Abstract

The 2001-2002 Zambia Demographic and Health Survey (ZDHS) was carried out by the Central Statistical Office and the Central Board of Health. It is a nationally representative sample of 7,658 women age 15-49 and 2,145 men age 15-59. The principal objective of the survey was to provide data to policymakers and planners on the population and health situation in Zambia. Most of the information collected in the 2001-2002 ZDHS represents updated estimates of basic demographic and health indicators covered in the 1992 ZDHS and 1996 ZDHS surveys.

The 2001-2002 ZDHS was conducted by the Central Statistical Office (CSO) and the Central Board of Health (CBoH). ORC Macro of Calverton, Maryland provided technical assistance to the project through its contract with the U.S. Agency for International Development (USAID). Funding for the survey was supplied by ORC Macro (from USAID), the Government of Japan through a trust fund managed by the United Nations Development Programme (UNDP) and through bilateral agreements between the Government of the Republic of Zambia and the United Nations Population Fund (UNFPA), and the Danish International Development Agency (DANIDA).

The primary objectives of the ZDHS are: - To collect up-to-date information on fertility, infant and child mortality and family planning; - To collect information on health-related matters such as breastfeeding, antenatal care, children's immunisations and childhood diseases; - To assess the nutritional status of mothers and children; - To support dissemination and utilisation of the results in planning, managing and improving family planning and health services in the country;
- To enhance the survey capabilities of the institutions involved in order to facilitate the implementation of surveys of this type in the future; and - To document current epidemics of sexually transmitted infections and HIV/AIDS through use of specialised modules.

Specifically, the 2001-2002 ZDHS collected detailed information on fertility and family planning, child mortality and maternal mortality, maternal and child health and nutritional status, and knowledge, awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections. New features of the 20012002 ZDHS include the collection of information on violence against women and testing of individuals for HIV and syphilis.

Geographic coverage

The DHS 2001-02 is a nationally representative survey. The primary focus of the 2001 Zambia DHS is to provide estimates of key population and health indicators, including fertility and mortality rates, for the country as a whole, and for urban and rural areas separately. Also, the sample was designed to provide estimates of key variables for the nine provinces, namely, 1) Central, 2) Copperbelt, 3) Eastern, 4) Luapula, 5) Lusaka, 6) Northern, 7) North-Western, 8) Southern, and 9) Western. In addition, the sample provides basic information for a total of 12 combined districts (not each separately) that are the special focus of the Zambia Integrated Health Programme (Livingstone, Kalomo, Chibombo, Kabwe Urban, Ndola Urban, Kitwe, Chipata, Lundazi, Chama, Kasama, Samfya, and Mwense).

Analysis unit

• Household
• women age 15-49
• Men age 15-59
• Children under five years

Universe

The population covered by the 2001-2002 ZDHS is defined as the universe of all women age 1549 in Zambia and all men age 15-59. A sample of households was selected and all women age 15-49 identified in the households were interviewed. In addition, in a subsample of one-third of all the households selected for the ZDHS, all men 15-59 were eligible to be interviewed if they were either permanent residents or visitors present in the household on the night before the survey.

Kind of data

Sample survey data

Sampling procedure

The 2001-2002 Zambia Demographic and Health Survey (ZDHS) is a comprehensive nationally representative population and health survey carried out by the Central Statistical Office in partnership with the Central Board of Health. ORC Macro provided financial and technical assistance for the survey through the USAID-funded MEASURE DHS+ programme. Additional funding for the ZDHS was received from the Government of Japan, UNFPA, and DANIDA. The principal objective of the ZDHS is to provide current and reliable data on fertility and family planning behaviour, child mortality, children's nutritional status, the utilization of maternal, child health services, knowledge and prevalence of HIV and syphilis.

SAMPLE DOMAINS

The Zambia DHS collected demographic and health information from a nationally representative sample of women and men age 15-49 and 15-59, respectively. The primary focus of the 2001 Zambia DHS is to provide estimates of key population and health indicators, including fertility and mortality rates, for the country as a whole, and for urban and rural areas separately. Also, the sample was designed to provide estimates of key variables for the nine provinces, namely, 1) Central, 2) Copperbelt, 3) Eastern, 4) Luapula, 5) Lusaka, 6) Northern, 7) North-Western, 8) Southern, and 9) Western. In addition, the sample provides basic information for a total of 12 combined districts (not each separately) that are the special focus of the Zambia Integrated Health Programme (Livingstone, Kalomo, Chibombo, Kabwe Urban, Ndola Urban, Kitwe, Chipata, Lundazi, Chama, Kasama, Samfya, and Mwense).

SAMPLE FRAME

Zambia is divided into nine provinces. In turn, each province is subdivided in districts, each district into constituencies, and each constituency into wards. In addition to these administrative units, during the 2000 population census, each ward was subdivided into convenient areas called census supervisory areas (CSAs), and in turn each CSA into standard enumeration areas (SEAs). In total Zambia has 72 districts, 150 constituencies, 1,289 wards, about 4,400 CSAs, and about 16,400 SEAs. Preliminary information on the counts of households and population, as well as cartographic materials were available from the 2000 population census for the SEAs. Therefore, the sample frame for this survey was the list of SEAs developed from the 2000 population census.

STRATIFICATION

In the preliminary census frame, the SEAs were grouped by CSAs, by CSAs within a ward, by wards within a constituency, by constituencies within a district and by districts within a province for purposes of the ZDHS. The SEAs were further stratified separately by urban and rural areas within each province.

SAMPLE ALLOCATION

The primary sampling unit (PSU), the cluster for the 2001-2002 ZDHS, is defined on the basis of SEAs from the census frame. A minimum requirement of 85 households for the cluster size was imposed in the design. If an SEA did not have 85 households, it was combined with an adjacent SEA; thus, the ZDHS cluster comprised one or more SEAs. The number of clusters in each district was not allocated proportional to the total population due to the need to present estimates by each of the nine provinces. Zambia is a country where two-thirds of the population reside in rural areas, and one-third in urban areas.

The target for the 2001-2002 ZDHS sample was 8,000 completed interviews. Based on the level of non-response found in the 1996 ZDHS, to achieve this target, approximately 8,200 households were selected, with all women age 15-49 being interviewed. The target was to reach a minimum of 750 completed interviews per province. In each province the number of households was distributed proportionately among the urban and rural areas. Table A.2 shows the distribution of about 8,200 households by province.

The urban-rural distribution was also considered in distributing the sample. The selected households were distributed in 320 clusters in Zambia, 100 clusters in the urban areas, and 220 clusters in the rural areas.

Under this final allocation, the 12 combined districts of the Zambia Integrated Health Programme have 77 selected clusters, 36 in urban areas and 41 in rural areas.

SAMPLE SELECTION

The 2001-2002 ZDHS sample was selected using a stratified two-stage cluster design consisting of 320 clusters, 100 in urban and 220 in rural areas. Once the number of households was allocated to each combination of province by urban and rural areas, the number of clusters was calculated based on an average sample take of 25 completed interviews among women 15-49 years. In each urban or rural area in a given province, clusters were selected systematically with probability proportional to the number of households in each cluster.

Mode of data collection

Face-to-face

Research instrument

Three questionnaires were used for the 2001-2002 ZDHS: a) the Household Questionnaire, b) the Women's Questionnaire c) the Men's Questionnaire.

The contents of these questionnaires were based on the model questionnaires developed by the MEASURE DHS+ programme for use in countries with low levels of contraceptive use.

In consultation with technical institutions, local and international organisations, the CSO modified the DHS model questionnaires to reflect relevant issues in population, family planning and other health issues in Zambia. A series of questionnaire design meetings were organised by the CSO with the assistance of ORC Macro, 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.

a) The Household Questionnaire was used to list all the usual members and visitors in the selected

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