Zambia Demographic and Health Survey 2001-2002 - Measure DHS

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In the current national Strategic Framework 2001-2003, a combination of interventions are being implementedto (National HIV/AIDS/TB Council, 2000):1. Reduce HIV/AIDS transmission, mainly focussing on children, youth, women and high riskpopulations; and2. Reduce the socio-economic impact of HIV/AIDS on individuals and families at the workplace,in the homes and on the whole Zambian society.The interventions include:1. Information, education and communication to inform the general public about HIV/AIDS;2. Condom promotion and distribution;3. Early and effective diagnosis and treatment of sexually transmitted infections;4. Blood screening;5. Counselling and testing;6. Special programmes for orphans, widows and widowers;7. Support for persons living with AIDS;8. Advocacy for the introduction of non-discriminatory practices and laws.1.6 OBJECTIVES AND ORGANISATION OF THE SURVEYObjectivesThe Zambia Demographic and Health Survey (ZDHS) is a nationally representative sample survey ofwomen and men of reproductive age designed to provide information on fertility, family planning, child survivaland health of children.OrganisationThe primary objectives of the ZDHS are:1. To collect up-to-date information on fertility, infant and child mortality and family planning;2. To collect information on health-related matters such as breastfeeding, antenatal care, children’simmunisations and childhood diseases;3. To assess the nutritional status of mothers and children;4. To support dissemination and utilisation of the results in planning, managing and improvingfamily planning and health services in the country;5. To enhance the survey capabilities of the institutions involved in order to facilitate the implementationof surveys of this type in the future; and6. To document current epidemics of sexually transmitted infections and HIV/AIDS throughuse of specialised modules.The 2001-2002 ZDHS was conducted by the Central Statistical Office (CSO) and the Central Boardof Health (CBoH). ORC Macro of Calverton, Maryland provided technical assistance to the project throughits contract with the U.S. Agency for International Development (USAID). Funding for the survey was suppliedby ORC Macro (from USAID), the Government of Japan through a trust fund managed by the UnitedNations Development Programme (UNDP) and through bilateral agreements between the Government of theRepublicof Zambia and the United Nations Population Fund (UNFPA), and the Danish International DevelopmentAgency (DANIDA).1.7 SAMPLE DESIGNThe sample for the 2001-2002 Zambia Demographic and Health Survey covered the population resid-Introduction | 5
ing in private households in the country. A representative probability sample of approximately 8,000households was selected for the ZDHS. This sample was constructed in such a manner as to allow for separateestimates for key indicators for each of the 9 provinces in Zambia. As a result, the ZDHS sample is notself-weighting at the national level.A list of Standard Enumeration Areas (SEAs) prepared for the 2000 Population Census constitutedthe frame for the ZDHS sample selection. A total of 320 clusters (100 urban and 220 rural) were selectedfrom this frame. In general, the ZDHS clusters included only one SEA; however, in order to achieve theminimum cluster size of 85 households, 34 clusters comprised two SEAs. The final stage of selection involvedthe systematic sampling of households from a list of all households that was prepared for each of theselected SEAs.All women age 15-49 who were either permanent residents of the households in the ZDHS sample orvisitors present in the household on the night before the survey were eligible to be interviewed in the survey.In addition, in a subsample of one-third of all the households selected for the ZDHS, all men age 15-59 wereeligible to be interviewed if they were either permanent residents or visitors present in the household on thenight before the survey. Finally, all women and men (approximately 2,500 of each) living in the householdsselected for the men’s survey and eligible for the DHS interview were asked to voluntarily give blood forsyphilis and HIV testing.1.8 QUESTIONNAIRESThree questionnaires were used for the 2001-2002 ZDHS: the Household Questionnaire, theWomen’s Questionnaire and the Men’s Questionnaire. The contents of these questionnaires were based on themodel questionnaires developed by the MEASURE DHS+ programme for use in countries with low levels ofcontraceptive use. The questionnaires are reproduced in Appendix E.In consultation with technical institutions, local and international organisations, the CSO modified theDHS model questionnaires to reflect relevant issues in population, family planning and other health issues inZambia. A series of questionnaire design meetings were organised by the CSO with the assistance of ORCMacro, and the inputs generated in these meetings were used to produce the first draft of the ZDHS questionnaires.These questionnaires were translated from English into the seven major languages, namely Bemba,Kaonde, Lozi, Lunda, Luvale, Nyanja, and Tonga.The Household Questionnaire was used to list all the usual members and visitors in the selectedhouseholds. Some basic information was collected on the characteristics of each person listed, including his orher age, sex, education, and relationship to the head of the household. The main purpose of the HouseholdQuestionnaire was to identify women and men who were eligible for the individual interview. The HouseholdQuestionnaire collected information on characteristics of the household’s dwelling unit, such as the source ofwater, type of toilet facilities, materials used for the floor of the house, ownership of various durable goods,and ownership and use of mosquito nets. The Household Questionnaire was also used to record height andweight measurements of women 15-49 and children under the age of 6, and, where syphilis and HIV testingwas conducted, to record the respondents’ consent to the testing. In order to maintain confidentiality, separateforms were used for recording the results of the syphilis and HIV testing.The Women’s Questionnaire was used to collect information from all women age 15-49. Thesewomen were asked questions on the following topics:6 | Introduction• Background characteristics (education, residential history, media exposure, etc.)• Knowledge and use of family planning methods• Fertility preferences• Antenatal and delivery care• Breastfeeding and infant feeding practices• Vaccinations and childhood illnesses• Marriage and sexual activity• Woman’s work and husband’s background characteristics
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
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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
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Page 25 and 26: ZAMBIALake TanganyikaLake MweruTanz
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Page 37 and 38: CHARACTERISTICS OF HOUSEHOLDS AND2R
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Page 47 and 48: 2.5 HOUSING CHARACTERISTICS ANDHOUS
Page 49 and 50: Thirty percent of households own a
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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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