PRESENTAT TATION Background of the National MICS Survey Putting - PowerPoint PPT Presentation

PRESENTAT TATION  Background of the National MICS Survey  Putting the National MICS results into the context of the HSMTDP  Key Findings:  Maternal Health  Child Health  Nutrition  NHIS  Water and Sanitation  Conclusions

BACKGROUND  The Ghana National MICS (with an enhanced Malaria module and biomarker) was conducted by the Ghana Statistical Service with financial and technical support from:  National Malaria Control Programme/GHS  Navrongo Research Centre  USAID/CDC/ICF-MACRO  UNICEF  Government of Japan  UNFPA  A lot of technical support from other DPs, UN Agencies and MDAs

BACKGROUND  2010 Census Sampling Frame was used, and a total of 12,250 Households were sampled;  4 Regions (Upper East, Upper West, Northern and Central) were oversampled to provide more precise data  4 Questionnaires were used: HH, Women 15-49 yrs, Children 0-5 yrs, and Men 15-59 years;  Anthropometry, Malaria/Anaemia testing for children under-5 yrs, and salt was tested (Rapid test kits, and titration);  Survey methodology similar to that of Demographic and Health Survey (DHS), therefore, data is comparable;  Presentation only captures a few core indicators, and additional results will be available in the next one month.

OBJECTIVES OF THE MICS  Provide more current information for assessing the situation of children and women, and reporting on country progress on achieving the GSGDA goals/targets, the MDGs and the reporting requirements of other local and international development declarations and agenda;  Provide much-needed data on practices used to treat malaria among children under-five and the use of specific anti-malarial medications, bednet coverage and use, coverage of IPTP for pregnant women, treatment practices for childhood fever, and prevalence of malaria and anaemia among children age 6-59 months;  Provide baseline data for the new United Nations Development Framework (UNDAF) (2012-2016).

National MICS in the context of HSMTDP  MICS 2011 provides a mid-term snapshot on progress on key HSMTDP 2010-2013 strategic objectives  HO1: Bridge equity gaps in access to health care and ensure sustainable financing arrangements that protect the poor  HO3: Improve access to quality maternal, neonatal, child and adolescent health and nutrition services  MICS 2011 provides nationally representative data that can inform development of next health sector medium term plan.

MATERNAL HEALTH

In aggregate, positive trends in maternal care indicators, although disparities exist…….. 120 Mater erna nal Care e In Indic icat ator ors Target is Target is 96.7 100 95 80% for 92 89 60% for 86 2013 84.7 82 2013 78.2 80 69.4 68.4 62.3 Per Cent 58.9 59 60 47 44 44 40 40 20 0 ANC from health ANC from health Skilled assistance at delivery professional, at least one professional, 4 or more visits visit GDHS 1988 GDHS 1993 GDHS 1998 GDHS 2003 GDHS 2008 MICS 2011

Skilled deliveries still a challenges to many women in the northern region…. 2008 2011 Upper East Upper East 67% 47% Upper Upper Ratio of highest to West West lowest is 1:2.43 60% 46% Northern Northern Target: 1:1.8 (2011) 37% 27% Was: 1:3.1 (2008) Brong Ahafo Volta Brong Ahafo Volta 64% 64% 66% 54% Ashanti Ashanti 74% Eastern Key 73% Eastern 78% Below 61% 50% Western Central Greater Accra Western Central 65% 51-70% Greater Accra 63% 90% 62% 54% 84% Above 70%

The richer, educated and urban residents benefiting more from skilled deliveries… NATIONAL 68.4 WEALTH QUINTILE Richest 98.3 Fourth 86.0 Middle 70.2 Second 55.0 Poorest 40.2 MOTHER EDUCATION Secondary + 98.1 Middle/JSS 79.4 Primary 66.2 None 54.5 RESIDENCE Urban 88.2 Rural 53.9 .0 20.0 40.0 60.0 80.0 100.0 120.0

Assistance by TBAs during delivery reducing, but still high in some regions… Upper East 4% Upper Assis ista tance ce during g Deli liver ery West 60 13% Northern 50 54 33% 40 44 30 30 20 10 16 13 12 11 2 1 2 1 8 3 3 Brong Ahafo 0 Volta 11% 11% Ashanti 12% Eastern 12% 2008 DHS 2011 MICS Key Western Central Above 30% Greater Accra 25% 30% 5% 20-30% Below20%

PNC for mother and child fairly high, although not uniform across regions… 100 97 90 92 95 88 88 87 86 80 85 88 83 82 88 88 87 79 77 76 75 70 73 72 72 60 63 50 40 30 20 10 0 Western Central Greater Volta Eastern Asante Brong Northern Upper Upper Total Accra Ahafo East West PNC for the newborn PNC for the mother

The richer, educated and urban residents benefiting more from PNC… TOTAL WEALTH QUINTILE Richest Fourth Middle Second Poorest MOTHER'S EDUCATION Secondary + Middle/JSS Primary None RESIDENCE Rural Urban 0 10 20 30 40 50 60 70 80 90 100 PNC for the mother PNC for the newborn

Progress seen over time in prevention of malaria in pregnant women… % of pregnant gnant wo women en receiving iving at least st 2 d doses es of 100.0 IPTp 90.0 80.0 76.1 74.1 74.1 70.0 70.2 70.2 67.8 67.1 60.0 63.7 63.8 63.0 62.5 59.8 50.0 52.5 50.8 45.5 45.7 40.0 43.7 43.7 40.8 40.5 40.3 37.3 34.2 30.0 31.0 29.4 27.7 27.9 27.5 26 25.0 20.0 21.9 18.1 16.1 10.0 .0 Western Central Greater Volta Eastern Ashanti Brong Northern Upper Upper National Accra Ahafo East West MICS 2006 DHS 2008 MICS 2011

Use of modern contraceptives increasing…. Use of modern n met ethod ods 50 45 40 35 30 29 25 27 27 26 24 23 20 23 22 2008 22 22 21 21 19 15 17 17 17 2011 16 16 14 10 13 13 5 6 0

1 in 4 women in Ghana has unmet need for Contraception 80.0 Unmet et need fo for Contr traception aception 70.0 60.0 50.0 37.9 40.0 35.3 30.4 29.8 28.0 27.3 30.0 26.3 26.4 25.1 22.6 22.4 19.7 20.0 10.0 .0

CHILD HEALTH

Some gains made in immunization, but nearly 1 in 4 children missing out on vital immunization by age 1 120 % of Chil ildre dren n full lly im immunized unized by age 1 Target for Penta by age 1yr 100 is 91% by 2013 97.8 94.2 92.1 90.7 88.5 80 81.4 80.1 93.0 77.7 77.3 79.9 60 75.5 64.4 76.5 59.9 40 20 0 BCG OPV 3 Penta3 Measles All vaccinations MICS 2006 DHS 2008 MICS 2011

Increased no. of children sleeping under ITNs, but well below the national target of 70% by 2013 100 % of Chil ildre dren n under er-5 5 yrs who sle lept t under er an IT ITN 90 LLIN Campaigns took 80 place in these Regions 70 60 50 40 30 20 10 0 Greater Brong Upper Upper Western Central Volta Eastern Ashanti Northern Total Accra Ahafo East West MICS 2006 11.5 19.8 16.3 21.5 24.9 21.8 25.7 21.9 39.3 37.1 21.8 DHS 2008 35.5 18.9 17.2 40.4 35.7 25.3 50 11.2 36.8 34 28.2 MICS 2011 32.7 27.7 22.1 70.7 60.2 31.2 41.3 41.8 45.0 46.9 39.0 MICS 2006 DHS 2008 MICS 2011

NUTRITION

Concerted efforts required to promote breastfeeding….. Ex Exclu lusi sive e breast eastfeedin eeding Tim imely ely in init itia iation ion of breast astfeed eding ing 100 (1hr) r) 90 100 80 90 70 80 60 70 63 60 50 54 53 50 46 40 52 40 46 46 30 31 30 35 20 20 10 10 7 0 0 1993 DHS 1998 DHS 2003 DHS 2006 MICS 2008 DHS 2011 MICS 2003 DHS 2006 MICS 2008 DHS 2011 MICS Exclusive Breastfeeding Target is 70% by 2012

Some reduction in malnutrition rates, but still more than 1 in 5 children in Ghana is stunted…. Nutritiona ional l St Status us of Chil ildren ren under er-5 5 yrs 60 50 Target for U/W is 8% for 40 2013 Per Cent 35 34 30 31 28 20 23 22.8 20 18 14 13.4 10 10 9 9 8 6.2 0 Stunting Wasting Underweight 1988 1993 1998 2003 2008 2011

Wide disparities in malnutrition across regions and poverty quintiles - Stunting 2011 2008 Upper East Upper East 32% Upper 36% Upper West West 23% Northern 25% UE and Northern 37% Northern well 32% above national Target of 23% Brong Ahafo Volta Brong Ahafo 19% Volta 22% 25% 27% Ashanti Ashanti 22% Eastern 27% Eastern 21% 38% Key Western Central Western Greater Accra Central Above 30% Greater Accra 23% 23% 27% 14% 34% 14% 20-30% Below20%

NATIONAL HEALTH INSURANCE

At least 60% of children have NHIS in Ghana… NHIS Membe mbership hip fo for Chil ildren ren under er-5 5 yrs 100 90 80 70 60 50 40 30 20 10 0 Yes, card seen Yes card not seen

NHIS for women 15-49 yrs … 100.0 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 Yes, card seen Yes card not seen

NHIS for men 15-59 yrs … 100.0 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 Yes, card seen Yes card not seen

WA WATER, SANITATION AND HYG YGIENE

Perc ercent entage age of f po popu pula latio ion n wi with Im h Impro proved ved Source ce of Dr f Drin inking king Wat ater er National average is 80%, 4 regions fall below the National 100.0 also the Target for 2013 average 90.0 92.1 92.0 90.7 90.5 88.6 86.0 85.6 80.0 80.5 80.4 78.3 76.5 70.0 71.5 69.8 68.6 68.4 60.0 61.8 56.4 50.0 40.0 30.0 20.0 10.0 .0