Zambia Demographic and Health Survey 2001-2002 - Measure DHS

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The 2001-2002 ZDHS results show thatslightly more than four in ten births are deliveredin a health facility. A similar proportion aredelivered by a health professional: 39 percent bya nurse/midwife and the remaining 5 percent bya doctor or clinical officer. Almost four in tenbirths are delivered with assistance from a relativeor friend. A comparison between the threeZDHS surveys shows a steady decline in theproportion of births that are delivered in a healthfacility, from 51 percent in 1992 and 47 percentin 1996 to the current level of 44 percent.Postnatal care is not common in Zambia.Less than one in four women who deliver outsidea health facility receive postnatal care(23 percent).The 2001-2002 ZDHS collected dataallowing measurement of maternal mortality.The maternal mortality ratio during the sevenyearperiod prior to the 2001-2002 ZDHS wasestimated at 729 maternal deaths per 100,000live births. This represents a rise from 649 maternaldeaths per 1000,000 live births estimatedfrom the 1996 ZDHS.CHILD HEALTHAt current mortality levels, one in sixZambian children die before the fifth birthday,(under-five mortality rate of 168 deaths per1,000 birth), with slightly more than half ofthese deaths occurring during the first year oflife (infant mortality rate of 95 deaths per 1,000births). A comparison of the three ZDHS surveys,however, shows that mortality amongyoung children has declined from the fairly stablelevels observed in the late 1980s and early tomid-1990s. Infant mortality, which had shown amodest increase from 107 to 109 deaths per1,000 births between the 1992 and 1996 surveys,fell to 95 deaths per 1,000 births in the 2001-2002 ZDHS. Under-five mortality is 15 percentlower now than it was five to nine years ago,with the pace of decline very similar to the declinein infant mortality over the same time period(13 percent).Early childhood mortality is consistentlylower in urban areas than in rural areas. Maternaleducation is strongly correlated with childhoodmortality. Infant mortality is 32 percentlower and under-five mortality 48 percent loweramong mothers with some secondary education thanamong uneducated mothers.Survival of children is strongly associatedwith proper immunisation and treatment of childhoodillnesses. According to the World Health Organization,a child is considered fully vaccinated ifhe or she has received a BCG vaccine, three doses ofDPT vaccine, at least three doses of polio vaccine,and one dose of measles vaccine. Only 57 percent ofZambian children are fully vaccinated by 12 monthsof age; however, 70 percent of children 12-23months are fully vaccinated, with only 3 percent ofchildren not having received any vaccine.Looking at coverage for specific vaccines,94 percent of children 12-23 months received theBCG vaccine, 84 percent received measles vaccine,and 80 percent received the recommended threedoses of DPT and polio vaccines.Comparing the three ZDHS surveys, therewas a substantial rise in vaccination coverage in theearly to mid-1990s. In contrast, between 1996 and2001-2002, there was an 11 percent decline in theproportion of children 12-23 months who are fullyimmunised.Vitamin A is a micronutrient found in verysmall quantities in some foods. It is considered essentialfor normal sight, growth, and development.Zambia has recently introduced a programme of vitaminA supplementation for children 6 to 72months through health services and communitycampaigns. Data from the 2001-2002 ZDHS showthat two-thirds of children 6-59 months are reportedto have received a vitamin A supplement in the previous6 months.Fifteen percent of children under five yearsof age had symptoms of acute respiratory infection(ARI) in the two weeks preceding the survey. Sevenout of ten children with ARI symptoms were takento a health facility or provider for treatment.Forty-three percent of children under fivewere reported to have been ill with fever and/or convulsionsin the two-week period preceding the survey.Among these children, more than half took antimalarialdrugs (52 percent) and almost four in tentook antimalarial drugs the same or next day(37 percent).Summary of Findings | xxiii
According to mothers’ reports, around20 percent of children under age five had diarrhoeaat some time in the two weeks before thesurvey. Slightly more than four in ten childrenwho were ill with diarrhoea were taken to ahealth facility (43 percent). Mothers reportedthat almost two-thirds of children with diarrhoea(67 percent) were treated with some form of oralrehydration therapy; more than half (53 percent)were given a solution prepared with oral rehydrationsalts (ORS); and four in ten were givenincreased fluids. Twenty-one percent of childrenwith diarrhoea did not receive any type of treatment.BREASTFEEDING AND NUTRITIONBreastfeeding is nearly universal inZambia: 98 percent of children born in the fiveyears preceding the survey were breastfed. Morethan half of infants are put to breast within anhour of delivery and 90 percent are breastfedwithin the first day. The median duration ofbreastfeeding is 21 months, a slight increasefrom 1996 (20 months).Despite the high prevalence of breastfeedingin Zambia, the majority of infants arenot exclusively breastfed for the first six monthsof life. Only four in ten infants under 6 monthsof age are exclusively breastfed in Zambia.Complementary feedings starts early; more thanone-third of children under 6 months of age aregiven complementary foods.According to the 2001-2002 ZDHS findings,the level of malnutrition among childrenunder five is significant, with almost half ofZambian children (47 percent) stunted (short fortheir age), 5 percent wasted (thin for their age),and more than one-fourth underweight (28 percent).Generally, children who live in rural areasand children of uneducated mothers are morelikely to be malnourished than other children.The nutritional status of women is anotherissue of importance. The mean height ofZambian women is 158 cm. Only 2 percent ofwomen are shorter than the critical height of145 cm. Fifteen percent of women fall below thecut-off of 18.5 for the body mass index (BMI) -an indicator used to measure the level of chronicenergy deficiency among adults. In general, veryyoung women (age 15-19) and rural women aremore likely than other women to suffer from chronicenergy deficiency.WOMEN’S STATUS AND VIOLENCE AGAINST WOMENThe 2001-2002 ZDHS provides informationon the status of women in Zambia, and on physicaland sexual violence against women. Overall, morethan one in ten women age 15-49 have no education(12 percent) and women are generally less educatedthan men. Four in ten women in Zambia are illiterate.More than half of women were working atthe time of the survey (55 percent). Most womenwork seasonally (53 percent). Agriculture is the predominantsector of the economy, employing 54 percentof women in the 12 months preceding the survey.Forty-two percent of all working women inZambia are either paid in kind or not paid at all.Women working in the non-agricultural sector aremore likely to earn cash than women working in agriculture.Among currently married women who earncash for their work, 41 percent report that they alonemake decisions about how their earnings will beused and 32 percent report that they decide jointlywith their husband.Women in the 2001-2002 ZDHS were askedabout their beliefs on wife-beating. A large majorityof women (85 percent) believe that a husband is justifiedin beating his wife for at least one reason. Almosteight in ten women believe that a husband isjustified in beating his wife if she goes out with anotherman. A slightly smaller proportion agree that ifa woman neglects her children (61 percent), or argueswith her husband (52 percent), then he is justifiedin beating her.The 2001-2002 ZDHS found that more thanhalf of women report having experienced beatings orphysical mistreatment since the age of 15, and almostone in four women (24 percent) experiencedphysical violence in the 12 months preceding thesurvey. Among physically abused women currentlyin union, almost eight in ten report their current husband/partneras a perpetrator of the violence, whileamong never-married women who experiencedphysical abuse, the mother or father is the mostcommonly reported perpetrator (35 percent).xxiv | Summary of Findings
Page 1: ZambiaDemographic andHealth Survey2
Page 4 and 5: This report summarises the findings
Page 6: Page3.6 Women’s Employment ......
Page 9 and 10: Page11.3.2 Micronutrient Intake amo
Page 11 and 12: PageA.7 Sample Selection ..........
Page 13 and 14: PageTable 3.11 Decision on use of e
Page 15 and 16: Table 7.7 Wanted fertility rates ..
Page 17 and 18: PageTable 13.5 Discussion of HIV/AI
Page 19 and 20: PREFACEThe Zambia Demographic and H
Page 21: FAMILY PLANNINGKnowledge of contrac
Page 25 and 26: ZAMBIALake TanganyikaLake MweruTanz
Page 27 and 28: The 1980s marked the start of the f
Page 29 and 30: the peripheral structures. An impor
Page 31 and 32: ing in private households in the co
Page 33 and 34: subjects agreed) received a referra
Page 35 and 36: confidentiality.Finally, in additio
Page 37 and 38: CHARACTERISTICS OF HOUSEHOLDS AND2R
Page 39 and 40: Figure 2.2 Distribution of De Facto
Page 41 and 42: 2.4 EDUCATIONAL LEVEL OF HOUSEHOLD
Page 43 and 44: Figure 2.3 Percent Distribution of
Page 45 and 46: Figure 2.4 Net and Gross Attendance
Page 47 and 48: 2.5 HOUSING CHARACTERISTICS ANDHOUS
Page 49 and 50: Thirty percent of households own a
Page 51 and 52: CHARACTERISTICS OF RESPONDENTS3AND
Page 53 and 54: enrolment ratios suggest that educa
Page 55 and 56: 3.3 LITERACYThe ability to read is
Page 57 and 58: Figure 3.1 Youth Literacy100 Percen
Page 59 and 60: 3.5 MEN’S EMPLOYMENTMale responde
Page 61 and 62: Table 3.6 Occupation: menPercent di
Page 63 and 64: Table 3.8 Employment status: womenP
Page 65 and 66: non-agricultural occupations, since
Page 67 and 68: Table 3.12 Women’s control over e
Page 69 and 70: Table 3.14.1 Women’s participatio
Page 71 and 72: 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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