THE GAMBIA MULTIPLE INDICATOR CLUSTER SURVEY 2018

©UNICEF The Gambia/ 2018/Noorani

STATISTICAL SNAPSHOTS OF KEY FINDINGS Foreword

The Sixth round of Multiple Indicator Cluster Survey (MICS) for The Gambia was carried out in 2018 by Gambia Bureau of Statistics with technical support from the United Nations Children’s Fund (UNICEF), as part of the Global MICS Programme.

The Global MICS Programme was developed by UNICEF in the 1990s as an international multi-purpose household survey programme to support countries in collecting internationally comparable data on a wide range of indicators on the situation of children and women. MICS surveys measure key indicators that allow countries to generate data for use in policies, programmes, and national development plans, and to monitor progress towards the Sustainable Development Goals (SDGs) and other internationally agreed upon commitments. The specific objectives of The Gambia MICS 2018 were: • To provide high quality data for assessing the situation of children, adolescents, women and households in The Gambia; • To furnish data needed for monitoring progress toward national goals, as a basis for future action; • To collect disaggregated data for the identification of disparities, to inform policies aimed at social inclusion of the most vulnerable; • To validate data from other sources and the results of focused interventions; • To generate data on national and global SDG indicators; • To generate internationally comparable data for the assessment of the progress made in various areas, and to put additional efforts in those areas that require more attention; • To generate behavioural and attitudinal data not available in other data sources.

The objective of this report is to facilitate the timely dissemination and use of results from The Gambia MICS. The report contains detailed information on the survey methodology, and all standard MICS tables. The report is accompanied by a series of Statistical Snapshots of the main findings of the survey.

For more information on the Global MICS Programme, please go to mics.unicef.org.

Suggested citation: The Gambia Bureau of Statistics. 2019. The Gambia Multiple Indicator Cluster Survey 2018, Survey Findings Report. Banjul, The Gambia: The Gambia Bureau of Statistics. OUTLINE

1. Sample & Survey Characteristics slide 4 2. Mass Media, Communications & Internet slide 7 3. Child Mortality slide 11 4. Fertility & Family Planning slide 13 5. Adolescents slide 16 6. HIV & Sexual Behaviours slide 21 7. Child Health & Care of Illness slide 25 8. Immunization Coverage slide 28 9. Nutritional Status of Children slide 30 10.Early Childhood Development slide 32 11.Education slide 34 12.Early Grade Learning & Parental Involvement slide 38 13.Birth Registration slide 41 14.Child Discipline slide 43 15.Child Labour slide 45 16.Child Marriage slide 47 17.Female Genital Mutilation (FGM) slide 49 18.Child Functioning slide 51 19.Drinking Water, Sanitation & Hygiene – WASH slide 53 20.Gender Equality slide 59 The Gambia 2018

Sample & Survey Characteristics

Response Rates Household

Sampled 7750 Survey Occupied 7517 Implementation Interviewed 7405

99 Implementing agency: Gambia Bureau of Statistics

Women age 15-49 Sampling frame: 2013 Population and Housing Census Eligible for interview 14298 Interviewed 13640 95 Listing & mapping: August – September 2017

Men age 15-49 Interviewer training: Eligible for interview 5225 December 2017 - January 2018 Interviewed 4522

87 Fieldwork: January - April 2018

Children under 5 Eligible for interview 10156 Questionnaires: Mothers/Caretakers 9907 Household interviewed Women age 15-49 Men age 15-49 98 Children under 5 Children age 5-17 Water Quality Testing Children age 5-17

Eligible for interview 5850 Mothers/Caretakers interviewed 5696

97 Population Characteristics

Household Population Age & Sex Distribution Household Composition & Characteristics of Head of household Age Males Females 85+ 80-84 No one 18+ years 0 75-79 At least one man 15-49 years 78 70-74 At least one woman 15-49 years 85 65-69 60-64 At least one child <18 years 83 55-59 At least one child 5-17 years 77 50-54 45-49 At least one child <5 years 61 40-44 35-39 None 55 30-34 25-29 Primary 10

20-24 Secondary+ 35 15-19 10-14 5-9 Male 79 0-4 Female 21 10 5 0 5 10 0 50 100 Percent Percent

Percent distribution of household population by age group and sex Percent of households by selected characteristics

Women & Men’s Profile Children’s Profile

None 58 54 None 37 26 Primary 14 16 Primary 16 16 Secondary+ 27 30

Secondary+ 47 58 education

Currently married/in-union 64 38 Mother’s/caregiver’s Poorest 22 23

Widowed 10 Second 19 22

Divorced 41 Middle 19 21

Separated 10 Fourth 19 19

Never married/not in union 31 61 Richest 21 15

Has health insurance 24 Has health insurance 22 70 50 30 10 10 30 50 70 60 40 20 0 20 40 60 Percent Percent Women Men Children 5-17 Children under-five Percent distribution of women and men age 15-49 by background characteristics Percent distribution of children age 5-17 and under-five by background characteristics Children’s living arrangements*

Lives with both parents 56.7

Lives with neither biological parent 16.9

Lives with mother only 22.9

Lives with father only 3.3

No data 0.2

0 20 40 60 Percent

Percent distribution of children age 0-17 years according to living arrangements *Children 0-17 years LGA distribution of population (percent)

Children Children LGA Households Women Men under 5 5-17

National 100 100 100 100 100 Banjul 11 8 10 5 8 Kanifing 15 14 16 9 13 Brikama 15 15 19 13 15 Mansakonko 12 10 10 11 13 Kerewan 12 11 9 13 12 Kuntaur 12 12 11 16 13 Janjanbureh 12 12 13 15 13 Basse 11 17 12 19 13

Key Messages

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Survey and are available on mics.unicef.org/surveys. the global MICS programme. Technical Sample Characteristics. Data from this support was provided by the United Nations snapshot can be found in table SR. 1.1, SR. Children’s Fund (UNICEF). UNICEF, The 5.1W, SR.5.1M, SR.5.2, SR.5.3 and SR.2.3 Government of The Gambia, World Food in the Survey Findings Report. Programme and The Global Fund through the National Malaria Control Programme provided financial support. The Gambia 2018

Mass Media, Communications & Internet

Exposure to Mass Media

Newspaper Radio Television All Three

Women Women Women Women 6 4

15 11

Men Men Men Men

60 73 70 61

Percentage of women & men age 15-49 years who are exposed to specific mass media (newspaper, radio, television) on a weekly basis and percentage of women & men age 15-49 who are exposed to all three on a weekly basis

Inequalities in Access to Mass Media

Women with Access to Newspaper, Radio & Men with Access to Radio, Newspapers & Television Weekly Television Weekly National National 100 100

80 80

60 60

Percent Percent 40 40

Secondary+, 18 Richest, 19 20 Urban, 13 20 Richest, 10 Secondary +, 7 Urban, 5 Pre-primary or Pre-primary or 0 Rural, 2 Poorest, 2 0 none, 0 Rural, 0 none, 0 Poorest, 0 Area Education Wealth Quintile Area Education Wealth Quintile

Percentage of women age 15-49 years who are exposed to newspaper, radio, Percentage of women age 15-49 years who are exposed to newspaper, radio, and television on a weekly basis and television on a weekly basis Key Messages • (6%) of women aged 15-49 years read by television (70%). weekly newspapers, (60%) listen to radio and (61%) watch television. Percentage of women with access to the three on a weekly basis is (4%) This proportion is higher in urban areas and among women with secondary education or higher degrees who are among the richest wealth quintile. • For men, access to radio (72%), followed Household Ownership of Information & Communication Technology (ICT) Equipment & Internet at Home

Telephone- Telephone- LGA Radio Television Computer Internet at Home Fixed line Mobile

National

Banjul 57.9 84.2 3.8 99.3 23.3 76.4

Kanifing 64.5 82.6 3.2 99.1 29.0 75.7

Brikama 70.0 55.1 1.3 99.1 22.3 67.9

Mansakonko 67.8 24.6 0.7 97.2 4.2 46.2

Kerewan 74.8 22.3 0.2 98.1 7.8 46.7

Kuntaur 73.6 9.9 0.2 94.7 3.6 19.9

Janjanbureh 69.1 17.8 0.3 96.5 5.2 41.4

Basse 76.0 33.0 1.2 96.4 6.6 62.9

Percentage of households which own a radio, television-fixed line, telephone- mobile, computer and that have access to the internet at home

Inequalities in Household Ownership of ICT Equipment & Internet at Home

Household Ownership of a Radio Household Ownership of a Computer

National National 100.0 100

Richest, 75.9 80.0 Urban, 73.7 80

Richest, 52.5

60.0 Rural, 67.7 Poorest, 68.2 60

Percent Percent 40.0 40 Urban, 23.9

20.0 20

0.0 0 Rural, 4.1 Poorest, 0.8 Area Wealth Quintile Area Wealth Quintile

Percentage of households with a computer at home Percentage of households with a computer at home

Household Ownership of a Mobile Telephone Households with Internet

Urban, 99 Richest, 100 National National 100 100 Richest, 93

Rural, 97 Poorest, 95 80 80 Urban, 72

60 60

Percent Percent 40 Key40 Messages Rural, 38

20 20 Poorest, 23

0 0 Area Wealth Quintile Area Wealth Quintile

Percentage of households with mobile telephone Percentage of households with access to the internet at home Use of Information & Communication Technology

Internet Use: SDG17.8.1 Computer Use Mobile Phone Use Women Women Women 8

20

42 Men Men Men 60

95

91

Percentage of women and men age 15-49 years who during the last 3 months used a computer, used a mobile phone and used the internet

Disparities in Use of Information & Communication Technology

Disparities in Mobile Phone Use among Women Disparities in Mobile Phone Use among Men

Urban, 97 Secondary+, 97 Richest, 98 Richest, 96 National National 100 Urban, 94 Secondary+, 93 100 90.9 90.9 90.9 None, 94 Poorest, 90 80 None, 89 80 Rural, 89 Rural, 85 Poorest, 83

60 60

Percent Percent 40 40

20 20

0 0 Area Education Wealth Quintile Area Education Wealth Quintile

Percentage of women age 15-49 years who during the last 3 months used a Percentage of men age 15-49 years who during the last 3 months used a mobile phone mobile phone

Disparities in Internet Use among Women: SDG17.8.1 Disparities in Internet Use among Men: SDG17.8.1

National National 100 100 Richest, 84

Richest, 74 80 Secondary+, 72 80 Urban, 67

Secondary+, 57 60

60 Urban, 51

Percent Percent 40 40 Pre-primary or Rural, 33 none, 39 20 20 Pre-primary or Poorest, 23 Rural, 21 none, 25

0 Poorest, 10 0 Area Education Wealth Quintile Area Education Wealth Quintile

Percentage of women age 15-49 years who used the internet in the last 3 Percentage of men age 15-49 years who used the internet in the last 3 months months Information & Communication Technology (ICT) Skills

Specific Computer Skills

At least one of the 9 activities 17 6

Wrote a computer program in any programming language 1 1

Transfered a file between a computer and other device 14 4

Created an electronic presentation with presentation software, including text, images, sound, 6 3 video or charts

Found, downloaded, installed & configured software 9 4

Connected & installed a new device, such as a modem, camera or printer 7 3

Used a basic arithmetic formula in a spreadsheet 7 3

Sent e-mail with a file (e.g. document, picture or video) 10 4

Used copy & paste duplicate or move information in document 13 4

Copied or moved a file/folder 14 4

20 15 10 5 0 5 10 15 20 Percent

Men Women

Percentage of women and men age 15-49 years who in the last 3 months have carried out specific computer related activities and the percentage who have carried out at least one of these activities

LGA Data on ICT Use & Skills

Performed at Least 1 ICT LGA Computer Use Mobile Phone Use Internet Use activity

National

Banjul 32 32 32 33

Kanifing 33 33 33 45

Brikama 45 45 45 34

Mansakonko 34 34 34 33

Kerewan 33 33 33 45

Kuntaur 45 45 45 34

Janjanbureh 33 33 33 33

Basse 45 45 45 45

Percentage of women and men age 15-49 years who during the last 3 months used a computer, used a mobile phone and used the internet and percentage who performed at least 1 computer-related activity

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Mass Media, are available on mics.unicef.org/surveys. the global MICS programme. Technical Communications & Internet. Data from this support was provided by the United Nations snapshot can be found in table SR9.1W, Children’s Fund (UNICEF). UNICEF, The SR9.1M, SR 9.2, SR9.3W, SR9.3M, SR9.4W Government of The Gambia, World Food and SR9.4M . Programme and The Global Fund through the National Malaria Control Programme provided financial support. Gambia 2018

Child Mortality

Mortality Rates among Children Under-5

90 Under-5 mortality rate

Infant mortality rate 80 79 Neonatal mortality rate

70

61 60 57

51

Deaths per 1000 per 1000 live births Deaths 50

44 40 41

34 30 31 28

20 10-14 5-9 0-4 Years preceding the survey

Neonatal Under-5 Years preceeding Post-neonatal Infant mortality Child mortality mortality rate: mortality rate: the survey mortality rate rate rate SDG 3.2.2 SDG 3.2.1 31 10 41 17 57 0-4 28 15 44 19 61 5-9 34 17 51 29 79 10-14

Neonatal mortality (NN): probability of dying within the first month of life Post-neonatal mortality: calculated as difference between infant and neonatal mortality rates

Infant mortality (1q0): probability of dying between birth and first birthday Child mortality (4q1): probability of dying between the first and fifth birthday Under-5 mortality (5q0): probability of dying between birth and fifth birthday Key Messages

• Under 5, infant, child and neonatal the last 5 years from 28 to 31/1000 live mortality rates have in general decreased births. Which is a worrying trend and needs over the past 15 years. The values in the urgent attention. past 5 years (U5MR 57, IMR 41, CMR 17 and NMR 31 per 1,000 live births) are lower than in the past 15 years (U5MR 79, IMR 51, CMR 51 and NMR 34 per 1,000 live births. • Mortality rate however for neonatal mortality there has been an increase from Child Mortality Disparities

Under-5 mortality rate by socio-economic characteristics Under-5 mortality rate by demographic risk factors & area

National National 120 120 <2 years, 106

100 100

Poorest, 79 7+, 77 35+ years, 73 80 Pre-primary or 80 Rural, 64 none, 63 Male, 64

60 60

Urban, 53 20-34 years, 53 2-3, 52 40 Secondary+, 51 40 Female, 50

2 years, 45

Deaths births live per Deaths 1000 births live per Deaths 1000 Richest, 35 20 20

0 0 Area Wealth Quintile Mother's Education Sex Mother's Birth Order Previous Age at Birth Birth Interval

Under-five mortality rates for the five year period preceding the survey, by socio-economic characteristics, area and demographic risk factors

Neonatal & under-5 mortality rates by region Trends in under-5 mortality rates

Neonatal Under-5 Region 220 mortality mortality 200 National 31 57 180 Banjul 27 51 160 Kanifing 24 44 140 Brikama 35 56 120 Mansakonko 29 54 100

Kerewan 32 63 births live per Deaths 1000 80

Kuntaur 38 77 60

Janjanbureh 23 53 40 Basse 26 65 1980 1985 1990 1995 2000 2005 2010 2015 2020 Year DHS 2013 Census 2013 MICS 2010 MICS 2018 UN GME (2018) Neonatal mortality and under-5 mortality rates (deaths per 1000 live births) for the five year period preceding the survey, by region Note: The source data used in the above graph is taken from the final reports of MICS 2018, Census 2013 and DHS 2013 except for MICS 2010 and UN GME (2017) which are downloaded from the UN IGME web portal accessed on the 15th of August 2019. Uncertainty interval for 2017 from UN IGME is 39 to 104.

Child mortality source data and child mortality estimates are published on www.childmortality.org, the web portal of the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Data from the same source may differ between a report and UN IGME web portal as UN IGME recalculates estimates using smaller intervals and/or calendar years (if data are available).

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Child are available on mics.unicef.org/surveys. the global MICS programme. Technical Mortality. Data from this snapshot can be support was provided by the United Nations found in table CS.1, CS2, and CS3 in the Children’s Fund (UNICEF). UNICEF, The Survey Findings Report. Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support. The Gambia 2018

Fertility & Family Planning

Fertility

Age Specific Fertility Rates Total Fertility Rate

280

260

240 National: 4.4

220 Rural: 5.8 Area 200 Urban: 3.8 180

160 National: 4.4 140 Woman's Primary: 4.9 120 Education 100 Births per 1000 women per 1000 Births Higher: 3.3 80

60 National: 4.4

40 Wealth Quintile Poorest: 6 20 Richest: 2.7 0 15-19 20-24 25-29 30-34 35-39 40-44 45-49 National 0 Highest Total Rural Urban Lowest

Age-specific fertility rates (ASFR) are the number of live births in the The total fertility rate (TFR) is calculated by summing the age-specific last 3 years, divided by the average number of women in that age fertility rates (ASFRs) calculated for each of the five-year age groups group during the same period, expressed per 1,000 women of women, from age 15 through to age 49

Adolescent Birth Rate: SDG indicator 3.7.2

National Pre-primary or none, Adolescent Birth rate SDG 3.7.2 indicator is under target 3.7: 160 150 By 2030, ensure universal access to sexual and reproductive

140 health-care services, including for family planning, information and education, and the integration of reproductive health into

Poorest, 114 19 - 120 Rural, 108 national strategies and programmes

100 Reducing adolescent fertility and addressing the multiple

80 factors underlying it are essential for improving sexual and reproductive health and the social and economic well-being of 60 adolescents. Preventing births very early in a woman’s life is an important measure to improve maternal health and reduce Births age per 15 1000 Births women 40 Urban, 51 infant mortality.

20 Secondary+, 28 Richest, 25 Key Messages

0 For all ages fertility rate is higher in the urban areas as Area Woman's Education Wealth Quintile compared the rural. For Urban, the highest rate is between 25-29 at 258 births/1000 women. While for rural areas the ❖ Age-specific fertility rate for girls age 15-19 years for the three-year period rate peaks at 30-34 years of age at 180 births/1000 women. preceding the survey. ❖ Adolescent birth rates and total fertility rates for the three-year period For total fertility rate is high at 4.4 with urban TFR standing at preceding the survey 5.8 compared to 3.8 for rural areas. Early Child Bearing - before Age 18 Trends in Early Child Bearing – who had a live birth before Age 18

National 100 100 Urban Rural National 80 80

60 60

50 Percent

Percent 40 40 None, 32 Rural, 29 Poorest, 31 40 35 35 35 36 30 31 29 29 28 30 24 21 20 17 18 19 20 13

Urban, 13 0 Richest, 8 Secondary+ 0 Area Wealth Quintile Woman's Education 20-24 25-29 30-34 35-39 40-44 45-49

Percentage of women age 20-24 years who have had a live birth before age Percentage of women age 20-24 years who have had a live birth before age 18 18, by background characteristics Family Planning

Method of Family Planning by Various Characteristics Type of method* By Area By Age

0 6 0 Urban 18 Age 15-19 16 14 1 12 0 0 Rural Age 20-24

83 86 87 82 94 By Woman’s Education By Language of Household Head By Wealth Quintile

Higher 0 1 0 20 Wollof 0 8 0 Richest 21 16 25 15 1

Primary Sarahule Poorest

No Method 84 92 74 85 80 79 Any Modern Method Any Traditional Method

Percentage of women age 15-49 years currently married or in union who are using (or whose partner is using) a contraceptive method *Modern Methods include female sterilization, male sterilization, IUD, injectables, implants, pills, male condom, Female condom, diaphragm, foam, jelly and contraceptive patch Traditional methods refer to periodic abstinence and withdrawal Met Need for Family Planning

Met Need for Family Planning - Spacing Met Need for Family Planning – Limiting

National National 100 100

80 80

60 60 Percent 40 Percent 40

Secondary+, 16 Urban, 13 Richest, 15 30-34, 15 20 20 Pre-primary or 45-49, 12.8 Urban, 5.1 Richest, 6.0 none, 5.2

Rural, 10 0 Second, 9 Pre-primary or 0 none, 9 45-49, 4 Rural, 4.0 Poorest, 4.1 Secondary+, 4.2 15-19, 0.0 Area Wealth Quintile Woman's Education Age Area Wealth Quintile Woman's Education Age

Percentage of women age 15-49 years currently married or in union Percentage of women age 15-49 years currently married or in union with met need for family planning for spacing, by background with met need for family planning for limiting, by background characteristics characteristics Percentage of Demand for Family Planning Satisfied with Modern Methods - SDG indicator 3.7.1

National 100 The proportion of demand for family planning satisfied with modern

80 methods (SDG indicator 3.7.1) is useful in assessing overall levels of coverage for family planning programmes and services. Access to and use 60 of an effective means to prevent pregnancy helps enable women and their Richest, 48 Secondary+, 46

Urban, 43 40-44, 44 partners to exercise their rights to decide freely and responsibly the Percent 40 number and spacing of their children and to have the information, education and means to do so. Meeting demand for family planning with Rural, 34 Second, 33 Pre-primary or 20 none, 36 modern methods also contributes to maternal and child health by

15-19, 16 preventing unintended pregnancies and closely spaced pregnancies , 0 which are at higher risk for poor obstetrical outcomes. Area Wealth Quintile Woman's Education Age

LGA Data on Fertility & Family Planning

Contraception Demand for family Contraception Use of any planning satisfied Use of modern Adolescent Birth Total Fertility Child bearing Child bearing before method with modern LGA method among Rate Rate before 15* 18 among married methods among married / in- / in-union married / in-union union women women women

The Gambia 67 4 1 17 16 17 40

Banjul 39 3 0 9 26 26 50

Kanifing 33 3 2 12 19 19 45

Brikama 57 4 1 12 18 18 41

Mansakonko 75 5 2 25 14 14 36

Kerewan 89 6 1 26 18 19 40

Kuntaur 114 6 3 31 17 17 40

Janjanbureh 121 6 2 32 17 18 45

Basse 110 5 2 29 8 8 24

*Percentage of women age 20-24 years who have had a live birth before age 15

Key Messages

• At current fertility levels, a woman in • Currently Contraceptive Prevalence The Gambia will have an average of Rate (CPR) for The Gambia is 17 4.4 children in her life time. percent. Percentage of adolescents who have a functioning difficulty, by domain, Country, year • 17% of all women age 20-24 have had a live birth before age 18.

The Gambia Multiple Indicator Cluster National Malaria Control Programme Survey (MICS) was carried out in 2018 provided financial support. by the Gambia Bureau of Statistics as The objective of this snapshot is to part of the global MICS programme. disseminate selected findings from Technical support was provided by the The Gambia MICS 2018 related to Further statistical snapshots and the United Nations Children’s Fund Fertility and Family Planning. Data Survey Findings Report for this and (UNICEF). UNICEF, The Government of from this snapshot can be found in other surveys are available on The Gambia, World Food Programme table TM1.1, TM 2.1, TM2.2W, mics.unicef.org/surveys. and The Global Fund through the TM2.3W, TM3.1 and TM3.3. The Gambia 2018

Adolescents

The Adolescent Population: Age 10-19

Age & Sex Distribution of Household Population

Age Males Females 85+ 80-84 This snapshot of adolescent well-being is organized around key 75-79 priority areas for adolescents: 70-74 Every adolescent survives and thrives 65-69 • • Every adolescent learns 60-64 • Every adolescent is protected from violence and exploitation 55-59 • Every adolescent lives in a safe and clean environment 50-54 • Every adolescent has an equitable chance in life 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4

10 5 0 5 10

Percent Every Adolescent Survives & Thrives

Adolescence is by some measures the healthiest period in the life-course, yet it can also mark the first manifestations of issues which can have lifelong effects on health and wellbeing, such as unsafe sexual behavior, early childbearing and substance misuse. Nevertheless, health interventions during this period are shown to have long-lasting effects. Access to appropriate contraceptive methods is critical to prevent adolescent pregnancy and its related consequences, allowing adolescents to transition into adulthood with the ability to plan their pregnancies and live healthy and productive lives.

Adolescent Birth Rate: SDG 3.7.2 Modern Contraceptive Use, Unmet Need & Demand Satisfied for Modern Methods: SDG 3.7.1

Pre-primary or none, National 160 150 3 140 Unmarried 84 Poorest, 114

19 120

- Rural, 108 3 100

80 6

60 Married 29

40 Urban, 51

Births age per 15 1000 Births women 16

20 Secondary+, 28 Richest, 25 0 20 40 60 80 100 Percent 0 Area Woman's Education Wealth Quintile Modern Use Unmet Need Demand Satisfied (Modern Methods) SDG 3.7.1

Percentage of girls age 15-19 years who are using (or whose partner is using) a Age-specific fertility rate for girls age 15-19 years: the number of live births in the last 3 contraceptive method, percentage with an unmet need for contraception and percent of years, divided by the average number of women in that age group during the same period, demand for modern methods of family planning satisfied, by marital status expressed per 1,000 women Every Adolescent Survives & Thrives

Tobacco* & Alcohol Use

100 Girls Boys Alcohol and tobacco use typically have their onset 80 in adolescence and are major risk factors for adverse health and social outcomes, as well as for non-communicable diseases later in life. 60 Adolescence is a time of heightened risk-taking, independence seeking and experimentation. 41

Percent Adolescents are at increased risk of substance 40 use due to social, genetic, psychological or cultural reasons. Yet adolescence is also an 19 opportune time for education on the negative 20 consequences of substance use, and promote healthy behaviours that will last into adulthood. 4 2 <1 <1 <1 <1 0 Ever-use of tobacco Ever-use of alcohol Used tobacco during last Used alcohol during last month month Percentage of adolescent girls and boys age 15-19 who have ever used tobacco or alcohol Percentage of adolescent girls and boys age 15-19 who have used tobacco or alcohol in the last 1 month *Tobacco use in last month among adolescents is an age disaggregate of SDG 3.a.1

Every Adolescent Learns

Foundational Reading Skills Foundational Numeracy Skills SDG 4.1.1.(a) (i: reading) SDG 4.1.1.(a) (ii: numeracy) Quality education and experiences at school positively affect physical and mental health, 13 4 safety, civic engagement and social development. Adolescents, however, can also face the risk of school drop-out, early marriage or pregnancy, or being pulled into the workforce prematurely.

Data on reading and numeracy skills are collected in MICS through a direct assessment method. The Foundational Learning module captures information on children’s early learning in reading and mathematics at the level of Grade 2 in primary education. Percentage of children age 7-14 who can 1) read 90% of words Percentage of children age 7-14 who can successfully perform in a story correctly, 2) Answer three literal comprehension 1) a number reading task, 2) a number discrimination task, 3) questions, 3) Answer two inferential comprehension questions an addition task and 4) a pattern recognition and completion task

School Attendance Ratios Information & Communications Technology

Girls Boys (ICT) Skills* 100 Girls Boys 80 80 76 6 11

60 50

Percent 38 40 32 29

20

0 Primary Lower Secondary Upper Secondary

Adjusted net attendance ratio, by level of education and by gender Percentage of girls age 15-19 who can perform Percentage of boys age 15-19 who can perform at least one of the nine listed computer related at least one of the nine listed computer related activities activities *Age disaggregate of SDG 4.4.1: Proportion of *Age disaggregate of SDG 4.4.1: Proportion of youth and adults with information and youth and adults with information and communications technology (ICT) skills communications technology (ICT) skills Every Adolescent is Protected from Violence & Exploitation

Child Marriage: SDG 5.3.1

100 Married before age 15 Adolescence is a period of heightened risk to certain forms of Married before age 18 violence and exploitation. The onset of puberty marks an important 80 transition in girls’ and boys’ lives whereby gender, sexuality and sexual identity begin to assume greater importance, increasing vulnerability to particular forms of violence, particularly for 60 adolescent girls. Certain harmful traditional practices, such as female genital mutilation/cutting and child marriage, often take 44 place at the onset of puberty. At the same time, as children enter Percent adolescence, they begin to spend more time outside their homes and 40 interact more intimately with a wider range of people, including peers 26 and romantic partners. This change in social worlds is beneficial in 19 many respects, but also exposes adolescents to new forms of 20 14 violence. 8 5

0 Total Urban Rural

Percentage of women aged 20 to 24 years who were first married or in union before age 15 and before age 18, by area Female Genital Mutilation/Cutting: SDG 5.3.2 Age Attitudes towards Female Genital Disaggregate Mutilation/Cutting

100

80 75 74 76

60

Girls 44 49 5 2 Percent 40

20

0 0% 20% 40% 60% 80% 100% 15-19 18-19 15-17 Age in years Think FGM should continue Think FGM should stop Say it depends/not sure Don't know/missing

Percentage of girls age 15 to 19 years who have undergone FGM/C, by age group Percentage of boys and girls age 15-19 who have heard about FGM/C, by their attitudes on if the *Age disaggregate of SDG 5.3.2: Prevalence of FGM/C among women age 15-49 practice should continue

Child Discipline

Only non-violent Physical punishment Psychological aggression Any violent discipline*

Severe 8 16

81 Other 89 types 72

Percentage of children age 10 to 14 years who experienced any discipline in the past month, by type *Age disaggregate of SDG 16.2.1 Every Adolescent is Protected from Violence & Exploitation

Child Labour: SDG 8.7.1 *

Definition of Child Labour 27 Age 15-17 years 1 5 Age 5-11 years: At least 1 hour of economic work, 28 hours of unpaid household services per week or hazardous working 23 Age 12-14 years 13 conditions. 8 9 Age 12-14 years: At least 14 hours of economic work, 28 Age 5-11 years 17 hours of unpaid household services per week or hazardous 2 working conditions.

Age 15-17 years: At least 43 hours of economic or unpaid household services per week or hazardous working 15 Age 5-17 years 14 conditions. 4

-10 10 30 50 Economic activities include paid or unpaid work for someone who is not a member of the household, work for a family Percent farm or business. Household chores include activities such Hazardous working conditions Economic activities Household chores as cooking, cleaning or caring for children, as well as collecting firewood or fetching water. Percentage of adolescents age 5-17 years engaged in child labour, by type of activity and by age *Estimates from MICS of child labour are different from those in the SDG database for SDG 8.7.1, as the database excludes hazardous work & applies a threshold of 21 hours for household chores for children age 5-14 and no threshold for household chores for children age 15-17 Every Adolescent Lives in a Safe & Clean Environment

Water, Sanitation & Clean Fuel Use National 100 The data presented here are at the household level. Urban, 90.3 Evidence suggests that adolescent access to these services are comparable to household-level data.

80 Basic Drinking Water SDG 1.4: Drinking water from an improved source, provided collection time is not more than 30 minutes for a roundtrip including queuing. Improved Rural, 73.4 drinking water sources are those that have the potential to Urban, 55.9 60 deliver safe water by nature of their design and construction, and include: piped water, boreholes or tubewells, protected dug wells, protected springs, rainwater, of household members household of and packaged or delivered water 40

Percent Percent Basic Sanitation Services SDG 1.4.1/6.2.1 : Use of improved facilities which are not shared with other Rural, 28.7 households. Improved sanitation facilities are those 20 designed to hygienically separate excreta from human

Urban, 4.8 contact, and include: flush/pour flush to piped sewer system, septic tanks or pit latrines; ventilated improved pit

0 latrines, composting toilets or pit latrines with slabs Rural, 0.3 Basic Water Basic Sanitation Use of Clean Fuels Clean Fuels SDG 7.2.1: Primary reliance on clean fuels and technologies for cooking, space heating and lighting Every Adolescent has an Equitable Chance in Life

Functioning Difficulties in Adolescents Key Messages

Depression Achieving sustainable progress and results with regard to equity demands a human rights-based Anxiety approach. At the core of international human rights legal framework is the principle of non- Making friends discrimination, with instruments to combat specific forms of discrimination, including against women, Controlling behavior indigenous peoples, migrants, minorities, people with disabilities, and discrimination based on race Accepting Change and religion, or sexual orientation and gender Concentrating identity. As adolescents begin to form more of an individual identity, discrimination can often Remembering become more pronounced, taking form in

Domain harassment, bullying, or exclusion from certain Learning activities. At the same time, research has shown that discrimination during adolescence has a Communication particularly strong effect on stress hormones, potentially leading to life-long mental or physical Self-care health side effects.

Walking Children and adolescents with disabilities are one of the most marginalized groups in society. Facing Hearing daily discrimination in the form of negative Seeing attitudes, lack of adequate policies and legislation, adolescents with disabilities are effectively barred 0.0 0.5 1.0 1.5 2.0 2.5 from realizing their rights to health, education, and Percent even survival. Age 15-17 Age 10-14

Percentage of adolescents who have a functioning difficulty, by domain and age

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey (MICS) was carried out in 2018 by disseminate selected findings from The Summary Findings Report for this and other the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Adolescents. surveys are available on the global MICS programme. Technical Data from this snapshot can be found in mics.unicef.org/surveys. support was provided by the United Nations table SR4.1, SR9.4W/M, SR10,1, TM2.1, Children’s Fund (UNICEF). UNICEF, The TM3.1, TM3.4, LN1.2, LN4.1, LN4.2, PR2.1, Government of The Gambia, World Food PR3.3, PR4.1W, PR5.1W, PR5.2W, WS3.6, Programme and The Global Fund through TC4.1, EQ1.2 and EQ3.1W/M. the National Malaria Control Programme provided financial support.

A Statistical Snapshot of the Nutritional Status of Children: Sudan 2014 – 2 The Gambia 2018

HIV & Sexual Behaviours

HIV indicators

Women Men Key Messages Knowledge Age 15-49 Age 15-49 • 2 in 10 women and 2 in 10

Percent who know of the two ways 26 26 men know that the risk of of HIV prevention (having only one 23 23 getting HIV can be reduced faithful uninfected partner and by using condoms and using a condom every time), who know that a healthy looking limiting sex to one faithful, person can be HIV-positive, and Age 15-24 Age 15-24 uninfected partner, who reject the two most common • Discriminatory attitudes are misconceptions, and any other local misconception slightly higher in women than in men, the findings shows that young people express more discriminatory Stigma attitudes than adults in Age 15-49 Age 15-49 general- for both men and Percent of those who report women discriminatory attitudes towards people living with HIV, including 1) • Only 1 in 10 women and less would not buy fresh vegetables from a shopkeeper or vendor who than 1 in 10 men were is HIV-positive and 2) think Age 15-24 Age 15-24 tested and received results children living with HIV should not 80 within the last 12 months be allowed to attend school with 83 71 children who do not have HIV 73 before the survey

• 2 in 5 pregnant women with live birth in the last two years received HIV testing and counseling and received the Testing Age 15-49 Age 15-49 results during an ANC visit 14 8

Percent who have been tested for 9 3 HIV in the last 12 months and know the result

Aged 15-24 Aged 15-24

Testing during Antenatal Care Age 15-49 Percent of women who during their antenatal care for their last pregnancy were offered an HIV test, accepted and received 38 42 results, and received post-test health information or counselling Age 15-24 related to HIV HIV Indicators by Key Characteristics

Knowledge among Adolescent Girls & Young Knowledge among Adolescent Boys & Young Women (15-24)* Men (15-24)* National National 100 100

80 80

60 60

Percent Percent 40 Secondary+, 30 40 Urban, 27 Secondary+, 27 Urban, 22

20 20

Pre-primary or Pre-primary or Rural, 13 none, 9 none, 7 0 0 Rural, 11 Area Education Area Education

*Percent age 15-24 who know two ways of HIV prevention, who know that a healthy looking person can be HIV-positive, and who reject two most common misconceptions.

Tested for HIV in last 12 months LGA Data on HIV Testing

Women Men 100 Men who Women who Women tested in last tested in last testing at LGA 12 months 12 months ANC

80 National 8 13 43

Banjul 15 10 43 Kanifing 9 15 62 60 Brikama 7 13 43

Mansakonko 9 16 53 Percent

40 Kerewan 8 16 43 Kuntaur 9 16 40

Janjanbureh 7 16 37 19 19 20 14 13 13 Basse 9 9 21 12 11

4 4 2 0 15-19 20-24 25-29 30-39 40-49 Tested in last 12 months: percent age 15-49 who have been tested in the last 12 months and know the result HIV testing during ANC: percent of women age 15-49 who during their last antenatal care Percent age 15-49 who have been tested for HIV in the last 12 months and know the for their last pregnancy were offered an HIV test, accepted and received results, and result received post-test health information or counselling related to HIV

Key Messages • Across the LGAs and among men 15-49, each with 7% and tested for HIV during antenatal care Banjul had majority (15%) who within the • Within the past 12 months, only 8 % of and received the results last 12 months before the survey tested men across all age groups (15-49) have and received results while Brikama and been tested and received the results while Janjanbureh had the lowest each with 7% more than 1 in 10 women across all age • Across the LGAs and among women 15-49, groups (15-49) have been tested and mansakonko, kerewan, kuntaur and received the results janjanbureh had majority each with 16% • Among women who gave birth in the 5 who within last 12 months before the years before the survey, more than half survey tested and received results while (62% and 53%) in kanifing and brikama and janjanbureh had the lowest mansakonko respectively, wee counselled Sexual Behaviour by Key Characteristics

Sexually Active

Men Women In many settings, sexual behavior can be considered a risk factor for health and social issues. These include reproductive health, HIV and other sexually transmitted infections, and gender 15-24 32 23 equality and empowerment. An understanding of the population’s sexual behavior patterns can inform both disease prevention and health promotion programmes.

15-49 59 53 Young People who had Sex Before Age 15

100 50 0 50 100 Percent Adolescent boys & Adolescent girls & young men 15-24 young women 15-24

Multiple Partners 6 5

15-24 0 3

15-49 0 7

100 50 0 50 100 Percent Girls 15-19 who Report Sex with Partner 10 years or Older Condom Use

No, 44 15-24 10, Females 64, Males Yes, 56

15-49 19, Females 10, Males

100 50 0 50 100 Percent

Sexually active: Percent of women and men age 15-24 and 15-49 who had sexual intercourse within the last 12 months Multiple partners: Percent of women and men age 15-24 and 15-49 of those who had sex with more than 1 partner in the last 12 months Condom use: Percent of women and men age 15-24 and 15-49 who had more than one sexual partner in the last 12 months reporting that a condom was used the last time they had sex Sex before age 15: Percent of women and men age 15-24 who had sex before age 15 Sex with man 10 years or older: Percent of adolescent girls age 15-19 who had sex in the last 12 months who report having had sex with a man 10 or more years older in the last 12 months Note: Data for females aged 15-49 on Condom Use are based on 25-49 unweighted cases. Key Messages

• Less than 1% of young women and 3% of • 6 in 10 women of age 15-49 of sexually young men (15-24 years) had two or more active women reported having had sex with sexual partners in the past 12 months a man 10 or more years older in the last 12 months • Among young men and young women who had two or more partners in the past year, 19% of young women and 10% of young men reported using a condom at last sexual intercourse. Sexual Behavior by Key Characteristics

Condom Use among Young People Condom use among Young People

Adolescent boys 15-19 Adolescent boys and young men age 15-24 Adolescent girls and young women age 15-24

National 100

47 80 Secondary Adolescent girls 15-19 +, 67 Urban, 64

60 27 Secondary +, 37 Percent Urban, 37 40 Rural, 48 Young men 20-24 Primary, 42 20 Rural, 20

0 Area Education Area Education Young women 20-24 67 Percent of adolescents and young people age 15-24 who had more than one sexual partner in the last 12 months reporting that a condom was used the last time they had sex

38 Note: Data for females in Rural areas aged 15-24 on Condom Use are based on 25-49 unweighted cases

Percent of adolescents and young people age 15-24 who had more LGA Data on Sexual Behaviour than one sexual partner in the last 12 months reporting that a condom was used the last time they had sex Men 15-24 Women 15-24 Sex before Age 15 among Adolescent Girls Sex before Condom use Sex before Condom use & Young Women 15-24 15 15

100 LGA National National 6 61 5 34

80 Banjul 10 (67) 2 (*)

Kanifing 6 73 2 (38) 60 Brikama 4 60 4 (33)

Percent Mansakonko 11 (54) 6 (*) 40 Kerewan 6 58 7 (*)

Pre-primary or Kuntaur 14 (*) 9 (*) 20 none, 11 Rural, 7 Poorest, 8 Janjanbureh 10 43 8 (*) Urban, 4 0 Richest, 2 Secondary+, 2 Basse 10 56 8 (*) Area Wealth Education Quintile ( ) Figures that are based on 25-49 unweighted cases (*) Figures that are based on fewer than 25 unweighted cases Percent of adolescent girls and young women age 15-24 who had sex before age 15

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to HIV & Sexual are available on mics.unicef.org/surveys. the global MICS programme. Technical Behaviours. Data from this snapshot can be support was provided by the United Nations found in tables TM10.1M, TM10.1W, Children’s Fund (UNICEF). UNICEF, The TM10.2M, TM10.2W, TM11.1M, TM11.1W, Government of The Gambia, World Food TM11.3M, TM11.3W, TM11.4M, TM11.4W, Programme and The Global Fund through TM11.5, TM11.6M and TM11.6W. the National Malaria Control Programme provided financial support. The Gambia 2018

Child Health & Care of Illness

Diarrhoea

Care-seeking for Diarrhoea Disparities in Care-seeking for Diarrhoea

National 100

Public 46

80 Private 14

Rural, 58 Second, 58 Pre-primary or Community 3 60 Male, 53 none, 54

Other provider 1 Percent Female, 51 Primary, 49 40 Urban, 48 Richest, 42

20 A health facility or provider 52

0 20 40 60 80 100 0 Percent Sex Area Wealth Quintile Mother's Education

Percentage of children age 0-59 months with diarrhoea in the last two weeks for whom advice or Percentage of children age 0-59 months with diarrhoea in the last two weeks for whom treatment was sought by source of provider advice or treatment was sought at a health facility or provider

Feeding during Diarrhoea

Much less Somewhat less About the same More

Eating 23 25 35 10

Drinking 7 10 30 49

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Percent distribution of children age 0-59 months with diarrhoea in the last two weeks by amount of liquids and food given during episode of diarrhoea

ORS Treatment for Diarrhoea ORS + Zinc Treatment for Diarrhoea ORT + Continued Feeding for Diarrhoea

14

44 52 48 56

86

Percentage of children age 0-59 months with Percentage of children age 0-59 months with Percentage of children age 0-59 months with diarrhoea in the last two weeks treated with oral diarrhoea in the last two weeks treated with oral diarrhoea in the last two weeks who were given oral rehydration salt solution (ORS) rehydration salt solution (ORS) and zinc rehydration therapy (ORT) with continued feeding Malaria

Household Availability of Insecticide Treated Nets (ITNs) Children Under-Five who slept under an ITN

54

82

Percentage of households with at least one insecticide-treated net (ITN) Percentage of children age 0-59 months who slept under an ITN last night

Care-seeking during Fever Disparities in Care-seeking during Fever

National 100

Public 39

80 Private 17

Fourth, 61 Secondary+, 59 Male, 57 Urban, 58 Community 2 60

Female, 56 Rural, 55 Poorest, 54 Pri-primary or Other provider 1 Percent none, 55 40

20 A health facility or provider 57

0 20 40 60 80 100 0 Percent Sex Area Wealth Quintile Mother's Education

Percentage of children age 0-59 months with fever in the last two weeks for whom advice or treatment Percentage of children age 0-59 months with fever in the last two weeks for whom advice or treatment was sought at a health facility or provider was sought, by source of advice or treatment

Malaria Diagnosis Usage ACT Treatment among Children who Received Treatment

27 29

Percentage of children with fever who had blood taken from a finger or heel for testing Among children with fever who received anti-malarial treatment, percent treated with Artemisinin- based Combination Therapy (ACT) Symptoms of Acute Respiratory Infection (ARI)

Care-seeking for Symptoms of ARI Disparities in Care-seeking for Symptoms of ARI

National 100

Public 42 80 Fourth, 69 Private 23 Rural, 61 Primary, 56 60 Male, 54

Community 2 Percent Female, 53 Middle, 53 Secondary+, 52 Other provider 2 40 Urban, 49

20

A health facility or provider 53

0 20 40 60 80 100 0 Percent Sex Area Wealth Quintile Mother's Education

Percentage of children age 0-59 months with symptoms of ARI in the last two weeks for whom advice Percentage of children age 0-59 months with symptoms of ARI in the last two weeks for whom advice or treatment was sought, by source of advice or treatment or treatment was sought at a health facility or provider

LGA Data on Care-Seeking for Childhood Illness

Care-Seeking at a health facility or provider for: Key Messages LGA Symptoms • ARI (57%) was the predominant ailment for which care Diarrhoea Fever of ARI was sought at a health facility or provider, followed by fever (53%) and Diarrhoea (52%) National 52 53 57 • There is a significant disparity in terms of rural and Banjul 60 (*) 64 urban at 61% vs 49%. Kanifing 43 58 58 Brikama 47 44 57 Mansakonko 59 (*) 55 Kerewan 59 68 60 Kuntaur 59 62 56 Janjanbureh 63 62 56 Basse 57 55 54 (*) Figures that are based on fewer than 25 unweighted cases

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Child health & are available on mics.unicef.org/surveys. the global MICS programme. Technical Care of Illness. Data from this snapshot can support was provided by the United Nations be found in table SR1.1, SR 5.1W, SR5.1M, Children’s Fund (UNICEF). UNICEF, The SR 5.2, SR 5.3 and SR2.3. Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support.

A Statistical Snapshot of the Nutritional Status of Children: Sudan 2014 – 2 The Gambia 2018

Immunization Coverage

Vaccination against vaccine preventable childhood diseases

Tuberculosis Polio DPT/Hib/HepB

98 93 94

Percentage of children age 12-23 months who received Percentage of children age 12-23 months Percentage of children age 12-23 months who received at the third dose of DTP containing vaccine (DTP3) or the who received BCG containing vaccine at any least one dose of Inactivated Polio Vaccine (IPV) and the third/fourth dose of Hepatitis B containing vaccine time before the survey third/fourth dose of either IPV or Oral Polio Vaccine (OPV) vaccines at any time before the survey (HepB3)/the third dose of Hib containing vaccine (Hib3) at any time before the survey Pneumococcal Rotavirus Yellow fewer

83 94 84

Percentage of children age 12-23 months who Percentage of children age 12-23 months who Percentage of children age 12-23 months who received the third dose of Pneumococcal received the second/third dose of Rotavirus vaccine received yellow fever containing vaccine at (Conjugate) vaccine (PCV3) at any time before (Rota2/3) at any time before the survey any time before the survey the survey Measles Full immunization – Basic antigens Full immunization – All antigens

58 67 80

Percentage of children age 24-35 months who Percentage of children age 12-23 months who received Percentage of children age 24-35 months who received received the second measles containing all basic antigens recommended in the national all antigens recommended in the national immunization vaccine at any time before the survey immunization schedule at any time before the survey schedule at any time before the survey

Note: Basic Antigens : BCG, Polio3, DTP3, Measles1 Note: All Antigens : BCG, Polio3/IPV, DTP3, HepB3, Hib3, Key Messages Measles/Rubella, DT Booster 1 and Measles 2. Immunization Coverage: Disaggregates

Full Immunization – All antigens

National 100

80 Kerewan, 74 Rural, 65 Poorest, 66 Pre-primary or none, 59

60 Percent Urban, 53 Secondary+, 55 40 Fourth, 49 Kanifing, 44

20

0 Area Wealth Maternal Education LGA Quintile

Percentage of children age 24-35 months who received all antigens recommended in the national immunization schedule at any time before the survey, by background characteristics

LGA Data on Full Immunization – All antigens

% fully immunized

National 58

Banjul 50

Kanifing 44

Brikama 60

Mansakonko 52

Kerewan 74

Kuntaur 64

Janjanbureh 67

Basse 47

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to the are available on mics.unicef.org/surveys. the global MICS programme. Technical Immunisation of Children. Data from this support was provided by the United Nations snapshot can be found in table TC. 1.1 and Children’s Fund (UNICEF). UNICEF, The TC. 1.2. Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support. The Gambia 2018

Nutritional Status of Children

Anthropometric Malnutrition Indicators

Stunting: SDG 2.2.1 Wasting: SDG 2.2.2 6 19

Stunting refers to a child who is too Wasting refers to a child who is too thin short for his or her age. Stunting is for his or her height. Wasting, or acute the failure to grow both physically malnutrition, is the result of recent rapid and cognitively and is the result of weight loss or the failure to gain weight. chronic or recurrent malnutrition. A child who is moderately or severely Percentage children under-5 who wasted has an increased risk of death, Percentage children under-5 who are stunted but treatment is possible. are wasted

Overweight: SDG 2.2.2 1 Underweight 14

Overweight refers to a child who is too Underweight is a composite form of heavy for his or her height. This form of undernutrition that can include malnutrition results from expending too elements of stunting and wasting (i.e. few calories for the amount consumed an underweight child can have a from food and drinks and increases the reduced weight for their age due to Percentage children under-5 who Percentage children under-5 who risk of noncommunicable diseases later being too short for their age and/or are underweight in life. are overweight being too thin for their height).

Anthropometric Malnutrition Indicators by Age Key Messages 100 • In The Gambia, stunting is moderately high at 26 percent. Stunting is a result of chronic nutrition deprivation during the 80 first 1,000 days of life affecting a child’s optimal growth and development. It is irreversible and the long term consequences of stunting affect a child’s school 60 performance, an individual’s earning potential, and a nation’s economic productivity. The rate of stunting in the country starts to increase once a child starts complementary

Percent 40 feeding at 6-8 months. • The prevalence of wasting in the country generally low at 6.2% but children aged 6-11 months and 18-23 months are highly vulnerable with a wasting prevalence of 7.4% each. 20 Children suffering from acute malnutrition are more susceptible to sickness and have increased risk of death. • Stunting and wasting in the country affects young children 0 0 12 24 36 48 60 during the period of complementary feeding. It is therefore Age in months important to strengthen programmes that would improve the quantity, quality frequency and diversity of complementary Stunting Overweight Wasting Underweight food given to young children.

Percentage children who are underweight, stunted, wasted and overweight, by age in months Nutritional Status of Children: Disaggregates

Stunting: SDG 2.2.1 Wasting: SDG 2.2.2

National National 100 100

80 80

60 60

Percent Percent

40 40 Region 5, 27 Poorest, 24 Rural, 22 None, 21

20 20 Rural, 7 Poorest, 6 None, 7 18-23 months, 7 Urban, 17 Secondary+, 15 Richest, 13 Region 3, 14 0 0 Rural, 6 Poorest, 6 None, 6 18-23 months, 7 Area Wealth Maternal Education Region Area Wealth Quintile Maternal Education Age of Child Quintile

Percentage of under 5 children who are stunted, by background characteristics Percentage of under 5 children who are wasted, by background characteristics

LGA Data on Stunting, Overweight & Wasting

Stunting: SDG 2.2.1 Overweight: SDG 2.2.2 Wasting % stunted % wasted % wasted (severe) (moderate and severe) % overweight (moderate and severe, (moderate and severe) SDG 2.2.2)

National 19.0 1.2 6.2 1.0

Banjul 16.6 1.9 4.6 0.7

Kanifing 14.4 1.7 4.8 0.9

Brikama 17.8 1.4 5.7 0.6

Mansakonko 19.0 0.8 7.1 0.8

Kerewan 20.8 1.9 5.1 1.1

Kuntaur 26.6 0.5 7.8 1.5

Janjanbureh 24.3 0.7 7.4 1.4

Basse 19.5 0.5 8.2 2.0

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to the are available on mics.unicef.org/surveys. the global MICS programme. Technical Nutritional Status of Children. Data from support was provided by the United Nations this snapshot can be found in table TC. 8.1. Children’s Fund (UNICEF). UNICEF, The Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support. The Gambia 2018

Early Childhood Development

Support for Learning

Early Stimulation & Responsive Care Early childhood, which spans the period up to 8 years of age, is critical for cognitive, social, emotional and physical 25 development. During these years, a child’s newly developing brain is highly plastic and responsive to change. 16 Optimal early childhood development requires a stimulating and nurturing environment, access to books and learning materials, interactions with responsive and attentive caregivers, adequate nutrients, access to good 4 5 quality early childhood education, and safety and

Percent 1 protection. All these aspects of the environment contribute to developmental outcomes for children. Father Mother Any adult household member Children facing a broad range of risk factors including poverty; poor health; high levels of family and environmental stress and exposure to violence, abuse, -15 neglect and exploitation; and inadequate care and learning opportunities face inequalities and may fail to reach their Percentage of children age 2-4 years with whom the father, mother or adult household members engaged in activities that promote learning and school readiness during the last three days developmental potential. Investing in the early years is one of the most critical and cost-effective ways countries can Note: Activities include: reading books to the child; telling stories to the child; singing songs to the child; taking the child reduce gaps that often place children with low social and outside the home; playing with the child; and naming, counting or drawing things with the child economic status at a disadvantage. Attendance at Early Childhood Education Programmes

50 43 40 34

30 27 24 25 23 20 19 13 Percent 13 10

Total Girls Boys Age 3 years Age 4 years Rural Urban Region with Region with Poorest Richest lowest highest -10 attendance attendance Percentage of children aged 36-59 months attending an early childhood education programme, by background characteristics Key Messages

• Early childhood development programmes are limited with the poorest population with limited access. Poorest have 19% while the richest attendance is 40% • Mothers play a critical role in engaging children on activities that promotes learning and readiness for children. (1% Fathers, 4% Mothers) Learning Materials & Child Supervision

Access to Play & Learning Materials Inadequate supervision of children

LGA Left in inadequate supervision 3 or more children's books 1 National 16

Banjul 11

2 or more types of playthings 49 Kanifing 20

Brikama 15 Toys from a shop/ manufactured 49 toys Mansakonko 32

Kerewan 7 Household objects/ objects found 74 outside Kuntaur 20 Janjanbureh 23

Homemade toys 29 Basse 14

0 20 40 60 80 100 Percentage of children under age five left alone or under the supervision of Percent another child younger than 10 years of age for more than one hour at least once in the last week, by LGA Percentage of children under age five according to their access to play and learning materials

Early Childhood Development Index (ECDI)

ECDI: Total Score & Domains, SDG 4.2.1 ECDI: Disaggregates

National 100 ECDI 67

Richest, 78 Attending, 80 80 Urban, 72 Secondary+, 73 Female, 69 4 years, 71

60 Physical 96 No education, 65 Male, 65 Poorest, 63 3 years, 64 Not attending, 63

Rural, 59 Percent

Learning 95 40

Social-emotional 68 20

Literacy-numeracy 15 0 Area of Wealth Maternal Sex of child Age of child ECE attendance 0 20 40 60 80 100 residence Quintile education

Percent ECDI: Early Childhood Development Index; percentage of children age 3-4 years ECDI by various characteristics who are developmentally on track in literacy-numeracy, physical, social- ECE = early childhood education emotional, and learning domains

Key Messages: Further statistical snapshots and the Survey • Despite the known benefits of play and The objective of this snapshot is to Findings Report for this and other surveys learning materials in the development of disseminate selected findings from The are available on mics.unicef.org/surveys. the child, almost all children have no Gambia MICS 2018 related to Early access to books and more than half do Childhood Development. Data from this not have access to toys. snapshot can be found in tables TC10.1, LN1.1, TC10.2, TC10.3, and TC11.1. • Supervision of young children is critical, thus exposing them not only to lack of stimulation, but also to danger and abuse. The Gambia 2018

Education

Attendance Rates & Inequalities

School Net Attendance Rates (adjusted)

Early Childhood Education (36-59 months) 24

1 year prior to primary school entry age 31

Primary 78

Lower secondary 44

Upper secondary 31

0 20 40 60 80 100 Percent

Inequalities in Attendance in Early Childhood Education & Participation in Organized Learning

Net Attendance Rate for Early Childhood Education Participation Rate in Organized Learning (1 Year Prior to Primary Entry Age): SDG 4.2.2 National National 100 100 Richest, 91

Urban, 79 80 80 Female, 75

Male, 75 60 60 Rural, 67 Poorest, 62

Richest, 40

Percent Percent 40 40 Female, 25 Urban, 27

20 20 Male, 23 Rural, 20 Poorest, 19

0 0 Sex Area Wealth Quintile Sex Area Wealth Quintile

Percentage of children age 36-59 months who are attending early childhood Percentage of children attending an early childhood education programme, or education primary education (adjusted net attendance ratio), who are one year younger than the official primary school entry age at the beginning of the school year Inequalities in Attendance Rates

Adjusted Primary School Adjusted Lower Secondary School Adjusted Upper Secondary School Net Attendance Rate Net Attendance Rate Net Attendance Rate National National National 100 Richest, 91 100 100 Female, 80 Urban, 82 80 80 80 Richest, 64 Male, 76 Rural, 71 60 Richest, 52

60 Poorest, 68 60 Female, 50 Urban, 51

Percent Percent Percent Urban, 37 Female, 32 40 40 40

Male, 38 20 20 Rural, 31 Poorest, 20 Male, 29 29 Rural, 15 Poorest, 0 0 0 14 Sex Area Wealth Quintile Sex Area Wealth Quintile Sex Area Wealth Quintile

Percentage of children of primary school age (as of the beginning Percentage of children of lower secondary school age (as of Percentage of children of upper secondary school age (as of of school year) who are attending primary or secondary school the beginning of the current or most recent school year) who the beginning of the current or most recent school year) who are attending lower secondary school or higher are attending upper secondary school or higher

LGA Data for Net Attendance Rates (adjusted)

Participation rate Early Childhood Lower Upper LGA in organized Primary Education Secondary Secondary learning

National 24 75 78 44 31

Banjul 43 88 93 73 51 Kanifing 34 84 87 60 43 Brikama 26 78 82 50 35 Mansakonko 25 85 86 46 23 Kerewan 19 65 71 39 20 Kuntaur 13 52 59 25 17 Janjanbureh 18 61 63 32 19 Basse 18 73 74 22 10

Key Messages • Many children start school at primary level, • Early Childhood Education (ECE) is more (adjusted) in urban and rural areas, and thus missing the advantage of preparation prevalent in Banjul (43%) than Kanifing among the poorest and richest increase as for effective learning. Many children also (34%), Brikama (26%) or any of the children progress from Primary education leave school after primary or lower remaining Local Government Areas. to Junior Secondary education and on to secondary, and lack sufficient tools to • School net attendance rates (adjusted) are Senior Secondary education. integrate working force. Much effort must highest for Primary education (78%), but be made to render childhood and upper decreases to 44% in Lower Secondary level education available for the most education and 31% in Upper Secondary vulnerable children. education. • The disparities in net attendance rate Completion Rates

Primary 65

Lower secondary 46

Upper secondary 29

0 20 40 60 80 100

Percent

Inequalities in Completion Rates

Primary School Lower Secondary Upper Secondary

National National National 100 Richest, 88 100 100 Urban, 85 Female, 80 80 80 80

60 Male, 70 Rural, 71 60 60 Poorest, 62 Richest, 43

Percent Female, 36 Urban, 37

Percent Percent 40 40 40 Female, 30 Richest, 32 Urban, 26

20 20 20

Male, 15 Rural, 15 Poorest, 15 Male, 15 Rural, 15 Poorest, 15 0 0 0 Sex Area Wealth Quintile Sex Area Wealth Quintile Sex Area Wealth Quintile

Percentage of children who age 3 to 5 years above the intended Percentage of children who age 3 to 5 years above the intended Percentage of children or youth who age 3 to 5 years above the age for the last grade of primary school who have completed age for the last grade of lower secondary school who have intended age for the last grade of upper secondary school who primary education completed lower secondary education have completed upper secondary education

LGA Data in Completion Rates

LGA Primary Lower Secondary Upper Secondary

National 66 46 29 Banjul 81 66 54 Kanifing 79 60 42 Brikama 75 53 33 Mansakonko 65 35 15 Kerewan 54 28 16 Kuntaur 33 20 7 Janjanbureh 46 30 8 Basse 36 15 8

Key Messages: Currently more girls compared to boys are enrolled and completing primary, lower secondary and upper secondary levels. There is a need for better understanding of and actions on the issues affecting boys and girls dropping out of schools.

There is steep decline in completion rates from primary to lower secondary and upper secondary level; if the issue is not addressed adequately, The Gambia is not likely to meet its Human Capital targets and the future work force will lack capacities to take the country forward. Out of School Rates

Out of School Dimensions for Levels of Education

Dimension 1: Children not attending an early childhood education 20 DE1 24 programme or primary education

Dimension 2: Children of primary school age who are not in primary or 20 DE2 secondary school 24 Dimension 3: Children of lower secondary school age who are not in 22 primary or secondary school DE3 31 Dimension 4: Children who are in primary school but at risk of dropping

7 out (overage by 2 or more years) DE4 8 Dimension 5: Children who are in lower secondary school but at risk of dropping out (overage by 2 or more years) 19 DE5 27

0 20 40 60 80 100 Percent Female Male

SDG Summary for Education SD MICS Definition & Notes Value G Indicator 4.1.4 LN.8 a,b,c Completion rate (primary education, lower secondary, upper secondary education) 65.5%/45.8%/29.2% 4.1.5 LN.6 a,b,c Out-of-school rate (primary education, lower and upper secondary education) 21.8%/26.2%/40.5% 4.1.6 LN.10 a,b Percentage of children over-age for grade (primary education, lower secondary education) 7.2%/22.2% Participation rate in organized learning (one year before the official primary entry age), 4.2.2 LN.2 M:74.5%/F:74.6% by sex Parity indices (female/male, rural/urban, bottom/top wealth quintiles) for primary adjusted 4.5.1 LN.5 a 1.06/1.01/1.04 net attendance rate Parity indices (female/male, rural/urban, bottom/top wealth quintiles) for lower secondary 1.30/1.18/1.07 4.5.1 LN.5 b adjusted net attendance rate

Key Messages • Completion rates are highest for Secondary education and Upper and poorest Primary Education (65.5%), and Secondary education. progressively decrease for Lower • The disparities in completion rates Secondary Education (45.8%), and increase as children move from Upper Secondary Education Primary education to Lower (29.2%). Secondary, and on to Upper • There are slightly more girls than Secondary education in urban and boys completing primary, Lower rural areas, and among the richest

The Gambia Multiple Indicator Cluster Survey The objective of this snapshot is to Further statistical snapshots and the Survey (MICS) was carried out in 2018 by the disseminate selected findings from The Findings Report for this and other surveys are Gambia Bureau of Statistics as part of the Gambia MICS 2018 related to Education. available on mics.unicef.org/surveys. global MICS programme. Technical support Data from this snapshot can be found in was provided by the United Nations table LN.1.1, LN.1.2, LN.2.3, LN.2.4, LN.2.5 , Children’s Fund (UNICEF). UNICEF, The LN.2.6, and LN.2.7. Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support.

A Statistical Snapshot of the Nutritional Status of Children: Sudan 2014 – 2 The Gambia 2018

Early Grade Learning & Parental Involvement

Early Grade Learning

Foundational Reading Skills: SDG 4.1.1.(a) (i: reading)

Reads 90% of words correctly in story 18

Answers literal comprehension questions correctly 16

Answers inferential comprehension questions correctly 16

Has foundational reading skills* 12

0 20 40 60 80 100

Percent

*Percentage of children age 7-14 who can 1) read 90% of words in a story correctly, 2) Answer three literal comprehension questions, 3) Answer two inferential comprehension questions

Disaggregates in Foundational Reading Skills LGA Data on Foundational Reading Skills

National LGA Boys Girls Total

40

Richest, 29 National 11 13 12

Banjul 21 32 27 Percent 20 Urban, 16 Kanifing 20 28 24 Female, 13 Brikama 14 14 14 Male, 11 Mansakonko 12 7 10 Rural, 7 Poorest, 5 0 Kerewan 8 8 8 Sex Area Wealth Quintile Kuntaur 2 6 4 Janjanbureh 4 7 6 Key Messages Basse 2 6 4 Early Grade Learning

Foundational Numeracy Skills: SDG 4.1.1.(a) (ii: numeracy)

Number reading 36

Number discrimination 40

Addition 31

Pattern recognition and completion 12

Has foundational numeracy skills* 9

0 20 40 60 80 100 Percent

*Percentage of children age 7-14 who can successfully perform 1) a number reading task, 2) a number discrimination task, 3) an addition task and 4) a pattern recognition and completion task

Disaggregates in Foundational Numeracy Skills LGA Data on Foundational Numeracy Skills

National LGA Boys Girls Total

40 National 7 10 9 Banjul 13 19 17

Kanifing 14 13 13 Percent Brikama 8 16 12 20 Richest, 15 Mansakonko 5 4 5 Urban, 12 Female, 10 Kerewan 4 5 5 Kuntaur 2 2 2 Male, 7 Janjanbureh 4 5 4 Rural, 3 Poorest, 3 0 Basse 3 3 3 Sex Area Wealth Quintile

Reading & Numeracy Skills Data in MICS

• The Foundational Learning module adopts • The content of reading assessment is attendance and numerous individual and a direct assessment method for children’s customized in each country, ensuring that household characteristics, such as early learning in reading and mathematics the vocabulary used are part of the Grade location, household socio-economic status, at the level of Grade 2 in primary 2 reading textbook. This ensures national and ethnicity, the most marginalized sub- education. This contributes to SDG4.1.1.(a) question relevance in terms of vocabulary populations of children can be identified Global Indicator. and cultural appropriateness). The for support to improve learning outcomes. • For the Foundational Learning module, one questions on mathematics are based on child age 7 to 14 (inclusively) is randomly universal skills needed for that grade level. selected in each household. • As MICS also collects data on school Parental Involvement: Learning Environment at Home

Children with 3 or more books to read Children who read books or are Children who receive help at home read to at home with homework

National National National 100 100 100

Richest, 77 Richest, 75 80 80 80 Urban, 67 Urban, 66 Male, 64 Male, 63

60 60 60 Female, 63 Female, 62

Rural, 57 Percent Percent Percent Rural, 54 Poorest, Poorest, 40 40 Richest, 30 40 54 51 Urban, 19 Female, 15 20 20 20

Male, 14 0 0 0 Rural, 8 Poorest, 6 Sex Area Wealth Quintile Sex Area Wealth Quintile Sex Area Wealth Quintile

Parental Involvement: Support for learning at School

100

84

80 74 72

62

60

51 Percent

40 37

20

0 Children for whom School has a Attended meeting A meeting discussed Attended school Met with teachers to an adult household governing body open called by governing key education/ celebration or sport discuss child's member in the last to parents body financial issues event progress year received a report card for the child Involvement by adult in school management in last year Involvement by adult in school activities in last year

Although improvement could be made, the The objective of this snapshot is to Further statistical snapshots and the Survey school system creates space for parents disseminate selected findings from The Findings Report for this and other surveys involvement and discussions around Gambia MICS 2018 related to Early Grade are available on mics.unicef.org/surveys. children’s issues in schools. Efforts must be Learning & Parental Involvement. Data from made for more meetings between parents this snapshot can be found in table LN.3.1, and teachers to discuss needs and progress LN.3.3, LN.4.1 and LN.4.2. of children. This will help improve the learning outcomes and improve the learning outcomes and improves completion. The Gambia 2018

Birth Registration

Birth Registration Levels

Birth registration for Children Under-Five: SDG 16.9.1 Key Messages

100 • A name and nationality is every child’s right, enshrined in the Convention on the Rights of 80 Children (CRC) and other international treaties. • Birth registration is low in The 60 Gambia at less than 60%, 11 11 11 although more than 75% of Registered but no birth certificate Percent mothers know how to register 40 their children. Boys and girls are equally affected. Has birth certificate 47 48 45 20

0 Total Male Female

Percentage of children under age 5 whose births are registered, by whether or not they have a birth certificate and by sex

Birth registration by Age

100

80 73 66

58 60 51

Percent 38 40

20

0 0-11 months 12-23 months 24-35 months 36-47 months 48-59 months

Percentage of children under age 5 whose births are registered, by age in months Birth Registration: Inequalities

National 100

80

Richest, 61 Rural, 58 Secondary+, 60 60

Urban, 58 Pre-primary or none, 57 Percent Poorest, 54 40

20

0 Area Wealth Quintile Maternal Education

Percentage of children under age 5 whose births are registered, by background characteristics

LGA Data on Birth Registration Mother’s (or Caregiver’s) Knowledge of How to Register

LGA Total registered Total 21 79 National 67

Banjul 98 Mother/caregiver has no education 21 79 Kanifing 96 Mother/caregiver has secondary+ 19 81 Brikama 80 education

Mansakonko 59 Poorest quintile 16 85 Kerewan 79 Richest quintile 24 76 Kuntaur 96

Janjanbureh 79

Rural 18 82 Basse 70

Urban 23 77

Percentage of children under age 5 whose births are registered, by LGA 0 20 40 60 80 100

Unregistered children whose mothers do not know how to register them

Unregistered children whose mothers know how to register them

Percentage of children under age 5 whose births are not registered, by mother’s (or caregiver’s) knowledge of how to register a child

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Birth are available on mics.unicef.org/surveys. the global MICS programme. Technical Registration. Data from this snapshot can be support was provided by the United Nations found in table PR1.1. Children’s Fund (UNICEF). UNICEF, The Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support. The Gambia 2018

Child Discipline

Child Discipline

Types of Child Discipline Physical punishment Only non-violent Psychological aggression Any violent discipline: SDG 16.2.1 Severe 8 16

81 Other 89 types 56 Percentage of children age 1 to 14 years who experienced any discipline in the past month, by type

Violent Discipline: Inequalities

National 100 Urban, 90 Male, 90 Poorest, 88 Physical punishment: Shaking, hitting or slapping a child on the hand/arm/leg, hitting 80 Rural, 88 Richest , 87 Female, 88 on the bottom or elsewhere on the body with a hard object, spanking or hitting on the bottom with a bare hand, hitting or slapping on the face, 60 head or ears, and hitting or beating hard and

repeatedly. Percent 40 Severe physical punishment: Hitting or slapping a child on the face, head or ears, and hitting or 20 beating a child hard and repeatedly.

0 Psychological aggression: Shouting, yelling or screaming at a child, as well as calling a child Area Wealth Quintile Sex of child offensive names such as ‘dumb’ or ‘lazy’. Violent discipline: Any physical punishment and/or psychological aggression. Percentage of children aged 1 to 14 years who experienced any violent discipline in the past month, by background characteristics Key Messages

• 89.2% of children aged 1 to 14 years • The use of violent discipline was slightly experienced some form of violent higher in urban areas, among the richest discipline, and with males.

• 81% of children aged 1 to 14 years experienced psychological aggression as a form of discipline. Violent Discipline: Age Patterns Physical Punishment: Attitudes & Experiences

100

80 Percentage of respondents who think that physical punishment is necessary 25

60 Percent 40

20

Percentage of children age 1-14 years who 72 experienced any physical punishment

0 1-2 years 3-4 years 5-9 years 10-14 years

Psychological aggression Physical punishment

Severe physical punishment Any violent discipline 0 10 20 30 40 50 60 70 80 90 100 Percent Percentage of children age 1 to 14 years who experienced any violent discipline in the past month, by type and by age

Attitudes to Physical Punishment

100.0

80.0

60.0 Percent 40.0 31 31 28 25 25 26 25 24 22 22 24 24 20 19 20.0

0.0 Total Female Male Urban Rural Below ageAge 25-34Age 35-49 Age 50 Pre- Primary Secondary Richest Poorest 25 years years years years and primary or + quintile quintile above none

Percentage of respondents to the child discipline module who think that physical punishment is necessary to raise or educate children, by their background characteristics

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Child are available on mics.unicef.org/surveys. the global MICS programme. Technical Discipline. Data from this snapshot can be support was provided by the United Nations found in tables PR2.1 and PR2.2. Children’s Fund (UNICEF). UNICEF, The Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support. The Gambia 2018

Child Labour

Child Labour: Levels & Disaggregates

Child Labour for Age 5-17 years: SDG 8.7.1*

100

80

60 39 34 37 Percent 40 31 29 25 25 24 23 20 17 20 9

0 Total Girls Boys 5-11 years 12-14 15-17 Urban Rural Attending Not Richest Poorest years years school attending school Percentage of children age 5 to 17 years engaged in child labour, by background characteristics *Estimates from MICS of child labour are different from those in the SDG database for indicator 8.7.1, as the database excludes the hazardous work component and applies a threshold of 21 hours for household chores for children age 5-14 and no threshold for household chores for children age 15-17 Types of Child Labour Definition of Child Labour 31 Age 15-17 years 1 Age 5 to 11 years: At least 1 hour of economic work, 5 28 hours of unpaid household services per week or 34 hazardous working conditions. Age 12-14 years 13 8 Age 12 to 14 years: At least 14 hours of economic 20 Age 5-11 years 17 work, 28 hours of unpaid household services per week 2 or hazardous working conditions.

Age 15 to 17 years: At least 43 hours of economic or unpaid household services per week or hazardous 15 working conditions. Age 5-17 years 14 4 Economic activities include paid or unpaid work for 0 20 40 60 80 100 someone who is not a member of the household, work Percent for a family farm or business. Household chores include Hazardous working conditions Economic activities Household chores activities such as cooking, cleaning or caring Percentage of children age 5 to 17 years engaged in child labour, by type of activity and by age for children, as well as collecting firewood or fetching water. Note: These data reflect the proportions of children engaged in the activities at or above the age specific thresholds outlined in the definitions box. Key Messages

• Overall, 25% of children age 5-17 in The Gambia are involved in child labour

• The percentage engaged in labour is almost the same among boys (24%) and girls (25%)

• The proportion of children engaged in labour is substantially higher among rural children (39%) than urban children (17%), It is to be noted however that children in the rural areas and the poorest quintiles are more subjected to child labour; this maybe attributed to the needs of farming abd parents using their children for work in the poor rural areas.

• 37.1 percent of children in the poorest wealth quintile are engaged in child labour compared to 8.5 percent in the richest wealth quintile. Inequalities in Child Labour & Hazardous Conditions

Child Labour Inequalities Hazardous Conditions Inequalities

National 100 Total 18

Poorest 28 80 Richest 7

60 Not attending school 23

Attending school 16 Percent 40

Rural 22 Boys, 16 Boys, 16 20 Urban 8 Girls, 6 Girls, 14 Girls, 12 Boys 21 0 Boys, 1 Girls 15

Hazardous working conditions Economic activities at or above Household chores at or above 0 20 40 60 80 100 age specific threshold age specific threshold Percent Percentage of children age 5 to 17 years engaged in child labour, by type of activity and by sex Percentage of children age 5 to 17 years working under hazardous conditions, by background characteristics LGA Data on Child Labour

LGA Total Child Labour

National 25 Banjul 8 Kanifing 11 Brikama 18 Mansakonko 38 Kerewan 44 Kuntaur 31 Janjanbureh 37 Basse 33

Percentage of children age 5 to 17 years engaged in child labour, by LGA

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Child Labour. are available on mics.unicef.org/surveys. the global MICS programme. Technical Data from this snapshot can be found in support was provided by the United Nations tables PR3.1, PR 3.2 and PR3.3. Children’s Fund (UNICEF). UNICEF, The Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support. The Gambia 2018

Child Marriage

Child Marriage: Levels & Disaggregates

Marriage before Age 15 & Age 18: SDG 5.3.1 Disaggregates in Marriage before Age 18

Total 34.2

26

Total

Pre-primary or no education 51 8

Primary 43

Secondary+ 14 44

Rural

14 Poorest 49

Second 43

19 Middle 37

Urban Fourth 29 5

Richest 19

0 20 40 60 80 100 0 20 40 60 80 100 Percent Percent Married by 18 Married by 15

Percentage of women age 20-24 years who were first married or in union Percentage of women age 20-49 years who were first married or in before age 15 and before age 18*, by residence union before age 18, by wealth quintile and education Key Messages • 1 in 5 adolescent girls age 15-19 are currently married, half of which are in a polygynous union

• 1 in 10 married adolescents age 15-19 have a partner who is 10 or more years older

• 15% of men aged 20 to 24 years were first married or in union before age 18.

• Child marriage remains a serious issue in The Gambia; the most vulnerable population are the most at risk, as the highest levels are registered among populations with no or little scalarization, as well as those in the poorest quintile.

• Child marriage has severe consequences on child and maternal health, child abuse and on education with a strong link on the perpetuation of the poverty cycle. It should therefore be among the priorities for girls rights, women’s empowerment and development programming. LGA Data on Child Marriage

LGA Marriage by age 18 Marriage before the age of 18 is a reality for many young girls. In many parts of the world National 34 parents encourage the marriage of their Banjul 21 daughters while they are still children in hopes Kanifing 24 that the marriage will benefit them both Brikama 30 financially and socially, while also relieving Mansakonko 47 financial burdens on the family. In actual fact, Kerewan 41 child marriage is a violation of human rights, Kuntaur 44 compromising the development of girls and often resulting in early pregnancy and social Janjanbureh 55 isolation, with little education and poor Basse 47 vocational training reinforcing the gendered Percentage of women aged 20 to 49 years who were first married or in union before age 18, by LGA nature of poverty. The right to 'free and full' consent to a marriage is recognized in the Universal Declaration of Human Rights - with the recognition that consent cannot be 'free and full' when one of the parties involved is not sufficiently mature to make an informed decision about a life partner.

Trends in Child Marriage

100

80

60 Percent 40

20

0 45-49 40-44 35-39 30-34 25-29 20-24 Age cohort Married by 15 Married by 18

Percentage of women age 20-49 years who were first married or in union before age 15 and before age 18, by age cohort

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Early are available on mics.unicef.org/surveys. the global MICS programme. Technical Marriage. Data from this snapshot can be support was provided by the United Nations found in tables PR4.1W. Children’s Fund (UNICEF). UNICEF, The Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support. The Gambia 2018

Female Genital Mutilation (FGM)

Female Genital Mutilation

Level & Disaggregates of FGM Among Women 15-49 Female genital mutilation (FGM) refers to “all 100 procedures involving partial or total removal of the female external genitalia or other injury to the female 77.3 1 80 75.7 genital organs for non-medical reasons.” FGM is a 71.7 67.4 68.2 violation of girls’ and women’s human rights and is condemned by many international treaties and 60 conventions, as well as by national legislation in many countries. Yet, where it is practised FGM is performed

Percent in line with tradition and social norms to ensure that 40 girls are socially accepted and marriageable, and to uphold their status and honour and that of the entire family. UNICEF works with government and civil society 20 partners towards the elimination of FGM in countries where it is still practised.

0 Total Rural Urban Richest Poorest 1. World Health Organization, Eliminating Female Percentage of girls and women age 15 to 49 years who have undergone FGM*, by residence and wealth quintile Genital Mutilation/Cutting: An interagency statement, *SDG 5.3.2 WHO, UNFPA, UNICEF, UNIFEM, OHCHR, UNHCR, UNECA, UNESCO, UNDP, UNAIDS, WHO, Geneva, 2008, Disaggregates of FGM Among Daughters 0-14 years p. 4.

60 55 52 52 51 48 45 41 42

40 Percent

20

0 Total Rural Urban No education Primary complete Secondary or Richest Poorest higher

Percentage of girls age 0 to 14 years who have undergone FGM (as reported by their mothers), by residence, mother's education and wealth quintile Key Messages The progress that has been made in opening discussion channels on FGM is being translated into an increasing number (49%) of women believing that FGM should stop, and by a sharp reduction in the practice, as evidenced by the fact that 75.7% of women between 15 and 49 years old have gone through FGM, while the younger population between 0 to 14 reveals a lower number of 51%. Strong efforts and coordination at national and decentralized levels need to continue to ensure continuation of progress. Female Genital Mutilation

Trends in FGM Type of FGM

100

Sewn closed 15 76 76 77 80 74 76 75 75

60 Flesh removed 81 Percent 40 Nicked 1

20 Form not determined 4

0 0 20 40 60 80 100 45-49 40-44 35-39 30-34 25-29 20-24 15-19 years years years years years years years Percent

Percentage of girls and women age 15 to 49 years who have undergone FGM, by age cohort Percentage distribution of girls and women age 15 to 49 years who have undergone FGM, by type

Attitudes to FGM

National 100 Think FGM should 44 continue

80

Think FGM should 49 60 Middle, 52 stop Primary, 50

Urban, 45 20-24, 47 Percent 40 Say it depends / are Rural, 42 5 Secondary+, 39 15-19, 41 not sure Richest, 36 20

Don't know / missing 2 0 Area Wealth quintile Education of head Age 0 20 40 60 80 100 of household Percent

Percentage distribution of girls and women age 15 to 49 years who have heard about Percentage of girls and women age 15 to 49 years who have heard about FGM and FGM, by their attitudes about whether the practice should continue think the practice should continue, by wealth quintile, education, residence and age Key Messages

The progress that has been made in efforts and coordination at national and opening discussion channels on FGM is decentralized levels need to continue to being translated into an increasing ensure continuation of progress. number (49%) of women believing that FGM should stop, and by a sharp reduction The objective of this snapshot is to Further statistical snapshots and the in the practice as evidenced by the fact disseminate selected findings from The Survey Findings Report for this and that 75% of women between 15-49 years Gambia MICS 2018 related to Female other surveys are available on old have gone through FGM, while the Genital Mutilation. Data from this mics.unicef.org/surveys. younger population between 0 to 14 snapshot can be found in tables PR5.1, reveals a lower number of 51%. Strong PR5.2 and PR5.3. KazakhstanThe Gambia2015 2018

ChildChild Functioning Functioning

Child Functioning: Levels & Domains

Child Functioning Levels by Age-Group

20

15 12 11 10 10 9 Percent 8 7 6 5 4 5

0 2 - 4 years 5 - 17 years 2 - 17 years

Total Male Female

Child Functioning Domains

care

Seeing

Playing Anxiety

Change

Hearing

Walking

Learning

Self

Accepting

Behaviour

Controlling

FineMotor

Depression

Concentrating

Remembering

Making FriendsMaking Communication

National

2-4 years 0.1 0.2 0.4 0.1 1.0 1.5 0.2 2.8 N/A N/A N/A N/A N/A N/A N/A

5-17 years 0.4 0.1 1.2 N/A 0.8 1.5 N/A 0.8 0.7 1.1 0.6 2.7 0.3 2.2 1.6

Percentage of children aged 2–17 years with functional difficulty in at least one domain, by domain of difficulty N/A- Not Applicable Key Messages Children with disabilities are among the most marginalized groups in society. Facing daily discrimination in the form of negative attitudes, and lack of adequate policies and legislation, children with disabilities are effectively barred from realizing their rights to health, education, and even survival. Children with disabilities are often likely to be among the poorest members of the population and are less likely to attend school, access medical services, or have their voices heard in society. Discrimination against and exclusion of children with disabilities also puts them at a higher risk of physical and emotional abuse or other forms of neglect, violence and exploitation. The Convention on the Rights of the Child (UNICEF, 1989) and the more recent Convention on the Rights of Persons with Disabilities (UN, 2006) explicitly state the rights of children with disabilities on an equal basis with other children. These Conventions focus on the disparities faced by children with disabilities and call for improvements in their access to services, and in their participation in all aspects of life. In order to achieve these goals, there is a need for cross-nationally comparable, reliable data.

In the case of Gambia, the data collected reveled the 1 child aged 2 to 17 years in 10 is concerned by that wealth issue, with more concerns for boys than girls. The Controlling Behaviour seems to be the predominant functioning problem for young child (under 4 years) while the change acceptance seems to cause more functioning problem among those kids aged 5 to 17 years. Child Functioning: Inequalities

20

15

Rural, 9

Percent 10 Poorest, 9

Pre-primary or none, 10 Male, 6

5

Female, 4

Urban, 3 Richest, 3 Secondary +, 8 0

Sex of child Area Wealth Quintile Mother's education

LGA Data on Child Functioning Child Functioning & the Use of Assistive Devices 20

2-4 5-17 2-17 LGA years years years 18

National 5 10 9 16 16

Banjul 3 7 6 14 Kanifing 4 9 8 12 11 Brikama 1 9 7 Percent

10 Mansakonko 1 10 8

Kerewan 13 18 17 8

Kuntaur 7 10 9 6

Janjanbureh 15 10 11 4 Basse 5 8 7 2 1

Percentage of children aged 2–17 years with functional difficulty in at least one domain, by LGA 0 Wear glasses Use hearing aid Use equipment/assistance for walking

Percentage of children aged 2-17 years who use assistive devices and have functional difficulty within domain of assistive device

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Child are available on mics.unicef.org/surveys. the global MICS programme. Technical Functioning. Data from this snapshot can be support was provided by the United Nations found in tables EQ1.1, EQ1.2, and EQ1.3. Children’s Fund (UNICEF). UNICEF, The Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support. The Gambia 2018

Drinking Water, Sanitation & Hygiene - WASH

Basic Drinking Water, Sanitation & Hygiene Services

Basic drinking water Basic sanitation Basic hygiene

100 1 1 2 8 8 5 10 13 9 2 6 26 80 14 37

62 18 60 61 59 66 15

Percent 90 85 40 73 8 56 47 20 29 31 32 29

0 National Urban Rural National Urban Rural National Urban Rural At least basic At least basic Basic Limited No facility Limited Limited Unimproved Unimproved No service No service

Percent of population by drinking water, sanitation and hygiene coverage

Drinking water ladder: At least basic drinking water services (SDG 1.4.1) refer to an improved source, provided collection time is not more than 30 minutes for a roundtrip including queuing. Improved drinking water sources are those that have the potential to deliver safe water by nature of their design and construction, and include: piped water, boreholes or tubewells, protected dug wells, protected springs, rainwater, and packaged or delivered water. Limited refers to an improved source more than 30 minutes roundtrip. Unimproved sources include unprotected dug wells and unprotected springs. No service refers to the direct collection of water from surface waters such as rivers, lakes or irrigation channels.

Sanitation ladder: At least basic sanitation services (SDG 1.4.1) refer to the use of improved facilities which are not shared with other households. Improved sanitation facilities are those designed to hygienically separate excreta from human contact, and include: flush/pour flush to piped sewer system, septic tanks or pit latrines; ventilated improved pit latrines, composting toilets or pit latrines with slabs. Limited sanitation service refers to an improved facility shared with other households. Unimproved sanitation facilities include flush/pour flush to an open drain, pit latrines without a slab, hanging latrines and bucket latrines. No service refers to the practice of open defecation.

Hygiene ladder: A basic hygiene service (SDG 1.4.1 & SDG 6.2.1) refers to the availability of a handwashing facility on premises with soap and water. Handwashing facilities may be fixed or mobile and include a sink with tap water, buckets with taps, tippy-taps, and jugs or basins designated for handwashing. Soap includes bar soap, liquid soap, powder detergent, and soapy water but does not include ash, soil, sand or other handwashing agents. Limited hygiene service refers to a facility lacking water and/or soap. No facility means there is no handwashing facility on the household’s premises.

Key Messages

• 85% of households have access to basic drinking water services, however only 34% (one third) of households are using safely managed drinking water services.

• Large disparity between the richest (91 percent) and poorest(15 percent) with regard to access to basic sanitation

• About one third (34 percent) of households are using safely managed drinking water services WASH: Inequalities in Basic Services

Basic Drinking Water LGA Data on Basic Services

Banjul, 100 Richest, 100 National 100 Urban, 90 Secondary+, 91 Basic Basic Basic LGA Drinking 80 Sanitation Hygiene Pre-primary or Water None, 82 Rural, 73 60 Kuntaur, 66 Poorest, 66 National 85 47 31

Percent Banjul 40 100 56 52 Kanifing 98 63 34

20 Brikama 86 53 31

Mansakonko 88 41 45 0 Area Region Wealth Quintile Education of Kerewan 72 25 31 Household Head Percent of population using basic drinking water services by background characteristics Kuntaur 66 13 29

Janjanbureh 69 26 18

Basic Sanitation Basse 84 50 24

National Percent of population using basic drinking water, sanitation and hygiene services 100 Richest, 91 by LGA

80

Kanifing, 63 Secondary+, 63 Urban, 56

60 Percent 40 Pre-primary or None, 41

20 Rural, 29

Poorest, 15 Kuntaur, 13 0 Area Region Wealth Quintile Education of Household Head

Percent of population using basic sanitation services by background characteristics

Basic Hygiene National 100

80

Richest, 55 60 Banjul, 52

Secondary+, 40 Percent 40 Urban, 32

20 Rural, 29 Pre-primary or Middle, 22 None, 27 Janjanbureh, 18

0 Area Region Wealth Quintile Education of Household Head

Percent of population using basic hygiene services by background characteristics Accessibility of Water & Sanitation Facilities

Time Spent Each Day Collecting Water Who Primarily Collects Water for the Household

100 100 3 3 3 2 6 5 10 85

14 14 80 80 21

16 60 60 18

DK/Missing Percent Percent 40 Over 3 hours 40 77 Over 1 hour to 3 hours 60 31 mins to 1 hour 20 47 Up to 30 minutes 20 7 5 1 1 0 Women 15+ Men 15+ years Girls <15 years Boys <15 years DK/Missing/ 0 years Members do not National Urban Rural collect

Percent of population by mean time person primarily responsible for water collection spends Percent of population by gender and age of person primarily responsible for collecting collecting water each day in households without water on premises drinking water in households without water on premises

Sanitation Accessibility & Privacy Open Defecation

National 40 100

80

60

20 Percent Percent 7.5 0.4 40 3 0.6 1 3

20 13 13 11 Secondary+, 1 Urban, 1 Poorest, 3 Kuntaur, 3 Fourth, 0 0.00 Rural, 2 1 0 0 Improved facilities Improved in Improved in Improved, Banjul/Kanifing, 0 dwelling plot/yard elsewhere Area Region Wealth Quintile Education of household head 5 households or less Pre-primary or >5 households None, 1 Public facility

Percent of the population sharing improved sanitation facilities, by location of sanitation facility Percent of the population practising open defecation, by background characteristics Safely Managed Drinking Water Services: SDG 6.1.1

Improved, basic & safely managed drinking water Drinking water coverage: National, urban & rural

100 8 90 10 13 88 2 85 6

80 14

41 62 59

60 51 Percent

40 34 72

Unimproved 50 20 Limited 34 Basic

Safely managed 0 2 Improved Basic Improved Improved Improved Safely National Urban Rural + + + managed Accessible Available Free from on premises when needed contamination Percent of population by drinking water coverage

Percent of population using improved, basic and safely managed drinking water services

Safely managed (SDG 6.1) are improved sources: accessible on premises, available when needed, free from contamination

Drinking Water Quality at Source & Home Availability of Drinking Water Source Low High

Household National Low High

National 100 Kerewan, 95 100 Basse, 95 Rural, 92 Poorest, 93 Richest, 92 Rural, 90 Secondary+, 88

80 80 Pre-primary or Poorest, 84 Urban, 82 None, 87 Poorest, 68 Rural, 66 Mansakonko, 66 Mansakonko, 71 60 60

Urban, 63

Percent Percent

40 40

Richest, 44 Urban, 35 Banjul, 34

20 20

Richest, 18

0 0 Banjul, 4 Area Area Region Region Wealth Wealth Area Region Wealth Quintile Education of Definitions Quintile Quintile household head

Percent of population using drinking water sources with E. coli (orange) and Percent of population using drinking water sources with sufficient drinking water in proportion with E. coli in glass of drinking water in household drinking water (teal) the last month Water Quality Testing response rates for Household and Source testing are 95.6% and 90.4% respectively Safely Managed Sanitation Services: SDG 6.2.1

Types of Sanitation Facility Types of Sanitation Facility by LGA

Sewer Onsite LGA connection sanitation Sewer connection 1

National 1 61

Onsite sanitation 61 Banjul 98 1

Kanifing 0 89

Brikama 0 66 Unimproved 37 Mansakonko 0 49

Kerewan 0 40

No sanitation facility 1 Kuntaur 0 22

Janjanbureh 0 31 0 20 40 60 80 100 Basse 0 57 Percent

Percent of population using sewer connections and onsite sanitation, by LGA Percent of population by type of sanitation facility, grouped by type of disposal

Management of Sanitation Services

Disposal of excreta

60

42

40 37 Percent

20 18

1 0 1 Definitions0 Safely disposed Unsafe disposal Removal Connected to sewer Using unimproved Practising open in situ of excreta for treatment sanitation facilities defecation

Onsite facilities Percent of population using onsite improved sanitation facilities, by final disposal of excreta Safely managed sanitation services represents an ambitious new level of service during the SDGs and is the indicator for target 6.2. Safely managed sanitation services are improved facilities that are not shared with other households and where excreta are safely disposed of in situ or transported and treated offsite. The MICS survey collected information on the management of excreta from onsite facilities. For households where excreta are transported offsite (sewer connection, removal for treatment), further information is needed on the transport and treatment of excreta to calculate the proportion that are safely managed. Menstrual Hygiene Management Inequities in Access to Appropriate Materials & Private Place to Wash & Change at Home

Women with a private place to wash National Rural, 98 Kuntaur, 98 Poorest, 98 Pre-primary or & change at home 100 none, 95

Urban, 94 Fourth, 93 Secondary+, 95 Kanifing, 92 96 80

60 Women with appropriate

materials Percent

40 98

20 Women with appropriate materials & a private place to wash & change at home 0 Area Region Wealth Quintile Woman's Education 95 Percent of women age 15-49 using appropriate menstrual hygiene materials with a private place to wash and change while at home, among women reporting menstruating in the last 12 months Denominator for all 3 indicators: women age 15-49 who reported menstruating in the last 12 months

Exclusion from Activities during Menstruation Exclusion from Activities during Menstruation by Various Characteristics National 100 40

80

Secondary+, 26 Mansakonko, 23 Richest, 24 60 Urban, 22

20

Percent Percent 40 33 Rural, 17 Poorest, 17 27 Basse, 14 Pre-primary or None, 13 20 17 12 10

0 0 15-19 20-24 25-29 30-39 40-49 Area LGA Wealth Quintile Education of Age group household head

Percent of women who did not participate in social activities, school or work due to their last Percent of women who did not participate in social activities, school or work due to their last menstruation in the last 12 months, by age, among women reporting menstruating in the last 12 menstruation in the last 12 months, by residence, wealth quintile, education and LGA, among months women reporting menstruating in the last 12 months

The Gambia Multiple Indicator Cluster The objective of this snapshot is to Further statistical snapshots and the Survey Survey (MICS) was carried out in 2018 by disseminate selected findings from The Findings Report for this and other surveys the Gambia Bureau of Statistics as part of Gambia MICS 2018 related to Drinking are available on mics.unicef.org/surveys. the global MICS programme. Technical Water, Sanitation & Hygiene - WASH. Data support was provided by the United Nations from this snapshot can be found in tables Children’s Fund (UNICEF). UNICEF, The WS1.1 to WS4.2. Government of The Gambia, World Food Programme and The Global Fund through the National Malaria Control Programme provided financial support. TheCountry GambiaYear 2018 Gender Equality Gender Equality

Gender equality means that girls and boys, women and men, enjoy the same rights, resources, opportunities and protections. Investments in gender equality contribute to lifelong positive outcomes for children and their communities and have considerable inter-generational payoffs because children’s rights and well-being often depend on women’s rights and well-being. This snapshot shows key dimensions of gender equality during the lifecycle. It is organized around: 1) the first decade of life (0-9 years of age) when gender disparities are often small, particularly in early childhood; 2) the second decade of childhood (10-19 years of age) when gender disparities become more pronounced with the onset of puberty and the consolidation of gender norms; and 3) adulthood, when gender disparities impacts both the wellbeing of women and girls and boys. Every Girl & Boy Survives & Thrives: The First Decade of Life Nutrition and a supportive environment in early childhood are among the key determinants of the health and survival of children and their physical and cognitive development. Generally, girls tend to have better biological endowments than boys for survival to age five, and thus higher survival chances under natural circumstances. However, gender discrimination against girls can affect survival, resulting in higher than expected female mortality. Similarly, stunting rates are typically lower among girls than boys, potentially due to the higher risk for preterm birth among boys, which is inextricably linked with lower birth weight. However, children with mothers who gave birth at a young age or who have no education may be more likely to be malnourished. Children with restricted cognitive development during early life are at risk for later neuropsychological problems, poor school achievement, early school drop-out, low-skilled employment, and poor care of their own children. Stimulation and interaction with parents and caregivers can jumpstart brain development and promote well- being in early childhood. This is also the period of development when gender socialization, or the process of learning cultural roles according to one’s sex, manifests. Caregivers, particularly fathers, may respond to, and interact with, sons and daughters differently.

Mortality Rates among Children Under-5, Malnutrition: Stunting (Moderate & Severe) SDG 3.2.1 Sex Disaggregate among Children Under-5, SDG 2.2.1 100 200 National Girls Boys

80 150

60

100 Percent 74 40

Boy, 22 No education, 21 48 50 <20 years, 19

Deaths births liveper Deaths 1,000 50 34 20 20-34 years, 18 Girl, 16 Secondary+, 15 0 0 Infant Mortality Rate Under-five Mortality Rate Sex Maternal Education Age of Mother at Birth

Infant mortality: probability of dying between birth and the first birthday Stunting refers to a child too short for his or her age Under-five mortality: the probability of dying between birth and the fifth birthday

Malnutrition: Wasting (Moderate & Severe) among Malnutrition: Overweight (Moderate & Severe) Children Under-5, SDG 2.2.2 among Children Under-5, SDG 2.2.2 100 100 National National

80 80

60 60

Percent Percent 40 40

20 20 Boy, 7 No education, 7 20-34 years, 6

Boy, 1 Secondary +, 1 20-34 years, 1 0 Girl, 6 Secondary+, 6 <20 years, 6 0 Sex Maternal Education Age of Mother at Birth GirlSex, 1 MaternalNo education Education, 1 Age of<20 Mother years at, 1 Birth Wasting refers to a child who is too thin for his or her height Overweight refers to a child who is too heavy for his or her height Every Girl & Boy Survives & Thrives: The First Decade of Life

Early Stimulation & Responsive Care by Adults Early Childhood Development Index,

Girls Boys SDG 4.2.1 100

Boys 80

60

Girls Percent 40

69 65 18 20 15

4 4 1 1 0 Father Mother Any Adult

Percentage of children age 2-4 years with whom adult household members engaged in activities that promote Percentage of children age 3-4 years who are developmentally on track in at least 3 of the learning and school readiness during the last three days, by person interacting with child and sex of child. following 4 domains: literacy-numeracy, physical, social-emotional, and learning domains, by sex Note: Activities include: reading books to the child; telling stories to the child; singing songs to the child; taking the child outside the home; playing with the child; and naming, counting or drawing things with the child

Every Girl & Boy Is Protected From Violence & Exploitation: The First Decade of Life

Registering children at birth is the first step in securing their recognition before the law, safeguarding their rights, and ensuring that any violation of these rights does not go unnoticed. While vitally important for both girls and boys, the implications of low birth registration rates for girls are significant, rendering them more vulnerable to certain forms of exploitation they are at greater risk of, including child marriage and international trafficking. Although average birth registration rates are similar for girls and boys, children with mothers who have no education may be less likely to have their births registered. While girls and boys face similar risks of experiencing violent discipline -which includes physical punishment and psychological aggression- by caregivers in the home, gender inequality and domestic violence are among the factors associated with an elevated risk of violence against both girls and boys.

Birth Registration, SDG 16.9.1 Sex Disaggregate Violent Discipline, SDG 16.2.1 Sex & Age Disaggregate

100

90 Any violent discipline 80 88

Boy Secondary+ 60 73.6

Girl None Physical punishment Percent

40 70

20 81 Psychological aggression 80 0 Sex Maternal Education 0 20 40 60 80 100

Percent Boys Girls

Percentage of children under age 5 whose births are registered, by sex and maternal education Percentage of children age 1-14 years who experienced violent discipline in the past month, by level sex Note: The age group 1-14 spans the first and second decades of life. Every Girl & Boy Learns: The First Decade of Life

Investment in good quality early childhood education services prior to entering school improves learning outcomes for children. It also enhances the efficiency of the school system by reducing repetition and drop-out and improving achievement, especially among girls and marginalized groups. Primary education provides the foundation for a lifetime of learning. Considerable progress has been made in achieving universal education and closing the gender gap but gender disparities to the disadvantage of girls still exist in some countries. Further, girls still comprise the majority of the world’s out-of-school population. Note: Because children of primary school age range from 6-14 years, these indicators include some children in their second decade of life.

Participation Rate in Organized Learning, SDG 4.2.2 Primary School Attendance 100

80 100 Girls, 92 National Girls, 85 64 Girls, 80 61 80 Boys, 89 Girls, 72 60 Girls, 69 Boys, 79 Boys, 76 Boys, 71 Percent 60 Boys, 68 40

40 Percent 20

20

0 Girls Boys 0 Total Poorest Richest Rural Urban Percent distribution of children age one year younger than the official primary school entry Percentage of children of primary school age attending primary or secondary school age at the beginning of the school year, by attendance to education, and attendance to an (adjusted net attendance ratio), by wealth quintile and urban/rural residence early childhood education programme or primary education (adjusted net attendance ratio), by sex

Children of Primary School Age Out of School Primary Completion

National 100 100

80 80

63

60

60 53

Percent Percent 40 40 Boys, 32 Boys, 29 Boys, 24 Boys, 21 Girls, 31 20 Girls, 28 20 Boys, 11 Girls, 20 Key Messages Girls, 15 0 0 Girls, 8 Girls Boys Total Poorest Richest Rural Urban

Percentage of children of primary school age not attending either primary or secondary Percentage of children who age 3 to 5 years above the intended age for the last school, by wealth quintile and area grade of primary school who have completed primary education, by sex Every Adolescent Girl & Boy Survives & Thrives: The Second Decade of Life

While adolescence carries new health risks for both girls and boys, girls often face gender-specific vulnerabilities, with lifelong consequences. Complications related to pregnancy and childbirth are among the leading causes of death worldwide for adolescent girls age 15 to 19. Preventing adolescent pregnancy not only improves the health of adolescent girls, but also provides them with opportunities to continue their education, preparing them for jobs and livelihoods, increasing their self-esteem and giving them more say in decisions that affect their lives. Yet, too often, adolescent girls lack access to appropriate sexual and reproductive health services, including modern methods of contraception. Additionally, despite having a higher risk of contracting HIV due to both greater physiological vulnerabilities and gender inequalities, adolescent girls are often less knowledgeable than adolescent boys about how HIV is transmitted. However, gender norms adversely impact adolescent boys as well. For example, norms around masculinity that encourage risk taking may heighten adolescent boys’ use of alcohol and tobacco, increasing their likelihood of developing noncommunicable diseases later in life.

Contraceptive Use & Demand Satisfied Early Childbearing - by Age 18

100 100 Married

Unmarried, sexually active

80 80

60 60 Percent Percent 40 40 40 31 28 28 29

20 17 16 20 17 13

0 0 Current use of any Current use of any Demand satisfied for Total Urban Rural method modern method family planning by modern methods

Contraceptive use and demand for family planning satisfied by modern methods Percentage of women age 20-24 years who had a live birth by age 18, by urban/rural among adolescent girls age 15-19, by marital status residence

Comprehensive Knowledge of HIV Tobacco* & Alcohol Use

100 100

Girls Boys

80 80

60 60

Percent Percent 40 40

27 21 20 20 16

4 4 1 0 0 0 0 0 0 Ever-use of tobacco Ever-use of alcohol Used tobacco Used alcohol Girls Boys during last month during last month

Percent of girls and boys age 15-19 who know of the two ways of HIV prevention Tobacco and alcohol use among adolescents age 15-19, by sex (having only one faithful uninfected partner and using a condom every time), who know *Includes an age and sex disaggregate of SDG 3.a.1: use of tobacco that a healthy looking person can be HIV-positive, and who reject the two most common misconceptions, and any other local misconception. Every Adolescent Girl & Boy is Protected from Violence & Exploitation: The Second Decade of Life

Adolescence presents unique vulnerabilities to violence and exploitation for girls. In many countries, marriage before the age of 18 is a reality for girls due to the interaction of several factors that place a girl at risk, including poverty, social norms, customary or religious laws that condone the practice, an inadequate legislative framework and the state of a country’s civil registration system. Child marriage often compromises a girl’s development by resulting in early pregnancy and social isolation, interrupting her schooling, and limiting her opportunities for career and vocational advancement. It also often involves a substantial age difference between the girl and her partner, thus further disempowering her and putting her at greater risk of partner violence, sexually transmitted diseases and lack of agency. Attitudes about wife beating serve as a marker for the social acceptability of intimate partner violence. Acceptance of wife beating among adolescent girls and boys suggests that it can be difficult for married girls who experience violence to seek assistance and for unmarried girls to identify and negotiate healthy and equitable relationships. Female genital mutilation/cutting is a human rights issue that also affects girls and women. Adolescence, in particular, is a vulnerable period for girls who have undergone FGM/C because they may experience heightened consequences of the procedure as they become sexually active and begin childbearing. Gender-based discrimination may be one of the most ubiquitous forms of discrimination adolescent girls face, and it has long-lasting and far-reaching effects on their personal trajectories as well as on all aspects of social and economic development. While in most regions, girls and boys are equally likely to be involved in child labour, gender is a determinant of the types of activities boys and girls engage in, with girls more likely to be involved in domestic work.

Child Marriage, SDG 5.3.1 Spousal Age Difference

26 Total Secondary+ 0 9 30 59 1 8

19 No education 1 6 23 67 3 Urban 5

Richest 0 10 12 79 0 44 Rural 14 Poorest 2 8 31 57 3

11 Richest 3

44 Poorest Total 1 9 27 61 2 13

0 20 40 60 80 100 0 20 40 60 80 100 Percent Percent Married by 18 Married by 15 Younger 0-4 years 5-9 years 10+ years Age unknown

Percentage of women aged 20-24 years who were first married or in union before age 15 and Percent distribution of adolescent girls age 15-19 currently married or in union by age difference before age 18*, by residence with their partner, education level and wealth quintile

Attitudes toward Domestic Violence

100 Girls Boys

80

67

60 55

45 Percent 40

26

20

0 15-17 18-19

Percentage of adolescents age 15-19 years who justify wife beating for any of the following reasons: she goes out without telling him; she neglects the children; she argues with him; she refuses sex with him; she burns the food, by sex and age group Every Adolescent Girl & Boy is Protected from Violence & Exploitation: The Second Decade of Life

Female Genital Mutilation (FGM), Child Labour, SDG 8.7.1 SDG 5.3.2 Age Disaggregate

FGM among girls 10-14 100 Hazardous Working FGM among adolescent girls 15-19 Conditions (mother’s report)a (self-report)b Economic Activities 100 Household Activities 80

80 75 68 60

60 Percent

40 Percent 40 14 16 20 12 20 16 6 0 1 Girls 5-17 Boys 5-17 0 10-14 15-19

a Percentage of girls age 10-14 whose mothers report they have undergone FGM Percentage of children age 5 to 17 years engaged in child labour, by sex, age group and type of b Percentage of adolescent girls age 15-19 who report having undergone FGM activity

FGM refers to all procedures involving partial or total removal of the external female genitalia or other injury to * Note: Indicator includes children in the first & second decade of life the female genital organs for non-medical reasons. **Estimates from MICS of child labour are different from those in the SDG database for indicator 8.7.1, as the database excludes the hazardous work component and applies a threshold of 21 hours for household chores for children aged 5-14 and no threshold for household chores for children aged 15-17

Every Adolescent Girl & Boy has an Equitable Chance in Life: The Second Decade of Life

To become empowered, adolescent girls and boys need to be engaged as civic participants in the decisions affecting their lives and communities. People’s sense of security and freedom from the fear of crime influences how they move about those communities, access services and economic opportunities and participate in public life. Adolescent girls and boys are likely to have different perceptions of personal safety due to different gender-based vulnerabilities to sexual violence and other crimes. Life satisfaction measures an individual’s perceived level of well-being or how an individual feels about their life as a whole. Measuring adolescent girls’ and boy’s satisfaction with their lives can provide important insights into their mental health during a stage of life when gender norms consolidate and girls and boys experience different risk factors for mental health disorders.

Life Satisfaction

10 Girls Boys

8

6.6 6.0 6.0 6.1

6 Percent 4

2

0 15-17 18-19

Among adolescents age 15-19, average life satisfaction score on a scale of 0 to 10, by sex and age group Every Adolescent Girl & Boy Learns: The Second Decade of Life

While participation in secondary education is expanding, progress lags behind primary education. Gender disparities disadvantaging girls are also wider and occur in more countries at the secondary level than at the primary level. Yet, advancing girls’ secondary education is one of the most transformative development strategies countries can invest in. Completion of secondary education brings significant positive benefits to girls and societies – from increased lifetime earnings and national growth rates, to reductions in child marriage, stunting, and child and maternal mortality.

Lower Secondary Attendance Upper Secondary Attendance Net Attendance Rate Net Attendance Rate National National 100 100

80 80

Girls, 66

Girls, 58 Girls, 58 60 60

Girls, 50 Boys, 62 Percent Percent Girls, 40

40 Girls, 33 40 Girls, 32 Boys, 46 Girls, 32 Boys, 43 Boys, 38 Boys, 34 Boys, 28 Boys, 29 20 Boys, 27 20 Girls, 15 Girls, 15

Boys, 14 Boys, 14

0 0 Total Poorest Richest Rural Urban Total Poorest Richest Rural Urban

Percentage of children of lower secondary school age attending lower secondary school Percentage of children of upper secondary school age attending upper secondary school or higher or higher (adjusted net attendance ratio), by sex, wealth quintile and area (adjusted net attendance ratio), by sex, wealth quintile and area

Lower Secondary Completion Upper Secondary Completion

100 100

80 80

60 60 48

43 Percent 40 Percent 40 31 28

20 20

0 Girls Boys 0 Girls Boys

Percentage of children who age 3 to 5 years above the intended age for the last grade of Percentage of children or youth who age 3 to 5 years above the intended age for the last grade lower secondary school who have completed lower secondary education, by sex of upper secondary school who have completed upper secondary education, by sex Every Adolescent Girl & Boy Learns: The Second Decade of Life

Children of Lower Secondary School Age Out of School

National 100

80

60

Percent Boys, 40 Girls, 38 40 Boys, 31 Boys, 27 Girls, 38 Boys, 38 Boys, 20 20 Girls, 22

Girls, 14 Girls, 14 0 Total Poorest Richest Rural Urban

Percentage of children of lower secondary age not attending either primary or secondary school, by wealth quintile and area

Every Adolescent Girl & Boy Lives in a Safe & Clean Environment: The Second Decade of Life

Menstrual Hygiene Management

The ability of adolescent girls to safely manage their monthly menstrual cycle in privacy and with dignity is fundamental to their health, psychosocial well-being and mobility. Girls in low-resource and emergency contexts without access to adequate menstrual Menstural Hygiene Management 95 hygiene management facilities and supplies experience stigma and social exclusion while also forgoing important educational, social and economic opportunities.

Menstrual Hygiene Management: Among adolescent girls age 15-19 who reported menstruating in the last 12 months, percentage using appropriate menstrual hygiene materials with a private place to wash and change while at home Exclusion from Activities 33 during Menstruation Exclusion from Activities during Menstruation: Among adolescent girls age 15-19 who reported menstruating in the last 12 months, percentage of women who did not participate in social activities, school or work due to their last menstruation in the last 12 months

0 20 40 60 80 100 Percent

Key Messages

Key Messages

A Statistical Snapshot of the Nutritional Status of Children: Sudan 2014 – 2 Gender Equality in Adulthood

To survive and thrive, all children require care and support from women and men. Care and support can be substantively improved by fostering gender equality, an important goal in its own right, and by reducing the gender-related barriers. Gender-related barriers include women’s and girls’ disproportionate lack of information, knowledge and technology, resources, and safety and mobility, as well as the gender division of labour and gender norms. For example, a mother’s lack of mobility, due to prohibitive norms or lack of transportation, may impede birth registration, nutrition, and other child outcomes. The internalization of gender norms around masculine and feminine expectations and behaviours may influence women’s and men’s attitudes toward intimate partner violence and physical punishment of children as well as self-perceptions of well-being, including life satisfaction and expectations for the future. Access to Knowledge, Information & Technology Literacy Media Access Internet Use: SDG17.8.1

Men Men Men

42 Women Women Women 48

60 63 84

88

Percentage of adults age 15-49 who are literate, by sex Percentage of adults age 15-49 who read a newspaper, listen to the Percentage of adults age 15-49 using the internet at least radio, or watch television at least once a week once in the past 3 months, by sex Access to Resources Mobile Phone Ownership, SDG 5.b.1 Health Insurance Coverage

100 Men Men Men

Men Men 80 Women 40 Women Women 60 Women

Women Percent 40 Percent 20

20 Men

0 0 Women Total Poorest Richest Rural Urban Total Poorest Richest Rural Urban

Percentage of adults age 15-49 who own a mobile phone, by sex, wealth quintile and area Percentage of adults age 15-49 with health insurance,, by sex, wealth quintile and area

Time on Household Chores: Water Collection Time spent on water collection Who collects water?

1 1 100 3 7 7 1 5 5 15 80 7 12

17 60

DK/Missing Percent 40 Over 3 hours Women 15+ 72 Girls <15 59 Over 1 hour to 3 hours

85 Men 15+ 20 31 mins to 1 hour

Boys <15 Up to 30 minutes

DK/Missing/Members do 0 not collect Women Men

Percent distribution of household members without drinking water on premises by Percent distribution of average amount of time spent collecting water per day by sex of person primarily person usually collecting drinking water used in the household responsible for water collection in households without drinking water on premises Gender Equality in Adulthood Feminine & masculine attitudes & expectations

Attitudes toward domestic violence Attitudes toward physical punishment

Total 50 Women 26 Men

Men 24 Richest 27 14 25

Poorest 71 Women 45

Urban 39 20

Rural 76 48

0 20 40 60 80 100 Percent

Percentage of adults age 15-49 who justify wife beating for any of the following reasons: she goes out Percentage of caretakers who believe that physical punishment is needed to bring up, raise, or without telling him; she neglects the children; she argues with him; she refuses sex with him; she burns educate a child properly, by sex of caretaker the food, by sex, wealth quintile and area

Life satisfaction Perceptions of a better life

6 Women Women Total Total 93 6 97 Men Men 6 Richest Richest 96 6 96

5 Poorest Poorest 90 6 96

Ever 6 Ever 92 married 6 married 96

Never 6 Never 94 married 6 married 97

0 2 4 6 8 10 Score 80 100 Percent

Among adults age 15-49, average life satisfaction score on a scale of 0 to 10, by sex, wealth quintile Percentage of adults age 15-49 who expect that their lives will get better in one year, by sex, wealth and marital status. Higher scores indicate higher satisfaction levels. quintile and marital status

Key Messages

• A slightly higher proportion of women than men believe that physical punishment is justified for child up bringing • Men generally tend to have a higher perception of better life compared to women, especially among those in the poorest wealth quintile • Men have a higher satisfaction of life especially men from poorest, ever married and never married categories comparedKey Messages to women in same categories. ©UNICEF The Gambia/ 2018/Noorani