Core Welfare Indicator Questionnaire 2003

The 2003 Core Welfare Indicators Questionnaire (CWIQ) Survey is a nationwide sample survey, designed to provide indicators for monitoring poverty and living standards in the country, at national, regional and district levels. It is a district-based probability sample that covered a total of 49,003 households nationwide, with 405 households drawn from each district, except for the metropolitan areas, which had samples of households as follows: Accra, 2,430; Kumasi, 11,620; and Shama-Ahanta East, 1,215; as well as the Tema Municipal Area, 810.

Key Findings were as follows:

Adult Literacy

About 50 per cent of the population aged 15 years can read and write (53.4 per cent), an increase of about 10 per cent over the rate recorded in the 1997 CWIQ Survey. Males have a higher literacy rate than females, 65.8 per cent compared to 42.3 per cent. There is a 30 percentage point gap between urban and rural literacy rates (69.6 per cent and 39.8 per cent respectively). Females are more disadvantaged in rural areas where the literacy rate is less than 30 per cent compared urban areas where the rate is more than 50 per cent. The female literacy rates are also lower than the male rates in both urban and rural areas of the country.

Youth Literacy

Among the youth, i.e., the population aged 15 - 24 years, the proportion that can read and write increased only slightly from 64.1 per cent in 1997 to 68.7 per cent in 2003. The female youth made some modest gains in their literacy levels, which increased by 10 per cent, while that of males increased by only 4 per cent over the five-year period. The literacy rate for urban youth (81.7 per cent) is considerably higher than that of the rural youth (56.4 per cent). The rural poor have however remained disadvantaged, with just a third of its females and less than half of its males being able to read and write.

Net Enrolment

Seven in 10 children aged 6 to 11 years are enrolled in primary school, for girls as for boys. The differences between the enrolment rates for girls and boys at the national level, and in the rural and urban areas are marginal. The biggest gender gap is 2.4 percentage points among the urban poor, with boys having the edge.

Substantially fewer children progress from primary to secondary level. Of the children aged 12 to 17 years, only about 4 in 10, are enrolled in secondary school, and the gender disparity in 1997 has reversed. Overall, enrolment at the secondary level declined marginally, from 40.0 percent in 1997 to 38.1 per cent in 2003. The rate however declined appreciably for males (from 43.6 to 37.9 per cent) but increased slightly for females (from 36.4 to 38.4 per cent) over the five year period. There are substantial differences between the urban and rural areas (50.5 per cent compared to 28.7 per cent), and between the poor in urban and rural areas (40.3 per cent compared to 15.2 per cent).

Access to School

A high proportion of primary school children (85.4 per cent) have a primary school within 30 minutes of their home, compared to only 43.3 per cent, for secondary schools. Access to a primary school is substantially high for all four subgroups - rural versus urban and rural poor versus urban poor. The rural poor have the lowest access rate (72.7 per cent), with 93.4 percent of the urban poor reporting access. In contrast, about 62.6 per cent of secondary level students in urban areas, but only 28.8 per cent of their counterparts in rural areas have a secondary school within 30 minutes of their home. The corresponding proportions for the

urban and rural poor are 55.1 and 12.9 per cent, respectively.

Satisfaction with Education

About two-thirds (68.0 per cent) of all primary school children report being satisfied with the school they attend while a higher proportion (75.0 per cent) of the secondary school students report being satisfied with their school. However, primary pupils and secondary students in rural areas, especially the rural poor, are less satisfied with their schools than their counterparts in the urban areas.

Access to Health Facilities.

The time required to reach a health facility could affect the chances of survival of sick people, especially in emergency situations. Yet, only 57.6 per cent of the population live within 30 minutes of a health facility. This is however a significant improvement over the 1997 average of 37.2 per cent. More than three quarters (78.5 per cent) of urban households have good access to health facilities compared to 42.3 per cent of the rural households. The urban poor have an access rate (72.7 per cent) below the average rate for all urban areas (78.5 percent); while the rural poor is more disadvantaged, relative to their counterparts - in all rural areas and the urban poor. Only 27 per cent of the rural poor live within 30 minutes of a health facility.

Adequacy of Health Services

About 18 per cent of the population reported having been sick or injured in the four-week period preceding the survey, and there has been little change in the situation since 1997 (18.6 percent). In general, only 18.4 per cent of the people consult a health practitioner. Nearly eight out of ten (78.6 per cent) persons who use health services are satisfied with the services they receive, a considerable improvement over the 1997 rate of 57 per cent. The level of satisfaction with the medical services show very little variation across groups. Equal proportions of rural and urban users of the health services are satisfied, and a slightly lower percentage of the rural than urban poor users of these facilities are satisfied.

Prenatal Care

About nine in ten women (93.4 per cent) aged 12-49 years who had live births within 12 months of the survey, received prenatal care. The urban and rural poor have lower participation in prenatal care than their counterparts. The proportion of these women who received prenatal care is 95.9 per cent for the urban poor, and 97.3 per cent for all urban areas. Similarly, the rural poor have lower participation in prenatal care than all rural areas; 86.5 per cent compared to 91.2 percent, respectively.

Births Assisted by Trained Health Professionals

About half of the children aged under five years, were delivered with the assistance of a trained health professional (doctors, nurses and midwifes) in 2003 (51.8 per cent), an increase over the proportion in 1997 (44.7 per cent). The involvement of trained professionals in birth deliveries is more than twice as high in the urban areas (83.3 per cent), than in the rural areas (34.7 per cent). The rate of professionally assisted births is extremely low among the rural poor, for whom the corresponding proportion is only 17.3 per cent compared to that for the urban poor, almost four times as high.

Child Nutritional Status

Of the three anthropometric indicators of malnutrition (stunting, wasting and underweight), stunting is the most prevalent among the children aged 0-4 years. Nearly one-third (32.4 percent) of the children under the age of five years are stunted (short for their age) compared to 15.5 per cent for wasted (underweight for age for height) and 25.8 per cent for underweight (underweight for their height for age). Stunting is higher in rural children (33.6 per cent) than in urban children (30.0 per cent), while children of the poor in both rural and urban areas are worse off relative to the national average. However, the urban rates for both wasting and

underweight are considerably higher than the rural rates, and the urban rates are higher than the national average, while the rural rates are lower. While the level of underweight barely changed over the five year period, (26.0 per cent, in 1997), the rates of stunting and wasting have worsened, and in the case of wasting, it is more than double the 1997 rate (6.5 per cent).

Availability of Employment

The proportion of the population aged 15 years and older who are unemployed averaged 5.4 percent, a slight increase over the 1997 figure (4.6 per cent). The proportion for urban areas (7.6 per cent) is about twice that of rural areas (3.5 per cent). The underemployment rate stood at 13.6 per cent, with the rural rate being 14.9 per cent, and urban, 12.1 per cent.

Meeting Food Needs

More than a tenth (12.8 per cent) of the households report having problems to meet their basic food needs. However, this problem is more prevalent among the rural poor. The proportion of rural households that have difficulty meeting their basic food needs is slightly higher (13.8 per cent) than for urban areas (11.6 per cent).

Access to Water

More than 90 per cent of households are within 30 minutes of their source of drinking water, compared to 82.1 per cent recorded in 1997. Both the rural and urban households record an access level of over 90 per cent. The rural poor have a lower access rate of 83.1 per cent, compared to 94.9 per cent for the urban poor.

Improved Water Source

The quality of drinking water is of great importance to the health of every individual. A higher percentage of households obtain their drinking water from improved water sources- pipe water in the dwelling, outdoor tap, borehole, and protected well-(74.1 per cent), compared to the 1997 figure of 65.2 per cent. Urban households record a higher percentage than rural households (87.3 per cent and 63.0 per cent, respectively), with over 20 percentage points difference.

Safe Sanitation

Safe sanitation, defined as the use of flush toilet, covered pit latrine and VIP/KVIP, is available to 55 per cent of households. Although this represents an improvement over the 1997 rate of 45.8 per cent, safe sanitation is more of an urban (80.9 per cent) than rural phenomenon (33.1 per cent). Safe sanitation facilities are even scarcer among the rural poor, with only 9.2 per cent of their households with these facilities. Moreover, the proportion of urban poor households with safe sanitation (66.9 per cent), is twice as high as that of rural households.

Improved Waste Disposal

Almost two-thirds (65.8 per cent) of the households in the country use improved waste disposal methods (that is, their refuse is either collected or disposed of at a public dump). The rates for the urban and rural households are 81.9 per cent and 52.3 per cent, respectively. Only 21.1 per cent of the rural poor households use improved waste disposal methods.

Electricity

About half of the households in the country have access to electricity. The rates for the urban and rural households are substantially different, 81.0 per cent and 24.9 per cent, respectively. Less than one in ten (7.2 per cent) rural poor households has access to electricity compared to 54.9 per cent of the urban poor households.

Non-wood Fuel Used for Cooking

The use of non-wood fuel for cooking (that is, all types of fuel, with the exception of firewood and charcoal) increased from 4.9 per cent in 1997 to 11.4 per cent in 2003. The dependency on wood fuel continues to be high, with 96.0 per cent of rural households and 79.8 per cent of urban households, using wood products for their fuel. The situation is slightly worse for the urban poor, relative to the rural poor, with 97.3 per cent of their households dependent on wood fuel for their cooking, compared to 94.7 per cent for the rural poor households.

Households Economic Situation Compared to One Year Ago

The perception of about half of the households (51.5 per cent) is that their economic situation has worsened in one year, and only 27 per cent report being better off. There are only marginal differences between the urban and rural rates. Meanwhile, households' land ownership situation is shifting but very slightly. Over the five years, proportionately fewer households (4.5 per cent and 2.6 per cent, for 1997 and 2003, respectively) reported they had less land compared to a year ago; and yet 2.9 per cent in 2003 compared to 4.2 in 1997, stated they had acquired more land within a year.