| Table of contents |
Acknowledgement iii
List of Tables vii
List of Figures xi
List of Abbreviations xiii
Executive Summary xxi
I. INTRODUCTION 1
Background 1
Survey Objectives 2
II. SAMPLE AND SURVEY METHODOLOGY 5
Sample Design 5
Questionnaires 5
Training and Fieldwork 7
Data Processing 7
III. SAMPLE COVERAGE AND THE CHARACTERISTICS OF HOUSEHOLDS AND RESPONDENTS 9
Sample Coverage 9
Characteristics of Households 10
Characteristics of Female Respondents 15-49 Years of Age,
Male 15-59 years and Children Under-5 15
IV. CHILD MORTALITY 23
Assessment of Data Quality in childhood mortality 24
Levels and Trends of Early Childhood Mortality 25
Early childhood mortality rates by region, residence and socio-economic characteristics 27
Residence and Socio-economic Differentials in Childhood Mortality 30
Demographic Characteristics and Childhood Mortality 31
V. NUTRITION 35
Nutritional Status 35
Breastfeeding and Infant and Young Child Feeding 38
Salt Iodization 52
Rapid Test Kits Results 53
Salt Sample for analysis 54
Agreement between Rapid Test Kits and Titration in identifying
adequately and inadequately Iodized salts 56
Children’s Vitamin A Supplementation 57
Low Birth Weight 60
Anaemia and Diet Diversity in Children aged 6-59 months 63
VI. CHILD HEALTH 65
Vaccinations 65
Neonatal Tetanus Protection 68
Oral Rehydration Treatment 71
Care Seeking and Antibiotic Treatment of Pneumonia 77
Solid Fuel Use 80
VII. MALARIA AND BIOMARKER 85
Background of Malaria in Ghana 85
Malaria: Causes and Transmission 85
National strategies for Malaria Control 86
Malaria PRevention 88
Insectiside Treated Mosquito Nets (ITNs) 88
Brief History of ITN Distribution in Ghana 89
Household Ownership Mosquito Nets 90
USe of Mosquito Nets by Persons on the Household 93
USe of Mosquito Nets by Children Under Five Years 95
USe of Mosquito Nets by Pregnant Women 98
Source, Cost and Disposal of ITNs 101
Indoor Residual Spraying Against Mosquitoes 101
Intermitent Preventive Treatment of Malaria in Pregnancy 103
Prevalence, Diagnosis, and Treatment of Fever in Children Under-Five 105
Type and Timing of Antimalarial Drug Use for Children 109
Knowledge of Malaria Symptoms 111
Knowledge of Causes of Malaria 112
Knowledge of ways to avoid Malaria 114
Specific Messages Seen or Heard about Malaria 116
Malaria Biomarkers: Anaemia and Malaria in Children Aged 6-59 Months 120
Anaemia Prevalence in Children 122
VIII. WATER AND SANITATION 131
Water 131
Sanitation 131
Use of Improved Water Sources 131
Use of Improved Sanitation Facilities 140
Handwashing 147
IX. REPRODUCTIVE HEALTH 153
Fertility 153
Contraception 156
Unmet Need 156
Antenatal Care 161
Assistance at Delivery 167
Place of Delivery 168
Post-Natal checks 170
X. CHILD DEVELOPMENT 183
Early Childhood Education and Learning 183
Early Childhood Development 190
XI. LITERACY AND EDUCATION 195
Literacy among Young Women 195
School Readiness 196
Primary and Secondary School Participation 198
XII. CHILD PROTECTION 213
Birth Registration 213
Child Discipline 216
Types of Disciplinary Methods 218
Early Marriage and Polygyny 218
Female Genital Mutilation/Cutting 226
Attitudes toward Domestic Violence 230
Children’s living arrangements and Orphanhood 234
XIII. HIV/AIDS, SEXUAL BEHAVIOUR 239
Knowledge about HIV Transmission and Misconceptions about HIV/AIDS 239
Comprehensive knowledge of HIV methods and transmission 240
Knowledge of Mother to Child Transmission of HIV 246
Accepting Attitudes toward People Living with HIV & AIDS (PLHIV) 249
Knowledge of a Place for HIV Testing, Counselling and Testing during Antenatal Care 252
Sexual Behaviour Related to HIV Transmission 260
XIV. NATIONAL HEALTH INSURANCE 273
National Health Insurance Registration 273
Reasons why individuals (women, children and men) did not have a valid NHIS card 277
Achievement of Membership 280
Opinion on the quality of service offered to the NHI
valid card holders, compared to other clients 283
XV. ACCESS TO MASS MEDIA AND ICT TECHNOLOGY 289
Access to Mass Media 289
Use of Computers and Internet 292
List of References 297
Appendix A. Sample Design 310
Appendix B. Malaria Biomarkers: Anaemia and Malaria in Children Aged 6-59 Months 309
Appendix C. List of Personnel Involved in the Survey 313
Appendix D. Estimates of Sampling Errors 318
Appendix E. Data Quality Tables 354
Appendix F. MICS4 Indicators: Numerators and Denominators 371
Appendix G. Questionnaires 382 |
