Middle class population and Leaders’ attitudes and opinions towards Child Mortality 2009-2010

MDG-4 CampaignMiddle class population and

Leaders’ attitudes and opinions towards Child Mortality

GLOBAL REPORT

June 2010

Agenda

Introduction and objectives

Middle class population survey

Leaders Interviews

Main results

Annex I – Questionnaires used

Annex II – Middle Class definition for each country

Introduction and objectives

After 10 years of policy and programme efforts since the Millennium Development Goals were established, progress has been made towards the achievement of MDG-4 ( see www.childinfo.org/mortality.html ) However, though the rate of decline in under-five mortality increased over the past few years, it is still clearly insufficient to reach the goal by 2015. Equally importantly, child mortality is increasingly concentrated : recent data indicate that approx. 75% of child deaths occur in only 18 countries. India and Nigeria together account for nearly one third of the total number of child deaths worldwide. Therefore, the GMC encouraged social mobilization campaigns, in countries where the problem is most serious, to galvanize public opinion in order to push for a redoubling of efforts to reduce child mortality. Through a multi-level communications and grassroots activation strategy, the GMC particularly recommends engaging the middle class - a so far neglected section of the public- who might have little insight or experience in the issue, but who has influence on decision-makers by virtue of its position in the society. Middle class members can hold the Government accountable as they represent taxpayers, and often share similar backgrounds, education, cultural references or even product tastes. In addition, wealth creators ( the business community ), opinion formers and reflectors ( people in the media ), academics and students are all categories that have the ability to influence governments. The GMC believes that by targeting this section of society and shifting their attitude towards child mortality along a continuum from “acceptable/unavoidable” to “unacceptable/solvable” will create the pressure required for Government action. Following these objectives the GMC conducted a research to develop insights and better understand these groups attitudes and opinions towards child mortality, particularly their degree of awareness of the problem and their willingness to do something about it. It was felt that such information is clearly a pre-requisite to design any meaningful communication strategy. The research was carried out in 8 countries : India; Cambodia; Mali; Nigeria; Kenya; Zambia; Ethiopia and Bolivia.

The presentation that follows shows the main results for all countries.

For further detail regarding results by country, specially at a regional level, please refer to the country specific report

http://www.childinfo.org/mortality.html

Coverage

Bolivia:

La Paz

Santa Cruz

Cochabamba

Mali:

Bamako

Segou

Sikasso

Nigeria:

Yenagoa

Akure

Onitsha

Ilorin

Kebbi

Damaturu

Lagos

Enugu

Kano

Zambia:

Lusaka

Ndola

Livingstone

India:

Delhi

Mumbai

Chennai

Kolkata

Bangalore

Ethiopia:Addis AbabaAwassaMekeleArba Minch NazarethAmbo Awash Gambella Assosa Jijiga

Kenya:NairobiMombasa Kisumu

Cambodia:Phnom Penh Battambang Siemreap Sihanoukville Kampong Cham

Middle Class opinions

5

Methodology

6

Universe: Middle Class The target of study, in terms of middle class, was the population group (in many cases a minority) with formal education and professional work. The assumption is that this group has better access to media and information, and is an influential section of the public .

In all cases middle class was defined in terms of Socio economic level, and in a country by country basis according to the country context.

For further information see Annex 2 - Middle class definition by country

Data collection technique: Face to face interviews in household

Sample size: 1000 interviews were conducted in each country. Total: 8121 interviews

Sampling method: stratified probabilistic

Margin error: +4.2%

Methodology Specifications

General Context

8

Bolivia:

-Corruption

-Crime

-Economic problems

Mali:

-Hunger

-Corruption

-Education

Nigeria:

-Corruption

-Poverty

-Economic problems

Zambia:

-Corruption

-Unemployment

-Poverty

India:

-Corruption

-Poverty

-Economic problems

Ethiopia:-Poverty-Economic problems-Corruption

Kenya:-Corruption-Poverty-Unemployment

Cambodia:-Drugs-Economic problems-Corruption

Top 3 problems by countryQuestion: Which of the following do you think is the most important problem your country faces today?

Countries’ main problemsCorruption is one of the main concerns in all countries

Basis: Middle class population in each country

Zambia Kenya Nigeria Mali Ethiopia India Cambodia Bolivia

Corruption 36% 30% 38% 21% 14% 32% 20% 26%

Poverty 14% 18% 14% - 24% 14% 10% 7%Hunger/ Not enough food 2% 7% 5% 51% 2% 2% 2% 1%

Economic problems 10% 3% 11% 3% 18% 10% 20% 9%

Unemployment 16% 16% 8% - 6% 8% 5% 8%

Crime / Insecurity 1% 3% 4% 4% 2% 5% 2% 25%

HIV/ AIDS 11% 9% 2% - 10% 1% 3% 1%

Drugs and drug abuse 1% 3% 2% 2% 2% 1% 26% 6%

Education 1% 1% 3% 15% 2% 6% 3% 3%

Terrorism/ internal conflicts/ human right violations

- 1% 2% - 5% 7% 1% 5%

Child Mortality 2% - 1% 3% 3% 8% 2% 2%The gap between the rich and the poor

2% 4% 1% - 3% 1% 1% 1%

Lack of democracy / lack of freedom

1% 1% 2% - 5% 1% 1% 3%

Other health problems 1% - 2% - 2% - 2% 1%

Environmental issues 1% 1% 2% - - 2% 2% 1%

Top problem by country 2nd main problem by country

Trust in institutionsPercentage A lot + Some Confidence


Zambia Kenya Nigeria Mali Ethiopia India Cambodia

Bolivia

Donor Countries 86% 92% 73% 74% 84% 83% 95% 72%

International Development Organizations 84% 93% 76% 74% 89% 83% 94% 66%

Hospital/ Clinics 87% 84% 84% 70% 85% 83% 93% 65%

Religious Groups / Institutions 85% 84% 85% 67% 78% 67% 73% 62%

Civil Society Organizations 78% 84% 70% 62% 78% 78% 86% 53%

Schooling System 85% 81% 74% 49% 68% 76% 94% 53%

Press 79% 82% 67% 50% 62% 72% 87% 47%

National Government 66% 65% 71% 54% 74% 80% 93% 35%

Major Companies 62% 71% 55% 48% 65% 59% 68% 42%

The Civil Service 60% 44% 58% 43% 68% 67% 69% 38%

Labor Unions 48% 48% 55% 30% 60% 55% 70% 14%

Armed Forces / The Military 39% 48% 41% 39% 51% 65% 71% 24%

The Justice System 51% 31% 52% 34% 62% 61% 52% 21%

The Police 36% 24% 21% 27% 64% 42% 66% 22%

Political Parties 35% 27% 32% 16% 34% 34% 49% 9%

% below 50%

Percentages are calculated excluding don´t know / no answer

Trust in HOSPITAL/ CLINICS


Question: Could you please tell me how much confidence you have in each of the following? Would you say you have a lot of confidence, some confidence, not much confidence or no confidence at all?

64%54%

50% 48% 48% 47%

37%

19%

30%

29% 36%36% 35% 37%

33%

45%

2%11%

9% 13%12% 13%

21%25%

5% 5% 4% 2% 5% 3%9% 10%

Cambodia Nigeria Zambia Ethiopia India Kenya Mali Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in DONOR COUNTRIES



67%59%

50%43% 45%

41%34%

30%

25%37%

36%41%

28%42%

36%41%

6%4%

9% 12%

20%

12%

17% 20%

2% 1%5% 4% 6% 5%

9% 8%

Kenya Cambodia Zambia Ethiopia Mali India Nigeria Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in INTERNATIONAL DEVELOPMENT ORGANIZATIONS



61%53% 55%

43% 43% 42% 38%

25%

31%42% 33%

31%38%

31%44%

40%

7% 5%9%

16%12%

20%

12%

20%

1% 2%8% 5% 6% 4%

13%

Kenya Cambodia Ethiopia Nigeria India Mali Zambia Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in NATIONAL GOVERNMENT



53%44% 43%

37%

26% 25%20%

8%

40%

29%36%

33%

38% 40%

33%

27%

6%

17%

15%

18%22% 22%

30%

28%

1%9%

5%11% 13% 12%

16%

36%

Cambodia Ethiopia India Nigeria Kenya Zambia Mali Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in POLITICAL PARTIES



11% 10% 10% 9% 9%4% 3% 1%

20% 24% 24%18%

40%

28%

13%8%

30%29% 34%

29%

36%

33%

30%

22%

37% 34% 31%

44%

15%

28%

51%

69%

Nigeria Zambia India Kenya Cambodia Ethiopia Mali Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in RELIGIOUS GROUPS / INSTITUTIONS



58%48%

53%47%

38% 35%25%

20%

27%

29%

31%37%

28% 38%

36% 46%

10%15%

13% 11%

22%

20%

21%22%

5% 7%3% 4%

11%7%

16%11%

Nigeria Ethiopia Kenya Zambia Mali Cambodia Bolivia India A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in THE PRESS



41% 39%

26% 24% 23% 19% 17%11%

41%38% 62%

42%49%

42%

32%36%

16%16%

12%

23%21%

28%

34%35%

2% 5%1%

9% 7% 9%15% 17%

Kenya Zambia Cambodia Nigeria India Ethiopia Mali Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in SCHOOLING SYSTEM



44% 43%39% 38% 36% 35%

25%16%

50%

40%

35% 35%46%

32%

24%37%

5%

12%

19%16%

15%

24%

23%

37%

1% 3% 5%10%

4%8%

29%

10%

Cambodia Zambia India Nigeria Kenya Ethiopia Mali Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in CIVIL SOCIETY ORGANIZATIONS



33% 33% 32% 32% 32% 31%22%

11%

44%53%

44% 44%37%

52%

39%

41%

18%

12%

18% 16%

20%

13%

28%

29%

4% 2% 4% 5%9%

3%10%

17%

India Cambodia Ethiopia Zambia Nigeria Kenya Mali Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in MAJOR COMPANIES



20% 20% 19% 17% 16% 13% 12% 10%

40% 38%

51%46%

36%34%

55%

31%

25% 31%

24%27%

28%37%

23%

29%

12% 10%5% 7%

15% 13%8%

28%

Zambia India Kenya Ethiopia Nigeria Mali Cambodia Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in ARMED FORCES / THE MILITARY



31% 31%23%

16% 15% 12% 11%4%

33%41%

26%

22%33%

27% 26%

20%

24%21%

27%

33%

28%31%

28%

29%

10% 8%

20%27%

23% 26% 29%

46%

India Cambodia Ethiopia Mali Kenya Nigeria Zambia Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in LABOR UNIONS



18% 18% 17% 14% 11% 10%6%

2%

39%35% 36%

55%

37%35%

22%

12%

27%30% 28%

23%

32% 29%

40%

25%

11% 14% 15%7%

20% 20%26%

60%

Ethiopia Nigeria India Cambodia Kenya Zambia Mali Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in THE CIVIL SERVICE



24%18%

5%

19%15% 13% 11% 10%

42%49%

32%

38% 44%56%

33% 33%

23% 16%

33%

25%28%

26%

36% 38%

10%15%

28%

16%11%

5%

19% 19%

India Ethiopia Bolivia Nigeria Zambia Cambodia Kenya Mali A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in THE JUSTICE SYSTEM



28%19%

15% 13% 10% 8% 7%3%

33%

41%

35%36% 43%

25%23%

18%

22% 26%

29% 25%31%

35%

35%

31%

15% 12%18% 22%

17%

28%33%

48%

Ethiopia India Nigeria Zambia Cambodia Mali Kenya Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Trust in THE POLICE



27%

17% 14%9% 7% 6% 5% 4%

36%48%

28%

26%

19%14% 19% 18%

21%25%

29%34%

30%

26% 25% 28%

14%9%

28% 29%

42%50% 51% 49%

Ethiopia Cambodia India Zambia Mali Nigeria Kenya Bolivia A lot of confidence Some confidence DK / NA Not much confidence No confidence at all

Interest towards Politics

23%17% 16% 14% 13% 12% 10% 9%

24%26%

35%

24%30%

41% 42%

11%

19% 25%

25%

36% 24%

20%33%

29%

33% 30%24% 25%

31%27%

16%

50%

Nigeria Mali Zambia Ethiopia India Kenya Cambodia Bolivia A great deal Fair amount Not very interested Not interested

Question: In general, how interested would you say you are in politics?


Influence in Social and political environment

28% 24% 24%20% 19% 18% 16%

4%

31% 35%34% 45%

21%

50%

41%

38%

26% 23%39% 26%

46%

19%34%

39%

15% 14%

3%9%

13% 13%9%

19%

Nigeria Mali India Zambia Bolivia Kenya Ethiopia Cambodia A great deal Fair amount Not very much Not at all

Question: To what extent would you say that people like you may have an influence in social and political events that surround us? Would you say that you may influence: a great deal, a fair amount, not very much, or not at all?

Basis: Middle class population in each country28

Question: Now I’m going to read out some forms of political action that people can take, and I’d like you to tell me, for each one, whether you have done any of these things, whether you might do them or would never under any circumstances do them.

Social Actions


Signing a petition

Done 10% 9% 6% 19% 9% 19% 12% 19%

Might 56% 63% 32% 67% 28% 54% 43% 56%

Never 25% 27% 51% 8% 35% 18% 43% 22%

Attending a demonstration

Done 20% 18% 16% 42% 24% 14% 4% 16%

Might 39% 37% 30% 49% 27% 66% 14% 39%

Never 37% 44% 45% 6% 30% 16% 82% 44%

Volunteering in a non-profit organization

Done 23% 39% 23% 16% 25% 14% 19% 13%

Might 67% 56% 45% 67% 51% 60% 61% 68%

Never 6% 4% 27% 11% 14% 22% 20% 17%

Being a member of a political party

Done 19% 10% 17% 24% 12% 6% 19% 4%

Might 37% 35% 30% 41% 16% 32% 23% 17%

Never 39% 54% 45% 28% 48% 55% 57% 75%Donating money or something else for a cause

Done 35% 42% 31% 32% 29% 22% 52% 22%

Might 62% 52% 48% 58% 44% 63% 40% 61%

Never 2% 6% 15% 3% 12% 9% 8% 14%

Advocacy

Done 22% 19% 18% 23% 36% 12% 17% 8%

Might 68% 67% 50% 64% 46% 54% 48% 65%

Never 6% 13% 24% 7% 9% 27% 34% 24%


What they would NEVER do

Social Actions


Signing a petition 25% 27% 51% 8% 35% 18% 43% 22%

Attending a demonstration 37% 44% 45% 6% 30% 16% 82% 44%

Volunteering in a non-profit organization 6% 4% 27% 11% 14% 22% 20% 17%

Being a member of a political party 39% 54% 45% 28% 48% 55% 57% 75%

Donating money or something else for a cause

2% 6% 15% 3% 12% 9% 8% 14%

Advocacy 6% 13% 24% 7% 9% 27% 34% 24%


Barrier for the country – more than half the middle class would never do it

Awareness of the Millennium Development GoalsQuestion: In the year 2000 the world leaders agreed on a certain number of programs to solve the world’s most important problems. A set of goals was established to be accomplished by 2015. This agreement is known as the Millennium Development Goals. Have you heard of this initiative?

79% 78%

64%59%

42%

27%24% 23%

Zambia Kenya Ethiopia Nigeria Mali Cambodia Bolivia India


Bolivia:

-Eradicate extreme poverty & hunger

-Achieve universal primary education

-Reduce child mortality

Mali:



-Combat HIV/AIDS, malaria and other diseases

Nigeria:




Zambia:




India:


- Reduce child mortality

- Achieve universal primary education

Ethiopia:-Eradicate extreme poverty & hunger -Achieve universal primary education – Combat HIV/AIDS, malaria and other diseases

Kenya:



- Achieve universal primary education

Cambodia:


-Promote gender equality and empower women



Top 3 MDG by countryQuestion: Which of the following do you think is the most important problem your country faces today?

Main MDG for the countryQuestion: I will enumerate the different Millennium Development Goals. Could you please tell me which one you consider the most important one for this country? And which one do you think is the second most important goal for

this country? 1ST + 2ND MENTION


Eradicate extreme poverty & hunger 75% 82% 73% 60% 80% 58% 69% 75%

Combat HIV/AIDS, malaria and other diseases

53% 52% 21% 31% 31% 17% 25% 10%

Achieve universal primary education 21% 16% 26% 50% 37% 31% 16% 27%

Reduce child mortality 11% 8% 23% 23% 16% 39% 25% 26%

Improve maternal health 7% 8% 22% 11% 10% 22% 16% 16%

Promote gender equality and empower women 12% 10% 13% 7% 12% 16% 25% 7%

Develop a global partnership for development

14% 11% 9% 12% 8% 6% 16% 15%

Ensure environmental sustainability 5% 13% 11% 5% 7% 11% 7% 19%


Top MDG by country 2nd main MDG by country

Child Mortality as the main MDG for the country1st + 2nd mention

39%

26% 25% 23% 23%

16%11%

8%

India Bolivia Cambodia Nigeria Mali Ethiopia Zambia Kenya


Child mortality: Awareness & Problem dimension

35

22%

39%

25%20% 21%

12%

24%

5%

57%

34%

47%

44% 39%

47%

34%

48%

21%

21% 25%

29% 34% 34% 39%40%

6%2%

7% 6% 7%3%

7%

Kenya Nigeria India Zambia Bolivia Ethiopia Mali Cambodia A great deal Fair amount Not very much Nothing

Awareness on child mortalityQuestion: Focusing on what you know about child mortality, how much would you say you know…?


Main sources of information about child mortalityQuestion: Which sources of information have you used to learn about the issue?


TV 54% 78% 69% 71% 68% 90% 70% 73%

Radio 40% 65% 59% 62% 64% 17% 52% 27%

Magazines / Newspapers 46% 60% 27% 29% 47% 80% 23% 30%

Comments of someone you know 8% 16% 23% 15% 21% 16% 16% 6%

Campaigns in public places 8% 16% 12% 6% 12% 15% 8% 7%

Community centers 10% 14% 11% 9% 11% 10% 8% 3%

Internet 8% 10% 7% 13% 22% 10% 1% 17%


Question: And from the following causes of child mortality that I am going to mention, which one would you say is the most relevant one in your country?

Main cause of child mortality


Malnutrition 27% 17% 20% 25% 24% 39% 9% 56%Malaria 16% 34% 28% 47% 8% 4% 7% - Lack of access to health services 21% 15% 23% 7% 24% 7% 11% 18%

Lack of improved water & sanitation services 6% 8% 9% 9% 15% 18% 31% 8%

HIV / AIDS 18% 8% 2% 2% 12% 3% 7% 1%Diarrhea 4% 3% 4% 2% 8% 6% 8% - Acute Respiratory infections 2% 1% 2% 1% 4% 9% 15% 5%

Infections 2% 3% 3% 2% - 7% 2% 2%Tetanus - - - - - - 3% - Measles 1% 4% 6% - - 1% 1% 1%Pneumonia 1% 4% 1% 1% 1% 3% 4% 1%Droughts - 2% - - 3% 1% 1% - Wars / Tribal conflicts 1% - 1% - 1% - - -


Top cause by country 2nd main cause by country

Concern about child mortality in their countryQuestion: How concerned would you say you are about child mortality in (MENTION COUNTRY)?

69% 68%

55% 53% 52% 51%45% 45%

18%28%

38%

31%

41%

32%38% 39%

8%

4% 8%

13%

5%

14% 15% 13%

3%1%

3%1% 2% 2% 2%

Nigeria Ethiopia Cambodia Bolivia India Zambia Kenya Mali Very Somewhat Not very much Not at all Dk/ Na


Assessment of child mortality as a serious problemQuestion: How would you rate the problem of child mortality in your country? Would you say it is...?

65%61% 59% 56% 54% 52% 52%

43%

22% 33% 36%35% 39%

36%36%

47%

8%

6% 3%7%

5%7%

11%10%1%

1% 1% 1% 1%

Nigeria Kenya India Ethiopia Mali Zambia Bolivia Cambodia Very serious Somewhat serious Not to serious Not serious at all Dk/ Na

40

Number of children dying every yearQuestion: According to what you may know or may have heard: how many children under 5 die every year in your country? I know this is a difficult question and that you probably don’t know the number but your best estimation based on what you know or believe will do. (CARD SHOWN)

26%21%

8% 10%4% 3% 2%

13%

13%

4%

11%

7%

3%5%

2%

46%62%

65%

59%81%

77%

93%

83%

15%

4%

24%20%

6%

19%14%

Zambia Kenya Nigeria Mali Ethiopia India Cambodia Bolivia Overestimated Correct Underestimated Dk/ Na

41

Evolution of child mortality in the last yearsQuestion: Regarding the present situation of child mortality in Mali in the last 3 years, would you say that it has improved, it has got worse, or it has stayed the same?

88%

75%66%

55% 53% 52%45%

29%

7%

12%

13%

20%20% 24%

23%

23%

5%

6%15% 23% 25% 17%

24%

46%

7% 6%2% 2%

7% 8%3%

Cambodia Ethiopia Mali India Kenya Nigeria Zambia Bolivia Improved Stayed the same Got worse Dk/ Na

42

Expectations on Child Mortality for the next yearsQuestion: And thinking about the next 3 years, would you say that it will improve, it will get worse, or it will stay the same as it is now?

95%90%

83% 82%

70% 70%

59%

37%

3%7%

6% 5%

11%15%

16%

18%

1%1%

8%5%

9%

12%

17%

36%

2% 2%7% 10%

3%8% 8%

Cambodia Ethiopia Kenya Mali Nigeria India Zambia Bolivia Will improve Will stay the same Will get worse Dk/ Na

43

Likeliness of achieving MDG4Question: One of the objectives to be achieved by 2015, as set by the world leaders in the Millennium Development Goals, is to reduce under-five mortality rate by two thirds. How likely do you think it is for this goal to be achieved in your country?

51%

37% 34%28% 25% 25% 24%

13%

32%55%

54%58%

51%

73%

51%

60%

7%

3%1% 7%

4% 3%1%

3%4%

8%5%

13%

2%

15% 20%

7%2% 3% 2%

8%1%

7% 6%

Nigeria India Kenya Ethiopia Zambia Cambodia Mali Bolivia Very likely Somewhat likely Dk/ Na Somewhat unlikely Very unlikely

44

39%

25% 25%20% 19% 19% 17%

8%

40%

58% 59%

45% 49%

60%57%

60%

10% 15% 14%

27%28%

14% 21%31%

4% 2% 2%6% 4% 4% 2% 1%

Nigeria Kenya India Bolivia Ethiopia Mali Zambia Cambodia Can be fully solved Can be greatly improved Can only be slightly improved Cannot be solved

Can child mortality in the country be solved? Question: There are different opinions regarding child mortality. Which one would you say is closer to your view?

45

Question: When it comes to child mortality, who do you think is mostly responsible for its solution in the country?

Institution most responsible for solving child mortality


The national government 62% 66% 49% 52% 59% 31% 42% 18%

The local government 20% 19% 20% 21% 25% 45% 25% 69%

International development organizations 3% 4% 9% 12% 4% 10% 14% 4%

Civil society organizations 8% 7% - 8% 8% 12% 5% 3%

Donor Countries 3% 2% 7% 4% 3% 2% 12% 3%

DK/NA 3% - 3% 1% - - - 1%


Question: And who do you think would be the most efficient one in solving the problem in this country?

Institution most efficient for solving child mortality







Donor Countries 9% 7% 11% 8% 12% 2% 13% 5%

No one - - - - 1% 1% - 3%

DK/NA 4% - 3% 1% - - - 2%

47

Question: And who would be the most reliable one? (CARD SHOWN)

Institution most reliable for child mortality






Donor Countries 23% 22% 12% 24% 16% 10% 13% 9%


No one 1% 1% - 1% 2% 4% - 8%

DK/NA 5% 1% 4% 1% - 1% - 4%

48

Child mortality: People’s initiatives

49

% who have taken actions/ initiatives regarding child mortalityQuestion: Have you taken any action/ initiative regarding child mortality in the last 5 years?

40%

31%27% 27% 26%

20% 20% 19%

Kenya Cambodia Zambia Nigeria Mali India Bolivia Ethiopia



Volunteering 38% 62% 46% 26% 69% 50% 54% 44%

Donate Money 24% 40% 34% 24% 39% 66% 59% 28%

Advocacy 51% 32% 27% 26% 21% 23% 23% 19%

Participate in demonstrations 11% 3% 16% 24% 5% 31% 1% 5%

Sign petitions / requests 3% 3% 4% 4% 5% 28% 10% 6%

Support a political party / politician depending on their interest on this matter

5% 5% 9% 13% 9% 6% 3% 2%

Others 7% 8% - 21% 3% 1% - 29%

DK / NA - - - 8% 1% 3% - -

Actions/ initiatives carried out regarding child mortality Question: Which kind of action/ initiative have you carried out?

Basis: Middle class population – respondents who declare to have taken any action/ initiative regarding child mortality in the last 5 years.51

Reasons for not taking any actions/ initiatives

Basis: Middle class population – respondents who declare NOT to have taken any action/ initiative regarding child mortality in the last 5 years.

Question: And why didn’t you take any action/ initiative regarding the child mortality issue in your country?


I do not know what I can do to help 41% 56% 25% 17% 51% 41% 34% 26%

Nothing that I could do would make a difference 15% 21% 22% 18% 18% 13% 3% 11%

I don't have enough money/resources 25% 17% 30% 42% 20% 4% 17% 12%

I have no time 20% 18% 11% 14% 6% 28% 50% 42%

It is not my responsibility to solve it 6% 3% 23% 12% 4% 7% 6% 5%

I am not interested in the issue 2% 2% 3% 13% 16% 6% 22% 4%

It is not a serious problem 2% 2% 2% 1% 3% 3% 2% 3%

Never had an opportunity 1% 1% - - 2% - - 1%

52

Reaction to Child Mortality Facts and Figures

Stimulus Child Mortality Fact and Figures in the different countries

Some figures about child mortality in [country]

In [country] [#] children under 5 die every year.

More than 50% is due to [main causes for the country].

Most of these deaths could be prevented by providing [simple everyday solutions for each cause, for example: antibiotics for Respiratory Infections; sleeping under mosquito nets for Malaria and giving the child to drink a simple solution made of sugar and salt in case of diarrhoea]. Most of these things are available locally and they are not expensive.

Interviewer: Next, I will show you a short document about the issue of child mortality…

DOCUMENT SHOWN ABOUT CHILD MORTALITY:

54

Are aware of the facts & figures shownQuestion: Did you know the information you have just read?ANSWERED YES

81%

75%69%

60%55% 53% 53%

36%

Cambodia Nigeria India Kenya Mali Zambia Bolivia Ethiopia


Most outstanding informationQuestion: What piece of information was most outstanding for you?

71% 68%59% 58% 55%

43% 41%

25%

14% 22%

25% 25%22%

19%32%

19%

14%9%

15% 17%23%

35%

28%

53%

1% 1% 1% 1% 3% 2%

Ethiopia Mali Bolivia Zambia Kenya India Cambodia Nigeria The number of children dying every year The causes The solutions Dk/ Na


Stimulus impact: Interest in the information presentedQuestion: While you were reading this information on child mortality, did you have the feeling that people like you may be interested in the subject?ANSWERS ‘YES’

97% 95% 95% 95%92% 91% 89% 89%

Cambodia Kenya Mali Bolivia Ethiopia Nigeria Zambia India


Stimulus impact: Interest in receiving informationQuestion: Would you like to receive similar information occasionally?ANSWERS ‘YES’

98% 98% 97% 96% 96% 96%92% 90%

Kenya Ethiopia Mali Zambia Cambodia Bolivia Nigeria India


Stimulus impact: Information worth CommunicatingQuestion: Did this information on child mortality give you the feeling that what was said or shown was worth communicating? ANSWERS ‘YES’


Stimulus impact: Word of mouthQuestion: If you were talking to someone about child mortality, do you think that you would mention any of the points of the information you have just read? ANSWERS ‘YES’

98% 98% 98% 97% 97% 96%92%

85%

Cambodia Bolivia Ethiopia Zambia Kenya Mali Nigeria India


Impact on concern on child mortalityQuestion: As a result of reading this information on child mortality, would you say that you are…?

83% 82%77% 75%

67% 66% 63%56%

16% 18%21%

18%

13%

30%34%

38%

1% 2%6%

20%

3% 3%5%

1% 1%

Kenya Ethiopia Zambia Nigeria Cambodia Bolivia Mali India More concerned about this issue As concerned as before Less concerned about this issue Dk/ Na


More interest in carrying out actionsQuestion: Has this information on child mortality that you have just read raised your interest in carrying out actions in order to improve the situation?ANSWERS ‘YES’

96% 94%91% 90%

87% 86% 84%

76%

Ethiopia Kenya Cambodia Zambia Bolivia Mali Nigeria India


Likeliness in carrying out actionsQuestion: And how likely are you to carry out any actions in order to fight child mortality in the next 12 months?

46% 46%

35%30% 27% 27% 26%

21%

47%

27% 49%

36%47%

63%

55%71%

5%

13%

10%

18%

12%

9%

13%

7%1%

11%5%

11%11%

1%5%

Kenya Nigeria Zambia Mali India Cambodia Bolivia Ethiopia Very likely Somewhat likely Somewhat unlikely Very unlikely Dk/ Na



Volunteering 54% 80% 47% 44% 79% 51% 59% 54%

Donate Money 24% 58% 40% 36% 49% 56% 60% 25%

Advocacy 38% 39% 29% 36% 51% 30% 28% 21%

Participate in demonstrations 12% 16% 16% 46% 22% 25% 3% 9%

Sign petitions / requests 7% 12% 4% 19% 17% 22% 18% 19%

Support a political party / politician depending on their interest on this matter

12% 13% 14% 27% 14% 8% 9% 3%

Others 1% 3% - 14% 2% - 3% 12%

DK / NA 1% - 1% - 1% 1% - 2%

Actions to carry outQuestion: What actions would you carry out/ are you currently carrying out?

Basis: Middle class population – respondents who declare to be willing to take action/ initiative regarding child mortality in the last 5 years.

64


I don't have the time 32% 18% 11% 13% 25% 48% 60% 45%

I do not know what I can do to help 20% 36% 17% 20% 33% 26% 32% 17%

I don't have enough money/resources 22% 25% 28% 29% 10% 5% 29% 13%

Nothing that I could do would make a difference 19% 18% 22% 16% 30% 8% 5% 7%

It is not my responsibility to solve it 6% 7% 19% 14% 11% 12% 6% 5%

I am not interested in the issue 4% 3% 5% 13% 17% 3% 14% 8%

It is not a serious problem 2% 6% 1% 2% 1% 6% 9% 3%

DK / NA 4% 16% 3% 5% 1% 2% - 3%

Reasons for not willing to carry out actionsQuestion: Why wouldn’t you carry out any actions?

Basis: Middle class population – respondents who declare NOT to be willing to take any action/ initiative regarding child mortality in the last 5 years.

65

Whom would they contact?Question: Could you please tell me the kind of organization or institution you would approach?


Hospital / clinics 55% 47% 38% 32% 66% 42% 53% 40%

Community center 39% 27% 19% 34% 30% 26% 21% 18%

International organizations 14% 27% 14% 35% 36% 31% 31% 20%

Schools 20% 20% 22% 26% 41% 21% 32% 13%

Civil society organizations 23% 20% 11% 18% 23% 53% 27% 15%

Religious groups / institutions 25% 38% 32% 12% 26% 15% 3% 15%

Political Parties 8% 10% 9% 10% 8% 20% 5% 5%

Basis: Middle class population in each country who would know who to contact66

Ministry of Health and/or Local Government Health Department

42%

Leaders opinions

67

Universe: Leaders: policy makers and influencersLeaders belonged to different spheres: Policy makers, politicians, Religion leaders, Business leaders, Well known sport men and Women, singers, actors, Heads from local national NGOs, Journalists, media and broadcasting

Data collection technique: Face to face interviews

Sample size: 30 interviews were conducted in each country. Total: 120 interviews

Sampling method: Convenience Sampling

Methodology Specifications

68

General context

Top problems by country

Basis: Leaders in each country

Bolivia:Unemployment

Poverty

Lack of politic consensus

Mali:

Unemployment

Corruption

Education

Nigeria:

Corruption

Poverty

Electricity problems

Illiteracy

Zambia:

Corruption

Unemployment

Poverty

HIV

India:

Corruption

Poverty

Inflation

Ethiopia:

Poverty

Economic problems/HIV Corruption

Kenya:

Corruption

Poverty

Unemployment

Health problems/ HIV

Cambodia:

Traffic accidents

Drug/ Alcohol abuse

Poverty

Economic problems

Question: What would you say are the country’s most serious problems? (OPEN ENDED) And from these which one would you say is the most serious problem? (ONE MENTION)

Underlying reasons behind the biggest problems in the countryQuestion: What is the underlying reason for … to be the biggest problem your country faces? OPEN ENDED

•Bolivia: Lack of political stability and poor management are seen as drivers of the economic problems Bolivia faces.•Kenya: The unemployment level is perceived as very high, with a direct impact on people’s living conditions. Rising prices, partially explained by an increase in commodity prices, are also a serious concern. The reasons of the economic problems are attributed to bad leadership and also to climate change. There is a deep concern for poverty in the country.•Cambodia: Lack of job opportunities and of education are seen as drivers of the economic problems Cambodia faces. Environmental issues are also considered relevant.•Zambia: A privatization process of public companies and the closure of industries is one of the causes mentioned for economic problems. There is criticism regarding an unequal distribution of wealth in the country.•Ethiopia: Lack of job opportunities and of education are seen as drivers of the economic problems Ethiopia faces. Also political corruption is mentioned by some leaders•Mali: There is a deep concern for poverty in the country. The income of the population is considered as too low and prices are rising, particularly commodity; also there is concern because the income distribution is unequal.•Nigeria: Poverty and lack of power supply/ shutdowns are seen as drivers of the economic problems Nigeria faces. Lack of energy affects adversely companies, employment and individual life.•India: The global crisis as well as the country's corruption and the lack of education are all seen as drivers of the economic problems India faces. Environmental issues and increasing population are also seen as relevant facts

ECONOMY

The underlying reasons for the economic problems in these countries are mainly related to poor management of governments. An unequal distribution of income and unemployment are a result of these. In Bolivia, leaders mention lack of political consensus. Environmental problems are mentioned in India and Cambodia, while in Nigeria the lack of energy supply worries most of the leaders.


POLITICS

•Bolivia: Lack of political stability is associated to lack of consensus among different sectors.•Kenya: Policy makers and politicians are perceived as having too much power. There is criticism towards the lack of leadership and the way decisions are made. There is also concern regarding political instability and violence, specially with the conflict of the Mau Forest evictions, and tribal conflicts. Corruption is considered to be widespread among politicians. Lack of control and impunity are some of the causes of corruption. Corruption is both the cause and consequence of a crisis of values•Cambodia: Lack of political will and internal and external conflicts are the underlying reasons for political problems•Zambia: Political problems are caused by the lack of leadership and the inability of politicians to be opened to dialogue. Regarding corruption, the high rate of unemployment seems to be one of its causes.•Mali: Policy makers and politicians are perceived as not taking care of the people’s necessities, There is criticism towards lack of power. There is also concern regarding corruption.•Nigeria: Leadership issues and corruption are behind the social and political issues mentioned by leaders. Disregardment of political leaders is mentioned.•Ethiopia: Political corruption is mentioned by some leaders.•India: Corruption is the main political problem and is associated to the lack of government power and bad governance

Corruption is signaled as a major problem for their countries by leaders. Politics issues are caused by lack of leadership, bad governance and lack of consensus among the different sectors. In some countries there’s a perception of negligence by governments towards people and their needs.


SOCIAL ISSUES

•Bolivia: Lack of political decision and a weak educational system are the underlying reasons for the social problems Bolivia faces•Cambodia: Poverty, lack of education in the law and social conflict are the underlying reasons for the social problems Cambodia faces•Zambia: HIV/AIDS is being caused by prostitution and employment. The lack of proper health facilities is causing health problems•Ethiopia: The economic issue is behind the social issues mentioned by leaders (poverty, unemployment)•Mali: There is a deep concern for poverty in the country. The considerable level of famine worsens the situation•India: Terrorism, education and large population are the social issues. Poverty and education are the underlying reasons for the social problems India faces

The reasons for the social issues impacting in these countries are mainly related to lack of political decision or carelessness. Poverty and unemployment are issues in these countries, which lead to lack of education and no proper health care for the population

Child mortality

Concern on Child MortalityQuestion: How concerned would you say you are about child mortality in your country?

67% 70%

83%

67% 67%

43%

93%

67%

33% 27%

17%

30%

7%

40%

7%

27%

3% 3%

20%

13%

7%3%7%

Bolivia Cambodia Ethiopia India Kenya Mali Nigeria Zambia

Very Somewhat Not very much Not at all DK / NA

Basis: Leaders in each country75

Assessment on seriousness of the issueQuestion: How would you rate the problem of child mortality in your country? Would you say it is...?

83%

57%47%

67%57%

40%

88%

50%

17%

40%

47%

33%

30%

50%

9%

37%

3% 6%

3%7%

3%

10%

3%10%

3%


Very serious Somewhat serious Not too serious Not at all DK / NA


Causes of Child MortalityQuestion: You’ve said child mortality is a … problem in your country. Why would you say this? What is the underlying reason? OPEN ENDED

•Bolivia: The lack of access to education and health for everyone, therefore the lack of prevention of child sickness.•Kenya: Healthcare system is perceived to be too expensive and remote. There is also criticism regarding its poor quality•Cambodia: Lack of health facilities and disease: Not enough health centres, not available for everyone, no access from rural areas, public health service is weak and ineffective. The lack of knowledge and awareness of parents and, subsequently, their neglecting of children•Zambia: There is a perceived lack of infrastructure and resources in the health system. There is also criticism regarding negligence in the healthcare service (laziness of personnel). The lack of parents´ education is one of the reasons•Ethiopia: Lack of health facilities is the main reason for child mortality (specially in rural areas) lack of access financial and distance. Also inadequate skills among doctors. However, some leaders are optimistic and think this problem is somewhat improving nowadays.•Mali: There is a perceived lack of infrastructure and resources in the health system. The lack of parents´ education is one of the reasons for child mortality.•Nigeria: Lack or deficiency of health facilities and lack of parental and society awareness are the main reason for child mortality.•India: The lack of knowledge and awareness, especially among parents. Lack of health facilities: basic healthcare is not available in hospitals, there is a lack of adequate number of doctors, nurses, beds and treatment facilities in government hospitals. This problem is a bigger issue in rural India.

LACK OF ACCESS TO EDUCATION AND HEALTH

Leaders of all these countries agree that the lack of proper health facilities is causing high rates of child mortality. Besides, the difficult access to education for a large portion of the population is causing parents unawareness on how to take proper care of their children.Rural areas are the most affected by these two problems.

•Bolivia: Poverty, and malnutrition as a sub derivate. Government responsibility.•Kenya: Poverty is seen as a major obstacle for accessing good health services. Poor living conditions also increase the risk for children. Some regions appear to be more affected. Government is regarded as the main responsible actor for child mortality. But parents also have a share of responsibility•Zambia: Poverty itself is causing the death of children•Ethiopia: Poverty itself is seen by some leaders as the reason of child mortality in Ethiopia•Mali: Poverty itself is causing the deaths of children, and the absence of consistent policies to take care of the issue•India: Poverty itself is causing the deaths of children: malnutrition increases. Government responsibility: carelessness and negligence of government towards health care

POVERTY

Causes of Child MortalityQuestion: You’ve said child mortality is a … problem in your country. Why would you say this? What is the underlying reason? OPEN ENDED

Some leaders explain child mortality by poverty itself and, subsequently, malnutrition of children, bad living conditions and lack of access to proper health care attention and education.Government is seen as having the main responsibility for it.

Evolution on solving Child mortality in the past 3 yearsQuestion: Thinking about the present situation of child mortality in your country in the last 3 years, would you say that it has improved, it has got worse, or it has stayed the same?

54%

94%

73%

50% 50%

83%

43%

67%

4%

7%

23% 20%

7%

33%

10%29%

3%

13% 27%

17%

7%

18%23%

13%3% 7%

13%3% 6%


Improved Got worse Stayed the same DA/DK


Evolution on solving Child mortality in the next 3 yearsQuestion: And thinking about the next 3 years, would you say that it will improve, will get worse, or will stay the same as it is now?


67%

94% 94%

57% 57%

80%

61% 63%

13%

3%

10% 7%

7%

12%13%

21%

3%

27%

13%

10%

9%

17%

3% 3% 7%

23%

3%

18%7%


Will improve Will get worse Will stay the same DA/DK

Opinion on the possibility of solving Child MortalityQuestion: There are different opinions regarding child mortality. Which one would you say is closer to your view?: Child mortality in your country is a problem that …

3% 7% 3%4%

33%23%

23%

3%

20%

12%

27%

54%

57%

47%

70%

30%

67%

49%

53%

42%

10%

30%

3%

60%

7%

39%

7%

7% 10%


cannot be solved can only be slightly improved can be greatly improved can be fully solved DA/DK


Measures for solving child mortality

HEALTH SERVICES

•Bolivia: Education is key to solve the problem, in a preventive role. Improving access to health, meaning FREE health services.•Kenya: Free medical assistance and improvement of health care facilities.•Cambodia: Strong demand for more health services and facilities, build some more hospitals, provide medicine and trained doctors in rural areas. Education on sanitation•Zambia: Some mention aspects related to the healthcare infrastructure and resources. This is especially important in rural areas, where the access to medical services is more difficult. Another aspect is to count with more and better human resources in the Healthcare system•Ethiopia: Although some point out this issue is being taken care of, there is a demand for more health services and facilities. Building more facilities and increasing the number of health workers, equipment and medicine. Give free health service.•Mali: Leaders ask for more government presence in improving the health care system, providing free assistance, especially in rural areas•India: There is a demand for more health services and facilities and especially for FREE health services; this is seen as the government's responsibility.

Question: What things do you think your country could do to solve this problem? What else? Is there anything else you can think of? OPEN ENDED. And what do you think is the one best thing your country could do that would have the biggest impact on solving this problem? What is the underlying reason for it to be the best solution for child mortality in your country? OPEN ENDED

Given the difficulties for poor people to access healthcare services, most leaders mention free medical assistance as one of the most important measures to reduce child mortality. This would include free medical attention and drugs (especially for children and mothers) and provision of mosquito nets and supplies. Some mention aspects related to the healthcare infrastructure, including the need to create and improve medical centers. This is especially important in rural areas, where the access to medical services is more difficult. Another aspect is to count with more and better human resources in the Healthcare system.

Measures for solving child mortality

PUBLIC POLICIES/ GOOD GOVERNANCE

Question: What things do you think your country could do to solve this problem? What else? Is there anything else you can think of? OPEN ENDED. And what do you think is the one best thing your country could do that would have the biggest impact on solving this problem? What is the underlying reason for it to be the best solution for child mortality in your country? OPEN ENDED

•Bolivia: Strong belief in the governments´ responsibility towards this issue. Besides, some point out the need to get the support of the community to make effective this public policy:•Kenya: The level of corruption in the institutions is perceived as a major obstacle for effective public policies that could reduce child mortality. Thus, tackling this problem becomes crucial. There is also a demand for better leadership•Zambia: There is a demand for better leadership and smart policies to face the problem•Mali: There is a demand for better leadership by the government•Nigeria: Leaders agree that the Government should take more action on the subject, by improving the health sector as well as the sanitation system and general living conditions. Raising awareness and education are also measures demanded to the Government. Some leaders point out the need of community participation and institution interaction to make these measures effective.

•Kenya: Many interviewees think that better economic conditions are necessary in order to reduce child mortality•Kenya: The problems of the economy have a direct impact in people’s daily lives and the welfare of children•Zambia: The perception is that in order to improve child mortality, the country’s economy should also improve

IMPROVE THE ECONOMY

The need for more, and better, public policies addressing child mortality is mentioned by some leaders. This has to be accompanied by good governance: decision and proper use of resources by the Government

In Kenya and Zambia some leaders mention the improvement of the economy in general as the main measure to take regarding child mortality

Measures for solving child mortalityQuestion: What things do you think your country could do to solve this problem? What else? Is there anything else you can think of? OPEN ENDED. And what do you think is the one best thing your country could do that would have the biggest impact on solving this problem? What is the underlying reason for it to be the best solution for child mortality in your country? OPEN ENDED

EDUCATION

•Bolivia: Education is key to solve the problem, in a preventive role. •Kenya: The Government should implement education campaigns oriented to teach people on how to prevent causes of child mortality•Cambodia: Most leaders point out promoting awareness of the issue and educating parents as the main actions to do. Some mention that education on child mortality issues must be led by NGOs and government•Zambia: The Government should implement education campaigns oriented to teach parents on how to prevent causes of child mortality•Ethiopia: Awareness and education, especially among mothers, and empowerment of women in general are the main measures suggested to fight child mortality. There is a strong belief in community participation and networking to make these measures effective.•Mali: Government should implement education campaigns oriented to teach prevention among parents and children •India: Some mention specific education on child mortality issues led by NGOs and government. But others mention the improvement of education in general

Raising awareness of child mortality is key for some leaders. They mention education campaigns oriented to parents and the society as a whole.Government and NGO’s are the institutions mentioned to lead these actions.

Actions

% who have taken actions/ initiatives regarding child mortalityQuestion: Have you taken any action/ initiative regarding child mortality in the last 5 years?

75%

30%

60%57%

40%

27%

61%

40%



Actions/ initiatives regarding child mortalityQuestion: Have you taken any action/ initiative regarding child mortality in the last 5 years?


Mainly lack of awareness of the problem Lack of time or resources Different duty Lack of knowledge/ information on the subject Other institutions taking care of the problem

WHY NOT?

Advocacy Volunteering/ working or leading a non-for-

profit-organization Social plans (government members) Donations Educating people by reaching the community

PERCEIVED IMPACT

MOST COMMON ACTIONS

Those who have taken actions think they are making a contribution to reduce child mortality

BARRIERS

Lack of coordination with the Government Lack of awareness or interest in society and target

population Lack of resources. The financial and transaction costs Lack of collaboration by society Low education of target population/ illiteracy However, many think there are no barriers for help

Reaction to Stimulus

Concern on the issue after seeing the stimulusQuestion: As a result of reading this information on child mortality, would you say that you are…?


42%34%

90%

70% 80%

57%

70%77%

58%

33%

7%

20%17% 43%

30%23%

33%

3%3%13%


More concerned As concerned as before Less concerned DA/DK

Interest on carrying out actions after seeing the stimulusQuestion: Has this information on child mortality that you have just read raised you interest in carrying out actions in order to modify the situation?

71%

97% 97%

73%

93% 93% 91%97%

3%3%

20%

3% 3% 6%3%

29%

7% 3%3% 3% 3%


Yes No No, I already do DK / NA


Call for actionQuestion: And how likely are you to carry out any actions in order to fight child mortality in the next 12 months?

75%

63%

77%

27%

90%

33%

64% 63%

21%

33%

17%

47%

10%

37%

24% 30%

4% 3% 6%

12% 23%

9%7%

11%

1% 3% 7% 3%


Very likely Somewhat likely Somewhat unlikely Very unlikely DK / NA


EDUCATION/ AWARENESS

Question: What actions would you carry out/ are you currently carrying out? OPEN ENDED

Actions that would carry out

In Bolivia, Zambia and Mali some leaders are willing to work, or already working, on social plans to fight child mortality.

SOCIAL PLANS

Most leaders in all these countries mention awareness as the main action they would carry out. There is a high interest in educating people (especially mothers and pregnant women) about preventive measures for child mortality. Some interviewees related to the media are willing to use their position to reach a large public; religious leaders claim they will work with their community educating people on this issue.

•Bolivia: The leaders that are part of the Government or institutions dedicated to the issue are conducting different measures:•Zambia: Some mention direct involvement in health centers and health policies•Mali: Some mention direct involvement in health centers and health policies

•Bolivia: Some think about giving economic contributions or volunteer work to support institutions dedicated to fight child mortality.•Kenya: Some interviewees are willing to fight child mortality by getting actively involved in the community, supporting institutions related to the issue•Cambodia: Some leaders are willing to volunteer by reaching out to the community and providing supplies•Zambia: Only a few think about donations•Ethiopia: Some leaders are willing to volunteer by reaching out to the community and donating money or clothing•Mali: Only a few think about donations•Nigeria: Some leaders are willing to volunteer by reaching out to the community and donating•India: Some think about donations, in some cases related to education

SUPPORT TO INSTITUTIONS

Question: What actions would you carry out/ are you currently carrying out? OPEN ENDED

Actions that would carry out

Some of the leaders declare that they will get involved, or continue to participate, in existing organizations, while others say that they will use their position to create and promote new ones. Whilst education and volunteering are the main actions considered, only a few think of donations

Summary

Summary (I)

•Corruption and poverty, the two common issues of the surveyed countries’ agenda. When asked about the most important problem for the country, in general, the most frequently mentioned issues are corruption and poverty. However, each country has its own particularities. In Mali, hunger stands out; in Zambia, unemployment; in Cambodia, drugs; in Bolivia, the economic problems as well as crime and insecurity (according to other studies, a common topic in Latin America).

•As for the specific Millennium Development Goal, “Eradicate extreme poverty and hunger” is, according to the respondents, the most important for the country. The importance of fighting 'HIV/AIDS' increases significantly in Zambia and Kenya. As per 'reduce child mortality', this goal is mentioned among the top 3 in 4 out of the 8 countries, especially in India

•Hospitals, institutions with good reputation among the middle classes. Considering a number of organizations and institutions, trust in donor countries and international development organizations is high. Regarding local institutions, it is significant the trust in hospitals and clinics. When it comes to undertake initiatives to fight child mortality, hospitals and health centers are also the places where people would go. In contrast, political parties and the police are the institutions that people distrust the most.

Summary (II)

•Respondents call for state intervention to solve the problem of child mortality. Considering a number of potential actors, the national government is viewed as primarily responsible for solving this problem. In two countries (Bolivia and India), greater responsibility is allocated to the local governments than to the national government. In terms of efficiency and reliability, although governments receive the better assessment, other actors like international development organizations and civil society organizations are also well regarded. In Africa, the donor countries are considered more reliable to solve the issue of child mortality.

•Child mortality is perceived as a serious problem. Although it does not come up as one of the top concerns for the middle class, when asked about child mortality, this issue is regarded as a serious problem in all the countries. At the same time, most respondents say they are very or fairly concerned about it.

Summary (III)

•Respondents perceive improvements and are optimistic regarding the future. Respondents recognize improvements in the field of child mortality. In most countries, especially in Cambodia, it is believed that child mortality has improved over the past three years. The exception is Bolivia, where the largest proportion of the middle class is critical on this issue. Another finding of this study indicates that, in general, there is a strong optimism about the evolution of this problem. Most respondents also agree that child mortality is a problem that will improve; they consider that the MDG4 objectives on child mortality will be achieved.

•Respondent say they know more of what they actually do. In all countries, middle class members say they know a great deal or a fair amount about child mortality. However, when specifically asked about the main causes of child mortality, the most frequently mentioned reasons are not the most relevant for the country. Additionally, the vast majority underestimates or ignores the number of children who die every year in their countries.

Summary (IV)

•Respondent say they know more of what they actually do: In all countries, middle class members say they know a great deal or a fair amount about child mortality. However, when specifically asked about the main causes of child mortality, the most frequently mentioned reasons are not the most relevant for the country. Additionally, the vast majority underestimates or ignores the number of children who die every year in their countries.

•The magnitude of the problem, one of the most surprising aspects of child mortality: When respondents are shown specific information on three aspects of child mortality (a. the dimension of the problem, b. the principal causes and c. some solutions), the most striking information for them, in almost all countries, is the number of children who die every year. Only in one country, Nigeria, the solutions to the problem became the most valuable piece of information for respondents.

Summary (V)

•The magnitude of the problem, one of the most surprising aspects of child mortality. When respondents are shown specific information on three aspects of child mortality (a. the dimension of the problem, b. the principal causes and c. some solutions), the most striking information for them, in almost all countries, is the number of children who die every year. Only in one country, Nigeria, the solutions to the problem became the most valuable piece of information for respondents.

•Receiving information on child mortality motivates people to action. After being shown information about child mortality (dimension, causes and solutions), respondents report feeling more concerned about this issue, more willing to talk and to receive information about it. Respondents say they are motivated to carry out concrete actions to improve the situation. Regarding the main actions they are willing to carry out, middle class members mention volunteering, donating money and advocacy (talk about, communicate and position the issue on the agenda). Those who deem unlikely to undertake any action, mention as the main reason for it, “the lack of time”. Other barriers mentioned, which could be addressed in a potential campaign, are “lack of knowledge about what can be done” or the belief that “individual action does not make any difference”.

Summary (VI)

•Non-governmental leaders are potential allies of MDG4. Regarding the leaders, it is remarkable and positive to see their interest in the issue, as well as their willingness to participate in the solution of it. This is especially true for non-political leaders, like those in the media, actors, singers, business men, etc. These respondents have undertaken some initiatives and are interested in taking action to fight child mortality. At the same time, there are not great obstacles to take action; it is mainly a matter of lack of coordination or knowledge.

Main Ideas

Child mortality is considered an important issue, although it is not on the agenda

People believe they know more of what they actually do

Receiving information on child mortality increases the commitment to the issue

Annex I – Questionnaires used

Middle class population Questionnaire Your usual introduction, but add: We are conducting this survey in several countries around the world, asking people like you for their views and opinions regarding social issues. Please be assured that we are not selling or soliciting anything and that your responses will remain anonymous and only aggregated results will be reported

General context – Agenda Q1. Which of the following do you think is the most important problem your country faces today? SHOW CARD 1 WITH PROBLEMS AND READ PROBLEMS OUT LOUD – SINGLE ANSWER CorruptionCrime / InsecurityDrugs and drug abuseEconomic problemsChild MortalityEducationEnvironmental issuesHIV/ AIDS Other health problemsHuman rights violations Hunger/ not enough foodLack of democracy / lack of freedomPoverty Refugees, asylum, and refugee problemsReligious / Ethnic problems TerrorismUnemploymentInternal conflictsExternal conflictsThe gap between the rich and the poorOthers– specifyDK/NA

Q2. In the year 2000 the world leaders agreed on a certain number of programs to solve the world’s most important problems. A set of goals was established to be accomplished by 2015. This agreement is known as the Millennium Development Goals. Have you heard of this initiative?

YesNo 103

Middle class population Questionnaire

Q3. Next, I will enumerate the different Millennium Development Goals. Could you please tell me which one you consider the most important one for this country? READ OUT AND ROTATE. SINGLE ANSWER Q4. And which one do you think is the second most important goal for this country? READ OUT AND ROTATE. SINGLE ANSWER

Eradicate extreme poverty & hungerAchieve universal primary educationPromote gender equality and empower womenReduce child mortalityImprove maternal healthCombat HIV/AIDS, malaria and other diseasesEnsure environmental sustainabilityDevelop a global partnership for developmentNone of these (DO NOT READ)DK/NA (DO NOT READ)

Child mortality: Awareness – Problem dimension – People’s initiatives Now we are going to talk more specifically about child mortality Q5. Focusing on what you know about child mortality, how much would you say you know…? READ OUT – SINGLE ANSWER

A great dealFair amountNot very muchNothing DK / NA

Q6. Which sources of information have you used to learn about the issue? READ OUT – MULTIPLE

Magazines / NewspapersRadioTVInternetCampaigns in public placesCommunity centersComments of someone you knowOthers – specify NoneDK / NA

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Q7. How concerned would you say you are about child mortality in (MENTION COUNTRY)? READ OUT - SINGLE ANSWER VerySomewhatNot very muchNot at allDK / NA

Q8.How would you rate the problem of child mortality in your country? Would you say it is...? READ OUT - SINGLE ANSWERVery seriousSomewhat seriousNot too seriousNot serious at all DK / NA Q9. According to what you may know or may have heard: how many children under 5 die every year in your country? I know this is a difficult question and that you probably don’t know the number but your best estimation based on what you know or believe will do. SHOW CARD 2 - SINGLE ANSWERFrom 5,000 to 10,000From 10,000 to 50,000From 50,000 to 100,000From 100,000 to 200,000From 200,000 to 300,000From 300,000 to 500,000From 500,000 to 1,000,000From 1,000,000 to 1,500,000From 1,500,000 to 2,000,000From 2,000,000 to 2,500,000From 2,500,000 to 3,000,000From 3,000,000 to 4,000,000More than 4,000,000 DK/NA

Q10. Regarding the present situation of child mortality in (MENTION COUNTRY) in the last 3 years, would you say that it has improved, it has got worse, or it has stayed the same? ImprovedGot worseStayed the sameDK/NA 105


Q11. And thinking about the next 3 years, would you say that it will improve, it will get worse, or it will stay the same as it is now?Will improveWill get worseWill stay the sameDK/NA

Q12. One of the objectives to be achieved by 2015, as set by the world leaders in the Millennium Development Goals, is to reduce under-five mortality rate by two thirds. How likely do you think it is for this goal to be achieved in your country? READ OUT – SINGLE ANSWERVery likelySomewhat likelySomewhat unlikelyVery unlikelyDK / NA

Q13. There are different opinions regarding child mortality. Which one would you say is closer to your view? READ OUT - SINGLE ANSWERChild mortality in NAME COUNTRY is a problem that cannot be solvedChild mortality in NAME COUNTRY is a problem that can only be slightly improvedChild mortality in NAME COUNTRY is a problem that can be greatly improved Child mortality in NAME COUNTRY is a problem that can be fully solved DK/NA

FOR THOSE WHO ANSWER CODE 1 OR 2 IN Q13 – OTHERS GO TO Q15 Q14. Why do you think that child mortality is a problem that can not be solved / can only be slightly improved? ASK ACCORDING TO ANSWER IN Q13? OPEN ENDED

ASK ALL Q15. a) When it comes to child mortality, who do you think is mostly responsible for its solution in MENTION COUNTRY? (SHOW CARD 3) b) And who do you think would be the most efficient one in solving the problem in this country? c) And who would be the most reliable one? The local governmentThe national government Civil society organizationsInternational development organizationsDonor CountriesOthers, who? No oneDK/NA

106


Q16. From what you may know or may have heard: what would you say is the main cause of child mortality in your country? UNAIDED – SINGLE ANSWER

Q17. And from the following causes of child mortality that I am going to mention, which one would you say is the most relevant one in your country? SHOW CARD 4 – SINGLE ANSWER MalnutritionLack of improved water & sanitation servicesMalariaMeaslesAcute Respiratory infectionsDiarrheaHIV / AIDSDroughtsWars / Tribal conflictsLack of access to health servicesPneumoniaInfectionsTetanusOther, specifyDK/NA

Q18. Have you taken any action/ initiative regarding child mortality in the last 5 years?

Yes No

IF IN Q18 THE ANSWER IS YES (CODE 1)– OTHERS GO TO Q20 Q19 Which kind of action/ initiative have you carried out? DO NOT READ OUT – IT CAN BE MULTIPLEVolunteering Donate MoneyAdvocacySign petitions / requestsParticipate in demonstrationsSupport a political party / politician depending on their interest on this matterOthers – specify DK / NA

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IF THE ANSWER IN Q18 IS NO (CODE 2)– OTHERS GO TO Q 21 Q20. And why didn’t you take any action/ initiative regarding the child mortality issue in NAME COUNTRY? DO NOT READ OUT – IT CAN BE MULTIPLE

I am not interested in the issueI have no timeIt is not a serious problemNothing that I could do would make a differenceI do not know what I can do to helpIt is not my responsibility to solve itI don’t have enough money/resourcesOthers – specifyDK / NA

Child mortality – Stimulus reaction Next I will show you a short document about the issue of child mortality SHOW DOCUMENT (CARD 5) ABOUT CHILD MORTALITY

Some figures about child mortality in Kenya In Kenya 175.000 children under 5 die every year. More than 50% is due to acute respiratory infections, malaria and diarrhea. Most of these deaths could be prevented by providing antibiotics for Respiratory Infections; sleeping under mosquito nets for Malaria and giving the child to drink a simple solution made of sugar and salt in case of diarrhea. Most of these things are available locally and they are not expensive.

Q21. Did you know the information you have just read?Yes NoDK/NA

Q22. What piece of information was most outstanding for you? READ OUT - SINGLE ANSWER

The number of children dying every year The causesThe solutionsOther, specify (DO NOT READ OUT)Dk/ Na (DO NOT READ OUT)

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Q23. While you were reading this information on child mortality, did you have the feeling that people like you may be interested in the subject?Yes NoDK/NA

Q24. Would you like to receive similar information occasionally?Yes NoDK/NA

Q25. Did this information on child mortality give you the feeling that what was said or shown was worth communicating?Yes NoDK/NA

Q26. If you were talking to someone about child mortality, do you think that you would mention any of the points or impressions of the information you have just read?Yes NoDK/NA

Q27. As a result of reading this information on child mortality, would you say that you are…? READ OUT – SINGLE ANSWERMore concerned about this issue As concerned as before Less concerned about this issueDK/NA (DO NOT READ)

Q28. Has this information on child mortality that you have just read raised your interest in carrying out actions in order to improve the situation?Yes NoNo, I already do so (UNAIDED)DK/NA

Q29 And how likely are you to carry out any actions in order to fight child mortality in the next 12 months? READ OUT – SINGLE ANSWER

Very likelySomewhat likelySomewhat unlikelyVery unlikelyDK / NA

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ASK ONLY THOSE WHO MENTIONED CODE 1 OR 2 IN Q29 - OTHERS GO TO Q31 Q30. What actions would you carry out/ are you currently carrying out? ASK ACCORDING TO ANSWER IN Q28. READ OUT –ROTATE ORDER – IT CAN BE MULTIPLEVolunteeringDonate MoneyAdvocacySign petitions / requestsParticipate in demonstrationsSupport a political party /politician depending on their interest in this matterOthers– specifyDK / NA

ASK THOSE WHO MENTIONED CODE 3, 4 OR 9 IN Q29 Q31. Why wouldn’t you carry out any actions?I am not interested in the issueI don’t have the timeIt is not a serious problemNothing that I could do would make a differenceI do not know what I can do to helpIt is not my responsibility to solve itI don’t have enough money/resourcesOthers – specify DK / NA

ASK ALL Q32. If you were interested in carrying out any action in order to change the situation, would you know what organization or institution to approach?Yes No

Q33. Could you please tell me the kind of organization or institution you would approach? DO NOT READ OUT –ROTATE ORDER – IT CAN BE MULTIPLESchoolsPolitical partiesCommunity centerReligious groups / institutionsHospital / clinicsInternational organizationsCivil society organizationsOthers specify DK/ NA

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Middle class population Questionnaire Q34. And would you know how to reach this organization?Yes No

ASK ALL Q35. Could you please tell me how much confidence you have in each of the following? Would you say you have a lot of confidence, some confidence, not much confidence or no confidence at all? READ OUT AND ROTATE INSTITUTIONS – ONE ANSWER EACH Schooling systemThe pressPolitical partiesReligious groups / institutionsArmed forces / the militaryLabor unions The justice systemThe civil serviceThe policeHospital / clinicsNational governmentMajor companies Civil Society OrganizationsInternational development organizationsDonor Countries

Q36. To what extent would you say that people like you may have an influence in social and political events that surround us? Would you say that you may influence: a great deal, a fair amount, not very much, or not at all? A great dealFair amountNot very muchNot at allDK / NA

Q37. In general, how interested would you say you are in politics? READ OUT – SINGLE ANSWERA great dealFair amountNot very interestedNot interestedDon’t know (DO NOT READ)No answer (DO NOT READ)

111


Q38. Now I’m going to read out some forms of political action that people can take, and I’d like you to tell me, for each one, whether you have done any of these things, whether you might do them or would never under any circumstances do them.READ OUT PHRASES –ROTATE ORDER - SINGLE ANSWER

Signing a petitionAttending a demonstrationVolunteering in a non-profit organizationBeing a member of a political partyDonating money or something else for a causeAdvocacy

Demographics

Gender

Age

Total household income before taxes

Education: Highest attained

Employment

Religion

FamilyDo you have any children?If yes: Do any of them live with you?Do you have any children under the age of 5?

City

Interview duration

Interview date

Supervision

112

Public opinion Leaders/ Influencers Questionnaire INTRODUCTIONWe appreciate that you have agreed to respond to our survey today. As we mentioned on the phone, you have been chosen at random from a diverse group of influential leaders and thinkers to take part in a survey about some challenges in NAME COUNTRY. Your responses to the survey will be kept confidential, and neither your name nor your professional position will be used in any publication. Results will be reported in aggregate form only. 1. What would you say are [COUNTRY] most serious problems? OPEN ENDED

2. And from these which one would you say is the most serious problem? ONE MENTION

3. What is the underlying reason for [RESPONSE TO 2] to be the biggest problem your country faces [COUNTRY]? OPEN ENDED

Now we would like to talk specifically about one of [COUNTRY] problems: child mortality 4. How concerned would you say you are about child mortality in [COUNTRY]? READ OUT - SINGLE ANSWERVerySomewhatNot very muchNot at allDK / NA

5. How would you rate the problem of child mortality in your country? Would you say it is...? READ OUT - SINGLE ANSWERVery seriousSomewhat seriousNot too seriousNot serious at all DK / NA

6. Thinking about the present situation of child mortality in [COUNTRY] in the last 3 years, would you say that it has improved, it has got worse, or it has stayed the same?ImprovedGot worseStayed the sameDK/NA

7. And thinking about the next 3 years, would you say that it will improve, will get worse, or will stay the same as it is now?Will improveWill get worseWill stay the sameDK/NA

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Public opinion Leaders/ Influencers Questionnaire

8. You’ve said child mortality is ANSWER IN Q5 problem in [COUNTRY]. Why would you say this? What is the underlying reason? OPEN ENDED

9. Having said that, what things do you think [COUNTRY] could do to solve this problem? What else? Is there anything else you can think of? OPEN ENDED

10. And what do you think is the one best thing [COUNTRY] could do that would have the biggest impact on solving this problem? ONE MENTION ONLY.

11. What is the underlying reason for [RESPONSE TO 10] to be the best solution for child mortality in [COUNTRY]? OPEN ENDED

12. There are different opinions regarding child mortality. Which one would you say is closer to your view? READ OUT - SINGLE ANSWER

Child mortality in NAME COUNTRY is a problem that cannot be solvedChild mortality in NAME COUNTRY is a problem that can only be slightly improvedChild mortality in NAME COUNTRY is a problem that can be greatly improved Child mortality in NAME COUNTRY is a problem that can be fully solved DK/NA

FOR THOSE WHO ANSWER CODE 1 OR 2 IN Q12 – OTHERS GO TO Q14 Q13. Why do you think that child mortality is a problem that can not be solved / can only be slightly improved? ASK ACCORDING TO ANSWER IN Q12? OPEN ENDED

14. Have you taken any initiative regarding child mortality in the last 5 years? OPEN ENDEDYes No

IF THE ANSWER IN Q14 IS YES (CODE 1)– OTHERS GO TO Q17 15 Which kind of initiative have you carried out? OPEN ENDED

16.a And how do you believe that this initiative could impact on the problem of child mortality? OPEN ENDED

16.b Which were the main issues and barriers that you faced when conducting this initiative? OPEN ENDED

IF THE ANSWER IN Q14 IS NO (CODE 2) – OTHERS GO TO Q 18 17. And why haven’t you taken any initiative regarding child mortality in NAME COUNTRY? Is there any other reason? OPEN ENDED

114


SHOW DOCUMENT ABOUT CHILD MORTALITY:

Some figures about child mortality in Kenya In Kenya 175.000 children under 5 die every year. More than 50% is due to acute respiratory infections, malaria and diarrhea. Most of these deaths could be prevented by providing antibiotics for Respiratory Infections; sleeping under mosquito nets for Malaria and giving the child to drink a simple solution made of sugar and salt in case of diarrhea. Most of these things are available locally and they are not expensive.

18. As a result of reading this information on child mortality, would you say that you are…? READ OUT – ONE ANSWER

More concerned about this issue As concerned as before reading the informationLess concerned about this issueDK/NA (DO NOT READ)

19. Has this information on child mortality that you have just read raised you interest in carrying out actions in order to modify the situation?Yes NoNo, I already do so (UNAIDED)DK/NA

20 And how likely are you to carry out any actions in order to fight child mortality in the next 12 months? READ OUT – ONE ANSWER

Very likelySomewhat likelySomewhat unlikelyVery unlikelyDK / NA

ASK ONLY THOSE WHO MENTIONED CODE 1 OR 2 IN Q20. OTHERS GO TO Q21 21. What actions would you carry out/ are you currently carrying out? ASK ACCORDING TO ANSWER IN Q20. OPEN ENDED

ASK THOSE WHO MENTIONED CODE 3, 4 OR 9 IN Q20 22. Why wouldn’t you carry out any actions? OPEN ENDED 115


ASK ALL 23. Is there anything else you would like to add regarding [COUNTRY] child mortality and how it could best meet its challenges? OPEN ENDED

Thank you very much for your time. Type of leader

policy makers, politiciansReligion leadersBusiness leaderswell known sport men and Women, singers, actorsheads from local national NGOsJournalists, media and broadcasting

CityDelhiMumbaiChennaiKolkataBangalore Interview duration: Please record in minutes Interview date: Please record DD/MM SupervisionWas the interview supervised? This refers to directly as well as interviewee re contactedYesNo

116

Annex II – Middle class definition for each country

Bolivia

In Bolivia, socioeconomic level is defined in terms of education, occupation and household incomeMiddle class correspond to socioeconomic C, where:

C1 or middle high represents 4% of the population and are households with monthly income above 1.500 US$ and whose head of household has university studies and works as manager in middle size and large companies, or owns and SME or is a successful independent professional. C2 or middle represents 12% of the population and are households with monthly incomes between 800 US$ y 1.500 US$ and whose head of household has more than high school studies (some specialization or university) and works as middle management in a private company or high management in public offices or as an independent professional.

A. ¿Hasta qué curso educativo alcanzó el jefe de su hogar, es decir quien más dinero aporta a la casa?

1 Primaria incompleta 3 Secundaria incompleta 5 Técnico incompleto 7 Universidad incompleta 9 Posgrado

2 Primaria completa 4 Secundaria completa 6 Técnico completo 8 Universidad completa 0 Ninguna

B. ¿A qué se dedica el jefe de hogar? (Profundizar la actividad del jefe de hogar, para hacer una buena asignación es necesario aclarar lugar de trabajo)

(Leer una a una las opciones y pedir al encuestado que asigne la que más se relaciona con la ocupación del jefe)

1 Albañil, sereno, electricista, mesero, peon de campo, 5 Dueño de pequeño negocio con máximo 5 empleados

empleada doméstica, jardinero, puesto en el mercado (taller, tienda de barrio, peluquería, librería, etc)

2 Chofer de taxi o de micro, camionero, promotora de 6 Rentistas o Profesionales independientes como arquitectos,

ventas, costurera, mecánico, contratista, maestro de obra médicos, abogados, consultores, docentes universitarios

3 Militar, maestro, policía, enfermera o trabajador de base 7 Mando medio de empresa privada o institución pública

en una institución pública (Alcaldía, prefectura, etc) (jefe, supervisor, coordinador, encargado, etc)

4 Obrero de planta, recepcionista, asistente, auxiliar, jubilado, 8 Dueño, gerente o socio accionista de empresa con más de 5

ama de casa o trabajador de base en una empresa privada trabajadores

C. Sumando todo lo que ganan las personas que viven en su casa y trabajan, ¿De cuántos Bolivianos serían los

ingresos familiares de su hogar? Bs.

1 1 a 1.000 Bs 2 1001 a 2000 Bs 3 2001 a 4000 Bs 4 4001 a 8000 Bs 5 Más de 8000 Bs 6 Más de 12000 Bs

1 D2 (1-4) 2 D1 (5-9) 3 C3 (10-14) 4 C2 (15-18) 5 ABC1 (19-23)SUMAR PA + PB + PC

AHORA ME GUSTARIA QUE HABLEMOS DEL JEFE DE HOGAR, ES DECIR QUIEN MÁS DINERO APORTA EN SU CASA

C3 or middle low represents 19% of the population and are households with monthly incomes between 500 US$ and 800 US$ and whose head of household has finished high school and works in a private company, in a public office or in a shop or as an independent professional.

118

Cambodia

119

In Cambodia socioeconomic level is defined in terms of income.Based on Cambodia Socio-Economic Survey 1999 from the National Institute of Statistic, socioeconomic levels are defined as:

US$ per month SEC Class More than 400 A 301 to 400 B201 to 300 C101 to 200 DLess than 100 E

Where middle groups B and C are consider middle class.

In order to decided if an interviewee belonged to middle class the following question was asked:

Could you please tell me, which category on this card best describes your household income?

Monthly Income Less than 50 USD (<200,000 R) 50 to 100 USD (200,001-400,000R) 101 to 150 USD (400,001-600,000R) 151 to 200 USD (600,001-800,000R) 201 to 250 USD (800,001-1,000,000R) 251 to 300 USD (1,000,001-1,200,000R) 301 to 350 USD (1,200,001-1,400,000R) 351 to 400 USD (1,400,001-1,600,000R) More than 400 USD (>1,600,000R) Don't Know Refused

India

In India, socioeconomic level is defined in terms of education and occupationBelow is the Socioeconomic grid for India – those highlighted in yellow correspond to the middle class

Illiterate School up to 4th

School 5th -9th

SSC/ HSC Grad.

SSC/HSC.Not gradu

GRAD/ P.GGenl

GRAD/ P.GProfl

Unskilled E2 E2 E1 D D D DSkilled worker E2 E1 D C C B2 B2Petty trader E2 D D C C B2 B2Shop owner D D C B2 B1 A2 A2Business with number of employees

D C B2 B1 A2 A2 A1- None- 1 - 9 C B2 B2 B1 A2 A1 A1- 10 + B1 B1 A2 A2 A1 A1 A1Self empl profl. D D D B2 B1 A2 A1Clerical/ salesman D D D C B2 B1 B1Supervisory level D D C C B2 B1 A2Off / exec - junior C C C B2 B1 A2 A2Off/exec-mid/senior B1 B1 B1 B1 A2 A1 A1

120

Africa: Kenya, Nigeria, Mali, Zambia and Ethiopia

In these countries Middle Class was defined in terms of the “Living Standard Measure “LSM is the most widely used tool in Africa to segment the population in Social Classes. It groups people according to their living standards using criteria such as degree of urbanization and ownership of cars and major appliances.In order to achieve this categorization a questionnaire is applied where each response implies a number of points, depending on the points is the social class the person belongs too.

AB = 70 points and moreC1 = 56 to 69 pointsC2 = 35 to 55 pointsD = less than 35 points

In general, middle class belong to the C1 Social Economic Classification scale. These are individuals who have attained high education (University degree or slightly lower), live in a Medium density environment (in flats not necessarily detached, likely to own major household appliances e.g. Car, TV, fridge, etc.

Questionnaire:

Ownership - Which of the following things do you have at home?Description Points

Household help 2

Fridge / deep freezer 3

Video 1

Car 2

Colour TV 1

Music system 1

Description Points

Cable satellite 2Telephone (land) 3Telephone (mobile) 1Personal driver 2Multiple cars 3Computer 3Computer laptop 4Generator 4

Description Points

Air conditioning unit (split) 4

Satellite dish 3

Washing machine 4

Black & White TV 1

DVD (Digital video disk) 4121


LSM Questionnaire (continuation)

Cooking - What type of cooking facilities do you have at home?

Toilet type - What type of toilet do you have at home?

Main water source - What is your main water source?

Description Points

Gas / Electric cooker 2Kerosene stove 1Charcoal / wood 0

Description Points

Inside / Outside WC 2Pit latrine 1None 0

Description Points

Inside tap 2Outside pipe borne tap 1Self-owned borehole 3Communal borehole 1Well 1Stream 0

122



Education - What is your highest level of achieved education?

Residential area Type of house - How would you describe the place where you live?

Description Points

Primary incomplete 1Primary complete 2Secondary incomplete 3Secondary complete 4University / Polytechnic: OND

4

University / Polytechnic: HND

5

Post University incomplete

3

Post University complete 5Illiterate / No education 0

Description Points

Low density 3Medium density 2High density 1

Description Points

Self-occupied bungalow 2Villa 5Flat 3Duplex 4Mini flat 2Room and parlour 1Room 1

123



Occupation - How would you describe your occupation?

Lifestyle - Which of the following apply to you?

Description Points

Senior Management / Admin 5Managing Director 5Head of Department / Senior Manager 4Manager 3Professional e.g. Doctor, Lawyer, Engineer, Surveyor etc. 4Skilled workers e.g. Mechanic, Tailor, Carpenter, Bricklayer etc.

2

Unskilled workers 1Clerical workers 1Unemployed, Housewife / Househusband, Student, Retired 0

Description Points

I have membership to social / recreational club 3I travel abroad for holidays 4I read regularly as a habit 2I spend leisure time with friends 1I attend social occasions 1I like modern fashion 1

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MDG-4 CampaignMiddle class population and

Leaders’ attitudes and opinions towards Child Mortality

GLOBAL REPORT

June 2010Preliminary Report125

Health & Medicine

Middle class population and Leaders’ attitudes and opinions towards Child Mortality 2009-2010