Multiple Indicator Cluster Surveys
Survey Design Workshop
Questionnaire for Children Under Five:
Breastfeeding
MICS4 Survey Design Workshop
WHO/UNICEF Feeding
Recommendations
• Exclusive breastfeeding for first six months
• Continued breastfeeding up to two years and beyond
• Safe, appropriate and adequate complementary
foods beginning at six months
• Frequency of complementary feeding:
– Breastfed: 2 times per day for 6-8 month olds; 3 times per day for 9-23 month
olds;
– Non-breastfed: 4 times per day for 6 – 23 months
MICS4 Survey Design Workshop
Background information
Indicators:
• Revised set of global indicators (2008)
• MICS4 adapted accordingly (a few exceptions flagged
later)
Module:
• All (living) children <5 years
• Current status --24 hours preceding interview
MICS4 Survey Design Workshop
Breastfeeding Module
Caretakers are asked about the following for each
child under five
– Whether child was ever and is currently breastfed
– Was the child was fed and liquids or foods in the preceding
24 hours
– Types of liquids
– Types of milk products and number of times consumed
– Number of times non-liquid foods
MICS4 Survey Design Workshop
Infant and young child feeding
(IYCF) indicators in MICS
•
Exclusive breastfeeding (< 6 months)
•
Continued breastfeeding (at one year and at two years)
•
Predominant breastfeeding (<6 months)
•
Duration of breastfeeding
•
Bottle feeding
•
Introduction of solid, semi-solid or soft foods
•
Minimum meal frequency (for breastfed children and for non-breastfed children)
•
Age-appropriate breastfeeding
•
Milk feeding frequency for non-breastfed children
Note that early initiation of breastfeeding and children ever breastfed
calculated from Maternal and Newborn Health Module
MICS4 Survey Design Workshop
Exclusive breastfeeding (<6 months)
# 2.6: Proportion of infants 0–5 months of age
who are fed exclusively with breast milk
– Includes breast milk from bottle, wet nurse
– Includes vitamins, medicines, ORS
– Based on previous 24 hours
– Related indicator:
# 2.9: Predominant breastfeeding under 6 months
MICS4 Survey Design Workshop
Continued breastfeeding
# 2.7: At one year:
Proportion of children 12–15 months of age who are
fed breast milk
# 2.8: At two years:
Proportion of children 20-23 months of age who are
fed breast milk
– Includes breast milk from bottle, wet nurse
– Related indicator: Duration of breastfeeding
MICS4 Survey Design Workshop
Introduction of solids, semi-solid
or soft foods
# 2.12: Proportion of infants 6–8 months of age who
receive solid, semi-solid or soft foods
– Substituted for “timely introduction of complementary
foods”
– Based on all infants age 6-8 months
– Narrow age range = larger confidence intervals
– Related indicator: Bottle feeding
MICS4 Survey Design Workshop
Minimum meal frequency
# 2.13: Proportion of breastfed and non-breastfed
children 6–23 months of age who receive solid, semisolid, or soft foods the minimum number of times or
more
– Two separate indicators (proxy for energy intake)
– For non-breastfed children includes milk feeds
– “Minimum number of times” varies by age, breastfeeding
status
MICS4 Survey Design Workshop
Other indicators
# 2.14: Age-appropriate breastfeeding
– Proportion of children 0–23 months of age who are
appropriately breastfed
• <6 months exclusively breastfed
• 6-23 months breasfed and consuming foods
# 2.15: Milk feeding frequency for non-breastfed
children
– Proportion of non-breastfed children 6–23 months of age who receive
at least 2 milk feedings
MICS4 Survey Design Workshop
Methodological issues
• Local adaptation of liquids necessary (including
appropriate local terms)
• MICS does not include questions on dietary diversity
– Minimum dietary diversity
– Minimum acceptable diet
– Consumption of iron-rich or iron-fortified foods
MICS4 Survey Design Workshop
Infant feeding area graph example
Breastfeeding practices by age, Rwanda 2005
100
90
80
Weaned (not breastfed)
Percent
70
Breastfed and solid/semi-solid foods
Breastfed and other milk/ formula
60
Breastfed and non-milk liquids
50
Breastfed and plain water only
Exclusively breastfed
40
30
20
10
0
Age (months) 0-1
2-3
4-5
6-7
8-9
10-11
12-13
14-15
MICS4 Survey Design Workshop
16-17
18-19
20-21
22-23
Infant feeding area graph example
MICS4 Survey Design Workshop
Prepared by:
Holly Newby
Statistics and Monitoring Section
UNICEF/New York
1-212-303-7932
hnewby@unicef.org
MICS4 Survey Design Workshop