PERCENT OF POPULATION WITH ACCESS TO PRIMARY HEALTH CARE FACILITIES

PERCENT OF POPULATION WITH ACCESS TO PRIMARY HEALTH CARE FACILITIES
Social	Health	Healthcare Delivery

1. INDICATOR

(a) Name: Percentage of Population with Access to Primary Health Care Facilities.

(b) Brief Definition: Proportion of population with access to primary health care facilities.

2. Policy Relevance

(a) Purpose: To monitor progress in the access of the population to primary health care.

(b) Relevance to Sustainable/Unsustainable Development (theme/sub-theme): Accessibility of health services, going beyond just physical access, and including economic, social and cultural accessibility and acceptability, is of fundamental significance to reflect on health system progress, equity and sustainable development. It should, however, be supplemented by indicators of utilization of services, or actual coverage, and quality of care. In addition, accessibility is an instrumental goal, a means to an end, to achieving the final intrinsic goals of the system. The more accessible a system is, the more people should utilize it to improve their health.

(c) International Conventions and Agreements: World Health Assembly Resolution WHA34.36, Global Strategy for Health for All by the Year 2000.

(d) International Targets/Recommended Standards: International targets have been outlined in the Global Strategy for Health for All and more recently in the Ninth General Programme of Work. In addition, many countries have established national targets.

(e) Linkage to Other Indicators: This indicator is associated with other socioeconomic indicators on the proportion of people covered by other essential elements of primary health care. It should also, as indicated above, be linked with indicators of utilization of services and quality of care.

3. Methodological Description

(a) Underlying Definitions and Concepts:

(i) Primary health care: is essential health care made accessible at a cost the country and community can afford, with methods that are practical, scientifically sound and socially acceptable.

(ii) Population covered: All the population living in the service area of the health facility.

(iii) Access: Definition of accessibility may vary between countries, for different parts of the country and for different types of services.

(b) Measurement Methods: The numerator - the number of persons living within a convenient distance to primary care facilities; the denominator - the total population.

(c) Limitations of the Indicator: The existence of a facility within reasonable distance is often used as a proxy for availability of health care. If the existing primary care facility, however, is not properly functioning, provides care of inadequate quality, is economically not affordable, and socially or culturally not acceptable, physical access has very little value as this facility is bypassed and not utilized. Therefore, other factors, as mentioned in 3(e) have to be taken into account.

(d) Status of the Methodology: Not Available.

(e) Alternative Definitions/Indicators: In the light of 3(c) the indicator must be supplemented by indicators of availability of services, quality of services, acceptability of services, affordability of services, or utilization of services.

4. Assessment of Data

(a) Data Needed to Compile the Indicator: The number of people with access to primary health care facilities, total population in service areas of health facilities.

(b) National and International Data Availability and Sources: No routinely available data. Information has to be acquired through surveys. Data Sources include Ministries of Health and National Statistical Offices.

5. Agencies Involved in the Development of the Indicator

(a) Lead Agency: The lead agency is the World Health Organization (WHO). The contact point is the Director, Department of Organization of Health Services Delivery, fax: 41 22 791 4747.

(b) Other Contributing Organizations: None.

6. REFERENCES

(a) Readings:

HIS Development Strategy and Catalogue of Health Indicators, Geneva 2000 (EIP/OSD/00.12)

WHO, The World Health Report 2000; Health Systems: Improving Performance, Geneva, 2000.

El-Bindari-Hammad, Smith, DL, Primary Health Care Reviews, Guidelines and Methods, WHO, Geneva, 1992.

WHO, Development of Indicators for Monitoring Progress towards Health for All by the Year 2000, Geneva, 1981.

WHO, Evaluating the Implementation of the Strategy for Health for All by the Year 2000, Common Framework: Third Evaluation, Geneva, 1996.

WHO, Health Centres: the 80/20 Imbalance; Burden of Work Vs Resources, Geneva, 1999.

(b) Internet site: World Health Organization. http://www.who.org

(b) Brief Definition: The percent of the eligible population that have been immunized according to national immunization policies. The definition includes three components: (i) the proportion of children immunized against diphtheria, tetanus, pertussis, measles, poliomyelitis, tuberculosis and hepatitis B before their first birthday; (ii) the proportion of children immunized against yellow fever in affected countries of Africa; and (iii) the proportion of women of child-bearing age immunized against tetanus.

(a) Purpose: This indicator monitors the implementation of immunization programs.

(b) Relevance to Sustainable/Unsustainable Development (theme/sub-theme): Health and sustainable development are intimately interconnected. Both insufficient and inappropriate development can lead to severe health problems in both developing and developed countries. Addressing primary health needs is integral to the achievement of sustainable development. Particularly relevant is the provision of preventative programmes aimed at controlling communicable diseases and protecting vulnerable groups. Good management of immunization programmes, essential to the reduction of morbidity and mortality from major childhood infectious diseases, is a basic measure of government commitment to preventative health services.

(d) International Targets/Recommended Standards: In the Global Strategy for Health and the Ninth General Programme at Work, all children and 90% of children respectively, should be immunized against diphtheria, tetanus, pertussis, measles, poliomyelitis, tuberculosis and hepatitis B (see section 6 below). The 1992 World Health Assembly agreed that all children should be immunized against hepatitis B as part of expanded national programmes of immunization. In addition, all children in affected countries of Africa should be immunized against yellow fever. At the World Summit for Children it was resolved that all pregnant women should be immunized against tetanus.

(e) Linkages to Other Indicators: This indicator is linked to other health indicators, particularly those associated with the young, such as infant mortality and life expectancy. It is influenced by such indicators as health expenditure and the proportion of population in urban areas.

(a) Underlying Definitions and Concepts: A child is considered adequately immunized against a disease when he or she has received the following number of doses: tuberculosis (1 dose); diphtheria, tetanus and pertussis (DTP) (2 or 3 doses according to the immunization scheme adopted in the country); poliomyelitis (3 doses of live or killed vaccine); measles (1 dose); hepatitis B (3 doses); and yellow fever (1 dose). A pregnant woman is considered adequately immunized against tetanus if she has received at least 2 doses of tetanus toxoid during pregnancy or was already previously immunized.

i) Infant population: The numerator is the number of infants fully immunized with the specified vaccines x 100, while the denominator is the number of infants surviving to age one. For immunizations against tuberculosis the denominator is the number of live births. If the national schedule provides for immunization in a different age group, such as measles in the second year of age, the value should be the percentage of children immunized in the target age group. For the proper management of immunization programmes, it is however essential to be able to break down the data in such a way as to show the percentage covered in the first year of life (or second year for measles immunization).

ii) Women of child-bearing age: The numerator is the number of women immunized with two or more doses of tetanus toxoid during pregnancy x 100, while the denominator is the number of live births.

(c) Limitations of the Indicator: It is useful to have a composite indicator of adequate coverage by immunization. However, it is easier to collect data on the global coverage of a population against one disease than on the immunization of each child against all target diseases at the same time. This is why in most countries only the former data are easily available and collected.

The percent of pregnant women immunized with two or more doses of tetanus toxoid during pregnancy is rather easy to monitor through routine data collection in the health services. However, it underestimates the percent of pregnant women actually immunized against tetanus. It does not tale into account women who are already adequately immunized when becoming pregnant and therefore do not require new doses of tetanus toxoid during pregnancy. Women in this category are not numerous in countries where neonatal tetanus is still an issue and where, accordingly, this indicator is mainly used. But in some countries in transition, with long-standing child immunization programmes, the percent of pregnant women receiving tetanus toxoid is misleading as a significant number of them may be already immunized at the moment of pregnancy.

The indicator does not reflect other health preventative measures, such as education, diet, and pollution prevention. The international targets are not very meaningful for many countries.

(a) Data Needed to Compile the Indicator: The number of infants fully immunized against: DTP; poliomyelitis; measles; the number of infants surviving to age one year; against tuberculosis; the number of births; the number of infants living in African countries exposed to yellow fever; the number of pregnant women immunized against tetanus; and the number of live births.

(b) National and International Data Availability and Sources: Data is readily available from national immunization programmes of most countries, at least at the national level. Reporting of vaccinations performed annually or nation-wide surveys are the most common data sources.

(a) Lead Agency: The lead agency is the World Health Organization (WHO). The contact point is the Director, Office of Global and Integrated Environmental Health, WHO; fax no. (41 22) 791 4123.

(b) Other Contributing Organizations: The United Nations Children’s Fund is a cooperating agency.

WHO. Ninth General Programme of Work Covering the Period 1996-2001. Geneva, WHO, 1994.

WHO. WHO-Recommended Standards for Surveillance of Selected Vaccine-Preventable Diseases. WHO/EPI/GEN/99.012,1999.

(b) Brief Definition: This indicator is generally defined as the percent of women or reproductive age using any method of contraception. It is usually calculated for married women of reproductive age, but sometimes for other base population, such as all women of reproductive age, or for men of a specified age group.

(a) Purpose: The measure indicates the extent of people's conscious efforts to control their fertility. It does not capture all actions taken to control fertility, since induced abortion is common in many countries.

(b) Relevance to Sustainable/Unsustainable Development (theme/sub-theme): Increased contraceptive prevalence, is, in general, the single most important proximate determinant of inter-country differences in fertility, and of ongoing fertility declines in developing countries. Contraceptive prevalence can also be regarded as an indirect indicator of progress in providing access to reproductive health services including family planning, one of the eight elements of primary health care. Agenda 21 discusses reproductive health programmes, which include family planning, as among the programmes that promote changes in demographic trends and factors towards sustainability.

Health benefits include the ability to prevent pregnancies that are too early, too closely spaced, too late, or too many. Current contraceptive practice depends not only on people's fertility desires, but also on availability and quality of family planning services; social traditions that affect the acceptability of contraceptive use; and other factors, such as marriage patterns and traditional birth-spacing practices, that independently influence the supply of children.

(c) International Conventions and Agreements: Family planning is discussed in the broader context of reproductive, sexual health, and reproductive rights by Chapter VII of the Programme of Action, International Conference on Population and Development (ICPD); and Strategic Objective C of the Platform for Action adopted at the Fourth World Conference on Women.

(d) International Targets/Recommended Standards: International agreements do not establish specific national or global targets for contraceptive prevalence. Recent international conferences have strongly affirmed the right of couples and individuals to choose the number, spacing and timing of their children, and to have access to the information and means to do so. The ICPD Programme of Action states that "Governmental goals for family planning should be defined in terms of unmet needs for information and services. Demographic goals, while legitimately the subject of government development strategies, should not be imposed on family-planning providers in the form of targets or quotas for the recruitment of clients" (paragraph 7.12).

(e) Linkages to Other Indicators: The level of contraceptive use has a strong, direct effect on the total fertility rate (TFR) and, through the TFR, on the rate of population growth. Use of contraception to prevent pregnancies that are too early, too closely spaced, too late, or too many has benefits for maternal and child health. This indicator is also closely linked to access to primary health care services particularly those pertaining to reproductive health care. Furthermore, it has broader and predictive implications for many other sustainable development indicators and issues, such as rate of change of school-age population, woman's participation in the labour force, and natural resource use.

3. Methodological Description

(a) Underlying Definitions and Concepts: The standard indicator is the percentage currently using any method of contraception among married women aged 15-49 or 15-44. In this context, the married group usually includes those in consensual or common-law unions in societies where such unions are common. Contraceptive prevalence is also frequently reported for all women of reproductive age, and statistics are sometimes presented for men instead of, or in addition to, women.

Users of contraception are defined as women who are practising, or whose male partners are practising, any form of contraception. These include female and male sterilization, injectable and oral contraceptives, intrauterine devices, diaphragms, spermicide, condoms, rhythm, withdrawal and abstinence, among others.

For this indicator, too early is defined as under age 15. Such adolescents are 5 to 7 times more likely to die in pregnancy and childbirth than women in the lowest risk group of 20-24 years. Too closely spaced means women who become pregnant less than two years after a previous birth. Greater adverse consequences to women and their children are experienced under such circumstances. Women who have had five or more pregnancies (too many) or who are over 35 (too late), also face a substantially higher risk than the 20-24 year old group.

When presenting information about contraceptive use, it is useful to show the data according to specific type of contraception; by social characteristics such as rural/urban or region of residence, education, marital status; by 5-year age group, including specific attention to adolescents aged under 18 years; and by family size.

(b) Measurement Methods: Measurements of contraceptive prevalence come almost entirely from representative sample surveys of women or men of reproductive age. Current use of contraception is usually assessed through a series of questions about knowledge and use of particular methods.

(c) Limitations of the Indicator: For surveys, under-reporting can occur when specific methods are not mentioned by the interviewer. This can be the case with the use of traditional methods such as rhythm and withdrawal, and use of contraceptive surgical sterilization. The list of specific methods is not completely uniform in practice, but in most cases is sufficiently consistent to permit meaningful comparison. "Current" use is often specified in surveys to mean "within the last month", but sometimes the time reference is left vague, and occasionally longer reference periods are specified. With statistics from family planning programmes, the accuracy of the assumptions is often difficult to assess. The derived estimates obviously omit contraceptive users who do not use the programme's services, and thus tend to underestimate the overall level of use.

Service statistics maintained by family planning programmes are also sometimes used to derive estimates of contraceptive prevalence. In such cases it is necessary to apply assumptions in order to derive estimates of numbers of current users from the records of numbers of family planning clients. Base population statistics (numbers of women or of married women) are in this case usually derived from census counts, adjusted to the reference date by the Population Division of the Department of Economic and Social Affairs (DESA), as part of its preparations of the official United Nations population estimates and projections.

(d) Status of the Methodology: The methodology is widely used in both developed and developing countries.

(e) Alternative Definitions/Indicators: None.

4. Assessment of Data

(a) Data Needed to Compile the Indicator: Number of women of childbearing age using family planning methods. Number of women of childbearing age. Both data sets are frequently limited to married women.

(b) National and International Data Availability and Sources: The most recent United Nations review of contraceptive prevalence includes statistics for 119 countries and areas with information dating from 1975 or later. These countries include 90 per cent of world population. This review includes contraceptive prevalence measures for all women of reproductive age in 64 countries and areas and for samples of men in 27 countries and areas.

Contraceptive prevalence is one of the few topics for which data coverage is more complete and more current for developing than for developed countries. Most surveys provide estimates for major regions within countries as well as at the national level. Less frequently the sample design permits examining prevalence at the state, provincial, or lower administrative levels. In addition to those with national or near-national coverage, surveys covering this topic are sometimes available for particular geographic areas. Data are much less widely available for population groups other than married women, although such information has increased in recent years.

(c) Data References: Executing agencies for surveys covering this topic vary. National statistical offices and ministries of health are the most common source, but other governmental offices, non-governmental voluntary or commercial organizations are frequently involved. Many surveys are conducted in collaboration with international survey programmes. The Population Division, DESA regularly compiles information about contraceptive prevalence and publishes it in the annual World Population Monitoring report.

5. Agencies Involved in the Development of the Indicator

(a) Lead Agency: The lead agency is the World Health Organization (WHO). The contact point is the Director, Office of Global and Integrated Environmental Health, fax no. (41 22) 791 4123.

(b) Other Contributing Organizations: The United Nations Department of Economic and Social Affairs (DESA), with the contact point as the Director, Population Division, fax no. (1 212) 963 2147.

6. REFERENCES

(a) Readings:

Levels and Trends of Contraceptive Use as Assessed in 1988 (United Nations, Sales No. E.89.XIII.4).

Levels and Trends of Contraceptive Use as Assessed in 1994 (United Nations, ST/ESA/SER.A/146, forthcoming).

Programme of Action of the International Conference on Population and Development, Report of the International Conference on Population and Development, Cairo, Egypt, September 5-13, 1994. (United Nations Document - A/CONF. 171/13).

World Population Monitoring, 1993 (Sales No. E.95.XIII.8, New York).

World Population Monitoring, 1996 (ESA/P/WP.131).

(b) Internet site: World Health Organization. http://www.who.org

(b) Brief Definition: The estimated proportion of the population entering primary school who reach grade 5.

(a) Purpose: This indicator provides an estimate of the proportion of children entering primary school who reach grade 5 of primary education and thereby acquire basic literacy.

(b) Relevance to Sustainable/Unsustainable Development (theme/sub-theme): Education is a process by which human beings and societies reach their fullest potential. Education is critical for promoting sustainable development and improving the capacity of people to address environment and development issues. It is also critical for achieving environmental and ethical awareness, values, and skills consistent with sustainable development and effective public participation in decision-making.

Policy-makers concerned with children’s retention in schools and their eventual acquisition of basic literacy and numeracy skills would find this indicator particularly useful as it indicates the functioning, or internal efficiency of the education system and its ability to turn out literate people.

Appropriate policies and measures could then be adopted to address problems of grade repetition and drop-out as well as bottlenecks with regard to retention in school. Indirectly, this indicator reflects the quality and performance of schools.

(d) International Targets/Recommended Standards: With values that can vary form 0 to 100%, the general target would be 100%. This implies complete retention of children in school to grade 5 (or zero drop-out).

(e) Linkages to Other Indicators: Literacy is closely linked to indicators reflecting basic needs such as education, capacity-building, information and communications, and the role of major groups. Besides assessing the functioning of the education system, this indicator is often used together with enrolment ratios to depict respectively the complementary aspects of participation and retention in education. It can be cross-referenced with adult literacy which reflects the cumulative output of the education system over the years.

(a) Underlying Definitions and Concepts: Efforts to extend literacy depend on the ability of the education system to ensure full participation of school-age children and their successful progression to reach at least grade 5, which is the stage when they are believed to have firmly acquired literacy and numeracy. By estimating the percentage survival to grade 5, this indicator measures the proportion of the population entering primary school who eventually reach grade 5.

(b) Measurement Methods: This indicator can be derived using the reconstructed cohort student flow method, which is analogous to that used in demography to determine survival rates from one age to the next. This method first derives the grade promotion, repetition and drop-out rates based on available data on enrolment and repeaters by grade for two consecutive years using Markov chain calculations. It then applies these rates to a cohort of 1,000 students in grade 1 to reconstruct their passage through the education system assuming that these student flow rates by grade remain unchanged throughout the life-time of the cohort. From the reconstructed cohort student flow, the percentage survival to grade 5 can be derived.

If pi, ri and di represent respectively promotion rate, repetition rate and drop-out rate at grade i of primary education, they can be derived but the following condition on the flow rates have to be satisfied:

When these conditions are not satisfied, the method used to derive survival is no longer valid since it is not possible to isolate the original cohort and any inferences made will be of a dubious nature.

A fundamental assumption is that the probability of the cohort entering primary school, irrespective of the age of the pupils not reaching grade 5 is the same as that of the entrance age population for this level of education. That is, the drop-out rate is the same for all pupils regardless of the age at which they enter school.

(c) Limitations of the Indicator: The measurement method described in 4b above is rather a cumbersome one to administer. In addition, in some countries such as Germany and Austria, the concept of grade 5 does not exist in primary education. Moreover, data on enrolment and repetition by grade may not be available for consecutive years for some countries and certain regions or schools within a country. The reconstructed cohort student flow method assumes that promotion rates, repetition rates and drop-out rates do not change from year to year. When applying this method to sub-national and school levels, the derived drop-out rates by grade may sometimes present a negative value due to transfers between schools. A suggested solution to this problem is to collect data on transferred students by grade, and to deduct them from the corresponding enrolment figures before applying the reconstructed cohort method.

(d) Status of the methodology: This indicator has the status of a recommendation since the basic data elements to derive it are included in the Revised Recommendation Concerning the International Standardization of Education Statistics adopted by the UNESCO General Conference at its twentieth session, Paris, 1978.

(e) Alternative Definitions: In the absence of data on repeaters, the methodology outlined in section 4 (b) above may be adjusted by assuming that the repetition rate is 0. However, this assumption, in addition to those described in 4 (b), presupposes that the repetition rates are quite low and that their magnitude does not vary much between grades.

An alternative indicator for education effectiveness would be school drop-out rates, grade by grade.

(a) Data Needed to Compile the Indicator: Basic data required to derive this indicator include: enrolment and repeaters by grade for at least two consecutive years.

(b) National and International Data Availability and Sources: Data on enrolment and repeaters by grade in primary school are generally available in most countries and also at sub-national and school levels. For sound measurement, this indicator must be supported by consistent data for gender and area (such as rural/urban zones).

(a) Lead Agency: The lead agency is the United Nations Educational, Scientific and Cultural Organization (UNESCO). The contact point is the Director, UNESCO Institute of Statistics, UNESCO, fax: (33 1) 45 68 55 20.

6. REFERENCES

(a) Readings:

World Education Report (UNESCO), 1995, 1998.

Education for All: Year 2000 Assessment (UNESCO)

International Standard Classification of Education Manuals

Statistical Information System in Education

(b) Internet site: http://www.unesco.org/statistics

ADULT SECONDARY EDUCATION ACHIEVEMENT LEVEL
Social	Education	Education level

1. INDICATOR

(a) Name: Adult Secondary Education Achievement Level.

(b) Brief Definition: The proportion of the population of working age (25-64 years) which has completed at least (upper) secondary education.

(d) Placement in the CSD Indicator Set: Social/Education/Education Level.

2. POLICY RELEVANCE

(a) Purpose: This indicator provides a measure of the quality of the human capital stock within the adult population of approximately working age. Those who have completed secondary education can be expected either to have an adequate set of skills relevant to the labour market or to have demonstrated the ability to acquire such skills. The indicator can be made more dynamic by presenting the results in 10-year age bands (25-34, 35-44, 45-54, 55–64) in order to give an indication of changes over time in actual secondary education completion rates.

(b) Relevance to Sustainable/Unsustainable Development: Education is a process by which human beings reach their fullest potential. It is critical for promoting and communicating sustainable development and improving the capacity of people to address environment and development issues. It facilitates the achievement of environmental and ethical awareness, values, and skills consistent with sustainable development and effective public participation in decision-making.

(d) International Targets/Recommended Standards: International agreements do not establish specific national or global targets for this indicator.

(e) Linkages to Other Indicators: Education is closely linked to indicators reflecting basic needs such as literacy, capacity-building, information and communications and the role of major groups. This indicator also is a broad measure of the quality of the human capital stock within countries (and hence, an indication of the potential for future sustained development).

3. METHODOLOGICAL DESCRIPTION

(a) Underlying Definitions and Concepts: The International Standard Classification of Education (1997) defines levels of education (pre-primary, primary, secondary etc) in an internationally comparable manner.

(b) Measurement Methods: To calculate the adult secondary education achievement level, divide the number of adults aged 25-64 years who have completed secondary or tertiary education by the corresponding total population aged 25-64 years and multiply by 100.

Educational achievement levels are mostly based on self-declaration or declaration of the head of household, which may give rise to concerns about data reliability and consequently comparability, especially for females in many developing countries. Some countries determine completion of secondary education by making inference using data on the number of years of schooling received rather than qualifications obtained. In some cases, the available data only indicate whether an individual has studied at secondary level as opposed to having completed secondary education.

(d) Status of the methodology:

This indicator has the status of an international recommendation since the basic data elements to derive it are included in the Revised Recommendation concerning the International Standardization of Education Statistics adopted by the UNESCO General Conference at its twentieth session, Paris, 1978. In the latest revised Principles and Recommendations for Population and Housing Censuses in 1999, the concerned UN agencies co-operated with international experts in upgrading the methodology used in collecting statistics on literacy and educational characteristics.

(e) Alternative Definitions:

Where relatively small numbers of the population have completed secondary education, alternative indicators are either the Adult Primary Education Achievement Level (although this may be closely correlated with the Adult Literacy Rate) or the Adult Lower Secondary Education Achievement Level.

4. ASSESSMENT OF DATA

(a) Data Needed to Compile the Indicator: Data on the number of people of the relevant age (recommended to be 25-64) who have completed at least secondary education and the corresponding population of the same age.

(b) National and International Data Availability and Sources: Data are usually collected during national population censuses, or during household surveys such as Labour Force Surveys. Official statistics exist for many countries in the world but are often out-of-date due to censuses taking place every ten years and late census data release. For sound measurement, the ratio must be supported by consistent data by gender and age-group.

5. AGENCIES INVOLVED IN THE DEVELOPMENT OF THE INDICATOR

(a) Lead Agency: The lead agency is the United Nations Educational, Scientific and Cultural Organization (UNESCO). The contact point is the Director, UNESCO Institute for Statistics, UNESCO; e-mail: uis@unesco.org and fax (33-1) 45 68 55 20.

(b) Other Organizations: The International Labour Organization (ILO) also collects statistics on educational attainment from national Labour Force Surveys and the Organisation for Economic Co-operation and Development (OECD) publishes such data.

6. REFERENCES

(a) Readings:

UNESCO, World Education Report, 1995, 1998.

UNESCO, Statistics of Education in Developing Countries: an Introduction to their Collection and Analysis, 1983.

(b) Internet site: http://www.unesco.org/statistics

(b) Brief Definition: The proportion of the adult population aged 15 years and over that is literate.

IMMUNIZATION AGAINST INFECTIOUS CHILDHOOD DISEASES
Social	Health	Healthcare Delivery

CONTRACEPTIVE PREVALENCE RATE
Social	Health	Healthcare Delivery

CHILDREN REACHING GRADE 5 OF PRIMARY EDUCATION
Social	Education	Education Level

ADULT LITERACY RATE
Social	Education	Literacy