Kenya, Nyanza Province Monitoring the situation of children and women Multiple Indicator Cluster Survey 2011 Kenya National Bureau of Statistics United Nations Children’s Fund Kenya, Nyanza Province Multiple Indicator Cluster Survey 2011 Siaya Kisumu Kisii Homa Bay Nyamira Migori N N July, 2013 The Nyanza province Multiple Indicator Cluster Survey (MICS) was carried out in 2011 by Kenya National Bureau of Statistics in collaboration with County and Provincial administration. The survey covered all the 6 constituent counties of Nyanza, namely: Siaya, Kisumu, Homa Bay, Migori, Kisii, and Nyamira. Financial and technical support was provided by the United Nations Children’s Fund (UNICEF). MICS is an international household survey programme developed by UNICEF. The Nyanza province MICS was conducted as part of the fourth global round of MICS surveys (MICS4). MICS provides up-to-date information on the situation of children and women and measures key indicators that allow countries to monitor progress towards the Millennium Development Goals (MDGs) and other internationally agreed upon commitments. Additional information on the global MICS project may be obtained from www. childinfo.org. In Kenya, this information is important to guide the planning and implementation of new development plans targeting the new administrative County -levels of governance. Suggested citation: Kenya National Bureau of Statistics. 2013. Nyanza Province Multiple Indicator Cluster Survey 2011, Final Report. Nairobi, Kenya: Kenya National Bureau of Statistics. Nyanza Province Multiple Indicator Cluster Survey 2011 Kenya National Bureau of Statistics and United Nations Children’s Fund July, 2013 Table of Contents Table of Contents .....................................................................................................................................iii List of Tables ..............................................................................................................................................v List of Figures .........................................................................................................................................viii List of Abbreviations ................................................................................................................................ix Foreword ....................................................................................................................................................x Executive Summary ..................................................................................................................................xi Summary Table of Findings ....................................................................................................................xv I. Introduction ...................................................................................................................................... 1 Background .................................................................................................................................. 1 Survey Objectives ........................................................................................................................ 2 II. Sample and Survey Methodology .................................................................................................. 3 Sample Design ............................................................................................................................. 3 Questionnaires ............................................................................................................................. 3 Training and Fieldwork ................................................................................................................. 5 Data Processing ........................................................................................................................... 5 III. Sample Coverage and the Characteristics of Households and Respondents ........................... 6 Sample Coverage ......................................................................................................................... 6 Characteristics of Households ..................................................................................................... 7 Characteristics of Female Respondents 15-49 Years of Age and Children Under-5 ................. 10 IV. Child Mortality ................................................................................................................................ 14 Levels of Childhood Mortality ..................................................................................................... 14 V. Nutrition .......................................................................................................................................... 18 Nutritional Status ........................................................................................................................ 18 Breastfeeding and Infant and Young Child Feeding ................................................................... 21 Salt Iodization ............................................................................................................................. 30 Children’s Vitamin A Supplementation ....................................................................................... 32 Low Birth Weight ........................................................................................................................ 34 VI. Child Health .................................................................................................................................... 37 Vaccinations ............................................................................................................................... 37 Neonatal Tetanus Protection ...................................................................................................... 41 Oral Rehydration Treatment ....................................................................................................... 42 Care Seeking and Antibiotic Treatment of Pneumonia ............................................................... 49 Solid Fuel Use ............................................................................................................................ 51 Malaria ........................................................................................................................................ 53 VII. Water and Sanitation ..................................................................................................................... 60 Use of Improved Water Sources ................................................................................................ 60 Use of Improved Sanitation Facilities ......................................................................................... 69 Hand washing practices ............................................................................................................. 77 Contents iii VIII. Reproductive Health ...................................................................................................................... 80 Fertility ........................................................................................................................................ 80 Contraception ............................................................................................................................. 84 Antenatal Care ............................................................................................................................ 86 Assistance at Delivery ................................................................................................................ 90 Place of Delivery ......................................................................................................................... 92 Postnatal Care ............................................................................................................................ 93 IX. Child Development ........................................................................................................................ 95 Early Childhood Education and Learning ................................................................................... 95 Early Childhood Development .................................................................................................. 100 X. Literacy and Education ............................................................................................................... 103 Literacy among Young Women ................................................................................................ 103 School Readiness..................................................................................................................... 104 Primary and Secondary School Participation .......................................................................... 104 XI. Child Protection ........................................................................................................................... 112 Birth Registration ...................................................................................................................... 112 Child Labour ............................................................................................................................. 113 Child Discipline ......................................................................................................................... 115 Early Marriage and Polygyny