874
67
.00.
023
.90.
50.
00.
97.
610
0.0
67.1
5,8
58
Oth
er m
unic
ipal
ities
/urb
an
92.0
7.9
12,2
29
50.7
0.4
39.1
0.2
0.0
1.6
8.0
100.
051
.1 1
2,21
7 D
ivis
ion
Baris
al81
.618
.4 7
49
43.6
0.3
36.3
0.2
0.0
1.3
18.4
100.
043
.9 7
49
Chitt
agon
g94
.75.
3 3
,334
53
.70.
237
.60.
30.
02.
95.
310
0.0
53.9
3,3
34
Dha
ka90
.49.
3 9
,263
55
.30.
133
.80.
40.
01.
19.
310
0.0
55.4
9,2
37
Khul
na94
.65.
3 1
,657
56
.61.
136
.00.
40.
00.
65.
310
0.0
57.6
1,6
55
Rajs
hahi
92.2
7.8
1,9
88
60.8
0.8
27.9
0.4
0.0
2.2
7.8
100.
061
.6 1
,988
Ra
ngpu
r97
.92.
1 1
,238
54
.00.
542
.70.
20.
00.
52.
110
0.0
54.5
1,2
38
Sylh
et90
.29.
7 6
58
54.7
0.0
34.8
0.1
0.0
0.6
9.7
100.
054
.8 6
57
Educ
atio
n of
hou
seho
ld h
ead
No
educ
atio
n86
.613
.2 4
,202
33
.60.
649
.20.
40.
02.
913
.210
0.0
34.2
4,1
93
Prim
ary
inco
mpl
ete
87.0
12.7
3,0
50
39.3
0.3
45.5
0.4
0.0
1.8
12.7
100.
039
.6 3
,040
Pr
imar
y co
mpl
ete
92.3
7.7
1,9
85
49.4
0.3
40.7
0.4
0.0
1.5
7.7
100.
049
.7 1
,985
Se
cond
ary
inco
mpl
ete
93.8
6.1
5,7
88
60.0
0.2
32.2
0.3
0.0
1.2
6.1
100.
060
.2 5
,779
Se
cond
ary
com
plet
e or
hig
her
98.5
1.4
3,7
93
87.2
0.1
11.0
0.2
0.0
0.1
1.4
100.
087
.3 3
,792
M
issi
ng/D
K88
.311
.7 6
9 56
.61.
828
.70.
00.
01.
111
.710
0.0
58.4
69
Wea
lth in
dex
quin
tile
Low
est
83.4
16.2
3,7
77
18.5
0.9
60.3
0.3
0.0
3.7
16.3
100.
019
.4 3
,764
Se
cond
87.2
12.5
3,7
66
31.2
0.3
53.9
0.4
0.0
1.7
12.6
100.
031
.5 3
,757
M
iddl
e92
.57.
5 3
,778
47
.80.
342
.10.
60.
01.
77.
510
0.0
48.1
3,7
78
Four
th96
.73.
3 3
,781
81
.30.
014
.90.
20.
00.
33.
310
0.0
81.3
3,7
80
Hig
hest
99.5
0.4
3,7
85
96.5
0.0
2.9
0.2
0.0
0.0
0.4
100.
096
.5 3
,780
Re
ligio
nIs
lam
91.5
8.3
17,1
0854
.50.
335
.20.
40.
01.
48.
310
0.0
54.8
17,0
80H
indu
95.0
5.0
1,63
161
.10.
231
.50.
10.
02.
05.
010
0.0
61.3
1,63
1Bu
ddhi
st(*
)(*
)84
(*)
(*)
(*)
(*)
(*)
(*)
(*)
100.
0(*
)84
Chris
tian
99.6
0.4
6070
.60.
127
.61.
20.
00.
10.
410
0.0
70.7
60
(*)
Figu
res
that
are
bas
ed o
n fe
wer
than
25
unw
eigh
ted
case
s
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
112
The Percentage of households by availability of soap or other cleansing agent anywhere in the households can be seen in Table 6.8. It shows that 97.3 per cent of urban households had soap or other cleansing agent available somewhere in the households.
Table 6.8: Availability of soap or other cleansing agent
Per cent distribution of households by availability of soap or other cleansing agent in the dwelling, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Place for handwashing observed Place for handwashing not observed
Total Percentage of households with soap or other
cleansing agent
anywhere in the dwelling
Number of house-
holdsSoap or other
cleans-ing
agent obser-
ved
Soap or other cleansing agent not observed at place for handwashing
Soap or other
cleans-ing
agent shown
No soap or other cleans-
ing agent in house-hold
Not able/Does not want to
show soap or other
cleansing agent
Soap or other
cleansing agent shown
No soap or other
cleansing agent in
household
Not able/Does not want to
show soap or other cleansing
agent
Total 55.7 34.3 1.7 0.1 7.3 0.8 0.0 100.0 97.3 18,887
Area
City Corporation slum 36.2 48.1 3.8 0.1 9.6 2.3 0.0 100.0 93.9 784
City Corporation non-slum 67.4 22.7 2.0 0.1 6.3 1.5 0.1 100.0 96.4 5,874
Other municipalities/urban 51.3 39.0 1.5 0.1 7.6 0.4 0.0 100.0 98.0 12,229
Division
Barisal 44.0 37.0 0.4 0.1 18.0 0.3 0.0 100.0 99.1 749
Chittagong 54.2 38.7 1.7 0.1 4.7 0.6 0.0 100.0 97.6 3,334
Dhaka 55.6 32.7 2.1 0.1 8.4 1.1 0.0 100.0 96.7 9,263
Khulna 58.0 35.1 1.1 0.5 4.1 1.3 0.0 100.0 97.2 1,657
Rajshahi 62.0 29.6 0.3 0.3 7.5 0.3 0.0 100.0 99.1 1,988
Rangpur 54.7 40.9 2.3 0.0 2.1 0.0 0.0 100.0 97.7 1,238
Sylhet 54.9 32.1 3.3 0.0 9.3 0.5 0.0 100.0 96.2 658
Education of household head
No education 34.6 47.8 4.2 0.1 11.7 1.5 0.1 100.0 94.1 4,202
Primary incomplete 39.9 45.3 1.6 0.2 11.9 1.1 0.0 100.0 97.1 3,050
Primary complete 50.1 41.4 0.7 0.1 7.3 0.4 0.0 100.0 98.7 1,985
Secondary incomplete 60.4 31.8 1.4 0.2 5.5 0.7 0.0 100.0 97.7 5,788
Secondary complete or higher 87.4 10.9 0.2 0.0 1.4 0.1 0.0 100.0 99.7 3,793
Missing/DK 58.4 29.4 0.4 0.0 11.7 0.0 0.0 100.0 99.6 69
Wealth index quintile
Lowest 19.6 59.2 4.3 0.3 14.8 1.7 0.1 100.0 93.6 3,777
Second 31.8 52.0 3.3 0.1 11.2 1.6 0.0 100.0 95.0 3,766
Middle 48.7 43.0 0.7 0.1 7.1 0.4 0.0 100.0 98.8 3,778
Fourth 81.5 14.8 0.2 0.1 2.9 0.4 0.0 100.0 99.3 3,781
Highest 96.6 2.7 0.2 0.0 0.5 0.0 0.0 100.0 99.8 3,785
Religion
Islam 55.0 34.6 1.8 0.1 7.6 0.8 0.0 100.0 97.3 17,108
Hindu 61.4 32.4 0.9 0.2 4.0 0.8 0.2 100.0 97.8 1,631
Buddhist (66.9) (20.8) (4.9) 0.0 (4.9) (2.4) 0.0 100.0 (92.7) 84
Christian 71.9 25.3 2.4 0.0 0.4 0.0 0.0 100.0 97.6 60
( ) Figures that are based on 25-49 unweighted case
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
113
7 CHILD DEVELOPMENT, LITERACY AND EDUCATION
UNICEF/BANA2014-00171/Kiron
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
114
Key Findings:
� Only 26.2 per cent of urban children age 36-59 months were attending an early childhood education (ECE) programme or pre-school, with about 30.4 per cent in CC non-slums, 24.2 per cent in other urban areas and 23.8 per cent in CC slums.
� Attendance to an ECE programme was 9.4 per cent among children age 36-47 months, while this was 41.7 per cent in the age group 48-59 months.
� Overall literacy among urban young women age 15-24 years is high at 82.6 per cent, with higher (about 84 per cent) in other urban areas and CC non-slums and low at 59.0 per cent in CC slum areas.
� Sixty-eight per cent of the urban children who were currently attending the first grade of primary school had attended pre-school the previous year. Attendance to pre-school was substantially low in CC slums (56.1 per cent) compared to CC non-slums (59.1 per cent) and other urban areas (72.7 per cent). Among the divisions, it was the highest in Khulna (86.9 per cent), and lowest in Sylhet (61.5 per cent).
� Net intake rate in primary school was found to be 62.2 per cent with a high of 66.9 per cent in CC non-slums compared to 40.5 per cent in CC slum areas.
� The primary school adjusted net attendance ratio (NAR) was 85.5 per cent. It was very low at 69.4 per cent in CC slum areas as compared to other areas.
� The secondary school adjusted net attendance ratio was 63.1 per cent, which is 22 Percentage points lower than the primary school NAR. The secondary school NAR was substantially low in CC slums (33.3 per cent) compared to CC non-slums (62.0 per cent) and other urban areas (65.5 per cent). It was the highest in Barisal (74.4 per cent), and lowest in Dhaka division (59.4 per cent).
� The effective transition rate to secondary school was 97.3 per cent, with little variation by domains and divisions.
� Girls are in advantage in both primary school and secondary school attendance. The Gender Parity Index (GPI), defined as the ratio of girls to boys attending primary or secondary education, was 1.05 for primary and 1.18 for secondary education. The advantage of girls was noticed for all categories of children, and was particularly pronounced in children with no/less educated mothers and children of lower quintiles.
Readiness of children for primary school can be improved through attendance to early childhood education programme or through pre-school attendance. Early childhood education programmes include programmes for children that have organized learning components as opposed to baby-sitting and day-care where do not typically have organized education and learning. In Bangladesh, Early Childhood Care and Education (ECCE) models have been developed, piloted and are being implemented. The Education Policy encourages two years of early education for children age below five years. For children age 36-59 months are expected to attend pre-school as part of organized early childhood education programme. The survey collected information from mothers/caregivers of 36-59 months old children on whether they were attending an organized early childhood education programme.
7 CHILD DEVELOPMENT, LITERACY AND EDUCATION
115
Education influences a person’s behavior and attitude. Education is often seen as a proxy measure of social progress and economic development. In line with the UN Child Rights Convention, primary education is mandatory in Bangladesh (Primary Education Law 1990). In addition to Primary and Secondary education, the government of Bangladesh has initiated opening up non-grade-level schools for pre-primary/preschool education. The CWS 2016 collected information from household level on education of all household members aged 3 years and above. Based on this data, status of literacy among young women age 15-24 years and a number of indicators relating to school readiness, participation of school going children in primary and secondary education, gender parity in primary and secondary education, etc. were assessed. The data here refers to the age at the beginning of the school year 2016. The year 2016 refers to the current academic year, and previous year refers to the 2015 academic year, since January to December period is the academic year in Bangladesh for secondary education or below.
7.1 Attendance in Early Childhood EducationTable 7.1 provides Percentage of urban children age 36-59 months attending an organized early childhood education (ECE) programme. It shows that only 26.2 per cent of urban children age 36-59 months in Bangladesh were attending pre-school as part of organized early childhood education programme. Male children and children of younger age group were less likely to attend early childhood education program. Twenty four per cent of male against 28.2 per cent of female, and 9.4 per cent of children age 36-47 months against 41.7 per cent in the age group 48-59 months reported to be attending an organized early childhood education programme.
Fig 7.1: Percentage of children age 36-59 months attending early childhood education, Bangladesh, CWS 2016
Attendance in an early childhood education programme also varied by area of residence, divisions, mother’s education and socio-economic status of households in which the children were growing. Attendance was high among children of CC non-slum areas (30.4 per cent) compared to those of CC slums (23.8 per cent) and other urban areas (24.2 per cent). As regards divisions, attendance was the highest in Khulna (31.5 per cent), and lowest in Sylhet division (20.1 per cent). C
hild
Dev
elo
pm
ent,
Lit
erac
y an
d E
du
cati
on
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
116
About 17.6 per cent of children age 36-59 months whose mothers had no formal education reported to be attending an ECE programme, and this prevalence was 37.0 per cent among those with secondary or higher level educated mothers. Similarly, 19.3 per cent children of the lowest wealth quintile against 38.4 per cent of the highest quintile have been attending an ECE programme.
Table 7.1: Attendance to Early Childhood Education
Percentage of children age 36-59 months who are attending an organized early childhood education programme by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Percentage of children age 36-59 months attending early childhood education
Number of children age 36-59 months
Total 26.2 3137
Sex
Male 24.2 1609
Female 28.2 1528
Area
City Corporation slum 23.8 150
City Corporation non-slum 30.4 989
Other municipalities/urban 24.2 1999
Division
Barisal 23.8 129
Chittagong 23.9 603
Dhaka 27.7 1599
Khulna 31.5 225
Rajshahi 21.7 260
Rangpur 26.7 181
Sylhet 20.1 140
Age of child
36-47 months 9.4 1526
48-59 months 41.7 1577
Mother’s education
No education 17.6 348
Primary incomplete 24.2 495
Primary complete 19.9 320
Secondary incomplete 26.7 1509
Secondary complete or higher 37.0 464
Missing/DK 100.0 1
Wealth index quintile
Lowest 19.3 644
Second 21.6 641
Middle 25.3 585
Fourth 27.9 725
Highest 38.4 541
Religion
Islam 24.8 2887
Hindu 39.8 233
Buddhist 31.8 6
Christian 90.0 10
117
Ch
ild D
evel
op
men
t, L
iter
acy
and
Ed
uca
tio
n
7.2 Literacy among Young WomenIn the CWS 2016, if a person was able to read a short simple statement about every day of life or attended secondary or higher education was classified as literate. Using this definition, literacy rate among young women age 15-24 was estimated. The Youth Literacy Rate (literacy among youths age 15-24 years) reflects the outcome of primary education over the previous 10 years or so. As a measure of effectiveness of the primary education system, it is often seen as a proxy measure of social progress and achievements.
Table 7.2 provides Percentage of young women age 15-24 years who are literate. It indicated that 82.6 per cent of urban young women of Bangladesh aged 15-24 years were literate. Literacy varied by area of residence; it was higher in other urban areas (83.8 per cent), and CC non-slums (83.7 per cent), compared to CC slum areas (59.0 per cent). It did not vary greatly by divisions (the highest in Khulna (91.8 per cent), and lowest in Sylhet (76.8 per cent)).
Socio-economic Status had positive impact on literacy; over three in five of the young women from the poorest quintile (61.9 per cent) were literate, whereas among those in the highest wealth quintile nearly all were literate (98.3 per cent). These results are in conformity with the results from recent surveys collecting such information.
Table 7.2: Literacy rate among young women
Percentage of women age 15-24 years who are literate by selected background characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Percentage literate Percentage not known Number of women
Total 82.6 8.5 4488
AreaCity Corporation slum 59.0 24.9 215City Corporation non-slum 83.7 9.9 1,347Other municipalities/urban 83.8 6.6 2,926
DivisionBarisal 87.6 5.8 179Chittagong 79.8 10.5 873Dhaka 80.9 9.1 2,194Khulna 91.8 3.4 390Rajshahi 88.8 6.2 423Rangpur 81.9 8.5 294Sylhet 76.8 11.1 135
EducationNo education 0.0 95.7 213Primary incomplete 22.9 28.6 560Primary complete 64.3 4.1 379Secondary incomplete 100.0 0.0 2,632Secondary complete or higher 100.0 0.0 703
Age15-19 85.5 6.1 1,52020-24 81.1 9.7 2,967
Wealth index quintileLowest 61.9 21.9 1,054Second 77.5 8.2 1,020Middle 89.2 4.3 843Fourth 94.7 2.2 869Highest 98.3 1.5 702
Religion*Islam 82.1 8.6 4,157Hindu 89.1 6.3 315
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
118
7.3 School ReadinessPre-school or pre-primary education is important for the readiness of children for primary education. Table 7.3 shows the proportion of children in the first grade of primary school in 2016 (regardless of age) who attended pre-school the previous year (year 2015). In urban areas of Bangladesh, 68.0 per cent of the children who were currently attending the first grade of primary school attended pre-schools the previous year. Attendance to pre-school was substantially low in CC slum areas (56.1 per cent) compared to CC non-slums (59.1 per cent) and it was most common in other urban areas (72.7 per cent).
Fig 7.2: School readiness by areas, Bangladesh, CWS 2016
Attendance to pre-school education varied by divisions; it was the highest in Khulna (86.9 per cent), and lowest in Dhaka (60.2 per cent). Male first graders were somewhat less likely to attend pre-school (67.8 per cent) than females (68.1 per cent). Mother’s education and attendance to pre-school education appeared to be highly correlated; only 59.6 per cent of first grade children with attended pre-school the previous academic year when their mothers had no formal education, against 66.6 per cent when their mothers were secondary or higher educated. Readiness of children for primary education were positively associated with wealth (Table 7.3).
Table 7.3: School readiness
Percentage of children attending first grade of primary school (in 2016) who attended pre-school the previous year (2015) by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
CharacteristicsPercentage of children attending first grade
who attended preschool in previous yearNumber of children attending first grade of primary school
Total 68.0 1,927
Area
City Corporation slum 56.1 85
City Corporation non-slum 59.1 570
Other municipalities/urban 72.7 1,272
119
Ch
ild D
evel
op
men
t, L
iter
acy
and
Ed
uca
tio
n
Table 7.3: continued
CharacteristicsPercentage of children attending first grade
who attended preschool in previous yearNumber of children attending first grade of primary school
Division
Barisal 64.3 81
Chittagong 80.5 371
Dhaka 60.2 929
Khulna 86.9 134
Rajshahi 73.7 202
Rangpur 65.6 118
Sylhet 61.5 92
Sex
Male 67.8 965
Female 68.1 962
Mother’s education
No education 59.6 315
Primary incomplete 60.3 338
Primary complete 70.3 257
Secondary incomplete 74.2 780
Secondary complete or higher 66.6 234
Wealth index quintile
Lowest 64.9 447
Second 64.6 394
Middle 72.3 423
Fourth 75.4 365
Highest 61.6 298
Religion*
Islam 67.7 1,793
Hindu 73.4 127
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
7.4 Primary and Secondary School ParticipationBasic Education for all is one of the goals set in the education policy of Bangladesh. In Bangladesh, children enter primary school at age 6 and enter secondary school at age 11. There are five grades in primary school and five grades in secondary school. In primary schools, grades are referred to as year 1 to year 5 or class I to Class V. For secondary schools, the grades are referred to as class VI to class X (or grade 6 to grade 10). The school year typically runs from January to December of a year.
7.4.1 Net Intake Rate in Primary School
Table 7.4 provides `net intake rate’ in primary school. It is defined as the proportion of children of primary school entry age of six entering Grade 1. Table 8.3 shows that among the children in urban areas of Bangladesh who are of primary school entry age of six, 62.2 per cent were attending the first grade of primary school (Table 7.4). This proportion was much higher in CC non-slums (66.9 per cent) and other urban areas (61.5 per cent) than CC slum areas (40.5 per cent). Sex differential was not significant; however, notable differences exist by divisions. Children of Sylhet division were better off at 70.5 per cent to enter primary grade 1 at age six, and they were least likely Khulna division (57.1 per cent).
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
120
Table 7.4: Net intake rate in primary education
Percentage of children of primary school entry age of six entering Grade 1, (net intake rate) by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
CharacteristicsPercentage of primary school entry age
children entering grade 1Number of children of
primary school entry age
Total 62.2 1459
Area
City Corporation slum 40.5 69
City Corporation non-slum 66.9 448
Other municipalities/urban 61.5 942
Division
Barisal 68.7 61
Chittagong 57.5 323
Dhaka 65.2 666
Khulna 57.1 99
Rajshahi 58.6 157
Rangpur 57.6 85
Sylhet 70.5 69
Sex
Male 60.4 712
Female 63.9 747
Mother’s education
No education 44.7 220
Primary incomplete 68.4 219
Primary complete 60.7 177
Secondary incomplete 66.1 620
Secondary complete or higher 63.3 221
Wealth index quintile
Lowest 57.9 308
Second 55.5 303
Middle 71.3 274
Fourth 69.4 281
Highest 58.1 292
Religion*
Islam 61.7 1319
Hindu 70.5 126
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
7.4.2 Primary School Net Attendance Ratio
Primary school net attendance ratio (adjusted) is defined as the proportion of children of primary school age 6 to 10 years (as of the beginning of school year) who are attending primary or secondary school. The term adjusted is used since not only primary school attendance, but also secondary school attendance are included in the number.
Table 7.5 presents the Percentage of children of primary school age 6 to 10 years who are attending primary or secondary school and those who are out of school. Results show that 85.5 per cent of the children were attending school and 11.5 per cent were out of school. Attendance rate was very low for children age 6 who appeared to be starting late in school (64.0 per cent), as seen by a relatively higher Percentage attending preschool (29.6 per cent).
121
Ch
ild D
evel
op
men
t, L
iter
acy
and
Ed
uca
tio
n
Tab
le 7
.5: Pr
imar
y sc
hool
att
enda
nce
and
out
of s
choo
l chi
ldre
nP
erce
nta
ge
of
child
ren
of
pri
mar
y sc
ho
ol a
ge
atte
nd
ing
pri
mar
y o
r se
con
dar
y sc
ho
ol (
adju
sted
net
att
end
ance
rat
io),
Per
cen
tag
e at
ten
din
g p
resc
ho
ol,
and
Per
cen
tag
e o
ut
of
sch
oo
l, C
hild
Wel
l-b
ein
g S
urv
ey in
Urb
an A
reas
, Ban
gla
des
h, 2
016
M
ale
Fem
ale
Tota
l N
et
atte
ndan
ce
ratio
(a
djus
ted)
Perc
enta
ge o
f chi
ldre
n:N
o. o
f ch
ildre
nN
et
atte
ndan
ce
ratio
(a
djus
ted)
Perc
enta
ge o
f chi
ldre
n:N
o. o
f ch
ildre
nN
et a
ttend
ance
ra
tio (a
djus
ted)
Perc
enta
ge o
f chi
ldre
n:N
o. o
f ch
ildre
nN
ot
atte
ndin
g sc
hool
or
pres
choo
l
Atte
ndin
g pr
esch
ool
Out
of
scho
ola
Not
at
tend
ing
scho
ol o
r pr
esch
ool
Atte
ndin
g pr
esch
ool
Out
of
scho
ola
Not
at
tend
ing
scho
ol o
r pr
esch
ool
Atte
ndin
g pr
esch
ool
Out
of
scho
ola
Tota
l83
.34.
29.
113
.34,
290
87.8
1.2
8.5
9.7
4146
85.5
2.7
8.8
11.5
8,43
6
Are
a City
Cor
pora
tion
slum
69.2
9.1
10.1
19.3
194
69.7
6.4
14.8
21.2
181
69.4
7.8
12.4
20.2
375
City
Cor
pora
tion
non-
slum
83.0
4.9
8.3
13.1
1,23
286
.91.
18.
79.
81,
220
85.0
3.0
8.5
11.5
2,45
2O
ther
mun
icip
aliti
es/u
rban
84
.33.
69.
412
.92,
864
89.4
0.8
8.1
8.9
2,74
586
.82.
28.
711
.05,
610
Div
isio
nBa
risal
85.2
2.3
9.6
12.0
174
93.9
0.6
3.9
4.5
171
89.5
1.5
6.8
8.2
344
Chitt
agon
g79
.34.
611
.115
.788
486
.70.
98.
08.
982
682
.92.
89.
612
.41,
710
Dha
ka82
.55.
68.
514
.12,
087
87.0
1.6
9.2
10.9
1,94
484
.73.
78.
912
.64,
031
Khul
na91
.00.
56.
56.
933
388
.90.
59.
710
.231
390
.00.
58.
18.
564
6Ra
jsha
hi86
.11.
510
.712
.338
091
.00.
08.
08.
041
488
.70.
79.
310
.179
4Ra
ngpu
r84
.72.
39.
311
.624
985
.91.
39.
811
.129
085
.31.
89.
611
.353
9Sy
lhet
87.1
2.7
6.2
8.9
184
88.8
1.3
5.3
6.5
188
88.0
2.0
5.7
7.7
372
Age
at
begi
nnin
g of
sch
ool
661
.90.
231
.131
.271
265
.90.
528
.128
.774
764
.00.
429
.629
.91,
459
781
.82.
811
.514
.484
183
.50.
611
.912
.587
982
.71.
711
.713
.41,
720
885
.66.
75.
312
.095
595
.30.
33.
53.
986
590
.23.
74.
58.
11,
819
993
.93.
51.
14.
784
096
.72.
40.
42.
981
695
.33.
00.
83.
81,
655
1088
.76.
51.
27.
794
395
.51.
90.
62.
583
991
.94.
30.
95.
21,
782
Mot
her’s
edu
catio
nN
o ed
ucat
ion
67.9
9.9
12.1
22.1
738
80.3
1.9
10.1
12.1
755
74.1
5.9
11.1
17.0
1,49
3Pr
imar
y in
com
plet
e84
.14.
46.
310
.776
188
.42.
37.
59.
872
186
.23.
46.
910
.31,
481
Prim
ary
com
plet
e82
.66.
47.
213
.550
690
.00.
08.
98.
950
086
.33.
28.
011
.21,
007
Seco
ndar
y in
com
plet
e88
.11.
79.
511
.21,
709
90.4
0.5
8.2
8.7
1,61
489
.21.
18.
910
.03,
323
Seco
ndar
y co
mpl
ete
or h
ighe
r88
.02.
19.
511
.657
187
.71.
58.
49.
955
287
.91.
89.
010
.81,
123
Wea
lth in
dex
quin
tile
Low
est
72.7
9.5
9.2
18.7
808
82.5
1.9
10.9
12.8
836
77.7
5.7
10.0
15.7
1,64
3Se
cond
79.6
3.8
11.8
15.7
904
86.3
1.2
8.1
9.3
821
82.8
2.6
10.1
12.7
1,72
5M
iddl
e88
.33.
46.
59.
988
192
.30.
86.
47.
286
990
.32.
16.
48.
61,
750
Four
th
88.5
2.2
7.3
9.5
862
92.9
0.4
6.2
6.5
808
90.6
1.3
6.7
8.0
1,67
1H
ighe
st86
.72.
310
.713
.083
584
.91.
411
.212
.681
185
.81.
910
.912
.81,
647
Relig
ion
Isla
m82
.64.
49.
213
.63,
927
87.5
1.2
8.8
10.0
3,82
985
.02.
99.
011
.97,
757
Hin
du89
.31.
78.
410
.133
594
.30.
24.
44.
627
991
.51.
06.
67.
661
4Bu
ddhi
st(*
)(*
)(*
)(*
)16
(*)
(*)
(*)
(*)
15(*
)(*
)(*
)(*
)32
Chris
tian
(*)
(*)
(*)
(*)
9(*
)(*
)(*
)(*
)20
(65.
5)(0
.0)
(17.
7)(1
7.7)
29a
The
perc
enta
ge o
f chi
ldre
n of
prim
ary
scho
ol a
ge o
ut o
f sch
ool a
re th
ose
not a
ttend
ing
scho
ol a
nd th
ose
atte
ndin
g pr
esch
ool
Not
e:
Due
to 1
unw
eigh
ted
case
s, ‘M
issi
ng’ c
ateg
ory
unde
r ‘ed
ucat
ion’
is n
ot s
how
n(*
) Fi
gure
s th
at a
re b
ased
on
few
er th
an 2
5 un
wei
ghte
d ca
ses
( )
Figu
res
that
are
bas
ed o
n 25
-49
unw
eigh
ted
case
s
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
122
The adjusted primary school net attendance ratio (NAR) for children of CC non-slums and other urban areas was 85.0 per cent and 86.8 per cent respectively, while it was 69.4 per cent in CC slums. The NAR varied little by division, but some variations were observed by mother’s education and socio-economic status. The NAR was 4 Percentage points higher among female (87.8 per cent) than male (83.3 per cent).
7.4.3 Secondary School Net Attendance Ratio
Secondary school net attendance ratio (adjusted) is defined as the Percentage of children of secondary school age 11 to 15 years who are attending secondary school or higher. The secondary school adjusted net attendance ratio (NAR) for urban children of Bangladesh is presented in Table 7.6. Among the urban children of secondary school age, 63.1 per cent were attending secondary school or higher. The NAR at secondary level is significantly lower than primary school net attendance ratio (85.5 per cent).
Table 7.6: Secondary school attendance and out of school children
Percentage of children of secondary school age attending secondary school or higher (adjusted net attendance ratio), Percentage attending primary school, and Percentage out of school, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Male Female Total
Net attendance
ratio (adjusted)
Percentage of children:
Number of
children
Net atten-dance ratio
(adjusted)
Percentage of children:
Number of
children
Net atten-dance ratio
(adjusted)
Percentage of children:
Number of
childrenAttending primary school
Out of schoola
Attending primary school
Out of schoola
Attending primary school
Out of schoola
Total 57.9 15.7 23.1 5,797 68.4 12.4 17.8 5,807 63.1 14.0 20.5 11,604
Area
City Corporation slum 31.1 20.8 38.9 237 35.5 17.4 41.8 246 33.3 19.1 40.4 483
City Corporation non-slum 55.9 15.7 22.3 1,630 67.9 11.3 18.8 1,694 62.0 13.4 20.5 3,324
Other municipalities /urban 60.3 15.4 22.6 3,930 70.8 12.6 15.9 3,867 65.5 14.0 19.3 7,797
Division
Barisal 70.8 11.8 16.9 231 77.9 9.7 12.1 232 74.4 10.7 14.5 463
Chittagong 55.5 14.8 26.4 1,182 65.9 14.9 17.1 1,255 60.9 14.9 21.6 2,437
Dhaka 53.1 17.3 25.3 2,670 65.7 10.9 22.2 2,707 59.4 14.1 23.7 5,377
Khulna 69.1 13.1 17.3 491 73.9 13.1 11.9 446 71.4 13.1 14.7 937
Rajshahi 65.4 14.1 17.4 553 75.4 12.0 12.0 528 70.3 13.1 14.8 1,081
Rangpur 63.8 14.9 19.7 397 75.1 14.5 8.8 374 69.3 14.7 14.4 771
Sylhet 60.0 15.7 20.6 274 66.9 14.6 16.4 264 63.4 15.1 18.5 538
Age at beginning of school year
11 36.0 51.5 11.2 850 51.6 43.1 4.7 851 43.8 47.3 8.0 1,701
12 52.7 32.0 12.8 913 70.8 22.5 5.5 931 61.8 27.2 9.1 1,845
13 69.8 12.8 14.5 809 79.4 11.3 7.6 784 74.5 12.0 11.1 1,593
14 63.2 6.6 26.7 772 79.8 3.7 14.8 747 71.4 5.2 20.8 1,519
15 67.3 2.5 26.2 855 68.8 2.6 26.4 821 68.0 2.6 26.3 1,677
16 60.8 0.4 35.8 865 71.3 0.5 26.3 891 66.1 .5 31.0 1,757
17 56.5 0.0 37.3 732 58.3 0.0 41.4 781 57.4 0.0 39.4 1,513
123
Ch
ild D
evel
op
men
t, L
iter
acy
and
Ed
uca
tio
n
Table 7.6: continued Male Female Total
Net attendance
ratio (adjusted)
Percentage of children:
Number of
children
Net atten-dance ratio
(adjusted)
Percentage of children:
Number of
children
Net atten-dance ratio
(adjusted)
Percentage of children:
Number of
childrenAttending primary school
Out of schoola
Attending primary school
Out of schoola
Attending primary school
Out of schoola
Mother’s education
No education 34.6 29.2 29.7 813 51.0 33.6 12.9 720 42.3 31.2 21.8 1,533
Primary incomplete 42.8 31.4 24.5 654 63.4 23.4 12.8 658 53.1 27.4 18.7 1,311
Primary complete 52.6 30.3 15.1 374 70.5 21.7 6.9 402 61.9 25.8 10.8 776
Secondary incomplete 67.4 24.6 6.4 1,156 81.9 14.5 2.7 1,153 74.7 19.6 4.6 2,309
Secondary complete or higher 86.8 12.4 0.8 343 79.7 11.7 7.1 370 83.1 12.0 4.1 713
Wealth index quintile
Lowest 34.0 16.2 40.8 944 37.5 21.8 38.5 887 35.7 18.9 39.7 1,831
Second 36.8 20.4 37.7 1,134 55.9 15.8 26.1 1,111 46.3 18.1 32.0 2,245
Middle 57.3 17.3 24.1 1,403 75.3 11.1 13.1 1,272 65.9 14.4 18.9 2,675
Fourth 75.5 12.0 11.1 1,194 79.6 9.0 10.5 1,252 77.6 10.5 10.8 2,446
Highest 81.1 12.3 5.3 1,122 82.8 7.6 8.2 1,285 82.0 9.8 6.8 2,407
Religion
Islam 56.6 16.1 24.0 5,311 67.9 12.5 18.3 5,352 62.3 14.3 21.1 10,663
Hindu 70.6 11.9 14.8 460 74.0 11.5 13.5 411 72.2 11.7 14.2 871
Buddhist (*) (*) (*) 18 (*) (*) (*) 21 (*) (*) (*) 39
Christian (*) (*) (*) 8 (*) (*) (*) 20 (73.6) (9.4) (4.0) 28
a The percentage of children of primary school age out of school are those not attending school and those attending preschoolNote: Due to 3 unweighted cases, ‘Missing/DK’ category under ‘education’ is not shown(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted cases
Results also show that a high proportion (20.5 per cent) of secondary school age children were out of school, which includes 14.0 per cent who were still attending primary school. This was also evident from the NAR for children of secondary school entry age of 11 years, among whom NAR is 43.8 per cent, and 47.3 per cent were still attending primary schools.
As observed in Primary school net attendance ratio, Secondary school NAR was considerably low among male than female secondary school age children. It was 10 Percentage points higher for female children (68.4 per cent) than male (57.9 per cent). The secondary school NAR varied significantly by urban domains: it was only 33.3 per cent in CC slum areas, against 62.0 per cent in CC non-slums and 65.5 per cent in other urban areas. NAR at secondary was highest in Barisal (74.4 per cent), and lowest in Dhaka division (59.4 per cent).
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
124
Fig 7.3: Primary and Secondary School Net Attendance Ratio (adjusted) by areas, Bangladesh, CWS 2016
7.4.4 Children Reaching the Last Grade of Primary School
Children reaching the last grade of primary school, also known as the survival rate to the last grade of primary school, is defined as the Percentage of children attending the first grade of primary school who would be expected to reach the last grade of primary school, if current rates of transition from one grade of primary school to the next are applicable. In Bangladesh context, where primary school consists of 5 grades, this is calculated as the product of the following probabilities;
� The probability that a child completes the first grade and enters the second grade. � The probability that a child completes the second grade and enters the third grade. � The probability that a child completes the third grade and enters the fourth grade. � The probability that a child completes the fourth grade and enters the fifth grade
Using the information on the attendance to primary school for two school years (year 2016 and previous year 2015), calculation were carried out on the basis of a hypothetical cohort that is assumed to experience transition rates during the previous and current school year.
125
Ch
ild D
evel
op
men
t, L
iter
acy
and
Ed
uca
tio
n
Table 7.7: Children reaching last grade of primary school
Percentage of children entering first grade of primary school who eventually reach the last grade of primary school (Survival rate to last grade of primary school), Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Per cent attending grade
1 last school year who are in grade 2 this
school year
Per cent attending grade 2 last
school year who are attending grade 3 this school year
Per cent attending grade 3 last school
year who are attending grade 4 this school year
Per cent attending grade 4 last
school year who are attending grade 5 this school year
Per cent who reach grade 5 of those who enter grade
Total 98.8 99.0 98.4 98.4 94.7
Area
City Corporation slum 96.6 95.3 94.0 95.5 82.6
City Corporation non-slum 97.3 99.6 98.9 96.4 92.4
Other municipalities/urban 99.6 99.0 98.4 99.3 96.3
Division
Barisal 99.2 99.6 99.1 97.4 95.4
Chittagong 99.1 99.7 99.7 99.2 97.7
Dhaka 98.0 99.0 97.5 97.3 92.1
Khulna 100.0 98.8 99.5 99.7 98.0
Rajshahi 100.0 97.2 100.0 100.0 97.1
Rangpur 99.7 98.0 97.0 98.9 93.8
Sylhet 100.0 100.0 99.1 99.4 98.6
Sex
Male 98.2 98.2 98.0 98.2 92.8
Female 99.6 99.8 98.8 98.6 96.8
Mother’s education
No education 97.5 96.8 98.8 99.2 92.6
Primary incomplete 98.8 98.3 98.1 94.8 90.3
Primary complete 97.6 99.8 97.4 99.3 94.3
Secondary incomplete 99.5 99.7 99.1 99.6 97.9
Secondary complete or higher 100.0 100.0 100.0 100.0 100.0
Missing/DK 100.0
Wealth index quintile
Lowest 96.9 97.7 96.8 95.1 87.2
Second 98.8 97.8 98.2 98.0 92.9
Middle 100.0 99.7 98.4 98.3 96.5
Fourth 98.8 99.5 99.9 99.9 98.0
Highest 100.0 100.0 98.6 100.0 98.5
Religion
Islam 98.7 98.9 98.3 98.3 94.3
Hindu 100.0 100.0 99.7 99.6 99.3
Buddhist 100.0 100.0 100.0 100.0 100.0
Christian 100.0 100.0 100.0 98.4 98.4
Table 7.7 presents the Percentage of children entering first grade who eventually reach the last grade of primary school. It shows that of all urban children starting grade one, most of them (94.7 per cent) will eventually reach the last grade. Differentials by divisions and other characteristics were not significant, but variation by CC slums and CC non-slums areas was quite high (92.4 per cent in CC non-slums vs. 82.6 per cent in CC slums).
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
126
7.4.5 Primary School Completion and Transition to Secondary School
The primary school completion rate and transition rate to secondary education are presented in Table 7.8. The primary school completion rate is the ratio of the total number of students, regardless of age, entering the last grade of primary school (Class V in Bangladesh) for the first time, to the number of children of the primary graduation age (age 11 year) at the beginning of the current year school year (year 2016).
The transition rate to secondary education is the Percentage of children who were in the last grade of primary school during the previous year and who are attending the first grade of secondary school in the current year. The effective transition rate is similar to the transition rate, except that the denominator excludes repeaters.
Table 7.8 shows that the primary school completion rate was 87.5 per cent. More than nine in ten (97.2 per cent) of the children who were attending the last grade of primary in the previous year were found to be attending the first grade of secondary school in the current year (year 2016). The table also provides “effective” transition rate which takes account of the presence of repeaters in the final grade of primary school. The effective transition rate to secondary school was 97.3 per cent.
Fig 7.4: Primary school completion and transition to secondary school of those who completed primary by areas, Bangladesh, CWS 2016
Primary School Completion Rate (PSCR) was found to be significantly higher in other urban areas (92.8 per cent) compared to city corporation CC non-slums (77.4 per cent) and CC slums areas (73.1 per cent). The PSCR was the highest in Rajshahi division (99.4 per cent), and lowest in Dhaka (81.8 per cent). It was positively associated with Mother’s education and socio-economic status. Similar trend was noticed in the transition rate to secondary school, and also in the effective transition rate.
127
Ch
ild D
evel
op
men
t, L
iter
acy
and
Ed
uca
tio
n
Table 7.8: Primary school completion and transition to secondary school
Primary school completion rates and transition and effective transition rates to secondary school, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Primary school
completion rate
Number of children of primary
school completion
age
Transition rate to
secondary school
Number of children who were in the
last grade of primary school
the previous year
Effective transition
rate to secondary
school
No. of children who were in the last grade of primary school the
previous year and are not repeating that grade in the current
school year
Total 87.5 1,782 97.2 1,466 97.3 1,465
Area
City Corporation slum 73.1 77 92.5 41 92.5 41
City Corporation non-slum 77.4 513 98.5 394 98.5 394
Other municipalities/urban 92.8 1,191 96.8 1032 97.0 1,031
Division
Barisal 86.2 74 99.3 78 99.3 78
Chittagong 94.4 355 98.5 329 98.5 329
Dhaka 81.8 839 95.8 618 95.8 618
Khulna 88.8 153 95.2 129 96.1 128
Rajshahi 99.4 160 99.8 133 99.8 133
Rangpur 86.9 120 98.0 113 98.0 113
Sylhet 92.5 81 98.4 67 98.4 67
Sex
Male 83.7 943 96.0 675 96.0 675
Female 91.9 839 98.2 792 98.4 791
Mother’s education
No education 68.5 390 94.0 260 94.4 259
Primary incomplete 77.6 360 95.3 244 95.3 244
Primary complete 89.2 236 97.9 179 97.9 179
Secondary incomplete 100.0 594 99.6 514 99.6 514
Secondary complete or higher 81.4 201 99.0 186 99.0 186
Wealth index quintile
Lowest 66.9 366 93.7 191 93.7 191
Second 81.7 396 95.9 276 95.9 276
Middle 98.2 353 96.7 342 97.0 341
Fourth 84.5 374 99.2 355 99.2 355
Highest 100.0 293 98.7 303 98.7 303
Religion*
Islam 86.8 1,661 97.0 1,361 97.0 1,360
Hindu 100.0 106 100.0 96 100.0 96
Note: Due to 1 unweighted cases, ‘Missing/DK’ category under ‘education’ is not shown* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
7.4.6 Education Gender Parity
The ratio of girls to boys attending primary and secondary education is known as the Gender parity Index (GPI). The ratio of girls to boys attending primary and secondary education is provided in Table 7.9. The ratios included here are obtained from net attendance ratios rather than gross attendance ratios.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
128
The table shows that gender parity for primary school adjusted NAR (net attendance ratio) was 1.05 indicating an advantage in the attendance of girls over boys in primary school or higher. The index rises even higher to 1.18 for secondary education. The advantage of girls was obvious in almost all categories of children, and was particularly pronounced in children with less educated mothers and children from poorer households (lower quintiles).
Table 7.9: Education gender parity
Ratio of adjusted net attendance ratios of girls to boys, in primary and secondary school by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Primary school Secondary schoolPrimary school
adjusted net attendance ratio (NAR),
girls
Primary school
adjusted net attendance ratio (NAR),
boys
Gender parity index (GPI) for primary school adjusted NAR
Secondary school
adjusted net attendance ratio (NAR),
girls
Secondary school
adjusted net attendance ratio (NAR),
boys
Gender parity index (GPI)
for secondary school adjusted
NAR
Total 87.8 83.3 1.05 68.3 57.8 1.18
Area
City Corporation slum 69.7 69.2 1.01 35.5 31.1 1.14
City Corporation non-slum 86.9 83.0 1.05 67.9 55.8 1.22
Other municipalities/urban 89.4 84.3 1.06 70.6 60.2 1.17
Division
Barisal 93.9 85.2 1.10 77.9 70.8 1.10
Chittagong 86.7 79.3 1.09 65.9 55.5 1.19
Dhaka 87.0 82.5 1.06 65.6 52.9 1.24
Khulna 88.9 91.0 .98 73.9 69.0 1.07
Rajshahi 91.0 86.1 1.06 75.3 65.4 1.15
Rangpur 85.9 84.7 1.01 75.1 63.8 1.18
Sylhet 88.8 87.1 1.02 66.6 59.8 1.11
Mother’s education
No education 80.3 67.9 1.18 51.0 34.6 1.47
Primary incomplete 88.4 84.1 1.05 63.4 42.8 1.48
Primary complete 90.0 82.6 1.09 70.5 52.6 1.34
Secondary incomplete 90.4 88.1 1.03 81.9 67.4 1.21
Secondary complete or higher 87.7 88.0 1.00 79.7 86.8 0.92
Cannot be determineda na 100.0 na 100.0 0.0 na
Wealth index quintile
Lowest 82.5 72.7 1.13 37.5 34.0 1.10
Second 86.3 79.6 1.08 55.9 36.8 1.52
Middle 92.3 88.3 1.04 75.3 57.3 1.31
Fourth 92.9 88.5 1.05 79.6 75.1 1.06
Highest 84.9 86.7 0.98 82.4 81.1 1.02
Religion
Islam 87.5 82.6 1.06 67.8 56.5 1.20
Hindu 94.3 89.3 1.06 74.0 70.6 1.05
Buddhist 100.0 100.0 1.00 90.2 98.1 0.92
Christian 50.7 97.5 0.52 68.5 83.6 0.82
a Information on education of the mother’s/caretaker’s education was not collected for all children age 15 and abovena= Not available
129
Ch
ild D
evel
op
men
t, L
iter
acy
and
Ed
uca
tio
n
7.4.7 Out of School Gender Parity
Table 7.10 gives the Percentage of girls in the total out of school population, in both primary and secondary school. It shows that at the primary level girls account for 41.4 per cent of the out-of-school population; and the corresponding Percentage for secondary level was 43.6 per cent, showing that ‘Girls’ share increased by 2.3 Percentage point from primary to secondary school out of school population and that boys form the major share of the out of school children at both the levels.
Fig 7.5: Out of School Gender Parity by areas, Bangladesh, CWS 2016
Table 7.10: Out of school gender parity
Percentage of girls in the total out of school population, in primary and secondary school, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Primary school Secondary schoolPercen-tage of out of school
children
Number of
children of
primary school
age
Percen-tage of
girls in the total out of school
population of primary school age
Number of
children of
primary school
age out of school
Percen-tage of out of school
children
Number of
children of
secondary school
age
Percentage of girls in
the total out of school
population of secondary school age
Number of children of secondary
school age out of
school
Total 11.5 8,436 41.4 972 20.5 11,604 43.6 2378
AreaCity Corporation slum 20.2 375 50.5 76 40.4 483 52.6 195City Corporation non-slum 11.5 2,452 42.6 281 20.5 3,324 46.7 680Other municipalities/urban 11.0 5,610 39.7 615 19.3 7,797 41.0 1502
DivisionBarisal 8.2 344 26.9 28 14.5 463 41.9 67Chittagong 12.4 1,710 34.6 212 21.6 2,437 40.8 526Dhaka 12.6 4,031 41.7 506 23.7 5,377 47.1 1,276Khulna 8.5 646 58.0 55 14.7 937 38.5 138Rajshahi 10.1 794 41.7 80 14.8 1,081 39.6 160Rangpur 11.3 539 52.7 61 14.4 771 29.6 111Sylhet 7.7 372 42.9 29 18.5 538 43.3 100
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
130
Table 7.10: continued Primary school Secondary school
Percen-tage of out of school
children
Number of
children of
primary school
age
Percen-tage of
girls in the total out of school
population of primary school age
Number of
children of
primary school
age out of school
Percen-tage of out of school
children
Number of
children of
secondary school
age
Percentage of girls in
the total out of school
population of secondary school age
Number of children of secondary
school age out of
school
Mother’s education
No education 17.0 1,493 35.9 254 21.8 1,533 27.7 334
Primary incomplete 10.3 1,481 46.4 152 18.7 1,311 34.4 245
Primary complete 11.2 1,007 39.4 113 10.8 776 32.8 84
Secondary incomplete 10.0 3,323 42.5 331 4.6 2,309 29.5 105
Secondary complete or higher 10.8 1,123 45.2 121 4.1 713 (90.1) 29
Wealth index quintile
Lowest 15.7 1,643 41.5 258 39.7 1,831 47.0 727
Second 12.7 1,725 35.1 218 32.0 2,245 40.5 717
Middle 8.6 1,750 42.0 150 18.9 2,675 33.1 505
Fourth 8.0 1,671 39.4 134 10.8 2,446 49.9 264
Highest 12.8 1,647 48.5 211 6.8 2,407 64.1 165
Religion
Islam 11.9 7757 41.7 919 21.1 10,663 43.5 2,253
Hindu 7.6 614 27.6 47 14.2 871 44.9 123
Buddhist (*) 32 na na (*) 39 (*) na
Christian (17.7) 29 (*) 5 (4.0) 28 (*) 1
Note: Due to 3 unweighted cases, ‘Missing/DK’ category under ‘education’ is not shown(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted casesna= Not available
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
131
8 CHILD PROTECTIONUNICEF/UNI77811/Khatun
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
132
Key Findings:
� Almost all the mothers or caretakers of children under the age of 5 whose births have not been registered were aware of how to register a birth (99.7 per cent), but registration of birth is still not widely practiced with only 29.3 per cent of births registered. A huge gap between knowledge and practice persists across all domain irrespective of background characteristics in relation to registration of births.
� While violent methods (psychological or physical punishment) were common forms of discipline applied by household members for child discipline (82.4 per cent), only 35.4 per cent women actually approved physical punishment to bring, raise or educate a child properly.
� Overall, 12.4 per cent of urban children age 5-17 years were in child Labour, with 11.3 per cent in CC non-slums, 22.9 per cent in CC slums, and 9.7 per cent in other urban areas. It was the highest in Rangpur (15.3 per cent), and lowest in Barisal (7.7 per cent). As expected, proportion of children in child labour were higher as the age increased.
� Prevalence of Child Labour among children age 5-14 years was 8.1 per cent, with 7.0 per cent in non CC slums, 14.3 per cent in CC slums, and 8.2 per cent in other urban areas.
� About 22.5 per cent of women age 15-49 years were (first) married before the age of 15, with 20.0 per cent in CC non-slums, 28.1 per cent in CC slums and 23.4 per cent in other urban areas. Among the women aged 20-49 years, the proportion who married before the age of 18 was 59.7 per cent, with 53.3 per cent in CC non-slums, 66.4 per cent in CC slums, and 62.3 per cent in other urban areas.
� Polygamy is not common among urban women of Bangladesh. Overall, 2.8 per cent of women aged 15-49 years were in polygynous union. Only 1.0 per cent of the youngest women aged 15-19 were in polygynous union as compared to 4.8 per cent of the oldest (aged 45-49).
� About 4.7 per cent of urban children age 0-17 years were living with neither of biological parents, with 4.4 per cent in CC non-slums, 4.4 per cent in CC slums and 4.9 per cent in other urban areas.
Child protection refers to the protection of children from violence, exploitation, abuse and neglect. UNICEF defines a “Child Protection System” as: the set of laws, policies, regulation and services needed across all social sectors ---- especially social welfare, education, health, security and justice --- to support prevention and response to protection related risks.
This section discusses certain issues which are important for the protection of children and for ensuring their universally accepted rights. The issues/topics considered are birth registration, child discipline, attitude towards physical punishment, involvement of children in economic and household activities, child labour, living arrangement, orphanhood, early marriage and other related issues.
8 CHILD PROTECTION
133
8.1 Birth RegistrationTo make every girls and boy visible in the eyes of the law is to provide them with a first form of legal identity, a birth certificate. A birth certificate is a proof of age to access services like issuance of passport, admission into school, receiving social or other benefits and marriage registration. Unfortunately, 230 million children around the world have not had their births registered, while more than 100 developing countries don’t have well-functioning system in place to register key events, like births, deaths and marriages. In Bangladesh, the Birth and Death Registration Act 2004 provides a legal basis for mandatory birth registration. Local government administrations facilitates births and deaths registration. An online Birth Registration Information System (BRIS) had been introduced in 2009, which allows local registrar nationwide and Embassies abroad to register births and deaths and issue official certificates through a wave-based application.
Table 8.1: Birth registration
Percentage of children under age 5 by whether birth is registered and Percentage of children not registered whose mothers/caretakers know how to register birth by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Children under age 5 whose birth is registered with civil authorities
Number of
children under age 5
Children under age 5 whose birth is not registered
Has birth certificate No birth certificate
Total regis-tered
Per cent of children whose mother/caretaker knows
how to register birth
Number of children under age 5 without
birth registrationSeen Not seen
Total 15.3 13.1 0.9 29.3 7,521 99.7 5,320
AreaCity Corporation slum 13.0 18.5 1.4 32.9 336 100.0 225City Corporation non-slum 14.1 18.1 1.1 33.2 2,242 99.7 1,497Other municipalities/urban 16.0 10.4 0.7 27.2 4,943 99.7 3,598
DivisionBarisal 15.4 10.6 0.2 26.3 318 99.4 234Chittagong 19.5 14.1 0.7 34.3 1,562 99.4 1,026Dhaka 13.3 15.0 1.0 29.3 3,580 99.8 2,530Khulna 14.1 9.6 0.9 24.5 542 99.7 409Rajshahi 16.3 7.3 0.8 24.5 695 100.0 525Rangpur 13.8 11.0 0.5 25.3 487 99.6 364Sylhet 19.5 10.8 0.7 31.0 337 99.6 232
SexMale 15.6 12.7 1.1 29.4 3,783 99.9 2,671Female 15.1 13.5 0.6 29.1 3,738 99.5 2,649
Age0-11 months 6.0 7.8 0.8 14.6 1,382 99.5 1,18012-23 months 10.0 11.8 0.2 22.0 1,521 99.8 1,18724-35 months 17.7 13.3 0.4 31.4 1,534 100.0 1,05236-47 months 17.4 16.5 1.1 34.9 1,511 99.6 98448-59 months 24.4 15.5 1.8 41.7 1,573 99.7 917
Mother’s educationNo education 13.5 13.4 0.3 27.1 693 100.0 505Primary incomplete 11.0 11.7 1.2 23.9 1,077 100.0 819Primary complete 15.1 10.7 1.0 26.8 751 99.5 550Secondary incomplete 16.4 13.4 0.9 30.7 3,677 99.6 2,547Secondary complete or higher 16.8 14.7 0.6 32.1 1,324 99.7 899
Wealth index quintileLowest 11.2 14.7 0.5 26.3 1,563 99.9 1,151Second 11.9 12.3 0.8 25.1 1,388 99.9 1,040Middle 16.9 9.3 0.8 26.9 1,474 99.3 1,077Fourth 17.2 15.2 0.8 33.2 1,686 99.9 1,126Highest 19.4 13.5 1.5 34.4 1,410 99.4 925
Religion*Islam 15.2 12.9 0.8 29.0 6,909 99.7 4,905Hindu 16.1 14.7 1.4 32.2 558 99.9 378
* Figures for Buddhist and Christian religion have been suppressed from the table due to a small number of unweighted cases
Ch
ild P
rote
ctio
n
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
134
Based on the data collected in the CWS 2016, Percentage of urban children under age 5 by whether birth was registered, and Percentage of non-registered children whose mothers/caretakers knew how to register births were calculated and presented in Table 8.1. It shows that about three in ten (29.3 per cent) births of children under 5 years of age in urban areas of Bangladesh had been registered. Overall, 28.4 per cent of the children possessed a birth certificate, though the certificate could be seen for only 15.3 per cent. Birth registration was almost at the same level in CC non-slums (33.2 per cent) and CC slums (32.9 per cent) and was lower in other urban areas (27.2 per cent). This prevalence was highest in Chittagong (34.3 per cent), and lowest in Rajshahi division (24.5 per cent). Registration of births becomes more likely as a child grows older, and peaks at age 4 to 41.7 per cent.
Lack of knowledge about how and where birth should be registered may hamper the fulfillment of a child’s right to identity. Data in Table 8.1 also shows that almost all of mothers/caretakers (99.7 per cent) of unregistered children were aware of how to register births. Prevalence of this awareness/knowledge was almost identical in all the areas and divisions, irrespective of education and socio-economic status of mothers/caretakers. This shows a huge gap between level of awareness/knowledge and putting knowledge into practice in relation to birth registration.
Fig 8.1: Percentage of children under age five whose births are registered, Bangladesh, CWS 2016
135
Ch
ild P
rote
ctio
n
8.2 Child DisciplineEvery parent wants their children to be happy, respectful, respected by others, and able to find their place in the society as well-behaved adults when they grow up. But sometimes these goals remain miles away for child’s behavior. Child discipline is the process of teaching a child what type of behavior is acceptable and what type is not acceptable. In other words, discipline teaches a child to follow rules. Loving and supportive family environment enhance discipline. Sometimes, punishment may be an effective tool, but that does not mean that good discipline is mostly about punishments. Research shows that exposing children to violent discipline have harmful consequences. Violence hampers children’s development, learning attitude and school performance.
Table 8.2: Child discipline
Percentage of children age 1-14 years by child disciplining methods experienced during the last one month by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Percentage of children age 1-14 years who experienced: Number of children age 1-14 years
Only non-violent discipline
Psychological aggression
Physical punishment Any violent discipline methodAny Severe
Total 13.1 72.1 55.9 17.6 82.4 21,038
AreaCity Corporation slum 10.4 74.2 62.6 23.3 84.9 888City Corporation non-slum 13.6 67.4 59.1 18.9 81.9 6,249Other municipalities/urban 13.0 74.1 54.0 16.7 82.5 13,901
DivisionBarisal 15.2 75.1 50.9 15.3 80.6 883Chittagong 12.7 75.5 55.7 18.6 83.6 4,246Dhaka 13.1 67.9 58.2 18.7 81.6 10,051Khulna 11.1 76.0 52.6 16.2 83.3 1,600Rajshahi 11.9 79.5 57.3 18.6 85.6 1,962Rangpur 16.8 72.0 43.2 7.6 80.0 1,356Sylhet 13.5 76.2 58.4 18.6 82.9 940
SexMale 11.5 74.4 58.8 19.5 84.0 10,532Female 14.6 69.7 53.1 15.7 80.8 10,506
Age1-2 13.7 57.8 49.1 11.2 71.9 2,7063-4 9.2 72.5 68.1 22.3 86.2 3,1565-9 10.2 77.2 63.9 20.2 87.9 7,50210-14 17.3 72.0 45.5 15.4 79.1 7,675
Education of household headNo education 9.5 74.1 67.1 22.3 86.8 5,373Primary incomplete 11.4 76.7 60.9 19.9 86.8 8,544Primary complete 11.8 68.8 20.9 7.0 73.9 120Secondary incomplete 20.4 69.4 37.2 11.5 75.2 4,286Secondary complete or higher (*) (*) (*) (*) (*) 5
Wealth index quintileLowest 8.7 77.3 63.5 23.7 86.3 3,992Second 11.8 73.8 59.6 20.1 84.0 4,200Middle 10.3 76.5 59.4 17.1 86.5 4,345Fourth 14.6 69.6 55.0 17.6 81.6 4,373Highest 20.0 63.3 42.1 9.9 73.5 4,129
ReligionIslam 12.8 72.3 56.2 17.9 82.7 19,299Hindu 15.0 70.1 53.1 13.8 79.3 1,583Buddhist (41.6) (58.0) (32.5) (6.6) (58.0) 81Christian 10.9 72.9 64.0 25.9 88.7 65
Note: Due to 1 unweighted cases, ‘Missing/DK’ category under ‘education’ is not shown(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
136
In the CWS 2016, respondents were asked a series of questions on the methods adults in the household used to discipline a (randomly selected) child of the household age 1-14 years during the past month preceding the survey. Results in Table 8.2 show that more than four in every five (82.4 per cent) children age 1-14 years were subjected to at least one form of psychological or physical punishments by household members during the past month. This matches closely with findings from other surveys.
A combination of disciplinary practices were prevalent, while 72.1 per cent of children experienced psychological aggression, 55.9 per cent experienced physical punishment of any form, and about one-fifth (17.6 per cent) faced severe physical punishment. Severe form of physical punishment included hitting the child on the head, ears, face, or hitting the child hard and repeatedly. Practice of only non-violent discipline was very low (13.1 per cent).
Fig 8.2: Percentage of child disciplining methods by areas, Bangladesh, CWS 2016
Boys and girls of all urban domains (slums, CC non-slums, and other urban areas), divisions and wealth quintiles, irrespective of mothers’ education level, experienced virtually the same level of violent discipline. Children in the age groups 5-9 and 3-4 years were most likely to experience violent discipline (87.9 and 86.2 per cent, respectively).
8.3 Attitude towards Physical PunishmentThe survey also collected information regarding attitude of women towards physical punishment as a method of child discipline. Table 8.3 presents Percentage of women who believe that physical punishment is needed to bring up, raise, or educate a child properly by selected background characteristics. Figure 8.3 shows the rates for the different divisions.
137
Ch
ild P
rote
ctio
n
Fig 8.3: Percentage of respondents to the child discipline module who believe that physical punishment is needed by division, Bangladesh, CWS 2016
Table 8.3: Attitudes toward physical punishment
Percentage of respondents to the child discipline module who believe that physical punishment is needed to bring up, raise, or educate a child properly by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Respondent believes that a child needs to be physically punished
Number of respondents to the child discipline module
Total 35.4 12,167
Area
City Corporation slum 37.8 495
City Corporation non-slum 34.4 3,679
Other municipalities/urban 35.7 7,993
Division
Barisal 33.5 512
Chittagong 23.9 2,230
Dhaka 41.1 5,878
Khulna 36.7 1,064
Rajshahi 43.7 1,250
Rangpur 12.1 789
Sylhet 34.4 444
Sex
Male 28.1 629
Female 35.8 11,538
Age
<25 33.0 1,837
25-39 37.1 7,483
40-59 32.7 2,591
60+ 30.5 257
Respondent’s relationship to selected child
Mother 30.7 475
Father 36.2 9,996
Other 32.2 1,696
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
138
Table 8.3: continued Respondent believes that a child needs to
be physically punishedNumber of respondents to the child discipline
module
Respondent’s education
No education 40.8 2,068
Primary incomplete 43.4 2,002
Primary complete 37.6 1,278
Secondary incomplete 34.9 5,004
Secondary complete or higher 20.4 1,815
Wealth index quintile
Lowest 41.0 2,279
Second 39.3 2,488
Middle 38.8 2,490
Fourth 33.2 2,509
Highest 24.9 2,403
Religion
Islam 36.1 11,057
Hindu 29.4 1,002
Buddhist (19.8) 55
Christian 29.9 49
Note: Due to 2 unweighted cases, ‘Missing/DK’ category under ‘education’ is not shown ( ) Figures that are based on 25-49 unweighted cases
Table 8.3 shows that, while violent methods were common forms of discipline applied by household members for child discipline (82.4 per cent), only 35.4 per cent respondents actually approved physical punishment to bring, raise or educate a child properly. This attitude prevailed almost equally in CC non-slums, CC slums or in other urban areas, but varied greatly by division, mother’s education and socio-economic status of respondents. More fathers (36.2 per cent) than mothers (30.7 per cent) approved of physical punishment. About 43.7 per cent women of Rajshahi division were in favour of physical punishment, against only 12.1 per cent of Rangpur division. Women with a higher level of education were less likely to be in favour of physical punishment. For example, 20.4 per cent of women with secondary or higher level of education favoured it, against 40.8 per cent among those who did not have any education. This approval rate was 24.9 per cent among women of highest wealth quintile versus 41.0 per cent of lowest quintile.
8.4 Child LabourChild labour is, generally speaking, work by children that hampers them or exploits them in some way (physically, mentally, morally or by blocking their access to education).
There is no universally accepted definition of child labour. `Child and Childhood’ are defined differently by different culture. Children age 5-17 are not expected to work, rather this is the age for developing and preparing themselves for work in the future through education. Unfortunately, according to International Labour Organization (ILO), worldwide 215 million children age below 18 work, many fulltime. In sub Saharan Africa, 1 in 4 children aged 5-17 work, compared to 1 in 8 in Asia Pacific, and 1 in 10 in Latin America. Child Labour also prevails in Bangladesh.
139
Ch
ild P
rote
ctio
n
In the CWS 2016, a child labour module was administered for children aged 5-17 years and information was collected about their involvement and extent of involvement in economic activities, household chores, and work in hazardous conditions. Economic activity was defined as any of the following activities: work in agriculture, gardening, taking care of domestic animals, assisting in business (own or relative), production or sale of handicrafts, cloths, food or agriculture items and other such items or goods.
Household chores was defined as any of the following: collection of water and fuel for household, household purchase, repair of household items, cooking and cleaning of utensils and house, washing of clothes, child care, care for elderly household members and such other household works.
For assessing child labour the following three age-specific thresholds for the number of hours a child can perform economic activity without it being classified as Child Labour were used. A child that performed economic activities during the last one week for more than the age specific number of hours was classified as in child labour:
For age 5-11 years : 1 hour or more
For age 12-14 years : 14 hours or more and
For age 15-17 years : 43 hours or more
Similarly, child labour used two age-specific thresholds for the number of hours a child can perform household chores without being classified as Child Labour. A child that performed household chores during the last week for more than the age-specific number of hours was classified as in child labour:
For age 5-11 and age 12-14 years : 28 hours or more
And for age 15-17 years : 43 hours or more
Besides, if a child works under hazardous condition, it falls in child labour.
8.4.1 Children’s Involvement in economic activities
Table 8.4 gives Percentage of children age 5-11years, 12-14 years, and 15-17 years by their involvement in economic activities in hours during the last one week. Among the children as young as 5-11 years of age, 7.1 per cent were involved in economic activity for at least one hour in the last one week. Children of CC non-slum areas were less likely to be involved in economic activities for at least one hour (4.9 per cent) than children of CC slum areas (8.7 per cent). This varied greatly by divisions; 9.5 per cent of 5-11 years old children of Khulna division, 9.4 per cent in Rajshahi were at the higher end against 4.7 per cent of Barisal as per their involvement in economic activities.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
140
Table 8.4: Children’s involvement in economic activities
Percentage of children by involvement in economic activities during the last week, according to age groups by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Percentage of children age 5-11 years involved in economic
activity for at least one hour
Num-ber of
children age 5-11
years
Percentage of children age 12-14 years involved in:
Num-ber of
children age 12-14 years
Percentage of children age 15-17 years involved in:
Num-ber of
children age 15-17 years
Economic activity less
than 14 hours
Economic activity for 14 hours or
more
Economic activity less
than 43 hours
Economic activity for 43 hours or
more
Total 7.1 8,065 11.0 8.1 2,783 17.5 9.4 3,027
AreaCity Corporation slum 8.7 328 13.2 23.0 108 23.5 20.7 128City Corporation non-slum 4.9 2,363 8.8 8.5 837 16.9 10.8 831Other municipalities/urban 8.0 5,375 11.9 7.1 1,838 17.4 8.1 2,068
DivisionBarisal 4.7 357 7.2 3.8 121 17.5 2.9 115Chittagong 5.5 1,540 9.1 6.2 553 13.0 10.0 612Dhaka 7.3 3,895 10.5 10.5 1,260 16.2 12.2 1,416Khulna 9.5 658 15.7 4.1 245 24.4 4.6 264Rajshahi 7.4 796 12.2 6.8 285 24.5 5.7 306Rangpur 9.4 496 14.0 8.3 197 21.1 4.5 192Sylhet 6.3 322 12.4 8.0 121 18.0 6.0 122
SexMale 7.9 4,077 11.5 12.0 1,450 20.4 12.4 1,514Female 6.4 3,988 10.5 3.9 1,333 14.7 6.3 1,513
School attendanceYes 7.1 6,521 10.8 2.4 2,398 14.7 1.8 2,090No 7.3 1,544 12.3 43.6 385 23.7 26.2 937
Mother’s educationNo education 5.0 1,643 23.1 27.3 78 8.6 38.9 64Primary incomplete 7.4 5,571 11.1 22.8 604 28.9 34.9 279Primary complete 76.3 30 18.3 33.2 51 37.1 23.0 120Secondary incomplete 6.9 821 10.4 2.4 2,041 15.4 3.1 1,989Secondary complete or higher na na (0.0) (8.1) 5 (14.5) (3.7) 33
Wealth index quintileLowest 10.6 1,534 16.8 19.5 441 21.2 16.7 439Second 9.5 1,759 10.0 13.8 479 22.7 22.0 571Middle 6.5 1,702 17.1 5.3 609 20.0 8.5 711Fourth 5.8 1,551 9.3 2.6 615 15.9 3.3 628Highest 2.9 1,519 3.7 4.0 639 9.6 0.5 678
ReligionIslam 6.8 7,348 11.2 8.3 2,518 17.5 9.6 2,752Hindu 8.6 633 9.2 7.0 246 18.4 7.6 257Buddhist (*) 40 (*) (*) 13 (*) (*) 13Christian (42.0) 38 (*) (*) 7 (*) (*) 5
(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted casesna= not available
As expected, proportions of children involved in economic activities were higher as the age increased. About 8.1 per cent of children age 12-14 years were involved in economic activities for 14 hours or more and therefore in Child labour. Proportion in child labour among 12-14 years old children was very high in CC slums (23.0 per cent), compared to CC non-slums (8.5 per cent) and other municipal areas (7.1 per cent). Again, this was highest in Dhaka (10.5 per cent), and lowest in Barisal (3.8 per cent). It was higher among male (12.0 per cent) than among female (3.9 per cent); primarily among those not attending school (43.6 per cent) than
141
Ch
ild P
rote
ctio
n
those who are in school (2.4 per cent); and also among those in lowest wealth quintile (19.5 per cent) compared to those in the richest households (4.0 per cent in highest quintile).
Overall, 9.4 per cent of children age 15-17 years were involved for more than 43 hours in the last week in economic activities and, therefore, one in ten children (9.4 per cent) were in child labour. Again, this varied greatly by urban domains, division, sex of children, schooling status, mother’s education, and socio economic status. It was very high in CC slums (20.7 per cent) compared to CC non-slums (10.8 per cent) and other urban areas (8.1 per cent). Among the divisions, this was highest in Dhaka (12.2 per cent), and lowest in Barisal (2.9 per cent). About 12.4 per cent of male against 6.3 per cent of female, 26.2 per cent of not in school children against only 1.8 per cent of those attending school, and 16.7 per cent in the lowest quintile against only 0.5 per cent in the richest quintile worked for 43 or more hours for earning income or benefits.
8.4.2 Children’s Involvement in Household Chores
Table 8.5 provides Percentage of children age 5-11years, age 12-14 years and age 15-17 years by their involvement in household chores during the last one week, according to age groups and hours of involvement by selected characteristics. It shows that, child labour, as per thresholds described above for child labour on account of involvement (with duration) in household chores, was negligible across all age groups: 5-11, 12-14 and 15-17 years of age.
Table 8.5: Children’s involvement in household chores
Percentage of children by involvement in household chores during the last week, according to age groups by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Percentage of children age 5-11 years involved in:
Number of
children age 5-11
years
Percentage of children age 12-14 years involved in:
Number of
children age 12-14
years
Percentage of children age 15-17 years involved in:
Number of
children age 15-17
years
House-hold
chores less than 28 hours
House-hold
chores for 28
hours or more
House-hold
chores less than 28 hours
House-hold
chores for 28
hours or more
House-hold
chores less than 43 hours
House-hold
chores for 43
hours or more
Total 52.9 0.4 8,065 72.4 1.7 2,783 77.6 1.3 3,027
Area
City Corporation slum 60.5 1.2 328 77.1 3.1 108 80.2 2.7 128
City Corporation non-slum 45.9 0.5 2,363 60.7 2.7 837 75.8 2.6 831
Other municipalities/urban 55.5 0.3 5,375 77.5 1.2 1,838 78.2 0.7 2,068
Division
Barisal 46.5 0.2 357 79.3 0.5 121 77.4 0.6 115
Chittagong 53.0 0.7 1,540 75.9 0.7 553 75.1 1.1 612
Dhaka 49.9 0.5 3,895 66.4 2.6 1,260 76.0 1.3 1,416
Khulna 72.6 0.0 658 88.6 1.5 245 89.2 2.4 264
Rajshahi 58.9 0.0 796 74.1 1.4 285 76.5 1.5 306
Rangpur 50.4 0.0 496 75.8 0.0 197 81.4 1.4 192
Sylhet 44.2 0.5 322 70.4 2.8 121 81.3 1.2 122
Sex
Male 47.1 0.1 4,077 65.0 0.5 1,450 66.1 0.4 1,514
Female 58.7 0.7 3,988 80.6 3.1 1,333 89.1 2.3 1,513
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
142
Table 8.5: continued
Percentage of children age 5-11 years involved in:
Number of
children age 5-11
years
Percentage of children age 12-14 years involved in:
Number of
children age 12-14
years
Percentage of children age 15-17 years involved in:
Number of
children age 15-17
years
House-hold
chores less than 28 hours
House-hold
chores for 28
hours or more
House-hold
chores less than 28 hours
House-hold
chores for 28
hours or more
House-hold
chores less than 43 hours
House-hold
chores for 43
hours or more
School attendanceYes 56.7 0.2 6,521 74.6 0.9 2,398 76.8 0.3 2,090No 36.5 1.3 1,544 59.1 7.2 385 79.4 3.6 937
Mother’s educationNo education 34.9 0.4 1,643 29.9 13.9 78 46.5 0.9 64Primary incomplete 56.9 0.5 5,571 74.0 2.1 604 83.2 1.4 279Primary complete (*) (*) 30 61.0 15.4 51 83.5 0.6 120Secondary incomplete 62.7 0.0 821 73.9 0.8 2,041 75.6 0.3 1,989Secondary complete or higher Na Na na (*) (*) 5 (49.9) (0.0) 33
Wealth index quintileLowest 60.2 0.7 1,534 79.7 1.0 441 83.5 1.0 439Second 53.8 0.5 1,759 71.4 2.2 479 79.9 2.1 571Middle 55.0 0.1 1,702 80.5 1.8 609 81.1 1.2 711Fourth 52.3 0.1 1,551 70.8 0.5 615 77.0 1.2 628Highest 42.5 0.7 1,519 62.0 3.1 639 68.7 1.1 678
ReligionIslam 53.0 0.4 7,348 71.8 1.9 2,518 77.4 1.4 2,752Hindu 50.4 0.0 633 77.5 0.0 246 78.8 0.8 257Buddhist (*) (*) 40 (*) (*) 13 (*) (*) 13Christian (62.5) (62.5) 38 (*) (*) 7 (*) (*) 5
(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted casesna= not available
8.4.3 Total Child Labour
According to the definition of `Child Labour’ as stated earlier and considering their involvement and extent in economic activity, household chores, and work under hazardous condition, total child labour was estimated.
Table 8.6: Child labour
Percentage of children age 5-17 years by involvement in economic activities or household chores during the last week, Percentage working under hazardous conditions during the last week, and Percentage engaged in child labour during the last week according to selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Children involved in economic activities for a total number of
hours during last week:
Children involved in household chores for a total number of
hours during last week:
Children working under
hazardous conditions
Total child
labour
Number of children age 5-17
yearsBelow the age specific threshold
At or above the age specific
threshold
Below the age specific threshold
At or above the age specific
threshold
Total 7.7 8.5 63.6 0.8 9.8 12.9 19,370
AreaCity Corporation slum 10.3 15.1 69.1 2.1 19.2 23.1 833City Corporation non-slum 6.1 8.3 55.8 1.3 8.6 12.0 5,541Other municipalities/urban 8.1 8.1 66.5 0.5 9.7 12.6 12,996
143
Ch
ild P
rote
ctio
n
Table 8.6: continued Children involved in economic
activities for a total number of hours during last week:
Children involved in household chores for a total number of
hours during last week:
Children working under
hazardous conditions
Total child
labour
Number of children age 5-17
yearsBelow the age specific threshold
At or above the age specific
threshold
Below the age specific threshold
At or above the age specific
threshold
Division
Barisal 5.8 5.0 60.3 0.3 5.2 8.1 801
Chittagong 5.9 6.8 65.3 0.6 9.3 11.3 3,987
Dhaka 7.1 10.1 59.7 1.1 10.6 14.0 9,028
Khulna 11.5 7.3 81.1 0.7 8.3 12.8 1,562
Rajshahi 9.4 7.2 66.8 0.7 8.6 11.5 1,871
Rangpur 10.5 8.7 64.1 0.2 12.1 15.4 1,245
Sylhet 8.4 6.8 60.2 1.1 9.4 12.0 877
Sex
Male 8.0 10.9 55.4 0.3 12.4 15.3 9,768
Female 7.3 6.0 72.0 1.3 7.1 10.4 9,602
Age
5-11 1.3 7.5 53.1 0.4 4.3 7.9 10,161
12-14 11.5 9.0 73.0 1.5 12.8 15.0 4,693
15-17 18.1 10.2 77.5 1.2 19.0 21.8 4,516
School attendance
Yes 6.8 5.0 65.8 0.3 5.3 8.1 15,359
No 10.8 21.9 55.3 2.7 27.0 31.2 4,011
Mother’s education
No education 2.8 9.7 35.7 1.2 9.0 11.7 2,292
Primary incomplete 3.9 11.2 60.6 0.6 9.6 13.5 8,612
Primary complete 29.4 32.4 71.1 4.6 50.2 59.9 306
Secondary incomplete 11.7 3.6 73.4 0.4 7.5 9.1 7,470
Secondary complete or above 12.3 3.5 54.8 0.0 3.3 5.9 47
Wealth index quintile
Lowest 9.6 14.5 69.3 0.8 17.9 20.6 3,381
Second 8.3 14.2 63.9 1.2 14.7 19.5 3,870
Middle 10.1 7.4 68.0 0.6 9.0 12.6 4,269
Fourth 6.4 4.9 62.4 0.3 5.6 8.4 3,935
Highest 3.9 2.4 54.7 1.2 3.0 4.4 3,915
Religion
Islam 7.8 8.4 63.5 .9 10.0 12.9 17,724
Hindu 6.8 8.4 64.5 .2 7.8 11.8 1,502
Buddhist (7.8) (5.2) (67.0) (0.0) (7.8) (13.0) 79
Christian 0.1 31.0 70.1 0.0 .3 31.1 57
( ) Figures that are based on 25-49 unweighted cases
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
144
Table 8.6a: Child labour
Percentage of children age 5-14 years by involvement in economic activities or household chores during the last week, and Percentage engaged in child labour during the last week according to selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
All Survey areas Number of children (5-14) years agedCity Corporation slum City Corporation non-
slumOther municipalities/urban
Total 8.1 14.3 7.0 8.2 13,316
Division
Barisal 5.4 3.3 5.9 576
Chittagong 6.1 10.8 5.1 5.9 2,653
Dhaka 9.3 17.6 8.1 9.5 6,294
Khulna 7.7 10.3 2.5 9.0 1,056
Rajshahi 7.0 6.8 5.6 7.1 1,301
Rangpur 9.9 9.9 4.4 10.7 848
Sylhet 7.5 0.0 10.2 6.2 588
Table 8.6 gives Percentage of children age 5-17 years by their involvement in economic activities or in household chores during the last week, Percentage working under hazardous conditions during the last week, and Percentage engaged in child labour during the last week, according to selected characteristics. Overall, 8.5 per cent of children age 5-17 years were involved in economic activities for a total number of hours during the last week at or above the age specific thresholds (for child labour), and only 0.8 per cent for involvement in household chores. About 9.8 per cent of 5-17 years old children reported of working under hazardous conditions in the last week preceding the survey.
Fig 8.4: Percentage engaged in child labour by areas, Bangladesh, CWS 2016
Considering involvement of children age 5-17 years in economic activities, household chores and work under hazardous condition, the total child labour was estimated at 12.9 per cent. As expected, this was more prevalent in CC slums (23.1 per cent) than other areas. Among divisions it was most prevalent in Rangpur division (15.4 per cent). The proportions in the age
145
Ch
ild P
rote
ctio
n
group 15-17 years was more (21.8 per cent). Child labour more common among children 5-17 years that were not attending school (31.2 per cent) than those attending. Children from the lowest or poorest wealth quintile were more into child labour (20.6 per cent) than those from the richest (4.4 per cent).
Considering involvement of children age 5-14 years in economic activities and household chores in the last week at or above the age specific thresholds (for child labour), Table 8.6a shows that prevalence of child labour was 8.1 per cent, with 7.0 per cent in CC non-slums as compared to 14.3 per cent in CC slums. Figure 8.4 shows prevalence of child labour among children age 5-14 years and age 5-17 years.
8.5 Early marriage and PolygamyMarriage before the age of 18 years for girls is considered as early marriage or child marriage. The legal minimum age at marriage for girls is also 18 years in Bangladesh. However, for various reasons, a high proportion of girls get married in their childhood, and this is common in many countries including Bangladesh. Child marriage (or early marriage) is a violation of human rights, compromising the development, education, and skills of girls for self-reliance. Early marriage often results in early pregnancy that may contribute in high maternal deaths.
Information about early marriage in urban areas of Bangladesh is provided in Table 8.7. It gives proportion of women age 15-49 years who first married or entered a marital union before their 15th birthday, proportion of women age 20-49 years who first married or entered a marital union before their 15th and 18th birth days, Percentage of women age 15-19 years currently married or in union, and the Percentage of women who are in a polygynous marriage or union by selected characteristics.
Table 8.7: Early marriage and polygyny (women)
Percentage of women age 15-49 years who first married or entered a marital union before their 15th birthday, Percentages of women age 20-49 years who first married or entered a marital union before their 15th and 18th birthdays, Percentage of women age 15-19 years currently married or in union, and the Percentage of women who are in a polygynous marriage or union by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Women age 15-49 years
Women age 20-49 years Women age 15-19 years
Women age 15-49 years
Percen-tage
married before age 15
Number of women age 15-49
years
Percen-tage
married before age 15
Percen-tage
married before age 18
Number of women age 20-49
years
Percen-tage
currently married/in union
Number of women age 15-19
years
Percen-tage in polygy-
nous marriage/
union
Number of women age 15-49 years
currently married/in
union
Total 22.5 24525 26.7 59.7 19983 32.9 4542 2.8 20359
AreaCity Corporation slum 28.1 1015 33.2 66.4 807 34.8 208 4.4 844City Corporation non-slum 20.0 7658 23.8 53.3 6286 32.9 1372 2.4 6194Other municipalities/urban 23.4 15853 27.7 62.3 12890 32.7 2962 3.0 13320
DivisionBarisal 22.7 959 26.9 61.9 788 31.9 172 1.8 817Chittagong 18.7 4742 22.7 56.2 3813 23.5 929 1.8 3804Dhaka 22.6 11544 26.7 60.3 9383 36.4 2161 3.3 9658Khulna 30.2 2158 35.6 65.9 1771 40.9 387 3.0 1855Rajshahi 25.0 2513 28.9 62.6 2098 37.6 415 3.2 2152Rangpur 25.3 1637 29.9 61.8 1354 29.0 283 2.3 1350Sylhet 12.3 971 14.9 40.4 777 18.1 195 2.7 724
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
146
Table 8.7: continued Women age 15-49
yearsWomen age 20-49 years Women age 15-19
yearsWomen age 15-49 years
Percen-tage
married before age 15
Number of women age 15-49
years
Percen-tage
married before age 15
Percen-tage
married before age 18
Number of women age 20-49
years
Percen-tage
currently married/in union
Number of women age 15-19
years
Percen-tage in polygy-
nous marriage/
union
Number of women age 15-49 years
currently married/in
union
Age
15-19 4.0 4542 na na na 32.9 4542 1.0 1640
20-24 12.2 4048 12.2 41.8 4048 na na 1.5 3162
25-29 24.3 4290 24.3 54.7 4290 na na 2.2 4030
30-34 29.2 3448 29.2 64.1 3448 na na 3.0 3380
35-39 30.4 3062 30.4 65.5 3062 na na 3.6 3034
40-44 34.3 2262 34.3 68.8 2262 na na 3.5 2247
45-49 38.1 2874 38.1 73.5 2874 na na 4.8 2867
Education
No education 40.8 3570 42.2 77.8 3427 38.5 143 8.0 3428
Primary incomplete 34.1 3521 38.4 73.5 3081 36.2 440 4.5 3189
Primary complete 33.7 2279 37.0 72.0 2044 44.7 236 1.9 2106
Secondary incomplete 17.4 11057 22.7 60.8 7879 28.2 3178 1.3 8572
Secondary complete or higher 4.1 4095 4.7 20.6 3550 50.7 545 0.2 3061
Wealth index quintile
Lowest 27.2 4102 31.9 69.2 3345 41.4 756 6.5 3597
Second 27.3 4543 32.8 67.2 3683 40.4 861 3.8 3929
Middle 26.1 4894 31.0 66.4 4015 29.7 879 2.1 4096
Fourth 19.5 5341 23.1 56.7 4313 31.3 1028 1.4 4407
Highest 15.0 5645 17.9 43.7 4627 24.5 1018 1.1 4330
Religion
Islam 23.3 22158 27.7 61.0 18012 33.4 4145 3.1 18417
Hindu 16.0 2156 18.6 48.8 1794 30.4 362 0.2 1788
Buddhist 1.8 111 2.1 26.2 97 (*) 14 (0.0) 86
Christian 7.3 95 8.8 32.1 76 2.0 19 6.1 64
Note: Due to 5 unweighted cases, ‘Other/DK/missing’ category under ‘education’ is not shown(*) Figures that are based on fewer than 25 unweighted cases( ) Figures that are based on 25-49 unweighted casesna= not available
Among the adolescent girls age 15-19 years, 32.9 per cent were found currently married. This proportion was not very different for different areas within urban areas viz., CC slums, CC non-slums and other urban areas. Differentials by division, education of women and socio-economic status were however quite high.
Among the urban women age 15-49 years, 22.5 per cent were (first) married before age 15 (see Figure 8.5). While, among women age 20-49 years, 26.7 per cent got married before age 15 years, and 59.7 per cent women were married before age 18 (Figure-8.6).
147
Ch
ild P
rote
ctio
n
Fig 8.5: Early marriage before age 15 among women age 15-49, Bangladesh, CWS 2016
About 22.5 per cent of women age 15-49 were first married by age 15, while this was only 4.0 per cent of women age 15-19, 12.2 per cent in the age group 20-24, 24.3 per cent in age group 25-29 and as high as 38.1 per cent among women of age 45-49 years. Nearly 59.7 per cent of women age 20-49 years married before age 18, while this was 41.8 per cent among women age 20-24 years, and 73.5 per cent among women age 45-49.
Fig 8.6: Early marriage before age 18 among women age 20-49 by areas, Bangladesh, CWS 2016
Table 8.7 shows a strong negative correlation between early marriage and education. Women were much more likely to be subjected to early marriage (before age 18) if they had no education (77.8 per cent) as compared to those having secondary or higher education (20.6 per cent).
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
148
Fig 8.7: Trend in early marriage (before age 18) by age group, Bangladesh, CWS 2016
It was also evident that 2.8 per cent of women aged 15-49 years in urban areas were in polygynous marriage/union, with some difference by CC slums (4.4 per cent), CC non-slums (2.4 per cent) and other urban areas (3.0 per cent). This prevalence was the highest in Dhaka (3.3 per cent) and Rajshahi (3.2 per cent), and lowest in Barisal and Chittagong (1.8 per cent). Only 1.0 per cent of the youngest women (aged 15-19) were in polygynous union as compared to 4.8 per cent of the oldest (aged 45-49).
Figure 8.7 shows trend in early marriage (marriage before age 18 years) by age groups. It is evident that early marriage declined over time. This is also shown in table 8.8.
Table 8.8: Trends in early marriage (women)
Percentage of women who were first married or entered into a marital union before age 15 and 18, by area and age groups by selected characteristics, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
City corporation slum City corporation non-slum Other municipalities/Urban All
Percen-tage of women married before age 15
Number of
women age
15-49 years
Percen-tage of women married before age 18
Number of
women age
20-49 years
Percen-tage of women married before age 15
Number of
women age
15-49 years
Percen-tage of women married before age 18
Number of
women age
20-49 years
Percen-tage of women married before age 15
Number of
women age
15-49 years
Percen-tage of women married before age 18
Number of
women age
20-49 years
Percen-tage of women married before age 15
Number of
women age
15-49 years
Percen-tage of women married before age 18
Number of
women age
20-49 years
Total 28.1 1,015 66.4 807 20.0 7,658 53.3 6,286 23.4 15,853 62.3 12,890 22.5 24,525 59.7 19,983
Age
15-19 8.5 208 na na 2.5 1,372 na na 4.4 2,962 Na na 4.0 4,542 na na
20-24 16.9 177 53.0 177 10.6 1,310 37.3 1,310 12.6 2,560 43.3 2,560 12.2 4,048 41.8 4,048
25-29 32.2 187 60.1 187 23.0 1,384 49.5 1,384 24.4 2,718 56.9 2,718 24.3 4,290 54.7 4,290
30-34 39.9 155 70.8 155 25.8 1,069 55.2 1,069 30.1 2,224 68.0 2,224 29.2 3,448 64.1 3,448
35-39 40.6 123 80.0 123 26.0 953 57.7 953 31.9 1,986 68.3 1,986 30.4 3,062 65.5 3,062
40-44 38.3 71 73.9 71 30.1 758 61.0 758 36.2 1,433 72.7 1,433 34.3 2,262 68.8 2,262
45-49 41.2 93 73.4 93 35.3 811 71.1 811 39.1 1,970 74.5 1,970 38.1 2,874 73.5 2,874
na= Not available
149
Ch
ild P
rote
ctio
n
8.6 Child’s Living Arrangements and OrphanhoodFor proper development of personality, a child needs to grow up in a family environment, in an atmosphere of happiness, love and understanding. There is no equal substitute of parents for proper care of children. Unfortunately, many children grow up without the care of their parents for various reasons, such as premature death of parents, migration of parents for work, separation and others. In these situations, children are cared by other family members, or grow up in other families as adapted child, domestic worker, or as a street child.
This survey (the CWS 2016) collected information for urban children age 0-17 years on their living arrangements: whether living with both parents, living with mothers only, living with fathers only, or living with neither of biological parents. Results as presented in Table 8.9 shows that 84.3 per cent of urban children aged 0-17 years were living with both parents, while 4.7 per cent were living with neither of biological parents. Percentage of children living with both parents was nearly the same in all urban domains, and divisions, but the proportion decreased as age of the child increased. About 7.2 per cent of urban children were living with mothers only when their fathers are alive, and 0.4 per cent with fathers only even when mothers are alive.
The Percentage of children with one or both parents dead was 4.1 per cent. This ‘orphanhood’ varied little between CC slums, CC non-slums or other urban areas, but variation by division was prominent. Orphanhood was the highest in Sylhet (6.3 per cent) and lowest in Rajshahi (3.1 per cent).
Table 8.9: Children’s living arrangements and orphanhood
Per cent distribution of children age 0-17 years according to living arrangements, Percentage of children age 0-17 years not living with a biological parent and Percentage of children who have one or both parents dead, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Living with both
parents
Living with neither biological parent
Living with mother only
Living with father only
Missing informa-tion on father/ mother
Total
Living with neither
biological parent
One or both pare-nts
dead
Number of
children age 0-17
years
Only father alive
Only mother
alive
Both alive
Both dead
Father alive
Father dead
Mother alive
Mother dead
Total 84.3 0.0 0.0 3.9 0.0 7.2 0.0 0.4 0.0 4.2 100.0 4.7 4.1 2,9267
Area
City Corporation slum 84.2 0.0 0.0 3.1 0.0 5.6 0.0 0.8 0.0 6.3 100.0 4.4 6.2 1,267
City Corporation non-slum 85.8 0.0 0.0 3.2 0.0 5.7 0.0 0.4 0.0 4.9 100.0 4.4 4.8 8,482
Other municipalities/urban 83.7 0.0 0.0 4.2 0.0 7.9 0.0 0.4 0.0 3.8 100.0 4.9 3.7 19,518
Division
Barisal 83.9 0.0 0.0 4.5 0.0 6.8 0.0 0.7 0.0 4.1 100.0 5.5 4.1 1,199
Chittagong 81.4 0.0 0.0 1.9 0.0 11.7 0.0 0.2 0.0 4.9 100.0 2.5 4.7 6,077
Dhaka 84.6 0.0 0.0 4.1 0.0 6.7 0.0 0.4 0.0 4.1 100.0 5.2 4.0 13,754
Khulna 86.4 0.0 0.0 4.8 0.0 5.0 0.0 0.6 0.0 3.2 100.0 5.2 3.2 2,266
Rajshahi 86.7 0.0 0.0 5.2 0.0 4.2 0.0 0.7 0.0 3.2 100.0 5.9 3.1 2,747
Rangpur 87.3 0.0 0.0 5.3 0.0 2.7 0.0 0.5 0.0 4.2 100.0 6.1 4.2 1,900
Sylhet 82.9 0.0 0.0 3.2 0.0 7.2 0.0 0.3 0.0 6.3 100.0 4.2 6.3 1,324
Sex
Male 85.8 0.0 0.0 2.4 0.0 7.4 0.0 0.4 0.0 4.1 100.0 3.0 3.9 1,4734
Female 82.9 0.0 0.0 5.4 0.0 6.9 0.0 0.5 0.0 4.4 100.0 6.5 4.3 1,4533
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
150
Table 8.9: continued Living
with both
parents
Living with neither biological parent
Living with mother only
Living with father only
Missing informa-tion on father/ mother
Total
Living with neither
biological parent
One or both pare-nts
dead
Number of
children age 0-17
years
Only father alive
Only mother
alive
Both alive
Both dead
Father alive
Father dead
Mother alive
Mother dead
Age
0-4 90.5 0.0 0.0 0.7 0.0 7.7 0.0 0.2 0.0 0.8 100.0 0.9 0.8 7,686
5-9 87.0 0.0 0.0 2.2 0.0 7.6 0.0 0.4 0.0 2.9 100.0 2.7 2.7 8,195
10-14 83.4 0.0 0.0 3.5 0.0 7.2 0.0 0.5 0.0 5.3 100.0 4.5 5.3 8,440
15-17 72.0 0.0 0.0 12.1 0.0 5.4 0.0 0.6 0.0 9.8 100.0 14.5 9.7 4,946
Wealth index quintile
Lowest 84.4 0.0 0.0 4.0 0.0 5.8 0.0 0.6 0.0 5.1 100.0 5.1 5.0 5,383
Second 85.1 0.0 0.0 4.1 0.0 6.1 0.0 0.3 0.0 4.5 100.0 5.2 4.4 5,716
Middle 86.1 0.0 0.0 3.9 0.0 5.4 0.0 0.5 0.0 4.1 100.0 4.4 4.0 6,215
Fourth 83.4 0.0 0.0 4.1 0.0 8.6 0.0 0.4 0.0 3.5 100.0 4.7 3.4 6,140
Highest 82.7 0.0 0.0 3.3 0.0 9.7 0.0 0.3 0.0 4.1 100.0 4.3 4.0 5,813
Religion
Islam 84.0 0.0 0.0 3.9 0.0 7.5 0.0 0.4 0.0 4.2 100.0 4.8 4.1 2,6840
Hindu 88.5 0.0 0.0 3.5 0.0 3.4 0.0 0.3 0.0 4.3 100.0 3.9 4.3 2,208
Buddhist 90.7 0.0 0.0 5.1 0.0 3.4 0.0 0.0 0.0 0.7 100.0 5.1 0.7 120
Christian 74.6 0.0 0.0 10.9 0.0 10.3 0.0 0.0 0.0 4.2 100.0 10.9 4.2 87
Table 8.10 shows that for about one in twenty children (4.9 per cent) of age 0-17 years, either of the parents (father or mother) was living abroad. This was the highest for Chittagong division (9.2 per cent) and lowest for Rangpur (0.7 per cent). The proportion was very small when only mother was living abroad.
Table 8.10: Children with parents living abroad
Per cent distribution of children age 0-17 years by residence of parents in another country, Child Well-being Survey in Urban Areas, Bangladesh, CWS 2016
Per cent distribution of children age 0-17 years: Percentage of children age 0-17 years with at least one parent living
abroad
Number of children age 0-17
years
With at least one parent living abroad With neither parent living
abroad
Total
Only mother abroad
Only father abroad
Both mother and father abroad
Total 0.2 4.7 0.1 95.1 100.0 4.9 29,267
Area
City Corporation slum 0.4 .7 0.0 98.9 100.0 1.1 1,267
City Corporation non-slum 0.3 2.7 0.1 96.9 100.0 3.1 8,482
Other municipalities/urban 0.1 5.8 0.0 94.1 100.0 5.9 19,518
151
Ch
ild P
rote
ctio
n
Table 8.10: continued Per cent distribution of children age 0-17 years: Percentage of
children age 0-17 years with at least one parent living
abroad
Number of children age 0-17
years
With at least one parent living abroad With neither parent living
abroad
Total
Only mother abroad
Only father abroad
Both mother and father abroad
Division
Barisal 0.2 3.5 0.0 96.3 100.0 3.7 1,199
Chittagong 0.1 9.1 0.0 90.8 100.0 9.2 6,077
Dhaka 0.2 3.9 0.1 95.8 100.0 4.2 13,754
Khulna 0.1 3.4 0.1 96.4 100.0 3.6 2,266
Rajshahi 0.2 2.6 0.0 97.2 100.0 2.8 2,747
Rangpur 0.1 .5 0.1 99.3 100.0 .7 1,900
Sylhet 0.2 5.6 0.1 94.2 100.0 5.8 1,324
Sex
Male 0.1 4.6 0.1 95.2 100.0 4.8 14,734
Female 0.2 4.7 0.0 95.1 100.0 4.9 14,533
Age group
0-4 0.0 4.9 0.1 95.0 100.0 5.0 7,686
5-9 0.2 5.6 0.1 94.1 100.0 5.9 8,195
10-14 0.2 4.3 0.1 95.4 100.0 4.6 8,440
15-17 0.3 3.3 0.0 96.3 100.0 3.7 4,946
Wealth index quintile
Lowest 0.1 1.1 0.0 98.8 100.0 1.2 5,383
Second 0.4 2.8 0.0 96.9 100.0 3.1 5,716
Middle 0.1 3.8 0.1 96.0 100.0 4.0 6,215
Fourth 0.1 7.1 0.2 92.5 100.0 7.5 6,140
Highest 0.1 8.1 0.0 91.8 100.0 8.2 5,813
Religion
Islam 0.2 4.9 0.1 94.9 100.0 5.1 26,840
Hindu 0.0 2.0 0.0 98.0 100.0 2.0 2,208
Buddhist 0.0 0.0 0.0 100.0 100.0 0.0 120
Christian 0.0 4.4 0.0 95.6 100.0 4.4 87
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
152
Bangladesh Bureau of Statistics (BBS) and UNICEF, 2014. Bangladesh Multiple Indicator Cluster Survey 2012-2013, Progotir Pathey: Final Report, Dhaka, Bangladesh.
Government of Bangladesh (GOB). 2011. Health, Population and Nutrition Development Programme 2011-16: Programme Implementation Plan, Vol. 1. Dhaka, Bangladesh: Ministry of Health and Family Welfare.
National Institute of Population Research and Training (NIPORT), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), and MEASURE Evaluation. Bangladesh Urban Health Survey 2013 (UHS 2013). Final Report. Dhaka, Bangladesh and Chapel Hill, North Carolina, (USA): NIPORT, icddr,b, and MEASURE Evaluation.
National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. 2013. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA: National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International.
Pan American Health Organization (PAHO), and World Health Organization (WHO). 2003. Guiding Principles for Complementary Feeding of the Breastfed Child. Washington, D.C., USA, and Geneva, Switzerland: WHO.
World Health Organization (WHO). 2003. The management of nutrition in major emergencies. Geneva, Switzerland: WHO.
World Health Organization (WHO). 2005. Guiding Principles for Feeding Non-breastfed Children 6 to 24 Months of Age. Geneva, Switzerland: WHO.
World Health Organization (WHO). 2006. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: WHO.
World Health Organization (WHO). 2008. Indicators for Assessing Infant and Young Child Feeding Practices: Conclusions of Consensus Meeting Held 6-8 November 2007 in Washington D.C., USA, Geneva, Switzerland: WHO.
REFERENCES
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxv
Appendix A
UNICEF/BANA2016_00298/Haque
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxvi
The main features of the sampling design of the Child Well-being Survey (CWS) in Urban Areas of Bangladesh include estimation of sample size, stratification, sampling frame, sample allocation for the different domains (strata), and sample selection and calculation of sampling weights. The sampling design followed had the following details.
Sample sizeSample size was estimated based on vaccination coverage among children age 12-23 months. Considering the predicted value of the indicator of immunization of 12-23 months’ children with marginal error of 12 per cent the sample size was estimated at 996 rounded to 1000 households using the standard statistical formula and with a confidence level of 95%. The sample size was adjusted by design effect and the possible non-responses. To ensure equal precision at the domain level estimates, equal sample size was taken for all domains except for city-slums of Khulna, Rajshahi and Rangpur because of very small populations in these domains. Separate domains of city slums for Sylhet and Barisal were not considered as the slum population for these divisions was very small. It may be noted that domain level estimates may not be available for some smaller target groups, e.g., exclusive breastfeeding of 0-5 month children, for which divisional level and overall estimates will be available.
Sample DesignThe sample for the CWS was nationally representative and covers entire urban population residing in non-institutional dwelling units in urban areas of Bangladesh. The sample of households was drawn using two-stage stratified cluster sampling method, stratified by 19 strata or domains. The strata/domains were; (i) City Corporation Non-slum, City Corporation Slum, and other Municipalities/Urban areas in Dhaka, Chittagong, Khulna, Rajshahi and Rangpur divisions; and (ii) City Corporations and Other Municipalities/Urban areas in the remaining two divisions - Barisal and Sylhet. A stratum/domain is considered as an independent stratum/domain.
In the first stage of sampling, from each stratum/domain, Mauza/Mahallas (slum in the City Corporation slum stratum/domain) were selected randomly as Primary Sampling Units (PSUs) using probability proportional to size (PPS), size being the number of households in the PSU. In total, 920 PSUs were selected, taking 50 PSUs from each stratum/domain except three stratum/domains of City Corporation slums of Rajshahi, Khulna and Rangpur, from each of which 40 PSUs were selected.
Using Population census (2011) list of Mauzas/Mahalla as sampling frame, BBS selected 700 non-slum urban PSUs, while Urban Slum Census (2014) data were used to select 220 slum PSUs from five City Corporation slum domains. Necessary adjustments were made in the population estimates in the two sampling frames prior to selection of PSUs to bring them to a reference of 2014.
In Mouzas/Mohallas, for the second stage, segments of equal size of around 100 households were created for each PSU through a physical mapping exercise in each selected PSU, and then one of the segments was selected randomly. A segment was randomly selected and
Appendix A
SAMPLE DESIGN AND ESTIMATES OF SAMPLING ERRORS
xxvii
is referred to as a cluster. Segment was not done for smaller PSU's. A household listing operation was conducted in each cluster using a structured enumeration form. A sample of 20 households were planned to be selected from each such cluster following systematic random sampling procedure, resulting into a planned total selection of 18,400 households from 920 clusters. This sample size is expected to provide estimates with at most 12 percent margin of error at 95% level of confidence. Since the availability of household members during a survey is sometimes not ensured in urban areas, a 10 per cent oversampling of households at the cluster level was done, leading to a selection of 22 households from each cluster.
Survey could not be conducted in 4 preselected clusters due to eviction of slums and other reasons. Ultimately, a total of 20,134 households from 916 clusters were attempted for interview.
The following table presents the sample sizes, number of clusters and cluster size per domain.
Sample size
Number of clusters and households included in the sample by division (Dhaka, Chittagong, Rajshahi, Khulna, Rangpur, Barisal and Sylhet), and areas (City Corporation slum, City Corporation non-slum and other municipalities/urban areas), Child Well-being survey in urban areas, Bangladesh, CWS 2016.
Division Area/DomainNumber of clusters
Number of Households @22 HHs/Cluster
Dhaka City Corporation non-slum 50 1,100
City Corporation slum 48 1,056
Other municipalities/urban 50 1,100
Chittagong City Corporation non-slum 50 1,100
City Corporation slum 50 1,097
Other municipalities/urban 50 1,100
Rajshahi City Corporation non-slum 49 1,078
City Corporation slum 40 877
Other municipalities/urban 50 1,100
Khulna City Corporation non-slum 50 1,100
City Corporation slum 39 848
Other municipalities/urban 50 1,100
Rangpur City Corporation non-slum 50 1,100
City Corporation slum 40 880
Other municipalities/urban 50 1,100
Sylhet City Corporation non-slum 50 1,100
Other municipalities/urban 50 1,100
Barisal City Corporation non-slum 50 1,098
Other municipalities/urban 50 1,100
Total 19 916 20,134
Ap
pen
dix
A :
Sam
ple
Des
ign
an
d E
stim
ates
of
Sam
plin
g E
rro
rs
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxviii
Weight calculationWeighting was not needed in producing the estimates for each domain since the sample was self-weighted within it. However, appropriate weights were needed to produce the combined estimates.
We use the following notations:
P1hi: first-stage sampling probability of the ith cluster in stratum h
P2hi: second -stage sampling probability within the ith cluster (households)
Let ah be the number of PSUs selected in stratum/domain h, Mhi the number of households according to the sampling frame in the ith PSU, and ∑ Mhi the total number of households in the stratum. The probability of selecting the ith EA is calculated as follows:
ah Mhi
∑ Mhi
Let bhi be the proportion of households in the selected cluster compared to the total number of households in PSUi in stratum h if the PSU is segmented, otherwise bhi = 1. Then the probability of selecting cluster i in the sample is:
P1hi =ah Mhi x bhi∑ Mhi
Let Lhi be the number of households listed in the household listing operation in cluster i in stratum h, let ghi be the number of households selected in the cluster. The second stage’s selection probability for each household in the cluster is calculated as follows:
P2hi =ghi
Lhi
The overall selection probability of each household in cluster i of stratum h is therefore the product of the two stages selection probabilities:
Phi = P1hi x P2hi
The sampling weight (Design weight) for each household in cluster i of stratum h is the inverse of its overall selection probability:
Whi = 1/Phi
Estimates of Sampling ErrorsSampling errors are measures of variability in the estimates. The extent of variability is not known exactly, but can be estimated statistically from the survey data.
The following sampling error measures are presented for each of the selected indicators;
� Standard error (se): Standard error is the square root of the variance of the estimate, and is a measure of the sampling error. For survey indicators that are means, proportions or ratios, the Taylor series linearization method is used for the estimation of standard errors.
� Coefficient of variation (se/r): Coefficient of variation is the ratio of the standard error to the mean value (r) of the indicator, and is a measure of the relative sampling error.
� Design effect (deff): Design effect is the ratio of the actual variance of an indicator, under the sampling method used in the survey, to the variance calculated under the assumption
xxix
Ap
pen
dix
A :
Sam
ple
Des
ign
an
d E
stim
ates
of
Sam
plin
g E
rro
rs
of simple random sampling based on the same sample size. The square root of the design effect (deff) is used to show the efficiency of the sample design in relation to the precision. A deff value of 1.0 indicates that the sample design of the survey is as efficient as a simple random sample for a particular indicator, while a deff value above 1.0 indicates an increase in the standard error due to use of a more complex sample design.
� Confidence limits: Confidence limits are calculated to show the interval within which the true value for the population can be reasonably assumed to fall, with a specified level of confidence. For any given statistic calculated from the survey, the value of that statistic will fall within a range of plus or minus two times the standard error (r+2.se or r–2.se) of the statistic in 95 per cent of all possible samples of identical size and design.
For the calculation of sampling errors from the CWS data, programs developed in CSPro Version 4.1, SPSS Version 23.0 Complex Samples module have been used.
The results are shown in the tables that follow. In addition to the sampling error measures described above, the tables also include weighted and unweighted counts of denominators for each indicator. Given the use of normalized weights, by comparing the weighted and unweighted counts it is possible to determine whether a particular domain has been under-sampled or over-sampled compared to the average sampling rate. If the weighted counts is smaller than the unweighted counts, this means that the particular domain had been over-sampled.
Sampling errors are calculated for indicators of primary interest, for the urban Bangladesh level, for urban domains, and for all divisions.
Table SE.1: Indicators selected for sampling error calculations
List of indicators selected for sampling error calculations, and base populations (denominators) for each indicator, Child Well-being survey in urban areas, Bangladesh, CWS 2016.
Indicator Base PopulationHousehold members
Use of improved drinking water sources All household membersa
Use of improved sanitation All household membersa
Primary school net attendance ratio (adjusted)Secondary school net attendance ratio (adjusted)
Children of primary school ageChildren of secondary school age
WomenUnmet need Women age 15-49 years who are
currently married or in unionAntenatal care coverage (1+ times, skilled provider) Women age 15-49 years with a live birth
in the last 2 yearsAntenatal care coverage (4+ times, any provider) Women age 15-49 years with a live birth
in the last 2 yearsSkilled attendant at delivery Women age 15-49 years with a live birth
in the last 2 yearsPost-natal health check for the newborn Women age 15-49 years with a live birth
in the last 2 yearsLiteracy rate (young women) Women age 15-24 yearsKnowledge about HIV prevention (young women) Women age 15-24 years
Under-5sBirth registration Children under age 5 yearsExclusive breastfeeding Children under 6 months of ageUnderweight prevalence (moderate and severe) Children under age 5 yearsUnderweight prevalence (severe) Children under age 5 yearsStunting (moderate and severe) Children under age 5 yearsStunting (severe) Children under age 5 yearsWasting (moderate and severe) Children under age 5 yearsWasting (severe) Children under age 5 years
a To calculate the weighted results of Indicators ‘use of improved drinking water sources’ and ‘use of improved sanitation’ the household weight is multiplied by the number of household members in each household. Therefore the unweighted base population presented in the SE tables reflect the unweighted number of households, whereas the weighted numbers reflect the household population.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxx
Table SE.02: Sampling Errors: all urban sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 0.9917 0.00130 0.001 3.589 1.894 82,228 18,887 0.989 0.994
Use of improved sanitation 0.5727 0.01130 0.020 9.855 3.139 82,228 18,887 0.550 0.595
Primary school net attendance ratio (adjusted) 0.8550 0.00880 0.010 5.262 2.294 8,436 8,462 0.837 0.873
Secondary school net attendance ratio (adjusted) 0.6315 0.01040 0.016 5.448 2.334 11,604 11,802 0.611 0.652
Women
Contraceptive prevalence 0.6726 0.00710 0.010 4.073 2.018 18,252 18,029 0.659 0.687
Unmet need 0.0778 0.00340 0.044 2.906 1.705 18,252 18,029 0.071 0.085
Antenatal care coverage (1+ times, skilled provider) 0.8109 0.01110 0.014 2.289 1.513 2,882 2,850 0.789 0.833
Antenatal care coverage (4+ times, any provider) 0.4594 0.01630 0.035 3.036 1.742 2,882 2,850 0.427 0.492
Skilled attendant at delivery 0.6423 0.01740 0.027 3.761 1.939 2,882 2,850 0.607 0.677
Literacy rate (young women) 0.8260 0.01060 0.013 3.496 1.870 4,488 4,454 0.805 0.847
Post-natal health check for the newborn 0.7991 0.01420 0.018 3.556 1.886 2,882 2,850 0.771 0.827
Post-natal health check for the mother 0.7751 0.01400 0.018 3.181 1.783 2,882 2,850 0.747 0.803
Under-5s
Birth registration 0.2926 0.01050 0.036 4.015 2.004 7,521 7,521 0.272 0.314
Exclusive breastfeeding (under 6 months of age) 0.5267 0.01820 0.035 0.921 0.960 662 696 0.490 0.563
Underweight prevalence (moderate and severe) 0.2043 0.00770 0.038 2.516 1.586 6,888 6,928 0.189 0.220
Underweight prevalence (severe) 0.0395 0.00370 0.093 2.474 1.573 6,888 6,928 0.032 0.047
Stunting prevalence (moderate and severe) 0.2631 0.01030 0.039 3.762 1.940 6,888 6,928 0.243 0.284
Stunting prevalence (severe) 0.0779 0.00580 0.074 3.216 1.793 6,888 6,928 0.066 0.089
Wasting prevalence (moderate and severe) 0.0990 0.00550 0.056 2.350 1.533 6,888 6,928 0.088 0.110
Wasting prevalence (severe) 0.0219 0.00280 0.128 2.558 1.599 6,888 6,928 0.016 0.028
xxxi
Ap
pen
dix
A :
Sam
ple
Des
ign
an
d E
stim
ates
of
Sam
plin
g E
rro
rs
Table SE.03: Sampling Errors: city corporation slum sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 0.9802 0.00864 0.009 17.128 4.139 3,302 4,457 0.963 0.997
Use of improved sanitation 0.1890 0.01849 0.098 9.944 3.153 3,302
4,457 0.152 0.226
Primary school net attendance ratio (adjusted) 0.6945 0.01975 0.028 3.721 1.929 375 2,025 0.655 0.734
Secondary school net attendance ratio (adjusted) 0.3331 0.01636 0.049 3.327 1.824 483 2,764 0.300 0.366
Women
Contraceptive prevalence 0.7376 0.01118 0.015 2.682 1.638 731 4,155 0.715 0.760
Unmet need 0.0587 0.00457 0.078 1.573 1.254 731 4,155 0.050 0.068
Antenatal care coverage (1+ times, skilled provider) 0.6767 0.02431 0.036 1.831 1.353 127 679 0.628 0.725
Antenatal care coverage (4+ times, any provider) 0.3582 0.02536 0.071 1.897 1.377
127 679 0.307 0.409
Skilled attendant at delivery 0.5546 0.03021 0.054 2.506 1.583
127 679 0.494 0.615
Literacy rate (young women) 0.5900 0.02562 0.043 3.343 1.828
215 1,233 0.539 0.641
Post-natal health check for the newborn 0.6485 0.03002 0.046 2.681 1.637
127 679 0.588 0.709
Post-natal health check for the mother 0.6141 0.02716 0.044 2.111 1.453
127 679 0.560 0.668
Under-5s
Birth registration 0.3292 0.01866 0.057 2.846 1.687 336 1,805 0.292 0.367
Exclusive breastfeeding (under 6 months of age) 0.6235 0.03155 0.051 0.661 0.813
28 157 0.560 0.687
Underweight prevalence (moderate and severe) 0.3076 0.01496 0.049 1.775 1.332 311 1,689 0.278 0.338
Underweight prevalence (severe) 0.0793 0.00947 0.119 2.073 1.440 311 1,689 0.060 0.098
Stunting prevalence (moderate and severe) 0.4035 0.01745 0.043 2.134 1.461 311 1,689 0.369 0.438
Stunting prevalence (severe) 0.1538 0.01565 0.102 3.178 1.783 311 1,689 0.123 0.185
Wasting prevalence (moderate and severe) 0.1163 0.01088 0.094 1.943 1.394 311 1,689 0.095 0.138
Wasting prevalence (severe) 0.0209 0.00547 0.262 2.468 1.571 311 1,689 0.010 0.032
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxxii
Table SE.04: Sampling Errors: city corporation non-slum sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 0.9902 0.00244 0.002 4.371 2.091
25,015 7,151 0.985 0.995
Use of improved sanitation 0.5127 0.02785 0.054 22.204 4.712
25,015 7,151 0.457 0.568
Primary school net attendance ratio (adjusted) 0.8497 0.01707 0.020 6.918 2.630
2,452 3,031 0.816 0.884
Secondary school net attendance ratio (adjusted) 0.6198 0.02006 0.032 7.205 2.684
3,324 4,220 0.580 0.660
Women
Contraceptive prevalence 0.6659 0.01238 0.019 4.659 2.159
5,505 6,765 0.641 0.691
Unmet need 0.0775 0.00491 0.063 2.281 1.510 5,505 6,765 0.068 0.087
Antenatal care coverage (1+ times, skilled provider) 0.8406 0.01934 0.023 2.811 1.677
811 1,008 0.802 0.879
Antenatal care coverage (4+ times, any provider) 0.6082 0.02726 0.045 3.140 1.772
811 1,008 0.554 0.663
Skilled attendant at delivery 0.7365 0.02905 0.039 4.377 2.092
811 1,008 0.678 0.795
Literacy rate (young women) 0.8369 0.01455 0.017 2.377 1.542
1,347 1,535 0.808 0.866
Post-natal health check for the newborn 0.8391 0.02467 0.029 4.539 2.130
811 1,008 0.790 0.888
Post-natal health check for the mother 0.8033 0.02436 0.030 3.781 1.944
811 1,008 0.755 0.852
Under-5s
Birth registration 0.3325 0.02091 0.063 5.357 2.314 2,242 2,720 0.291 0.374
Exclusive breastfeeding (under 6 months of age) 0.5754 0.03182 0.055 1.057 1.028
188 256 0.512 0.639
Underweight prevalence (moderate and severe) 0.1772 0.01614 0.091 4.463 2.113
2,042 2,499 0.145 0.209
Underweight prevalence (severe) 0.0266 0.00582 0.219 3.266 1.807
2,042 2,499 0.015 0.038
Stunting prevalence (moderate and severe) 0.2519 0.02410 0.096 7.701 2.775
2,042 2,499 0.204 0.300
Stunting prevalence (severe) 0.0730 0.01239 0.170 5.662 2.379
2,042 2,499 0.048 0.098
Wasting prevalence (moderate and severe) 0.0727 0.00842 0.116 2.626 1.621
2,042 2,499 0.056 0.090
Wasting prevalence (severe) 0.0206 0.00408 0.198 2.067 1.438
2,042 2,499 0.012 0.029
xxxiii
Ap
pen
dix
A :
Sam
ple
Des
ign
an
d E
stim
ates
of
Sam
plin
g E
rro
rs
Table SE.05: Sampling Errors: other municipalities/urban sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 0.9931
0.00144 0.001 2.205 1.485
53,911 7,279 0.990 0.996
Use of improved sanitation 0.6241
0.01125 0.018 3.927 1.982
53,911 7,279 0.602 0.647
Primary school net attendance ratio (adjusted) 0.8680
0.01086 0.013 3.505 1.872
5,610 3,406 0.846 0.890
Secondary school net attendance ratio (adjusted) 0.6550
0.01288 0.020 3.536 1.880
7,797 4,818 0.629 0.681
Women
Contraceptive prevalence 0.6717 0.00905 0.013 2.639 1.625 12,016 7,109 0.654 0.690
Unmet need 0.0791 0.00464 0.059 2.102 1.450 12,016 7,109 0.070 0.088
Antenatal care coverage (1+ times, skilled provider) 0.8074
0.01422 0.018 1.510 1.229
1,944 1,163 0.779 0.836
Antenatal care coverage (4+ times, any provider) 0.4040
0.02095 0.052 2.117 1.455
1,944 1,163 0.362 0.446
Skilled attendant at delivery 0.6088
0.02277 0.037 2.530 1.591
1,944 1,163 0.563 0.654
Literacy rate (young women) 0.8384
0.01475 0.018 2.705 1.645
2,926 1,686 0.809 0.868
Post-natal health check for the newborn 0.7924
0.01817 0.023 2.330 1.527
1,944 1,163 0.756 0.829
Post-natal health check for the mother 0.7739
0.01792 0.023 2.134 1.461
1,944 1,163 0.738 0.810
Under-5s
Birth registration 0.2721 0.01289 0.047 2.513 1.585 4,943 2,996 0.246 0.298
Exclusive breastfeeding (under 6 months of age) 0.5001
0.02317 0.046 0.606 0.778
446 283 0.454 0.546
Underweight prevalence (moderate and severe) 0.2094
0.00901 0.043 1.342 1.158
4,536 2,740 0.191 0.227
Underweight prevalence (severe) 0.0426
0.00489 0.115 1.606 1.267
4,536 2,740 0.033 0.052
Stunting prevalence (moderate and severe) 0.2586
0.01107 0.043 1.751 1.323
4,536 2,740 0.236 0.281
Stunting prevalence (severe) 0.0749
0.00667 0.089 1.758 1.326
4,536 2,740 0.062 0.088
Wasting prevalence (moderate and severe) 0.1096
0.00744 0.068 1.555 1.247
4,536 2,740 0.095 0.124
Wasting prevalence (severe) 0.0226
0.00384 0.170 1.830 1.353
4,536 2,740 0.015 0.030
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxxiv
Table SE.06: Sampling Errors: barial division sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 0.9879 0.00732 0.007 9.317 3.052
3,343 2,076 0.973 1.003
Use of improved sanitation 0.8072 0.01353 0.017 2.441 1.562 3,343 2,076 0.780 0.834
Primary school net attendance ratio (adjusted) 0.8973 0.01197 0.013 1.474 1.214
344 950 0.873 0.921
Secondary school net attendance ratio (adjusted) 0.7437 0.01890 0.025 2.316 1.522
463 1,237 0.706 0.782
Women
Contraceptive prevalence 0.7110 0.01166 0.016 1.341 1.158 751 2,029 0.688 0.734
Unmet need 0.0506 0.00519 0.103 1.137 1.066 751 2,029 0.040 0.061
Antenatal care coverage (1+ times, skilled provider) 0.7828 0.02862 0.037 1.479 1.216
120 308 0.726 0.840
Antenatal care coverage (4+ times, any provider) 0.3728 0.02871 0.077 1.083 1.040
120 308 0.315 0.430
Skilled attendant at delivery 0.6821 0.03308 0.048 1.549 1.245
120 308 0.616 0.748
Literacy rate (young women) 0.8764 0.02039 0.023 1.731 1.316
179 452 0.836 0.917
Post-natal health check for the newborn 0.9327 0.01725 0.018 1.456 1.206
120 308 0.898 0.967
Post-natal health check for the mother 0.8850 0.02258 0.026 1.538 1.240
120 308 0.840 0.930
Under-5s
Birth registration 0.2626 0.02468 0.094 2.653 1.629 318 844 0.213 0.312
Exclusive breastfeeding (under 6 months of age) 0.6418 0.03377 0.053 0.407 0.638
35 83 0.574 0.709
Underweight prevalence (moderate and severe) 0.1871 0.02423 0.129 2.990 1.729
291 776 0.139 0.236
Underweight prevalence (severe) 0.0360 0.01026 0.285 2.350 1.533
291 776 0.015 0.057
Stunting prevalence (moderate and severe) 0.2560 0.02175 0.085 1.926 1.388
291 776 0.213 0.300
Stunting prevalence (severe) 0.0752 0.01303 0.173 1.892 1.375
291 776 0.049 0.101
Wasting prevalence (moderate and severe) 0.0815 0.01307 0.160 1.768 1.330
291 776 0.055 0.108
Wasting prevalence (severe) 0.0175 0.00440 0.251 0.870 0.933 291 776 0.009 0.026
xxxv
Ap
pen
dix
A :
Sam
ple
Des
ign
an
d E
stim
ates
of
Sam
plin
g E
rro
rs
Table SE.07: Sampling Errors: chittagong division sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 0.9902 0.00258 0.003 2.111 1.453 16,019 3,063 0.985 0.995
Use of improved sanitation 0.6363 0.01687 0.027 3.765 1.940
16,019 3,063 0.603 0.670
Primary school net attendance ratio (adjusted) 0.8288 0.01503 0.018 2.388 1.545
1,710 1,501 0.799 0.859
Secondary school net attendance ratio (adjusted) 0.6088 0.01829 0.030 2.878 1.696
2,437 2,050 0.572 0.645
Women
Contraceptive prevalence 0.6468 0.01368 0.021 2.424 1.557 3,383 2,960 0.619 0.674
Unmet need 0.1151 0.00952 0.083 2.636 1.624 3,383 2,960 0.096 0.134
Antenatal care coverage (1+ times, skilled provider) 0.7562 0.02476 0.033 1.772 1.331
651 534 0.707 0.806
Antenatal care coverage (4+ times, any provider) 0.3551 0.03029 0.085 2.135 1.461
651 534 0.295 0.416
Skilled attendant at delivery 0.5416 0.03720 0.069 2.971 1.724
651 534 0.467 0.616
Literacy rate (young women) 0.7978 0.01759 0.022 1.532 1.238
873 800 0.763 0.833
Post-natal health check for the newborn 0.7338 0.03167 0.043 2.738 1.655
651 534 0.670 0.797
Post-natal health check for the mother 0.729 0.02918 0.040 2.296 1.515
651 534 0.671 0.787
Under-5s
Birth registration 0.3433 0.02250 0.066 3.052 1.747 1,562 1,360 0.298 0.388
Exclusive breastfeeding (under 6 months of age) 0.6199 0.02278 0.037 0.249 0.499
132 114 0.574 0.665
Underweight prevalence (moderate and severe) 0.2374 0.01536 0.065 1.611 1.269
1,410 1,237 0.207 0.268
Underweight prevalence (severe) 0.0529 0.00674 0.127 1.121 1.059
1,410 1,237 0.039 0.066
Stunting prevalence (moderate and severe) 0.3036 0.01549 0.051 1.402 1.184
1,410 1,237 0.273 0.335
Stunting prevalence (severe) 0.0859 0.01055 0.123 1.752 1.324
1,410 1,237 0.065 0.107
Wasting prevalence (moderate and severe) 0.1064 0.00964 0.091 1.207 1.099
1,410 1,237 0.087 0.126
Wasting prevalence (severe) 0.0272 0.00570 0.210 1.519 1.232
1,410 1,237 0.016 0.039
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxxvi
Table SE.08: Sampling Errors: dhaka division sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 0.9956 0.00146 0.001 1.467 1.211
38,509 3,001 0.993 0.999
Use of improved sanitation 0.4713 0.02264 0.048 6.173 2.484
38,509 3,001 0.426 0.517
Primary school net attendance ratio (adjusted) 0.8469 0.01656 0.020 2.861 1.692
4,031 1,354 0.814 0.880
Secondary school net attendance ratio (adjusted) 0.5944 0.01946 0.033 2.826 1.681
5,377 1,799 0.555 0.633
Women
Contraceptive prevalence 0.6659 0.01313 0.020 2.130 1.459 8,639 2,751 0.640 0.692
Unmet need 0.0793 0.00545 0.069 1.119 1.058 8,639 2,751 0.068 0.090
Antenatal care coverage (1+ times, skilled provider) 0.839 0.01900 0.023 1.184 1.088
1,320 444 0.801 0.877
Antenatal care coverage (4+ times, any provider) 0.5201 0.02764 0.053 1.355 1.164
1,320 444 0.465 0.575
Skilled attendant at delivery 0.6677 0.03010 0.045 1.809 1.345
1,320 444 0.608 0.728
Literacy rate (young women) 0.8094 0.01982 0.024 1.854 1.361
2,194 729 0.770 0.849
Post-natal health check for the newborn 0.7928 0.02498 0.032 1.683 1.297
1,320 444 0.743 0.843
Post-natal health check for the mother 0.7624 0.02497 0.033 1.525 1.235
1,320 444 0.712 0.812
Under-5s
Birth registration 0.2934 0.01870 0.064 2.010 1.418 3,580 1,193 0.256 0.331
Exclusive breastfeeding (under 6 months of age) 0.4938 0.03567 0.072 0.504 0.710
300 100 0.422 0.565
Underweight prevalence (moderate and severe) 0.1875 0.01334 0.071 1.280 1.131
3,289 1,096 0.161 0.214
Underweight prevalence (severe) 0.0333 0.00662 0.199 1.492 1.221
3,289 1,096 0.020 0.047
Stunting prevalence (moderate and severe) 0.2453 0.01917 0.078 2.174 1.474
3,289 1,096 0.207 0.284
Stunting prevalence (severe) 0.0763 0.01070 0.140 1.779 1.334
3,289 1,096 0.055 0.098
Wasting prevalence (moderate and severe) 0.0943 0.00979 0.104 1.229 1.109
3,289 1,096 0.075 0.114
Wasting prevalence (severe) 0.0214 0.00505 0.236 1.336 1.156
3,289 1,096 0.011 0.032
xxxvii
Ap
pen
dix
A :
Sam
ple
Des
ign
an
d E
stim
ates
of
Sam
plin
g E
rro
rs
Table SE.09: Sampling Errors: khulna division sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 0.9705 0.00783 0.008 6.206 2.491
6,988 2,900 0.955 0.986
Use of improved sanitation 0.6518 0.01674 0.026 3.581 1.892
6,988 2,900 0.618 0.685
Primary school net attendance ratio (adjusted) 0.8998 0.01275 0.014 2.009 1.417
646 1,115 0.874 0.925
Secondary school net attendance ratio (adjusted) 0.7135 0.02392 0.034 4.775 2.185
937 1,707 0.666 0.761
Women
Contraceptive prevalence 0.6931 0.01346 0.019 2.388 1.545
1,685 2,805 0.666 0.720
Unmet need 0.0556 0.00643 0.116 2.210 1.487 1,685 2,805 0.043 0.068
Antenatal care coverage (1+ times, skilled provider) 0.8717 0.02601 0.030 2.153 1.467
193 357 0.820 0.924
Antenatal care coverage (4+ times, any provider) 0.5412 0.04323 0.080 2.679 1.637
193 357 0.455 0.628
Skilled attendant at delivery 0.8028 0.03248 0.040 2.372 1.540
193 357 0.738 0.868
Literacy rate (young women) 0.9178 0.01344 0.015 1.615 1.271
390 675 0.891 0.945
Post-natal health check for the newborn 0.9524 0.01228 0.013 1.183 1.088
193 357 0.928 0.977
Post-natal health check for the mother 0.9602 0.00987 0.010 0.909 0.953
193 357 0.940 0.980
Under-5s
Birth registration 0.2451 0.02128 0.087 2.404 1.550 542 983 0.203 0.288
Exclusive breastfeeding (under 6 months of age) 0.3267 0.04657 0.143 0.887 0.942
48 91 0.234 0.420
Underweight prevalence (moderate and severe) 0.2104 0.01869 0.089 1.919 1.385
502 914 0.173 0.248
Underweight prevalence (severe) 0.034 0.00733 0.215 1.492 1.221
502 914 0.019 0.049
Stunting prevalence (moderate and severe) 0.2049 0.01844 0.090 1.906 1.381
502 914 0.168 0.242
Stunting prevalence (severe) 0.0508 0.00924 0.182 1.617 1.272
502 914 0.032 0.069
Wasting prevalence (moderate and severe) 0.1022 0.01097 0.107 1.196 1.094
502 914 0.080 0.124
Wasting prevalence (severe) 0.0242 0.00606 0.251 1.422 1.193
502 914 0.012 0.036
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xxxviii
Table SE.10: Sampling Errors: rajshahi division sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 1.0000 0.00000 0.000 - -
8,430 2,909 1.000 1.000
Use of improved sanitation 0.6651 0.01587 0.024 3.290 1.814 8,430 2,909 0.633 0.697
Primary school net attendance ratio (adjusted) 0.887 0.01470 0.017 2.438 1.562
794 1,132 0.858 0.916
Secondary school net attendance ratio (adjusted) 0.703 0.02550 0.036 4.998 2.236
1,081 1,606 0.652 0.754
Women
Contraceptive prevalence 0.7296 0.01306 0.018 2.446 1.564 1,953 2,831 0.703 0.756
Unmet need 0.0457 0.00977 0.214 6.198 2.490 1,953 2,831 0.026 0.065
Antenatal care coverage (1+ times, skilled provider) 0.8039 0.02283 0.028 1.240 1.114
272 376 0.758 0.850
Antenatal care coverage (4+ times, any provider) 0.4578 0.04826 0.105 3.519 1.876
272 376 0.361 0.554
Skilled attendant at delivery 0.6546 0.04480 0.068 3.329 1.825
272 376 0.565 0.744
Literacy rate (young women) 0.8882 0.01349 0.015 1.248 1.117
423 682 0.861 0.915
Post-natal health check for the newborn 0.8281 0.03220 0.039 2.730 1.652
272 376 0.764 0.893
Post-natal health check for the mother 0.7881 0.03553 0.045 2.836 1.684
272 376 0.717 0.859
Under-5s
Birth registration 0.2446 0.02035 0.083 2.186 1.478 695 976 0.204 0.285
Exclusive breastfeeding (under 6 months of age) 0.4361 0.04833 0.111 0.798 0.893
60 85 0.339 0.533
Underweight prevalence (moderate and severe) 0.2153 0.01674 0.078 1.511 1.229
641 912 0.182 0.249
Underweight prevalence (severe) 0.0457 0.00889 0.194 1.649 1.284
641 912 0.028 0.063
Stunting prevalence (moderate and severe) 0.2714 0.01874 0.069 1.618 1.272
641 912 0.234 0.309
Stunting prevalence (severe) 0.0756 0.00838 0.111 0.917 0.957
641 912 0.059 0.092
Wasting prevalence (moderate and severe) 0.1066 0.01599 0.150 2.446 1.564
641 912 0.075 0.139
Wasting prevalence (severe) 0.0122 0.00615 0.504 2.861 1.692
641 912 0.000 0.025
xxxix
Ap
pen
dix
A :
Sam
ple
Des
ign
an
d E
stim
ates
of
Sam
plin
g E
rro
rs
Table SE.11: Sampling Errors: rangpur division sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 0.9992 0.00074 0.001 2.078 1.442
5,554 2,903 0.998 1.001
Use of improved sanitation 0.6544 0.01820 0.028 4.249 2.061
5,554 2,903 0.618 0.691
Primary school net attendance ratio (adjusted) 0.8533 0.01804 0.021 3.319 1.822
539 1,278 0.817 0.889
Secondary school net attendance ratio (adjusted) 0.6930 0.01588 0.023 2.125 1.458
771 1,793 0.661 0.725
Women
Contraceptive prevalence 0.6897 0.01264 0.018 2.032 1.425 1,210 2,724 0.664 0.715
Unmet need 0.0534 0.00675 0.126 2.455 1.567 1,210 2,724 0.040 0.067
Antenatal care coverage (1+ times, skilled provider) 0.8300 0.03227 0.039 3.232 1.798
198 439 0.765 0.895
Antenatal care coverage (4+ times, any provider) 0.4834 0.04305 0.089 3.250 1.803
198 439 0.397 0.570
Skilled attendant at delivery 0.6928 0.04293 0.062 3.793 1.948
198 439 0.607 0.779
Literacy rate (young women) 0.819 0.02661 0.032 3.345 1.829
294 701 0.766 0.872
Post-natal health check for the newborn 0.8535 0.02706 0.032 2.566 1.602
198 439 0.799 0.908
Post-natal health check for the mother 0.8247 0.02856 0.035 2.471 1.572
198 439 0.768 0.882
Under-5s
Birth registration 0.2535 0.01900 0.075 2.170 1.473 487 1,138 0.216 0.292
Exclusive breastfeeding (under 6 months of age) 0.6641 0.03359 0.051 0.637 0.798
55 127 0.597 0.731
Underweight prevalence (moderate and severe) 0.1745 0.02008 0.115 2.922 1.709
445 1,045 0.134 0.215
Underweight prevalence (severe) 0.0278 0.00803 0.289 2.491 1.578
445 1,045 0.012 0.044
Stunting prevalence (moderate and severe) 0.2613 0.02699 0.103 3.940 1.985
445 1,045 0.207 0.315
Stunting prevalence (severe) 0.0610 0.01378 0.226 3.461 1.860
445 1,045 0.033 0.089
Wasting prevalence (moderate and severe) 0.0945 0.01615 0.171 3.182 1.784
445 1,045 0.062 0.127
Wasting prevalence (severe) 0.0204 0.00574 0.282 1.726 1.314
445 1,045 0.009 0.032
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xl
Table SE.12: Sampling Errors: sylhet division sample Value (r) Standard
error (se)Coefficient of variation
(se/r)
Design effect (deff)
Square root of design
effect (deft)
Weighted count
Unweighted count
Confidence limits
Lower bound r - 2se
Upper bound r + 2se
Household members
Use of improved drinking water sources 0.9684 0.01370 0.014 12.468 3.531
3,385 2,035 0.941 0.996
Use of improved sanitation 0.6666 0.01956 0.029 3.502 1.871
3,385 2,035 0.627 0.706
Primary school net attendance ratio (adjusted) 0.8796 0.01170 0.013 1.461 1.209
372 1,132 0.856 0.903
Secondary school net attendance ratio (adjusted) 0.6336 0.02363 0.037 3.870 1.967
538 1,610 0.586 0.681
Women
Contraceptive prevalence 0.5934 0.01265 0.021 1.280 1.131 632 1,929 0.568 0.619
Unmet need 0.0949 0.00920 0.097 1.899 1.378 632 1,929 0.077 0.113
Antenatal care coverage (1+ times, skilled provider) 0.7203 0.02267 0.031 0.997 0.999
128 392 0.675 0.766
Antenatal care coverage (4+ times, any provider) 0.2891 0.02304 0.080 1.009 1.005
128 392 0.243 0.335
Skilled attendant at delivery 0.5088 0.03300 0.065 1.704 1.305
128 392 0.443 0.575
Literacy rate (young women) 0.7685 0.02197 0.029 1.123 1.060
135 415 0.725 0.812
Post-natal health check for the newborn 0.6932 0.02794 0.040 1.435 1.198
128 392 0.637 0.749
Post-natal health check for the mother 0.654 0.02999 0.046 1.554 1.247
128 392 0.594 0.714
Under-5s
Birth registration 0.3102 0.02173 0.070 2.264 1.505 337 1,027 0.267 0.354
Exclusive breastfeeding (under 6 months of age) 0.5615 0.05830 0.104 1.311 1.145
32 96 0.445 0.678
Underweight prevalence (moderate and severe) 0.2581 0.01837 0.071 1.669 1.292
309 948 0.221 0.295
Underweight prevalence (severe) 0.0608 0.00874 0.144 1.269 1.126
309 948 0.043 0.078
Stunting prevalence (moderate and severe) 0.3549 0.02062 0.058 1.759 1.326
309 948 0.314 0.396
Stunting prevalence (severe) 0.133 0.01119 0.084 1.028 1.014
309 948 0.111 0.155
Wasting prevalence (moderate and severe) 0.1159 0.01170 0.101 1.266 1.125
309 948 0.093 0.139
Wasting prevalence (severe) 0.0268 0.00548 0.204 1.090 1.044
309 948 0.016 0.038
xli
Ap
pen
dix
A :
Sam
ple
Des
ign
an
d E
stim
ates
of
Sam
plin
g E
rro
rs
CWS 2016 Indicators Module Numerator Denominator
NUTRITION1.1a
1.1b
Underweight prevalence
AN Number 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
Total number of children under age 5
2.2a
2.2b
Stunting prevalence AN Number of children under age 5 who fall below
(a) minus two standard deviations (moderate and severe)
(b) below minus three standard deviations (severe) of the median height for age of the WHO standard
Total number of children under age 5
2.3a
2.3b
Wasting prevalence AN Number 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
Total number of children under age 5
2.4 Overweight prevalence AN Number of children under age 5 who are above two standard deviations of the median weight for height of the WHO standard
Total number of children under age 5
2.5 Children ever breastfed MN Number of women with a live birth in the last 2 years who breastfed their last live-born child at any time
Total number of women with a live birth in the last 2 years
2.6 Early initiation of breastfeeding
MN Number of women with a live birth in the last 2 years who put their last newborn to the breast within one hour of birth
Total number of women with a live birth in the last 2 years
2.7 Exclusive breastfeeding under 6 months
BD Number of infants under 6 months of age who are exclusively breastfed
Total number of infants under 6 months of age
2.8 Predominant breastfeeding under 6 months
BD Number of infants under 6 months of age who received breast milk as the predominant source of nourishment during the previous day
Total number of infants under 6 months of age
2.9 Continued breastfeeding at 1 year
BD Number of children age 12-15 months who received breast milk during the previous day
Total number of children age 12-15 months
2.10 Continued breastfeeding at 2 years
BD Number of children age 20-23 months who received breast milk during the previous day
Total number of children age 20-23 months
2.11 Age-appropriate breastfeeding
BD Number of children age 0-23 months appropriately fed during the previous day
Total number of children age 0-23 months
2.12 Introduction of solid, semi-solid or soft foods
BD Number of infants age 6-8 months who received solid, semi-solid or soft foods during the previous day
Total number of infants age 6-8 months
2.13 Milk feeding frequency for non-breastfed children
BD Number of non-breastfed children age 6-23 months who received at least 2 milk feedings during the previous day
Total number of non-breastfed children age 6-23 months
2.14 Minimum meal frequency
BD Number 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 times1 or more during the previous day
Total number of children age 6-23 months
Appendix B
CWS 2016 INDICATORS: NUMERATORS AND DENOMINATORS
1 Breastfeeding children: Solid, semi-solid, or soft foods, two times for infants age 6-8 months, and three times for children 9-23 months; Non-breastfeeding children: Solid, semi-solid, or soft foods, or milk feeds, four times for children age 6-23 months
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xlii
CWS 2016 Indicators Module Numerator Denominator
2.15 Minimum dietary diversity
BD Number of children age 6–23 months who received foods from 4 or more food groups2 during the previous day
Total number of children age 6–23 months
2.16 Minimum acceptable diet
BD (a) Number 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) Number 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
(a) Number of breastfed children age 6–23 months
(b) Number of non-breastfed children age 6–23 months
2.17 Bottle feeding BD Number of children age 0-23 months who were fed with a bottle during the previous day
Total number of children age 0-23 months
2.18 Low-birthweight infants MN Number of most recent live births in the last 2 years weighing below 2,500 grams at birth
Total number of most recent live births in the last 2 years
2.19 Infants weighed at birth MN Number of most recent live births in the last 2 years who were weighed at birth
Total number of most recent live births in the last 2 years
CHILD HEALTH3.1 Neonatal tetanus
protection MN Number of women age 15-49 years with a live
birth in the last 2 years who were given at least two doses of tetanus toxoid vaccine within the appropriate interval prior to the most recent birth or 5 doses during lifetime
Total number of women age 15-49 years with a live birth in the last 2 years
3.2 Children with diarrhea Number of children under age 5 with diarrhoea in the last 2 weeks
Total number of under 5 children
3.3 Diarrhoea treatment with oral rehydration therapy (ORT) and continued feeding
CA Number of children under age 5 with diarrhoea in the last 2 weeks who received ORT (ORS packet, pre-packaged ORS fluid, recommended homemade fluid or increased fluids) and continued feeding during the episode of diarrhoea
Total number of children under age 5 with diarrhoea in the last 2 weeks
3.4 Children with ARI symptoms
CA Number of children under age 5 with ARI symptoms in the last 2 weeks
Total number of under 5 children
3.5 Care-seeking for children with acute respiratory infection (ARI) symptoms
CA Number of children under age 5 with ARI symptoms in the last 2 weeks for whom advice or treatment was sought from a health facility or provider
Total number of children under age 5 with ARI symptoms in the last 2 weeks
3.6 Antibiotic treatment for children with ARI symptoms
CA Number of children under age 5 with ARI symptoms in the last 2 weeks who received antibiotics
Total number of children under age 5 with ARI symptoms in the last 2 weeks
3.7 Use of solid fuels for cooking
HC Number of household members in households that use solid fuels as the primary source of domestic energy to cook
Total number of household members
3.8 Measles immunization coverage
IM Number of children age 12-23 months who received all vaccinations recommended in the national immunization schedule by their first birthday
Total number of children age 12-23 months
WATER AND SANITATION4.1 Use of improved
drinking water sourcesWS Number of household members using improved
sources of drinking waterTotal number of household members
4.2 Water treatment WS Number of household members in households using unimproved drinking water who use an appropriate treatment method
Total number of household members in households using unimproved drinking water sources
2 The indicator is based on consumption of any amount of food from at least 4 out of the 7 following food groups: 1) grains, roots and tubers, 2) legumes and nuts, 3) dairy products (milk, yogurt, cheese), 4) flesh foods (meat, fish, poultry and liver/organ meats), 5) eggs, 6) vitamin-A rich fruits and vegetables, and 7) other fruits and vegetables
xliii
Ap
pen
dix
B :
CW
S 2
016
Ind
icat
ors
: Nu
mer
ato
rs a
nd
Den
om
inat
ors
CWS 2016 Indicators Module Numerator Denominator
4.3 Use of improved sanitation
WS Number of household members using improved sanitation facilities which are not shared
Total number of household members
4.4 Safe disposal of child’s faeces
CA Number of children age 0-2 years whose last stools were disposed of safely
Total number of children age 0-2 years
4.5 Place for handwashing HW Number of households with a specific place for handwashing where water and soap or other cleansing agent are present
Total number of households
4.6 Availability of soap or other cleansing agent
HW Number of households with soap or other cleansing agent
Total number of households
REPRODUCTIVE HEALTH5.1 Adolescent birth CM - BH Women age 15-19 years who have had a live birth
5.2 Early childbearing CM - BH Number of women age 20-24 years who had at least one live birth before age 18
Total number of women age 20-24 years
5.3 Contraceptive prevalence rate
CP Number 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
Total number of women age 15-49 years who are currently married or in union
5.4 Unmet need UN Number 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
Total number of women age 15-49 years who are currently married or in union
5.6
5.6
Antenatal care coverage
MN Number 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
Total number of women age 15-49 years with a live birth in the last 2 years
5.7 Content of antenatal care
MN Number 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
Total number of women age 15-49 years with a live birth in the last 2 years
5.8 Skilled attendant at delivery
MN Number 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
Total number of women age 15-49 years with a live birth in the last 2 years
5.9 Institutional deliveries MN Number 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
Total number of women age 15-49 years with a live birth in the last 2 years
5.10 Caesarean section MN Number of women age 15-49 years whose most recent live birth in the last 2 years was delivered by caesarean section
Total number of women age 15-49 years with a live birth in the last 2 years
5.11 Post-partum stay in health facility
PN Number of women age 15-49 years who stayed in the health facility for 12 hours or more after the delivery of their most recent live birth in the last 2 years
Total number of women age 15-49 years with a live birth in the last 2 years
5.12 Post-natal health check for the newborn
PN Number of last live births in the last 2 years who received a health check while in facility or at home following delivery, or a post-natal care visit within 2 days after delivery
Total number of last live births in the last 2 years
5.13 Post-natal health check for the mother
PN Number of women age 15-49 years who received a health check while in facility or at home following delivery, or a post-natal care visit within 2 days after delivery of their most recent live birth in the last 2 years
Total number of women age 15-49 years with a live birth in the last 2 years
LITERACY AND EDUCATION6.1 Attendance to early
childhood educationEC Number of children age 36-59 months who are
attending an early childhood education programmeTotal number of children age 36-59 months
6.2 Literacy rate among young women
WB Number of women age 15-24 years who are able to read a short simple statement about everyday life or who attended secondary or higher education
Total number of women age 15-24 years
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xliv
CWS 2016 Indicators Module Numerator Denominator
6.3 School readiness ED Number of children in first grade of primary school who attended pre-school during the previous school year
Total number of children attending the first grade of primary school
6.4 Net intake rate in primary education
ED Number of children of school-entry age who enter the first grade of primary school
Total number of children of school-entry age
6.5 Primary school net attendance ratio (adjusted)
ED Number of children of primary school age currently attending primary or secondary school
Total number of children of primary school age
6.6 Secondary school net attendance ratio (adjusted)
ED Number of children of secondary school age currently attending secondary school or higher
Total number of children of secondary school age
6.7 Children reaching last grade of primary
ED Proportion of children entering the first grade of primary school who eventually reach last grade
6.8 Primary completion rate
ED Number of children attending the last grade of primary school (excluding repeaters)
Total number of children of primary school completion age (age appropriate to final grade of primary school)
6.9 Transition rate to secondary school
ED 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
Total number of children attending the last grade of primary school during the previous school year
6.10 Gender parity index (primary school)
ED Primary school net attendance ratio (adjusted) for girls
Primary school net attendance ratio (adjusted) for boys
6.11 Gender parity index (secondary school)
ED Secondary school net attendance ratio (adjusted) for girls
Secondary school net attendance ratio (adjusted) for boys
CHILD PROTECTION7.1 Birth registration BR Number of children under age 5 whose births are
reported registeredTotal number of children under age 5
7.2 Violent discipline CD Number of children age 1-14 years who experienced psychological aggression or physical punishment during the last one month
Total number of children age 1-14 years
7.3 Child labour (5-14 years)
CL Number of children age 5-11 years who are involved more than 1 hour per week and more than 14 hours for 12-14 years in economic activities and more than 28 hours in household chores for both groups
Total number of children age 1-14 years
7.4 Child labour (5-17 years)
Number of children age 5-11 years who are involved more than 1 hour per week and more than 14 hours for 12-14 years in economic activities and more than 28 hours in household chores for both groups and more than 43 hours for 15-17 years involved in economic activities and household chores
Total number of children age 1-17 years
7.5 Marriage before age 15 MA Number of women age 15-49 years who were first married or in union before age 15
Total number of women age 15-49 years
7.6 Marriage before age 18 MA Number of women age 20-49 years who were first married or in union before age 18
Total number of women age 20-49 years
7.7 Young women age 15-19 years currently married or in union
MA Number of women age 15-19 years who are married or in union
Total number of women age 15-19 years
7.8 Polygyny MA Number of women age 15-49 years who are in a polygynous union
Total number of women age 15-49 years who are married or in union
7.9 Children’s living arrangements
HL Number of children age 0-17 years living with neither biological parent
Total number of children age 0-17 years
7.10 Prevalence of children with one or both parents dead
HL Number of children age 0-17 years with one or both biological parents dead
Total number of children age 0-17 years
7.11 Children with at least one parent living abroad
HL Number of children 0-17 years with at least one biological parent living abroad
Total number of children 0-17 years
xlv
Ap
pen
dix
C :
Qu
esti
on
nai
res
CHILD WELL-BEING SURVEY IN URBAN AREAS OF BANGLADESH
QUESTIONNAIRE
Appendix C
QUESTIONNAIRES
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xlvi
HOUSEHOLD (HH) QUESTIONNAIRE
Household Information
HH1. Cluster number: HH2. Household number:
HH3. Interviewer name and code:
Name: ...................................................................................
HH4. Supervisor name and code:
Name: ..................................................................................
HH5. Day/Month/Year of Interview:
HH7. Division:
Barisal ........................................................................................................... 10
Chittagong ................................................................................................ 20
Dhaka ............................................................................................................ 30
Khulna .......................................................................................................... 40
Rajshahi ...................................................................................................... 50
Rangpur ...................................................................................................... 55
Sylhet ............................................................................................................ 60
HH6. Type of Domain:
City Corporation non-slum .................................................... 1
City Corporation slum ................................................................ 2
Other Municipalities/Urban ................................................... 3
HH7A. District name and code:
Name: ...................................................................................
Informed Consent:
We are from Associates for Community and Population Research (ACPR). We are collecting information on behalf of a project of Bangladesh Government and UNICEF on HH information, maternal and child health, education, and child labour. I would like to talk to you about these subjects. The interview will take about 30 minutes. All the information we obtain will remain strictly confidential and your answers will never be shared with anyone other than our project team.
May I start now?
Yes, permission is given Go to HH18 to record the time and then begin the interview.
No, permission is not given Circle 04 in HH9. Discuss this result with your supervisor.
After all questionnaire for the HH have been completed, fill in the following information:
HH8. Name of head of household:
...........................................................................................................................................
HH10. Respondent to household questionnaire:
Name & line #: ............................................................................................
HH9. Result of household interview:
Completed ...................................................................................................... 01
No HH member or no competent respondent at home at time of visit .............................................................................................. 02
Enter HH absent for extended period of time ................. 03
Refused ............................................................................................................. 04
Dwelling vacant/address not a dwelling .............................. 05
Dwelling destroyed ................................................................................. 06
Dwelling not found ................................................................................. 07
Other (specify) ............................................................................................. 96
HH11. Total number of HH members:
HH12. No. of ever married women age 15-49 years: .
HH13.# of women’s questionnaire completed:
HH14. Number of under 5 years child:
HH14A. Number of under 2 years child:
HH16. Field editor name & code:
............................................................................
HH17. Data entry clerk (1st) name & code:
............................................................................
HH17A. Data entry clerk (2nd) name & code:
............................................................................
xlvii
Ap
pen
dix
C :
Qu
esti
on
nai
res
HO
USEH
OLD
LIS
TIN
G F
ORM
H
L
HH
18. R
eco
rd t
he
tim
e:
H
ou
rs
M
inu
tes
FIR
ST
, PLE
AS
E T
ELL
ME
TH
E N
AM
E O
F E
AC
H P
ER
SO
N W
HO
US
UA
LLY
LIV
ES
HE
RE
, ST
AR
TIN
G W
ITH
TH
E H
EA
D O
F T
HE
HO
US
EH
OLD
.In
stru
ctio
n: L
ist t
he
hea
d o
f th
e h
ou
seh
old
in li
ne
01. L
ist a
ll h
ou
seh
old
mem
ber
s (H
L2),
thei
r re
lati
on
ship
to th
e h
ou
seh
old
hea
d (H
L3),
an
d
thei
r s
ex (
HL4
). T
hen
ask
: AR
E T
HE
RE
AN
Y O
TH
ER
S W
HO
LIV
E H
ER
E, E
VE
N IF
TH
EY
AR
E N
OT
AT
HO
ME
NO
W?
If y
es, c
om
ple
te li
stin
g f
or
qu
esti
on
s H
L2-H
L4.T
hen
ask
qu
esti
on
s st
arti
ng
wit
h H
L5 f
or
each
per
son
at
a ti
me.
Use
an
ad
dit
ion
al q
ues
tio
nn
aire
if a
ll ro
ws
in t
he
ho
use
ho
ld li
stin
g f
orm
hav
e b
een
use
d.
HL1
Li
ne
no.
HL2
N
ame
HL3
Wha
t is
the
rela
tions
hip
of (n
ame)
to
the
head
of
hous
ehol
d?
HL4
Is (n
ame)
m
ale
or
fem
ale?
HL5
Wha
t is
(nam
e)’s
dat
e of
birt
h?D
K-M
onth
=98,
D
K-Ye
ar=9
998
HL6
How
old
is
(nam
e)?
Reco
rd in
co
mpl
eted
yea
rs.
If ag
e is
95
or
abov
e, re
cord
95.
If le
ss th
an 1
ye
ar w
rite
‘00’
For H
H
mem
ber a
ge
15 a
nd a
bove
For W
omen
ag
e 15
-49
For c
hild
ren
age
5-14
Fo
r chi
ldre
n un
der a
ge 5
For c
hild
ren
ag
e 0-
17
year
Fo
r chi
ldre
n a
ge 0
-17
year
HL6
AIs
(nam
e)
ever
mar
ried?
HL7
Circ
le
line
no o
f w
oman
ag
ed 1
5-49
(HL4
=2,
HL6
=15-
49,
HL6
=1)
HL8
W
ho is
the
mot
her o
r pr
imar
y ca
reta
ker
of th
is c
hild
?Re
cord
line
no
. of
mot
her/
care
take
r
HL9
W
ho is
the
mot
her o
r pr
imar
y ca
reta
ker
of t
his
child
?Re
cord
line
no
. of
mot
her/
care
take
r
HL.
11
Is (n
ame)
’s
natu
ral
mot
her
aliv
e?
HL.
12
Does
(nam
e)’s
na
tura
l mot
her
live
in th
is
hous
ehol
d?
Reco
rd
mot
her’s
line
nu
mbe
r & if
no
circ
le 0
0.
HL.
12A
Whe
re d
oes
(nam
e)’s
na
tura
l m
othe
r liv
e?
HL.
13Is
(nam
e)’s
na
tura
l fa
ther
aliv
e?
HL.
14Do
es (n
ame)
’s
natu
ral f
athe
r liv
e in
this
ho
useh
old?
Re
cord
fa
ther
’s li
ne
num
ber &
if
no c
ircle
00.
HL.
14A
Whe
re d
oes
(nam
e)’s
na
tura
l fa
ther
live
?
Line
Nam
eRe
latio
n*Se
xM
onth
&
Year
Age
Mar
riage
15-4
9M
othe
r/ Ca
reta
ker
Mot
her/
Care
take
rM
othe
r aliv
eM
othe
r’s
line
#M
othe
r liv
e in
Fath
er a
live
Fath
er’s
lin
e #
Fath
er li
ve
in
01
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
01
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
02
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
02
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
03
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
03
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
04
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
04
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
xlviii
HL1
Li
ne
no.
HL2
N
ame
HL3
Wha
t is
the
rela
tions
hip
of (n
ame)
to
the
head
of
hous
ehol
d?
HL4
Is (n
ame)
m
ale
or
fem
ale?
HL5
Wha
t is
(nam
e)’s
dat
e of
birt
h?D
K-M
onth
=98,
D
K-Ye
ar=9
998
HL6
How
old
is
(nam
e)?
Reco
rd in
co
mpl
eted
yea
rs.
If ag
e is
95
or
abov
e, re
cord
95.
If le
ss th
an 1
ye
ar w
rite
‘00’
For H
H
mem
ber a
ge
15 a
nd a
bove
For W
omen
ag
e 15
-49
For c
hild
ren
age
5-14
Fo
r chi
ldre
n un
der a
ge 5
For c
hild
ren
ag
e 0-
17
year
Fo
r chi
ldre
n a
ge 0
-17
year
HL6
AIs
(nam
e)
ever
mar
ried?
HL7
Circ
le
line
no o
f w
oman
ag
ed 1
5-49
(HL4
=2,
HL6
=15-
49,
HL6
=1)
HL8
W
ho is
the
mot
her o
r pr
imar
y ca
reta
ker
of th
is c
hild
?Re
cord
line
no
. of
mot
her/
care
take
r
HL9
W
ho is
the
mot
her o
r pr
imar
y ca
reta
ker
of t
his
child
?Re
cord
line
no
. of
mot
her/
care
take
r
HL.
11
Is (n
ame)
’s
natu
ral
mot
her
aliv
e?
HL.
12
Does
(nam
e)’s
na
tura
l mot
her
live
in th
is
hous
ehol
d?
Reco
rd
mot
her’s
line
nu
mbe
r & if
no
circ
le 0
0.
HL.
12A
Whe
re d
oes
(nam
e)’s
na
tura
l m
othe
r liv
e?
HL.
13Is
(nam
e)’s
na
tura
l fa
ther
aliv
e?
HL.
14Do
es (n
ame)
’s
natu
ral f
athe
r liv
e in
this
ho
useh
old?
Re
cord
fa
ther
’s li
ne
num
ber &
if
no c
ircle
00.
HL.
14A
Whe
re d
oes
(nam
e)’s
na
tura
l fa
ther
live
?
Line
Nam
eRe
latio
n*Se
xM
onth
&
Year
Age
Mar
riage
15-4
9M
othe
r/ Ca
reta
ker
Mot
her/
Care
take
rM
othe
r aliv
eM
othe
r’s
line
#M
othe
r liv
e in
Fath
er a
live
Fath
er’s
lin
e #
Fath
er li
ve
in
05
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
05
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
06
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
06
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
07
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
07
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
08
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
08
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
09
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
09
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
xlix
Ap
pen
dix
C :
Qu
esti
on
nai
res
HL1
Li
ne
no.
HL2
N
ame
HL3
Wha
t is
the
rela
tions
hip
of (n
ame)
to
the
head
of
hous
ehol
d?
HL4
Is (n
ame)
m
ale
or
fem
ale?
HL5
Wha
t is
(nam
e)’s
dat
e of
birt
h?D
K-M
onth
=98,
D
K-Ye
ar=9
998
HL6
How
old
is
(nam
e)?
Reco
rd in
co
mpl
eted
yea
rs.
If ag
e is
95
or
abov
e, re
cord
95.
If le
ss th
an 1
ye
ar w
rite
‘00’
For H
H
mem
ber a
ge
15 a
nd a
bove
For W
omen
ag
e 15
-49
For c
hild
ren
age
5-14
Fo
r chi
ldre
n un
der a
ge 5
For c
hild
ren
ag
e 0-
17
year
Fo
r chi
ldre
n a
ge 0
-17
year
HL6
AIs
(nam
e)
ever
mar
ried?
HL7
Circ
le
line
no o
f w
oman
ag
ed 1
5-49
(HL4
=2,
HL6
=15-
49,
HL6
=1)
HL8
W
ho is
the
mot
her o
r pr
imar
y ca
reta
ker
of th
is c
hild
?Re
cord
line
no
. of
mot
her/
care
take
r
HL9
W
ho is
the
mot
her o
r pr
imar
y ca
reta
ker
of t
his
child
?Re
cord
line
no
. of
mot
her/
care
take
r
HL.
11
Is (n
ame)
’s
natu
ral
mot
her
aliv
e?
HL.
12
Does
(nam
e)’s
na
tura
l mot
her
live
in th
is
hous
ehol
d?
Reco
rd
mot
her’s
line
nu
mbe
r & if
no
circ
le 0
0.
HL.
12A
Whe
re d
oes
(nam
e)’s
na
tura
l m
othe
r liv
e?
HL.
13Is
(nam
e)’s
na
tura
l fa
ther
aliv
e?
HL.
14Do
es (n
ame)
’s
natu
ral f
athe
r liv
e in
this
ho
useh
old?
Re
cord
fa
ther
’s li
ne
num
ber &
if
no c
ircle
00.
HL.
14A
Whe
re d
oes
(nam
e)’s
na
tura
l fa
ther
live
?
Line
Nam
eRe
latio
n*Se
xM
onth
&
Year
Age
Mar
riage
15-4
9M
othe
r/ Ca
reta
ker
Mot
her/
Care
take
rM
othe
r aliv
eM
othe
r’s
line
#M
othe
r liv
e in
Fath
er a
live
Fath
er’s
lin
e #
Fath
er li
ve
in
10
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
10
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
11
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
11
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
12
Mal
e ...
.... 1
Fem
ale
.. 2
Mon
th
Year
Ye
ars
Yes
.....
. 1
No
......
.. 2
HL1
1
12
Yes
......
.1
No .
......
..2
NA
.....
...8
HL1
3
HL1
3N
o ...
......
.. 00
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Yes
......
.1
No .
......
..2
NA
.....
...8
Nex
t row
Nex
t row
No .
......
....0
0
In a
noth
erH
H in
this
coun
try
....
1A
broa
d ...
.. 2
Inst
itutio
n/H
oste
l ....
... 3
DK
......
......
.. 8
Tic
k he
re if
add
ition
al q
uest
ionn
aire
use
d
Prob
e fo
r ad
ditio
nal H
H m
embe
rs:
Pro
be
esp
ecia
lly f
or
any
infa
nts
or
smal
l ch
ildre
n n
ot
liste
d, a
nd
oth
ers
wh
o m
ay n
ot
be
mem
ber
s o
f th
e fa
mily
(su
ch a
s se
rvan
ts, f
rien
ds)
bu
t w
ho
usu
ally
live
in t
he
ho
use
ho
ld. I
nse
rt
nam
es o
f ad
dit
ion
al m
emb
ers
in t
he
ho
use
ho
ld li
st a
nd
co
mp
lete
fo
rm a
cco
rdin
gly
.
* C
odes
for
HL3
: Rel
atio
nshi
p to
hea
d of
hou
seho
ld:
01 H
ead
02 W
ife/
hu
sban
d
03 S
on
/Dau
gh
ter
04 S
on
-in
- La
w/ D
aug
hte
r-in
- La
w
05 G
ran
dch
ild
06 P
aren
t
07 P
aren
t-in
-Law
08 B
roth
er/S
iste
r
09 B
roth
er-i
n-
Law
/Sis
ter-
in-L
aw
10 U
ncl
e/A
un
t
11 N
iece
/Nep
hew
12 O
ther
rel
ativ
e
13 A
do
pte
d/F
ost
er/S
tep
child
14 N
ot
rela
ted
98 D
on
’t k
no
w
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
l
PARTICIPATION IN GARMENT INDUSTRY PG
PG1. What is the main source of livelihood for your household
Self-employment .................................................... 1
Manufacturing sector ........................................ 2
Service sector ............................................................. 3
Remittance ................................................................... 4
From rent ......................................................................... 5
Other ..................................................................................... 6
(Specify)
PG2. Whether any member works in the garments industry as wage earner?
Yes ........................................................................................... 1
No ............................................................................................. 2 ED1
PG3. How many members work in garment industry as wage earner?
One ......................................................................................... 1
Two ......................................................................................... 2
Three or more ............................................................ 3 PG4.1
PG4.2
PG4. PLEASE TELL ME the NAME OF member WHO IS working in the garment industry:
NAME: ......................................................................................................
(WRITE THE LINE NUMBER FROM HL1 & AGE FROM HL 6 IN APPROPRIATE BOX)
Line number Age ED1
PG4.1 PLEASE TELL ME the NAME OF memberS WHO IS working in the garment industry:
NAME: ......................................................................................................
NAME: ......................................................................................................
(WRITE THE LINE NUMBER FROM HL1 & AGE FROM HL 6 IN APPROPRIATE BOX)
1. Line number Age
2. Line number Age
ED1
ED1
PG4.2 PLEASE TELL ME the NAME OF memberS WHO IS working in the garment industry:
NAME: ......................................................................................................
NAME: ......................................................................................................
NAME: ......................................................................................................
(WRITE THE LINE NUMBER FROM HL1 & AGE FROM HL 6 IN APPROPRIATE BOX) (Consider three youngest members by age)
1. Line number Age
2. Line number Age
3. Line number Age
li
Ap
pen
dix
C :
Qu
esti
on
nai
res
EDU
CA
TIO
NED
For h
ouse
hold
mem
bers
age
3 y
ears
and
abo
ve
For h
ouse
hold
mem
bers
age
3-2
4 ye
ars
ED1L
ine
num
ber
ED2
Nam
e an
d ag
e
Copy
from
Hou
seho
ld L
istin
g Fo
rm, H
L2 &
HL6
.
ED3
Has
(nam
e)
ever
atte
nded
pr
esch
ool,
prim
ary
scho
ol, s
econ
dary
sc
hool
, col
lege
or
uni
vers
ity,
mad
rash
a?
ED4A
Wha
t is
the
high
est l
evel
of
scho
ol (n
ame)
ha
s at
tend
ed?
ED4B
Wha
t is
the
high
est g
rade
(n
ame)
com
plet
ed
at th
is le
vel?
If
less
tha
n 1
grad
e, e
nter
00,
G
rade
: 98
DK
ED5
Dur
ing
the
2016
sch
ool
year
, did
(nam
e) a
ttend
pr
e-sc
hool
, prim
ary
scho
ol, s
econ
dary
sc
hool
, col
lege
or
univ
ersi
ty, m
adra
sha
at
any
time?
ED6
Dur
ing
this
sch
ool y
ear,
whi
ch
leve
l & g
rade
is/w
as (n
ame)
at
tend
ing?
ED7
Dur
ing
the
prev
ious
sc
hool
yea
r, th
at is
20
15 d
id (n
ame)
atte
nd
pres
choo
l, pr
imar
y sc
hool
, se
cond
ary
scho
ol, c
olle
ge
or u
nive
rsity
, mad
rash
a at
an
y tim
e?
ED8
Dur
ing
that
pre
viou
s sc
hool
yea
r, w
hich
leve
l & g
rade
did
(nam
e)
atte
nd?
Line
Nam
eA
geYe
s/N
oLe
vel
Gra
deYe
s/N
oLe
vel
Gra
deYe
s/N
o/D
KLe
vel
Gra
de
01
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
02
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
03
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lii
For h
ouse
hold
mem
bers
age
3 y
ears
and
abo
ve
For h
ouse
hold
mem
bers
age
3-2
4 ye
ars
ED1L
ine
num
ber
ED2
Nam
e an
d ag
e
Copy
from
Hou
seho
ld L
istin
g Fo
rm, H
L2 &
HL6
.
ED3
Has
(nam
e)
ever
atte
nded
pr
esch
ool,
prim
ary
scho
ol, s
econ
dary
sc
hool
, col
lege
or
uni
vers
ity,
mad
rash
a?
ED4A
Wha
t is
the
high
est l
evel
of
scho
ol (n
ame)
ha
s at
tend
ed?
ED4B
Wha
t is
the
high
est g
rade
(n
ame)
com
plet
ed
at th
is le
vel?
If
less
tha
n 1
grad
e, e
nter
00,
G
rade
: 98
DK
ED5
Dur
ing
the
2016
sch
ool
year
, did
(nam
e) a
ttend
pr
e-sc
hool
, prim
ary
scho
ol, s
econ
dary
sc
hool
, col
lege
or
univ
ersi
ty, m
adra
sha
at
any
time?
ED6
Dur
ing
this
sch
ool y
ear,
whi
ch
leve
l & g
rade
is/w
as (n
ame)
at
tend
ing?
ED7
Dur
ing
the
prev
ious
sc
hool
yea
r, th
at is
20
15 d
id (n
ame)
atte
nd
pres
choo
l, pr
imar
y sc
hool
, se
cond
ary
scho
ol, c
olle
ge
or u
nive
rsity
, mad
rash
a at
an
y tim
e?
ED8
Dur
ing
that
pre
viou
s sc
hool
yea
r, w
hich
leve
l & g
rade
did
(nam
e)
atte
nd?
Line
Nam
eA
geYe
s/N
oLe
vel
Gra
deYe
s/N
oLe
vel
Gra
deYe
s/N
o/D
KLe
vel
Gra
de
04
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
05
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
06
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
liii
Ap
pen
dix
C :
Qu
esti
on
nai
res
For h
ouse
hold
mem
bers
age
3 y
ears
and
abo
ve
For h
ouse
hold
mem
bers
age
3-2
4 ye
ars
ED1L
ine
num
ber
ED2
Nam
e an
d ag
e
Copy
from
Hou
seho
ld L
istin
g Fo
rm, H
L2 &
HL6
.
ED3
Has
(nam
e)
ever
atte
nded
pr
esch
ool,
prim
ary
scho
ol, s
econ
dary
sc
hool
, col
lege
or
uni
vers
ity,
mad
rash
a?
ED4A
Wha
t is
the
high
est l
evel
of
scho
ol (n
ame)
ha
s at
tend
ed?
ED4B
Wha
t is
the
high
est g
rade
(n
ame)
com
plet
ed
at th
is le
vel?
If
less
tha
n 1
grad
e, e
nter
00,
G
rade
: 98
DK
ED5
Dur
ing
the
2016
sch
ool
year
, did
(nam
e) a
ttend
pr
e-sc
hool
, prim
ary
scho
ol, s
econ
dary
sc
hool
, col
lege
or
univ
ersi
ty, m
adra
sha
at
any
time?
ED6
Dur
ing
this
sch
ool y
ear,
whi
ch
leve
l & g
rade
is/w
as (n
ame)
at
tend
ing?
ED7
Dur
ing
the
prev
ious
sc
hool
yea
r, th
at is
20
15 d
id (n
ame)
atte
nd
pres
choo
l, pr
imar
y sc
hool
, se
cond
ary
scho
ol, c
olle
ge
or u
nive
rsity
, mad
rash
a at
an
y tim
e?
ED8
Dur
ing
that
pre
viou
s sc
hool
yea
r, w
hich
leve
l & g
rade
did
(nam
e)
atte
nd?
Line
Nam
eA
geYe
s/N
oLe
vel
Gra
deYe
s/N
oLe
vel
Gra
deYe
s/N
o/D
KLe
vel
Gra
de
07
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
08
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
09
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
liv
For h
ouse
hold
mem
bers
age
3 y
ears
and
abo
ve
For h
ouse
hold
mem
bers
age
3-2
4 ye
ars
ED1L
ine
num
ber
ED2
Nam
e an
d ag
e
Copy
from
Hou
seho
ld L
istin
g Fo
rm, H
L2 &
HL6
.
ED3
Has
(nam
e)
ever
atte
nded
pr
esch
ool,
prim
ary
scho
ol, s
econ
dary
sc
hool
, col
lege
or
uni
vers
ity,
mad
rash
a?
ED4A
Wha
t is
the
high
est l
evel
of
scho
ol (n
ame)
ha
s at
tend
ed?
ED4B
Wha
t is
the
high
est g
rade
(n
ame)
com
plet
ed
at th
is le
vel?
If
less
tha
n 1
grad
e, e
nter
00,
G
rade
: 98
DK
ED5
Dur
ing
the
2016
sch
ool
year
, did
(nam
e) a
ttend
pr
e-sc
hool
, prim
ary
scho
ol, s
econ
dary
sc
hool
, col
lege
or
univ
ersi
ty, m
adra
sha
at
any
time?
ED6
Dur
ing
this
sch
ool y
ear,
whi
ch
leve
l & g
rade
is/w
as (n
ame)
at
tend
ing?
ED7
Dur
ing
the
prev
ious
sc
hool
yea
r, th
at is
20
15 d
id (n
ame)
atte
nd
pres
choo
l, pr
imar
y sc
hool
, se
cond
ary
scho
ol, c
olle
ge
or u
nive
rsity
, mad
rash
a at
an
y tim
e?
ED8
Dur
ing
that
pre
viou
s sc
hool
yea
r, w
hich
leve
l & g
rade
did
(nam
e)
atte
nd?
Line
Nam
eA
geYe
s/N
oLe
vel
Gra
deYe
s/N
oLe
vel
Gra
deYe
s/N
o/D
KLe
vel
Gra
de
10
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
11
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
12
In y
ears
Yes
......
......
1
No
......
......
.. 2
Nex
t row
Pres
choo
l ....
0(S
kip
to E
D.5
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
G
o to
ED
7
Pres
choo
l ....
0(S
kip
to E
D.7
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
DK
......
......
.... 9
8
Yes
......
......
..1
No .
......
......
...2
DK.
......
......
...8
(S
kip
to n
ext r
ow)
Pres
choo
l ....
0(S
kip
to n
ext
row
)Pr
imar
y ..
......
1Se
cond
ary/
high
er
seco
ndar
y ...
2H
ighe
r ...
......
.. 3
DK
......
......
......
.. 8
Clas
sD
K ...
......
......
. 98
Co
de:
ED
4B/
ED
6A/E
D8A
0-P
resc
ho
ol:
Gra
de-
00
1-P
rim
ary:
Gra
de
01 t
o 0
5
2-S
eco
nd
ary/
Hig
her
sec
on
dar
y:
Gra
de
01 t
o 0
7
3-H
igh
er:
Gra
de
01 t
o 0
5
3-H
igh
er (
MB
BS
):
Gra
de
11 t
o 1
5
3-H
igh
er (
En
gin
eeri
ng
):
Gra
de
21 t
o 2
5
3-H
igh
er (
Ph
D):
Gra
de
31 t
o 3
5
lv
Ap
pen
dix
C :
Qu
esti
on
nai
res
WATER AND SANITATION WSWS1 What is the main source of drinking water for
members of your household?PIPED WATER
Piped into dwelling .................... 11 Piped into compound,
yard or plot ................................. 12
Piped to neighbour .................... 13
Public tap/standpipe .................. 14
Tube well, borehole ........................ 21
DUG WELL
Protected well ............................ 31 Unprotected well ....................... 32
WATER FROM SPRING
Protected spring ......................... 41
Unprotected spring .................... 42
Rainwater collection ....................... 51
Tanker-truck .................................... 61
Cart with small tank/drum .............. 71
Surface water (River, stream,
dam, lake, pond, canal,
irrigation channel) ..................... 81
Bottled water ................................... 91 Other ................................................ 96
(Specify)
WS6
WS6
WS2 WHAT IS THE MAIN SOURCE OF WATER USED BY YOUR HOUSEHOLD FOR OTHER PURPOSES SUCH AS COOKING AND HANDWASHING
PIPED WATER Piped into dwelling .................... 11 Piped into compound, yard or plot ................................. 12 Piped to neighbour .................... 13 Public tap/standpipe .................. 14Tube well, borehole ........................ 21DUG WELL Protected well ............................ 31 Unprotected well ....................... 32WATER FROM SPRING Protected spring ......................... 41 Unprotected spring .................... 42Rainwater collection ....................... 51Tanker-truck .................................... 61Cart with small tank/drum .............. 71 Surface water (River, stream, dam, lake, pond, canal, irrigation channel) ..................... 81Other ................................................ 96
(Specify)
WS6 Do you do anything to the water to make it safer to drink?
Yes ..................................................... 1
No ....................................................... 2 Don’t know ........................................ 8
WS8
WS7 What do you usually do to make the water safer to drink?
Probe:
Anything else?
Record all items mentioned.
Boil ..................................................... A
Add bleach/chlorine .......................... B
Strain through a cloth ...................... C
Use water filter (ceramic,
sand, composite, etc.) ...................... D
Solar disinfection .............................. E
Let it stand and settle ....................... F
Use purify tablet ............................... G
Other (Specify) .................................. X
Don’t know ........................................ Z
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lvi
WS8 What kind of toilet facility do members of your household usually use?
If “flush” or “pour flush”, probe: where does it flush to?
If necessary, ask permission to observe the facility.
Flush or pour flush toilet
Flush to piped sewer system ........... 11
Flush to septic tank .................... 12
Flush to pit (latrine) ................... 13
Flush to somewhere else .......... 14
Flush to unknown place/
not sure/don’t know where ........ 15
Pit latrine
Ventilated improved pit latrine ........ 21
Pit latrine with slab .................... 22
Pit latrine without slab/open pit ........ 23
Composting toilet ........................... 31
Bucket .............................................. 41
Hanging toilet, Hanging latrine ........... 51
No facility, bush, field ..................... 95 Other ................................................ 96
(Specify)
HC1A
WS9 Do you share this facility with others who are not members of your households?
Yes ..................................................... 1
No ....................................................... 2 HC1A
WS10 Do you share this facility only with members of other households that you know, or is the facility open to the use of the general public?
Other households only
(not public) ........................................ 1
Public facility ..................................... 2 HC1A
WS11 How many households in total use this toilet facility, including your own household?
Number of households (if less than 10) ........................... 0
Ten or more households ................ 10
Don’t know ...................................... 98
HOUSEHOLD CHARACTERISTICS HCHC1A What is the religion of the head of this
household?Islam ...................................................................................................... 1
Hinduism ........................................................................................ 2
Buddhism ...................................................................................... 3
Christianity .................................................................................. 4
Other religion ......................................................................... 6
(Specify)
No religion ................................................................................... 7
HC2 HOW MANY ROOMS IN THIS HOUSEHOLD ARE USED FOR SLEEPING?
Number of rooms ................................................
HC3 Main material of the dwelling floor:
RECORD OBSERVATION
Natural floor
Earth/Sand ..................................................................... 11
Dung ........................................................................................ 12
Rudimentary floor
Wood planks .............................................................. 21
Palm/Bamboo ........................................................... 22
Finished floor
Parquet or polished
wood ........................................................................................ 31
Vinyl or asphalt strips ................................. 32
Ceramic tiles/Mosaic .................................... 33
Cement ................................................................................ 34
Carpet .................................................................................... 35
Other ................................................................................................. 96
(specify)
lvii
Ap
pen
dix
C :
Qu
esti
on
nai
res
HC4. Main material of the roof:
RECORD OBSERVATION
Natural roofing
No Roof ............................................................................... 11
Thatch/Palm leaf .................................................. 12
Sod ............................................................................................. 13
Rudimentary Roofing
Rustic mat ....................................................................... 21
Palm/Bamboo ........................................................... 22
Wood planks .............................................................. 23
Cardboard ....................................................................... 24
Finished roofing
Metal/Tin ........................................................................... 31
Wood ...................................................................................... 32
Calamine/Cement fiber ............................. 33
Ceramic tiles ............................................................... 34
Cement ................................................................................ 35
Roofing shingles .................................................. 36
Other ............................................................................................. 96
(Specify)
HC5. Main material of the exterior walls:
RECORD OBSERVATION
Natural walls
No walls ............................................................................. 11
Cane/Palm/Trunks ............................................. 12
Dirt .............................................................................................. 13
Rudimentary walls
Bamboo with mud ............................................ 21
Stone with mud .................................................... 22
Uncovered adobe .............................................. 23
Plywood ............................................................................. 24
Cardboard ....................................................................... 25
Reused wood ............................................................ 26
Tin ................................................................................................ 27
Finished walls
Cement ................................................................................ 31
Stone with lime/cement .......................... 32
Bricks ...................................................................................... 33
Cement blocks ......................................................... 34
Covered adobe ....................................................... 35
Wood planks/shingles ................................ 36
Other ............................................................................................... 96
(Specify)
HC6. What type of fuel does your household mainly use for cooking?
Electricity ................................................................................... 01
Liquefied Petroleum Gas (LPG) ...................... 02
Natural gas ............................................................................. 03
Biogas ............................................................................................. 04
Kerosene ..................................................................................... 05
Coal/lignite .............................................................................. 06
Charcoal ....................................................................................... 07
Wood ................................................................................................ 08
Straw/Shrubs/Grass ................................................. 09
Animal dung ......................................................................... 10
Agricultural crop residue ................................ 11
No food cooked in household .......................... 95 Other ................................................................................................. 96
(Specify)
HC8
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lviii
HC7 IS THE COOKING USUALLY DONE IN THE HOUSE, IN A SEPARATE BUILDING, OR OUTDOORS?
If ‘In the house’, probe: IS IT DONE IN A SEPARATE ROOM USED AS A KITCHEN?
In the house
In a separate room used as
Kitchen ............................................................................................... 1
Elsewhere in the house ......................................... 2
In a separate building ............................................... 3
Outdoors ......................................................................................... 4
Other (specify) ....................................................................... 6
HC8. Does your household have:
READ OUTYes No
A. Electricity 1 2
B. Radio 1 2
C. Television 1 2
D. Non-mobile telephone 1 2
E. Refrigerator 1 2
F. Electric fan 1 2
G. Cot/Bed 1 2
H. Table 1 2
I. Almirah/wardrobe 1 2
J. Sofa set 1 2
K. Water dispenser 1 2
L. Water pump 1 2
HC9. Does any member of your household own:
READ OUTYes No
A. Watch 1 2
B. Mobile telephone 1 2
C. Bicycle 1 2
D. Motorcycle/Scooter 1 2
E. Animal drawn-cart 1 2
F. Car/Truck 1 2
G. Boat with motor 1 2
H. Rickshaw/van 1 2
I. NNasiman/ Kariman/ Votbati
1 2
J. Easy bike/Auto bike (Battery driven)
1 2
K. Computer 1 2
HC10. Do you or someone living in this household own this dwelling?
If ‘no’ then ask: Do you rent this dwelling from someone not living in this households?
Own ......................................................................................................... 1
Rent ......................................................................................................... 2
Other (Not owned or rented) ........................ 6
HC11 Does any member of this household own any land that can be used for agriculture?
Yes ............................................................................................................ 1
No ............................................................................................................... 2 C13
HC12 How many acres of agricultural land do members of this household own?
If less than1, record ‘00’, If 95 or more, record ‘95’ If unknown, record ‘98’.
Acres .........................................................................................
HC13 DOES THIS HOUSEHOLD OWN ANY LIVESTOCK, HERDS, OTHER FARM ANIMALS, OR POULTRY?
Yes ............................................................................................................ 1
No ............................................................................................................... 2 HC15
lix
Ap
pen
dix
C :
Qu
esti
on
nai
res
HC14 HOW MANY OF THE FOLLOWING ANIMALS DOES THIS HOUSEHOLD HAVE? (READ OUT)
[A] CATTLE, MILK COWS, OR BULLS?
[B] HORSES, DONKEYS, OR MULES?
[C] GOATS?
[D] SHEEP?
[E] CHICKEN/DUCKS?
[F] PIGS?
If none, record ‘00’.
If 95 or more, record ‘95’.
If unknown, record ‘98’.
Cattle, milk cows, or bulls ........................
Horses, donkeys, or mules ......................
Goats ............................................................................................
Sheep ........................................................................................
Chicken/Ducks ..............................................................
Pigs .................................................................................................
HC15 DOES ANY MEMBER OF THIS HOUSEHOLD HAVE A BANK ACCOUNT?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
HC16 DO YOU DO ANYTHING TO GET PROTECTION FROM MOSQUITO BITES?
Yes ............................................................................................................ 1
No ............................................................................................................... 2 Dk ................................................................................................................ 3
SL1
HC17 WHAT ARE YOU DOING TO GET PROTECTION FROM MOSQUITO BITES?
Circle all that apply.
Mosquito net .......................................................................... A
Coil .......................................................................................................... B
Spray .................................................................................................... C
Electric mat ................................................................................ D
Other (specify) .................................................................... X
DK ............................................................................................................... Z
SELECTION OF ONE CHILD FOR CHILD LABOUR/CHILD DISCIPLINESL1 Check HL6 in the list of household members and
write the total number of children age 1-17 years.Number ......................................................................................... No children age 1-17 years .............................. 0 HW1
SL2 Check the number of children age 1-17 years in SL1and tick in appropriate box. One Go to SL9 and record the rank number as’1’, enter the line number, child’s name and
age. Two or more Continue with SL2A
SL2A List each of the children aged 1-17 years below in the order they appear in the List of Household Members. Do not include other household members outside of the age rang 5-17 years. Record the line number, name, sex, and age for each child.
SL3Rank
Number
SL4Line number
from HL1
SL5Name from HL2
SL6Sex from HL4
SL7Age from
HL6
Rank Line Name Male Female Age
1 Male .................. 1 Female .......... 2 2 Male .................. 1 Female .......... 2 3 Male .................. 1 Female .......... 2 4 Male .................. 1 Female .......... 2 5 Male .................. 1 Female .......... 2 6 Male .................. 1 Female .......... 2 7 Male .................. 1 Female .......... 2 8 Male .................. 1 Female .......... 2
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lx
SL8 � Check the last digit of the household number (HH2) from the cover page. This is the number of the row you should go to in the table below.
� Check the total number of children age 1-17 in SL1 above. This is the number of the column you should go to in the table below.
� Find the box where the row and the column meet and circle the number that appears in the box. This is the rank number (SL3) of the selected child.
Last digit of household number (from HH2)
Total number of Eligible Children in the Household (from SL1)2 3 4 5 6 7 8+
0 2 2 4 3 6 5 4
1 1 3 1 4 1 6 5
2 2 1 2 5 2 7 6
3 1 2 3 1 3 1 7
4 2 3 4 2 4 2 8
5 1 1 1 3 5 3 1
6 2 2 2 4 6 4 2
7 1 3 3 5 1 5 3
8 2 1 4 1 2 6 4
9 1 2 1 2 3 7 5
SL9 Record the rank number (SL3), line number (SL4), name (SL5) and age (SL7) of the selected child.
Rank number ....................................................................... Line number .................................................................
Name: ........................................................................................................
Age ...............................................................................................
CHILD LABOUR CLCL1 Check the age of child in SL9 and tick an
appropriate box.Age 01-04 years .............................................................. Age 05-17 years ..............................................................
CD1
CL2 Now I would like to ask about any work children in this household may do.
Since last (day of the week), did (name) do any of the following activities, even for only one hour?
[A] Did (name) do any work or help on his/her own or the household’s plot/ farm/food garden or looked after animals?
For example, growing firm produce, harvesting, or feeding, grazing, milking animals?
[B] Did (name) help in family business or relative’s business with or without pay, or run his/her own business?
[C] Did (name) produce or sell articles, handicrafts, clothes, food or agricultural products?
[D] Since last (day of the week), did (name) engage in any other activity in return for income in cash or in kind,
even for only one hour?
If ‘No’, probe:
Please include any activity (name) performed as a regular or casual employee, self-employed or employer: or as an unpaid family worker helping out in household business or farm
Yes No
Work on plot/farm/food garden/looked after animals .. 1 2
Helped in family/relative’s business/ran own business ...... 1 2
Produce/sell articles/handicrafts/ clothes/food or agriculture products ............................. 1 2
Any other activity ...................................... 1 2
lxi
Ap
pen
dix
C :
Qu
esti
on
nai
res
CL3 Check CL2A-CL2D and tick in appropriate box. At least one code 1 is circled .................... All code 2 is circled ...................................................
CL8
CL4 Since last (day of the week), about how many hours did (name) engage in this activity/these activities, in total?
Number of hours ..................................................
CL5 Does the activity/Do these activities require carrying heavy loads?
Yes ............................................................................................................ 1 No ............................................................................................................... 2
CL8
CL6 Does the activity/Do these activities require working with dangerous tools (knives etc.) or operating heavy machinery?
Yes ............................................................................................................ 1 No ............................................................................................................... 2
CL8
CL7 How would you describe the work environment of (name)?
[A] Is (name) exposed to dust, fumes or gas? Yes ............................................................................................................ 1
No ............................................................................................................... 2
[B] Is (name) exposed to extreme cold, heat or humidity?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
[C] Is (name) exposed to loud noise or vibration? Yes ............................................................................................................ 1
No ............................................................................................................... 2
[D] Is (name) required to work at heights? Yes ............................................................................................................ 1
No ............................................................................................................... 2
[E] Is (name) required to work with chemicals (pesticides, glues, etc.) or explosives?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
[F] Is (name) exposed to other things, processes or conditions bad for (name)’s health or safety?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
CL8 Since last (day of the week), did (name) fetch water or collect firewood for household use?
Yes ............................................................................................................ 1
No ............................................................................................................... 2 CL10
CL9 In total, how many hours did (name) spend on fetching water or collecting firewood for household use, since last (day of the week)?
If less than one hour, record ‘0’.
Number of hours ..........................................................
CL10 Since last (day of the week), did (name) do any of the following for this household?
[A] Shopping for household?
[B] Repair any household equipment?
[C] Cooking or cleaning utensils or the house?
[D] Washing clothes?
[E] Caring for children?
[F] Caring for the old or sick?
[G] Other household tasks?
Yes No
Shopping for household ....................... 1 2
Repair any household equipment .............................................................
1 2
Cooking or cleaning utensils or the house ................................................................
1 2
Washing clothes ......................................... 1 2
Caring for children .................................. 1 2
Caring for the old or sick ...................... 1 2
Other household tasks ..................... 1 2
CL11 Check CL10A-CL10G and tick in appropriate box. At least one code 1 is circled .................... All code 2 is circled ...................................................
CD1
CL12 Since last (day of the week), about how many hours did (name) engage in this activity/these activities, in total?
If less than one hour, record ‘00’.
Number of hours ..................................................
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxii
CHILD DISCIPLINE CDCD1 Check the age of child in SL9 and tick an appropriate
box.Age 01-14 years ..............................................................
Age 15-17 years .............................................................. HW1
CD2 Write the line number (SL4) and name (SL5) of the child selected.
Line number .................................................................
Name: ........................................................................................................
CD3 Adults use certain ways to teach children the right behavior or to address a behavior problem. I will read various methods that are used and I want you to tell me if you or anyone else in your household has used this method with (name) in the past month?
[A] Took away privileges, forbade something (name) liked or did not allow him/her to leave house.
[B] Explained why (name)’s behavior was wrong.
[C] Shook him/her.
[D] Shouted, yelled at or screamed at him/her.
[E] Gave him/her something else to do.
[F] Spanked, hit or slapped him/her on the bottom with bare hand.
[G] Hit him/her on the bottom or elsewhere on the body with something like a belt, hairbrush, stick or other hard object.
[H] Called him/her dumb, lazy, or another name like that.
[I] Hit or slapped him/her on the face, head or ears.
[J] Hit or slapped him/her on the hand, arm or leg.
[K] Beat him/her up, that is hit him/her over and over as hard as one could
Yes No
Took away privileges ................................. 1 2
Explained wrong behavior ................. 1 2
Shook him/her ................................................. 1 2
Shouted, yelled, screamed ................ 1 2
Gave something else to do ................ 1 2
Spanked, hit, slapped on bottom with bare hand .............................................. 1 2
Hit with belt, hairbrush, stick or other hard object ....................................... 1 2
Called dumb, lazy, or another name ............................................................................... 1 2
Hit/slapped on the face, head or ears ................................................................................... 1 2
Hit/slapped on the hand, arm or leg ....................................................................................... 1 2
Beat up, hit over and over as hard as one could ...................................................... 1 2
CD4 Do you believe that in order to bring up, raise, or educate a child properly, the child needs to be physically punished?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
Don’t know/No opinion .......................................... 8
lxiii
Ap
pen
dix
C :
Qu
esti
on
nai
res
HANDWASHING HWHW1 Please show me where members of your
household most often wash their hands.Observed ........................................................................................ 1
Not observed
Not in dwelling/plot/yard .......................... 2
No permission to see ...................................... 3
Other reason .................................................................. 6
(Specify)
HW4
HW2 OBSERVATION ONLY:
OBSERVE PRESENCE OF WATER AT THE
SPECIFIC PLACE FOR HANDWASHING.
VERIFY BY CHECKING THE TAP/PUMP, OR BASIN, BUCKET, WATER CONTAINER OR SIMILAR OBJECTS FOR PRESENCE OF WATER.
WATER IS AVAILABLE ............................................ 1
WATER IS NOT AVAILABLE ........................... 2
HW3 OBSERVATION ONLY:
RECORD IF SOAP OR DETERGENT IS PRESENT AT THE SPECIFIC PLACE FOR HANDWASHING
Circle all that apply
Bar Soap ........................................................................................ A
Detergent (powder/liquid/paste) ...................... B
Liquid soap ................................................................................ C
Ash/mud/sand ...................................................................... D
None ..................................................................................................... Y
HH19
HW4 Do you have any soap or detergent in your household for washing hands?
Yes ............................................................................................................ 1
No ............................................................................................................... 2 HH19
HW5 Can you please show it to me?
RECORD OBSERVATION.
Circle all that apply
Bar Soap ...................................................................................... A
Detergent (powder/liquid/paste) ...................... B
Liquid soap .............................................................................. C
Ash/mud/sand ...................................................................... D
Not able/Does not want to show ..................... Y
HH19 Record the time
Hour and minutes .......................... : HH20 Thanks for the respondent for his/her cooperation and check the household questionnaire:
Return to the cover page and make sure that all information is entered, including the number of eligible women (HH12), under 2 children (HH14A) and under 5 children (HH14).
Make arrangement for individual women questionnaire has been issued for each married woman aged 15-49 years in the Household List (HL7).
Important instruction Check HH14 and HH14A. If there is no eligible woman aged 15-49 years in the HH, then ask the Immunization, For children under 5 and Anthropometry module to the caretakers, if the under 5 and under 2 child in the HH.
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxiv
QUESTIONNAIRE FOR INDIVIDUAL WOMAN
Woman’s InformationThis questionnaire is to be administered to all married women age 15 through 49 (see Household listing Form,
column HL7). A separate questionnaire should be used for each eligible woman.
WM1. Cluster number: WM2. Household number:
WM3. Woman’s name
Name: ..................................................................................................................................................................
WM4. Woman’s line number:
WM5. Interviewer name and code:
Name: .................................................................................................................................................
WM6. Day/Month/Year of Interview:
Informed Consent
Repeat greeting if not already read to this woman: If greeting at the beginning of the household questionnaire has already been read to this woman, then read the following:
We are from Associates for Community and Population Research (ACPR). We are collecting information on behalf of a project of Bangladesh Government and UNICEF on HH information, maternal and child health, education, and child labour. I would like to talk to you about these subjects. The interview will take about 40 minutes. All the information we obtain will remain strictly confidential and your answers will never be shared with anyone other than our project team.
Now I would like to talk to you more about your & your child’s health and other topics. This interview will take about 40 minutes. Again, all the information we obtain will remain strictly confidential and your answers will never be shared with anyone other than our project team.
May I start now?
Yes, permission is given Go to WM10 to record the time and then begin the interview.
No, permission is not given Circle 03 in WM7. Discuss this result with your supervisor.
WM7. Result of woman’s interview: Completed ......................................................................................................................................... 01
Not at home .................................................................................................................................... 02
Refused ................................................................................................................................................... 03
Partly completed ..................................................................................................................... 04
Incapacited ........................................................................................................................................ 05
Other (specify) ............................................................................................................................. 96
WM8. Field editor name & code:
............................................................................
WM9. Data entry clerk (1st) name & code:
............................................................................
WM9A. Data entry clerk (2nd) name & code:
............................................................................
WM10. Interview starting time Hours ..................................................................................................................
Minutes ...........................................................................................................
lxv
Ap
pen
dix
C :
Qu
esti
on
nai
res
WOMAN’S BACKGROUND WBWB1. In what month and year were you born? Date of birth
Month ......................................................................................
DK month ................................................................................... 98
Year ...........................................................................
DK year ................................................................................... 9998
WB2. How old are you?
Probe: How old were you at your last birthday?
Compare and correct WB1 and/or WB2 if inconsistent
Age (in completed years) .......................
WB3. Have you ever attended pre-primary school, primary school, secondary school, college or university, madrasha?
Yes ............................................................................................................. 1
No ................................................................................................................ 2 WB7
WB4. What is the highest level of pre-primary school, primary school, secondary school, college or university, madrasha you attended?
Preschool ........................................................................................ 0 Primary ............................................................................................... 1
Secondary/Higher secondary ....................... 2
Higher ................................................................................................... 3
WB7
WB5. What is the highest grade you completed at the level of pre-primary school, primary school, secondary school, college or university, madrasha?
If less than 1 grade, enter ‘00’
Grade ........................................................................................
WB6. Check WB4 (Highest level) and circle in appropriate code.
Code 2 or 3 (secondary/higher)
is circled ....................................................................................... Code 1(primary) is circled ..............................
MA6
WB7. Now I would like you to read this sentence to me.
Show sentence on the card to the respondent. If respondent cannot read whole sentence, probe:
Can you read part of the sentence to me?
Cannot read at all .............................................................. 1
Able to read only parts of sentence .................. 2
Able to read whole sentence ......................... 3
No sentence in required
language .......................................................................................... 4
(Specify language)
Blind/visually impaired ............................................ 5
MARRIAGE MAMA6. What is your marital status now: Are you currently
married, widowed, divorced, separated or never married?
Currently married ............................................................. 1
Widowed ......................................................................................... 2
Divorced ........................................................................................... 3
Separated ....................................................................................... 4
Never married ........................................................................ 5
AN7
MA7. Have you been married only once or more than once?
Only once ....................................................................................... 1
More than once .................................................................... 2
MA8. In what month and year did you start living with your (first) husband? Month ......................................................................................
DK month ................................................................................... 98
Year .......................................................................... DK year ................................................................................... 9998
BH1
MA9 How old were you when you started living with your (First) Husband?
Age
(in completed years) ....................................... BH1. Now I would like to ask about the birth you have
had during your life.
Have you ever given birth?
Yes ............................................................................................................. 1
No ................................................................................................................ 2 CP0
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxvi
BH2. What was the date of your first birth?
I mean the very first time you gave birth, even if the child is no longer living, or whose father is not your current husband.
Day ...............................................................................................
DK day ............................................................................................. 98
Month ......................................................................................
DK month ................................................................................... 98
Year .......................................................................... DK year ................................................................................... 9998
BH4
BH3. How many years ago did you have your first birth? Years ago
(in completed years) ..................................... BH4. How many live birth you have had during your
life?One ............................................................................................................ 1
More than one ................................................................... BH6
BH5. Check BH2 & BH3: Birth occurred within the last 2 years, that is, since (day and month of interview) in 2014/2015.
No live birth in last 2 years
(Februay 2014) ................................................................ Live birth in last 2 years
(February 2014) .............................................................
CP0
BH8
BH6. What was the date of your last birth (even if he or she has died)?
Month and year must be recorded.
Day ...............................................................................................
DK day ............................................................................................. 98
Month ......................................................................................
Year ...........................................................................
BH7. Check BH6: Last birth occurred within the last 2 years, that is, since (day and month of interview) in 2014/2015.
No live birth in last 2 years
(February 2014) ...........................................................
One or more live birth in last 2 years (February 2014) ..........................................
CP0
BH8. Ask for the name of the child whose birth occurred within the last 2 years.
If child has died, take special care when referring to this child by name in the following modules.
Name of last born child:
...............................................................................................................................
BH9. Is the youngest child is alive? If alive, whether he/she is living in this household?
Yes alive, live in the household ........................... 1
Yes alive, not live in the household ................. 2
Dead ........................................................................................................ 3
MATERNAL AND NEWBORN HEALTH MNMN0 This module is to be administered to all women with a live birth in the 2 years preceding the date of
interview.
Check BH8 and record name of (last born) child here. Name: ....................................... Use this child’s name in the following questions, where indicated.
MN1. Did you see anyone for antenatal care during your pregnancy with (name)?
Yes ............................................................................................................. 1
No ................................................................................................................ 2 MN5
MN2. Whom did you see?
Probe:
Anyone else?
PROBE FOR THE TYPE OF PERSON SEEN AND CIRCLE ALL ANSWERS GIVEN.
Health Professional
Qualified Doctor ...................................................... A
Nurse/Midwife/Paramedic ...................... B
FWV .............................................................................................. C
Community skilled birth
attendant (CSBA) ................................................. D
MAS/SACMO ................................................................. E
Community Health Provider .......................... F
Health Assistant (HA) ..................................... G
Family Welfare Assistant (FWA) ................... H
NGO worker ...................................................................... I
lxvii
Ap
pen
dix
C :
Qu
esti
on
nai
res
Other Professional
Trained Traditional birth
attendant(TTBA) ....................................................... J
Untrained Traditional birth
attendant(UTBA) ..................................................... K
Quack .......................................................................................... L
Other ..................................................................................................... X
(Specify)
MN3. How many times did you receive antenatal care during this pregnancy?
Number of times ...................................................
DK ............................................................................................................ 98
MN4. As part of your antenatal care during this pregnancy, were any of the following done at least once: Read out
Yes No
[A] Was your blood pressure measured? Blood pressure ........................................... 1 2
[B] Did you give a urine sample? Urine sample ................................................. 1 2
[C] Did yo give a blood sample? Blood sample ................................................ 1 2
MN5. Do you have a card or other document with your own immunizations listed?
MAY I SEE IT PLEASE?
If a card is presented, use it to assist with answers to the following questions.
Yes (card seen) ...................................................................... 1
Yes (card not seen) ........................................................ 2
No ................................................................................................................ 3
DK ................................................................................................................ 8
MN6. When you were pregnant with (name), Did you receive any injection in the arm or shoulder to prevent the baby from getting tetanus,that is convulsions after birth?
Yes ............................................................................................................. 1
No ................................................................................................................ 2
DK ................................................................................................................ 8
MN9
MN9
MN7. How many times did you receive this tetanus injection during your last pregnancy with (name)?
If 7 or more times, record ‘7’Number of times ............................................................
DK ................................................................................................................ 8 MN9
MN8. How many tetanus injections during last pregnancy were reported in MN7?
At least 2 tetanus injection during last pregnancy ..............................................
Only one tetanus injection during last pregnancy ..............................................
MN17
MN9.
Did you receive any tetanus injection at any time before your pregnancy with (name), either to protect yourself or another baby?
Yes ............................................................................................................. 1
No ................................................................................................................ 2
DK ................................................................................................................ 8
MN17
MN17
MN10. How many times did you receive a tetanus injection before your pregnancy with (name)?
If 7 or more times, record ‘7’Number of times ............................................................
DK ................................................................................................................ 8 MN17
MN11. How many years ago did you receive the last tetanus injection before your pregnancy with (name)?
Years ago ...........................................................................
MN17. Who assisted with the delivery of (Name)?
Probe:
Anyone else?
Probe for the type of person assisting and circle all answers given.
If respondent says no one assisted, probe to determine whether any adults were present at the delivery.
Health Professional
Qualified Doctor ...................................................... A
Nurse/Midwife/Paramedic ...................... B
FWV .............................................................................................. C
Community skilled birth
attendant (CSBA) ................................................. D
MA/SACMO ...................................................................... E
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxviii
Community Health Provider .......................... F
Health Assistant (HA) ..................................... G
Family Welfare Assistant (FWA) ...................... H
NGO worker ...................................................................... I
Other Professional
Trained Traditional birth
attendant(TTBA) ....................................................... J
Untrained Traditional birth
attendant(UTBA) ..................................................... K
Quack .......................................................................................... L
Relatives ............................................................................. M
Neighbour/friends ................................................ N
Other ..................................................................................................... X
(Specify)
No one ................................................................................................ Y
MN18. Where did you give birth to (Name)?
Probe to identify the type of source.
If unable to determine whether public or private, write the name of the place.
............................................................................................................
(Name of place)
Home
Respondent’s home ....................................... 11
Other home .................................................................. 12
Public sector
Govt. hospital ........................................................... 21
Govt. clinic/health centre ...................... 22
Govt. health post ................................................ 23
Other public ................................................................. 26
(Specify)
Private Medical sector
Private hospital ...................................................... 31
Private clinic ................................................................ 32
Private maternity home ........................... 33
NGO clinic/hospital ......................................... 34
Other private medical ................................. 36
(Specify)
Other .................................................................................................. 96
(Specify)
MN20
MN20
MN20
MN19. Was (name) Delivered by caesarean section? That is, Did they cut your belly open to take the baby out?
Yes ............................................................................................................. 1
No ................................................................................................................ 2
MN20 WHEN (name) WAS BORN, WAS HE/SHE VERY LARGE, LARGER THAN AVERAGE, AVERAGE, SMALLER THAN AVERAGE, OR VERY SMALL?
Very large ....................................................................................... 1
Larger than average ..................................................... 2
Average ............................................................................................. 3
Smaller than average ................................................. 4
Very small ...................................................................................... 5
DK .............................................................................................................. 8
MN21. Was (name) weighed at birth? Yes ............................................................................................................. 1
No ................................................................................................................ 2
DK ................................................................................................................ 8
MN24
MN24
lxix
Ap
pen
dix
C :
Qu
esti
on
nai
res
MN22. How much did (name) weigh?
Record weight from health card, if available.
Kg
From card .............................................. 1 .
From recall .......................................... 2 .
Don’t know ................................................................... 99998
MN24. Did you ever breastfeed (name)? Yes ............................................................................................................. 1
No ................................................................................................................ 2
BF2A
MN25. How long after birth did you first put (name) to the breast?
If less than 1 hour, record ‘00’ hours.
If less than 24 hours, record hours.
Otherwise, record days.
Immediately ....................................................................... 000
Hours .................................................................................. 1
Days ...................................................................................... 2
Don’t know/remember ..................................... 998
MN26. In the first three days after delivery, was (name) given anything to drink other than breast milk?
Yes ............................................................................................................. 1
No ................................................................................................................ 2 BF2
MN27. What was (name) given to drink?
Probe:
Anything else?
Milk (Other than breast milk) ....................... A
Plain water ................................................................................... B
Sugar or glucose water ......................................... C
Gripe water ................................................................................. D
Sugar-salt-water solution .................................... E
Fruit juice ........................................................................................ F
Infant formula ........................................................................ G
Tea/Infusions ........................................................................... H
Honey ...................................................................................................... I
Other ..................................................................................................... X
(Specify)
BF2. Is (name) still being breastfed? Yes ............................................................................................................. 1
No ................................................................................................................ 2
DHS558
DHS459A For how many months did you breastfeed (Name)?
Months ...................................................................................
Don’t know ............................................................................... 98
BF2A. Check BH9 and circle in appropriate code. Yes alive, live in the household ........................... 1
Yes alive, not live in the household ........................ 2
Dead ....................................................................................................... 3
PN0
PN0
DHS558 Now I would like to ask you about liquids or foods that (NAME) had yesterday during the day or at night. I am interested in whether your child had the item I mention even if it was combined with other foods.
Did (NAME) (drink/eat):
Liquids/foods Yes No DK
a. Plain water? 1 2 8
b. Juice or juice drinks? 1 2 8
c. Milk such as tinned, powdered, or fresh animal milk?
1 2 8
IF YES: How many times did (NAME) drink milk?
IF 7 OR MORE TIMES, RECORD ‘7’.
Number of times
drank milk
d. Infant formula like Lactogen? 1 2 8
IF YES: How many times did (NAME) drink infant formula?
IF 7 OR MORE TIMES, RECORD ‘7’.
Number of times
drank formula
e. Any other liquids? 1 2 8
f. Yogurt? 1 2 8
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxx
IF YES: How many times did (NAME) eat yogurt?
IF 7 OR MORE TIMES, RECORD ‘7’.
Number of times ate
yogurt
g. Any commercially fortified baby food like Cerelac?
1 2 8
h. Bread, rice, noodles, porridge, or other foods made from grains?
1 2 8
i. Pumpkin, carrots, squash or sweet potatoes that are yellow or orange inside?
1 2 8
j. White potatoes, white yams, manioc, cassava, or any other foods made from roots?
1 2 8
k. Any dark green, leafy vegetables like spinach, poi sag, methi, kolmi, kochu, palong?
1 2 8
l. Ripe mangoes, papayas, ripe kathal, bangi or other Vitamin A rich fruits?
1 2 8
m. Any other fruits like banana, grapes, apple, guava or other vegetables like cabbage, patal, kopi?
1 2 8
n. Liver, kidney, heart or other organ meats? 1 2 8
o. Any meat, such as beef, pork, lamb, goat, chicken, or duck?
1 2 8
p. Eggs? 1 2 8
q. Fish, shrimps or crab? 1 2 8
r. Any foods made from beans, peas, lentils, or nuts?
1 2 8
s. Cheese or other food made from milk like paneer?
1 2 8
t. Drink clear broth/clear soup? 1 2 8
u. Drink or eat vitamin or mineral supplements or any medicines?
1 2 8
v. Drink ORS (Oral Rehydration Solution)? 1 2 8
DHS559 Check DHS558: Any yes code from g to v is circled.
No 1 (yes) code is circled .................................
One or more than one 1(yes) code is circled .................................................................... BF17
BF16 Did (name) eat solid or semi-solid (soft mushy) food yesterday, during the day or night?
Yes ............................................................................................................. 1
No ................................................................................................................ 2
DK ................................................................................................................ 8
BF18
BF18
BF17 How many times did (name) eat solid or semi-solid (soft mushy) food yesterday, during the day or night?
Number of times ...................................................
BF18. Yesterday, during the day and night, did (name) drink anything from a bottle with a nipple ?
Yes ............................................................................................................. 1
No ................................................................................................................ 2
Don’t know ................................................................................... 8
lxxi
Ap
pen
dix
C :
Qu
esti
on
nai
res
POST-NATAL HEALTH CHECKS PNPN0. This module is to be administered to all women with a live birth in the 2 years preceding the date
of interview. Record name of last born child from BH8.
Name: ........................................................................................................ . Use this child’s name in the following questions, where indicated.
PN1. Check MN18. Was the child delivered in a health facility?
Yes, child was delivered in a health facility (code21-26 or31-36 is circled) ..............................
No, child was no delivered in a health facility (code 11,12 or 96 is circled) ................................................. PN6
PN2. Now I would like to ask you some questions about what happened in the hours and days after the birth of (name).
You have said that you gave birth in (name of facility in MN18). How long did you stay there after the delivery?
If less than one day, record hours.
If less than one week, record days.
Otherwise, record weeks.
Hours ................................................................................. 1
Days ..................................................................................... 2
Weeks ............................................................................... 3
Don’t know/remember .................................... 998
PN3. I would like to talk to you about checks on (name)’s health after delivery for example, someone examining (name), checking the cord, or seeing if (name) is OK.
Before you left the (name of facility in MN18), Did anyone check on (name)’s health?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
PN4. And what about checks on your health – I mean, someone assessing your health, for example asking questions about your health or examining you.
Did anyone check on your health before you left (name or type or facility in MN18)?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
PN5. Now I would like to talk to you about what happened after you left (name or type or facility in MN18).
Did anyone check on (name)’s health after you left (name or type or facility in MN18)?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
PN11
PN16
PN6 Check MN17. Did a health professional, traditional birth attendant, or community health worker assist with the delivery?
Yes, delivery assisted by a health professional, TBA, or community health worker (code A-K is circled) ..........................................
No, delivery not assisted by a health professional, TBA, or community health worker (code A-K is not circled) ..............................
PN10
PN7 You have already said that (person or persons in MN17) assisted with the birth. Now I would like to talk to you about checks on (name)’s health after delivery, for example examining (name), checking the cord, or seeing if (name) is OK.
After the delivery was over and before (person or persons in MN17) left you, did
(person or persons in MN17) check on (name)’s health?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxxii
PN8. And did (person or persons in MN17) Check on your health before leaving?
By check on your health, I mean assessing your heatlh, for example asking questions about your health or examining you.
Yes ............................................................................................................ 1
No ............................................................................................................... 2
PN9. After the (person or persons in MN17) left you, did anyone check on the health of (name)?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
PN11
PN18
PN10. I would like to talk to you about checks on (name)’s health after delivery -- for example, someone examining (name), checking the cord, or seeing if the baby is OK.
After (name) was delivered, did anyone check on his/her health?
Yes ............................................................................................................ 1
No ............................................................................................................... 2 PN19
PN11. Did such a check happen only once or more than once?
Once ....................................................................................................... 1
More than once ................................................................... 2 PN12B
PN12A How long after delivery did that check happen?
If less than one day, record hours.
If less than one week, record days.
Otherwise, record weeks.
Hours ................................................................................ 1
Days .................................................................................... 2
Weeks .............................................................................. 3
Don’t know/remember .................................... 998
PN13
PN12B How long after delivery did the first of these checks happen?
If less than one day, record hours.
If less than one week, record days.
Otherwise, record weeks.
Hours .................................................................................................... 1
Days ........................................................................................................ 2
Weeks .................................................................................................. 3
Don’t know/remember .................................... 998
PN13 Who checked on (name)’s health at that time? Health Professional
Qualified Doctor ................................................... 11
Nurse/Midwife/Paramedic ................... 12
FWV ........................................................................................... 13
Community skilled birth
attendant (CSBA) .............................................. 14
MA/SACMO .................................................................. 15
Community Health Provider ...................... 16
Health Assistant (HA) .................................. 17
Family Welfare Assistant (FWA) ............ 18
NGO worker ................................................................ 21
Other Professional
Trained Traditional birth
attendant(TTBA) ................................................... 31
Untrained Traditional birth
attendant(UTBA) .................................................. 32
Quack ...................................................................................... 33
Other ................................................................................................. 96
(Specify)
lxxiii
Ap
pen
dix
C :
Qu
esti
on
nai
res
PN14. Where did this check take place?
Probe to identify the type of source.
If unable to determine whether public or private, write the name of the place.
.............................................................................................................
(Name of place)
Home
Respondent’s home ....................................... 11
Other home .................................................................. 12
Public sector
Govt. hospital ........................................................... 21
Govt. clinic/health centre ...................... 22
Govt. health post ................................................ 23
Other public ................................................................. 26
(Specify)
Private Medical sector
Private hospital ...................................................... 31
Private clinic ................................................................ 32
Private maternity home ........................... 33
NGO clinic/hospital ......................................... 34
Other private medical ................................. 36
(Specify)
Other ................................................................................................. 96
(Specify)
PN15. Check MN18: Was the child delivered in a health facility?
Yes, child was delivered in a health facility(code21-26 or31-36 is circled) ....................................... No, child was not delivered in a health facility (code 11,12 or 96 is circled) ....................... PN17
PN16. After you left (name or type of facility in MN18), did anyone check on your health?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
PN20
CA15
PN17. Check MN17: Did a health professional, traditional birth attendant, or community health worker assist with the delivery?
Yes, delivery assisted by a health professional, TBA, or community health worker (code A-K is circled) ..........................................
No, delivery not assisted by a health professional, TBA, or community health worker (code A-K is not circled) .............................. PN19
PN18. After the delivery was over and (person or persons in MN17) left, did anyone check on your health?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
PN20
CA15
PN19. After the birth of (name), did anyone check on you health?
I mean someone assessing your health, for example asking questions about your health or examining you.
Yes ............................................................................................................ 1
No ............................................................................................................... 2
CA15
PN20. Did such a check happen only once or more than once?
Once ....................................................................................................... 1
More than once ................................................................... 2 PN21B
PN21A. How long after delivery did that check happen?
If less than one day, record hours.
If less than one week, record days.
Otherwise, record weeks.
Hours ................................................................................ 1
Days .................................................................................... 2 Weeks ............................................................................... 3
Don’t know/remember .................................... 998
PN22
PN21B. How long after delivery did the first of these checks happen?
If less than one day, record hours.
If less than one week, record days.
Otherwise, record weeks.
Hours ................................................................................. 1
Days ..................................................................................... 2
Weeks ............................................................................... 3
Don’t know/remember .................................... 998
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxxiv
PN22. Who checked on your health at that time? Health Professional
Qualified Doctor ................................................... 11
Nurse/Midwife/Paramedic ................... 12
FWV ........................................................................................... 13
Community skilled birth
attendant (CSBA) ................................................ 14
MA/SACMO .................................................................. 15
Community Health Provider ...................... 16
Health Assistant (HA) .................................. 17
Family Welfare Assistant (FWA) ............... 18
NGO worker ................................................................ 21
Other Professional
Trained Traditional birth
attendant(TTBA) ................................................... 31
Untrained Traditional birth
attendant(UTBA) .................................................. 32
Quack ...................................................................................... 33
Other ................................................................................................. 96
(Specify)
PN23. Where did this check take place?
Probe to identify the type of source.
If unable to determine whether public or private, write the name of the place.
.............................................................................................................
(Name of place)
Home
Respondent’s home ....................................... 11
Other home .................................................................. 12
Public sector
Govt. hospital ........................................................... 21
Govt. clinic/health centre ...................... 22
Govt. health post ................................................ 23
Other public ........................................................................... 26
(Specify)
Private medical sector
Private hospital ...................................................... 31
Private clinic ................................................................ 32
Private maternity home ........................... 33
NGO clinic/hospital ......................................... 34
Other private medical ................................. 36
(Specify)
Other ................................................................................................. 96
(Specify)
CA15. The last time (name) passed stools, what was done to dispose of the stools?
Child used toilet/latrine ...................................... 01
Put/rinsed into toilet/latrine ........................ 02
Put/rinsed into drain or ditch ................... 03
Thrown into garbage (solid waste) ................. 04
Buried .............................................................................................. 05
Left in the open ............................................................... 06
Other ................................................................................................. 96
(Specify)
Don’t know .............................................................................. 98
lxxv
Ap
pen
dix
C :
Qu
esti
on
nai
res
IMMUNIZATION IMIM0. Check BH9 and circle in appropriate code. Yes alive, live in the household .................................... 1
Yes alive, not live in the household .......................... 2
Dead ....................................................................................................... 3 CP0
IM1 Do you have a card where (name)’s vaccinations are written down?
IF YES, May I see it please?
Yes, seen ........................................................................................ 1
Yes, not seen ........................................................................... 2
No card .............................................................................................. 3
IM3
IM6
IM2 Did you ever have a vaccination (child health) card for (name)?
Yes ............................................................................................................ 1 No ............................................................................................................... 2
IM6
IM3 a) Copy dates for each vaccination from the card.
b) Write “44” in day column if card shows that vaccination was given but no date is recorded.
Date of immunization
DAY MON YEAR
Copy date of birth if written on card.
BCG BCG
PENTAVELENT 1 PENTA 1
PENTAVELENT 2 PENTA 2
PENTAVELENT 3 PENTA 3
OPV 1 OPV 1
OPV 2 OPV 2
OPV 3 OPV 3
OPV 4 OPV 4
MR at 9 months MR 9
Measles at 15 months M 15
IM4. Check IM3.Are all vaccines (BCG to measles at 15 months) recorded?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
IM19
IM5. In addition to what is recorded on this card, did (name) receive any other vaccinations- including vaccinations received in campaigns or immunization days?
Yes ............................................................................................................ 1
(GO BACK TO IM3 AND PROBE FOR THESE
VACCINATIONS AND WRITE “66” IN THE
CORRESPONDING DAY COLUMN FOR EACH
VACCINE MENTIONED. WHEN FINISHED, SKIP
TO IM19)
No ............................................................................................................... 2
Don’t know .................................................................................. 8
IM19
IM6 Has (name) ever received any vaccinations to prevent him/her from getting diseases, including vaccinations received in a campaign or immunization day?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
Don’t know .................................................................................. 8 IM19
IM7 Has (name) ever received a BCG vaccination against tuberculosis -- that is, an injection in the left shoulder that usually caused a scar?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
Don’t know .................................................................................. 8
IM8 Has (name) ever received any vaccination drops in the mouth to protect him/her from Polio?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
Don’t know .................................................................................. 8 IM11
IM9 Was the first polio vaccine received in the first two weeks after birth or later?
First 2 weeks ............................................................................. 1
Later ....................................................................................................... 2
IM10 How many times was the polio vaccine received?Number of times ...........................................................
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxxvi
IM11 Has (name) ever received a Penta vaccination -- that is, an injection in the thigh to prevent him/her from getting tetanus, whooping cough, or diphtheria?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
Don’t know .................................................................................. 8 IM13
IM12 How many times was the Penta vaccine received?Number of times ...........................................................
IM13 A measles injection or and measles and rubella (MR) injection – that is, a shot in the arm at the age of 9 months or older – to prevent him/her from getting measles?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
Don’t know .................................................................................. 8 IM19
IM14 A measles injection – that is, a shot in the arm at the age of 15 months or older – to prevent him/her from getting measles?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
Don’t know .................................................................................. 8
IM19 Did (name) receive any polio vaccine from the National Immunization Days (NID)?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
Don’t know .................................................................................. 8 CP0
IM19A Please tell me if (name) has participated in any of the following campaigns, national immunization days and/or Vitamin A or child health days:
Yes No DK
Immunization day-1 .............
(Polio/Nov, 2015)
1 2 8
Immunization day-2 .............
(Polio/Apr, 2015) ......................
1 2 8
Immunization day-3 .............
(Polio/Nov, 2014) ....................
1 2 8
CONTRACEPTION CPCP0. Check MA6 (Marital status) and circle in
appropriate code.Currently married ............................................................ 1Widowed ........................................................................................ 2 Divorced .......................................................................................... 3 Separated ...................................................................................... 4Never married ....................................................................... 5
UF0
CP1. I would like to talk with you about another subject – family planning.
Are you pregnant now?
Yes, currently pregnant ......................................... 1
No ............................................................................................................... 2
Unsure/DK .................................................................................... 8
CP2A
CP2. Couples use various ways or methods to delay or avoid a pregnancy.
Are you or your husband currently doing something or using any method to delay or avoid getting pregnant?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
CP3
CP2A Have you or your husband ever done something or used any method to delay or avoid getting pregnant?
Yes ............................................................................................................ 1 No ............................................................................................................... 2
UN1
CP3. What are you or your husband doing to delay or avoid a pregnancy?
Do not prompt.
If more than one method is mentioned, circle each one.
Female sterilization ...................................................... AMale sterilization .............................................................. BIUD ........................................................................................................... CInjectables ................................................................................... DImplants ........................................................................................... EPill .............................................................................................................. FMale condom ......................................................................... GFemale condom ................................................................. HDiaphragm ..................................................................................... IFoam/Jelly ................................................................................... JLactational amenorrhoea method (LAM) ................................................................................................... KPeriodic abstinence/Rhythm ......................... LWithdrawal .............................................................................. MOther .................................................................................................... X
(Specify)
lxxvii
Ap
pen
dix
C :
Qu
esti
on
nai
res
UNMET NEED UNUN1 Interviewer: Check CP1 (Current pregnancy status)
and circle in appropriate code.Yes, currently pregnant ......................................... 1
No ............................................................................................................... 2
Unsure or DK ........................................................................... 8 UN5
UN2 Now I would like to talk to you about your current pregnancy.
When you got pregnant, did you want to get pregnant at that time?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
UN4
UN3 Did you want to have a baby later on or did you not want any (more) children?
Later ....................................................................................................... 1
No more ........................................................................................... 2
UN4 Now I would like to ask some questions about the future.
After the child you are now expecting, would you like to have another child, or would you prefer not to have any more children?
Have another child ......................................................... 1
No more/None ...................................................................... 2
Undecided/Don’t know ........................................... 8
UN7
UN13
UN13
UN5 Interviewer: Check CP3 (Currently using female sterilization) and circle in appropriate code.
Code A is circled ................................................................ 1
Code A is not circled ................................................... 2
UN13
UN6 Now I would like to ask you some questions about the future.
Would you like to have (a/another) child, or would you prefer not to have any (more) children?
Have (a/another) child .............................................. 1
No more/None ...................................................................... 2
Says she cannot get pregnant ................... 3
Undecided/Don’t know ........................................... 8
UN9
UN11
UN9
UN7 How long would you like to wait before the birth of (a/another) child?
Months ............................................................................ 1
Years .................................................................................. 2
Soon/Now ............................................................................. 993
Says she cannot get pregnant ...................... 994
After marriage ............................................................... 995
Other ............................................................................................. 996
Don’t know .......................................................................... 998
UN11
UN8 Interviewer: Check CP1 (Current pregnancy status) and circle in appropriate code.
Yes, currently pregnant ......................................... 1
No ............................................................................................................... 2
Unsure or DK ........................................................................... 8
UN13
UN9 Interviewer: Check CP2 (Currently using a method) and circle in appropriate code.
Code 1 is circled ................................................................. 1
Code 1 is not circled .................................................... 2
UN13
UN10 Do you think you are physically able to get pregnant at this time?
Yes ............................................................................................................ 1
No ............................................................................................................... 2
DK ............................................................................................................... 8
UN13
UN13
UN11 Why do you think you are not physically able to get pregnant?
Infrequent sex/No sex ............................................. A
Menopausal .............................................................................. B
Never menstruated ...................................................... C Hysterectomy (surgical removal
of uterus) ....................................................................................... D
Has been trying to get pregnant for
2 years or more without result .................. E
Postpartum amenorrheic .................................... F
Breastfeeding ........................................................................ G
Too old .............................................................................................. H
Fatalistic ............................................................................................. I
Other .................................................................................................... X
(Specify)
Don’t know .................................................................................. Z
UF0
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxxviii
UN13 When did your last menstrual period start?
Record the answer using the same unit stated by the respondent.
Days ago ...................................................................... 1
Weeks ago ................................................................ 2
Months ago ............................................................. 3
Years ago .................................................................... 4
In menopause/has had hysterectomy .................. 994
Before last birth .......................................................... 995
For Children Under 5
UF0 Check household listing form column HL 6 and write the number of under 5 children in the household.
Number of under 5 children ...
No under 5 child ...................... 0 Go to CA14A & write the finishing time and thanks to responders and end interview
UF00 Interviewer: Have you collected the information of under 5 from another respondent?
Yes .................................................... 1
No ..................................................... 2
Go to CA14A & write the finishing time and thanks to responders and end interview
UF0A ENTER THE LINE NUMBER AND NAME IN THE TABLE FROM HOUSEHOLD LIST FORM COLUMN HL1 AND HL2 SINCE FEBRUARY 2011 OR LATER. ASK THE QUESTIONS ABOUT ALL OF THESE CHILDREN. BEGIN WITH THE YOUNGEST CHILD. (IF THERE ARE MORE THAN 2 CHILDREN, USE LAST COLUMN OF ADDITIONAL QUESTIONNAIRE.)
UF0B Write the line number from HL1, name from HL2 and identify mother/caretaker from HL9.
Child name & line number:
......................................................
Mother/Caretaker name
& line number: ..................
Child name & line number:
......................................................
Mother/Caretaker name
& line number: .................. BR1 Does (name) have a birth
certificate?
If yes, ask: May I see it?
Yes, seen ...................................... 1
Yes, not seen ............................. 2
Skip to BR2A
No ..................................................... 3
DK ..................................................... 8
Yes, seen ...................................... 1
Yes, not seen ............................. 2
Skip to BR2A
No ..................................................... 3
DK ..................................................... 8BR2 Has (name)’s birth been registered
with the civil authorities?Yes .................................................... 1
No ..................................................... 2
DK ..................................................... 8
Yes .................................................... 1
No ..................................................... 2
DK ..................................................... 8BR2A Check HL6 and circle in
appropriate code.Age is 03 or 04 years ........... 1
Age is 00 or 01 or 02 years ...... 2
(Skip to CA1)
Age is 03 or 04 years ............. 1
Age is 00 or 01 or 02 years ...... 2
(Skip to CA1)
EC5. Does (name) attend any organized learning or early childhood education programme, such as a Government or private facility, including kindergarten or community child care or madrasha?
Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA1)
Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA1)
EC6 Within the last seven days, about how many hours did (name) attend? Number of hours ............. Number of hours .............
lxxix
Ap
pen
dix
C :
Qu
esti
on
nai
res
CARE OF ILLNESSCA1. In the last two weeks, has (name)
had diarrhoea?Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA7)
Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA7)
CA2. I would like to know how much (name) was given to drink during the diarrhoea (including breastmilk).
During the time (name) had diarrhoea, was he/she given less than usual to drink, about the same amount, or more than usual to drink?
If less, probe:
Was he/she given much less than usual to drink, or somewhat less?
Much less ..................................... 1
Somewhat less ......................... 2
About the same ........................ 3
More ................................................ 4
Nothing to drink ....................... 5
Don’t know .................................. 8
Much less ..................................... 1
Somewhat less ......................... 2
About the same ........................ 3
More ................................................ 4
Nothing to drink ....................... 5
Don’t know .................................. 8
CA3 During the time (name) had diarrhoea, was he/she given less than usual to eat, about the same amount, more than usual, or nothing to eat?
If less, probe: Was he/she given much less than usual to eat or somewhat less?
Much less ..................................... 1
Somewhat less ......................... 2
About the same ........................ 3
More ................................................ 4
Stopped food ............................. 5
Never gave food ...................... 6
Don’t know .................................. 8
Much less ..................................... 1
Somewhat less ......................... 2
About the same ........................ 3
More ................................................ 4
Stopped food ............................. 5
Never gave food ...................... 6
Don’t know .................................. 8CA10A Did you seek advice or treatment
for the illness from any source?Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA4)
Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA4)
CA11A From where did you seek advice or treatment?
Probe: Anywhere else?
Circle all providers mentioned, but do not prompt with any suggestions.
Probe to identify each type of source.
If unable to determine if public or private sector, write the name of the place
....................................................................
(Name of places)
Public sector
Govt. hospital ..................... A Govt. health center ........... B Govt. health post ............... C Village health worker ..... D Mobile/outreach clinic .... EOther public ............................... H
(specify)
Private medical sector
Private hospital/clinic ........ I Private physician ............... J Private pharmacy .............. K Mobile clinic ......................... L NGO clinic/hospital ........ MOther private medical .......... O
(specify)
Other source
Relative/friend ..................... P Shop ......................................... Q Traditional practitioner .. ROther .............................................. X
(specify)
Public sector
Govt. hospital ..................... A Govt. health center ........... B Govt. health post ............... C Village health worker ..... D Mobile/outreach clinic .... EOther public ............................... H
(specify)
Private medical sector
Private hospital/clinic ........ I Private physician ............... J Private pharmacy .............. K Mobile clinic ......................... L NGO clinic/hospital ........ MOther private medical .......... O
(specify)
Other source
Relative/friend ..................... P Shop ......................................... Q Traditional practitioner .. ROther .............................................. X
(specify)
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxxx
CA4 During the episode of diarrhea, was (name) given to drink any of the following:
Read each item aloud and record response before proceeding to the next item.
[A] A fluid made from a special
saline packet called PACKET
SALINE (for example OR saline)?
[B] Rice based ORS packet for
diarrhea?
[C] Sugar and salt solution?
[D] Green coconut water?
[E] Rice water?
[F] Boiled rice water?
[G] Zinc syrup?
[H] Zinc tablets?
Yes No DK
Fluid from ORS
packet
1 2 8
Rice-based ORS
packet
1 2 8
Suger & salt
sulation
1 2 8
Green coconut
water
1 2 8
Rice water 1 2 8
Boiled rice water 1 2 8
Zinc syrup 1 2 8
Zinc tablets 1 2 8
Yes No DK
Fluid from ORS
packet
1 2 8
Rice-based ORS
packet
1 2 8
Suger & salt
sulation
1 2 8
Green coconut
water
1 2 8
Rice water 1 2 8
Boiled rice water 1 2 8
Zinc syrup 1 2 8
Zinc tablets 1 2 8
CA5 Was anything (else) given to treat the diarrhea?
Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA7)
Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA7)
CA6 What (else) was given to treat the diarrhea?
Probe: Anything else?
Record all treatment given. Write brand name(s) of all medicines mentioned.
....................................................................
(Name of medicine)
Pill/Syrup Antibiotic ............................... A Antimotility ........................... B Zinc ............................................ C Other pill or syrup (Not antibiotic, antimotility or zinc) .................................... G Unknown pill or syrup ... HInjection Antibiotic ................................ L Non-antibiotic .................... M Unknown injection ......... NIntravenous ................................ OHome remedy/herbal medicine ...................................... QOther .............................................. X (Specify)
Pill/Syrup Antibiotic ............................... A Antimotility ........................... B Zinc ............................................ C Other pill or syrup (Not antibiotic, antimotility or zinc) .................................... G Unknown pill or syrup ... HInjection Antibiotic ................................ L Non-antibiotic .................... M Unknown injection ......... NIntravenous ................................ OHome remedy/herbal medicine ...................................... QOther .............................................. X
(Specify)
CA7 At any time in the last 2 weeks, has (name) had an illness with a cough?
Yes .................................................... 1No ..................................................... 2 Don’t know .................................. 8
(Skip to CA14)
Yes .................................................... 1No ..................................................... 2 Don’t know .................................. 8
(Skip to CA14)
CA8 When (name) had an illness with a cough, did he/she breathe faster than usual with short, rapid breaths or have difficulty breathing?
Yes .................................................... 1No ..................................................... 2 Don’t know .................................. 8
(Skip to CA14)
Yes .................................................... 1No ..................................................... 2 Don’t know .................................. 8
(Skip to CA14)
CA9 Was the fast or difficult breathing due to a problem in the chest or to a blocked or runny nose?
Problem in chest only ........... 1Blocked or runny nose only .... 2
(Skip to CA14)Both ................................................. 3Other ............................................... 6
(Specify)(Skip to CA14)
Don’t know .................................. 8
Problem in chest only ........... 1Blocked or runny nose only .... 2
(Skip to CA14)Both ................................................. 3Other ............................................... 6
(Specify)(Skip to CA14)
Don’t know .................................. 8
lxxxi
Ap
pen
dix
C :
Qu
esti
on
nai
res
CA10 Did you seek advice or treatment for the illness from any source?
Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA12)
Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA12)
CA11 From where did you seek advice or treatment?
Probe: Anywhere else?
Circle all providers mentioned, but do not prompt with any suggestions.
Probe to identify each type of source.
If unable to determine if public or private sector, write the name of the place
....................................................................
(Name of places)
Public sector
Govt. hospital ..................... A Govt. health center ........... B Govt. health post ............... C Village health worker ..... D Mobile/outreach clinic .... EOther public ............................... H
(specify)
Private medical sector
Private hospital/clinic ........ I Private physician ............... J Private pharmacy .............. K Mobile clinic ......................... L NGO clinic/hospital ........ MOther private medical ........ O
(specify)
Other source
Relative/friend ..................... P Shop ......................................... Q Traditional practitioner .. ROther .............................................. X
(specify)
Public sector
Govt. hospital ..................... A Govt. health center ........... B Govt. health post ............... C Village health worker ..... D Mobile/outreach clinic .... EOther public ............................... H
(specify)
Private medical sector
Private hospital/clinic ........ I Private physician ............... J Private pharmacy .............. K Mobile clinic ......................... L NGO clinic/hospital ........ MOther private medical ........ O
(specify)
Other source
Relative/friend ..................... P Shop ......................................... Q Traditional practitioner .. ROther .............................................. X
(specify)
CA12 Was (name) given any medicine to treat this illness?
Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA14)
Yes .................................................... 1
No ..................................................... 2
Don’t know .................................. 8
(Skip to CA14)
CA13 What medicine was (name) given?
Probe: Any other medicine?
Circle all medicines given. Write brand name(s) of all medicines mentioned.
....................................................................
(Name of medicines)
Antibiotic
Pill/Syrup ............................... A Injection .................................. BAnti-malarials .......................... MParacetamol/panadol/
acetaminophen ......................... PAspirin ........................................... QIbuprofen ...................................... ROther .............................................. X
(Specify)
Don’t know .................................. Z
Antibiotic
Pill/Syrup ............................... A Injection .................................. BAnti-malarials .......................... MParacetamol/panadol/
acetaminophen ......................... PAspirin ........................................... QIbuprofen ...................................... ROther .............................................. X
(Specify)
Don’t know .................................. ZCA14 Go back to UF0B in next column;
or if no more birth, write the finishing time and go to AN0.
Go back to UF0B and use last column of additional sheet; or if no more birth, write the finishing time and go to AN0.
CA14A Hour Minute
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxxxii
ANTHROPOMETRY
After questionnaires for all children are complete, the measurer weighs and measures each child. Record weight and length/height below, taking care to record the measurements on the correct questionnaire for each child. Check the child’s name and line number on the household listing before recording measurements.
AN0. Write the child’s line number from HL1 and name from HL2. Name: ..................................... Name: .....................................
AN0A Starting time: Hour Minute Hour Minute
AN1. Measurer’s name and code:Name: ............................... Name: ...............................
AN2 Result of height/length and weight measurement.
Either or both measured ..... 1
Child not present ..................... 2
Child or mother/caretaker refused ........................................... 3
Other ............................................... 6
(Specify)(Skip to AN6)
Either or both measured ..... 1
Child not present ..................... 2
Child or mother/caretaker refused ........................................... 3
Other ............................................... 6
(Specify)(Skip to AN6)
AN3 Child’s weight (in kilogram)Record in appropriate box.
Kilograms (kg) ......... .
Weight not measured .... 99.9
Kilograms (kg) ......... .
Weight not measured .... 99.9
AN4 Child’s length or height (in centimeter).Record in appropriate box. Child under 2 years old Measure length (lying down) Child aged 2 or more years Measure height (standing up)
Length (cm)Lying down ........ 1 .
Height (cm)Standing up ....... 2 .
Length/height not measured ......................................... 9999.9
Length (cm)Lying down ......... 1 .
Height (cm)Standing up ........ 2 .
Length/height not measured ............................................ 9999.9
AN6 Is there another child in the household who is eligible for measurement
Yes .................................................
Write the ending time then Measurement for next child
No ..................................................
Yes .................................................
Write the ending time then Measurement for next child
No ..................................................
AN7 Ending time Hour Minute Hour Minute
CHECK THAT ALL QUESTIONS ARE COMPLETED AND THANK RESPONDENT.
lxxxiii
Ap
pen
dix
C :
Qu
esti
on
nai
res
Interviewer’s Observations
Field Editor’s Observations
Supervisor’s Observations
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxxxiv
The Coverage Report is jointly produced by Implementing, Monitoring and Evaluation Division, Ministry of Planning, Bangladesh Bureau of Statistics (BBS); Bangladesh Institute of Development Studies (BIDS); and UNICEF under a Memorandum of Understanding between IMED and BIDS. Many people from the following organizations contributed to the assignment in conceptualizing, analyzing and preparing the report:
Implementing, Monitoring and Evaluation (IMED)
Md. Mofizul Islam, Secretary in Charge, IMED; Kazi Jahangir Alam, former Director General, Education and Social Sector, IMED.
Bangladesh Bureau of Statistics (BBS)
Md. Amir Hossain, Director General, Bangladesh Bureau of Statistics (BBS); AKM Ashraful Haque, Project Director, SVRS, BBS.
Bangladesh Institute of Development Studies (BIDS)
Mohammad Yunus, Senior Research Fellow; Md. Mainul Haque, Research Fellow.
General Economic Division
Professor Shamsul Alam, Member, General Economic Division (GED), Planning Commission, Government of Bangladesh.
UNICEF Bangladesh
Carlos Acosta Bermúdez, Chief, Social Policy, Evaluation Analytics and Research (SPEAR) Section; Shantanu Gupta, Monitoring and Evaluation Specialist; Md. Azizur Rahman, Social Policy Specialist, Mashiur Rahman Khan, Knowledge Management Officer.
AC
KN
OW
LED
GEM
ENT
S ACKNOWLEDGEMENTS
Ch
ild W
ell-
bei
ng
Su
rvey
in U
rban
Are
as o
f B
ang
lad
esh
lxxxvi