DG Khan has highest infant mortality rate, Pindi lowest

LAHORE

The DG Khan division has the highest infant and under-five child mortality rates in Punjab of 91 and 118 deaths per 1,000 live births while Rawalpindi division has the lowest 59 and 72 deaths per 1,000 live births respectively.

This was disclosed in the Multiple Indicators Cluster Survey (MICS) Report Punjab 2014 launched by the government on Tuesday. The report was prepared by Bureau of Statistics P&D and Unicef. The MICS report based on a district level survey capturing socio-economic indicators, particularly focusing on children and women, has been put together by the BOS, P&D and Punjab with technical support from the United Nations.

Information collected on nutrition of children shows that 34 percent of children under five are underweight. The same proportion of children is stunted while 18 percent are wasted.

The three anthropometric indicators vary from household wealth.

Nearly half of children living in the households in the lowest quintile are stunted (49%) and 48 percent are underweight compared to 17 percent for stunting and underweight in the highest quintile. Underweight, stunting and wasting are less common among the children in Rawalpindi division compared to the other divisions.

Breastfeeding

Ninety-four percent of the children under two years have ever been breastfed. Early initiation of the breastfeeding is only 11 percent that is children that were put to the breast within one hour of birth. Only 17 percent of children aged 0–5 months are exclusively breastfed as recommended by the WHO guidelines while 48 percent of children aged 6-23 months are predominantly breastfed. The median duration of any breastfeeding is 17.4 months and this declines to 0.6 months for exclusive breastfeeding. Sixty-one percent of the infants aged 6-8 months have been introduced to solid, semi-solid and soft food. Overall, 65 percent of the children aged 6-23 months are receiving solid, semi-solid and soft foods in the minimum number of times. However, only 10 percent of these children are benefiting from a diet sufficient in both diversity and frequency.

The findings also show that 58 percent of the children aged 0-23 months are being fed through a bottle with a nipple. By education of the mother, 72 percent of children whose mothers have higher education are bottle fed compared to 49 percent of children whose mothers have pre-school or no education. The findings further show that the practice of bottle feeding with a nipple among children aged under six months is not uncommon even though it is discouraged as 45 percent of the children are fed using a bottle with a nipple.

Results from MICS Punjab 2014 show that 49 percent of the households are found to be using adequately iodised salt. Use of iodised salt is lowest in Sargodha division (33%) and highest in Gujranwala division (63%).

Information on child vaccination shows that 62 percent of the children are fully vaccinated and only 56 percent of children were vaccinated by their first birthday as recommended. About three in four children living in the households in the highest quintile are fully vaccinated (74%) compared to 42 percent living in the households in lowest quintile. Approximately, 93 percent of children aged 12-23 months received a BCG vaccination by their first birthday and the first dose of PENTA vaccine was given to 85 percent of children. The percentage declines to 81 percent for the second dose of PENTA and to 72 percent for third dose. Similarly, 95 percent of children received polio 1 by first birthday and this declines to 85 percent by third dose. For the first dose of measles vaccine, 72 percent of children received the vaccine by first birthday.

In Punjab, 65 percent of children aged 6–59 months received a high dose Vitamin A supplement in the six months preceding the survey.

Information collected on childhood diseases shows that 17 percent of children under five had diarrhea in the two weeks preceding the survey. Out of these children, 47 percent were given Oral Rehydration Therapy (ORT) whereas 39 percent were treated with ORT with continued feeding. About three percent of the children had symptoms of ARI in the two weeks preceding the survey. Of these, 77 percent were taken to a health facility or provider and 39 percent of the children were given antibiotics. The results also show that 21 percent of children were found to have an episode of fever, of which 79 percent were taken to a health facility or provider. Only 1 percent of children with fever were treated with anti-malarial drug; Of these, nine percent were given Artemisinin-based Combination Therapy.

In Punjab, 94 percent of the population is using improved sources of drinking water and 81 percent have water on their premises. The main sources of improved drinking water are motorised pumps (42%) and hand pumps (31%).

Seventy five percent of the population is using improved sanitation facilities; higher in urban (92%) and lower in rural (67%). Most commonly used facilities are flush toilets connected to septic tanks (44%) and facilities connected to a sewerage system (21%). In Punjab, 18 percent of the population still has no access to toilet facilities and this proportion rises to 25 percent in rural areas.

One other issue of interest is disposal of children’s stool. The results show that stools of 71 percent of the children under two years were disposed of safely. The most commonly reported method of children’s stool disposal was rinsing into toilet or latrine (65%). For 17 percent of children, stool was thrown into garbage. Safe disposal of child’s faeces is found to be higher in urban (89%) compared to rural areas (64%).

Information collected on hand-washing shows that at the time of the survey, 80 percent of households with a place for hand-washing had both water and soap (or another cleansing agent) present at the hand-washing place. In 17 percent of the households, only water was available at the hand-washing place. However, 93 percent of households had soap or other cleansing agent available somewhere in the household.

In Punjab, 61 percent of the population aged 10 years and above is able to read and write. Literacy rate among young women aged 15-24 is 76 percent. Literacy is higher among males than females. By age, only 19 percent of population aged 75 years or older is literate compared to 78 percent of population aged 15-19.

School readiness that is percentage of children attending first grade at the time of the survey who attended pre-school in previous year is 93 percent and 26 percent of children of primary school entry age have entered the first grade. The Net Attendance Rate (NAR) i.e. children aged 5-9 years who attend primary or secondary school is 58 percent. Four percent of children aged 5-9 years are attending government schools and 46 percent private schools. It is interesting to note that of all the children starting grade 1, the majority (96%) eventually reaches the last grade of primary school.

In case of secondary school children (10–14 years), 42 percent are attending secondary school, with a lower percentage in rural areas (36%) compared to urban (54%). There is only a small difference in the attendance of girls and boys in primary and secondary schools. The Gender Parity Index (GPI) that is the ratio of girls to boys attending school is 0.97 for primary school and 0.98 for secondary school. The GPI is lower in rural areas, 0.94 for primary and 0.88 for secondary schools.

The MICS Punjab 2014 results on attitudes towards domestic violence show that 40 percent of women believe that a husband is justified in hitting or beating his wife if she goes out without telling him, neglects the children, argues with him, refuses sex with him or burns the food. Twenty seven percent of women agree and justify violence in instances when a wife neglects the children and 26 percent of women justify violence if a wife goes out without telling her husband or argues with him.

Three percent of household members were reported to have had a cough for the past three weeks. Almost six percent of the population in Sahiwal division was reported to have had a cough, a proportion much higher than the other divisions. Furthermore, less than one percent of the household population was reported to have been diagnosed with tuberculosis and two percent was diagnosed with hepatitis.

The unemployment rate among population aged 10 years and over is seven percent.

In Punjab, 87 percent of the population is living in a household that owns a house, 30 percent own agricultural land and 45 percent own livestock. Ownership of agricultural land and livestock is higher amongst the rural population.

The survey also collected information on remittances. The results reveal that three percent of the respondents report to receive remittances from within the country while seven percent report to receive remittances from outside the country. In addition, seven percent of the household members are living in a household who receive benefits such as Zakat, dearness allowance, health and education subsidy from the government schemes of social protection.