Zambia Demographic and Health Survey 2001-2002 - Measure DHS

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SUMMARY OF FINDINGSThe 2001-2002 Zambia Demographicand Health Survey (ZDHS) was carried out bythe Central Statistical Office and the CentralBoard of Health. It is a nationally representativesample of 7,658 women age 15-49 and 2,145men age 15-59. The principal objective of thesurvey was to provide data to policymakers andplanners on the population and health situationin Zambia. Most of the information collected inthe 2001-2002 ZDHS represents updated estimatesof basic demographic and health indicatorscovered in the 1992 ZDHS and 1996 ZDHSsurveys. Specifically, the 2001-2002 ZDHS collecteddetailed information on fertility and familyplanning, child mortality and maternal mortality,maternal and child health and nutritionalstatus, and knowledge, awareness and behaviourregarding HIV/AIDS and other sexually transmittedinfections. New features of the 2001-2002 ZDHS include the collection of informationon violence against women and testing ofindividuals for HIV and syphilis.FERTILITYSurvey results indicate that the total fertilityrate (TFR) in Zambia is 5.9. This meansthat at current fertility levels, the average Zambianwoman who is at the beginning of herchildbearing years will give birth to 5.9 childrenby the end of her reproductive period. Resultsfrom the 2001-2002 ZDHS show that fertility ishighest in Northern province (6.9 births perwoman) and lowest in Lusaka (4.3 births perwoman). Education has a marked effect on fertility,with uneducated women having three andone-half more births than women with at leastsome secondary education (7.4 births versus 3.9births).Zambia’s fertility continues to declinealthough comparatively slowly. The TFR hasdeclined from a level of 6.5 births per woman in1992 and 6.1 births per woman in 1996 to thecurrent level of 5.9. Despite the decline, fertilityin Zambia remains one of the highest in sub-Saharan Africa.A drop in urban childbearing is the principalreason for overall decline in fertility levels. Betweenthe 1992 and 2001-2002 surveys, the urban TFR fellby 1.5 births, from a rate of 5.8 to 4.3 births perwoman. In contrast, the rural TFR remained essentiallystable over this period (7.1 and 6.9 births perwoman, respectively). Women who have at leastsome secondary education experienced a steady declinein fertility, with the TFR for such womendropping by one birth over the period covered by thethree ZDHS surveys.The length of the interval between births influencesthe overall fertility level, as well as thehealth status of the mother and child. There is now anew international consensus that the optimal intervalbetween births is at least 36 months. In Zambia,41 percent of births occur at least 36 months after aprevious birth. Although 16 percent of births occurless than 24 months after a previous birth, this is animprovement from 1996 when almost one in fivebirths (19 percent) occurred less than two years aftera previous birth. The median birth interval is33 months, 3 months shorter than the “safe” birthinterval. This represents a one-month increase fromthe 1996 ZDHS median birth interval (32 months).Childbearing begins early in Zambia. By age18 almost half of women age 45-49 have had theirfirst birth. Most women typically become mothersbefore the age of 20, with 60 to 70 percent of womenin all age groups having given birth by that age. Themedian age at first birth for women age 25-49 is18.7 years. Three in ten teenage women (age 15-19)have begun childbearing, with 26 percent having hada child and 6 percent pregnant with their first child.A comparison of the data from the 1996 and2001-2002 ZDHS surveys indicates that there hasbeen an increase in the median duration of postpartumamenorrhoea from 11.5 months to 13.3 months.There has been little change in the median durationof sexual abstinence or insusceptibility to the risk ofpregnancy following childbirth.Summary of Findings | xxi
FAMILY PLANNINGKnowledge of contraceptive methods isalmost universal in Zambia, with 98 percent ofall women and men knowing at least one methodof family planning. The male condom and thepill are the most widely known methods amongboth women and men. Knowledge of familyplanning methods has increased steadily over thelast decade. For example, knowledge of at leastone contraceptive method has increased amongwomen from 89 percent in 1992 to 96 percent in1996 to the current level of 98 percent. Since1996, the mean number of family planningmethods known has increased from 5.3 to 6.8 forwomen and from 5.0 to 6.1 for men.Mass media are important sources ofinformation on family planning. Almost half ofwomen (49 percent) and six in ten men (62 percent)have heard or seen a family planning messageon the radio, television or in a newspaper/magazine.Radio is the most frequent sourceof family planning messages for both women(46 percent) and men (57 percent).The 2001-2002 ZDHS data indicate that70 percent of currently married women and81 percent of currently married men have used afamily planning method at least once in theirlifetime. There is a noticeable discrepancy betweenever use and current use, with slightlymore than one-third of currently married women(34 percent) currently using some method ofcontraception. Modern methods of contraceptionare more commonly used than traditional methods;almost one-fourth of currently marriedwomen use modern methods (23 percent) comparedwith about one in ten who use traditionalmethods (12 percent). The pill is the mostwidely used modern method (12 percent), whilewithdrawal is the most popular traditionalmethod (5 percent).Six in ten women currently using modernmethods obtain their method from the publicsector (61 percent), 20 percent from the privatemedical sector, and 17 percent from othersources such as shops and community-basedagents.Contraceptive use in Zambia has increasedover the past decade from 15 percent in1992 to 26 percent in 1996 and 34 percent in 2001-2002. Considering specific methods, the largestgains in use during the ten-year period are observedfor contraceptive pills and injectables.The large majority of currently marriedwomen who know of family planning approve of itsuse (87 percent). Moreover, two-thirds of marriedwomen who know of a contraception method believetheir husband approves of family planning.The majority of currently married women(71 percent) and currently married men (58 percent)either want to space their next child or want no morechildren, and thus have a potential need for familyplanning. In Zambia, almost one in three currentlymarried women has an unmet need for family planning(27 percent) – 17 percent for spacing their nextbirth and 11 percent for limiting births. If the unmetneed for family planning of all currently marriedwomen who say they want to space or limit theirbirths were met, the contraceptive prevalence rate inZambia would increase from 34 to 62 percent.MATERNAL HEALTHUse of professional maternity care is commonin Zambia: more than nine in ten mothers whohad a live birth in the five years preceding the surveyreceived antenatal care from a health professional;only 2 percent received antenatal care from a traditionalbirth attendant or other person. Almost threequartersof these women had four or more antenatalcare visits during their pregnancy (72 percent).Among mothers who received antenatalcare, over three-fourths were given at least one tetanustoxoid injection during pregnancy for their mostrecent birth (75 percent). Over the past 10 years,there has been a decrease in the proportion ofwomen who received at least one tetanus toxoid injectionduring their most recent pregnancy, from81 percent in 1992 and 85 percent in 1996 to the currentlevel of 75 percent. The 2001-2002 ZDHS datashow that seven in ten mothers receive iron tablets,syrup or folic acid during pregnancy. Ninety-fourpercent of mothers have their height measured duringantenatal care visits, while 25 percent areweighed. Eighty-seven percent of mothers had theirblood pressure measured during their antenatal care,and urine and blood sampling was done for 25 and44 percent of mothers, respectively.xxii | Summary of Findings
Page 1: ZambiaDemographic andHealth Survey2
Page 4 and 5: This report summarises the findings
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Page 17 and 18: PageTable 13.5 Discussion of HIV/AI
Page 19: PREFACEThe Zambia Demographic and H
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Page 25 and 26: ZAMBIALake TanganyikaLake MweruTanz
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Page 49 and 50: Thirty percent of households own a
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Page 53 and 54: enrolment ratios suggest that educa
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Table 3.14.2 Women’s participatio
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Table 3.15.1 Women’s attitudes to
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3.7.3 Attitudes toward Refusing Sex
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Table 3.16.2 Men’s attitudes towa
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Table 3.17.1 Smoking of tobacco: wo
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FERTILITY4Richard Banda and Margare
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As the comparison in Figure 4.1 ind
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Figure 4.3 Total Fertility Rate by
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Table 4.4 Trends in fertility by ba
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Results from the 2001-2002 ZDHS ind
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The median birth interval is 33 mon
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4.6 TEENAGE FERTILITYAdolescent chi
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FERTILITY REGULATION5Mika Bwembya a
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Table 5.1.2 Knowledge of contracept
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Seventy percent of currently marrie
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Table 5.4 Current use of contracept
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Table 5.7 Number of children at fir
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Table 5.10 Source of contraceptionP
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The pattern is slightly different f
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5.14 EXPOSURE TO FAMILY PLANNING ME
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Table 5.16.1 Exposure to specific r
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Table 5.17 shows that 18 percent of
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Table 5.19 Attitudes of couples tow
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Table 6.1 shows that one-fourth of
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Table 6.3 Age at first marriagePerc
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Table 6.5 Age at first sexual inter
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Table 6.7.1 Recent sexual activity:
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Almost four in ten (38 percent) of
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FERTILITY PREFERENCES AND UNMET NEE
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The above results show an increase
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7.3 UNMET NEED FOR FAMILY PLANNINGW
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Figure 7.4 Unmet Need for Spacing a
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The mean ideal number of children f
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Table 7.7 shows the total wanted fe
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Fifty-nine percent of all neonatal
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Table 8.3 Early childhood mortality
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Table 8.5 Early childhood mortality
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Only 27 percent of births are in a
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MATERNAL AND CHILD HEALTH9Miriam Ch
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Expectant mothers should beginanten
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There are particularly sharp differ
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Table 9.5 Place of deliveryPercent
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Table 9.7 shows that only 2 percent
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Table 9.8 Postnatal carePercent dis
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Table 9.9 Visits by health workersP
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Table 9.10.2 Neighbourhood Health C
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No major variations were observed w
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Table 9.13 Vaccinations by backgrou
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Table 9.14 Prevalence of injections
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Eastern province has the highest pr
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Table 9.18 Diarrhoea treatmentPerce
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Table 9.20 Household knowledge and
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10.1.1 Use of Bednets by Children a
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Table 10.4 Use of antimalarial drug
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Luapula province has the highest pe
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INFANT FEEDING, NUTRITIONAL PRACTIC
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than half (51 percent) of the infan
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tamination after cleaning, the nipp
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11.2 COMPLEMENTARY FEEDING11.2.1 Ty
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Few children under two years of age
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Table 11.6 Iodisation of household
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11.3.2 Micronutrient Intake among C
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11.3.3 Micronutrient Supplementatio
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11.4 HOUSEHOLD FOOD SECURITYFood se
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Table 11.12 Nutritional status of c
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Table 11.12 indicates that children
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VIOLENCE AGAINST WOMEN 12Mary Kazun
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Table 12.2 Experience of beatings o
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Results show that almost eight out
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Table 12.5 Experience of sexual vio
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More than four out of ten never-mar
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AIDS/HIV/STI-RELATED KNOWLEDGE AND1
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Table 13.2 Knowledge of ways to avo
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Knowledge of HIV prevention methods
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Table 13.5 Discussion of HIV/AIDS w
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The view that HIV status of a famil
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Table 13.8 Knowledge of “Trendset
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Figure 13.1 Unmet Need for HIV Test
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Table 13.10 Men's attitudes toward
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Men in sales and services and skill
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Table 13.13 Alcohol consumption by
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Table 13.14.2 Knowledge of symptoms
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The peak age for having STI symptom
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used condoms, 34 percent took medic
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The practice of having multiple par
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Table 13.21 Use of condoms by type
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PREVALENCE OF HIV AND SYPHILIS 14Ku
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14.1.2 Coverage for HIV Testing by
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14.1.3 Approach to Weighting Syphil
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14.2 SYPHILIS PREVALENCE RATES 1Tab
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Table 14.8 Syphilis prevalence by a
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The 2001-2002 ZDHS data can be used
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Figure 14.2 illustrates the distinc
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Figure 14.3 HIV Prevalence AmongWom
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ADULT MORTALITY15Ann A. WayData col
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Table 15.2 Adult mortality ratesDir
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While again not definitive, the res
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124 | ReferencesGaisie, K., A. Cros
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SAMPLE DESIGNAppendix AA.1 INTRODUC
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Table A.2. Expected number of selec
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Similarly, a total of 2,658 potenti
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Table A.5 Sample implementation: me
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where h represents the stratum whic
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Table B.2 Sampling errors for selec
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Table B.10 Sampling errors for sele
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Table B.12 Sampling errors for sele
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DATA QUALITY TABLESAppendix CTable
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Table C.3 Completeness of reporting
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Table C.6 Reporting of age at death
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Provincial CoordinatorsMr Martin Nj
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Data Processing StaffMr Mathews Muv
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286 | Appendix E
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HOUSEHOLD SCHEDULENow we would like
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LINENO.USUAL RESIDENTSAND VISITORSR
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NO. QUESTIONS AND FILTERS CODING CA
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INFORMED CONSENT FOR SYPHILIS AND H
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September 28, 20012001 ZAMBIA DEMOG
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SECTION 1. RESPONDENT’S BACKGROUN
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SECTION 2: REPRODUCTIONNO. QUESTION
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212 213 214 215 216 217IF ALIVE:218
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NO QUESTIONS AND FILTERS CODING CAT
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NO. QUESTION AND FILTERS CODING CAT
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NO. QUESTION AND FILTERS CODING CAT
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407AWhere did the first antenatal v
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NAMELAST BIRTHNEXT-TO-LAST-BIRTHNAM
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NAMELAST BIRTHNEXT-TO-LAST-BIRTHNAM
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SECTION 4B. IMMUNIZATION, HEALTH AN
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LAST BIRTHNEXT-TO-LAST BIRTHNAMENAM
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LAST BIRTHNEXT-TO-LAST BIRTH474B CH
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LAST BIRTHNEXT-TO-LAST BIRTH480 Wha
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NO QUESTIONS AND FILTERS CODING CAT
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SECTION 5. MARRIAGE AND SEXUAL ACTI
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SECTION 6. FERTILITY PREFERENCESNO.
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SECTION 7. HUSBAND'S BACKGROUND AND
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SECTION 9. MATERNAL MORTALITYNO. QU
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904 What wasname given toyour oldes
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NAME OF EDITOR:____________________
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SUPERVISOR FIELD EDITOR OFFICE EDIT
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14 Have you heard of any other ways
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SECTION 5. FERTILITY PREFERENCESNO.
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SECTION 7. AIDS AND OTHER SEXUALLY
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