Zambia Demographic and Health Survey 2001-2002 - Measure DHS

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INTRODUCTION1Kumbutso Dzekedzeke and Chanda Mulenga1.1 HISTORY, GEOGRAPHY, AND ECONOMYHistoryHistorical and archaeological evidence indicates that by the year 1500, much of modern Zambia wasoccupied by Bantu-speaking horticulturalists, farming people who were ancestors of the present inhabitants.In the late nineteenth century, various parts of what was to become Northern Rhodesia were administered bythe British South Africa Company. In 1924, the British Colonial Office assumed responsibility for administeringthe territory, and in 1953, Northern Rhodesia (Zambia) and Southern Rhodesia (Zimbabwe) joinedNyasaland (Malawi) to form the Central African Federation of Rhodesia and Nyasaland, despite the oppositionof Northern Rhodesia’s Africans. The Federation was, however, dissolved in 1963. In October 1964,Zambia gained political independence and adopted a multiparty system of government. In December 1972,Zambia became a one-party state. The current multiparty system was implemented in 1991.GeographyZambia is a land-locked country covering an area of 752,612 square kilometres (about 2.5 percent ofAfrica). It shares borders with the Democratic Republic of Congo (DRC) and Tanzania in the north; Malawiand Mozambique in the east; Zimbabwe and Botswana in the south; Namibia in the southwest and Angola inthe west. Administratively, the country is divided into nine provinces and 72 districts. Of the nine provinces,two are predominantly urban, namely Lusaka and Copperbelt provinces. The remaining provinces—Central,Eastern, Northern, Luapula, North-Western, Western and Southern—are predominantly rural provinces. Fourof ten Zambians live in urban areas.Zambia lies between 8 and 18 degrees south latitude and between 20 and 35 degrees east longitude. Ithas a tropical climate and vegetation with three distinct seasons: the cool dry winter from May to August, ahot dry season during September and October and a warm wet season from November to April.Among the main river water sources in Zambia are the Zambezi, Kafue, Luangwa and Luapula. Thecountry also has major lakes such as Tanganyika, Mweru, Bangweulu and the man-made Kariba. The northernpart of the country receives the highest rainfall with an annual average ranging from 1,100 mm to over1,400 mm. The southern and eastern parts of the country have less rainfall, ranging from 600 mm to 1,100mm annually, which often results in droughts.EconomyZambia has a mixed economy consisting of a modern urban sector that, geographically, follows therail line and a rural agricultural sector. For a long time, the modern sector has been dominated by parastatalorganisations, while private businesses have predominated in construction and agriculture sectors. Since1991, with the introduction of a liberalised market-oriented economy, the parastatals have been privatisedand, in some cases, liquidated.Copper mining is the country’s main economic activity, accounting for 95 percent of export earningsand contributing 45 percent of government revenue during the decade following independence (1965-1975).In the mid-1970s following a sharp decline in copper prices and a sharp increase in oil prices, the country’seconomy deteriorated. Attempts were made to minimise dependency on copper exports by diversifying theeconomy through the creation of import substitution parastatals. This did not achieve the desired results.Introduction | 1
The 1980s marked the start of the first phase of implementing Structural Adjustment Programmes(SAP) amidst a stagnating economy. However, the SAP failed to substantially alter the economy and increasedthe poverty of the majority of Zambians. Currently, around 73 percent of Zambians are classified aspoor. Poverty is more prevalent in rural areas than urban areas (83 percent and 56 percent, respectively).Poverty in the Zambian context can be defined as lack of access to income, employment opportunities, entitlementsfor citizens to such things as freely determined consumption of goods and services, shelter and otherbasic needs of life (MOFNP, 2002).In an effort to halt the economic recession, the Movement for Multiparty Democracy (MMD) Governmenthas launched an Economic Recovery Programme (ERP) to turn around the protracted decline of theeconomy into sustained positive growth, leading to improvement in living standards and the quality of life ofthe people (Republic of Zambia, 1992).1.2 POPULATIONThe 1980, 1990, and 2000 national censuses reported total populations of 5.7 million, 7.8 million and10.3 million, respectively, with a growth rate of 2.9 percent per annum in 2000 (see Table 1.1). During the1990-2000 intercensal period, the growth rates varied by province, ranging from 1.3 percent in Copperbeltprovince to 4.3 percent in Northern province.Table 1.1 Demographic characteristicsSelected demographic indicators, Zambia, 1980, 1990,and 2001Census yearIndicator 1980 1990 2000Population (millions) 5.7 7.8 10.3 aDensity (pop./sq. km.) 7.5 10.4 13.7Percent urban 39.9 38 36Total fertility rate 7.2 6.7 6.0Completed family size(women age 45-49) 6.6 7.1 6.8Infant mortality rate 97 123 110Life expectancy at birthMale 50.4 46.1 47.5Female 52.5 47.6 51.7aAdjusted preliminary estimate from the 2000 NationalCensusSources: Central Statistical Office, 1985a, 1985b, 1995b,and 2002b2 | IntroductionThe population density in Zambia increased from 7.5 people per square kilometre in 1980 to 10.4 in1990 and 13.7 in 2000. The average density in 2000 ranged from 65 people per square kilometre in Lusakaprovince to 5 people per square kilometre in North-Western province. In addition to being the most denselypopulated provinces, Lusaka and Copperbelt are also the most urbanised.The decline in the economy has gradually reduced the proportion of the population in urban areas.The proportion of the population living in urban areas has decreased steadily from 40 percent in 1980 to38 percent in 1990 and 36 percent in 2000. The proportion of the urban population varies by province, from91 percent in Copperbelt province to 9 percent in Eastern province (CSO, 2002b).Total fertility rates estimated from the 1969 and 1980 censuses are in the neighbourhood of 7.0 birthsper woman. The rate declined to 6.7 births per woman in 1990 and to 6.0 in 2000. Life expectancy at birthfor males was 50 years in 1980 and was estimated to have declined to 46 years by 1990. In 2000, it increasedto 48 years. Zambian women live, on average, 4 years longer than men. Mortality levels are highest in
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 and 22: FAMILY PLANNINGKnowledge of contrac
Page 23 and 24: According to mothers’ reports, ar
Page 25: ZAMBIALake TanganyikaLake MweruTanz
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
Page 73 and 74: Table 3.15.1 Women’s attitudes to
Page 75 and 76: 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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