Table of Content

iv

TABLE OF CONTENT
Acknowledgement
List of Tables
List of Figures
List of Abbreviations
Executive Summary

iii
vii
xi
xiii
xxi

I. INTRODUCTION

Background
Survey Objectives

1
2

II. SAMPLE AND SURVEY METHODOLOGY

Sample Design
Questionnaires
Training and Fieldwork
Data Processing

VI. CHILD HEALTH

5
5
5
7
7

III. SAMPLE COVERAGE AND THE CHARACTERISTICS OF

HOUSEHOLDS AND RESPONDENTS
Sample Coverage
Characteristics of Households
Characteristics of Female Respondents 15-49 Years of Age,
Male 15-59 years and Children Under-5

15

IV. CHILD MORTALITY

Assessment of Data Quality in childhood mortality
Levels and Trends of Early Childhood Mortality
Early childhood mortality rates by region, residence and socio-economic characteristics
Residence and Socio-economic Differentials in Childhood Mortality
Demographic Characteristics and Childhood Mortality

23
24
25
27
30
31

V. NUTRITION
Nutritional Status
Breastfeeding and Infant and Young Child Feeding
Salt Iodization
Rapid Test Kits Results
Salt Sample for analysis
Agreement between Rapid Test Kits and Titration in identifying
adequately and inadequately Iodized salts
Childrens Vitamin A Supplementation
Low Birth Weight
Anaemia and Diet Diversity in Children aged 6-59 months

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9
10

35
35
38
52
53
54
56
57
60
63

65

Vaccinations

65

Neonatal Tetanus Protection

68

Oral Rehydration Treatment

71

Care Seeking and Antibiotic Treatment of Pneumonia

77

Solid Fuel Use

80

VII. MALARIA AND BIOMARKER

85

Background of Malaria in Ghana

Malaria: Causes and Transmission
National strategies for Malaria Control
Malaria PRevention
Insectiside Treated Mosquito Nets (ITNs)
Brief History of ITN Distribution in Ghana
Household Ownership Mosquito Nets
USe of Mosquito Nets by Persons on the Household
USe of Mosquito Nets by Children Under Five Years

85
85
86
88
88
89
90
93
95

USe of Mosquito Nets by Pregnant Women

Source, Cost and Disposal of ITNs
Indoor Residual Spraying Against Mosquitoes
Intermitent Preventive Treatment of Malaria in Pregnancy
Prevalence, Diagnosis, and Treatment of Fever in Children Under-Five
Type and Timing of Antimalarial Drug Use for Children
Knowledge of Malaria Symptoms
Knowledge of Causes of Malaria
Knowledge of ways to avoid Malaria
Specific Messages Seen or Heard about Malaria
Malaria Biomarkers: Anaemia and Malaria in Children Aged 6-59 Months
Anaemia Prevalence in Children

98
101
101
103
105
109
111
112
114
116
120
122

VIII. WATER AND SANITATION

Water
Sanitation
Use of Improved Water Sources
Use of Improved Sanitation Facilities
Handwashing

131
131
131
131
140
147

IX. REPRODUCTIVE HEALTH

Fertility
Contraception
Unmet Need
Antenatal Care
Assistance at Delivery
Place of Delivery
Post-Natal checks

153
153
156
156
161
167
168
170

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X. CHILD DEVELOPMENT
Early Childhood Education and Learning
Early Childhood Development

183
183
190

XI. LITERACY AND EDUCATION

Literacy among Young Women
School Readiness
Primary and Secondary School Participation

195
195
196
198

XII. CHILD PROTECTION

Birth Registration
Child Discipline
Types of Disciplinary Methods
Early Marriage and Polygyny
Female Genital Mutilation/Cutting
Attitudes toward Domestic Violence
Childrens living arrangements and Orphanhood

213
213
216
218
218
226
230
234

XIII. HIV/AIDS, SEXUAL BEHAVIOUR

Knowledge about HIV Transmission and Misconceptions about HIV/AIDS
Comprehensive knowledge of HIV methods and transmission
Knowledge of Mother to Child Transmission of HIV
Accepting Attitudes toward People Living with HIV & AIDS (PLHIV)
Knowledge of a Place for HIV Testing, Counselling and Testing during Antenatal Care
Sexual Behaviour Related to HIV Transmission

239
239
240
246
249
252
260

XIV. NATIONAL HEALTH INSURANCE

National Health Insurance Registration
Reasons why individuals (women, children and men) did not have a valid NHIS card
Achievement of Membership
Opinion on the quality of service offered to the NHI
valid card holders, compared to other clients

273
273
277
280

XV. ACCESS TO MASS MEDIA AND ICT TECHNOLOGY

289

Access to Mass Media

Use of Computers and Internet
List of References
Appendix A. Sample Design
Appendix B. Malaria Biomarkers: Anaemia and Malaria in Children Aged 6-59 Months
Appendix C. List of Personnel Involved in the Survey
Appendix D. Estimates of Sampling Errors
Appendix E. Data Quality Tables
Appendix F. MICS4 Indicators: Numerators and Denominators
Appendix G. Questionnaires

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297
310
309
313
318
354
371
382

List of Tables

Table HH.1:
Table HH.2:
Table HH.3:
Table HH.3:
Table HH.3:
Table HH.4:
Table HH.4M:
Table HH.5:
Table HH.A1:
Table HH.A2:

Results of household, womens and under-5 interviews

Household age distribution by sex
Household composition
Household composition
Household composition y residence
Womens background characteristics
Mens background characteristics
Under-5s background characteristics
Household age distribution by sex and residence
Housing Characteristics

Table NU.1:
Table NU.2:
Table NU.3:
Table NU.3A:
Table NU.4:
Table NU.5:
Table NU.6:
Table NU.7:
Table NU.8:
Table NU.9:
Table NU.9A:
Table NU.9B:
Table NU.10:
Table NU.11:
Table NU.12:
Table NU.13:
Table NU.14:

Nutritional status of children

Initial breastfeeding
Breastfeeding
Infant feeding patterns by age
Duration of breastfeeding
Age-appropriate breastfeeding
Introduction of solid, semi-solid or soft food
Minimum meal frequency
Bottle feeding
Iodized salt consumption
Iodized salt consumption using titration method
Iodized salt consumption. Comparison between rapid test kits and titration method
Childrens vitamin A supplementation
Low birth weight infants
Prevalence of anaemia in children
Prevalence of anaemia and dietary diversity in children
Prevalence of haemoglobin <8.0 g/dL and dietary diversity in children

Table CH.1:
Table CH.2:
Table CH.3:
Table CH.4:
Table CH.5:
Table CH.6:
Table CH.7:
Table CH.8:
Table CH.9:
Table CH.10:

Vaccinations in first year of life

Vaccinations by background characteristics
Neonatal tetanus protection
Oral rehydration solutions and recommended homemade fluids
Feeding practices during diarrhoea
Oral rehydration therapy with continued feeding and other treatments
Care seeking for suspected pneumonia and antibiotic use during suspected pneumonia
Knowledge of the two danger signs of pneumonia
Solid fuel use
Solid fuel use by place of cooking

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